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PubMed2006

Patient satisfaction with awake craniotomy for tumor surgery: a comparison of remifentanil and fentanyl in conjunction with propofol.

In this study we compared the effectiveness of the use of remifentanil to fentanyl in conjunction with propofol in providing conscious sedation for awake craniotomy for tumor surgery and to assess patient satisfaction with both techniques. The ability to maintain appropriate levels of sedation, adequate analgesia, and hemodynamic stability was assessed in 50 patients randomized to receive either fentanyl or remifentanil. All complications were documented. Patients were interviewed at 1 h, 4 h, and 24 h after surgery to note their recall of procedure and pain and their overall satisfaction. There were no differences in sedation and pain scores or in hemodynamic and respiratory variables between the two groups. The incidence of intraoperative complications was not different (fentanyl, 14; remifentanil, 16). Respiratory complications occurred in 9 (18%) patients (fentanyl 6, remifentanil 3). The recall and satisfaction scores were not different; 93% of all patients were completely satisfied at all interview times. The use of remifentanil infusion in conjunction with propofol is a good alternative to fentanyl and propofol for conscious sedation for the awake craniotomy and these techniques are both well accepted by the patient.

Adult↗
PubMed1974

Conjunctive schedules of reinforcement. I. Rate-dependent effects of pentobarbital and d-amphetamine.

Key pecking of pigeons was maintained under conjunctive schedules of food presentation in which both a fixed-interval and a fixed-ratio schedule had to be completed before a peck produced food. For two pigeons, pecks on a single key completed both schedule requirements (fixed-interval 3-min, fixed-ratio 50 for one bird, fixed-interval 5-min, fixed-ratio 50 for the second). For two other pigeons, each requirement was scheduled on a separate key. On the two-key schedule, a peck after 5 min on the key scheduling the fixed-interval requirement produced food if at least 10 pecks had occurred on the ratio key (conjunctive fixed-interval 5-min, fixed-ratio 10). When each requirement was scheduled on a separate key, response rates on the fixed-ratio key were generally higher in the early portion of the interval and declined as the interval progressed; responding on the fixed-interval key, once initiated, typically remained at a constant rate throughout the interval. Responding under the single-key schedule was characterized by a high rate early in the interval; this then changed to a lower rate that continued until a peck produced food. For all pigeons, increases in response rates with pentobarbital and d-amphetamine were inversely related to the control rate of responding. When equivalent rates on each key of the two-key schedule were compared, both drugs increased rates on the fixed-ratio key less. Although the effects of both drugs were rate dependent, each drug differentially modified the pattern of responding under the single-key schedule.

Animals↗
PubMed1976

Conjunctive schedules of reinforcement: III. A fixed-interval adjusting fixed-ratio schedule.

Key pecking of three pigeons was studied under a conjunctive schedule that specified both a fixed-interval and an adjusting fixed-ratio requirement. The fixed-interval schedule was 6 min for one pigeon and 3 min for the other two. The size of the ratio requirement was determined within each cycle of the fixed interval by the duration of the pause before responding began. The fixed-ratio value was at maximum at the start of each fixed interval and decreased linearly until the first response occurred (adjusting fixed-ratio schedule). A peck produced food when the number of responses remaining on the fixed-ratio schedule was completed and when the fixed interval had elapsed. If no response occurred during the interval, the fixed-ratio requirement decreased to one and a single response after the interval elapsed produced food. The initial value of the adjusting fixed-ratio schedule was studied over a range of 0 to 900. Increases in the adjusting fixed-ratio schedule to about 300 responses increased both pause duration and running response rate and also modified the pattern of responding from that obtained under the fixed-interval schedule. Higher values of the adjusting fixed ratio generally decreased pause duration and running response rate and also disrupted responding. Interreinforcement time under the conjunctive schedule was increased substantially when the adjusting fixed-ratio size exceeded 300 responses.

Journal Article↗
PubMed1986

Varying response-reinforcer contiguity in a recycling conjunctive schedule.

Three experiments describe the effects of manipulating the frequency of response-reinforcer contiguity in a recycling conjunctive schedule. The schedule arranged that a reinforcer was delivered after 30 s provided at least one response had occurred; otherwise the next cycle started immediately. In Experiment 1, this schedule produced the typical pause-respond-pause pattern, with most responses at mid-interval; and, when a limited number of contiguities between responses and food delivery were added, the pattern became more like the monotonic scallop seen on fixed-interval schedules. In Experiment 2, the schedule was initially presented with an additional contingency that allowed contiguity on every trial. Fixed-interval-like behavior occurred and tended to persist as contiguities were gradually eliminated. In Experiment 3, the recycling conjunctive schedule alternated with a condition in which a large number of contiguities occurred. The pause-respond-pause pattern and fixed-interval-like performance occurred with few or many contiguities, respectively. The results of all three experiments illustrate how contiguity interacts with a small number of other variables to determine performance on interval schedules and illuminate previous findings with fixed-interval and fixed-time schedules.

Journal Article↗
PubMed1999

Periodontal and computer tomography scanning evaluation of endosseous implants in conjunction with sinus lift procedure. A 6-case series.

The aim of the present study was to evaluate endosseous implants in conjunction with the sinus lift procedure using periodontal parameters and computed tomography (CT) scanning. In 6 patients, 8 sinus lift procedures were performed to the atrophic posterior maxilla. Fourteen endosseous implants were placed. The condition of the peri-implant mucosa was assessed postoperatively at an average of 31 months using periodontal parameters such as plaque index, probing depth, clinical attachment level, and bleeding on probing. All the implants were maintained in a clinically healthy condition throughout the observation period. CT images revealed the difference in the morphology of the sinus floor between the locations of the block-shaped bone and the small pieces of bone which were both grafted. The results indicated that endosseous implants in conjunction with the sinus lift procedure could be maintained by monitoring the periodontal parameters.

Adult↗
PubMed1990

Effects of the presence or absence of satellite chick-waterers in conjunction with nipple-drinkers on the mortality and productive performance of broiler chicks from young and old dams.

Two runs of one experiment were conducted to study the effects of the presence or absence of satellite (SAT) chick-waterers in conjunction with nipple-drinkers on the mortality and productive performance of mixed-sex, broiler chicks grown to 42 days of age. Data were combined for analysis. The chicks were obtained from dams 29, 31, 61 and 65 wk of age. The treatments were: 1) chicks from 61- and 65-wk-old dams, nipple-drinkers only; 2) chicks from 29- and 31-wk-old dams, nipple-drinkers only; 3) chicks from 61- and 65-wk-old dams, nipple-drinkers plus one SAT-waterer per replication; 4) chicks from 29- and 31-wk-old dams, nipple-drinkers plus one SAT-waterer. The SAT waterers were removed after 11 days. Routine management procedures were followed. The chicks from the older dams (61 and 65 wk of age) were heavier (1.60 versus 1.58 kg, P less than .05) tha those from the young dams (29 and 31 wk of age). Chicks from the young dams had better feed conversion (1.89 versus 1.93 g/g, P less than .01). The age of dam had no effect on the mortality of the broiler chicks. The presence or absence of SAT-waterers had no effect on body weight or feed conversion. A difference (P less than .05) occurred in mortality through 42 days of age; the chicks using the SAT waterers had a lower mortality level (3.23 versus 4.22%), than those using nipple-drinkers. The presence of ST-waterers in conjunction with nipple-drinkers appears to improve livability in broiler chicks.

Age Factors↗
PubMed1993

Illusory conjunctions and the cerebral hemispheres.

Two visual half-field experiments tested Moscovitch's (1979) proposition that cerebral asymmetry does not concern the earliest perceptual stages but only later processing. Subjects were briefly shown displays that included one (Experiment 1) or two (Experiment 2) types of forms differing in size and which, according to previous evidence, might lead to opposite laterality effects. Laterality effects were assessed for correct detections and for illusory conjunctions, both in terms of raw detection scores and in terms of perceptual discriminability (d' scores). In Experiment 1, displays included either rectangles or triangles. In the first case, the target was a cross; in the second case, it was a Star of David. A hemifield x size interaction was observed both on correct detections and on associated discriminability. Yet, no such interaction was obtained for illusory conjunctions or for associated d' scores. In Experiment 2, the two types of forms were presented simultaneously, with the small ones either inside or outside the large ones. No laterality effects were observed. Some implications of these data for both hemispheric asymmetry and feature integration issues are discussed. The results suggest that early preattentive processes of feature extraction are not lateralized, whereas some integrative mechanisms, such as Treisman's (1988) focal attention, may operate differently in the two hemispheres.

Adolescent↗
PubMed2006

Immunologic control of tumors by in vivo Fc gamma receptor-targeted antigen loading in conjunction with double-stranded RNA-mediated immune modulation.

Despite the expression of non-self or neo-epitopes, many tumors such as lymphoid malignancies or cancers induced by oncogenic viruses are able to gradually overcome the immune defense mechanisms and spread. Using a preclinical model of hematological malignancy, we show that Ig-associated idiotypic determinants are recognized by the immune system in a fashion that results in immune deviation, allowing tumor progression and establishment of metastases. Using gene-targeted mice, we show that anti-idiotypic MHC class I-restricted immunity is promoted by ITAM motif (ITAM+) FcgammaR, but kept in check by ITIM motif (ITIM+) FcgammaRIIB-mediated mechanisms. In addition to interfering with the functionality of ITIM+ FcgammaR, effective anti-idiotypic and antitumoral immunity can be achieved by FcgammaR-targeted delivery of epitope in conjunction with administration of stimulatory motifs such as dsRNA, correcting the ineffective response to idiotypic epitopes. The immune process initiated by FcgammaR-mediated targeting of epitope together with dsRNA, resulted in control of tumor growth, establishment of immune memory and protection against tumors bearing antigenic variants. In summary, targeted delivery of MHC class I-restricted epitopes via ITAM+ FcgammaR, in conjunction with use of TLR-binding immune stimulatory motifs such as dsRNA, overcomes suboptimal responses to idiotypic determinants and may constitute a novel approach for the treatment of a broad range of malignancies. Finally, the results shed light on the mechanisms regulating the idiotypic network and managing the diversity associated with immune receptors.

Animals↗
PubMed1975

Recurrent T.R.I.C. kerato-conjunctivitis: treatment with tetracycline.

Trachoma inclusion conjunctivitis agent infections have a spectrum of clinical presentations which in their more chronic forms are often difficult to recognize. Patients with epithelial erosions of the upper cornea, episodic E.K.C. type subepithelial infiltrates, pannus or micropannus, and with or without lid scarring, merit conjunctival scrapings as an aid to diagnosis. Since the agents which produce these infections have a genital reservoir, as the prevalence of venereal diseases increases, the incidence of this type of keratoconjunctivitis will also increase. If the diagnosis is suspected treatment with systemic tetracycline is effective and relatively safe. Simultaneous treatment of sexual consorts of inclusion conjunctivitis patients and families of trachoma patients should decrease recurrences.

Adult↗
PubMed2002

Liposomal doxorubicin in conjunction with reirradiation and local hyperthermia treatment in recurrent breast cancer: a phase I/II trial.

PURPOSE: This is the first study to evaluate the tolerability and activity of liposomal doxorubicin (Caelyx; Schering-Plough Pharmaceuticals) < or =60 mg/km(2) in patients with locally recurrent breast cancer, when administered in conjunction with reirradiation and local hyperthermia treatment. EXPERIMENTAL DESIGN: Fifteen female patients, who had undergone a radical mastectomy and conventional radiotherapy (60 Gy) in the front chest wall, were entered on a multimodal protocol consisting of initial treatment with radiotherapy and a monthly infusion of liposomal doxorubicin < or =60 mg/m(2) in conjunction with local hyperthermia treatment. All patients received reirradiation up to a total dose of 30.6 Gy (1.8 Gy/fraction, 5 days a week). To evaluate the drug's safety, the first 5 patients initially received a dose of 40 mg/m(2) liposomal doxorubicin, which was then escalated to 60 mg/m(2). The other 10 patients received 60 mg/m(2) for all six cycles of chemotherapy. Hyperthermia (HT) was produced in the region of interest (ROI) using waveguides at a frequency of 433 MHz. The RSS was obtained from the curves representing the change in the ROI's surface with time for each patient, as fitted by linear regression. Linear regression analysis was used to study the relationship between the time interval from liposomal doxorubicin infusion to HT and the RSS. RESULTS: At doses of < or =60 mg/m(2), liposomal doxorubicin was well tolerated, with only mild hematological and nonhematological toxicity. All patients showed an objective measurable response, with 3 patients (20%) demonstrating a clinically complete response. There was a significant correlation between the duration of response and Avg Min T(90) > 44 degrees C (r(s) = 0.917, P < 0.0001) and the Mean[Tmin] (r(s) = 0.909, P < 0.0001). The RSS was significantly correlated with the interval between liposomal doxorubicin infusion and HT, as the smaller the time interval, the greater the clinical benefit (r = 0.76, P = 0.001). CONCLUSIONS: The multimodal treatment was effective and well tolerated, producing an objective measurable response in all patients. Local HT had a significant effect on patients' response to the drug. The relationship between thermal dose and liposomal action requires further investigation.

Antineoplastic Agents↗
PubMed2003

Visualization of intraaneurysmal flow patterns with transluminal flow images of 3D MR angiograms in conjunction with aneurysmal configurations.

BACKGROUND AND PURPOSE: How the complex flow phenomena generated within unruptured cerebral aneurysms relate to the corresponding aneurysmal geometry is unknown. To estimate the interaction between flow patterns and morphologic features of unruptured cerebral aneurysms, we developed a method to visualize intraanuerysmal flow patterns with transluminal flow imaging of 3D MR angiograms in conjunction with aneurysmal configurations. METHODS: Transluminal images of the vessel lumen were reconstructed with use of a parallel volume-rendering algorithm by selecting information on the margin of lumina from the volume data sets of 3D time-of-flight MR angiograms. Transluminal flow images were then created by superimposing flow-related intraluminal information onto transluminal images. Intraaneurysmal flow patterns were evaluated in three cases of unruptured cerebral aneurysms, based on the animated display of transluminal flow images with stepwise extracted intraluminal volume data of signal intensity, in conjunction with the corresponding aneurysmal configurations depicted on 3D MR angiograms. RESULTS: Transluminal flow images showed 3D visualization of flow-related signal intensity distribution obtained from volume data of MR angiograms, so that qualitative information regarding intraaneurysmal flow patterns could be estimated with respect to morphologic features of cerebral aneurysms. CONCLUSION: Transluminal flow images of 3D MR angiograms allowed feasible visualization of intraaneurysmal flow patterns that were studied. More work is required to validate the technique and clarify the significance of being able to visualize intraaneurysmal flow patterns.

Aged↗
PubMed2003

[Surgical management of metastatic disease in the conjunctive area between neck and thorax].

OBJECTIVE: To study the surgical management of metastatic disease in the conjunctive area between the neck and thorax and its efficacy. METHODS: Fourteen cases with metastatic node disease in the area between neck and thorax were collected and analysed. Eleven tumors were from the thyroid cancer, and the other three were from the hypopharyngeal cancer, esophagual cancer and malignant pheochromocytoma, respectively. The clavicle was displaced or resected, and the upper half of the manubrium might also be resected when necessary. The recurrent laryngeal nerve and phrenic nerve were exposed and protected. The metastatic disease was completely removed with the internal jugular and/or the brachiocephalic vein resected or spared, depending on the disease condition. RESULTS: In 10 cases with metastases from the thyroid, no local recurrence was found within the follow-up period from 2 to 5 years. In contrast, no patient with metastatic disease from hypopharyngeal or esophageal cancer survived more than 11 months. No serious complications were found in this group. CONCLUSIONS: The surgical treatment of node metastases in the conjunctive area between neck and thorax from the well-developed thyroid cancer has promising effect and is comparatively safe.

Adenocarcinoma, Follicular↗
PubMed1991

[Intratumoral injection of OK-432 in conjunction with fibrinogen greatly enhances antitumor effect on colorectal carcinomas].

We found that antitumor effect of OK-432, a lyophylized preparation of an attenuated strain of streptococcus pyogenes, on colorectal carcinoma was greatly augmented when it was injected intratumorally in conjunction with fibrinogen. Twenty cases of colorectal cancer received intratumoral injection of 5 KE of OK-432 mixed with 80mg of fibrinogen including factor-XIII and 1ml of aprotinin at the time of endoscopic examination. Changes in the shape of the tumors were observed endoscopically within a few days after injection, and in most cases, decrease in the height of tumor margin was noted. Histopathological findings on surgically resected specimens revealed that the fine meshwork of fibrin was formed at the injected site soon after the injection, and a marked infiltration of inflammatory cells including neutrophils, plasma cells, macrophages, eosinophils and lymphocytes. Such granulomatous changes developed over 7 days after injection, and the degradation of tumors were observed. By 14 days after the injection, tumor tissues were largely replaced with granulomas, and shrinkage of tissues were observed. These findings indicated that fibrinogen including factor-XIII and aprotinin has a potential ability to augment the immunoreaction induced by biological response modifiers, and intratumoral injection of OK-432 in conjunction with fibrinogen solution was superior to intratumoral injection of OK-432 alone as the local immunotherapy of colorectal cancer.

Aprotinin↗
PubMed1991

The safety of dimetridazole alone and in conjunction with oxytetracycline in Hereford crossbred steers.

Dimetridazole was given intraruminally alone, and in conjunction with oxytetracycline to healthy, 10-11 month-old Hereford cross-bred steers (n = 6). Intraruminal treatment with dimetridazole was given through a fistula at 75 mg kg-1 daily for 5 d, while the oxytetracycline was injected intramuscularly at 10 mg kg-1 on Days 1 and 3 of the dimetridazole treatment. The animals were observed at various intervals throughout the trial period for adverse reactions, including effects on ruminal activity and motility, changes in live-mass, venous acid-base balance, haematology and ruminal and serum ammonia concentrations. Dimetridazole, either when used alone or in conjunction with oxytetracycline, had a marked effect on ruminal function. Within 6 h of dosing, the ruminal pH fell to below 5, but then returned to pretreatment values over the next 24-48 h. This was followed by the eradication of the ruminal protozoal population in all animals tested and an increase in the methylene blue reduction time to more than 6 min. Ruminal motility remained unaffected throughout this period. During the week of treatment, the mean live-mass of the animals dropped by 20 +/- 9.9 kg in the dimetridazole treated group and by 13.3 +/- 2.8 kg in the animals treated with both dimetridazole and oxytetracycline. A mild to severe watery diarrhoea, which continued for 1 to 2 d, occurred in 4 animals after the first dimetridazole treatment. A compensated metabolic acidosis and an increase in haematocrit were observed. An initial transient rapid rise in rumen ammonia concentrations did not result in a concurrent rise in serum ammonia concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

The effect of risk assessment in conjunction with health promotion education on compliance with preventive behaviors.

In this study, 55 subjects were given prevention-oriented recommendations from general, detailed nutritional, and Type A personality risk assessments in conjunction with health promotion education. Changes in compliance with health behaviors were measured 13 months after the first assessment, using the same three risk assessment instruments. Based on self-report, a statistically significant number of persons changed from noncompliance to compliance on three nutritional behaviors, three behaviors related to health-promoting exercise and recreation, and one medical screening behavior. A statistically significant reduction in mean from the first to second year was observed for daily sodium intake and percent of calories from fat, and a significant increase in mean percent of time using seatbelts. Though limited by study design, the results provide encouraging evidence in support of the proposition that risk assessment in conjunction with health promotion education can effect positive change in preventive behaviors.

Adult↗
PubMed1985

Tumor promoters in conjunction with calcium ionophores mimic antigenic stimulation by reactivation of alloantigen-primed murine T lymphocytes.

Antigen binding to its specific receptor on T cells initiates a series of intracellular events that result in cell differentiation, activation, and clonal expansion. However, the mechanism by which these antigen-occupied receptors induce the transmembrane signal transduction needs clarification. Because this mechanism appears to involve an increase in intracellular free Ca2+ concentration and activation of protein kinase C (PKC), we tested the effect of Ca2+ ionophores and PKC activators on alloantigen-specific primary mixed leukocyte culture cells. Both calcium ionophores, A23187 and ionomycin, in conjunction with 12-O-tetradecanoylphorbol 13-acetate (TPA) mimicked the effect of antigen or interleukin 2 (IL 2) by inducing strong proliferative and alloantigen-specific cytotoxic responses. In addition, Ca2+ ionophore and TPA induced IL 2 receptor expression and IL 2 secretion. The capacity of other phorbol esters or a non-phorbol ester tumor promoter (teleocidin) to replace TPA in induction of cell activation correlated with their ability to bind to and to activate PKC. In addition, the synergistic effect of Ca2+ ionophore and TPA was blocked by either a Ca2+ chelator (EGTA) or cAMP, which is thought to inhibit phosphatidylinositol metabolism. To determine whether the induction of this cytotoxic activity was mediated by a direct effect of Ca2+ ionophore and TPA on cytotoxic T (Tc) cells or was secondary to IL 2 secretion by activated helper T (Th) cells, we tested the effect of Ca2+ ionophore and TPA on isolated populations of cloned, alloantigen-specific Th and Tc cells. Both agents induced cell proliferation and IL 2 production by Th cells, but not by Tc cells. Activation of mixed clones of Th and Tc cells, but not of Tc cells alone, resulted in cytotoxic activity, an effect that could be blocked by anti-IL 2 receptor antibodies. The results thus demonstrate that an increased concentration of intracellular Ca2+ in conjunction with PKC activation can bypass the signal provided by antigen-receptor interaction on Th cells, but does not substitute for IL 2 in activating cytotoxicity by isolated Tc cells.

Animals↗
PubMedDate not supplied

[Pharmacokinetic characteristics of the antibiotics comprising antimicrobial biocompatible conjunctive elements for the internal organs].

It was found during the study of pharmacokinetics of gentamycin and cephamesine being constituents of antimicrobial conjunctive elements for the internal organs that in the process of diffusion of the antibiotics from the polymer film gentamycin level in the organism increased by the 1st day of observation and cephamesine level by the 3rd day. Thereafter their concentrations decreased by the 7th and 10th days, respectively. The depot of the antibiotics is created at the site of the film application, and their highest concentrations occurring in the periods dangerous for the development of postoperative inflammatory complications exceed the minimal suppressive concentrations with regard to their main causative agents. It is advisable to use antimicrobial conjunctive elements with the given antibiotics for prevention of postoperative inflammatory complications following cesarean section.

Absorption↗
PubMed1994

Reversal of vagal tone in conjunction with high-dose epinephrine in a canine asphyxial pulseless electrical activity model.

OBJECTIVE: To investigate the effects of surgical vagotomy in conjunction with high-dose epinephrine (0.2 mg/kg) on return of spontaneous circulation rates in a canine model of asphyxial pulseless electrical activity. DESIGN: Prospective, controlled laboratory investigation, using an asphyxial canine cardiac arrest model randomized to receive bilateral cervical vagotomy or no vagotomy. SETTING: Emergency medicine animal research laboratory. SUBJECTS: Sixteen mongrel dogs weighing 15 to 25 kg. INTERVENTIONS: Pulseless electrical activity arrest was induced by clamping the endotracheal tube. All animals remained in untreated pulseless electrical activity for 10 mins and then were randomized to receive bilateral cervical vagotomy (n = 8) or no vagotomy (n = 8). All animals received standard external cardiopulmonary resuscitation and high-dose epinephrine (0.2 mg/kg every 5 mins) throughout resuscitation. MEASUREMENTS AND MAIN RESULTS: The electrocardiogram complex rate, arterial blood gases, and coronary perfusion pressure during resuscitation were not statistically different between groups. Return of spontaneous circulation was achieved in 88% (7/8) of the no vagotomy vs. 63% (5/8) of the vagotomy animals (p = NS). All animals that achieved return of spontaneous circulation survived 1 hr. CONCLUSIONS: In conjunction with high-dose epinephrine, vagotomy did not improve the return of spontaneous circulation rate in this pulseless electrical activity arrest model. Additionally, the hemodynamic effects of high-dose epinephrine overshadowed the effects of vagotomy.

Analysis of Variance↗