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Notizen: Cyclosporin (CyA) has been shown to be highly effective and well tolerated in the short-term treatment of severe childhood atopic dermatitis; however, there is limited experience in its longer-term use. The aim of this study was to compare multiple short courses of CyA with continuous therapy for 1 year, with respect to efficacy, safety, tolerability and quality of life. Children aged 2–16 years, with a diagnosis of severe atopic dermatitis refractory to topical steroid therapy, were randomly assigned to receive short course therapy (multiple courses of 12 weeks) or continuous therapy. The starting dose and maximum dose for all patients was 5 mg/kg per day. Disease activity was monitored using the Six Area Six Sign Atopic Dermatitis score and the ‘Rule of Nines’ area score. Pruritus, sleep disturbance and irritability were measured using visual analogue scales, and topical therapy was monitored. Safety measurements included monitoring of serum creatinine, blood pressure and adverse events. Forty patients were included in the efficacy analysis, 21 of whom were randomized to the short course group (of whom six were withdrawn) and 19 to the continuous group (of whom five were withdrawn). Significant improvements were seen in all efficacy parameters at every time-point. There were no significant differences between groups, although the improvement was more consistent in the continuous arm. In the short course arm, 7 out of 21 patients could be managed by at least two short courses. The remaining 14 patients includes 12 who could not be controlled by at least two short courses, one patient who failed to return after week 12 and another patient who was withdrawn at week 4 due to an adverse event. Quality of life improved for both the children and their families. Tolerability was considered good or very good in at least 80% of the patients at week 12 and at the end of the study. No clinically significant change was seen in mean serum creatinine and no change was seen in mean blood pressure in either group. CyA is effective in controlling severe atopic dermatitis in children over a 1-year period and is well tolerated. More consistent control is achieved with continuous treatment; however, short course therapy was adequate for some patients, indicating that treatment should be tailored to the individual patient’s needs. Short course treatment may produce prolonged remission in some cases and reduce the cumulative exposure to the drug.

Notizen: In sets of empirical data that can he described by a skewed distribution function such as the rank size, relationships exist among the total observations, the relative size of the largest observation, the number of categories, and the slope of the distribution We consider only one phenomenon, the distribution of urban population into urban centers of various sizes. The properties become the total urban population, the size of the largest center, the number of places, and the slope characterizing the distribution. We present an analytical model which defines these relationships for various sizes of urban populations and various slopes. Numerical examples demonstrate the results of the analysis. The advantages of using the Principal Axis to measure slope are discussed, and we demonstrate this method. The model shows clearly how the proportion of the urban population in the largest center declines and also how the number of smaller centers grows dramatically as total urban population increases. Implications are discussed for the nature of changes to be expected in those areas of the world where urbanization is still taking place, such as Asia, Latin America, and Africa.

Notizen: The relationship between urbanization and level of income has been the subject of considerable theoretical debate and empirical study for many years. However, little recent work has been done to determine whether or not previous findings still hold, and there has been even loss multi-country analysis to explore the degree of generality. Analysis of data for metropolitan areas in the United States from 1970 to 1990 indicates per capita income increases directly with population size. For states of the United States and 113 countries for 1960 and 1980 a strong positive relationship exists and holds temporally between level of per capita Gross Domestic Product and percent of the population that is urban.

Notizen: Abstract. Circulating food antibodies, intestinal permeability and HLA status were studied in twelve blood donors previously identified as being selectively IgA deficient from screening 10 000 donations by means of a latex agglutination inhibition test, and confirmed by laser nephelometry. Assessment of intestinal function also included clinical history and standard laboratory tests. The donors proved to be healthy with no evidence of autoimmune disease or allergy. Nine donors (75%) had precipitins to food antigens. None had increased intestinal permeability as measured by the cellobiose/mannitol absorption test. HLA-A, B and DR antigen distribution was normal. IgG sub-class distribution was normal with the exception of an IgG2 level slightly below normal in one donor (0·9 g/1). An unexpected finding was a return of IgA levels to normal in four donors (33%) within 6 months.

Notizen: Corporations are attracted to leasing transactions with real property in order to secure occupancy of a property for a specified time frame without having to purchase. Investors in corporate real estate are also attracted to thesetransactions, because of a combination of a stable cash flow and residual value. By understanding the investor's underwriting criteria, the corporate real estate officer can decide how to achieve the lowest possible occupancy cost of abuilding.

Notizen: Summary Background There is a limited range of treatments for severe atopic dermatitis (AD). Azathioprine has often been used but there has been no randomized controlled trial of this drug to confirm its efficacy in AD. Objectives To establish or refute the efficacy of azathioprine in severe AD. To investigate the safety and tolerability of azathioprine in this patient population. Methods We performed a double-blind, randomized, placebo-controlled, crossover trial of azathioprine in adult patients with severe AD. Each treatment period was of 3 months' duration. Treatments were azathioprine 2·5 mg kg−1 day−1 and matched placebo. Disease activity was monitored using the SASSAD sign score. In addition, severity of pruritus, sleep disturbance and disruption of work/daytime activity were monitored using visual analogue scales. Adverse events were recorded and haematological and biochemical monitoring was performed. Results Thirty-seven subjects were enrolled, mean age 38 years (range 17–73). Sixteen were withdrawn, 12 during azathioprine treatment and four during placebo treatment. The SASSAD score fell by 26% during treatment with azathioprine vs. 3% on placebo (P 〈 0·01). Pruritus, sleep disturbance and disruption of work/daytime activity all improved significantly on active treatment but not on placebo. The difference in mean improvement between azathioprine and placebo was significant for disruption of work/daytime activity (P 〈 0·02) but not for pruritus or sleep disturbance. Gastrointestinal disturbances were reported by 14 patients during azathioprine treatment and four were withdrawn as a result of severe nausea and vomiting. Leukopenia was observed in two patients and deranged liver enzymes in eight during treatment with azathioprine. Conclusions Azathioprine is an effective and useful drug in severe AD although it is not always well-tolerated. Monitoring of the full blood count and liver enzymes is advisable during treatment.