Hypersensitivity pneumonitis recognised by open lung biopsy in patients at the Institute of Tuberculosis and Lung Diseases

Diagnosis of hypersensitivity pneumonitis (HP) is made on the basis of a combination of clinical features connected with the exposition to organic dusts, radiographic abnormalities, lung function tests and immunological tests. Open lung biopsy (OLB) and histological examination is not necessary and is indicated mainly in chronic and subacute form of HP. In the chronic form of HP symptoms often do not show a temporal relationship with antigen exposure and errors occur especially if specific questions are not asked about exposure to antigen if HP. The aim of this paper was to analyse whether OLB was necessary in all patients in whom HP was recognised just after this procedure. Material included 21 patients in whom microscopic examination suggested HP among 258 pts in whom OLB was performed in the period of 1998-2003. There were 13 men and 8 women at the age of 18 to 65 years, mediana 42 years. RESULTS: We found 3 groups of pts. Group "+" included 9 exposed pts. They were asked and confirmed contact with birds, hay and 7 of them observed correlation between exposition and symptoms. The second Group "-" included 7 pts who were asked about exposition and who answered in the negative. In all of them HRCT scans suggested HP. Restriction was below 70% of VC in 3 pts. The third Group "0" included 5 pts who were not asked about exposition and correlation with symptoms. Two from them lived in the rural area. CONCLUSIONS: Open lung biopsy was not necessary for 6 patients in Group "+", because then had enough symptoms to recognise HP. In 3 patients of Group "+" and in 5 of Group "0" OLB could be not necessary because specific anamnesis and additional examinations were not collected. OLB was necessary method for 7 patients in Group "-".     

Congenital deficiency of alpha feto-protein

Alpha-fetoprotein (AFP) is the main fetus serum glycoprotein with a very low concentration in the adult. AFP deficiency is a rare phenomenon. We studied two families with congenital AFP deficiency and searched for mutations in the AFP gene. We identified one mutation of 2 base deletion in exon 8, in both families, that leads to the congenital deficiency of AFP. The mutation nt930-931delCT (T294fs25X) creates a frameshift after codon 294 that leads to a stop codon after 24 amino acids, thus truncating the normal length of AFP of 609 amino acids. All the affected children were found to be homozygous for the mutation as was one of the fathers. The affected individuals were asymptomatic and presented normal development. This first identification of a mutation in the AFP gene demonstrates for the first time that deficiency of AFP is compatible with human normal fetal development and further reproduction in males.     

Equipotential projection-based magnetic resonance electrical impedance tomography and experimental realization

In this study, a direct, fast image reconstruction algorithm, based on the fact that equipotential lines are perpendicular to current lines in a volume conductor, is proposed for magnetic resonance electrical impedance tomography (MR-EIT). The proposed technique is evaluated both on simulated and measured data for conductor and insulator objects.     

Attenuation of spinal transients at heel strike using viscoelastic heel insoles: an in vivo study

BACKGROUND: The transients introduced at heel strikes were linked with increased risk for low back pain. The present study was designed to monitor the transients acting on the spinal column at gait, and to find out whether said transients are attenuated by interposition of a viscoelastic heel insoles. METHODS: A lightweight (2 g) accelerometer was held against the forehead with an elastic strap. The subject was instructed to walk naturally along an 8-m rigid walkway with a built-in, high-frequency (<500 Hz) response Kistler force plate. Seven subjects, shod in leather-soled shoes, were studied sequentially without and with viscoelastic heel insoles (Viscoheel, Bauerfeind). Ground reaction force and vertical acceleration were simultaneously recorded. The data were analog-stored and analyzed with respect to time and frequency domains. RESULTS: Under the aforementioned conditions, the heel strike introduced a transient that averaged 60% of body weight and lasted for up to 5 ms. Maximal deceleration was recorded in the order of 5G, with a frequency spectrum of 100 Hz. Interposition of silicone heel insoles attenuated the ground reaction force by one third and deceleration by two thirds, the highest frequency components having been eliminated. CONCLUSION: Viscoelastic heel insoles significantly attenuate the strain on the spinal column that is caused by walking.     

Carbamoylphosphonate matrix metalloproteinase inhibitors 6: cis-2-aminocyclohexylcarbamoylphosphonic acid, a novel orally active antimetastatic matrix metalloproteinase-2 selective inhibitor--synthesis and pharmacodynamic and pharmacokinetic analysis

cis-2-Aminocyclohexylcarbamoylphosphonic acid ( cis-ACCP) was evaluated in vitro and in two in vivo cancer metastasis models. It reduced metastasis formation in mice by approximately 90% when administered by a repetitive once daily dosing regimen of 50 mg/kg via oral or intraperitoneal routes and was nontoxic up to 500 mg/kg, following intraperitoneal administration daily for two weeks. Pharmacokinetic investigation of cis-ACCP in rats revealed distribution restricted into the extracellular fluid, which is the site of action for the antimetastatic activity and rapid elimination ( t 1/2 approximately 19 min) from blood. Sustained and prolonged absorption ( t 1/2 approximately 126 min) occurred via paracellular mechanism along the small and large intestine with overall bioavailability of 0.3%. The in vivo concentrations of cis-ACCP in the blood in rats was above the minimal concentration for antimetastatic/MMP-inhibitory activity, thus explaining the prolonged action following once daily administration. Finally, 84% of the intravenously administered cis-ACCP to rats was excreted intact in the urine.     

Sociodemographic and disease-related determinants of return to work among women with breast cancer: a German longitudinal cohort study

Background

Return to work (RTW) is a key parameter of outcome quality that ensures social participation. Therefore, this study analyses the sociodemographic and disease-related determinants of RTW among newly diagnosed breast cancer patients.

Methods

In a prospective, multicentre cohort study, breast cancer patients were surveyed three times: directly after surgery, after 10?weeks, and after 40?weeks. Logistic regression analysis was applied to estimate the association of RTW at 40?weeks following discharge with sociodemographic and disease-related characteristics (n =?577).

Results

The sociodemographic variables “entrance certificate at a university of applied science” compared to “university entrance certificate” (OR?=?3.1, 95%-CI?=?1.2–8.1), age group “55–59?years” compared to “18–44?years” (OR?=?3.2, 95%-CI?=?1.2–8.4) and “having children” (OR?=?2.8, 95%-CI?=?1.2–6.2) as well as the disease-related variables “rehabilitation” (OR?=?0.5, 95%-CI?=?0.3–0.9), self-rated health “good” and “excellent” compared to “bad” (OR?=?2.7, 95%-CI?=?1.4–5.5; OR?=?11.6, 95%-CI?=?4.2–31.8) and the UICC-classification “stage II” and “stage III/IV” in comparison to “stage 0/I” (OR?=?0.5, 95%-CI?=?0.3–0.8; OR?=?0.2, 95%-CI?=?0.1–0.5) significantly affect RTW among breast cancer patients (Nagelkerke’s Pseudo-R² =?0.275).

Conclusions

The findings show that significant differences in RTW exist between patient groups and suggest that RTW issues must be addressed more effectively before, during and after treatment. For future research on RTW in Germany, longitudinal studies with a follow-up of several years are necessary. Information and support deficits should be tackled by social services or breast care nurses.

Trial registration

Database Health Services Research, VfD_PIAT_12_001630, registered 01.03.2012

     

Schematic processes in pain perception

Thirty-six subjects in a cold pressor experiment were asked to periodically rate the unpleasantness of the experience and estimate the water temperature, under three attention conditions. Subjects were given (1) instructions to monitor their sensations, (2) instructions to monitor their emotions, or (3) no monitoring instructions. With their hands immersed in the cold water, subjects had to learn and later recognize a list of words related in varying degrees to either the sensory or the emotional features of coldness. As predicted, subjects who monitored their sensations rated the experience as less unpleasant, but their estimates of the water temperature did not differ from the other two conditions. In addition, these subjects had a higher rate of hits and false alarms for words associated with the sensory features of coldness. These results are seen as providing tentative support for the parallel-processing model of pain perception and specifically, the hypothesis that pain reduction can result from a modification of a pain schema.