The RNA extracted from normal peritoneal macrophages exposed to a linear, random synthetic polypeptide, Glu(60)Ala(30)Tyr(10), initiated an immune response in C57B1/6J mice, although this strain responds very poorly to the antigen itself. From 10 to 150 micrograms of RNA obtained from mouse, rat, or rabbit macrophages was injected intraperitoneally into recipient mice, and specific antibody was detectable by passive hemagglutination 3 to 4 weeks later. Treatment of the RNA with ribonuclease destroyed its ability to initiate a specific immune response. The RNA contained by weight 0.02 percent of the (specific) antigen. The RNA obtained from cells incubated with a second polypeptide, Glu(36)Lys(24)Ala(40), initiated a response specific for this polymer. This RNA even when incubated in vitro with Glu(60)Ala(30)Tyr(10) failed to initiate antibody formation specific for Glu(60)Ala(30)Tyr(10).

Animals↗

PubMed1966

Antibody formation initiated in vitro. 3. Antibody formation and allotypic specificity directed by ribonucleic acid from peritoneal exudate cells.

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Animals↗

PubMedDate not supplied

Psychiatric care for patients with HIV infection. The varying perspectives.

This article reviews the literature on the classification and treatment of psychiatric morbidity associated with infection from the human immunodeficiency virus (HIV). The psychiatric disorders seen in HIV-infected patients are formulated by using one of the following four perspectives as treatment guides: 1) the syndromal or disease perspective, 2) the dispositional or personality perspective, 3) the behavioral or addictive perspective, and 4) the life story perspective.

Antipsychotic Agents↗

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The effectiveness of psychiatric treatment for HIV-infected patients.

The study sought to determine the effectiveness of a model program of psychiatric care for human immunodeficiency virus (HIV)-infected patients. This was a cohort study of 126 HIV-positive outpatients referred for psychiatric evaluation and treatment (average follow up of 14 months) in a HIV-dedicated primary-care outpatient clinic in the inner city. A global outcome measure (encompassing symptom relief, functioning, and HIV-risk behaviors), and a measure of abstinence from alcohol and illicit substances were used. Fifty percent of patients improved, with 19% "nearly well" at follow-up. Abstinence was achieved 48% of the time. Good compliance with treatment and the absence of injection drug use were the primary predictors of good outcomes. Of the compliant patients, 94% improved, with 45.7% being nearly well. Psychiatric treatment of HIV-infected patients is effective when located in the HIV primary-care setting and administered by a multidisciplinary team under the direction of a psychiatrist, using evidence-based interventions.

Adult↗

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Endophthalmitis in a patient with disseminated cryptococcosis and AIDS who was treated with itraconazole.

We report a case of presumed cryptococcal endophthalmitis that occurred in a patient with severe disseminated cryptococcosis and AIDS. Multiple small, spherical lesions appeared bilaterally on the surface of the retina 2 weeks after cryptococcal meningitis was diagnosed; the lesions were associated with multiple blind spots, blurred vision, and the perception of flaring of light. Over the next week, many more lesions with adjacent hemorrhages appeared. Therapy with itraconazole over the next 3 months resulted in complete resolution of the lesions. Cryptococcal endophthalmitis is a rare disease. Fewer than 20 cases, including five in patients with AIDS, have previously been reported. None of these patients regained normal vision.

Acquired Immunodeficiency Syndrome↗

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Cardiac MR imaging in Pompe disease.

The magnetic resonance (MR) imaging findings in a 5-month-old infant with glycogen storage disease of the heart revealed hypertrophy of the right and left ventricles and the interventricular septum with an irregular inhomogeneous appearance of the myocardium. The descriptive features of the MR study are correlated with cardiac angiography and echocardiography in Pompe disease.

Angiocardiography↗

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B-scan ocular ultrasonography in preterm and term infants.

PURPOSE: To evaluate the normal B-scan ocular ultrasonographic findings in preterm and term newborns. This information would be useful in making perinatal ocular diagnoses, especially in consideration of the rapidly changing eyes of normal infants shortly after birth. METHODS: One hundred two healthy infants aged 28 to 48 weeks postconception were prospectively studied. Eighty-six had complete sonograms, while others had incomplete examinations due to systemic instability. B-scan ultrasonography was conducted through acoustic coupling medium and a closed eyelid using the Coopervision Ultrascan 404 unit. The ultrasound findings were evaluated relative to the infant's postconceptional age and weight at examination and the axial lengths of each eye. The ultrasonographer, who determined the presence of abnormal findings, was masked to the parameters mentioned above. RESULTS: Four specific findings frequently were noted in newborns that would be considered abnormal in adult eyes. These were: 1) a visible Tenon's capsule; 2) prominent superior ophthalmic vein; 3) sonolucent extraocular muscles; and 4) vitreous opacities. These findings were more common in the more premature infants (P < 0.01 by t test). CONCLUSIONS: The presence of these four ultrasonographic findings in the eyes of infants should be considered normal, and should not necessarily prompt further work up until after the perinatal period.

Adult↗

PubMedDate not supplied

An academic medical center reaches out.

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Academic Medical Centers↗

PubMedDate not supplied

Neurologic complications of heart transplantation in children.

Neurologic complications can add significant morbidity to otherwise successful orthotopic heart transplantations in children. Complications have been reported to occur in up to 50% of children undergoing heart transplantation. The purpose of this study was to identify the prevalence and outcome of neurologic complications of heart transplantation in children. We reviewed all children who received orthotopic heart transplantation at Texas Children's Hospital from November 1984 to November 1990. Twenty-two patients (ages, 3 weeks to 17 years; mean, 8.5 years) underwent heart transplantation using cardiopulmonary bypass with moderate hypothermia. For analysis, we compared results during the first 3 years of our experience, 1984 through 1987 (group 1), to 1987 through 1990 (group 2). Survival was 45% (5 of 11 patients) for group 1 and 73% (8 of 11 patients) for group 2. A neurologic complication was defined as a change in the neurologic examination and/or status. Neurologic complications included seizures (6 of 22 patients), strokes (3 of 22 patients), unresponsiveness (3 of 22 patients), and change in mental status (2 of 22 patients). Early (within 2 weeks after operation) neurologic complications occurred in 45% (10 of 22 patients), were persistent (sequelae lasting more than 4 months) in 27% (6 of 22 patients), and resulted in death in 9% (2 of 22 patients). Late (after 2 weeks after operation) neurologic complications occurred in 23% (5 of 22 patients), were persistent in 9% (2 of 22 patients), and have occurred in only two survivors. Neurologic factors were not responsible for the cause of death in group 2. No neurologic complications (early or late) were seen in 1 of 11 patients in group 1 as compared with 7 of 11 patients in group 2 (p < 0.015). Serious neurologic morbidity decreased between the two groups after preoperative cyclosporine was avoided and postoperative hypertension was controlled. All survivors are functioning at age-appropriate levels. Although neurologic complications may be frequent, long-term neurologic disability in survivors is rare.

Adolescent↗