Speech therapy for Parkinson's disease

Twenty-six patients with the speech disorder of Parkinson's disease received daily speech therapy (prosodic exercises) at home for 2 to 3 weeks. There were significant improvements in speech as assessed by scores for prosodic abnormality and intelligibility' and these were maintained in part for up to 3 months. The degree of improvement was clinically and psychologically important, and relatives commented on the social benefits. The use of a visual reinforcement device produced limited benefit over and above that from prosodic exercises alone, except to patients with severe speech disorder.

Pharmacokinetics of theophylline in young and elderly subjects

Theophylline kinetics were evaluated in 6 elderly (age 65-75 years) and 5 young (age 22-28 years), nonsmoking males following the oral administration of 200 mg of Elixophylline. Theophylline serum concentration in the postabsorptive phase declined in a monoexponential manner. Total body clearance, elimination half-life, volume of distribution and protein binding were determined. There were no statistically significant differences in these kinetic parameters between the elderly and young subjects. Therefore, advancing age should not be used as a sole factor in the adjustment of theophylline dosage.

Speech therapy for patients with Parkinson's disease

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Effect of fructose feeding on insulin secretion and insulin action in the rat

Insulin secretion and insulin action were studied in rats fed either a diet containing (as percent of calories) 66% fructose, 22% protein, and 12% fat, or standard rat chow (60% vegetable starch, 29% protein, 11% fat) for 7 days. Plasma glucose concentration following either an oral glucose or fructose load (180 mg/100 g body weight) were slightly higher in the fructose-fed rats, and this was associated with a much greater elevation of plasma insulin concentrations. The ability of insulin to stimulate disposal of glucose load was determined during the continuous infusion of epinephrine, propranolol, glucose, and insulin. Under these condtions the steady state plasma insulin levels were the same in the two groups of rats, whereas the steady state plasma glucose levels were almost twice as high in the fructose fed rats. Thus, fructose feeding for 7 days resulted in an increase in the insulin response to an oral carbohydrate challenge, as well as to a loss of normal insulin sensitivity.

A biotype of Enterobacteriaceae intermediate between Citrobacter and Enterobacter

The authors isolated two strains of an unnamed bacterial biotype with characteristics intermediate between those of Enterobacter and Citrobacter. The organisms did not produce acetyl-methyl carbinol, but decarboxylated lysine. Apart from the latter trait, they most closely resemble H2S-negative Citrobacter freundii. They differ biochemically from all other currently accepted species of enterobacteriaceae. Their pathogenic significance appears similar to that of the two genera they most closely resemble. Only by recognition and study of additional strains can their identity be more definitively delineated and their significance more fully assessed.

Plasma catecholamine levels and pulmonary dysfunction in sepsis

In a retrospective analysis of 18 patients with sepsis and adult respiratory distress syndrome, we found that high plasma epinephrine and noradrenalin levels were associated with severe defects in oxygenation that accompany this disease. The result of previous experimental work support the concept that high plasma catecholamine levels augment already existing defects in the ventilation to perfusion ratio and increases the measured intrapulmonary shunt fraction. The results of this study do not, however, delineate whether or not the relationship between high circulating plasma catecholamine levels and severe adult respiratory distress syndrome is causal or simply a measurement of two indexes which reflect the severity of the underlying disease process.

White and West Indian infants in London: development from birth to 44 weeks of age

Fifty white and 50 West Indian babies were examined on four occasions between birth and the age of 10 months. The West Indian babies were significantly advanced over the white babies when newborn, but by 6 weeks of age were losing their advantage; there were no significant differences at 6 months and 10 months of age. The ethnic origin, growth pattern, feeding customs and relevant socioeconomic factors were considered and the implications discussed.

The hemodynamic importance of the geometry of bifurcations in the circle of Willis (glass model studies)

The critical Reynolds number, Re c , at which turbulence developed in glass model bifurcations was measured with an Evans blue indicator for bifurcations with a branch/trunk area ratio of unity, and bifurcation angles of 45°, 90°, 135°, and 180°. The Re c dropped from 2,500 in a straight tube to 1,200 in the 180° bifurcation. Further drops occured with pulsatile flow (if the mean flow rate was used to calculate the velocity). Three sizes of aneurysms at the apex of the 90° bifurcation lowered the Re c at small bifurcations, and less in the 180° ones. The curves for steady and pulsatile flow crossed at 135°. We did qualitative, but not quantitative, assessments of axial stream impingement on the apex of the bifurcation in the site of aneurysm formation, and of boundary layer separation and vortex shedding at the lateral angles. Both appeared to vary with the angle of the bifurcation and the Reynolds number. We also studied flow profiles in glass models of anterior cerebral-anterior communicating artery bifurcations and the posterior communicating artery origin from the internal carotid. The relevance of these studies to localization of intimal cushions, aneurysms, and atherosclerosis was discussed.

Comparison of the elastic properties of human intracranial arteries and aneurysms

Static pressure–volume curves were done on seven intracranial saccular aneurysms and 16 major cerebral arteries from human autopsies. The aneurysms were much less distensible than the arteries. The major change was in the initial or elastin part of the curve (elastance of 6 ± 5 S.D. × 105 dynes/cm per 100% elongation in the artery compared to 13.5 ± 5 × 105 dynes/cm per 100% elongation for the aneurysm; p < 0.005). This agrees well with histological studies which show that elastin is decreased and fragmented in aneurysms.As the aneurysm enlarges, its wall must become thinner. This change, coupled with the loss of distensibility, makes it more prone to rupture. Obviously the larger the aneurysm, the thinner the wall (if the volume of tissue remains constant), and the greater the risk of rupture.The distensibility of major cerebral arteries could be dramatically decreased by two or three runs to pressures of 200 mm Hg. The elastance of the initial part of the curve changed from 2 ± 1 × 105 dynes/cm per 100%; elongation to 8 ± 1 × 105 dynes/cm per 100% elongation (different at p < 0.001). The final elastance was altered less significantly (42 ± 6 × 105 dynes/cm per 100% elongation to 82 ± 28 × 105 dynes/cm per 100% elongation; p < 0.01). This shift in distensibility was accompanied by a significant increase in diameter of the artery. High pressures appear able to break the single elastin layer of cerebral arteries.

Intestinal calcium absorption: nature of defect in chronic renal disease

When compared to that of normal animals, calcium-binding protein activity of duodenal mucosa obtained from uremic rats was decreased. There was no change in this activity after vitamin D(3), therapy. In contrast, prior treatment with 25-hydroxycholecalcijerol resulted in increased transport of calcium-45 and calcium-binding protein activity in the intestine.

An Uncommon Type of Bezold's Mastoiditis

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Nerve-Graft in the Treatment of Facial Paralysis: Ballance and Duel Method

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