State and prospects of antituberculous care for the population of the Republic of Marii El

Over the last several years, there has been a growing awareness of a need for better integration of the liberal arts into nursing curricula. To facilitate this process, the authors describe a creative teaching strategy and offer specific suggestions for the selection and use of novels, short stories, plays, and poems to supplement the teaching of specific nursing content.     

The epidemiological aspects of a study of hereditary nervous system diseases in Amur Province

The prevalence of neurogenetic diseases per 100,000 was studied in Amur Province [correction of Territory]. Charcot-Marie's neural amyotrophy held the lead, Huntington's chorea ranked next. Among the multinational population, the diseases were detected among the Russians, but they were absent in the Evenki. Out of 225 cases, 138 males were afflicted. The most unfavourable factors that predisposed to the disease proved to be infectious processes, toil, and stresses. Epidemiological studies of neurogenetic diseases provide highly valuable information on the migration of abnormal genes and promote to the timely organization of therapeutical and preventive measures.     

Life-threatening rashes: dermatologic signs of four infectious diseases

OBJECTIVE: To review clinical and laboratory features of lupus panniculitis from a large group of patients. METHODS: Retrospective chart review of patients diagnosed with lupus panniculitis at a tertiary medical center from 1976 to 1993. RESULTS: Lupus panniculitis occurred most frequently in adult women. Skin lesions involved proximal extremities, trunk, face, and scalp. Only 4 of 40 patients fulfilled criteria for systemic lupus erythematosus (SLE), and, other than positive antinuclear antibodies, a paucity of other autoantibodies was seen. Average disease duration was 6 years (range 0-38). Treatment with antimalarial agents was undertaken in most cases. Disease related morbidity (disfigurement and disability) was relatively common, but death was rare. CONCLUSION: Lupus panniculitis is a chronic inflammatory disease of subcutaneous adipose tissue that can develop during the course of SLE, although most patients do not develop systemic lupus.     

Identification of a hereditary pancreatitis mutation in four West Virginia families

Hereditary pancreatitis (HP) is the second most common cause of chronic childhood pancreatitis in the United States. Mutations in the cationic trypsinogen gene on chromosome 7 are known to cause HP. We identified four families in West Virginia with symptoms consistent with HP. To determine whether members of these families had defects in the trypsinogen gene, we tested for linkage between the HP gene and simple tandem repeat markers on chromosome 7q and screened for a specific mutation in the cationic trypsinogen gene. Two-point linkage analysis indicated that the disease gene is closely linked to three 7q markers (D7S661, D7S2511, and D7S1805). Restriction fragment length polymorphism analysis showed that all clinically affected members and nonpenetrant carriers from the four families carried a G to A mutation in the third exon of the trypsinogen gene. These findings indicate that this mutation is the cause of HP in the families in our study. The observation that most individuals who carry the mutation have symptoms of HP is consistent with the high but incomplete penetrance of the trait. The presence of a single mutation and a common linked haplotype indicates that the defective allele arose in an ancestor common to all four families.     

Childhood asthma in four regions in Scandinavia: risk factors and avoidance effects

BACKGROUND: The high and increasing prevalence of childhood asthma is a major public health issue. Various risk factors have been proposed in local studies with different designs. METHODS: We have made a questionnaire study of the prevalence of childhood asthma, potential risk factors and their relations in four regions in Scandinavia (Ume? and Malm? in Sweden, Kuopio in eastern Finland and Oslo, Norway). One urban and one less urbanized area were selected in each region, and a study group of 15962 children aged 6-12 years was recruited. RESULTS: The prevalence of symptoms suggestive of asthma varied considerably between different areas (dry cough 8-19%, asthma attacks 4-8%, physician-diagnosed asthma 4-9%), as did the potential risk factors. Urban residency was generally not a risk factor. However, dry cough was common in the most traffic polluted area. Exposure to some of the risk factors. such as smoking indoors and moisture stains or moulds at home during the first 2 years of life, resulted in an increased risk. However, current exposure was associated with odds ratios less than one. CONCLUSIONS: Our findings were probably due to a combination of early impact and later avoidance of these risk factors. The effects of some risk factors were found to differ significantly between regions. No overall pattern between air pollution and asthma was seen, but air pollution differed less than expected between the areas.     

Viral hepatitis delta in the republic of Belarus

26,740 blood donors and persons of high risk groups with respect to HBV infection, residing in different regions of Belarus, were examined for the presence of HBsAg in 1983-1997. Of these, 1372 persons (5.1%) were found to have HBsAg, and out of 1081 HBsAg-positive persons anti-HDV antibodies (Ab) were detected in 96 persons (8.9%). In spite of a decrease in acute virus hepatitis B morbidity and in HBsAg carriership, the occurrence of anti-HBV Ab remained stable during the period of 16 years and was equal, on the average, about 4% among asymptomatic HBsAg carriers. Patients having tuberculosis, rheumatoid arthritis, diabetes mellitus, hematological diseases, chronic hepatitides and cirrhosis of the liver were an important reservoir of HBV and HDV infections for regions with the low level of the spread of HBV. A decrease in the detection rate of anti-HDV Ab in patients with cirrhosis of the liver from 47.6% to 15.4% was noted. In 1991-1997 a decrease in the detection rate of anti-HDV Ab in patients with chronic hepatic lesions in comparison with 1983-1990 was observed, and in the age group older than 50 years this decrease was from 33.3% to 8.3%. This difference was particularly pronounces in patients with cirrhosis of the liver: 53.9% and 7.7% respectively.     

Spongecake and eggroll: two hereditary diseases in Drosophila resemble patterns of human brain degeneration

Various neuronal degenerative diseases are characterized by late onset, relentless progression, and finally death. Many have a direct genetic basis; others are of still unknown etiological mechanisms [1,2]. The study of human neurodegenerative diseases is complicated by the difficulty of obtaining tissue samples at various stages of progression, especially early in the course of the disease. Since neurodegeneration occurs in many organisms [3-5], model organisms amenable to genetic and molecular techniques, such as the mouse, offer important advantages. Much less laborious and expensive are worms or flies, which have short generation times and can be rapidly screened for mutations. To investigate the use of the fly as a model system for identifying genes related to such diseases, we screened for mutants having reduced lifespan, then examined them for brain degeneration. We describe here two such mutants, each with a different pattern of degeneration as characterized by light and transmission electron microscopy. The brain of the aging spongecake mutant exhibits regionally specific, membrane-bound vacuoles similar to those seen in spongiform degenerations such as Creutzfeldt-Jakob disease [6,7]. The mutant eggroll develops dense, multilamellated structures in the brain, resembling ones found in lipid storage diseases such as Tay-Sachs [8].     

Current diagnosis: hereditary metabolic diseases of the liver (primary hemochromatosis, Wilson disease)

Primary hemochromatosis is characterized by a specific pattern of clinical manifestations. It includes liver disease with hepatomegaly, glucose intolerance, e.g. diabetes, hyperpigmentation oft the skin, impotence/ amenorrhea, arthropathy, cardiomyopathy and fatigue. Laboratory investigation reveals significantly elevated serum ferritin and transferrin saturation with iron. The diagnosis is confirmed by liver biopsy and quantitative determination of elevated liver iron content. Wilson's disease represents a copper storage disease. Prominent clinical features are hepatomegaly and splenomegaly. Neurological alterations and detection of Kayser-Fleischer corneal rings are typical. In the acute initial phase the often young patients present with Coombs-negative hemolysis. Psychiatric alterations, cardiomyopathy, arthropathy, nephropathy, as well as thrombocytopenia and leucopenia are other clinical features. Laboratory parameters of Wilson's disease include low serum ceruloplasmin and serum copper. There is an elevated urinary copper excretion and elevated serum free copper concentration. The diagnosis is confirmed by liver biopsy with quantitative determination of an elevated liver copper content.     

Nucleolar organizer regions in lymphomas: a quantitative study

Using a silver staining technique, nucleolar organizer region-associated proteins (Ag-NORs) have been studied in paraffin sections of 76 non-Hodgkin's lymphomas, five normal lymph nodes, and five lymph nodes. The mean number of nucleolar organizer regions per nucleus was 1.19 (SD:0.09) for normal lymphocytes, 3.04 (SD:0.14) for reactive lymph nodes, 2.79 (SD:0.44) for low-grade lymphomas, 6.33 (SD:1.58) for intermediate-grade lymphomas, and 10.53 (SD:1.97) for high-grade lymphomas. There were highly significant differences in Ag-NOR counts among the groups (p < 0.001). The Ag-NOR regions were often observed in nuclei in areas where nucleoli themselves were invisible. It is suggested that this method is useful in diagnostic histopathology and in differentiation of the grade of lymphomas.     

Angiographic findings in hereditary hemorrhagic teleangiectasia: a case study of Rendu-Osler-Weber disease

A case of Rendu-Osler-Weber disease in 48 year old male was described. Selective arteriography of superior mesenteric artery revealed its widening (including intestine branches), numerous anastomoses in the form of microhaemangioma and fast venous return with broad superior mesenteric and portal vein.     

Lifetime use of alternative therapy: a study of Florida residents

OBJECTIVE: To determine the bacteriologic efficacy of ceftriaxone in nonresponsive acute otitis media in children. METHODS: In a prospective study 92 patients ages 3 to 36 months (median, 11 months) with culture-proved nonresponsive acute otitis media were studied from January, 1995, through August, 1997. The patients were treated with intramuscular ceftriaxone (50 mg/kg/l/day) for 3 days. Middle ear fluid was aspirated for culture by tympanocentesis on day of enrollment (Day 1); a second tap was performed on Days 4 to 10. Additional middle ear fluid cultures were obtained if clinical relapse occurred. Bacteriologic failure was defined by positive culture on Days 4 to 10. Patients were followed until Day 17+/-2. Susceptibility was measured by E test. RESULTS: The main drugs administered before enrollment were amoxicillin (38%), amoxicillinclavulanate (25%) and cefaclor (20%). Organisms recovered (n=105) were: Haemophilus influenzae, 54; Streptococcus pneumoniae, 47; Moraxella catarrhalis, 2; and Streptococcus pyogenes, 2. Thirty-four (72%) of the 47 S. pneumoniae isolates were intermediately resistant to penicillin (MIC 0.1 to 1.0 microg/ml), but all were susceptible to ceftriaxone (MIC < 0.5 microg/ml). Bacteriologic eradication was achieved in 100 of 105 (95%) cases: 54 of 54 (10O%) H. influenzae, 43 of 47 (92%) S. pneumoniae, 1 of 2 (50%) M. catarrhalis and 2 of 2 (100%) S. pyogenes. Bacteriologic success (with no relapse) occurred in 13 of 13 (100%) penicillin-susceptible S. pneumoniae vs. 28 of 34 (82%) S. pneumoniae intermediately resistant to penicillin (4 cases of bacteriologic failure and 2 cases of relapse). CONCLUSION: A 3-day intramuscular ceftriaxone regimen is efficacious for the treatment of nonresponsive acute otitis media. The optimal duration of treatment in cases of nonresponsive acute otitis media and whether ceftriaxone is efficacious for the treatment of nonresponsive otitis media caused by S. pneumoniae highly resistant to penicillin is yet to be determined.     

Motivation in management: A study of four managerial levels.

Can managers be properly spoken of as a class? 155 managers responded to a questionnaire about their work. "Within the four levels of management studied, there was a high degree of commonality regarding conditions of work considered to be important… . In a sense, then, perhaps one can accurately talk about 'management' as a meaningful, cohesive class sharing common motivations regarding what they want from their work, if their responsibilities are defined in terms of job rather than organizational effectiveness." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Immunohistochemical study of calpain-mediated alpha-crystallin proteolysis in the UPL rat hereditary cataract

The purpose of this study is to examine if microencapsulated PC12 cells may provide long term effects to the hemiparkinsonian rats. A modified technique was used to encapsulate PC12 cells into gelled microspheres. We found that the PC12 cells can survive in the modified microcapsules in vitro. Most of the PC12 cells formed cluster 3 weeks after incubation. The PC12 cell-loaded microcapsules were also examined in vitro. Adult Sprague-Dawley rats, anesthetized with chloral hydrate, were injected unilaterally with 6-hydroxydopamine into the medial forebrain bundle. The effectiveness of this lesion was tested by measuring apomorphine or methamphetamine-induced rotation one month after lesioning. The unilaterally lesioned rats were transplanted with microencapsulated PC12 cells. Results showed that apomorphine and methamphetamine-induced rotations were greatly suppressed after transplantation. One year after the grafting, the animals were anesthetized with urethane for the voltammetric study. Low dose of KCl was directly injected into the grafted striatum through pressure microejection. We found that KCl-induced DA release, as measured by voltammetric techniques, was regenerated in the striatum. The animals were later sacrificed for histological examination. We found that capsules were present in the lesioned striatum one year after grafting. Most of the capsules contained no PC12 cell. However, some capsules were filled entirely with PC12 cells. Taken together, our data suggested that PC12 cells can survive in the capsule in vitro and may provide long-term dopaminergic effects to the hemiparkinsonian rats.     

Liposarcomas of the oral tissues: a clinicopathologic study of four tumors

Liposarcomas of the oral tissues are rare. There have been 28 previously reported in the literature. A clinicopathologic study of 4 patients with liposarcoma involving the oral tissues is presented--one in the tongue, one in the palate, and two in the submandibular space. Two of the tumors were myxoid, one was of well-differentiated type and one was of pleomorphic type. Three of the lesions were diagnosed clinically as benign. The most important lesson to be learned from the histopathology is the positive identification of atypical lipoblasts. Follow-up data indicate that prognosis generally corresponds to the tumor type. The patients with myxoid and well-differentiated liposarcoma remain alive and with no evidence of disease. The patient who died of tumor had a pleomorphic liposarcoma. Treatment of these lesions should consist of wide surgical excision and consideration of adjunctive or palliative radiotherapy.     

Lymphomatoid granulomatosis: A clinicopathologic study of four cases

Four cases of lymphomatoid granulomatosis were studied. One case, previously reported, has had a prolonged remission of 8 years' duration. In one case, the course was rapid and progressive, and the patient died 2 months after the onset of the disease. In two other patients, the disease appears to be arrested effectively, both clinically and radiographically, by administration of corticosteroids. In the fatal case, postmortem examination revealed a typical angiocentric and destructive polymorphous lymphoreticular infiltrate in the lungs, kidneys, and adrenal glands. The diagnosis was made on specimens obtained from three patients by open thoracotomy. An adequate specimen is mandatory for diagnosis and thoractomy is indicated. To be considered in the differential diagnosis are Wegener's granulomatosis, the limited form of Wegener's granulomatosis, lymphoma, allergic granulomatosis, lymphocytic interstitial pneumonia, plasma cell granuloma, and infectious granuloma.