bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosis and Treatment of Tuberculosis in Hemodialysis and Renal Transplant Patients
Authors: Vachharajani Tushar , Abreo Kenneth , Phadke Ajit , Oza Umesh , Kirpalani Ashok 
Published: April 2003

<i>Background:</i> The incidence of <i>Mycobacterium tuberculosis</i> in hemodialysis (HD) and renal transplant (RT) patients in developing countries is high. With the resurgence of tuberculosis in the US, insights gained in the diagnosis and treatment of this infection in HD and RT patients in developing countries should be valuable to physicians in the West. <i>Methods:</i> A retrospective study of 40 cases of tuberculosis, 24 in HD patients (24/177, 13.6%) and 16 in RT patients (16/109, 14.7%) diagnosed over a period of 21 months in one center. <i>Results:</i> The clinical features, diagnostic procedures, and management dilemmas of this group of patients are described in this report. Diabetes mellitus was the most common associated disease in both groups of patients. Fever, the most common presenting sign, was persistent low grade in 66.6% of HD patients and high intermittent in 56.2% of RT patients. Fever of unknown origin was only seen in RT patients. Pulmonary involvement was most common in both groups, presenting either as infiltrates or effusions. Tuberculous peritonitis was seen only in HD patients (33.3%). Eight HD patients were treated for tuberculosis for variable periods prior to transplantation, 4 of whom had less than 6 months of therapy. None had a recurrence of tuberculosis after transplantation. Because of the known cyclosporin-lowering effect of rifampicin resulting in an increased cost of immunosuppressive therapy, 13 patients were treated successfully with rifampicin-sparing therapy. <i>Conclusion:</i> Tuberculosis should be included in the differential diagnosis of fever in HD and RT patients, especially if fever is of unknown origin in the RT patient. <i>M. tuberculosis</i> in the renal transplant patient can present with high intermittent fever. Partial treatment of tuberculosis is sufficient prior to renal transplantation but treatment should be continued to completion after transplantation. If the cost of immunosuppressive therapy is prohibitive because of rifampicin, rifampicin-sparing antituberculosis therapy can be successfully employed in RT patients.
Degeneration of Spiral Ganglion Cells in the Chinchilla afterInner H air Cell Loss Induced by Carboplatin
Authors: Takeno Sachio , Wake Mark , Mount Richard J. , Harrison Robert V. 
Published: April 2003

The anticancer drug carboplatin has been used to generate inner hair cell (IHC) lesions in the cochlea of chinchillas. This has provided a valuable model for the study of the relative roles of IHCs and outer hair cells (OHCs). In the present study, we examined the pathological and temporal relationships between the degeneration of the cochlear IHCs and type I spiral ganglion cells (SGCs). A single intravenous dose of 200 mg/m<sup>2</sup> carboplatin produced extensive IHC loss with no apparent effect on the OHCs. The auditory brainstem response threshold was significantly elevated by 2 weeks following treatment and remained stable through 12 weeks. Elevated thresholds were well correlated with morphological lesions. On the other hand, the SGC population progressively decreased from 2 to 12 weeks after treatment, to about half of the control density values. A positive correlation existed between the density of SGC and the number of surviving IHCs. These results indicate that selective damage to IHCs causes a distinct loss of SGCs.
The Effects of Amplitude Modulation on Acoustic Reflex Decay
Authors: Cook Raymond D. , Ferguson Michael O. , Hall III Joseph W. , Grose John H. , Pillsbury III Harold C. 
Published: April 2003

The temporal decay of the acoustic reflex provides the basis for an objective audiological test that differentiates cochlear from retrocochlear pathologies. The classic sign of a neural lesion is a rapid decay of the reflex under conditions of pure-tone stimulation for frequencies of 1,000 Hz and below. This restriction to lower frequencies is due to the fact that even normal ears show decay for higher-frequency signals. At present, it is unclear whether the acoustic reflex decay (ARD) seen in normal ears is related to frequency-specific channels or whether the critical variable is the timing information coded within the channels. This study examined ARD in subjects with normal hearing and middle ear function. The degree of ARD was measured for both modulated and unmodulated carrier frequencies of 500, 1,000, 2,000 and 4,000 Hz with amplitude modulation rates of 50–400 Hz. The dependent variable was the half-life of the decaying reflex (ARD 50%) over a 20-second stimulation interval. Significant ARD was present for high-frequency unmodulated carriers but not for low-frequency carriers. For all listeners, ARD was diminished for all modulated stimuli. The results of this study suggest that resistance to ARD is mediated by both the temporal aspects and frequency of a stimulus.
Effect of Long-Term Noise Exposure on the Developing and Developed Ear in the Rat
Authors: Freeman Sharon , Khvoles Roza , Cherny Lily , Sohmer Haim 
Published: April 2003

There have been reports that the developing ear is more sensitive than the adult ear to noise-induced hearing loss. This was investigated by testing auditory function in rats, both electrophysiologically and histologically, following exposure to broad-band noise (12 h/day for 15 days) at different stages of auditory development (neonates and adults), and also in age-matched controls. An exposure of 90 dB SPL broad-band noise caused no long-term change in auditory function in either age group. A higher exposure (102 dB SPL) caused greater long-term changes in hearing in the adult compared to the young noise-exposed rats, although histology showed greater damage to hair cells in the younger animals. Therefore, functionally, the developing ear does not seem more vulnerable than the developed ear to acoustic trauma.
<i>D</i>-Methionine Attenuates Inner Hair Cell Loss in Carboplatin-Treated Chinchillas
Authors: Lockwood D.S. , Ding D.L. , Wang J. , Salvi R.J. 
Published: April 2003

Carboplatin, a second-generation platinum-based antineoplastic drug, preferentially destroys inner hair cells (IHCs) in the chinchilla while sparing outer hair cells (OHCs). <i>D</i>-Methionine (<i>D</i>-Met), a sulfur-containing amino acid, has been shown to protect hair cells from cisplatin damage in rats, but its ability to protect IHCs from carboplatin damage has not yet been evaluated in the chinchilla. We tested whether <i>D</i>-Met would protect the hair cells in the chinchilla from carboplatin. Animals were divided into two groups: a control group that only received carboplatin (100 mg/kg, i.p.) and an experimental group that received 300 mg/kg <i>D</i>-Met (i.p.) 30 min before carboplatin treatment. Ototoxicity was assessed by measuring the amount of IHC and OHC loss. Average IHC loss in the group treated with <i>D</i>-Met was 62% compared with 84% in the untreated control group. Thus, <i>D</i>-Met causes a statistically significant reduction in IHC loss induced by carboplatin.
Auditory Evoked Response Test Strategies to Reduce Cost and Increase Efficiency: The Postauricular Muscle Response Revisited
Authors: Patuzzi Robert B. , Thomson Susmita M. 
Published: April 2003

We describe a number of techniques in auditory evoked response (AER) testing for hearing loss which should decrease its cost and increase its efficiency, making its use in infant hearing screening more viable. We demonstrate the use of bit-stream averaging of the electrical signals from the head as a cheap alternative to analogue averaging and show that the average waveforms obtained are similar with both techniques. We demonstrate how the postauricular muscle response (PAMR) can be potentiated by lateral rotation of the eyes and argue that uncontrolled eye movements in previous studies have led to an unfounded belief that the PAMR is not stable. When eye rotation is used to potentiate the PAMR, the response becomes very stable and so large in most subjects that it is clearly visible in the raw traces. We also demonstrate that when the PAMR is potentiated by eye rotation, stable PAMR waveforms can be reliably obtained with tone bursts with frequencies up to and above 8 kHz and with sound levels within 30 dB of the subjective detection threshold. As a result the PAMR can be used to rapidly determine an objective audiogram in most subjects within minutes. Finally, we demonstrate a correlation technique for detecting the PAMR without waveform averaging and the need for an expensive computer. We are sure that a combination of these techniques can be used to increase the efficiency of AER screening for infant deafness and lower its cost dramatically.
Carotid Artery Stenting in Patients at Surgical High Risk: Clinical and Ultrasound Findings
Authors: Griewing B. , Brassel F. , von Smekal U. , Al Ahmar M.T. , Kessler Ch. 
Published: April 2003

Angioplasty and stenting (A/S) provide an alternative for patients with simultaneous severe cardiac and cerebrovascular disease, or with medical illnesses which carry a high perioperative risk. We conducted A/S in 20 high-risk patients (15 males, 5 females, mean age = 64.5 years, range = 49–83 years) with symptomatic (n = 16) and asymptomatic (n = 4) high-grade stenosis (>70%, NASCET criterion) of the internal carotid artery. Patients had neurological examinations before, during and after the procedure. Color-coded duplex sonography was performed before and 24 h and every 3 months after the procedure; the 3-month examination also included cerebral angiography. The mean degree of stenosis was reduced from 85.75 ± 7.47 to 8.0 ± 22.09% in angiography. In an 18-month follow-up with color-coded duplex sonography the effects of the A/S could be visualized effectively: 2 with local, transient vasospasms, 1 with asymptomatic occlusion, 2 carotid arteries with remaining stenosis of 50% and 2 with minimal hyperplasia within the stent. In conclusion, in patients with a high perioperative risk, A/S is a therapeutic alternative to surgery.
Delayed Intrahemispheric Remote Hypometabolism
Authors: Iglesias S. , Marchal G. , Viader F. , Baron J.-C. 
Published: April 2003

Although ‘intrahemispheric diaschisis’ (i.e. a hypometabolism affecting the cerebral hemisphere ipsilateral to but remote from the infarct) may classically exacerbate acute-stage neurological deficit and influence early recovery, it has been studied only rarely. Out of a series of 30 patients with first-ever middle cerebral artery (MCA) territory stroke, we analyzed the data from 19 survivors investigated by <sup>15</sup>O positron emission tomography (PET) both in the acute (within 5–18 h of clinical onset) and subacute (approximately 3 weeks later) stage, and for whom chronic-stage CT coregistered with PET was available to assess infarct topography and size. Orgogozo’s MCA scale was used to assess neurological deficits at the time of, and recovery between, the PET studies. Oxygen consumption was obtained for both PET sessions for the whole ipsilateral hemisphere (excluding ventricles and infarct), as well as for the thalamus and the occipital and mesial-prefrontal cortex (i.e. potentially deafferented tissue outside the MCA territory). In all regions except the occipital cortex, the oxygen consumption significantly decreased between the first and the second session, without significant correlation with the concomitant changes in MCA scores. However, acute-stage mesial-prefrontal metabolism was significantly correlated with neurological recovery. Also, both the hemisphere and the mesial-prefrontal metabolism at the second session were significantly correlated with both infarct size and concomitant MCA scores, but the latter relationship became insignificant when infarct size was taken into account. This study reveals no evidence of acute intrahemispheric diaschisis after MCA territory stroke in man. However, it documents for the first time a phenomenon of delayed intrahemispheric remote hypometabolism developing while the patients clinically recover. Because the degree of this secondary phenomenon is a function of infarct size, a mechanism of degeneration of the damaged neuron terminals is likely. Finally, contrary to other reports, neurological recovery was not a function of thalamic hypometabolism, but appeared to be influenced by acute-stage mesial-frontal metabolism, perhaps because this region is part of a network that has an important compensatory role in motor recovery.
French Physicians’ Knowledge about Hereditary Breast/Ovarian Cancer: The Need for Continuing Vocational Training in Genetics
Authors: Julian-Reynier Claire , Eisinger François , Moatti Jean-Paul , Sobol Hagay 
Published: April 2003

<i>Objectives:</i> The aim of this study was to determine what medical specialists knew about recent findings in the genetics of breast/ovarian cancer, according to their speciality and the methods they used to keep themselves up to date. <i>Methods:</i> A national random sample of 1,169 surgeons and gynaeco-obstetricians was surveyed using a mailed questionnaire, to which 700 of those contacted responded (60%). <i>Results:</i> Two years after it had been identified, BRCA1 was known by only 54% of the practitioners, whereas BRCA2 was known by 49.1% 1 year after it was first identified. The lifetime breast cancer risk of women in the general population was estimated by 37.6% of the participants to be between 6 and 10%, and 35.7% rated the penetrance of a breast cancer mutated gene at between 70 and 90%. After multivariate adjustment, the overall score for knowledge of hereditary breast/ovarian cancer was mainly determined as follows: by the speciality (p < 0.001), since the gynaeco-obstetricians scored the highest and the general surgeons the lowest; by the size of practice (p < 0.001), since a larger practice was associated with a higher score, and by whether or not the participants were accustomed to reading the international literature (p < 0.01). <i>Conclusions:</i> These results show the need for physicians who are not geneticists to acquire further knowledge about cancer genetics. We discuss the role of international reviews in communicating the latest knowledge available in genetics to specialists working in other medical fields.
Ciliogenesis in the Uterine Tube of Control and Superovulated Heifers
Authors: Abughrien Badia M. , Dore Michael A.P. 
Published: April 2003

Ciliogenesis was investigated in the uterine tube epithelium of control and superovulated heifers during day 1 to day 7 of the oestrous cycle. Seventy-two heifers were used, consisting of four control groups and four superovulated groups. All heifers received cloprostenol (PG) to induce oestrus (day 0). Superovulated heifers received 24 mg pFSH at doses of 4.5, 3.5, 2.5 and 1.5 mg given twice daily. Control and superovulated heifers were slaughtered on days 1, 3, 5 and 7 of the oestrous cycle. Samples from the ampulla, preisthmus and isthmus of the uterine tube were collected and processed for light and electron microscopy, following standard procedures. Both centriolar and acentriolar pathways were involved in the development of basal bodies. Formation of basal bodies and protrusion of ciliary shafts mostly occurred during days 1 and 3 of the oestrous cycle. The centriolar pathways, in which procentrioles generate with the aid of preexisting centrioles, played a minor role in the heifer uterine tube. In the acentriolar pathways, fibrous granules were the first structures which appeared in the course of ciliogenesis and they initially occurred in association with free ribosomes. Subsequently, deuterosomes arose in the aggregates of fibrous granules, and then procentrioles containing microtubules originated around deuterosomes or apart from deuterosomes. Newly formed centrioles migrated to the apical cytoplasm, and ciliary shafts extended first at the periphery of the luminal surface of ciliogenic cells. Deuterosomes as well as rootlet formation were considered to be related to the fibrous granules. Quantitative examinations by light microscopy showed that the number of ciliated cells in the ampullar, preisthmic and isthmic epithelium of the superovulated heifers was significantly higher than in the control heifers during day 1 and day 3 of the oestrous cycle.
Serial Position Effects in Dementia of the Alzheimer Type
Authors: Burkart Martin , Heun Reinhard , Benkert Otto 
Published: April 2003

<b>Background: </b>The aim of the present study was to analyse serial position effects for immediate and delayed free recall in patients with dementia of the Alzheimer type and controls. <b>Experiment 1:</b> 44 patients with dementia of the Alzheimer-type and 24 non-demented controls were asked for immediate and delayed free recall of 12 schematic drawings of common objects presented at the rate of 10 s/picture. Steep primacy effects were obtained at all delays in controls. By contrast, primacy effects were significantly impaired in patients with dementia at all delays of recall. Small immediate and delayed recall recency effects were found in both, patients and controls. <b>Experiment 2: </b>19 patients with dementia of the Alzheimer type and 21 controls were asked for immediate and delayed free picture recall with presentation rates of 10, 5 and 1 s/picture. Again, primacy effects were significantly impaired in demented patients versus controls. With shorter presentation times, immediate recall recency effects were more pronounced than with longer presentation times, and no delayed recall recency effects were found. <b>Conclusions: </b>Primacy effect is impaired for immediate and delayed recall in dementia of the Alzheimer type. By contrast, immediate recall recency effect and possibly also long-term recency effect are preserved. The loss of the primacy effect contributes to the impairment of episodic memory in dementia of the Alzheimer type. Therefore further research is warranted into pharmacological and psychological interventions that might re-establish the primacy effect. Possibly, the orientation of demented patients might be improved by psychological techniques that rely on long-term recency effect.
Metrifonate Therapy in Alzheimer’s Disease: A Pooled Analysis of Four Randomized, Double-Blind, Placebo-Controlled Trials
Authors: Farlow M.R. , Cyrus P.A. 
Published: April 2003

This retrospective analysis assessed the efficacy of metrifonate in the treatment of mild to moderate Alzheimer’s disease (AD). Those four studies meeting Food and Drug Administration guidelines for establishing the efficacy of an AD therapeutic agent were pooled for further analysis. Data were included from all patients valid for the intent-to-treat analyses (last observation carried forward). Patients received once daily placebo (n = 550), metrifonate 30–60 mg (by weight, n = 769) or 60/80 mg (by weight, n = 197). Metrifonate 60/80 mg significantly improved the cognitive abilities [AD Assessment Scale – Cognitive Subscale (ADAS-Cog), p = 0.0001; Mini Mental State Examination (MMSE), p = 0.0001], psychiatric and behavioral disturbances (Neuropsychiatric Inventory, p = 0.039; ADAS – Noncognitive Subscale, p = 0.0001), performance of instrumental and basic activities of daily living (Disability Assessment for Dementia, p = 0.0002) and global status (Clinician’s Interview-Based Impression of Change with Caregiver Input, p = 0.0001) of AD patients when compared with placebo. Metrifonate effects across these domains were dose related. Metrifonate 60/80 mg significantly improved the cognitive performance relative to both placebo and to baseline as evaluated by both the ADAS-Cog and the MMSE. Metrifonate is the first cholinesterase inhibitor consistently shown under prospective, placebo-controlled conditions to improve significantly behavior in addition to cognition, function in activities of daily living and global functional status of patients with mild to moderate AD.
Prevalence of Epileptic Seizures along the Wakefulness-Sleep Cycle in Adult Rats Submitted to Status epilepticus in Early Life
Authors: Ferreira Branca L.C. , Valle Angela C. , Cavalheiro Esper A. , Timo-Iaria Cesar 
Published: April 2003

In 70 adult Wistar rats submitted to pilocarpine-induced status epilepticus in early life the electro-oscillograms were recorded from neocortical areas 10, 3 and 17, from CA1 and CA3 hippocampal fields and, in 10 rats, also from the ventrolateral nuclei and amygdala. Head, eye, rostrum + vibrissae, ear and forelimb movements were recorded as well. Fifty rats were subjected to 4-hour daily recording sessions and 20 to continuous 24-hour recordings. In all the rats spike-wave discharges (SWD) were found in every site from which the electro-oscillograms were recorded, and clonic seizures were also displayed by all the animals. Most seizures (83.75%, mean = 6.59 fits/h) were concentrated in nearly 9 h and 16.25% (mean = 0.77 fits/h) in the remaining 15 h. Eye movements occurred during 49.2% of the total duration of motor events, the head moved in 42.8% and the rostrum + vibrissae in 8.1% of the time, departing from normal rats. Therefore, pilocarpine-induced status epilepticus produces striking changes in the wakefulness-sleep cycle characteristics.
Electrophysiological and Morphological Analyses of Cortical Neurons Obtained from Children with Catastrophic Epilepsy: Dopamine Receptor Modulation of Glutamatergic Responses
Authors: Cepeda C. , Li Z. , Cromwell H.C. , Altemus K.L. , Crawford C.A. , Nansen E.A. , Ariano M.A. , Sibley D.R. , Peacock W.J. , Mathern G.W. , Levine M.S. 
Published: April 2003

The present study examined the electrophysiological effects produced by activation of specific dopamine (DA) receptors and the distribution of DA receptor subtypes and glutamate receptor subunits [N-methyl-<i>D</i>-aspartate (NMDAR1) and GluR1] in cortical tissue samples obtained from children (ages 3 months to 16 years) undergoing epilepsy surgery. DA receptor activation produced differential effects depending on the receptor subtype that was activated. D1 receptor family agonists generally enhanced cortical excitability and favored the emergence of epileptogenic activity. In contrast, D2 receptor family agonists had more variable effects on cortical excitability and the expression of epileptiform discharges. Activation of D1 or D2 receptors decreased the amplitude of non-NMDA-mediated excitatory postsynaptic potentials. In contrast, DA and D1 agonists increased the amplitude of NMDA-mediated potentials. Immunohistochemical analysis showed that the DA receptor subtypes and glutamate receptor subunits examined were present in all cortical layers and areas throughout development. Whole-cell voltage clamp recordings of pyramidal neurons visualized with differential interference contrast optics and infrared videomicroscopy indicated that these neurons displayed a persistent Na<sup>+</sup> current, followed by an outward current. DA reduced the outward current but had little effect on the persistent Na<sup>+</sup> current. These results suggest a dual role for DA’s actions in the human cerebral cortex. Activation of D2 receptors or antagonism of D1 receptors may help control seizures in children.