Grambank reveals the importance of genealogical constraints on linguistic diversity and highlights the impact of language loss

While global patterns of human genetic diversity are increasingly well characterized, the diversity of human languages remains less systematically described. Here, we outline the Grambank database. With over 400,000 data points and 2400 languages, Grambank is the largest comparative grammatical database available. The comprehensiveness of Grambank allows us to quantify the relative effects of genealogical inheritance and geographic proximity on the structural diversity of the world's languages, evaluate constraints on linguistic diversity, and identify the world's most unusual languages. An analysis of the consequences of language loss reveals that the reduction in diversity will be strikingly uneven across the major linguistic regions of the world. Without sustained efforts to document and revitalize endangered languages, our linguistic window into human history, cognition, and culture will be seriously fragmented.

Human papillomavirus 6a lesions of the lower eyelid and genitalia

A 42-year-old white man presented with a lower eyelid lesion and recurrent condylomata acuminata of his genitalia due to human papillomavirus (HPV) type 6a. Polymerase chain reaction analysis of both lesions was performed. The eyelid lesion was excised and found to be a papilloma caused by HPV6a infection. An extensive literature search revealed one previous report of concurrent conjunctival papilloma and genital papilloma involving HPV6a. Rare cases of solitary lesions of the eyelid secondary to HPV6a infection have been reported. HPV should be considered as a possible cause of an eyelid papilloma.

Manometric assessment of the effect of the diaphragmatic crural sling in gastro-oesophageal reflux: implications for surgical management

A manometric method to measure the effect of contraction of the crural sling of the diaphragm on intraoesophageal pressure is described. The manometric crural pressure was measured in 57 patients with gastro-oesophageal reflux disease, documented by 24-h ambulatory pH monitoring, and compared between patients with and without hiatal hernia. Repeat measurements were made in 33 patients who underwent antireflux surgery that incorporated a crural repair. Mean crural pressure in 41 patients with hiatal hernia was 5.0 mmHg, compared with 15.0 mmHg in 16 without hiatal hernia (P < 0.01). In the 33 patients undergoing antireflux surgery, mean crural pressure rose from 7.1 mmHg before operation to 11.6 mmHg afterwards (P < 0.02) overall, and from 4.7 to 10.1 mmHg (P < 0.01) in the 26 patients with hiatal hernia. These results confirm a measurable contribution of the diaphragmatic crural sling to resting pressure at the high-pressure zone. The crural pressure is deficient in patients with hiatal hernia compared with that in those with reflux but no hernia. The mean crural pressure is increased in patients by antireflux surgery, particularly in those with hiatal hernia. The results provide objective support for the role of the crural diaphragm in the antireflux mechanism and the rationale of performing crural repair during antireflux surgery, particularly in the presence of hiatal hernia.

Laparoscopic 'physiological' antireflux procedure: preliminary results of a prospective symptomatic and objective study

The 'physiological' antireflux procedure has been shown to be as effective as Nissen fundoplication in reflux control, but with a significant reduction in the incidence of mechanical complications. This technique was attempted laparoscopically in 26 patients in a prospective study involving independent symptomatic, manometric and pH assessment performed before operation and at a mean of 5.5 months after operation. The procedure was successfully completed laparoscopically in 23 (88 per cent) patients. Mean hospital stay was 3.8 days and mean time to return to work 1.8 weeks. There was neither mortality nor reoperation; 91 per cent of patients obtained symptomatic relief (82 per cent Visick grade 1). There was no gas-bloat or inability to belch or vomit. All 14 patients who underwent objective testing had a normal oesophageal pH profile, the mean percentage total time that pH < 4 falling from 11.0 to 1.1 (P < 0.001). Lower oesophageal sphincter characteristics, including relaxation, were similar to control values. These preliminary results suggest symptomatic and objective results comparable to those following open surgery, but with the benefits of a shorter hospital stay and time off work. In addition to a lower incidence of mechanical complications, the relative ease of performance of this procedure confers an additional advantage over Nissen fundoplication when performed laparoscopically.

Occupational carpal tunnel syndrome in Washington State, 1984-1988

BACKGROUND

There are no published population-based studies of occupational carpal tunnel syndrome (OCTS) using a strict case definition. Most studies are either industry specific or present patient self-report of symptoms.

METHODS

We conducted a population-based incidence study of OCTS using the Washington State Workers' Compensation database. Incident OCTS claims were identified with paid bills for physician reported ICD codes 354.0 and 354.1.

RESULTS

There were 7,926 incident OCTS claims identified for the years 1984-1988, which yields an industry-wide incidence rate of 1.74 claims/1,000 FTEs. The mean age (37.4 years) and female/male ratio (1.2:1) in this population differ from those reported in nonoccupational carpal tunnel studies (mean age, 51 years; female/male ratio, 3:1). The female-specific OCTS incidence rate increased significantly during the study period. The highest industry specific OCTS rates were found in the food processing, carpentry, egg production, wood products, and logging industries.

CONCLUSION

Demographic differences and industry-specific rates consistent with workplace exposures suggest that OCTS is distinct from CTS occurring in nonoccupational settings. Workers' compensation data proved useful in identifying high risk industries.