Intersection of reality and fiction in art perception: pictorial space, body sway and mental imagery.

BACKGROUND: The thesis of embodied cognition claims that perception of the environment entails a complex set of multisensory processes which forms a basis for the agent's potential and immediate actions. However, in the case of artworks, an agent becomes an observer and action turns into a reaction. This raises questions about the presence of embodied or situated cognition involved in art reception. AIMS: The study aimed to assess the bodily correlates of perceiving fictional pictorial spaces in the absence of a possibility of an actual physical immersion or manipulation of represented forms. METHOD: The subjects were presented with paintings by Vermeer and De Hooch, whilst their body sway and eye movements were recorded. Moreover, test and questionnaires on mental imagery (MRT, VVIQ and OSIQ) were administered. RESULTS: Three major results were obtained: (1) the degree of pictorial depth did not influence body sway; (2) fixations to distant elements in paintings (i.e. backgrounds) were accompanied by an increase in body sway; and (3) mental rotation test scores correlated positively with body sway. CONCLUSIONS: Our results suggest that in certain cases--despite the fictional character of art--observers' reactions resemble reactions to real stimuli. It is proposed that these reactions are mediated by mental imagery (e.g. mental rotation) that contributes to the act of representing alternative to real artistic spaces.

Synthesis and anticonvulsant activity of N-(benzoylalkyl)imidazoles and N-(omega-phenyl-omega-hydroxyalkyl)imidazoles.

A novel series of N-(benzoylalkyl)imidazoles and N-(omega-phenyl-omega-hydroxyalkyl)imidazoles was synthesized and evaluated for anticonvulsant activity in mice against maximal electroshock induced seizures. Some of the compounds showed an activity comparable to or better than phenytoin and phenobarbital. The N-[beta-[4-(beta-phenylethyl)phenyl]-beta-hydroxyethyl]imidazole (38) was selected for further studies; preclinical toxicology and additional efficacy evaluations are in progress. Structure-activity relationships are discussed.

1-(2-pyridinyl)piperazine derivatives with antianaphylactic, antibronchospastic, and mast cell stabilizing activities.

New 1-(2-pyridinyl)piperazine derivatives were synthesized and tested as inhibitors of the reaginic passive cutaneous anaphylaxis in the rat (PCA), of the histamine-induced bronchospasm in the guinea pig, and of the rat mesenteric mast cell degranulation induced by compound 48/80. On the basis of test results, a series of N-(substituted phenyl)-omega-[4-(2-pyridinyl)-1-piperazinyl]alkanamides was prepared. The nature of substituents at the anilide ring strongly influenced mast cell stabilizing activity, whereas it was less determining in the case of the other two tests. No clear correlation between the most common physicochemical parameters (pi, sigma, Vw volume) of substituents and activity could be detected. With regard to the position of substituents at the anilide ring, the rank order of potency, in the PCA and bronchoconstriction tests, was para greater than meta greater than ortho. Introduction of substituents in the 1-(2-pyridinyl)piperazinyl moiety of the N-(substituted phenyl)propanamide derivatives hardly affected activity, or the effect was deleterious. Some of the new compounds exhibited a simultaneous remarkable activity in all the three assays employed.

Catheter-induced pulmonary artery perforation. Mechanisms, management, and modifications.

Six cases of pulmonary artery perforation associated with the use of Swan-Ganz catheters are reviewed. Risk factors included pulmonary hypertension, anticoagulation, and hypothermia. The mechanisms leading to perforation were clarified by the use of postmortem studies employing isolated whole lung preparations. These studies revealed that perforation results from (1) tip perforation of vasculature, (2) eccentric balloon configuration propelling the balloon through the vessel wall, and (3) balloon inflation disrupting the pulmonary artery (mean intraballoon pressure 250 mm Hg). Early clinical symptoms include hemoptysis of bright red blood and/or hypotension. Immediate evaluation may necessitate examination with a fiberoptic bronchoscope and "wedge" angiogram. If massive hemoptysis occurs, isolation of the unaffected lung by endobronchial intubation is mandatory. Pneumonectomy or lobectomy may be required. Revised guidelines for catheter insertion and pulmonary capillary wedge pressure (PCWP) measurements are presented. Finally, consideration is given to redesigning the pulmonary artery flow-guided catheter, particularly for use in patients undergoing cardiac operations with systemic anticoagulation. Modifications should be directed at (1) softer catheter tip with temperature-insensitive body, (2) low-pressure balloon, and (3) balloon pressure relief valve.

Elevated maternal serum alpha-fetoprotein and mild fetal uropathy.

Sixty-one consecutive patients referred because of elevated maternal serum alpha-fetoprotein (MSAFP) levels and 80 referred for second-trimester ultrasound for other reasons were examined. Ultrasound examination of the genitourinary tract and assignment of phenotypic sex was done by ultrasonographers blinded to the MSAFP results. Among male fetuses with elevated MSAFP, 33% had pyelectasis compared with only 5% of controls. Among female fetuses, pyelectasis was seen in 16% of cases and no controls. Increased MSAFP not caused by an open neural tube defect may be seen in conjunction with mild benign uropathy in the second trimester.

Maternal smoking and accelerated placental maturation.

In a prospective study of 367 patients referred for obstetric ultrasound evaluation, maternal cigarette smoking was found to have an important effect on the rate of placental maturation. The frequencies of grades 0, I, II, and III placentas throughout gestation were determined for both smoking and nonsmoking groups. Overall, the smoking mothers had more mature placentas than the nonsmoking mothers. This was reflected by the earlier mean gestational age at appearance of each of the placental grades in the smoking group as compared with the nonsmoking group. The mean gestational ages at appearance of grades 0, I, II, and III placentas for smoking mothers were 23.5, 27.9, 32, and 34.4 weeks, respectively, as compared with 26, 31.6, 35.7, and 38.3 weeks in the nonsmoking group. Smokers had a greater frequency of grade II placentas from 22-35 weeks than nonsmokers, and a greater frequency of grade III placentas beyond 25 weeks.

Transverse cerebellar diameter/abdominal circumference ratio throughout pregnancy: a gestational age-independent method to assess fetal growth.

In a prospective study of 162 patients, measurements of the transverse cerebellar diameter (TCD) and abdominal circumference (AC) were obtained between 15-38 weeks' gestation. A ratio between the TCD and AC was calculated after each examination. This ratio remained constant during gestation. The mean ratio was 13.7% (fifth and 95th percentiles of 11.9 and 15.9%, respectively); the median ratio was 13.6%. Forty-two patients had repeat measurements and the ratio did not change. This ratio is gestational age-independent; however, further investigation is needed to determine its application in the assessment of fetal growth abnormalities.

Can airway complications following multilevel anterior cervical surgery be avoided?

OBJECT: The authors conducted a study to determine how to avoid emergency postoperative reintubation and its associated morbidity in patients who have undergone multilevel anterior-posterior cervical spine surgery. METHODS: In a group effort between the departments of anesthesia and neurosurgery, a protocol was developed to avoid having to reintubate patients postoperatively. As a preventative measure, patients remained intubated overnight; on the 1st postoperative day or thereafter, based on direct fiberoptic visualization of reactive tracheal swelling, an anesthesiologist extubated the patients. Fifty-eight patients underwent multilevel anterior corpectomy with fusion (ACF; with 41 receiving plates and 17 not receiving plates), posterior wiring and fusion (PWF), and application of a halo. On average, ACF involved three levels, whereas PWF included 6.5 levels. Surgery typically lasted 10 hours, and an average 2.6 U of blood was required. Forty patients were successfully extubated on the 1st, five on the 2nd, three on the 3rd, two on the 4th, two on the 5th, and three on the 7th postoperative day. Three elective tracheostomies were performed on the 7th postoperative day. Risk factors associated with delayed extubation or tracheostomy in 18 patients included: operative time longer than 10 hours (12 patients), obesity greater than 220 lbs (12 patients), transfusion of more than 4 U of blood (10 patients), ACF reoperations (nine patients), ACF including C-2 (seven patients), four-level ACF (five patients), and asthma (five patients). In the only case in which emergency reintubation was required, three risk factors were present. CONCLUSIONS: Emergency reintubation following anterior-posterior cervical surgery and fusion can be avoided by maintaining intubation overnight and subsequently having an anesthesiologist remove the tube after healing is fiberoptically confirmed. Familiarity with major risk factors contributing to airway compromise, combined with this protocol, should minimize the significant morbidity associated with reintubation following multilevel anterior-posterior cervical fusion.

Evaluation of intraoperative somatosensory-evoked potential monitoring during 100 cervical operations.

Continuous intraoperative somatosensory-evoked potential monitoring during scoliosis surgery, along with improved instrumentation techniques, has contributed to the reduction of neurologic injury from 4-6.9% to 0-0.7%. To assess whether somatosensory-evoked potential monitoring might play a similar role in cervical surgery, the authors compared the morbidity and mortality rates associated with 218 patients who were not monitored and were operated on between 1985-1989 with those found in 100 consecutive somatosensory-evoked potential monitored procedures done from 1989-1991. The cervical procedures were conducted for disc disease, stenosis, spondylosis, and ossification of the posterior longitudinal ligament. Eight of 218 unmonitored patients became quadriplegic (3.7%) and 1 died (0.5%); no instances of quadriplegia and no deaths were encountered among the 100 monitored patients. The reduction of neurologic deficit was attributed in part to early somatosensory-evoked potential detection of vascular or mechanical compromise of the spinal cord or nerve roots and to the immediate alteration of anesthetic or surgical technique in response to somatosensory-evoked potential changes, i.e., reversal of systemic or "relative" hypotension, adjustment of operative position, release of distraction, and cessation of manipulation. Continuous intraoperative somatosensory-evoked potential monitoring also was a practical tool in monitoring cervical surgery.

Advantages of topical marcaine during spinal surgery. Technical note.

Marcaine applied to irritated nerve roots during extradural spinal surgery may attenuate sympathetically mediated and somatosensory (pain)-related hypertensive and tachycardic crises.

Role of vagus nerve signaling in CNI-1493-mediated suppression of acute inflammation.

CNI-1493 is a potent anti-inflammatory agent, which deactivates macrophages and inhibits the synthesis of proinflammatory mediators. The objective of the present study was to identify the role of the central nervous system (CNS) and efferent vagus nerve signaling in CNI-1493-mediated modulation of acute inflammation in the periphery. CNI-1493 was administered either intracerebroventricularly (i.c.v., 0.1-1,000 ng/kg) or intravenously (i.v., 5 mg/kg) in anesthetized rats subjected to a standard model of acute inflammation (subcutaneous (s.c.) injection of carrageenan). I.c.v. CNI-1493 significantly suppressed carrageenan-induced paw edema, even in doses at least 6-logs lower than those required for a systemic effect. Bilateral cervical vagotomy or atropine blockade (1 mg/kg/h) abrogated the anti-inflammatory effects of CNI-1493 (1 microg/kg, i.c.v. or 5 mg/kg, i.v.), indicating that the intact vagus nerve is required for CNI-1493 activity. Recording of the efferent vagus nerve activity revealed an increase in discharge rate starting at 3-4 min after CNI-1493 administration (5 mg/kg, i.v.) and lasting for 10-14 min (control activity=87+/-5.4 impulses/s versus CNI-1493-induced activity= 229+/-6.7 impulses/s). Modulation of efferent vagus nerve activity by electrical stimulation (5 V, 2 ms, 1 Hz) of the transected peripheral vagus nerve for 20 min (10 min before carrageenan administration and 10 min after) also prevented the development of acute inflammation. Local administration of the vagus nerve neurotransmitter, acetylcholine (4 microg/kg, s.c.), or cholinergic agonists into the site of carrageenan-injection also inhibited acute inflammation. These results now identify a previously unrecognized role of efferent vagus nerve activity in mediating the central action of an anti-inflammatory agent.

Obstetrical applications of computer technology.

Computer technology and the use of personal computers in obstetrics, particularly antepartum, and intrapartum fetal evaluation, are discussed. The future direction of computer technology in fetal assessment is also addressed.

Hospital-based nursing response to perinatal drug exposure.

This study examined hospital-based nursing interventions used for the problem of drug exposure in newborns and their mothers. Although there are few published reports of treatment services for this at-risk population, there is a consensus among health care providers on the need for treatment and the type of services that a treatment program should offer. A questionnaire measured use of assessment tools for newborn drug exposure and maternal drug use, patterns of referral, and use of aftercare and community treatment programs. The mean number of policies was 2.5, and the mean number of services offered was 1.042, consisting mostly of referral to community programs after discharge. Results can be used to develop quality assurance programs to address this issue and provide a more comprehensive response to the problem.

Synthesis and anticonvulsant evaluation of 1,2-diphenylethane derivatives, potential metabolites of denzimol.

A number of new 1,2-diphenylethane derivatives were synthesized and tested for anticonvulsant activity. Their structure was designed on the basis of the potential metabolic degradation of the imidazole ring present in denzimol ( ( +/- )-N-[2-[4-(beta-phenylethyl)phenyl]-2-hydroxethyl]imidazole), a potent anticonvulsant. The compounds which inhibited the electroshock-induced seizures (MES) in mice, namely N-[4-(beta-phenylethyl)phenacyl]formamide (VII) and N-[2-[4-(beta-phenylethyl)phenyl]-2-hydroxyethyl]formamide (IX), proved active also as inhibitors of the pentylenetetrazole-induced tonic seizures. The results of the pharmacological screening were evaluated in relation to the lipophilicity of the compounds.

Parent-infant interaction during perinatal addiction treatment.

Studies of parent-child interactions during perinatal addiction treatment are needed to offer insights into the nature of child development outcomes for this population. A purposeful sample of 17 women in a drug and alcohol addiction treatment program and their infants was studied over the course of their first year in the program. The purpose of this naturalistic field study was to examine parent-child interactions during addiction treatment. The following research question guided the inquiry: What is the nature of parent-infant interaction during the first year in a perinatal addiction treatment program? This study combined grounded theory methodology with the quantitative methods of descriptive and differential statistics. Open-coding of interviews, field notes, and the treatment records followed grounded theory methodology. A time-sampling procedure was used to examine stability of interactions at the beginning of program participation, again when each infant was 6 months old, and when each infant was 12 months. Results are used to describe parent-child interactions across samples and over time. Chi-square procedures were performed on number of children in each family, length of time in the program, sobriety, and mutual enjoyment of interaction. A significant difference in interaction by length of time in the program (chi 2 = 7.0801, df = 1, p < .00) as well as in interaction by percent sobriety (chi 2 = 4.1538, df = 1, p < .04) was evident. Behaviors of the infants reflected the emotional tone and parenting responses of their mothers. Dyads whose interactions showed a pattern of mutuality were more likely to continue in the treatment program and to maintain sobriety. The ability of a mother to enjoy her infant seemed to be the one factor that made the most difference in child behaviors. Results can be used by clinicians to guide the choice of treatment approaches that support the parent-child relationship during addiction treatment.

A curriculum self-study of writing assignments and reflective practice in nursing education.

Reflective practice is an ongoing process of purposeful thinking about one's clinical practice to develop understanding, insight, and clinical judgment. It can be enhanced through careful use of writing assignments that require reflection, evaluation, and thoughtful analysis. The uses of writing assignments in the undergraduate nursing programs at a midwestern college of nursing were studied over a 2-year period, using survey methodology. A purposive sample of all faculty who taught in baccalaureate or associate of science (ASN) programs (n=21) completed a questionnaire and were interviewed about the number and purpose of writing assignments in courses they taught. Quantification of the results in tabular form allowed the faculty to look at all writing assignments required of students across both programs with regard to the number, length, and nature of those assignments. Results were then recategorized by type of assignments, changes needed, and faculty assessment of the usefulness of these writing assignments. The summary of written assignments was then cross-referenced according to program, semester, and program level. This produced a working document that illustrated the quantity and type of writing assignments that each student, in each program, at a given level and semester must complete. Information was used by faculty teaching across courses to make changes that more effectively linked course writing assignments by association, themes, concepts, or areas of study. This process enables faculty to collaboratively develop writing assignments that facilitate the adult student's linking and associating concepts across courses, as a true exercise in critical thinking.

[Update on laparoscopic surgery: on the treatment of hydatid cyst of the liver and peritonitis caused by a perforated duodenal ulcer]. / Attualità in tema di chirurgia celioscopica: a proposito del trattamento di una cisti idatidea del fegato e di una peritonite da ulcera duodenale perforata.

Laparoscopic surgery represents a real innovation with respect to the traditional laparotomic way of access, owing to its undeniable advantages, both intraoperative and postoperative. This new technique reduces the complications connected with the surgical wound and with forced allerement. Therefore it allows the patient's fast recovery. Laparoscopic surgery application ground get's wider and wider every day: in fact, the authors report two medical cases, one of elective surgery (treatment of a hidatid cyst of the liver) and the other in emergency surgery (peritonitis due to perforated duodenal ulcer), both obtaining a positive result about the clinical and the postoperative timing of recovery.

[Primary hydatid cyst of the coracobrachial muscle. A clinical case]. / Cisti da echinococco primaria del muscolo coracobrachiale. Caso clinico.

Primary localization of hydatidosis in the musculoskeletal system is a quite rare occurrence. We report a case of a 67 year old man with an infestation of the coracobrachialis muscle. We discuss several instrumental and serologic diagnosis methods and the hypothesis of a primary muscular localization.

The importance of statistics in documentation on hip prostheses.

The authors illustrate the possibilities and the limits of instruments that statistics currently make available in the analysis of a medical series involving hip prosthesis surgery. An analysis of the survival rate constitutes one of the most important tools with regard to data in the study of the effectiveness of implants, but its correct application is influenced by the assumption that so-called censored cases have no differences in survival in relation to those that remain under observation even in periods that follow. Simulation reveals the need to process series with a high number of cases, in order to obtain reliable estimates. Finally, only multivaried techniques allow for a correct evaluation of the incidence that single factors have in causing failure of implants.

Metal-UHWMPE (Ultra High Molecular Weight Polyethylene) wear: experimental testing.

Testing conducted on a hip joint simulator verified the Charnley hypothesis that the diameter of the prosthetic head is proportional to wear. The study was conducted by pairing heads in Ortinox TM with acetabular cups in polyethylene at high molecular weight (UHMWPE). A comparison between the different sizes of the heads (26 and 30 mm in diameter) showed a different trend in the wear rate; in particular, the head with a smaller diameter behaves better tribologically than the head with a larger diameter.