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Cloning Of Human Acetyl-Coa Carboxylase-Beta And Its Unique Features., Joohun Ha, Jung-Kee Lee, Kyung-Sup Kim, Lee A. Witters, Ki-Han Kim Oct 1996

Cloning Of Human Acetyl-Coa Carboxylase-Beta And Its Unique Features., Joohun Ha, Jung-Kee Lee, Kyung-Sup Kim, Lee A. Witters, Ki-Han Kim

Dartmouth Scholarship

Acetyl-CoA carboxylase, which has a molecular mass of 265 kDa (ACC-alpha), catalyzes the rate-limiting step in the biosynthesis of long-chain fatty acids. In this study we report the complete amino acid sequence and unique features of an isoform of ACC with a molecular mass of 275 kDa (ACC-beta), which is primarily expressed in heart and skeletal muscles. In these tissues, ACC-beta may be involved in the regulation of fatty acid oxidation, rather than fatty acid biosynthesis. ACC-beta contains an amino acid sequence at the N terminus which is about 200 amino acids long and may be uniquely related to the …


Moving Occupation Into Treatment: Clinical Interpretation Of "Legitimizing Occupational Therapy's Knowledge"., Janice P. Burke Sep 1996

Moving Occupation Into Treatment: Clinical Interpretation Of "Legitimizing Occupational Therapy's Knowledge"., Janice P. Burke

Department of Occupational Therapy Faculty Papers

No abstract provided.


Efficient Vasoactive Intestinal Polypeptide Hydrolyzing Autoantibody Light Chains Selected By Phage Display, Sonia Tyutyulkova, Qing-Sheng Gao, Austin Thompson, Stephen I. Rennard, Sudhir Paul Aug 1996

Efficient Vasoactive Intestinal Polypeptide Hydrolyzing Autoantibody Light Chains Selected By Phage Display, Sonia Tyutyulkova, Qing-Sheng Gao, Austin Thompson, Stephen I. Rennard, Sudhir Paul

Journal Articles: Pulmonary & Critical Care Med

An immunoglobulin light chain (L chain) library derived from the peripheral blood lymphocytes of a patient with asthma was cloned into a phagemid vector. Phage particles displaying L chains capable of binding vasoactive intestinal polypeptide (VIP) were isolated by affinity chromatography. Two VIP binding L chains were expressed in Escherichia coli in soluble form and purified to electrophoretic homogeneity by metal chelating and protein L affinity chromatography. Both L chains catalyzed the hydrolysis of [tyr10-125I]VIP substrate. The catalytic activity eluted at the molecular mass of the monomer form of the L chain (28 kDa) from a gel filtration column. The …


Cloning Of The Mammalian Type Ii Iodothyronine Deiodinase. A Selenoprotein Differentially Expressed And Regulated In Human And Rat Brain And Other Tissues., Walburga Croteau, Jennifer C. Davey, Valerie Anne Galton, Donald L. St Germain Jul 1996

Cloning Of The Mammalian Type Ii Iodothyronine Deiodinase. A Selenoprotein Differentially Expressed And Regulated In Human And Rat Brain And Other Tissues., Walburga Croteau, Jennifer C. Davey, Valerie Anne Galton, Donald L. St Germain

Dartmouth Scholarship

The deiodination of thyroid hormones in extrathyroidal tissues plays an important role in modulating thyroid hormone action. The type II deiodinase (DII) converts thyroxine to the active hormone 3,5,3'-triiodothyronine, and in the rat is expressed in the brain, pituitary gland, and brown adipose tissue (BAT). Complementary DNAs (cDNAs) for the types I and III deiodinases (DI and DIII, respectively) have been isolated and shown to code for selenoproteins. However, information concerning the structure of the mammalian DII remains limited, and the pattern of its expression in human tissues is undefined. We report herein the identification and characterization of rat and …


Measuring Hospital Use Without Claims: A Comparison Of Patient And Provider Reports., R E. Clark, S K. Ricketts, G J. Mchugo Jun 1996

Measuring Hospital Use Without Claims: A Comparison Of Patient And Provider Reports., R E. Clark, S K. Ricketts, G J. Mchugo

Dartmouth Scholarship

We compared the validity of hospital admission and length of stay reports from patients, outpatient providers, and hospitals, and we examined possible sources of error. Data were collected from people enrolled in a randomized trial of treatment for severe mental illness and substance use disorders, from community mental health centers (CMHCs), and from hospitals. Reports for each of the 74 study participants covered two-year time periods beginning and ending at various times between 1989 and 1993. We compared reports from the various sources and constructed a hybrid with data from all three sources. Using parametric and non-parametric statistics, we compared …


Is The Use Of Life History And Narrative In Clinical Practice Reimbursable? Is It Occupational Therapy?, Janice P. Burke, Stephen B. Kern May 1996

Is The Use Of Life History And Narrative In Clinical Practice Reimbursable? Is It Occupational Therapy?, Janice P. Burke, Stephen B. Kern

Department of Occupational Therapy Faculty Papers

No abstract provided.


A Novel Iron-Regulated Metal Transporter From Plants Identified By Functional Expression In Yeast., David Eide, Margaret Broderius, Jeanette Fett, Mary Lou Guerinot May 1996

A Novel Iron-Regulated Metal Transporter From Plants Identified By Functional Expression In Yeast., David Eide, Margaret Broderius, Jeanette Fett, Mary Lou Guerinot

Dartmouth Scholarship

Iron is an essential nutrient for virtually all organisms. The IRT1 (iron-regulated transporter) gene of the plant Arabidopsis thaliana, encoding a probable Fe(II) transporter, was cloned by functional expression in a yeast strain defective for iron uptake. Yeast expressing IRT1 possess a novel Fe(II) uptake activity that is strongly inhibited by Cd. IRT1 is predicted to be an integral membrane protein with a metal-binding domain. Data base comparisons and Southern blot analysis indicated that IRT1 is a member of a gene family in Arabidopsis. Related sequences were also found in the genomes of rice, yeast, nematodes, and humans. In Arabidopsis, …


A Polymorphism Of A Platelet Glycoprotein Receptor As An Inherited Risk Factor For Coronary Thrombosis., Ethan J. Weiss, Paul F. Bray, Matthew Tayback, Steven P. Schulman, Thomas S. Kickler, Lewis C. Becker, James L. Weiss, Gary Gerstenblith, Pascal J. Goldschmidt-Clermont Apr 1996

A Polymorphism Of A Platelet Glycoprotein Receptor As An Inherited Risk Factor For Coronary Thrombosis., Ethan J. Weiss, Paul F. Bray, Matthew Tayback, Steven P. Schulman, Thomas S. Kickler, Lewis C. Becker, James L. Weiss, Gary Gerstenblith, Pascal J. Goldschmidt-Clermont

Cardeza Foundation for Hematologic Research

BACKGROUND: Platelet glycoprotein IIb/IIIa is a membrane receptor for fibrinogen and von Willebrand factor, and it has an important role in platelet aggregation. It is known to be involved in the pathogenesis of acute coronary syndromes. Previously, we found a high frequency of a particular polymorphism, PlA2, of the gene encoding glycoprotein IIIa in kindreds with a high prevalence of premature myocardial infarction.

METHODS: To investigate the relation between the PlA2 polymorphism and acute coronary syndromes, we conducted a case-control study of 71 case patients with myocardial infarction or unstable angina and 68 inpatient controls without known heart disease. The …


"The Profession Of Dentistry:" The University Of Kentucky's Curriculum In Professional Ethics, David A. Nash Apr 1996

"The Profession Of Dentistry:" The University Of Kentucky's Curriculum In Professional Ethics, David A. Nash

Oral Health Science Faculty Publications

Among the most important learning that occurs in our nation's colleges of dentistry is learning to be a professional. While knowledge, perceptual-motor skills, and problem-solving abilities are basic to becoming a dentist, helping aspiring colleagues to apply their newly developing skills with integrity must be a fundamental concern. Increasingly, we are realizing that the quality of health care depends as significantly on the character of the health professional as it does on the individual's knowledge and skills. Concern for character, virtue, and integrity is the domain of ethics. This paper advances a justification for including a curriculum in professional ethics …


A Tandem Duplication Within The Fibrillin 1 Gene Is Associated With The Mouse Tight Skin Mutation., Linda D. Siracusa, Rodney Mcgrath, Qing Ma, John J. Moskow, Jayanthi Manne, Paul J. Christner, Arthur M. Buchberg, Sergio A. Jimenez Apr 1996

A Tandem Duplication Within The Fibrillin 1 Gene Is Associated With The Mouse Tight Skin Mutation., Linda D. Siracusa, Rodney Mcgrath, Qing Ma, John J. Moskow, Jayanthi Manne, Paul J. Christner, Arthur M. Buchberg, Sergio A. Jimenez

Department of Medicine Faculty Papers

Mice carrying the Tight skin (Tsk) mutation have thickened skin and visceral fibrosis resulting from an accumulation of extracellular matrix molecules. These and other connective tissue abnormalities have made Tskl + mice models for scleroderma, hereditary emphysema, and myocardial hypertrophy. Previously we localized Tsk to mouse chromosome 2 in a region syntenic with human chromosome 15. The microfibrillar glycoprotein gene, fibrillin 1 (FBN1), on human chromosome 15q, provided a candidate for the Tsk mutation. We now demonstrate that the Tsk chromosome harbors a 30- to 40-kb genomic duplication within the Fbn1 gene that results in a larger than normal in-frame …


Disruption Of The Cbfa2 Gene Causes Necrosis And Hemorrhaging In The Central Nervous System And Blocks Definitive Hematopoiesis., Qing Wang, Terryl Stacy, Michael M Binder, Miguel Marin-Padilla, Arlene H. Sharpe, Nancy A. Speck Apr 1996

Disruption Of The Cbfa2 Gene Causes Necrosis And Hemorrhaging In The Central Nervous System And Blocks Definitive Hematopoiesis., Qing Wang, Terryl Stacy, Michael M Binder, Miguel Marin-Padilla, Arlene H. Sharpe, Nancy A. Speck

Dartmouth Scholarship

The CBFA2 (AML1) gene encodes a DNA-binding subunit of the heterodimeric core-binding factor. The CBFA2 gene is disrupted by the (8;21), (3;21), and (12;21) chromosomal translocations associated with leukemias and myelodysplasias in humans. Mice lacking a CBF alpha 2 protein capable of binding DNA die between embryonic days 11.5 and 12.5 due to hemorrhaging in the central nervous system (CNS), at the nerve/CNS interfaces of cranial and spinal nerves, and in somitic/intersomitic regions along the presumptive spinal cord. Hemorrhaging is preceded by symmetric, bilateral necrosis in these regions. Definitive erythropoiesis and myelopoiesis do not occur in Cbfa2-deficient embryos, and disruption …


Cd40-Cd40 Ligand Interactions In Experimental Allergic Encephalomyelitis And Multiple Sclerosis., Koen Gerritse, Jon D. Laman, Randolph J. Noelle, Alejandro Aruffo Mar 1996

Cd40-Cd40 Ligand Interactions In Experimental Allergic Encephalomyelitis And Multiple Sclerosis., Koen Gerritse, Jon D. Laman, Randolph J. Noelle, Alejandro Aruffo

Dartmouth Scholarship

We investigated the role of CD40-CD40 ligand (CD40L) interactions in multiple sclerosis (MS) and experimental allergic encephalomyelitis (EAE). Activated helper T cells expressing CD40L (gp39) surface protein were found in MS patient brain sections, but not in brain tissue sections of normal controls or patients with other neurological disease. CD40L-positive cells were co-localized with CD40-bearing cells in active lesions (perivascular infiltrates). Most of these CD40-bearing cells proved to be of the monocytic lineage (macrophages or microglial cells), and relatively few were B cells. To functionally evaluate CD40-CD40L interactions, EAE was elicited in mice by means of proteolipid-peptide immunization. Treatment with …


An Alternating Treatments Comparison Of Two Intensive Interventions For Food Refusal., W H Ahearn, Mary Louise Kerwin, P S Eicher, J Shantz, W Swearingin Jan 1996

An Alternating Treatments Comparison Of Two Intensive Interventions For Food Refusal., W H Ahearn, Mary Louise Kerwin, P S Eicher, J Shantz, W Swearingin

College of Science & Mathematics Departmental Research

We compared two treatment packages involving negative reinforcement contingencies for 3 children with chronic food refusal. One involved physically guiding the child to accept food contingent on noncompliance, whereas the other involved nonremoval of the spoon until the child accepted the presented food. Subsequent to baseline, an alternating treatments comparison was implemented in a multiple baseline design across subjects. After each child had been exposed to at least nine sessions of each treatment condition and percentage of bites accepted had increased to at least 80%, the child's caregivers selected the preferred treatment package. The results indicated that both treatments were …


Basics Of Research (Part 5): Ethics And Human Rights, Eric Davis, Edward A. Panacek, Cheryl Thompson Jan 1996

Basics Of Research (Part 5): Ethics And Human Rights, Eric Davis, Edward A. Panacek, Cheryl Thompson

Journal Articles: College of Nursing

No abstract provided.


Stimulation Of Alpha 1(I) Procollagen Gene Expression In Nih-3t3 Cells By The Human T Cell Leukemia Virus Type 1 (Htlv-1) Tax Gene., E. Munoz, D. Suri, S. Amini, K. Khalili, Sergio A. Jimenez Nov 1995

Stimulation Of Alpha 1(I) Procollagen Gene Expression In Nih-3t3 Cells By The Human T Cell Leukemia Virus Type 1 (Htlv-1) Tax Gene., E. Munoz, D. Suri, S. Amini, K. Khalili, Sergio A. Jimenez

Selected Works of Sergio Jiménez, MD, MACR

The mechanisms that regulate the expression of genes encoding extracellular matrix proteins in fibroblasts and other mesenchymal cells have remained elusive. Studies from several laboratories have indicated that Tax, a trans-regulatory protein from the human T cell leukemia virus type I not only augments viral gene expression but also triggers the expression of various cellular genes. Here, we examined the hypothesis that the expression of collagen genes may also be modulated by Tax. NIH-3T3 cells were simultaneously transfected with a Tax expressor plasmid and a chimeric construct containing regulatory sequences (-804 to +42 bp) of the alpha 1(I) procollagen gene …


Computer-Assisted Instruction As A Learning Resource For Applied Anatomy And Kinesiology In The Occupational Therapy Curriculum., Susan Toth-Cohen Sep 1995

Computer-Assisted Instruction As A Learning Resource For Applied Anatomy And Kinesiology In The Occupational Therapy Curriculum., Susan Toth-Cohen

Department of Occupational Therapy Faculty Papers

OBJECTIVES: The purpose of these studies was to examine the learning outcomes of a computer-assisted instruction (CAI) tutorial in applied anatomy and kinesiology for occupational therapy students and to determine its applicability for use in two university settings.

METHOD: Two separate pilot studies were conducted at two universities. In each study, the learning outcomes of an experimental group of occupational therapy students using a CAI program and a control group using books to study the same material were compared. Learning outcomes were assessed with post-test achievement test scores on an applied anatomy and kinesiology test and responses to an attitude …


Impact Of Spinal Cord Injury On The Life Roles Of Women., M Claire Quigley Sep 1995

Impact Of Spinal Cord Injury On The Life Roles Of Women., M Claire Quigley

Department of Occupational Therapy Faculty Papers

This qualitative study was conducted to explore and describe the role experience of five women whose lives were disrupted by a traumatic spinal cord injury and who later returned to their communities after completing intensive rehabilitation programs. In-depth interviews and participant observations were used to examine the experiences of these women. The findings exemplify how the women's use of adaptation and negotiation and the development of a new role as self-advocate facilitated the reestablishment of their life roles. As the women's occupational roles were redefined, the processes of adaptation and negotiation were evident in three aspects of their lives: daily …


A Call To Action: The Institute Of Medicine Report On Emergency Medical Services For Children., J F. Knapp Jul 1995

A Call To Action: The Institute Of Medicine Report On Emergency Medical Services For Children., J F. Knapp

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.


The Oral Physician... Creating A New Oral Health Professional For A New Century, David A. Nash May 1995

The Oral Physician... Creating A New Oral Health Professional For A New Century, David A. Nash

Oral Health Science Faculty Publications

No abstract provided.


The Costs Of Eating: A Behavioral Economic Analysis Of Food Refusal., Mary Louise Kerwin, W H Ahearn, P S Eicher, D M Burd Jan 1995

The Costs Of Eating: A Behavioral Economic Analysis Of Food Refusal., Mary Louise Kerwin, W H Ahearn, P S Eicher, D M Burd

College of Science & Mathematics Departmental Research

Behavioral economic concepts were applied to the analysis and treatment of pediatric feeding disorders in a clinical setting. In Experiment 1, children who chronically refused food were presented with varying amounts of food on a spoon (empty, dipped, quarter, half, and level). Each child exhibited a different but orderly demand function of response (acceptance, expulsion, and mouth clean) by cost (increasing spoon volume) for a constant pay-off of toys and social interaction. In Experiment 2, physical guidance or nonremoval of the spoon for food refusal was initiated at the smallest spoon volume with low levels of acceptance, and was subsequently …


Roc Curve Regression Analysis: The Use Of Ordinal Regression Models For Diagnostic Test Assessment, Anna N.A. Tosteson, Milton C. Weinstein, Jack Wittenberg, Colin B. Begg Nov 1994

Roc Curve Regression Analysis: The Use Of Ordinal Regression Models For Diagnostic Test Assessment, Anna N.A. Tosteson, Milton C. Weinstein, Jack Wittenberg, Colin B. Begg

Dartmouth Scholarship

Diagnostic tests commonly are characterized by their true positive (sensitivity) and true negative (specificity) classification rates, which rely on a single decision threshold to classify a test result as positive. A more complete description of test accuracy is given by the receiver operating characteristic (ROC) curve, a graph of the false positive and true positive rates obtained as the decision threshold is varied. A generalized regression methodology, which uses a class of ordinal regression models to estimate smoothed ROC curves has been described. Data from a multi-institutional study comparing the accuracy of magnetic resonance (MR) imaging with computed tomography (CT) …


Bridging Conflicting Ideologies: The Origins Of American And British Occupational Therapy., Ruth L. Schemm Nov 1994

Bridging Conflicting Ideologies: The Origins Of American And British Occupational Therapy., Ruth L. Schemm

Department of Occupational Therapy Faculty Papers

Occupational therapy practice has bridged two contradictory value systems for more than 100 years. This article describes the origins of practice ideas in both the United States and Britain and demonstrates that founding members of the occupational therapy profession all shared a core of humanistic beliefs while embracing the emerging paradigm of scientific medicine. The result has been an intellectual tension between the biological and the psychosocial aspects of practice. For more than 75 years, occupational therapists struggled to balance the art and science of patient care; recent debates on modalities, practice domains, and research priorities indicate that the unifying …


The Life-Long Learning Imperative... Ends And Means, David A. Nash Oct 1994

The Life-Long Learning Imperative... Ends And Means, David A. Nash

Oral Health Science Faculty Publications

No abstract provided.


Functional Analysis Of Human Alpha 1(I) Procollagen Gene Promoter. Differential Activity In Collagen-Producing And -Nonproducing Cells And Response To Transforming Growth Factor Beta 1., Sergio A. Jimenez, John A. Varga, Anne Olsen, Liye Li, Arturo Diaz, Janet Herhal, Julie Koch Apr 1994

Functional Analysis Of Human Alpha 1(I) Procollagen Gene Promoter. Differential Activity In Collagen-Producing And -Nonproducing Cells And Response To Transforming Growth Factor Beta 1., Sergio A. Jimenez, John A. Varga, Anne Olsen, Liye Li, Arturo Diaz, Janet Herhal, Julie Koch

Department of Medicine Faculty Papers

To gain a further understanding of the regulation of human type I collagen gene expression under physiologic and pathologic conditions, we characterized 5.3 kilobase pairs (kb) of the human alpha 1(I) procollagen gene promoter. A series of deletion constructs containing portions of the alpha 1(I) procollagen 5'-flanking region (with end points from -5.3 kb to -84 base pairs (bp)) ligated to the chloramphenicol acetyltransferase (CAT) reporter gene were transiently transfected into NIH/3T3 cells. Maximal CAT activity was observed with constructs having 5' end points from -804 to -174 bp. A further 5' deletion to -84 bp caused a marked reduction …


A Tension Between Two Cultures ... Dentistry As A Profession And Dentistry As Proprietary, David A. Nash Apr 1994

A Tension Between Two Cultures ... Dentistry As A Profession And Dentistry As Proprietary, David A. Nash

Oral Health Science Faculty Publications

No abstract provided.


Elevated Expression Of Type Vii Collagen In The Skin Of Patients With Systemic Sclerosis. Regulation By Transforming Growth Factor-Beta., Lidia Rudnicka, John Varga, Angela M. Christiano, Renato V. Iozzo, Sergio A. Jimenez, Jouni Uitto Apr 1994

Elevated Expression Of Type Vii Collagen In The Skin Of Patients With Systemic Sclerosis. Regulation By Transforming Growth Factor-Beta., Lidia Rudnicka, John Varga, Angela M. Christiano, Renato V. Iozzo, Sergio A. Jimenez, Jouni Uitto

Department of Dermatology and Cutaneous Biology Faculty Papers

A hallmark of systemic sclerosis (SSc) is the development of tissue fibrosis. Excessive production of several connective tissue components normally present in the dermis, including type I, III, V, and VI collagens as well as fibronectin and proteoglycans, is a consistent finding in the skin of SSc patients. Type VII collagen is a major constituent of anchoring fibrils, present in the skin at the dermal-epidermal basement membrane zone. TGF-beta has been shown to upregulate the expression of the type VII collagen gene. In this study, we assessed the expression of type VII collagen and TGF-beta in the skin of patients …


The Random Inactivation Of The X Chromosome Carrying The Defective Gene Responsible For X-Linked Hyper Igm Syndrome (X-Him) In Female Carriers Of Higm1, D Hollenbaugh, L H. Wu, H D. Ochs, S Nonoyama Jan 1994

The Random Inactivation Of The X Chromosome Carrying The Defective Gene Responsible For X-Linked Hyper Igm Syndrome (X-Him) In Female Carriers Of Higm1, D Hollenbaugh, L H. Wu, H D. Ochs, S Nonoyama

Dartmouth Scholarship

No abstract provided.


Management Decisions Made By Caregiver Spouses Of Persons With Alzheimer's Disease., Mary A. Corcoran Jan 1994

Management Decisions Made By Caregiver Spouses Of Persons With Alzheimer's Disease., Mary A. Corcoran

Department of Occupational Therapy Faculty Papers

OBJECTIVES: As the incidence of Alzheimer's disease increases, so does the effect on families and friends who assume caregiving responsibilities. Despite the proliferation of caregiving studies reported in the literature, little is known of the day-to-day management styles and preferences of caregivers. To develop, implement, and test interventions designed to sustain caregivers in their role, more information is needed about the caregiving experience. Results of a descriptive study are presented as a first step in understanding the complex process of choosing, organizing, and implementing everyday caregiving tasks.

METHOD: Subjects of the study were 26 persons who provide care for a …


Basic Fibroblast Growth Factor And Fibroblast Growth Factor Receptor I Are Implicated In The Growth Of Human Astrocytomas., R S Morrison, F Yamaguchi, H Saya, J M Bruner, Alan M. Yahanda Md, Facs, L A Donehower, M Berger Jan 1994

Basic Fibroblast Growth Factor And Fibroblast Growth Factor Receptor I Are Implicated In The Growth Of Human Astrocytomas., R S Morrison, F Yamaguchi, H Saya, J M Bruner, Alan M. Yahanda Md, Facs, L A Donehower, M Berger

PCI Publications and Projects

Malignant astrocytomas are highly invasive, vascular neoplasms that comprise the majority of nervous system tumors in humans. A strong association has previously been made between malignancy in human astrocytic tumors and increased expression of certain fibroblast growth factor (FGF) family members, including basic and acidic FGF. The influence of endogenous basic FGF on glioblastoma cell growth in vitro was evaluated using basic FGF-specific antisense oligonucleotides. These studies indicated that human glioblastoma cell growth in vitro, can be inhibited by suppressing basic FGF expression. Human astrocytomas also exhibited changes in FGF receptor (FGFR) expression during the course of their progression from …


A Clustering Of Childhood Meningococcal Disease: A Challenge For Physicians, Press And Community., Michael S. Dreyer, Stephen C. Eppes, Joel D. Klein Nov 1993

A Clustering Of Childhood Meningococcal Disease: A Challenge For Physicians, Press And Community., Michael S. Dreyer, Stephen C. Eppes, Joel D. Klein

Department of Pediatrics Faculty Papers

The Delaware Division of Public Health reported only two cases of documented meningococcal infection in the pediatric population in 1992. As of March 1, 1993, the Morbidity and Mortality Weekly Report indicated only one case of meningococcal disease in the state of Delaware for 1993. However, from the end of February to early April 1993, approximately six weeks, there were seven cases of documented meningococcal infection in the pediatric population that either presented or were transferred to one of the pediatric care facilities in the Wilmington, Delaware area. Notification of these cases to the Delaware Division of Public Health prompted …