Language and memory functions after long recovery periods in left-hemispherectomized subjects.

Two subjects who had infantile brain damage and left hemispherectomies at the ages of 17 and 18 yr are assessed after 28 and 16 yr recovery periods. Deficits on the comprehension of passive-negative sentences disappeared when the subjects read rather than heard the sentences, and performances were normal on the Token and Reporter's Tests, and tests of verbal memory. These results suggest that if damage to the left hemisphere occurs early in life and there is a long recovery period, the right hemisphere can mediate verbal memory and the more subtle aspects of language.

Congenital malformations of the lower extremities.

An understanding of the normal and pathologic development of the lower limb allows the physician a fuller appreciation of the clinical and functional disabilities that each congenital malformation may present. Treatment to allow achievement of each child's fullest potential may then be better attained.

The UAS of the yeast PGK gene contains functionally distinct domains.

The upstream activation site (UAS) of the yeast phosphoglycerate kinase gene (PGK) has been localised by deletion analysis (1). Here we show that the UASPGK contains two functionally distinct domains. These two domains, designated activator (A) and modulator (M), appear to be located within bases -460 to -402 and -531 to -461, respectively, relative to the initiating ATG; although it is possible that part of the M domain resides within the A domain.

Enteral and parenteral branched chain amino acid-supplemented nutritional support in patients with encephalopathy due to alcoholic liver disease.

The effects of branched chain amino acid (BCAA)-enriched diets (fed for 7 days) on encephalopathy, plasma amino acid concentrations, aromatic amino acid turnover, and protein synthesis rates were determined in eight patients with alcoholic liver failure. Four patients were given the diet intravenously (iv group) (total amino acids, 60-80 g/day, BCAA content 51%, energy 2000 kcal/day) and four patients (NG group) were given a semi-elemental formulation via constant nasogastric (NG) infusion (amino acids 58 g, BCAA 43%, oligopeptides 19.5 g, energy 2000 kcal/day).

Physeal injuries of the cervical spine.

Four cases of cervical spine growth plate ("ring apophysis") injury are described. Two nonfatal injuries involved anterior displacement of a portion of the inferior physis and epiphyseal ossification center in the lower cervical spine. Neither injury was associated with neurological damage.

Metacarpal epiphyseal fractures.

Five cases of injuries to the distal metacarpal physis and epiphysis are reviewed. Axially applied loads may result in growth disturbances. The extent of the physeal injury is not always evident on the initial radiographs.

A method for early postoperative mobilization of the cerebral palsy patient using a removable abduction bar.

An abduction device is described that allows mobility and continued physical therapy for cerebral palsy patients who are recovering from multilevel lower-extremity surgery. An easy-to-use, removable abduction bar allows ongoing therapy and ambulation in the postoperative casts when the bar is removed and maintenance of hip abduction when the bar is in place. This has aided our patients in achieving maximal benefit of the surgical/therapy program and minimized the regression of presurgical motor skills during the immobilization period.

Diagnosis of developmental pathology of the neuraxis by magnetic resonance imaging.

We have used magnetic resonance imaging (MRI) to evaluate 22 patients with various clinical and/or radiographic findings potentially associated with intraspinal pathology whose evaluation would have necessitated myelography or computed tomography scanning in the past. Ten of these 22 children were diagnosed by MRI to have significant intraspinal lesions: diastematomyelia in four, syringomyelia in four, tethered spinal cord in three, intraspinal lipoma in two, and spinal cord tumor in one. MRI is noninvasive, requires no exposure to ionizing radiation, and provides multiplanar images and three-dimensional reconstruction potential, all with superior soft tissue imaging.

Fracture and ischemic necrosis of the immature scaphoid.

The progressively ossifying scaphoid of the child is well protected but is not immune to injury. The diagnosis of scaphoid fracture may be difficult when the fracture occurs through the osteochondral interface. Nonunion and ischemic necrosis of the proximal pole fragment--complications more often seen in adults sustaining scaphoid fracture--may occur in children, as shown by the young patient presented here.

Break dance hip: chronic avulsion of the anterior superior iliac spine.

A case of chronic, progressive avulsion of the anterior superior iliac spine leading to the formation of a long, attenuated spur of bone in an 18-year-old black male break dancer is described. The mechanism of formation appeared to be repetitive avulsion from break dancing.

Tamarin model of pneumococcal bacteremia.

Tamarins (Saguinus labiatus) were utilized to study host defenses against pneumococcal bacteremia. Tamarins had a poor antibody response to immunization with varying doses of pneumococcal capsular polysaccharide (PCP) vaccine (2 of 15 positive) or to infection with serotype 7F Streptococcus pneumoniae (2 of 14 positive). Tamarins were protected against challenge with a lethal dose of serotype 7F S.

Neuropsychological and psychological sequelae of shunt surgery in young adults with hydrocephalus.

Three patients with hydrocephalus aged 16, 26, and 33 years demonstrated memory deficits before or after the insertion of a ventricular shunt but at no time demonstrated ataxia, incontinence, or dementia. Following shunt surgery, memory functions improved rapidly in the patient who had had a recent acute onset of hydrocephalus, but in the two patients with a long period of hydrocephalus before shunting, memory impairments did not recover significantly in one patient, and in the other, memory impairments had become more severe by 12 months postshunt. Other neuropsychological and psychological sequelae of adult hydrocephalus are discussed, and it is suggested that for patients with chronic hydrocephalus, an extended period of neurological and neuropsychological monitoring may be advantageous before a decision is made to perform shunt surgery.

Efficient expression of the Saccharomyces cerevisiae PGK gene depends on an upstream activation sequence but does not require TATA sequences.

The Saccharomyces cerevisiae PGK (phosphoglycerate kinase) gene encodes one of the most abundant mRNA and protein species in the cell. To identify the promoter sequences required for the efficient expression of PGK, we undertook a detailed internal deletion analysis of the 5' noncoding region of the gene. Our analysis revealed that PGK has an upstream activation sequence (UASPGK) located between 402 and 479 nucleotides upstream from the initiating ATG sequence which is required for full transcriptional activity.

The accessory navicular synchondrosis.

The accessory navicular, which is considered an anatomic variant, may be the source of pain in athletes. There are three types of accessory naviculars: Type I is an ossicle in the substance of the posterior tibial tendon; Type II forms a synchondrosis with the navicular; and Type III, "the cornuate navicular," represents the possible end stage of Type II. Nine feet had Type II accessory naviculars.

Tension band wiring of displaced tibial tuberosity fractures in adolescents.

Twelve adolescent boys with avulsion fractures of the tibial tuberosity were treated with open reduction and tension band wire fixation. Fasciotomies were required in two cases for associated compartmental syndromes. All fractures healed in anatomic position.

Mapping regions of the matrix protein of vesicular stomatitis virus which bind to ribonucleocapsids, liposomes, and monoclonal antibodies.

The matrix (M) protein of vesicular stomatitis virus (VSV) appears to function as a bridge between the ribonucleocapsid (RNP) core and the envelope in assembly of the virion. Two such properties would necessitate at least one site for interaction with the nucleocapsid and one with the envelope. In this study M protein was found to mediate the in vitro binding to RNP cores of phospholipid vesicles, representing membrane structures.

The Grenz Ray technique for painting analysis.

A Grenz Ray unit was used in conjunction with standard medical radiographic film to accomplish a detailed analysis of a painting from the 16th century. This procedure demonstrates the application of basic radiographic technique to a nonmedical field. The resulting radiographic analysis demonstrated the required information and saved the museum time and money.

Radiology of postnatal skeletal development. XIII. C1-C2 interrelationships.

Composites of C1 and C2 were analyzed in various roentgenographic projections to elucidate osseous interrelationships and the effect of overlap of different portions of these two vertebrae in standard radiographic projections during differing stages of postnatal chondro-osseous transformation. In anteroposterior projections the dentocentral synchrondroses of C2 normally was located below the inferior rim of the C1 anterior ossification center. The upper extent of the dens ossification center was behind this anterior C1 center.

Isolation of a novel type of mutation in the mitotic control of Schizosaccharomyces pombe whose phenotypic expression is dependent on the genetic background and nutritional environment.

The major cell cycle control in the fission yeast Schizosaccharomyces pombe acts at entry to mitosis, and involves three previously identified genes cdc2, cdc25 and wee1. The presence of a wee1 mutation phenotypically suppresses cdc25 mutations. This paper describes the isolation and subsequent analysis of a strain in which the suppression is reversed by the presence of a new mutation, designated win1.

Autotopagnosia. Occurrence in a patient without nominal aphasia and with an intact ability to point to parts of animals and objects.

A patient with a metastasis in the left parietal lobe demonstrated difficulty in pointing to body parts although he could name them when they were pointed to by someone else. As he had no nominal aphasia, could understand complex verbal instructions and could correctly describe the functions of named body parts, his autotopagnosia is unlikely to be a result of a category-specific comprehension deficit. As he is able to point to parts of objects, plants and animals on command, his disorder is also unlikely to be part of a general inability to analyse a whole into its details.

Successful autogenous corticocancellous grafting of a radial defect complicating acute hematogenous osteomyelitis in an infant.

Recurrent osteomyelitis of the radius during infancy after initial hematogenous onset is rare. When encountered, this lesion may result in a segmental defect associated with limitation of forearm motion and progressive deformity. A 10-month-old girl developed distal radial osteomyelitis following bilateral otitis media.

Monoclonal antibodies to the matrix protein of vesicular stomatitis virus (New Jersey serotype) and their effects on viral transcription.

Of 33 hybridomas raised by immunization of BALB/c mice with the matrix (M) protein of the New Jersey serotype of vesicular stomatitis virus (VSV), 17 secreted monoclonal antibodies (mAb) of the IgG isotype and, unexpectedly, 16 of the IgM isotype. All these monoclonal antibodies bound strongly to VSV-New Jersey M protein by ELISA, immunoprecipitation, and immunoblotting assays, but exhibited only slight or no cross-reactivity with the M protein of VSV-Indiana. Four antigenic determinants of VSV-New Jersey M protein could be identified by competitive binding of 125I-labeled monoclonal antibodies but three of these epitopes exhibited partial overlap.

Parasites of the Dall's porpoise (Phocoenoides dalli True).

The prevalences of three helminths, Campula oblonga, Halocercus dalli and Crassicauda sp., recovered from Dall's porpoises which were net-entrapped incidentally in the vicinity of the Western Aleutian Islands in the northwest Pacific are reported. Specimens of Campula oblonga were found within the bile ducts of 46% of 127 livers examined.