Phenytoin has little effect on in-vitro models of wound healing

It has been reported that phenytoin induces gingival and connective tissue hyperplasia and may be of use in wound healing. In this study the effect of phenytoin on human epidermal keratinocytes and skin fibroblasts has been investigated in vitro. Cell cultures were exposed to increasing concentrations of phenytoin from 10(-9) to 10(-4) M in the presence of 1 and 10% serum supplemented medium. In addition the effect of phenytoin on epidermal cell migration (epiboly) has been investigated using organ culture of human skin. No stimulation of cell growth was observed, and only a mild toxicity affecting keratinocytes was seen at the highest concentrations. Similarly, no effect on epidermal cell migration in vitro was observed. The lack of a direct effect in vitro suggests that any in-vivo effect was not the result of interaction between phenytoin and keratinocytes or fibroblasts but possibly due to indirect modulation via other cell types, such as inflammatory or lymphoreticular cells.     

Knowledge and opinions of speech therapy in teachers, doctors and nurses

Three types of professionals who were potential referers to the speech therapy service were questioned about their knowledge and opinions of speech therapy. The responses of qualified teachers, doctors and health visitors were compared with those of students at or near to the beginning of vocational training for these professions. The responses of practising and intending speech therapists were used as a baseline. Between 70% and 100% questionnaires were returned for each group, and a random sample of 33 from each (total 264) was analysed. The answers showed that teachers were the least well informed about many aspects of speech therapy, including the nature and location of the work and the range of disorders for which such therapy is available. In view of recent recommendations that teachers should cooperate with other professionals in working with those children with special needs who are now being educated in mainstream schools, there would seem to be a strong need for teacher training to include more information about speech therapy.     

Inversion,rotation and ectopic eruption of a mandibular second premolar

Summary. This case illustrates complete inversion, rotation and ectopic extra-oral eruption of a mandibular right second premolar and the congenital absence of the contralateral tooth. As far as can be ascertained, the simultaneous expression of these four abnormalities in one patient has not been reported before. Résumé. Ce cas illustre l'inversion complète, la rotation, l'éruption en position ectopique d'une seconde prémolaire mandibulaire droite et l'absence congénitale de la dent contra-latérale. Pour autant que nous le sachions, l'expression simultanée de ces quatre anomaies chez le même patient n'a jamais été rapportée jusqu'à maintenant. Zusammenfassung. Dieser Fall wird die Inversion, Rotation und der ektopische Durchbruch eines zweiten Prämolars im Unterkiefer beschreiben sowie die congenitale Nichtanlage des kontralateralen Zahnes. Soweit bekannt wurden das simultane Auftreten von diesen vier Abnormalitäten an einem Patienten bis anhin nicht beschrieben. Resumen. Este caso ilustra la inversión completa, rotación, y erupción ectópica del segundo premolar mandibular derecho y la ausencia congénita del diente contralateral. Por lo que se puede determinar, la expresión simultanea de estas cuatro anormalidades en un solo paciente no ha sido reportado.     

Acetylated Polyamines in Lungs from Rats with Monocrotaline-Induced Pneumotoxicity

Multiple lines of evidence implicate the polyamines, putrescine,spermidine, and spermine in the lung injury and hypertensivepulmonary vascular disease produced in rats by the pyrrolizidinealkaloid monocrotaline. While increases in lung polyamine contentevoked by monocrotaline can be attributed in part to inductionof the two rate-limiting enzymes in de novo polyamine synthesis,ornithine decarboxylase and S-adenosylmethionine decarboxylase,little attention has been paid to the role that catabolic interconversionprocesses might play in lung polyamine accumulation. Accordingly,the present study evaluated dose (10–60 mg/kg) and time(0–21 days)-dependent effects of monocrotaline on lungcontents of acetylated polyamines and on the activity of spemidine/spermineacetyltransferase (SAT), the enzyme affecting spermidine acetylation.A single subcutaneous injection of monocrotaline produced dose-and time-dependent increases in the lung contents of N¹-acetylspermidine.Neither N¹-acetylspermine nor N¹-acetylputrescine could be detectedin lungs from control rats or from rats treated with monocrotaline.SAT activity also was increased in monocrotaline-treated ratlungs in a dose- and tunedependent manner that was closely relatedto increases in the lung burden of N¹-acetylspermidine. As expected,monocrotaline also caused dose- and time-dependent elevationsin the lung contents of the primary polyamines, putrescine,spermidine, and spermine. Right ventricular hypertrophy, anindex of sustained pulmonary hypertension, did not develop inanimals treated with 10 or 20 mg/kg monocrotaline despite elevationsin the lung contents of putrescine and N¹-acetylspermidine andincreases in the activity of SAT. In contrast,30 and 60 mg/kgmonocrotaline provoked right ventricular hypertrophy accompaniedby elevations in the primary polyaming N¹-acetylspermidine,and SAT activity. These observations indicate that monocrotaline-inducedpneumotoxicity, characterized by development of sustained pulmonaryhypertension, is associated with increased activity of SAT andaccumulation of N¹-acetylspermidine as well as the primary polyamines.This association suggests that polyamine interconversion pathwaysmay be important in development of monocrotaline-induced pneumotoxicity.     

The learning needs of cancer patients

"People learn best when they are helped or define their own problems, acknowledge and accept their strengths and weaknesses, decide on a course of action, and evaluate the consequences of their decisions."
C. Coles (1989)     

Epidermolysis bullosa acquisita with pulmonary tuberculosis: a case report

Our case is that of a 67-year-old man who presented with a blistering, scarring eruption at sites of trauma. Histologically the blistering was subepidermal. IgG and C₃ were present at the basement membrane zone. Electronmicroscopy demonstrated bulla formation to be beneath the basal lamina and that it contained amorphous electron-dense material. These clinical and investigational findings are consistent with a diagnosis of epidermolysis bullosa acquisita (EBA). The patient also had pulmonary tuberculosis which again highlights the association between EBA and diseases in which the immune system is compromised.