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PubMed1994

Lack of Purkinje cell loss in adult rat cerebellum following protracted axotomy: degenerative changes and regenerative attempts of the severed axons.

The cerebellar Purkinje cells, due to their geometrical disposition and their high calbindin content, offer an optimal system in which to test the adequacy of current opinions on axotomy effects. We have, therefore, analyzed with calbindin immunostaining the morphological changes of Purkinje cells from 1 day to 6 months after axonal section in the cerebellar white matter. This method allows us to study the morphological changes in their dendrites, cell bodies, and axons. We have also searched for simultaneous changes in glial cells and vascularization by using cell type-specific markers. In addition, an ultrastructural study of Purkinje cells, 7 days after large electrolytic lesions affecting the white matter and the overlying granular layer, was carried out to determine whether amputation of the recurrent collateral system provokes a fast neuronal death. Neither the Purkinje cells axotomized close to their cell bodies (electrolytic lesions) nor those axotomized in the white matter (cerebellar transection) degenerated. Thus, this study demonstrates that Purkinje cells are extremely resistant to axotomy; those severed in the white matter at distances varying from 100 microns to 3 mm remain alive for as long as 6 months. At all survival times studied, axotomized Purkinje cells exhibited few changes in their somata and dendrites, as well as in their glial microenvironment. The major changes occurred in the axonal compartment. Axonal alterations, namely the presence of torpedoes and hypertrophy of the recurrent collateral system, were early events already noticeable 24 hours after the lesion, although they later differed in their time course and spatial distribution. It is remarkable that the distal segments of the central stumps of the cut axons survived in large numbers without any apparent retraction, with their terminal varicosities apposed to the wall of the wound cavity even 6 months after the lesion. Nevertheless, these segments were thinner than normal Purkinje cell axons (axonal atrophy). Despite this apparent immutability, some regenerative attempts did occur in the severed axons, such as axonal sprouts penetrating the deeper region of the granular layer in zones close to the lesion, presence of arciform axons, and hypertrophy of the recurrent collateral system. However, the Purkinje cell axons did not regenerate, and these neurons remained separated from their targets by a cavity in virtually all cases.

Animals↗
PubMed1985

Ocular rotation as a tool for superior oblique tendon exposure.

In several clinical studies involving superior oblique surgery it was noticed that the posterior insertion of the superior oblique tendon can be moved outside from the undersurface of the superior rectus muscle. This was achieved by rotating the eye in a maximum nasal and downwards direction while avoiding intorsion or retraction of the globe. Traction was applied on the superior temporal quadrant of the globe.

Humans↗
PubMed1991

Skin retraction following suction lipectomy by treatment site: a study of 500 procedures in 458 selected subjects.

I identified 500 suction lipectomy procedures involving sites on the body and in the cervicofacial region in 458 selected patients and studied the influence of treatment site on postoperative skin retraction by comparing preoperative and postoperative skin condition. Postoperative skin condition was evaluated first in the immediate postoperative period (second or third day); then at a more remote date (after at least 2 months of follow-up). On the body, restoration of the preoperative condition of the skin was obtained in 94.6 percent of treatment sites in the immediate postoperative period; after a longer follow-up, this proportion was 87.9 percent because of delayed development of modifications. The time interval needed to obtain a stable result increased with increasing age, regardless of the nature of this result, as well as with the total amount of fat removed. On the neck, liposuction improved or even eliminated preexisting skin looseness, and this improvement was even more noticeable as follow-up increased. The neck thus appears as the site of choice for suction lipectomy. On the face, in contrast, favorable results deteriorated over time, a finding that leads me to advocate combination with a face-lift whenever ptosis is present. Thus treatment site obviously has a substantial impact on the potential of the skin for retracting postoperatively.

Abdomen↗
PubMed1992

The treatment of severe 'gummy' Class II division 1 malocclusion using the maxillary intrusion splint.

This paper describes a modified Maxillary Intrusion Splint (M.I.S.) system which incorporates a near vertical pull headgear, and its use in the management of severe 'gummy' Class II division 1 malocclusion. The appliance was designed to reduce the visibility and vulnerability of the maxillary incisors in this difficult clinical situation by achieving the intrusion of maxillary teeth, restraining maxillary growth, and encouraging an element of subsequent forward mandibular rotation. The authors' initial experience using this system is presented in a retrospective cephalometric analysis of the lateral skull films of 26 treated patients contrasted with a similar number of comparable controls. The results showed that the principal effects of the M.I.S. were on the maxillary teeth giving decisive overjet control and incisor retraction with actual maxillary incisor intrusion. There was a similar effect on the maxillary molar and the M.I.S. provided effective en masse vertical control of the maxillary dentition. There was some degree of maxillary restraint in the M.I.S. group, but no noticeable difference in the change of mandibular position between the groups at the end of treatment. The possible reasons for this are discussed and suggestions made to improve this aspect of treatment in these patients.

Cephalometry↗
PubMed1999

[Middle ear cholesteatoma surgery].

UNLABELLED: To verify the efficiency of surgical techniques used by the senior author in cholesteatoma surgery, 1,048 cases operated on between 1966 and 1997 are reviewed: 739 in adults and 309 in children. In adults, the majority of cases were between 16 and 40 (64.5%) without difference between both sexes. On the contrary in children, boys were 200 and girls 109; 30 cases were less than 4. In adults only 312 cases were operated on first hand, instead in children almost all cases were operated on first hand (273 cases). The beginning of the cholesteatoma was usually the Shrapnell membrane in adults (58%) while in children the postero-superior region was as common as the Shrapnell membrane (34% 35%); the cholesteatoma was congenital in 13% of cases. Surgical techniques: Mostly two techniques were used: closed technique in two stages and obliteration technique in one or two stages. The closed technique requires remodeling of the postero-superior region of the bony canal, performing a correct posterior tympanotomy, placing a silastic sheeting in all the middle ear to prevent fibrosis and finally rebuilding all the bony defects and a large part of the tympanic membrane with thin cartilage with its perichondrium. The second stage is performed 18 months later in children, 24 months in adults. The ossiculoplasty is often performed at the first stage if the stapes arch is intact and safe. The obliteration technique requires also a precise removal of the lesions, a lowering of the facial ridge, the rebuilding of the tympanic membrane with fascia and the posterior cavities obliteration with Palva flap and free connective grafts. If the tympanic and posterior cavities are reasonably safe, and if the stapes arch is intact, one stage is performed. Otherwise a second stage is performed usually 18 months later, ossiculoplasty only or combined with a second look of posterior cavities under the flap. RESULTS: Residual cholesteatoma was noticed in adults in 16% of first hand closed technique and 19% of second hand closed technique. It is only of 7% in first hand obliteration technique and 13% in second hand obliteration technique. It was 16% in radical cavity reconstruction. Retraction pocket was almost only observed in closed technique. In adults, an early retraction pocket was observed in 3.5% of cases and in children 12.5% of cases at the moment of the second stage. A larger cartilage more precisely fixed with fibrin glue seems to have almost suppressed the early retraction pocket. Some late retraction pockets nevertheless appeared: 6 cases in adults over 394 and 5 cases in children over 236. Hearing results in adult were the best with first hand closed technique 84% of good results if the stapes was intact and 51% if the crura were missing. If the closed technique was performed second hand, these results were only 57% if the stapes was intact and 29% if the crura were missing. For the obliteration technique these results are for the first hand 70% of good result if the stapes was intact and 60% if the crura were missing, for the second hand, only 36% if the stapes was intact and 39% if the crura were missing. In radical cavity reconstruction 63% of good results were achieved when the stapes was intact and 48% if the crura were missing. The good result is an air-bone gap between 0 and 20 dB for the three frequencies 0.5, 1 and 2 kHz.

Adolescent↗
PubMed1988

Immunotherapy of hepatocellular carcinoma with autologous lymphokine-activated killer cells and/or recombinant interleukin-2.

Five patients with hepatocellular carcinoma were subjected to immunotherapy: three patients were treated by adoptive immunotherapy with lymphokine-activated killer (LAK) cells and recombinant interleukin-2 (rIL-2), and two patients by systemic administration of rIL-2 alone. In one patient with diffuse-type hepatocellular carcinoma and portal vein thrombosis who was treated by infusion of LAK cells (a total number of 1.5 x 10(10) cells/13 doses) and continuous rIL-2 administration (a total dose of 1.25 x 10(8) units) via a percutaneously placed hepatic arterial catheter, the size of the tumor reduced dramatically and the portal vein thrombosis retracted. In two patients who had LAK cells infused (totals of 6.6 x 10(9) cells/4 doses and 3.1 x 10(9) cells/2 doses, respectively) during hepatic angiogram followed by systemic administration of rIL-2 twice a day, no clinical improvement was noticed. In two patients who received rIL-2 alone systemically (total doses of 8.9 x 10(7) and 5.5 x 10(7) units, respectively), neither clinical improvement nor severe side effects were observed. The results suggest that adoptive immunotherapy combined with continuous local administration of rIL-2 via a percutaneously placed hepatic arterial catheter may be an effective therapy without apparent side effects for patients with hepatocellular carcinoma who cannot be treated by conventional cancer therapy.

Adult↗
PubMed1994

Acute lower respiratory infections in hospitalised urban pre-school Nigerian children: a clinical overview.

One hundred and three hospitalised urban pre-school Nigerian children aged 2 weeks to 4 years with various acute lower respiratory tract infection (ALRI), were studied prospectively over a 9- month period (August 1985 - April 1986). Overlapping seasonal peaks, corresponding to the rainy/early harmattan months of August through November were most noticeable for the two major viral ALRI syndromes namely, bronchiolitis and croup. The overall M:F ratio was 1.1:1, but a corresponding ratio of 1.6:1 was recorded in the infants. The commonest ALRI symptoms were cough, breathlessness and fever while chest wall retraction, nasal flaring, tachypnoea and auscultatory crepitations were the most frequently recognised physical findings. Grunting respiration was recognised in 26 patients, majority of whom had pleural effusion and/or severe bronchopneumonia. Bronchopneumonia was the single commonest ALRI diagnosis, recorded alone or in combination with another lower respiratory syndrome, in 64 (61.2%) of the 103 cases. The croup:bronchiolitis: pneumonia ratio was 1:2.3:8.3. Nasopharyngitis was recorded in 42 (40.7%) of cases, and was frequently associated with the presumably viral ALRI syndromes of croup and bronchiolitis. Pleural effusion, frequently purulent, was the commonest respiratory complication, while heart failure and anaemia were the most frequently recognised associated conditions, found predominantly in patients with pneumonia and bronchiolitis. There was an overall ALRI case-fatality of 7.8%, representing 8 deaths, in 3 of whom measles was a co-morbid condition. All the 8 deaths had a final diagnosis of pneumonia with or without other ALRI syndromes/associated complications. While subjects with complicating pleural effusion recorded the longest mean duration of hospitalisation, those with bronchiolitis had the shortest duration of hospitalisation and no death. The epidemiologic, as well as the diagnostic and therapeutic implications of our observations are discussed.

Acute Disease↗
PubMedDate not supplied

Subperiosteal facelift: a 5-year experience.

UNLABELLED: In classic rhytidectomy, there is little improvement in the center portion of the face. Aesthetic correction of malar prominence ptosis, accentuated nasolabial line, and jawl line, in most of the cases, require different approaches, such as the subperiosteal facelift. AIM: to show the cases and to evaluate the results and complications of subperiosteal facelift in the our service. PATIENTS AND METHODS: From January of 2001 to December of 2005, 25 patients, ranging from 44 to 60 years, 24 females, were submitted to subperiosteal facelift. Results and complications were retrospectively appraised. RESULTS: Of these, 20 presented satisfactory results, 4 presented aesthetic deficits noticed both by the patients and by the surgeon, and 1 presented aesthetic deficit needing revision surgery. All the patients presented improvement of nasolabial line, malar prominence and better definition of the jawl line. Revision surgery was necessary in one patient that referred little improvement. Four patients presented skin retraction in malar area due to the suspension sutures. A patient presented transitory paralysis of the front branch of the facial nerve. CONCLUSION: Subperiosteal facelift with temporal access has shown satisfactory results in the great majority of the cases.

Adult↗
PubMed1975

[The luminal surface of the rat trachea during ontogenesis].

To complete the hitherto existing results about the trachea epithelium, the scanning electron microscope was used to get representative statements about the apical surface of the epithelium: First of all the epithelium consists of undifferentiated round cells with cytopodia. The cells rarely carry single cilia at the same time. At the 18. day of pregnancy nearly all of the cells have a single cilium. Until the end of the intrauterine phase the single cilia are retracted again. At the 20. day ciliated cells and cells with protrusions are formed. Mucus granula are secreted into the lumen already before birth. Immediately post partum much mucus appears. Its distribution, viscosity and optical behaviour is different. For ciliated cells and goblet cells no special characteristical distribution was noticed. The building of the cells surface was detailed discussed. The question about function of the single cilia cannot yet be answered.

Animals↗
PubMed1984

Respiratory effects of intermittent exposure to ozone of rats.

Intermittent exposures of rats to ozone (O3) of 1 and 0.5 ppm were performed. Flow resistance of the lungs left in situ in the chest cavity opened after the sacrifice was measured at different levels of elastic pressure, and it was shown that daily 3-hr exposures to 1 ppm O3 for 30 consecutive days mainly produced increased resistance of more-central airways, while daily 6-hr exposures to 0.5 ppm O3 for 60 consecutive days mainly increased the resistance of peripheral airways. Morphological changes of the lungs caused by both exposures were in general similar in nature, but differences in secretion were noticed: it was more evident in larger to middle-sized bronchi in the animals intermittently exposed to 1 ppm O3, but more evident in the peripheral airway region in the animals intermittently exposed to 0.5 ppm O3. No change in the pulmonary static volume-pressure curve, indicative of the altered retractive forces of alveoli, was observed in both exposures, although a slight reduction in lung distensibility was suggested.

Airway Resistance↗
PubMed1981

A piezoelectric device to aid penetration of small nerve fibers with microelectrodes.

A small piezoelectric device for cell penetration is described. It retracts the micropipette slowly by electrostriction, and pushes it very fast (less than 5 microsecond) forward by short-circuiting the transducer. The design, operation circuit, and performance under test conditions are described. Penetration examples from small nerve fibers (less than 5 micrometer) show that membrane puncture occurs only with the fast forward push. Cells are not noticeably damaged, even if the device is repeatedly operated after cell penetration.

Animals↗
PubMed2005

A team approach to musculo-skeletal disorders.

INTRODUCTION: The majority of patients with musculo-skeletal problems referred to hospitals in the UK have to wait for months, if not over a year, before finally seeing an orthopaedic surgeon. In Stobhill Hospital, Glasgow, the waiting time for an out-patient appointment was 182 days in 1995, with only 20% of the referrals requiring surgery. The aim of this paper was to reduce the out-patient waiting times based on a co-ordinated team approach. METHODS: An outpatient musculo-skeletal service was developed over a 7-year period at Stobhill Hospital. The traditional consultant-based model, in which the consultant and a trainee saw all new patients referred to the hospital, was gradually replaced with a team approach, based on continuous reconfiguration of the roles of the orthopaedic surgeon and rheumatologist and extending the roles of nurses, physiotherapists and podiatrists. This was achieved by: (i) protocol-based daily triage for all referrals to the most appropriate health professional in the team, by the senior out-patient nursing staff; (ii) allocation of appointments based on clinical priority, with a fast-track for urgent cases; and (iii) improvement of inter-disciplinary communication, facilitating the retraction as well as the extension of traditional roles. RESULTS: Despite the number of GP referrals to the orthopaedic out-patient department at Stobhill nearly doubling in a period of 5 years, the out-patient waiting time decreased by about 50% (90 days from 182 days). This reduction in waiting times improved patient and GP satisfaction levels. We also noticed an improved morale and personal development of the health professionals as they saw patients appropriate to their skills and expertise. CONCLUSION: The team's experience demonstrates the effectiveness of a team approach in tackling what is often seen as the insoluble problem of orthopaedic waiting times. This is based on excellent communication and collaboration, with a clear aim of improving patient care that is evidence based.

Clinical Protocols↗
PubMed2001

Laparoscopic bilateral hand assisted nephrectomy for autosomal dominant polycystic kidney disease: initial experience.

PURPOSE: The laparoscopic technique for bilateral nephrectomy in patients with autosomal dominant polycystic kidney disease is technically difficult. The procedure may be more acceptable if alterations to the technique made it safer and easier to perform. We describe our initial experience with, and the feasibility and potential benefits of hand assisted laparoscopic nephrectomy for approaching these large kidneys in patients with autosomal dominant polycystic kidney disease. MATERIALS AND METHODS: This approach was successfully applied in 3 patients with end stage renal disease due to autosomal dominant polycystic kidney disease. After obtaining transumbilical pneumoperitoneum ports were placed in the umbilicus (12 mm.), sub-xiphoid in the midline (12 mm.) and subcostal in the midclavicular line on each side (12 mm.). The table was tilted 40 degrees away from the planned side of initial nephrectomy with the patient in the half lateral position. A 7 cm. midline incision was made that incorporated the umbilical port and a commercially available hand assistance device was positioned. One surgeon hand was inserted into the abdomen to serve as a retractor/blunt dissector, while the other operated the electrosurgical instruments. The right hand was inserted for left nephrectomy and the left hand was inserted for right nephrectomy. The laparoscope was passed via the sub-xiphoid port and the instruments were placed through the ipsilateral subcostal laparoscopic port. Nephrectomy was completed and the specimen was removed through the hand port incision by draining the cysts as they were exposed to view via the midline incision. When dissection was difficult, an additional port was placed in the anterior axillary line at the umbilical level. Some cysts were ruptured or aspirated to decrease overall kidney size and make extraction possible via the 6 to 7 cm. midline incision. RESULTS: All procedures were successfully completed. Mean operative time for bilateral hand assisted laparoscopic nephrectomy was 5.5 hours (range 4.5 to 6.6). Estimated blood loss was 200 cc or less. Patients resumed oral intake on postoperative day 1. The mean amount of parenteral analgesics required postoperatively was decreased. Mean hospital stay was 4.3 days but it was 3 days when considering nephrectomy only. Patients returned to normal activity after an average of 2 weeks. There was sustained resolution of preoperative discomfort based on pain analog scales. At 1 month or less all patients recorded absent pain. They uniformly noticed improved preoperative pulmonary and gastrointestinal symptoms CONCLUSIONS: Hand assisted laparoscopic nephrectomy in patients with autosomal dominant polycystic kidney disease makes bilateral nephrectomy a reasonable option. The bilateral procedure may be performed as rapidly as laparoscopic only, unilateral nephrectomy in these cases. The advantages of the hand assisted approach include using tactile sensation to facilitate dissection, rapid blunt finger dissection, hand retraction and the application of immediate tamponade when needed. This procedure provides the benefits of minimal intraoperative blood loss, minimal postoperative pain, brief hospital stay and rapid convalescence in this group of patients at high risk.

Adult↗
PubMed2001

Bleeding tendency in Wolfram syndrome: a newly identified feature with phenotype genotype correlation.

Wolfram syndrome (WS) is a recessively inherited disorder associated with recognised clinical features. Bleeding tendency was noticed in some of our patients, although this has not been reported before. We therefore studied this problem in all our WS patients and tried to postulate a possible pathogenesis. At the same time, a genetic linkage study provided evidence of locus heterogeneity of this syndrome and showed that the majority of our patients belong to the second WS locus identified in that study. Our study group consisted of 13 WS patients, belonging to WSF2 locus (group I). Controls consisted of 4 healthy siblings of WS patients (group II) and 7 diabetics who do not have WS (group III). Relevant clinical data were obtained, and a coagulation screen was carried out for all groups. All individuals in the three study groups have normal platelet count, thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (aPTT), clot retraction, Factor VIII activity (FVIIIc) and von Willebrand factor antigen (vWAg). Eleven of the WS patients have prolonged template bleeding time (BT) compared with both control groups. Patients with WS have a longer BT (mean 9.6 min, 95% CL 8.61-10.53 min) than the siblings group (mean 6.75 min, 95% CL 5.52-7.98 min) and the diabetic group (mean 5.49 min, 95% CL 4.56-6.42 min). The differences between the study group and controls are statistically significant, p = 0.02 and 0.0002, respectively. In the three groups, platelet aggregation studies were normal using adenosine diphosphate (ADP), ristocetin and epinephrine. Aggregation with collagen was either absent or impaired, with failure of secondary wave being noticed in 11 of the WS patients (85%) and normal in the control groups. The pathogenesis of this problem is not known, but could be due to an inhibitory effect of vWAgII, deficiency of thrombospondin or a defect in the platelet membrane GPIa/IIa. Bleeding diathesis is a new additional feature to the clinical spectrum of WS, which is probably a feature of the disorder WFS2 and not WFS1, as bleeding has never been reported in the latter. This provides further evidence for the phenotypic and genotypic heterogeneity of this complex disorder and may provide clues to the search for the second gene responsible for this phenotype.

Adolescent↗
PubMed2005

Bipedicled strap muscle transposition for vocal fold deficit after laser cordectomy in early glottic cancer patients.

OBJECTIVE: In treating early glottic carcinomas, the outcomes of endoscopic laser cordectomy have been proven to be valuable in local control, survival, and vocal function preservation. In some extended cases, however, laser cordectomy may leave patients with poor vocal function because of vocal fold deficit. This work assesses the vocal outcome of medialization laryngoplasty with bipedicled strap muscle transposition for vocal fold deficit resulting from laser cordectomy in early glottic cancer patients. STUDY DESIGN: A prospective clinical series. METHODS: Thirteen early glottic cancer patients who had vocal fold deficit caused by previous laser cordectomy underwent medialization laryngoplasty with bipedicled strap muscle transposition. The thyroid lamina on the cordectomy side was paramedially separated. The inner perichondrium was circumspectly raised from the overlying thyroid cartilage. After separating the thyrohyoid and cricothyroid membranes, the lamina was retracted laterally. A bipedicled strap muscle flap was then transposed into the area between the lamina and the paraglottic soft tissue. The thyroid cartilages were carefully sutured back in position. All patients received pre- and postoperative voice assessments comprising laryngostroboscopy and vocal function studies. RESULTS: Vocal enhancement was present in 92% (12/13) of patients after medialization laryngoplasty with strap muscle transposition. The glottal closure and maximal phonation time were noticeably improved by surgery. No dyspnea or other significant complications were observed in any patients. CONCLUSION: The outcomes show that bipedicled strap muscle transposition is a prosthesis-free, safe, and valuable laryngoplastic technique for correcting glottal incompetence caused by endoscopic laser cordectomy in early glottic cancer patients.

Glottis↗
PubMed1971

A scanning electron microscope study of the human glomerulus.

The three-dimensional fine structure of human glomeruli taken at autopsy and by biopsy was studied under the scanning electron microscope. The podocytes and their cytoplasmic processes in their elaborate ramification on the capillary wall were clearly demonstrated in the glomerulus of the autopsy specimens fixed by perfusion of glutaraldehyde as late as 3 hours after death, and in the glomerulus of the biopsy specimen fixed by immersion in the same fixative. The human podocytes were characterized by marked irregularity in the ramification pattern of their cytoplasmic processes, as compared with those of the rat and the rabbit. The interdigitation of the terminal processes was always noticed between those of different cells. The extended loss of the terminal processes was seen in the glomerulus of a case with severe proteinuria. The presence of intercellular spaces between the sheet-like cell peripheries of the podocytes supports the author's hypothesis in his studies on experimental nephrosis of rats that the disappearance of the terminal processes is not due to syncytial fusion of neighboring podocytes, but to retraction of swollen processes toward the central portion.

Adolescent↗
PubMed1988

The development of the corpus callosum in cats: a light- and electron-microscopic study.

Changes in the size and shape of the corpus callosum (CC)--and in number, size, and structure of callosal axons--between embryonic day 38 (E38) and postnatal day 150 (P150) were studied by light and electron microscope in 25 kittens. The development of the CC was divided into three phases: 1. Embryonic development (E38, 53, 58): At E38, only part of the body of the CC was formed. At E53 and E58, the CC was still very short, but its different parts (genu, body, and splenium) had formed. The cross-sectional callosal area (CCA) was 5.4 mm2 at E53 and 5.6 mm2 at E58. The CC contained 46.3 and 56.4 million axons at E53 and E58 respectively. Mean axon diameters were 0.26 micron at E53 and 0.27 micron at E58. 2. Early postnatal development (P4, 9, 15, 18, 21, 26): The CC at P4 was much longer than at E58 and still slightly elongated during this phase; CCA reached 8.55 mm2 at P4 and 8.88 mm2 at P26. There was a substantial axonal loss (66.8 million at P4 and 52.6 million at P26). From P15 onward, premyelinated and myelinated axons were seen. Mean axon diameter increased from 0.30 micron at P4 to 0.33 micron at P26. 3. Late postnatal development (P39, 57, 92, 107, 150). The CC grew dramatically in both length and thickness, the latter especially in the genu. CCA was 10.1 mm2 at P39 and 15.3 mm2 at P150. The number of axons still decreased (46.5 million at P39 and 31.9 million at P150). The growth of the CCA paralleled the increase of myelinated axons (0.5% at P26 and 29.6% at P150 and in the mean axon diameters (0.34 micron at P39 and 0.42 micron at P150). A number of axonal ultrastructural peculiarities (electron-dense bodies, large vacuoles, lamellated bodies, etc., including those mentioned below) were noticed; their frequency at different ages was estimated as the percent of total axons. Interestingly, accumulations of vesicles inside axons increased from 4.1% at E53 to 8.9% at P26, dropped to 0.2% at P39, and remained below 1% thereafter. Swollen mitochondria increased from 0.2% at E53 to 0.9% at P26 and dropped to 0.06% (on the average) from P39 onward. Accumulations of vesicles and swollen mitochondria increased during the phase of rapid axonal elimination; thus, they may indicate axonal retraction and/or degeneration. Microglia-gitter cells and astrocytes showing signs of phagocytosis were found during the embryonic and early postnatal development and may be involved in axon elimination.

Aging↗
PubMed1992

The impact of case characteristics on child abuse reporting decisions.

Drawing distinctions on the basis of at least some case characteristics in making reporting decisions makes considerable sense. Using data from a national survey of mandated reporters that included vignettes in which case and personal characteristics were systematically varied, this paper examines the impact of selected characteristics while controlling for others. The data reveal that respondents noticed and responded to case characteristics. Abuse-relevant judgments and reporting intentions varied, often substantially, as a function of case characteristics. Three case characteristics--previous abuse, severity of abuse, and recantation--were powerful predictors of vignette outcomes. A history of previous abuse led to judgments of greater seriousness, a more salutary impact of a report, and greater likelihood of reporting. More severe abuse was more likely to be labelled as abuse, and was more likely to be reported. When the alleged victim retracted her accusation upon questioning by an authority figure, respondents were significantly less likely to intend a report. Child age, perpetrator intent and family socioeconomic status also influenced abuse-relevant judgments and reporting intentions. Respondents were more likely to intend a report when younger children, lazy or angry perpetrators and children from poorer families were portrayed.

Adolescent↗