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Purpose:Primary ovarian insufficiency before the age of 40 years affects 1% of the female population and is characterized by permanent cessation of menstruation. Genetic causes include FMR1 expansion mutations. Previous studies have estimated mutation prevalence in clinical referrals for primary ovarian insufficiency, but these are likely to be biased as compared with cases in the general population. The prevalence of FMR1 expansion mutations in early menopause (between the ages of 40 and 45 years) has not been published.Methods:We studied FMR1 CGG repeat number in more than 2,000 women from the Breakthrough Generations Study who underwent menopause before the age of 46 years. We determined the prevalence of premutation (55–200 CGG repeats) and intermediate (45–54 CGG repeats) alleles in women with primary ovarian insufficiency (n = 254) and early menopause (n = 1,881).Results:The prevalence of the premutation was 2.0% in primary ovarian insufficiency, 0.7% in early menopause, and 0.4% in controls, corresponding to odds ratios of 5.4 (95% confidence interval = 1.7–17.4; P = 0.004) for primary ovarian insufficiency and 2.0 (95% confidence interval = 0.8–5.1; P = 0.12) for early menopause. Combining primary ovarian insufficiency and early menopause gave an odds ratio of 2.4 (95% confidence interval = 1.02–5.8; P = 0.04). Intermediate alleles were not significant risk factors for either early menopause or primary ovarian insufficiency.Conclusion:FMR1 premutations are not as prevalent in women with ovarian insufficiency as previous estimates have suggested, but they still represent a substantial cause of primary ovarian insufficiency and early menopause.Genet Med 16 1, 19–24.

Purpose To present a unique case of a 65-year-old man using warfarin who presented with acute unilateral loss of vision due to hemorrhagic Descemet membrane detachment (DMD) with pupillary block and elevated intraocular pressure and its subsequent treatment and challenges.Methods Case report.Results Clinical examination showed a visual acuity of finger counting, central DMD with near contact to the iris and premembrane hemorrhage, an intraocular pressure (IOP) of 19 mmHg, and normal pupillary reaction. An International Normalized Ratio (INR) of 4.9 was treated with dose reduction and vitamin K. Twelve hours later the patient re-presented with an acute increase in pain and an IOP of 78 mmHg with pupillary block and iris bombé. YAG-laser membranotomy, anterior chamber paracentesis, and maximal topical and systemic therapy were unsuccessful in reducing the IOP. Surgical management, including irrigation and aspiration of blood, led to a normalization of the IOP. Descemet stripping automated endothelial keratoplasty (DSAEK) resulted in a visual acuity of 0.3. Deep stromal/pre-Descemet membrane neovascularization was found bilaterally, suspicious for a previous interstitial keratitis.Conclusions The previously unreported complication of pupillary block following a pre-Descemet membrane hemorrhage was treated successfully for the first reported time, in a 2-step DSAEK. This indicates that DSAEK could be considered as a treatment option for DMD, especially in traumatic circumstances.

A retrospective cohort study of the 2002 Victorian prehospital emergency care documentation completed by ambulance paramedics had the objectives: (i) to design and implement a quality assessment tool to determine the quality of the ambulance patient care record (PCR) information; and (ii) to identify critical demographic and clinical items on the ambulance PCR that needed improvement. The study outcomes included a functioning quality assessment tool and associated user guide for prehospital use, and the identification of three critical PCR components requiring improvement. Ninety percent of PCRs passed the quality assessment; 10% (approximately 5 300) contained measurably poor or incomplete documentation.

The AGG interspersion pattern and flanking microsatellite markers and their association with instability of the FMR1 (CGG)n repeat, involved in the fragile X syndrome, were analyzed in DNA from filter-paper blood spots randomly collected from the Danish newborn population. Comparison of DXS548-FRAXAC1 haplotype frequencies in the normal population and among fragile X patients suggested strong linkage disequilibrium between normal alleles and haplotype 7–3 and between fragile X alleles and haplotype 2–1 and 6–4. Comparison of the AGG interspersion pattern in 143 alleles, ranging in size from 34–62 CGG, and their associated haplotypes indicates the existence of at least three mutational pathways from normal alleles toward fragile X alleles in the Danish population. Two subgroups of normal alleles, with internal sequences of (CGG)10AGG(CGG)19 and (CGG)9AGG(CGG)12 AGG(CGG)9, possibly predisposed for expansion, were identified in the data set. When alleles larger than 34 CGG were investigated, comparing the length of 3' uninterrupted CGG triplets (uCGG), we found that alleles associated with haplotype 2–1 and 6–4 contain significantly longer stretches of uCGG than alleles associated with haplotype 7–3. Thus, the data support that (CGG)n instability is correlated to the length of uCGG. Am. J. Med. Genet. 93:99–106, 2000. © 2000 Wiley-Liss, Inc.

We described the development of five oligonucleotide probes which target the small sub-unit rRNA of Toxoplasma gondii. These probes bind to different regions within the rRNA and all were effective in producing a detectable signal with as little as 10 ng of total cellular RNA. One probe in particular, TGB, was able to detect as little as 1 ng of RNA and was the most specific. A sixth probe, previously developed for hybridization with Sarcocystis spp., was evaluated for its specificity and was shown to be useful as a multi-species coccidial probe. Four of the five T. gondii-specific probes did not cross-hybridize with RNA from nine related species of coccodia, Escherichia coli, cattle, people, cat of dog. One probe cross-hybridized strongly with RNA of Eimeria ahsata and Isospora suis, but not to RNA of any other coccidia species tested nor bovine, human, feline or canine RNA. The potential of this assay for use in veterinary and human medicine as well as food safety programmes is discussed. Copyright 1993, 1999 Academic Press

While granulocyte transfusions have been shown to be effective in the treatment of patients with infections, the effects of the leukapheresis collection procedure on certain granulocyte functions remain in question. We studied the bactericidal function of granulocytes collected by continuous-flow centrifugation (CFC) and filtration leukapheresis (FL) with 5. aureus, E. coli,and S. typhimurium.Killing of all organisms was normal with CFC and FL cells if the medium in which the cells were suspended was buffered. Low pH suspension medium had an adverse effect on bactericidal function. Chemotaxis of FL cells was slightly but not significantly reduced. Adrenocorticosteroids are frequently administered to white blood cell donors in order to increase the yield of collected cells. Granulocytes collected by routine venipuncture from subjects who had taken a single dose of prednisone or dexamethasone had normal bactericidal function. Prednisone administration appeared to increase migration of granulocytes in vitro. Evaluation of function of FL granulocytes stored at 4°C showed significant decrease in bactericidal function at 72-96 hr with a more rapid and significant decrease in chemotactic function at 24 hr. These studies provide guidelines for methods of collection and storage of granulocytes that will preserve optimal cell function.

The ability of HLA antisera to inhibit granulocyte erythrophagocytosis (EP) of opsonized red blood cells (RBC) was evaluated. Human granulocytes (PMN) were separated from heparinized whole blood by the Ficoll-Isopaque technique and suspended in McCoy's medium. EP occurred when the PMN were incubated with opsonized RBC. For six HLA antibody specificities evaluated, prior incubation of PMN with HLA antisera resulted in significant inhibition of EP without cytolysis when the PMN donor was positive for the specific HLA antigen, but not when the donor was negative for the antigen. The inhibition was time- and dose- dependent. Prior absorption of HLA antisera with HLA-specific platelets reduced or abolished the inhibition. An example of anti-NB1 also inhibited EP in 4 individuals. These data suggest that HLA antibody may adversely affect granulocyte phagocytic function. Inhibition of EP might be useful in evaluating compatibility prior to granulocyte transfusion.

Describes extremes of boorish behavior in lawyers. Complaint; Written discovery; Depositions; Motions; Negotiation and settlement; Trial; Conflict resolution.

No abstract.

The article offers information on the U.S. Senator Richard Marcellais's proposal of creating a cultural competency training law and the proposal's criticism by the Republican Party lawmakers, and discusses the Dakota Access Pipeline protests of 2016.

The article informs on a proposal by North Dakota lawmaker to tighten the penalties on people involved in riots, an ongoing protests against the Dakota Access oil pipeline, and mentions that more than 100 people found participating in a riot could be punished with both imprisonment and penalty.

The article reports that North Dakota's legislative body has been doing measures by introducing bills on four-state pipeline to ease the dispute between Dakota Access protesters and law enforcement.

The article focuses on the issues related to the petroleum pipeline safety with the oil spill at Belle Fourche pipeline and the spill at the Dakota Access pipeline may threaten the tribe's drinking water, which is drawn from the Missouri River.

The article focuses on the clergy who joined the demonstration against the Dakota Access pipeline construction in North Dakota, and talks of ceremonial burning of religious document, threat to drinking water and cultural sites of Native Americans, and singing hymns at the clash between protesters and law officers.

The article reports on the lawsuit filed by the Standing Rock Sioux Tribe in 2016 to challenge the decision of the U.S. Army Corps of Engineers to grant permits at water crossings for the Dakota Access pipeline.

The article reports on the issuance by U.S. District Judge Daniel Hovland of a temporary restraining order for North Dakota's voter identification law in 2016 following complaints from a group of American Indians.

The article reports on the $500 million federal stimulus money for the American Indian tribes for schools, housing, infrastructure improvements, loans and job programs on reservations. It notes that this announcement of the U.S. Interior Secretary Ken Salazar does not include more than $7 million for repairs and maintenance to tribal detention centers. He also notes that the Interior Department is planning to invest $2.5 billion in Indian Country.

The article focuses on the Turtle Mountain State Bank on the Turtle Mountain Reservation in north central North Dakota. Turtle Mountain State Bank is believed to be the first bank on a U.S. reservation to be privately owned by American Indians. The article explains that banks on other reservations are normally owned by tribes or non-Indian companies.

The article reports that Standing Rock Sioux Tribal Chairman Dave Archambault has appealed to North Dakota lawmakers to do more to protect the public and environment from oil impacts.

The article reports on the nearly one million gallons of industrial saltwater has leaked from a pipeline in North Dakota which affects drinking water for a reservation, according to chairman Tex Hall of three Affiliated Tribes.

The article reports on the sanction pushed by tribal leaders in North Dakota against any student who are caught wearing a t-shrit with a caricature of the University of North Dakota's former Indian head logo drinking out of a beer bong .

The article discusses the tribal conference for Native Americans that was held at the campus of United Tribes Technical College in Bismarck in Bismarck, North Dakota on June 5, 2014.

The article reports on the visits made by Air Force Secretary Deborah Lee James on the Minot Air Force Base in North Dakota.

The article reports on the prohibition of the Turtle Mountain Band of Chippewa of horizontal drilling techniques and hydraulic fracturing on the north-central North Dakota reservation, citing that contentious oil and gas recovery techniques may spur development and threaten water resources.