Movements and postures of infants aged 3 to 5 months: to what extent is their optimality related to perinatal events and to the neurological outcome?

BACKGROUND: The quality of spontaneous general movements (GMs), assessed in the individual infant, has emerged as one of the most reliable and valid predictors especially of severe neurological impairments. AIMS: To implement a more detailed assessment of GMs and co-existing movements and postural patterns in a rehabilitation clinic, and to examine to what extend is the optimality of movements and postures of infants aged 3 to 5 months related to perinatal events and the neurological outcome. STUDY DESIGN: Prospective study of 41 infants (15 boys and 26 girls; 11 infants born preterm) admitted to the Department of Paediatric Neurology and Rehabilitation of the St. Joseph's Hospital in Kyoto (Japan). OUTCOME MEASURES: Clinical, neurological and psychological status at age 5. RESULTS: Motor optimality at age 3 to 5 months correlated positively with neonatal optimality (r=0.48, p<0.01), especially regarding factors associated with hypoxic events. A non-optimal motor performance (lowest possible scores) predicted cerebral palsy with 100% accuracy. Other adverse outcomes such as developmental delays, developmental coordination disorders, pervasive developmental disorder or attention deficit hyperactivity disorder turned out not to be associated with early motor performance. In 13% of cases absence of fidgety movements proved to be false positives, but their normal appearance along with a smooth concurrent motor performance was solely found in infants with a normal neurological development. CONCLUSION: Assessing the quality of motor performance at age 3 to 5 months considerably improves our ability to identify infants at risk for maldevelopment.

Changes in heart rate with refeeding in anorexia nervosa: a pilot study.

OBJECTIVE: To find differences in heart rate before and after refeeding and to identify which parameters of autonomic activity and endocrine function are associated with these differences. METHODS: Before and after the start of refeeding, body weight, RR interval (RRI), heart rate variability, endocrine function, and energy expenditure were measured in nine female anorexia nervosa patients. RESULTS: After short-term refeeding, mean daytime heart rate rose from 54.9 to 69.4 bpm (P<.05). The changes in sympathetic activity were correlated negatively with the changes in RRI (r=-.933, P<.001). Urine C-peptide, IGF-1, and fT3 increased significantly, and norepinephrine tended to increase. CONCLUSION: We demonstrated that autonomic nervous activity was relevant to changes in heart rate during refeeding, and it is speculated that the increases in insulin secretion, thyroid function, and IGF-1 were responsible for the mechanisms.

Difficulty of food intake in patients with temporomandibular disorders.

PURPOSE: Although patients with temporomandibular disorders (TMD) often report impaired eating, the features of food intake difficulty have rarely been estimated. This study compared subjective difficulty in 4 categories of food intake situations among 3 subgroups of TMD patients. MATERIALS AND METHODS: A total of 511 TMD patients (402 women, 109 men, mean age 36.4 +/- 15.4, range 12 to 82) participated in this study. Subjects were divided into 3 TMD subgroups: myofascial pain (MFP), disc displacement with/without reduction (DD), and arthralgia or osteoarthritis (Arth). Patients' level of food intake difficulty was assessed using a visual analogue scale (VAS) for 4 categories of food intake situations: difficulty in putting food into mouth (PUT), difficulty in biting off foods (BIT), difficulty in grinding down foods (GRD), and overall difficulty in consuming a meal (OAL). RESULTS: Nearly all patients (98.6%) exhibited food intake difficulty in at least 1 category. In the category of PUT, the DD group exhibited significantly more difficulty than the MFP and Arth groups (P < .048), and the Arth group had a higher VAS score than the MFP group (P = .030). With regard to BIT and GRD, there was no significant difference among the TMD subgroups. In OAL, the DD group showed more difficulty than the MFP group (P = .046). CONCLUSION: TMD patients experienced impaired food intake ability. In particular, the DD group experienced more difficulty than the MFP group. Concerns about types of food and food intake behavior for each TMD subtype should be taken into account in the management of TMD patients.

Does the Aging Males' Symptoms scale assess major depressive disorder?: A pilot study.

OBJECTIVES: The objectives of the study were to find the prevalence of major depressive disorder (MDD) in male climacteric outpatients in Japan, and to determine whether symptoms on the Aging Males' Symptoms (AMS) scale scores differed between patients with and without MDD, with the aim of increasing the specificity of future symptoms scales for partial androgen deficiency of the aging male (PADAM). METHODS: Eighty-three patients aged 40-70 who visited the male-climacteric services as outpatients were assessed using three items: a self-administered questionnaire corresponding to diagnosis for MDD, the Beck Depression Inventory, and the AMS scale. RESULTS: Almost half the patients had MDD. The total AMS score, the scores on the AMS psychological, somatic and sexual subscales, and the scores for all except three questionnaire symptoms were higher in patients with MDD. There were strong correlations between the AMS scale and the Beck Depression Inventory. CONCLUSIONS: There is a higher prevalence of MDD in male-climacteric outpatients and scores on most items of the AMS scale were higher for patients with MDD. We suggest that only those symptoms whose scores did not differ between patients with and without MDD are used to assess symptoms of PADAM in the presence of MDD, or that the current AMS is used only after diagnosis of MDD and elimination of these patients. Then the relevance of each item of the AMS to testosterone levels should be simultaneously examined in the future study, which will determine the items highly specific to PADAM symptoms.

Development of a new questionnaire to assess pain-related limitations of daily functions in Japanese patients with temporomandibular disorders.

BACKGROUND: Various measures/scales have been used to assess oral health-related quality of life in patients with temporomandibular disorders (TMDs). However, there have been few reports on the validity of questionnaires, and even fewer assessments of their use in Japanese sociocultural conditions. OBJECTIVES: The objectives of the study were: (i) to develop and refine the number of questions concerning pain-related limitations of daily function in the TMD questionnaire (LDF-TMDQ, 13 items) in Japanese patients with TMD, (ii) to assess factor validity, and (iii) to determine convergent and discriminant validity of the LDF-TMDQ with the observed items within a multidimensional questionnaire. METHODS: Four hundred and fifty-six (85.9%) outpatients with TMD were enrolled. The subjects were allocated into two roughly equal groups--E-group (233) for exploratory factor analysis and C-group (223) for confirmatory factor analysis [structural equation modeling (SEM)]. RESULTS: The exploratory factor analysis extracted 10 items and three factors. SEM showed the revised model to accurately describe the relationships between the measured items. As to convergent validity, the factor 'limitation in executing a certain task' and 'limitation of mouth opening' showed significant correlations with the observed items within the multi-dimensional questionnaire. However, the factor 'limitation of sleeping', show no correlation with any item. As to discriminant validity, all three factors had correlation coefficients below 0.4 with the psychological scale, the personality scale, and the visual analog scale for pain intensity. CONCLUSION: The LDF-TMDQ was reduced from 13 items to 10. The factor validity of the LDF-TMDQ, and the construct validity of 'limitation in executing a certain task' and 'limitation of mouth opening' were confirmed, while that of 'limitation of sleeping' remains to be determined.

Simple preparations of alkyl and cycloalkyl alpha-glycosides of maltose, cellobiose, and lactose.

Alkyl, cycloalkyl, allyl, 4-pentenyl, and benzyl alpha-glycosides of maltose, cellobiose, and lactose were prepared (17-77% yield; alpha/beta=70/30-96/4) via a direct reaction of the free disaccharides with a binary AcBr-AcOH mixture, followed by glycosidation with alcohol using FeCl3 in MeNO2 or CH2Cl2, Zemplén deacetylation, and resolution of the anomeric mixture of glycosides by chromatography. Using MeCN as solvent for the glycosidation step, the corresponding beta-biosides were also prepared (16-61% yield; alpha/beta=25/75-5/95).

[Postoperative evaluation of surgically treated cases with temporary silicone implant in temporomandibular joint].

We have carried out temporary silicone implants after diskectomies or arthroplasties in temporomandibular joint surgeries to avoid postoperative adhesion and to maintain articular space. We evaluated 19 joints in 15 patients who had received dacron-reinforced silicone implant after silicone sheet removal through follow-up for at least 6 months. The cases included temporomandibular joint disorder (10 joints in 9 patients), psoriatic arthritis (2 joints in 1 patient), ankylosis (4 joints in 3 patients) and synovial chondromatosis (2 joints in 2 patients). On the basis of the criteria of temporomandibular dysfunction for the results, they were classified as bad (4 patients). It is thought that factors other than the implant are related to the bad results in the postoperative evaluation. In this study, lymphadenopathy induced by exfoliated silicone debris could not be confirmed. The temporary silicone implant in the temporomandibular joint was thought to be useful.

Dynamic multislice helical CT of ameloblastoma and odontogenic keratocyst: correlation between contrast enhancement and angiogenesis.

PURPOSE: The purpose of this study was to assess whether the enhancement characteristics of dynamic multislice helical CT (MS-CT) could help in the differential diagnosis of ameloblastomas and odontogenic keratocysts. The correlation between enhancement characteristics and immunohistochemical findings, especially with regard to angiogenesis, was also evaluated. METHOD: Dynamic MS-CT was performed in 13 consecutive patients (8 ameloblastoma cases and 5 odontogenic keratocyst cases). The percentage of density increase (Enh%) was measured in dynamic MS-CT images taken during the arterial phase, and microvessel density (MVD) was analyzed using immunohistochemical study with anti-CD31 antibody. The Mann-Whitney U test was used to evaluate the significance of the Enh% or the MVD values between lesion subtypes, and the Spearman correlation coefficient was used to evaluate the correlation between the Enh% and the MVD in ameloblastomas and odontogenic keratocysts. RESULTS: The Enh% in ameloblastomas was significantly higher than that of odontogenic keratocysts (P < 0.005). The MVD of ameloblastomas was also significantly higher than that of odontogenic keratocysts (P < 0.005). The Enh% values for ameloblastomas and odontogenic keratocysts were positively correlated with the respective MVD values (r = 0.92, P < or = 0.000). CONCLUSION: Dynamic MS-CT is useful tool for differentiating between ameloblastomas and odontogenic keratocysts on the basis of the contrast enhancement values of intratumoral vascularities during the arterial phase. Furthermore, the Enh% obtained by dynamic MS-CT is correlated with the MVD in ameloblastomas and odontogenic keratocysts.