Temporomandibular Joint Air in Fractures of the Skull Base

Basilar skull fractures involving the temporal bone extend through the tympanic part of the temporal bone in two-thirds of cases. The anatomical relationship of this part of the temporal bone and the temporomandibular joint enables air to pass from the auditory canal into the joint. Air in the temporomandibular joint is demonstrated on CT scans as an indirect sign of temporal bone fracture.     

Diversity in Clinical Psychology

Clinical psychology is not as diverse as society, and the generalizability of clinical psychology to diverse groups has largely been untested. Some progress has been made in increasing the number of ethnic minorities receiving PhD degrees in clinical psychology and in increasing ethnic minority representation in clinical trials. Nevertheless, clinical psychologists and clinical psychology research are not diverse. A stages of change model may be useful in motivating clinical psychologists to diversify. A future scenario involving inertia and a second involving change are offered.     

Expanding Our Strategies to Study the Process of Change

The conceptual and methodological framework proposed by Doss (this issue) makes valuable suggestions for strategic choices in future research. This commentary addresses conceptual and terminological distinctions adopted by Doss, as well as his criticism of add-on/ dismantling studies. We also suggest research topics and methodological developments that could be integrated in Doss's framework to further expand understanding of therapeutic change.     

On the form of the internal model for reaching

We investigated, by using simulations, possible mechanisms responsible for the errors in the direction of arm movements exhibited by deafferented patients. Two aspects of altered feedforward control were evaluated: the inability to sense initial conditions and the degradation of an internal model. A simulation which assumed no compensation for variations in initial arm configuration failed to reproduce the characteristic pattern of errors. In contrast, a simulation that assumed random variability in the generation of joint torque resulted in a distribution of handpaths which resembled some aspects of the pattern of errors exhibited by deafferented patients.     

Morphometric insights into nephrotic syndrome in children: Are we any wiser?

Summary: The present study was undertaken in the hope that conflicting opinions concerning interrelationships among minimal change disease (MCD), mesangial proliferative glomerulonephritis (MPG) and focal segmental glomeruloscierosis (FSGS) might be elucidated by morphometric methods performed by image analysis, as well as to study whether serum creatinine and changes in quantitatively analysed glomeruli could correlate with the interstitial fibrosis in these glomerulopathies. Fifteen renal biopsy specimens from children with MCD, 10 with primary MPG and 12 with FSGS for whom both light and electron microscopy as well as immunofluorescence microscopy and full clinical data were available, were examined quantitatively. As a control five biopsy and 10 autopsy specimens of the normal kidneys were used. Our quantitative study showed that in MCD, MPG and FSGS glomerular and interstitial values differed from normal. Morphometric differences between MPG and both MCD and FSGS groups were also shown. Although the mean values of total glomerular area and relative interstitial volume were increased in FSGS patients, in total glomerular cells per unit of glomerular area and mesangium (% of total glomerular area) were similar in both MCD and FSGS groups. In MPG strong positive correlations existed between interstitial volume and serum creatinine, interstitial volume and total glomerular cells per unit of glomerular area as well as between interstitial volume and glomerular mesangium (% of total glomerular area). In FSGS there was significant positive correlation between interstitial volume and serum creatinine. In the MCD group all correlations were weak and not significant. In conclusion, our morphometric studies suggest a close relationship between MCD and FSGS, and indicate that MPG is a separate morphologic entity in children.     

Inhibitory effect of amiloride and gadolinium on fine afferent nerves in the rat knee: evidence of mechanogated ion channels in joints

Synovial joints are complex sensory organs which provide continuous feedback regarding position sense and degree of limb movement. The transduction mechanisms which convert mechanical forces acting on the joint into an electrochemical signal which can then be transmitted to the central nervous system are not well understood. The present investigation examined the effect of the mechanogated ion channel blockers amiloride and gadolinium on knee joint mechanosensitivity. In deeply anaesthetised rats (sodium thiopental: 100–120 mg/kg, i.p.), single unit extracellular recordings were made from knee joint group III (Aδ) and group IV (C) primary afferents in response to mechanical rotation of the joint. Afferent firing rate was measured before and after topical application of either amiloride (0.1 mM, 1 mM) or gadolinium (250 μM) onto the receptive field of the sensory unit and recording was continued every 10 min up to a total of 50 min. With normal rotation of the knee, joint mechanosensitivity was significantly reduced by both amiloride (P<0.0001; n=10–21) and gadolinium (P=0.001; n=12) and this effect was sustained throughout the recording period. This investigation provides the first in vivo electrophysiological evidence that joint mechanotransduction involves the activation of amiloride and gadolinium-sensitive mechanogated ion channels. Future studies to determine the mechanogated ion channel subtypes present in joints and the modulation of their gating properties during inflammation may yield novel approaches for the control of arthritis pain. Funding: JJMcD is funded by the Alberta Heritage Foundation for Medical Research, the Canadian Institutes for Health Research, and the Arthritis Society of Canada.     

47例骨髓穿刺干抽的临床和病理分析

分析４７例骨髓穿刺干抽的临床和病理改变，干抽占同期１３１９例骨穿的３．６％。根据骨髓细胞的密度和间质纤维增殖的程度，把干抽的原因分为４类：高细胞伴间质细胞增多者１９例（４２．２％）；间质细胞增多者１４例（３１．１％）；高细胞者８例（１７．８％）及低细胞者４例（８．９％）。主要疾病为：急性淋巴细胞白血病（２５．５％），急性非淋巴细胞白血病（１７．０％），慢性白血病（１４．９％），骨髓转移瘤（１０．６     

Acoustic transmission in normal human hips: structural testing of joint symmetry

An acoustical technique has been developed for the measurement of structural symmetry of the hip joints. A mild vibratory force was applied to the sacrum and sound signals were picked up at both hips by a pair of microphones installed in two stethoscopes. These stethoscope–microphone assembles were calibrated to achieve a difference in relative sensitivity of less than 0.2 dB. The relative transmission of sound signals was analysed and compared between both hips by a dual-channel signal analyser. Twenty-seven healthy adults, 20 healthy pre-school children and 19 normal neonates were tested. Results from these three groups showed high coherence of the sound signals and that the discrepancy between both hips was smallest in the frequency range of 200–315 Hz. For normal neonates, the sound signals maintained a high coherence (γ²>0.97) and small discrepancy (D<1.25 dB) between both hips. This study has shown that the acoustical technique provides a practical structural testing for bony symmetry of the hips and the results offer a baseline for further investigation into developmental dysplasia of the hip (DDH) in neonates. Clinical screening for DDH is still problematic in developing countries.     

LHRH messenger RNA in neurons in the intact and castrate male rat forebrain,studied by in situ hybridization

Summary The slow potential change (spc) accompanying spreading depression (SD) was studied in rats and in a seizure-sensitive strain of Mongolian gerbil under three different experimental paradigms, each involving the use of naloxone. Gerbils undergoing electroconvulsive shock treatment displayed SD during the post-ictal phase, which was blocked by the intraperitoneal (i.p.) administration of naloxone (20–50 mg kg^-1). Topical application of naloxone to the exposed cortex of the anaesthetized gerbil and rat blocked the spc of SD evoked by KCl. Microiontophoretic ejection of naloxone during extracellular recordings reversed cell refractoriness following the spc, demonstrated by the observation of a maintained sensitivity to iontophoretic pulses of glutamate. The results suggest a possible involvement of naloxone-sensitive processes in the mechanism responsible for cortical SD.