Sessile dislocations by reactions in NiAl severely deformed at room temperature.

B2 ordered NiAl is known for its poor room temperature (RT) ductility; failure occurs in a brittle like manner even in ductile single crystals deforming by single slip. In the present study NiAl was severely deformed at RT using the method of high pressure torsion (HPT) enabling the hitherto impossible investigation of multiple slip deformation. Methods of transmission electron microscopy were used to analyze the dislocations formed by the plastic deformation showing that as expected dislocations with Burgers vector [Formula: see text] carry the plasticity during HPT deformation at RT. In addition, we observe that they often form [Formula: see text] dislocations by dislocation reactions; the [Formula: see text] dislocations are considered to be sessile based on calculations found in the literature. It is therefore concluded that the frequently encountered 3D dislocation networks containing sessile [Formula: see text] dislocations are pinned and lead to deformation-induced embrittlement. In spite of the severe deformation, the chemical order remains unchanged.

A retrospective study of serum levels and electrocardiographic effects of nortriptyline in children and adolescents.

OBJECTIVE: We retrospectively evaluated a large pediatric population treated with nortriptyline (NT) in an outpatient psychopharmacology clinic to assess pharmacokinetic and electrocardiographic (EKG) effects. METHODS: A systematic search revealed 82 children and adolescents treated naturalistically with NT. All patients with available EKGs and serum NT levels were included in the series with the exception of those receiving concomitant antipsychotic agents. Forty-three percent of subjects were receiving medications in addition to NT. RESULTS: Patients received an average (+/- SE) NT dose of 2.0 +/- 0.1 mg/kg yielding mean serum NT levels of 105.5 +/- 7.4 ng/mL. There was a linear relationship of NT dose (mg/kg) to serum NT levels (r = 0.50, p < 0.0001). NT treatment resulted in small increases in heart rate, and PR, QRS, and QTc intervals (all ps < 0.01), of similar magnitude in children and adolescents. Individuals with the highest baseline EKG indices had the least amount of change in those indices with NT treatment. There were only a few statistically significant associations between NT dose or serum NT levels and EKG parameters. NT treatment was significantly associated with the onset of asymptomatic sinus tachycardia (heart rate > 100 beats per minute), and prolongation of the EKG QRS (> 100 msec) and QTc (> 440 msec) intervals. CONCLUSIONS: These findings suggest: (1) NT has a predictable dose to level relationship, (2) the effect of NT on the EKG in this age group is mild and similar to that reported with other tricyclic antidepressants, and (3) there are few age-specific differences in NT-induced EKG changes.

Nortriptyline in the treatment of ADHD: a chart review of 58 cases.

OBJECTIVE: The potential benefit of the tricyclic antidepressant medication, nortriptyline (NT), in the treatment of children and adolescents with attention deficit hyperactivity disorder (ADHD) was evaluated. METHOD: A systematic search was conducted from a computerized data base of all clinic patients in an outpatient pediatric psychopharmacology unit treated with NT for ADHD. The records of the 58 subjects identified (37 children and 21 adolescents) were reviewed for overall response, dose, serum levels, and adverse effects. RESULTS: Ninety-seven percent of the identified subjects had failed to respond to an average of four previous medication trials, 84% had at least one comorbid diagnosis with ADHD, and 47% were receiving at least one concurrent medication. NT doses ranged from 0.4 to 4.5 mg/kg (X +/- SD = 2.0 +/- 1.0 mg/kg) and subjects received NT from 0.4 to 57.9 months (11.9 +/- 14.0 months). Overall, 76% of subjects were considered to have a moderate to marked improvement by an independent rater, which was corroborated by their clinicians. There was no association between response and age, rate of comorbidity, number of previous medication trials, or concurrent pharmacotherapy (all p NS). Although there were no overall differences in serum NT levels between responders and nonresponders, significantly more patients within the suggested therapeutic range in adults of 50 to 150 ng/ml were classified as "markedly improved" than those outside this range (68% versus 35%, p < 0.03). Mild adverse effects were reported in 20 subjects (34%). CONCLUSIONS: These findings suggest that NT may be an effective well-tolerated agent for ADHD children and adolescents. Additional controlled investigations utilizing NT for ADHD should be undertaken.

Nortriptyline treatment of children with attention-deficit hyperactivity disorder and tic disorder or Tourette's syndrome.

Although as many as 50% of patients with Tourette's syndrome (TS) also meet diagnostic criteria for Attention-deficit Hyperactivity Disorder (ADHD), until recently little attention has been paid to ADHD symptoms in the assessment of therapeutic outcome of TS or patients with chronic motor tics (CMT). Because antipsychotics are of limited value in controlling the symptoms of ADHD and stimulants can exacerbate tics, alternative treatments for patients with chronic tic disorder (CTD) (TS or CMT) plus ADHD (CTD+ADHD) patients are direly needed. We examined the efficacy of the tricyclic antidepressant nortriptyline in the treatment of pediatric patients with CTD+ADHD ascertained from systematic chart reviews of all subjects with this diagnosis treated with nortriptyline. Of the 12 identified patients, 67% had significant improvement in CTD symptomatology and 92% significantly improved ADHD symptoms without major adverse effects over an average follow-up period of 19 months. Although the conclusions from this retrospective report can be only seen as preliminary until replicated in a controlled investigation, the magnitude and persistence of the response is encouraging and suggest a therapeutic role for nortriptyline in the treatment of CTD+ADHD patients.

Pelvic abscess: examination and transvaginal drainage guided by real-time ultrasonography.

We have reported a case involving a multiloculated pelvic abscess that was examined, incised, and drained under the guidance of real-time ultrasonography. This method is safe and has certain distinct advantages over more traditional surgical techniques.

Nonimmune hydrops fetalis: clinical experience and factors related to a poor outcome.

Twenty-one cases of nonimmune hydrops fetalis diagnosed at the Medical College of Georgia during a 2-year period are presented. All fetuses satisfied strict diagnostic criteria and were evaluated according to a standard protocol. The corrected mortality rate was 95% with pulmonary hypoplasia being the most common cause of perinatal death. The mean gestational age at diagnosis was 24.8 weeks; in 57% of the cases the cause of nonimmune hydrops fetalis was identified. Fifteen fetuses had serial ultrasound assessment and in 19 cases postnatal evaluation was performed. Two factors that consistently conveyed a poor perinatal outcome were ultrasonographic evidence of malformation and/or the presence of persistent pleural effusions. A method for the quantification of fetal pleural effusions is presented and its clinical relevance is discussed.

[Technic and value of the carbachol nasal test in vasomotor rhinopathies]. / Technique et intérêt du test nasal à la carbacholine dans les rhinopathies vasomotrices.

The carbacholine nasal test assesses "nasal hyperreactivity", particularly its parasympathetic component, in vasomotor rhinopathies. This simple, reproducible test has been applied to two groups of subjects: a group of 26 healthy subjects without any rhinopharyngeal and/or allergic affections, and 10 patients with aperiodic non-allergic (6 cases) or allergic (4 cases) vasomotor rhinopathy, the 4 cases with allergy including 3 allergic to house dust mite and one to house dust mite and grass pollen. Nasal reactivity to carbacholine was evaluated by measuring the amount of rhinorrhea following variable concentrations (1/1000, 1/100, 1/25) and volumes (0,10 to 0,50 ml) of carbacholine solution. Nasal secretion was markedly increased in patients with a vasomotor rhinopathy (1.80 +/- 0.65 ml) when compared with control subjects (0.64 +/- 0.17 ml). The main conclusions to be drawn from this study, and possible applications of this test in rhinology are discussed.