A factor released by monocytes in the presence of dexamethasone stimulates neutrophil locomotion.

1. Steroid-treated monocyte supernatants cause a dramatic increase in the speed of locomotion of human neutrophils and a significant decrease in their adhesion to protein-coated glass. In contrast, control monocyte supernatants have a smaller effect on the speed of locomotion, but cause a large increase in their adhesiveness. 2. This supernatant activity was produced equally well in the presence or absence of serum after 24 h culture at 37 degrees C with 10(-6) M dexamethasone. 3. The effect of the steroid-treated monocyte supernatants on the speed of locomotion of human peripheral blood neutrophils was not altered by rabbit polyclonal antisera against lipocortins 1-6. 4. Rabbit anti-interleukin-8 antibody which blocked the effect of IL-8 on the speed of locomotion of neutrophils did not antagonize the locomotion stimulating action of steroid-treated monocyte supernatants. 5. The exocellular release of this factor(s) by human mononuclear leucocytes suggests that it may be an in vivo mediator of the anti-inflammatory effect of glucocorticoids.     

Book reviews

JGIM solicits reviews of new books from its readers. If you wish to review a book, please submit a letter of intent that identifies the book in question (title, author, and publisher) to Robert Aronowitz, MD, Book Review Editor,JGIM, Department of Medicine, Cooper Hospital, 3 Cooper Plaza—Suite 220, Camden, NJ 08103, telephone (609)342-2489.     

A critical survey of hypotheses regarding Post-traumatic Stress Disorders in light of recent research findings

This paper reviews briefly recent findings from psychobiological research upon Post-traumatic Stress Disorders. A critical assay is provided of the various hypotheses advanced as the result of this research data. The author suggests neuropsychological theory provides the best explanation for understanding and classifying both the clinical phenomenology and the biological abnormalities discovered in the chronic forms of PTSD.Initial draft presented at a workshop Delayed Effects of Post Traumatic Stress Disorders, sponsored by the Emergency Services Branch of the National Institutes of Mental Health April 14–15, 1986.     

Post-Traumatic Headache with Scintillating Scotoma Treated with Phenytoin (Dilantin)

A post-traumatic headache patient was experiencing "flashing lights" in her visual field that correlated with sharp waves on the EEG. Phenytoin markedly improved the symptoms. The value of the EEG in post-traumatic headaches is reviewed. The use of phenytoin in headache syndromes and in prevention of post-traumatic epilepsy is discussed.     

Long-term biocompatibility of implanted polymer-based intrafascicular electrodes

Polymer-based longitudinal intrafascicular electrodes (polyLIFEs) were chronically implanted into the sciatic nerve of white New Zealand rabbits (n=8) for a period of 6 months (hereafter referred to as the long-term group). The impact of the implantation procedure, as observed 6 months post surgery, was evaluated in a sham-treated control group (n=9). The contralateral sciatic nerve served as the control for each animal. Nerve-fiber counts, fiber diameters, and myelin thickness were estimated at the level of the implant site, 1.5 cm proximally, and 1.5 cm distally for both nerves in sham-treated and long-term groups. Implantation of polyLIFEs had no significant effect on fiber counts, nerve-fiber diameter, or myelin thickness. A slight increase in connective tissue in the vicinity of the implant site was evident in the long-term group, including a thin but dense capsule immediately surrounding the implanted electrode.     

Fatal Dieulafoy's type ulcer in a case of gastric AL-amyloidosis

Dieulafoy's ulcer is a particular form of gastric ulcer confined to a persistent caliber artery and may lead to severe hemorrhage. We report a case of fatal gastric bleeding in a woman with benign biclonal gammapathy. Autopsy found a typical Dieulafoy's ulcer centered by a persistent caliber artery which wall was thickened by AL-amyloid deposits. Amyloidosis involved the gastric wall, but also middle caliber arteries of the liver, the lung, the pancreas, the kidney and the myocardium. AL-amyloidosis is a rare and late complication of monoclonal gammapathy and may be asymptomatic. Pathogenesis of Dieulafoy's ulcer remains unclear. In our case, local ischemia may have facilitated gastric ulceration, and amyloid deposits may have contributed to arterial rupture.