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Familial Mediterranean fever (FMF) is an autosomal recessive hereditary disease. FMF-related arthritis affects large joints, especially in the lower extremities. It starts with acute pain and swelling and affects one joint at a time. Fever is the most common symptom in FMF. Monoarthritis as the sole symptom is relatively rare and thus delayed diagnosis of the disease in a patient who had been suffering from monoarthritis for several years. Genetic analysis showing typical mutations in the patient eventually resulted in correct diagnosis, although classical clinical diagnostic criteria were not met. The patient received appropriate therapy with colchicine, which led to remission of the symptoms.

Background: The Modified Mini-Mental State Examination-revised (3MS-R) is a brief cognitive test designed to detect cognitive impairment, which is often used in Canada and USA., Objective: To assess the accuracy of the 3MS-R in identifying Alzheimer's disease (AD) in comparison with the conventional Mini-Mental State Examination (MMSE) in a German-speaking population., Subjects: The study refers to 31 patients with early AD and 5 patients with moderate dementia of AD etiology, as well as to 46 age-matched cognitively normal participants., Method: The 3MS-R and the MMSE were validated against an expert diagnosis based on a comprehensive diagnostic workup. The 3MS scores were adjusted for educational attainment. Statistical analysis was performed using the Receiver Operating Characteristics (ROC)., Results: ROC curves demonstrated the superiority of the ACE over the MMSE in identifying AD (Area under the Curve: 3MS-R vs. MMSE: 0.995 vs.0.953). The optimal cut-off score for the 3MS for detecting AD was 88 and had a sensitivity of 98% and a specificity of 94%. The German version of the 3MS-R is a short and practical but accurate test battery for the identification of AD. The effectiveness of the German version of the test in detecting other forms of dementias or mild cognitive impairment could be a task for future studies.

A major objective of peptide vaccination is the induction of tumor-reactive CD8+ T-cells. We have shown that HLA-A2 positive cancer patients frequently develop an antigen-specific CD8+ T-cell response after vaccination with NY-ESO-1 peptides p157-165/p157-167. These T-cells are highly reactive with the peptides used for vaccination, but only rarely recognize HLA-matched, NY-ESO-1 expressing tumor cell lines. To address the apparent lack of tumor recognition of vaccine-induced CD8+ T-cell responses, we used autologous tumor cells for in vitro stimulation and expansion of pre- and postvaccine CD8+ T-cells. In contrast to standard presensitization methods with peptide-pulsed antigen-presenting cells, mixed lymphocyte tumor culture favored the selective expansion of low-frequency tumor-reactive T-cells. In four patients, we were able to demonstrate that antigen-specific and tumor-reactive T-cells are detectable and are indeed elicited as a result of NY-ESO-1 peptide vaccination. Further analyses of postvaccine antigen-specific T-cells at a clonal level show that vaccine-induced antigen-specific T-cells are heterogeneous in functional activity. These results suggest that the methods of immunomonitoring are critical to identify the proportion of tumor-reactive T-cells within the population of vaccine-induced antigen-specific effector cells. Our results show that immunization with NY-ESO-1 peptides leads to strong tumor-reactive CD8+ T-cell responses. Our findings suggest that approaches to peptide vaccination may be improved to induce higher numbers of antigen-specific T-cells and to selectively increase the proportion of CD8+ T-cells that have the capacity to recognize and eliminate tumor cells., (Copyright (c) 2007 Wiley-Liss, Inc.)

Influences of non-steroidal anti-inflammatory drugs (NSAID) on concentrations of thyroid hormones are known for a long time. These effects could be explained with interference between NSAIDs and thyroid hormone binding. We investigated the effects of a single dose of aceclofenac on thyroid function and thyroid hormone binding in 18 healthy volunteers. Serum levels of free thyroid hormones (FT3, FT4) and thyrotropin (TSH) were measured with commercial available kids and thyroid hormone binding was estimated with a specially modified horizontal argarose-gel-electrophoresis prior to and 2 hours after receiving a single dose of aceclofenac. We found a significant decrease in T3 binding on TBG and a significant increase of albumin-bound T3. All other investigated thyroid hormone binding parameters, FT3 and FT4, showed no significant changes. We conclude that aceclofenac leads to a significant redistribution of T3 protein binding. These effects seem to be explained by T3 displacement from TBG induced by aceclofenac.

The frequent occurrence of both rheumatoid arthritis and autoimmune thyroiditis was already investigated with in part many conflicting results. We investigated a number of 792 patients (383 of them suffering from rheumatoid arthritis and 409 with osteoarthritis). In all patients antithyroid peroxidase and antithyroglobulin antibodies were determined. Patients with rheumatoid arthritis showed a significantly higher occurrence of circulating thyroid antibodies than those with osteoarthritis (9.1% versus 3.7%, p = 0.0016). We conclude that there exists a cumulate coincidence of both diseases. Patients suffering from rheumatoid arthritis should undergo a thyroid examination especially for the presence of autoimmune thyroiditis.

Effects of gender and age on quantitative sacroiliac joint imaging are discussed controversially. In most investigations the number of controls has been small and might not exactly reflect the change of sacroiliac/sacral (SI/S) ratios related to different age and gender. The aim of our study was to evaluate the changes SI/S ratios according to age and gender. In 125 patients without any history of either diseases or complaints of the sacroiliac joints a bone scintigraphy was obtained and the SI/S ratios were calculated. We observed a significant negative correlation of SI/S index with age. After separation into 4 different age groups a significant decline of the ratios could be shown. There were no significant differences between male and female patients. We conclude that the influence of age on SI/S ratios is substantial. But also many other factors like patient position, algorithm of SI/S ratio calculation, the time interval between application of the radiopharmaceutical and data acquisition may exert effects on SI/S ratios. It seems necessary for each department to evaluate their own age related reference values of SI/S ratios.

During nodulation of soybean (Glycine max) by Rhizobium japonicum, variations in the activities of two enzymes of heme biosynthesis, delta-aminolevulinic acid synthase (ALAS) and delta-aminolevulinic acid dehydrase (ALAD) are described. delta-Aminolevulinic acid synthase activity is found in the bacteroid fraction of nodules, but is not detected in the plant fraction. Bacteroid ALAS activity parallels heme accumulation during nodule development. delta-Aminolevulinic acid dehydrase activity is found in both bacteroid and plant cytosol fractions. Bacteroid ALAD activity is constant or increases during nodulation while plant ALAD activity falls.Bacteroid ALAD activity is found in effective, not in inefficient nodules. Plant ALAD activity is found in both effective and inefficient nodules. Plant ALAD activity falls during development of both types of root nodules.These results support the contention that it is the bacteroid ALAS and ALAD activities, not those of the plant, that are directly involved in formation of leghemoglobin heme, suggesting that the bacteroid may be solely responsible for formation of leghemoglobin heme in the nodule symbiosis.

Results and experiences in 51 transhepatic endless drainage operations according to the method of Goetze-Dick are dealt with, the indication as well as the technique of the operation are discussed in detail. The advantage of this method is based on the fact, that the drain can be easily changed. So patients with inoperable obstructive jaundice can often be given many month of worthwhile life. The extracorporal part of the drain is hardly found to trouble the patients. Also benign intrahepatic obstructions, where no bile duct is left to be anastomized, can be operated on satisfactorily with this method. In spite of the blunt penetration of the liver necessitated by this technique, intra- and postoperative complications are rare. Postoperative care is paramount in avoiding cholangitis.

The ionic specificity of IAA-induced acidification by Avena coleoptiles was studied, using zwitterionic, presumably impermeant buffers. The acidification was almost totally dependent on divalent cations with an order of effectiveness of Ca(2+) >/= Sr(2+) > Mn(2+), Mg(2+); whereas other polyvalent cations tested were ineffective. The Ca(2+) response was IAA-dependent. The CaCl(2) concentration was optimal at 0.3 to 1 mm and inhibitory at higher concentrations. Sr(2+) inhibited Ca(2+)-dependent acidification and monovalent cations such as K(+) did not induce additional acidification in the presence of optimal CaCl(2). These data are consistent with a mechanism for IAA-induced acidification involving a Ca(2+) -H(+) exchange.

A sensitive luminometer is used to measure directly the low rates of oxygen evolution during greening of etiolated barley (Hordeum vulgare L. var. Wong) leaves. Oxygen evolution is measured in leaf segments infiltrated with p-benzoquinone. When illuminated, these leaves do not produce significant amounts of oxygen until the end of the lag phase of chlorophyll synthesis. Chlorophyll is increased by feeding delta-aminolevulinic acid to leaves in the lag phase, but this does not cause an earlier appearance of photosynthesis. Chloramphenicol, and to a lesser extent cycloheximide, when fed to leaves together with delta-aminolevulinic acid, strongly inhibit the development of oxygen evolution in the light while only slightly inhibiting chlorophyll synthesis. The ability to evolve oxygen develops to only a slight extent in darkness, even in the presence of high levels of chlorophyll.We conclude that the development of photosystem II is limited by the synthesis of proteins in both the cytoplasm and the plastid, not by chlorophyll synthesis. Prolonged illumination is necessary for the development of oxygen evolution.

In 7- to 10-day-old leaves of etiolated barley (Hordeum vulgare), all of the enzymes that convert delta-aminolevulinic acid to chlorophyll are nonlimiting during the first 6 to 12 hours of illumination, even in the presence of inhibitors of protein synthesis. The limiting activity for chlorophyll synthesis appears to be a protein (or proteins) related to the synthesis of delta-aminolevulinic acid, presumably delta-aminolevulinic acid synthetase. Protein synthesis in both the cytosol and plastids may be required to produce nonlimiting amounts of delta-aminolevulinic acid. The half-life of a limiting protein controlling the synthesis of delta-aminolevulinic acid appears to be about 1(1/2) hours, when determined with inhibitors of protein synthesis. Acceleration of chlorophyll synthesis by light is not inhibited by inhibitors of nucleic acid synthesis, but is inhibited by inhibitors of protein synthesis. A model for control of chlorophyll synthesis is proposed, based on a light-induced activation at the translational level of the synthesis of proteins forming delta-aminolevulinic acid, as well as the short half-life of these proteins. Evidence is presented confirming the idea that the holochrome on which protochlorophyllide is photoreduced to chlorophyllide functions enzymatically.