Friction, capacitance and transepidermal water loss (TEWL) in dry atopic and normal skin

The biophysical properties of non-eczematous skin at three locations in atopics and non-atopics were characterized using non-invasive physical methods. Skin friction was measured with a newly developed sliding friction instrument, the degree of hydration with a capacitance meter (Corneometer CM 820), and the transepidermal water loss (TEWL) was determined using an Evaporimeter EP1. The areas examined (dorsum of the hand, volar forearm and lower back) showed lower values of friction and capacitance in the atopic patients than did corresponding sites in the normal controls. In most areas a significant correlation between friction and capacitance was found. The TEWL was increased in atopic skin, but TEWL seems to correlate neither to friction nor to capacitance.     

Electrode Configurations for a Respiratory Impedance Measurement Suitable for Rate Responsive Pacing

A rate responsive cardiac pacemaker will benefit the patient only if the input parameter is a reliable indicator of exercise, Part of the reliability is dependent upon selection of the best physiological parameter and part is dependent upon the measurement technique. Twenty-six patients have been studied in order to ascertain the best measurement configuration for an intravascular impedance respiratory monitor. Four electrode configurations have been examined at rest and during exercise. The results have been compared using measures of sensitivity and specificity. The ideal configuration requires that a current field be established between the right ventricular blood and the pacemaker case. And, that voltage sensing be done between an electrode in the SVC and the pacemaker case.     

An In Vitro Model for the Expansion of Vγ9δ2 T Lymphocytes During Development

The 7/γ/δTlymphocytes represent a minority of T lymphocytes in human peripheral blood. Although there have been reports of reactivity against (myco-) bacterial antigens and heat shock proteins, their function and antigen specificity remain ill defined. The biological role of γ/δ T cells has been related to functions within the 'first line of defense'. Similar to γ/δ T lymphocytes in the T-cell compartment, CD5 positive B cells represent a small subset of B lymphocytes, which is thought to be involved in the maintenance of natural immunity and autoimmunity. We provide evidence for the cooperation of γ/δ T cells and CD5 positive B cells in the proliferative response of γ/δ T cells to bacterial antigens. Our data indicate a strong proliferation of Vγ9δ2 T cells in response to gram-negative bacteria, which is dependent upon the presence of CD5 positive B-CLL or activated normal B lymphocytes. The selective stimulation of the Vγ9δ2 subpopulation by gram-negative bacteria is also confirmed by analysis of different γ/δ T-cell clones. The interaction of γ/δ T cells with activated B cells and gram-negative bacteria may prove to be a useful model similar to the expansion of the Vγ9δ2 subpopulation during development. In addition, our in vitro system should provide new insights in the interaction of CLL B cells with the immune system and the antigens recognized by γ/δ T cells.     

Mouse Liver Carcinogenesis: Mechanisms and Relevance

Symposium Overview: Mouse Liver Carcinogenesis: Mechanisms andRelevance. GOODMAN, J. I., WARD, J. M., POPP, J. A., KALUNIG,J. E., AND FOX, T. R. (1991). Fundam. Appl. Toxicol. 17, 651–665.     

ENDOMETRIOSIS OF THE SIGMOID COLON AND RECTUM

Endometriosis is a common disease of women which occasionally causes serious symptoms in virtue of involvement of the distal large intestine. Two cases are reported, illustrating opposite ends of the spectrum of this disorder, one presenting with a complete large-bowel obstruction, and the other with periodical per-rectal bleeding. Endometriosis in these locations can closely mimic carcinoma, and from a consideration of our cases and the literature, those features which might help to distinguish one from the other are discussed. The treatment of endometriosis itself is briefly outlined. Either to avoid unnecessarily radical surgery, or to plan appropriate specific treatment at the time of surgery for the colorectal lesion, a preoperative diagnosis is desirable, but it Is unlikely unless the clinician is aware of this unusual form of endometriosis.     

Symposium on neurobiology of the basal ganglia

The basal ganglia occupy a commanding place in neuroscience research, in clinical neurology and in biomedical education. The paucity of our understanding of the role of the basal ganglia in normal everyday life combined with our more extensive knowledge of their deficiencies in a variety of clinical syndromes is a potent spur to continuing investigation. That some of these neurodegenerative syndromes—such as Parkinson's disease—are already common only heightens the need for insight in the face of a population with increasing expectations of longevity. About a decade ago an explosion of information on the connectivity and immunocytochemistry of forebrain structures gave rise to concepts which have shaped the fabric of basal ganglia theory—‘patch and matrix’, ‘disinhibition’, ‘parallel circuits’. Some of these ideas seemed to facilitate an understanding of the basal ganglia, others to render them more complex and impenetrable. Perhaps unsurprisingly, the work of the last decade has tended towards consolidation and refinement. However, several new developments are receiving attention, many of them related to disorders of the basal ganglia. The realisation that some forms of Parkinson's disease have a genetic determinant is gaining strength. The molecular biology of the dopaminergic synapse on the one hand and of the production of insoluble proteins on the other will clearly influence future research into therapeutic options and neuroprotection. The importance of apoptosis, neural plasticity and free radical formation remains unresolved but these are potential areas of promise. Meanwhile, scanning techniques for brain imaging are allowing real time investigation of the working striatum in normal and disordered humans and animals. We believe that the time is opportune for a broad review of current thinking on the basal ganglia in health and disease. The following articles are based on presentations given at a Symposium on the Neurobiology of the Basal Ganglia held at Glasgow University in July 1999 as part of the Summer Meeting of the Anatomical Society of Great Britain and Ireland. The invited speakers were chosen to be wide ranging and contributions encompassed evolution, circuitry and receptors of the basal ganglia, striatal remodelling after dopamine loss, striatal functioning in humans with Huntington's disease and in primate models after midbrain fetal transplants, and the genetics of basal ganglia disorders. Short presentations and posters of current results supplemented the main presentations and some are also included amongst these reviews.     

Clinical Performance of the Implantable Cardioverter Defibrillator: Electrocardiographic Documentation of 101 Spontaneous Discharges

Records of 105 patients, who received an automatic implantable Cardioverter defibrillator (AICD), were studied to investigate the causes of spontaneous AJCD discharges and to correlate the symptoms with the arrhythmias triggering AJCD discharges. During a follow-up period of 13 ± 8 months, 46/105 (44%) patients had 566 spontaneous AICD discharges. A total of 101 discharges were documented with Holter monitoring in 23 patients. In this study group, there were 8 (8%) AICD discharges for 5 episodes of ventricular fibrillation, and 68 (67%) discharges for 63 episodes of sustained ventricular tachycardia. Patients lost consciousness in all episodes of ventricular fibrillation, but were symptomatic prior to only 36 (53%) discharges in ventricular tachycardia. Non-sustained ventricular tachycardia persisting for a period of 7,5 ± 2 seconds resulted in 20 AICD discharges; patients were symptomatic prior to 13 (65%) discharges. Supraventricular tachycardias triggered three discharges. One patient had two spurious discharges during sinus rhythm. In conclusion, most of the spontaneous AICD discharges were appropriate for the detected rhythms, but only clinically appropriate for the management of arrhythmias in 75% of the cases. A significant portion of the patients with sustained or nonsustained ventricular tachycardias triggering AICD discharges were asymptomatic prior to discharge, which requires further assessment of the physiology of the arrhythmia as a component of the detection algorithm.     

DDIR Versus VVIR Pacing in Patients with Paroxysmal Atrial Tachyarrhythmias

Patients with sinus node dysfunction (SND) in particular those with tachycardia-bradycardia syndrome and patients undergoing atrioventricular nodal ablation procedures for refractory paroxysmal atrial tachyarrhythmias (PAT), are candidates for single chamber (VVIR mode) or dual chamber rate responsive (DDIR mode) systems. To evaluate the benefits and disadvantages of each pacing mode we retrospectively analyzed 33 patients with a history of frequent PAT who received a VVIR (22 patients); or a DDDR pacemaker (11 patients) programmed to the DDIR mode. The mean follow-up time was 25 and 18 months, respectively. Preimplant left atrial diameter was significantly smaller in the DDIR group. Chronic atrial fibrillation developed in 54% of the VVIR patients and 27% of the DDIR group, but this difference was not significant. Complications of patients with VVIR pacemakers included new mitral and tricuspid insufficiency, stroke, pacemaker inlolerance and aggravated congestive heart failure. Patients with DDIR pacemakers had a lower incidence of symptoms and complications. However, this group received more antiarrhythmic medication, required a closer follow-up, and their pacemakers needed frequent reprogramming. Our findings suggest that VVIR is a poor choice for patients with SND, congestive heart failure, and PAT, and that DDIR may be an acceptable alternative.     

Impairment in movement skills of children with autistic spectrum disorders

Aim  We undertook this study to explore the degree of impairment in movement skills in children with autistic spectrum disorders (ASD) and a wide IQ range.
Method  Movement skills were measured using the Movement Assessment Battery for Children (M-ABC) in a large, well defined, population-derived group of children ( n =101: 89 males,12 females; mean age 11y 4mo, SD 10mo; range 10y–14y 3mo) with childhood autism and broader ASD and a wide range of IQ scores. Additionally, we tested whether a parent-completed questionnaire, the Developmental Coordination Disorder Questionnaire (DCDQ), was useful in identifying children who met criteria for movement impairments after assessment ( n =97 with complete M-ABCs and DCDQs).
Results  Of the children with ASD, 79% had definite movement impairments on the M-ABC; a further 10% had borderline problems. Children with childhood autism were more impaired than children with broader ASD, and children with an IQ less than 70 were more impaired than those with IQ more than 70. This is consistent with the view that movement impairments may arise from a more severe neurological impairment that also contributes to intellectual disability and more severe autism. Movement impairment was not associated with everyday adaptive behaviour once the effect of IQ was controlled for. The DCDQ performed moderately well as a screen for possible motor difficulties.
Interpretation  Movement impairments are common in children with ASD. Systematic assessment of movement abilities should be considered a routine investigation.     

Methamphetamine use,dependence and treatment access in rural and regional North Coast of New South Wales,Australia

Introduction and Aims. To identify the sociodemographic, health, drug use patterns, treatment coverage and barriers to treatment among regular methamphetamine users in rural and regional North Coast of New South Wales. Design and Methods. A structured questionnaire was used to measure sociodemographic factors, health and well‐being, drug use patterns, methamphetamine dependence, engagement in methamphetamine treatment and barriers to treatment. Participants were 140 regular methamphetamine users. Dependent and non‐dependent participants were compared to identify factors associated with dependence. Results. Participants were predominantly in their thirties, male and had low levels of education, high levels of unemployment and polydrug use. Participants who were dependent on methamphetamine (59%) were more likely to report impaired mental health and to have been diagnosed with depression, anxiety and drug‐induced psychosis. One quarter of dependent methamphetamine users had received treatment in the last year and half had ever received treatment. The main barriers to receiving treatment were a lack of perceived need or motivation to seek treatment and concerns about confidentiality. Discussion and Conclusions. Methamphetamine users living on the North Coast of New South Wales require treatment options tailored to address a complex array of physical and psychological problems. The findings highlight the need for psychiatric support and improved coordination between mental health and drug and alcohol services in rural and regional areas.[Wallace C, Galloway T, McKetin R, Kelly E, Leary J. Methamphetamine use, dependence and treatment access in rural and regional North Coast of New South Wales, Australia. Drug Alcohol Rev 2009]