Ectopic eruption of maxillary first permanent molars in children with cleft lip

The main aims of therapy for inflammatory bowel disease (Crohn disease) in children and adolescents are (1) the induction and maintenance of remission, (2) the correction of nutrient deficits and (3) the restoration of growth and maturation. These goals are reached with the use of a combination of therapeutic methods, including pharmacologic agents, nutritional and psychological support, and surgical intervention. The commonly used drugs sulfasalazine, corticosteroids and metronidazole have all been shown to be safe and efficacious when given to children. Newer steroid preparations that are rapidly degraded either in the target tissue or elsewhere are being studied. Of these, budesonide currently shows promise as an efficacious drug with few side effects, but its use in children needs further study. Newer 5-amino-salicylate preparations such as Asacol have been shown to be effective in children, but the number of patients studied is small. Immunomodulatory drugs such as azathioprine and 6-mercaptopurine appear to be safe and efficacious for children; cyclosporine has been used infrequently to treat refractory Crohn disease in children. The use of other agents such as methotrexate, tacrolimus, monoclonal antibodies to cytokines, antibiotics and specific dietary products such as fish oils have not been intensively studied in children with Crohn disease. Nutritional therapy remains a mainstay of treatment because it corrects nutritional deficits, replaces losses and stimulates growth.     

How are the retired physicians?

As part of an extensive cross-sectional survey of Norwegian physicians carried out in 1993 the 1,158 retired members of The Norwegian Medical Association were sent a questionnaire about their social situation, work activity, health and well-being. The response rate was 76%. 62% of the respondents were 75 years or older, and 13% were women. 44% were still active, doing clinical, research, or consultation work. The most prevalent complaint was lower back trouble, followed by arthrosis and hypertension. It was relatively common to prescribe one's own drugs. 6-8% of physicians under 75 years and 28% of those over 84 years needed practical help, but the great majority rated their life quality as good or excellent.     

The Alcohol Use Disorders Identification Test (AUDIT) in a routine health examination of long-term unemployed

A representative sample of 310 long-term unemployed in Norway was followed for 2 years with clinical examinations and the AUDIT questionnaire. 30% of the men and 8% of the women scored over the cut-off point for an alcohol use disorder. This gives a probable prevalence of 16%. The test predicted return to employment in this sample. The AUDIT answers were also used as a basis for dividing into three groups: 'normal', 'hazardous' and 'harmful'. At 2 year follow-up, 27% had changed group, 32 respondents to the worse and 24 to the better. This 'unstable' group was characterized by weaker social network and more frequent drinking. The AUDIT was judged as a useful instrument both in a routine health examination and as an epidemiological tool.     

Identification of amidated forms of GLP-1 in rat tissues using a highly sensitive radioimmunoassay

This study has determined long-term continuation rates of clients who attended clinics of the New Zealand Association of Natural Family Planning and became autonomous users. It has also identified factors which might influence the continuation of NFP use. A total of 509 female subjects, 452 of them with their male partners, were enrolled in the study at the beginning of clinic teaching. Once autonomous they were sent questionnaires at 6-monthly intervals for a period of 24 months. Time out was allowed for pregnancy. The number of female subjects entering the 2-year follow-up phase of the study was 406 (79.8%). Of these 164 completed 2 years of use with 102 (20% of study entrants) using NFP and 62 (12.2%) using fertility awareness in combination with a barrier method. Subjects for whom NFP was their first family planning method, who were Catholic or who gave religion as their reason for choosing NFP were more likely to continue long-term use. The majority of subjects (> 90%) were highly satisfied with NFP use, with the most common reasons for satisfaction being self-awareness, freedom from drugs, naturalness and effectiveness. The difficulties reported related to abstinence and cycle interpretation.     

Corticostriatal mechanisms of behavior

This article presents the results of three series of experiments on cats, dogs, and lower primates, performed to investigate the structural, neurophysiological, and mediator mechanisms of the corticostriatal systems involved in the organization of behavior. Morphological studies of corticostriatal connections showed that along with the diffuse distribution of afferent terminals within the striatum, there were also elements of topical organization defined by anteroposterior and mediolateral gradients. Neurophysiological experiments on dogs and lower primates were used to study the spike activity of the prefrontal region of the cortex and the head of the caudate nucleus during training to conditioned first- and second-order reflexes and during the solution of complex problems involving delayed spatial selection. Studies demonstrated that while in dogs, most of the neurons recorded showed a transition to responses to the conditioned signal at a particular stage of carrying out a conditioned response, in monkeys all cells recorded showed specific responses at different periods of solving the task at all stages of the study. Neuropharmacological experiments on dogs showed that agents blocking glutamine receptors in the caudate nucleus had more pronounced effects at the phase of developing conditioned movement reflexes. Administration of these agents during the reflex reinforcement phase affected only the differentiation of inhibition. These results lead to the conclusion that the prefrontal area of the cortex and, to some extent, the caudate nuclei, act on incoming information specifying the current dominant need and the states of the external and internal environments, to carry out programmed actions and assess the results of these actions.     

Tropical splenomegaly: surgical aspects

At the University College Hospital, Ibadan, Nigeria, in a 22-month period from January 1975 to September 1976, nine splenectomies were electively performed for unruptured spleens. The diagnoses were either tropical splenomegaly syndrome (when no obvious cause was found to be responsible for, or associated with, the splenomegaly) or splenic abscess in various stages of formation. The weights of the spleens removed ranged from 160 g in a 15-year-old girl to 5080 g in a 39-year-old male. One death due to uncontrollable bleeding from the splenic bed occurred. Histology of the spleens after removal showed lymphosarcoma in one, non-specific changes in another, and thickened fibrous capsule, perisplenitis, haemorrhagic infarcts, pockets of chocolate-coloured fluid and inflammatory processes in various stages in the other seven. In the tropics, enlarged spleens with no obvious cause or associated condition are often best treated by splenectomy for histological diagnosis, definitive treatment and the prevention of rupture caused by minor trauma. There are, as yet, no convincing data which show that splenectomy in the tropics causes a significant diminution of immunity to malaria (or other diseases) and it does not, therefore, predispose to the development of cerebral malaria.     

Association kinetics with coupled diffusional flows. Special application to the lac repressor--operator system

The time development of the association of the lac repressor to the operator is considered in a model where the repressor is allowed to bind unspecifically to DNA and move along the DNA chain in a one-dimensional diffusion. The coupling to the three-dimensional diffusion outside the chain is introduced by letting the repressor associate and dissociate from the chain until it is finally bound to the operator. All distance correlations along the chain are included. The mean time of association is calculated and through a comparison with experimental data the molecular parameters are determined. The one-dimensional diffusion constant is found to be of the order of 10(-9) cm(2)s(-1). The model is sufficiently general to be applicable to other similar systems.