Development of Canine Systemic Lupus Erythematosus Model

The purpose of this study was to develop a model for canine systemic lupus erythematosus. Systemic lupus erythematosus (SLE) is a systemic autoimmune syndrome defined by clinical and serological features, including arthritis, glomerulonephritis, dermatitis and autoantibodies. SLE was induced in eight normal dogs by immunization with heparan sulphate, the major glycosaminoglycan of the glomerular basement membrane. All the heparan sulphate-immunized dogs showed mild-to-moderate levels of proteinuria and skin disease. Cutaneous signs associated with SLE including alopecia, erythema, crusting, scaling and seborrhoea were observed. Immunohistological examination of the skin lesions revealed deposition of immunoglobulin M and complement in the dermal-epidermal junction. Three of eight dogs showed lameness. The antinuclear antibody tests were positive with the antibody titres higher than 1:128. Therefore, this experimental SLE model could be useful for studying immune-mediated skin disease and autoimmunity.

A risk reduction approach for schizophrenia: the Early Psychosis Intervention Programme

Schizophrenia is a serious mental disorder with a profound impact on patients, their caregivers and society. Most patients who develop schizophrenia experience a prodromal phase where there is a change in premorbid functioning prior to the onset of frank psychotic symptoms. Once psychosis sets in, the subsequent course can be variable but schizophrenia tends to run a chronic course, resulting in considerable disabilities. The prognosis of schizophrenia could potentially be improved by reducing the duration of untreated psychosis (DUP). The Early Psychosis Intervention Programme (EPIP) in Singapore adopts a risk-reduction approach. It seeks to reduce the DUP through public education, networking with the primary healthcare providers (general practitioners, counsellors, traditional healers), and the screening of conscripts into the Singapore Armed Forces. Integral to this programme is a service for those in the prodromal phase of psychosis, that addresses the concerns of stigmatisation and pharmacotherapeutic interventions. Our tertiary prevention strategies aim to reduce mortality and morbidity, and to improve the quality of the lives of the individuals diagnosed with this disorder through a comprehensive and holistic management programme that comprises case-management, the judicious use of antipsychotics, and various psychosocial interventions. Since EPIP's initiation in April 2001, there has been a steady increase in the number of individuals screened and accepted into the programme. Our networking strategy is gaining momentum and there has been a significant increase in the number of primary healthcare providers whom we have trained to identify early signs of psychosis. However, there remain various challenges which we are yet to overcome.

A novel option in proton pump inhibitor dosing: lansoprazole orally disintegrating tablet dispersed in water and administered via nasogastric tube

BACKGROUND

Lansoprazole orally disintegrating tablet, which rapidly disintegrates on the tongue or in water, provides a dosing alternative for patients with difficulty in swallowing. Gastric and nasogastric tubes are increasingly placed in patients with more severe swallowing disorders.

AIM

This study assessed the pharmacokinetic profile of lansoprazole orally disintegrating tablet dispersed in a small volume of water and administered through a small-bore nasogastric tube.

METHODS

Forty healthy adult men and women (18-43 years) received two single 30 mg lansoprazole orally disintegrating tablet doses (one administered directly onto the tongue without water, and one dispersed in water and administered via nasogastric tube) in a randomized, crossover fashion.

RESULTS

The total plasma exposure to lansoprazole was comparable following both dosing regimens; mean AUC values for the lansoprazole orally disintegrating tablet nasogastric dispersion were < or =8.6% greater than those for the intact lansoprazole orally disintegrating tablet. Lansoprazole Cmax for the lansoprazole orally disintegrating tablet nasogastric dispersion was 20.9% greater than that for the intact lansoprazole orally disintegrating tablet, a difference of no clinical significance.

CONCLUSIONS

Dispersion of the lansoprazole orally disintegrating tablet in a small volume of water and administering via nasogastric tube does not reduce the pharmacokinetic profile of the intact lansoprazole orally disintegrating tablet. This alternative dosing method may be useful in patients with nasogastric or gastric tubes.

Comprehensive conventional and molecular cytogenetic characterization of B-CPAP, a human papillary thyroid carcinoma-derived cell line

Cell lines derived from different thyroid tumor histotypes are useful for the in vitro study of both the phenotypic and genetic features of these cancers. Although karyotypic changes are known to be associated with thyroid lesions, the chromosome patterns of only a few cell lines have been published. Herein, we report an extensive conventional and molecular cytogenetic investigation of the human papillary thyroid carcinoma derived cell line B-CPAP. Morphological studies and expression of tumor markers in this cell line have been reported previously, but no detailed characterization on the origin of the chromosome markers is available. B-CPAP cells have a rather stable hypertriploid karyotype, with chromosome polysomies and structural chromosome abnormalities featuring whole chromosome arm imbalances. Chromosome banding revealed a main clone with nine chromosome markers, and fluorescence in situ hybridization (FISH) with whole chromosome paint (wcp), partial chromosome paint (pcp), and centromeric probes clarified their origin. The use of centromeric probes provided accurate refinement of the rearrangements classified as whole-arm translocations by banding and FISH with wcp probes. Both chromosomal and array-based comparative genomic hybridization experiments confirmed the cytogenetic characterization of this cell line. Moreover, the use of fluorescence immunophenotyping and interphase cytogenetics as a tool for the investigation of neoplasms (FICTION) technique, which simultaneously shows nuclear ploidy and cytoplasmic immunofluorescence, detailed the oncocytic feature of the cells. Intriguingly, despite their origin, they lack most of the features expressed in papillary thyroid tumor cells and have a chromosomal pattern reminiscent of that of a subgroup of oncocytic malignant thyroid tumors.

Anisotropy of acceleration in turbulent flows

Third-order Lagrangian stochastic models for the evolution of fluid-particle hyperaccelerations (material derivatives of Lagrangian accelerations) are shown to account naturally for the anisotropy of acceleration variances in low-Reynolds-number turbulent flows and for their dependency upon the energy-containing scales of motion. Model predictions are shown to be in close accord with the results of direct numerical simulations for a turbulent channel flow and with previously acquired simulation data for a homogeneous turbulent shear flow.

A novel option for dosing of proton pump inhibitors: dispersion of lansoprazole orally disintegrating tablet in water via oral syringe

BACKGROUND

A new formulation of lansoprazole, the lansoprazole orally disintegrating tablet, rapidly disintegrates in water eliminating the need for swallowing whole pills.

AIM

To assess the effect that dispersing the lansoprazole orally disintegrating tablet in water would have on lansoprazole pharmacokinetics.

METHODS

Forty healthy adult men and women (18-43 years) received two single 15 mg lansoprazole orally disintegrating tablet doses separated by 3 days (one administered directly onto the tongue without water and one dispersed in water and administered orally via syringe) in a randomized, crossover fashion. Serial plasma samples were determined from 0 to 12 h for each dose. Ratios of central values for peak plasma exposure (C(max)) and mean overall extent of exposure (area under the plasma concentration) were used to compare the bioavailability.

RESULTS

The two dosing regimens were bioequivalent, with the point estimate for area under the plasma concentration equalling 1.080 (confidence interval 1.012-1.152) and the point estimate for C(max) equalling 1.082 (confidence interval 0.961-1.218).

CONCLUSIONS

Dispersing the 15 mg lansoprazole orally disintegrating tablet in water and administering the dose orally via syringe is bioequivalent to the 15 mg intact lansoprazole orally disintegrating tablet with respect to lansoprazole area under the plasma concentration and C(max). This dosing route provides an additional, convenient dosing option for lansoprazole.

Is Clinical Otolaryngology publishing patient-centred research?

We asked how patient centred is Clinical Otolaryngology? Using two new models for analysing the patient-centredness of medical literature, three reviewers classified 176 papers (91 articles and 85 abstracts) published in this journal during the year 2000. Patients appeared as clinical subjects in 98 (56%), were interviewed by closed questionnaires in 21 (12%) and open questionnaires in 6 (3%), represented only by demographic details in 40 (23%) and not part of the study in 11 (6%) of papers. Papers were considered to address a biomedical frame of reference in 48 (27%), the patient's frame of reference in 6 (3%), technical aspects of the clinical encounter in 109 (62%) and communicative aspects in 7 (4%), and the setting for the encounter in 6 (3%) of papers. We show that some patient-centred research is published in Clinical Otolaryngology but suggest that it could publish more.

The prevalence of male urinary incontinence in four centres: the UREPIK study

OBJECTIVES

To report the results of the prevalence and health status associated with male urinary incontinence (UI) in a population-based, multicentre study in four countries, and to assess the epidemiology of this condition.

SUBJECTS AND METHODS

A standard questionnaire asking about frequency and amount of urine loss, use of pads and stress incontinence, was used to measure the prevalence of UI among men in four countries (Boxmeer, The Netherlands; Auxerre, France; Birmingham, UK; and Seoul, Korea). Self-reported urinary leakage was also recorded, with details of visits to the doctor for the symptoms. The samples were selected randomly from population registers of men aged 40-79 years, which provided representative samples in each community.

RESULTS

In all, 4979 men responded; from incontinence symptom scores, 7.3% of men aged 40-79 years in Auxerre, 16.3% in Boxmeer, 14.4% in Birmingham and 4.3% in Seoul reported mild to severe UI. On a self-reported question, 14.8% and 14.5% of men in Birmingham and Boxmeer thought that they had urinary leakage, compared with 7.5% and 7.1% of men in Auxerre and Seoul, but typically the reported incontinence was leaking drops of urine a few times a week. Of men with urinary leakage in the three European centres, 25.9% visited the doctor with this problem, compared with only 9.0% of men in Seoul. Of men in the European centres, 5.9% used pads at least occasionally, compared with only 1.6% of men in Seoul. UI was age-related and the reporting of it varied among centres, with 14.4% of men in Birmingham and 12.7% of men in Boxmeer aged 40-49 years reporting mild to severe UI, compared with 5.2% in Auxerre and 1.9% in Seoul. Among men aged 60-69 years the corresponding percentages were 13.7% in Birmingham, 22.6% in Boxmeer, 9.2% in Auxerre and 8.0% in Seoul.

CONCLUSIONS

UI is more common in older men and relatively uncommon among younger men. Some men reported no problems on the symptom questionnaire but replied positively to a direct question. Surprisingly many men wear protective pads at least occasionally as a result of their problem. UI appears to be a problem for men and which remains largely untreated; this may partly be a result of cultural differences.

Genome-wide detection of alternative splicing in expressed sequences using partial order multiple sequence alignment graphs

We present a method for high-throughput alternative splicing detection in expressed sequence data. This method effectively copes with many of the problems inherent in making inferences about splicing and alternative splicing on the basis of EST sequences, which in addition to being fragmentary and full of sequencing errors, may also be chimeric, misoriented, or contaminated with genomic sequence. Our method, which relies both on the Partial Order Alignment (POA) program for constructing multiple sequence alignments, and its Heaviest Bundling function for generating consensus sequences, accounts for the real complexity of expressed sequence data by building and analyzing a single multiple sequence alignment containing all of the expressed sequences in a particular cluster aligned to genomic sequence. We illustrate application of this method to human UniGene Cluster Hs.1162, which contains expressed sequences from the human HLA-DMB gene. We have used this method to generate databases, published elsewhere, of splices and alternative splicing relationships for the human, mouse and rat genomes. We present statistics from these calculations, as well as the CPU time for running our method on expressed sequence clusters of varying size, to verify that it truly scales to complete genomes.

Malignant vasovagal syndrome?

We present the management of a patient with nasopharyngeal carcinoma with a history of recurrent syncopal attacks diagnosed as malignant vasovagal syndrome. We discuss clinical presentation as well as the resolution of disease symptoms. The importance of metastatic nasopharyngeal malignancy in relation to syncope is discussed.