FDG PET evaluation of granular cell tumor of the breast.

Granular cell tumor is a rare, usually benign neoplasm of neural origin that may arise in virtually any site and, when situated in the breast, can mimic breast carcinoma. We describe a case of granular cell tumor of the breast in a 57-yr-old woman. Clinical evaluation, mammography, sonography and MRI suggested a carcinoma with infiltration of skin and muscle. However, the tumor did not display increased glucose metabolism on PET. Clinical findings, imaging results, histological characteristics and surgical management are discussed.

Differences among black smoke, PM(10), and PM(1.0) levels at Urban Measurement Sites.

n Amsterdam, the Netherlands, we measured airborne particulate matter (PM) during winter 1998-1999, taking daily average measurements at an urban background site, at a busy street, and at a motorway. Comparison of black smoke, PM(10), and PM(1.0) levels showed that daily averages were highly correlated over time. Median daily concentrations were elevated at sites affected by traffic. The highest increase relative to the background in median daily concentration was noted for black smoke at the motorway (300%), whereas for PM(10) and PM(1.0) the increase was only 37% and 30%. These results indicate that mass measurements of ambient particulate matter underestimate the exposure to particles generated by traffic.

[Kinetics of the transformation of dihydroambazone into ambazone]. / Kinetik der Umwandlung von Dihydroambazon in Ambazon.

The oxidation of dihydroambazone (1) by oxygen is dependent on the pH-values of the solutions used. This transformation can be inhibited and excluded, respectively, by ascorbic acid using defined concentrations. The oxidation product ambazone (2) was determined spectroscopically at different pH-values. The rate of transformation in serum depends on the temperature and can also be inhibited with ascorbic acid.

INR control calculation: comparison of Dutch and international methods.

Results of trials with new oral anticoagulant drugs and vitamin K antagonists (VKA) might not be directly applicable to Dutch clinical practice due to the high level of control of anticoagulation in the Netherlands. In addition, the Dutch method for assessing anticoagulation control uses cross-sectional international normalised ratio (INR) test results while the method used in the trials is based on person-time. To enable comparisons, the two calculation methods were applied to INR data of a cohort of 5422 atrial fibrillation patients treated with VKA. Overall, 74% of test results and 77% of person-time were in the therapeutic range [2.0-3.5]. For the narrower target INR interval [2.5-3.5], 59% of test results and 61% of person-time were in range. It was only between two and six months after the start of treatment that the percentage of person-time in range was lower than the percentage of test results in range. Control of anticoagulation, expressed as a percentage of person-time spent in range, in this Dutch dataset was similar to recent trials with new oral anticoagulants, although it should be noted that the Dutch INR target is higher than the target in these trials. INR control as estimated by the two calculation methods (cross-sectional and longitudinal) was similar.

Leary's circle matrix: a comprehensive model for the statistical measurement of Horney's clinical concepts.

Three issues associated with the lack of statistical evaluation of Horney's theory were presented. They are the preference for professional and clinical impression over the use of more objective methods for defining and evaluating behaviors; the difficulty involved in validly assessing the dysfunctional nature of the expansive type; and the disregard of many objective scales for intrapsychic processes that should be viewed in terms of the total "organization of personality." Leary's model was described as a systematic and formal set of procedures that are relevant and appropriate to the measurement of behavior within the context of Horney's theory. Additionally, a current study was cited that used Leary's model with significant results pertaining to the statistical implications of Leary's procedures and the adaptation of the model to Horney's theory. It is clear that any theory which presumes to provide therapeutic treatment to clients in an ethical manner must be critiqued and evaluated to safeguard the welfare of its clients. However, it is a common practice to accept therapeutic concepts that are nestled in a defined model without testing them in a relatively objective manner. With the help of Leary's circle matrix and operational procedures, it is crucial that Horney's constructs be further submitted to empirical testing on a formal basis. The procedures have been available since 1957.

An application of the interpersonal models developed by Karen Horney and Timothy Leary to type A-B behavior patterns.

Using Horney's clinical concepts and Leary's circle matrix procedures, this study investigated the Type A and B patterns of personality. Significant findings showed the Type A-B continuum to represent two distinct poles, with the Type A direction reflecting the expansive personality pattern (power and aggressiveness) and the Type B direction reflecting the self-effacing pattern (helplessness and affiliation) for self-perceived roles. For behavioral roles, the power-versus-helplessness traits described the two contrasting directions of personality involvement. Three subgroups were identified for behavioral role in each A and B extreme group. The shift in affect between the ACL and MMPI instruments may reflect two factors: the degree of ambiguity set up by the nature of the tests and the responding "pull" of the individual, which was described as an "active" or "quiescent" form of the A and B patterns. Hence, it may be more effective to diagnose individuals in terms of a specific behavioral subtype and active or quiescent enactments. Three maladjustment indicators were investigated. Significant findings showed the A2 group as exhibiting increasing rigidity of behavioral role with lower Type A scores and the A1 group as exhibiting greater discrepancies with increasing Type A scores. The lack of discrepancy for the Type B groups may reflect a dysfunction in that these individuals may be stagnated in their work situations and complacent in the docile-dependent role. The three findings of behavioral subgroups, rigidity of role, and discrepancy were discussed as possible mediating psychosocial factors associated with coronary heart disease. Since this was the first major examination and use of Leary's model (to the author's knowledge) since the late 1950s, it is important to consider these results tentative and heuristic, until replications can be conducted. It is hoped that representative norms from diverse samples can be obtained for developing standard scores on Leary's circle matrix axes. The present study was limited by the narrow demographic characteristics of its subjects, who were mostly white-collar workers in professional, technical, or management positions.

Effect of ambient winter air pollution on respiratory health of children with chronic respiratory symptoms.

The acute respiratory effects of ambient air pollution were studied in a panel of 73 children with chronic respiratory symptoms in the winter of 1990 to 1991. The participating children were selected from all children aged 6 to 12 yr in Wageningen and Bennekom, two small, nonindustrial towns in the east of the Netherlands. Peak flow was measured twice daily with MiniWright meters. A diary was used to register the occurrence of acute respiratory symptoms and medication use by the children. Exposure to air pollution was characterized by the ambient concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2), black smoke (BS), and particulate matter less than 10 microns (PM10). Associations between air pollution concentrations and health outcomes were analyzed using time series analysis. During the study period an air pollution episode occurred, with moderately elevated concentrations of PM10 and SO2. There were 6 days with 24-h average PM10 concentrations in excess of the WHO suggested lowest observed effect level of 110 micrograms/m3. After adjustment for ambient temperature, there were small but statistically significant negative associations of PM10, BS, and SO2 with both morning and evening PEF. There was a consistent positive association between PM10, BS, and SO2 with the prevalence of wheeze and bronchodilator use. Overall, the observed associations suggest a mild to moderate response to these moderately elevated levels of air pollution in a group of potentially sensitive children.

Bradykinin action in the rat duodenum: Ca2(+)-dependent effects of bradykinin on the activity of particulate guanylate cyclase.

The nonapeptide bradykinin has been found to exert opposite effects on cGMP synthesis in a plasma membrane fraction from the rat duodenum. In the absence of exogenous Ca2+ BK increased the activity of the duodenal particulate guanylate cyclase which is decreased, in contrast, in a medium containing 1 mM exogenous Ca2+. In a Ca2(+)-free medium, on the other hand, both BK effects are completely prevented. The results suggest a presumable role of pGC in BK signal transmission in the rat duodenum with calcium ions as a mediator and/or essential cofactor.

Home dampness and respiratory health status in european children.

BACKGROUND: Living in a damp home has been associated with impaired respiratory health in previous studies, but objective data on lung function variability and atopy have been lacking from most studies. OBJECTIVES: Data collected in the winter of 1993-1994 in the framework of the PEACE study (Pollution Effects on Asthmatic Children in Europe) were used to study the association between home dampness and Peak Flow (PEF) variability, frequency of respiratory symptoms and relief medication use during the period of observation. METHODS: Children were selected with a screening questionnaire on the basis of positive answers to questions on symptoms of asthma and chronic cough. Children were instructed to perform PEF measurements with Miniwright PEF meters twice daily over a period of 2 months. Parents kept diaries on respiratory symptoms and medication use of their children. Data on demographic and housing characteristics were derived from a parent-administered questionnaire. As indicators for home dampness reported moisture stains and moulds were used. Children were tested for atopy with skin-prick tests. Data from 1614 children from 13 centres in 10 different countries were available for analysis. Linear regression models and prevalence rate ratios were used to investigate the association between home dampness and PEF variability and the period prevalence of cough, phlegm, lower and upper respiratory symptoms and bronchodilator use. RESULTS: In atopic children, PEF variability was positively related to self-reported moulds but not to moisture stains. The period prevalence of cough and upper respiratory symptoms was significantly higher in children living in houses with reported moulds, compared with 'dry' homes. CONCLUSIONS: These results show that self-reported moulds in homes are associated with objective as well as subjective markers of airway lability in European children with chronic respiratory symptoms.

Daily mortality and air pollution along busy streets in Amsterdam, 1987-1998.

Time-series studies on the association between daily mortality and air pollution levels have been criticized because they use background air pollution measurement sites to estimate exposure of the whole population, including those living along busy roads. To evaluate whether the exposure of people living along busy roads is estimated with error, we calculated separate effect estimates with separate exposure estimates using background and traffic-influenced measurement stations. We used Poisson regression analysis with generalized additive models to correct for long-term trends, influenza, ambient temperature and relative humidity, and day of the week. Black smoke and nitrogen dioxide were associated with mortality (relative risk of 1.38 and 1.10, respectively, for an increase of 100 microg/m3 on the previous day). Effect estimates were larger in the summer and in the population living along busy roads. Effect estimates were also larger using background stations rather than traffic stations. Overall, we found differences in the association between mortality and air pollution using different methods of exposure assessment; these differences are attributable to exposure misclassification for populations living along busy roads.

Effects of prostaglandins, calcium, and bradykinin on guanylate cyclase in different organs.

The effects of prostaglandins and bradykinin on the activity of guanylate cyclase in plasma membranes from rat uterus and duodenum have been found strongly dependent on calcium content.

Daily variations in air pollution and respiratory health in a multicentre study: the PEACE project. Pollution Effects on Asthmatic Children in Europe.

The Pollution Effects on Asthmatic Children in Europe (PEACE) study is a multicentre study of the acute effects of particles with a 50% cut-off aerodynamic diameter of 10 microm (PM10), black smoke (BS), sulphur dioxide (SO2) and nitrogen dioxide (NO2) on the respiratory health of children with chronic respiratory symptoms. The study was conducted in the winter of 1993/1994 by 14 research centres in Europe. A total of 2,010 children, divided over 28 panels in urban and suburban locations, was followed for at least 2 months. Exposure to air pollution was monitored on a daily basis. Health status was monitored by daily peak expiratory flow (PEF) measurements and a symptom diary. The association between respiratory health and air pollution levels was calculated with time series analysis. Combined effect estimates of air pollution on PEF or the daily prevalence of respiratory symptoms and bronchodilator use were calculated from the panel-specific effect estimates. Fixed effect models were used and, in cases of heterogeneity, random effect models. No clear associations between PM10, BS, SO2 or NO2 and morning PEF, evening PEF, prevalence of respiratory symptoms or bronchodilator use could be detected. Only previous day PM10 was negatively associated with evening PEF, but only in locations where BS was high compared to PM10 concentrations. There were no consistent differences in effect estimates between subgroups based on urban versus suburban, geographical location or mean levels of PM10, BS, SO2 and NO2. The lack of association could not be attributed to a lack of statistical power, low levels of exposure or incorrect trend specifications. In conclusion, the PEACE project did not show effects of particles with a 50% cut-off aerodynamic diameter of 10 microm, black smoke, sulphur dioxide or nitrogen dioxide on morning or evening peak expiratory flow or the daily prevalence of respiratory symptoms and bronchodilator use.

17 Alpha-oestradiol and 17 beta-oestradiol do not affect basal and follicle-stimulating hormone-stimulated inhibin B secretion by highly purified rat Sertoli cells.

The effects of 17 alpha-oestradiol and 17 beta-oestradiol on basal and follicle-stimulating hormone (FSH)-stimulated inhibin B secretion by rat Sertoli cells were studied. Sertoli cells were isolated and cultivated from testes of 18-day-old Wistar rats in the presence and absence of FSH and different doses of oestrogens. On day 4 of culture, secreted inhibin was measured by enzyme-linked immunosorbent assay. Neither 17 alpha-oestradiol nor 17 beta-oestradiol had any effect on the secreted inhibin level in either the presence or absence of FSH. It is concluded that these oestradiols do not play an essential role in regulatory processes involving inhibin or FSH.

Association between PM10 and decrements in peak expiratory flow rates in children: reanalysis of data from five panel studies.

Panel studies have found 1-3% increases in reports of acute respiratory symptoms associated with each 10 microg x m(-3) increase in ambient concentrations of particles with a 50% cut-off aerodynamic diameter of 10 microm (PM10). Statistically significant decrements in population mean peak expiratory flow (PEF) have also been observed but their magnitude is only about 0.1% for the same exposure. This study evaluated whether this difference is due to the different measurement scales used for the expression of the effects of air pollution on PEF and respiratory symptoms. The association between the prevalence of large decrements in PEF (more than 10% or 20% below the median) and PM10 concentrations was analysed using data from five recent panel studies. The effect estimates were compared to the effect estimates from original studies based on the population mean PEF. The decrement in the population mean PEF for an increase of 10 microg x m(-3) of the same-day PM10 concentration was 0.07%, averaged over all panels. A significant relative increase of 2.7% (95% confidence interval 1.6-3.8) in the prevalence of PEF decrements greater than 10% was associated with the same exposure. In conclusion, defining the peak expiratory flow response by the prevalence of large decrements provides effect estimates of a comparable magnitude to effect estimates for the prevalence of reports of acute lower respiratory symptoms.

PM10 elemental composition and acute respiratory health effects in European children (PEACE project). Pollution Effects on Asthmatic Children in Europe.

The ability of particles with a 50% cut-off aerodynamic diameter of 10 microm (PM10) to cause respiratory health effects possibly depends on their composition. This study evaluated whether the soluble elemental concentrations in PM10 were related to acute respiratory health effects. The Pollution Effects on Asthmatic Children in Europe (PEACE) study is a multicentre study of the acute effects of PM10 and other air pollution components on the respiratory health of children with chronic respiratory symptoms in urban and suburban panels. Children, 1208, divided among 17 panels were followed for > or =2 months. Exposure to air pollution was monitored on a daily basis. Health status was monitored by twice daily peak expiratory flow (PEF) measurements and a symptom diary. Median concentrations of iron ranged 105-1,110 ng x m(-3) in the urban and 32-517 ng x m(-3) in the suburban locations. The daily concentrations of most elements were not associated with daily variation in PEF, prevalence of respiratory symptoms or bronchodilator use. Silicon and iron concentrations tended to be negatively associated with PEF, and positively associated with the prevalence of phlegm. In two pollutant models, PM10 effect-estimates on phlegm prevalence were reduced and lost significance, whereas the effect-estimates of iron or silicon remained essentially unchanged. The effects of silicon and iron could not be separated. In conclusion, this study provides only weak support for the hypothesis that daily fluctuations in soluble elemental concentrations in ambient particulate matter are responsible for acute health effects.

Inhomogeneity in response to air pollution in European children (PEACE project).

OBJECTIVES: The PEACE study is a multicentre panel study of the acute effects of particles with a 50% cut off aerodynamic diameter of 10 microns (PM10), black smoke (BS), sulphur dioxide (SO2), and nitrogen dioxide (NO2) on respiratory health of children with chronic respiratory symptoms. In the complete panels no consistent association between air pollution and respiratory health was found. The study evaluated whether potentially more sensitive subgroups in the panels did show effects of air pollution. METHODS: To evaluate heterogeneity in response to air pollution, effect estimates of air pollution on peak expiratory flow (PEF) and respiratory symptoms were calculated in subgroups based on presence of chronic respiratory symptoms, use of respiratory medication, atopy, sex, and baseline lung function. RESULTS: The association between PEF and air pollution was positive in asthmatic children who used respiratory medication whereas the associations tended to be negative in children who did not use respiratory medication selected only on cough. No consistent association was found among asthmatic children who did not use medication. The association between daily prevalence of symptoms and concentrations of air pollution was not different between these subgroups. CONCLUSION: None of the predefined potentially more sensitive subgroups showed a consistent association between air pollution, PEF, and respiratory symptoms.

Chronic respiratory symptoms, skin test results, and lung function as predictors of peak flow variability.

We examined how chronic respiratory symptoms, reported in a questionnaire, and results of skin prick tests and spirometry predicted variability in peak expiratory flow (PEF) among 6-12-yr-old children (n = 1,854). After characterization with skin tests and spirometry, children were followed for 2-3 mo during the winter of 1993-1994. Peak expiratory flow was measured daily in the morning and evenings. Children with asthmatic symptoms (wheeze and/or attacks of shortness of breath with wheeze in the past 12 mo and/or ever doctor diagnosed asthma) had a greater variation in PEF than children with dry nocturnal cough as their only chronic respiratory symptom. Similarly, doctor-diagnosed asthma was associated with a greater variation in PEF, also among children with asthmatic symptoms. Peak flow variability increased with an increasing number of symptoms reported in the questionnaire. Atopy, positive skin test reactions to house dust mite and cat and lowered level (as % of predicted) in FEV1 and in MMEF were also associated with an increased variation in PEF. All the differences were observed in both diurnal and day-to-day variation in PEF. In conclusion, chronic respiratory symptoms reported in a questionnaire, spirometric lung function and skin prick test results among asthmatic children predicted variation in PEF measured during a 2-3 mo follow-up. The difference in morning PEF coefficient of variation (CV) between children with asthmatic symptoms and children with cough only was somewhat bigger in girls than in boys. The effect of atopy on morning PEF CV was somewhat bigger in young than in older children.

Effects of photochemical air pollution and allergen exposure on upper respiratory tract inflammation in asthmatics.

Asthma is an inflammatory disease of the airways, and exacerbations of this disease have been associated with high levels of air pollution. The objective of this study was to examine whether ambient air pollution and/or allergen exposure induces inflammatory changes in the upper airways of asthmatics. Sixty patients with intermittent to severe persistent asthma visited the Hospital's Out Patient Clinic every 2 wk for a period of 3 mo, and on each visit a nasal lavage was obtained. Associations between nasal inflammatory parameters and seasonal allergens and/or air pollution exposures were analyzed using linear regression analysis. The study ran from July 3 to October 6, 1995, during which period ozone (8-h mean: 80 micrograms/m3) and PM10 (24-h mean: 40 micrograms/m3) were the major air pollutants; the major aeroallergen was mugwort pollen (24-h mean: 27 pollen grains/m3). Effects on both cellular and soluble markers in nasal lavage were demonstrated for both ozone and mugwort pollen, but not for PM10. Ambient ozone exposure was associated with an increase in neutrophils (112% per 100 micrograms/m3 increase in 8-h average ozone concentration), eosinophils (176%), epithelial cells (55%), IL-8 (22%), and eosinophil cationic protein (ECP) (19%). Increases in environmental mugwort pollen counts were associated with an increase in nasal eosinophils (107% per 100 pollen/m3) and ECP (23%), but not with neutrophils, epithelial cells, or lL-8. This study demonstrated that both ambient ozone and allergen exposure are associated with inflammatory responses in the upper airways of subjects with asthma, although the type of inflammation is qualitatively different.