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Forty relapsing multiple sclerosis patients with 1-15 gadolinium (Gd)-enhancing lesions on screening brain magnetic resonance imaging (MRI) and Expanded Disability Status Scale (EDSS) scores 0-6.5 were randomized to receive short-term induction therapy with mitoxantrone (three monthly 12 mg/m(2) infusions) followed by 12 months of daily glatiramer acetate (GA) therapy 20 mg/day subcutaneously for a total of 15 months (M-GA, n = 21) or daily GA 20 mg/day for 15 months (GA, n = 19). MRI scans were performed at months 6, 9, 12 and 15. The primary measure of outcome was the incidence of adverse events; secondary measures included number of Gd-enhanced lesions, confirmed relapses and EDSS changes. Except age, baseline demographic characteristics were well matched in both treatment arms. Both treatments were safe and well tolerated. M-GA induction produced an 89% greater reduction (relative risk (RR) = 0.11, 95% confidence interval (CI): 0.04-0.36, p = 0.0001) in the number of Gd-enhancing lesions at months 6 and 9 and a 70% reduction (RR = 0.30, 95% CI: 0.11-0.86, p = 0.0147) at months 12 and 15 versus GA alone. Mean relapse rates were 0.16 and 0.32 in the M-GA and GA groups, respectively. Short-term immunosuppression with mitoxantrone followed by daily GA for up to 15 months was found to be safe and effective, with an early and sustained decrease in MRI disease activity.

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We have investigated the somatic activity of the maize Activator (Ac) element in haploid and diploid aspen with the objective of developing an efficient transposon-based system for gene isolation in the model tree species Populus. It was shown that Ac is reinserted, frequently into or near coding regions in aspen, and therefore can be used for gene tagging studies. A number of phenotypic variants were also found following transformation of constructs harbouring the rolC gene. Comparative analyses of T-DNA flanking regions of variants and wild type lines indicate that T-DNA insertion has occurred in or near coding regions. However, the frequency of T-DNA insertion into genes is about one half of the frequency of Ac insertion hitting coding sequences. The results obtained give a proof-of-concept for transposon tagging in a tree system. Given the long generation cycles in tree species, gene tagging strategies are practical only to obtain dominant gain-of-function mutants that do not require selfing or test crossing. In order to obtain recessive loss-of-function mutants, we have regenerated haploid lines from immature pollen. These lines were successfully transformed with a construct containing the rolC transgene from Agrobacterium rhizogenes and Ac element from maize. The results indicate that Ac is also active in haploid aspen and hence can be used in general for gene tagging in trees.

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OBJECTIVE: To discuss the effects of an active care protocol that includes isolated lumbar spine strengthening on a chronic low back pain patient. CLINICAL FEATURES: A 20-yr-old female college basketball player suffered from a 7-month history of debilitating low back and left leg pain. Four previous independent physicians expressed diagnostic and therapeutic uncertainty. Bone scan, MRI, nerve conduction study, electromyography, CT, discogram and laboratory evaluation had all failed to identify the etiology of the problem. The patient was forced to discontinue basketball and drop out of college as a result of her spinal problem. Treatment by her prior physicians consisted of analgesics and prolonged bedrest. INTERVENTION AND OUTCOMES: The patient underwent a functional restoration program consisting of isolated lumbar extensor progressive resistance exercise (PRE) on a MedX lumbar instrument, PRE to ancillary musculature, progressive aerobic exercise, static stretching and proprioceptive exercises. She showed a 368% increase in average lumbar isometric strength, 41% increase in isolated lumbar sagittal plane range of motion and decrease in pain. The patient returned to school after 8 wk of care; at 18-month check-up, she remained asymptomatic. CONCLUSION: Functional restoration, even with uncertain diagnosis, can be effective in the resolution of chronic low back pain.

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The selective exposure hypothesis argues that the false consensus effect occurs because people base their estimates about the prevalence of behaviors, beliefs, and traits on a mental sample of those around them, overrepresenting others who are similar. It was hypothesized that psychiatric patients would be less subject to the false consensus effect because they would recognize the deviance of their peers and avoid using them to make estimates. Sixty male and female college students and 32 psychiatric patients estimated the percentage of average Americans who endorsed 32 behaviors, beliefs, and self-descriptive traits. Contrary to prediction, the psychiatric patients' estimates were no less likely than the college students' to exhibit false consensus effects.

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Different ways of conceptualizing and measuring change in attitudes during transition to motherhood are examined. A series of analyses was performed on data from a cross-sectional sample (N = 667) and a smaller longitudinal sample (n = 48) to demonstrate sound psychometric properties for 2 new scales and to show construct comparability across different phases of childbearing. For Childbearing Attitudes Questionnaire, results demonstrated equality of covariance for 16 scales and comparability of structure and meaning of 4 higher order factors--identification with motherhood, social orientation, self-confidence, and negative aspects of giving birth. For Mothering Self-Definition Questionnaire, results demonstrated equality of covariance of 5 scales and comparability of structure and meaning of a single higher order factor, interpreted as reflecting positive feelings about one's mothering characteristics. Analyses of correlations and mean differences identified areas of change and stability.

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We report two cases of a previously unrecognized clinical entity: concurrent adenoviral and herpetic ocular infection. The first case was recognized clinically by the presence of herpetic keratitis and findings attributable to epidemic keratoconjunctivitis (EKC) including lid swelling, pseudomembranous and follicular conjunctivitis, subconjunctival hemorrhages, preauricular lymphadenopathy, and corneal infiltrates. Only Herpes simplex virus was recovered by culture. In the second case of apparent EKC (again initially only Herpes simplex was isolated) after maintaining virus cultures long enough to isolate adenovirus, the diagnosis of concurrent infection was established when the second virus was isolated.

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The self-definitional processes accompanying the transition to motherhood were examined in this study. A cross-sectional sample of more than 600 women who were planning to get pregnant within 2 years, pregnant, or in the postpartum stage completed extensive questionnaires pertaining to their experiences of pregnancy and motherhood. On the basis of the assumption of the "self-socialization" perspective that individuals actively construct their identities in response to life transitions, our analyses focused on the role of information-seeking in the developing self-definitions of women becoming mothers. As predicted, (a) women actively sought information in anticipation of a first birth, (b) they used this information to construct identities incorporating motherhood, and (c) after the birth the determinants of their self-definitions shifted from indirect sources of information to direct experiences with child care. Hence, consistent with the self-socialization perspective, information-seeking did play an important role in the women's developing self-conceptions during this life transition. Mechanisms by which information gathered may alter self-conception are discussed.

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Adolescents (75 males, 150 females) assumed the role of parent surrogate and responded to nine problem situations involving younger siblings. Responses were coded into 21 categories--grouped as high, medium, low and non-power as well as "effective" or "ineffective"--and analyzed by sex, grade (10, 11, or 12) and birth order (first-, second-, or laterborn). Ninety-two percent of responses were categorized as "ineffective" (i.e., not communicating own or sibling's feelings). Seniors used less high and more medium and non-power responses than younger students. Most students, particularly females, expressed interest in joining a group to learn better ways of relating to younger siblings.

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The various surgical managements of herpes simplex keratitis are listed. Our management is "atraumatic" keratoplasty, if vision is reduced, if the disease is protracted, or if perforation occurs. Our preoperative care is aimed at the production of a quiet eye with no active virus infection, by the use of antiviral drops, steroids, antibiotics, and bandage contact lenses. Removal of all corneal disease is desirable, but not mandatory. Perforations are managed in the same manner, but the host window is started at the perforation. Postoperative management is characterized by the use of therapeutic modalities necessary to prevent or treat complications, including steroids and frequent observation to check for complications of treatment. Our understanding of herpes simplex virus infections as they relate to surgical management is presented. The results of treatment warrant continuation of our efforts--but lead to the conclusion that it would be most helpful if latent virus infection could be eradicated.

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