Photosynthetic phenological variation may promote coexistence among co-dominant tree species in a Madrean sky island mixed conifer forest.

Across much of western North America, forests are predicted to experience a transition from snow- to rain-dominated precipitation regimes due to anthropogenic climate warming. Madrean sky island mixed conifer forests receive a large portion of their precipitation from summertime convective storms and may serve as a lens into the future for snow-dominated forests after prolonged warming. To better understand the linkage between physiological traits, climate variation, and the structure and function of mixed conifer forests, we measured leaf photosynthetic (A) responses to controlled variation in internal CO2 concentration (Ci) to quantify interspecific phenological variation in A/Ci-derived ecophysiological traits among ponderosa pine (Pinus ponderosa Lawson and C. Lawson), southwestern white pine (Pinus strobiformis Engelm.) and Douglas-fir (Pseudotsuga menziesii (Mirb.) Franco). Species had similar, positive responses in net photosynthesis under ambient conditions (Anet) to the onset of summertime monsoonal precipitation, but during the cooler portions of the year P. ponderosa was able to maintain greater Anet than P. menziesii and P. strobiformis. Moreover, P. ponderosa had greater Anet in response to ephemerally favorable springtime conditions than either P. menziesii or P. strobiformis. Monsoonal precipitation was associated with a sharp rise in the maximum rates of electron transport (Jmax) and carboxylation (VCmax) in P. menziesii in comparison with P. ponderosa and P. strobiformis. In contrast, species shared similar low values of Jmax and VCmax in response to cool winter temperatures. Patterns of relative stomatal limitation followed predictions based on species' elevational distributions, reinforcing the role of stomatal behavior in maintaining hydraulic conductivity and shaping bioclimatic limits. Phenological variation in ecophysiologial traits among co-occurring tree species in a Madrean mixed conifer forest may promote temporal resource partitioning and thereby contribute to species' coexistence. Moreover, these results provide a physiological basis for predicting the ecological implications of North American mixed conifer forests currently transitioning from snow- to rain-dominated precipitation regimes.

A community-oriented programme for rehabilitation of persons with arthritis.

A community-oriented programme for rehabilitation of persons with arthritis is described. It combines an 8-week ambulatory rehabilitation course (including patient education) at a rehabilitation institution, with long-term self-rehabilitation (at patients' homes), supervised by primary-care nurses. Sixty persons (mean age 54; 80% females) with a 13-year average duration of arthritis, were suffering pain, physical limitations, difficulties in social activities, tension and a tendency to depression. They had completed the course and a 12-month self-rehabilitation at home, and were assessed with the Arthritis Impact Measurement Scales (AIMS) questionnaire on admission to the course, at its completion and 1 year thereafter. Assessment upon completion of the course showed improvement in all areas studied. Measurements at follow-up showed that the majority carried out self-rehabilitation activities and preserved the improved functional status. The programme provided a much-needed service to arthritis sufferers living in the community, and promoted both the reorientation of institution-based rehabilitation professionals towards the community and self-rehabilitation and the cooperation between the institution and primary care.

Juvenile Parkinson's disease and its response to L-dopa therapy.

Four youngsters, between the ages of 13-27 years, presented dystonic foot. Two to three years following the appearance of the dystonic foot, cogwheel rigidity and tremor appeared on the dystonic foot side. Treatment with low doses of levodopa/carbidopa consistently reversed the symptoms. "On-off" phenomena appeared in the first years of treatment and persisted for the entire period of 5 to 15 years of illness. No parkinsonian signs were present when the dystonic foot appeared. Based on our observations and on a review of the literature, we conclude that responsiveness to low doses of L-dopa is the major marker of juvenile Parkinson's disease.

Activation of paraplegic patients by functional electrical stimulation: training and biomechanical evaluation.

A training method for the activation of the lower limb muscles of paraplegics by functional electrical stimulation (FES) for standing and walking is described. It consists of a daily program which does not interfere with the normal routine of the patient. The treatment of four patients, paralysed form 7 to 30 years, is described. In these patients, a good standing position was achieved by stimulating the quadriceps, sometimes supplemented by the gluteus maximus or medius muscles. Gait was obtained by activation of the flexion reflex in a single stimulation and by tilting the trunk. Difficulties during gait were encountered due to the strong adduction of the legs. No mechanical support was required for locking of the lower limb joints. However, to maintain the equilibrium of the body, external support such as parallel bars, walker or Canadian crutches were used. During treatment gait improved due to reduction of spasticity and better stability of the body. Biomechanical measurements of weight bearing on the legs indicated values ranging between 41 to 65% of the body weight. During gait, a steady improvement of velocity was noted, with a parallel decrease in stance and stride times.

Pure sensory polyneuropathy of herpes virus origin associated with meningoencephalitis. A case report.

A patient who had meningoencephalitis and corneal inflammation originating in a herpes virus infection sustained severe pure sensory polyneuropathy with superficial pain sensitivity and proprioceptive sensory deficits. The sensory deficiencies were diagnosed both in clinical and in electromyographic testings. The clinical EMG picture pointed to a pure sensory polyneuroplathy with a viral background according to blood serum and CSF examinations.