Altered resting-state functional connectivity in emotion-processing brain regions in adults who were born very preterm.

BACKGROUND: Very preterm birth (VPT; <32 weeks of gestation) has been associated with impairments in emotion regulation, social competence and communicative skills. However, the neuroanatomical mechanisms underlying such impairments have not been systematically studied. Here we investigated the functional integrity of the amygdala connectivity network in relation to the ability to recognize emotions from facial expressions in VPT adults. METHOD: Thirty-six VPT-born adults and 38 age-matched controls were scanned at rest in a 3-T MRI scanner. Resting-state functional connectivity (rs-fc) was assessed with SPM8. A seed-based analysis focusing on three amygdalar subregions (centro-medial/latero-basal/superficial) was performed. Participants' ability to recognize emotions was assessed using dynamic stimuli of human faces expressing six emotions at different intensities with the Emotion Recognition Task (ERT). RESULTS: VPT individuals compared to controls showed reduced rs-fc between the superficial subregion of the left amygdala, and the right posterior cingulate cortex (p = 0.017) and the left precuneus (p = 0.002). The VPT group further showed elevated rs-fc between the left superficial amygdala and the superior temporal sulcus (p = 0.008). Performance on the ERT showed that the VPT group was less able than controls to recognize anger at low levels of intensity. Anger scores were significantly associated with rs-fc between the superficial amygdala and the posterior cingulate cortex in controls but not in VPT individuals. CONCLUSIONS: These findings suggest that alterations in rs-fc between the amygdala, parietal and temporal cortices could represent the mechanism linking VPT birth and deficits in emotion processing.

Gender differences in the sensitivity to negative stimuli: cross-modal affective priming study.

BACKGROUND: There is evidence showing that men and women differ with regard to the processing of emotional information. However, the mechanisms behind these differences are not fully understood. METHOD: The sample comprised of 275 (167 female) right-handed, healthy participants, recruited from the community. We employed a customized affective priming task, which consisted of three subtests, differing in the modality of the prime (face, written word, and sound). The targets were always written words of either positive or negative valence. The priming effect was measured as reaction time facilitation in conditions where both prime and target were emotional (of the same positive or negative valence) compared with conditions where the emotional targets were preceded by neutral primes. RESULTS: The priming effect was observed across all three modalities, with an interaction of gender by valence: the priming effect in the emotionally negative condition in male participants was stronger compared with females. This was accounted for by the differential priming effect within the female group where priming was significantly smaller in the emotionally negative conditions compared with the positive conditions. The male participants revealed a comparable priming effect across both the emotionally negative and positive conditions. CONCLUSION: Reduced priming in negative conditions in women may reflect interference processes due to greater sensitivity to negative valence of stimuli. This in turn could underlie the gender-related differences in susceptibility to emotional disorders.

Backward and forward visual masking in schizophrenia and its relation to global motion and global form perception.

Whilst visual backward masking deficits in schizophrenia have been reliably reported and may reveal magnocellular dysfunction, forward masking, which may rely more heavily on the parvocellular system, has been under investigated. In a group of 64 schizophrenia patients and 65 matched controls we undertook a visual masking paradigm containing both conditions, together with tests of 'global motion' and 'global form' perception, two 'down-stream' visual tasks reflecting later processing linked to magnocellular and parvocellular function respectively. In the patient group, a significant but small deficit on the masking task, equivalent across forward and backward conditions was seen. Correlations between the masking and motion/form tasks supported the predominant theoretical framework describing the neural processes involved in masking. Performance on the motion and form tasks was differentiated by a trend-level motion processing deficit but near-normal form processing. The results suggest an 'early visual' processing deficit in both magno- and parvocellular systems but one which is only transferred to 'down-stream' processing areas with predominantly magnocellular input.

Spontaneous bony orbital auto-decompression in thyroid ophthalmopathy.

Orbital 'auto-decompression' in TED (thyroid eye disease) is a well recognised phenomenon in older patients where lax orbital septa allow proptosis to decompress the orbit. Bony 'auto-decompression' in TED is a different entity which to the best of our knowledge has not been previously reported. We describe such a case which presented spontaneously, in the absence of trauma or bony pathology, and discuss possible causes.

Corneal toxicity secondary to inadvertent use of benzalkonium chloride preserved viscoelastic material in cataract surgery.

AIMS: To study the long term toxic effects of intraocular benzalkonium chloride (BAC). METHODS: 19 patients exposed to intraocular BAC preserved viscoelastic during cataract surgery in February 1999 developed severe striate keratopathy immediately postoperatively. 16 patients, including two who underwent penetrating keratoplasty, were studied in the period April to June 2000. Ocular symptoms, visual acuity, biomicroscopy, intraocular pressure, dilated funduscopy, specular endothelial microscopy, and corneal pachymetry findings were recorded. The corneal and iris specimens of the two patients who underwent keratoplasty were studied by light, transmission, and scanning electron microscopy. RESULTS: Six males and 10 females, aged 64-98 years, were studied 14-16 months postoperatively. All patients were symptomatic. 12 patients had best corrected visual acuity of 6/12 or better and four patients of between 6/18 and 6/60. Five patients had corneal epithelial oedema and 11 had Descemet's membrane folds. The central corneal thickness, 620 (SD 71) microm, in affected eyes was significantly higher (p<0.005, two tailed paired t test) than that of the contralateral eyes, 563 (SD 48) microm. The endothelial cell density was significantly lower (p<0.0001, two tailed paired t test) in affected eyes: 830 (SD 280) cells/mm2 v 2017 (SD 446) cells/mm2. The mean average cell area was significantly higher in the BAC treated eyes: 1317 (SD 385) microm2 v 521 (SD 132) microm2. There was no significant difference in the coefficient of variation of cell size between the two eyes (p=0.3, two tailed paired t test). Two corneal specimens displayed morphological features of bullous keratopathy and other non-specific abnormalities. Extracellular melanosomes were present in a portion of the iris of one case. CONCLUSION: BAC is toxic to the corneal endothelium when used intraocularly, leading to severe striate keratopathy. This cleared in most cases but left varying degrees of residual stromal thickening in all eyes. If penetrating keratoplasty is required the results are excellent.

Repair of transversely incised abdominal wall fascia in a rabbit model.

OBJECTIVE: To compare several commonly used methods of closing transversely incised anterior abdominal wall in order to determine which technique results in the strongest incisional tensile strength. METHODS: Thirty-six rabbits were randomized to receive either interrupted or continuous closure with 0-Vicryl. Within these groups, each animal was randomized to one of three different bite and interval techniques: 1-cm bites/0.5-cm intervals, 1-cm bites/1-cm intervals, and 2-cm bites/1-cm intervals. Each rabbit received three to four transverse abdominal wall incisions of approximately 3-8 cm in length. The incisions were excised en bloc and stored at -70C at postoperative week 1, 2, or 4 in a random fashion. Representative 1-cm strips were harvested from each incision after thawing. The Instron tensiometer was used to determine the maximum intrinsic tensile strength required to disrupt each tissue strip at the incision. Statistical analysis was performed using analysis of variance, two-sample t test, Scheffé multiple comparison, and Kruskal-Wallis test. RESULTS: Two hundred thirty-seven strips were analyzed. The mean maximum tensile strength of all of the interrupted and continuous suture repairs was 48 and 38 lb, respectively (P < .001). The maximum tensile strength for interrupted closures was achieved at week 1 and was similar at week 4. The continuous closure was weakest at week 1 and increased to a maximum value during week 4. There was no difference in maximum tensile strength between the interrupted and continuous closure groups at week 4. There was no significant difference in the maximum tensile strength of the three repair techniques. The mean maximum tensile strength of all specimens was significantly less among those harvested during weeks 1 and 2 compared with week 4 (P = .001). CONCLUSION: In this randomized study, the interrupted closure had a greater maximum tensile strength than the continuous closure in repair of transverse incisions during the first 2 postoperative weeks. Both repair methods were associated with a similar maximum tensile strength at 4 postoperative weeks. Repair techniques using different bite sizes and intervals resulted in similar maximum tensile strengths.

Vesicouterine fistula after cesarean section. A case report.

A 27-year-old woman, gravida 3, para 2002, underwent repeat cesarean section and inadvertent cystotomy, with subsequent development of a vesicouterine fistula. The fistula did not resolve with prolonged bladder catheterization and required total abdominal hysterectomy with resection of the fistula tract and primary closure for definitive treatment.

Partial hydatidiform molar pregnancy presenting with severe preeclampsia prior to twenty weeks gestation: a case report and review of the literature.

A previously healthy 37-year-old Latin American female presented at 17 6/7 weeks gestation with clinical manifestations of preeclampsia. Ultrasound revealed a growth-retarded fetus with hypoechoic bowel, a thickened cystic placenta, bilateral multicystic adnexal masses, and oligohydramnios. The patient had laboratory evidence of hyperthyroidism and the maternal serum alpha-fetoprotein was 12.3 multiples of the mean. Subclinical disseminated intravascular coagulation rapidly ensued and an induction of labor was performed. This was productive of a 110-g female fetus with a markedly distended abdomen and syndactyly. The placenta weighted 650 g with gross hydropic changes throughout. The clinical aspects of this case and review of the literature on partial molar pregnancies will be discussed.

Laser ablation of squamous cell carcinoma in situ of the anal canal. A case report.

A case of squamous cell carcinoma in situ of the anal canal was discovered incidentally during a hemorrhoidectomy in a man. The anal canal was evaluated by colposcopy prior to ablation of the lesion with a CO2 laser. To our knowledge, this technique has not been reported previously.

An unusual cutaneous reaction to anticoagulant therapy.

Unusual complications of warfarin therapy include cutaneous necrosis and the "purple toe syndrome." The latter is more common in men and is not associated with vascular compromise; it usually occurs 3 to 8 weeks after warfarin therapy is begun and may persist for many months after the medication is discontinued. The following is a case of a 63-year-old woman who received warfarin therapy in conjunction with heparin for treatment of a left leg deep vein thrombosis. Approximately 8 hours after receiving her first dose of warfarin (15 mg), she developed acute pain, edema, and discoloration of the entire left leg to the mid-thigh, most prominent in the left great toe. After discontinuation of warfarin therapy, her symptoms completely resolved within 48 hours. This may be a report of a new cutaneous lesion associated with anticoagulant therapy.

Retrobulbar phenol injection in blind painful eyes.

Retrobulbar phenol injection was used as a neurolytic to manage blind chronically painful eyes in ten patients. The cause of the blind painful eye was absolute glaucoma in eight of the ten eyes. We used 1.5mL of 1:15 (6.7%) aqueous phenol solution in each case. None of the patients experienced any pain from the injection. Seven patients obtained complete pain relief after the procedure, and one patient had some improvement. We found a range of duration of pain relief of 4.5 to 48 months (mean, 15 months), which compares favorably with retrobulbar alcohol injection. We believe retrobulbar phenol injection is preferable to alcohol. It has the advantage of being less painful during injection because of its local anesthetic properties.

Alteration of the stromal architecture and depletion of keratan sulphate proteoglycans in oedematous human corneas: histological, immunochemical and X-ray diffraction evidence.

The structure and content of the extracellular stromal matrix of several oedematous human corneas was investigated using electron microscopy, X-ray diffraction and biochemical techniques. Electron microscopy revealed the presence of wavy lamellae and various sized collagen-free 'lakes' within the stroma of the oedematous corneas, with their posterior sections containing by far the largest 'lakes'. The existence of 'lakes' was supported by the equatorial X-ray diffraction evidence. Staining the oedematous corneas with Cuprolinic blue prior to electron microscopical and meridional X-ray diffraction studies demonstrated a loss of stromal proteoglycans normally associated with collagen. Immunochemical evidence demonstrated reduced levels of antigenic keratan sulphate in the oedematous corneas while biochemical techniques revealed constant chondroitin sulphate levels in the same corneas.

Automated chromatographic determination of chlorhexidine in pharmaceutical preparations.

An automated method for the determination of chlorhexidine (Hibitane) and its salts in formulated pharmaceutical products is described. The equipment consists of a high efficiency liquid chromatograph, a variable wavelength high sensitivity ultraviolet spectrophotometric detector, the output of which is monitored simultaneously by a suitable recorder, and a digital computer. The sample is automatically introduced onto a 10-cm silica gel column by use of a slide valve. Results are calculated and printed out by the computer.

Parasites of the black-tailed jackrabbit in north central Colorado.

Forty-four black-tailed jackrabbits, Lepus californicus melanotis Mearns, 1890, were collected near Denver from August, 1972, through July, 1973, and amined for parasites. Recovered parasites and their infection rates were: Eimeria sp. 100%, Cittotaenia sp.27%, coenuri of Multiceps sp. 57%, Cediopsylla inaequalis 14%, Hoplopsyllus affinis 9%, Haemodipsus setoni 2%, Dermacentor andersoni 14%, and Haemaphysalis leporis-palustris 25%.