Suicide in the course of the treatment of depression

Five different mechanisms have been proposed whereby antidepressant treatment might lead to suicide: first by simply ameliorating depressions more rapidly; second by an action intrinsic to the specific antidepressant effects; third by toxicity in overdose; fourth by side-effects of specific antidepressants; and finally by virtue of treatment inefficacy. Evidence from randomized control trials (RCT), controlled case studies and epidemiological studies on this question is reviewed and it is concluded that antidepressants can be implicated in some cases of suicide during treatment. Modifications of clinical trial methods and pharmacogenetic studies would yield a richer data set to explore this issue further.     

Interleukin-1 receptor antagonist in newborn babies and pregnant women

We have used patch-clamp techniques to study the effect of the sulfhydryl group oxidizing agents mercury and thimerosal on calcium-activated nonselective cation channels from brown adipose tissue. 100 nmol/l mercury and 50 mol/l thimerosal induced a complete block. Blockade could be reversed by reduction of the mercaptide by dithiotreitol (DTT). Mercury was found to be the most potent blocker (IC₅₀-value 21×10^–9 mol/l), whereas thimerosal (IC₅₀-value 1.5×10^–6 mol/l) was as effective as 3,5-dichlorodiphenylamine-2-carboxylic acid (DCDPC). The DCDPC effect, however, could not be reversed by DTT, indicating different blocking mechanisms. It is concluded that SH-groups are involved in gating of the calcium-activated nonselective channel.     

SALMONELLA BACTERAEMIA OCCURRING CONCURRENTLY WITH THE FIRST PRESENTATION OF SYSTEMIC LUPUS ERYTHEMATOSUS

There is increasing recognition of the association between Salmonellainfections and systemic lupus erythematosus (SLE). However,these infections have usually occurred in patients with establishedSLE who were receiving immunosuppressive therapy. We describetwo young women with previously undiagnosed SLE who developedSalmonella bacteraemia. Neither of these patients had receivedimmunosuppressive drugs. From these and two previously reportedpatients, it may be concluded that SLE per se is likely to beassociated with a defect in host defences to Salmonella bacteria. KEY WORDS: SLE, Non-typhoid Salmonella, Septicaemia     

Plant nurseries: a reliable resource for plant identification?

Poison Centers frequently rely on the assistance of local plant nurseries to identify unknown plants involved in exposures. The reliability and accuracy of utilizing this method has never been studied; therefore, our objective was to evaluate this primary resource of plant identification. A study was done in which callers were instructed to take plant samples to a local nursery for visual identification. Once the patient was treated according to our normal protocol, the plant specimen was sent to a botanist for a second identification. The botanist provided his identification results through a blinded process. The collected data was gathered from 68 cases that completed the necessary study criteria. In 58% of the cases, plant nurseries were an unreliable source for plant identification. These incorrect identifications resulted in the "undertreatment" in 24% of the exposures.     

Primary cerebral lymphoma: a study of 47 cases probed for Epstein-Barr virus genome.

AIMS: To determine the prevalence of Epstein-Barr virus genome in primary cerebral lymphomas occurring in the absence of immune suppression. METHODS: Forty eight consecutive patients with lymphomas restricted to the central nervous system were identified, all of whom had had neurosurgical biopsies performed at the National Hospitals for Neurology and Neurosurgery, London. Only five patients had some form of underlying immune deficiency; 43 were apparently normal. The tumours were studied with immunohistochemical markers and by in situ hybridisation, using a biotinylated probe to the internal repeat region of Epstein-Barr virus. RESULTS: All the lymphomas were B cell in origin. Tumours from the five immunosuppressed patients all showed hybridisation, as did two of the "spontaneous" tumours. CONCLUSIONS: This is the largest series of cerebral lymphomas so far probed for Epstein-Barr virus genome: as more are examined, it is suggested that a small proportion of the tumours from immunocompetent patients will also contain the virus.     

穿龙薯芋中两种水难溶性甾体皂甙的结构研究

中国科学院成都生物研究所等单位用四川汶川,茂汶产的穿龙薯芋根茎为原料,研制成治疗冠心病,抗动脉粥样硬化的药——“穿龙冠心宁”,经鉴定有一定疗效。我们从“穿龙冠心宁”的原料穿龙薯芋(Dioscorea nipponica Makino)中提取出两种水难溶组分:其一为无色针状晶体,熔点275.5～280℃(分解),[α]_D~(21)-118°(C=0.39吡啶),易溶于吡啶,氯仿一甲醇(3:1)混合液和热甲醇,稍溶于氯仿,微溶于乙醇,不溶于水,命名为Da;其二亦为无色针状晶体,熔点293～295℃(分解),[α]_D~(21)-81°(C=0.31吡啶),易溶于吡啶,热正丁醇—乙醇—水(3:1:1)混合液,可溶于甲醇,微溶于乙醇,不溶于水,命名为Db。Da、Db与水溶性成分共存时,则具有较大的水溶性。     

Comparison of enhancement of GGTase-positive foci and induction of ornithine decarboxylase in rat liver by barbiturates

The induction of ornithine decarboxylase (ODC) by barbituratesand the ability of barbiturates to enhance neoplastic progressionof chemically initiated cancer was examined in rat liver. Allseven barbiturates induced ODC with barbital (7.7 fold increase)and phenobarbital (5.7 fold increase) demonstrating the mostpotent activity. Maximum induction of ODC by phenobarbital wasobtained in 18 h. Barbital (500–5000 p.p.m.) and phenobarbital(500 p.p.m.) administered in the drinking water enhanced theappearance of diethylnitrosamine (DENA)-initiated -glutamyltranspeptidase(GGTase)-positive foci. Amobarbital, hexabarbital and pentabarbitaldid not enhance the appearance of GGTase-positive foci. In theabsence of previous initiation by DENA, the enhancing regimenof the barbiturates did not cause the appearance of GGTase-positivefoci. Barbiturates induced ODC activity in rat liver and enhancedthe incidence of DENA initiated GGTase-positive foci.     

Paraplegia episodes revealing tuberculous myelitis

A 38 year-old woman, without previous medical history, presented, since 1993, several paraplegic fits carrying herself progressively through to a severe paraplegia. Diagnoses successively proposed were spinal cord compressions by slipped discs, spinal cord infarct and multiple sclerosis. In November 1998, the patient presented back pain and fever. Spinal cord magnetic resonance imaging (MRI) revealed a mildly enlarged dorsal cord with signal abnormalities. The lesions were isointense on T1-weighted images, hyperintense on T2-weighted images and showed a ringlike contrast enhancement. A lumbar puncture showed a trouble cerebrospinal fluid (CSF) with leucocytes 600/mm(3) (85 p.100 polynuclear), protein 6.7 g/l, glucose 0.26 g/l, chloride 109 mmol/l. The patient was first treated with parenteral unspecific antibiotherapy. Microbiological studies of blood and CSF were negative. CSF examination with polymerase chain reaction (PCR) was positive for Mycobacterium tuberculosis. Clinical (pain and fever) symptoms and CSF abnormalities decreased after antituberculous treatment. However, paraparesis remain severe. Spinal tuberculous localizations often lead to diagnostic and therapeutic errors. Improvement of spinal cord MRI sequences and using of PCR technics in CSF would contribute to reduce these difficulties.