Review of novel particulate antigen delivery systems with special focus on treatment of type I allergy.

For the treatment of infectious diseases, cancer and allergy, the directed induction of an appropriate immune response is the ultimate goal. Therefore, with the development of pure, often very small proteins, peptides or DNA by molecular biology techniques, the research for suitable adjuvants or delivery systems became increasingly important. Particle formulations are made of a variety of materials, including lipids, proteins or amino acids, polysaccharides, polyacrylic substances or organic acids. Microparticles serve as vehicles and provide a depot for the entrapped or coupled antigen. The release occurs in a pulsatile or continuous manner, a feature, which is well controllable for many particulate systems. Particles attract antigen presenting cells to the administration site, thereby guaranteeing the efficient presentation of the antigen to the immune system. Importantly, particles also protect the entrapped substance. This is especially necessary after oral application to avoid gastric or tryptic breakdown. In this article, the design and construction of different antigen delivery systems and their immune effects, with special focus on the suitability for allergy treatment, are discussed.     

Phenotypic and genotypic characterization of prolyliminopeptidase-negative Neisseria gonorrhoeae isolates in Denmark

In the study presented here 26 recent Danish clinical isolates of prolyliminopeptidase (PIP)-negative Neisseria gonorrhoeae were phenotypically and genotypically characterized to investigate whether one or more PIP-negative strains are circulating in the Danish community. The profiles of these isolates were compared with those of three isolates from a recent outbreak of PIP-negative N. gonorrhoeae infection in the UK. Twenty-five of the Danish isolates and all three UK isolates had similar antibiograms and were designated serovar IB-4. Genotypic characterization by pulsed-field gel electrophoresis, porB1b gene sequencing, and opa-typing revealed that these isolates were indistinguishable or closely related. The results indicate that at least one PIP-negative N. gonorrhoeae strain is currently circulating in the Danish community, and this strain is indistinguishable from the one that caused an outbreak in the UK.An erratum to this article can be found at     

Luftverschmutzung und Lungenkrebs

This review on air pollution and lung cancer recapitulates the main issues in this field (urban-rural-gradients; experimental data and occupational epidemiology of exposure to PAH; smoking and occupation as confounders). Definite risk increases have been observed in the vicinity of point emission sources. Within Switzerland lung cancer shows an urban/rural gradient in both sexes. The geographical distribution of the male cases can hardly be explained only by the patterns of smoking alone.     

Was verstehen wir unter Sucht?

In the past, addiction disorders were considered to be mainly substance use disorders. The main focus has been on dependence disorders. Dependence criteria do not differ substantially in the two main classification systems ICD and DSM, while harmful use (ICD) and abuse (DSM) criteria show much less concordance. Presently diagnostic criteria for behavioral addiction disorders are only available for pathological gambling, however, under the category of disorders of impulse control, while other disorders have to be categorized under disorders not otherwise specified. Evidence of neurobiological similarities implies that future ICD and DSM revisions, in addition to other needed changes, will group behavioral addiction and substance use disorders together.     

Larynxtubus beim Traumapatienten

A multiply injured patient’s airway is primarily secured with a laryngeal tube by the responding EMS. For helicopter transfer the flight physician decides not to intubate the patient’s trachea. Mechanical ventilation was performed without complications.     

Health-related quality of life and its predictive role for analgesic effect in patients with painful polyneuropathy.

Painful polyneuropathy is a common neuropathic pain condition. The present study describes health-related quality of life (HRQL) in a sample of patients with painful polyneuropathy of different origin and the possible predictive role of HRQL for analgesic effect. Ninety-three patients with a diagnosis of painful polyneuropathy were included in the analysis. Data were obtained from three randomised, placebo-controlled cross-over studies testing the effect of different drugs on polyneuropathic pain (St. John's wort, venlafaxine/imipramine and valproic acid). Patients completed a HRQL questionnaire (SF-36) after a drug-free baseline period and at the end of each treatment period. At baseline, all eight SF-36 scores were lower than in the normal population. No significant differences were found between SF-36 scales during placebo and treatment with valproic acid and St. John's wort. Those two drugs had not shown a pain relieving effect in former analysis. The SF-36 scale of bodily pain (BP) was improved by venlafaxine treatment (p=0.023). General health (GH) and vitality (VT) were improved under treatment with imipramine (GH: p=0.006, VT: p=0.015). In a multivariate logistic regression analysis, baseline SF-36 scores predicted subsequent response to pharmacological treatment. Results show an impaired HRQL in painful polyneuropathy and suggest that HRQL may predict response to analgesic treatment.     

Excellent results of a femoral press-fit stem cemented with a thin mantle: 116 hips followed for 11–18 years

We report the outcome of a femoral stem designed for press-fit insertion and cemented with a thin mantle. During the years 1986–1992 we performed 346 primary total hip replacements in 305 patients. Their mean age at the time of the surgery was 75 (range, 52–91 years). During the follow-up, 206 patients had died (227 hips) and 3 were lost. This left us with 96 patients (116 hips), who were followed for a mean of 13 years (range, 11–18 years). Stem survivorship according to Kaplan–Meier analysis indicated a total survival of 0.982 (confidence intervals, 0.952–1). The mechanical survival rate was 0.985 (confidence intervals, 0.955–1) at 17 years with one patient at risk. Fifty-nine (70%) of the surviving patients were very satisfied with the operated hip, 22 (26%) were satisfied, 2 (2.5%) were content, and 1 (1.5%) was dissatisfied. Then, the press-fit stem allowing minimal cement has a 17-year survival rate of 0.98.     

Medizinische Beurteilungskriterien zu bandscheibenbedingten Berufskrankheiten der Lendenwirbelsäule (II)

The first part of this serial paper dealt with the medical criteria used in evaluation of the clinical picture caused by physical stress and the evaluation of other candidate causes and was published in issue no. 3/2005 (pp. 711–752) of Trauma and Berufskrankheit. This follow-up paper (II) presents criteria to be used in the evaluation of whether it is necessary to give up the occupations putting the spine at risk and in estimation of the degree of disability.