bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utility of 99mTc‐sestamibi scintigraphy as a first‐line imaging procedure in the preoperative evaluation of hyperparathyroidism
Authors: Caixàs Assumpta , Bernà Lluis , Piera Joan , Rigla Mercedes , Matías‐Guiu Xavier , Farrerons Jordi , Puig‐Domingo Manel 
Published: March 2008

SummaryOBJECTIVE The use of preoperative imaging in patients with hyperparathyroidism remains controversial. Many of the available techniques are insufficiently sensitive and specific to justify their routine use. We have evaluated the Sensitivity and specificity of 99mTc‐sestamibi scintigraphy in the management of patients with different forms of hyperparathyroidism.DESIGN Preoperative imaging evaluation was carried out by sclntigraphic detection of pathological parathyroid glands using 99mTc‐sestamibi as a radiotracer; confirmation of scan findings was obtained surgically.PATIENTS A group of 25 patients with primary (n= 21) or secondary (n=4) hyperparathyroidism were studied. All were considered for surgical treatment.MEASUREMENTS In all cases parathyroid imaging was carried out by 99mTc‐sestamibi scintigraphy together with at least one other imaging technique which included CT‐scan, ultrasonography, MRI or 201TI/99mTc subtraction scintigraphy. Blood tests included measurements of total calcium and PTH.RESULTS 99mTc‐sestamibi scintigraphy correctly localized 20 out of 21 adenomas, giving a sensitivity of 95.2%, markedly higher than that obtained with the other imaging techniques (ultrasonography 75%, 201TI/99mTc subtraction scintigraphy 57.1%, CT‐scan 41.7% and MRI 33%). Of a total of 17 glands identified surgically as hyperplastic and confirmed by pathological examination, 99mTc‐sestamibi scintigraphy showed a positive image in 10, corresponding always to the larger abnormal glands (sensitivity 58.8%, higher than that observed with the other techniques). No false positive images were obtained with 99mTc‐sestamibi. All the ectopic adenomas (n= 3) were identified preoperatively, which contributed significantly to the surgical approach.CONCLUSION In patients with hyperparathyroidism, 99mTc‐sestamibi scintigraphy may be used as the single imaging technique as it shows a very high sensitivity and specificity in the preoperative localization of pathological parathyroid glands; the benefit of localizing parathyroid tissue prior to surgery in cases of ectopic adenomas clearly indicates that when an imaging procedure is required, this technique may be of great help in the management of hyperparathyroidism.
Diagnostic and clinical features in azoospermia
Authors: Foresta C. , Ferlin A. , Bettella A. , Rossato M. , Varotto A. 
Published: March 2008

SummaryBACKGROUND AND OBJECTIVE The recent advances In assisted fertilization and gamete micromanipulation techniques have enabled fertilization in some forms of azoospermia; for example, epididymal sperm aspiration in obstructive azoospermia. Therefore knowledge of the specific degree of testicular damage is of primary importance, since other clinical parameters, such as FSH plasma levels and testicular volume, do not discriminate between the different testiculopathies. in order to further Characterize the specific testicular conditions present in azoospermia, we have examined a large group of azoospermic subjects on the basts of testicular cytological analysis obtained by fine needle aspiration. DESIGN AND PATIENTS One hundred and twenty‐two infertile, azoospermic men were studied by physical examination, FSH radioimmunoassay, testicular ultrasound examination and fine needle aspiration of the testes. Thirty‐five infertile normozoospermic subjects were studied as controls.RESULTS The cytological analysis Identified five different sub‐types in azoospermic subjects: I, Sertoli cell‐only syndrome; II, hypospermatogenesis; III, spermatogonial and/or spermatocytic arrest; IV, spermatidic arrest; and V, normal germ line. The testicular volume was reduced in groups I and II, while the FSH plasma levels were Increased in groups I, II and III, suggesting a primary role of spermatids In the control of FSH secretion.CONCLUSIONS in azoospermic subjects, testicular cytological analysis permits the Identification of different sub‐types and this classification may be very important in determining therapy, particularly the choice between surgical treatment and the hypothetical use of assisted fertilization techniques by retrieval of epididymal or Intratesticular spermatozoa or spermatids.
Clinical efficacy and safety of low‐dose flutamide alone and combined with an oral contraceptive for the treatment of idiopathic hirsutism
Authors: Dodin Sylvie , Faure Nacia , Cédrin Isabelle , Mechain Catherine , Turcot‐Lemay Luclle , Guy Jocelyne , Lemay André 
Published: March 2008

SummaryBACKGROUND AND OBJECTIVE High doses of flutamide, which is the only antiandrogen that specifically blocks the androgen receptor, have recently been used with good clinical results in women with hirsutism. Since regression of hair growth requires long‐term therapy, clinical and economic considerations are important. The use of the lowest efficacious dosage could reduce costs. This study was undertaken to compare safety and efficacy of a low dose of flutamide (125 mg twice daily) alone and in combination with a triphasic oral contraceptive (OC) in women with idiopathic hirsutism.PATIENTS Flutamide was administered orally in a low dose of 125mg twice daily for 12 months alone in women with no risk of pregnancy or during the use of an oral contraceptive.MEASUREMENTS Women were seen every 3 months and were evaluated for hirsutism score, hormone and lipid measurements.DESIGN The study, which was conducted as a prospective open trial, was proposed to patients with idiopathic hirsutism, that is, with serum androgen levels in normal range and LH/FSH ratio less than 2.RESULTS A statistically significant decrease in hirsutism score as compared to baseline was observed after only 3 months with either treatment, flutamlde alone (16.9 ± 1.6 vs 14.2 ± 1.7, P < 0.0001) or the combination of flutamide with OC (15.6 ± 0.8 vs 11.9 ± 0.8, P < 0.001). Three months after cessation of treatment a statistically significant decrease from baseline was observed in the two groups. Nevertheless, at 6 months post‐treatment this decrease was still Significant only in the group who took flutamlde in Combination with an oral Contraceptive. Flutamide alone does not appear to modify the levels of lipoproteins. The association of flutamide with a triphasic formulation significantly Increased the HDL‐C levels. CONCLUSIONS This study shows beneficial effects of a low dose of flutamide in women with idiopathic hirsutism. The addition of an oral contraceptive is judicious to prevent pregnancy and reduce recurrence of hirsutism after cessation of flutamide. Peripheral androgenic blockage does not modify lipid profiles and it might reduce the negative effect of oral contraceptive on HDL‐C levels. The addition of electrolysis delays the recurrence of hirsutism after cessation of flutamide.
Extra‐adrenal effects of metyrapone include inhibition of the 11‐oxoreductase activity of 11β‐hydroxysteroid dehydrogenase: a model for 11‐HSD I deficiency
Authors: Raven P. W. , Checkley S. A. , Taylor N. F. 
Published: March 2008

SummaryBACKGROUND AND OBJECTIVE Previous studies suggesting effects of metyrapone on extra‐adrenal cortico‐steroid metabolism have involved significant alterations in plasma cortisol. We have therefore studied effects of metyrapone on urinary excretion of steroids in a group of patients treated concurrently with hydrocortisone so that changes in plasma cortisol were minimized.DESIGN Replacement doses of hydrocortisone (30 mg/ day) were given concurrently with metyrapone (2–4 g/ day) for 2 weeks. Blood samples were taken and 24‐hour urinary steroid collections were made at baseline and after 1 and 2 weeks of treatment.PATIENTS Subjects were 6 female patients with major depression from a trial of metyrapone as an antidepressant.MEASUREMENTS Urinary steroid profiles were measured by gas chromatography; plasma cortisol and urinary free cortisol were measured by fluorescence immunoassay.RESULTS Plasma cortisol levels were not significantly decreased by treatment, while excretion of 11‐deoxycortisol metabolites increased eightfold after 2 weeks indicating that concurrent hydrocortisone administration had not suppressed the adrenal. Ratios reflecting 11β‐hydroxyl 11‐oxo metabolites of cortisol were significantly decreased, consistent with inhibition of the 11‐oxoreductase activity of 11β‐hydroxysteroid dehydrogenase (11‐HSD). Other changes included significant decreases in the rates of 5αvs 5β and of 20αvs 20β reduction of corticosteroids.CONCLUSIONS Metyrapone has multiple effects on extra‐adrenal corticosteroid metabolism and is the only agent we know of which selectively inhibits 11‐oxoreductase. Metyrapone thus provides a model for 11‐HSD I deficiency and a tool for in‐vitro studies of cortisol‐cortisone Interconversion. The results also suggest mechanisms whereby corticosteroid effects can be regulated separately from corticosteroid synthesis.
EPILEPTOID PSYCHOSIS: A GROUP OF ATYPICAL ENDOGENOUS PSYCHOSES
Authors: Sawa Masaichi 
Published: March 2008

SummaryClinical and EEG studies were performed on 60 cases of a group of atypical endogenous psychoses. The onset of psychic symptoms was sudden after a short period of melancholia, displeasure and insomnia.In a catatonic type, the patients showed a violent catatonic excitement. Their illusion and hallucination were fantastic and fluctuating. They had the delusions of persecution and other delusive ideas. Their thinking was incoherent and fragmental, their affect excitable and explosive. A catatonic stupor followed such a catatonic excitement, whereby patients were apathetic and abulic. However, sometimes abnormally impulsive and fitful behaviors were also observed.In hebephrenic type, the patients had various sorts of hallucinations, delusive ideas of reference, and the delusion of persecution. Their affect showed the loss of ireshness, apathy and indifference. Their thinking was dull and retarded, their psychomotility was lowered even to akinesia.In a manic type, the patients were very hyperkinetic. Their affect was exalted and easily led to anger. On the contrary, the patients of a depressive type showed a colorless, unfresh emotional state. Their psychomotility was hypokinetic and even akinetic. There were some cases of manic‐depressive type and the transitional type to schizophrenic type.To all these types, the cloudiness of consciousness, though varied in degree, was common.In a considerable number of the patients, certain singular tendencies that is called “epileptic personality” were observed. There were also some patients whose relatives had epileptic seizures.The EEGs of all these patients showed epileptic abnormalities either in a rest state or due to Metrazol activation. The activation threshold values of Metrazol were evidently lower than those of schizophrenics, manic‐depressive psychotics and also normal control cases. There were some, among the patient's close relatives, who showed abnormal EEGs by Metrazol activation.
ELECTROPHYSIOLOGICAL STUDY ON THE PERFUSED CAT BRAIN BASED ON ELECTROENCEPHALOGRAPHY
Authors: Yamada Takaharu , Ikeda Hisao 
Published: March 2008

SummaryWe studied electroencephalographically on the perfused cat brains both under glucose‐containing condition and glucose‐free condition, and discussed the relation between the electrical activity and metabolism of the brain. The results were as follows:1. In case of brain perfusion in which an anesthetic agent is used for premedication.a) EEG of both glucose‐containing cases and glucose‐free cases reveal high voltage spindle bursts that appear regularly, speak for that there exists a specific effect of the anesthetic agent used in premedication. From this result we would like to assume that by this perfusion method we stood in position to observe the brain function and metabolism under the influence of anesthetic agent.b) In the two cases of the brain perfusion there could not be recognized any essential differences in their EEG patterns. Shortly, EEG must have come in accord with the changes of brain metabolism.2. The brain perfusion under premedication with d‐tubocurarine, that is, under unanesthetized state.a) In the case of glucose‐containing perfusion it can be divided into three stages according to the changes of EEG of neocortex, and EEG pattern shifts from low voltage fast waves of 25–30c/s, 20–30pV to spindle bursts and then to irregular slow waves. Throughout this period the amygdala reveals low voltage fast waves, indicating dissociation of electrical activity between the amygdala and neocortex. At the hippocampus there appear first regular hippocampal slow waves but in response to the appearance of slow waves in neocortex its regularity is lost by increased fast wave components.b) In the case of glucose‐free perfusion there appear irregular low voltage spindle bursts in the neocortex, low voltage fast waves in amygdala, and likewise there appear in the hippocampus for a certain period of time regular hippocampal slow waves, proving dissociation of the electrical activity between the neocortex and the limbic system.c) In two modes of brain perfusion there can be recognized differences in EEG patterns as well as in the time of EEG appearance, whereby in the glucose‐free perfusion the EEG of neocortex disappears within 10 odd minutes or around 30 minutes after the commencement of the perfusion. In other words, by this method the presence or the absence of glucose in the perfused blood constitutes an important factor in the fluctuations of the neocortex EEG.d) By this method of the brain perfusion, seizure discharge occurs frequently at the site centered around the limbic system when the excitatory level of the brain is low and, as for the brain metabolism, there can be recognized an increase in the oxygen consumption and glucose uptake of the brain after the onset of seizure disharge.
ELECTROGRAPHIC AND EVOKED POTENTIAL STUDIES DURING SLEEP IN THE CAT (THE STUDY ON SLEEP, I)
Authors: Okuma Teruo , Fujimori Masamoto 
Published: March 2008

SummaryIn order to study the neural mechanism underlying the physiological sleep of the cat, especially of the stage of sleep characterized by an electrographic pattern similar to those of the arousal stage and also by disappearance of the postural muscle tone, the spontaneous electrograms of the brain as well as the evoked potentials induced by stimulation of peripheral and central nervous structures were studied in different stages of sleep by using chronically implanted cats.(1) Physiological sleep of the cat was divided into 4 stages: A (arousal), S1 (sleep with 6 to 14 c/sec. spindle burst in the neocortical electrogram), S2 (sleep with spindle burst and high voltage slow activity in the neocortical electrogram) and Sa (sleep with electrographic features similar to those of the arousal stage) stages.(2) It was difficult to differentiate between the low voltage fast activity in the neocortical electrograms during the Sa stage and those during the arousal stage.(3) The hippocampal rhythmic activity was of higher frequency during the Sa stage than in the arousal stage. The frequency became particularly high during the period of the rapid eye movements in the Sa stage.(4) During the Sa stage, spindle burst of 10 to 14 c/sec. activity was frequently observed in the caudal pontine and bulbar reticular formation with or without concomitant spindle burst in the neocortical electrogram. Spindles of 6 to 10 c/sec. were seen less frequently.(5) Evoked potentials in the specific systems induced by direct electric stimulation of the brain decreased amplitude during the S1 and S2 stages with slow background activity and showed the amplitude equal to or higher than the arousal level during the Sa stage. The enhancement of the evoked potential appeared more remarkably when low frequency repetitive stimulation was used. The amplitude of the evoked potential was particularly large during the period of the rapid eye movements in the Sa stage.(6) Evoked potentials in the non‐specific thalamocortical system such as the recruiting response were enhanced in the S1 and S2 stages and suppressed during the Sa stage of sleep.(7) Some components of the evoked potential in the mesencephalic reticular formation showed diminution of amplitude in the S1 and S2 stages and enhancement in the Sa stage, while those in the caudal pontine and bulbar level showed marked suppression during the Sa stage.(8) It was suggested that the Sa stage of sleep might be due to the inhibitory process in the lower brain stem. The hypothesis was presented that during the Sa stage, the structures lying above the mesencephalon was in the state of overactivation due to release from the ascending inhibitory (EEG synchronizing) mechanism of the lower brain stem.
PERFORMANCE OF CONDITIONED AVOIDANCE RESPONSE UPON HYPOTHALAMIC STIMULATION IN CATS
Authors: Ikeda Terutika 
Published: March 2008

ResuméWith the use of 7 adult cats as the subjects of experiment, the performance of conditioned avoidance behavior was observed by implanting electrodes in the hypothalamus, midbrain reticular formation, hippocampus, amygdala, and caudate nucleus under application of electric stimuli. The result reads as follows:A. Facilitation of the learning behavior was observed under relatively weak stimulation from all the electrodes implanted in the hypothalamus.B. When the stimulation was intensfied through the electrodes implanted in the hypothalamus, 1) the action latency was markedly reduced under the stimulation given to the medial part of anterior hypothalamus, but spontaneous avoidance response occurred and the performance of the learning behavior was disorganized. 2) Under the stimulation on the ventromedial, posterolateral part of the hypothalamus, the learning behavior once facilitated was inhibited.C. The stimulation given to the midbrain reticular formation caused facilitation of the learning behavior.D. Inhibition was the common outcome of stimulation given to all other structures (hippocampus, amygdala, and caudate nucleus.)On the basis of the above facts, the facilitation and inhibition of learning behavior was discussed with reference to its formation of motivation.
AN EXPERIMENTAL STUDY OF THE COURSE AND TERMINATION OF THE PROJECTION FIBERS FROM CORTICAL AREAS 4 AND 6 IN THE CAT
Authors: Niimi Kahee , Kishi Seiichiro , Miki Michihiro , Fujita Shiroyuki 
Published: March 2008

SummaryThe axon degeneration following cortical ablation of areas 4 and 6 of the cat has been traced in serial sections impregnated by the Nauta‐Gygax method.The results obtained are as follows:1. The motor cortex projects ipsilaterally to the caudate nucleus, the putamen, the claustrum, the amygdaloid complex, the thalamic nuclei, the subthalamic nucleus, the zona incerta, the field of Forel, the substantia nigra, the red nucleus, the central gray, and to the superior and inferior colliculi. In addition to ipsilateral projections, the motor cortex has a few projections to the contralateral subcortical centers, that is the caudate nucleus, the putamen, the claustrum, the ventral thalamic nucleus, the red nucleus, the central gray and the suparior colliculus.2. Practically no fibers from the motor cortex reach the motor nuclei of the cranial nerves except for the nucleus ambiguus and the nucleus of the accessory nerve, both of which appear to receive only a very few fibers. On the contrary, the motor cortex projects to some sensory nuclei of the cranial nerves such as the main sensory and spinal nuclei of the trigeminal nerve, the lateral and inferior vestibular nuclei and the nucleus of the solitary tract.3. The motor cortex sends fibers profusely to the reticular formation and the nuclei pontis, and to a lesser degree to the gracile and cuneate nuclei.4. The corticospinal tract is composed of the crossed and uncrossed lateral pyramidal tracts, and the crossed and uncrossed ventral pyramidal tracts. The crossed lateral pyramidal tract can be traced as far as the caudal end of the spinal cord, while the uncrossed terminates at the level of the third lumbar segment. The uncrossed anterior pyramidal tract reaches the levels from the third cervical to the second thoracic segment, but the crossed ends at the level of the third cervical segment.5. The corticospinal tract sends fibers to the dorsal horn, the nucleus dorsalis, the intermediate zone and the lateral horn, but sends scarcely any fibers to the ventral horn and the substantia gelatinosa.6. The corticobulbar and corticospinal tracts contain more numerous ipsilateral fibers than is generally thought. Moreover, it should be mentioned that very few crossed fibers appear to recross the midline and end in the dorsal column nuclei and the dorsal horn of the operated side.7. The projection fibers from the motor cortex are generally classified into the pyramidal and the cortical extrapyramidal tracts. However, it is regarded as impossible to distinguish morphologically between these tracts.This work was aided by grants from the Ministry of Education for Scientific Rcsearch, for which the authors wish here to express their deepest thanks.
THE ANACLITIC DRUG‐PSYCHOTHERAPY —A synthesis of psychoanalysis and high dose drugtherapy—*
Authors: Nishizono Masahisa 
Published: March 2008

SummaryPsychopathological states are said to be rooted in frustrated personality development through distorted childhood experiences, which is psychoanalytically designated as fixation. I assume that the nature of the fixation is essentially psychophysiological, and thus a purely psychological maneuver such as psychotherapy alone is not effective in some cases. An integrative approach on the basis of psychophysiological standpoint, however, can easily induce therapeutic regression and assist the movement in treatment. According to this thesis, I instituted “Anaclitic Drug‐psychotherapy” by administrating high doses of Levomepromazine and psychoanalytically oriented psychotherapy as well as anaclitic nursing. Many of the patients who had not responded to various psycho‐ and drug‐therapies in the past were helped by this therapy, even though this did not happen in the same fashion. Those who had a high tolerance for Levomepromazine, which is a strong neuroleptic, did not respond so readily. This phenomenon also indicates the psychophysiological nature of fixation.