Is the hygiene hypothesis relevant for the risk of multiple sclerosis?

The hygiene hypothesis, suggesting that low exposure to pathogens early in life can increase the risk for immune-mediated diseases, has been proposed as an explanation for the increase in incidence of allergy and autoimmune diseases in industrialized countries during the last decades. Several aspects of the hygiene hypothesis have been related to MS. Already in 1966, the risk of MS was suggested to be higher in individuals with high hygienic standard during childhood. Further, an episode of infectious mononucleosis is an independent risk factor for MS and can be regarded as an indicator of low exposure to pathogens early in life, as infection with Epstein-Barr virus often is asymptomatic when it occurs in young children. Conflicting results have been reported regarding number of siblings, attendance in a day care center and exposure to animals during childhood in relation to MS risk, but common childhood infections and vaccinations do not seem to influence the risk of MS. In line with the hygiene hypothesis, two large meta-analyses have recently shown that infection with Helicobacter pylori is negatively correlated with MS. Moreover, a protective influence of helminth infection on MS has been observed in several, small clinical studies, but more knowledge is needed before a potential role of helminth-derived therapy in MS is determined. Also, it has been hypothesized that infection with the parasite Toxoplasma gondii could be protective against MS.

The relationship between motor competence, physical fitness and self-perception in children.

AIM: The aim of the current research was to explore the relationship between motor competence, physical fitness and self-perception, and to study to which extent this relationship may vary by gender. METHODS: A sample of 67 children (mean age 11.46 years, SD 0.27) completed Harter's Self-Perception Profile for Children (SPPC), the Movement Assessment Battery for Children (MABC) and the Test of Physical Fitness (TPF) to assess self-perception, motor competence and physical fitness. RESULTS: The SPPC was stronger related to total score on TPF than to total score on MABC. However, when looking at boys and girls separately, this result was found for the boys only. In the group in general, total scores on both TPF and MABC correlated significantly with three of the domains of SPPC (social acceptance, athletic competence and physical appearance) and general self-worth. This relationship varied by gender. Interestingly, TPF was highest correlated with perception of athletic competence in boys but with perception of social acceptance in girls. A high and significant correlation was found between physical fitness and motor competence for both genders. CONCLUSION: The results indicated a strong relationship between physical fitness, motor competence and self-perception in children that varied by gender. This implies that all these factors are essential contributions in order to facilitate participation in physical activity in children.

Research on children with developmental coordination disorder--some challenges! Commentary on C. L. Tsai and S. K. Wu (2008).

This commentary focuses on the need for proper inclusion criteria for research on children who have motor problems. Researchers must be aware of the large range of individual differences found in samples used in research on children with Developmental Coordination Disorder. New theoretical perspectives in development and learning are a basis for research and practice.

Epidemiological profile and surveillance activity of tuberculosis in South Batinah, Oman, 2017 and 2018.

Background: Understanding the current surveillance activity and the challenges is important to ensure a continuous success toward the elimination goal for tuberculosis (TB). South Batinah Governorate (SBG) ranked the fourth on the top reporting governorates in the period 2010-2016 in Oman. The objective of this study is to describe the epidemiological profile and activities of the surveillance program of TB in the SBG in the years 2017 and 2018. Methods: A retrospective quantitative analysis and a qualitative review were performed to the surveillance data present in the department of disease surveillance and control in the SBG in the years 2017 and 2018. Results: A total of 39 pulmonary TB (PTB) and 21 extrapulmonary TB (EPTB) cases were diagnosed in 2017 and 2018. More Omanis (22, 56.4%) were diagnosed with PTB compared to non-Omanis; however, the EPTB was solely diagnosed among Omanis (P < 0.001). Majority of the TB patients (35%) were between 30 and 49 years. More than 50% of the TB cases of both the types were diagnosed in <3 months, and the median of diagnosis delay was 33.5 (standard deviation = 95.5). Bacillus Calmette-Guérin vaccine scar was present in only 20.5% of the PTB patients, compared to 57.1% of EPTB (P = 0.004). Patients with PTB presented mainly with cough (31, 79.5%), loss of weight and appetite (25, 64.1%), and fever (22, 56.4%). Enlarged lymph nodes and loss of weight and appetite were the common symptoms among EPTB patients, 38.1 for each (P < 0.001). Staffing, incomplete notifications, difficulty in tracing the results, and absence of regular feedbacks are the major existing challenges. Conclusion: SBG continues to sustain low incidence rate of tuberculosis; however, additional strategies are urgently required for further reduction. Hence, the priority is to enhance all essential components of the surveillance system at this stage.

A new spectrophotometric method for the determination of methyldopa.

A new, simple and low cost spectrophotometric method for the determination of methyldopa in pharmaceutical preparations was developed. The method was based on the coupling of methyldopa with 2,6-dichloroquinone-4-chlorimide (DCQ). The absorbance maximum (λ max) of the resulted colored product was at 400 nm. Different buffers were used to determine the optimal pH for the reaction. About 1% w/v acetate buffer with pH 8.0 gave the optimal pH required for the reaction. Of the different solvents tried, water and ethanol were found to be the most suitable solvents. Beer's law was obeyed in concentration range of 4-20 µg/ml methyldopa. The correlation coefficient was found to be (r = 0.9975). The limit of detection and limit of quantification were 1.1 µg/ml and 3.21 µg/ml, respectively. The reaction ratio between methyldopa and DCQ was studied and found to be 1:3. The work included the study of the possible interference of hydrochlorothiazide found in combination with methyldopa tablets. The method was validated and results obtained for the assay of two different brands of methyldopa tablets were compared with the BP method (colorimetric). The repeatability and reproducibility of the developed method were evaluated and the obtained results quoted. The derivative formed as a result of the reaction of methyldopa with DCQ was isolated and its possible mechanistic pathway was suggested.

The relationship between physical fitness and motor competence in children.

BACKGROUND: This study examined the relationship between physical fitness and motor competence in children aged 9-10 years. METHODS: A sample of 67 children (mean age 9.7, SD 0.3 year) participated in the study. To assess motor competence, each child completed the Movement Assessment Battery for Children. Physical fitness was measured by the Test of Physical Fitness, comprising nine different tasks including running, jumping, throwing and climbing. RESULTS: The results show a strong and significant correlation between motor competence and physical fitness within the sample. CONCLUSIONS: These results are relevant to the work of maintaining and developing both sufficient physical fitness and motor competence in children as these factors are important contributors to their health and well-being.

Interrelationship among selected measures of motor skills.

BACKGROUND: This study set out to explore the interrelationship among selected measures of motor skills. METHODS: Ninety-one 4-year-old children from 10 nursery schools were tested using eight motor tasks from the Movement Assessment Battery for Children test. RESULTS: The most striking finding was that there were very low correlations between the motor tasks. CONCLUSIONS: In relation to these findings, it is possible to argue that learning of particular motor skills is specific to that task. This is discussed in relation to the principle of task specificity of learning.

[Vacuum-assisted wound closure in the management of deep sternal wound infection].

We herein present a case who underwent vacuum-assisted wound closure (VAC) therapy for post-sternotomy mediastinitis. A 71-year-old female with chronic renal failure on dialysis underwent a graft replacement of the ascending aortic aorta for the treatment of an acute aortic dissection. After she was discharged from the hospital, a purulent discharge was noted to occur from the median sternal wound. The wound was therefore reopened and all sternal wires were removed. Thereafter, polyurethane foam which was shaped to fit the defect was placed within the cavity. The area was covered with adhesive drape and suction drainage was carried out at -100 mmHg. The polyurethane foam was replaced every few days. The wound was finally closed using a muscle flap at 49 days after surgery. VAC therapy is therefore considered to be a useful treatment modality for deep sternal wound infections.

Carcinogenic activity of Symphytum officinale.

The carcinogenicity of Symphytum officinale L., Russian comfrey, used as a green vegetable or tonic, was studied in inbred ACI rats. Three groups of 19--28 rats each were fed comfrey leaves for 480--600 days; four additional groups of 15--24 rats were fed comfrey roots for varying lengths of time. A control group was given a normal diet. Hepatocellular adenomas were induced in all experimental groups that received the diets containing comfrey roots and leaves. Hemangioendothelial sarcoma of the liver was infrequently induced.

Carcinogenic activity of petasitenine, a new pyrrolizidine alkaloid isolated from Petasites japonicus Maxim.

The carcinogenic activity of petasitenine, a new pyrrolizidine alkaloid isolated from young flower stalk of Petasites japonicus, was studied in ACI rats. All rats that had received a 0.05% solution of petasitenine in drinking water died or were killed in moribund condition 72 days after the start of experiment. They showed necrosis, hemorrhage, and remarkable proliferation of the bile ducts in the liver. In another group that had received a 0.01% solution, 8 of 10 animals surviving beyond 160 days developed tumors in the liver, i.e., hemangioendothelial sarcomas in 5 rats and liver cell adenomas in 5 rats, 2 of which simultaneously developed hemangioendothelial sarcomas. No tumors were observed in the livers of the control animals.

Induction of hepatic tumors in rats by senkirkine and symphytine.

The carcinogenicity of the pyrrolizidine alkaloids senkirkine and symphytine was studied in male inbred ACI rats. Animals were divided into 3 groups: Group I received ip injections of freshly prepared senkirkine at a dose of 10% of the median lethal dose (LD50) twice weekly for 4 weeks and then once a week for 52 weeks. Group II received ip injections of symphytine at a dose of 10% of the LD50 by the same injection schedule as in group I. The control group was given ip injections of a 0.9% NaCl solution following the same injection schedule as in experimental groups. All group I rats survived for more than 290 days after the start of injections, and 9 of 20 rats developed liver cell adenoma. All group II animals survived for more than 330 days after the start of injections. Of 20 rats, 4 had liver tumors, 3 had hemangioendothelial sarcomas, and 1 had liver cell adenoma. The hemangioendothelial sarcomas showed metastasis in the lungs of 2 rats. The control group had no liver tumors.

Aminolysis of acyl-chymotrypsins by amino acids. Kinetic appearance of concentration effect in peptide yield enhancement by freezing.

The effects of reagent concentrations, various added substances, pH and temperature on the yield of peptide synthesis by chymotrypsin in frozen and liquid solutions at subzero temperatures have been studied. Increased nucleophile concentration in the liquid microinclusions of ice has been shown to be sufficient for explaining the peptide yield improvement found at freezing conditions.

Peptide synthesis by chymotrypsin in frozen solutions. Free amino acids as nucleophiles.

Nucleophilic efficiency of the free amino acids in chymotrypsin-catalyzed acyl transfer in ice at -18 degrees C using ethyl esters of N-maleyl-L-tyrosine and L-tyrosine as the acyl group donors has been studied. Although the amino acids did not act as acyl acceptors in liquid water, the high yields of peptides were obtained in frozen solutions at pH 10.5 (before freezing). The efficiency of amino acids in the formation of the corresponding dipeptides depended on the substrate used, and decreased in the order Ser,Thr,Gln > Lys > Cit > Ala > Ala > Gly > Asn > Arg > Glu > Val > Orn > Asp with no peptide formed with His, Leu, Ile and Pro) for N-maleyl-L-tyrosine ethyl ester and Ser > Lys > Orn > Arg,Cit > Gln > Thr > Asn > Ala > Gly (with no peptide formed with Glu, Val, Asp, His, Leu, Ile and Pro) for L-tyrosine ethyl ester.

Long-term survival of cardiac allografts in rats treated before and after surgery with monoclonal antibody to CD2.

The rejection of a transplanted allograft is dependent on T cell activation, which requires T cell receptor engagement by antigen and costimulatory signals delivered by T cell surface molecules such as CD2. Anti-CD2 mAbs have been shown to suppress cell-mediated immunity. The effects of anti-CD2 mAbs OX34 and OX54 on rejection of BN (RT1n) rat hearts transplanted heterotopically to LEW (RT1l) rats were investigated. Administration of OX34 (7 mg/kg/day i.p.), either for 3 consecutive days immediately before or 8 consecutive days immediately after transplantation induced indefinite allograft survival (median survival time: 7, > 150, and > 150 days for control, preoperative treatment, and postoperative treatment, respectively). In contrast, pre- or postoperative treatment with OX54 (40 mg/kg/day) prolonged median survival time to only 28 and 11 days, respectively. Administration of OX34 or OX54 to naive rats induced a transient depletion of T cells in the peripheral immune organs. In vitro studies revealed that whereas OX54 had no effect on the allogeneic mixed lymphocyte reaction, OX34 partially inhibited both the allogeneic mixed lymphocyte reaction, in an IL-2-reversible manner, and T cell proliferation in response to immobilized mAb to either the T cell receptor or CD3. OX34-treated rats in which the cardiac allograft had survived > 100 days accepted a second heart from the donor strain. Treatment with OX34 induced an alloantigen-unresponsive state in T cells. These results suggest that treatment with an appropriate anti-CD2 mAb, especially postoperatively, may prove an effective approach for preventing cardiac allograft rejection.

Synergistic effect of anti-T cell receptor monoclonal antibody and 15-deoxyspergualin on cardiac xenograft survival in a mouse-to-rat model.

BACKGROUND: Successful xenograft transplantation faces several obstacles including the presence of xenoantibodies, natural killer cell- and macrophage-mediated rejection, and T lymphocyte activation. METHODS: A mouse-to-rat cardiac xenograft model was used to examine the synergistic effect of anti-T cell receptor (TCR) monoclonal antibodies (mAb) and 15-deoxyspergualin (DSG) on graft survival. RESULTS: Pretransplantation injections (days -5, -3, and -1) of anti-TCR mAb (500 microg/kg/day) combined with continuous i.p. infusion of DSG (5 mg/kg/day) from day -7 to 28 significantly prolonged graft survival compared to untreated controls (3.3+/-0.5 vs. 44.2+/-5.6 days, P<0.001). Postoperative splenectomy combined with discontinuation of all other treatment on day 28 enhanced graft survival in rats treated with anti-TCR mAb and DSG to 71.0+/-2.5 days. Histological examination of grafts showed characteristic signs of vascular rejection: interstitial edema and hemorrhage, and polymorphonuclear cell infiltration. Antimouse antibody titers in recipients were increased upon rejection in each group that received a xenograft. Flow cytometry analysis showed a markedly decreased T cell population and a relatively increased mature B cell population (IgM(bright)/IgD(dull)) in spleens of rats treated with anti-TCR mAb and DSG on day 28. CONCLUSIONS: The mechanism of prolonged xenograft survival in this model may include inhibition of antibody production by arrest of B-cell maturation during development from IgM(dull)/IgD(bright) mature B cells to antibody producing cells, and inhibition of T cell activation. The rejection seen in our model may be caused by xenoreactive antibodies and may be associated with T cells, natural killer cells, and macrophages.

Carcinogenic activity of Farfugium japonicum and Senecio cannabifolius.

The carcinogenicity of Farfugium japonicum and Senecio cannabifolius was studied in ACI rats. In Group I, rats were given a diet containing 20% Farfugium japonicum. Groups II, III, IV and V were given diets containing 8%, 4%, 1% and 0.2% Senecio cannabifolius until the end of the experiment, respectively. The experiment was terminated after 480 days, except for Group V which was terminated 560 days after the start of feeding. Hemangioendothelial sarcoma of the liver and liver cell adenoma were induced in Groups I, IV and V. All rats in Groups II and III died of hepatotoxicity within a short period.

Pulmonary function after segmentectomy for small peripheral carcinoma of the lung.

OBJECTIVE: The aim of this study is to compare the pulmonary function after a segmentectomy with that after a lobectomy for small peripheral carcinoma of the lung. PATIENTS AND METHODS: Between 1993 and 1996, segmentectomy and lobectomy were performed on 48 and 133 good-risk patients, respectively. Lymph node metastases were detected after the operation in 6 and 24 patients of the segmentectomy and lobectomy groups, respectively. For bias reduction in comparison with a nonrandomized control group, we paired 40 segmentectomy patients with 40 lobectomy patients using nearest available matching method on the estimated propensity score. RESULTS: Twelve months after the operation, the segmentectomy and lobectomy groups had forced vital capacities of 2.67 +/- 0.73 L (mean +/- standard deviation) and 2.57 +/- 0.59 L, which were calculated to be 94.9% +/- 10.6% and 91.0% +/- 13.2% of the preoperative values (P =.14), respectively. The segmentectomy and lobectomy groups had postoperative 1-second forced expiratory volumes of 1.99 +/- 0.63 L and 1.95 +/- 0.49 L, which were calculated to be 93.3% +/- 10.3% and 87.3% +/- 14.0% of the preoperative values, respectively (P =.03). The multiple linear regression analysis showed that the alternative of segmentectomy or lobectomy was not a determinant for postoperative forced vital capacity but did affect postoperative 1-second forced expiratory volume. CONCLUSION: Pulmonary function after a segmentectomy for a good-risk patient is slightly better than that after a lobectomy. However, segmentectomy should be still the surgical procedure for only poor-risk patients because of the difficulty in excluding patients with metastatic lymph nodes from the candidates for the procedure.

The influence of lung cancer mass screening on surgical results.

BACKGROUND: After the introduction of the mass screening program for lung cancer, the number of patients detected by mass screening increased as well as the number of early staged patients. Therefore, we examined the influence of lung cancer mass screening on surgical results. METHODS: A total of 1177 primary lung cancer cases, who underwent surgery from 1963 to 1992, were retrospectively reviewed. They were grouped according to the changes in the mass screening system: the first period (1963-1977) before lung cancer screening started, the second period (1978-1986) when mass screening was conducted by the local government, and the third period (1987-1992) after the launching of the national screening program. RESULTS: The rate of cases detected by mass screening increased over time and the 5-year survival rate improved significantly, from 33.7% in the first period, to 51.8% in the second period and finally, to 58.4% in the third period. The improvement is attributable to a relative increase of rate of stage I cases and better stage I survival rate. Specifically, in stage I cases, improvement resulted from a relative increase of stage IA in peripheral type and roentgenographically occult lung cancer cases and from better survival rate of these two groups. CONCLUSION: As lung cancer screening has come into widespread use, detection of peripheral small-sized lung cancer and roentgenographically occult lung cancer have increased and consequently, surgical results have improved.

Successful implantation of a cardioverter defibrillator in an infant.

We report the successful implantation of a cardioverter defibrillator (ICD) in a 12-month-old infant. A single-lead ICD using an epicardial patch and a cathodal pulse-generator titanium shell electrode was very useful for implantation in this infant.

Effects of bilobalide on gamma-aminobutyric acid levels and glutamic acid decarboxylase in mouse brain.

We have previously demonstrated that bilobalide, a constituent of the Ginkgo biloba extract, possesses anticonvulsant activity, and suggested that the mechanism of its anticonvulsant action involves modulation of y-aminobutyric acid (GABA)-related neuronal transmission. This study examined the effects of bilobalide on the level of GABA and glutamate, the activity and the amount of glutamic acid decarboxylase (EC 4.1.1.15), and the function of GABA(A) receptors in the hippocampus, cerebral cortex and striatum of the mouse. GABA levels, glutamic acid decarboxylase activity, and the protein amount of 67 kDa glutamic acid decarboxylase in the hippocampus of mice treated with bilobalide (30 mg/kg, p.o., once a day for 4 days) were significantly higher than those in controls. However, there were no significant differences in glutamate levels or, the number and the dissociation constants of GABA(A) receptors in the hippocampus between control and bilobalide-treated mice. These results suggest that the anticonvulsant effect of bilobalide is due to elevation of GABA levels, possibly through potentiation of glutamic acid decarboxylase activity and enhancement of the protein amount of 67 kDa glutamic acid decarboxylase by bilobalide.