Spectrographic analysis of vowel and word duration in apraxia of speech

Most normal speakers of English reduce the duration of the stem word vowel as words increase in length. Theoretically, this durational reduction reflects low-level linguistic knowledge. We posed two questions in this study: First, do speakers with apraxia of speech progressively reduce vowel durations as words increase in length, and second, do these vowel and word durations differ significantly from normal productions? We asked 11 apraxia of speech patients and 11 normal speakers to repeat three sets of three words which progressively increased in length, and we analyzed these productions spectrographically. Our results revealed that both groups reduced vowel duration as words increased in length. Word and vowel duration for apraxia of speech patients, however, were often significantly longer than those for normal speakers. Our results suggest that vowel reduction is a robust phenomenon which resists impairment in apraxia of speech, despite often significant disturbances in motor programming.

High-frequency precise excision of the Drosophila foldback transposable element

Precise excision of transposable elements in prokaryotes is a rare event which occurs at a significantly lower rate than transposition and other element-mediated events. Thus, we were intrigued by a eukaryotic transposable element which seemed capable of precise excision at high frequencies. The white-crimson (wc) mutation in Drosophila, a highly unstable allele of the X-linked eye colour locus, white, resulted from the insertion of a member of the foldback (FB) transposable element family. This mutation reverts to its parental phenotype at a frequency of greater than 1 in 10(3) X chromosomes. Characterization of these revertants by Southern blots of genomic DNA indicated that they resulted from loss of the wc insertion. Here we report the nucleotide sequence of the excision point in these revertants, and conclude that the FB element responsible for the wc mutation is capable of precise excision at high frequencies.

An inhibitory effect of tumour promoters on human epithelial cell growth can be dissociated from an effect on junctional communication

Studies with rodent cells have indicated that the abilities of various tumour promoters to inhibit metabolic cooperation correlate with their potencies as mitogens. Here we have examined the effects of the most potent phorbol ester tumour promoter 12-O-tetradecanoyl phorbol-13-acetate (TPA), on metabolic cooperation and growth of human epidermal cells transformed by SV40 (SVK14 cells). In this system, TPA inhibits junctional communication and at the same concentration also inhibits growth in a reversible fashion. These effects appear to be mediated by binding of phorbol ester to a single class of high affinity binding site with a Kd similar to that reported for rodent cells (Kd = 20.9 nM at 4 degrees C). Further studies on the effects of phorbol esters on other human epithelial cell lines reveal that the inhibitory effects of TPA on growth and metabolic cooperation may be completely dissociated. Alternative mechanisms by which TPA may exert its growth-inhibitory effects are discussed.

Limitations of available tests for diagnosis of infectious mononucleosis

Among 500 students seen at a university health service for illnesses resembling infectious mononucleosis (IM), the diagnosis of IM was established in 124 (25%) on the basis of the initial presence or subsequent emergence of the spectrum of Epstein-Barr virus (EBV) antibodies characteristic of a primary EBV infection. Of these 124 patients, 113 had an EBV-specific antibody pattern in the initial serum indicative of current primary infection; however, 11 (9%) had no detectable immunoglobulin G antibodies to EBV-specific antigens in their first serum. The sensitivity of this panel of EBV antibody assays was 91% and the specificity was 100%. Initial sera had detectable heterophil antibodies for 107 (86%) of the 124 students with IM and for 2 with other illnesses. Among our patients, the Monospot (Ortho Diagnostics Inc.) test had a sensitivity of 86% and a specificity of 99%. Reliance on hematological criteria (lymphocyte count greater than or equal to 50% and atypical lymphocyte count greater than or equal to 10%) gave a sensitivity of only 39%, but a specificity of 99%. Students with IM who showed a delayed emergence of the spectrum of EBV-specific antibodies characteristic of an acute infection were compared with control patients who had such antibodies at the time of their initial visit to the health service. They were found to have a briefer duration of illness (P greater than 0.05), lower leukocyte (P less than 0.005), lymphocyte (P less than 0.005), and atypical lymphocyte (P less than 0.05) counts, and a less frequent occurrence of heterophil antibodies (P less than 0.05).

Effects of subacute low level lead exposure on glucose homeostasis

Administration of low levels of lead (0.001, 0.005 and 0.025 micrograms/g/day p.o.) to neonate rats from age three days to eight weeks failed to alter the activities of hepatic glucose-6-phosphatase, fructose-1,6-diphosphatase, pyruvate carboxylase and phosphoenolpyruvate carboxykinase, the four key gluconeogenic enzymes. Administration of lead at a higher dose (0.1 micrograms/g/day p.o.) was also observed to produce no alterations in enzyme activity at eight weeks. However, the higher dose did enhance the activities of fructose-1,6-diphosphatase and phosphoenolpyruvate carboxykinase at age six weeks. Plasma insulin and glucagon were not significantly altered by up to 0.025 micrograms/g exposure to lead until eight weeks of age, although levels of these hormones appear to be slightly dose-responsive tending towards elevated glucagon and decreased insulin levels with increasing lead dosage. At 0.1 micrograms/g/day glucagon was significantly increased at eight weeks. Blood glucose and hepatic glycogen remained unaltered. Blood, hepatic and pancreatic lead levels were unchanged by treatment with lead up to 0.025 micrograms/g/day to eight weeks of age, but there was evidence of lead accumulation in pancreatic tissue whereas levels of the metal in the liver paralleled those in the blood. Significant increases were observed with 0.1 micrograms/g/day lead at six and eight weeks in blood and pancreas. Data are presented which suggest that six week old animals are more influenced by subacute lead exposure than are the eight week old animals, as reflected in some alteration of gluconeogenic enzyme activity in younger rats.

Interdisciplinary model for the inpatient treatment of adolescents with anorexia nervosa

This paper describes the inpatient phase of an anorexia nervosa treatment program in an adolescent unit of a children's hospital. This program focuses on four goals: improving eating behavior, improving socialization, achieving initial weight gain, and engaging the patient and her family with an outpatient psychotherapist. The patients were divided into three groups according to severity. All five Group I patients (less than 25% body weight loss) had a composite 100% achievement of the four goals. Twenty out of 21 Group II patients (greater than 25% body weight loss) had 100% achievement of the four goals. Three out of six Group III patients (greater than 25% body weight loss and requiring hyperalimentation) had 100% achievement of the four goals. The success of this inpatient program is felt to be due to the pediatric-psychiatric collaboration, the involvement of the family during the inpatient phase, the therapeutic use of an interdisciplinary team and of the social system of the inpatient unit including other patients and recreation therapist.

Potentially life-threatening hypophosphatemia in anorexia nervosa

An anorexia nervosa patient with hypophosphatemia secondary to starvation and laxative abuse is reported. During the course of refeeding by tube with a high caloric balanced formula, the patient's serum phosphorous dropped from low normal on admission (2.7 mg/dl) to 0.4 mg/dl aggravated by an overdose of laxative she had stolen from the medicine cart. This required ICU monitoring during intravenous phosphorous administration. This case points out the potential hazard of oral realimentation in a severely cachectic anorectic.

Dermatologic practice: implications for a primary care residency curriculum

The problems encountered, diagnostic procedures performed, and treatments prescribed in dermatology were studied in a primary care practice and in a dermatology clinic. Referrals from a primary care practice to a dermatology practice were analyzed. It was determined that nine disease categories accounted for more than 75 percent of the problems encountered in both settings. Only one diagnostic procedure was performed commonly in both the primary care and dermatology practices--skin scraping for fungal infection. Approximately 90 percent of the treatments prescribed in both settings fell within 13 categories. It is proposed that these findings be the basis for designing the curriculum in dermatology for residents in primary care medicine. The curriculum also should provide practical experience in dermatology and familiarity with selected, rarely encountered dermatologic conditions that have important therapeutic implications.

Comparison of ADCC and NK activities of peripheral blood mononuclear cells from patients at risk for acquired immune deficiency syndrome (AIDS)

Numerous cellular immune defects have been described in patients with acquired immune deficiency syndrome (AIDS). These include anergy, reduced numbers of helper T cells, and decreased effectiveness of natural killer (NK) cells. In this study, we have measured the lytic activity of antibody-dependent cellular cytotoxic (K) cells using a recently described 51Cr release assay in patients clinically displaying lymphadenopathy syndrome (LAD). We then compared ADCC activity with NK activity, T helper/T suppressor ratios and NK cell number in these same patients. Our results indicate that a reduction of ADCC activity can occur in patients with LAD. In our study, patients that showed reduced ADCC activity also showed reduced NK cell function. Other individuals in this study had reduced NK function while ADCC values remained within the normal range. The degree of reversal of the T helper/T suppressor cell ratio was not a useful indicator of cellular immune function as measured by these assays in that individuals with very low ratios often had normal cytotoxic cell function while some patients with ratios in the normal range had decreased cytotoxicity. The percentage of NK cells as determined by HNK-1 monoclonal antibody also did not prove useful in defining potential cytotoxic activities.

An objective feature extraction technique applied to the Doppler waveforms from the groin: a prospective study

A group of 80 patients presenting with lower limb ischaemia were classified according to their arteriographic findings. The maximum frequency envelope from the Doppler waveforms obtained from the common femoral artery were retrospectively analysed using a mathematical feature extraction technique, principal component analysis (PCA). Two of the three coefficients uniquely describing each waveform were plotted and classified according to their arteriographic groupings. The best separating planes were then defined. Twenty-eight new patients were subsequently prospectively assessed using the principal components and separating planes defined in the previous study. The results were compared with the arteriographic findings and showed that PCA represents a significant improvement in diagnostic accuracy when compared with other techniques.

FB elements are the common basis for the instability of the wDZL and wC Drosophila mutations

The DNA insertions that cause the highly unstable mutations wC and wDZL share extensive homology with the FB family of transposable elements. FB elements carry long, internally repetitious, inverted terminal repeats and thus differ in structure from other transposable elements. Our results suggest that FB elements may excise and cause chromosomal rearrangements at unusually high frequencies. The wC insertion is a single FB element. The wDZL insertion differs in that it contains two FB elements, one at each terminus. The wC and wDZL insertions contain 4.0 and 6.5 kilobase nonhomologous segments between their terminal repeats. In contrast to the middle repetitive FB elements, the central segment of the wDZL insertion is single-copy and present at a fixed location in the wild-type genome. It has apparently been transposed by the action of flanking FB elements, causing the wDZL mutation at its new location.

Structure of the Drosophila mutable allele, white-crimson, and its white-ivory and wild-type derivatives

The white locus in Drosophila is required for a normal brick-red eye color; deletions of this locus result in a bleached-white eye color. The white-crimson (wc) allele of white was isolated as a partial revertant of another mutant white allele, white-ivory (wi), a mutation due to duplication of sequences within the white locus. The wc allele reverts at high frequencies to wild-type and wi phenotypes and generates white-eyed derivatives, including deletions with one endpoint at the white locus. We analyzed the structure of the wc allele by molecular cloning and by Southern blot analysis of genomic DNA and found that the wc phenotype results from the insertion of a 10 kilobase DNA sequence into the wi duplication. Five independent phenotypic revertants of wc to wi were examined, and in each case reversion was accompanied by apparently precise excision of the insertion. Reversion of wc to a wild-type phenotype in each of the six cases examined was mediated by excision of both the insertion and one copy of the wi duplication, restoring gene structure to wild-type.

Inhibition of epidermal growth factor binding to mouse cultured cells by fibroblast-derived growth factor. Evidence for an indirect mechanism

Fibroblast-derived growth factor (FDGF), a basic, heat- and acid-stable polypeptide partially purified from the serum-free conditioned medium of BHK cells transformed by simian virus 40, is a potent mitogen for Swiss 3T3 cells and causes a marked reduction in 125I-labeled epidermal growth factor (125I-EGF) binding to these cells. The activity which inhibits EGF binding coelutes with the growth-stimulating activity after gel filtration, ion exchange chromatography, and sodium dodecyl sulfate polyacrylamide gel electrophoresis. Both cellular responses are elicited by the same range of FDGF concentration in several murine cell types. The inhibition of EGF binding is rapid and results from a decrease in the apparent affinity of cellular receptors for 125I-EGF. FDGF does not affect the rate of cell-mediated 125I-EGF degradation. Several lines of evidence suggest that FDGF does not bind directly to EGF receptor. First, the effect of FDGF is dependent on the temperature of the assay; furthermore, treatment of cells with EGF results in loss of EGF receptors while exposure to FDGF for up to 24 h does not induce "down-regulation" of EGF receptors. Further, in A431 cells which display a large number of specific EGF receptors, 125I-EGF binding is not sensitive to FDGF. Finally, the effect of FDGF on 125I-EGF binding is not observed with isolated plasma membranes. Taken together, these findings suggest that FDGF binds to sites which are separate from EGF receptors. The results show a novel mechanism whereby a growth-promoting factor produced by a tumor cell line can rapidly modulate the affinity of the cellular receptors for EGF in an indirect manner.

Vibrotactile stimulation for intersystemic reorganization in the treatment of apraxia of speech

Intersystemic reorganization in the treatment of apraxia of speech involves pairing fragments of a speech motor program with internal cues generated by some other, more intact system. Gestural reorganization, pairing speech with limb gestures, somehow provides an organizational framework for the proper sequencing of motor speech movements. This paper briefly develops some hypotheses suggesting that afference resulting from limb movements rather than a central movement program is involved in gestural reorganization, and that vibrotactile stimulation may have advantages over visual or auditory modalities. The effectiveness of vibrotactile as compared to auditory stress cues was assessed in a multiple schedule design for 1 patient who had had a cerebrovascular accident. Results indicated that, in an imitative paradigm, vibrotactile plus auditory stress and rhythm cues were more effective than auditory cues alone improving an apraxic patient's imitative production of single words.

The psychological significance of somatic complaints

Patients experiencing psychological distress often come to their physicians with primarily somatic complaints. While patients provide their physicians with multiple clues that there is a functional cause to their complaints, physicians often fail to recognize these. Psychological states, including depression, schizophrenia, hypochondriasis, malingering, conversion reactions, anxiety states, the "identified patient" in a dysfunctional family, and the patient with a "hidden agenda" are examples of this somatization process. Physicians may recognize these problems and avoid needless interventions if they consider these diagnostic possibilities and ask their patients questions that differentiate the various psychological possibilities.

Experimental antigen-antibody complex disease in mice. The role of antibody levels, antibody affinity and circulating antigen-antibody complexes

Chronic antigen-antibody complex disease (A-ACD) was induced in mice by daily injections of HSA. The disease was characterized by death, intense glomerular basement membrane deposition of complexes in the kidneys, proteinuria and an impairment of the glomerular filtration rate. In mice that had been selectively bred to produce antibody of low affinity to protein antigens injected in saline, the incidence of chronic A-ACD was 61% compared to 21% in mice selectively bred to produce antibody of high affinity. Low affinity female mice produced approximately ten times as much free antibody to HSA as did low affinity males and high affinity males and females, but this did not result in an increase incidence of chronic A-ACD in low affinity female mice. Low affinity female mice also had the highest levels of circulating antigen-antibody complexes detected by conglutinin and Clq binding assays, but there was no correlation between the presence of high levels of complexes in serum and tissue damage. In both lines of mice the mean affinity of free antibody to HSA started low and increased with time and the number of injections of antigen. However, development of chronic A-ACD in individual low affinity mice appeared to be associated with a failure to produce this time-associated increase in antibody affinity. These results are discussed with reference to the relevance of the measurement of the amount of affinity of free antibody in serum and the levels of circulating antigen-antibody complexes to the production of tissue damage in this model of chronic A-ACD.

The distribution of acetylcholinesterase and choline acetyl transferase in the cerebellum and posterior lateral line lobe of weakly electric fish (Gymnotidae)

Cholinesterase was demonstrated in the caudal lobe of the cerebellum but not the corpus cerebelli of weakly electric gymnotid fish. It had a patchy distribution in the granule cell layer and was very dense in the molecular layer; the cholinesterase staining was also dense in the contiguous molecular layer of the subjacent electrosensory region. Choline acetyltransferase was also found in far greater amounts within the electrosensory region and caudal lobe of the cerebellum than within the corpus cerebelli itself.

Expression of the ribosomal DNA insertions in bobbed mutants of Drosophila melanogaster

We have shown earlier that interrupted rRNA genes in Drosophila melanogaster do not contribute significantly to rRNA production by a splicing mechanism (Long and Dawid 1979). In the work reported here the expression of interrupted rRNA genes was tested in several stocks that carry bobbed mutations, i.e., have partial deletions of their rRNA gene clusters. Transcripts of the major 5 kb type 1 insertion are very rare in bobbed flies as they are in the wild type, occurring at a concentration in embryos of less than one copy per nucleus. Transcripts of short type 1 insertions are more abundant in certain bobbed stocks, especially those carrying the car bb chromosome. However, other severely bobbed flies have no increase in these insertion transcripts over the wild-type levels. Type 2 insertions are transcribed into very rare RNA molecules in the wild type and in the bobbed genotypes that were studied. From these results we conclude that interrupted rRNA genes are not expressed through a splicing mechanism into mature rRNA in mutant or wild-type flies. Since even severely bobbed flies fail to utilize their interrupted rRNA genes, we suggest that these genes cannot be transcribed productively in D. melanogaster.

The effect of protein deficiency on the development of chronic antigen-antibody complex disease in mice

Mice genetically selected to produce antibodies of either high or low affinity to protein antigens injected in saline were fed either a normal protein diet or a protein-deficient diet and were given daily injections of HSA for up to 73 days to induce chronic antigen-antibody complex disease. In low-affinity mice fed the normal protein diet, this resulted in impairment of renal function, deposition of immunoglobulin, C3 and HSA in the glomeruli, high levels of circulating antigen-antibody complexes and death from apparent renal failure in 50% of the animals. High-affinity mice on either diet had no impairment of renal function, fewer deposits in the glomeruli, lower levels of circulating complexes and no deaths. Low-affinity mice fed the protein-deficient diet had less impairment of renal function and less glomerular deposition of complexes than did low-affinity mice fed the normal diet. In addition, none of these mice died from renal failure. These results demonstrate that the protein-deficient diet reduced the severity of the experimental chronic antigen-antibody complex disease in low affinity mice but did not increase the susceptibility of high-affinity mice to the disease.