Incidence of intestinal gamma/delta T cells in children with celiac disease and ulcerative colitis]

Authors studied the numbers of T-cell receptor-alpha/beta, gamma/delta positive lymphocytes and the proportion of gamma/delta positive cells with a non-disulfide linked form of gamma/delta receptor in jejunal mucosa from 19 coeliatic children, in rectal specimens from 14 children with ulcerative colitis, as well as in specimens of 23 healthy controls. Monoclonal antibodies and a sensitive indirect peroxidase method were used. In the lamina propria and epithelium of a normal jejunum and rectum, as well as in the rectal and colonic mucosae of patients with ulcerative colitis only low numbers of gamma/delta positive cells were seen. In the lamina propria, in the surface epithelium, as well as, in the epithelium of the Lieberkühn crypts the number of gamma/delta positive cells were significantly higher than in the controls before treatment, during gluten free diet and after the gluten challenge. In the epithelium the absolute numbers of these cells remained constant during gluten elimination and provocation. The constantly elevated population of gamma/delta positive T-cells in coeliac disease might show their primary pathogenetic role in this disorder. The detection of elevated number of intraepithelial gamma/delta T-cells may have significance in the diagnosis of coeliac disease.     

Granular cell abrikossoff tumours of the larynx and tongue treated with the carbon dioxide (CO2) laser

Seven cases of granular cell Abrikossoff tumours of the larynx and tongue are reported: four in the tongue and three in the larynx. All of these tumours were removed with the carbon dioxide (CO₂) laser. The anatomical site of the origin and clinical features of granular cell tumours (GCT) are not specific. Histological, light microscopic, electron microscopic (EM) and immunohistochemical studies are required for diagnosis. The histogenesis and cellular derivation of GCTs is still controversial. The biological potential and lack of cellular atypia define a benign process. However, it is important to take into account that these tumours have ill-defined borders without a capsule. Radiation therapy has proved ineffective in the past. Surgical excision with a wide margin is required. Because of numerous advantages, for example, no bleeding, no oedema, minimal pain and quick recovery, CO₂ laser removal is the treatment of choice. The authors have not seen any recurrence or complications.     

Tardive dyskinesia on Hungarian psychiatric wards

The authors found tardive dyskinesia (TD) in 23.5% of 200 hospitalized schizophrenic patients, most of whom had received neuroleptic treatment for at least two years. The frequency and severity of TD increased with age, and the more advanced the age at which the patient started taking neuroleptics, the more likely it was that TD would develop. Severe TD was more common in men than in women. Prolonged treatment with neuroleptics or the use of antiparkinsonism drugs increased the risk of TD.     

Dexamethasone suppression test as an aid for selection of specific antidepressant drugs in patients with endogenous depression

The dexamethasone suppression test (DST) and response to two different antidepressant drugs (maprotiline as a specific noradrenergic, and amitriptyline as a predominantly serotoninergic drug) were investigated in 44 endogenously depressed female inpatients. The more anxious and/or agitated patients were mostly treated with amtiriptyline, the non-anxious and retarded patients with maprotiline. It was found that among maprotiline responders (N = 15) there were significantly more abnormal DSTs and postdexamethasone serum cortisol levels were significantly higher than among amitriptyline responders (N = 16). On the other hand, DST abnormalities among amitriptyline non-responders (N = 10) were similar to those among maprotiline responders. The results confirm earlier reports by Brown et al. (1980), Ettigi et al. (1983) and Fraser (1983) and indicate that abnormal DST may identify the "noradrenergic" subtype of endogenous depression and that the DST represents a good way of selecting a specific antidepressant drug for the treatment of endogenously depressed patients.     

Reduced platelet MAO activity in healthy male students with blood group O

The association between the two genetic markers of affective disorders, ABO blood group system and platelet MAO (monoamine oxidase) activity was studied in 70 healthy young males. The platelet MAO activity of subjects with blood type O was significantly lower than that of subjects with blood type A and with blood types A + B AB + B together. This finding could constitute a "bridge" between the two genetic approaches to affective disorders.     

Infarction of the septomarginal band and tricuspid papillary muscle rupture related to alcohol septal ablation for hypertrophic cardiomyopathy

We presented a 77‐year‐old man with hypertrophic obstructive cardiomyopathy applied with flail tricuspid leaflet and severe tricuspid regurgitation leading to right heart failure 2 months after the failed septal ablation. The ruptured anterior tricuspid papillary muscle resulted from infarction of the base of anterior papillary muscle of the right ventricle (RV) confirmed by magnetic resonance imaging. As the septomarginal band is frequently lit up by intracoronary contrast that particular attention should be paid to the RV papillary muscles. And, if the papillary muscles or the RV free wall is brightened, then the use of that septal artery should be avoided.     

Immediate and Follow‐Up Results of Repeat Percutaneous Mitral Balloon Commissurotomy for Restenosis After a Succesful First Procedure

Background: The widespread use of percutaneous mitral commissurotomy (PMC) has led to an increase in restenosis cases. The data regarding follow‐up results of repeat PMC are quite limited. The aim of this retrospective analysis is to evaluate the immediate and midterm results of the second PMC, in patients with symptomatic mitral restenosis after a succesful first procedure. Methods: Twenty patients (95% female, mean age 37 ± 4 years) who have undergone a second PMC, 6.3 ± 2.5 years after a first successful intervention built the study group. All were in sinus rhythm, with a mean Wilkins score of 8.5 ± 1.2. Results: The valve area increased from 1.2 ± 0.2 to 1.9 ± 0.2 cm² and mean gradient decreased from 10.5 ± 3.4 to 6.1 ± 1.1 mmHg. There were no complications except for a transient embolic event without sequela (5%) and two cases (10%) of severe mitral regurgitation. The immediate success rate was 90%. The mean follow‐up was 70 ± 29 months (36–156 months). The 5‐year restenosis and intervention (repeat PMC or valve replacement) rates were 9.1 ± 5.2% and 3.6 ± 3.3%, respectively. The intervention free 5‐year survival in good functional capacity (New York Heart Association [NYHA] I–II) was 95.1 ± 5.5% and restenosis and intervention free 5‐year survival with good functional capacity was 89.7 ± 6.8%. Conclusions: Although from a limited number of selected patients, these findings indicate that repeat PMC is a safe and effective method, with follow‐up results similar to a first intervention and should be considered as the first therapeutic option in suitable patients. (Echocardiography 2010;27:765‐769)