Resonance peak in Sr(2)RuO(4): signature of spin triplet pairing.

We study the dynamical spin susceptibility, chi(q,omega), in the normal and superconducting states of Sr(2)RuO(4). In the normal state, we find a peak in the vicinity of Q(i) approximately (0.72 pi,0.72 pi) in agreement with recent inelastic neutron scattering experiments. We predict that for spin triplet pairing in the superconducting state a resonance peak appears in the out-of-plane component of chi, but is absent in the in-plane component. In contrast, no resonance peak is expected for spin singlet pairing.

Mothers' reactions to prenatal diagnostic procedures and dexamethasone treatment of congenital adrenal hyperplasia.

A retrospective survey of mothers' attitudes toward and experiences of chorionic villus sampling, amniocentesis and dexamethasone (DEX) treatment was conducted in 38 women who underwent a prenatal diagnostic procedure for congenital adrenal hyperplasia because of a previously affected child (n = 37) or because the mother herself was affected (n = 1). Both diagnostic procedures were well tolerated and almost every woman said that the anxiety or discomfort associated with the procedure was far outweighed by the value of knowing whether or not her fetus was affected. The earlier diagnostic information provided by chorionic villus sampling was highly valued. Maternal side-effects of DEX were common (75%) and more than one-third of the women rated one or more side-effects as "severe' (weight gain, fatigue, stomach pain, irritability, facial hair growth). Many women expressed anxiety about possible short- and long-term side-effects of DEX on their unborn children and themselves but all said they would undergo DEX treatment again to prevent virilization.

Psychiatric diagnosis in child and adolescent suicide.

BACKGROUND: The age, sex, and ethnic distribution of adolescents who commit suicide is significantly different from that of the general population. The present study was designed to examine psychiatric risk factors and the relationship between them and demographic variables. METHODS: A case-control, psychologic autopsy study of 120 of 170 consecutive subjects (age, <20 years) who committed suicide and 147 community age-, sex-, and ethnic-matched control subjects who had lived in the Greater New York (NY) area. RESULTS: By using parent informants only, 59% of subjects who committed suicide and 23% of control subjects who met DSM-III criteria for a psychiatric diagnosis, 49% and 26%, respectively, had had symptoms for more than 3 years, and 46% and 29%, respectively, had had previous contact with a mental health professional. Best-estimate rates, based on multiple informants for these parameters, for suicides only, were 91%, 52%, and 46%, respectively. Previous attempts and mood disorder were major risks factors for both sexes; substance and/or alcohol abuse was a risk factor for males only. Mood disorder was more common in females, substance and/or alcohol abuse occurred exclusively in males (62% of 18- to 19-year-old suicides). The prevalence of a psychiatric diagnosis and, in particular, substance and/or alcohol abuse increased with age. CONCLUSION: A limited range of diagnoses--most commonly a mood disorder alone or in combination with conduct disorder and/or substance abuse--characterizes most suicides among teenagers.

Seasonal rhythm of platelet [3H]imipramine binding in adolescents who attempted suicide.

OBJECTIVE: This study was designed to determine the seasonality of serotonin functions among adolescents who attempt suicide. METHOD: Platelet [3H]imipramine binding was assessed over a period of 18 months in 98 adolescents who attempted suicide and a comparison group of 23 never-suicidal youths with conduct disorder. RESULTS: [3H]Imipramine (Bmax) was uncorrelated with age, but showed considerable seasonal variability over time in those who had attempted suicide. CONCLUSIONS: [3H]Imipramine binding density in adolescents who attempted suicide exhibited significant seasonality, reaching a nadir in late winter/early spring.

Demographic predictors of treatment attendance among adolescent suicide attempters.

The relationship between age and gender and treatment attendance was prospectively examined among a consecutive series of 143 adolescent emergency room attendees referred for outpatient therapy after a suicide attempt. Consistent with previous reports, nonadherence was high. Over 40% of patients had their cases terminated because of nonattendance; on average, however, patients received almost 6 sessions of treatment and 91% attended at least 1 therapy session. Adolescents terminated from treatment for nonadherence were significantly older than those completing treatment. Younger male patients were scheduled for significantly more therapy sessions than older male patients and kept significantly more scheduled sessions than did older male and female patients. Vigorous case-tracking procedures may have a significant impact on treatment attendance. Nevertheless, therapists must design strategies to increase treatment adherence among older adolescent, especially male, patients.

Effects of early prenatal dexamethasone on the cognitive and behavioral development of young children: results of a pilot study.

The effect of early prenatal dexamethasone (DEX) exposure on cognitive and behavioral development, behavior problems, and temperament were examined in 26 consecutively identified children aged 6 mo to 5 1/2 years, whose mothers had been DEX-treated during pregnancy because their offspring was at risk for congenital adrenal hyperplasia (CAH), and compared with 14 children from untreated CAH-risk pregnancies. Three children in each group were CAH-affected. Assessments were performed by way of mother-completed standard questionnaires. No significant differences in cognitive abilities or behavior problems were identified. On temperament questionnaires, DEX-exposed children showed more Shyness (p < .004), greater Emotionality (p < .03), less Sociability (p < .04), and a trend for greater Avoiddance (p < .07) than unexposed children. DEX-exposed children also had significantly higher Internalizing (p < .002) and Total Problem scores (p < .05) on the behavior problem measure for 2-3 year olds. The results should be considered preliminary until they have been replicated by the study of a larger sample and direct examination of the children.

Divergent in vivo and in vitro antileukemic activity of recombinant interferon beta in patients with chronic-phase chronic myelogenous leukemia.

It was the aim of this study to investigate the antileukemic activities of recombinant interferon beta (rIFN beta) in chronic-phase CML in vitro and in vivo. Nine patients in the early chronic-phase of CML were treated in a phase-II trial with escalating doses of rIFN beta. In parallel, antiproliferative and immunomodulatory activities of rIFN beta and rIFN alpha 2b were studied in vitro. rIFN beta exhibited a significantly higher antiproliferative activity on hematopoietic progenitor cells of CML patients in vitro than rIFN alpha 2b. In contrast, only very limited clinical antileukemic efficacy of rIFN beta was observed. None of the patients achieved a complete or partial hematologic response (0% response rate, 0-36% 95 C.I.). Primary resistance of CML patients to rIFN beta treatment was caused neither by antibody formation against the recombinant material nor by deficient IFN receptor targeting and/or signaling; Induction of serum levels of beta-2-microglobulin (beta-2-m) and neopterin after administration of rIFN beta was comparable to that seen after administration of rIFN alpha. However, rIFN beta treatment less effectively induced biosynthesis of interleukin-1 receptor antagonist protein (IL-1-Ra) than rIFN alpha 2b. Thus, we conclude that rIFN beta at doses up to 12 MU/day s.c. is ineffective for treatment of chronic-phase CML. Further investigations into divergent biologic responses to various type-I interferons might help to elucidate mechanisms crucial for IFN action in patients with CML.

Are adolescent suicide attempters noncompliant with outpatient care?

The outpatient clinic attendance patterns of 115 consecutively referred 10- to 18-year-old suicide attempters and of 110 nonattempters were compared. The two groups did not differ in number of appointments scheduled or missed, but attempters kept significantly fewer appointments than did nonattempters. Seventy-seven percent of each group dropped out of treatment, but attempters dropped out significantly faster. Attendance and dropout were unrelated to age, reason for referral, or previous attempts. Girls missed more appointments than did boys, and Hispanic patients kept a smaller percentage of scheduled appointments than did other ethnic groups. We conclude that adolescent attempters are not more likely to drop out of treatment but keep fewer appointments and remain in care more briefly than do other outpatients. Recommendations for triage and brief case management are made.

Psychiatric diagnoses in minority female adolescent suicide attempters.

Psychiatric diagnoses were examined using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children semistructured interview among three groups of minority adolescent females aged 12 to 17:61 suicide attempters, 31 psychiatrically disturbed nonattempters, and 23 nonattempting, nondisturbed girls. Major or minor depressive disorder was found in 42% of the suicide attempters; conduct disorder in 46%; multiple diagnoses in 38%, no diagnosis in 13%. These rates were very similar to those found in disturbed nonattempters. Only one symptom, suicidal ideation, distinguished attempters from disturbed nonattempters, while many symptoms distinguished these two groups from nondisturbed nonattempters.

Cognitive style and pleasant activities among female adolescent suicide attempters.

Cognitive style and pleasant activities of 77 suicide-attempting female minority adolescents were compared with those of 2 groups of non-suicide-attempting female minority adolescents, 39 who were psychiatrically disturbed and 23 who were nondisturbed. Suicide attempters differed from other groups, even when depression and IQ were statistically controlled. They reported significantly fewer alternatives for solving interpersonal problems, were significantly more focused on problems, and were more likely to report a wishful thinking style of coping in stressful situations than were members of the nondisturbed comparison group. Across groups, depression was associated with significantly more dysfunctional attributions. Interpersonal problem-solving ability and attributional style best distinguished the suicide attempters. Results suggest using different cognitive-behavioral interventions with depressed and nondepressed minority female adolescent suicide attempters.

Inhibition of alpha-crystallin aggregation by gamma-crystallin.

The transparency of the mammalian lens is primarily maintained by short range order among the major proteins of the lens fiber cells, the crystallins. Although these proteins are highly conserved at the amino acid sequence level, it has proven difficult to establish that they possess other than structural functions. We find that when non-lens proteins are added to concentrated solutions of alpha-crystallin, aggregation is induced, presumably through excluded volume effects. In contrast, the monomeric gamma-crystallins and the low molecular weight form of beta-crystallin (beta L) cause a decrease in the size of alpha-crystallin. When the naturally aggregated form of alpha-crystallin is examined, gamma- and beta L-crystallin, as well as a reducing agent, also cause partial dissociation as detected by dynamic light scattering and size exclusion chromatography, while no effect is seen with non-crystallin proteins. Furthermore, the chemical cross-linking of alpha-crystallin is inhibited by gamma- and beta L-crystallin but not by other proteins. The ability of gamma-crystallin to inhibit the association of alpha-crystallin is primarily localized to the gamma-II form which contains a high degree of exposed thiols. Only small amounts of gamma- and beta L-crystallin, however, can be cross-linked to alpha-crystallin in mixtures of the three proteins even at very high protein concentrations. These results suggest that one possible role for the lower molecular weight crystallins may be to minimize through a reductive effect the intrinsic tendency of alpha-crystallin to aggregate, an association reaction implicated in the loss of lens transparency.

A differential scanning calorimetric study of the bovine lens crystallins.

Differential scanning calorimetry was performed on the five major lens crystallin fractions [HM-alpha, alpha, beta H, beta L, and (beta s + gamma)] of the bovine lens as well as on more purified forms of alpha- and gamma-crystallins. All were found to be relatively thermally stable although the alpha-crystallin were found to at least partially unfold at an approximately 10 degrees C lower temperature than the beta and gamma fractions. Increasing protein concentration had little effect on gamma-crystallin thermograms but had marked effects on those of the alpha- and beta-crystallins. Increases in the thermal stability with increasing protein concentration for the beta-crystallins can be explained most simply by the known beta L/beta H equilibrium, but, in the case of the alpha-crystallins, excluded volume effects may be an important factor. In both cases, the increased stability at high concentrations could be of physiological relevance. As well as the expected endothermic unfolding transitions, all of the lens crystallins revealed exothermic peaks that correlate with protein precipitation. Interestingly, this phenomenon occurs only after extensive structural alteration in the case of the alpha-crystallins but is present very early in the initial stages of structural perturbation of the beta- and gamma-crystallins.

Pediatric management of suicidal behavior.

Emergency evaluation of the adolescent suicide attempter presents the pediatrician with a complex challenge. The attempter is acutely ill, in a psychosocial crisis, and may have one or more major mental disorders and a highly disturbed family. The adolescent rarely has planned the attempt for more than a few minutes, and usually does not know the dangerousness of the chosen method. Suicide attempts are quite common among adolescents and suicide quite rare, yet the risk of later death among attempters is substantial. Suicide is associated with a variety of problems and diagnoses, and in most ways attempters do not differ from other emotionally troubled adolescents. Suicide attempters and their families are often quite resistant to treatment, and this resistance seems to increase with the number of problems identified. How should the clinician proceed? We have stressed the importance of rapid evaluation of parent and adolescent to identify individual and family risk factors (Table 1). As the number of risk factors increases, greater caution should be exercised. A short hospitalization can allow a more thorough evaluation of complicated cases. Brief, problem-oriented therapy (Table 2) is most likely to be accepted by the family and can result in rapid improvement. A smaller number of adolescents will require long term care.

Prediction of intellectual deficits in children with acute lymphoblastic leukemia.

Possible predictors of reported lower cognitive functioning in irradiated children with acute lymphoblastic leukemia (ALL) were investigated. Thirty-four subjects, 5-14 years old, with ALL in continuous complete remission and without evidence of current or past central nervous system disease, were examined 9-110 months after diagnosis, using standard measures of intelligence and academic achievement. Subjects with a history of post-irradiation somnolence syndrome were significantly older at diagnosis than nonsomnolent subjects. Intelligence (IQ) was found to be unrelated to history of somnolence syndrome. IQ and achievement were unrelated to age at irradiation, irradiation-examination interval, and radiation dosages. The strongest predictor of IQ by far is parental social class. The importance of controlling for social class differences when searching for treatment effects on IQ and achievement is stressed.

Electrostatic properties of cryoimmunoglobulins.

Inhibition of the cryoprecipitation of cryoimmunoglobulins by neutral salts suggests that intermolecular electrostatic (charge-charge) interactions are responsible for their abnormal solution properties. To test this hypothesis, H+ titration curves and isoelectric points were measured for two monoclonal IgG cryoglobulins (Ger and Muk) and compared with four normal (cold soluble) monoclonal IgG. The cryoglobulin Ger manifested values outside the range encountered for the other proteins. The partitioning of the IgG proteins was also examined in aqueous polyethylene glycol-dextran two-phase systems in the presence of both positive and negative salt-induced electrostatic potentials across the phase interface. Both cryoglobulins were found to behave as if they were more negatively charged than the noncryoglobulins. The experiments support the hypothesis that the differences in solubility behavior of monoclonal cryoglobulin and noncryoglobulin proteins are caused by differences in the electrostatic properties of the proteins.