No differences in the Sry gene between males and XY females in Akodon (Rodentia, Cricetidae).

Several species of the South American genus Akodon present fully fertile XY females besides XX ones. To analyze the possibility of a Sry mutation as the cause of sex reversal in A. azarae and A. boliviensis, we determined the sequence of the Sry gene in 2 males and 3 XY females from each of these species. The Sry gene sequence was also studied in A. dolores, a species that does not have XY females. In inter-specific comparisons, the percentage identities with respect to the region analyzed varied between 96.8% and 97.9%. An ORF of 543 nucleotides was identified, and the predicted Sry proteins comprised 180 amino acids, with an HMG domain of 83 amino acids. Our results indicate that female sex reversal in A. azarae and A. boliviensis cannot be explained by sequence differences in the Sry region analyzed here, which includes the complete ORF and, together with previous results concerning the inheritance of the XY condition, show that Sry mutation is not the basis of sex reversal.

Chromosomal localization of telomeric sequences in three species of Akodon (Rodentia, Sigmodontinae).

The distribution of the vertebrate telomeric sequence T2AG3 in three species of the rodent genus Akodon was examined by FISH with a peptide nucleic acid probe. In addition to the expected telomeric hybridization, non-telomeric signals were observed in the three species. In A. dolores, centromeric signals were visible in two of the four biarmed autosome pairs featuring Robertsonian polymorphism, indicating the retention of at least part of the telomeric sequences during the fusion process, and an interstitial signal of lower intensity was observed in the short arm of another. In A. boliviensis, a strong signal was observed near the centromeric end of the first chromosome pair. The first pair of A. azarae (homologous to the first pair of A. boliviensis) showed a similar but markedly amplified signal, and a subcentromeric signal in the X chromosome corresponding to a heterochromatic region; additionally, interstitial signals of lower intensity were present in one to four chromosomes in the majority of cells examined.

Randomised trial of acupuncture compared with conventional massage and "sham" laser acupuncture for treatment of chronic neck pain.

OBJECTIVES: To compare the efficacy of acupuncture and conventional massage for the treatment of chronic neck pain. DESIGN: Prospective, randomised, placebo controlled trial. SETTING: Three outpatient departments in Germany. PARTICIPANTS: 177 patients aged 18-85 years with chronic neck pain. INTERVENTIONS: Patients were randomly allocated to five treatments over three weeks with acupuncture (56), massage (60), or "sham" laser acupuncture (61). PRIMARY OUTCOME MEASURE: maximum pain related to motion (visual analogue scale) irrespective of direction of movement one week after treatment. SECONDARY OUTCOME MEASURES: range of motion (3D ultrasound real time motion analyser), pain related to movement in six directions (visual analogue scale), pressure pain threshold (pressure algometer), changes of spontaneous pain, motion related pain, global complaints (seven point scale), and quality of life (SF-36). Assessments were performed before, during, and one week and three months after treatment. Patients' beliefs in treatment were assessed. RESULTS: One week after five treatments the acupuncture group showed a significantly greater improvement in motion related pain compared with massage (difference 24.22 (95% confidence interval 16.5 to 31.9), P=0.0052) but not compared with sham laser (17.28 (10.0 to 24.6), P=0.327). Differences between acupuncture and massage or sham laser were greater in the subgroup who had had pain for longer than five years (n=75) and in patients with myofascial pain syndrome (n=129). The acupuncture group had the best results in most secondary outcome measures. There were no differences in patients' beliefs in treatment. CONCLUSIONS: Acupuncture is an effective short term treatment for patients with chronic neck pain, but there is only limited evidence for long term effects after five treatments.

Specific heterochromatic banding of metaphase chromosomes using nuclear yellow.

The bis-benzimidazole compound nuclear yellow (NY) belongs to the same chemical family as the DNA binding fluorochromes Hoechst 33258 and Hoechst 33342. Spectroscopic studies of NY alone and in the presence of calf thymus DNA show high DNA binding affinity and behavior similar to the Hoechst fluorochromes above. Mitotic metaphase chromosomes from Balb/c mice stained with NY show C-banding and weak G/Q-banding, both of them disappearing after distamycin A (DA) or methyl green (MG) counterstaining. The same staining of human metaphase chromosomes from lymphocyte cultures, however, reveal only faint G/Q-banding (NY) and a characteristic DA-DAPI-like banding (NY-DA, NY-MG). Image analysis of NY stained human chromosomes, confirms that NY is suitable for studying polymorphisms affecting size in the pericentromeric heterochromatin of pairs 1, 9 and 16, and shows significant enhancement of NY fluorescence induced by DA in DA-DAPI heterochromatin. Our spectroscopic and cytological results show that NY, either alone or counterstained with DA or MG, can be used for DNA cytochemistry and chromosome banding. Possible mechanisms for the banding patterns induced by NY are discussed.

[Physical therapy with analgesic effects in inflammatory rheumatic diseases]. / Analgetisch wirksame Physiotherapieverfahren bei entzündlich rheumatischen Erkrankungen.

In praxis, one is not only concerned about the linear connection between rheumatic inflammation and pain therapy--pharmacological or physical treatment--but about an optimal connection of the whole spectrum of symptoms regarding the joint status with different options of actions on one hand, and the treatment procedure of choice beside pain therapy on the other hand. The understanding of the mode of action regarding physiotherapeutic methods with analgetic effects is due to the knowledge about the pathophysiologic relationship between inflammation and pain. On one hand, the information of pain from the periphery causes a sensibilisation of central nervous areas and therefore allodynia as well as irradiation of the painful area. On the other hand, biochemical processes lead to a neurogenic and alogenic inflammation due to the impact on the pain nerves. Beside the arthritis itself, the physiotherapy of a rheumatic-inflamed painful joint has to take into account the components arthralgia, irritation of the capsula, periarthropathia, and allogenic inflammation. Physiotherapeutic pain treatment has three modes of action: a causal effect on the structural level, suppression of over-excitation of the tissue as well as the central nervous transmission areas, and activation of the decelerating pain modulating systems. Each treatment procedure with analgetic effects like cooling, heating, localized mechanical methods, the activation techniques with proprio- and exteroceptive effects (TENS, Maitland-mobilisation), the electrotherapeutic option, and physical training therapy is characterized with its specific mode of action. The dosage of physiotherapeutic techniques has to be taken into account since it has to remain within physiologic limits and the tissue's irritability must not be reached.

Clear and complete presentation of air sampling data.

One important area in which change and improvement is needed in industrial hygiene practice is in the presentation of air sampling data. Many types of people rely on such industrial hygiene data when dealing with chemical exposures. Yet there is presently no standard of good practice among industrial hygienists and data is now presented in many different formats. Tables of data, many of which invite misinterpretation, are common. Adoption of the suggested report elements and tabular format presented here will help to establish a standard of good practice in the presentation of industrial hygiene sampling data.

Adjuvant cisplatin chemotherapy following cystectomy for bladder cancer: results of a prospective randomized trial.

Between April 1984 and May 1989, 77 eligible patients with invasive, nonmetastatic (stage M0) transitional cell carcinoma of the bladder were stratified after radical cystectomy and pelvic lymph node dissection on the basis of nodal status (stage pN0 versus pN1-2) and were randomly assigned to either observation or postoperative cisplatin chemotherapy (3 courses of 90 mg./m.2 cisplatin given for 3 consecutive days at monthly intervals). Patient eligibility included a creatinine clearance of greater than 60 ml. per minute. There were 40 eligible patients in the control group (median age 61 years) and 37 in the cisplatin group (median age 64 years). In regard to postoperative tumor stage and nodal status, there was no statistical difference between the 2 patient groups. In the cisplatin group 21 patients received the full dose, 9 required dose reduction and 7 refused treatment. Median followup was 5 years 9 months (range 3 to 8 years). Survival analysis showed no significant difference (log rank p = 0.65) between the 40 patients in the control group and the 37 in the cisplatin group. The survival rate at 5 years was 54% (95% confidence interval 39 to 69%) in the control group and 57% (95% confidence interval 40 to 74%) in the treatment group. Patients with cancer confined to the bladder wall (stage pT3a or less) had a 5-year overall survival rate of 70% and those with tumor growth in the perivesical fat or into the prostate (stages pT3b plus pT4a) had a 5-year overall survival rate of 40%. This difference in survival between the low stage subgroup (stages pT3a or less) and the high stage subgroup (pT3b plus pT4a) is highly significant (p = 0.0043). However, no difference between the controls and the cisplatin group was found within either the low or high stage subgroups. The reasons for failing to show a survival benefit from adjuvant high dose cisplatin monotherapy after radical cystectomy are discussed.

[Value of physiotherapy in chronic rheumatoid arthritis]. / Der Stellenwert der Physiotherapie bei chronischer Polyarthritis.

The main reasons for the importance of physiotherapy in treatment of rheumatoid arthritis are the biomechanical and neurophysiological factors, influencing not only joint function but also trophism. The dependence of the mechanical-structural differentiation of all parts of the joint from the regular practical usage, which is clinically obvious and can be pathophysiologically explained, enables us to use successfully all types of functional therapies. The treatment principle of calisthenics and ergotherapy must always again be derived from the therapy-relevant principles of joint physiology: the requirement of normal joint sensory; physiological instability; continuous activity for nutrition and structural differentiation; taking into consideration receptor sensitization during arthralgia; therapeutic usage of regeneration potency within its limits; and to avoid the unphysiological of an arthritis. The sketchy presentation of the hand's biomechanic lets us recognize easily the generation and prophylactics of the most important deformities: the so-called zig-zag deformities--button hole, swan neck, scoliosis of the hand, the subluxation, particularly those towards palmar, and the radial deviation of the carpus. In praxis we are searching for stabile joint positions, and we try to avoid lax joint positions to transmit force; also we are looking for early recognition of subluxations resp. deformities to train the joints, to fight reflex-dystrophic after-pain, the usage of orthotic devices, and finally treatment resp. prophylactics of contractures. Also part of physiotherapy are supporting and accompanying passive physiotherapeutic measures, therapeutic sport and handling of chronic states of pain. The sense and importance of all three supporting each other therapeutic concepts, will also be pointed out.

Clinical meaning of the torque between stance leg and ground for the analysis of gait mechanism.

Transversal torque between the stance leg and the ground was measured in 169 test persons with normal gait (91 women, 78 men; ages 15-79 years) using three-dimensional force plates. Taking the average of six to ten single steps produces reproducible person- and group-specific data. This permits the isolation and study of individual solutions to specific problems of locomotion, so-called gait mechanisms. The relatively great torque during the double-stance phase is caused mainly by the medially directed, short-term impact peak at heel strike, with the stride length as lever arm. Double-stance torque is therefore determined by motion dynamics and does not help in understanding individual gait mechanisms. Torque measured during the single-stance phase is, in comparison, rather small and is interindividually relatively variable. Experimentally measured torque is considered in terms of various hypotheses concerning the creation of torque in the human gait. Men obviously tend, for reasons of equilibrium and stability, to compensate the various torques. Better than the more known vertical, sagittal, and frontal force components, the remaining torque represents the individual problem solution and therefore permits the study of specific gait mechanisms, both physiological and pathological. Using the characteristic gait of patients with hemiplegia as an example, it is shown that pathological torque observed systematically on the nonaffected side in such patients is a quantitative measure of the trunk rotation necessary to move the plegic side forward. Measurement of this torque therefore permits precise determination of the degree of damage, as well as quantitative control and objective documentation of the rehabilitation progress.

[Value and characteristics of physical medicine and health resort medicine in advanced age]. / Chancen und Besonderheiten der Physikalischen Medizin und Kurortmedizin im höheren Alter.

Physical medicine and spa medicine both have the impetus of rehabilitation in common. In addition, they share the therapeutical orientation toward the performance capacity of organs and functional systems, as well as to activities of daily living, the consideration of chronobiological rules of training and adaptation, and an acknowledging of the fact that diseases and, therefore, the basics of rehabilitation are constantly changing. With increasing age the relation of therapy to function resp. rehabilitation becomes increasingly important. Gerontorehabilitation is distinguished from general rehabilitation by the following three characteristics: a) the focus on particular diseases of the elderly, for instance osteoporosis; b) the therapeutical awareness of multimorbidity with the obvious involution of the skeletal muscle mass, the labilization and generalization of vegetative reactions and the special psychosocial situation; c) the consideration of specific reactions of the organism in advanced age to additional and unexpected events (immobilization syndrome, regulative rigidity, long-term adaptation). Gerontorehabilitation has to deal with specific problems of the elderly, problems that may seem medically banal, but which may be partly either serious or at least very inconvenient, e.g., the multifactorial-caused kyphosis, motor deficiency and slowed reactions, the tendency to fall, itching or stinging extremities due to many causes, latent heart insufficiency of undetermined origin, disturbance of sleep and therefore of recreation, and impairment of higher brain functions.

Effects of glutathione and of cysteine on intestinal absorption of selenium from selenite.

The influence of glutathione (1 mmol/L) (GSH) on in vitro mucosal uptake and in vivo absorption of 75Se-labeled selenite (10 mumol/L) was investigated in rat jejunum. For comparison, the effect of L-cysteine (1 mmol/L) on in vivo absorption of 75Se-labeled selenite was also studied. In the in vitro uptake experiments, only the mucosal surface was exposed to the incubation medium for 3 min. For the in vivo experiments, a luminal perfusion technique was employed. GSH inhibited in vitro mucosal Se uptake, whereas absorption in vivo was stimulated by GSH. L-Cysteine also stimulated in vivo Se absorption, confirming former in vitro mucosal uptake experiments. Thus, unlike L-cysteine, GSH affected in vitro and in vivo absorption of Se from selenite differently. Enzymatic cleavage of products of the reaction of selenite with GSH occurring more efficiently under in vivo than in vitro conditions may be a prerequisite for the stimulatory effect of GSH on Se absorption. This apparently does not apply to the stimulatory effect of cysteine. Since GSH occurs in the intestinal lumen under physiological conditions, it may contribute to the high bioavailability of Se from selenite.

Stimulation of mucosal uptake of selenium from selenite by some thiols at various sites of rat intestine.

The influence of several thiols (conc. 1 mmol/L) on mucosal uptake of 75Se from 75Se-labeled selenite (conc. 10 mumol/L) across the brush border of rat jejunum and cecum was investigated in vitro using a short-term uptake technique. L-Cysteine (L-Cys) stimulated 75Se uptake in the mid- and distal jejunum and cecum, but not in the proximal jejunum. The effect was maximal in the distal jejunum. D-Cys was less effective in the jejunum and similarly effective in the cecum. L-Leucine (L-Leu) and L-glutamic acid significantly reduced the stimulatory effect of L-Cys on Se uptake in the distal jejunum, whereas the respective effect of D-Cys was not diminished by L-Leu. Cysteamine stimulated mucosal 75Se uptake at all intestinal sites tested, whereas the effect of mercaptopyruvate was restricted to the distal jejunum. Thioglycolate also enhanced 75Se uptake in the distal jejunum. The stimulatory effects of L-Cys, mercaptopyruvate, and thioglycolate were Na(+)-dependent, whereas the effect of cysteamine also occurred in the absence of Na+. Mercaptosuccinate, D-penicillamine, ergothioneine, and thiosulfate did not enhance mucosal 75Se uptake. It is concluded from these findings that the reaction of some thiols with selenite results in Se compounds that are rapidly absorbed by the intestinal epithelium through various Na(+)-dependent and Na(+)-independent mechanisms. The high bioavailability of Se from selenite found by others might thus be the result of the presence of thiols in the gastrointestinal tract.

[The role of the family physician in cooperation and coordination management of chronic rheumatic patients]. / Der Hausarzt als Kooperations- und Koordinationsinstanz chronischer Rheumakranker.

Rheumatoid arthritis (RA) is a disease that confronts the primary care practitioner with medical and organizational problems. There are only few experiences in diagnosis and therapy of (early) RA because of the low prevalence rate. Especially in rural districts there is a deficit in physiotherapists, ergotherapists, and psychologists with knowledge in rheumatology. The cooperation with rheumatologists is an organizational problem. In a study of 817 RA patients it could be shown that organizational help and, the offer of complementary therapy in the vicinity of a patient's home led to an increase of well-being and decrease in costs and severity of the disease.

Functional evaluation of sacral nerve root integrity. Report of a technique.

We report our technique of direct stimulation of the sacral roots governing voiding by which the functional and anatomic integrity of these nerve roots can be assessed in patients with voiding dysfunction. The muscular responses to stimulation of each sacral root are described, as are the landmarks and approach used to achieve stimulation.

[Therapy of metastatic prostatic cancer by orchiectomy plus Anandron versus orchiectomy plus placebo. Initial results of a randomized multicenter study]. / Die Therapie des metastasierten Prostatakarzinoms durch Orchiektomie plus Anandron versus Orchiektomie plus Placebo. Erste Ergebnisse einer randomisierten Multizenterstudie.

In the course of a randomized double blind trial conducted by 7 Swiss urological centres, 51 patients with advanced, not pretreated carcinoma of the prostate were included. Following orchiectomy the patients were either administered 300 mg Anandron daily (Roussel RU 23908) or Placebo. Twelve months later the Anandron-group shows a slightly better objective response whereas there is no difference in survival rates. The adverse effects of Anandron-treatment are described.