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Ascoviruses are members of a recently described new family (Ascoviridae) of large double-stranded DNA viruses that attack immature stages of insects belonging to the order Lepidoptera, in which they cause a chronic, fatal disease. Ascoviruses have several unusual characteristics not found among other viruses, the most novel of which are their transmission by endoparasitic wasps and a unique cytopathology that resembles apoptosis. Cell infection induces apoptosis and in some species is associated with synthesis of a virus-encoded executioner caspase and several lipid-metabolizing enzymes. Rather than leading directly to cell death, synthesis of viral proteins results in the rescue of developing apoptotic bodies that are converted into large vesicles in which virions accumulate and continue to assemble. In infected larvae, millions of these virion-containing vesicles begin to disperse from infected tissues 48-72 h after infection into the blood, making it milky white, a major characteristic of the disease. Circulation of virions and vesicles in the blood facilitates mechanical transmission by parasitic wasps. Although ascoviruses appear to be very common, only five species are currently recognized, with the type species being the Spodoptera frugiperda ascovirus 1a. Ascovirus virions are large, enveloped, typically bacilliform or reniform in shape, and, depending on the species, have genomes that range from 119 to 186 kbp. Molecular phylogenetic evidence indicates that ascoviruses evolved from iridoviruses (family Iridoviridae) that attack lepidopteran larvae and are likely the evolutionary source of ichnoviruses (family Polydnaviridae), which assist endoparasitic hymenopterans in overcoming the defense responses of their insect hosts. Thus, as other molecular evidence suggests that iridoviruses evolved from phycodnaviruses (family Phycodnaviridae), an evolutionary pathway is apparent from phycodnaviruses via iridoviruses and ascoviruses to ichnoviruses.

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BACKGROUND: Omeprazole and lansoprazole can be given in sodium bicarbonate as, respectively, simplified omeprazole suspension and simplified lansoprazole suspension. We previously found the antisecretory effect of omeprazole 20 mg given as simplified omeprazole suspension to be lower than with intact capsules. However, lansoprazole 30 mg as simplified lansoprazole suspension produced an effect similar to that seen with intact capsules. AIM: To evaluate the absorption of both drugs when given orally as capsules or as suspensions in sodium bicarbonate. METHODS: In random order, we gave 5-day courses of omeprazole 20 mg and lansoprazole 30 mg as capsules and as suspensions in sodium bicarbonate to 12 healthy women. Serial blood samples were taken on days 1 and 5 of each course for pharmacokinetic measurements. RESULTS: There was impairment of omeprazole absorption when given as simplified omeprazole suspension. Maximum plasma concentration and area under the concentration/time curve were lower with simplified omeprazole suspension than with omeprazole capsules (P=0.034 and 0.013, respectively, on day 5). No differences were found in lansoprazole absorption when simplified lansoprazole suspension was compared with its standard capsule formulation. Relative bioavailability of omeprazole from simplified omeprazole suspension compared to the capsule was 58.4% on day 5. The corresponding value for lansoprazole was 84.7%. CONCLUSIONS: Simplified omeprazole suspension 20 mg does not supply adequate omeprazole for systemic absorption. Lansoprazole absorption from simplified lansoprazole suspension is maintained.

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BACKGROUND: In the 1992-1996 period Methodist Clinical Laboratory Services of the Methodist Health Group, Indianapolis, was restructuring all work processes. In one initiative, point-of-care testing (POCT) was used to optimize the decision cycle time while reducing the overall cost of providing information. DEVELOPING THE COMPARATIVE MODEL: In a typical month (May 1994) for hospital admissions and laboratory usage, events related to the traditional blood analysis process were observed. In March 1995 the same model that was applied to analyze the traditional blood analysis process was used to evaluate the newly implemented POCT blood analysis process. Comparisons of both processes, cost per test panel, nursing time spent, and overall turnaround time were made between the two methodologies. RESULTS: A restructure of delivery of blood analysis with the POCT system saved the hospital $392, 336 compared to the total annual cost of the traditional approach for delivering blood analysis. The average cost per test panel was $15.33 with the traditional model and $8.03 with the POCT system. Improvements in the overall turnaround time of test results affected the decision cycle time of the caregiver. The POCT system saved four steps on the patient care floor and ten in the laboratory. DISCUSSION: It is critical to establish a POCT committee, including the most vocal critics of POCT1-to look at how a program of this nature will affect the organization. CONCLUSIONS: POCT became more than just an isolated change-it became a core strategy of moving laboratory testing out of the traditional laboratory setting to where it could become immediately accessible to caregivers as information.

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Structural information on drug degradants and impurities can serve to accelerate the drug discovery and development cycle. Traditional structure elucidation methodologies for obtaining this information are often slow and resource-consuming; therefore, LC/MS profiling and LC/MS/MS substructural analysis methodologies have been developed to rapidly and accurately elucidate structures of impurities and degradants. This work is a further development of methodologies used for the elucidation of degradation products of paclitaxel [K.J. Volk et al., Proc. 9th AAPS Ann. Meeting, 1994, p.29]. In this study cefadroxil was used as a model compound for the evaluation of a predictive strategy for the production and elucidation of impurities and degradants induced by acid, base, and heat, using LC/MS and LC/MS/MS profiling methodology, resulting in an LC/MS degradant database which includes information on molecular structures, chromatographic behavior, molecular weight, UV data, and MS/MS substructural information. Furthermore, libraries such as this can provide a predictive foundation for pre-clinical development work involving drug stability, synthesis, and monitoring.

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A recently published study discussed the trauma-related death toll that plagues northeastern Ontario, which has a much higher death rate from nonintentional trauma than the rest of the province Dr. Gary Bota, one of the study authors hates calling these tragedies accidents because that implies a random, act-of-God nature that he does not accept. "They're not accidents," he maintains. "They're patterns, just like infectious diseases."

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A Toronto psychologist has conducted a 50-year follow-up study of the psychologic problems faced by Canadian troops who landed on the beaches of Dieppe, France, in 1942. Lynne Beal says many of the men have suffered in silence, never realizing that they were experiencing the widespread condition known as post-traumatic stress disorder. The veterans hope her work will help them win greater official recognition of their condition.

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A group of doctors concerned about the environment and health has applied for letters patent and charitable status registration for a new organization, the Canadian Association of Physicians for the Environment. The goal of the new group, says founder Dr. Tee Guidotti, is to create a network for physicians who are interested in the relationship between health and the environment, and to educate and support physicians who take an active interest in environmental issues in their communities.

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Some advocacy groups are becoming more willing to engage in political activism. One is the Ontario Lung Association, which has been calling attention to government inaction on air-pollution issues such as controlling smog and improving indoor air quality. These lobbying efforts are supported by some physicians, who believe that environmental factors are behind the increased incidence of respiratory illness.

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Two cases of basal ganglia calcification involving the globus pallidus are presented. Both patients had cognitive dysfunction, temporal lobe-like symptoms (including amnestic state, perceptual distortions, or complex visual hallucinations), and myoclonus. Patient 1 manifested depression, auditory hallucinations, anxiety, paranoia, and postural tremor; patient 2 manifested multifocal dystonia with dystonic tremor. These cases supplement other reports of psychotic features and dementia associated with pallidal pathology. Additionally, the phenomena encountered in these cases are considered in light of recent advances in our understanding of basal ganglia functional pathways. These cases afford a potential pathophysiological window to the possible role of the globus pallidus in these neuropsychiatric conditions. In concert with other recent findings, these cases suggest specific pathway involvement in hallucinations, paranoia, depression, myoclonus, and dystonia. Further research will indicate if these pathways play a role in schizophrenia, mood disorders, and anxiety disorders.

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Scrotal ectopia or accessory scrotum are both rare conditions. This report describes a neonate with both abnormalities, who also has elements of the VATER association. This constellation of anomalies has not been previously described.

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The authors report 5 patients with bipolar disorders in the context of primary idiopathic dystonia. Four patients had DSM-III-R bipolar disorder, mixed, and one had cyclothymic disorder as diagnosed using the Structured Clinical Interview for DSM-III-R (SCID). All cases of bipolar disorder manifested rapid cycling. Three patients with bipolar disorder experienced onset of this illness soon after the onset of cervicocranial dystonia (5 neck dystonia, 4 craniofacial, 2 brachial, 1 vocal cord, 1 thoracic). These cases apparently represent a first report of bipolar disorders in dystonia. Clinical management, relevant literature, and putative neurobiology are reviewed.

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