The impact of protease inhibitors on maternal serum screening analyte levels in pregnant women who are HIV positive

OBJECTIVE: The purpose of this study was to compare alpha-fetoprotein, human chorionic gonadotropin, and unconjugated estriol levels in women who take protease inhibitors and those women who do not. STUDY DESIGN: This retrospective review from August 2000 to May 2003 was performed for maternal serum screen results, medication use, pregnancy, and perinatal outcomes. RESULTS: Thirty-nine women met study criteria. Sixteen women were treated with protease inhibitors, and 23 women were not treated with protease inhibitors. There was no difference in initial viral load or initial CD4 count between the groups. No difference was found for human chorionic gonadotropin and estriol levels; significantly lower alpha-fetoprotein multiples of the median were found for the women who were treated with protease inhibitors compared with the women who were not (0.97 +/- 0.32 [SD] MoM vs 1.2 +/- 0.4 MoM, respectively; P = .04). Six of 39 women (15%) had positive maternal serum screens. All the babies were normal at birth, and there were no cases of perinatal transmission of human immunodeficiency virus. CONCLUSION: Protease inhibitors are associated with lower alpha-fetoprotein levels in women who are infected with human immunodeficiency virus.     

Role of magical thinking in obsessive-compulsive symptoms in an undergraduate sample

Thought action fusion (TAF) is an important presenting feature of many individuals with obsessive-compulsive disorder (OCD). "Magical thinking" is a similar construct (developed within the literature on schizotypy) that may provide a more accurate depiction of difficulties encountered by individuals with OCD. This study seeks to examine relationships between components of magical thinking, TAF, and superstitiousness; establish the extent to which these constructs are independently related to OCD proneness; and establish the extent to which these biased reasoning styles are related to each of the major OCD symptom clusters (e.g., washing, checking). The Padua Inventory (PI), the Maudsley Obsessional-Compulsive Inventory (MOCI), the Magical Ideation Scale (MI), the Lucky Behaviours (Lbeh) and Lucky Beliefs (Lbel) Scales, and the Thought Action Fusion-Revised scale (TAF-R) were given to a cohort of 86 undergraduate students. Of all the measures, the MI scale was found to be the most strongly related to obsessive-compulsive symptoms. Large and significant relationships between MI scores and the two measures of OCD (i.e., MOCI and PI) were obtained even when alternative mediators (i.e., Lbeh, Lbel, TAF-R) were held constant. No other variable remained significantly related to the MOCI or PI when magical ideation scores were held constant. The findings suggest that a general magical thinking tendency may underpin previous observed links between superstitiousness, thought action fusion, and OCD severity.     

Transplanted multipotential neural precursor cells migrate into the inflamed white matter in response to experimental autoimmune encephalomyelitis

Transplanted neural precursor cells remyelinate efficiently acutely demyelinated focal lesions. However, the clinical value of cell transplantation in a chronic, multifocal disease like multiple sclerosis will depend on the ability of transplanted cells to migrate to the multiple disease foci in the brain. Here, we expanded newborn rat neural precursor cells in spheres and transplanted them intracerebroventricularly or intrathecally in rats. The cells were labeled by the nuclear fluorescent dye Hoechst or by incubation with BrdU to enable their identification at 2 days and 2 weeks after transplantation, respectively. Spheres consisted of PSA-NCAM(+), nestin(+), NG2(-) undifferentiated precursor cells that differentiated in vitro into astrocytes, oligodendrocytes, and neurons. Spheres that were transplanted into intact rats remained mostly in the ventricles or in the spinal subarachnoid space. Following transplantation at peak of experimental autoimmune encephalomyelitis, cells migrated into the brain or spinal cord parenchyma, exclusively into inflamed white matter but not into adjacent gray matter regions. After 2 weeks, many transplanted cells had migrated into distant white matter tracts and acquired specific markers of the astroglial and oligodendroglial lineages. Thus, the inflammatory process may attract targeted migration of transplanted precursor cells into the brain parenchyma.     

Pattern of lateral geniculate synapses on neuron somata in layer IV of the cat striate cortex

The distribution of geniculate synapses on neuron cell bodies in layers IVab and IVc of cat area 17 was studied. Electron microscope autoradiography was used to identify geniculate terminals that were labeled by anterograde transport of radioactivity injected into the A-laminae of the lateral geniculate nucleus. Thirty-eight cell bodies (19 in layer IVab and 19 in layer IVc) were examined in a series of 138 consecutive sections. Two pyramidal somas were studied and had no geniculate contacts. All of the other somas studied were nonpyramidal, and of these, 85% received geniculate contacts. The proportion of somas receiving somatic geniculate input differed in layers IVab and IVc. In layer IVab, 70% of the nonpyramidal somas received geniculate contacts; in IVc, 100%. Such high percentages indicate that geniculate afferents synapse with more types of layer IV neuron than the aspinous neurons that synthesize gamma-aminobutyric acid (GABA) (Freund et al., '85b). The pattern of input to somas was so diverse that it was impossible to form groups of neurons based on only this criterion. We wondered if it would be possible to form groups of neurons based on a range of characteristics among which would be pattern of synaptic input. To this end, pyramidal neurons and neurons that contained a cytoplasmic laminated body (CLB) (Winfield, '79; Einstein et al., '84) were treated as two separate classes. We found fair agreement among the features of these neurons within their own classes, with the CLB-cells in layer IVab and IVc forming separate groups. Among the remaining neurons there was too little agreement within the range of features to enable us to treat them in this manner. Geniculate somatic contacts in both sublayers were of 2 forms, those with round vesicles and asymmetric thickenings (RA) and those with pleomorphic vesicles and symmetric thickenings (PS) (Einstein et al., '87). The distribution of these forms varied: some cells received contacts exclusively from one form or the other; other cells received contacts from both. On one cell that bore 33 somatic geniculate terminals, 61% were RA and 39% were PS. Such substantial numbers of geniculate contacts located near the site of impulse initiation are likely to contribute significantly to the receptive field properties of this neuron, and the possible effects are discussed.     

Strangulation in child abuse: CT diagnosis

The central nervous system is commonly affected in child abuse. Between April 1985 and July 1986 three infants were identified in whom the primary mode of injury had been strangulation. In each case computed tomography (CT) demonstrated a large cerebral infarction confined to vascular territories associated with small subdural hematomas. There was no history or visible evidence of significant head trauma. Autopsy of one infant confirmed the presence of a hemispheric infarct, thin subdural hematoma, and an area of subintimal hemorrhage in the carotid artery ipsilateral to the infarct. The remaining two patients survived with residual hemiparesis. CT findings of a large cerebral infarction with an associated subdural hematoma in an infant without a history of a significant trauma should suggest the possibility of child abuse and may be the primary manifestation of abuse in some patients.     

Evaluation of tumor measurements in oncology: use of film-based and electronic techniques.

PURPOSE: To evaluate the variability in bidimensional computed tomography (CT) measurements obtained of actual tumors and of tumor phantoms by use of three measurement techniques: hand-held calipers on film, electronic calipers on a workstation, and an autocontour technique on a workstation. MATERIALS AND METHODS: Three radiologists measured 45 actual tumors (in the lung, liver, and lymph nodes) on CT images, using each of the three techniques. Bidimensional measurements were recorded, and their cross-products calculated. The coefficient of variation was calculated to assess interobserver variability. CT images of 48 phantoms were measured by three radiologists with each of the techniques. In addition to the coefficient of variation, the differences between the cross-product measurements of tumor phantoms themselves and the measurements obtained with each of the techniques were calculated. RESULTS: The differences between the coefficients of variation were statistically significantly different for the autocontour technique, compared with the other techniques, both for actual tumors and for tumor phantoms. There was no statistically significant difference in the coefficient of variation between measurements obtained with hand-held calipers and electronic calipers. The cross-products for tumor phantoms were 12% less than the actual cross-product when calipers on film were used, 11% less using electronic calipers, and 1% greater using the autocontour technique. CONCLUSION: Tumor size is obtained more accurately and consistently between readers using an automated autocontour technique than between those using hand-held or electronic calipers. This finding has substantial implications for monitoring tumor therapy in an individual patient, as well as for evaluating the effectiveness of new therapies under development.     

Zur Differentialdiagnostik der Nierenkrankheiten

Zusammenfassung 1. Die Methodik zur Bestimmung der im Urin auftretenden Serumund Nierenlipase wird quantitativ ausgebaut. 2. Es wird eine Methodik angegeben, die gestattet, das bei Albuminurie ausgeschiedene Eiwei? qualitativ zu differenzieren. 3. Bei jeder Albuminurie findet sich ein stark sauer geladenes Albumin; bei den mit degenerativen Prozessen an den Nierenepithelien verlaufenden Nierenerkrankungen findet sich eine Gruppe von Eiwei?k?rpern mit geringerer relativer Acidit?t, die wir als Harnglobulin zusammenfassen. 4. Es lassen sich drei gro?e Gruppen von Erkrankungen nach den Befunden aufstellen. Diese Gruppen sind keine wesensverschiedenen Erkrankungen, sondern gehen flie?end ineinander über. 5. Das Auftreten von Harnalbumin und Serumlipase wird als Zeichen einer gest?rten Permeabilit?t des Nierenfilters infolge exsudativer Prozesse, das Auftreten von Harnglobulin und Nierenlipase als Zeichen degenerativer Prozesse aufgefa?t.