Middle fossa cyst presenting as a delayed complication of temporal lobectomy: case report.

Symptomatic middle fossa cysts have not previously been described as complications of temporal lobectomy that has been performed to control complex partial seizures. A patient is described who developed a middle fossa cyst causing mass effect, intracranial hypertension, and neurological deterioration > 2 years after temporal lobectomy for complex partial seizures. An enlarging cyst with cerebrospinal fluid imaging characteristics was detected on neuroimages 1 year before neurological deterioration. The patient was treated by the insertion of a cystoperitoneal shunt for cerebrospinal fluid diversion. The potential causes of an acquired arachnoid cyst and hydrocephalus are discussed.

Discrimination of phase spectra in complex sounds by the bullfrog (Rana catesbeiana).

1. Male bullfrogs at two different natural calling sites were presented with playbacks of synthetic advertisement calls differing in phase spectra. Sounds were presented in a ABA design to analyze the ability of the animals to perceive changes in repeated series of stimuli. 2. The number of individual croaks in an answering call significantly increased over repeated presentations of two of the three stimulus phase types in condition A1. There were significantly fewer croaks to the third stimulus. These data suggest that two stimuli were perceived in a similar manner. 3. Latency of calling to stimuli presented in conditions A and B changed in response to shifts in phase spectrum at a low density calling site. These differences were significant when comparing latency to playbacks where shifts in the phase spectrum changed the temporal fine-structure and waveform periodicity of the stimulus. 4. The increase in number of croaks and decrease in response latency across condition A1 and the increase in latency in condition B suggest that discrimination may take the form of stimulus-specific sensitization. In this context, sensitization might reflect an increase in arousal due to repeated presentation of a salient stimulus. 4. The operation of a hypothetical 'mating call detector', based on linear summation of temporal responses from the eighth nerve, provides output similar to the behavioral results.

A translation of Christopher Jacob Trew's article, "Observations presenting examples of missing palate. 1757.

The following "Observation" appeared (in Latin) in the Deutsche Akademie der Naturforscher Leopoldina of 1757 and to our knowledge has never been published in the English literature. We came across the report in the early 1970s while preparing the report "Cleft lip and cleft palate: one genetic system" (Chabora and Horowitz, 1974). The 1757 paper was translated by a member of the Columbia University Greek and Latin Department, but reached us too late for inclusion in our references. Forgotten for many years, the paper, and its translation, recently came to light in our files. Christopher Jacob Trew's clear description of penetrance and expressivity in a kindred in which both cleft lip and palate and isolated cleft palate are segregating may be something of an historic curiosity at this point, but we expect that others will enjoy reading this early example of a careful and thoughtful pedigree study.

Increased merger activity quickens the pace of antitrust actions.

Antitrust law dates back to the Sherman Act of 1890. However, it is only in the last 10 years that these provisions and their enforcement have been actively aimed at the healthcare industry. Recently, with growing merger activity in health care, antitrust litigation has been increasing. Therefore, it is important to understand the antitrust considerations arising from merger activity and how it could affect the healthcare organization.

CNS toxoplasmosis in acquired immunodeficiency syndrome.

Several distinct patterns of neurological involvement occur in epidemic acquired immune deficiency syndrome (AIDS). Two patients with this disorder had Toxoplasma gondii encephalitis, one suspected and one proved. Computed tomographic (CT) scanning showed focal lesions in both patients. Spinal fluids were remarkable for elevated protein, hypoglycorrhachia, and absence of pleocytosis. In patients with AIDS, focal CT scan findings and serum indication of past T gondii infection should prompt strong consideration of the diagnosis of CNS toxoplasmosis. The absence of specific IgM antibody or rise in IgG antibody titer to T gondii does not exclude this condition in the immune compromised host. In the patient with AIDS, CNS lesions mimicking brain abscess warrant biopsy or empiric therapy for T gondii. Early recognition and initiation of a prolonged or indefinite course of pyrimethamine plus sulfonamide therapy could reduce the mortality associated with this infection in AIDS. Computed tomographic scans, repeated frequently, appear, at present, to be the best guide to monitor the status of CNS involvement.

Practice patterns of recent female dental graduates.

Current practice patterns of female dentists were recorded through a survey of 130 women who received their professional degrees between 1975 and 1981. Replies were received from 95 individuals, a 73% response rate. More than three quarters of the respondents are in private practice full- or part-time. Those in part-time practice most frequently combine that activity with another dental activity such as teaching or hospital service. Most respondents are in general practice, with 24% in various specialty fields. In general, practice patterns of women dentists approximate those of recent male graduates. Important elements that have an effect on individual female practitioners include not only the drive for professional achievement, but also personal factors such as societal attitudes toward professional women and the role of the female dentist as a wife and mother. Unresolved conflicts that exist in these areas require further attention and evaluation by the profession.

Factor analysis of craniofacial morphology in complete bilateral cleft lip and palate.

The lateral roentgencephalograms of 29 children with repaired complete bilateral clefts of the lip and palate (BCLP) were compared with those of an equal number of non-cleft children matched for age (+/- 0.9 yr.) and sex. Of 21 spatial, angular, and linear measurements used to evaluate craniofacial skeletal morphology, 11 showed significant differences between the groups. Using factor analysis, covariation between variables was reduced to a set of six factors: I cranial base; II mandible; III palate; IV lower face; V nasomaxillary-pharyngeal complex; VI clivus. The six-factor solution accounts for 91.7 percent of the variance. Factors II, III, and V provide the best discrimination between BCLP and noncleft individuals.

Bronchoscopic CO2 laser surgery.

The problem of removing or palliating obstructing lesions of the trachea nd bronchi has been solved by using the CO2 laser in conjunction with an endoscopic adaptor. We have used this laser successfully in 18 patients who had this particular problem. The advantages of laser surgery in this area are 1) reduced bleeding, 2) minimal exposure of the surgical field, 3) decreased swelling, 4) decreased postoperative hospital stay and less discomfort, and 5) no tumor spread or seeding. Patient acceptability of this modality is excellent, and general general, as well as local, anesthesia can be used. The results of laser ablation in the tracheobronchial tree have been quite satisfactory and can be repeated as often as necessary.

An analysis of the relationship between posterior dental cross-bite and vertical palatal asymmetry.

The relationship between unilateral posterior cross-bite and vertical proportions of the palatal vault observed in the frontal plane was studied in twenty cross-bite cases wtih asymmetric palates and twenty control cases. The contour of the palate was registered from study models at three different anteroposterior levels with an adjustable template. The tracings of the contours obtained from roentgenograms of the instrument were used to measure the asymmetry of the palate.