[MRI aspects of filaria scrotum elephantiasis. MRI-anatomopathological correlations]

We report a case of filaria scrotum elephantiasis explored by MRI. MRI and pathological description of the three muscular layers (superficial, medium, deep) were well correlated.

Anaphylaxis after ingestion of wheat flour contaminated with mites

BACKGROUND

Anaphylaxis after ingestion of flours contaminated with mites has been recently reported.

OBJECTIVE

The study was designed to determine whether four-induced reactions in the absence of food sensitivity may result from mite contamination.

METHODS

Patients with systemic reactions after ingestion of foods containing wheat flour and without food sensitivities were included in a prospective study. The flours were examined microscopically, and major Dermatophagoides allergens were quantified by monoclonal antibody techniques. Skin prick tests and IgE determinations to mites and flours were performed. Single-blind, placebo-controlled oral challenges were also performed.

RESULTS

Sixteen patients were included in our protocol. They showed respiratory allergies to dust mites (100%) and intolerance to acetylsalicylic acid (87%). Microscopic examination of four flours implicated in allergic reactions revealed a high degree of mite contamination: Dermatophagoides farinae in one case and Thyreophagus entomophagus in three cases. Our patients' skin test and specific IgE responses to the flours implicated in the reactions were positive. A high level of Der 2 was found in the flour infested by D. farinae. Three of six food challenges with contaminated flours resulted in systemic reactions. Good tolerance to control flours was shown in our patients.

CONCLUSION

Ingestion of foods contaminated with mites may induce systemic anaphylactic reactions in patients with respiratory allergy to mites.

Specific depletion of the house dust mite allergen Der p 1 cereal flour prolamins

BACKGROUND

Quantitation of Der 1 and Der 2 in dust samples by specific monoclonal antibodies is a method used increasingly to evaluate mite allergen exposure. The level of Der 1 has been proposed as a risk factor for sensitization.

AIM

We report a drastic decrease in the Der 1/Der 2 ratio when dust samples are collected in bakeries.

METHODS

Wheat flour and purified mites were extracted simultaneously; levels of Der p 1 and Der p 2 and cysteine protease activity were determined by ELISA and inhibition experiments.

RESULTS

High titers of Der 2, but only trace amounts of Der p 1, were detected in dust collected from bakeries. Both the level and proteolytic activity of Der p 1 appeared greatly decreased when mites and wheat flour were coextracted.

CONCLUSION

Group 1 protein was found to be masked by flour components, resulting in an underestimation of the mite content in bakery dust. This problem was not found for group 2 allergen.

Intra-operative ultrasound (US) appearance of cavernous hemangiomas of the brain

Two cases of cerebral cavernous hemangiomas are reported. The different appearances of cavernomas are described. Ultrasound intra-operative localization allows identification of the lesions and facilitates complete surgical removal.

[X-ray computed tomographic abnormalities in schizophrenia. Trial of relationship with clinical data]

Computerized tomography (CT-scan) studies in schizophrenia revealed that some patients have neuromorphological abnormalities. The structural changes consist mainly in lateral and third ventricle enlargement, and in cortical atrophy. The present study evaluates these three changes in 42 schizophrenics aged 18 to 50, compared to 24 healthy controls. Diagnosis were established from information gathered by personal interview with the SADS-LA. Clinical sub-types were evaluated according to the DSM III-R criteria. Moreover, detailed symptoms were rated according to the Positive And Negative Syndrome Scale (PANSS). CT scans were recorded in floppy disks and blindly analyzed. Schizophrenics shown significant higher mean size of lateral and third ventricles, and higher mean anterior cortical atrophy than healthy subjects. Significant differences were also found between subtypes, with more marked abnormalities in the disorganized group. The relationship between brain abnormalities and clinical symptoms recorded with the PANSS, were analysed using Pearson correlates. Positive correlations concerned mainly negative symptoms like blunted affect, emotional withdrawal, difficulties in abstract thinking, passive apathetic social withdrawal and lack of spontaneity of conversation. Positive correlations are also observed with some symptoms classified with the PANSS in the General Psychopathology scale such as mannerism and disorientation. Negative correlation concerned most of PANSS positive symptoms.

Measurement of muscle mass in humans: validity of the 24-hour urinary creatinine method

Measuring muscle mass is an important component of the nutritional assessment examination and a suggested index of this body space is the 24-h urinary excretion of creatinine. The method originated from studies in a variety of animal species in whom early workers found a parallelism between total body creatine and urinary excretion of creatinine. Assuming that nearly all creatine was within muscle tissue, that muscle creatine content remained constant and that creatinine was excreted at a uniform rate, an obvious "corollary" was that urinary creatinine was proportional to muscle mass. The so-called "creatinine equivalence" (kg muscle mass/g urinary creatinine) ranged experimentally from 17 to 22. One of the limiting factors in firmly establishing this constant and its associated variability was (and is) the lack of another totally acceptable noninvasive technique of measuring muscle mass to which the creatinine method could (or would) be compared. An improved understanding of creatine metabolism and a variety of clinical studies in recent years has tended to support the general validity of this approach. However, specific conditions have also been established in which the method becomes either inaccurate or invalid. While creatinine excretion may serve as a useful approximation of muscle mass in carefully selected subjects, there remains a need for accurate and practical indices of muscle mass for use in the individuals in whom the method cannot be reliably applied.

Increased ureagenesis and impaired nitrogen use during infusion of a synthetic amino acid formula: a controlled trial

In a controlled trial conducted to assess the biologic value of High Nitrogen Vivonex, we compared this "elemental" diet with predigested protein--Product MJ7041--and with solid food during eight-day balance periods. Each formula was evaluated in three patients with malabsorption and one without it, by measuring apparent absorption of nitrogen and energy, nitrogen balance, and blood and urinary urea nitrogen. Overall energy and nitrogen absorption in the patients with malabsorption was better with either special diet than with solid food; net intestinal uptake of Vivonex tended to be higher but not consistently so in al patients. However, nitrogen balance differed consistently during the three diets; with solid food and MJ7041, retention of absorbed nitrogen was respectively, nine and 16 times greater than with Vivonex. Moreover, institution of each Vivonex period led to a prompt increase in urea nitrogen--a trend quickly reversed by the alternative diets. Although the mechanism for the impairment of nitrogen use caused by High Nitrogen Vivonex is unknown, its low biologic value and tendency to cause azotemia should be kept in mind.