Effect of cadmium pollution of atmospheric origin on field-grown maize in two consecutive years with diverse weather conditions.

The aim of the study was to analyse the effect of atmospheric cadmium (Cd) pollution of atmospheric origin in maize compared to a control without Cd pollution. The plant parameters investigated were the timing of phenological phases, leaf area index (LAI) and yield, while radiation and water regime parameters were represented by albedo (reflection grade) and evapotranspiration, respectively. In treatments with and without irrigation, Cd caused a significant reduction in LAI, accompanied by lower evapotranspiration. The mean annual albedo in the Cd-polluted treatment only rose to a moderate extent in 2011 (in 2010 there was hardly any change), but changes within the year were more pronounced in certain phases of development. Cd led to greater reflection of radiation by plants during the vegetative phase, so the radiation absorption of the canopy was reduced leading to a lower level of evapotranspiration. In the dry, hot year of 2011 maize plants in the non-irrigated treatments showed a substantial reduction in grain dry matter, but maize yield losses could be reduced by irrigation in areas exposed to Cd pollution.

Distinct phenotypes in mixed connective tissue disease: subgroups and survival.

The aim of the present study was to assess the autoantibody profile, dominant clinical symptoms and cluster characteristics of different mixed connective tissue disease (MCTD phenotypes. Two-hundred-and-one patients with MCTD were followed-up longitudinally. Five clinical parameters, Raynaud's phenomenon, pulmonary artery hypertension (PAH), myositis, interstitial lung disease (ILD), erosive arthritis and five auto-antibodies besides anti-U1RNP, antiendothelial cell antibodies (AECA), anti-CCP, anti-cardiolipin (anti-CL), anti-SSA/SSB and IgM rheumatoid factor (RF) were selected for cluster analysis. The mean age of patients was 52.9 ± 12.4 years and the mean follow-up of the disease was 12.5 ± 7.2 years. Patients were classified into three cluster groups. Cluster 1 with 77 patients, cluster 2 with 79 patients and cluster 3 with 45 patients. In cluster 1 the prevalence of PAH (55.8%; p < 0.001), Raynaud's phenomenon (92.2%; p < 0.001) and livedo reticularis (24.6%, p < 0.001) was significantly greater than in cluster 2 and 3. In cluster 2, the incidence of ILD (98.7%; p < 0.001), myositis (77.2%; p < 0.001), and esophageal dysmotility (89.8%; p < 0.001) was significantly greater than that in cluster 1 and 3. In cluster 3, anti-CCP antibodies were present in 31 of 45 patients (68.8%) with erosions. Anti-CCP antibodies were present in 37 of 42 patients (88.0%) with erosions. PAH, angina, venous thrombosis was observed in cluster 1 and pulmonary fibrosis in cluster 2, musculosceletal damage, gastrointestinal symptoms and osteoporotic fractures were most frequent in cluster 3. Cumulative survival assessment indicated cluster 1 patients having the worst prognosis. Cluster analysis is valuable to differentiate among various subsets of MCTD and useful prognostic factor regarding the disease course.

Hungarian hospital antibiotic consumption at the regional level, 1996-2005.

BACKGROUND: Regional variations in antibiotic consumption in outpatients have been reported previously, but nothing is as yet known about the regional distribution of antibiotic consumption in the hospital sector in Hungary. This study was designed to explore regional variations and investigate determinants of antibiotic consumption in hospital care in Hungary. MATERIALS AND METHODS: Regional distribution-based antibiotic sales data were obtained for a 10-year period (1996-2005) for the 20 Hungarian counties. Systemic antibacterial use (Anatomical Therapeutic Chemical code: J01) was expressed as the number of defined daily doses (DDD) per 100 patient-days. The multiple linear regression model was applied to investigate the determinants of regional differences in hospital antibiotic consumption. Independent variables related to health care access, utilization of hospital resources, doctors' workload, type of hospital care provided, and patient's characteristics and infections were considered as possible determinants, and data on these variables were obtained for 2 years (2004, 2005). We also tested the association between hospital and ambulatory care antibiotic consumption in Hungarian regions using the Pearson correlation test. RESULTS: For each year during the 1996-2005 study period, there were large and stable variations in total hospital antibiotic consumption (e.g., min-max(1996): 16.0-28.2; min-max(2005): 15.2-32.2 DDD per 100 patient-days) depending on the region. In the two developed models (Model 1 and Model 2), the number of reported infections accounted for 53% of the observed regional variations in hospital antibiotic consumption (Model 1), and the number of reported infections together with the case-mix index were responsible for 61% (Model 2) . Total antibiotic consumption in hospitals showed a positive correlation (R = 0.71, p = 0.002) with total antibiotic consumption in ambulatory care. CONCLUSION: The case-mix index and the number of reported infections explained some of the observed regional variations. However, the moderate value of the models in explaining these regional variations suggest that determinants which could not be explored in this preliminary study may also contribute to regional differences. Future studies should aim at collecting data for each individual hospital as well as data on possible determinants for hospital antibiotic consumption.

Budesonide, but not tacrolimus, affects the immune functions of normal human keratinocytes.

Topical immunosuppressant therapy is widely used in the treatment of inflammatory skin diseases such as psoriasis and atopic dermatitis. Besides its beneficial therapeutic effects, application of topical anti-inflammatory drugs may render the epidermis more vulnerable to invading pathogens by suppressing innate immune responses in keratinocytes, such as cytokine production and Toll-like receptor (TLR) expression. In order to evaluate and compare the immunosuppressive effects of different immunosuppressant drugs on keratinocytes, we treated lipopolysaccharide (LPS)-stimulated and -unstimulated normal human keratinocytes with the synthetic corticosteroid budesonide and the macrolide tacrolimus. The expressions of the pattern recognition receptors (PRRs) TLR2 and TLR4 were measured by quantitative RT-PCR, pro-inflammatory cytokines IL-1alpha, IL-8 and TNF-alpha were monitored by quantitative RT-PCR and by ELISA, and alterations in TLR2 protein level were measured by flow cytometry. Budesonide had a suppressive effect on both constitutive and LPS-induced IL-8 gene expression. The amount of TNF-alpha mRNA was diminished in unstimulated keratinocytes, while TLR2 mRNA expression was markedly enhanced both in unstimulated and LPS-treated cells after incubation with budesonide. This increase in TLR2 mRNA expression was also detectable at the protein level in LPS-stimulated cells. Tacrolimus had no effect on any of the examined genes. Budesonide, but not tacrolimus, significantly inhibited the NF-kappaB-dependent luciferase reporter activity in HaCaT cells after induction with LPS or TNF-alpha. Although tacrolimus and budesonide are both effective treatments in some inflammatory skin diseases, the data provided here imply differences in local therapeutic and adverse effects of these two topical immunosuppressants.

Quality of life of patients with epilepsy (Hungarian survey).

We assessed the quality of life (QOL) of patients with epilepsy using the Quality of Life in Epilepsy Inventory (QOLIE-31). As the first step we compared our results with the data from an American survey in order to validate the test in Hungary. The results show that the Hungarian values were lower but that they followed the same trends as the American data. There was only one controversial result in the question-group of the 'the effects of treatment', which could be explained by the differences in habits and conventions, opportunities and expectations between Hungarian and American epileptic patients. We found significant differences in many aspects of quality of life with respect to (a) gender (general quality of life, seizure worry), (b) pharmacological treatment form (cognitive functions, medication effects, total score and social and role functioning) and (c) economic activity of patients (cognitive functions, emotional well-being, energy/fatigue, medication effects, overall quality of life, overall scores, seizure worry, social and role functioning). We have tried to explain the differences found by taking either the characteristics of epilepsy or the social background of the epileptic patient into consideration. Based on previous knowledge we have tried to define the situations where the assessment of quality of life for people with epilepsy, may be beneficial to their core.

[Contact dermatitis after topical use of ketoprofen gel]. / Ketoprofen tartalmú gél használatát követóen kialakult kontakt ekzema.

Authors present 5 cases of generalized contact and photocontact dermatitis due to topically applied ketoprofen, a non-steroidal anti-inflammatory drug. They investigated the sensitisation and photosensitisation to the drug and also the possible cross-reactivity.

The effect of chronic otitis media on the immunoreactivity of human inner ear.

Twenty temporal bones (TBs) were removed from autopsy cases and prepared for immunohistochemical examination. Ten TBs were free of ear disease whereas the other ten TBs showed the signs of chronic otitis media. Expression of markers for monocyte-macrophages (25F9, 27E10) and natural killer cells (anti-Leu-11) was examined immunohistochemically. There were no specific positive stainings with 25F9 or anti-Leu-11 antibodies in any of the specimens. Staining for 27E10 was found to be negative in each section obtained from normal cochlea. However, 27E10 positivity was detected in three of ten TBs with signs of chronic ear inflammation. This positivity can be explained by two theories: (1) activated monocytes can enter the inner ear from the systemic circulation as a consequence of chronic antigen challenge; (2) mesothelial cells could become activated as a result of a cross-reaction, with resultant positivity. Development of sensorineural hearing loss in some cases of chronic otitis media may be due to these immunological reactions.

Candida endocarditis in a premature infant.

Endocarditis is an uncommon complication of invasive candidiasis. We present a fatal case of endocarditis caused by Candida albicans in a very low birth weight infant. The 780-g male infant did not have any structural heart disease and a central venous catheter was not placed. Endocarditis developed in spite of parenteral fluconazole treatment. Echocardiography was a valuable tool in making the diagnosis. The infant died on the 40th day of life. The development of Candida endocarditis in a premature infant who was treated with fluconazole had not been previously reported. In the case of systemic candidiasis, premature infants require very careful monitoring for the progression of the disease, even if antifungal therapy is administered.

[Care of patients with oral cavity tumors in the hospital and at home]. / A szájüregi daganatos betegek ápolása kórházi és otthoni körülmények között.

This study reports on experience acquired during the care of patients who could not participate in surgery, chemotherapy or radiation therapy because of the extent of the primary, recurrent or metastatic tumour, or because of the deterioration of the general condition or (in the event of recurrence), intervention with a curative aim could not be performed for the mentioned reasons. In these cases, improvement or preservation of the quality of life is the fundamental goal to be achieved at all times, for these patients must receive the best possible supportive treatment for the remainder of their lives, Unfortunately, the quaranteeing of this often tends to become mainly a financial question rather than a professional one. The medical staff has very little chance to influence the financial aspects, and must therefore do everything possible to ensure the highest possible level of care during hospitalization. Attention is drawn to the significant roles to be played by the family, the family doctor, the various home-care services and the hospice.

Integration status of virus DNA and p53 codon 72 polymorphism in human papillomavirus type 16 positive cervical cancers.

BACKGROUND: The aim of this study was to determine the physical state of HPV16 DNA and to reveal any association between the physical state of virus DNA and pathologic or prognostic factors in HPV16 positive cervical cancers. The other aim was to estimate the role of p53 codon 72 polymorphism in disease progression. MATERIALS AND METHODS: The presence and physical state of HPV16 DNA was analysed by Southern blot hybridisation and E1-E2 specific PCRs in the primary tumours and pelvic lymph nodes of 85 cervical carcinoma patients. Results Integrated HPV16 DNA was found in 32 out of 41 (78%) primary tumours and 2 out of 22 (95%) lymph nodes carrying HPV16 DNA. No significant association was found between integration of virus DNA and course of the disease. There was a trend towards an association between disease recurrence and the presence of the p53 codon 72 arginine homozygous genotype (OR = 3.41, p = 0.23). CONCLUSION: The physical state of HPV16 DNA does not seem to play a major role as a prognostic indicator in Hungarian cervical cancer patients, while the p53 codon 72 genotype may have an impact on the clinical outcome of the disease.

[Virologic aspects of juvenile laryngeal papillomatosis]. / A juvenilis gégepapillomatosis virológiai vonatkozásai.

Juvenile laryngeal papillomatosis is the most common benign tumor of the larynx in childhood. The specific etiological factors are non-oncogenic human papillomavirus types 6 and 11. In the present study two cases (a 6-year-old male and a 5 and a half-year-old female) operated five times each and harbouring type 11 DNA in papillomas excised in the first operations are analysed from the following virological aspects: 1. the examination of vertical transmission by general primer-polymerase chain reaction of maternal cervical exfoliation; 2. sites of papilloma predilections in the larynx; 3. histopathology; 4. viral DNA detection from the formalin-fixed and paraffin-embedded archive tissues and from a fresh papilloma tissue in one case by polymerase chain reaction applying type-specific primers. We did not find any signs of maternofoetal transmission in the anamnesis and the maternal cervix proved to be negative for viral DNA. However, the vertical route of transmission can not be excluded due to the special natural history of papillomavirus infections. Papillomas usually localised in normal squamociliary junctions of the larynx. The histopathologic review did not reveal any signs of malignancy. Koilocytosis referring to productive viral infection and the signs of abnormal keratinisation were present in each tissue. All tissues of the patients proved to be positive for the short amplimer deriving from the genome of human papillomavirus type 11.

Expression of p53 and pRb in bladder and prostate cancers of patients having both cancers.

Evidence has been presented that tumor suppressor genes p53 and Rb play a crucial role in the development of both human prostate and bladder cancer. Patients with either cancer are at an increased risk for developing the other malignancy as compared to the general population. The purpose of the present study was to investigate whether there is abnormal expression of these two suppressor proteins in both the bladder and prostate cancers of the same patient. The expression of p53 and pRb in bladder and prostate cancer specimens obtained from 15 patients having both cancers was studied using immunohistochemical staining with antibodies against these proteins. The expression of p53 and pRb in both bladder and prostate cancers of the same patient was congruent in 8 of 15 cases (53%) for p53 and 9 of 15 cases (60%) for pRb. The significance of these findings warrants further investigations.

[Severe lead poisoning caused by an ingested fishing weight]. / Lenyelt horgásznehezék okozta súlyos ólommérgezés.

Authors describe the case-history of a 17 year old male who accidentally ingested a fishing weight that was retained in the stomach and caused a serious lead poisoning. It is worth mentioning that beside the wellknown symptoms and signs of lead intoxication also the liver was seriously affected. The histologically verified toxic lesion of the liver presumably can be attributed to the large quantities of lead absorbed within a short period. This also explains the appearance of symptoms and signs indicating to encephalopathy beside the young age of the patient. The foreign body could not be removed by means of gastroscopy, therefore a gastrotomy was carried out followed by chelating treatment with i.v. CaNa2EDTA that resulted in complete clinical and laboratory recovery. The case history draws the attention to the importance of the quick removal of the retained lead containing objects out of the gastrointestinal tract.

Apoptosis in the human inner ear. Detection by in situ end-labeling of fragmented DNA and correlation with other markers.

The aim of this study was to obtain baseline data on the recently described special form of single cell death, apoptosis, in normal human inner ears. For this purpose, in situ end-labeling of the fragmented DNA was applied, in conjunction with apoptosis-related markers, to detect cellular elements showing programmed cell death in decalcified and paraffin-embedded tissues. Over 20 specimens were analyzed which were obtained from autopsy cases with no history of acoustic lesions confirmed by histopathology. Based on staining results, we saw no apoptotic signs in the majority of normal adult inner ears. An apoptotic cell captured in the Reissner's membrane of the cochlea from an old patient may, however, indicate an age-related subtle cell loss with the process of apoptosis. Nevertheless, the fact that more apoptosis was not found in our cases suggests that this phenomenon does not contribute significantly to the tissue homeostasis in the adult inner ear under normal conditions. These data are in accordance with our immunohistochemical findings on the p53 nucleoprotein, and proliferating cell nuclear antigen expression since there was no staining in any of the cellular elements, including the mesenchymal cells. This reflects a stationary and stable condition of cells of the vestibular and the cochlear structures, probably to maintain their integrity and the fine sensory functions. As opposed to the above findings, during inner ear development, the epithelial cells lining the cochlear lumen, the ossifying cartilage of the temporal bone, and the mesenchymal cells show different degrees of proliferation in combination with single cell death as signs of maturation of the vestibular and the cochlear apparatus. In addition, apoptosis has been demonstrated in cells of the cochlear stria vascularis from an adult patient treated with high doses of cisplatin, vinblastine and bleomycin prior to death. Furthermore, a wide range of apoptosis could be induced experimentally in a normal ear by an external perfusion of actinomycin D (ActD), which is known to produce programmed cell death in many cell types of different origins. The potential role of cytostatic agents in the apoptotic process of the inner ear needs, however, to be confirmed in large-scale specimens from patients treated with genotoxins. The fact, however, that apoptotic cells are also seen in association with ActD indicates that the fine sensory structure of the cochlea may also be a target for certain chemotherapeutic agents when administered in high doses.

Na-K-2Cl cotransporters are present and regulated in simian eccrine clear cells.

In freshly dissociated rhesus palm eccrine clear cells, regulatory volume increase (RVI) was studied using image analysis as a measure of Na-K-2Cl cotransport activity. Pseudo-RVIs, as well as RVI during methacholine (MCh)-induced cell shrinkage, were observed in clear cells and were inhibited by 100 microM bumetanide or in Na-free medium, but were not inhibited by amiloride or ouabain. RVI in hypertonic medium and RVI after MCh-induced cell shrinkage were accelerated by adenosine 3',5'-cyclic monophosphate (cAMP)-elevating agents (forskolin+isoproterenol) and inhibited by phorbol ester. RVI in hypertonic medium was enhanced by a phosphatase inhibitor, okadaic acid. mRNA for Na-K-2Cl cotransporter (NaKCC) was demonstrated in freshly isolated rhesus sweat secretory coils by polymerase chain reaction (PCR) after reverse transcription using a set of primers derived from the published human NaKCC (hNaKCC) 1 sequence, i.e., nucleotides 2,043-2,810. The deduced amino acid sequence of the PCR-amplified 767-base pair segment was identical to that of hNaKCC 1 from a human colon cell line (T84). The data are interpreted to indicate that NaKCC, showing strong homology to secretory type hNaKCC 1, is present in rhesus eccrine secretory coils and may participate in the cotransport component of eccrine sweat secretion and cell volume regulation, especially during cholinergic stimulation. The data also raise the possibility that sweat gland NaKCC may be upregulated by cAMP-mediated protein phosphorylation and downregulated by protein kinase C.

Comparative intraosseal growth of human prostate cancer cell lines LNCaP and PC-3 in the nude mouse.

BACKGROUND: More than 75% of patients with advanced prostate carcinoma have skeletal involvement, which is the principal metastatic site and the major complication of this disease. The goal of this work was to compare the osseous metastasis of androgen-sensitive and insensitive prostate cancers in the nude mouse. MATERIALS AND METHODS: Androgen-sensitive LNCaP or -insensitive PC-3 human prostate carcinoma cells were injected directly into the femur medullas of male nude Beige mice, the animals were then sacrificed at successive time intervals to study the gross and microscopic characteristics of the established tumors. RESULTS: LNCaP and PC-3 both colonized in the bone marrow within a week, then gradually expanded to the entire bone medulla followed by osseous infiltration to produce obvious symptoms in the affected extremities. Based on the morphology, both osteoblastic and osteolytic changes occurred during the course of tumor progression. In addition, PC-3 tumors eventually broke through the bone cortex, invaded the surrounding tissues, and metastasized to the regional lymph nodes. In contrast, LNCaP remained localized within the bone, and appeared to eventually regress and die after displacing the normal bone marrow cells. Immunohistochemically, LNCaP tumors were consistently positive for prostate-specific antigen in bone metastasis, while PC-3 tumors were negative. Tumor cell nuclei of both PC-3 and LNCaP hybridized to a human repeated sequence DNA probe indicating that the proliferating malignant cells were of human origin. CONCLUSIONS: These cancer cell lines produced a high incidence of growth in the bone that differed in histogenesis. The relative malignancy of these cell lines was demonstrated in this model.

Reexamination of tympanic membrane temperature as a core temperature.

Controversies surrounding tympanic temperature (Tty) itself and techniques for measuring it have dampened the potential usefulness of Tty in determining core temperature (operationally defined here as the body temperature taken at a deep body site). The present study was designed to address the following questions. 1) Can a tympanic membrane probe be made that is safer and more reliable than its predecessors? 2) Why is the effect of facial cooling and heating on Tty so inconsistent in reports from different laboratories? 3) Is Tty still useful as a measure of core temperature? Data from this study, obtained with a modified thermocouple probe, suggest that the widely reported facial skin cooling effect on Tty is most probably due to thermal contamination from the surrounding ear canal wall and/or suboptimal contact of the probe sensor with the tympanic membrane because 1) Tty that fell during facial cooling was increased to the precooling level by the repositioning of the probe sensor; 2) Tty determined by using a probe with a larger sensor area (the sensor soldered to a steel wire ring)tended to fall in response to facial cooling, whereas Tty determined with a thermally insulated probe ring did not; and 3) Tty obtained under careful positioning of the insulated probe was relatively insensitive to facial cooling or heating. Because Tty was practically identical to esophageal temperature (Tes) in the steady state, i.e., 36.83 +/- 0.20 (SD) degrees C for Tty and 36.87 +/- 0.16 degrees C for Tes at room temperature (n = 11), and because facial cooling had little effect on both Tty and Tes (36.86 +/- 0.17 degrees C for Tty and 36.86 +/- 0.26 degrees C for Tes during facial or scalp skin cooling), we support the postulate that Tty is a good measure of core temperature. The temperature transient in response to foot warming was detected 5 min (n = 2) faster with Tty than with Tes. Thus, with further improvements in the design of the probe. Tty can become a standard for determination of core body temperature.

Maintenance of human hyperplastic prostate implants at different sites in athymic mice.

The present study determined the influence of implantation sites, androgens, and the graft's fibrovascular elements on the maintenance of epithelial elements of human benign hyperplastic prostate tissue (BPH) in the nude mouse. BPH fragments prepared from fresh surgical specimens were implanted subcutaneously (s.c.), intraperitoneally (i.p.), or under the renal capsules (r.c.) into male Beige nude mice, which had been implanted s.c. with a Silastic tube filled with 4-dihydrotestosterone (DHT) or cholesterol. Two weeks later the BPH tissues were removed from the mouse and examined microscopically. The implants from all three sites maintained a comparable morphology, with epithelial and/or angio-leiomyomatous stromal hyperplastic appearance, without striking signs of atrophy, irrespective of supplementation with DHT. Expression of proliferating cell nuclear antigen in the implants was comparable, indicating that there was no significant influence of implantation site on the proliferative ability of either epithelia or the stromal fibroblasts. The PCNA-positive cells in the implants, including the vascular and myofibrous elements, hybridized in situ to a human-specific repeated-sequence DNA probe, indicating that these proliferating cells were of human origin. Our data suggest that during the early phases of the adaptation and maintenance of BPH implants, survival of epithelial cells is actively supported by fibro-vascular mesenchymal elements of the prostate grafts in a manner apparently unaffected by DHT supplements.

Correlation of human papillomavirus 16 and 18 with prognostic factors in invasive cervical neoplasias.

Forty-seven patients with cervical carcinoma were examined in order to correlate human papillomavirus (HPV) types with prognostic factors in invasive cervical neoplasias. Age, clinical stage, histological type, and grade and parity were analysed with respect to HPV status as determined by a general primer mediated polymerase chain reaction (PCR) or a type specific PCR. All but one sample (98%) harboured HPV sequences: HPV 16 was found in 26 cases (55%), HPV 18 in 19 cases (40%), and HPV 31 in 1 case. The presence of HPV 18 DNA was significantly associated with cancers developed below 40 years of age (P = 0.029). HPV 18 detection was associated with poor differentiation malignancy (P = 0.045) and histological types of poor prognosis (adenocarcinoma or nondifferentiated carcinoma; P = 0.006). HPV 18 positivity was also correlated with advanced clinical stages (FIGO II and III; P = 0.032). Parity and HPV status proved to be independent of each other (P approximately 0.99). Eighty-seven percent (27/31) of pelvic lymph nodes from HPV positive patients contained HPV DNA. The virus types found in lymph nodes were identical with those of the primary tumours in all cases. Virological results were compared to those obtained by routine histological examination. Only 6 of 27 patients with HPV positive lymph nodes had any histological evidence of metastasis. Nevertheless, the lack of metastasis as detected by histology does not exclude the possibility of relapses. Follow-up of the clinical prognostic significance of PCR detection of HPV in the possible sites of early metastases.