Spinal cord stimulation for multiple sclerosis: quantifiable benefits.

From 1984 to 1991, a quantitative study of 5 multiple sclerosis (MS) patients has been determining benefits from epidural (C7-T1 level) spinal cord stimulation (SCS). The 5 patients (4 male, 1 female; 4 tetraparetics, 1 hemiparetic) were 36-45 years of age having had symptoms for 12-22 years. Five quantitative tests were given prior to and during SCS on 4-8 occasions; 'off' periods were planned and also did occur when the electrode(s) broke (3 patients). With SCS, hand dynamometry showed a 2- to 4-fold increase in the 3 patients with weak hand function. Jebson Hand Time Testing showed a rapidity improvement to 1/2-1/7 of time in the same 3 patients. Minnesota Manipulation Testing with SCS was improved to 1/3-1/2 of time in 2 of these 3 patients tested. Manual muscle strength increased in all patients by 20-50% in 'normal range'. Ambulation in the parallel bars increased with SCS in 2 of the 4 wheelchair patients, while the hemiparetic patient could walk without his cane. All patients showed varying quantifiable improvements with SCS, but over the duration of testing the patients slowly deteriorated. SCS is a rehabilitation option for the weakened MS patient, to be used earlier rather than later in the deterioration of MS patients.     

The Surgeon General's warnings in outdoor cigarette advertising. Are they readable?

Outdoor advertising media represent a major vehicle by which cigarette companies promote their products. We investigated the readability of the Surgeon General's warning in cigarette advertisements (ads) in two outdoor media: billboards and taxicab ads. In an experiment in metropolitan Atlanta under typical driving conditions, observers were able to read the entire health warning on 18 (46%) of 39 street billboards but on only two (5%) of 39 highway billboards. In contrast, the content of the ads (ie, brand name, other wording, and notable imagery) could be recognized under the same conditions on more than 95% of the billboards. In a similar study of 100 taxicab cigarette ads in New York City, observers were unable to read the health warning in any of the ads but were able to identify the brand name in all ads and notable imagery in 95% of the ads. Significant differences between the readability of the warning and identification of the advertising content persisted even when partially read warnings were considered to have been read. We conclude that the Surgeon General's warning is not readable in its current form in the vast majority of billboard and taxicab ads. Factors contributing to unreadability include the small size of the letters, the excessive length of the warnings, the distance between the viewers and the ads, and movement between the viewers and the ads.     

Recovery and probable persistence of cytomegalovirus in human inner ear fluid without cochlear damage

Cytomegalovirus (CMV) was recovered from a 5-month-old infant with probable congenital infection. In life, no hearing impairment had been observed. Auditory brain stem evoked responses were bilaterally intact. At necropsy, both temporal bones were morphologically normal, as demonstrated by light and electron microscopy. Sensory hair cells of the organ of Corti appeared intact. Cytomegalovirus was recovered from a mixture of perilymph and endolymph, but not the brain, CSF, or vitreous humor. This appears to be the first report of an individual with an inner ear CMV infection in which neither structural nor functional alterations of the inner ear were apparent. This case also suggests that CMV can persist within the inner ear for prolonged periods following congenital infection.     

The relation of high density lipoprotein cholesterol and its subfractions to apolipoprotein A-I and fasting triglycerides: the role of environmental factors. The Atherosclerosis Risk in Communities (ARIC) Study.

Cross-sectional analysis of four general representative populations of middle-aged adults in the United States in 1986-1989 provides estimates of the close relation of high density lipoprotein cholesterol (HDL cholesterol) to its major structural apolipoprotein (apolipoprotein A-I) and to fasting plasma triglyceride levels. HDL cholesterol differences of approximately 0.4 mg were associated with 1-mg differences in apolipoprotein A-I; differences of 20% in HDL cholesterol (reductions) were associated with triglyceride doublings. Variation in apolipoprotein A-I and triglyceride concentration together accounted for 66% of the population variance in HDL cholesterol. The uniformity of this pattern in the four race-sex groups studied suggests an important role of triglyceride-cholesterol transfer as a determinant of HDL cholesterol. The fundamental relations observed among HDL cholesterol, apolipoprotein A-I, and triglycerides were unaltered by levels of factors under personal volition. The volitional factors appeared to influence HDL cholesterol indirectly: Obesity and physical activity were affected primarily through their associations with triglycerides, and alcohol use and smoking through associations with apolipoprotein A-I. The association of alcohol use with elevated HDL cholesterol was attenuated in persons with greater body mass.     

Behavioral management of psychogenic cough: alternative to the "bedsheet" and other aversive techniques

The treatment of persistent psychogenic cough, a potentially debilitating condition among pediatric patients, can pose diagnostic and treatment dilemmas. Its treatment by the use of a procedure called reinforced suggestion technique was described previously. The use of an alternative procedure relying upon parental and self-monitoring of coughing and either social or material rewards for decreasing rates of coughing is presented.     

Evaluation of eight bioaerosol samplers challenged with aerosols of free bacteria.

The need to quantify airborne microorganisms in the commercial microbiology industry (biotechnology) and during evaluations of indoor air quality, infectious disease outbreaks, and agriculture health investigations has shown there is a major technological void in bioaerosol sampling techniques to measure and identify viable and nonviable aerosols. As commercialization of microbiology increases and diversifies, it is increasingly necessary to assess occupational exposure to bioaerosols. Meaningful exposure estimates, by using area or environmental samplers, can only be ensured by the generation of data that are both precise and accurate. The Andersen six-stage viable (microbial) particle sizing sampler (6-STG) and the Ace Glass all-glass impinger-30 (AGI-30) have been suggested as the samplers of choice for the collection of viable microorganisms by the International Aerobiology Symposium and the American Conference of Governmental Industrial Hygienists. Some researchers consider these samplers inconvenient for evaluating industrial bioprocesses and indoor or outdoor environments. Alternative samplers for the collection of bioaerosols are available; however, limited information has been reported on their collection efficiencies. A study of the relative sampling efficiencies of eight bioaerosol samplers has been completed. Eight samplers were individually challenged with a bioaerosol, created with a Collison nebulizer, of either Bacillus subtilis or Escherichia coli. The samplers were evaluated under controlled conditions in a horizontal bioaerosol chamber. During each experimental run, simultaneous samples were collected with a reference AGI-30 to verify the concentration of microorganisms in the chamber from run to run and day to day.(ABSTRACT TRUNCATED AT 250 WORDS)