Longitudinal Speech Outcome at 5 and 10 Years in UCLP: Influence of Speech Therapy and Secondary Velopharyngeal Surgery.

OBJECTIVE: To investigate speech development of children aged 5 and 10 years with repaired unilateral cleft lip and palate (UCLP) and identify speech characteristics when speech proficiency is not at 'peer level' at 10 years. Estimate how the number of speech therapy visits are related to speech proficiency at 10 years, and what factors are predictive of whether a child's speech proficiency at 10 years is at 'peer level' or not. DESIGN: Longitudinal complete datasets from the Scandcleft project. PARTICIPANTS: 320 children from nine cleft palate teams in five countries, operated on with one out of four surgical methods. INTERVENTIONS: Secondary velopharyngeal surgery (VP-surgery) and number of speech therapy visits (ST-visits), a proxy for speech intervention. MAIN OUTCOME MEASURES: 'Peer level' of percentage of consonants correct (PCC, > 91%) and the composite score of velopharyngeal competence (VPC-Sum, 0-1). RESULTS: Speech proficiency improved, with only 23% of the participants at 'peer level' at 5 years, compared to 56% at 10 years. A poorer PCC score was the most sensitive marker for the 44% below 'peer level' at 10-year-of-age. The best predictor of 'peer level' speech proficiency at 10 years was speech proficiency at 5 years. A high number of ST-visits received did not improve the probability of achieving 'peer level' speech, and many children seemed to have received excessive amounts of ST-visits without substantial improvement. CONCLUSIONS: It is important to strive for speech at 'peer level' before age 5. Criteria for speech therapy intervention and for methods used needs to be evidence-based.

Bax-induced cytochrome C release from mitochondria is independent of the permeability transition pore but highly dependent on Mg2+ ions.

Bcl-2 family members either promote or repress programmed cell death. Bax, a death-promoting member, is a pore-forming, mitochondria-associated protein whose mechanism of action is still unknown. During apoptosis, cytochrome C is released from the mitochondria into the cytosol where it binds to APAF-1, a mammalian homologue of Ced-4, and participates in the activation of caspases. The release of cytochrome C has been postulated to be a consequence of the opening of the mitochondrial permeability transition pore (PTP). We now report that Bax is sufficient to trigger the release of cytochrome C from isolated mitochondria. This pathway is distinct from the previously described calcium-inducible, cyclosporin A-sensitive PTP. Rather, the cytochrome C release induced by Bax is facilitated by Mg2+ and cannot be blocked by PTP inhibitors. These results strongly suggest the existence of two distinct mechanisms leading to cytochrome C release: one stimulated by calcium and inhibited by cyclosporin A, the other Bax dependent, Mg2+ sensitive but cyclosporin insensitive.

Bid-induced conformational change of Bax is responsible for mitochondrial cytochrome c release during apoptosis.

Here we report that in staurosporine-induced apoptosis of HeLa cells, Bid, a BH3 domain containing protein, translocates from the cytosol to mitochondria. This event is associated with a change in conformation of Bax which leads to the unmasking of its NH2-terminal domain and is accompanied by the release of cytochrome c from mitochondria. A similar finding is reported for cerebellar granule cells undergoing apoptosis induced by serum and potassium deprivation. The Bax-conformational change is prevented by Bcl-2 and Bcl-xL but not by caspase inhibitors. Using isolated mitochondria and various BH3 mutants of Bid, we demonstrate that direct binding of Bid to Bax is a prerequisite for Bax structural change and cytochrome c release. Bcl-xL can inhibit the effect of Bid by interacting directly with Bax. Moreover, using mitochondria from Bax-deficient tumor cell lines, we show that Bid- induced release of cytochrome c is negligible when Bid is added alone, but dramatically increased when Bid and Bax are added together. Taken together, our results suggest that, during certain types of apoptosis, Bid translocates to mitochondria and binds to Bax, leading to a change in conformation of Bax and to cytochrome c release from mitochondria.

Radiation damage in tungsten from cascade overlap with voids and vacancy clusters.

We have performed a systematic molecular dynamics investigation of the effects of overlap of collision cascades in tungsten with pre-existing vacancy-type defects. In particular, we focus on the implications for fusion neutron irradiated tungsten in relation to comparisons with damage production under ion irradiation conditions. We find that overlap of a cascade with a vacancy-type defect decreases the number of new defects with roughly the same functional dependence as previously shown for interstitial clusters. We further find that different mechanisms govern the formation of dislocation loops, resulting in different Burgers vectors, depending on the degree of overlap between the cascade and the defect. Furthermore, we show that overlapping cascades consistently decrease the size of the pre-existing defect. We also observe void-induced cascade splitting at energies far below the subcascade splitting threshold in tungsten. The impact of these mechanisms on radiation damage accumulation and dose rate effects are discussed.

Collision cascades overlapping with self-interstitial defect clusters in Fe and W.

Overlap of collision cascades with previously formed defect clusters become increasingly likely at radiation doses typical for materials in nuclear reactors. Using molecular dynamics, we systematically investigate the effects of different pre-existing self-interstitial clusters on the damage produced by an overlapping cascade in bcc iron and tungsten. We find that the number of new Frenkel pairs created in direct overlap with an interstitial cluster is reduced to essentially zero, when the size of the defect cluster is comparable to that of the disordered cascade volume. We develop an analytical model for this reduced defect production as a function of the spatial overlap between a cascade and a defect cluster of a given size. Furthermore, we discuss cascade-induced changes in the morphology of self-interstitial clusters, including transformations between [Formula: see text] and [Formula: see text] dislocation loops in iron and tungsten, and between C15 clusters and dislocation loops in iron. Our results provide crucial new cascade-overlap effects to be taken into account in multi-scale modelling of radiation damage in bcc metals.

A model of defect cluster creation in fragmented cascades in metals based on morphological analysis.

The impacts of ions and neutrons in metals cause cascades of atomic collisions that expand and shrink, leaving microstructure defect debris, i.e. interstitial or vacancy clusters or loops of different sizes. In De Backer et al (2016 Europhys. Lett. 115 26001), we described a method to detect the first morphological transition, i.e. the cascade fragmentation in subcascades, and a model of primary damage combining the binary collision approximation and molecular dynamics (MD). In this paper including W, Fe, Be, Zr and 20 other metals, we demonstrate that the fragmentation energy increases with the atomic number and decreases with the atomic density following a unique power law. Above the fragmentation energy, the cascade morphology can be characterized by the cross pair correlation functions of the multitype point pattern formed by the subcascades. We derive the numbers of pairs of subcascades and observed that they follow broken power laws. The energy where the power law breaks indicates the second morphological transition when cascades are formed by branches decorated by chaplets of small subcascades. The subcascade interaction is introduced in our model of primary damage by adding pairwise terms. Using statistics obtained on hundreds of MD cascades in Fe, we demonstrate that the interaction of subcascades increases the proportion of large clusters in the damage created by high energy cascades. Finally, we predict the primary damage of 500 keV Fe ion in Fe and obtain cluster size distributions when large statistics of MD cascades are not feasible.

Nitric oxide donors mediate vasodilation in human placental arteries partly through a direct effect on potassium channels.

We have investigated the involvement of potassium channels in the NO-induced relaxation of small ET-1 precontracted arteries from placentas of normal pregnancies in the presence of the potassium channel modulating agents charybdotoxin, 4-AP, glibenclamide, TEA and the blocker of soluble guanylyl cyclase, ODQ, respectively. We have studied the effect of the NO-donor S-nitroso-N-acetylpenicillamine (SNAP) in vessels precontracted by different concentrations of potassium and we have also investigated the presence of BK(Ca) channels in placental arteries by immunohistochemistry and immunoblotting. Our results show that charybdotoxin, an inhibitor of large- and intermediate-conductance Ca(2+)-activated potassium channels, inhibits relaxation in placental arteries. In presence of both charybdotoxin and ODQ, the inhibition of relaxation was significantly stronger, which indicates that NO-induced relaxation of human placental arteries is partly mediated through cGMP, and partly through a direct effect on potassium channels of the BK(Ca) type. The NO-donor SNAP preferentially relaxes contractions induced by 75 mM K(+) as compared to 100 mM K(+). This effect profile is a unique feature of drugs acting by K(+) channel opening. The immunohistochemistry shows that BK(Ca) channels are located both in smooth muscle and in endothelium in placental arteries.

Mutational analysis of PAX6: 16 novel mutations including 5 missense mutations with a mild aniridia phenotype.

Mutations in the developmental control gene PAX6 have been shown to be the genetic cause of aniridia, which is a severe panocular eye disease characterised by iris hypoplasia. The inheritance is autosomal dominant with high penetrance but variable expressivity. Here we describe a mutational analysis of 27 Danish patients using a dideoxy fingerprinting method, which identified PAX6 mutations in 18 individuals with aniridia. A thorough phenotype description was made for the 18 patients. A total of 19 mutations, of which 16 were novel, are described. Among these were five missense mutations which tended to be associated with a milder aniridia phenotype, and in fact one of them seemed to be non-penetrant. Four of the five missense mutations were located in the paired domain. We also describe a third alternative spliced PAX6 isoform in which two of the four missense mutations would be spliced out. Our observations support the concept of dosage effects of PAX6 mutations as well as presenting evidence for variable expressivity and gonadal mosaicism.

Common and distinct fusion proteins in axonal growth and transmitter release.

We have used the proteolytic properties of botulinum and tetanus neurotoxins (BoNT, TeNT) to cleave three proteins of the membrane fusion machinery, SNAP-25, VAMP/synaptobrevin, and syntaxin, in developing and differentiated rat central neurons in vitro. Then, we have studied the capacity of neurons to extend neurites, make synapses, and release neurotransmitters. All the toxins showed the expected specificity with the exception that BoNT/C cleaved SNAP-25 in addition to syntaxin and induced rapid neuronal death. In developing neurons, cleavage of SNAP-25 with BoNT/A inhibited axonal growth and prevented synapse formation. In contrast, cleavage of VAMP with TeNT or BoNT/B had no effects on neurite extension and synaptogenesis. All the toxins tested inhibited transmitter release in differentiated neurons, and cleavage of VAMP resulted in the strongest inhibition. These data indicate that SNAP-25 is involved in vesicle fusion for membrane expansion and transmitter release, whereas VAMP is selectively involved in transmitter release. In addition, our results support the hypothesis that synaptic activity is not essential for synapse formation in vitro.

Physical and clinical evaluation of high-resolution thyroid pinhole tomography.

UNLABELLED: High-resolution pinhole-SPECT (PSPECT) is a new method for examining the thyroid gland. METHODS: The camera is tilted slightly so that it is as close to the thyroid as possible. Patients are injected with 185-260 MBq (5-7 mCi) of [99mTc]pertechnetate and examined for 20 min. The reconstruction algorithm is based on filtered back-projection. RESULTS: We performed static scintigraphy on the thyroids of 114 patients, followed by PSPECT. The major advantage of P SPECT is high resolution. Three- and 4-mm-pinholes produce resolutions of 6 mm and 7 mm, respectively, while resolutions obtained with a parallel collimator are always above 15 mm. The second advantage associated with this method is the good visualization of the cold nodules surrounded by higher activity. Finally, the reconstruction program provides exact sizes of thyroids. CONCLUSION: SPECT is a powerful tool for examining the thyroid.

About the possible origin and mechanism of circulating DNA apoptosis and active DNA release.

BACKGROUND: In addition to cell lysis, apoptosis has been advanced as the origin of circulating DNA on the basis of several observations. Plasma or serum DNA often presents a ladder pattern reminiscent of that displayed by apoptotic cells when subjected to electrophoresis. However, the phenomenon of active release of DNA from cells might also be expected to result in a ladder pattern on electrophoresis. Non-dividing cells, such as lymphocytes, frog auricles and cultured cell lines including HL-60, spontaneously release a nucleoprotein complex within a homeostatic system in which newly synthesized DNA is preferentially released. CONCLUSION: In relation to DNA synthesis, the phenomenon of extracellular DNA in different culture conditions favors apoptosis or spontaneous active DNA release.

Antisense Blockade of Expression : SNAP-25 In Vitro and In Vivo.

With the advent of modern molecular genetics and molecular biology, we will face more and more situations where novel gene products with unknown functions are identified. Genetic linkage analysis will allow the association of novel or known genes to Important diseases (1). Similarly, sensitlve differential cloning procedures will identify rare genes expressed in specific physiological or pathological situations (1, 3). In both cases, establishing the precise function of the identified gene is an essential step for the understanding of the cellular mechanisms that either lead to the disease or are pivotal in important physiological processes.

Oesophageal transit patterns in healthy subjects.

Oesophageal transit was studied in 49 healthy volunteers. When a good quality bolus was reached, the tracer passed through the oesophagus leaving no residual activity. The mean time of transit of the total oesophagus was 4.5 +/- 1.3 s. In cases of fragmented bolus, residual activity was found in about 80% of the cases giving rise to a prolonged transit time. When using 81Krm, artefacts due to fragmented bolus can easily be overcome by repeating the test as often as necessary.

Hypofixation on bone scintigraphy in reflex sympathetic dystrophy syndrome.

We report an adult case of reflex sympathetic dystrophy. In contrast to the usual findings in adults, three phase bone scintigraphy showed decreased bloodflow and bloodpool with hypofixation on delayed steady state bone scan of the affected lower limb. In spite of various therapeutic attempts severe dystrophy developed.

[Risk-taking behavior and accidents in adolescence in developed countries]. / Comportement de prise de risque et accidents à l'adolescence dans les pays développés.

Injuries due to accidents are the primary cause of fatalities among adolescents. Between the ages of 10 and 19, mortality caused by accidents augments significantly, and there is an excess of male mortality, increasing with age. This mortality has remained virtually unchanged over the past 25 years, except for a small narrowing of rate differences by sex. Traffic accidents, particularly those involving motorcycles, are the leading cause of accident fatalities. Though not easily assessed, morbidity due to accidents is probably very high, especially among males. Sports accidents are the most frequent. Adolescents appear to be particularly exposed to some risks, but also tend to be careless about safety. Risk-taking is a source of rewards: pleasure, self-affirmation, sense of independence; but it is described by some authors as self-destructiveness, death from accidents reflecting suicidal tendencies. Paradoxical results of prevention have been observed in this age group.

The contribution of reactive oxygen species and p38 mitogen-activated protein kinase to myofilament oxidation and progression of heart failure in rabbits.

BACKGROUND AND PURPOSE: The formation of reactive oxygen species (ROS) is increased in heart failure (HF). However, the causal and mechanistic relationship of ROS formation with contractile dysfunction is not clear in detail. Therefore, ROS formation, myofibrillar protein oxidation and p38 MAP kinase activation were related to contractile function in failing rabbit hearts. EXPERIMENTAL APPROACH AND KEY RESULTS: Three weeks of rapid left ventricular (LV) pacing reduced LV shortening fraction (SF, echocardiography) from 32 +/- 1% to 13 +/- 1%. ROS formation, as assessed by dihydroethidine staining, increased by 36 +/- 8% and was associated with increased tropomyosin oxidation, as reflected by dimer formation (dimer to monomer ratio increased 2.28 +/- 0.66-fold in HF vs. sham, P < 0.05). Apoptosis (TdT-mediated dUTP nick end labelling staining) increased more than 12-fold after 3 weeks of pacing when a significant increase in the phosphorylation of p38 MAP kinase and HSP27 was detected (Western blotting). Vitamins C and E abolished the increases in ROS formation and tropomyosin oxidation along with an improvement of LVSF (19 +/- 1%, P < 0.05 vs. untreated HF) and prevention of apoptosis, but without modifying p38 MAP kinase activation. Inhibition of p38 MAP kinase by SB281832 counteracted ROS formation, tropomyosin oxidation and contractile failure, without affecting apoptosis. CONCLUSIONS AND IMPLICATIONS: Thus, p38 MAP kinase activation appears to be upstream rather than downstream of ROS, which impacts on LV function through myofibrillar oxidation. p38 MAP kinase inhibition is a potential target to prevent or treat HF.

Argon laser treatment of exudative senile maculopathy.

Fourty-nine eyes with exudative senile maculopathy (ESM) have been treated with argon laser photocoagulation. Fluorescein angiography studies were done pre- and postoperatively. The follow-up time is 6 to 12 months after end of treatment. The results suggest a beneficial effect in selected cases of ESM.

Study of antigenic epitopes recognized by monoclonal antibodies to recombinant interferon-gamma.

Seven hybridomas (BG 1-7) which secreted monoclonal antibodies against recombinant interferon-gamma were produced. The ascites fluids containing four of the seven monoclonal antibodies (BG 1-4) neutralized the antiviral activity of both natural and recombinant interferon-gamma. Competition between labeled and unlabeled monoclonal antibodies for interferon-gamma in a solid phase immunoassay showed that BG 1 was competed by both BG 3 and BG 4 but not by BG 2; BG 2 was competed by BG 3 but not by BG 1 nor by BG 4. These results suggest that human interferon-gamma has at least two antigenic epitopes; one of the epitopes reacted with BG 1 & BG 4 while the other reacted with BG 2; BG 3 either binds to a region overlapping with the other two epitopes or reacts with both epitopes. The antigenic epitopes recognized by these four neutralizing monoclonal antibodies are likely at or closely related to the active sites of interferon-gamma.

Argon laser trabeculoplasty--5 years experience from a local eye department.

Argon Laser Trabeculoplasty (ALT) have been used in the treatment of open angle glaucoma since 1982. During a five-year period, 1982-1986, the annual rate of glaucoma filtering operations has decreased steadily from 65 to 8. The pressure reducing effect is good both in simple and capsular glaucoma. In secondary glaucoma ALT failed to control the intraocular pressure in about 50%. Simple and capsular glaucoma respond well to repeated ALT, but in secondary glaucoma repeated ALT seems to be useless.