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Early development of transient hypothyroidism after I131 therapy for thyrotoxicosis.

295 patients of Graves' disease were studied for early development of transient hypothyroidism (TH) and its prognostic value following I131 therapy. 278 patients received I131 < 10 mci (6.4 +/- 1.7 mci) and 17, a dose of > 10 mci (12.6 +/- 2.6). TH was diagnosed on the basis of low T4 regardless of TSH within the first year after I131 therapy followed by normal T4 and TSH. 32 patients developed TH following administration of < 10 mci I131 and it was symptomatic in 10 patients. No instance of TH after high dose of I131 was noted. I131 uptake > 60% at 2 hours before treatment was a risk factor for developing TH (odds ratio 2.6, 95% confidence interval 0.8-9.6). At diagnosis of TH basal TSH was high in 53%, normal in 32%, or low in 15%; Hypothyroidism recognized during the first six months with basal TSH of 50 microU/ml or higher ruled out TH. Development of TH and its hormonal profile did not influence long term thyroid functions. As no prognostic factors predicted TH before I131 therapy or at the time of diagnosis, re-evaluation of thyroid functions later is essential to avoid unnecessary chronic replacement therapy, if hypothyroidism has been diagnosed within a few months of I131 treatment.

Female↗

The effect of cerebral dominance on time sharing between speaking and tapping by preschool children.

48 kindergartners tapped as fast as they could with either the right index finger or the left, either alone or while reciting or repeating verbal material. The secondary tasks diminished tapping rate on both sides, but disproportionately on the right. This result was predicted by a model that postulates greater interference between concurrent activities when both are programmed by the same cerebral hemisphere. Children appear to be more vulnerable to this type of interference than adults. This attribute of immature motor development can be used as an indicator of cerebral lateralization of function in children.

Age Factors↗

Sculpting the developing brain.

The developing brain experiences major construction during fetal life and for at least the first decade of childhood. Many more neurons and synoptic connections are produced than are needed for later function, and the mature brain is what remains after these excess building materials are "sculpted" away. This process is thought to be the basis for the developing brain's plasticity, or the capacity to adapt its behavior and circuitry to stimulation from the external environment. Plastic reorganization of the brain is now being studied in children and adults with new noninvasive tools such as functional brain magnetic resonance imaging. This exploratory tool and other new clinical methods demonstrate how the brain's functional "maps" undergo major reorganization in response to early environmental changes. The neurobiology of brain reorganization during development is also being studied with use of new insights into the molecular mechanisms for activity-dependent neuronal plasticity. Clinical disorders such as lead poisoning, metabolic and epileptic encephalopathies, and psychosocial deprivation may arise from disrupted brain plasticity. Several mental retardation syndromes and cognitive disorders recently recognized as being secondary to genetic disruption of intracellular signaling cascades may also disrupt this process. Understanding how the brain's circuitry is sculpted during development provides an important perspective for thinking about neurodevelopmental disorders.

Brain↗

Secondary bone grafting for unilateral alveolar clefts: a review of surgical techniques.

For the past 5 years we have been performing the closure of the oronasal fistula with alveolar bone grafting in the early-to-late secondary time period. The final decision as to whether early or late grafting should be done is based on if a grafting is needed to support the eruption of a functional lateral incisor. Generally the Moczair type buccal flap, with a "Z" release for wide clefts, is used for the buccal flap. This is combined with lateral releasing incisions on the palate for palatal closure. Separate nasal and oral closures are performed in all cases, with bone placed between the two layers in the alveolar defect. It is believed that this treatment sequence best fulfills the criteria for successful alveolar bone grafting outlined at the beginning of this chapter. Figure 8 demonstrates an alveolar bone grafting procedure in a 10-year-old girl just before eruption of the canine tooth treated with a buccal Moczair flap, lateral releasing incisions on the palate, two-layered closure, and the placement of an iliac bone graft.

Alveolar Process↗

[Comparative bilateral morphometric characteristics of human finger bones].

The morphometric parameters of fingers of the hand in teenage girls were studied using the measurement complex developed by the author. The quantitative characteristics of distal phalangers, individual finger segments and the whole fingers as local anatomical structures belonging to hand, are presented. The analysis of these parameters was performed from the point of view of principles of bilateral and radial symmetry, structural and functional lateralization and evolutionary development of hand of the prehensile type. The results obtained may find application in designing the peripheral devices for telecommunication and computer techniques.

Adolescent↗

Reversal of hemispheric asymmetry on auditory tasks in children who are poor listeners.

We examined hemispheric activation patterns during auditory and visual processing in two groups of children: 13 boys in the age range from 9 to 12 years rated by their parents and teachers as poor listeners and 11 boys in the same age range rated as normal listeners. Three tasks were employed: auditory gap detection, detection of auditory movement, and a control task involving visuospatial discrimination. Electrical activity was recorded from 30 scalp electrodes as participants responded to target stimuli in an event-related potential paradigm. In the visual task, hemispheric activation was relatively symmetric around the midsagittal plane in both groups. In the two auditory tasks, however, hemispheric activation patterns differed significantly between groups. In the normal-listener group, activation was asymmetric to the right hemisphere. In the poor-listener group, however, activation tended toward asymmetry, favoring the left hemisphere. These results suggest that abnormalities in hemispheric lateralization of function may underlie the auditory processing problems of at least some children described as poor listeners.

Attention↗

Hemispheric asymmetry (lateralization) in electroencephalographic activity while viewing familiar and unfamiliar patterns from Kimura figures.

Kimura Recurring Figures were presented after the priming trial to the upper or lower, left or right, tachistoscopic fields while monopolar electroencephalographic activity was measured over the left and right parietal, occipital, and temporal lobes for 9 men and 9 women. The relative proportions of alpha rhythms during the 2 sec after each of 64 presentations were employed as the primary measure. The powerful asymmetry in electroencephalographic activity, manifested as a paucity of alpha activity over the right temporal lobe compared to the left temporal lobe, was not observed for the parietal or occipital regions. There was conspicuously more relative activity over the parietal and occipital lobes, but not over the temporal lobes, during presentations of the familiar figures compared to the unfamiliar figures. Several interactions--explaining more than 25% of the variance--between gender, left and right hemispheric EEG activity, and visual quadrants were consistent with lateralization of function and gender differences in functional brain organization.

Adult↗

[Observation of general movements in newborns and young infants: prognostic and diagnostic value].

OBJECTIVES: In this paper a new approach to clinical and neurological assessment of newborns and young infants is described, based on qualitative evaluation of spontaneous motor patterns, and particularly of General Movements (GMs), which are gross movements involving the whole body. DEVELOPMENT: The results of several researchers on this topic, carried out in the last decade and supporting the validity of this method for clinical practice and for research, are reviewed. It is particularly suitable for being applied to fragile infants, such as preterm infants in the incubator. GM findings correlate very well with neuroimaging findings, and with the results of classical neurological examination, when this latter is applicable. Its results strongly correlate with the neurological outcome. Trained observers show a very high inter observer reliability. CONCLUSIONS: The technique is particularly useful to identify infants at high risk for cerebral palsy early in life, and provides useful information to predict its type and the severity of later functional impairment.

Diagnosis, Differential↗

[Results of animal experiments on alloplastic tendon replacements using the Bader tendon prosthesis].

Based on our experimental results with the Bader tendon prosthesis, encouraging results for alloplastic tendon replacement were obtained. However a general recommendation for its clinical use cannot be given. Over a period of 4-6 weeks of immobilization healing of the artificial tendon with inflammation could be observed. In the biopsies we found the equivalent of connective tissue attachment between vital tissue and the alloplastic material. We could not clarify whether this connection would endure strain. The pronounced adhesions between the anstomosis and surrounding tissue make later function questionable.

Animals↗

[Binocular coordination during reading].

Is there an effect on binocular coordination during reading of oculomotor imbalance (heterophoria, strabismus and inadequate convergence) and of functional lateral characteristics (eye preference and perceptually privileged visual laterality)? Recordings of the binocular eye-movements of ten-year-old children show that oculomotor imbalances occur most often among children whose left visual perceptual channel is privileged, and that these subjects can present optomotor dissociation and manifest lack of motor coordination. Close binocular motor coordination is far from being the norm in reading. The faster reader displays saccades of differing spatial amplitude and the slower reader an oculomotor hyperactivity, especially during fixations. The recording of binocular movements in reading appears to be an excellent means of diagnosing difficulties related to visual laterality and to problems associated with oculomotor imbalance.

Child↗

The effects of pyridostigmine bromide on visual performance.

The effects of pyridostigmine bromide (PB) on selected visual functions were measured on four healthy aviator candidates. Following a pretreatment day during which baseline measurements were completed, subjects were administered currently recommended doses (30 mg, t.i.d.) of PB for 3 d during which their visual functions were assessed using a repeated measures design. Spatial resolution ability was evaluated with high and low contrast visual acuity charts and contrast sensitivity charts at three luminance levels. Dark adaptation was evaluated by measuring visual thresholds for 40 min after a standardized retinal photopigment bleach. Also, refractive error and several oculomotor functions (lateral phoria, fusional vergence, accommodative amplitude, and pupil size) were measured. On days that the subjects ingested PB, only refractive error and pupil diameter were significantly different, and these only minimally. We conclude that the use of PB at doctrinal doses will not significantly compromise an aviator's visual ability.

Accommodation, Ocular↗

[Chronic pain impairs spatial learning and memory ability and down-regulates Bcl-2 and BDNF mRNA expression in hippocampus of neonatal rats].

OBJECTIVE: To investigate the effect and possible mechanism of complete Freund's adjuvant induced chronic pain on later function of learning and memory in neonatal rats. METHODS: Sixty Sprague-Dewley rat pups (10 litters of 6 pups) were randomly divided into control group and chronic pain group (n = 30 in each group). In the chronic pain group, left hind paws of the rats were treated with subcutaneous injection of 20 microl of CFA on postnatal day-2. The control rat pups received normal saline. The hippocampus of rats were separated on postnatal days 10 and 21 (one rat in each group from every litter, n = 10). The expression of Bcl-2 and BDNF mRNA were investigated by RT-PCR. Morris water maze tests were performed on day 21 (one rat in each group from every litter, n = 10). RESULTS: In hidden-platform training of Morris water maze, the mean escape latency of rats in the chronic pain group were longer than that of the control rats. In spatial probe tests, the average percentages of the swimming time and distances in the platform quadrant in the pain group rats were less than those in the control group. There was no significant difference in visible-platform training between the two groups. The Bcl-2 and BDNF mRNA expressions in hippocampus of the pain group rats were lower than those in the control at day 10, but no significant difference at day 21. CONCLUSION: Chronic pain stress induced by CFA impairs the spatial learning and memory function in neonatal rats. These effects might exert through down-regulating Bcl-2 and BDNF mRNA expression in the hippocampus.

Animals↗

[Predisposing factors for ureteric strictures in renal transplantation].

OBJECTIVE: Renal transplantation is a well defined surgical procedure, but it nevertheless remains associated with a risk of medical and surgical complications. Ureteric strictures, with an incidence ranging from 2% to 7.5% according to the series, are the most frequent urological complication. The objective of this study was to determine the incidence of ureteric strictures and the existence of risk factors predisposing to the development of ureteric strictures and to evaluate their consequences on patient and graft survival, based on a single-centre retrospective series of renal transplantations. PATIENTS AND METHODS: From January 1990 to December 2002, 1787 renal transplantations were performed consecutively in our centre. Graft, donor and recipient characteristics were extracted from a computerized database and validated by an independent observer. The parameters studied included donor's age and recipient's age, donor's haemodynamic status and serum creatinine at the time of harvesting, cause of death, graft weight and number of graft arteries, cold ischaemia and reperfusion times, number of HLA incompatibilities and percentage anti-HLA immunization, time to return of graft function, acute rejection, presence or absence of a double J stent, episodes of acute pyelonephritis, CMV infection and patient and graft survival according to the Kaplan-Meier method. RESULTS: Ureteric stricture was observed in 74 patients (4.1% of cases) and a donor age greater than 65 years (p < 0.0001), the presence of more than 2 arteries on the graft (p = 0.03) and recipients with an anti-HLA immunization less than 25% (p = 0.037) were identified as independent risk factors. Furthermore, grafts complicated by ureteric stricture resumed function later (p = 0.001). The development of ureteric stricture did not have an unfavourable impact on the 10-year recipient and graft survival rates.

Adolescent↗

Cellular retinoic acid-binding protein messenger RNA: levels in rat tissues and localization in rat testis.

Studies were conducted to explore the tissue- and cell-specific regulation of cellular retinoic acid-binding protein (CRABP) expression in the rat. Two studies were carried out. The first explored the regulation of CRABP mRNA levels in selected rat tissues by dietary retinoid status, and the relationship between CRABP mRNA and protein levels in different tissues. The second examined the cellular localization of CRABP expression in the testis. In order to conduct these experiments, a cDNA encoding CRABP was isolated and characterized. The DNA sequence of the coding region had 96% identity with that of the mouse CRABP cDNA and encodes a protein identical to mouse and bovine CRABP. CRABP mRNA and protein levels were quantified in five tissues from normal, retinoid-deficient, and retinol-repleted rats. Tissue CRABP and CRABP mRNA levels were highly correlated (P less than 0.01) indicating that inter-tissue variability of CRABP levels mainly results from regulation of CRABP mRNA levels. Neither CRABP protein nor mRNA levels were affected by retinol deficiency, in marked contrast with results previously demonstrated with cellular retinol-binding protein (CRBP) (J. Lipid Res. 1990. 31: 821-829). 35S-labeled CRABP cRNA probes were used to localize CRABP mRNA within the testis of adult rats by in situ hybridization. CRABP mRNA was localized selectively in the periphery of the seminiferous tubules, primarily in type A spermatogonia. The localization of CRABP mRNA differs from that of CRABP protein, which is known to be enriched in maturing and more mature germinal cells. This difference suggests that CRABP in germ cells may be highly stable, remaining in the maturing germ cells without degradation long after CRABP mRNA levels have declined to very low levels. The specific localization of CRABP mRNA and protein presumably reflects the biological roles of retinoic acid in the development and/or later function of germinal cells.

Amino Acid Sequence↗

Evolution of neurohypophyseal hormones and their receptors.

Nine active neurohypophyseal principles have been isolated and identified among the vertebrates. Arginine-vasotocin is the most ubiquitous, occurring in pituitary glands from representatives of all the major vertebrate groups. There is much more variation in structure among the principles that resemble oxytocin. The manner in which these evolved remains unclear. Arginine-vasotocin stimulates smooth muscles from a wide variety of vertebrate species. It can stimulate contraction of oviducts from many jawed fishes and tetrapods. The oxytocin-like peptides are usually less active in this respect. Among adult mammals arginine-vasotocin is replaced by arginine-vasopressin which has much less oxytocin activity. Thus, although arginine-vasotocin may both stimulate oviducts and cause water retention in nonmammalian tetrapods, oxytocic and antidiuretic functions can be regulated independently by oxytocin and vasopressin in mammals. Arginine-vasotocin elicits vasoconstrictor responses in even the most primitive vertebrates. These may be systemic or regional. Their distribution may determine whether arginine-vasotocin acts as a diuretic or an antidiuretic agent. It is possible that the most primitive neurohypophyseal functions were related to cardiovascular regulation and that the neurohypophysis acquired its osmoregulatory functions later in vertebrate evolution.

Animals↗

[Lateral instability of the ankle joint (2). Active training programs can prevent surgery].

One hundred consecutive patients with chronic lateral functional instability of the ankle were treated non-operatively with physiotherapy (active range-of-motion training, strengthening exercises and co-ordination training with a tilt-board). All patients were evaluated functionally with a special rating scale, and radiologically with standardised stress radiographs measuring anterior talar translation (ATT) and talar tilt (TT). Excellent or good functional results were obtained in 49 of the patients, fair or poor in the remainder. The outcome was better in those with painful functional instability or mild mechanical instability, while those with more pronounced mechanical instability required further treatment (i e, reconstructive surgery). Of 10 patients with generalised joint laxity, only fair or poor results were obtained in seven, all of whom had mechanical instability.

Adult↗

[Results of long-term longitudinal studies of lateralization of motor and sensory functions].

Results of a follow-up study of the lateralisation of motory and sensory functions are presented. The development of handedness, the preference of one leg, one eye and one ear was determined for about 200 probands at the age of 3/4 to 17 years. Three types of lateralisation were found: (i) the "non-right" motory and sensory functions type (ambivalence); (ii) the "right" motory functions/"non-right" sensory functions type; (iii) the "right" motory and sensory functions type (univalence).

Adolescent↗

[Embryological development of the chick tongue].

Evolutionary, structural, ultrastructural and cytochemical studies (PAS, alcian blue, toluidine blue, Ruthenium red) were performed in chick tongues 7 to 19 days development, with the aim of observing the histomorphological changes during growth and differentiation. At 7 days the tongue was covered by a flat epithelium without cornification, with four cell lines. As an axis was observed a central hyaline-cartilaginous skeleton surrounded by mesenchyma. Since 11 days appeared glandular buds and canalized cell cords united trough complexes. At 15 days the epithelial thickness increased remarkably. The subepithelial connective tissue, already notably differentiated, formed papillae. Glandular acini contained PAS positive, alcianophilic, metachromatic and positive ruthenium red substance. Ultrastructurally, glands showed clear cells, with decreased electronic density and organoids randomly distributed and dark cells having electrodense cytoplasm and more organized organoids. At 19 days the epithelium was cornified in the tongue anterior half. A net increment of glycoconjugates was detected in glands. These observations show: 1) lingual glands secrete mucins since 15 days of embryonic development; 2) the cornified anterior epithelium is the result of a genetic pattern and not of a later functional adaptation to the type of feeding (grain eating birds).

Animals↗