A deletion in the second exon of an HLA-DRB1 allele found in a DR2-negative narcolepsy patient.

In this report, we describe a new allele of the HLA-DRB 1 gene carrying a form of mutation that has not been observed before. It appeared in an HLA-DR2-negative narcolepsy patient who, besides HLA-DR4, revealed a serologic HLA-DR blank segregating with HLA-DQ1. Oligotyping showed that the new allele belongs to the HLA-DR8 group.

Activity-dependent structural changes during neuronal development.

Activity during the early postnatal period can have a pronounced effect on the structure of neurons in the central nervous system. Recent studies in the cat visual system and in the vertebrate and invertebrate neuromuscular system, have provided new insights into the cellular and molecular features of this process.

Stress, Multiple Sclerosis, and Everyday FunctioningA Review of the Literature with Implications for Intervention.

Numerous studies have described an association between stress and the onset or exacerbation of multiple sclerosis (MS). Most of the studies that have been conducted to date, however, have had methodological flaws including: (1) retrospective designs, (2) inadequate or absent control groups, (3) small sample sizes, (4) clinical measures that are insensitive to underlying disease activity, and (5) wide variation in the measurement of stress. Animal models of MS have enabled researchers to examine the effects of stress directly in the central nervous system.

Psychosocial, Affective, and Behavioral Consequences of Multiple SclerosisTreatment of the "Whole" Patient.

Multiple sclerosis (MS) challenges the individual, the family, and society because (1) it can produce wide-ranging functional losses; (2) it is generally progressive with functional losses increasing over time; and (3) its course is unpredictable. Persons affected by MS respond by (1) experiencing changes in their perception of themselves and their world; (2) altering their social roles; and (3) undergoing a variety of emotional responses, especially depression and grief over the losses caused by the illness. Psychosocial interventions that address MS challenges include (1) educational interventions such as lectures, workshops, and books; (2) supportive interventions such as counseling and support groups; (3) psychoeducational interventions such as communication skills training; and (4) somatic therapies such as antidepressants.

N-methyl-D-aspartate receptors are transiently expressed in the developing spinal cord ventral horn.

Quantitative receptor autoradiography was used to map the distribution of N-methyl-D-aspartate (NMDA) receptors in the developing rat spinal cord. Three different specific ligands, which label partially overlapping subpopulations of NMDA receptors, were used: an agonist (L-[3H]glutamate), a noncompetitive antagonist ([3H]MK-801), and a competitive antagonist ([3H]CGP-39653). In the adult, NMDA receptors labeled with all three ligands are restricted to the substantia gelatinosa in the spinal dorsal horn.

Activity-dependent development of spinal cord motor neurons.

Patterned neuronal activity in early postnatal life can regulate the acquisition of the mature morphological and electrophysiological properties of neurons. Many properties of motor neurons are developmentally regulated and may be influenced by epigenetic factors. The pattern of activation of motor neurons can regulate axon terminal morphology and synaptic efficacy at the neuromuscular junction.

Evaluation of halobetasol propionate ointment in the treatment of plaque psoriasis: report on two double-blind, vehicle-controlled studies.

The results of two studies are presented that reveal the efficacy and safety of 0.05% halobetasol ointment in the treatment of patients with plaque psoriasis of at least moderate severity. Both multicenter studies were randomized, double-blind, and vehicle controlled, and study medications were applied twice daily for 2 weeks.

Induction of demyelination by intraneural injection of antibodies against sulfoglucuronyl paragloboside.

Sulfoglucuronyl glycolipids (SGGLs) carry the glucuronyl 3-sulfate (HNK-1) epitope which is recognized by monoclonal IgM paraproteins from patients with demyelinating polyneuropathy. We report that intraneural injections of rat anti-SGGL antibodies induce demyelination in rat sciatic nerve, along with mild to moderate clinical symptoms. Morphologically, vesiculation and loosening of the myelin sheath were observed 3 h postinjection, followed by extensive demyelination and macrophage infiltration after 4 days.

Persistent light reaction to hexachlorophene.

The first patient with what appears to be persistent light reaction caused by hexachlorophene alone is reported. Persistent light reaction may occur in patients with milder degrees of photosensitivity, and appropriate photopatch testing should be performed.

Induction of a neuronal proteoglycan by the NMDA receptor in the developing spinal cord.

Activation of the N-methyl-D-aspartate (NMDA) subclass of glutamate receptors is a critical step in the selection of appropriate synaptic connections in the developing visual systems of cat and frog. Activity-dependent development of mammalian motor neurons was shown to be similarly mediated by activation of the NMDA receptor. The expression of the Cat-301 proteoglycan on motor neurons was developmentally regulated and could be specifically inhibited by blockade of the NMDA receptor at the spinal segmental level.

The safety of halobetasol 0.05% ointment in the treatment of psoriasis.

The effects on the hypothalamic-pituitary-adrenal axis of the ultra-high potency corticosteroid halobetasol in the treatment of psoriasis were evaluated in seven patients with extensive, long-standing plaque psoriasis. Each patient applied 3.5 g halobetasol 0.

Large diameter primary afferent input is required for expression of the Cat-301 proteoglycan on the surface of motor neurons.

The expression of a cell surface proteoglycan, recognized by monoclonal antibody Cat-301, is regulated by neuronal activity in early life. Here we report that the expression of the Cat-301 proteoglycan on motor neurons depends on primary afferent input in the early postnatal period. Previously we showed that in two different systems, Y-cells in the cat lateral geniculate nucleus and motor neurons in the hamster spinal cord, the expression of the Cat-301 antigen requires neuronal activity during a circumscribed period in development.

Medicine as metaphor and medium in group psychotherapy with psychiatric patients.

A conceptualization is presented which encourages a renewed exploration of the way in which psychiatric patients discuss their medications in the group therapy setting. It is suggested that process-oriented group therapists tend to harbor subtle prejudices which may inhibit examination of this material. If we listen to medication-related discourse more carefully, we find that patients disclose important information about hopes and fears about treatment, self-efficacy, attitudes about control and authority, and other sensitive or disowned parts of experience.

Characterization of an activity-dependent, neuronal surface proteoglycan identified with monoclonal antibody Cat-301.

Monoclonal antibody Cat-301 was previously shown to recognize a surface-associated antigen on subsets of mammalian CNS neurons whose expression is regulated by neuronal activity early in an animal's postnatal life. We now present the partial purification and characterization of the Cat-301 antigen and demonstrate that it is a chondroitin sulfate proteoglycan. Extracellular localization of the Cat-301 epitope is demonstrated by staining live, intact neurons in situ.

Penile encrustation due to a condom catheter.

We report a 68-year-old man with penile encrustation caused by a condom catheter used for urinary incontinence. High-resolution x-ray crystallographic analysis of the encrustation revealed struvite [MgNH4PO4.6H2O] and apatite [Ca5(PO4)3(OH)].

Creutzfeldt-Jakob disease probably acquired from a cadaveric dura mater graft. Case report.

A case of Creutzfeldt-Jakob disease (CJD) is reported in a 28-year-old woman who had received a cadaveric dural graft 19 months earlier after resection of a cholesteatoma. The circumstances of the case point to the graft as the most likely source of the disease. Cadaveric dura should be added to the list of materials that may transmit CJD, and it must be very carefully screened if it is used at all for grafting.

Molecular evidence for early activity-dependent development of hamster motor neurons.

Monoclonal antibody Cat-301 recognizes a surface antigen on subsets of neurons in many areas of the mammalian CNS, including Y-cells in the cat dorsal lateral geniculate nucleus (LGN) and spinal motor neurons in several species. We have shown previously that the Cat-301 antigen is expressed relatively late in postnatal development, with a time course that matches that of late developmental features of both LGN and spinal cord neurons. The developmental time course of the expression of the Cat-301 antigen in the LGN correlates with the period during which visual deprivation can alter LGN Y-cells.

Allergic contact dermatitis from bacitracin.

Bacitracin is a commonly used topical antibiotic. Although occasional reports of adverse reactions to bacitracin have appeared in the medical literature, it is considered to be a nonsensitizing agent by most dermatologists. A description of two patients who demonstrated allergic contact dermatitis from bacitracin is presented, with a review of the pertinent literature.