A sudden awakening from a near coma after combined intake of gamma-hydroxybutyric acid (GHB) and ethanol

OBJECTIVE: The excess of pediatric emergencies going to hospitals has been the subject of many studies in Spain and, on some occasions, this problem has attributed to the inefficiency of pediatric primary care. Our main objective was to evaluate whether or not our community health center is an efficient filter for hospital emergencies. PATIENTS AND METHODS: We conducted a prospective one year long study of all pediatric emergency demands within our normal office hours (workdays, from 08:00 to 21:00 hours). RESULTS: The total number of emergencies amounted to 1,294, with an average of 5.78 per day. The largest inflow occurred in September and the lowest in August. Most of the emergencies were between 16:00 and 19:00 hours. Fifty percent of the patients were under 4 years of age. We made 86 different diagnoses according to the WONCA classification. Only 10 diagnoses came with a frequency superior to 3%, and 60% of the emergencies were related to one of these 10 diagnoses. Of all pediatric emergencies, 94.7% were completely resolved by us. Only 60 patients (4.6%) were sent-on to hospital emergency services. Among these patients, 40 required traumatological or surgical attention, 5 ophthalmological care, 3 otorhinolaryngological care, and only 12 exclusively needed pediatric attention. In 55.7% of the cases there was no reason to use the emergency channel. CONCLUSIONS: During our office hours, our community health center is an efficient filter for hospital pediatric emergencies.     

Myelolipoma of the thoracic spine

We describe a myelolipoma of the thoracic spine in a patient with gradual and progressive myelopathy. MR imaging showed this predominately fatty lesion to be extradural in location.     

Patterns in the shaping and realization of individual experience

This article describes the methodological approach of systemic psychology. In the framework of this approach a wide range of experimental data is analyzed: results of neuronal recordings in vitro and in awake normal and pathological animals learning to perform and performing both complex instrumental and simple behavioral acts. Another block of analyzed data is based on the experiments with human subjects that learn and perform the tasks of categorization of words and operator tasks, subjects, performing group game activity and answering the questionnaires of psychodiagnostic methods. As a result of this analysis, the system psychology approach is used to describe qualitatively and quantitatively the formation and realization of individual experience.     

Optic nerve ganglioglioma. Case report

Gangliogliomas of the optic nerve are extremely rare. The case is reported of a 38-year-old man who presented with a visual field deficit and was discovered to have an optic nerve ganglioglioma. The possible embryological origins of this neoplasm, its histological and immunohistochemical features, and its appearance on magnetic resonance imaging are examined. The prognoses of optic nerve glioma and of gangliogliomas occurring elsewhere in the nervous system are compared.     

Effects of speech intelligibility level on concurrent visual task performance

Four experiments were performed to determine if changes in the level of speech intelligibility in an auditory task have an impact on performance in concurrent visual tasks. The auditory task used in each experiment was a memory search task in which subjects memorized a set of words and then decided whether auditorily presented probe items were members of the memorized set. The visual tasks used were an unstable tracking task, a spatial decision-making task, a mathematical reasoning task, and a probability monitoring task. Results showed that performance on the unstable tracking and probability monitoring tasks was unaffected by the level of speech intelligibility on the auditory task, whereas accuracy in the spatial decision-making and mathematical processing tasks was significantly worse at low speech intelligibility levels. The findings are interpreted within the framework of multiple resource theory.     

Glucose repression/derepression in budding yeast: SNF1 protein kinase is activated by phosphorylation under derepressing conditions, and this correlates with a high AMP:ATP ratio

BACKGROUND: Genetic studies of Saccharomyces cerevisiae have shown that Snf1p and Snf4p, which together form the SNF1 complex, are essential for gene derepression on removal of glucose from the medium. However the metabolic signal(s) involved, and the exact role of SNF1, have remained enigmatic. Recently, the AMP-activated protein kinase (AMPK) was shown to be the mammalian homologue of SNF1. AMPK is activated by the elevation of the cellular AMP:ATP ratio, which occurs during cellular stress in mammalian cells. The mechanism of activation involves phosphorylation of AMPK by an upstream protein kinase (AMPKK). We have investigated whether a similar mechanism might explain the role of SNF1 in yeast in the response to the stress of glucose starvation. RESULTS: The protein kinase activity of SNF1 was dramatically and rapidly activated by phosphorylation on removal of glucose from the medium. SNF1 was not activated directly by AMP, but could be inactivated by protein phosphatases and reactivated by mammalian AMPKK. We also demonstrated that an endogenous SNF1-reactivating factor, most likely an upstream protein kinase, is present in yeast extracts. Under a variety of different growth conditions, there was a correlation between cellular adenine nucleotide levels and the activation state of SNF1. CONCLUSIONS: Apart from the lack of direct allosteric activation of SNF1 by AMP, the regulation of the mammalian AMPK and yeast SNF1 protein kinase cascades is highly conserved. Adenine nucleotides are now good candidates for metabolic signals which indicate the lack of glucose in the medium, triggering activation of SNF1 and derepression of glucose-repressed genes.     

Differential proliferative and interleukin-10 responses to fractionated filarial antigens: preferential recognition by patients with chronic lymphatic dysfunction

To characterize filarial antigens that may be associated with the development of chronic lymphatic dysfunction in persons with lymphatic filariasis, T cell responsiveness to Brugia pahangi adult worm extracts and SDS-PAGE antigen fractions were examined among Haitians from an area in which Wuchereria bancrofti is endemic. Greater T cell proliferation and interleukin-10 (IL-10) production were observed in amicrofilaremic patients with hydrocele or elephantiasis than in amicrofilaremic or microfilaremic asymptomatic persons. Antigen fractions that stimulated the highest proliferative responses (in the 25-49 kDa range) and IL-10 production were not identical. Further separation of an immunodominant 30- to 38-kDa fraction by ion exchange high-pressure liquid chromatography identified several subfractions, including a 32-kDa protein band, that elicited T cell responses from patients with elephantiasis or hydrocele. By immunoblot, these patients also had markedly greater humoral reactivity to parasite antigens of approximately 52, 43, 32, and 30 kDa.     

Astrocytic messenger RNA responses to striatal deafferentation in male rat

This investigation describes the schedule and regional distribution of astrocytic responses in striatum following deafferentation by unilateral frontal cortex ablation. In the ipsilateral deafferented striatum, glial fibrillary acidic protein and clusterin (sulfated glycoprotein-2) messengerRNA showed peak elevations by 10 days postlesioning (Northern blots). Vimentin messengerRNA responded faster, with a transient elevation by three days postlesioning. The messengerRNA for glial fibrillary acidic protein, clusterin and vimentin returned toward control levels by 27 days postlesioning. However, the neuronal marker growth-associated protein messengerRNA, was decreased at all postlesion times. By in situ hybridization, the increased glial fibrillary acidic protein messengerRNA and clusterin messengerRNA signals were localized mainly to the dorsal half of the ipsilateral deafferented striatum and followed the same schedule as found by Northern blots. Glial fibrillary acidic protein messengerRNA was widely diffused in the dorsal striatum and was excluded from fascicles of the internal capsule; a similar distribution was found for glial fibrillary acidic protein-immunopositive astrocytes. While clusterin messengerRNA signal showed a distinct clustering, its immunoreactivity appeared as deposits in the deafferented striatal neuropil; Western blots confirmed the immunocytochemical results. By in situ hybridization, vimentin messengerRNA was mostly localized to the cortical wound cavity dorsal to the deafferented striatum and overlapped the distribution of vimentin-immunopositive cells. These findings suggest a coordination of striatal astrocytic messengerRNA responses with the degeneration of corticostriatal afferents. We also compared these same parameters with those from published reports on the hippocampus after deafferenting lesions. Certain astrocyte molecular responses to deafferentation are detected about five days earlier in the hippocampus than in the striatum. This different schedule in response to decortication may pertain to differences in synaptic remodeling in the hippocampus vs striatum.