Personality styles in patients with fibromyalgia,major depression and healthy controls

Background  

The fibromyalgia syndrome (FMS) is suggested to be a manifestation of depression or affective spectrum disorder. We measured the cognitive style of patients with FMS to assess personality styles in 44 patients with fibromyalgia syndrome (FMS) by comparing them with 43 patients with major depressive disorder (MDD) and 41 healthy controls (HC).     

Curriculum factors influencing knowledge of communication skills among medical students

Background  

Communication training builds on the assumption that understanding of the concepts related to professional communication facilitates the training. We know little about whether students' knowledge of clinical communication skills is affected by their attendance of communication training courses, or to what degree other elements of the clinical training or curriculum design also play a role. The aim of this study was to determine which elements of the curriculum influence acquisition of knowledge regarding clinical communication skills by medical students.     

BCG Antibody Profiles in Tuberculoid and Lepromatous Leprosy

In sera from 12 patients with polar tuberculoid leprosy, 12 with subpolar tuberculoid leprosy, and 16 with lepromatous leprosy were demonstrated a total number of 125 anti-BCG precipitins by means of crossed immunoelectrophoresis with intermediate gel. Up to 14 different precipitins were found in individual sera, and the complexity in antibody response was higher than previously realized. The specificity of 69% of the antibodies was defined, and these antibodies were titrated in three arbitrary titer units. A highly significant difference (P < 0.002) was found in antibody response between the tuberculoid and the lepromatous group. Due to simplicity, sensitivity, and high resolution, the method used is a promising tool for providing exact data to be used as guidelines for purification of important individual mycobacterial antigens. The need for reference antisera is emphasized.     

The interface between tapasin and MHC class I: identification of amino acid residues in both proteins that influence their interaction

Prior to the binding of antigenic peptide, a complex of chaperone proteins associates with the Major Histocompatibility Complex (MHC) class I heavy chain/β₂m heterodimer. Although each dornain of the MHC class I heavy chain contains amino acid resid uses that influence chaperone binding, there are several pieces of evidence that point to an interaction between the MHC clas 1α2/α3 domains and tapasin. In egard to the site on tapasin involved in the tapasin/MHC interface, we have found that a particular region of tapasin (containing amino acid residues 334–342) is necessary for the binding of tapasin to the MHC class I heavy chain. Our results also indicate that amino acids in this region of tapasin also affect the proportion of MHC class I open forms expressed at the cell surface and MHC class I egress from the endoplasmic reticulurn. Based on these results and those obtained by other laboratories, a model for MHC class I/tapasin interaction is proposed.     

Prognostic value of renal vein renin determination in suspected renovascular hypertension

Surgical correction of unilateral renal artery stenosis was performed in 31 hypertensive patients. Preoperative renal vein renin ratios (RVRR) before and after dihydralazine stimulation were measured in all patients. Postoperative blood pressure were normal in 12, improved in 17 and unchanged in 2 patients. Six patients did not have renin lateralization, but all were cured or improved after surgery. RVRR was a poor predictor of the results of surgery in patients with unilateral renal artery stenosis.     

Release of corticosteroids from human adrenals in vitro

From morphological criteria, it is often difficult to evaluate whether adrenocortical tumors secrete hormones or not. An increasing number of nonfunctioning tumors are detected using modern imaging techniques. In a consecutive series of 13 patients with adrenocortical disease, a functional characterization was done by determining the ability of the resected tissue to release cortisol and aldosterone in vitro. Significant secretion of aldosterone was only found in tumors from 4 patients with hyperaldosteronism, 1 of whom turned out to have a cortisol-secreting tumor as well. All other tumors, both from patients with Cushing's syndrome and patients judged to have nonfunctioning adenoma, released cortisol in vitro. The method provides valuable pathophysiological information on adrenal tumors.

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Resumen Con base en criterios morfológicos, frecuentemente es difícil determinar si los tumores adrenocorticales secretan hormonas o no. Con el uso de las modernas técnicas de imagenología, se détecta un numéro creciente de tumores no funcionantes. En una serie consecutiva de 13 pacientes con patología adrenocortical, se realizó una caracterización funcional determinando la capacidad del tejido resecado para liberar cortisol y aldosterona in vitro. Se encontró secreción significativa de aldosterona sólo en tumores provenientes de 4 de nuestros pacientes con hiperaldosteronismo, 1 de los cuales también presentó un tumor secretor de cortisol. Todos los otros tumores, tanto de pacientes con síndrome de Cushing como de pacientes que se considéró tenían adenoma no funcionante, liberaron cortisol in vitro. El método provee valiosa información patofisiologica sobre los tumores suprarrenales.

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Résumé Il est souvent difficile, à partir des critères morphologiques, d'évaluer si les tumeurs corticosurrénaliennes sont des tumeurs sécrétantes ou non. Un nombre croissant de tumeurs dites nonfonctionnantes sont détectées par l'utilisation des techniques modernes d'imagerie. Une caractérisation fonctionnelle est réalisée par les auteurs à partir d'une série consécutive de 13 patients présentant une pathologie corticosurrénalienne en determinant les capacités de sécrétion in vitro de cortisol et d'aldostérone du tissu réséqué. Une sécrétion significative d'aldostérone est présente seulement dans les tumeurs de 4 patients avec hyperaldostéronisme, l'un d'entre eux révéla posseder de même une tumeur sécrétant du cortisol. Dans tous les autres cas, aussi bien chez les patients avec un syndrome de Cushing que chez les patients considérés comme ayant un adénome nonfonctionnant, les auteurs observent une sécrétion de cortisol in vitro. Cette méthode donne une information physiopathologique précieuse sur les tumeurs surrénaliennes.

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Presented at the International Association of Endocrine Surgeons in Paris, September 1985.

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Supported by grants from the Swedish Medical Research Council (2330) and Karolinska Institute.     

The “Scandinavian Star” ferry disaster 1990 -a challenge to forensic odontology

Summary With 158 victims, the fire on board the Scandinavian Star was one of the world's worst ferry disasters. A team of identification experts, including dentists, were employed to secure evidence for identification and to remove the victims from the ferry. Four parallel teams, each with 2 dentists, examined and autopsied the victims at the Institute of Forensic Medicine, University of Oslo. Using the INTERPOL Disaster Victim Identification forms and aided by computers, all victims were identified within 17 days. Dental identity could be established in 107 cases (68%).     

Testing the new ICRU 62 'Planning Organ at Risk Volume' concept for the rectum.

BACKGROUND AND PURPOSE: To study the impact of the new ICRU 62 'Planning organ at Risk Volume' (PRV) concept on the relationship between rectum dose-volume histogram (DVH) data and toxicity. PATIENTS AND METHODS: The acute gastro-intestinal (GI) RTOG toxicity in 127 prostate cancer patients prescribed a total dose of 70 Gy with conformal irradiation to either the prostate, the prostate and seminal vesicles or the whole pelvis (initial 50 Gy only) were analysed. DVHs were derived for the rectum only and for rectum extended with six PRV margin sets (narrow/intermediate/wide; anterior/anterior and posterior). The data was analysed using permutation tests, logistic regression and effective uniform dose (EUD) calculations. RESULTS: Acute Grade 2 GI toxicity was seen in 22 of 127 cases (17%). Permutation tests showed that the difference between DVHs for patients with and without Grade 2 effects was significant, both for rectum only and rectum PRVs (P-value range: 0.02-0.04), with generally lower P-values for the PRVs. In the logistic regression, the fractional DVH variables (i.e. volumes) were significantly related to toxicity, with approximately 2-3 times as many significant dose levels for the PRVs as for rectum only. E.g. with wide anterior and posterior margins (16 and 11 mm, respectively) the relation was significant at 26 different dose levels (6-7, 13-14, 35-43, 60-71 and 73 Gy), compared to nine levels (38-40, 43-44 and 71-74 Gy) for rectum only. EUDs were significantly different for patients with and without Grade 2 effects both for rectum only and the PRVs (95% confidence interval for EUD increase with Grade 2 effects: 0.1-3.1 Gy). CONCLUSIONS: All statistical methods applied indicated a small, but definite difference in DVH parameters between patients with versus those without Grade 2 effects. The difference was most pronounced when margins of 16 mm anterior and 11 mm posterior were applied.     

Experimental Tests and Numerical Simulations on the Ballistic Impact Response of a Highly Inhomogeneous Aluminium Foam

A sandwich structure is a composite material consisting of thin skins encapsulating a cellular core. Such structures have proven to be excellent energy absorbents and are frequently found in various types of protection. Even so, few studies exist in the open literature on the response of the core material itself under extreme loadings such as blast and impact. Since a blast load is usually accompanied by numerous fragments, it is important to understand and be able to predict the ballistic impact resistance of the often highly inhomogeneous cellular core materials in design. In this study, the ballistic impact response of an aluminium foam with a complex cell structure has been investigated both experimentally and numerically. First, an extensive material test program involving compression tests on cubic specimens loaded in the thickness direction of the foam was carried out to reveal the mechanical properties of the material. In addition, several of the specimens were scanned before testing using X-ray Micro Computed Tomography (XRMCT) to map the multi-scale topology and morphology of the material. These data were later analysed to extract density-variation plots in many different material orientations. Second, ballistic impact tests were conducted using a gas gun where rigid spheres were launched towards aluminium foam plates, and the ballistic limit velocity and curve of the foam material were established. Finally, numerical simulations of both the material tests and the ballistic impact tests were carried out using LS-DYNA and different modelling approaches based on the XRMCT data. It will be shown that, independent of the modelling strategy applied, good agreement between the experimental impact tests and the numerical predictions can be obtained. However, XRMCT data are important if the final goal is to numerically optimise and improve the behaviour of inhomogeneous foams with respect to energy absorption, thermal isolation, or similar properties.