Comparison of the performance of normal individuals and survivors of traumatic brain injury on repeat administrations of the Wisconsin Card Sorting Test.

Repeat administrations of the Wisconsin Card Sorting Test (WCST) are a common clinical practice to assess changes in cognitive functions of individuals recovering from traumatic brain injury (TBI). Yet, little is even known about the performance of healthy individuals on repeat administrations of the test. The present study compared the effects of repeat administration of the WCST in normal individuals and survivors of traumatic brain injury.

Population pharmacodynamics of midazolam administered by target controlled infusion in SICU patients after CABG surgery.

Background: Midazolam is used commonly for sedation in the surgical intensive care unit. A suboptimal dosing regimen may lead to relative overdosing, which could result in delayed extubation and increased cost. This multicenter trial characterized midazolam pharmacodynamics in patients recovering from coronary artery bypass grafting.

Population pharmacokinetics of midazolam administered by target controlled infusion for sedation following coronary artery bypass grafting.

Background: Midazolam is commonly used for short-term postoperative sedation of patients undergoing cardiac surgery. The purpose of this multicenter study was to characterize the pharmacokinetics and intersubject variability of midazolam in patients undergoing coronary artery bypass grafting.

Methods: With institutional review board approval, 90 consenting patients undergoing coronary artery bypass grafting were enrolled at three study centers.

Sclerosing sweat-duct carcinoma (malignant syringoma) of the upper eyelid: a patient report with immunohistochemical and ultrastructural analysis.

Sclerosing sweat-duct carcinoma or malignant syringoma is a rare eyelid tumor. The authors report the first patient with sclerosing sweat-duct carcinoma involving the upper eyelid and present its immunohistochemical and ultrastructural features. The clinical features and the histopathologic and ultrastructural findings that distinguish this tumor from its benign counterparts are discussed.

Protamine reversal of heparin affects platelet aggregation and activated clotting time after cardiopulmonary bypass.

Unlabelled: Bleeding after cardiopulmonary bypass (CPB) is related to multiple factors. Excess protamine weakens clot structure and decreases platelet function; therefore, an increased activated clotting time (ACT) after protamine reversal of heparin may be misinterpreted as residual heparin anticoagulation. We evaluated the effects of protamine, recombinant platelet factor 4 (rPF4), and hexadimethrine on ACT in blood obtained after CPB.

Testing for mutations of the ataxia telangiectasia gene in radiosensitive breast cancer patients.

Background And Purpose: To determine if clinical radiosensitivity in breast cancer patients is related to mutations of the ataxia telangiectasia gene (ATM).

Materials And Methods: Fifteen patients who had developed a severe late reaction to a standard radiotherapy schedule were examined for evidence of increased in vitro radiosensitivity using the MTT assay. Mutation analysis was performed using a protein truncation assay.

Mucoepidermoid carcinoma of the parotid gland: a rare presentation in a young child.

Although mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland neoplasm in childhood and adolescence, it is rarely found in children under the age of 10. A 6-year-old girl had an asymptomatic neck mass for 5 months. Clinical examination findings showed a 1.

Patient perceived health status, hospital length of stay, and readmission after coronary artery bypass surgery.

This study evaluates the effect of length of stay and baseline health status on health status and readmission rates 3 months after coronary artery bypass graft surgery. Baseline health status showed a trend toward worse scores for patients who were readmitted. Readmitted patients had longer lengths of stay, and worse 3-month health status scores, and women and patients with heart failure had higher readmission rates.

Multidimensional scaling of synthetic musical timbre: perception of spectral and temporal characteristics.

The perceptual correlates of acoustic parameters involved in musical timbre were investigated by examining judgements of timbre dissimilarity. Nine synthetic sounds were created, derived from crossing three levels of spectral and temporal parameters (number of harmonics and rise time, respectively). Two separate conditions were tested, one using single tones, the other using short melodies.

Multiple congenital anomalies in a fetus with 45,X/46,X,r(X)(p11.22q12) mosaicism.

Ring X chromosomes that do not undergo inactivation may cause malformations and mental retardation. We report on a fetus with anencephaly, total dorsal rachischisis, and diaphragmatic hernia that was found to have a mosaic 45,X/46,X,r(X)(p11.22q12) karyotype.

Superficial vein thrombosis: incidence in association with pregnancy and prevalence of thrombophilic defects.

Superficial venous thrombotic (SVT) events are a feature of thrombophilic abnormalities, particularly those involving the protein C pathway. We have determined the incidence of SVT associated with pregnancy and the early postpartum period in a retrospective study involving 72000 deliveries. Fourty-nine cases occurring in 47 individuals were recorded, with an overall incidence of 0.

Radiosensitive melanoma cell line with mutation of the gene for ataxia telangiectasia.

The human melanoma cell lines MM96L, A2058 and HT144 were examined for sensitivity to ionizing radiation and UVB radiation. HT144 demonstrated a significant increase in sensitivity to ionizing and UVB radiation compared with the MM96L and A2058 cells. Sensitivity to both agents was associated with susceptibility to apoptosis.

Renal dysfunction after myocardial revascularization: risk factors, adverse outcomes, and hospital resource utilization. The Multicenter Study of Perioperative Ischemia Research Group.

Background: Acute changes in renal function after elective coronary bypass surgery are incompletely characterized and represent a challenging clinical problem.

Objective: To determine the incidence and characteristics of postoperative renal dysfunction and failure, perioperative predictors of dysfunction, and the effect of renal dysfunction and failure on in-hospital resource utilization and patient disposition after discharge.

Design: Prospective, observational, multicenter study.

Risk factors for pregnancy associated venous thromboembolism.

In an attempt to reduce the incidence of pregnancy associated venous thromboembolism (PA-VTE), some researchers have advocated screening of all women for the factor V(Leiden) mutation during early pregnancy. We have conducted a large retrospective study (over 72,000 deliveries) to determine if this would be useful. Sixty-two objectively confirmed venous thrombotic events (51 DVT, 11 PE) were recorded at two maternity units in the UK.

On the registration of time and the patterning of speech movements.

In order to study speech coordination we frequently average kinematic and other physiological signals. The averages are assumed to be more representative of the underlying patterns of production than individual records. In this note we outline different approaches to averaging and present a new nonlinear normalization technique that offers better information than ensemble averaging, linear normalization, or feature alignment methods.

Cellular localisation of the ataxia-telangiectasia (ATM) gene product and discrimination between mutated and normal forms.

The recently cloned gene (ATM) mutated in the human genetic disorder ataxia-telangiectasia (A-T) is involved in DNA damage response at different cell cycle checkpoints and also appears to have a wider role in signal transduction. Antibodies prepared against peptides from the predicted protein sequence detected a approximately 350 kDa protein corresponding to the open reading frame, which was absent in 13/23 A-T homozygotes. Subcellular fractionation, immunoelectronmicroscopy and immunofluorescence showed that the ATM protein is present in the nucleus and cytoplasmic vesicles.

Electrocardiographic and hemodynamic changes and their association with myocardial infarction during coronary artery bypass surgery. A multicenter study. Multicenter Study of Perioperative Ischemia (McSPI) Research Group.

Background: Electrocardiographic (ECG) changes during coronary artery bypass graft surgery have not been described in detail in a large multicenter population. The authors describe these ECG changes and evaluate them, along with demographic and clinical characteristics and intraoperative hemodynamic alterations, as predictors of myocardial infarction (MI) as defined by two sets of criteria.

Methods: Data from 566 patients at 20 clinical sites, collected as part of a clinical trial to evaluate the efficacy of acadesine for reducing MI, were analyzed at core laboratories.

Advances in anesthesia for cardiac surgery: an overview for the 1990s.

Anesthetic care for patients undergoing cardiac surgery has changed dramatically in the past 10 years. Examples of such change include same-day admissions, "fast-track" protocols, selective use of pulmonary artery catheters, transesophageal echocardiography, and the introduction of new drugs such as phosphodiesterase inhibitors and antifibrinolytic agents. Under pressure from our peers and those funding health care, we are making major efforts to reduce costs and the length of hospitalization while maintaining high quality of care.

Optimizing the lyophilization cycle and the consequences of collapse on the pharmaceutical acceptability of Erwinia L-asparaginase.

The antileukemia enzyme, Erwinia L-asparaginase, occurs as a tetramer which can be dissociated by the stresses of lyophilization into four subunits (subunit M(r) 34 000 Da). Dissociation can be reduced by adding protectants to the formulation to stabilize the biopolymer, while the product should dry to form a pharmaceutically elegant, shelf-stable cake which is readily soluble. Using analytical ultracentrifugation, HPLC, and circular dichroism we have related structural dissociation of the enzyme during lyophilization to biological activity.

Cardiovascular responses during sedation after coronary revascularization. Incidence of myocardial ischemia and hemodynamic episodes with propofol versus midazolam. Institutions of the McSPI Research Group.

Background: Propofol sedation offers advantages for titration and rapid emergence in the critically ill patient, but concern for adverse hemodynamic effects potentially limits its use in these patients. The current study compares the cardiovascular effects of sedation with propofol versus midazolam during the first 12 h after coronary revascularization.

Methods: Three hundred fifty-one patients undergoing coronary revascularization were anesthetized using a standardized sufentanil/midazolam regimen, and assigned randomly to 12 h of sedation with either propofol or midazolam while tracheally intubated.