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PubMed1986

Functional limb salvage with multimodality treatment in epithelioid sarcoma of the hand: a report of two cases.

Two cases of epithelioid sarcoma in the hand are reported. The first presented as a space-occupying lesion causing carpal tunnel syndrome, which has not been previously reported. The second case presented with a tumor in the palm that was initially misdiagnosed as a benign tumor and was treated inadequately and recurred. With treatment consisting of surgical excision, adjuvant local radiotherapy, and pulsed systemic chemotherapy combined with early detection and aggressive treatment of distant metastases, both patients have functional hands without local recurrence. They are presently free of obvious disease and remain under close observation at short follow-up of 6 and 4 years, respectively.

Adult↗
PubMed1999

Multiresidue analysis of beta2-agonist in human and calf urine using multimodal solid-phase extraction and high-performance liquid chromatography with electrochemical detection.

Various beta2-agonists are used as illegal growth promoters in man and in animals. We developed a multiresidue procedure for the analysis of four beta-agonists in human and calf urine. The sample was pre-extracted with an Extrelut column at alkaline pH. The beta-agonists were eluted with a mixture of tert.-butylmethyl ether and hexane. Then the extract was further cleaned with a mixed mode SPE column, or with a combination of immunoaffinity chromatography (IAC) and the mixed mode SPE column. The IAC column contained antibodies against salbutamol, which were suitable for multiresidue extractions. The extract was then brought onto a mixed mode SPE column at an acidic pH. The column was washed with 70% methanol in water. Thereafter, the beta-agonists were eluted with ammoniated ethanol-hexane. The extract was analysed with an HPLC method with electrochemical detection. The beta-agonists were separated on a reversed-phase column using a mobile phase buffered at pH 5.5 and containing an ion-pair reagent. Recoveries were higher when the IAC procedure was not performed (90-105% vs. 65-75%), but the extracts were cleaner when the latter step was included. Detection limits in human and calf urine were in the low ng/ml range. The study indicated that beta2-agonists can be analysed in human and calf urine without the selectivity of a mass spectrometer, but that comprehensive clean-up is required to avoid the interference of urine matrix components.

Adrenergic beta-2 Receptor Agonists↗
PubMed1985

Multimodality evoked potentials in progression of metachromatic leukodystrophy.

A 2-yr-3-mo-old girl with metachromatic leukodystrophy (MLD) was examined using serial multiple electrophysiological procedures. Sensory nerve conduction velocity was delayed earlier and more severely than motor nerve conduction velocity. Visual evoked potentials (VEPs) showed prolonged latency of wave IV. Auditory brainstem responses (ABRs) showed prolonged latency of waves I and V, and the I-V interval. As to the interpeak latency of somatosensory evoked potentials (SEPs), the P9-P14 and the P14-N20 intervals were prolonged on admission. Two months later, both intervals were more prolonged, but the prolongation of the P9-P14 interval was the most prominent. The demyelination in our case may have started in the cerebral white matter, progressed to the peripheral nerves, and at last via the spinal root reached the brainstem. An electrophysiological follow-up study may be valuable in the understanding of the progressive pathological changes and in the evaluation of therapeutic measures.

Brain Stem↗
PubMed1995

Multimodality treatment of extra-visceral soft tissue sarcomas M0: state of the art and trends.

We here outline principles and trends in the treatment of soft tissue sarcomas without distant metastases (M0). Over the last 15 years significant advances have been made in the diagnostic imaging and histological classification of these tumors as well as in their treatment. Magnetic resonance imaging (MRI) has essentially replaced computerized tomography (CT) for the evaluation of the local growth pattern, although the latter is still preferred for the detection of pulmonary metastases. Immunohistochemistry techniques and electron microscopy have improved the histological diagnosis, although the results obtained should always be interpreted in the context of routine light microscopy. Adequate surgical resection and radiotherapy can reduce the incidence of local recurrence, which is still high for head-neck and retroperitoneal sarcomas. Limb-sparing surgery in combination with irradiation and/or intra-arterial or perfusion chemotherapy is considered the treatment of choice in 90% of limb sarcomas, with a local recurrence rate of less than 20%. New radiotherapeutical techniques and anti-neoplastic agents are now under investigation in an attempt to improve local control. There is also a need for a more effective adjuvant chemotherapy. Randomized clinical trials using doxorubicin/ifosfamide and growth factors are now underway.

Animals↗
PubMed2002

[Multimodal monitoring of head injuries in children].

As in the case of adults, there are three main goals in the monitoring of severe head trauma in children: to prevent or minimize the apparition of secondary lesions, to optimize treatment, to help make precise prognosis. The basic monitoring is composed of repeated clinical examinations, brain radiological imaging and control of vital parameters (blood pressure, temperature, PaO2 (SpO2), PaCO2 (FETCO2), haemoglobin, haematocrit. On the other hand, during specific brain monitoring, the brain perfusion (TCD, intracranial pressure), the electrical activity of the brain and sometimes the brain oxygenation (SvjO2) are controlled. The data obtained from the brain monitoring must always be interpreted carefully. A child with a severe head trauma, in ICU, always requires constant and competent medical attention.

Child↗
PubMedDate not supplied

Multimodal comparisons of social phobia subtypes and avoidant personality disorder.

The purpose of the present study was to further clarify the behavioral, physiological, and verbal response of patients with circumscribed social (speech) phobia, generalized social phobia without avoidant personality disorder, and generalized social phobia with avoidant personality disorder. Patients completed a battery of verbal report instruments and participated in two behavioral assessment tests. Measures of avoidance/escape behavior, cardiac response, level of behavioral skill, state anxiety, and positive and negative self-statements during performance were collected. Significant differences across response domains were found between the circumscribed social phobia and the generalized groups. Most of the distinctions were between individuals with circumscribed social phobia and those with both generalized social phobia and avoidant personality disorder, with the former group having less overall psychopathology. In addition, there was substantial overlap of problems between generalized social phobia individuals with and without avoidant personality disorder. Implications for the conceptualization of social phobia are discussed in terms of the differences among social phobia subtypes.

Adult↗
PubMed1997

Multimodality therapy for adenocarcinoma of the esophagus.

The incidence of adenocarcinoma of the esophagus is rapidly increasing in the Western world. In North America and western Europe, a marked shift in the epidemiologic profile of this disease has occurred. In the past, most patients with esophageal cancer were found to have epidermoid carcinoma. These patients frequently abused tobacco or alcohol, had multiple comorbid medical conditions, and were elderly. Over the last 10 to 15 years, a rapid increase in the number of patients having adenocarcinoma of the esophagus has been noted. In contrast, these patients are predominantly young white men from 35 to 55 years old who much less frequently smoke or drink, and many have few or no comorbid medical conditions, are fit, and are able to tolerate aggressive combined therapy. This article focuses on the adenocarcinoma subgroup of patients, although identical therapeutic approaches are being studied in appropriate patients with epidermoid carcinomas.

Adenocarcinoma↗
PubMed2001

Multimodal standardization of voice among four multicultural populations formant structures.

A stratified random sample of 20 males and 20 females matched for physiologic factors and cultural-linguistic markers was examined to determine differences in formant frequencies during prolongation of three vowels: [a], [i], and [u]. The ethnic and gender breakdown included four sets of 5 male and 5 female subjects comprised of Caucasian and African American speakers of Standard American English, native Hindi Indian speakers, and native Mandarin Chinese speakers. Acoustic measures were analyzed using the Computerized Speech Lab (4300B) from which formant histories were extracted from a 200-ms sample of each vowel token to obtain first formant (F1), second formant (F2), and third formant (F3) frequencies. Significant group differences for the main effect of culture and race were found. For the main effect gender, sexual dimorphism in vowel formants was evidenced for all cultures and races across all three vowels. The acoustic differences found are attributed to cultural-linguistic factors.

Adult↗
PubMed2001

Multimodal standardization of voice among four multicultural populations: fundamental frequency and spectral characteristics.

A stratified random sample of 20 males and 20 females matched for physiological factors and cultural-linguistic markers were examined to determine differences in fundamental frequency and spectral characteristics during prolongation of three vowels: [a], [i], and [u]. The ethnic-gender breakdown included four sets of five male and five female subjects comprised of Caucasian and African-American speakers of standard American English, native Hindi Indian speakers, and native Mandarin Chinese speakers. Acoustic measures were analyzed using the Multidimensional Voice Program (Kay Elemetrics, Lincoln Park, NJ) (Model 4305) from which fundamental frequency and associated acoustic spectra were extracted from a 200-ms sample of each vowel token. Statistically significant group differences for the main effects of culture, race, and gender were found. The acoustic differences found are attributed to biomechanical, physiological, cultural, and linguistic factors.

Adult↗
PubMed2001

Nonresponder anorectic patients after 6 months of multimodal treatment: predictors of outcome.

Currently the therapy of anorexia nervosa is a relevant clinical problem. The percentage of patients who respond to short-term pharmacotherapy and psychotherapy is still low and the condition often leads to chronic pathology or death. The present study aims to determine outcome predictors beyond personality traits, eating psychopathology, or particular clinical features. Forty patients with restricter type anorexia nervosa were tested, at T0 and after 180 days, with psychometric tests and clinical evaluation instruments. Patients were then divided into two groups. One group included patients who showed relevant clinical improvement; the other included not-yet-improved patients. A lower Novelty Seeking, higher levels of Ascetism and Maturity Fears characterised the not-yet-improved group. Correlation showed evidence of diverse bonds between personality and psychopathology in the improved and not-yet-improved groups. The psychopathology of non-yet-improved patients seemed to be more linked to their temperamental features, whereas improved patients seemed to be more influenced by their character. Different levels of psychological functioning can be expressed. The present data suggest focusing pharmacotherapy and psychotherapy, even family counseling, with a progression more strictly related to the current personality functioning level and psychopathology of each patient.

Adolescent↗
PubMed1998

Multimodal imaging of residual function and compensatory resource allocation in cortical atrophy: a case study of parietal lobe function in a patient with Huntington's disease.

In a case of Huntington's disease (HD) with dementia and pronounced parieto-frontal atrophy, the functional state of the affected regions was investigated using functional magnetic resonance imaging (fMRI) and fluorodeoxyglucose-positron emission tomography (FDG-PET). It was observed that although parietal areas showed extensive atrophy and reduced resting glucose metabolism, the patient performed with similar accuracy but with longer response time in a visuospatial task compared with healthy control subjects. At the same time, the blood oxygen level-dependent (BOLD) fMRI signal in these areas, which are involved in visuospatial processing, showed a similar task-dependent modulation as in control subjects. The signal amplitude (signal percent change) of the task-dependent activation was even higher for the HD patient than in the control group. This residual functionality of parietal areas involved in visuospatial processing could account for the patient's performance in the task concerned, which contrasted with his poor performance in other cognitive tasks. The increased percent-signal change suggests that a higher neuronal effort was necessary to reach a similar degree of accuracy as in control subjects, fitting well with the longer reaction time. We propose that fMRI should be considered as a tool for the assessment of functionality of morphologically abnormal cortex and for the investigation of compensatory resource allocation in neurodegenerative disorders.

Adult↗
PubMedDate not supplied

Functional multimodality of axonal tree in invertebrate neurons.

This review, based on invertebrate neuron examples, aims at highlighting the functional consequences of axonal tree organization. The axonal organization of invertebrate neurons is very complex both morphologically and physiologically. The first part shows how the transfer of information along sensory axons is modified by presynaptic inhibition mechanisms. In primary afferents, presynaptic inhibition is involved in: 1) increasing the dynamic range of the sensory response; 2) processing the sensory information such as increasing spatial and/or temporal selectivity; 3) discriminating environmental information from sensory activities generated by the animal's own movement; and 4) modulating the gain of negative feedback (resistance reflex) during active rhythmic movements such as locomotion. In a second part, the whole organization of other types of neurons is considered, and evidence is given that a neuron may not work as a unit, but rather as a mosaic of disconnected 'integrate-and-fire' units. Examples of invertebrate neurons are presented in which several spike initiating zones exist, such as in some stomatogastric neurons. The separation of a neuron into two functionally distinct entities may be almost total with distinct arborizations existing in different ganglia. However, this functional separation is not definitive and depends on the state of the neuron. In conclusion, the classical integrate-and-fire representation of the neuron, with its dendritic arborization, its spike initiating zone, its axon and axonal tree seems to be no more applicable to invertebrate neurons. A better knowledge of the function of vertebrate neurons would probably demonstrate that it is the case for a large number of them, as suggested by the complex architecture of some reticular interneurons in vertebrates.

Animals↗
PubMedDate not supplied

Multimodal sensory integration in weakly electric fish: a behavioral account.

The ability to integrate multisensory information is a fundamental characteristic of the brain serving to enhance the detection and identification of external stimuli. Weakly electric fish employ multiple senses in their interactions with one another and with their inanimate environment (electric, visual, acoustic, mechanical, chemical, thermal, and hydrostatic pressure) and also generate signals using some of the same stimulus energies (electric, acoustic, visual, mechanical). A brief overview provides background on the sensory and motor channels available to the fish followed by an examination of how weakly electric fish 'benefit' from integrating various stimulus modalities that assist in prey detection, schooling, foraging, courtship, and object location. Depending on environmental conditions, multiple sensory inputs can act synergistically and improve the task at hand, can be redundant or contradictory, and can substitute for one another. Over time, in repeated encounters with familiar surrounds, loss of one modality can be compensated for through learning. Studies of neuronal substrates and an understanding of the computational algorithms that underlie multisensory integration ought to expose the physiological corollaries to widely published concepts such as internal representation, sensory expectation, sensory generalization, and sensory transfer.

Animals↗
PubMed1989

Multimodality imaging of the thyroid gland.

The continued development of high technology in the rapidly expanding field of computer-based imaging has had a significant impact on many areas of diagnostic imaging. The problem of rising medical costs emphasizes the importance of reaching a diagnosis by the most straightforward and cost-effective method while providing minimal patient discomfort. This responsibility to the patient and the medical care system rests with the physician. It is therefore essential that both imaging and referring physicians have a broad background of information regarding the potential limitations and relative merits of both old and new technologies available to patients with thyroid disorders. The appropriate utilization and relative roles of these imaging modalities have been discussed with respect to the individual clinical problem in this chapter.

Diagnostic Imaging↗