Different kinetics of lung clearance of technetium-99m labelled diethylene triamine penta-acetic acid in patients with sarcoidosis and smokers

The rate of clearance from the lungs of inhaled technetium-99m labelled diethylene triamine penta-acetic acid (^99mTc-DTPA) is often increased in interstitial lung disease as well as in smoking. In smokers a bi-exponential clearance course of ⁹⁹mTc-DTPA when measured over 3 h has previously been shown. This study was performed to compare the kinetics of clearance of ^99mTc-DTPA, measured for 3 h, in sarcoid patients and healthy smokers. Forty-one never-smoking patients with sarcoidosis and radiological signs of intrathoracic disease were studied. The results were compared with those of 16 healthy current smokers and of 14 healthy never-smokers reported previously. A mono-exponential clearance equation described the clearance in 22 of the sarcoid patients and all normal never-smokers, but with a shorter average tracer half-life in the patients (P<0.05). In 19 patients and all smokers a bi-exponential equation gave a significantly better curve fit. The rate of clearance of the slow component was higher in patients with sarcoidosis than in smokers (P< 0.05). The fraction of the tracer cleared by the fast clearance component was smaller in patients with sarcoidosis than in smokers (P<0.01). Differences in kinetics of clearance of ^99mTc-DTPA in sarcoidosis and smoking could thus be demonstrated, suggesting that the abnormal clearance is caused by diverging pathophysiological mechanisms.     

Mumpsimpfstoffe: Virologische Grundlagen

Zusammenfassung Nur attenuierte Lebendimpfstoffe haben sich bisher für die Prävention der Mumpsvirusinfektion als wirksam erwiesen. Die verschiedenen Impfstämme unterscheiden sich im. Grad ihrer Attenuierung, die schwer steuerbar ist. Der Grat zwischen Restvirulenz und Überattenuierung ist schmal. Wenig attenuierte Impfstämme zeigten zwar eine höhere Immunogenität, aber auch häufiger Impfkomplikationen. Heute werden nur noch relativ stark abgeschwächte Impfstämme verwendet, die zwar kaum je zu einer impfassoziierten Erkrankung führen, deren Immunogenität aber geringer sein dürfte als ursprünglich angenommen.

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Summary The prevention of mumps virus infection reties on the application of live, attenuated mumps virus vaccines. The process of attenuation from a wildtype mumps isolate to a safe vaccine has been empirical. A lower degree of attenuation results in solid immunity but carries an increased risk of post-vaccination meningitis due to the vaccine strain. Currently used vaccine strains are highly attenuated and essentially free of vaccine strain induced disease. However, their immunogenicity may be lower than previously reported.

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Résumé La prévention des oreillons est effectuée grâce aux vaccins contenant des virus ourliens vivants atténués. La différence entre un virus ourlien sauvage et un atténué est très petite. Un virus légèrement atténué engendre une forte immunité mais augmente le risque de développer des méningites postvaccinales. Actuellement on utilise des souches fortement atténuées qui ne font que très peu de complications mais dont l'immunogénicité semble plus faible que prévue.

     

Physicochemical aspects of drug release. XV. Investigation of diffusional transport in dissolution of suspended, sparingly soluble drugs

The dissolution rates of sparingly soluble, fine particulate, suspended drugs have been studied using a Coulter Counter Model TAII. For two sieve fractions of oxazepam the dissolution rates were monitored in media with varying viscosities brought about by the addition of glycerol, while for griseofulvin the change in the medium's viscosity was induced by changing the temperature. By calculating the dissolution rate, and compensating for differences in particle surface area and media solubility, it was shown that the dissolution rate was diffusion controlled. After additional normalization for the diffusion coefficient, it was suggested that the so-called apparent diffusional distance decreased substantially with particle size. The effect of particle size was more limited above approx. 15 μm.     

CAG repeat polymorphism within the KCNN3 gene is a significant contributor to susceptibility to anorexia nervosa: a case-control study of female patients and several ethnic groups in the Israeli Jewish population.

The human small-conductance Ca(2+)-activated potassium channel gene KCNN3 has been involved in mechanisms underlying neuronal function and plasticity. A multiallelic CAG repeat polymorphism within the KCNN3 has been associated with schizophrenia and bipolar disorder. We have previously reported in a family-based study that longer CAG repeats are preferentially transmitted to patients with anorexia nervosa (AN). The present study extends the analysis of KCNN3 allele distribution to a larger series of AN female patients and control groups, incorporating information on ethnicity and co-morbidities associated with AN. The data analysis is presented while considering separately the two alleles of each individual, namely a minor (shorter) and a major (longer) allele. This study has found that the KCNN3 allele distribution in the general Israeli population does not differ significantly in at least four Jewish ethnic groups of Ashkenazi, North African, Iraqi, and Yemenite origin. These have been used as control groups in a matched case-control analysis that has demonstrated a significant over-representation of KCNN3 alleles with longer CAG repeats among AN patients (P < 0.001 for the major allele and P = 0.035 for allele sum). Under dichotomization, a significantly higher prevalence of the L allele (>19 repeats) has been observed among AN patients (P < 0.001). While considering AN and co-morbid phenotypes, a tendency towards longer (L) alleles has been observed in the subset of patients with obsessive-compulsive disorder (OCD) co-morbidity. These findings further implicate KCNN3 as a significant contributor to predisposition to AN.     

Induction of antigen-specific isotype switching by in vitro immunization of human naive B lymphocytes

The use of in vitro immunization technology for the generation of human antigen-specific antibodies has essentially resulted in low affinity IgM antibodies, resembling an in vivo primary immune response. We now describe a detailed reproducible protocol for a two-step in vitro immunization, which yields isotype switched, antigen-specific human antibodies. The immunizing antigen was a 30aa synthetic peptide, containing both a B (15aa V3 peptide of the HIV-1) and a T helper cell epitope (15aa peptide from tetanus toxin). The immunization protocol includes: (i) a selection procedure of donors with a memory T cell response against tetatus toxoid; (ii) immunization of mature naive peripheral B lymphocytes in two distinct phases, involving a primary and a secondary step. None of the donors which were examined after primary 7immunization showed at any time an IgG anti-V3 specific antibody response, while all the donors showed an IgM response. After the secondary immunization step, anti-V3 antibodies of both IgM and IgG isotypes were detected. The switch frequency event was high among the tested donors (5/8).     

Radiologic long-term results after cervical vertebral interbody fusion with Polymethyl Methacrylat (PMMA)

Long-term results of cervical interbody fusion with PMMA were evaluated in a retrospective study. X-ray films of 83 patients were obtainable. Post-operative follow-up in this series was between 15 and 20 years. The results show that PMMA is engrafted after about 2 years. Stable vertebral interbody fusion is obtained in about 90% of cases. Development of malignoma was not observed. Resorptive bone alterations, which can be seen in about 2% of cases one to two years after operation are shown not to be progressive. This process heals and stable fusion develops.     

Testing for skin sensitization according to the notification procedure for new chemicals: the Magnusson and Kligman test

The notification procedure for new chemicals in the European Union (called the Chemicals Act in Germany) requires a skin sensitization test when the amount of a new chemical produced exceeds 100 kg/year. The preferred test is that of Magnusson and Kligman; more than 90% of the tests submitted are performed with it. Though the Magnusson and Kligman test is described in the literature, and in the test guidelines of the European Union and of the OECD, discrepancies do occur in the performance of the test between test laboratories. In this paper, recommendations are given for standardized performance of the Magnusson and Kligman test.     

Ruminative Response Style and Vulnerability to Episodes of Dysphoria: Gender, Neuroticism, and Episode Duration

A number of recent laboratory and prospectivefield studies suggest that the tendency to ruminateabout dysphoric moods is associated with more severe andpersistent negative emotional experiences (e.g., Morrow & Nolen-Hoeksema, 1990;Nolen-Hoeksema & Morrow, 1991). The current paperreports two studies that tested the hypotheses that (a)ruminative response styles act as a trait vulnerabilityto dysphoria, particularly to relativelypersistent episodes of dysphoria; (b) aspects ofrumination that are not likely to be contaminated withthe presence and severity of previous symptomatology(introspection/self-isolation, self-blame) demonstrate vulnerability effects;and (c) rumination mediates the effects of gender andneuroticism on vulnerability to dysphoria. Consistentsupport was found for each of these hypotheses. Overall, our data suggest that rumination mightreflect an important cognitive manifestation ofneuroticism that increases vulnerability to episodes ofpersistent dysphoria.     

Die Indikation für Veneninterponate bei der mikrochirurgischen Rekonstruktion komplexer Defekte der unteren Extremität nach Tumor und Trauma

Reconstructive microsurgery has become a routine procedure in plastic surgery. Success rates in major centers range between 95 and 98%. In selected “high risk” cases, vein grafts are required to facilitate microsurgical anastomoses, as in complex defects of the lower leg, post ischemic syndrome (PIS) or following major tumor resections. The indications and results of vein grafts or A-V loops are demonstrated in these three groups. 25 patients with defects of the lower leg were operated using vein interposition grafts. Ten A-V loops were created prior to flap transfer. Three flaps had to be revised, only one flap was lost due to recurrent arterial thromboembolism from an injured proximal segment. Data show that vein grafts are clinically reliable and may be used without hesitation in appropriate clinical situations.