Changes in phrenic, hypoglossal and recurrent laryngeal nerve activities after intravenous infusions of aminophylline in cats

Aminophylline is known to have respiratory stimulant properties, and it has been suggested that it may also be effective in sleep apnoea. However, its role in this disorder remains uncertain. Theoretically, increasing upper airway motoneural activity in order to maintain airway patency might alleviate obstructive sleep apnoea. On the other hand, increasing the respiratory drive may also prove beneficial in treating central sleep apnoea. In these studies, we attempted to determine the effect of aminophylline on neural activities of the upper airway and diaphragm. We administered intravenously either a low dose (4 mg.kg-1) or a high dose (16 mg.kg-1) of aminophylline to decerebrated, vagotomized and paralysed cats, and continuously recorded the phrenic hypoglossal and recurrent laryngeal nerve activities for 3 h. Results showed that a high dose of aminophylline induced a marked increase in phrenic nerve activity, but not hypoglossal or recurrent laryngeal nerve activity. In a group treated with a low dosage of aminophylline, a significant increase of activity was found in all three nerves. Furthermore, phrenic nerve activity increased more with a high dose than with a low dose. We confirmed that aminophylline has dose-dependent and selective effects on respiratory neural activity. A low dose acts on the upper airway and diaphragm, but a high dose induces a marked increase in central respiratory drive. According to our results, low dose aminophylline might be beneficial in obstructive sleep apnoea, whereas, a high or low dose might improve some cases of central sleep apnoea.

Changes in phrenic, hypoglossal and recurrent laryngeal nerve activities after intravenous infusions of aminophylline in cats

Aminophylline is known to have respiratory stimulant properties, and it has been suggested that it may also be effective in sleep apnoea. However, its role in this disorder remains uncertain. Theoretically, increasing upper airway motoneural activity in order to maintain airway patency might alleviate obstructive sleep apnoea. On the other hand, increasing the respiratory drive may also prove beneficial in treating central sleep apnoea. In these studies, we attempted to determine the effect of aminophylline on neural activities of the upper airway and diaphragm. We administered intravenously either a low dose (4 mg.kg-1) or a high dose (16 mg.kg-1) of aminophylline to decerebrated, vagotomized and paralysed cats, and continuously recorded the phrenic hypoglossal and recurrent laryngeal nerve activities for 3 h. Results showed that a high dose of aminophylline induced a marked increase in phrenic nerve activity, but not hypoglossal or recurrent laryngeal nerve activity. In a group treated with a low dosage of aminophylline, a significant increase of activity was found in all three nerves. Furthermore, phrenic nerve activity increased more with a high dose than with a low dose. We confirmed that aminophylline has dose-dependent and selective effects on respiratory neural activity. A low dose acts on the upper airway and diaphragm, but a high dose induces a marked increase in central respiratory drive. According to our results, low dose aminophylline might be beneficial in obstructive sleep apnoea, whereas, a high or low dose might improve some cases of central sleep apnoea.

Ocular hypotensive effects of L-arginine and its derivatives and their actions on ocular blood flow

Effects of L-arginine and some related compounds on the intraocular pressure recovery (IOPR) and ocular blood flow in rabbits had been studied. It was found that L-arginine (RVC-579) and N alpha-benzoyl-L-arginine ethyl ester (RVC-578) delayed the IOPR markedly: The IOPR of the contralateral non-treated eye was delayed to the same extent as the treated eye. The effects of closely related congeners L-(+)-canavanine (RVC-581) and L-homoarginine (RVC-580) on the IOPR were qualitatively similar to RVC-579 and RVC-578 but less effective. RVC-578 was found to increase the blood flow significantly in ciliary body, retina and choroid. On the other hand, NG-nitro-L-arginine, a nitric oxide (NO) synthase inhibitor, reduced the blood flow in choroid at 60 and 120 min after drug administration and did not increase the blood flow in iris, ciliary body and retina. These results indicate that L-arginine and its derivative are capable of lowering the IOP possibly through the formation of nitric oxide to relax the blood vessel and to reduce the IOP as a result.

Effects of cromakalim and nicorandil on intraocular pressure after topical administration in rabbit eyes

In the study two potassium channel activators, cromakalim and nicorandil, were investigated in rabbits using three different levels of intraocular pressures (IOPs), including alpha-chymotrypsin-induced ocular hypertension, hypotension (IOP recovery method) and normal tension. Cromakalim significantly increased IOP during the initial period in normotensive and hypotensive rabbits, but in the later time, reduced IOP in the alpha-chymotrypsin-induced model. Nicorandil had a similar but less potent effect. In addition, cromakalim also affected ocular blood flows, which had a trend to reduce blood flow about 2-3 hr later, after topical administration of the eyedrop. Two possible mechanisms for increasing IOP effect of potassium channel activators were: (a) enhancing the formation of aqueous humor; (b) relaxing the trabecular meshwork to reduce the outflow of aqueous humor.

Distribution of ganglion neurons in the trachea of the rat

The nerve plexuses and ganglionic nerve cells of rat trachea were studied quantitatively in whole-mount preparations stained for acetylcholinesterase. Two nerve plexuses were observed overlaying the smooth muscle layer of the membranous part or the rat trachea. On average, 70 ganglia (range 63-78, S.D. = 6) and 549 neurons (range 334-661, S.D. = 125) were found on the nerve plexuses. About 80% of ganglia are distributed in the thoracic part of the trachea. The ganglia are relatively small, 77% of the tracheal ganglia contain only 5 (or fewer) neurons. The profile area of neurons are about 474 microns2 (range 207 microns2-918 microns2). It appears that the uneven distribution of neurons is attributed to the increased volume of the thoracic tracheal smooth muscle. The ultrastructural features of the rat tracheal ganglia is similar to that of other species. A few regular processes of fibroblasts form the perineurium of the ganglia. Collagen fibrils, myelinated and unmyelinated nerve fibers and blood vessels are present inside the ganglia. The presence of muscular blood vessel within the tracheal ganglion has nerve been reported before. This may further support the possibility that the tracheal ganglion receives a separate blood supply.

The mucoceles or pyoceles of the paranasal sinuses

Fifty-five mucopyoceles in 53 patients were diagnosed during the 10-year period from 1982 to 1992 in our department. These included 8 from the frontal sinus, 25 from the maxillary sinus, 10 from the ethmoidal sinus, 1 from the maxillary and ethmoidal sinuses, 7 from the frontoethmoidal sinuses and 4 from the sphenoethmoidal sinuses. The patients ranged in age from 8 to 78 years (mean 47.1 years). The ratio of males to females was 31 to 22. The rhinologic symptoms occurred most often in maxillary mucopyoceles and were rare in the other groups whereas ophthalmic symptoms were noticed in most of the cases. All of the cases received surgery and postoperatively most of the initial symptoms subsided except that two patients still had occasional diplopia and one did not recover at all from complete blindness. Two cases had a recurrence and one suffered from subarachnoid hemorrhage shortly after discharge. Surgery is the only treatment modality for mucopyoceles and the building of a new patent communication between the lesion and nasal cavity is important for the success of this surgery.

Protamine-induced acute lung injury and the protective effect of agents that increase cAMP

Polycations, such as protamine sulfate and polylysine, have been implicated in acute lung injury. We studied the vascular effect of protamine sulfate and the protective effect of agents that increase cAMP in isolated rat lungs perfused with a cell- and plasma-free solution. Protamine sulfate (3 mg) markedly increased pulmonary artery pressure (PAP) from 15.6 +/- 0.5 to 30.8 +/- 1.2 mmHg (P < 0.01) and lung weight gain (LWG) by 7.8 +/- 1.5 g within 30 min (P < 0.001). The protective effects of pharmacological agents that increase intracellular cAMP were investigated. These agents included dibutyryl adenosine 3',5'-cyclic monophosphate (DBcAMP, a cAMP analogue), aminophylline and pentoxifylline (both are phosphodiesterase inhibitors). Pretreatment with these agents 5 min before protamine administration largely attenuated the increases in PAP and LWG. Because DBcAMP, aminophylline and pentoxifylline all share the effects of increasing intracellular cAMP and were effective on the protamine-induced lung changes, the intracellular level of cAMP could be a major determinant of lung injury. Since there is no blood in the perfusate, the mechanism of cAMP on cellular components in the blood such as neutrophils, can be ruled out. The endothelial cells are likely to be the target cells because charge interaction is believed to occur on the endothelial surface. This result will be very important in the elucidation of the protective effect of cAMP in acute lung injury.

Alteration of amino acid in plasma and cerebrospinal fluid of children with seizure disorders

Amino acid levels in plasma were measured by amino acid autoanalyser in 130 convulsive children. The levels of taurine, serine and tryptophan were significantly lower in convulsive children as compared to normal control; in contrast, isoleucine, homocystine, GABA, histidine, arginine and ammonia were higher. The children with paroxysmal disorders (headache, dizziness and abdominal epilepsy) had the highest levels of isoleucine, histidine and arginine and the lowest levels of glutamate and cystein. Clinical seizure activity within 6 months prior to the test seemed to have no obvious effect on the plasma amino acid pattern, except for the levels of glycine and arginine tended to return to normal, and the level of GABA was significantly increased in patients with the seizure being controlled. The patients treated with carbamazepin as a single anticonvulsant had the highest GABA level compared to those with other anticonvulsants. Hyperglycinemia and hyperammonaemia were also noted in patients who took valproic acid. The levels of serine, isoleucine and phenylalanine in the CSF within 6 hours after convulsion were significantly lower than the normal control; while asparagine, tyrosine, lysine and arginine were significantly higher. The concentration of ammonia in the CSF was also elevated after convulsion as compared to the normal control. Amino acids play an important role in the generation of epilepsy and recently there has been an increasing number of studies to help determine their effects during an epileptic attack. However, there still is much debate and controversy on this topic. Therefore, further studies are needed and researchers should carefully consider factors that might affect the accurate assessment of the results.

Duchenne muscular dystrophy: MR grading system with functional correlation

The pelvic girdle, thigh, and calf muscles of 29 patients with Duchenne muscular dystrophy (DMD) were evaluated with magnetic resonance (MR) imaging. The muscles that were most resistant to disease were the gracilis, followed by the sartorius, semitendinous, and semimembranous. Sixteen patients had asymmetric involvement in part of the muscle bundles of thigh. An MR grading system was developed to assess the number of preserved pelvic and thigh muscles, the severity of fatty infiltration of the calf, and the increase of subcutaneous fat. Statistically significant correlations were obtained between MR grade and clinical functional grade (P < .01), MR grade and disease duration (P < .01), and MR grade and patient age (P < .01). An inverse correlation was observed between the creatine kinase values and the MR grade (P < .05). The MR grading system helped identify disease severity in patients with low clinical functional grades. Twenty-four follow-up studies were performed in 22 patients. In 13 of the 24 cases, the MR grade progressed while the clinical functional grade remained unchanged. Both the MR and clinical functional grades progressed in six cases. The results suggest that MR imaging may be useful in prebiopsy mapping and may help accurately monitor the progression of DMD.

Studies of topical carbonic anhydrase inhibitors: ocular hypotensive effect of thiadiazole derivatives

A series of thiadiazole derivatives were topically applied in gels or suspensions to rabbits to determine their ocular hypotensive effect. As a result, the compounds with higher corneal permeabilities showed stronger effect in lowering IOP. In addition, gels also caused stronger effect than suspensions. Different concentrations of gel preparations produced diverse ocular hypotensive effects. A linear relationship between the integrated IOP response and logarithm concentration of inhibitor was found. It is proposed that the ocular hypotensive effect was attributed to the level of inhibitor in ciliary body.

Studies of carbonic anhydrase inhibitors: physicochemical properties and bioactivities of new thiadiazole derivatives

A series of thiadiazole derivatives of carbonic anhydrase inhibitors were prepared and their physicochemical properties and pharmacological activities such as corneal permeabilities, inhibition of carbonic anhydrase activities were evaluated. The solubilities and pKa values were determined in varied pH of phosphate buffers at 35 degrees C after equilibrium. Intrinsic solubility and pKa value were calculated from the plot of solubility versus the reciprocal of hydrogen ion concentration. The distribution coefficient was determined in the system of octanol/pH 7.65 phosphate buffer. As a result, the sigma (Hammett constant) and pi (hydrophobic substituent constant) values of substituents were found to be correlated to the logarithm of Ka and partition coefficient. Corneal permeabilities of the analogue were determined in a specially designed diffusion cell using excised rabbit cornea, which ranged from 1.32 x 10(-5) (compound II) to 3.48 x 10(-7) cm/sec (compound VI). Compound with high permeability might be expected to be absorbed well after topical administration into the eye. The methodology of pH-stat was used to determine the inhibition of the carbonic anhydrase activity of the analogue. The IC50 values of the analogue around 10(-8) M as determined were less than that of acetazolamide. The results suggest that the analogue had good pharmacological activity. Finally, an equation for quantitative structure-activity relationship was established for the analogue, which is as follows: [formula: see text]

Complete nucleotide sequence and genetic organization of papaya ringspot virus RNA

The complete nucleotide sequence of the RNA genome of papaya ringspot virus (PRSV) was determined from four overlapping cDNA clones and by direct sequencing of viral RNA. The genomic RNA is 10326 nucleotides in length, excluding the poly(A) tract, and contains one large open reading frame that starts at nucleotide positions 86 to 88 and ends at positions 10118 to 10120, encoding a polyprotein of 3344 amino acids. The highly conserved sequence AAAUAAAANANCUCAACACAACAUA at the 5' end of the RNA of PRSV and those of the other five reported potyviruses shows 80% similarity, suggesting that this region may play a common important role for potyvirus replication. Two cleavage sites of the polyprotein were determined by amino acid sequencing of the N termini of helper component (HC-Pro, amorphous inclusion) and cylindrical inclusion (CI) proteins. Other cleavage sites were predicted by analogy with the other potyviruses. The genetic organization of PRSV is similar to that of the other potyviruses except that the first protein processed from the N terminus of the polyprotein (NT protein) has an M(r) of 63K, 18K to 34K larger than those of the other potyviruses. The cleavage site for liberating the N terminus of the HC-Pro protein was found at the same location down-stream from the consensus sequence FI(V)VRG as that reported for tobacco vein mottling virus. The NT protein of potyviruses is the most variable and may be considered important for identification of individual potyviruses. The most conserved protein of potyviruses appears to be the NIb protein, the putative polymerase for the replication of the potyviral RNA. The genetic organization of PRSV RNA is tentatively proposed to be VPg-5' leader-63K NT-52K HC-Pro-46K-72K CI-6K-48K NIa-59K NIb-35K coat protein-3' non-coding region-poly(A) tract.

Role of platelets in microembolism-induced acute lung injury

The role of platelets in acute lung injury has not been well defined. In the present study of isolated perfused rat lungs, a significant increase in pulmonary arterial pressure (PAP), lung weight and the lung lavage fluid protein concentration occurred when 3 mL of a CaCl2 suspension (25 mg/mL) was mixed with blood-KHB (Krebs-Henseleit Buffer) perfusate; or when platelets were added instead of blood. However, such an increase was not observed (p > 0.05) when only KHB was used. When a comparatively small amount (0.75 mL) of the CaCl2 suspension (50 mg/mL) was added to the KHB perfusate, PAP, lung weight and the lung lavage protein concentration increased only when PAF (platelet activating factor) and platelets were both added before, but not separately. The above phenomena show that platelets are actively involved in the mechanism of acute lung injury and play an extremely important role in this microembolic model.

Dimethylthiourea ameliorates acute lung injury induced by phorbol myristate acetate in dogs

BACKGROUND AND METHODS

The protective effects of dimethylthiourea, a potent scavenger of hydroxy radical (.OH) and hydrogen peroxide, in experimental lung injury in large animals remain controversial. The present study was designed to determine whether dimethylthiourea can ameliorate the acute lung injury produced in dogs by phorbol myristate acetate. Six dogs were infused with dimethylthiourea (0.75 g/kg in saline) for 1.5 hrs, beginning 1 hr before an i.v. bolus injection of phorbol myristate acetate (17 micrograms/kg); six dogs received phorbol myristate acetate (17 micrograms/kg) alone; and six dogs were infused with saline alone. Hemodynamic changes, arterial oxygenation, and the development of lung edema were monitored for 4 hrs after phorbol myristate acetate injection to assess the extent of lung damage.

RESULTS

As compared with the dogs that received phorbol myristate acetate alone, the edematous lung damage was significantly reduced in those dogs that received dimethylthiourea as well as phorbol myristate acetate. In the dimethylthiourea-treated dogs, the lung wet/dry weight ratios were smaller (p less than .01); protein concentrations in lung lavage fluid were lower (p less than .01); the decrease in PaO2 was significantly reduced (p less than .01); and there were significant reductions in the alveolar-arterial oxygen tension difference (P[A-a]O2) (p less than .01) and shunt (Qsp/Qt) (p less than .05). Also, dimethylthiourea significantly lowered the increased mean pulmonary arterial pressure levels during the second half of the experiment.

CONCLUSIONS

These experimental data suggest that dimethylthiourea is capable of reducing the neutrophil-mediated lung injury produced by the release of hydroxy radical and/or hydrogen peroxide in dogs exposed to phorbol myristate acetate.

Stability studies of topical carbonic anhydrase inhibitor 6-hydroxyethoxy-2-benzothiazole sulfonamide

A new carbonic anhydrase inhibitor, 6-hydroxyethoxy-2-benzothiazole sulfonamide (6-hydroxyethyoxyzolamide), was studied to determine its stability in aqueous solution from pH 2.9 to 9.2 at a constant ionic strength of 0.15 M. This newly synthesized derivative of ethoxyzolamide has demonstrated clinical efficacy for use as an ophthalmic drug to lower intraocular pressure. Drug solution in sealed ampules was placed in a constant temperature over either at two temperatures (75 and 85 +/- 0.2 degrees C) or four temperatures (75, 80, 85, and 90 +/- 0.2 degrees C). Samples were analyzed by known HPLC methods. The results indicated that 6-hydroxyethoxyzolamide is most stable at pH 4 to 5.5. The aqueous drug solutions at pH 7.0 and 8.0 were, nevertheless, sufficiently stable, based on extrapolation of kinetic data at high temperatures using the experimentally determined Arrhenius equation. The degradation compound was identified by spectral analysis to have a hydroxyl group substituting for the original -SO2NH2 group.

Recombinant pseudorabies virus carrying a plasmodium gene: herpesvirus as a new live viral vector for inducing T- and B-cell immunity

In Balb/c mice, the sterile protective immunity induced by immunization with radiation-attenuated Plasmodium yoelii sporozoites is eliminated by in vivo depletion of CD8+ T lymphocytes, suggesting that cytotoxic T lymphocytes (CTL) against malaria antigens expressed on infected hepatocytes are required for mediating this protective immunity. To produce a vaccine that would induce CTL against the P. yoelii circumsporozoite protein (CS), we constructed an attenuated pseudorabies virus (PRV) containing a gene encoding this protein. Balb/c mice that received three doses of 10(7) plaque-forming units (p.f.u.) of this vaccine intravenously at 3 week intervals developed high levels of antibodies to sporozoites (indirect fluorescent antibody titre = 4096) and CTL against a 16 amino acid epitope (SYVPSAEQILEFVKQI, amino acids 281-296) from the P. yoelii CS protein designated PYCTL1. The cytotoxic activity of the CTL was antigen-specific, MHC-restricted, and dependent on CD8+ T cells. Furthermore, these CTL eliminated P. yoelii-infected hepatocytes from in vitro culture, indicating that they recognize this peptide on the surface of infected hepatocytes. However, all nine mice that were challenged with 200 sporozoites developed a blood-stage malaria infection. We attribute this lack of protection to the great difficulty of inducing sterile immunity against this highly infectious parasite P. yoelii. We conclude that recombinant pseudorabies virus (PRV) worked successfully as a live vaccine vector to induce both antibodies and CTL, albeit non-protective in vivo, and the herpesviruses should be considered as subunit vaccines where T- and B-cell immunity is required.

Spinal muscular atrophy: MR evaluation

The neurogenic myopathy of spinal muscular atrophy (SMA) is degeneration of anterior horn cells of the spinal cord and associated muscle weakness. In three patients with the severe type, according to Dubowitz's classification, magnetic resonance imaging (MRI) of the lower extremity showed severe atrophy of the entire muscle bundles of the thigh and the calf. Nine intermediate type patients had ragged atrophy of muscle bundles of the thigh and the calf with selective preservation of adductor longus muscle. Five patients with the mild type had fatty infiltration of muscle bundles and increased intermuscular fat planes. MRI was insufficient for the evaluation of cervical cord abnormalities. MRI of the lower extremity was a reliable complementary modality for the diagnosis and follow-up of SMA patients.

Dystrophin immunostaining of muscle from Chinese patients with various neuromuscular diseases

The localization of dystrophin was studied using the immunohistochemical method of diagnostic muscle specimens from 68 patients, aged 9 days to 65 years, with various neuromuscular disorders. Additionally muscle specimens from 2 normal humans and 2 normal mice were used as positive controls, and those from 2 mice with x-linked muscular dystrophy as negative controls. The specimens from all 14 Duchenne muscular dystrophy (DMD) patients, including one with preclinical DMD, showed negative dystrophin staining except for two which had 0.2% to 0.8% positive fibers. The mdx mice also showed negative dystrophin staining. In Becker muscular dystrophy (BMD), muscle fibers stained in a patchy or discontinuous fashion. Two symptomatic DMD carriers exhibited a distinct mosaic pattern of dystrophin positive and negative fibers. In contrast, dystrophin was present in all 7 biopsies from patients with 4 other types of muscular dystrophy (limb-girdle, congenital, myotonic and facioscapulohumeral). Other specimens, those from normal humans and control mice, revealed homogeneous immunostaining along the surface membranes of all muscle fibers. We thus conclude that immunohistochemical dystrophin staining can aid in differentiating DMD from preclinical DMD or BMD, as well as in the detection of DMD carriers.

Mental retardation in congenital nonprogressive myopathy with uniform type 1 fibers

A 12-year-old girl with proximal muscle weakness and delayed psychomotor development from early infancy is presented. She had a myopathic face, high-arched palate, nasal tone vocalization, positive Gowers' sign, waddling gait and decreased deep tendon reflexes. Her IQ was 40 (PIQ = 39, VIQ = 51). The serum creatine kinase level and peripheral nerve conduction velocity as well as electrocardiogram were normal. The electromyogram showed myopathic changes. Magnetic resonance imaging (MRI) of thigh muscles revealed fatty infiltration of all muscle groups, the hypertrophic biceps femoris and semimembranous muscles being spared. A biopsy specimen from the left biceps brachii muscle revealed small caliber fibers, increased variability of fiber size and uniformity of type 1 fibers (greater than 99%). This case was diagnosed as having congenital nonprogressive myopathy with uniform type 1 fibers, and had a non-deteriorating clinical course as in most congenital nonprogressive myopathy cases.

Pleomorphic adenoma of the trachea: report of two cases

Two unusual cases of pleomorphic adenoma (benign mixed tumor) of the trachea were found in a 56-year-old woman and a 20-year-old man. Both patients had been initially treated for presumed bronchial asthma for 5 years and 4 years, respectively. Pulmonary function tests in each showed typical extrathoracic obstruction. The diagnosis of tracheal lesions in both cases was based principally on the following: 1) dyspnea without complete remission over an extended period of time following initial examination; 2) marked retraction of the supraclavicular and suprasternal notches during inspiration with stridor on physical examination; and 3) a high degree of suspicion. Large tumors were found within the air column of the trachea by soft tissue density X-ray films and electroradiographs of the neck, CT scans of the neck and mediastinum in each patient revealed that the tumor originated from the membranous layers of the trachea in the woman and the posterolateral wall of the trachea in the man. Fiberoptic bronchoscopy confirmed the clinical diagnosis. Both cases were successfully treated by segmental resection of the trachea with end-to-end anastomosis.

Increased incidence of asthma and pulmonary dysfunction after severe lower respiratory tract infection in infancy

In the present study we tried to define the effect of lower respiratory tract infections upon pulmonary function and/or asthma in childhood. Thirty-five children with history of pneumonia in infancy were followed five to ten years later; all were asked to respond questionnaire, received physical examination and were diagnosed for pulmonary function. The results follow: 13 children (37%) had developed asthma, a significantly higher percentage than normal prevalence among students in this area. Simple pulmonary function test, pulmonary function test after distilled water mist and after hypertonic saline (4.5%) mist all showed abnormal values in VC (17%, 14%, 29% respectively), in IVC (46%, 51%, 53%), in FVC (20%, 23%, 24%), in FEVl (17%, 23%, 29%), in FEF25-75% (37%, 49%, 47%), in FEF75% (26%, 23%, 29%) and in FEVl/VC (20%, 14%, 29%). Methacholine challenge test (PC20) showed a marked decrease of PC20 in asthmatic children; each was less than 5 mg/ml (mean value; 0.99 mg/ml). Family-allergy in at least one parent and wheeze were the two significant risk factors. Nevertheless, in 22 non-family-allergy children, the occurrence of asthma was also higher than general prevalence (18.2% vs 5.6%). Wheezing was evident in viral infections in infancy, but bacterial culture from sputum or throat swabs failed to find pathogenic bacteria. These results indicate that while the genetic factor may be important, viral infections may be more important because, even in non-family-allergy children, the occurrence of asthma was higher for infants infected in early infancy than the general prevalence for age-matched students.

Somatostatin, substance P, prolactin and vasoactive intestinal peptide levels in serum and cerebrospinal fluid of children with seizure disorders

Seventy patients aged from one month to 18 years with seizure disorders were classified into three groups: I. Patients who had hard control seizure attacks even under medication; II. those who had occasional seizure attacks (less than 6 times per year) and III. those who had no seizure attacks after receiving medication for at least one year. Blood samples were taken for somatostatin, substance P, prolactin and vasoactive intestinal peptide (VIP) assays. Lumbar puncture was made in 32 children and CSF samples were also assayed for neuropeptides. Somatostatin levels in serum were significantly elevated in group I and group II (P = 0.05, ANOVA) but not in group III and control group. Similar observations were made in substance P, prolactin and VIP studies. In CSF, the somatostation can better indicate the difference between epileptic and normal children (comparison with group I, P greater than 0.001; with group II, P less than 0.001; even with those who were seizure free after medication, P less than 0.05). In conclusion, the levels of several neuropeptides (somatostatin, substance P. prolactin, VIP) were elevated in children with seizure disorders both in serum and CSF. The present investigation provides a new category for the understanding of the pathogenesis, treatment as well as prognosis of seizure disorders.

Effect of stabilization temperature on the degradation of adriamycin in albumin microspheres

The effect of stabilization temperature on the degradation of adriamycin HCl during the preparation of albumin microspheres was investigated. The degradation of adriamycin HCl by heating at various temperature with different time interval in dried adriamycin HCl powder, adriamycin HCl aqueous solution, wetted Adriablastina (adriamycin HCl with lactose) powder and Adriablastina aqueous solution was also studied. In the presence of water the degradation of adriamycin HCl was found; whereas, in the absence of water no degradation occurred. The degradation of adriamycin HCl in solution and wetted powder showed a zero order reaction. An increase in temperature increased degradation rate. The rate constant for adriamycin HCl degradation in Adriablastina solution obtained was in good agreement with that in adriamycin HCl solution. It was suggested that the presence of lactose had no interference in the degradation of adriamycin HCl. The zero-order reaction of degradation was attributed to the drug behaved like a suspension. The degradation of adriamycin HCl at various stabilization temperature during the preparation of microspheres had the same tendency as those of the adriamycin HCl solution and the wetted adriamycin HCl powder that were heated by the DSC instrument with the condition similar to the preparation of microspheres.

Minimal change myopathy: report of a case

A young boy, aged 5 years 7 months, presented with generalized hypotonia and proximal muscle weakness, and had exhibited delayed motor milestones since birth, He showed talipes planovalgus, a myopathic face, nasal tone vocalization, positive Gowers' sign and decreased tendon reflexes, but there was no intellectual impairment or seizure. The serum creatine kinase level and peripheral nerve conduction velocity, as well as the electromyogram and electrocardiogram, were within normal limits. A biopsy specimen from the left biceps brachii muscle revealed minimal nonspecific changes and mild variations in fiber size with an increased number of undifferentiated type 2C fibers, but no subcellular abnormalities were found on either the histochemical or electron microscopic examinations. The patient was diagnosed as having minimal change myopathy and improved clinically in muscle strength after one year of follow-up.

Congenital fiber type disproportion: report of one case

Congenital fiber type disproportion (CFTD) is described clinically as muscle weakness and hypotonia with delayed motor development, usually from infancy. Muscle biopsy reveals that type 1 fibers predominate and smaller than type 2 fibers by a margin greater than 12% of the diameter of the type 2 fibers. There are no other subcellular abnormalities, and generally prognosis is good. The CFTD case is a six-month-old girl who manifested clinically as a floppy infant. A biopsied specimen from the left biceps brachii muscle revealed type 1 fiber predominance and hypoplasia with an increased number of undifferentiated type 2C fibers. Electromyogram, nerve conduction velocity and serum creatine kinase level were normal. The child learned to walk without assistance at 1 year 7 month old. Now 2-years and 10-months old, she can climb stairs without difficulty, although she cannot run fast.