[Lambert-Eaton Myasthenic Syndrome associated with vocal cord carcinoma]. / Syndrome myasthénique de Lambert-Eaton associé à un carcinome épidermoïde de la corde vocale.

INTRODUCTION: Lambert-Eaton Myasthenic Syndrome (LEMS) is an autoimmune channelopathy in which patients produce autoantibodies directed against voltage-gated calcium channels. LEMS is paraneoplastic in 50% of patients, most frequently associated with small cell lung carcinoma. We describe a case of paraneoplastic LEMS associated with a vocal cord carcinoma. OBSERVATION: A 64-year-old man developed in five months muscle weakness affecting gait. Clinical examination showed proximal muscular deficiency, areflexia and dysphonia. Electrophysiologic study showed potentiation greater than 500% after post exercise facilitation and 76 percent increment response at high-rate repetitive nerve stimulation (20Hz). Diagnosis of LEMS was confirmed by electrophysiologic study and anti-voltage gated calcium channel antibodies (90pM, positive value greater or equal to 70pM). Left vocal cord lesion histology showed epidermoid carcinoma. A combination of vocal cord tumor removal by endoscopy and treatment by pyridostigmine, 3-4 diaminopyridine and intravenous human immunoglobulin improved neurological symptoms. CONCLUSION: Paraneoplastic syndromes in association with cancers of the larynx and hypopharynx are unusual. Only two cases are reported with LEMS associated with larynx carcinoma. We describe an unusual case of LEMS associated with a left vocal cord carcinoma.

Serum concentrations of follicle stimulating hormone may predict premature ovarian failure in FRAXA premutation women.

It is now recognized that female carriers of fragile X premutations are at increased risk of premature ovarian failure. We have studied 51 premenopausal women from fragile X families, to determine whether premutation carriers have variations in the hormonal markers of menopause, compared to full mutations and controls. We found a significant increase in serum follicle stimulating hormone in premutation carriers, suggesting that as a group they will enter menopause before full mutation carriers and unaffected controls. These results have important implications for fertility in these women.

Induction from a single instance: formation of a novel category.

This study examines whether preschoolers can use information from a known category to induce a characteristic attribute of a novel, contrasting category based on a single instance. We showed 32 four-year-olds three instances of a Given Category and one instance of a Target Category. These objects could vary along two attribute dimensions, such as color and shape. All instances of the Given Category shared identical values of one attribute (e.g., all were blue), but could have different values of the other attribute (e.g., a circle, a square, and a triangle). The single instance of the Target Category was different from the Given on both attribute dimensions (e.g., a red diamond). Children gave yes/no judgements as to whether additional objects were instances of the Target Category. There were two possible sources of information about the relevance of an attribute to classification: explicit (labeling) and implicit (variation in the Given Category). There were four conditions such that each source of information was either available or not. Both types of information were effective in eliciting inductions of the relevant kind of attribute and the characteristic value of this attribute in the novel category (explicit: p = .0004; implicit: p = .031). This suggests that children use an inductive bias that the instances of two related but distinct categories tend to be alike in the same way.

Countable entities: developmental changes.

The canonical countable entity for 3- and 4-year-old children is a discrete physical object. When children were asked to count labeled entities such as "forks", they counted each detached part of a fork as a separate entity. When asked to count kinds ("How many kinds of animals?") or properties ("How many colors?"), where each kind or property was exemplified by several separate objects, they included each discrete object in their count. Their counts of classes were more accurate in the absence of objects, or in the presence of a single member of each class, than in the presence of several members of each class. Young children are evidently predisposed to process discrete physical objects. Evidence is presented that, developmentally, this bias precedes learning to count. It is proposed that this discrete physical object bias facilitates mastery of counting.

The class-inclusion task: question form and distributive comparisons.

The class-inclusion task is regarded by Piaget as a measure of the child's mastery of the structure of hierarchical classification. Class-inclusion was improved by changing the wording of the question to conform to standard English usage. A theoretical argument is offered that the child's difficulties with this task derive from confusion of collective comparisons, in which properties of classes are compared, and distributive comparisons, in which properties of elements are compared. A grammatical constraint on expression of distributive comparisons--an element of a class cannot be compared to an element of an included subclass--is hypothesized to be overgeneralized to expressions referring to collective comparisons such as the class-inclusion task. This hypothesis accounts for the improvement in class-inclusion performance with changes in wording of the question and for the finding that young children's response to class-inclusion questions and to ungrammatical requests for comparison of an element of a class and an element of an included subclass are similar: the children respond readily but understand wrongly that the comparison involves coordinate classes.

Bulk laxative efficacy of a psyllium seed hydrocolloid and of a mixture of cellulose and pectin.

The cellulose/pectin combination (C/P) investigated in this study is as efficacious as a psyllium seed product widely used as a bulk laxative. Because of its physical characteristics (whiteness, lack of flavor and odor, lack of gelling upon standing), it is easy to use as a component of baked foods, sauces, drinks, stews, and in other recipes. Given its fecal bulking equivalence to the popular psyllium-based products, C/P offers advantages to the patient who takes a bulking agent regularly because of the wide choice of methods of consumption, ensuring better compliance over long periods of time. This cellulose/pectin combination appears to be a viable alternative to the limited choice presently available to the bulk laxative user and could also be used as a plant fiber supplement whenever this is desirable.

Recent progress in dietary fiber (plantix) in human nutrition.

Dietary fiber was extensively discussed in an article by G.A. Spiller and R.J. Amen in this journal in 1975 (Volume 7 Issue 1). The progress in this field has been tremendous in the past 2 years. What was an uncertain field in 1975 and what at that time to some investigators still appeared as a hypothesis or fad without much proof has turned into a much more respected part of nutritional sciences. The scientific quality of recent studies on dietary fiber in human nutrition shows a great deal of sophistication and care. Improved analytical methodologies are being used more extensively. Many nutritionists and clinicians have accepted the fact that a reasonable increase in the dietary fiber intake in the U.S. and U.K would be advisable. In this article, the possible beneficial effects of dietary fiber on health, the possible harmful side effects, and the food science aspects are carefully discussed after an update on chemistry, analytical procedures, and nomenclature. Undoubtedly, dietary fiber has found a new niche in the sciences of nutrition, medicine, epidemiology, and foods.

Mariner 9 television reconnaissance of Mars and its satellites: preliminary results.

At orbit insertion on 14 November 1971 the Martian surface was largely obscured by a dust haze with an extinction optical depth that ranged from near unity in the south polar region to probably greater than 2 over most of the planet. The only features clearly visible were the south polar cap, one dark, spot in Nix Olympica, and three dark spots in the Tharsis region. During the third week the atmosphere began to clear and surface visibility improved, but contrasts remained a fraction of their normal value. Each of the dark spots that apparently protrude through most of the dust-filled atmosphere has a crater or crater complex in its center. The craters are rimless and have featureless floors that, in the crater complexes, are at different levels. The largest crater within the southernmost spot is approximately 100 kilometers wide. The craters apparently were formed by subsidence and resemble terrestrial calderas. The south polar cap has a regular margin, suggsting very flat topography. Two craters outside the cap have frost on their floors; an apparent crater rim within the cap is frost free, indicating preferentia loss of frost from elevated ground. If this is so then the curvilinear streaks, which were frost covered in 1969 and are now clear of frost, may be low-relief ridges. Closeup pictures of Phobos and Deimos show that Phobos is about 25 +/-5 by 21 +/-1 kilometers and Deimos is about 13.5 +/- 2 by 12.0 +/-0.5 kilometers. Both have irregular shapes and are highly cratered, with some craters showing raised rims. The satellites are dark objects with geometric albedos of 0.05.