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Belastungen und Ressourcen von Eltern psychisch erkrankter Kinder. KINDHEIT UND ENTWICKLUNG 2022. [DOI: 10.1026/0942-5403/a000361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Eltern von psychisch erkrankten Kindern sind vielfältigen Belastungen ausgesetzt. Fragestellung: Lassen sich Eltern psychisch erkrankter Kinder hinsichtlich Stressmerkmalen und Bewältigungsstrategien empirisch in Subgruppen mit ähnlichem Muster unterteilen ? Methode: N = 100 Elternteile wurden bei psychiatrischer Erstvorstellung ihrer Kinder mittels evaluierter Fragebögen nach aktuellen Stressoren und Copingstrategien sowie nach erzieherischen Rahmenbedingungen befragt. Die Subgruppen wurden mittels Clusteranalyse anhand der drei Stress-Skalen gebildet. Ergebnisse: Es bildeten sich zwei Cluster mit unterschiedlicher Stressbelastung. Höhere Stressbelastung war mit geringerem Alter der Eltern, höherem Alleinerziehenden-Anteil, ungünstigen Bewältigungsmechanismen und mehr psychischer Erkrankung auf Elternseite assoziiert. Diskussion und Schlussfolgerung: In der Elternarbeit sollten die unterschiedlichen Belastungen und Ressourcen beachtet werden.
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Improving recovery during sleep in depression: A pilot study with slow oscillating transcranial direct current stimulation. Psychiatry Res 2021; 301:113989. [PMID: 34022658 DOI: 10.1016/j.psychres.2021.113989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/03/2021] [Indexed: 10/21/2022]
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P6214How to improve long-term prevention in young patients after myocardial infarction - the IPP-Y study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Patients who experienced myocardial infarction (MI) at a young age are of special medical and socioeconomic interest; cardiovascular risk factor control to prevent recurrent events is crucial in this specific cohort.
Objectives
The purpose of the study was to evaluate long-term risk factor control in young MI-patients in clinical practice and investigate the effects of a modern intensive prevention program in a prospective randomized trial. In a genetic substudy it was analyzed if prevention effects were depending on individual genetic risk.
Methods
Patients who had MI at age of ≤45 years were revisited after a mean period of 5.7±4.0 years to evaluate long-term risk factor control. Furthermore a 12-months intensive prevention program in young MI-patients (IPP-Y), coordinated by non-physician prevention assistants and including personal teachings, telephone contacts, clinical and telemetric control of risk factors, was compared to usual care in a randomized trial. Primary endpoint of the randomized trial was prevention success, defined as improvement of one of the risk factors smoking, LDL cholesterol or physical inactivity without deterioration of the others. As the opposite prevention failure was defined as deterioration of one of the risk factors without improvement of the others. Genetic risk was assessed by polygenetic risk scores, based on 163 SNPs.
Results
Only a minority of the 277 young patients after MI achieved guideline-recommended risk factor targets at long-term follow-up visits: mean body mass index was 29.9±5.1 kg/m2, just 14.8% had a body mass index <25 kg/m2. More than one third (38.3%) were persistent or recurrent smokers. Mean LDL cholesterol level was 94±38 mg/dl, only 27.1% of the patients achieved LDL cholesterol levels <70 mg/dl.
However, the long-term prevention program IPP-Y led to a higher rate of the primary endpoint prevention success (IPP-Y: 49% vs. UC: 27%, p<0.05) and a lower rate of prevention failure (IPP-Y: 15% vs. UC: 38%, p<0.05) compared to usual care after 12 months (see figure). Telemetric control of risk factors as part of the prevention program was used by 71.4% of the patients.
In the genetic subanalysis prevention effects were found in both, patients with high genetic risk as well as patients with low genetic risk assessed by polygenetic risk scores (p=0.79 high vs. low genetic risk).
Effects of IPP-Y during 12 months
Conclusions
To our knowledge this is the first study on young patients with MI that demonstrates insufficient long-term risk factor control in clinical practice and significant effects of an intensive prevention program. Prevention effects were independent from individual genetic risk.
Acknowledgement/Funding
This work was supported by the Stiftung Bremer Herzen, Bremen, Germany and the Stiftung Bremer Wertpapierbörse, Bremen, Germany
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Abstract
Periodontitis has low-prevalence, highly severe disease manifestations with an early onset and rapid progression. The diagnosis is based on severe destruction of the alveolar bone in adolescents and young adults. Genetic susceptibility variants and smoking are well-established risk factors, but their interactions in modifying disease susceptibility have not been studied. We aimed to identify genetic risk variants of early-onset periodontitis that unmask their effects on tobacco smoke exposure. To this end, we analyzed 79,780,573 common variants in 741 northwest Europeans diagnosed to have >30% bone loss at >2 teeth before 35 y of age, using imputed genotypes of the OmniExpress BeadChip. Never versus ever smokers were compared in a logistic regression analysis via a case-only approach. To explore the effect of tobacco smoke on the expression of the G×S-associated genes, cultures of primary gingival fibroblasts ( n = 9) were exposed to cigarette smoke extract, and transcripts were quantified by reverse transcription polymerase chain reaction. We identified 16 loci for which our analysis suggested an association with G×S increased disease risk ( P < 5 × 10−5). Nine loci had previously been reported to be associated with spirometric measures of pulmonary function by an earlier G×S genome-wide association study. Genome-wide significant cis expression quantitative trait loci were reported for G×S-associated single-nucleotide polymorphisms at ST8SIA1 and SOST, indicating a causal role of these genes in tobacco-related etiopathology. Notably, SOST is a negative regulator of bone growth, and ST8SIA1 has a role in tissue remodeling. Cigarette smoke extract significantly altered the expression of 2 associated genes: SSH1 ( P = 5 × 10−07), which is required for NF-κB activation and innate immune responses to bacterial invasion, and ST8SIA1 ( P = 0.0048). We conclude that the genetic predisposition to early-onset periodontitis is in part triggered by smoking and that tobacco smoke directly affects the expression of genes involved in bone homeostasis, tissue repair, and immune response.
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Abstract
Periodontitis is one of the most common inflammatory human diseases with a strong genetic component. Due to the limited sample size of available periodontitis cohorts and the underlying trait heterogeneity, genome-wide association studies (GWASs) of chronic periodontitis (CP) have largely been unsuccessful in identifying common susceptibility factors. A combination of quantitative trait loci (QTL) mapping in mice with association studies in humans has the potential to discover novel risk loci. To this end, we assessed alveolar bone loss in response to experimental periodontal infection in 25 lines (286 mice) from the Collaborative Cross (CC) mouse population using micro-computed tomography (µCT) analysis. The orthologous human chromosomal regions of the significant QTL were analyzed for association using imputed genotype data (OmniExpress BeadChip arrays) derived from case-control samples of aggressive periodontitis (AgP; 896 cases, 7,104 controls) and chronic periodontitis (CP; 2,746 cases, 1,864 controls) of northwest European and European American descent, respectively. In the mouse genome, QTL mapping revealed 2 significant loci (-log P = 5.3; false discovery rate = 0.06) on chromosomes 1 ( Perio3) and 14 ( Perio4). The mapping resolution ranged from ~1.5 to 3 Mb. Perio3 overlaps with a previously reported QTL associated with residual bone volume in F2 cross and includes the murine gene Ccdc121. Its human orthologue showed previously a nominal significant association with CP in humans. Use of variation data from the genomes of the CC founder strains further refined the QTL and suggested 7 candidate genes ( CAPN8, DUSP23, PCDH17, SNORA17, PCDH9, LECT1, and LECT2). We found no evidence of association of these candidates with the human orthologues. In conclusion, the CC populations enabled mapping of confined QTL that confer susceptibility to alveolar bone loss in mice and larger human phenotype-genotype samples and additional expression data from gingival tissues are likely required to identify true positive signals.
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Abstract
Periodontitis is a common dysbiotic inflammatory disease with an estimated heritability of 50%. Due to the limited sample size of available periodontitis cohorts and the underlying trait heterogeneity, genome-wide association studies (GWAS) of chronic periodontitis (CP) have been unsuccessful in discovering susceptibility factors. A strategy that combines agnostic GWAS with a well-powered candidate-gene approach has the potential to discover novel loci. We combined RNA-seq data from gingival tissues with quantitative trait loci (QTLs) that were identified in a F2-cross of mice resistant and susceptible to infection with oral bacterial pathogens. Four genes, which were located within the mapped QTLs, showed differential expression. The chromosomal regions across the human orthologous were interrogated for putative periodontitis-associated variants using existing GWAS data from a German case-control sample of aggressive periodontitis (AgP; 651 cases, 4,001 controls), the most severe and early onset form of periodontitis. Two haplotype blocks, one upstream to the coding region of UGT2A1 (rs146712414, P = 9.1 × 10-5; odds ratio [OR], 1.34; 95% confidence interval [CI], 1.16-1.56) and one downstream of the genes PF4/PPBP/CXCL5 (rs1595009, P = 1.3 × 10-4; OR, 1.32; 95% CI, 1.15-1.52), were associated with AgP. The association of rs1595009 was validated in an independent cohort of CP of European Americans (1,961 cases and 1,864 controls; P = 0.03; OR, 1.45; 95% CI, 1.01-1.29). This association was further replicated in another sample of 399 German CP cases (disease onset <60 y of age) and 1,633 controls ( P = 0.03; OR, 1.75; 95% CI, 1.06-2.90). The combined estimates of association from all samples were P = 2.9 × 10-5 (OR, 1.2; 95% CI, 1.1-1.3). This study shows the strength of combining QTL mapping and RNA-Seq data from a mouse model with association studies in human case-control samples to identify genetic risk variants of periodontitis.
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GBA-associated parkinsonism and dementia: beyond α-synucleinopathies? Eur J Neurol 2015; 23:520-6. [PMID: 26549049 DOI: 10.1111/ene.12894] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 08/24/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE To date the role of GBA mutations beyond α-synucleinopathies in the parkinsonism-dementia spectrum is still unclear. The aim of the study was to screen for GBA mutations in progressive supranuclear palsy (PSP), corticobasal syndrome (CBS), primary progressive aphasia (PPA) and the behavioural variant of frontotemporal dementia (bvFTD). METHODS In all, 303 patients with a clinical diagnosis of PSP (n = 157), CBS (n = 39), PPA (n = 35) and bvFTD (n = 72) and 587 neurologically healthy controls were screened for the most common GBA mutations. RESULTS GBA mutations were detected in one healthy control and four patients with a clinical diagnosis of PSP (n = 1), probable CBS (n = 2) and PPA (n = 1, with concomitant C9orf72 expansion). Overall the prevalence of GBA mutations was low in non-α-synucleinopathies but significantly higher in the CBS subgroup compared to controls. CONCLUSION Although numbers are small, our findings indicate that the clinical phenotype of GBA-associated neurodegenerative disease is more heterogeneous than previously assumed, including phenotypes not usually associated with underlying α-synucleinopathies. This may be of relevance, once causal therapeutic strategies for GBA-associated neurodegenerative disease are developed.
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3D-based visual physical activity assessment of children. CURRENT DIRECTIONS IN BIOMEDICAL ENGINEERING 2015. [DOI: 10.1515/cdbme-2015-0111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
In the last decades, an alarming rise in prevalence of childhood overweight and obesity has been observed which is partly attributed to a lack in physical activity and has started to become a public health concern. Therefore, the necessity for accurate physical activity assessment has become more and more apparent. Physical activity can be assessed objectively using accelerometers or combined devices. The application of such devices is sometimes complex and wearing the device may influence the behaviour of the test person. Therefore, assessment without any worn device would be an advantage.
A RGB-D camera device captures motion of the test person in a specific measurement area. After reducing the data and subtraction of the voxel distance, an activity level can be calculated.
The calculated activity level is similar to acceleration data of common monitoring devices. The calculated activity level is the sum of the person’s activity. Little activity with small movement can be differentiated from intense activity with large movement and high acceleration as well as no activity. The data can be structured in body-activity and limb-activity. Classifying those categories increases the benefit of this assessment compared to common accelerometers.
With the RGB-D based assessment objective, contextual information of different physical activity levels can be provided. Physical activity assessment without a worn device offers advantages such as the lack of manipulation of the device and its positioning, also the person’s compliance is no issue influencing the assessment. The RGB-D based assessment is similar to acceleration data and can be converted into comparable data and units after calibration. For more specific assessments a validation with accelerometers and the calibration of the derived data is necessary.
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14 Next generation sequencing (NGS) approach to identify genetic alterations in head and neck squamous cell carcinoma. Oral Oncol 2015. [DOI: 10.1016/j.oraloncology.2015.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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10
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Risk of recurrent cervical artery dissection during pregnancy, childbirth and puerperium. Eur J Neurol 2014; 22:736-9. [DOI: 10.1111/ene.12602] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 09/24/2014] [Indexed: 11/28/2022]
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Transcranial oscillatory direct current stimulation during sleep improves declarative memory consolidation in children with attention-deficit/hyperactivity disorder to a level comparable to healthy controls. Brain Stimul 2014; 7:793-9. [PMID: 25153776 DOI: 10.1016/j.brs.2014.07.036] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 07/17/2014] [Accepted: 07/17/2014] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Slow oscillations (<1 Hz) during slow wave sleep (SWS) promote the consolidation of declarative memory. Children with attention-deficit/hyperactivity disorder (ADHD) have been shown to display deficits in sleep-dependent consolidation of declarative memory supposedly due to dysfunctional slow brain rhythms during SWS. OBJECTIVE Using transcranial oscillating direct current stimulation (toDCS) at 0.75 Hz, we investigated whether an externally triggered increase in slow oscillations during early SWS elevates memory performance in children with ADHD. METHODS 12 children with ADHD underwent a toDCS and a sham condition in a double-blind crossover study design conducted in a sleep laboratory. Memory was tested using a 2D object-location task. In addition, 12 healthy children performed the same memory task in their home environment. RESULTS Stimulation enhanced slow oscillation power in children with ADHD and boosted memory performance to the same level as in healthy children. CONCLUSION These data indicate that increasing slow oscillation power during sleep by toDCS can alleviate declarative memory deficits in children with ADHD.
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Sleep promotes consolidation of emotional memory in healthy children but not in children with attention-deficit hyperactivity disorder. PLoS One 2013; 8:e65098. [PMID: 23734235 PMCID: PMC3667133 DOI: 10.1371/journal.pone.0065098] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 04/22/2013] [Indexed: 12/01/2022] Open
Abstract
Fronto-limbic brain activity during sleep is believed to support the consolidation of emotional memories in healthy adults. Attention deficit-hyperactivity disorder (ADHD) is accompanied by emotional deficits coincidently caused by dysfunctional interplay of fronto-limbic circuits. This study aimed to examine the role of sleep in the consolidation of emotional memory in ADHD in the context of healthy development. 16 children with ADHD, 16 healthy children, and 20 healthy adults participated in this study. Participants completed an emotional picture recognition paradigm in sleep and wake control conditions. Each condition had an immediate (baseline) and delayed (target) retrieval session. The emotional memory bias was baseline–corrected, and groups were compared in terms of sleep-dependent memory consolidation (sleep vs. wake). We observed an increased sleep-dependent emotional memory bias in healthy children compared to children with ADHD and healthy adults. Frontal oscillatory EEG activity (slow oscillations, theta) during sleep correlated negatively with emotional memory performance in children with ADHD. When combining data of healthy children and adults, correlation coefficients were positive and differed from those in children with ADHD. Since children displayed a higher frontal EEG activity than adults these data indicate a decline in sleep-related consolidation of emotional memory in healthy development. In addition, it is suggested that deficits in sleep-related selection between emotional and non-emotional memories in ADHD exacerbate emotional problems during daytime as they are often reported in ADHD.
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Sleep restores daytime deficits in procedural memory in children with attention-deficit/hyperactivity disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2011; 32:2480-2488. [PMID: 21820271 DOI: 10.1016/j.ridd.2011.06.021] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Accepted: 06/24/2011] [Indexed: 05/31/2023]
Abstract
Sleep supports the consolidation of declarative and procedural memory. While prefrontal cortex (PFC) activity supports the consolidation of declarative memory during sleep, opposite effects of PFC activity are reported with respect to the consolidation of procedural memory during sleep. Patients with attention-deficit/hyperactivity disorder (ADHD) are characterised by a prefrontal hypoactivity. Therefore, we hypothesised that children with ADHD benefit from sleep with respect to procedural memory more than healthy children. Sixteen children with ADHD and 16 healthy controls (aged 9-12) participated in this study. A modification of the serial-reaction-time task was conducted. In the sleep condition, learning took place in the evening and retrieval after a night of sleep, whereas in the wake condition learning took place in the morning and retrieval in the evening without sleep. Children with ADHD showed an improvement in motor skills after sleep compared to the wake condition. Sleep-associated gain in reaction times was positively correlated with the amount of sleep stage 4 and REM-density in ADHD. As expected, sleep did not benefit motor performance in the group of healthy children. These data suggest that sleep in ADHD normalizes deficits in procedural memory observed during daytime. It is discussed whether in patients with ADHD attenuated prefrontal control enables sleep-dependent gains in motor skills by reducing the competitive interference between explicit and implicit components within a motor task.
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Change in delusions is associated with change in "jumping to conclusions". Psychiatry Res 2009; 170:124-7. [PMID: 19906443 DOI: 10.1016/j.psychres.2008.10.020] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2008] [Revised: 08/26/2008] [Accepted: 10/23/2008] [Indexed: 11/27/2022]
Abstract
Evidence has been put forward that premature termination of data collection and jumping to conclusions behavior (JTC) is associated with delusions. However, few investigations have attempted to track associations between changes in delusions and changes in JTC measures. In the current study individuals with schizophrenia spectrum disorders completed a version of the JTC task (involving fishing from lakes as opposed to drawing beads from a jar) at two timepoints 12 weeks apart. The results revealed significant negative correlations between change in task performance (number of requested pieces of information) and change in delusion scores over time. This evidence is consistent with the contention that the JTC task is sensitive to the cognitive systems underlying delusions in schizophrenia spectrum disorders.
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HIV epidemics among men who have sex with men in central and eastern Europe. Sex Transm Infect 2009; 85:336-42. [PMID: 19773456 DOI: 10.1136/sti.2008.035436] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
BACKGROUND The "Lister family complex," an extensive Swedish family with autosomal dominant Parkinson disease, was first described by Henry Mjönes in 1949. On the basis of clinical, molecular, and genealogic findings on a Swedish and an American family branch, we provide genetic evidence that explains the parkinsonism in this extended pedigree. METHODS Clinical methods included a detailed neurologic exam of the proband of the Swedish family branch, MRI, and ([123]I)-beta-CIT SPECT imaging. Genomic analysis included alpha-synuclein sequencing, SNCA real-time PCR dosage, chromosome 4q21 microsatellite analysis, and high-resolution microarray genotyping. The geographic origin and ancestral genealogy of each pedigree were researched in the medical literature and Swedish Parish records. RESULTS The proband of the Swedish family branch presented with early dysautonomia followed by progressive parkinsonism suggestive of multiple system atrophy. Molecular analysis identified a genomic duplication of <0.9 Mb encompassing alpha-synuclein and multimerin 1 (SNCA-MMRN1), flanked by long interspersed repeat sequences (LINE L1). Microsatellite variability within the genomic interval was identical to that previously described for a Swedish American family with an alpha-synuclein triplication. Subsequent genealogic investigation suggested that both kindreds are ancestrally related to the Lister family complex. CONCLUSION Our findings extend clinical, genetic, and genealogical research on the Lister family complex. The genetic basis for familial parkinsonism is an SNCA-MMRN11 multiplication, but whereas SNCA-MMRN1 duplication in the Swedish proband (Branch J) leads to late-onset autonomic dysfunction and parkinsonism, SNCA-MMRN1 triplication in the Swedish American family (Branch I) leads to early-onset Parkinson disease and dementia.
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Abstract
Presented is a pedigree with infancy-onset benign hereditary chorea (BHC) caused by a novel nonsense mutation in exon 3 (523G-->T, E175X) of the TITF-1 (Nkx2.1) gene. Four confirmed mutation carriers showed the typical movement disorder of BHC and congenital hypothyroidism. Surprisingly, treatment with levodopa improved gait dramatically and reduced chorea in two patients. Dopaminergic drugs should be considered a useful therapeutic option in BHC.
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Mechanical gradient interphase by interdiffusion and antiplasticisation effect—study of an epoxy/thermoplastic system. POLYMER 2005. [DOI: 10.1016/j.polymer.2005.06.098] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Korrelation von quantitativer sensorischer Testung und Dichte intraepidermaler Nervenfasern bei schmerzhaften Neuropathien. AKTUELLE NEUROLOGIE 2004. [DOI: 10.1055/s-2004-833435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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[Medical informatics in obstetrics and gynecology - the actual challenge?]. ZENTRALBLATT FUR GYNAKOLOGIE 2003; 125:441-5. [PMID: 14634872 DOI: 10.1055/s-2003-44577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
There is common agreement about the importance of information management systems in obstetrics and gynecology. Those systems are necessary tools for medical quality management and are essential for the actual preparation for the age of the "diagnosis related groups" that will be introduced in Germany next year. Nevertheless there are only small scientifically activities to improve information management systems and to evaluate their performance. Great efforts are necessary to develop new features and not to loose the conflict between the needs of the physicians and their patients and the needs and demands of hospital administrative authorities.
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Use of scanning force microscopy studies with combined friction, stiffness and thermal diffusivity contrasts for microscopic characterization of automotive brake pads. SURF INTERFACE ANAL 2002. [DOI: 10.1002/sia.1171] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Abstract
We present a case illustration of the significant effect that deep brain stimulation (DBS) of the thalamus can have on vocal tremor. A 72-year-old female with a history of essential tremor was noted preoperatively to have a moderate vocal tremor (3 on a scale of 1-5). Following bilateral DBS of the thalamus, the vocal tremor rating improved to 1. Acoustic analysis demonstrated her vocal tremor to be affecting the amplitude of her voice at 5.58 Hz preoperatively, at 1. 93 Hz postoperatively with both leads on and at 1.54 Hz with only the left lead on. A videotaped endoscopic view of the patient's vocal cords (presented at the 1999 ASSFN meeting) clearly illustrated the dramatic changes apparent in the vocal tremor when the stimulators were turned on and off.
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Abstract
We present our technique for deep brain stimulation (DBS) of the subthalamic nucleus (STN) and include information which may be helpful in general DBS. With the patient in a stereotactic head frame, the anterior and posterior commissures are identified on SPGR-sequence magnetic resonance imaging (MRI). STN coordinates are based on a stereotactic brain atlas at 12 mm lateral, 2 mm posterior and 5 mm caudal to the midcommissural point. Surgical navigation software allows for planning of the trajectory. Electromyography is used to quantitatively measure tremor responses to macrostimulation. Permanent lead placement is confirmed with intraoperative fluoroscopy and postoperative MRI.
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Total body and regional bone mineral densitometry (BMD) and soft tissue measurements: correlations of BMD parameter to lumbar spine and hip. Calcif Tissue Int 2000; 67:111-5. [PMID: 10920214 DOI: 10.1007/s00223001124] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Bone loss in men and women seems to differ according to the skeletal regions or particular areas being evaluated. Dual energy X-ray absorptiometry (DXA) is the method of choice for measuring total body and regional bone mineral area density (BMD). The aim of the study was to evaluate the importance of DXA measurements of total body in relation to lumbar spine and hip in different scan beam designs. In 300 patients, ages 43-80 years, lumbar spine, hip, total body and regional bone mineral area density, and soft tissue measurements were performed on all subjects in the supine position on a QDR 2000 using single beam (SB) and fan beam (FB). Short-term precision errors were 0.7% (SB) and 1.2% (FB) for BMD total of the total body and between 1.2% and 8.0% for soft tissue measurements. All mid-term precision errors of BMD total, right and left leg, and pelvis were below 2.0% with SB and FB, whereas precision errors of thoracic and lumbar spine varied depending on the scan mode being applied. In contrast, all mid-term precision errors of soft tissue measurements were greater (2.6-11.0%). All SB values of BMD and soft tissue measurement were significantly higher than FB values, except for BMD values of the head, thoracic spine, and pelvis. Furthermore, BMD total of the total body scan correlated significantly (P < 0. 001) with all subregional parameters with best "r"-values (0.86-0. 92) for the right and left leg in SB and FB design. In addition, there were excellent correlations (r > 0.94, P < 0.001) between the right and left legs (SB and FB) or arms (SB). There were also highly significant correlations between the lumbar spine (or hip) and total body, being best for the subregional thorax. Our data demonstrate short-and mid-term precision errors of BMD with reproducible results for most areas in SB and FB design, whereas soft tissue measurements vary depending on the area being measured. Furthermore, there is a close relationship between BMD values of total body total and subregional parameters and lumbar spine and hip scans, respectively.
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Interphase characterization via the stiffness contrast of a scanning force microscope in displacement modulation mode. SURF INTERFACE ANAL 2000. [DOI: 10.1002/1096-9918(200008)30:1<410::aid-sia846>3.0.co;2-g] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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29
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Lexical and semantic retrieval changes after pallidotomy for Parkinson's disease. Arch Clin Neuropsychol 1998. [DOI: 10.1093/arclin/13.1.108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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30
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Bone mineral density of opposing hips using dual energy X-Ray absorptiometry in single-beam and fan-beam design. Calcif Tissue Int 1997; 61:445-7. [PMID: 9383269 DOI: 10.1007/s002239900365] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Bone densitometry focuses on bone mineral area density (BMD in g/cm2) of the proximal femur and spine in anterior-posterior (AP) projections. Artifacts, such as osteoarthritis and osteophytic calcifications (OC) influence spine BMD, especially in AP scans. If only two sites are measured, as is usual in clinical practice, there may be advantages to measuring both femora rather than one femur and the spine. This would not be useful, however, if there was strong symmetry between the two sides. Furthermore, fan beam (FB) techniques have become available for measuring BMD with less data acquisition time. We compared densitometry of opposing femora in 421 patients (369 women, mean age 59.0 +/- 4.8; 52 men, mean age 56.9 +/- 7.4) using dual-energy X-ray absorptiometry (DXA): both single-beam (SB) and FB modes were evaluated. The precision errors in vivo (short- and midterm) of total BMD were 0.7% for both SB and FB. The total BMD and BMC of the left hip (0.817 +/- 0.124 g/cm2, 31. 3 +/- 6.4 g) were significantly (P < 0.001) higher (2-3%) than the corresponding values of the right hip (0.801 +/- 0.125 g/cm2, 30.3 +/- 6.3 g) in both SB and FB (left BMD 0.802 +/- 0.117 g/cm2, BMC 30. 0 +/- 6.2 g versus right BMD 0.795 +/- 0.117 g/cm2, BMC 29.3 +/- 6.3 g) modes. However, BMD of the femoral neck and Ward's triangle were not significantly (P > 0.05) different between the two sides. The FB results were generally 2% lower than SB results. There were highly significant (P < 0.001) correlations (r > 0.9) between both hips using both SB and FB. For diagnostic procedures and longitudinal studies, one should consider that there are bilateral differences of femur BMD, as well as differences between FB and SB scan modes.
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Inhibition of voluntary activity by thalamic stimulation in humans: relevance for the control of tremor. Mov Disord 1997; 12:727-37. [PMID: 9380056 DOI: 10.1002/mds.870120517] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The motor effects of stimuli delivered through four-channel, quadripolar macroelectrodes chronically implanted in the ventrolateral thalamus were studied in 20 awake cooperating human subjects. Single stimuli could inhibit voluntary contraction of the contralateral first dorsal interosseous muscle (FDI) for up to 200 ms. The inhibition was often followed by a rebound facilitation or by oscillatory activity. This inhibition appeared to arise from the ventrolateral thalamus and could not be obtained in other patients by stimulation of the periventricular grey matter (PVG), the globus pallidus internus (GPI), or the subthalamic nucleus (STN). The neural elements activated by the stimulus had a short chronaxie and a short refractory period, implying that they were large-diameter axons. Similar effects were obtained from each of the four electrodes in the row, suggesting that this fiber system lay parallel rather than perpendicular to the implanted macroelectrode. The inhibition resulting from a single stimulus was diminished by a prior stimulus or train of stimuli. A continuous train of stimuli produced inhibition for only the first 200 ms. We propose that the thalamic stimulus activates a neural network which includes thalamic relay cells and neurons of the thalamic reticular nucleus and that the inhibition of thalamic relay cells habituates with repeated stimuli. It has been suggested that parkinsonian rest tremor results from synchronization of the oscillatory activity of this network. If this is the case, continuous thalamic stimulation might disrupt this oscillation by diminishing the inhibitory phase.
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Chronic electrical stimulation of the gasserian ganglion for the relief of pain in a series of 34 patients. J Neurosurg 1997; 86:197-202. [PMID: 9010419 DOI: 10.3171/jns.1997.86.2.0197] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The use of an implanted system for chronic electrical stimulation of the gasserian ganglion for relief of facial pain was described in 1980 by Meyerson and Håkansson. Between 1982 and 1995, the senior author (R.R.T.) performed gasserian ganglion stimulation in 34 patients for the relief of chronic medically intractable facial pain. The etiology of pain was peripheral damage to the trigeminal nerve in 22 patients (65%), central (stroke) damage in seven (21%), postherpetic neuralgia in four (12%), and unclassifiable cause in one (3%). All patients received a trial of transcutaneous stimulation (Stage 1). Successful trials in 19 patients (56%) were followed by implantation of a permanent system (Stage II). Trial and postimplantation stimulation were deemed successful when there was a reduction of pain by at least 50% whenever the stimulator was on. Success rates varied from five (71%) of seven patients for central pain to five (23%) of 22 for peripheral pain and none (0%) of four for postherpetic neuralgia. The median follow-up duration in successful cases was 22.5 months. Infections occurred in seven patients, all of whom had undergone Stage II treatment. Infections were more frequent when the stimulating electrode from Stage I was left in place for Stage II (six [43%] of 14) than when completely new hardware was used and prophylactic antibiotic drugs were administered (one [20%] of five). Other complications included iatrogenic injury to the trigeminal nerve or ganglion in three cases (9%), transient diplopia in two (6%), increased pain in two (6%), and various technical problems in 10 (29%). It is concluded that pain of central origin (stroke) is the type most likely to be relieved by this procedure. This finding is new, as the few other clinical series reported to date contain no patients with this type of pain. The risk of infection seems to be lower when completely new hardware is used for Stage II and prophylactic antibiotic drugs are administered.
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Abstract
Deep brain stimulation (DBS) and thalamotomy are both capable of abolishing tremor. However, no technique is perfect and if thalamotomy proves inadequate so that tremor recurs, presumably because of suboptimal lesion location, the only option is to repeat the thalamotomy. With DBS all that has been necessary to date is to change the parameters of stimulation. Similarly with complications such as the "cerebellar" ones and paraesthesiae. If these occur after thalamotomy one can only wait and hope that they will subside and they do not always do so. With DBS, changing the parameters in the authors' patients has so far been successful in eliminating them. DBS, like thalamotomy is very effective for controlling tremor in Parkinson's disease (PD) and essential tremor (ET) and for improving dexterity in ET, but both techniques are less useful for the control of dopa dyskinesia, Parkinsonian rigidity, or impaired dexterity in PD, though DBS may be better than thalamotomy for the latter condition. On the other hand, both DBS and thalamotomy are very effective in improving dexterity in PD and ET may depend upon the fact that in PD bradykinesia is a major component, whereas in ET only the tremor is. The advantages of DBS over thalamotomy have to be weighed against the peculiar risks of DBS and of course, its cost.
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Lateral spine dual-energy X-ray absorptiometry bone mineral measurement with fan-beam design: effect of osteophytic calcifications on lateral and anteroposterior spine BMD. Rheumatol Int 1995; 15:151-4. [PMID: 8835296 DOI: 10.1007/bf00301772] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Recently, fan beam (FB) designs have been made available by several manufacturers (Aloka, Hologic Lunar and Sophar) to measure lumbar spine bone mineral area density (BMD) in both an anteroposterior (AP) and a lateral projection. The present study was performed to evaluate some characteristics of a new dual energy X-ray absorptiometry (DXA) system for supine lateral scans in normals and to study possible advantages for patients with osteophytic calcifications (OC). The precision errors of in vitro and in vivo measurements were estimated by an anthropomorphic phantom and in healthy volunteers. To study the effect of osteoarthritic changes on AP and lateral DXA measurements, BMC (bone mineral content) and BMD were measured in age-matched women (n = 150) with and without OC. Precision errors for lateral BMD in vitro over 1 and 6 months were 0.58/0.67% (slow/fast scan modes) and 0.67/0.77% (slow/fast scan modes), respectively. The short- and mid-term reproducibility of BMD values were 2% and 3.5%, respectively, using the compare function (3.5% and 7.5%, respectively, without the compare facility). The analysis of women with and without OC (n = 150) demonstrated higher mean values for AP BMD (0.892 +/- 0.145 g/cm2) in patients with OC (n = 75) than in normals (0.836 +/- 0.135 g/cm2, n = 75, difference 6.3%). For lateral scans, BMD differed to a minor degree (3.1%) in patients with OC (0.629 +/- 0.133 g/cm2) compared with normals (0.610 +/- 0.117 g/cm2). Corresponding results were obtained in fast FB mode. Furthermore, we found significant (P < 0.0001) correlations between BMD in lateral and AP scans in patients without OC (r = 0.63) and in patients with OC (r = 0.57). Although the FB design facilitated fast AP and lateral scans, the higher precision errors of lateral scans could limit its application in longitudinal studies. The use of compare function should be recommended. However, BMD of lateral scans was less influenced by OC.
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Evaluation of dual-energy X-ray absorptiometry bone mineral measurement--comparison of a single-beam and fan-beam design: the effect of osteophytic calcification on spine bone mineral density. Calcif Tissue Int 1995; 56:192-5. [PMID: 7750022 DOI: 10.1007/bf00298608] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Dual energy X-ray absorptiometry (DXA) using a single-beam (SB) design is a well-established procedure for measuring bone mineral area density (BMD). Recently, fan beam (FB) techniques have become available to measure BMD. We evaluated the QDR1000 and QDR2000 densitometers with regard to precision and cross-compared values using single beam (SB) and FB techniques. To study the effect of osteoarthritic changes on bone measurement (BMC in g) and bone mineral area density (BMD in g/cm2), both parameters were measured in patients with and without osteophytic calcifications (OC) of the lumbar spine. Precision errors for BMD in vitro over 1 and 6 months using the QDR2000 were 0.4% and 0.6% for SB and 0.5% and 0.7% for the three FB modes. For QDR1000 only SB is available. Using this scan mode, the BMD difference (delta = 0.1%) in vitro between QDR1000 and QDR2000 was not significant. The short-term (same day) reproducibility of BMD in vivo was 0.85% for SB mode and 1.1% for FB scan mode (n = 33). The midterm (1 month) precision errors were 0.9% for SB and 1.5% for FB (n = 11). The spine BMD of 751 patients from our outpatient clinic and department of rheumatology was 1.7% lower with FB than with SB (0.878 +/- 0.137 versus 0.888 +/- 0.146 g/cm2). Lower (1.8%) BMD values were also found in the hip with FB compared to SB (0.805 +/- 0.111 versus 0.821 +/- 0.111 g/cm2). There was a highly significant (P < 0.00001) correlation between SB and FB on the spine (r = 0.99) and hip (r = 0.98) using the QDR2000. Correlations found QDR1000 and QDR2000 were lower on the spine (r = 0.97) and hip (r = 0.93).(ABSTRACT TRUNCATED AT 250 WORDS)
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Otitis media and CNS complications. THE JOURNAL OF OTOLARYNGOLOGY 1992; 21:224-6. [PMID: 1404577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Intracranial complications from otitis media can be quite devastating to the patient if an early diagnosis is not made. Patients may develop meningitis, venous sinus thrombosis or cranial nerve palsies, as well as intracranial abscess. The presenting features in such cases may be subtle and include headache, nausea, vomiting, personality changes and signs of increased intracranial pressure as well as focal neurological deficits. A case of intracranial brain abscess is presented in a patient with a history of chronic otitis media with cholesteatoma. Delay in the diagnosis of intracranial complications of otitis media can lead to improper treatment with increased morbidity and mortality. The etiology and treatment of complications affecting the CNS is discussed.
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Interurban migration and the dynamics of a system of cities: 1. The stochastic framework with an application to the French urban system. ENVIRONMENT & PLANNING A 1992; 24:181-198. [PMID: 12343536 DOI: 10.1068/a240181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
"A stochastic framework for the modelling of interurban migration is presented. The model is an extension of a recently developed master-equation approach to interregional migration. The population dynamics of the French urban system, described by a set of 78 cities, is investigated within the period 1954-82. The importance of synergy effects (self-reinforcing collective effects) as well as socioeconomic macrovariables for the understanding of urban dynamics becomes obvious. A forecasting of urban dynamics...[up to the year 2002 confirms] this result and [gives] further insight into the nested structure of urban systems."
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Abstract
The case of a 65-year-old woman who developed a spinal synovial cyst at the L4-5 disk space is reported. Her clinical signs and symptoms are presented. A comparison among her preoperative myelogram, computed tomography scan, and magnetic resonance imaging showed magnetic resonance imaging to be more accurate in detailing both the intraoperative and pathological findings.
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Abstract
"The dynamic process of settlement formation is a fundamental issue in regional science. Our proposed model integrates the economic and migratory sectors in terms of endogenous variables in order to describe the evolution of continuous population distributions as a self-organising process.... The purpose...is to show that under strongly idealised conditions, a population consisting of different subpopulations with different economic activities will evolve into a differentiated population pattern. Each member of the subpopulations has the possibility to migrate between locations stimulated by rational economic reasons. This idea, which seems almost self-evident on the level of qualitative argumentation, [will] be cast into a mathematically self-contained quantitative dynamic model."
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Characteristic frequencies in the semiclassical Jaynes-Cummings model. PHYSICAL REVIEW. A, GENERAL PHYSICS 1987; 35:5274-5277. [PMID: 9898162 DOI: 10.1103/physreva.35.5274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Abstract
To investigate activation and discharge patterns of central nervous system neurons that regenerate lengthy axons along peripheral nerve grafts we inserted a 4 cm long autologous segment of sciatic nerve into the dorsolateral medulla oblongata of adult rats. Two to 6 months after grafting, the distribution of the cells of origin of the regenerating axons in many nuclei of the brainstem was documented by retrograde horseradish peroxidase labelling from the cut end of the grafts. Functional properties of neurons regenerating axons into the grafts were studied by recording from single regenerated fibers teased from the grafts. Conduction velocities of graft fibers ranged from less than 1 m/s to 25 m/s (30 degrees C). Spontaneous centrifugal impulse traffic in the grafts included units firing in bursts synchronously with the respiratory cycle. Activity in other units was either elicited or inhibited by natural or electrical stimulation of the periphery. Most units recorded in the grafts were neither spontaneously active nor responsive to stimulation of primary afferents. We conclude that: there are central nervous system neurons projecting into the grafts that respond to both excitatory and inhibitory transsynaptic influences; at least some of the spontaneous and induced activity recorded from axons in the grafts resembles that known for normal nerve cells in the regions of the brainstem from which axonal growth arises; and it is possible that many central neurons regenerating axons into peripheral nerve grafts have significantly reduced or altered synaptic inputs.
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'Shaking pups': a disorder of central myelination in the spaniel dog. III. Quantitative aspects of glia and myelin in the spinal cord and optic nerve. Neuropathol Appl Neurobiol 1983; 9:355-68. [PMID: 6646343 DOI: 10.1111/j.1365-2990.1983.tb00121.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Quantification of glial cells, axonal size and myelin thickness and volume were carried out in selected areas of the three funiculi of the cervical spinal cord and the optic nerve of 'shaking pups' and normal littermates at 4 and 8 weeks of age. There was a marked reduction of oligodendrocytes in the affected pups with many of these cells having distended rough endoplasmic reticulum. Oligodendrocyte death was not noticeable. Astrocyte numbers were similar in both normal and affected pups. Axonal diameters were not reduced in the affected pups and there was no apparent correlation between myelination and axonal size in these animals. Total myelin volume and thickness were greatly reduced in the 'shaking pups.' Impaired stem cell division together with metabolic disturbance of oligodendrocytes are considered to be the main causes of the hypomyelination in this mutant.
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Investigations on direct and maternal genetic components of calving performance in heifers. GENETICS SELECTION EVOLUTION 1982. [PMCID: PMC2734613 DOI: 10.1186/1297-9686-14-4-569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Investigations on the individual and maternal components of calving performance in cattle. GENETICS SELECTION EVOLUTION 1980. [PMCID: PMC2736282 DOI: 10.1186/1297-9686-12-4-425b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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47
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Investigations on the individual and maternal components of calving performance in cattle. GENETICS SELECTION EVOLUTION 1980. [PMCID: PMC2740781 DOI: 10.1186/1297-9686-12-4-425c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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48
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[A retrospective study of 83 cases of children with aseptic meningitis]. HAREFUAH 1970; 79:167-70. [PMID: 5503255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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