Axial rotation in the lumbar spine and gaping of the zygapophyseal joints

Axial rotation and zygapophyseal joint gaping was studied using 12 human lumbar spines from individuals ranging in age from 14 to 75 years. Using weight and pulley tests and manipulative testing in a torque apparatus, the movement produced by twisting the spine was found not to be pure axial rotation, but rather movement coupled with various combinations of lateral bending and flexion or extension. This motion may not be possible in testing an individual mobile segment. The twisting movements of the spine do not normally produce gaping of the zygapophyseal joints. These joints adapt to the axial rotation by the compliance of their articular cartilages and the movement of fat pads in and out of the joint capsule. Hypermobility appears to be associated with evidence of damage to part of the mobile segment, suggesting that the hypermobility (gaping) at a joint could be due to instability caused by injury.     

Bile acid receptors in colorectal cancer

Bile acids are thought to be involved in both the aetiology and development of colorectal cancer. In this study the existence of specific bile acid receptor proteins has been postulated. A receptor assay which involved labelling with 14C-deoxycholic acid was performed as well as autoradiography using 3H-deoxycholic acid. In an initial study resected colorectal cancer and adjacent histologically normal colorectal mucosa from 39 patients were studied, as were samples of normal gastric mucosa, cancers and benign colorectal tumours. Specific receptors to deoxycholic acid were detected in 12 (30.8 per cent) of the colorectal cancers, but in only 1 (2.6 per cent) of the samples from normal colorectal mucosa (X2 = 11.16, P less than 0.005). No deoxycholic acid receptors were detected in any other tissue studied. Autoradiographs of colorectal cancers showed binding of 3H-deoxycholic acid in receptor-positive tumour tissue. These findings might provide some explanation for the evidence linking bile acids with the disease.     

Ivermectin treatment of onchocerciasis

Ivermectin is a recently developed macrocyclic lactone that has widespread antiparasitic activity. A series of clinical trials has shown that ivermectin is safe and effective in the treatment of human infection with Onchocerca volvulus. Although it is rapidly microfilaricidal, it does not cause a severe reaction as is seen with diethylcarbamazine treatment. The drug also temporarily interrupts production of microfilaria but has no known long-lasting effects on the adult worms. In patients with onchocerciasis, a single oral dose of ivermectin (150 micrograms/kg) repeated once a year leads to a marked reduction in skin microfilaria counts and ocular involvement. At this dose, ivermectin causes minimal side effects and appears to be sufficiently free of severe adverse reactions to be used on a mass scale. Its use promises to revolutionise the treatment of onchocerciasis.     

Cognitive dysfunction in melancholia

Sixty-seven patients with melancholia and 42 normal controls were tested with a battery of neuropsychological tasks selected to assess regional cortical functioning in both hemispheres. Compared with controls, melancholics exhibited a pattern of bifrontal and right parietal impairment, which was independent of age, sex, handedness and drug administration. These findings confirm and extend prior studies and contrast with those we and others have reported in patients with schizophrenia.