Neurofibroma of the ulnar nerve in the carpal canal in a dog: treatment by marginal neurectomy.

Peripheral nerve sheath tumours arising in the plexus or peripheral nerves can be treated by limb amputation. There are few reports of these tumours affecting peripheral nerves in the distal regions of the limbs. Here we describe a case of neurofibroma affecting the palmar branch of the ulnar nerve in an Irish setter. Surgical treatment in the region of the carpus by ulnar neurectomy resulted in resolution of chronic thoracic limb lameness. At 11 months following the surgery, clinical examination and MRI did not detect any evidence of recurrence. Neurectomy may be a feasible option for management of selected cases of distally located peripheral nerve sheath tumours.

Histopathological and immunohistochemical evaluation of 53 cases of feline lymphoplasmacytic enteritis and low-grade alimentary lymphoma.

Low-grade alimentary lymphoma (LGAL) is a recently described entity displaying many microscopical features similar to lymphoplasmacytic enteritis (LPE). The aim of this study was to review the histopathological and immunohistochemical features of LPE and LGAL to determine if specific features are useful in distinguishing between these disorders. Fifty-three cases of LPE (n=24) or LGAL (n=29) were recruited retrospectively and prospectively. Of the 24 cases of LPE, 12 were mild, seven were moderate and five were marked in severity. The ileum and jejunum were the most common sites affected for both LGAL and LPE (70-90% of cases). Involvement of the stomach was more common with LPE (29%) than LGAL (7%) (P<0.0001). Twelve cases of LGAL (41%) had evidence of concurrent LPE. Microscopical features significantly associated with LGAL were epitheliotropism, involvement of the muscularis propria and/or serosa, more severe infiltration and more severe changes to the villus and crypt architecture. Plasma cell infiltration within the mucosa, conversely, was a feature of LPE. Twenty-eight of the 29 cases of LGAL were of T-cell phenotype. While many LGAL and most LPE cases had a mixed infiltrate of T and B lymphocytes, LGAL cases had a clear predominance of the T-cell phenotype. Expression of class II molecules of the major histocompatibility complex by enterocytes did not differentiate between LGAL and LPE. In eight of 12 cases of moderate-marked LPE there was disparity in diagnosis by two pathologists regarding differentiation from LGAL, requiring assessment by a third pathologist to reach a consensus diagnosis. This demonstrates the inherent difficulty in differentiating LPE from LGAL on the basis of microscopical and immunohistochemical features alone. Other diagnostic tools such as clonality testing may assist in the definitive diagnosis of such cases.

Refinement of the Region for Split Hand/Foot Malformation 5 on 2q31.1.

Background: Deletions that encompass 2q31.1 have been proposed as a microdeletion syndrome with common clinical features, including intellectual disability/developmental delay, microcephaly, cleft palate, growth delay, and hand/foot anomalies. In addition, several genes within this region have been proposed as candidates for split hand-foot malformation 5 (SHFM5). Methods: To delineate the genotype-phenotype correlation between deletions of this region, we identified 14 individuals with deletions at 2q31.1 detected by microarray analysis for physical and developmental disabilities. Results: All subjects for whom detailed clinical records were available had neurological deficits of varying degree. Seven subjects with deletions encompassing the HOXD cluster had hand/foot anomalies of varying severity, including syndactyly, brachydactyly, and ectrodactyly. Of 7 subjects with deletions proximal to the HOXD cluster, 5 of which encompassed DLX1/DLX2, none had clinically significant hand/foot anomalies. In contrast to previous reports, the individuals in our study did not display a characteristic gestalt of dysmorphic facial features. Conclusion: The absence of hand/foot anomalies in any of the individuals with deletions of DLX1/DLX2 but not the HOXD cluster supports the hypothesis that haploinsufficiency of the HOXD cluster, rather than DLX1/DLX2, accounts for the skeletal abnormalities in subjects with 2q31.1 microdeletions.

Ectoparasitic dermatitis in free-ranging swamp wallabies (Wallabia bicolor) in New South Wales.

We report extensive dermatological lesions in three, free-ranging, adult, male swamp wallabies (Wallabia bicolor), presented to Taronga Western Plains Zoo wildlife hospital. All three animals were moderately infested with the louse species Heterodoxus ualabati, and two were concurrently infested with a previously undescribed sarcoptiform mite of the genus Diabolicoptes. Histological changes included moderate to marked compact hyperkeratosis, focal deep pyoderma and superficial dermatophytosis. Mild to moderate hyperplastic perivascular and periadnexal dermatitis with marked superficial and follicular hyperkeratosis was evident in the skin of the inguinal region and lateral thigh of the two wallabies infested with the Diabolicoptes species. This is the first report of ectoparasitic dermatitis in free-ranging swamp wallabies and the first report of mites of the genus Diabolicoptes from a macropodid.

Early sildenafil dose optimization and personalized instruction improves the frequency, flexibility, and success of sexual intercourse in men with erectile dysfunction.

We investigated the effect of early sildenafil dose optimization and personalized instructions on sexual intercourse success in 1109 men beginning sildenafil therapy for erectile dysfunction. In phase 1 (4 weeks), patients followed the instructions contained in the sildenafil (50 mg) sample pack and had 1.4 sexual intercourse attempts per week with 82% success. Patients (17%) had a second intercourse attempt (80% successful): 58% occurred within 4 h, 20% within 5-8 h, and 22% within 9-24 h of the first attempt. In phase 2 (4 weeks), sildenafil was adjusted as needed (53% to 100 mg, and 2% to 25 mg), and investigators provided personalized instructions to facilitate patient success. Sexual intercourse attempts increased to 1.7 per week, with 91% success, and 18% were followed by a second attempt, of which 91% were successful. Most patients requested the 100-mg dose, which helped improve sexual intercourse frequency, flexibility and success.

Free fetal DNA is not increased before 20 weeks in intrauterine growth restriction or pre-eclampsia.

BACKGROUND: The aim of this study was to quantify maternal plasma fetal DNA and total DNA in early pregnancy in intrauterine growth restriction (IUGR) or pre-eclampsia (PET). METHODS: A nested case control study was carried out in a University Teaching Hospital. Plasma samples were obtained from 1993 women before 20 weeks of gestation. Pregnancies complicated by IUGR or PET were identified and compared to controls. DNA was extracted and real-time quantitative PCR applied for the SRY and beta-actin genes. IUGR or PET groups were compared to controls using the chi(2) and Wilcoxon rank sum tests. RESULTS: SRY was detected in 86% of IUGR (31/36), 94% of PET (15/16) and 78% of controls (56/72). The median SRY was similar in women with IUGR (28 GE/mL) or PET (30.5 GE/mL) and controls (27.5 GE/mL). beta-actin was increased in the IUGR group (3975 GE/mL) compared to controls (1835 GE/mL) (p = 0.045). Cigarette consumption was greater in the IUGR group compared to controls (p = 0.004). CONCLUSIONS: Fetal DNA quantitation in maternal plasma before 20 weeks is not a useful predictor of IUGR or PET. beta-actin levels were elevated before 20 weeks in women with IUGR and may be a marker of maternal susceptibility to this condition.

Suppression of Raman gain in single-transverse-mode dual-hole-assisted fiber.

Measurements of backscattered Raman amplified spontaneous emission in single-mode dual-hole-assisted fiber indicate suppression of Raman gain by more than two orders of magnitude compared to SMF. These results imply that fiber lasers based on the dual-hole-assisted fiber design are effectively immune to SRS, thus enabling significant power scaling beyond current limits from a single-mode core.

Subcellular localization of presenilin 2 endoproteolytic C-terminal fragments.

Mutations in the genes that encode the presenilin 1 and 2 (PS1 and PS2) proteins cause the majority of familial Alzheimer's disease (FAD). Differential cleavage of the presenilins results in a generation of at least two C-terminal fragments (CTFs). An increase in the smaller of these two CTFs is one of the few changes in presenilin processing associated with FAD mutations in both PS1 and PS2. Interestingly, the phosphorylation of PS2 modulates the production of the smaller, caspase-derived PS2 CTF, which indicates that the generation of this fragment is a regulated, physiologic event. To date, there is no data concerning the subcellular distribution of the caspase-derived PS2 CTF. Because this fragment is normally present at levels that are difficult to detect, we have used cell lines in which the production of wild-type or N141I mutant PS2 is controlled by a tetracycline-regulated promoter in order to assess the subcellular localization of the caspase CTF in relation to the larger, constitutive PS2 CTF and to PS2 holoprotein. We have found that when levels of PS2 are low, the constitutive CTF colocalizes with markers consistent with localization in the early Golgi-ER-Golgi intermediate compartment (ERGIC) while the caspase CTF colocalizes with markers for the endoplasmic reticulum (ER). Following induction of wild-type or mutant PS2, when the levels of PS2 are high, the primary localization of the constitutive CTF appears to shift from the early Golgi-ERGIC in addition to the ER. Interestingly, while the induction of wild-type PS2 resulted in the localization of the caspase CTF primarily in the ER, the induction of mutant PS2 resulted in the localization of the caspase CTF to both the ER and the early Golgi-ERGIC. In summary, these data suggest that the two presenilin 2 CTFs have different patterns of subcellular localization and that the N141I PS2 mutation alters the localization pattern of the PS2 caspase fragment.

Calsenilin is a substrate for caspase-3 that preferentially interacts with the familial Alzheimer's disease-associated C-terminal fragment of presenilin 2.

Calsenilin is a member of the recoverin family of neuronal calcium-binding proteins that we have previously shown to interact with presenilin 1 (PS1) and presenilin 2 (PS2) holoproteins. The expression of calsenilin can regulate the levels of a proteolytic product of PS2 (Buxbaum, J. D., Choi, E. K., Luo, Y., Lilliehook, C., Crowley, A. C., Merriam, D. E., and Wasco, W. (1998) Nat. Med. 4, 1177-1181) and reverse the presenilin-mediated enhancement of calcium signaling (Leissring, M. A., Yamasaki, T. R., Wasco, W., Buxbaum, J. D., Parker, I., and LaFerla, F. M. (2000) Proc. Natl. Acad. Sci. U. S. A. 97, 8590-8593). Here, we have used cultured mammalian cells that transiently or stably express calsenilin to extend the characterization of calsenilin and of the calsenilin-PS2 interaction. We have found that calsenilin has the ability to interact with endogenous 25-kDa C-terminal fragment (CTF) that is a product of regulated endoproteolytic cleavage of PS2 and that the presence of the N141I PS2 mutation does not significantly alter the interaction of calsenilin with PS2. Interestingly, when the 25-kDa PS2 CTF and the 20-kDa PS2 CTF are both present, calsenilin preferentially interacts with the 20-kDa CTF. Increases in the 20-kDa fragment are associated with the presence of familial Alzheimer's disease-associated mutations (Kim, T., Pettingell, W. H., Jung, Y., Kovacs, D. M., and Tanzi, R. E. (1997) Science 277, 373-376). However, the finding that the production of the 20-kDa fragment is regulated by the phosphorylation of PS2 (Walter, J., Schindzielorz, A., Grunberg, J., and Haass, C. (1999) Proc. Natl. Acad. Sci. U. S. A. 96, 1391-1396) suggests that it is a regulated physiological event that also occurs in the absence of the familial Alzheimer's disease-associated mutations in PS2. Finally, we have demonstrated that calsenilin is a substrate for caspase-3, and we have used site-directed mutagenesis to map the caspase-3 cleavage site to a region that is proximal to the calcium binding domain of calsenilin.

Child care health consultation: an ecological model.

ISSUES AND PURPOSE: To present an ecological model of child care health consultation that defines the role of the health consultant as a resource and advocate within child care programs, as well as a supportive link among families, child care providers, and the healthcare system. CONCLUSIONS: Nurses have provided health consultation to child care programs for more than 30 years and represent the majority of health consultants nationally. Pediatric nurses and advanced practice nurses are well prepared to shape and lead the development of this emerging role. PRACTICE IMPLICATIONS: With expertise in caring for children, understanding families, and care across systems, pediatric nurses and advanced practice nurses should engage in current state and national efforts to develop child care health consultants.

Child care health consultation: the Connecticut experience.

OBJECTIVES: The quality of child care is of increasing national concern. Federal initiatives are recommending child care health consultation to promote healthy, safe, and developmentally appropriate care. However, few studies have investigated the implementation of this recommendation. The purpose of this study was to explore the experience of Connecticut child care center directors and their health consultants who were engaged in mandated, weekly, on-site health consultation. METHODS: One hundred Connecticut child care center directors and their health consultants participated in a mailed, self-administered survey. The centers were stratified by region and selected by random probability sampling. Descriptive analyses of the data examined the perspectives of both groups. RESULTS: Eighty-four percent of the child care center directors reported that health consultation visits were important or very important for the management of their programs. Eighty-one percent of the health consultants believed that their directors considered the visits important or very important. The reported tasks of the health consultants were consistent with regulatory requirements. Cost was cited as a factor that negatively influenced access to services by at least 37% of the director sample. Demographics of the sample, description of the role, and recommendations by directors and health consultants are included. CONCLUSIONS: Health consultation visits were highly valued among this sample as an effective means of promoting children's health and development in child care centers. Future initiatives should promote child care health consultation through training, infrastructure development, and funding of health consultation services.

Developmentally regulated tissue-associated cues influence axon sprouting and outgrowth and may contribute to target specificity.

The heart circuitry of the medicinal leech (Hirudo medicinalis) is a highly stereotyped circuit in the adult, but selection of the heart tube (HT) as a definitive target by heart excitor (HE) motor neurons during embryogenesis involves redirection of axonal arbors. In the present study we have confirmed the specificity of mature innervation using a retrograde marker and have used a combination of tissue/organ coculture and in situ manipulations to test the ability of HT and body wall to support axon outgrowth compared to CNS associated tissue. We also examined the temporal limits of target influence and the specificity of its action. Embryonic and young juvenile HT and body wall, but not adult HT, support or stimulate marked axon outgrowth from CNS ganglia, including those that would not innervate these tissues in vivo. Outgrowth support/stimulation by young tissue is largely contact based with little or no overt selectivity. Thus, outgrowth-supporting cues are developmentally regulated in the periphery, decreasing in efficacy with age while adult CNS-derived tissues consistently provide effective substrates supporting extensive axon outgrowth and regrowth. The HE motor neuron was very discriminating in that it showed little axon extension onto the HT compared to that of other neurons generally. These studies support a role for bidirectional communication in target selection. We suggest a working hypothesis that the HE motor neuron may initially select HT in response to a hierarchy of outgrowth supporting cues that have very broad influence and subsequently responds to selective signals for slowing or stopping growth and terminating on the functionally appropriate target.

Calsenilin: a calcium-binding protein that interacts with the presenilins and regulates the levels of a presenilin fragment.

Most early-onset familial Alzheimer disease (AD) cases are caused by mutations in the highly related genes presenilin 1 (PS1) and presenilin 2 (PS2). Presenilin mutations produce increases in beta-amyloid (Abeta) formation and apoptosis in many experimental systems. A cDNA (ALG-3) encoding the last 103 amino acids of PS2 has been identified as a potent inhibitor of apoptosis. Using this PS2 domain in the yeast two-hybrid system, we have identified a neuronal protein that binds calcium and presenilin, which we call calsenilin. Calsenilin interacts with both PS1 and PS2 in cultured cells, and can regulate the levels of a proteolytic product of PS2. Thus, calsenilin may mediate the effects of wild-type and mutant presenilins on apoptosis and on Abeta formation. Further characterization of calsenilin may lead to an understanding of the normal role of the presenilins and of the role of the presenilins in Alzheimer disease.

Antibody production in rabbits and chickens immunized with human IgG. A comparison of titre and avidity development in rabbit serum, chicken serum and egg yolk using three different adjuvants.

The antibody response in rabbits and chickens (serum and egg yolk) immunized with human immunoglobulin G was studied during a 1-year immunisation period comparing the efficacy of three adjuvants: Freund's complete adjuvant (FCA), Freund's incomplete adjuvant (FIA) and Hunter's TiterMax adjuvant (HTM). Monthly boosters of the antigen in saline were administered. Adjuvants were used in the initial immunisation and in a booster at week 26. FCA was found to result in the highest titre in both species. FIA was more efficient than HTM in mediating an antibody response in rabbits. In chickens, FIA resulted in similar antibody titres in serum and egg yolk. The effect of HTM was similar to FIA in chicken serum but lower in egg yolk. The titres obtained in rabbits were approximately a factor 1.5-2.0 higher than in the corresponding chicken groups. However, the antibody productivity of the chicken, when using the egg yolk as the antibody source, was a factor 5-10 higher than that of the rabbit depending on the adjuvant used. FCA and FIA resulted in similar antibody avidity in rabbits whereas HTM had a lesser effect. In chickens FCA initially resulted in the highest antibody avidity in both serum and egg yolk, but after the booster with adjuvant the antibody avidity became similar for all three adjuvants.

Transurethral resection of the prostate versus open prostatectomy: long-term mortality comparison.

To determine whether transurethral prostatectomy results in higher long-term mortality rates than open prostatectomy, we reviewed retrospectively 1,125 patients treated by transurethral and 190 treated by nonperineal open prostatectomy for benign disease at 1 institution from 1978 through 1987. Patients in whom prostatic cancer was found were excluded. We identified age, preoperative medical illnesses and urinary retention, American Society of Anesthesiologists category, type of anesthesia, length of followup, health status and cause of death. For statistical analysis the study cohort consisted of 527 patients in whom the charts were complete and followup was adequate (421 in the transurethral prostatectomy and 106 in the open prostatectomy groups). Mean age for the 2 groups was 66.3 and 67.5 years, respectively. With an average followup of 70.7 months 77% of the transurethral prostatectomy group were alive, compared to 78% of the open prostatectomy group at an average followup of 71.4 months. We found no supportive evidence that transurethral prostatectomy results in higher long-term mortality rates than does an open operation (log-rank test p = 0.74). Also, there was no significant survival difference in patients who required a preoperative Foley catheter. We also examined a subset of patients with adequate followup who had no significant medical history (for example hypertension, diabetes, heart disease and so forth) and compared them to patients with medical illnesses at prostatectomy. There was a significant survival difference between those with and without preoperative medical conditions (Wilcoxon test p = 0.047) in the transurethral prostatectomy group but not in the open group (p = 0.58). However, there was no significant survival difference between procedures among the healthiest subset of patients (p = 0.16).

Development and comparison of purification strategies for chicken antibodies from egg yolk.

With regard for animal welfare as well as cost, antibodies purified from the egg yolk of immunized chickens are an attractive alternative to antibodies raised in serum of mammals. Various purification strategies based on initial purification by a freeze-and-thaw method followed by one of three precipitation methods--ammonium sulfate, polyethylene glycol 6000, or caprylic acid--were compared. Ammonium sulfate precipitation (25 to 40%) was found to give the best combination of high purity and yield (58%). Moreover, this method is inexpensive and well suited for standard purification of egg yolk antibodies in large scale production facilities.

Assessment of lacrimal IgA as a potential parameter for measurement of long term stress in poultry.

This study, considering the stress of caging on laying hens, looks at the possible use of a product of the immune system; immunoglobulin A (IgA), as a representative measure of the effect of this chronic stress on the immune system of birds. Recording of serum corticosterone served as a traditional measure of stress. The study also considers the possibility of using IgA from the tears as a noninvasive source of samples. Lacrimal IgA is easily accessed by glycerol induction and measured by rocket immunoelectrophoresis. The amount of IgA in tears as well as in serum and possibly the synthesis of IgA seems to be affected by high levels of plasma corticosteroids. Lacrimal IgA levels vary independently of the IgA levels in plasma. It can be concluded that lacrimal IgA may be a useful marker of the effect of stress in poultry. Further studies are needed to facilitate a better understanding of the biological mechanisms that are involved, and to further examine IgA's usefulness as a long-term stress parameter.

Improving the effectiveness of condom advertising: a research note.

A limited number of studies have examined ways that health promotion messages about condoms can be improved, leading to increased purchase and use. This study tests alternative message structures as a potential avenue to improving condom advertising. As hypothesized, two-sided messages (positive and negative information about the product category) result in more positive attitudes toward the advertisement and the brand than do one-sided messages (positive information only about the product category). The study's implications for health care marketers interested in developing more effective advertising for condoms and other health care products are discussed.