Left ventricular function in children with the Marfan syndrome

Aortic dilatation and heart valve lesions are common in theMarfan syndrome but whether primary alterations occur in leftventricular (LV) function has not been studied hitherto. LVsize, mass and systolic as well as diastolic function were studiedby M-mode and Doppler echocardiography and cine magnetic resonanceimaging in 22 Marfan children aged 3.0–15.4 years andin 22 age-matched healthy children. No child had significantvalve disease. Heart rate and systolic blood pressure were comparablein the groups but diastolic blood pressure was higher in thecontrols (67 ± 7 mmHg vs 62 ± 8 mmHg, P=0.030).No statistically significant differences were found in LV size,mass or systolic function. The Marfan children had slower LVpeak diameter lengthening rates (106 ± 27 mm s^–1vs 132 ± 29 mm. s^–1, P=0.004), prolonged relaxationtimes (155 ± 22 ms vs 140 ± 19ms, P=0.023), slowerdeceleration of the early transmitral velocity (580 ±144 cm.s^–2 vs 720 ± 160 cm. s^–2, P=0.006),and smaller early-to-late peak velocity ratios (1.99 ±0.40 vs 2.29 ± 0.46, P=0.031). These data indicate thatI.V early diastolic function (relaxation) is impaired in theMarfan syndrome. Weakened elastic recoil due to the underlyingconnective tissue abnormality may best explain this novel observation.     

The schistosomulicidal activity and the production of IL-1 and TNF-α by peritoneal macrophages from infected mice and their potentiation by muramyl tripeptide-phosphatidyl ethanolamine (MTP-PE) treatment

Production of TNF-α and IL-1 by adherent peritoneal exudate macrophages (APEM) was monitored for 20 weeks in Schistosoma mansoni infected mice in comparison to their schistosomulicidal activity. LPS-triggered IL-1 and TNF-α production by APEM peaked 10 weeks post infection (p.i.) and declined thereafter. The schistosomulicidal activity of APEM also peaked after 10 weeks but remained elevated thereafter. Infected mice were also treated with the immunostimulator liposomal muramyl tripeptide-phosphatidyl ethanolamine (MTP-PE) 6 or 10 weeks p.i., and their APEM were tested 4 weeks later. APEM from such treated animals showed elevated IL-1 and TNF-α production when treatment commenced 6 weeks p.i., while their schistosomulicidal activity increased when treatment commenced either 6 or 10 weeks p.i. The L-arginine inhibitor, N^G monomethyl arginine, markedly inhibited the schistosomulicidal activity but not the IL-1 and TNF-α production of APEM. Our results show that monokine production increases during the acute phase of infection and declines during its chronic phase, while macrophage schistosomulicidal activity remains constant throughout. Furthermore, TNF-α or IL-1 may play a minor role in APEM mediated killing of schistosomula.     

Modern Methods for Reliable Preoperative Localization of Insulinoma

A case of insulinoma is reported in which the correct localization of tumor was made with PTP and immunoreactive insulin values from the portal venous system and in which pancreas angiography indicated a false positive tumor localization. PTP should be done to every patient to confirm the preoperative location of the insulinoma(s).     

Neurophysiological correlates of mental arithmetic

Thirteen subjects were extensively trained on nine multiplication problems varying in difficulty. Practice was associated with a reaction time speed up and an attenuation of the problem size effect. The introduction of previously unpracticed problems led to a performance rebound to pretraining levels, indicating practice specificity. The event-related potentials were characterized by a late positive complex, followed by a positive slow wave. Offset latency of positive slow wave and preresponse amplitude at parietal electrodes showed practice specificity effects that systematically changed with practice and problem size, indicating an association with the load imposed on working memory. The peak of the late positive complex probably reflects task learning or adaptation effects because it was attenuated by practice predominantly at frontal electrodes, showed no practice specificity, and was not affected by problem size.     

Behavioural changes and children's memories after intravenous, inhalation and rectal induction of anaesthesia

Ninety two-to-seven-year-old children admitted for routine day case ENT operations were randomly allocated to have either intravenous thiopentone (group I), halothane inhalation (group II) or rectal methohexitone (group III) for anaesthesia induction. Using a postoperative questionnaire, the parents evaluated the changes in the child's behaviour one day, one week and one month after the operation. Problematic changes were detected in 17 (59%) children in group I, 14 (50%) in group II and 17 (58%) in group III (NS). Although the children in group II behaved most calmly during the induction they had significantly more negative memories of the induction of anaesthesia (six children in group II vs two in group I and one in group III) and of the hospital in general (17 in group II vs 11 in group I and eight in group III) than children in the other groups. Judging from memories of young children, intravenous and rectal inductions are less distressing to them than inhalational induction.     

EVIDENCE OF RIBOFLAVIN DEPLETION IN BREAST-FED NEWBORNS AND ITS FURTHER ACCELERATION DURING TREATMENT OF HYPERBILIRUBINEMIA BY PHOTOTHERAPY

Abstract. Phototherapy in the treatment of newborns with hyperbilirubinemia, resulting in degradation of bilirubin, also appears to have other photodynamic effects on metabolism. We studied flavin adenine dinucleotide (FAD) saturation of erythrocyte glutathione reductase, which should reflect riboflavin nutritional status, in 28 healthy newborns, and followed 37 newborns with hyperbilirubinemia prior to the start of and during phototherapy. The results indicate that healthy newborns on human milk feeding, relatively poor in riboflavin, have evidence of a transient riboflavin depletion soon after birth. This effect is made more pronounced by phototherapy and partially prevented by parenteral or oral administration of moderate amounts of riboflavin.     

Impact of streptozotocin-induced diabetes on rat blood and alveolar bone affected by occlusal stress

Abstract – Adult male and female rats were used as test animals. The experimental diabetes, mellitus was provoked with one dose of i.v. injection of streptozotocin (65 mg/kg body weight), which interferes with the insulin release mechanism in pancreatic β cells. After a follow-up period of 10 wk an average loss of 10% of body weight and an increase of 25% in the amount of blood obtained by decapitation was recorded in the test animals. The biochemical assays performed on the serum of the diabetic rats showed, for both sexes, a fourfold rise in the plasma glucose level, a threefold rise in plasma alkaline phosphatase activity and plasma alanine transferase activity as well as a 1.5-fold rise in plasma creatine value. The two latter values indicated systematic disorders reflected in the liver and the kidneys. An increase in serum total calcium and hydroxyproline values was also detected. The clinical studies of the gingiva showed diminished tissue resistance in diabetic rats. The histologic studies of alveolar bone revealed retarded formation of bone matrix and new bone in diabetic animals. However, the stimulated metabolism in alveolar bone, due to the artificially induced stress, increased marginal bone cell activity in both the diabetic and the control group, resulting in increased crestal resorption in the former group. The differences in tissue response observed among the diabetic animals affected and unaffected by stress originated from the disturbed recovering mechanism typically found in diabetic animals.     

Diseases Mimicking Thrombosis of the Limb – A Retrospective Radiological Study

To demonstrate misinterpretation of phlebography findings we present 14 cases, which were first diagnosed as deep vein thrombosis, but later turned out to be caused by expansive processes around veins, e.g. popliteal cyst, haematoma, muscle necrosis and abscess.