Adult survivors of childhood sexual abuse. Do I have them in my practice?

The long term sequelae of childhood sexual abuse include many symptoms commonly encountered in general practice settings. Guidelines to empathic history taking, comprehensive assessment, and an overview of management are presented, together with a contextual background.     

Precision and accuracy of total body bone mass and body composition measurements in the rat using x-ray-based dual photon absorptiometry

Lean body mass (LBM), total body bone mineral mass (BMC), total body bone areal density (BMD), and body fat mass (FM) were measured in rats by dual photon absorptiometry (DXA), using two different instruments. The coefficients of variation for repeated measurements of LBM and FM were about 0.4 and 2.5%, respectively, over an animal body weight range of 150 to 600 g. For BMC and BMD, the coefficients of variation were less than 2%. The correlation coefficients for LBM, FM, BMC, and BMD measured on the two densitometers were all greater than 0.94. The slope of the regression line relating LBM measured by DXA and LBM measured by carcass analysis was 0.999, and the correlation coefficient was 0.99. For FM the slope was 1.05, and the correlation coefficient was 0.98. BMC measures by DXA were falsely low in small animals. For larger animals, the correlation between BMC and ash weight was 0.93, but the slope of the regression line was 0.78. DXA measures of LBM and FM were accurate and reproducible for rats weighing between 150 and 600 g. There was a size-dependent error in BMC, which will be significant in longitudinal measurements of bone mass.     

Standing surface waves on helium induced by second sound. Observations and calculations

Standing waves of second sound in superfluid helium deform the free helium surface. Schlieren observations on cylindrical cavities with vertical axis give the wave patterns predicted by Sorbello. Calculations and experiments show that the deformation is stationary, with only a very small time-dependent component. At low second-sound levels the wave amplitude is proportional to intensity. At higher levels the relation of wave height to second-sound intensity becomes nonlinear and when a critical value is reached, the waves break. Their height then increases abruptly, and the dominant wave number doubles.     

Focal segmental glomerulosclerosis in primates infected with a simian immunodeficiency virus

Focal and segmental glomerulosclerosis (FSG) with endothelial tubuloreticular inclusions (TRIs) is the typical lesion of human HIV-associated glomerulopathy. Autopsy studies showed the presence of FSG in 3 of 15 macaques dying 15-120 weeks after experimental infection with a simian immunodeficiency virus (SIVMne). Ultrastructural studies generally revealed numerous endothelial TRIs (also present in normals), mesangial expansion, and evidence of mesangial cell injury. One additional animal had a small-vessel polyarteritis with a proliferative and focally crescentic glomerulonephritis; seven animals had mild, multifocal interstitial nephritis. All animals had documented viremia after infection; 14 of 15 developed antibodies to SIV postinoculation. Additional postmortem findings included severe enterocolitis, encephalitis, and opportunistic infections. In contrast, autopsy studies of macaques infected with a type D simian retrovirus (SAIDS-D/Washington, SRV-2) for similar periods of time (n = 40) showed no evidence of FSG. One SRV-infected animal had a mild proliferative glomerulonephritis. These studies indicate SIV-infected primates may provide a relevant model for study of human HIV-associated nephropathy. They also indicate the variable pathology that can be seen in primate infections of distinct retrovirus types, each of which produces a simian immunodeficiency state that resembles human AIDS.     

Gel-entrapment of perfluorocarbons: a fluorine-19 NMR spectroscopic method for monitoring oxygen concentration in cell perfusion systems

Oxygenation is a major determinant of the physiological state of cultured cells. 19F NMR can be used to determine the oxygen concentration available to cells immobilized in a gel matrix by measuring the relaxation rate (1/T1) of perfluorocarbons (PFC) incorporated into the gel matrix. In calcium alginate gel beads without cells the relaxation rate (1/T1) of the trifluoromethyl group of perfluorotripropylamine (FTPA) varies linearly with oxygen concentration, with a slope of 1.26 +/- 0.15 x 10(-3) s-1 microM-1 and an intercept of 0.50 +/- 0.04 s-1. During perfusion with medium equilibrated with 95%/5% O2/CO2, changes in PFC T1s indicate that the average oxygen concentration was reduced from 894 +/- 102 microM in the absence of cells to 476 +/- 65 microM and 475 +/- 50 microM in the presence of 0.7 x 10(8) EMT6/Ro and RIF-1 murine tumor cells per milliliter of gel, respectively. The presence of 0.2 microliters of FTPA/ml of gel had no effect on the energy status of the cells as indicated by 31P NMR spectra. To calculate oxygen gradients within the beads from the average PFC T1 of the sample, a mathematical model was used assuming that oxygen is the limiting nutrient for cell metabolism and that the cellular oxygen consumption rate is independent of oxygen concentration. Data for EMT6/Ro cells were fit using experimentally determined perfusion parameters together with literature values for cell volume and oxygen consumption rate.(ABSTRACT TRUNCATED AT 250 WORDS)     

Hearing loss after spinal anesthesia. An audiological controlled trial

Audiological tests were conducted on 34 patients before and after undergoing an operation in spinal anaesthesia. One of these patients developed a considerable unilateral hearing loss in the low-frequency range, which persisted until an epidural blood-patch was given. Unexpectedly, we also found a general small but significant threshold shift at 500 Hz, which has never before been described in the literature. The biological mechanism is discussed, and the results suggest that the explanation of the hearing loss could be a condition similar to endolymphatic hydrops, resulting from perilymphatic hypotension due to loss of liquor during and after the spinal anaesthesia.     

Association of age and body weight with periodontal disease in North American dogs

Thirteen hundred and fifty dogs were examined under anesthesia at veterinary hospitals in the USA and Canada. Periodontal health was recorded in detail. Teeth were frequently absent (particularly lower third molar, upper and lower first premolars, and incisor teeth). Calculus was most extensive on the upper fourth premolar and molar teeth. Missing teeth, mobility of remaining teeth, extent of calculus and gingival inflammation, and furcation exposure and attachment loss all were more common in small dogs compared with larger dogs, and in order dogs compared with younger dogs.