Aortic valve replacement with the freestyle stentless bioprosthesis: five-year experience.

BACKGROUND: Stentless aortic valves were designed to provide a more physiological flow pattern and lower transvalvular gradient, which may have an important bearing on postoperative left ventricular function and remodeling. In this study, we prospectively analyzed the 5-year clinical results with the Freestyle valve (Medtronic, Inc) and its hemodynamic performance by serial echocardiography. METHODS AND RESULTS: Between January 1993 and August 1997, 95 patients with a mean age of 75 years underwent aortic valve replacement with the Freestyle prosthesis. Sixty-four percent of patients received valves

The boston corpus of aphasic naming errors.

This report provides verbatim error responses to picture naming given by 30 aphasic patients (10 Broca's aphasics, 6 Wernicke's aphasics, 7 conduction aphasics, and 7 anomic aphasics). The error corpus is intended to supply a rich set of raw data for investigators interested in the characteristics of aphasic word-finding problems as well as those interested in general models of lexical retrieval.

The importance of word-initial phonology: error patterns in prolonged naming efforts by aphasic patients.

Whether multiple conscious efforts at word search bring a subject closer to an elusive word and to eventual successful retrieval remains a subject of debate. Previous work with normal participants has shown that multiple attempts eventuating in correct retrieval are not usually associated with a systematic progression toward target word phonology in the intervening attempts. In this study we analyzed the naming errors produced by 30 aphasic patients who had received the Boston Naming Test. The analyses were designed to elucidate the characteristics of responses that led to eventual success. Our data showed that among aphasics, as with normal subjects, the presence of target-initial phonology in the subject's first response was the most important predictor of correct retrieval. Moreover, progression towards target phonology in the course of multiple attempts was unrelated to eventual correct retrieval.

Modeling age using cognitive, psychosocial and physiological variables: the Boston Normative Aging Study.

A structural equation model is computed for 36 variables from eight domains of data using 100 healthy male subjects whose age varies between 30 and 80 years. Chronological age is required to be an exogenous variable while cognitive function variables are required to be an ultimate endogenous or outcome set. The model suggests that the direct effect of age on cognition is substantially reduced when social, life style, physiological, and brain state variables are allowed to become intervening variables. The study also finds that there is an association between cognitive function and psychosocial measures relating to general psychiatric symptomatology and social support systems.

Impalement injuries to the thorax as a result of motor vehicle accidents.

We report three cases of thoracic impalement by large-diameter steel pipes as a result of motor vehicle accidents. The steel pipes were removed in all patients in the operating room under general anesthesia and controlled circumstances. Despite the dramatic nature and presentation of these injuries, all 3 patients had nonlethal injuries and have recuperated without sequelae. Orderly care with standard surgical procedures is required and will give good results.

Category specific dissociations in naming and recognition by aphasic patients.

Two studies examined category specific retrieval deficits in aphasic patients. The first study tested naming performance of 24 aphasic patients for pictures of objects representing 16 semantic categories. Instances of deviantly high and low naming scores relative to a patient's general level of naming ability were encountered, most notably for letters, body parts and colors. The second study compared name production versus name recognition for 117 aphasic patients across six stimulus categories. Although a general superiority of name recognition over name production was found, thirteen patients, predominantly fluent aphasics, accounted for most instances of correct naming in the absence of correct name recognition. Letters, body parts and colors were again most notable. Several issues in lexical access for name recognition versus name production are discussed.

Narrative strategies of aphasic and normal-speaking subjects.

A Picture Story Test for eliciting narrative speech was administered to five patients in each of the subgroups of Broca's and Wernicke's aphasic subjects and matched controls. While Wernicke's subjects and normal-speaking subjects did not differ significantly total output, the proportion of significant target lexemes was four times as great for normal-speaking subjects as for Wernicke's aphasic subjects. Broca's aphasic subjects, in spite of their telegraphic output, also had a smaller proportion of target lexemes than normal speakers. The proportion of nouns to verbs was elevated in the speech of Broca's asphasic subjects and depressed in the speech of Wernicke's aphasic subjects. Grammatical complexity was reduced in Wernicke's aphasic subjects, who used simple concatenation much more often than normal-speaking subjects. The Picture Story Test is suggeted as a clinically useful technique.