Peak oxygen uptake and maturation in 12-yr olds

OBJECTIVE: The purpose of this study is to report a new sign, "acinar filling," observed on dynamic MR pancreatography after secretin stimulation in patients with suspected early chronic pancreatitis. CONCLUSION: Acinar filling might reflect tissue hypertension or loss of pancreatic parenchyma compliance or both. This finding is probably an insensitive but specific sign of early chronic pancreatitis.     

Formation of individual somatotype parameters and features of constitutional organization in 7-12-year-old boys (longitudinal)

Individual somatotype parameters and peculiarities of constitution in 7-12 years boys were evaluated in the present investigation. The age range studied was shown to be divided on 3 stages. Regular growth processes with the prevalence of "infantal" proportions occur at the age of 7-9. Signs of definite constitutional type are expressed yet insufficiently. The age of 10-11 is transitional which shows in delay of muscle growth. At the age of 11-12 prepubescent sets in, during which features of constitution types and appropriate somatotype parameters are distinctly manifested.     

Kinetics of oxygen uptake at the onset of exercise in boys and men

The objective of this study was to compare the O2 uptake (VO2) kinetics at the onset of heavy exercise in boys and men. Nine boys, aged 9-12 yr, and 8 men, aged 19-27 yr, performed a continuous incremental cycling task to determine peak VO2 (VO2 peak). On 2 other days, subjects performed each day four cycling tasks at 80 rpm, each consisting of 2 min of unloaded cycling followed twice by cycling at 50% VO2 peak for 3.5 min, once by cycling at 100% VO2 peak for 2 min, and once by cycling at 130% VO2 peak for 75 s. O2 deficit was not significantly different between boys and men (respectively, 50% VO2 peak task: 6.6 +/- 11.1 vs. 5.5 +/- 7.3 ml . min-1 . kg-1; 100% VO2 peak task: 28.5 +/- 8.1 vs. 31.8 +/- 6.3 ml . min-1 . kg-1; and 130% VO2 peak task: 30.1 +/- 5.7 vs. 35.8 +/- 5.3 ml . min-1 . kg-1). To assess the kinetics, phase I was excluded from analysis. Phase II VO2 kinetics could be described in all cases by a monoexponential function. ANOVA revealed no differences in time constants between boys and men (respectively, 50% VO2 peak task: 22. 8 +/- 5.1 vs. 26.4 +/- 4.1 s; 100% VO2 peak task: 28.0 +/- 6.0 vs. 28.1 +/- 4.4 s; and 130% VO2 peak task: 19.8 +/- 4.1 vs. 20.7 +/- 5. 7 s). In conclusion, O2 deficit and fast-component VO2 on-transients are similar in boys and men, even at high exercise intensities, which is in contrast to the findings of other studies employing simpler methods of analysis. The previous interpretation that children rely less on nonoxidative energy pathways at the onset of heavy exercise is not supported by our findings.     

Malnutrition and developmental defects of enamel in 2- to 6-year-old Saudi boys

The density and distribution of N-methyl-D-aspartate receptor (NMDAR1) mRNA expression in the rat midbrain periaqueductal gray (PAG) following exposure to unilateral peripheral inflammation or chronic constrictive injury (CCI) as models for chronic peripheral nociception were examined using in situ hybridization technique. The NMDAR1 hybridization signal intensities increased significantly in the ventrolateral areas of the caudal and middle thirds of the PAG after 3 days of Complete Freund's Adjuvant (CFA) injection. Likewise, rats subjected to CCI showed significant increase in hybridization signal intensities in comparison to sham-operated animals in both the ipsi- and contra-lateral ventrolateral quadrants of the caudal and middle thirds of the PAG. In the caudal dorsal raphe, the CFA and the CCI treated animals showed a significant increase in signal hybridization compared to control and sham-operated groups while the rostral dorsal raphe showed no significant changes in either CCI or CFA treated groups. In contrast, there was no significant change in signal intensity of NMDAR1 mRNA in the dorsal subdivisions of the PAG following either CCI or CFA treatment. These results demonstrate significant bilateral increase in NMDAR1 mRNA expression in the ventrolateral areas of the caudal and middle thirds of the PAG and the caudal one half of the dorsal raphe following chronic nociception. The up-regulation phenomenon may constitute a reactive mechanism against chronic neuropathic pain in the PAG.     

Specific cognitive abilities in 5- to 12-year-old twins

Eleven tests of specific cognitive abilities were administered to 108 pairs of young twins (average age of 7.6 years). Internal consistencies are high for all measures except Raven's Coloured Progressive Matrices and Delayed Picture Memory. Two-month, test-retest reliabilities are also reported. The twin sample is representative in terms of both means and variances when compared to normative data from standardization samples, and twin correlations for height and weight are similar to those obtained in six other twin studies. Because all measures were highly correlated with age (average correlation with age was 0.64), scores were aged adjusted. Previous twin studies of specific cognitive abilities in adolescents and adults found genetic variance for nearly all tests. In contrast, our study of young twins yielded significant genetic influence for only 1 of the 11 measures, PIAT Reading Recognition, and suggested the possibility of genetic influence on 2 others (vocabulary and WISC-R mazes). Environmental influences seem to dominate, particularly for nonverbal measures, as children begin their education. In accord with other studies, we found that between-family environmental factors have an important influence on the development of nearly all of the measures of specific cognitive abilities. However, we found that our tests of perceptual speed and memory were substantially influenced by within-family environmental factors independent of error.     

Linguistic environment of 1- to 2-year-old twins.

Investigated differences in the language learning environments of singletons and twins, with special reference to pragmatic factors that might be expected to differ in dyadic and triadic interactive situations. Six twin pairs and 12 singleton children (all firstborn) were observed in natural interactions with their mothers, once at 15 mo of age and again at 21 mo of age. Findings reveal that twins were lower than singletons on all measures of language development and that their language learning environments were significantly different. Although twin mothers spoke and interacted with their children as much as singleton mothers when twins were analyzed together, when analyzed as individuals, twin children received less speech directed specifically to them, participated in fewer and shorter episodes of joint attentional focus, and had fewer and shorter conversations with their mothers. Twin mothers were also more directive in their interactional styles. Correlational analyses indicated that variation of these language learning environment factors for the sample as a whole, and variation for some of these factors within the twin group itself, were related to early language growth. It is proposed that both the quantitative and qualitative differences observed in the language learning environments of singletons and twins derive from the nature of the triadic situation and that these differences have important effects on the child's early language development. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Peak oxygen uptake, muscle volume, and the growth hormone-insulin-like growth factor-I axis in adolescent males

OBJECTIVES: To define the molecular genetic basis of the MELAS phenotype in five patients without any known mutation of mitochondrial DNA. METHODS: Systematic automated mitochondrial DNA sequencing of all mitochondrial transfer RNA and cytochrome c oxidase genes was undertaken in five patients who had the MELAS phenotype. RESULTS: A novel heteroplasmic mitochondrial DNA mutation was identified in the transfer RNA gene for phenylalanine in one case (patient 3). This mutation was not detected in the patient's blood or in her mother's blood. No pathogenic mutations were identified in the other four patients. CONCLUSIONS: This is the first point mutation in the transfer RNA gene for phenylalanine to be associated with MELAS. The absence of mutations in the remaining four patients suggests that there is further genetic heterogeneity associated with this mitochondrial phenotype.     

Multiple pleomorphic xanthoastrocytoma tumors in a 12-year-old girl

This report presents a case of multiple bilateral hemispheric tumours (pleomorphic xanthoastrocytoma) in a practically asymptomatic 12-years-old girl. The tumours were removed radically in a staged procedure, with a favorable clinical outcome. Clinical history and neuropathologic findings are described. A review of pertinent literature is included.     

Attention problems, inhibitory control, and intelligence index overlapping genetic factors: A study in 9-, 12-, and 18-year-old twins.

It is assumed that attention problems (AP) are related to impaired executive functioning. We investigated the association between AP and inhibitory control and tested to what extent the association was due to genetic factors shared with IQ. Data were available from 3 independent samples of 9-, 12-, and 18-year-old twins and their siblings (1,209 participants). AP were assessed with checklists completed by multiple informants. Inhibitory control was measured with the Stroop Color Word Task (Stroop, 1935), and IQ with the Wechsler Intelligence Scale for Children (Wechsler et al., 2002) or Wechsler Adult Intelligence Scale (Wechsler, 1997). AP and inhibitory control were only correlated in the 12-year-old cohort (r = .18), but appeared non-significant after controlling for IQ. Significant correlations existed between AP and IQ in 9- and 12-year olds (r = ?.26/–.34). Inhibitory control and IQ were correlated in all cohorts (r = ?.16, ?.24 and ?.35, respectively). Genetic factors that influenced IQ also influenced inhibitory control. We conclude that the association between AP and inhibitory control as reported in the literature may largely derive from genetic factors that are shared with IQ. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mutans streptococci, lactobacilli and caries experience in 12-year-old Icelandic urban children, 1984 and 1991

Routine pelvic radiography is carried out in all blunt trauma patients referred to our Emergency Department according to advanced trauma life support protocols. In this retrospective study, we questioned whether it is cost-effective to obtain 'routine' pelvic X-ray films. The notes and X-rays of all consecutive patients with blunt trauma who were referred to the Emergency Department of Dokuz Eylül University Hospital, Izmir, Turkey, between August and December, 1993 were re-evaluated. Eighteen patients who were unconscious and/or intoxicated and/or not fully orientated were excluded from the study. The remaining 65 patients were divided into three groups according to whether they were complaining of pain and whether pain was present on pelvic examination; group A consisted of those complaining of pain who also had pelvic pain on examination (28 patients), group B consisted of those complaining of pain or who had pain on pelvic examination (four patients) and group C consisted of those with no history of pain and no pain on pelvic examination (33 patients). Among the 65 patients whose pelvic X-rays were evaluated, 14 (22%) cases were shown to have fracture and all of these patients belonged to group A. The remaining 51 (78%) patients revealed no fractures. The difference between the groups were statistically significant (p < 0.001). As a result, we concluded that 'routine' pelvic radiography should be performed in the setting of blunt trauma only if the patient is: (a) unconscious, uncooperative or intoxicated, or (b) conscious, fully orientated and cooperative and complaining of pain both in the history and on pelvic examination. These limitations would allow us to decrease the amount of irradiation received, render more cost-effective treatment, and reduce the workload of emergency and radiology departments.     

Capillary-venous malformation in the labia majora in a 12-year-old girl

The case of a capillary-venous malformation in the labia majora of a 12-year-old girl is reported. The tumour increased in volume with puberty. The authors present a differential diagnosis between immature haemangioma and vascular malformation. The diagnosis is based on clinical examination, ultrasound, nuclear magnetic resonance, arteriography and gynaecological exploration. This malformation can be excised locally.     

Velocity of oxygen uptake response at the onset of exercise: A comparison between children after cardiac surgery and healthy boys

A comparison was carried out concerning maximal oxygen uptake, oxygen uptake adjustment at the onset of high-intensity exercise, and maximal blood lactate between 10 healthy prepubertal boys and 35 children after repair of cardiac malformations or after Fontan operation. Mean maximal oxygen uptake (VO2) was moderately reduced in children after repair of tetralogy of Fallot or after Mustard or Senning operations and severely reduced after Fontan operations. Conversely, mean half-time of VO2 response was moderately prolonged in children after repair of tetralogy of Fallot or after Senning and Mustard operations and considerably prolonged after Fontan operations. According to our results unfavorable kinetics of VO2 response to physical exercise are present in addition to reduced aerobic power in many of the operated children. Besides being less qualified for endurance performance, these children are also less prepared for short, high-intensity exercise.     

Parental smoking and risk factors for cardiovascular disease in 10- to 12-year-old children

Combined alteration of the pyruvate dehydrogenase complex and respiratory chain function is described in a 21 year-old male patient with overlapping MELAS (mitochondrial encephalomyopathy, lactic acidosis, and 'stroke-like' episodes) and Kearns-Sayre syndrome. Progressive external ophthalmoplegia, pigmentary retinopathy and right bundle branch block were present when he experienced the first 'stroke-like' episode at 18 years old. The A>G tRNALeu(UUR) point mutation at nucleotide 3243 of the mitochondrial DNA was predominant in muscle tissue (79%) and present, but at lower levels in fibroblasts (49%) and blood cells (37%). Biochemical analysis revealed diminished activities of pyruvate dehydrogenase (23%) and respiratory chain complexes I and IV (57%, respectively) in muscle, but normal activities in the fibroblasts. Immunochemical studies of the muscular pyruvate dehydrogenase components showed normal content of E1alpha, E1beta and E2 protein. Molecular screening of the E1alpha gene did not indicate a nuclear mutation. These observations suggest that mitochondrial DNA defects may be associated with altered nuclear encoded enzymes which are actively imported into mitochondria and constitute components of the mitochondrial matrix. Biochemical workup of mitochondrial disorders should not be restricted to the respiratory chain even if mitochondrial DNA mutations are present.     

NGF-induced cytotoxicity in PC12 cells in a hypoglycemic environment

Surprisingly, we observed that nerve growth factor (NGF) potentiated death of PC12 cells induced by glucose withdrawal, although NGF is widely believed to exert its protective role against several types of cell death. Since either glucose withdrawal or NGF treatment increases intracellular calcium levels of target cells in many cases, we hypothesized that further increase of intracellular calcium by NGF may be a determinant factor in the NGF-mediated cell death. To test this hypothesis, we examined the effect of NGF on cell death pharmacologically by measuring cell viability and traced the changes of intracellular calcium in various conditions using a confocal laser microscope. NGF promoted cell death under a glucose-deprived condition in a manner dependent on extracellular calcium, and nifedipine, but not ryanodine, could partially block the cell death. NGF treatment augmented further intracellular calcium that had been elevated by glucose withdrawal, the event that nifedipine could block. In this study, therefore, we tentatively concluded that NGF potentiates cell death of starved PC12 cells by accelerating the initial increase of intracellular calcium through activation of a dihydropyridine-sensitive calcium channel.     

Productivity of a breeding place of Aedes albopictus in an urban environment

BACKGROUND: Traditionally, patients presenting with uncomplicated dyspepsia have been managed using empiric antisecretory therapy, followed by endoscopy in the event of persistent symptoms or complication. Since Helicobacter pylori is now accepted as an important and potentially reversible cause of ulcer disease, it is important to reevaluate the management of dyspepsia. The goal of this study is to evaluate seven outpatient strategies for the management of dyspeptic patients using a cost-utility analysis. METHODS: The study design was that of a cost-utility analysis. The model assumes that an adult patient with signs of dyspepsia but no signs of complication presents to the outpatient office of a primary care physician. Seven strategies are modeled: empiric antisecretory therapy; empiric H pylori eradication using oral omeprazole (20 mg [corrected] twice daily), clarithromycin (500 mg twice daily), and amoxicillin (1000 mg twice daily); use of either upper endoscopy, an upper gastrointestinal barium study (an upper GI), or the serum titer for H pylori as a diagnostic test to identify patients for H pylori eradication; or use of an initial diagnostic test followed by the serum titer for H pylori. The primary outcome was the cost per quality-adjusted life year (QALY) for each strategy for a 1-year period from presentation; secondary outcomes included the probability of symptomatic ulcer recurrence, cost per ulcer cure, and mortality. RESULTS: Three strategies were similarly cost-effective: empiric H pylori eradication ($1198 per QALY), use of a serum H pylori titer as an initial diagnostic test ($1214 per QALY), and empiric antisecretory therapy ($1288 per QALY). Empiric antisecretory therapy, however, was associated with significantly more symptomatic ulcer recurrences and deaths than any other strategy. CONCLUSIONS: This cost-utility analysis suggests that two strategies are reasonable for patients presenting with dyspepsia: (1) empiric H pylori eradication and (2) use of a serum H pylori titer to identify patients who might benefit from H pylori eradication. The latter strategy may be preferable because it is less likely to lead to antibiotic resistance. Strategies utilizing an upper GI or upper endoscopy (either with or without serum H pylori titer) or empiric antisecretory therapy do not improve outcomes and are associated with greater cost, morbidity, and/or mortality.     

Homeless patients in the psychiatric clinic. Results of a 12-month study of the living conditions of psychiatric patients in an urban public health clinic

BACKGROUND: Percutaneous transhepatic biliary drainage (PTBD) has been employed for decompression of the obstructed biliary tract to palliate jaundice and pruritus and for the management of cholangitis. We present our data to review the indications, therapeutic results and associated mortality and complications of this procedure. We have also studied the effect of size of drainage catheters on the improvement in liver functions and procedure related complications. METHODS: PTBD was attempted in 41 patients (18 men, age 56 +/- 12 years; 23 women, age 55 +/- 11 years) with obstructive jaundice (37 malignant, 4 benign). RESULTS: PTBD was successful in 39 (95%) patients. Mean serum bilirubin and alkaline phosphatase concentration declined significantly (p < 0.000001 for both) after 1 week, however thereafter decline was slow. Complete relief of pruritus and cholangitis was noted in most patients. Major complications such as cholangitis, bile leak into the peritoneum, malfunction of drainage catheter, intraperitoneal haemorrhage and renal failure, occurred in 11 (28%) patients, 2 (5%) of whom died. Large catheters (> 10 Fr) were superior to small size catheters (< 10 Fr) in relief of jaundice and had lower catheter related cholangitis. CONCLUSIONS: We conclude that PTBD is useful for palliation of malignant obstructive jaundice with intractable symptoms and cholangitis. Catheters larger than 10 Fr should be used.