NMDA receptor activation during epileptiform responses in the dentate gyrus of epileptic patients.

We previously showed that a low frequency (1 Hz) train of perforant path stimulation evokes burst discharges in the dentate gyrus of hippocampal slices obtained from patients surgically treated for intractable temporal lobe epilepsy. We report here that multiple population spikes that characterize the burst discharge are blocked reversibly by the specific NMDA receptor antagonist, D-(-)-2-amino-5-phosphonovaleric acid (D-APV). The epileptiform discharge evoked in human dentate gyrus by stimulation trains of 1 Hz could be reproduced in the rat dentate gyrus in vitro by the same stimulation protocol but required the presence of low concentrations (0.2-0.6 mM) of extracellular magnesium. We suggest that low frequency orthodromic stimulation of dentate granule cells through the perforant path progressively evokes an increase in the activation of NMDA receptors resulting in burst discharges in tissue from epileptic patients.     

Epidemiology of rabies virus variants. Differentiation using monoclonal antibodies and discriminant analysis

Rabies virus was isolated by cell culture from the brains of 104 confirmed rabies cases diagnosed by the fluorescent-antibody staining technique in the United States during 1974-1984. Eighty-seven isolates were obtained from wild-life species, 10 from humans, and seven from domestic animals. These isolates were tested in virus neutralization and immunofluorescence assays using a panel of 34 monoclonal antibodies specific for rabies virus nucleocapsid protein, 44 monoclonal antibodies specific for rabies virus glycoprotein, and two monoclonal antibodies specific for rabies virus nucleocapsid-associated phosphoprotein. Using discriminant analysis, a distinctly different reactivity pattern was revealed between virus isolates from terrestrial (raccoon, skunk) and nonterrestrial (bat) reservoir hosts. The usefulness of this approach for studying the epidemiology of rabies and for predicting the source of infection when this information is unknown is discussed.     

Long-term follow-up of the ileoanal anastomosis in children and young adults

The purpose of this study was to carry out a long-term study of the ileoanal anastomosis (IAA) in children and young adults, comparing the straight IAA to the J pouch. One hundred twenty-one young people who had undergone IAA were studied, with 114 available for long-term follow-up. One hundred one were 18 years and under. Forty-nine patients had a straight IAA and 72 had a J-pouch reservoir. There were no deaths. After surgery, three children had intraabdominal sepsis and one had pelvic sepsis, but it did not lead to excision of the IAA. The mean stool frequency in all 114 patients was 5.0 +/- 2.5 per day and 1.2 +/- 1.1 at night. The mean number of stools for the straight IAA was 6 per day and 2.1 at night. The mean number of stools for the straight IAA with balloon dilations was 5.8 per day and 1.2 at night, and for the J pouch it was 4 per day and 1 at night. Patients with both the J pouch and straight IAA had good to excellent sensation, with patients with the J pouch always able to distinguish flatus from stool in 87% of patients and almost always in 13%. Daytime continence was very good in both groups. Moderate nighttime loss of stool occurred in 10 patients, 6 with a straight IAA and 4 with a J pouch. Ninety-five percent of the 114 patients were satisfied or very satisfied, with most children with a J pouch very satisfied. The J pouch remains the procedure of choice in young people.     

Why should pediatric rheumatology be recognized as a separate subspecialty: an open letter to medical councils and government agencies

Some pediatric rheumatologists in the West may take for granted that pediatric rheumatology (PR) is a recognized subspecialty. Yet pediatric rheumatology has been accepted as a subspecialty in the United States only since 1990. There are still countries where many pediatric subspecialties are not given official recognition and support, including PR. This lack of recognition delays and impedes the development of PR, appropriate musculoskeletal and rheumatic teaching in medical schools, and optimal diagnosis and treatment for children with these illnesses. In the opinion of editorial staff, each country where pediatric rheumatology is reasonably well developed as a subspecialty has an obligation to help our pediatric rheumatologists elsewhere gain recognition, support, and respect. The Pediatric Rheumatology European Society (PReS) and the Pediatric Rheumatology International Trial Organization (PRINTO) have been leaders in this effort, but in many countries, pediatric rheumatology is still not recognized. This editorial offers rationales and justifications for medical and governmental entities accrediting pediatric rheumatology as a separate subspecialty that may aid in these efforts.     

Social and psychological factors associated with adolescents'' self-acceptance of occlusal condition

Studies using plaster models of teeth and photographs simulating the full range of occlusal conditions have found high agreement between measures of adolescent social acceptability of these conditions and perceived need for orthodontic treatment. This study examined the association between adolescents' acceptability of their own occlusal condition, severity of malocclusion, and likelihood of undergoing orthodontic treatment. The factors predicting the acceptability of occlusal condition of 13-yr-olds, as assessed by the SASOC scale, were measurements of acceptability of general physical appearance, and the severity of occlusal condition. Variability in SASOC scores appeared to be independent of gender, socioeconomic status, and ethnicity. Gender, and severity of occlusal condition were important differences between subjects who had received, planned, or were undergoing orthodontic treatment, and those who had not. Neither SASOC scores nor perceived need for treatment accounted for a significant proportion of the variance between these groups. Although adolescents seeking orthodontic treatment had a greater severity of malocclusion than those not, little difference was observed between these groups in acceptance of occlusal condition.     

Second-trimester sex hormone-binding globulin and subsequent development of pre-eclampsia.

OBJECTIVE: To investigate whether maternal plasma sex hormone-binding globulin (SHBG) concentrations are reduced in women who subsequently develop pre-eclampsia. METHODS: This was a cross-sectional study, carried out at antenatal clinics in seven hospitals in and around London. Healthy women underwent uterine artery Doppler velocimetry as a screening method for pre-eclampsia at 22-24 weeks of gestation. The first group (408 women) had normal uterine artery Doppler waveforms (mean uterine artery pulsatility index (PI) below 1.6). The second group (274 women) had increased impedance to flow in the uterine arteries (mean PI above the 95th centile, 1.6). Maternal plasma SHBG concentrations were measured retrospectively using a competitive chemiluminescent immunoassay. Pre-eclampsia was as defined by the International Society for the Study of Hypertension in Pregnancy. RESULTS: Plasma SHBG concentrations in the 80 (11.7%) women who subsequently developed pre-eclampsia were significantly lower than in the 585 (85.8%) women with normal pregnancy outcomes (median 336, range 142-674 nmol/l vs. median 336, range 142-674 nmol/l, p = 0.001). There was a strong correlation between SHBG concentrations and body mass index (r =-0.232246, p < 0.0001). There were no significant differences in maternal plasma SHBG concentrations in women with abnormal uterine artery Doppler (n = 274) compared with controls (n = 408) (median 324, range 101-635 nmol/l vs. median 336, range 142-674 nmol/l, p = 0.09). CONCLUSION: Maternal plasma SHBG concentrations are reduced in women who subsequently develop pre-eclampsia.     

The influence of partnership centrality on organizational perceptions of support: a case study of the AHLN structure

Background  

Knowledge of the structure and character of inter-organizational relationships found among health promotion organizations is a prerequisite for the development of evidence-based network-level intervention activities. The Alberta Healthy Living Network (AHLN) mapped the inter-organizational structure of its members to examine the effects of the network environment on organizational-level perceptions. This exploratory analysis examines whether network structure, specifically partnership ties among AHLN members, influences organizational perceptions of support after controlling for organizational-level attributes.