Rorschach revisited: A new look at an old test.

Two control samples (21 and 27 college students) and a sample of 21 short-term psychiatric patients (aged 21-26 yrs) scaled all pairs of Rorschach inkblots for perceived similarity. Data were analyzed using J. D. Carroll and C. C. Chang's individual scaling (INDSCAL) model, which resulted in a good fit in 2 dimensions. These 2 dimensions were interpreted as a dimension of color and 1 of form ("twoness"), and empirically validated in a 2nd study, using 2 groups of controls (20 and 33 college students) and 6 short-term schizophrenic patients. It was also found that the saliences estimated by INDSCAL for each S formed 3 virtually nonoverlapping distributions. This implies a possible use of the method within a diagnostic context. (42 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Monitoring clinical research: an obligation unfulfilled

The revelation that data obtained for the US-based National Surgical Adjuvant Breast and Bowel Project (NSABP) from subjects enrolled at H?pital Saint-Luc in Montreal was falsified has eroded public trust in research. Institutions can educate researchers and help prevent unethical research practices by establishing procedures to monitor research involving human subjects. Research monitoring encompasses four categories of activity: annual reviews of continuing research, monitoring of informed consent, monitoring of adherence to approved protocols and monitoring of the integrity of data. The authors describe characteristics of research projects that may call for monitoring procedures in each category. The form taken by such monitoring depends on the nature of the protocol. Although appropriate research monitoring requires substantial investment of personnel and financial resources, it is required under guidelines regulating research involving human subjects in Canada. Research monitoring is a step forward in re-establishing public confidence in medical research.     

Factor analysis of rank-ordered data: An old approach revisited.

Responds to the J. B. Kruskal and R. N. Shepard (see record 1975-00098-001) work in which a solution to the problem of nonmetric factor analysis is offered. An investigation comparing this method and factor analysis of rank-ordered data suggests that the practicality of the Kruskal-Shepard method is limited by computational cost and sensitivity to random error. In situations in which linearity is questioned, an attractive practical alternative that is much less costly and substantially more robust to random error is linear principal-components analysis of the rank-ordered data. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early identification of learning disabled children: An old problem revisited.

Preschool screening has not improved significantly in the past decade. Despite numerous methodological commentaries and the importance of the problem, attempts to validate preschool screening instruments continue to lack rigor. The most frequent problems include insufficient longitudinal validation, the confounding of screening and outcome assessments, and inadequate assessment of the predictive utility of the screening device. Despite these problems, a selective review of available studies shows that early identification is a viable process. Advances in reading theory and research point to new variables that may enhance the predictive power of early screening devices and facilitate early intervention. The incorporation of these variables with previous research on prediction and a rigorous evaluative methodology should push a promising area of prevention into fruition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nitroglycerin: new concepts about an old drug

The ultimate goal of the cone method of colostomy irrigation is to return patients with colostomies to their former role in society with confidence in themselves to the extent that having a colostomy is not considered a handicap. The results have generally been excellent. We believe all patients with stomas should be afforded the opportunity to attempt colostomy irrigation.     

Intestinal tuberculosis: return of an old disease

OBJECTIVE: Tuberculosis (TB) can no longer be considered a rare disease in the United States due, in part, to the AIDS epidemic. Because the signs and symptoms of intestinal TB are nonspecific, a high index of suspicion must be maintained to ensure a timely diagnosis. The aim of this article is to review the history, epidemiology, pathophysiology, and treatment of TB. METHODS: This review is based on an examination of the world literature. RESULTS: In only 20% of TB patients is there associated active pulmonary TB. Areas most commonly affected are the jejunoileum and ileocecum, which comprise >75% of gastrointestinal TB sites. Diagnosis requires colonoscopy with multiple biopsies at the ulcer margins and tissue sent for routine histology, smear, and culture. If intestinal TB is suspected, empiric treatment is warranted despite negative histology, smear, and culture results. Treatment is medical, and all patients should receive a full course of antituberculous chemotherapy. Exploratory laparotomy is necessary if the diagnosis is in doubt, in cases in which there is concern about a neoplasm, or for complications that include perforation, obstruction, hemorrhage, or fistulization. CONCLUSIONS: This review draws attention to the resurgence of tuberculosis in the United States. An increased awareness of intestinal tuberculosis, coupled with knowledge of the pathophysiology, diagnostic methods, and treatment should increase the number of cases diagnosed, thus improving the outcome for patients with this disease.     

Reeler: new tales on an old mutant mouse

Local anaesthetics block action potentials in the membranes of excitable cells but their effects on non-excitable cells are less well known. Some local anaesthetics are applied directly onto the skin, and for this reason the effect of procaine (p-aminobenzoic acid diethylamino-etyl ester hydrochloride) and tetracaine (4-[butylamino]benzoic acid 2-[dimethylamino]ethyl ester) upon the morphology and cytoskeleton organisation of human skin fibroblasts was investigated. The time lapse video recording of fibroblasts cultured in serum-enriched medium revealed that the cells rapidly change shape after the addition of the anaesthetic. These effects were fully reversible. The microscopic observations were confirmed by quantitative analysis of projected cell area and cell shape parameters. Local anaesthetics significantly changed the actin cytoskeleton organisation, inducing total disappearance of stress fibres. Serum-starvation or myosin light chain kinase inhibitors, KT 5926 inhibitor (8R*,9S*,11S*)-(-)-9-hydroxy-9-methoxycarbonyl-8-methyl-14-n-propoxy-2,3 ,9, 10-tetrahydro-8,11-epoxy,1H,8H,11H-2,7b,11a-triazadibenzo[a,g]c ycloocta[cde] trinden-1-one or wortmannin, which induce the 'relaxed' morphology of the cells, prevent both the anaesthetic-induced changes in cell shape and the disassembly of stress fibres. Together, the observations suggest that local anaesthetics affect the actomyosin system, inducing contraction.     

The archetypal senex: an exploration of old age

A stacked generalization strategy in which an evolutionary algorithm generates baselevel predictive models is described. The evolutionary algorithm incorporates model validation and an inductive ranking criterion which encourages diversity of prediction errors. Higher levels of the stack of generalizers yield predictors that work through memory-based correction and combination of predictions produced by populations of models obtained in lower levels of the stack. The strategy has been applied to the classic problem of predicting annual sunspots activity. Baselevel predictors are drawn from a class of recurrent neural networks. Normalized mean squared errors of 0.064 and 0.19 for the conventional test intervals of 1921-1955 and 1956-1979, respectively, improve upon previously published results. The strategy has also been used to accurately forecast the behaviour of a synthetic system which makes random transitions between two states of low-dimensional chaos.     

Men as caregivers: reciprocal relationships or obligation?

The adult cuticular wing of Drosophila is covered by an array of distally pointing hairs that reveals the planar polarity of the wing. We report here that mutations in dachsous disrupt this regular pattern, and do so by affecting frizzled signaling. dachsous encodes a large membrane protein that contains many cadherin domains and dachsous mutations cause deformed body parts. We found that mutations in dachsous also result in a tissue polarity phenotype that at the cellular level is similar to frizzled, dishevelled and prickle, as many cells form a single hair of abnormal polarity. Although their cellular phenotype is similar to frizzled, dishevelled and prickle, dachsous mutant wings display a unique and distinctive abnormal hair polarity pattern including regions of reversed polarity. The development of this pattern requires the function of frizzled pathway genes suggesting that in a dachsous mutant the frizzled pathway is functioning - but in an abnormal way. Genetic experiments indicated that dachsous was not required for the intracellular transduction of the frizzled signal. However, we found that dachsous clones disrupted the polarity of neighboring wild-type cells suggesting the possibility that dachsous affected the intercellular signaling function of frizzled. Consistent with this hypothesis we found that frizzled clones in a dachsous mutant background displayed enhanced domineering non-autonomy, and that the anatomical direction of this domineering non-autonomy was altered in regions of dachsous wings that have abnormal hair polarity. The direction of this domineering nonautonomy was coincident with the direction of the abnormal hair polarity. We conclude that dachsous causes a tissue polarity phenotype because it alters the direction of frizzled signaling.     

Treatment-induced mucositis: an old problem with new remedies

Mucositis may be a painful, debilitating, dose-limiting side-effect of both chemotherapy and radiotherapy for which there is no widely accepted prophylaxis or effective treatment. The basis of management is pain relief, prevention of dehydration and adequate nutrition. When tested vigorously, most antiseptic mouthwashes and anti-ulcer agents are ineffective. Simple mechanical cleansing by saline is the most effective traditional measure. A variety of new agents are effective. Granulocyte macrophage colony-stimulating factor (GM-CSF) and granulocyte colony-stimulating factor (G-CSF) act outwith the haemopoeitic system and can reduce mucositis, but the best schedule, dosage and method of administration is not known or which is the best growth factor to prevent this side-effect. A placebo-controlled randomized trial of antibiotic pastilles has shown a significant reduction in mucositis and weight loss during radiotherapy for head and neck cancer. Another method to reduce radiation effects in normal tissue is to stimulate cells to divide before radiotherapy by silver nitrate or interleukin 1. These methods may be particularly effective when given along with hyperfractionated radiation treatment such as CHART.     

Myofibroblastoma of the breast revisited: an etiologic association with androgens?

In order to test the hypothesis that normal gravity is an important influence on human serum [Erythropoietin] ([Epo]), the hematologic response to 16 d of 6 degrees head-down tilt (HDT, n = 6 men) was compared with 16 d of normal gravity exposure (CON, n = 7 men). Prior to bed rest, CON and HDT subjects, respectively, were similar in the following characteristics (mean +/- SD): age = 40 +/- 3, 39 +/- 6 yr; height = 181 +/- 5, 182 +/- 6 cm; weight = 88.5 +/- 11.3, 81.7 +/- 12.0 kg; maximal oxygen consumption in supine 6 degrees head-down tilt position (VO2max) = 2.63 +/- 0.38, 2.67 +/- 0.52 L.min-1; hematocrit = (Hct) 41.6 +/- 2.4, 43.0 +/- 3.4%; hemoglobin ([Hb]) = 15.1 +/- 1.0, 14.5 +/- 1.0 g.100 ml-1; plasma volume (PV) = 3829 +/- 857, 3768 +/- 512 ml; and [Epo] = 11.6 +/- 2.9, 10.0 +/- 6.2 mU.ml-1. Calculated red cell volume (RCV) was greater in HDT than CON (2845 +/- 410 vs. 2139 +/- 253 ml, p < 0.05) at baseline. Decreases in PV (-15%, 580 ml, p < 0.05) and an insignificant decrease in RCV (-12%, 354 ml, p = 0.07) were observed in the HDT group, with a concurrent 6% increase in [Hb] (p < 0.05). PV, RCV and [Hb] remained unchanged in the CON group. [Epo] remained unchanged during HDT (12.2 +/- 3.2; 10.8 +/- 3.8; 11.2 +/- 3.1; 11.2 +/- 2.6 mU.ml-1 for HDT days 1, 2, 8 and 16, respectively). There was no difference between CON and HDT groups in [Epo] before or during HDT. It was concluded that the insignificant change (-12%) in RCV observed during HDT was insufficient to stimulate an increase in [Epo], probably because the content of oxygen in arterial blood remained unaffected. The observation that [Epo] remained unchanged despite this loss of RCV during HDT also suggests a possible decrease in the responsiveness of the erythropoietic system to [Epo].     

A new use for an old Holter monitor: an ambulatory cough meter

Cough is commonly used as an outcome measure in clinical studies, although the subjective reporting of cough is unreliable when compared to objective measures. We describe an inexpensive new ambulatory cough meter that is based on a disused Holter monitor. The cough meter consists of a Holter monitor and a cough processor, designed on a computer to select the most appropriate filters. The cough meter was then validated against the overnight tape recorder on 21 occasions in 18 children (aged 6-15 yrs). The agreement between the cough meter and the tape recorder was good (mean difference of -0.3 coughs x h(-1); limits of agreement -2.2 to 1.7 coughs x h(-1)). We conclude that our newly described ambulatory cough meter provides a valid and inexpensive method of objectively monitoring cough for up to 24 h.