Persistent mirror movements: a clinical study of 17 children, adolescents and young adults

The author reports a series of 17 cases of congenital mirror movements of the hands and forearms (and in a few cases the toes), but no other signs of gross neurological deviation. This is an uncommon disorder that often goes unrecognised. This slight but definite disability seems to persist largely unchanged at least into the late teens, and probably into adulthood. A hereditary background is suggested in about half of the cases. Various neuropsychiatric deficits were seen in combination with the mirror movements in about half the cases, as well as a high incidence of non-right-handedness. Although the clinical heterogeneity of the disorder was clear, the phenomenon of mirror movements was similar in all cases. Recent progress in understanding the pathophysiology of this disorder is reviewed.

The prevalence of caries in groups of children aged 4-5 and 7-8 years in Khartoum, Sudan

A total of 544 children, 275 pre-school children (aged 4-5 years) and 269 school children (aged 7-8 years), were examined for dental caries using WHO criteria with some modifications. The children were resident in Khartoum, Sudan. The mean dmft was 1.68 in the 4-5-year group, and 58% of them were caries-free. In the 7-8-year group the mean dmft (molars and canines) was 2.77, and 33% of the children were caries-free. Most of the caries in both groups was untreated. In decayed teeth which were not beyond repair, occlusal caries was most prevalent in the pre-school group and approximal caries most prevalent in the school group. The mean DMFT in the 7-8-year group was 0.15, and only occlusal surfaces in first molars were affected. Ninety-four percent in the 7-year group and 88% in the 8-year group were caries-free in the permanent dentition. When the children were grouped according to their socio-economic level, there were no statistically significant differences in caries prevalence between the groups. Since this is the first comprehensive caries prevalence study of these age groups in Sudan, it is impossible to conclude whether caries is increasing or not. The prevalence of caries-free preschool children is above the global goal of FDI/WHO for the year 2000, but below the goal for developing countries.

Enamel defects in primary canines related to traditional treatment of teething problems in Sudan

In parts of Sudan and some other countries, teething is thought to be the cause of severe health problems in infants, and a traditional treatment involves lancing the alveolar process over the unerupted canines with a heated needle, a procedure known as 'haifat'. Three hundred and ninety-eight children aged 4-8 years were examined for the presence of enamel defects on primary canines, and their parents or guardians were questioned regarding past teething problems and their treatment. Two hundred and fifty-eight (65%) of the children had experienced health problems that had been attributed to teething, and 89 (22%) had been subjected to 'haifat'. 'Haifat' had been practised by all socio-economic groups, but was most prevalent in the lower groups. Enamel defects on the buccal surface of the primary canines were found in 25 (28%) of the children in the 'haifat' group and in 25 (8%) of the other children.

[Pseudomonas infection associated with whirlpool bath]

After using a whirlpool-spa when the chlorine concentration in the water was very low (0.1 mg/l free chlorine) approximately 20 persons developed a follicular rash. No cases were registered in bathers when the chlorine concentration was acceptable (0.9-1.2 mg/l). The same sero-group and phagetype of Pseudomonas aeruginosa was cultivated from a patient and from the piping system of the spa. The importance of following directions for the installation of whirlpool-spas and regulations for their operation and control is strictly stressed. The National Agency for Environmental Protection is asked to reinforce the existing regulations concerning whirlpool-spas.

Synthesis and collagenase inhibition of new glycosides of aranciamycinone: the aglycon of the naturally occurring antibiotic aranciamycin

Glycosides of aranciamycinone were prepared by glycosylation with sugar acetates and trimethylsilyl triflate in dichloromethane. Glycosides of the following sugars were prepared: alpha-L-rhamnopyranose, beta-D-glucopyranose, beta-D-ribopyranose, beta-D-xylopyranose, alpha-L-fucopyranose, 2-azido-2,6-dideoxy-alpha-L-mannopyranose, 2,6-dideoxy-alpha-L-arabino-hexopyranose, 3,6-dideoxy-alpha-L-arabino-hexopyranose, and 4,6-dideoxy-alpha-L-lyxo-hexopyranose. The new glycosides were tested for inhibition of Clostridium histolyticum collagenase and Yoshida Sarcoma tumor cells.

Inhibition of collagenase by aranciamycin and aranciamycin derivatives

Aranciamycin (1), an anthracycline antibiotic, was found to be an inhibitor of Clostridium histolyticum collagenase, with an IC50 = 3.7 x 10(-7) M. Elastase and trypsin were not inhibited at concentrations less than or equal to 10(-5) M. A number of aranciamycin derivatives 2-13 were prepared and tested for collagenase inhibition. While loss of activity was found for derivatives modified in the sugar ring or rings B and D of the aglycone, increased potency was found when the tertiary alcohol at C-9 was esterified. All compounds 1-13 were found to inhibit DNA synthesis of Yoshida sarcoma tumor cells.

Facial pain. IV. A prospective study of 1052 patients with a view of: precipitating factors, associated symptoms, objective psychiatric and neurological symptoms

In a prospective material of 1052 patients the precipitating factors, associated symptoms, psychological and neurological deficits have been examined. Mastication and talking are the most frequently occurring precipitating factors, 76% as regards Neuralgia, with typical starting difficulties. As regards Non-neuralgiform Pain 24%, with precipitation late in the masticatory process. There were trigger zones in 50% of the cases of Typical Trigeminal Neuralgia and in 9% of the patients with Non-neuralgiform Pain. In a series of cases the jaw joint is perceived as a trigger zone. Cold precipitates pain in 48%-39%. Other precipitating factors are much more rare--psychological stress in 15% of the patients with Non-neuralgiform Pain, however. "Vegetative" associated symptoms were relatively frequent, lacrimation occurred in 31% of the cases of Typical Trigeminal Neuralgia and in 20% of the cases of Non-neuralgiform Pain. Rhinorrhea and salivation were less frequent. In terms of figures migrainoid associated symptoms had no connection with vegetative associated symptoms or with pain in the eye. In 11% of the patients pain occurred most frequently during the night and in 20% the frequency of pain was the same day and night. About 1/3 of the patients with Neuralgia experienced seasonal variations. Tenderness of foramina is a symptom of no significance. Very few patients had primary sensory loss. No eye or ear symptoms have been found which may be referred to as the patho-anatomical basis of the pain. About 1/3 of the patients with Non-neuralgiform Pain had psychological symptoms whereas hardly any patients with Neuralgia had them. MMPI test performed on a small matched material showed no difference between Neuralgia and Non-neuralgiform Pain. In material B an examination has been made of the jaw joint arthrosis symptoms. A restriction of the diagnosis of arthrosis has had the effect that it must be recognized that patients with facial pain do not have the high frequency of jaw joint diseases previously assumed. As was also the case in a series of normal material previously published, between 1, 5 and 1, 3 of the patients with Neuralgia had jaw joint arthrosis which was due to old age. This study has not revealed any connection between previous diseases, the onset of pain, the character and course of the pain, the character of the attack, the localization of pain, precipitating factors, associated symptoms and symptoms of loss on the one hand and the patho-anatomical substratum on the other.

Facial pain. III. A prospective study of the localization of facial pain in 1052 patients

The study is based on 1052 prospective patients. They have been divided into 3 groups according to the duration of the attack. The purpose of this study is to evaluate the importance of localization of the pain in order to determine its patho-anatomical basis. The right/left ratio was 2/1 in the Neuralgia Patients. There was no difference in patients with Non-neuralgiform Pain. There were extremely few cases of bilateral pain among the Neuralgia Patients, 15% among patients with Non-neuralgiform Pain. In the Neuralgia Patients there was a predominantly deep localization up to 50%, the Non-neuralgiform Pain 74%. Seventeen points of origin of pain have been registered in the face. By far the most frequent is a point of origin with radiation. If the percentage distribution is calculated according to each trigeminal division, the point of origin of pain in 74% is the eyebrow in the area of the 1st division, as regards the 2nd and 3rd divisions more than 30% from the upper gingiva, the area in front of the ear and the lower gingiva and between 11 and 20% from the forehead and the hairline, the upper lip and the nasolabial sulcus, the maxilla and the cheek. Pain radiation is generally most frequent to the division from which the pain originates. Neuralgia hardly radiates outside the boundaries of the face. The pain is localized within the area of one division in 42%. The radiation is not systematic. It is not possible from the localization of the pain to decide any patho-anatomical basis of the pain. Nothing in the localization of pain can be used for classification of facial pain (particularly not the "parallelism" or the "peripheral course').

Facial pain. II. A prospective survey of 1052 patients with a view of: character of the attacks, onset, course, and character of pain

The material, definition, delimitation, and classification of facial pain, general data, hereditary conditions, and previous diseases have been discussed in a preceding study. According to the character of the attacks the material has been classified into TTN = Typical Trigeminal Neuralgia (1/4), ATN = Atypical Trigeminal Neuralgia (1/4), and NNFP = Non-neuralgiform Facial Pain (1/2). The typical Trigeminal Neuralgia is a transitory, shooting pain, well defined. The other two groups are less well defined. The patients come to be treated by specialists 1-5 years after the onset of pain. The oral cavity is often perceived as the origin of the pain. A systematic examination shows that demonstrable pathological diseases in the masticatory organs are rarely connected with the pain condition. Dental treatment has provided poor results. Facial pain is a very constant phenomenon which does not- or only to a negligible degree--change over an agelong course. In the present material 8 characters of pain are used: Shooting-cutting, boring, squeezing-pressing, throbbing-hammering, dull, burning-smarting, prickling-sticking, paraesthetic. With the exception of a few cases of apoplexy and herpes zoster there is no pain reaction which can be referred to on an aethilogical basis.

Facial pain. I. A prospective survey of 1052 patients with a view of: definition, delimitation, classification, general data, genetic factors, and previous diseases

1052 patients with facial pain have been examined and followed up by the author for an 18-year period. The patients are classified according to type of attack into: Typical Trigeminal Neuralgia (brief pain paroxysms with pain-free intervals). Atypical Trigeminal Neuralgia (pain paroxysms with intervals of pain or paroxysms lasting for minutes). Non-neuralgiform Facial Pain (pain lasting or occurring for long periods). The material was equally distributed between patients with Neuralgia and Non-neuralgiform Facial Pain. In the majority of cases Trigeminal Neuralgia occurred after the age of 50. Non-neuralgiform Pain mainly between 30 and 50. There is a majority of women with Non-neuralgiform Pain. No genetic factors could be demonstrated. A detailed registration of previous diseases in the central nervous system, the peripheral nerves, and the facial structures revealed no relation to important aetiological factors.

[Do pregnant women with a low-situated placenta in the 16th week constitute a risk group?]

The object of this investigation was to elucidate whether pregnant women with low-placed placentae in the 16th week of pregnancy had more frequent haemorrhagic complications during pregnancy or during delivery and to demonstrate how many had placenta praevia at the time of delivery. In addition, the frequency of Caesarean section, the perinatal mortality, birthweights under 2,500 g in the infants delivered and placental anomalies were registered. A total of 1,572 pregnancies were investigated sonographically at about the 16th week of pregnancy and in 166 (10.6%) the placenta was found in the lower uterine segment. 40% of the 15 women with complete placenta praevia at the 16th week of pregnancy developed haemorrhage necessitating hospitalization, 27% were delivered by Caesarean section and 20% had placenta praevia at delivery. Out of 99 women with partial placenta praevia at the 16th week of pregnancy, one was found to have placenta praevia at the time of delivery but no significantly increased risk of haemorrhage necessitating hospitalization, abortion or Caesarean section. In 52 women with "deep insertion" of the placenta at the 16th week of pregnancy, one was subsequently found to have complete placenta praevia but the frequency of complications was not increased as compared with that in women with a free orifice. This investigation reveals a basis for control sonography of women with complete placenta praevia at the 16th week of pregnancy.

Precocious puberty in a monozygous twin: report of case

This report describes some effects of premature production of sex hormones observed in a boy with precocious puberty. The data presented are compared with corresponding skeletal and oral factors in an unaffected monozygous twin brother.

Fibrous dysplasia of the skull with acromegaly and sarcomatous transformation. Two cases with a review of the literature

Two cases of fibrous dysplasia of the skull are reported. Both patients were young women with acromegaly and were treated with radiotherapy. Progressive pareses of cranial nerves, pain, and a malignant course of the disease were characteristic in both patients, and the diagnosis of osteogenous sarcoma proved in one of them by histological examination. The clinical picture of fibrous dysplasia of the skull and the role of radiotherapy with the risk of development of malignancy is discussed.

Lipid X protects mice against fatal Escherichia coli infection

Lipid X, the major monosaccharide precursor of lipid A, is nontoxic and has previously been shown to protect mice and sheep from the harmful effects of endotoxin. To test the hypothesis that lipid X could be therapeutic against infections with gram-negative organisms, neutropenic ICR mice were infected by intramuscular inoculation of Escherichia coli and subsequently treated with lipid X alone or in combination with the antibiotic ticarcillin. Lipid X slightly prolonged survival; treated mice had a significantly improved rate of survival 18 h after intramuscular inoculation as compared with controls (P less than 0.025). By 24 h, however, this difference disappeared. When lipid X was combined with ticarcillin, survival differences were both significant and prolonged. Treatment of mice with one to two doses of lipid X for a total dose of 1 mg intravenously and with 1,200 mg of ticarcillin per kg every 6 h improved survival over a 48-h treatment period from 5 to 23% (P less than 0.0025). Treatment with lipid X and ticarcillin over a broad range of antibiotic dosages in 362 mice demonstrated improved survival of two- to fourfold (P less than 0.0001 at 24 h after inoculation, P less than or equal to 0.0005 at 48 h, and P less than or equal to 0.0001 at 5 days). Lipid X enabled the dose of ticarcillin necessary to protect 50% of mice from death to be reduced by two- to fivefold. Pretreatment with lipid X was not necessary to improve survival: 16 of 17 (94%) infected and visibly ill animals that received lipid X and ticarcillin 6 h after thigh inoculation survived versus 30 of 44 (68%) control animals treated with ticarcillin alone (P less than 0.0001). Lipid X had no antimicrobial activity in vitro. Lipid X is a novel agent that enhances survival in an animal model of severe infection with gram-negative organisms.

Pneumocystis carinii involvement of the bone marrow in acquired immunodeficiency syndrome

A case of Pneumocystis carinii involvement of the bone marrow in acquired immunodeficiency syndrome is reported. The literature is reviewed for other cases of known extrapulmonary dissemination of Pneumocystis. Potential mechanisms of dissemination of Pneumocystis and its clinical implications are discussed.

Cognitive social learning mediators of aggression

This research explored links between aggression in elementary school children and 2 classes of social cognitions that might influence children's decisions about whether to behave aggressively. Aggressive and nonaggressive children (mean age 11.3 years) responded to 2 questionnaires. One questionnaire measured children's perceptions of their abilities to perform aggression and related behaviors (perceptions of self-efficacy), and the other measured children's beliefs about the reinforcing and punishing consequences of aggression (response-outcome expectancies). Compared to nonaggressive children, aggressive subjects reported that it is easier to perform aggression and more difficult to inhibit aggressive impulses. Aggressive children also were more confident that aggression would produce tangible rewards and would reduce aversive treatment by others. There were negligible sex differences in perceived self-efficacy for aggression but large sex differences in anticipated social and personal consequences for aggression, with girls expecting aggression to cause more suffering in the victim and to be punished more severely by the peer group and by the self. It was concluded that children's knowledge of their capabilities and children's knowledge of the consequences of their actions are factors that need to be taken into account by cognitive models of aggression.

Effect of calcium deprivation on rat dams on fetuses and newborn offspring

Calcium-deficient rats were put to breeding, and fetuses and offsprings were collected at 18 days in utero, at birth, and at 5-10 days post partum. Furthermore, blood and milk were collected from the dams, and blood from the offsprings. The rat pups had normal weights at 18 days in utero and at birth, whereas at 5-10 days post partum the growth was significantly reduced. The relative amount of total solids in the body was also decreased at 5 and 10 days post partum (increased water content). Despite the fact that serum Ca in the dams was severely reduced, the calcium content in the serum of the offspring was only moderately lowered, and there was no correlation between serum Ca in dams and offspring. The content of total solids in the rat milk was increased, whereas the calcium content remained unchanged. The body content of Ca and P in the rat pups was decreased only at 5 and 10 days post partum. The degree of reduction was nearly the same for all these elements, amounting to 15-19% at 5 days post partum and 38-40% at 10 days post partum. If, however, the content of the elements was calculated as percentage of total body solids, a significant increase was found for all of them at 5 and 10 days post partum. Significant differences in Ca:P ratios were not found at any age.