The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Environmental risk factors and their role in the management of atopic dermatitis

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.     

HLA genes in Amerindians from Mexico San Vicente Tancuayalab Teenek/Huastecos

Huastecos or Teenek Amerindians are presently living at North East Mexico (San Luis Potosi State). They have probably one of the most ancient culture of Mexico and Central America together with Mayas and Olmec groups with which also show close relationships. Proximity to Atlantic Ocean/Mexican Gulf originated that Spaniards had very early contact with them at about 1519 CE or before. In the present paper we have aimed to study HLA gene profile which may be useful for HLA and disease epidemiology and transplant programs in Teeneks. HLA-DRB1*04:07, -DRB1*14:06 and -DRB1*04:11 have been found in high frequency like in other Amerindian groups. High frequency typical Amerindians HLA extended haplotypes have been found, such as A*02-B*35-DRB1*04:07-DQB1*03:02; A*68-B*39-DRB1*04:07-DQB1*03:02 and A*02-B*39-DRB1*04:07-DQB1*03:02; also new haplotypes have been described, like A*02-B*52-DRB1*04:11-DQB1*03:02, A*68-B*35-DRB1*14:02-DQB1*03:01 and A*68-B*40-DRB1*16:02-DQB1*03:01. Genetic proximity is observed not only to linguistically close Mayans, but also to Mazatecans, Mixtecans and Zapotecans, who speak an altogether different languages; it shows once more that genes and languages do not correlate. This population was greatly diminished after European contact between 1500 and 1600 years CE; in fact, North and South America First Inhabitants population was brought from 80 down to 8 million people because of diseases (i.e.: measles, smallpox or influenza), slavery and war.     

État de l’art : nouveaux anticoagulants et transfusion

Direct oral anticoagulants (DOAC) are indicated for stroke prevention in atrial fibrillation and for the prevention and treatment of venous thromboembolism. As any anticoagulant, they are associated with a bleeding risk. Management of DOAC-induced bleeding is challenging. Idarucizumab, antidote for dabigatran, is currently available and is part of the therapeutic strategy, whereas antidotes for anti-Xa agents are under development. Activated or non-activated prothrombin concentrates are proposed, although their efficacy to reverse DOAC is uncertain. We propose an update on DOAC-associated bleeding management, integrating the availability of idarucizumab and the critical place of DOAC concentration measurements.     

Die Bindungsfähigkeit des Serum-Albumins für Bromsulphthalein bei Patienten mit chronischer Urämie während Hämodialyse-Behandlung

Zusammenfassung Im Verlauf der Hämodialysc chronisch Nierenkranker verhält sich die mit der Acrylamidgel Elektrophorese nachweisbare Bindung von Bromsulphthalein und Albumin etwa umgekehrt proportional zur Konzentration unveresterter Fettsäuren. Diese Fettsäuren verdrängen den Farbstoff aus seiner Albuminbindung. Der Effekt ist in vivo durch die vorübergehende Zunahme von Fettsäuren infolge der Postheparin-Lipolyse anläßlich der Heparinisierung bei der Hämodialyse auslösbar und auch nach Zugabe von Ölsäure zu einer reinen Albumin-Bromsulphthalein-Lösung in vitro nachweisbar. Bereits bei physiologischen Hyperlipacidämien wird dieser Verdrängungsmechanismus wirksam. Er kann möglicherweise — dem Bromsulphthalein vergleichbar — Medikamente aus ihrer Albuminbindung verdrängen, wodurch deren Wirkung auf die Gewebe und/oder die Ausscheidung durch die Nieren beeinflußt wird.     

Electron microscopic analysis of bacteriophages P1, P1Cm, and P7. Determination of genome sizes, sequence homology, and location of antibiotic-resistance determinants

The sizes of the genomes of bacteriophages P1, P1Cm, and P7 (φAMP) and their corresponding plasmid prophages were measured by electron microscopy. It was found that the genomes from the phage particles were the same size, while the prophage DNA molecules of P1Cm and P7 were larger than the P1 prophage by an amount close to the size of the antibiotic determinant which they carried. Heteroduplex analysis of hybrids formed in vitro between P1 and P1Cm DNA showed one region of nonhomology, an insertion of 2.2 kilobases (kb) which was presumed to be the Cm^r determinant. Similar hybrids between P1 and P7 DNA showed six regions of nonhomology, two insertion-deletion loops, and four substitution loops. Further analysis showed that the insertion of a 5.5-kb segment contained the determinant for ampicillin resistance. Sequence homology between P1 and P7, determined from heteroduplex analysis, was about 90% with respect to the genome size of P1.     

Origin of transmitters released by electrical stimulation from a small metabolically very active vesicular pool of cholinergic synapses in guinea-pig cerebral cortex.

The turnover of true and false transmitters was measured to find out from which subcellular pool in guinea-pig cerebral cortex acetylcholine is released after electrical stimulation. [N-Me-¹⁴C]choline was injected along with [N-Me-³H]pyrrolidinecholine or [N-Me-³H]homocholine into cortical tissue. Both choline analogues were acetylated, although two to five times less favourably than choline. All acetylated forms were incorporated into synaptic vesicles; this vesicular uptake was enhanced by low-frequency electrical stimulation (0.1 Hz) and occurred preferentially into a metabolically very active subpopulation of synaptic vesicles closely attached to the presynaptic membrane which can be isolated at the interphase between 0.8 M and 1.0 M sucrose (fraction H), using the sucrose density gradient separation technique. Acetylhomocholine was preferentially localized within the cytoplasmic compartment and taken up into synaptic vesicles to a smaller extent than acetylpyrrolidinecholine.Locke's solution was placed in Perspex cylinders (cups) applied to the surface of the cortex and acetylcholine as well as acetylpyrrolidinecholine and acetylhomocholine were released into these cups by diffusion. High-frequency stimulation (30 Hz) approximately doubled the amount of transmitters released. The molar ratios of the transmitters ([¹⁴C]acetylcholine/[³H]acetylpyrrolidinecholine or [¹⁴C]acetylcholine/[³H]acetylhomocholine) released during stimulation closely approximated those found in fraction H but differed significantly from the molar ratios determined in the monodisperse synaptic vesicle fraction (fraction D) at the 0.4 M sucrose level and also from that in the cytoplasmic compartment. Moreover, the specific activity of the released transmitter was nearly identical with that in fraction H.It is concluded that electrical stimulation releases acetylcholine from a distinct, metabolically very active vesicular pool in the guinea-pig cortex and that synaptic activation in some way facilitates the vesicular uptake of transmitters.     

Familiäre perniziöse Anämie

Zusammenfassung Es wird über eine Familie mit 16 lebenden Blutsverwandten in 3 Generationen berichtet, bei der Mutter und Sohn an einer essentiellen perniziösen Anämie erkrankt waren. Hinweise für eine Bluterkrankung ergaben sich bei keinem der Angehörigen.Wir fanden bei keinem der 16 Untersuchten typische strukturelle Chromosomenanomalien, dagegen vermehrt unspezifische Chromosomenaberrationen.Bei 12 von 16 untersuchten Familienangehörigen war die Aktivität der alkalischen Leukocytenphosphatase stark erniedrigt wie es bei manifester megaloblastärer Anämie gefunden wird.5mal beobachteten wir Belegzellantikörper, obgleich nur 2 von 15 Untersuchten älter als 40 Jahre, 9 dagegen jünger als 15 Jahre waren, so daß eine altersbedingte Häufung nicht als Erklärung herangezogen werden kann. Zusätzlich ließen sich 4mal Schilddrüsenantikörper nachweisen.Der Ausfall des Schillingtests war, von den beiden Erkrankten abgesehen, normal.Die erhobenen Befunde werden im Hinblick auf die genetische Disposition der Erkrankung zusammen mit den Beobachtungen der Literatur diskutiert.     

Participation of opioid and serotoninergic brain receptors in amphetamine-induced stereotypy and hyperthermy

The inbred rat strains WAG and Fischer-344 were found to differ in the duration of amphetamine-induced stereotypy and the degree of hyperthermy elicited by this drug, the stereotypy lasting longer in WAG rats and the hyperthermy being more pronounced in Fischer—344 rats. A comparison of interstrain differences in the amphetamine effects, in receptor binding, and in the pharmacological activity of receptor agonists suggests that the μ-opiate system of the brain may be involved in the manifestation of amphetamine-induced stereotypy, while its serotoninergic system may mediate the elevation of body temperature caused by this drug. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 120, N ^o 9, 242–243, September, 1995 Presented by V. N. Yarygin, Member of the Russian Academy of Medical Sciences     

Non-glucocorticoid drugs for the treatment of Takayasu's arteritis: A systematic review and meta-analysis

Background

Takayasu's Arteritis (TAK) affects mostly young women and causes significant morbidity. Most patients are refractory to glucocorticoids (GC) or relapse when GC doses are reduced. The objective of this study is to summarize the literature pertaining to the effectiveness of non-GC drugs for the treatment of TAK.

On the mechanisms of ageing suppression by dietary restriction-is persistent glycolysis the problem?

The mechanism(s) by which dietary restriction (DR) suppresses ageing and onset of age-related pathologies are discussed in relation to frequency of glycolysis, and the reactivity of glycolytic intermediates. Most glycolytic intermediates are potentially toxic and readily modify (i.e. glycate) proteins and other macromolecules non-enzymically. Attention is drawn to the reactivity of methyglyoxal (MG) which is formed predominantly from the glycolytic intermediates dihydroxyacetone- and glyceraldehyde-3-phosphates. MG rapidly glycates proteins, damages mitochondria and induces a pro-oxidant state, similar to that observed in aged cells. It is suggested that because DR animals' energy metabolism is less glycolytic than in those fed ad libitum, intracellular MG levels are lowered by DR The decreased glycolysis during DR may delay senescence by lowering intracellular MG concentration compared to ad libitum-fed animals. Because of the reactivity MG and glycolytic intermediates, occasional glycolysis could be hormetic where glyoxalase, carnosine synthetase and ornithine decarboxylase are upregulated to control cellular MG concentration. It is suggested that in ad libitum-fed animals persistent glycolysis permanently raises MG levels which progressively overwhelm protective processes, particularly in non-mitotic tissues, to create the senescent state earlier than in DR animals. The possible impact of diet and intracellular glycating agents on age-related mitochondrial dysfunction is also discussed.     

Stages of Development of the Ribosome-Lamella Complex: An Ultrastructural Study

Ribosome-lamella complexes (RLC) are intracytoplasmic organelles observed in a wide variety of disorders, but mostly in hematologic malignancies. Although their close topographic relationship with rough endoplasmic reticulum (RER) suggests their derivation from it, their development and functional role are unclear. Their maturation phases were studied in 20 cases (19 hematologic neoplasms and 1 parathyroid adenoma) where electron microscopy had evidenced their presence. In 19 of these cases, RLC were in an advanced stage of maturation, whereas in one (acute monoblastic leukemia) they were observed in the early stages of development and appeared to arise from peculiar RER configurations within blast cells, which were rich in both organelles. In this case, the authors observed numerous RER cisternae with distinctive cylindric, concentric and/or whorl configurations, RLC associated and not associated with these configurations, and intermediate structures. The latter were characterized by lamellae devoid of ribosomes oriented parallel to the RER configurations. Reticulum configurations were observed in no other case. The ultrastructural aspects observed in these 20 cases suggest that RLC synthesis proceeds as follows: (1) arrangement of RER in cylindric configurations; (2) synthesis of lamellae oriented parallel to the cylindric configurations (pre-RLC); (3) formation of RLC when ribosomes appear between the lamellae associated with configurations (immature RLC); (4) formation of mature RLC with disappearance of the reticulum.     

Das Eindringen Äu\erer thermischer Störungen in den Körper homoiothermer Lebewesen,Teil I

Zusammenfassung Es wird die allgemeine Bedeutung der mittleren Krümmung für WÄrmeleitungsprobleme begründet und eine Symmetrie mit konstanter mittlerer Gesamtkrümmung der IsothermenflÄchen definiert. Die Anwendbarkeit auf Körperformen homoiothermer Lebewesen wird dargelegt und die WÄrmeleitungsgleichung für diesen Fall aufgestellt. Im Zusammenhang mit der Quellen-funktion wird durch Definition der WÄrmefreisetzung = WÄrmeproduktion + konvektive Scheinproduktion die Reduktion auf ein WÄrmeleitungsproblem erreicht, auch wenn konvektiver WÄrmetransport im Körper des Homoiothermen vorliegt. Es werden Formeln für die WÄrmeabgabe und Gleichgewichts-Temperaturprofile im Körperinnern gebracht. Für den Fall sprunghafter Änderung der WÄrmeabgabe wird die WÄrmeleitungsgleichung gelöst und eine einfache Formel unter Verwendung dimensionsloser Koordinaten abgeleitet. Die mittlere Krümmung ¯H erweist sich als der Parameter, der den örtlich-zeitlichen Temperaturverlauf am stÄrksten beeinflu\t. Die Lösung lÄ\t unschwer die Bedeutung der thermischen TrÄgheit des Warmblüterkörpers erkennen, weil die Äu\eren Störungen stark zeitlich phasenverschoben in den Körper eindringen.     

Effects of ability- and chance-determined competition outcome on testosterone

Winning competitions has been shown to lead to higher testosterone (T) relative to losing in men and males of other species. In Experiment 1, 38 women and 37 men provided a saliva sample, completed a novel computer-based vocabulary competition task at which they won or lost based on their own ability, provided feedback about the competition via questionnaire, and then produced a second saliva sample. Task outcome and performance was not sexually differentiated, and overall task performance was negatively correlated with T. Male but not female winners had lower baseline and post-competition T, and male losers had a larger decrease in T from baseline to post-competition. In Experiment 2, 31 men and 43 women completed the same as above, but were randomly assigned to win or lose. In this case, competition outcome did not affect T for men but there was an effect such that women who would have had an ability-determined loss showed a larger decrease in T than women who would have had an ability-determined win. Thus, earned wins appear to attenuate a decline in T in men, consistent with past research into the competition effect and T, and perhaps women under complex circumstances.