Fulminant Anti-GAD antibody encephalitis presenting with status epilepticus requiring aggressive immunosuppression.

Antibodies against glutamic acid decarboxylase (GAD) are reported in association with numerous neurological conditions including temporal lobe epilepsy and limbic encephalitis. We report a case of Anti-GAD-Antibody associated encephalitis presenting with epilepsia partialis continua (EPC) progressing to a fulminant encephalopathy preferentially affecting the frontal lobes associated with coma and refractory status epilepticus. The abnormalities identified on MRI included marked bilateral frontal lobe involvement which has not been reported in other auto-immune encephalitides and may be specific for Anti-GAD-Antibody associated encephalitis. Similar to the majority of cases of Anti-GAD associated neurological disturbance no underlying malignancy was identified. Treatment with high dose corticosteriods, IVIG and plasmapheresis had minimal response, but escalation of treatment with rituximab and cyclophosphamide was associated with clinical improvement, reducing antibody titers and resolution of MRI changes.

Transforming growth factor-beta receptor type I gene is frequently mutated in ovarian carcinomas.

Ovarian carcinomas (OCs), particularly recurrent OCs, are frequently resistant to transforming growth factor (TGF)-beta-mediated growth inhibition. Mutations in the TGF-beta receptor type II (TbetaR-II) gene are only evident in a minority of OCs, suggesting that other alterations of the TGF-beta signaling pathway may be involved in OC. Using PCR, cold single-strand conformation polymorphism, and DNA sequencing, we now show that 33% of primary OCs (10 of 30) harbor somatic changes in exons 2, 3, 4, and 6 of the TGF-beta receptor I (TbetaR-I) gene. Most of the changes are missense mutations and clustered largely in the catalytic domain of the receptor kinase. Interestingly, seven additional cases (23.3%) showed heterozygous carriers of an allelic variant [a 9-nucleotide deletion, del(GGC)(3)] in exon 1 of the TbetaR-I gene. This is in contrast with 10.6% of del(GGC)(3) heterozygous carriers in a recent report of a large normal population (n = 735; B. Pasche et al., Cancer Res., 59: 5678-5682, 1999). These results indicate that TbetaR-I is frequently mutated in OC and suggest that resistance to TGF-beta-mediated growth inhibition may frequently involve alterations of the TbetaR-I gene.

Carbon-13 nuclear magnetic resonance investigations into the interactions of bisulfite with pyrimidine nucleosides and nucleotides.

Carbon-13 NMR is utilized to demonstrate the attack of bisulfite anion on uridine, 5-fluorouridine, and uridine 5'-monophosphate. The attack produces a pair of diastereomeric adducts similar in structure to those seen in the uracil series. Intensity data from the equilibrium system give an estimate for the individual equilibrium constants. Thymidine and thymidine 5'-monophosphate show no evidence of nucleophilic attack by bisulfite. This evidence indicates that bisulfite addition to nucleosides and nucleotides models the enzymatic methylation of uridine by the enzyme thymidylate synthetase better than the uracil bisulfite system.

Pharmacokinetics of hepatobiliary imaging agents in rats: concise communication.

The distribution and elimination kinetics of Tc-99m pyridoxlidene glutamate (Tc-99m PG), of Tc-99m N-(2,6-dimethyl-phenylcarbamoylmethyl) iminodiacetic acid (Tc-99m HIDA), and of I-131 rose bengal in blood were quantitated after i.v. injection in rats. This was performed by use of a unique indwelling catheter that externalizes the systemic circulation, permitting continuous monitoring of blood radioactivity. The blood activity-time curves of Tc-99m PG and Tc-99m HIDA are described by the sum of three exponential functions. Only two exponentials are required in the case of I-131 rose bengal. The rank order for the rates of loss from blood was Tc-99m HIDA less than Tc-99m PG less than I-131 rose bengal. Bile was collected after administration of Tc-99m HIDA and Tc-99m PG. The total excretion of radioactivity over a 70-min period amounted to 95.7% and 42.8% of the dose of Tc-99m HIDA and Tc-99m PG, respectively. A linear compartmental kinetic model was developed to account for the disappearance from blood and the biliary excretion of these radiopharmaceuticals in rats.

Determination of gallium concentration in "blood-free" tissues using a radiolabeled blood marker.

Radioiodinated serum albumin has been used as a blood marker to define and quantitate physiological volumes for 12 organs and tissue types. The concentration of gallium-67 in "blood-free" tissues of rats was also determined at various times after intravenous administration. Tissues were divided into two kinetically distinguishable types based on reported nonuniform distribution of the blood marker and the gallium distribution observed in the present study. Gallium distribution into the liver and spleen was observed to be slow, with a discernable accumulation phase followed by monoexponential elimination. In contrast, gallium accumulation into the stomach, small and large intestines, heart, lung, skin/adipose tissue, and muscle was rapid and elimination was monophasic.

Automobile seat belt practices of pregnant women.

Despite the fact that seat belts have been proved effective in reducing deaths and serious injuries, many pregnant women do not wear seat belts. A study was conducted to examine the seat belt practices of pregnant women. Of the 87 women who were interviewed, 40 reported using seat belts regularly during pregnancy. However, almost one-third of them did not adjust the belts properly for maximum protection. Older women and those with more education were more likely to use their seat belts routinely. Only 20 women recalled receiving information about seat belts during their pregnancies, but 48 women would have liked to receive more information.

Children of alcoholic parents: a neglected issue.

Little attention has been focused on the children of alcoholic families, and the few studies that have been conducted indicate that these children are at grave risk for developing long-lasting psychosocial and educational problems. Their self-esteem suffers as a result of constant conflict, inconsistency, and role confusion in the home, and it is also known that academic performance and the ability to develop positive peer relationships are also greatly affected. In an effort to determine the scope of this problem, 51 Iowa school nurses attending an Annual School Nurse Conference were queried about: a) their awareness of the problem, b) who should be responsible for intervening with these children, and c) what the role of the school nurse is in working with these youngsters. Based on their responses as well as findings in the literature, suggestions regarding appropriate nursing interventions are offered.

Riding with Bucklebear: an automobile safety program for preschoolers.

Almost half of the accidental deaths of children are directly attributable to motor vehicle accidents, yet many children continue to ride unrestrained. This study was designed to determine if an educational program could increase preschool children's knowledge of car safety and improve their behavior when riding in cars. Knowledge scores increased significantly following the educational program, but the use of seat belts did not change markedly. Although young children can learn self-care skills in respect to seat belt use, they apparently need strong support and reinforcement from parents in their implementation.