Amygdalar and hippocampal volumetry in control participants: differences regarding handedness.

BACKGROUND AND PURPOSE: Amygdalar and hippocampal volume measurements indicate a right-greater-than-left asymmetry for right-handed normal participants in most studies. The purpose of this study was to compare amygdalar and hippocampal volume ratios between right- and left-handed participants. METHODS: Amygdalar and hippocampal volume measurements were performed in 34 (20 right-handed and 14 left-handed) normal participants. All participants completed a 10-item handedness questionnaire. The MR imaging sequence was a 3D T1-weighted gradient-echo acquisition of the whole brain (24/6 [TR/TE]; flip angle, 25 degrees). MR images were spatially normalized, and volumes were painted with a 1.0-mm(3) resolution cursor on an SGI workstation. RESULTS: In right-handed participants, the amygdala and hippocampus (P <.001 for both) were significantly larger on the right side than on the left. The left-handed group did not show a significant difference between right- and left-sided structures. Right-to-left volume ratios differed significantly between right- and left-handed participants for both amygdalar (P <.02) and hippocampal (P <.01) structures. Gender did not affect right-to-left amygdalar and hippocampal volume ratios in right- or left-handed participants. CONCLUSION: Handedness, but not gender, seems to affect right-to-left amygdalar and hippocampal volume ratios.

Location-probability profiles for the mouth region of human primary motor-sensory cortex: model and validation.

The mouth representation of the human, primary motor cortex (M1) is not reliably identified by surface anatomy but may be reliably localized by means of spatial coordinates. For this report, three quantitative metanalyses were performed which jointly described the mean location, location variability and location-probability profiles of the human M1-mouth representation. First, a literature metanalysis of intersubject functional-area variability was performed using eleven, per-subject studies, each of which reported a coordinate-referenced measure of intersubject variability for one or more brain areas. From these data, a weighted-mean value for intersubject variability was computed, which proved to be small (5.6 mm, standard deviation), consistent across coordinate axes (x, y, z), and consistent across brain areas. Second, a literature metanalysis of the location of M1-mouth was performed using seven, coordinate-referenced, group-mean studies (71 subjects in all), each of which reported a grand-average location for M1-mouth. From this, a weighted-mean location and weighted values for total variability (interlaboratory plus interindividual) were determined. Using these two literature metanalyses as input data, location-probability profiles were computed for the cardinal axes (x, y, and z) of the reference space, using the functional volumes modeling (FVM) statistical model. Third, an original-data metanalysis was performed on in-house PET data from 30 normal subjects performing overt-speech tasks. M1-mouth's mean location, location variability, and location-probability profiles were consistent with those conjointly modeled by FVM from the two literature metanalyses. Collectively, these observations provide a detailed, consensus probabilistic description of the location of the human M1-mouth representation in standardized coordinates.

Automated Talairach atlas labels for functional brain mapping.

An automated coordinate-based system to retrieve brain labels from the 1988 Talairach Atlas, called the Talairach Daemon (TD), was previously introduced [Lancaster et al., 1997]. In the present study, the TD system and its 3-D database of labels for the 1988 Talairach atlas were tested for labeling of functional activation foci. TD system labels were compared with author-designated labels of activation coordinates from over 250 published functional brain-mapping studies and with manual atlas-derived labels from an expert group using a subset of these activation coordinates. Automated labeling by the TD system compared well with authors' labels, with a 70% or greater label match averaged over all locations. Author-label matching improved to greater than 90% within a search range of +/-5 mm for most sites. An adaptive grey matter (GM) range-search utility was evaluated using individual activations from the M1 mouth region (30 subjects, 52 sites). It provided an 87% label match to Brodmann area labels (BA 4 & BA 6) within a search range of +/-5 mm. Using the adaptive GM range search, the TD system's overall match with authors' labels (90%) was better than that of the expert group (80%). When used in concert with authors' deeper knowledge of an experiment, the TD system provides consistent and comprehensive labels for brain activation foci. Additional suggested applications of the TD system include interactive labeling, anatomical grouping of activation foci, lesion-deficit analysis, and neuroanatomy education.

Functional volumes modeling: scaling for group size in averaged images.

Functional volumes modeling (FVM) is a statistical construct for metanalytic modeling of the locations of brain functional areas as spatial probability distributions. FV models have a variety of applications, in particular, to serve as spatially explicit predictions of the Talairach-space locations of functional activations, thereby allowing voxel-based analyses to be hypothesis testing rather than hypothesis generating. As image averaging is often applied in the analysis of functional images, an important feature of FVM is that a model can be scaled to accommodate any degree of intersubject image averaging in the data set to which the model is applied. In this report, the group-size scaling properties of FVM were tested. This was done by: (1) scaling a previously constructed FV model of the mouth representation of primary motor cortex (M1-mouth) to accommodate various degrees of averaging (number of subjects per image = n = 1, 2, 5, 10), and (2) comparing FVM-predicted spatial probability contours to location-distributions observed in averaged images of varying n composed from randomly sampling a 30-subject validation data set.

The anaesthetic management of autistic children.

Autistic children are difficult to manage and there are no anaesthesia studies to suggest management strategies. We present five case reports which describe an integrated management program taking into account the special needs of autistic children and their families. We describe a method of early warning and recognition of these patients and the establishment of a database to allow review of our program. We also present a process to minimize the stress and problems inherent in the conventional admission process. Oral ketamine (6 to 7 mg/kg) has proven to be the most reliable preoperative sedative for these patients.

Automated labeling of the human brain: a preliminary report on the development and evaluation of a forward-transform method.

A forward-transform method for retrieving brain labels from the 1988 Talairach Atlas using x-y-z coordinates is presented. A hierarchical volume-occupancy labeling scheme was created to simplify the organization of atlas labels using volume and subvolumetric components. Segmentation rules were developed to define boundaries that were not given explicitly in the atlas. The labeling scheme and segmentation rules guided the segmentation and labeling of 160 contiguous regions within the atlas. A unique three-dimensional (3-D) database label server called the Talairach Daemon (http://ric.uthscsa.edu/projects) was developed for serving labels keyed to the Talairach coordinate system. Given an x-y-z Talairach coordinate, a corresponding hierarchical listing of labels is returned by the server. The accuracy and precision of the forward-transform labeling method is now under evaluation.

Soot morphology: an application of image analysis in high-resolution transmission electron microscopy.

Interest in the fine structure of soots and carbon blacks is motivated by a variety of possible applications. The structure provides information on the origins of the particles and on their adsorptive and reactive properties. This paper describes a method for quantification of the structure of soots and carbon blacks based on direct electron microscopic observation followed by image analysis of these materials. High-resolution transmission electron microscopy (HRTEM) provides a very detailed observation of particle structure. The differences in soot structure, because of its complexity, may not be easily quantifiable with the human eye; therefore, high-level computer software has been used to manipulate HRTEM images. This technique involves the application of fast Fourier transforms (FFT) to single particles and the measurement of characteristic parameters such as interplanar spacings and crystallite sizes from these particles. The methodology and application of this characterization technique are presented here. Results are shown for different samples obtained from soot and carbon black particles selected to illustrate the capabilities of the methodology. Quantitative information can be obtained on structural characteristics, e.g., interplanar spacing, circularity, orientation, elongation, and length distribution of lattice fringes, as well as on the fractional coverage of the extracted pattern.

Characterization by scanning transmission electron microscopy of silica particles from alveolar macrophages of coal miners.

The structure and composition of silica-rich particles recovered by lavage from the lungs of three active miners with different medical histories were studied using high-resolution electron microscopy and chemical microanalysis. The results are compared to the similarly determined structure and composition of respirable-size mineral particles obtained from roof-bolter dust-box samples from two coal mines of widely different bulk quartz concentrations. The results show that the lungs of the miners contain silica-based particles with structures not found in the mine samples. Also, the particle structures and compositions found in the macrophages were different in each of the miners. The results suggest that possibility that intracellular processes may affect the susceptibility of individuals to silica-induced pneumoconioses.

Professional attitudes toward hospice care.

Among studies made to determine the need for and feasibility of a hospice program at a major university hospital, a survey was made of the hospital professional staff's attitudes towards hospice care. The anonymous questionnaire was distributed in July 1983 to 395 faculty physicians, Department of Medicine house staff, hospital nurses, and clinical social workers. Among the 243 respondents (62% response rate), only 38% felt that current services were "satisfactory," with 90% of respondents indicating that the hospital needs a hospice program.

Effects of preparatory patient education for radiation oncology patients.

Sixty cancer patients undergoing their first course of radiotherapy were assigned to one of two patient education conditions as they entered treatment: patients in the high-information condition were shown an audiovisual program, presenting procedural and sensory information about radiotherapy; patients in the low-information condition received standard care without exposure to the patient education program. On the basis of psychologic testing, patients were also classified on "vigilant-avoidant" and "repression-sensitization" coping style dimensions. Outcome variables, assessed during the first and last weeks of treatment (T1 and T2, respectively) induced ratings of treatment-related knowledge, state anxiety, and total mood disturbance. Preparatory patient education produced positive results regardless of coping style. Patients in the high-information condition showed significantly greater treatment-related knowledge (at T1) and less emotional distress (at T2). There was no significant main effect for coping style, nor was there an interaction effect (coping style by intervention condition). Results are discussed in terms of the manifest need for preparatory information in radiation therapy settings, the role of coping style factors, and the clinical utility of patient education interventions.

Cancer counseling by telephone help-line: the UCLA Psychosocial Cancer Counseling Line.

This paper describes the Psychosocial Cancer Counseling Line (PCCL) of the University of California at Los Angeles, a National Cancer Institute-supported communications project in which the feasibility of providing psychological support to cancer patients and their significant others by telephone has been explored. Staffed by a combination of professional and paraprofessional volunteer counselors, the PCCL provides (a) direct telephone counseling to cancer patients, their families, and their friends; (b) referrals, when necessary, to community resources relevant to the psychosocial needs of callers; and (c) telephone consultation and information to health professionals. Call-record data reveal that the service is used mainly by family and friends of patients (45 percent of callers) and by patients themselves (23 percent), who represent a wide range of cancer diagnoses. Demographically, the modal caller is a well-educated, white, non-Hispanic woman in her thirties. Among the many different psychosocial concerns presented by callers, the most frequently discussed issues are requests for referral to a support group, anxiety associated with the disease or its treatment, family problems engendered or exacerbated by illness, and difficulties in doctor-patient communications. On the basis of the PCCL experience, the author argues that a telephone counseling service can perform important functions within the broad spectrum of psychosocial services needed by cancer patients and their families. These functions include provision of information, needs assessment, linkage to health professionals, psychological interventions during intervals between in-person contacts, provision of continuing emotional support not available elsewhere, and outreach to psychologically underserved populations.

Death education for oncology professionals: a personal construct theory perspective.

Using observations from a psychosocial training program for oncology professionals, this article illustrates how one can model, while training the student, the very methods he or she can adopt in working with patients and families. One starts with an elicitation of the student's (patient's) operative personal constructs and then devises strategies to elaborate, integrate, loosen, tighten, preempt, or take other action, as needed. The very means used to promote movement within the student's own death-related constructs can be adopted for use by him or her in the clinical situation. As the helper's pathways of action and thought with regard to this domain become more comprehensive and as the helper becomes more skilled at moving freely along them, he or she becomes more perceptive and resourceful to those in need.