Measurement of functional ability and health status in the arthritic patient

Chronic arthritis may have great impact on the patient but also on his or her family, relatives and friends. The assessment of the consequences of chronic arthritis and the effect of therapy not only in terms of physical, but also psychological and social dimensions deserves more attention. Functional ability and health status can be measured using a questionnaire or ‘instrument’, high-lighting important aspects not quantified with more traditional measurements. In this paper, arguments to apply such instruments more frequently are given. Health status instruments can be used not only to assess beneficial but also deleterious (side-)effects of therapeutic interventions. The properties are summarized of the most frequently used instruments assessing functional ability and health status. Many of these instruments have been evaluated sufficiently for validity and reliability; their sensitivity to detect change seems to be satisfactory. Therefore it is advisable to choose an internationally accepted, frequently used instrument, reflecting the area of interest.     

Epitope specificity is critical for high and moderate avidity cytotoxic T lymphocytes associated with control of viral load and clinical disease in horses with equine infectious anemia virus

Equine infectious anemia virus (EIAV) is a lentivirus that causes persistent infections in horses. We hypothesized that high-avidity CTL specific for nonvariable epitopes might be associated with low viral load and minimal disease in EIAV-infected horses. To test this hypothesis, memory CTL (CTLm) responses were analyzed in two infected horses with high plasma viral loads and recurrent disease (progressors), and in two infected horses with low-to-undetectable viral loads and mild disease (nonprogressors). High-avidity CTLm in one progressor recognized an envelope gp90 epitope, and the data documented for the first time in EIAV that viral variation led to CTL escape. Each of the nonprogressors had high-to-moderate avidity CTLm directed against epitopes within Rev, including the nuclear export and nuclear localization domains. These results suggested that the epitope specificity of high- and moderate-avidity CTLm was an important determinant for disease outcome in the EIAV-infected horses examined.     

尼古丁依赖的功能影像学研究进展

在过去10年中,随着功能脑影像学技术在物质滥用领域的发展,越来越多的研究者运用这些技术以探讨尼古丁成瘾的神经生物学机制。本文主要总结了尼古丁急、慢性暴露下对脑功能影响的神经脑影像学研究进展,证实了尼古丁依赖与中脑边缘犒赏系统、调节注意、记忆、运动以及联想相关脑环路之间的相关性。这些研究发现将为揭示尼古丁依赖的神经生物学机制提供更多的证据支持,进一步促进今后戒烟治疗的发展。     

Determining appropriate models for joint control using surface electrical stimulation of soleus in spinal cord injury

The mechanical impedance of the ankle joint during electrical stimulation of the soleus is studied by applying constant-velocity 10° angular perturbations to the ankle and measuring the resultant torque. Both neurologically intact subjects and spinal cord injured subjects are tested. Lumped, piecewise linear models are developed to predict the torque from the measured displacement and acceleration signals. The commonly used second-order mass-spring-dashpot model fails to predict the changes in torque that occur following imposed movements. A fiveelement, directionally-dependent piecewise linear model is much better at predicting the measured responses for velocities up to 50° s⁻¹. Numerical least squared error indentification techniques are used to estimate the model parameters for three neurologically intact and three spinal cord injured subjects. The average error between the model’s response and the measured response across all subjects is 10·9%. There is some evidence that a velocity-dependent non-linear model could produce better results than the directionally-dependent piecewise linear model.     

Responses of sacral visceral afferents from the lower urinary tract,colon and anus to mechanical stimulation

The discharge characteristics of sacral visceral afferents supplying the urinary bladder, urethra, colon and anus to mechanical stimuli were analyzed in the anaesthetized cat. The stimuli used were passive distension (urinary bladder, colon), isovolumetric contraction (urinary bladder), movements of the urethral catheter and mechanical shearing stimuli (mucosal skin of the anal canal). (1) In total 245 afferent units which projected in the pelvic nerve were isolated from the sacral dorsal roots. From one of the following organs, urinary bladder, colon, urethra and anus 117 afferent units were activated. By these stimuli from the bladder, urethra and anus 122 afferent units could not be activated, and as far as tested also not from the colon; in 6 afferent units the classification was unclear. (2) Afferent units from the urinary bladder and the colon responded consistently to passive distension of the respective organ. The units from the urinary bladder showed graded responses at intraluminal pressures of about 10–70 mm Hg and responded also to isovolumetric contractions of the organ. The thresholds of the units from the bladder to passive distension and contraction varied from about 5 to 20 mm Hg intravesical pressure. (3) The afferent units from the urethra and the anus did not react or showed some weak phasic and irregular responses to distension and contraction applied to the urinary bladder or to distension of the colon. They were consistently excited by low threshold mechanical stimulation of the urethra and anus, respectively. (4) The axons from the bladder, urethra and anus were presumably myelinated (conduction velocity above 2 m/s) and conducted at 10.3±6.1 m/s (n=34, mean±SD), 26.3±9.3 m/s (n=13) and 9.5±5.1 m/s (n=37), respectively. The axons from the colon conducted at about 0.5 to 16 m/s (n=20), 13 of them conducting at less than 2 m/s. About 75% of the axons which could not be activated by mechanical stimulation of the visceral organs were presumably unmyelinated (conduction velocity below 2 m/s). (5) Some ongoing activity was found in 9 out of 26 afferent units from the anus but, with one exception, the afferent units from the bladder, urethra and colon were silent. (6) It is concluded that the pelvic afferent units from the urinary bladder, urethra, colon and anus consist of distinct populations with characteristic response patterns. There is no indication from this investigation that the urinary bladder is supplied by sacral afferents which are only recruited at high intravesical pressures during passive distension and isovolumetric contractions and which are possibly associated with pain.Supported by the Deutsche Forschungsgemeinschaft     

内隐记忆的研究证据及临床意义

内隐记忆 (ｉｍｐｌｉｃｉｔｍｅｍｏｒｙ)一词最初由Ｇｒａｆ与Ｓｃｈａｃｔｅｒ于 1985年提出 ,指对特定的过去经验进行有意识或外显的回忆测验中表现出来的对先前获得信息的无意识提取 ,也就是说 ,在有意或无意间获得的信息、技能或习惯 ,虽不能有意识地回忆和再认 ,但会影响类似作业的成效和行为的有效性。这一概念的提出扩大了记忆研究的内涵 ,因此迅速成为记忆研究的热点之一。目前内隐记忆的研究在测量方法与理论解释方面都取得了一些进展 ,大量证据表明它与外显记忆存在质的不同 ,是一个相对独立的记忆系统。不过现存的问题也很多 ,…     

我国人类基因组研究面临的机遇与挑战

中国的人类基因组计划自１９９３年启动以来，已在各民族的遗传资源保存和遗传多态性研究、建立较完整的基因组研究技术、致病基因及其相关基因的ｃＤＮＡ克隆３个方面取得了显著成绩。与此同时，一支高层次研究人员队伍和一批研究基地已经形成。中国人类基因组计划下一阶段的任务是：根据中国的国情和优势：（１）继续扩大中华民族基因资源库（包括ＤＮＡ和永生细胞株库），并开展微卫星和单核苷酸多态性研究与基因分型工作；（２）发展疾病基因组学，做好疾病遗传资源的调查、登记、采集和保存，形成现代化管理的样品库和数据库，并争取在肿瘤、遗传病和多基因病相关基因的定位、克隆，突变检测与大规模测序方面有所突破，获得一批重要的疾病基因；（３）启动以生物信息学、基因转录和翻译表达谱测定为主的功能基因组学研究，并以疾病基因组为研究基因组功能的重点；（４）加强与基因组科学有关的伦理、法律和社会问题的研究     

Die Beanspruchung des menschlichen Ellenbogengelenks

Zusammenfassung Bei 80 Objekten werden die Gelenkflächen des menschlichen Ellenbogengelenks untersucht. Die Trochlea und das Capitulum humeri sowie das Caput radii zeigen keine nennenswerten Unterschiede in der Ausdehnung der mit typischem Gelenkknorpel bedeckten Flächen. Dagegen lassen sich für die Ulnazange drei charakteristische Formgruppen abgrenzen: In 3 Fällen kann eine einheitliche Knorpelfläche beobachtet werden. Bei etwa zwei Drittel der untersuchten Objekte liegt im mittleren Bereich der Incisura trochlearis in horizontaler Richtung ein 2–5 mm breiter knorpelfreier Streifen, der den Gelenkknorpel in 2 vollständig getrennte Flächen unterteilt. Das restliche Drittel der Objekte besitzt eine unvollständige Trennung der Gelenkfläche. Unter Berücksichtigung der Vorstellungen von Pauwels über die causale Histogenese der mesenchymalen Stützgewebe sowie der Materialverteilung im Knochengewebe in Abhängigkeit von der einwirkenden Spannungsgröße werden die morphologischen Befunde den für die jeweiligen Skeletelemente von Pauwels ermittelten Spannungsdiagrammen gegenübergestellt. An der Trochlea und dem Capitulum humeri und am Caput radii findet sich eine geradezu ideale Übereinstimmung in der Ausdehnung der Knorpelfläche und der Knochendichte unter den Gelenkflächen mit den entsprechenden Spannungsdiagrammen. An der Ulna trifft dies nur für einen geringen Teil der Objekte zu. Für die unterschiedliche Ausgestaltung der Incisura trochlearis werden zwei mögliche Ursachen diskutiert: 1. die Resultierende R verharre während des Bewegungsablaufes in einzelnen Positionen innerhalb der Incisura trochlearis verschieden lange; 2. der Krümmungsradius der Trochlea humeri sei größer als derjenige im mittleren Bereich der Ulnazange, so daß hier wegen des fehlenden Kontaktes der Gelenkflächen keine Druckübertragung möglich ist.

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The stress of the human elbow jointI. Functional morphology of the articular surfaces

Summary The articular surfaces of 80 human elbow joints are analysed. The trochlea and capitulum humeri and the caput radii of the investigated individuals show no particular differences in the extent of their surfaces covered with typical articular cartilage. On the other hand the form of the incisura trochlearis is rather variable. Three characteristic formgroups are to be discerned. In three objects a continuous cartilage surface has been observed. In 50 of the investigated joints there is a small intersection free from cartilage in the midst of the incisura trochlearis, dividing the articular cartilage in two isolated surfaces. In the rest of the analysed objects the articular surface is divided only partially. According to Pauwels' hypothesis on the causal histogenesis of the mesenchymal supporting tissues and of the density distribution of the bone dependence upon the magnitude of the local unit stress the morphological findings in the single investigated parts of the elbow joint are confronted with the corresponding stress diagram as described by Pauwels. In the trochlea and capitulum humeri and in the caput radii a nearly ideal correspondence of the extent of the articular surface and the density of the bone tissue with the unit stress diagrams are found. In the ulna this correspondence exists only in few of the analysed objects. For the different form of the incisura trochlearis two possible explanations are discussed: 1, during the motion the resultant of forces may stay for a different time in their single positions in the incisura trochlearis; 2. the curvature radius of the trochlea humeri may be greater than that one of the incisura trochlearis in the central area. So no pressure occurs in this part of the articular surface.

Mit freundlicher Unterstützung durch die Deutsche Forschungsgemeinschaft.