[Clinical features and prurigo nodularis in nephrogenic pruritus]. / Klinische Charakteristika und Prurigo nodularis bei nephrogenem Pruritus.

BACKGROUND: Nephrogenic pruritus (NP) is a well-known associated symptom in patients with chronic renal failure. The aim of the present study was to make a detailed dermatological analysis including distribution of excoriations and their correlation with pruritus characteristics. PATIENTS AND METHODS: Data on a total of 17 patients with NP (14 males, mean 65.4 ± SD 14.3 years) were subjected to retrospective analysis. Most of the patients developed NP after start of kidney disease; however, in 20 % of the patients, there was premonitory appearance of the symptom 18 months (median) earlier. A majority of patients reported neuropathic symptom qualities (burning, stinging). In 94.1 % of patients xerosis was present; in 58.8 %, prurigo nodularis. The latter group of patients had a longer duration of pruritus as well as up to 10 years longer duration of renal disease than those without prurigo. RESULTS: Pruritus characteristics of NP show a wide variance without a clear profile that is useful for clinical diagnosis. NP can occur premonitorily, and, if of long duration and with coexistent metabolic diseases, can develop into prurigo.

[Low-grade-/high-grade-synovitis: synovitis-score as a gold standard?]. / Low-grade-/High-grade-Synovialitis. Standardisierte Diagnostik von Synovialektomiepräparaten mittels des Synovialitisscores.

BACKGROUND: Synovectomy specimens represent important material submitted from the orthopedist to the pathologist. However, no consistent histopathological grading system for chronic synovitis has been established so far. PATIENTS AND METHODS: The three compartments of chronic synovitis (enlargement of lining cell layer, density of synovial stroma cells, leukocytic infiltrate) are graded semiquantitatively (from 0=absent to 3=strong), and the points for each compartment add up to the synovitis score: 0-1 = no synovitis, 2-4 = low-grade synovitis, 5-9 = high-grade synovitis. A total of 618 synovial specimens (resections n=559, biopsies n=59) from degenerative and inflammatory joint diseases were graded by two independent observers. RESULTS: Median synovitis scores when correlated to clinical diagnoses were: 1, control; 2, osteoarthritis and post-traumatic arthritis; 3, psoriatic arthritis; 5, reactive and rheumatoid arthritis. The differences between rheumatic and non-rheumatic diseases were significant (p<0.001). The correlation between the two observers was high (p<0.001). CONCLUSIONS: The proposed synovitis score enables stratification of chronic synovitis into low-grade (score 2-4) and high-grade (score >4), which is correlated to the nature of the disease (low-grade to non-rheumatic, high-grade to rheumatic), and it therefore contributes to the diagnosis of rheumatic and non-rheumatic joint diseases.

Supramolecular staircase via self-assembly of disklike molecules at the solid-liquid interface.

A series of soluble hexabenzocoronene (HBC) derivatives with pendant optically active (S)-3,7-dimethyloctanyl and (R,S)-3,7-dimethyloctanyl (mixture of stereoisomers) hydrocarbon side chains with and without a phenylene spacer were assembled into differently ordered arrays at the interface between a solution and the basal plane of highly oriented pyrolytic graphite (HOPG). Molecularly resolved scanning tunneling microscopy (STM) images revealed that all derivatives self-assemble into oriented crystals in quasi-two dimensions. However, while for the alkyl-substituted HBCs (1,4) all of the single aromatic cores within a monolayer exhibit the same contrast in the STM, the single aromatic cores with a phenylene group between the alkyl side chains and the aromatic core (2a,2b,3) exhibit different contrasts within a monolayer. For the disks carrying racemic branched or n-alkyl side chains (2b,3) a random distribution of the two different contrasts within the 2D-crystal is observed, while the optically active phenylene-alkyl-substituted HBC (2a) exhibits a periodical distribution of three contrasts within the monolayer. We attribute the different contrasts of the aromatic cores in the presence of the phenylene groups to a loss of the planarity of the whole molecule and different conformations, which allow the conjugated disks to attain different equilibrium positions above the surface of HOPG. In the case of the optically active side chains a regular superstructure with three distinctly different positions such as in a staircase is attained. The self-assembly processes are governed by the interplay of intramolecular as well as intermolecular and interfacial interactions. In the present case, the interactions may induce both the molecules to acquire well distinct positions along the z axis and to adopt different conformations. The reported results open new avenues of exploration. For instance, the different couplings of conjugated molecules with the substrate at different separations can be investigated by means of scanning tunneling spectroscopy (STS). Furthermore, experiments on the STM tip-induced switching of single molecules embedded in a monolayer appear feasible.

Relationship between fatty acid profile and vitamin E content in maize hybrids (Zea mays L.).

The balance between the vitamin E (tocochromanols) and polyunsaturated fatty acid (PUFA) contents mainly determines the susceptibility to lipid peroxidation and the storage stability of corn oil. In 1997, field experiments were conducted at two different locations to evaluate a collection of 30 corn hybrids for fatty acid profiles and tocochromanol contents. Hybrids differed significantly (p < 0.01) for major fatty acids, as well as for tocochromanol contents and composition. The major fatty acids were palmitic, oleic, and linoleic acids, whose contents were in the ranges 9.2-12.1%, 19.5-30.5%, and 53.0-65.3%, respectively. The tocopherol contents ranged as follows: alpha-tocopherol, 67-276 mg (kg of oil)(-1); beta-tocopherol, 0-20 mg (kg of oil)(-1); gamma-tocopherol, 583-1048 mg (kg of oil)(-1); delta-tocopherol, 12-71 mg (kg of oil)(-1); total tocopherol, 767-1344 mg (kg of oil)(-1). gamma-Tocopherol was the predominant derivative among all tocopherols. The tocotrienol contents were in the ranges 46-89, 53-164, and 99-230 mg (kg of oil)(-1) for alpha-, gamma-, and total tocotrienol contents, respectively. The tocotrienol profile was not characterized by the predominance of any tocotrienol homologue. alpha-Tocopherol was positively correlated with PUFA (r = 0.41) and with the vitamin E equivalent (vit E equiv) (r = 0.84), and it was not correlated with gamma-tocopherol. gamma-Tocopherol was highly correlated with total tocopherol and tocochromanol contents (r = 0.93 and r = 0.90, respectively), indicating that the contribution of this vitamer to the total tocochromanol content is the most important among all tocochromanols. The high positive correlation found between the vit E/PUFA ratio and the vit E equiv, as well as the absence of correlation between this ratio and PUFA indicates that a higher vit E/PUFA ratio can be easier achieved be increasing the vitamin E content than by modifying fatty acid profile in corn oil.

Plasmodium falciparum dihydrofolate reductase alleles and pyrimethamine use in pregnant Ghanaian women.

Drug resistance in Plasmodium falciparum affects prevention of malaria in pregnancy. In a cross-sectional study of 530 pregnant Ghanaian women, P. falciparum dihydrofolate reductase (DHFR) gene mutations linked with pyrimethamine resistance were assessed and associations with pyrimethamine intake were analyzed. P. falciparum infected 69% of women without pyrimethamine use, 59% of those who had a history of pyrimethamine consumption but a negative urine test, and 53% of individuals with a positive urine test. Eighty-one percent, 43%, and 74% of the isolates contained the mutations Asn-108, Ile-51, and Arg-59, respectively. Thr-108 occurred in 8%. Pyrimethamine use was associated with increased frequencies of Asn-108 and Arg-59 but not of Ile-51 or Thr-108. In women with prophylaxis, wild-type parasites were absent and anemia tended to be more common with an increasing number of DHFR gene mutations. Pyrimethamine appears to be not adequately effective in this part of Ghana, most likely due to the predominance of resistant parasites. Selection for resistance following insufficient prophylaxis could possibly affect the efficacy of future intermittent sulfadoxine-pyrimethamine treatment.

Design and pharmacology of quinuclidine derivatives as M2-selective muscarinic receptor ligands.

In our search for M2-selective muscarinic receptor antagonists, we synthesized 1,3-disubstituted indenes. The effects of different basic moieties with regard to binding and selectivity towards the five distinct muscarinic receptor subtypes were investigated. The results show that the quinuclidine series afforded the most promising compounds in terms of both receptor affinity and M2-subtype selectivity.

[Occipitocervical fusion in rheumatoid arthritis]. / Okzipitozervikale Fusion bei rheumatoider Arthritis.

A case of spontaneous occipitocervical fusion is discussed. The authors believe that fusion at the occipitocervical junction will occasionally occur in rheumatoid arthritis in the adult population. As a result of fusion, the dens axis is unable to exert compression on the spinal cord with increased neck flexion.

Comparative study on concentrations of deoxynivalenol and zearalenone in kernels of transgenic Bt maize hybrids and nontransgenic maize hybrids.

Ears from seven pairs of Bt maize hybrids / isogenic maize hybrids from field experiments in the year 1999 were collected arbitrarily and divided into corn borer (ECB) infested and not infested ears, respectively. The kernels were analysed for the mycotoxins deoxynivalenol (DON) and zearalenone (ZON).The percentage of infested ears was significantly lower in case of Bt maize (5%) as compared with non transgenic maize (31%). The study demonstrated further that the DON concentration in kernels of ECB infested ears of the non Bt maize hybrids was significantly higher than the DON concentration of the other groups. In the case of zearalenone, the same trend was observed. When the mean concentrations of the Bt and non-Bt hybrids, respectively, are considered, the lower contamination of Bt maize hybrids with DON and ZON, compared with their isogenic counterparts, is even more evident.

[Treatment of the ankle joint in rheumatoid arthritis with surgical and radiation synovectomy]. / Die Behandlung des rheumatischen oberen Sprunggelenks mit Synovektomie und Radiosynoviorthese.

Results of surgical synovectomy and radiation synovectomy (radiosynoviorthesis) of the tibiotalar joint in rheumatoid patients are reported. The staged concept for management of the rheumatoid ankle joint is presented which is based on the radiographic appearance of disease progression. Results of 16 rheumatoid patients with disease to the ankle joint suggest that pain and walking capability is positively influenced by synovectomy and radiosynoviorthesis. Follow-up of 30 months revealed no deterioration of postoperative clinical improvement. In the absence of contraindications to radiosynoviorthesis it is suggested to combine arthroscopic synovectomy with radiosynoviorthesis for the treatment of early stages of rheumatoid disease of the ankle joint. Open synovectomy is preferred to arthroscopic synovectomy, if tenosynovectomy is simultaneously required.

Treatment of the ankle joint in rheumatoid arthritis with surgical and radiation synovectomy.

Results of surgical synovectomy and radiation synovectomy (radiosynoviorthesis) of the tibiotalar joint in rheumatoid patients are reported. The staged concept for management of the rheumatoid ankle joint is presented which is based on the radiographic appearance of disease progression. Results of 16 rheumatoid patients with disease to the ankle joint suggest that pain and walking capability is positively influenced by synovectomy and radiosynoviorthesis. Follow-up of 30 months revealed no deterioration of postoperative clinical improvement. In the absence of contraindications to radiosynoviorthesis it is suggested to combine arthroscopic synovectomy with radiosynoviorthesis for the treatment of early stages of rheumatoid disease of the ankle joint. Open synovectomy is prefered to arthroscopic synovectomy, if tenosynovectomy is simultaneously required.

Spondylolysis and spondylolisthesis: correlation with sport.

Spondylolysis and spondylolisthesis occur predominantly in the lower lumbar spine. Besides congenital defects such as predisposition of spondylolysis the correlation between competitive sports activities and an increased incidence of spondylolysis is proved. In early stages, complete healing can be achieved by conservative treatment (abstinence from sports activities for 3 months, orthesis). Persistence of pain, neurologic symptoms and progression of vertebral slipping are indications for operative treatment (reconstruction of the isthmus, dorso-ventral spondylodesis). The exercise tolerance depends on the extent of instability, progression of vertebral slipping and clinical symptoms. The limits of exercise tolerance vary among the individual athletes and require the decision of the physician. Backstroke swimming, abdominal and back muscle strengthening exercises, and types of sport involving smooth movements are advisable. Sports education in school is possible without restriction in patients with stable spondylolysis and in those with spondylolisthesis without unfavourable concomitant factors.

[Spondylolysis and spondylolisthesis and sports]. / Spondylolyse und Spondylolisthesis und Sport.

Spondylolysis and spondylolisthesis occur predominantly in the lower lumbar spine. Besides congenital defects such as predisposition of spondylolysis the correlation between competitive sports activities and an increased incidence of spondylolysis is proved. In early stages, complete healing can be achieved by conservative treatment (abstinence from sports activities for 3 months, orthesis). Persistence of pain, neurologic symptoms and progression of vertebral slipping are indications for operative treatment (reconstruction of the isthmus, dorso-ventral spondylodesis). The exercise tolerance depends on the extent of instability, progression of vertebral slipping and clinical symptoms. The limits of exercise tolerance vary among the individual athletes and require the decision of the physician. Backstroke swimming, abdominal and back muscle strengthening exercises, and types of sport involving smooth movements are advisable. Sports education in school is possible without restriction in patients with stable spondylolysis and in those with spondylolisthesis without unfavourable concomitant factors.

Electrophoretic protein analysis for the identification of doubled haploid 1A-1R, 1B-1R wheat-rye double translocation lines and for the assessment of their genetic stability.

Eighteen available doubled haploid wheat lines with a cytologically proven 1A-1R, 1B-1R double translocation, which where derived via anther culture from four crosses of the 1A-1R wheat-rye translocation cv "Amigo" with several 1B-1R wheat-rye translocation forms, were subjected to electrophoretic seed protein analysis. Besides, the five parents used in the crosses and some other wheat cultivars and doubled haploid lines (19 with a 1B-1R single translocation, 10 with a 1A-1R translocation and 7 without any 1R translocation) were also included in the investigation. It was found that the gliadin patterns visualized after SDS polyacrylamide gel electrophoresis of alcohol-soluble seed protein extracts can differentiate not only 1B-1R and 1A-1R translocation forms from wheats without any 1R-translocation chromosome, but also 1B-1R and 1A-1R wheats from each other. Moreover, 1A-1R, 1B-1R double translocation lines can be distinguished as well due to characteristic differences revealed between 1A-1R and 1B-1R translocation forms. Thus, all of tested dh1- and dh2-grains of the double translocation lines showed the expected doublet: the 1A-1R translocation ("Amigo")-typical rye band and the 1B-1R translocation ("Kawkas")-typical rye band. Consequently, gliadin patterns estimated after SDS electrophoresis may be used as markers for the fast detection of the desired 1A-1R, 1B-1R double translocation forms among 1A-1R single translocation lines, 1B-1R single translocation lines and lines without any 1R-translocation in the progenies of appropriate crosses. Furthermore, by means of gliadin tests on the dh2-generation the excellent stability of the double translocation 1A-1R, 1B-1R during more than one propagation phase has been proven. Estimations of high-molecular weight (HMW) glutenin subunits coded by 1A and 1B chromosomes are compatible with the double translocation constitution. A few deviating results can be explained by crossing-over events. Seed protein analysis revealed that it is possible to produce 1A-1R, 1B-1R double translocation lines with good glutenin compositions provided that adequate favourable parents are used.