3H-Mepyramine binding and histamine-stimulated cAMP accumulation in mammalian retina

The specific binding of different amounts of³H-mepyramine to the bovine retina revealed a quasi-hyperbolic curve which approached saturation at³H-ligand concentration over 9–12 nM. Scatchard analysis of the binding data showed two binding sites with K_D values of 0.76 nM and 7.3 nM and B_max of 49.3 and 194.6 fmole/mg protein, respectively. In the guinea-pig brain³H-mepyramine bound to a single population of binding sites with K_D value of 1.6 nM and B_max of 291 fmole/mg protein. Various H₁-antihistamines were potent competitors of the³H-mepyramine binding: there was a big difference in potency of d- and 1-chlorpheniramine in both membrane preparations.In the rabbit retina slices histamine, in contrast to dopamine, weakly stimulated cAMP accumulation.The data suggest that the mammalian retina may possess histamine receptors.     

Prognostic factors in sudden sensorineural hearing loss: our experience and a review of the literature

OBJECTIVES: We investigated prognostic factors in sudden sensorineural hearing loss (SSNHL). METHODS: Our study group consisted of 133 patients with SSNHL who were treated at our department between 1980 and 2000. Eighty-one of them (group B) were treated between 1980 and 1996; they received vasodilators and small doses of steroids. The others (52 patients; group A) were treated between 1997 and 2000; they received vasodilators, steroids at high doses, and hyperbaric oxygen. A multivariate stepwise linear regression was used to identify the prognostic factors that were related to hearing improvement as measured by objective change of gain in the overall average (0.5, 1, 2, 4, 6, 8 kHz), the pure tone average (0.5, 1, 2 kHz), the high tone average (4, 6, 8 kHz), and the pure middle tone average (0.5, 1, 2, 4 kHz). The following factors were included in the analysis: group (method of treatment), age, gender, seasonal occurrence of disease, presence of tinnitus and vestibular symptoms, time delay before first visit, type of initial audiogram, and type of caloric reaction. In group A, an additional analysis was conducted to include the results of certain laboratory tests: blood morphology parameters, erythrocyte sedimentation rate, glucose level, coagulogram, lipidogram, thyroid-stimulating hormone, autoantibodies (antimitochondrial antibodies, smooth muscle antibodies, and anti-brush border antibodies), and immunoglobulins G, A, and M. Values for p of less than .05 were considered significant. RESULTS: Our analysis suggests the presence of the following prognostic factors for SSNHL: method of SSNHL treatment (better results in group A); time delay before the start of treatment (better results when treatment started within 10 days of the first symptoms of SSNHL); and type of caloric reactions (worse results in patients with canal paresis). In group A, the factors for poor prognosis for absolute hearing improvement were as follows: delayed treatment, labyrinth responsiveness disorders, and decreased level of thyroid-stimulating hormone. In group A, better hearing improvement was observed in those patients in whom SSNHL was diagnosed in the spring. CONCLUSIONS: A short time delay before starting treatment (within 10 days), treatment with high doses of steroids and hyperbaric oxygen, preserving complete caloric function of the labyrinths, normal function of the thyroid, and seasonal occurrence of the disease in the spring were positive prognostic factors for hearing recovery in SSNHL.     

Joint Clinical Consensus Statement of the American College of Foot and Ankle Surgeons® and the American Association of Nurse Practitioners™: Etiology,Diagnosis, and Treatment Consensus for Gouty Arthritis of the Foot and Ankle

Gout is a condition that commonly affects the foot and ankle, and practitioners who treat these structures should be aware of the methods used to diagnose and treat this form of arthritis. Practitioners also need to recognize extra-articular manifestations of the disease. Although the acutely red, hot, swollen joint is a common presentation, chronic tophaceous gout can be associated with pain, nodule formation, and cutaneous compromise. Since the underlying causes that lead to excessive monosodium urate deposition may be treatable, early and accurate diagnosis has been very beneficial and may even prevent articular degeneration. In this clinical consensus statement, gout as it affects the foot and ankle is discussed.     

Effect of salbutamol on specific airway resistance in infants with a history of wheezing.

The purpose of this study was to assess the effectiveness of nebulized salbutamol in infants with a history of wheezing. Eighty-eight children aged 3-24 months with a history of wheezing were studied, in seven groups: I (n = 15) and I/A (n = 17) with elevated specific airway resistance (SRaw); II (n = 17) with normal SRaw; III (n = 23), III/A (n = 17), and IV (n = 18) with normal SRaw exposed to carbachol bronchial challenge (CBC); and V (n = 13) serving as control. Infants for groups I/A and III/A were selected to match by age and by baseline and post-carbachol SRaw values, respectively. Baseline airway resistance and thoracic gas volume (TGV) were measured plethysmographically. Specific airway resistance was selected as an index of bronchial function. Thereafter every child in groups I, I/A and II inhaled 200 micrograms of salbutamol by tidal breathing, and the children in groups III, III/A, and IV were exposed to CBC. Following positive reaction to carbachol, children of groups III and III/A inhaled salbutamol (200 micrograms, tidal breathing), and those of group IV received no drug. Controls from group V with normal SRaw received placebo (phosphate-buffered saline). Plethysmography was repeated in all children at 5 minute intervals. Following salbutamol SRaw was reduced in children with elevated and normal SRaw. In contrast, children not receiving salbutamol had unchanged SRaw value. The response to salbutamol measured by SRaw, Raw, and TGV was not significantly different in the spontaneously obstructed infants compared to those who received carbachol. In conclusion, infants with a history of wheezing do respond to inhaled salbutamol.     

Effect of selenium on the organ distribution and binding of bismuth in rat tissues

Subcutaneous administration of bismuth, both single and multiple, resulted in deposition of this metal mainly in the kidneys which contained over 50% of the accessible pool of bismuth. In the kidneys bismuth was bound mainly by the soluble fraction in which it was complexed with a protein of molecular weight of about 7000. Multiple administration of bismuth increased the level of this protein. Selenite administration brought about an increase in the accessible pool of bismuth, probably due to a drop in excretion, and also changes in the organ distribution of this metal. The retention in the kidneys was diminished while those in the liver and in other tissues were augmented. These changes were accompanied by a change in the chemical form of bismuth present in the kidneys manifested by the total disappearance of the protein complex of molecular weight of 7000. The increased synthesis of this protein due to bismuth administration was not abolished completely.

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Zusammenfassung Nach einmaliger und wiederholter subkutaner Verabreichung wurde Wismut zu mehr als 50% der erreichbaren Menge in den Nieren gefunden. Es war dort vorwiegend in der löslichen Frakion und in großem Umfang an einen Eiweißstoff vom Molekulargewicht 7000 gebunden. Bei wiederholter erabreichung von Wismut wurde auch dieser Eiweißstoff vermehrt gefunden. Die gleichzeitige Verabreichung von Selen erhöhte die verfügbare Menge von Wismut, wahrscheinlich wegen eingeschränkter Ausscheidung. Zugleich wurden Unterschiede in der Organverteilung von Wismut festgestellt. Der Anteil in den Nieren wirde geringer und derjenige in Leber und sonstigen. Organen größer. Der Eiweißkomplex mit dem Molekulargewicht 7000 verschwand gänzlich. Die durch Wismut stimulierte Synthese dieses Eiweißstoffes wirde aber nicht ganz verhindert.

     

Pulmonary embolism: a fatal complication of arterial chemoembolization for advanced hepatocellular carcinoma

The case of a child with advanced hepatocellular carcinoma that did not respond to systemic chemotherapy is presented. Three courses of chemoembolization (hepatic arterial chemoembolization) were given, with partial tumor response. The hepatic artery was cannulated via the femoral artery using the Seldinger technique. Arteriography was performed, and chemoembolization suspension (cisplatin + doxorubicin + mitomycin mixed with Lipiodol) was injected. After the third hepatic arterial chemoembolization, the patient developed fatal pulmonary oil embolism. Hepatic arterial chemoembolization seems to be a useful method for treatment of high-risk hepatocellular carcinoma cases, which can induce responses, even in metastatic patients refractory to standard systemic chemotherapy. However, it may result in pulmonary embolism, which is a potentially fatal complication. In children, Lipiodol should be used as an embolizing material and cytostatic carrier with extreme care. Consideration should be given to replacing it with other materials, including albumin or collagen.