Social cognition and Theory of Mind in patients with relapsing-remitting multiple sclerosis.

BACKGROUND: Theory of Mind (ToM) is an ability to understand and interpret another person's beliefs, emotions, and intentions. ToM requires both cognitive and emotional perspective taking and is deficient in several neuropsychiatric disorders all connected with impaired social functioning. Cognitive and mood dysfunctions have been recognized as common symptoms in multiple sclerosis (MS). METHODS: We investigated social cognition in 40 ambulatory patients with MS compared to 35 healthy controls by using verbal and non-verbal ToM tests (Faux Pas, Baron-Cohen's Adult Eyes and Faces test) and Baron-Cohen's Empathy questionnaire. The effect of disability and disease duration on social cognition was also analyzed by multiple logistic regression analysis after adjusting for confounding factors of age, gender, intelligence, depression, and anxiety. RESULTS: Even when adjusted, patients with MS made significantly more mistakes in non-verbal test (adult Eyes Test), and more disabled patients performed worse in both verbal and non-verbal ToM tests (Eyes Test and Faux Pas) compared to controls. Patients with a shorter disease course described themselves as more empathetic. DISCUSSION: In the absence of marked cognitive decline and disability, patients with ambulatory MS had a deficit interpreting social situations and performing in interpersonal contexts.

Immunohistochemical localization of amelogenins in enameloid of lower vertebrate teeth.

The indirect method of immunofluorescence was used to demonstrate the presence of amelogenins in the enameloid of teeth and dermal denticles of Chondrichthyes; in the enameloid of Teleostei and Amphibia; and in the enamel of Reptilia. Nonmammalian amelogenins are formed in the ectodermal cells of tooth organs and chemically are so similar to mammalian amelogenins that they interact with antiserum prepared from bovine enamel matrix.

Regional gray matter reduction and theory of mind deficit in the early phase of schizophrenia: a voxel-based morphometric study.

OBJECTIVE: We tested the association between theory of mind (ToM) performance and structural changes in the brains of patients in the early course of schizophrenia. METHOD: Voxel-based morphometry (VBM) data of 18 patients with schizophrenia were compared with those of 21 controls. ToM skills were assessed by computerized faux pas (FP) tasks. RESULTS: Patients with schizophrenia performed significantly worse in FP tasks than healthy subjects. VBM revealed significantly reduced gray matter density in certain frontal, temporal and subcortical regions in patients with schizophrenia. Poor FP performance of schizophrenics correlated with gray matter reduction in the left orbitofrontal cortex and right temporal pole. CONCLUSION: Our data indicate an association between poor ToM performance and regional gray matter reduction in the left orbitofrontal cortex and right temporal pole shortly after the onset of schizophrenia.

[The results of a multicenter trial of acute lymphoblastic leukemia treatment on ALL-MB 91/ALL-BFM 90m in children: analysis of efficacy and toxicity].

AIM: A comparative analysis of efficacy and toxicity of two chemotherapy regimens: standard German protocol ALL-BFM 90m and less intensive original test protocol ALL-MB 91 in a multicenter trial of acute lymphoblastic leukemia (ALL) in children. MATERIAL AND METHODS: In 1995-2002 a total of 834 patients with newly diagnosed ALL aged 0-18 years were admitted to 10 clinics of Russia. Of them, 713 were randomized in two groups: treatment program ALL-BFM 90m (n = 355) and ALL-MB 91 program (n = 358). RESULTS: In 7-year follow-up median, 10-year event-free survival (EFS) and overall survival (OS) did not differ significantly between the groups and was 67 +/- 3 and 68 +/- 3% (ALL-MB 91) and 74 +/- 2, 71 +/- 3% (ALL-BFM 90m), respectively. Though the rate of isolated recurrences in CNS in patients on the protocol ALL-MB 91 was 2.8%, they developed only in 0.8% patients of the standard risk group. Anemia, thrombocytopenia and agranulocytosis developed less frequently, hospital stay was significantly shorter on the test protocol vs the control one (p < 0.01). CONCLUSION: EFS and OS on the test (ALL-MB 91) and control (ALL-BFM 90m) protocols were equivalent in lower toxicity and cost of therapy.

Immunofluorescent evidence for the similarity of amelogenins in calf, mouse and pig teeth.

Antiserum was prepared to fetal bovine enamel matrix and was used to localize the amelogenins in developing bovine molars by immunofluorescent microscopy. Amelogenins could be identified to preameloblasts, secretory ameloblasts, stratum intermedium cells, and the newly deposited enamel matrix. Mature enamel matrix did not fluoresce except in a thin line along the DEJ and adjacent to the ameloblasts. Immature enamel matrix of murine and porcine teeth fluoresced when treated with antiserum to bovine enamel matrix. No other portions of tooth buds or other tissues reacted with the specific antiserum.

Sustained flexibility in infant feeding tubes containing nonmigrating plasticizer.

Due to medical complications related to stiffness developed in polyvinyl chloride (PVC) feeding tubes presently manufactured with di-octylphthalate (DOP), we have assessed the flexibility of PVC tubes manufactured with a nonmigrating plasticizer, ti-octyltrimellitate (TOTM) (National Catheter Co., Argyle, NY). Two sizes of DOP and TOTM PVC feedings tubes were evaluated, #5 French and #8 French. Number 5 French DOP tubes became significantly stiffer as early as 1 to 2 days after intubation and continued to stiffen up to 8 days of use. Among the #5 French DOP tubes, those placed in the jejunum were found to become significantly stiffer than those placed in the stomach. No correlations were found between the development of stiffness and gestational age, postnatal age, sex, birthweight, or kinds of feedings. In contrast, #5 French TOTM and #8 French tubes (DOP and TOTM) did not develop any significant stiffness up to 5 to 8 days of use. This study demonstrates the sustained flexibility of TOTM tubes, and important factor to increase the safety of enteral feedings in newborn infants.

Quantification of cerebrospinal fluid proteins in children by high-resolution agarose gel electrophoresis.

Physiologic alterations in cerebrospinal fluid proteins occur inter alia with aging. Agarose gel electrophoresis discriminates many cerebrospinal fluid proteins and in addition quantifies concentration alterations. This study aimed to investigate the time course of these alterations in children and to establish normative values for cerebrospinal fluid protein properties. In 202 children without diseases known to alter cerebrospinal fluid, normative protein properties were quantified using nephelometry, ultrafiltration, high-resolution electrophoresis, and Gaussian curve fit densitometry. Total protein and protein concentrations (albumin and gamma-globulins) decreased from birth until 7 months age, and, from then on, increased slightly (transthyretin, albumin, and alpha2-proteins) or strongly (gamma-globulins). Protein proportions (transthyretin and transferrin) increased until about 3 years of age and decreased from then on. These normative values for children as quantified by high-resolution agarose gel electrophoresis are presented in a significance-structured percentile table. The time courses of these cerebrospinal fluid properties reflect physiologic alterations of the blood-brain barrier function during childhood.

Gingival plasma cell granuloma.

Plasma cell granulomas (pseudotumors) are rare benign, tumor-like proliferations composed chiefly of plasma cells that manifest primarily in the lungs, but may occur in various anatomic locations. We report this case of a 54-year-old male who presented with an unusual maxillary anterior gingival overgrowth treated by excisional biopsy. Histological examination revealed a dense inflammatory cell infiltrate containing mainly plasma cells. Immunohistochemistry for kappa and lambda light chains showed a polyclonal staining pattern confirming a diagnosis of plasma cell granuloma. Intraoral plasma cell granuloma is exceedingly rare, although case reports documenting such lesions have been reported. This case highlights the need to biopsy unusual lesions to rule out potential neoplasms.

Immunocytochemical localization of enamelin proteins in developing bovine teeth.

Enamelins were localized at both the light and electron microscopic level using an antienamelin monoclonal antibody and indirect immunogold methods. Bovine fetal incisors (crown-rump length 17-30 cm) were preserved in Karnovsky's fixative and embedded in Epon. For light microscopy, 2 microM thick sections were immunostained by the indirect method using the monoclonal antibody and goat anti-mouse IgG linked to 5 nM gold particles, followed by silver enhancement to increase the sensitivity of the method. For electron microscopy, thin sections were immunostained (indirect) with the antienamelin monoclonal antibody and goat anti-mouse IgG linked to 5 or 15 nM gold. Control samples were treated with an unrelated monoclonal antibody. The localization of enamelins was confined in the light microscopic sections to the extracellular enamel matrix. No gold staining was observed in the ameloblasts or other enamel organ cells even though the gold-silver technique is extremely sensitive. Ultrastructurally, enamelin was localized in the enamel extracellular matrix and associated ameloblasts. Both the crystal-containing and granular matrix were positively stained, with most gold particles being closely associated with the crystals. Counting of gold particles indicated more than 4 times as many amelogeninas enamelin-reactive antigenic sites in similar regions. Decalcification did not increase immunostaining with the anti-enamelin antibody in the extracellular matrix. Within ameloblasts, the gold particles were associated with secretory granules and Golgi complexes. Thus it appears that enamelins are synthesized in ameloblasts and secreted into the extracellular matrix in a similar manner to amelogenins and are preferentially associated with matrix hydroxyapatite crystals. Transient levels of enamelins within the ameloblasts are apparently too low to be detected by light microscopy.

An immunohistochemical study of the effects of fluoride on enamel development in the rat incisor.

A monoclonal antiamelogenin antibody was used to investigate the effects of fluoride on enamel development in the rat incisor. The results suggested that during secretion the enamel matrix molecules are arranged in such a way as to mask the epitope recognized by the monoclonal antibody. However, during the transition stage of development as the matrix begins to be degraded the epitope becomes exposed and labelling intensity increases to reach a maximum at the end of transition/start of maturation. The effect of fluoride is to delay the appearance of labelling within the enamel matrix until the end of transition. This suggests that the fluoride may inhibit enzymatic degradation or disaggregation of the matrix, the resulting residual matrix then inhibiting crystal growth.

Monoclonal antibody and immunogold cytochemical localization of amelogenins in bovine secretory amelogenesis.

Amelogenin enamel-protein epitopes in developing incisors were ultrastructurally localized with high specificity resolution. They formed clumps scattered over the enamel organic matrix between the hydroxyapatite crystals, and were also present over islands of stippled or granular material at the forming surface of the enamel matrix demonstrating that this material consists in part of amelogenin enamel protein. The amounts of amelogenin, as judged by labelling density, were not greater in the stippled or the surface crystal-containing matrix as compared to the enamel matrix up to 50 micron deep. Amelogenins were also localized in the rough endoplasmic reticulum. Golgi apparatus and secretory granules of the ameloblasts, which suggests they are merocrine secretions.

Cortisol inhibition of development of various lysosomal enzymes in cultured palatal shelves from mouse embryos.

The lysosomal enzymes, non-specific esterases, beta-glucuronidase, N-acetyl-beta-glucosaminidase and aryl sulphatases A and B, were examined histochemically in medial-edge epithelia (MEE) of single palatal shelves in vitro. Activities of most enzymes increased gradually in MEE with a peak at 24-26 h of culture. Aryl sulphatase B activities were lower than the others and aryl sulphatase A activities could not be detected in the palatal cells during the entire culture period. By 48 h, MEE cells degenerated and were lost. Cortisol suppressed increased activities of these hydrolytic enzymes and prevented programmed breakdown of the palatal epithelium.

Monoclonal antibodies to different epitopes in amelogenins from fetal bovine teeth recognize high-molecular-weight components.

Enamel proteins were extracted and partitioned into amelogenin and enamelin fractions. Although several attempts were made to raise monoclonal antibodies to each protein fraction, monoclonal antibodies were only obtained against the amelogenin fraction. Six monoclonal antibodies were generated, and these could be classified into three groups recognizing different epitopes by a competitive enzyme-linked immuno-absorbent assay. A model for the arrangement of the epitopes is proposed. In Western-blotting experiments, all six monoclonal antibodies recognized amelogenin components of approx. 45,000 and 60,000 daltons as well as lower molecular-weight components of 10,000 to 30,000. It is proposed that the 45,000 and 60,000 dalton components are precursors of the lower molecular-weight components.

Production of a monoclonal antibody to bovine tooth enamel proteins.

Several monoclonal antibodies to bovine enamel proteins were produced using the mouse myeloma system. Each antibody recognized the same two protein bands on gel electrophoresis. The clones were tested in situ and clone 185 localized specifically in the enamel layer. Clones 185 and 121 were shown to recognize different antigenic determinants.

A meta-model of chemotherapy planning in the multi-hospital/multi-trial-center-environment of pediatric oncology.

OBJECTIVE: Chemotherapy planning in pediatric oncology is complex and time-consuming. The correctness of the calculation according to state-of-the-art research is crucial for curing the child. Computer-assistance can be of great value. The objective of our research was to work out a meta-model of chemotherapy planning based on the Unified Modeling Language (UML). The meta-model is used for the development of an application system which serves as a knowledge-acquisition tool for chemotherapy protocols in pediatric oncology as well as for providing protocol-based care. METHODS: We applied evolutionary prototyping, software reengineering techniques and grounded theory, a qualitative method in social research. We repeated the following steps several times over the years: Based on a requirements analysis (i) a meta-model was developed or adapted, respectively (ii). The meta-model served as a basis for implementing evolutionary prototypes (iii). Further requirements were identified (i) from clinical use of the systems. RESULTS: We developed a comprehensive UML-based meta-model for chemotherapy planning in pediatric oncology (chemoMM). We implemented it and introduced evolutionary prototypes (CATIPO and DOSPO) in several medical centers. Systematic validation of the prototypes enabled us to derive a final meta-model which covers the requirements that have turned out to be necessary in clinical routine. CONCLUSIONS: We have developed an application system that fits well into clinical routine of pediatric oncology in Germany. Validation results have shown that the implementation of the meta-model chemoMM can adequately support the knowledge acquisition process for protocol-based care.

["Folie a deux hallucinatoire"--a new case of induced hallucinatory psychosis. A new entity?]. / "Folie a deux hallucinatoire"--indukált hallucinózis újabb esete. Uj entitás?

The authors in their case report show a case of induced hallucinatory psychosis induced in a wife of a patient with alcoholic hallucinosis. They deal with the nosological position of "folie a deux hallucinatoire" (induced hallucinatory psychosis) and integrate the consequences of the case to the general psychopathological theory of hallucinations.