Ventilatory control in diabetes mellitus

The ventilatory control system was evaluated in a group of 40 diabetic patients (20 with autonomic neuropathy (AN), and 20 without autonomic neuropathy) and 20 controls. The ventilatory increase in response to transient hypoxia was less in diabetics without AN than in controls, but even weaker in diabetics with AN. This pattern was repeated in the ventilatory response to hypercapnia. There was no correlation between the presence of abnormal respiratory responses and the duration of diabetes.

[Intrapulmonary percussion. A new method of respiratory therapy]

Intrapulmonary percussion with a high-frequency jet system is a new method in the treatment of respiratory impairment. It imitates the conventional percussion massage of the thorax by introducing high-frequency gas oscillations (300 impulses per minute) into the tracheobronchial system. In 14 patients with abnormal alveolo-arterial oxygen differences due to bronchial mucostasis ventilation was satisfactorily improved by its application.

A retroviral myc gene induces preneoplastic transformation of lymphocytes in a bursal transplantation assay

Treatment of chicken embryos with cyclophosphamide results in ablation of bursal lymphocytes. Bursal follicles can be reconstructed by infusion of embryonic bursal cells. Histologic examination of reconstituting bursal follicles showed that the first lymphocytes to appear were large pyrinophilic lymphoblasts that lined up adjacent to the bursal basement membrane and appeared to serve as progenitors for the differentiation of bursal medullary lymphocytes. When these cells were infected with the avian myelocytomatosis virus HB1 bearing a v-myc oncogene they appeared to home to the region of the bursal basement membrane but failed to differentiate. Instead, they formed structures indistinguishable from the preneoplastic transformed follicles that develop during bursal lymphomagenesis induced by lymphoid leukosis viruses. The DNA from these transformed follicles contained the HB1 v-myc gene but lacked the ability to transform NIH/3T3 mouse cells. Therefore these preneoplastic lesions were induced directly by HB1 myc and did not require the expression of Blym-1 or similar oncogenes. Exploitation of this transplantation technique with the chicken bursa will provide a useful method for assessing the stage-specific activity of oncogenes in vivo.

Effects of AY 9944 on low density lipoprotein metabolism in cultured human fibroblasts

Treatment of cultured human fibroblasts with the hypocholesterolemic drug AY 9944 resulted in a marked increase in low density lipoprotein internalization and degradation for concentrations up to 5 X 10(-6)M. Low density lipoprotein binding was less affected. Concentrations above 5 X 10(-6)M resulted in a relative decrease in low density lipoprotein degradation, whereas binding and internalization plateaued. The stimulation of low density lipoprotein internalization took place within the first hours of incubation of cells with the drug, which suggests a direct effect on the cell membrane. Such phenomenon could account at least partially for the hypocholesterolemic effect of the drug, besides its inhibitory effect on 7-dehydrocholesterol reductase.

Binding of a spin-labelled chlorpromazine analogue to calmodulin

The binding of a spin-labelled derivative of chlorpromazine to calmodulin was investigated by e.s.r. spectrometry. The completion of the spectroscopic changes requires the presence of 4 Ca2+ ions per calmodulin molecule. The influences of various physicochemical factors (pH, ionic strength) are discussed in relation to the nature (hydrophobic and polar) of the interactions that hold the drug-calmodulin complex together.

Linoleate incorporation into rat liver membranes phospholipids: effect on plasma membrane ATPase activities and physical properties

Plasma membrane phospholipids were modified by incubation in the presence of linoleyl-CoA with or without added lysolecithin (LPC) for various length of time. In the absence of LPC, a maximum of 10 nmoles linoleyl-phosphatidylcholine (PC) were synthesized and the ATPase specific activities were not affected whereas in the presence of LPC, when linoleyl-PC synthesis rose from 10 to 80 nmoles, the ATPase activities were decreased. The decrease was similar in the Na,K- or in the Mg-dependent-ATPase and reached maximally 30-40%. LPC by itself did not modify the ATPases. A concomitant decrease in DPH polarization was observed when linoleate was incorporated into phospholipids. We concluded that the decreased ATPase specific activities may be due to an increased fluidity of membranes produced by linoleyl- PC synthesis. We compare this modulation of ATPases by the membrane fluidity with the specific effect of linoleyl- PC species on adenylate cyclase.

Effects of phenothiazines on low density lipoprotein metabolism in cultured human fibroblasts

Treatment of cultured human fibroblasts with trifluoperazine or chlorpromazine resulted in a biphasic effect on low density lipoprotein (LDL) catabolism, depending upon the dose. At up to 10(-5) M, a marked increase in LDL binding, internalization and degradation was observed. This phenomenon took place within the first hours of incubation with the drugs, suggesting a direct effect on cell membrane physical characteristics, probably related to the lipophilic properties of phenothiazines. Concentrations above 2 X 10(-5) M resulted in a relative decrease in LDL binding and internalization, and in a dramatic decrease in LDL degradation, which may be related to an inhibition of calmodulin-dependent processes.

Protein-stimulated enrichment of human platelet membranes in linoleylphosphatidylcholines. Effect upon adenylate cyclase and fluidity

In order to study the effect of linoleyl enrichment of platelet membranes upon adenylate cyclase activity and membrane fluidity, manipulations of platelet phospholipids are carried out with phosphatidylcholine-loaded high-density lipoproteins (HDL) or phospholipid-exchange protein and phospholipid-cholesterol mixed vesicles. Incubation with HDL does not appear to be valuable for this purpose. On the other hand, phospholipid-exchange protein and mixed vesicles can be used successfully. Phospholipid-exchange protein stimulated 3-fold the spontaneous exchange of 2-linoleylphosphatidylcholine between the vesicles and the platelets. Linoleyl enrichment of platelets by dilinoleylphosphatidylcholine is about 25% and by 2-linoleylphosphatidylcholine is about 45-50%. The unsaturation index remains constant when the enrichment is performed using dilinoleylphosphatidylcholine but it increases with 2-linoleylphosphatidylcholine. Basal and prostaglandin E1-stimulated adenylate cyclase activities are not modified by dilinoleylphosphatidylcholine, while they increase significantly in the case of 2-linoleylphosphatidylcholine. There is no significant variation in diphenyl hexatriene fluorescence polarization parameters, either with dilinoleylphosphatidylcholine or with 2-linoleylphosphatidylcholine.

[Differential diagnostic problems and polygraphic studies in a case of Pickwickian syndrome]

The case report of a male patient with the Pickwickian syndrome is presented. The results of the relevant neurophysiological examinations (polygraphic registration of EEG, electrocardiogram, respiration, thorax excursions, submental and intercostal electromyogram, electrooculogram) give an insight into the pathomechanisms and enable the differential diagnosis to be made between this condition and narcolepsy and also the Kleine-Levin syndrome; respiratory investigations (spirometry, hypercapnic ventilatory response: mouth occlusion pressure) make it possible to differentiate between the Pickwickian and Ondine's curse syndrome. The therapeutic management is discussed.

[Serum paraaminobenzoic acid following the use of N-benzoyl-L-tyrosyl-paraaminobenzoic acid in the diagnosis of pancreatic insufficiency]

In 25 patients with chronic exocrine pancreatic insufficiency and 37 controls, the PABA test was compared with the concentration of chymotrypsin in stool. In additional 16 patients the test could not be evaluated (rate 21%). By determination of the PABA levels in serum before and one hour after ingestion of N-benzoyl-L-tyrosyl-PABA the test can be shortened and simplified: 1 hour serum levels in 9 patients with exocrine pancreatic insufficiency were 0.5 +/- 0.5 nMol/ml compared with 8 controls with 6.4 +/- 2.0 nMol/ml. PABA serum levels correlated significantly with chymotrypsin in stool. Compared with the conventional PABA test, since it is easily applicable in outpatients and the results are not influenced by medication or food.

Decreased prostacyclin sensitivity of human platelets after jogging and squash

8 healthy male volunteers performed jogging (as an example of an aerobic metabolic condition) and squash (as an example of an intermittently anaerobic metabolic condition). The platelets sensitivity to prostacyclin (PGI2) decreased after jogging. After squash, a statistically significant (p 0,001) decrease in the sensitivity of the platelets could be seen. Our findings suggest that an early alteration of platelet sensitivity might play a key role in maintaining the hemostatic balance and could be of greater importance than the vascular wall PGI2-synthesis, as the sensitivity changes immediately, whereas the PGI2-formation change is a long-term process.

[Renal lesions after irradiation and chemotherapy with adriamycin, vincristin and 5-fluoro-uracil (author's transl)]

After hysterectomy and bilateral annexectomy for bilateral ovarian carcinoma, a 34 years old woman was treated by radiotherapy and chemotherapy associating adriamycin, vincristin and 5-fluoro-uracil. After this treatment, proteinuria and progressive renal failure developed. Renal biopsy showed prominent glomerular lesions with mesangiolysis and some necrotic arteriolar lesions. The role of radiotherapy and chemotherapy in the pathogenesis of these lesions is discussed.

Psychosocial aspects of living with cancer: a review of the literature

Up until several years ago, little systematic effort was directed at developing an empirically based understanding of issues pertinent to psychosocial aspects of living with cancer. Recently, however, increased interest has been focused on this topic. This manuscript reviews over 100 articles, papers, and books written between 1960 and 1980 on the psychosocial impact of cancer on the adult patient and on methods of psychosocial treatment providing a “state of the art” appraisal of the area. A methodological critique of the research studies is provided as well.

Differing effects of acid versus neutral phosphate therapy of hypercalciuria

Studies were performed on 12 patients with idiopathic hypercalciuria to evaluate the hypothesis that the acid load accompanying potassium acid phosphate would adversely affect renal calcium reabsorption and citrate excretion compared to the neutral form of the phosphate salt. During acute clearance studies, neutral phosphate (NP) led to a fall in FECa (2.2 +/- 0.6% to 0.8 +/- 0.1%, P less than 0.02) and no change in titratable acidity (TA) or net acid excretion (NAE). Acid phosphate (AP) did not reduce FECa acutely, and led to a rise in TA (22 +/- 4 to 62 +/- 6 muEq/min, P less than 0.02) and NAE (46 +/- 6 to 6 89 +/- 7 muEq/min, P less than 0.02). During chronic administration, AP resulted in higher urinary calcium excretion in both absorptive (187 +/- 29 vs. 141 +/- 18 mg/day, P less than 0.02) and renal hypercalciuric patients (233 +/- 24 vs. 173 +/- 190.02 mg/day, P less than 0.02). Also, TA and NAE were higher following AP, whereas citrate excretion was lower (375.4 +/- 64.6 vs. 633.4 +/- 28.8 mg/day, P less than 0.01). These data suggest that the reported ineffectiveness of AP in the therapy of nephrolithiasis may be related to the deleterious effects of the acid load on calcium and citrate metabolism.