Benign intracranial hypertension and recombinant growth hormone therapy in Australia and New Zealand

Benign intracranial hypertension (BIH) is reported in three children from Australia and one from New Zealand, who were being treated with recombinant human growth hormone (rhGH). Three males and one female, aged between 10.5 and 14.2 y, developed intracranial hypertension within 2 weeks to 3 months of starting treatment. A national database, OZGROW, has been prospectively collecting data on all 3332 children treated with rhGH in Australia and New Zealand from January 1986 to 1996. The incidence of BIH in children treated with growth hormone (GH) is small, 1.2 per 1000 cases overall, but appears to be greater with biochemical GHD (<10IUml ^-1), i.e. 6.5/1000 (3 in 465 cases), relative risk 18.4, 95% confidence interval 1.9-176.1, than in all other children on the database. The incidence in patients with Turner's syndrome was 2.3/1000 (1 in 428 cases). No cases in patients with partial GHD (10–20 IUml ^-1) or chronic renal failure were identified. Possible causative mechanisms are discussed. The authors'practice is now to start GH replacement at less than the usual recommended dose of 14IUm-² week^-1 in those children considered to be at high risk of developing BIH. Ophthalmological evaluation is recommended for children before and during the first few months following commencement of rhGH therapy and is mandatory in the event of peripheral or facial oedema, persistent headaches, vomiting or visual symptoms. The absence of papilledema does not exclude the diagnosis.     

O,O′-二烷基-O″-(5-取代-3-苯并噻吩乙腈肟)磷酸酯及硫代磷酸酯的合成

合成了18个O,O′-二烷基-O″-(5-取代-3-苯并噻吩乙腈肟)磷酸酯及硫代磷酸酯类化合物(Ⅰ_1～18)。初步杀螺试验结果表明,其中5个化合物,即Ⅰ_2,3,7,11,12有明显的杀螺增效作用。     

Normal anatomy of the lumbosacral spine and pelvis. A correlation of SPECT and radiographic techniques

SPECT of the lumbosacral spine and pelvis is an advancement over planar imaging, which allows for improved lesion detection and more precise anatomic localization of an abnormality. Recognition of skeletal anatomy shown by SPECT is paramount for diagnostic accuracy as well as for meaningful consultations with referring physicians and diagnostic radiologists. This is a correlative study of normal anatomy of the lumbosacral spine and pelvis demonstrated by SPECT and radiography in order to assure that morphologic detail resulting from SPECT is recognized and matched with radiographic landmarks in the same area.     

The Complex Nature of Interactive Neuroregeneration-Related Molecules

We review the growing list of molecules that may be involved in wound healing in the central nervous system (CNS). It is known that many of these molecules are present during normal development and neoplastic growth in both neural and nonneural tissues, often in areas where pattern formation or tissue remodeling is evident; however, their functional roles are often quite elusive. In order to understand the changes that occur in and around a brain wound, we review proposed functions of neuroregeneration-related molecules in in vitro and in vivo preparations, as well as note their expression in other healing tissues including skin. A hypothesis that wound healing events in the CNS supersede neuritic growth around a lesion is presented. In contrast to the classical view of failed regeneration, there may be significant amounts of circuit reorganization that occur following injury, and such plasticity may be further enhanced by manipulating the molecular environment around a brain wound and in synaptically related structures.     

Platelet satellitism: experimental studies

Platelet satellitism (PS), the in vitro phenomenon of platelets rosetting about nonlymphocytic leukocytes, is an uncommon and poorly understood finding reported in the ethylenediaminetetra-acetic acid (EDTA)-anticoagulated blood of patients with a wide variety of clinical conditions. This report presents experimental studies investigating the nature of this phenomenon by utilizing the blood of patients with platelet satellitism. Wet preparation studies and electron microscopy (transmission and scanning) demonstrated the morphologic sequences involved in the phenomenon, including eventual phagocytosis of platelets by neutrophils. The results of varying conditions such as time, temperature, and anticoagulant are described. All of five patients tested were found to have cryofibrinogenemia. Certain blood components from all of three patients tested were capable of inducing PS in normal whole blood, whereas components from normal subjects usually were not. In one patient (A), the PS-inducing capability appeared to be present in both plasma and platelets. In another patient (B) the PS-inducing capability was present in platelets (in both 1966 and 1975) and also in the cryosupernate of serum and plasma; among various antisera, antifibrinogen had the greatest ability to reduce the degree of PS in patient blood; addition of moderate amounts of CaCl2 and/or MgCl2 did not diminish the phenomenon; and two sisters and two daughters demonstrated no PS. In a third patient (C) the PS-inducing capability appeared to be largely concentrated in the cryoprecipitable fraction of plasma. These studies suggest that there are different factors in the patients' blood resulting in PS. Further studies showed PS could be induced in normal blood by adding certain nonprimate antihuman antisera (anti-IgM, antialbumin or antifibrinogen) and also by adding some preparations of normal washed platelets to the same individuals's normal whole blood. This indicates that the phenomenon of PS can be produced by factors other than those specifically present in patients with PS. Antigen-antibody complexes, either formed in vivo (mixed cryoglobulinemia) or in vitro, did not result in PS when mixed with normal blood. These and other studies suggest that PS can result from the presence of several different factors, usually proteins (in conjunction with EDTA), which probably attach to the surface of platelets apparently resulting in some alteration (such as change in surface charge) causing the platelets to be attracted to and phagocytosed by neutrophils.     

CT metrizamide myelography in syringomyelia: sensitivity and specificity

In a retrospective study of 32 patients with "proven" syringomyelia and 15 patients with an alternate proven diagnosis, a change in the caliber of the spinal cord with different positions ("collapsing cord sign or cord collapse") had a sensitivity of 38% and a specificity of 87%. Central cord enhancement ("bull's-eye") on delayed CT had a sensitivity and specificity of 91% and 87%, respectively. The positive predictive value of cord collapse was 87%, while the positive predictive value of central cord enhancement was 94%.