Polysomnographic sleep measures in patients with uremic and idiopathic restless legs syndrome

In the present study, the nocturnal electroencephalographic sleep pattern, the number of periodic leg movements (PLM) during sleep and wakefulness, and the subjective sleep parameters of patients with uremic (n = 10) and idiopathic (n = 17) restless legs syndrome (RLS) were compared. The main finding was that the total number of PLM (p = 0.019), the PLM index (p = 0.018), and the PLM index while awake (p = 0.003) were significantly higher in patients with uremic RLS compared with patients who had idiopathic RLS. Additionally, both groups showed a distinct time-of-night pattern of PLM activity. Polysomnographic measures of sleep continuity (total sleep time, sleep efficiency, sleep onset latency, time awake) and sleep architecture (amount of nonrapid eye movement sleep stages 1, 2, 3, and 4 and the amount of rapid eye movement sleep) did not differ between uremic and idiopathic RLS patients. With regard to subjective parameters, sleep quality was estimated to be worse in uremic RLS (p = 0.033), whereas other parameters (for example, severity of RLS, quality of life) did not differ between the two groups. It is suggested that uremia itself worsens the motor symptoms of RLS, probably as a result of increased excitability.     

Osteoprotegerin production by human osteoblast lineage cells is stimulated by vitamin D, bone morphogenetic protein-2, and cytokines

Rheumatoid arthritis(RA) is a chronic, deforming and destructive arthritis of unknown etiology. For the medical treatment of RA, NSAID has been the first choice of drug. Recently it has been known that early use of DMARD may result in clinical remission. Understanding of the pivotal role of cytokines and adhesion molecules for the rheumatoid joint destruction enabled us to target these cytokines and molecules as therapeutic measures. Monoclonal antibodies were produced against the cytokines and adhesion molecules such as IL-1, IL-6, IL-6R, TNF-alpha, as well as CD4 molecules. Clinical use of these monoclonal antibodies was found to be effective for rheumatoid arthritis. However these therapeutic measures have several disadvantages such as transient efficacy and side effect.     

Allelotype analysis of uterine leiomyoma: localization of a potential tumor suppressor gene to a 4-cM region of chromosome 7q

The degree and nature of patient involvement in consultations with health professionals influences problem and needs recognition and management, and public accountability. This paper suggests a framework for understanding the scope for patient involvement in such consultations. Patients are defined as co-producers of formal health services, whose potential for involvement in consultations depends on their personal rights, responsibilities and preferences. Patients' rights in consultations are poorly defined and, in the National Health Service (NHS), not legally enforceable. The responsibilities of patients are also undefined. I suggest that these are not to deny, of their own volition, the rights of others, which in consultations necessitate mutuality of involvement through information-exchange and shared decision-making. Preferences should be met insofar as they do not militate against responsibilities and rights.     

Detection of intrauterine illicit drug exposure by newborn drug testing. National Academy of Clinical Biochemistry

Identification of intrauterine drug-exposed newborns with toxicological screening may have benefits including close follow-up of the infant by both medical and social services. Applying specific written guidelines to select newborns for drug testing decreases bias and protects the physicians and hospitals involved. All drugs reported as positive should be confirmed by an appropriate second test. Urine and meconium testing are the best current options for identifying drug-exposed neonates. Urine testing sensitivity is low because of problems encountered in urine collections and the high thresholds used in current urine assays. The disadvantage to meconium testing is the increased labor and time required to work with this material. Testing of newborn hair is unlikely to be widely used until technically less demanding assays become available. Testing of amniotic fluid or gastric lavage is still in the developmental stages. Adopting lower urine assay thresholds for newborn samples would increase sensitivity and would be an appropriate modification of current methodologies.     

Possible involvement of plasmids in degradation of malathion and chlorpyriphos by Micrococcus sp

Culture is the basic method in bacteriology. It allowed the discovery of Helicobacter pylori. Problems in the culture of this fragile, slow-growing bacterium concern transport and processing in the laboratory, but they can be solved. Culture has a 100% specificity. When performed properly, it has a sensitivity in the range of the other best diagnostic methods for Helicobacter pylori. It allows strain typing and, most importantly, susceptibility testing to antibiotics, because an increased rate of acquired resistance of Helicobacter pylori is currently observed. Culture must be performed in clinical trials, at least when antibiotics, to which Helicobacter pylori may be resistant, are used. In clinical practice, culture and susceptibility testing can generally be restricted to treatment failures. However, it is important to monitor Helicobacter pylori susceptibility to antibiotics at a national or regional level in order to give recommendations for primary treatment.     

Role of hepatic resection in surgery for bilateral intrahepatic stones

The effect of phenylephrine-induced reflex parasympathetic stimulation on QT interval and its dispersion was studied in 16 healthy subjects with a history of paroxysmal supraventricular tachycardia, both during sinus rhythm and during atrial pacing. Results demonstrate that rapid reflex parasympathetic stimulation does not influence QT interval duration or QT dispersion, and also emphasize the inappropriateness of Bazett's formula, the need for comparison of QT intervals during identical heart rates, and the importance of analyzing all 12 leads of a standard electrocardiogram when assessing the effects of various interventions on the QT interval.     

Up- and down-regulation of calpain inhibitor polypeptide, calpastatin, in postischemic hippocampus

A dental student developed swelling of the lips and peri-oral urticaria, immediately after placement of a dental rubber dam during a chairside demonstration of clinical dentistry. A provisional diagnosis of a Type I hypersensitivity reaction to natural rubber latex was made and an appointment organised for specialist investigations. The student reported an atopic history and allergy to peanuts. A Radioallergosorbent Test (RAST), to measure Ig-E antibodies to latex, was positive. The dental student was given advice concerning the avoidance of natural rubber latex. Dental staff must be aware of potentially serious reactions to natural rubber latex in the dental surgery.     

Colosplenic fistula in a patient treated with interleukin-2 for malignant melanoma

Interleukin-2 (IL-2) therapy often causes gastrointestinal side effects and at least 8 cases of bowel perforation have been reported. The patient reported here developed a colosplenic fistula, diagnosed by CT, with no neoplastic involvement of these organs. Awareness of these complications of IL-2 can help lead to earlier diagnosis.     

Functional complementation of UL3.5-negative pseudorabies virus by the bovine herpesvirus 1 UL3.5 homolog

The UL3.5 gene is positionally conserved but highly variable in size and sequence in different members of the Alphaherpesvirinae and is absent from herpes simplex virus genomes. We have shown previously that the pseudorabies virus (PrV) UL3.5 gene encodes a nonstructural protein which is required for secondary envelopment of intracytoplasmic virus particles in the trans-Golgi region. In the absence of UL3.5 protein, naked nucleocapsids accumulate in the cytoplasm, release of infectious virions is drastically reduced, and plaque formation in cell culture is inhibited (W. Fuchs, B. G. Klupp, H. Granzow, H.-J. Rziha, and T. C. Mettenleiter, J. Virol. 70:3517-3527, 1996). To assay functional complementation by a heterologous herpesviral UL3.5 protein, the UL3.5 gene of bovine herpesvirus 1 (BHV-1) was inserted at two different sites within the genome of UL3.5-negative PrV. In cells infected with the PrV recombinants the BHV-1 UL3.5 gene product was identified as a 17-kDa protein which was identical in size to the UL3.5 protein detected in BHV-1-infected cells. Expression of BHV-1 UL3.5 compensated for the lack of PrV UL3.5, resulting in a ca. 1,000-fold increase in virus titer and restoration of plaque formation in cell culture. Also, the intracellular block in viral egress was resolved by the BHV-1 UL3.5 gene. We conclude that the UL3.5 proteins of PrV and BHV-1 are functionally related and are involved in a common step in the egress of alphaherpesviruses.