Semantic memory in Alzheimer's disease: representativeness, ontologic category, and material

Alzheimer's disease (AD) patients with semantic memory difficulty and AD patients with relatively preserved semantic memory named pictures and judged the category membership of words and pictures of natural kinds and manufactured artifacts that varied in their representativeness. Only semantically impaired patients were insensitive to representativeness in their category judgments. AD subgroup judgments did not differ for natural kinds compared to manufactured artifacts nor for words compared to pictures. AD subgroup differences could not be explained by dementia severity, memory, reading, and visuoperception. The similarity process for relating coordinate members of a taxonomic category contributes to the normal appreciation of word and picture meaning, and this process is compromised in AD patients with semantic difficulty.

A study of the efficacy of a comprehensive memory enhancement program in healthy elderly persons

Well educated, high functioning older adults (ages 60-90) were given a comprehensive memory enhancement training program to determine the effectiveness of the program in increasing cognitive performance and positively influencing self-assessments of memory efficacy. The 68 subjects who participated in the memory enhancement training were compared to 74 subjects who were enrolled in a video control group. Between subject differences were analyzed prior to the interventions and at three time points following the interventions (immediately post, 3 months and 6 months). Only one cognitive measure, assessing verbal memory, revealed a significant difference between the groups, with participants in the memory enhancement group showing less decline from baseline than the video control group immediately following the intervention but with no difference between groups at 6 months post-intervention. Several self-report measures showed that the memory enhancement training subjects experienced improved memory functioning and decreased memory concerns relative to the video control group. The self-reported effects of the training were sustained over the 6-month follow-up period.

Cognitive, neuroimaging, and pathological studies in a patient with Pick's disease

We conducted cognitive, imaging, and neuropathological studies on a patient with Pick's disease. The patient was impaired at interpreting sentences with complex grammatical constructions, differing significantly from control subjects and patients with Alzheimer's disease (AD). Evaluation of regional brain functioning at rest, with positron emission tomography, revealed reduced left frontal activity compared with control subjects and AD patients. Autopsy demonstrated the classic pathology of Pick's disease, including massive neuron loss and gliosis in the frontal and cingulate cortex as well as numerous tau-positive hippocampal Pick bodies. The abnormal tau proteins were phosphorylated at the same amino acid residues as AD paired helical filament tau (PHFtau), but they exhibited a unique migration profile on western blot. Our observations support the hypothesis that a distinct variety of hyperphosphorylated tau in Pick's disease compromises the long-term viability of selectively vulnerable populations of neurons in frontal cortices that contribute to sentence processing.

Language comprehension and regional cerebral defects in frontotemporal degeneration and Alzheimer's disease

We related profiles of language comprehension difficulty to patterns of reduced cerebral functioning obtained with high-resolution single photon emission computed tomography (SPECT) in patients with neurodegenerative conditions. We found different patterns of reduced relative cerebral perfusion in patients with frontotemporal degeneration (FD) and patients with Alzheimer's disease (AD). Cognitive assessments also showed different patterns of impaired comprehension in patients with FD and patients with AD. Grammatical comprehension difficulty in FD correlated with relative cerebral perfusion in left frontal and anterior temporal brain regions; impaired semantic processing in AD correlated with relative cerebral perfusion in inferior parietal and superior temporal regions of the left hemisphere. These findings are consistent with the hypothesis that a neural network distributed throughout the left hemisphere subserving different aspects of language comprehension, rather than a single brain region, is responsible for understanding language.

Semantic memory in Alzheimer's disease: representativeness, ontologic category, and material

Alzheimer's disease (AD) patients with semantic memory difficulty and AD patients with relatively preserved semantic memory named pictures and judged the category membership of words and pictures of natural kinds and manufactured artifacts that varied in their representativeness. Only semantically impaired patients were insensitive to representativeness in their category judgments. AD subgroup judgments did not differ for natural kinds compared to manufactured artifacts nor for words compared to pictures. AD subgroup differences could not be explained by dementia severity, memory, reading, and visuoperception. The similarity process for relating coordinate members of a taxonomic category contributes to the normal appreciation of word and picture meaning, and this process is compromised in AD patients with semantic difficulty.

Genetic evaluation by best linear unbiased prediction using marker and trait information in a multibreed population

Genetic evaluation by best linear unbiased prediction (BLUP) requires modeling genetic means, variances, and covariances. This paper presents theory to model means, variances, and covariances in a multibreed population, given marker and breed information, in the presence of gametic disequilibrium between the marker locus (ML) and linked quantitative trait locus (MQTL). Theory and algorithms are presented to construct the matrix of conditional covariances between relatives (Gv) for the MQTL effects in a multibreed population and to obtain the inverse of Gv efficiently. Theory presented here accounts for heterogeneity of variances among pure breeds and for segregation variances between pure breeds. A numerical example was used to illustrate how the theory and algorithms can be used for genetic evaluation by BLUP using marker and trait information in a multibreed population.

Lexical acquisition in probable Alzheimer's disease

Patients with probable Alzheimer's disease (pAD) were exposed to a new verb in a naturalistic fashion. We probed their knowledge of the word's semantic and grammatical characteristics for several minutes following this exposure, and compared this with their performance on parallel measures assessing known words. Significant differences were seen between pAD patients and controls in the acquisition of the new verb's semantic meaning and its argument structure, but pAD patients did not differ from controls in the acquisition of the new word's grammatical form class. Individual patient analyses demonstrated parallel deficits restricted to the semantic meaning and argument structure of the new word and known words in several pAD patients, suggesting that a selective language impairment contributed to their word learning deficit. This pattern is consistent with an intimate relationship between semantic meaning and argument structure in semantic memory. Other pAD patients had difficulty learning about all aspects of the new word, despite good performance with known words, suggesting that compromised memory may have limited their lexical acquisition.

Genetic evaluation by BLUP in two-breed terminal crossbreeding systems under dominance

To obtain estimates of breeding values by BLUP using Henderson's mixed-model equations, it is necessary to invert the covariance matrix for each random effect in the model. In a model in which the genotypic value is included as a random effect (genotypic model), it is necessary to invert the genotypic covariance matrix. Under additive inheritance, the inverse of the genotypic covariance matrix can be computed efficiently. Under dominance inheritance, however, an efficient method to invert the genotypic covariance matrix has not yet been developed, especially for crossbred populations. Thus, the use of a genotypic model for BLUP is not suitable for genetic evaluation in large, crossbred populations. We present an equivalent model in which the genotypic effect is partitioned into additive and dominance effects. With this equivalent model, methods used for within-breed genetic evaluation by BLUP can be used for a two-breed terminal cross under dominance.

Tick paralysis in a red wolf

A free-ranging male red wolf (Canis rufus) in North Carolina (USA), exhibiting paresis, anorexia and heavy tick infection was diagnosed with tick paralysis. The wolf recovered completely following the removal of all ticks. This is the first record of tick paralysis in the red wolf.

Selective expression of insulin-like growth factor II in the songbird brain

Neuronal replacement occurs in the forebrain of juvenile and adult songbirds. To address the molecular processes that govern this replacement, we cloned the zebra finch insulin-like growth factor II (IGF-II) cDNA, a factor known to regulate neuronal development and survival in other systems, and examined its expression pattern by in situ hybridization and immunocytochemistry in juvenile and adult songbird brains. The highest levels of IGF-II mRNA expression occurred in three nuclei of the song system: in the high vocal center (HVC), in the medial magnocellular nucleus of the neostriatum (mMAN), which projects to HVC, and to a lesser extent in the robust nucleus of the archistriatum (RA), which receives projections from HVC. IGF-II mRNA expression was developmentally regulated in zebra finches. In canary HVC, monthly changes in IGF-II mRNA expression covaried with previously reported monthly differences in neuron incorporation. Combining retrograde tracers with in situ hybridization and immunocytochemistry, we determined that the HVC neurons that project to area X synthesize the IGF-II mRNA, whereas the adjacent RA-projecting neurons accumulate the IGF-II peptide. Our findings raise the possibility that within HVC IGF-II acts as a paracrine signal between nonreplaceable area X-projecting neurons and replaceable RA-projecting neurons, a mode of action that is compatible with the involvement of IGF-II with the replacement of neurons. Additional roles for IGF-II expression in songbird brain are likely, because expression also occurs in some brain areas outside the song system, among them the cerebellar Purkinje cells in which neurogenesis is not known to occur.

Impairment in category fluency in ischemic vascular dementia

The underlying mechanisms for impaired output on letter (F, A, and S) and category (e.g., animal) word list generation (WLG) tasks in subcortical ischemic vascular dementia (IVD) were investigated. Normal control (NC) and Alzheimer's disease (AD) participants were also studied. IVD and NC participants performed better on category than letter WLG tasks, whereas the opposite was observed among AD participants. IVD participants produced fewer responses than AD participants on letter WLG tasks, but there was no difference between AD and IVD participants on the "animal" WLG task. AD participants scored lower than IVD and NC participants on animal WLG indexes measuring semantic knowledge. There were few differences between IVD and NC participants. The reduced output on the animal WLG task for IVD participants is consistent with search-retrieval deficits. The reduced output of AD participants may be caused by degraded semantic knowledge.

Constraints on the cerebral basis for semantic processing from neuroimaging studies of Alzheimer's disease

OBJECTIVE

Functional activation studies of semantic processing in healthy adults have yielded conflicting results. The purpose was to evaluate the relative role of the brain regions implicated in semantic processing with converging evidence from imaging studies of patients with impaired semantic processing.

METHODS

Semantic memory was assessed in patients with Alzheimer's disease using two measures, and these performance patterns were related to profiles of reduced cerebral functioning obtained with high resolution single photon emission computed tomography (SPECT). Patients with frontotemporal degeneration were similarly evaluated as a control group.

RESULTS

Reduced relative cerebral perfusion was seen in parietal and posterior temporal brain regions of patients with Alzheimer's disease but not patients with frontotemporal degeneration. Impairments on semantically guided category membership decision tasks were also seen in patients with Alzheimer's disease but not those with frontotemporal degeneration. Performance on the semantic measures correlated with relative cerebral perfusion in inferior parietal and superior temporal regions of the left hemisphere only in Alzheimer's disease. Relative perfusion was significantly lower in these regions in patients with Alzheimer's disease with semantic difficulty compared with patients with Alzheimer's disease with relatively preserved semantic processing.

CONCLUSION

These findings provide converging evidence to support the contribution of superior temporal and inferior parietal regions of the left hemisphere to semantic processing.

Nutrient flows in agriculture in The Netherlands with special emphasis on pig production

Annual nitrogen (N), phosphorus (P), and potassium (K) flows in agriculture in The Netherlands were identified and quantified in 1990, with special emphasis on pig production. Also, the effects that various management strategies in pig production have on NPK emission in 1990 were compared using a static deterministic simulation model. Ammonia emission from pig production in 1990 (60.9 Gg N) exceeded the defined target for the year 2000 (12.7 Gg N). Measures that affect volatilization of ammonia directly (i.e., introduction of low-emission stables, manure storage facilities, or manure application techniques) reduced ammonia emission most effectively. These measures, however, should be combined with a reduction in application of artificial N fertilizer to avoid an increase in N losses through leaching, run-off, or denitrification. Targets for ammonia emission in the year 2010 require a reduction in the pig population of 24 to 62%, in addition to implications of measures described in this article. National NPK losses in 1990 through leaching, run-off, or denitrification, predicted at 223.5 kg/ha for N, 32.7 kg/ha for P, and 67 kg/ha for K, exceeded government targets for the year 2010 (185 kg N/ha; 8.7 kg P/ha; norm not set for K). Reducing application of artificial NPK fertilizer reduced national NPK losses most effectively. For P, use of phytase and feeding pigs in accordance with their P requirements is required, in addition to limited use of artificial P fertilizer to meet targets for the year 2010. Hence, from an environmental point of view, pig production in The Netherlands is limited primarily by ammonia emission targets for the year 2010.

Impairment in category fluency in ischemic vascular dementia

The underlying mechanisms for impaired output on letter (F, A, and S) and category (e.g., animal) word list generation (WLG) tasks in subcortical ischemic vascular dementia (IVD) were investigated. Normal control (NC) and Alzheimer's disease (AD) participants were also studied. IVD and NC participants performed better on category than letter WLG tasks, whereas the opposite was observed among AD participants. IVD participants produced fewer responses than AD participants on letter WLG tasks, but there was no difference between AD and IVD participants on the "animal" WLG task. AD participants scored lower than IVD and NC participants on animal WLG indexes measuring semantic knowledge. There were few differences between IVD and NC participants. The reduced output on the animal WLG task for IVD participants is consistent with search-retrieval deficits. The reduced output of AD participants may be caused by degraded semantic knowledge.

Object recognition difficulty in visual apperceptive agnosia

Two patients with visual apperceptive agnosia were examined on tasks assessing the appreciation of visual material. Elementary visual functioning was relatively preserved, but they had profound difficulty recognizing and naming line drawings. More detailed evaluation revealed accurate recognition of regular geometric shapes and colors, but performance deteriorated when the shapes were made more complex visually, when multiple-choice arrays contained larger numbers of simple targets and foils, and when a mental manipulation such as a rotation was required. The recognition of letters and words was similarly compromised. Naming, recognition, and anomaly judgments of colored pictures and real objects were more accurate than similar decisions involving black-and-white line drawings. Visual imagery for shapes, letters, and objects appeared to be more accurate than visual perception of the same materials. We hypothesize that object recognition difficulty in visual apperceptive agnosia is due to two related factors: the impaired appreciation of the visual perceptual features that constitute objects, and a limitation in the cognitive resources that are available for processing demanding material within the visual modality.

Cigarette taxes. The straw to break the camel's back

Teenage cigarette smoking is sensitive to the price of cigarettes. The most recent research suggests that a 10% increase in price would reduce the number of teenagers who smoke by 7%. If the proposed 43-cent hike in the Federal excise tax rate on cigarettes contained in the Hatch-Kennedy Bill were enacted, the number of teenage smokers would fall by approximately 16%. This translates into more than 2.6 million fewer smokers and more than 850,000 fewer smoking-related premature deaths in the current cohort of 0 to 17-year-olds. Adjusted for inflation, the current 24-cent-a-pack tax costs the buyer about half of the original cigarette tax of 8 cents imposed in 1951. A substantial tax hike would curb youth smoking; this strategy should move to the forefront of the antismoking campaign.

Serial position and temporal cue effects in multiple sclerosis: two subtypes of defective memory mechanisms

Neurocognitive studies of multiple sclerosis (MS) have identified a robust long-term memory deficit. We hypothesized that this is due in part to the limited representation and use of serial order information. MS patients and controls were studied with a supraspan list learning procedure with post-encoding retrieval and recognition trials. MS patients demonstrated post-encoding negative recency with normal recognition, and word order recall was impaired. These findings appear to be in part to difficulty using temporal order cues in long-term memory. Two dissociable memory deficits were identified, suggesting that there are at least two neurocognitive mechanisms underlying memory impairment in MS.

Anomaly judgments of subject-predicate relations in Alzheimer's disease

Claims that patients with probable Alzheimer's disease (AD) have semantic memory difficulty have received equivocal support. A common assumption has been that defining or core information determines the truth value of word meaning on measures requiring semantic memory such as category membership judgments or confrontation naming, but this assumption may not be valid. In the present study, we assessed the comprehension of subject-predicate sentences independent of their truth value by asking AD patients to judge the coherence of statements such as "The tulip is tall" or "*The tulip is jealous." We found that AD patients are significantly more impaired than controls at judging the coherence of these simple subject-predicate sentences. Moreover, AD patients were more successful at judging the coherence of statements that contain attributes with a narrow scope of reference compared to attributes with a broad scope of reference. These findings support the hypothesis that AD patients have a semantic memory impairment and suggest a specific deficit processing the network of semantic relations underlying word meaning in semantic memory.

Functional activation during an auditory comprehension task in patients with temporal lobe lesions

Functional magnetic resonance imaging (fMRI) was used to map regional brain activation during an auditory comprehension task in two normal controls and two patients with left temporal lobe lesions. Activity in the superior temporal and angular gyrus regions was detected in all normal subjects. In the patients, the spatial distribution of activation ipsilateral to the lesions differed from the pattern observed in contralateral cortex or in control subjects. These studies highlight the potential of fMRI for mapping abnormal functional anatomy in the human brain.

Language comprehension profiles in Alzheimer's disease, multi-infarct dementia, and frontotemporal degeneration

We assessed language functioning in 116 age-, education-, and severity-matched patients with the clinical diagnosis of Alzheimer's disease (AD), multi-infarct dementia (MID) due to small-vessel ischemic disease, or a frontotemporal form of degeneration (FD). Assessments of comprehension revealed that patients with AD are significantly impaired in their judgments of single word and picture meaning, whereas patients with FD had sentence comprehension difficulty due to impaired processing of grammatical phrase structure. Patients with MID did not differ from control subjects in their comprehension performance. Traditional aphasiologic measures did not distinguish between AD, MID, and FD. Selective patterns of comprehension difficulty in patients with different forms of dementia emphasize that language deficits cannot be explained entirely by the compromised memory associated with a progressive neurodegenerative illness.

Category-specific difficulty naming with verbs in Alzheimer's disease

We studied 20 patients with Alzheimer's disease (AD) on a picture-naming task consisting of frequency-matched pairs of nouns and verbs that were homophonic and homographic (e.g., paint). Intragroup comparisons revealed that verb naming is significantly more difficult for patients with AD than noun naming. An error analysis demonstrated that patients with AD produce significantly more semantic and descriptive errors for verbs than nouns. We correlated verb naming and noun naming with measures of grammatical comprehension, lexical retrieval, and visuoperceptual processing, but there were no selective effects for verbs compared with nouns. Differences in the mental representation of concepts underlying verbs and nouns may account, in part, for the relative difficulty naming with verbs in AD.

Verb comprehension deficits in probable Alzheimer's disease

Studies of lexical comprehension in probable Alzheimer's disease (pAD) have focused almost exclusively on nouns. In the following preliminary study, we examined whether lexical comprehension for verbs is also impaired in 25 pAD patients. The semantic meaning of motion verbs, cognition verbs, and perception verbs was assessed with a triadic comparison task. Structural meaning associated with these verbs was evaluated by asking the patients to judge the coherence of sentence frames that accept these verbs naturally or awkwardly. We found that pAD patients are significantly impaired at identifying semantic relations among verbs. pAD patients also encountered significantly more difficulty judging the coherence of sentences than control subjects. Correlation and regression analyses demonstrated that semantic characteristics of verbs are projected from the verb's sentence frames in control subjects, but there was minimal evidence for such a structural-semantic relationship in pAD. We consider several possible explanations for our preliminary observations of an impairment that has consequences for processing both semantic and structural aspects of verb meaning.

Freehand drawing impairments in probable Alzheimer's disease

We evaluated freehand picture production of familiar objects in patients with probable Alzheimer's disease. The overall recognizability of their drawings was significantly compromised. Error analyses revealed the production of category violations and the frequent inclusion of incorrect features in a picture that were borrowed from semantically related objects, suggesting difficulty distinguishing between items with overlapping features sets in semantic memory. Analyses of individual patient drawing profiles also revealed that some patients are disproportionately compromised in expressing a particular perceptual feature, implicating difficulty at the level of perceptual processing. Regression analyses demonstrated the contribution of limited visual attentional resources. We conclude that impaired freehand drawing in probable Alzheimer's disease is multifactorial in nature.

Multiphasic analysis of embryonic mortality in chickens

Infertility and embryonic mortality are economically important for the commercial broiler industry because they are components of hatchability. Embryonic mortality in chickens is not uniformly distributed over the course of incubation; two phases of embryonic mortality are characteristic of chicken development. The objective of this paper was to develop a mathematical model to assess infertility and to characterize the distribution over time of embryonic mortality in chickens. A model was constructed based on evidence in the literature for multiple phases of embryonic mortality before and during incubation. A multiphasic model, with two phases, included parameters for the proportion of eggs that were infertile and the proportion that were fertile but the embryo died before or during incubation. For those eggs that were fertile but the embryo died, the model included the proportion of embryonic mortality during each phase, day of peak mortality, and duration of phase. Data on embryonic mortality for white Cornish chickens were used to illustrate the multiphasic model. Model parameters could be estimated easily and interpreted with clear biological meaning. Estimates of parameters, in general, were reasonably precise and consistent with the literature. With multiphasic analysis, one can assess infertility and characterize the distribution of embryonic mortality in chickens, which can lead to a useful understanding of management and genetic aspects of these components of hatchability.

The semantic memory impairment of Alzheimer's disease: category-specific?

We addressed the question of whether Alzheimer's Disease (AD) causes a selective impairment for knowledge of living things. Although we replicated a previous finding that AD subjects name pictures of living things less accurately than pictures of nonliving things, we also failed to observe this selective impairment when we used two new stimulus sets, which more tightly controlled the overall naming difficulty of the living and nonliving items. We conclude that, whereas some individuals may have bona fide selective impairments in semantic memory as a result of herpes simplex encephalitis or head injury, AD does not generally give rise to selective impairments in knowledge of living things.

Safety and feasibility of liver-directed ex vivo gene therapy for homozygous familial hypercholesterolemia

OBJECTIVE

The purpose of this report was to provide detailed information on the safety and feasibility of surgical procedures associated with the first ex vivo liver-directed gene therapy trial for the treatment of vivo gene therapy for homozygous familial hypercholesterolemia (FH).

SUMMARY BACKGROUND DATA

Familial hypercholesterolemia is an autosomal dominant disease in which the gene encoding the low density lipoprotein receptor is defective. Patients homozygous for this mutation have extraordinarily high levels of cholesterol and accelerated atherosclerosis and die prematurely of myocardial infarction. The concept of liver-directed gene therapy was based on the report of normalization of cholesterol levels by orthotopic cardiac/liver transplant in a child with homozygous FH.

METHODS

Five patients with homozygous FH were selected for inclusion in this trial. The patients underwent hepatic resection and placement of a portal venous catheter. Primary hepatocytes cultures were prepared from the resected liver and transduced with a recombinant retrovirus encoding the gene for the human low density lipoprotein receptor. The genetically modified cells were then transplanted into the liver through the portal venous catheter.

RESULTS

Numerous clinical, laboratory, and radiologic parameters were analyzed. Elevations of the hepatic transaminases and leukocyte counts and a decline in hematocrit count were noted. Transient elevations of the portal pressure were observed during cell infusion. No major perioperative morbidity--specifically, myocardial infarct, perioperative hemorrhage, or portal vein thrombosis--or death occurred as a result of this protocol.

CONCLUSION

Liver-directed ex vivo gene therapy can be accomplished safely in humans and is appropriate for selected patients.

Clinical, neuroimaging, and pathologic features of progressive nonfluent aphasia

We report the clinical, neuroimaging, and neuropathologic features of progressive nonfluent aphasia (PNFA), a rare neurodegenerative syndrome most notable for its distinct language disturbance. Longitudinal observations of 3 patients revealed progressively telegraphic speech and writing, followed by gradual deterioration of sentence comprehension, and finally, preterminal mutism and dementia. Magnetic resonance imaging revealed cortical atrophy most pronounced in anterior regions of the left hemisphere. Functional neuroimaging demonstrated reduced cerebral activity most prominently in left frontal and temporal regions. At necropsy, microscopic pathology of brain was most consistent with the diagnosis of "dementia lacking distinctive histology" (DLDH). A review of published primary progressive aphasia cases with adequate clinical and histopathological descriptions reveals that the most common pathology underlying PNFA is DLDH. PNFA is one example of a family of clinical syndromes with similar underlying histopathology that affects different regions of the frontal lobe.

Multiphasic analysis of reproductive efficiency of dairy bulls

Reproductive efficiency of dairy bulls is usually measured by nonreturn rate. Nonreturn is a compound trait that is a result of two events, conception and gestation, that lead to calving. Nonreturn rates can be used to derive more elementary biological measures for reproductive efficiency, such as conception rate and calving rate, which separately might be more reliable than nonreturn rate itself to evaluate the fertility of a bull or the performance of an AI technician. The challenge of this study was to examine the decline in nonreturn rate in light of the theory of multiphasic analysis. A multiphasic logistic function was developed to model decline in nonreturn rate by estimating conception rate, calving rate, and characteristics of the first two estrous cycles. The model is illustrated with data on daily nonreturn rates to 120 d. From the proportion of cows that conceived but failed to complete gestation because postsignal embryonic death, the model estimates conception rate and calving rate. From the proportion of cows that failed to conceive or that conceived but failed to complete gestation because of presignal embryonic death, the model estimates the proportion of returns, or probability of detecting estrus, duration of nonreturns, and time of maximum decline in nonreturn rate for the first two cycles. Using the proposed model, conception rate and calving rate estimated from daily nonreturn rates might be more reliable for evaluation of performance of an AI technician and fertility of a bull than nonreturn rates at arbitrarily chosen days after insemination.

Phonologic processing deficits in Alzheimer's disease

We investigated phonologic production in patients with mild to moderate Alzheimer's disease (AD) on a repetition task. AD patients produced significantly more speech errors than age-matched controls. AD patients' errors, unlike those of controls, resulted in the transformation of real words into pseudowords, occurred disproportionately in word-initial positions, and were not influenced by the phonologic environment. This pattern of errors suggests a lexical phonologic retrieval deficit in AD.

The neural basis of the central executive system of working memory

Working memory refers to a system for temporary storage and manipulation of information in the brain, a function critical for a wide range of cognitive operations. It has been proposed that working memory includes a central executive system (CES) to control attention and information flow to and from verbal and spatial short-term memory buffers. Although the prefrontal cortex is activated during both verbal and spatial passive working memory tasks, the brain regions involved in the CES component of working memory have not been identified. We have used functional magnetic resonance imaging (fMRI) to examine brain activation during the concurrent performance of two tasks, which is expected to engage the CES. Activation of the prefrontal cortex was observed when both tasks are performed together, but not when they are performed separately. These results support the view that the prefrontal cortex is involved in human working memory.

A pilot study of ex vivo gene therapy for homozygous familial hypercholesterolaemia

The outcome of the first pilot study of liver-directed gene therapy is reported here. Five patients with homozygous familial hypercholesterolaemia (FH) ranging in age from 7 to 41 years were enrolled; each patient tolerated the procedure well without significant complications. Transgene expression was detected in a limited number of hepatocytes of liver tissue harvested four months after gene transfer from all five patients. Significant and prolonged reductions in low density lipoprotein (LDL) cholesterol were demonstrated in three of five patients; in vivo LDL catabolism was increased 53% following gene therapy in a receptor negative patient, who realized a reduction in serum LDL equal to approximately 150 mg dl-1. This study demonstrates the feasibility of engrafting limited numbers of retrovirus-transduced hepatocytes without morbidity and achieving persistent gene expression lasting at least four months after gene therapy. The variable metabolic responses observed following low-level genetic reconstitution in the five patients studied precludes a broader application of liver-directed gene therapy without modifications that consistently effect substantially greater gene transfer.

Aging and sense of control

Three groups representing different phases of the developmental lifecycle--12 senior citizens, 67 young adults, and 14 healthy middle-aged normal adults--were assessed using a multidimensional control inventory. Senior citizens had a healthy over-all sense of control comparable to those of the other two groups and a significantly lower (healthier) negative sense of control. They also were significantly more likely to endorse acceptance as a way of addressing areas of concern and to complement self as a source of control with a sense of control coming from others (including God, belief in a higher power).

Sentence comprehension in multiple sclerosis

INTRODUCTION

Explanations of sentence processing difficulty in aphasia have implicated slowed information processing speed. We tested this hypothesis by evaluating sentence comprehension in multiple sclerosis (MS), and relating comprehension performance to measures of information processing speed.

MATERIAL & METHODS

Twenty right-handed, high school-educated, non-demented, native English speakers with clinically definite MS and 16 age- and education-matched control subjects were examined on 3 different sentence comprehension measures that stress grammatical appreciation. Performance was related to quantitative assessments of mental information processing speed.

RESULTS

Group-wide analyses demonstrated a trend toward sentence comprehension difficulty in MS. Analyses of individual patient profiles identified a subgroup of MS patients who were consistently impaired to a significant extent across all sentence comprehension tasks. Their sentence comprehension difficulty was associated with selectively compromised mental information processing speed.

CONCLUSION

Sentence comprehension difficulty in MS is associated with slowed information processing speed. This finding supports the claim that information processing speed contributes to sentence processing.

Immunization. Past successes, future challenges

Global eradication of smallpox, elimination of poliomyelitis in the Western Hemisphere, and a 90% decrease in Haemophilus influenzae meningitis in the Western Hemisphere mark some of the achievements of immunization programs around the world. Yet many serious problems continue to exist, particularly in the developing world. Advances in biotechnology and the renewed interest by industry, governments, and the World Health Organization in vaccine development and delivery in the field provide an exciting prospect for major advances in immunization in the next few decades.

In vivo confocal scanning laser microscopy of human skin: melanin provides strong contrast

Confocal scanning laser microscopy of live human skin was performed to investigate the correlation of in vivo cellular and morphologic features to histology, the effect of wavelength on imaging, and the role of melanin as a contrast agent. We built a video-rate confocal scanning laser microscope for in vivo imaging of human skin. Using a 100 x microscope objective, we imaged high-contrast optical "sections" of normal skin, vitiliginous skin, and a compound nevus. In vivo "confocal histology" correlated well with conventional histology. The maximum imaging depth increased with wavelength: the epidermis was imaged with visible 400-700-nm wavelengths; the superficial papillary dermis and blood cells (erythrocytes and leukocytes) in the deeper capillaries were imaged with the near infrared 800-900-nm wavelengths. For confocal reflectance imaging, melanin provided strong contrast by increased backscattering of light such that the cytoplasm in heavily pigmented cells imaged brightly. In vivo confocal microscopy potentially offers dermatologists a diagnostic tool that is instant and entirely non-invasive compared to conventional histopathology.

Parental relationships, coping strategies, received support, and well-being in adolescents of separated or divorced and married parents

The purpose of this cross-sectional study was to examine the impact of the perceived quality of the parental relationship and family status on coping strategies, received support, and well-being in adolescents from separated or divorced and married parents. Two hundred forty-four matched adolescents from separated/divorced and married households were drawn from an initial sample of 1,044 students who were tested at five colleges and three high schools of a large metropolitan and rural area. Regression analyses supported the hypothesis that a perceived poor parental relationship, and not family status, was associated with low life satisfaction and sense of future, and high anxiety in adolescents of divorced and married households. Hierarchical regression techniques revealed that coping strategies and received support did not mediate the association between a perceived poor parental relationship and low levels of well-being in adolescents from divorced and married households. The findings underscore the importance of intervening with adolescents within the context of their family relationships.

A model for reproductive efficiency of dairy bulls

Reproductive efficiency of bulls is usually measured by nonreturn rate, which is commonly defined as the proportion of cows that were inseminated and did not return for another service within a specified number of days. The AI organizations use nonreturn rate to evaluate fertility of a bull or performance of a technician. Measures derived from nonreturn rate, such as conception rate and calving rate, might be more reliable for evaluation than nonreturn rate itself. Estimated conception rate is a better early measure of efficiency than nonreturn rate, because conception rate depends on the population of spermatozoa at insemination and not on developmental potential of the conceptus after insemination. A mathematical function is presented to model reproductive efficiency of bulls by estimation of the probability of conception at time of insemination (conception rate) and the probability of completing gestation after insemination (calving rate) through the relationship of nonreturn rate to the concentration of spermatozoa at insemination and the time after insemination. The model is illustrated with three bulls, using nonreturn rates by 28, 56, and 84 d after insemination.

The low density lipoprotein receptor is not required for normal catabolism of Lp(a) in humans

Lipoprotein(a) [Lp(a)] is an atherogenic lipoprotein which is similar in structure to low density lipoproteins (LDL). The role of the LDL receptor in the catabolism of Lp(a) has been controversial. We therefore investigated the in vivo catabolism of Lp(a) and LDL in five unrelated patients with homozygous familial hypercholesterolemia (FH) who have little or no LDL receptor activity. Purified 125I-Lp(a) and 131I-LDL were simultaneously injected into the homozygous FH patients, their heterozygous FH parents when available, and control subjects. The disappearance of plasma radioactivity was followed over time. As expected, the fractional catabolic rates (FCR) of 131I-LDL were markedly decreased in the homozygous FH patients (mean LDL FCR 0.190 d-1) and somewhat decreased in the heterozygous FH parents (mean LDL FCR 0.294 d-1) compared with controls (mean LDL FCR 0.401 d-1). In contrast, the catabolism of 125I-Lp(a) was not significantly different in the homozygous FH patients (mean FCR 0.251 d-1), heterozygous FH parents (mean FCR 0.254 d-1), and control subjects (mean FCR 0.287 d-1). In summary, absence of a functional LDL receptor does not result in delayed catabolism of Lp(a), indicating that the LDL receptor is not a physiologically important route of Lp(a) catabolism in humans.

Received support and psychological adjustment in critically-injured patients and their family

A pilot study was conducted to identify support behaviors associated with the psychological adjustment of 39 critically-injured patients and 39 family members. Although the majority of critically-injured patients recover physically, current work shows that psychological difficulties persist. This study hypothesized that the psychological adjustment of critically-injured patients and family members will be a function of the type of support received. The second hypothesis was that support behaviors associated with psychological adjustment will differ between critically-injured patients and family members. Patients and family members completed the following paper and pencil instruments: The Instrument of Socially Supportive Behaviors, the Well-being Scale, State/Trait Anxiety Scale, Life Experience Survey, The Blishen Occupational Index and a demographic questionnaire. Using multiple regression with backward elimination, squared semi-partial correlations and partial F, cross-sectional data showed that the measure of well-being but not anxiety was related to different types of support behaviors in partial support of the first hypothesis. Support for the second hypothesis was provided by the finding that the critically-injured patient's level of well-being was positively associated with nondirect support and instrumental aid, and negatively with direct guidance. In contrast, instrumental aid was found to be associated with poor well-being in family members. The findings offer neuroscience nurses insights into the types of support that may enhance the well-being of critically-injured patients and their family members.

Theory for modelling means and covariances in a two-breed population with dominance inheritance

This paper presents theory and methods to compute genotypic means and covariances in a two breed population under dominance inheritance, assuming multiple unlinked loci. It is shown that the genotypic mean is a linear function of five location parameters and that the genotypic covariance between relatives is a linear function of 25 dispersion parameters. Recursive procedures are given to compute the necessary identity coefficients. In the absence of inbreeding, the number of parameters for the mean is reduced from five to three and the number for the covariance is reduced from 25 to 12. In a two-breed population, for traits exhibiting dominance, the theory presented here can be used to obtain genetic evaluations by best linear unbiased prediction and to estimate genetic parameters by maximum likelihood.

An aspect of sentence processing in Alzheimer's disease: quantifier-noun agreement

We assessed sentence processing in Alzheimer's disease (AD) with measures of sentence-picture matching, grammaticality judgments of sentences, and sentence completion. The results demonstrated significant and consistent difficulty with a grammatical feature of sentences on all three experiments. This impairment could not be explained by factors such as sentence length, dementia severity, or a short-term memory deficit and was independent of difficulty interpreting the meanings of words. We hypothesize that AD patients are impaired at appreciating the conceptual relations that underlie certain grammatical features of sentences.

Hemiachromatopsia of unilateral occipitotemporal infarcts

Two patients developed unilateral occipitotemporal infarcts that produced inferior quadrantic achromatopsia and an accompanying superior quadrantanopia. Magnetic resonance imaging and single-photon emission computed tomographic studies of both patients supported the current view that color vision is encoded in the lingual and fusiform gyri. Although the quadrantic defect in color processing was profound, neither patient was aware of it. Simple bedside testing of patients with superior quadrantanopia may disclose an unrecognized quadrantic achromatopsia.