The ADL Taxonomy - from Individual Categorical Data to Ordinal Categorical Data

The ADL taxonomy comprises 12 defined activities organized into actions from the easiest to the more demanding ones. The purpose of the study was to determine whether the actions in the activities have an ordered, categorical structure, and to compare the distribution of individuals at the levels within each activity in three different samples. Data were collected by occupational therapists from the following three samples: (i) persons 65 years or older with home help (n=684); (ii) patients from different fields of occupational therapy (n=373); and (iii) patients with stroke (n=226). This study shows that there is an ordered, categorical structure within each activity defined in the ADL-taxonomy. The median proportion error of scales was 4%. Some of the activities/actions were redefined and one action was excluded because of the concentration of errors. People living in their own homes had a significantly higher level of ability in all activities compared to the other groups. The ADL taxonomy can be used for evaluation at individual as well as group levels, as every single activity can be used as an ordered scale.     

Osseointegration of titanium with an antimicrobial nanostructured noble metal coating

Nanometer scale surface features on implants and prostheses can potentially be used to enhance osseointegration and may also add further functionalities, such as infection resistance, to the implant. In this study, a nanostructured noble metal coating consisting of palladium, gold and silver, never previously used in bone applications, was applied to machined titanium screws to evaluate osseointegration after 6 and 12 weeks in rabbit tibiae and femurs. Infection resistance was confirmed by in vitro adhesion test. A qualitatively and quantitatively similar in vivo bone response was observed for the coated and uncoated control screws, using histology, histomorphometry and electron microscopy. The bone-implant interface analysis revealed an extensive bone formation and direct bone-implant contact. These results demonstrate that the nanostructured noble metal coating with antimicrobial properties promotes osseointegration and may therefore be used to add extra implant functionality in the form of increased resistance to infection without the use of antibiotics.From the Clinical EditorThe authors of this paper demonstrate that nanostructured noble metal coating of implants and prostheses used in orthopedic procedures promotes osseointegration and may be used to add extra implant functionality in the form of increased resistance to infection without the use of antibiotics.     

Verschiedene Wirkmechanismen im teratologischen Experiment

Ohne Zusammenfassung     

Experimental human muscle pain and muscular hyperalgesia induced by combinations of serotonin and bradykinin.

In the present study, we assessed the muscle pain and possible development of muscular hyperalgesia to mechanical stimuli after two subsequent intramuscular infusions of serotonin (5-HT) and bradykinin (BKN). The pain intensity after the infusions was continuously scored on a visual analogue scale (VAS). The subjects drew the distribution of the pain areas on a map. Pressure pain thresholds (PPTs) and suprapressure pain thresholds (SPPTs) stimulations as 150% of the pre-infusion PPTs were assessed with a pressure algometer at the injection site (10 cm below the patella), at the ankle, and at the contralateral leg and ankle. Skin sensibility was assessed with a Von Frey hair at the same sites. This was done before and after an infusion into the tibialis anterior (TA) muscle on the right leg in ten volunteers. The first infusion in each combination was either serotonin (20 nmol) or isotonic saline (NaCl 0.9%). The second infusion was bradykinin (5 or 10 nmol) or isotonic saline. The two infusions were given over 20 s and separated by 3 min. The isotonic saline followed by BKN did not induce muscle pain or muscular hyperalgesia. However, the combination of 5-HT and BKN (10 nmol) produced: (1) significantly higher VAS scores (P < 0.05) compared with all other combinations; (2) significantly longer pain offset (P < 0.05) compared with the combinations of isotonic saline and BKN; (3) significantly lower PPTs at 5, 20, and 40 min post-infusion (P < 0.05) compared with baseline PPT and PPTs after all other combinations. Cutaneous sensibility to mechanical stimuli and SPPTs were not affected by any of the combinations. The combinations of serotonin and bradykinin produce experimental muscle pain and muscular hyperalgesia to mechanical stimuli. Pre-treatment with serotonin may enhance the effect of bradykinin in the generation of muscle pain and muscular hyperalgesia in humans.     

Processing of laser-Doppler signals from free flaps.

As conventional graphical laser-Doppler flowmetric (LDF) registrations from free flaps are difficult to interpret we explored the use of refined computerized signal processing to enhance the reliability of the blood flow supervision postoperatively. From eleven free flaps LDF data were collected using a software programme and a personal computer for analysis. Findings were compared with the clinical outcome. Nine flaps healed whereas one had wound problems and one suffered a partial necrosis. From the nine uneventful flaps, a peak within the range of frequencies from 0.04 to 0.23 Hz was seen. In the remaining two, such a low frequency peak could hardly be observed. Frequency analysis using computerized processing of LDF signals thus has the capacity to demonstrate the status of the flap perfusion. The slow wave vasomotion component seems to be of particular importance. Other frequency components warrant further investigation. A custom made monitoring device would be of great clinical value.     

Un cas de pyohémie,de concert avec une méningite aiguë et des arthrites,provoquée par le bacille de Pfeiffer.

La moitié de tous les cas de pleurésie se rencontrent de 16 à 25 ans. Dans notre statistique la morbidité et la mortalité par tuberculose après la pleurésie sont plus faibles que dans celle de Köster, mais plus élevées que dans celle des sociétés d'assurances. La morbidité par tuberculose est surtout élevée dans les trois premières années qui suivent la pleurésie (10.2 %, 4.4 % et 4.2 %); la mortalité l'est surtout pendant les quatre premières années (de 2.8 à 1.7 %). La mortalité de la tuberculose consécutive à la pleurésie est plus faible chez les enfants que chez les adultes. Les grands épanchements s'accompagnent d'une fièvre plus prolongée et sont suivis de tuberculose plus souvent que les exsudats moins abondants et les pleurésies sèches. L'infection d'origine familiale ou domiciliaire est d'une fréquence égale aussi bien chez les individus demeurés ultérieurement bien portants que chez ceux devenus tuberculeux; il en est de měme pour les différentes formes de pleurésie. La pleurésie débute plus souvent en mars—mai que dans les autres mois (carence de vitamines?).     

Fluorescence monitoring of a topically applied liposomal Temoporfin formulation and photodynamic therapy of nonpigmented skin malignancies.

Meso-tetra(hydroxyphenyl)chlorin (mTHPC) (INN: Temoporfin) is a potent photodynamically active substance in clinical use today. Usually, the substance is given systemically and a known drawback with this administration route is a prolonged skin light sensitization. For the first time to our knowledge, a liposomal Temoporfin gel formulation for topical application was studied in connection with photodynamic therapy (PDT) of nonpigmented skin malignancies in humans. Intervals of 4 hr between drug administration and light irradiation were used. Sensitizer distribution within tumor and surrounding normal skin was investigated by means of point monitoring and imaging fluorescence spectroscopy before, during, and after PDT, showing high tumor selectivity. Furthermore, the bleaching of Temoporfin was studied during the PDT procedure by monitoring the fluorescence following excitation by using a therapeutic light. A 30-35% light-induced photometabolization was shown. No pain occurred during or after treatment. It was also observed that the treated area did not show any swollen tissue or reddening, as is often seen in PDT using topical delta-aminolevulinic acid. On controlling the patients one week after treatment, healing progress was observed in several patients and no complications were registered.     

Individual quality of life in schizophrenic patients – description and applicability of GRIDQoL in a computer‐based version

The measurement of individual quality of life in patients with schizophrenia has been limited to clinician‐rated instruments. The repertory grid is a clinician‐assisted method to measure individual quality of life that has been found to be more sensitive than questionnaires in a clinical trial with patients with anxiety. In this pilot study the applicability of the GRIDQoL repertory grid method was evaluated in patients with schizophrenia. Free personal constructs were elicited at the first visit using the GRIDQoL technique, a semi‐structured interview technique whereby the clinician helps the patient to develop his or her personal quality of life scale. The fixed psychological constructs were based on the PCASEE index. The results showed that the PCASEE index was adequate with respect to the fixed GRIDQoL constructs. The free constructs were illustrated for a selected patient, including the factor scores as outcome measures. In total 73% of the patients, who fulfilled the inclusion criteria, were willing and able to test their quality of life. The results of this pilot study support further development of the GRIDQoL module for schizophrenic patients. Copyright © 2001 Whurr Publishers Ltd.     

The synthesis of metoprolol monitored using Raman spectroscopy and chemometrics.

The synthesis of Metoprolol base was studied using Raman spectroscopy with a 785-nm laser, optical fibres, a holographic transmission grating, confocal optics and a charge-coupled device (CCD) detector. The reaction mixture was heated according to a temperature gradient and spectra of the reaction mixture were obtained by focusing the laser beam through ordinary reaction flasks. Because of overlapping bands, multivariate techniques such as principal components analysis (PCA) and partial least-squares projections to latent structures (PLS) were used in the evaluation of the obtained spectra. The use of PCA or PLS against time does not require any calibration samples and a quantitative calibration is not necessary in order to monitor the reaction. A method for reaction endpoint determination, based on euclidean distances in the score space, is presented. The use of multivariate batch control charts have been demonstrated and a number of problems and solutions regarding the sample presentation have been discussed. The effect of spectral pretreatment on the multivariate results is shown and discussed. The monitoring results show that the time to produce Metoprolol base could be reduced.