Immunoglobulin A (IgA) deficiency and alternative celiac disease-associated antibodies in sera submitted to a reference laboratory for endomysial IgA testing.

Immunoglobulin A (IgA) deficiency occurs more frequently in patients with celiac disease (CD) than in the general population and can lead to false-negative results in the best serologic test for CD, endomysial IgA (EMA). To evaluate the impact of IgA deficiency on serologic detection of CD in a reference laboratory setting, IgA levels were measured in 510 consecutive serum specimens submitted for testing for EMA; 510 consecutive serum specimens submitted for Helicobacter pylori IgG testing served as a gastrointestinal symptom control group. The frequency of IgA deficiency was significantly higher among the specimens submitted for testing for EMA (5.

Effect of gender on anti-inflammatory and analgesic actions of two kappa-opioids.

The higher incidence of inflammatory and painful disorders in women and recent reports that have emphasized the importance of gender in nociceptive sensitivity and responsiveness to analgesics prompted us to investigate gender as a factor in the variability in response to opioids. We studied the anti-inflammatory and antinociceptive effects of two kappa-opioid agonists in adjuvant-induced arthritis, one that acts both peripherally and centrally (PNU50488H; 20 mg/kg/day), the other which is peripherally selective (asimadoline; 5 mg/kg/day). Both drugs had equally powerful anti-inflammatory effects in both male and female rats (reducing measures by 60-80%).

Involvement of substance P in the anti-inflammatory effects of the peripherally selective kappa-opioid asimadoline and the NK1 antagonist GR205171.

We have previously shown that kappa-opioids have antiarthritic properties. In this study, using two differently acting drugs (the peripherally selective kappa-agonist, asimadoline, and the NK1-antagonist, GR205171), we have examined possible roles of the neuropeptide substance P (SP) in the pathogenesis and maintenance of experimental arthritis in rats. The anti-inflammatory actions and the time dependence of these drugs were compared, and concentrations of SP determined in joint tissue.

Relevance of complement fixing antinuclear antibodies.

Background: Connective tissue diseases (CTDs) are a heterogeneous group of disorders defined by the association of a variety of clinical manifestations with immunologic and other laboratory findings. Overlap of syndromes and aberrant findings appear rather frequently.

Methods: Sera of eight antinuclear antibody (ANA) negative, cases of subacute cutaneous lupus erythematosus (SCLE) with antibodies to Ro (SS-A) and a ninth case with clinical and laboratory signs of Sjögren's syndrome and systemic lupus erythematosus (SLE) were tested for complement (C') fixing antinuclear antibodies (C-ANAs).

Leptospirosis in an urban setting: case report and review of an emerging infectious disease.

Leptospiosis is a common zoonosis affecting most mammals. Leptospirosis has protean manifestations ranging from a flu-like illness to fulminant hepatic and renal failure culminating in death. Although the diagnosis is often not considered upon presentation, the literature suggests that leptospirosis is a reemerging infectious disease in urban centers throughout the industrialized world.

Treatment of hyperfunctional lines of the face with botulinum toxin A.

Since Botulinum toxin A became a mainstay therapy for blepharospasm, its use in treating other dystonic conditions, spasticity disorders, as well as hyperfunctional lines of the face has increased exponentially in recent years. The following article summarizes our experience in establishing a safe and reliable method of administration of botulinum toxin A for treating hyperfunctional lines of the face.

Stimulation of phospholipase C-beta2 by the Rho GTPases Cdc42Hs and Rac1.

Neutrophils contain a soluble guanine-nucleotidebinding protein, made up of two components with molecular masses of 23 and 26 kDa, that mediates stimulation of phospholipase C-beta2 (PLCbeta2). We have identified the two components of the stimulatory heterodimer by amino acid sequencing as a Rho GTPase and the Rho guanine nucleotide dissociation inhibitor LyGDI. Using recombinant Rho GTPases and LyGDI, we demonstrate that PLCbeta2 is stimulated by guanosine 5'-O-(3-thiotriphosphate) (GTP[S])-activated Cdc42HsxLyGDI, but not by RhoAxLyGDI.

Standardized measurement of major immunoglobulin class (IgG, IgA, and IgM) antibodies to beta2glycoprotein I in patients with antiphospholipid syndrome.

Patients with the antiphospholipid syndrome (APS) have autoantibodies directed against epitopes on beta2 glycoprotein I (beta2GPI). We describe herein the performance characteristics of standardized enzyme-linked immunosorbent assays (ELISAs) for anti-beta2GPI of the three major immunoglobulin classes: IgG, IgA, and IgM. All three assays generated highly linear standard curves (5 points, r > or = 0.

Effect of the peripherally selective kappa-opioid agonist, asimadoline, on adjuvant arthritis.

1. Opioids, though widely used as analgesics, have not been seriously considered as therapy for rheumatoid arthritis. The present study evaluated the dose-effect and time-dependence relationships of a new peripherally selective kappa agonist, asimadoline, in rats with adjuvant arthritis.

Antinuclear antibodies (ANA) and complement fixing ANA in systemic connective tissue diseases.

Screening for antinuclear antibodies (ANA) with parallel tests for complement fixing ANA (C-ANA) reveal that C-ANA react either as strongly as or more strongly than ANA in most cases of systemic lupus erythematosus (SLE) and related disorders including CREST syndrome. But sera of drug induced LE and other ANA positive subjects have weak or no C-ANA. (P < 0.

The management of hyperfunctional facial lines with botulinum toxin. A collaborative study of 210 injection sites in 162 patients.

Objective: To determine the optimum dose and efficacy of botulinum toxin injections in the management of hyperfunctional facial lines.

Design: This study included 210 hyperfunctional facial sites in 162 different patients. The patients had preinjection and postinjection photographic documentation and ratings on a 4-point qualitative evaluation scale of lines at rest and with action.

Effect of mu-opioids morphine and buprenorphine on the development of adjuvant arthritis in rats.

Objective And Design: On the basis that endogenous opioids play a role in the physiological response to inflammation, this study tests the anti-arthritic effects of a mu-opioid agonist, morphine and the partial mu-agonist, buprenorphine.

Material: Male Lewis rats were used.

Treatment: Rats were inoculated subcutaneously with 0.

Effect of desmopressin substitution during organ procurement on early renal allograft function.

Background: As diabetes insipidus in brain-dead organ donors leads to hypovolaemia, hyponatraemia, and hypotension, desmopressin is recommended for treatment of diabetes insipidus. As its effect on early renal allograft function remains unclear, we conducted a study to evaluate the effect of desmopressin on renal-graft survival.

Methods: We report the results of a prospective study in 41 brain-dead organ donors (mean age 45 +/- 12 years) with diabetes insipidus, who were treated either with adequate fluid substitution and bolus application of desmopressin (desmopressin group; n = 22) or with volume substitution along (control group; n = 19).

Reconstruction of posttraumatic and congenital facial deformities with three-dimensional computer-assisted custom-designed implants.

The principles, method, and benefits of combining three-dimensional computed tomography (CT) and computer-aided design/computer-aided manufacture (CAD/CAM) technology for development of custom-designed prostheses are applied in the repair of posttraumatic and congenital facial contour deficiencies. Each prosthesis is generated to fit the bone defect exactly, with external contours adjusted to compensate for overlying soft-tissue disparities. Three representative case reports from a series of 17 demonstrate the applications and advantages of using this technique.

Botulinum toxin A for hyperkinetic facial lines: results of a double-blind, placebo-controlled study.

Previous work on patients with muscular dystonia has shown that small intramuscular doses of botulinum toxin A eliminated hyperkinetic facial lines for approximately 6 months. The purpose of this study was to determine the efficacy of botulinum toxin A injections in eliminating facial wrinkles in aesthetic surgery patients who do not have muscular dystonia. Eleven healthy subjects were studied in a double-blind fashion.

[Can administration of trasylol in reduced Hammersmith dosage with simultaneous transfusion of autologous blood meet the requirements of open heart surgery?].

Problem: The general positive effect of the proteinase inhibitor trasylol on blood loss and transfusion demand in cardiac surgery has been demonstrated in several placebo-controlled studies. Given the possibility of cardiac and renal side effects associated with a high dose of trasylol (Hammersmith dosage: 6 x 10(6) kallikrein inactivator units KIU), the question of a dose reduction was raised.

Methods: Being designed as a randomized double-blind comparative group study, the investigation included 120 patients with elective primary cardiac surgery from November 1990 to April 1992.

Results and implications of high-resolution surface dosimetry of ruthenium-106 eye applicators.

The dosimetry of 106Ru/106Rh beta-emitting eye applicators is still inadequate. Manufacturer's specifications of absolute dose rates are loaded with a +/- 30% error, and the relative distribution of activity on the surface is measured on a few points only, using a 3-mm plastic scintillation probe. While reducing the absolute error of dose rate measurements to +/- 15% by a method published earlier, we now present a phantom using small thermoluminescent dosimetry crystals for refined assessment of its distribution over the surface.

[Interstitial radiotherapy of breast cancer. Preliminary report of a prospective study of 165 cases subjected to breast-conserving treatment].

Unlabelled: The results of a prospective study on breast conserving therapy in early stage breast cancer are presented. From January 1983 to June 1987 165 patients were treated by a standardized therapy-protocol. The criteria for entering the trial were stage T1 to T2 and N0 to N1.

[Brachytherapy using Ru-106 applicators in ophthalmology].

Two Ru-106 applicators of the type CCB as manufactured by the "Zentralinstitut für Isotopen- und Strahlenforschung" (Berlin, GDR) were investigated. The homogeneity of the relative dose distribution at the surface of the applicators was determined. For the evaluation of the data extremely small TLD crystals (2 x 1 x 1 mm) had to be manufactured as well as an almost tissue equivalent acrylic eye phantom.

Submalar augmentation: a procedure to enhance rhytidectomy.

The use of submalar augmentation in facial rejuvenation surgery satisfies the need for enhancement of the midface to obtain longer lasting and better results from rhytidectomy. Submalar augmentation is a new surgical technique that positions anatomically designed silicone implants over the midthird of the face. It provides the appearance of restoring midfacial soft tissue and reduces the depth of anterior facial folds.

Submalar augmentation. An alternative to face-lift surgery.

Submalar augmentation is a new approach that effectively deals with many of the problems encountered in midfacial rejuvenation. This study reports the results of 78 patients who were successfully treated over 6 years by submalar augmentation. This procedure consists of inserting newly designed Silastic (silicone rubber) implants over the midface to create the appearance of restoring the vibrant and youthful fullness of the middle third of the face while avoiding distortion of normal facial anatomy.

Assessment of echographic regression criteria in ruthenium-irradiated melanoma.

Steady flattening of the tumor, increasing reflectivity and decreasing vascularity are echographic signs of successful irradiation treatment. The specific example of an irradiated choroidal melanoma shows that the absence of echographic changes by no means excludes tumor destruction. Because of a dense vitreous body hemorrhage, the melanoma could only be evaluated echographically.

Current concepts and diagnostic evaluation of autoimmune disease.

This article discusses autoimmune reactions and the numerous mechanisms by which an autoimmune response may be initiated, including genetic factors, T-cell bypass mechanisms, and idiotypes. Human autoimmune diseases are classified into three main groups, ie, organ-specific, non-organ specific, and disorders with non-organ-specific autoantibodies with lesions restricted to one or a few organs, that are examined in detail. General laboratory tests and interpretation of results in relation to state or treatment of the particular disease, age and sex of the patient, and the sensitivity of the test system used are reviewed.

Radiotherapy of metastatic renal cell carcinoma.

Modern oncological treatment of metastatic renal cell carcinoma may have different goals: first of all, improvement of survival rates; secondly, elimination of symptoms like pain from osseous lesions or disorders of central nervous system functions. Chemotherapy or radiotherapy or the combination of both should improve life quality and be tolerable to the patient. Close interdisciplinary contacts of medical and radiological oncologists are therefore necessary.