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Difficulty recalling people's names.

BACKGROUND: Difficulty recalling people's names is common in the adult population, especially in the elderly. The subject is scarcely mentioned in the literature. An 82-year-old patient gave the history that for 33 years he had made prospective observations on his own difficulty with people's names. METHOD: Documentation and analysis of the patient's personal observations in which his ability to recall the names of friends, acquaintances, colleagues, public figures, movie stars and athletes is compared with that of his spouse. A suitable test-battery for the names of famous North American persons was not available. RESULTS: The patient's capability in recalling people's names was clearly inferior to that of his spouse. The patient's intellect was otherwise intact and the impairment seemed to be isolated to the category of proper-naming. Doubts were raised about the patient's own conclusion that the deficit was progressive. CONCLUSIONS: A parallel may be drawn between benign difficulty recalling people's names and the acquired categorical deficit for proper naming reported in the literature in recent years. Based on Damasio's concept of anatomically compartmentalized sensory subsystems, it is hypothesized that our patient's symptom represents an innate limited capacity for proper naming.

Aged↗

Differential effect of L-NAME and S-methyl-isothiourea on leukocyte emigration in carrageenin-soaked sponge implants in rat.

1. The role of nitric oxide (NO) in leukocyte (polymorphonuclear cells, monocytes and lymphocytes) emigration was studied in a model of carrageenin-sponge implants in rats. 2. The subcutaneous implantation of 1% (w/v) of lambda-carrageenin-soaked sponges elicited an inflammatory response that was characterized by a time-related increase in leukocyte infiltration in the sponges and increased levels of nitrite in the exudate. Total leukocyte infiltration and nitrite production were maximal at 24 h and decreased after 48 and 96 h. The mononuclear cell influx was maximal at 48 h (21% of the total leukocytes). Therefore, this time point was used in the successive experiments. 3. Polymorphonuclear cell (PMN) and lymphocyte infiltration in the sponges significantly increased when rats were treated with the non-specific NO-synthase (NOS) inhibitor, NG-nitro-L-arginine methylester (L-NAME) (1 mg ml-1) in drinking water ad libitum). Monocyte emigration was not affected by L-NAME treatment. The nitrite levels in the exudate of L-NAME-treated rats were significantly reduced. The concomitant ingestion of L-arginine (30 mg ml-1) resulted in a reversion of the L-NAME effect, while D-arginine (30 mg ml-1) had no effect, indicating the involvement of the L-arginine: NO pathway. 4. Administration of L-NAME resulted also in an increased release of tumour necrosis factor-alpha (TNF-alpha) and prostacyclin (measured as the stable metabolite, 6-keto-PGF 1 alpha). L-NAME had no effect on monocyte chemoattractant protein-1 (MCP-1) release in the exudate. 5. Since L-NAME may have effects on the local blood flow, phenylephrine (0.034 mg ml-2) in drinking water) was used as it has an effect on the local blood flow similar to L-NAME. Phenylephrine had no effect on either leukocyte emigration, or on nitrite, TNF-alpha, prostacyclin or MCP-1 accumulation in the exudate. 6. In contrast, the more selective iNOS inhibitor S-methyl-isothiourea (SMT) (10 micrograms ml-1) in drinking water) significantly reduced PMNs and lymphocyte influx in the sponge having no effect on monocyte influx. Moreover, SMT decreased nitrite production in the exudate to a comparable extent as L-NAME. 7. Administration of SMT significantly reduced MCP-1 release in the exudate, without an effect on TNF-alpha or prostacyclin production. Moreover SMT did not produce any changes in local blood flow. 8. Our results show that a different outcome of the inflammatory process can be obtained depending on the types of NOS inhibitor used.

Animals↗

Inhibition of leukotriene synthesis with MK-886 prevents a rise in blood pressure and reduces noradrenaline-evoked contraction in L-NAME-treated rats.

(1) Long-term treatment of rats with Nomega-nitro-l-arginine methyl ester (l-NAME) induces hypertension associated with inflammatory and vascular changes. Leukotrienes are proinflammatory vasoactive products that are suspected to be involved in the pathogenesis of hypertension. We investigated, in rats chronically treated with l-NAME, the involvement of leukotrienes in the in vivo regulation of blood pressure and the in vitro contraction elicited by noradrenaline in isolated aorta. (2) Rats were randomly assigned to four groups and orally treated for 3 weeks with l-NAME (1 mg ml-1), l-NAME (1 mg ml-1) plus the leukotriene biosynthesis inhibitor MK-886 (0.1 mg ml-1), MK-886 (0.1 mg ml-1) alone or vehicle (Methocel, 0.1%). All the drugs were added to the drinking fluid. (3) The mean arterial blood pressure (MABP) increased significantly in l-NAME-treated rats (173.3+/-9.4 mmHg (n=25)) vs Methocel-treated rats (110.7+/-4.8 mmHg (n=11), P<0.001). Chronic treatment with MK-886 prevented this rise in MABP. (4) Aortic rings with or without endothelium were suspended in organ baths for recording isometric changes in response to noradrenaline. Pretreatment with either MK-886 (10 microm), the CysLT1 receptor antagonist MK571 (1 microm) or the dual CysLT1/CysLT2 receptor antagonist BAY-u9773 (0.1 microm) reduced (P<0.05) noradrenaline-induced contractions in intact aortic rings from l-NAME-treated rats only. (5) Noradrenaline (0.3 microm) induced a two-fold increase in cysteinyl leukotriene (CysLT) release (measured by enzyme immunoassay) in intact aortic rings from l-NAME-treated rats only. (6) These data suggested (1) a role for the 5-lipoxygenase pathway in the regulation of blood pressure in l-NAME-treated rats and (2) the involvement of endothelial CysLTs in noradrenaline-induced contraction in aorta from l-NAME-treated rats.

Animals↗

Cognitive loci of impairments in picture naming by aphasic subjects.

In order to identify the process or processes responsible for impaired naming by aphasic patients, ten aphasic adults and ten normal adults performed three independent tasks--picture naming, modified Sternberg picture recognition, and modified Sternberg random shape recognition (Sternberg, 1966). Response times and error percentages were the dependent variables. Independent variables in naming were stimulus codability measured in bits of uncertainty (two levels) and number of naming trials (three trials). Independent variables in the recognition tasks were uncertainty (two levels), number of stimuli to be remembered (two or four stimuli) and response type ("yes" or "no"). The results showed that uncertainty had significant effects on naming but not on recognition performance. The aphasic group produced significantly longer naming response times regardless of uncertainty level. The differences between groups were much greater for high-uncertainty pictures (1100 msec) than for low-uncertainty pictures (270 msec). A comparison of estimates of word retrieval times showed that the two subject groups differed significantly for high-uncertainty but not for low-uncertainty items. It was concluded that (1) use of the term "word retrieval problem" rather than "loss of memory problem" was justified to describe the major component in the aphasic naming impairment for high-uncertainty items, and (2) when naming low-uncertainty items these aphasic subjects did not demonstrate a word retrieval problem. The results indicate that treatment procedures designed to improve naming should be process rather than content oriented.

Adult↗

Effects of the chronic in vivo administration of L-NAME on the contractile responses of the rat perfused mesenteric bed.

The effects of the chronic in vivo inhibition of nitric oxide synthase (NOS) with N(omega)-nitro-L-arginine methyl ester (L-NAME) on vascular contractility were studied in the rat perfused mesenteric bed. The chronic treatment with L-NAME during 4 weeks induced a rise in systolic blood pressure (basal: 115.1 +/- 6.5 mmHg; chronic L-NAME treatment: 171.7 +/- 7.7 mmHg, n = 16, P < 0.05). After the chronic NOS inhibition, the potentiation of the maximal vasoconstrictor responses to noradrenaline, phenylephrine and KCl was to the same extent as that observed after the in vitro exposure to 100 microM L-NAME. No further potentiation of the contractile responses was achieved when the mesenteric beds isolated from L-NAME treated rats were incubated in vitro with 100 microM L-NAME. The endothelium removal but not the inhibition of prostanoid synthesis with either 10 microM indomethacin or 10 microM 17-octadecynoic acid potentiated the contractions to noradrenaline and to KCl both under control conditions as well as after the chronic in vivo administration of L-NAME. These observations taken together suggest that after chronic L-NAME maximum inhibition of nitric oxide synthase was achieved and no compensatory mechanisms able to counterbalance the increase in contractile responses were developed. Further studies are necessary to elucidate the nature of the factors, other than nitric oxide, that contribute to the potentiation of contractile responses observed when the endothelium is removed after L-NAME treatment.

Animals↗

Anomia for people's names, a restricted form of transient epileptic amnesia.

A 37-year-old man consulted after two episodes of transient anomia for people's names over a period of 6 months. The first episode lasted about 10 min and was restricted to an inability to remember his 2-year-old son's first name. The second, was limited to an inability to recall his daughter's first name for 5 min with clear abnormal experiential quality. Witnessed descriptions of the attacks confirmed the absence of any other cognitive impairment or motor automatisms. The neurological examination was normal except for hyposmia. Inter-ictal cognitive evaluation was normal apart from the anomia for people's names or retrieval of names of familiar people in his childhood on definition and on famous faces naming test. A wake electroencephalograph showed left temporal epileptiform abnormalities, following hyperpnea. On magnetic resonance imaging, quantitative analysis revealed a mildly decreased volume of the left hippocampus. The diagnosis of transient epileptic amnesia (TEA) was considered and the patient did not recur for 6 months under lamotriginum. Thus anomia for people's names may be the sole clinical manifestation of TEA. Such a clinical presentation may easily be overlooked. Treatment may prevent further recurrence and the installation of more important and permanent autobiographical memory impairment. Our observation may suggest an isolated system not only for people's knowledge, but for people's naming. It is consistent with the notion of proper name as pure referring expression.

Adult↗

The effect of name category and discriminability on the search characteristics of colour sets.

Within (and between) cultures, people tend to agree on which parts of colour space are easiest to name and what the names for these regions are. Therefore it is likely that the manipulation of ease of naming (nameability) of colours should change performance in tasks where categorisation by colour name is important. More specifically? highly 'nameable' colour sets should lead to better performance than metrically equivalent but less categorically distinct sets, when the task requires categorisation. This hypothesis was investigated by testing observers on a name-based task, the naming and subsequent identification by name of colour sets with up to sixteen members. These sets were designed to be easy to name (nameable), maximally discriminable, or matched discriminable. The first were derived from previously generated data, the second by a standard algorithm to space colours widely in colour space, and the latter by closely matching their metric characteristics to those of an easy-to-name colour set. This final condition was metrically (but not categorically) equivalent to the nameable set. It was found that sets designed to be nameable did indeed lead to superior performance as measured by response times, confidence ratings, and response accuracy. Perceptual colour similarity, measured by a AE metric, did not predict errors. Nameability may thus be a valid, manipulable, aspect of sets of colours, and one which is not otherwise duplicated in the metric characteristics of such sets.

Classification↗

Age of acquisition for naming and knowing: a new hypothesis.

This paper reports an investigation into the age of acquisition of object names and object knowledge in a cross-sectional study of 288 children aged between 3 years 7 months and 11 years 6 months, comprising equal numbers of boys and girls. The objects belonged to four categories: animals, fruit and vegetables, implements, and vehicles. They were presented in three image types: line drawings, black-and-white photographs, and coloured photographs. In the knowledge test, five probe questions were asked for each object given the spoken name. Results showed that line drawings were more difficult to name than either black-and-white photographs or coloured photographs, which did not differ. The boys significantly out-performed the girls at naming and knowing, both overall and specifically for the category of vehicles. Naming and knowledge increased steadily with age but while young children below about 6 years 6 months showed an advantage to naming, older children showed an advantage to knowing. Similarly, age-of-acquisition measures for each item revealed a significant shift in the relationship between naming and knowing at around 80 months. We argue that differences in learning experience lead younger and older children to associate object names with different types of information, and we suggest that this difference probably accounts for the age-of-acquisition effects reported in adult object naming.

Child↗

Naming concepts: evidence of two routes.

This study examines a parallel distributed processing (PDP) model (partly based on the Wernicke-Lichtheim information processing model) that posits two routes for naming concepts, whole word and phonological. To test the two naming route hypothesis of this model, we performed confrontation naming tests that were either uncued, semantically cued, or phonologically cued in a patient with naming impairment due to Broca's aphasia. In spoken language and in uncued naming to confrontation, word retrieval was severely impaired and marked by semantic but no phonemic paraphasic errors. With semantic cues, naming behavior was unchanged; however, with phonological cues, naming success was enhanced but frequent phonemic paraphasias were produced. These results suggest that the patient spontaneously engaged the whole word naming route, but when given phonological cues, he engaged an alternative phonological naming route that incorporated phonological sequence knowledge.

Adaptation, Psychological↗

Knowing about people and naming them: can Alzheimer's disease patients do one without the other?

It has recently been suggested that patients with semantic breakdown may show the phenomenon of so-called "naming without semantics". If substantiated, this finding would clearly have a major impact on theories of face and object processing, all of which assume that access to semantic knowledge is a prerequisite for successful naming. In order to investigate this issue, we studied recognition, identification (the ability to provide accurate information), and naming of 50 famous faces by 24 patients with mild to moderate dementia of Alzheimer type (DAT) and 30 age-matched controls. The DAT group was impaired in all three conditions. An analysis of the concordance between identification and naming by each patient, for each stimulus item, established that naming a famous face was possible only with semantic knowledge sufficient to identify the person. Our data support the hypothesis that naming is not possible unless semantic information associated with the target is available. Naming without semantics, therefore, did not occur in patients with DAT. By contrast, there were 206 instances (17% of the total responses) in which the patients were able to provide detailed, accurate identifying information yet were unable to name the person represented. The implication of these findings for models of face identification and naming are discussed.

Aged↗

Naming, labeling, and packaging of pharmaceuticals.

The problem of medical errors associated with the naming, labeling, and packaging of pharmaceuticals is discussed. Sound-alike and look-alike drug names and packages can lead pharmacists and nurses to unintended interchanges of drugs that can result in patient injury or death. The existing medication-use system is flawed because its safety depends on human perfection. Simplicity, standardization, differentiation, lack of duplication, and unambiguous communication are human factors concepts that are relevant to the medication-use process. These principles have often been ignored in drug naming, labeling, and packaging. Instead, current methods are based on long-standing commercial considerations and bureaucratic procedures. The process for naming a marketable drug is lengthy and complex and involves submission of a new chemical entity and patent application, generic naming, brand naming, FDA review, and final approval. Drug companies seek the fastest possible approval and may believe that the incremental benefit of human factors evaluation is small. "Trade dress" is the concept that underlies labeling and packaging issues for the drug industry. Drug companies are resistant to changing trade dress and brand names. Although a variety of private-sector organizations have called for reforms in drug naming, labeling, and packaging standards have been proposed, the problem remains. Drug names, labels, and packages are not selected and designed in accordance with human factors principles. FDA standards do not require application of these principles, the drug industry has struggled with change, and private-sector initiatives have had only limited success.

Drug Industry↗

Electrocorticographic high gamma activity versus electrical cortical stimulation mapping of naming.

Subdural electrocorticographic (ECoG) recordings in patients undergoing epilepsy surgery have shown that functional activation is associated with event-related broadband gamma activity in a higher frequency range (>70 Hz) than previously studied in human scalp EEG. To investigate the utility of this high gamma activity (HGA) for mapping language cortex, we compared its neuroanatomical distribution with functional maps derived from electrical cortical stimulation (ECS), which remains the gold standard for predicting functional impairment after surgery for epilepsy, tumours or vascular malformations. Thirteen patients had undergone subdural electrode implantation for the surgical management of intractable epilepsy. Subdural ECoG signals were recorded while each patient verbally named sequentially presented line drawings of objects, and estimates of event-related HGA (80-100 Hz) were made at each recording site. Routine clinical ECS mapping used a subset of the same naming stimuli at each cortical site. If ECS disrupted mouth-related motor function, i.e. if it affected the mouth, lips or tongue, naming could not be tested with ECS at the same cortical site. Because naming during ECoG involved these muscles of articulation, the sensitivity and specificity of ECoG HGA were estimated relative to both ECS-induced impairments of naming and ECS disruption of mouth-related motor function. When these estimates were made separately for 12 electrode sites per patient (the average number with significant HGA), the specificity of ECoG HGA with respect to ECS was 78% for naming and 81% for mouth-related motor function, and equivalent sensitivities were 38% and 46%, respectively. When ECS maps of naming and mouth-related motor function were combined, the specificity and sensitivity of ECoG HGA with respect to ECS were 84% and 43%, respectively. This study indicates that event-related ECoG HGA during confrontation naming predicts ECS interference with naming and mouth-related motor function with good specificity but relatively low sensitivity. Its favourable specificity suggests that ECoG HGA can be used to construct a preliminary functional map that may help identify cortical sites of lower priority for ECS mapping. Passive recordings of ECoG gamma activity may be done simultaneously at all electrode sites without the risk of after-discharges associated with ECS mapping, which must be done sequentially at pairs of electrodes. We discuss the relative merits of these two functional mapping techniques.

Adolescent↗

A metamemory perspective on odor naming and identification.

A metacognitive perspective is utilized to elucidate why it is so difficult to name common odors and what characterizes the subjective knowledge people have about their actual odor knowledge. Odor-naming failures are often accompanied by strong feelings of knowing (FOK) or feelings of imminent retrieval of what it is that smells. The paper's two experiments investigate FOK judgements and tip of the tongue (TOT) experiences for odor and person names. The data indicate that our inability to correctly name odors are typically not due to the often proposed uniquely poor association between odors and their proper names, but rather due to failures to identify the odors, that is, failures to know 'what it is'. It was also found that (i) TOT experiences are very unusual for odor names and more so than for person names; (ii) FOK judgements about odor names are significantly less predictive of later retrieval than equivalent judgements about names of persons; (iii) FOK judgements were highly correlated with the familiarity of the cue (odor or picture of famous person), rendering some support for the idea that FOK judgements are based on the perceived familiarity of the cue triggering the FOK; and (iv) the idea that FOK judgements are based on the amount of available information about the sought-for memory (accessibility theory) was also supported.

Adult↗

Cardiac hypertrophy and fibrosis in chronic L-NAME-treated AT2 receptor-deficient mice.

BACKGROUND: The role of angiotensin II type 1 (AT1) and type 2 (AT2) receptors in cardiac hypertrophy and fibrosis is incompletely understood. The availability of AT2 receptor-deficient mice (AT2 -/y) makes it possible to study the effects of AT1 receptors without the confounding influence of AT2 receptor activity. OBJECTIVE: To test the hypothesis that the AT2 receptor affords protection from left ventricular hypertrophy and fibrosis in chronic hypertension induced by N-nitro-L-arginine methyl ester (L-NAME). DESIGN: Four groups of mice were studied over a period of 3 weeks: AT2 -/y mice with and without L-NAME, and AT2 +/y mice with and without L-NAME. METHODS: Blood pressure and heart rate were monitored by telemetry in groups of AT2 +/y and AT2 -/y mice for 4 weeks. L-NAME groups received the compound in drinking water for the last 3 weeks. We determined left ventricular AT1 receptor expression, cardiac hypertrophy and fibrosis, with and without L-NAME treatment. We used a miniaturized conductance-manometer system to measure pressure-volume loops at the time when the animals were killed. RESULTS: AT2 -/y mice treated with L-NAME showed worse left ventricular hypertrophy, more perivascular fibrosis and greater concentrations of brain natriuretic peptide than did AT2 +/y mice treated with L-NAME. The end-systolic pressure-volume relationship, an index of left ventricular contractility, was decreased in AT2 -/y mice treated with L-NAME. CONCLUSIONS: The AT2 receptor is not essential for development of L-NAME-induced cardiac hypertrophy, fibrosis and concomitant changes in left ventricular performance. In contrast, the AT2 receptor offers a protective effect.

Animals↗

Inhibition of nitric oxide synthesis by L-name exacerbates acute lung injury induced by hepatic ischemia-reperfusion.

Hepatic Kupffer cells and pulmonary alveolar macrophages together constitute a macrophage-axis involved in the regulation of regional and systemic inflammatory responses. Systemic inflammatory response syndrome induced by overproduced pro-inflammatory mediators is the major cause of adult respiratory distress syndrome. In the present study, we examined the anti-inflammatory role of nitric oxide (NO) in a rat model of acute lung injury induced by hepatic ischemia-reperfusion (HI/R). The left and median lobes of the liver were subjected to 30 min of ischemia by clamping the relevant branches of hepatic artery and portal vein, followed by a 4-h reperfusion achieved by removal of the vascular clamp. Four groups of animals were studied: sham control + saline; sham control + N(omega)-nitro-L-arginine methyl ester (L-NAME, 10 mg/kg, i.v., 10 min before reperfusion); HI/R + saline; HI/R + L-NAME. Results show that (1) administration of L-NAME to rats subjected to HI/R decreased plasma NO levels; however, the attenuation of NO increased plasma alanine aminotransferase (ALT) activity and superoxide generation in the ischemic lobes of liver, compared to HI/R alone. (2) Inhibition of NO synthesis with L-NAME in rats subjected to HI/R also enhanced systemic inflammatory response as assessed by the increase in the number of circulating leukocytes and levels of plasma tumor necrosis factor-alpha (TNFalpha) and interleukin 1-beta (IL-1beta). (3) The overwhelming systemic inflammatory response induced by administration of L-NAME in rats subjected to HI/R also augmented pulmonary vascular permeability and superoxide generation in the lung tissue. (4) Pulmonary alveolar macrophages isolated from rats subjected to HI/R + L-NAME produced higher levels of TNFalpha and IL-1beta in the supernatant of culture medium than that of rats subjected to HI/R alone. (5) There were no differences between the groups of sham + saline and sham + L-NAME in terms of plasma NO levels and ALT activity, circulating leukocytes, superoxide generation in the liver and lung, lavage protein levels, and TNFalpha and IL-1beta levels in plasma and bronchoalveolar lavage fluid. Our results suggest that inhibition of NO synthesis by L-NAME in rats subjected to HI/R not only augments ischemic liver injury, but also enhances the systemic inflammatory response and exacerbates remote lung injury. The increase in TNFalpha and IL-1beta production by alveolar macrophages may, in part, account for L-NAME-induced enhancement of acute lung injury.

Alanine Transaminase↗

Effect of NG-nitro-L-arginine methylester (L-NAME) on functional and biochemical alpha 1-adrenoceptor-mediated responses in rat blood vessels.

1. The modulation by NG-nitro-L-arginine methylester (L-NAME) of alpha 1-adrenoceptor-mediated contraction was investigated on isolated segments of rat tail artery and aorta. The influence of L-NAME on inositol phosphates accumulation by alpha 1-adrenoceptor agonists was also investigated to elucidate the intracellular mechanism responsible for this modulation. 2. In aorta but not in tail artery L-NAME (30 microM) enhanced the sensitivity (3.3 times) and the maximum contraction (Emax) induced by the full agonist, phenylephrine. 3. St-587, a partial alpha 1-adrenoceptor agonist, behaved as a weak agonist in the aorta (22.2% of phenylephrine Emax). However, when the same agonist was studied in tail artery rings a maximum contraction that was 78.4% of the phenylephrine induced Emax was reached. 4. L-NAME increased (3.3 times) the Emax for St-587 contraction in the aorta but not in the tail artery. Sensitivity to St-587 was slightly but significantly (P < 0.001) enhanced (1.9 times) by L-NAME in tail artery segments. 5. Contractile responses to phenylephrine after partial alkylation with phenoxybenzamine were analyzed by the nested hyperbolic null method. To elicit 50% of Emax for contraction only 1.1% of the receptors in the tail artery and 21% of the receptors in the aorta need to be occupied. These results indicate a higher receptor reserve for the tail artery than the aorta. 6. In the tail artery but not in the aorta, St-587 activates phosphoinositide turnover. The presence of L-NAME was without effect on inositol phosphates accumulation induced by this partial alpha 1-adrenoceptor agonist. 7. The maximum contraction induced by phenylephrine, after partial alpha-adrenoceptor alkylation, was enhanced by L-NAME in tail artery rings. However, the NO synthase inhibitor was unable to modify the phenylephrine-induced accumulation of inositol phosphates in the presence of phenoxybenzamine. 8. These results indicate that the differences in St-587-induced contraction and the modulation by L-NAME of alpha 1-adrenoceptor-mediated contraction observed between the tail artery and aorta are associated with differences in receptor reserve. In addition, our biochemical studies indicate that the potentiating effect of L-NAME is independent of intracellular calcium release via phosphatidylinositol turnover.

Adrenergic alpha-Agonists↗

Naming decline after left anterior temporal lobectomy correlates with pathological status of resected hippocampus.

PURPOSE: To evaluate the determinants of postoperative change in visual confrontation naming ability and the differential sensitivity of two common tests of confrontation naming. METHODS: In a group of 99 patients undergoing lobectomy of the left, language-dominant anterior temporal lobe, we examined naming ability using two measures: the 60 item Boston Naming Test (BNT), and the Visual Naming (VN) subtest of the Multilingual Aphasia Examination (MAE). ATL entailed resection of lateral temporal lobe followed by microsurgical complete removal of hippocampus. Language mapping was not performed. The status of the resected hippocampus was graded on a scale 0-4 of hippocampal sclerosis (HS). A dichotomous grouping HS- (grades 0 and 1, n = 34) and HS+ (grades 3 and 4, n = 61) was effected. Age at surgery, age of epilepsy onset, sex, extent of lateral temporal resection, Full-Scale IQ (FSIQ), and preoperative naming scores were also examined as potential predictors of pre- versus postoperative naming change. RESULTS: Preoperative BNT and VN scores were significantly worse for HS+ than for HS- (BNT, p < 0.05; VN, p = 0.001). Postoperatively, BNT and VN scores significantly declined for HS- as compared with HS+ patients (p < 0.001). For individual risk, the 90th centile of reliable change index (RCI) was used. By this criterion, of the total sample, 39% evidenced decline on the BNT and 17% evidenced decline on the VN. Logistic regression analysis with backward elimination showed HS to be the only predictor of decline in BNT and HS and sex to be the only predictors of VN decline. Males were more at risk than females. Age, age at onset, extent of lateral resection, preoperative scores, and FSIQ were not predictors. Using age at onset as a proxy for HS+/HS- we calculated probabilities for naming decline for given onset age. CONCLUSIONS: Both preoperative and postoperative change in naming ability are associated with the pathological status of the hippocampus. The potential interpretations and implications of these findings are discussed.

Adult↗

Renal 20-HETE inhibition attenuates changes in renal hemodynamics induced by L-NAME treatment in pregnant rats.

We previously reported that inhibition of nitric oxide (NO) synthesis by N-nitro-L-arginine methyl ester (L-NAME) during late pregnancy leads to increased production of renal vascular 20-hydroxyeicosatetraenoic acid (20-HETE), a cytochrome P-450 (CYP) 4A-derived vasoconstrictor, in pregnant rats. However, the effect of upregulation of vascular 20-HETE production on renal function after NO inhibition is not known. To test the hypothesis that increased gestational vascular 20-HETE synthesis after NO inhibition is involved in mediating blood pressure and renal functional changes, we first determined the IC(50) value of the effect of nitroprusside (SNP), a NO donor, on renal 20-HETE production in cortical microsomes. We then divided pregnant rats and age-matched virgin rats into a vehicle control group, an L-NAME treatment group (0.25 mg/ml in drinking water), and a group treated with L-NAME plus N-methylsulfonyl-12,12-dibromododec-11-enamide (DDMS; CYP4A-selective inhibitor, 10 mg.kg(-1).day(-1) iv). After 4 days of treatment, we measured blood pressure, renal blood flow (RBF), renal vascular resistance (RVR), and glomerular filtration rate (GFR) in each group. The addition of SNP (IC(50) = 22 microM) decreased renal cortical 20-HETE production. In pregnant rats, L-NAME treatment led to significantly higher mean arterial pressure (MAP) and RVR, and lower RBF and GFR. Combined treatment with DDMS and L-NAME significantly attenuated the increases in MAP and RVR and the decrease in GFR, but not the reduction in RBF induced by L-NAME treatment. L-NAME and L-NAME plus DDMS had no significant impact on renal hemodynamics in virgin rats. In addition, chronic treatment with DDMS selectively inhibited cortical 20-HETE production without a significant effect on CYP4A expression in L-NAME-treated pregnant rats. In conclusion, NO effectively inhibits renal cortical microsomal 20-HETE production in female rats. In pregnant rats, the augmentation of renal 20-HETE production after NO inhibition is associated with increased MAP and RVR, whereas decreased GFR is negated by treatment of a selective and competitive CYP4A inhibitor. These results demonstrate that the interaction between renal 20-HETE and NO is important in the regulation of renal function and blood pressure in pregnant rats.

Age Factors↗