Antibody-dependent Lymphocyte-mediated Cytotoxicity in Man: No Requirement for Lymphocytes with Membrane-bound Immunoglobulin

Normal human lymphocytes, depleted of B-lymphocytes by passage through nylon-wool columns, manifested intact antibody-dependent cell-mediated cytotoxicity. Similar findings were made with lymphocytes from four hypo-gammaglobulinaemic patients lacking B-lymphocytes. It is concluded that antibody-induced cell-mediated cytotoxicity in man is independent of B-lymphocytes, as identifiable by membrane-bound immunoglobulin.     

The effect of blood glucose regulation on retinal nerve fiber layer thickness in diabetic patients

PURPOSE: To evaluate the effect of blood glucose (BG) regulation on the retinal nerve fiber layer (RNFL) in diabetic patients by using a scanning laser polarimeter (NFA-GDx). METHODS: We prospectively assessed RNFL thickness in diabetic patients and an age-matched control group. Patients without diabetic retinopathy, with BG >250 mg/dl, HbA1c >8%, fructosamine >285 micromol/l and triglyceride >200 mg/dl were included in the study. RNFL assessment was performed before and after metabolic regulation of diabetes. Symmetry, superior maximum, ellipse modulation and the average thickness variables of NFA-GDx were used for the assessment. Mann-Whitney U and Wilcoxon tests were used for the statistical analysis. RESULTS: A total of 40 diabetic patients were included in the study and a repeat RNFL examination could be performed in 22 of them following regulation of BG levels. None of the GDx variables were significantly different between pre- and postregulation measurements (p > 0.05, Wilcoxon test). The mean superior maximum, ellipse modulation and average thickness values of the diabetic group were significantly lower than the control group (p < 0.05, Mann-Whitney U-test). CONCLUSIONS: Poor metabolic control of diabetes mellitus adversely affects the thickness of RNFL and this effect does not seem to be acute since it was not reversed by short-term BG regulation. This issue needs to be kept in mind when assessing glaucomatous progress in diabetic patients.     

Plasma growth hormone response to growth hormone-releasing hexapeptide (GH-RP-6) in children with short stature

Eighteen children with short stature were evaluated for growth hormone (GH) reserve after pharmacological tests and a single iv injection of GH-RP-6. These children were divided into two groups: 10 were diagnosed as having idiopathic GH deficiency by classical stimulation tests (group A) and the remaining 8 (group B) were considered growth-retarded children with normal GH secretion, following conventional stimulation, but reduced endogenous GH secretion. The results were compared with a group of 12 normal children. As a group, patients in group A showed a lower GH response to GH-RP-6, while patients in group B had a similar response as normal controls. However, on an individual basis, a considerable degree of overlapping in responses among the three groups was evident. These data indicate that, on an individual basis, GH-RP-6 testing is not of diagnostic value in children suspected of having idiopathic GH deficiency.GH deficiency, GH-RP-6, short stature C Dieguez, PO Box 563, 15705 Santiago de Compostela, Spain     

Epidural metastasis of testicular yolk sac tumor: an unusual cause of spinal cord compression. Case report

Testicular tumors in the pediatric age group are rare. Yolk sac tumor (YST) is the most common malignant tumor of germinal origin in this group, and it may spread to the retroperitoneal lymph nodes. We have been unable to find any previously published report of metastasis of testicular YST to the epidural space of the spinal cord presenting as a cause of spinal cord compression.     

Pars plana lensectomy with double-capsule-supported intraocular lens implantation in children

An alternative technique to manage pediatric cataracts comprises a pars plana lensectomy and anterior vitrectomy with anterior and posterior capsulotomies and posterior chamber heparin-surface-modified intraocular lens (IOL) implantation in the ciliary sulcus through a scleral tunnel. The surgical results in 7 eyes of 6 consecutive patients between 3.5 and 12.0 years old with developmental or traumatic cataract who had surgery using this technique were evaluated prospectively. Follow-up ranged from 12 to 19 months. All 7 eyes maintained a clear pupillary axis and a well-centered IOL from immediately after surgery to the last follow-up. Final best corrected visual acuity was 20/40 or better in 71% of cases.     

Effect of topiramate on enlargement of head in Canavan disease: a new option for treatment of megalencephaly

Canavan disease (CD) is a rare autosomal recessive genetic disorder characterized by early onset progressive spongy degeneration of the brain involving the axon's myelin sheath. Patients with CD have leukoencephalopathy and megalencephaly; clinically they show a variable course ranging from slow neurodegenerative course to no neurological development or rapid regression. Current treatment is symptomatic including management of seizures and spasticity. Topiramate (TPM) is a novel antiepileptic drug for treatment of a broad spectrum of seizure types in adults and children. We used TPM in two of our patients diagnosed with CD at six months of age. At seven months and 15 months' follow-up, respectively, each patient showed a decrease in head growth velocity. We suggest that TPM can be used in patients with CD and possibly in other childhood neurodegenerative diseases with leukoencephalopathy and megalencephaly. Further studies are required to reveal the underlying mechanisms that lead to decreased head growth velocity, and to conclude whether this ameliorates the clinical course of CD.