Trends in hospitalized discharge rates for head injury in Maryland, 1979-86.

Hospital discharge data from all acute care hospitals in Maryland were used to examine trends in hospitalized head injury incidence and outcome by severity. From 1979 to 1986, discharge rates increased by 3.4/100,000 per year; the largest percent increase was for more severe injuries.

Models of hypoxia and cerebral ischemia.

Most models of hypoxia and ischemia are used for evaluating the metabolic consequences of cerebral insult. They have also been used for inducing cognitive disturbance. The pathological cascade after severe hypoxia or ischemia includes decreased ATP, influx of Ca2+ and Na+ with decrease in intracellular K+ leading to depolarization, release of glutamate, noradrenaline and acetylcholine, changes in neuronal plasticity, cell death, and cognitive impairment.

Acute gastrointestinal illness and child care arrangements.

This study uses data from the 1981 National Health Interview and the 1981 Child Health Supplement to assess the extent to which family day care homes and child care centers pose a risk of acute gastrointestinal illness among preschool children. The study uses a nationally representative sample of children 0-5 years of age (n = 4,845). Acute gastrointestinal illness was identified from parental reports of acute illness in a 2-week period.

The lifetime cost of injury.

This paper discusses the development of estimates of the lifetime costs of injuries for 1985. Total costs are estimated to be $158 billion for the 57 million persons injured in 1985. Updating these costs to 1988, the results are even more impressive-$182 billion.

A study of the effect of introducing a restrictive cervical screening policy on laboratory workload and cervical cancer detection rates.

This study examines the effect of a change in screening policy on the detection rate of severe dyskaryosis. During 1987 a total of 423 cases of severe dyskaryosis were identified by the Avon Screening Programme. Eleven per cent of these abnormal smears were repeat smears taken without clinical indication within the recommended 5 year recall period (interval smears).

Differential effects of electrical stimulation of the dorsal raphe nucleus and of cervical sympathectomy on serotonin and noradrenaline concentrations in major cerebral arteries and pial vessels in the rat.

The levels of noradrenaline (NA), serotonin (5-HT), and 5-hydroxyindoleacetic acid were measured by HPLC and compared between the large arteries of the circle of Willis and the small pial vessels in the rat, following either electrical stimulation of the dorsal raphe nucleus or bilateral superior cervical ganglionectomy. With electrical stimulation, the 5-HT concentrations were reduced (-48%) in the small pial vessels, but were unchanged in the major cerebral arteries. NA concentrations were dramatically reduced following cervical sympathectomy in the large arteries (-77%), though the reduction was less pronounced (-34%) in the small vessels.

Further evidence that the site of the breakpoint in the major breakpoint cluster region (M-bcr) may be a prognostic indicator.

A break in chromosome 22 within the major breakpoint cluster region (M-bcr) is a characteristic of Philadelphia chromosome-positive CML. We have determined the zone of the breakpoint in 80 chronic myelogenous leukemia (CML) patients and have confirmed our previous observation that a relationship does exist between the subregion of the breakpoint within the M-bcr and the average length of the chronic phase of the disease. Patients with a 3' breakpoint have a statistically shorter chronic phase (25 months) than patients with a 5' break (55 months).

Hospitalized head-injured patients in Maryland: incidence and severity of injuries.

Hospital discharge data collected from all acute care hospitals in Maryland were used to examine severity-specific rates of hospitalized head injuries in 1986. Findings indicate that males are at twice the risk of females for hospitalization for head injury; whites and nonwhites are at similar risk. Evidence that the rate of hospitalization for head injury may be increasing underscores the importance of head injury as a major public health problem in Maryland.

Cortical blood flow increases induced by stimulation of the substantia innominata in the unanesthetized rat.

The possible implication of projections from the substantia innominata (SI) to the cerebral cortex in the control of local cortical blood flow (CoBF) was studied in adult Fischer rats. Local blood flow (by helium clearance) and tissue gas partial pressures (pO2, pCO2) as metabolic indices, were measured in the frontal and parietal cortices in unanesthetized animals via chronically implanted probes connected to a mass spectrometer. Stimulating electrodes, also implanted chronically, were placed in the region of the SI.

Effect of pre-existing disease on length of hospital stay in trauma patients.

Hospital discharge data for all adult trauma admissions (n = 27,029) to acute care hospitals in a five-county area were used to examine the effect of pre-existing chronic conditions (PECs) on length of hospital stay (LOS). The per cent increase in mean LOS and the relative odds of an extended LOS (i.e.

Pharmacological properties of the receptor(s) involved in the 5-hydroxytryptamine-induced contraction of the feline middle cerebral artery.

The characterization of the receptor(s) involved in the 5-hydroxytryptamine (5-HT)-induced contraction was studied in the cat middle cerebral artery. 5-HT agonists and antagonists were tested on isolated arterial segments and their vascular potency correlated with their affinity value for 5-HT receptor subtypes as defined in the literature. 5-Carboxamidotryptamine (5-CT) and RU 24969 (5-HT1A-1B agonists) were more potent and as potent as 5-HT, respectively.

Acetylcholine and vasoactive intestinal peptide in cerebral blood vessels: effect of extirpation of the sphenopalatine ganglion.

The innervation of cerebral blood vessels by nerve fibers containing acetylcholinesterase (AChE) and vasoactive intestinal peptide (VIP) and the vasomotor effects of the two neurotransmitters have been analyzed in the rat following the uni- or bilateral removal of the sphenopalatine ganglion (SPG), which is thought to be the major origin of this innervation. Histochemistry of AChE-positive nerve fibers and the immunoreactivity toward VIP revealed only a 30% reduction in the innervation pattern of the rostral part of the cerebral circulation following the operation. At approximately 4 weeks postoperatively, the original nerve network was restored.

Time course of effects of unilateral lesions of the nucleus basalis of Meynert on glucose utilization by the cerebral cortex. Positron tomography in baboons.

In order to investigate the effects of a partial cholinergic deafferentation on the functional activity of the cortex, the cerebral metabolic rate of glucose (CMRGlu) was measured with positron emission tomography and 18F-2-fluoro-2-deoxy-D-glucose in 5 baboons (Papio anubis) both before and serially following stereotaxic electrocoagulation of the left nucleus basalis of Meynert (NbM). Four days postlesion, significant metabolic depression was present in the entire ipsilateral cerebral cortex, most marked in the frontotemporal region, and which slowly recovered close to normal within 6-13 weeks. Postmortem studies showed that the lesions were located largely in the NbM, and that a significant decrease in choline-acetyltransferase (ChAT) activity was present in the ipsilateral frontal, temporal and parietal cortices.

Classifying trauma severity based on hospital discharge diagnoses. Validation of an ICD-9CM to AIS-85 conversion table.

This report describes the development and validation of a computerized system for converting ICD-9CM rubrics to Abbreviated Injury Scale (AIS) scores. In collaboration with the Committee on Injury Scaling of the Association for the Advancement of Automotive Medicine, AIS-85 scores were assigned to 2,062 injury-related ICD-9CM rubrics. To validate the conversion table, AIS and Injury Severity Scores (ISS), derived using the conversion, were compared with those obtained by reviewing the complete medical record for 1,120 trauma cases.

Use of health and rehabilitation services following head injury.

The impact on public health of head injury as a major source of death and disability, especially among adolescents and young adults, is well recognized. In Maryland the primary annual incidence of head injury severe enough to result in death or hospitalization has been estimated to be 149 per 100,000 population. These figures are comparable to national and other regional estimates reported in the literature.

Differentiation stage-specific expression of a gene during granulopoiesis.

Differential screening of a recombinant cDNA library using cDNAs transcribed from poly(A)+ RNA of normal or leukemic leukocytes revealed a number of recombinants homologous to mRNAs characteristic of particular leukemias. The occurrence of one of these (pCG14) in high abundance was shown to be sufficiently characteristic of the circulating leukocyte population of chronic granulocytic leukemia (CGL) patients to distinguish them from all other populations of leukocytes. We have now characterized the gene encoding this mRNA and shown that its expression is specific to the granulocyte lineage in hemopoietic cells and is, moreover, limited to a narrow stage of differentiation during granulopoiesis.

The economic impact of traumatic injuries. One-year treatment-related expenditures.

Considerable attention has focused in recent years on developing estimates of the economic costs associated with illness and injury. Consistent throughout all of this work has been the finding that traumatic injuries rank among the most costly of conditions. This article provides detailed information on one-year charges related to the receipt of health care and rehabilitation services for a panel of 487 trauma patients aged 16 to 45 years who were injured severely enough to be initially hospitalized at one of two trauma centers.

Effect of stimulation of the sphenopalatine ganglion on cortical blood flow in the rat.

The effects of electrical stimulation of the sphenopalatine ganglion on cortical blood flow and gas partial pressures (PO2 and PCO2) were studied in the anesthetized rat. Tissue PO2, PCO2, and local CBF were measured simultaneously in both parietal cortices by means of mass spectrometry. Stimulation of the sphenopalatine ganglion increased CBF and tissue PO2 by approximately 50 and 20%, respectively, in the ipsilateral parietal cortex.

Imaging of human brain lesions with an omega 3 site radioligand.

The topography and magnitude of increase in peripheral type benzodiazepine binding sites (omega 3 sites) was investigated autoradiographically in the brains of patients with ischemic cerebrovascular disease, with multiple sclerosis, and with malignant glioma. 3H-PK 11195, a selective omega 3 site ligand, was employed. A manyfold increase in omega 3 site density was observed in all these disease states; this increase reflects macrophage invasion or glial proliferation or both as demonstrated by neuropathological studies carried out in parallel.

Ifenprodil and SL 82.0715 as cerebral anti-ischemic agents. II. Evidence for N-methyl-D-aspartate receptor antagonist properties.

The effects of the anti-ischemic agents ifenprodil and its derivative SL 82.0715 ((+/-)-alpha-(4-chlorophenyl)-4-[(4-fluorophenyl) methyl]-1-piperidineethanol] have been analyzed in a number of models indicative of N-methyl-D-aspartate (NMDA) antagonistic potential in vitro and in vivo. Ifenprodil and SL 82.

Ifenprodil and SL 82.0715 as cerebral anti-ischemic agents. I. Evidence for efficacy in models of focal cerebral ischemia.

Recent studies have strongly implicated the excitatory neurotransmitter glutamate in the cascade of pathological mechanisms that cause neuronal loss after certain types of brain ischemia. The neurotoxic effects of glutamate are mediated, at least in global ischemia, via NMDA receptors. In the present study we have examined the effects of compounds that possess NMDA receptor antagonist properties (ifenprodil, SL 82.

The site of the breakpoint within the bcr is a prognostic factor in Philadelphia-positive CML patients.

The Philadelphia (Ph1) chromosome, characteristic of chronic myelogenous leukemia (CML), arises from a reciprocal translocation between chromosomes 9 and 22. The site of the breakpoint on chromosome 22 is within a small region called the breakpoint cluster region (bcr). We have mapped the breakpoint within the bcr in peripheral blood leukocyte DNA from 22 Ph1-positive CML patients.

Temporal evolution of regional energy metabolism following focal cerebral ischemia in the rat.

Focal cerebral ischemia in the rat was induced by occlusion of the left middle cerebral artery. The temporal evolution of regional energy metabolism was studied over the 14 days consequent to the induction of ischemia in the frontal, cingulate, parietal, and occipital cortices as well as in the striatum. Regional concentrations of adenosine triphosphate (ATP), phosphocreatine, and lactate and, in addition, glucose and the cerebral/plasma glucose ratio (C/P) were measured in the hemispheres both ipsilateral and contralateral to the occlusion.

The quantification of cerebral infarction following focal ischemia in the rat: influence of strain, arterial pressure, blood glucose concentration, and age.

Focal cerebral ischemia was induced by occlusion of the middle cerebral artery in rats. The volumetric assessment of infarcted tissue, 2 days following occlusion, was calculated from the examination of eight preselected coronal sections. Five differing rat strains were examined.