Acute Disseminated (Non-Lipid) Reticuloendotheliosis

In several publications W allgren has dealt with problems related to storage diseases. In 1940 he advanced the idea that the so-called acute reticulo-endotheliosis bears close relationship to Schüller-Hand-Christian's disease and that these two maladies represent only different types of one and the same underlying disturbance. Since then this idea has gained wider acceptance. The eosinophilic granuloma has also become incorporated in the same syndrome. In the following paper some of the inherent problems are discussed in a clinical conference at the Vanderbilt Pediatric Clinic.     

Comparison between the MHC-restricted antibody repertoire to Ascaris antigens in adjuvant-assisted immunization or infection

Genetic restrictions to the immune repertoire will be an important consideration in the development of anti-nematode vaccines. It has already been established that the major histocompatibility complex (MHC) limits responsiveness to nematode antigens in infection, but little is known of whether this also applies under other routes of sensitization, such as with adjuvants. The specificity of the antibody response was, therefore, compared in infection and adjuvant-assisted immunization using secreted and somatic antigens of Ascaris suum as a model system in mice and rats. The findings were, first, that the lack of responsiveness to certain antigens in infection was not circumvented by Freund's adjuvant-based immunization, despite the fact that the latter generally elicited higher levels of response. Secondly, that adjuvant-assisted immunization could elicit responses to parasite products which were not detectable in the context of infection. Conversely, some specificities were detectable in infection but absent under adjuvant immunization. Finally, immunization with a defined parasite allergen (ABA-1) in Freund's adjuvant did not provoke an IgE response which would be anticipated if the molecule were to have an intrinsic allergenic property. These results are likely to be of general importance to the application of subunit or recombinant vaccines against nematodiases and to the hypersensitivity reactions which vaccination might engender or recall.     

INAPPROPRIATE GROWTH HORMONE RELEASE IN THE DIENCEPHALIC SYNDROME OF CHILDHOOD: CASE REPORT AND 4 YEAR ENDOCRINOLOGICAL FOLLOW-UP

A boy with an astrocytoma in the anterior hypothalamic area and typical features of the diencephalic syndrome of childhood was followed with yearly endocrinological evaluation from 10 months of age until he was 5½-years-old. Radiation therapy resulted in temporary clinical improvement. At the time of diagnosis height and bone age were advanced. Basal concentrations of growth hormone (GH) were markedly elevated and could only be partially suppressed by an oral glucose load. There was a paradoxical decline of GH levels following arginine-insulin infusion and an abnormal GH release with TRH administration. Abnormal GH response to the various stimuli persisted for 2 years after radiation therapy. Pituitary secretion of LH, FSH, TSH, prolactin and ACTH remained intact. The characteristic clinical features as well as the endocrinological findings remain unexplained.     

Attachment among adult children of alcoholics

Disturbed or impoverished relationships have been identified as a predominant feature of adult children of alcoholics (ACOAs). Recently, the concept of co-dependency has been advanced to depict the interpersonal difficulties of these individuals, but lacks definitional rigor. The notion that childhood experiences with parents are ‘carried forward’ to affect attitudes and behaviors relevant to later intimate relationships is also consistent with attachment theory. This study examined the patterns of attachment of ACOAs as compared to adult children of non alcoholics (ACONAs). A cross-sectional sample of 203 individuals attending either a short term hospital based outpatient psychiatric program or a community based alcoholism treatment program was included in this study. Results supported the hypothesis that female ACOAs had a distinctive dysfunctional attachment profile. There were no significant differences in the attachment styles of male ACOAs as compared to ACONAs, or male substance abusers as compared to non-abusers.