MODULATION OF ALCOHOL PREFERENCE BY NMDA ANTAGONISTS IN MALE RATS

Chronic alcoholization by alcohol inhalation was used to studythe properties of magnesium, a non-competitive NMDA receptorantagonist, and CGP 39551, a competitive NMDA receptor antagonist,on behavioural dependence as estimated by the free-choice paradigm[alcohol 10% (v/v) vs. water], on the hypermotility after alcoholwithdrawal, and finally on the cortical vascularization. Thefirst experimental group received the drugs per os during thewhole alcoholization period. Magnesium (20 mg/kg/day) decreasedthe alcohol dependence while CGP 39551 (5 and 10 mg/kg/day)increased, in a dose-dependent manner, the dependence to alcohol.A second group of animals received the same drugs at the samedosages, not simultaneously during chronic alcoholization, butimmediately after alcoholization in one shot i.p. injection.In this case, rats receiving 5 mg/kg CGP 39551 never showedany dependence towards alcohol, while 10 mg/kg CGP 39551 or20 mg/kg magnesium prolonged the number of days of alcohol dependence.These results thus indicate the close interaction between NMDAreceptor function and dependence for alcohol. Magnesium hadno effects on hypermotility, while CGP 39551-treated animalspresented a decrease in the hypermotility observed after alcoholwithdrawal. Neither drug affected the hypervasculanzation accompanyingthe chronic alcoholization.     

LYME PERICARDITIS LEADING TO TAMPONADE

We report the case of a 62-yr-old man who presented with Lymepericarditis leading to cardiac tamponade shortly followed byan arthritis. IgM and IgG antibodies to Borrelia burgdorferiwere demonstrated in serum by indirect immunofluorescence. Borreliaburgdorferi was demonstrated and identified in pericardial fluidby indirect immunofluorescence using serum from a patient withproven Lyme disease and by a monoclonal antibody immuno-goldsilver stain. Spirochetes were also found in synovial biopsiesusing a silver stain. The tamponade was treated with pericardiocentesis;the arthritis was treated with intravenous ceftriaxone (2 gonce daily) for 14 days. The patient recovered completely withindays of commencing treatment. This case report demonstratesthat borrelial infection may lead to pericarditis and cardiactamponade. KEY WORDS: Borrelia burgdorferi infection, Arthritis, Pericarditis, Tamponade     

Determination of left ventricular volume by two-dimensional echocardiography: comparison with magnetic resonance imaging

Left ventricular volume was determined in 12 healthy volunteersusing a newly developed two-dimensional echocardio-graphic delineationmethod. The results were compared with those of magnetic resonanceimaging, which served as the method of reference. Left ventricularend-diastolic volume was 123 ± 12 ml, echocardiographicallydefined, and 121 ± 12 ml calculated with magnetic resonanceimaging. End-systolic volume was 41 ± 7 ml on echocardiographyand 37±6 ml on magnetic resonance imaging. Left ventricularejection fraction was 67 ± 4%, echocardiographicallydefined, and 70 ± 5%, calculated with magnetic resonanceimaging. There was no statistical difference for any of themeasured parameters. Interstudy and inter-observer variabilitywas minimal. In conclusion, in healthy volunteers left ventricularvolume was accurately defined, using this newly developed two-dimensionalechocardiographic delineation method. During endocardial delineationa dynamic display is continuously available on a second window,allowing precise visual edge-detection. Moreover, correctionscan be made easily and quickly. These two advantages enhancethe accuracy of the method, even in cases of poor echogenicity.     

Occupational transmission of HIV in health care workers: A review

Health care workers have a small but real risk of acquiringHIV infection as a result of occupational exposure. In thispaper, we review all reports in the scientific literature from1984 through to December 1993 of confirmed and probable casesof HIV seroconversion after a specific occupational exposure.A total of 64 confirmed cases have been reported, 24 in Europe,36 in the USA and 4 in other countries. Most seroconversionshave resulted from percutaneous exposure (91%) to AIDS patients(62%), usually caused by hollow bore needlestick injuries inflictedduring blood drawing procedures. Almost all seroconversionshave been detected within 6 months of exposure (94%) and haveusually been preceded by an episode of acute illness (73%).Ten seroconversions have occurred in spite of partial or completecourses of zidovudine prophylaxis. An additional 113 probablecases have been reported, 75 in the USA, 35 in Europe and 3in other countries. Aggregating the results of the prospectivestudies carried out, it is calculated that the risk of seroconversionfollowing percutaneous exposure is 0.33% or 3 in 1000 exposures(95% Cl: 0.21–0.52%), while the risk following mucocutaneousexposure is much lower (0.04%, 95% Cl: 0.006–0.31%). Thedocumented failure of zidovudine prophylaxis following occupationalexposure in a number of instances indicate its effect is, atbest, only partial; furthermore, exposure to source patientswho have been receiving the drug may lead to transmission ofzidovudine-resistant strains of HIV. Risk factors for occupationalexposure to HIV and for transmission, given that an exposurehas occurred, are discussed.     

Potentiation of the mitogenic effect of estrogen on the pituitary-gland by alcohol-consumption

The effect of alcohol on estrogen-regulated lactotropic cell proliferation was examined in Fisher 344 rats. Alcohol was administered for 2 weeks using liquid diet containing 8.7% ethanol (v/v) and 37% ethanol-derived calories. The control group was pair-fed with an isocaloric diet minus the ethanol or adlib-fed with normal diet. Ethanol-treated rats showed mean blood ethanol concentrations between 60-90 mg/dl. Alcohol treatment did not effect the body growth rate, but increased the DNA synthesis in lactotropes and reduced the levels of lactotropic growth inhibitory transforming growth factor-beta 1 (TGF-beta 1) protein and mRNA in the pituitary. These results suggest that alcohol promotes estrogen-induced lactotropic proliferation, possibly by down regulating the inhibitory TGF-beta 1 control of lactotropic function.     

VOLTAGE FIELDS SURROUNDING NEEDLES USED IN REGIONAL ANAESTHESIA

Using a bench model, we have studied the voltage fields surroundingboth insulated and uninsulated needles used in regional anaesthesia.The findings were compared with earlier computer predictionswhich suggested that the fields would be markedly differentfor the two types of needle. The results confirm that the fieldsdiffer markedly and suggest that the use of insulated needlesmay not necessarily improve the accuracy of nerve location andthat uninsulated needles may be more appropriate. ^*Present addresses: Department of Anaesthetics, Hull Royal Infirmary,Hull, Humberside. Droitwich Knee Foundation, Saga House, SansomePlace, Worcester Present addresses: Droitwich Knee Foundation, Saga House, SansomePlace, Worcester.     

Neoadjuvant cisplatin plus ifosfamide in patients with stage IIB cervical cancer: a single center phase II study

The objective of this study was to evaluate cisplatin plus ifosfamide as neoadjuvant chemotherapy with regard to toxicity and clinical response in patients with stage IIB cervical cancer. Sixty-eight patients with previously untreated stage IIB cervical cancer were given two cycles of chemotherapy: cisplatin 20 mg m⁻² on Days 1–5, infused over 1 h; ifosfamide 1.2 g m⁻² on Days 1–5 infused over 30 min. Mesna 120 mg m⁻² was administered as a bolus 15 min before ifosfamide, and a continuous infusion, delivering Mesna 1.2 g m⁻², was given subsequently over the next 16 hours. The treatment cycle was repeated on day 21. Responders were then randomized to surgery or radiation therapy. All 68 patients were evaluable for toxicity. Toxicity was found to be acceptable. One patient died at home one month after completion of the second treatment cycle. There was one grade 4 thrombocytopenia. Grade 3 toxicities included anemia in four patients, leucopenia and nausea and vomiting in one patient each. Sixty-two patients were evaluable for response. A clinical response was documented in 44 of the 55 evaluable patients (80%), with 17 complete responses (31%) and 27 partial responses (49%) (95% confidence limits 69%–91%, 19%–43%, and 36%–62% respectively). The intent-to-treat response rate was 64.7%. Twenty-one patients were randomized to surgery and 23 patients to radiation therapy. Amongst the eight patients with a complete clinical response, one patient had a complete pathological response and one patient had residual intra-epithelial neoplasia. The drug combination of cisplatin plus ifosfamide had acceptable toxicity and gave a clinical response rate of 80% in previously untreated patients with stage IIB cervical cancer.     

Leiomyoma of the esophagus associated with bronchial obstruction owing to inflammatory pseudotumor in a child

Although relatively common in adults, leiomyoma of the esophagus is a rare disorder in children. A single case report describes the coexistence of both esophageal and bronchial leiomyoma in a child. The authors describe the diagnostic and treatment challenges encountered in a 2-year-old boy with coexisting inflammatory pseudotumor and esophageal leiomyoma presenting as massive atelectasis.     

利尿酸是打开血-迷路屏障的钥匙

目的观察在不同的时机应用利尿酸以暂时破坏耳蜗血管纹上皮是否能够开放血-迷路屏障,从而促使庆大霉素进入耳蜗或者从耳蜗排出.方法听神经动作电位测试技术,全耳蜗毛细胞计数定量观察技术和荧光偏振免疫法测定庆大霉素浓度的技术被用于以下两个不同目的的实验观察.(1)当庆大霉素血中浓度高于内耳液浓度时,应用利尿酸破坏蜗管外壁以促使更多的庆大霉素进入耳蜗以制备不同程度耳蜗损害的动物模型.(2)当庆大霉素内耳浓度高于血中浓度时,应用利尿酸损坏蜗管外壁以促使蓄积在耳蜗内的庆大霉素从内耳排出以达到挽救毛细胞的目的.结果1.当庆大霉素血中浓度高于内耳液浓度时,注射利尿酸可造成更多的毛细胞损害和听功能障碍,外淋巴中药物的峰值浓度和半衰期浓度也均比单独一次注射庆大霉素动物外淋巴中药物浓度增加一倍,说明同时注射利尿酸可促使更多的庆大霉素从血液进入耳蜗并造成更严重的毛细胞损害.2.当血液中庆大霉素排空之后,注射利尿酸可减少毛细胞数量的损失程度,同时发现延迟注射利尿酸组动物的听力损失程度比不经利尿酸处理动物组有所减轻,外淋巴中药物浓度也比不经利尿酸处理动物组降低一半,说明当GM在耳蜗内蓄积但血清中已经排空时注射EA有助于降低药物在耳蜗内的蓄积并挽救尚未被破坏的毛细胞.结论利尿酸可以做为打开血-迷路屏障的钥匙,但是应用利尿酸开放血-迷路屏障可以产生双向结果,其关键在于注射利尿酸的时机.