An invitation to the dance: an empirical response to Chief Justice Warren Burger's "time-consuming procedural minuets" theory in Parham v. J.R.
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Axon guidance in the developing nervous system is accomplished by a remarkable structure, the axon growth cone. This structure navigates, often over long distances, to find and synapse with target cells. Transformation of the growth cone to a terminal arbor establishes functional circuitry. The navigational properties of growth cones, and their interactions with target tissue, have been studied widely by examining individual cells in vitro, and have also been inferred from histological sections. Recent advances in labelling techniques and imaging of living cells have enabled direct observation of the growing axon tip in intact embryos as well as in slice preparations. To understand how pathways and terminal arbors are formed, the challenge now is to relate the dynamic morphology and behaviour of living growth cones to surrounding cues in the complex environment of the developing embryo.
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During an all-day retreat, a psychiatric nursing staff identified its patient care mission and interpersonal behaviors which inhibited accomplishing it. Collaborating with managerial interventions, staff members learned how to communicate in their practice environment effectively to their own benefit and that of their patients.
Eleven children with Sydenham's chorea (8 girls and 3 boys, mean age = 8.4 +/- 2.2 [SD] years) underwent comprehensive physical, neuropsychologic, and psychiatric examination. The chorea was manifested as dysarthria, gait disturbances, and frequent adventitious movements of the face, neck, trunk, and extremities. Antineuronal antibodies were present in 10 of 11 children. All children exhibited concomitant psychologic dysfunction, specifically obsessive-compulsive symptomatology, increased emotional lability, motoric hyperactivity, irritability, distractibility, and age-regressed behavior. Obsessive-compulsive symptoms were observed in 9 (82%) children, 4 of whom met diagnostic criteria for obsessive-compulsive disorder. These behavioral symptoms began several days to weeks before the chorea was observed, and they waxed and waned in severity along with the motoric abnormalities. These results suggest that psychologic, particularly obsessive-compulsive, symptoms are accompanying manifestations of Sydenham's chorea which may require medical attention.
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