New measurement of the K+-->pi+ nunu branching ratio.

Three events for the decay K+-->pi+ nunu have been observed in the pion momentum region below the K+-->pi+pi0 peak, 140 < Ppi < 199 MeV/c, with an estimated background of 0.93+/-0.17(stat.) -0.24+0.32(syst.) events. Combining this observation with previously reported results yields a branching ratio of B(K+-->pi+ nunu) = (1.73(-1.05)+1.15) x 10(-10) consistent with the standard model prediction.

Improved measurement of the K+-->pi+nunu; branching ratio.

An additional event near the upper kinematic limit for K+-->pi(+)nunu; has been observed by experiment E949 at Brookhaven National Laboratory. Combining previously reported and new data, the branching ratio is B(K+-->pi(+)nunu;)=(1.47(+1.30)(-0.89))x10(-10) based on three events observed in the pion momentum region 211

Further evidence for the decay K+ -->pi+nu(nu).

Additional evidence for the rare kaon decay K+-->pi+nu(nu) has been found in a new data set with comparable sensitivity to the previously reported result. One new event was observed in the pion momentum region examined, 211pi+nu(nu)) = 1.57(+1.75)(-0.82)x10(-10).

Measurement of direct photon emission in K+-->pi(+)pi(0)gamma decay

We have performed a measurement of the K+-->pi(+)pi(0)gamma decay and have observed 2x10(4) events. The best fit to the decay spectrum gives a branching ratio for direct photon emission of (4.7+/-0.8+/-0. 3)x10(-6) in the pi(+) kinetic energy region of 55 to 90 MeV and requires no component due to interference with inner bremsstrahlung.

Further search for the decay K+-->pi(+)nunu;

A search for additional evidence for the rare kaon decay K+-->pi(+)nunu; has been made with a new data set comparable in sensitivity to the previous exposure that produced a single event. No new events were found in the pion momentum region examined, 211pi(+)nunu;) = 1.5(+3.4)(-1.2)x10(-10).

Measurement of structure-dependent K+ --> &mgr;(+)nu(&mgr;)gamma decay

We report the first measurement of a structure-dependent component in the decay K+-->&mgr;(+)nu(&mgr;)gamma. Using the kinematic region where the muon kinetic energy is greater than 137 MeV and the photon energy is greater than 90 MeV, we find that the absolute value of the sum of the vector and axial-vector form factors is |F(V)+F(A)| = 0.165+/-0.007+/-0.011. This corresponds to a branching ratio of B(SD+) = (1.33+/-0.12+/-0.18)x10(-5). We also set the limit -0. 04

[Cleidocranial dysplasia: a case report].

A 3-month-old female infant who presented with patent sagittal suture and loss of weight is described. Physical examination revealed a large sagittal and metopic suture showing delayed closure, a high-arched palate, saddle nose, hypertelorism and nonpalpable edges of the bilateral clavicles. The clavicles also showed undue mobility. Radiological investigations of the cranial skeletal abnormalities revealed enlargement of the sagittal and metopic sutures, and the anterior and posterior fontanelles. A chest radiograph showed a small, bell-shaped thoracic rib cage with partial aplasia of both clavicles. On the basis of the clinical findings, cleidocranial dysplasia was diagnosed. Cleidocranial dysplasia is an uncommon generalized skeletal disorder which, as its name implies, shows striking involvement of the cranial vault and clavicles. The clinical features reflect a generalized defect of both membranous and endochondral bone formation. It is characterized by delayed ossification of the skull, aplastic or hypoplastic clavicles, delayed deciduous dentition, and hereditary characteristics. The amount of calvarial growth is generally small, and the shape remains nearly unaltered. In all cases, calvarial bone thickness increases with age, but in the midline, the fontanelle area, which is shown to be defective at the first examination, remains open in all cases. The midfrontal area is poorly developed and exhibits a groove in many patients. It is inherited as an autosomal dominant trait, with wide variability of expression but a high degree of penetrance. Cytogenetic abnormalities involving chromosome 6p21 have been reported with a cleidocranial dysplasia phenotype. Although psychosocial disorders associated with the abnormal facial and body features may occur, patients have a good overall prognosis and life expectancy. Skull deformity, and delayed closure of the fontanelles and cranial sutures are the most important problems for neurosurgeons. The postero-lateral fontanelle closes before adulthood, whereas the opening in the midfrontal sutural area may persist. Many children with cleidocranial dysplasia whom we have encountered have persisting fontanelles and patent sutures, but this does not seem to predispose them to an abnormal calvarial growth pattern, at least in the age groups investigated. Congenital midface retrusion in the presence of relative or absolute mandibular prognathism is also a major deformity. Care is supportive, including attention to neurosurgical, orthopedic, pediatric and dental problems.

A material-control single-case study of the efficacy of treatment for written and oral naming difficulties.

Twenty-two right-handed aphasics with written and/or oral naming difficulties were treated with a traditional language therapy: copying and repetition of words. The efficacy and maintainability of the treatment were evaluated using a variation of the single-case design, which was termed the material-control single-case design. Effectiveness of the treatment for written naming difficulty was demonstrated for 9 of 21 subjects in a first treatment and 3 of 14 subjects in a second treatment. Three of the 14 subjects benefitted overall from both treatments in written naming. In oral naming, 2 of 18 subjects responded well to the first treatment while 2 of 16 responded well to the second treatment. One of the 16 subjects showed benefits from both the first and second treatments in oral naming. Although written and oral naming disturbances were difficult to improve using ordinary language treatment, a small proportion of subjects clearly showed effectiveness of the therapy. Maintenance of the effects of treatment was observed in all of the improvers.

A critical appraisal of neuropsychological correlates of Japanese ideogram (kanji) and phonogram (kana) reading.

Owing to the Japanese language's unique writing system, which consists of phonograms and ideograms, reading impairments of Japanese brain-damaged patients have attracted the interest of many researchers. Past case reports as well as some widely accepted handbooks and textbooks have concluded that a specific aphasia type or lesion site is associated with a particular impairment pattern of phonograms and ideograms in reading. However, the methodology and analytical procedures in previous studies were inadequate for reliable generalizations to be made. First, the test materials were unspecified or inappropriate, or the number of test items was small. Secondly, the conclusions were presented without providing individual performance data to support them. Thirdly, in associating patterns of reading impairment with lesion sites, only single cases were reported. The present investigation was designed to overcome the omissions of previous studies, and examined the ability to read 46 single phonograms and 46 single ideograms aloud in four groups of sufficiently large numbers of patients; namely, seven pure alexics, 23 Broca aphasics, 13 Wernicke aphasics, and seven patients with alexia and agraphia. Ours are the first data to demonstrate unequivocally no consistent linkage between aphasia type and the patterns of impairment of phonogram and ideogram reading. The impairment patterns were not uniform across patients even in the same aphasia group. A majority of the cases in each group showed that phonograms and ideograms were unselectively impaired. However, ideogram reading was more difficult in three cases in the pure alexia and Broca aphasia groups, respectively, and in one case in the Wernicke aphasia group. Phonogram reading was more severely disturbed in four cases among the Broca aphasics and in one case among the patients with alexia with agraphia. An apparent variability of impairment patterns characterized the Broca aphasic group. These dyslexic patterns did not appear to correlate with the site and extent of lesions identified by computerized tomography scans. Past reports linking a particular impairment pattern of phonogram and ideogram reading and a specific lesion site were studies of single cases, and their conclusions seem oversimplified. While sensory and motor dysfunctions can usually be neuroanatomically localized in individuals, impairments of certain high cortical functions, such as the reading of phonograms and ideograms, may not be correlated with damage to definite neuroanatomical structures.

Electropalatographic analysis of apraxia of speech in a left hander and in a right hander.

Two cases with 'pure' apraxia of speech are reported. The articulatory disturbances were quite similar. One of the two cases was a left-handed male with a subcortical haemorrhage and the other a right-handed male with a cerebral infarct. The MRI and CT scans showed that the first case had a lesion that mainly involved the right precentral gyrus and its deep white matter, and that the second had a lesion mainly affecting the lower parts of the left precentral and postcentral gyri and their deep white matter. These findings and a literature review suggest that a corticosubcortical lesion of the lower part of the left precentral gyrus in most right handers and a lesion of the symmetric region in the right hemisphere in some left handers cause apraxia of speech. The omission errors for sounds articulated by the tongue and the hard palate were analysed using electropalatography, which records visually the dynamics of the palatolingual contact. The results demonstrated that there were three kinds of omission errors: true omissions (no palatolingual contact); omissions with incorrect contact (palatolingual contact for a different sound or undifferentiated sound); and omissions with correct contact (correct palatolingual contact for a target sound). The latter two types of omission error were observed for initial consonants and they were probably caused by a delay in air flow. The patients also showed a tendency to substitute one of the two consonants/t, t/for other sounds, which suggested that they had difficulty in the inhibition of tongue activity.

Regional cerebral blood flow correlates of aphasia outcome in cerebral hemorrhage and cerebral infarction.

The relationship between recovery from aphasia and regional cerebral blood flow (CBF) was compared in 87 patients, 44 with cerebral hemorrhage and 43 with non-embolic cerebral infarction. CBF values correlated poorly with aphasia outcome in patients with cerebral hemorrhage whereas a tight correlation was demonstrated in patients with non-embolic cerebral infarction. A marked variability of CBF values in the acute and subacute stage might account for the poor correlation between CBF and aphasia outcome in patients with cerebral hemorrhage. On the other hand, a sharp discrimination was achieved between those with a good recovery from aphasia and those with a poor recovery by the dimensions of the hematoma on CT. In non-embolic cerebral infarction, a relative frontal ischemia was associated with motor aphasia while a relative temporal ischemia was associated with sensory aphasia. This dichotomy was not demonstrated in the regional CBF values in patients with cerebral hemorrhage.