A comparison of chromosomal aberrations induced by in vivo radiotherapy in human sperm and lymphocytes.

Chromosomal aberrations in human sperm and lymphocytes were compared before and after in vivo radiation treatment of 13 cancer patients. The times of analyses after radiotherapy (RT) were 1, 3, 12, 24, 36, 48 and 60 months. The median total radiation dose was 30 Gy and the testicular dose varied from 0.4 to 5.0 Gy. Human sperm chromosome complements were analysed after fusion with golden hamster eggs. There were no abnormalities in sperm or lymphocytes before RT. Following RT there was an increase in the frequency of numerical and structural chromosomal abnormalities in both lymphocytes and sperm. For structural abnormalities there were more rejoined lesions (dicentrics, rings) in lymphocytes and more unrejoined lesions (chromosome breaks, fragments) in sperm. After RT there was a dramatic increase in the frequency of chromosomal abnormalities in lymphocytes: at 1 mo. the frequency was 42%, at 3 mo. 25%, at 12 mo. 14%, at 24 mo. 11%, at 36 mo. 9%, at 48 mo. 7% and at 6 mo. 4%. Since the majority of men were azoospermic after RT, there is little data on sperm chromosome complements before the analyses performed at 24 mo. post-RT. At 24 mo. the frequency of abnormalities was 13%, followed by 21% at 36 mo., 12% at 48 mo. and 22% at 60 mo. Thus it appears that the frequency of lymphocyte chromosomal abnormalities had an initial marked increase after RT followed by a gradual decrease with time whereas the frequency of sperm chromosomal abnormalities was elevated when sperm production recovered and remained elevated from 24 to 60 mo. post-RT. This difference in the effect of time makes it very difficult to compare abnormality rates in lymphocytes and sperm and to use analysis of induced damage in somatic cells as surrogates for germ cells since the ratio between sperm and lymphocytes varied from 1:1 (at 24 mo. post-RT) to 5:1 (at 60 mo. post-RT).

An increased frequency of human sperm chromosomal abnormalities after radiotherapy.

13 cancer patients were studied before radiotherapy (RT) and at regular intervals after RT to determine the effect of RT on chromosomal abnormalities in sperm. The men were 19-47 years old and received testicular radiation doses of 0.4-5.0 Gray. Human pronuclear sperm chromosomes were analysed after penetration of zona-pellucida-free hamster eggs. Unfortunately the hamster egg penetration rates were exceedingly low, both before and after RT and this limited the number of sperm chromosome complements which could be analysed. Before RT, the frequency of abnormal sperm chromosome complements was 0% (0/9). After RT, the majority of men were azoospermic for 24 months but complements could be analysed from 4 men. In the first 12 months the frequency of abnormalities was 13% (1/8) and at 24 months it was 13% (7/55). By 36 months after RT, most men had recovered sperm production and the frequency of abnormalities in 8 men was 21% (18/86), which is significantly higher than the rate in control donors (8.5%). For individual men the range was 6-67%, and there was a significant correlation between testicular radiation dose and the frequency of sperm chromosomal abnormalities. The frequencies of both numerical and structural abnormalities were significantly increased after RT. This is the first evidence that radiation may increase the frequency of chromosomal abnormalities in human gametes.

Six-year follow-up of a case of radiation injury following treatment for medulloblastoma.

Recent reports in the literature have documented long-term sequelae of radiation treatment in children, the most notable of which are diminished endocrine functioning and decline in intellectual ability. A case is presented in which both these long-term effects were seen 7 years after radiation treatment for medulloblastoma. Growth hormone and thyroid hormone deficiencies were identified and treated. Full-Scale IQ dropped from the 79th percentile to the 3rd percentile, and neuropsychological functioning ranged from normal to impaired. However, magnetic resonance imaging reveals few direct imaging correlates of J.M.'s neuropsychological deficits. If identified, hormone deficiencies in such patients can be successfully treated; intellectual deficits may present more of a management problem. In this case, cognitive deficits have contributed to considerable difficulty in school; however, with special classes and modifications, the patient is making progress. Our findings indicate that the long-term outcome for children with radiation injury may be improved significantly with hormone therapy and appropriate academic intervention, and argue strongly for systematic, sequential follow-up of such children so that appropriate intervention can be implemented and continued as necessary.

Separate verbal memory and naming deficits in attention deficit disorder and reading disability.

In this study, verbal memory and naming abilities were investigated in reading disabled (RD) and control children who were characterized according to the presence or absence of attention deficit disorder (ADD). Results indicate that deficits in learning and memory for recently acquired information occur as a function of ADD rather than RD while deficits in naming are specific to RD rather than ADD. We conclude that ADD is a major source of additional and separate cognitive morbidity in RD children.

Ambulatory hospital dentistry.

The scope of outpatient hospital dentistry is broad and embraces a full range of patient care as well as education and investigative activities. The ambulatory dental service provides an ideal setting for the care of medically compromised patients and treatment requiring a multidisciplinary approach. The hospital dental staff and administration are especially well qualified to bring dignified, high quality, total health care to patients and educational programs to the profession. These factors are paramount in formulating a strategy for meeting the future health care needs of our population.

Haemophilic arthropathy: a ten year radiological and clinical study.

A ten-year retrospective study has been undertaken on a group of ten haemophiliacs for whom previous haematological and radiological data was available. Radiological and clinical assessment of their knees and elbows (40 joints) have been correlated to the accurate recording of all haemarthroses suffered by these joints. There is a statistically significant association between the number of haemarthroses and the radiological change in the joint, as determined significant association between number of haemarthroses and deterioration in clinical function. Several bleeds can occur in a haemophilic joint without necessarily causing permanent radiological change; this new finding in adults may be due to modern therapy.

Hormonal influences on psychomotor reminiscence.

Psychomotor reminiscence was measured in contraceptively medicated and non-medicated subjects on Days 2, 8, and 14 of their menstrual cycles. As previously reported, mean reminiscence in non-medicated subjects was relatively low on Days 2 and 8, but significantly higher on Day 14. By contrast, reminiscence means in medicated subjects were relatively low and essentially alike across all testing days. These results are discussed within the context of reactive inhibition theory, wherein the adrenergic properties of mid-cycle concentrations of estrogenic hormones are thought responsible for more vigorous responding, hence more reactive inhibition and higher reminiscence. Such concentrations were, of course, precluded by contraceptive medication.

PIP: Psychomotor reminiscence was measured in contraceptively medicated and nonmedicated subjects on days 2, 8, and 14 of their menstrual cycles. The experimental sample of 89 subjects included 48 who were not using contraceptive medication and 41 who had used it consistently for an average of approximately 17 months. All subjects were Caucasian and right-handed and ranged in age from 18 to 25 years. Subjects were required to use mirror vision to track a small silver target as it moved clockwise at 1 rpm through a narrow star-shaped pathway and to keep the tracking stylus on the moving target as long as possible and to avoid touching the sides of the pathway. Time on target to the nearest .01 second was recorded for each minute of practice. 3 successive menstrual cycles for each subject were monitored to provide estimates of average cycle length. The subjects within each medication strategy were then assigned without bias to testing on days 2, 8, or 14 their cycles, or, in the latter case, on proportionately equivalent days as determined from average cycle length. After instruction and demonstration, all subjects executed a sequence consisting of 3 minutes massed practice, 3 minutes rest, 3 minutes massed practice, 3 minutes rest, and 3 minuts massed practice. When endogenous concentrations of estrogenic hormones were kept low by contraceptive medication, mean reminiscence values remained low and essentially alike across testing days, and they were not significantly different from those of nonmedicated subjects who were tested at the nadirs of their cycles. When estrogen concentrations were allowed to reach their natural midcycle peak, as in nonmedicated subjects, mean reminiscence values peaked accordingly. These results are interpreted to mean that the adrenergic properties of high estrogen concentrations promoted correspondingly more vigorous responding and greater accumulations of reactive inhibition, which across rest was manifested as higher reminiscence.

The effect of exposure to a condom script on attitudes toward condoms.

PIP: The effect of reading an erotic script that described condom placement on attitudes toward condom use was investigated in 102 male and 108 female US university students. It was hypothesized that, when integrated into an erotic script, condom use would become viewed as a pleasurable activity rather than just a means of avoiding pregnancy or disease. Controls received identical scripts except that the use of condoms was omitted or received no stories. Subjects who read the erotic accounts exhibited a positive change from pretest to posttest in attitudes toward condom use, but there was no difference in this outcome between condom story and no-condom erotic story conditions. In women, but not men, a high level of arousal induced by the script was associated with negative attitudes toward condoms, suggesting that males and females may require different reading materials. Given the finding, at least in women, of an inverse relationship between explicit eroticism/sexual arousal and condom attitude scores, a 2nd experiment involving less explicit stories written by college students was conducted. Here, 100 men and 100 women students received erotic stories that either featured or did not include condom use. Again, males who read stories incorporating condom placement held more positive attitudes toward condom use than same-sex controls, but women were not affected by the manipulation. For women, a positive attitude toward condom use was associated only with history of sexual activity. Helpful would be the preparation of erotic scripts that appeal to both sexes given the demonstrated effectiveness of this social learning technique with the male subjects in both experiments.^ieng

Multinucleate epithelial change in colorectal hyperplastic polyps: a review of 27 cases.

AIM: To document the histological features of multinucleated epithelial giant cells (MEGs) in colorectal hyperplastic polyps and determine a possible aetiological agent. METHODS: Hyperplastic polyps were assessed for MEGs during the routine reporting at a private laboratory and public hospital laboratory. The histological features and clinical data were assessed, and immunohistochemical stains were performed to assess for viral infection (cytomegalovirus (CMV) and herpes simplex virus (HSV) 1 and 2) and to assist in the assessment of dysplasia (Ki-67, beta-catenin and p53). Ultrastructural examination was performed in one case. RESULTS: MEGs were identified in 27 polyps (24 patients). There was active inflammation in the polyps in nearly all cases (n = 24) and most showed changes in adjacent non-hyperplastic bowel mucosa such as focal basal cryptitis and apoptosis of crypt epithelium (16 patients). Immunohistochemistry for CMV, HSV and p53 was negative in all cases. The MEGs showed nuclear positivity for the proliferative marker Ki-67 and membranous positivity for beta-catenin. Ultrastructural studies failed to reveal viral particles. CONCLUSIONS: All the polyps containing MEGs showed active inflammation and apoptosis, and in most there was also focal inflammation and apoptosis in the adjacent mucosa. Inflammation in conjunction with the increased epithelial proliferation characteristics of hyperplastic polyps could be the mechanism for the MEG formation. In this series, all the polyps were associated with sodium phosphate bowel preparation (NaP) and the pro-inflammatory properties of NaP may be a stimulus for the induction of giant cells.

Long-term follow-up of a childhood amnesic syndrome.

In attempting to explain observed dissociations between impaired and preserved memory functioning in amnesia, various dichotomous memory systems (e.g., procedural versus declarative, episodic versus semantic, working versus reference memory) have often been employed. In such cases, the assumption has been that memory subserved by one system is preserved, while that of the other system is impaired. Cohen and Squire have suggested that in amnesia, declarative memory is impaired, although procedural memory is preserved. Long-term follow-up of a densely amnesic patient refutes this view by demonstrating significant anterograde learning of school subjects including reading, vocabulary, spelling, and arithmetic, all of which include some component of declarative memory. It appears that the procedural/declarative dichotomy is not adequate to explain preserved memory in amnesia.