[Aberrant internal carotid artery in the middle ear]

An aberrant internal carotid artery in the middle ear is rare. We present a new case with a red mass behind the eardrum. The diagnosis must be established by radiology and angiography. The consequences of injury and surgical intervention are serious. The purpose of this paper is to review the literature on the subject of vascular anomalies of the middle ear and to discuss the diagnosis and management of this lesion.

Electron microscopic studies on the pars intermedia of the rat under stress

Using electron microscopy, we have studied the pars intermedia (PI) of the pituitary gland of Wistar rat under psychogenic stress, finding a considerable increase in dark cells. The cells of the PI present striking vacuoles in all their cytoplasms, increasing up to a phase of total cellular disintegration. We have also observed a cell type, not found in the animal control group, of regular size and electrondense matrix of medium contrast.

[Proliferative response of murine lymphocytes caused by the activity of amphiphilic molecules from Propionibacterium acnes]

Splenic lymphocytes from mice treated with Propionibacterium acnes cells as well as with their cell walls were found to be variably active on the lymphoproliferative responsiveness. Furthermore, the effect of these bacterial agents on the ex vivo Con A response of the lymphocytes showed a certain stimulation that was higher with oral treatments. In the same conditions the influence of these agents on the LPS lymphocytes stimulation was almost without any statistical significance. In vitro blastogenesis experiments were undertaken in order to elucidate the influence of different amphiphilic molecules from peripheric bacterial structures on the lymphoproliferative response of murine splenocytes. Stimulation rates were also determined as a function of the (3H) thymidine incorporation. Combined effects of mitogens (Con A and LPS) with bacterial amphiphilic molecules were also evaluated as a function of the DNA synthesis variations. All cases resulted in a variable inhibition of the mitogenic response which appeared dose-dependent and more active for associations of Con A and amphiphilic molecules. The most effective intrinsic mitogenic activities were detected with teichoic acids and intracellular polysaccharides. These last molecules without purification, assayed as cytoplasmic fractions, appeared modified in the intensity of their action, depending on their carbohydrate/protein ratios.

Serum ferritin in haemodialysis patients: role of blood transfusions and 'haemochromatosis alleles' HLA A3, B7 and B14

In 48 patients on maintenance haemodialysis (HD), serum ferritin (SF) levels were measured and compared with 'haemochromatosis alleles', (HA), HLA A3, B7 and B14. A positive correlation was found between high SF levels and the presence of HA. When patients who had received 10 or fewer blood transfusions were studied, it was observed that this correlation did not exist, but it was evident, however, in patients who had received more than 10 blood transfusions. After 14 months in which blood transfusions were restricted, no significant difference in SF was observed between HA carriers and the rest. Our findings suggest that repeated blood transfusions can cause high SF in HD patients, especially in those with HLA A3, B7 or B14 antigens. Among our patients, restriction of blood transfusions seems sufficient to decrease high SF levels.

[Social cost effectiveness of 2 systems of treatment of malnourished children, in Chile]

Two approaches in the care of malnourished children were evaluated in order to ascertain both their medical and economical effectiveness. One was a group of 745 children under an ambulatory nutritional rehabilitation program that included health care, supplementary foods and nutrition education; a second group of 420 children attended Day Care Centers (8 hours a day and five days per week) where they received a balanced diet, psychomotor stimulation according to age, and health care. The evolution of nutritional status was followed up and plotted against the NCHS/WHO weight-for-height tables. The rate of recovery was unsatisfactory; below 50% in mild cases of malnutrition, and even less in the more severe cases. The average length of time for attaining normality was longer for moderate malnutrition and for the ambulatory program. When the calculation included a correction for the probability of recovery for each system, the advantage of the Day Care Centers became even more evident: the mean length of time for recovery was 33.2% less than the ambulatory program. The social cost per child, per day, was substantially lower in the ambulatory program. The integral calculus of social cost per child, per day, and the corrected mean time for recovery provided the social cost-effectiveness of nutritional recovery. This figure was clearly adventageous for the ambulatory program for all ages and degrees of malnutrition, exception made for moderately malnourished children below two years of age. In this case, the Day Care Centers appeared to be the most effective therapeutic alternative. This type of analysis is a contribution to the evaluation of medico-social programs for the recuperation of malnutrition. The advantage lies in the fact that it allows an optimization in the allocation of resources, when the previous step is the choice of best therapeutic alternative based upon the patient's age and nutritional status.

[Infantile malnutrition: social cost of respiratory and digestive pathology]

Information from the hospital records of 1,660 children under two years of age admitted to the Hospital Roberto del Río (Northern District of Santiago) during 1979, allowed carrying out an analysis of the effect of malnutrition upon the admission rate and length of stay for diarrhea and respiratory infections. The following indexes were calculated and related to nutritional status: a) Admission rate for the total population of children under two years of age from the Northern District of Santiago; b) frequency of associated and intercurrent pathology, and c) length of stay. The three indexes evidenced a clear relationship with nutritional status (P much less than 0.01), showing a progressive deterioration as the relationship weight/age became impaired. The admission rate for diarrhea was nine times higher, and the length of stay 16.9% higher (P less than 0.001) in children with mild malnutrition as compared with normal patients. For respiratory infections the rates were 2.4 and 24.7% higher (P less than 0.001) in malnourished patients than in normals. The excess of admission rate for diarrhea and respiratory pathology, conditioned by malnutrition in the Northern District of Santiago, was estimated as the cost equivalent to 10,609 extra days of stay, with an annual cost above US$300,000. The investment of such an amount of money in health promotion and protection activities would certainly increase its social cost-effectiveness.

[Gaucher's disease. Morphological study of lymph nodes by electron microscopy]

The morphological study of lymph node biopsies by light and electron microscopes is reported. The patient was a 7 months old infant with Gaucher's disease and infection symptoms of upper respiratory ducts. We believe this to be a case of lesser affection, since the patient was admitted complaining of complications that gave way to medical treatment. Lymphadenopathy and moderate liver and splenomegaly were occasional findings during examination. Through the light microscope, Gaucher's cells showed an eccentric nucleous, cytoplasmic striae which, at the electron microscope showed to be tubular bodies.

[Bifid sternum. a case report (author's transl)]

A newborn with bifid sternum and early surgical management is reported.

Changes in (3H)leucine incorporation into pineal proteins following estradiol or testosterone administration: involvement of the sympathetic superior cervical ganglion

Pineal denervation by superior cervical ganglionectomy (Gx) decreased high affinity binding of estradiol (E2) to the pineal cytosol of female rats and of testosterone to the cytosol of male rats by 40 and 26% and by 75 and 80%, 5 and 14 days after sugery; hormone binding remained unchanged up to 24 h after surgery. Binding to the nuclear fraction decreased sigificantly by 2 weeks after incorporation of (3H) leucine into pineal proteins in Gx. A single injection of E2 (mug) to testosterone propionate (TP) (500 mug) failed to increase the Gx rats when injected 1 or 5 days after surgery. Significant increases were observed in sham-operated controls or in rats subjected to bilateral decentralization of ganglia; however on the 5th day an impairment was observed in hormone ability to enhance [3H]leucine incorporation in decentralized rats. The administration of isoproterenol 19 and 3 h before sacrifice replenished pineal-binding sites for E2 and testosterone in Gx rats, but failed to restore the responsiveness of denervated pineals to hormone administration. Moreover, E2 or TP treatment blocked the increase in labeled amino acid incorporation into proteins brought about by isoproterenol per se. The administration of propranolol 2 and 7 h after hormone injection decreased the ability of E2 and TP to enhance [3H]leucine incorporation by 55 and 41%, respectively. Tyrosine hydroxylase activity of the superior cervical ganglia decreased by 36 and 41% 6 h after E2 or TP administration, and by 43 and 47% after 3 daily injections of the hormones, whereas pineal tyrosine hydroxylase remained unchanged. Hormone treatment for 3 days increased the in vitro uptake of norepinephrine by the ganglia but did not affect uptake in the pineal gland. These data indicate that the integrity of neurons of the superior cervical ganglia is an absolute requirement for E2 and testosterone to enhance [3H]leucine incorporation into pineal proteins in rats.

Further evidence for histamine facilitating oestrogen action in the uterus

The effect of doses of estradiol ranging from 0-0125 to 1-6 mug on the uterine weight of the spayed rat was studied 24 h after a single s.c. injection of the hormone. The lowest dose inducing a significant increase in uterine weight was 0-32 mug. When histamine dihydrochloride (50 mg) was simultaneously injected with the hormone, the effect of small doses of oestradiol (0-0125--0-2 mug) was significantly increased. When oestradiol and histamine were administered for 3 successive days, the uterine weight of animals receiving 0-0125 mug oestradiol, if compared with untreated controls, was increased only in the histamine-treated group. When 0-05 mug oestradiol was administered histamine did not modify the increase already produced by the hormone. Spermidine and burimamide, two substances structurally related to histamine, increased [3H]oestradiol uptake by the spayed rat uterus. The latter (an antihistamine drug acting on H2-receptors) as well as pyrathiazine (a histamine releaser having antihistamine properties) decreased the effect of histamine on oestradiol uptake whereas diphenhydramine (an antihistamine drug blocking H1-receptors) did not modify it. Pyrathiazine was itself able to diminish oestradiol uptake.