Intranasal or oral immunization of inbred and outbred mice with murine or human rotavirus VP6 proteins protects against viral shedding after challenge with murine rotaviruses

Intranasal (i.n.) administration of an Escherichia coli-expressed chimeric VP6 protein from the EDIM strain of murine rotavirus to adult BALB/c (H-2(d)) mice along with LT(R192G), an attenuated mutant of the mucosal adjuvant E. coli heat-labile toxin, has been found to consistently stimulate ca. 99% reductions in rotavirus shedding after subsequent EDIM challenge. This study was designed to determine the robustness of this protection, i.e. can VP6 immunization consistently protect against shedding in this model, thus, providing an indication of its potential as a vaccine. Intranasal immunization with two 8.8 microg doses of EDIM VP6 and 10 microg of LT(R192G) was found to stimulate 99% reductions in EDIM shedding in four additional strains of inbred mice belonging to three haplotypes, i.e. DBA/2 (H-2(d)), C57BL/6 (H-2(b)), 129 (H-2(b)) and C3H (H-2(k)). Protection stimulated against EDIM antigen shedding following i.n. immunization with VP6 from the human CJN strain was less (P=0.02) than induced by EDIM VP6 (86% versus 99%), but no further loss of protection was observed when the dose of CJN VP6 was reduced 100-fold. Protection against EDIM shedding was also maintained after i.n. immunization of three strains of outbred mice (CF-1, CD-1 and Swiss Webster) with either EDIM or CJN VP6, i.e. EDIM VP6 immunization reduced EDIM shedding by 99% while CJN VP6 immunization produced reductions of 86-96%. Protection stimulated by oral immunization of BALB/c mice with two 8.8 microg doses of either VP6 chimera plus LT(R192G) was not significantly different from that induced by i.n. immunization. Finally, protection found after either oral or i.n. immunization with EDIM or CJN VP6 was no different when the mice were challenged with McN, another strain of murine rotavirus. These results support further evaluation of VP6 as a vaccine.     

Caloric restricted male rats demonstrate fewer synapses in layer 2 of sensorimotor cortex

Previous studies have demonstrated an age-related decline in the density of presumptive inhibitory synapses in layer 2 of rat sensorimotor cortex [J. Comp. Neurol. 439(1) (2001) 65]. Caloric restriction has been shown to ameliorate age-related deterioration in a variety of systems and to extend life span. The present study tested the hypothesis that caloric restriction would prevent the previously reported age-related synaptic decline. Accordingly, synaptic density in layer 2 of sensorimotor cortex was compared between 29-month-old male rats fed ad libitum and 29-month-old male rats that were caloric restricted (60% of ad libitum calories) from 4 months of age. In serial electron micrographs, the physical disector was used to determine the numerical density of presumptive excitatory and inhibitory synapses (those containing round or nonround vesicles, respectively) as well as that of neurons. Not only was the previously reported age-related decline in numerical density of presumptive inhibitory synapses not ameliorated by caloric restriction, the numerical density was significantly lower in caloric restricted than in ad libitum fed rats for total as well as for presumptive excitatory and inhibitory synapses. Analysis further revealed no difference in the numerical density of neurons in this region. Relating synapse density to neuron density as the ratio of synapses to neuron also demonstrated significantly fewer synapses per neuron in caloric restricted than in ad libitum fed old rats. Finally, synapse length was significantly less in caloric restricted rats. These results suggest that not only does caloric restriction fail to prevent the age-related decline in presumptive inhibitory synapses, it results in fewer presumptive excitatory synapses as well.     

反应停治疗难治性多发性骨髓瘤25例

1临床资料我院2001-02/2004-01接受2个疗程卡氮芥 环磷酰胺 马法兰 泼尼松 长春新碱或2个疗程长春新碱 阿霉素 地塞米松方案化疗无效或复发的难治性多发性骨髓瘤患者25(男16,女9)例,年龄42～80(中位年龄57.2)岁.单用反应停口服治疗,起始剂量200 mg/d,如无不良反应,每周增加100 mg,根据患者耐受情况,最高剂量为600 mg/d,3 mo为1疗程.服药期间禁止使用糖皮质激素类药物及细胞毒药物.     

Nurses' perceived barriers to the implementation of a Fall Prevention Clinical Practice Guideline in Singapore hospitals

Background  

Theories of behavior change indicate that an analysis of barriers to change is helpful when trying to influence professional practice. The aim of this study was to assess the perceived barriers to practice change by eliciting nurses' opinions with regard to barriers to, and facilitators of, implementation of a Fall Prevention clinical practice guideline in five acute care hospitals in Singapore.     

What is a geriatrician?

A geriatrician is something more than a physician who simply cares for old people. The geriatrician should, above all, be well grounded in internal medicine, have a genuine fondness for the elderly and their problems, and be experienced in neurology, psychiatry and rehabilitation medicine. A possible additional role is that of organizer and coordinator of health services for old people.     

Defining a cognitive function decrement in schizophrenia.

BACKGROUND: Although cognitive impairment is described as a core component of the characterization of schizophrenia, a sizable percentage of patients are classified as unimpaired by traditional definitions of impairment. The purpose of this study was to determine the percentage of patients with schizophrenia meeting criteria for a "cognitive function decrement" defined as a current level of cognitive function that falls below the level predicted by premorbid estimates. METHODS: Linear regression analyses were performed on a healthy control population to determine a predicted composite cognitive score based on maternal education, paternal education, and reading score as indicators of premorbid intellectual function. The percentages of patients with current cognitive function above and below predicted values were calculated. RESULTS: When the Wide Range Achievement Test-3 (WRAT-3) score and maternal education are both used to predict current cognitive performance, as expected, about half (42%) of control subjects fall below expectations. However, 98.1 % of patients fall below expectations. CONCLUSIONS: When cognitive function decrement is defined as a failure to reach the expected level of cognitive functioning, almost all patients with schizophrenia meet this definition.     

Oral contrast agents for CT of abdominal trauma in pediatric patients: a comparison of dilute hypaque and water

OBJECTIVE: Dilute Hypaque Sodium is generally well accepted as an oral contrast agent for CT of pediatric patients who have experienced recent blunt abdominal trauma. However, Hypaque can cause complications. Using water as a substitute contrast agent eliminates these potential complications. The purpose of our study was to compare the performance of water with that of dilute Hypaque as an oral contrast agent. Our hypothesis was that we would find no significant difference in performance between the two agents in defining anatomic details of the hollow gastrointestinal tract. MATERIALS AND METHODS: We performed a retrospective review of 74 CT scans obtained in infants and children who had received blunt abdominal trauma, scoring the quality of visualization of bowel structures, the presence of non-bowel-related findings, and the confidence level in making each assessment. The date range of the scans reviewed overlapped with the period in which the oral contrast material used for scanning such patients was switched from dilute Hypaque to water. Of the 74 CT scans that we reviewed, 53 were obtained with dilute Hypaque and 21 were obtained with water. The sex distribution between the two groups was compared using a chi-square test, whereas the mean age was compared using a two-sample two-sided Student's t test. A two-sample one-sided Student's t test of equivalence was used to analyze the data. RESULTS: Sex distribution for the two groups of patients was not significantly different (69.81% of the group who received dilute Hypaque were boys; 68.18% of the group who received water were boys). Furthermore, the difference in the mean age for the two groups was not statistically significantly (dilute Hypaque group, 8.86 years; water group, 10.18 years). No statistically significant difference in performance of the contrast agents was found with respect to the detection of intraabdominal abnormality. As an oral contrast material, water performed as well as dilute Hypaque in facilitating visualization of all intraabdominal anatomic structures. CONCLUSION: In defining anatomic details of the hollow gastrointestinal tract, water is as effective as dilute Hypaque as an oral contrast agent for CT in the setting of acute blunt abdominal trauma in pediatric patients.