Genetic analysis of deciduous tooth size in Australian twins

Investigations of permanent dental crown size in twins and family groups indicate a high degree of transmissible control, but little is known about the relative contributions of genetic and environmental factors to variation in size of the deciduous (primary) teeth. Here, maximum mesiodistal and buccolingual crown dimensions of maxillary and mandibular primary teeth were measured from dental models of 602 individuals, including 99 monozygous (MZ) twin pairs, 81 dizygous (DZ) same-sex pairs, 41 DZ opposite-sex pairs, and 160 singletons. Data were subjected to univariate genetic analysis with the structural-equation-modelling package, Mx using the normal assumptions of the twin model. A model incorporating additive genetic (A) and unique environmental (E) variation was found to be the most parsimonious for all tooth-size variables. Estimates of heritability for deciduous crown size ranged from 0.62 to 0.91. This study shows that variation in deciduous crown size has a strong genetic component, similar to that observed in the permanent dentition. Further studies are required to determine whether the underlying genetic mechanisms are the same for both deciduous and permanent teeth.

Relationship between performance on tests of basic visual functions and visual-perceptual processing in persons after brain injury

OBJECTIVE

In this correlational study of adults receiving occupational therapy who sustained a cerebrovascular accident (CVA), the relationship between basic visual functions (including acuity, visual field deficits, oculomotor skills, and visual attention or scanning) and higher level visual-perceptual processing skills (e.g., visual closure and figure-ground discrimination) was investigated.

METHOD

Thirty adults who sustained CVA and 20 adults without a history of CVA were given a basic visual function screening and the Motor-Free Visual Perception Test (MVPT). Scores on the vision screening and the MVPT were correlated statistically.

RESULTS

A Pearson product-moment correlation analysis produced a correlation of r = .75 between vision screening scores and scores from the MVPT.

CONCLUSION

These results suggest that a positive relation exists between basic visual functions and visual-perceptual processing skills. Further, the results suggest that evaluation of visual-perceptual processing skills must begin with assessment of basic visual functions so that the influence of these basic visual functions on performance in more complex tests can be taken into consideration.

Therapeutic interventions to improve upper extremity recovery and function

In this article, the authors discuss motor control deficits in the upper extremity following stroke that interfere with the ability to perform daily life activities. The authors then review conditions of practice that promote learning of motor skills and how well several current intervention approaches adhere to these practice conditions. For each intervention approach, the authors discuss the evidence for effectiveness of the approach in facilitating motor skill gains.

Vaccination with irradiated autologous melanoma cells engineered to secrete human granulocyte-macrophage colony-stimulating factor generates potent antitumor immunity in patients with metastatic melanoma

We conducted a Phase I clinical trial investigating the biologic activity of vaccination with irradiated autologous melanoma cells engineered to secrete human granulocyte-macrophage colony-stimulating factor in patients with metastatic melanoma. Immunization sites were intensely infiltrated with T lymphocytes, dendritic cells, macrophages, and eosinophils in all 21 evaluable patients. Although metastatic lesions resected before vaccination were minimally infiltrated with cells of the immune system in all patients, metastatic lesions resected after vaccination were densely infiltrated with T lymphocytes and plasma cells and showed extensive tumor destruction (at least 80%), fibrosis, and edema in 11 of 16 patients examined. Antimelanoma cytotoxic T cell and antibody responses were associated with tumor destruction. These results demonstrate that vaccination with irradiated autologous melanoma cells engineered to secrete granulocyte-macrophage colony-stimulating factor stimulates potent antitumor immunity in humans with metastatic melanoma.

Comparison of exposed dentinal surfaces resulting from abrasion and erosion

The aim of this study was to compare the shape of exposed dentinal surfaces caused by abrasion and erosion with a view to developing a diagnostic clinical test. The study material consisted of 80 natural teeth and 129 dental models obtained from Australian Aborigines known to display considerable dental abrasion due to their diet, and dental models of 37 Caucasians diagnosed with dental erosion through detailed history and dietary analysis. Polyvinyl siloxane impressions were obtained of all occlusal surfaces with dentinal scooping in both the 'abrasion' and 'erosion' groups. All impressions were sectioned buccolingually through the deepest point of the scooped dentine, and then the profiles were photocopied at x2 magnification. The breadth and depth of dentinal profiles were measured to an accuracy of 0.1 mm, enabling ratios of depth:breadth to be determined, and the position of the deepest part of each scooped surface was recorded. The mean depth:breadth ratio of scooped dentine was significantly greater in the Aboriginal natural teeth (0.19 +/- 0.06, mean +/- SE) than in the Aboriginal dental models (0.15 +/- 0.04). Both Aboriginal natural teeth and models with abrasion showed significantly smaller ratios (p < 0.05) than the Caucasian models showing erosion (0.33 +/- 0.07). Furthermore, in the abrasion samples, the deepest region of the scooped dentine tended to be lingually placed more often in maxillary teeth but buccally placed more often in mandibular teeth (p < 0.05). These results indicate that scooped dentine on abraded occlusal surfaces of teeth displays significant differences in shape compared with that caused mainly by erosion.

A randomized, controlled pilot study of a home-based exercise program for individuals with mild and moderate stroke

BACKGROUND AND PURPOSE

Many stroke survivors have minimal to moderate neurological deficits but are physically deconditioned and have a high prevalence of cardiovascular problems; all of these are potentially modifiable with exercise. The purposes of this randomized, controlled pilot study were (1) to develop a home-based balance, strength, and endurance program; (2) to evaluate the ability to recruit and retain stroke subjects; and (3) to assess the effects of the interventions used.

METHODS

Twenty minimally and moderately impaired stroke patients who had completed inpatient rehabilitation and who were 30 to 90 days after stroke onset were randomized to a control group or to an experimental group that received a therapist-supervised, 8-week, 3-times-per-week, home-based exercise program. The control group received usual care as prescribed by the patients' physicians. Baseline and postintervention assessments included the Fugl-Meyer Motor Assessment, the Barthel Index of Activities of Daily Living (ADL), the Lawton Scale of Instrumental ADL, and the Medical Outcomes Study-36 Health Status Measurement. Functional assessments of balance and gait included a 10-m walk, 6-Minute Walk, and the Berg Balance Scale. Upper extremity function was evaluated by the Jebsen Test of Hand Function.

RESULTS

Of 22 patients who met study criteria, 20 completed the study and 2 refused to participate. The experimental group tended to improve more than the control group in motor function (Fugl-Meyer Upper Extremity: mean change in score, 8. 4 versus 2.2; Fugl-Meyer Lower Extremity: 4.7 versus -0.9; gait velocity: median change, 0.25 versus .09 m/s; 6-Minute Walk: 195 versus 114 ft; Berg Balance Score: 7.8 versus 5; and Medical Outcomes Study-36 Health Status Measurement of Physical Function: 15. 5 versus 9). There were no trends in differences in change scores by the Jebsen Test of Hand Function, Barthel Index, and Lawton Instrumental ADL Scale.

CONCLUSIONS

This study demonstrated that a randomized, controlled clinical trial of a poststroke exercise program is feasible. Measures of neurological impairments and lower extremity function showed the most benefit. Effects of the intervention on upper extremity dexterity and functional health status were equivocal. The lasting effects of the intervention were not assessed.

Cancrum oris (noma) in a patient with acute lymphoblastic leukaemia. A complication of chemotherapy induced neutropenia

Cancrum oris (noma) has been most commonly described in malnourished debilitated children with poor oral hygiene following systemic childhood infections such as measles, pertussis or scarlet fever. We describe a patient who developed this condition during a period of profound neutropenia following cytotoxic chemotherapy for acute lymphoblastic leukaemia.

The effect of gender and age at onset of depression on mortality

BACKGROUND

Depression has a marked negative impact on geriatric patient mortality and morbidity. The risk factors and exact reasons for these effects are not well understood.

METHOD

Seeking to better define the factors, we retrospectively analyzed the effects of gender and age at onset of affective disorder in a naturalistic study of 192 geriatric patients consecutively admitted to a large midwestern tertiary care center between 1980 and 1987 for the treatment of unipolar depression.

RESULTS

After controlling for age at index admission, patients with an onset of depression before age 40 suffered significantly (p < .05) less mortality in follow-up than those with onset after age 40. When effects of gender are examined, the effects of age at onset are most profound in women, with a threefold increase in the rate of death in the cohort with age at onset of depression after 70 years when compared to those with onset before age 40.

CONCLUSION

These results and those of others suggest that depressed elderly women with no previous history of affective disorder are at a markedly increased risk compared with elderly women with a history of affective illness for morbidity and mortality and that a significant proportion of elderly depressed patients are admitted to a psychiatric hospital for a depression that is secondary to serious medical illness.

Palatal rugae patterns in Australian aborigines and Caucasians

The purpose of this study was to determine whether rugae patterns change with age and to compare the number and pattern of rugae in Australian Aborigines with those of Caucasians. For the longitudinal part of the study, serial dental casts of ten Aborigines, from 6 to 20 years of age, were examined and rugae patterns were recorded. To enable comparisons to be made between different ethnic groups an additional 100 dental casts of Australian Aborigines and 200 casts of caucasians, ranging in age from 13 to 17 years, were examined. Characteristics observed were number, length, shape, direction and unification of rugae. The length of rugae increased significantly with age but the total number of rugae remained constant. Thirty-two per cent of rugae showed changes in shape, while 28 per cent displayed a change in orientation. In contrast to studies suggesting that rugae move forward with age, the majority of Aboriginal rugae that changed direction moved posteriorly. Changes in rugae patterns have been assumed to result from palatal growth but alterations in pattern were observed in the Aboriginal sample even after palatal growth had ceased. The mean number of primary rugae in Aborigines was higher than in Caucasians, although more primary rugae in Caucasians exceeded 10 mm in length than in Aborigines. The most common shapes in both ethnic groups were wavy and curved forms, whereas straight and circular types were least common. There was a statistically significant association between rugae forms and ethnicity, straight forms being more common in Caucasians whereas wavy forms were more common Aborigines.

Activation without selection: parallel right hemisphere roles in language and intentional movement?

Because language and praxis each require the activation and selection of knowledge structures in long-term memory (MacKay, 1985, 1987), it is reasonable to consider whether hemisphere asymmetries for such processes span both domains. Language and skilled movement are thought to be strongly lateralized to the left hemisphere in most individuals. Yet, although recent evidence suggests that the right hemisphere also contributes to language use in context, few similar arguments have been made for the right hemisphere's involvement in motor planning. In this paper, we review some of the evidence for a right hemisphere role in language and action processing and propose that within each domain the right hemisphere activates a range of relevant knowledge structures without selection.

Pulmonary Nocardiosis in a patient with human immunodeficiency virus disease

Nocardiosis is an uncommon disease which occurs most often in patients with impaired cellular immunity, yet is rarely reported in patients with Human Immunodeficiency Virus Disease. We present the first case of Nocardiosis seen at the University Hospital of the West Indies, occurring in a well-controlled diabetic with Human Immunodeficiency Virus Disease.

Effect of ECT on mortality and clinical outcome in geriatric unipolar depression

BACKGROUND

Recent reports have called into question the safety and effectiveness of electroconvulsive therapy (ECT).

METHOD

To investigate these claims, the effects of ECT on clinical outcomes were examined as part of a retrospective, naturalistic study of 192 geriatric patients consecutively admitted between 1980 and 1987 to a large midwestern tertiary care center for the treatment of depression. Data were analyzed by a variety of parametric and nonparametric methods including ANOVA and survival analysis.

RESULTS

Patients who received ECT (N = 108) were more likely to exhibit psychomotor retardation and to have had prior courses of ECT than those who did not receive ECT (N = 84). Furthermore, despite the absence of differences in the overall rate or severity of medical comorbidity, patients receiving ECT were more likely to be alive at follow-up and to demonstrate greater clinical improvement than those treated only with pharmacotherapy.

CONCLUSION

These results confirm previous studies demonstrating the superior efficacy of ECT as compared with conventional pharmacotherapy treatment in patients hospitalized with depression and document its safety in long-term follow-up.

Activation of lexical codes for simultaneously presented words: modulation by attention and pathway strength

Horizontal and vertical stings were presented in a "crosswords" format within left or right visual fields. Distractor strings were varied to examine the extent to which prelexical, orthographic-phonological, and semantic codes are activated for words not focally attended. The results supported 2 predictions of the pathway strength model of attentional modulation (JD Cohen, K Dunbar & JL McClelland, 1990). First, distractor influences were greater when participants attended to the weaker (ie, vertical) item and ignored the stronger (ie, horizontal) string, than vice versa. Second, distractors similar to the target facilitated, whereas dissimilar distractors interfered with, pronunciation responses. It is concluded that spatial attention can modulate word recognition processes, and that some interesting questions emerge when one abandons the assumptions of serial, noninteractive word recognition processes.

Agenesis of permanent maxillary lateral incisors in South Australian twins

The frequency of agenesis of maxillary lateral incisors (I2) in a sample of South Australian twins was determined, and associations with gender, zygosity, birthweight and dental crown size were investigated. Ten of the 446 twins examined (2.24 per cent) displayed agenesis of one or both I2, a similar frequency to that reported for Australian singletons. Seven of the ten affected individuals were monozygous female twins, including two pairs, while the three affected dizygous twins were each from different male twin pairs. Five pairs of monozygous twins were identified who displayed varying expressions of normal, small, peg-shaped or missing I2. These twin pairs displayed disparate birthweights suggesting they may have been mono-chorionic. These findings are consistent with a multifactorial threshold model linking size and number of I2 with developmental influences modifying phenotypic expression in those monozygous twins whose genetic predisposition places them near to the threshold for agenesis.

Case study: antimanic effectiveness of dextroamphetamine in a brain-injured adolescent

A relatively enduring and counterintuitive antimanic response to dextroamphetamine in a brain-injured adolescent who had failed trials involving divalproex, lithium, haloperidol, and carbamazepine is described. This finding combined with data from previous reports of antimanic effects of test doses of stimulants imply that such a pharmacological probe may prove relevant for the prediction of treatment response of mania to dextroamphetamine and perhaps for subclassification of bipolar disorder.

Depth of associated activation in the cerebral hemispheres: mediated versus direct priming

This study investigated the depth of associative activation in the cerebral hemispheres. Semantic priming was assessed for direct (WATER-DRINK) and indirect (mediated: SOAP-DRINK) associates presented to the left and right visual fields across stimulus-onset-asychronies (SOAs) of 50, 250 and 750 msec. Priming for both the direct and indirect associates was found in both visual fields at all SOAs. Our results imply that activation via associated relations in semantic memory is early and extensive in both hemispheres. We relate our findings to the previous suggestion [5, 9, 14] that meaning activation is more narrow in the left hemisphere (LH) than in the right hemisphere (RH).

Providing instruction in independent living and vocational rehabilitation for individuals with head injuries within an entry-level occupational therapy curriculum

With the goal of occupational therapy being to assist persons in living independently, few occupational therapists (OTs) work in independent living and vocational settings or are heavily engaged in independent living and vocational interventions. Ultimately, clients suffer when attempting to reintegrate into the community without adequate resources, especially persons with head injuries who present with numerous disabilities. Perhaps OTs are not well-trained to provide these services. This paper describes the incorporation of information about service provision within the independent living and vocational rehabilitation models, especially related to individuals with head injuries, into the University of Kansas' occupational therapy curriculum. Evaluations indicated success in increasing knowledge about and improving attitudes regarding service provision within these models and the community integration of individuals with head injuries.

Female submissiveness, nonverbal behavior, and body boundary definition

Previous studies in the United States have suggested that submissive women may be more vulnerable to criminal victimization because they present certain cues of vulnerability. Richards, Rollerson, and Phillips (1991) observed that submissive women exhibited more controlled body movements and more body-concealing clothing than did dominant women. Our purpose here was to determine whether such variability might be due to differences in body boundary definition. The results revealed no significant difference in the body boundary indicators of dominant and submissive subjects but did suggest that highly feminine women are more likely to have weak body boundaries than are more androgynous women.

Feminist method and qualitative research about midlife

This paper identifies criteria seen as essential to feminist research. In light of these criteria, issues which have arisen during our current research on women and their experiences of midlife and menopause are discussed. Issues considered include the researchers' responsibilities to participants when exploring sensitive and highly personal issues relating to participants' life experiences, and less clear cut issues such as knowledge construction, power and control. In relation to the latter the balance of power in the research-participant relationship, and the role and responsibilities of the researcher in knowledge construction, are explored. Foucault's notions of knowledge construction and power and control and the feminist researcher's position, are considered in terms of rigour in feminist research and dissemination of research reports. Issues which are seen as problematic and worthy of further debate are: the relations between interviewer and interviewee; the intellectual (the researcher) as the bearer of universal values and as truth teller; and the level of critical activism possible in research studies of this nature.

Leukemia inhibitory factor prevents the death of axotomised sensory neurons in the dorsal root ganglia of the neonatal rat

Leukemia inhibitory factor (LIF) has several characteristics of a neurotrophic factor for sensory neurons. Here we have investigated whether LIF also supports the survival of axotomised sensory neurons in vivo. Newborn rat pups received a unilateral sciatic nerve transection and the injury site was treated with gelfoam soaked in phosphate buffered saline (PBS), nerve growth factor (NGF), or LIF. Neuronal nucleoli in the L5 dorsal root ganglia were counted, appropriate corrections applied, and the resultant neuronal loss expressed as a percentage of the contralateral intact side. In animals where LIF was administered neuronal loss was significantly reduced: 2 days after LIF treatment neuronal loss was 19.5% compared to 43% in PBS-treated animals; 3 days after LIF treatment neuronal loss was 20.4% compared to 40.2% in PBS-treated animals; however, 7 days after LIF treatment there was no significant reduction in the number of neurons lost. The degree of rescue of sensory neurons in vivo by LIF was found to be similar to NGF, which was not surprising as both factors supported the survival of a similar population of sensory neurons in vitro. Rescue was not observed when LIF-containing gelfoam was placed away from the axotomised nerve, suggesting that LIF's action may be associated with its retrograde transport or direct signalling at the site of nerve injury.

Childhood diarrhoea and acute respiratory infections in developing countries

In 1990 childhood diarrhoea and acute respiratory infections together accounted for 7.5 million deaths of children younger than five years of age in developing countries. To decrease mortality and treatment costs associated with these illnesses, the World Health Organization has developed standard diagnostic and treatment procedures for health staff, and is working on strategies for disease prevention. Immunisation against measles, adequate nutrition, including exclusive breastfeeding for the first four to six months, and improved water supplies and sanitation are the most important preventive measures. The 1990 World Summit for Children has set goals of a 50% reduction in childhood mortality from diarrhoea and a 33% reduction in mortality from acute respiratory diseases by the year 2000. These goals can be achieved by political commitment and a major investment of resources, but sustained support for these efforts from the medical professions is crucial.