The Effect of Quisqualic Acid-Induced Lesions of the Nucleus Basalis Magnocellularis on Latent Inhibition

Latent inhibition (LI) is a reduction in the rate of acquisition of a Pavlovian conditioned response that results from prior nonreinforced preexposure to a conditioned stimulus (CS). LI has been suggested to reflect the operation of mechanisms involved in stimulus selection for subsequent cognitive processing. The present experiment was conducted to assess the effect of bilateral lesions of the nucleus basalis magnocellularis (NBM) on LI employing a conditioned emotional response paradigm. Bilateral lesions of the NBM were produced by administration of 0.12 M quisqualic acid and resulted in decreased cortical acetylcholinesterase staining, as well as a 40% reduction in cortical choline acetyltransferase activity. Following lever press training, preexposed animals received 40 presentations of a 60-s tone CS. Nonpreexposed animals received no tone presentations. Acquisition of conditioned suppression was then assessed over the course of 4 tone-shock (0.6 mA, 0.5 s) pairings. Control, preexposed animals displayed a retarded rate of acquisition in comparison to nonpreexposed controls, thereby demonstrating that the parameters used in the present experiment produced LI. In contrast, lesioned animals preexposed to the CS acquired conditioned suppression as readily as non-preexposed lesioned animals. However, the acquisition of conditioned suppression in both lesioned groups was found to be similar to that displayed in the preexposed control group. This pattern of results was interpreted as being attributable to a lesion-induced impairment in the ability to maintain stimulus processing, rather than a deficit in the ability to filter a stimulus. Copyright © 1996 Elsevier Science Inc.     

Establishment of a liaison service for pregnant opiate-dependent women

A pregnancy liaison and outreach service was developed as part of a community drug team to attract pregnant drug-dependent women into treatment. Women were provided with information on harm reduction, safer drug use and offered treatment for drug dependence. In total, 43 women (45 pregnancies) presented to the service over a 30-month period. Thirty-four women began out-patient treatment of opiate dependence. There was a significant reduction in maternal methadone dose by delivery. Of the 45 pregnancies, four women had therapeutic abortions, two first trimester and two second trimester spontaneous abortions and 34 live births (three women remained untraceable). All the pregnancies that continued to the third trimester proceeded uneventfully with a consequent live birth. Mean gestational age was 37.9 ±3.7 weeks, mean birth weight was 2863 ± 526 g, 10 of the babies were small for gestational age. Fifteen babies required medication for neonatal withdrawal symptoms; mothers whose babies exhibited withdrawal symptoms were using significantly higher doses of methadone at delivery than mothers whose babies did not withdraw. The importance of providing this type of service for women drug users in the 1990s is discussed.     

LICHEN PLANUS SUBTROPICUS: DIRECT IMMUNOFLUORESCENCE FINDINGS AND THERAPEUTIC RESPONSE TO HYDROXYCHLOROQUINE

A 32-year-old black woman presented with the complained of a l-year history of asymptomatic “dark areas” on her face and neck. New lesions developed throughout this time and, once present, slowly increased in size and persisted. She denied systemic symptoms, including arthralgias and myalgias. Her occupation as a real estate agent involved frequent outdoor work. The family history was noncontributory. On physical examination there were multiple hyperpig-mented round-to-oval macules and papules measuring from 0.5 to 2.0 cm in diameter and located over the photoexposed lateral aspects of the face and neck (Figs. 1 and 2). New lesions were papules characterized by a subtle, raised “thread-like” border (Fig. 1, arrow). Older lesions were mac-ular, some with a slightly atrophic, hypopigmented center (Fig. 1, Flesh-colored polygonal papules were present in the V-shaped area on the anterior neck (Fig. 2). The remainder of the cutaneous examination, including the oral mucosa, was unremarkable. Histopathologic examination of a flesh-colored papule viewed on low power revealed a bandlike lymphohistiocytic infiltrate that focally obscured the dermoepidermal junction. Numerous homogenous eosinophilic bodies (Civatte bodies, cytoid bodies, apoptotic cells) and scattered melanophages were identified. In addition, there was epidermal hyperplasia, overlying orthokeratosis, and V-shaped hyper-granulosis. The rete was jagged and possessed a slightly eosinophilic hue (Fig. 3). Hyperpigmented, oval macules had a more patchy lichenoid infiltrate, less epidermal hyperplasia, but possessed a greater number of melanophages in the papillary dermis than new lesions. Periodic acid-Schiff (PAS) stained sections of either type of specimen were negative for basement membrane thickening and also negative for dermal mucin using the colloidal iron reagent. No deposits of immunoglobulin or complement were identified at the dermoepidermal junction by direct immunofluorescence microscopy, but numerous immunoglobulin-coated cytoid bodies were present. Laboratory testing was significant for a negative antinu-clear antibody (ANA) reaction and RPR. A complete blood cell count, results of serum chemistry, and the angiotensin converting enzyme level were within normal limits. Chest roentgenogram revealed no active cardiopulmonary disease. Based on the distinctive histopathology and the impressive, characteristic clinical presentation, the diagnosis of lichen planus subtropicus was made. Therapy with hydroxy-chloroquine 200 mg per day, topical hydrocortisone valerate 0.2% cream b.i.d. to inflammatory lesions, 3% hydroquinone solution b.i.d. to hyperpigmented lesions, and photoprotection were initiated. Partial resolution of the lichenoid lesions has occurred, new lesions have ceased to appear, and the hyperpigmentation has slightly improved.     

Disappearance of phantom limb pain following hyperbaric oxygen therapy

A 67 year old man with severe peripheral vascular disease and subsequent bilateral below knee amputations was treated with hyperbaric oxygen therapy for non-healing ulcers on his right leg stump. After one treatment on a 10 metre table (105 minutes) his previously severe phantom limb pain resolved and has since not returned. This has not previously been described and warrants further study.     

Aetiology of Acute Pharyngitis and Clinical Response to Empirical Therapy with Erythromycin Versus Amoxicillin

Guthrie R M, Ruoff G E, Rofman BA, Ginsberg D, Karp R R, BrownS M and Schulz GA. Aetiology of acute pharyngitis and clinicalresponse to empirical therapy with erythromycin versus amoxicillin.Family Practice 1988; 5: 29–35. One hundred and eighty-nine adults with acute pharyngitis hadculture and serological evaluation for groupA beta haemolyticstreptococci (GABHS), Mycoplasma pneumoniae, and Branhamellacatarrhalis. Sixteen patients had evidence for infection withGABHS, none for M. pneumoniae, and one for B. catarrhalis. Forthose with GABHS, there was no significant difference betweenempirical treatment by erythromycin or amoxicillin. For thosewithout GABHS, empirical treatment with erythromycin appearedto result in a statistically significant reduction in coughand a noticeable but less than significant reduction of othersymptoms when compared to empirical treatment with amoxicillin.The new formula tion of erythromycin utilized in this study(PCE) may be associated with a reduction in gastrointestinalintolerance from that reported with other erythromycin products.     

Phonological development: a normative study of British English‐speaking children

This paper reports a normative study on the phonological development of British English‐speaking children. Speech samples of 684 children, aged between 3;0 and 6;11 years, randomly selected from nurseries and schools in eight different areas throughout the UK, were collected and analysed to obtain normative data. This paper reports on two aspects of speech development: the age of acquisition of sounds (phonetic acquisition) and the age that error patterns were suppressed (phonemic acquisition). It discusses the effects of age, gender and socio‐economic status on speech sound development. The study found that older children had more accurate production and fewer error patterns in their speech. It found no gender differences in the younger age groups. However, in the oldest age group, it found the phonological accuracy measures of girls' better than boys. It found no significant effects of socio‐economic status on any of the phonological accuracy measures.     

Lipoprotein snthesis and secretion b cultured human intestinal mucosa

Abstract. We tested whether cultured human jejunal mucosa incorporates fatt acid into esterified lipids and whether organ culture can serve as a model ss'em to stud lipoprotein secretion b the human gut. Jejunal biopsies obtained from seven subjects were cultured for 24 h in medium containing 2 μCi of [³H]palmitic acid. More than 95% of the radioactivit incorporated b the tissue was found to be associated with esterified lipids: triglcerides, cholesterol esters and phospholipids, 7–8±1–2, 0–5±01 and 14-0±1–5 nmol/10 mg weight respectivel. During the culture labelled triglcerides, phospholipids and cholesterol esters were secreted to the medium. Most of the newl snthesized esterified lipids in the medium were found in the d < 1 019 g/ml and d = 1019–1063 g/ml fractions. The majorit of the newl snthesized triglcerides were found in the d < 1 019 g/ml fraction. Labelled cholesterol esters were enriched in the d = 1 -063-1-21 g/ml fraction.
Boiled biopsies adsorbed negligible amounts of radioactive palmitic acid and did not snthesize esterified lipids. The addition of puromcin to the culture medium and preincubation with colchicine resulted in decreased uptake of the labelled fatt acid and decreased secretion of esterified lipids to the medium. These experiments indicate that cultured human intestinal mucosa is a suitable model to stud lipid snthesis and lipoprotein secretion b the human intestine.     

A comparison of bonfils fiberscope‐assisted laryngoscopy and standard direct laryngoscopy in simulated difficult pediatric intubation: a manikin study

Introduction: Difficult airway management in children is challenging. One alternative device to the gold standard of direct laryngoscopy is the STORZ Bonfils fiberscope (Karl Storz Endoscopy, Tuttlingen, Germany), a rigid fiberoptic stylette‐like scope with a curved tip. Although results in adults have been encouraging, reports regarding its use in children have been conflicting. We compared the effectiveness of a standard laryngoscope to the Bonfils fiberscope in a simulated difficult infant airway. Methods: Ten pediatric anesthesiologists were recruited for this study and asked to perform three sets of tasks. For the first task, each participant intubated an unaltered manikin (SimBaby ^TM, Laerdal, Puchheim, Germany) five times using a styletted 3.5 endotracheal tube (ETT) and a Miller 1 blade (group DL‐Normal). For the second task, a difficult airway configuration simulating a Cormack‐Lehane grade 3B view was created by fixing a Miller‐1 blade into position in the manikin using a laboratory stand. Each participant then intubated the manikin five times with a styletted 3.5 ETT using conventional technique but without touching the laryngoscope (group DL‐Difficult). In the third task, the manikin was kept in the same difficult airway configuration, and each participant intubated the manikin five times using a 3.5‐mm ETT mounted on the Bonfils fiberscope as an adjunct to direct laryngoscopy with the Miller‐1 blade (group BF‐Difficult). Primary outcomes were time to intubate and success rate. Results: A total of 150 intubations were performed. Correct ETT placement was achieved in 100% of attempts in group DL‐Normal, 90% of attempts in group DL‐Difficult and 98% of attempts in BF‐Difficult. Time to intubate averaged 14 s (interquartile range 12–16) in group DL‐Normal; 12 s (10–15) in group DL‐Difficult; and 11 s (10–18) in group BF‐Difficult. The percentage of glottic opening seen (POGO score) was 70% (70–80) in group DL‐Normal; 0% (0–0) in group DL‐Difficult; and 100% (100–100) in group BF‐Difficult. Discussion: The Bonfils fiberscope‐assisted laryngoscopy was easier to use and provided a better view of the larynx than simple direct laryngoscopy in the simulated difficult pediatric airway, but intubation success rate and time to intubate were not improved. Further studies of the Bonfils fibrescope as a pediatric airway adjunct are needed.