Enhanced Mucosal Interleukin-6 and -8 in Helicobacter pylori-Positive Dyspeptic Patients

Objectives: To determine the concentrations of interleukin-1β, interieukin-6, and interieukin-8 in tissue homogenates of mucosal biopsy specimens from Helicobacter pylori-positive and -negative patients. Methods: In 43 consecutive patients who underwent upper gastrointestinal endoscopy, seven antral biopsies were taken; three specimens were used for cytokine determination and the remaining four biopsies were processed for H. pylori detection. Peripheral venous blood was collected and IgG to H. pylori was assayed by an ELISA technique. Results: Twenty-nine of 43 patients (67%) were histologically positive for H. pylori; all had chronic gastritis. The mucosal levels of interleukin-6 and interleukin-8 were significantly higher in H. pylori-positive patients than in the negative patients p < 0.001). A significantly higher percentage of interleukin-8 was found in patients colonized by H. pylori with active superficial chronic gastritis (85.7%), compared to quiescent superficial gastritis (12.5%) ( p < 0.01), and the median and range were, respectively, 400 (0–1000) and 0 (0–200) pg/mg protein (p < 0.001). In patients with active superficial gastritis, a significant correlation between interleukin-6 and -8 was found ( p 0.01). No difference was found regarding the mucosal levels of interleukin-lβ according to the presence of H. pylori. Conclusions: These results suggest a possible pathogenetic role for interleukin-6 and interleukin-8 in H. pylori -associated gastritis.     

Report from the Rockefellar Foundation Sponsored International Workshop on reducing mortality and improving quality of life in long-term survivors of Hodgkin's disease: July 9–16, 2003, Bellagio, Italy

Abstract:  A workshop, sponsored by the Rockefellar Foundation, was held between 9 to 16 July, 2003 to devise strategies to reduce mortality and improve quality of life of long-term survivors of Hodgkin's disease. Participants were selected for their clinical and research background on late effects after Hodgkin's disease therapy. Experts from both developed and developing nations were represented in the workshop, and efforts were made to ensure that the proposed strategies would be globally applicable whenever possible. The types of late complications, magnitude of the problem, contributing risk factors, methodology to assess the risk, and challenges faced by developing countries were presented. The main areas of late effects of Hodgkin's disease discussed were as follows: second malignancy, cardiac disease, infection, pulmonary dysfunction, endocrine abnormalities, and quality of life. This report summarizes the findings of the workshop, recommendations, and proposed research priorities in each of the above areas.     

Pseudo-drunk-patron evaluation of bar-staff compliance with Western Australian liquor law

Abstract: Compliance of bar staff with the Western Australian liquor law prohibiting service to drunk patrons was assessed through the deployment of actors trained to behave in a drunken manner. The serving practices of 23 licensed premises (19 hotels and four nightclubs) were examined. During 120 visits to hotel and nightclub bars, more than 350 drink orders were placed by pairs of pseudo-drunk actors who ordered up to three drinks each on each visit. On placing these drink orders, pseudo-drunks were refused service by bar staff on only 12 occasions. The rate of refusal of service across all premises was 10 per cent of visits. Partial interventions by servers, such as offering food or low-alcohol or nonalcoholic drinks, occurred in only four instances of the 120 visits. Qualitative observations and results obtained from a separate study examining a subsample of the servers who trained in responsible service of alcohol are discussed.     

Use of pseudo-patrons to assess compliance with laws regarding under-age drinking

Abstract: The extent to which door and bar staff of licensed premises responded to possibly under-age patrons was assessed through the use of research assistants (young pseudo-patrons) selected for having the appearance of being under 18 years old. A total of 156 visits were made to 13 licensed premises: 1. before delivery of a server training program, 2. immediately after training, and 3. after three months. Staff rarely checked the age and/or identification (ID) of the young pseudo-patrons before or after training. However, a significant interaction was found between the sex of the pseudo-patron and the type of premises. Door staff, who were predominantly at nightclubs, were more likely to check the ID of female pseudo-patrons and hotel bar staff were more likely to check the ID of males. In most cases, however, nonphotographic ID was accepted. While some strategies are suggested, the strongest and most effective measure to prevent under-age drinking will be a more rigorous enforcement of existing liquor laws.     

Stentless Porcine Bioprostheses in the Treatment of Aortic Valve Infective Endocarditis

Between January 1992 and June 1994, 23 patients underwent surgery for aortic valve endocarditis at the Department of Cardiovascular Surgery of the University of Verona; a subgroup of 10 patients underwent aortic valve replacement with a porcine stentless valve (Biocor LTDA n = 8; Toronto SPV n = 2). There were 7 males and 3 females with a mean age of 56.3 years (range, 36 to 73 years). Eight patients had active endocarditis and two had healed endocarditis. Nine patients had native valve in endocarditis, the presence of a bicuspid aortic valve in 2, and 1 patient had recurrent prosthetic valve endocarditis (PVE), 7 of whom were in New York Heart Association (NYHA) Functional Class IV. The main indications for operation were congestive cardiac failure, active sepsis, and presence of large and mobile vegetations by echo and arrhythmias. There were no operative or late mortalities in this subgroup of patients. Short-term survival is 100% at a mean follow-up time of 11.2 months (range, 4 to 18 months), with no recurrent endocarditis or valve-related complications.     

The effect of plaque control in subjects with shallow pockets and high prevalence of periodontal pathogens

Abstract In a previous study, it was shown that professional tooth cleaning 3X a week had a significant influence on the subgingival microbiota of shallow pockets. The purpose of this investigation was to study the effect of a single episode of full-mouth supragingival cleaning and oral hygiene instructions in subjects with minimal periodontal disease but high prevalence of putative periodontal pathogens. 10 subjects from Arabic countries, aged between 22 and 48 years, which had previously not been exposed to any dental care other than extractions and fillings, were selected for this trial. DNA probe analysis of subgingival samples, taken in the deepest pocket of each quadrant, showed presence of Porphyromonas gingivalis and Prevotella intermedia in all patients, and presence of Actinobacillus actinomycetemcomitans in 5 individuals. 85% of all samples were P. gingivalis-positive, 83% were positive for P. intermedia and 43% were A. actinomycetemcomitans-positive. 4 weeks after treatment, subgingival microbiological samples were again taken in the same sites. In 8 patients. P. gingivalis could still be detected after treatment. However, the number of P. gingivalis positive samples was reduced from 85% to 38%, and the bacterial counts in positive samples were markedly lower than at baseline. P. intermedia-positive samples were obtained from 7 patients after treatment. 33% of all samples were still positive, but showed markedly reduced bacterial counts. 4 patients still yielded A. actinomycetem comitans-positive samples after treatment. Here, the number of positive samples was reduced to 15%, and the bacterial counts were barely exceeding the detection limit. Concomitantly, the % of pockets deeper than 3 mm was reduced from 13% to 3% and the percentage of sites bleeding upon probing was reduced from 68% to 20%. This study demonstrated a considerable, although not maximal clinical and microbiological effect of supragingival plaque control in subjects with high prevalence of periodontal pathogens but minimal periodontal disease.     

Retrospective Analysis of the Effects of Psychotherapeutic Interventions on Outcomes of Psychogenic Nonepileptic Seizures

Summary: Purpose: Uncertainty exists regarding the effectiveness of psychotherapy in patients with psychogenic nonepileptic seizures (PNES). We retrospectively reviewed the outcomes of therapeutic interventions in a cohort of patients with PNES.
Methods: We identified patients with PNES by outpatient video-EEG (VEEG) between 1992 and 1996. We retrospectively analyzed the effects on outcomes of various types of interventions for PNES administered at random, using a structured interview and review of medical records. Patients with subjective events and severe psychosis were excluded. Patients who required inpatient monitoring because the outpatient VEEG was inconclusive were also excluded.
Results: One hundred patients were diagnosed with PNES between 1992 and 1996: 61 patients completed the study. The average age was 43.3 years, and 90% were female. Nine (15%) had had PNES <1 year, and 7 (11%) had epilepsy. Eleven of 16 patients (68%) who received five or more counseling sessions, including showing the videotaped recording of the nonepileptic spell (13 of 16) by the comprehensive epilepsy program (CEP) psychotherapist had cessation (7 of 16) or reduction (4 of 16) of their episodes. Eleven of 15 patients (73%) who received only the feedback and care of their CEP neurologists had similar favorable outcome. Twelve of 25 patients (48%) who received counseling by a non-CEP psychotherapist or psychiatrist had cessation (10 of 25) or reduction (2 of 25) of episodes. Five patients who received no feedback or intervention had no improvement (4 of 5) or worsening (1 of 5) of the PNES.
Conclusions: Psychotherapy or feedback provided by CEP professionals with experience in epilepsy and PNES improves outcome and may be superior to other or no interventions.     

Association study of Glutathione S-transferase P1 (GSTP1) with asthma and bronchial hyper-responsiveness in two German pediatric populations

Glutathione S-Transferase P1 ( GSTP1 ) is an important enzyme in the detoxification of products of oxidative stress. Several studies have shown an association of the amino acid variant Ile105Val with bronchial asthma and the reaction of the lung to inhalant pollutants. The aim of this study was to test the two known amino acid variants in GSTP1 for association with bronchial asthma and airway hyper-responsiveness in two German pediatric populations. We genotyped Ile105Val and Ala114Val in the Multicenter Allergy Study cohort (85 children with asthma, 123 controls) and asthmatic children from Freiburg (n = 178). We did not find association of either polymorphisms with bronchial asthma or airway hyper-responsiveness. We conclude from our data that polymorphisms within GSTP1 do not play a major role in the development of bronchial asthma in German children.     

Non-synaptic Localization of the Glutamate Transporter EAACI in Cultured Hippocampal Neurons

It has been postulated for several years that the high affinity neuronal glutamate uptake system plays a role in clearing glutamate from the synaptic cleft. Four different glutamate transporter subtypes are now identified, the major neuronal one being EAAC1. To be a good candidate for the reuptake of glutamate at the synaptic cleft, EAAC1 should be properly located at synapses, either at pre- or postsynaptic sites. We have investigated the distribution of EAAC1 in primary cultures of hippocampal neurons, which represent an advantageous model for the study of synaptogenesis and synaptic specializations. We have demonstrated that EAAC1 immunoreactivity is segregated in the somatodendritic compartment of fully differentiated hippocampal neurons, where it is localized in the dendritic shaft and in the spine neck, outside the area facing the active zone. No co-localization of EAAC1 immunoreactivity with the stainings produced by typical presynaptic and postsynaptic markers was ever observed, indicating that EAAC1 is not to be considered a synaptic protein. Accordingly, the developmental pattern of expression of EAAC1 was found to be different from that of typical synaptic markers. Moreover, EAAC1 was expressed in the somatodendritic compartment of hippocampal neurons already at stages preceding the formation of synaptic contacts, and was also expressed in GABAergic interneurons with identical subcellular distribution. Taken together, these data rule against a possible role for EAAC1 in the clearance of glutamate from within the cleft and in the regulation of its time in the synapse. They suggest an unconventional non-synaptic function of this high-affinity glutamate carrier, not restricted to glutamatergic fibres.