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PubMed2001

Multimodal hyperspectral imaging for the noninvasive diagnosis of cervical neoplasia.

OBJECTIVE: To determine the ability of Multimodal Hyperspectral Imaging (MHI) to noninvasively detect, localize and diagnose cervical neoplasia. MATERIALS AND METHODS: The cervical epithelium was interrogated by MHI using tissue fluorescence and reflectance measurements after the probe was placed on the ectocervix. A Papanicolaou smear was taken, and a colposcopic examination was performed and cervical histologic specimens were collected, when indicated. MHI and Pap smear sensitivity and specificity data were compared with colposcopic and histologic results. RESULTS: Nineteen patients had CIN2 or higher, 30 had CIN1, 34 had benign cellular changes or metaplasia, and 28 were normal by both Pap smear and colposcopic examination. At equal specificity (70%) for both tests, the sensitivity of MHI was 97%, compared to 72% for the Pap smear. CONCLUSION: MHI detected cervical cancer precursors at a rate greater than that obtained by a simultaneously collected Pap smear.

Journal Article↗
PubMed2006

Reduction of verbal pain scores after anterior cruciate ligament reconstruction with 2-day continuous femoral nerve block: a randomized clinical trial.

BACKGROUND: Single-injection femoral nerve block analgesia and spinal anesthesia have been associated with fewer postoperative nursing interventions and successful same-day discharge after anterior cruciate ligament reconstruction. In the current study, the authors prospectively determined the effect of continuous femoral nerve block on a numeric rating scale (NRS) of pain intensity with movement for 7 postoperative days. METHODS: Patients undergoing this surgery with no history of previous invasive surgery on the same knee were recruited for this study. After standardized spinal anesthesia, intravenous sedation, and perioperative multimodal analgesia, patients received a femoral nerve catheter with (1) saline bolus (30 ml) plus saline infusion (270 ml at 5 ml/h, placebo group); (2) levobupivacaine (0.25%) bolus with saline infusion (group I), or (3) levobupivacaine (0.25%) bolus and infusion (group II). Patients were surveyed preoperatively and on postoperative days 1-4 and 7 to determine NRS scores (scale 0-10). RESULTS: Data from 233 participants were analyzed. On days 1-2, 50% of placebo patients had NRS scores of 5 or above, whereas among group II patients, only 25% had scores of 5 or above (P < 0.001). In regression models for NRS scores during days 1-4, group II was the only factor predicting lower pain scores (odds ratios, 0.3-0.5; P = 0.001-0.03). Overall, patients with preoperative NRS scores greater than 2 were likely to report higher NRS scores during days 1-7 (odds ratios, 3.3-5.2; P < 0.001). CONCLUSIONS: Femoral nerve block catheters reliably keep NRS scores below the moderate-to-severe pain threshold for the first 4 days after anterior cruciate ligament reconstruction.

Adolescent↗
PubMed1996

Preoperative infusional chemoradiation, selective intraoperative radiation, and resection for locally advanced pelvic recurrence of colorectal adenocarcinoma.

OBJECTIVE: The results of preoperative infusional chemoradiation, resection, and selective intraoperative radiation (IORT) boost in 43 previously nonirradiated patients with locally advanced pelvic recurrence of colorectal adenocarcinoma are described. SUMMARY BACKGROUND DATA: After surgery alone 10% to 30% of patients with carcinoma of the distal colon and rectum will develop isolated pelvic recurrence. In most cases, the disease is locally advanced and not amenable to curative resection. Preoperative infusional chemoradiation has been shown to increase resectability and decrease local recurrence in primary locally advanced colorectal cancer. Based on this experience, we initiated a multimodality treatment protocol to treat patients with pelvic recurrence of colorectal adenocarcinoma. METHODS: Forty-three consecutive patients with histologically proven pelvic recurrence of colorectal adenocarcinoma were enrolled on a multimodality treatment protocol. The treatment plan consisted of 5 weeks of concurrent pelvic external beam radiotherapy (45 Gy) with continuous intravenous infusion of 5-fluorouracil and/or cisplatin. This was followed by surgery that included IORT boost (10-20 Gy) for 21 patients and brachytherapy for 4 patients. RESULTS: Forty patients (93%) underwent operation and 33 (77%) underwent resection with curative intent. There were 29 (88%) margin-negative resections. Fifteen patients (48%) underwent sphincter-preserving operations. There were no treatment-related deaths. Twenty-two patients experience perioperative complications. Median follow-up for the 43 patients was 26 months. The local recurrence rate was 36%. Median survival for the patients who underwent resection was 34 months, and actuarial 5-year disease-free and overall survival were 37% and 58%, respectively. CONCLUSIONS: Tumor cytoreduction by preoperative chemoradiation can increase resectability and enable sphincter-preserving surgery in patients with locally advanced pelvic recurrence of colorectal cancer.

Adenocarcinoma↗
PubMed2002

Bisphosphonates: their evolving role in the management of prostate cancer-related bone disease.

PURPOSE OF REVIEW: The use of androgen deprivation therapy has increased because of its use as part of multimodality therapy for high-risk early stage disease and in recurrent nonmetastatic disease. Hormonal therapy is associated with secondary osteoporosis and increased skeletal morbidity. Furthermore, in patients with established bone metastases, osseous complications are a significant problem. Bisphosphonates have been investigated in the prevention of bone density loss and skeletal morbidity. Results of these studies are now becoming available. RECENT FINDINGS: Data are emerging that demonstrate that bisphosphonates can prevent skeletal morbidity, such as pathologic fractures and spinal cord compression in men with hormone-refractory prostate cancer. The early use of bisphosphonates has also been shown to prevent bone loss due to androgen deprivation therapy. Current third-generation bisphosphonates are several hundred times more potent than their predecessors. Evidence is emerging that these drugs not only inhibit bone resorption but also are cytotoxic to prostate cancer cells. SUMMARY: Bisphosphonates are assuming a prominent ancillary role in prostate cancer therapy through their ability to prevent skeletal morbidity. Their potential to interfere with the formation of osseous tumor deposits has lead to investigations into the capacity of these drugs to prevent bone metastasis.

Bone Diseases↗
PubMed1987

Electrophysiological monitoring in the intensive care unit.

Spontaneous electrical activity (EEG) and event-related computer averaged brain electrical potentials (EPs) are becoming an integral part of CNS function monitoring in neurological intensive care patients. EEG monitoring using the compressed spectral array (CSA) computer analysis offers continuous information about cerebral electrical activity, permitting an accurate definition of the severity of brain injury, forecasting patient's course, and early detection of secondary intracranial changes. It offers more precise indications for treatment and prognosis. Combining EEG with multimodality EPs permits a finer diagnosis of the location and extent of CNS damage and contributes information, not otherwise obtainable, on the integrity of CNS pathways. Changes is electrophysiological patterns are often related to changes in other physiological parameters or events affecting the patient. Consequently, it appears advantageous to monitor simultaneously other CNS and body functions and record, process and display the data obtained in the patient care area. To make this comprehensive monitoring system reliable and useful, a wise application of advanced computer technology and a high degree of understanding of intracranial dynamics are required.

Brain↗
PubMed2006

Dehydrated and Cs+-exchanged MFI zeolites: location and population of Cs+ from in situ diffraction data as a function of temperature and degree of exchange.

H-MFI type zeolitic materials of different Si/Al ratios have been completely or partially cesium-exchanged (cesium content ranging from 0.7 to 7.7 Cs/unit-cell (uc)). Examined with synchrotron X-ray powder diffractometry, an anhydrous sample with the Cs6.6H0.3Al6.9Si89.1O192 chemical composition revealed at ambient temperature the presence of five discrete Cs locations: Cs1 located in the channel intersection near a 10-ring window of the zigzag channel; Cs2 and Cs2', both located in the straight channel but 1.23 A apart; Cs3 and Cs3', both located in the zigzag channel and rather close to each other (2.51 A). The populations of the Cs species amounted to 2.61/0.81/1.85/0.86/0.47/uc for Cs1/2/2'/3/3', respectively. The continuous but multimodal nature of the C2 split site is well-described by a joint-probability density function. The 10-ring of the straight channel in the framework is highly elliptical (epsilon = 1.218). The populations for the same sites were also determined at higher temperatures: 131, 237, 344, and 450 degrees C. At 450 degrees C, Cs2' has migrated toward the center of the channel intersection, and the site separation between Cs2 and Cs2' has lengthened to 2.23 A. Using a temperature-controlled laboratory X-ray diffractometer, similar studies were carried out on partially or almost totally Cs-exchanged samples from various sources with differing Cs contents. They show that over the 0.7 to 4 Cs/uc range all the individual Cs populations vary linearly as a function of total Cs/uc present. At higher total Cs/uc content (4 to approximately 7 Cs/uc) solely Cs1 continues to do so. For Cs2+Cs2' and Cs3+Cs3', the variation is almost linear over the whole concentration range. Computer simulations using a 6-exp-1 Buckingham-type atom-atom van der Waals interaction model yield six possible Cs sites in the actual Cs6.6MFI framework structure. Four of them lie very close to those determined from difference Fourier maps using the room temperature data. A fifth one is close to the Cs2' species after thermal migration at 450 degrees C, and the sixth one is close to the center of the channel intersection. However, this latter site is observed experimentally only in the case of hydrated CsMFI phases. In the anhydrous Cs6.6MFI phase at room temperature, the shortest Cs-framework oxygen distance is Cs3'-O25 = 3.08 A, and the next shortest distances are Cs1-O26 = 3.37, Cs2-O11 = 3.34, Cs2'-O22 = 3.47, and Cs3-O20 = 3.34 A. The framework T(Si,Al) sites most involved in these contacts are the T9, T11, T12, T10, and T3 sites. This implies that these sites are prime candidates for Si/Al substitution.

Journal Article↗
PubMed2002

German Observational Study of Adult Twins (GOSAT): a multimodal investigation of personality, temperament and cognitive ability.

The German Observational Study of Adult Twins (GOSAT) is the largest population-based observational twin study in Germany to date. Embedded in the Bielefeld Longitudinal Study of Adult Twins (BiLSAT), it addresses the etiology of personality, temperament and cognitive ability in a sample of 300 monozygotic (MZ) and dizygotic (DZ) adult twin pairs between 18 and 70 years of age. A major aim of the GOSAT lies in the utilization of different modes of measurement, (i.e., peer reports and observational data), in addition to self-reports which have been used predominantly in past behavioral genetic research on personality and temperament in adults. Participants completed a full day assessment at the University of Bielefeld including videotaped social interactions and presentations, psychometric intelligence tests and computerized elementary cognitive tasks as well as objective measures and unobtrusive behavior counts. The research design of the GOSAT was devised to reduce the potential impact of systematic rater bias on estimates of genetic and environmental influences to a minimum. In combination with extensive self- and peer report data on key personality and personality related dimensions available from the BiLSAT, the GOSAT provides a rich dataset, which currently includes DNA samples from 80% of its participants.

Adult↗
PubMed2001

Photodynamic therapy for chest wall progression from breast carcinoma is an underutilized treatment modality.

BACKGROUND: Chest wall progression of breast carcinoma after failure of salvage surgery, radiation, and chemohormonal therapy is a quagmire with limited therapeutic options. Because photodynamic therapy (PDT) offers excellent results in cutaneous lesions, PDT may play a role in this indication. However, to the authors' knowledge, published data for this subgroup of patients using the only commercially available photosensitizing agent, Photofrin, often show high treatment morbidity, limiting PDT's usefulness. The authors report the feasibility of decreasing the photosensitizer drug dose as a means of exploiting photobleaching kinetics to improve the therapeutic ratio for these individuals. METHODS: One hundred two chest wall sites were treated with PDT after failure of multimodality salvage therapy. In these 9 patients, lesion size ranged from 0.57 to 9 cm. Photodynamic therapy consisted of outpatient intravenous infusion of 0.8 mg/kg of Photofrin, followed 48 hours later by 630 nm light treatment of 135-170 J/cm2 delivered by a KTP:YAG laser coupled to dye unit. Two patients underwent a second PDT procedure due to new lesion formation. All patients were observed for a minimum of 6 months, and none was lost to follow-up. RESULTS: Photodynamic therapy was well tolerated with no photosensitivity reported. Despite all patients having failed surgery, full dose radiation and multiagent chemohormonal therapy, chest wall lesions healed with no scarring. Only 1 (9 cm) lesion took longer than 3 months to granulate over. The authors were able to evaluate all treatment sites, and complete response, defined as total lesion elimination, was noted in 89% of the lesions; reduction without regrowth occurred in 8% with no response in 3% of the lesions. CONCLUSIONS: Despite having prior treatment and fragile tissues, low dose Photofrin-induced PDT offers excellent clinical response with minimal morbidity. These results show that PDT should play an important role in the management of chest wall failure from breast carcinoma.

Adult↗
PubMedDate not supplied

Multimodal treatment for squamous cell esophageal cancer.

Preoperative chemotherapy (CTx) and combination radiochemotherapy (RTx/CTx) in patients with squamous cell esophageal carcinoma has recently received increasing attention. Although several prospective randomized trials could not show any benefit of neoadjuvant therapy in patients with potentially resectable tumors, preoperative CTx and combination RTx/CTx appear to increase the resection rate, the rate of complete tumor resection, and survival time in patients with locally advanced tumors. Most available studies show that a survival benefit from multimodal therapy can be expected primarily in patients who have a complete histopathologic response to preoperative treatment (i.e., no viable tumor in the resected specimen). Preoperative RTx/CTx increases the response rate and improves local tumor control compared to preoperative CTx alone, but it is associated with substantial perioperative mortality and morbidity. Distant tumor recurrences are insufficiently controlled with current combined modality protocols. These data indicate that neoadjuvant therapy must be considered investigational in patients with potentially resectable esophageal carcinoma but may soon become standard in patients with locally advanced tumors. Research must focus on modalities that allow pretherapeutic identification of those patients who will respond to neoadjuvant therapy. Furthermore, more effective and less toxic preoperative therapy regimens are required to increase the response rates and combat systemic recurrences. Finally, randomized prospective studies are essential to assess the role, extent, and timing of surgical resection for the combined modality approach to patients with squamous cell esophageal carcinoma.

Antineoplastic Agents↗
PubMed1991

Child sexual abuse prevention: evaluation and one-year follow-up.

Because of the high incidence and negative psychological consequences of child sexual abuse, prevention programs have been developed and implemented nationwide. Few programs, however, have been comprehensively evaluated. In this multimodal study, a 3-session adaptation of the Feeling Yes, Feeling No curriculum was provided to 286 third and fourth graders from four schools whose responses were compared to 113 delayed-treatment control children from two schools. Program impact was assessed using a knowledge scale, the State-Trait Anxiety Inventory for Children, a videotape vignettes measure, a parent questionnaire, and disclosure data. Treatment children exhibited significantly greater knowledge and better ability to discriminate safe from unsafe situations on the video measure than control children at posttesting. These gains were maintained at 6-week follow-up testing. There were no differences in treatment and control children's self-reported anxiety or parents' reports of negative emotional/behavioral consequences, which were minimal. Over 5% of participating children reported ongoing or past sexual abuse. In the One-Year Follow-Up Study, children's knowledge gains and prevention skills scores on the video measure were maintained at one-year follow-up. A 1-session "booster shot" program further enhanced children's safety discrimination skills on the video measure.

Adaptation, Psychological↗
PubMed1986

Behavioral remediation of chronic pain: a status report.

The literature concerning the behavioral treatment of chronic pain other than headache was reviewed with particular emphasis on those studies being published since the most recent reviews from 1982. In general, the quality of these studies is much better than those included in the previous reviews. Several studies used broad outcome measures and many studies employed control conditions. The critical examination indicates that the operant program is effective in increasing activity levels and in decreasing medication consumption, and probably also in improving reported levels of pain and mood. Relaxation, in the form of biofeedback, showed mixed results. However, progressive relaxation and relaxation used as a coping strategy, proved to be useful especially in controlling pain ratings. No additional studies of pure 'cognitive' methods were found and the multimodal studies continued to be methodologically problematic. It was concluded that there is substantial evidence for the efficacy of some behavioral treatments for chronic pain. The comparative work suggests that relaxation may be a particularly valuable tool in remediating reported pain intensity. One question is which methods are most effective and economical and it remains for future research to find an answer. The data also suggest that treatment gains tend to be maintained and that patients continue to use assigned techniques although at a lower rate than recommended. Finally, it was pointed out that rehabilitation seldom leads to 100% improvement. Consequently, the need for prevention was stressed.

Adaptation, Psychological↗
PubMed2003

Depression in children and adolescents with epilepsy.

Depression in children and adolescents with epilepsy is a common but often unrecognized disorder. Both epilepsy and depression are characterized by a chronic course and poor long-term psychosocial outcome. The risk of suicide is even greater in depressed youth with epilepsy than in the general youth population. Educating parents about mood disorders may allow them to be more receptive to psychiatric treatment for their child or themselves. Epidemiological and clinical data on depression in children/adolescents with epilepsy are presented. Seizure-related and general risk factors for the development of depression in youth with epilepsy are reviewed. General guidelines for diagnosis and treatment of depression in children and adolescents are discussed. The early identification and treatment of childhood-onset depression is an important clinical task for all pediatric specialists. Safe and effective multimodal treatment approaches are available.

Adolescent↗
PubMedDate not supplied

Multimodal assessment of the primary healthcare system of Serbia: a model for evaluating post-conflict health systems.

INTRODUCTION: Conflicts, social unrest, and disasters can significantly affect the ability of a healthcare system to provide for the needs of its citizens. The collapse of the primary healthcare system in Serbia is a model of the effects that civil unrest can have on the health of a population. However, with improving social and political conditions, focus now can be turned towards the greatly needed development and reorganization of the primary healthcare system in Serbia. Due to the complexity of health-system reform in the post-conflict/post-disaster setting, attempts to restructure health services are fraught with pitfalls that often are unanticipated because of inadequate preliminary assessments. A multimodal assessment involving quantitative and qualitative methodologies may provide a more robust mechanism to identify key programmatic priorities and critical barriers for appropriate and sustainable health-system interventions. The purpose of this study is to describe a multimodal assessment using primary healthcare in post-conflict Serbia as a model. METHODS: Integrated quantitative and qualitative methodologies--system characterization and observation, focus group discussions, free-response questionnaires, and Q-methodology--were used to identify needs, problems, and potential barriers to primary healthcare development in Serbia. Participants included primary healthcare providers and administrators from 13 institutions throughout Belgrade. RESULTS: Demographic data indicate a well-established infrastructure of primary health centers and stations. However, focus group discussions and free-response questionnaires reveal significant impediments to delivery of care: (1) Inadequate equipment, supplies, and medications; (2) Poor financial investment; (3) Discouraging worker salaries; (4) Few opportunities for professional development; and (5) Little emphasis on or respect for primary healthcare. Q-methodology of provider perceptions and opinions supports these concerns, shows remarkable consensus among participants, and provides further insights toward system development by grouping respondents into distinctive types. CONCLUSIONS: This study identified the critical needs and barriers to development of primary healthcare in Serbia. This combined methodology may serve as a model for future health system assessments in the post-conflict and post-disaster settings.

Delivery of Health Care↗
PubMed2000

Affective aggression in patients with temporal lobe epilepsy: a quantitative MRI study of the amygdala.

Recurrent episodes with interictal affective aggression are a rare but well-recognized problem in patients with temporal lobe epilepsy. They are referred to as episodic dyscontrol or, more precisely, as intermittent explosive disorder (IED). The amygdala play a crucial role in the affective evaluation of multimodal sensory input and the neurobiological mediation of aggressive behaviour. With hippocampal sclerosis, in the context of mesial temporal lobe sclerosis, being the most common cause of temporal lobe epilepsy, we hypothesized that the amygdala might be affected by the same pathogenic process in aggressive patients. We investigated 50 patients with temporal lobe epilepsy: 25 with and 25 without a history of IED. Data from clinical, electrophysiological, neuropsychological and psychometric investigations were obtained, as well as MRI scans for the quantitative assessment of possible amygdala pathology. We found no evidence of a higher prevalence of amygdala sclerosis in the aggressive patients. Hippocampal sclerosis was significantly less common in patients with temporal lobe epilepsy and IED. However, a significant subgroup of patients (20%) with temporal lobe epilepsy and aggressive behaviour had severe amygdala atrophy in the context of a history of encephalitis. Another subgroup of aggressive patients (28%) had different left temporal lesions affecting either the amygdala or periamygdaloid structures. IED was associated with left-sided or bilateral EEG and MRI abnormalities, low IQ and high scores in depression and anxiety.

Adolescent↗
PubMed1993

Improved survival with neoadjuvant therapy and resection for adenocarcinoma of the esophagus.

OBJECTIVE: This study sought to determine the impact of preoperative chemotherapy and radiation therapy (neoadjuvant therapy) followed by resection in patients with adenocarcinoma of the esophagus. SUMMARY BACKGROUND DATA: Long-term survival in patients with carcinoma of the esophagus has been poor. An increase in the incidence of adenocarcinoma of the esophagus has been reported recently. METHODS: Fifty-eight patients with biopsy-proven adenocarcinoma of the esophagus treated at this institution from January 1951 through February 1993 were studied. Since 1989, 24 patients were entered prospectively into a multimodality treatment protocol consisting of preoperative cisplatin, 5-fluorouracil (5-FU), and leucovorin with or without etoposide, and concomitant mediastinal radiation (30 Gy). Patients were re-evaluated and offered resection. RESULTS: There were no deaths related to neoadjuvant therapy and toxicity was minimal. Before multimodality therapy was used, the operative mortality rate was 19% (3 of 16 patients). With multimodality therapy, there have been no operative deaths (0 of 23 patients). The median survival time in patients treated before multimodality therapy was 8 months and has yet to be reached for those treated with the neoadjuvant regimen (> 26 months, p < 0.0001). The actuarial survival rate at 24 months was 15% before multimodality therapy and 76% with multimodality therapy. No difference in survival was noted in neoadjuvant protocols with or without etoposide (p = 0.827). CONCLUSIONS: Multimodality therapy with preoperative chemotherapy and radiation therapy followed by resection appears to offer a survival advantage to patients with adenocarcinoma of the esophagus.

Actuarial Analysis↗
PubMed2005

Juvenile xanthogranuloma in childhood and adolescence: a clinicopathologic study of 129 patients from the kiel pediatric tumor registry.

Juvenile xanthogranuloma (JXG) is an uncommon non-Langerhans cell histiocytosis. We investigated 148 biopsy specimens from 129 patients collected in the Kiel Pediatric Tumor Registry (KPTR) between 1965 and 2001. The clinical, histologic, and immunohistochemical characteristics of JXG were evaluated to gain more and deeper insights into the morphology and clinical behavior of JXG. Conventionally stained lesions were classified into the following morphologic subtypes: early JXG (EJXG), classic JXG (CJXG), transitional JXG (TJXG), or combined lesions with more than one basic pattern (combined JXG). Immunohistochemistry included antibodies against macrophages (Ki-M1P), S-100 protein, CD1a, and factor XIIIa (FXIIIa). Clinical data were obtained by means of a standardized questionnaire. The relative incidence of JXG in the KPTR is 0.52%. The male/female ratio was 1.4:1. The mean age was 22.4 months (median, 5 months; range, 0-244 months). A total of 34.5% of the cases of JXG were congenital, and 71.0% of the lesions were diagnosed within the first year of life. Most cases of cutaneous JXG were solitary (81.0%). Five cases (3.9%) presented with visceral (systemic) involvement. Histologically, CJXG was most frequent (47.2%), followed by EJXG (27.1%) and TJXG (16.0%). A total of 9.7% of the lesions represented combined JXG. Histiocytes, including giant cells, were positive for Ki-M1P (100%) and in most cases for FXIIIa (99%). The CD1a and S-100 protein reactions were generally negative. Clinical and follow-up data showed a generally favorable prognosis with a low relapse rate (7.0%) and even complete involution after incomplete resection. Only 1 of 5 patients with widespread congenital systemic disease died after 34 days. JXG is an uncommon, mostly cutaneous, and prognostically favorable histiocytic tumor of infancy. Simple tumor excision is the therapy for choice except in the very rare systemic JXG, in which multimodal chemotherapy is indicated.

Adolescent↗
PubMed2006

The yips in golf: multimodal evidence for two subtypes.

PURPOSE: To determine whether a model of two subtypes of yips is supported by evidence from a range of physiological, behavioral, and psychological measures. METHODS: Fifteen golfers who experience yips symptoms while putting (mean age 58.1 yr, SD 13.6 yr), and nine golfers with no yips symptoms (mean age 39.6 yr, SD 19.3 yr) were recruited. Participants completed a golf history questionnaire to determine their playing experience and the nature of any yips symptoms experienced. In experiment 1, participants performed a putting task while electromyographic data were recorded from the forearm flexors and extensors and biceps brachii, bilaterally. The task was performed in two sessions, under low-pressure and high-pressure experimental conditions. The high-pressure condition was intended to increase anxiety through the use of a monetary incentive, video-taping of performance, and the presence of a confederate who provided negative feedback. Participants' state of anxiety was assessed using a questionnaire before each of the experimental sessions. In experiment 2, participants completed a task that required the inhibition of an anticipated response. Their accuracy and ability to inhibit their response was determined. RESULTS: The golfers who experienced yips could be categorized according to whether they reported mainly movement-related symptoms (Type I) or anxiety-related symptoms (Type II). The Type I group exhibited greater muscle activity during putting and greater errors and less inhibition of the anticipated response task. The Type II group exhibited greater changes in cognitive anxiety and normal performance of the anticipated response task. CONCLUSION: This study provides evidence in support of two yips subtypes. Type I is related to impaired movement initiation and execution, whereas Type II is related to performance anxiety.

Adolescent↗
PubMed1992

Comparative imaging of the jaws.

Explosive growth in high-technology imaging continues in dentistry as in all health sciences. Some new technology will find its way into general and some specialty dental practices; two examples, digital intraoral radiography and multimodality panoramic machines, are reviewed. New developments in the application of current imaging procedures (both conventional and "high tech") to diagnosis and management of diseases and injuries of the jaws, muscles of mastication, and salivary glands are presented. Recent information suggests that the risk of radiation-induced cancer in exposed populations may be greater than had been recognized. The impact of this data on both occupational and patient radiation exposure in dentistry is reviewed.

Humans↗