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PubMed2005

Breast surgery as a specialized practice.

The interest in breast surgery as a specialized practice has expanded over the last decade as technology advances and medicine became more complex and specialized overall. There is evidence that breast cancers treated in high-volume centers and by specialists result in improved survival and that the demand for breast surgical oncologists will increase with the aging population. Breast specialists of the future are more likely to be trained in oncoplastic techniques, thereby providing more comprehensive care.

Breast Neoplasms↗
PubMed2004

Hemispheric specialization and independence for word recognition: a comparison of three computational models.

Two findings serve as the hallmark for hemispheric specialization during lateralized lexical decision. First is an overall word advantage, with words being recognized more quickly and accurately than non-words (the effect being stronger in response latency). Second, a right visual field advantage is observed for words, with little or no hemispheric differences in the ability to identify non-words. Several theories have been proposed to account for this difference in word and non-word recognition, some by suggesting dual routes of lexical access and others by incorporating separate, and potentially independent, word and non-word detection mechanisms. We compare three previously proposed cognitive theories of hemispheric interactions (callosal relay, direct access, and cooperative hemispheres) through neural network modeling, with each network incorporating different means of interhemispheric communication. When parameters were varied to simulate left hemisphere specialization for lexical decision, only the cooperative hemispheres model showed both a consistent left hemisphere advantage for word recognition but not non-word recognition, as well as an overall word advantage. These results support the theory that neural representations of words are more strongly established in the left hemisphere through prior learning, despite open communication between the hemispheres during both learning and recall.

Dominance, Cerebral↗
PubMed2005

Atypical hemispheric specialization for language in right-handed schizophrenia patients.

BACKGROUND: The literature suggests that schizophrenia could be related to a failure in the setting up of left hemisphere dominance for language. We sought to determine hemispheric specialization for language in schizophrenic patients, using functional magnetic resonance imaging. METHODS: Twenty-one right-handed patients with DSM-IV schizophrenia and 21 right-handed control subjects matched by age, gender, and level of education were recruited. Fractional blood oxygen level dependent (BOLD) signal variations in anatomic regions of interest were compared between groups. Functional asymmetry indices (FAIs) were calculated in a region (LANG) resulting from the merging of activated regions showing a Group x Hemisphere interaction. The FAI difference between each patient and their matched control subject was computed. RESULTS: We found lower BOLD signal changes in patients as compared with their control subjects in a network comprising areas of the left middle temporal gyrus, the left angular gyrus, and the pars triangularis of the left inferior frontal gyrus, merged to constitute LANG. The intra-pair differences of FAIs in this area showed that 76% of the patients exhibited less leftward functional asymmetry than their matched control subjects, including six patients with a rightward asymmetry. CONCLUSIONS: These results demonstrated the existence of an anomaly in left hemisphere specialization for language in schizophrenic subjects.

Adult↗
PubMed2006

Specialization of phonological and semantic processing in Chinese word reading.

The purpose of this study was to examine the neurocognitive network for processing visual word forms in native Chinese speakers using functional magnetic resonance imaging (fMRI). In order to compare the processing of phonological and semantic representations, we developed parallel rhyming and meaning association judgment tasks that required explicit access and manipulation of these representations. Subjects showed activation in left inferior/middle frontal gyri, bilateral medial frontal gyri, bilateral middle occipital/fusiform gyri, and bilateral cerebella for both the rhyming and meaning tasks. A direct comparison of the tasks revealed that the rhyming task showed more activation in the posterior dorsal region of the inferior/middle frontal gyrus (BA 9/44) and in the inferior parietal lobule (BA 40). The meaning task showed more activation in the anterior ventral region of the inferior/middle frontal gyrus (BA 47) and in the superior/middle temporal gyrus (BA 22,21). These findings are consistent with previous studies in English that suggest specialization of inferior frontal regions for the access and manipulation of phonological vs. semantic representations, but also suggest that this specialization extends to the middle frontal gyrus for Chinese. These findings are also consistent with the suggestion that the left middle temporal gyrus is involved in representing semantic information and the left inferior parietal lobule is involved in mapping between orthographic and phonological representations.

Acoustic Stimulation↗
PubMed2025

Primulina pan-genome reveals differential gene retention following whole-genome duplications and provides insights into edaphic specialization.

Primulina, a genus of >200 species specialized to extreme soils, provides a model for edaphic adaptation. We assemble seven genomes and construct a pan-genome spanning nine species from karst, Danxia, and acidic soils. Comparative analyses reveal that karst-adapted species have smaller genomes. Two lineage-specific whole-genome duplications (WGDs) exhibit biased duplicate loss in large gene families but preferential retention of transcription factors, indicating combined adaptive and nonadaptive forces. Pan-genome analyses identify ion channel and transporter genes enriched in variant hotspots and under positive selection in karst lineages. Candidate genes for drought and salt stress tolerance include ABC transporters and ion channels. Notably, an ABC transporter shows positive selection in karst species and unique structural variation in non-karst species. Together, our findings show that genome downsizing, biased post-WGD retention, and evolution of ion-transport pathways shape adaptation to extreme soils. The Primulina pan-genome provides a resource for dissecting mechanisms underlying edaphic specialization.

Gene Duplication↗
PubMed2006

Development and application of a specially designed heating system for temperature-programmed high-performance liquid chromatography using subcritical water as the mobile phase.

A specially designed heating system for temperature-programmed HPLC was developed based on experimental measurements of eluent temperature inside a stainless steel capillary using a very thin thermocouple. The heating system can be operated at temperatures up to 225 degrees C and consists of a preheating, a column heating and a cooling unit. Fast cycle times after a temperature gradient can be realized by an internal silicone oil bath which cools down the preheating and column heating unit. Long-term thermal stability of a polybutadiene-coated zirconium dioxide column has been evaluated using a tubular oven in which the column was placed. The packing material was stable after 50h of operation at 185 degrees C. A mixture containing four steroids was separated at ambient conditions using a mobile phase of 25% acetonitrile:75% deionized water and a mobile phase of pure deionized water at 185 degrees C using the specially designed heating system and the PBD column. Analysis time could be drastically reduced from 17 min at ambient conditions and a flow rate of 1 mL/min to only 1.2 min at 185 degrees C and a flow rate of 5 mL/min. At these extreme conditions, no thermal mismatch was observed and peaks were not distorted, thus underlining the performance of the developed heating system. Temperature programming was performed by separating cytostatic and antibiotic drugs with a temperature gradient using only water as the mobile phase. In contrast to an isocratic elution of this mixture at room temperature, overall analysis time could be reduced two-fold from 20 to 10 min.

Chromatography, High Pressure Liquid↗
PubMed2005

Eyes are special but not for everyone: the case of autism.

Current research indicates that human gaze direction is a special cue for shifting attention for one of two reasons: (1) it reflects social desires and intentions and (2) its basic perceptual features usually correspond to important events in the environment. This study, conducted with individuals with autism and with age- and IQ-matched typically developing individuals, dissociates these two often-confounded explanations and demonstrates that eyes appear to be special for typically developing individuals because of their social power, whereas gaze effects are mediated by feature correspondence among persons with autism.

Attention↗
PubMed2004

Specially adapted interactive tools for an improved 3D-segmentation of the spine.

For imaging purposes of the spine, segmented image data provides the basis for a variety of modern clinical applications. However, the anatomical complex structure of the spine as well as the extensive degenerative bony deformations apparent in the clinical situation, generally complicate the application of a fully automated segmentation. To serve the special needs for image segmentation of the spine anatomy a newly developed software system is presented, that implements specially adapted interactive tools, taking its 'axis'-skeletal structure into account. A standardized protocol combines the newly developed interactive tools (rotation transformation, warped dissection plane) with standard segmentation tools to provide both a fast and accurate segmentation procedure. The introduced software environment has been valuable for the segmentation of cervical, thoracic and lumbar spines segments based on clinical routine and research images.

Computers↗
PubMed2006

Touching on somatosensory specializations in mammals.

Specialized species often reveal general principles of brain organization and provide systems for analysis of sensory function. Subterranean species dependent on touch have particularly large somatosensory areas with modular cortical representations of sensory surfaces. Some species have added cortical areas to processing networks, have developed tactile foveas and have superior colliculi primarily devoted to somatosensation rather than vision. Recent studies reveal surprisingly large cortical representations of oral structures in primates and mole-rats. Cortical modules represent a range of different sensory surfaces in rodents, star-nosed moles and primates, indicating that similar developmental mechanisms operate in diverse species. Finally, manipulation of patterning genes in mice suggests evolutionary mechanisms for producing the specialized corticies of subterranean species.

Afferent Pathways↗
PubMed2006

Traumatic memories of war veterans: not so special after all.

Several authors have argued that traumatic experiences are processed and remembered in a qualitatively different way from neutral events. To investigate this issue, we interviewed 121 Croatian war veterans diagnosed with posttraumatic stress disorder (PTSD) about amnesia, intrusions (i.e., flashbacks and nightmares), and the sensory qualities of their most horrific war memories. Additionally, they completed a self-report scale measuring dissociative experiences. In contrast to what one would expect on the basis of theories emphasizing the special status of traumatic memories, amnesia, and high frequency intrusions were not particularly typical for our sample of traumatized individuals. Moreover, traumatic memories were not qualitatively different from neutral memories with respect to their stability and sensory qualities. The severity of PTSD symptoms was not significantly correlated with dissociative experiences. Our findings do not support the existence of special memory mechanisms that are unique to experiencing traumatic events.

Adult↗
PubMedDate not supplied

Challenges and opportunities of nursing care in special-needs shelters.

Hurricanes Katrina and Rita forced many individuals along the coast of Texas and Louisiana to seek shelter inland. Among the evacuees were residents with special needs and residents of nursing homes and group homes caring for mentally retarded and physically disabled persons. Many nurses volunteered to provide health care for those in need. This article discusses challenges and opportunities that were encountered by nurses volunteering in special-needs shelters. Issues related to human and physical resources, patient care, and confidentiality are discussed including lessons learned. As nurses who cared for evacuees in the shelter, it is hoped some of the lessons learned can be utilized in future disasters.

Persons with Disabilities↗
PubMed2006

TRPML cation channels regulate the specialized lysosomal compartment of vertebrate B-lymphocytes.

B-lymphocytes possess a specialized lysosomal compartment, the regulated transformation of which has been implicated in B-cell antigen presentation. Members of the mucolipin (TRPML) family of cation channels have been implicated in regulated vesicular transport in several tissues, but a role for TRPML function in lymphocyte vesicular transport physiology has not been previously described. To address the role of TRPML proteins in lymphocyte vesicular transport, we analyzed the lysosomal compartment in cultured B-lymphocytes engineered to lack TRPML1 or after expression of N- or C-terminal GFP fusion proteins of TRPML1 or TRPML2. Consistent with previous analyses of lymphocytes derived from human patients with mutations in TRPML1, we were not able to detect abnormalities in the lysosomes of TRPML1-deficient DT40 B-lymphocytes. However, while N-terminal GFP fusions of TRPML2 localized to normal appearing lysosomes, C-terminal GFP fusions of either TRPML1 or TRPML2 acted to antagonize endogenous TRPML function, localizing to large vesicular structures, the histological properties of which were indistinguishable from the enlarged lysosomes observed in affected tissues of TRPML1-deficient humans. Endocytosed B-cell receptors were delivered to these enlarged lysosomes, demonstrating that a TRPML-dependent process is required for normal regulation of the specialized lysosome compartment of vertebrate B-lymphocytes.

Animals↗
PubMed2004

Pain management in elderly persons who require assistance with activities of daily living: a comparison of those living at home with those in special accommodations.

OBJECTIVES: To describe and compare the methods of pain management used by elderly individuals with chronic pain and requiring assistance with activities of daily living, depending on whether they live alone, with someone, at home or in special accommodations. METHODS: This study comprised 294 people aged 76-100 years, identified as having chronic pain and requiring assistance with activities of daily living. Pain and pain management methods were compared using the Multidimensional Pain Inventory, Swedish version, and the Pain Management Inventory. RESULTS: Those living in special accommodations reported more pain than those living at home. Those living with someone reported more pain and interference in daily life than those living alone, despite using more pain-relief methods and having greater social support. The median number of pain-relieving methods used was 3.0 (75th-25th percentile: 5-2). Some (3.8%) did not use any method to relieve their pain. The most frequently used methods were prescribed medicine (20%), rest (20%) and distraction (15%). The methods rated most effective were using cold, exercise, hot bath/shower and consuming alcohol. CONCLUSION: Participants had only a small repertoire of pain management methods and these were mostly conventional in nature. Few non-pharmacological methods were used. The findings suggest the importance of thorough assessment, and the need to fully discuss pain management options with the elderly.

Activities of Daily Living↗
PubMed2005

Pharmacological modulation of cholinergic brain activity and its reflection in special EEG frequency ranges from various brain areas in the freely moving rat (Tele-Stereo-EEG).

Due to the electrochemical nature of the communication structure of the brain an intimate relationship between neurotransmitter activity on one side and field potentials (EEG) on the other side can be suspected. In order to learn more about this relationship pharmacological manipulation of the cholinergic transmitter system by means of agonistic and antagonistic receptor active drugs was used. Continuous recording of electrical activity from four selected brain areas (frontal cortex, hippocampus, striatum and reticular formation) in freely moving day-night converted Fisher rats was used (Tele-Stereo-EEG). Frequency analysis of telemetrically transmitted data and special definitions of frequency ranges were used to analyse the data from 45 min pre-drug and 180 min postdrug periods. Pharmacological modulation of brain activity by the selective nicotinic agonist metanicotine as well as the alpha 7 selective nicotinic antagonist methyllycaconitine revealed major changes in delta (1-4.5 Hz) and alpha2 (9-12.5 Hz) frequencies. In general blockade of the cholinergic system resulted in electrical power increases and activation in decreases. Unspecific modulation of cholinergic activity by using the cholinesterase inhibitors physostigmine, tacrine and galantamine led to alpha1 frequency (7-9.5 Hz) changes in addition to the delta and alpha2 changes. These three drugs produced a nearly identical pattern of frequency changes. Theta (4.75-6.75 Hz) and beta1 frequencies (12.75-18.5 Hz) changed to a lesser degree. A peculiar finding arose with respect to the effects of the antagonistic drugs scopolamine and biperiden since biperiden-besides the massive increase of delta and alpha1 power in common-induced a general decrease of alpha2 frequencies within all brain areas opposite to the effect of scopolamine. This special property of biperiden gives a plausible explanation for its efficacy in Parkinsonian patients since decreases of alpha2 waves in this model indicate enhancement of dopaminergic transmission [Dimpfel, W., Spüler, M., Koch, R., Schatton, W., 1987. Radioelectroencephalographic comparison of memantine with receptor-specific drugs acting on dopaminergic transmission in freely moving rats. Neuropsychobiology 18, 212-218]. Except for the effects of methyllycaconitine (p<10%) all results were statistically significant at least at the p<5% level. The results are best explained by assuming that electrical delta activity reflects cholinergic transmitter control followed by and closely linked to changes in dopaminergic transmission as indicated by additional concomitant changes in alpha2 electrical power.

Alpha Rhythm↗
PubMed2003

Munchausen syndrome by proxy (MSBP): an extreme form of child abuse with a special forensic challenge.

Munchausen syndrome by proxy (MSBP) is a special form of child abuse in which an adult repeatedly produces symptoms of illness in a person under his/her care. In most cases the perpetrators are mothers who repeatedly and in different ways produce or feign symptoms of illness in their children in order to obtain medical treatment for them. MSBP is thus a special form of child abuse that is also of importance in the field of forensic medicine and a particular challenge to the medicolegal expert. We report two cases of poisoning with different substances (clozapine and clonidine) detected by toxicological investigations at our Department of Legal Medicine. The relevance of the problem for the medicolegal expert and the importance of an interdisciplinary co-operation are pointed out.

Antipsychotic Agents↗
PubMed2024

Molecular mechanisms of the specialization of human synapses in the neocortex.

Synapses of the neocortex specialized during human evolution to develop over extended timescales, process vast amounts of information and increase connectivity, which is thought to underlie our advanced social and cognitive abilities. These features reflect species-specific regulations of neuron and synapse cell biology. However, despite growing understanding of the human genome and the brain transcriptome at the single-cell level, linking human-specific genetic changes to the specialization of human synapses has remained experimentally challenging. In this review, we describe recent progress in characterizing divergent morphofunctional and developmental properties of human synapses, and we discuss new insights into the underlying molecular mechanisms. We also highlight intersections between evolutionary innovations and disorder-related dysfunctions at the synapse.

Humans↗
PubMedDate not supplied

High-altitude-related disorders--Part II: prevention, special populations, and chronic medical conditions.

This second section of a 2-part review on high-altitude-related disorders focuses on strategies for prevention of high-altitude illness, identification of populations at increased risk for high-altitude illness, and effects of high altitude on selected chronic medical conditions. Practical aspects of advising and educating patients traveling to high altitude will be discussed, with special reference to pregnant women, infants and young children, healthy elders, and chronic medical conditions that may place persons at greater risk for high-altitude illness. The special concerns of pre-verbal children will be covered relative to the risks of high altitude for those too young to voice symptoms of illness and, thus, at-risk for potential serious consequences caused by delay in diagnosis and treatment.

Age Factors↗
PubMed2006

Contacts with public services, with special reference to mental health care, preceding a serious crime: a retrospective study of 268 subjects of forensic psychiatric investigations.

Between July 1995 and June 1996, 533 subjects underwent forensic psychiatric investigation I Sweden. Odd case numbers (n = 268) were included in the study. Of these 268 people, 50% had been in contact with psychiatric services during the six-month period preceding the crime leading to forensic psychiatric assessment. Contacts with psychiatric services during the six-month period preceding the crime were significantly more common in three categories of individuals than others. These were: women, individuals who were diagnosed as having a psychotic disorder during the forensic psychiatric investigation, and individuals found to suffer from a serious mental disorder as defined in the legislation. Subjects who were found not to suffer from a serious mental disorder and were thus not eligible for special sanctions on medicolegal grounds had significantly less psychiatric contacts before the crime, as did subjects under 20 years of age. However, these two groups still had considerably more psychiatric contacts than the general population. The present results suggest that the patient category studied requires special monitoring and case management in general psychiatry in Sweden. To this end, we call for closer studies of high-risk individuals, particularly of previously violent offenders and potentially violent offenders, and closer studies of their psychiatric contacts. This will provide a basis for the development of adequate programs and guidelines for effective care and treatment within the psychiatric sector.

Adult↗