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Case Reports 2006; 27(Suppl 1): 17-24 PubMed PMID: 17261998 Citation  Keywords:  Adult, Aged, Dental Amalgam:toxicity, Environmental Exposure, Female, Humans, Hypersensitivity:diagnosis, Immunoassay:methods, Lymphocyte Activation, Metals:toxicity, Middle Aged, Occupational Exposure, Reproducibility of Results, Sensitivity and Specific.   

OBJECTIVES: Chronic low-level metal exposure may result in metal sensitization and undesirable side-effects. The main sources of metal exposure are from the environment or from corrosion of dental metal alloys. Affected patients are routinely diagnosed with the epicutaneous (patch) test. However, such testing may induce false-positive (irritative) reactions and may in itself sensitize or exacerbate symptoms. Alternatively, MELISA (Memory Lymphocyte ImmunoStimulation Assay), an optimized lymphocyte transformation test (LTT), can be used. In this study we analyzed the overall frequency and distribution of metal sensitization among symptomatic, metal-exposed patients. In addition, we determined the reproducibility of the assay and assessed its clinical relevance for detecting and monitoring hypersensitivity to metals.

METHODS: To analyze the frequency and distribution of metal sensitization, blood from 700 consecutive patients was tested against a total of 26 metals in the validated LTT-MELISA. For reproducibility testing, 391 single metal tests from 63 patients were performed in parallel. Finally, to assess clinical relevance, 14 patients with known metal exposure showing local (dry mouth, Oral Lichen Planus, Burning Mouth Syndrome, eczema) and/or systemic (chronic infections, fatigue, autoimmune disorders, central nervous system disturbances, depression) effects were tested in LTT-MELISA. In 7 cases testing was repeated following removal of the allergy-causing metals or, in 2 additional cases, without therapeutic intervention.

RESULTS: Of the 700 patients tested, 74.6% responded to >/= 1 metal in LTT-MELISA, with a subgroup of 17.9% responding to >/= 3 metals. Reactivity was most frequent to nickel (68.2%), followed by cadmium (23.7%), gold (17.8%), palladium (12.7%), inorganic mercury (11.4%), molybdenum (10.8%), beryllium (9.7%), titanium dioxide (4.2%), lead (3.7%), and platinum (3.4%). Reproducibility was 94.9%, with most discordant results in a low-positive range. Removal of the alloys or prostheses containing allergenic metals resulted in remarkable clinical improvement correlating with a significant reduction or complete normalization of specific lymphocyte reactivity. In contrast, both LTT-MELISA reactivity and clinical symptoms remained unchanged in follow-up samples from the 2 patients who did not remove the source of metal exposure.

CONCLUSION: The optimized LTT-MELISA test is a clinically useful and reliable tool for identifying and monitoring metal sensitization in symptomatic metal-exposed individuals....

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Journal Article 2006; 27(Suppl 1): 31-35 PubMed PMID: 17261997 Citation  Keywords:  Adolescent, Adult, Aged, Aged, 80 and over, Dental Implants:adverse effects, Humans, Hypersensitivity:diagnosis, Immunoassay, Lymphocyte Activation, Middle Aged, Prostheses and Implants:adverse effects, Titanium:adverse effects,.   

OBJECTIVES: This study was carried out to investigate the potential of titanium to induce hypersensitivity in patients chronically exposed to titanium-based dental or endoprosthetic implants.

METHODS: Fifty-six patients who had developed clinical symptoms after receiving titanium-based implants were tested in the optimized lymphocyte transformation test MELISA against 10 metals including titanium. Out of 56 patients, 54 were patch-tested with titanium as well as with other metals. The implants were removed in 54 patients (2 declined explantation), and 15 patients were retested in MELISA.

RESULTS: Of the 56 patients tested in MELISA, 21 (37.5%) were positive, 16 (28.6%) ambiguous, and 19 (33.9%) negative to titanium. In the latter group, 11 (57.9%) showed lymphocyte reactivity to other metals, including nickel. All 54 patch-tested patients were negative to titanium. Following removal of the implants, all 54 patients showed remarkable clinical improvement. In the 15 retested patients, this clinical improvement correlated with normalization in MELISA reactivity.

CONCLUSION: These data clearly demonstrate that titanium can induce clinically-relevant hypersensitivity in a subgroup of patients chronically exposed via dental or endoprosthetic implants....

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Journal Article 2006; 27(6): 828-832 PubMed PMID: 17187024 Citation  Keywords:  Acromegaly:blood, Adenoma:blood, Adult, Aged, Aged, 80 and over, Bromocriptine:therapeutic use, Female, Follow-Up Studies, Hormone Antagonists:therapeutic use, Human Growth Hormone:blood, Humans, Insulin-Like Growth Factor I:analysis, Male, Middle Aged, P.   

OBJECTIVES: Acromegaly is a rare disease with increased mortality rate. The aim was to present our centre experience in the diagnosis and treatment of a series of patients suffering from acromegaly.

METHODS: 130 patients (55 men, 75 women) aged 19-84 years presenting with clinical and hormonal features of acromegaly, attending Department of Endocrinology and Out-patient Clinic between 1990 and 2004 were studied. They were analyzed their GH and IGF-1 levels, CT and MRI scans, and they were administered medical therapy, neurosurgery and radiotherapy.

RESULTS: We have observed 106 macro-, 16 microadenomas and 1 case of ectopic GHRH. 115 patients were operated, as cured were recognized 74 of them. Pituitary irradiation was applied to 11 patients, in 4 of them it did not cure the disease. Medical therapy was efficacious in 12% patients treated with bromocriptine, 73% with long-acting lanreotide and 58% with long-acting octreotide. In 7 patients other malignant neoplasm were detected. 11 patients died during the follow-up.

CONCLUSIONS: There is possible underdiagnosis of acromegaly in our region, especially in males. We have observed better diagnostic opportunities in recent years when MRI was available. It was accompanied by better outcome of surgical and pharmacological treatment and better control of the complications of the disease....

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Journal Article 2006; 27(6): 769-772 PubMed PMID: 17187022 Citation  Keywords:  Adult, Atrophy, Case-Control Studies, Female, Humans, Hypothalamus:pathology, Intracellular Signaling Peptides and Proteins:metabolism, Magnetic Resonance Imaging:instrumentation, Male, Middle Aged, Narcolepsy:metabolism, Neurons:metabolism, Neuropeptides.   

OBJECTIVES: Narcolepsy with cataplexy is associated with a loss of hypocretin. The question is, if there is an autoimmune or neurodegenerative process selectively killing the hypothalamic hypocretin-containing neurons or if these cells survive but fail to produce hypocretin. To support one of these hypothesis we aimed to detect structural changes in the hypothalamus of narcoletic patients.

MATERIALS AND METHODS: Nineteen narcoleptic patients were compared to 16 healthy controls. We used voxel-based morphometry (VBM), an unbiased MRI morphometric method with a high sensitivity for subtle changes in gray and white matter volumes to investigate hypothalamic region in this condition.

RESULTS: Classical MRI protocol revealed no structural abnormalities, but using VBM we found significant reduction in hypothalamic gray matter volumes between patients and controls.

CONCLUSIONS: VBM showed hypothalamic gray matter loss in narcolepsy with cataplexy. This suggest that functional abnormalities of hypocretin neurons in narcolepsy are associated with structural changes of hypothalamus....

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Case Reports 2006; 27(6): 729-732 PubMed PMID: 17187021 Citation  Keywords:  Diagnosis, Differential, Eye Diseases:congenital, Female, Humans, Melanocytes:pathology, Melanoma:complications, Melanosis:congenital, Middle Aged, Nevus, Pigmented:pathology, Optic Disk:pathology, Optic Nerve Neoplasms:pathology, Uveal Neoplasms:complica.   

: A case of a 57-year old woman with uveal melanoma of the posterior pole arising in the congenital ocular melanocytosis mimicking clinically malignant transformation of the optic disc melanocytoma is presented....

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Comparative Study 2006; 27(6): 773-778 PubMed PMID: 17187019 Citation  Keywords:  Adolescent, Adult, Age Factors, Aged, Aging:blood, Atherosclerosis:blood, Case-Control Studies, Chemokine CCL2:blood, Child, Child, Preschool, Down Syndrome:blood, Female, Humans, Interleukin-6:blood, Male, Middle Aged, Nerve Growth Factor:blood, Statisti.   

OBJECTIVES: Down's syndrome (DS) is the most frequent chromosomal aberration in men and it is invariably associated with mental retardation.

MATERIAL AND METHODS: Plasma levels of nerve growth factor (NGF), interleukin-6 (IL-6), and monocyte chemoattractant protein-1 (MCP-1) from non demented DS subjects of three different age-cohorts (2-14 years; 20-50 yrs; >60 yrs) and healthy controls were measured. No clinical and sub-clinical inflammation was apparent in DS patients.

RESULTS: Plasma levels of NGF were higher in children, adult and old DS subjects than in controls. However, a significant age-related decrease of NGF levels was present in DS subjects. Serum levels of IL-6 and MCP-1 were also increased in DS children and adults, but not in older DS patients.

CONCLUSIONS: High levels of circulating NGF might protect DS from clinical complications of atherosclerosis. However, the striking decrement of peripheral NGF levels with advancing age may predispose DS to clinical manifestation of dementia after adulthood....

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Journal Article 2006; 27(6): 745-747 PubMed PMID: 17187018 Citation  Keywords:  Acidosis:blood, Adult, Apgar Score, Asphyxia Neonatorum:blood, Birth Weight, Blood Gas Analysis, Female, Fetal Blood:chemistry, Gestational Age, Humans, Infant, Newborn, Insulin-Like Growth Factor Binding Protein 3:blood, Insulin-Like Growth Factor I:anal.   

OBJECTIVE: Determination and pathogenesis of perinatal asphyxia is still an important problem. During the asphyxial insult and recovery phase, alteration of the growth factors has been demonstrated and there is evidence that expression of insulin-like growth factors (IGF) and their insulin-like growth factor binding proteins (IGFBP) in injured sites in experimental studies. Aim of this study was to evaluate relationship between serum IGF-1, IGFBP-3 levels and perinatal asphyxia.

PATIENTS AND METHODS: 18 term-newborn who defined as perinatal asphyxia and 12 term-healthy newborn were enrolled. Umbilical cord IGF-1 and IGFBP-3 levels were detected and searched correlation with apgar scores and umbilical artery gas analysis as pH, pC02, pO2, base excess, HCO3, ctO2, SO2 and lactate levels.

RESULTS: Cord blood IGF-1 and IGFBP-3 levels for asphyxiated newborns were lower than normal group (27.8+/-2.6 ng/ml, 55.1+/-2.8 ng/ml respectively, p<0.01 for IGF-1; 1107.7+/-320.4, 1682.5+/-364.1, p<0.001 for IGFBP-3). Cord blood IGF-1 levels were positively correlated with birth weight; first and 5th minute Apgar score, cord blood arterial pH, ABE, HCO3, SO2 levels. Cord blood IGFBP-3 levels were positively correlated with first and 5th minutes Apgar scores, cord blood arterial pH, pCO2, ABE, HCO3, sO2, and also negatively correlated with cord CO2 and cord lactate levels.

CONCLUSION: Our study demonstrates that exposure to hypoxia and acidosis at birth strongly correlated with a fall in IGF-1 and IGFBP-3 levels in cord blood....

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Journal Article 2006; 27(6): 711-718 PubMed PMID: 17187017 Citation  Keywords:  Biological Evolution, Choice Behavior, Dominance-Subordination, Female, Homosexuality:psychology, Humans, Internet, Male, Masochism:psychology, Power (Psychology), Psychological Theory, Sadism:psychology, Statistics, Nonparametric,.   

OBJECTIVES: Dominance and submissiveness represent strong sexual arousal stimuli for a considerable part of population. In contrast to men's sexual dominance and women's sexual submissiveness, the opposite preferences represent an evolutionary enigma. Here, we studied prevalence and strength of particular preferences in general population by Internet-trap-method.

DESIGN: The subjects who clicked the banner displayed in the web interface of e-mail boxes were allowed to choose icons with homosexual or heterosexual partner of different hierarchical position.

RESULTS: Dominant partner was chosen by 13.8% men and 20.5% women, and submissive partner by 36.6% men and 19.8% women. Homosexual partners were chosen by 7.3% men and 12.2% women. The response times for the submissive and dominant stimuli did not differ while for the equal-status stimuli were significantly longer, suggesting that part of subjects with equal-status preferences probably intentionally mask their natural interests.

CONCLUSIONS: Large number of people who chose unequal sexual partner suggests that hierarchical status plays important role in human mating system....

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