Asymptomatic uveitis in young people with inflammatory bowel disease.

PURPOSE: To ascertain the prevalence of uveitis in a population of pediatric patients with inflammatory bowel disease without ocular symptoms. METHODS: We prospectively evaluated all young people who came to the pediatric gastroenterology clinic with endoscopically proven inflammatory bowel disease between March 1994 and June 1995. All the patients were examined for evidence of ocular manifestations of inflammatory bowel disease. The examination consisted of slit-lamp examination, tonometry, and indirect ophthalmoscopy. None of the patients had visual or ocular symptoms. Eighteen patients had Crohn's disease and 14 had ulcerative colitis. RESULTS: Of the 32 patients evaluated, four (12.5%) had evidence of asymptomatic ocular inflammation, defined as anterior chamber cell and flare. All patients with ocular inflammation were male. Three of these four male patients had Crohn's disease; the other had ulcerative colitis. Five patients had posterior subcapsular cataract, one had esotropia and amblyopia, and one had unilateral high myopia. CONCLUSIONS: The prevalence of asymptomatic uveitis in our population of young people with inflammatory bowel disease was 12.5%. These findings suggest the need for a screening ophthalmologic examination to rule out occult eye disease in young people with inflammatory bowel disease.     

Tinea corporis caused by Microsporum canis: Report of a Nosocomial outbreak

In an unusual nosocomial outbreak, 13 staff and 11 patients in an acute and chronic health care facility were infected with the zoophilic dermatophyte, Microsporum canis. The dermatophyte was apparently introduced into the facility by a single infected patient. Likely modes of subsequent disease transmission include person-to-person contact, handling of contaminated laundry, and use of a shared razor. Infection control measures for managing such outbreaks are discussed.     

Family management of schizophrenia: A comparison of behavioral and supportive family treatment

This paper reports a comparison of behavioral and supportive family treatment for family management of schizophrenia. The family project applied two psychoeducational approaches to a highly treatment resistant population of young adults afflicted with chronic mental illness. The study compares and contrasts the effects of behavioral and supportive family management programs on clinical outcomes. Clinical improvements were associated with both family interventions. Discussion is provided on the relevance of this work to the growing body of evidence concerning the efficacy of psychoeducational family intervention for the management of schizophrenia.     

Systematic discrimination: A strategy for survival

The Reagan administration's federal policy of underdevelopment, social deficits, and disinvestment in social programs has contributed to widening the service gap between the rich and poor. The expansion of private and public insurance coverage has left the short term and near poor as the most vulnerable segment of our population. The article documents the scope of the problem, the challenges it presents to mental health administrators, and recommends strategies for dealing with the problems.     

Autoradiographic evidence of primary projections to the caudal cochlear nucleus in cats

Six adult cats received unilateral cochlear injections of 30–70 μCi ³H-leucine (³-H-leu) in saline. After 20–48 hours, their brains were prepared for autoradiography. The octopus cell area (OCA) and the dorsal region (DCN) of the cochlear nucleus of both the injected and uninjected sides were studied in detail. Grain counts of autoradiographs always showed much greater label in the injected side. Autoradiography confirmed uniform distribution of primary afferents in the OCA, as seen in grain counts over the whole area (both somata and neuropil); however, grains were more densely packed over somata than neuropil of the OCA. In DCN, grain counts showed a gradient of label from the deep to superficial layers, a greater density of label over somata than neuropil of the deep DCN, and uniform distribution of label over the whole fusiform cell layer of the DCN. These results showed (1) best resolution and localization in cats that survived 24 hours and with exposures of two weeks, (2) no significant diffusion of label to other CNS regions than the auditory nuclei,and (3) transneuronal transport of label after 48-hour survival times. Liquid scintillation counts (LSC) of cochlear nerve roots ipsilateral and contralateral to the injection showed at least a 10:1 ratio in all cats. This report not only gives new autoradiographic evidence of the distribution of primary afferents within the caudal cochlear nucleus, but also provides a useful approach to the study of distribution of specific amino acids implicated in central neurotransmission by cochlear terminals.     

Inactivation of Exonuclease 1 in mice results in DNA mismatch repair defects,increased cancer susceptibility,and male and female sterility

Exonuclease 1 (Exo1) is a 5'-3' exonuclease that interacts with MutS and MutL homologs and has been implicated in the excision step of DNA mismatch repair. To investigate the role of Exo1 in mammalian mismatch repair and assess its importance for tumorigenesis and meiosis, we generated an Exo1 mutant mouse line. Analysis of Exo1(-/-) cells for mismatch repair activity in vitro showed that Exo1 is required for the repair of base:base and single-base insertion/deletion mismatches in both 5' and 3' nick-directed repair. The repair defect in Exo1(-/-) cells also caused elevated microsatellite instability at a mononucleotide repeat marker and a significant increase in mutation rate at the Hprt locus. Exo1(-/-) animals displayed reduced survival and increased susceptibility to the development of lymphomas. In addition, Exo1(-/-) male and female mice were sterile because of a meiotic defect. Meiosis in Exo1(-/-) animals proceeded through prophase I; however, the chromosomes exhibited dynamic loss of chiasmata during metaphase I, resulting in meiotic failure and apoptosis. Our results show that mammalian Exo1 functions in mutation avoidance and is essential for male and female meiosis.     

Recurrent chondromyxoid fibroma of the thoracic spine 30 years after primary excision: case report and review of the literature

We report a case of late recurrence of chondromyxoid fibroma (CMF) arising in a thoracic vertebra in an 11-year-old male. This was treated by curettage, and 30 years later, the patient noticed shoulder pain and leg weakness. A recurrent mass appeared at the same site in the spinous process of T6. The histologic features of the recurrent tumor were similar to those of the primary lesion. A total of 38 cases of CMF of the vertebra have been reported. Only 3 of 38 previously reported vertebral CMF recurred. Tumors recurred 2 years after operation in 2 cases, and 7 years after operation in 1 case.     

Homozygosity mapping of achromatopsia to chromosome 2 using DNA pooling

Achromatopsia is an autosomal recessive disease of the retina, characterized clinically by an inability to distinguish colors, impaired visual acuity, nystagmus and photophobia. A genome-wide search for linkage was performed using an inbred Jewish kindred from Iran. To facilitate the genome-wide search, we utilized a DNA pooling strategy which takes advantage of the likelihood that the disease in this inbred kindred is inherited by all affected individuals from a common founder. Equal molar amounts of DNA from all affected individuals were pooled and used as the PCR template for short tandem repeat polymorphic markers (STRPs). Pooled DNA from unaffected members of the kindred was used as a control. A reduction in the number of alleles in the affected versus control pool was observed at several loci. Upon genotyping of individual family members, significant linkage was established between the disease phenotype and markers localized on chromosome 2. The highest LOD score observed was 5.4 (theta = 0). When four additional small unrelated families were genotyped, the combined peak LOD score was 8.2. Analysis of recombinant chromosomes revealed that the disease gene lies within a 30 cM interval which spans the centromere. Additional fine-mapping studies identified a region of homozygosity in all affected individuals, narrowing the region to 14 cM. A candidate gene for achromatopsia was excluded from this disease interval by radiation hybrid mapping. Linkage of achromatopsia to chromosome 2 is an essential first step in the identification of the disease-causing gene.