Construct validation and test-retest reliability of the seniors in the community: risk evaluation for eating and nutrition questionnaire.

BACKGROUND: We performed two studies. Study 1 was a construct validation of Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN), a 15-item questionnaire for assessing nutritional risk. In Study 2, we examined the test-retest reliability of SCREEN. METHODS: Study 1 was a cross-sectional study, and Study 2 was a cohort study. For Study 1, ten diverse community sites were used to recruit participants. A total of 128 older adults attended a clinic to provide medical and nutritional history and anthropometric measurements. A dietitian interviewed each participant. Dietitians used clinical judgment to rate the probability of nutritional risk from 1 (low risk) to 10 (high risk). Spearman's rho correlation and receiver operating characteristic curves were completed. An abbreviated SCREEN was developed through multiple linear regression analysis. In Study 2, SCREEN was randomly distributed to members of a seniors' recreation center where a self-selected sample (n = 124) completed two mailed SCREENs, 4 weeks apart. The test-retest reliability was estimated through paired correlations of total scores and individual items. RESULTS: In Study 1, total and abbreviated SCREEN scores were significantly associated with the dietitian nutritional risk rating (rho = -.47 and rho = -.60, respectively). Study 2 revealed that the test-retest reliability of SCREEN was adequate. CONCLUSIONS: SCREEN appears to be a valid and reliable tool for identifying community-dwelling older adults at risk for impaired nutritional states.

Diagnosis and management of intralabyrinthine schwannomas.

OBJECTIVES/HYPOTHESIS: Describe the symptoms, signs, radiographic findings, and treatment results for four patients with intralabyrinthine schwannoma beginning either primarily within the labyrinth or extending secondarily into the labyrinth from the internal auditory canal. STUDY DESIGN: Retrospective review. METHODS: Review of clinic records, operative records, imaging studies with follow-up telephone interview, and when possible, repeat examination. RESULTS: Four patients with intralabyrinthine schwannoma treated by the first author were identified. Episodic vertigo, indistinguishable from Meniere's disease, was present in all but one of the patients in this study. A progressive unilateral hearing loss was also found in all of the patients. Magnetic resonance imaging revealed tumor isolated to the vestibule in two patients with the cochlea primarily involved in the other two patients. Intracochlear tumor extending into the internal auditory canal had been missed on preoperative imaging in one patient and was found during a translabyrinthine vestibular nerve section. In another patient with an intracanalicular schwannoma, tumor extending into the basal turn of the cochlea was not removed during a translabyrinthine approach to the internal auditory canal. The tumor subsequently recurred, necessitating a transotic approach for removal. A transmastoid/translabyrinthine approach was used to successfully remove tumor in one patient. Another patient with good hearing and no vestibular symptoms at time of this writing is being followed with serial imaging studies. As expected, the three patients who underwent surgery have anacusis in the operated ear and are free of vertigo at follow-up intervals of 12, 26, and 65 months. CONCLUSIONS: Intralabyrinthine schwannomas are rare tumors with optimal treatment being determined by the symptoms, tumor location, and hearing. Findings of an intralabyrinthine schwannoma on magnetic resonance imaging may be easily overlooked and attributed to inflammatory changes.

Benign intracranial hypertension and recombinant growth hormone therapy in Australia and New Zealand.

Benign intracranial hypertension (BIH) is reported in three children from Australia and one from New Zealand, who were being treated with recombinant human growth hormone (rhGH). Three males and one female, aged between 10.5 and 14.2 y, developed intracranial hypertension within 2 weeks to 3 months of starting treatment. A national database, OZGROW, has been prospectively collecting data on all 3332 children treated with rhGH in Australia and New Zealand from January 1986 to 1996. The incidence of BIH in children treated with growth hormone (GH) is small, 1.2 per 1000 cases overall, but appears to be greater with biochemical GHD (<10 IU ml(-1)), i.e. 6.5/1000 (3 in 465 cases), relative risk 18.4, 95% confidence interval 1.9-176.1, than in all other children on the database. The incidence in patients with Turner's syndrome was 2.3/1000 (1 in 428 cases). No cases in patients with partial GHD (10-20 IU ml(-1)) or chronic renal failure were identified. Possible causative mechanisms are discussed. The authors' practice is now to start GH replacement at less than the usual recommended dose of 14 IU m(-2) week(-1) in those children considered to be at high risk of developing BIH. Ophthalmological evaluation is recommended for children before and during the first few months following commencement of rhGH therapy and is mandatory in the event of peripheral or facial oedema, persistent headaches, vomiting or visual symptoms. The absence of papilloedema does not exclude the diagnosis.

Serotonergic innervation of the foot of the pond snail Lymnaea stagnalis (L.).

The aminergic innervation of the foot of Lymnaea stagnalis was investigated using electron microscopy, immunocytochemistry, and HPLC. The foot was found to contain large amounts of serotonin and dopamine, though at lower concentrations than are found in nervous tissue. Serotonin containing tissue was concentrated in the ventral surface of the foot, under ciliated areas of the epidermis where it occurred in varicosities, with fine tracts joining these varicosities. Varicosities also occurred in deeper tissues, probably adjacent to mucus cells. Positive fluorescence for serotonin in axons was found in nerves innervating the foot, but few neuronal cell bodies containing serotonin were detected, indicating that most of the innervation was coming from the central ganglia. Axon varicosities were found using TEM on ciliated cells, mucus cells, and muscle cells as well as interaxonal junctions (possibly non-synaptic) within nerves. The neuronal varicosities contacting the ciliated cells and mucus cells contained mostly dense-cored vesicles of between 60 and 100 nm in diameter. Smaller, lucent vesicles also occurred in these terminals. The origin and significance of this innervation is discussed. It is suggested that both serotonin and dopamine may play a large role in controlling ciliary gliding by the foot.

Subcuticular bacteria from the brittle star Ophiactis balli (Echinodermata: Ophiuroidea) represent a new lineage of extracellular marine symbionts in the alpha subdivision of the class Proteobacteria.

Many species of echinoderms, in all five extant classes, contain subcuticular bacterial symbionts (SCB). The role of these extracellular symbionts and the nature of the relationship remain unclear. We have sequenced 16S rRNA genes from symbionts to determine their phylogenetic affinities. Symbionts of an ophiuroid, Ophiactis balli, appear closely related to bacteria within the alpha group of the class Proteobacteria, including intracellular endosymbionts and pathogens. SCB are clearly of separate origin from other documented major groups of marine symbiotic bacteria.

Preliminary results of intracranial angioplasty for vascular stenosis caused by atherosclerosis and vasculitis.

PURPOSE: To evaluate the results of balloon angioplasty of 17 stenoses resulting from intracranial atherosclerosis and vasculitis. METHODS: Seventeen skull-base and intracranial lesions were dilated with a microballoon angioplasty catheter. RESULTS: Initially, 16 of the 17 stenoses showed improvement at angiography. Moderate residual stenosis was found in 2 of 12 atherosclerotic lesions, both in the distal vertebral artery. Angioplasty in 1 of 12 atherosclerotic lesions caused worsening of the stenotic site, also in the distal V4 region of the vertebral artery. All but one of the patients improved clinically. However, all five lesions caused by acute vasculitis progressed to occlusion after initial improvement. CONCLUSION: Intracranial percutaneous transluminal angioplasty is a viable nonsurgical option for the treatment of atherosclerotic vascular insufficiency, but it may not be as successful in treating lesions caused by vasculitis in the acute phase.

Trigeminal-cavernous fistula: Saltzman anatomy revisited.

We report a case of a carotid-cavernous fistula through a persistent trigeminal artery with endovascular treatment, and discuss the Saltzman classification of persistent trigeminal artery anatomy and its importance in treatment of this lesion.

The echinoderm surface and its role in preventing microfouling.

Antifouling is a property of the epidermis in echinoderms. There is neither production of biocides that act at any distance from the surface nor is the sloughing rate of the entire surface capable of explaining the observed antifouling capability. As with many invertebrates, the epidermis in echinoderms is overlain by thin surface coats, often termed the cuticle. The outermost coat has attenuated fibrils radiating outwards from the underlying cuticle. As these fibrils are the "real"; surface of the echinoderm, this is the level at which any antifouling defense must operate. It is suggested that their function is primarily antifouling. The cuticle contains chondroitin sulphate proteoglycan molecules and is negatively charged. The cuticle appears to be a highly extended glycocalyx. It is suggested that the primitive function of cellular glycocalyces is to modulate adhesive interactions at the cell or organismal surface.

The Incidence and Morphology of Subcuticular Bacteria in the Echinoderm Fauna of New Zealand.

New Zealand echinoderms (33 species drawn from all five extant classes) were examined for the presence of symbiotic bacteria by fluorescence and electron microscopy. Gram-negative, subcuticular bacteria (SCB) were found in 17 species from four classes. The SCB could be classified into two major morphological types. Some species had both types of SCB. The distribution of SCB was not obviously linked to host ecology but did appear to be related to host phylogeny. Related species usually all have SCB or all lack them. The number of SCB in five species was estimated to be between 8.41 x 108 and 4.96 x 109 g-1 ash-free dry weight of host tissue. Significant differences in bacterial load and relative proportions of the different types of bacteria were found among three congeneric echinoids (Pseudechinus huttoni, P. albocinctus and P. novaezealandia). Ophiocoma bollonsi was peculiar in having groups of bacteria enclosed in host cells (bacteriocytes) within the connective tissue of the tube feet.

Effects of temperature on the anaesthetic potency of halothane, enflurane and ethanol in Daphnia magna (Cladocera: Crustacea).

1. The effects of temperature on the anesthetic potencies of halothane, enflurane and ethanol have been studied in the water flea Daphnia magna. 2. In the absence of anaesthetics, decreasing temperature resulted in decreased activity by the daphnids. 3. Potencies in the gas phase decreased with increasing temperature for all of the anaesthetics, while aqueous potency decreased for halothane and enflurane but increased for ethanol. 4. Enthalpy calculations suggest that the observed potency changes for the inhalational anaesthetics cannot be accounted for in terms of changing solubility in lipid bilayers but most likely reflect more specific interactions with animal target sites.

A model to test the potency of inhalation anaesthetics.

The water flea Daphnia magna was studied as a potential model of the potency of inhalation anaesthetics in humans. Anaesthesia was defined as lack of movement to a noxious stimulus (strong light). Effective concentrations which produced anaesthesia of 50% of the individuals (EC50) for halothane, isoflurane and enflurane were 1.006, 1.156 and 1.415, respectively. Anaesthesia was reversible rapidly. It is suggested that Daphnia should replace vertebrates in early studies of inhalation anaesthetic potency.

A new metabolism cage suitable for the study of mice.

Nitrogen recoveries of 98% have been obtained, significantly better than those obtained using a commercial metabolism cage.

Color subtraction arthrography in the diagnosis of component loosening in hip arthroplasty.

While component loosening in arthroplasty of the hip joint may not always be associated with pain, the painful total hip arthroplasty frequently can be shown to be associated with loosening of one or both components. The application of color subtraction techniques to routine arthrography of the hip has greatly increased the authors' accuracy in identifying component loosening in the painful total hip. The technique and its method of application are described in this preliminary report. Several examples of its use are presented. The authors have found this technique to be a useful adjunct to routine arthrography of the hip in selected instances. It has improved overall diagnostic accuracy and is more rapid and less costly than standard photographic subtraction techniques.