Construct validity and frequency of euphoria sclerotica in multiple sclerosis.

Using the Neuropsychiatric Inventory (NPI), we studied euphoria and other behavioral changes in 75 consecutive, unselected multiple sclerosis (MS) patients and 25 healthy controls. We also assessed disease duration, clinical course, physical disability, personality, depression, insight, cognition, and caregiver distress. Factor analysis identified a cluster of symptoms--labeled euphoria/disinhibition--similar to the euphoria sclerotica syndrome originally described by Charcot and others.

Pioneers in musculoskeletal oncology: Musculoskeletal Tumor Society Founders Lecture.

I was invited to deliver the third annual Musculoskeletal Tumor Society's Founder's Lecture, at our annual meeting on May 2, 2003 in Chicago, IL. The Musculoskeletal Tumor Society began in 1977 when a small group of physicians, mainly orthopaedic surgeons, met to discuss ways of improving the outcome of the rare and usually fatal primary malignant neoplasms of bone. Treatment of patients with these types of cancers most often was amputation.

Tone probe event-related potential differences during a face recognition task in prepubertal children and Turner Syndrome girls.

Hormones have been shown to play a role in both cerebral development and neurocognitive function. Turner Syndrome (TS) provides the opportunity to study the effect of the lack of estrogen on neurocognitive development. In this study, event-related potential (ERP) differences were examined among 12 TS girls, 20 prepubertal control girls, and 20 prepubertal control boys during a face recognition memory task.

Correlating brain atrophy with cognitive dysfunction, mood disturbances, and personality disorder in multiple sclerosis.

Neuropsychological impairment is a common feature of multiple sclerosis. Affected patients often have deficits in information-processing speed and memory and exhibit psychopathological states such as depression. A minority of patients have rarer affect/mood disorders such as euphoria sclerotica and pathological laughter/crying.

Proximal tibial osteotomy: where did you go?

The prevalence of knee osteotomy seems to have diminished. Better total knee arthroplasty (TKA) results, greater survival, increased use of unicompartmental arthroplasty, and decreased surgeon confidence for osteotomy are likely causes. However, continued use of knee osteotomy is encouraged by this author.

Nutrition and infectious diseases in developing countries and problems of acquired immunodeficiency syndrome.

Infectious diseases are the major causes of death and morbidity in underdeveloped countries, particularly in children. Increasing evidence suggests that malnutrition-both Protein-Energy type Malnutrition (PEM) and essential micronutrient (vitamins, trace minerals, essential amino acids, polyunsaturated fatty acids) type-is the underlying reason for increased susceptibility to infections. On the other hand, certain infectious diseases also cause malnutrition, which results in a vicious cycle.

In-hospital deaths following elective total joint arthroplasty.

Elective hip or knee arthroplasty is considered a relatively safe orthopedic procedure. However, given the number of procedures performed, catastrophic complications, such as death, occur. Between January 1995 and March 2001, 3438 patients underwent elective hip or knee arthroplasty at our institution.

Precursor B lymphoblastic leukemia with surface light chain immunoglobulin restriction: a report of 15 patients.

We describe 15 patients (9 children) with precursor B-cell (pB) acute lymphoblastic leukemia (ALL) with surface immunoglobulin (sIg) light chain restriction revealed by flow cytometric immunophenotyping (FCI). The same sIg+ immunophenotype was present at diagnosis and in 3 relapses in 1 patient. In 15 patients, blasts were CD19+ CD10+ (bright coexpression) in 14, CD34+ in 12, surface kappa+ in 12, surface lambda+ in 3; in 8 of 8, terminal deoxyribonucleotidyl transferase (TdT)+; and in 4, surface IgD+ in 2 and surface IgM+ in 1.

Prediction of neuropsychological impairment in multiple sclerosis: comparison of conventional magnetic resonance imaging measures of atrophy and lesion burden.

Background: Cognition and magnetic resonance imaging correlations are well established in patients with multiple sclerosis (MS), but it is unclear whether lesion burden or atrophy accounts for most of the predictive variance. These indices have been directly compared in only a few studies. No such study included measurement of the third ventricle, which was strongly predictive of neuropsychological competence in the early literature.

Functional imaging during covert auditory attention in multiple sclerosis.

Recent literature suggests that the brain in multiple sclerosis (MS) undergoes reorganization that subserves the performance of visual and motor tasks. We identified sites of cerebral activity in 16 MS patients while performing a covert attention (CA) task, presented in the auditory modality. Positron emission tomography (PET) revealed activation of rostral/dorsal anterior cingulate cortex (ACC) in normal subjects studied previously.

Association of drug abuse with inhibition of HIV-1 immune responses: studies with long-term of HIV-1 non-progressors.

Recreational drug use has been proposed to affect the course of human immunodeficiency virus (HIV) infections. To investigate the effects of substance abuse on HIV infections, we compared virus-specific cytotoxic T lymphocyte (CTL) responses and the expression of IL-16, TGF-beta1, and CXCR4 in three different cohorts of HIV-infected patients: (1) long-term nonprogressors (LT-NPs) of HIV infection who do not use recreational drugs; (2) nondrugs using normal progressors (NPs), and (3) drugs using NPs. Our results show that LT-NPs manifest increased CTL activity and IL-16 expression and decreased expression of TGF-beta1 and CXCR4 compared to NPs, regardless of recreational drug usage.

The world wide web and robotic heart surgery.

Purpose: The primary goal of this study was to (1) determine patients' access to and use of the Internet for healthrelated information before and after endoscopic atraumatic coronary artery bypass (Endo-ACAB) surgery, (2) investigate patients' methods of searching for such information, and (3) suggest future improvements for Internet-based patient education. The secondary goal of this study was to determine (1) patients' health-related quality of life and (2) degree of satisfaction following the Endo-ACAB procedure.

Methods: A follow-up study was conducted of 50 consecutive patients who had undergone Endo-ACAB procedures at the Center for Less Invasive Cardiac Surgery and Robotic Heart Surgery in Buffalo, New York.

Interval results with right gastroepiploic bypass.

Objective: Right gastroepiploic artery bypass grafting has proved to be a viable surgical choice since the mid-1980s. Long-term graft patency, however, has been challenged ever since. We present 43 patients who underwent right gastroepiploic artery bypass surgery off pump with minimal invasive techniques with an average follow-up period of 57.

Free interferon-alpha/beta receptors in the circulation of patients with adenocarcinoma.

Background: Many viral and neoplastic diseases are resistant to interferon-alpha/beta (IFN-alpha/beta) therapy or develop resistance during the course of IFN treatment. In patients with viral diseases, the authors identified four IFN inhibitors, of which the most important, most likely is a free IFN receptor of type 1 appearing in the circulation that captures and neutralizes IFN-alpha/beta.

Methods: Ninety-one cancer patients and 25 healthy individuals were studied.

Effector cell mediated cytotoxicity measured by intracellular Granzyme B release in HIV infected subjects.

CD8+ cytotoxic T lymphocyte (CTL) activity is currently believed to be one of the key immunologic mechanisms responsible for the prevention or attenuation of HIV-1 infection. The induction of CD8+ T cell activation may also result in the production of soluble or non-classical lytic factors that are associated with protection from infection or slower disease progression. Traditionally, CD8+ CTL responses have been measured by the classic chromium release assay, monitoring the ability of T cells (Effector cells) to lyse radiolabelled HLA - matched "target cells" that express the appropriate antigen-MHC complex.

Genomic effects of IFN-beta in multiple sclerosis patients.

The purpose of this report was to characterize the dynamics of the gene expression cascades induced by an IFN-beta-1a treatment regimen in multiple sclerosis patients and to examine the molecular mechanisms potentially capable of causing heterogeneity in response to therapy. In this open-label pharmacodynamic study design, peripheral blood was obtained from eight relapsing-remitting multiple sclerosis patients just before and at 1, 2, 4, 8, 24, 48, 120, and 168 h after i.m.

REVIEW: Fast-Tracking Cardiac Surgery.

A "fast track" approach to cardiac surgery can be defined as a perioperative process involving rapid progress from preoperative preparation through surgery and discharge from the hospital. Although highly individualized among the various heart surgery centers, the fast-track process is a team activity. It requires a team of health care providers to interact with the patient at various phases, from admission to discharge.

Validity of the Beck Depression Inventory-Fast Screen in multiple sclerosis.

Introduction: The Beck Depression Inventory-Fast Screen (BDI-FS) is a brief self-report inventory designed to evaluate depression in patients with medical illness. As depressive disorder is especially prominent in multiple sclerosis (MS), a cost-effective procedure for identifying depressive disorder in MS is sorely needed. The BDI-FS may be useful in this regard although, to date, its validity in MS patients has not been assessed.

Intra-tumoral injection of CpG results in the inhibition of tumor growth in murine Colon-26 and B-16 tumors.

Direct tumor injections of CpG (ODN #1826) into murine tumors markedly suppressed the tumor growth and increased the survival of the mice. Tumor growth was reduced by 60-67% in Colon Tumor 26 (CT-26) and B-16 melanoma tumors treated with CpG as compared to untreated one. In CT-26 and B-16 tumors treated with CpG, the average survival of the animals were prolonged to 26 and 28 d as compared to 16 and 18 d in control respectively.

Basiliximab plus low-dose cyclosporin vs. OKT3 for induction immunosuppression following renal transplantation.

Background: Current immunosuppressive therapies are very effective in preventing acute rejection (AR) and graft loss following renal transplantation. Newer agents now make it possible to develop equally efficacious but better tolerated and less toxic strategies. This is especially relevant for our ageing recipients.

Role of cytokines in nasal polyposis.

Chronic hyperplastic sinusitis and nasal polyposis (CHS/NP) is associated with significant morbidity. The response to medical treatment is often unsatisfactory, and surgery often provides only temporary relief. The genesis and pathophysiology of polyps are poorly understood.

Heparin dose, transfusion rates, and intraoperative graft patency in minimally invasive direct coronary artery bypass.

Background: Many investigators have demonstrated the short-term and midterm efficacy of minimally invasive direct coronary artery bypass (MIDCAB). However, the influence of heparin dosing during MIDCAB on postoperative and immediate graft patency is less well defined. This report outlines our experience with MIDCAB employing a variety of heparinization protocols.