A measure of chronic quality of life predicts socioeconomic and medical outcomes in psoriasis patients.

BACKGROUND: Psoriasis is a chronic skin disorder that detracts from quality of life, including elements of physical, psychological and social functioning. OBJECTIVE: This study investigated whether retrospective questions about chronic quality of life (CQoL) were better predictors of poor socioeconomic and medical outcomes than the current Dermatology Life Quality Index (DLQI). METHODS: One hundred fourteen participants answered the 10 questions used in the standard DLQI for 'over the last week', 'over the last year' and 'over your lifetime with psoriasis'. Subjects were examined and completed a self-administered questionnaire regarding disabilities, relationships, education and medical and economic outcomes (a smaller subset of 58 subjects also answered questions regarding religion and discrimination). RESULTS: Greater lifetime DLQI (LT DLQI) correlated with lower satisfaction with treatment (P = 0.007), greater concern that psoriasis will worsen (P = 0.012), worse perceived general health (P = 0.003), younger age at which weight became problematic (P = 0.002), greater likelihood of believing psoriasis had caused weight gain (P < 0.001), shorter retention of current job (P = 0.001), more experiences of discrimination at work (P = 0.002) and in social settings (P < 0.001) over one's lifetime and more severe discrimination in social settings over one's lifetime (P = 0.002). Greater LT DLQI predicted more packs smoked per day (P = 0.005), greater likelihood of believing psoriasis caused smoking (P = 0.012), greater likelihood of recreational drug use (P = 0.004), greater likelihood of a depression diagnosis (P < 0.001), greater likelihood of having felt depressed (P = 0.011) and greater likelihood of believing psoriasis caused depression (P < 0.001). CONCLUSION: Compared to the standard LW DLQI, LT DLQI was a better predictor of patient outcomes related to weight, discrimination and depression.

The relative impact of psoriasis and obesity on socioeconomic and medical outcomes in psoriasis patients.

BACKGROUND: Psoriasis is a chronic, inflammatory skin disorder that is associated with obesity. Independently, both psoriasis and obesity likely impose impressive physical and psychosocial burdens on affected patients. OBJECTIVE: The purpose of this study was to evaluate the relative impact of body mass index (BMI) on the socioeconomic status, medical co-morbidities, and current and chronic quality of life of psoriasis patients. METHODS: Overall, 114 subjects were examined and asked to complete a self-administered questionnaire regarding disabilities, relationships, education, as well as medical and economic outcomes. Participants also answered the ten questions used in the Dermatology Life Quality Index modified to ask 'over the last week', 'over the last year' and 'over your lifetime with psoriasis'. Survey responses were compared amongst the three patient groups based on BMI (normal, overweight, obese). RESULTS: Patients with elevated BMI were more likely to rate their general health lower (P < 0.001), believe that psoriasis caused their weight gain (P = 0.014), experience sleep problems over their lifetime (P = 0.016), hide their psoriasis over their lifetime (P = 0.010), have their self-confidence affected by their psoriasis over their lifetime (P = 0.011) and avoid common activities over their lifetime (P = 0.012). CONCLUSION: There are long-term negative effects of elevated BMI that impose additional burdens on psoriasis patients, including impairments in sleep quality and increased social anxiety.

[Fate of the Viennese Jewish pediatricians 1938-1945]. / Das Schicksal der Wiener jüdischen Kinderärzte zwischen 1938 und 1945.

The article summarizes the first results of an attempt to reconstruct the destinies of the Jewish pediatricians of Vienna after the German occupation of Austria in March 1938. Traditionally pediatrics in Vienna were characterized by a high percentage of Jewish specialists. In 1938 they were confronted with abrupt humiliations and persecutions by the sudden introduction of the Nazi racial laws. The paper describes the foregoing, developments in Germany since 1933 and analyses the fates of 96 pediatric specialists of Vienna, who were affected by these events.

Flow cytometric assay of cytochemically demonstrated NAD(P)H oxidoreductase (diaphorase) activities.

The tetrazolium salt 5-cyano-2,3-di-p-toluyl-tetrazolium chloride (CTC), yielding a fluorescent formazan on reduction, was used to measure NAD(P)H oxidoreductase activity. In this study, optimal conditions for the flow cytometric technique were determined empirically with tissue culture cell lines and mouse Ehrlich ascites cells. Applying a coupled reaction procedure, NADH and NADPH as substrates of the oxidoreductases to be measured are generated endogenously by lactate or glucose-6-phosphate dehydrogenase, respectively. The results were evaluated by combining spectrophotometry and flow cytometry. We obtained integral activities for each group of NADH and NADPH oxidoreductases. Furthermore, by counterstaining the DNA with DAPI, followed by bivariate analysis of flow cytometric data, our assay gives a detailed distribution of enzyme activities of all cells, even in subgroups present in heterogeneous cell populations. Therefore, this protocol permits the study of NAD(P)H oxidoreductase activities in ex vivo tumor samples in which mixed cellular populations may be present.

Experimental estimation of hydrophobic parameters of tetrazolium salts.

A simple method for estimation of the hydrophobic parameters (partition coefficient lg P and Hansch pi-value) of tetrazolium salts is reported using their relative velocities in reverse-phase layer chromatography. The experimental test values are close to relevant calculated values of the literature.

On the mechanism of the multistep reduction of tetrazolium salts with special reference to the involvement of tetrazolium radicals.

Thin layer chromatography (TLC) was performed to analyze which products are formed when unstable tetrazolinyl radicals are generated during the reduction of tetrazolium salts under physiological conditions of biochemical and histochemical assays. It was found in aqueous media that irrespective the assay conditions, reduction of 2,3-di(4-nitrophenyl)-5-phenyl-2H-tetrazolium chloride (p-DNTTC) or 2,3-di(4-nitrophenyl)-5-t-butyl-2H-tetrazolium chloride (t-butyl-DNTC) always lead to production of formazan and never to generation of the corresponding 2(4-nitrophenyl)-5-phenyl- (respectively t-butyl-) tetrazoles by splitting off a nitrophenyl side chain from the tetrazolium ring as a cation. This reaction is known to occur in non-aqueous media (Neugebauer, 1973). Because p-DNTTC is analogous to tetrazolium salts that are used in biochemical and histochemical assays, it is concluded that reduction of tetrazolium salts leads to formation of formazans only under these conditions.

[Teaching and learning in medicine--or: how does one become a physician?]. / Lehren und Lernen in der Heilkunde--Oder: Wie wird man Arzt?

Since the beginning of a formalized medical education in the high Middle Ages continue to be discussed in principle three hypothesis how an effective doctor should be trained: by organizing an ingenious program of studies, by canonizing the content of knowledge, or by taking in consideration the demand of public utility. All three viewpoints produced typical forms of communication within the teaching of medicine, without finding an ideal type until today.

Factors affecting the selection and use of tetrazolium salts as cytochemical indicators of microbial viability and activity.

The reduction of four tetrazolium cations (TCs), nitroblue tetrazolium (NBT), neotetrazolium (NT), methylthiazolyldiphenyltetrazolium (MTT) and iodonitrophenyltetrazolium (INT), by viable micro-organisms, immobilized on glass cover slips, was examined by light microscopy with a view to determining a systematic basis for applying these reagents as cytochemical indicators of microbial viability and activity. The potential value of histochemical information about TC reactions for developing their microbiological applications was also assessed. INT and MTT detected viable cells more readily than NBT and NT. In order to obtain cell-localized formazan, MTT required cobalt ions in the reaction mixture and INT reactions had to be assessed soon after mounting. In general, formazan deposition could be accelerated by the addition of glucose and an intermediate electron carrier (IEC) to the reaction mixture, although inhibitory effects of IECs were also detected. Cultures in exponential phase, in stationary phase and inhibited by chloramphenicol could be differentiated with MTT but not with INT. For some organisms, notably Candida albicans, Pseudomonas aeruginosa and Enterococcus faecalis. TC reactions proved to be a relatively insensitive means of demonstrating viability. Two parameters used in selecting TCs for histochemical reactions, lipophilicity and reducibility appeared to be predictive for the relative sensitivity of these reagents as indicators of cell viability. The concepts of substantivity, a measure of non-specific interactions between reagents and staining substrates, and TC oxygen sensitivity, the effect of competition between oxygen and TCs for electrons, were found to be relevant to formazan deposition in live microbes. These findings support the use of TCs as cytochemical probes of microbial activity in defined settings and the use of histochemical knowledge to support further development of these techniques.

Calibration of a flow cytometric assay of glucose-6-phosphate dehydrogenase activity.

The reduction of tetrazolium salts to colored formazans is a reaction which has been exploited both in histo- and cytochemistry. Tetrazolium salts forming fluorescent formazans prove suitable for measuring defined cellular dehydrogenase activities in automated processes. This study considers an important aspect of formazan measurement in flow cytometry, namely, calibration. Calibration is performed by correlating the number (and fluorescence intensity) of formazan-bearing cells measured by flow cytometry with simultaneously performed biochemical analyses of the same material. The method is demonstrated by an example of glucose-6-phosphate dehydrogenase. Using the data of a typical experiment, the enzyme activity is expressed in femtomol of hydrogen transferred per cell during incubation time. Furthermore, through spatially resolved double excitation of formazan and nuclear DAPI fluorescence, an independent analysis of cell cycle and cellular enzymatic activity is established.

The tetrazolium-formazan system: design and histochemistry.

Our increasing knowledge about the chemistry and the correlations between chemical structure and histochemical properties of the tetrazolium/formazan system is resulting in: a better understanding of existing histochemical tetrazolium techniques; the selection of optimal tetrazolium salts for qualified use in histochemistry, cytochemistry and biochemistry; both qualitative and quantitative improvements in histochemical techniques for purposes demonstrating the activities of various dehydrogenating enzymes; an extended insight into the "state" of the tested biological object by means of tetrazolium indicators with special properties; and the combination of histochemical enzyme determination with further morphological techniques. This article has attempted to illustrate the progress in the use of the tetrazolium/formazan-system for histochemical purposes.

[Histochemical model investigations of the action mechanisms of lathyrogenic substances]. / Histochemische Modellversuche zum Wirkungsmechanismus lathyrogener Substanzen.

In histochemical model studies, aminoacetonitrile and 3-aminopropionitrile can form hydrolysis-stable azomethines (Schiff bases) with periodate-induced aldehyde groups of tissue slices. Both substances and triethylentetramine do not inhibit the histochemical monoaminoxidase activity, they even can act as substrates of this enzyme. These substances cause an inhibition of the histochemical aminopeptidase M activity, but this inhibition was recognized as a methodological error due to the formation of complexes between diazonium salts and aliphatic amines. The results indicate that the inhibition of the lysyl oxidase will not be the only mechanism of action of lathyrogenic substances.

Histophotometry--the method of choice in quantifying dehydrogenase histochemistry.

Succinate, malate, and lactate dehydrogenase were demonstrated histochemically and measured histophotometrically in the heart and skeletal muscle (m. extensor digitorum longus and m. soleus) of rats at different ages. To prove the value of histophotometry, the enzymes of the tissues were estimated biochemically. The gel film technique cannot sufficiently prevent the diffusion of the soluble enzymes (malate-, lactate dehydrogenase) out of the tissue sections. Because of the different mobility, various isoenzymes, histophotometry cannot give reliable results. But, as far as membrane-bound dehydrogenases (succinate dehydrogenase) are concerned, histophotometry is the method of choice for basic measurements as in routine practical work, especially with tissues where the enzyme activities are heterogeneously distributed, e.g. in different types of muscle fibres in skeletal muscles.

[Functional morphology of the human placenta]. / Funktionelle Morphologie der menschlichen Plazenta.

An account is given of latest knowledge on the structure of the human placenta. Reference is made to the early stages of development as well as to maturation under both normal and pathological conditions. The paper is intended to contribute to better understanding of the pathogenesis of chronic placental insufficiency.

[Model studies in the histochemical investigation of hydrolases using tetrazolium salts]. / Modelluntersuchungen zur histochemischen Darstellung von Hydrolasen mit Tetrazoliumsalzen.

As a model alkaline phosphatase and non-specific esterase were investigated with indoxyl substrates and 11 tetrazolium salts of different reducible substances in livers and kidneys of rat. Besides their localizing qualities, the reducibility of the used tetrazolium salts is the most important parameter for their use in histochemistry of hydrolases. The composition of the reaction products depends on the reducibility of the indicator and the pH of the reaction. The of phenazine methosulphate improves the indoxyl-tetrazolium techniques above all in the neutral and acid range.