Learning a high-precision locomotor task in patients with Parkinson's disease.

We evaluated the acquisition and performance of a high-precision locomotor task in patients with Parkinson's disease (PD) and healthy subjects. All subjects walked on a treadmill and had to step repetitively as low as possible over an obstacle without touching it. During blocks 1 and 2, the subjects had full vision and received additional acoustic warning and feedback signals. During block 3, vision became restricted. Changes in foot clearance and the number of obstacle hits were evaluated. Initially, PD patients performed poorer and improved foot clearance slower. After task repetition, the groups performed similarly. Restricting vision deteriorated performance in both groups. The similar performance of PD patients after task repetition might indicate that adequate training could improve adaptive locomotor behavior in PD patients.     

Comparison of three immunoassays for diagnosing sensitization to latex in children with spina bifida

As natural rubber latex (latex) has become more widespread in our environment, physicians have become increasingly aware of the problem of possible allergic reactions. Many fatal and near-fatal incidents have been reported (mainly during surgery) (1—3) and data has been published on groups frequently exposed to latex, such as patients with spina bifida (4—9), healthcare professionals (10—12) and occupationally exposed persons (13). The incidence of latex allergy in children seems to be increasing (14). Tests are therefore needed which can reliably detect sensitization to latex. Our aim was to compare the diagnostic accuracy of three commercial immunoassays for measuring specific IgE in serum to latex.     

Definition of An Optimal First-line Chemotherapy in Metastatic Breast Cancer

Single-agent chemotherapy of metastatic breast cancer is the treatment of choice in patients with slow tumor progression and asymptomatic disease. In this patient group, the choice of drugs is based more on good tolerability than on efficacy. By contrast, symptomatic or rapidly progressing disease requires the use of highly active regimens where more weight is put on reliable antitumor activity. While anthraycline-based combination regimens have set the standard of effective treatment, the addition of docetaxel (and to a lesser extent paclitaxel) has improved tumor response, but failed to induce a consistent prolongation of survival. Based on retrospective analyses, it is hypothesised that the combined use of anthracyclines and taxanes in first-line therapy may be most beneficial in defined subgroups: after adjuvant chemotherapy, in patients with HER-2 gene amplification, possibly also in patients with rapidly progressing visceral disease.     

Cultural adaptation is associated with atopy and wheezing among children of Turkish origin living in Germany

BACKGROUND: Turkish children have been found to suffer less from atopic diseases than their German peers. The underlying causes are unknown. OBJECTIVE: To evaluate rates of sensitization and atopic disease among children in Germany with German or Turkish ethnicity and different degrees of cultural adaptation. METHODS: This was a cross-sectional study. The setting was screening for school eligibility in an inner-city district of Berlin/Germany. The participants were preschool children born in Germany with double German or double Turkish parental citizenship. Cultural adaptation of Turkish children was assessed by the language parents used to communicate with their child: only Turkish (n = 60, group A); Turkish and German (n = 269, group B); and only German (n = 103, group C). Group D contained children from German parents (n = 383). The main outcome measures were specific sensitization to common aeroallergens (CAP-System, Pharmacia Phadiatop >or= 0.35 kU/L), and lifetime and 1-year prevalences of allergic disease symptoms (ISAAC questionnaire in German and Turkish, Mantel-Haenszel test for trend). RESULTS: Sensitization rates for groups A, B, C and D were 8.0%, 6.8%, 18.9% and 18.3%, respectively (P = 0.004). The corresponding prevalence rates for wheeze ever were 6.7%, 9.3%, 12.6% and 21.3% (P < 0.001), wheeze in the past year 3.3%, 3.7%, 9.7% and 10.2% (P = 0.001), itchy rash ever 3.3%, 6.3%, 8.7% and 13.7% (P < 0.001), itchy rash in the past year 1.7%, 3.7%, 4.9% and 9.5% (P < 0.001), respectively. No significant differences were found for hay fever symptoms. CONCLUSIONS: Higher cultural adaptation is correlated with higher rates of allergic sensitization and disease among children of Turkish origin living in Berlin. This correlation suggests that environmental rather than genetic differences are responsible for the differences observed.     

Sex differences of human trabecular bone microstructure in aging are site-dependent.

In this study, we characterize bone microstructure, specifically sex differences, at multiple skeletal sites in 165 subjects >52 yr of age, using microCT technology in vitro. Significant sex differences are observed at the distal radius, femoral neck, and femoral trochanter, but not at the iliac crest, calcaneus, and lumbar vertebral body. Correlations in BV/TV between sites ranged from r = 0.13 to 0.56. INTRODUCTION: The goals of this study were (1) to assess potential sex differences of bone microstructure and their difference between skeletal sites and (2) to explore the relationship of trabecular microstructural properties between relevant skeletal sites. MATERIALS AND METHODS: Trabecular bone microstructural properties were measured in vitro in 165 subjects 52-99 yr of age using microCT. Defined volumes of interest (cylinders with 6 mm diameter and 6 mm length) were scanned at a resolution of 26 microm (isotropic) in six different anatomical sites: distal radius, femoral neck and trochanter, iliac crest, calcaneus, and second lumbar vertebral body. RESULTS: At the radius and femoral neck, trabecular bone displayed a more plate-like structure, thicker trabeculae, smaller separation/higher trabecular number, higher connectivity, and a higher degree of anisotropy in men than in women (p < 0.05). At the trochanter, men displayed more plate-like structure and thicker trabeculae (p < 0.05), but no differences in trabecular separation or other parameters compared with the women. At the calcaneus, iliac crest, and second lumbar vertebra none of the bone parameters displayed significant differences between sexes. The BV/TV at one site explained a range of only 2-32% of the variability at other sites. CONCLUSIONS: These results suggest that trabecular bone microstructural properties are remarkably heterogeneous throughout the skeleton. Significant differences between men and women are observed at some, but not at all, sites. The magnitude of sex differences in trabecular microstructure coincides with that of fracture incidence observed for some of the sites in epidemiological studies.     

Posttraumatisches septisches Abdomen

Abdominal infection has the fifth highest incidence of all posttraumatic infections but has the second highest mortality rate with 25%,pneumonia,with 29%, being the only posttraumatic infection that is more frequently lethal.Posttraumatic abdominal sepsis, on the other hand, has a mortality rate of almost 50%.This rate cannot be reduced except by prompt identification of the correct diagnosis of the underlying injury or complication.This means that delayed laparotomy is strikingly detrimental in these patients, with 46% mortality as opposed to 11% in patients who undergo laparotomy promptly. In parallel with this, the mortality of fresh-onset and localized peritonitis is 14%,whereas that of diffuse purulent peritonitis is up to a devastating 42%.     

Is 1,2-bis(2,4-octadecadienoyl)-sn-glycero-3-phosphorylcholine (DODPC) an efficient chiral probe to study conformational changes in lipid membranes?

In order to study its possible use as a chiral membrane probe, small unilamellar vesicles of 1,2-bis(2,4-octadecadienoyl)-sn-glycero-3-phosphorylcholine (DODPC, 1 ), a doubly unsaturated phospholipid molecule, and vesicles of 1,2-dipalmitoyl- or 1,2-dimyristoyl-sn-glycero-3-phos-phorylcholine or egg-lecithin, containing DODPC, were prepared and investigated by UV and circular dichroism (CD) spectroscopy. The phase transitions that are clearly manifest in the UV effect reproducible but only small changes in the CD. This indicates that at least in the area of unsaturation the molecule is rather stiff and insensitive to its micro-environment. A non-membrane-forming short-chain model compound, 1,2-bis(2,4-hexadienoyl)-sn-glycero-3-phos-phorylcholine, 2 , was used to study the chiroptic properties of the isolated molecule; the results are in agreement with calculations and support the contention that bis-unsaturated lipid molecules should in principle be able to function as chiral labels.     

Intraoperative blood salvage in cancer surgery: safe and effective?

To support blood supply in the growing field of cancer surgery and to avoid transfusion induced immunomodulation caused by the allogeneic barrier and by blood storage leasions we use intraoperative blood salvage with blood irradiation. This method is safe as it provides efficient elimination of contaminating cancer cells, and as it does not compromise the quality of RBC. According to our experience with more than 700 procedures the combination of blood salvage with blood irradiation also is very effective in saving blood resources. With this autologous, fresh, washed RBC a blood product of excellent quality is available for optimal hemotherapy in cancer patients.