Lymph node biopsy in patients with human immunodeficiency virus infections

Twenty-one male homosexuals were followed up by repeated lymph node biopsy for a mean (+/- SEM) follow-up of 99 +/- 18 weeks. Four histologic patterns were seen on biopsy: explosive follicular hyperplasia (EFH), follicular involution (FI), a mixed pattern of EFH with FI in the same node, and lymphocyte depletion. Patients with FI and lymphocyte depletion had mean survival times that were significantly less than those for the subjects with EFH. The percentage of lymph node follicles with suppressor cell clusters (T8) in EFH lymph nodes was significantly higher (43% vs 8%) than in nodes from patients without risk for human immunodeficiency virus infection. Helper/suppressor T-cell ratios in control nodes were 1.6; in EFH nodes, 0.97; and in FI nodes, 0.88. A remarkable 33% of patients in this lymphadenopathy group ultimately developed large-cell (B-cell) lymphoma, suggesting that the follicular stimulation noted histologically played a role in the development of this neoplasm. These data show that there is a progressive destruction of lymph node follicles that correlates with the progression of the disease and that lymph node histologic features may provide important prognostic information.     

Analysis of lick rate measures the positive and negative feedback effects of carbohydrates on eating

Previous work has shown that measuring the rate of ingestion of liquid diets, rather than simply volume, reveals important features of ingestive behavior which can help to explain why a particular volume of a liquid is ingested. This study is an extension of that work to a variety of different test solutions. In this study the rate of ingestion of saccharin, two different concentrations of glucose and sucrose and their mixtures with saccharin and seven different concentrations of maltose were measured. The rate functions were fit by the least-squares method to a linear function to determine the intercepts and slope constants. Analysis of how these two parameters changed with the concentration and composition of the test solutions confirms, using different test solutions, a previously reported conclusion that the initial rate of ingestion (the intercept) measures palatability and that the slope constant is a measure of the rate of development of a negative feedback satiety signal.     

Retinal pigment epithelial change and partial lipodystrophy

Cuticular drusen and retinal pigment epithelial changes were found incidentally in a 27 year old Lebanese woman during assessment of partial lipodystrophy. Her vision was normal despite involvement of both maculae. The patient had hypocomplementaemia, but serum C3 nephritic factor was absent and renal function was normal. She had impaired glucose tolerance and a continuous infusion of glucose with model assessment (CIGMA) test revealed low normal tissue insulin sensitivity and high normal pancreatic beta cell function. Mild fasting hypertriglyceridaemia (2.0 mmol/l) may have been secondary to impaired insulin sensitivity. Endocrine function was otherwise normal apart from a completely absent growth hormone response to adequate hypoglycaemia. The simultaneous occurrence of partial lipodystrophy and retinal pigmentary epithelial and basement membrane changes appears to be a newly recognized syndrome.     

Computer-directed stereotactic biopsy of intrinsic brain stem lesions

Despite advances in the neuro-imaging of the brain stem, an accurate diagnosis of intrinsic lesions in this region requires tissue sampling and histological verification. We have performed a series of computer-directed stereotactic procedures in 12 patients with intrinsic brain stem lesions. A positive diagnosis was obtained in 11 cases and therapeutic intervention was possible in four. There was no operative mortality. Because of the importance of an accurate diagnosis in order to avoid inappropriate therapy, together with the relative safety of the technique, computer-directed stereotactic biopsy should be considered in all patients harbouring an intrinsic brain stem mass.     

Developing teaching strategies based on new knowledge

New research in the areas of cognition, learning, memory, and motivation indicates that people can learn more and at a faster rate, than was previously thought, by means of improved teaching strategies aimed specifically at enhancing memory storage and retrieval, cognition, and learning (Estes, 1983; Kirby & Biggs, 1980; Murphy & Smith, 1982). Other research in psychology, educational psychology, biochemistry, and neurology shows that human intelligence can be more fully developed or modified (Machado, 1980). One of the means to achieve these ends is teaching strategies developed specifically to enhance the brain's natural capacities.     

Endocrine changes in Alzheimer's disease

In conclusion, at present, no consistent endocrine abnormalities can be detected in patients suffering from Alzheimer's disease. However, assessment of neuroendocrine function might help identify subpopulations of patients with particular neurotransmission abnormalities who are likely to benefit from a specific pharmacologic strategy. For example, patients in whom cholinomimetic drugs produce the greatest elevation in plasma cortisol concentration appear to derive the most symptomatic benefit from these drugs.