Listeria Meningitis, one of your five a day? A case report of Listeria Monocytogenes Meningitis in a fit and well 62-year-old woman.

Listeria Monocytogenes is transmitted via ingestion of contaminated food products and can cause invasive disease in susceptible hosts. Risk factors include immunocompromise; pregnancy; being elderly; and new-born. Listeriosis is uncommon but can occur in immunocompetent individuals and has a high mortality rate. We report a case of a 62-year-old female with no obvious risk factors who presented with atypical meningism. The patient was subsequently diagnosed with listeria meningitis and made a good recovery. The patient was a gardener regularly handling soil and ingested vegetables from her allotment patch; this case is reported to highlight less common risk factors and atypical ways in which listeria may present to the acute medical take.

Assembly and annotation of human chromosome 2q33 sequence containing the CD28, CTLA4, and ICOS gene cluster: analysis by computational, comparative, and microarray approaches.

Human chromosome 2q33 is an immunologically important region based on the linkage of numerous autoimmune diseases to the CTLA4 locus. Here, we sequenced and assembled 2q33 bacterial artificial chromosome (BAC) clones, resulting in 381,403 bp of contiguous sequence containing genes encoding a NADH: ubiquinone oxidoreductase, the costimulatory receptors CD28, CTLA4, and ICOS, and a HERV-H type endogenous retrovirus located 366 bp downstream of ICOS in the reverse orientation. Genomic microarray expression analysis using differentially activated T-cell RNA against a subcloned CTLA4/ICOS BAC library revealed upregulation of CTLA4 and ICOS sequences, plus antisense ICOS transcripts generated by the HERV-H, suggesting a potential mechanism for ICOS regulation. We identified four nonlinked, polymorphic, simple repetitive sequence elements in this region, which may be used to delineate genetic effects of ICOS and CTLA4 in disease populations. Comparative genomic analysis of mouse genomic Icos sequences revealed 60% sequence identity in the 5' UTR and regions between exon 2 and the 3' UTR, suggesting the importance of ICOS gene function.

Confidence in word detection predicts word identification: implications for an unconscious perception paradigm.

The present experiments extend the scope of the independent observation model based on signal detection theory (Macmillan & Creelman, 1991) to complex (word) stimulus sets. In the first experiment, the model predicts the relationship between uncertain detection and subsequent correct identification, thereby providing an alternative interpretation to a phenomenon often described as unconscious perception. Our second experiment used an exclusion task (Jacoby, Toth, & Yonelinas, 1993), which, according to theories of unconscious perception, should show qualitative differences in performance based on stimulus detection accuracy and provide a relative measure of conscious versus unconscious influences (Merikle, Joordens, & Stoltz, 1995). Exclusion performance was also explained by the model, suggesting that undetected words did not unconsciously influence identification responses.

Descending projections of infralimbic cortex that mediate stimulation-evoked changes in arterial pressure.

The infralimbic cortex (IL) of the rat can modify autonomic nervous system activity, but the critical pathway(s) that mediate this influence are unclear. To define the potential pathways, the first series of experiments characterizes the descending projections of IL and the neighboring cortical areas using Phaseolus vulgaris leucoagglutinin (PHA-L). IL has prominent projections to the central nucleus of the amygdala (Ce), the mediodorsal nucleus of the thalamus (MD), the lateral hypothalamic area (LHA), the periaqueductal gray (PAG), the parabrachial nucleus (Pb), and the nucleus of the solitary tract (NTS). The density and selectivity of these projections suggest that the LHA and the PAG mediate the ability of the IL to regulate cardiovascular function. The second series of experiments demonstrates that locally anesthetizing neurons in either the LHA or PAG with lidocaine attenuates the hypotensive effects produced by electrical stimulation of the IL. Similarly, microinjections of cobalt chloride (a neurotransmission blocker) into the anterior portion of the LHA also decrease the arterial pressure responses to IL stimulation, suggesting that the ability of lidocaine to reversibly block the evoked response is due to inactivation of neurons in the LHA. These data indicate that hypotension evoked by stimulation of IL is mediated, at least in part, by direct or indirect projections to the LHA and through the PAG.

Associational projections of the anterior midline cortex in the rat: intracingulate and retrosplenial connections.

Past studies indicate that distinct areas of anterior midline cortex in the rat contribute to diverse functions, such as autonomic nervous system regulation and learning, but the anatomical substrate for these functions has not been fully elucidated. The present study characterizes the associational connections within the midline cortex of the rat by using the anterograde transport of Phaseolus vulgaris leucoagglutinin and Fluororuby. The prelimbic area and the rostral part of the anterior cingulate area (both dorsal and ventral subdivisions) are extensively interconnected with each other. In addition, the caudal half of anterior cingulate cortex has extensive projections to precentral medial cortex and caudally directed projections to retrosplenial cortex. Other cortical areas within anterior midline cortex have relatively limited cortical-cortical projections. The infralimbic, dorsal peduncular, and medial precentral cortices have dense intrinsic projections, but have either very limited or no projections to other areas in the anterior midline cortex. Although it has been suggested that cortical-cortical projections from anterior cingulate cortex and prelimbic cortex to infralimbic cortex may be important for linking learning processes with an autonomic nervous system response, the paucity of direct projections between these areas calls this hypothesis into question. Conversely, the results suggest that the anterior midline cortex contains two regions that are functionally and connectionally distinct.

Driving following traumatic brain injury: prevalence, exposure, advice and evaluations.

Survivors of traumatic brain injury often have long-term sensory, cognitive and motor deficits that may impair vehicle operation. However, relatively little is known about the driving status and driving characteristics of brain injury survivors. To better understand driving following traumatic brain injury, a survey of driving status, driving exposure, advice received about driving and evaluations of driving competency was administered to a convenience sample of traumatic brain injury survivors (n = 83). The majority of survey participants had experienced either moderate or severe traumatic brain injuries based on the Glasgow Coma Scale. A total of 60% of the survey participants reported that they were currently active drivers. Most individuals (> 60%) who had returned to driving reported driving every day and more than 50 miles per week. Traumatic brain injury survivors frequently received advice about driving from family members, physicians or non-physician health care professionals, but over half (63%) had not been professionally evaluated for driving competency. The presence of high driving exposure, coupled with a lack of widespread driving fitness testing, suggests that some traumatic brain injury survivors have characteristics that may evaluate their risk for vehicle crashes. However, subsequent prospective studies that directly assess driver safety will be needed to confirm this possibility.

The DHR78 nuclear receptor is required for ecdysteroid signaling during the onset of Drosophila metamorphosis.

Pulses of ecdysteroids direct Drosophila through its life cycle by activating stage- and tissue-specific genetic regulatory hierarchies. Here we show that an orphan nuclear receptor, DHR78, functions at the top of the ecdysteroid regulatory hierarchies. Null mutations in DHR78 lead to lethality during the third larval instar with defects in ecdysteroid-triggered developmental responses. Consistent with these phenotypes, DHR78 mutants fail to activate the mid-third instar regulatory hierarchy that prepares the animal for metamorphosis. DHR78 protein is bound to many ecdysteroid-regulated puff loci, suggesting that DHR78 directly regulates puff gene expression. In addition, ectopic expression of DHR78 has no effects on development, indicating that its activity is regulated post-translationally. We propose that DHR78 is a ligand-activated receptor that plays a central role in directing the onset of Drosophila metamorphosis.

Pressor and depressor sites are intermingled in the cingulate cortex of the rat.

Electrical stimulation of area infraradiata in the rat evokes transient changes in arterial pressure, but the locations that evoke these responses have not been mapped by neurochemical methods. To localize more specifically the regions of area infraradiata that modify cardiovascular activity, the present study measured cardiovascular responses to localized chemical stimulation of neurons in area infraradiata of urethane-anesthetized rats (n = 21). Microinjections (50-200 nl) of the glutamate agonist D,L-homocysteic acid into area infraradiata evoked both increases and decreases in arterial pressure and heart rate. Injections in the ventral subdivisions of rostral area infraradiata (IRa alpha and IRb alpha) produced cardiovascular responses with the highest probability and greatest magnitude. Of 53 injections in this area, 18 decreased arterial pressure and heart rate, whereas 4 increased arterial pressure and heart rate. In contrast to the results from the ventral subdivision of rostral infraradiata cortex, injections of D,L-homocysteic acid in the dorsal subdivision of rostral infraradiata cortex (IRc alpha) or any of the caudal subdivisions of area infraradiata (IR beta) produced less consistent changes in arterial pressure. To demonstrate that the general anesthesia did not significantly alter the evoked responses in this study, similar injections of D,L-homocysteic acid were made into area infraradiata of unrestrained, conscious rats (n = 10) and the responses were similar to the responses evoked in urethane-anesthetized rats. These results indicate that the ventral subdivisions of rostral area infraradiata (IRa alpha and IRb alpha) are more involved in cardiovascular regulation than other areas of infraradiata cortex (IRc alpha and IR beta), and that both pressor and depressor sites are present in both areas.

Driving after stroke: driving exposure, advice, and evaluations.

OBJECTIVE: Little is known about the extent to which stroke survivors return to driving and the advice and/or evaluations they receive about driving. This study sought to estimate the prevalence of driving after stroke and to determine whether stroke survivors receive advice and evaluation about driving. DESIGN: A convenience sample of stroke survivors was surveyed regarding driving status following stroke, driving exposure, advice received about driving, and evaluation of driving performance. PARTICIPANTS: Two hundred ninety stroke survivors who were between 3 months to 6 years poststroke. RESULTS: Thirty percent of stroke survivors who drove before the stroke resumed driving after the stroke. Stroke survivors are often poorly informed by health care professionals about driving, with 48% reporting that they did not receive advice about driving and 87% reporting that they did not receive any type of driving evaluation. Almost one third of poststroke drivers had high exposure, driving 6 to 7 days per week and/or 100 to 200 miles per week. CONCLUSIONS: These findings suggest that many stroke survivors are making decisions about their driving capabilities without professional advice and/or evaluation. The results also suggest that rehabilitation professionals need to devote more attention and resources to driving issues when working with stroke survivors and their families.

Isolation, regulation, and DNA-binding properties of three Drosophila nuclear hormone receptor superfamily members.

We have designed a rapid cloning and screening strategy to identify new members of the nuclear hormone receptor superfamily that are expressed during the onset of Drosophila metamorphosis. Using this approach, we isolated three Drosophila genes, designated DHR38, DHR78, and DHR96. All three genes are expressed throughout third-instar larval and prepupal development. DHR38 is the Drosophila homolog of NGFI-B and binds specifically to an NGFI-B response element. DHR78 and DHR96 are orphan receptor genes. DHR78 is induced by 20-hydroxyecdysone (20E) in cultured larval organs, and its encoded protein binds to two AGGTCA half-sites arranged as either direct or palindromic repeats. DHR96 is also 20E-inducible, and its encoded protein binds selectively to the hsp27 20E response element. The 20E receptor can bind to each of the sequences recognized by DHR78 and DHR96, indicating that these proteins may compete with the receptor for binding to a common set of target sequences.

Biochemical characterization of binding of multiple HIV-1 Rev monomeric proteins to the Rev responsive element.

Recombinant HIV-1 Rev protein was overexpressed in Escherichia coli using translational coupling to the beta-glucuronidase gene and demonstrated to interact with high affinity and specificity with the Rev responsive element (RRE). A complex Rev-dependent binding pattern was observed using the gel shift assay which could be simplified to one or two primary bands in the presence of stoichiometric concentrations of RRE. Competition of these bands with a series of homopolymer RNA species demonstrated that Rev is essentially a poly-G binding protein, although poly-I was also shown to compete for specific RRE binding. The stoichiometry of the Rev-dependent gel shift complexes was determined using 125I-labeled Rev. The stable, lowest mobility complex was determined to possess a ratio of between 7 and 8 Rev molecules per RRE containing RNA fragment while the two fastest migrating complexes contained ratios of one and two Rev molecules per RRE, respectively. Using the Hill equation as a model for cooperative interactions, a Hill coefficient of n(app) = 2 was obtained from fitting of direct nitrocellulose filter binding assays, reflecting cooperatively bound Rev molecules on the RRE under equilibrium binding conditions. An increase in ionic strength from 0.0 to 0.3 M NaCl reduced cooperative Rev binding to the RRE, but specificity of Rev for the RRE relative to antisense RNA was increased 100,000-fold. At molar ratios of Rev to RRE above 2, Rev dissociated from the RRE with a T1/2 of approximately 20-25 min.(ABSTRACT TRUNCATED AT 250 WORDS)

Impaired learning and memory in mature spontaneously hypertensive rats.

In very old, normotensive rats, a disorganization occurs selectively in the retrosplenial cortex, and a similar disorganization occurs in this area in spontaneously hypertensive rats (SHR) at a much earlier age. Since this breakdown compromises a neural circuit involved in learning and memory, this study tests the hypotheses that these functions are disturbed in mature SHR and that they can be prevented or attenuated by long-term, anti-hypertensive therapy. SHR and Sprague Dawley rats (SD) at 3- and 12 months of age, and a group of SHR that had been normotensive from 3 to 12 months of age (CAP-SHR) were trained on an 8 arm radial maze task. Of the 12-month-old groups, SD reached criterion earliest (28 +/- 2 days) and made the least number of total errors. In comparison, 12-month-old SHR took significantly longer to reach criterion (39 +/- 2 days) and made nearly twice as many total errors. CAP-SHR were intermediate between the other two groups (32 +/- 2 days). Three-month-old SD learned the task at the same rate as the 12-month-old SD. In contrast, 3-month-old SHR learned the task significantly faster (21 +/- 1 days) and with fewer errors than any other group. These data indicate that, in SHR, learning and memory are compromised by 12 months of age, and that anti-hypertensive therapy with captopril partially prevents this decline.

Characterization of HIV-1 REV protein: binding stoichiometry and minimal RNA substrate.

The HIV-1 REV protein binds to the stem II region of the REV-responsive element (RNA). Studies to further define the RNA sequence and structure specifically bound by REV protein identify a minimal RNA element of 40 nucleotides. Analysis of RNA fragments by gel retardation and filter binding suggest that a core element composed of one particular stem with flanking sequences capable of forming a second double stranded region is essential for specific recognition by REV protein. Stable REV-RNA complexes are formed in a stoichiometry of 1 REV: 1 RNA. The minimal RNA element binds 1 REV molecule while the stem II saturates at 3 REV molecules per RNA. These results establish that REV recognizes a primary binding site within the RRE and support the notion that the initial viral transcript binding event involves a monomeric REV protein.

The C. elegans unc-104 gene encodes a putative kinesin heavy chain-like protein.

Mutations in the unc-104 gene of the nematode C. elegans result in uncoordinated and slow movement. Transposon insertions in three unc-104 alleles (e2184, rh1016, and rh1017) were used as physical markers to clone the unc-104 gene. DNA sequence analysis of unc-104 cDNAs revealed an open reading frame capable of encoding a 1584 amino acid protein with similarities to kinesin heavy chain. The similarities are greatest in the amino-terminal ATPase and microtubule-binding domains. Although the primary sequence relatedness to kinesin is weak in the remainder of the molecule, the predicted secondary structure and regional isoelectric points are similar to kinesin heavy chain.

The effect of sodium valproate on tardive dyskinesia--revisited.

As a treatment for tardive dyskinesia, sodium valproate was tested in a double-blind placebo-controlled parallel group trial, with 6-week base-line observation period followed by 6 weeks of treatment. Sodium valproate was not found to be an effective treatment for either tardive dyskinesia or drug-induced Parkinsonism, and did not affect mental state or behaviour.