Aktuelles aus dem Medizinrecht

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Current aspects of forensic lawFrom October 2004 to March 2005

     

The genetic and environmental contributions to oppositional defiant behavior: a multi-informant twin study

OBJECTIVE: To estimate the genetic and environmental contributions to oppositional defiant behavior (ODB) from mother, father, and teacher report using the Conners Revised Short Forms in a large twin sample. METHOD: ODB data were collected from 1,595 mothers, 1,114 fathers, and 793 teachers of 7-year-old twin pairs from the Netherlands Twin Registry in the 1990-1992 cohort with an 80% response rate. Models were fit for each informant to determine the genetic, environmental, gender, and informant influences on ODB. RESULTS: Genetic analyses of the ODB quantitative scale showed additive genetic (A) by mother (55%), by father (57%), and by teacher (21% girls, 38% boys) unique environmental (E) (mother, 22%; father, 29%; teacher, 48% girls, 39% boys) and shared environmental (C) (mother, 14%; father, 23%; teacher, 31% girls, 23% boys) influences. CONCLUSIONS: Additive genetic and unique environmental factors account for the majority of the influences on ODB for boys and girls by all informants.     

Apoptosis via the B cell antigen receptor requires Bax translocation and involves mitochondrial depolarization, cytochrome C release, and caspase-9 activation

Various routes to apoptosis can be active during B cell development. In a model system of mature B cells, differences in caspase-3 processing have suggested that antigen receptor (BCR)-mediated apoptosis may involve a zVAD-insensitive initiator protease(s). In search of the events leading to caspase-3 activation, we now establish that both CD95- and BCR-mediated apoptosis depend on Bax activation and cytochrome C (cytC) release. Nevertheless, the timing and caspase-dependence of mitochondrial membrane depolarization differed considerably after CD95- or BCR-triggering. To delineate events subsequent to cytC release, we compared apoptosis induced via BCR triggering and via direct mitochondrial depolarization by CCCP. In both cases, partial processing of caspase-3 was observed in the presence of zVAD. By expression in 293 cells we addressed the potential of candidate initiator caspases to function in the presence of zVAD, and found that caspase-9 efficiently processed caspase-3, while caspase-2 or -8 were inactive. Finally, retroviral expression of dominant-negative caspase-9 inhibited both CD95- and BCR-mediated apoptosis. In conclusion, we obtained no evidence for involvement of a BCR-specific protease. Instead, our data show for the first time that the BCR-signal causes Bax translocation, followed by mitochondrial depolarization, and cytC release. Subsequent caspase-9 activation can solely account for events further downstream.     

Regeneration and tolerance factor modulates the effect of adenosine triphosphate-induced interleukin 1 beta secretion in human macrophages

These studies characterize a molecule known as regeneration and tolerance factor (RTF), which controls inflammation by regulating interleukin 1 beta (IL-1 beta) secretion. Recently, it has been demonstrated that the interaction of adenosine triphosphate (ATP) with the P2X7 purinoceptor induces the secretion of IL-1 beta and initiates the inflammatory response. In these experiments, that the addition of ATP to macrophages was found to induce P2X7 activation and secretion of IL-1 beta. This secretion is enhanced with anti-RTF antibody in combination with exogenous ATP (p< 0.005). RTF is also revealed to be able to influence surface ATPase activity and, increase PI incorporation, which is an indicator of P2X7 activation. We demonstrate that RTF has a role in controlling IL-1 beta secretion by regulating P2X7 activity.     

Life before birth: effects of cortisol on future cardiovascular and metabolic function

The concept of fetal programming is an area that is now under rigorous investigation in many laboratories throughout the world. We need to engender a fascination in all segments of society, not just pregnant women, about life in the womb.

Conclusion: Everyone needs to understand that improving the condition of the fetus will have personal, social and economic benefits. The time has come to realize that, in a sense, it is not just women who are pregnant but it is the family and the whole of society.     

What is the dentist's role in the recognition of child abuse?

For a Dutch dentist, the chance to recognise a physical abused child with injuries in the head-neck region, is less than once every 18 months. But child abuse is difficult to recognize. In spite of all this, it's still important for dentists to know how to recognise child abuse, since the effects on a child can be harmful. Child abuse finds its expression in, for example bruises, burns, laceration of the labial frenulum or avulsed teeth. There are also often behavioural problems. Clothes can mask lesions. The fact that child abuse can't be reported anonymously is a misconception. Professionals can report a case of child abuse anonymously to the "Advies en Meldpunten Kindermishandeling", although a not anonymous report is favoured.     

Elderly patients with head and neck cancer: short-term effects of surgical treatment on quality of life

Elderly patients with head and neck cancer are less likely to be treated surgically. However, little is known about surgical outcome and quality of life (QOL) in elderly patients after a major surgery. This prospective study compared the QOL and the surgical outcome of 54 elderly (> or =70 years) and 75 younger patients (45-60 years) with carcinoma of the oral cavity (stage > or = II), pharynx (stage > or = II) or larynx (stage > or = III). Before and 3 months after surgery, the patients completed questionnaires about QOL (EORTC QLQ-C30 and QLQ-H&N35) and depression (CES-D). Before treatment, elderly and younger patients did not differ in QOL. Three months after the treatment, both groups scored worse on most QOL aspects, but there were no significant differences between the elderly and the younger patients. Surgical and systemic complication rates were similar for both the groups. In conclusion, we found no significant differences in the complication rate and QOL aspects between surgically treated elderly and younger patients.     

高压培养对血管内皮细胞t-PA和PAI-1的影响及卡托普利干预的效果

目的：高血压常伴有纤溶功能的异常,但其机制尚不清楚。本研究拟观察高静水压培养对人脐静脉内皮细胞（HUVECs）t-PA和PAI-1的影响以及卡托普利的干预效果,并探讨其可能的作用机制。方法：选用第4～6代HU-VECs,接种于24孔培养板中。依培养压力分为3组：大气压组（0mmHg）,中压组（90mmHg）,高压组（180mmHg）。在同一压力组,根据不同药物干预又分为两个亚组。即对照组（Ctrl）和卡托普利组（Cap,10^-5mol/L）。每组6份标本。采用ELISA法测定上清液t-PA和PAI-1的抗原浓度,并用细胞内总蛋白进行标化（单位：ng/μg proteins）。同时测定细胞内Ca^2＋浓度（nmol/L）。结果：与大气压组相比,中压和高压组t-PA浓度均显著降低,PAI-1浓度显著增高,t-PA/PAI-1比值显著降低,[Ca^2＋]i也显著增高。卡托普利对大气压组的t-PA、PAI-1和[Ca^2＋]i无显著影响,但在两个高压组,卡托普利显著升高t-PA浓度,显著降低PAI-1浓度,t-PA/PAI-1比值显著升高,[Ca^2＋]i显著地降低。结论：高静水压可损害内皮细胞的纤溶功能,而卡托普利的干预可降低高压所升高的[Ca^2＋]i,并改善高静水压对内皮细胞纤溶功能的影响。     

Dynamic holographic imaging of the beating human heart

Background--Currently, the reporting and archiving of echocardiographic data suffer from the difficulty of representing heart motion on printable 2-dimensional (2D) media. Methods and Results--We studied the capability of holography to integrate motion into 2D echocardiographic prints. Images of normal human hearts and of a variety of mitral valve function abnormalities (mitral valve prolapse, systolic anterior motion of the mitral leaflets, and obstruction of the mitral valve by a myxoma) were acquired digitally on standard echocardiographic machines. Images were processed into a data format suitable for holographic printing. Angularly multiplexed holograms were then printed on a prototype holographic "laser" printer, with integration of time in vertical parallax, so that heart motion became visible when the hologram was tilted up and down. The resulting holograms displayed the anatomy with the same resolution as the original acquisition and allowed detailed study of valve motion with side-by-side comparison of normal and abnormal findings. Comparison of standard echocardiographic measurements in original echo frames and corresponding hologram views showed an excellent correlation of both methods (P<0.0001, r2=0.979, mean bias=2.76 mm). In this feasibility study, both 2D and 3D holographic images were produced. The equipment needed to view these holograms consists of only a simple point-light source. Conclusions--Holographic representation of myocardial and valve motion from echocardiographic data is feasible and allows the printing on a 2D medium of the complete heart cycle. Combined with the recent development of online holographic printing, this novel technique has the potential to improve reporting, visualization, and archiving of echocardiographic imaging.     

Dermatomyositis in childhood. Review of eight cases

Eight cases of dermatomyositis in children admitted to Scottish hospitals between 1962 and 1972 have been reviewed. 6 of the 8 were currently in complete remission. In the other 2 cases the disease remained active in 1 and 1 had died of cardiac failure 6 years after the onset of disease. 5 had developed extensive soft tissue calcification for which 2 were treated with ethanehydroxydiphosphonate, one showing definite improvement and the other no change. All had been treated with corticosteroids and two in addition had had cytotoxic agents (methotrexate or cyclophosphamide). The overal prognosis had probably been improved by the use of corticosteroids but not by the cytotoxic drugs. Only one of the patients was incapacitated by residual contractures or calcinosis.