Gastrointestinal manifestations of neurofibromatosis in childhood

Von Recklinghausen's neurofibromatosis (VRN) is a familial disorder characterised by a generalized neuroectodermal dysplasia--symptomatic involvement of the gastrointestinal tract is rare. We report on our experience with two children who had proven gastrointestinal neurofibromas and highlight the need for careful assessment in children with VRN who develop abdominal pain.

[Radioimmunoassay of serum and CSF myelin basic protein and its application to patients with acute cerebrovascular accident]

Myelin basic protein (MBP) was measured in the serum and CSF of patients with acute cerebrovascular disease (CVD, 34 cases), demyelinating disorders (DMD, 30 cases) and other neurological diseases (OND, 26 cases) by using a double antibody radioimmunoassay (RIA). Patients with acute CVD had a mean serum MBP concentration and positivity rate much higher than those with DMD and OND. The differences were significant (P < 0.05). In CSF, MBP levels in patients with acute CVD and patients with DMD were significantly greater than those in OND patients (P < 0.05). The results also show that there was a linear relationship between the CSF MBP levels and the serum MBP levels in patients with acute CVD (r = 0.72, P < 0.01), but no such relationship in patients with DMD and OND. The amount of serum MBP was also significantly correlated to the severity of acute CVD, to the level of consciousness disorder and limb paralysis, and to the extent and site of the cerebral lesion at CT-scan (P < 0.05). This study shows that the measurement of brain specific MBP in serum as a marker of cerebral damage may have clinical value in the diagnosis and prognosis of patients with CVD.

A study of the detection of sperm antibody in cervical mucus with a modified immunobead method

OBJECTIVE

To develop a new immunobead binding test (IBT) procedure that will detect sperm antibody in cervical mucus (CM), especially in very small samples of mucus.

DESIGN

After the interaction of donor sperm with bromelin-dissolved CM, the motile sperm cells were separated from other cells and debris and then tested with a standard immunobead method.

SETTING

The CM and serum samples were obtained from a sequence of referred patients who were sent to this testing laboratory.

PATIENTS

There were 60 women who provided 64 samples of CM and 41 samples of blood serum. They were partners in infertile couples.

INTERVENTIONS

None.

MAIN OUTCOME MEASURE

A useful distinction was made between positive and negative results for the mucus samples by this CM-IBT procedure. The usable samples of mucus could be as little as 0.05 g (wet weight).

RESULTS

From the 60 women, seven mucus samples were positive; in the repeated testing, the same results were obtained with five of the six positive samples and seven of seven negative samples.

CONCLUSION

This method (CM-IBT) can be clinically useful for detecting sperm antibody in CM, especially because it is effective for tiny samples. In this method, the motile sperm cells are better separated from the debris after the incubation step. When the IBT was applied to the serum samples from the same women, there was no correlation between serum-IBT and CM-IBT, showing that both materials must be tested.

Immunopharmacological activity of cefodizime in young and elderly subjects: in vitro and ex vivo studies

The biological response modifying activities of cefodizime (CDZ), a new third-generation cephalosporin, were investigated in vitro and ex vivo. In vitro investigations using cells isolated from the blood of young healthy donors showed no stimulating activity of CDZ on peripheral blood lymphocytes, natural killer cell activity, IL-1 production by adherent mononuclear cells, PMN chemiluminescence or PMN chemotaxis. A slight but statistically insignificant increase in PMN phagocytosis and phagocytic index was observed in the same population. IL-1 production was increased in three subjects with low resting state values. In a controlled ex vivo study, 20 healthy elderly subjects selected on the basis of depressed phagocytic function were treated with CDZ 1 g i.m. b.i.d. or placebo for eight days. PMN function was determined at baseline and on the day after the last dose. In the CDZ group a significant increase in both phagocytosis and phagocytic index was found, while there were no changes in the placebo group. In conclusion, CDZ restored depressed PMN phagocytic function in a population of elderly subjects. Patients with impaired PMN function who require antibiotic treatment may benefit from this activity of CDZ.

Internalization of CD4 molecules in human T-cells demonstrated by immuno-electron microscopy

Internalization of CD4 molecules on human CD4-enriched T-cells was demonstrated by immunocytochemical electron microscopy. CD4+ T-cell subclones were obtained from normal human peripheral blood, followed by one-way MLC screening and co-culturing with IL-2. Fixed and non-fixed T-cell samples were indirectly immunolabeled with mouse anti-human CD4 monoclonal antibody and goat anti-mouse IgG conjugated with peroxidase. Unfixed T-cells were immunolabeled at 4 degrees C and then re-incubated for 5-45 min at 37 degrees C. The selected CD4+ T-cell subclones showed strong CD4 binding on the cell surface after IL-2 incubation. However, fresh T-cells, monocytes, bone marrow cells and CD8+ T-cells all stained negative for CD4. The distribution of CD4 molecules on the fixed cell surface showed a homogeneous pattern. Capping and internalization of CD4-antibody-peroxidase complexes from the cell surfaces were observed follow a pathway of receptor-mediated endocytosis in unfixed T cells. Endocytotic vesicles, vacuoles of diverse sizes and shapes near the cell membrane or deep in the cell center were found to contain CD4 molecules. Negatively stained Golgi saccules were observed up to 45 min after re-incubation. These results suggest that increased CD4 molecules can be induced on the surface of normal human T-cells in vitro. Internalization and accumulation of CD4 molecules occurred in CD4-enriched T-cells with IL-2 pretreatment.

Fentanyl and medetomidine anaesthesia in the rat and its reversal using atipamazole and either nalbuphine or butorphanol

The intraperitoneal injection of anaesthetic agents is a simple and convenient method of anaesthetizing rats. However, all of the anaesthetic combinations in current use which are administered by intraperitoneal injection produce prolonged sedation, and full recovery of consciousness may take several hours. Fentanyl, a mu agonist opioid, and medetomidine, an alpha 2-adrenoceptor agonist were mixed and administered as a single intraperitoneal injection. Combinations of 300 micrograms/300 micrograms/kg and 300 micrograms/200 micrograms/kg of fentanyl/medetomidine were shown to produce surgical anaesthesia in the rat. This anaesthetic regimen produced significant respiratory depression (P less than 0.01) and animals did not regain their righting reflex until 193 +/- 21 min (mean +/- 1 SD) after injection. Administration by intraperitoneal injection of atipamezole, a specific alpha 2-adrenoceptor antagonist (1 mg/kg) mixed with a mu antagonist/k agonist opioid (nalbuphine, 2 mg/kg or butorphanol 0.4 mg/kg), resulted in a rapid (less than 8 min) reversal of anaesthesia and the associated respiratory depression, and apparent full recovery of consciousness.

[Photochemically induced focal cerebral infarction in rat and its pathological observation]

Cerebral infarction in Wistar rats was induced by photochemical method. A photochemical reaction was produced by the photosensitive agent rose bengal under the effects of green light (560 +/- 60 nm). This reaction released free radicals which may damage the endothelium of cerebral vessels and induce platelet aggregation, and then may cause thrombosis in cerebral parenchymal vessels. There were typical changes of thrombosis and ischemic necrosis in the irradiated region of the cerebrum under light and electron microscopy. Serial pathologic findings suggested that the critical phase of progressive necrosis lies at the time of 1-6 hours after cerebral ischemia induced photochemically. Therefore, effective protection of the brain is important in the early stage of cerebral ischemia.

Glycosylation is not required for ligand or receptor binding by expressed rat intrinsic factor

A cDNA clone encoding rat intrinsic factor (IF), pIFQ, has been inserted into the eukaryotic expression vector pSVL and used to transfect COS-1 cells. The IF produced by the transfected cells was secreted nearly exclusively into the medium at concentrations of 0.1-0.2 micrograms/ml. Tunicamycin treatment (1-10 micrograms/ml) completely blocked N-linked glycosylation but had no effect on IF secretion. The secreted glycosylated IF retained all the properties of native IF, i.e., high affinity for cobalamin (Cbl) and for the IF-Cbl receptor and relative resistance to low pH and to proteolysis. The nonglycosylated IF also retained these properties except that it was more protease sensitive. The protease degradation was prevented by the presence of the ligand Cbl. The presence of carbohydrate may play a role in protecting IF from digestion by pancreatic proteases in the intestinal lumen.

Gas chromatographic determination of aldicarb and its metabolites in urine

A method is described for the determination of aldicarb and its metabolites (the sulphoxide and sulphone) in urine by gas chromatography with flame photometric detection (GC-FPD). The sample was concentrated with a column containing activated charcoal and Florisil, and then eluted with dichloromethane-acetone (1:1, v/v). The aldicarb and aldicarb sulphoxide in the eluate solution were oxidized to aldicarb sulphone and the total sulphone concentration was determined by GC-FPD after extraction with dichloromethane and clean-up with an activated charcoal column. The detection limit was 0.0024 mg/l. The mean recoveries from spiked urine in the range 0.04-0.12 mg/l were 90.9%, 86.6%, 92.6% for aldicarb, aldicarb sulphoxide and aldicarb sulphone, respectively.

[A new serotype of Shigella boydii]

Two strains which belong to the same serotype of Shigella were isolated from the bloody-pus stool of two patients (in 1986) and is reported in this paper. The results were identical both showing agglutination in low titer with serotype 8 of S. dysenteriae and serotype 4 of S. boydii when the two strains were checked well with all kinds of diagnostic antisera and vice versa, ie the antisera produced by the two strains were also checked well with sera prepared with the representative strains of all Shigella spp. No cross agglutination with O6, O7, and O150 of E. coli were found. Consequently, It appears to be a new serotype of Shigella. These two strains possess the ability of causing keratitis in guinea-pigs as well as invading epithelial cells, the DNA of both strains in agarose-electrophoresis showed a large plasmid, indicating that they are virulent strains possessing invasive ability. It was concluded that these two strains belonged to Shigella boydii as they fermented mannitol and non-related antigenically with Shigella flexneri. Since serotype 1-18 of S. boydii have been reported recently, we propose that this new serotype should be serotype 19 of Shigella boydii.

In vivo enhancement of NK-cell activity by thymopentin

Natural killer (NK) activities of fresh and IL-2-precultured peripheral blood mononuclear cells (PBMC) were investigated in 13 elderly subjects before and after thymopentin (TP-5) treatment and in 12 age-matched controls. The NK activity of fresh PBMC was found to be significantly higher in subjects given TP-5 at 50 mg s.c. three times per week for one month. Conversely, this type of treatment with TP-5 did not significantly modify the cytotoxic capacity of IL-2-precultured PBMC.

[An epidemiologic survey of cataract in Shunyi County, Beijing]

The report presents the findings of an epidemiologic study of cataract in Shunyi County, Beijing, conducted in 1985, revealing that the general prevalence of senile cataract was 5.99%, and in people over 40 years of age, 18.58%; the rate obviously increased with age. Cataract accounted for 14.54% of the blind and 20.51% of the low-vision. The diagnostic criteria for senile cataract in surveys and the strategy for the prevention and treatment of senile cataract are recommended.

[An epidemiologic survey of trachoma in Shunyi County, Beijing]

The report presents the results of an epidemiologic survey of trachoma in Shunyi County, Beijing, conducted in 1985, revealing that trachoma was the major eye disease in Shunyi County with a prevalence of 38.68%, which obviously related with age. Most of the trachoma patients were mild cases; only 2.88% were of the severe type, while trachomatous complications occurred in 10.50% of the patients. The morbid characteristics of trachoma in rural areas and measures of treatment and prevention are discussed.

NK cells in patients with peripheral neuropathy and IgM monoclonal protein reacting with the myelin-associated glycoprotein (MAG)

We studied Leu 7+ cell distribution and natural killer (NK) activity in the peripheral blood of six patients who had peripheral neuropathy and monoclonal IgM protein directed against myelin-associated glycoprotein (anti-MAG IgM). We did not find any difference between patients and control subjects (healthy or polyneuropathic, some with IgM monoclonal paraprotein but without anti-MAG activity). The presence of autologous sera did not interfere with these results. We noted an increase in Leu 11+ cell percentages after pre-incubation of the patient cells with autologous sera but the phenotypes of cells from control subjects did not change after incubation with autologous or patient sera.

[Pathologic study on the treatment-effect of hematoporphyrin derivative in carcinoma of the gastric cardia]

42 patients with carcinoma of gastric cardia treated by HPD are reported. The endoscopic biopsy specimens of these patients were classified histologically before treatment. There were 2 papillary adenocarcinoma (PAC), 14 well differentiated adenocarcinoma (WDAC), 11 moderate differentiated adenocarcinoma (MDAC), 5 poor differentiated adenocarcinoma (PDAC), 6 mucinous adenocarcinoma (MAC), 1 undifferentiated carcinoma (UDC) and 3 squamous cell carcinoma (SCC). After four weeks' treatment, reexaminations by endoscopy and biopsy were done in 39 patients and operation were performed on three. Histologic changes following the treatment were degeneration, necrosis of tumor cells, and infiltration of lymphocytes and plasmacytes in the stroma to different degrees. The histologic changes were graded into H0, H1, H2 and H3 by the authors. Grades H0, H1 are considered as noneffective and grades H2, H3 as effective. Of 42 patients, 10 were H0, 21 H1, 8 H2 and 3 H3. The overall effective rate was 26.2% (11/42) which was correlated with the histologic type of carcinoma. Thus, 21.4% (3/14) of WDAC, 18% (2/11) of MDAC, 40% (2/5) of PDAC, 50% (3/6) of MAC and 100% (1/1) of UDC responded well to the treatment, but all SCC and PAC were refractory. It should also be noted that the HPD treatment was effective in patients with tumor infiltrations relatively limited and superficial in the gastric wall, but was unsatisfactory in patients with wider and deeper infiltrations.