Coexistence of Reflection Asymmetric and Symmetric Shapes in

Level structures in the neutron-rich ^{144}Ba nucleus have been reinvestigated by measuring prompt γ rays in the spontaneous fission of ^{252}Cf. The previous s=+1 octupole band structure with reflection asymmetric shape has been expanded, and a side quadrupole band structure based on a 3^{+} state with reflection symmetric shape is identified. Thus, the results show the coexistence of reflection asymmetric and symmetric shapes in ^{144}Ba. This is a first identification of such a shape coexistence structure in a nuclear structure. The other structural characteristics are discussed.

CYP2D6 gene test in psychiatric patients and healthy volunteers.

BACKGROUND: Antipsychotic drug therapy meets difficulties in predicting response in psychiatric patients. The medical treatment of these patients may be improved significantly by systematic phamacogenetic diagnosis identifying the drug metabolic capacities of each patient. Genetic polymorphisms in the coding sequence for the drug metabolizing cytochrome P450 enzyme CYP2D6 represent a pharmacogenetic target. METHODS: A cohort (n = 225) representing psychiatric patients seen during an 18-month trial period was included in the project after the subjects accepted a blood sample being taken to analyse their CYP2D6 allelic composition. To investigate any putative difference in allele frequencies among the psychiatric patients compared to earlier publications on allele frequencies in Caucasian populations, another cohort (n = 122) of local healthy volunteers was likewise included. RESULTS: Allelic frequencies in the psychiatric patients and healthy volunteers were indistinguishable. Alleles *1 and *2 encoding for normal enzyme activity and alleles *3, *4, *5, *6, *13/*16 representing non-active forms were found as well as alleles *9, *10, *41 encoding for enzymes with decreased activity. Furthermore, examples of the previously described duplications of *1 and *2, which result in enhanced enzyme activity, were also identified. CONCLUSION: A systematic CYP2D6 gene test of hospitalized psychiatric patients revealed the identification of pharmacogenetically relevant alleles affecting capacity to metabolize antipsychotics. The frequencies of phenotypes in affected patients were 8.4 % intermediate metabolizers (IMs), 8.4 % poor metabolizers (PMs) and 3.1 % ultrafast metabolizers (UMs), whereas 52.4 % were extensive metabolizers (EMs) and 27.6 % heterozygous EMs.

[Treatment of familial Mediterranean fever. A not so rare diagnosis in Denmark]. / Behandling af familiaer middelhavsfeber. En ikke ualmindelig diagnose i Danmark.

Familial Mediterranean fever (FMF) is characterised by recurrent episodes of fever and painful serositis. It is inherited as an autosomal recessive disease, predominantly in people from the Eastern Mediterranean area. The patient described here was followed-up for 6 years. He had FMF diagnosed primarily on clinical grounds, which is now verified by a gene test.

Analysis of somatic hybrids between two sterile dihaploid Solanum tuberosum L. breeding lines. Restoration of fertility and complementation of G. pallida Pa2 and Pa3 resistance.

Fourteen somatic hybrids generated by electrofusion of mesophyll protoplasts from a non-flowering dihaploid S. tuberosum clone, DHAK-11, and a male-sterile dihaploid clone S. tuberosum, DHAK-33, were grown in the greenhouse and subjected to morphological assessments and tests for fertility and resistance to the white potato cyst nematode Globodera pallida pathotypes Pa2 and Pa3. The ploidy level of the hybrids ranged from 38 to 63 chromosomes. All hybrids developed flowers with violet petals except for one, hy-56, that possessed red petals. The colour of the tuber skin was purple in all hybrids except in hy-56 where the tuber skin was red. All of the hybrids were female fertile and generated viable seeds. Near-tetraploid hybrids produced the highest number of seeds per fruit and these seeds had a normal size. Hybrids with 58 or more chromosomes produced smaller seeds and less seeds per fruit. The germination frequency of the seeds was not influenced by the chromosome number of the hybrids. Pollen viability was determined and the male fertility of three hybrids was tested. Pollination with these three hybrids gave rise to fruit development, but only one produced viable seeds. The hybrids were tested for resistance to G. pallida pathotypes Pa2 and Pa3. A high level of resistance to Pa3, inherited from one parental clone, DHAK-11, and a high level of resistance to Pa2, inherited from the other parental clone, DHAK-33, was combined in four hybrids. These results demonstrate, that protoplast fusion is an efficient method for restoring the fertility of somatic hybrids generated from sterile parent clones, and is a powerful procedure for the complementation of multigenetic disease resistance traits in potato breeding lines.

[Acute schistosomiasis (Katayama fever)]. / Akut schistosomiasis (Katayama-feber).

Acute schistosomiasis (Katayama fever) may present with a broad spectrum of symptoms three to six weeks after primary infection by Schistosoma (S) mansoni, S. japonicum or, more rarely, S. haematobium. The acute phase of schistosomiasis is frequently confused with other feverish diseases. It occurs almost exclusively in nonimmune visitors to endemic areas. We describe seven cases of acute S. mansoni infection. The pathogenesis, clinical features, diagnosis and treatment are briefly discussed. Katayama fever should be considered in patients returning from endemic areas with fever and eosinophilia. Clinically normal, but potentially exposed travel companions should be examined as well. Early diagnosis and treatment may be important in preventing the infection's serious sequelae of the infection.

Longterm physical training in rheumatoid arthritis. A randomized trial with different training programs and blinded observers.

The objective was to study the long-term effect (2 years) of different training programs in patients with rheumatoid arthritis. The method was a randomized trial with 75 patients participating. The measured variables included morning stiffness, a pain score, number of swollen joints, a health assessment score, a functional score, ESR, Hb, the cost of medicine, and progression using X-rays of hands and feet. The results showed no effect of training on the disease activity or on the progression of the disease. The conclusion is that although most patients are in favour of training, the present study does not support that training lessons per se affect the disease activity or the progression of the disease.

Impairment of grip function in rheumatoid arthritis--studies with a simple hand test.

A new, simple and quick method for assessment of impaired grip function was evaluated in a rheumatology department, 208 of 211 patients with definite rheumatoid arthritis were unable to do the test, 48 of these patients had regarded their hands as unaffected when questioned. The impairment of grip function was closely related to clinical and functional observations but not related to the most common laboratory tests. The study confirms the hypothesis that almost all patients with RA are unable to do the hand test, even those who consider their hand function as normal.

Construction of a simple test for assessment of hand function in primary care. Theories and experimental trials for the test situation.

This paper describes a hand test consisting of three steps to test the subject's ability to grasp firmly another person's hand to hold a pencil firmly with fingers II-V with straight knuckles and maximally flexed finger joints, while the investigator pulls the pencil to hold on to a piece of paper with a rounded pinch grip between thumb and index finger while the investigator pulls the paper with a rounded pinch grip with submaximal strength. All three steps must be performed with each hand without causing pain. The test was an adequate parameter for the grip function, and at the same time could register work-load elicited pain, strength, and mobility. The test can be carried out by healthy subjects, but not by patients with rheumatoid arthritis. The test is logically constructed and has a high validity and reliability.

[The incidence of fibromyalgia in patients admitted to a rheumatology department]. / Forekomst af fibromyalgi hos patienter indlagt på en reumatologisk afdeling.

One hundred patients admitted consecutively to Kong Christian X Hospital for rheumatic conditions were examined for symptoms of fibromyalgia. 47% of the patients had not only histories of pain in three or more anatomically separate regions but also presence of at least seven tender points in the soft tissues on palpation of 15 sites of predilection for tender points. This investigation suggests a high incidence of secondary fibromyalgia in patients admitted on account of various rheumatic conditions.

[Examination of tender points in soft tissue. Palpation versus pressure-algometer]. / Undersøgelse for ømme punkter i bløddelene ("tender points"). Palpation versus trykalgometer.

Tender points may be identified by two methods, either by palpation or employment of a pressure-algometer. The inter- and intra-observer agreements between the two methods are investigated in the present article. The investigation consists of three sections: 1. Twenty-five female patients with various rheumatic conditions were examined by two investigators for tender points at 15 sites of predilection, immediately after one another both as regards palpation/palpation and pressure-algometer/pressure-algometer. Acceptable inter-observer agreement was found on palpation with an average value employing Cohen's kappa-coefficient of 0.68 and an unacceptable inter-observer agreement with average values employing Cohen's kappa-coefficient of 0.42, 0.39 and 0.44 with pressure thresholds of under 3.0, 4.0 and 5.0 kg/cm2. 2. Twenty-five female volunteers in whom only knees were visible were examined twice immediately after one another by the same examiner by palpation on the medial fat pad of the right knee and by pressure with the pressurealgometer on the medial fat pad of the left knee. Good intra-observer agreement was found by both methods with Cohen's kappa-coefficient ranging between 0.75 and 0.83. 3. Sixty-five consecutive patients admitted to Kong Christian X Hospital for Rheumatic Diseases were examined for tender points at 15 sites of predilection by two examiners immediately after one another employing palpation/pressure-algometer. Poor agreement was found between the two methods. Employment of the pressure-algometer may be useful in research where quantitating of the threshold of pain is desired, but, in the daily clinical routine, palpatory examination for tender points is just as good or better than employment of an algometer.

Hand handicap and rheumatoid arthritis in a fish-eating society (the Faroe Islands).

In the county of Klaksvik, the Faroes, a simple hand test was used for screening all inhabitants between the ages of 40 and 74 years. With its high sensitivity and specificity it revealed a diagnostic panorama entirely different from that seen in previous investigations in other nordic countries. In Klaksvik the prevalence of hand handicap was about 40%, which is due to the high incidence of osteoarthrosis. The prevalence of rheumatoid arthritis was 1.1%. The high functional capacity and the lower occurrence of rheumatic nodules and erosions found in the patients with rheumatoid arthritis as compared with previous studies suggest that the disease takes a milder course in Klaksvik. This should support the hypothesis that RA patients benefit from a diet rich in fish.

Treating genitourinary and pharyngeal gonorrhoea with single dose ceftriaxone.

The efficacy of ceftriaxone 250 mg given as a single intramuscular dose to treat genitourinary and pharyngeal gonorrhoea is compared with the outcome of the Danish standard treatment for uncomplicated genitourinary gonorrhoea, pivampicillin 1.4 g and probenecid 1 g, both given by mouth. The study comprised 327 patients for whom the diagnosis of gonorrhoea was made by microscopy of a methylene blue stained smear at their first visit to the clinic and for whom the diagnosis was later confirmed by culture of Neisseria gonorrhoeae. One hundred and seventy patients with genitourinary gonorrhoea (18 with and 152 without concomitant pharyngeal infection) were treated with ceftriaxone. One hundred and fifty seven (17 with and 140 without concomitant pharyngeal infection) were treated with pivampicillin. One week after treatment N gonorrhoeae was isolated from none of 18, 1/152, (1%), 11/17 (65%), and 6/140 (4%) patients, respectively. At a second attendance two weeks after treatment no further treatment failure was found. During the study period, a further 52 patients with pharyngeal infection (with or without concomitant genitourinary infection) that was shown by culture only were treated with a single intramuscular injection of 250 mg ceftriaxone. No treatment failure was observed in this group. Only minor adverse drug reactions were seen. Ceftriaxone 250 mg as a single intramuscular injection is therefore safe and effective in treating gonorrhoea, including pharyngeal infection.

Blood-monocyte functions in acute bacterial meningitis.

The blood-monocyte chemotactic, phagocytic and microbicidal activities were studied in 20 patients with acute bacterial meningitis. The cell functions were measured on admission, during treatment and after clinical recovery. In general, monocyte functions were within normal range on admission. However, in 2/2 patients with Neisseria meningitidis meningitis, complicated by disseminated intravascular coagulation, defective chemotaxis was observed. Other patients had normal or enhanced monocyte chemotaxis. Two patients died: one had normal monocyte functions, one had initially defective chemotaxis and microbicidal activity. During treatment, cell functions normalized and after recovery all but one patient had a normal blood-monocyte function profile. In conclusion, acute bacterial meningitis is not due to, or followed by, abnormal nonspecific functions of blood monocytes. However, development of disseminated intravascular coagulation is associated with depressed chemotactic responsiveness.

Prednisolone does not prevent post-herpetic neuralgia.

In a randomised, double-blind, controlled study of the effect of prednisolone on the development of post-herpetic neuralgia 78 patients with herpes zoster whose pain and exanthema had been present for less than 96 h were given 800 mg acyclovir five times daily for 7 days and prednisolone in a total dose of 575 mg, starting with 40 mg daily in the first week and tapering off over the next 2 weeks. 18 (23%) of the patients had post-herpetic neuralgia at 6 months after the acute zoster, 9 (24.3%) having received prednisolone and 9 (22.5%) placebo. The 95% CI for the difference between the placebo and prednisolone groups in the proportion of patients having pain at 6 months was minus 17% to plus 20%. Prednisolone, however, relieved pain for the first 3 days. The 1-2 week interval between admission and reappearance of pain and development of triggered pain seems to be the time needed to establish neuralgia. Once established, the type and intensity of pain remained largely unaltered.

Screening for complement deficiencies in unselected patients with meningitis.

Two hundred and nine patients consecutively admitted to hospital with a tentative diagnosis of meningitis were screened for complement deficiency by measuring classical and alternative pathway serum haemolytic complement activity and the plasma concentration of C3d. Abnormal test results were followed up by quantitative immunochemical measurements of individual complement components. No patients with homozygous complement deficiency were found in our material. One patient with pneumococcal meningitis with probable heterozygous C2-deficiency was identified. Patients with purulent meningitis of various etiologies or meningococcal disease had significantly increased plasma C3d concentration at admission compared to patients with serous meningitis or without meningitis. Furthermore, increased plasma level of C3d at admission in patients with purulent meningitis or meningococcal disease was associated with an increased lethality. Our findings do not support the hypothesis that complement deficiency is commonly associated with sporadically occurring meningococcal disease or purulent meningitis.

Delta excitations and shell-model information in heavy-ion, charge-exchange reactions.

We calculate total cross sections for coherent pion production using localized plane-wave approximations for the shell-structure of valence nucleons that are excited to delta particles in the intermediate state in the (12C, 12B) and (12C, 12N) charge-exchange, heavy-ion reactions. We find comparable agreement to projectile downshift data for 12C(12C, 12B)12N. Then we improve the formalism by replacing the localized plane wave bound states with harmonic oscillator states which are imbedded in a multipole expansion approach and calculate pion differential cross sections to test for the sensitivity of the spectra to the single-particle mass parameter.

Opsonic activity of serum in the acute phase of meningitis.

The present study was designed to determine the opsonic activity of serum obtained from meningitis patients in the acute stage of their illness. This study was part of a Danish multicentre prospective study on various aspects of meningitis for a 12-month period. The opsonic activity of serum was determined by a phagocytosis and a chemiluminescence assay using human peripheral blood polymorphonuclear leukocytes. The mean chemiluminescence and phagocytosis indices determined in the sera of 58 patients suffering from various forms of bacterial or non-bacterial meningitis did not differ significantly from that of control sera. Although sera of 4 patients with pneumococcal, 3 with meningococcal, and 1 with streptococcal meningitis exhibited lower opsonic activity than the control sera in the chemiluminescence assay, their values in the phagocytosis assay were similar to control value. It is concluded that serum opsonic activity in meningitis patients is normal and similar to that of healthy individuals.