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Topperzer MK, Larsen HB, Hoffmann M, Schmiegelow K, Lausen B, Madsen M, Roland P, Sørensen JL. Response to: Patient-centred medical education: A proposed definition. Med Teach 2020; 42:360-361. [PMID: 31185784 DOI: 10.1080/0142159x.2019.1625315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Martha Krogh Topperzer
- Paediatric Oncology Research Laboratory, Department of Paediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen (UCPH), Copenhagen, Denmark
| | - Hanne Bækgaard Larsen
- Paediatric Oncology Research Laboratory, Department of Paediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen (UCPH), Copenhagen, Denmark
| | - M Hoffmann
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, UCPH, Copenhagen, Denmark
| | - K Schmiegelow
- Paediatric Oncology Research Laboratory, Department of Paediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen (UCPH), Copenhagen, Denmark
| | - B Lausen
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, UCPH, Copenhagen, Denmark
| | - M Madsen
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, UCPH, Copenhagen, Denmark
| | - P Roland
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, UCPH, Copenhagen, Denmark
| | - J L Sørensen
- Juliane Marie Centre, Rigshospitalet, UCPH, Denmark
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Suárez-Calvet X, Toquet S, Danel C, Couvelard A, Roland P, Uzunhan Y, Balada E, Selva-O'Callaghan A, Allenbach Y, Benveniste O. The pathogenesis of dermatomyositis associated to MDA5 autoantibodies: An in vitro and in vivo study. Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Jacob R, Gupta S, Isaacson B, Kutz JW, Roland P, Xi Y, Booth TN. High-resolution CT findings in children with a normal pinna or grade I microtia and unilateral mild stenosis of the external auditory canal. AJNR Am J Neuroradiol 2014; 36:176-80. [PMID: 25125664 DOI: 10.3174/ajnr.a4067] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SUMMARY A subset of patients presents with unilateral conductive hearing loss, a normal pinna or grade I microtia, and mild external auditory canal stenosis. The physical findings of microtia and a small external canal are commonly absent or subtle in this group of patients, who are being commonly referred for imaging to evaluate isolated conductive hearing loss. We present a case series of patients with unilateral conductive hearing loss and characteristic ossicular abnormalities, commonly anterior fixation of the malleus. All patients had a significantly increased distance from the cochlear promontory to the handle of the malleus and an abnormal incudostapedial angle, indicative of an abnormal ossicular position and/or morphology. Successful surgical reconstruction of the ossicular chain was attempted and accomplished in 3 patients.
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Affiliation(s)
- R Jacob
- From the Departments of Radiology (R.J., Y.X., T.N.B.)
| | - S Gupta
- Otolaryngology (S.G., B.I., J.W.K., P.R.), Children's Medical Center of Dallas, University of Texas, Southwestern Medical Center, Dallas, Texas
| | - B Isaacson
- Otolaryngology (S.G., B.I., J.W.K., P.R.), Children's Medical Center of Dallas, University of Texas, Southwestern Medical Center, Dallas, Texas
| | - J W Kutz
- Otolaryngology (S.G., B.I., J.W.K., P.R.), Children's Medical Center of Dallas, University of Texas, Southwestern Medical Center, Dallas, Texas
| | - P Roland
- Otolaryngology (S.G., B.I., J.W.K., P.R.), Children's Medical Center of Dallas, University of Texas, Southwestern Medical Center, Dallas, Texas
| | - Y Xi
- From the Departments of Radiology (R.J., Y.X., T.N.B.)
| | - T N Booth
- From the Departments of Radiology (R.J., Y.X., T.N.B.)
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Bristow R, Powell M, Al-Hammadi N, Chen L, Miller J, Roland P, Mutch D, Cliby W. Hugh Barber Outstanding Abstract AwardDisparities in epithelial ovarian cancer according to race and socioeconomic status: Adherence to National Comprehensive Cancer Network (NCCN) guidelines and survival outcome, a study of 47,160 patients from the National Cancer Data Base. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Lisacek F, Chichester C, Gonnet P, Jaillet O, Kappus S, Nikitin F, Roland P, Rossier G, Truong L, Appel R. Shaping biological knowledge: applications in proteomics. Comp Funct Genomics 2011; 5:190-5. [PMID: 18629073 PMCID: PMC2447358 DOI: 10.1002/cfg.379] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2003] [Revised: 12/12/2003] [Accepted: 12/18/2003] [Indexed: 12/01/2022] Open
Abstract
The central dogma of molecular biology has provided a meaningful principle
for data integration in the field of genomics. In this context, integration reflects
the known transitions from a chromosome to a protein sequence: transcription,
intron splicing, exon assembly and translation. There is no such clear principle for
integrating proteomics data, since the laws governing protein folding and interactivity
are not quite understood. In our effort to bring together independent pieces of
information relative to proteins in a biologically meaningful way, we assess the bias of
bioinformatics resources and consequent approximations in the framework of small-scale
studies. We analyse proteomics data while following both a data-driven (focus
on proteins smaller than 10 kDa) and a hypothesis-driven (focus on whole bacterial
proteomes) approach. These applications are potentially the source of specialized
complements to classical biological ontologies.
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Affiliation(s)
- F Lisacek
- R&D GeneBio, 25 Avenue de Champel, Geneva 1206, Switzerland.
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Powell M, Cliby W, Bristow R, Al-Hammadi N, Chen L, Miller J, Roland P, Mutch D. Adherence with National Comprehensive Cancer Network (NCCN) Guidelines Associated with improved survival in ovarian cancer patients, a study of 144,449 patients from the National Cancer Data Base: A project from the Society of Gynecologic Oncologists (SGO) Quality and Outcomes Committee. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2011.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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7
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Stone-Elander S, Roland P, Halldin C, Schwenner E, Boeshagen H, Widen L. Synthesis of [11C]sodium thiocyanate and [isopropyl-11C]nimodipine for the in vivo study of ion channels using PET. J Labelled Comp Radiopharm 2011. [DOI: 10.1002/jlcr.25802601108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Roland P. Miniseminar: ototopical therapy for ear disease: the good, the bad, and the ugly. Otolaryngol Head Neck Surg 2003. [DOI: 10.1016/s0194-5998(03)01024-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Arnold W, Bredberg G, Gstöttner W, Helms J, Hildmann H, Kiratzidis T, Müller J, Ramsden RT, Roland P, Walterspiel JN. Meningitis following cochlear implantation: pathomechanisms, clinical symptoms, conservative and surgical treatments. ORL J Otorhinolaryngol Relat Spec 2002; 64:382-9. [PMID: 12499760 DOI: 10.1159/000067579] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Pneumococcal otogenic meningitis is a rare postsurgical complication that can develop following stapedectomy or after cochlear implantation. The bacterial infection can be fatal in some instances. A recent increase in the incidence of otogenic meningitis among cochlear implant wearers is of concern. The majority of meningitis cases are associated with a 2-component electrode manufactured by one cochlear implant company. The device with the added 'positioner' component has been withdrawn from the market (FDA Public Health Web Notification: Cochlear Implant Recipients may be at Greater Risk for Meningitis, Updated: August 29, 2002, www.fda.gov/cdrh/safety/cochlear.html). Not all cases have been subsequent to otitis media and symptoms have developed from less than 24 h up to a few years after implantation. The purpose of this paper is to review and discuss the pathogenesis, pathology/bacteriology and to elaborate on some clinical features of otogenic meningitis in implanted children and adults. Essential aspects of surgery, electrode design, and cochleostomy seal are discussed. Conclusions are drawn from the available data and recommendations are made for good practice in cochlear implantation and follow-up.
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Affiliation(s)
- W Arnold
- Department of Otorhinolaryngology, Head and Neck Surgery, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany.
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Roland P, Svensson G, Lindeberg T, Risch T, Baumann P, Dehmel A, Frederiksson J, Halldorson H, Forsberg L, Young J, Zilles K. A database generator for human brain imaging. Trends Neurosci 2001; 24:562-4. [PMID: 11576652 DOI: 10.1016/s0166-2236(00)01924-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sharing scientific data containing complex information requires new concepts and new technology. NEUROGENERATOR is a database generator for the neuroimaging community. A database generator is a database that generates new databases. The scientists submit raw PET and fMRI data to NEUROGENERATOR, which then processes the data in a uniform way to create databases of homogeneous data suitable for data sharing, met-analysis and modelling the human brain at the systems level. These databases are then distributed to the scientists.
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Grefkes C, Geyer S, Schormann T, Roland P, Zilles K. Human somatosensory area 2: observer-independent cytoarchitectonic mapping, interindividual variability, and population map. Neuroimage 2001; 14:617-31. [PMID: 11506535 DOI: 10.1006/nimg.2001.0858] [Citation(s) in RCA: 280] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We analyzed the topographical variability of human somatosensory area 2 in 10 postmortem brains. The brains were serially sectioned at 20 microm, and sections were stained for cell bodies. Area 2 was delineated with an observer-independent technique based on significant differences in the laminar densities of cell bodies. The sections were corrected with an MR scan of the same brain obtained before histological processing. Each brain's histological volume and representation of area 2 was subsequently reconstructed in 3-D. We found that the borders of area 2 are topographically variable. The rostral border lies between the convexity of the postcentral gyrus and some millimeters deep in the rostral wall of the postcentral sulcus. The caudal border lies between the fundus of the postcentral sulcus and some millimeters above it in the rostral wall. In contrast to Brodmann's map, area 2 does not extend onto the mesial cortical surface or into the intraparietal sulcus. When the postcentral sulcus is interrupted by a gyral bridge, area 2 crosses this bridge and is not separated into two segments. After cytoarchitectonic analysis, the histological volumes were warped to the reference brain of a computerized atlas and superimposed. A population map was generated in 3-D space, which describes how many brains have a representation of area 2 in a particular voxel. This microstructurally defined population map can be used to demonstrate activations of area 2 in functional imaging studies and therefore help to further understand the role of area 2 in somatosensory processing.
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Affiliation(s)
- C Grefkes
- C. and O. Vogt Brain Research Institute, University of Düsseldorf, 40001 Düsseldorf, Germany
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Herath P, Klingberg T, Young J, Amunts K, Roland P. Neural correlates of dual task interference can be dissociated from those of divided attention: an fMRI study. Cereb Cortex 2001; 11:796-805. [PMID: 11532885 DOI: 10.1093/cercor/11.9.796] [Citation(s) in RCA: 149] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
When people perform two tasks simultaneously, the tasks are often executed slower and with more errors than when they are carried out as single tasks. This is called dual task interference. With functional magnetic resonance imaging (fMRI), we show that concurrently performed visual and somatosensory reaction time (RT) tasks engage almost identical volumes of cortical and subcortical motor structures. Moreover, dual RT tasks engaged additional cortical regions that are not activated by the component RT tasks had they been performed as single tasks. When the inter-stimulus interval was <300 ms, the first task interfered with the second, and a field in the right inferior frontal gyrus (RIFG) appeared with activity correlated with the increased RT to the second stimulus. This activation was spatially distinct from the cortical activity of the main effect of dual task performance. Thus, the performance of single RT tasks, dual RT tasks and dual RT tasks that interfere differ psychophysically and in the brain structures subserving these tasks. A short occupancy of the common motor structures can explain the interference effect. The increased activity of the RIFG correlated with the interference effect is very likely to be a specific outcome of situations where two concurrent tasks interfere with each other. The brain appears to recruit the RIFG for a subsequent (delayed) response when there is interference between dual tasks.
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Affiliation(s)
- P Herath
- Division of Human Brain Research, Department of Neuroscience, Karolinska Institute, Stockholm 171 77, Sweden.
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13
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Abstract
The anatomical pathways for processing of odorous stimuli include the olfactory nerve projection to the olfactory bulb, the trigeminal nerve projection to somatosensory and insular cortex, and the projection from the accessory olfactory bulb to the hypothalamus. In the majority of tetrapods, the sex-specific effects of pheromones on reproductive behavior is mediated via the hypothalamic projection. However, the existence of this projection in humans has been regarded as improbable because humans lack a discernable accessory olfactory bulb. Here, we show that women smelling an androgen-like compound activate the hypothalamus, with the center of gravity in the preoptic and ventromedial nuclei. Men, in contrast, activate the hypothalamus (center of gravity in paraventricular and dorsomedial nuclei) when smelling an estrogen-like substance. This sex-dissociated hypothalamic activation suggests a potential physiological substrate for a sex-differentiated behavioral response in humans.
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Affiliation(s)
- I Savic
- Division of Human Brain Research, Department of Neuroscience, Karolinska Institute, Stockholm, Sweden.
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14
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Young J, Geyer S, Amunts K, Zilles K, Roland P. Connectivity of area 2 in the human: a correlation analysis of resting state PET data. Neuroimage 2001. [DOI: 10.1016/s1053-8119(01)92354-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Sitko D, Commenges-Ducos M, Roland P, Papaxanthos-Roche A, Horovitz J, Dallay D. IVF following impossible or failed surgical reversal of tubal sterilization. Hum Reprod 2001; 16:683-5. [PMID: 11278218 DOI: 10.1093/humrep/16.4.683] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Microsurgical re-anastomosis or IVF offer ways of reversing previous tubal sterilization. This retrospective study analysed 56 attempts of IVF in 37 couples after impossible or failed surgical sterilization reversal. Efficacy of IVF in this group (TL) was compared with that of a tubal pathology control group (TP) at all stages of IVF (stimulation, fertilization and implantation). Depending on patient age, significantly fewer oocytes were produced after ovarian stimulation in the TL group than in the control (TP) group (P = 0.023 for all TL patients; P = 0.02 when patients aged >38 years were excluded). The total number of embryos available for transfer was significantly lower in the TL group (P = 0.0042), but this was age-related, since when women aged >38 years were excluded there was no significant difference between the two groups. The ongoing pregnancy rate was similar in both groups, the probability of ongoing pregnancy appearing to depend on patient age rather than on previous fertility.
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Affiliation(s)
- D Sitko
- Département d'Obstétrique et de Gynécologie, Hôpital Pellegrin, Bordeaux, France
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16
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Abstract
When family members became dissatisfied with a restrictive visiting policy in a combined coronary and medical intensive care unit, this situation was seen as an opportunity to better meet patient and family needs. A review of the literature indicated that open visitation policies enhance patient and family satisfaction, while a survey of patients, families, and health care team members revealed a desire for a more open visitation policy. Nursing staff, with input from other disciplines, developed and implemented a less restrictive visitation policy. Post-intervention surveys revealed higher patient and family satisfaction and a marked decrease in formal complaints.
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Affiliation(s)
- P Roland
- Central Arkansas Veterans Healthcare System Little Rock, Arkansas, USA
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Small W, Mahadevan A, Roland P, Vallow L, Zusag T, Fishman D, Massad S, Rademaker A, Kalapurakal JA, Chang S, Lurain J. Whole-abdominal radiation in endometrial carcinoma: an analysis of toxicity, patterns of recurrence, and survival. Cancer J 2000; 6:394-400. [PMID: 11131490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
PURPOSE The purpose of this study was to determine the toxicity, patterns of recurrence, and survival in high-risk endometrial cancer patients treated with whole-abdominal radiation. MATERIALS AND METHODS All patients with endometrial cancer treated at Northwestern University since 1994 and at Rush University since 1993 were retrospectively reviewed. Patients believed to be at high risk for intra-abdominal recurrence and who received whole-abdominal radiation were reviewed for this study. RESULTS A total of 30 patients completed whole-abdominal radiation (WAR) and were available for study. The mean and median follow-up was 2.3 and 2.1 years, respectively, with a range of 0.13 to 6.1 years. Seventy-eight percent of the cohort received surgical staging with bilateral salpingo-oophorectomy/total abdominal hysterectomy/lymph node sampling. Forty-seven percent of the patients were found to have serous histology as a component of their tumor. Surgical staging results included 19% stage 1B, 4% stage IC, 8% stage IIB, 37% stage IIIA, 26% stage IIIC, and 7% stage IVB. Two patients had gross residual disease at the completion of surgery. Megestrol acetate (Megace) was used as an adjuvant treatment in 37% of patients, and no cases received initial chemotherapy. All patients received WAR with a mean total dose and dose per fraction of 2620 and 143 cGy, respectively. Twenty-two percent of patients received a para-aortic boost. The mean total pelvic dose was 4956 cGy. Seventy percent of patients received a vaginal cuff boost. Eight percent of patients had grade 3 acute gastrointestinal morbidity, and 4% had grade 4 acute gastrointestinal morbidity. No other grade 3 or greater acute or long-term morbidity was noted. At last follow-up, seven (23%) patients had experienced recurrence. The pattern of first recurrence was 0% in the vaginal cuff, 3% other vaginal, 7% pelvic, 7% upper abdominal, 3% lung, 7% bone, and 7% para-aortic lymph nodes. Ultimate recurrences were similar. At last follow-up, 77% patients had no evidence of disease, 13% were alive with disease, and 10% had died of disease. CONCLUSIONS Utilizing a conservatrive total whole-abdominal radiation dose and limited para-aortic nodal boost resulted in very tolerable treatments. The patterns of recurrence and survival in this early report are encouraging.
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Affiliation(s)
- W Small
- Section of Radiation Oncology, Robert H Lurie Cancer Center Northwestern University, Chicago, Illinois, USA
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18
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Abstract
How the human brain processes the perception, discrimination, and recognition of odors has not been systematically explored. Cerebral activations were therefore studied with PET during five different olfactory tasks: monorhinal smelling of odorless air (AS), single odors (OS), discrimination of odor intensity (OD-i), discrimination of odor quality (OD-q), and odor recognition memory (OM). OS activated amygdala-piriform, orbitofrontal, insular, and cingulate cortices and right thalamus. OD-i and OD-q both engaged left insula and right cerebellum. OD-q also involved other areas, including right caudate and subiculum. OM did not activate the insula, but instead, the piriform cortex. With the exception of caudate and subiculum, it shared the remaining activations with the OD-q, and engaged, in addition, the temporal and parietal cortices. These findings indicate that olfactory functions are organized in a parallel and hierarchical manner.
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Affiliation(s)
- I Savic
- Department of Neuroscience, Uppsala University, Sweden.
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Karadimas H, Hemery F, Roland P, Lepage E. DbMap: improving database interoperability issues in medical software using a simple, Java-Xml based solution. Proc AMIA Symp 2000:408-12. [PMID: 11079915 PMCID: PMC2243793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
In medical software development, the use of databases plays a central role. However, most of the databases have heterogeneous encoding and data models. To deal with these variations in the application code directly is error-prone and reduces the potential reuse of the produced software. Several approaches to overcome these limitations have been proposed in the medical database literature, which will be presented. We present a simple solution, based on a Java library, and a central Metadata description file in XML. This development approach presents several benefits in software design and development cycles, the main one being the simplicity in maintenance.
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Affiliation(s)
- H Karadimas
- Département d'Information Hospitalier, CHU Henri Mondor AP-HP, Créteil, France
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Martinez SA, Mendelsohn DB, Ginsburg MI, Steele JR, Mickey B, Roland P. Brain stem abscess with direct extension through the internal auditory canal. Otolaryngol Head Neck Surg 1999; 121:474-5. [PMID: 10504607 DOI: 10.1016/s0194-5998(99)70240-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- S A Martinez
- Department of Radiology, University of Texas Southwestern Medical Center at Dallas, USA
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Abstract
PURPOSE Maximizing patient satisfaction is of prime importance in today's competitive outpatient surgery market. The authors recently devised a system, one-stop surgery, which simplifies outpatient surgery for pediatric patients and their families by combining the traditionally separate preoperative evaluation and subsequent operation into one visit. This report describes our initial experience with one-stop surgery. METHODS Umbilical hernia repair, circumcision, and portacath removal were considered surgical procedures appropriate for our one-stop surgery pilot study. Medical information obtained by phone or fax from referring physicians was used to identify potential candidates. Families were contacted, precertified for their surgical procedure, and given nothing by mouth instructions. The day of surgery the child was evaluated by the attending pediatric surgeon. If the diagnosis was confirmed, and no contraindications to surgery were identified, the child immediately underwent the prescheduled surgical procedure. RESULTS From April through October 1997, 61 children were scheduled for one-stop surgery. Nine patients (15%) were no shows, and one additional family opted not to proceed with circumcision. The remaining 51 children (83%) underwent their one-stop surgical procedure: umbilical hernia repair (n = 23), circumcision (n = 19), portacath removal (n = 8), and inguinal hernia repair (n = 1). No child had an anesthetic contraindication to surgery, and only one minor postoperative complication (wound hematoma) occurred. CONCLUSIONS This pilot study has demonstrated that with appropriate patient screening and cooperation of the entire surgical team, a variety of outpatient surgical procedures can be handled using this one-stop surgery method. By combining one-stop surgery with our previously reported phone follow-up system, many minor surgical procedures can be managed with only one visit to the hospital. Decreasing the "hassle factor" of outpatient surgery for children and their families, who frequently live far from their closest children's hospital, while providing the highest quality of specialized surgical and anesthetic care, may potentially be a very powerful marketing tool for pediatric surgical specialists.
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Affiliation(s)
- E P Tagge
- Medical University of South Carolina, Charleston 29425, USA
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22
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Abstract
Massive calcium pyrophosphate crystal deposition is a rare disorder that may affect the temporomandibular joint and temporal bone. The diagnosis is difficult, and misdiagnosis as malignancy, particularly chondrosarcoma, is frequent. This can lead to unnecessarily aggressive management. The clinical, radiographic, and pathologic features of this entity are reviewed, and treatment options are discussed.
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Affiliation(s)
- J A Jordan
- Department of Otolaryngology, University of Texas Southwestern Medical Center, Dallas 75235-9035, USA
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Harvey SC, Roland P, Bailey MK, Tomlin MK, Williams A. A randomized, double-blind comparison of rocuronium, d-tubocurarine, and "mini-dose" succinylcholine for preventing succinylcholine-induced muscle fasciculations. Anesth Analg 1998; 87:719-22. [PMID: 9728861 DOI: 10.1097/00000539-199809000-00044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- S C Harvey
- Department of Anesthesia & Perioperative Medicine, Medical University of South Carolina, Charleston 29425-2207, USA
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Abstract
Presently available noninvasive methods correctly localize epileptogenic regions in only approximately 50% of patients with frontal lobe epilepsy (FLE). Earlier studies have shown that temporal lobe epileptogenic regions may be identified readily by positron emission tomography (PET) measurements of regional benzodiazepine (BZD) receptor binding. We tested the specific applicability of this method in patients with FLE. Six patients with frontal partial seizures and 7 healthy men were investigated with PET and the BZD receptor ligand [11C]flumazenil. All patients had magnetic resonance (MR) brain scans. The independent assessment of seizure-onset region was based on seizure semiology, intra- and extracranial EEG and, in 4 cases, also on [18F]fluorodeoxyglucose (FDG)-PET. The epileptic focus/seizure-generating region was correctly identified by [11C]flumazenil PET in all patients. This region was characterized by a significant reduction in BZD receptor density. The area with reduced BZD receptor density was better delimited than the corresponding hypometabolic region, which was observed in 50% of patients investigated with [18F]FDG-PET. MRI was normal in 5 patients. Visualization of BZD receptors with [11C]flumazenil PET appears to be a promising approach for noninvasive identification of frontal lobe epileptogenic regions.
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Affiliation(s)
- I Savic
- Department of Neuroscience, Karolinska Institute, Stockholm, Sweden
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Conroy JM, Bailey MK, Roland P. DROPERIDOL VERSUS ONDANSETRON FOR EMESIS PROPHYLAXIS. South Med J 1993. [DOI: 10.1097/00007611-199309001-00007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Roland P, Lode G. [New patients' rights can create unrealistic expectations. Interview by Bjørn Arild Ostby]. J Sykepleien 1992; 80:14-5. [PMID: 1463638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Stone-Elander S, Roland P, Schwenner E, Halldin C, Widén L. Synthesis of [isopropyl-11C]nimodipine for in vivo studies of dihydropyridine binding in man using positron emission tomography. Int J Rad Appl Instrum A 1991; 42:871-5. [PMID: 1657834 DOI: 10.1016/0883-2889(91)90227-r] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Nimodipine, an antagonist of the L-type calcium ion channel, was labelled with 11C for in vivo positron emission tomography studies of dihydropyridine binding in the human brain. The synthesis was based on esterification of the corresponding acid (W2100) using [2-11C]isopropyl iodide as the labelling precursor. The effects of different bases, solvent mixtures and reaction temperatures on radiochemical yields were investigated. The synthesis including purification by semi-preparative reversed-phase HPLC, required 60-65 min. Conversion of [2-11C]isopropyl iodide to [isopropyl-11C] nimodipine was of the order of 60-80%. The radiochemical yield (isolated) was 20-25%, based on [11C]carbon dioxide. The specific activity of the isolated product varied from 4-40 GBq/mumol (end-of-synthesis).
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Abstract
Impaired cortical inhibition may be involved in epileptogenic mechanisms. In a positron-emission tomography (PET) study, we demonstrated a reduction of the cortical benzodiazepine (BZD) receptor density in the epileptic foci of patients with partial epileptic seizures. In the present study, we used the same method in 10 patients with primary generalized epilepsy to determine whether an altered BZD receptor binding could also be demonstrated in this patient group. The [11C]-labeled BZD receptor antagonist Ro 15-1788 was used as ligand. Receptor affinities and densities were calculated in various cortical regions and then compared with the values from corresponding "nonepileptic" regions in the previously examined partial epilepsy patients. Focal alterations of the BZD receptor density or affinity were not demonstrated in patients with generalized epilepsy. This patient group had a slight tendency toward lower mean cortical BZD receptor density, however, as compared with corresponding values from 10 patients with partial epilepsy. Our results strongly suggest that a focal alteration of cortical inhibition is not a prominent feature of human generalized epilepsy. The observed tendency toward lower mean cortical BZD receptor density may be a consequence of diffusely impaired cortical inhibition. Further investigations of this issue are therefore indicated.
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Affiliation(s)
- I Savic
- Department of Clinical Neurophysiology, Karolinska Hospital, Stockholm, Sweden
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Affiliation(s)
- N K Krane
- Tulane University School of Medicine, Tulane Department of Medicine, Charity Hospital, New Orleans, Louisiana
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Stone-Elander S, Roland P, Halldin C, Hassan M, Seitz R. Synthesis of [11C]sodium thiocyanate for in vivo studies of anion kinetics using positron emission tomography (PET). Int J Rad Appl Instrum B 1989; 16:741-6. [PMID: 2613531 DOI: 10.1016/0883-2897(89)90148-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Sodium thiocyanate (NaSCN) was labelled with carbon-11 for in vivo studies of anion kinetics using positron emission tomography (PET). The synthesis was complete in 35 min from end of bombardment using [11C]ammonium cyanide as the labelled precursor. [11C]NaSCN was produced by the reaction of [11C]sodium cyanide with elemental sulfur and subsequently separated by semi-preparative high performance liquid chromatography (HPLC). Radiochemical yields (isolated) were of the order of 25%. The specific activity was 18 GBq/mmol and the radiochemical purity better than 99%. A PET study performed in a healthy volunteer showed distribution of [11C]SCN- to areas corresponding to cortical fluid spaces known to be accessible to inorganic ions such as Cl-. An accumulation of the tracer was observed during the 70 min investigation, indicating at least three compartments of distribution.
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Abstract
Ten patients with partial epilepsy and five healthy controls had positron emission tomography (PET) of the brain after intravenous administration of the 11C-labelled benzodiazepine (BZ) receptor ligand 'Ro-15 1788'. In all ten patients BZ receptor binding was significantly lower in the epileptic focus than in the contralateral homotopic reference region and the remaining neocortex. No asymmetries in BZ receptor binding were observed between homotopic reference regions in the controls or the non-epileptic regions of patients. These results demonstrate the potential of the BZ receptor as a biochemical marker for display of epileptic foci by PET, and also strengthen the hypothesis that inhibitory mechanisms are disturbed in the epileptic focus.
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Affiliation(s)
- I Savic
- Department of Clinical Neurophysiology, Karolinska Hospital, Stockholm, Sweden
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Lippton HL, Lepak K, Cohen G, Roland P, Kadowitz PJ, Hyman AL. Vasodilator activity of human alpha-calcitonin gene-related peptide in the feline mesenteric vascular bed. Am J Hypertens 1988; 1:124S-126S. [PMID: 3137942 DOI: 10.1093/ajh/1.3.124s] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Human alpha-calcitonin gene-related peptide (CGRP) is a substance immunohistochemically present in a number of organ systems; however, the biologic significance of this peptide is uncertain. The present study was undertaken to investigate the effects of CGRP in the feline mesenteric vascular bed under conditions of controlled blood flow. Bolus injections of CGRP decreased mesenteric perfusion pressure in a dose-related fashion. When compared with nitroglycerin, CGRP possesses markedly greater vasodilator activity in the intestinal vascular bed of the cat. Because circulating levels of CGRP have been identified, the present data suggest CGRP may play a role in the regulation of systemic vasomotor tone and regional hemodynamics, as well as involve altered calcium metabolism seen with other calcium-regulating hormones in hypertensive states.
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Affiliation(s)
- H L Lippton
- Department of Pharmacology, Tulane University School of Medicine, New Orleans, Louisiana 70112
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Stone-Elander S, Roland P, Eriksson L, Litton JE, Johnström P, Widén L. The preparation of 11C-labelled fluoromethane for the study of regional cerebral blood flow using positron emission tomography. Eur J Nucl Med 1986; 12:236-9. [PMID: 3490979 DOI: 10.1007/bf00251976] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Fluoromethane, previously labelled with 18F and used as a tracer in the measurement of regional cerebral blood flow, was 11C-labelled by the reaction of 11C-methyl iodide with tetraethylammonium fluoride. Sufficient quantities of radiotracer were prepared with a minimum amount of handling from 15 min target irradiations in the 14N(p, alpha)11C reaction. Total synthesis time was 25 min from end-of-bombardment, allowing serial blood flow measurements 30 min apart. The use of 11C-fluoromethane as a cerebral blood flow tracer in positron emission tomography is discussed.
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Abstract
Ten skull-base neuromas treated at the Otology Group P.C. are presented. Each case is reported in detail. The method by which preoperative diagnosis was made is reviewed. Specific attention is paid to distinguishing these tumors from chemodectomas. Presenting signs and symptoms are enumerated. Operative--especially postoperative--management is discussed in detail.
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Roland P, Stovner J. [Brain damage after collapse of endotracheal tube under anesthesia. Elasticity and permeability of polyvinylchloride]. Tidsskr Nor Laegeforen 1975; 95:1347-50. [PMID: 1179349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Abstract
A 13-year-old boy undergoing tympanoplasty lasting 3 1/2 hours developed serious airway obstruction at the end of surgery leading to permanent brain damage. It appeared that the no. 7 Portex "blue line" endotracheal tube had collapsed under the cuff. This was concluded because deflation of the cuff had promptly relieved the obstruction of the airway. Further support for this conclusion was the finding that shortly after extubation the inflation of 8 ml air caused the tube to collapse. Collapse of these tubes cannot normally be produced unless they have been made to collapse shortly before. Investigation of such tubes in vitro at 37 degrees C showed that overinflation of the cuff caused a symmetrical collapse of the tube wall along the x-ray opaque blue line. The collapse occurred with cuff pressures varying from 310 mmHg up to 460 mmHg for tubes from different batches. During anaesthesia with 66% nitrous oxide, this gas together with carbon dioxide were found to diffuse into the cuff at steady rates of 3.69 vol % and 0.36 vol % per hour, respectively. Corresponding increases in intracuff volumes were found. It is advised that disposable tubes should be carefully inspected before use and that endotracheal cuffs should be deflated periodically during anaesthesia to avoid excessive rise in cuff pressure.
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Anigstein R, Elkin M, Roland P, Schulz RJ. The obstructive nephrogram--microradiographic studies. Invest Radiol 1972; 7:24-32. [PMID: 4551067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Lind B, Roland P, Grimeland J. [Control of postoperative vomiting with thioproperazine (Majeptil)]. Anaesthesist 1970; 19:200-2. [PMID: 4397207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Lind B, Roland P. [Brief anesthesia with propranidid. What is the incidence of nausea?]. Anaesthesist 1969; 18:82-5. [PMID: 5359868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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