Selective kainic acid lesions in cultured explants of rat hippocampus

Summary The influence of the excitotoxin kainic acid (KA) on cultivated explants of rat hippocampus was investigated. Addition of 3 M KA to the culture medium over 24–48 h induced a destruction of the pyramidal cells in the CA3 region, whereas the CA1 pyramidal cells and the granule cells were left undamaged. Higher concentrations (10–100 M) of KA destroyed also the latter cell groups. The selectivity of the KA lesion at 3 M was further indicated by the fact that the acetylcholinesterase-positive neurons in the hippocampus were not destroyed through KA administration and that the stereoisomer dihydrokainic acid was ineffective in inducing lesions. Application of tetrodotoxin did not protect the CA3 pyramidal cells from KA lesion, whereas -glutamylaminomethylsulphonic acid (GAMS) only offered a very small, statistically not significant, protection. Baclofen protected the cultures slightly from KA lesions but not when added together with GAMS. Possible mechanisms responsible for the KA lesions in these cultures are discussed.Supported in part by a grant from the Swiss National Foundation for Scientific Research (No. 3.528.-0.83)     

Computers in radiology. Interfacing with peripheral devices

A fundamental part of building a computer system is control of and communication with peripheral devices. With use of graphics display terminals, video image digitizers, and array processors as examples, the basics of peripherals are discussed as they affect radiologic applications.     

A Healthy Life for African American Women Caregivers: A Concept Mapping Study

ObjectiveAfrican American women experience a higher burden of caregiving, but they are often underrepresented in studies on caregiver health. This study used a participatory process to elucidate how African American women caring for older adults view health and factors that influence health.MethodsWe invited African American women ages 24–64 years old who reported caring for an older adult for group concept mapping, a process consisting of five steps: 1) preparation, 2) idea generation, 3) sorting and rating, 4) creating maps, and 5) interpreting maps. Participants (n = 29) first completed idea generation by responding to the focus prompt “A healthy life for a caregiver includes _____.” Participants then sorted ideas into clusters based on conceptual similarity and rated each idea on desirability and importance. Data were managed via The Concept System Global MAX Software.ResultsIdea generation identified 512 ideas that reduced to 99 unique ideas. Using the 99 ideas, a cluster map with 12 outcome domains best fit the data. Identified clusters included spirituality, maintaining relationships, good character, taking action to cope, preserving oneself, support, personal empowerment, resources, striving for peace, handling emotions, wellness, and taking care of self and place. Forty-three ideas representing 10 of the 12 domains were rated high for desirability and importance.ConclusionA participatory research method was used to integrate the voices of African American women caregivers and provide a rich set of elements necessary for their health and well-being. We also identified potential focus areas for interventions aimed at promoting the health of these caregivers.     

Outcomes Research in Orthopaedics

A new agenda in outcomes research has developed in the past decade. The stimulus has come as the result of rapidly increasing health care costs, marked variations in utilization of health care services, and deficiencies in the research literature. Outcomes research includes methods such as analysis of large databases, small-area analysis, structured literature reviews (meta-analysis), prospective clinical trials, decision analysis, and guideline development. Clinical research should be prospective and should employ modern statistical and assessment methods. The focus of this research is on patient-oriented outcomes of care rather than on assessments of the process of care. To illustrate these applications in orthopaedics, lumbar spine fusion with internal fixation for "spinal instability" is presented as an example. Completed large-database analyses, small-area variation studies, and a meta-analysis indicate the need for clinical studies. An outline of the form and content of such a study is presented.     

Effects of methylphenidate (Ritalin) on auditory performance in children with attention and auditory processing disorders.

A double-blind, placebo-controlled study was used to investigate the effects of methylphenidate (Ritalin) on tests of auditory processing in children diagnosed with both Attention Deficit Hyperactivity Disorder (ADHD) and Central Auditory Processing Disorder (CAPD). Thirty-two subjects received three Central Auditory Processing (CAP) tests and the Auditory Continuous Performance Test (ACPT), a measure of attention/impulsivity, at two separate test sessions: once when medicated with Ritalin and once when nonmedicated (placebo). Sixteen subjects were assigned randomly to receive their medication first and 16 to receive the placebo first. A counterbalanced 2 x 2 mixed factorial analysis of variance was conducted for each of the four dependent variables: Staggered Spondaic Word (SSW), Phonemic Synthesis (PS), Speech-in-Noise (SN), and ACPT measures. Analyses revealed that Ritalin did not have a significant effect on any of the three CAP measures. However, ACPT performance was significantly better (p < .000) for the Ritalin versus placebo condition.     

A retrospective clinicopathological study of 37 patients with chordoma: a danish national series

Purpose. There are, in general, few published series on chordoma. It is a rare disease and further data are still needed.Patients/methods. The data of 37 patients with chordoma were retrospectively analyzed. Treatment was surgical excision in 11, radical radiotherapy in 9 and a combination of the two in 16 cases. The male to female ratio was 2.7 : 1. Median age was 59 years (range 1-89 years).Results. The most common symptoms at diagnosis were pain (98%), neurological disturbances (42%) and incontinence (33%). The tumours were located in the sacro-coccygeal region in 68%, the spheno-occipital region in 16% and the vertebrae in 16% of the patients. Median tumour.size was 7 cm (range 1-30 cm). Local recurrence occurred in 21/36 treated cases and distant metastases developed in eight patients (23%). The median time to recurrence/progression after primary treatment was 2 years (range 1-10 years). The actuarial 5-year rates of overall, progression-free and symptom-free survival were 40%, 31% and 20%, respectively. The corresponding 10-year rates were 26%, 21% and 14%, respectively. At the time of analysis, seven patients were alive, six without evidence of disease. Four of the six patients without active disease were symptom free. A univariate analysis showed that age, sex, tumour size, histopathology, surgical safety margin, treatment modality and radiation dose did not significantly affect overall, progression-free or symptom-free survival. Only turnout site had a prognostic value with turnouts in the spheno-occipital region carrying the worst prognosis.Discussion. We conclude that effective treatment against chordomas is still lacking and a prospective multi-institutional registration study may provide more information on the optimal work-up and treatment of this rare disease.     

Remission and relapse in subjects with panic disorder and panic with agoraphobia: a prospective short-interval naturalistic follow-up

This article reports on the course of uncomplicated panic disorder and panic with agoraphobia on 309 patients participating in the Harvard/Brown Anxiety Research Project, a prospective longitudinal study of patients with DSM-III-R-defined anxiety disorders. At 1 year, there was a .39 probability of full remission for uncomplicated panic disorder and a .17 probability of full remission for panic disorder with agoraphobia Similar differences in time to remission for these syndromes were still found when criteria for remission were made less stringent. However, even requiring less improvement for remission left a large percentage of subjects in an episode, and for those that remitted, relapse occurred quickly, indicating a chronic and recurrent course of illness. This is the first longitudinal, prospective, naturalistic study on a large cohort of subjects with anxiety disorders to have regular, structured, short-interval follow-up. Our results are consistent with the view that panic disorder has a chronic course with high rates of relapse after remission and longer episodes when agoraphobia is a part of the constellation of symptoms.