Magnetic resonance imaging and single-photon emission computed tomography changes in hypoglycemia-induced chorea.

We present two case studies, one of generalized chorea and one of hemichorea, both after severe hypoglycemia episodes. Both cases showed hyperperfusion in their SPECT scans. The MRI and SPECT findings serve as clues regarding the role of basal ganglion dysfunction associated with chorea.     

Human papillomaviruses and small cell carcinoma of the uterine cervix.

The in vitro DNA amplification technique of polymerase chain reaction was used to evaluate the possible presence of human papillomavirus (HPV) in small cell carcinoma of the uterine cervix. None of the 12 cases examined contain detectable amounts of either HPV type 16, 18, 31, or 33 DNA. On the other hand, HPV types 16 and 18 DNA were found in 14 (93.3%) and 9 (60.0%) of 25 invasive cervical squamous carcinoma tissues. The results seem to suggest that these types of HPV are not present or are present in extremely small quantities in cervical small cell carcinoma. Such an absence of HPV DNA makes it unlikely that these types of HPV play any etiological role in the pathogenesis of cervical small cell carcinoma.     

Double-labelling with rhodamine beads and biocytin: a technique for studying corticospinal and other projection neurons in vitro

Corticospinal neurons retrogradely labelled with rhodamine-labelled latex microspheres (RLMs) in vivo were studied intracellularly in a slice preparation up to 13 months later with electrodes containing biocytin. The physiological properties of these double-labelled corticospinal neurons were indistinguishable from those of comparable neurons which were impaled with biocytin-containing electrodes without prior RLM-labelling, and neurons studied with potassium acetate-filled electrodes in similar areas. Thus, neither labelling with RLMs nor injection of biocytin affected neuronal properties. This important advantage of RLMs makes them suitable for prelabelling projection neurons in vivo for subsequent studies that take advantage of the versatility of a brain slice preparation. In addition to its lack of effects on neuronal properties, intracellular labelling with biocytin also provides high-quality morphological details ideal for anatomical analysis. The compatibility of retrograde labelling with RLMs and intracellular staining with biocytin make this a useful combined technique for tracking electrophysiological and anatomical changes in identified projection neurons over time.     

Locomotor strategies before independent walking: prospective study of 50 mentally retarded children.

To investigate the association between pre-walking locomotor strategies and psychomotor developments in children with mental retardation (MR), 50 children with non-specific MR were included in this study. There were 29 boys and 21 girls, 96% of whom had moderate to severe MR. They were followed from 4-53 months to 25-99 months of age, and their follow-up periods ranged from 10 to 48 months (mean 30 months). According to the pre-walking locomotor strategies, these children were categorized into three groups: the crawling group (n = 34) who used crawling or creeping as their main locomotion pattern before independent walking; the shuffling group (n = 9) who used shuffling prior to independent walking; and the direct-walking group (n = 7) who did not have any other locomotor strategies except rolling. In almost all motor developmental milestones, children in the direct-walking group developed earlier than those in the crawling and shuffling groups. Children in the crawling group had more advanced developments than those in the shuffling group. The difference in the mean ratio developmental quotients of the Bayley Mental Scale among the three groups was not significant. The present study showed that crawling may not be a necessary prerequisite for early ambulation or better cognitive function in MR children.     

Delayed traumatic intracerebral hemorrhage: a study of prognostic factors.

Experience in the management of 32 patients with delayed traumatic intracerebral hemorrhage (DTICH) is presented with emphasis on the incidence, clinical significance and factors affecting the outcome. The incidence was 1.4% of all hospitalized head-injury patients, or 5.9% of only those patients with neurologic signs or abnormal findings on computed tomography (CT) identified on admission. After an injury, every patient had an immediate CT scan to diagnose intracranial pathology. Initially, nine patients underwent a craniotomy for intracranial hematomas, and 23 patients had nonoperative treatment. CT follow-up was carried out in 10 patients due to clinical deterioration and on 22 patients due to failure to recover neurologically. The delayed hemorrhage was found after a time interval varying from seven hours to 10 days (average, three days and seven hours). Six patients underwent operations for DTICH, and 26 were treated conservatively. Twenty-four patients (75%) were functional (good or moderately disabled condition) after one year of follow-up treatment, as measured on the Glasgow Outcome Scale. The mortality was 16%. The patients were predicted to have a poor prognosis if associated with an earlier occurrence, the hematoma was large, the patient had a poor Glasgow Coma Scale score at the time of CT follow-up, clinical deterioration was noted, or partial or complete effacement of the suprachiasmatic cistern was noted on the CT scan. The results indicate that the prognosis of DTICH is not as poor as it was previously thought to be, and the factors affecting the outcome in this study seem to justify a more vigilant approach.     

Friction, capacitance and transepidermal water loss (TEWL) in dry atopic and normal skin

The biophysical properties of non-eczematous skin at three locations in atopics and non-atopics were characterized using non-invasive physical methods. Skin friction was measured with a newly developed sliding friction instrument, the degree of hydration with a capacitance meter (Corneometer CM 820), and the transepidermal water loss (TEWL) was determined using an Evaporimeter EP1. The areas examined (dorsum of the hand, volar forearm and lower back) showed lower values of friction and capacitance in the atopic patients than did corresponding sites in the normal controls. In most areas a significant correlation between friction and capacitance was found. The TEWL was increased in atopic skin, but TEWL seems to correlate neither to friction nor to capacitance.     

Hyperoxaluria, nephrolithiasis, nephrocalcinosis and renal failure after massive resection of the small intestine: report of a case.

Hyperoxaluria is frequently seen in patients with inflammatory bowel disease, or after resection of the ileum. It is assumed to be responsible for the development of nephrolithiasis, nephrocalcinosis (oxalate nephrosis) and progressive renal impairment in these patients. Steatorrhea may aggravate the severity of hyperoxaluria. A 60-year-old male underwent massive resection of the jejunum and ileum 10 years prior to admission, due to strangulation of the small bowel, with occlusion of the superior mesenteric artery. He remained well except for steatorrhea which developed two-and-a-half years prior to admission, when microhematuria, proteinuria and oxaluria developed progressively. Since that time, the nephrolithiasis, nephrocalcinosis and renal failure have continued to worsen despite therapy with oxalate restriction and oxalate-binding agents. A renal biopsy, performed late in the clinical course, showed severe changes in the renal parenchyma. The decline in renal function proved irreversible. The unusual metabolic consequences of massive resection of the small intestine and their mechanisms are discussed.     

The use of microimplants in orthodontic anchorage.

PURPOSE: Various types of temporary implants have been introduced to serve as orthodontic anchorage. The hypothesis of this study is that microimplants of 1.2 mm diameter can be used as orthodontic anchors, and that their success is related to their length. The aim of this study is to determine the incidence of anchor retention after orthodontic force application for moving teeth, and to determine the relationship of microimplant length to retention rate. METHODS: Fifty-nine microimplants (diameter: 1.2 mm) were placed in 29 patients as orthodontic anchorages. After 2 weeks of microimplant placement, a force of 100 to 200 g was loaded with an elastometric chain or NiTi coil spring. Risk factors were characterized as to why a microimplant may fail, and Fisher's exact test was used for statistical analysis. RESULTS: Nine microimplants were removed and the overall success rate was 84.7%. Exploring the causes for failure, we found significant differences between the length of microimplants and success rate; 6 mm was 72.2% and 8 mm was 90.2%. CONCLUSIONS: The results suggest that microimplants are suited as an alternative orthodontic anchorage. We recommend that 8-mm microimplants are preferable to 6-mm.     

Regional left atrial voltage in patients with atrial fibrillation

BACKGROUND: Regional differences in fibrosis, particularly related to the posterior wall and septum, may be important in atrial fibrillation (AF). Using electroanatomic mapping, voltage can be used as a measure of fibrosis. OBJECTIVES: The purpose of this study was to determine if patients with AF have disproportionately lower voltage in the septal and posterior walls of the left atrium. METHODS: Sinus rhythm left atrial electroanatomic maps were used in serial patients presenting for left atrial ablation of AF (8-mm tip). Patients undergoing left atrial mapping for focal atrial tachycardia (AT) were used as a comparison group (4-mm tip). Animal experiments were performed to assess the influence of ablation catheter tip size on voltage amplitude. RESULTS: The posterior and septal walls exhibited the lowest voltages in both groups. Compared with the anterior wall, there was a 3.78-fold greater odds of finding a low-voltage point (<0.5 mV) in the septum (P <.001) and a 3.37-fold greater odds of finding a low-voltage point in the posterior wall (P <.001) in the AF patients; the proportion of low-voltage points by region were not significantly different in the AT group. In the animal model, the mean voltage obtained from an 8-mm ablation catheter was significantly higher (0.30 +/- 0.17 mV) than that obtained from the same points using a 4-mm catheter (0.22 +/- 0.17, P = .05). CONCLUSION: Regional differences in voltage are present in patients with atrial arrhythmias, with AF patients exhibiting significantly more low-voltage areas in the septum and posterior walls.     

Ärztliche Fehleroffenbarung – Strafrechtliche Strategien für postinvasive Arzt-Patientengespräche

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