A dual-route account for access to grammatical gender: evidence from functional MRI

Research investigating the neural correlates of grammatical gender processing has provided contradictory evidence with respect to activation in the left inferior frontal gyrus (IFG). A possible account for these discrepancies is a dual-route model proposing explicit vs implicit access to the gender information. In this event-related fMRI experiment, we investigated this issue by taking into account different processing strategies reported by the subjects. The participants performed two tasks, a gender judgement of German nouns and a non-lexical baseline task (spacing of consonant letter strings). Depending on the reported strategy (silent production of the definite determiner or direct access to the gender information), different patterns of activation in the left IFG were observed. Direct access to gender information yielded activation in the inferior tip of BA 44, whereas the verbalisation strategy elicited activation in the superior portion of BA 44, BA 45/47, and the fronto-median wall. These results speak in favour of a dual-route account for modelling the access to grammatical gender information during language comprehension.     

Presence of creatine phosphokinase brain band in the serum of chronic renal disease patients.

The almost universal presence of the isoenzyme creatine phosphokinase brain band (CPK-BB) in the sera of patients with chronic renal insufficiency and serum creatinine above 4.5 mg/dl is noted. It is absent in patients with severe acute renal failure and in transplanted patients with normal renal function. The source of the enzyme may be nerve tissue and may represent neuronal cell damage in uremics over a period of time.     

Colon perforation following percutaneous nephrostomy and renal calculus removal

Two patients had colonic perforation as a result of percutaneous nephrostomy placement followed by track dilatation and renal calculus removal. We present the technical aspects of nephrostomy placement and stone removal, as well as the clinical diagnosis and management of these cases. Both patients recovered well with conservative therapy and required no surgical intervention. This report reviews the anatomic considerations for percutaneous nephrostomy in patients undergoing renal stone removal.     

Influence of prosodic information on the processing of split particles: ERP evidence from spoken German

Spoken language comprehension involves the use of different sources of linguistic information such as prosodic, syntactic, lexical, and semantic information. The question, however, of 'when' and 'how' these sources of information are exploited by the language processing system still remains unanswered. In the present study, we used event-related brain potentials (ERPs) to investigate the interaction between prosodic, syntactic, and lexical information during the processing of spoken German sentences. The sentence structure was manipulated by positioning a split particle at the end of the sentences after the occurrence of inflected verb whose lexical entry does not contain a split particle (e.g., *Sie alarmierte den Detektiv an [*She alerted at the detective]) [According to linguistic convention, incorrect sentences are marked by an asterisk.]. The prosodic contour of the verb stems was manipulated such that it marked either the presence of a split particle at a later position in the sentence or not. Participants performed an off-line probe-detection task. ERP data indicate that prosodic information of German-inflected verb stems is consulted on-line by the language processing system ('parser') in order to 'predict' the presence of a split particle at a later position in the sentence. An N400 effect was observed for the processing of split particles following verb stems which do not take a particle. However, this effect was only observed when the prosody of the verb stem did signal the presence of a split particle. We argue that the N400 component reflects the high costs associated with the lexical search that the language processing system has to perform when confronted with nonexisting words such as these resulting from the combination of the split particle and the verb stem in the present study. Furthermore, as a general reflection of prosodic processes, a Closure Positive Shift (CPS) was found at intonational phrase boundaries. In sum, the present findings provide strong evidence that prosodic information is a good 'predictor' of upcoming information during the auditory processing of German sentences.     

Survival after ruptured abdominal aortic aneurysm: effect of patient, surgeon, and hospital factors

OBJECTIVE: The purpose of this study was to determine the effects of patient, surgeon, and hospital factors on survival after repair of ruptured abdominal aortic aneurysm (AAA) and to compare them with risk factors for survival after elective AAA repair. It was hypothesized that patients operated on by high-volume surgeons with subspecialty training would have better outcomes, which might argue for regionalization of AAA surgery. METHODS: In this population-based retrospective cohort study, surgeon billing and administrative data were used to identify all patients who had undergone AAA repair between April 1, 1992, and March 31, 2001, in Ontario, Canada. Demographic information was collected for each patient, as well as numerous variables related to the surgeons and hospitals. RESULTS: There were 2601 patients with ruptured AAA repair, with an average 30-day mortality rate of 40.8%. Significant independent predictors of lower survival were older age, female gender, lower patient income quintile, performance of surgery at night or on weekends, repair in larger cities, surgeons with lower annual volume of ruptured AAA operations, and surgeons without vascular or cardiothoracic fellowship training. There were 13,701 patients with elective AAA repair, with an average 30-day mortality rate of 4.5%. Significant independent predictors of lower survival were similar, except gender was not significant, but the Charlson Comorbidity Index was. When the hazard ratios associated with predictive factors were compared, surgeon factors appeared to be more important in ruptured AAA repair, and patient factors appeared more important in elective AAA repair. CONCLUSION: For elective AAA repair, and even more so for ruptured AAA repair, high-volume surgeons with subspecialty training conferred a significant survival benefit for patients. Although this would seem to argue in favor of regionalization, decisions should await a more complete understanding of the relationship between transfer time, delay in treatment, and outcome.