bluuebunny/crossref_metadata_2025 huggingface dataset:
Review Article: Pediatric Neurosonography
Authors: Grant Edward G. , White E. Maureen
Published: June 2008

Neurosonography is an excellent modality for imaging a wide array of intracranial pathology in the infant and newborn. Neurosonography is also finding increasing use in other accessible regions of the central nervous system, including the adult brain during craniotomy and the spine during laminectomy. Sonography represents the primary modality for the evaluation of the preterm brain. Because of the high incidence of pathology in gestationally immature neonates, screening sonography is required in every infant. The sonographic features of intracranial hemorrhage include areas of increased echogenicity in the region of the germinal matrix, within the ventricles, or in the surrounding cerebral parenchyma. Careful follow-up of these children for sometimes severe posthemorrhagic hydrocephalus is essential. Premature neonates are also at risk for ischemic disease, particularly periventricular leukomalacia, which is accurately diagnosed sonographically and implies a poor prognosis in almost every infant so affected. Cranial sonography is also an excellent method to evaluate abnormalities that are not associated with gestational immaturity. Cranial sonography offers excellent anatomic imaging of the brain when evaluating for congenital anomalies; because sections may be obtained in a multitude of orientations, sonography is actually more versatile than computed tomographic (CT) scans. Cranial sonography is also of use when evaluating children with inflammatory processes such as ventriculitis; sonography is superior to CT scans in identifying intraventricular septae typical of the process. Intrauterine inflammatory processes, however, are frequently associated with intracranial calcifications, CT scans may be more accurate in these cases. CT scans may also be more efficacious in the diagnosis of subdural, epidural, and subarachnoid hemorrhage. Intracranial neoplasms are rare in the younger population and although they are visible with ultrasound, CT scans with contrast are essential in an effort to obtain added information and because of a greater experience using CT scans. Sonography represents an excellent modality with which to evaluate the infant and neonatal brain. In a number of diseases it may be diagnostic alone. The informed clinician, however, should keep in mind those instances where a complimentary modality such as CT scanning can add additional or even essential information. ( J Child Neurol 1986;1:319-337)
Basilar Artery Occlusion in an Adolescent Girl: A Risk of Oral Contraceptives?
Authors: Biller José , Haberland Catherine , Toffol Gilbert J. , O'Reilly Daniel , Tentler Robert L.
Published: June 2008

An 18-year-old adolescent girl died of an extensive pontine infarction. At postmortem examination she was found to have a thrombosis of the basilar and intracranial vertebral arteries with associated focal hyperplasia of the intima. Her ovaries were grossly small and inactive, with absent corpora lutea. Based on these findings, we suspect she was taking oral contraceptives. In cases of unexplained fatal strokes in young females, careful pathologic examination of the ovaries may provide etiological clues. ( J Child Neurol 1986;1:347-350)
A Model of Methotrexate Encephalopathy: Neurotransmitter and Pathologic Abnormalities
Authors: Silverstein Faye S. , Johnston Michael V.
Published: June 2008

Methotrexate may cause seizures, dementia, and leukoencephalopathy when given in toxic doses to children with leukemia or solid tumors. Even in therapeutic doses, treatment with this drug is associated with an increased incidence of seizures in children with leukemia. To study mechanisms of injury, juvenile rats were given multiple intraventricular injections of methotrexate and the brains were analyzed for histopathology and biogenic amine metabolites of dopamine and serotonin. Disruption of monoamine metabolism has been proposed as a cause of brain dysfunction from this chemotherapy. Multiple injections (1 or 2 mg/kg) produced convulsions in an increasingly larger percentage of animals at higher cumulative doses, and five doses produced the neuropathological changes seen in human leukoencephalopathy. A single dose reduced the concentration of brain metabolites of dopamine, but not serotonin, six hours later. The effect was less pronounced after five doses. This rodent model should be useful for studying the metabolic basis of methotrexate encephalopathy. ( J Child Neurol 1986;1:351-357)
Coincident Down's and Tourette Syndromes: Three Case Reports
Authors: Barabas Gabor , Wardell Barbara , Sapiro Marilyn , Matthews Wendy S.
Published: June 2008

Three patients with Down's syndrome and coincident Tourette syndrome are presented. Two patients had trisomy for G-group chromosome and one patient had mosaic trisomy. All had characteristic features of Gilles de la Tourette syndrome with multiple motor and vocal tics. While Tourette syndrome has been reported in other chromosomopathies, this report appears to be the first to note an association with Down's syndrome. The authors hypothesize that neurotransmitter abnormalities existing in Down's syndrome may predispose such individuals to basal ganglia dysfunction and the subsequent development of tics. In particular, abnormalities in serotonin metabolism may be involved. ( J Child Neurol 1986;1:358-360)
Review Article: Introduction to the Kaufman Assessment Battery for Children (K-ABC) for Pediatric Neuroclinicians
Authors: Kaufman Alan S. , O'Neal Marcia R. , Avant Anna H. , Long Sandra W.
Published: June 2008

This article introduces the neuroclinician to the Kaufman Assessment Battery for Children (K-ABC), a new test of intelligence and achievement with a strong theoretical base supported by diverse cognitive and neuropsychological research. The K-ABC global scales and their subtests are described in some detail, followed by a discussion of the neuropsychological relevance of the K-ABC subtests. The article also provides discussions of research in the following areas: (1) psychometric properties of the K-ABC and a comparison to the Wechsler scales; (2) interpretation and remediation of sequential-simultaneous processing differences; (3) the value of the K-ABC in the assessment of minority children; and (4) controversy surrounding the K-ABC. ( J Child Neurol 1987;2:3-16).
Depression and Dexamethasone Suppression Testing in Children and Adolescents
Authors: Emslie Graham J. , Weinberg Warren A. , Rush A. John , Weissenburger Jan , Parkin-Feigenbaum Linda
Published: June 2008

The authors compare the incidence of dexamethasone nonsuppression in a large group of child and adolescent inpatients (N = 94) diagnosed by two criteria ( DSM-III and Weinberg criteria). The incidence of dexamethasone suppression test nonsuppression in patients diagnosed with DSM-III major depressive disorder (n = 33) was 55%, compared to 11% in those with no affective disorder (n = 35). This was compared to the incidence of dexamethasone suppression test nonsuppression utilizing Weinberg criteria. In addition, symptoms that to varying degrees discriminated suppressors from nonsuppressors were examined. These included change in school performance and, to a lesser degree, somatic complaints and weight and appetite changes. Differences in the diagnostic criteria are discussed. ( J Child Neurol 1987;2:31-37).
An Unusual Case of Neonatal Myasthenia
Authors: Heckmatt John Z. , Placzek Monica , Thompson Anne H. , Dubowitz Victor , Watson Graham
Published: June 2008

An unusual case of neonatal myasthenia gravis is reported in an infant who had respiratory failure due to diaphragmatic weakness. Although power and tone in the limbs were normal, fatiguability of both diaphragm and peripheral muscles was demonstrated. Acetylcholine receptor antibodies were absent in the mother, which suggests that an alternative humoral mechanism may have been responsible for the transient (6-week) neonatal weakness. ( J Child Neurol 1987;2:63-66)
Chronic Sorrow in Families of Disabled Children
Authors: Copley Margaret Freeman , Bodensteiner John B.
Published: June 2008

Among professionals who work with disabled children and their families, the need has arisen for better articulation of the concept of chronic sorrow, a bereavement process parents experience in response to life with a disabled child. This article presents information and concepts about the nature of chronic sorrow that permit clarification and understanding of the meaning of what is otherwise often confusing parent behavior. Implications for the professional in assisting the parent's movement through the bereavement process will be discussed. ( J Child Neurol 1987;2:67-70).
Magnetic Resonance Imaging in Pediatric Neurologic Disorders
Authors: Roach E. Steve , Smith Thomas , Terry Charles V. , Riela Anthony R. , Laster D. Wayne
Published: June 2008

We present our initial experience with magnetic resonance imaging (MRI) in 301 pediatric patients with a variety of neurologic disorders. MRI does not require ionizing radiation and can be done easily and safely in children. It is equal or superior to computed cranial tomographic (CT) scans in demonstrating most types of pediatric neurologic disorders. MRI is often superior to CT scans in demonstrating intracranial tumors, although both studies are usually abnormal in highly malignant tumors. No clear advantage was shown with either MRI or CT scans for fluid-filled intracranial lesions. Lesions of the brain stem and upper cervical region, such as Chiari malformation, are well delineated by MRI. Increased signal from the paranasal sinuses was frequently evident by MRI, but, in most instances, there was no clinical indication of sinus disease. Large arteries can be visualized as an area of diminished signal, and intracranial hemorrhage, dural sinus thrombosis, and cerebral infarction were demonstrated. The increased anatomic detail pictured by MRI allows the diagnosis of congenital defects, such as agenesis of the corpus callosum or septum pellucidum, that are not always apparent with CT scans. Although our experience with spinal cord lesions was not extensive, fluid-filled lesions within the cord can be reliably demonstrated. (J Child Neurol 1987;2:111-116).
The 14 & 6-Associated Clinical Complex: A Rejected Hypothesis Revisited
Authors: DeLong G.R. , Rosenberger P.B. , Hildreth S. , Silver I.
Published: June 2008

The 14 & 6 Hz positive spike phenomenon is generally considered a normal variant finding. Our experience prompted this re-evaluation, which consisted of three parts: (1) In children referred for sleep electroencephalograms (EEGs), 100 children with normal EEG and 100 with 14 & 6—the 14 & 6 correlated with behavior disorder and aggression; (2) In 75 children referred for neurological evaluation and EEG because of behavior problems, 52% had 14 & 6 (excluding those with paroxysmal EEGs); and (3) In 57 symptomatic children having prominent 14 & 6, tabulation of symptoms yielded a complex but coherent clinical picture, including disturbances of temper, mood, attention, learning, and sleep. We conclude that 14 & 6 has clinical associations and deserves study. (J Child Neurol 1987;2:117-127).
The Future of Clinical Child Neurology
Authors: Aicardi Jean
Published: June 2008

I would first like to thank the Child Neurology Society for the honor that it has bestowed upon me. I am aware of the prestige which is attached to the Hower Award and I deeply value this distinction, especially as I realize that it is the first time the Award has been given to a non-American child neurologist. In addition to honoring me, the Child Neurology Society wanted to demonstrate that neuropediatrics has no geographic, political, or linguistic borders and that the care of neurologically disabled children requires the efforts of all men and women of good will across lands and oceans.
The Brain in Partial Trisomy 18: A Case Report
Authors: Novotny Edward J. , Urich Henry
Published: June 2008

This is a clinical and neuropathological report of a 27-year-old male with partial trisomy of the long arm of chromosome 18. Severe psychomotor retardation, blindness, and epilepsy were the major clinical features. Microcephaly, an unusual diverticulum of the left occipital lobe, and severe atrophy of the visual system were the major findings on neuropathological examination. ( J Child Neurol 1987;2:194-197).
Thermal Biofeedback in the Treatment of Symptoms Associated With Reflex Sympathetic Dystrophy
Authors: Barowsky Ellis I. , Zweig Joseph B. , Moskowitz Joanne
Published: June 2008

A 12-year-old male, unresponsive to therapy for symptoms associated with reflex sympathetic dystrophy, was treated by thermal biofeedback techniques. Within the first four treatment sessions, transfer of training from digital warming to warming the affected knee area produced skin temperature elevation around the gastrocnemius and patellar areas. Attenuation of localized vasospasm and cold intolerance resulted, followed by total abolition within ten sessions. After symptom alleviation, a return to premorbid activity levels was reported. Implications for use of thermal biofeedback as a primary noninvasive technique for treatment of symptoms associated with reflex sympathetic dystrophy are discussed. ( J Child Neurol 1987;2:229-232).
Autonomic Dysfunction and Adrenocortical Unresponsiveness to ACTH
Authors: Makari George , Hoffman William H. , Carroll James E. , Savage Diane R. , Van der Zalm Theodora
Published: June 2008

A child is reported with adrenocortical unresponsiveness to ACTH and autonomic dysfunction. The latter consisted of cold extremities, progressive loss of tear production, the development of achalasia of the esophagus, pupillary dysfunction, and an abnormal histamine skin test. These findings suggest progressive parasympathetic denervation as a cause for the adrenocortical abnormality. (J Child Neurol 1988;3:174-176).
Transient Global Amnesia Precipitated by Emotion in an Adolescent
Authors: Tirman Phillip J. , Woody Robert C.
Published: June 2008

Transient global amnesia has been reported to be precipitated by intense emotion in adult patients. Transient global amnesia is uncommon in the pediatric age group. We report the unusual occurrence of this syndrome, apparently precipitated on two occasions by emotion, in an adolescent who had earlier in life suffered a left temporal and occipital lobe embolic infarction from congenital heart disease. Transient global amnesia following intense emotion may be a cause of some confusional states in children and adolescents. ( J Child Neurol 1988;3:185-188).
Paroxysmal Facial Itch: A Presenting Sign of Childhood Brainstem Glioma
Authors: Summers C. Gail , MacDonald John T.
Published: June 2008

Two children with neurofibromatosis and a chief complaint of severe, episodic, unilateral facial itching were found to have brainstem glioma. Initial computerized tomography of the brain was thought to be normal, but the brainstem tumor was subsequently demonstrated on magnetic resonance imaging. The paroxysmal facial itching resolved in both cases after a course of radiation therapy. The pathophysiology of the attacks of facial itching is unknown but must be related to the brainstem glioma. This is the first report of paroxysmal, unilateral facial itching as a presenting sign of childhood brainstem tumor. (J Child Neurol 1988;3:189-192).
Neural Defects in Jarcho-Levin Syndrome
Authors: Reyes Marc G. , Morales Augusto , Harris Vivian , Barreta Telly M. , Goldbarg Hilda
Published: June 2008

Neuropathologic examination of two autopsied patients with Jarcho-Levin syndrome showed no pathologic changes in the brain, spinal cord, or nerve roots of one and diastematomyelia of the thoracolumbar spinal cord in the other. The abnormalities of the spinal cord in one of our patients and in another patient described in the literature establish neural defects as a component of the Jarcho-Levin syndrome. ( J Child Neurol 1989;4:51-54).
Pigmented, Lipid-Laden Histiocytes in the Central Nervous System in Chronic Granulomatous Disease of Childhood
Authors: Riggs Jack E. , Quaglieri Frank C. , Schochet Sydney S. , Dove Douglas J.
Published: June 2008

In addition to granulomas, infiltrates of pigmented, lipid-laden histiocytes are a consistent morphologic finding in visceral organs of the reticuloendothelial system in patients with chronic granulomatous disease. We report a case with widespread meningeal and focal brain stem infiltrates of these distinctive histiocytes. The noninfectious involvement of the central nervous system in chronic granulomatous disease may be greater than previously recognized and related to the role of the CNS in the reticuloendothelial system. (J Child Neurol 1989;4:61-63).
Transcranial Doppler and Real-Time Cranial Sonography in Neonatal Hydrocephalus
Authors: Fischer Asma Q. , Livingstone John N.
Published: June 2008

Nine hydrocephalic infants who were less than 1 year old and 7 age-matched control subjects were examined by real-time and transcranial Doppler sonography to evaluate cerebral blood flow and to correlate it to ventricular size. These 16 infants were placed in one of three groups: infants in group 1 (n = 7) had a normal ventricular size, infants in group 2 (n = 3) had a progressively increasing ventricular size, and infants in group 3 (n = 6) had ventriculomegaly with either stable or decreasing ventricular size or a functioning ventriculoperitoneal shunt. All scans performed on group-2 infants showed markedly increased ventricular size and increased pulsatility index, while those on group-1 infants showed a normal ventricular size and pulsatility index. However, the scans of group-3 infants revealed increased ventricular size and normal pulsatility index. Regression analysis of the data showed rather weak correlations between ventricular size and pulsatility index for all groups. The regression data suggest that ventricular size is not the main determinant of cerebral blood flow in the neonate with hydrocephalus and that intracranial pressure may be a more critical factor. These data suggest that pulsatility index, as measured by transcranial Doppler, can be clinically more important than just the anatomical data alone in the evaluation of hydrocephaly. This points to a possible use of transcranial Doppler sonography in the evaluation of hydrocephalic patients for placement of ventriculoperitoneal shunts. (J Child Neurol 1989;4:64-69).
Subtle Encephalomyelitis in Children: A Variant of Acute Disseminated Encephalomyelitis
Authors: Johnsen Stanley D. , Sidell Alvin D. , Bird C. Roger
Published: June 2008

Four children with chronic, mild, nonspecific symptoms are described in whom magnetic resonance imaging (MRI) showed the presence of multifocal white-matter lesions suggestive of acute disseminated encephalomyelitis. The children ranged in age from 14 months to 15 years. The clinical picture was vague and inconclusive and consisted of several months of headaches, irritability, clumsiness, and personality change. Physical examinations were noncontributory. Laboratory investigation revealed no other cause of the demyelination. All of the patients have done well without any treatment, with a disappearance of symptomatology. The white-matter lesions on MRI scan in these children may indicate subtle exposure to a myelinolytic antigen. It has been suggested that such an exposure may create a state of complete or partial resistance to the encephalitogenic potential of the next infection or immunization. With complete resistance, the patient remains healthy and with partial resistance progressive demyelination results. Verification of these findings by others would suggest a possible benefit of a multicenter study of such patients, with virological, HLA testing, and long-term follow-up, in understanding the etiopathogenesis of multiple sclerosis. (J Child Neurol 1989;4:213-216).
Review Article: Dystrophin-Related Muscular Dystrophies
Authors: Witkowski J.A.
Published: June 2008

The gene for the locus involved in Duchenne and Becker muscular dystrophies has been cloned and subject to intense analysis. The protein product of the locus is called dystrophin, and it has been shown to be associated with the muscle fiber membrane. The new knowledge of the molecular genetics of these disorders is being applied rapidly in clinical practice. Carrier detection and prenatal diagnosis have been revolutionized by the use of probes for the gene. These probes are also being employed to clarify cases where conventional clinical examination results in equivocal diagnoses. It is suggested that the disorders characterized by dystrophin abnormalities should be called dystrophin-related muscular dystrophies (DRMD). There are mouse and dog models for DRMD and these are being used to explore therapeutic strategies for treating DRMD patients. (J Child Neurol 1989;4:251-271).
Rigid Spine Syndrome and Rigid Spine Sign in Myopathies
Authors: Merlini Luciano , Granata Claudia , Ballestrazzi Alessandro , Marini Maria Letizia
Published: June 2008

We studied eight patients with rigid spine syndrome aged 8 to 20 years at the time of first examination. Muscle weakness, rigid spine, and flexion contracture of elbows and ankles were noted in the first 6 years of age. Radiological study of the cervical spine revealed considerable reduction not only of flexion, but also of extension, of the neck. The "alligator sign" was demonstrated. Progression of scoliosis and of contractures reduced the functional capacity in six patients. A restrictive ventilatory syndrome was observed in all, while central apneas with oxygen desaturation were shown in two. Cardiac arrhythmias were observed in four. We suggest that a distinction should be made between myopathic rigid spine and rigid spine syndrome. Myopathic rigid spine is a clinical sign which is rarely sought but is present in several types of well-defined myopathies, meaning the myopathic involvement of the extensor muscles of the spine. Rigid spine syndrome is an axial myopathy with peculiar clinical and radiographic signs and a characteristic natural history. (J Child Neurol 1989;4:273-282).
Hematologic Monitoring in Children With Epilepsy Treated With Carbamazepine
Authors: Evans Owen B. , Gay Hanah , Swisher Ann , Parks Bruce
Published: June 2008

One hundred seventy-six children treated with carbamazepine for epilepsy were monitored over a 12-month period to determine the effects of carbamazepine on the hematologic system. There were no significant changes within the total population in the mean hematocrit or platelet count. The white blood cell count and total neutrophil count showed declines at 1, 8, and 12 months, but the differences did not achieve statistical significance. There was no correlation between the hematologic parameters and carbamazepine blood level, age or sex, or the presence of other drugs. Pretreatment leukopenia and neutropenia were present in 2.8% and 4.0% of children, respectively. During carbamazepine therapy, 8.0% and 17.0% of the children developed leukopenia and neutropenia, respectively, and it was persistent in 1.7% and 2.8%, respectively. The changes in the white blood cell count could be attributed to the changes in the total neutrophil count. (J Child Neurol 1989;4:286-290).
Congenital Difficulties With Swallowing and Breathing Associated With Maternal Polyhydramnios: Neurocristopathy or Medullary Infarction?
Authors: Alvord Ellsworth C. , Shaw Cheng-Mei
Published: June 2008

Two babies with congenital difficulties in swallowing and breathing are presented and contrasted. Both were associated with maternal polyhydramnios, but one was due to medullary infarction and the other to a malformation ("neurocristopathy"). In the former case, isolated tenth and twelfth cranial nerve palsies provided the clue as to the correct etiology, whereas the latter baby had dyscoordination of swallowing and breathing with sleep apnea ("Ondine's curse"). It is somewhat ironic that the case without a difficult delivery had the infarct, probably prenatal in onset, whereas the one with a difficult delivery had the congenital malformation. Neural crest cells are known to migrate widely and to develop greatly different functions, but the fact that their central associations of neural tube origin may also be affected has not previously been emphasized in the etiopathogenesis of the congenital malformation. A variety of syndromes with combinations of many defects may be seen in which too many or too few cells are formed, with more or less serious consequences especially for the respiratory and gastrointestinal systems. (J Child Neurol 1989;4:299-306).
Absence of β-Amyloid Immunoreactivity in Mesial Temporal Lobe in Cockayne's Syndrome
Authors: Woody Robert C. , Harding Brian N. , Brumback Roger A. , Leech Richard W.
Published: June 2008

Cockayne's syndrome is associated with dementia and other physical signs of premature senescence. Death usually occurs in the first or second decade of life. Because previous neuropathologic descriptions have included neurofibrillary tangles and calcific and dystrophic cerebrovascular changes, we examined the mesial temporal lobes of three children with Cockayne's syndrome (confirmed by 254-nm ultraviolet light studies). Immunohistochemistry was used to determine if β-amyloid immunoreactivity was present in the parenchyma or cerebral blood vessels. Tissues from the mesial temporal lobe of patients with Alzheimer's disease and Down syndrome were used as controls. None of the three temporal lobes from patients with Cockayne's syndrome contained β-amyloid immunoreactive material in either the parenchyma or vessels; all of the Alzheimer's disease and Down syndrome controls had β-amyloid immunoreactivity. ( J Child Neurol 1991;6:32-34).
Labor and Deliver Characteristics and the Risk of Germinal Matrix Hemorrhage in Low Birth Weight Infants
Authors: Leviton Alan , Fenton Terence , Kuban Karl C. K. , Pagano Marcello
Published: June 2008

To assess the influence of labor and delivery events on the risk of germinal matrix hemorrhage in preterm newborns, we conducted a review of data collected on 449 babies who weighed 1.5 kg or less. Babies delivered vaginally were more likely to have germinal matrix hemorrhage than were babies delivered abdominally (odds ratio, 2.5; 95% confidence interval, 1.4,3.3). Among babies delivered vaginally, the risk of germinal matrix hemorrhage was increased by 39% if labor lasted more than 12 hours. Among babies delivered abdominally, the occurrence of any labor was accompanied by a 150% increased risk of germinal matrix hemorrhage. The only indication for abdominal delivery associated with an increased risk of germinal matrix hemorrhage was impending amnionitis (odds ratio, 2.6; 95% confidence interval, 1.2,5.7), whereas the only indication associated with a decreased risk was preeclampsia (odds ratio, 0.2; 95% confidence interval, 0.6). Epidural and local anesthesia were associated with a reduced risk of germinal matrix hemorrhage among babies delivered abdominally. We conclude that delivery practices, or their indications, appear to influence the risk of germinal matrix hemorrhage in low birth weight babies. ( J Child Neurol 1991;6:35-40).
Multiple Sclerosis in Black Children
Authors: Zelnik Nathanel , Gale Arnold D. , Shelburne Samuel A.
Published: June 2008

Six cases of childhood multiple sclerosis (MS) are presented. All patients (three boys and three girls) were black and came from the Washington, DC, metropolitan area. Age at onset of the disease ranged from 8 to 17 years. Although motor deficits, optic neuritis, and ataxia were similar to those previously reported in pediatric patients, mental symptoms were more prominent and the course more intractable. The pattern of disease was characterized by a high frequency of relapses, with short remission and rapid progression. Within 1 to 7 years, one patient had died, one became severely handicapped, and three were steroid dependent with recurrent relapses. Our findings suggest that MS, though uncommon, exists also in black children. In the cases presented, the clinical course seems to be more malignant than previously reported. ( J Child Neurol 1991;6:53-57).
Large Postnatally Acquired Porencephalic Cysts: Unexpected Developmental Outcomes
Authors: Blackman James A. , McGuinness Gail A. , Bale James F. , Smith Wilbur L.
Published: June 2008

To determine the neurodevelopmental outcome for infants with posthemorrhagic intraparenchymal cysts, we reviewed retrospectively clinical, ultrasonographic, and developmental features in 16 affected children. At a mean follow-up age of 33 months, five subjects had normal cognitive outcomes (developmental quotient [DQ] or IQ > 83), nine had borderline to mild deficits (DQ or IQ, 52 to 83), but only three had moderate to severe deficits (DQ or IQ < 52). Spastic cerebral palsy was present in 13 (81%); only one child (6%) had a chronic seizure disorder requiring medication. Cognitively normal children were less likely to have had neonatal seizures (P < .05) and tended to have more localized cysts. Otherwise, we found no relationship between outcome and neonatal clinical or laboratory findings. Overall, these results suggest that although motor deficits are common in infants with severe intraventricular hemorrhage and porencephalic cysts, cognitive outcomes may be more favorable than has been suspected previously. ( J Child Neurol 1991;6:58-64).
Demyelinating Disease of Schilder Type in Three Young South African Children: Dramatic Response to Corticosteroids
Authors: Pretorius Marie-Louise , Loock Diane B. , Ravenscroft Alice , Schoeman Johan F
Published: June 2008

Three young children with the Schilder variant of multiple sclerosis were seen within a 3-year period at our hospital. The diagnosis was made on the basis of the typical (but not pathognomonic) clinical and magnetic resonance imaging (MRI) findings after eliminating other demyelinating and post-infectious disorders of the central nervous system. All three patients were treated with prednisone (2 mg/kg/day), which resulted in complete recovery in one patient and mild and moderate residual hemiparesis in the two other patients, respectively. Corticosteroid therapy was continued until the patients' neurologic condition normalized or no further clinical improvement occurred. No relapses were seen after discontinuation of corticosteroid treatment. Computed tomographic (CT) scan and MRI findings after completion of corticosteroid therapy were equally dramatic and corresponded with the clinical improvement. A strongly positive tuberculin skin test and a positive history of contact with adult tuberculosis in two of our patients raise the possibility of a connection between tuberculosis and Schilder's disease. (J Child Neurol 1998;13:197-201).
Preparation and Characterization of Triamcinolone Acetonide-loaded Poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHx) Microspheres
Authors: Bayram Cem , Denkbaş Emir Baki , Kiliçay Ebru , Hazer Baki , Çakmak Hasan Basri , Noda Isao
Published: June 2008

Triamcinolone acetonide loaded in poly(3-hydroxybutyrate-co-3 hydroxyhexanoate) (PHBHx) microspheres were prepared to treat cystoid macular oedema (CMO) and acute posterior segment inflammation associated with uveitis. The PHBHx microspheres were prepared by solvent evaporation technique using methylene chloride as the solvent and aqueous poly(vinyl alcohol) emulsifier as the dispersion medium. The PHBHx microspheres obtained were well formed with narrow size distribution; the average size prepared ranged from 40—200 μm depending on the formulation used. The stirring rate of the dispersion medium, emulsifier concentration, and polymer/solvent ratio parameters were varied to determine their effect on the size and size distribution of the PHBHx microspheres. Increasing the stirring rate and emulsifier concentration decreased the size and the size distribution of the microspheres, while increasing the polymer/solvent ratio caused the opposite effect. The polymer/drug ratio was the most effective parameter for controlling drug loading and release properties. More than 90% of the loaded drug was released within the first 24 h; after that, the release rate was slower for all formulations.
Synthesis of Starch—Poly(Sodium Acrylate-co-Acrylamide) Superabsorbent Hydrogel with Salt and pH-Responsiveness Properties as a Drug Delivery System
Authors: Sadeghi Mohammad , Hosseinzadeh Hossein
Published: June 2008

The synthesis and swelling behavior of a superabsorbent hydrogel based on starch (St) and polyacrylonitrile (PAN) were investigated. The physical mixture of St and PAN was hydrolyzed with NaOH solution to yield St—poly(sodium acrylate-co-acrylamide) superabsorbent hydrogels. The nitrile groups of PAN were completely converted to a mixture of hydrophilic carboxamide and carboxylate groups during the basic hydrolysis followed by in situ crosslinking of the PAN chains by the starch alkoxide ions. A mechanism for hydrogel formation was proposed and the structure of the product was established using FTIR spectroscopy. The effect of reaction variables, such as, base concentration, hydrolysis time, and temperature were systematically optimized to achieve a hydrogel with swelling capacity as high as possible. The optimized swelling capacity in distilled water was found to be >500g/g. The absorbency of the hydrogels indicated that the swelling ratios decreased with ionic strength increases. The St—poly(sodium acrylate-co-acrylamide) hydrogel exhibited a pH-responsive swelling—deswelling behavior at pH's 2 and 8. This on—off switching behavior provides the hydrogel with the potential to control delivery of bioactive agents. Release profiles of ibuprofen (IBU), a poor watersoluble drug, from the hydrogels were studied under both simulated gastric and intestinal pH conditions. The release was much quicker at pH 7.4 than at pH 1.2. The swelling rates of the hydrogels with various particle sizes were investigated as well.
Alliance, Genealogy and Political Power
Authors: Sheikh Samira
Published: June 2008

In 1472, the Cūdāsamā ruler of Junagadh in Saurashtra (peninsular western Gujarat) was finally defeated, after a long struggle, by the armies of Mahmūd, the sultan of Ahmadabad, a turning point in the history of Gujarat. The Cūdāsamās, hitherto dominant rulers, were reduced to the status of minor landholders. For the sultanate, it marked the abandonment of an administration based largely on tribute and alliance with local chieftains in favour of more direct rule. The transition in their government from military garrison-based rule to a more settled, bureaucratic sovereignty marked a significant shift away from the former system of politics in Gujarat. In spite of this history of violent antagonism between the Cūdāsamās and the sultans, this article hopes to show how both groups belonged to a common, transforming arena of politics in which alliance-making, genealogy and patronage were markers of status, a form of politics which may still be recovered from texts, genealogies and the accounts of professional record-keeping groups.
The Effect of the Lebanese Peg to the US Dollar on Market Efficiency and Risk
Authors: Azar Samih Antoine
Published: June 2008

The theory of self-fulfilling currency attacks predicts that pegged foreign exchange rates are extremely sensitive to adverse and hostile speculation. This is true whenever fiscal policy and monetary policy are inconsistent with each other, or even when intensive and public official intervention is initiated by a central bank with limited foreign exchange reserves. The experience of Lebanon, with its peg to the US-dollar since December 1998, shows that contrary to the received wisdom, a peg can stabilise the financial markets and eliminate inefficiencies such as serial correlation, a bias of the forward rate and the presence of a Peso problem. Moreover, risk was not only reduced during the Lebanese peg but was also dissipated.
Risk and Return in the Next Frontier
Authors: Girard Eric , Sinha Amit
Published: June 2008

This article investigates the risk-return relations of stocks traded in frontier markets, a class of small, illiquid, less accessible and less known emerging markets that has escaped the attention of many researchers. We examine the cross-section of risk premiums of 360 stocks traded in 19 frontier markets for the period from January 1997 to June 2004. We first observe that frontier markets provide greater return potentials than emerging and developed markets as well as further diversification benefits. Our investigation indicates that the risks involved when investing in frontier markets can be better understood by using a multifactor extension of CAPM which consists of fundamental factors like beta, price to book and size, and country specific factors including political, economic and financial risk ratings. Two surprising findings emerge from this study: (1) small and value stocks are less risky investment avenues than large and growth stocks, and (2) political, economic and financial risk factors have the greatest impact on risk premiums. Global investors should pay greater attention to institutional reforms in frontier economies leading to a more decentralised political system, improved national governance and a more transparent institutional and legal framework.
Franchise Values, Regulatory Monitoring, and Capital Requirements in Optimal	Bank Regulation
Authors: Andersen Thomas Barnebeck , Harr Thomas
Published: June 2008

This paper demonstrates that financial deregulation is likely to make standard prudential regulatory instruments less effective in curbing excessive risk-taking incentives among banks. This has interesting implications for optimal bank regulation. When there is an increase in competition, the optimal capital requirement should increase, whereas regulatory auditing should decrease. In contrast, when there is an increase in gambling yields, auditing should always increase, whereas the optimal capital requirement may increase or decrease.
How Sovereign Is Hobbes' Sovereign?
Authors: Kaplan Morton A.
Published: June 2008

THESIS: The injunction by Hobbes to found a Leviathan is thoroughly consistent with the end of life specified by Hobbes, namely, the avoid ance of death. It is equally inconsistent with a theory of sovereignty, i.e., with a theory which makes the state the source of obligation. Hobbes believed, however, that it would be dangerous to the security of lif e — that is, to the maintenance of the powerful state which was the great protector of life — if this position were stated openly. There fore he employed a private and a public language in the Leviathan. He shifted the definitions of his crucial concepts, though informing the careful reader he was doing so, in order to create the benign myth of legal sovereignty. From this, it also follows that man is not by nature asocial according to the theory of Hobbes and that consent does not provide a source of obligation.
The Economics of Specialty Hospitals
Authors: Schneider John E. , Miller Thomas R. , Ohsfeldt Robert L. , Morrisey Michael A. , Zelner Bennet A. , Pengxiang Li
Published: June 2008

Specialty hospitals, particularly those specializing in surgery and owned by physicians, have generated a relatively high degree of policy attention over the past several years. The main focus of policy debates has been in two areas: the extent to which specialty hospitals might compete unfairly with incumbent general hospitals and the extent to which physician ownership might be associated with higher usage. Largely absent from the debates, however, has been a discussion of the basic economic model of specialty hospitals. This article reviews existing literature, reports, and findings from site visits to explore the economic rationale for specialty hospitals. The discussion focuses on six factors associated with specialization: consumer demand, procedural operating margins, clinical efficiencies, procedural economies of scale, economies (and diseconomies) of scope, and competencies and learning. A better understanding of the economics of specialization will help policy makers evaluate the full spectrum of advantages and disadvantages of specialty hospitals.
Assessment of Sex Offenders Using Standardized Slide Stimuli and Procedures: A Multisite Study1
Authors: Laws D.R. , Gulayets M.J. , Frenzel R.R.
Published: June 2008

Thirty sex offenders were assessed for age and gender preference with a set of standardized erotic slides and an assessment protocol which specified each step in the procedure. This procedure was intended to be a normative study to be carried out at multiple sites in the United States and Canada. It was hypothesized that (1) the procedure would discriminate child molesters as heterosexual, homosexual, or bisexual, (2) the procedure would differentiate child molesters from normal subjects, and (3) both of these hypotheses would be confirmed at all sites. Data are reported here for 20 of the 30 subjects tested in groups labeled heterosexual pedophilia, homosexual pedophilia, heterosexual incest, and rape. Although the groups were quite small and measured response levels were low, good discriminations were obtained between groups and stimulus categories. It was concluded that the obtained data confirmed Hypothesis 1 and partially confirmed Hypothesis 2. Although the assessment protocol had to be altered to suit local conditions, it proved adequate and could serve as a guide in future standardization studies. Of particular interest was the finding that a 30-sec slide exposure was effective in producing discriminations in the critical categories related to the tested hypotheses.
Exit Examination for Sexual Offenders
Authors: Roys Deloris T.
Published: June 2008

Sexual offender treatment has a large educational, as well as therapeutic, component. An exit examination was devised to measure retention of knowledge gained by the offender during the course of a community-based treatment program. The exit examination, which signifies transition from a 3 hr-per-week 2-year therapy program to a once-per-month follow-up program, was structured to sample the domain of the offender's new learning. The sample was culled from elements of six major topic categories—relationships, judgment, understanding of feelings, identification of appropriate and inappropriate control techniques, recognition of damage done by victimizing behaviors, and recognition of patterns of deviance — in order to provide the therapist with an understanding of how much information was supplied to and retained by the offender. In addition, two other topic categories — thinking errors and tactics to avoid change — were addressed in their entirety in the examination because of their importance in providing an external view of the offender's recognition and recall of his ways of thinking that contributed to his deviance.
A Comparison of Verbal Satiation and Minimal Arousal Conditioning to Reduce Deviant Arousal in the Laboratory
Authors: Gray Steven R.
Published: June 2008

Two groups of incarcerated inmates were assessed by means of plethysmography and treated with two methods to reduce tested deviant arousal. Group 1 completed a variation of minimal arousal conditioning which included masturbating to ejaculation to an appropriate audio tape and then administering ammonia when aroused to a subsequent tape of their deviant interest. Group 2 was exposed to a variation of masturbatory satiation followed by minimal arousal conditioning (as above). Clients were tested by plethysmography following each course of treatment. Percentage arousal was subjected to Mann-Whitney U tests of significance. Analysis revealed minimal arousal conditioning to be an effective method in reducing deviant arousal.
The Utility of the MMPI and the MSI for Identifying a Sexual Offender Typology
Authors: Schlank Anita M.
Published: June 2008

Sexual offenders are known to be heterogeneous in their behavior and their psychologic functioning; however, studies of their heterogeneity have focused on standard measures of psychopathology rather than on measures of sexual deviance. The purpose of the current study was to determine if the Multiphasic Sex Inventory (MSI) would be more effective in developing a typology than the instrument most often used in sexual offender studies, the MMPI. Incarcerated sexual offenders in the Nebraska and Florida prison systems were chosen and multivariate cluster analyses were conducted using both their MMPI scores and their scores from the MSI. Results suggested that the MSI was more effective in determining clinically different subgroups of sexual offenders. These subgroups were independent of victim maturity and victim gender, and the results were consistent regardless of geographic location. The characteristics which differentiated the subgroups suggested the need for somewhat different treatment approaches for each subgroup.
The Value of the MMPI in Deciding Forensic Issues in Accused Sexual Offenders
Authors: Marshall W.L. , Hall G.C.N.
Published: June 2008

Research attempting to distinguish various types of sexual offenders in terms of their responses on the MMPI are reviewed. The results generally display inconsistency across studies, but two common features that emerge are heterogeneity of responses among each type of sexual offender and considerable overlap in response profiles between sexual offenders and other subjects. It is concluded that these results deny the value of using the MMPI to assist courts in the determination of the guilt or innocence of a person accused of committing a sexual offense.
The Sex Offender Treatment Rating Scale: Initial Reliability Data
Authors: Anderson Ronald D. , Gibeau Dennis , D'Amora David A.
Published: June 2008

The Sex Offender Treatment Rating Scale (SOTRS) is proposed as a potential process and outcome measure for cognitive/behavioral sex offender treatment. Therapists complete a 6-point rating scale with behavioral descriptors of Insight, Deviant Thoughts, Awareness of Situational Risks, Motivation, Victim Empathy, and Offense Disclosure. The ratings are combined to produce a single treatment progress score. Pairs of therapists providing treatment for 122 court-referred male sexual offenders in 15 therapy groups independently completed the SOTRS twice, at 5-month intervals. The results showed that internal consistency, interrater agreement, and test-retest reliability were all high. While further studies are needed to validate the SOTRS against recidivism criteria, it can presently be used for staff development, treatment planning, program evaluation, and quality assurance objectives.
Evolution, Psychopathology, and Sexual Offending: Aping Our Ancestors
Authors: Maletzky Barry M.
Published: June 2008

Koko at first appears amused by Mbara's approach. The shameless silverback stares at her before exposing his erect penis, while his human scientist cousins make notes at a furious pace; it is not every day observers are privileged to witness such emotionally charged ape behavior. Perhaps their note-taking distracts Koko. She lumbers off into the brush and Mbara does not pursue.

Across the continent, Nambuko, a male bonobo, is chased off by several dominant males when he tries to mount Antemba. After an appropriate period of sulking, Nambuko approaches and mounts Tafet, a juvenile bonobo, inexperienced in these matters. She shrieks and tries to fight him off, surprisingly successfully. The troop's ears are alerted and Tafet's mother, Okapa, and her sister Poke, rush in to protect their offspring. Nambuko sulks again.