Five-year prognosis for dysthymic disorder in old age

The 5-year prognosis for 199 elderly patients (60 yr+) suffering from dysthymic disorder is described. Twenty-nine per cent of the men and 39% of the women recovered, 26% of both were suffering from depression after 5 years, 9% of both had a possible dementia, 32% of the men and 22% of the women had died and 3% of the men and 5% of the women could not be contacted. The outcome did not differ between the sexes or age groups. A poor prognosis among men was related to a low educational level, a non-independent previous occupation, the occurrence of depression previously, a high number of hobbies and the following depressive symptoms: initial and delayed insomnia, retardation and psychomotor agitation. A poor prognosis was also found for those whose functional capacities, hobbies or emotional relations with their wives had declined or who had experienced a pulmonary disease or few or no social growth events during the follow-up. A poor prognosis among women was related to low self-perceived health, high sum score of the Hamilton Rating Scale for Depression, thyroid disorder and the following depressive symptoms: loss of libido and diurnal variation of symptoms. A poor prognosis was also found for those whose physical health, functional capacities, social participation rate or hobbies had declined or who had experienced a serious disease during the follow-up. A favourable prognosis was found for women who moved to live alone or became more active in taking physical exercise.     

Interferon-gamma protects human endothelial cells from lymphokine-activated killer cell-mediated lysis

In adoptive immunotherapy the lymphokine-activated killer (LAK) cells, known to be cytotoxic to many tumor cell lines, are injected i.v. into tumor-bearing animals or cancer patients. However, in addition to a significant reduction in tumor masses, complications occur in many cases, most severe of which are the vascular leak syndrome and hypotension. In this report we show that LAK cells are also cytotoxic to normal vascular endothelial cells, which may partly contribute to these complications. Incubation of the endothelial cells with interferon-gamma (IFN-gamma), but not with interleukin 1 (IL 1) or tumor necrosis factor, protects the endothelial cells from LAK-mediated lysis in a dose- and time-dependent manner. The protective effect is abolished by monoclonal antibody against IFN-gamma. However, the IFN-gamma treatment does not protect LAK-sensitive tumor cell lines from LAK-mediated lysis. Concomitantly IFN-gamma also induces both class I and class II antigens on endothelial cells. The induction of these major histocompatibility complex (MHC) antigens does not explain the protective effect: timewise, the protection is complete already within 24 h after addition of IFN-gamma to endothelial cell culture, whereas the induction of MHC antigens peaks at 72 h, and antibodies against these antigens are not able to abolish the protective effect.     

Effectiveness of the Alcohol Use Disorders Identification Test in Occupational Health Screenings

This study evaluated the effectiveness of the 10-item Alcohol Use Disorders Identification Test (AUDIT) among occupational health screenings. AUDIT was available from 32 male and 93 female employees, mainly of academic organizations; 22 alcoholic men reporting to treatment at a detoxification clinic served as a reference group. Two other structured questionnaires, the Malmö modified Michigan Alcoholism Screening Test (Mm-MAST) and the CAGE, were compared with the AUDIT, and comparisons were also made to the self-reported weekly alcohol consumption. The total score on the AUDIT correlated equally with the self-reported alcohol consumption, especially when the alcoholics were excluded ( r = 0.73, p < 0.001) as the Mm-MAST ( r = 0.58, p < 0.001) and CAGE ( r = 0.33, p = 0.005). All three questionnaires were good at detecting male alcoholics: using the cut-off point of at least 8 positive answers on the AUDIT, 3 on the Mm-MAST, and 3 on the CAGE. The sensitivities were 100%, 100%, and 91%, respectively. In the AUDIT, however, there was a clearer difference related to the cut-off level than with the Mm-MAST and CAGE. With the cut-off of 8 points, 31% of the male and 11 % of the female employees were classified as suspect heavy drinkers. The AUDIT was significantly more often accurate than the two other questionnaires, especially among female employees in detecting suspect early-phase heavy drinkers and thus seems to be suitable for health screenings.     

Angiotensin-converting enzyme genotypes in the high- and low-risk area for coronary heart disease in Finland

The deletion/deletion genotype of the insertion (I)/deletion (D) polymorphism of the angiotensin-converting enzyme (ACE) gene has been suggested to be a risk factor for myocardial infarction (MI). The objective of this study was to evaluate whether genotypic distributions of the I/D polymorphism of the ACE gene are different between individuals from high-risk and low-risk areas for coronary heart disease in the genetically isolated population of Finland and to assess the impact of this genetic risk factor by comparing individuals with different parental histories of MI. Representative population-based samples of middle-aged men (n = 363) and women (n = 358) from two areas of Finland were used. The area had a borderline significant effect on the prevalence of the genotype DD (β = 0.35, SE = 0.16, χ² = 4.70, df = 1, P = 0.03), the DD genotype being more prevalent in eastern Finland (the high-risk area). The II genotype was more prevalent in women with parental history of MI, so we could not replicate the previous findings of the risk-increasing effect of DD genotype in this sample. Although the observed difference in the ACE DD genotype between the high-risk and low-risk areas for coronary heart disease might represent one of the genetic factors contributing to the difference in risk of coronary heart disease between eastern and southwestern Finland, the data emphasize the fact that also other risk factors, including other genes, contribute to this difference and the high incidence of MI in Finland. ©1995 Wiley-Liss, Inc.     

Bayesian oligogenic analysis of quantitative and qualitative traits in general pedigrees

A Bayesian method for multipoint oligogenic analysis of quantitative and qualitative traits is presented. This method can be applied to general pedigrees, which do not necessarily have to be “peelable” and can have large numbers of markers. The number of quantitative/qualitative trait loci (QTL), their map positions in the genome, and phenotypic effects (mode of inheritances) are all estimated simultaneously within the same framework. The summaries of the estimated parameters are based on the marginal posterior distributions that are obtained through Markov chain Monte Carlo (MCMC) methods. The method uses founder alleles together with segregation indicators in order to determine the genotypes of the trait loci of all individuals in the pedigree. To improve mixing properties of the sampler, we propose (1) joint sampling of map position and segregation indicators, (2) omitting data augmentation for untyped or uninformative markers (homozygous parent), and (3) updating several markers jointly within a single block. The performance of the method was tested with two replicate GAW10 data sets (considering two levels of available marker information). The results were concordant and similar to those presented earlier with other methods. These analyses clearly illustrate the utility and wide applicability of the method. Genet. Epidemiol. 21:224–242, 2001. © 2001 Wiley‐Liss, Inc.     

Slowing of electroencephalogram and choline acetyltransferase activity in post mortem frontal cortex in definite Alzheimer's disease.

Twenty-five (96%) of 26 patients with histologically verified moderate to severe Alzheimer's disease had abnormal electroencephalograms. The patients with the slowest (5-6 Hz) dominant occipital rhythms had significantly lower choline acetyltransferase activity in the post mortem frontal cortex than the patients with highest rhythm (8-9 Hz) (analysis of covariance adjusted for the neuropsychological test score). Concentrations of dopamine, noradrenaline or serotonin in the frontal cortex did not differ in the patient groups with the slowest and highest rhythms. Neither did scores of senile plaques or neurofibrillary tangles differ between these groups. In Alzheimer patients, the frequency of the dominant occipital rhythm correlated with the total score of the neuropsychological test (r = 0.58, P less than 0.01) and with the subscales of praxic functions and expressive speech, memory and general reasoning. The results suggest that the cholinergic deficit may contribute to the slowing of the electroencephalogram found in patients with Alzheimer's disease.     

Neuromagnetic responses from the second somatosensory cortex in man

Cerebral magnetic fields elicited by electric stimulation of peripheral nerves were studied in man. Responses were found over the Sylvian fissure at latencies of 95-125 ms for both contra- and ipsilateral stimuli. The field distribution indicated that the responses are generated in the second somatosensory cortex SII at the upper bank of the Sylvian fissure. These responses seem to provide the first non-invasive tool to study the function of SII in man.     

Shear bond strength of Bis-GMA resin and methacrylated dendrimer resins on silanized titanium substrate.

OBJECTIVES: The study compared the bond strengths of three resins, Bis-GMA and two novel experimental methacrylated polyester dendrimer resins to grit-blasted titanium substrate with three silanes. METHODS: Two commercial dental silanes (ESPE Sil and Monobond-S) and an experimental 0.5 vol% 3-methacryloxypropyltrimethoxysilane were applied to grit-blasted Ti substrates. Light-polymerizable resins of Bis-GMA and methacrylated dendrimer were applied to the grit-blasted Ti substrate with polyethylene molds. The substrates with resin stubs (n = 10) were thermocycled (6000 cycles, 5-55 degrees C) or kept in water (37 degrees C, 24 h). The shear bond strength of the resin was measured at a crosshead speed of 1.0 mm min(-1). The surface examination, before and after silanization, was made with a scanning electron microscope (SEM). The silane reactions on the Ti surface were monitored by Fourier transform infrared spectrometry. RESULTS: Statistical analysis (ANOVA) showed that the highest shear bond for thermocycled samples was obtained for Bis-GMA with Monobond-S (19.4 MPa, standard deviation (SD) 7.1 MPa), and after water storage with a laboratory-made silane (26.4 MPa, SD 8.1 MPa). The dendrimer and Bis-GMA resins conferred equal bonding properties to grit-blasted titanium after thermocycling. The silane, resin type, and storage conditions significantly affected the shear bond strength (p < 0.001 for all factors). SEM images suggested a mainly cohesive type of bonding failure. SIGNIFICANCE: A dendrimer based resin and the Bis-GMA resin systems conferred statistically equivalent bonding properties to silica-coated Ti after thermocycling.     

Femoral neck structure in adult female athletes subjected to different loading modalities.

Loading modality is a strong external determinant of structure and concomitant strength of the femoral neck. Particularly effective seem to be loadings, which arise from high impacts or impacts from atypical loading directions. INTRODUCTION: Physical loading plays an important role, not only in the process of bone modeling and remodeling, but also in shaping a mechanically appropriate bone structure. This study aimed at testing the hypothesis that the type of loading partly determines the femoral neck structure. MATERIALS AND METHODS: A total of 255 premenopausal female athletes representing volleyball, hurdling, squash-playing, soccer, speed skating, step aerobics, weight-lifting, orienteering, cross-country skiing, cycling, and swimming and their 30 nonathletic counterparts were measured with DXA. Besides the conventional areal BMD (aBMD) of the femoral neck, the hip structure analysis (HSA) was used to estimate the cross-sectional area (CSA), subperiosteal width (W), and section modulus (Z, an index of bone strength) at the narrowest section of the femoral neck. Also, training history, muscle strength, and calcium intake were assessed. The above-mentioned sports were classified according to the type of loading they apparently produce at the hip region; that is, high-impact loading (volleyball, hurdling), odd-impact loading (squash-playing, soccer, speed-skating, step aerobics), high-magnitude loading (weightlifting), low-impact loading (orienteering, cross-country skiing), and nonimpact loading (swimming, cycling). RESULTS: High-impact and odd-impact loading sports were associated with the highest age-, weight-, and height-adjusted aBMD (23% and 29% higher values compared to nonathletic referents), CSA (22% and 27%), and Z (22% and 26%). In contrast, repetitive, nonimpact loading sports were not associated with any clear benefit in any bone value compared with the referents. The W at the narrowest femoral neck section was similar in all groups. Body height and weight accounted virtually for one-half of the variation in Z, whereas the type of loading predicted 13% of the total variation of this variable-clearly more than the 2% attributable to isometric leg extension strength. Both high-impact and odd-impact loading modalities were associated with a large benefit in Z, corresponding to >1 SD in the reference group, whereas repetitive, low-impact loading showed a benefit that was only one-half of that. Surprisingly, high-magnitude loading (weightlifting) was not associated with a statistically significant increase in Z. CONCLUSION: We conclude that mechanical loading and its modality are strong external determinants of structure and concomitant strength of the femoral neck. Particularly effective seem to be loadings, which arise from high impacts or impacts from atypical loading directions.