Bos d 13, A Novel Heat-Stable Beef Allergen

SCOPE

Red meat, a staple food of Western diets, can also induce IgE-mediated allergic reactions. Yet, apart from the heat-labile protein serum albumin and the carbohydrate α-Gal, the molecules causing allergic reactions to red meat remain unknown.

METHODS AND RESULTS

IgE reactivity profiles of beef-sensitized individuals are analyzed by IgE-immunoblotting with protein extracts from raw and cooked beef. Two IgE-reactive proteins are identified by peptide mass fingerprinting as myosinlight chain 1 (MYL1) and myosin light chain 3 (MYL3) in cooked beef extract and are designated Bos d 13 isoallergens. MYL1 and MYL3 are produced recombinantly in Escherichia coli. ELISAs proved their IgE reactivity and circular dichroism analysis showed that they represent folded molecules with remarkable thermal stability. In vitro gastrointestinal digestion experiments showed the higher stability of rMYL1 as compared to rMYL3. Exposure of a monolayer of Caco-2 cells to rMYL1 indicated that the molecule is able to cross intestinal epithelial cells without disturbing the integrity of the tight junctions, suggesting the sensitizing capacity of MYL1.

CONCLUSION

MYLs are identified as novel heat-stable bovine meat allergens.

Evaluation of facial aesthetics by laypersons in patients undergoing intraoral quadrangular Le Fort II osteotomy compared with conventional Le Fort I osteotomy

In this study we compared the aesthetic outcome of (1) Le Fort I (LFI) osteotomy and (2) intraoral quadrangular Le Fort II (IQLFII) osteotomy for surgical correction of skeletal class III dysgnathia involving midfacial deficiency. The aim was to investigate whether laypersons see differences in facial changes that occur due to variations of the osteotomy cuts. The patient collectives consisted of 23 patients in each group. Pre- and postoperative photographs were presented in a random sequence to 40 layperson raters. The rating procedure was conducted with a four-point Likert scale. Assessed characteristics were 'attractiveness' ('Attraktivität'), 'likeability' ('Sympathie'), 'intelligence' ('Intelligenz'), 'aggressiveness' ('Aggressivität') and 'dominance' ('Dominanz'). For preoperative photographs we found a significant difference for 'likeability' with lower ratings for the IQLFII group; all other criteria were rated similarly. For the IQLFII group we found a significantly larger shift from lower to higher ratings for 'attractiveness' and 'likeability' and a significantly larger shift from higher to lower ratings for 'aggressiveness' and 'dominance' than for the LF I group. Our study shows that lay raters detect significant differences between the two surgical groups. Thus, IQLFII osteotomy, when indicated, represents a favourable alternative to conventional LFI osteotomy, if patients desire the expectable change in recognition by their social circle.

[Network against multidrug-resistant organisms in the Rhine-Main region, Germany. A first evaluation]

BACKGROUND

Multidrug-resistant organisms (MDROs) are not only a problem in the hospital but also in the community setting. The MRE-Net Rhine-Main was founded in order to decrease the rate of development and spread of MDROs in the region and to counter the stigmatisation of people with MDROs. The network attempts to achieve these goals by offering telephone support, information flyers, internet services, information events and training for health-care practitioners from hospitals (HOSP), residential and nursing homes (RNH), outpatient care services (OCS), emergency services (ES), medical practices (MP) and rehabilitation centers (RC). A first interim evaluation examined the expectations each institution had associated with its participation and how well these objectives were fulfilled. Furthermore the utilisation and acceptance of the services offered by the network were investigated.

METHOD

The participating institutions (n=143) received a standardised questionnaire adapted to the type of institution by mail including questions focusing on the above-mentioned issues.

RESULTS

96 questionnaires could be evaluated (response 67.1%). More than 90% of the participants expected to participate in trainings, receive improved information, to gain more confidence in handling patients and to improve hygiene measures - with great differences between HOSP, RNH and OCS. These expectations were largely satisfied. 65.5% of the institutions participated at least once in a training, particularly RNH, OCS, whereby the usefulness of the trainings was rated high by these institutions. 14.4% of the institutions had made use of the telephone service, the gain of information was rated as high by HOSP, RNH and OCS. 81% knew of and used the flyers, but almost half of the institutions did not know the homepage of the network.

CONCLUSIONS

Overall the expectations of the network participants were met well to very well and the benefit derived from the trainings and the print and online media was rated as high. Therefore the network will continue and further intensify its work.

Is failure of condylar neck osteosynthesis predictable based on orthopantomography?

BACKGROUND

Osteosynthesis failure rates of 11.3% with 1 miniplate, 6.7% with 2 miniplates, and 4.4% with a single Medartis condyle plate were reported in previous studies of our clinic. Current science is still focused on the osteosynthesis material. Besides clinical parameters, conventional radiographs are still the first choice to detect osteosynthesis failures. This study scrutinized several factors assessable in postoperative orthopantomographs which might elevate the risk of osteosynthesis failure.

STUDY DESIGN

A total of 136 patients (22 with osteosynthesis failure, 114 without) with 151 mandibular condyle fractures were included in this study. Eight parameters were assessed in postoperative orthopantomographs.

RESULTS

The best predictor of osteosynthesis failure was a simplified concept of ramus height. In cases of reduced or normal ramus height, the odds of osteosynthesis failure was significantly (P = .000001) reduced to a 10th. Isolated fractures were significantly more error prone (P = .0009).

CONCLUSIONS

Postoperative orthopantomographs depict factors which increase the risk of osteosynthesis failure.

Assessing interest in an osteoporosis website: a survey among women eligible for osteoporosis screening

A survey was conducted to assess interest in an osteoporosis website. Two thirds of respondents indicated they would read about osteoporosis on a website, and half reported they might use the website more interactively. Women were receptive to the concept of web-based education and management of osteoporosis care.

INTRODUCTION

As Americans increasingly use the Internet as a source for health information, healthcare providers continue to develop disease management and education websites. Providence Health & Services conducted a survey among female patients eligible for osteoporosis screening to assess interest in a physician-prescribed osteoporosis website.

METHODS

In 2006, a self-administered survey designed to assess osteoporosis status, Internet use, and the likelihood of using an osteoporosis website for information and disease management was sent to 3,000 active female patients between the ages of 50 and 85 in the Portland, Oregon metropolitan area.

RESULTS

Among 778 respondents, 80% reported having access to the Internet, and 70% indicated they were likely to use the Internet for health-related information gathering. While 65% of respondents indicated they would be likely to read about osteoporosis on a dedicated website, only about half reported they might use the website for more interactive disease management activities such as scheduling appointments, receiving test results, or consulting with their physician. Both Internet access and interest in the osteoporosis website declined significantly with age.

CONCLUSIONS

These data suggest that middle-aged women are moderately receptive to the concept of web-based care for certain components of osteoporosis management and education.

[Diabetes study in Bavaria: known risk factors correlate with an increased level of HbA1c]

BACKGROUND AND OBJECTIVE

Approximately six million Germans have been diagnosed with diabetes mellitus. A continuously increasing number of people with diabetes is expected within the next few years. Genetic disposition, age and especially lifestyle play an important role in the development of the disease. Diabetes normally develops during a long preclinical phase. During this preclinical phase an impaired glucose tolerance can easily be detected. Since an impaired glucose tolerance is often reversible the onset of diabetes can be prevented effectively by a change of lifestyle during this phase. The Bavarian Red Cross Blood Transfusion Service therefore determined the diabetes risk among its blood donors during two one-week study periods.

PATIENTS AND METHODS

The diabetes risk of the participating donors was assessed by using the FindRisk diabetes test published by the German Diabetes Foundation and the HbA1c test.

RESULTS

Approximately 12 percent of the participants (8187 persons aged 18-68 years) showed a moderate, high or even very high risk of developing diabetes within the next 10 years. The probability of developing the disease ranged from 17% (moderate risk) to 50% (very high risk). This corresponds to 3% of persons with unknown diabetes among the total population. An elevated HbA1c was found in approximately 5% of the donors in the first study week and in approximately 19% in the second study week. The analysis of the questionnaire and the HbA1c results indicated that elevated HbA1c values correlate with known diabetes risk factors. Persons with a body mass index greater than 25, an increased score in the FindRisk questionnaire and aged over 50 years more frequently showed an elevated HbA1c value.

CONCLUSIONS

The combination of a diabetes risk questionnaire and HbA1c testing could be used successfully for diabetes screening in an identified risk group.

Preoperative radiochemotherapy and radical resection for stages II to IV oral and oropharyngeal cancer: grade of regression as crucial prognostic factor

The purpose of this study was to assess the prognostic value of histological response to preoperative radiochemotherapy in an established multimodal therapy concept for advanced oral and oropharyngeal cancer. Two hundred and twenty-two patients who underwent preoperative radiochemotherapy (RCT: 50 Gy, mitomycin C and fluorouracil) and radical surgery were retrospectively evaluated. Resected tumours of all patients were histologically analysed and response to RCT was classified in histopathological grades of regression (RG). In a multivariate statistical analysis, RG was compared with established factors regarding their predictive value for overall and disease-specific survival. The 5-year overall survival probability in the different groups of histopathological regression grades were: RG1 (no vital tumour): 73.4%, RG2 (minimal tumour remnants encompassing less than 5%): 72.1%, RG3 (5-50% vital tumour cells): 41.9%, RG4 (more than 50% vital tumour): 37.9%. For disease-specific survival probability no significant differences were found between both groups of "responders" (RG1 and RG2) nor between "non-responders" (RG3 and RG4), whereas responders and non-responders differed significantly from each other (log-rank test; p < 0.001). T-classification, N-classification and disease stage, histological grading, tumour site, age, and sex had less prognostic value than RG in a Cox regression model. In the neoadjuvant multimodal therapy concept, histological response to preoperative RCT is a crucial prognostic factor even when surgical R0-resection is accomplished. Thus, non-responders have to be regarded as high-risk patients for recurrence and may benefit from further therapy.

Preoperative radiochemotherapy and radical resection for stages II–IV oral and oropharyngeal cancer: outcome of 222 patients

To analyse survival and locoregional control in patients with advanced oral and oropharyngeal squamous cell carcinoma (SCC) after multimodal therapy with preoperative radiochemotherapy (RCT) and radical surgery. We included in this analysis 222 patients who underwent multimodal therapy between 1990 and 2000. Eligible were patients with UICC disease stages II-IV (T2: 33.3%; T3: 12.6%; T4: 54.1%; N0: 45.9%; N1: 17.6%; N2: 33.3%; N3: 3.2%; stage II: 21.1%; stage III: 14.9%; stage IV: 64%). Patients received preoperative radiochemotherapy consisting of Mitomycin C (15-20 mg/m2, day 1) plus 5-Fluorouracil (750 mg/m2/24 h-infusion, days 1-5) and concomitant radiotherapy for a total dose of 50 Gy. Radical locoregional en bloc-resection according to the pretherapeutic tumour extension was carried out in all patients. After a median surveillance period of 72.3 months (24-152 months), 131 patients (59%) were alive, and 91 (41%) patients died; 12 (5%) of them died postoperatively, 46 (21%) due to tumour recurrence, and 33 (15%) deaths were not directly related to the primary tumour. Overall survival probability was 76% after 2 years, and 62% after 5 years. Two- and 5-year local control probability were 88 and 81%, respectively. Regarding the high percentage of stage IV disease in the reported patients, the multimodal concept is an effective therapy offering excellent survival and local control probability.

Isolierte Orbitabodenfrakturen

BACKGROUND

The goal of this retrospective study was quantitative calculation of area and volume of isolated orbital floor fractures from computed tomography (CT) and correlation of these data with post-traumatic ophthalmologic findings.

PATIENTS AND METHODS

A total of 76 patients with isolated orbital floor fractures were evaluated radiologically and clinically. CT scanning was performed in coronal sections (1.5-mm to 3.0-mm slice thickness) with contiguous table feed. Orbital floor and fracture area as well as volume of displaced tissue were measured and calculated from the CT dataset. The relation of quantitative CT data to ophthalmologic findings (motility, diplopia, and globe position) was assessed statistically.

RESULTS

Calculation of the CT dataset revealed a mean orbital floor area of 6.33+/-1.05 cm(2), a mean fracture area of 2.60+/-1.14 cm(2), and a mean volume of displaced tissue of 1.16+/-0.80 cm(3). Volume of displaced tissue correlated significantly with ophthalmologic findings (p< or =0.01). Fracture area correlated significantly with globe position (p< or =0.01) and was less associated with diplopia and motility disturbances (p<0.10).

CONCLUSION

Efficient evaluation of two-dimensional CT data enables quantitative assessment of orbital floor fractures. Position and function of the globe are mainly affected by the volume of displaced periorbital tissue.

Two stage reconstruction with revascularized grafts after resection of retromolar and oropharyngeal carcinoma

The clinical outcome of two stage reconstruction with revascularized grafts after resection of extensive retromolar and oropharyngeal squamous cell carcinoma in 17 patients is presented. In the first operation, the intraoral soft tissue defect was covered by a revascularized jejunal flap, and the mandibular defect was bridged by a reconstruction plate. After a period of 5-28 months, mandibular reconstruction was performed with a microsurgically revascularized iliac crest graft that was positioned under the jejunal graft. Clinical follow up included tumour recurrence rate, the form of nutrition, speech disorders and mouth opening restrictions. Quality of life was analysed by the EORTC questionnaires. Fifteen patients were free of recurrence and alive. Twelve patients were able to swallow food. The jejunal flap provided perfect lining of the soft palate, the pharynx and the base of the tongue, thus supporting functional restoration. Despite the gravity of disease and invasiveness of therapy, the two stage procedure leads to satisfying functional and aesthetic results thus obtaining appropriate QOL.

Follow-up study of treatment of orbital floor fractures: relation of clinical data and software-based CT-analysis

This retrospective study quantifies isolated orbital floor fractures using software-based CT-analysis and compares the clinical outcome across surgical and non-surgical treatment groups. Depending on the surgeon's interpretation of the clinical and radiological appearance, 10 fractures were treated non-surgically and 20 fractures surgically, either with antral balloon catheter alone or in combination with an orbital implant. Ophthalmologic findings were evaluated until 12 weeks after injury. Fracture area, and volume of displaced tissue (VDT) were assessed by software-based CT-analysis. VDT was marginally significantly smaller in non-surgically than in surgically-treated patients (P=0.08). Ophthalmologic findings improved in all groups during follow-up and no statistical difference was found between the groups. Diplopia remained moderate in three patients with balloon catheter alone, and minimal in four patients in both surgical groups. In one patient with non-surgical treatment, diplopia remained minimal after 12 weeks. Although CT-analysis revealed no significant difference between both surgical groups, patients treated with balloon catheter alone presented more diplopia after 12 weeks. Using balloon catheters for fracture repair a combined approach should be performed when large fractures involve the orbital floor to achieve sufficient reduction of orbital content and placement of an orbital implant. Software-based CT-analysis is helpful for objective interpretation in managing of orbital fractures.

The radial free forearm flap--prelaminated versus non-prelaminated: a comparison of two methods

In the present work two methods of harvesting the RFFF (radial free forearm flap) are compared: the prelaminated fasciomucosal and the non-prelaminated fasciocutaneous version. The flaps were employed for intraoral reconstruction after radical oncological surgery of the oral cavity. In most cases a squamous cell carcinoma was the present malignant tumour. A total of 32 patients were included in the study, 16 in each group. The design was retrospective. Data were obtained by clinical follow up, chart review and compiled database. Analysis included the amount of shrinkage of the flaps during the follow-up period, early postoperative complications, following function improving operations and early and late donor site difficulties. Prelaminated fasciomucosal flaps showed a higher shrinkage rate than fasciocutaneous non-prelaminated flaps. Due to this circumstance the number of following function improving operations was higher in the prelaminated flap group. Early wound healing difficulties were also seen more often in the prelaminated flap group, whereas donor site problems occurred more frequently in the non-prelaminated group. Mucosal prelamination of the RFFF is a promising method for a most physiological reconstruction of intraoral defects resulting from tumour surgery. Postoperative shrinkage is a problem in prelaminated RFFF. Our aim is to improve the prelamination technique in order to prevent shrinkage. The almost complete absence of donor site difficulties in prelaminated RFFF may represent a solution to this common and yet unsolved problem.

Quality of life 2-10 years after combined treatment for advanced oral and oropharyngeal cancer

This study reports the findings of an evaluation of Quality of Life (QOL) in long-term survivors of advanced oral and oropharyngeal cancer treated with preoperative chemoradiotherapy followed by surgery (combined treatment=multimodal therapy). All patients had T2-T4 tumours and all received locoregional radical resection and simultaneous microvascular reconstruction. From 1990 to 1998, 181 patients have been treated at the University Hospital of Cranio-Maxillofacial and Oral Surgery in Vienna. 100 (55%) of these patients were alive and free of disease in 2000. Sixty-seven of them completed the EORTC questionnaires QLQ 30 and QLQ H&N 35. We found these questionnaires to be very good tools for determining QOL, which constitutes part of the therapeutic success. Patients tended to report good to very good QOL. A comparison between groups according to clinical data was conducted as well as a group comparison of patients who claimed especially high or low QOL in the questionnaires. It was found that combined treatment not only offers the best chances for survival, but also allows a subsequent QOL, that is comparable to other forms of therapy.

A computer-based method for calculation of orbital floor fractures from coronal computed tomography scans

PURPOSE

A computer program recently developed for the calculation of the orbital floor and fracture areas from coronal computed tomography (CT) scans was used in a study to evaluate the accuracy and ability of this new method.

MATERIAL AND METHODS

The size of orbital floors and fabricated fractures in 14 dried, anatomic specimens were measured in coronal CT scans by 3 independent observers. Based on this data set, the orbital floor and fracture regions were calculated with the newly developed computer program. These calculated regions were then compared with a direct measurement of the specimens that had been obtained by digital photography. The accuracy of the computer-based calculations was assessed using Lin's concordance correlation coefficient.

RESULTS

The size of the orbital floor (mean +/- SD) was found to be 5.21 +/- 0.39 cm(2) by direct measurement of the specimens and 5.30 +/- 0.52 cm(2) by calculation with the computer program. The region of the fracture (mean +/- SD) was 1.05 +/- 0.64 cm(2) by direct measurement and 1.01 +/- 0.62 cm(2) by computer calculation. The between-method mean difference (direct measurement minus computer based calculation) was -0.09 cm(2) (or 1.7% of mean orbital floor region) for orbital floor region and 0.04 cm(2) (or 3.8% of mean fracture region) for fracture region.

CONCLUSIONS

This accurate and time-saving method is practicable for determining the size and location of orbital floor fractures. This calculation program can be advantageously applied in the clinical management of blowout fractures of the orbit.

The L-shaped osteotomy for vertical callus distraction in the molar region of the mandible: a technical note

The following report refers to a well described surgical procedure using a prototype vertical distractor developed in Cologne in cooperation with Martin Medizintechnik GmbH. The surgical technique has been refined by an L-shaped osteotomy stabilized posteriorly by a miniplate to limit the amount of callus regeneration in the molar region where no increase in vertical height is required. The surgical technique with its advantages and one complication is described as used in four patients undergoing six distraction treatments.

Endoscopy of the middle ear through the eustachian tube: anatomic possibilities and limitations

HYPOTHESIS

This anatomic study was designed to provide otosurgeons with a detailed description of the technique of transtubal middle ear endoscopy and anatomic landmarks facilitating orientation. To establish the role of transtubal endoscopy, its anatomical potentials and limitations were studied.

BACKGROUND

Transtubal endoscopy has recently been described as an atraumatic tool for exploring the tympanic cavity. From the nasopharynx, a thin, flexible endoscope is advanced into the middle ear through the Eustachian tube. After the endoscope has been placed, it offers an anteroposterior view of the tympanic structures.

METHODS

Temporal bone blocks and whole skulls of recently deceased persons were examined to define the average range of view obtained by transtubal endoscopy. Key structures in each region of the tympanic cavity were chosen for inspection, and positive identifications were noted.

RESULTS

With a 0.8-mm, flexible, steerable scope, most mesotympanic structures (stapes suprastructure, incudostapedial joint, tympanic chord, and inner surface of the eardrum) were clearly defined. Areas of the posterior wall that were not accessible with the otomicroscope (lateral tympanic sinus, tympanic sinus, and facial recess) were also seen. Unlike with transtympanic endoscopy, the epitympanum (incudomalleal joint and malleus neck) was also evaluable. The stapes footplate was not seen well and the round window niche was unable to be inspected in the anteroposterior view inherent in the technique. Technical factors (poor illumination and small image size) and the unfamiliar anteroposterior view made orientation in the middle ear difficult.

CONCLUSION

Transtubal middle ear endoscopy is a suitable method for exploring the tympanic cavity without traumatizing the eardrum.

Two-port endoscopy of the middle ear: endoscopic anatomy

OBJECTIVES

To shed light on the endoscopic anatomy of the middle ear seen on 2-port endoscopy and to describe potential clinical applications.

DESIGN

Anatomical structures were visualized by transmeatal or transtympanic rigid scopes of different angles and by a flexible scope in the eustachian tube. This arrangement ensured reciprocal guidance of the scopes and provided access to regions not seen otherwise.

SETTING

The Department of Anatomy 1, University of Vienna, Vienna, Austria.

MATERIALS

Forty tympanic cavities obtained from cadaver skulls without prior fixation were examined. Specimens did not show any abnormalities and were chosen without regard to age or sex.

RESULTS

Depending on the angle of view, rigid transmeatal or transtympanic endoscopes provided a full view of the entire tympanic cavity except for the epitympanum, access to which was barred by the incudomallear joint, the mallear folds, and the tympanic chord, but the epitympanum was well visualized through the flexible, steerable, transtubal scope.

CONCLUSIONS

Two-port endoscopy of the middle ear offers a full view of all structures in the tympanic cavity. The atraumatic transtubal approach to the tympanic cavity enhances the safety of transmeatal interventions and facilitates postoperative follow-up.

[Combined effect of temperature a(W) and pH on proteases from Pseudomonas and Bacillus spp]

The factors affecting protease activity were investigated on certain media. Five strains of Bacillus (B.) cereus, four strains of B. subtilis, five strains of Pseudomonas (Ps.) aeruginosa and two strains of Ps. fluorescens produced the proteases that were tested. The enzyme activity was evaluated under 32 different combinations of temperature (2 and 7 degrees C), water activity (aw) (0.80-0.98) and pH (4.0-7.3). A decrease in water activity and pH and/or temperature caused a decrease in protease activity. It appeared that the combined effect of temperature, aw and pH influences enzyme production significantly compared with the influence of single environmental factors. Temperature plays the crucial role in these reactions. Enzyme activities could be observed even at low temperature. Although the exoprotease of Ps. spp. showed intense activity at refrigeration temperature, low pH and aw, Bacillus proteases were comparably less active under the same conditions, but nevertheless proved to be significant.

A minimally invasive technique for endoscopic middle ear surgery

Middle ear endoscopy should be considered a useful adjunctive or alternative method to microscopic surgical exploration for middle ear pathology. This minimally invasive technique provides excellent visualization for viewing the surgical micromorphology and pathological findings of the middle ear. Selected patients underwent middle ear endoscopy using a transtympanic approach. Rigid endoscopes of 2.7 mm and 1.9 mm caliber and 0 degrees, 30 degrees and 70 degrees viewing angles were introduced into the tympanic cavity through small tympanostomy incisions. The indications and technique with video monitoring are discussed.

Clinical assessment of periodontal conditions in patients treated with nifedipine

Calcium antagonists are widely used in treating acute and chronic coronary insufficiency disorders. A major side effect of long-term treatment is gingival hyperplasia. In the present study, 70 patients taking nifedipine for at least six months and 70 controls similar in age, gender, approximal hygiene and systemic disease with at least 6 anterior teeth in upper and lower arches were examined. Their periodontal conditions were determined by modified Sulcus-Bleeding-Index (mSBI), modified Approximal-Plaque-Index (mAPI), Community Periodontal Index of Treatment Needs (CPITN), a hyperplasia index quantifying the extent of gingival overgrowth, probing depths, clinical attachment loss and the modified Phenytoin-Gingival-Inflammation-Index (mPGI). A mild to moderate gingival hyperplasia was diagnosed in 21 of 70 patients resulting in a prevalence of 30% compared to 8.5% in controls. The hyperplastic changes were situated mainly in the anterior region of the dentition. Significant differences between both groups could be found comparing the severity of the gingival hyperplasia, the CPITN, mSBI, probing depths and the part of mPGI evaluating colour and turgor of the gingiva (p < 0.05). The severity of gingival overgrowth was strongly correlated with the inflammatory gingival changes, probing depths, the periodontal treatment need and the approximal hygiene of the patients. No statistically significant correlation could be found between the severity of gingival hyperplasia and the age and gender of the patient, or the dose or duration of nifedipine therapy. Gingival changes seemed to be more pronounced in patients with cardiovascular disorders than in patients under hemodialysis. The high incidence of gingival hyperplasia in patients receiving nifedipine on a long-term basis emphasises the role of the dentist and general practitioner in the early detection and prophylaxis of gingival changes and requires a thorough information to the patient concerning periodontal side effects.

Regional induction of tumor necrosis factor alpha expression in the mouse brain after systemic lipopolysaccharide administration

Tumor necrosis factor alpha (TNF-alpha) is a cytokine that is responsible, in part, for several aspects of the acute-phase response to inflammation, including the generation of fever. TNF-alpha has direct effects on central nervous system neurons deep within the hypothalamus that are involved in producing the febrile response, but the blood-brain barrier prevents circulating TNF-alpha from having access to these sites. We therefore have hypothesized that TNF-alpha may be produced in the brain and used as a mediator in the cerebral components of the acute-phase response. We used in situ hybridization to determine the distribution of production of TNF-alpha mRNA in the mouse brain after systemic administration of lipopolysaccharide. During the initial phase of fever, hybridization was observed in perivascular cells and neurons in circumventricular organs, including the vascular organ of the lamina terminalis, median eminence, and area postrema, as well as along the ventral surface of the medulla; hybridization was also prominent over many cell in the meninges. During the late phase of the response, hybridization was observed over neurons in the pericircumventricular nuclei such as the anteroventral periventricular and arcuate nuclei of the hypothalamus and the nucleus of the solitary tract. TNF-alpha produced by a cascade of neurons within the brain may participate in the complex autonomic, neuroendocrine, metabolic, and behavioral responses to infection and inflammation.

Cytomegalovirus reactivation and tumour necrosis factor

Tumour necrosis factor-alpha (TNF) stimulates cytomegalovirus (CMV) activity in a transfected human monocytic cell line. We assessed whether this finding is relevant in vivo by evaluating the frequency of active CMV infection in patients with diseases that enhance plasma TNF. In septic disease, peripheral blood mononuclear cells of almost all patients studied were positive for CMV. Furthermore, CMV antigenaemia and enhanced plasma TNF occurred in many patients with liver cirrhosis, common variable immunodeficiency, and B-cell chronic lymphocytic leukaemia. Thus, TNF may have a central role in CMV reactivation.

Baking stability of acesulfame K

The stability of acesulfame K during baking was investigated at different baking temperatures and baking times. The contents of acesulfame K in baked and unbaked doughs were determined by HPLC. The recovery rate of acesulfame K was independent of the baking conditions chosen and correlated with the recovery rate of acesulfame K in the unbaked doughs. As the stability of acesulfame K cannot only be affected by baking temperature and baking time but also by pH value and moisture content of the baked goods, additional stability investigations were performed with acidic fillings and apple pie. Even under these extreme baking conditions no decomposition of acesulfame K could be detected.

[Chemical and toxicologic studies of native corn in flour and bread]

During the bread-baking process, total alkaloid content is reduced by about 50%, the pharmacologically active alkaloids (the '-in' types) being reduced to a much greater extent than the less active type ('-inin' type). Using ergotamin and ergokryptin as a basis, total alkaloid levels were calculated from the HPLC data; these results were in a good agreement with the total alkaloid content calculated from 13 individual ergot alkaloids. The changes in the alkaloid spectrum caused by pelletin are shown. In feeding experiments with growing, pregnant, and lactating mice, diets with 0%, 1% and 2% unbaked (MM) or baked (MB) rye ergot were compared for possible toxic effects on reproduction, using animals fed ad libitum or pair-fed controls. A mean ingestion of 3.6 mg of alkaloids/kg body weight per day (MM 2%) was maternally toxic and caused inhibition of conception and implantation. Feeding with 1.3 or 1.6 mg of alkaloids/kg body weight per day (MM 1% and MB 2%) during pregnancy had no significant toxic effect on the embryo or fetus, but resulted in gestation time being prolonged to about 10 h. During lactation, an intake of 2.9 and 3.0 mg of alkaloids/kg body weight per day (MM 1% and MB 2%) led to a considerable reduction in growth (up to 50%) in the young mice compared to the control animals fed ad libitum. Both the determination of total ergot alkaloid content and the feeding experiment indicate that the bread-baking process causes a reduction and consequently a detoxification of ergot alkaloids of about 50%.

[A method for the determination of ergot alkaloids in food]

A suitable method has been developed for the routine analysis of the ergot alkaloids ergometrine, ergometrinine, ergosine, ergosinine, ergotamine, ergotaminine, ergocornine, ergocorninine, alpha-ergocryptine, alpha-ergocryptinine, beta-ergocryptine, beta-ergocryptinine, ergocristine and ergocristinine in cereal products. The method consists of food extraction, cleaning of the crude extract by a modified form of the Extrelut method, and identification and quantitative determination of the alkaloids by high pressure liquid chromatography (HPLC). The results are confirmed by thin layer chromatography (TLC) and gas-chromatography/mass spectrometry (GC/MS). Market investigations have shown contaminations in ecological as well as in conventional products, with rye products mainly being contaminated. Within the EEC, a maximum value of 0.05% ergot respectively a total alkaloid content of 1 mg/kg in cereals used for food production is prescribed. This value was not exceeded in any of the investigated samples.

[Ergot alkaloids in cereals--description of an analytical method]

A method is described for the isolation, separation and quantitative determination of ergot alkaloids in cereals and cereal products.

[Temperature dependence of rosette-forming lymphocytes in healty subjects and women with gynecological tumors]

In blood donors (n equal 39) and women with gynaecological tumours (n equal 12) the number of lymphocytes, rosette-forming with sheep and mouse erythrocytes (SRBC + MRBC), was investigated at 4, 22, 29, 33 and 37 degrees C. SRBC clearly decrease at temperatures of more than 22 degrees C and they also decrease in rosette size, MRBC behave constant in temperature. At an incubation temperature of 4 degrees C SRBC-values of 59 +/- 7.5% and MRBC-values of 7.6 +/- 3.9% could be recognized. The two rosette-tests did not show any significant differences between the sexes, the blood groups and the groups. The temperature-depending SRBC-phenomenon demands the observation of the steadiness of temperature in incubation. The behaviour of the subpopulation of B-lymphocytes forming MRBC, which is constant in temperature, is again described. It speaks for completely other binding forces than in SRBC. The method of a differentiation of the normal person from a tumour carrier by the different rosette-formation with SRBC at 29 and 33 degrees C, inaugurated in literature by West and co-workers, does not find any corresponding case in our group of tumours. The hope of finding a criterion of differentiation for the immunological tumour diagnostics by means of the temperature-different behaviour of the T-lymphocytes must on account of the present level of knowledge be regarded as little hopeful, even when the groups of patients are enlarged. At present immune defect diseases are regarded as a field of secure diagnostic indication for the SRBC-test, selected lymphoproliferative diseases for the SRBC-test.