Distinguishing schizophrenic patients from healthy controls by quantitative measurement of eye movement parameters.

BACKGROUND: Eye tracking dysfunction is a putative trait marker for susceptibility to schizophrenia; however, it cannot be recommended as an additional tool for the diagnosis of schizophrenia, due to low sensitivity and specificity. METHODS: To assess the diagnostic potentials of combinations of eye movement paradigms, four smooth pursuit experiments (1: constant velocity of 15 degrees/sec; 2 and 3: combination with either visual or auditory distractors; 4: constant velocity of 30 degrees/sec) and two saccadic eye movement experiments (1: reflexive saccades; 2: voluntary saccades) were conducted. Fourteen patients with residual schizophrenia and 17 healthy controls were studied. Two sets of discriminant analyses (each with the resubstitution and with the "leaving one out" method) were calculated. RESULTS: In the first set, all 10 characteristic variables were included, whereas for the second set, the three most powerful parameters were selected (two from smooth pursuit tasks and one from a voluntary saccade experiment). This procedure provided the best classification results, regarding concordance between clinical diagnoses and eye movement dysfunction (kappa = .67-.80). CONCLUSIONS: Schizophrenic patients of the residual subtype can be differentiated from healthy individuals with considerable criterion validity on the basis of paradigms from two different ocular motor systems.

Luteinizing hormone-releasing hormone agonist triptorelin in combination with cytotoxic chemotherapy in patients with advanced ovarian carcinoma. A prospective double blind randomized trial. Decapeptyl Ovarian Cancer Study Group.

BACKGROUND: Several lines of evidence suggest that the proliferation of ovarian carcinoma might be stimulated by gonadotrophins. A number of Phase I/Phase II clinical trials have reported that the suppression of endogenous luteinizing hormone and follicle-stimulating hormone secretion by luteinizing hormone-releasing hormone (LHRH) analogs induced objective remissions and/or disease stabilization in 10-30% of patients with advanced refractory ovarian carcinoma. The current study was performed to evaluate whether the addition of LHRH agonist treatment to standard platinum-based chemotherapy could prolong survival of patients with surgically treated Stage III or IV epithelial ovarian carcinoma. METHODS: One hundred and thirty-five patients with Stage III or IV epithelial ovarian carcinoma participated in this prospective randomized double blind trial. After cytoreductive surgery, 69 patients received monthly injections of a depot preparation of the LHRH agonist [D-Trp6] LHRH (triptorelin, 3.75 mg) and 66 patients received placebo until their deaths or termination of trial, respectively. All patients were treated with a standard platinum-based chemotherapy, and, if necessary, with second- or third-line cytotoxic regimens. RESULTS: Endogenous gonadotrophins were reliably suppressed in patients treated with triptorelin. However, their progression free and overall survival were not significantly different from that of patients receiving placebo injections (statistical power > 80% for a difference between both groups of > or = 20%). CONCLUSIONS: The results of this trial suggest that the suppression of endogenous gonadotrophins by conventional doses of an LHRH agonist produces no relevant beneficial effects in patients with advanced ovarian carcinoma who receive standard surgical cytoreduction and cytotoxic chemotherapy.

Long term exposure to manganese in rural well water has no neurological effects.

BACKGROUND: There is debate on the neurological impact of chronic exposure to Manganese (MN). METHODS: MN burden from rural well water was studied cross-sectionally in two proband cohorts from rural dwellings located in northern Germany. Both cohorts had exposure times for up to 40 years and were separated on the basis of well water MN content. Group A (41 subjects; mean age 57.5 years) was exposed to MN water contents of at least 0.300 mg/l (range 0.300 to 2.160), while group B (74 subjects; mean age 56.9 years) was exposed to concentrations of less than 0.050 mg/l. Both proband groups were homogenous with regard to age, sex, nutritional habits, and drug intake. Neurological assessments by clinical investigators blinded for proband's exposure status was done using structured questionnaires, standardized neurological examination with assessment of possible Parkinsonian signs by the Columbia University Rating Scale, and instrumental tests of fine motor coordination. RESULTS: No significant difference in any neurological measure was found between groups. Results were not confounded by demographic and dietary features. CONCLUSION: Exposure to high body burden of MN does not result in detectable neurological impairment. Exposure to MN in drinking water does not seem to be a risk factor for idiopathic Parkinson's disease.

Quantitative surface topography as a tool in the differential diagnosis between melanoma and naevus.

BACKGROUND/AIMS: The mainstays of the clinical diagnosis of melanoma are asymmetry, border irregularity, color variegation, and a diameter >6 mm, and any major progress in diagnostic accuracy will probably be related to the development of additional criteria. Such independent criteria might arise from the study of the geometry of the tumour surface, because this quality has been substantially disregarded until now. Our work is aimed at utilizing the surface topography for the differential diagnosis between malignant melanoma and naevocytic naevus. METHODS: Dynamically focusing optical profilometry was used to measure the surfaces of negative replicas of melanocytic skin tumours and of the surrounding normal skin. 21 silicone imprints of superficial spreading melanomas and 25 imprints of naevocytic naevi were examined. RESULTS: Melanomas and naevi differed with respect to a variety of statistical surface parameters, and a linear discriminant analysis correctly allocated 19 out of 21 melanomas (90%) and 21 out of 25 naevi (84%). To get an unbiased estimate of the errors to be expected with this classification rule, we calculated bootstrap-corrections to the apparent errors. Estimated probabilities of correct allocation were 84.1% for melanomas and 77.1% for naevi. CONCLUSION: Our findings suggest that simple statistical parameters of surface topography can differentiate effectively between malignant melanomas and naevocytic naevi.

Oral iodized oil for correcting iodine deficiency: optimal dosing and outcome indicator selection.

Oral iodized oil is the major alternative to iodized salt for correcting endemic iodine deficiency. This study responds to a need for better guidelines in its use. Schoolchildren, aged 6-11 yr, from a severely iodine-deficient area of Algeria received iodized poppy seed oil (Lipiodol) in a single oral dose containing 120, 240, 480, or 960 mg iodine (groups A-D) or in an im injection of 480 mg iodine (group E). Thyroid volume by ultrasonography had not changed 395 days after treatment in groups A, B, and C, had decreased in groups D and E. Urinary iodine concentration rose rapidly from an initial median of 0.21 mumol/L, but fell below 0.79 mumol/L (the currently accepted level for indicating iodine deficiency) by 150 days for groups A and B, and by 395 days for groups C and D. Median serum TSH and T4 levels were normal before and after treatment, whereas high initial serum thyroglobulin values decreased in all groups after iodized oil treatment. For correcting iodine deficiency in children, we recommend single oral doses of Lipiodol containing 240 mg iodine for 6-month coverage or 480 mg for 12 months. These doses may not completely sustain iodine sufficiency, but will prevent the worst of the iodine deficiency disorders. Additionally, we conclude that the urinary iodine concentration is the most useful epidemiological indicator for assessing current iodine status, and thyroid volume and serum thyroglobulin levels are the best markers for assessing chronic effects.

Sex difference in the serostatus of adults to the Epstein-Barr virus.

A total of 1047 adults, aged between 18 and 90 years, including blood donors and surgical patients of the Medical University of Lübeck in Germany, were screened for IgG antibodies to the Epstein-Barr Virus, either by standard indirect immunofluorescence or by a novel enzyme-linked immunosorbent assay (Enzygnost Anti-EBV/IgG, Behring, Marburg, Germany). There was a significant sex difference in the serostatus to the Epstein-Barr virus in adults. Male adults were more likely than females (p < 1%) to be EBV-seronegative. The same trend was seen in both a group of 713 blood donors and 334 surgical patients and when different test methods were used. However, this sex difference was not shown in the sera of 86 pediatric patients of the Medical University of Lübeck tested by indirect immunofluorescence for IgG antibodies to the Epstein-Barr virus. Furthermore, titers of IgG antibodies to Epstein-Barr virus specific antigens of female adults, obtained by the enzyme-linked immunosorbent assay (Enzygnost Anti-EBV/IgG), had significantly higher median values than male adults (p < 5%).

[Iodine deficiency in Germany]. / Jodmangel in der Bundesrepublik Deutschland.

Urinary iodine excretion was determined in 2094 adults from 36 cities in the Federal Republic of Germany. The mean concentration was 94.1 +/- 93.1, median 66 micrograms iodine/g creatinine, or 6.2 +/- 6.0, median 4,4 iodine/dl urine, respectively. 194 (9.2%) subjects had an iodine excretion > 600 micrograms iodine/g creatinine or > 40 micrograms iodine/dl, which cannot be reached by normal nutrition. The median excretion found in West Germany (70.2 micrograms iodine/g creatinine and 5.0 iodine/dl urine, respectively) was higher than in East Germany (61.3 and 3.9, respectively), however the difference was not significant. There was no slope of urinary iodine excretion from North to South. The iodine creatinine index when compared with the iodine concentration alone did not improve the epidemiological accuracy (r = 0.75, p < 0.01). The iodine intake of the population is still below the minimum of the WHO recommendation. An efficient iodized salt prophylaxis would save approximately 1.3 billion DM annually and contribute to a genuine reduction in health-care costs.

Influence of phospholipid liposomes (PLL) on UVB-induced erythema formation.

Application of liposomal phospholipids (Natipide II) caused a significant decrease in erythema induced by UVB (280-312 mm) in patients with skin types II and III (n = 31). In accordance with findings in other organs, e.g. liver, the present findings suggest that phospholipids are capable of reducing H2O2 formation and/or increasing glutathione synthesis in human skin, thus reducing erythema formation by preventing oxidative stress.

Comparison of silver stainings and immunohistology for the detection of neurofibrillary tangles and extracellular cerebral amyloid in paraffin sections.

The sensitivities of six silver-staining methods and immunohistology for beta and tau protein were compared for their ability to demonstrate neurofibrillary tangles (NFT) and senile plaques (SP) in paraffin sections. Serial sections of the hippocampal area of 35 brains showing these neuropathological findings were cut and stained by the methods of Cross, Campbell, Bielschowsky, Gallyas, Yamaguchi, our variant (method of Reusche) and immunohistology. In the detection of NFT, the techniques of Gallyas, Bielschowsky, our method and tau protein immunostaining were the most sensitive methods. The procedure of Campbell and again our method were proven to be superior to the other stainings in demonstrating SP as well as diffuse and subpial amyloid. Moreover, our method reliably stained vascular and perivascular amyloid which can be identified in brains with congophilic angiopathy. Due to a lack of control in certain steps of the procedures most of the silver-staining methods are complicated and to not present reliable results. Our variant is easy to perform and, thus, may be used as a sensitive, simple and reliable alternative for the impregnation of the main lesions (NFT and SP) occurring in senile dementia of Alzheimer type and brains with normal aging for screening, retrospective and quantitative studies and for routine purposes.