Surfactant protein D deficiency influences allergic immune responses.

Background: The collectin surfactant protein D (SP-D) confers protection against pulmonary infection and inflammation. Recent data suggest a role for SP-D in the modulation of allergic inflammation.

Objective: The aim of this study is to characterize the immune responses of SP-D-deficient (SP-D(-/-)) mice in a kinetic model of allergic inflammation.

Costimulatory molecule OX40L is critical for both Th1 and Th2 responses in allergic inflammation.

T cell activation and cytokine secretion are important mediators of inflammation in allergic asthma. The costimulatory pathway CD28/CD80/CD86 has been shown to play an important role in T cell activation in allergic asthma, but less is known about the effect of other costimulatory molecules in allergy. The costimulatory molecule OX40 ligand (OX40L), a member of the tumor necrosis factor superfamily, has been shown to be important in T cell priming and cytokine production.

Churg-Strauss syndrome in patients receiving montelukast as treatment for asthma.

Study Objectives: We previously reported eight patients who developed Churg-Strauss syndrome in association with zafirlukast treatment for asthma and postulated that the syndrome resulted from unmasking of a previously existing condition due to corticosteroid withdrawal and not from a direct drug effect. The availability of montelukast, a new leukotriene receptor antagonist with a different molecular structure, permitted us to test this hypothesis. Our goals were to ascertain whether the Churg-Strauss syndrome developed in patients taking montelukast and other novel asthma medications, and to describe potential mechanisms for the syndrome.

Pathological jealousy appearing after cerebrovascular infarction in a 25-year-old woman.

Objective: To report pathological jealousy (Othello syndrome) occurring in a young woman with a right hemisphere cerebrovascular infarction and to review diagnosis and possible organic mechanisms for the generation of this syndrome.

Clinical Picture: A 20-year-old woman was admitted to hospital with a right hemisphere stroke associated with a history of severe migraine and the use of oral contraceptives. The patient made a good recovery with minimal neurological deficits but 5 years later developed the syndrome of morbid jealousy with depression and a near fatal overdose.

Memory processes in depressed geriatric patients with and without subcortical hyperintensities on MRI.

In this study, 12 patients over age 60 with depression with moderate to severe subcortical hyperintensities (SH) localized to the periventricular white matter were identified by quantitative MRI. Using the California Verbal Learning Test, they were compared with 12 age-, education-, and severity-matched patients with depression with minimal white matter changes on specific aspects of memory performance. Patients with cortical lesions, neurologic or systemic illness affecting cognition, and history of substance abuse were excluded.

Clinical features of obsessive-compulsive disorder in elderly patients.

There has been no systematic study of the clinical features of obsessive-compulsive disorder (OCD) in elderly patients. This study describes the symptoms and characteristics of OCD among 32 outpatients age 60 or older and 601 younger patients meeting DSM-III-R criteria and given the Yale-Brown Obsessive-Compulsive Scale (YBOCS), NIMH scale, and a 41-item symptom questionnaire. Elderly patients had a later age at onset compared with younger patients.

Neuropsychiatric factors in the illusion of visitors among geriatric patients: a case series.

The 'illusion of visitors' is a common phenomenon among geriatric patients presenting for psychiatric or neurologic evaluation and treatment. Although these illusory beliefs are etiologically diverse, patients may commonly have visual impairment and functional and/or structural disruption of frontal and right-hemisphere-mediated cognitive functioning. This article outlines eight cases of illusory beliefs among elderly patients, presenting psychiatric, neurologic, neuroimaging, and neuropsychological findings among these patients.

Subcortical hyperintensities on MRI and activities of daily living in geriatric depression.

Data from 30 elderly inpatients with major depression were analyzed to explore the relationship between subcortical hyperintensities (SH) on MRI and activities of daily living (ADLs). A comparison of subjects based on a median split of the severity of SH revealed that subjects with greater SH performed worse on both instrumental and physical ADLs. A hierarchical multiple regression revealed that age, depression severity, neuropsychological test performance, and SH variables accounted for a total of 53% of the variance in ADL functioning.

MRI and neuropsychological differences in early- and late-life-onset geriatric depression.

We sought to determine whether geriatric patients with late-life-onset major depression have more subcortical hyperintensities on MRI and greater cognitive impairment than age-matched geriatric patients with early-life-onset major depression, suggesting that subcortical disease may be etiologic in late-life depression. Most negative studies of the clinical significance of subcortical hyperintensities on MRI in geriatric patients have sampled from a restricted range of subjects, have employed limited batteries of neuropsychological tests, or have not quantified MRI changes; the present study attempted to address these limitations. Thirty subjects from a geriatric psychiatry inpatient service who were over 60 years of age and presented with major depression were divided into groups with onset of first depression after age 60 (mean = 72.

"Grievous bodily harm:" gamma hydroxybutyrate abuse leading to a Wernicke-Korsakoff syndrome.

Gamma-hydroxybutyrate (GHB) is a naturally occurring GABA-like drug used illicitly by bodybuilders. Although there are reports of several cases of GHB abuse, with a variety of nervous system complications, we present the first case associated with a Wernicke-Korsakoff syndrome.

Relationship between sleep spindles and hypersomnia.

Sleep spindles (SS) and K complexes constitute the physiological markers of stage 2 sleep. Because sleep allows a spontaneous thalamic manifestation in the form of SS, one could hypothesize that there is some kind of relationship between SS and the complaint of hypersomnia. To investigate this possible relationship we compared nonhypersomnolent subjects with hypersomnolent patients who carried a diagnosis of narcolepsy or idiopathic hypersomnia.

Personality disorder diagnoses and age in inpatients with major depression.

To ascertain the prevalence of personality disorder in elderly patients with major depression and to explore issues of diagnostic practice and bias, the authors reviewed triaxial diagnoses of 2322 psychiatric hospital inpatients with Axis I diagnoses of major depression. They found that Axis II diagnoses had been made in 367 cases (15.8%).

An outbreak of acute rheumatic fever in Tennessee.

From January, 1987, until July, 1988, a significant increase in newly diagnosed cases of acute rheumatic fever was noted at our hospital. In sharp contrast to the 3 cases seen in 1986, 14 cases were diagnosed in 1987 (a significant increase from 1985 to 1986, P = 0.001).

Ventilatory response to isocapnic hypoxia in parents of victims of sudden infant death syndrome.

Ventilatory response to progressive isocapnic hypoxia was measured in 14 parents of victims of sudden infant death syndrome (SIDS) and 12 matched control parents. Controls had a value for a measure of ventilatory responsiveness (parameter A) of 200.8 +/- 46.

Urate nephrolithiasis in ranch mink.

Urate nephrolithiasis with epistaxis and bleeding around foot pads was diagnosed in ranch mink. Investigation of affected, unaffected-related, and unaffected-unrelated mink did not disclose the cause of these problems but did eliminate inherited bleeding disorders as a cause of the bleeding. All affected mink were males, had been sired by related sires, and were affected in the 1st year of life.

Ventilatory control in parents of victims of sudden-infant-death syndrome.

Since a defective ventilatory-control mechanism may have a role in the sudden-infant-death syndrome (SIDS), and hereditary factors influence the degree of ventilatory drive, we measured ventilatory responsiveness to carbon dioxide with and without increased airway resistance in 12 parents of SIDS victims and 12 control parents matched for age and size. Ventilatory response (delta VI/delta PCO2) and "respiratory drive" (delta P100/delta PCO2) were measured both with and without added resistance to inspiratory flow. SIDS parents had significantly lower ventilatory response with added resistance (P less than 0.

The behavioral control of obesity: a descriptive analysis of a large-scale program.

Evaluated a behavoiral treatment program for 147 obese patients in a Weight Control Clinic. Weight losses during treatment averaged 11.01 pounds with large inter-S variability.