Report on a conference on organic solvents and the nervous system.

At two scientific conferences in 1985, one in Copenhagen sponsored by the Nordic Council of Ministers and the World Health Organization (WHO), the other in Raleigh, NC, it was concluded that chronic toxic encephalopathy may develop following long-term occupational exposure to organic solvents (1,2). The terms organic affective syndrome, mild and severe chronic toxic encephalopathy were suggested for this condition describing increasing severity. In May 1990, a conference on organic solvents and the nervous system was held in Copenhagen sponsored by the Commission of the European Communities and the Danish Ministry of the Environment (3). Scientists and representatives from the governments, industries, and labour organisations from the EEC and US participated.     

Has smoking changed the epidemiology of ulcerative colitis?

The influence of smoking on the risk of developing ulcerative colitis is well documented. Compared with lifetime non-smokers, the risk is reduced in smokers and increased in ex-smokers. During the past 50 years general smoking habits have changed considerably. The proportions of smokers and ex-smokers among men and women have undergone significant changes and, consequently, probably also their risk of ulcerative colitis. A review of 56 earlier epidemiologic studies of ulcerative colitis from 1930 to 1990 showed that the sex distribution in ulcerative colitis has changed from an earlier female predominance that has now been replaced by a male predominance. In contemporary pediatric studies no such changes were seen. We propose that these changes in adults are not related to the disease per se but to an extrinsic factor affecting adults but not children--namely smoking.     

Does damage of perivascular astrocytes in multiple sclerosis plaques participate in blood-brain barrier permeability?

In six young and two senile MS cases perivascular astrocytes within demyelination lesions were evaluated immunocytochemically. The peroxidase-antiperoxidase method of Sternberger et al. (1970) was used for visualization of glial fibrillary acidic protein (GFAP). In all cases very weak immunoreactivity of perivascular astrocytes was noted. Accumulation of perivascular glial fibers, and infrequently their fragmentation were observed both within active and old demyelination plaques. Clasmatodendrosis, Rosenthal's fibers and prominent regressive changes of astrocyte perikarya were found only in old plaques. A lack of immunoreactivity of perivascular astrocytes was noted within old demyelination lesions. The background of the latter was often immunonegative to GFAP. It is suggested that secondary damage of perivascular astrocytes influences vascular permeability within demyelination lesions including old plaques.     

Susceptibility to endometrial cancer: influence of allelism at p53, glutathione S-transferase (GSTM1 and GSTT1) and cytochrome P-450 (CYP1A1) loci.

A case-control study was designed to identify associations between polymorphisms at p53, cytochrome P-450 (CYP1A1) and glutathione-S-transferases and endometrial cancer susceptibility. Among all polymorphisms analysed, an insertional variant in p53 (P53PIN3) and two polymorphisms in the 3''-end and exon 7 of CYP1A1 showed significant association with enhanced endometrial cancer risk.     

Chromosome mapping of Rett syndrome: a likely candidate region on the telomere of Xq.

Rett syndrome (RS) is a disease of neurological development. First reported 30 years ago in 1966, its biological and genetic basis remains obscure. RS is commonly thought of as an X linked dominant disorder lethal to hemizygous males. The few familial cases would arise through mosaicism or because of occasional females failing to manifest the disorder through skewed X inactivation in relevant cell types. We have one family where the mother and daughter are affected with RS, and which can be explained according to this hypothesis. If the alternative proposal of Thomas (1996) is correct, that the lack of males affected by such disorders is the result of a high male to female ratio of germline mutations rather than of gestational lethality, then the RS gene should be located on the grandpaternal chromosome. Genomic screening with markers covering the whole X chromosome has been performed. Studies using multiple informative markers indicate that the RS locus is likely to be located close to one of the X chromosome telomeres. Further investigations in eight additional families suggest the most likely region for the RS gene to be is the distal part of Xq (Xq28).     

Pulmonary sequelae of long-term ventilation of very low birth weight premature infants. Results of a follow-up study of 6-to-9-year-old children

Fifty six children with a birth weight of less than 1500 g and gestational age less than 34 weeks were studied at a mean age of 7.7 years. All had required mechanical ventilation, 36 suffered from hyaline membrane disease, 17 from atelectasis and three from pneumonia. Of these patients 37 developed broncho-pulmonary dysplasia (BPD). The study included skin prick test, measurement of ciliary beat frequency, chest X-ray, whole-body plethysmography and histamine challenge. Eight patients suffered from recurrent pulmonary infections up to the age of 4 years. Eleven children had a positive skin prick test. Three suffered from allergic asthma and six from hay-fever. The family history of atopy in these premature infants was no different from that of the general population. Ciliary beat frequency was normal in all cases (frequency: 11.8 +/- 1.8 Hz). In 34 patients X-rays showed minimal changes (peribronchial thickening n = 6, mild emphysema n = 28). Pulmonary function was normal except for an increase of thoracic gas volume which was correlated to grade of BPD according to Northway. There was a significant correlation between oxygen-score and radiological stage of BPD (r = 0.7). Histamine challenge showed hyperresponsiveness in 53% of the children. Eight patients showed a threshold similar of mild asthma (less than 1000 micrograms histamine per ml). The degree of airway hyperreactivity was correlated to the grade of BPD (r = 0.7; p less than 0.01) and the oxygen-score (r = -0.63; p less than 0.05). The oxygen-score may be considered a predictor of hyperresponsiveness and pulmonary outcome in later childhood.     

Chronic maxillary sinusitis. Energy metabolism in sinus mucosa and secretion

The energy metabolism in maxillary sinus mucosa and secretion from 41 patients with, in most cases, recurrent or chronic sinusitis was studied and compared with that in mucosal samples from patients with no previous history of sinus abnormality or infection. In freeze-dried samples, glucose and lactate were measured by enzymatic assays and adenine nucleotides by HPLC. In chronic sinusitis the lactate concentration in the mucosa was increased, probably as a result of increased glycolysis or of impaired diffusion within the mucosa. The lactate concentrations in purulent and non-purulent secretions were 16.3 and 1.1 mmol x kg-1 w.w., respectively. The higher concentration in the purulent secretion was due mainly to leucocyte metabolism. The adenine nucleotide contents in the mucosa were similar in all groups studied. Anaerobic bacteria were isolated only in secretions with a high lactate concentration.     

Contrasting subjective judgement and objective tests in the hearing-impaired.

The Hearing Performance Inventory (HPI, Giolas et al., 1979) was used to measure 21 moderately hearing-impaired persons' subjectively experienced problems in everyday listening. The HPI rating data show that the greatest problems are experienced on the dimensions 'understanding speech without visual cues', and 'perceived intensity' of sounds. 'Understanding speech with visual cues' has a high positive correlation with both 'social situation' and 'work situation' dimensions, whereas 'understanding speech without visual cues' correlates with 'social' and 'personal situation'. The correlations between the HPI and actual performance in the speechreading tests, and between the HPI and cognitive abilities that were assumed to be critical for speechreading ability, were also examined. It was found that vocabulary size, highly intercorrelated with guessing, was important to the 'social situation' dimension on the HPI. Guessing also constitutes an important cognitive predictor of speechreading skill. However, none of the HPI dimensions was directly related to objective communicative competence. Given the limitations of speechreading training, the data suggest that vocabulary and social skills should be focused on during communicative training.