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PubMed2006

[The levels of recognition and hand functions of patients with Alzheimer's disease: a pilot study based on the simple test for evaluating hand function].

AIM: The purpose of this study was to analyze the levels of recognition and hand functions of the patients with Alzheimer's disease (AD) based on the Simple Test for Evaluating Hand Function (STEF). METHODS: Forty subjects with AD (AD group) and 20 without AD (control group) in a facility for elderly health care services participated in this study. The AD group consisted of 20 subjects with Clinical Dementia Rating (CDR) 1 and 20 other subjects with CDR2. RESULTS: The results were as follows: Time required for full motion of right hand dexterity was significantly longer in both the CDR1 and CDR2 groups compared to the control group (p < 0.05, p < 0.01). Time required for the control group and CDR1 group were significantly shorter for motion of right hand dexterity compared to the left hand. No significant difference was observed between the times of right and left hand dexterity among subjects of CDR2. The disparity of right-left hand dexterity decreased in the order of control, CDR1 and CDR2. The correlations between the sub-items for CDR scale and the right-left hand disparity were significant in "memory" and "judgment". The right-left hand disparity decreased with the shortened time for left hand motion, as the "memory" or "judgment" scores increased. CONCLUSION: These findings suggest that right hand dexterity speed in patients in the mild AD stage was low when their dominant hand superiority declined. Moreover the decline of dominant hand superiority correlated with the recognition of memory and judgment.

Aged↗

PubMed2005

Discrepant findings for Wada test and functional magnetic resonance imaging with regard to language function: use of electrocortical stimulation mapping to confirm results. Case report.

The Wada test is still considered the gold standard for determining the language-dominant hemisphere prior to brain surgery. The authors report on a 34-year-old right-handed woman whose Wada test results indicated that the right hemisphere was dominant for language. In contrast, functional magnetic resonance (fMR) imaging was indicative of bilaterally represented language functions. Activation in the left hemisphere demonstrated on fMR imaging was most pronounced in the Broca area. Importantly, fMR imaging results in this area were confirmed on electrocortical stimulation mapping. These contradictory findings indicated that a right hemispherre dominance for language according to the Wada test should be questioned and verified using electrocortical stimulation. Nonetheless, the question remains whether involvement of these areas in the left frontal hemisphere is critical for language, as these were spared during surgery.

Adult↗

PubMed1992

[The functional asymmetry of the olfactory control of visceral functions].

In amphibia (frogs) and mammals (rats, guinea pigs, cats), unilateral electrical stimulation of olfactory lobes or section of olfactory tracts resulted in considerable functional changes in respiratory and cardiovascular systems, the olfactory influences being functionally asymmetric. Possible interactions of asymmetric influences at the level of truncal visceral centers, are discussed.

Animals↗

PubMed2004

Sympathetic nervous function in patients with hypertrophic cardiomyopathy assessed by [123I]-MIBG: relationship with left ventricular perfusion and function.

AIM: The aim of the present study was to evaluate [123I] MIBG uptake and clearance in patients with hypertrophic cardiomyopathy (HCM) and to assess their relationships with left ventricular function (systolic and diastolic) and perfusion. METHODS: Eleven consecutive patients with HCM (8 men and 3 women; mean age 38+/-12 years, none in the dilated phase) underwent (in separate days, in random order) [123I]-MIBG scintigraphy, [(99m)Tc]-MIBI SPET at rest, and echocardiography. All patients were studied in fasting condition, and all medications were discontinued. [(99m)Tc]-MIBI SPET study was performed 1 hour after tracer injection. [123I]-MIBG study was acquired 5 minutes (planar) and 4 hours (planar and SPET) after the i.v. injection of [123I]-MIBG. Heart to mediastinum ratio (H/M) was computed at 4 hours. Wash out rate (WOR) was computed as: (H early - H delayed)/(H early), after decay correction. Both [123I]-MIBG and [(99m)Tc]-MIBI SPET were analyzed on 3 short axis views (apical, middle, and basal). Left ventricular outflow tract gradient (LVOTG), ejection fraction, volumes, septum thickness, and left atrial fractional shortening (LAFS) were evaluated on echocardiography. RESULTS: [123I]-MIBG WOR showed a positive relationship with LVOTG (r=0.84, p<0.001) and septum thickness (r=0.76, p<0.01), while a negative one was found with LAFS (r= -0.66, p<0.05). The study group was divided into: Group A (n=5) with higher, and Group B (n=6) with lower WOR than the median value (i.e. 11%). Group A patients had significantly lower LAFS (17.6+/-4.8 vs 26.8+/-7.2%, p<0.05), higher LVOTG (49+/-35 vs 3+/-3 mmHg), and thicker septum (21+/-2 vs 17+/-2 mm) than Group B patients. Inferior and septal wall [123I]-MIBG uptake on 4 hour SPET was significantly lower in Group A than in Group B. On the other hand, no differences were found in (99m)T-MIBI SPET rest regional uptake between the 2 subgroups of patients. CONCLUSION: These results suggest that cardiac sympathetic activity correlates to cardiac anatomy (i.e. degree of hypertrophy) and diastolic function in patients with HCM.

3-Iodobenzylguanidine↗

PubMed2006

[Effects of specific cycloxygenase-2 inhibition on the renal functions of ederly patients with renal function impairment].

BACKGROUND: Elderly patients suffering from nociceptive pain of locomotive organs and concomitantly from renal impairment represent a target population for painkilling drugs. That is why they are predisposed to nephrotoxic effects non-steroidal anti-inflammatory drugs. The aim of our study was to evaluate cycloxygenase-2 (COX-2) inhibition effect on renal function in elderly with moderate impairment of renal function. METHODS AND RESULTS: Based on 24-h urine collection we assessed creatinine clearance (C(Cr), fractional excretion of sodium (FE(Na)), potassium (FE(K)), chloride (FE(Cl)), osmotic active solutes (FE(OSM)) and 24h urinary excretion of prostaglandin PGE2 and PGF(2 alpha). Under conditions of sub-maximal water load fractional excretion of electrolytes, inulin clearance (C(in)), serum cystatin C (S(cyst)) were assessed. In addition basal and stimulated plasma renin activity (PRA) and plasma aldosteron (P(aldo)) were examined. Using comparison of parameters before and at the end of 7-days rofecoxib treatment we found out C(in) 0,82 +/- 0,34 vs 0,74 +/- 0,18 ml/s/l,73 m2, FE(Na) 1,0 +/- 0,3 vs 1,2 +/- 0.4 (p=0,02), FE(OSM) 2.9 +/- 0,7 vs 3,7 +/- 1,2% (p=0,03), U(PGE2 alpha),V 663 +/- 528 vs 414 +/- 195 (p=0,059), U(PGD2) V (559 +/- 625) vs 205 +/- 174 eta g/24h (p=0,02), stimulated PRA 0.94 +/- 0,73 vs 0,4 +/- 0,27 +/- pg/l/h (p=0,019), P(aldo) 104,56 +/- 50,15 vs 56,94 +/- 27,08 eta g/l/h (p=0,008). CONCLUSIONS: Short-term COX-2 inhibition in patients with moderate renal impairment was associated with significant decrease of tubular transport of sodium, without changing GFR and water excretion.

Aged↗

PubMed1991

[Impaired diastolic ventricular function in dilated cardiomyopathy with variously reduced systolic function. A Doppler echocardiography analysis].

Diastolic ventricular function was assessed by Doppler echocardiography in 50 patients with idiopathic dilated cardiomyopathy (DCM) and sinus rhythm. The patients were subdivided into two groups with either a moderately reduced ejection fraction (less than 32%; group 1, n = 25) or a severely reduced ejection fraction (less than 32%; group 2, n = 25), the latter having an unfavorable prognosis. The degree of heart failure according to the NYHA classification was more pronounced in group 2 (p less than 0.05). Mean pulmonary capillary wedge pressure (PCm) was also higher in group 2 (gr. 1:9.8 +/- 5.5 vs. gr. 2: 16.2 +/- 8.9; p less than 0.02), and the morphological parameters obtained by conventional M-mode echocardiography showed increased left ventricular volumes and mass in both groups with DCM, as compared with a control group (n = 16); there was a reduced volume/mass ratio in group 2. The parameters of systolic function derived from M-mode and Doppler echocardiography were reduced in patients with DCM, but were more pronounced in group 2. Doppler parameters of diastolic ventricular filling were differently affected in both groups with DCM. In group 1 there was a reduced contribution of the early diastolic phase to ventricular filling (FE/FA) (contr.: 2.29 +/- 0.99 vs gr. 1: 1.40 +/- 0.45; p less than 0.05) and a reduced early peak Doppler velocity, indicating an impaired ventricular relaxation. In group 2, as compared with controls and group 1, there was an increased ratio of early/late diastolic peak velocities (VE/VA) (contr.: 1.49 +/- 0.54 vs gr. 2: 2.32 +/- 1.37; p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Flow Velocity↗

PubMed1991

Assessment of ventricular function with an ambulatory left ventricular function monitor.

Changes in ventricular function caused by activities of daily living, including standing, walking, stair climbing, and mental stress, were evaluated using a radionuclide device that recorded left ventricular function on a beat-by-beat basis. The ambulatory monitor was positioned over the patient's left ventricle after a gated blood pool scan. Monitoring revealed a 10% increase of left ventricular ejection fraction from baseline to brisk walking, an 18% increase during stair climbing, and a 6% increase with mental stress. In some subjects, however, the increase in ejection fraction during mental stress exceeded that during exercise.

Activities of Daily Living↗

PubMed1990

[The prognostic value of liver function tests--clinical aspects, laboratory chemical parameters and quantitative function tests].

In view of increasing therapeutic possibilities interest focuses on prognosis of liver cirrhosis. Until nowadays studies on prognosis revealed significant importance only for some parameters: Ascites, encephalopathy and portal hypertension as signs of decompensation, bilirubin, albumin and prothrombin time as laboratory indices of decreasing liver function. The commonly used Child-Pugh-score is based on these parameters and allows a reasonable classification of diseased patients. Cholestasis and inflammation seem to be of minor prognostic importance. Assessment of liver function by quantitative tests is desirable (e.g. aminopyrine breath test, bile acids). The prognostic value, however, has not yet been proven in large studies. Use of these tests should therefore be restricted to studies (prognosis, therapy, indication to liver transplantation).

Hepatic Encephalopathy↗

PubMed1989

Origins of chloride and bicarbonate secretory defects in the cystic fibrosis pancreas, as suggested by pancreatic function studies on control and CF subjects with preserved pancreatic function.

Pancreatic function studies were performed under continuous intravenous stimulation with secretin and cholecystokinin (0.125 mu/kg/min) in 40 patients with CF who had no evidence of steatorrhea and 69 control subjects without CF, who also lacked evidence of steatorrhea. A total of 41 studies in CF patients and 74 in control subjects were analysed for trypsin, electrolyte, and water secretion. 51% of the CF and 51% of the control tests showed trypsin secretion responses between 1000 mu/kg/hr (the lower limit of the normal range) and 2695 mu/kg/hr, while 16.2% of the control tests exceeded this range. Secretion of water and electrolytes, including both chloride and bicarbonate, was significantly lower in the CF subjects when compared to the appropriate controls in the normal and subnormal trypsin output range. Chloride-bicarbonate ratios, although higher in subjects with evidence of pancreatic damage, were identical in CF and control studies. A specific ductal lesion in CF which altered the balance of acinar (predominately chloride) and ductal (predominately bicarbonate) secretion, or encouraged the equilibration of ductal fluid with plasma in the distal ducts, would increase chloride-bicarbonate ratios, as in the subjects with reduced trypsin secretion. Since this did not occur in the patients with normal function, our results suggest that chloride and bicarbonate secretions are impaired to a similar extent in CF, possibly through a dependence on the same phenotypic abnormality.

Bicarbonates↗

PubMed1989

[Role of prostanoids in the control of renal function in normal potassium balance and in acute experimental potassium depletion. 4. Relation of extrarenal parameters, renal function parameters and urinary excretion of prostanoids].

The renal function has been evaluated by clearance (cl.) method during hypotonic polyuria and successive moderate antidiuresis induced by a low dose of lysine-8-vasopressin; four 15 min and two 60 min cl. periods were performed, respectively. Glomerular filtration rate was estimated by creatinine cl.; the osmotic cl. (Cosm, CH2O), the absolute and fractional excretions of water, sodium, potassium and chloride were determined by usual methods. The urinary concentrations of PGE2, 6-keto-PGF1 alpha (6KPGF) and TxB2 were measured by RIA. The study protocol was applied in normal potassium balance and experimental potassium balance (KD), both in absence and presence of indomethacin. In KD groups with a potassium cumulative deficit of 198.4 +/- 22.2 meq (D3; n = 6) during polyuria significant correlations are consistent with the hypothesis that the lower the plasma potassium concentration is the higher the urinary chloride excretion and the inhibition of distal fractional chloride reabsorption. Moreover, by utilizing the polyuria and antidiuresis data pool, the effects of urine flow rate changes on PGE2 and 6KPGF urinary excretions are blunted as compared to normal potassium balance (n = 14). After indomethacin treatment (D3.I) the following functional relationships are disclosed: a) the lower the kaliemia is the lower the urinary chloride and potassium excretions and the higher the fractional isosmotic reabsorption; b) the lower the urinary potassium excretion is the lower the urinary chloride excretion. In both D3 and D3.I experimental groups the positive correlation between urinary chloride excretion and urinary potassium excretion is significant.

6-Ketoprostaglandin F1 alpha↗

PubMedDate not supplied

Reference values and modelling of lung function development as a transcendent function of age, body height and mass.

We present new lung function reference values based on an investigation of 1024 healthy subjects aged 6-81 years. The dependent variables, i.e. VC, FEV1, RV, FRC, TLC, PEF, MEF50 and MEF25 are expressed as transcendent functions of age, body height and mass. A single equation covers the age range from 6 to 81 years and reflects certain phenomena such as growth, maturation, ageing, sex differences and the undermass-overmass effect. This allows a more accurate determination of individualized reference values and normal limits.

Adolescent↗

PubMed1977

Grip function of the healthy hand in a standardized hand function test. A study of the Rancho Los Amigos test.

In an experimental study 30 healthy subjects performed the tests of prehensile function in the Rancho Los Amigos test. The subjects were allowed a free choice of grip instead of those prescribed when the test is used for clinical purposes. The hand-grips were filmed and registered by means of a descriptive code system and the results were subjected to automatic data processing. The results showed that healthy subjects performing the RLA test used a stereo-typed grip pattern as a consequence of the uniform purpose of the hand-grips. Comparison with the results from a standardized meal study in the same subjects showed that functional assessment of a patient with a test of this type is not directly applicable to integrated daily activities, as several of the hand-grips most frequent in daily activities were rarely used. Comparison with types of grip prescribed for clinical use of the test showed that normal subjects often did not spontaneously handle the objects in the manner intended by the test.

Activities of Daily Living↗

PubMed1980

[Physiopathological studies of thyroid function in the calf. 1. Diagnosis of thyroid function in the calf].

Clinico-chemical and radiometric methods, common in routine diagnosis in human medicine for in-vitro assessment of thyroid function, were tested for their applicability to calf. The assessment of protein-fixed iodine and of iodine extractable from stock, the thyroxine test, the tri-iodothyronine test, the tri-iodothyronine radio-immuno assay, and the effective thyroxine ratio test, basically, were applicable to diagnosis of thyroid function in calf. The thyrotrophin releasing hormone test, in conjunction with efforts to determine peripheral thyroid gland hormone concentration (in particular tri-iodothyronine), was also applicable to calf, although thyroid stimulation hormone with radio-immuno assay, another procedure in human medicine (specificity of thyroid stimulation hormone antibody), proved unsuitable for the determination of bovine thyroid stimulation hormone.

Animals↗

PubMed1994

Function of adhesion molecules lymphocyte function-associated antigen-3 and intercellular adhesion molecule-1 on human epidermal Langerhans cells in antigen-specific T cell activation.

In addition to the interaction between the TCR and the MHC/Ag complex on the APC, optimal T cell activation also requires interaction between adhesion molecules on the APC and their ligands on T cells. We determined the presence of adhesion molecules on human epidermal Langerhans cells (LC) and their role in Ag-specific T cell activation. Freshly isolated LC did not display ICAM-1 (CD54), ICAM-2, LFA-1 (CD11a), and LFA-3 (CD58), as detected by double-color FACS analysis, using HLA-DR expression for LC identification. Upon culture, LC clearly expressed ICAM-1 and LFA-3, both already detectable after 1 day, reaching a plateau at day 2. ICAM-2 and LFA-1 were undetectable on cultured LC and attempts to induce this expression by different culture conditions remained unsuccessful. mAb against ICAM-1, LFA-1, LFA-3, and CD2, continuously present during culture, inhibited the T cell proliferative response to Candida albicans presented by cultured LC. Pretreatment of LC and/or T cells with mAb indicated that anti-ICAM-1 and anti-LFA-3 inhibited at the LC level, whereas anti-LFA-1 and anti-CD2 inhibited at the T cell level. The mAb-induced inhibition was dose-dependent, but a total blockade of the response was never achieved. Time-course observations revealed that ICAM-1 and LFA-3 on LC only functioned during the initiation phase of T cell activation. Our study demonstrates that both ICAM-1 and LFA-3 on LC considerably contribute to the generation of a T cell response. The high expression of these accessory molecules enable LC, at least in part, to perform their powerful Ag-presenting function.

Antigen-Presenting Cells↗

PubMed1995

[Lung transplantation and respiratory function tests. Functional outcome in the presence and absence of chronic rejection].

Between may 1988 and march 1993, twenty five double lung transplants were performed and five heart/lung transplants. Lung function tests (EFR) were performed on these patients for a period of 19.2 +/- 3.4 months. The aim of this study was two-fold. First, to report our overall results and to estimate the role of the single breath nitrogen washout test (N2 slope) in the early detection of chronic rejection (RC). Secondly, to assess the diagnostic value of EFR in the discrimination of acute rejection (RA) and of cytomegalovirus pneumonitis (PCMV). There were 41 episodes of RA and 21 episodes of PCMV and they were analysed as a function of the presence or absence of RC. In the absence of RC, RA produced no change in EFR and PCMV was accompanied by a pure restrictive ventilatory defect. On the otherhand, RA and PCMV lead to a worsening of obstruction and an hypoxaemia which characterises RC. The diagnosis of RC was made, on average, 14.4 +/- 2.9 months after surgery. However, from the sixth month the nitrogen slope was significantly increased and other parameters of EFR (particular maximal flows at low lung volume) remained normal. Thus, our results suggest that the N2 slope, measured in the absence of any evidence of acute rejection, constitutes an early test for chronic rejection. When its pathological rise is compared to the results of histology (presence or absence of RC), it shows a sensitivity of 0.94 and a specificity of 0.93.

Acute Disease↗

PubMed1994

99Tcm-cystine, a renal function and imaging agent: a comparative study in dog with 131I-hippurate and 99Tcm-glucoheptonate to evaluate its functional and imaging characteristics.

99Tcm-cystine, which has been proposed as a renal radiopharmaceutical for evaluating renal morphology and function in a single experiment, is compared with 131I-orthoiodohippurate (OIH) with respect to its renal clearance and extraction parameters and with 99Tcm-glucoheptonate (GHA) regarding its imaging characteristics. In spite of its comparable renal accumulation with 131I-OIH, its clearance (10.1 +/- 1.0 ml min-1 kg-1) was lower than that of 131I-OIH (21.5 +/- 0.9 ml min-1 kg-1) but was higher than that of 125I-iothalamate (5.4 +/- 0.6 ml min-1 kg-1). Extraction efficiencies of 99Tcm-cystine, 131I-OIH and 125I-iothalamate were 39 +/- 5, 64 +/- 4 and 27 +/- 3, respectively. The glomerular filtration components of 99Tcm-cystine and 131I-OIH were 26 and 16% of their respective clearances. In probenecid-treated animals the clearance of both agents was affected to a similar extent and fell to half of their respective control values, whereas tubular secretory components were found to be 19 and 31% of the controls. The kidney images obtained with 99Tcm-cystine were superior to those obtained with 99Tcm-GHA at different time points. Therefore, considering both renal function and imaging properties of 99Tcm-cystine it appears that this radiopharmaceutical offers some definite advantages over the currently available renal agents and commands further study.

Animals↗

PubMed1993

Accessory cell function of keratinocytes for superantigens. Dependence on lymphocyte function-associated antigen-1/intercellular adhesion molecule-1 interaction.

A growing body of evidence points to a role for epidermal keratinocytes as active participants in immunologic reactions. Inasmuch as certain T cell-mediated skin diseases, such as psoriasis and atopic dermatitis, are triggered by microbial infection, we asked whether multipassaged human keratinocytes could provide the costimulatory signals necessary to induce autologous T cell proliferation in response to bacterial-derived super-antigens. On exposure to IFN-gamma, keratinocytes are induced to express HLA-DR and HLA-DQ class II MHC Ag, and the lymphocyte function-associated Ag-1 counter-receptor intercellular adhesion molecule-1 (ICAM-1). This change in keratinocyte phenotype is accompanied by the ability of these cells to support T cell proliferation induced by two different bacterial-derived superantigens, staphylococcal enterotoxins A and B. Superantigen-driven proliferation in the presence of IFN-gamma-treated keratinocytes was significantly inhibited (70-90% reduction) by mAb against the LFA-1 alpha- or beta-chain or ICAM-1. Proliferation was not inhibited by mAb against the CD28 ligands BB-1 or B7, even though these keratinocytes express BB-1. In addition to previous defined roles for class II MHC Ag, stimulation of LFA-1 on the T cells by ICAM-1 on the keratinocytes also plays an important costimulatory role in this superantigen-mediated response. The accessory cell capability of keratinocytes was not unique to superantigen driven responses as PHA, as well as anti-CD3 mAb also induced vigorous T cell proliferation when IFN-gamma-treated keratinocytes were added. However, IFN-gamma-treated keratinocytes consistently failed to provoke an allogeneic response. These data demonstrate that 1) keratinocytes can serve as accessory cells for T cell proliferation using a variety of different stimuli, 2) the LFA-1/ICAM-1 interaction plays a major role in keratinocyte-mediated costimulation, and 3) previous reports in which IFN-gamma-treated keratinocytes failed to support T cell proliferation to nominal or alloantigens, may reflect impaired Ag presentation via class II MHC molecules, rather than lack of necessary costimulatory signals. These findings highlighting the accessory cell function of keratinocytes may have implications for our understanding of the pathogenesis of immunologic disorders of the skin.

Antibodies, Monoclonal↗

PubMed1995

A comparison of the effect of enalapril and metoprolol on renal function, potassium balance, lipid profile, cardiac function, exercise tolerance and quality of life in hypertensive dialysis patients.

26 patients with hypertension while on hemodialysis or continuous ambulatory peritoneal dialysis for end-stage renal diseases were treated first with enalapril and then changed to metoprolol. Both drugs were shown to be similarly effective in controlling blood pressure. There was no difference between the two drugs in their effects on renal function, potassium balance, lipid profile, cardiac function, exercise tolerance, and quality of life. Mild worsening of anemia was observed during treatment with enalapril. No serious side effects were reported. Use of enalapril is safe in the treatment of hypertension in dialysis patients.

Adult↗