The Involvement of Agmatine in Individual Pain Sensitivity

Distribution of agmatinase (AGM), an enzyme of agmatine metabolism, was studied in the spinal cord and dorsal root ganglia of rats with different levels of initial thermal pain sensitivity under normal conditions and during the development of inflammatory pain using immunohistochemistry. The initial type of pain threshold affects the specific pain response of an animal to pain so that the rats with a higher threshold exhibit a less-expressed behavioral pain response. We found a specific distribution and time course of activity of AGM in the brain regions of animals with different nociceptive thresholds. The animals with a lower threshold had a higher number of AGM-immunoreactive neurons in the ganglia and a lower density of fibers and neurons in the dorsal roots of the spinal cord compared to the animals with a higher threshold. The development of tonic pain was associated with differently directed changes of AGM activity in the studied structures and depended on the threshold of nociception. Our data suggest that the endogenous system of agmatine metabolism may be involved in the initial threshold of nociception, as well as in organization of the behavioral response to pain.     

Provocation tests in clinical examination of carpal instabilities: part I]

Basing on a review of available literature, the author presents 9 provocative tests used in diagnosing carpal instability. Their methodology and principles of clinical interpretation are reviewed. Test used to diagnose instability in the following joints: radio-carpal, scapho-lunate, luno-triquetral and carpo-metacarpal II-V are discussed.     

Management of focally malignant pedunculated adenomatous colorectal polyps

A hospital record review identified 59 patients whose sole colorectal pathology was a pedunculated, adenomatous polyp with a focus of malignancy confined to the head of the tumor. Thirty-one patients had polyps with in-situ carcinoma, and 28 patients had foci of invasive carcinoma. Sixteen patients who had lesions in situ underwent laparotomy, and not a single instance of metastasis was found. Twenty patients who had carcinoma in situ received only local treatment, and 15 are alive and well. None of the patients treated locally has developed subsequent colorectal cancer, and 12 have survived at least five years following treatment. Of the 28 patients who had invasive carcinoma confined to the head of an adenoma, 19 are alive and well, and 17 have lived five years or more following treatment. There was one instance of lymph-node metastasis, which occurred in a patient who had a malignant lesion extending to the neck of the tumor and tumor cells in the lymphatics in the head of the polyp. All of the eight patients treated locally are alive and well, and five have lived at least five years following treatment. The results of this study, coupled with the rarity of reported metastasis from focally malignant, pedunculated, adenomatous colorectal polyps, strongly suggest that local treatment is sufficient for the vast majority of these lesions. Evidence from the literature suggests that resective therapy should be considered when 1) lymphatics within the head of the polyp contain tumor cells; 2) the cancer is highly undifferentiated; 3) the pedicle is extremely short and malignant changes extend to the neck of the adenoma.     

Motorcycle helmet-use laws and head injury prevention.

OBJECTIVE--To rebut criticism of a previous study of motorcycle helmet-use laws through reanalysis with improved measures of exposure, stratification for regional differences in crash risk, and addressing of total motorcycle-related mortality and the grounds for targeting motorcyclists for helmet-use laws. DESIGN--Death certificate-based correlational study of motorcycle-related deaths and motorcycle helmet-use laws. POPULATION STUDIED--United States resident deaths from 1979 through 1986. RESULTS--Regardless of the denominator used (resident population, motorcycle registrations, or motorcycle crashes), states with full helmet-use laws had consistently lower head injury-associated death rates than states without such laws, even when stratified by region. Total motorcycle-related mortality, however, was similar between law groups. On a registration or crash basis, motorcyclists who died in crashes had a fivefold to sixfold higher risk of head injury than those who died using any other type of motor vehicle. CONCLUSION--Full helmet-use laws were consistently associated with lower rates of head injury-associated death. While disagreement remains on the acceptability of the legislative approach, the scientific basis for motorcycle helmet-use laws as a head injury prevention tool appears sound.     

SERVICE CONTENT AS A DETERMINANT OF HOMELESS ADULTS’ PERCEPTIONS OF PROGRAM EFFICACY

This work analyzes the relationship between the services clients receive in treatment programs and client ratings of program efficacy. It relies on data from a random sample of clients served by Chicago's homelessness system (N = 554). Regressions utilizing that data suggest that ratings of program efficacy are positively predicted by program ambiance, the ambiance of referral arrangements, residence in programs providing housing, and receipt of employment services. The measures of ambiance are predicted by receipt of professional services and help in locating housing. Receipt of advocacy services does not predict ratings of program efficacy nor ambiance; receipt of tangible services is negatively related to ratings of program efficacy. Results suggest that clients rate highly programs that have a positive ambiance or that provide services that clients view as immediately helpful for solving long‐term needs. Clients thereby discount services known to contribute to the amelioration of homelessness.