Acute Pancreatitis and Systemic Lupus Erythematosus: Necropsy of a Case and Review of the Pancreatic Vascular Lesions

The role of systemic lupus erythematosus (SLE) in the development of acute pancreatitis is a matter of controversy since, in many cases, this complication has been attributed to the drugs administered. In this study, we present a patient diagnosed as having SLE who developed acute pancreatitis with no apparent cause aside from her basic disease, and in whose necropsy was observed vascular damage consisting of severe intimal proliferation. Pancreatic vascular lesions in previously reported patients with lupus are reviewed.     

Role of copper in mitochondrial iron metabolism

Heme synthesis by copper-deficient cells was investigated to elucidate the nature of the defect in intracellular iron metabolism. Iron uptake from transferrin by copper-deficient reticulocytes was 52% of normal, and the rate of heme synthesis was 33% of normal. Hepatic mitochondria isolated from copper-deficient animals were deficient in cytochrome oxidase activity and failed to synthesize heme from ferric iron (Fe III) and protoporphyrin at the normal rate. The rate of heme synthesis correlated with the cytochrome oxidase activity. Heme synthesis from Fe(III) and protoporphyrin by normal mitochondria was enhanced by succinate and inhibited by malonate, antimycin A, azide, and cyanide. It is proposed that an intact electron transport system is required for the reduction of Fe(III), thereby providing a pool of ferrous iron (Fe II) for protoheme and heme a synthesis.     

Necrotizing fasciitis caused by Salmonella enteritidis

A 76-yr-old man developed necrotizing fasciitis due to Salmonella enteritidis 1 month after an episode of gastroenteritis due to the same microorganism. The fact that S. enteritidis was the only organism isolated despite adequate anaerobic cultures confirm the ability of salmonellae to produce severe monomicrobial soft tissue infections.     

Heparin-associated thrombocytopenia in a patient with polycythemia vera: the importance of a marked drop in platelet count

The present report describes a patient with polycythemia vera who developed a severe arterial and venous thrombosis caused by systemically administered heparin. An immunologic implication has been proposed as pathophysiological mechanism of this heparin-associated thrombocytopenia and thrombosis syndrome. It is suggested, however, that a strong decrease in platelet count as occurred in this patient leads to a higher chance of developing this complication.     

Factors in the pathogenesis of acute schistosomiasis mansoni.

Acute schistosomiasis mansoni was studied in 26 Puerto Rican patients whose clinical presentations differed widely in severity. Severity of illness was found to be positively correlated (r = 0.79) with the intensity of infection as measured by the concentration of eggs of Schistosoma mansoni in stool specimens. However, some patients had severe illness but relatively light infections. The disappearnace of symptoms and return toward normal of laboratory measures of disease activity were not associated with any diminution in the fecal egg count. Elevations of IgG, IgM, IgE, and of titers of anibody in serum indicated that the illness is associated with intense immune activity. The magnitude of the IgG and IgE responses was related to intensity of infection. The fact that incubation periods were shorter than the time needed for schistosomes to reach adulthood and lay eggs suggests that the syndrome can be initiated by parasite stages present before oviposition. No marked changes in complement (C3, C3p, C4, and CH50) and no signs of renal disease were noted in any of these patients.     

Double-blind test of metronidazole and tinidazole in the treatment of asymptomatic Entamoeba histolytica and Entamoeba hartmanni carriers.

One hundred and fifteen persons with asymptomatic Entamoeba histolytica or E. hartmanni infection, or both, were given metronidazole (750 mg three times daily for 5 days), tinidazole (1 g twice daily on 2 consecutive days), or a starch placebo. Three post-treatment stools were examined in the 2 weeks following initiation of treatment. Cysts of E. histolytica reappeared in the stools of 37% of 30 given metronidazole, 62% of 34 given tinidazole, and 70% of 31 given placebo. Cysts of E. hartmanni reappeared in the stools of 46% of 24 given metronidazole, 69% of 16 given tinidazole, and 90% of 10 given placebo. Rapid absorption and short duration of treatment make both drugs ineffective for the treatment of ameba carriers.     

Patterns of colonic motility as recorded by a sham fecaloma reveal differences among patients with idiopathic chronic constipation

BACKGROUND: By using a technique designated sham fecaloma, we were able to identify two types of segmentary motor phenomenon: displacement motor phenomena and nondisplacement motor phenomena. The aim of the study contained herein was to evaluate for identification of patients with different types of slow-transit constipation. METHODS: Studies were performed in healthy subjects (n=5; colonic transit time <30 hours) and in constipated patients (n=6; colonic transit time >125 hours; normal rectoanal manometry). A Foley®-type recording probe with two perfused catheters (proximal and distal) was used. A rigid sigmoidoscope was used to place the probe at the sigmoid colon. Values recorded by the distal catheter were subtracted (point by point) from the values recorded by the proximal catheter. Subtraction curves were analyzed to quantify characteristics of displacement motor phenomena (an anally directed pressure gradient) and nondisplacement motor phenomena (an orally directed pressure gradient). RESULTS: All healthy subjects had contractions during the recording session. Displacement motor phenomena were predominant (displacement motor phenomena/30 minutes = 21.2±13.2; range, 3–39). Constipated patients yielded two different patterns: three patients had a very small number of contractions, and three patients had a prevalence of nondisplacement motor phenomena, with numbers similar to numbers of displacement motor phenomena in healthy subjects. A comparison of the patterns of constipated patients revealed a statistically significant difference (P=0.039). CONCLUSION: Sham fecaloma is a simple and safe test. Constipated patients in this study had two different patterns of colonic motility scarce activity without haustration and normal activity without displacement motor phenomena. This method might be useful as a diagnostic tool for clarification of the pathophysiology of severe colonic motor disorders.Supported in part by a grant from Fondo de Investigaciones Sanitarias (FIS) (Spain) and by a grant from Junta de Comunidades de Castilla-La Mancha (Spain).Software and analytic systems used during the course of this study were developed by Prof. P. Carrion, Prof. F. Garcia-Sevilla, and Prof. M. Martinez-Iniesta, all of Castilla-La Mancha University (Department of Electronics) Albacete, Spain.