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At least 1,189 records · Page 66Linked to original sources

PubMed1999

Pharyngeal transport dysfunction consequent to an organ-sparing protocol.

OBJECTIVE: To investigate the effects of a protocol of concomitant intravenous hydroxyurea and hyperfractionated, accelerated, external-beam radiation therapy on the swallowing mechanism of patients with advanced-stage head and neck cancer. DESIGN: Posttreatment videofluoroscopic swallow function studies, using images of single-bolus swallows of low-density liquid barium, were analyzed in real time, slow motion, and frame by frame using an integrated system that allows objective analysis of video recordings through image processing and digitization (Kay Elemetrics Computerized Swallowing Station). Radiological descriptors were used for pharyngeal transport abnormalities, and temporal measures were obtained of structural movements. SETTING: Academic, tertiary care, referral medical center. PATIENTS: Fifteen consecutive patients with previously untreated, stages III and IV, nonmetastatic squamous cell carcinoma of the head and neck who underwent a phase 1 study of prolonged infusion hydroxyurea therapy in combination with hyperfractionated, accelerated external-beam radiation therapy for their disease. RESULTS: All patients had anterior pharyngeal segment dysfunction, characterized by no epiglottic movement and slowed laryngeal motility (1.011 +/- 0.379 seconds [mean +/- SD). Anterior pharyngeal dysfunction was more severe in patients with primary tumors of the hypopharynx than in those with cancer of the oropharynx. Twelve (80%) of our patients demonstrated posterior pharyngeal segment dysfunction characterized by impaired pharyngeal constrictor motility. All 15 patients displayed pharyngeal stage abnormalities that limited bolus transport and clearance. CONCLUSIONS: Severe pharyngeal physiological abnormalities were present that led to impaired bolus transport and that were frequent and debilitating consequences of this organ-sparing protocol. Long-term follow-up of this group will be required to assess the permanence of the abnormalities.

Adult↗

PubMed2002

Long-term results of olfaction rehabilitation using the nasal airflow-inducing ("polite yawning") maneuver after total laryngectomy.

OBJECTIVES: To study the long-term results of the nasal airflow-inducing maneuver (NAIM) as an olfaction rehabilitation tool after laryngectomy and to investigate the effectiveness of a new, simpler odor detection test (ODT) called the smell disk test (SDT), or Zürcher Geruchstest. DESIGN: Intervention study. SETTINGS: National cancer center. PATIENTS: Forty-one laryngectomees who received olfaction rehabilitation training with the NAIM 4 months to 2 years earlier. This so-called polite yawning maneuver creates an "underpressure" in the oral cavity, which, in turn, generates a nasal airflow that enables odor molecules to again reach the olfactory epithelium. MAIN OUTCOME MEASURES: Olfaction acuity testing with a standard ODT, along with a questionnaire, providing a subjective olfaction score (present odor perception scale [POPS]), and the SDT, as well as assessment of the patients' correct execution of the NAIM by speech-language pathologists on video recordings made during odor testing and long-term assessment of olfaction acuity. RESULTS: The correlation between the previously used ODT-POPS combination and the SDT was kappa = 0.56 (P<.001). Based on these results, we preferred to use the much simpler SDT instead of the laborious combination of the ODT-POPS. Based on the SDT results, 19 (46%) of the 41 laryngectomees were "smellers" and could be considered normosmic. There was a significant relationship (P =.03) between the patient's correct execution of the NAIM and whether or not the laryngectomee was a smeller according to the SDT. CONCLUSIONS: The effectiveness of the NAIM, or so-called polite yawning technique, for the rehabilitation of olfaction in individuals who have undergone total laryngectomy was reconfirmed. Long-term olfaction rehabilitation was achieved in about 50% of the patients, but more intensified training may be needed to increase the percentage of successfully rehabilitated individuals. The SDT is an effective and simple test for the assessment of olfaction acuity after laryngectomy.

Adult↗

PubMed1984

Speech pattern element stimulation in electrical hearing.

A sensation of hearing is provided for the otherwise totally deaf adult by the use of an electrode arrangement, placed external to the cochlea, which provides only larynx frequency speech pattern information. This is normally obtained by acoustic analysis and is presented so that, although its pattern is preserved, its physical form is matched to the patient's auditory capacity. Speech-receptive improvement has been shown using interactive synthetic speech techniques, video-recorded lipreading tests, and interactive conversational-type presentations. Speech production skills are also enhanced by self-monitoring, and examples of voice range improvement and jitter reduction are given. The particular electrode system used is especially suitable for promontory stimulation in adult patients without a tympanic membrane. The work as a whole is relevant, however, to the design of other conservative prostheses for both deaf adults and children.

Acoustic Stimulation↗

PubMed1990

Cochlear microcirculation. Effect of adrenergic agonists on arteriole diameter.

We used intravital fluorescent microscopy coupled with computerized video image processing to examine the cochlear microvasculature. In Mongolian gerbils the bulla was opened ventrally and a small window was made in the second turn of the cochlea. After fluorescein isothiocyanate-dextran administration, the radiating arterioles were video-recorded under X675 magnification. Computer determinations of arteriolar response to norepinephrine bitartrate (mixed alpha 1/alpha 2 agonist), phenylephrine hydrochloride (alpha 1 agonist), and UK 14,304 tartrate (alpha 2 agonist) were made at multiple dose levels over time. Findings were consistent with arteriolar constriction in response to alpha-adrenergic stimulation. The presence of alpha 1 and alpha 2 receptors was established, and a predominance of alpha 2 receptors in the cochlea was suggested.

Adrenergic alpha-Agonists↗

PubMed1995

Genetic questions for environmental studies. Differential parenting and psychopathology in adolescence.

BACKGROUND: Recent genetic evidence suggests that the most important environmental influences on normal and pathologic development are those that are not shared by siblings in the same family. We sought to determine the relationship between differences in parenting styles and depressive symptoms and antisocial behavior in adolescence, and to compare the influence of these nonshared experiences with genetic influences. METHODS: We studied 708 families with at least two same-sexed adolescent siblings who were monozygotic twins (93 families), dizygotic twins (99 families), ordinary siblings (95 families), full siblings in step families (181 families), half siblings in step families (110 families), and genetically unrelated siblings in step families (130 families). Data on parenting style were collected by questionnaire and by video recording of interaction between parents and children. RESULTS: Almost 60% of variance in adolescent antisocial behavior and 37% of variance in depressive symptoms could be accounted for by conflictual and negative parental behavior directed specifically at the adolescent. In contrast, when a parent directed harsh, aggressive, explosive, and inconsistent parenting toward the sibling, we found less psychopathologic outcome in the adolescent. CONCLUSIONS: Parenting behavior directed specifically at each child in the family is a major correlate of symptoms in adolescents. Furthermore, harsh parental behavior directed at a sibling may have protective effects for adolescents, a phenomenon we call the "siblin barricade."

Adolescent↗

PubMed2001

Laparoscopic Heller myotomy and Dor fundoplication for achalasia: analysis of successes and failures.

BACKGROUND: In the treatment of achalasia, surgery has been traditionally reserved for patients with residual dysphagia after pneumatic dilatation. The results of laparoscopic Heller myotomy have proven to be so good, however, that most experts now consider surgery the primary treatment. HYPOTHESIS: The outcome of laparoscopic myotomy and fundoplication for achalasia is dictated by technical factors. SETTING: University hospital tertiary care center. DESIGN: Retrospective study. PATIENTS AND METHODS: One hundred two patients with esophageal achalasia underwent laparoscopic Heller myotomy and Dor fundoplication. Fifty-seven patients had been previously treated by pneumatic dilatation or botulinum toxin. The design of the operation involved a 7-cm myotomy, which extended 1.5 cm onto the gastric wall, and a Dor fundoplication. Esophagrams, esophageal manometric findings, and video records of the procedure were analyzed to determine the technical factors that contributed to the clinical success or failure of the operation. MAIN OUTCOME MEASURE: Swallowing status. RESULTS: In 91 (89%) of the 102 patients, good or excellent results were obtained after the first operation. A second operation was performed in 5 patients to either lengthen the myotomy (3 patients) or take down the fundoplication (2 patients). Dysphagia resolved in 4 of these patients. The remaining 6 patients were treated by pneumatic dilatation, but dysphagia improved in only 1. At the conclusion of treatment, excellent or good results had been obtained in 96 (94%) of the 102 patients. CONCLUSIONS: These data show that a Heller myotomy was unsuccessful in patients with an esophageal stricture; a short myotomy and a constricting Dor fundoplication were the avoidable causes of residual dysphagia; a second operation, but not pneumatic dilatation, was able to correct most failures; and that the identified technical flaws were eliminated from the last half of the patients in the series.

Adolescent↗

PubMed1996

Characteristics of forearm-hand exposure in relation to symptoms among automobile assembly line workers.

The aims of this paper are to present a new computerized observation method, HandPEO (portable ergonomic observation), which quantifies duration, frequency, and holding time of work operations and hand grips, and to measure the physical exposure of the forearm-hand among automobile assembly line workers by using HandPEO registrations of video recordings in simulated real-time. Agreement between two recordings was tested for five subjects by calculating the proportion of specific intrarater agreement; it was approximately 70% for hand grips and 60-80% for work operations. Registrations were made on work stations with high (HS) and low (LS) prevalence of symptoms. The major differences were longer holding times per operation and a larger proportion of power tool usage for HS. The HandPEO method may be used to describe the characteristics of the work studied and may serve as basis for job redesign. The results suggest an association between holding time, certain work operations, and prevalence of symptoms.

Automobiles↗

PubMed1996

Simultaneous assessment of bioprosthetic heart valve biomechanical properties and collagen crimp length.

A new morphologic method is described for the simultaneous quantitation of porcine aortic valve collagen crimp length and the assessment of biomechanical properties. This method utilizes the simultaneous real-time video recording of collagen crimp morphology and acquisition of crimp length data through the combination of polarized light microscopy and morphometry. We felt that the development of this method was warranted, due to the fundamental role played by collagen in porcine aortic valve performance. The development of this method involved the design and fabrication of a uniaxial microtensile stage, suitable for mounting on a standard microscope stage. The validation of our test method was accomplished by a comparison of untreated and glutaraldehydetreated porcine aortic valve leaflet tissue, because the biomechanical and morphologic characteristics of the native and fixed aortic valve have been extensively studied. The method described in this communication enables the collection of morphologic and biomechanical data from a single tissue specimen, eliminating the need for independent studies of multiple specimens. Furthermore, this method obviates the need for making assumptions, which may be difficult to verify, concerning the homogeneity of different test specimens with respect to their morphology and corresponding mechanical response to different experimental conditions.

Animals↗

PubMed1997

Kinematics and functional morphology of aquatic feeding in Australian snake-necked turtles (Pleurodira;Chelodina).

Head kinematics during aquatic feeding of the Australian long-necked turtle (Chelodina) were studied by means of high speed video recordings. Buccal expansion was assessed by calculation of elliptical cross-sectional surfaces. Further, displacements of head, carapace, and prey in the earth bound frame, of the prey relative to the center of the gape, and of the head relative to the carapace were determined. Rates of change (velocities) of all these variables were calculated. These data are combined with information on the osteology and myology of the head. The robust development of the large hyobranchial apparatus, the massive intercornuatus muscle, and the presence of the branchiosquamosus muscle were related to aquatic feeding skills. Head kinematics are variable in amplitude and relative timing, but proceed always in a rostrocaudal sequence. According to their effect on the prey, two components are distinguished in the process of expansion. The first compensates for head/body movements (compensatory suction). The second causes distinct acceleration of water and prey (inertial suction). The latter component is mainly driven by the abduction of the second branchial arch. In spite of largely different structural solutions, optimal feeding conditions as deduced for suction in feeding fishes are also employed by Chelodina. This further promotes the assumption that hydrodynamics constrain evolutive solutions for aquatic feeding.

Animals↗

PubMed1999

Cross-species collapse activity of polarized radial glia on retinal ganglion cell axons.

Inhibition of incorrect axonal outgrowth has been shown to be a crucial guidance mechanism during the development of the nervous system. Within the visual system of chick and rat, extension of retinal ganglion cell axons is essentially restricted to distinct layers of the retina and distinct brain regions such as the tectum opticum. In addition, populations of ganglion cells from defined retina locations project topographically to defined tectal areas, their growth possibly being inhibited by radial glia in incorrect tectal regions. In the current study, we aimed to analyse potential inhibitory activity of retinal glia during outgrowth of ganglion cell axons of embryonic chick and rat. The response of ganglion cell axons originating from different retina locations when exposed to purified retinal radial glia cell membranes were monitored in collapse assays by time lapse video recording. The interaction of axons growing on purified glial somata or glial endfeet was analysed in outgrowth assays. Our results indicate that (1) nasal and temporal chick growth cones are equally induced to collapse by cell membranes from retinal radial glia: 75% nasal and 72% temporal. (2) The collapse inducing component of radial glia can be inactivated by defined heat treatment, reducing collapsing activity to 6% nasal and 5% temporal. (3) Rat growth cones respond in a similar way to chick radial glia. (4) Rat axons grow perfectly on endfeet but not on somata of radial glia of the chick. In summary, the data suggest that radial glia are functionally polarized with permissive endfeet and inhibitory somata based on heat-labile proteins. Glia polarization is likely to inhibit aberrant growth of ganglion cell axons into outer retina layers. However, retinal radial glia are unlikely to participate in preordering axons within the retina and therefore do not affect the topographic projection. Finally, the inhibitory function of radial glia is conserved between birds and mammals and represents possibly a fundamental mechanism for structuring the central nervous system.

Animals↗

PubMed1996

Environmental temperature modulates onset of independent feeding: warmer is sooner.

Individual dams and their litters were observed from Days 14-22 in a seminatural environment consisting of a nestbox attached to a larger, open field in which powdered chow was available. Ambient temperature in the field was either warm (30 degrees C), moderate (21 degrees C), or cold (10 degrees C); nest temperature was always moderate. Behavior was monitored 12 hr/day by time-lapse video recording. The pups' egressions into the field and onset of independent feeding were temperature-related: Weaning was earliest in the warmth and increasingly late with decreasing ambient temperature. Among subjects in the cold condition, there was a positive correlation between duration in the field and duration feeding. Pup growth was unaffected by the temperature regimes. Environmental temperature has emerged as a determinant for early nest egressions and weaning onset.

Animals↗

PubMed1998

The reactivation of demembranated human spermatozoa lacking outer dynein arms is independent of pH.

The effect of pH, Mg-ATP, and free calcium on activity of the inner dynein arm was investigated using demembranated human spermatozoa lacking the outer dynein arms (LODA). The results were compared with those obtained for demembranated-reactivated normal spermatozoa to evaluate the functional properties of the inner and outer dynein arms in axonemal motility. The reactivation of Triton X-100-demembranated LODA spermatozoa was analysed at various pHs and concentrations of Mg-ATP and calcium using video recordings. The percentage of reactivated LODA spermatozoa as a function of Mg-ATP concentration was not dependent on pH, whereas reactivation of normal human spermatozoa is pH dependent. This suggests that there may be a pH-dependent regulatory mechanism associated with the outer dynein arms. A delay in the principal bend propagation of normal and LODA reactivated cells was found at pH 7.1. This disappeared at pH 7.8 in normal but not in LODA populations. This suggests a role for outer dynein arms in the initiation of the propagation of flagellar bends at alkaline pH. The level of LODA and normal sperm reactivation both depended on the calcium concentration in the medium. At lower free calcium concentrations, the reactivation level and beat frequency of reactivated cells were higher. Our results suggest a functional difference between outer and inner dynein arms of human spermatozoa based on a differential pH sensitivity. Moreover, calcium seems to exert its regulatory action elsewhere than on the outer dynein arms.

Adenosine Triphosphate↗

PubMed1998

Comparative motility of X and Y chromosome-bearing bovine sperm separated on the basis of DNA content by flow sorting.

A combination of flow cytometric sperm sorting of X and Y chromosome-bearing sperm (X and Y sperm) and computer-assisted sperm analysis (CASA) for measuring sperm motility allows assessment of motion parameters in the two populations. Bull sperm were separated into X and Y populations by flow cytometry following staining with the DNA-binding dye Hoechst 33,342. The motion parameters differed depending on sperm concentration. Decreasing sperm concentration resulted in higher velocities and straighter trajectories. The concentrations of control (stained-unsorted and unstained-unsorted) and flow-sorted sperm were therefore adjusted to similar numbers (5 x 10(6) sperm per milliliter). Samples of sorted X and Y sperm and control sperm were transferred to prewarmed slides on a heated stage (37 degrees C) and their motion video recorded for 2 min using a magnification of x 100 and a high-resolution camera. The sperm analysis was carried out on a Hobson Sperm Tracker (HST) using HST 7 software. The following motion parameters were measured: curvilinear, straight-line, and average path velocity; mean angular displacement (MAD); beat cross-frequency; amplitude of lateral head displacement; linearity (LIN); and straightness of path (STR). Sperm movement was unaffected by staining with Hoechst 33,342, excitation by ultraviolet (UV) light, or the physical process of cell sorting. Significant differences were seen between X and Y sperm for MAD, LIN, and STR. No difference was observed for the other parameters. The results indicate that in a simple salts solution, Y bull sperm do not swim faster than X sperm but may be distinguished from X sperm on the basis of LIN and STR.

Animals↗

PubMed1995

Combined stereotactic thalamotomy and posteroventral pallidotomy for Parkinson's disease.

Stereotactic thalamotomy has traditionally provided good relief of tremor for patients with intractable tremor-dominant Parkinson's disease. However, bradykinesia, dyskinesia, and rigidity are often less reliably treated with this technique. Although posteroventral pallidotomy (PVP) can alleviate dyskinesias, appendicular bradykinesia, and rigidity, tremor may not be completely ameliorated. We have combined Vim/VOp junction thalamotomy and PVP in 29 patients with severe tremor, rigidity, and bradykinesia. Patients underwent unilateral Vim thalamotomy followed at the same sitting by PVP. The distinct physiological consequences of each procedure were documented by intraoperative electromyography (EMG) and video recording, revealing the effects on both tremor and agonist/antagonist co-contraction. Lack of reciprocal inhibition of antagonistic muscle groups often remained following thalamotomy but was eliminated by subsequent PVP. The complementary therapeutic effects of PVP and Vim thalamotomy may be due to the interruption of different neuronal circuits by the two procedures. The effect of Vim thalamotomy has been attributed to the interruption of the rubrothalamocortical loop. PVP interrupts the outflow of the globus pallidus interna (GPi), which may cause disinhibition of locomotor centers in the mesencephalon and spinal cord. There is no direct interruption of the rubrothalamocortical loop by PVP, explaining why this procedure sometimes exacerbates tremor in certain patients. The combination of the two procedures appears to provide excellent relief of the majority of symptoms in patients suffering from tremor-dominant Parkinson's disease.

Adult↗

PubMed2000

Random locomotion and chemotaxis of human blood polymorphonuclear leukocytes from a patient with leukocyte adhesion deficiency-1: normal displacement in close quarters via chimneying.

The beta2 integrins are known to be important in the motile function of leukocytes in general and in the adhesive response to inflammatory stimuli in particular. In the current study, under direct microscopic observation with concomitant time-lapse video recording, we examined the locomotion of human blood PMN from a patient with Leukocyte Adhesion Deficiency-1 (LAD), a disorder in which beta2 integrins on the cell surface are markedly deficient in number or function. In thin slide preparations such that the leukocytes were somewhat compressed between slide and cover slip, PMNLAD exhibited normal random locomotion and chemotaxis, apparently by using the opposing surfaces to generate the force for locomotion (chimneying). In thicker preparations, an adherence deficit was evident, but chemotaxis still occurred, even by PMNLAD anticoagulated in EDTA. Consistent with the paucity of beta2 integrins on the surface of the PMNLAD was their failure to aggregate in the presence of antibodies to beta2 integrins, even when they had been brought together by chemotaxis. We relate these findings to the reported independence from integrins of PMN in the lung vasculature in LAD, as well as in certain experimental conditions.

Antibodies, Monoclonal↗

PubMed1982

Analyses of therapist variables in a series of psychotherapy sessions with two child clients.

Studied the process of child psychotherapy by means of an analyses of therapist verbal behaviors. Audio-video recordings were made of nine intermittent psychotherapy sessions with 2 child clients, aged 8 and 12. A randomized mastertape of 4-minute segments was rated for empathic understanding and respect by means of the Carkhuff scales. Transcripts were categorized by means of the Hill Counselor Verbal Response Category System, and a preliminary set of 12 grammatical variables. Transcripts were minutized, and all the therapist variables were intercorrelated and factor-analyzed. According to the research expectations, high levels of interrater reliabilities for the Carkhuff scales and relatively high agreement levels for Hill's system were found. Analyses of the therapist variables demonstrated the nature of the therapeutic interventions as well as the pattern of change across successive psychotherapy sessions. The overall verbal response behavior of each therapist was summarized best through the factor analyses. Communalities and individual differences between the therapists were discussed. Future directions for the study of therapist variables in child psychotherapy process research were indicated.

Affective Symptoms↗

PubMed1982

Analyses of client variables in a series of psychotherapy sessions with two child clients.

Studied the process of child psychotherapy by means of analyses of client verbal behaviors. Audio-video recordings were made of nine intermittent psychotherapy sessions with 2 child clients, aged 8 and 12. A randomized mastertape of 4-minute segments was rated for self-exploration by means of the Carkhuff scale. Transcripts were categorized by means of an extended Snyder system and a preliminary set of grammatical variables. Transcripts then were minutized, and all client variables were intercorrelated and factor-analyzed. According to the research expectations, a high level of interrater reliability for the Carkhuff scale and high levels of interjudge agreement for the extended Snyder system were found. Analyses of the client variables demonstrated the nature of each client's verbal responding as well as their pattern of change across successive therapy sessions. The overall verbal response behavior of each client was summarized best through the factor analyses. Communalities and individual differences between the clients were discussed. Future directions for the study of client variables in child psychotherapy process research were suggested.

Affective Symptoms↗

PubMed1999

Distinct vascular patterns of early synovitis in psoriatic, reactive, and rheumatoid arthritis.

OBJECTIVE: To examine the macroscopic vascular pattern of early synovitis in psoriatic arthritis (PsA), reactive arthritis (ReA), and rheumatoid arthritis (RA) and to assess the reliability of the grading features for synovitis. METHODS: Forty-four patients (14 PsA, 12 ReA, and 18 RA) with knee synovitis who were undergoing arthroscopy were assessed. Video recordings of the examination were scored independently by 3 arthroscopists who were blinded to the patient's identity and clinical details. Features of vascularity, villous formation, pannus, granularity, and capillary hyperemia were recorded and kappa values (-1 or =0.8) for features of vascularity, villous hypertrophy, and pannus. Seventy-three percent of the PsA and ReA patients had predominantly tortuous, bushy vessels; 89% of the RA patients had mainly straight, branching vessels. CONCLUSION: The distinct vascular patterns in PsA and ReA compared with those in RA may reflect different specific vascular factors in the pathogenesis of these arthritides. Vascularity and villous hypertrophy are the most reliable features of synovitis grading.

Adult↗