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Background: Currently, the metatarsophalangeal angle (hallux valgus angle) is measured based on radiographic images. However, using X-ray examinations for epidemiological or screening purposes would be unethical, especially in children. For this reason it is discussed to measure the hallux valgus angle of the margo medialis pedis (medial border of the foot) documented on foot outline drawings or foot scans. As a first step on the way to prove the validity of those approaches this study assesses the hallux valgus angle measured on the margo medialis pedis based on the same x-ray pictures as the metatarsophalangeal hallux valgus., Methods: Radiographic images of the foot were obtained from patients with symptomatic hallux valgus malformation. Twelve sets of contact copies of the 63 originals were made, and were marked and measured according to three different methods, each one performed by two observers and with two repeated measurements. Thus, data sets from 756 individual assessments were entered into the multifactorial statistical analysis.Comparisons were made between the angle of the margo medialis pedis and the metatarsophalangeal angle, which was determined by two different methods. To determine the inter- and intraobserver reliability of the different methods, each assessment was conducted by two independent experts and repeated after a period of several weeks., Results: The correlations between the hallux valgus angles determined by the three different methods were all above r=0.89 (p<0.001) and thus highly significant. The values obtained by measuring the margo medialis pedis angle, however, were on average 4.8 degrees smaller than the metatarsophalangeal angles. No significant differences were found between the observers. No systematic deviations for any observer between repeated measurements were detected., Conclusions: Measurements of the radiographic hallux angle of the margo medialis pedis are reliable and show high correlation with the metatarsophalangeal angle. Because the hallux valgus angles based on margo medialis pedis measurements were slightly but statistically significantly smaller, these measurements should be considered conservative estimates of the metatarsophalangeal angle. Significant differences between hallux valgus angles based on radiographic and non-radiographic material are unlikely. However this question has to be treated in a second stage in detail.

Background: Wearing shoes of insufficient length during childhood has often been cited as leading to deformities of the foot, particularly to the development of hallux valgus disorders. Until now, these assumptions have not been confirmed through scientific research. This study aims to investigate whether this association can be statistically proven, and if children who wear shoes of insufficient length actually do have a higher risk of a more pronounced lateral deviation of the hallux., Methods: 858 pre-school children were included in the study. The study sample was stratified by sex, urban/rural areas and Austrian province. The hallux angle and the length of the feet were recorded. The inside length of the children's footwear (indoor shoes worn in pre-school and outdoor shoes) were assessed. Personal data and different anthropometric measurements were taken. The risk of hallux valgus deviation was statistically tested by a stepwise logistic regression analysis and the relative risk (odds ratio) for a hallux angle > or = 4 degrees was calculated., Results: Exact examinations of the hallux angle could be conducted on a total of 1,579 individual feet. Only 23.9% out of 1,579 feet presented a straight position of the great toe. The others were characterized by lateral deviations (valgus position) at different degrees, equalling 10 degrees or greater in 14.2% of the children's feet.88.8% of 808 children examined wore indoor footwear that was of insufficient length, and 69.4% of 812 children wore outdoor shoes that were too short. A significant relationship was observed between the lengthwise fit of the shoes and the hallux angle: the shorter the shoe, the higher the value of the hallux angle. The relative risk (odds ratio) of a lateral hallux deviation of > or = 4 degrees in children wearing shoes of insufficient length was significantly increased., Conclusions: There is a significant relationship between the hallux angle in children and footwear that is too short in length. The fact that the majority of the children examined were wearing shoes of insufficient length makes the issue particularly significant. Our results emphasize the importance of ensuring that children's footwear fits properly.

The effect of a chemical lesion of the cholinergic septo-hippocampal pathway induced by ethylcholine aziridinium (AF64A) on brain potentials evoked by species-specific vocalization containing informations of high biological relevance was studied in young adult (10 months) and aged (24 months) rats by means of neocortical electroencephalographic recordings. In control rats, the perception of a rat's vocalization in a life endangering situation (lasting 0.8 s) initiated an evoked potential followed by a late positive slow wave (LPSW)-complex and a direct current shift with a duration of up to 16 s. Four months after treatment with AF64A (2 nmol into each of the lateral ventricles), the mean negative component of the initial acoustic evoked potential (peak latency of about 60 ms after stimulus onset) was reduced (P = 0.04) both in young adult and aged rats. Further changes included a decrease of the late positive wave amplitude in young adult rats (P = 0.001) and a shorter duration of the LPSW-complex in aged rats (P = 0.03). AF64A induced also changes in specific components revealed by Principle Component Analysis, but only in the group of young rats. A decrease in the slow wave component (factor 1, 3000-4000 ms after stimulus onset; P = 0.02) was observed. Age per se affected the late positive potential shifts as indicated by a shorter latency of the late positive wave (P = 0.03). A detailed analysis of the major neurotransmitter markers proved an almost exclusive reduction of the activity of choline acetyltransferase in the ventral and dorsal hippocampus (up to 60%), which was equal in young adult and aged rats. The irreversible loss in choline acetyltransferase activity, which was restricted to the hippocampus, was associated by a slight reduction in serotonergic function. The present data suggest that the complex cognitive and emotional processes initiated by species-specific vocalization appear to be affected by aging. Furthermore, as a consequence of a cholinergic deficit in the hippocampus, the integration processes essential for the recognition of the biological meaning of a species-specific vocalization are considerably disturbed. These findings provide an experimental basis for studying disturbances in the perceptual response to stimuli of high emotional value in patients with hypocholinergic function as in Alzheimer's disease.

Breast self examination (BSE) is recommended for the early detection of breast cancer in the European Code against Cancer. Evidence from North America suggests that there is reasonable public awareness of its importance, but compliance with regular BSE is reported by only a minority of young women. Attitudes to and practice of BSE has rarely been studied outside North America. In the present study, attitudes to BSE were evaluated by questionnaire in a sample of 16,486 students aged 17-30 from 20 European countries. Frequency of BSE practice was reported by the 9,181 women in the sample. Information on public recommendations concerning BSE was obtained from cancer organizations in each country. The data were collected as part of the European Health Behaviour Survey, an international study on health beliefs and health behaviour. The results showed that BSE was recommended in 16 countries and 'breast awareness' in two, while two countries did not recommend self-examination. 54% of women reported as never having practiced BSE. Regular practice (monthly) was reported by only 8% of the sample, with another 36% reporting occasional BSE. Significant differences emerged between centres in different countries ranging from 6% to 15% reporting regular BSE. Attitude towards BSE was a significant predictor of BSE practice within each centre and across all centres combined. Attitudes towards BSE were significantly less positive in the two centres from countries without BSE recommendations than in the others, but levels of practice were similar.(ABSTRACT TRUNCATED AT 250 WORDS)

The investigation was performed in winter 1990 and 1991 when measurements were taken in 16 dwellings of patients, recruited from a pulmologic outpatient centre. Patients suffered from repeated respiratory irritations which they attributed to dwelling conditions. Inhabitants reported by means of questionnaires and standardized scales the dwelling situation and their dwelling behaviour, subjective ratings of indoor environmental quality as well as ratings of wellbeing. The load of indoor pollutants (CO2, CO, NO2, HCHO), biological agents (fungal spores, house dust mites) as well as indoor climate factors were assessed. The measurements revealed an evident load at least in one parameter; in the majority of dwellings combined loads of air pollutants and biological agents were apparent. Homes supplied with gas as main energy source had significantly higher concentrations of CO2, CO and NO2. At noon, exposure limits of CO2 and NO2 were frequently exceeded. Inhabitants of homes being supplied with electricity instead of gas gave significantly better air quality ratings. The correlations between the average score concerning the rated health quality of their homes and the rate of excess of exposure limits are significant: The health quality ratings are significantly related to the concentrations of "air quality indicators", which induce the feeling of stale air (CO2) and mucosa irritations (NO2). Ratings of wellbeing are significantly connected to objective parameters, i.e. NO2 baseline load, fungal spores in the air and the difference between wall-air temperature. Our study suggests that people suspecting a connection between their health impairment and dwelling conditions should be taken serious. The measurement program proved to be a suitable screening procedure to assess adverse environmental influences in homes. More homes should be investigated to further support our findings.

The occurrence of infraslow potential oscillations (ISPOs) of the brain was investigated during a listening and a resting condition in 44 subjects (Ss) with high (HAC) and low ability to concentrate (LAC). The occurrence of ISPOs was found in 36% of the Ss. While in the HAC group the occurrence of ISPOs did not change from listening to resting, in the LAC group Ss with ISPOs were affected by experimental conditions, showing ISPOs during the listening condition. For Ss with ISPOs only during listening a lower score was found for ability to concentrate, suggesting ISPOs as a possible underlying mechanism. For Ss with stable ISPOs a higher I.Q. was found compared to Ss without ISPOs.

In order to assess age-related effects of carbon monoxide (CO) on brain wave-activity and sleep, auditory evoked potentials (AEP) were measured during sleep in 10 healthy young volunteers (20-25 years) and in a group (N = 10) of healthy elderly Ss (55-72 years) under control- and exposure-conditions in counterbalanced order. Sleep-stages were classified according to the Rechtschaffen and Kales scoring-system. In addition to electrophysiological measures memory-performance and subjective feeling (mood-scale) was assessed before and after sleep. Eight hours of CO-exposure (100 ppm) gave rise to about 8% COHb. In the group of young Ss there was a significant (p less than 0.05) increase of deep sleep (stages 3,4), and a decrease of stage REM-sleep during CO-exposure, whereas in elderly Ss similar but non-significant sleep-changes occurred. Some CO-related AEP-changes within different sleep-stages, namely shorter latencies in elderly Ss and higher amplitudes in young Ss, approached significance. Within the group of young Ss there was a tendency to more depressed mood after CO-exposure, as well as to CO-related impairment of memory consolidation; no such effects were observed in elderly Ss. The general hypothesis of more pronounced CO-susceptibility of elderly people was, therefore, not supported in this study.

Carbon monoxide (CO) and nitric oxide (NO) are air pollutants frequently appearing in combination. Information available on the mechanisms of NO intoxication suggests that in mixtures with CO additive effects should be assumed. In this study CO and NO-induced changes and their interaction were investigated at different levels of integration: carboxyhemoglobin (COHb) and methemoglobin (met-Hb) formation as well as centrally mediated effects were analyzed using evoked potential techniques and behavioral data from a complex discrimination learning experiment. Slight enhancements of COHb and met-Hb concentrations were seen for the combined CO + NO exposure conditions at low and high exposure levels when compared to isolated exposure conditions. The performance decrease was clearly higher under NO exposure than under CO exposure. Decrements were overadditive when simultaneous CO + NO exposure was used in higher concentration. Both gases affected early evoked potential components (P10, N30) in the same way: latencies were prolonged and amplitudes increased. Later potential components were differently influenced by CO and NO. Mainly the N150 amplitude was decreased in NO exposure and increased in CO conditions. N150 amplitude was also decreased after combined CO + NO exposure. At high levels this effect was overadditive indicating a dominant role of NO in the CO + NO combinations used in this experiment.

The present experiment was undertaken to demonstrate the effect of muscular force as well as duration of muscular work on the electromyographic (EMG) DC potential. Thirty subjects had to lift different weights by flexing the right forearm within a defined and constant setting for 20 s. The experimental variables were weight (0.5, 1, 2, and 3 kg) and time. The EMG was recorded from the belly of the right biceps brachii muscle in a quasi-unipolar manner and split into an integrated ac channel (IEMG) and a dc channel (DC-EMG). The average IEMG showed a ramp-like shape. Analysis showed a positive relationship for weight (p less than 0.0001) and time (p less than 0.0001) with the IEMG. The average shape of the DC-EMG showed a negative initiation potential, a monotonically increasing negative potential during contraction (contraction potential), a positively peaking off potential and a slow return to baseline (after potential). Analyses of variance demonstrated a significant (p less than 0.001) relationship of weight to the magnitude of the initiation and the termination potential. Regression analyses displayed an inverse relationship of time to the termination (p less than 0.01) and to the resolution potential (p less than 0.001). The DC-EMG showed higher peaks (initiation and termination potential) for heavier weights. For the termination and after potential less positive deflections were found with increasing time (fatigue). A control condition (isometric contraction) indicated that the initiation, contraction, and termination potential of the DC-EMG may also be related to aspects of the movement. Results suggest that the DC-EMG is a more complex measure of muscular activity than the IEMG.

The prevalence of the coronary-prone behavior pattern and its interaction with psychosocial and primary coronary risk factors was studied in a Viennese population sample consisting of 1459 people (634 men, 825 women). The sample was representative with respect to sex, age greater than 16 years, socio-economic status and local distribution. A questionnaire-based short rating scale developed by Bortner was used. The distribution of the study population on the A-B axis was unimodal (means = 174.95 +/- 40.76). The upper and the lower third of the A-B dimension was designated to represent type A1 and type B4, respectively. The mean Bortner score and rate of type A1 persons clearly decreased at lower (16 to 20 years) and higher ages (greater than 60 years). Within the group of employed subjects aged 21 to 60 years the mean type A score and the rate of A1 subjects for men (177 +/- 39; 6%) differed significantly from that of their female counterparts (188 +/- 39; 13%). Housewives had a mean score of 178 +/- 41 and 10% of them were scored A1, thus indicating significantly lower mean scores than employed females but the same rate of A1. Subjects with higher educational level showed only a tendency to increased type A. The socio-economic status was positively correlated to the global Bortner score, especially in men, but no relation was found to the rate of Type A1 persons. There was no significant correlation between type A score and systolic or diastolic blood pressure, body mass index or smoking behavior, but a significant correlation between type A score and the subjective feeling of overload. Type A subjects scored themselves significantly more often as continuously overload.

In the course of a clinical study oral administration of two different diazepine derivatives as well as i.m. injection of pethidine and promethazine have been explored with a view to their anxiolytic, sedating and hypnotic action. The study involved 128 patients, randomized into four groups. Group 1 received flunitrazepam 1,5-2 mg p.o. only the evening before operation to group 2 flunitrazepam 1,5-2 p.o. was administered the evening before and the morning of the operation, group 3 were given lormetazepam 2-2,5 mg p.o. at the same time as group 2, in group 4 nitrazepam, 5 mg p.o. the evening before operation and pethidine, 50-100 mg combined with promethazine, 25 mg was given i.m. 60 min before surgery. In group 1 anxiolytic and sedating effect of flunitrazepam were not persistent enough to provide the patient with adequate premedication until the onset of surgery. Intensive sedation and fatigue as well as minimum recollection were observed under medication 2, however, increase in anxiety and depression as well as deterioration of mood were not prevented. Under medication 3 patients felt less exhausted and fatigued than under medication 2, but likewise anxiety and depression increased in the course of the operating day. Group 4 emerged as the last effective premedication both with regard to sleep during the previous night and the conditions of the day of the operation itself.