[Response of dermatomyositis with lung involvement to Janus kinase inhibitor treatment]. / Ansprechen einer Dermatomyositis mit Lungenbeteiligung auf eine Januskinase-Inhibitor-Therapie.

We report on a 32-year-old male patient presenting with anti-MDA-5 and anti-Ro52 antibody positive hypomyopathic dermatomyositis (CADM) with clinically leading interstitial pulmonary involvement. Under several immunosuppressive treatment regimens including high-dose steroids, cyclophosphamide, rituximab, immunoglobulins, plasmapheresis, ciclosporin and mycophenolate mofetil, pulmonary involvement was refractory to progressive. Based on the detection of a clear-cut interferon signature by flow cytometric determination of SIGLEC-1 as an interferon-dependent marker, treatment with the Janus kinase inhibitor tofacitinib was initiated. This resulted in a response to treatment with a significant increase in physical performance, an ameliorated skin condition and computed tomographic (CT) morphologically improved interstitial lung disease with overall good tolerability.

Mortality and institutionalization following hip fracture.

OBJECTIVES: To identify determinants of mortality and institutionalization after hip fracture and to identify those older hip fracture patients at high risk of death or institutionalization after hip fracture. DESIGN: Population-based prospective inception cohort study of hip fracture patients; patients were assessed in the hospital and at 3 months following the hip fracture. SETTING: Edmonton area hip fracture patients admitted to one of two Edmonton, Alberta, Canada, acute care centers between July 10, 1996, and August 31, 1997. PARTICIPANTS: Patients were residents of the Edmonton area and over the age of 64. Those who had previously fractured the same hip within the past 5 years or had some pathological condition underlying the hip fracture were excluded. Of 610 eligible patients, 558 contributed some baseline information and were included in the mortality analysis; the institutionalization analysis was restricted to the 338 patients who lived in the community before fracture, survived the 3-month period postfracture, and had completed a 3-month follow-up interview. MEASUREMENTS: The baseline interview was done in the hospital to assess mental status, prefracture physical function, prefracture health perception, and prefracture social support. The 3-month follow-up interview was done by phone to assess physical function, health perception, and social support 3 months postfracture. Demographic and comorbidity information was collected from medical records. RESULTS: Low mental status in hospital was found to increase the chances of mortality and institutionalization, and male gender was found to increase mortality risk fourfold. Each additional 10 years of age increased the risk of institutionalization approximately 2.5 times. Patients with lower postfracture physical function had at least five times the risk of institutionalization compared to patients with high postfracture physical function. CONCLUSIONS: Cognitive impairment, older age, and gender were associated with increased risk of poor outcome following hip fracture. The socioeconomic variables--social support and health perception--did not contribute significant additional information in explaining mortality or institutionalization risk. While demographic factors cannot be modified, physical function 3 months postfracture may be amenable to intervention and may reduce the risk of institutionalization. Intervening to increase postfracture physical function may be particularly beneficial to older patients, or to those who are cognitively impaired.

Spectrophotometric determination of lead in tap water with 5,10,15,20-tetra(4-N-sulfoethylpyridinium)porphyrin using merging zones flow injection.

Determination of lead at concentrations of > or = 15 micrograms I-1 in aqueous samples was achieved by selective reaction with 5,10,15,20-tetra(4-N-sulfoethylpyridinium)porphyrin at pH 9.4 and 30 degrees C in a merging zones flow injection manifold followed by detection at 480 nm after an elapsed time of 45 s. Interference by aluminium (125-fold excess), cadmium (25-fold excess), copper (25-fold excess), manganese (200-fold excess) and zinc (200-fold excess) was eliminated by the use of 1.0 mol I-1 NH3-NH4CI as a buffer/masking agent; interference by iron (10-fold excess) was eliminated by the addition of 1% v/v of acetylacetone to the reagent mixture and use of the method of standard additions for sample analysis. Recoveries from tap water samples, to which various amounts of lead had been added, ranged from 98 to 109% with a detection limit of 10 micrograms I-1 when iron was present in the sample matrix and 4.2 micrograms I-1 when it was not. Results of analyses of tap water samples using this method were in good agreement with those obtained by electrothermal atomic absorption spectrometry.

[Dye exclusion test and LDH release assay (author's transl)]. / Farbstoffexklusions- und LDH-Freisetzungstest.

Trypanblue exclusion test and LDH release assay were compared concerning correlation and sensitivity. Short time cultures (4 h; 37 degrees C) of human blood leucocytes were carried out in the presence of various doses of either different tissue extracts or digitonin and assayed by the described methods. Three different reaction types have been found: 1. synchronic type: In dependence on the used antigen the LDH release and the number of coloured cells both show either an analogous dose-dependent positive tendency or a negative reaction. 2. asynchronic type: In this case the trypanblue exclusion test shows negative results. In contrast an increase of LDH release is determined suggesting a permeability-increasing influence of the used substance. 3. stabilization type: In comparison with the control the release of LDH is clearly suppressed up to a definite concentration of the substance. The trypanblue exclusion test is not able to detect this cell stabilizing effect. The LDH release assay is sensitive, objective and in the case of an automatic measurement very effective. A necessary presumption for the test is the absence of LDH or enzyme activity-influencing factors in the substance itself. Reasons for the three types of reaction were discussed. It is recommended to apply this enzyme release assay to methods basing on cellular in-vitro short-time-cultures of nucleic cells (testing of pharmaca, potential antigens or allergen preparations and bio-materials).

Pulmonary excretion of hydrogen sulfide, methanethiol, dimethyl sulfide and dimethyl disulfide in mice.

Neither hydrogen sulfide nor any other volatile sulfur metabolites were found in the expired breath of mice given sodium sulfide intraperitoneally in doses up to the LD50. The detection system was sensitive to less than 0.1% of the sulfur in the given dose. The intraperitoneal administration of dimethyl disulfide resulted in its appearance in the expired breath of mice as well as much smaller amounts of both methanethiol and dimethyl sulfide. The intraperitoneal administration of methanethiol resulted in its pulmonary excretion as well as that of dimethyl sulfide. Administration of dimethyl sulfide led to its appearance alone in expired breath. Mice pretreated with ammonium acetate and then injected with dimethyl disulfide excreted the same three compounds via the lungs as above, but there were complex changes in the proportions and in the time sequence of their appearance. The absolute amounts of all three were increased, and the peak excretion for each was delayed. The amount excreted as dimethyl sulfide was particularly increased.

Field and temperature dependent recombination in anthracene.

The quantum efficiency of photoconductivity in anthracene depends on electric field and temperature. Analysis of these results strongly suggests that the generation of free holes and electrons can be described by a model in which, following the initial ionization, most electron-hole pairs are thermalized while still bound by their mutual Coulomb field. The electron and hole may then either recombine or separate as free carriers as they diffuse subject to their mutual Coulomb field and the applied field. Interpreted in the light of this model, the dependence of free carrier quantum yield on temperature and photon energy indicates that the primary ionization process involves energy relaxation and autoionization rather than direct ionization.