Restoratively guided orthodontic treatment: The pre-orthodontic bonding concept.

OBJECTIVE: Communication between the orthodontist and the restorative dentist has always been difficult due to the inability of the orthodontist to achieve the desired orthodontic goals with just words in a referral note. CLINICAL CONSIDERATIONS: A better method of communication is for the restorative dentist to create the ideal tooth anatomy either before or during orthodontic treatment to direct the orthodontic tooth movement. CONCLUSION: It is the purpose of this article to present a technique, which makes the pre-restorative orthodontic treatment both more accurate and more efficient. CLINICAL SIGNIFICANCE: It is very difficult for the orthodontist to move teeth into their correct positions when the teeth are anatomically incorrect due to attrition/erosion or due to developmental malformation. When the restorative dentist makes the teeth anatomically correct with either pre-orthodontic or intermediate orthodontic bonding, the orthodontist has the benefit of ideal tooth anatomy to finalize the tooth positions. This then allows the restorative dentist to create final restorations, which are ideal, both functionally and esthetically.

Evaluation of loop-mediated isothermal amplification assay and enzyme-linked immunosorbent assay in detecting Schistosoma japonicum in Siargao Island, Surigao del Norte, the Philippines.

OBJECTIVES: This study aimed to describe the prevalence and seroprevalence of schistosomiasis in Siargao Island, Surigao del Norte and to compare the performance of enzyme-linked immunosorbent assay antibody test (ELISA Ab) and loop-mediated isothermal amplification assay (LAMP) for diagnosis of schistosomiasis. METHODS: The study was conducted in selected barangays (villages) in five municipalities in Siargao Island, Surigao del Norte and included school-age children (SAC) who submitted stool and blood samples. Stool samples were examined using the Kato-Katz technique. Blood samples were collected through venipuncture. The stool samples and the blood samples collected were tested using LAMP assay and polymerase chain reaction (PCR). The blood samples were examined using ELISA Ab. Diagnostic performance of LAMP assay using stool specimen was evaluated using Kato-Katz technique and PCR assay as the composite reference standard, while PCR assay was used as the reference standard to evaluate LAMP assay and ELISA Ab using blood specimens. RESULTS: A total of 417 stool samples from SAC were examined. The prevalence of schistosomiasis and moderate-heavy intensity (MHI) schistosomiasis were 3.8% and 1.4%, respectively. Schistosomiasis and soil-transmitted helminthiases (STH) coinfection prevalence were 2.6%. A total of 425 blood samples were examined using ELISA Ab. Seroprevalence was 61.6%. The municipality of San Isidro had the highest seroprevalence at 84.8%, while Burgos had the lowest seroprevalence at 48.5%.LAMP assay had higher sensitivity and positive predictive value but lower specificity when using stool than when using blood samples. Its negative predictive value was similar regardless of the specimen used. ELISA Ab has higher sensitivity and negative predictive value than LAMP assay although it has lower specificity and positive predictive value. This may be due to ELISA Ab measuring Schistosoma exposure and is thus unable to distinguish past from active infection. CONCLUSIONS: Schistosomiasis remains a public health concern in Siargao Island, Surigao del Norte. The locally developed LAMP assay offers a simpler diagnostic test for schistosomiasis compared with PCR, while minimizing the risk of misdiagnosis compared with Kato-Katz technique. It could serve as a point of care diagnostics for schistosomiasis. ELISA Ab is more useful in surveillance particularly in low-endemicity areas where determination of exposure is more important than differentiating past from active infection. ELISA Ab may be helpful in the clinical setting when coupled with the expertise of a physician who is familiar with schistosomiasis.

Health and Education Officials' Perspectives on the Impact of Typhoon Haiyan on Mass Drug Administration for Soil-Transmitted Helminth Infections in the Philippines.

OBJECTIVES: In the Philippines, morbidity control of soil-transmitted helminth (STH) infections is done through mass drug administration (MDA) of anthelmintics to school-age children (SAC). In 2013, the Philippines was devastated by the deadliest cyclone ever recorded, Typhoon Haiyan. The study aimed to understand the impact of Typhoon Haiyan on the MDA of anthelmintics to SAC in the provinces of Capiz and Iloilo in the Philippines from the perspectives of local health and education officials. METHODS: The study was conducted in the municipalities of Panay and Pilar in Capiz and the municipalities of Estancia and Sara in Iloilo, areas that were devastated by Typhoon Haiyan. Qualitative, semi-structured key informant interviews were conducted with 16 total participants, which included officials of the Department of Health, Department of Education, and concerned local government units. All interviews were transcribed verbatim and coded in an open, iterative manner. Codes were reviewed to identify patterns and themes. RESULTS: Participants described the following themes: (1) their perception that the typhoon had no effect on the MDA program or on resources necessary to complete the program; (2) the program's simple design allowed for 1-time administration to a pre-assembled population; (3) the program allowed a sense of community cohesiveness; (4) the program served as a vehicle for altruism, particularly regarding helping needy children, in this time of calamity. CONCLUSIONS: Our informants perceived that the MDA program in Region VI was not affected by Typhoon Haiyan. They attributed the resilience to the program's simple procedure, attitudes of altruism, program importance, and community cohesiveness. Despite Typhoon Haiyan's mass destruction of infrastructure and livelihood leading to incredible challenges, mobilization of the community allowed for the continuation and successful implementation of the MDA program. The experience of Region VI may serve as a model for other low- and middle-income countries prone to natural disasters.

Use of geographic information system as a tool for schistosomiasis surveillance in an endemic Municipality in Eastern Samar, The Philippines.

This study aimed to demonstrate the use of geographic information systems (GIS) in identifying factors contributing to schistosomiasis endemicity and identifying high-risk areas in a schistosomiasis- endemic municipality in the Philippines, which was devastated by Typhoon Haiyan in 2013. Data on schistosomiasis determinants, obtained through literature review, the Philippine Department of Health, and concerned local government units, were standardized and incorporated into a GIS map using ArcGIS. Data gathered included modifiable [agriculture, poverty, sanitation, presence of intermediate and reservoir hosts, disease prevalence and mass drug administration (MDA) coverage] and nonmodifiable (geography and climate) determinants for schistosomiasis. Results showed that most barangays (villages) are characterized by favourable conditions for schistosomiasis transmission which include being located in flood-prone areas, presence of vegetation, low sanitary toilet coverage, presence of snail intermediate host, high carabao (water buffalo) population density, previously reported ≥1% prevalence using Kato-Katz technique, and low MDA coverage. Similarly, barangays not known to be endemic for schistosomiasis but also characterized by the same favourable conditions for schistosomiasis as listed above and may therefore be considered as potentially endemic, even if not being high-risk areas. This study demonstrated the importance of GIS technology in characterizing schistosomiasis transmission. Maps generated through application of GIS technology are useful in guiding program policy and planning at the local level for an effective and sustainable schistosomiasis control and prevention.

Effects of gut microbiota on obesity and atherosclerosis via modulation of inflammation and lipid metabolism.

Recent studies have revealed a close relationship between inflammatory and metabolic pathways, and inflammation is now recognized to have a major role in obesity and metabolic diseases such as insulin resistance and atherosclerosis. The human body is home to a large number of distinct microbial communities, with the densest population in the distal gut (the gut microbiota). Bacteria have long been known to activate inflammatory pathways, and recent data demonstrate that the gut microbiota may affect lipid metabolism and function as an environmental factor that influences the development of obesity and related diseases. Here, we review how the gut microbiota may affect metabolic diseases by activating the innate immune system.

Dietary supplementation of tetradecylthioacetic acid increases feed intake but reduces body weight gain and adipose depot sizes in rats fed on high-fat diets.

AIM: The pan-peroxisome proliferator-activated receptor (PPAR) ligand and fatty acid analogue tetradecylthioacetic acid (TTA) may reduce plasma lipids and enhance hepatic lipid metabolism, as well as reduce adipose tissue sizes in rats fed on high-fat diets. This study further explores the effects of TTA on weight gain, feed intake and adipose tissue functions in rats that are fed a high-fat diet for 7 weeks. METHODS: The effects on feed intake and body weight during 7 weeks' dietary supplement with TTA ( approximately 200 mg/kg bw) were studied in male Wistar rats fed on a lard-based diet containing approximately 40% energy from fat. Adipose tissue mass, body composition and expression of relevant genes in fat depots and liver were measured at the end of the feeding. RESULTS: Despite higher feed intake during the final 2 weeks of the study, rats fed on TTA gained less body weight than lard-fed rats and had markedly decreased subcutaneous, epididymal, perirenal and mesenteric adipose depots. The effects of TTA feeding with reduced body weight gain and energy efficiency (weight gain/feed intake) started between day 10 and 13. Body contents of fat, protein and water were reduced after feeding lard plus TTA, with a stronger decrease in fat relative to protein. Plasma lipids, including Non-Esterified Fatty Acids (NEFA), were significantly reduced, whereas fatty acid beta-oxidation in liver and heart was enhanced in lard plus TTA-fed rats. Hepatic UCP3 was expressed ectopically both at protein and mRNA level (>1900-fold), whereas Ucp1 mRNA was increased approximately 30-fold in epididymal and approximately 90-fold in mesenteric fat after lard plus TTA feeding. CONCLUSION: Our data support the hypothesis that TTA feeding may increase hepatic fatty acid beta-oxidation, and thereby reduce the size of adipose tissues. The functional importance of ectopic hepatic UCP3 is unknown, but might be associated with enhanced energy expenditure and thus the reduced feed efficiency.

Child development center-based sentinel surveillance of soil-transmitted helminthiases in preschool-age children in selected local government units in the Philippines.

Soil-transmitted helminthiasis (STH) remains a public health concern in developing countries, such as the Philippines. Preschool-age children (PSAC) are among the high-risk groups for STH. Data on the status of STH in PSAC are needed to help guide policy formulation and program implementation; however, in the usual setting, such data may remain limited. This study aimed to describe the parasitologic status of PSAC in selected local government units (LGUs) in the Philippines through sentinel surveillance methodology in a child-development center (CDC)-based setting. This cross-sectional study, which included 1732 PSAC in selected barangays (a village or the smallest administrative unit in the country) in the provinces of Cavite, Guimaras, Iloilo, Negros Occidental, and Davao del Norte and cities of Iloilo and Lapu-Lapu in the Philippines, utilized Kato-Katz technique to determine parasitologic status. A single Kato-Katz smear was prepared from the adult-thumb sized stool sample submitted by each participant. Ten percent of Kato-Katz slides examined by field microscopists were re-examined by a reference microscopist as part of quality control. Results showed a prevalence of any STH infection and a moderate-heavy ((M-H)) intensity prevalence of 24.9% and 10.3%, respectively. Five cases of schistosomiasis were found in Lapu-Lapu City and Davao del Norte. While the Philippines' Department of Health (DOH) - Integrated Helminth Control Program (IHCP) target for prevalence of any STH of less than 50% was attained, none of the barangays or villages met the World Health Organization (WHO) target for (M-H) intensity STH prevalence of less than 1%, despite the program being implemented for almost a decade. Sentinel surveillance in PSAC, possibly adopting a CDC-based approach, may be implemented biannually in the Philippines and other countries where a similar early child care development system exist to generate data needed to guide policy formulation and program implementation. Preventive chemotherapy through facility-based mass drug administration (MDA), such as CDC-based MDA, may be explored to improve the mode of MDA delivery and coverage in PSAC.

The use of geographic information system as a tool for schistosomiasis surveillance in the province of Davao del Norte, the Philippines.

Schistosomiasis (SCH) in The Philippines is caused by Schistosoma japonicum and remains endemic in 28 provinces in 12 regions. Effective SCH control requires describing areas at risk where control efforts may be focused. This study aims at demonstrating the utility of geographical information system (GIS) as a tool for SCH surveillance in the province of Davao del Norte. Qualitative and quantitative data on SCH determinants, obtained from local government offices, partner agencies and institutions, were standardised, formatted and incorporated into a GIS map. Atrisk areas are described in terms of determinants and (variables), which included geography and climate (topography, temperature and flood-prone areas), agriculture (irrigation and land use), poverty (percentage of households with income below the poverty threshold), sanitation level (percentage of households with sanitary toilets), intermediate and reservoir hosts (presence of snail colonies and reservoir hosts) as well as prevalence and treatment coverage. Endemic villages (barangays) were generally found to be located in flood-prone areas in the lowlands near major rivers. New Corella has the highest poverty index among the SCH-endemic areas studied as well as the highest number of confirmed snail colonies. Among known endemic localities in Davao del Norte, Tagum City was found to be the only city meeting the poverty index target of <16.6%. Clustering of SCH cases were reported in six barangays ranging from 0.48% (8 out of 1,655) in Braulio Dujali to 2% (25 out of 1,405) in Asuncion. This study demonstrates the utility of GIS in predicting and assessing SCH risk, which allows prioritisation and allocation of control resources and delivery of services in areas at the highest risk for SCH.

Functional outcome scales in traumatic brain injury: a comparison of the Glasgow Outcome Scale (Extended) and the Functional Status Examination.

Clinical trials aimed at developing therapies for traumatic brain injury (TBI) require outcome measures that are reliable, validated, and easily administered. The most widely used of these measures, the Glasgow Outcome Scale (GOS) and the GOS-Extended (GOS-E), have been criticized as suffering from ceiling effects. In an attempt to develop a more useful and dynamic outcome measure, the Functional Status Examination (FSE) was developed, which grades outcome across 10 functional domains. The FSE has been demonstrated to be reliable and sensitive in monitoring recovery after TBI. This manuscript compares FSE with GOS-E in a cohort of patients with a wide range of injury severities. 177 individuals who survived at least 6 months after TBI were studied. The FSE and GOS-E were administered 6-12 months after injury. FSE and GOS-E scores correlated well with each other. FSE scores were distributed throughout the range, indicating that ceiling and floor effects were not present. Physiologic measures of injury severity (Glasgow Coma Score [GCS]) did not correlate with anatomic measures (Abbreviated Injury Scale [AIS] and Injury Severity Score [ISS]). GCS correlated weakly with both outcome measures, but AIS/ISS did not. We conclude that FSE and GOS-E are reliable outcome measures for TBI survivors, and FSE may offer some advantages over GOS-E due its ability to provide a more detailed description of deficits. The majority of the variance in outcome is not accounted for by currently available measures of injury severity.

The cholesterol-raising diterpenes from coffee beans increase serum lipid transfer protein activity levels in humans.

Cafestol and kahweol-diterpenes present in unfiltered coffee-strongly raise serum VLDL and LDL cholesterol and slightly reduce HDL cholesterol in humans. The mechanism of action is unknown. We determined whether the coffee diterpenes may affect lipoprotein metabolism via effects on lipid transfer proteins and lecithin:cholesterol acyltransferase in a randomized, double-blind cross-over study with 10 healthy male volunteers. Either cafestol (61-64 mg/day) or a mixture of cafestol (60 mg/day) and kahweol (48-54 mg/day) was given for 28 days. Serum activity levels of cholesterylester transfer protein, phospholipid transfer protein and lecithin:cholesterol acyltransferase were measured using exogenous substrate assays. Relative to baseline values, cafestol raised the mean (+/- S.D.) activity of cholesterylester transfer protein by 18 +/- 12% and of phospholipid transfer protein by 21 +/- 14% (both P < 0.001). Relative to cafestol alone, kahweol had no significant additional effects Lecithin:cholesterol acyltransferase activity was reduced by 11 +/- 12% by cafestol plus kahweol (P = 0.02). It is concluded that the effects of coffee diterpenes on plasma lipoproteins may be connected with changes in serum activity levels of lipid transfer proteins.

Influence of the carboxylesterase inhibitor bis-p-nitrophenylphosphate on the rates of hydrolysis of various alpha-esters of 1-(N-methyl-N-nitrosamino)-methanol in vitro and in vivo and on the acute toxicity and carcinogenicity of 1-(N-methyl-N-nitrosamino)-methylacetate.

The effect of an in vivo treatment with the carboxylesterase inhibitor bis-p-nitrophenylphosphate (BNPP) on the hydrolysis of 1-(N-methyl-N-nitrosamino)-methylacetate (NNMA), 1-(N-methyl-N-nitrosamino)-methylbutyrate (NNMB), 1-(N-methyl-N-nitrosamino)-methylbenzoate (NNMBz) and 1-(N-methyl-N-nitrosamino)-methylpivaloate (NMMP) in rat tissue homogenates was studied. The rates of hydrolysis were specific for each compound and different in every organ tested; the extent of inhibition of the hydrolysis by BNPP was also substrate and organ specific. In some cases no inhibition at all was observed. The rate of elimination of NNMA, NNMB, and NNMP from blood was not influenced by BNPP pretreatment. The LD50 of NNMA after i.v. application showed a rise of 85% with a BNPP pretreatment. BNPP also influenced the carcinogenicity of NNMA, whereby the total carcinogenic potency was not altered, but the organotropism had changed slightly.

Detection of human androgen receptor mRNA expression abnormalities by competitive PCR.

A competitive polymerase chain reaction (PCR) method for analysis of androgen receptor (AR) mRNA expression is described. The technique involves the use of an in vitro-transcribed RNA (cRNA) corresponding to a region of the AR mRNA transcript as a competitor in reverse transcription and PCR (RT-PCR) using total cellular RNA. The competitor RNA contains a site-directed mutation that produces a restriction fragment length polymorphism after RT-PCR and endonuclease digestion. We demonstrate that incorporation of the competitor RNA into RT-PCR reactions allows rapid semiquantitative determination of relative AR mRNA levels without the necessity of following PCR product formation kinetically; reaction products are assessed at the conclusion of the reaction sequence and without the use of radioactive probes or other specialized detection systems. We have used competitive PCR to demonstrate low levels of AR mRNA in an androgen-unresponsive human prostate cell line (PC3). In addition, we have also used this method to confirm that genital fibroblasts obtained from a subject with penoscrotal hypospadias (a non-intersex masculinization defect) that exhibit low levels of high-affinity androgen binding also exhibit abnormally low AR mRNA levels. These last results suggest that some non-intersex malformations of the urogenital tract are associated with abnormalities in the expression of the androgen receptor.

Incidence of the bell-clapper deformity in an autopsy series.

OBJECTIVES: Testicular torsion is seen in all age groups. The bell-clapper deformity (BCD) when present predisposes the patient to torsion. This study was undertaken to determine the incidence of the BCD. METHODS: An autopsy series of 51 males with 101 testes was dissected by the senior author to determine the incidence of the BCD. RESULTS: The manner of testicular investment by the tunica vaginalis was classified as normal, intermediate, or absent (BCD). Seventy-six testes were normal, 13 were intermediate, and 12 were of the bell-clapper type. CONCLUSIONS: The incidence of the BCD in this autopsy series was 12%. Because the incidence of testicular torsion in the general population is far less than 12%, other factors in addition to anatomic predisposition must be involved.

Cerebrospinal fluid shunt infection secondary to Escherichia coli bacteriuria.

A 10-year-old girl with a lumbosacral myelomeningocele, managed with clean intermittent catheterization, presented with headache, vomiting, and lethargy. The cerebrospinal fluid (CSF) and urine cultures revealed Escherichia coli, documented to be the same subtype. The organisms were subtyped and the E. coli from both the urine and CSF were noted to be of the same strain. Management consisted of intravenous antibiotics and ultimate replacement of the ventriculoperitoneal shunt. Children with myelodysplasia and CSF shunts should be carefully monitored in a multidisciplinary fashion to anticipate, correctly diagnose, and treat CSF shunt infections associated with bacteriuria.

Long-term results of combined cataract and glaucoma surgery versus trabeculectomy alone in low-risk patients.

PURPOSE: To compare the long-term results of combined extracapsular cataract extraction (ECCE), intraocular lens (IOL) implantation, and trabeculectomy with those of trabeculectomy alone in low-risk patients. SETTING: An ophthalmic department in a British general district hospital. METHODS: We did a retrospective analysis of the case records of all low-risk patients who had either combined ECCE, IOL implantation, and trabeculectomy (combined group) or trabeculectomy alone between August 1991 and February 1993 with a minimum of 12 months follow-up (mean 21 months). The combined group comprised 21 patients (14 women) and the trabeculectomy group, 24 patients (18 women). The mean ages were 79.8 years (range 66 to 90 years) and 76.0 years (range 61 to 87 years), respectively. We measured final intraocular pressure (IOP), number of medications used, best corrected visual acuity, visual field, and complication rates. RESULTS: Average IOPs at diagnosis, the preoperative visit, and last follow-up visit were 27.6, 23.1, and 15.6 mm Hg, respectively, in the combined group and 31.8, 26.7, and 15.3 mm Hg, respectively, in the trabeculectomy group. The differences between groups were not statistically significant at any stage. All patients had an IOP lower than 22 mm Hg at the last follow-up. In more than 75% of patients in the combined group, visual acuity improved by more than one Snellen line. CONCLUSIONS: The combined procedure compared favorably with trabeculectomy alone in low-risk patients.

Incidence of contralateral inguinal hernia: a prospective analysis.

BACKGROUND/PURPOSE: Contralateral groin exploration in children with unilateral inguinal hernia is still controversial, particularly in infants. The authors have attempted to determine the age- and gender-stratified incidence of contralateral hernia and the necessity of routine bilateral procedures. METHODS: This is a prospective study of 656 patients during a 34-month period at a single institution. Patients with unilateral hernia underwent an ipsilateral procedure only, regardless of age, gestational age, or gender. Follow-up was 6 to 40 months (mean, 25.5 months). Chi-square analysis was used for intergroup comparison (P < .05 significant). RESULTS: Of 656 children, 108 (16.5%) presented with synchronous bilateral hernias. Bilateral inguinal hernia was significantly more common in premature infants (28.0%) and young children (33.8% if <6 months, 27.4% if <2 years). Of the remaining 548, a metachronous contralateral hernia developed in 48 (8.8%) at a median interval of 6 months (range, 4 days to 7 years). This incidence was 13 of 105 (12.4%) in infants less than 6 months of age, 20 of 189 (10.6%) in children less than 2 years of age, 8 of 54 (14.8%) in premature infants, 6 of 81 (7.4%) in girls, and 8 of 29 (27.6%) in children with an incarcerated hernia. In the latter group, P < .05, chi2 analysis. CONCLUSION: Routine contralateral inguinal exploration, without clinical evidence of a hernia, may be advisable in children with incarceration and possibly in premature infants. The low incidence of contralateral hernias in all other patients, regardless of gender or age, does not justify routine contralateral exploration.

Extracorporeal membrane oxygenation in the neonate with congenital renal disease and pulmonary hypoplasia.

Extracorporeal membrane oxygenation (ECMO) is an effective treatment modality for the newborn with refractory hypoxemia. Oligohydramnios can be associated with congenital renal disease (CRD) and can result in respiratory insufficiency from pulmonary hypoplasia, delayed lung maturation, and persistent pulmonary hypertension of the newborn. In this retrospective study, the authors reviewed the outcome of four children with CRD who required ECMO in the neonatal period. Between October 1987 and December 1995, ECMO was used in four newborns with CRD and pulmonary hypoplasia unresponsive to maximal medical management. The causes of CRD were urinary obstruction (2), renal dysplasia (1), and vesicoureteral reflux (1). Neonatal survivors of ECMO with CRD had regular follow-up with a nephrologist, urologist, and pediatrician. Developmental history, assessment of renal function, and a nutritional evaluation were recorded on each visit. The follow-up period ranged from 6 months to 5 years. All patients with CRD were successfully weaned from ECMO. One child died, at 1 month of age, because of renal failure. The estimated glomerular filtration rates in the three survivors were 20, 24, and 60 mL/min/1.73 m2. Growth and development have been delayed in two patients. Based on the author's experience, ECMO may improve the survival of neonates with pulmonary hypoplasia and CRD. Factors associated with successful long-term outcome include (1) renal disease amenable to surgical correction, (2) aggressive nutritional support, and (3) a reliable social support system.

Encoding and retrieval processes in learning-disabled, head-injured, and nondisabled young adults.

Using a multi-trial, free-recall paradigm (Rey Auditory-Verbal Learning Test; Lezak, 1983), the acquisition and retention by learning disabled (LD) young adults with a Halstead Impairment Index less than or equal to 0.3 (low LD) or greater than or equal to 0.4 (high LD) was compared with that of nondisabled and head-injured (HI) young adults. Significant group differences, particularly during the last three acquisition trials, confirmed the effectiveness of this method in revealing subtle learning and retention deficits. Analyses of Trial 1 recall showed group differences in the prerecency but not the recency portion of the serial position curve, thus implicating long-term but not short-term memory differences between the groups. Analyses of pair frequency (Sternberg & Tulving, 1977) data showed that the three clinical groups had difficulty organizing the to-be-learned material for effective retrieval. Following an interpolated task, retention was poorer for the clinical groups than for the nondisabled and varied inversely with the degree of neuropsychological impairment. Finally, during retention, the nondisabled and low LD groups retained and used the list organization established during acquisition whereas the high LD and HI groups did not.

[Collagenous colitis. Studies on the differentiation and incidence of the syndrome]. / Die kollagene Kolitis. Untersuchungen zur Abgrenzung und Häufigkeit eines Syndroms.

All colon biopsy specimens of 28 months collected in an institute of pathology, providing a region of 660,000 inhabitants were reviewed for thickening of the subepithelial layer above the normal range of 7 mu. 16 cases were found, eleven of them with mild, uncharacteristic symptoms, eight even without diarrhea. Of the five cases with collagen layers above 10 mu, three suffered from intestinal diseases (unspecific protocolitis, active ulcerative colitis and malabsorption after ileum resection); two showed chronic diarrhea as symptoms of collagenous colitis. We conclude, that a subepithelial collagen layer is without any significance. Above 10 mu, two forms can be postulated: a reactive one, following chronic intestinal diseases and the idiopathic collagenous colitis syndrome of unknown etiology and pathogenesis. The presence of 185 cases is assumed in Western Germany, five of them already published.

An interim report on the development of the Psychological Trauma and Resources Scales.

The William S. Hall Psychiatric Institute Psychological Trauma and Psychological Resources Scales is a preliminary measure for the assessment of psychological trauma and psychological health from a developmental perspective. This three-part article (1) discusses the various rationales leading to the development of the scales, (2) provides a factor-analysis of responses of 336 college students, and (3) addresses current (N = 37) and planned efforts to establish reliability and validity of a more refined version.