Rapid genetic engineering of human cytomegalovirus by using a lambda phage linear recombination system: demonstration that pp28 (UL99) is essential for production of infectious virus.

A highly efficient lambda phage recombination system previously utilized for studies of bacterial artificial chromosome (BAC)-maintained mouse chromosomal DNA was adapted for the study of the role of human cytomegalovirus (HCMV)-encoded pp28 (UL99) in virus replication. Incorporating a two-step mutagenesis strategy with blue/white selection in Escherichia coli containing a HCMV AD169 BAC, we have shown that we can rapidly introduce point mutations into the HCMV BAC using linear PCR fragments. All manipulations were carried out in bacteria, which greatly accelerated the introduction and analysis of mutations in the viral genome.

Rational design of peptide vaccines for autoimmune disease: harnessing molecular recognition to fix a broken network.

Autoreactive T-cells and antibodies are found at low levels in normal individuals and are thought to be kept at bay by regulatory T-cells and a network of idiotypic and anti-idiotype-bearing antigen receptors on lymphocytes as well as idiotypic anti-idiotypic antibodies. Disruption of this network by genetic, environmental and unknown factors is thought to result in autoimmune diseases. An obvious, ideal and specific therapy for such disorders would be to harness this regulatory network to re-establish immunologic homeostasis.

Sexual behavior of HIV discordant couples after HIV counseling and testing.

Background And Objectives: Sexual behavior following voluntary HIV counseling and testing (VCT) is described in 963 cohabiting heterosexual couples with one HIV positive and one HIV negative partner ('discordant couples'). Biological markers were used to assess the validity of self-report.

Methods: Couples were recruited from a same-day VCT center in Lusaka, Zambia.

Sp1 transcription factor as a molecular target for nitric oxide-- and cyclic nucleotide--mediated suppression of cGMP-dependent protein kinase-Ialpha expression in vascular smooth muscle cells.

cGMP-dependent protein kinase (PKG) expression is highly variable and decreases in cultured vascular smooth muscle cells (VSMCs), exposure of cells to nitric oxide (NO), or in response to balloon catheter injury in vivo. In this study, the mechanisms of human type I PKG-alpha (PKG-Ialpha) gene expression were examined. Three structurally unrelated NO donors decreased PKG-Ialpha promoter activity after transfection of a promoter/luciferase construct in VSMCs.

The lateral notch sign associated with acute anterior cruciate ligament disruption.

We prospectively studied all of the patients with anterior cruciate ligament disruptions who sought treatment at the senior author's office during a 36-month period. Plain radiographs identified depressions measuring 2 mm or more in the lateral femoral condyle (lateral notch sign) in 9 of 120 knees (7.5%) with acute anterior cruciate ligament disruption and in 2 of 44 knees (4.

Health promotion among ethnic minorities: the importance of cultural phenomena.

Ethnic minority groups have varying health promotion needs, which differ according to six cultural phenomena outlined in the nursing literature: communication, space, social organization, time, environmental control, and biological variations. This article reports on some of the research available in each of these areas in relation to ethnic minorities. If health promotion is to be improved for people in all sectors of the population, it is important for rehabilitation nurses to learn how to assess the needs of ethnic minorities and to respond to those needs with appropriate interventions.

Thalamic thought disorder: on being "a bit addled".

Humans can generate and maintain relatively coherent trains of thought in natural discourse. The neural mediation of this ability and the phenomenology of its breakdown are not well understood. We report a case of a woman with paramedian thalamic strokes involving the mammillothalamic tract, intralaminar nuclei, parts of the dorsomedial and ventral lateral nuclei bilaterally.

The relationship between maternal characteristics and fetal and neonatal anthropometric measurements in women delivering at term: a summary.

Background: We wanted to determine the relationship between a number of maternal characteristics and various fetal and neonatal anthropometric measurements determined by ultrasound and at birth.

Methods: A total of 1205 term singleton maternal-infant pairs were studied. Various ultrasound measurements obtained at 18, 24, 30 and 36 weeks' gestation and neonatal anthropometric measurements obtained at birth were studied in relationship to various maternal characteristics using univariate and multivariate techniques.

Functional treatment of patellar dislocation in an athletic population.

Fifty-eight athletically active study participants with 69 knees that had experienced patellar dislocations were available for followup after being selected for a functional rehabilitation program without antecedent immobilization. Follow-up evaluation was at a minimum of 24 months after onset of treatment and averaged 46.2 months.

Results of arthroscopic debridement of glenoid labral tears.

We studied the long-term results of a prospectively selected group of 24 patients with 12 anteroinferior and 12 posterior glenoid labral lesions; all patients had functional instability but none had ligamentous detachment. After arthroscopic debridement, patients involved in throwing sports were not allowed to return to full athletic activity until full strength of the external rotators was achieved and documented on isokinetic evaluation. Followup was 36 to 72 months with an average of 48 months.

The effects of graft rotation on attachment site separation distances in anterior cruciate ligament reconstruction.

We created a model to see if twisting the graft in an anterior cruciate ligament reconstruction affected the distance separating the femoral and tibial attachments of the perimeter fibers of a patellar tendon graft. Graft bone plugs were simulated by two 12.5-mm diameter Delrin cylinders.

Prevention of HIV infection in women: overcoming barriers.

The proportion of total reported cases of acquired immune deficiency syndrome (AIDS) in US women increased annually between 1988 and 1994 from 10% to 18%, indicating an urgent need for prevention measures. Interventions designed to reduce unsafe sex and drug-using behaviors in women have been limited. Barriers to human immunodeficiency virus (HIV) prevention for women include a disproportionately low investment of resources, inadequacy and inaccessibility of substance abuse treatment programs, the crack/cocaine epidemic and resulting unsafe sex behaviors, lack of a woman-controlled method to prevent sexual transmission of HIV, and unique social and cultural factors that limit women's power in sexual decision making.

Cross-over, completion and confabulation in unilateral spatial neglect.

Patients with left-sided neglect generally mis-bisect horizontal lines to the right of mid-position. However, with short lines they frequently cross over and place their marks to the left; a phenomenon not easily explained by current theories of neglect. It is difficult to ascertain whether patients neglect the ipsilateral segment of short lines, perceptually distort these lines, or extend these lines leftward at a representational level.

Value of dynamometry in assessing upper extremity function in children with myelomeningocele.

Children with myelodysplasia frequently have abnormal hand function. Etiologies include brainstem and cervical cord compression due to the Chiari II malformation, syringomyelia, hydrocephalus, and cerebral dysmorphism. Determination of potentially correctable causes of hand dysfunction may be difficult.

Progressive pulmonary venous obstruction and pulmonary interstitial fibrosis associated with tetralogy of Fallot.

Stenosis of individual pulmonary veins is a rare condition associated with a very high mortality. The present report is the first known case of progressive pulmonary venous obstruction associated with the tetralogy of Fallot. This clinical and anatomical study suggests that initial dynamic and possibly reversible occlusion occurs at the junction of the pulmonary vein and left atrium.

Three-port perineal sparing technique.

The records were reviewed of 103 patients with low-lying pelvic malignancies irradiated with a skin-sparing technique involving use of a pair of anteroposterior-posteroanterior opposed ports and a direct perineal port. Patients had rectal, anal, cervical, vaginal, urethral, or vulvar cancer. Use of a special lead compensator allowed the three beams to be applied perpendicularly to the surface, while delivery of a homogeneous dose to the pelvis and perineum was maintained.

Multiple complications from an intracranial epidermoid cyst: case report and literature review.

Intracranial epidermoid and dermoid tumors are unusual benign lesions that are potentially curable. Subtotal removal carries a high incidence of recurrence, plus the rare possibility of carcinomatous degeneration of the remnants. Aseptic meningitis from spillage of cyst contents into the subarachnoid space is frequent after operation and has been reported to occur spontaneously.

Spiritual discernment in psychiatric patients.

The author uses resources from the Christian tradition of discernment of spirits to provide clinicians with guidelines for distinguishing the authentic and pathological aspects of religion in psychiatric patients.