Intravitreal tolerance of a new perfluorocarbon vitreous replacement, Multifluor APF-144

OBJECTIVE: To evaluate the intravitreal tolerance of a new perfluorocarbon vitreous replacement, Multifluor APF-144 (perfluorotetramethylcyclohexane). DESIGN: Ten New Zealand albino rabbits (one eye from each) underwent vitrectomy. The vitreous was replaced in five eyes with Multifluor APF-144 and in five eyes with saline (control group). OUTCOME MEASURES: Appearance on indirect ophthalmoscopy, electroretinography recordings before and 2, 4 and 8 weeks after vitrectomy, findings on electron and light microscopy at 8 weeks. RESULTS: Endophthalmitis did not develop in any of the eyes. There was no significant change in electroretinography values for the experimental eyes after vitrectomy. No evidence of retinal toxicity was found on light or electron microscopic examination. CONCLUSIONS: Multifluor APF-144 shows promise as a short-term postoperative retinal tamponading agent.     

Approximation of sleep duration and sleep efficiency using actography

The actography is a cost-effective semiobjective method to measure sleep/wake-cycles. This is the reason why the actography should be used first. The actography is after the cost-intensive polysomnography the best method in diagnosis of sleep disorders and monitoring of sleep disorder therapy. Actography over several days allows a precise estimation of total sleep time and sleep efficiency and makes possible an analysis of sleep/wake in natural conditions. The estimation is better if the patient is in high wake body activity and the recording time is longer. The mean values of total sleep time and sleep efficiency from polysomnography and actography are congruent.     

Dual recognition of lipid A and DNA by human antibodies encoded by the VH4-21 gene: a possible link between infection and lupus

The VH4-21 (V4-34) gene segment, a member of the VH4 family, is expressed early in B-cell maturation and is utilized by approximately 6% of normal adult B lymphocytes. This prevalence indicates an importance of VH4-21 in the B-cell repertoire. The gene also encodes certain autoantibodies being mandatory for pathological IgM anti-red cell antibodies directed against the I/i antigen, and also capable of encoding anti-DNA antibodies. Recognition of I/i antigen or DNA appears to be via two distinct sites on VH, with I/i binding mediated by sequences in the framework region, and DNA binding correlating with the presence of positively charged amino acids in complementarity-determining region 3. However, these positively charged residues appear to suppress the ability of the framework region to interact with I/i, rendering a single sequence monospecific for I/i or DNA. The IgM anti-DNA antibodies also recognize bacterial lipid A, whereas the anti-I/i antibodies do not, indicating that CDR3 may be involved in binding the negatively charged lipid A. Structural similarities between the DNA backbone and lipid A provide a possible explanation for this cross-reactivity. This dual recognition of bacterial antigen and autoantigen provides a potential link between infection and autoimmunity.     

The significance of gastric helicobacteriosis in the genesis hemorrhage from duodenal peptic ulcer

Based on a comprehensive analysis of findings from examination and surgical treatment of 196 patients with bleeding pyloroduodenal ulcers, it was found out that patients with concurrent helicobacteriosis of the stomach are prone to more unfavourable course of their illness, which fact is evidenced by a greater loss of blood and higher risk for bleeding recurrences. A classification is proposed by the authors, taking advantage of the data from endoscopic, microscopic and immunoenzymatic techniques, with the purpose of providing an assessment of degree of severity of helicobacteriosis of the stomach.     

Gewissensfreiheit in der Apotheke

Background In recent years, it has been intensively debated whether and how the conscience must be protected in the context of pharmacies. Currently, Germany and Austria have no legal regulation regarding this problem. Objective The ethical framework for a coping strategy dealing with the problem of freedom of conscience in the pharmacy will be outlined. Method By applying legal ethics' principle of proportionality within German and Austrian constitutional law as well as the European Convention on Human Rights, the problem is analyzed on its individual, corporative, and societal level. Results On the individual level, the pharmacist's and the patient's stakes and rights (e.g., the freedom of conscience) are carefully balanced by using the principle of proportionality. On the corporative level, the autonomy granted by the fundamental right of freedom of religion and belief legitimatizes a pharmacy's ideological profile as an organization and may cause conflicts of loyalty within the pharmacy. On the societal level, four pro-active options of shaping the legal framework are available: a social-welfare, a libertarian, a professional, and a communitarian. How conflicts on the individual or the corporative level can be solved depends on the option(s) that are chosen on the societal level. Conclusion If the status quo is to be changed, this article argues for two approaches: a) the introduction of a qualified conscience clause for pharmacists (including duties to consult, refer, treat in emergencies, and inform); b) a ‘weak’ communitarian option, striving for a compromise between a pharmaceutical corporation (i.e., pharmacy or pharmaceutical professional association) with an ideological profile and the public healthcare system. Both approaches satisfy a careful balancing of legitimate goods.     

Mutation analysis of the MEN1 gene in multiple endocrine neoplasia type 1, familial acromegaly and familial isolated hyperparathyroidism

Multiple endocrine neoplasia type 1 (MEN 1) is an autosomal dominant disease characterized by neoplasia of the parathyroid glands, the endocrine pancreas, and the anterior pituitary gland. In addition, families with isolated endocrine neoplasia, notably familial isolated hyperparathyroidism (FIHP) and familial acromegaly, have also been reported. However, whether these families constitute MEN 1 variants or separate entities remains speculative as the genetic bases for these diseases are unclear. The gene for MEN 1 has recently been cloned and characterized. Using single strand conformation analysis (SSCA) and sequencing, we performed mutation analysis in: a) a total of 55 MEN 1 families from 7 countries, b) 13 isolated MEN 1 cases without family history of the disease, c) 8 acromegaly families, and d) 4 FIHP families. Mutations were identified in 27 MEN 1 families and 9 isolated cases. The 22 different mutations spread across most of the 9 translated exons and included frameshift (11), nonsense (6), splice (2), missense mutations (2), and in-frame deletions (1). Among the 19 Finnish MEN 1 probands, a 1466del12 mutation was identified in 6 families with identical 11q13 haplotypes and in 2 isolated cases indicating a common founder. One frameshift mutation caused by 359del4 (GTCT) was found in 1 isolated case and 4 kindreds of different origin and haplotypes; this mutation therefore represents a common "warm" spot in the MEN1 gene. By analyzing the DNA of the parents of an isolated case one mutation was confirmed to be de novo. No mutation was found in any of the acromegaly and small FIHP families, suggesting that genetic defects other than the MEN1 gene might be involved and that additional such families need to be analyzed.