Chylothorax: report of a case complicating orthotopic heart transplantation

This report describes a case of t(15;17) acute promyelcytic leukaemia (APL, FAB subtype M3) with dysgranulopoiesis at diagnosis in a patient who developed myelodysplasia (MDS) and then a second phenotype of t(7;21) acute myeloblastic leukaemia (AML, FAB subtype M1) at the time of relapse. To our knowledge, there is no report of a second phenotype of AML occurring after complete remission (CR) of APL. Furthermore, this is the first report of chromosomal abnormality t(7;21) in a case of AML. Several hypotheses for this unusual course of APL are discussed.     

Private health insurance coverage and disability among older Americans

OBJECTIVES: This study examines the relationship between the lack of private supplemental health insurance coverage and the development of disability among adults aged 65 and older. METHODS: Data are from the baseline and six follow-up waves of the Duke Established Populations for Epidemiologic Studies of the Elderly survey (N = 4,000). Discrete-time hazard models were used to estimate the impact of insurance coverage and other risk factors on the incidence of disability among those unimpaired at baseline. RESULTS: Controlling for education, income, and other potential confounders, the odds of developing disability were 35-49% higher among those without private coverage. Insurance coverage also statistically explained part of the increased risk of disability among low-income persons. DISCUSSION: The results indicate that changes in health insurance coverage as well as in individual behaviors may be needed to reduce disability generally and disability among the socioeconomically disadvantaged, in particular.     

A comparison of stool characteristics from normal and constipated people

In people with constipation, it is not known if decreased frequency of defecation is associated with abnormalities in the weight or in the consistency of stools or if the weight or the consistency of stools correlates with the severity of various discomforts associated with bowel movements. In neither normal nor constipated subjects has the consistency of stools been carefully correlated with their relative contents of water and solids. Our aim was to gain insight into these questions. Twenty subjects with idiopathic chronic constipation and 20 age- and sex-matched control subjects were recruited by advertisement. Stools were collected for one week. After each bowel movement, the subject's perception of various discomforts associated with the bowel movement were recorded. The stools were then analyzed. The results and conclusions were as follows: (1) Stool weight per bowel movement was similar in the two groups but stool weight per week was markedly reduced in constipated subjects. (2) Reduced stool weight per week in constipated subjects was due to a nearly proportional reduction in stool water and stool solids output. (3) Using data from both groups, there was a curvilinear correlation between percent insoluble stool solids and stool hardness, as measured by a texture analyzer; hardness increased only slightly as percent insoluble solids increased between 7 and 20%, but hardness increased dramatically when percent insoluble solids exceeded 25%. (4) Only 6% of stools from constipated subjects (2 of 34) had abnormally high values for percent stool solids and physical hardness. (5) In subjects with constipation, the severity of various discomforts associated with bowel movements (such as straining) correlated poorly with the weight or the hardness of stool that was produced by the bowel movement.     

Elevated serum levels of cyclo (His-Pro), an endogenous inhibitor of pituitary prolactin secretion, in systemic lupus erythematosus patients

We sought to determine whether an increased frequency of the HLA-DR11 (formerly DR5) phenotype is found in human immunodeficiency virus (HIV)-infected children with parotid gland enlargement. In HIV-infected adults, parotid gland enlargement may be part of the diffuse infiltrative CD8 lymphocytosis syndrome. An increased frequency of expression of HLA-DR11 has been described in association with diffuse infiltrative CD8 lymphocytosis syndrome. We conducted a case-control study with 26 HIV-infected children, 13 of whom had parotid gland enlargement and 13 of whom did not but who were matched for age, race, and sex with those with parotid gland enlargement. Clinical and laboratory parameters (including HLA-DR11 phenotype) were compared between the two groups. HIV-positive children with parotid gland enlargement showed an increased frequency of HLA-DR11, similar to their adult counterparts with diffuse infiltrative CD8 lymphocytosis syndrome. The HLA-DR11 phenotype may be associated with the development of parotid gland enlargement in HIV-infected children and may be a marker for a more benign outcome of HIV infection.     

Academic, social, and general self-concepts of behavioral subgroups of learning disabled children.

This study assessed perceived competence in 60 children (aged 8–13 yrs) who were classified into 4 carefully matched groups: (1) non-learning-disabled (non-LD), non-behavior-disordered, (2) LD, non-behavior-disordered, (3) LD with externalizing symptoms, and (4) LD with externalizing and internalizing symptoms. Results indicated that the scores of the non-behavior-disordered groups were higher than those of the behavior-disordered groups in cognitive, social, and general self-concept. The scores of the non-LD group did not differ from those of the non-behavior-disordered LD group. Correlation and regression analyses demonstrated that cognitive and social self-concept are at least as strongly related to behavioral factors as they are to achievement level. Implications for education and future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Transient memory impairment in monkeys with bilateral lesions of the entorhinal cortex

Performance on five behavioral tasks was assessed post-operatively in Macaca fascicularis monkeys prepared with bilateral lesions of the entorhinal cortex (E group). Three of the tasks were also readministered 9-14 months after surgery. Initial learning of the delayed nonmatching-to-sample (DNMS) task was impaired in the E animals relative to unoperated control monkeys. On the delay portion of DNMS, the performance of E animals was nearly at control levels at short delays (up to 60 sec) but was impaired at 10 min and 40 min retention intervals. On the retest of DNMS, the E animals performed normally at all retention intervals. The E animals were unimpaired on the four other memory tasks. Neuroanatomical studies revealed a significant transverse expansion of the terminal field of the perirhinal cortical projection in the CA1 region of the hippocampus. Compared to unlesioned, anatomical control monkeys, the transverse length of the perirhinal terminal field in CA1 increased approximately 70% in the E monkeys. Although this was a striking morphological alteration, it is not known whether the sprouting of this projection influenced the behavioral recovery. The results of these studies suggest that the entorhinal cortex may normally participate in the learning and performance of tasks that are dependent on the medial temporal lobe memory system. However, recovery of normal DNMS performance demonstrates that the entorhinal cortex is not, by itself, essential for learning and performance of such tasks.     

Metacarpophalangeal pattern profile analysis in Williams syndrome

Autoantibodies to SSA/Ro and SSB/La antigens may have a pathogenic role in photosensitive skin disease and congenital complete heart block. Since salivary glands are the major target organ in Sjogren's syndrome (SS) we wondered whether these autoantibodies are present in saliva and may be involved in the sicca syndrome. Whole saliva and serum were collected from 15 patients with SS. Elisa analysis disclosed that 8 of the patients had anti-SSA/Ro antibodies, while 6 of them also had anti-SSB/La antibodies. Studies of immunoglobulin classes showed that the sera contained mainly IgG and IgM anti-SSA/Ro or SSB/La antibodies. One serum also contained IgA antibodies. Analysis of the saliva showed that in all positive samples IgG and IgA classes were present, while none of them contained IgM. Elisa and immunoblot analysis of sera and saliva from SLE patients without the sicca syndrome disclosed that both fluids contained anti-Sm antibodies. These findings suggest that the presence of anti-SSA/Ro and anti-SSB/La antibodies in saliva is not a unique phenomenon, characterizing the sicca syndrome. Therefore, their role in the pathogenicity of the Sjogren's syndrome has to be elucidated.     

Dynamic space reconfiguration for Bayesian search and tracking with moving targets

This paper presents a technique for dynamically reconfiguring search spaces in order to enable Bayesian autonomous search and tracking missions with moving targets. In particular, marine search and rescue scenarios are considered, highlighting the need for space reconfiguration in situations where moving targets are involved. The proposed technique improves the search space configuration by maintaining the validity of the recursive Bayesian estimation. The advantage of the technique is that autonomous search and tracking can be performed indefinitely, without loss of information. Numerical results first show the effectiveness of the technique with a single search vehicle and a single moving target. The efficacy of the approach for coordinated autonomous search and tracking is shown through simulation, incorporating multiple search vehicles and multiple targets. The examples also highlight the added benefit to human mission planners resulting from the technique’s simplification of the search space allocation task.