Challenges of current geriatric education-inspired by the Nordic geriatric professors' meetings

Geriatric educators are faced with several different challenges. The rapid growth of aged population in the Western world has led to a growing need for health and social services and thus, an increased need for trained professionals in this field. In addition, new learning theories and activating learning methods have achieved wide acceptance in academic medicine. How has geriatric education applied these new learning methods? In this article we review the current status of academic geriatric education in Western countries in these respects. We especially review the literature of how geriatric training has been experimenting with the new learning methods.     

Glabellar rhytids in thyroid-associated orbitopathy

PURPOSE: To correlate the presence and severity of glabellar rhytids with disease severity in patients with thyroid-associated orbitopathy (TAO). METHODS: Retrospective, noncomparative medical record review of 113 consecutive new patient visits with the clinical diagnosis of TAO. Ocular examination features studied included assessment of visual acuity, optic nerve appearance and function, proptosis, strabismus, eyelid position, and exposure keratopathy. These features were correlated with graded clinical photographs evaluating rhytid severity using the Fisher exact text. RESULTS: Eighty of 97 patients included in the study (82.5%) had glabellar rhytids. Eyelid retraction was present in 95 of the 97 patients (98%). Patients with diplopia had more severe rhytids (p < 0.05). Patients with at least three abnormal clinical findings tended to have more severe rhytids. CONCLUSIONS: Glabellar rhytids are a common finding in patients with TAO, and tend to be present in patients with diplopia and multiple stigmata of the disease.     

ELISA for quantitation of tumor necrosis factor-α in serum

A sensitive and precise ELISA has been developed for the quantitation of recombinant Tumor Necrosis Factor-Alpha (rTNF-α) in undiluted sera. Affinity purified rabbit antibody was used as capture antibody and mouse monoclonal antibody labelled with horseradish peroxidase was used as the second antibody in a sandwich ELISA. The assay range was from 50 to 2000 pg/ml and the relative standard deviation was 8% or less for both interassay and intra-assay precision studies. Recovery of rTNF-α added to 10 different human and 10 different monkey sera ranged from 81 to 102% and 100 to 120% of the expected value, respectively.This ELISA has been used to measure serum rTNF-α levels in over 60 patients in Phase I Clinical Trials treated with rTNF-α. The levels in a representative, pharmacokinetic study showed low variability between 8 patients receiving intravenous bolus administration of 100 μ rTNF-α/m². The ELISA results correlated well with TNF bioassay data with a mean specific activity of 2.5 × 10⁷ U/mg.     

Intracellular alterations of the creatine kinase isoforms in brains of schizophrenic patients

Postmortem brain tissues of schizophrenic patients were found to contain 5–10 times less water-soluble creatine kinase (BB CK) and 1.5–3 times less mitochondrial creatine kinase as compared to control. The major part of BB CK in schizophrenic brain tissues, contrary to control, was found to be insoluble in water (particulate form of BB CK) and could be extracted from brain tissue with strong denaturating agents. The particulate form of BB CK did not have any enzymatic activity but activity was found after the solubilization of this isoenzyme. The observed BB CK translocation into the particulate inactive form and the decrease of mitochondrial CK content to schizophrenic brains may reflect changes in the synthesis and the utilization of creatine phosphate.     

Immunochemical studies on gastrins in the urine.

The concentration and molecular form of gastrin in urine were determined radioimmunochemically. Urine from hypergastrinaemic patients (Zollinger-Ellison syndrome and pernicious anaemia) contained gastrins corresponding to the serum components I and II. The excretion of gastrin increased with increasing gastrin concentrations in serum. Urine from six subjects with normal concentrations of gastrin in serum contained "apparent" gastrin immunoreactivity which could not be removed by specific immunoabsorption. No gastrin was detectable by gel filtration of desalted and concentrated urine from normal subjects. The apparent immunoreactivity was due partly to interference by sodium chloride. The results indicate that hypergastrinaemic patients, in contrast to normal subjects, excrete gastrins in the urine.     

Effect of physical overloads on the state of the cardiomyocytes in experimental autoimmune cardiomyopathy]

Morphology and energetic processes in the myocardium of rats suffering from autoimmune cardiomyopathy, and their changes under the influence of physical load were studied. Chronic cardiac insufficiency in autoimmune cardiomyopathy is explained by a decreased level of adenosin triphosphate (ATP) and creatinphosphate (CP), death of some cardiomyocytes, atrophy of contractile myofilaments in the working cells and disorders at the level of micro circulation bed. Physical load resulted in the appearance of ultrastructural signs of acute cardiac insufficiency without significant changes in the initial low content of ATP and CP, but with a high total creatinphosphokinase activity. Such a reaction of cardiomyocytes of the heart to physical load in autoimmune cardiomyopathy is due to the disorders in the process of energy transportation at the level of mitochondrial crystae.     

Synergistic effects of cis-platinum and cytosine arabinoside on ovarian carcinoma cell lines, demonstrated by dual-parameter flow cytometry

Ovarian cancer tends to remain confined to the peritoneal cavity even after widespread dissemination. In order to test the in vitro cytotoxic effect of cis-platinum (CP) and cytosine arabinoside (ara-C), a combination which, in theory, is particularly suitable for intraperitoneal (IP) administration, ovarian cancer cells were exposed to each drug alone and in combination and then sampled serially for 336 hr with cell counts and flow cytometry (FCM). We used dual parameter FCM analysis to study changes in DNA and nuclear protein simultaneously. There was good correlation between the degree of cell kill noted in the counts and the duration of observed cytokinetic disturbances in all the treated series. CP and ara-C alone produced temporary cytotoxic and cytokinetic changes. Together, the two agents produced an enhanced CP effect which lasted 336 hr and was accompanied by continued evidence of cell kill in the counts. We conclude that CP and ara-C in vitro act synergistically on ovarian cancer to achieve a high level of cell kill after a single simultaneous application.