[Cerebral vasculitis in children]

Vasculitis is the predominant feature of a large number of diseases in childhood. Cerebral vasculitis are quite common and sometime misinterpreted. They can be to express the direct vascular damage caused by the bacterial, viral, mycotic and protozoal agents; otherwise they can be to arise from some type of immunopathology including the presence of circulating immune complexes, or the prevalent defect of the T-Cells, or else still not well-know. The histological anatomy will to display the leukocytoclastic vasculitis or the granulomatous arteritis, and often will to make clear the pathogenetic's doubts of the clinical features. That is of the paramount importance for the very quick and correct therapy.

Transitory L-carnitine depletion in rat skeletal muscle by D-carnitine

Weanling and adult rats were intraperitoneally injected with D-carnitine for 40 days. After 15 days of treatment a statistically significant depletion in the muscle levels of free and total L-carnitine was observed, but after 40 days this depletion became slight and statistically not significant. These findings suggest the presence of a compensatory mechanism acting on the inhibition of L-carnitine transport into skeletal muscle fibres.

Single-photon emission computed tomography studies with 99mTc-hexamethylpropyleneamine oxime in dementia: effects of acute administration of L-acetylcarnitine

The acute effects of intravenously administered L-acetylcarnitine (LAC) were evaluated with single-photon emission computed tomography (SPECT) and 99mTc-hexamethylpropyleneamine oxime in 30 demented patients (21 with a clinical diagnosis of Alzheimer's dementia and 9 with mixed-type dementia). Two SPECT scans were performed: in basal conditions, and 30 min after the administration of 500, 1,000, 1,500, or 2,000 mg LAC intravenously. Tracer activity ratios were determined in 10 pairs of cerebellar, cortical and subcortical regions. After administration of the lowest dose of LAC, no changes from the basal values were observed in any of the regions examined. The higher doses of the drug significantly elevated the tracer activity in cortical regions, particularly in the parietal lobe, which showed an impaired regional cerebral blood flow in the basal study. These effects of LAC and their relation with the cholinomimetic properties of the drug are discussed.

Effects of L-5HTP with and without carbidopa on plasma beta-endorphin and pain perception. Possible implications in migraine prophylaxis

L-Tryptophan (L-TP) has been used in migraine and other pain conditions. The mechanism underlying the analgesic effect is still partly undefined. In this study the effects of subchronic administration of L-5-hydroxy-tryptophan (L-5HTP) (with and without carbidopa) on plasma beta-endorphin (beta-EP) levels and subjective pain threshold and tolerance were investigated in seven healthy volunteers. To measure also an objective indicator for pain, the nociceptive flexion reflex threshold was studied. L-5HTP treatment with and without carbidopa administration increased beta-EP levels significantly (p less than 0.05). L-5HTP plus carbidopa induced an increase in beta-EP significantly (p less than 0.05) higher than that after L-5HTP alone. Neither subjective pain threshold and tolerance nor RIII threshold was modified by either treatment. Our data seem to point to the existence of a complex linkage between plasma opioid levels and pain perception.

Effects of L-5HTP with and without carbidopa on plasma beta-endorphin and pain perception: possible implications in migraine prophylaxis

L-Tryptophan (L-TP) has been used in migraine and other pain conditions. The mechanism underlying the analgesic effect is still partly undefined. In this study the effects of subchronic administration of L-5-hydroxytryptophan (L-5HTP) (with and without carbidopa) on plasma beta-endorphin (beta-EP) levels and subjective pain threshold and tolerance were investigated in seven healthy volunteers. To measure also an objective indicator of pain, the nociceptive flexion reflex threshold was studied. L-5HTP treatment with and without carbidopa administration increased beta-EP levels significantly (p less than 0.05). L-5HTP plus carbidopa induced an increase in beta-EP significantly (p less than 0.05) greater than that induced by L-5HTP alone. Neither the subjective pain threshold and tolerance nor the RIII threshold was modified by either treatment. Our data seem to point to the existence of a complex linkage between plasma opioid levels and pain perception.

Behavioral effects of acetyl-l-carnitine in the male rat

The behavioral activity of carnitine acetylate derivative, acetyl-l-carnitine has been studied in the male rat. Intraperitoneal (IP) injection of acetyl-l-carnitine was followed by an increase in ambulation and rearing items in the open field behavior. Both the number of conditioned avoidance response (CARs) and the percentage of learners in the acquisition of shuttle-box active avoidance behavior appeared to be increased by IP or intracerebroventricular (ICV) injection of the drug at different doses. Subchronic administration of the drug mimicked the effects found after acute injection. The number of CARs in the extinction of shuttle-box active avoidance behavior appeared to be increased after acute IP or ICV injection, and after subchronic administration of acetyl-l-carnitine. The retention of passive avoidance behavior was facilitated by IP injection of the substance. The behavioral effects of acetyl-l-carnitine may involve central mechanisms, e.g., cholinergic neurotransmission in the brain.

Hypogammaglobulinemia with hyper-IgM, severe T-cell defect, and abnormal recirculation of OKT4 lymphocytes in a girl with chronic lymphadenopathy

We describe here one 8-year-old girl with an unusual form of immunodeficiency, characterized by hypogammaglobulinemia with hyper-IgM, severe T-cell defect, and chronic lymphadenopathy. Patient's B cells failed to produce IgG or IgA in vitro following stimulation with either pokeweed mitogen or Epstein-Barr virus, suggesting an intrinsic B-cell defect. Abnormal T-cell function was demonstrated by impaired in vivo delayed type hypersensitivity, reduction of mitogen-induced proliferation and interleukin 2 production, reduction of interferon-gamma production, and marked decrease of circulating OKT4+ cells. The latter cells were found in normal proportion in the patient's lymph node tissue. This finding suggests that the decrease of OKT4+ cells in peripheral blood was due to the abnormal recirculation of these cells. The identity of this syndrome with the infantile form of the acquired immunodeficiency syndrome was apparently ruled out by the failure to demonstrate HTLV-III-related sequences in patient's lymphocytes or virus-specific serum antibodies.

Cluster analysis of cognitive performance in elderly and demented subjects

48 elderly normals, 14 demented subjects and 76 young controls were tested for basic cognitive functions. All the tests were quantified and could therefore be subjected to statistical analysis. The results show a difference in the speed of information processing and in memory load between the young controls and elderly normals but the age groups differed in quantitative terms only. Cluster analysis showed that the elderly and the demented formed two distinctly separate groups at the qualitative level, the basic cognitive processes being damaged in the demented group. Age thus appears to be only a risk factor for dementia and not its cause. It is concluded that batteries based on precise and measurable tasks are the most appropriate not only for the study of dementia but for rehabilitation purposes too.

Effects of intravenously administered L-acetylcarnitine on somatosensory-evoked potentials. Studies of healthy and diseased volunteers with focal cerebral lesions

The acute effects of intravenously administered L-acetylcarnitine (L-AC) were evaluated in 5 healthy and 20 diseased volunteers (17 vascular, 3 tumoral cerebral lesions). Short-latency scalp somatosensory-evoked potentials (SEPs) to simultaneous median, and separate unilateral peroneal nerve stimulation were carried out before and after L-AC administration (at 10-, 30- and 60-min intervals). L-AC did not influence peak and interpeak latencies; however, in a percentage of healthy and diseased volunteers a clear-cut amplitude increase was evident affecting all those peaks generated between the thalamus and the cortex. While in normal and tumoral volunteers the voltage increase was bilaterally balanced, the amplitude increments were more evident on the 'affected' hemisphere in vascular patients, partially reversing the abnormal amplitude ratios between homologous peaks on 'healthy' and 'affected' hemispheres. In no case were transient clinical changes, either of an objective or subjective nature, associated with SEP amplitude changes; these were still present at the 60th minute, having reached their nadir at the 30th minute in 'responders'.

L-5HTP treatment in primary headaches: an attempt at clinical identification of responsive patients

The therapeutic response to L-5HTP, a serotonin precursor, was studied in an attempt to identify clinical subgroups of primary headache patients. The results at the 4th month control in 100 patients under L-5HTP treatment at the dose of 300 mg/day confirm previous observations on the activity profile of the drug, the effects of which are equally distributed between recurrent and daily forms as well as among clinical subtypes. The emerging profile of the responsive patients is characterized by such peculiar traits as prevalence of previous major mood disturbances and minor frequency of anxiety, longer duration of the illness and higher occurrence of some associated symptoms, lower incidence of exogenous and hormonal trigger factors, and previously positive response to pizotifen treatment.