Visual acuity and visual field development after cryocoagulation in infants with retinopathy of prematurity

Visual development was studied in 10 very-low-birth-weight infants (less than 1500 g) with retinopathy of prematurity (ROP) stage 3+ who had been treated with cryocoagulation in both eyes. Binocular visual acuity (acuity cards method) and binocular visual fields (kinetic perimetry) were assessed repeatedly in the first year of life. At 12 months corrected age, visual acuity was normal in seven and impaired in three infants, who appeared to be severely myopic. Normal visual fields were found in eight infants at this age. The results indicate that cryotherapy in cases of ROP stage 3+ does not interfere with visual acuity development. The effect on visual field development needs further investigation.     

Progressive loss of cerebellar volume in childhood-onset schizophrenia

OBJECTIVE: Childhood-onset schizophrenia is a severe and unremitting form of the disorder. Prospective brain magnetic resonance imaging (MRI) studies have found progressive loss of total cerebral volume during adolescence, primarily attributable to accelerated loss of cortical gray matter. Because there is evidence of cerebellar involvement in schizophrenia, the authors examined cerebellar volume and its relation to cortical gray matter development during adolescence in patients with childhood-onset schizophrenia and healthy comparison subjects. METHOD: Total cerebellar volume was algorithmically calculated for 108 anatomical brain MRI scans from 50 patients (20 of whom were female) and 101 scans from 50 age- and gender-matched healthy volunteers (20 of whom were female). The age range of the patients and comparison subjects was 8 to 24. Midsagittal vermal area and posterior-inferior vermal lobe volume were measured by hand. Prospective rescans were obtained at approximately 2-year intervals. Cross-sectional and longitudinal data were combined in mixed model regressions to compare developmental changes for the groups. RESULTS: In contrast to healthy volunteers, patients with schizophrenia showed a progressive loss of cerebellar volume during adolescence. Cerebellar and cerebral volume decreases were significantly correlated in childhood-onset schizophrenia. CONCLUSIONS: Childhood-onset schizophrenia is associated with significant progressive loss of cerebellar volume during adolescence, consistent with previously reported decreases in total cerebral and cortical gray matter. At least in these patients with severe early-onset schizophrenia, the loss appears secondary to a generalized process.     

Posttraumatic distress and coping strategies among rescue workers after an earthquake

Disaster workers are at high risk for developing psychiatric morbidity. This study examined the prevalence rates of psychiatric and posttraumatic distress and the relationship between psychiatric and posttraumatic morbidity and coping strategies among rescue workers following an earthquake in Taiwan on September 21, 1999. Eighty-four male firefighters who had been exposed to earthquake rescue work were assessed 5 months after the event. The Chinese Health Questionnaire (CHQ), the Impact of Event Scale (IES), and the Ways of Coping Questionnaire (WCQ) were used to assess psychiatric morbidity, posttraumatic morbidity, and coping strategies. The observed prevalence rates were 16.7% and 21.4% for general psychiatric morbidity and posttraumatic morbidity, respectively. Results from multivariate logistic regression indicated that job experience and confrontive coping were significant predictors of psychiatric morbidity, while job experience, distancing, escape-avoidance, and positive reappraisal were significant predictors of posttraumatic morbidity. Rescue workers with longer job experience were at the highest risk for developing psychiatric and posttraumatic distress.     

Association between regional cerebral blood flow and eye-tracking performance and the Wisconsin Card Sorting Test in schizophrenics: a single photon emission computed tomography study

The objectives of this study were (1). to examine the changes in regional cerebral blood flow (rCBF) during Wisconsin Card Sorting Test (WCST) performance in two different eye-tracking groups; (2). to explore the relationship between eye-tracking movement and rCBF at rest; and (3). to estimate the association between WCST performance and rCBF in patients with schizophrenia. A total of 17 patients with schizophrenia were recruited. SPECT with Tc-99m HMPAO (Tc-99m hexamethylpropyleneamine oxime) was carried out while patients were performing the WCST and resting. Brodmann area 9 of the prefrontal cortex, a part of the dorsal lateral prefrontal cortex (DLPFC), was less activated during performance of the WCST in poor trackers (relative to good trackers). The eye pursuit tracking error measure in schizophrenic patients was negatively associated with decreases in rCBF in the middle temporal area, superior parietal lobule, thalami, and caudate nuclei. The rCBF increased significantly in the superior temporal gyri, inferior parietal lobe, and some frontal regions during WCST performance; however, this was not the case in the DLPFC. Additionally, significant correlations were found between WCST scores and rCBF during WCST performance in the prefrontal lobes, and in thalamic and cerebellar regions. Our findings suggest that the rCBF changes during WCST performance may be distinctive in different eye-tracking groups. Our results confirm the hypothesis that the middle temporal area, superior parietal lobule, thalami, and caudate nuclei-mainly parts of the oculomotor circuit-are involved in eye pursuit tracking. Surprisingly, no significant association was found in the frontal eye field. Although the frontal lobe plays a significant role in WCST performance, our findings demonstrate that WCST performance is widely involved with other regions in patients with schizophrenia.     

Regret and psychological well-being among voluntarily and involuntarily childless women and mothers

This study examines regret and psychological well-being among 72 middle-aged and older women who are either voluntarily childless, involuntarily childless, or mothers. Group comparisons indicate that, when compared to involuntarily childless women, voluntarily childless women show higher levels of overall well-being, rate themselves as more autonomous with greater environmental mastery, and are less likely to have a child-related regret. An unexpected finding is that about one-third of women categorized by researchers as involuntarily childless indicate that they are "childless by choice." These women report making an active decision to accept the childless lifestyle and focus on the future, in essence exerting control over their situations. Results from this small and selective sample should be interpreted cautiously. However, they do suggest that researchers' definitions of childlessness may not map directly onto those of participants, and they emphasize the importance of ascertaining respondents' perceptions of control over their situations.     

金龙胶囊配合辨证用药治疗中晚期恶性肿瘤40例

1临床资料2003-12/2004-10采用北京建生药业生产的金龙胶囊配合辨证用药治疗中晚期癌症40例.Karnofsky评分≥40分,预计生存期>2 mo.     

Features of transient hypogammaglobulinaemia in infants screened for immunological abnormalities

The incidence of transient hypogammaglobulinaemia of infancy (THI) detected in a major paediatric centre over a 10 year period was examined. A total of 2468 subjects less than 2 years of age had an IgG measurement taken between July 1979 and March 1990. Subjects with known immunodeficiencies were excluded. Fifteen patients were classified as having THI with an initial IgG level less than the fifth centile followed by a second measurement within the normal range. A further 24 patients were identified as having possible THI with a single low IgG concentration. There were 60,174 live births each year in Victoria in the years 1979-88. This gives an incidence of proved THI of 23 per 10(6) births, and including proved and probable THI an incidence of 61 per 10(6) live births. Of those patients with proved THI 12/15 had symptoms of either atopic disease or food allergy/intolerance and three had gastrointestinal symptoms without any evidence of atopic disease. At presentation 12/15 (80%) were IgA deficient and 9/15 had IgM concentrations less than the 20th centile for age. It is suggested that in view of the preponderance of atopic and food intolerant patients that subclinical protein loss from the bowel due to allergic inflammation may be a contributing factor to the development of THI in some patients.     

Elderly Patients with Suppressed Serum TSH but Normal Free Thyroid Hormone Levels Usually Have Mild Thyroid Overactivity and are at Increased Risk of Developing Overt Hyperthyroidism

The clinical and biochemical characteristics of 15 elderly patientswith low levels of thyrotrophin (TSH) (<0.1 mU/L) but normalfree tri-iodothyronine, (T3) and free thyroxine (T4) (groupS) were compared with 10 euthyroid subjects (group E) and 10hyperthyroid patients (group T). Free T3 and free T4 were significantlyhigher (p<0.05) in group S(6.3±0.5 and 18.6±1.0pmol/l, respectively) than in group E(4.6±0.3, 12.6+0.6).In common with elderly hyperthyroid patients (group T)patientsin group S had few signs or symptoms of thyrotoxocosis, butthe Wayne score (clinical index of hyperthyroidism) was higherin group S than in euthyroid subjects (p<0.05). Thyroid microsomal,thyrogolobulin or thyrotrophin receptor antibodies were commonin group T (n=9)but not in groups S(n=2) or E(n=1). This suggestsa low prevalence of Graves' disease in group S compared to groupT. Combined thyrotrophin releasing hormone (TRH; 200 µgi.v.) and gonadotrophin releasing hormone GnRH; 100 µgi.v.) tests were performed; no cases of low TSH due to hypopituitarismwere identified in group S. During a mean of 7.9 (4–12)months of observation TSH reverted to the normal range (>0.2mU/L)in 7 of 15 patients in group S; thyroid hormone concentrationsrose above the normal range in four, however, only two patientsrequired treatment for hyperthyroidism. It is unlikely thatthe suppressed TSH of patients in group S was due to mild thyroidhormone excess; although this is often a transitory phenomenon,these patients are at increased risk of developing overt hyperthyroidism.