Trends in prevalence of atopic diseases and allergic sensitization in children in Eastern Germany.

Trends in prevalence of atopic diseases and allergic sensitization in children from Eastern Germany during the 1990s were analysed. The study consisted of three regional cross-sectional surveys of a total of 7,632 children (aged 5-14 yrs) in 1992-1993, 1995-1996, and 1998-1999. Information was gathered on atopic diseases and potential predictors by a parental questionnaire. Allergic sensitization for birch, grass, mite, cat, and cladosporium were assessed by radioallergosorbent test (RAST). After adjustment for age, sex and the study area of the participants, prevalence increased between the first and third survey for hay fever, for asthma and for atopic eczema. The adjusted prevalence of allergic sensitization (RAST > 0.35 kU x L(-1)) showed a decrease, whereas the prevalence of strong sensitization (RAST > or = 17.5 kU x L(-1)) increased significantly, specifically in cohorts born after 1989. Further adjustment for possible determinants of these atopic diseases did not change the trend estimates. A clear increase in the prevalence of atopic diseases, with the exception of hay fever, was observed as well as a shift towards a stronger allergic sensitization, which might affect the onset of clinical manifestations of atopic diseases. Differences in the epidemiology of respiratory symptoms, illnesses and allergies between populations living in the former East Germany and those living in the former West Germany have been reported. Among East German children, lower prevalence rates of asthma, and positive skin-prick tests were observed compared to West German children in the early 1990s. Similarly, among East German adults, lower specific immunoglobulin (Ig) E levels and lower prevalence rates of asthma, wheezing, positive methacholine-challenge tests, allergic rhinitis, and positive skin-prick tests have been reported compared to those of West German adults.     

Effects of stimulation of the centromedian nucleus of the thalamus on the activity of striatal cells in awake rhesus monkeys

Although the existence of a massive projection from the caudal intralaminar nuclei of the thalamus [i.e. the centromedian (CM) and parafascicular nuclei] to the striatum is well documented, the effects of CM activation upon striatal cells remain poorly understood. Therefore, we studied the effects of electrical stimulation of CM on the electrophysiological activity of striatal neurons, and on striatal levels of γ-aminobutyric acid (GABA) and acetylcholine in rhesus monkeys. Striatal cells did not respond to single-pulse stimulation (bipolar biphasic stimulation, 175–500 μA), but the large majority of recorded neurons responded to burst stimulation (100 Hz, 1 s, 150–175 μA) of CM, often with a delay of tens of milliseconds. Striatal phasically active neurons, which likely correspond to projection neurons, responded mainly with increases in firing (13/28 cells), while tonically active neurons (likely cholinergic interneurons) often showed combinations of increases and decreases in firing (24/46 cells). In microdialysis studies, CM stimulation led to a reduction of striatal acetylcholine levels. This effect was prevented by addition of the GABA-A receptor antagonist gabazine to the microdialysis fluid. We conclude that CM stimulation frequently results in striatal response patterns with excitatory and inhibitory components. Under the conditions chosen here, the specific patterns of striatal responses to CM stimulation are likely the result of striatal processing of thalamic inputs. Through these indirect effects, local CM stimulation may engage large portions of the striatum. These effects may be relevant in the interpretation of the therapeutic effects of CM stimulation for the treatment of neurological disorders.     

Epidemiologische Erforschung und ökonomische Bewertung gesundheitlicher Umweltrisiken

In environmental health research, methods for quantitative analysis of human population studies data are gaining importance. In recent years, it has been realized that they can also provide an important link to the economic view on environmental health effects. In this review, fundamental concepts and methods from environmental epidemiology and health economics are presented and it is shown how they can be linked in order to support environmental policy decisions. In addition, the characteristics of environmental epidemiology and the role of epidemiologic studies in risk assessment are discussed. From the economic point of view, cost-of-illness studies and cost effectiveness studies are the main approaches, and we have placed special focus on methods of monetary valuation of health effects that are generally proposed in the environmental context. Two conceptually differing strategies to combine epidemiologic and economic evidence are presented: the environmental attributable fraction model as a top-down approach and the impact pathway approach which follows a bottom-up analysis strategy. Finally, two examples are used to illustrate the application of these concepts and methods: health risks caused by fine particle air pollution and their costs, and the cost-effectiveness of radon exposure reduction policies.     

Effect of metabotropic glutamate receptor activation on receptor-mediated cyclic AMP responses in primary cultures of rat striatal neurones

Co-activation of group I metabotropic glutamate (mGlu) receptors and adenosine receptors resulted in an augmented cyclic AMP response in primary cultures of rat striatal neurones. -glutamate and the selective group I agonist, (S)-dihydroxyphenylglycine (S-DHPG) evoked concentration-dependent potentiations of cyclic AMP accumulation stimulated by the adenosine receptor agonist, 5′-N-ethylcarboxamidoadenosine (NECA), with EC₅₀ values of 3.41±0.39 and 5.69±1.64 μM, respectively, and maximal augmentations of approximately 350% at concentrations of 100 μM. The S-DHPG potentiation was inhibited by group I mGlu receptor antagonists and a protein kinase C inhibitor, Ro 31-8220, implicating products of PI hydrolysis in this effect. Furthermore, -glutamate and S-DHPG stimulated PI hydrolysis in striatal neuronal cultures with similar EC₅₀ values to those observed for the augmentation of NECA cyclic AMP responses (5.19±1.18 and 3.78±1.42 μM, respectively). In situ hybridization and immunofluorescence techniques indicate that group I mGlu receptor-evoked potentiations are likely to be mediated via mGlu₅ receptors, which are expressed at high levels in these cultures. In contrast to cross-chopped slices of neonatal rat striatum, of equivalent age, the group II mGlu receptor agonist, (2S,2′R,3′R)-2-(2′,3′-dicarboxycyclopropyl)glycine (DCG-IV) was without effect on NECA- or forskolin-stimulated cyclic AMP responses in primary striatal neuronal cultures. This lack of effect might be due to a low level of expression of group II mGlu receptors in cultured striatal neurones.     

Intensity of MR contrast enhancement does not correspond to clinical and electroneurographic findings in acute inflammatory facial nerve palsy.

PURPOSETo determine the value of MR contrast enhancement in predicting the course of acute inflammatory facial nerve palsy and in selecting patients for surgical decompression.METHODSSix patients with an acute inflammatory incomplete or complete peripheral facial nerve palsy (five idiopathic and one herpetic in origin) had repeated MR imaging studies with and without contrast enhancement, electroneurography, and clinical examinations to establish a connection between the intensity of contrast enhancement on MR images, the clinical condition, and the electrophysiological data. The examinations were performed every second day starting on the first day of admission until clinical recovery was proved by clinical deblockage (spontaneous clinical improvement). The last examination was performed 3 months after the onset of the facial nerve palsy.RESULTSAn abnormal, very intense contrast enhancement of the facial nerve was always present in the distal intrameatal and proximal tympanic segments and in the geniculate ganglion. The labyrinthine segment exhibited a mild to moderate enhancement, and the distal tympanic and mastoid segments showed a moderate to intense enhancement. The intensity of contrast enhancement did not correspond to the severity, duration, or course of the facial nerve palsy, and the electroneurographic data had no predictive value in indicating the severity of the inflammatory process. Three months after clinical recovery, a persistent and more or less unchanged or even slightly more intense contrast enhancement was observed.CONCLUSIONThe long-lasting intense contrast enhancement seen in the facial nerve segments of patients who have acute peripheral inflammatory facial nerve palsy is explained by a two-phase breakdown of the blood-nerve barrier.     

Is the prevalence of atopic diseases in East and West Germany already converging?

Studies comparing respiratory health of residents in the areas of former East and West Germany have shown higher rates of asthma and allergies in children and young adults in former West Germany. It has been speculated that some factors associated with western lifestyle may be related to higher rates of atopic diseases among residents of former West Germany. We examined if the prevalence rates of self-reported asthma and nasal allergies in adults converged between the areas of former East and West Germany five years after re-unification. During the years 1990–1992 and 1994–1995 two independently drawn random samples of more than 3,000 subjects between the ages of 20 to 44 years answered a screening questionnaire of the European Community Respiratory Health Survey in Erfurt (East Germany) and in Hamburg (West Germany). The prevalence rates of asthma attacks, asthma medication use, allergic rhinitis, and wheezing remained stable in Hamburg but increased significantly in Erfurt approaching those of Hamburg. The data indicate that there is a tendency for the prevalence rates of self-reported allergic rhinitis and asthma-related respiratory symptoms in the eastern part of Germany to increase to West-German levels. It is not yet clear if this is due to a true increase in morbidity or only to a higher awareness for these diseases among doctors and the public.