Pulmonary Venous Flow Pattern in Severe Aortic Regurgitation with Diastolic-Systolic Mitral Regurgitation Detected by Transesophageal Echocardiography

The pulmonary venous flow patterns of two patients with severe aortic regurgitation (AR) (one with 2+ diastolic, 2 + /3 + systolic mitral regurgitation (MR), the other with minimal diastolic and 1 + /2 + systolic MR) was examined with TEE. A reduced systolic forward flow and an accentuated diastolic reversal flow were found in each case, irrespective of the amount of MR. According to the first impression it could perhaps be possible to judge the amount of AR on the basis of the VTI measurement of the pulmonary venous flow pattern.     

PERINATAL CAMPYLOBACTER FETUS SS JEJUNI ENTERITIS

ABSTRACT. Vesikari, T., Huttunen, L. and Mäki, R. (Department of Clinical Sciences, University of Tampere; Department of Paediatrics, Central Hospital of Päijät-Häme, and Department of Microbiology, Tampere Central Hospital, Finland). Perinatal Campylobacter fetus ss jejuni enteritis. Acta Paediatr Scand, 70:261, 1980. –A 2-day-old breast-fed male infant developed mucoid and bloody diarrhoea, and Campylobacter fetus ss jejuni was isolated from the stools but not from the blood. The probable source of transmission was his mother in whom symptoms of Campylobacter jejuni - associated illness began one day earlier. Both showed IgM, IgG and IgA antibody responses to autologous and reciprocal strains of Campylobacter jejuni as studied by ELISA.     

Hypochlorous acid induced activation of human neutrophil and gingival crevicular fluid collagenase can be inhibited by ascorbate

Abstract— Interstitial collagenase either obtained from human neutrophils by phorbol myristate acetate (PMA) induced degranulation or isolated from human gingival crevicular fluid was found to be activated by addition of an oxidative agent, hypochlorous acid (HOCl). Collagenase released by PMA stimulated neutrophils was completely in latent form but underwent partial autoactivation during 16 h incubation at 22°C in the presence of soy bean trypsin inhibitor. The partial autoactivation was potentiated to complete activation of released collagenase after addition of exogenous HOCl. Ascorbate prevented this activation of neutrophil collagenase. Isolated human gingival crevicular fluid collagenase represented an apparent M_r of 70 kD in completely latent form, whereas 70/54 kD enzyme species were detected for partially autoactive form of the enzyme. Western blot analysis of gingival crevicular fluid using a polyclonal antibody raised against purified human neutrophil collagenase revealed the same 70/54 kD molecular forms of the enzyme. The latent gingival crevicular fluid collagenase was also activated by HOCl and this activation could be prevented by ascorbate. Activation of the 70 kD latent collagenase by HOCl as well as by other non-proteolytic activators such as an organomercurial compound (phenylmercuric chloride) and a gold (I) compound (gold thioglucose) was not associated with detectable changes in apparent M_r, whereas trypsin activation resulted in fragmentation of 70 kD enzyme to 54 kD species. Our results provide further evidence for the neutrophil origin of gingival crevicular fluid collagenase and suggest that, in addition to proteolytic activation, oxidative and antioxidative agents seem to be able to regulate neutrophil collagenase activity.     

Incidence,prognosis and recovery of Bell's palsy A survey of about 1000 patients (1974–1983)

Over a 10-year period the diagnosis Bell's palsy was made in 1293 patients. The files of 1235 patients were studied; the relevant data were stored in a computer and analysed. Factors analysed included the source of referral of the patients as well as their age and sex, the time of onset of the paralysis, recurrence, side of the face, and pregnancy. The incidence of hypertension, diabetes and other diseases was evaluated. The fate of the nerve is determined to a large extent in the first week of the disease. The nerve excitability test is a reliable predictor of the final outcome. The system of classification of recovery we have used for many years is compared to the International Facial Nerve grading system. If denervation and poor recovery are to be prevented as far as possible, early examination and treatment of selected patients with prednisone is mandatory. An important factor in recovery is the age of the patient.     

Neurologic Sequelae Following Interferon Therapy of Juvenile Laryngeal Papilloma

ABSTRACT. Human leukocyte interferon at doses from 2 million units every two days to 3 million units daily was given to a 2-year-old boy for the treatment of recurrent juvenile laryngeal papilloma. After 7 months of treatment the child developed spastic diplegia, which persisted despite the discontinuation of interferon therapy. The clinical picture was consistent with an upper motor neuron lesion; no evidence of peripheral neuropathy was found.     

Stopping Insulin Treatment in Middle-aged Diabetic Patients with High Postglucagon Plasma C-Peptide

ABSTRACT We studied the successfulness of stopping insulin treatment in middle-aged diabetic patients aged 45–64 with a high postglucagon C-peptide level and the effects of this change on glycaemic control, serum lipids and lipoproteins. Insulin treatment was successfully stopped in 15 of our 22 patients who satisfied the inclusion criteria for the study and were selected on the basis of a computer file including practically all diabetic patients treated with insulin in the Kuopio University Central Hospital region (population base 250000 inhabitants). Insulin therapy was restarted in seven patients during the first 3 months after discharge. During the following 9 months insulin therapy was restarted in another three patients so that after a 1-year follow-up period half of the diabetic patients whose insulin therapy was stopped had been switched back to insulin. Insulin therapy was seldom successfully stopped if the postglucagon C-peptide value was under the limit of 1.0 nmol/l. Glycaemic control did not change during the follow-up, although there was a significant weight loss in diabetic patients. No changes were observed in serum lipids or lipoproteins with the exception of LDL cholesterol, which showed a significant reduction during the 3-month follow-up. In conclusion, insulin therapy can often be successfully stopped in patients with postglucagon C-peptide over the limit of 1.0 nmol/l without worsening of glycaemic control and without unfavourable changes in serum lipid and lipoprotein levels.     

Effects of a β-blocking agent, timolol maleate, on saliva in healthy volunteers

Abstract — The effects of timolol maleate on the secretion and composition of human saliva were studied in vivo. Eight healthy volunteers received orally 10 mg timolol maleate. Stimulated parotid saliva samples, resting whole saliva samples, and blood samples were collected immediately before and four times after the drug intake at intervals of 1 h. The levels of total protein, lysozyme, IgA, IgG and IgM, salivary peroxidase, myeloperoxidase, lactoferrin, amylase, thiocyanate (SCN^-), and hypothiocyanite (OSCN^-) were analyzed from saliva samples. Drug levels were measured both from parotid saliva and blood samples. Results were compared to the analyses of the samples collected in a similar way but without administration of any drugs. Decreased levels of total protein, lactoferrin, amylase, and salivary peroxidase were observed in parotid saliva after a single oral dose of timolol maleate. No such decrease was found in lysozyme, myeloperoxidase, SCN-, OSCN-, or immunoglobulins. Salivary flow rate was not significantly changed after drug intake. The results suggest that the β-blocking drug may cause qualitative changes in the composition of saliva by inhibiting the synthesis and/or release of acinar proteins.     

Amyloid-Associated Muscle Pseudohypertrophy and Multiple Myeloma in a Man with Hypernephroma

ABSTRACT. Amyloidosis is known to occur both in renal adenocarcinoma and multiple myeloma. This paper describes a 52-year-old man who developed multiple myeloma and widespread amyloidosis after surgical removal of a hypernephroma. Multiple myeloma presented with osteolytic bone lesions and slight bone marrow plasmocytosis. Both kappa light chains and monoclonal IgG were secreted. Amyloidosis was seen as muscle pseudohypertrophy with wood-hard masses of amyloid in shoulders, girdle, buttocks and proximal limbs. Macroglossia was impressive and swelling of submandibular structures and the floor of the mouth was marked. Knowing the peculiar immunological potency of hypernephroma, attention is called to associations between renal carcinoma and monoclonal gammopathies, including amyloidosis.