[Some current trends in the use of prolonged injectable antipsychotics in the conditions of modernization of the psychiatric service]. / Nekotorye sovremennye tendentsii primeneniya prolongirovannykh in"ektsionnykh antipsikhotikov v usloviyakh modernizatsii psikhiatricheskoi sluzhby.

OBJECTIVE: A pharmacoeconomical analysis of the use of prolonged injectable antipsychotics in the treatment of patients with schizophrenia in Moscow over 2015-2019 in the context of the reform of the psychiatric service. MATERIAL AND METHODS: The authors studied the economic costs of treatment of psychiatric patients with prolonged injectable antipsychotics on the pharmaceutical market in Moscow for five years on the example of patients diagnosed with paranoid schizophrenia (ICD-10 F20.0) based on the dynamics of the registered contingent of patients with schizophrenic spectrum disorders over the past fifteen years including the period of active modernization of the psychiatric service. RESULTS AND CONCLUSION: A constant increase in public spending on treatment, including therapy with prolonged injectable neuroleptics (both first-generation drugs and atypical antipsychotics), was shown. At the same time, the increase in the use of atypical antipsychotics is ahead of schedule. The number of patients receiving treatment with prolonged injectable haloperidol and zupentixol increased approximately twice during this period, the number of patients receiving treatment with injectable risperidone and paliperidone palmitate increased by more than 3 and 13 times, respectively. There is a significant increase in public spending on the purchase and use of these drugs for the treatment of privileged categories of patients, most of this applies to injectable forms of paliperidone, the cost of using these drugs has increased more than 20 times over a five-year period. These trends indicate a shift in emphasis towards outpatient psychiatric care and improvement of approaches to treatment of patients with schizophrenia, which indicate a new stage in the development of out-of-hospital treatment and rehabilitation systems based on the latest achievements of psychopharmacology and the development of social support systems for patients with schizophrenia spectrum disorders.

Acquisition of tolerance to egg and peanut in African food-allergic children with atopic dermatitis.

BACKGROUND: There are no previous data on tolerance development in children with atopic dermatitis (AD) and concomitant food allergy in low- and middle-income settings. OBJECTIVES: To determine the rate of tolerance acquisition to egg and peanut 5 years after diagnosing food allergies in South African (SA) children with AD, and to explore factors influencing tolerance acquisition. METHODS: Five years after first diagnosing food allergy in 37 SA children with egg and/or peanut allergy, they were reassessed for their allergies by questionnaire, skin-prick tests (SPTs) and ImmunoCAP-specific IgE (sIgE) tests (Thermo Fisher Scientific/Phadia, Sweden) to egg white, ovomucoid, peanut and Arachis hypogaea allergen 2 (Ara h 2), and incremental food challenges. RESULTS: Eighteen of 25 originally egg-allergic patients and 19 of 24 originally peanut-allergic children were followed up at a median age of 8 years and 3 months and 9 years and 6 months, respectively. A high percentage of children (72.2%) outgrew their egg allergy, and 15.8% outgrew their peanut allergy. Allergic comorbidity remained high, with asthma increasing over time, and AD remaining moderate in severity in the cohort overall. At diagnosis, sIgE egg white ≤9.0 kU/L and sIgE ovomucoid ≤2.0 kU/L were associated with tolerance development to egg 5 years later. At follow-up, sIgE egg white ≤0.70 kU/L, sIgE ovomucoid ≤0.16 kU/L, SPT egg-white extract ≤1 mm and SPT fresh egg ≤5 mm were associated with tolerance. At diagnosis, sIgE Ara h 2 ≤1.7 kU/L and SPT peanut ≤10 mm were associated with tolerance development to peanut 5 years later. At follow-up, sIgE peanut ≤0.22 kU/L, sIgE Ara h 2 ≤0.18 kU/L and SPT peanut ≤5.5 mm were associated with tolerance. CONCLUSIONS: Egg allergy was outgrown in 72.2% and peanut allergy in 15.8% of SA children 5 years after diagnosis of AD. This is in keeping with findings derived from studies in higher socioeconomic settings, and can help to guide the counselling of patients with allergies to these foods of high nutritional value.

[Clinical features of depressive episode with onset in adolescence and the risk of bipolar depression]. / Osobennosti depressivnogo épizoda s debiutom v podrostkovom vozraste i risk razvitiia bipoliarnoi depressii.

AIM: To study clinical features of depressive episode with the onset in late adolescence associated with the risk of bipolar affective disorder (BAD). MATERIAL AND METHODS: Forty patients with BAD (ICD-10 F31), who experienced depressive state at the age of 15-18 years corresponding to the diagnostic criteria of 'Depressive episode' (F32), were examined. The duration of follow-up was from 3 to 5 years. Clinical-psychopathologic, follow-up, statistical methods were applied. RESULTS: Duration of depressive episodes did not exceed 6 months in 70% of patients with BAD. Characteristic clinical features included the frequent presence of psychomotor retardation, anergia, anhedonia, melancholy, irritability, affective instability with increased emotional reactivity, hypersomnia. Other 'atypical' depressive symptoms were less characteristic. There was a significant incidence of suicidal tendencies, comorbid psychopathic-like behavioral disorders and substance abuse. In most cases, the depressive state was accompanied by a deterioration in social functioning and led to educational maladaptation. CONCLUSION: Characteristic clinical features of bipolar depression manifested in late adolescence were a relatively short duration, the prevalence of typical depressive symptoms (melancholy, psychomotor retardation), irritability, increased emotional reactivity, hypersomnia, a significant incidence of suicidal tendencies.

Extensively hydrolysed infant formulas: Need for aligned definition of peptide size characteristics and standardisation of analytical methods.

Letter by Nutten et al. on article by Levin et al. (Levin ME, Blackhurst DM, Kirstein F, Kok D, van der Watt GF, Marais AD. Residual allergenicity of amino acid-based and extensively hydrolysed cow's milk formulas. S Afr Med J 2017;107(9):763-767. S Afr Med J 2017;107(3):258-263. https://doi.org/10.7196/SAMJ.2017.v107i9.12137); and response by Levin et al.

Respiratory comorbidity in South African children with atopic dermatitis.

BACKGROUND: Atopic dermatitis (AD) is an early and important step in the propagation of the allergic march, enhancing food and respiratory allergies via epicutaneous sensitisation to allergens. OBJECTIVES: To determine the prevalence and patterns of aeroallergen sensitisation, asthma and allergic rhinitis in South African (SA) children with AD. METHODS: This was a prospective, observational study in a paediatric university hospital in Cape Town, SA. Children with moderate to severe AD, aged 6 months - 10 years, were recruited randomly and investigated for food sensitisation and allergy. They were assessed for sensitisation to aeroallergens by the immuno solid-phase allergen chip test. House-dust mite DerP and DerF, dust mite Eur m, Timothy grass, Bermuda grass, tree pollen, mould (Alternaria), cat and dog sensitisation patterns were analysed. Symptoms of asthma and allergic rhinitis were elicited using a questionnaire modified from the International Study of Asthma and Allergies in Childhood study questions. RESULTS: One hundred participants (59 black Africans and 41 of mixed ethnicity) were enrolled (median age 42 months). Of the participants, 39% had symptoms of asthma and 53% symptoms of allergic rhinitis; 89% tested positive to at least one aeroallergen, most commonly house-dust mite DerP or DerF (81%), dust mite Eur m (51%), Timothy grass (36%) and cat (35%). Asthma, allergic rhinitis and aeroallergen sensitisation all increased with increasing age, while food allergy decreased with age. Food allergy was not an independent risk factor for respiratory allergies. Children were sensitised to indoor allergens (house-dust mite, pets) from an early age, while pollen allergies increased with age. CONCLUSIONS: In this cohort of SA children with moderate to severe AD, comorbidity with respiratory allergies was high. The prevalence of respiratory allergies increased with age while food allergy decreased with age, in keeping with the pattern of the allergic march. Seasonal allergies increased with age, while house-dust mite and pet allergy peaked in younger children, in keeping with early exposure via a defective skin barrier. Early and effective restoration of the skin barrier in AD may be a target for reducing aeroallergen-related diseases.

Residual allergenicity of amino acid-based and extensively hydrolysed cow's milk formulas.

BACKGROUND: Criteria for labelling infant feeds as suitable for the dietary management of cow's milk protein allergy (CMPA) rely on proving the hypoallergenicity of such feeds or clinical studies showing that the feeds are tolerated by 90% of children with proven CMPA. South African (SA) labelling legislation does not indicate what testing is necessary to prove hypoallergenicity. OBJECTIVES: To evaluate all extensively hydrolysed cow's milk formulas and amino acid-based formulas available in SA for residual allergen content, protein size and amino-acid content. RESULTS: All amino-acid and extensively hydrolysed formulas were found to be similar in composition, with no residual cow's milk allergens detectable by enzyme-linked immunosorbent assay. Furthermore, proteins were absent and only small molecules in the size range of amino acids and possibly of very small oligopeptides were detected. CONCLUSIONS: These findings indicate that the formulas are extremely likely to be compliant with the definition of hypoallergenicity as tolerance in 90% of proven sufferers from cow's milk allergy. The formulas may therefore be labelled as suitable for the dietary management of infants with CMPA.

Respiratory comorbidity in South African children with atopic dermatitis

Background. Atopic dermatitis (AD) is an early and important step in the propagation of the allergic march, enhancing food and respiratory allergies via epicutaneous sensitisation to allergens.Objectives. To determine the prevalence and patterns of aeroallergen sensitisation, asthma and allergic rhinitis in South African (SA) children with AD. Methods. This was a prospective, observational study in a paediatric university hospital in Cape Town, SA. Children with moderate to severe AD, aged 6 months - 10 years, were recruited randomly and investigated for food sensitisation and allergy. They were assessed for sensitisation to aeroallergens by the immuno solid-phase allergen chip test. House-dust mite DerP and DerF, dust mite Eur m, Timothy grass, Bermuda grass, tree pollen, mould (Alternaria), cat and dog sensitisation patterns were analysed. Symptoms of asthma and allergic rhinitis were elicited using a questionnaire modified from the International Study of Asthma and Allergies in Childhood study questions.Results. One hundred participants (59 black Africans and 41 of mixed ethnicity) were enrolled (median age 42 months). Of the participants, 39% had symptoms of asthma and 53% symptoms of allergic rhinitis; 89% tested positive to at least one aeroallergen, most commonly house-dust mite DerP or DerF (81%), dust mite Eur m (51%), Timothy grass (36%) and cat (35%). Asthma, allergic rhinitis and aeroallergen sensitisation all increased with increasing age, while food allergy decreased with age. Food allergy was not an independent risk factor for respiratory allergies. Children were sensitised to indoor allergens (house-dust mite, pets) from an early age, while pollen allergies increased with age. Conclusions. In this cohort of SA children with moderate to severe AD, comorbidity with respiratory allergies was high. The prevalence of respiratory allergies increased with age while food allergy decreased with age, in keeping with the pattern of the allergic march. Seasonal allergies increased with age, while house-dust mite and pet allergy peaked in younger children, in keeping with early exposure via a defective skin barrier. Early and effective restoration of the skin barrier in AD may be a target for reducing aeroallergen-related diseases

South African food allergy consensus document 2014.

The prevalence of food allergy is increasing worldwide and is an important cause of anaphylaxis. There are no local South African food allergy guidelines. This document was devised by the Allergy Society of South Africa (ALLSA), the South African Gastroenterology Society (SAGES) and the Association for Dietetics in South Africa (ADSA). Subjects may have reactions to more than one food, and different types and severity of reactions to different foods may coexist in one individual. A detailed history directed at identifying the type and severity of possible reactions is essential for every food allergen under consideration. Skin-prick tests and specific immunoglobulin E (IgE) (ImmunoCAP) tests prove IgE sensitisation rather than clinical reactivity. The magnitude of sensitisation combined with the history may be sufficient to ascribe causality, but where this is not possible an incremental oral food challenge may be required to assess tolerance or clinical allergy. For milder non-IgE-mediated conditions a diagnostic elimination diet may be followed with food re-introduction at home to assess causality. The primary therapy for food allergy is strict avoidance of the offending food/s, taking into account nutritional status and provision of alternative sources of nutrients. Acute management of severe reactions requires prompt intramuscular administration of adrenaline 0.01 mg/kg and basic resuscitation. Adjunctive therapy includes antihistamines, bronchodilators and corticosteroids. Subjects with food allergy require risk assessment and those at increased risk for future severe reactions require the implementation of risk-reduction strategies, including education of the patient, families and all caregivers (including teachers), the provision of a written emergency action plan, a MedicAlert necklace or bracelet and injectable adrenaline (preferably via auto-injector) where necessary.

Guideline for the management of acute asthma in children: 2013 update.

BACKGROUND: Acute asthma exacerbations remain a common cause of hospitalisation and healthcare utilisation in South African children. AIM: To update the South African paediatric acute asthma guidelines according to current evidence, and produce separate recommendations for children above and below 2 years of age. METHODS: A working group of the South African Childhood Asthma Group was established to review the published literature on acute asthma in children from 2000 to 2012, and to revise the South African guidelines accordingly. RECOMMENDATIONS: Short-acting inhaled bronchodilators remain the first-line treatment of acute asthma. A metered-dose inhaler with spacer is preferable to nebulisation for bronchodilator therapy to treat mild to moderate asthma. Two to four puffs of a short-acting bronchodilator given every 20 - 30 minutes, depending on clinical response, should be given for mild attacks; up to 10 puffs may be needed for more severe asthma. Children with severe asthma or oxygen saturation (SpO2) <92% should receive oxygen and frequent doses of nebulised beta-2-agonists, and be referred to hospital. Nebulised ipratropium bromide (via nebulisation or multidosing via pMDI-spacer combination) should be added if there is a poor response to three doses of ß2-agonist or if the symptoms are severe. Early use of corticosteroids reduces the need for hospital admission and prevents relapse; oral therapy is preferable. Assessment of acute asthma in children below the age of 2 years can be difficult, and other causes of wheezing must be excluded. Treatment of acute asthma in this age group is similar to that of older children. CONCLUSION: Effective therapy for treatment of acute asthma - primarily inhaled short-acting ß2-agonists, oral corticosteroids and oxygen with appropriate delivery systems - should be available in all healthcare facilities and rapidly instituted for treatment of acute asthma in children. ENDORSEMENT: The guideline document was endorsed by the Allergy Society of South Africa (ALLSA), the South African Thoracic Society (SATS), the National Asthma Education Programme (NAEP), the South African Paediatric Association (SAPA) and the South African Academy of Family Practice.

Associations between asthma and bronchial hyper-responsiveness with allergy and atopy phenotypes in urban black South African teenagers.

OBJECTIVES: To determine asthma and allergy phenotypes in unselected urban black teenagers and to associate bronchial hyper-responsiveness (BHR) with asthma, other atopic diseases and allergen sensitisation. METHODS: This was a cross-sectional study of 211 urban high-school black children of Xhosa ethnicity. Modified ISAAC questionnaires regarding asthma, eczema and rhinitis were administered. BHR was assessed by methacholine challenge using hand-held nebulisers. Skinprick tests (SPTs) were performed for 8 aeroallergens and 4 food allergens. RESULTS: Asthma was reported in 9%, and 16 % demonstrated BHR. Rhinitis was reported in 48% and eczema in 19%. Asthma was strongly associated with BHR. Asthma was associated with eczema whereas BHR was associated with rhinitis. SPTs were positive in 34% of subjects, aeroallergens in 32%, and food allergens in 5%. The most common sensitivities were to house dust mites (HDM) and German cockroach. BHR was associated with sensitivity to any aeroallergen, cat, HDM, cockroach and bermuda grass. The number of positive SPTs was associated with asthma and BHR. With each level of SPT positivity, there was 40% increased prevalence of asthma and 70% increased prevalence of BHR. The rate of allergen sensitisation in subjects with BHR (72%) was much higher than those without BHR (28%); house dust mite sensitivity was 69% in subjects with BHR and 18% in those without. CONCLUSIONS: These are the highest rates of allergen sensitisation in subjects with BHR documented in an African setting and the widest difference in sensitisation rates between subjects with and without BHR.

Total IgE in urban Black South African teenagers: the influence of atopy and helminth infection.

Total IgE levels are usually elevated in allergic diseases, being highest in atopic eczema, followed by atopic asthma and allergic rhinitis. Genetic factors are believed to play a role in total IgE levels, with higher levels seen in Black African subjects. Total IgE is also raised in parasite infection. Thus, the higher total IgE levels in Black Africans could be because of environmental rather than genetic factors. Few studies have investigated the usefulness of total IgE levels in the evaluation of atopy in Black Africans. The objective of this study was to determine the total IgE levels in unselected urban Black African high school children and to correlate this with atopy and ascaris sensitization. Atopic status was assessed by means of specific allergen sensitization (skin prick tests to eight inhalant and four food allergens), self-reported asthma and bronchial hyper-responsiveness measured by methacholine challenge. Ascaris sensitization was assessed by means of ascaris IgE measured by CAP-RAST. Total IgE levels were markedly skewed toward the left and were not distributed in a Gaussian or a log-normal distribution. Skin prick tests were positive for aeroallergens in 32.3% of subjects. Thirty four percent had elevated ascaris IgE. Total IgE was higher in atopic vs. non-atopic subjects and correlated with the number of positive skin prick tests, self-reported asthma and bronchial hyper-responsiveness. Subjects without allergy (or) atopy had a median total IgE of 80-90 kU/I. In addition total IgE correlated with ascaris IgE. Subjects with no ascaris sensitization had median total IgE of 77.1 kU/l. Subjects with neither atopy/asthma nor ascaris sensitisation had a median total IgE of 69.9 kU/I, similar to the levels seen in people of other genetic origins. This study suggests that helminthic infection rather than genetic differences, may be the major determining factor of IgE levels in certain populations.

The reactivity of sodium borohydride with various species as characterized by adiabatic calorimetry.

The reactivity of sodium borohydride in the presence of other species has been examined by adiabatic calorimetry. In combination with water, sodium borohydride exhibits an exotherm at room temperature accompanied by generation of gas (presumed to be hydrogen). Addition of potassium hydroxide to a sodium borohydride-water mixture is found to stabilize the solution and require a higher temperature for reaction to occur. However, if iron oxide is also included, reaction takes place near room temperature. Very rapid reaction was found when a metal chloride was brought in contact with a solution containing sodium borohydride, water, and potassium hydroxide. When sodium borohydride was added to an oxygenated hydrocarbon, reaction at room temperature also took place, but to a more limited extent. Peak temperatures above 200 degrees C and maximum pressures in excess of 2000 psia were observed in most cases. Kinetics extracted from the calorimetry data are presented for some of the sodium borohydride combinations.

Language as a barrier to care for Xhosa-speaking patients at a South African paediatric teaching hospital.

BACKGROUND: Disease is closely linked to the social context in which we live. Difficulty with communication, cultural incompatibility between patients and health care providers and socioeconomic obstacles are important barriers to quality care when doctors and patients come from different backgrounds and speak different languages. Red Cross War Memorial Children's Hospital (RCH) is a paediatric teaching hospital in Cape Town where staff members communicate mainly in English or Afrikaans, while many patients speak Xhosa as their first language. OBJECTIVES: The study aimed to identify barriers to optimal care for Xhosa-speaking parents of patients at RCH. The contribution of language difficulties was assessed as a possible barrier to health care for this group. DESIGN: A questionnaire was developed and administered to 53 Xhosa-speaking parents of children admitted to the short-stay ward at RCH. The questionnaire examined parents' perceptions of barriers to their children's care, using openended questions, closed-ended questions and selection from lists. RESULTS: Parents experienced significant structural and socioeconomic barriers to access of health care for their children. Language and cultural barriers were cited by more parents as a major barrier to health care than structural and socioeconomic barriers. Parents did not have access to same-language practitioners, as only 6% of medical interviews were conducted partly or wholly in the patient's home language. Of the 94% of interviews where no Xhosa was spoken by medical staff, 21% were conducted with the aid of an interpreter (formal or ad hoc) and in 79% no interpreter was used. Parents experienced difficulties with understanding the doctors (64%), making themselves understood (54%) and asking questions (38%). Sixty-nine per cent of parents were dissatisfied with communication between themselves and their doctors and 45% were concerned about negative effects of poor communication on them or their children. Parents tended to blame their own linguistic limitation rather than those of the doctors.

Different use of medical terminology and culture-specific models of disease affecting communication between Xhosaspeaking patients and English-speaking doctors at a South African paediatric teaching hospital.

BACKGROUND: Language and cultural differences between patients and health care providers may have adverse health consequences. Red Cross War Memorial Children's Hospital is a paediatric teaching hospital in Cape Town where staff communicate mainly in English or Afrikaans, while many patients speak Xhosa as their first language. OBJECTIVES: To examine whether differences in the definitions of common respiratory medical terminology by patients and doctors cause miscommunication and to explore culture-specific models if used by parents in their definitions. DESIGN: In-depth, semi-structured interviews were conducted with three speech communities, viz. 8 English-speaking doctors and 33 Xhosa-speaking parents, educated to grade 12 level or less and recruited from two areas in the hospital, the short-stay ward (Xhosa s-s) and the allergy clinic (Xhosa allergy). The sum of both groups of Xhosa-speaking patients are referred to as 'Xhosa all'. Definitions were elicited for common respiratory terminology in both Xhosa and English. Contrastive linguistic analysis was used to identify the semantic properties for each group in order to condense the groups' definitions into representative 'core definitions'. Differences in the definitions of terminology were identified and words were classified as concordant (used in the same way) or discordant (used in different ways) by the three speech communities. RESULTS: Parents experience difficulty in understanding terms used by doctors and words in common use were understood differently by these two groups. Most Xhosa words were not in the doctors' vocabulary, and some common English words were not in the parents' vocabulary. Where words were in the vocabulary of both groups, significant differences existed in the number and range of definitions, with many clinically significant discordances of definition being apparent. Some common examples relevant to paediatric respiratory problems are presented. Three culture-specific explanatory models of respiratory illness, ingqele, xakaxa and idliso, are illustrated.

Kinetics of acid-catalyzed cleavage of cumene hydroperoxide.

The cleavage of cumene hydroperoxide, in the presence of sulfuric acid, to form phenol and acetone has been examined by adiabatic calorimetry. As expected, acid can catalyze cumene hydroperoxide reaction at temperatures below that of thermally-induced decomposition. At elevated acid concentrations, reactivity is also observed at or below room temperature. The exhibited reactivity behavior is complex and is significantly affected by the presence of other species (including the products). Several reaction models have been explored to explain the behavior and these are discussed.

The reactivity of 1,3-butadiene with butadiene-derived popcorn polymer.

Adiabatic calorimetry performed on butadiene-derived popcorn polymer samples from industrial facilities has revealed exothermic behavior accompanied by non-condensible gas production, indicative of possible decomposition, at elevated temperatures. In the presence of low concentrations of 1,3-butadiene, reactivity is observed at temperatures of 60-70 degrees C; that is, 20-30 degrees C below those usually seen for butadiene alone. Once the butadiene is consumed, the reaction behavior reverts to that of the popcorn polymer alone. At higher butadiene concentrations, the low temperature reaction persists, eventually merging with typical butadiene behavior. The butadiene reactivity with popcorn polymer is attributed to polymerization reaction at free radical sites in the popcorn polymer. Different popcorn polymer samples exhibit distinct extents of reactivity, presumably depending on the nature and concentration of the free radical sites and the structure of the material. Uninhibited butadiene exposed to 100 psia air, which may act to generate peroxide species, shows a small, additional exotherm around 50-80 degrees C. Contact of butadiene with lauroyl peroxide, providing free radicals upon decomposition, generates an exotherm at temperatures as low as 60 degrees C.

The reactivity of ethylene oxide in contact with iron oxide fines as measured by adiabatic calorimetry.

Samples of various iron oxides suspended above ethylene oxide in an adiabatic calorimeter exhibit exothermic activity at temperatures as low as room temperature. A gamma-Fe(2)O(3) sample was found to show the highest reactivity with ethylene oxide. Ethylene oxide in combination with most of the iron oxide fines tested displayed exothermic activity below 100 degrees C. Self-heat rates near 2000 degrees C/min were observed for the gamma-Fe(2)O(3) fines while rates in excess of 100 degrees C/min were found for other fines (alpha-Fe(2)O(3) and hydrated alpha-Fe(2)O(3)). In two cases (alpha-Fe(3)O(4) and alpha-Fe(2)O(3)), pressurization rates above 1000 psi/min took place. No reactivity was observed for ethylene oxide with the FeO. Thermal inertia effects in commercial operation, such as heat uptake by the equipment to which fines are attached, are presumed to be a factor in limiting the occurrence of related exotherms in ethylene oxide manufacturing facilities.

Temporally and spatially regulated expression of a candidate G-protein-coupled receptor during cerebral cortical development.

Genes expressed in layer-specific patterns in the mammalian cerebral cortex may play a role in specifying the identity of different cortical layers. Using PCR-differential display, we identified a cDNA that encodes rCNL3, a gene cloned previously by sequence homology to G-protein-coupled receptors. rCNL3 is expressed predominantly in layers 2-4 of the young rat cortex and in the developing and adult striatum. Cortical expression of rCNL3 begins postnatally at P3 and continues at high levels until around P15, while striatal expression begins at E20 and continues through adulthood. rCNL3 expression is not detectable in the ventricular zone precursors that generate the neurons of layers 2-4. The expression pattern of rCNL3 in the developing cortex suggests that rCNL3 is not involved in the initial specification of laminar fate, but rather may be involved with later differentiation events within the superficial cortical layers.