Investigation of the site occupation of atoms in pure and doped TiAl/Ti3Al intermetallic.

Dual-phase TiAl/Ti3Al-alloys consisting of a lamellar structure, comprising gamma-phase plus a small amount of alpha2-phase, with addition of 1, 5 and 10at% Nb were prepared. The samples were investigated by means of field ion microscopy (FIM) and atom probe tomography (APT). The influence of doping elements on the variation of field evaporation and microstructural parameters in the gamma-phase as studied by FIM and APT will be reported in this contribution. The intermetallic gamma-Phase of TiAl exhibits a L1(0)-structure, which has alternating Ti- and Al-planes in the [001]-superstructure direction. Because of the significant difference in the evaporation field strengths of Ti and Al, it is usually not possible to directly distinguish Ti- and Al-planes in this direction in the APT data. Therefore, it is not possible to assign Nb to any plane, as well. To solve this problem an algorithm, using statistical methods, was developed, which allows to inherently distinguish the planes. A comparison of the results for [100]- and [001]-directions shows that Nb prefers Ti-sites. The sequence of field evaporation field strengths, which follows the trend E(Nb) > E(Al) > E(Ti), could also be deduced.

An APT investigation of an amorphous Cr-B-C thin film.

A magnetron sputtered amorphous Cr-B-C thin film was investigated by means of atom probe tomography (APT). The film is constituted of two phases; a Cr-rich phase present as a few nanometer large regions embedded in a Cr-poor phase (tissue phase). The Cr-rich regions form columnar chains oriented parallel to the growth direction of the film. It was found that the Cr-rich regions have a higher B:C ratio than the Cr-poor regions. The composition of the phases was determined as approximately 35Cr-33B-30C and 15Cr-40B-42C (at%), respectively. The results suggest that this type of nanocomposite films has a more complex structure than previously anticipated, which may have an importance for the mechanical and electrical properties.

Improvement in neuropsychological performance in patients with refractory seizures after intensive diagnostic and therapeutic intervention.

Tests of cognitive, perceptual, motor, and memory function were administered to patients with refractory seizures before and after intensive treatment on a specialized epilepsy unit. Improved test performance related to withdrawal of barbiturates and an overall reduction in the number of antiepileptic drugs but not with reduction of seizure frequency.

Patients with pseudoseizures: intellectual and cognitive performance.

We compared cognitive and intellectual performance of patients with pseudoseizures (pseudoseizure-only group), pseudoseizures and epilepsy (mixed seizure group), and generalized epileptic seizures (generalized seizure group). The pseudoseizure-only group performed significantly better on all measures except those of simple motor function. There were no significant differences between those with mixed and generalized seizures. Therefore, cognitive and intellectual performances of patients with pseudoseizures are influenced by the presence or absence of concomitant epilepsy, and suggest that it is necessary to distinguish patients with and without epilepsy in studies of pseudoseizures.

Intellectual development in school-aged children with asymptomatic congenital cytomegalovirus infection.

Congenital cytomegalovirus infection occurs in about 1% of live births. Although symptomatic congenital infection often results in severe developmental deficits and mental retardation, about 90% have asymptomatic infection. Previous studies of the intellectual development in children with asymptomatic congenital cytomegalovirus have resulted in mixed findings. To control for the effects of hearing impairment (which occurs in about 15% of asymptomatic children) on intelligence scores, we tested 18 prospectively followed, normally hearing, school-aged children with asymptomatic congenital cytomegalovirus (15 black, ten male) and 18 controls matched for age, sex, race, school grade, and socioeconomic status. Children were tested via the Wechsler Intelligence Scale for Children-Revised, the Kaufman Assessment Battery for Children, and the Wide Range Achievement Test. Multivariate analysis revealed no differences between groups on intelligence scores or subscales, achievement scores, or incidence of learning disabilities (defined as significant discrepancy between intelligence and achievement), and mean scores for both groups were very close to national norms. It is concluded that the 25,000 children born in the United States each year with asymptomatic congenital cytomegalovirus and normal hearing are not likely to be at increased risk of mental impairment.

Activities of daily living among heart transplant candidates: neuropsychological and cardiac function predictors.

BACKGROUND: The ability of patients to perform day-to-day tasks (e.g., medication management, dietary regulation) is an important concern of transplant teams. METHODS: We studied a clinical series of 75 heart transplant candidates and 38 controls to examine the predictive validity of demographic, neuropsychologic, and cardiac function variables to a performance-based measure of instrumental activities of daily living (IADL) capacity (i.e., Everyday Problems Test, EPT). RESULTS: Multiple regression analyses, controlling for education and race, indicated that neuropsychologic tests accounted for between 34% and 67% of the variance across IADL domains (e.g., cooking, household chores, medication management). The IADL capacity was most consistently predicted by long-standing verbal ability (Shipley Institute of Living Scale-Vocabulary, SILS-VOC) and psychomotor speed and mental flexibility (Trail Making Test-Part B, TMT-B). Similarly, SILS-VOC and TMT-B also tended to show the best operating characteristics (i.e., sensitivity, specificity, positive predictive power, negative predictive power) for detection of dependence across IADL domains. In contrast, cardiac function measures (e.g., cardiac output, mean atrial pressure) were largely unrelated to the patient's performance on the paper-and-pencil EPT task. CONCLUSIONS: Long-standing intellectual ability, and a measure of speeded information processing and mental flexibility are the best predictors of IADL capacity.

Postdoctoral education and training for clinical service providers in health psychology.

It was recommended by the 1983 National Working Conference on Education and Training in Health Psychology (Stone, 1983) that 2 years of postdoctoral education and training be mandated for future licensed health service providers in health psychology. The background for requiring this postdoctoral training, a model for education, criteria for developing programs, issues of funding, and a rationale for accepting this mandate are presented. Highlighted are the stable and consistent growth of health psychology, the need to expand the period of clinical training to meet the many advances in the field, and the challenges that exist for the fully trained clinical health service provider.

Neuropsychological sequelae of minor head injury.

Seventy-one patients with minor head injury were given extensive neuropsychological evaluations 3 months after injury. A significant percentage of the patients demonstrated cognitive impairment, which seemed essentially unrelated to the length of unconsciousness or of posttraumatic amnesia. Impaired patients evidenced memory and visuospatial deficits. Cognitively impaired patients also had difficulty returning to work after injury. The psychological and cognitive impairment that follows minor head injury is discussed in relation to diagnostic and intervention issues.

Two procedures for Kirschner wire osteosynthesis of distal radial fractures. A randomized trial.

BACKGROUND: The treatment of displaced Colles-type fractures of the distal part of the radius remains a challenge. Two procedures for closed reduction and Kirschner wire osteosynthesis of these fractures were compared in a prospective randomized study. METHODS: One hundred consecutive patients with a Colles fracture of the distal part of the radius (AO classification 23-A2, 23-A3, or 23-C1) were treated over an eighteen-month period. One group was managed with the conventional method, described by Willenegger and Guggenbuhl in 1959, in which two Kirschner wires are introduced into the styloid process of the radius. The other group was treated with the Kapandji method, as modified by Fritz et al., in which two Kirschner wires are inserted into the fracture gap and a third is placed through the styloid process. Postoperative care was standardized for both groups and carried out according to a strict procedure. Forty patients who had been operated on according to the modified Kapandji method and forty-one treated with the Willenegger technique were available for follow-up, for a follow-up rate of 81%. The follow-up assessment was performed with a modified version of the Martini score. RESULTS: The median time to follow-up was ten months (range, six to twenty months). The results as assessed with the Martini score were, on the average, good to very good for the patients treated with the Kapandji method and satisfactory to good for the patients treated with the conventional Kirschner wire fixation. The duration of radiographic exposure was significantly shorter with the Kapandji method than with the Willenegger technique. CONCLUSIONS: Conventional Kirschner wire fixation remains a good method of osteosynthesis for the treatment of displaced fractures of the distal part of the radius. We found both the functional and radiographic outcomes of the Kapandji method to be significantly better than those of the Willenegger technique. LEVEL OF EVIDENCE: Therapeutic study, Level I-1a (randomized controlled trial [significant difference]). See Instructions to Authors for a complete description of levels of evidence.

Measuring behavior.

In this article, the author provides an overview of the neuropsychologic approach to evaluation of neurologic dysfunction. The various strengths and weaknesses of this methodology are discussed, and the steps of the neuropsychologic evaluation are detailed.

A shortened intermediate version of the Halstead Category Test.

An effort was made to determine whether the intermediate (ages 9-14) version of the Halstead Category Test (HCT) could be shortened to increase clinical utility without altering it's basic psychometric properties. The Long Intermediate Halstead Category Test was administered to four clinical groups. Statistics were conducted to verify that these groups did not relate differentially to the Category Test or other neuropsychological measures. Twelve shortened Category Tests were then extracted. The psychometric properties of these extracted shortened versions were compared to the long version and the three best were selected for further tests. These three shortened versions were then cross validated. Results indicated that the psychometric properties were similar across the shortened versions. The shortest version was there for chosen which best retained the characteristics of the original test.

Epilepsy, neuropsychological deficits, and EEG lateralization.

One hundred eight epileptic patients (59 men, 49 women; 55% partial seizures, 45% generalized) were examined on 45 indices comprising a modified Halstead Neuropsychological Test Battery. Factor analyses identified five dimensions: Verbal Comprehension, Perceptual Organization, Selective Attention, Motor Skills, Abstract Reasoning. These factors are similar to those previously reported for neurocognitive abilities in several different populations. Relative deficits on Verbal Comprehension and Abstract Reasoning were related, as predicted, to left hemispheric dysfunction as indexed by EEG localization. Perceptual Organization demonstrated a further, predictable relationship to right hemispheric function. Deficits on Selective Attention were not clearly lateralized, being correlated with a wide variety of electroencephalographic abnormalities. The implications of these findings for the use of neurocognitive profiles in treatment planning for this population are discussed.

Neuropsychological functioning in patients with asymptomatic congenital cytomegalovirus infection.

Congenital cytomegalovirus (CMV) infection has an affinity for the central nervous system and has been implicated in a variety of neurological impairments. Analysis of cognitive functioning in children with asymptomatic congenital CMV infection, however, has revealed no general intellectual deficits. The present study was designed to explore neuropsychological test performance in these children, compared with healthy control subjects, providing data from more sensitive measures of neurocognitive functioning. The sample consisted of 109 children diagnosed with asymptomatic congenital CMV infection and 173 control subjects who were compared on tests measuring various aspects of perceptual and motor functioning, memory, problem solving, and traditional intelligence measures. Young (41NDASH6 yr) control patients performed significantly better on the Full-Scale but not the Verbal or Performance intelligence quotient (IQ) measures than patients with asymptomatic congenital CMV infection, without accompanying consistent neuropsychological performance differences. However, no IQ or neuropsychological differences were found between groups of older children. The present study adds to the existing literature finding no reliable, lasting differences in IQ scores and adds to our knowledge by finding no reliable, lasting differences in neuropsychological test performance.

Intellectual assessment of children with asymptomatic congenital cytomegalovirus infection.

The findings of previous studies examining the neurocognitive development of children with clinically inapparent (asymptomatic) cytomegalovirus (CMV) infection have demonstrated mixed results. These studies have generally depended on small sample sizes (i.e., < 50). We examined the intellectual development of children with asymptomatic congenital CMV infection using a sample larger than previous studies. Two hundred and four cases aged 5 to 200 months were compared with 177 uninfected siblings ranging in age from 6 to 203 months. Parents were administered the Developmental Profile, a measure of developmental achievement. Children who were older than 30 months were administered an objective intelligence measure. Results of this study showed that children with asymptomatic congenital CMV infection do not demonstrate intellectual impairment, and that they perform similarly to uninfected siblings. Parents tended to overestimate their child's level of functioning regardless of whether the child had CMV infection.

Effects of parathyroidectomy on tissue calcium, phosphorus, magnesium, and copper concentrations in aluminum-loaded uremic rats.

Rats were subjected to a two-stage 5/6 nephrectomy and treated with Al for 2 and 4 wk with a cumulative dose of 4.2 and 8.4 mg of Al, respectively. Other animals were parathyrectomized (PTx) and loaded with 8.4 mg of Al for 4 wk. Total Al, Ca, P, Mg, and Cu contents were analyzed in the liver, kidney, and bone by inductively coupled plasma atomic emission spectrometry (ICP-AES). The results showed that Al given to growing uremic rats significantly increased the content of Al in the liver, kidney, and bone. Moreover, Al treatment increased the liver and kidney Ca levels and decreased the Ca and P values in bone. Previous parathyroidectomy significantly reduced Al accumulation within organs and changes in the Ca and P levels in the bone, liver, and kidney. The result was not influenced by different degrees of renal failure.

Hearing loss and congenital symptomatic cytomegalovirus infection: a case report of multidisciplinary longitudinal assessment and intervention.

More than 6000 children born annually in this country have hearing loss resulting from congenital cytomegalovirus (CMV) infection, the leading nonhereditary congenital cause of hearing loss in children. This exemplary congenital symptomatic CMV case focuses on the results of longitudinal audiologic, educational, medical, psychological, and visual evaluations and intervention. Decreased ocular motor control and visual acuity were observed as was bilateral deterioration of hearing from 3 days though 9 years of age. Treatment with dexamethasone and histamine resulted in almost complete reversal of the most recent progression of hearing loss in the left ear.

The utility of K-correction to adjust for a defensive response set on the MMPI.

This study examined the utility of the K-correction procedure to adjust for a defensive response set on the MMPI. The sample consisted of 61 patients with end-stage lung disease undergoing psychosocial evaluation for transplantation. Participants were separated into defensive and non-defensive groups using a median split on the K scale (defensive group T score 59) as the cutoff score. The MMPI was scored once in the standard manner and then rescored omitting all K-scale items from the clinical scales. As hypothesized, raw score analysis after omitting K-scale items showed the defensive group endorsed significantly fewer items on all five scales involving K-correction (Scales Hs, Pd, Pt, Sc, Ma). Analysis of K-corrected T scores on Scales Hs, Pd, Pt, and Sc using standard procedures showed a significant group difference only on Scale Hs with a higher T score found among the defensive group. The defensive and nondefensive groups were not significantly different in demographic, medical, or psychiatric characteristics suggesting that the tendency to respond in a defensive manner is the major characteristic that distinguishes the two groups. Taken together, these results provide support for the use of the K-correction procedure when examining MMPI clinical profiles among patients with end-stage pulmonary disease undergoing evaluation for transplantation.

Self-report measures among transplant candidates: the impact of evaluative situations.

Experiment 1 was a between-subjects design comparing transplant candidates completing self-report measures under an evaluative versus an anonymous research condition. A cardiac disease group and a healthy community group served as controls. Transplant candidates in the anonymous research condition reported significantly more depression, anxiety, and negative affectivity as compared with transplant candidates in the evaluative condition and community controls. In contrast, the evaluative transplant group (a) did not differ from the community controls on any of the self-report measures, and (b) reported significantly less depression than cardiac disease controls. Experiment 2 was a within-subjects design with transplant candidates completing self-report measures under both an evaluative and an anonymous research condition. Significantly greater anxiety was reported under the anonymous research condition. Social desirability was significantly related to change in self-reported anxiety and depression across conditions, but was unrelated to change in endorsement of personality characteristics.

Tactile-perceptual functioning as a factor in general psychological abilities.

This investigation was designed to study the influence of simple sensory perceptual ability (tactile perception) on various human abilities such as language acquisition, visuo-spatial problem solving, concept formation, motor skills, memory, and learning. Children with documented evidence of impaired brain functions (seizure disorder and corresponding EEG abnormality) and children without evidence or suspicion of neurological impairment were examined. The results suggest that tactile perceptual ability exerts a significant effect on the adequacy of a broad range of human abilities.

Rod-and-frame and MMPI scores for a group of female psychiatric inpatients.

75 recently admitted female psychiatric inpatients were given the rod-and-frame task and the Minnesota Multiphasic Personality Inventory (MMPI). All patients with an admission diagnosis of schizophrenia, organic brain syndrome, or a reported history of alcoholism or previous electroconvulsive therapy were excluded from the study. Personality disturbance, as measured by the MMPI, for the remaining 75 patients, was significantly less severe for extremely high-error (field dependent) rod-and-frame performers than for other patients in the sample. Hospital records and performance on self-rating scales showed, however, that patients with a high rate of error on rod-and-frame performance were subjectively as uncomfortable as the others tested. Results are discussed in terms of the possible contribution of perceptual impairment to the psychological complaints made by these individuals.