Total body water and the exchangeable hydrogen. I. Theoretical calculation of nonaqueous exchangeable hydrogen in man.

A theoretical calculation of the total nonaqueous exchangeable hydrogen in protein, carbohydrates, and fat in man has been made. It shows that of the total exchangeable hydrogen in the body 5.22% is located in biochemical components, soluble in body water, containing hydrogen that is exchangeable with the isotope. This value represents a maximum upward distortion of total body water measurements by isotope dilution, due to the maximum possible exchangeability in these molecular conformations. From comparative measurements reported in the literature it is clear that this maximum is not achieved during the short period of time during which tritium-dilution studies are performed. It is the authors' belief that the hard-to-exchange amide hydrogens described by Blout in the protein conformations account for this failure of the isotope to achieve complete exchange in the short time allowed.     

Total body water,extracellular water,plasma volume,and total body potassium in cirrhosis of the liver

Summary Extracellular water (EWC; 82-bromide), total body water (TBW; 3-THO), intracellular water (ICW=TBW-ECW), plasma volume (PV; 51-Cr), and total body potassium (TBK; 40-K) were studied in patients with cirrhosis of the liver (n=12) and in controls (n=12). ECW (39%), TBW (28%), ICW (19%), and PV (24%) increased, TBK (28%) however, decreased in cirrhosis. The results indicate that it is less the lean body mass, but rather the intracellular potassium concentration that is lowered (cirrhosis: 84±21 mmol/l ICW; controls: 115±23 mmol/l ICW). Decreased potassium per cell (mmol) and increased intracellular water are discussed as possible reasons for this. The correlation between TBK (%) and serum potassium (mmol/l) was found to ber=0.56 (p<0.002). Correlations between the biochemical parameters gamma-globulins, cholin esterase, serum sodium and serum albumin (g/l PV) and characteristic fluid disturbances in cirrhosis are highly significant whereas albumin (g/kg bodyweight) was the same in both groups. We can support the overflow theory of ascites formation [19].This paper is part of a medical doctorate of O. Schober     

A comparative morphologic study of the cardiac innervation in domestic animals II. The feline

Detailed morphological studies of the cardiac innervation of the cat were reported. Sympathetic cardiac nerves arose from the thoracic, cervicothoracic, vertebral, and intermediate ganglia. Parasympathetic cardiac nerves arose from the vagi, both cranial and caudal to the origin of the recurrent laryngeal nerves, and from the right recurrent laryngeal nerve. Left cardiac nerves passed primarily to the caudal and right surfaces of the left chambers while right ones ramified on the right chambers and left portion of the left chambers. Left cardiac nerves are more prominent around the coronary sinus and atrioventricular node, while right ones contribute more to the area of the sinoatrial node. Both sympathetic and parasympathetic nerves were followed to each chamber. Interconnections through the cardiac plexus facilitated overlapping of nerve distributions.     

A comparative study of the isolation of type II epithelial cells from rat,hamster, pig and human lung tissue

Data is reported on the reproducibility and purity of alveolar type II cell isolations from 4 species. Human and pig type II cells were isolated using a tissue slice method to remove blood and contaminating cells, whilst rat and hamster cells were isolated using the method of protease instillation. All cells were purified on Percoll gradients and by differential attachment. Cell type purity was assessed by phase contrast microscopy, electron microscopy (EM), percentage of cells alkaline phosphatase (AP) positive and percentage of cells staining strongly for NADPH dependent nitro blue tetrazolium reductase (NBT). These enzymes are considered as markers for type II and Clara cells respectively. The purity of all cell preparations was enhanced following 24 h culture on a biomatrix and whilst plating efficiency was similar for all species, the human tissue consistently yielded the highest purity of type II cells. All cells with lamellar bodies did not contain AP, and activity was variable between species. Further studies are needed to determine if NBT is equally non-specific as a cell marker enzyme. In summary, sufficient type II cells of high purity can be isolated thus permitting interspecies comparative studies to investigate the effects of selective and non-specific pulmonary toxins, but more specific marker enzymes are required to identify Type II and Clara cells.     

A new, reliable lower-body nociception device for unrestrained animals yields data comparable to a new portable version of the face-rub test

A novel lower body heating device is described for use in lower body analgesiometry with freely-moving, small animals. It consists of a resistor in contact with a hindlimb. The defensive biting response to heat shows reliable dose-response effects with morphine which compare well with our similar upper body device (Rosenfeld et al. 1978). Issues dealing with upper versus lower body nociception effects may be tested with the new device set described.     

Somatoparaphrenia: a body delusion. A review of the neuropsychological literature

A review of published brain-damaged patients showing delusional beliefs concerning the contralesional side of the body (somatoparaphrenia) is presented. Somatoparaphrenia has been reported, with a few exceptions, in right-brain-damaged patients, with motor and somatosensory deficits, and the syndrome of unilateral spatial neglect. Somatoparaphrenia, most often characterized by a delusion of disownership of left-sided body parts, may however occur without associated anosognosia for motor deficits, and personal neglect. Also somatosensory deficits may not be a core pathological mechanism of somatoparaphrenia, and visual field disorders may be absent. Deficits of proprioception, however, may play a relevant role. Somatoparaphrenia is often brought about by extensive right-sided lesions, but patients with posterior (parietal-temporal), and insular damage are on record, as well as a few patients with subcortical lesions. Possible pathological factors include a deranged representation of the body concerned with ownership, mainly right-hemisphere-based, and deficits of multisensory integration. Finally, the rubber hand illusion, that brings about a bodily misattribution in neurologically unimpaired participants, as somatoparaphrenia does in brain-damaged patients, is briefly discussed.     

Complex II deficiency—A case report and review of the literature

Complex II deficiency is a rare cause of mitochondrial respiratory chain defects with a prevalence of 2–23%. It is exclusively nuclear encoded and functions in the citric acid cycle by oxidizing succinate to fumarate and in the mitochondrial electron transport chain (ETC) by transferring electrons to ubiquinone. Of the four subunits, SDHA and SDHB are catalytic and SDHC and SDHD are anchoring. Mutations in SDHA and SDHAF1 (assembly factor) have been found in patients with CII deficiency and a mitochondrial phenotype. We present a patient with CII deficiency with a previously undescribed phenotype of dilated cardiomyopathy, left ventricular noncompaction, failure to thrive, hypotonia, and developmental delay. Also, a comprehensive review of 36 cases published in the literature was undertaken. The results show that CII deficiency has a variable phenotype with no correlation with residual complex activity in muscle although the phenotype and enzyme activities are comparable within a family. For some, the condition was fatal in infancy, others had multisystem involvement and some had onset in adulthood with mild symptoms and normal cognition. Neurological involvement is most commonly observed and brain imaging commonly shows leukoencephalopathy, Leigh syndrome, or cerebellar atrophy. Mutations in SDHAF1 are associated with leukoencephalopathy. Other organ systems like heart, muscle, and eyes are only involved in about 50% of the cases but cardiomyopathy is associated with high mortality and morbidity. In some patients, riboflavin has provided clinical improvement. © 2013 Wiley Periodicals, Inc.     

Pulmonary artery sarcomas. A review and report of a case

We examined a case of primary pulmonary artery sarcoma and reviewed 45 cases that we found previously reported in the English literature, with particular attention given to the pathologic features. These sarcomas involve the pulmonary arterial trunk, left and right main pulmonary arteries, pulmonary valve, and right ventricular outflow tract. They have prominent intravascular growth along the arterial intima. Lung involvement commonly occurs by direct extension through the pulmonary vasculature or by distant metastases. These sarcomas contain a variety of heterologous components and areas of bone, cartilage, and fibrous tissue may be remarkably well-differentiated. Management of these sarcomas will be aided by an understanding of their biologic behavior and pathologic features.     

Mesectodermal leiomyoma of the ciliary body: report of a case and review of the literature

Mesectodermal leiomyoma of the ciliary body is a rare benign tumor with double (muscular and neural) differentiation. This neoplasm is considered to originate from the ciliary body smooth muscle, a neural crest derivative. We report a case of mesectodermal leiomyoma of the right eye occurring in a 53-year-old woman, who presented with significant decrease of visual acuity. A malignant melanoma was highly suspected on clinical evaluation, and the globe was enucleated. The tumor measured 1.2cm in greatest dimension, and consisted of spindle and ovoid cells with abundant fibrillary cytoplasmic processes. Immunohistochemical stains revealed positivity for smooth muscle actin, caldesmon, neuron-specific enolase, and CD56 antigen. A review of the 23 cases thus far reported in the literature shows a striking predilection for women, as well as significant difficulties in differentiating this tumor from malignant melanoma on clinical grounds.     

Leptomyxid ameba, a new agent of amebic meningoencephalitis in humans and animals.

Amebae belonging to the order Leptomyxida are regarded as innocuous soil organisms incapable of infecting mammals. We report here the isolation of a leptomyxid ameba from the brain of a pregnant baboon (Papio sphinx) that died of meningoencephalitis at the San Diego Zoo Wild Animal Park. By using rabbit anti-leptomyxid serum in the immunofluorescence assay, we have identified the leptomyxid ameba in the brain sections of a number of human encephalitic cases from around the world as well as a few cases of meningoencephalitis in animals in the United States, which suggests that the leptomyxid amebae are potential etiologic agents of fatal meningoencephalitis in humans and animals.     

Spondyloepimetaphyseal dysplasia of Maroteaux (pseudo-Morquio type II syndrome): report of a new patient and review of the literature

An 11-year-old girl was seen with short stature, a head positioned in hyperextension, mild arched palate, prominent joints, limited elbow movements, hyperextensible wrists and fingers, brachydactyly, broad thorax, pectus carinatum, short trunk, a genu valgum, and flat feet. A radiographic skeletal survey revealed a generalized osteoporosis, platyspondyly, thoracic kyphoscoliosis, small and square iliac wings, short femoral necks, dysplastic epiphyses, flared metaphyses and brachydactyly with various carpal, metacarpal, and finger malformations. These features are very close to a very rare entity: the spondyloepimetaphyseal dysplasia (SEMD) of Maroteaux or "pseudo-Morquio" type II syndrome, whose specific radiological characteristics are found in this case.     

Cancer diagnostic test of Field and Caspary: Part II. A review and interpretation of the collected data

Tables are presented showing data collected to date on the clinical trials of the macrophage electrophoretic mobility test for cancer of Field and Caspary. Seven variations on the original technique are summarized. The original antigen used in these tests was the basic protein of CNS myelin. Four additional proteins have been shown to function in these tests in place of the basic protein. There appears not to be a strong immunological crossreaction between these proteins. This paper discusses a possible solution to the problem of why non-crossreactive proteins appear to crossreact when testing cancer patients with the macrophage electrophoretic mobility related tests. All lymphocytes in saline suspension without added protein will aggregate. This is prevented in normals by the addition of some proteins to the culture, but is not so prevented in cancer and other diseases. Aggregation results in lymphokine release that makes the macrophage electrophoretic mobility test and variants positive. Aggregation occurs in the first incubation step of these tests and this non-immunological aggregation is the underlying phenomenon detected rather than specific antigen recognition as has been heretofore presumed.     

Cytogenetic profile of a thymoma. A case report and review of the literature

Cytogenetic analysis of mixed lymphocyte and epithelial thymoma in a nonmyasthenic female patient revealed deletion of part of the short arm of chromosome 6. To our knowledge, this cytogenetic abnormality in a benign thymoma has not been previously described in the literature, which is reviewed.     

Benign oesophageal papillomatosis. A case report with a review of the literature.

An 18-year-old boy presented with a four-year history of dysphagia which had been treated repeatedly by endoscopic removal of papillomata of the oesophagus. Eventually, due to increasing dysphagia and repeated recurrences of the papillomata, resection of the affected lower third of the oesophagus was deemed necessary. The resected segment of the oesophagus was carpeted with numerous benign squamous papillomata. The clinical features, radiographic appearances, and pathology of this extremely rare tumour are presented. Only two acceptable cases of oesophageal papillomata can be found in the literature, making this the third case, and apparently the only one with multiple lesions.     

Hodgkin's disease in sarcoidosis. A case report and a review of the literature

A patient with Hodgkin's disease preceded by sarcoidosis is presented and the difficulties introduced by the lack of specificity for the sarcoid-like granulomas to differentiate between the dual pathology are discussed. A review of the literature disclosed 9 similar case reports. It is suggested that the finding of non-caseating epithelioid cell granulomas in relatively old patients with lymphadenopathy, systemic symptoms and absolute neutrophil leucocytosis could be warning signals of the appearance of Hodgkin's disease.