Child abuse in Hong Kong revisited after 15 years: characteristics of victims and abusers

The purpose of this paper was to examine the characteristics of the victims and abusers of child abuse cases on the Child Protection Registry in Hong Kong as of March 1995 and to compare findings with a similar community report of child abuse in Hong Kong conducted approximately 15 years earlier. As of March 31, 1995, there were 457 active cases of child abuse or suspected child abuse (44% male and 56% female) on the computerized Child Protection Registry. Fifty percent of the victims were grade school age children between 7-12, and 62.4% suffered physical abuse. The abusers or suspected abusers were 52% male and 48% female with nearly half (49%) in their thirties. The majority of abusers were married/cohabiting (75%) with only a grade school education (60%). As compared to 1979, there was an increase of sexual child abuse cases, female victims of child abuse, and an increase in male abusers or suspected abusers.     

Phenotypic analysis of antigen-specific T lymphocytes

Identification and characterization of antigen-specific T lymphocytes during the course of an immune response is tedious and indirect. To address this problem, the peptide-major histocompatability complex (MHC) ligand for a given population of T cells was multimerized to make soluble peptide-MHC tetramers. Tetramers of human lymphocyte antigen A2 that were complexed with two different human immunodeficiency virus (HIV)-derived peptides or with a peptide derived from influenza A matrix protein bound to peptide-specific cytotoxic T cells in vitro and to T cells from the blood of HIV-infected individuals. In general, tetramer binding correlated well with cytotoxicity assays. This approach should be useful in the analysis of T cells specific for infectious agents, tumors, and autoantigens.     

Disappearing left atrial vegetation in an intravenous drug abuser

Isolated left atrial mural endocarditis is rare. We report a case where the diagnosis was made clinically and supported by blood cultures and transoesophageal echocardiography. Appropriate intravenous antibiotics were administered and serial transoesophageal echocardiograms helped in monitoring the decrease in size and final disappearance of the vegetation, thus avoiding the need for surgical intervention.     

The next challenge for newborn intensive care in Alaska: improving the survival of the larger neonate

Using information from our database, a review of mortality for the Newborn Intensive Care Unit at Providence Alaska Medical Center was conducted for 1987-1996. There has been a significant decline in mortality over the last decade (p = 0.003). An analysis of mortality by birthweight and gestational age groups demonstrated a decline in mortality (p = 0.005) for infants with birthweight < 2 kg and infants < or = 34 weeks gestation, but no change for infants > or = 2 kg and > or = 35 weeks gestation. As a result, larger and more mature babies now account for an increasing proportion of NICU deaths. For 1995 and 1996 the major contributors to mortality for the smaller neonates were respiratory distress syndrome and congenital and nosocomial sepsis/pneumonia. The major contributors to mortality for larger neonates were persistent pulmonary hypertension of the newborn, congenital heart disease, congenital diaphragmatic hernia, and primary birth asphyxia. A majority of deaths in the larger neonates were due to non-lethal causes. We contend that improved survival in the larger neonate is an important and achievable goal. The introduction of ECMO (Extracorporeal Membrane Oxygenation) for the NICU and a focused review of the neonatal cardiac program offers the best possible potential for achieving this goal.     

Aldosterone and dexamethasone stimulate calcineurin activity through a transcription-independent mechanism involving steroid receptor-associated heat shock proteins

1. PD 81,723 has been shown to enhance binding of adenosine to A1 receptors by stabilizing G protein-receptor coupling ('allosteric enhancement'). Evidence has been provided that in the perfused hearts and isolated atria PD 81,723 causes a sensitization to adenosine via this mechanism. 2. We have studied the effect of PD 81,723 in guinea-pig isolated atrial myocytes by use of whole-cell measurement of the muscarinic K+ current (I[K(ACh)]) activated by different Gi-coupled receptors (A1, M2, sphingolipid). PD 81,273 caused inhibition of I[K(ACh)] (IC50 approximately 5 microM) activated by either of the three receptors. Receptor-independent I[K(ACh)] in cells loaded with GTP-gamma-S and background I[K(ACh)], which contributes to the resting conductance of atrial myocytes, were equally sensitive to PD 81,723. At no combination of concentrations of adenosine and PD 81,723 could an enhancing effect be detected. 3. The compound was active from the outside only. Loading of the cells with PD 81,723 (50 microM) via the patch pipette did not affect either I[K(ACh)] or its sensitivity to adenosine. We suggest that PD 81,723 acts as an inhibitor of inward rectifying K+ channels; this is supported by the finding that ventricular I(K1), which shares a large degree of homology with the proteins (GIRK1/GIRK4) forming I[K(ACh)] but is not G protein-gated, was also blocked by this compound. 4. It is concluded that the functional effects of PD 81,723 described in the literature are not mediated by the A1 adenosine receptor-Gi-I[K(ACh)] pathway.     

Continuous liquid-phase piezoelectric biosensor for kinetic immunoassays

The reactions of immunoglobulins with protein A and, subsequently, of antibodies to these immunoglobulins were continuously monitored by a piezoelectric biosensor. AT-cut crystals, with a fundamental resonant frequency of 10 MHz, were mounted in a Plexiglas holder, and one side was directly coated with protein A. Upon exposure to solutions containing rabbit or human IgG the resonant frequency was followed continuously and its decrease due to the binding of IgG to protein A observed. Subsequent addition of sheep antihuman IgG to the now immobilized human IgG caused a specific 3-fold further decrease in resonant frequency. We observed a frequency change of approximately 1 Hz fore each 10 ng of added immunoglobulin. Decreasing the pH to 3 released the bound IgG but not the protein A and permitted reuse of the crystal for further IgG binding.     

Optical sequence generation based on collision avoidance usingchaotic mode transitions

An adaptive optical sequence generation scheme has been described in a nonlinear optical ring which exhibits chaotic dynamics. The adaptation is based on avoidance of collisions between the ring output and signals from another source. It is shown that collision-avoiding sequences can be autonomously selected via chaotic mode transitions induced by the feedback of collision signals. Experimental results demonstrate that the method can be successful for various collision signal patterns with different periods and pulsewidths. The mechanism of inducing chaos with collision signals is examined both experimentally and with numerical simulations and the results verify the effectiveness of the proposed adaptation method. A possible application of the proposed signal generation scheme in intelligent optical communication networks is mentioned     

Implanted functional electrical stimulation hand system in adolescents with spinal injuries: an evaluation

OBJECTIVE: To study the utility and functional benefits of an implanted functional electrical stimulation (FES) system for hand grasp and release in adolescents with tetraplegia secondary to spinal cord injuries. DESIGN: Intervention study with before-after trial measurement with each subject as his or her own control. SETTING: Nonprofit pediatric orthopedic rehabilitation facility specializing in spinal cord injury. PARTICIPANTS: A convenience sample of five adolescents between 16 and 18 years of age with C5 or C6 level tetraplegia at least 1 year after traumatic spinal cord injury. Key muscles for palmar and lateral grasp and release were excitable by electrical stimulation. INTERVENTIONS: A multichannel stimulator/receiver and eight electrodes were surgically implanted to provide stimulated palmar and lateral grasp and release. In conjunction with implantation of the FES hand system, surgical reconstruction in the form of tendon transfers, tendon lengthenings and releases, and joint arthrodeses was performed to augment stimulated hand function. Rehabilitation of the tendon transfers and training in the use of the FES hand system were provided. MAIN OUTCOME MEASURES: Measurements of pinch and grasp force, the Grasp and Release Test (GRT), and an assessment of six activities of daily living (ADL) were administered before implantation of the FES hand system and at regular follow-up intervals. Results of the stimulated response of individual muscles and surgical reconstruction were evaluated using standard and stimulated muscle testing techniques and standard assessment of joint range of motion. All subjects completed followup testing. RESULTS: Lateral and palmar forces were significantly greater than baseline forces (p = .043). Heavy objects on the GRT could only be manipulated with FES, and FES increased the level of independence in 25 of 30 ADL comparisons (5 subjects, 6 activities) as compared to baseline. After training, FES was preferred in 21 of 30 comparisons over the typical means of task completion. Of the 40 electrodes implanted, 37 continue to provide excellent stimulated responses and all of the implanted stimulators have functioned without problems. The surgical reconstruction procedures greatly enhanced FES hand function by either expanding the workspace in which to utilize FES (deltoid to triceps transfer), stabilizing the wrist (brachioradialis to wrist extensor transfer), or stabilizing joints (intrinsic tenodesis transfer, FPL split transfer). CONCLUSION: For five adolescents with tetraplegia, the combination of FES and surgical reconstruction provided active palmar and lateral grasp and release. Laboratory-based assessments demonstrated that the FES system increased pinch force, improved the manipulation of objects, and typically increased independence in six standard ADL as compared to pre-FES hand function. The study also showed that the five adolescents generally preferred FES for most of the ADL tested. Data on the benefits of the implanted FES hand system outside of the laboratory are needed to understand the full potential of FES.