A Japanese case of Behçet’s disease complicated by recurrent optic neuropathy involving both eyes: a third case in the English literature

Abstract

We report a case of acute optic neuropathy with Behçet’s disease (BD) in a 27-year-old man. The patient experienced two episodes of acute optic neuropathy in one year. The first was in the right eye and the second was in the left eye. In both episodes, several months before acute optic neuropathy developed, oral and genital ulcers, erythema nodosa and epididymitis were noted. The patient was diagnosed with BD. High-dose systemic corticosteroid resulted in clinical improvement in both episodes. Neurological involvement in BD is well known. Brainstem disturbance, meningomyelitis and palsy involving cranial nerves VI, VII have been reported. However, optic neuropathy in BD is very rare. This case suggests that optic neuropathy can affect both eyes and be recurrent. This case provides clinical insight into optic nerve involvement in BD.     

紫芝中的一个新三萜

目的研究紫芝Ganoderma sinense子实体的化学成分。方法通过反复硅胶、凝胶柱色谱进行分离纯化,利用多种波谱技术鉴定化合物的结构。结果分离鉴定了4个化合物,分别为紫芝酸(sinensoic acid,1)、cere-broside D(2)、poke-weed cerebroside(3)、泥湖鞘鞍醇(hemisceramide,4)。结论化合物1为新化合物,命名为紫芝酸(sinensoic acid),其余化合物均为首次从灵芝属真菌中分离得到。     

Relationship between lipogenesis,ketogenesis, and malonyl-CoA content in isolated hepatocytes from the obese Zucker rat adapted to a high-fat diet

The relationship between lipogenesis and ketogenesis and the concentration of malonyl coenzyme A (CoA) was investigated in hepatocytes from adult obese Zucker rats and their lean littermates fed either a control low-fat diet or a high-fat diet (30% lard in weight). With the control diet, lipogenesis—although strongly inhibited in the presence of either 1 mmol/L oleate, 10^?6 mol/L glucagon or 0.1 mmol/L TOFA (a hypolipidemic drug)—remained about fifteen-fold higher in the obese rats than in the lean rats. In contrast, ketogenesis under some conditions (oleate + TOFA) was not significantly lower (30%) as compared with the lean rats. After adaptation to the high-fat diet, lipogenesis was depressed fourfold in the lean rats and ninefold in the obese ones; however its magnitude remained significantly higher in the latter, namely at a value close to that measured in control-fed lean rats. Ketogenesis was comparable in lean and obese rats and much higher in the presence of 1 mmol/L oleate than of 0.3 mmol/L oleate, whereas lipogenesis did not vary with increasing oleate concentration in the medium. Acetyl-CoA carboxylase activity measured in liver homogenates was higher in the obese group, but was stepwise inhibited by increasing concentrations of oleyl-CoA regardless of the diet for both lean and obese rats, thus showing no abnormality of in vitro responsiveness to this inhibitor. With the control diet, hepatocyte malonyl-CoA levels were significantly higher in the obese rats, both in the basal state and after inhibition of lipogenesis by oleate and TOFA. However, after the high-fat diet, there was no longer a significant difference between the genotypes. These results show that in the obese Zucker rats, ketogenesis is dependent on hepatocyte malonyl-CoA content in the sense that their ketogenic capacity becomes “normalized” when malonyl-CoA is decreased to the levels found in the lean littermates, as it is the case after fat-feeding. This normalization of malonyl-CoA levels in spite of higher lipogenesis in the obese rats may result from the activities of enzymes of its formation and utilization.     

Existence of asymptomatic changes in left ventricular function in the diabetic. Noninvasive study

49 diabetics (D) (26 IDD and 23 NIDD) were compared to 32 controls (C). Absence of ischemic cardiopathy (IC) was confirmed by routine investigations and noninvasive cardiovascular techniques, including an exercise ECG using 12 leads and a thallium 201 scintigraphy. Our results show: a) a prolonged mean isovolumetric relaxation time (IVRT) as studied by the M mode echocardiography and phonomechanography: D = 0,10 sec +/- 0,04; C = 0,05 sec +/- 0,02; p less than 0,0001; b) a reduced mean EF slope: D = 97,48 +/- 37,08 mm / sec; C = 125,68 +/- 34,35; p less than 0,005; c) a high mean Weissler index (ratio of PEP to LVET): D = 40 +/- 0,08; C = 33 +/- 0,05; p less than 0,01. IVRT and EF slope abnormalities are related to increased myocardial stiffness and impaired LV compliance. In the absence of changes in preload and afterload, the high Weissler index reflects impaired contractility of the myocardium. These abnormalities are related neither to the duration of diabetes nor to the presence or severity of the complications. With the M mode echocardiography, mean diastolic and systolic thickness of the septum is greater in D with retinopathy than in C (p less than 0,005 and p less than 0,03 respectively); mean diastolic and systolic thickness of the posterior wall is greater in NIDD than in C (p less than 0,001 and p less than 0,025). We conclude that there is evidence of left ventricular functional abnormalities specific to diabetes and unrelated to IC and hypertension. Our findings support the hypothesis that they may be due to metabolic disorders and/or myocardial microangiopathy.     

Effect of exogenous insulin on glucose kinetics in rats with noninsulin-dependent diabetes

Noninsulin-dependent diabetes (NIDD) was induced in adult female rats by neonatal administration of streptozotocin. Despite elevated basal plasma glucose values in the postabsorptive state (196 +/- 16 mg/100 mL as compared to 118 +/- 7 in the controls), the glucose disappearance rate measured after the intravenous glucose load was not significantly lower in the diabetic than in control rats. In contrast, in vivo glucose-induced insulin release was drastically reduced, thus suggesting that endogenous insulin was more effective on the target tissues of the diabetic rats. Glucose kinetics (glucose production, utilization, and clearance) in response to intravenous insulin injection were studied in anesthetized postabsorptive diabetic and control female rats using [6-3H] glucose. With a maximal dose of insulin (0.5 U/kg body weight) no difference in blood glucose-lowering effect of insulin was found between the 2 groups. With 2 submaximal insulin doses (0.15 and 0.3 U/kg body weight), glucose production was inhibited more rapidly and more efficiently in diabetic rats than in control rats: 2 minutes after the 0.15 U/kg insulin injection, endogenous glucose production fell by 79 +/- 5% in the diabetics while being unchanged in the controls and the maximal decrease of glucose production after the same insulin injection was significantly greater in the diabetic rats (79 +/- 5% at 2 minutes) compared to the controls (33 +/- 4% at 6 min). The rise of glucose clearance in response to insulin was not significantly different in the 2 groups. These findings are discussed in view of the increased insulin clearance rate in these diabetic females.(ABSTRACT TRUNCATED AT 250 WORDS)     

Non-invasive assessment of bleeding pulmonary artery aneurysms due to Behçet disease

Because of its ability to depict intravascular, intramural, and extramural pathology, non-invasive imaging is well suited to assessing life-threatening hemoptysis that may complicate Beh?et disease. We made exclusive use of CT angiography supplemented by MR to identify pulmonary thromboembolism, mediastinal lymphadenopathy, and bilateral pulmonary artery aneurysms with signs of previous unilateral rupture. Two-dimensional reformatted CT images provided surgeons with a road map of upstream and downstream vascular relationships prior to aneurysm resection. Imaging findings were confirmed by surgery and pathology. Non-invasive imaging proved to be a useful alternative to standard catheter arteriography in the preoperative assessment of hemoptysis in this patient with Beh?et disease. Received 2 April 1997; Revision received 20 June 1997; Accepted 1 September 1997     

应用苯妥英钠后急性低压缺氧条件下大鼠脑单胺递质的变化

目的探讨苯妥英钠（Ｄｉｐｈｅｎｙｌｈｙｄａｎｔｏｉｎ，ＤＰＨ）在急性缺氧条件下的脑保护作用。方法给大鼠应用ＤＰＨ，用荧光分光法检测其在低压舱模拟升空７．５ｋｍ后１ｈ、２ｈ的脑匀浆单胺递质含量，同时观察脑细胞形态学改变。结果ＤＰＨ实验组在缺氧１ｈ及２ｈ时脑多巴胺和５－羟色胺含量升高（Ｐ＜０．０５），而脑去甲肾上腺素在缺氧１ｈ时降低（Ｐ＜０．０５），缺氧２ｈ恢复正常。电镜形态学观察，低压缺氧条件下对照组大鼠脑细胞水肿，线粒体嵴严重缺失，细胞核明显变形；应用ＤＰＨ的实验组细胞形态基本正常。结论给大鼠应用苯妥英钠后，在急性缺氧条件下，动物脑单胺递质含量的变化可能与缺氧适应或耐受的形成有关。     

复方红芪减方对周围神经再生影响的实验研究

目的　研究复方红芪提取液进行减方后对周围神经再生的作用。方法　建立钳夹损伤大鼠双侧坐骨神经的动物模型。按术后每日灌服药物的不同将 40只SD雄性大鼠随机均分为 4组。对照组 :灌服生理盐水 ;复方红芪组 :灌服复方红芪提取液 2ml ;减方组 :灌服复方红芪减方后提取液 2ml;补阳还五汤组 :灌服补阳还五汤 2ml。术后 2周及 4周 ,观察坐骨神经功能指数、运动神经传导速度及单位视野有髓神经纤维计数。结果　坐骨神经功能指数 :红芪组和减方组与对照组、红芪组与减方组的差异均有显著意义 (P >0 .0 5 ) ,且减方组优于红芪组 (P >0 .0 5 )。有髓神经纤维计数 :复方红芪组优于对照组 (P<0 0 1) ,减方组明显优于对照组 (P <0 .0 1) ,而红芪组与减方组间无显著差异。运动神经传导速度 :红芪组、减方组、补阳还五汤组与对照组相比 ,均优于对照组 (P <0 .0 5 ) ,但前 3组间无明显差异。结论　复方红芪减方提取液早期可以促进周围神经再生 ,药效更为专一 ,且优于传统方剂补阳还五汤。