Association of human papillomavirus type 58 variant with the risk of cervical cancer

Human papillomavirus (HPV) type 58 has been found to be prevalent among Chinese patients with cervical cancer. This study examined the oncogenic risk of HPV58 variants in Hong Kong, a southern part of China. Altogether, 1924 women were studied: 42.8% with a normal cervix, 16.2% with cervical intraepithelial neoplasia (CIN) I, 12.7% with CIN II, 20.8% with CIN III, and 7.6% with invasive cervical cancer (ICC). The overall prevalence of HPV58 was 11.4% (220) and increased statistically significantly with the severity of neoplasia (P(trend)<.001, chi(2) test for trend). Among HPV58-positive women, the occurrence of E7 632C-->T (T20I) and E7 760G-->A (G63S) variants (T20I/G63S) showed a positive trend of association with the severity of neoplasia (P(trend)<.001, chi(2) test for trend). HPV58 variants carrying these two substitutions showed an odds ratio (OR) for ICC of 26.79 (95% confidence interval = 10.14 to 74.72), and this OR was 6.9-fold higher than the ORs of variants without these substitutions. Patients with CIN III or ICC who were also infected with T20I/G63S variants had a statistically significant younger age at diagnosis than those infected with other variants (median age = 37 years versus 48 years; P =.038, two-sided Mann-Whitney U test). Thus, HPV58 variants carrying E7 T20I/G63S substitutions may be associated with an increased risk for cervical cancer.     

Retrograde tracing of zinc-enriched (ZEN) neuronal somata projecting to the olfactory bulb

Zinc ions seem to be important to several neurological functions and have been connected to the pathophysiology of epilepsy, neuronal cell death after seizure or stroke, and Alzheimer's disease. Both epilepsy and Alzheimer's disease are clinical conditions believed to involve the olfactory bulb. The mammalian olfactory bulb is densely innervated by zinc-enriched (ZEN) neurons, and the distribution of the ZEN terminals in the mouse olfactory bulb has previously been described. The aim of this study was to describe the origins of ZEN terminals projecting into the main olfactory bulb of the rat. Selective labeling of ZEN terminals was accomplished by intracerebral infusion of sodium selenide, whereby zinc selenium clusters are created in the ZEN terminals. Some of these clusters move by retrograde axonal transport to the somata where they can be silver-enhanced by autometallography (AMG). After infusion of sodium selenide into the main olfactory bulb, retrogradely labeled ZEN somata were found (1) ipsilaterally in all anterior olfactory nuclei, taenia tecta, piriform cortex and lateral entorhinal cortex, and (2) contralaterally in anterior olfactory nuclei except the external division. The ipsilateral anterior olfactory nucleus had the densest population of ZEN somata, and it was found that these somata originated mainly from pyramidal neurons in layers II and III of each area. The olfactory-related centrifugal afferents to the main olfactory bulb are discussed.     

Therapist and case manager perceptions of client barriers to treatment participation and use of engagement strategies

This study of 33 mental health therapists and 30 case managers examined the relationship between practitioners' assessments of the importance of potential treatment barriers and their use of engagement strategies to overcome those barriers and improve treatment participation. Results confirmed the hypothesis that workers who viewed treatment barriers as more important were significantly more active in their reported efforts to engage clients (r = .28, p < .05). Although no significant differences between the two groups were found in overall use of engagement strategies, we found a significant interaction effect between position and types of strategies used, with therapists employing more discussion strategies while case managers were more likely to employ practical engagement strategies (F = 35.79, p < .001). Findings suggest the desirability of enhancing mental health workers' sensitivity to the range of barriers that clients may experience, and expanding the repertoire of engagement strategies they use to encourage client retention.     

Prominent pruritic periumbilical papules: allergic contact dermatitis to nickel

We report a case series of 38 children with suspected allergic contact dermatitis (ACD) to nickel who presented with prominent subumbilical and periumbilical papules and a generalized, lichenoid papular dermatitis resembling an id reaction. We speculated that this was an ACD to nickel and performed patch tests in 9 (24%) of these patients. All 9 (100%) patients had positive patch test results for nickel, thus confirming the diagnosis.     

Predictors of early recovery from major depression among persons admitted to community-based clinics: an observational study

BACKGROUND: Twenty years have elapsed since the National Institute of Mental Health Collaborative Depression Study reported on the early course and treatment of major depression within the mental health sector. Using similar methods, an observational study was conducted to assess relationships between initial depression severity, personality dysfunction and other baseline characteristics, subsequent treatment, and 3-month outcomes among persons admitted to public and voluntary sector outpatient clinics, including 1 academic program. METHODS: A 2-stage sampling technique was used to recruit subjects (N = 165) diagnosed by the Structured Clinical Interview for DSM-IV, Patient Version, as having a major depression episode. Sociodemographic and clinical characteristics were assessed at admission. Data on treatment and outcome were obtained at 3 months using structured instruments from the Longitudinal Interview Follow-up Evaluation. Logistic regression was used to assess hypothesized predictors of early recovery. Analyses were carried out in the total sample and after dichotomizing subjects by baseline depression severity. RESULTS: Fifty (30.3%) of the 165 subjects met recovery criteria. Less than half of the subjects (45%) met criteria for adequate pharmacotherapy. Less severe depression, having received adequate antidepressant treatment, female sex, and being married independently predicted early recovery. In the more depressed subgroup, early recovery was associated with female sex. Among less severely depressed subjects, high personality dysfunction scores and being married were significant predictors. CONCLUSIONS: Initial depression severity and receiving adequate pharmacotherapy predict early recovery in individuals with major depression seeking outpatient treatment. A minority of persons receive intensive antidepressant treatment. Less severe personality dysfunction and being married predicts early recovery among persons with less severe depression.     

A comparison between averaged spikes and individual visually-analyzed spikes in rolandic epileptiform discharges

PURPOSE:This study compared some morphological features of individual rolandic epileptiform discharges, used to obtain an averaged estimate, with those of the resulting estimate. METHOD: Twenty-four averaged discharges from EEGs of 24 children showing rolandic spikes were compared with 480 individual discharges used in the averaging. The analysis was based on the occurrence of tangential dipole and "double spike" patterns. RESULTS: In 15 averaged discharges the tangential dipole pattern was found. Individual spikes used in the averaging process displayed the same pattern in 35-100% of them; in the remaining 9 averaged discharges, up to 20% of the individual spikes showed the same pattern, although this was not found in the averaged waveforms. "Double spike" pattern was found in 11 of the averaged waveforms and was recognized in 50-100% of its individual discharges, whereas up to 45% of individual spikes showed this pattern without expression in the averaged waveform. CONCLUSION: When visually analyzing an EEG with rolandic spikes, caution should be exercised in characterizing these patterns, since a few discharges showing them may not be expressed in the averaged waveform and the clinical correlations proposed for these patterns may not apply.     

Primary pituitary abscess: case report

Pituitary abscesses are potentially life-threatening lesions if not appropriately diagnosed and treated. The authors have operated on more than five hundred cases of pituitary tumors and only one represented a case of pituitary abscess. A 35-year-old woman was investigated for chronic frontal headache. CT scan showed a cystic sellar lesion with ring enhancement after contrast injection leading to an initial diagnosis of pituitary adenoma. She underwent a sublabial transsphenoidal approach to the pituitary gland. After dural opening, purulent material was obtained and no tumor or other associated lesion was detected. There was no evidence of current or previous septicemic illness, meningitis, cavernous sinus thrombosis or sinus infection. Cultures were negative. She was put on antibiotics and discharged after 4 weeks. Nowadays, 10 years after treatment, she is doing well, with no anterior pituitary hormone deficit. MRI shows a partially empty sella without residual lesion and the pituitary stalck is in the midline. The early diagnosis and adequate treatment of this life-threatening lesion may result in excellent prognosis.     

Guanine and adenine nucleotidase activities in rat cerebrospinal fluid

Adenine and guanine nucleotides have been shown to exert multiple roles in central and peripheral nervous systems, and the sequential breakdown of these nucleotides by enzymatic systems is an important step in the modulation of their extracellular effects. The aim of this study was to investigate whether nucleotide hydrolysis also occurs in the cerebrospinal fluid (CSF) of rats. CSF was able to hydrolyze all guanine and adenine nucleotides investigated (2.0 mM): GDPADP=ATP=GTPAMP=GMP. More detailed studies with the diphosphate nucleotides showed that the hydrolysis of ADP and GDP was linear with incubation time and protein concentration. The apparent K_M (Henry–Michaelis–Menten constant) and V (maximal velocity) values for ADP and GDP were 164.3±54.7 μM and 12.2±3.8 nmol P_i/min per mg protein, and 841.0±90.2 μM and 22.8±8.0 nmol P_i/min per mg protein. The sum of ADP, GDP and UDP hydrolysis (2.0 mM) upon individual incubations with CSF was similar to the hydrolysis observed when all three nucleotides were incubated together. This pattern of hydrolysis strongly suggests the involvement of more than one enzyme activity. The higher maximum activity for GDP and UDP compared to ADP is compatible with presence of a soluble NTDPase5.