Paraspinal ultrasonography: lack of accuracy in evaluating patients with cervical or lumbar back pain.

This study evaluates the ability of paraspinal ultrasonography to identify abnormal echogenicity in patients with cervical or lumbar back pain, or both. Paraspinal ultrasonography was performed on 82 subjects, including 23 asymptomatic controls. Echogenicity in the region of nerve roots and facets was assessed. Readings were correlated with location of patients' symptoms, if any. Receiver operating characteristic analysis demonstrated that evaluation of nerve roots by all four readers did not differ significantly from chance (0.07 < P < 0.99). Specificities ranged from 0 to 0.68. Kappa values were 0.06 for cervical and -0.06 for lumbar spine. Ultrasonography was unable to demonstrate abnormal echogenicity adjacent to facets in symptomatic patients. Paraspinal ultrasonography is neither accurate nor reproducible in evaluating patients with cervical and lumbar back pain.

Superficial melanoma metastases: appearances on gray-scale and color Doppler sonography.

OBJECTIVE: The purpose of this study was to describe the sonographic appearances of melanoma metastases of the skin, subcutaneous tissues, and superficial lymph nodes. MATERIALS AND METHODS: Gray-scale sonography was performed on 31 superficial melanoma metastases in 18 patients. Discreteness of borders, contours, echogenicity, echotexture, and degree of acoustic through-transmission were evaluated for each lesion. Color Doppler sonography was also performed on 25 of the 31 lesions, by which the amount of internal color flow was qualitatively assessed. RESULTS: Twenty-eight (90%) of the 31 metastases had well-defined borders. Contours were smooth in 17 (55%), lobulated in 12 (39%), and spiculated in two (6%). Nineteen metastases (61%) were hypoechoic to muscle, 10 (32%) were isoechoic, and two (6%) were hyperechoic. Echotexture was homogeneous in six lesions (19%), mildly heterogeneous in 13 (42%), moderately heterogeneous in 11 (35%), and markedly heterogeneous in one (3%). Twenty-two lesions (71%) showed enhanced acoustic through-transmission. Of the 25 melanoma metastases for which we performed color Doppler sonography, 18 (72%) had internal arterial color flow and seven (28%) did not. The flow was characterized as mild in 13 (72%) of 18, moderate in four (22%), and marked in one (6%). CONCLUSION: On sonography, superficial melanoma metastases typically are well-defined hypoechoic lesions with smooth or lobulated contours, mild to moderate heterogeneity, and enhanced acoustic through-transmission. Internal flow revealed by color Doppler sonography is present in many, but not all, superficial melanoma metastases.

Religion as a resource for bereaved parents.

This paper addresses the relationship between bereavement and religious beliefs for parents. In-depth, qualitative interviews of twenty-seven couples were used to address the question of the relative value of religion as a coping resource during grief. Also addressed were ways in which religion was a positive resource (enhancing recovery), a neutral resource (having no impact), or a negative resource (retarding recovery). Conclusions are presented regarding the resource value of religion and ways in which others, primarily clergy, family, and friends, can enhance positive and minimize negative impact of religion during bereavement.

Oxidized glutathione modulates N-methyl-D-aspartate- and depolarization-induced increases in intracellular Ca2+ in cultured rat forebrain neurons.

We have investigated the interaction of reduced and oxidized glutathione (GSSG) with intracellular Ca2+ increases produced by N-methyl-D-aspartate (NMDA), kainate and KCl in primary cultures of forebrain neurons derived from fetal rats. Responses to NMDA, applied with glycine, were inhibited by GSSG (10 mM), but were unaffected by reduced glutathione and L-cysteine. Inhibition by GSSG was still apparent after cells were oxidized by 5,5'-dithio-bis-2-nitrobenzoic acid, and this effect showed spontaneous but only partial reversal. This suggests that modulation of the redox site on the NMDA receptor could not account for all of the effects produced by GSSG. However, the observation that complete recovery from GSSG treatment required exposure of cells to dithiothreitol suggests that oxidation of the redox site contributes to the action of GSSG. GSSG also inhibited responses produced by 50 mM KCl but not those produced by 50 microM kainate. The effects of GSSG on KCl responses were fully and rapidly reversible. These results suggest that high concentrations of GSSG may modulate NMDA receptors, and that some of the actions of GSSG may be mediated by the redox site on the receptor complex.

Parental divorce during childhood and use of violence in dating relationships.

355 women and 173 men university students between the ages of 17 and 23 yr. completed a questionnaire which included Straus's Conflict Tactic Scales, and from which whether the respondents had experienced the divorce of their parents could be assessed. Two hypotheses were tested. First, individuals from divorced families would be more likely to report that violence existed in their current relationship than would individuals from intact families. Second, in those relationships which included violence, individuals from divorced families would report higher levels of violence than would individuals from intact families. Analyses indicated that individuals from divorced families were no more likely to report themselves as experiencing violence in their current relationship than were their cohorts from intact families. However, when the conflict tactic scores for men from divorced, men from intact, women from divorced, and women from intact families were compared, differences were found. Men from divorced families reported levels of violence for themselves that approached significance. Also, men from divorced families reported that their partners' verbal aggression approached significance and that their partners' use of violent behavior reached significance when compared to those of the other groups. These results indicate that having experienced a divorce in one's family may have a greater effect on later relationships for men than for women.