Cerebellar activation patterns in deaf participants for perception of sign language and written text

To address the influence of language presentation on cerebellar activation, hearing volunteers were compared with deaf individuals using functional magnetic resonance imaging during observation of German sign language and text reading. In deaf participants, German sign language revealed activation of the auditory and language-related areas including the medial temporal gyrus (BA 21) and Crus I. In normal hearing participants not understanding German sign language, Crus I was less activated during observation of German sign language but strongly activated during text reading and accompanied by activation of the medial temporal gyrus. Our results indicate that cerebellar activation in Crus I corresponds to language perception as correlated with cortical activation in language-related areas and is not dependent on the mode of language presentation.     

The experience of living with a person with an eating disorder: the impact on the carers

Using a combination of focus groups and individual in-depth interviews, the experience of living with a person with an eating disorder was explored in 24 carers. Attention was given to the progression of the disorder to understand its impact upon the family throughout the stages of the illness. Caring for a person with an eating disorder impacted upon the primary carer and the family throughout the course of the illness. Despite this, the impact on the carers was seldom acknowledged and the needs of these carers and their families were unrecognized and neglected by health professionals.     

Spatial interference during bimanual coordination: differential brain networks associated with control of movement amplitude and direction

Bimanual interference emerges when spatial features, such as movement direction or amplitude, differ between limbs, as indicated by a mutual bias of limb trajectories. Although first insights into the neural basis of directional interference have been revealed recently, little is known about the neural network associated with amplitude interference. We investigated whether amplitude versus directional interference activates differential networks. Functional magnetic resonance imaging (fMRI) was applied while subjects performed cyclical, bimanual joystick movements with either the same vs. different amplitudes, directions, or both. The kinematic analysis confirmed that subjects experienced amplitude interference when they moved with different as compared to the same amplitude, and directional interference when they moved along different as compared to the same direction. On the brain level, amplitude and directional interference both resulted in activation of a bilateral superior parietal-premotor network, which is known to contribute to sensorimotor transformations during goal-directed movements. Interestingly, amplitude but not directional interference exclusively activated a bilateral network containing the dorsolateral prefrontal cortex, anterior cingulate, and supramarginal gyrus, which was shown previously to contribute to executive functions. Even though the encoding of amplitude and directional information converged and activated the same neural substrate, our data thus show that additional and partly independent mechanisms are involved in bimanual amplitude as compared to that in directional control.     

Human endogenous retrovirus (HERV)-W ENV and GAG proteins: Physiological expression in human brain and pathophysiological modulation in multiple sclerosis lesions

Antigen expression of a human endogenous retrovirus family, HERV-W, in normal human brain and multiple sclerosis lesions was studied by immunohistochemistry by three independent groups. The HERV-W multicopy family was identified in human DNA from the previously characterized multiple sclerosis-associated retroviral element (MSRV). A panel of antibodies against envelope (ENV) and capsid (GAG) antigens was tested. A physiological expression of GAG proteins in neuronal cells was observed in normal brain, whereas there was a striking accumulation of GAG antigen in axonal structures in demyelinated white matter from patients with MS. Prominent HERV-W GAG expression was also detected in endothelial cells of MS lesions from acute or actively demyelinating cases, a pattern not found in any control. A physiological expression of ENV proteins was detected in microglia in normal brain; however,a specific expression in macrophages was apparently restricted to early MS lesions. Thus, converging results from three groups confirm that GAG and ENV proteins encoded by the HERV-W multicopy gene family are expressed in cells of the central nervous system under normal conditions. Similar to HERV-W7q ENV (Syncitin), which is expressed in placenta and has been shown to have a physiological function in syncytio-trophoblast fusion, HERV-W GAG may thus also have a physiological function in human brain. This expression differs in MS lesions, which may either reflect differential regulation of inherited HERV-W copies, or expression of "infectious" MSRV copies. This is compatible with a pathophysiological role in MS, but also illustrates the ambivalence of such HERV antigens, which can be expressed in cell-specific patterns, under physiological or pathological conditions.     

Gaseous distention of the hypopharynx and cervical esophagus with nasal CPAP: a mimicker of pharyngeal perforation and esophageal atresia

Background: Nasal continuous positive airway pressure (CPAP) has been used since 1975 as the initial treatment for respiratory distress syndrome (RDS) in very premature infants. Gaseous distention of the abdomen (CPAP belly) is a common secondary effect of CPAP. Gaseous distention of the hypopharynx is also common. Objective: To determine the incidence of hypopharyngeal distention in infants on CPAP. Materials and methods: We performed a retrospective review of the chest radiographs of 57 premature infants treated with CPAP during a 4-week period to find the presence and degree of hypopharyngeal distention. Results: Of the 57 radiographs, 14 (25%) revealed gaseous distention of the hypopharynx and/or cervical esophagus. On occasion, this raised concern for pharyngeal perforation or esophageal atresia. Conclusion: Awareness that CPAP-related hypopharyngeal distention is common should help radiologists avoid erroneous consideration of esophageal atresia or hypopharyngeal perforation.     

Human torovirus: a new virus associated with neonatal necrotizing enterocolitis

AIM: Toroviruses have been associated with gastroenteritis in both animals and humans. The aim of this study was to examine the fecal excretion of torovirus in infants with necrotizing enterocolitis (NEC). METHODS: We reviewed all infants with NEC admitted to our tertiary care NICU over a 5-y period who had stool specimens sent for microbial culture and virology. Infants in the NICU during the same period with diagnoses other than NEC served as controls. RESULTS: Forty-four infants with NEC stages I-III were identified, and pathogenic organisms were identified in 27 (61%). Toroviruses were identified in stool cultures in 48% of patients with NEC, and 17% of the non-NEC controls (p<0.001). There was no significant difference in illness severity or mortality between the torovirus-positive and -negative infants with NEC. CONCLUSION: Torovirus should be added to the list of infectious agents associated with NEC in newborn infants. The exact role torovirus plays in the etiology and progression of NEC warrants further investigation.     

Comparative long term immunogenicity of two recombinant hepatitis B vaccines and the effect of a booster dose given after five years in a low endemicity country

BACKGROUND: Few data are available concerning the long term immunogenicity of the pediatric doses of hepatitis B vaccines given to preteenagers. The long term effect of the booster dose in teenagers is unknown. We evaluated the immunogenicity of 2 pediatric hepatitis vaccines after primary vaccination and after a booster dose. METHODS: A prospective 15-year follow-up study of the immunogenicity of 2 hepatitis B vaccines was initiated in 1995 in Quebec City, Canada. One year apart, 1129 children 8-10 years old received Engerix-B 10 microg (EB), and 1126 received Recombivax-HB 2.5 microg (RB) vaccine after a 0-, 1-, 6-month schedule. After 5 years, one-third of the 2 cohorts were randomly selected. A booster dose of EB 10 microg or RB 5 microg was administered according to the vaccine used in the primary immunization. Antibodies were measured before, 1 month after and 1 year after the booster injection. RESULTS: Before the booster dose, anti-HB surface antibody (HBs) was detected in 94.7% of the EB subjects and in 95.2% of the RB subjects (P = 0.85). The geometric mean titer (GMT) was higher in the EB than in the RB group (252 mIU/mL versus 66 mIU/mL, P < 0.0001). One month after the booster, 99.7% of subjects in the EB group and 99.6% in the RB group had a detectable anti-HBs, and 99.0 and 99.3%, respectively, had anti-HBs > or =10 mIU/mL. The anti-HBs GMT was 113,201 mIU/mL in the EB and 16,623 mIU/mL in the RB groups (P < 0.0001). One year after the booster, 99.3% of subjects in the EB group and 100% in the RB group had detectable anti-HBs, and 97.9 and 98.5% respectively, had anti-HBs > or =10 mIU/mL. The anti-HBs GMT was 14,028 mIU/mL in the EB and 3437 mIU/mL in the RB group (P < 0.0001). CONCLUSIONS: The immunity persists for at least 5 years after the primary vaccination with both pediatric vaccines in 99% of children vaccinated at the age of 8-10 years. It confirms that no booster is needed at that point.