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PubMed1989

[Value consciousness in the integrity of the personality].

Personality as intact functional integrity, a set of individual conditions of practical relationships generated by natural and social development, implies a system of information items and their mental traces specific for man which in its controlled function is termed value consciousness. Its identification substance is primarily conceptual and its reality is mass-individual, of different levels, yet with an overall orientation on the development of its biological species, society, and itself, on the process whose dynamics and specific orientation has determined its development and maintenance. As the principle of a person, consciousness is a substantial manifestation of the endowment of active sociability and intelligence. Therefore its highest quality of cognizance and conscientiousness requires effective operation with key concepts of rational, internal, sufficiently reflected aspects of practice. Following the primordial basic trend of the development of human life to full selfrealization of mankind, i. e. unity of the species, society, and the principle of the individual, it eventually overcomes the emotional consumer attitude to the sense of life and makes a correct handling of life, relations, functions, and values possible. Its developed form has a decisive, quality providing value for interpersonal, social and historical relationships, cultural and control functions, with a marked everyday impact particularly on human medicine.

Humans↗

PubMed2004

Functional significance of the cell volume for detecting sperm membrane changes and predicting freezability in dog semen.

Due to the similarity of plasma membrane changes induced by capacitation and cryopreservation, the parameters describing sperm response to capacitating conditions can be used for evaluating the cryopreservation response in many animal systems. In dog sperm, the response of the total sperm population to ionophore treatment has been shown to be an indication of the freezability of semen samples. Another sperm functional characteristic decisive for cryopreservability is cell volume regulation, due to the generation of essential osmotic gradients across the plasma membrane during the freeze-thaw cycles. In the present study, cryopreservation-induced changes in the membrane functional integrity were examined by monitoring the osmotically induced response of cell volume and the response to an ionophore in live cell populations. Cell volume measurements were performed on Percoll-washed suspensions of freshly diluted and frozen-thawed dog spermatozoa. The proportion of live acrosome-reacted cells was evaluated by flow cytometry after incubation under capacitating conditions in the presence of the calcium ionophore, A23187. During freezing-thawing, significant membrane changes occurred related to the disturbance of volume control ability and the loss of a proportion of live acrosome-reacted cells (P < 0.05). There were significant differences between individuals with respect to the degree of functional and structural membrane changes after thawing. Significant correlations were found between acrosomal integrity and functional membrane integrity. When assessed in freshly diluted semen, these parameters correlated with those of frozen-thawed semen samples, pointing to the similarities between mechanisms of cryopreservation-related changes and those mechanisms that mediate changes in membrane permeabilities and in cell volume regulation. The detection of changes in the sperm plasma membrane by monitoring the sperm cell volume represents a simple, rapid and sensitive method to estimate sperm quality after the cryopreservation procedure. The individual variability in response to osmotic stress or to calcium ionophore treatment appears to reflect the subtle differences in the sperm membrane functionality which are crucial for the prediction of cryopreservability.

Animals↗

PubMed2005

Assessing the spatiotemporal evolution of neuronal activation with single-trial event-related potentials and functional MRI.

The brain acts as an integrated information processing system, which methods in cognitive neuroscience have so far depicted in a fragmented fashion. Here, we propose a simple and robust way to integrate functional MRI (fMRI) with single trial event-related potentials (ERP) to provide a more complete spatiotemporal characterization of evoked responses in the human brain. The idea behind the approach is to find brain regions whose fMRI responses can be predicted by paradigm-induced amplitude modulations of simultaneously acquired single trial ERPs. The method was used to study a variant of a two-stimulus auditory target detection (odd-ball) paradigm that manipulated predictability through alternations of stimulus sequences with random or regular target-to-target intervals. In addition to electrophysiologic and hemodynamic evoked responses to auditory targets per se, single-trial modulations were expressed during the latencies of the P2 (170-ms), N2 (200-ms), and P3 (320-ms) components and predicted spatially separated fMRI activation patterns. These spatiotemporal matches, i.e., the prediction of hemodynamic activation by time-variant information from single trial ERPs, permit inferences about regional responses using fMRI with the temporal resolution provided by electrophysiology.

Adult↗

PubMed1996

The long-term outcome in men with exstrophy/epispadias: sexual function and social integration.

PURPOSE: We evaluated the long-term outcome of social integration and sexual function in 29 men with bladder exstrophy and epispadias. MATERIALS AND METHODS: Four men with epispadias and 25 with bladder exstrophy were available for long-term followup. Patients were interviewed by telephone regarding sexual history and social integration. Semen analyses were obtained in 8 cases. RESULTS: Patient assessment of genital appearance was good or fair in 71%. Potency was present in all patients, and erections were straight in 66% and curved in 34% with no curvature so severe as to prevent sexual intercourse. Semen analysis showed a normal sperm count in 63% of the men and no azoospermia. Social integration was satisfactory: 100% of the men attended high school, 55% have a college education and all who are not attending school have full-time jobs. CONCLUSIONS: Our long-term review demonstrates that despite what appears to be a significant sexual handicap, patients with exstrophy/epispadias can have adequate sexual function and overall successful social integration.

Bladder Exstrophy↗

PubMed1999

Are cognitive processes manifested in event-related gamma, alpha, theta and delta oscillations in the EEG?

Gamma oscillations, now widely regarded as functionally relevant signals of the brain, illustrate that the concept of event-related oscillations bridges the gap between single neurons and neural assemblies. Taking this concept further, we review experiments concerning oscillatory responses to events (in the alpha, theta and delta ranges) as possible correlates of sensory and cognitive functions. It is argued that selectively distributed delta, theta, alpha and gamma oscillatory systems act as resonant communication networks through large populations of neurons, with functional relations to memory and integrative functions.

Alpha Rhythm↗

PubMed1999

A model for the assessment and management of children with multiple disabilities.

Children with multiple disabilities present complex management problems, both for their families and for the professionals involved in their care. For any one child, the list of functional and medical problems that need to be addressed is frequently reflected in an even longer list of involved professionals, leading to conflicting advice and problems in co-ordination of care. A hierarchical model for assessment and management is proposed, which highlights the interdependency of apparently different areas of functioning. The model aims to assist both parents and professionals in determining priorities, to improve interdisciplinary working, and to underpin staff training. Illustrative case studies indicate the importance of resolving issues in areas such as visual functioning, positioning and nutrition before integrated functions such as communication skills can be addressed successfully.

Child↗

PubMed1991

The brain and higher mental function.

Critical evaluation of biological theories of psychiatric disorder requires an understanding of current concepts of higher mental function and its related biology. Both the nature of the topic and the rapidity of advances in the field make it difficult to obtain an updated synthesis. Part I of this paper attempts to provide that by reviewing current concepts of the mind/body relationship, emotion, arousal, attention, consciousness and motivation. Part II considers those concepts in relation to recent work on the structure and function of the reticular, limbic and anterior cerebral systems. It is concluded that the model of the limbic system as subserving emotional life could now perhaps be set aside in favour of the model of a core set of chemically identified neurons in the reticular system being necessary but not sufficient to subserve higher mental function whilst also subserving other integrating functions for which no mental terminology is required. The problem of developing an eclectic theory of higher mental function that will embrace these concepts is discussed.

Animals↗

PubMed2006

Fixing healthcare from the inside: teaching residents to heal broken delivery processes as they heal sick patients.

There is a marked gap between the potential of medical science to treat illness and injury and the performance of the health care system in which hard-working, intelligent, well-trained people put that science to work. Care is available to too few, and costs and risks of injury are too high. This is avoidable. Experience in Boston, Pittsburgh, Salt Lake City, Seattle, and elsewhere indicates that quality can be raised-while risks and costs are dramatically reduced-by applying lessons from the highest-performing industrial organizations to designing, operating, and improving health care processes. What are these lessons? Improve sick processes with the same approaches used to treat patients. Specify "normal." When problems in quality, safety, efficiency, responsiveness, and the like occur, quickly determine exactly what is abnormal and determine what might be causing them. Develop a "treatment plan"-process changes that will eliminate or counteract the causal factors. Run the process (or a facsimile) with a modified, watching for gaps between actual and expected outcomes. When gaps occur, do a new work-up, diagnosis, treatment plan, and test. Lessons in designing, operating, and improving processes can be taught just as medical expertise is developed. Teach basic frameworks didactically; then, provide hands-on experience in applying those principles to real problems. Start with simple well-bounded situations that can be practiced frequently, with rapid feedback and close mentoring before advancing to more complex, less well bounded situations that occur less frequently and provide less immediate feedback between action and outcome. Incorporate development of process improvement skills into residency training so that deepening expertise within specialties is complemented by greater skill at integrating functional knowledge into well-integrated care processes.

Delivery of Health Care↗

PubMed1991

Clinical correlation between degenerative spine disease and dermatomal somatosensory-evoked potentials in humans.

The relationship between clinical status and preoperative and intraoperative dermatomal somatosensory-evoked potentials was investigated as a function of test site. Results indicated that the specificity and sensitivity of dermatomal somatosensory-evoked potentials varied with level of involvement: L5 demonstrated greatest agreement with equal correlation at L3, L4, and S1. Variables that influenced correlation included history of previous surgeries, type of anesthetic used, interpretation criteria, and whether the patient was awake or asleep. It was concluded that dermatomal somatosensory-evoked potentials can provide the surgeon with diagnostic and intraoperative information regarding the functional integrity of single nerve root function.

Evoked Potentials, Somatosensory↗

PubMed1989

Stroke rehabilitation: sensorimotor integrative treatment versus functional treatment.

This study compares the effectiveness of two occupational therapy approaches to treating cerebrovascular accident patients--the functional and sensorimotor integrative approaches. Subjects were 90 patients admitted to Holy Family Hospital in Vancouver, Canada, within 12 weeks after a first stroke. Consenting subjects were randomly assigned on admission to one of two occupational therapy treatment groups. All subjects received similar medical and nursing care and physical therapy. An independent clinical evaluator assessed subjects' function in self-care and mobility, meal preparation, and sensorimotor integration at specified times after admission. Neither the evaluator nor the subjects were aware of the treatment group to which they had been assigned. Results showed no statistically significant differences between the two treatment groups on the three outcome measures. We therefore concluded that any differences between the effectiveness of the two approaches are small.

Activities of Daily Living↗

PubMed2000

Cellular copper transport and metabolism.

The transport and cellular metabolism of Cu depends on a series of membrane proteins and smaller soluble peptides that comprise a functionally integrated system for maintaining cellular Cu homeostasis. Inward transport across the plasma membrane appears to be a function of integral membrane proteins that form the channels that select Cu ions for passage. Two membrane-bound Cu-transporting ATPase enzymes, ATP7A and ATP7B, the products of the Menkes and Wilson disease genes, respectively, catalyze an ATP-dependent transfer of Cu to intracellular compartments or expel Cu from the cell. ATP7A and ATP7B work in concert with a series of smaller peptides, the copper chaperones, that exchange Cu at the ATPase sites or incorporate the Cu directly into the structure of Cu-dependent enzymes such as cytochrome c oxidase and Cu, Zn superoxide dismutase. These mechanisms come into play in response to a high influx of Cu or during the course of normal Cu metabolism.

Adenosine Triphosphatases↗

PubMed1999

Recommendations for physical activity in patients with multiple sclerosis.

For many years, patients with multiple sclerosis (MS), an inflammatory demyelinating disease of the central nervous system, have been advised to avoid exercise. MS is believed to be autoimmune in origin, mediated by activated T cells which penetrate the blood-brain barrier and attack myelin. The pathophysiology, with respect to function is an impairment of saltatory conduction, specifically, slowing of conduction speed and/or conduction block. Symptoms can temporarily worsen on exposure to heat or during physical exercise. Exercise programmes must be designed to activate working muscles but avoid overload that results in conduction block. Fatigue, often severe, affects about 85% of MS patients and, along with motor and sensory symptoms, results in decreased mobility and reduced quality of life. Physical activity and recreation are reduced in patients with MS. Before developing recommendations, physical activity patterns and the physical effects of MS should be assessed in individual patients. Patients may then be functionally classified. Physical activity can also be classified in a pyramid structure, with the most basic functions forming the base and the most integrated functions on top. The muscular fitness pyramid progresses through passive range of motion, active resistive, specific strengthening and integrated strength exercises Overall physical activity may be increased according to functional level by performing activities of daily living, incorporating inefficiencies into daily living, pursuing more active recreation and eventually developing a structured exercise programme. The importance of the proper exercise environment, balance and coordination issues and factors related to adherence are discussed.

Activities of Daily Living↗

PubMed1999

[Theory of functional systems and integrative physiology].

The paper postulates that the theory of functional systems proposed by P. K. Anokhin has given an impetus to the understanding of the body's integrative activities. The functional systems are shown to be units of the activities. Individual functional systems in their characteristic processes of self-organization and self-regulation, hierarchic, multi parametric and consecutive interactions of the body's functional systems have integrative properties. The theory of functional systems have disclosed many unknown brain integrative properties: the specificity of ascending activating influences of subcortical formations on the cortex, various patterns of excitation convergence on cortical neurons, the specific features of chemical postsynaptic processes that are characteristic of each functional system. Particular emphasis is laid on the informational mechanisms of the integrative activities of functional systems.

Brain↗

PubMed1991

[The "preoxygenation" special function in mechanical ventilators. Medically necessary and an ergonomic plus?].

Hypoxia-related cardiovascular complications and unnecessary monitor and ventilator alarms are well-known problems during tracheobronchial suctioning. Preoxygenation together with temporary muting of acoustic alarms for tracheobronchial suctioning are provided by a single operational control of the ventilator "Evita", software release 9 (Drägerwerk AG). This integrated function was evaluated in medical and ergonomic respects. METHODS. Thirty tracheobronchial suctioning procedures each, with or without preoxygenation, were evaluated. The subjects were patients in our anesthesiological intensive care unit who were under continuous positive-pressure ventilation with FIO2 between 0.25 and 0.6. They ranged in age from 18 months to 72 years. Each patient served as her/his own control after about 1-h delays. Depending on the preference of the nurse, the procedures were either both on-ventilator (via the catheter port) or both off-ventilator suctionings. Arterial samples for blood gas analyses as well as arterial oxygen saturation (SaO2) determinations were taken before preoxygenation, at the moment of disconnection or opening of the catheter port, at reconnection or closure of the port, and 5 min later. Moreover, the number of changes in position of the performing nurse, the number of acoustic ventilator alarms, and the duration of the procedure were recorded. Finally, assessments of the integrated ventilator feature by the 28 participating nurses were collected both as a score from 1 ("most useful and innovative") to 5 ("completely superfluous and distracting") and as detailed statements. RESULTS. Arterial blood gas results and SaO2 courses differentiated as to procedures with or without preoxygenation as well as on-ventilator and off-ventilator suctioning are shown in Table 1 (values are mean +/- standard deviation). Without preoxygenation, most patients did not exhibit threatening drops in SaO2 (values fell from 98.2%) to 97.0% on the average). Nevertheless, preoxygenation provided an additional safety margin (100% saturation throughout the procedure in all patients). Under certain conditions, e.g., low functional residual capacity as in small children or patients with adult respiratory distress syndrome (in 1 of these cases we observed a SaO2 drop to 87%), it is mandatory. Although occurring far less frequently, unnecessary acoustic alarms were not completely excluded by the integrated function because the ventilator would not recognize the insertion of the suction catheter via the catheter port as the expected disconnection. Thus, coughing was able to trigger the "high airway pressure" alarm. As expressed by an average score of 2.8, approval of the integrated ventilator function prevailed among the involved nursing staff.

Adolescent↗

PubMed2026

Mov10 mitigates hematopoietic stem cell exhaustion under stress by modulating the Camp-mediated inflammatory pathway.

The integrity of hematopoietic stem cell (HSC) function is crucial for robust hematopoietic regeneration following stress. Inflammatory responses are pivotal drivers of HSC stress response, yet the precise modulation of inflammatory pathways remains incompletely defined. In this study, we identify the RNA helicase Mov10 as a negative regulator of stress-induced inflammatory pathways in HSC. Our study indicates that Mov10, which is critically required for HSC maintenance, is highly expressed in HSC, and its loss adversely affects HSC fitness and survival during hematopoietic stress induced by bone marrow transplantation and irradiation (IR). Mechanistically, Mov10 mitigates excessive inflammatory activation to sustain HSC functional integrity during hematopoietic stress, primarily by enhancing the translation of CAMP, which inhibits the interaction between TNF-α and its receptor TNFR1 and suppresses NF-κB activation. Overall, our results imply that Mov10 plays a critical role in averting functional failure of hematopoiesis under stress, presenting viable paths for the therapeutic intervention of relevant diseases.

Camp↗

PubMed1997

Bone marrow failure by cytomegalovirus is associated with an in vivo deficiency in the expression of essential stromal hemopoietin genes.

Bone marrow (BM) failure associated with cytomegalovirus (CMV) infection is a feared complication after clinical BM transplantation. Experiments in long-term BM cultures have indicated that BM stromal cells (BMSC) are targets of productive CMV infection, but an in situ infection of BM stroma remained to be documented, and the pathomechanism is open to question. Here we describe a murine in vivo model of lethal CMV aplastic anemia (CMV-AA). The reconstitution of hematopoietic progenitor cells expressing stem cell factor (SCF) receptor was found to be defective in CMV-AA. While murine CMV replication in permissive parenchymal tissues is cytolytic, the hematopoietic cord was found to be a site of very limited virus production with foci of reticular BMSC expressing the intranuclear viral IE1 protein, but with only a few BMSC positive for viral genome in the in situ hybridization. XX-XY BM chimeras were established in order to quantitate Y-chromosome-tagged BMSC by a PCR specific for the male-sex-determining gene Tdy. This approach revealed that murine CMV infection is not associated with a significant loss of BMSC. Despite the physical integrity of the stromal network, the functional integrity of the stroma was impaired. While housekeeping genes were expressed normally in BMSC of infected mice, the expression of genes encoding the essential hemopoietins SCF, granulocyte colony-stimulating factor, and interleukin-6 was markedly reduced. In conclusion, the mechanism of BM failure is not a stromal lesion but an insufficient stromal function. These findings explain CMV-AA as a manifestation of multiple hemopoietin deficiency.

Anemia, Aplastic↗

PubMed1990

Effect of nifedipine on antipyrine and theophylline disposition.

On the basis of reports that some calcium channel blockers impair the elimination of some drugs, the effect of nifedipine on the disposition of antipyrine and theophylline was assessed in healthy volunteers. Antipyrine half-life of 10.04 +/- 1.43 h (mean +/- SD) after a week intake of nifedipine (20 mg twice daily) was not significantly different from the control value of 10.64 +/- 2.15 h; nor was that of 10.02 +/- 1.49 h after 2 weeks pretreatment with the calcium channel blocker in eight healthy volunteers. Control antipyrine clearance (ml min-1) of 44.40 +/- 10.58 was not significantly different from that of 45.66 +/- 9.34 and 46.87 +/- 9.63 after nifedipine pretreatment of 1 and 2 weeks, respectively. Similarly volume of distribution was unaltered: 0.601 +/- 0.074, 0.591 +/- 0.078 and 0.602 +/- 0.051 l kg-1, respectively. A week pretreatment with nifedipine did not significantly alter either of theophylline half-life (7.32 +/- 0.81 h (control) to 7.50 +/- 0.80 h) or clearance (42.10 +/- 5.84 ml min-1 (control) to 43.77 +/- 4.00 ml min-1) in six volunteers. However the change in volume of distribution: 0.451 +/- 0.053 l kg-1 (control) to 0.483 +/- 0.062 l kg-1 was significant (p less than 0.025). Generally, theophylline plasma levels were lower after nifedipine pretreatment and the difference was significant at 2 and 4 h post-dosing (p less than 0.05). It is suggested that nifedipine, unlike diltiazem and verapamil, is unlikely to interfere with the functional integrity of the hepatic mixed-function oxygenase enzymes, but might displace theophylline from plasma protein.

Adult↗

PubMed1995

A study of intercellular relationships between trabecular bone and marrow stromal cells in the murine femoral metaphysis.

The cellular relationship between the substantia spongiosa of bone (cancellous or trabecular bone) and the haematopoietic bone marrow in the femoral metaphysis of C57BL/6NJCL mice was studied by transmission electron microscopy (TEM). Special attention was directed to intercellular junctions between osteocytes, osteoblasts, and bone marrow reticular cells. These were gap junctions and adhesive devices of simple architecture referred to as primitive junctions or zonula adherens-like junctions. Gap junctions were observed between osteocytes (within the trabeculae) and osteoblasts (at the trabecular surface) and between osteoblasts and marrow reticular cells. Gap junctions were also observed between the same cell type within each of these categories. These junctions involved the plasmalemmal membranes of adjacent cell bodies and of processes. Primitive cell junctions had a similar cellular distribution. Quantitative analysis of the cell types covering or positioned around the trabecular bones and of gap junctions between these and other cells was carried out by TEM. It was found that osteoblasts were the most numerous cell type, occupying 31% of the total of each cell type positively identified around the trabeculae (31%), while pre-osteoblasts, (flattened bone marrow reticular cells) took up 26%. These data emphasise the intimate relationship of the various mesenchymal cells based on processes and intercellular junctions, and point to an anatomical and probably functional integration of trabeculae and marrow. The functional significance and putative regulatory activity of this unit are discussed.

Animals↗