Serial casting for the management of spasticity in the head-injured adult

Soft tissue contractures resulting from spasticity are a frequent sequella of traumatic head injuries. This article identifies rationale for the use of serial casting to manage these deformities, provides guidelines for cast fabrication and application, and reports the results of lower extremity casting on 42 head-injured adults at Rancho Los Amigos Hospital.

The effect of manipulating phonation duration on stuttering

Two single-subject experiments with two adult stutterers were conducted to assess the effect of changing the frequency of phonation intervals that were shorter or greater than prescribed durations during spontaneous speech. Both subjects modified the frequency of prescribed phonation intervals and showed changes in the frequency of these intervals that were positively related to decreases and increases in stuttering frequency. A perceptual analysis of the subjects' speech quality during phonation control conditions showed that when stuttering frequency was reduced, listeners could detect changes in the speech quality of both subjects; however, only one subject's speech during these conditions was described as nonnormal sounding. The therapeutic and theoretical implications of these findings are discussed.

Leptospiral infection in horses in Northern Ireland: serological and microbiological findings

Thirteen strains of pathogenic leptospires were isolated from 12 of 91 horses; seven strains belonged to the Australis serogroup (serotype bratislava) with three, two and one strains belonging to the Icterohaemorrhagiae, Hebdomadis (serotype hardjo) and Autumnalis serogroups respectively. Using leptospires isolated from horses and others representing the known parasitic Leptospira serogroups, a sample of 650 mares' sera was tested for agglutinating antibodies. Antibodies were found in 89.1 per cent of sera. The predominant reaction was to serotype bratislava, strain S/1334/79, isolated in this study, antibodies to which were detected in 81.8 per cent of sera. It is suggested that serotype bratislava may be adapted to, and maintained by, the horse population in Northern Ireland.

Apparent gastrointestinal origin of cis-4-hydroxycyclohexanecarboxylic acid

We identified by gas chromatography-mass spectrometry the unusual substance cis-4-hydroxycyclohexanecarboxylic acid (4-HCH) in the urine of a child. Urinary excretion of 4-HCH and intestinal bacteria were both suppressed by neomycin treatment. We propose that 4-HCH is a by-product of bacterial metabolism.

Effects of feedback stimulation training and cyclical electrical stimulation on knee extension in hemiparetic patients

Positional feedback stimulation training and cyclical electrical stimulation were used in combination as a treatment for facilitating knee extension in hemiparetic patients. Forty adult hemiparetic patients who demonstrated minimal active control of their quadriceps femoris muscles were randomly assigned to control or study groups. The control patients received a program of physical therapy, and the study patients received the positional feedback stimulation training in addition to their therapy program. The stimulation training provided the patient with immediate auditory and visual feedback of his changing joint angle while he voluntarily extended his knee. When the patient reached a near maximal extension effort, electrical stimulation of the quadriceps femoris muscle was automatically triggered, completing the patient's available range of motion in extension. The stimulation training was supplemented with two hours of cyclical electrical stimulation daily. At the end of four weeks, analysis revealed a statistically significant increase in knee extension torque and active synergistic range of motion in the study group. No change was noted in their ability to extend their knees using isolated quadriceps femoris muscle control. This study suggests that positional feedback stimulation training is effective when used to augment a facilitation program for improving knee extension control in hemiparetic patients.

Alterations in the pharmacokinetics of 3H-delta9-tetrahydrocannabinol in mice by bacterial endotoxin

Mice were pretreated with either bacterial endotoxin (3 mg/kg, ip) or saline 3 hr prior to an ip injection of 100 mg of 3H-delta9-tetrahydrocannabinol (3H-delta9-THC) per kg, a combination that results in synergistic lethality. Five hours after the injection of 3H-delta9-THC, the endotoxin-pretreated mice contained a significantly greater amount of radioactivity in kidney, liver, heart, plasma, urine, and brain than those without pretreatment. However, the plasma and brain levels of the animals tested with both endotoxin and 3H-delta9-THC (100 mg/kg) were significantly less than those in mice treated only with 200 mg of 3H-delta9-THC per kg, a sublethal dose. The percentage of radioactivity corresponding to unchanged 3H-delta9-THC in extracts of livers and brains was significantly greater in the endotoxin-pretreatment group than in controls. The brain level of 3H-delta9-THC in the endotoxin-pretreated mice was 50% higher than that in the saline-pretreated mice 5 hr after 3H-delta9-THC (100 mg/kg) administration. However, the brain levels of 3H-delta9-THC in the mice treated with endotoxin and 3H-delta9-THC (100 mg/kg) was one-third of that in brains of mice receiving the LD50 of 3H-delta9-THC (300 mg/kg).

Therapy evaluation and management of patients with hemiplegia

Appropriate treatment of the hemiplegic patient depends on a thorough evaluation of sensation and motion in the affected extremities. Realistic goals for self-care, mobility, home, and community skills may be then established. The basic role of therapy when dealing with a stroke patient includes preventing and correcting deformities, improving a patient's functional ability, and increasing strength, control, and upper extremity use when appropriate. Medical intervention may be necessary to augment the occupational and physical therapy programs in the areas of relief of pain and correction of deformities.

Peripheral blood T and B cell characteristics in a patient with severe combined immune deficiency (SCID) maintained in a gnotobiotic environment

Peripheral blood lymphocytes obtained at 24-30 months after birth from a male with X-linked severe combined immune deficiency maintained in a gnotobiotic environment were characterized by T and B cell surface markers. A high proportion (55-80 percent) of circulating lymphocytes bore surface IgM as detected by direct immunofluorescence. A receptor for the activated C3 complement component was detected on 27-47 percent of his lymphocytes. Only 4-12 percent of the peripheral blood lymphocytes formed spontaneous rosettes with sheep erythrocytes (E-R). In general, no blastogenesis was detected in lymphocyte cultures stimulated with pokeweed mitogen or phytohemagglutinin although transient slightly positive responses to both mitogens were occasionally observed. Incubation of lymphocytes with bovine thymosin Fraction V did not increase the percentage of E-R nor induce lymphocyte blastogenesis in the presence of phytohemagglutinin.

Systematic observation of play behavior in autistic children

The play behavior, defined as interaction with peers and objects, of five autistic children was systematically observed in four environments, i.e., a stark environment, a theraplay unit, a playroom, and an outside play deck. The preliminary results suggested that (1) with some children environment has little or no effect on their play behavior; (2) with multiple objects, autistic children frequently related to the objects rather than to their peers; (3) object play was most frequently at the manipulative stage and often included repetitive and negative behavior; (4) within a confined space with no objects present, autistic children frequently engaged in solitary repetitive behavior; and (5) within a confined space designed to facilitate a movement flow (theraplay), autistic children modeled and imitated and were involved in gross motor play together.

Improvement of physical function after stroke: surgical and orthotic management

Initial and subsequent programs for the orthotic and surgical management of the post-stroke patient are outlined, particularly with regard to impairmant of the lower extremities in hemiplegic patients. New developmentsin functional electrical stimulation are described.

The importance of seeing red: self-teaching techniques for adult aphasia

The use of color in speech therapy for adult aphasics offers new, effective, and interesting techniques to the speech clinician. Two specific techniques, “instant definition” and “over-training,” are described.