The adaptation of The parental reflective functioning questionnaire adolescent version to the Hungarian language and presentation of its psychometric characteristics

Introduction

Parental reflective function is the ability of a parent to attribute mental states to their child and to themselves. The Parental Reflective Functioning Questionnaire is widely used for the measurement of this construct, the adolescent version of which can be used by parents of children aged 12-18.

Objectives

The aim of our research was to adapt the adolescent version of The Parental Reflective Functioning Questionnaire to the Hungarian language.

Methods

In our study 240 mothers completed the adolescent version of The Parental Reflective Functioning Questionnaire (PRFQ-A), and the Reflective Function Questionnaire (RFQ).

Results

Confirmatory factor analysis did not confirm the original three-factor structure. The principal component analysis resulted in a two-factor structure. Factors corresponded to the original questionnaire’s certainty in mental states (Alpha = .81) and interest and curiosity subscales (Alpha = .70). When analyzing the relationship between parental reflective function and reflective function, the subscales of the parental reflective function questionnaire were examined with two types of median coding in addition to polar coding. During the first median coding, the frequency of scores in the middle of the scales reflected optimal mentalization, while the frequency of extreme values on the scales corresponded to less favorable reflective functioning. With the second median coding, hypermentalization and hypomentalization subscales were also created. The second median transcoding proved to be the most suitable for capturing the relationship between RFQ and PRFQ-A.

Conclusions

The questionnaire proved to be a reliable measure on the Hungarian sample and we recommend using the additional subscales.

Disclosure

No significant relationships.

Children living in institutional care: How can mentalization-based interventions improve their perspective-taking and conflict resolution skills?

Introduction

Trauma, stress, and attachment problems are negatively related to the development of mentalization. Children raised in institutional care are more exposed to these difficulties, therefore the development of population-specific interventions that aim to improve mentalization skills would be highly desirable.

Objectives

Our goal is to develop mentalization-based intervention programs for specific age groups (9-13 years, 14-18 years, and adult staff members of institutional care centers) - that support children’s and adolescents’ social functioning and conflict resolution skills.

Methods

The mentalization-based intervention targeting institutional care staff was launched first. Due to the pandemic, this intervention was executed online with two intervention (N = 17) and two passive control (N = 15) groups. Before and after the intervention, participants completed a demographic questionnaire, the Parenting Sense of Competence Scale, the Reflective Functioning Questionnaire, the Mini Oldenburg Burnout Inventory, The Strengths, and Difficulties Questionnaire, and the Ways of Coping Questionnaire.

Results

The intervention protocol and our results will be shown at the conference. There was no significant difference between the two intervention and two passive control groups in the demographic features. Mentalization uncertainty and burnout was positively related(rs(23) = .42, p = .034), while mentalization uncertainty and parental competence was negatively associated (rs(23) = - .41, p = .041).

Conclusions

The intervention program will be fine-tuned and optimized based on the results of the pilot study. In the next interventions, we plan to focus on the issues that the staff perceived as most difficult and to conduct interventions among the children.

Disclosure

No significant relationships.

The relationship between parental reflective functioning, attachment style, parental competence, and stress

Introduction

Previous studies indicated, that mentalization mediates the link between adult attachment and stress, however, this relationship was not tested before among non-clinical parents of children aged between 12 and 18 years.

Objectives

The aim of this study was to explore the relationship between parental reflective functioning, attachment style, perceived parental sense of competence, and stress among parents.

Methods

After providing written consent, 186 non-clinical mothers completed a questionnaire packet that included a demographic form, The Parental Reflective Functioning Questionnaire - Adolescent version, the Attachment Style Questionnaire, the Parental Sense of Competence Scale, and the Perceived Stress Scale. A moderated mediation analysis with parental sense of competence as a dependent variable, mother’s attachment style as an independent variable, certainty about mental states hypermentalization subscale as a mediator, and stress as a moderator was conducted.

Results

In the moderated mediation analysis, the direct effect of the attachment style on the parental sense of competence in the case of preoccupied attachment style was significant (p < .001). The interaction term of the hypermentalization subscale by perceived stress was also significant in the case of low level (w = -1.57, p < .001) and high level of perceived stress (w= 1.21, p = .049) among mothers with a preoccupied attachment style.

Conclusions

These findings suggest that the preoccupied attachment style is related to the parental sense of competence through certainty about mental states hypermentalization in case of low level and high level of perceived stress, so mentalization-based interventions are warranted.

Disclosure

No significant relationships.

The relationship between mothers’ attachment style, mindful parenting, and perception of the child

Introduction

Maternal attachment style plays a major role in the intergenerational transmission of psychopathology. Previous studies indicated that a secure attachment style is associated with higher levels of mindfulness and a higher quality of the parent-child relationship.

Objectives

The aim of this study was to explore the relationship between the mothers’ attachment style, mindful parenting, and perception of the child.

Methods

Data was collected from 144 non-clinical mothers, who have a child below the age of 3 years. Mothers completed self-report questionnaires including the following scales: a demographic questionnaire, Attachment Style Questionnaire (ASQ), Interpersonal Mindfulness in Parenting Scale (IMP), and the Mothers’ Object Relations Scale (MORS-SF). Mediation analyses with Mothers’ Object Relations Scale warmth and invasion subscales as dependent variables, mother’s attachment style as an independent variable and, mindful parenting as a mediator were conducted.

Results

In mediation analysis, the direct effects of the mothers’ attachment style on the perception of the child were not significant. However, indirect effects through mindful parenting were significant; higher levels of mindful parenting were associated with higher levels of MORS-SF warmth and lower levels of MORS-SF invasion.

Conclusions

These findings suggest that attachment styles are related to the perception of the child through mindful parenting. Mindfulness-based parenting training might be useful in case of attachment-related problems to improve the parent-child relationship.

Disclosure

No significant relationships.

Integrated twin-screw wet granulation, continuous vibrational fluid drying and milling: A fully continuous powder to granule line

Highly homogeneous low-dose (50 μg) tablets were produced incorporating perfectly free-flowing granules prepared by a fully integrated Continuous Manufacturing (CM) line. The adopted CM equipment consisted of a Twin-Screw Wet Granulator (TSWG), a Continuous Fluid Bed Dryer (CFBD) and a Continuous Sieving (CS) unit. Throughout the experiments a pre-blend of lactose-monohydrate and corn starch was gravimetrically dosed with 1 kg/h into the TSWG, where they were successfully granulated with the drug containing water-based PVPK30 solution. The wet mass was subsequently dried in the CFBD on a vibratory conveyor belt and finally sieved in the milling unit. Granule production efficiency was maximized by determining the minimal Liquid-to-Solid (L/S) ratio (0.11). Design of Experiments (DoE) were carried out in order to evaluate the influence of the drying process parameters of the CFBD on the Loss-on-Drying (LOD) results. The manufactured granules were compressed into tablets by an industrial tablet rotary press with excellent API homogeneity (RSD < 3%). Significant scale-up was realized with the CM line by increasing the throughput rate to 10 kg/h. The manufactured granules yielded very similar results to the previous small-scale granulation runs. API homogeneity was demonstrated (RSD < 2%) with Blend Uniformity Analysis (BUA). The efficiency of TSWG granulation was compared to High-Shear Granulation (HSG) with the same L/S ratio. The final results have demonstrated that both the liquid distribution and more importantly API homogeneity was better in case of the TSWG granulation (RSD 1.3% vs. 4.5%).

Thin-Layer Chromatography-Densitometry and Liquid Chromatography Analysis of Alkaloids in Leaves of Papaver somniferum Under Stress Conditions

The effect of stress conditions on the concentrations of secondary metabolites were examined during various developmental stages of Papaver somniferum plants. P. somniferum plants were grown in laboratory conditions (Budakalász). The experiment consisted of 22 treatments. Significantly different alkaloid contents can be observed under different stress conditions. In general, the alkaloid contents of plants are very low; therefore, a highly sensitive and reliable method has to be developed for analysis. The amount of alkaloids was measured by 2 separation and detection techniques. Accuracy of the thin-layer chromatography method for quantitative analysis is limited. Without purification of samples the background is too noisy. Column liquid chromatography is a sensitive and relatively inexpensive method that allows precise quantitative determination of the alkaloid content.

Next-generation sequencing identifies novel mitochondrial variants in pituitary adenomas

PURPOSE

Disrupted mitochondrial functions and genetic variants of mitochondrial DNA (mtDNA) have been observed in different human neoplasms. Next-generation sequencing (NGS) can be used to detect even low heteroplasmy-level mtDNA variants. We aimed to investigate the mitochondrial genome in pituitary adenomas by NGS.

METHODS

We analysed 11 growth hormone producing and 33 non-functioning [22 gonadotroph and 11 hormone immunonegative] pituitary adenomas using VariantPro™ Mitochondrion Panel on Illumina MiSeq instrument. Revised Cambridge Reference Sequence (rCRS) of the mtDNA was used as reference. Heteroplasmy was determined using a 3% cutoff.

RESULTS

496 variants were identified in pituitary adenomas with overall low level of heteroplasmy (7.22%). On average, 35 variants were detected per sample. Samples harbouring the highest number of variants had the highest Ki-67 indices independently of histological subtypes. We identified eight variants (A11251G, T4216C, T16126C, C15452A, T14798C, A188G, G185A, and T16093C) with different prevalences among different histological groups. T16189C was found in 40% of non-recurrent adenomas, while it was not present in the recurrent ones. T14798C and T4216C were confirmed by Sanger sequencing in all 44 samples. 100% concordance was found between NGS and Sanger method.

CONCLUSIONS

NGS is a reliable method for investigating mitochondrial genome and heteroplasmy in pituitary adenomas. Out of the 496 detected variants, 414 have not been previously reported in pituitary adenoma. The high number of mtDNA variants may contribute to adenoma genesis, and some variants (i.e., T16189C) might associate with benign behaviour.

Effectiveness of the Gerundium Youth Educating Program in Hungary

The acceptance of brain death and the legitimation of organ transplantation is very much dependent on the general knowledge of the society. In Hungary, the legislation of brain death is based on presumed consent. There is no structural education about the topic so far.

AIM

The role of the Gerundium program is to educate high school students about the importance of transplantation and the meaning of brain death. The goal of this study was to evaluate the effectiveness of the Gerundium contemporary educational program in a pilot study.

METHOD

The education was held by medical students who successfully completed a preparatory elective course consisting of relevant information in the topic. Medical students used simple language during the 45-minute presentations. Two tests with simple but representative questions created by experts were completed by high school students: one directly before contemporary education and another 5 to 6 weeks after the lecture.

RESULTS

A total of 147 tests were completed: 78 before and 69 after the presentation in the city of Debrecen and 294 before the lecture in the city of Győr. In Debrecen, the overall correct answers increased by 6.05% (P < .05; before vs after). The results show that the knowledge transfer is highly effective in this manner and the students know significantly more weeks after the lectures.

CONCLUSION

There is much to do to broadly inform society about transplantation and brain death, but we will continue to increase the number of students and measure the dynamic change of the students' knowledge.

Left atrial thrombus under dabigatran in a patient with nonvalvular atrial fibrillation

Dabigatran is a new direct competitive inhibitor of thrombin and is equally effective and safe as warfarin in the prevention of thromboembolism in patients with nonvalvular atrial fibrillation. We present a case of a 60-year-old man with persistent nonvalvular atrial fibrillation who switched from acenocoumarol to dabigatran 110 mg twice daily. After five months the patient developed a large atrial thrombus, occlusion of the tibial arteries of the right foot, cerebellar infarction and multiple infarctions in kidneys and spleen. Blood test showed a dabigatran concentration of 35 ng/ml six hours after intake, correlating with a low trough concentration of 24-27 ng/mL and significantly increased thromboembolic risk. Other risk factors for thromboembolism were excluded. The present case indicates that in selected patients, there might be an indication for dose adjustments based on serum levels of dabigatran to ensure patient efficacy (thromboembolic events) and safety (bleeding).

Vitamin D-neutralizing CYP24A1 expression, oncogenic mutation states and histological findings of human papillary thyroid cancer

OBJECTIVE

The aims of the present study were to examine gene and protein expression of the vitamin D-inactivating 24-hyroxylase (CYP24A1) and the activating 1-alpha-hydroxylase (CYP27B1) enzyme in human papillary thyroid cancer (PTC), furthermore, to investigate the association between CYP24A1 expression and numerous clinical, histological parameters and somatic oncogene mutation status of thyroid tumor tissues.

MATERIALS AND METHODS

Gene expression analysis was carried out in 100 Hungarian thyroid samples, both normal and papillary tumor tissue sections of the same patient. The specific mRNA to the selected genes was analyzed by TaqMan probe-based quantitative real-time RT-PCR. The somatic oncogene mutation states of BRAF, NRAS, HRAS and KRAS were also tested.

RESULTS

CYP24A1 mRNA expression was markedly increased in 52 cases (52%) of the examined papillary cancers compared with that of normal thyroid tissue. There was a tendency toward difference in the distribution of high-level CYP24A1 in the PTC accompanied with somatic oncogene mutation. Positive correlation was seen between increased CYP24A1 expression rate and a group of variables reflecting tumor malignity (mainly vascular invasion, lymph node metastasis, tumor size, hypothyreosis) by principal components analysis. No significant alteration was seen in CYP27B1 gene expression between neoplastic and normal tissues.

CONCLUSIONS

A definite alteration was seen in vitamin D3-inactivating CYP24A1 gene activity in PTC compared to their normal tissues on a relatively large patient population. Our findings raise the possibility that CYP24A1 may also directly be involved in thyroid carcinogenesis.

Cell sorting in a Petri dish controlled by computer vision

Fluorescence-activated cell sorting (FACS) applying flow cytometry to separate cells on a molecular basis is a widespread method. We demonstrate that both fluorescent and unlabeled live cells in a Petri dish observed with a microscope can be automatically recognized by computer vision and picked up by a computer-controlled micropipette. This method can be routinely applied as a FACS down to the single cell level with a very high selectivity. Sorting resolution, i.e., the minimum distance between two cells from which one could be selectively removed was 50–70 micrometers. Survival rate with a low number of 3T3 mouse fibroblasts and NE-4C neuroectodermal mouse stem cells was 66±12% and 88±16%, respectively. Purity of sorted cultures and rate of survival using NE-4C/NE-GFP-4C co-cultures were 95±2% and 62±7%, respectively. Hydrodynamic simulations confirmed the experimental sorting efficiency and a cell damage risk similar to that of normal FACS.

Astroglia‐derived retinoic acid is a key factor in glia‐induced neurogenesis

Astroglial cells are essential components of the neurogenic niches within the central nervous system. Emerging evidence suggests that they are among the key regulators of postnatal neurogenesis. Although astrocytes have been demonstrated to possess the potential to instruct stem cells to adopt a neuronal fate, little is known about the nature of the glia-derived instructive signals. Here we propose that all-trans retinoic acid, one of the most powerful morphogenic molecules regulating neuronal cell fate commitment, may be one of the glia-derived factors directing astroglia-induced neurogenesis. According to data obtained from several complementary approaches, we show that cultured astrocytes express the key enzyme mRNAs of retinoic acid biosynthesis and actively produce all-trans retinoic acid. We show that blockage of retinoic acid signaling by the pan-RAR antagonist AGN193109 prevents glia-induced neuron formation by noncommitted stem cells. Therefore, we provide strong in vitro evidence for retinoic acid action in astroglia-induced neuronal differentiation.

Phase transition in the collective migration of tissue cells: experiment and model

We have recorded the swarming-like collective migration of a large number of keratocytes (tissue cells obtained from the scales of goldfish) using long-term videomicroscopy. By increasing the overall density of the migrating cells, we have been able to demonstrate experimentally a kinetic phase transition from a disordered into an ordered state. Near the critical density a complex picture emerges with interacting clusters of cells moving in groups. Motivated by these experiments we have constructed a flocking model that exhibits a continuous transition to the ordered phase, while assuming only short-range interactions and no explicit information about the knowledge of the directions of motion of neighbors. Placing cells in microfabricated arenas we found spectacular whirling behavior which we could also reproduce in simulations.

Caspofungin susceptibility testing of Candida inconspicua: correlation of different methods with the minimal fungicidal concentration

Minimal inhibitory and minimal fungicidal concentrations of caspofungin were determined for 48 Candida inconspicua isolates. By using CLSI (formerly NCCLS) methodology with the partial inhibition endpoint criterion, caspofungin exhibited a good fungicidal effect against C. inconspicua (the MIC(90) was 0.25 microg/ml and the minimum fungicidal concentration [MFC] was 0.5 microg/ml after 24 h). Total inhibition yielded falsely elevated MICs, exceeding even the respective MFCs.

Thin-layer chromatography-densitometry and liquid chromatography analysis of alkaloids in leaves of Papaver somniferum under stress conditions

The effect of stress conditions on the concentrations of secondary metabolites were examined during various developmental stages of Papaver somniferum plants. P. somniferum plants were grown in laboratory conditions (Budakalász). The experiment consisted of 22 treatments. Significantly different alkaloid contents can be observed under different stress conditions. In general, the alkaloid contents of plants are very low; therefore, a highly sensitive and reliable method has to be developed for analysis. The amount of alkaloids was measured by 2 separation and detection techniques. Accuracy of the thin-layer chromatography method for quantitative analysis is limited. Without purification of samples the background is too noisy. Column liquid chromatography is a sensitive and relatively inexpensive method that allows precise quantitative determination of the alkaloid content.

Auto-reverse nuclear migration in bipolar mammalian cells on micropatterned surfaces

A novel assay based on micropatterning and time-lapse microscopy has been developed for the study of nuclear migration dynamics in cultured mammalian cells. When cultured on 10-20-microm wide adhesive stripes, the motility of C6 glioma and primary mouse fibroblast cells is diminished. Nevertheless, nuclei perform an unexpected auto-reverse motion: when a migrating nucleus approaches the leading edge, it decelerates, changes the direction of motion, and accelerates to move toward the other end of the elongated cell. During this process, cells show signs of polarization closely following the direction of nuclear movement. The observed nuclear movement requires a functioning microtubular system, as revealed by experiments disrupting the main cytoskeletal components with specific drugs. On the basis of our results, we argue that auto-reverse nuclear migration is due to forces determined by the interplay of microtubule dynamics and the changing position of the microtubule organizing center as the nucleus reaches the leading edge. Our assay recapitulates specific features of nuclear migration (cell polarization, oscillatory nuclear movement), while it allows the systematic study of a large number of individual cells. In particular, our experiments yielded the first direct evidence of reversive nuclear motion in mammalian cells, induced by attachment constraints.

Restriction enzyme analysis of ribosomal DNA shows that Candida inconspicua clinical isolates can be misidentified as Candida norvegensis with traditional diagnostic procedures

We identified 29 yeast isolates from 22 patients using the API ID32C panel. Twenty-eight of these isolates were Candida norvegensis and one was C. inconspicua. Although C. norvegensis is considered a pseudohypha-producing species, only one isolate produced pseudohyphae. Restriction enzyme analysis of PCR-amplified ribosomal DNA with four different enzymes proved that all isolates were C. inconspicua.

TPPP/p25 promotes tubulin assemblies and blocks mitotic spindle formation

Recently, we isolated from bovine brain a protein, TPPP/p25 and identified as p25, a brain-specific protein that induced aberrant tubulin assemblies. The primary sequence of this protein differs from that of other proteins identified so far; however, it shows high homology with p25-like hypothetical proteins sought via blast. Here, we characterized the binding of TPPP/p25 to tubulin by means of surface plasmon resonance; the kinetic parameters are as follows: kon, 2.4 x 10(4) M(-1) x s(-1); koff, 5.4 x 10(-3) s(-1); and Kd, 2.3 x 10(-7) M. This protein at substoichometric concentration promotes the polymerization of tubulin into double-walled tubules and polymorphic aggregates or bundles paclitaxel-stabilized microtubules as judged by quantitative data of electron and atomic force microscopies. Injection of bovine TPPP/p25 into cleavage Drosophila embryos expressing tubulin-GFP fusion protein reveals that TPPP/p25 inhibits mitotic spindle assembly and nuclear envelope breakdown without affecting other cellular events like centrosome replication and separation, microtubule nucleation by the centrosomes, and nuclear growth. GTP counteracts TPPP/p25 both in vitro and in vivo.

Distribution and susceptibility of Candida species isolated in the Medical University of Debrecen

Data of Candida albicans and non-albicans Candida species isolated during the 1997-2000 period in the Medical and Health Science Center of the University of Debrecen are analysed. The number of yeast isolates increased from 408 to 1213 per year during this period. Dominance of C. albicans has been persistent, but a slight increase of C. glabrata and C. krusei could be observed. Distribution of different Candida species isolated from 16 body sites indicates that C. albicans seems to be still the most aggressive Candida species. Investigation of 244 urinary Candida isolates (parallel with bacterial cultures) suggests that tha aetiological role of Candida species in the pathogenesis of urinary tract infections can be hypothesized if colony forming unit (CFU) number of yeasts is higher than 10(4)/ml and bacteria are present in low CFU number or are absent. Antifungal susceptibility testing of C. albicans, C. glabrata, C. tropicalis and C. krusei against Flucytosine, Amphotericin-B, Miconazole, Ketoconazole and Fluconazole suggests that Amphotericin-B is still the most effective antifungal agent. Finally, the problems in judging the aetiological role of isolated Candida species in the pathogenesis of different types of diseases are critically discussed.

Searching for new-type antifungal drugs (an outline for possible new strategies)

New approaches for treatment of invasive fungal infections are necessary to cope with emerging resistant fungal pathogens of humans. In this paper, three different strategies are presented and evaluated to find new-type antifungal drugs and their targets. While experimental data obtained with potent chitinase inhibitors, e.g. allosamidin, and small-size antifungal proteins of fungal origin are encouraging more efforts are needed to verify and exploit the possible involvement of intracellular thiols, e.g. glutathione, and their metabolic enzymes in the pathogenesis of mycoses caused by dimorphic fungi. Chitinase inhibitors seem to hinder the cell separation of yeasts and the fragmentation of filamentous fungi quite effectively and, hence, they may be implicated in future therapies of systemic mycoses. In addition, small-size antifungal proteins possessing a broad inhibition spectrum may also provide us with promising new agents for the treatment of different kinds of (e.g. cutaneous) fungal infections.

Distinct behavior of mutant triosephosphate isomerase in hemolysate and in isolated form: molecular basis of enzyme deficiency

In a Hungarian family with severe decrease in triosephosphate isomerase (TPI) activity, 2 germ line-identical but phenotypically differing compound heterozygote brothers inherited 2 independent (Phe240Leu and Glu145stop codon) mutations. The kinetic, thermodynamic, and associative properties of the recombinant human wild-type and Phe240Leu mutant enzymes were compared with those of TPIs in normal and deficient erythrocyte hemolysates. The specific activity of the recombinant mutant enzyme relative to the wild type was much higher (30%) than expected from the activity (3%) measured in hemolysates. Enhanced attachment of mutant TPI to erythrocyte inside-out vesicles and to microtubules of brain cells was found when the binding was measured with TPIs in hemolysate. In contrast, there was no difference between the binding of the recombinant wild-type and Phe240Leu mutant enzymes. These findings suggest that the missense mutation by itself is not enough to explain the low catalytic activity and "stickiness" of mutant TPI observed in hemolysate. The activity of the mutant TPI is further reduced by its attachment to inside-out vesicles or microtubules. Comparative studies of the hemolysate from a British patient with Glu104Asp homozygosity and with the platelet lysates from the Hungarian family suggest that the microcompartmentation of TPI is not unique for the hemolysates from the Hungarian TPI-deficient brothers. The possible role of cellular components, other than the mutant enzymes, in the distinct behavior of TPI in isolated form versus in hemolysates from the compound heterozygotes and the simple heterozygote family members is discussed.

[Magnetic resonance imaging in the diagnosis of breast diseases]

Authors report about the role of contrast medium enhanced magnetic resonance imaging in diagnosis of breast diseases, and experiences with this method. The aim of the study was to determine the diagnostic accuracy of the method. The results was correlated with the histopathological findings, and compared to the diagnostic accuracy of the conventional X-ray mammography in breast lesions. X-ray and MR-mammography were evaluated in 220 patients (238 breasts) scheduled for breast surgery. The breasts were examined with T1-weighted transversal images using contrast medium enhanced semidynamic technique with 3D fast low angle shot (FLASH) sequence. Each breast was given a routine examination with 3 mammographic views. Contrast enhanced MR-mammography is a highly sensitive method for the detection of breast cancer, it has a higher diagnostic accuracy (84.5%), than conventional X-ray mammography (82.4%). When MRI and conventional X-ray mammography were used together, very high sensitivity but a lower diagnostic accuracy (81.5%) was achieved. MRI was effective in revealing mammographically equivocal or occult lesions and multifocal tumors even in dense breasts, but it was less reliable for some invasive lobular cancers, non-invasive ductal carcinomas, fibroadenomas and hyperplastic breast changes. Presently accepted indications for MRI of the breast are: (1) patients with breast implants--to demonstrate prothesis complications and tumor relapses; (2) postoperative imaging in patients after tumorectomy and radiation therapy--in these cases MRI allows differentiation between tumor relapses and extensive scars; (3) proven axillary lymph node metastasis from an unknown primary carcinoma; (4) preoperative MR imaging in cases suspected or verified carcinomas within dense breasts to exclude multicentricity/multifocality; (5) follow-up in chemotherapy of breast cancer; (6) patients with high-risk constellation.

Characterisation of Rhodococcus equi strains isolated from foals and from immunocompromised human patients

The cultural, morphological, biochemical, serological characteristics and antibiotic susceptibility of 25 Rhodococcus equi strains isolated from lungs and lung abscesses of pneumonic foals and 5 R. equi strains isolated from immuno-compromised human patients were examined. All R. equi strains showed common cultural, morphological and biochemical characteristics both with conventional tests and on the basis of their enzyme profile. The R. equi strains examined were resistant to penicillins with the exception of ampicillin, to sulphamethazine and several strains also to sulphamethoxazole-trimethoprim. All strains were susceptible to erythromycin and rifampicin. The strains isolated from humans showed somewhat higher rate of antibiotic resistance to penicillin, cefotaxime, kanamycin, streptomycin, lincomycin, and oxytetracycline. The overwhelming majority (96%) of the equine isolates belonged to serotype 1 in Prescott's serotyping system, while the human isolates could not be serotyped.

A model for the hillock formation on graphite surfaces by 246 MeV Kr+ ions

Scanning tunnelling microscopy has been used to study the effect of ion bombardment at different angles of incidence on a graphite surface. The 246 MeV energy of Kr+ ions was selected in the medium energy range, where the electronic and nuclear stopping is nearly balanced. The low dose (1 x 10(12)/cm2) of ions allows the characterization of single features caused by bombardment in perpendicular, at 30 degrees and at 60 degrees incidence. The density of hillocks caused by the ion bombardment is significantly lower than the ion dose and this density depends on the angle of incidence. The hillocks are attributed to knocked-on atoms leaving the sample surface. A simple model for the scattering process is presented to enlighten the hillock density differences. Other features produced by the ion bombardment, such as elongated traces and (square root of 3 x square root of 3) R30 superstructures are also reported.

Isolation of rare opportunistic pathogens in Hungary: case report and short review of the literature. Rhodococcus equi

Rhodococcus equi is a well-established pathogen in foal pneumonia and is increasingly recognized as a pathogen in immunocompromised humans. We have isolated a Gram-positive coccobacillus from 8 blood samples and lung tissues of a renal transplant patient. Colony morphology, growth in Lowenstein-Jensen medium, 21 biochemical reactions, the characteristic morphological cycle (coccus-rod-coccus) and the CAMP test established the R. equi diagnosis. Histological studies of 2 lung biopsy specimens revealed numerous microabscesses with aggregates of polymorphonuclear leukocytes surrounded by abundant foamy macrophages. Our isolates proved to be sensitive to majority of antibacterial drugs. The appropriate therapy (amoxicillin-clavulanate) proved to be effective, however six months later a relapse was observed. Data show that in spite of its rare occurrence, R. equi infection represents a diagnostic and therapeutic challenge. The taxonomical, epidemiological, clinico-pathological, diagnostic and therapeutic data of R. equi are discussed.

A new potent calmodulin antagonist with arylalkylamine structure: crystallographic, spectroscopic and functional studies

An arylalkylamine-type calmodulin antagonist, N-(3, 3-diphenylpropyl)-N'-[1-R-(3, 4-bis-butoxyphenyl)ethyl]-propylene-diamine (AAA) is presented and its complexes with calmodulin are characterized in solution and in the crystal. Near-UV circular dichroism spectra show that AAA binds to calmodulin with 2:1 stoichiometry in a Ca(2+)-dependent manner. The crystal structure with 2:1 stoichiometry is determined to 2.64 A resolution. The binding of AAA causes domain closure of calmodulin similar to that obtained with trifluoperazine. Solution and crystal data indicate that each of the two AAA molecules anchors in the hydrophobic pockets of calmodulin, overlapping with two trifluoperazine sites, i.e. at a hydrophobic pocket and an interdomain site. The two AAA molecules also interact with each other by hydrophobic forces. A competition enzymatic assay has revealed that AAA inhibits calmodulin-activated phosphodiesterase activity at two orders of magnitude lower concentration than trifluoperazine. The apparent dissociation constant of AAA to calmodulin is 18 nM, which is commensurable with that of target peptides. On the basis of the crystal structure, we propose that the high-affinity binding is mainly due to a favorable entropy term, as the AAA molecule makes multiple contacts in its complex with calmodulin.

[The coupling of canine ventricular myocyte beta2-adrenoceptors to L-type calcium current]

To establish the functional coupling of beta adrenoceptor (beta AR) subtypes of beta 1AR and beta 2AR to L-type calcium current (ICaL), we investigated the non-selective agonist isoproterenol (ISO), and the relatively selective beta 2AR agonists zinterol (ZIN) and salbutamol (SAL) on ICaL in isolated canine ventricular myocytes in the presence and absence of CGP 20712A (CGP) and atenolol (AT), selective beta 1AR antagonists, and ICI 118,551 (ICI) a selective beta 2AR antagonist. Peak ICaL was determined using "patch type" microelectrodes and whole cell voltage clamp. ISO (0.5 microM) increased ICaL maximally 3.5 +/- 0.67 fold. ZIN (10.0 microM) and SAL (10.0 microM) increased ICaL maximally 1.5 +/- 0.2 (n = 5) fold and 1.4 +/- 0.1 (n = 5) fold, respectively. These effects were fully inhibited by CGP (0.3 microM) and AT (1.0 microM), inhibitors of beta 1AR but not by ICI (0.1 microM) a beta 2AR inhibitor. ZIN at relatively lower concentrations (< or = 0.1 microM) did not increase ICaL. CGP (0.3 microM) but not AT and ICI inhibited ICaL in the absence of beta AR agonists. CGP inhibition of ICaL was absent in the presence of forskolin (FK, 1.0 microM) that increases cAMP levels and ICaL by directly stimulating the adenylate cyclase. These indicate that none of the antagonists affect ICaL through an action downstream of beta AR.

CONCLUSION

beta-adrenergic agonists increase ICaL via beta 1AR but not beta 2AR in canine ventricular myocytes.

Antiretroviral immune response and plasma interferon in different phases of chronic granulocytic leukemia

Forty patients with chronic granulocytic leukemia (CGL) were tested for antibodies and lymphocytes reacting with gibbon ape leukemia virus (GaLV) and baboon endogenous virus (BaEV) antigens as well as for plasma interferon levels. Antibodies reacting with envelope antigens of GaLV and BaEV were found frequently and in high titers in patients with the quiescent phase of CGL but rarely and in low titers in the accelerated and blastic phase of the disease. Results of radioimmunoprecipitation studies were in concordance with those obtained in virus neutralization experiments. Cellular and humoral cytotoxic activity of blood plasma and lymphocyte samples against autologous tumor cells showed a similar phase-specific distribution. Most of these activities could be blocked by GaLV and BaEV gp70 antigens. Elevated plasma interferon (IFN)-alpha levels were found in the quiescent and accelerated phase of CGL, whereas no significant differences could be detected between IFN levels of patients with the blastic crisis of CGL and those of the control persons. Follow up studies of four patients confirmed this stage-specific distribution of antiretroviral immune and interferon response.

Prevalence and specificity of lymphocytotoxic antibodies in different stages of HIV infection

Sera obtained from 27 HIV-infected persons were investigated for complement-dependent humoral cytotoxicity. Uninfected as well as HTLV-IIIB-infected H9 cells were used as cellular targets either before or after stimulation by phytohemagglutinin (PHA) or concanavalin A (Con-A). The degree of cytotoxicity was determined by 51Cr-release assay. Two different antibodies could be found in sera of HIV-infected persons, one being directed against HIV-induced cell surface component(s) and the other reacting with structure(s) present on activated T4 cells. Asymptomatic HIV-carries were found to have antibodies exerting complement-dependent cytotoxicity to HIV-infected T4 cells. These antibodies were reactive mainly after stimulation of HIV-infected target cells by Con-A. Sera of ARC and AIDS patients contained autoantibodies reactive with PHA-stimulated or HIV-infected T4 lymphocytes. These data suggest that HIV-specific antibodies represent an anti-viral immune defense, while autoantibodies may be important in destruction of the immune system in AIDS.

Neutralizing and complement-dependent enhancing antibodies in different stages of HIV infection

Reclustering and indirect immunofluorescence assays on MT-4 cells [carrying both CD4 and complement receptor type 2 (CR2)] were used to measure neutralizing and enhancing antibodies in sera obtained from HIV-1-infected individuals. Heat-inactivated sera were tested before and after mixing 1:1 with fresh seronegative human serum. Using heated samples, neutralizing antibodies were found in 20 out of 20 and 11 out of 19 serum samples of asymptomatic and symptomatic [AIDS, AIDS-related complex (ARC)] HIV-seropositive patients, respectively. In complement-restored samples, neutralizing activity was found in eight sera of asymptomatic patients and in none of the sera of AIDS and ARC patients; enhancing activity could be detected in four and 12 sera, respectively. A significant positive correlation was observed between the titres of neutralizing antibodies measured in the complement-restored samples and the absolute number of CD4+ lymphocytes. These findings indicate that the appearance of complement-dependent enhancing antibodies coincident with the loss of neutralizing antibodies may indicate a poor prognosis in HIV infection.

Neutralizing antibodies and serum interferon levels in the different stages of HIV infection

The sera of patients infected with HIV were investigated for neutralizing antibodies (NA) and interferons. All samples from asymptomatic HIV carriers contained NA in high titres. In the sera of patients with AIDS related complex and AIDS the antibodies were found rarely and in lower titres. An early peak of acid-labile interferon (IFN)-alpha was observed in asymptomatic HIV-infected persons, and a late peak was found in AIDS patients. The data suggest that HIV NA may have beneficial effect in the asymptomatic phase. The presence of acid-labile IFN-alpha may indicate stimulation of IFN system by HIV-infected cells.

Complement-dependent cytotoxicity of antibodies reactive with HIV-induced cell surface antigens in HIV-carrying haemophiliacs

Sera obtained from HIV-infected as well as uninfected haemophiliacs and from healthy subjects were investigated for the presence of lymphocytotoxic antibodies. Using the 51Cr-release test, HIV-infected haemophiliacs were found to produce serum antibodies exerting complement-dependent cytotoxic effect on HIV-infected T4 cells. The antibodies were reactive mainly when HIV-infected target cells were stimulated with concanavalin-A. Results of complement-dependent antibody cytotoxicity and indirect membrane immunofluorescence tests suggest that envelope antigen(s) of HIV may be the target(s) for cytotoxic antibodies.

gamma-Aminobutyric acid stimulates pituitary growth hormone secretion in the neonatal rat. A superfusion study

The putative inhibitory neurotransmitter gamma-aminobutyric acid (GABA) elicited a dose-dependent increase in GH secretion from the pituitary of newborn rats. GH secretion increased within 3 min after GABA administration with a peak response at 5-6 min. The lowest effective dose of the GABA agonist muscimol was about 10 times smaller than that of GABA. The GABA effect was antagonized by picrotoxin and bicuculline, suggesting that GABA acts at GABA-A type receptors. The pituitary responsiveness to GABA gradually decreased during the second and third postnatal weeks. If the neonatal pituitaries were continuously exposed to GABA for 3 h GH secretion rapidly increased to a maximum within the first 10 min and then gradually decreased to a less elevated level by 1 h and remained at this level for the next 2 h. After 3 h of GABA exposure muscimol had no effect on GH secretion but human pancreatic GH-releasing factor stimulated it, indicating receptor desensitization during prolonged GABA administration. The significance of GABAergic regulation of GH secretion in the neonate is emphasized by the finding that simultaneous administration of picrotoxin diminished the GH releasing activity of the hypothalamic extract of 2-day-old rats by more than 60%. These results indicate that in the postnatal period the regulation of GH secretion differs from that of the adult animal and GABA might play an important role in the maintenance of the high GH secretion during the first days of life.

Reduced responsiveness of glomerulosa cells after prolonged stimulation with angiotensin II

The purpose of this study was to examine whether sustained exposition to angiotensin modifies the responsiveness of adrenal glomerulosa cells when extra-adrenal factors are eliminated. Isolated rat glomerulosa cells were stimulated for 6 h in a superfusion system with angiotensin II or potassium. Their responsiveness to angiotensin II, potassium, and corticotropin (ACTH) was examined before and after the superfusion. Stimulation of the cells during the superfusion with angiotensin II or with potassium reduced their responsiveness to all three stimuli. The steroid synthesis inhibitor aminoglutethimide, applied during the superfusion, overcame the effect of potassium but failed to influence that of angiotensin. This suggests that the reduced responsiveness after stimulation with potassium is related to the increased steroid production whereas the action of angiotensin is independent of that. The results establish the existence of desensitization to angiotensin in the absence of modifying extra-adrenal factors.

Studies on the specificity of human antibodies reacting with GP70 and P15 antigens of baboon endogenous (BaEV) and gibbon ape leukaemia (GaLV) viruses

Antibodies reacting with gp70 and p15 antigens of baboon endogenous virus (BaEV) and gibbon ape leukaemia virus (GaLV) were detected by radioimmunoprecipitation (RIP) in blood plasma samples of patients with chronic granulocytic leukaemia, acute myeloid leukaemia and with potentially preleukaemic haematological disorders. Anti-gp70 antibodies were found more frequently than anti-p15 antibodies. Digestion of the carbohydrate part of gp70 antigens by glycosidase treatment abrogated the precipitation mediated by IgM antibodies, whereas that mediated by IgG antibodies was not markedly affected. Data suggest that antibodies detected in human plasma samples may have oncovirus specificity, but in considerable part of cases they can be of heterophil nature.

Antibodies to primate retrovirus antigens in circulating immune complexes of patients with acute myeloid leukemia

Circulating immune complexes were isolated from sera of 8 patients with acute myeloid leukemia (AML) in relapse, and 20 healthy blood donors. F(ab')2 fragments were prepared from the isolated complexes. Using a radioimmunoassay (RIA), these F(ab')2 fragments, the undigested complexes and the original sera were examined for the presence of antibodies against a panel of primate retrovirus antigens: gp70, p15 and p30 of gibbon ape leukemia virus (GaLV) and baboon endogenous virus (BaEV). F(ab')2 fragments derived from the immune complexes of all patients reacted with one or more of the antigens tested, whereas no antibody activity was found in the sera or undigested immune complexes of the same patients. By a competitive RIA, antigens related to GaLV and/or BaEV were found in the serum of 7 out of 8 patients. No markers of these retroviruses were detected in the F(ab')2 preparations, in immune complexes or in sera of any of the 20 control subjects. Our results indicate that a part of the circulating immune complexes in AML contain antigens related to primate retroviruses and specific antibodies to these antigens.

The effect of external sodium on ouabain-insensitive K influx in fresh human red blood cells

The rate of 42K influx was investigated at various external sodium and ouabain concentrations in human red blood cells. In agreement with earlier reports, in red blood cells not treated with ouabain, Na did not affect K influx when [K]0 was 5.0 mM while it reduced the influx at [K]0 = 0.15 mM. However, Na stimulated 42K influx at both 5.0 mM and 0.15 mM in cells treated with ouabain (1 X 10(-5) M). When external Na concentration was raised from 0 to 72 mM the rate of 42K influx increased at [K]0 = 0.15 mM and at ouabain = 1 X 10(-5) M. The effect of external Na at different ouabain concentrations showed that K influx was inhibited by Na without or with ouabain in less than 5 X 10(-6) M while an increased K influx could be observed with higher ouabain concentrations in the incubation media. The results suggest that in the case of the complete inhibition of ouabain-sensitive K influx the electrochemical gradient of the Na ions may serve as a driving force for the inward movement of potassium.