Correlated cerebral events between physically and sensory isolated pairs of subjects exposed to yoked circumcerebral magnetic fields.

In three different experiments pairs of unrelated people sitting in two different rooms were exposed simultaneously to different rates of circumcerebral rotations of weak, complex magnetic fields in order to produce "dynamic similarity". Quantitative electroencephalographic (QEEG) measurements were taken for one member of each pair in one room while the other sat in a closed chamber in another room and intermittently observed 5Hz, 8Hz, 10Hz, or 15Hz flashing lights. Reliable increases in QEEG power within specific frequencies over the right parietal region were observed during the similar-frequency light flashes when the shared temporal-spatial complexity of the circumcerebral rotating fields was based on 100ms, the average duration of normal microstates. The development of this experimental procedure could facilitate rational understanding of this class of "coincidence" phenomena.

Fatal Clostridium difficile enteritis caused by the BI/NAP1/027 strain: a case series of ileal C. difficile infections.

Clostridium difficile generally causes diarrhoea and colitis. Small-bowel infections are considered to be rare. Twelve cases of ileal C. difficile infections are presented, including the first reported case proven to be caused by the hypervirulent BI/NAP1/027 strain. This case series suggests that small bowel involvement in C. difficile infections may be more frequent than previously thought.

Elevated free calcium levels in the subretinal space elevate the absolute dark-adapted threshold in hypopigmented mice.

Abundant evidence spanning 25 years demonstrates that hypopigmentation is associated with sensory abnormalities manifested most clearly as elevated absolute dark-adapted thresholds in hypopigmented mice. Here we show that when ocular melanin is increased in the himalayan mouse via alpha-melanocyte stimulating hormone (alpha-MSH) injections, dark-adapted thresholds drop in proportion to the change in ocular melanin. We further measured free calcium concentration with calcium-sensitive microelectrodes in both albino and black mouse retinal eyecups in living subjects. The recordings were done in anesthetized animals as the defect is not present in isolated retinas or in the superfused eye preparation. A double-barreled electrode--pCa and Vref--was used to simultaneously record the calcium concentration and the electroretinogram (ERG) at each of many depths as the electrode was driven through the retina. The position of the electrode was confirmed with ERG and 1,1'-dioctadecyl-3, 3,3',3'-tetramethylindocarbocyanine perchlorate electrode tract reconstruction. Dark-adapted albinos (n = 6) had 1.4 +/- 0.015 mM calcium in the subretinal space compared with 0.80 +/- 0.025 mM in black mice (n = 6). The results of these experiments are consistent with the hypothesis that ocular hypopigmentation causes elevated calcium levels in the subretinal space that in turn mimic light adaptation in hypopigmented mice.

The health of Cree, Inuit and southern Quebec women: similarities and differences.

Using the data from a number of the surveys conducted over the last 10 years by Santé Québec, this study examines the health characteristics of two populations of Aboriginal women of northern Quebec compared to those of women in the rest of the province. The northern populations had a larger proportion of young women. Aboriginal women have heavier family responsibilities than other Quebec women. Inuit women had a much higher prevalence of smoking and drug use. Alcohol consumption was less frequent in northern women, but the quantity consumed was higher compared to other Quebec women. Cree women tended to be more obese, had higher levels of blood glucose and lower levels of cholesterol. Inuit women tended to have lower rates of hypertension and higher rates of declared hearing problems and mental disorders. The similarities and differences observed among these three populations of women can assist decision-makers in setting priorities with regards to maintaining and improving their health.

The impact of a Children's health insurance program by age.

OBJECTIVES: 1) To examine age variation in unmet need/delayed care, access, utilization, and restricted activities attributable to lack of health insurance in children before they receive health insurance; and 2) to examine the effect of health insurance on these indicators within each age group of children (in years). METHODS: We use cohort data on children before and after receiving health insurance. The study population consists of 750 children, 0 through 19 years of age, newly enrolling in two children's health programs. The families of the newly enrolled children were interviewed at the time of their enrollment (baseline), and again at 6 months and 1 year after enrollment. The dependent variables measured included access to regular provider, utilization, unmet need or delayed health care, and restrictions on activities attributable to health insurance status. All these indicator variables were examined by age groups (0-5, 6-10, 11-14, and 15-19 years of age). chi(2) tests were performed to determine whether these dependent variables varied by age at baseline. Using logistic regression, odds ratios were calculated for baseline indicators by age group of child, adjusting for variables commonly found to be associated with health insurance status and utilization. Changes in indicator variables from before to after receiving health insurance within each age group were documented and tested using the McNemar test. A comparison group of families of children enrolling newly 12 months later were interviewed to identify any potential effects of trend. RESULTS: All ages of children saw statistically significant improvements in access, reduced unmet/delayed care, dental utilization, and childhood activities. Before obtaining health insurance, older children, compared with younger children, were more likely to have had unmet/delayed care, to have not received health care, to have low access, and to have had activities limited by their parents. This pattern held for all types of care except dental care. Age effects were strong and independent of covariates. After being covered by health insurance, the majority of the delayed care, low utilization, low access, and limited activities in the older age groups (11-14 and 15-19 years) was eliminated. Thus, as levels of unmet need, delayed care, and limitations in activities approached zero in all age groups by 1 year after receipt of health insurance, age variation in these variables was eliminated. By contrast, age variation in utilization remained detectable yet greatly reduced. CONCLUSION: Health insurance will reduce unmet need, delayed care, and restricted childhood activities in all age groups. Health care professionals and policy makers also should be aware of the especially high health care delay, unmet need, and restricted activities experienced by uninsured older children. The new state children's health insurance programs offer the potential to eliminate these problems. Realization of this potential requires that enrollment criteria, outreach strategies, and delivery systems be effectively fashioned so that all ages of children are enrolled in health insurance.

Determination of cefepime and cefpirome in human serum by high-performance liquid chromatography using an ultrafiltration for antibiotics serum extraction.

The aim of this study was to describe a high-performance liquid chromatography (HPLC) assay for the determination of cefepime and cefpirome in human serum without changing chromatographic conditions. The assay consisted to measure cefepime and cefpirome which were unbound to proteins having a molecular mass of 10,000 or more by ultrafiltration followed by HPLC with a Supelcosil ABZ+ column and UV detection at a wavelength of 263 nm. The assay was been found to be linear and has been validated over the concentration range 200 to 0.50 microg/ml for both cefepime and cefpirome, from 200 microl serum, extracted. In future, the assay will support therapeutic drug monitoring for cefepime and cefpirome in neutropenic patients in correlation with microbiological parameters such as MIC90 (minimal inhibitory concentration of antibiotic which kills 90% of the initial bacterial inoculum) and clinical efficacy.

Disruption of laminin beta2 chain production causes alterations in morphology and function in the CNS.

From the elegant studies of Ramon y Cajal (1909) to the current advances in molecular cloning (e.g., Farber and Danciger, 1997), the retina has served as an ideal model for the entire CNS. We have taken advantage of the well described anatomy, physiology, and molecular biology of the retina to begin to examine the role of the laminins, one component of the extracellular matrix, on the processes of neuronal differentiation and synapse formation in the CNS. We have examined the effect of the deletion of one laminin chain, the beta2 chain, on retinal development. The gross development of retinas from laminin beta2 chain-deficient animals appears normal, and photoreceptors are formed. However, these retinas exhibit several pathologies: laminin beta2 chain-deficient mice display abnormal outer segment elongation, abnormal electroretinograms, and abnormal rod photoreceptor synapses. Morphologically, the outer segments are reduced by 50% in length; the outer plexiform layer of mutant animals is disrupted specifically, because only 7% of observed rod invaginating synapses appear normal, whereas the inner plexiform layer is undisturbed; finally, the rate of apoptosis in the mutant photoreceptor layer is twice that of control mice. Physiologically, the electroretinogram is altered; the amplitude of the b-wave and the slope of the b-wave intensity-response function are both decreased, consistent with synaptic disruption in the outer retina. Together, these results emphasize the prominence of the extracellular matrix and, in particular, the laminins in the development and maintenance of synaptic function and morphogenesis in the CNS.

Impact of a children's health insurance program on newly enrolled children.

CONTEXT: Although there is considerable interest in decreasing the number of US children who do not have health insurance, there is little information on the effect that health insurance has on children and their families. OBJECTIVE: To determine the impact of children's health insurance programs on access to health care and on other aspects of the lives of the children and their families. DESIGN: A before-after design with a control group. The families of newly enrolled children were interviewed by telephone using an identical survey instrument at baseline, at 6 months, and at 12 months after enrollment into the program. A second group of families of newly enrolled children were interviewed 12 months after the initial interviews to form a comparison sample. SETTING: The 29 counties of western Pennsylvania, an area with a population of 4.1 million people. SUBJECTS: A total of 887 families of newly enrolled children were randomly selected to be interviewed; 88.3% agreed to participate. Of these, 659 (84%) responded to all 3 interviews. The study population consists of 1031 newly enrolled children. The children were further classified into those who were continuously enrolled in the programs. The 330 comparison families had 460 newly enrolled children. MAIN OUTCOME MEASURES: The following access measures were examined: whether the child had a usual source of medical or dental care; the number of physician visits, emergency department visits, and dentist visits; and whether the child had experienced unmet need, delayed care, or both for 6 types of care. Other indicators were restrictions on the child's usual activities and the impact of being insured or uninsured on the families. RESULTS: Access to health care services after enrollment in the program improved: at 12 months after enrollment, 99% of the children had a regular source of medical care, and 85% had a regular dentist, up from 89% and 60%, respectively, at baseline. The proportion of children reporting any unmet need or delayed care in the past 6 months decreased from 57% at baseline to 16% at 12 months. The proportion of children seeing a physician increased from 59% to 64%, while the proportion visiting an emergency department decreased from 22% to 17%. Since the comparison children were similar to the newly enrolled children at enrollment into the insurance programs, these findings can be attributed to the program. Restrictions on childhood activities because of lack of health insurance were eliminated. Parents reported that having health insurance reduced the amount of family stress, enabled children to get the care they needed, and eased family burdens. CONCLUSIONS: Extending health insurance to uninsured children had a major positive impact on children and their families. In western Pennsylvania, health insurance did not lead to excessive utilization but to more appropriate utilization.

[Cloning, expression and characterization of HIV-1 gp60 partially or completely deleted in the V3 loop]. / Clonage, expression et caractérisation de gp160 du VIH-1, portant des délétions partielles ou totales dans la boucle V3.

In order to better understand the role of the immunodominant V3 loop in the type-specific immune response and also to determine if this sequence has a role in AIDS pathogenesis, notably in the induction of apoptosis in CD4+ cells, we have introduced 2 modifications in the env gene from pNL4-3: a partial deletion in the V3 loop, keeping only the conserved tip of the loop GPGRAF consensus sequence (env delta V3-GPGRAF) and, secondly, a complete deletion of V3 sequence plus 43 nucleotides in C3 (env delta V3+). These constructions as well as the non-modified env gene, were cloned and expressed in a baculovirus system. Western blot analysis has shown that both modified env gene products reacted with a reference anti-HIV-1 serum to the same extent as the non-modified gp 160. However, in contrast to the non-modified env-protein and to env delta V3-GPGRAF, the env delta V3+ protein failed to bind to CD4 molecule, although V3 is not directly involved in receptor binding. These modified and non-modified recombinant proteins will be very useful to determine the potential of the partially or totally V3-deleted gp 160 to induce broadly reactive neutralizing antibodies and also to determine if V3 has a role in certain aspects of HIV-induced pathogenesis, notably apoptosis.

Case study: anorexia nervosa and autistic disorder in an adolescent girl.

The development of anorexia nervosa in a high-functioning, early adolescent, autistic female is described. This case raises the issue of co-occurrence of childhood-onset disorders sharing the phenomena of obsessions and compulsions. The role of dysregulation of the serotonergic neurotransmitter system as a common underlying mechanism in these disorders is suggested. Psychoactive agents affecting the serotonin system and in particular the atypical neuroleptic risperidone may be of value in these disorders. There is added benefit to the combined use of biological and behavioral therapies.

Requirement of the Pr55gag precursor for incorporation of the Vpr product into human immunodeficiency virus type 1 viral particles.

The human immunodeficiency virus type 1 (HIV-1) particles consists of two molecules of genomic RNA as well as molecules originating from gag, pol, and env products, all synthesized as precursor proteins. The 96-amino-acid Vpr protein, the only virion-associated HIV-1 regulatory protein, is not part of the virus polyprotein precursors, and its incorporation into virus particles must occur by way of an interaction with a component normally found in virions. To investigate the mechanism of incorporation of Vpr into the HIV-1 virion, Vpr- proviral DNA constructs harboring mutations or deletions in specific virion-associated gene products were cotransfected with Vpr expressor plasmids in COS cells. Virus released from the transfected cells was tested for the presence of Vpr by immunoprecipitation with Vpr-specific antibodies. The results of these experiments show that Vpr is trans-incorporated into virions but at a lower efficiency than when Vpr is expressed from a proviral construct. The minimal viral genetic information necessary for Vpr incorporation was a deleted provirus encoding only the pr55gag polyprotein precursor. Incorporation of Vpr requires the expression but not the processing of gag products and is independent of pol and env expression. Direct interaction of Vpr with the Pr55gag precursor protein was demonstrated by coprecipitation experiments with gag product-specific antibodies. Overall, these results indicate that HIV-1 Vpr is incorporated into the nascent virion through an interaction with the Gag precursor polyprotein and demonstrate a novel mechanism by which viral protein can be incorporated into virus particles.

Expression in Escherichia coli of the cloned polyhedrin gene of Bombyx mori cytoplasmic polyhedrosis virus.

Cloned cDNA of genomic segment 10 of Bombyx mori cytoplasmic polyhedrosis virus (CPV) was placed downstream from the lambda PL promoter in expression plasmid pRC23 and expressed in Escherichia coli cells. A polypeptide of the same molecular weight (28 kDa) as natural polyhedrin was synthesized at the level of approximately 10% of total host cell protein. This polypeptide was identified as CPV polyhedrin (r-polyhedrin) after comparative studies. The r-polyhedrin did not form any crystalline structure in E. coli cells but instead accumulated in the form of an insoluble inclusion body, even though natural polyhedrin is known to form a crystalline matrix (polyhedra) in infected insect cells. The purified r-polyhedrin complex, like natural polyhedra, was not soluble in neutral or acidic buffer but soluble in alkaline buffer. Upon solubilization, the r-polyhedrin complex did not undergo proteolytic degradation, while natural polyhedra were digested into small peptides by the associated protease. Incubation of r-polyhedrin with natural polyhedra in alkaline buffer, however, degraded the r-polyhedrin, resulting in an identical profile of peptide products to that of natural polyhedra. These results indicate that even though r-polyhedrin molecules produced in E. coli cells are not in the natural conformation, the molecules can present the identical cleavage sites to the polyhedra-associated alkaline protease. Experiments showed that the alkaline protease was associated with the matrix of polyhedra and not with virus particles.

Prevalence of diabetes mellitus among the James Bay Cree of northern Quebec.

OBJECTIVE: To determine the prevalence of diabetes mellitus among the James Bay Cree in northern Quebec. DESIGN: Chart survey of physician-diagnosed cases of diabetes. The biochemical criteria of the World Health Organization were used to confirm the diagnoses. SETTING: Eight James Bay Cree communities: six remote and two rural. SUBJECTS: All James Bay Cree with diabetes whose names were in a chronic disease registry or on a diabetes clinic list kept at each community clinic. OUTCOME MEASURES: Prevalence rates, both crude and standardized to the 1986 Canadian population, were estimated by sex, age group and type of diabetes. RESULTS: A total of 235 cases of diabetes were confirmed, for a crude prevalence of 2.7%. The age-standardized rate of non-insulin-dependent diabetes mellitus was 6.6% among people 20 years and over. The prevalence increased as the latitude decreased. CONCLUSIONS: Our crude prevalence resembles that in similar native linguistic and cultural groups elsewhere in Canada. Diabetes is becoming an important disease in the Cree population of Quebec. A better understanding of the sociocultural changes in this population is necessary.

[Appreciation of the evolution of the price of drugs in Rouen from 1640 to 1788]. / Appréciation de l'évolution du prix des médicaments à Rouen de 1640 à 1788.

34 accounts of medicines found in the rolls of "Maîtrise Notre-Dame" of Rouen were studied. Data concerning clysters, ptysans, violet sirup, theriac, marsh-mallow paste and physic were particularly collected. Their interpretation showed a relative stability of the market prices of drugs and medicines, expressed in pounds, during a century and a half, in Rouen.

Intracerebral implantation of ionic synthetic hydrogels: effect of polar substrata on astrocytosis and axons.

In previous studies, hyperporous synthetic hydrogels of poly(glyceryl methacrylate) or p(GMA), containing bioadhesive substrates of collagen, were implanted into rat cerebral tissue in order to provide systems of oriented guidance channels for directing the growth of the scar and axons /28/. In the present study, ionic p(GMA)-collagen hydrogels containing polar chemical groups, either basic amino groups or acidic carboxyl groups, were evaluated for their tolerance and their effects on the brain scarring response and axonal reactivity after long-term implantation in the cerebral cortex. In all animals, the implants were well tolerated. Although both types of gels influenced the astroglial reaction near the bioimplant, hydrogels carrying carboxyl groups had the strongest influence on the elongation, the direction and the organization of astrocytic processes so that a glial matrix could form in regions of the gel. Extracellular material (e.g. reticulin) was also deposited into the gels carrying carboxyl groups. Although cortical nerve fibers in the surrounding tissue showed a regenerative response, extending onto or into the matrices, this behavior seemed to depend more on the organization of the astrocytic scar imposed by the gel than on the type of gel. We conclude that matrices carrying negatively charged groups influence favorably the astrocytosis and the deposition of connective tissue, and that this approach represents a new avenue in attempting to modulate the brain scar formation.

Evaluation of a community health representative program among the Cree of northern Quebec.

The James Bay Cree Community Health Representative (CHR) program was implemented in 1984 to train persons from the Cree population of northern Quebec to act as health care advocates and educators, as intermediaries between the Cree population, health services and local organizations, and as participants in assessing health needs. A formative evaluation was initiated which included quantitative analysis of the daily tasks of CHRs and a qualitative component based on documentary research, observation and semi-structured interviews. The evaluation revealed that CHRs actively participated in the ongoing community health programs mainly through health education; the people interviewed showed a high level of satisfaction. However, direct supervision, sufficient continuing education for the CHRs and better integration into health care teams are long-term goals which need to be emphasized in the program.