Coordination between respiration and deglutition in a preterm infant mammal, Sus scrofa

In adult mammals, the path of a swallowed bolus of solid food crosses the laryngeal opening, so that coordination between respiration and deglutition is critical for airway protection. The nature of such coordination in preterm, low-birth-weight infants with immature nervous systems, is not clear. Using preterm pigs as a model, two measures of respiration were recorded and then coordinated with a high-resolution cineradiographic record of swallowing. Swallows, divided into three distinct events, began before inhalation ended, but expiration did not start until after the milk had passed around the laryngeal opening. These results support the idea that a high degree of coordination between swallowing and respiration exists in preterm infant pigs, although other aspects of the nervous system have not fully matured.     

Phosphorylation of ATPase subunits of the 26S proteasome

OBJECTIVE: To evaluate the impact of the 1993 French National Policy which made it mandatory to offer screening for the presence of human immunodeficiency virus (HIV) to all pregnant women who planned to give birth, although women remained free to refuse the test. DESIGN: Successive surveys in April 1992 and May 1994 in south-eastern France. Logistic regressions were performed to identify factors which affected access to HIV testing for women who gave birth and those who terminated their pregnancy, and for each year of study. MAIN OUTCOME MEASURES: Attitudes and access to HIV testing among pregnant women, irrespective of pregnancy outcome. SETTING: All obstetrics and gynaecology departments and abortion clinics in the region. POPULATION: 3497 women in 1992 (2775 who were delivered and 722 who chose termination) and 3407 in 1994 (2701 who were delivered and 766 who chose termination). The response rates were 82% and 88%, respectively. RESULTS: In 1994 of women who were delivered, 73% had an HIV test, compared with 63% in 1992 (P < 0.001); however of women who terminated their pregnancy, only 28% had an HIV test, compared with 24.5% in 1992 (P not significant), although they were more at risk for HIV infection. Socioeconomic differences affecting access to testing were reduced between 1992 and 1994, but only among women who gave birth. CONCLUSION: Introduction of a policy which makes it mandatory to offer HIV screening to all women who intended to have their baby improved access to screening but did not improve the rate of preventative counselling. A mandatory requirement to offer HIV screening should be extended to women who request termination of pregnancy.     

Elevated serum tryptase levels in a patient with protracted anaphylaxis

BACKGROUND: Anaphylactic reactions usually occur seconds to minutes after exposure to the relevant antigen. Late onset, biphasic, and protracted anaphylaxis also occur. The incidence of prolonged responses is unknown, but may be common. In all nonfood-related cases, levels of tryptase were not measured during protracted episodes. Tryptase has been shown to be a useful specific indicator of mast cell involvement in anaphylaxis. OBJECTIVE: To determine whether mast cell activation, as demonstrated by elevated serum tryptase concentrations, can occur in protracted anaphylaxis. METHODS: Case report; serum tryptase concentrations were measured by radioimmunoassay. RESULTS: A 33-year-old white man developed hives three days prior to admission. The next day, vomiting, abdominal cramps and bloating, lower lip swelling, wheezing, and a feeling of tightness over his throat and chest were experienced. The gastrointestinal symptoms continued until his hospital admission. One day prior to admission, he developed transient lightheadedness. On admission he had generalized urticaria and abdominal tenderness. Blood pressure of 115/58 mm/Hg rose to 180/60 and heart rate fell from 107/min to 90/min following 2.2 L of intravenous fluids. Serum tryptase levels were elevated at 7.2 ng/mL and 5.1 ng/mL on the first and second hospital days (fourth and fifth days of symptoms). Serum tryptase was < 1.0 ng/mL 5 months later. CONCLUSIONS: The elevated serum tryptase levels at 96 and 120 hours following the onset of symptoms strongly suggest that continued mast cell degranulation can occur during protracted anaphylaxis. This strengthens the argument that mast cell activation is important in the pathophysiology of protracted anaphylaxis.     

Monoclonal antibody against CD45RB for the therapy of rejection and autoimmune diseases

Rejection continues to be the single largest impediment to successful organ transplantation. Current therapy, which must be taken for a lifetime is nonspecific and has significant side effects including infection and cancer. There is a need to develop improved means of immunosuppression. The current goal of transplantation immunology is to induce a prolonged state of nonreactivity to the allograft but preserving an otherwise intact immune system (tolerance). We have recently reported that a monoclonal antibody against CD45RB is a potent immunosuppressive agent, and that it induces donor specific tolerance in the mouse. In this contribution we briefly review our understanding of the molecular basis for the activity of this therapy and update results in various transplant and autoimmune disease animal models. The clinical relevance and future development of this novel therapy is also discussed.     

Missense mutation in a von Willebrand factor type A domain of the alpha 3(VI) collagen gene (COL6A3) in a family with Bethlem myopathy

OBJECTIVE: The purpose of this retrospective study was to examine the value of whole-body nuclear medicine imaging and to evaluate the typical scintigraphic pattern of sternocostoclavicular hyperostosis (SCCH) and/or pustulotic arthroosteitis (PAO). In this entity the correct diagnosis is frequently missed because of uncharacteristic changes in other imaging modalities. MATERIALS AND METHODS: Forty-nine patients (age range 15-65 years old, mean age 36 years) with sternocostoclavicular hyperostosis (SCCH) and/or pustulotic arthroosteitis (PAO) were examined with whole-body scintigraphy and conventional radiography. RESULTS: Forty-three of 49 patients with SCCH/PAO showed a characteristic "bullhead"-like high tracer uptake of the sternocostoclavicular region with the manubrium sterni representing the upper skull and the inflamed sternoclavicular joints corresponding to the horns (= bullhead sign). Scintigraphy revealed additional skeletal manifestations (spondylitis, sacroiliitis, osteitis) in 33 of 49 patients with SCCH and/or PAO. CONCLUSIONS: Bone scintigraphy is the imaging modality of choice for the diagnosis of skeletal involvement in PAO. Nuclear medicine reveals unexpected locations and shows the typical pattern of focal hot spots of the spine, sacroiliac joints and/or appendicular skeleton in the large majority of cases in combination with a bullhead-like tracer uptake of the sternocostoclavicular region. The bullhead sign is the typical and highly specific scintigraphic manifestation of SCCH and PAO in radionuclide bone scans and helps to avoid unnecessary biopsies.     

An ethnographic, controlled study of the use of a computer-based histology atlas during a laboratory course

Data regarding future residential plans were collected from 141 mothers of adult children with mental retardation. Results demonstrate that greater caregiving burden was associated with more extensive planning for residence within the formal service system and less planning for residence with a family member. More frequent service use also predicted greater planning for future residence within the formal system. Planning for residence with a family member and higher functional ability on the part of the child significantly decreased the sense of worry mothers had about the child's future whereas plans for the child to reside within the formal system had no association with worry about the future.     

Effects of lead exposure on GnRH and LH secretion in male rats: response to castration and alpha-methyl-p-tyrosine (AMPT) challenge

Duchenne and Becker muscular dystrophies are X-linked genetic disorders characterized by dystrophin gene defects. We have studied 250 families with Duchenne and Becker muscular dystrophies (D/BMD) by molecular genetic methods since 1992. Nineteen exons of the dystrophin gene were analyzed for deletion. In families with no deletion, linkage analysis was performed to follow the inheritance of mutant alleles in the affected families. Twenty of these families requested prenatal diagnosis. Six mothers were found to be non-carriers (99% accuracy), thus fetuses were examined in the remaining 14. Two fetuses were affected and terminated. We report our experience and our current clinical practice in providing prenatal studies for D/BMD.