Phylogeography of the Afromontane Prunus africana reveals a former migration corridor between East and West African highlands.

Scattered populations of the same tree species in montane forests through Africa have led to speculations on the origins of distributions. Here, we inferred the colonization history of the Afromontane tree Prunus africana using seven chloroplast DNA loci to study 582 individuals from 32 populations sampled in a range-wide survey from across Africa, revealing 22 haplotypes. The predominant haplotype, HT1a, occurred in 13 populations of eastern and southern Africa, while a second common haplotype, HT1m, occurred in populations of western Uganda and western Africa. The high differentiation observed between populations in East Africa was unexpected, with stands in western Uganda belonging with the western African lineage. High genetic differentiation among populations revealed using ordered alleles (N(ST) = 0.840) compared with unordered alleles (G(ST) = 0.735), indicated a clear phylogeographic pattern. Bayesian coalescence modelling suggested that 'east' and 'west' African types likely split early during southward migration of the species, while further more recent splitting events occurred among populations in the East of the continent. The high genetic similarity found between western Uganda and west African populations indicates that a former Afromontane migration corridor may have existed through Equatorial Africa.

Building a residential treatment program for dually diagnosed women with their children.

The epidemic of drug and alcohol abuse in our nation impacts millions of women, mothers, and children. Addicted mothers with complex problems and numerous co-morbidities present unique treatment challenges. This intergenerational cycle of abuse and addiction is difficult to stop. Arkansas CARES (Center for Addictions Research Education and Services, referred to in this article as CARES) initially was created to treat addicted pregnant and postpartum women and their infants. CARES evolved into a residential treatment program for dually diagnosed mothers with their children. This paper is a synopsis of a presentation delivered at the North American Society for Psychosocial Obstetrics and Gynecology. It shares a glimpse inside the treatment program and lessons learned along the way in an effort to assist others who are interested in building treatment programs for addicted women with their children.

Magnetic resonance imaging of chronic subdural hematoma.

This article highlights the unique ability of magnetic resonance imaging in evaluating the evolution of the subdural hematoma. Topics specifically discussed are computed tomography sensitivity and the extent, age, and complexity of the subdural hematoma.

Pontine-crossed paralysis consequent to multiple trauma: case report.

The case of a multiple trauma victim with a brain-stem injury, resulting in a syndrome of pontine-crossed paralysis, is presented. Demonstration of these disorders in the setting of multiple trauma is highly unusual, but the diagnosis is established quickly and accurately through magnetic resonance imaging. A possible mechanism of injury is presented for discussion.

Physical exercise, stressful life experience, and depression in adults with epilepsy.

Adults with epilepsy completed self-report measures of exercise participation, barriers to exercise, stressful life experience, depression, and general psychosocial adjustment (n = 133) as part of routine outpatient visits. Descriptive statistics showed lower levels of depression among patients who exercised regularly. Structural equation analyses confirmed the fit of a path model that included significant direct effects of exercise and stressful life experience on depression. These effects were independent of each other, and independent of the influence of other predictor variables, such as seizure frequency, age, and gender. Stressful life experience also had a direct unique effect on seizure frequency in the multivariate models. These results suggest that problems with depression, which are common in adults with epilepsy, are significantly lower among those who exercise regularly and avoid stressful life change.

Identification of ethanol-intoxicated patients with minor head trauma requiring computed tomography scans.

OBJECTIVE: To determine whether clinical parameters and neurologic scores can be used to guide the decision to obtain computed tomography (CT) head scans for ethanol- intoxicated patients with presumed-minor head injuries. METHODS: In a prospective cohort analysis, 107 consecutive adult patients who presented to a county emergency department (ED) with serum ethanol levels >80 mg/dL and minor head trauma were studied. Commonly used clinical variables were determined for each patient. Each patient also underwent an abbreviated neurologic scoring examination and a Glasgow coma scale (GCS) score evaluation at the time of presentation and one hour later, after which a cranial CT scan was done. For purposes of analysis, patients with and patients without intracerebral injuries visible on CT scans of the head were compared. RESULTS: Nine of 107 patients (8.4%; 95% confidence interval [CI] = 3.9-15.4%) had CT scans that were positive for intracerebral injury. Two patients (1.9%; 95% CI = 0.2-6.6%) needed craniotomy. Five patients had hemotympanum and two patients had bilateral periorbital ecchymosis, but CT scans were negative for intracerebral injury in these patients. There was no statistically significant difference between the patients with and without CT scan abnormalities, based on the clinical variables, the GCS scores, or the abbreviated neurologic scoring examinations at presentation or at one hour. CONCLUSION: The prevalence of intracerebral injury in CT scans of ethanol-intoxicated patients with minor head injuries was 8.4%. Commonly used clinical parameters and neurologic scores at presentation and one hour later were unable to predict which patients would have intracerebral injuries and evidenced by CT scans. Our low (1.9%) neurosurgical intervention rate supports the need to develop a selective approach to CT scanning in this population.

An aid to nasotracheal intubation in orthognathic surgery.

An atraumatic and reliable technique of nasal intubation in patients with previous pharyngoplasty or pharyngeal flap is presented. Using the tight and smooth fit of the fluted end of a red rubber catheter over the end of a nasotracheal tube is the technique described.

Imaging of the nontraumatic acute abdomen.

Plain-film radiography of the abdomen is often the first-line imaging modality used for the patient in the ED. It is capable of demonstrating abnormal locations of gas, abnormal viscera, calcifications and foreign material, and skeletal and lower lung pathology. PFR findings may aid in the decision to proceed to other modalities. Contrast studies have a limited role in the ED but may be necessary to diagnose disease inadequately visualized by PFR, as in the case of perforated duodenal ulcer, missed on PFR in approximately 15 per cent of cases. Ultrasound is most useful in the ED for obstetric and gynecologic illness, as well as disorders of the hepatobiliary system. Nuclear medicine studies can be very useful for GI bleeding and inflammatory conditions but may not always be as available or convenient as other modalities. CT has very broad usefulness. Angiography is very useful for locating bleeding sites, especially in the large bowel, and for determination of mesenteric arterial patency in suspected mesenteric ischemia. Finally, MRI, which has enormous potential, is not funded by many third-party payment plans for use in emergencies, and must overcome certain obstacles before it assumes common usage in the ED.

Dietary obesity and weight cycling: effects on blood pressure and heart rate in rats.

The overconsumption of rich and palatable foods and "yo-yo" dieting are feeding patterns involved in obesity and possibly hypertension in humans. We therefore examined the effects of diet-induced obesity and weight cycling on the blood pressure and heart rate levels of 60-day-old male normotensive Sprague-Dawley (S-D) and spontaneously hypertensive (SHR) rats. Six months on a high-fat and high-sucrose diet (HF/M) produced a greater obesity in S-D rats than in SHR rats. The caloric intakes of S-D rats fed the HF/M diet were greater than the caloric intakes of pellet-fed controls, whereas those of SHR rats were similar. The obesity of both strains was associated with hyperinsulinemia, heavier white (retroperitoneal) and brown (interscapular) fat pads, heavier heart weights, and tachycardia. Despite these changes, diet-induced obesity failed to increase systolic blood pressure obtained under light ether anesthesia or mean arterial pressure in the conscious state. Paradoxically, the blood pressures of SHR rats fed HF/M diet were reduced perhaps as a result of the high polyunsaturated fat component of the diet. A second S-D dietary obese group was alternated between 2-wk periods of unrestricted HF/M diet and 50% restricted pellet chow. Although their body weights were similar to pellet-fed controls, three cycles of weight loss and weight regain resulted in the consumption of increased dietary fat, increased food efficiency, heavier fat pads, and hyperinsulinemia. Heart rate and to some extent blood pressure fluctuated with diet, being elevated during HF/M feeding and reduced during restricted pellet feeding. Although weight cycling intensified the physiological responses to food ingestion, we found that weight cycling in dietary obese S-D rats did not elevate blood pressure levels.

The negative radionuclide venogram: an indication for conservative therapy?

A retrospective study of 51 patients with a negative lower extremity radionuclide venogram and a 6-month follow-up was performed. None of the patients received anticoagulation. Fifty of the 51 patients had no subsequent symptoms nor signs suggesting undiagnosed deep venous thrombosis or pulmonary emboli. On reviewing the radionuclide venogram of the one patient who returned with persistent symptoms and signs of deep venous thrombosis, it was found that the initial radionuclide venogram was misinterpreted. These findings suggest that a negative radionuclide venogram, properly performed and interpreted, implies the absence of clinically significant deep venous thrombosis.

CT scan of retroperitoneal hematoma with neuropathy.

A hematoma in the left iliacus muscle induced by anticoagulant therapy and causing a femoral neuropathy was demonstrated by CT scan. The scan returned to normal after the surgical evacuation of the hematoma. Other possible uses of the CT scan to demonstrate neurological lesions in this region are discussed.

Studies on glucagon secretion using isolated islets of Langerhans of the rat.

Glucagon secretion and its control have been studied in perifused isolated islets of Langerhans of the rat. It was shown that a low concentration of glucose per se does not cause increased glucagon secretion, but that at low glucose concentrations the amino acid arginine stimulates a biphasic secretory response. Such amino acid stimulated glucagon secretion can be suppressed by increasing the glucose content of the perifused media from 1.67 to 5.5 or 16.7 mM; insulin secretion is also then increased. Since high concentrations of added porcine insulin (10 mU/ml) did not affect amino acid stimulated glucagon secretion at low glucose concentration, it was concluded that high concentrations of glucose and not insulin secreted in response to that glucose are probably responsible for suppression of glucagon secretion. At low concentrations of glucose, epinephrine (2.5 X 10(-7) M) also stimulated glucagon secretion. It is concluded that isolated rat islets of Langerhans can be used for the study of glucagon secretion in vitro, and that substances appearing in the blood in vivo at low glucose concentrations are probably responsible for increased glucagon secretion under conditions associated with hypoglycemia.