Psychosocial status after pediatric traumatic brain injury: a subtype analysis using the Child Behavior Checklist.

This study identified subtypes of psychosocial functioning in children who had sustained traumatic brain injury (TBI). Child Behavior Checklist (CBCL) profiles for 92 participants, aged 12 to 18 years, who had sustained a mild, moderate, or severe TBI were subjected to Q-Factor analysis. Sixty-four of the participants (75%) were classified into a four-category psychosocial typology labelled Normal (n = 32), Attention (n = 14), Delinquent (n = 10), and Withdrawn-Somatic (n = 8). This typology was found to overlap in part with previous TBI psychosocial typology (Butler et al., 1997), and with three of the clinical profile types derived by Achenbach (1993) for the CBCL. The majority of participants, including those who sustained severe TBI, were assigned to the Normal subtype and the overall level of psychosocial deviance was relatively mild in the other three subtypes. The results of this study support previous typology efforts and confirm the heterogeneous presentation of social and emotional functioning following TBI.     

The effect of prenatal alcohol exposure on attention in the rat

The effect of prenatal exposure to alcohol on the development of basal heart rate and on the elicitation and habituation of the heart rate orienting response was examined in three experiments with rats. In all experiments, Etoh dams consumed large, daily amounts of alcohol and their weight gain during pregnancy was less than that of ad lib or pairfed dams. In addition, Etoh-exposed pups weighed less and grew more slowly than their ad lib or pairfed counterparts. Although prenatal exposure to alcohol had a significant effect on the ontogeny of basal heart rate, there was no effect on the magnitude of the heart-rate response to a novel olfactory stimulus or on habituation of the heart-rate response to that stimulus. Implications of the present findings for models of alcohol-induced attention deficits are discussed.     

Angiokeratomas, connective tissue nevus, hemangioma

A 7-year-old white boy had multiple angiokeratomas, connective tissue nevus of the right foot, and cavernous hemangioma with hemiatrophy of the right lower extremity. The triad of abnormalities is distinct from previously described multiple malformation syndromes.     

Immune potential in human uraemia. 2. Changes after regular haemodialysis therapy.

Parameters of both humoral and cellular immune potential were measured in a group of patients with severe renal failure before and after three months' regular haemodialysis therapy. Evidence is presented of improvement in cellular immune potential and of a tendency of the response of lymphocytes to PHA to return to normal. No improvement in humoral responsiveness was demonstrable, and it is suggested that uraemic patients on regular haemodialysis may have an impaired capacity to establish new immunological memory.     

Chest Pain Associated with Nutcracker Esophagus: A Preliminary Study of the Role of Gastroesophageal Reflux

A review of our 402 motility records of patients undergoing evaluation of noncardiac chest pain identified 40 patients with the diagnosis of nutcracker esophagus. Gastroesophageal reflux was found in 13 of 20 patients (65%) who underwent pH studies, and endoscopy detected one patient with erosive esophagitis. Thus, at least 14 (35%) of our nutcracker esophagus patients had evidence of reflux. Twelve of these subjects agreed to enter an open-label therapeutic trial. After 8 wk of intensive antireflux treatment with high doses of ranitidine or omeprazole, repeat 24-h pH studies and endoscopy demonstrated normalization of pH parameters and healing of esophagitis in all patients. Ten (83%) patients obtained significant symptomatic improvement in frequency of pain episodes, number of days with pain, and pain severity. However, repeat manometry showed normalization of motor findings in only two (18%) patients. These observations warrant further placebo-controlled trials. Until more information is available, the results of this study suggest that gastroesophageal reflux should be excluded in patients with noncardiac chest pain and nutcracker esophagus before initiation of smooth muscle relaxant therapy.     

A study of the effect of rheumatoid synovial fluid on proliferation and IL-2 production by total mononuclear cells and purified CD4+ cells of synovial fluid and peripheral blood

T cells from synovial fluid (SF) of rheumatoid arthritis (RA) patients have previously been shown to proliferate less after mitogenic stimulation and produce less interleukin 2 (IL-2) than normal T cells. To test whether SF is responsible for the reduced T-cell responses, we studied the effect of inflammatory SF on peripheral blood (PB) RA and normal mononuclear cells (MNC) and CD4+ T cells and on RA SF MNC and CD4+ cells in vitro. Most rheumatoid SF present in concentrations of 50% and 5% during in vitro stimulation increased mitogen-induced IL-2 production and proliferative response by normal PB and RA MNC and CD4+ cells. Other rheumatoid SF samples did not influence the T cell responses, while only a few samples had an inhibitory effect. The results indicate that SF contain both stimulatory and inhibitory factors and that the resultant effect on T cells may depend on the net effect of these. The results do not support the hypothesis that the apparently impaired function of SF T cells is due to contact with SF.