Childhood dermatomyositis. Clinical course and long-term follow-up

The presentation, clinical course, and long-term follow-up (3-22 years) of 39 children with dermatomyositis followed from 1962-1982 is presented. The medical course of these patients was complicated by respiratory diseases (20%), gastrointestinal diseases (24%), and calcinosis (30%). Patients presenting prior to 1972 received a wide variety of treatments. Since 1972, treatment has consisted of long-term prednisone, supplemented in some patients with azathioprine. Ten patients died (eight of whom were first seen before 1972) of complications after intestinal perforation (5) or aspiration pneumonia (5). Of 29 survivors, three have persistent calcinosis and/or contractures. Improved outcome since 1972 probably relates to better clinical assessment, management of complications, and regulation of drug therapy.

Body fat distribution as a risk factor for coronary artery atherosclerosis in female cynomolgus monkeys

Central fat deposition is associated with increased risk of coronary heart disease morbidity and mortality in women. Subcutaneous fat distribution was investigated as a potential factor that might exacerbate diet-induced coronary artery atherosclerosis (CAA) in female cynomolgus monkeys (Macaca fascicularis) which share with North American Caucasian women a gender-related protection against CAA. In a retrospective necropsy study (n = 36), the distribution of the antemortem ratio of subscapular/triceps skinfold thickness was divided at the mean and the two resulting groups were designated high and low for this variable. CAA was quantified as the mean cross-sectional intimal area based on nine coronary artery sections. The extent of CAA was significantly greater in the high skinfold ratio group as compared to the low skinfold ratio group. Ponderosity was closely associated with the skinfold ratio but was not a useful predictor of CAA. These findings suggest that female cynomolgus macaques may provide a primate model of the health consequences of regional fat distribution in women.

Biologic activities of interleukin-1 relevant to rheumatic diseases

In conclusion, IL-1 has multiple biologic activities relevant to rheumatic diseases. It mediates the acute-phase response, and exerts control over many metabolic functions of connective tissue, including muscle, bone, cartilage, synovium, and endothelium. IL-1 also has a profound effect on leukocyte function. Although few clinical studies have been reported, there is suggestive evidence that IL-1 plays a role in the pathogenesis of arthritis, scleroderma, SLE and vasculitis. That drugs useful in the therapeutic management of these conditions influence IL-1 activity provides indirect support for the involvement of IL-1 in pathogenesis. Clearly, further studies are needed in this area. With the recent development of recombinant preparations of IL-1, further investigation of IL-1 in connective tissue metabolism and clinical rheumatic disease can be carried out. Finally, the future development of pharmacologic agents specifically designed to alter IL-1 responses may allow specifically targeted therapy for rheumatic diseases.

Behavioral responsiveness of young chimpanzees (Pan troglodytes) to a novel environment

Behavioral responsiveness to a novel environment was documented in 22 chimpanzees grouped according to age; 6-months, 1-year, 2-years and 5-years. An attachment figure, a human caretaker, accompanied each subject during the 15-min test sessions so as to preclude confounding of responses to novelty with separation responses. Extreme distress reported previously for chimpanzees and human children when tested alone in a novel situation was rarely observed in these tests when an attachment figure was present. Stereotyped rocking, an indication of mild distress occurred more frequently in the younger animals. Younger animals engaged in distal visual exploration of the environment while remaining close to the attachment figure, whereas the older animals locomoted more frequently and explored the environment directly with their hands. Repeated exposure to the environment reduced the differences among the 6-month, 1-year and 2-year groups. The 6-month group, however, continued to locomote least and least frequently engaged in tactile exploration. These data on chimpanzees resemble data on human children which suggest that an attachment figure: attenuates the distress exhibited by young individuals of these species when exposed to novel stimuli, and thereby provides a secure base which supports the exploration of novel stimuli, a prerequisite to behavioral adaptation.

Effects of ovariectomy on vertebral trabecular bone in the cynomolgus monkey (Macaca fascicularis)

Seventeen ovariectomized and twenty-one intact female cynomolgus macaques were examined for differences in vertebral trabecular bone volume. The ovariectomized group exhibited significantly less trabecular bone than the intact group (p less than .005), 22 months post-ovariectomy. This finding encourages the use of the cynomolgus monkey as a model for the mechanism of bone loss in ovariectomy or postmenopausal osteoporosis.

Nonhuman primate models of atherosclerosis: potential for the study of diabetes mellitus and hyperinsulinemia

Nonhuman primates have been used for many years to investigate the pathogenesis and progression of atherosclerosis. The use of these animal models has resulted in a better understanding of the risk factors associated with atherosclerosis. Nonhuman primates that have consumed an atherogenic diet for several years develop lesions that are comparable to those found in human beings. Diabetes, both spontaneous and chemically induced, has been described in a number of nonhuman primate species. These diabetic models may be used to understand the accelerated progression and vascular complications of atherosclerosis in diabetic human beings.

Effect of cooling on force oscillations during maximal voluntary eccentric exercise

The effect of superficial cooling on force oscillations during maximal eccentric exercises of the quadriceps femoris was studied in 10 adults. Maximal (i) shortening (concentric) and (ii) lengthening (eccentric) exercises were performed at a velocity of 120 degrees/s through 60 degrees of knee flexion while linear envelope EMG signals were recorded from the surface of the vastus medialis muscle. Force oscillations (12.4 +/- 2.8 Hz) were present in all subjects in the first series of eccentric exercises. After 30 min of cooling, the oscillations were eliminated in two subjects and were reduced in number in two others of the five subjects in the experimental group. In contrast, all subjects in the control group still had oscillations when retested after a 30-min rest period. During the eccentric exercises, a synchronous silent period in the EMG tracings was evident just before a decrease in force. Subsequently, the EMG activity resumed and the force increased (force oscillation). Because the force oscillations were of large amplitude and occurred only during eccentric exercise, we conclude that the force oscillations were similar to physiological action tremor. Because the force oscillations and EMG patterns were altered by cooling, the mechanisms that initiate such oscillations during maximal eccentric exercise are suspected to include a neural component.

Bone measurement by enhanced contrast image analysis: ovariectomized and intact Macaca fascicularis as a model for human postmenopausal osteoporosis

This paper presents an image enhancement and analysis system (DARWIN) based on an inexpensive microcomputer and applies the system to two bone morphometry problems relevant to postmenopausal osteoporosis. Using ovariectomized and intact female Macaca fascicularis as a model, we examined the radiodensity of the sixth lumbar vertebra and the cross-section area of the right femur. Significantly lower bone density was observed in the vertebral segments of the ovariectomized animals. No significant differences were observed in comparisons of the femoral cross sections. The reduction in radiographic density of the ovariectomized animals' vertebrae is similar to that observed in postmenopausal women, supporting the use of female cynomolgus macaques as models of bone loss in postmenopausal osteoporosis.

Wegener granulomatosis in pediatric patients

Wegener granulomatosis is more easily recognized as a distinct clinical entity than other vasculitides because the initial clinical features frequently include granulomatous vasculitis of the upper and lower respiratory tract and glomerulonephritis. Although the disease has been lethal in the past, prolonged survival and avoidance of end-stage kidney disease can now be expected when cyclophosphamide therapy is introduced early in the course. We report four children with Wegener granulomatosis in whom the initial clinical findings suggested Henoch-Schönlein purpura. In two of the patients Wegener granulomatosis was not recognized until after end-stage kidney disease had developed. The course in these patients emphasizes the need for attention to even scant evidence of inflammation of the upper or lower respiratory tract in patients with glomerulonephritis. Appropriate diagnostic studies may then lead to recognition of Wegener granulomatosis and the prompt institution of appropriate treatment.

Diethylstilbestrol exposure in utero and endometriosis in infertile females

Endometriosis was found in 39% and in utero diethylstilbestrol (DES) exposure in 5% of 397 infertile women who had undergone laparoscopy and/or laparotomy among 750 consecutively evaluated infertile couples. Fifty percent of the DES-exposed infertile women also had endometriosis, similar to the 39% with endometriosis among non-DES-exposed women. Cervical stenosis was found in 25% of all DES-exposed patients and in 83% of those who had undergone cryocautery or conization. However, 40% did not have endometriosis. Thus, while the frequency of endometriosis and cervical stenosis is extremely high in infertile women exposed in utero to DES, a significant association beyond that found in non-DES-exposed patients could not be established. Some of the infertility may be associated with cervical stenosis alone.

Menstrual cycle patterns of hormones and sexual behavior in gorillas

Oppositely sexed pairs of gorillas were tested behaviorally during the menstrual cycle to determine the relationship between hormone concentrations of the female and the frequency of sexual activity by the pair. Five females were tested individually during two cycles with each of two males, but serum samples for hormone assay were obtained from each female only during the first cycle of testing. There was no clear relationship between hormones and behavior for the single cycle in which the serum samples were obtained, with the exception that no copulations occurred after the early luteal phase, when progesterone was greater than 5 ng/ml. Normalized behavioral data from all four test cycles for all pairs suggested that female-solicited copulations were restricted primarily to the periovulatory period. Male sexual initiative (by one of the males) accounted for most copulations temporally dissociated from the periovulatory period. Normalized hormone data for all of the females suggested that (1) attractivity was associated with estradiol concentrations during the follicular phase, (2) proceptivity with estradiol and testosterone at midcycle, whereas (3) receptivity was not associated with hormone patterns or cycle phase. The data suggest that hormones are one of several variables that contribute to the regulation of sexual behavior in gorillas.

Transplantation of the adult kidney into the very small child. Technical considerations

Transplantation of adult kidneys into very small children is not performed in most centers because of concerns regarding the technical difficulty of the procedure. Advantages of the procedure include the possibility of living related donor transplantation and the increased availability of adult donor kidneys as compared with pediatric cadaver donor kidneys. We have transplanted adult kidneys into 12 children aged 11 months to 3.5 years who weighed 5,400 to 8,800 g. Ten children received living related donor and two cadaver donor grafts. Herein we describe in detail the pretransplant management, surgical strategies, intraoperative management, surgical techniques, and postoperative management which we use for transplantation of adult kidneys into very small children. Intraoperative and postoperative complications have been described to illustrate the evolving clinical principles in this area. Since 10 of the children are presently alive, 8 with their original grafts, 16 months to 9 years after transplantation, we advocate this approach for suitable small children with terminal renal failure.

Why never forgetting a face matters: visual imagery and social memory

This research tested the hypothesis that individuals who tend to form vivid visual images of others (vivid imagers) have more accurate social memories than those who form relatively nonvivid visual images of others (nonvivid imagers). In the first investigation, vivid imagers outperformed nonvivid imagers in remembering details concerning the attitudes, activities, and life history of a woman whom they observed being interviewed. Investigation 2 provided more definitive evidence for the link between visual imagery and social memory by demonstrating that vivid imagers had more accurate memories after seeing an interviewee answer questions, whereas seeing the interviewee had no impact on the memories of nonvivid imagers. The discussion considers the impact that imagery processes may have on a variety of social thought processes.

Why never forgetting a face matters: visual imagery and social memory

This research tested the hypothesis that individuals who tend to form vivid visual images of others (vivid imagers) have more accurate social memories than those who form relatively nonvivid visual images of others (nonvivid imagers). In the first investigation, vivid imagers outperformed nonvivid imagers in remembering details concerning the attitudes, activities, and life history of a woman whom they observed being interviewed. Investigation 2 provided more definitive evidence for the link between visual imagery and social memory by demonstrating that vivid imagers had more accurate memories after seeing an interviewee answer questions, whereas seeing the interviewee had no impact on the memories of nonvivid imagers. The discussion considers the impact that imagery processes may have on a variety of social thought processes.

Transplantation of adult kidney into the very small child: long-term outcome

Adult kidneys were transplanted into 12 children weighing between 5,400 and 8,800 gm. Ten received parental and two received cadaver grafts. Ten of the 12 children are alive 18 months to 9 years post transplant; eight have their original grafts and two required retransplantation-their original grafts were lost at 4 and 9 years because of chronic rejection. All but these two surviving children had normal or accelerated growth rates despite growth retardation prior to transplant. All children evidenced moderate to severe delay in psychomotor development prior to transplant. Seven of the ten survivors now have normal psychomotor function. Two are behind in school, and one with a degenerative central nervous system disease prior to transplant remains profoundly retarded. We conclude that because of donor availability, capacity for good donor-recipient matching, and minimization of time on dialysis, transplantation of adult kidneys into pediatric patients is preferable to awaiting the relatively uncommon pediatric cadaver donor. We further conclude that the procedure is warranted.

Influence of male aggression on mating of gorillas in the laboratory

The frequency of sexual interactions between oppositely-sexed pairs of gorillas tested in the laboratory was directly related to the frequency of male aggression directed toward the female. The data suggest that male aggression stimulated female presenting and copulation, and accounted for mating temporally dissociated from the periovulatory period. Among the great apes tested in the laboratory, the male primarily accounts for mating that is unlikely to contribute to reproduction.

Dimensions of adolescent psychopathology

A factor-analytic study of parent ratings of 253 male and female adolescents between the ages of 13 and 17 referred for psychiatric and delinquent problems is reported. Parents rated their children on the Adolescent Form of the Louisville Behavior Checklist. One hundred thirty-seven items were intercorrelated and subjected to a principal component factor analysis and nine factors wre rotated to varimax solution. The nine factors were named: Egocentric-Exploitive, Destructive-Assaultive, Social Delinquency, Academic Disability, Adolescent Turmoil, Apathetic Isolation, Neuroticism, Dependent-Inhibited, and Neurological or Psychotic Abnormality. A second-order analysis revealed two broad-band Internalizing and Externalizing dimensions. The factors were shown to be similar to but different from DSM III categories as well as from other factor-analytic studies of adolescents. This study indicates that much research will be required before a consensus can be reached on the basic dimensions of psychopathology of adolescence.

Organization and development of brain stem auditory nuclei of the chicken: ontogeny of n. magnocellularis and n. laminaris

Nucleus magnocellularis (NM) and nucleus laminaris (NL) are, respectively, second- and third-order auditory nuclei in the chicken brain stem. In this report the morphogenesis of these nuclei is examined. The times of origin of the cells of these nuclei were studied with 3H-thymidine autoradiography. The number of cells in each nucleus and their rostro-caudal distribution within each nucleus was determined in Nissl-stained sections at 9, 11, 13, 15, 17, 19, and 21 days of incubation. For the above ages the volumes of NM and NL were also calculated planimetrically and the rostro-caudal distribution of volume within each nucleus was studied.

Method factors associated with assessment of child behavior: fact or artifact?

A sample of 64 phobic children between the ages of 6 and 16, with their general population matched controls, were rated by parents on the Louisville Behavior Check List and Louisville Fear survey and by School Behavior check list. The analysis of ratings by factor analysis revealed three instrument factors while a multiple discriminant analysis elicited a multidimensional phobic trait that crossed observers, situations, and instruments. The results are discussed in terms of the implications for multivariant analysis of behavior change as well as for classification of psychopathological disorders of childhood. The thesis is advanced that instrument factors elicited by factor analysis in psychotherapy change studies are statistical artifacts and that a multiple discriminant analysis is a more appropriate technique for the study of change as well as for classification.