Experimental check of the Gerasimov-Drell-Hearn sum rule for 1H

For the first time we checked the fundamental Gerasimov-Drell-Hearn (GDH) sum rule for the proton experimentally in the photon energy range from 0.2-2.9 GeV with the tagged photon facilities at MAMI (Mainz) and ELSA (Bonn). New data of the doubly polarized total cross section difference are presented in the energy range from 1.6 to 2.9 GeV. The contribution to the GDH integral from 0.2-2.9 GeV yields [254+/-5(stat)+/-12(syst)] microb with negative contributions in the Regge regime at photon energies above 2.1 GeV. This trend supports the validity of the GDH sum rule.

Effects of corticosterone on place conditioning to ethanol

RATIONALE AND OBJECTIVE

Effects of corticosterone on place conditioning to ethanol were investigated in mice using two conditioning schedules; the conventional method and a rapid conditioning schedule in which exposure to the CS+ followed immediately on exposure to the CS-.

METHODS

Effects of administration of corticosterone, 10 mg/kg, on the acquisition of place conditioning produced by ethanol, 1-2.5 g/kg, were investigated using the conventional method of conditioning, with exposure to the CS+ and the CS- on alternate days, and also using the rapid conditioning method. Total and free blood corticosterone concentrations were measured after administration of ethanol and corticosterone.

RESULTS

In the conventional, alternate day, conditioning schedule, ethanol produced significant place preference at 2 and at 2.5 g/kg, but when these alcohol doses were given with corticosterone 10 mg/kg, significant place conditioning was not seen. In contrast, in the rapid, same day, conditioning schedule corticosterone significantly decreased the dose at which ethanol produced an apparent place preference, with significant place conditioning being seen with ethanol at 1 and 1.5 g/kg in combination with corticosterone, 10 mg/kg. Total and free corticosterone concentrations were increased after ethanol, 1.5 g/kg, compared with controls, and administration of corticosterone, 10 mg/kg, caused a significantly greater increase. There were no significant differences in spontaneous locomotor activity or brain alcohol concentrations between any of the treatment groups.

CONCLUSIONS

The effects of corticosterone on ethanol-induced place conditioning are substantially affected by the conditioning schedule used.

Clinically evidenced unilateral dissociation of saccades and pursuit eye movements

A patient affected by an ischaemic lesion of the right medial thalamic nucleus presented with a uniocular dissociation of upward vertical saccades and pursuit movement, with absent upward vertical saccades in the left eye. Clinical observations were confirmed by magnetic field scleral search coils analysis. During the vertical eye movement the patient denied any diplopia, thus suggesting a transient visual suppression in the left eye.

Photoproduction of eta-mesic 3He

The photoproduction of eta-mesic 3He has been investigated using the TAPS calorimeter at the Mainz Microtron accelerator facility MAMI. The total inclusive cross section for the reaction gamma3He-->etaX has been measured for photon energies from threshold to 820 MeV. The total and angular differential coherent eta cross sections have been extracted up to energies of 745 MeV. A resonancelike structure just above the eta production threshold with an isotropic angular distribution suggests the existence of a resonant quasibound state. This is supported by studies of a competing decay channel of such a quasibound eta-mesic nucleus into pi(0)pX. A binding energy of (-4.4+/-4.2) MeV and a width of (25.6+/-6.1) MeV is deduced for the quasibound eta-mesic state in 3He.

Combining entacapone with levodopa/DDCI improves clinical status and quality of life in Parkinson?s Disease (PD) patients experiencing wearing-off, regardless of the dosing frequency: results of a large multicentre open-label study

The efficacy of entacapone and its impact on patient quality of life (QOL) was investigated in an open-label study of 899 patients with idiopathic Parkinson's Disease (PD) experiencing wearing-off fluctuations. Patients were divided into 3 groups (3, 4 or 5 doses daily) based on their current levodopa dosage frequency. Patients received 200 mg entacapone with each levodopa/dopa-decarboxylase inhibitor (DDCI) dose, while continuing their same levodopa/DDCI dosage regimen for 4 weeks. Primary efficacy measure was the Investigators' Clinical Global Impression of Change (CGIC). Patient QoL was assessed using the validated 8-item Parkinson's Disease Questionnaire (PDQ-8). Investigators' CGIC revealed that 76.5% of entacapone treated patients experienced an improvement in global status after 4 weeks. Treatment with entacapone was also associated with improvement in patient QoL, with a mean reduction (improvement) in PDQ-8 score of 1.8 from baseline. This study confirms and extends the results of earlier studies demonstrating that, independent of dosing frequency, completing levodopa/DDCI therapy with entacapone provides clinically relevant improvements in global status and QoL in PD patients experiencing wearing-off on their current levodopa dosing frequency.

Early Postoperative Ultrasound of Kidney Transplants: Evaluation of Contrast Medium Dynamics Using Time-intensity Curves

OBJECTIVE

To evaluate kidney recipients in the early posttransplant phase by semiquantitative analysis of the arterial arrival of ultrasound (US) contrast medium using time-intensity curves.

PATIENTS AND METHODS

Twenty-two kidney recipients underwent US examination after intravenous bolus administration of 2.4 ml of US contrast medium (SonoVue, Bracco Altana) 5 to 7 days after transplantation. The examinations were performed with the Aplio US system (Toshiba) and a 3.5-MHz wideband transducer using contrast harmonic imaging at a low mechanical index of 0.1. Arterial arrival was documented digitally over 60 sec (image repetition rate: 10 images per sec) for subsequent evaluation of contrast medium kinetics in the main renal artery, interlobar artery, subcapsular area, and renal vein using the system's integrated time-intensity curve (TIC) software. The increase, decrease, and percentage enhancement factor were calculated from the curves. Four patients were excluded from analysis because of perirenal hematoma (n = 3) or a polar perfusion loss demonstrated by power Doppler (n = 1).

RESULTS

Twelve of the remaining 18 patients assigned to the nonrejection group showed an uneventful clinical course. These had uniform TICs with an early and steep increase of similar magnitude in the main renal artery (11.7 +/- 4.5 intensity units/sec), interlobar artery (8.7 +/- 4.6 intensity units/sec), and subcapsular area (8.3 +/- 3.7 intensity units/sec) followed by a washout and subsequent plateau phase. Six patients showed histologically proven acute rejection on day 5 or 6 after transplantation (rejection group). This group had a delayed (time to peak in the subcapsular area: 32.9 +/- 8.3 sec in the rejection group versus 20.9 +/- 4.7 sec in the nonrejection group, p < 0.05) and smaller subcapsular percentage increase (41.2 +/- 21.9 % versus 114.4 +/- 59.8 %, p < 0.05). In the rejection group the subcapsular area (3.8 +/- 2.3 intensity units/sec) showed a less pronounced increase than the main renal artery (7.9 +/- 5.9 intensity units/sec) and interlobar artery (8.7 +/- 3.8 intensity units/sec). The RI in the rejection group was in the normal range at the time of contrast-enhanced US (day 5: 0.78 +/- 0.06) and increased to abnormal levels in the further course (day 7: 0.94 +/- 0.09).

CONCLUSIONS

Quantitative determination of arterial arrival of an US contrast medium in the early phase after kidney transplantation is possible. This new US procedure might identify acute rejection earlier than conventional techniques.

[Excruciating flank pain: "acute renal colic"]

The classic presentation of acute renal colic is the sudden onset of very severe pain in the flank primarily caused by the acute ureteral obstruction. The diagnosis is often made on clinical symptoms only, although confirmatory exams are generally performed because many others significant disorders may present with symptom of flank pain that mimics renal colic. Life threatening emergency such as abdominal aortic aneurysm must be ruled out. While non contrast CT has become the standard imaging modality, in some situations, a plain abdominal radiograph associated with a renal ultrasound or a contrast study such as intravenous pyelogram may be preferred. Hematuria is frequently present on urine analysis. The usual therapy represented by analgesic and nonsteroidal anti-inflammatory drugs should be started as soon as possible. Size and location of the stone are the most important predictors of spontaneous passage. Uncontrolled pain by medical therapy, fever, oligo-anuria suggest complicated stone disease. Such conditions require emergency treatment by drainage or stone extraction. Although recurrent stone rate is important, extensive metabolic explorations are not recommended after an uncomplicated first episode. Nevertheless fluid intake is encouraged and a stone chemical analysis should be performed whenever possible.

The Football Association Medical Research Programme: an audit of injuries in professional football--analysis of hamstring injuries

OBJECTIVE

To conduct a detailed analysis of hamstring injuries sustained in English professional football over two competitive seasons.

METHODS

Club medical staff at 91 professional football clubs annotated player injuries over two seasons. A specific injury audit questionnaire was used together with a weekly form that documented each clubs' current injury status.

RESULTS

Completed injury records for the two competitive seasons were obtained from 87% and 76% of the participating clubs respectively. Hamstring strains accounted for 12% of the total injuries over the two seasons with nearly half (53%) involving the biceps femoris. An average of five hamstring strains per club per season was observed. A total of 13 116 days and 2029 matches were missed because of hamstring strains, giving an average of 90 days and 15 matches missed per club per season. In 57% of cases, the injury occurred during running. Hamstring strains were most often observed during matches (62%) with an increase at the end of each half (p<0.01). Groups of players sustaining higher than expected rates of hamstring injury were Premiership (p<0.01) and outfield players (p<0.01), players of black ethnic origin (p<0.05), and players in the older age groups (p<0.01). Only 5% of hamstring strains underwent some form of diagnostic investigation. The reinjury rate for hamstring injury was 12%.

CONCLUSION

Hamstring strains are common in football. In trying to reduce the number of initial and recurrent hamstring strains in football, prevention of initial injury is paramount. If injury does occur, the importance of differential diagnosis followed by the management of all causes of posterior thigh pain is emphasised. Clinical reasoning with treatment based on best available evidence is recommended.

Gender disparities in tuberculosis: report from a rural DOTS programme in south India

SETTING

Tiruvallur District, south India.

OBJECTIVES

To examine gender differences in tuberculosis among adults aged >14 years with respect to infection and disease prevalence, health care service access, care seeking behaviour, diagnostic delay, convenience of directly observed treatment (DOT), stigma and treatment adherence.

METHODS

Data were collected from 1) community survey, 2) self-referred out-patients seeking care at governmental primary health institutions (PHIs), 3) tuberculosis suspects referred for sputum microscopy at PHIs, and 4) tuberculosis patients notified under DOTS. Community survey results were compared with those for patients notified at PHIs.

RESULTS

In the community, 66% of males and 57% of females had tuberculosis infection. The prevalence of smear-positive tuberculosis was 568 and 87/100,000, respectively, among males and females. Fewer males than females attended PHIs (68 men for every 100 women). Females constituted 13% of all smear-positive patients detected in the community survey, and 20% of those detected at PHIs (P < 0.05). The probability of notification decreased significantly with age among both males and females. Significantly more females than males felt inhibited discussing their illness with family (21% vs. 14%) and needed to be accompanied for DOT (11% vs. 6%). Males had twice the risk of treatment default than females (19% vs. 8%; P < 0.01).

CONCLUSIONS

Despite facing greater stigma and inconvenience, women were more likely than men to access health services, be notified under DOTS and adhere to treatment. Men and elderly patients need additional support to access diagnostic and DOT services.

Distribution of hydrophobic residues is crucial for the fusogenic properties of the Ebola virus GP2 fusion peptide

The lipid-destabilizing properties of the N-terminal domain of the GP2 of Ebola virus were investigated. Our results suggest that the domain of Ebola virus needed for fusion is shorter than that previously reported. The fusogenic properties of this domain are related to its oblique orientation at the lipid/water interface owing to an asymmetric distribution of the hydrophobic residues when helical.

Imaging in gene therapy of patients with glioma

Over 10 years ago, the first successful gene therapy paradigms for experimental brain tumors models have been conducted, and they were thought to revolutionize the treatment of patients with gliomas. Application of gene therapy has been quickly forced into clinical trials, the first patients being enrolled in 1994, with overall results being disappointing. However, single patients seemed to benefit from gene therapy showing long-term treatment response, and most of these patients bearing small glioblastomas. Whereas the gene therapy itself has been performed with high sophistication, limited attention has been paid on technologies, which (i) allow an identification of viable target tissue in heterogenous glioma tissue and which (ii) enable an assessment of successful vector administration and vector-mediated gene expression in vivo. However, these measures are a prerequisite for the development of successful gene therapy in the clinical application. As biological treatment strategies such as gene and cell-based therapies hold promise to selectively correct disease pathogenesis, successful clinical implementation of these treatment strategies rely on the establishment of molecular imaging technology allowing the non-invasive assessment of endogenous and exogenous gene expression in vivo. Imaging endogenous gene expression will allow the characterization and identification of target tissue for gene therapy. Imaging exogenously introduced cells and genes will allow the determination of the 'tissue dose' of transduced cell function and vector-mediated gene expression, which in turn can be correlated to the induced therapeutic effect. Only these combined strategies of non-invasive imaging of gene expression in vivo will enable the establishment of safe and efficient vector administration and gene therapy protocols for clinical application. Here, we review some aspects of imaging in gene therapy trials for glioblastoma, and we present a 'proof-of-principle' 2nd-generation gene therapy protocol integrating molecular imaging technology for the establishment of efficient gene therapy in clinical application.

hIan5: the human ortholog to the rat Ian4/Iddm1/lyp is a new member of the Ian family that is overexpressed in B-cell lymphoid malignancies

The family of immune associated nucleotide binding proteins (Ian) is a distinct family of GTP-binding proteins conserved in plants, mice, rats and humans that are associated with immune functions, suggesting involvement in conserved defense mechanisms. Recently, the rat Ian4 (rIan4) was cloned and it appears to be identical to the gene Iddm1/lyp responsible for severe lymphopenia and the development of insulin-dependent diabetes in the BB-DP rat. Here we describe the characterization of a new human member of the Ian family: hIan5. hIan5 is highly homologous to rIan4, has a predicted molecular weight of 35 kDa and contains distinct G motifs of GTP-binding proteins (G-1 to G-4) in the N-terminus. Human Ian5 is anchored to the mitochondria by the hydrophobic COOH-terminal domain. Human Ian5 is highly expressed in lymph node and spleen. Different blood fractions show high hIan5 expression in CD4- and CD8-positive T cells and monocytes, but not in B lymphocytes. In contrast, in B-CLL (chronic lymphocytic leukemia) and mantle cell lymphoma samples, hIan5 mRNA was upregulated. The current data underline the role of hIan5 in T-lymphocyte development and function, and for the first time suggest that upregulation of Ian proteins is associated with B-cell malignancy, possibly by inhibiting apoptosis.

Duration of amantadine benefit on dyskinesia of severe Parkinson's disease

BACKGROUND

Recent short-term studies suggested that amantadine (Ama) might ameliorate dyskinesia in patients with Parkinson's disease. A double-blind study programmed over 12 months was designed to assess the duration of the antidyskinetic effect of amantadine on levodopa induced dyskinesia.

METHODS

40 patients treated for 7.5 (2.2) years with levodopa (729.3 (199.4) mg/day) and dopaminoagonists, having peak dose or dyphasic dyskinesia with or without pain, were assessed with the Unified Parkinson's Disease Rating Scale subscale IV, Items 32-34, the Dyskinesia Rating Scale and Investigator Global Assessment. Twenty patients received amantadine chloridrate (100 mg) and 20 received a placebo. The Ama or placebo could be withdrawn when scores indicated worsening of dyskinesia, after agreement with the patient.

RESULTS

After 15 days of amantadine treatment there was a reduction by 45% in the total dyskinesia scores. All patients in the placebo group were withdrawn in 1-3 months and all patients in the Ama group were withdrawn in 3-8 months (p = 0.01, p<0.001). Ama withdrawal induced a rebound with increase of dyskinesia by 10-20% in 11 patients.

CONCLUSION

300 mg amantadine reduces dyskinesia in Parkinson's disease by approximately 45% but the benefit lasted less than eight months.