Alternative brain organization after prenatal cerebral injury: convergent fMRI and cognitive data.

The current study presents both longitudinal behavioral data and functional activation data documenting the effects of early focal brain injury on the development of spatial analytic processing in two children, one with prenatal left hemisphere (LH) injury and one with right hemisphere (RH) injury. A substantial body of evidence has shown that adults and children with early, lateralized brain injury show evidence of spatial analytic deficits. LH injury compromises the ability to encode the parts of a spatial pattern, while RH injury impairs pattern integration. The two children described in this report show patterns of deficit consistent with the site of their injury. In the current study, their longitudinal behavioral data spanning the age range from preschool to adolescence are presented in conjunction with data from a functional magnetic resonance imaging (fMRI) study of spatial processing. The activation results provide evidence that alternative profiles of neural organization can arise following early focal brain injury, and document where in the brain spatial functions are carried out when regions that normally mediate them are damaged. In addition, the coupling of the activation with the behavioral data allows us to go beyond the simple mapping of functional sites, to ask questions about how those sites may have come to mediate the spatial functions.     

Remodeling Adult Nursing

This article describes a nursing education experience in which a critical thinking approach was planned and implemented. Background discussion on critical thinking concepts and related research provides a foundation for presentation of the Mackie teaching model. The model uses a community-based, family-centered scenario as the basis for developing problemfocused nursing intervention skills from a holistic viewpoint. Role expectations of students and faculty are outlined, and related implementation difficulties, together with their resolution strategies, are described. Evaluation methods and outcomes are reviewed in the conclusion.     

Allergic bronchopulmonary aspergillosis: Reactivity of IgE and IgG antibodies with antigenic components of Aspergillus fumigatus (IgE/IgG antigen complexes)

Sera of patients with ABPA were tested by XRIE tests incorporating their own serum (self-XRIE) to detect the presence of IgG/IgE antigen complexes to a “reference” Aspergillus fumigatus preparation. Of the 32 sera studied, 29 (90%) had visible precipitin (IgG) peaks, and 27 of these 29 as well as the three apparently precipitin-negative sera, i.e., 30 (94%), showed binding of specific IgE by autoradiography. The two precipitin-positive sera that did not show IgE binding were also skin test negative and RAST negative to this A. fumigatus antigen. Specific IgG as determined in ELISA correlated well with the grading of the XIE precipitin peaks (p < 0.05). There was also a highly significant correlation between specific IgE by RAST and grading the radioactive uptake seen in the autoradiograph (p < 0.001) indicating, for each serum, the presence of IgG antibodies to most of the components to which there was specific IgE. In the self-XRIE tests there was considerable variation of reactivity from serum to serum, in numbers of antigen/antibody peaks observed, in relative peak heights, and in the intensity of the respective staining. By comparing each test to a “reference” pattern developed with the use of an ABPA serum pool, the antigenic components of A. fumigatus were found to be of two main types: (1) antigens that appeared to be poorly precipitating (possibly low-molecular-weight components) but showed strong IgE binding (these were apparently major allergenic components and with one exception proved to be the faster migrating components) and (2) antigens that produced the strongest precipitin reactions with only weak binding of specific IgE and therefore minor allergenic components.