Imaging of the central nervous system in pediatrics and adolescence.

Magnetic resonance imaging (MRI) has taken its place beside computed tomography (CT) and ultrasonography in effective imaging of the central nervous system in infants and children. The major initial impact of MRI in pediatric neuroradiology has been the displacement or replacement of the more expensive and invasive procedures such as angiography, myelography, cisternography, and ventriculography. Ultrasonography remains the screening procedure for fetal and infant central nervous system abnormalities, whereas CT continues to be an effective brain screening technique after loss of the ultrasonography windows with growth of the child. The better the clinical information transmitted to the radiologist in advance of imaging of the patient, the more likely the clinician will receive valuable information in return.     

Adenosine as a vasodilator in primary pulmonary hypertension

BACKGROUND. The acute administration of vasodilator drugs to patients with primary pulmonary hypertension has been advocated to identify those with reversible pulmonary vasoconstriction. Unfortunately, the usefulness of the drugs currently available is limited by accompanying systemic hypotension. A vasodilator with effects confined to the pulmonary circulation would therefore be advantageous in such patients. METHODS AND RESULTS. The purine nucleoside adenosine was infused into the pulmonary artery in seven patients with primary pulmonary hypertension (baseline pulmonary vascular resistance [PVR], 442-1,295 dyne/cm/sec-5) to determine its effect on PVR. In all patients, there was a dose-dependent and significant reduction (mean maximal percent decrease from baseline, 38.9%; p less than 0.001) in PVR mediated through a decrease in pulmonary artery pressure and an increase in cardiac output. Systemic vascular resistance (SVR) also decreased, but the ratio of PVR to SVR decreased (maximal mean percent decrease from baseline) by 10.5% (p less than 0.025), indicating that adenosine has a preferential vasodilator effect on the pulmonary circulation when administered in this manner. CONCLUSIONS. Because of its pharmacokinetic and vasodilator properties, adenosine may have a specific role in the investigation of primary pulmonary hypertension.     

Immunomodulation of Delayed Hypersensitivity to Methylated Bovine Serum Albumin (MBSA) in Mice Using Subliminal and Normal Sensitization Procedures

Delayed hypersensitivity (DH) was induced in the footpads of mice sensitized to methylated bovine serum albumin (MBSA). The magnitude of this DH response increased with increasing sensitizing concentration of MBSA. Levamisole administered 1 hr prior to MBSA challenge stimulated the DH response and this was optimal using subliminal sensitizing concentrations of antigen. A number of antirheumatic agents, immunomodulators mediator antagonists and antiallergies were subsequently examined using the subliminal sensitizing concentration of MBSA. The same drugs were also evaluated using a normal sensitizing procedure. These studies indicate that the sensitizing concentration of antigen is critical in establishing whether a drug will stimulate or suppress a DH response.     

Effects of haloperidol on motor and cognitive functioning in aged mice

The effects of haloperidol on motor and functioning and cognitive functioning were studied in young (3-5 months old) and aged (20-22 months old) male mice by examining haloperidol-induced catalepsy and haloperidol-induced decrements in performance on a radial arm maze. The aged mice were much more sensitive to these adverse effects of haloperidol than were the young mice. Studies of the distribution of radioactivity from [3H]haloperidol to the brain indicated that the differences in sensitivity to this drug were not due to pharmacokinetic differences. The results demonstrate that mice are suitable for studies of aging-induced changes in the behavioral effects of neuroleptic agents.     

Erythema induratum (Bazin's disease).

Four patients with erythema induratum (EI) have been diagnosed at the Dermatology Department within the past two years. All four patients had a history of recurrent painful nodules on their calves for at least three years before diagnosis. Three of the patients, all with positive Mantoux reaction to tuberculin skin tests, had neither a personal or family history of tuberculosis. The other patient who had a six year history of recurrent painful leg nodules developed a tuberculous breast abscess. There was a dramatic response to anti-tuberculous chemotherapy in all four patients but one subsequently had recurrent nodules which spontaneously subsided without further chemotherapy.