Diagnosing attention deficit disorders with the Behavioral Assessment System for Children and the Child Behavior Checklist: test and construct validity analyses using optimal discriminant classification trees

The usefulness of the Behavioral Assessment System for Children (BASC) and Child Behavior Checklist (CBCL) Parent scales was examined with respect to (a) differentiating students with attention deficit-hyperactivity disorder (ADHD) from non-ADHD students and (b) discriminating between the predominantly inattentive-type and combined-type ADHD-afflicted students. For both the BASC and the CBCL, a different optimal discriminant classification tree analysis (CTA) model was developed for each of the 2 diagnostic predictions. For distinguishing ADHD students from non-ADHD students, the BASC model was more parsimonious and accurate than the CBCL model. Toward the goal of differentiating between primarily inattentive and combined types, the CBCL's model was superior for predicting primarily inattentive students. The results demonstrate the diagnostic utility of the BASC and CBCL and describe salient behavioral dimensions associated with subtypes of ADHD.     

Neovascularization after transmyocardial laser revascularization in a model of chronic ischemia

BACKGROUND: The mechanism of clinical improvement after transmyocardial laser revascularization (TMR) is unknown. One hypothesis holds that TMR causes increased myocardial perfusion through neovascularization. This study sought to determine whether angiogenesis occurs after TMR in a porcine model of chronic myocardial ischemia. METHODS: Six miniature pigs underwent subtotal left circumflex coronary artery occlusion to reduce resting blood flow to 10% of baseline. After 2 weeks in the low-flow state, dobutamine stress echocardiography and positron emission tomography were performed to document ischemic, viable myocardium. The animals then underwent TMR and were sacrificed 6 months later for histologic and immunohistochemical analysis. RESULTS: Histologic analysis of the lased left circumflex region demonstrated many hypocellular areas filled with connective tissue representing remnant TMR channels. Histochemical staining demonstrated a highly disorganized pattern of neovascularization consistent with angiogenesis located predominantly at the periphery of the channels. Immunohistochemical analysis confirmed the presence of endothelial cells within neovessels. Vascular density analysis revealed a mean of 29.2+/-3.6 neovessels per high-power field in lased ischemic myocardium versus 4.0+/-0.3 (p<0.001) in nonlased ischemic myocardium. CONCLUSIONS: This study provides evidence that neovascularization is present long term in regions of ischemic, viable myocardium after TMR. Angiogenesis may represent the mechanism of clinical improvement after TMR.     

Primary diagnosis of osseous carpal area injuries--a comparison of conventional examination methods with digital luminescence radiography

Despite recent progress in improving diagnostic methods carpal bone lesions are still a major problem of primary diagnosis. Diagnostic imaging with digital luminescence radiography (DLR) allows the reliable presentation of traumatologically relevant carpal structures. In this study on 39 patients with suspected carpal bone injuries individually worked over DLR images were superior to "standard" DLR and conventional X-ray film/screen images. Though "standard" DLR images were inferior to film images edge-enhanced DLR images showed definite advantages in the demonstration of soft tissues. Fractures undetectable in conventional X-rays could not be recognized by digital imaging. In our experience bone-scanning remains the most reliable method for definite exclusion of carpal bone fractures after standard and digital X-ray methods are exhausted.     

Affinity-based screening of combinatorial libraries using automated, serial-column chromatography

We have developed an automated serial chromatographic technique for screening a library of compounds based upon their relative affinity for a target molecule. A "target" column containing the immobilized target molecule is set in tandem with a reversed-phase column. A combinatorial peptide library is injected onto the target column. The target-bound peptides are eluted from the first column and transferred automatically to the reversed-phase column. The target-specific peptide peaks from the reversed-phase column are identified and sequenced. Using a monoclonal antibody (3E-7) against beta-endorphin as a target, we selected a single peptide with sequence YGGFL from approximately 5800 peptides present in a combinatorial library. We demonstrated the applicability of the technology towards selection of peptides with predetermined affinity for bacterial lipopolysaccharide (LPS, endotoxin). We expect that this technology will have broad applications for high throughout screening of chemical libraries or natural product extracts.     

Chronic low intakes of vitamin A-rich foods in households with xerophthalmic children: a case-control study in Nepal

Dietary patterns in 81 rural Nepali households with a 1-6-y-old child with a history of xerophthalmia were compared with dietary patterns of 81 households with an age-matched nonxerophthalmic control subject. Weekly food-frequency questionnaires were collected from case and control "focus" children, a younger sibling (if present), and the household 1-2 y after recruitment and treatment of cases. Control households and children were more likely than case households and children to consume vitamin A-rich foods during the monsoon (July-September) and major rice harvesting (October-December) seasons. Cases were less likely to consume preformed vitamin A-rich foods throughout the year [odds ratio (OR) = 1.2-4.5] with the strongest differences observed from October to December (OR = 2.0-4.2). Dietary risks were generally shared by younger siblings of cases, suggesting that infrequent intake of beta-carotene and preformed vitamin-A rich foods begins early in life and clusters among siblings within households, a pattern that is consistent with their higher risk of xerophthalmia and mortality. In developing countries where vitamin A deficiency is endemic, dietary counseling for children with xerophthalmia should be extended to their younger siblings. Moreover, dietary intake of preformed vitamin A may be as, or more, important as carotenoid-containing food consumption in protecting children and other members of households from vitamin A deficiency.     

Ultrasonic examination in soft-tissue and long-bone injuries of the limbs

Compulsory sterilization, where jail sentences will be imposed on couples if both partners remain unsterilized after the birth of their 3rd child, will be introduced in India, and it is thought that such a program will fail. Indian officials justify compulsory sterilization on the grounds that the country's survival is at stake. This argument, however, is not self-evident. Coercion entails potential moral and political consequences. Preliminary evidence on the effects of a combination of income redistribution, lowered infant mortality, improved literacy, and readily available family planning services and information show that such "packages," however slow and costly, may make smaller families an attractive alternative to the poorest family. The Indian government seems to be looking for a "short-cut," which will require complicated record keeping and readily available health facilities. If India were ready for the successful introduction of compulsory sterilization, it would also be ready for "development" since much the same structure would be required.