MMPI profiles of acute and chronic PTSD in a civilian sample

In a treatment setting, a group of 165 subjects presenting with either acute or chronic posttraumatic stress disorder (PTSD) were compared to 72 subjects presenting with panic disorder only in order to determine whether the MMPI PTSD assessment strategy developed with Vietnam veterans could be validly used with civilians. Results indicated that the MMPI profile, codetype, diagnostic decision rule, and PK scale developed with samples of Vietnam veterans did not apply well to civilians, especially those presenting with acute PTSD. It is thus recommended that specific assessment strategies be developed for these populations.     

Cholangiographic features in fibrosis and cirrhosis of the liver

The cholangiographic features of intrahepatic bile ducts associated with cirrhosis or fibrosis are not well known. In order to achieve a radiological—pathological correlation, we studied nine livers with fibrosis or cirrhosis excised at autopsy. Cholangiograms were obtained within 24 hr after death from the nonfixed liver and multiple tissues samples were taken for histologic examination. Radiological data were interpreted by two independent investigators blinded to the clinical and histological findings. Cirrhosis (alcoholic in 4, posthepatitis in two) was observed in six livers, fibrosis (alcoholic in 2, posthepatitis in one) in three. No liver with fibrosis had cholangiographic abnormalities. In contrast, cholangiography of all livers with cirrhosis was abnormal. Abnormalities were a diminished arborization, a decrease of the distal opacification, an irregularity of caliber, and a tortuous course of the bile ducts. Histological study showed that the irregular and tortuous course were due to compression of the bile ducts by regenerative nodules. Furthermore, a thick fibrosis was organized around the bile ducts. In conclusion, fibrosis alone was not associated with cholangiographic abnormalities. In cirrhotic livers, intrahepatic bile ducts showed an irregular and tortuous course, a diminished arborization and a decrease of the distal opacification. These abnormalities were secondary to the presence of regenerative nodules and fibrosis organized around the bile ducts.     

Effect of Cigarette Smoke on UDP-Glucuronosyltransferase Activity and Cytochrome P450 Content in Liver,Lung and Kidney Microsomes in Mice

Abstract: The effect of cigarette smoke on the expression of several cytochromes P450 (CYP) and UDP-glucuronosyltransferases (UGT) was studied in mice. The animals were exposed to cigarette smoke for 4 to 30 days. Enzymatic activities supported by CYP1A1, 1A2, 2B, 2E1 and the glucuronidation activity toward phenols were measured in lung, liver and kidney microsomes. Cigarette smoke induced several CYPs, especially in lung. CYP2E1 was more induced than CYP1A1 in this organ. The expression of CYP2E1 was also increased in kidney (5.6 times after 30 days). The glucuronidation in kidney was non-sensitive to the treatment whatever substrate used. In contrast, this activity was enhanced in liver and particularly in lung, in which the glucuronidation of 1-naphthol and 2-hydroxybiphenyl was increased by 122 and 180%, respectively. Interestingly, the times of induction differed according to the substrate used, thus suggesting the presence of different UGTs active toward phenols that were differentially affected by cigarette smoke. The LIGT activities toward phenols were low in lung, when compared with those measured in liver or kidney. In conclusion, cigarette smoke greatly affected both glucuronidation activity and the hydroxylation reactions supported by CYPs in mouse liver and lung.     

Anti-immunoglobulin antibodies IV. Cross-reaction of anti-idiotypic antibodies specific for rabbit and murine anti-a1 allotype antibodies with Fc fragment of human immunoglobulins

Anti-idiotype (Id) antibodies against anti-a₁ rabbit allotype antibodies were produced in rabbits and mice by immunization with polyclonal rabbit anti-a₁ allotype or with a monoclonal murine anti-a₁ allotype antibody, respectively. These antibodies recognize an interspecies cross-reactive idiotope on anti-a₁ allotype antibodies. However, these anti-Id antibodies also react with various subclasses of human IgG. In multiple systems, it was shown that these anti-Id antibodies interact with the Fc fragment of human IgG and, therefore, exhibit a rheumatoid factor-like activity. These results support the hypothesis that γ-globulin may not be the only stimulus to clones producing rheumatoid factors and that perhaps other antibodies, especially anti-Id antibodies, also bind γ-globulin secondarily.     

Renin in hypertension: how important as a risk factor?

An analysis of the plasma renin levels in relation to the incidence of severe cardiovascular complications (coronary thrombosis, stroke, ruptured aortic aneurysm) was made in 325 patients with various types of hypertension. These patients had one to four measurements of plasma renin activity taken under standard conditions of sodium intake and posture in the period 1963-68. The follow-up was 5 to 10 years in the four groups of hypertensive patients (essential hypertension, malignant hypertension, hypertension secondary to renal parenchymatous disease and hypertension caused by, or associated with, renal artery obstruction). For all 325 patients, the incidence of such complications was 23.6, 20.4 and 44.7% in the low, normal and high renin groups. These findings are at variance with the claim that renin constitutes a serious risk factor in hypertensive patients, especially if it is isolated from other parameters such as the level of diastolic pressure, the adequacy of kidney function, the effectiveness of dietary and drug management of hypertension, and especially the presence or absence of atherosclerotic lesions of the large vessels at the time of the renin determination.     

Perforation of the Pharynx in the Newborn: A Condition Mimicking Esophageal Atresia

Three cases of perforation of the pharynx in the newborn are presented. This condition resembles esophageal atresia, in that: (a) the symptoms are identical; (b) in both conditions there is failure to pass a nasogastric tube; (c) opacification of the esophagus through a nasogastric tube gives x-ray pictures confusingly similar. Careful examination of the radiographs can differentiate the two conditions. Although the three patients presented were operated on, conservative treatment is probably adequate for this condition.     

The 4-O-methyl metabolites of catecholamines. Homo-iso-vanillin acid in rat urine and brain; urinary iso-vanyl compounds after intraperitoneal administration of dopamine and of dopamine precursors and derivatives

Homo-iso-vanillic acid (3-hydroxy, 4-methoxyphenylacetic acid, iso-HVA was detected in rat urine and brain, with a molar ratio of iso-HVA to HVA of 0·07 in urine and about 0·35 in brain. The free urinary iso-vanyl and vanyl phenolcarboxylic acids were studied after intraperitoneal loads with the following compounds: l-dopa, $\text{l}\text{-3-O-}\text{methyldopa}\text{,}\text{l}\text{-4-O-}\text{methyldopa}$, dopamine, 3-O-methyldopamine, 4-O-methyldopamine and 3,4-dihydroxyphenylacetic acid. The results suggest the following conclusions. (1) The molar ratio iso-HVA/HVA is not constant. After dopa as well as dopamine loads it rises with the increase of the dose of precursor administered, showing that, in vivo, the 4-O-methylation process depends, to some extent, on the substrate concentration. (2) In contrast with the other catechols (dopamine and 3,4-dihydroxyphenylacetic acid), l-dopa itself does not seem to be para-O-methylated. It is therefore unlikely that 4-O-methyldopa would be a metabolite of l-dopa in vivo. (3) Distinct urinary metabolites from $\text{l}\text{-3-O-}\text{methyldopa}$ (vanylmandelic and vanillic acids) on one hand and from l-4-O-methyldopa (unknown iso-vanyl phenolcarboxylic acid) on the other, support evidence that some of the metabolic transformations of the side-chain of the O-methyl-catecholamines are different according to whether the methyl group is bound on the meta or on the para position. (4) The high level of cerebral iso-HVA might be due to either a lower iso-HVA than HVA transport outside the brain, or to the existence, in addition to the dopamine source, of a second cerebral metabolic pathway for the production of iso-HVA.     

Recent developments in French public mental health

Sectorization, which began as a glorious underground movement, is now official French policy-and so, inevitably, some of the romance and intense dedication has faded.Despite budget cuts for personnel, programs, and new construction, an administrative structure has been created to provide an adequate standard of community mental health for the French people.