The relationship patterns questionnaire (RPQ): validation by using a representative sample

In this study the present form of the Relationship Patterns Questionnaire (RePat) will be presented as a successor of the Interpersonal Relationship Patterns Questionnaire (IRQ). Similar to the IRQ the RePat assesses the behavior of relationship concerning both one's own and the anticipated behavior of an important person on the basis of the SASB model and the CCRT method. In contrast to the IRQ, the RePat is much shorter and thus easier to use. The study describes the construction and the psychometric examination of the questionnaire by using a representative study (n = 2007, East = 1015, West = 992). The samples of East and West Germany show structural differences concerning its relationship patterns, which in our opinion are plausible for political and historical reasons. The clinical application and their implications for therapeutic interventions will be demonstrated by a single case using both the patient's and her partner's assessment of their relationship.     

Keratoacanthomas frequently show chromosomal aberrations as assessed by comparative genomic hybridization

Keratoacanthomas are commonly occurring benign skin lesions localized to sun-exposed areas. They typically develop rapidly and may show cellular atypia and infiltration like cutaneous squamous cell carcinomas, but they finally regress spontaneously. This benign lesion shows a high degree of genetic instability as assessed by comparative genomic hybridization, with 35.7% (25 of 70) of the analyzed lesions harboring chromosomal aberrations. The same frequency of genetic imbalance was found in lesions from immunosuppressed organ transplant recipients (36.4%, 20 of 55) and in patients with keratoacanthomas without immunosuppression (33.3%, five of 15), indicating a common pathway in both situations. Recurrent aberrations, given as a fraction of lesions with aberrations, were gains on 8q (20.0%), 1p and 9q (each 16.0%), and deletions on 3p (20.0%), 9p (20.0%), 19p (20.0%), and 19q (16.0%). Many of the most frequently appearing aberrations in keratoacanthomas were not detected in any of the 10 squamous cell carcinomas analyzed, whereas some aberrations were shared by both types of lesions. Aberrations were found in early and late stages of keratoacanthoma development, indicating a role for genetic instability in the progression as well as involution of keratoacanthomas. There were no significant correlations between cytologic atypia and genetic imbalance, or between degree of infiltration and genetic aberrations, although there was a trend for keratoacanthomas with severe atypia to have aberrations. Thus malignant phenotypic development does not appear to be driven by the detected genetic aberrations. More detailed studies of chromosomal areas with recurrent aberrations are needed for the localization of putative genes that determine the biologic behavior of keratoacanthomas, and that may distinguish them from squamous cell carcinomas.     

Verhalten DF32P-markierter Granulocyten nach homologer Übertragung bei vortransfundierten und nicht vortransfundierten Empfängern

Zusammenfassung Es wurde der Einfluß vorangegangener Transfusionen auf das Verhalten homolog übertragener Granulocyten geprüft. Dazu wurden mit Dextran angereicherte, DF³²P-markierte Granulocytenkonzentrate homolog neun vortransfundierten Patienten übertragen. Kontrolluntersuchungen wurden an insgesamt zehn nicht vortransfundierten gesunden Personen nach homologer und autologer Granulocytenübertragung durchgeführt. Die Zahl der peripher nachweisbaren übertragenen Granulocyten und die Effektivität der Transfusionen erwiesen sich bei der Gruppe der vortransfundierten Patienten als signifikant niedriger als bei den beiden Vergleichsgruppen.Studie im Rahmen des Assoziationsvertrages Hämatologie Euratom-GSUF No. 031-64-I BIAD und des Sonderforschungsbereiches 37 der Universität München.     

A non-living nasal influenza vaccine can induce major humoral and cellular immune responses in humans without the need for adjuvants

Twenty-eight healthy adult volunteers were immunized intranasally with an inactivated whole-virus influenza vaccine based on the strain A/New Caledonia/20/99 (H1N1), either in saline or mixed with formaldehyde-inactivated Bordetella pertussis as a mucosal adjuvant, or in a thixotropic vehicle with mucoadhesive properties. After four doses, all groups of vaccinees developed significant IgG- and IgA-antibody responses, measured by ELISA, in respectively serum and nasal secretions. None of the volunteers had demonstrable hemagglutination inhibition (HAI) antibodies in serum before being immunized, whereas more than 80% of them reached HAI titers>or=40, considered protective, after immunizations. In addition, cellular immune responses, measured as significant increases in CD4+ T-cell proliferation and granzyme B-producing cytotoxic T-cells, were detected against the vaccine strain as well as against heterologous virus strains (H3N2). However, no additive effect on these responses could be demonstrated with use of B. pertussis or the thixotropic substance in the present vaccines. It appeared, actually, that the mucoadhesive vehicle containing the thixotropic substance was less efficient than were the two other formulations. An influenza vaccine made as a simple particulate formulation of inactivated virus, and given repeatedly onto the nasal mucosa, may thus be an attractive alternative to currently available vaccines.     

Transductive Machine Learning for Reliable Medical Diagnostics

In the past decades Machine Learning tools have been successfully used in several medical diagnostic problems. While they often significantly outperform expert physicians (in terms of diagnostic accuracy, sensitivity, and specificity), they are mostly not being used in practice. One reason for this is that it is difficult to obtain an unbiased estimation of diagnoses reliability. We discuss how reliability of diagnoses is assessed in medical decision making and propose a general framework for reliability estimation in Machine Learning, based on transductive inference. We compare our approach with a usual (Machine Learning) probabilistic approach as well as with classical stepwise diagnostic process where reliability of diagnose is presented as its posttest probability. The proposed transductive approach is evaluated on several medical data sets from the UCI (University of California, Irvine) repository as well as on a practical problem of clinical diagnosis of the coronary artery disease. In all cases significant improvements over existing techniques are achieved.     

Influence of CARD15 mutations on disease activity and response to therapy in 65 pediatric Crohn patients from Saxony, Germany

OBJECTIVES: Certain genetic variants in the CARD15 gene are accompanied by an enhanced risk to develop Crohn disease with the main activity in the terminal ileum and ensuing stricturing early in life. The objective of this study was to evaluate the relation between CARD15 mutations and overall disease activity and response to therapy in pediatric patients. METHODS: 65 genomic DNA samples from such patients were tested for the presence of three main Crohn associated mutations in CARD15 by direct genomic sequencing. The number of mutations (none, one or two alleles affected) was correlated with body mass index and height, Pediatric Crohn Disease Activity Index, therapy and therapeutical success in terms of body mass index and Pediatric Crohn Disease Activity Index improvement. RESULTS: The authors found a nonsignificant trend of a lower body mass index and higher Pediatric Crohn Disease Activity Index in patients with CARD15 mutations. Physicians uninformed about their CARD15 status prescribed significantly more budesonide and prednisolone intermittently and more alimentary supplementation to these patients. The average improvement in terms of body mass index and Pediatric Crohn Disease Activity Index after 2 years of therapy was roughly similar in all patient groups. CONCLUSIONS: Pediatric Crohn patients with CARD15 mutations have a higher disease activity and need a more intensive therapy. With some exceptions, their medium-term response to therapy is nevertheless satisfying.