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Biomedical subjects

R Cohen

Publications and source records attributed to R Cohen.

At least 289 records · Page 16Linked to original sources
PubMed1993

Metabolic and cognitive changes in hereditary ataxia.

Fourteen subjects (affected, n = 7; at risk, n = 7) from one well-known kindred with adult onset autosomal dominant olivopontocerebellar atrophy (OPCA), were studied with [18F]-2-deoxy-D-glucose (FDG) positron emission tomography (PET), magnetic resonance imaging (MRI), cognitive testing and scored neurological examination, and compared with normal controls. The neurological examination, MRI and cognitive tests showed no significant differences between at risk and normal control subjects. Mild cognitive deficits were seen in affected subjects; the degree of cognitive change appeared to relate to the severity of the illness. MRI demonstrated cerebellar and brainstem atrophy in all affected subjects. PET studies showed higher global metabolic rates (mean [SD]) in at risk subjects (10.5 [1.5] mg per min per 100 g) as compared to affected (9.0 [0.8] mg per min per 100 g) and normal control subjects (9.1 [1.5] mg per min per 100 g). Normalized (region/global average) regional metabolic rates were reduced in cerebellar hemispheres and vermis, and in frontal and prefrontal areas of affected subjects in comparison to at risk and normal control subjects. These findings indicate that functional changes in some forms of autosomal dominant hereditary cerebellar ataxia may extend beyond the cerebellum and brainstem to involve other parts of the neuraxis.

Adult↗
PubMed1993

The opioid receptor binding of dezocine, morphine, fentanyl, butorphanol and nalbuphine.

The ability of morphine, fentanyl, butorphanol, nalbuphine, and dezocine to compete with radiolabeled ligands for binding at the mu1, mu2, kappa1, and delta opioid receptors and the sigma receptor was characterized. In the absence of sodium, the potency of opioid receptor competition at each receptor site was found to be: mu1-fentanyl > butorphanol > morphine > or = dezocine = nalbuphine; mu2-butorphanol > fentanyl > nalbuphine > morphine = dezocine; kappa1-butorphanol > nalbuphine >> morphine > or = dezocine > fentanyl; and delta-butorphanol > nalbuphine > or = dezocine > morphine > fentanyl. For all five compounds, competition at the sigma receptor was weak, with nalbuphine and dezocine having Kis of approximately 0.5 microM and the other opioids having Kis of greater than 1 microM. Since the presence of 100 mM NaCl during the competitive binding decreased the K(i), to varying degrees, of all five opioids at the mu1 and delta receptors and of some of the opioids at the mu2 and kappa1 receptors, the five compounds studied appear to differ in efficacy at the five receptor sites.

Analgesics, Opioid↗
PubMed1993

Medical costs of children of alcoholics--pay now or pay later.

Inpatient hospital utilization rates are compared for children of alcoholics (COAs) and other children. Data for the study are from hospital utilization statistics on 1.6 million insurance subscribers and their dependents. The findings indicate that COAs have higher rates of inpatient hospital admissions, spend more days in the hospital and incur greater hospital charges, and are more susceptible to specific illnesses than other children. COAs are also more susceptible than other children to specific illnesses such as mental illness, substance abuse, and injuries and poisonings. The findings demonstrate the need to train health care professionals about the relationship between parental alcoholism and childhood illnesses and the need for drug and alcohol prevention and intervention programs for children.

Adolescent↗
PubMed1993

Reproducibility of resting cerebral blood flow measurements with H2(15)O positron emission tomography in humans.

Two consecutive measurements of resting CBF were carried out in normal volunteers (n = 25) using H2(15)O positron emission tomography. Absolute whole-brain blood flow (WBBF; ml 100 g-1 min-1, mean +/- SD) for the first (40.3 +/- 6.4) and second (39.3 +/- 6.5) measurements was not significantly different (mean % difference 2.3 +/- 8.7). Analysis of regions of interest showed no significant differences in absolute regional CBF (rCBF) and normalized (rCBF/WBBF) rCBF. Left-right differences were also not significant. These data demonstrate the reproducibility of resting CBF measurements in normal humans.

Adult↗
PubMed1993

Guidelines for estimating the real cost of an objective structured clinical examination.

A major impediment to the use of the objective structured clinical examination (OSCE) is that it is a labor-intensive and costly form of assessment. The cost of an OSCE is highly dependent on the particular model used, the extent to which hidden costs are reported, and the purpose of the examination. The authors detail hypothetical costs of running a four-hour OSCE for 120 medical students at one medical school. Costs are reported for four phases of this process: development, production, administration, and post-examination reporting and analysis. Costs are reported at two ends of the spectrum: the high end, where it is assumed that little is paid for by the institution and that faculty receive honoraria for work put into the examination; and the low end, where it is assumed that the sponsoring institution defrays basic costs and that faculty do not receive honoraria for their participation. The total costs reported for a first-time examination were $104,400 and $59,460 (Canadian dollars) at the high and low ends, respectively. These translate to per-student costs of $870 and $496. The cost of running an OSCE is high. However, the OSCE is uniquely capable of assessing many fundamental clinical skills that are presently not being assessed in a rigorous way in most medical schools.

Canada↗
PubMed1993

Phaeochromocytoma in multiple endocrine neoplasia type 2 A: survey of 100 cases.

OBJECTIVE: We report clinical, biochemical, morphological and histological data of phaeochromocytoma in 40 French families and in apparently sporadic cases of multiple endocrine neoplasia (MEN) type 2 A (medullary thyroid carcinoma, phaeochromocytoma, with or without hyperparathyroidism). DESIGN: This retrospective study was obtained from cases registered by the 'Groupe d'Etudes des Tumeurs à Calcitonine' from 1968 to 1990. We analysed the cases having sufficiently precise data on phaeochromocytoma with Pigas Software. PATIENTS: Characteristics of phaeochromocytoma in 100 patients with MEN 2 A were reviewed. Phaeochromocytoma was bilateral in 51%. The disease was inherited in 94 patients from 40 families (40 probands, 54 relatives), and was apparently sporadic in six. RESULTS: In this series, diagnostic circumstances were highly suggestive of phaeochromocytoma in 39.8% of the cases, whereas in 43.2%, diagnosis was made through systematic investigations of patients, either before (27.3%) or after (13.6%) thyroidectomy, or after discovery of hyperparathyroidism (2.3%). Fifteen per cent of patients were detected by family screening. Sudden death occurred in 8.9%, malignant phaeochromocytoma in 3%, and ectopic tissue in 4% of the cases. Urinary metanephrines appeared to be the most sensitive screening test. The extent of clinical symptoms was not associated with a particular hormonal pattern. Bilateral adrenalectomy was performed in 60% (in one step in 50%, in two steps in 10%). In these patients, bilateral histological lesions were observed in 92.5%. Simultaneous diagnosis for adrenal and thyroid disease was made in 73.4%, but phaeochromocytoma may be diagnosed before (9.6%) or after (17%) medullary thyroid carcinoma, with an interval greater than 2 years in 25 cases. CONCLUSION: Owing to variable clinical symptoms of phaeochromocytoma in these 100 cases of MEN 2 A, systemic biological adrenal assay is required. The search for phaeochromocytoma in medullary thyroid carcinoma (and vice versa) has to be systematically performed, even in apparently sporadic cases. Screening for phaeochromocytoma must be repeated for years, owing to the frequency of bilateral adrenal disease.

Adrenal Gland Neoplasms↗
PubMed1993

Inclusion body myositis as a cause of respiratory failure.

Inclusion body myositis (IBM) is a slowly progressive myopathy that has not been reported to affect respiratory muscles. It is often refractory to treatment and a muscle biopsy specimen is necessary for the diagnosis. This is a report of a patient with IBM who quickly progressed to respiratory muscle failure requiring intubation.

Aged↗
PubMed1993

A rapid field test for the determination of colostral ingestion by calves, based on gamma-glutamyltransferase.

A qualitative field test for determining the blood level of the enzyme gamma-glutamyltransferase is described for the evaluation of colostral ingestion. The method for enzyme determination is based on dry chemistry technology, and a simple 37 degrees C incubator and colour chart for estimating the activity. There were good correlations between results obtained with the field tests and those obtained with the Reflotron and the wet chemistry conventional methods. Following colostral intake by the calf, blood gamma-glutamyltransferase increased more than 100 fold. There were good correlations between gamma-glutamyltransferase and total globulins in the serum on days 2 and 3 after colostrum intake. Lower but significant correlations were seen between the enzyme and serum total proteins. Good correlation was also seen between the serum enzyme activity and the albumin to globulin ratio. Electrophoretic separation of calf serum showed a significant increase of gamma-globulins after colostral ingestion. The implications and importance of field test are discussed.

Animals↗
PubMed1993

[Antibiotherapy as first choice in infectious meningitis].

The choice of antibiotics in bacterial meningitis must integrate several parameters. i) The bacterial epidemiology of community acquired meningitis: Haemophilus influenzae (Hi) Neisseria meningitidis (Nm), Streptococcus pneumoniae (Sp) represents more than 95% of cases; ii) The increase of antibiotic bacterial resistance, particularly preoccupying for Sp; iii) The microbiological properties and pharmacokinetics of antibiotics, especially their penetration in CSF: the concentrations achieved must be several times higher than the MBC. In fact, CSF is not favourable to the antibiotic activity; iv) The results of clinical comparative trials; v) The contribution of animal models to the knowledge of meningitis physiopathology. Third generation cephalosporins (cefotaxime, ceftriaxone) satisfy this objective for Hi, Nm, and penicillin sensitive strains of Sp. For penicillin resistant Sp, no treatment can achieve antibiotic CSF concentrations higher than ten times the MBC. An increase in dosage of cephalosporins, the use of an other regimen (Vancomycin or imipenem) and antibiotic association (rifamycin, fosfomycin) are needed.

Anti-Bacterial Agents↗
PubMed1993

Real-time measurement of sub-PPM concentrations of airborne chemicals in semiconductor manufacturing.

Real-time mass spectroscopy (ICAMS) can provide hourly or daily estimates of employee exposure. Field calibration of the unit indicated essentially linear response from 0.01 (Cellosolve Acetate) and 0.03 ppm (Diglyme) to 1 ppm in semiconductor cleanrooms. The instrument can be programmed for 4 minute readings on a single compound, or for rotation among several chemicals, each requiring 4 minute dwell times for analysis. In contrast to full shift personal sampling methods to measure exposure, ICAMS offers insights into the occurrence of peak exposures. In addition, in the occupational environment ICAMS results can be integrated to estimate full-shift within a zone exposures. Thus, the ICAMS extends measurement sensitivities below those currently available and offers a viable alternative to personal sampling in the semiconductor industry.

Air Movements↗
PubMed1992

Physical aspects of the EEG in schizophrenics.

Physical and dynamic aspects of the electroencephalogram (EEG) were evaluated in 12 schizophrenic patients and 12 matched healthy control subjects by means of two descriptive measures proposed by Hjorth (complexity and mobility) and by a nonlinear measure, dimensional complexity. These measures were compared to power spectra analyses. EEG was recorded from frontal, central, and parietal leads under resting conditions (eyes open and eyes closed) for 12 epochs each of 25 sec. Patients showed the expected increased activity in the 1-7 Hz band and, furthermore, a scalp distribution of dimensional complexity and Hjorth complexity opposite to the distribution in controls: in patients dimensional complexity yielded higher values at frontal (Fz) than central (Cz) leads, whereas the resemblance to sinusoidal waveshape (Hjorth complexity) was larger at Fz than Cz. Results indicate more dynamic complexity or variables determining the dynamics of brain processes in frontal areas in patients.

Adult↗
PubMed1992

Tarsal lameness of dairy bulls housed at two artificial insemination centers: 24 cases (1975-1987).

Degenerative joint disease of the tarsi was diagnosed in 20 of 24 Holstein bulls with tarsal lameness at 2 artificial insemination centers from 1975 to 1987. Each of the 2 centers housed about 100 bulls/yr. Of the 24 bulls with tarsal lameness, 22 were from the artificial insemination center designated as A, and 2 were from the center designated as B. Examination of the housing and management procedures revealed that center A had concrete floors with cuboidal-shaped yards, whereas center B had deep sand flooring, with long, narrow yards. The only other difference between the 2 centers was that center A used 1- and 2-year-old bulls as teasers for older, heavier bulls to mount, whereas center B used bulls that were at least 6 years old to withstand the stress placed on their hind limbs by the weight of bulls undergoing semen collection. Radiographic lesions of tarsi of bulls from both centers ranged from distention of the tibiotarsal joint pouch to hypertrophic degenerative osteoarthritis of the distal, intertarsal, and tarsometatarsal joints. It was concluded that the concrete flooring and the semen collecting practices were responsible for the high prevalence of tarsal lameness and degenerative joint disease of the tarsi in bulls housed at center A.

Animals↗
PubMed1992

CCP II: a novel calcitonin carboxy terminal peptide is expressed in normal thyroid tissue.

We have recently identified in medullary thyroid carcinoma the existence of a second calcitonin messenger, generated by a splicing between the 3' coding region of exon 4 and exon 5 of Calc I gene. It differs from the first one in its 3' coding sequence and codes for a calcitonin precursor which generates the same N terminal peptide, calcitonin and a specific 21 amino acid carboxy terminal peptide differing from Katacalcin by its 8 last amino acids. We searched for the expression of this new messenger in normal human thyroid tissue by Northern and by polymerase chain reaction techniques. This second calcitonin messenger was expressed in 4/4 normal thyroids and 4/5 medullary thyroid carcinoma tissue samples. The expression of this second messenger is apparently a common occurrence in C cells whether normal or tumoral.

Amino Acid Sequence↗