Typically, before and after surgical correction faces are assessed on still images by surgeons, orthodontists, the patients, and family members. We hypothesized that judgment of faces in motion and by naïve raters may closer reflect the impact on patients' real life, and the treatment impact on e.g. career chances. Therefore we assessed faces from dysgnathic patients (Class II, III and Laterognathia) on video clips. Class I faces served as anchor and controls. Each patient's face was assessed twice before and after treatment in changing sequence, by 155 naïve raters with similar age to the patients. The raters provided independent estimates on aesthetic trait pairs like ugly /beautiful, and personality trait pairs like dominant /flexible. Furthermore the perception of attractiveness, intelligence, health, the persons' erotic aura, faithfulness, and five additional items were rated. We estimated the significance of the perceived treatment related differences and the respective effect size by general linear models for repeated measures. The obtained results were comparable to our previous rating on still images. There was an overall trend, that faces in video clips are rated along common stereotypes to a lesser extent than photographs. We observed significant class differences and treatment related changes of most aesthetic traits (e.g. beauty, attractiveness), these were comparable to intelligence, erotic aura and to some extend healthy appearance. While some personality traits (e.g. faithfulness) did not differ between the classes and between baseline and after treatment, we found that the intervention significantly and effectively altered the perception of the personality trait self-confidence. The effect size was highest in Class III patients, smallest in Class II patients, and in between for patients with Laterognathia. All dysgnathic patients benefitted from orthognathic surgery. We conclude that motion can mitigate marked stereotypes but does not entirely offset the mostly negative perception of dysgnathic faces.
In patients with cystic fibrosis (CF), the progression of pulmonary disease differs considerably, even in identical cystic fibrosis transmembrane conductance regulator-genotypes which could reflect an additional influence of the host's immune response. This study therefore measured cytokine expression patterns in CF patients with different clinical presentation. Expression of interleukin (IL)-8, interferon gamma (IFN-gamma), IL-4, IL-10, and transforming growth factor (TGF)beta(I) was assessed in bronchial mucosal biopsies of eight CF patients with acute exacerbation (age 6.0-14.2 yrs), eight CF patients with chronic stable disease (age 7.3-17.4 yrs), and in five normal control subjects by semiquantitative and quantitative reverse transcriptase polymerase chain reaction combined with histopathological assessment and immunohistochemical staining. All CF patients expressed IL-8. In acute exacerbation, expression of TGF-beta1 and IFN-gamma was either absent or extremely low. In contrast, all patients with stable disease strongly expressed TGF-beta1. The highest expression of TGF-beta1 and IFN-gamma was found in CF patients with mild disease and a history of infrequent exacerbations. No correlation was found between the expression of IL-4 and IL-10 and patient history. In normal control subjects, only a weak expression of TGF-beta1 was observed. These results show a remarkable correlation between cytokine pattern and the clinical course of cystic fibrosis. High expression of transforming growth factor-beta1 and interferon gamma was associated with mild disease, whereas no or very weak expression of these cytokines was typical for patients with acute disease and frequent exacerbations suggesting a contribution of the immune response to the progression of pulmonary disease in cystic fibrosis.
BACKGROUND Continuous intravenous treatment with epoprostenol significantly improves pulmonary haemodynamics and survival in patients with primary pulmonary hypertension (PPH). Its beneficial effect, however, may be blunted due to adverse effects such as catheter sepsis and systemic hypotension. Recent investigations have shown that inhaled iloprost is effective in the treatment of PPH. Based on their different pharmacokinetics, we hypothesised that the combination of intravenous epoprostenol and inhaled iloprost would be more efficacious than epoprostenol alone during acute testing in patients with PPH. METHODS The effect of a single dose of inhaled iloprost (30 μg total over 15 minutes) on pulmonary haemodynamics was examined in eight patients with PPH (initial non-responders to nitric oxide) who had considerable adverse effects during treatment with epoprostenol. RESULTS The combination of inhaled iloprost and intravenous epoprostenol significantly improved mean pulmonary artery pressure (MPAP), cardiac index (CI), mixed venous oxygen saturation (Sv o 2 ), and systemic arterial oxygen pressure (Pa o 2 ) compared with epoprostenol treatment alone. Mean systemic arterial pressure (MSAP) and pulmonary capillary wedge pressure (PCWP) remained unchanged. CONCLUSIONS The pulmonary vasoreactivity shown by additional iloprost inhalation during effective epoprostenol treatment suggests that an improvement of treatment for pulmonary hypertension may be possible by combining vasoactive substances.
Neurotransmitters regulate mood, attention vigilance and other clinical symptoms linked with depression. Various medications ameliorate symptoms of depression and mood disorders by interference with the serotonic metabolism. Serotonin metabolism depends on nutritional cofactors such as pyridoxin together with essential mineral and trace elements. Both, inflammation and metabolic conditions seem to affect the bioavailability of serotonin crucially. We hypothesized that serotonin supply depends on relevant gastrointestinal precursor absorption and on the availability of nutritive antiinflammatory cofactors.We performed a randomized placebo controlled clinical trial in healthy participants to study the bioavailabilty of ingredients of the multivitamin and trace element LaVita' in a prospective randomized placebo controlled double blind trial to establish the mood ameliorating potential. Serotonin and its precursor tryptophan were measured in dry blood samples. Serum parameters like chromium and zinc, as well as vitamin D, vitamin B3 and B6 were determined before intake, and after 3 months and 6 months consumption of the test substances.After 3 months a slight increase of tryptophan (p=0.059) and a significant increase of serum serotonin (p < 0.013) was observed in the verum group. After 6 months the verum group showed a highly significant mean increase in niacin (p < 0.001) and the cofactors of serotonin metabolism pyridoxin (p=0.03), chromium p < 0.01), and zinc (p < 0.001). Serotonin levels droped after 6 months indicating a low risk for overdosing.We conclude that a continuous supply with ingredients from the natural source compound LaVita' may contribute to mood improving neurotransmitter activity.
A common pathomechanism involved in many degenerative manifestations of non-communicable diseases is nitrosative stress, giving rise to a chronic insidious inflammation causing silent inflammation at a cellular level. The release of nitric oxide inhibits multiple enzyme reactions with reduced oxidative phosphorylation and mitochondrial ATP depletion.We hypothesized that enzyme-inhibition can be alleviated by micronutrient supply, and studied laboratory parameters associated with nitrosative stress (nitrotyrosine, mitochondrial activity) after a micronutrient supplementation (a multivitamin mineral and trace element formulation as verum: LaVita®) and a placebo in healthy volunteers (n=150) for six months.Mean nitrotyrosine levels dropped significantly after 3 month in the verum and placebo group, whereas mitochondrial activity increased after three month in the verum group (p=0,087), but not in the placebo group (p=0,990). Ubiquinone - an essential ingredient for mitochondrial function- increased after six months in the verum group, but not after placebo consumption (p=0,001). Serum zinc and cellular zinc increased steadily after 3 and 6 month verum intake (p<0,001). As the enzyme superoxide dismutase (SOD) is mainly involved in the formation of nitrosative stress (peroxides) we measured the activity, and found significant differences in the placebo and verum group after 3 and 6 month (p=0,050 and p=0,003 respectively).We conclude that a balanced combination of vital nutrients may reduce nitrosative stress and silent inflammation, and consequently the risk for various forms of degenerative diseases.
