A longitudinal study of pulmonary function in Danish patients with systemic sclerosis

Allergen-specific lymphocyte proliferation was measured by flow cytometry in 16 children with atopic dermatitis (AD). 26 with bronchial asthma (BA) and 13 non-atopic controls. Although the level of mite-S.I.F. (stimulation index measured by flow cytometry) in the younger AD children (2-7 y) was significantly higher than that in the non-atopic subjects (189.6 +/- 70.7 vs 113.9 +/- 11.0, p < 0.02), there was no elevation in the younger BA children (122.6 +/- 23.4). It is therefore likely that the elevated mite-S.I.F. level is related to the development of the allergic cellular inflammation representing the pathology of AD, rather than the IgE-mediated allergic reaction as a mechanism of childhood BA. Because the level of mite-specific IgE antibody in the younger BA children is elevated (93.6 +/- 41.2 PRU/ml), the result also indicates that mite-specific peripheral T lymphocytes do not play a critical role in stimulating the mite-specific IgE synthesis. On the contrary, the older BA children (8-15 y) showed an elevated mite-S.I.F. level (176.0 +/- 54.6) significantly higher than that in the non-atopic subjects (114.6 +/- 13.9, p < 0.05) as well as that in the younger BA children (p < 0.05). Because other investigators have reported that the level of mite-specific lymphocyte proliferation is increased in the adult BA patients, the transition from childhood BA to adult-type BA may start at the age of about 8 y.     

A longitudinal study of visuospatial discrimination in parkinsonian patients

The heparin-binding growth-associated molecule HB-GAM (also named pleiotrophin) and the retinoic acid-induced heparin-binding protein RIHB (chicken midkine) are developmentally regulated proteins forming a new family of heparin-binding molecules with putative functions during cell growth and differentiation. A direct involvement of these molecules during chondrogenesis in vivo was suggested by their patterns of expression. The putative chondrogenic activity of these molecules was investigated in vitro using micromass cultures from chicken limb bud mesenchymal cells. Exogenous HB-GAM, not RIHB, was found to enhance chondrogenesis in this system. These results provide a strong incentive for considering and further investigating the role of this protein in the control of limb cartilage differentiation.     

A study on protein metabolism in nephrotic patients treated with Chinese herbs

It was found in our previous studies that two Chinese herbs Astragali and Angelica (A&A) together with high protein diet could ameliorate the lowering of serum albumin level and increase the synthesis rate of protein as shown by 15N-glicine tracer priming protein turnover study in nephrotic rats. Further experiment was designed to investigate the role of A&A and high protein intake in protein dynamic study and nitrogen balance in nephrotic patients. The level of serum total protein (STP), serum albumin (SA), urinary protein loss (UP), serum cholesterol (Cho) and index number of protein turnover and nitrogen balance in 7 patients were measured before and after treatment of 30 days with A&A. The results showed that after treatment the patients had significantly increased STA and SA (44.3 +/- 5.60 vs 49.7 +/- 6.80 P < 0.01; 22.6 +/- 0.42 vs. 29.4 +/- 7.40 P < 0.05), decreased UP and Cho (6.54 +/- 1.83 vs 4.63 +/- 1.33 P < 0.05; 9.69 +/- 2.31 vs. 7.82 +/- 1.95 P < 0.05) and increased net rates of total protein synthesis (1.06 +/- 0.03 vs 1.27 +/- 0.12 P < 0.05). It is concluded that A&A together with high protein intake could improve the disorder of protein metabolism and increase the level of serum protein by improving the net rate of protein synthesis in nephrotic patients.     

Predicting prospective episodes of depression in patients with panic disorder: A longitudinal study.

This study used a naturalistic, longitudinal study to examine predictors of the emergence of major depression among 90 nondepressed patients with panic disorder who were followed for a 2-yr period. 24% of the sample experienced a major depressive episode during the study period. Adequacy and type of medication treatment were not associated with decreased risk. Past history of major depression was associated with a greater risk for a prospective episode. The degree of assertiveness, presence of comorbid generalized anxiety disorder, and severity of agoraphobia were each significant predictors of the occurrence of depression when considered alone and when the influence of past history of depression was statistically controlled. The implications of these findings for the clinical management of patients with panic disorder are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A prospective safety-monitoring study of immunotherapy with biologically standardized extracts

We evaluated the safety of immunotherapy in 419 patients who attended our allergy department for treatment. They were suffering from rhinitis and asthma caused by sensitization to grass pollen or Dermatophagoides pteronyssinus. Immunotherapy was given by biologically standardized aluminum hydroxide adsorbed extracts according to a conventional schedule. Local reactions were recorded in 10.5% of the patients and systemic reactions in 4.8%. Only 0.37% of the doses administered were associated with systemic side-effects. We found that 84% of the patients who showed systemic reactions were asthmatic subjects (P < 0.01), and most of them were sensitized to D. pteronyssinus (71%). Side-effects occurred more frequently during the dose-increase period (P < 0.05). After 9482 doses had been administered, no anaphylactic shock or life-threatening reactions were registered. We believe the risk associated with immunotherapy to be drastically reduced when treatment is carefully monitored by skilled personnel. In such conditions, as shown by our study, immunotherapy is safe.     

A long-term outcome study of 170 surgically treated patients with compressive cervical radiculopathy

BACKGROUND: There is a general impression that publications in neuro-surgical journals have comprehensively evaluated the relative merits of various operative techniques with long-term follow-up in patients treated for compressive cervical radiculopathy. However, in some 20,000 neurosurgical papers over the past 50 years, only 74 (0.3%) have addressed this common surgical problem. METHODS: Long-term outcome was assessed by the standardized Functional Economic Outcome Rating Scale of Prolo. Information was obtained primarily by telephone interviews and office visits. No patients were operated upon without a confirmatory neuroradiologic study. Single level soft discs were removed through a posterior-lateral foraminotomy with hemilaminectomy or laminectomy the root was decompressed by the same technique with hard discs. RESULTS: One hundred seventy patients were operated on from 1959-91 with a 96% follow-up. The mean follow-up period was 15 years. Patients who had sedentary occupations and housewives, had statistically higher Economic Prolo scores (p < 0.001) than those who did strenuous work. Of 10 patients with a total Prolo score of 5 or less, seven did strenuous work and had Workers' Compensation claims; the remaining had legal claims or were at psychologic risk for operation. In 86% of patients outcome was good; defined as a Prolo score of 8 in 5%, 9 in 38%, and 10 in 43%. Of 10 recurrences (6%), seven occurred within 3 years after operation and were treated by discectomy and anterior cervical fusion. There were two patients with postoperative deltoid motor weakness who recovered within 1 year. CONCLUSIONS: Although outcome studies must have subjective criteria, the Prolo Scale is more objective and quantitative than currently used methods. The posterior approach to disc lesions causing compressive cervical radiculopathy should be compared to other techniques using the Prolo Outcome Scale.     

A study of the incidence and hospital follow-up of epistaxis in patients treated with anticoagulant acenocoumarol

Nosebleed is a common reason for emergency ENT consultations, but it is infrequent in patients anticoagulated with acenocoumarol. In a retrospective 5-year study, nosebleed was the second most frequent type of hemorrhage among anticoagulated patients. Such patients do not necessarily have prolonged coagulation times. In a comparison of patients hospitalized for nosebleed (n = 14) with a similar group with no hemostasis abnormalities, patients with nosebleed had longer hospital stays and required more control measures. The greater the tendency to hypocoagulation, the more difficult it was to manage nosebleed. Recent onset of anticoagulation therapy and previous long coagulation times favored the appearance of hard-to-manage nosebleed. Therefore, hematologists should closely control patients under anticoagulation therapy and cooperate with the ENT department when such patients are admitted for nosebleed.     

A prospective longitudinal study of the outdoor behaviour and symptoms of photosensitive patients

The purpose of this study was to determine the measures that photosensitive patients use to control their sun exposure. Each week from March until September 1995, 30 patients with polymorphic light eruption (PLE) and 17 patients with chronic actinic dermatitis (CAD) returned a set of reply paid postcards on which they recorded information about their outdoor behaviour and symptoms. The principal differences between the two groups were that CAD patients had a much greater incidence of symptoms despite making more use of protective measures such as covering arms, wearing hats and applying sunscreen, than patients with PLE. And that as summer approached the PLE patients spent more time outdoors, whereas there was less seasonal variation in this respect among CAD patients. Tentative conclusions drawn from mathematical modelling indicated that the incidence of rash on a particular day was influenced by ambient ultraviolet radiation and length of time spent outdoors. There were indications that wearing a hat and keeping the arms covered offered some protection, whereas use of sunscreen may actually increase the likelihood of symptoms.     

A longitudinal study of three-year-old children with delayed development of language

From January 1982 to December 1986, 113 three-year-old children (100 boys and 13 girls) visited the department of pediatrics, Asahikawa Medical College, because of delayed development of language (their expressive language age less than two-year-old). Of these children, 102 children (90%) have visited until they graduated from junior high school for the evaluation of intelligence quotient (IQ), diagnosis, the type of attended school and complications. The mean follow-up period was 10.8 years. The 113 children ware classified as 32 cases of developmental language disorder (DLD), 38 of autistic disorder (Au), 39 of mental retardation (MR), and 4 of deafness based on the results of clinical examination (DSM-III-R), ABR and WPPSI/WISC-R. The purpose of this study is to compare the assessment of language development at the age 3 with the prognosis for intelligence, academic achievement and behavioral adjustment. At the age of three, we divided them into three groups using the Enjoji shiki hattatsu kensa-hyo. Group A including 31 children (29 boys and 2 girls) means delayed development in verbal expression only. Group B including 23 children (17 boys and 6 girls) means delayed development in verbal expression and comprehension. Group C including 59 children (54 boys and 5 girls) means delayed development not only in verbal expression and comprehension but also in communication skills. RESULTS: ABR: Four (2 boys and 2 girls) of 113 children did not show any significant waves on ABR at aged 3, and were also diagnosed as deafness by another audiometry. Comparison between the assessment of verbal expression at aged 3 and full scale IQ (FSIQ): FSIQs in 77% of group A were more than 70, while FSIQs in 79% of groups B and C were 70 or below. The assessment of verbal comprehension at aged 3 was significantly related with FSIQ (x2 = 23.88, p < 0.01). Classification of disorders and type of schools according to the assessment at aged 3: [Group A] Thirty one children were classified as 25 cases of DLD and 6 of MR. Before a graduation from junior high school, 20 children attended regular classes and 8 attended special classes for MR. [Group B] Twenty three children were classified as 4 cases of DLD, 10 of MR, 5 of Au and 4 of deafness. Before a graduation from junior high school, 4 children attended regular classes, 8 attended special classes for MR, 6 attended special schools for MR and 4 attended schools for deafness. [Group C] Fifty nine children were classified as 3 cases of DLD, 23 of MR and 33 of Au. Before graduating from junior high school, 10 children attended regular classes, 18 attended special classes for MR, 19 attended special schools for MR and 2 entered educational facilities. CONCLUSION: 1. Poor mental outcome could be predicted by delayed development of both expressive and comprehensive language, particularly associated with dysfunction of communication skills at the age of three. 2. ABR is a useful method for detecting of hearing loss in non-cooperative young children with delayed development of language.     

Serum chemokines in patients with psoriatic arthritis treated with cyclosporin A

OBJECTIVE: To investigate the possible effects of neuropeptide Y on steroid release by human granulosa cells in culture. DESIGN: Prospective study. SETTING: A university laboratory and the division of obstetrics and gynecology in a hospital. PATIENT(S): Sixteen normally ovulating women. INTERVENTION(S): Ovulation induction for IVF-ET with an LH-releasing hormone analogue and gonadotropins. MAIN OUTCOME MEASURE(S): E2 and progesterone were assayed in the media conditioned by granulosa cells with the use of a double-antibody RIA. RESULT(S): Neuropeptide Y stimulates E2 production in a dose-dependent fashion. Preincubation for 3 hours with hCG led to a statistically significant increase in neuropeptide Y-induced E2 secretion. In contrast, whereas 3 hours of preincubation with 10(-7) mol/L of neuropeptide Y did not elicit a statistically significant increase in hCG-induced E2 secretion, coincubation for 48 hours significantly increased hCG-stimulated secretion. Unlike E2, progesterone secretion did not undergo any statistically significant or dose-dependent variation after treatment with neuropeptide Y. CONCLUSION(S): Neuropeptide Y plays a role in human ovarian steroidogenesis directly at the level of the granulosa cells of the follicles in the early stage of luteinization. In this way, neuropeptide Y could play an important role in controlling the positive feedback effect exerted by the ovarian steroids on LH-releasing hormone and gonadotropins in humans.     

Results of specific immunotherapy with Allergovit in patients with pollen allergy

The immunotherapy among patients with pollen allergy was performed by individuals composed Allergovit. The effects of this treatment was compared to patients with pollenosis who don't have desensitization because they would'nt it. This results indicated that is need to do the nasal provocation test before the choice of antigens for the specific immunotherapy because the prick skin test was very often positive but patients don't have the symptoms. Precise composition of the vaccine improved the course in first season in 77.9 per cent, in second season in 87.5 per cent and in third season in 91.6 per cent.     

Cerebrovascular reactivity in hypertensive patients: a transcranial Doppler study

PURPOSE: We studied the usefulness of transcranial Doppler sonography for assessing changes in vasoreactivity in patients with hypertension and the hemodynamic consequences of hypertension. METHODS: The study group comprised 25 patients with chronic severe hypertension and 25 age- and sex-matched healthy subjects. Cerebrovascular reserve capacity was assessed by transcranial Doppler recording of the blood flow velocity in both middle cerebral arteries before and 5, 10, 15, and 20 minutes after intravenous injection of 1 g of acetazolamide (Diamox). Blood pressure, blood gases, and other blood parameters were also measured before and after acetazolamide injection. The sizes of the left atrium, left ventricle, and aortic root were measured by echocardiography and correlated with the vasoreactivity after acetazolamide injection. RESULTS: After acetazolamide injection, no significant changes in blood pressure were observed in either group. The mean blood flow velocity in the middle cerebral arteries of hypertensive patients (60.8 +/- 2.6 cm/sec) was not significantly different from that of controls (58.8 +/- 1.9 cm/sec) before acetazolamide injection. Ten minutes after acetazolamide injection, the percentage change in blood flow velocity was significantly lower in the hypertensive group (36.2 +/- 4.5%) than in the controls (52.6 +/- 3.7%). A significant negative correlation (p < 0.05) between decreased vasoreactivity and increased size of the left atrium and aortic root was observed. CONCLUSIONS: Vasoreactivity decreases in hypertensive patients without neurologic deficits or computed tomography abnormalities. Enlargement of the left atrium correlates well with the severity of the impairment in vasoreactivity. Transcranial Doppler sonography can be a sensitive tool in the investigation of vascular impairment caused by hypertension and in the follow-up of hypertensive patients.     

A longitudinal study of ego development.

Using the Washington University Sentence Completion Test of Ego Development, 32 lower-class and lower-middle-class 12th graders (Group A) who had been given the test by A. Blasi (1971) as 6th graders were retested. The relationship between ego development and vocational attitudes and plans was also examined using a vocational choice questionnaire and the Career Maturity Inventory (CMI). To increase sample size, an additional 23 12th graders (Group B) were also administered the 3 measures. Results of statistical analyses show an increase at the .0005 level between 6th and 12th grades. Among Group A, sex differences at both grade levels were not significant; however, among Group B, girls had significantly higher ego levels than boys. In addition, ego development was significantly related to vocational maturity but not to reasons for vocational choices. Ego levels for 6th and 12th graders were significantly lower than those of middle- and upper-class Ss of comparable ages tested in other studies, suggesting a significant relation between ego development and socioeconomic status. Results are seen as evidence for the developmental nature of the ego, and support the sequentiality hypothesis, which suggests that stages follow in an invariant order. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of family context on adult offspring of patients with Alzheimer's disease: A longitudinal study.

The authors examined over time the relationship between characteristics of the family caregiving system for older persons with Alzheimer's disease and the health of 136 adult offspring who were involved in care. The goal was to determine if family and offspring health relationships found at point of initial patient evaluation (Tl) remained consistent over a 12-month period (T2) and if qualities of the family environment assessed at Tl predicted a change in offspring health and well-being as the demands for care increased over time. Offspring carehours, gender, education, distress, and patient severity (Step 1); measures of family functioning (Step II); and family by distress interaction terms (Step III) were used to predict offspring health and well-being at T2. Findings indicated that (a) family characteristics associated with offspring health at Tl displayed consistent predictions of health over time and (b) family emotion management variables predicted a reduction in offspring health scores by T2. These data document the ongoing effects of the family context of care and suggest the family setting as a target for intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cytogenetic study of thyroid patients treated with external irradiation or radioiodine

Where clinically permitted, either external irradiation or radioiodine therapy is usually recommended for the treatment of differentiated thyroid cancer patients. This paper describes an attempt to clarify the radiation burden and the distribution of radiation doses on the lymphocytes in consequence of these two therapeutic modalities, and the circumstances of the applicability of biological dosimetry. Thyrotoxic patients with intact thyroid glands underwent 131I therapy were also analysed for this purpose. An analysis was made of the extent to which exposure to local neck irradiation (50 Gy) or radioiodine therapy (1734-2600 MBq) causes chromosomal aberrations in the lymphocytes of thyroid disease patients after total or subtotal thyroidectomy, or thyrotoxic patients with intact thyroid glands (185-595 MBq). The irradiated volume of lymphatic tissues played the most important role in the formation of chromosomal aberrations. External irradiation caused 10-times more aberrant cells than 131I therapy did in cancer patients. In thyrotoxic patients the lower therapy doses of radioiodine caused a significantly higher frequency of aberrations than that observed in thyroid cancer patients. Selective radiosensitivity of lymphocytes was supported by the analysis of the Poisson distribution of aberrations, which suggested a homogeneous dose distribution only in 131I-treated and thyroidectomized cancer patients. In conclusion, we suggest that the results of studies of the genetic alterations in the lymphocytes exposed to radioiodine, under well-defined circumstances should not be ignored before the mode of radiation treatment is chosen. On the other hand, in the modelling of accidental environmental radioiodine exposure, only thyrotoxic patients with an intact thyroid gland and heterogeneous dose-distribution are a suitable group.     

Predictors of health care utilization in patients with inflammatory bowel disease: a longitudinal study

OBJECTIVE: To study the changes in normal sexual behavior that accompany the vulvar vestibulitis syndrome and to gauge an appropriate classification for the resulting sexual dysfunction. STUDY DESIGN: Following full medical screening, questionnaires were administered to assess sexual history, illness behavior and vulvar discomfort. Forty patients who met the criteria of vestibulitis syndrome composed the study cohort. RESULTS: The average duration of reported vulvar pain was 33 months (range, 3-240). The cohort showed no significant differences when compared with normative data on the sexual history form in their level of sexual desire, duration of intercourse or chance of female orgasm with intercourse or masturbation. Patients were: (1) highly likely to experience vulvar pain with intercourse (P < .001), (2) highly likely to have significantly reduced arousal potential (P < .001), (3) highly likely to complain of vulvar symptoms preventing intercourse from occurring (P < .001), (4) highly likely to have a reduced interest in intercourse and to have negative feelings toward it (P < .001); and (5) highly likely to refuse a partner's sexual advances (P < .001). CONCLUSION: In the case of vulvar vestibulitis, the most appropriate Diagnostic and Statistical Manual of Mental Disorders, fourth edition, classification appears to be sexual dysfunction due to a general medical condition.