The cytoskeleton of cultured skin fibroblasts from patients with Huntington's chorea

Cultured skin fibroblasts from patients with Huntington's chorea were prepared for indirect immunofluorescence using monospecific antibodies to tubulin, actin, and fibronectin. The fibroblasts were also visualized by transmission electron microscopy. The fibroblasts were observed after 3 hours of plating and treatment with various concentrations of colcemid and cytochalasin B to test the reaction of the microfibrillar network to stressful conditions. Disorders were not apparent in the cytoskeletal system (microtubules, microfilaments, and intermediate filaments) when compared with normal controls. Fibronectin was arranged in a fibrillar pattern similar to that seen with actin immunofluorescence. This colinear arrangement was not disturbed in Huntington's chorea cells. Microtubules, microfilaments, and 10-nm intermediate filaments became more parallel as the incubation period increased from 3 to 24 hours. This study showed that the cytoskeleton and the attachment of one surface protein (fibronectin) are not affected in Huntington's chorea.     

Accurate patient history contributes to differentiating diabetes insipidus: a case study.

This case study highlights the important contribution of nursing in obtaining an accurate health history. The case discussed herein initially appeared to be neurogenic diabetes insipidus (DI) secondary to a traumatic brain injury. The nursing staff, by reviewing the patient's health history with his family, discovered a history of polydipsia and long-standing lithium use. Lithium is implicated in drug-induced nephrogenic DI, and because the patient had not received lithium since being admitted to the hospital, his treatment changed to focus on nephrogenic DI. By combining information from the patient history, the physical examination, and radiologic and laboratory studies, the critical care team demonstrated that the patient had been self-treating his lithium-induced nephrogenic DI and developed neurogenic DI secondary to brain trauma. Thus successful treatment required that nephrogenic and neurogenic DI be treated concomitantly.     

Differences in the fiber composition of the pyramidal tract in two- and 14-month-old rats

The present study is aimed at an electron-microscopic morphometrical analysis of the pyramidal tract of 14-month-old rats at the level of the pyramis medullae and the second cervical segment, and a comparison with data obtained for rats of two months of age. Between 2 and 14 months of age there is, at the level of the pyramis medullae of the left pyramidal tract, a statistically significant increase of the number of myelinated fibers, from 91,000 to 118,000, whereas the total number of unmyelinated fibers decreases from 133,000 to 101,000. On the right side at the same level there is no statistically significant change in the number of myelinated fibers, whereas there is a significant decrease of unmyelinated fibers at this side, from 148,000 to 89,000. At the second cervical level, a statistically significant increase in the number of myelinated fibers has been noted at both sides (from 43,000 to 60,000) between 2 and 14 months, whereas the mean total number of unmyelinated fibers at this level decreases somewhat (from 35,000 to 28,000), but is not statistically significant. Several processes which might be involved in the age-related changes observed are discussed, including the possibility of a shift from unmyelinated fibers to myelinated ones, withdrawal of corticobulbar fibers and ongoing outgrowth of myelinated corticofugal fibers after two months of age, and a summarizing scheme is presented. We conclude that the pyramidal tract of the rat changes in composition after the age of two months and that continuing outgrowth of myelinated corticospinal fibers is an important aspect of this continuing development.     

Neonatal alloimmune thrombocytopenia after maternal immunization with paternal mononuclear cells: successful treatment with intravenous gamma globulin.

We report a case of neonatal alloimmune thrombocytopenia and intracranial hemorrhage in an infant whose mother received immunizations of paternal mononuclear cells. This therapy is designed to prevent unexplained first trimester miscarriages. No previous cases of platelet autoimmunization associated with maternal immunization with paternal mononuclear cells has been reported. Treatment with antenatal maternal infusions of intravenous gamma globulin (IVGG) did not prevent fetal thrombocytopenia, but IVGG may become the treatment of choice for postnatal, antibody-mediated thrombocytopenia of the newborn.     

Initial evaluation of a continuous speech recognition program for radiology

The aims of this work were to measure the accuracy of one continuous speech recognition product and dependence on the speaker's gender and status as a native or nonnative English speaker, and evaluate the product's potential for routine use in transcribing radiology reports. IBM MedSpeak/Radiology software, version 1.1 was evaluated by 6 speakers. Two were nonnative English speakers, and 3 were men. Each speaker dictated a set of 12 reports. The reports included neurologic and body imaging examinations performed with 6 different modalities. The dictated and original report texts were compared, and error rates for overall, significant, and subtle significant errors were computed. Error rate dependence on modality, native English speaker status, and gender were evaluated by performing ttests. The overall error rate was 10.3 +/- 3.3%. No difference in accuracy between men and women was found; however, significant differences were seen for overall and significant errors when comparing native and nonnative English speakers (P = .009 and P = .008, respectively). The speech recognition software is approximately 90% accurate, and while practical implementation issues (rather than accuracy) currently limit routine use of this product throughout a radiology practice, application in niche areas such as the emergency room currently is being pursued. This methodology provides a convenient way to compare the initial accuracy of different speech recognition products, and changes in accuracy over time, in a detailed and sensitive manner.     

Cricoid pressure: knowledge and performance amongst anaesthetic assistants

We investigated the cricoid pressure technique of 135 anaesthetic assistants attending the annual conference of the British Association of Operating Department Assistants in May 1997. Their knowledge and training were assessed using a structured interview. Technique was assessed using a simulator measuring applied force during sham cricoid pressure. Our additional aims were to see whether a knowledge of the required force and practical training in the application of a target force would affect performance. Our results highlight a lack of knowledge relating to the manoeuvre. Only about one-third of subjects could quote an appropriate force and fewer than half could give a single contraindication to its use. Very few subjects had been trained on a model before practising the technique on a patient. Technique was poor and we observed a large variation in the force actually applied. Performance, as assessed by the variability of forces applied and proportion of subjects applying force within our target range (30-44 N), was improved markedly by providing simple instruction about the required force in an understandable form. Performance was further improved by practical training in the application of target force on a simulator.