Alcoholic foamy degeneration in Spain. Prevalence and clinico-pathological features

Among 389 consecutive chronic alcoholics in whom a liver biopsy was performed for diagnostic purposes, nine patients (2.3%) had histological changes of "alcoholic foamy degeneration" (AFD), characterized by numerous small fat droplets in the swollen hepatocytes of the centrilobular area. In five cases, there were non-specific clinical features, while the other four cases presented acute hepatic decompensation with jaundice and a reduced prothrombin activity. Seven patients had high serum lipid concentrations including hypertriglyceridemia and hypercholesterolemia, which improved after withdrawal of alcohol intake. In conclusion, AFD has a broad clinicopathological spectrum including asymptomatic patients and other cases with severe liver decompensation manifested by jaundice and reduced prothrombin activity. AFD is usually associated with hyperlipemia.     

Factors associated with the blood levels of lead in residents of Mexico City

A study aimed at detecting risk factors for high blood lead levels in Mexico City inhabitants, undertaken at the local National Institute of Public Health, is described. Measurements of blood lead levels for a sample of 300 civil servants were related to several potential risk factors. The statistical analysis was based on analysis of variance and logistic regression. The results of the analysis seem to suggest differences in blood levels by sex, zone of residence, hours of transportation and eating habits, such as the consumption of canned meals and the use of "earthenware dishes" in the preparation of meals. The nature of the study is exploratory, but it seems to suggest directions of research in the complex problem of lead levels in people of polluted cities.     

The effect of the development of the group on the therapeutic effect

The authors compared the results of six-week treatment in a therapeutic community comprising 484 patients who had therapy in groups which were classified as "good" by their therapists, and 91 patients having therapy in groups, classified by the therapists as "poor". No significant difference was found in the two groups as regards mitigation of symptoms, insight, change of attitudes and behavior at the time of completion of treatment and after an interval of one year. Effective factors of group psychotherapy obviously are equally effective also in groups with which the therapists are not satisfied.     

The Drosophila Mutant tetanic Interacts with a Gene Complex Including the Structural Locus of K+ Channels and Shows Altered Dephosphorylation and Learning

The tetanic (tta; X.-52.6) mutation has been isolated on the basis of its sensitivity to extradoses of the normal Shaker gene complex (ShC) where the K+ channel la is encoded. The mutant shows up to threefold elevation of the membrane bound protein phosphatase type 1 (PP1) activity in body extracts, probably due to reduced levels of the PP1 specific inhibitor 2 (I-2). By contrast, PP1 activity in the head is only half of the normal value. In addition, tta fails to perform normally in a negative reinforcement olfactory paradigm. The functional relationships between phosphorylation, K+ currents, phosphatase activity and modulation of synaptic activity during learning and memory are discussed in the light of their possible genetic links.     

High levels of plasma FVIII and vWF in the toxic epidemic syndrome patients

Factor VIII and von Willebrand factor proteins were evaluated in 115 patients having the chronic phase of the Toxic Epidemic Syndrome (TES), a new multisystemic disease probably caused by the ingestion of denatured rapeseed oil, and in 50 control volunteers. Higher circulating levels of factor VIII procoagulant activity (VIII:C) (158 +/- 58.4 U/dl), von Willebrand factor antigen (vWF:Ag) (166.1 +/- 55.5 U/dl) and von Willebrand factor ristocetin cofactor activity (vWF:RCo) (178.7 +/- 55.2 U/dl) were seen in TES patients (p less than 0.001, TES patients versus control subjects, for each parameter). The increased levels of vWF:Ag and vWF:RCo observed in TES patients correlated with the scleroderma like lesion of the skin, with the sicca syndrome and with Raynaud's phenomenon (p less than 0.01), but not with other clinical manifestations. The multimeric analysis of vWF in 92% of the TES patients was similar to that found in normal plasma, but in the remaining 8% a very slight increase of larger vWF multimers in plasma were observed. The raised levels of vWF found in TES patients in the chronic phase may reflect an "in vivo" vascular injury.     

GABA and its neural regulation in rat brown adipose tissue

Summary By using a radioreceptor assay GABA was detectable in rat interscapular brown adipose tissue (IBAT), the levels being 1% those of CNS and 10-fold those of peripheral plasma. Injection of the glutamic acid decarboxylase (GAD) inhibitor 3-mercaptopropionic acid lowered IBAT GABA levels by about half while injection of the GABA transaminase inhibitor -acetylenic GABA increased them by 230%. Rats kept at 4C for 14 days exhibited IBAT GABA levels that were about half those found at 22C. Accumulation of IBAT GABA after -acetylenic GABA increased by 2-fold in cold-exposed rats. Sympathetic denervation of IBAT prevented the effect of the cold environment on GABA content and impaired that on GABA accumulation. GAD activity was detectable in IBAT homogenates and isolated brown adipocytes. Exposure of rats to cold increased V_max of GAD without modifying its Km, regardless of intactness of innervation. In binding studies with³H-GABA as a ligand, two types of sites were uncovered of K_D=14 and 146 nM, respectively. In the presence of 2.5 mM Ca²⁺ bicuculline and baclofen were 57 and 46% as effective as GABA to displace³H-GABA from IBAT binding sites. The results indicate existence, possible synthesis and type A and B receptors of GABA in rat IBAT.     

Therapeutic criteria in hydrocephalic children

The xanthine, hypoxanthine, and total oxypurine levels were determined in the CSF of 28 hydrocephalic patients (age from newborn to 2 years) and 8 healthy controls using HPLC. The Evans' index, the mean weekly increase in cranial circumference, and the intracranial pressure were also measured. Of the hydrocephalic patients 13 were self-compensated and the other 15 had a shunt implanted during the course of the study. The mean xanthine, hypoxanthine, and total oxypurine levels in the normal children were 5.20, 5.94, and 11.29 mol/l, respectively. In the self-compensated hydrocephalics these levels were 5.17, 5.71, and 10.79 mol/l, respectively. In the noncompensated hydrocephalics, they were 9.90, 9.91, and 19.82 mol/l. The differences between the latter group and the first two are statistically significant (P<0.001). The mean Evans' index and the mean weakly increase in cranial circumference in the self-compensated hydrocephalics were 0.35 and 0.25 cm, respectively. In the noncompensated hydrocephalics, they were 0.55 and 0.95 cm. The differences between the two groups are statistically significant (P<0.001). Two weeks after implantation of shunts in the noncompensated cases, the mean xanthine, hypoxanthine, and total oxypurine levels fell to 4.22, 4.57, and 8.80 mol/l, respectively. These changes are statistically significant (P<0.001). We think that the two criteria (clinical and biochemical) are equally useful for the prediction of self-compensation in hydrocephalic children and that the oxypurine values after shunt implantation can be used to monitor progress in noncompensated cases.     

Possibilities of finger substitution

Authors deal, in connection with their clinical cases, with the replacement of the fingers of the hand. Attention is called to the fact, that a minimal requirement of the reconstruction, performed on the severe, multiply amputated hand, should be the formation of a "basic hand", and that at the planning of such operations the aim may be the reconstruction of the function of the hand only. Among the methods presented the most modern methods, requiring microvascular surgical technique, are also shown. Although the right of using these is obvious, the older, however well proved methods should not be forgotten either. The possibilities of finger replantation are described didactically; considering the extent of this theme however authors did not strive to completeness.     

Connective tissue metabolism in children with chronic renal failure

To assess the characteristics of connective tissue metabolism in chronic renal failure (CRF), urinary excretion of glycosaminoglycan (GAG) fractions and hydroxyproline (HYP) was determined in ten patients with CRF and in ten age-matched healthy children. CRF was found to be associated with elevated free HYP (19.9±6.1 vs 9.8±3.6 mol/day,P<0.05) and depressed peptide HYP excretion (33.1±13.5 vs 225.2±17.7 mol/day,P<0.01), a low rate of total GAG excretion (7.0±2.4 vs 16.1±1.9 mol uronic acid/day,P<0.05) with low chondroitin 4 — sulphate + chondroitin 6 — sulphate (Ch-Ss) (14.0±9.9 vs 65.0±22.1%) and a high proportion of non-sulphated or under-sulphated fractions, i.e. hyaluronic acid + chondroitin + heparan sulphate (HA+Ch+HS) (75.3±11.4 vs 31.5±5.7%). Urinary 3-methyl-histidine (3-met-HIS) excretion and plasma essential free amino acids did not differ in the two groups. In response to haemodialysis no consistent change occurred in urinary excretion of 3-met-HIS, peptide-bound HYP, total GAG or percentage distribution of individual GAG fractions. After haemodialysis all plasma amino acids decreased significantly, and there was a significant increase in urinary excretion of free HYP (P<0.05). We conclude that the alterations in urinary excretion of total and individual GAGs observed in CRF may reflect disturbed connective tissue metabolism which does not appear to be accounted for by protein malnutrition or enhanced protein breakdown and remains uninfluenced by haemodialysis therapy.     

Experience with a new "reserve protocol" in advanced and pretreated Hodgkin's disease

Between 1983-1987 16 patients with advanced stage Hodgkin disease, most of whom in an immunsuppressed, immundeficient state, were treated with a new "post-COPP", or "post-ABVD" reserve-protocol. In all cases megavoltage Co radiotherapy and COPP (CVPP) or ABVD polychemotherapy had previously been. Compared with the previously administered polychemotherapy the new 3-component cytostatic agent was well tolerated by the patients. The LEAMP-protocol therapy is therefore recommended in cases of ineffective combined radiochemotherapy (chemoresistance) or intolerance to chemotherapy. In four cases prolonged, complete, in nine cases partial remission was achieved and in more than a half of the patients favourable clinical effects and changes were experienced. In two cases temporary, partial remission was seen. One cases, because of the short period of treatment could not be evaluated. On the basis of the longitudinal observations the results achieved seemed subjectively and objectively favourable. The LEAMP-protocol was found to be well tolerated and satisfactorily effective.