bluuebunny/crossref_metadata_2025 huggingface dataset:
Focal Cerebral Pathology Presenting as Tonic Seizures
Authors: Patel Hema , Smith Jodi , Garg Bhuwan
Published: June 2007

We report a case of a 14-year-old boy with a dysembryoplastic neuroepithelial tumor and mental retardation with intractable seizures, which were demonstrated to be predominantly tonic seizures by video-electroencephalography (EEG). He did not have any electrographic evidence of Lennox-Gastaut syndrome. Head magnetic resonance imaging (MRI) revealed a right parietal dysembryoplastic neuroepithelial tumor. He has been seizure free since surgical removal of the tumor. Clinicians need to be aware that tonic seizures can be associated with an underlying focal pathology that might be treatable. (J Child Neurol 2006;21: 813—816; DOI 10.2310/7010.2006.00186).
Different Additional Risk Factors for Cerebral Infarctions Associated With the Factor V Leiden Mutation in a Family
Authors: Vagiakou Eleni A. , Voudris Konstantinos A. , Dimitriou Yvonne , Skardoutsou Angeliki , Mastroyianni Sotiria
Published: June 2007

Several cases with cerebral infarctions associated with the factor V Leiden mutation have been reported. However, bearing in mind the large number of asymptomatic individuals with the factor V Leiden mutation, additional risk factors for cerebral infarctions should be considered. In this report, two siblings with cerebral infarctions associated with a combination of heterozygous factor V Leiden mutation and different additional exogenous and endogenous thrombogenic risk factors are described. Respiratory problems in the perinatal period and increased lipoprotein (a) concentrations in the first patient and an episode of gastroenteritis from Shigella infection and persistent high titers of serum anticardiolipin and β2-glycoprotein I antibodies in the second patient were recorded as additional thrombogenic risk factors. Furthermore, both patients were found to be heterozygous for the methylenetetrahydrofolate reductase gene C677T mutation. These findings suggest that even in the same family, different additional thrombogenic risk factors can be present in infants with cerebral infarctions associated with the factor V Leiden mutation. An extensive search of additional circumstantial and genetic thrombogenic risk factors should be useful for prophylaxis and prognosis of these infants with cerebral infarctions associated with the factor V Leiden mutation and of their related family members. To our knowledge, the second patient in this study is the first patient reported to have cerebral infarctions associated with the combination of the factor V Leiden mutation and persistent high titers of serum β2-glycoprotein I antibodies. (J Child Neurol 2006;21:903—907; DOI 10.2310/7010.2006.00198).
Transient Nonketotic Hyperglycinemia and Defective Serotonin Metabolism in a Child With Neonatal Seizures
Authors: Lin Foong-Yi , Gascon Generoso G. , Hyland Keith , Chugani Harry , Chugani Diane
Published: June 2007

Neonatal nonketotic hyperglycinemia is usually fatal or, less commonly, severely developmentally disabling, whereas transient nonketotic hyperglycinemia has usually been followed by normal development. We report a boy who had transient neonatal nonketotic hyperglycinemia but a coexistent disorder of serotonin metabolism manifested by initially low cerebrospinal fluid 5-hydroxyindoleacetic acid (which later normalized), low whole blood serotonin, and decreased platelet serotonin uptake. He survived the neonatal period but was neurodevelopmentally delayed and developed an autistic-like disorder. Later, his positron emission tomographic (PET) scans with α[11C] methyl-L-tryptophan revealed a pattern characteristic of autistic children. Although we know of no link between glycine and serotonin metabolism, and our patient had low, rather than high, central and peripheral serotonin, this case might represent a novel infantile disorder that affects both the glycine and serotonin neurotransmitter systems. (J Child Neurol 2006;21: 900—903; DOI 10.2310/7010.2006.00204).
Acute Necrotizing Encephalopathy of Childhood in Non-Asian Patients: Report of Three Cases and Literature Review
Authors: Mastroyianni Sotiria D. , Gionnis Dimitrios , Voudris Konstantinos , Skardoutsou Angeliki , Mizuguchi Masashi
Published: June 2007

Acute necrotizing encephalopathy of childhood is a novel type of parainfectious encephalopathy with a racial and geographic predilection, rarely reported from other than East Asian areas. The objective was to describe the clinical, imaging, and other laboratory findings of non-Asian patients with acute necrotizing encephalopathy. Data were collected from three patients diagnosed in Athens over a 4-year period plus 16 cases reported from other European and North American countries. One of the Greek children died, and the other two had a normal outcome. A neuropathologic examination in the fatal case showed edematous necrosis without inflammatory, reactive, or proliferative changes. Data from Greek and other non-Asian patients support the homogeneity of the disease worldwide. (J Child Neurol 2006;21:872—879; DOI 10.2310/7010.2006.00210).
Childhood Encephalitis in Crete, Greece
Authors: Ilias Anestis , Galanakis Emmanouil , Raissaki Maria , Kalmanti Maria
Published: June 2007

This study included all 18 cases of children hospitalized for encephalitis in the referral university hospital of Heraklion, Crete, Greece, during the 5-year period from 2000 to 2004. Encephalitis was attributed to viral infection (echovirus, herpes simplex virus 1, varicella-zoster virus, cytomegalovirus, and influenza A) in eight children and to bacteria (Mycoplasma pneumoniae, group A β-hemolytic streptococcus, and Rickettsia typhi) in a further five cases. Multiple hyperintense brain lesions on magnetic resonance imaging (MRI) were associated with a severe clinical presentation but not with a guarded long-term outcome. Five children still presented with mild to moderate sequelae after 1.5 to 5.3 (median 4.0) years. Our findings confirm the elimination of measles, mumps, and rubella—associated encephalitis in the postvaccine era. MRI appeared to be of great diagnostic value. Although no fatalities were observed, deficits did persist in several patients. (J Child Neurol 2006;21:910—912; DOI 10.2310/7010.2006.00217).
Lobar Asymmetries in Subtypes of Dyslexic and Control Subjects
Authors: Zadina Janet N. , Corey David. M. , Casbergue Renee M. , Lemen Lisa C. , Rouse Jeffrey C. , Knaus Tracey A. , Foundas Anne L.
Published: June 2007

Reading involves phonologic decoding, in which readers ``sound out'' a word; orthographic decoding, in which readers recognize a word visually, as in ``sight reading''; and comprehension. Because reading can involve multiple processes, dyslexia might be a heterogeneous disorder. This study investigated behavior and gross lobar anatomy in subtypes of dyslexic and control subjects. Subjects aged 18 to 25 years with identified reading problems and a group of healthy controls were given cognitive and behavioral tests and volumetric brain magnetic resonance imaging (MRI). Because atypical cerebral laterality has been proposed as a potential neural risk for dyslexia, dyslexic and control subjects were compared on anatomy of gross lobar regions. On asymmetry quotients, no significant differences were found between groups. Examination of the percentage of total brain volume of each structure revealed that control and dyslexic subjects were significantly different (P = .018). Dyslexic subjects had a larger percentage of brain volume than did the controls in the areas of total prefrontal (P = .003; 9.30% larger) and superior prefrontal (P = .004; 11.48% larger region). A Pearson correlation was performed to investigate whether a relationship existed between behavioral measures and either volumes of total prefrontal and total occipital regions or asymmetry quotients. A significant positive relationship between the left total occipital and word identification performance existed (R = .452, P = .045). Because it is believed by some that dyslexia occurs in varying degrees of severity, and because one of the research questions in this study is whether anatomy relates to severity or to distinct biologic groups, subjects were grouped according to both the nature and distinct pattern of reading or language performance and the degree of deficit. A battery of reading tests revealed five clinical subgroups of control (two) and dyslexic (three) subjects. These subgroups were statistically different on all cognitive and behavioral measures. When asymmetry was investigated across subgroups, significant differences between
Novel Mutation Causing Partial Biotinidase Deficiency in a Syrian Boy With Infantile Spasms and Retardation
Authors: Mikati Mohamad A. , Zalloua Pierre , Karam Pascale , Habbal Mohamad-Zuheir , Rahi Amal C.
Published: June 2007

We report a case of partial biotinidase deficiency (plasma biotinidase levels: 1.30 nm/minute/mL) in a 7-month-old boy who presented with evidence of perinatal distress followed by developmental delay, hypotonia, seizures, and infantile spasms without alopecia or dermatitis. His neurologic symptoms improved markedly on biotin supplementation and antiepileptic drug therapy. DNA mutational analysis revealed that the patient was homozygous for a novel E64K mutation and his parents were heterozygous for the same mutation. Whereas preexisting perinatal distress probably contributed to the severity of the patient's symptoms, the described mutation is novel and is possibly responsible for at least some of his clinical manifestations. (J Child Neurol 2006;21:978-981; DOI 10.2310/ 7010.2006.00200).
Novel Mitochondrial DNA Transversion Mutation in Transfer Ribonucleic Acid for Leucine 2 (CUN) in a Patient With the Clinical Features of MELAS
Authors: Abu-Amero Khaled K. , Ozand Pinar T. , Al-Dhalaan Hesham
Published: June 2007

We describe an 11-year-old Saudi boy who had an encephalopathy suggestive of mitochondrial encephalomyopathy with lactic acidosis and strokelike episodes (MELAS). We screened his entire mitochondrial DNA coding region and detected one novel transversion point mutation at nt-12299 A > C in the transfer ribonucleic acid for leucine 2 (CUN) that is located in the anticodon loop. We believe that this mutation is the cause of his disease condition. (J Child Neurol 2006;21:971—972; DOI 10.2310/7010.2006.00208).
Occurrence of and Mortality From Childhood Neuronal Ceroid Lipofuscinoses in Norway
Authors: Augestad Liv Berit , Flanders William Dana
Published: June 2007

The aim of this study was to estimate the prevalence of, incidence of, and survival from childhood neuronal lipofuscinoses in Norway. All children with neuronal ceroid lipofuscinoses living in Norway are referred to the Tambartun National Resource Centre for the Visually Impaired. We based the data collection on the medical records at Tambartun. We identified 70 children with neuronal ceroid lipofuscinoses who were born in Norway from 1957 to 1998. Seven had a diagnosis of late infantile neuronal ceroid lipofuscinoses, and 63 had the juvenile form of neuronal ceroid lipofuscinoses. In 2005, the prevalence of childhood neuronal ceroid lipofuscinoses was 8.3 per million inhabitants in Norway, and all children were diagnosed with the juvenile form. The average annual incidence rate of childhood neuronal ceroid lipofuscinoses was 1.8 per 100,000 live births using the years from 1957 to 1978 and 3.9 using the years from 1978 to 1999. The trend in incidence increased at an annual rate of about 3.3% per year (P = .001), averaged over this period. Restricted to the most recent period (1967—1998), the trend was much weaker (1.4% increase per year; P = .3), and confidence intervals included the possibility of no trend. The median age at death of children diagnosed with late infantile neuronal ceroid lipofuscinoses was 12 years (95% confidence interval 9—14) and 26 years (95% confidence interval 25—30) for children diagnosed with the juvenile form. The results did not support the hypothesis that children with neuronal ceroid lipofuscinoses born in 1975 or later lived longer than those born from 1957 to 1975 (relative risk 1.0, 95% confidence interval 0.36—2.8). Mortality was similar for both genders (hazard ratio 0.97, 95% confidence interval 0.4— 2.2). (J Child Neurol 2006;21:917—922; DOI 10.2310/7010.2006.00215).
Association of Optic Nerve Hypoplasia With Mitochondrial Cytopathies
Authors: Taban Mehryar , Cohen Bruce H. , Rothner A. David , Traboulsi Elias I.
Published: June 2007

Ocular complications are common in the mitochondrial cytopathies and include optic atrophy and retinal degeneration. We retrospectively reviewed 80 patients with nonsyndromic mitochondrial cytopathies (ie, not Kearns-Sayre syndrome, myoclonus epilepsy associated with ragged red fibers [MERRF], mitochondrial encephalomyopathy, lactic acidosis, and strokelike episodes [MELAS], neuropathy ataxia and retinitis pigmentosa, Leigh disease, maternally inherited diabetes and deafness, and myoneurogastrointestinal disorder and encephalopathy) and found 10 cases of optic nerve hypoplasia. Optic nerve hypoplasia occurs in at least 12% of patients with nonsyndromic mitochondrial cytopathies. Although the exact pathogenesis of optic nerve hypoplasia in the context of mitochondrial cytopathy is unknown, we postulate that it is the result of excessive apoptosis during embryonic ganglion cell and/or axonal development from abnormal mitochondrial function and cellular energy metabolism. (J Child Neurol 2006;21:956—960; DOI 10.2310/7010.2006.00240).
Advances in the Management of Tachyarrhythmias
Authors: Herre John M.
Published: June 2007

Recent developments of both diagnostic and therapeu tic techniques in the management of tachyarrhythmias have broadened the options available to physicians car ing for patients with tachyarrhythmias. Newer diag nostic methods allow more precise identification of the arrhythmia and better understanding of its mechanism. Long-term epidemiologic studies have identified groups of patients who do and do not require antiarrhythmic therapy. Antitachycardia pacemakers and automatic im plantable defibrillators allow effective treatment for pa tients for whom drugs were ineffective or in whom in tolerable side effects developed. Finally, several new antiarrhythmic agents have become available recently. Proper use of these new techniques and drugs requires greater understanding of the pathophysiology of cardiac arrhythmias.
Lactic Acidosis: An Update
Authors: Kreisberg Robert A.
Published: June 2007

Lactic acidosis is an etiologically and biochemically heterogeneous disorder that is due to the overproduc tion of lactic acid or the underutilization of lactate. It occurs with disorders in which tissue oxygenation is impaired (Type A) and with disorders in which it is not (Type B). Lactic acidosis is an anion-gap metabolic acidosis in which the lactate concentration is greater than or equal to 5 mM and the systemic pH is less than 7.30. Treatment is largely empiric and generally unsatis factory. The use of sodium bicarbonate in lactic acidosis is currently controversial. The adverse effects of bicar bonate and the beneficial effects of dichloroacetate in experimental models of lactic acidosis are reviewed.
Central Venous Catbeterization: A Comprehensive Review, Part II
Authors: Seneff Michael G.
Published: June 2007

In Part I of this article, the indications and contraindica tions of central venous catheterization were reviewed, and the antecubital, external jugular, and femoral vein routes discussed. In Part II, the internal jugular and sub clavian vein routes for central venous catheterization are reviewed, and an overview of catheter maintenance and infection control presented. The internal jugular vein and subclavian vein are the two most useful sites for central venous access. There is greater experience with the subclavian vein, and it is largely because of a perceived high complication rate associated with this approach that the internal jugular vein was cultivated as an access route in adults. The debate remains as to which route is preferable. In reality, each method has advantages in a given clinical situation.
Burn Wound Sepsis
Authors: Hansbrough John F.
Published: June 2007

Wound sepsis remains perhaps the most feared sequela in the patient who has suffered major burn injuries and leads to overwhelming mortality among patients with extensive burn wounds. The presence of large areas of devitalized, necrotic tissue, coupled with the profound immunosuppression that usually follows major injury, sets the stage for rapid microbial proliferation in the wound; when microbes invade subjacent, previously vi able tissues, invasive burn wound sepsis is defined. Top ical antimicrobial drugs probably have only a limited effect in preventing wound sepsis, and organisms now frequently emerge that are resistant to the commonly used topical agents. Salient factors in the diagnosis and treatment of invasive wound sepsis are discussed in this review. Prevention of wound sepsis, however, is one of the primary objectives of current burn care. Early burn wound excision and immediate wound closure with autograft or a suitable biologic dressing has emerged as the best means for prevention of generalized wound sepsis.
Hyperkalemia: Disorders of Internal and External Potassium Balance
Authors: Williams Mark E. , Rosa Robert M.
Published: June 2007

The serum potassium level is normally preserved de spite changes in potassium intake and output (the exter nal potassium balance) and changes in its distribution in the body (the internal potassium balance). External potassium homeostasis depends primarily on renal ex cretion of the daily exogenous potassium burden. Inter nal homeostasis depends on the extrarenal regulation of potassium. Skeletal muscle and liver are the dominant sites of that regulation. The two chief regulators of inter nal balance are insulin and catecholamines, the latter acting through β-adrenergic receptors. Acid-base bal ance and the cellular potassium content are other important regulators of internal balance. The major disorders of external balance are renal failure, hypo reninemic hypoaldosteronism, interstitial nephritis, and a variety of drugs that impair renal potassium excretion. The major disorders of internal balance are diabetes mellitus, acidosis, medications, and release of endoge nous potassium during vigorous exercise, traumatic muscle injury, or tumor lysis chemotherapy. These dis orders frequently result in troublesome elevations of serum potassium in the intensive care setting. Their re view in this article includes a thorough discussion of the evaluation and proper management of the hyperkalemic patient.
Fulminant Colitis and Toxic Megacolon
Authors: Hanan Ira M. , Hanauer Stephen B.
Published: June 2007

Toxic megacolon may be a complication of various forms of fulminant colitis. The high mortality associated with unattended toxic megacolon signifies the impor tance of early detection. The removal of potential pre cipitating factors, along with aggressive medical sup port, may prevent the need for surgical intervention. Treatment of patients with toxic megacolon should in clude immediate resuscitative measures, use of nasogas tric suction, and administration of antibiotic and intrave nous steroids. Vigorous replacement of fluid and blood to stabilize and maintain blood pressure and an ade quate central venous pressure is critical. A period of observation of 24 to 48 hours should be undertaken, during which time clinical assessment and serial radio graphs should be used to gauge improvement. If there is either deterioration or no improvement, surgery should be performed without delay.
Analytic Reviews : Potential New Therapies for Acute Ischemic Stroke
Authors: Wechsler Lawrence R.
Published: June 2007

Evidence from animal models of acute stroke suggests ischemia may be reversible if blood flow is restored in the first few hours. Studies of human stroke using posi tron emission tomography demonstrate areas with re duced blood flow and relatively preserved metabolism, indicating potentially reversible ischemic brain. Resto ration of blood flow during this reversible phase should improve outcome after stroke.

Many therapeutic strategies for treatment of acute ischemic stroke have been proposed, including increas ing collateral flow, removing vascular obstructions, and interfering with the intracellular cascade of events that lead to neuronal cell death. Hypervolemic hemodilution reduces viscosity and increases cerebral blood flow, and this may hopefully raise blood flow above the critical threshold of irreversible ischemia. Naloxone, calcium channel blockers, and glutamate antagonists alter blood flow and influence intracellular events during and after acute ischemia. Thrombolytic therapy restores blood flow by lysis of obstructing clot. These therapies show promise in preliminary studies, but additional ran domized controlled studies are needed.
Lightning-strike Injury
Authors: Hiestand Daniel , Colice Gene L.
Published: June 2007

Although lightning-strike injury is uncommon, it is the cause of death in more people in the United States annu ally than any other natural disaster. Consequently, the emergency medicine specialist and intensivist should be familiar with the special problems of a lightning-strike victim. Lightning is a massive electrical discharge that results from a complex sequence of atmospheric events. When this massive electrical discharge strikes a human being, it causes predictable cardiac and neurological in juries. Synchronous myocardial contraction occurs at the moment of impact and is followed by a variable period of asystole. Prolonged asystole may cause isch emia and ventricular fibrillation. Alternatively, ventric ular fibrillation may occur primarily if the electrical discharge strikes during the vulnerable period of the cardiac cycle. Unconsciousness, depression of respira tory efforts, and seizures are also immediate conse quences of lightning strike. Respiratory arrest is pre sumed to be a consequence of inhibition of the medullary respiratory center. Retrograde and antegrade amnesia, confusion, disorientation, and vasomotor insta bility with transient paralysis of usually the lower ex tremities are commonly seen in lightning-strike victims. Other complications occur more variably, but should be carefully sought by the responsible clinician. These in clude burns at the exit and entrance sites of the light ning strike, eye injuries (e.g., cataracts, corneal lesions, intraocular bleeding), and rupture of the tympanic membrane. Besides describing the pathophysiology of these and other consequences of lightning strike, a com prehensive approach to the initial and long-term man agement of the lightning-strike victim is discussed.
Analytic Reviews : Hyperbaric Oxygen Therapy
Authors: Thom Stephen R.
Published: June 2007

The physiological effects of hyperbaric oxygen extend beyond the elevation of oxygen concentration in body tissues, and clinical data is available to support its use in more than gas bubble diseases. Hyperbaric medicine is discussed within the context of its recognized mecha nisms of action. The experimental data and clinical ex perience for hyperbaric oxygen therapy are reviewed for the following conditions: clostridial myonecrosis, necrotizing soft-tissue infections, chronic refractory os teomyelitis, radiation necrosis, refractory cutaneous ul cerations, compromised skin grafts and flaps, crush in jury and acute peripheral ischemia, carbon monoxide poisoning, arterial gas embolism, decompression sick ness, and thermal burns. Risks associated with hyper baric oxygen therapy are discussed, and cost analysis data are noted for specific conditions.
Prevention, Care, and Treatment of Pressure (Decubitus) Ulcers in Intensive Care Unit Patients
Authors: Herman Lori E. , Rothman Karen F.
Published: June 2007

Pressure (decubitus) ulcers occur in approximately 4% of hospitalized patients. Patients in intensive care units are particularly at risk because they are relatively im mobile. Prolonged pressure, shearing forces, friction, and moisture are all etiological factors. Pressure ulcers may be complicated by infection and, rarely, carcinoma. Prevention depends on excellent nursing care that con centrates on meticulous skin care and relief of pressure. Once a pressure ulcer occurs, alleviation of local pres sure, maintenance of a clean ulcer base, promotion of new skin growth, and attention to nutritional and other medical conditions that might debilitate the patient fur ther are all necessary for healing.
The Role of Nutrition in Weaning from Mechanical Ventilation
Authors: Wilson David O. , Rogers Robert M.
Published: June 2007

The role of nutrition in weaning patients from mechani cal ventilation is receiving increased attention. The net protein catabolism and loss of protein stores that are characteristic of the metabolic response to injury have detrimental effects on skeletal muscle function. Adverse effects of malnutrition on lung function include de creased respiratory muscle function, decreased ventila tory drive, and altered pulmonary defense mechanisms. Nutritional therapy should be considered for patients who are undernourished at the time of initiation of me chanical ventilation as well as for patients who will re quire prolonged ventilatory support. Early administra tion of protein and energy in support of enhanced demands is an important factor in allowing time for stabilization of clinical status, recovery from acute lung injury, and successful weaning from mechanical ven tilation.
Analytic Reviews : Hypoxic Pulmonary Vasoconstriction: Physiology and Pathophysiology
Authors: Cutaia Michael V. , Rounds Sharon
Published: June 2007

Hypoxic pulmonary vasoconstriction is the unique re sponse of the lung circulation to ventilation with hy poxic gas, resulting in an increase in pulmonary arterial pressure and vascular resistance. The site of hypoxic vasoconstriction is the small pulmonary arteries. The hypoxic pressor response optimizes ventilation and per fusion matching and thus preserves arterial oxygen ten sion. The mechanism of this response is not clear, al though considerable knowledge has been gained about its modulation. We review the current state of under standing of the physiology and pathophysiology of hy poxic pulmonary vasoconstriction.
Massive Transfusion in the Intensive Care Unit
Authors: Higgins Martha J. , Klein Harvey G.
Published: June 2007

The transfusion of blood components is a frequent oc currence in intensive care units. Transfusion therapy demands not only a greater ability to meet the needs of acutely ill patients with an enlarging variety of blood components, but also an increasing awareness of previ ously recognized and newly discovered hazards of blood transfusion. Use of the more commonly adminis tered blood components is reviewed, and problems per tinent to the large-volume massively or multiply trans fused patient are discussed.
Comparison of Cimetidine and Placebo for the Prophylaxis of Upper Gastrointestinal Bleeding Due to Stress-related Gastric Mucosal Damage in the Intensive Care Unit
Authors: Karlstadt Robyn G. , Iberti Thomas J. , Silverstein Jeffrey , Lindenberg Leslie , Rright-Asare Peter , Rockhold Frank , Young Michael D.
Published: June 2007

A multicenter, randomized, double-blind, placebo- controlled study was conducted with 87 patients in in tensive care units to study the effectiveness of constant infusions of cimetidine (50 mg/hr) in the prophylaxis of stress-related mucosal bleeding. Fifty-four patients re ceived cimetidine and 33 received placebo. The groups were comparable by age, sex, and severity of illness. One (2%) of the 54 patients receiving cimetidine had upper gastrointestinal hemorrhage and 7 (21%) of the 33 patients receiving placebo had upper gastrointestinal hemorrhage (p = 0.002). The risk of bleeding for every 100 patient days in intensive care units was reduced by 94% in the patients receiving cimetidine. Constant infu sion cimetidine was well tolerated. Only one patient (cimetidine) developed pneumonia during the study, but it was not considered to be related to drug therapy. No patients experienced adverse drug interactions. Two patients (4%) experienced reversible side effects from treatment. Cimetidine, administered as a continuous in travenous 50-mg/hour infusion, is safe and significantly more effective than placebo for preventing upper gas trointestinal bleeding in critically ill patients.
Analytic Reviews : Fluid Resuscitation in Head Injury
Authors: Shackford Steven R.
Published: June 2007

Head injury, either alone or in combination with hy povolemic shock, is the leading cause of traumatic death in this country. Factors contributing to mortality in clude the primary impact injury as well as subsequent ischemia and hypoperfusion. Intravenous fluid therapy is required in all of these patients. However, fluid ther apy may increase brain swelling and cerebral edema formation which could lead to an increase in intracra nial pressure and a reduction in cerebral perfusion pres sure. The use of standard fluid therapy has been ques tioned, and novel therapies involving hyperosmolar and hypertonic solutions are now being investigated. This review covers recent advances in the understanding of the effects of fluid resuscitation on the brain. It also includes a brief summary of the determinants of trans- capillary fluid exchange and a review of relevant cere bral circulatory physiology and the physiological aberra tions produced by brain injury.
Tricyclic Antidepressants in the Intensive Care Unit
Authors: Dec G. William , Stern Theodore A.
Published: June 2007

Tricyclic antidepressants (TCAs) are one of the most commonly prescribed classes of antidepressant medica tions, and they may account for more than 25% of all serious drug overdoses for persons admitted to adult intensive care units (ICUs). TCA overdose is the most common life-threatening drug ingestion in the United States, with an in-hospital mortality ranging from 0.6 to 15%. Manifestations of a significant overdose include anticholinergic effects (fever, mydriasis, tachycardia, and urinary retention), central nervous system toxicity (confusion, agitation, coma, hallucinations, and grand mal seizures), respiratory depression, and cardiovascu lar toxicity (ventricular tachycardia or fibrillation, hypotension, and conduction defects). The principal cardiovascular findings associated with therapeutic doses of TCAs are discussed and grouped into three categories: (1) electrocardiographic changes—sinus tachycardia, repolarization abnormalities, conduction disturbances, and ventricular arrhythmias; (2) mild depression of myocardial contractility; and (3) sudden cardiac death. The therapeutic feasibility and selection of a TCA for patients with preexisting cardiovascular disease is discussed, and current recommendations on the diagnosis and management of TCA overdoses are reviewed.
Severe Liver Disease in Pregnancy
Authors: White Heather , Peters Marion
Published: June 2007

Liver disease is uncommon in pregnant women. It can be divided into disorders that occur only during preg nancy and those that can occur during pregnancy, but are not related directly to pregnancy. Jaundice during pregnancy is relatively rare, occurring in 1 in 1,500 pregnancies [ 1 ]. In this review we briefly discuss normal changes in hepatic physiology during pregnancy and then outline the liver disorders of pregnancy, emphasiz ing those that can be severe and result in admission to intensive care units.
Analytic Reviews : Red Cell Transfusion in a Critical Care Unit
Authors: Ulstad David R. , Godfrey Patricia M. , Robbins Royce , Camilli Anthony E.
Published: June 2007

The acquired immunodeficiency syndrome epidemic and recognition of human immunodeficiency virus transmission by blood products have increased concern over the risks of blood transfusion and generated discus sion on proper indications. To assess current practice with respect to red blood cell transfusion, we examined transfusion practices in a medical-surgical intensive care unit. The extensive clinical and physiological moni toring in this setting allowed us to examine indices of oxygen carrying capacity, oxygen delivery, tissue oxy genation, and their associations with subsequent trans fusion. We were unable to detect changes in hemody namic or tissue oxygenation measurements associated with transfusions. Tissue oxygenation measures were in frequently documented even in the presence of an in dwelling pulmonary artery catheter. Hemoglobin and hematocrit levels showed statistically significant de creases prior to initial and subsequent transfusions. He modynamic and tissue oxygenation indices available in intensive care settings merit further evaluation for use in the assessment of transfusion need.
Analytic Reviews : Radiological Assessment of Central Vascular Volume Status in an Intensive Care Unit Setting
Authors: Celoria Giovanni , Steingrub Jay S. , Teres Daniel , Vickers-Lahti Maureen , Parker Thomas , Vaughan Thomas E.
Published: June 2007

We studied the chest radiographs of 126 patients under going pulmonary artery catheterization. An experienced radiologist, unaware of the patient's clinical condition and results of pulmonary artery catheterization and without review of prior films, evaluated each radiograph focusing exclusively on fluid status, and assigned each one to one of the following four categories: definitely or probably elevated central vascular volume status, or definitely or probably nonelevated central vascular vol ume status. This assessment was then compared with the "official" reading, performed with knowledge of the patient's clinical status and with availability of previous chest radiographs. The radiologist's prediction was more accurate than the official report (65% proportion of correct classification vs. 59% ) ( p < 0.05). Patients with actual high pulmonary artery wedge pressure read ings were more difficult to diagnose correctly than pa tients with low or normal pulmonary artery wedge pres sure. In those patients in whom the radiologist felt more confident of his prediction (25% of patients), diagnostic accuracy improved considerably for both the high and normal pulmonary artery wedge pressure groups of pa tients to a proportion of correct classification of 71% and 80%, respectively. Although the radiological assess ment was not accurate enough to replace pulmonary artery catheterization, the official reading can be im proved by focusing on specific radiological features to estimate central vascular volume status.
No Longer a “Frowsy Drudge” Women’s Wardrobe Management: 1880-1930
Authors: Parsons Jean L.
Published: June 2007

The transformation from custom to factory-produced clothing occurred in uneven stages. To acquire clothing, women balanced budget constraints against sewing ability, available time, and fashion issues. They were also usually actively involved in at least some aspect of their own clothing production and often devised complex arrangements to clothe themselves. In this paper, I focus on women’s decision-making in a period of rapidly changing styles, changing markets, and new employment patterns. Analysis of family budget studies, women’s magazines and advice literature, and early home economics studies revealed that although income was important, lifestyle, sewing ability, and a desire to be up-to-date with the latest styles figured prominently. Rapid style changes and increased availability of ready-made clothing changed the standards by which all clothing was judged. Home sewn products, difficult to fit and time-consuming to make, lost prestige when compared to the style and finish of ready-made. Changes permanently altered women’s roles as both producers and consumers of clothing.
Development of an Instrument for a Visual Analysis of Dress from Pictorial Evidence
Authors: Cosbey Sarah , Damhorst Mary Lynn , Farrell-Beck Jane
Published: June 2007

We describe the development of an instrument for visually analyzing women’s daytime clothing styles as depicted in two women’s fashion magazines, The Delineator and Harper’s Bazar, from 1873 through 1912. The instrument was designed for a study examining relative changes in diversity among women’s clothing styles over time. Measures used in previous visual analysis research are reviewed and ways in which these measures were adapted to the new instrument are explained. Instrument validity and methods used in the evaluation of reliability are discussed and findings are reported. Recommendations for further evaluation and uses of the instrument are included.
Strategic Partnerships in the Domestic Textile Complex: Exploring Suppliers’ Perspectives
Authors: Divita Lorynn R. , Cassill Nancy L.
Published: June 2007

A strategic partnership is an alliance between two or more firms in which resources, capabilities, and core competencies are combined to pursue mutual benefits (Hitt, Ireland, & Hoskisson, 1997). The purpose of this pilot study was to examine strategic partnerships within the domestic textile complex. Qualitative interviews were conducted spring 1999 with seven textile complex executives. A two-page interview instrument was developed for data collection, based on a theoretical framework that incorporated both Thibaut and Kelley’s (1959) social exchange theory and the Lorange and Roos (1992) Partners’ Supply Chain Model. Results showed that a) partnerships did exist in the domestic textile complex; b) costs were both financial (for partnership establishment) and relational (conflict of interest between partners); and c) benefits included sharing of private company information, sharing of financial risk, receiving exclusive access to select goods and services, and reduced time to market. Strategic partnerships will play a key role in the future by strengthening communication and business relationships in the domestic textile complex.
The Distribution Channels for Foreign-brand Apparel in China: Structure, Government’s Role, and Problems
Authors: Zhang Li , Dickson Marsha A. , Lennon Sharron J.
Published: June 2007

The Chinese market is attractive to foreign-brand apparel manufacturers who have increasing access to the market as China’s economy has undergone a major transformation from a centrally planned to a market economy and has experienced continued growth. Because of China’s current economic transition and its status as a developing country, the channels for distributing foreign-brand apparel products to Chinese retailers presents special obstacles that foreigners may not anticipate. We detail the distribution channels for foreign-brand apparel in the Chinese market and identify problems in the channels. Because the Chinese government intervenes in the distribution channels in China, the role of the government in apparel distribution channels was also investigated. In-depth interviews were conducted with nine apparel retailers, three government officials, and one foreign-trade agent. Additionally, we surveyed 150 Beijing retailers who sell foreign-brand apparel. Contributions to the research on markets in less developed countries are addressed and implications for U.S. apparel manufacturers are presented.
Benefit Segmentation of the Korean Female Apparel Market: Importance of Store Attributes
Authors: Hong Heesook , Koh Aeran
Published: June 2007

This study identified segments of Korean consumers of female apparel and determined the relative importance of various store attributes. Six hundred and nineteen married women aged 20 to 59, from Seoul completed questionnaires regarding (a) benefits they sought from apparel, (b) importance of attributes of stores selling apparel and (c) personal demographics. Data were reduced using factor analysis, categorized using cluster analysis and analyzed using ϰ2 tests, t-tests and ANOVAs. Three segments of Korean female consumers were identified: brand-oriented (33.2%), budget-oriented (40.4%) and fashion-oriented (26.4%). Interactions between segment and education were significant for the importance of three store attributes: price/variety, discount policy and customer service/convenience. Significant differences among the three segments were also found in importance of information sources/promotion and apparel style.
Apparel Exports from China to the United States: A Marxist Perspective
Authors: Shen Dong , Dickson Marsha A.
Published: June 2007

Chinese and U.S. perspectives on trade are very different and thus can lead to misunderstandings. Although researchers in both countries have analyzed problems in trade relationships, they have done so solely from their own cultural perspectives. Researchers in each country have made little effort to understand the other’s way of thinking about trade between them. In this paper we summarize the history of Chinese apparel trade with the U.S.; outline ways retailers, manufacturers, consumers, and the U.S. government react to Chinese apparel exports; introduce Marx’s theory of political economy which provides the basis for Chinese ideology; and use this theory to analyze trade relationships between China and the U.S. Based on the central tenet of Marxism, that labor is the only source of profit, we argue that the Chinese believe that the U.S. obtains more profit than China, while China loses profit through apparel trade between the two countries. The U.S. profits by indirectly exploiting the Chinese labor force and taking advantage of sophisticated U.S. technology. Suggestions are made to policymakers who negotiate trade agreements so that they might better understand Chinese views.
The Design and Testing of Work Clothing for Female Pear Farmers
Authors: Choi Mee-Sung , Ashdown Susan P.
Published: June 2007

This research was undertaken to develop work clothing for pear farmers in Naju county, Korea. Pear farming is economically important here, but there has been little effort to develop work clothing to improve worker comfort and efficiency. This study presented special problems to the researcher/designer. The subjects were unable to verbalize their needs and were appreciative and accepting of any prototype design with little critical analysis of its function. The researchers adopted methodologies including field observation and in depth interviews to collect data of expert analysis of the prototypes.

Field observation, interviews, and questionnaires were used in Phase 1 of the research to collect data on clothing needs of male and female farmers. Survey results (113 questionnaires, 42 female, 71 male) and a pilot test revealed differences in requirements between females’ and males’ work clothing. Female pear farmers were selected as subjects for the final phases of the study. Four prototype work outfits for female workers (jackets and pants) were developed and tested for fit, mobility, and acceptability in the field. Perception of fit, function, and aesthetics of the four work outfits were evaluated by female pear farmers and expert judges.

The outfits for Korean female pear farmer workers developed and tested in this study have the potential to increase field performance and worker comfort. The concepts employed can be used to develop work outfits for workers in other fields, particularly for workers such as the pear farmers who are not skilled at verbalizing their needs or engaging in critical analysis of prototype garments.
The World Wide Web: An International Textile And Apparel Marketing Tool
Authors: Cone Diana , Perry Charles
Published: June 2007

A major goal of most university programs is to encourage students to capitalize on the entire sequence of professional courses while becoming familiar with the tools necessary for communicating in the global arena. One such tool is the World Wide Web. Many apparel related companies have formed on-line sourcing networks that can be accessed through the World Wide Web to serve as a sourcing and advertising tool for domestic and international markets. Students in textiles and apparel had an opportunity to participate in a special topics course that allowed them to start with a design of an apparel product and implement their ideas by marketing it to international audiences via the Web. The students were highly motivated to put considerable time and energy into the design and implementation of the project. They experienced firsthand how employees must interact and communicate professionally, stay focused on the goals of the company, make decisions quickly, and keep current with technology if they are going to be competitive in this fast changing industry.
Cultural Influences on Chinese Consumers’ Intentions to Purchase Apparel: Test and Extension of the Fishbein Behavioral Intentional Model
Authors: Shen Dong , Dickson Marsha A. , Lennon Sharron , Montalto Catherine , Zhang Li
Published: June 2007

There were two objectives of this study: (a) to test the cross-cultural applicability of the Fishbein Behavioral Intentional Model by studying Chinese consumers’ purchase intentions for apparel made in the United States and (b) to examine whether culture could enhance the validity of the model. Parents (N = 2,017) of students in the public school systems of Beijing, Shanghai, and Guangzhou completed usable questionnaires. Attitude toward purchasing apparel made in the United States (Ab) significantly influenced Chinese purchase intentions for that apparel (BI), but subjective norms (SN) did not. The validity of the Fishbein model may be product dependent, with culturally symbolic products influenced by both attitude and subjective norm, and products less culturally symbolic influenced only by attitudes. Adding cultural components to the Fishbein model enhanced its ability to explain purchase intentions.
Diversity of Daytime Clothing Styles as a Reflection of Women’s Social Role Ambivalence from 1873 through 1912
Authors: Cosbey Sarah , Damhorst Mary Lynn , Farrell-Beck Jane
Published: June 2007

The symbolic interaction theory of fashion proposed by Kaiser, Nagasawa, and Hutton (1995) suggests that, in the instance of transitional societal contexts, an increase in cultural ambivalence is reflected by an increase in the heterogeneity of appearance-modifying commodities that are offered in a capitalistic marketplace. This paper describes research that tested this relationship in the context of women’s daytime clothing styles of the later nineteenth and early twentieth centuries. At this time, society’s views on women’s roles became increasingly ambivalent as women challenged the confines of Victorian domesticity. A visual analysis instrument was used to code women’s daytime ensembles as represented in 252 fashion illustrations from Harper’s Bazar and The Delineator . Spearman rank correlation coefficient was used to test for heterogeneity or diversity trends in the time series data. Results supported the proposed positive relationship between ambivalence and heterogeneity in dress; specifically, fabrics in general and several bodice features showed increasing stylistic diversity as ambivalence about women’s roles increased. In addition, data suggested that diversity was linked to ensemble layering and that shifting areas of diversity may have coincided with shifts in visual emphasis from the skirt to the bodice over the 40-year period.