Two familial cases with a lethal gracile bone dysplasia and intrauterine growth retardation

A number of more or less distinct entities with low birth weight and abnormal radiographic appearances have been identified. We studied two sisters who were unusual because of severe intrauterine growth restriction, absence of growth after birth, decrease of pre- and postnatal spontaneous mobility, and early fatal outcome. The chondro-osseous morphology documented a distinctive osteochondrodysplasia. The radiographic examination was superficially similar to gracile bone dysplasias but was inconsistent with any known types of this group. These two patients appear to have a unique gracile bone dysplasia.     

A loudspeaker-driven system for rapid and multiple solution exchanges in patch-clamp experiments

A new and inexpensive system allowing rapid and synchronized changes of solutions around a membrane patch or a cell under voltage-clamp conditions is described. Four plastic capillary tubings (OD 640 m; ID 430 m) were glued together horizontally and attached to a coil of a commercially available loudspeaker. Servo-control of the position of the coil allowed the mouth of any of the capillaries to be positioned near the pipette tip within 6 ms. A high flow speed of the test solution was crucial to achieve rapid solution exchange. At a flow speed of 5 cm/s, complete exchange of the external environment of a frog ventricular cell was achieved within 20–30 ms. The time course of solution change was found to be 3–5 times faster at the tip of an open patch pipette. To preserve the physical integrity of the cell, the cell was usually perfused by a control capillary at a slow velocity (0.2 –0.4 cm/s) and test solutions flowing out of adjacent capillaries at high velocity (4–5 cm/s) were applied to the cell only for short periods. Determination of the three-dimensional contamination profile around the mouth of the control capillary allowed the optimal conditions for the use of the system to be established and possible sources of contamination to be avoided between adjacent capillaries with unmatched flow speeds. Successive and multiple changes in external solutions could be easily synchronized with voltage-clamp depolarizations to examine the time course of the effect of drugs on voltage-operated ion channels. An example of this application is given with rapid applications of the dihydropyridine agonist (-)BayK 8644 to the L-type Ca²⁺ channel current in frog ventricular myocytes.     

Alterations in hepatic mixed-function oxidase activity of rainbow trout after acute treatment with polybrominated biphenyl isomers and FireMaster BP-6

The effects of FireMaster BP-6 and several pure isomers on hepatic microsomal mixed-function oxidase (MFO) activity in rainbow trout have been investigated. After one parenteral injection of these agents at 150 mg/kg and sacrifice 5 d later, there was no elevation of hepatic cytochrome P-450. The noncoplanar isomers 2,4,5,2',4',5'-hexa and 2,3,4,5,2',4',5'-heptabromobiphenyl did not increase any MFO activity generally associated with an increase in cytochrome P-450 levels, including the dealkylations of ethoxycoumarin and benzphetamine. The coplanar isomer 3,4,5,3',4',5'-hexabromobiphenyl produced an increase in O-deethylation of both ethoxycoumarin and ethoxyresorufin, suggesting enhancement of cytochrome P-448 associated activity, but produced no increase in benzphetamine N-dealkylation. The "mixed inducer" 2,4,5,3',4',5'-hexabromobiphenyl, produced a small but insignificant elevation of cytochrome P-448 associated MFO activities and no increase in cytochrome P-450 associated activities. At both 150 and 500 mg/kg, the commercial mixture of polybrominated biphenyls FireMaster BP-6 produced marked elevations of both ethoxycoumarin and ethoxy-resorufin dealkylations but had no effect on demethylation of benzphetamine. When microsomes from rainbow trout treated with FireMaster BP-6 were examined electrophoretically, A coomassie Blue-staining band at 57,000 daltons was intensified, as seen after treatment of fish with the cytochrome P-448 inducer beta-naphthoflavone. It is concluded that coplanar polybrominated isomers produce an induction of hepatic cytochrome P-448 associated activity, while noncoplanar isomers are ineffective as inducers of cytochrome P-450 related MFO activities in rainbow trout.     

Psychotherapeutic and psychosocial therapy in general practice. Results of demonstration project on quality management in psychosocial primary care

Since 1987, psychosocial primary care (PPC) provided by General Practitioners, are reimbursed by German health insurances. The aim of the psychosocial primary care is to improve recognition and treatment of mental disorders in the primary care sector. As a part of a eight-center national demonstration program on quality management in the outpatient services, General Practitioners (n = 191) from 5 regions participated in the study. 1341 treatment episodes of patients with predominately psychosocial strain were documented. Differences between psychosocial strain, treatment and outcome were determined by analyses of variance. Men and patients beyond the age of 65 were underrepresented. Psychosocial treatments were offered more often to those patients, who had the highest level of anxiety and depression. Patients with physical illness, with pain and without psychological attribution to the illness belief were offered less psychosocial interventions and reached a worse outcome. The study outcome helps to improve training programs as to recognition and treatment of psychosocial problems in primary care. Male and generally elderly patients with somatic symptoms and lack of psychological attribution need a special psychosocial intervention to improve the outcome.     

Reducing delirium and cognitive dysfunction after off-pump coronary bypass: A randomized trial

BackgroundNeuropsychiatric complications of surgical coronary revascularization are inconspicuous but frequent and clinically relevant. So far, attempts to reduce their occurrence, such as the introduction of off-pump coronary artery bypass (OPCAB) grafting method, have not brought the desired results. The aim of this trial was to determine whether using any of the 2 selected modifications of OPCAB could decrease the incidence of these undesired sequelae.MethodsIn this single-center, assessor- and patient-blinded, superiority, randomized controlled trial, 192 patients scheduled for elective isolated OPCAB were randomized to 3 parallel arms. The control arm underwent “conventional” OPCAB with vein grafts. The first study arm underwent anaortic OPCAB (ANA) with total arterial revascularization. The second study arm underwent OPCAB with vein grafts using carbon dioxide surgical field flooding (CO₂FF). Outcomes included the incidence of postoperative delirium (PD) and early postoperative cognitive dysfunction (ePOCD).ResultsThe incidence of PD was 35.9% in the control (OPCAB) arm, 32.8% in the CO₂FF arm, and 12.5% in the ANA arm (χ² [2, N = 191] = 10.17; P = .006). Post hoc tests revealed that the incidence of PD in the ANA arm differed from that in the OPCAB arm (odds ratio [OR], 0.26; 95% confidence interval [CI], 0.09-0.68; P = .002). The incidence of ePOCD was 34.4% in the OPCAB arm, 28.1% in the CO₂FF arm, and 9.5% in the ANA arm (χ² [2, N = 191] = 11.58; P = .003). Post hoc tests revealed that the incidence of ePOCD differed between the ANA and OPCAB arms (OR, 0.20; 95% CI, 0.06-0.58; P < .001).ConclusionsPerforming ANA significantly decreases the incidence of PD and ePOCD compared with “conventional” OPCAB with vein grafts, whereas CO₂FF is inconsequential in this regard. These results, which probably reflect decreased delivery of embolic load to the brain in ANA, may have practical applicability in daily practice to improve clinical outcomes.     

How lonely they are? A degree of isolation among macrozoobenthos species in the Marine Protected Area, the Bay of Puck, the Southern Baltic

Extensive sampling (450 grabs) was performed all over the inner part of Puck Bay (105 km² area) in summers of 2007–2009. The GIS-based analysis of samples was performed to assess in detail the distribution of 32 benthic species. The minimum area of occurrence was less than 1 km² for Lekanosphaera rugicauda and the maximum was 83 km² for Cerastoderma glaucum. The material reveals that species with the pelagic larval stage were most widespread, with the least distance between individuals and the highest average density (e.g. Cerastoderma glaucum, Hydrobia ventrosa). The most isolated and the least dense species within the studied area were discretely mobile, non-larval crustaceans (e.g. Gammarus oceanicus and Lekanosphaera rugicauda), present at single sites with the largest distance from each other. We conclude that analysis of species distribution helps in understanding the threats to populations of marine invertebrates and marine spatial planning, through locating the isolated species and populations.     

On the Connection Between Affective Evaluation of Recollected Relationship Experiences and the Severity of the Psychic Impairment

This study, carried out at three different university centers contributes to validating the valence dimension of the CCRT-method. Working on the state of the CCRT-research on affective evaluation of relationship narratives, the connection between the valence dimension of the responses from others (RO), responses of the self (RS) and the severity of the psychological disorder has been analyzed with the help of a sample taken from 266 female patients. Both therapists as well as patients themselves evaluate the severity of the impairment similarly. The more the patients are impaired, the more negatively they describe both their own reactions and those of their interaction partners as shown in the relationship episodes. Die vorliegende multizentrizch Studie stellt einen Beitrag zur Vaidierungder Valenzdimension der ZBKT-Methode dar. Ausgehend vom Stand der ZBKT-Forschung bezüglich der affektiven Bewertung der Beziehungsschilderungen wurde an einer Stichprobe von 266 Patientinnen der Zusammenhang zwischen der Valenzdimension der Reaktionskomponenten und der Schwere der psychischen Störung untersucht. Für die Einschätzung der krankheitsschwere sowohldurch die therapeuten wie auch durch die patientinnen selbst Gilt: je schwerer gestört patientinnen sind, um so negativer beschreiben sie die eigenen Reaktionen und die ihrer Interaktionspartner in den Beziehungsepisoden. Cette étude menée dans trois centres universitaires contribue à la validation de la dimension positivité/négativité («valence») du CCRT. Dans notre travail sur la situation dela recherche concernant le CCRT et l'évaluation affective des épisodes relationnels, nous avons analysé, sur base d'un échantillon de 266 patientes, le lien entre ladimension «valence» des réponses de l'autre, de la réaction du sujet, et la gravité du trouble psychique. les thérapeutes et les patientes elles-mêmes arrivent à une jugement comparable de la Sévérité de l'atteinte. Plus les patientes sont atteintes, et plus le récit des réactions des autres et d'elles-mêmes dans les épisodes relationnels est négatif. Este estudio, llevado a cabo en tres centros universitarios diferentes, contribuye a validar la dimensión valencia del método CCRT. Trabajando sobre el estado actual de la investigació del CCRT en la evaluación afectiva de las narrativas relacionales, se analizó, en una muestra de 266 pacientes mujeres, la conexión entre la dimensión valencia en las respuestas de otros (Ro), las respuestas del self (RS) y la severidad del desorden psíquico.Los terapeuttas evaluaron la severidad de las perturbaciones en forma similar a las pacientes mismas. Como se ve en los episodios relacionales, cuanto màs perturbadas estàn las pacientes, mà negativamene describen sus propias reacciones y las de sus interlocutores.     

Only Hyperuricemia with Crystalluria,but not Asymptomatic Hyperuricemia,Drives Progression of Chronic Kidney Disease

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