Successful treatment of periungual warts using photodynamic therapy: a pilot study

AIM: The aim of this pilot study was an investigation on photodynamic therapy (PDT) whether it is a good alternative for treating periungual and subungual warts of the hands. STUDY DESIGN: Twenty patients (mean age: 30.5 years) with a total of 40 periungual and subungual warts were treated with PDT. A photosensitizer, 20%delta-aminolevulinic acid was applied on the warts. After a mean incubation time of 4.6 h (SD: 1.2), the warts were irradiated with the VersaLight for 5-30 min (15.2 +/- 4.3 min). RESULTS: After a mean of 4.5 treatments a mean clearance of 100% was achieved in 90% of the patients. One patient (5%) showed a clearance of 50% and another showed no improvement. The subungual or periungual location of the wart had no influence on the number of treatments or end result (P > 0.05). There were two recurrences during the mean follow-up period of 5.9 months (SD: 7.6). Besides mainly pain and hyperpigmentation, most treatments had no side-effects. CONCLUSION: PDT can offer a good alternative for treating periungual warts of the hands. Larger studies are indicated.     

Prescribing strengthening exercises for my patients: which equipment should I select?

This paper examines various devices used in strength building exercise programs. These include free weights, pulley machines, variable resistance weight machines, isokinetic units and elastic tubing and banding. Advantages and disadvantages of each are discussed and examined from the view point of the health care provider and the suitability of each type of device for prescribed progressive resistance exercise programs for patients. In addition to such practical aspects such as cost and maintenance, biomechanical factors, types of contraction elicited, ease of patient instruction and proprioception benefits are also compared in order to assist the clinician in selecting the most appropriate equipment for each individual patient.     

Poverty and health in West Germany

Summary The relationship between poverty and several health-related characteristics in West Germany was investigated. Data were derived from the National and Regional Health Surveys conducted in West Germany from 1984 to 1992. 25544 males and 25719 females with German nationality aged 25–69 years were examined. Poverty was defined as a household income of 50% less than the mean for West Germany. Multiple logistic regression analysis was used to analyze the relationship between poverty and four health variables: individual health behavior, subjective assessment of health status, cardiovascular disease risk factors, and self-reported prevalence of lifetime chronic diseases. 10.2% of males and 12.8% of females were classified as being below the poverty line. For most but not all health parameters, less favourable results were found for the segment of the population with a household income below the poverty line. The most striking poverty-related differences were observed for lack of regular sport activities, subjective health satisfaction, obesity and myocardial infarction/stroke. Significantly lower prevalence rates for study subjects below the poverty line were observed for hypercholesterolemia in females only. Allergic disorders were the only chronic diseases reported significantly less often in males and females below the poverty line. Poverty has strong effects on individual health status and the prevalence of chronic diseases. Due to the rising unemployment rates in Germany in the last years it is very likely that the strong negative consequences of poverty for health are increasing.

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Zusammenfassung Es wird untersucht, welche Zusammenhänge zwischen Armut und verschiedenen gesundheitsbezogenen Merkmalen bestehen. Datenbasis sind die nationalen und regionalen Gesundheitssurveys, die in den Jahren 1984 bis 1992 in Westdeutschland durchgeführt wurden. 25544 Männer und 25719 Frauen mit deutscher Nationalität im Alter von 25 bis 69 Jahren wurden einbezogen. Armut wurde definiert als ein Haushaltseinkommen, das um 50% niedriger ist als das mittlere Einkommen in Westdeutschland. Die statistische Auswertung erfolgte mittels multipler logischer Regressionsanalyse, 10,2% der Männer und 12,8% der Frauen hatten ein Haushaltseinkommen unterhalb der Armutsgrenze. Die ausgeprägtesten armutsbezogenen Unterschiede wurden beobachtet für den Mangel an körperlicher Bewegung, die subjektive Gesundheitszufriedenheit, das starke. Übergewicht und die kardiovaskulären Krankheiten. Signifikant niedrigere Prävalenzen für Personen mit Einkommen unterhalb der Armutsgrenze ergaben sich bei den Frauen für den Risikofaktor Hypercholesterinämie. Allergien waren die einzige chronische Krankheit, die bei beiden Geschlechtern signifikant seltener in der von Armut betroffenen Bevölkerungsgruppe berichtet wurde. Vor dem Hintergrund der in den letzten Jahren stark angestiegenen Arbeitslosigkeit in Deutschland ist zu befürchten, dass die negativen Konsequenzen der Armut für die gesundheitliche Lage deutlich zugenommen haben.

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Résumé Les rapports entre pauvreté et differents indices sanitaires ont été examinés. Les donnees proviennent des surveys de santé nationales et régionales, réalisées en Allemagne de l'Ouest durant les années 1984 à 1992. 25719 femmes et 25544 hommes de nationalité allemande entre 25 et 69 ans ont paticipé. Le seuil de pauvreté a été fixé à un revenu égal a 50% du revenu moyen en Allemagne de l'Ouest. On a analysé les indices sanitaires suivants: le comportement sanitaire individuell, l'auto-estimation de sa santé, les facteurs de risque cardio-vasculaires et la prévalence des maladies chroniques. L'analyse statistique a été réalisée par regression logique multiple. 12,8% des femmes et 10,2% des hommes avaient un revenu inferieur au seuil de pauvreté. Pour la majorité des indices sanitaires on a trouvé des résultats défavorables pour la groupe ayant un revenu au dessous du seuil de pauvreté. Le manque de mouvement, l'auto-estimation de sa santé, l'excés de poids et les maladies cardio-vasculaires sont les indices quid diffèrent, relatif à la pauvreté, le plus. Les femmes ayant un revenu au-dessous du seuil de pauvreté ont des pourcentages de prévalence inférieurs significatifs pour le facteur de risque hypercholestérolémie. Les allergies sont les seules maladies qui existent significativement moins souvent chez les deux sexes de la groupe des pauvres. En résumé, la pauvreté présente un désavantage pour la santé individuelle et la prévalence des maladies chroniques. Sachant que le taux de chômage s'est aggravé pendant les dernières années, il est à craindre que les effets négatifs de la pauvreté sur la situation sanitaire ont nettement augmenté.

     

PJA-BP expression and TCR delta deletion during human T cell differentiation

Recombination of deltaRec to psiJalpha will delete the TCR delta gene, which is thought to play an important role in the bifurcation of the TCR alphabeta versus TCR gammadelta differentiation lineages. We recently detected a DNA-binding protein in human thymocytes, the so- called PJA-BP, which recognizes the psiJalpha gene segment and might be one of the factors involved in the regulation of preferential deltaRec- psiJalpha rearrangements. We now investigate PJA-BP expression and its correlation with TCR delta gene deletion in thymocytes. Our electrophoretic mobility shift assay experiments showed that the PJA-BP is evolutionary conserved in human, murine and simian thymocytes. Using a large series of human hematopoietic malignancies (n = 30), we conclude that PJA-BP expression is thymocyte specific and seems to be restricted to thymocytes committed to the TCR alphabeta lineage. Analysis of seven well-defined human thymocyte subpopulations showed that preferential deltaRec-psiJalpha rearrangements as well as PJA-BP expression can be detected from the immature CD34-/CD1+/CD3- /CD4+/CD8alpha+beta- thymocyte differentiation stage onwards. These experiments indicate that expression of PJA-BP in human thymocytes starts simultaneously with preferential deltaRec-psiJalpha rearrangements, which supports our hypothesis that PJA-BP is one of the factors involved in the preferential recombination of deltaRec to psiJalpha.      

Cross-reactivity of Streptococcus mutans antigens and human heart tissue.

Rocket and two-dimensional immunoelectrophoreses were used to demonstrate that antisera from rabbits immunized with Streptococcus mutans strain B13 cross-reacted with human heart tissue. Absorption of the anti-S. mutans serum with S. mutans whole cells removed all reactivity to heart tissue, but did not remove the reactivity of an added antibody marker to its corresponding antigen. The anti-S. mutans serum reacted most intensely with heart tissue antigen and to a lesser degree with skeletal muscle, but not with liver or kidney tissues. These results support the conclusion that antigens of S. mutans cross-react with mammalian heart tissue and, further, suggest that caution should be exercised in the formulation of a dental caries vaccine containing S. mutans antigens.     

Molecular genetic analysis of autosomal dominant cerebellar ataxia with retinal degeneration (ADCA type II) caused by CAG triplet repeat expansion

Autosomal dominant cerebellar ataxia with retinal degeneration (ADCAII) was previously mapped by linkage analysis studies to chromosome 3p12- p21.1 (SCA7). Positional cloning efforts have recently identified a novel gene, SCA7 , containing a translated CAG repeat, expanded in SCA7 patients. We cloned the SCA7 gene from a yeast artificial chromosome (YAC) clone contig spanning the SCA7 candidate region. Using a combination of genomic sequencing and cosmid-based exon trapping, two expressed sequence tags were identified. Sequencing of the corresponding cDNA clones and RT-PCR analysis identified the full- length SCA7 cDNA. Together, our sequence data defined the intron/exon boundaries of the first two coding exons of the SCA7 gene, with the first exon containing the expanded CAG repeat. Further, sequence comparison with the published SCA7 cDNA identified one additional putative exon in the 5'-UTR region of the SCA7 gene. The SCA7 gene was mapped on the YAC contig in the 2.5 cM interval between D3S1600 and D3S1287. In one extended Belgian SCA7 pedigree the expanded alleles ranged from 38 to at least 55 repeats with allele lengths being inversely correlated with onset age of ADCAII symptoms. The SCA7 repeats increased in length in successive generations. Normal alleles had from four to 18 repeats, with 10 repeats being the most common allele.