Rezidivierende infantile Larynxpapillomatose bei Hypophysenvorderlappeninsuffizienz

Summary The report at issue discusses the relationship between laryngeal papillomatosis and the endocrine system. It is referred to the clinical course of a 19-years-old patient suffering infantil laryngeal papillomatosis and antuitary insufficiency since childhood. The cause of hormonal insufficiency was the destruction of the hypophysis by a craniopharyngeoma. As a result of this insufficiency the total metabolic process of the patient was reduced to a vita-minima-function for years. Despite this metabolic depression the laryngeal papillomas have grown excessively. The number of recurrent papillomas could not even be reduced by exstirpation of the craniopharyngeom although the secundary insufficiency of the adrenal cortex and the secundary hypothyreosis have been compensated by cortisone and thyroxine. A hormonal influence on the laryngeal papillomas by the adrenocorticotrophic hormone and the thyroid hormone could be excluded. An inhibitory effect on the papillomas by the somatotrophic hormone seems unlikely. Furthermore the effect of the sexual hormones remains doubtful. The regression of laryngeal papillomas frequently observed by the end of puberty supports a hormonal influence by gonadotrophic hormone.     

Adoptive immunity transferred by naive donor cells immunized in vitro

Speedy restoration of immune responsiveness in bone marrow recipients has been the objective of studies in which the donor was immunized so that specific immunologic memory could be transferred adoptively and selectively. Using unrelated rabbits, matched for major histocompatibility antigens but mismatched for their immunoglobulin allotypes, it could be shown that recipients of lymphoid cells from naive donors became B cell chimeras but did not use donor-derived B cells for their antibody responses to test antigens. In contrast, cells from donors primed for such antigens dominated antibody production in recipients in response to specific challenge. Clonal restriction in such adoptive responses was demonstrated. We now show that the induction of effective memory in cells from naive donors can be achieved in vitro during the preparation of donor cells for transfer to the recipient. Early challenge of the recipient enhances expression of the transferred immune response quantitatively and also results in the establishment or preservation of a larger diversity of clones from the donor.     

Pachygyriclike changes: topographic appearance at MR imaging and CT and correlation with neurologic status

Studies of 23 pediatric patients with pachygyriclike changes (PLCs) examined with computed tomography (CT) and magnetic resonance (MR) imaging were reviewed to determine topographic patterns and correlate them with various clinical syndromes and degrees of neurologic impairment. Three types of topographic distributions were identified: unilateral, diffuse, and bilateral nondiffuse (of which eight of 10 showed frontotemporal predominance). PLCs were an isolated finding in seven patients, were associated with various congenital syndromes in nine patients, and were associated with congenital infection in seven patients, six of whom showed marked white matter abnormalities. Although most patients had severe developmental delay, three with nondiffuse PLCs had less severe impairment, permitting less required care.     

Idiosyncratic thinking and personally overinvolved thinking in schizophrenic patients during partial recovery

The present research investigated the importance of idiosyncratic thinking and personally overinvolved thinking in schizophrenia and evaluated changes in these factors over two phases of the disorder (the acute phase and the phase of partial recovery). Five indexes of thinking derived from two tests were administered to 25 acute schizophrenic patients, 23 borderline patients, and 47 nonschizophrenic psychiatric patients at week one and week eight of hospitalization. Schizophrenic patients evidenced a significantly higher level of idiosyncratic thinking than nonschizophrenic patients at the acute phase (p < 0.001). As patients emerged from the acute phase, schizophrenics still tended to score higher on idiosyncratic thinking than nonschizophrenics. However, the differences had diminished considerably and on some indexes were no longer significant. In addition, all patients manifested less idiosyncratic thinking as the acute phase diminished, with this decrease being especially prominent among the schizophrenic group. This suggests that some aspects of disordered schizophrenic thinking are at least in part a function of the acute or active phase.There were no significant differences between the schizophrenic and non-schizophrenic patients in the level of personally overinvolved thinking at either time period. Although exhibiting less personally overinvolved thinking after the acute period, most of these hospitalized patients still showed a moderate amount of personalizing even during partial recovery. The results suggest that idiosyncratic thinking is an important characteristic of the acute schizophrenic thought disorder and is a useful parameter in differentiating acute schizophrenics from acute nonschizophrenics.     

Hemodialysis of phenytoin in a uremic patient.

Removal of phenytoin by hemodialysis was determined in a uremic patient. The rate of appearance of the drug in dialysate, the plasma concentration with time, and the plasma clearance by dialysis were measured. Plasma protein binding of phenytoin was also determined. In spite of greatly reduced plasma protein binding in the uremic patient, removal rate was observed to be less than 10% of the rate of presentation of the dialyzer. During the 6-hr period of dialysis, the plasma concentration showed little change. The amount collected in the dialyase, 43.6 mg, was only a small fraction of drug in the body. These results indicate that replacement of phenytoin based on the amount of drug removed by dialysis is unnecessary in chronically dialyzed uremic patients. In addition, the utility of hemodialysis in phenytoin overdose is questioned.