Clinical and neuropathological aspects of long-term damage to the central nervous system after lithium medication

Summary A female patient, who died at the age of 61 and had suffered from several manic-depressive psychoses for more than 30 years, developed three phases of intoxication under lithium therapy. There was a 15-year history of electro- and Pentetrazol-induced convulsive therapy prior to lithium medication; neuroleptics were still administered during lithium therapy. The last lithium intoxication, 3 years prior to death was during a low-dosage therapy with normal lithium levels followed by severe lasting impairment: akinesia, rigidity, dysarthria, ataxia, and an organic alteration in character. For the first time, neuropathological findings could be established in such a case: extensive damage to granule and Purkinje cells in the cerebellum; gliosis in the dentate nucleus, the inferior olives, and the nucleus ruber; cytoplasmic inclusions in various nerve cells of the cranial nerve nuclei; cytoplasmic vacuoles, especially in the cells of the supra-optic nucleus.Surprisingly little damage could be found in the substantia nigra and in the neostriatium. The clinical course as well as the pattern and intensity of the brain damage oppose an interpretation as a consequence of preceding convulsive shock therapy.     

The cytokine-dependent MUTZ-3 cell line as an in vitro model for the screening of contact sensitizers

Langerhans cells (LC) are key mediators of contact allergenicity in the skin. However, no in vitro methods exist which are based on the activation process of LC to predict the sensitization potential of chemicals. In this study, we have evaluated the performances of MUTZ-3, a cytokine-dependent human monocytic cell line, in its response to sensitizers. First, we compared undifferentiated MUTZ-3 cells with several standard human cells such as THP-1, KG-1, HL-60, K-562, and U-937 in their response to the strong sensitizer DNCB and the irritant SDS by monitoring the expression levels of HLA-DR, CD54, and CD86 by flow cytometry. Only MUTZ-3 and THP-1 cells show a strong and specific response to sensitizer, while other cell lines showed very variable responses. Then, we tested MUTZ-3 cells against a wider panel of sensitizers and irritants on a broader spectrum of cell surface markers (HLA-DR, CD40, CD54, CD80, CD86, B7-H1, B7-H2, B7-DC). Of these markers, CD86 proved to be the most reliable since it detected all sensitizers, including benzocaine, a classical false negative in local lymph node assay (LLNA) but not irritants. We confirmed the MUTZ-3 response to DNCB by real-time PCR analysis. Taken together, our data suggest that undifferentiated MUTZ-3 cells may represent a valuable in vitro model for the screening of potential sensitizers.     

Intracameral administration of α-MSH increases intraocular pressure in rabbits

A growing body of evidence suggests that neural peptides may induce important modulations on vegative and motor functions of the eye. The present study was designed to evaluate the effect of intracameral (I.C.) administration of α-melanocyte-stimulating hormone (α-MSH) and several other ocular peptides on intraocular pressure (IOP) in rabbits. α-MSH (5 μg) produced a significant and prolonged unilateral increase of IOP. This efeect of I.C. α-MSH was dose-dependent (ED₅₀ = 2.5 μg). Structure-activity studies revealed that equimolar doses of β-MSH and γ-MSH, unlike α-MSH, were totally ineffective. In addition, the structurally unrelated peptides β-endorphin, thyrotropin-releasing hormone (TRH) and gonadotropin-releasing hormone (Gn-RH) did not affect IOP, when tested in a dose equimolar to 5 μg of α-MSH.These results confirm and extend previous observations, suggesting that α-MSH may be an important factor involved in regulation of IOP.     

Alcohol embryo- and fetopathy. Neuropathology of 3 children and 3 fetuses.

Maternal chronic ethanol abuse during pregnancy causes malformations of the offspring. Three children (aged 6 months, 9 months, 4 1/2 years) and 3 fetuses (17th, 18th, and 20th gestational week) showed a wide spectrum of disorders ranging from severe dysraphic state, arhinencephaly, porencephaly, agenesis of corpus callosum, a range from hydranencephaly to microdysplasias (p.e. reduced gyration of dentate nucleus and inferior olives), and a range from gastrochisis or congenital heart defects to craniofacial dysmorphogenesis and palmar crease anomalies. The patterns of the cerebral malformations were not as uniform as the clinical phenotype of the alcohol embryopathy. The observations did not support the assumption that there exists a specific period for alcohol teratogenicity.     

Zur Pathogenese der zentralnervösen Störungen bei der chronischen Manganvergiftung

Ohne Zusammenfassung     

Obstructive jaundice secondary to benign hepatic cyst

A case of hepatic cyst causing obstructive jaundice is presented. Following percutaneous aspiration of the cyst, the jaundice was relieved. Modern interventional radiologic techniques can provide prompt diagnosis and treatment, thus avoiding major surgery and prolonged hospitalization.     

Über eine in der grauen Substanz sich ausbreitende Encephalitis nach Rubeolen

Zusammenfassung 4 Tage nach Abklingen einer 4tägigen Rubeolenkrankheit trat bei einem Knaben eine Encephalitis auf, der er am 13. Tage nach Ausbruch des Rubeolenexanthems erlag. Histologisch fand sich am Gehirn im Gegensatz zu früheren Literaturschilderungen eine Encephalitis vom polioencephalen Verteilungsbild mit lympho- und plasmacellulärer Gefäßinfiltration und zahlreichen atypischen Gliamitosen, jedoch ohne perivenöse Gliavermehrung und ohne Entmarkungen. Es wird die Möglichkeit erörtert, daß es sich dabei um eine primäre Virusencephalitis handelt, bedingt entweder durch das Rubeolenvirus selbst oder durch einen latenten anderen Erreger.Nach einem am 2. 8. 1954 auf der Tagung der Deutschen Neuropathologen in Hamburg gehaltenen Vortrag.