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Carbon and energetic uncoupling are associated with block of division at different stages of the cell cycle in several cdc mutants of Saccharomyces cerevisiae.

Cell proliferation arrest at 37 degrees C (restrictive temperature) of the cell division cycle (cdc) mutants of Saccharomyces cerevisiae cdc28, cdc35, cdc19, cdc21, and cdc17 was correlated with carbon and energy uncoupling. At 37 degrees C, cdc mutants diverted to biomass synthesis only 3 to 4% and 8 to 24% of the fluxes of carbon consumed and ATP obtained by catabolism, respectively, compared with 48 and 34% in the wild-type strain A364A. At the permissive temperature (25 degrees C), the wild type showed similar carbon and energy coupling indexes as at 37 degrees C. However, carbon and energy coupling indexes were two- to sevenfold higher at 25 degrees than at 37 degrees C in cdc mutants; e.g., at 25 degrees C two- to sevenfold higher amounts of carbon and ATP were directed to biomass production than at 37 degrees C. The wild-type strain exhibited a purely oxidative glucose catabolism at 37 degrees C (RQ approximately 1.0), while the cell proliferation arrest of cdc mutants at the same temperature was characterized by fermentative metabolism. At 37 degrees C, cdc mutants directed 50 to 60% of the carbon to ethanol production; 3 to 12% of the carbon was recovered as glycerol in cdc mutants as well as in the wild type. The proliferation arrest of the cell division cycle mutant cdc28 correlated with a significant decrease in the incorporation of radioactive precursors into DNA, RNA, and proteins. In the presence of 8-hydroxyquinoline, the wild-type strain underwent cell proliferation arrest and also exhibited metabolic uncoupling with bioenergetic and catabolic behavior similar to that of the cdc mutants at 37 degrees C. Experimental evidence obtained with cdc19, whose defective gene product is pyruvate kinase, suggests that the primary defect of cdc mutants correlates with a metabolically, highly uncoupled yeast cell. The results presented point to the existence of strong carbon and energy uncoupling together with cell division arrest exhibited by cdc mutants at the restrictive temperature. The degree of uncoupling appears to be tuned, at least in part, by the increase in flux of sugar catabolism through the ethanol fermentative pathway.

Carbon↗

Validation of the Dutch version of the CDC core healthy days measures in a community sample.

An important disadvantage of most indicators of health related quality of life used in public health surveillance is their length. In this study the authors investigated the reliability and validity of a short indicator of health related quality of life, the Dutch version of the four item 'CDC Core Healthy Days Measures' (CDC HRQOL-4). The reliability was evaluated by calculating Cronbach's alpha of the CDC HRQOL-4. The concurrent validity was tested by comparing the CDC HRQOL-4 with three other indicators of health related quality of life, the SF-36, the WHOQoL-BREF and the GHQ-12. The construct validity was evaluated by assessing the ability of the CDC HRQOL-4 to discriminate between respondents with and without a (non-mental) chronic condition, depression, a visit to the general practitioner and use of prescription drugs. Randomly sampled respondents from the city of Utrecht were asked to fill in a questionnaire. 659 respondents (response rate 45%) completed the questionnaire. Participants represented the adult, non-institutionalised population of the city of Utrecht, the Netherlands: 58% women; mean age 41 years; 15% of non-Dutch origin. The reliability of the CDC HRQOL-4 was good. Cronbach's alpha of three of the four CDC HRQOL-4-items was 0.77 which is good for internal consistent scales. The concurrent validity was good. The four items of the CDC HRQOL-4 showed higher correlations with their corresponding domains of the other instrument than the other domains. Comparison of respondents with or without a chronic condition, depression, visit to the GP and use of prescription drugs produced evidence for an excellent construct validity of the CDC HRQOL-4.

Adolescent↗

Cell cycle arrest of cdc mutants and specificity of the RAD9 checkpoint.

In eucaryotes a cell cycle control called a checkpoint ensures that mitosis occurs only after chromosomes are completely replicated and any damage is repaired. The function of this checkpoint in budding yeast requires the RAD9 gene. Here we examine the role of the RAD9 gene in the arrest of the 12 cell division cycle (cdc) mutants, temperature-sensitive lethal mutants that arrest in specific phases of the cell cycle at a restrictive temperature. We found that in four cdc mutants the cdc rad9 cells failed to arrest after a shift to the restrictive temperature, rather they continued cell division and died rapidly, whereas the cdc RAD cells arrested and remained viable. The cell cycle and genetic phenotypes of the 12 cdc RAD mutants indicate the function of the RAD9 checkpoint is phase-specific and signal-specific. First, the four cdc RAD mutants that required RAD9 each arrested in the late S/G2 phase after a shift to the restrictive temperature when DNA replication was complete or nearly complete, and second, each leaves DNA lesions when the CDC gene product is limiting for cell division. Three of the four CDC genes are known to encode DNA replication enzymes. We found that the RAD17 gene is also essential for the function of the RAD9 checkpoint because it is required for phase-specific arrest of the same four cdc mutants. We also show that both X- or UV-irradiated cells require the RAD9 and RAD17 genes for delay in the G2 phase. Together, these results indicate that the RAD9 checkpoint is apparently activated only by DNA lesions and arrests cell division only in the late S/G2 phase.

Cell Cycle↗

Looking inside the 2003 CDC dental infection control guidelines.

On Dec. 19, 2003, the Centers for Disease Control and Prevention published updated infection control guidelines for dentistry. The guidelines provide comprehensive information on all aspects of dental infection control. The recommendations are designed to prevent or reduce the potential for disease transmission from patient to dental health care personnel, from dental health care personnel to patient, and from patient to patient. Most recommendations will be familiar and are already practiced routinely. This article highlights major updates and additions in the CDC guidelines and provides additional information to assist readers in applying the latest guidelines. Almost a year ago, the CDC and Prevention published updated dental infection control guidelines in a supplement to the Morbidity and Mortality Weekly Report. The Guidelines for Infection Control in Dental Health Care Settings--2003 represent a collaborative effort between leading experts in infection control from other federal agencies, public health, and hospital epidemiology and infection control. Unlike regulatory agencies such as the Occupational Safety and Health Administration, the U.S. Food and Drug Administration, or the U.S. Environmental Protection Agency, the CDC cannot mandate certain practices; it can only recommend. However, the CDC is recognized as the nation's disease prevention agency and develops a broad range of guidelines intended to improve health care and to inform clinicians and the public. As a result, many dental licensing boards adopt CDC's recommendations, or variations of them, as the infection control standard for dental practice in their states. In contrast to the 1986 and 1993 CDC dental infection control recommendations, the 2003 CDC publication includes more background information and the scientific rationale for the recommendations. Also, readers will notice that each recommendation has a rank assigned to it categorizing the recommendation on the basis of existing scientific data, theoretical rationale, and applicability (Table 1). Most recommendations will be familiar and already are practiced routinely. As with previous CDC recommendations, the guidelines are designed to prevent or reduce the potential for disease transmission from patient to dental health care personnel; from dental health care personnel to patient, and from patient to patient. The following is an overview highlighting major updates and additions in the 2003 CDC guidelines. It is not intended to be a comprehensive review. Readers can access the complete document (Figure 1) by visiting www.cdc.gov/oralhealth/ infectioncontrol.

Centers for Disease Control and Prevention, U.S.↗

The failure of CDC screening questionnaire to efficiently detect elevated lead levels in a rural population of children.

BACKGROUND: In 1991, the Centers for Disease Control and Prevention (CDC) lowered the level for lead toxicity from 25 micrograms/dL to 10 micrograms/dL and published guidelines recommending that all children be tested for blood lead level at 12 months of age and again, if possible, at 24 months. The guidelines also called for periodic universal screening of children between the ages of 6 and 72 months using the CDC's lead screening questionnaire. However, blindly following these recommendations may result in unnecessary patient discomfort, wasted time, and extra expense. According to the CDC guidelines, deviation from this practice requires the determination of the local prevalence of lead poisoning. The purpose of this study was to measure the local prevalence of elevated blood lead levels (EBLL) and to assess the utility of the CDC's lead screening questionnaire in a rural setting. METHODS: Three hundred seventy-six children living on the Navajo Reservation in Arizona were studied. A consecutive series evaluation at well-child visits between the ages of 6 and 72 months was conducted using the CDC lead screening questionnaire and blood lead levels measured by anodic voltammetry. RESULTS: Of 376 children, 368 had their blood levels tested. Eight children tested positively with an EBLL of > or = 10 micrograms/dL for a prevalence of 2.2%. Three hundred twenty-three completed questionnaires; 83 (25.7%) of these children had false-positive results. The sensitivity and specificity of the CDC lead screening questionnaire were 42.9% and 73.7%, respectively. The positive predictive value of the questionnaire was 3.5%. CONCLUSIONS: In this rural population of children, the prevalence of lead poisoning was low, and the CDC lead screening questionnaire failed to efficiently identify those children with lead toxicity. Screening such a population using the CDC guidelines will result in unnecessary discomfort for children and will squander limited resources of time and money. Physicians who care for children should know the local prevalence of EBLL in order to effectively follow the CDC's recommendations for lead screening.

Arizona↗

Mitotic transmission of artificial chromosomes in cdc mutants of the yeast, Saccharomyces cerevisiae.

In the yeast, Saccharomyces cerevisiae, cell division cycle (CDC) genes have been identified whose products are required for the execution of different steps in the cell cycle. In this study, the fidelity of transmission of a 14-kb circular minichromosome and a 155-kb linear chromosome fragment was examined in cell divisions where specific CDC products were temporarily inactivated with either inhibitors, or temperature sensitive mutations in the appropriate CDC gene. All of the cdc mutants previously shown to induce loss of endogenous linear chromosomes also induced loss of a circular minichromosome and a large linear chromosome fragment in our study (either 1:0 or 2:0 loss events). Therefore, the efficient transmission of these artificial chromosomes depends upon the same trans factors that are required for the efficient transmission of endogenous chromosomes. In a subset of cdc mutants (cdc6, cdc7 and cdc16), the rate of minichromosome loss was significantly greater than the rate of loss of the linear chromosome fragment, suggesting that a structural feature of the minichromosome (nucleotide content, length or topology) makes the minichromosome hypersensitive to the level of function of these CDC gene products. In another subset of cdc mutants (cdc7 and cdc17), the relative rate of 1:0 events to 2:0 events differed for the minichromosome and chromosome fragment, suggesting that the type of chromosome loss event observed in these mutants was dependent upon chromosome structure. Finally, we show that 2:0 events for the minichromosome can occur by both a RAD52 dependent and RAD52 independent mechanism. These results are discussed in the context of the molecular functions of the CDC products.

Cell Division↗

CD4 count and viral load time-courses in patients treated with highly active antiretroviral therapy and association with the CDC staging system.

OBJECTIVES: The aim of the study was to analyse CD4 cell count and viral load dynamics in patients undergoing antiretroviral therapy and their association with the Centers for Disease Control and Prevention (CDC) classification system. METHODS: CD4 cell count and viral load were determined in 2982 patients who were classified according to clinical and immunological CDC stages. Measurements were carried out at baseline and at the 3rd, 6th and 12th months. RESULTS: Clear differences in the immunological and virological responses to therapy were observed depending on the CDC stage, with better results associated with less advanced stages. There was a marked parallelism in the CD4 cell count curves of the different CDC stages over the year of follow up, in both naïve and experienced patients, indicating that the increase in CD4 cell count at each time-point was similar for all clinical and immunological CDC stages. However, as the baseline values were closely associated with CDC stage, the CD4 cell counts finally reached were clearly dependent on CDC stage. The highest virological responses were observed during the initial 3 months, particularly in naïve patients, but whereas naïve patients showed additional increases up to the 6th month experienced patients reached a plateau at the 3rd month. The CD4 increases were also higher during the initial 3 months but persisted during the year of follow-up. CONCLUSION: Both clinical and immunological CDC stages at baseline are highly predictive of the immunological and virological response to therapy, a finding that could have clinical implications.

Adult↗

Identification of some clinical strains of CDC coryneform group A-3 and A-4 bacteria as Cellulomonas species and proposal of Cellulomonas hominis sp. nov. for some group A-3 strains.

CDC coryneform group A-3 and A-4 bacteria were defined by Hollis and Weaver in 1981, but their taxonomic position is still unclear. By using biochemical and chemotaxonomical methods, four clinical strains belonging to CDC coryneform groups A-3 (n = 2) and A-4 (n = 2) were studied and could be assigned to the genus Cellulomonas, resulting in the first description of Cellulomonas strains isolated from clinical specimens. CDC coryneform group A-3 and A-4 strains were compared with the type strains of the seven species constituting the genus Cellulomonas at present as well as with the closely related species Oerskovia turbata, Oerskovia xanthineolytica, and Jonesia denitrificans, but their biochemical patterns were not compatible with the patterns of any of those species. Almost the entire sequences of the 16S rRNA genes of one representative strain of both CDC taxa were determined, and comparative sequence analysis confirmed the placement of the CDC coryneform group A-3 and A-4 strains studied in the Cellulomonas-Oerskovia subbranch of the actinomycetes. Both CDC taxa exhibited > 99% base pair homology within their 16S rDNAs. On the basis of phenotypic and molecular data, we formally propose a new species, Cellulomonas hominis sp. nov., for the CDC coryneform group A-3 bacteria examined. The type strain is DSM 9581. The precise taxonomic status of the CDC coryneform group A-4 strains studied remains to be established by quantitative DNA-DNA hybridizations.

Actinomycetales↗

Depletion of the co-chaperone CDC-37 reveals two modes of PAR-6 cortical association in C. elegans embryos.

PAR proteins play roles in the establishment and maintenance of polarity in many different cell types in metazoans. In C. elegans, polarity established in the one-cell embryo determines the anteroposterior axis of the developing animal and is essential to set the identities of the early blastomeres. PAR-1 and PAR-2 colocalize at the posterior cortex of the embryo. PAR-3, PAR-6 and PKC-3 (aPKC) colocalize at the anterior cortex of the embryo. A process of mutual exclusion maintains the anterior and posterior protein domains. We present results indicating that a homolog of the Hsp90 co-chaperone Cdc37 plays a role in dynamic interactions among the PAR proteins. We show that CDC-37 is required for the establishment phase of embryonic polarity; that CDC-37 reduction allows PAR-3-independent cortical accumulation of PAR-6 and PKC-3; and that CDC-37 is required for the mutual exclusion of the anterior and posterior group PAR proteins. Our results indicate that CDC-37 acts in part by maintaining PKC-3 levels and in part by influencing the activity or levels of other client proteins. Loss of the activities of these client proteins reveals that there are two sites for PAR-6 cortical association, one dependent on CDC-42 and not associated with PAR-3, and the other independent of CDC-42 and co-localizing with PAR-3. We propose that, in wild-type embryos, CDC-37-mediated inhibition of the CDC-42-dependent binding site and PAR-3-mediated release of this inhibition provide a key mechanism for the anterior accumulation of PAR-6.

Animals↗

Engineering and public health at CDC.

Engineering is the application of scientific and technical knowledge to solve human problems. Using imagination, judgment, and reasoning to apply science, technology, mathematics, and practical experience, engineers develop the design, production, and operation of useful objects or processes. During the 1940s, engineers dominated the ranks of CDC scientists. In fact, the first CDC director, Assistant Surgeon General Mark Hollis, was an engineer. CDC engineers were involved in malaria control through the elimination of standing water. Eventually the CDC mission expanded to include prevention and control of dengue, typhus, and other communicable diseases. The development of chlorination, water filtration, and sewage treatment were crucial to preventing waterborne illness. Beginning in the 1950s, CDC engineers began their work to improve public health while developing the fields of environmental health, industrial hygiene, and control of air pollution. Engineering disciplines represented at CDC today include biomedical, civil, chemical, electrical, industrial, mechanical, mining, and safety engineering. Most CDC engineers are located in the National Institute for Occupational Safety and Health (NIOSH) and the Agency for Toxic Substances and Disease Registry (ATSDR). Engineering research at CDC has a broad stakeholder base. With the cooperation of industry, labor, trade associations, and other stakeholders and partners, current work includes studies of air contaminants, mining, safety, physical agents, ergonomics, and environmental hazards. Engineering solutions remain a cornerstone of the traditional "hierarchy of controls" approach to reducing public health hazards.

Centers for Disease Control and Prevention, U.S.↗

Human p55(CDC)/Cdc20 associates with cyclin A and is phosphorylated by the cyclin A-Cdk2 complex.

The initiation of anaphase and exit from mitosis depend on the activation of the anaphase-promoting complex/cyclosome (APC/C), a multicomponent, ubiquitin-protein ligase. The WD-repeat protein called p55(CDC)(Cdc20) directly binds to and activates APC/C. By using yeast two-hybrid screening, we found that cyclin A, a critical cell cycle regulator in the S and G2/M phases, specifically interacts with p55(CDC). Ectopically expressed p55(CDC) and cyclin A form a stable protein complex in mammalian cells. The p55(CDC)-cyclin A interaction occurs through the region containing the WD repeats of p55(CDC) and the region between the destruction box and the cyclin box of cyclin A. In addition to the physical interaction, p55(CDC) is phosphorylated by cyclin A-associated kinase. These findings suggest that the function of p55(CDC) is mediated or regulated by its complex formation with cyclin A.

Animals↗

Interaction of PAR-6 with CDC-42 is required for maintenance but not establishment of PAR asymmetry in C. elegans.

Caenorhabditis elegans embryonic polarity requires the asymmetrically distributed proteins PAR-3, PAR-6 and PKC-3. The rho family GTPase CDC-42 regulates the activities of these proteins in mammals, flies and worms. To clarify its mode of action in C. elegans we disrupted the interaction between PAR-6 and CDC-42 in vivo, and also determined the distribution of GFP-tagged CDC-42 in the early embryo. Mutant PAR-6 proteins unable to interact with CDC-42 accumulated asymmetrically, at a reduced level, but this asymmetry was not maintained during the first division. We also determined that constitutively active GFP::CDC-42 becomes enriched in the anterior during the first cell cycle in a domain that overlaps with PAR-6. The asymmetry is dependent on PAR-2, PAR-5 and PAR-6. Furthermore, we found that overexpression of constitutively active GFP::CDC-42 increased the size of the anterior domain. We conclude that the CDC-42 interaction with PAR-6 is not required for the initial establishment of asymmetry but is required for maximal cortical accumulation of PAR-6 and to maintain its asymmetry.

14-3-3 Proteins↗

Relationship between CDC cross-match in liver recipients and antibody screening by flow cytometry.

Several authors have shown that anti-donor antibodies before liver transplantation are associated with decreased graft survival. The aim of this study was to investigate the relationship between anti-donor antibodies detected by the CDC technique or by FlowPRA, and acute or chronic rejection as well as graft survival. Furthermore, we sought to determine whether anti-donor antibodies, detected by the CDC technique, correlated with those discovered by cytometric screening. The acute rejection incidence among patients with complement-dependent cytotoxicity positive CDC cross-match was similar to that for patients with a negative cross-match. None of the patients with a positive cross-match developed chronic rejection. Allograft survival was significantly lower among recipients with a positive T-lymphocyte cross-match. Indeed, the majority of recipients with positive CDC cross-matches displayed graft failures before first posttransplant year. The results of a positive FlowPRA determination were concordant with a positive CDC cross-match in 85.71% of cases. Our data demonstrate that pretransplant FlowPRA correlates with the final CDC cross-match results. This finding suggests that in the future prospective pretransplant antibody screening with FlowPRA or CDC techniques may be useful to identify high-risk recipients.

Acute Disease↗

Neisseria elongata subsp. nitroreducens subsp. nov., formerly CDC group M-6, a gram-negative bacterium associated with endocarditis.

CDC group M-6 is the vernacular name given to a gram-negative, oxidase-positive, aerobic, nonmotile, rod-shaped bacterium. This organism is biochemically similar to Kingella denitrificans and displays a cellular fatty acid profile consistent with CDC groups M-5 and EF-4 and with Neisseria elongata. Of the 95 M-6 strains referred to the Centers for Disease Control (CDC) for identification, 32 (64%) of the first 50 were from the throat or sputum and only 3 (6%) were from blood; only 5 (11%) of the next 45 isolates were from the upper respiratory tract and 23 (51%) were from blood, with many of these (15 or 65%) being associated with endocarditis. The major characteristics of CDC group M-6 include reduction of nitrate and nitrite with no gas formation; positive reaction for oxidase; negative reactions for catalase, urease, indole, and motility; and no acid production from carbohydrates. Guanine-plus-cytosine content determined spectrophotometrically by thermal denaturation was 55 to 58 mol % for six M-6 strains tested: 56 mol % for the N. elongata subsp. elongata type strain and for the N. elongata subsp. glycolytica type strain. By the hydroxyapatite method, DNAs from 24 M-6 strains showed an average of 78% relatedness to M-6 reference strain B1019 in reactions at 60 degrees C and 73% relatedness in reactions at 75 degrees C. M-6 strain B1019 was 79% related to the N. elongata type strain at 60 degrees C and 71% related at 75 degrees C; it was 75% related to the type strain N. elongata subsp. glycolytica at 60 degrees C and was 66% related at 75 degrees C. DNAs from CDC group EF-4, K. denitrificans, and CDC group M-5 were all less than 14% related to CDC group M-6 at 75 degrees C. The DNA relatedness data showed conclusively that all the M-6 strains belong in the species N. elongata. M-6 is different from N. elongata subsp. elongata in that M-6 reduces nitrate and sometimes weakly acidifies D-glucose, and it is different from N. elongata subsp. glycolytica in that it reduces nitrate and is negative for glucose and catalase. Because of the apparent clinical significance of M-6 compared with the clinical significance of N. elongata subsp. elongata and N. elongata subsp. glycolytica and the ease in distinguishing it biochemically, we propose M-6 as a third subspecies of N.elongata, N. elongata subsp. nitroreducens subsp. nov.

Adult↗

CDC WONDER: a comprehensive on-line public health information system of the Centers for Disease Control and Prevention.

OBJECTIVES: CDC WONDER, a comprehensive on-line public health information system of the Centers for Disease Control and Prevention (CDC), was developed to place timely, action-oriented information in the hands of public health professionals. METHODS: A unified system was developed de novo to be used for and to evolve along with public health. All data are stored and updated on the CDC mainframe. RESULTS: CDC WONDER provides menu-driven access to 24 databases with information on mortality, hospital discharges, cancer incidence, notifiable diseases, acquired immunodeficiency syndrome, the Morbidity and Mortality Weekly Report, etc.; each database has on-line documentation. Results can be tabulated and graphed, and there is full-text searching of textual databases. Non-CDC staff have access via telephone connection. From August 1991 through June 1992, system databases were accessed 10,698 times, and there were 842 users (mean of 97 new users per month). CONCLUSIONS: CDC WONDER has shown that it is possible to build a large, on-line database of scientific data for public health professionals. CDC WONDER provides a common foundation from which to build information-based public health plans and policy and could help strengthen the public health system.

Centers for Disease Control and Prevention, U.S.↗

Effective stage in the cell cycle for control of the budding direction of cdc mutants of Saccharomyces cerevisiae using electric stimulus.

Cell division cycle (cdc) mutants of Saccharomyces cerevisiae were used to determine the most effective stage for the directional control of cell budding using an electric stimulus. The selected mutants were cdc 35 and cdc 28, which could be reversibly arrested before spindle pole body satellite formation (SPBSF) and spindle pole body duplication (SPBD), respectively. The budding direction (theta) was defined so that the direction parallel to that of the electric field was 0 degree. Considering the symmetry of the experimental conditions, the range of theta was defined as 0-90 degrees. The electric stimulus applied in the present study was alternating pulses (pulse height, +/- 15 V; pulse width at half pulse height, 5 microseconds; frequency; 10 kHz). The peak height of the cross membrane potential was estimated as 472 mV, which was sufficient to induce considerable strain in the cell membrane. In the case of cdc 35, the 95% confidence interval (95% CI) of the budding direction was 7-25 degrees when subjected to electric stimulus, while the 95% CI of the budding direction without electric stimulus was 35-57 degrees. In the case of cdc 28, 95% CI values of the budding direction with and without electric stimulus were 1229 degrees and 23-56 degrees, respectively. These results demonstrate that the stage after SPBD is effective for the directional control of yeast cell budding using an electric stimulus. Simultaneously, an electric stimulus reduced the cell budding time of both the cdc mutants used. Therefore, the electric stimulus was also effective in promoting cell cycle progression under the present conditions.

Cell Cycle↗

CDC and ATSDR electronic information resources for health officers.

This article catalogs some of the Centers for Disease Control and Prevention's (CDC) more important information resource offerings, which make public health information accessible via computer and automated telephone systems and on electronic media (diskette and CD-ROM). We review mechanisms for (1) finding and retrieving CDC reports, (2) querying CDC's numeric data files, (3) transmitting surveillance and other data files to CDC, (4) exchanging electronic mail with CDC staff, and (5) disseminating state and local public health information and data by using CDC tools. Each resource is followed with a section on how to obtain access to these resources.

CD-ROM↗

Screening for HIV-associated distal-symmetric polyneuropathy in CDC-classification stages 1, 2, and 3.

OBJECTIVES: A total of 670 patients were screened for distal symmetric HIV-associated polyneuropathy during CDC stages 1-3 and its correlation to immunological deterioration. MATERIAL AND METHODS: Clinical examinations of 670 patients admitted to the neurological outpatient clinic at the Department of Neurology, University of Munster. Neurophysiological investigations were performed on the sural and peroneal nerve for detection of axonal and myelin lesion. RESULTS: Clinical examination proved progressive clinical signs and symptoms indicating distal symmetric polyneuropathy from CDC 1 (32%) to CDC 3 (55%). At least one neurophysiological result was impaired in CDC 1 in 25% and in CDC 3 in 45%. Significant correlation between neurophysiological changes and CDC4(+)-cells and beta-microglobuline were detected for stage CDC 3 C. CONCLUSION: Results show stage related prevalence of distal symmetric polyneuropathy already in early stages. In late stages of HIV-infection prevalence of distal symmetric polyneuropathy seems to be directly correlated to immunodeficiency syndrome. The pathogenesis of distal symmetric polyneuropathy during HIV-infection is up to now incompletely understood, but results indicate a clear dependency between progressive immunological dysfunction and neuropathy. High active antiretroviral therapy in patients suffering from distal symmetric polyneuropathy is a main topic of future studies.

Adult↗