Carpal and tarsal osteolysis

This report describes the symptoms, clinical course and radiological features in three cases of idiopathic carpotarsal osteolysis. Before signs of extensive osteolysis were noted, one of our patients showed flattening, loss of harmonious curvature and minimal osteoporosis of carpal and tarsal bones, all early radiological signs which have not been described previously. We discuss the findings, classification and our ideas as to the cause of the disorder.     

Comparison of the "toxic" and antigenic regions in toxin alpha isolated from Naja nigricollis venom

The present paper describes the “toxic” site and one topologically distinct antigenic determinant of N. nigricollis toxin α.     

Alarming prevalences of overweight and obesity for children of Turkish, Moroccan and Dutch origin in The Netherlands according to international standards

AIM: Prevalences of overweight in The Netherlands, defined by international cut-off points, are presented in 14 500 children of Dutch origin, 2904 of Turkish and 2855 of Moroccan origin, aged 0-21 y. RESULTS: The mean prevalence for Turkish boys and girls was 23.4% and 30.2%, for Moroccans 15.8% and 24.5%, for Dutch youths in large cities 12.6% and 16.5%, and for other Dutch participants 8.7% and 11.3%, respectively. CONCLUSION: The development of adequate prevention strategies is urgently needed.     

Advantages and limitations in the assessment of neuroprotective treatment of Parkinson's disease by functional imaging

INTRODUCTION: The development of neuroprotective strategies is a crucial issue for Parkinson's disease, since up to now only symptomatic therapies are available. The clinical evaluation of neuroprotective drugs is difficult considering the long-term effect of anti-Parkinsonian medication that nearly make impossible accurate measurement of the "true" clinical stage of the disease in the early years of progression. BACKGROUND: Two recent functional imaging studies (CALM-PD and REAL-PET) using positron emission tomography (PET) or single photon emission computed tomography (SPECT), suggest that dopamine agonist may have a neuroprotective effect compared to L-Dopa. CONCLUSION: These results are still controversial, notably because of the lack of clinical-imaging correlations, the absence of a placebo group and some important methodological considerations. Nevertheless, these studies are encouraging and give some arguments for the potential neuroprotective role of dopamine agonists. The aim of this work is first to present the pros and cons of these studies and second to propose guidelines in order to improve the design and methodology for future studies designed to assess the neuroprotective properties of new drugs in Parkinson's disease.     

Induction of infertility in adult male bonnet monkeys by immunization with phage-expressed peptides of the extracellular domain of FSH receptor

Active immunization of proven fertile adult male bonnet monkeys (Macaca radiata) with phage-expressed follicle-stimulating hormone receptor (FSHR)-specific peptides from the extracellular domain resulted in a progressive drop in sperm count with all animals becoming azoospermic by day 100. However, serum testosterone concentrations were unaltered during the entire course of study and animals exhibited normal mating behaviour. Breeding studies with proven fertile female monkeys revealed that all the immunized males were infertile. Following interruption of immunization on day 225, sperm counts returned to normal with restoration of fertility. These results indicate that infertility can be induced in adult male monkeys by interfering with the action of FSH using specific peptides of the extracellular domain of FSHR as antigens, without the risk of producing cross-reacting antibodies to the other glycoprotein hormones.     

Clinical and therapeutic features of nonpostoperative nosocomial intra-abdominal infections

OBJECTIVE: To compare the clinical, microbiological, and therapeutic features of nonpostoperative nosocomial intra-abdominal infections (non-PostopNAI) with community-acquired intra-abdominal infections (CAI). SUMMARY BACKGROUND DATA: Prospective (June 2000 through January 2001) consecutive case series analysis of patients operated for secondary nonpostoperative intra-abdominal infections collected in 176 study centers (surgical wards and intensive care units). PATIENTS AND METHODS: Clinical, microbiological, and therapeutic characteristics of CAI and non-PostopNAI infections were collected. Management of antibiotic therapy was decided by the attending physician. The efficacy of treatment was evaluated over a 30-day period after the index episode. RESULTS: Evaluatable observations (n = 1008) were collected (761 CAI and 247 non-PostopNAI), including 285 intensive care unit patients. When compared with CAI patients, non-PostopNAI patients presented an increased interval between admission to the surgical ward and operation (1.3 +/- 1.5 vs. 0.5 +/- 0.7 days in CAI patients; P < 0.001), increased proportions of underlying diseases, a more severe clinical condition as assessed by increased proportions of hospitalization in the intensive care unit (48% vs. 22% in CAI patients, P < 0.001) and a higher SAPS II score (34 +/- 15 vs. 24 +/- 14, P < 0.001). In non-PostopNAI patients, increased proportions of therapeutic failure (15% vs. 7% in CAI patients, P < 0.01) and of fatalities (12% vs. 4% in CAI patients, P < 0.001) were observed. CONCLUSIONS: Delayed diagnosis and increased severity are the main characteristics of non-PostopNAI infections. Microbiological features are quite similar in CAI and non-PostopNAI infections, suggesting that antibiotic therapy recommended for CAI infections could be applied to non-PostopNAI patients. Characteristics of non-PostopNAI patients should lead to identify them as a specific entity in clinical trials.     

Alarm treatment is successful in children with day- and night-time wetting

OBJECTIVE: To assess the effect of alarm treatment in children with day- and night-time wetting compared to those with night-time wetting only. MATERIAL AND METHODS: A total of 37 consecutive children (25 boys, 12 girls), all of whom suffered from both day- and night-time wetting, were compared to a group of 21 boys and 16 girls with nocturnal enuresis only. In both groups the age range was 5-13 years. Inclusion criteria were at least two wet nights a week in the previous 4 weeks combined with day-time wetting. The parents were asked to complete a diary during the study period. RESULTS: Sixty-five percent of the children with day- and night-time wetting became dry at night, the average time needed being 49 days (range 22-134 days). Seventy-six percent of the children with only night-time wetting became dry at night, the average time needed being 52 days (range 22-121 days). No significant differences were found between the success rates for the two groups or between the different age groups in the two groups. Of the children with day- and night-time wetting who became dry at night after alarm treatment, 42% also became dry during the day-time. Two years after alarm treatment, 15/16 traced children were still dry at night and all 10 traced children were still dry during the day-time. CONCLUSIONS: As with children with only night-time wetting, the majority of children with day- and night-time wetting become dry at night with the use of an enuresis alarm. The results are good compared to the spontaneous cure rate. By using alarm treatment at night, children often also become dry during the day.     

Modulation of voltage-dependent sodium channels by the delta-agonist SNC80 in acutely isolated rat hippocampal neurons

Following activation, voltage-gated Na+ currents (I(Na)) inactivate on two different time scales: fast inactivation takes place on a time scale of milliseconds, while slow inactivation takes place on a time scale of seconds to minutes. Both fast and slow inactivation processes govern availability of Na+ channels. In this study, the effects of the delta-opioid receptor agonist SNC80 on slow and fast inactivation of I(Na) in rat hippocampal granule cells were analyzed in detail. Following application of SNC80, a block of the peak Na+ current amplitude (EC50: 50.6 microM, Hill coefficient: 0.518) was observed. Intriguingly, SNC80 (50 microM) also caused a selective effect on slow but not fast inactivation processes, with a notable increase in the fraction of Na+ channels undergoing slow inactivation during prolonged depolarization. In addition, recovery from slow inactivation was considerably slowed. At the same time, fast recovery processes were unaffected. The effects of SNC80 were not mimicked by the peptide delta-receptor agonist DPDPE (10 microM), and were not inhibited by the opioid receptor antagonists naloxone (50-300 microM) or naltrindole (10 and 100 microM), indicating an opioid receptor independent modulation of Na+ channels. These data suggest that SNC80 not only affects delta-opioid receptors, but also voltage-gated Na+ channels. SNC80 is to our knowledge hitherto the only substance that selectively influences slow but not fast inactivation processes and could provide an important tool in unraveling the mechanism underlying these distinct biophysical processes.