[Usefulness of the determination of saliva cortisol in the study of adrenal gland glucocorticoid function]

To validate the adequacy of saliva as a biological specimen for the study of glucocorticoid adrenal function, the concentrations of salivary cortisol (SC) and serum total cortisol (TC) were measured by radioimmunoassay (RIA) in several groups of individuals in baseline state and during stimulation tests. The study of diurnal variations of SC in the reference population (n = 29) showed a nyctohemeral rhythm similar to that of TC, with maximal concentrations at 08.00-09.00 h (18 +/- 9 nmol/L) and 61% and 80% decreases at 15.30 and 23.00 h, respectively. After the administration of 1 mg of dexamethasone, SC was reduced in a 95% of its baseline value (n = 18). In all patients with Cushing's syndrome (n = 8) SC was increased whereas TC was normal in 3. All patients with adrenal failure (n = 11) had subnormal SC levels, while TC was normal in 4. The SC response to stimulation with intravenous synthetic adrenocorticotropin (Nuvacthen) (with and without previous suppression with 1 mg dexamethasone), insulin hypoglycemia and glucagon were qualitatively similar to those of TC, although more marked in proportion. These results, together with the practical advantages of saliva as a biological sample (easy obtention of specimen, absence of stress during its collection, and stability of cortisol in it), indicate that SC represents a more reliable measurement than TC as a useful clinical test to detect glucocorticoid dysfunction.

120 hours simultaneous infusion of cisplatin and fluorouracil in metastatic breast cancer

Thirty-six patients with metastatic breast cancer, 23 with documented progression of the disease after first-line chemotherapy (CAF or CMF) and 13 without prior chemotherapy, were treated with a simultaneous 120-h infusion of cisplatin (CDDP) and 5-fluorouracil (5-FU). Objective response was demonstrated in 19 patients (52.7%), stable disease in 7 patients (19.4%) and progression of the disease in 10 patients (27.7%). Similar response rate was observed according to tumor site (soft tissues, 50%; bone, 52%; lung, 63%; liver, 55%; and pleura and peritoneum, 42%) and previous treatment (previous chemotherapy, 48%; previously untreated, 61%). Median duration of response was 8 months. Toxicity was characterized by stomatitis and myelodepression and required dose adjustments in 30% of patients. CDDP and 5-FU infusion deserve further investigation because it appeared to have substantial activity in this preliminary study in metastatic breast cancer.

[Multidisciplinary protocol for the treatment of epidermoid carcinoma of the esophagus: experience from 1985 to 1989]

A phase II study activated in 1985 for the multidisciplinary treatment of squamous cell carcinoma of the esophagus is described. The treatment program included simultaneous neoadjuvant continuous infusion chemotherapy with cisplatinum and 5-fluorouracil, preoperative radiotherapy (46 Gy in 5 weeks) and delayed programmed surgery (or radical irradiation in selected cases). Twenty-one patients with tumor stages I (6), II (10), III (5) entered in the study and 20 patients completed the treatment program. Severe toxicity observed was: esophagitis 100%, bone marrow aplasia 30%, severe weight loss 52%. One patient developed a tracheo-esophageal fistula at the end of radiotherapy. Clinical objective tumor response rate was 85%. Pathologic complete tumor response rate was 47%. Median follow-up of the entire group is 11 months (range 2 + to 49 + months). Ten patients have been alive for more than 12 months; six are still alive without any evidence of disease (from 12 + to 49 + months). It is concluded that the protocol described is feasible, with treatment related severe but reversible toxicities, and able to induce a high rate of tumor response and long term survivors in patients with initial locally advanced tumor stages.

Production of acid and alkaline phosphatases by Myxococcus coralloides

Acid and alkaline phosphatase of Myxococcus coralloides were examined during vegetative growth in a liquid medium. Two extracellular phosphatases and two cell-bound phosphatases, acid and alkaline in both cases, were produced. The phosphatase production was unaltered by the presence of high concentrations of inorganic phosphate. Both enzymes were produced constitutively. These two hydrolases were released into the growth medium during the exponential growth phase (approximately 10% of total activity). The production of these enzymes was modified by the presence of organic acids and metal ions in the medium.

Does the pulvinar-LP complex contribute to motor programming?

Extracellular unit recording studies in the pulvinar lateral posterior complex (Pul-LP) of behaving monkeys have shown a response property not previously reported. In monkeys performing aimed arm reaching movements towards frontally located targets some cells showed a change in activity beginning 495 +/- 84 ms before the onset of the reaching movement. This change in frequency precedes that observed in primary motor and parietal posterior cortex for reaching movements. These findings seem to indicate the involvement of the Pul-LP in motor functions and suggest its possible contribution to motor programming.

Histological maturation of astroglial cells in the archicortex of young hypothyroid rats

The maturation of fibrous astrocytes was studied in the archicortex (hippocampus) of rats rendered hypothyroid by perinatal administration of propylthiouracil (PTU). A decrease in the number of protoplasmic processes and end-feet in fibrous astrocytes from the cortical molecular layer was observed. The diameter of the perikaryon and length of the prolongations were also decreased. In animals rehabilitated after weaning, the diameter of the perikaryon and length of protoplasmic processes returned to normal while that of number of prolongations per astroglial cell remained unchanged. It is postulated that hypothyroidism induced immediately after birth impairs differentiation of astroglia in the archicortex of the rat brain, probably as a response secondary to altered neuronal and capillary development.

Undifferentiated epithelial-rich invasive malignant thymoma: complete response to cisplatin, vinblastine, and bleomycin therapy

Two cases of complete remission plus one almost complete and another partial response of undifferentiated, invasive epithelial malignant thymoma using the combination of cisplatin, vinblastine, and bleomycin (PVB), are reported in four patients treated with this combination. Radiotherapy was instituted after completing the fourth course of chemotherapy in three patients. One patient died from intercurrent infection after the fourth cycle of combination chemotherapy. Three patients remain free of disease at the end of the treatment program. PVB appears to be highly active in this disease and deserves more extensive evaluation in multicenter clinical trials.

Endorectal pull-through with conservation of the rectal mucosa: experimental study

The present experimental work was designed to study an abdominoanal pull-through technique, with conservation of rectal mucosa. Continence was evaluated from clinical, radiologic, and histopathologic standpoints. The animals defecated normally. A good retention of barium was seen in the radiologic enema. On the reexploration of the animals, we found a distal dehiscence with elevation of the intussuscepted stump towards the rectum in all. A reepithelization process of serosa of the intussuscepted segment was noted.

[Anti-measles antibodies in the first 2 years of life]

In order to achieve a better understanding of the epidemiology of measles in Spain to foster vaccination policy in our country, we have conducted a serological survey of measles antibodies in children between birth and two years of life in the urban population of Madrid. Authors have established the rate at which maternal antibodies are lost in these children below 15 months of life. The results indicate that, in general maternal antibodies have already disappeared at 9 months. Vaccination can thus be indicated around this age.

[The cost of measles in Spain]

With the purpose of obtaining information useful to plan massive measles vaccination campaigns in this country two retrospective surveys were carried out to evaluate cost of care as well as age and seasonal distribution of measles in Spain. Two samples made of 1.781 and 701 school-children, living in a 137.000 inhabitants city and representative of the industrial, construction and services sectors of the spanish population (81.920 of it), were interviewed. The mean cost of care per case was of 8.252 pts. Before six years of age 92% of the individuals studied had had measles, 51% of them between March and May. Between 20 and 24% of patients were 24 months old or less; among the latter group age distribution was the following 50% below 12 months, 35% between 12 and 18 months and 15% between 18 and 24 months.

[3 patients with maple syrup urine disease]

Clinical manifestations, biochemistry and treatment of three patients with the inherited alteration of the so called maple syrup urine disease are presented. Diagnosis was based upon both detection of high concentrations of leucine, isoleucine, valine and their corresponding alpha-ketoacids in plasma and urine, and existence of a peculiar odor as well as an intense, progressive, neurological alteration. Considering the early onset of clinical symptoms, low protein tolerance and very reduced rate of leucine decarboxylation in cultured fibroblasts, the three patients exhibited grade I, classical type of this disease. None of them responded favorably to suprapharmacological doses of thiamine. Treatment of the patients is discussed and compared with that recommended in the literature.

Hydrogen ion CO2 and buffer capacity in brain from water depleted rats

pH, C02 and buffer capacity of the brain and blood acid-base status were studied in (C) control and in acutely water depleted (WD) rats. WD rats developed a greater metabolic [H+] increase in brain than in blood. The results suggest that brain [H+] change is a primary metabolic reply to acute dehydration.

Contribution to the study of the arterial nutrition of the cervical spinal cord

The feeding of the anterior spinal artery of the cervical cord is very poor. Angiographic studies have shown that only two to three radiculomedullar arteries assure the feeding of this arterial axis. Since it is possible that smaller feeding arteries exist, which are not visible on a conventional X-ray study, we have reviewed cases with arteriovenous aneurysms or vascularized tumors in the cervical region, and obstructions of the vertebral arteries. In these cases, the feeding arteries may be hypertrophic. In spite of being hypertrophic, their number is not increased, and the statistical proportion is the same as in the studies carried out in normal cases.

A human placental hormone (UTPH) with uterine growth and DNA promoting effects

A human placental protein previously described is studied in order to expand its biological characterization. Dose-response-curve of its action on uterine growth of prepuberal mice showed to be a significant logarithmic function and this effect is neutralized by its specific antiserum. It is also demonstrated that the uterine growth-promoting effect is not due either to estrogen, protein-bound estrogen, progesterone or chorionic gonadotrophin. Experimental evidence is given to demonstrate that the mechanism of action of this placental protein is to stimulate the synthesis and to increase the concentration of DNA in uterine tissue, differing then in this respect from the effect of estrogen. Previous work has shown that this placental protein is present in full-term placentas within similar ranges as HCG and HPL. It is also detected in blood during pregnancy and acts biologically in at least two target organs: uterus and mammary gland. Therefore the name of uterotrophic placental protein (UTPH) has been suggested for this substance.