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PubMed2003

A structural representation of migraine diagnostic criteria: the experts' view.

OBJECTIVE: To generate an empirically derived structural representation of migraine diagnostic criteria in a group of international headache experts using the Pathfinder network scaling algorithm in order to evaluate the validity of the migraine criteria used in the International Headache Society (IHS) classification system. BACKGROUND: Because it is a disease entity that lacks objective defining markers, developing valid diagnostic criteria for migraine is a challenge. The IHS committee relied on expert consensus to develop their classification system in 1988. Expert consensus also was used to evaluate the validity of the IHS classification system, but further studies employing alternative methods still are needed. METHODS: Headache experts representing the Executive Committee of the IHS and the Board of Directors of the American Headache Society analyzed 14 criteria (7 IHS and 7 non-IHS) considered relevant in diagnosing migraine. Their ratings were submitted to the Pathfinder algorithm to generate a network structure reflecting the experts' conceptualization of migraine diagnostic criteria. RESULTS: The expert network had 3 groupings: headache characteristics (eg, phonophobia, unilateral pain, throbbing pain), biological contributing factors (eg, family history, hormonal relationship, relief with sleep), and triggering factors (eg, worse with stress, food triggers). The IHS criteria were clustered together in the center portion of the network. A t test showed that each IHS criterion was closer conceptually to other IHS criteria than to non-IHS criteria. Graph theory indices revealed that the most central criteria were unilateral pain, moderate/severe intensity, and nausea/vomiting. CONCLUSION: The structural representation of migraine diagnostic criteria from these international headache experts is consistent with the migraine diagnostic criteria set forth in the IHS classification system and thus provides further support for the validity of migraine criteria in the IHS system.

Algorithms↗
PubMed1996

Risk factors for perinatal and postnatal mortality in lambs.

Factors associated with preweaning mortality in lambs were identified by developing risk profiles with logistic regressions for perinatal and postnatal mortality. Compared with heavy lambs, lambs of low birth weight had almost twice the risk of perinatal mortality (odds ratio [OR] = 1.9) and lambs of average weight had a slightly lower risk (OR = 0.7). Two of four lambing location categories affected perinatal mortality, with lambs born at unmonitored areas at greatest risk (OR = 2.7). Multiple births increased the risk of perinatal mortality (OR = 1.5), especially among Targhee lambs (OR = 4.0). Breed variations in perinatal mortality were significant in Suffolk lambs (OR = 1.9) and Booroola Rambouillet lambs (OR = 2.1). Lambs born weak had an increased risk of postnatal mortality while strong lambs had a decreased risk (OR = 3.7 and 0.6, respectively) if the dam had an adequate milk supply. Poor milk supply increased the risk of postnatal mortality for lambs of average vigour (OR = 3.3), but did not change the risk for weak or strong lambs. Male lambs castrated at 30 days of age were at less risk of postnatal mortality (OR = 0.3) than females. There were slight increases in the risk of postnatal mortality for intact males (OR = 1.3), low birth weight lambs (OR = 1.6), and lambs born in sheds (OR = 1.3). Suffolk lambs (OR = 1.8) and Targhee lambs (OR = 1.6) had a higher risk of postweaning mortality.

Animals↗
PubMed2001

The pattern of phylogenomic evolution of the Canidae.

Canidae species fall into two categories with respect to their chromosome composition: those with high numbered largely acrocentric karyotypes and others with a low numbered principally metacentric karyotype. Those species with low numbered metacentric karyotypes are derived from multiple independent fusions of chromosome segments found as acrocentric chromosomes in the high numbered species. Extensive chromosome homology is apparent among acrocentric chromosome arms within Canidae species; however, little chromosome arm homology exists between Canidae species and those from other Carnivore families. Here we use Zoo-FISH (fluorescent in situ hybridization, also called chromosomal painting) probes from flow-sorted chromosomes of the Japanese raccoon dog (Nyctereutes procyonoides) to examine two phylogenetically divergent canids, the arctic fox (Alopex lagopus) and the crab-eating fox (Cerdocyon thous). The results affirm intra-canid chromosome homologies, also implicated by G-banding. In addition, painting probes from domestic cat (Felis catus), representative of the ancestral carnivore karyotype (ACK), and giant panda (Ailuropoda melanoleuca) were used to define primitive homologous segments apparent between canids and other carnivore families. Canid chromosomes seem unique among carnivores in that many canid chromosome arms are mosaics of two to four homology segments of the ACK chromosome arms. The mosaic pattern apparently preceded the divergence of modern canid species since conserved homology segments among different canid species are common, even though those segments are rearranged relative to the ancestral carnivore genome arrangement. The results indicate an ancestral episode of extensive centric fission leading to an ancestral canid genome organization that was subsequently reorganized by multiple chromosome fusion events in some but not all Canidae lineages.

Animals↗
PubMed1977

The Erysichthon syndrome. Progression of coronary atherosclerosis and dietary hyperlipidemia.

One hundred nineteen patients with coronary artery disease confirmed by coronary arteriograms were studied. Cine coronary arteriography confirmed progression of atherosclerosis in 106 (89%) patients (mean age 50.9 yr) and nonprogression in 13 (11%) patients (mean age 50.3 yr). Progression was defined as follows: any increase to 50% stenosis, 50% to 75% narrowing, 75% to 90%, 90% to 99%, 99% to total occlusion. Only one patient of the 106 who progressed (less than 1%) had ideal values for both cholesterol and triglyceride. Three of 13 patients (23%) who did not progress had ideal lipid values (P less than 0.005). Fifty four of 106 patients who progressed had cholesterol levels greater than or equal to 250 mg%; none of 13 patients who did not progress had such levels (P less than 0.005). Thirty-nine of 98 (40%) patients who progressed had hypertension; only one (8%) who did not progress had hypertension (P less than 0.025). Seventy-four of 96 patients who progressed were smokers (77%); two of 13 nonprogression patients smoked (15%) (P less than 0.005).

Adult↗
PubMed1991

Is essential tremor benign?

We analyzed the results of the Sickness Impact Profile, a self-reporting measure of sickness-related dysfunction in 753 essential tremor (ET) patients, 87 controls from the general population, and 145 patients with Parkinson's disease (PD). Compared with the general population, ET patients had significantly greater dysfunction in all but one category. Communication, Work, Emotional Behavior, Home Management, and Recreation and Pastimes were particularly impaired in ET. The PD patients had significantly higher dysfunction in all categories as compared with ET patients. We conclude that significant disability can occur in ET and, compared with PD, ET tends to be less severe but causes relatively greater psychosocial dysfunction.

Aged↗
PubMed2002

Role of liver biopsy in the diagnosis of hepatic iron overload in the era of genetic testing.

We studied hepatic iron overload (HIOL) patterns in 32 patients who underwent liver biopsies and testing for HFE mutations (C282Y, H63D). Iron-stained biopsy specimens were examined for patterns of iron deposits: hereditary hemochromatosis (HH) pattern or non-HH pattern. Visual iron grade based on amount of cellular and lobular iron was evaluated. We found the HH pattern in 17 biopsy specimens (53%) and the non-HH pattern in 6 specimens (19%). HH with superimposed non-HH was noted in 9 cases (28%). In 25 patients with HFE mutations, HH alone and combined with non-HH patterns was noted in 22 specimens (88%). Visual iron grade correlated approximately with the hepatic iron index. Heavy HIOL was noted in C282Y homozygotes and 1 patient with cirrhosis without either HFE mutation. Mild steatohepatitis was found in 21 specimens (66%); it was associated with the non-HH pattern in 80% (12/15) and the HH pattern in 62% (16/26) of cases. Liver biopsy can identify pattern and grade of HIOL and associated pathology for diagnosis and management of patients with abnormal iron studies and elevated liver function test results. Genetic tests for HFE mutations and liver biopsies are complementary in the workup of these patients.

Adult↗
PubMed1999

Tyramide signal amplification (TSA)-FISH applied to mapping PCR-labeled probes less than 1 kb in size.

Tyramide signal amplification (TSA)-FISH was used to map one mouse and two human DNA probes of less than 1 kb in size. The two human probes were 319 and 608 bp, and the mouse probe was 855 bp. Probes, made from PCR products, were labeled by incorporating biotin-11-dUTP (human) and biotin-16-dUTP (mouse) during PCR amplification. Signals were readily observed in both interphase and metaphase cells following TSA-FISH for all three genes, whereas conventional FISH experiments produced no signals. The two human ATP-binding cassette (ABC) genes, EST883227 (GenBank Accession No. AA243820) and EST990006 (GenBank Accession No. AA348546), mapped to human chromosomes 7p21 and 17q25. The mouse gene, cmyc (exon 2) mapped to band D2 of mouse chromosome 15. These findings demonstrate the ability of this technique to map small probes (PCR products and expressed sequence tags) of less than 1 kb through highly increased signal amplification.

Animals↗
PubMed1991

Percutaneous gallstone lithotripsy. Results in acute and chronic swine models.

The authors describe here a rotary catheter for the percutaneous fragmentation of gallstones. Gallstones are drawn into the rotating impeller by a powerful vortex and mechanically fragmented. Fragments are aspirated from the gallbladder following use of the device. The safety and efficacy of the device was tested after placement of human gallstones in the pig's gallbladder in 19 acute, 15 chronic, and two control experiments. In 27 completed experiments, 206 human gallstones (6-20 mm) were implanted. Most residual fragments were less than 2 mm; 24 fragments were 2 to 4 mm and seven were 5 to 8 mm. Acute histologic changes included focal loss of mucosa, mucosal and submucosal hemorrhage, and deposition of biliary material in the mucosa and submucosa. At 30 and 90 days, gallbladder histology revealed regeneration of the mucosa with isolated granuloma formation.

Acute Disease↗
PubMed1986

Atypical lesions of the anal mucosa in homosexual men.

Recent studies suggest that there is an increased incidence of squamous cell carcinoma of the anus in male homosexuals, but a precursor lesion has not been identified. We retrospectively analyzed in a blind fashion all anal tissue removed surgically during 1984. Twelve (6.7%) of the 180 specimens from men contained lesions with foci of epithelial atypia. Only one (0.85%) of 118 specimens from women harbored similar atypia. Of seven additional file cases exhibiting atypical anal mucosa, six were from men. Of 14 men with atypical anal lesions whose sexual orientation was known, 11 (79%) were homosexuals. In the 20 cases found to have atypical mucosal lesions, three patterns of atypia were identified, with more than one often occurring in the same specimen. Anal intraepithelial neoplasia (dysplasia) was identified in seven cases (35%) and occurred primarily at the anorectal junction and in anal ducts. Atypical condyloma was found in three cases (15%). A third lesion histologically indistinguishable from Bowen's disease or bowenoid papulosis was found in 12 cases (60%). In ten of these the lesion was adjacent to a condyloma. Although the natural history of these lesions of the anal mucosa is presently unknown, it may resemble that of similar lesions in other anatomic locations.

Adult↗
PubMed1995

The pathology of AIDS.

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AIDS-Related Opportunistic Infections↗