Neisseria sicca osteomyelitis.

Neisseria sicca was identified as the cause of vertebral osteomyelitis in a male patient who had previously suffered a nonpenetrating, traumatic back injury. The identifying characteristics and antimicrobial susceptibility patterns are presented for this rare human pathogen, which heretofore has not been reported as a cause of infection localized to bone.     

Desmin as an immunochemical marker of human decidual cells and its expression in menstrual fluid

The expression of intermediate filament proteins in human endometrial tissue was examined. Desmin was selectively expressed in decidualized stroma, as demonstrated by SDS-PAGE analysis and positive response with a monoclonal antibody specific for desmin in ELISA and in western blot analysis. The same monoclonal antibody specifically stained human decidual cells in decidualized endometrium (secretory endometrium) in formalin-fixed paraffin-embedded sections prepared from diagnostic curettage samples. Desmin was also detected in menstrual fluid. Therefore, desmin might serve as a biochemical and histochemical marker of human decidualized endometrium.     

Sequential Measurements of Human Decidua-Associated Protein (hDP) 200 in the Uterine Fluid During the Menstrual Cycle

PROBLEM: To examine the relationship between the concentration of uterine fluid human decidua-associated protein (hDP) 200, identified as a monoclonal rheumatoid factor, and different phases of the menstrual cycle. METHODS: Sequential measurements of hDP 200 concentration in uterine fluid were performed in 11 normal ovulatory women, aged 22–36 years. The samples were collected in early proliferative phase, late proliferative phase, periovulatory period, early secretory phase, and late secretory phase. RESULTS: Consistent fluctuations of hDP 200 levels in uterine fluid were found throughout the menstrual cycle. High levels were found during early proliferative phase and periovulatory period related to significantly lower levels during late proliferative and early luteal phases. CONCLUSION: There is menstrual phase dependent variation in the uterine fluid levels of hDP 200.     

Enzyme-linked immunosorbent assays for determination of plasma aldosterone using highly specific polyclonal antibodies

Two enzyme-linked immunosorbent assays were established and compared for the estimation of plasma aldosterone. In the first method immobilized aldosterone-protein complexes on the ELISA plates compete with aldosterone to be determined for the binding of certain amount of anti-aldosterone antibodies. The sensitivity of this method depends on the protein carrier used to conjugate with aldosterone. In the second method, anti-aldosterone antibodies adsorbed on ELISA plates compete for binding of known amount of the enzyme-labeled aldosterone and aldosterone to be determined. The highly specific rabbit anti-aldosterone antibodies were obtained by injection of aldosterone-oxime thyroglobulin. The detection limit of aldosterone in both methods ranged between 2-20 pg. The proposed assays are suitable for the determination of aldosterone in biological fluids compared with other reported ELISA assays, as well as with RIA.     

A rapid and sensitive heterogeneous immunoelectrochemical assay using disposable electrodes.

In this novel enzyme-tagged immuoelectrochemical assay, disposable carbon felt discs serve both as electrodes and as the heterogeneous solid phase. Antibodies are immobilized on the carbon felt via a diaminoalkane-biotin-avidin-biotin bridge. Alkaline phosphatase is used as a label. Bound antibodies are monitored by following the electro-oxidation of aminophenol, produced enzymatically from p-amino-phenyl phosphate by the immobilized alkaline phosphatase at the electrode surface. A model system designed for determination of mouse IgG concentration yielded a calibration curve ranging from 10 pg/ml to 100 micrograms/ml. This assay can be performed rapidly and a single determination completed within 20 minutes. The system is useful also for rapid quantitation of a small number (approximately 80 organisms per ml) of bacteria.     

Factors affecting the decision to admit mental patients in a community hospital

Analysis of consecutive emergency referrals to a community mental hospital over a 2-month period indicates that admissions are affected by a combination of demographic, clinical, and time factors. Both referrals and admissions were slightly higher in men. The mean age at referral was 44 years and of admitted patients was 30 years. Although married subjects constituted the largest group of applicants, widowers and divorced people were hospitalized more often. Both referral and admission rates were inversely correlated with education and employment. Most of the applicants came to the emergency ward accompanied by an escort. A lower rate of admissions was observed among those who came unescorted. The main indications for admission were acute psychosis and a nonspecific clinical state when the patient was defined as "dangerous to himself or to others." The family constituted the main source of referral. Peak referrals were during the morning hours, but admission rates were highest at night. Referrals decreased gradually from Sunday to Saturday, but the rate of admission was practically steady throughout the week. We conclude that the decisions for admitting a patient to a mental institute are based not only on pure psychiatric criteria, but also on an intuitive approach, in which the admitting physician's personal and emotional factors may play a role.     

Applying cognitive-behavioral psychotherapy to the chronically ill elderly: treatment issues and case illustration.

A large percentage of older adults must endure at least one chronic medical illness. Clinically significant depression and anxiety are common among these patients. Specific psychotherapy approaches as well as adaptations required to address the unique issues of this population have not been delineated in the literature. We outline a cognitive-behavioral therapy approach and discuss five treatment issues we have found to be important for this population. These issues include: (1) resolving practical barriers to participation; (2) accepting depression as a separate and reversible problem; (3) limiting excess disability; (4) counteracting the loss of important social roles and autonomy; and (5) challenging the perception of being a "burden." A case study of a chronic obstructive pulmonary disease (COPD) patient with depression is presented and recommendations for future research are suggested.     

Genetische Ursachen

This contribution gives a brief overview of the current state of scientific knowledge on the genetic causes of knee osteoarthrosis. Correlations between genetic and molecular biological characteristics and the increased risk of premature knee joint degeneration are revealed, based on the results of numerous international studies. Their relevance to the assessment according to the Social Security Code VII is discussed.     

Mutations in TAX1BP3 Cause Dilated Cardiomyopathy with Septo‐Optic Dysplasia

We describe a Bedouin family with a novel autosomal recessive syndrome characterized by dilated cardiomyopathy and septo‐optic dysplasia. Genetic analysis revealed a homozygous missense mutation in TAX1BP3, which encodes a small PDZ domain containing protein implicated in regulation of the Wnt/β‐catenin signaling pathway, as the causative mutation. The mutation affects a conserved residue located at the core of TAX1BP3 binding pocket and is predicted to impair the nature of a crucial hydrophobic patch, thereby interrupting the structure and stability of the protein, and its ability to interact with other proteins. TAX1BP3 is highly expressed in heart and brain and consistent with the clinical findings observed in our patients; a knockdown of TAX1BP3 causes elongation defects, enlarged pericard, and enlarged head structures in zebrafish embryos. Thus, we describe a new genetic disorder that expands the monogenic cardiomyopathy disease spectrum and suggests that TAX1BP3 is essential for heart and brain development.