The specificity of the CPK MB enzyme kinetic test for the diagnosis of acute myocardial infarction (author's transl)

The clinical usefullness of the CPK MB test (spectophotometric method) was evaluated on 139 patients admitted to a Cardiovascular Diseases Department with a diagnosis of suspected myocardial infarction. Serial determinations of serum MB isoenzyme creatine kinase, total creatine kinase, lacate dehydrogenase and hydrossibutirrate dehydrogenase were made at 1st, 2th, 3th, 4th, 5th, 6th, 7th day. Incidence of CPK MB false positive and false negative data were also determined and correlated with the electrocardiogram pattern and serum levels of other standard enzymes. Results indicate that the CPK MB kinetic test is highly specific (94%) and promptly available in the early diagnosis of acute myocardial infarction.     

The relationship between rifle steadiness and rifle marksmanship and the effect of rifle training on rifle steadiness.

In two replications (N = 148, N = 200) an ataxiameter test of rifle steadiness was administered to army recruits before and after rifle training, and scores were correlated with a post-training marksmanship criterion. The test seems to be a reliable instrument (split-half r = .82, .87), but a poor predictor of rifle marksmanship. "No evidence is found that rifle training affects rifle steadiness." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correlation of dynamic contrast-enhanced magnetic resonance imaging with histologic tumor grade: comparison of macromolecular and small-molecular contrast media

BACKGROUND: The endothelial integrity of microvessels is disrupted in malignant tumors. Quantitative assays of tumor microvascular characteristics based on dynamic magnetic resonance imaging (MRI) were correlated with histopathologic grade in mammary soft tissue tumors. MATERIALS AND METHODS: A spectrum of tumors, benign through highly malignant, was induced in 33 female rats by administration of N -ethyl-N -nitrosourea (ENU), a potent carcinogen. Dynamic contrast-enhanced MRI was performed using a small-molecular contrast medium [gadopentetate, MW = 0.5 kDa] and a macromolecular contrast medium [albumin-(Gd-DTPA)30, MW = 92 kDa] at an interval of 1-2 days. Permeability surface area product (PS), as estimated by the corresponding endothelial transfer coefficient (KPS), and fractional plasma volume (fPV) were calculated for each tumor and each contrast agent using a two-compartment bi-directional kinetic model. MRI microvascular characteristics were correlated with histopathologic tumor grade. RESULTS: Tumor permeability to macromolecular contrast medium, characterized by KPS, showed a highly positive correlation with tumor grade (r 2 = 0.76, P < 10(-10)). KPS values were zero for all benign and some low-grade carcinomas, greater than zero in all other carcinomas, and increased in magnitude with higher tumor grade. A considerably smaller but significantly positive correlation was found between fPV and tumor grade using macromolecular contrast medium (r 2 = 0.25, P < 0.003). No correlation between KPS or fPV values and tumor grade was found using gadopentetate (r 2 = 0.01, P > 0.95 and r2 = 0.03, P > 0.15, respectively). CONCLUSION: Quantitative tumor microvascular permeability assays generated with macromolecular MRI contrast medium correlate closely with histologic tumor grade. No significant correlation is found using small-molecular gadopentetate.     

Comparison of the combined cortical thickness of the second metacarpal with Sharp's method for scoring hand microradiographs in rheumatoid arthritis

OBJECTIVE: To compare the correlation and specificity of the combined cortical thickness of the second metacarpal (CCT-MC) with Sharp's method (SM) for scoring joint erosions and joint space narrowing in rheumatoid arthritis (RA) and to compare the degree of interobserver agreement between the 2 methods. METHODS: Hand microradiographs of 22 women with RA, functional classes III and IV, were scored independently by 3 rheumatologists using the CCT-MC and the CCT of the middle phalanx and SM. RESULTS: (1) There was a highly significant correlation between the total SM score and the CCT-MC for the 3 observers (r = 0.61, p = 0.0026), but not between the CCT of the middle phalanx and SM (r = 0.15, p = 0.53). There was a lower degree of agreement between the observers for SM erosion scores compared to the CCT-MC (intraclass correlation 0.88 for the CCT-MC and 0.63 for the SM); (2) Both joint space narrowing and erosion scores correlated highly with the CCT-MC (r = -0.60, p = 0.004; and r = -0.51, p = 0.014, respectively); (3) CCT-MC measurements are more closely related to the inner (d) as opposed to the outer (D) diameter of the 2nd metacarpal; (4) The mean time to obtain the CCT-MC score was 3.43 min (SD = 1.38) versus 9.83 min (SD = 3.20) for SM (p = 0.0001); (5) the derivative, (D2-d2)/D2, was significantly correlated with SM (r = -0.72, p = 0.0002) and its erosion and joint space narrowing components (r = -0.63, p = 0.0019; and r = -0.71, p = 0.0002, respectively). CONCLUSION: The CCT-MC is a rapid, practical method with higher agreement among observers compared to SM and correlates highly with SM scores for joint damage in RA. CCT-MC appears to have a higher degree of specificity than other sites for CCT measurement. The CCT-MC is more closely related to the inner diameter than the outer diameter, which supports the notion that the principal site of accelerated bone loss due to RA in the hand occurs at the endosteal surface. The CCT-MC should be further assessed with respect to monitoring radiological progression in RA.     

Differences in duration of Huntington's disease based on age at onset

OBJECTIVE: The accurate determination of limitations in physical activity is important in evaluating patients with heart failure and in assessing the efficacy of treatment. However, the conventional measures used to evaluate hemodynamics, functional class, and exercise capacity all have limitations. Our objective was to develop a simple method (The Master-Borg test) for evaluating the physical activity of patients with chronic heart failure using self-evaluation of the sensation of dyspnea at a constant workload. METHODS: Patients with NYHA class I (N = 20), class II (N = 20), and class III (N = 20) chronic heart failure performed a symptom-limited treadmill exercise test to determine peak VO2 and anaerobic threshold (AT). Patients subsequently performed Master's two-step test for 90 s and maximal dyspnea was self-rated using the visual analog Borg scale (the Master-Borg test). RESULTS: The mean workload in the Master-Borg test was 15.2+/-1.6 mL x min(-1) x kg(-1). A significant correlation was found between the Master-Borg score and peak VO2 (r = 0.87) or AT (r = 0.84). The reproducibility of the Master-Borg tests was represented by a correlation coefficient of 0.93. CONCLUSION: Although simple and inexpensive, the Master-Borg test accurately represents ordinary activity levels, relates the sensation of dyspnea to peak exercise tolerance, and can be completed by most patients with heart failure. Master-Borg scores correlated with peak VO2 and AT, and can differentiate among NYHA classes I, II, and III. The Master-Borg test appears to be clinically useful for evaluating the value of physical activity and exercise capacity of patients with chronic heart failure.     

The relationship of various tibia bone measurements in hens

Tibias from 50 Single Comb White Leghorn hens were used to study the relationships among various bone measurements. The bone ash (BA), length, wet bone volume (V), fat-free dry matter (FFDM), fat-free bone density (BD; mass per unit bone volume), and bone breaking force (BF) were measured, and the BA concentration (BA/V) and BA as a percentage of FFDM (BA/FFDM) were calculated. Bone ash was highly correlated with FFDM (r = 0.975). The BD was poorly correlated with any of the parameters measured in the present study. The BF was highly correlated with BA (r = 0.922) and FFDM (r = 0.918), but less well correlated with BA/FFDM (r = 0.496) and BA/V (r = 0.694). However, the inclusion of volume2 significantly improved the BF predicting models when BA/V was used as predictor (R2 = 0.855), indicating that BF is not only a function of BA density but also of bone size. The BF adjusted for V may better reflect treatment effect upon bone status than BF alone. The coefficient of variation of BA/FFDM and BD was smaller (0.007) than the CV with BA/V (0.026), which may indicate the BA/V is potentially a better indicator of bone status than BA/FFDM and BD. Bone length was poorly correlated with BA, FFDM, and BF, but highly correlated with V (r = 0.844). The volume of the same bone measured by the water weight change method gave the most consistent measurement. The data showed that BA/V may be a better measurement to reflect the bone status changes of hens than other measurements tested. When BA, FFDM, or BF are used in laying hen's bone status studies, the data analysis needs to be adjusted for V, an V is closely correlated with these variables.     

Comparison of digital with videotape echocardiography in patients with chest pain in the emergency department

Sterol carrier protein 2 (SCP2) has been implicated in adrenal steroidogenesis by in vitro studies. In order to clarify the clinical significance of SCP2 in human steroidogenesis, we investigated the expression of SCP2 mRNA in various types of adrenocortical tissue and one testis and examined the correlation between the amounts of SCP2 and other values such as the free cholesterol content and the cholesterol side-chain cleavage (SCC) activity in the tissue mitochondria. The types of adrenocortical tissue examined included adrenocortical carcinomas (N = 3), adrenocortical adenomas from patients with Conn's syndrome (N = 3) and from patients with Cushing's syndrome (N = 3), non-functioning adrenocortical adenomas (N = 2) and normal adrenal glands (N = 2). Northern blot hybridization predominantly revealed a 1.8-kb SCP2 mRNA in all tissue specimens examined. The mRNA concentrations of SCP2 in two out of three adrenocortical carcinomas were relatively lower than those in other types of tissue. No other special tendency was observed regarding the mRNA expression levels in various tissue specimens. The mRNA concentrations of SCP2 correlated significantly with mitochondrial contents of free cholesterol (r = 0.67, p < 0.01), but was not correlated with the SCC activities in mitochondria measured by an in vitro enzyme assay. The mitochondrial SCC activities, however, were correlated significantly with the protein levels of mitochondrial P-450 scc determined by a Western blot analysis (r = 0.79, p < 0.01). The significant positive correlation between mRNA concentrations of SCP2 and the mitochondrial content of free cholesterol suggests that the central role of SCP2 in human steroidogenic tissues may be in part a translocation of cytoplasmic free cholesterol to the mitochondria, as demonstrated previously by in vitro studies.     

The biomechanics of twisting somersaults. Part IV: Partitioning performances using the tilt angle

2-Methoxyethanol (ethylene glycol monomethyl ether) (EGME), is one of the most commonly used solvents for industrial and consumer products. Although the solvent has been shown to be a reproductive toxin the genotoxic activities of EGME especially its metabolites, have not been adequately investigated. The mutagenicity and cytotoxicity of EGME and its major metabolites, methoxyacetaldehyde (MALD) and methoxyacetic acid (MAA) in Chinese hamster ovary (CHO) cells were therefore examined by us. We have determined the mutagenicity of these compounds at the hypoxanthine-guanine phosphoribosyltransferase (hprt) locus in CHO-K1-BH4 cells (CHO/HPRT assay) and the xanthine-guanine phosphoribosyl transferase (gpt) locus in CHO AS52 cells (AS52/GPT assay). The results show that these chemicals are not mutagenic to the hprt locus in CHO-K1-BH4 cells either with or without rat liver S9 mix as the metabolic activating system. With AS52 cells, only MALD is mutagenic in the absence of S9. It induced a dose-dependent mutagenic response. A dose-dependent cytotoxicity was induced by all compounds in both cell lines. MALD is the most and EGME is the least cytotoxic compounds. Our study shows that a metabolite of EGME, MALD, is highly cytotoxic and likely induces deletion-type mutations in AS52 cells. The genotoxic effect of EGME is, therefore, dependent upon its metabolism and its detection is dependent upon the assays used.     

Stroke volume measurement during supine and upright cycle exercise by impedance cardiography

This study evaluated impedance cardiography (ZCG) estimates of stroke volume (SV) during exercise. Seven subjects were studied at rest and during progressive cycle exercise in supine and upright positions. SV was determined by ZCG (SVZCG) during exercise and for the first 5 cardiac cycles following exercise. SVZCG was compared with separate measurements of SV by CO2 rebreathing (SVCO2). Static blood resistivity (p) was measured at each level of exercise. No significant differences were found between supine exercise and immediate post-exercise values for the peak of the first derivative of the impedance change (dZ/dtmax), left ventricular ejection time (LVET), or SVZCG. Small differences in dZ/dtmax and SVZCG, but not LVET, were found in exercise to post-exercise cycling in the upright position. Intra-individual SVZCG and SVCO2 were moderately correlated (upright mean r = 0.64, supine r = 0.42) from rest to 70% of peak VO2. Similar correlations were found between Pulse-O2 (VO2/heart rate, used as an index to SV) and both SVZCG (upright r = 0.73, supine r = 0.57) and SVCO2 (upright r = 0.8, supine r = 0.65). The ZCG parameters dZ/dtmax and LVET correlated better with Pulse-O2 (dZ/dtmax: upright r = 0.92, supine r = 0.73; LVET: upright r = -0.9, supine r = -0.9). SVZCG calculated with the Kubicek equation performed as well as SVCO2. ZCG might be a superior method if the inversely correlated parameters, dZ/dtmax and LVET, were not expressed as a product to calculate SV.     

A comparison of orocaecal transit times assessed by the breath hydrogen test and the sulphasalazine/sulphapyridine method in healthy beagle dogs

Orocaecal transit time (OCTT) was assessed in six healthy beagles by means of the breath hydrogen test (BH2T) and the sulphasalazine/sulphapyridine method (SLZ) after the administration of a test meal of canned food mixed with sulphasalazine. Orocaecal transit time was defined as the time taken from the oral administration of the test meal to the time when the first portion of the meal reached the colon. In five of the dogs the OCTTs assessed by the BH2T were shorter than those measured by the SLZ method by 30, 15, 45, 30 and 45 minutes. However, the median OCTT assessed by the BH2T (135 minutes, range 120 to 195 minutes) was not significantly different from that measured by the SLZ (180 minutes, range 150 to 210 minutes) and was highly correlated with it (r = 0.94, P = 0.016). The sixth dog maintained baseline hydrogen and plasma sulphapyridine readings throughout the monitoring period and the OCTT could not be measured.     

A comparison of the shake test, optical density, L/S ratio (planimetric and stechiometric) and PG for the assessment of fetal lung maturity

Our aim was to determine the diagnostic accuracy and reliability of four tests for the assessment of fetal lung maturity (FLM): shake test, optical density at 650 nm (OD650), lecithin to sphingomyelin ratio (L/S) by planimetry and stechiometry, and presence of phosphatydylglycerol. Amniotic fluid was obtained from 74 patients at various gestational ages. The shake test and the OD650 were performed according to published methods L/S was determined by TLC (thin-layer chromatography) and the ratio assessed by planimetry and stechiometrically by measurement of organic phosphorus from the chromatographic spots. PG was assessed similarly by TLC. When correlated with gestational age at amniocentesis, all tests correlated positively: shake test (r = 0.46, p < 0.005); OD650 (r = 0.31, p < 0.005); planimetric L/S (r = 0.77, p < 0.005); stechiometric L/S (r = 0.52, p < 0.005) and PG (r = 0.54, p < 0.005). The diagnostic accuracy of each test was as follows: the shake test and the OD650 had a sensitivity of 50%, while the steciometric L/S had a sensitivity of 75%, the planimetric L/S and the presence of PG were 100%. All four tests demonstrated a specificity greater than 64%, the highest for the PG presence being (83%) and the shake test (86%). Predictive negative values for lung maturity were > 93% for all tests, with the highest for the planimetric L/S and presence of PG being (100%). The study confirms that the determination of L/S ratio is still superior to other tests in terms of overall diagnostic accuracy. In addition, it was found that presence of PG was highly associated with the absence of respiratory complications in the newborn.     

Luminometric single step urea assay using ATP-hydrolyzing urease

An automatic enzyme kinetic luminometric method for determination of small quantities of urea in biological fluids and in microdialysates is presented. The method is based on the ATP-hydrolyzing urease reaction [urea amidohydrolase (ATP-hydrolyzing); EC 3.5.1.45], monitored by a luciferin-luciferase ATP reaction. The assay range is 100 pmol to 50 nmol with a detection limit of 5 micromol/L in the sample, compared with detection limits of 0.1 mmol/L in earlier spectrophotometric methods. To reduce the non-urea-dependent ATPase activity (v(blank)) and to increase the urea-dependent activity, 1,2-propanediol was included. Assay conditions were optimized by multivariate analysis. Recoveries of urea added to blood dialysate and plasma were 96-103%. No analytical interference of common metabolites, drugs, or other additives was observed. The total CVs (6 days and six concentrations, 1.2-21.8 mmol/L) were 3.6-8.5%. The results obtained with the present assay were highly correlated for dialysate (r = 0.979) and for plasma (r = 0.978) with those obtained by a spectrophotometric kit method with slopes of 1.02-1.03 and intercepts of 0.08-0.23 mmol/L.     

A comparison of the families of mothers with borderline and nonborderline personality disorders

The correlation between echocardiographically and angiographically calculated ejection fraction and systolic excursion of the mitral annulus was studied in 81 patients. Knowing that the mitral annulus changes its size, shape, and position during the cardiac cycle, the authors measured systolic excursion of the annulus by 2D echocardiography. Displacement of the mitral annulus was measured from four different points (medial, lateral, anterior, posterior) by apical four-chamber and apical two-chamber approaches. Patients with and without regional wall motion abnormalities were included. Left ventricular volumes and ejection fraction (EF) were calculated in the standard manner introduced by Teichholz et al and also with biplane left ventriculography. As a result, EF calculated by cineangiography, was moderately correlated with the Teichholz method (r = 0.66) while it was highly correlated with measurements of mitral annular motion (MAM) (r = 0.87). The correlation can be expressed by the regression equation, EF (angiography) = 5.7 MAM (in mm) -6.5. They conclude that measurements of annular motion is an easy and reliable index of left ventricular function as an alternative to traditional methods.     

New immunoseparation-based homogeneous assay for HDL-cholesterol compared with three homogeneous and two heterogeneous methods for HDL-cholesterol

We evaluated four new commercial methods for HDL-cholesterol determination. The three completely homogeneous assays were an immunoseparation-based (IS) method from Wako, a polyethylene glycol-modified enzyme (PEG) method from Boehringer Mannheim, and a synthetic polymer-based (SP) method from Genzyme. The fourth method was a new heterogeneous method in which lipoproteins are removed using dextran sulfate-coated magnetic beads and Mg2+ (MB, Reference Diagnostics). We compared these methods with the conventional phosphotungstic acid/MgCl2 precipitation (PTA) procedure. The homogeneous assays had good intraassay imprecision with total CVs <2.3%, whereas the CVs of the MB assay were <5.9%. Adding HDL to serum to achieve HDL-cholesterol (HDL-C) concentrations up to 1000 mg/L revealed nearly complete recoveries in the IS, PEG, and MB assays, whereas the SP assay showed a lower recovery (approximately 70%). The SP HDL-C apparently increased at increasing LDL-cholesterol and VLDL-triglyceride concentrations, whereas the IS, PEG, and MB methods were not influenced by LDL-cholesterol up to 6000 mg/L (MB, 5000 mg/L) and VLDL-triglycerides up to 9000 mg/L. Free fatty acids above approximately 2 mmol/L produced falsely high HDL-C in the IS and SP assays, the error amounting to as much as 50% in some samples. An intermethod comparison in 291 fresh serum samples yielded correlation coefficients of at least r = 0.95 for all assays, when compared with the PTA procedure. The slopes and intercepts of the regression lines were 1.05 and 57 (IS), 1.12 and 9.9 (PEG), 1.00 and 39 (SP), and 1.0 and 38 mg/L (MB), respectively. The new assays are precise and simplify the determination of HDL-C, but in part they lack specificity or are susceptible to interferences, resulting in discrepancies when compared with the established PTA procedure.     

Methylene Blue Sorption onto Oxygenated Pyrolytic Tire Char: Equilibrium and Kinetic Studies

A novel method is presented for pyrolyzing and activating waste tires for adsorptive removal of aqueous contaminants. The adsorption characteristics of a cationic dye (methylene blue, MB) by pyrolytic tire char were evaluated. Mechanistic insights into the adsorption of MB onto char made from pyrolyzed tires are discussed on the basis of equilibrium and kinetic studies. A comparative evaluation of the performance of unoxygenated, pyrolyzed chars (NoPPO) and oxygenated chars (P550250) is reported. Despite having similar surface areas between the oxygenated and unxoygenated chars, the adsorption capacity of the former was much higher than that of the latter. However, adsorption of MB is thermodynamically unfavorable (ΔG>0) although oxygenation lowers the free energy of adsorption. MB sorption onto P550250 is inhibited by an external film, which was not observed in the case of NoPPO. An increase in the solution temperature was found to reduce the adsorption rates of MB onto P550250 but increase the sorption capacity of NoPPO. Overall, oxygenation was found to improve the sorption of MB onto pyrolytic chars.     

Active site mutants of human herpesvirus-6 proteinase

OBJECTIVES: To assess the comparability of the Hybritech Tandem-R and Abbott AxSYM PSA assays in the setting of a hospital laboratory changing methods of PSA assay. METHODS: A total of 115 serum samples were tested simultaneously with both reagent kits. These include samples from patients evaluated for screening, benign prostatic hyperplasia, and follow-up of prostate cancer. RESULTS: The outcomes of the Hybritech Tandem-R PSA test ranged from 0.0 to 48.3 ng/mL with a median value of 2.4 ng/mL (mean 3.48, SD 5.46). The outcomes of the Abbott AxSYM PSA test ranged from 0.0 to 49.33 ng/mL with a median of 2.22 ng/mL (mean 3.82, SD 5.59). The outcomes of the two assays were found to be highly correlated by the Pearson correlation coefficient (r = 0.9942). When samples were divided according to PSA levels of 0.0 to less than 2.5, 2.5 to less than 4.0, 4.0 to less than 10.0, and 10.0 to less than 25.0 ng/mL, the outcomes were also highly correlated in all PSA level ranges (r = 0.9619, 0.8094, 0.9167, and 0.9081, respectively). CONCLUSIONS: The PSA values of the Tandem-R and Abbott AxSYM assays are highly correlated in the PSA level ranges of 0.0 to less than 2.5, 2.5 to less than 4.0, 4.0 to less than 10.0, and 10.0 to less than 25.0 ng/mL.     

Scaling of submaximal oxygen uptake with body mass and combined mass during uphill treadmill bicycling

This study examined the scaling relationships of net O2 uptake [V(O2)(net) = V(O2) - resting V(O2)] to body mass (MB) and combined mass (MC = MB + bicycle) during uphill treadmill bicycling. It was hypothesized that V(O2)(net) (l/min) would scale proportionally with MC [i.e., VO2(net) approximately M1.0C] and less than proportionally with MB [i.e., V(O2)(net) approximately MB]. Twenty-five competitive cyclists [73.9 +/- 8.8 and 85.0 +/- 9.0 (SD) kg for MB and MC, respectively] rode their bicycles on a treadmill at 3.46 m/s and grades of 1.7, 3.5, 5.2, and 7.0% while V(O2) was measured. Multiple log-linear regression procedures were applied to the pooled V(O2)(net) data to determine the exponents for MC and MB after statistically controlling for differences in treadmill grade and dynamic friction. The regression models were highly significant (R2 = 0.95, P < 0.001). Exponents for MC (0.99, 95% confidence interval = 0.80-1.18) and MB (0.89, 95% confidence interval = 0.72-1. 07) did not differ significantly from each other or 1.0. It was concluded that the 0.99 MC exponent was due to gravitational resistance, whereas the MB exponent was <1.0 because the bicycles were relatively lighter for heavier cyclists.     

Influence of dietary lysine on the utilization of zinc from zinc sulfate and a zinc-lysine complex by young pigs

To explain the increased plasma mitochondrial aspartate aminotransferase (mAspAT) observed in alcoholics, we cultured HepG2 hepatoma cells in ethanol. Acute (24 hour) exposure to 0, 20, 40, or 80 mmol/L ethanol produced a dose-dependent (r = .98) increase in mAspAT messenger RNA (mRNA) of < or = thirteen-fold, with no significant change in the cellular content of mAspAT or of several other enzymes. The recovery of mAspAT in the medium over 24 hours of ethanol exposure correlated with both ethanol concentration and with mAspAT mRNA (r = .90), reaching 808% of cellular enzyme content/24 hours at 80 mmol/L. Recovery of all other enzymes studied was < or = 20% of cellular content and unaffected by ethanol. Plasma membrane mAspAT content also correlated with mAspAT mRNA (r = .96) and mitochondrial levels were unchanged. No mitochondrial morphologic abnormalities were observed at any ethanol concentration studied. In cells cultured chronically at 0 to 80 mmol/L ethanol, fatty acid uptake Vmax increased in parallel with plasma membrane expression of mAspAT (r = .98). Cellular triglyceride content was highly correlated with Vmax. Thus, the data suggest that: 1) the increased plasma mAspAT observed in alcoholics may reflect pharmacologic upregulation of mAspAT mRNA and of mAspAT synthesis by ethanol; and 2) increased mAspAT-mediated fatty acid uptake may contribute to alcoholic fatty liver.     

Using the clinical linguistic and auditory milestone scale for developmental screening in high-risk preterm infants

Eighty-one preterm infants (mean gestational age 29 weeks, range 24-36 weeks) discharged from The Johns Hopkins Hospital Neonatal Intensive Care Unit were followed up sequentially from birth to 2 years of age by use of the Clinical Linguistic and Auditory Milestone Scale (CLAMS) to evaluate language development. Children were studied during three time intervals: Interval 1: 3-5 months chronologic age (CA); Interval 2: 9-14 months (CA); and Interval 3: 18-24 months (CA). Psychometric test scores were compared with CLAMS Language Quotients (LQ) by use of full, partial (75%, 50%, 25%), and no "correction" for weeks of prematurity to determine whether "correcting" for prematurity would yield a more accurate estimate of eventual cognitive outcome. CLAMS LQ at Interval 1 was highly correlated with CLAMS LQ at Interval 2 and CLAMS LQ at Interval 2 correlated well with CLAMS LQ at Interval 3 (r = 0.57 and 0.64, respectively, P = 0.0001). Correlations indicated that there was an orderly, sequential development of language in the preterm infant. CLAMS evaluations correlated significantly with psychometric test results during Interval 2 and Interval 3 (r = 0.34, P < 0.02 and r = 0.75, P = 0.0001, respectively). The CLAMS proved to be a useful instrument for monitoring preterm language development in the primary pediatric care setting.     

Comparison of left anterior oblique, anterior, and geometric mean methods in gastric emptying assessment of postpancreaticoduodenectomy patients

Although left anterior oblique (LAO) gastric emptying studies appear to be an adequate alternative to geometric mean (GM) measurements in patients with normal gastric anatomy, it is not clear whether they can be used after gastric or duodenal surgery. In this study, dual-phase gastric emptying studies with combined solid-liquid meal were performed in 54 patients who had undergone pancreaticoduodenectomy (Whipple procedure). Gastric emptying was studied with GM, LAO, and anterior (ANT) methods. T1/2 and percent gastric retention at 10, 30, 60, 90, and 120 minutes were calculated. Results from the three methods were compared using correlation analysis and the t test. The t test showed no significant difference in T1/2 and percent retention values between the GM and LAO or ANT views. The solid emptying T1/2 showed a better correlation between GM and LAO values (r = 0.824) than between GM and ANT (r = 0.589). For the liquid T1/2, the reverse was true. Correlation between GM and ANT (r = 0.939) was better than between GM and LAO (r = 0.839); however, both LAO and ANT views correlated well with GM liquid emptying. It is concluded that the LAO view can replace GM gastric emptying methods in postpancreaticoduodenectomy patients for evaluation of both solid and liquid emptying, although the ANT view appears completely adequate for the study of liquid emptying.