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Abscess of the orbit arising 48 h after root canal treatment of a maxillary first molar.

AIM: To discuss a rare, but severe complication arising following routine root canal treatment. SUMMARY: An orbital abscess is reported that occurred following routine root canal treatment. A young, healthy female patient, with no history of chronic paranasal infection had undergone root canal treatment of the right maxillary first molar. On hospital admission, she presented with extensive periorbital swelling and discreet diplopia. Computed tomography imaging identified massive purulent sinusitis and subsequent involvement of the orbit via the inferior and medial orbital wall within 48 h after completion of root canal treatment. Immediate surgical drainage of the maxillary sinus and the orbit was established and a high dose of perioperative antibiotics (Amoxicillin/Clavulanic acid, Gentamycin, Metronidazole) were administered. Vision remained undisturbed and mobility of the globe recovered within 10 days. KEY LEARNING POINTS: Rapid exacerbation of a periapical inflammation may occur following root canal treatment and may even involve the orbit. A typical speed of disease progression or ophthalmic symptoms should alert the clinician to at least consider unusual early orbital spread of odontogenic infection. When extra-alveolar spread and especially orbital spread is suspected, immediate referral to a maxillofacial or other specialized unit is mandatory.

Abscess↗

Building choice opportunities within occupational programmes for persons with profound developmental disabilities.

Choice opportunities were arranged within the occupational programmes of two subjects with profound developmental disabilities. The subject participating in Experiment 1 was already familiar with a computer-aided programme aimed at promoting independent occupation. That programme was now extended to allow him to choose activities and reinforcers. He was also exposed to a control programme involving the use of folders with drawings. The subject participating in Experiment 2 had no previous experience with special programmes. For this subject, two versions of a computer-aided programme were used: one to teach occupational engagement without choice; and the other occupational engagement with choice. The results have shown that the first subject was very successful in combining choice behaviour and constructive activity with the computer-aided programme, but not with the control programme. The second subject learned very rapidly independent activity engagement, but required relatively long time to develop 'meaningful' choice behaviour. General implications of the findings are discussed.

Adult↗

Learning multiple family therapy through simulated workshops.

Multiple Family Therapy (MFT) can be learned more rapidly through simulated workshops. A chronological approach to a simulated workshop is outlined describing mechanics and techniques. The hardest parts of simulated and real MFT are taking off and landing. Specific exercises are detailed to facilitate the early phases when professionals tend to simulate excessive psychopathology. However, recovery is usually rapid and dramatic in simulations; thus, the workshop leaders appear impressive. How to end "healthily" is the final challenge. Group input for assessment of simulated and real MFT is essential. From this feedback, subassertives and schizophrenics may be at the highest risk for deleterious effects from real MFT.

Family Therapy↗

Animating ground water levels with Excel.

This note describes the use of Microsoft Excel macros (programs written in Excel's internal language, Visual Basic for Applications) to create simple onscreen animations of transient ground water data within Excel. Compared to many specialized visualization software packages, the use of Excel macros is much cheaper, much simpler, and can rapidly be learned. The Excel macro can also be used to create individual GIF files for each animation frame. This series of frames can then be used to create an AVI video file using any of a number of graphics packages, such as Corel PhotoPaint. The technique is demonstrated through a macro that animates changes in the elevation of a water table along a transect over several years.

Computer Graphics↗

Encoding changes in orbitofrontal cortex in reversal-impaired aged rats.

Previous work in rats and primates has shown that normal aging can be associated with a decline in cognitive flexibility mediated by prefrontal circuits. For example, aged rats are impaired in rapid reversal learning, which in young rats depends critically on the orbitofrontal cortex. To assess whether aging-related reversal impairments reflect orbitofrontal dysfunction, we identified aged rats with reversal learning deficits and then recorded single units as these rats, along with unimpaired aged cohorts and young control rats, learned and reversed a series of odor discrimination problems. We found that the flexibility of neural correlates in orbitofrontal cortex was markedly diminished in aged rats characterized as reversal-impaired in initial training. In particular, although many cue-selective neurons in young and aged-unimpaired rats reversed odor preference when the odor-outcome associations were reversed, cue-selective neurons in reversal-impaired aged rats did not. In addition, outcome-expectant neurons in aged-impaired rats failed to become active during cue sampling after learning. These altered features of neural encoding could provide a basis for cognitive inflexibility associated with normal aging.

Action Potentials↗

Upper gastrointestinal endoscopy in a rural hospital: a facility assessed.

In an isolated hospital in Pakistan, upper gastrointestinal endoscopy has been used to clarify the pathological cause and significance of common symptoms. Indications for its use include dysphagia, vomiting, and epigastric pain related to meals. In small hospitals where results of barium studies are unsatisfactory, endoscopy, easily learned and rapidly carried out, can be a more informative and cost-effective alternative.

Adolescent↗

Effect of repetitive transcranial magnetic stimulation on rate of memory acquisition.

Repetitive transcranial magnetic stimulation (rTMS) may temporarily accelerate knowledge acquisition by neural networks, possibly by promoting rapid Hebbian learning. The authors tested this hypothesis in 20 normal subjects by comparing the impact of 25 minutes of high-frequency left dorsolateral prefrontal rTMS with that of sham rTMS on subsequent knowledge acquisition in several procedural and declarative memory domains. No significant group effects, positive or negative, were noted for any memory acquisition test, but prefrontal rTMS did reduce motor evoked potential threshold.

Adult↗

Effect of "missing" information on fast mapping by individuals with vocabulary limitations associated with intellectual disability.

One phenomenon of language development is a dramatic increase in vocabulary size, driven by rapid word learning. For individuals with intellectual disabilities, the size of the lexicon often lags behind what would be expected both for CA and MA. I examined how well individuals with severely limited receptive vocabulary associated with intellectual disability retained a new word-picture map after a single exposure under conditions of varying difficulty. This study was a direct replication of a previous investigation with typically developing preschool children, enabling a direct comparison. Individuals with intellectual disabilities performed equally as well as control children in the initial exposure phase but poorer when asked to remember the initial map in the presence of other novel distracters or labels.

Adolescent↗

Port-access aortic valve surgery: a technique in evolution.

BACKGROUND: Innovative minimally invasive surgical techniques have been developed for treating many cardiac diseases. We reviewed our experience with port-access aortic valve replacement (PAVR) surgery. METHODS: We retrospectively reviewed the charts of patients with aortic valve disease who underwent surgical correction using the Heartport System and minithoracotomy (PAVR) from January 1998 to December 2002 (n = 58) and matched them 1:1 with a cohort of patients who underwent AVR with conventional sternotomy. RESULTS: No preoperative statistical differences existed between the groups, including age, sex, New York Heart Association class, and ejection fraction. Perioperatively, there was a statistically significant difference between the AVR and PAVR groups with regard to aortic cross-clamp time (74.0 +/- 22.9 minutes versus 92.7 +/- 20.4 minutes, P < .01). Average operative times improved in the PAVR group by almost 83 minutes from the first 10 patients to patients 21 to 31 (P = .05). PAVR patients also averaged shorter stays in the intensive care unit (ICU) (1.5 days less) and hospital (1.8 days less) and were extubated sooner (4.9 hours). Mortality (1/58, 1.7%) and morbidity (reoperation for bleeding, infection, and stroke) were similar for both groups. CONCLUSIONS: This minimally invasive approach to aortic valve surgery allows patients to be extubated earlier and promotes shorter stays in the ICU and hospital. These data suggest that the PA approach is an attractive alternative for patients requiring aortic valve surgery. There also appears to be a rapid surgeon learning curve.

Aged↗

An olfactory discrimination procedure for mice.

This paper describes an olfactory discrimination procedure for mice that is inexpensively implemented and leads to rapid discrimination learning. Mice were first trained to dig in small containers of sand to retrieve bits of buried chocolate. For discrimination training, two containers were presented simultaneously for eight trials per session. One container held sand mixed with cinnamon, and the other held sand mixed with nutmeg. Both containers were baited with chocolate buried in the sand. One odor was designated S+, and mice were allowed to dig and retrieve the chocolate from this container. The other odor was S-, and both containers were removed immediately if subjects began to dig in an S- container. After meeting a two-session acquisition criterion, subjects were given a series of discrimination reversals. In Experiment 1, 12 Swiss-Webster mice (6 male and 6 female) acquired the olfactory discrimination in three to five sessions and completed 3 to 10 successive discrimination reversals within a 50-session testing limit. In Experiment 2, subjects were 14 Pah(enu2) mice, the mouse mutant for phenylketonuria; 7 were homozygotes in which the disorder was expressed (PKU), and 7 were heterozygotes with normal metabolism (non-PKU). Thirteen mice completed pretraining in four to seven sessions, acquisition required 3 to 12 sessions, and all mice completed at least three reversals. Learning rates were similar in PKU and non-PKU mice. We discuss issues related to implementation and several potentially useful procedural variations.

Animals↗

Method and complications of ileocutaneous anastomosis for collection of ileal digesta in neonatal pigs.

The purpose of our study was to develop a surgical method for collection of ileal digesta in neonatal (< 5 kg) pigs and to determine potential complications of the procedure. In 18 10-day-old pigs, we performed ileocutaneous anastomosis (ICA) via a right ventrolateral incision. The ICA was readily performed in these neonatal pigs; one pig died 24 hours after surgery because of intestinal volvulus. Pigs were monitored twice daily for development of post-operative complications. Ileal digesta were collected "free-catch" by using metabolism cages because attempts to use cannulas (diameter, 4 to 8 mm) and collection bags failed. To determine the effect of colon bypass on hydration, electrolytes, glucose, and serum enzyme activities, we collected serum biochemistry data before and 6 days after surgery. Changes in serum biochemical values included increased potassium, creatinine, total protein, albumin, and globulin and decreased ALP and glucose, but all values remained within normal ranges for neonatal pigs. ICA is tolerated well by neonatal pigs and is an easily learned and rapid technique for collection of ileal digesta. In addition, ICA is a useful alternative to "T-cannulas" and ileorectal anastomosis for nutrition research using neonatal pigs weighing < 5 kg.

Alkaline Phosphatase↗

In vivo measurement of extracellular serotonin in the ventral hippocampus during treadmill running.

The present study used the microdialysis technique to investigate the effect of treadmill running, without the use of an electric grid, on extracellular serotonin in the ventral hippocampus of male Lister hooded rat. Extracellular hippocampal serotonin was measured during 60min of treadmill running at 20m/min and compared with control animals who were placed on the stationary treadmill for 60min. The exercised animals had been habituated to the treadmill and trained for 4-5 weeks so as to be able to run for 60min, while the control animals had been placed on the stationary treadmill as frequently and for the same length of time as the exercising group. Extracellular hippocampal serotonin was higher (p < 0.05) during the first 40min of exercise than after 40min of being placed on the stationary treadmill, but this increase occurred only in those animals that learned more slowly and ran a shorter distance (1030+/-30m) and not in those that learned more rapidly and ran further (1150+/-20m).

Journal Article↗

Cueing properties of the decrease of white noise intensity for avoidance conditioning in cats.

In the main experiment two groups of 6 cats each were trained in active bar-pressing avoidance to a CS consisting of either a 10 dB or 20 dB decrease of the background white noise of 70 dB intensity. The two groups did not differ in rapidity of learning, however cats trained to the greater change .in background noise performed avoidance responses with shorter latencies than did cats trained to smaller change. Within-groups comparisons of cumulative distributions of response latencies for consecutive Vincentized fifths of avoidance acquisition showed the greatest changes in the region of latencies longer than the median latency of instrumental responses. On the other hand, the effects of CS intensity found in between-groups comparisons were located in the region of latencies shorter than the median latency of either group. Comparisons with data obtained in a complementary experiment employing additional 17 cats showed that subjects trained to stimuli less intense than the background noise level were marked by an exceptionally low level of avoidance responding with latencies shorter than 1.1 s, which was lower than expected from the probability of intertrial responses for this period of time. Due to this property of stimuli less intense than the background, the distributions of response latencies were moved to the right, in effect, prefrontal lesions influenced a greater part of latency distributions than in cats trained to stimuli more intense than the background.

Animals↗

The role of stimulus alignment in children's memory for line orientation.

In traditional tests of the "oblique effect," simultaneously presented mirror-image obliques are symmetrically aligned about a vertical axis, while vertical and horizontal stimuli are asymmetrically aligned. This work establishes that configurational cues associated with different alignments play an important role in children's memory for line orientation. In experiment 1, 16 kindergartners were tested on vertical-horizontal and oblique discriminations in symmetrical and asymmetrical alignments. When stimuli were asymmetrically aligned, the oblique discrimination was learned as rapidly as the vertical-horizontal discrimination. While performance on both problems was significantly better in the asymmetrical condition, stimulus alignment exerted its greatest influence on memory for oblique orientations; symmetrically aligned vertical and horizontal lines were easier to discriminate between than symmetrically aligned obliques. Experiment 2 demonstrated that the influence of configurational cues in memory for vertical-horizontal orientations increases when stimulus relationships between orthogonal stimuli are made salient. The 16 kindergartners tested found symmetrically aligned orthogonal lines as difficult to discriminate between as symmetrically aligned obliques, when stimuli were presented in diagonally oriented, rectangular frames. It is suggested that memory for orthogonal lines is more resistant to configurational cues because it typically involves an absolute code, while oblique memory always involves a relative code.

Child, Preschool↗

Avoidance responding in dogs trained in symmetrical or asymmetrical go, no-go differentiation.

The acquisition and the consolidation processes of avoidance responding in go, no-go differentiation with asymmetrical and symmetrical reinforcement procedures were studied in 49 male mongrel dogs. Differentiation training procedures with asymmetrical and symmetrical reinforcement were contrasted by the occurrence of painful shock on negative trials. The quality of conditioned stimuli and their relative saliency exerted strong effects on the rapidity of learning and the number of commision errors when the "asymmetrical" procedure was used, whereas these effects were strongly attenuated under "symmetrical" procedure of reinforcement. Dogs trained in "symmetrical" go, no-go differentiation showed characteristic responses executed with shorter latencies and larger percentages of errors on negative trials and numerous extra-and intertrial responding in early stages of differentiation learning. Retention tests showed a greater stability of acquired differential responding trained under "symmetrical" than under "asymmetrical" procedure of reinforcement. The data indicate that the strength of the secondary punishing effect of CS ;prolongation is directly related to the saliency of the stimulus. The relations between the primary and secondary punishing effects in the two types of differentiation task, and problem of signalling and arousing properties of stimuli used in training, were discussed.

Animals↗

The impact of active/cooperative instruction on beginning nursing student learning strategy preference.

Rapid changes in the nursing field and high demand for practicing nurses put pressure on nursing faculty to educate increasing numbers of nursing students, often without corresponding increases in resources. Although the use of active and cooperative instruction methods in the classroom has been associated with improved student learning, these practices require increased effort on the part of both faculty and students. In addition, little is known about whether these methods influence student nurses' use of these more elaborative processing strategies in their independent study. The purpose of this quasi-experimental investigation was to identify the impact of incorporating active and cooperative classroom instructional activities on student preference for teaching methods and use of learning strategies in independent study. A convenience sample of beginning baccalaureate nursing students at a large Mid-Atlantic University was randomly assigned by the registrar to two class sections. Students in one section received primarily active/cooperative instruction, while the other received primarily traditional lecture-based instruction. Results indicated that student nurses exposed to active/cooperative instructional methods had an increased preference for these methods after a semester of instruction, while those exposed to traditional instruction had a higher preference for traditional methods. In addition, students participating in active class instruction reported increased preference for more elaborative independent study strategies, although overall preference for both groups indicated a reliance on surface study strategies of memorization and recall. Implications for use of instruction and student testing methodologies are presented.

Consumer Behavior↗

Rapid cycling bipolar affective disorder and familial learning disability associated with temporal lobe (occipitotemporal gyrus) cortical dysplasia.

This case report describes a hitherto unreported association between temporal cortical dysplasia and rapid cycling bipolar affective disorder in a learning disabled young man with a family history of rapid cycling bipolar affective disorder in two dysmorphic and learning disabled maternal uncles, and probably learning disability in the mother and grandmother. An identical family with similar findings could not be located in the English literature.

Adult↗