Effects of an environmental estrogen on male Gulf pipefish, Syngnathus scovelli (Evermann and Kendall), a male brooding teleost.
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Biomedical subjects
Publications and source records attributed to T Sherman.
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OBJECTIVES: This study aimed to determine whether angiographically visualized collateral vessels in patients with chronic coronary artery disease imply the presence of viable myocardium in asynergic regions subtended by completely occluded coronary arteries. BACKGROUND: Patients with chronic coronary artery disease who are being considered for revascularization frequently exhibit angiographically visualized collateral vessels to completely occluded coronary arteries supplying severely asynergic myocardial regions. However, little is known about the relation between angiographic collateral flow and myocardial viability in these patients. METHODS: We studied 42 patients with 78 completely occluded coronary arteries supplying asynergic territories. Angiographic collateral vessels were interpreted as absent (grade 1) in 14 patients, minimal (grade 2) in 27 and well developed (grade 3) in 37. Myocardial viability was determined with positron emission tomography using nitrogen-13 (N-13) ammonia and fluorine-18 (F-18) deoxyglucose for assessment of regional perfusion and glucose uptake, respectively. Positron emission tomographic patterns were interpreted as mismatch (perfusion defect with enhanced F-18 deoxyglucose uptake); transmural match (severe concordant reduction or absence of both perfusion and F-18 deoxyglucose uptake) or nontransmural match (mild to moderate concordant reduction of both perfusion and F-18 deoxyglucose uptake). RESULTS: There was no significant correlation (p = 0.14) between the severity of perfusion deficit assessed by positron emission tomography and the collateral grade. The extent of mismatch was unrelated to either the presence or the magnitude of collateral vessels. Conversely, with increasing collateral vessels from grade 1 to 3, the total extent of positron emission tomographic match remained similar, whereas the ratio of transmural to nontransmural match decreased. Myocardial viability was usually present in severely hypokinetic regions (82%). It was lower in akinetic-dyskinetic regions (49%). Of the 64 regions with angiographic collateral vessels, 37 (58%) (95% confidence interval [CI] 46% to 70%) showed positron emission tomographic mismatch. In contrast, 7 (50%) of 14 (95% CI 24% to 76%) regions without collateral vessels on angiography exhibited positron emission tomographic mismatch. The presence of angiographically visualized collateral vessels was a sensitive (84%) but not specific (21%) marker of viability. CONCLUSIONS: In patients with chronic coronary artery disease, angiographically visualized collateral vessels to asynergic myocardial regions subtended by occluded coronary arteries do not always imply the presence of viable myocardium, suggesting that revascularization may not always provide a functional benefit.
This article summarizes a series of cognitive/neuropsychological studies of children with schizophrenia. One set of studies, which surveyed a broad range of neuropsychological functions, revealed no evidence that children with schizophrenia are consistently impaired in sensory, perceptual, or language functions. Rather, the studies showed that children with schizophrenia performed poorly on tasks requiring sensory, perceptual, and language processing that made extensive demands on information-processing capacity. A second series of studies, which examined visual information processing by manipulating the processing demands of span of apprehension tasks, yielded similar findings. The key characteristic of tasks that elicit impaired performance in children with schizophrenia is that the task makes extensive demands on processing resources. This suggests that these children have limited information-processing capacity. Three hypotheses are proposed concerning the cognitive processes that are impaired in children with schizophrenia: (1) the cognitive processes that seem to be impaired in these children are part of a more general, hierarchically organized attention system; (2) the component processes of the system are subserved by different brain structures; and (3) the structures are part of a network that includes the frontal lobe and thalamus in interaction with the reticular activating system.
Innovative methods of providing workplace education for health care professionals may be a key to the survival of rural hospitals in America. Such methods must overcome time, distance, cost and organizational constraints, and take into account the structure of the learning experience. The Texas Hospital Education and Research Foundation has recently been involved in two programs that tested new approaches to worker education using distance-learning strategies. The projects--resource sharing among rural directors of nursing and training for cancer tumor registrars--used computer-conferencing technology. A new model using existing satellite, audio-conferencing, and computer-based instruction augmented by computer conferencing is proposed. The Computer-Related Assisted Distance Learning Enhancement (CRADLE) model integrates existing technologies to provide education to health care workers at their desktop. The Cancer Learning Center (CLC) tested peer collaboration, the primary component of the model. The ultimate goal is to have the system available to all tumor registrars in Texas, and to secure funding to implement rural nursing and rural high-school health occupations education projects. Current projects from set-up through results are presented.
The authors present preliminary findings on the effects of surgery on the development of early non-verbal social communication skills in eight children with intractable infantile spasms. After a mean follow-up of 15.2 months, there was no statistically significant change in the post-surgical non-verbal communication behavior of these children beyond the expected developmental change. Implications of these findings for the developmental impairment associated with infantile spasms are discussed.
The nonverbal communication skills of 10 children (mean age = 44.2 months) who underwent hemispherectomy for early onset intractable seizures were tested before and after surgery. A within-group analysis suggests that the 10 seizure-free children used more nonverbal communication after a mean follow-up period of 11.2 months than before surgery. Young normal language age matches were available for the 4 older and higher functioning subjects in the sample. Before surgery, the surgical subjects used less requesting gestures than did the normal children. After surgery, these differences were no longer apparent. The patients also employed more gestures to focus an adult's attention on objects and events than language-age-matched normal children. The children who underwent left or right hemispherectomy used similar nonverbal communication behaviors. The study's findings suggest that children with early onset intractable seizures have impaired early social communication that improves to some extent after hemispherectomy.
The relations among formal thought disorder, the partial report span of apprehension task, the distractibility factor on the Wechsler Intelligence Scale for Children-Revised (WISC-R), and IQ scores were examined in 31 schizophrenic children, aged 7.4 to 12.5 years. The partial report span of apprehension scores of the schizophrenic children correlated significantly with their illogical thinking scores. Their scores on loose associations were significantly associated with the WISC-R distractibility factor score. The attention/information processing deficits that might underlie the clinical manifestations of illogical thinking and loose associations in childhood onset schizophrenia are discussed.
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Evidence of underlying liver disease and reticuloendothelial system dysfunction was sought in five adults with histories of idiopathic or "cryptogenic" liver abscess. Although no evidence of underlying liver disease was obtained (median follow-up, 3.4 years; range, 2.1 to 4.8 years), four of five individuals demonstrated a marked impairment in their ability to clear antibody-tagged erythrocytes from the systemic circulation. The results of this study suggest that patients who develop cryptogenic abscesses of the liver have an underlying reticuloendothelial cell defect that may predispose them to liver abscess formation.
The aim of this study was to determine the social and cognitive correlates of language acquisition in autistic children. Functional and symbolic play skills were shown to be associated with language abilities in a sample of young autistic children (mean CA 54.5 months), thereby replicating previous findings. Certain types of nonverbal communication skills were also shown to be significant correlates of language development in this group of autistic children. These involved the ability to use gestures to coordinate visual attention between social partners with respect to objects or events. The play and nonverbal communication variables were not significantly correlated, suggesting that these variables reflect independent psychological factors associated with language development in young autistic children.
The speech behavior of 14 depressed and 18 nondepressed mothers during conversations with their 3-year-old children was examined in this study. Given the general motor retardation, reduced energy level, and social withdrawal of depressed individuals, the speech patterns of depressed mothers were predicted to differ from the speech patterns of well mothers. Depressed mothers vocalized less often and responded less quickly to the cessation of their children's speech than healthy mothers. However, in a mildly stressful situation (awaiting a doctor's visit) the depressed mothers, but not the healthy mothers, significantly increased their level of speech productivity. Children of the depressed mothers spoke less than children of healthy women, particularly while sitting and eating lunch with their mothers. The observed difference in the mothers' behaviors was interpreted as an indication that the 2 groups of children are exposed to very different patterns of socialization. The offspring of depressed women are being taught both to keep social interaction to a minimum and to be overreactive to even mild stresses. The differences in the children's behavior may indicate that already these 3-year-old children have learned to keep their interactions with their mother to a minimum. This manner of adaptation may have negative effects on the child's continued social, emotional, and cognitive development.
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The social interactions of young autistic children and their caregivers were contrasted to interactions involving normal and mentally retarded controls. The autistic children displayed a much lower frequency of attention sharing behaviors, such as pointing to or showing objects. Alternatively, the autistic children directed as much looking, vocalizing and proximity behaviors toward their caregivers as did the other groups. Thus, although the autistic children did not show a clear lack of responsiveness to their caregivers, they did display a significant deficit in indicating behaviors during child-caregiver interaction.
Young autistic children were compared to normal and control samples on measures of non-verbal communication skills and object play skills. Deficits in non-verbal indicating behaviors best discriminated the children diagnosed as autistic from the other groups. Although the autistic children also exhibited deficits in object play behavior, these deficits did not add appreciably to the discriminant function based on the non-verbal communication behaviors. These results suggest that a deficit in the development of non-verbal indicating behaviors is a significant characteristic of young children who receive the diagnosis of autism.
Endoscopic laser ablation of atheroma using continuous wave lasers is limited by imprecise control of thermal ablation, resulting in a crater that expands in width and depth, with thermal damage to adjacent normal tissue. We compared the gross and histologic effects of pulsed 308 mm excimer irradiation to continuous-wave Nd:YAG and Argon Ion laser irradiation, and pulsed 1,060 nm, 532 nm, 355 nm, and 266 nm laser irradiation in 205 atherosclerotic aortic segments. In contrast to the continuous-wave Nd: YAG, Argon Ion, and pulsed 1,060 nm, 532 nm, and 355 nm laser irradiation, which produced gross and histologic evidence of uncontrolled ablation, the 308 nm and 266 nm pulsed lasers induced incisions that conformed precisely to the beam configuration without gross evidence of thermal injury. The incision edges from these two lasers were histologically smooth and comparable to a scalpel incision. Our histologic findings suggest that rapid, precise endoscopic ablation of vascular and nonvascular tissue can be performed at these shorter pulsed wavelengths with very high precision with relatively little damage or risk to adjacent tissue.
In this study, the development of intraoperative angioscopy, the value of the information obtained, and the problems encountered with the procedure are reported. Eight angioscopes, 1.5 to 2.8 mm in diameter, with a line resolution of greater than 0.4 mm at 5 mm, were used. One-hundred ten angioscopic investigations were performed in 46 patients; 24 at peripheral bypass surgery and 22 at coronary artery bypass surgery. These included 68 arteries, 28 new anastomoses, six old grafts, five laser angioplasties, and three in situ vein grafts. The most important finding was that angioscopic data provide information not available from probes or angiography. Angioscopic findings were responsible for a change in surgical procedures in 12 patients (26%) including three anastomotic revisions, three alterations in graft site placement, and two repeat thrombectomies. The most significant technical problems were lack of steerability and insufficient irrigation, which resulted in poor angiographic images. Further technical development is necessary before routine intraoperative angioscopy is practical. Nevertheless, if these problems are resolved, angioscopy will provide unique, high-resolution information which can directly alter surgical therapy.