[Nasal dermoid and sinus cysts in patients with cleft malformations]. / Nasenfisteln und -zysten bei Patienten mit Lippen-Kiefer-Gaumen-Spalten.

BACKGROUND: Nasal dermoid sinus cysts are uncommon congenital lesions. They are usually isolated occurrences and are not associated with syndromes or additional malformations. The coincidence of both, cleft malformations and nasal dermoid sinus cysts, has seldom been reported. CASE REPORTS: Within the last 2 years two patients with reconstructed cleft lip and palate and additional nasal dermoid sinus cysts underwent surgical removal. One patient with bilateral complete cleft lip exhibited a fistula from the medial third of the nasal dorsum up to the glabella. Another patient with unilateral cleft lip and Peters' plus syndrome had undergone removal of a nasal dermoid sinus cyst 12 years ago and was referred for management of recurrent disease. DISCUSSION: Concerning the common cleft-dependent nose malformations with no midline nasal masses, there are reasons for the assumption that a coincidence of both anomalies might be accidental. Especially in Peters' plus syndrome no frequent occurrence of nasal dermoids has thus far been documented. However, the proximity and temporal closeness of an embryological pathway of the frontonasal region and lip development could also argue for a unique formation of both lesions. Complete surgical removal and plastic reconstruction simultaneously or in a second step are recommended.

Fat tissue accumulation during peritoneal dialysis is associated with a polymorphism in uncoupling protein 2.

BACKGROUND: Chronic treatment with peritoneal dialysis (PD) is a unique long-term metabolic procedure entailing a continuous 24-hour supply of glucose absorbed from the dialysis fluid. One common and important side effect of this treatment is weight gain and accumulation of body fat stores. However, not all patients accumulate body fat mass during PD, and the reason for this is not clear. Recently, two new mitochondrial uncoupling proteins (UCP2 and UCP3) have been found to have thermogenic properties that suggest involvement in the control of metabolic efficiency in humans. Moreover, recent results suggest that a polymorphism in the UCP2 gene may contribute to adipose tissue accumulation through its effects on energy metabolism. It could therefore be speculated that genetic differences in the metabolic rate might contribute to the differences in the accumulation of fat tissue during PD. METHODS: Genotyping of a polymorphism in the 3' untranslated region of exon 8 of UCP2 was performed in 41 patients (53 +/- 2 years) with chronic renal failure for whom we had prospective data on body composition (as estimated by dual-energy x-ray absorptiometry) following PD. In addition, indices of dialysis adequacy, peritoneal glucose absorption, and urea kinetics were followed (3 to 6 times per year in each patient) during treatment with PD. The degree of physical activity was assessed before the start of PD. RESULTS: Twenty patients with the deletion/deletion UCP2 genotype had a significant increase in body weight (3.0 +/- 0.8 vs. -1.0 +/- 1.1 kg, P < 0.01) and body fat mass (3.8 +/- 0.9 vs. 0.8 +/- 1.0 kg, P < 0.05) during PD, compared with 19 patients with an insertion/deletion UCP2 genotype. On the other hand, no significant differences in indices of dialysis adequacy, peritoneal glucose absorption, urea kinetic parameters, or degree of physical activity were observed when comparing patients who accumulated or lost fat tissue during PD. CONCLUSIONS: As most patients with the deletion/deletion UCP2 genotype acquired fat tissue during PD, the present results suggest that the UCP2 polymorphism contributes to variations in body composition. Thus, variations in UCP2 production or activity may be factors contributing to adipose tissue accumulation in a subgroup of patients treated with PD. It is possible that the polymorphism has a similar effect in the general population.

Empirically derived personality subtypes of public psychiatric patients: effect on self-reported symptoms, coping inclinations, and evaluation of expressed emotion in caregivers.

Personality scales on the Millon Clinical Multiaxial Inventory-II (MCMI-II) for 195 psychiatric inpatients (93 men and 102 women) in a public facility were cluster analyzed to develop an empirical subtyping according to personality traits. Subjects also completed the Brief Symptom Inventory (BSI), Methods of Coping Scale (MOC), and the Level of Expressed Emotion Scale (LEE). The five personality subtypes that emerged were consistent across two clustering methods (K-means and complete linkage). Subtypes members differed on subscales of the BSI, MOC, and LEE. Results support the relevance of personality traits and disorders in assessing psychopathology in psychiatric patients. Results also support the relevance of subtyping these patients according to MCMI-II results.