Temperament, character and symptoms of anxiety and depression in the general population.

Few studies have investigated the relationship of temperament and character, as conceptualized in the Temperament and Character Inventory-Revised (TCI-R), to symptoms of depression and anxiety in the general population. In this study a random sample of subjects (20 to 70 years), in two Finnish cities, were surveyed with the TCI-R, Beck Depression and Anxiety Inventories, plus questions related to diagnosed lifetime mental disorders, health care use for psychiatric reasons during the past 12 months, and history of mental disorders in first-degree relatives. Altogether 347 subjects (38.6%) responded. Of the TCI-R dimensions, Harm Avoidance correlated with symptoms of depression (r(s)=0.555, p<0.001), anxiety (r(s)=0.560, p<0.001), self-reported lifetime mental disorder (r(s)=0.272, p<0.001), health care use for psychiatric reason during the past 12 months (r(s)=0.241, p<0.001) and family history of mental disorder (r(s)=0.202, p<0.001). Self-directedness correlated negatively with symptoms of depression (r(s)=-0.495, p<0.001), anxiety (r(s)=-0.458, p<0.001), lifetime mental disorder (r(s)=0.225, p<0.001) and health care use (r(s)=-0.135, p=0.013). Overall, Harm Avoidance and Self-directedness seem to associate moderately with depressive and anxiety symptoms, and somewhat predict self-reported use of health services for psychiatric reasons, and lifetime mental disorder. High harm avoidance may associate with a family history of mental disorder.     

Allogeneic grafts for bone tumor: 21 cases of osteoarticular and segmental grafts

We treated 21 aggressive and malignant bone tumors by wide resection and replacement with deep-frozen osteoarticular and segmental (intercalary and block) allografts. Radiologic and histologic studies showed a gradual accretion of new bone on the graft trabeculae, sometimes with total creeping substitution. Substantial resorption of grafted condylar bone occurred in 3 of 14 cases. One of them ended with arthrodesis; in the other 2 the result after augmentation autografts was fair. Radiographically, a gradual joint surface destruction was observed in all the osteoarticular grafts after 5 years, not correlating with joint function, however. Biopsies showed some cartilage regeneration. Each patient underwent, on an average, two operations. Function after osteoarticular grafts at 3-16 years was excellent in 1 case, good in 4, fair in 6, and poor in 1 case; 2 cases were too recent for evaluation. Function 3-12 years after segmental grafts was excellent in 3 cases and poor in 3 cases (1 amputation due to nonunion, 1 amputation due to recurrence, and 1 prosthetic replacement due to recurrence); 1 case was too recent for evaluation. We conclude that an allograft is an acceptable alternative in the reconstruction of large tumor defects. However, it still presents unsolved immunologic and preservation problems, which make the prognosis guarded.     

1H and13C NMR analysis of some trichothecenes

¹H and¹³C NMR chemical shifts were determined from the NMR spectra of low concentration solutions of T-2 toxin, T-2 triol, HT-2 toxin, diacetoxyscirpenol, and neosolaniol. Isomerization of neosolaniol was observed to occur in chloroform solution. 1D and 2D¹H and¹³C NMR techniques were used in order to determine the structure of the isomerization product, finally identified as 4,8-diacetoxy-3, 15-dihydroxy-12,13-epoxytrichothec-9-ene.     

Double-blind cross-over comparison of clenbuterol and salbutamol tablets in asthmatic out-patients

Summary A double-blind cross-over comparison of a new ₂-sympathomimetic bronchodilator, clenbuterol, with salbutamol and placebo has been made during a 24 day period of out-patient treatment of 19 adults with moderately severe asthma. Oral clenbuterol (10 µg 3 times a day) and salbutamol (4 mg 3 times a day) were equally and significantly (p<0.001) more effective than placebo, when daily records of peak expiratory flow or use of isoprenaline inhalations were the criteria of activity. Daily records of symptoms according to a questionnaire also suggested relief of the subjective effects of asthma during treatment with both active drugs (p<0.01).     

Intestinal permeability to mannitol and lactulose in children with type 1 diabetes with the HLA-DQB1*02 allele

Food antigens and enteroviruses are possible triggers of type 1 diabetes. Because permeability of the intestinal epithelium may facilitate contact of these antigens with the mucosal immune system, we set out to study intestinal permeability in patients with type 1 diabetes. Children with type 1 diabetes (n = 26, mean age 12 years, mean duration of disease 4 years) and 24 healthy age-matched control children were given mannitol and lactulose orally, and their intestinal permeability was measured as a percentage of this dose recovered in urine. Patients with type 1 diabetes did not differ in their permeability to lactulose, nor was their lactulose/mannitol ratio any different from that of controls. However, patients with type 1 diabetes who had the HLA-DQB 1*02 allele and, therefore, a higher risk for celiac disease (CD) absorbed significantly more mannitol (mean + 95% CI): 17.7% (15.2-20.2) than did those negative for this allele: 12.3% (8.2-16.4), p = 0.04. Their lactulose permeability was also higher: 0.30 (0.16-0.44) and 0.09% (0-0.18), respectively, p = 0.02. Although the differences in permeability reach statistical significance, there was still much overlap between the two groups in terms of actual laboratory values. The higher permeability of patients with the HLA-DQB1*02 allele suggests that these patients may be more prone to develop abnormal immune responses to food antigens.     

Inhaled procaterol versus salbutamol in bronchial asthma

Summary Procaterol is a new, potent, long-acting beta-2-adrenergic bronchodilator. The magnitude and duration of the immediate bronchodilatation produced by inhaled procaterol aerosol have been compared with those produced by inhaled salbutamol aerosol in 20 asthmatic patients. Patients inhaled two puffs of procaterol (20 g) or two puffs of salbutamol (200 g) and PEF, FVC and FEV₁ were measured after 5, 15, 30, 60, 120 and 180 min.The changes in mean PEF, FEV₁ and FVC values were greater after procaterol than salbutamol, but the difference in bronchodilatation was not significant. The response to rimiterol after 180 min was greater in the salbutamol group. The increases in heart rate and systolic blood pressure were slightly higher after procaterol. Eleven patients reported adverse effects; 5 after procaterol, 3 after salbutamol, and 3 after both drugs. Thus, procaterol was a potent bronchodilator when inhaled as a single dose of 20 g, but it did not appear to be an ultra long-acting preparation.     

Lower Limb Revascularization and Free Flap Transfer for Major Ischemic Tissue Loss

The objective of this study was to assess the value of lower limb revascularization and free flap transfer (LLR-FFT) in the management of critical leg ischemia and major tissue loss. A total of 29 consecutive patients with critically ischemic leg and major tissue loss underwent 24 simultaneous and 6 staged LLR-FFT procedures. The main outcome measures were bypass graft patency, free flap viability, leg salvage, patients alive with salvaged leg, and survival. At the 2-year follow-up, the bypass graft patency rate was 85%, secondary free flap viability rate was 82%, and 82% of patients achieved leg salvage and were ambulant. If the success was defined as patients being alive with a salvaged leg, the corresponding rate was 80%. Three patients achieved long-term primary patency and leg salvage despite free flap failure, which occurred during the 30-day postoperative period. Lower extremity revascularization plus free flap coverage of large ischemic lesions is valuable in achieving long-term leg salvage. Because revascularization and conventional management of major tissue loss alone can be effective in the management of a small number of cases, staged LLR-FFT is indicated, when appropriate, for better selection of patients undergoing such an aggressive and demanding treatment.