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2. Minimally invasive colon resection for malignant colonic conditions is associated with a transient early increase in plasma sVEGFR1 and a decrease in sVEGFR2 levels after surgery

Author

Shantha Kumara, H., Cabot, J., Hoffman, A., Luchtefeld, M., Kalady, M., Hyman, N., Feingold, D., Baxter, R., and Whelan, R.

Abstract

Abstract: Introduction: Plasma VEGF levels increase after minimally invasive colorectal resection (MICR) and remain elevated for 2–4 weeks. VEGF induces physiologic and pathologic angiogenesis by binding to endothelial cell (EC) bound VEGF-Receptor-1 (VEGFR1) and VEGFR2. Soluble forms of these receptors sequester plasma VEGF, decreasing the amount available to bind to EC-bound receptors. Ramifications of surgery-related plasma VEGF changes partially depend on plasma levels of sVEGFR1 and sVEGFR2. This study assessed perioperative sVEGFR1 and sVEGFR2 levels after MICR in patients with colorectal cancer. Methods: Forty-five patients were studied; blood samples were taken from all patients preoperatively (preop) and on postoperative days (POD) 1 and 3; in most a fourth sample was drawn between POD 7–30. Late samples were bundled into two time points: POD 7–13 and POD 14–30. sVEGFR1 and sVEGFR2 levels were measured via ELISA. sVEGFR2 data are reported as mean ± SD and were assessed with the paired samples t test. sVEGFR1 data were not normally distributed. They are reported as median and 95% confidence interval (CI) and were assessed with the Wilcoxon signed-Rank test (p < 0.05). Results: Preoperatively, the mean plasma sVEGFR2 level (7583.9 pg/ml) was greater than the sVEGFR1 result (98.3 pg/ml). Compared with preop levels, sVEGFR2 levels were significantly lower on POD 1 (6068.2 pg/ml, ±2034.5) and POD 3 (6227.6 pg/ml, ±2007.0), whereas sVEGFR1 levels were significantly greater on POD 1 (237.5 pg/ml; 95% CI, 89.6–103.5), POD 3 (200.2 pg/ml; 95% CI, 159–253), and POD 7−13 (102.9 pg/ml; 95% CI, 189.7–253). No differences were found on POD 7–13 for sVEGFR2 or POD 14–30 for either protein. Conclusions: sVEGFR2 values decreased and sVEGFR1 levels increased early after MICR; sVEGFR2 changes dominate due to their much larger magnitude. The net result is less plasma VEGF bound by soluble receptors and more plasma VEGF available to bind to ECs early after surgery.

Published
2010
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3. Minimally invasive colon resection is associated with a transient increase in plasma sVEGFR1 levels and a decrease in sVEGFR2 levels during the early postoperative period

Author

Shantha Kumara, H., Cabot, J., Hoffman, A., Luchtefeld, M., Kalady, M., Hyman, N., Feingold, D., Baxter, R., and Whelan, R.

Abstract

Abstract: Introduction: Plasma vascular endothelial growth factor (VEGF) levels are elevated for 2–4 weeks after minimally invasive colorectal resection (MICR). VEGF induces wound and tumor angiogenesis by binding to endothelial cell (EC)-bound VEGF-receptor 1 (VEGFR1) and VEGFR2. Soluble receptors (sVEGFR1, sVEGFR2) sequester VEGF in the blood and decrease VEGF’s proangiogenic effect. The importance of the MICR-related VEGF changes depends on the effect of surgical procedures on sVEGFR1 and sVEGFR2; this study assessed levels of these proteins after MICR for benign indications. Methods: Blood samples were taken (n = 39) preoperatively (preop) and on postoperative days (POD) 1 and 3; in most cases a fourth sample was drawn between POD 7 and 30. sVEGFR1 and sVEGFR2 levels were measured via enzyme-linked immunosorbent assay (ELISA), which detects free and VEGF bound soluble receptor. Late samples were bundled into POD 7–13 and POD 14–30 time points. Results are reported as mean and standard deviation. The data was assessed with paired-samples t-test. Results: Preop, mean plasma sVEGFR2 level (9,203.7 ± 1,934.3 pg/ml) was significantly higher than the sVEGFR1 value (132.5 ± 126.2 pg/ml). sVEGFR2 levels were significantly lower on POD 1 (6,957.8 ± 1,947.7 pg/ml,) and POD 3 (7,085.6 ± 2,000.2 pg/ml), whereas sVEGFR1 levels were significantly higher on POD 1 (220.0 ± 132.8 pg/ml) and POD 3 (182.7 ± 102.1 pg/ml) versus preop results. No differences were found on POD 7–13 or 14–30. Conclusions: sVEGFR2 values decreased and sVEGFR1 levels increased early after MICR; due to its much higher baseline, the sVEGFR2 changes dominate. The net result is less VEGF bound to soluble receptor and more free plasma VEGF.

Published
2009
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6. A radioimmunoprecipitation assay for antibodies to botulinum A

Author

Palace, J., Nairne, A., Hyman, N., Doherty, T. V., and Vincent, A.

Abstract

We quantified antibodies to botulinum A (anti-BTx) by immunoprecipitation of 125I-BTx. We tested seven bioassay-positive sera and 68 coded samples, including 18 from patients who had ceased to respond to BTx treatment. Compared with values from healthy control subjects and 42 neurologic control subjects, all bioassay-positive sera were positive (range, 258 to 2,809 pM) and 49 of 50 patients who continued to respond to BTx were negative (<130 pM). This simple, specific, sensitive, and quantitative assay should prove helpful in the investigation of BTx resistance.

Published
1998

7. American Society of Colon and Rectal Surgeons 95th Annual Convention Podium and Poster Abstracts June 9–14, 1996 Seattle, Washington

Author

Obrand, D., Gordon, P. H., Rowley, S., Grace, R. H., Rai, S., Moran, M. R., Rai, A. M., Farouk, R., Lee, P. W. R., Edwards, J., Thorne, M., MacDonald, A. W., Duthie, G. S., Monson, J. R. T., Shabahang, M., Brenner, R., Wright, A., Montgomery, E., Trock, B., Buras, R., Schumaker, L., Nolla, J., Buffan, A., Uskokovic, M., Nauta, R., Evans, S., Velázquez, O. C., Zhou, D., Seto, R. W., Choi, J., Jabbar, A., Breen, F., Rombeau, J. L., Casillas, S., Dietz, D. W., Brand, M. I., Vladisavljevic, A., Jones, S. C., Milsom, J. W., Stuntz, M., Wilmoth, G., Ong, J., Stabile, B., Stamos, M. J., Kahn, H., Alexander, A., Rakinic, J., Nagle, D., Fry, R., Simons, A. J., Kerr, R., Toms, C., Groshen, S., Ross, R., Morris, M., Beart, R., Ortega, A., Anthone, G., Lucha, P., Rosen, L., Stasik, J., Olenwine, J., Riether, R., Khubchandani, I., Ogunbivi, O., Birnbaum, E., Fleshman, J., Kodner, I., McLeod, R. S., Geerts, W., Sniderman, K., Greenwood, C., Gregoire, R., Taylor, B., Silverman, R., Atkinson, K., Burnstein, M., Marshall, J., Burul, C., Anderson, D., Ross, T., Wilson, S., Barton, P., Maetani, S., Onodera, H., Morimoto, H., Imamura, M., Hyams, D. M., Mamounas, E., Petrelli, N., Rockette, H., Jones, J., Wolmark, N., Sofo, L., Ratto, C., Valentini, V., Ippoliti, M., Nucera, P., Merico, M., Bellantone, R., Doglietto, G. B., Crucitti, F., Goes, R., Simons, A., Gunderson, L., Grado, G., Streeter, O., Sun, J. H., Decanini-Garza, P., Kim, D. G., Wong, W. D., Rothenberger, D. A., Madoff, R. D., Madlensky, L., Berk, T., Bapat, B., Redston, M., Gallinger, S., Cohen, Z., Winde, G., Schmid, K. W., Brandt, B., Müller, R., Osswald, H., Jang, Y., Steinhagen, R., Heimann, T., Schnitzler, M., Blackstein, M., McLeod, R., Devesa, J. M., Madrid, J. M. Fernandez, Enriquez, J. M., Geerdes, B. P., Heineman, E., Konsten, J., Baeten, C. G. M., Michot, F., Lehur, P. A., Denis, P., Grise, P. H., Leborgne, J., Teniere, P., Buzelin, J. M., Stebbing, J. F., Brading, A. F., Mortensen, N. J. McC, Gunn, J., Gardiner, A., Abdullah, N., Nyam, D. C. N. K., Pemberton, J. H., Ilstrup, D., Lund, J. N., Scholefield, J. H., Stamm, L., Matzel, K. E., Stadelmaier, U., Dünne, A., Hohenberger, W., Sala, C., Garcia-Granero, E., Molina, M. J., Garcia, J. V., Lledo, S., Ternent, C. A., Shashidharan, M., Blatchford, G. J., Christensen, M. A., Thorson, A. G., Sentovich, S. M., Jensen, L. L., Lowry, A. C., Zaheer, S., Reilly, W. T., Tsang, C., Singer, D., Richard, C. S., Stern, H. S., Oliveira, L., Daniel, N., Bernstein, M., DeMarta, D., Weiss, E. G., Nogueras, J. J., Wexner, S. D., Keighley, M. R. B., Korsgen, S., Agachan, F., Kim, D. -S., Goldberg, S. M., Durham, R. M., Pruitt, G., Longo, W. E., Marchesa, P., Oliart, S., Goldblum, J., Fazio, V. W., Rantis, P. C., Daniel, G. L., Vernava, A. M., Becker, J. M., Marie, G. St., Ferzoco, S., Franklin, M., Rosenthal, D., Goldstein, E. T., Bass, E. M., DelPino, A., Tan, A., Pearl, R., Orsay, C., Sher, M. E., Sands, L. R., Påhlman, Lars, Hewett, P. J., Thomas, W. M., King, G., Eaton, M., Allendorf, U. D. F., Bessler, M., Whelan, R. L., Trokel, M., Laird, D., Nowygrod, R., Treat, M. R., Vukasin, P., Steele, G., Weston, L., Allendorf, J. D. F., Sellers, G., Joo, J. S., Bruce, C. J., Coller, J. A., Murray, J. J., Schoetz, D. J., Roberts, P. L., Schoetz, D., Bockler, M., Rosenblatt, M., Malhorta, S., Roberts, P., Murray, J., Coller, J., Rusin, L., Liu, C. D., Newton, T. R., Zinner, M. J., Ashley, S. W., McFadden, D. W., Tusek, D. L., Church, J. M., Strong, S. A., Grass, J., Steinhart, A. H., Greenberg, G. R., Siminovich, K., Blair, J. E., Cruz, C., Prabhakar, L. P., Laramee, C., Nelson, H., Dozois, R. R., Ozuner, G., Hull, T., Fazio, V., Navaro, G., Bauer, J. J., Gorfine, S. R., Gelemt, I. M., Harris, M. T., Kreel, I., Marcello, P. W., Rusin, L. C., Veidenheimer, M. C., Ogunbiyi, O. A., Thibault, C., Sagar, P., Wolff, B. G., Lee, F., Lee, E. C., Pennoyer, W. P., Vignati, P. V., Cohen, J., MacRae, H. M., O'Connor, B., Ton, E., Hain, J. M., Perez-Ramirez, J. J., Spencer, M. P., Gemlo, B. T., Neto, J. A. Reis, Quilici, F. A., Cordeiro, F., Reis, J. A., Neto, C. I. Reis, Gottesman, L., Tjandra, J., Takano, M., Kuromizu, J., Tsuji, Y., Lee, C. S., Ferrara, A., Levy, J. R., Larach, S. W., Krecker, M., Williamson, P. R., Wong, D. W., Sarmiento, J. M., Burgart, L. J., Frizelle, F. A., Ilstrup, D. M., Salem, R., Smith, L. E., Rooney, P. S., Chapman, M. A. S., Steele, R. J. C., Koren, R., Gal, R., Kyzer, S., Chaimoff, CH., Rodríguez-Bigas, M. A., Mahoney, M. C., Weber, T. K., Petrelli, N. J., Ault, G., Ceron, O., Conti, P., Hadfield, M. B., Turnbull, L. W., Nicholson, A. A., Horsman, A., Shibata, D., Sentovich, S., Hyland, W., Busse, P., Bleday, R., Allendorf, J., Whelan, R., Horvath, K., Treat, M., Wronski, M., Arbit, E., Bilsky, M., Galicich, J. H., Miller, A. S., Lewis, W. G., Williamson, M. E. R., Sagar, P. M., Holdsworth, P. J., Johnston, D., Smith, A. H., Marchetti, F., Thompson-Fawcett, M. W., Warren, B. F., Mortensen, N. J. M., Bouchard, S., Belliveau, P., Trudel, J., Zinsmeister, A. R., Schleck, C. D., McIntyre, P. B., Hanson, R. B., Read, T. E., Dominguez, J. M., Hyman, N. H., Beck, D. E., Dayton, M. T., Stryker, S. J., Wolf, B. G., Young-Fadok, T. M., Meagher, A., Benn, P. L., Takao, Y., Chen, F. C., Wu, J., Milsom, J., Stein, B. L., Vasilevsky, C. A., Hartley, J. E., Cureshi, A., Sellers, G. J., Van, D., Ludwig, K. A., Garcia-Ruiz, A., Espat, N. J., Rao, G. N., Drew, P. J., Pfeifer, J., Park, U. C., Gonzalez, A., Okamoto, T., Konishi, F., Tsukamoto, T., Senba, S., Kashiwagi, H., Kojima, M., Togashi, T., Kanazawa, K., Yoon, W. H., Kang, Y. N., Hong, K. H., Park, H. D., Koo, S. H., Song, K. S., Kim, J. C., Roh, S. A., Park, K. C., Jessup, J. M., Changchien, C. R., Wang, J. Y., Hsu, K. C., Chen, J. S., Tang, R., You, Y. T., Ho, Y. S., Guttman, R., Nelson, R., Sardinha, T. G. S., Gilliland, J., Kroll, M., Lee, E., Wexler, J., Hudzinski, D., Glass, D., Wolff, B. D., King, D. W., Talley, N., Chen, W. S., Lin, W. C., Hsu, H., Wrightson, W. R., Galandiuk, S., LaRocca, R., Myers, S. R., Tada, M., Inoue, H., Tsubaki, M., Endo, M., Sobzcak, S., Welch, J. P., Cohen, J. L., Allen, L. W., Morrow, J. S., Behen, S. L., Smith, K. W., Cali, J. R., Bailey, H. R., Fucini, C., Elbetti, C., Messerini, L., Law, W. L., Butts, D. R., Max, E., Memon, M. A., Devine, J., Feeney, J., Talley, N. J., Stephenson, E. R., Ilahi, O., Koltun, W. A., Spellman, M., Rantis, R. C., Vernava, A. M., Parra, R. O., Breen, E., Hayes, P., Quinn, D., Whitlow, C. B., Opelka, F. G., Gathright, J. B., Golub, R. W., Maccabee, P. J., Combs, A. J., Grose, E. A., Taylor, B. M., Kozell, K., McGannon, E., Krogh, K., Nielsen, J., Djurhuus, J. C., Mosdal, C., Sabroe, S., Laurberg, S., Chen, M. F., Kerner, B. A., Khanduja, K. S., Wise, W. E., Padmanabhan, A., Meesig, D. M., Yasin, M. T., Aguilar, P. S., Ho, Y. H., Tan, M., Seow-Choen, F., Rustin, R. B., and Harmon, J. M.

Published
1996
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8. American Society of Colon and Rectal Surgeons 91st Annual Convention Podium and Poster abstracts

Author

Lechner, P., Lind, P., Binter, G., Golub, R. W., Kerner, B. A., Wise, W. E., Meesig, D. M., Hartmann, R. F., Khanduja, K. S., Sayre, J. W., Aguilar, P. S., Guillem, J. G., Forde, K. A., Treat, M. R., Neugut, A. I., O'Toole, K. M., Diamond, B. E., Kewenter, J., Brevinge, H., Haglind, E., Limberg, B., Elles, C. N., Boggs, W. H., Slagle, G. H., Cole, P. A., Coyle, D. J., Smith, L. E., Orkin, B., Saclarides, T. J., Sheridan, W. G., Lowndes, R. H., Young, H. L., Wong, W. D., Rothenberger, D. A., Bartolo, D. C. C., Wexner, S. D., Ger, G. C., Jorge, J. M. N., Lee, E., Nogueras, J. J., Jagelman, D. G., McKenna, K., Koltun, W. A., Bute, B., Lichliter, W., Le, T., Timmcke, A., Gathright, J. B., Mascagni, D., Hojo, K., Moriya, Y., Sugihara, K., Di, G., Zenni, G. C., Abraham, K., Dobrin, P. B., Harford, F. J., Suzuki, K., Gunderson, L., Devine, R. M., Dozois, R. R., Cavaliere, F., Pemberton, J. H., Fazio, V., Cosimelli, M., Beart, R. W., Giannarelli, D., Moran, M., Ramos, A., Rothenberger, D., Goldberg, S., Antonenko, D., Heymen, S., Gulledge, A. D., Jakate, S., Saclarides, T., Heine, J. A., Williams, J. G., VanBergen, E. H., Buie, W. D., Goldberg, S. M., Davies, N., Yates, J., Jenkins, S. A., Taylor, B. A., Bapat, B., Stern, H., Berk, T., Parker, J., Ray, P. N., McLeod, R., Cohen, Z., Rowe, J. K., Zera, R. T., Madoff, R. D., Bubrick, M. P., Roberts, J. C., Johnston, G. R., Fenney, D. A., Farouk, R., Duthie, G. S., McCue, J. L., Phillips, R. K. S., Viamonte, M., Cole, J., Gottesman, L., Solomon, M. J., McLeod, R. S., Kern, K., Jensen, L. L., Lowry, A. C., Vernava, A. M., Longo, W. E., Daniel, G. L., Ehrenpreis, E., Stone, J. M., Cosman, B. C., Wolfe, V. A., Nino-Murcia, M., Perkash, I., Marcello, P. W., Roberts, P. L., Schoetz, D. J., Murray, J. J., Coller, J. A., Veidenheimer, M. C., Keighley, M. R. B., Grobler, S. P., Hosie, K. B., Schmitt, S. L., James, K., Lucas, F., Peck, Donald A., Ferrara, A., Grotz, R. L., Perry, R. E., Hanson, R. B., Lewis, W. G., Holdsworth, P. J., Sagar, P. M., Johnston, D., Perry, T. G., Strong, S. A., Fazio, V. W., Lavery, I. C., Oakley, J. R., Church, J. M., Milsom, J. W., Fozard, J. B. J., Nelson, H., Schneebaum, S., Arnold, M. W., Young, D., LaValle, G. J., Petty, L., Berens, A., Mojizisik, C., Martin, E. W., Hase, K., Shatney, C. H., Trollope, M., Johnson, D., Vierra, M., Deutsch, A. A., Tulchinsky, H., Nudelman, I., Gutman, H., Reiss, R., Taylor, Brian M., Araujo, A., Bleday, R., Jessurun, J., Heine, J., Rosen, Les, Sipe, Paul, Riether, Robert, Stasik, John, Sheets, James, Khubchandani, Indru, Reiter, W., Friedberg, G., Morey, G., Goldstein, E., Williamson, P., Larach, S., Senagore, A. J., Luchtefeld, M. A., MacKeigen, J. M., Mazier, W. P., Wengert, T., Ott, M. T., Bailey, H. R., Hartendorp, P., Dailey, T. H., Church, J. C., Johansen, O. B., Daniel, N., Korst, M., Kuijpers, H. C., Pena, J. P., Christenson, C. E., Balcos, E. G., Lewis, W., Mitchell, C., MacFie, J., Hildebrandt, U., Ecker, K. W., Kraus, J., Schmid, T., Feifel, G., Tjandra, J. J., Scoggin, Steve, Frazee, Richard C., Ambroze, W. L., Nezhat, C., Pennington, E., Nezhat, F., Stolfi, V. M., Thorson, A. G., Falk, P. M., Fitzgibbons, R. J., Luukkonen, P., Järvinen, H. J., James, E., Paty, P. B., Enker, W. E., Cohen, A. M., Lauwers, G. Y., Saad, R., Birnbaum, E., DeVos, W., Fry, R., Kodner, I., Fleshman, J., Cali, R. L., Pitsch, R. M., Blatchford, G. J., Christensen, M. A., Schroeder, T. K., Easley, K. A., Ellis, C. N., Cheape, J. D., Hull, T. L., Salanga, V., Kokoszka, Joseph, Andrianopoulos, Georgia, Nelson, Richard, Abcarian, Herand, Kumar, D., Benson, M. J., Roberts, J., Martin, J. E., Swash, M., Wingate, D. L., Williams, N. S., Orkin, B. A., Emsellem, H., Dent, John, Tissaw, M. A., Shafik, A., Abel, M. E., Chiu, Y. S. Y., Russell, T. R., Volpe, P. A., Casillas, G. L., Mashas, W. E., Eastman, D. A., Grace, R. H., Anderson, J. M., Hacker, K., Heryer, J., Conner, W., Rubin, R., Eisenstat, T., Salvati, E., Oliver, G., Duberman, E., Simmang, C. L., Fry, R. D., Kodner, I. J., Fleshman, J. W., Corman, M. L., Galandiuk, S., Weiner, G. J., Kahn, D., Mitchell, E., Abdel-Nabi, H., Block, G. E., Mannella, E., Tedesco, M., Anza, M., Civalleri, D., Di Tora, P., Capussotti, L., Morandi, G. B., Tirelli, C., Da Pian, P. P., Cortesi, E., Ruggeri, E., Fitzgerald, S. D., Davis, Faith, Bowen, Phyllis, Sutter, Eileen, Kikendall, Walter, McGannon, E., Brantley, P. A., Czyrko, C., Falardeau, C., Trepashko, Don, Skosey, John, Michelassi, F., Staniunas, R. J., Vignati, P. V., Beck, D. E., Karulf, R., Roettger, R., Braidt, J., Ruoff, K., Ackroyd, F., Shellito, P., Goh, H. S., Lin, L. W., Edwards, E., Farmer, J., Walters, C. A., Hyman, N. H., Hebert, J. C., Richman, Irving M., Staren, E. D., Sessions, S. C., Scoma, R. S., Clements, B., Smink, R. D., Arai, K., Sugita, A., Yamazaki, Y., Harada, H., Fukushima, T., Armstrong, D. N., Ballantyne, G. H., Sillin, L. F., Davie, R. J., Harding, L. K., Birch, N. J., Yamanouchi, T., Bayer, I., Mitmaker, B., Gordon, P. H., Wang, E., Kynaston, H., Edelstein, P. S., Thompson, S. M., Davies, R. J., Farmer, K. C. R., Oliver, S. E., Spigelman, A. D., Bennett, P., O'Kelly, T. J., Brading, A. F., Mortensen, N. J., Paul, P., McGannon, E. M., Huth, P., Hull-Boiner, S., Pezim, M. E., Johnson, H. W., Gillespie, K. D., Willard, P., Owen, D. A., Ramsey, P. S., Leu, S. Y., Hsu, H., Al-Humadi, Adil H., Eisman, E., Tries, J., Gupta, N. C., Frick, M. P., Boman, B. M., Franceschi, D., Eckhauser, M. L., Pritchard, T., Konsten, J., Baeten, C. G. M. I., Havenith, M. G., Soeters, P. B., Lau, P. W. K., Lorentz, T. G., and Wong, J.

Published
1992
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9. Neuropsychological, neurological and functional outcome following pallidotomy for Parkinson's disease. A consecutive series of eight simultaneous bilateral and twelve unilateral procedures

Author

Scott, R, Gregory, R, Hines, N, Carroll, C, Hyman, N, Papanasstasiou, V, Leather, C, Rowe, J, Silburn, P, and Aziz, T

Abstract

Intellectual, psychological and functional outcomes were evaluated in a consecutive series of 20 Parkinsonian patients who had unilateral (UPVP) or simultaneous bilateral posteroventral pallidotomy (BPVP) using Image Fusion™ and Stereoplan™ (Radionics Inc., Boston, Mass., USA) with stimulation for lesion localization. Comprehensive baseline and 3 month postoperative neuropsychological and neurological assessment protocols were administered together with questionnaire measures of functional disability, quality of life and psychological symptomatology. Changes in patients' clinical presentation and scores on psychometric tests, questionnaires and observational rating scales were then examined. We observed no new neuropsychiatric sequelae directly related to pallidotomy. Cognitive sequelae were restricted to selective reductions in categorical verbal fluency following UPVP (P <0.01) and BPVP (P <0.01 and a reduction in phonemic verbal fluency following BPVP (p <0.01); these changes were not reported subjectively. A fall in diadochokinetic rates (P <0.01) and some subjective reports of a worsening in pre-existing dysarthria, hypophonia and hypersalivation/drooling following BPVP also suggested changes in speech motor apparatus; however these changes did not have significant functional consequences. There was one case of more generalized cognitive impairment following BPVP. We also observed significant symptomatic improvement on neurological rating scales; following UPVP, total unified Parkinson's disease rating scale (UPDRS) scores improved by 27% (P <0.01) and following BPVP the improvement was 53% (P <0.05). Patient's perceptions of reduced postoperative functional disability and improvements in 'quality of life' also achieved statistical significance on a number of both physical and psychosocial questionnaire subscales.Key words: pallidotomy; cognition; outcome; Parkinson's disease

Published
1998

10. Abstracts

Author

Rosen, L., Reed, J., Ufberg, D., Thorburn, H., Carter, K., Goldberg, J., Finlay, I. G., Church, J. M., Hill, G. L., Carter, F. M., Cohen, Z., McLeod, R. S., Bauer, J. J., Sher, M. E., Gelernt, I. M., Crim, R. W., Fazio, V. W., Lavery, I. C., Williams, J. G., Nemer, F. D., Rothenberger, D. A., Goldberg, S. M., Hyman, N. H., Tuckson, W. B., Deutsch, A. A., Gregoire, R., Cullen, J., Johnson, G. P., Wolff, B. G., Koltun, W., Schoetz, D. J., Roberts, P. L., Murray, J. J., Coller, J. A., Veidenheimer, M. C., Keighley, M. R. B., Hosie, K., Sakaguchi, M., Tudor, R., Kmiot, W., Ambroze, W. L., Dozois, R. R., Pemberton, J. H., Kelly, K. A., Wiltz, O., Hashmi, H., Fucini, C., Thayer, M. L., Madoff, R. D., Jacobs, D. M., Bubrick, M. P., Galandiuk, S., Tsao, J., Ilstrup, D. M., Duthie, G. S., Bartolo, D. C. C., Miller, R., Pinho, M., Kunin, J. D., Fleshman, J. W., Kodner, I. J., Fry, R. D., Wexner, S. D., Jagelman, D. G., Corredor, C., Salanga, V., Scholefield, J. H., Whatrup, C., Talbot, I. C., Northover, J. M. A., Sonnex, C., Safavi, A., Gottesman, L., Dailey, T., Moenning, S., Nightengale, S., Simonton, T., Huber, P., Odom, C., Kaplan, E., Strong, S. A., Milsom, J. W., Taylor, C. W., Cho, C. C., Stewart, W. R. C., Hartmann, R. F., Khanduja, K. S., Aguilar, P. S., Rahman, S. M., Arnold, M. W., Caushaj, P., Viratyosin, S., French, T., Madoff, R., Karamjit, S., Meesig, D. M., Macleod, C. A. H., Balcos, E. G., Buls, J. G., Nelson, H., Donohue, J. H., McKean, D. J., Leu, S. Y., Wang, S. R., Hsu, H., Ramanujam, P. S., Alberts, D. S., Clark, L., Ritenbaugh, C., Rowley, S., Kane, N., Jones, C., Davies, A., Baker, P., Neoptolemos, J. P., Devereux, D. F., Robertson, F. M., Spain, D. A., Cance, W. G., Cohen, A. M., Sigurdson, E. R., Enker, W. E., Konishi, F., Yasuda, Y., Ochiai, S., Kanazawa, K., Davis, M., Medina, V., Miller, D., Fielding, L. P., Prats, I., Berman, M., West, B., Savoca, P. E., Ballantyne, G. H., Flannery, J. T., Modlin, I. M., Tsukada, K., Jagelman, D. A., McGannon, E. M., Schroeder, T., Sakamoto, G. D., MacKeigan, J. M., Opelka, F., Timmcke, A., Gathright, J. B., Hicks, T., Ray, J., McKee, C. C., Ragland, J. J., Myers, J. O., Christie, J. P., Marrazzo, J., Flemming, F. X., Longo, W. E., Pollard, C. W., Nivatvongs, S., Rojanasakul, A., Jetmore, A. B., Baker, J., Wiltz, O. H., McKee, R. F., Lauder, J., Poon, F., Aitchison, M., Fleshman, James W., Dreznik, Zeev, Kodner, Ira J., Fry, Robert D., Kerner, B. A., Labow, S., Hoexter, B., Moseson, M., Cheape, J. D., Bowinkelman, K., Dziki, A. J., Malthaner, R. A., Harmon, J. W., Saini, N., Duncan, M. D., Fernicola, M. T., Fischer, B. A., Hakki, F. Z., Trad, K. S., Ugarte, R., Senagore, A. J., Mazier, W. P., Kilbride, M., Herrera, L., Goumas, W., Petrelli, N., Bailey, H. R., Huval, W. V., Max, E., Smith, K. W., Marks, G., Mohiuddin, M., Basile, M., Eitan, A., Wolff, B., Dozois, R., Devine, R., Beart, R., Kelly, A., Unti, J. A., Orsay, C. P., Pearl, R. K., Nelson, R. L., Duarte, B., Prasad, M. L., Abcarian, H., Senagore, A., Milson, J. W., Strong, S., Walshaw, R. K., Chaudry, I. H., Hojo, K., Sugihara, K., Katunuma, K., Vernava, A., Beart, R. W., Stewart, J., Diament, R. H., Salter, M., Brennan, T. G., Sheikh, F., Khubchandani, I. T., Miyajima, N., Uematsu, Y., Kodaira, S., Teramoto, T., Orrom, W. J., Duthie, G., Corne, H., Blatchford, G. J., Perry, R. E., Christensen, M. A., Thorson, A. G., Dreznik, Zeev, Wong, W. D., Jensen, L. L., Lee, K. H., Yoon, Choong, Joo, H. Z., Levien, D. H., Gibbons, S., Begos, D., Byrne, D. W., Gordon, P. H., Bégin, L. R., Mitmaker, B., Saclarides, T., Bhattacharyya, A., Britton, C., Stone, J. M., Lowry, A. C., Moran, M., Launer, D. P., McReynolds, D. G., Eastman, A. B., Peck, J. J., Rozycki, G. S., Ramanujam, Paravasthu S., Bellapravalu, Sharad, Venkatesh, Kurakurachi S., Griffin, Kathleen M., Vernava, A. M., Beckman, R., Andrus, C., Johnson, F., Herrmann, V., Kaminski, D. L., Wetter, L. A., Dinneen, M., Levitt, M., Motson, R. W., Rohrer, D. A., Bapna, M. S., Rotstein, L. E., Radhakrishnan, Jayant, Shrader, Charisse, Ravo, B., Frattaroli, F. M., Reggio, D., Litchy, W. J., Hanson, R. B., Morgado, Pedro J., Alfaro, Rodrigo, Alfonzo, Rafael, Vachon, D. A., Oliver, G. C., Eisenstat, T. E., Salvati, E. P., Rubin, R. J., Clay, R. P., Kumar, Sanath, Guillem, J. G., Levy, M. F., Hsieh, L. L., Johnson, M. D., Forde, K. A., Weinstein, I. B., Bilchik, A. J., Fleming, F. X., Pernikoff, B. J., Goldenring, J. R., Fozard, J. B., Lowndes, R. H., Young, H. L., Sackier, J., Leite, J. F. M. S., Fausto-Pontes, Martins, M. I., Kmiot, W. A., Youngs, D. J., Harding, L. K., Hesselwood, S. R., Smith, N., Hartley, M. G., Hudson, M. J., Hill, M. J., Gent, A. E., Grace, R. H., Swarbrick, E. T., Hellier, M. D., Procaccino, J. A., Oakley, J. R., Flanagan, R. A., Lapos, L., Riether, R. D., Stasik, J. J., Trostle, D. R., Sheets, J. A., Ferrara, A., Armstrong, D. N., Bjorck, S., McMillen, M. A., Nicholson, J. D., Halleran, D. R., Trivisonno, D. P., Ziegler, J. A., Lott, J., Saleeby, R., Sullivan, T., and Nelson, R.

Published
1990
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11. Progressive multifocal leucoencephalopathy and viral antibody titres

Author

Knight, R. S. G., Hyman, N. M., Gardner, S. D., Gibson, P. E., Esiri, M. M., and Warlow, C. P.

Abstract

Progressive multifocal leucoencephalopathy (PML) is caused by a papovavirus but serum antibody titres are generally considered unhelpful in clinical diagnosis because antibodies to the commonest causal agent (JC virus) are frequently found in normal adults. There is little published information about CSF titres but usually they have not been useful. Two cases of PML, confirmed by autopsy, are described where CSF antibody to JC virus was measured. In one case the JC antibody titre was significantly higher in the CSF than the serum and we suggest that this finding is diagnostically useful. In this case there was a transient stabilization of the disease following treatment with cytarabine with a change in antibody titres suggestive of reduced viral replication in the central nervous system and a host response to the infection. In the other case, which was untreated, rising serum antibody levels indicated active infection with a host response.

Published
1988
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12. Encephalomyelitis in primary hypogammaglobulinaemia

Author

Rudge, P., Webster, A. D. B., Revesz, T., Warner, T., Espanol, T., Cunningham-Rundles, C., and Hyman, N.

Abstract

The neurological features of 13 patients with primary hypogammaglobulinaemia are described. Seven patients had X-linked agammaglobulinaemia (XLA) and six had common variable immunodeficiency (CVID). Three clinical pictures emerged: (i) a progressive myelopathy (one case); (ii) a myelopathy progressing to an encephalopathy (four cases); (iii) a pure encephalopathy (eight cases). In four patients the encephalopathy was temporarily reversible; the relationship of this to immunoglobulin therapy is unclear. Additional features occurred in some patients. Three had a retinopathy interpreted as retinitis pigmentosa, in one of whom the retinopathy resolved. Two patients had a sensori-neural hearing loss and three had features of dermatomyositis; a variable pleocytosis was found in the CSF of nine patients. Imaging revealed atrophic changes in the cerebral hemispheres in eight cases. Ten patients have died, 1–11 years after the onset of the CNS manifestations, and in four autopsies were obtained. Two patients had an encephalopathy, one with XLA had evidence of end-stage encephalitis and the other with CVID had a multi-focal leucoencephalopathy. The other two with XLA had leptomeningitis without evidence of encephalitis. Enteroviral infection is probably an important cause of neurological disease in these patients as CSF from seven patients was either positive by polymerase chain reaction (PCR) or by culture for enteroviruses. Other possible mechanisms are discussed.

Published
1996
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14. Diagnosis of Enterovirus Brain Disease in Hypogammaglobulinemic Patients by Polymerase Chain Reaction

Author

Webster, A. D. B., Rotbart, H. A., Warner, T., Rudge, P., and Hyman, N.

Abstract

CSF samples taken from three patients with primary hypogammaglobulinemia and chronic brain disease were positive for enterovirus RNA by use of a technique based on the polymerase chain reaction (PCR) to amplify viral genomic sequences. Repeated attempts to culture viruses from the CSF from these patients were unsuccessful, possibly because the patients were treated regularly with intravenous immunoglobulin, which may have contained enough specific antibody to partially neutralize the viruses. Our data suggest that enteroviruses are responsible for diverse CNS features in patients with primary hypogammaglobulinemia and that for these patients the diagnosis should be pursued using PCR technology.

Published
1993
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