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The hearing threshold levels of children at school age. | To measure the hearing threshold levels by air conduction in a group of unselected and a group of selected (otologically normal) school-aged children.Six hundred eighty-seven unselected school children representing three age groups and 471 selected; otologically normal children were examined by pure-tone audiometry.The obtained results showed that hearing levels improved with age from 7 to 10 yr in children in both groups. The pure-tone averages (PTAs) of the right and the left ear in otologically normal ch | 8979035 | [
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The hearing threshold levels of children at school age. | ildren were; respectively; 1.8 and 1.2 dB HL in 7-yr-old children; -0.9 and -1.7 dB HL in 10-yr-old children; and -1.3 and -2.0 dB HL in 14-yr-old children. The PTAs were 0.2 to 1.9 dB poorer in the groups of unselected children.The present study provides new data on the hearing sensitivity among unselected 7-; 10-; and 14-yr-old school children. Furthermore; it provides normative values on the hearing thresholds of otologically normal children in these three age groups. | 8979035 | [
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Word recognition in continuous and interrupted broadband noise by young normal-hearing, older normal-hearing, and presbyacusic listeners. | Word recognition performance in continuous and interrupted broadband noise was examined in young normal-hearing (YNH); older normal-hearing (ONH); and presbyacusic (older hearing-impaired [OHI]) listeners.Participants (N = 36) were presented with identical Northwestern University Auditory Test No. 6 stimuli at 30 dB sensation level re their respective speech reception thresholds. The speech stimuli were presented in quiet and in both competing noise conditions with signal to noise ratios (S/Ns) of 10; 5; 0; | 8979036 | [
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Word recognition in continuous and interrupted broadband noise by young normal-hearing, older normal-hearing, and presbyacusic listeners. | -5; -10; -15; and -20 dB.In general performance was superior in quiet; improved with increasing S/N; and was greater in the interrupted broadband noise than in the continuous broadband noise. Significant main effects of group and S/N were found in both competing noises (p < 0.0001). Post hoc pairwise comparisons revealed all groups performed differently; with superior performance being displayed by the YNH group followed by the ONH and OHI groups; respectively (p < 0.05). A significant group by S/N interac | 8979036 | [
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Word recognition in continuous and interrupted broadband noise by young normal-hearing, older normal-hearing, and presbyacusic listeners. | tion was observed in only the interrupted noise condition (p = 0.019). The degree of change in word recognition performance as a function of S/N was greatest in the OHI group followed by the ONH group and the YNH group.Group effects observed in the interrupted noise would imply that the two older groups of listeners had an auditory temporal deficit relative to the YNH listeners. The paradigm reveals the patency of the temporal processes that are responsible for the perceptual advantage (i.e.; a release from | 8979036 | [
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Comparison of conventional amplification and an assistive listening device in elderly persons. | To assess the impact of personal amplification systems on quality of life of elderly persons and to compare conventional hearing aid with assistive listening device.Audiologic; neuropsychologic; and quality-of-life measures were prospectively administered to 180 elderly; hearing-impaired persons before and after randomized 6 wk trials of four treatment conditions-a no-amplification condition and three different types of amplification: 1) conventional hearing aid; 2) assistive listening device; and 3) a comb | 8979037 | [
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Comparison of conventional amplification and an assistive listening device in elderly persons. | ination of the two systems. All subjects volunteered to participate in a study comparing different amplification systems and were paid for their participation.Both self-perceived handicap and speech understanding were improved significantly by all three amplification systems. There were no significant group differences between new users and previous users of amplification in self-assessed handicap after amplification use. Anecdotally; subjects preferred the sound quality of the assistive listening device; b | 8979037 | [
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Comparison of conventional amplification and an assistive listening device in elderly persons. | ut an overwhelming majority (97.3%) still chose the conventional aid for use in daily living.Results affirm the significant impact of amplification on the quality of life of elderly persons. The strong preference for the conventional hearing aid in everyday use undoubtedly reflects the fact that elderly users usually are not willing to endure the difficulties associated with the use of remote-microphone systems. | 8979037 | [
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Refinement and psychometric evaluation of the Attitudes Toward Loss of Hearing Questionnaire. | To refine and statistically validate the Attitudes Toward Loss of Hearing Questionnaire (ALHQ) so that it will be appropriate for clinical application and to understand some of the personality attributes underlying attitudes toward hearing loss.An American-English version of an ALHQ; originally designed by Brooks (1989); was completed by 226 men; a subset of 80 also completed personality questionnaires. All subjects underwent pure-tone testing and speech audiometry. Factor analysis was used to extract scale | 8979038 | [
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Refinement and psychometric evaluation of the Attitudes Toward Loss of Hearing Questionnaire. | s from the ALHQ. Reliability analyses using Cronbach's alpha were carried out on each scale. Test-retest reliability was evaluated from questionnaires completed 6 to 18 mo after initial administration. Multiple regression analysis was used to examine the audiometric and personality determinants of attitudes.Five reliable scales were extracted from a 24-question version of the ALHQ: 1) Social and Emotional Impact of Hearing Loss; 2) Acceptance/ Adjustment to Hearing Loss; 3) Perceived Support from Significan | 8979038 | [
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Refinement and psychometric evaluation of the Attitudes Toward Loss of Hearing Questionnaire. | t Others; 4) Hearing Aid Stigma; and 5) Awareness of Hearing Loss. Audiometric data explained little of the variance in attitude scores; age and other demographic factors did not correlate with attitudes either. The personality traits of extroversion; self-esteem; and anxiety/neuroticism played a larger role in determining attitude.The ALHQ is psychometrically acceptable and is a potentially useful clinical tool. It is quick and easy to complete and to score and could be used as a basis for counseling and f | 8979038 | [
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Refinement and psychometric evaluation of the Attitudes Toward Loss of Hearing Questionnaire. | or following attitude change in patients over time. | 8979038 | [
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Measures of hearing aid gain for real speech. | Non-speech stimuli typically are used to estimate the electroacoustic characteristics of a hearing aid. At present; there is no consensus as to what type of input stimulus will best represent the gain for real speech. The purpose of this study was to measure hearing aid gain using continuous discourse and to compare these values with gain measured with five different types of simpler stimuli.Hearing aid gain as a function of frequency was measured in a 2 cm3 coupler for 20 commercially available hearing aid | 8979039 | [
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Measures of hearing aid gain for real speech. | s. Circuitry included features such as linear peak clipping; compression limiting; 1-; 2-; and 3-channel full dynamic range compression; and adaptive compression. Input stimuli were a) 15 sec of continuous discourse; b) swept pure tones (SPTs); c) speech weighted composite noise (SWCN); d) simulated speech; e) speech weighted warble tones; and f) speech modulated noise. Input levels ranged from 50 to 80 dB SPL.In general; both SPTs and SWCN tended to underestimate the high-frequency gain for real speech. Th | 8979039 | [
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Measures of hearing aid gain for real speech. | ese discrepancies increased as a function of input intensity. On average; the SPT produced the greatest departure from the gain for real speech; producing differences for individual hearing aids as large as 10 to 14 dB. An analysis by circuit type revealed that discrepancies most likely occurred when a hearing aid was operating in a nonlinear mode. Of the five non-speech stimuli used; speech modulated noise and simulated speech seemed to provide the closest approximation to the gain measured with continuous | 8979039 | [
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Measures of hearing aid gain for real speech. | discourse.When a hearing aid is operating in a nonlinear mode; non-speech stimuli will tend to underestimate the gain for real speech; particularly in the high frequencies. Under some conditions; these discrepancies may impact clinical decisions during the hearing aid fitting process. Additional studies are needed to elucidate the factors that contribute to the gain discrepancies observed in this study and to explore the use of additional stimuli (including short speech samples); which may result in better | 8979039 | [
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Electric response audiometry in young children before cochlear implantation: a short latency component. | Evaluation of a short latency component (SLC) observed in profoundly deaf young children during recordings of the auditory brain stem response (ABR) before cochlear implantation.Seventy young children (ages 2 to 11 yr) were investigated as part of their routine audiologic and diagnostic assessment; before cochlear implantation. The ABR was evoked using click stimuli and tone pips (500 Hz and 1 kHz) at intensity levels up to 105 dB nHL. The incidence of the SLC arising at a latency of 3 msec with high level | 8979041 | [
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Electric response audiometry in young children before cochlear implantation: a short latency component. | click stimuli; in addition to residual ABR waves; was assessed.An SLC was observed in a total of 18 of the 70 children investigated. It was present in 15 out of 31 congenitally deaf children (48%) compared with only 2 out of 33 children deafened after meningitis (6%). A chi-squared test employing a 2 x 2 contingency table shows that this dependency on etiology of deafness is highly statistically significant (p < 0.001). The presence of the SLC in the congenitally deaf children is related to age at the time | 8979041 | [
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Electric response audiometry in young children before cochlear implantation: a short latency component. | of the Electric Response Audiometry test and is more likely to be observed in the younger child (p < 0.01).Interpretation of the ABR in profoundly deaf children should take into consideration the possible presence of the SLC. An evoked potential arising from stimulation of the vestibular system; particularly the vestibular nuclei; is proposed as a likely origin for this component. Damage to sensory cells in the vestibular portion of the labyrinth might explain why an SLC is seen rarely in cases of deafness | 8979041 | [
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Electric response audiometry in young children before cochlear implantation: a short latency component. | after meningitis. | 8979041 | [
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Initial independent results with the Clarion cochlear implant. | This paper reports some preliminary findings from patients; implanted at the University of Iowa; using the Advanced Bionics Clarion cochlear implant (version 1.0). We compared the performance of patients using both simultaneous analog and nonsimultaneous pulsatile processing strategies. The performance of Clarion patients was also compared with a group of patients who were using either the feature-extraction Nucleus cochlear implant or the compressed-analog Ineraid cochlear implant.One aim was to compare th | 8979040 | [
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Initial independent results with the Clarion cochlear implant. | e analog and pulsatile stimulation in 19 patients using the Clarion implant. This aim could be accomplished only partially because of difficulties encountered in adequately fitting patients with the analog strategy. A second aim was to compare the Clarion users' performance with feature-extraction Nucleus and compressed-analog Ineraid patients. Comparisons were made with all patients having 9 mo experience postimplantation.Subjects performed better using the pulsatile mode compared with the analog mode. All | 8979040 | [
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Initial independent results with the Clarion cochlear implant. | subjects chose to use the pulsatile strategy after the first 3 mo of the study. Results comparing performance at 9 mo with our compressed-analog Ineraid and feature-extraction Nucleus patients indicated; in general; better average performance for the Clarion users.We conclude that the pulsatile version of the Clarion cochlear implant typically produces superior performance to the analog version of that device at this stage in its development. After 9 mo of experience; users of the Clarion implant are perfo | 8979040 | [
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Initial independent results with the Clarion cochlear implant. | rming better than are users of the feature-extraction Nucleus and compressed-analog Ineraid cochlear implants with comparable amounts of experience. | 8979040 | [
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Auditory evoked brain stem responses to trains of stimuli in human adults. | This study describes the effect of train length; interstimulus interval; intertrain interval (ITI); and stimulus duration on the transition from the unadapted to the adapted wave V auditory evoked brain stem response (ABR).ABRs were recorded to stimuli presented at two different rates: a slow rate characterizing the unadapted response and a fast rate characterizing the adapted response. Trains of stimuli (a sequence of stimuli separated by intervals of silence) also were presented. Different stimulus parame | 8979042 | [
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Auditory evoked brain stem responses to trains of stimuli in human adults. | ters defining the trains were varied.Given a sufficiently long ITI; the latency prolongation to the first three or four stimuli in a train was rapid. It was similar for trains differing in number of stimuli. After the first three or four stimuli; there was a more gradual latency prolongation as a function of stimulus number. Shorter ITIs had the effect of prolonging the latencies to all the stimuli in the trains; reducing the rate of latency prolongation over the first few stimuli; and causing responses to | 8979042 | [
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Auditory evoked brain stem responses to trains of stimuli in human adults. | trains of different length to differ (e.g.; two click train responses were shorter latency than four click train responses). An unexpected result was the latency prolongation of wave Vs after the presentation of the stimulus trains.In response to a train of clicks; there seems to be a rapid increase in wave V latency to the first few clicks in the train followed by a more gradual latency prolongation to subsequent clicks in the train. | 8979042 | [
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Blockade of opioid-induced changes in auditory function at the level of the cochlea. | We have previously investigated the auditory neural effects of the kappa-opioid receptor agonist; (-)pentazocine. When administered intravenously (i.v.); this drug temporarily alters auditory nerve compound action potential (CAP) amplitudes. To test the hypothesis that the observed neural effects of i.v. (-)pentazocine occur via kappa-receptor interactions within the cochlea; we attempted to block these effects by employing a specific kappa-opioid receptor antagonist applied directly to the cochlear round w | 8979043 | [
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Blockade of opioid-induced changes in auditory function at the level of the cochlea. | indow (RW) membrane.In 31 normal-hearing; male pigmented chinchillas; amplitude changes in the click-evoked auditory CAP (N1) were tracked at six stimulus intensities during a baseline and a postbaseline period in which i.v. (-)pentazocine (8 mg/kg) was administered. (-)Pentazocine administration was preceded by the delivery to the cochlear RW membrane of an artificial perilymph solution given alone or containing the kappa-opioid receptor selective antagonist; norbinaltorphimine (Nor-BNI); which was adminis | 8979043 | [
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Blockade of opioid-induced changes in auditory function at the level of the cochlea. | tered at two concentrations in separate groups of animals.The amplitude increase in the CAP after (-)pentazocine was significantly reduced when i.v. (-)pentazocine was preceded by RW-administered Nor-BNI (4 mM).The reversibility of agonist effects by Nor-BNI indicates direct or indirect opioid kappa-receptor-mediated auditory neural effects at the level of the cochlea and suggests a connection between kappa-receptors and auditory neural function. | 8979043 | [
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Effects of stapedial arch fractures on conductive hearing loss and stapedial reflexes. | It has been stated in the clinical literature that stapedial fractures could produce a significant conductive hearing loss while leaving the contralateral stapedial reflex intact. The objective of this study is to test this hypothesis in an animal model.Nine hooded rats underwent acoustic-stapedial reflex (ASR) and cochlear microphonic (CM) threshold determinations before and after middle ear surgery. An argon laser was used to divide the tensor tympani tendon; the anterior stapedial curs; and the posterior | 8979044 | [
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Effects of stapedial arch fractures on conductive hearing loss and stapedial reflexes. | stapedial crus; sequentially. The initial functional measures were repeated after each laser procedure to document its effect.Dividing the tensor tympani tendon and the anterior stapedial crus had variable and small effects on ASR and CM thresholds. Division of the second (posterior) crus eliminated stapedial reflexes and produced a significant hearing loss.This study refutes the hypothesis that fracture of one (anterior) stapedial crus will significantly alter ossicular sound transmission; but it supports | 8979044 | [
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Effects of stapedial arch fractures on conductive hearing loss and stapedial reflexes. | the hypothesis that measured stapedial reflexes would not be significantly altered by a single crus fracture. Therefore; the surgeon exploring an ear for a conductive hearing loss with an intact contralateral stapedial reflex should look carefully for another source of the hearing loss if finding only a single stapedial arch fracture. | 8979044 | [
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Two different patterns of airway branching regulated by different components of the extracellular matrix in vitro. | This study examined the effects of beta-D-xyloside (an inhibitor of proteoglycan synthesis) and cis-4-hydroxyl-L-proline (an inhibitor of collagen synthesis) on branching morphogenesis in cultures of fetal rat lung. Lungs from day 15 gestation were incubated for 4 days in (1) the control medium (Dulbecco's Modified Eagle Medium + 10% Fetal Bovine Serum) alone (control); (2) control medium plus 2 mM beta-D-xyloside (beta-XYL); (3) control medium plus 2 mM alpha-D-xyloside (alpha-XYL); (4) control medium plus | 8979045 | [
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Two different patterns of airway branching regulated by different components of the extracellular matrix in vitro. | 50 micrograms/mL cis-4-hydroxy-L-proline (cis-HYP). The number of peripheral buds of left lungs was counted daily. Histological examination was performed on lungs on days 2 and 4. beta-XYL inhibited proximal monopodial branching on day 2 without affecting lung size; but produced numerous peripheral buds on day 4 which were of abnormal appearance; suggesting that lung airway branching and growth may be regulated by different mechanisms. Histology and morphometry showed significantly enlarged airspaces and d | 8979045 | [
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Two different patterns of airway branching regulated by different components of the extracellular matrix in vitro. | iminished mesenchyme. cis-HYP did not affect proximal branching on 2 days in culture; but inhibited further dichotomous branching and lung growth after 2 days. On day 4; diminished branching and lung growth was accompanied by a proportional decrease in mesenchyme. The difference between effects of beta-XYL and cis-HYP on the branching pattern suggests that proteoglycans and collagen are involved in different patterns of branching morphogenesis. | 8979045 | [
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] |
Long-term follow-up after endoscopic sphincterotomy for bile duct stones in patients younger than 60 years of age. | Little is known about the long-term effects of endoscopic biliary sphincterotomy.We retrospectively evaluated the rate of late complications after endoscopic sphincterotomy (EST) for bile duct stones. Patients had to meet the following inclusion criteria: (1) treated between 1976 and 1980; (2) complete stone removal after EST; (3) prior cholecystectomy or elective cholecystectomy within 2 months after EST; and (4) 60 years old or younger at the time of ERCP. A total of 100 patients were identified. Informat | 8979051 | [
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Long-term follow-up after endoscopic sphincterotomy for bile duct stones in patients younger than 60 years of age. | ion was obtained from general practitioners and patients by telephone. Patients completed a postal questionnaire and a blood sample was obtained for liver function tests.Information was obtained for 94 patients (in the majority of cases [87%] from multiple sources). There were 26 men and 68 women with a mean age of 51 years at the time of ERCP (range; 23 to 60 years). Early complications (< 30 days) occurred in 14 patients (15%). One patient died of a retroperitoneal perforation secondary to EST. During a m | 8979051 | [
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Long-term follow-up after endoscopic sphincterotomy for bile duct stones in patients younger than 60 years of age. | edian period of 15 years (range; 3 to 18 years); 22 patients (24%) developed a total of 36 late complications. There were 21 patients with symptoms of recurrent bile duct stones and one patient with biliary pancreatitis. Other late complications; such as recurrent ascending cholangitis or malignant degeneration; were not observed. An ERCP was performed in 20 of the 22 patients with late complications and demonstrated bile duct stones in 13; combined with stenosis of the EST opening in 9 patients. Late compl | 8979051 | [
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Long-term follow-up after endoscopic sphincterotomy for bile duct stones in patients younger than 60 years of age. | ications were initially managed endoscopically and/or conservatively. One patient underwent surgery after failed endoscopic treatment and one patient died of cholangitis before she could undergo an ERCP. Twelve other patients died of unrelated causes during follow-up.After EST for bile duct stones; late complications occur in a significant proportion of patients. Stone recurrence remains the most important problem; but can in general be managed endoscopically. | 8979051 | [
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Specific neutrophil elastase inhibitor does not attenuate acute lung injury induced by air embolism in awake sheep. | To investigate the role played by neutrophil-derived elastase in acute lung injury; this study examined the effects of treatment of ONO-5046; a competitive; reversible; and specific neutrophil elastase inhibitor; on lung dysfunction induced by air emboli in awake sheep. Sheep were prepared with chronic lung lymph fistula. In experiment 1; air (1.23 mL/min) was infused over a 2-h period into the pulmonary artery and hemodynamic monitoring was performed over a 5-h period. In experiment 2; air was infused in t | 8979046 | [
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Specific neutrophil elastase inhibitor does not attenuate acute lung injury induced by air embolism in awake sheep. | he same manner as in experiment 1; 1 h after the continuous infusion of ONO-5046 (10 mg/kg h-1) had begun. In experiment 1; pulmonary artery pressure (Ppa) increased from the baseline value of 17.0 +/- 0.7 cm H2O to 28.3 +/- 1.8 1 h after the beginning of the air infusion. Ppa returned to the baseline values within 1 h after the air infusion was stopped. Lung lymph flow (Qlym) increased from the baseline value of 3.7 +/- 0.7 mL/0.5 h to 8.5 +/- 1.9 after 1 h of air infusion. After the air infusion was stopp | 8979046 | [
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Specific neutrophil elastase inhibitor does not attenuate acute lung injury induced by air embolism in awake sheep. | ed; Qlym continued to increase. When sheep were treated with ONO-5046; Ppa and Qlym increased in a fashion similar to that in the experiment 1. These findings suggest that ONO-5046 does not attenuate air embolism-induced lung injury and that neutrophil-derived elastase may not play an important role in air embolism-induced lung injury in awake sheep. | 8979046 | [
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The acute and long-term effect of balloon sphincteroplasty on papillary structure in pigs. | Balloon dilation or sphincteroplasty is emerging as a potentially safe and effective alternative to sphincterotomy in the management of bile duct stones. However; concerns related to the possible development of fibrosis or papillary stenosis led us to investigate the acute and long-term effects of balloon sphincteroplasty on papillary structure.Sixteen pigs (45 to 50 kg) underwent transduodenal cannulation of the bile duct while under general anesthesia. Balloon sphincteroplasty was performed in 10 pigs to | 8979052 | [
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The acute and long-term effect of balloon sphincteroplasty on papillary structure in pigs. | a diameter of 8 mm at a pressure of 10 atm. Sphincterotomy was carried out in 3 pigs while 2 other untreated pigs acted as controls. Eleven animals were sacrificed at intervals from 15 to 120 minutes after balloon sphincteroplasty or sphincterotomy. The remaining 5 animals were sacrificed between 6 and 12 weeks later. Histologic sections through the papilla were assessed for evidence of morphologic changes.When compared with controls; sections taken 15 to 120 minutes after balloon sphincteroplasty showed a | 8979052 | [
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The acute and long-term effect of balloon sphincteroplasty on papillary structure in pigs. | progressive increase in acute inflammation extending transmurally. Intramucosal; but no transmural; hemorrhage was noted. No architectural distortion or smooth muscle disruption was observed in contrast to the transmural hemorrhage; smooth muscle disruption; and mucosal necrosis seen following sphincterotomy. After 6 to 12 weeks; mild chronic inflammation with follicular hyperplasia was present but no smooth muscle disruption or fibrosis was observed.Balloon sphincteroplasty causes an acute transmural infla | 8979052 | [
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The acute and long-term effect of balloon sphincteroplasty on papillary structure in pigs. | mmatory response and chronic follicular hyperplasia but is not associated with fibrosis or altered papillary architecture. | 8979052 | [
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Expression of CYP2B1 in freshly isolated and proliferating cultures of epithelial rat lung cells. | Bronchiolar Clara cells and alveolar type 2 cells of the lung are known to express relatively high levels of P450 enzymes compared to other pulmonary cells. Populations of enriched type 2 cells and Clara cells were isolated from rat lung by a procedure including lung perfusion; protease digestion; centrifugal elutriation; and differential attachment. Alveolar macrophages were removed by lavage. The purity of the type 2 cell-enriched population was approximately 90%; and the purity of the Clara cell-enriched | 8979047 | [
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Expression of CYP2B1 in freshly isolated and proliferating cultures of epithelial rat lung cells. | population was 40-50%. Both type 2 cells and the cells of the Clara cell-enriched population proliferated in culture. CYP2B1 mRNA was expressed approximately to the same level in type 2 cells and the Clara cell-enriched population. The mRNA levels remained roughly constant for both cell types throughout the culture period; except for an early transient reduction. The apoenzyme level of CYP2B1 was 2-3 times higher in freshly isolated cells of the Clara cell-enriched population than in the type 2 cells. Both | 8979047 | [
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Expression of CYP2B1 in freshly isolated and proliferating cultures of epithelial rat lung cells. | epithelial cell types showed decreased level of CYP2B1 apoenzyme in culture. The differences in the CYP2B1 mRNA and apoenzyme expression levels in freshly isolated cells and cultured cells suggest the existence of a post-transcriptional regulatory mechanism for CYP2B1 expression in lung cells. The characterization of specific functions of lung cells in culture; such as P450 gene expression; provides necessary information for the use of the cells in in vitro pulmonary toxicology. | 8979047 | [
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Pulmonary response to plasmid DNA and immunohistochemical localization of transgene expression. | Tracheal insufflation of chloramphenicol acetyltransferase (CAT) expression plasmid (pBL-CAT) DNA without any gene delivery system results in transfection of rat lungs (Am J Physiol. 1995;268:L1052-L1056). This study investigated the pulmonary response to tracheal insufflation of plasmid DNA and the immunohistochemical localization of transgene expression in the lungs. Insufflation of 300 micrograms pBL-CAT DNA resulted in lung transfection without causing pulmonary injury as judged from the protein content | 8979048 | [
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Pulmonary response to plasmid DNA and immunohistochemical localization of transgene expression. | of alveolar lavage fluid; pleural effusion; and lung ultrastructure. There was; however; an acute alveolar inflammatory response at 6 h after insufflation due to contaminating endotoxin present in the plasmid DNA preparation. Reducing the amount of endotoxin from 0.022 to 0.0015 microgram per 300 micrograms pBL-CAT completely abolished the acute alveolar inflammatory response without affecting the lung transfecting efficiency of pBL-CAT. Immunohistochemistry revealed that insufflation of pBL-CAT transfecte | 8979048 | [
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Pulmonary response to plasmid DNA and immunohistochemical localization of transgene expression. | d predominantly small airway epithelial cells. | 8979048 | [
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Endosonography-guided celiac plexus neurolysis. | We have evaluated the safety and efficacy of performing endosonography-guided celiac plexus neurolysis (EUS CPN) in patients with pain due to intra-abdominal malignancies.Thirty patients with upper abdominal pain requiring narcotic analgesia and suspected or known intra-abdominal malignancy were selected for EUS CPN. This group included 25 patients with pancreas carcinoma and 5 patients with intra-abdominal metastases. Using the linear array ultrasound endoscope and a prototype needle catheter; transgastric | 8979053 | [
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Endosonography-guided celiac plexus neurolysis. | injection of the celiac plexus with bupivacaine and 98% dehydrated absolute alcohol was accomplished.Pain scores were significantly lower compared with baseline at 2; 4; 8; and 12 weeks after EUS CPN (median follow-up: 10 weeks). At these follow-up intervals; 82% to 91% of patients required the same or less pain medication and 79% to 88% of patients had persistent improvement in their pain score. Comparison of patients with TXNXM1 versus TXNXMO pancreatic carcinoma revealed higher initial pain scores (7.9 | 8979053 | [
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Endosonography-guided celiac plexus neurolysis. | +/- 1.92 versus 5.8 +/- 2.0; p = .02) and a greater decline in pain scores (decrease of 6.1 +/- 3.1 versus 4.8 +/- 2.0; p = .004). Complications were minor and consisted of transient diarrhea in four patients.EUS CPN is a safe and effective means for improving pain control in patients with intra-abdominal malignancy. The technique may be performed as an outpatient at the same setting as the EUS staging examination. | 8979053 | [
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Circulatory changes after surfactant bolus instillation in lung-lavaged adult rabbits. | Following surfactant instillation in infants treated for respiratory distress syndrome; a mean arterial blood pressure (MABP) decrease is often observed. Its etiology and pathogenesis are still unknown. In this study various circulatory parameters were recorded continuously after surfactant instillation to elucidate the role of pulmonary vascular resistance as one possible cause for the MABP drop. Seven anesthetized adult New Zealand white rabbits were artificially ventilated after tracheotomy. Arterial and | 8979049 | [
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Circulatory changes after surfactant bolus instillation in lung-lavaged adult rabbits. | right atrial pressure were recorded continuously. Pulmonary artery pressure and cardiac output were determined by means of a thermodilution catheter. After inducing surfactant deficiency by repeated saline lavages; 200 mg/kg body weight of a natural surfactant preparation was administered by tracheal bolus instillation. PaO2 increased rapidly from 8.0 +/- 1.3 kPa to 51.2 +/- 8.8 kPa (mean +/- standard deviation) within 2 min (p < .05). MABP dropped from 12.1 +/- 1.9 kPa to 8.9 +/- 2.3 kPa within 2 min (p < | 8979049 | [
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Circulatory changes after surfactant bolus instillation in lung-lavaged adult rabbits. | .05). Pulmonary artery pressure; cardiac output; and right atrial pressure did not change during the observation period of 60 min. The results suggest that a peripheral vasodilatation is the most likely cause for the drop in MABP. | 8979049 | [
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Results of culture form colonoscopically obtained specimens for bacteria and fungi in HIV-infected patients with diarrhea. | The aim of our study was to determine the diagnostic yield of culture for bacteria and fungi from colonic biopsy specimens in 290 consecutive HIV-infected patients with diarrhea.During each colonoscopy; three biopsy specimens were homogenized and cultured on media for Salmonella and Shigella and for Campylobacter and Yersinia; on Loewenstein medium and on Sabouraud medium.Cultures were found positive for one (n = 32) or two (n = 5) infectious agents in 37 cases; i.e.; in 12.8% of the patients. Bacteria were | 8979054 | [
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Results of culture form colonoscopically obtained specimens for bacteria and fungi in HIV-infected patients with diarrhea. | isolated in 24 cases; and identified as Campylobacter jejunl-coli (n = 14); Salmonella (n = 2); Shigella (n = 1); or Pseudomonas aeruginosa (n = 7). Among the 14 patients with C. jejuni-coli intestinal infection; 11 had normal-appearing mucosa at colonoscopy; and 3 had a concomitant stool culture negative for Campylobacter. Mycobacterial cultures were positive for Mycobacterium avium intracellulare in 6 patients; who were already known as having a disseminated M. avium intracellulare infection from positiv | 8979054 | [
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Results of culture form colonoscopically obtained specimens for bacteria and fungi in HIV-infected patients with diarrhea. | e blood cultures. Fungal cultures were positive for Candida in 10 cases; without clear clinical significance.The overall yield of culture for bacterial pathogens from colonic tissue in HIV-infected patients with diarrhea is low; but some individual cases of C. jejuni-coli infections may be detected from colonic tissue culture and not diagnosed by concomitant stool culture. | 8979054 | [
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Cutting thread at flexible endoscopy. | New thread-cutting techniques were developed for use at flexible endoscopy. A guillotine was designed to follow and cut thread at the endoscope tip. A new method was developed for guiding suture cutters. Efficacy of Nd: YAG laser cutting of threads was studied. Experimental and clinical experience with thread-cutting methods is presented.A 2.4 mm diameter flexible thread-cutting guillotine was constructed featuring two lateral holes with sharp edges through which sutures to be cut are passed. Standard sutur | 8979055 | [
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Cutting thread at flexible endoscopy. | e cutters were guided by backloading thread through the cutters extracorporeally. A snare cutter was constructed to retrieve objects sewn to tissue. Efficacy and speed of Nd: YAG laser in cutting twelve different threads were studied.The guillotine cut thread faster (p < 0.05) than standard suture cutters. Backloading thread shortened time taken to cut thread (p < 0.001) compared with free-hand cutting. Nd: YAG laser was ineffective in cutting uncolored threads and slower than mechanical cutters. Results of | 8979055 | [
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Cutting thread at flexible endoscopy. | thread cutting in clinical studies using sewing machine (n = 77 cutting episodes in 21 patients); in-vivo experiments (n = 156); and postsurgical cases (n = 15 over 15 years) are presented.New thread-cutting methods are described and their efficacy demonstrated in experimental and clinical studies. | 8979055 | [
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Comparison of lymphocyte subsets, monocytes, and NK cells in three different lung compartments and peripheral blood in the rat. | Investigations on leukocyte populations in the lung have shown that lymphocytes are found in different anatomical compartments. Lymphocytes can be seen to a different extent in the lung interstitium; the epithelium and lamina propria of the bronchi; the bronchoalveolar space; and the marginal lung vascular bed. Previous studies focused on one compartment only; or a mixture of leukocytes from lung homogenates were prepared. This study compared cellular yields from the lung parenchyma; the bronchoalveolar spa | 8979050 | [
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Comparison of lymphocyte subsets, monocytes, and NK cells in three different lung compartments and peripheral blood in the rat. | ce; and the perfusate of the lung vasculature of healthy male Lewis rats. All compartments were investigated in the same animal; and seven different lymphocyte subsets; monocytes; and natural killer (NK) cells were analyzed using flow cytometry. It was found that the perfusate contained a high proportion of CD4+ lymphocytes compared to the lung interstitium. A very high proportion of CD4+ lymphocytes in the bronchoalveolar lavage (BAL) expressed markers for "memory" T cells. Compared to the blood; the perce | 8979050 | [
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Comparison of lymphocyte subsets, monocytes, and NK cells in three different lung compartments and peripheral blood in the rat. | ntage of B and T cells was much lower in the perfusate; whereas the NK cells and monocytes were more frequent. Analysis of leukocyte subsets within all compartments revealed specific; distinguishable cell compositions. Extraction of interstitial lung cells was performed using two different methods. Enzymatic digestion of the lung tissue was compared with a mechanical disruption method. Hardly any differences were observed between the two methods regarding the distribution of lymphocyte subsets; monocytes; a | 8979050 | [
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Comparison of lymphocyte subsets, monocytes, and NK cells in three different lung compartments and peripheral blood in the rat. | nd NK cells. These data document the need to study more than one compartment before extrapolating to lymphocytes in the lung in general. Furthermore; changes in numbers of leukocytes and subsets can now be studied in models of lung infections and immune reactions; including the entry from the blood and intrapulmonary migration from one lung compartment to the other. | 8979050 | [
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Use of a pediatric colonoscope improves the success of total colonoscopy in selected adult patients. | Colonoscopy using a standard adult colonoscope can be difficult or impossible when there is a fixed; angulated sigmoid colon or stricture. It is sometimes possible to traverse such segments using a smaller-diameter; more flexible pediatric colonoscope.For this prospective study; one endoscopist started 645 consecutive; elective colonoscopies with a standard adult Olympus CF-100L colonoscope (52% women; 48% men). There were 36 examinations (5.6%) in which the adult colonoscope could not be passed through a f | 8979056 | [
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Use of a pediatric colonoscope improves the success of total colonoscopy in selected adult patients. | ixed; angulated sigmoid colon (n = 34) or a sigmoid colonic stricture (n = 2). In such instances (33 women and 3 men); the endoscopist switched to a pediatric colonoscope.The pediatric colonoscope successfully reached the cecum in 21 of the 36 cases (58.3%). The figure was 38.5% for the older Olympus CF-P20L fiberoptic colonoscope (n = 13) and 69.6% for the newer Olympus PCF-100 videocolonoscope (n = 23). Concomitant conditions in the 34 patients in whom the pediatric colonoscope was used because of a fixed | 8979056 | [
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Use of a pediatric colonoscope improves the success of total colonoscopy in selected adult patients. | ; angulated sigmoid included previous pelvic surgery in 22; pelvic radiation therapy in 2; pelvic endometriosis in 3; and two with previous sigmoid diverticulitis.The pediatric colonoscope; and particularly the newer Olympus PCF-100 colonoscope; is very useful in adult patients in whom it is not possible to traverse a fixed; angulated sigmoid colon or stricture using the standard adult colonoscope. This is predominantly a problem of female patients. Previous pelvic surgery may be an important causative fact | 8979056 | [
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Use of a pediatric colonoscope improves the success of total colonoscopy in selected adult patients. | or in this regard. | 8979056 | [
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Quantitative noninvasive testing for Helicobacter pylori does not predict gastroduodenal ulcer disease. | Helicobacter pylori is strongly associated with gastric and duodenal ulcer disease. However; the diagnosis of gastroduodenal ulcers requires an endoscopic or radiographic examination. In this study; we attempted to establish a relationship between the magnitude of [13C]urea breath test results or serum H. pylori IgG levels and endoscopic findings in H. pylori-infected individuals.Patients who had undergone endoscopy and had a positive [13C]urea breath test and/or positive H. pylori IgG serology were identif | 8979057 | [
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Quantitative noninvasive testing for Helicobacter pylori does not predict gastroduodenal ulcer disease. | ied. Endoscopic diagnoses included duodenal ulcer; gastric ulcer; nonulcer dyspepsia; and others. Results of 6% or greater on the [13C]urea breath test was defined as positive for H. pylori infection. H. pylori IgG serology was determined by an enzyme linked immunosorbent assay with values of greater than or equal to 1.0 being seropositive.One hundred seventy-five patients were seropositive (mean = 3.01 +/- 1.58). One hundred sixty-eight patients had a positive [13C]urea breath test (mean = 25.43 +/- 16.90) | 8979057 | [
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Quantitative noninvasive testing for Helicobacter pylori does not predict gastroduodenal ulcer disease. | . One hundred fifty-five patients were common to both the groups. Statistical analysis did not reveal any relationship between quantitative [13C]urea breath test results or H. pylori IgG values and endoscopic diagnoses.The magnitude of [13C]urea breath test or H. pylori IgG serology cannot be used to predict the presence or absence of gastroduodenal ulcer disease. | 8979057 | [
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Bacterial density of Helicobacter pylori predicts the success of triple therapy in bleeding duodenal ulcer. | We studied whether different initial bacterial densities of Helicobacter pylori would alter the eradication rate of H. pylori by triple therapy (amoxicillin 500 mg t.i.d. and metronidazole 500 mg t.i.d. for 14 days; bismuth subcitrate 120 mg t.i.d. for 28 days) in patients with duodenal ulcer bleeding.One hundred thirty-six cases with duodenal ulcer bleeding and H. pylori infection (proved by rapid urease test and histology during emergency endoscopy) were studied. One hundred twenty-seven of these patients | 8979058 | [
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Bacterial density of Helicobacter pylori predicts the success of triple therapy in bleeding duodenal ulcer. | completed a course of triple therapy. In each case; anti-H. pylori IgG titer; gastric biopsies for H. pylori density (score 1 to 5); and evaluation of severity of gastritis were collected at the first endoscopy and 1 month after completion of the triple therapy.The ulcer healing rate was 84.3% (107 of 127) at the time of the second evaluation. The eradication rate of H. pylori was 76.4% (97 or 127). Eradication for H. pylori failed in 30 cases. In these eradication failure cases; initial serologic titer an | 8979058 | [
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Bacterial density of Helicobacter pylori predicts the success of triple therapy in bleeding duodenal ulcer. | d density of H. pylori were higher than those of eradication success cases. The eradication rate of H. pylori decreased as the initial density of H. pylori increased (density of H. pylori: 1; 88.3%; 2; 83.8%; 3; 74.2%; 4; 68%; 5; 50%). At the second evaluation; the serologic titer was lower and continued to decline in eradication success cases whose mean residual titer ratio (100% x follow-up titer/initial titer) was lower than that of eradication failure cases (57.1% +/- 14.6% vs 107.1% +/- 24.1%; p < 0.00 | 8979058 | [
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Bacterial density of Helicobacter pylori predicts the success of triple therapy in bleeding duodenal ulcer. | 1). The mean residual titer ratio also disclosed an upward trend as the density of H. pylori increased (density of H. pylori 1 to 5: 57.5%; 66.6%; 73.5%; 75.3%; 81.8%; respectively).We suggest routine gastric biopsy to detect both the presence of H. pylori and its density inasmuch as quantitative results may predict the usefulness of triple therapy. The higher the H. pylori density; the less effective triple therapy will be at successful eradication of H. pylori. | 8979058 | [
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Papillary roof incision using the Erlangen-type pre-cut papillotome to achieve selective bile duct cannulation. | Prior studies evaluating pre-cutting the major papilla to access the bile duct when standard cannulation falls have usually used the needle-knife papillotome. We conducted a prospective study to evaluate the efficacy and safety of an Erlangen-type pre-cut papillotome for pre-cutting.Three hundred twenty-seven patients (114 men; mean age 67 years) who underwent first-time sphincterotomy at our institution were included. Pre-cutting was performed if free and wire-guided cannulation of the bile duct failed acc | 8979059 | [
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Papillary roof incision using the Erlangen-type pre-cut papillotome to achieve selective bile duct cannulation. | ording to an algorithm.Pre-cutting was performed in 123 patients (38%) and selective cannulation was successful in all. Post-ERCP serum pancreatic enzyme levels were more frequently elevated in the pre-cut group (50%) than the non-pre-cut group (27%; p < 0.001); however; there was no difference in the incidence of post-ERCP pancreatitis (pre-cut = 2.7%; 95% CI: 0.66% to 7.6%; non-pre-cut = 1.6%; 95% CI: 0.3% to 4.7%). The incidence of bleeding was similar (pre-cut; 2.4%; non-pre-cut; 3.9%; p > 0.05).Pre-cut | 8979059 | [
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Papillary roof incision using the Erlangen-type pre-cut papillotome to achieve selective bile duct cannulation. | ting the major papilla for biliary access using the Erlangen-type pre-cut papillotome is an effective and reasonably safe procedure when performed by endoscopists with extensive experience in pancreatobiliary endoscopy. | 8979059 | [
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Does intrabiliary pressure predict basal sphincter of Oddi pressure? A study in patients with and without gallbladders. | The endoscopic measurement of sphincter of Oddi pressure is a technically difficult procedure requiring significant expertise. Intrabiliary pressure is technically easy to measure. Furthermore; since it is believed that the pathogenesis of pain in patients with sphincter of Oddi dysfunction is attributable to increased intrabiliary pressure; its measurement may be more clinically relevant than measurement of sphincter of Oddi pressure.Intrabiliary pressures were blindly measured in 54 patients who had sphin | 8979060 | [
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Does intrabiliary pressure predict basal sphincter of Oddi pressure? A study in patients with and without gallbladders. | cter of Oddi manometry for abdominal pain.In all patients intrabiliary pressure was significantly higher in patients with sphincter of Oddi dysfunction than those with normal sphincter of Oddi pressure (19.6 +/- 2.2 vs 9.6 +/- 1.2 mm Hg; p < 0.01). These findings were similar when patients were stratified according to presence of intact gallbladder (19.3 +/- 1.6 vs 8.8 +/- 1.4; p < 0.01) and to patients without a gallbladder (20.1 +/- 3.8 vs 12/1 +/- 1.3; p = .034). There was positive correlation between in | 8979060 | [
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Does intrabiliary pressure predict basal sphincter of Oddi pressure? A study in patients with and without gallbladders. | trabiliary pressure and sphincter of Oddi basal pressure. This correlation was significant both in patients with and without gallbladders.These data suggest that increased intrabiliary pressure may be a useful surrogate marker of sphincter of Oddi dysfunction. | 8979060 | [
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Staging of ampullary and pancreatic carcinoma: comparison between endosonography and surgery. | The aim of the study was to update our previously published data on the clinical TNM staging of ampullary and pancreatic carcinoma by endosonography.Endosonography was performed in 70 patients with pancreatic cancer and in 32 patients with ampullary carcinoma. TNM staging was carried out before surgery and compared with findings of histology and/or surgery.Endosonography was accurate in staging the depth of tumor invasion. Early-stage carcinomas could be distinguished from advanced cancers. Nonresectability | 8979062 | [
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Staging of ampullary and pancreatic carcinoma: comparison between endosonography and surgery. | was accurately assessed on the basis of vascular involvement using real-time ultrasound. Tumor compression due to peritumoral pancreatitis and direct tumor invasion into the base of the mesocolon could not be diagnosed by endosonography. The overall accuracy in tumor staging for pancreatic and ampullary carcinomas was 83.6% and 84.4%; respectively. Endosonography was accurate in diagnosing regional lymph node metastases but not accurate in defining nonmetastatic lymphadenopathy and distant metastases.Endos | 8979062 | [
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Staging of ampullary and pancreatic carcinoma: comparison between endosonography and surgery. | onography was accurate in staging tumor stage and lymph node metastases. Minimally invasive methods of resection for superficial ampullary cancers should be based on endosonography staging. | 8979062 | [
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Endosonographic characterization of duodenal elevated lesions. | Endoscopic diagnosis of duodenal elevated lesions is problematic for two reasons. Endoscopic biopsy often fails to confirm a histologic diagnosis of submucosal lesions. Moreover; a biopsy specimen is often insufficient to verify a differential diagnosis of mucosal lesions. In this study; we evaluated the usefulness of endosonography in the resolution of these problems.The endoscopic and endosonographic features of 15 duodenal elevated lesions that had been confirmed histologically in our hospital were revie | 8979063 | [
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Endosonographic characterization of duodenal elevated lesions. | wed retrospectively.Of the 15 cases; 8 were submucosal lesions (lipoma; Brunner's gland hyperplasia; lymphangioma; carcinoid tumors; leiomyoma; and malignant lymphoma); the rest were mucosal lesions. A correct histologic diagnosis based on endoscopic biopsies was obtained in only 6 cases (three submucosal lesions and three mucosal lesions). On the other hand; ultrasonography was useful in the characterization of all submucosal lesions based on their echo level; layer of origin; and tissue homogeneity. As fo | 8979063 | [
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Endosonographic characterization of duodenal elevated lesions. | r mucosal lesions; the depth of infiltration was correctly estimated with endosonography. Either endoscopic resection or surgery was selected on the basis of endosonographic information.We conclude that endosonography is useful in the differential diagnosis of submucosal lesions and in determining suitable treatment methods for duodenal mucosal and submucosal lesions. | 8979063 | [
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Partial regression of Barrett's esophagus by long-term therapy with high-dose omeprazole. | Barrett's esophagus is mainly regarded as an acquired condition related to increased gastroesophageal reflux. Thus it is conceivable that abolition of acid reflux would lead to its regression. The aim of this study was to assess whether long-term treatment with high-dose omeprazole (60 mg/day) produces a consistent control of gastric acid production and normalizes the esophageal acid exposure; thus reducing the length of Barrett's epithelium.Fourteen patients (8 men and 6 women; mean age 52 years) with hist | 8979061 | [
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Partial regression of Barrett's esophagus by long-term therapy with high-dose omeprazole. | ologic diagnosis of columnar epithelium longer than 3 cm in the distal part of the esophagus were enrolled and began receiving 60 mg of omeprazole in a single daily morning dose. Before therapy and after 6 and 12 months of therapy; all patients had endoscopy with four-quadrant biopsies at 2 cm intervals. A 24-hour esophagogastric pH recording was performed at entry and after 10 days; 6 months; and 12 months of treatment in all patients.The initial length of Barrett's epithelium (4.5 +/- 1.9 cm) was signific | 8979061 | [
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Partial regression of Barrett's esophagus by long-term therapy with high-dose omeprazole. | antly reduced after 6 months (3.1 +/- 1.1; p < 0.01) and 12 months (2.1 +/- 1.6; p < 0.005) of treatment. Values were significantly lower at 12 than at 6 months (p < 0.03). The 24-hour mean gastric pH after 10 days (5.89 +/- 0.58); 6 months (5.71 +/- 0.55); and 12 months (5.54 +/- 0.76) of therapy was always higher (p < 0.001) than the basal level (1.9 +/- 0.49). No significant difference in gastric pH was seen over the treatment period. The 24-hour mean percent of time in which pH in the esophagus was belo | 8979061 | [
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Partial regression of Barrett's esophagus by long-term therapy with high-dose omeprazole. | w 4.0 decreased significantly (p < 0.001) from a basal rate of 29.4% to 3.5%; 3.0%; and 4.9% in the various time intervals of therapy. There was a normalization of esophageal acid exposure in all patients but two.It can be concluded that the antisecretory effect of 60 mg/day of omeprazole is consistent and is kept constant throughout the entire 1-year treatment period. The consequent normalization of esophageal acid exposure in almost all patients in our series led to a partial; but significant; regression | 8979061 | [
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Partial regression of Barrett's esophagus by long-term therapy with high-dose omeprazole. | in the length of Barrett's epithelium. | 8979061 | [
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