Neuronal nitric oxide synthase immunoreactivity in the nasal mucosa of patients with idiopathic and allergic rhinitis

The localization of neuronal nitric oxide synthase (nNOS) in the mucosa of the inferior and middle turbinates of 30 patients with and without allergic rhinitis was examined by immunohistochemical methods. Staining of paraffin sections from allergic and nonallergic patients revealed nNOS immunoreactivity (nNOS-IR) in the muscular layer of vessels, in the basal portion of submucosal glands and in the periost and the osteocytes of the turbinate bones. In contrast to earlier investigations, nNOS-IR was also seen in the nasal respiratory epithelium of allergic and nonallergic patients. The immunostaining of sections of submucosal glands from allergic patients was stronger than that of sections from patients with idiopathic rhinitis or patients with no nasal obstruction. The present result - nNOS-IR around glands is elevated in patients with allergic rhinitis - could indicate that this enzyme is involved in the pathogenesis and symptomatology of allergic rhinitis.     

Improvement of autoimmune hepatitis during pregnancy followed by flare-up after delivery

OBJECTIVES: Pregnancy in autoimmune hepatitis has been a rare event, but it has become more frequent with improved therapy. The present study aimed to analyze the consequences for mother and child in patients with autoimmune hepatitis. METHODS: Fourteen pregnancies have been followed in five patients with autoimmune chronic hepatitis (AIH) and in one with autoimmune sclerosing cholangitis (overlap AIH-PSC). RESULTS: Features of AIH improved markedly from the second trimester of pregnancy onward, allowing a decrease in immunosuppressive therapy. After delivery (or stillbirth in one patient), the activity of the autoimmune disease flared up rapidly in 12 of 14 events. CONCLUSIONS: Pregnancy induces a state of immune tolerance with improvement of the liver tests in AIH. This could result from a transition of TH1 to TH2 predominance during pregnancy. A flare-up often occurs after delivery. Preemptive increase of the immunosuppressive therapy is therefore advocated consecutive to delivery. Azathioprine use seems to be safe during pregnancy.     

The influence of handling and isolation postweaning on open field,exploratory and maternal behavior of female rats

Fifty-three black-hooded female rats, raised from the 28th to the 128th day of life under four types of environmental conditions differing in social and handling factors, had their behavioral performance evaluated in eight tests involving exploration of a complex environment (EX) in two open field (OF) tests and in three pup-retrieving tests. These tests were held before, during and after the period of lactation of their first brood. Females differed from (previously studied) males in that environmental raising conditions had a much smaller influence, especially during the lactation period. Nevertheless, females raised in isolation tended to remain for longer times inside a protected den in the exploration tests and to have greater locomotion in the open field. Previous handling allowed a greater exploration during the first contact with the novel complex environment as well as greater activity in the open field. The presence of small pups drastically reduced the exploratory motivation, but the presence of pups more than 20 days old tended to increase it. Maternal behavior evaluated in the pup retrieval test and in the test of time for the female to leave the nest side of the double box system was markedly refractory to previous environmental influences.     

Abnormal pulp calcification in primary molars after fluoride supplementation

Forty-five caries-free primary molars from children with continuous fluoride supplementation (n = 28) after birth and from children without fluoride prophylaxis (n = 17) were investigated by light microscopy. The following results were obtained: The prophylaxis group evidenced a special form of calcification consisting of fibrodentin-like hard tissue developing intramurally in the dentin wall especially at the pulp floor and spreading irregularily into the pulp cavity by displacing the degenerating pulp tissue (n = 24). These teeth were ankylosed in the bi- and trifurcation area as well as inside the roots. This kind of hard tissue was not observed in the teeth from untreated children. Only 5 children had greater calcifications attached at the pulp wall. Nevertheless, this difference was statistically significant (p = 0.001) and indicates a relationship between fluoride prophylaxis, the special form of pulp calcification and tooth ankylosis.     

Short-term safety and efficacy of human GH replacement therapy in 595 adults with GH deficiency: a comparison of two dosage algorithms

The aim of GH replacement therapy in GH-deficient adults is to optimize response with minimum incidence of adverse reactions, but optimal therapy regimens are still to be established. This two-arm parallel study examined effects of two GH dose algorithms in adults with GH deficiency of adult or childhood onset. Patients on low dose (LD; n = 302) received GH at 3 microg/kg per day for 3 months increasing to 6 microg/kg per day for 3 months, and those on conventional dose (CD; n = 293) started on 6 microg/kg per day for 3 months increasing to 12 microg/kg per day for 3 months. The proportion of patients completing therapy was greater for the LD group than the CD group for the first 3 months (93.0% vs. 88.1%; P = 0.037) and overall for the 6 months (90.7% vs. 84.0%; P = 0.013). Both dose groups showed significant increases in lean body mass and decreases in fat mass for all time points. Percent increase in lean body mass was less with LD than CD over the first 3 months (2.43 +/- 4.33 vs. 3.58 +/- 4.69%; P = 0.006) but not overall for the 6-month period (4.38% +/- 5.34% vs. 5.21% +/- 5.99%; P = 0.141). Percent decrease in fat mass was less with LD than CD for the first 3 months (-2.81% +/- 7.81% vs. -5.53% +/- 8.64%; P < 0.001) and overall for the 6-month period (-6.35% +/- 9.42% vs. -9.45% +/- 12.07%; P = 0.006). IGF-I SD score increased less with LD than CD for 0 to 3 and 0 to 6 months, although for IGF-binding protein-3 SD score, there was no significant difference between doses at any time. Arthralgia was the only adverse event that occurred significantly less frequently with LD than with CD. Calculated changes based on gender and onset indicated greater changes in males than females for body composition, but there was little difference in GH-related adverse events between males and females. The lower starting dose with dose titration appeared more favorable, but differences in response between genders and onset of GH deficiency need to be taken into account when setting an individual dose regimen.     

Intraarticular pathology of atraumatic shoulder dislocations. An arthroscopic study

AIM OF THE STUDY: According to the literature, atraumatic shoulder dislocations occur without or only minor trauma,self-reduction and no or little pain.Little is known about intraarticular pathology in this entity.It was the purpose of our study to evaluate such findings. METHODS: During a 2-year period,226 patients had surgery for shoulder dislocation.28 patients met the criteria for atraumatic dislocation as above (group A).Patients with bony pathology or recurrent microtrauma were excluded. All had been treated with a rehabilitation program without success.28 consecutive patients with surgery after posttraumatic dislocation served as a control group (group B). At the beginning of the surgery,arthroscopy was performed in all patients and the intraarticular findings were recorded.For the capsulo-labral pathology,we determined 3 types: type I had capsular elongation or scarring and included so called "non-Bankart-lesions"; type II had classic "Bankart"-lesions and type III more complex capsulo-labral lesions like e.g. "ALSPA"-lesions. RESULTS: The mean age in group A was 27.6 y and 26.2 y in group B.12 patients in group A and 5 in group B were female.The average no.of dislocations was 10 (1-30) or 9 (1-28), respectively.In group A we saw type I lesions in 11 patients (39.3%), type II lesions in 9 (32.1%) and type III lesions in 8 (28.6%) patients. In group B we found type I lesions in 8 (28.6%), type II lesions in 4 (14.3%) and type III lesions in 16 (57.1%) patients.Hill-Sachs lesions were found in 22 (78.6%) and 23 (82.1%) of the patients, respectively.Also, we saw chondral glenoid damage, cuff lesions and SLAP-lesions in both groups. CONCLUSION: The above mentioned criteria for atraumatic shoulder dislocation do not exclude intraarticular pathology comparable to posttraumatic cases, at least for patients, who do not respond to a conservative treatment. Besides the etiology, the given pathology must be considered for therapy.