Free rupture of the ascending aorta: successful resuscitation at a regional trauma center

After sustaining a free rupture of the intrapericardial ascending aorta secondary to blunt chest trauma, a 27-year-old man underwent successful aortic repair. To our knowledge, this is the first time a patient has ever survived this condition. Pericardial tamponade-together with rapid transport to the hospital and an aggressive surgical approach-was a key to the recovery of effective cardiac function and successful aortic repair. Although the patient succumbed to complications 74 days after surgery, this case illustrates the possibility of longterm survival after free rupture of the ascending aorta. The following report emphasizes the technical feasibility of controlling the perforated aortic root in such cases.     

Studies of the mechanism of tolerance induced by short-term immunosuppression with cyclosporine in high-risk corneal allograft recipients. I. Analysis of CTL precursor frequencies

Transplantation of unmatched allogeneic corneas into highly vascularized recipient eyes under the cover of short-term immunosuppression with cyclosporine enables permanent engraftment. The aim of this study was to further elucidate the mechanism(s) underlying this tolerant state. In eight "high-risk" cornea recipients the clone sizes of donor-specific and third-party reactive cytotoxic T cell precursors were assessed by limiting dilution analyses before and at three and six months after transplantation. Acquired allograft tolerance in these patients was not accompanied by clonal reduction of donor-specific CTL-p, whereas in the case of an irreversible rejection the donor-specific CTL pool size was significantly enlarged. This donor-specific CTL-p increase could already be seen two months before clinical manifestation. These patterns differed from that of tolerant renal transplant patients, in whom marked and donor-specific reduction of CTL-p was observed. During rejection identical patterns with increasing donor-specific CTL-p frequencies were seen in both groups of patients. We conclude that induction of tolerance by short-term CsA to unmatched cornea grafts is not caused by clonal reduction of the effector precursor cell pool.     

Minor Iridoid and Phenol Glycosides of Picrorhiza kurrooa

From the roots of PICRORHIZA KURROOA a new iridoid glycoside, 6-feruloylcatalpol has been isolated, along with veronicoside and minecoside and two phenol glucosides, picein and androsin.     

Communication of BRCA1 and BRCA2 results to at-risk relatives: a cancer risk assessment program's experience

We describe results from a survey designed to assess patterns of communication within families shortly after an individual receives results of BRCA1 and BRCA2 mutation carrier status. Shortly after disclosure of BRCA1 and BRCA2 genetic test results, the proband was contacted by phone to administer the post disclosure survey. Questions asked included whether they had shared their results with their siblings or adult children, if there were difficulties in communicating the test results, and if there was any distress associated with the sharing of results. A total of 162 women who have received results from BRCA1 and BRCA2 genetic testing participated in the survey. The probands shared their results more often with their female than their male relatives (P < 0.001). Probands who had tested positive for a mutation in the BRCA1 or BRCA2 gene shared their results more often with their relatives than did probands who were not carriers (P = 0.002). Probands reported more often that their siblings rather than their adult children had difficulties understanding the results (P = 0.001). The probands who were carriers more often reported having difficulties explaining their results to their relatives (P < 0.001) and their relatives were upset on hearing the result more often than were the relatives of probands who were not carriers (P < 0.001). The probands who were carriers reported more often that they were upset explaining their results to their relatives than did the probands who were not carriers (P < 0.001). Individuals are disclosing their test results to their relatives. Probands who are BRCA1- or BRCA2-positive are more likely to experience difficulty and distress with the communication of their test results to family members.     

Decreased prefrontal 5-HT2A receptor binding in subjects at enhanced risk for schizophrenia

The brain serotonin-2A receptor (5-HT_2AR) has been implicated in both the pathology of schizophrenia and the therapeutic action of atypical antipsychotics. However, little is known about the 5-HT_2AR status before the onset of schizophrenia and before the exposure to antipsychotics. We used [¹⁸F] altanserin and positron emission tomography (PET) in a pilot study of 6 individuals suspected to be at elevated risk for schizophrenia and seven age-matched controls to test the hypothesis that regional 5-HT_2AR binding is altered in the prodromal stages of schizophrenia. Distribution volume ratios (DVRs) as a proxy for 5-HT_2AR availability were significantly reduced in prefrontal cortex regions of at-risk subjects, implicating early abnormalities of serotonergic neurotransmission that antecede the onset of schizophrenia.     

Electrophysiologic studies on the pallido- and cerebellothalamic projections in squirrel monkeys (Saimiri sciureus)

Summary Thalamic projections of the pallidum and the deep cerebellar nuclei were studied by unitary recordings as well as field potential analysis in the thalamus of squirrel monkeys (Saimiri sciureus) under sodium pentobarbital anesthesia.Stimulation of the pallidum produced a positive field potential preceded by incoming afferent fiber volleys in the thalamus. Spontaneous discharges of thalamic neurons were suppressed during this positive potential, and intracellular recordings from the thalamic neurons revealed that the time course of this field potential corresponded to that of the hyperpolarizing potential. The hyperpolarization was presumed to be a monosynaptic inhibitory postsynaptic potential by the short synaptic delay (about 0.5–0.7 ms) and responsiveness to high frequency stimulation (over 150 Hz). The positive field potential on stimulation of the external pallidal segment was distributed in L.po (VA) and the reticular thalamic nucleus around L.po, whereas that on stimulation of the internal segment was in V.o.a (the anterior basal part of VL) and in Z.o (upper part of VL). The projection of the external segment appeared to be less dense than that of the internal segment.The projection of deep cerebellar nuclei was situated in V.o.a, V.o.p (posterior part of basal part of VL), V.o.i (VLm), the intralaminar nucleus (CL), and some part of V. im (the rostral part of VPLo). Projections of the interpositus and dentate nuclei were distributed in a more anterior part than those of the fastigial nucleus. A certain topographical arrangement of the projections of these three nuclei was found in V.o.p, V.o.i and V.im. No significant overlap was detected between projections of the pallidum and the deep cerebellar nuclei within the thalamus.