[Deep venous thrombosis caused by congenital inferior vena cava agenesis]. / Une thrombose veineuse profonde révélant une agénésie de la veine cave inférieure.

Congenital agenesis of the inferior vena cava, although rare, is found preferentially in young patients with proximal deep venous thrombosis. Exact diagnosis can be made thanks to enhanced computed tomography scan and/or magnetic resonance imaging, while Doppler ultrasonography is insufficient to establish an inferior vena cava malformation. A consensus has not yet been established for the treatment but lifelong anticoagulation with elastic stocking support to prevent post-thrombotic syndrome is commonly considered in most cases. We report a case of an unprovoked deep venous thrombosis caused by a congenital agenesis of the inferior vena cava localized to the infrarenal segment, in a 24-year-old man. An anticoagulation with low molecular weight heparin was started and prolonged oral anticoagulation was prescribed. In the absence of the usual thrombotic risk factors, the presence of an inferior vena cava anomaly should be considered.

Corrosion susceptibility of titanium covered by dental cements.

OBJECTIVES: The aim of this study is to determine the influence of acidic fluorinated cements (as glass ionomer (GI) cements) on the passivation of titanium, using electrochemical investigations. METHODS: We realized experimental electrodes that associate titanium and dental cements. Polarization resistance of titanium electrodes has been determined for uncovered metal and electrodes covered with three dental cements. Student's t-tests proved the reproducibility. We also compared successive voltammograms for uncovered titanium and GI covered titanium. RESULTS: Correct passivation was observed with zinc eugenate, but fluorinated GI or zinc phosphate coverage increased the corrosion susceptibility. SIGNIFICANCE: However there is no evidence of titanium depassivation when covered with cement. No clinical contraindication can be held.

The treatment of acute psychosis without neuroleptics: six-week psychopathology outcome data from The Soteria Project.

BACKGROUND: Today's treatment of acute psychosis usually includes short-term hospitalization and anti-psychotic drug treatment. The Soteria project compared this form of treatment (control) with that of a small, home-like social environment, usually without neuroleptics (experimental). METHOD: Newly diagnosed, young, unmarried persons with DSM-II schizophrenia were randomly assigned to treatment in two experimental and two control settings. Subjects and families were assessed at admission on 29 independent variables. Treatment environments were studied by means of Moos', COPES or WAS scales. Three dependent six week psychopathology outcome measures were collected. RESULTS: The groups were comparable on 25 of 29 admission variables. The environments of the two experimental and two control settings were different from each other. The milieus were similar to each other within each condition. At six weeks, psychopathology in both groups had improved significantly, and similarly, and overall change was the same. CONCLUSION: Specially designed, replicable milieus were able to reduce acute psychotic symptomatology within six weeks, usually without antipsychotic drugs, as effectively as usual hospital ward treatment that included routine neuroleptic drug use.

The vestigial locus of Drosophila melanogaster is involved in resistance to inhibitors of dTMP synthesis.

The vestigal (vg) gene encodes a nuclear protein which plays a major role in the formation of the wing of Drosophila. Resistance or sensitivity to aminopterin, an inhibitor of the dihydrofolate reductase enzyme in D. melanogaster, seems to be associated with a specific alteration in vg gene function. Wild-type and vg mutant strains selected for growth on increasing concentrations of aminopterin display changes in physiological and biochemical parameters such as viability on normal and aminopterin-containing media, duration of development, wing phenotype, dihydrofolate reductase activity, and cross-resistance to fluorodeoxyuridine (FUdR) and to methotrexate. Our results indicate that the mechanisms of resistance differ in the wild-type and mutant strains. The vg83b27 mutant, in which the major part of intron 2 of the vg gene is deleted, is associated with a high rate of resistance to FUdR, an inhibitor of thymidylate synthetase. Moreover, vg83b27/vgBG heterozygotes, which are wild type when grown on normal medium, display a strong vg phenotype when grown on aminopterin. Our results indicate a role for the vestigial locus in mediating resistance to inhibitors of dTMP synthesis.

Vestigial mutants of Drosophila melanogaster live better in the presence of aminopterin: increased level of dihydrofolate reductase in a mutant.

Vestigial (vg) mutants of Drosophila melanogaster are characterized by atrophied wings. In this paper we show that: (1) aminopterin an inhibitor of dihydrofolate reductase (DHFR) and fluorodeoxyuridine (FUdR), an inhibitor of thymidylate synthetase induce nicks in the wings of wild-type flies and phenocopies of the vg mutant phenotype when vg/+ and vgB/+ flies are reared on these substances (vgB is a deficiency of the vg locus). Only thymidine and thymidylate can rescue the flies from the effect of aminopterin. We propose that the vg phenotype is due to a decrease in the dTMP pool in the wings. (2) Mutant vg strains yield more offspring on medium containing aminopterin than on normal medium. The resistance of vg larvae to the inhibitor seems specific to the gene. This is the first case of aminopterin resistance in living eucaryotes. In contrast sensitivity of the vg larvae to FUdR is observed. (3) An increase in the activity and amount of DHFR is observed in mutant strains as compared with the wild-type flies. Our data suggest that the vg+ gene is a regulatory gene acting on the DHFR gene or a structural gene involved in the same metabolic pathway.

Residential facilities for the mentally ill: needs assessment and community planning.

The planning and development of community-based facilities for the mentally ill have been hindered by many factors, one of which is the lack of an acceptable methodology for determining the housing needs of this population. This paper describes a consumer-oriented needs assessment strategy that provides a basis for planning residential facilities for the mentally ill. Survey results provided detailed descriptions of the population in need of residential programs, the types of facilities needed, the total volume of need for each, and the distribution of need. Implications for program planning are discussed as well as the advantages and disadvantages in utilizing this approach for establishing a basis for residential facilities planning for the mentally ill.

Inhibitors of thymidylate synthesis increase whereas thymidine decreases meiotic recombination in Drosophila melanogaster.

We have demonstrated the effect of different media on meiotic recombination in Drosophila melanogaster. Recombination is more frequent when the medium is deprived of bases, nucleosides and nucleotides. We have shown that two inhibitors of thymidylate (dTMP) synthesis - aminopterin inhibiting dihydrofolate reductase (DHFR) and fluorodeoxyuridine (FUdR) inhibiting thymidylate synthetase - result in a significant increase in meiotic recombination in the yellow/white region on the X chromosome of Drosophila melanogaster. Moreover the addition of thymidine to the richest medium significantly lowers normal recombination. Such studies represent a powerful tool for future studies on the mechanism of meiotic recombination.

Dihydrofolate reductase activity and resistance to aminopterin in various species of Drosophila.

The aim of our work was to compare the mechanisms of resistance to aminopterin, inhibitor of the dihydrofolate reductase enzyme, between different Drosophila species and those described for cultured cells. Moreover we compared the systematic species divisions based on morphological traits and those based on a molecular approach. For this purpose, the effect of aminopterin on viability and wing phenotype was studied in different Drosophila species. Dihydrofolate reductase was measured in adult flies. We found an important dihydrofolate reductase activity in the melanogaster sub-group compared to the other species studies. Wing effect was observed only in this sub-group. The effects of aminopterin on the wing phenotype were very similar to the phenotype of rudimentary mutants. Both deplete the pyrimidine pool and it has been shown by the studies of the structural genes of the nucleotide pyrimidine pathway that the wing tissue is very sensitive to every pertubation of this metabolism. The D. ananassae species was found to be fully resistant at the concentrations of the inhibitor tested. No or very little dihydrofolate reductase activity was detected. The binding of the enzyme to the inhibitor was comparable to that found in the Oregon strain of D. melanogaster. The purine and pyrimidine salvage pathways were investigated and the D. ananassae species displayed an important thymidine kinase activity. The D. ananassae flies were sensitive on Sang medium compared to the Oregon flies but were able to use exogenous bases or nucleosides more efficiently.(ABSTRACT TRUNCATED AT 250 WORDS)

[Study of the effect of 2 inhibitors of nucleotide synthesis, aminopterin and fluorodeoxyuridine, on wild type strains and vestigial mutants in Drosophila melanogaster]. / Etude de l'effet de deux inhibiteurs de la synthèse des nucléotides l'aminoptérine et la fluorodésoxyuridine sur des souches sauvage et mutantes vestigial chez Drosophila melanogaster.

Two inhibitors of nucleotide metabolism, aminopterin and FUdR, were tested on a wild type strain, on two mutant strains: vg and vgnp, and on a vg strain with the wild type genetic background. Without inhibitors, a lengthening of the developing time was observed for the mutant strains compared to the wild type. With aminopterin, larval mortality and lengthening of developing time are significantly higher in the wild type than in the mutant strains. Mutant strains seemed to be resistant to low concentrations of FUdR. The hypothesis of a perturbed pyrimidine metabolism in the mutants seems to be confirmed.

A non-neuroleptic treatment for schizophrenia: analysis of the two-year postdischarge risk of relapse.

The efficacy of antipsychotic drug maintenance in reducing the risk of relapse among previously hospitalized schizophrenic patients has been well documented. However, data from an ongoing study comparing two cohorts of young first admission schizophrenics--one receiving neuroleptic-oriented treatment on the wards of a community mental health center (CMHC), the other an intensive interpersonal approach in a small homelike facility in the community (Soteria House)--raise questions about the routine use of neuroleptics with this population. Our questioning of this practice is based on data analyzed from these two cohorts by means of the life table, a statistical technique appropriate for longitudinal studies. Data are presented in two ways: (1) The overall effectiveness of the two independent treatment programs (Soteria, N = 32, vs. CMHC, N = 36) is compared in terms of the probabilities of not being readmitted over the 2-year postdischarge interval. (2) Analyses that look at the influence of the original treatment setting and postdischarge antipsychotic drug status on readmission rates are presented. Program comparisons reveal Soteria patients to have a consistently higher survival rate than CMHC patients throughout 2 years postdischarge. At 12 months postdischarge, the cumulative probability of remaining well (no readmissions) significantly favors the Soteria patients (p less than .05, Mantel chi2). The overall results of the Soteria program were achieved despite the fact that all CMHC patients received neuroleptics during their original inpatient stays and about 50 percent were maintained on neuroleptics up to the point of readmission or study termination, whereas only 10 percent of Soteria subjects were treated with or maintained on neuroleptics. The survival rates by postdischarge drug status and program affiliation show the Soteria no-drug group to have the highest proportion of survivors at almost every interval throughout 24 months, the CMHC drug-maintained group to have the lowest survival rate, and the CMHC unmaintained group to be surviving at a rate generally comparable to the Soteria no-drug group.

Community residential treatment for schizophrenia: two-year follow-up.

Two-year outcome data from a study comparing two kinds of treatment given similar groups of young, newly diagnosed, unmarried schizophrenic patients deemed in need of hospitalization are reported. The experimental program, Soteria, is a nonmedical, psychosocial program with minimal use of antipsychotic drugs; it is staffed by nonprofessionals and located in a home in the community. The control program is a short-stay, crisis-oriented inpatient service in a community mental health center where neuroleptic drugs are the principal treatment. The experimental group had significantly longer initial stays, and only 8 per cent received neuroleptics during their initial admission. Over the two-year follow-up period, there were no significant differences between the groups in readmissions or levels of symptomatology. However, experimental subjects significantly less often received medications, used less outpatient care, showed significantly better occupational levels, and were more able to live independently.

Being with madness: personality characteristics of three treatment staffs.

The personality characteristics of the nonprofessional staff of Soteria House, an innovative residential treatment program for schizophrenics, are assessed and compared with characteristics of representative staffs from two more traditional mental health programs for schizophrenics: a university psychiatric ward and a community-based program staffed by a specially trained group of state hospital aides. A battery of self-report personality questionnaires was used. Analysis of the data indicates an over-all similarity of personality profiles in the three groups. All groups demonstrated two sets of characteristics considered desirable for therapists of schizophrenics: the ego-strength qualities of self-assurance, emotional maturity, independence, and autonomy, and the affective qualities of warmth, sensitivity, and empathy. However, within a third set of characteristics, descriptive of cognitive-attitudinal qualities, the Soteria staff possessed significantly more intuition, introversion, flexibility, and tolerance of altered states of consciousness. The authors speculate that it is this last set of characteristics that allows the Soteria staff to function in the program's intensive, unstructured treatment environment.

Soteria: Evaluation of a home-based treatment for schizophrenia.

Data are reported from an ongoing study comparing outcome in two groups of young, first-admission schizophrenics - one receiving "usual" treatment (including drugs) on the wards of a good community mental health center, the other being treated by a non-professional staff (usually without phenothiazines) in a small home-like facility in the community. Six-month and one-year outcome data show few differences in symptoms between the two groups, but three measures of psychosocial functioning significantly favor the experimental group.