[Dysphagia and dysarthria: unusual presentation of Myasthenia Gravis].

Myasthenia Gravis is an autoimmune disorder that generally presents with ocular symptoms, specially diplopia and ptosis. Dysphagia may be a manifestation of the generalised type of the disease, but rarely is its presenting feature. The authors describe a case of Myasthenia Gravis in an old patient complaining of dysphagia and dysarthria.

Structural and functional analyses of the severe acute respiratory syndrome coronavirus endoribonuclease Nsp15.

The severe acute respiratory syndrome (SARS) coronavirus encodes several RNA-processing enzymes that are unusual for RNA viruses, including Nsp15 (nonstructural protein 15), a hexameric endoribonuclease that preferentially cleaves 3' of uridines. We solved the structure of a catalytically inactive mutant version of Nsp15, which was crystallized as a hexamer. The structure contains unreported flexibility in the active site of each subunit.

The role of phloem sieve elements and laticifers in the biosynthesis and accumulation of alkaloids in opium poppy.

The benzylisoquinoline alkaloids of opium poppy, including the narcotic analgesics morphine and codeine, accumulate in the multinucleate cytoplasm of specialized laticifers that accompany vascular tissues throughout the plant. In mature opium poppy plants, immunofluorescence labeling using specific antibodies showed that four alkaloid biosynthetic enzymes, (S)-norcoclaurine 6-O-methyltransferase (6OMT), (S)-coclaurine N-methyltransferase (CNMT), (S)-3'-hydroxy-N-methylcoclaurine-4'-O-methyltransferase (4'OMT) and salutaridinol-7-O-acetyltransferase (SAT) were restricted to sieve elements of the phloem adjacent or proximal to laticifers. The identity of sieve elements was confirmed by (i) the specific immunogold labeling of the characteristic cytoplasm of this cell type, (ii) the co-localization of a sieve element-specific H(+)-ATPase with all biosynthetic enzymes and (iii) the strict association of sieve plates with immunofluorescent cells.

Changing epidemiology of outpatient bacteremia in 3- to 36-month-old children after the introduction of the heptavalent-conjugated pneumococcal vaccine.

Background: The introduction of routine vaccination with heptavalent conjugated pneumococcal vaccine has changed the overall incidence of bacteremia in children 3 months-3 years old.

Objective: To describe the changing incidence and etiology of bacteremia in previously healthy toddlers presenting to outpatient clinical settings.

Methods: Retrospective case series of all blood cultures obtained between September 1998 and August 2003 in Kaiser Permanente Northern California outpatient clinics and emergency departments from previously healthy children 3 months-3 years old.

Development of a fast method for determining psychophysical tuning curves.

Psychophysical tuning curves (PTCs) can be used to assess the frequency selectivity of the auditory system and to detect and delimit "dead regions" in the cochlea. However, the traditional method for determining PTCs takes too long for use in clinical practice. We evaluated a fast method for determining PTCs, using a band of noise that sweeps in centre frequency and a Békésy method to adjust the masker level required for threshold.

Do bednets reduce malaria transmission by exophagic mosquitoes?

The impact of bednet coverage on malaria prevalence in a suburb of São Tomé was monitored, by passive case detection, over a three-year period (1997-1999), when bednet use increased from 20 to 74%. Malaria parasites were detected in 1651 (41.6%) of the 3967 slides taken during the study.

Comparison of two adaptive procedures for fitting a multi-channel compression hearing aid.

We compared two adaptive procedures for fitting a multi-channel compression hearing aid. "Camadapt" uses judgements of the loudness of speech stimuli and the tonal quality of music stimuli. "Eartuner" uses judgements of the loudness and clarity of speech stimuli with differing spectral characteristics.

Sanguinarine biosynthesis is associated with the endoplasmic reticulum in cultured opium poppy cells after elicitor treatment.

Three key benzylisoquinoline alkaloid biosynthetic enzymes, (S)-N-methylcoclaurine-3'-hydroxylase (CYP80B1), berberine bridge enzyme (BBE), and codeinone reductase (COR), were localized in cultured opium poppy (Papaver somniferum) cells by sucrose density gradient fractionation and immunogold labeling. CYP80B1 catalyzes the second to last step in the formation of (S)-reticuline, the last common intermediate in sanguinarine and morphine biosynthesis. BBE converts (S)-reticuline to (S)-scoulerine as the first committed step in sanguinarine biosynthesis, and COR catalyzes the penultimate step in the branch pathway leading to morphine.

The effect on speech intelligibility of varying compression time constants in a digital hearing aid.

The identification of nonsense syllables in quiet and in three types of background (babble, cafeteria and single female speaker) was measured using four hearing aid compression algorithms differing in attack and release time constants, and using linear amplification. The speech level was always 65 dB SPL. The compression algorithms, which were implemented in a Phonak Claro ITE hearing aid, were: (1) 'very fast'--the attack time was 8 ms and the release time was 32 ms, for all 20 channels; (2) 'slow-fast'--the attack and release times decreased from 500 ms for low frequencies to about lOOms for high frequencies; (3) 'fast-slow'-the attack and release times increased from about 50ms for low frequencies to 500 ms for high frequencies; and (4) 'slow + fast'-a very slow-acting gain control signal was combined with a fast-acting gain control signal, for each channel in a 10-channel system.

Speech-in-noise perception in high-functioning individuals with autism or Asperger's syndrome.

Background: High-functioning individuals with autism (HFA) or Asperger's syndrome (AS) commonly report difficulties understanding speech in situations where there is background speech or noise. The objective of this study was threefold: (1) to verify the validity of these reports; (2) to quantify the difficulties experienced; and (3) to propose possible mechanisms to explain the perceptual deficits described.

Method: Speech-in-noise perception abilities were measured using speech reception thresholds (SRTs), defined as the speech-to-noise ratio (SNR) at which approximately 50% of the speech is correctly identified.

Comparison of three procedures for initial fitting of compression hearing aids. III. Inexperienced versus experienced users.

We assessed whether gain requirements differ for experienced users and new users when fitted with multi-band compression hearing aids Three procedures for initial fitting were used: the Cambridge method for loudness equalization (CAMEQ), the Cambridge method for loudness restoration (CAMREST), and the desired sensation level input/output (DSL[i/o]) method. Twenty experienced hearing aid users and 20 new users with mild-to-severe sensorineural loss were fitted with Danalogic 163D digital hearing aids, using each procedure in turn in a counter-balanced order. The new users were given a pre-fitting with slightly reduced gains prior to the 'formal' fitting.

Chiropractic care of a patient with low back pain associated with subluxations and a Malgaigne-type pelvic fracture.

Objective: To describe the chiropractic care of a patient with a pelvic ring fracture and concomitant subluxations of multiple segments of the spinal column.

Clinical Features: A 23-year-old male, after falling down a flight of stairs, was initially hospitalized for fractures of the pelvis. Five weeks posthospitalization, the patient initiated chiropractic care with complaints of severe low back pain with lower extremity involvement.

Chiropractic care of a geriatric patient with an acute fracture-subluxation of the eighth thoracic vertebra.

Objective: To describe the chiropractic care of a geriatric patient with complaints of midthoracic and low back pain.

Clinical Features: A 74-year-old woman sought chiropractic care with complaints of thoracic spinal pain following a fall. Palpation findings included hypertonicity and tenderness along with painful muscle spasms in the paraspinal musculature of the thoracolumbar spine.

Comparison of three procedures for initial fitting of compression hearing aids. II. Experienced users, fitted unilaterally.

This paper is the second in a series comparing three procedures for the initial fitting of multichannel compression hearing aids. The first paper reported the results for a group of 10 experienced hearing aid users fitted bilaterally. This paper reports the results for a different group of 10 experienced hearing aid users fitted unilaterally.

Conflicting selection pressures on seed size: evolutionary ecology of fruit size in a bird-dispersed tree, Olea europaea.

Recent evidence indicates that fruit size has evolved according to dispersers' size. This is hypothesized to result from a balance between factors favouring large seeds and dispersers setting the maximum fruit size. This hypothesis assumes that (1) the size of fruits that can be consumed by dispersers is limited, (2) fruit and seed size are positively correlated, and (3) the result of multiple selection pressures on seed size is positive.

Precise and efficient cleavage of recombinant fusion proteins using mammalian aspartic proteases.

Expression of recombinant proteins as translational fusions is commonly employed to enhance stability, increase solubility and facilitate purification of the desired protein. In general, such fusion proteins must be cleaved to release the mature protein in its native form. The usefulness of the procedure depends on the efficiency and precision of cleavage and its cost per unit activity.

Phase effects in masking: within- versus across-channel processes.

The effects of bandwidth and component phase on masking were investigated using 200-ms narrowband (1-ERB(N)) and broadband (5-ERB(N)) cosine-phase (CP) and random-phase (RP) harmonic complex maskers, centered at 1 or 6 kHz. A continuous notched-noise was used to restrict off-frequency listening. The masker fundamental frequency (F0) was 25 Hz.

Chiropractic care of a pediatric patient with myasthenia gravis.

Objective: To describe the chiropractic care of a pediatric patient with complaints associated with myasthenia gravis. Clinical features A 2-year-old girl was provided chiropractic care at the request and consent of her parents for complaints of ptosis and generalized muscle weakness (ie, lethargy), particularly in the lower extremities. Prior to entry into chiropractic management, magnetic resonance imaging of the brain and acetylcholine receptor antibody tests were performed with negative results.

Chiropractic care of a patient with vertebral subluxation and Bell's palsy.

Objective: To describe the chiropractic care of a patient medically diagnosed with Bell's palsy and discuss issues clinically relevant to this disorder, such as its epidemiology, etiology, diagnosis, care, and prognosis.

Clinical Features: A 49-year-old woman with a medical diagnosis of Bell's palsy sought chiropractic care. Her symptoms included right facial paralysis, extreme phonophobia, pain in the right temporomandibular joint (TMJ), and neck pain.

Towards an understanding of the mechanisms of weak central coherence effects: experiments in visual configural learning and auditory perception.

The weak central coherence hypothesis of Frith is one of the most prominent theories concerning the abnormal performance of individuals with autism on tasks that involve local and global processing. Individuals with autism often outperform matched nonautistic individuals on tasks in which success depends upon processing of local features, and underperform on tasks that require global processing. We review those studies that have been unable to identify the locus of the mechanisms that may be responsible for weak central coherence effects and those that show that local processing is enhanced in autism but not at the expense of global processing.

Evaluation of the noise reduction system in a commercial digital hearing aid.

We evaluated the effectiveness of a noise reduction system implemented in a commercial digital multichannel compression hearing aid. Eight experienced hearing aid wearers with moderate sensorineural hearing loss were fitted bilaterally according to the manufacturer's fitting guidelines. After a 3-month period of regular use of two programs, one with and one without the noise reduction system, speech recognition thresholds (SRTs) were measured in four types of background noise, including steady noise, and noises with spectral and/or temporal dips.

The relative role of beats and combination tones in determining the shapes of masking patterns: II. Hearing-impaired listeners.

Masking patterns were measured for hearing-impaired subjects with varying degrees of hearing loss. In one set of conditions, three subjects were tested using narrowband noise ('noise') and sinusoidal ('tone') maskers and narrowband noise signals. The maskers had centre frequencies of 0.

Practice-based randomized controlled-comparison clinical trial of chiropractic adjustments and brief massage treatment at sites of subluxation in subjects with essential hypertension: pilot study.

Objective: To determine the feasibility of conducting a randomized clinical trial in the private practice setting examining short- and long-term effects of chiropractic adjustments for subjects with essential hypertension compared with a brief soft tissue massage, as well as a nontreatment control group.

Design: Randomized controlled-comparison trial with 3 parallel groups.

Setting: Private practice outpatient chiropractic clinic.