Lack of evoked laryngeal electromyography response in patients with a clinical diagnosis of vocal cord paralysis.

There has been recent debate about whether patients with vocal cord immobility have a neurologic paralysis or whether synkinesis, the misdirection of axons to competing laryngeal muscles, is responsible for the lack of voluntary vocal cord motion. This issue was studied in 15 patients with vocal cord paralysis who underwent laryngeal reinnervation. Evoked electromyography was performed with a surface electrode endotracheal tube.

Health promoting effects of friends and family on health outcomes in older adults.

Objective: To highlight the significant impact of social relationships on health and illness and suggest implications of these effects for health promotion efforts among older adults.

Data Sources: Published studies on social relationships and health (or health behaviors) for the period 1970-1998 were identified through MEDLINE by using the key words social relationships, social support, and health, as well as review of health-related journals such as the American Journal of Epidemiology, Annals of Epidemiology, American Journal of Public Health, Journal of Health and Social Behavior, Social Science and Medicine, and the Journals of Gerontology.

Study Selection: Major published original research was considered.

Protein C deficiency in microvascular head and neck reconstruction.

Objective: To determine the incidence of perioperative protein C deficiency in patients undergoing free flap reconstruction of cancer-related defects in the head and neck.

Study Design: Prospective case series.

Intervention: Ten patients underwent microvascular reconstruction after surgical therapy of carcinomas of the oral cavity or oropharynx.

Factors associated with elevated rates of adverse outcomes after cyclodestructive procedures versus drainage device procedures.

Objective: To identify factors associated with an increased risk of adverse outcomes after cyclodestructive or drainage device procedures.

Design: Retrospective, cohort analysis.

Participants: A total of 5570 Medicare patients who were older than 65 years of age and who underwent cyclodestructive or drainage device procedures in 1994 participated.

Alterations in cell surface carbohydrates on T cells from virally infected mice can distinguish effector/memory CD8+ T cells from naive cells.

Glycosylation changes on surface molecules of T cells affect cell trafficking and function and may be useful in discriminating between naive, effector, and memory T cells. To analyze oligosaccharide structures on T cells activated in vivo, we examined alterations in sialic acid residues on T cells following infection of mice with lymphocytic choriomeningitis (LCMV), vaccinia virus, and vesicular stomatitis virus. We found that the majority of CD8 T cells from mice acutely infected with these viruses showed increased binding to peanut agglutinin (PNA).

Secondary hyperparathyroidism in a patient with eight parathyroid glands.

The etiology of secondary hyperparathyroidism is multifactorial, and as many as 10% of patients will ultimately require surgical intervention. This condition is most commonly caused by four-gland hyperplasia. We describe a patient who presented with secondary hyperparathyroidism and symptoms of memory loss, pruritus, constipation, and bone and joint pain.

Analytical decision model for the cost-effective management of solitary pulmonary nodules.

Purpose And Methods: Multiple strategies are currently being used to manage patients who present with indeterminate solitary pulmonary nodules (SPN). We have used decision-analysis models to assess the cost-effectiveness of various strategies for the diagnosis and management of SPN. Four decision strategies were compared: a wait and watch strategy, a surgery strategy, a computed tomography (CT)-based strategy, and a CT-plus-positron emission tomography (PET) strategy.

Axial heterogeneity of sodium-bicarbonate cotransporter expression in the rabbit proximal tubule.

It is generally accepted that Na(HCO3)n cotransport is the most important mechanism mediating basolateral bicarbonate efflux in the early proximal tubule. The presence of basolateral Na(HCO3)n cotransport in the late proximal tubule (S3 segment) and in the juxtamedullary S1 and S2 segments has been controversial. The renal sodium-bicarbonate cotransporter (NBC) has been recently cloned from rat (M.

Ion channels in epilepsy.

There are specific alterations in the structure or function of ion channels in the epileptic brain. Some of these alterations may promote hyperexcitability, whereas others may protect neurons from the deleterious effects of epileptic discharges. With the use of human tissue resected from epilepsy patients and the comparison of cellular properties to those found in well-defined experimental models, we will continue to gain insight into the specific ion channel changes associated with epilepsies.

Fetal cardiovascular and breathing responses to an adenosine A2a receptor agonist in sheep.

CGS-21680 (CGS), a highly selective adenosine A2a receptor agonist, may excite the fetal carotid bodies. This study was designed to determine 1) whether CGS stimulates fetal breathing and 2) whether sinoaortic denervation abolishes CGS-induced tachycardia. In eight intact fetuses (> 0.

Development and testing of image-processing methods for the quantitative assessment of airway hyperresponsiveness from high-resolution CT images.

Purpose: Our goal was to develop a protocol and image-processing methods to quantitate both bronchial and lung attenuation changes in patients imaged with helical high-resolution CT (HRCT).

Method: Human subjects underwent helical HRCT at two suspended breath-hold conditions, functional residual capacity and residual volume, at baseline and following methacholine-induced bronchoprovocation. A semiautomated contouring program was used to define anatomically like bronchi and axial lung sections from the different physiologic sequences, from which automated measurements of area, shape, and attenuation were made.

Vestibular and optokinetic function in the normal guinea pig.

Vestibular and optokinetic function was quantitatively studied in the normal guinea pig through investigation of the vestibulo-ocular reflex (VOR), optokinetic nystagmus (OKN), and the visual vestibulo-ocular reflex (VVOR) by means of sinusoidal stimulation with a computer-controlled rate table (VOR and VVOR) or an optokinetic drum. The VOR exhibited high-pass filter characteristics with steady state gain achieved at 0.125 Hz.

DAX1 gene expression upregulated by steroidogenic factor 1 in an adrenocortical carcinoma cell line.

Two nuclear hormone receptor superfamily members, DAX1 and SF1, are required for normal adrenal cortical development. Mutations in DAX1 are responsible for X-linked adrenal hypoplasia congenita (AHC) and hypogonadotropic hypogonadism. Steroidogenic Factor 1 (SF1) regulates the expression of a number of steroidogenic genes and a putative SF1 response element (SF1-RE) in the DAX1 promoter which binds SF1 specifically.

Reduction of extracellular Na+ causes a release of Ca2+ from internal stores in airway epithelial cells.

Exchange of physiological salt solution with Na(+)-free solution caused an increase in intracellular Ca2+ concentration ([Ca2+]i) in 86.3% of cultured airway epithelial cells within 75 s. [Ca2+]i returned to near baseline levels within 45 s and frequently showed oscillatory increases thereafter.

Regulation of the expression of distinct human secreted IgE proteins produced by alternative RNA splicing.

The use of splice sites for human epsilon mRNAs is tightly regulated, as the potential number of splice products far exceeds that actually produced. Our studies show that use of the epsilon alternative splices is regulated by a limited number of stimuli, and the relative production of the epsilon mRNA variants follows a developmental profile. In addition, we have found disease-related changes in the pattern of epsilon mRNA variants encoding distinctive IgE isoforms.

Kinetics, Ca2+ dependence, and biophysical properties of integrin-mediated mechanical modulation of transmitter release from frog motor nerve terminals.

Neurotransmitter release from frog motor nerve terminals is strongly modulated by change in muscle length. Over the physiological range, there is an approximately 10% increase in spontaneous and evoked release per 1% muscle stretch. Because many muscle fibers do not receive suprathreshold synaptic inputs at rest length, this stretch-induced enhancement of release constitutes a strong peripheral amplifier of the spinal stretch reflex.

Immunotherapy and gene therapy.

Currently, there are many options for the treatment of metastatic renal cell carcinoma (RCC). Being a mostly chemoresistant malignancy, renal cell carcinoma is usually treated with immunotherapy. These therapies are generally based on interleukin-2 (IL-2) or interferon alfa (IFN-alpha), or involve more novel techniques such as gene therapy.

Free radicals enhance Na+/Ca2+ exchange in ventricular myocytes.

Oxygen-derived free radicals (OFR) have been implicated in the pathogenesis of intracellular Ca2+ overload and the arrhythmias that characterize cardiac reperfusion. These arrhythmias may in large part be due to activation of the pathological transient inward current (ITI). However, the identity of the ITI generated by OFR is uncertain.

Dobutamine positron emission tomography: absolute quantitation of rest and dobutamine myocardial blood flow and correlation with cardiac work and percent diameter stenosis in patients with and without coronary artery disease.

Objectives: This study sought to measure myocardial blood flow at rest and during dobutamine infusion and to correlate flow with cardiac work and severity of coronary artery disease.

Background: Dobutamine is used with cardiac imaging to induce possible ischemia in patients with known or suspected coronary artery disease. Positron emission tomography permits noninvasive quantitation of myocardial blood flow.

Novel insights into the genetics, biochemistry, and immunocytochemistry of the 30-kilodalton major extracellular protein of Mycobacterium tuberculosis.

The 30/32-kDa complex of major secretory proteins are among the most important and intensively studied proteins of Mycobacterium tuberculosis. The proteins have been demonstrated to be immunoprotective and to play a central role in the physiology of the mycobacterium. In this study, we present a series of novel insights into this key protein complex arising out of a combination of genetic, biochemical, and immunocytochemical analyses.

Angiolymphoid hyperplasia with eosinophilia and vascular tumors of the head and neck.

Purpose: The clinicopathologic distinctions between angiolymphoid hyperplasia with eosinophilia (AHE) and vascular tumors are controversial. Some investigators believe that AHE is a variant of hemangioma, whereas others state that it is an inflammatory phenomenon. To better delineate the clinicopathologic entity of AHE and investigate the efficacy of various treatment regimens, we undertook a retrospective analysis of AHE and compared it with other angiomatous lesions treated at a tertiary referral center.

Nodal nevi and cutaneous melanomas.

Nevocytes in melanoma-draining lymph nodes can be mistaken for melanoma metastases and may possibly transform to melanoma. During the development of a new technique for managing high-risk primary melanomas, selective lymph node dissection, we examined 4,821 nodes from 208 melanoma patients by light microscopy and immunohistochemistry. Nodal nevi were identified in 49 of 226 lymphadenectomy specimens (22%), a frequency considerably higher than previously recorded (5-6%).

Posterior segment neovascularization associated with optic nerve aplasia.

Purpose: To report the presence of posterior segment neovascularization in eyes with optic nerve aplasia.

Methods: Three eyes in two patients with clinical optic nerve aplasia were studied.

Results: Examination disclosed posterior segment neovascularization in one eye and progressive posterior segment neovascularization in two eyes.

Two-phase helical CT for pancreatic tumors: pancreatic versus hepatic phase enhancement of tumor, pancreas, and vascular structures.

Purpose: To quantitatively evaluate and validate a two-phase helical computed tomographic (CT) protocol for evaluation of pancreatic tumors.

Materials And Methods: Twenty-seven patients with pathologically proved pancreatic adenocarcinomas prospectively underwent two-phase CT examination with helical acquisition during the pancreatic phase (40-70 seconds after infusion of intravenous contrast material at 3 mL/sec) and the hepatic phase (70-100 seconds after infusion). Mean CT attenuation values of tumor, bordering pancreas, and all major peripancreatic vessels were obtained for both time intervals.