A trial of eye movement desensitization compared to image habituation training and applied muscle relaxation in post-traumatic stress disorder

Thirty-six patients with PTSD were randomly allocated to individual treatment with imaginal exposure (image habituation training -- IHT), or applied muscle relaxation (AMR) or eye movement desensitization (EMD). Assessment by a blind independent rater and self-report instruments applied pre and posttreatment and at 3-month follow-up indicated that all groups improved significantly compared with a waiting list and that treatment benefits were maintained at follow-up. Despite a failure to demonstrate differences among groups, there was some suggestion that immediately after treatment EMD was superior for intrusive memories.

Silicone-fat differentiation in the breast: exploiting the bright-fat phenomenon in fast spin-echo MR imaging

Selective suppression of silicone or fat with chemical shift-selective (CHESS) pulses is difficult because of the small chemical shift difference between the primary lipid signal and the primary silicone signal at 1.5 T. Differentiation of these chemically distinct species is, however, an important clinical task in assessing implant rupture and silicone migration in breast tissue. A method uniquely suited for silicone-fat differentiation with fast spin-echo (FSE) sequences is reported. It is based on the dependence of fat signal on echo spacing in FSE imaging and results show that it may provide a clinically robust method for silicone-fat differentiation in magnetic resonance imaging of the breast.

Two autistic savant readers

Two young autistic children of normal intelligence were tested repeatedly for their reading ability. Their comprehension was appropriate for their developmental status, however, they had reading speeds that were considerably faster than those of their age-matched normal controls. Randomizing word order, and thereby reducing meaningfulness, resulted in an equivalent reduction in relative reading speeds for the younger autistic subject and his control. For the older of the normal children, the effect of randomizing word order was very marked, whereas its effect was minimal for the older of the two autistic boys. The results are regarded as an indication that efficient grapheme-phoneme conversion is a modular component of the reading skill and this transcoding process is primarily responsible for the fast reading of the autistic children.

Synthesis and properties of a photoaffinity labeling reagent for protoporphyrinogen oxidases, the target enzymes of diphenyl ether herbicides

A diazoketone 3 has been synthesized in two steps from acifluorfen 1, a diphenyl ether herbicide. Like the parent compound 1, the diazoketone 3 is toxic to plant cells and inhibits protoporphyrinogen oxidase, the molecular target of diphenyl ether herbicides. On photolysis of 3 in methanol, the generated carbene mainly undergoes the Wolff rearrangement to a ketene which further adds methanol, but many other products are observed. A tritiated derivative of 3 has been prepared which is suitable for photoaffinity labeling experiments.

Postmastectomy complications in breast reconstruction

In a group of patients where breast reconstruction was performed at the time of mastectomy, the incidence of complications was studied. One hundred one consecutive patients had an autologous reconstruction using the transverse rectus abdominis musculocutaneous flap, and 115 consecutive patients had a prosthetic reconstruction with tissue expanders or with tissue expander and/or implant. One patient in the autologous reconstruction group had a cardiac arrhythmia requiring monitoring, but there were no other serious complications. Infection was more common in the group undergoing prosthetic reconstruction (5% compared with 3% in the autologous reconstruction group). A total of 8% of the patients in the group undergoing prosthetic reconstruction had to have their implants removed because of infection or exposure of the implant. Seven percent of the transverse rectus abdominis musculocutaneous flap patients had significant necrosis of a portion of the flap. Secondary surgical revision of the reconstructed breast was much more common (20%) in the prosthetic reconstruction group compared with 6% in the autologous reconstruction group.

An analysis of social and psychological characteristics of women volunteering to become oocyte donors

OBJECTIVES

To design a recruitment program and analysis to determine social and psychological characteristics of women who volunteer to be oocyte donors; to evaluate consistency between clinical interviews and psychological testing; and to determine whether socially and psychologically normal women tend to volunteer.

PARTICIPANTS

Over a 2-year period 95 women were recruited from a middle-class population surrounding the medical center. Candidates were evaluated on the basis of clinical interviews and performance on the Minnesota Multiphasic Personality Inventory. Seventy-three percent were accepted, and 63% donated oocytes.

INTERVENTIONS

Interviews and psychological test evaluation were conducted independently by a clinical sociologist and a clinical psychologist; selections were made in a meeting of the treatment team.

RESULTS

Interview and test data demonstrated consistency and indicated that women who volunteer tend to be socially conventional, outgoing, and free from psychopathology. The typical donor tends to be 26 years old, married with one or two children, holds religious or spiritual beliefs, has 2 years of college, works at least part-time in a white collar job, and is a person with high energy who has additional interests. Incidence of dysfunction in family of origin or family of orientation (abandonment, abuse) is unremarkable. Although motherhood is highly valued by oocyte donor volunteers, in test performance this group does not endorse traditional female role stereotypes.

CONCLUSIONS

We have determined that this recruitment protocol is reliable for screening normal oocyte donors and would recommend its use in programs involved in oocyte donation.

Do young calendrical calculators improve with age?

The calendrical calculation performance of two 10-year-old children of the same intelligence level (IQ 90) but different calendrical ability, was compared with the performance of eight adult idiot-savant calculators. The calculating speeds of the two 10-year olds fell within the range of the reaction times of the adult savants. No improvement was detectable in a series of successive trials over time, either in speed or accuracy. It is concluded that the young calculators have already inferred rules about calendrical structure and that their performance cannot be accounted for by practice alone, but these savants use cognitive strategies to aid their performance.

Talents and preoccupations in idiots-savants

The question was asked whether a diagnosis of autism or a tendency to repetitive behaviour and preoccupation with a restricted area of interest, were crucial features of idiot-savant talents. Answers by caretakers to a questionnaire on these topics revealed that autistic and nonautistic savants resembled each other closely in preoccupation but differed from controls matched for IQ and diagnosis. In addition, the mentally handicapped showed fewer repetitive tendencies than did autistic controls. It is concluded that independent of diagnosis, preoccupations and repetitive behaviour appear to be closely associated with the manifestation of idiot-savant talents.

A specific linguistic ability

A young man with diagnosed hydrocephalic brain injury was found to be an able linguist. His ability to translate into English from French, German, and Spanish was confirmed to be at a high level, and his capacity to express thoughts and describe scenes in these languages was also verified. A set of translations of the Peabody Picture Vocabulary Test was prepared in French, German, and Spanish, and IQs were derived in each language. The subject's performance intelligence was tested separately and found to be low, especially in relation to spatial reasoning. The subject's linguistic achievements were discussed in terms of an IQ-independent linguistic talent.

T cell receptor (TCR) gene rearrangements in the assignment of tumour cell lineage

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Factors and primes: a specific numerical ability

An autistic young man and a normal control were asked to factorize numbers and to recognize and generate primes. Both subjects made a similar number of errors and employed similar strategies, but they differed markedly in the speeds at which the arithmetical operations were carried out.

The recognition failure and graphic success of idiot-savant artists

Three groups of subjects, an idiot-savant group, a group of mentally handicapped subjects matched for IQ, and normal artistically gifted children, were compared for their recognition and graphic reproduction abilities. It was found that, independent of input modality, level of intelligence determined recognition performance, while graphic ability independent of IQ was the determining factor in reproduction accuracy.

Art and accuracy: the drawing ability of idiot-savants

The accuracy and the artistic merit of drawings produced by graphically gifted idiot-savants and by artistically able normal children were investigated in various conditions. Drawings had to be executed when a three- or two-dimensional model of the scene to be drawn was in view, or when it had to be remembered or drawn from another viewpoint. It was found that overall accuracy was better for the normal than for the mentally handicapped subjects. In contrast, ratings for artistic merit did not differentiate the groups. It is concluded that while the accuracy of drawings may be related to intelligence, the artistic quality of the graphic production is not.

Expanded nursing care for contraceptive use

Nursing actions to promote contraceptive self-care are described. Orem's self-care theory was used to develop assessment tools and to plan nursing actions.

The toxicity of mercury--myth or reality?

The use of mercury in dentistry has provoked considerable controversy. The pharmacology and possible signs and symptoms associated with the use of mercury are considered and evidence regarding its safety is examined in this review paper.

Intelligence and musical improvisation

We investigated whether somebody with a severe mental impairment could not only remember and reproduce music, but was also able to generate it. Musical improvisation requires the ability to recognize constraints and also demands inventiveness. Musical improvisations on a traditional, tonal and also on a whole tone scale composition were produced by a mentally handicapped and by a normal control musician. It was found that not only the control but also the handicapped subject could improvise appropriately within structural constraints, although with the tonal music the idiot-savant showed some stylistic latitude. It is concluded that cognitive processes such as musical input analysis, decision making, and output monitoring are independent of general intellectual status.

Fatal cutaneous T cell lymphoma in a child with atopic dermatitis

The development of a fatal cutaneous T cell lymphoma in a child with atopic disease is presented. From very early childhood the patient had classic atopic dermatitis, and at age 13 developed lymphoma-like skin tumors. The diagnosis--based on immunohistologic criteria--was initially difficult to establish, but cytogenetic and DNA studies of the dermal infiltrate supported the clinical suspicion of malignancy. In addition, the T cell receptor beta chain gene showed a clonal rearrangement pattern both in skin and in lymph node, suggesting malignancy. Whether the malignant evolution in our patient took place primarily in the skin or in the lymph nodes is difficult to decide. Further examination of the association between atopic dermatitis and cutaneous T cell lymphoma may lead to insights into both disorders.

The memory structure of autistic idiot-savant mnemonists

The memory organization of six autistic mnemonists was investigated in two experiments. The first of these provided some evidence that the material of special interest to the subjects, in the present instance bus numbers, was stored in memory in a categorized form. The second study showed that though the idiot-savant mnemonists did not differ from controls in the level of their general memory performance, the factor structure of a number of memory tests differed between the groups. In contrast to the controls, a verbal memory factor which seemed independent of measured verbal IQ was operative in the mnemonist subjects.

Low intelligence and special abilities

In summary, our research enables us to conclude that specific talents are found in people who differ widely in general intelligence levels and such talents should therefore be regarded as at least partly intelligence-independent. However, between normal and mentally handicapped populations and even within the idiot savant group, general cognitive capacity plays some part in determining the manner in which talents manifest themselves. Idiot savant special abilities can neither be regarded as the sole consequence of practice and training, nor are such skills based only on an efficient rote memory. Instead, idiots savants use strategies which are founded on the deduction and application of rules governing the material upon which their special ability operates. They also generate novel or new examples of such rule based structures just as we do in our use of language. Because of the much greater prevalence of idiots savants in the autistic than in the mentally handicapped population, some characteristic common to both autism and specific giftedness might be assumed. An obsessional pre-occupation with a limited section of the environment might be a common factor to both. It may be this rather than autism itself which is relevant to the idiot savant phenomenon.