Enzyme- and immuno-histochemical study of the thymic stroma in the rainbow trout, Salmo gairdneri, Richardson

Owing to the lack of data about thymic non-lymphoid cells in fish we decided to perform a histochemical characterization of these cells in order to ascertain their relationships to other thymic components. In the present study we analyze the enzyme-histochemical patterns for acid phosphatase, alkaline phosphatase, non-specific sigma-naphthyl acetate esterase and 5' nucleotidase activities, as well as the presence of keratin demonstrated by immunoperoxidase staining, in the non-lymphoid cell populations of the thymus of the rainbow trout, Salmo gairdneri. According to their location in the organ, morphology and histochemical reactivities, we were able to define seven different subpopulations of keratin-positive epithelial cells: 1) Epithelial cells limiting with the capsular and septal connective tissues; 2) Subcapsular epithelial cells; 3) Stellate epithelial cells of the inner thymic zone; 4) Large, ovoid epithelial cells of the inner thymic zone; 5) Acidophilic epithelial cells of the outer thymic zone; 6) Cystic cells; and 7) Goblet cells. The significance of the heterogeneity of the epithelial cell (EC) population, its specific distribution in the organ, which apparently conforms distinct cell microenvironments, as well as the possible phylogenetical relationships between these microenvironments and the classical cortex and medulla of the mammalian thymus, are discussed.

[Problems in the diagnosis of thyroid dysfunction of the elderly adult]

Thyroid disfunction in the aged is often misdiagnosed either due to scanty symptoms, masking by other ailments or because function tests can be altered by extrathyroid causes such as chronic diseases, drugs or undernutrition. We surveyed 93 patients from 60 to 104 years old (73 females) living in geriatric homes. Most received at least 2 drugs for control of hypertension, coronary artery disease, diabetes, parkinsonism or psycho-organic deterioration. No clinical evidence of thyroid disfunction was found in 75 patients. T3 was 73.6 +/- 25.5 ng/dl, T4 7.3 +/- 1.8 micrograms/dl, TSH 2.8 +/- 0.9 uU/ml and rT3 32.2 +/- 16.3 ng/dl. Antimicrosomal antibodies were negative in all. Significant differences were found comparing these values with those obtained in 26 normal adults with mean age 39.9 years: T3 was lower and TSH and rT3 were higher in the elderly (p less than 0.0001). T3 decreased and rT3 increased in relation to age and males had significantly lower values of T3, T4 and TSH than females. Some evidence of thyroid disfunction was present in the remaining 18 patients: 9 had multinodular and/or positive antimicrosomal antibodies with euthyroid hormone levels; 6 had elevated T3, T4 and fT4 so hyperthyroidism was suspected; the remaining 3 patients had TSH levels above 20 uU/ml indicating the presence of hypothyroidism of which only one had some clinical manifestation. Thus, thyroid disfunction in the elderly + is not uncommon (3.2% of hyperthyroidism and 2.6% hypothyroidism in this series) in the absence of clinical manifestation. Treatment may improve the quality of life in these patients.

Effect of the ingestion of an extract from Bauhinia monandra seeds on rats

Bauhinia monandra is a leguminous plant that would be used in human nutrition, however it shows a high hemagglutinating activity against trypsin-treated erythrocytes of rabbit, 2 ml of a NaCl-solution extract of the seeds was given to a group of rats for 10 days. Intestinal disaccharidase activity was determined. Histopathological and histochemical examinations were also performed. Lectins from Bauhinia monandra seeds did not cause any visible intestinal damage even when they seem to be able to bind to the enterocyte brush border. The low disaccharidase activity in the membrane and enterocyte fractions, which represent the enzyme synthesis level, indicates that lectins could reduce the synthesis of these enzymes rather than inhibit the active sites of the enzymes. This effect could be in turn related with the binding action of lectins, because no effect of the autoclaved extract on the disaccharidase activity was observed.

Mutagenicity of N-nitrosomorpholine biosynthesized from morpholine in the presence of nitrate and its inhibition by ascorbic acid

N-nitrosomorpholine biosynthesis and inhibition in mice treated with nitrate, morpholine and ascorbic acid, was studied by means of the mutagenic activity in urine samples. The preincubation method was used and Salmonella typhimurium TA 1535 was the test strain. The results suggest that N-nitrosomorpholine biosynthesis was carried out when the animals were fed high doses of nitrate, however ascorbic acid was an inhibitor of this process.

Peripheral blood morphologic changes after high-dose antineoplastic chemotherapy and recombinant human granulocyte colony-stimulating factor administration

The peripheral blood morphologic findings in 17 patients with cancer who had received high-dose cytotoxic chemotherapy followed by recombinant human-granulocyte colony-stimulating factor (rh-GCSF) were reviewed and compared with a control group of patients who received only high-dose chemotherapy. Both groups showed dysmyelopoiesis (abnormal granulation and nuclear lobulation) in the granulocytic series during the period of bone marrow recovery that followed the cytotoxic chemotherapy. Most of these morphologic abnormalities were more prominent in the rh-GCSF-treated group. Monocytic cells in both groups showed prominent vacuolation and immature nuclei. The percentages and absolute numbers of large granular lymphocytes were increased in the rh-GCSF group compared with the control group. No quantitative or qualitative abnormalities of eosinophilic or basophilic granulocytes were detected in either group. Both groups showed nonspecific red blood cell abnormalities, and large platelets were present in half of the control group smears. This report provides the first detailed peripheral blood morphologic description in patients treated with rh-GCSF and high-dose chemotherapy.

[Rapid diagnosis of cytomegalovirus in immunocompromised patients using monoclonal antibodies that detect early viral antigens]

A technique was applied to detect early fluorescent antigens (DEFA) of cytomegalovirus (CMV) using the E13 monoclonal antibodies in 52 immuno-compromised patients hospitalized in the Nephrology Institute of Havana. Of the 75 urine or blood (buffy coat) samples taken, 15 were found positive to CMV. Using classical diploid human fibroblast isolation technique, 12 CMV strains were isolation of previously detected positive samples by DEFA. In addition, CMV was isolated from one sample reported to be negative by DEFA. A coincidence of 80% was found between both techniques. With the ELISA test, all the sample studied have IgG antibodies to CMV.

Impact of intensive care management on the prognosis of tetanus. Analysis of 641 cases

These studies show the results of intensive care management of 306 consecutive patients with tetanus compared with 335 patients treated conservatively in the same hospital before the institution of the ICU. The impact of the ICU treatment was manifested in a decrease in mortality, from 43.58 percent to 15 percent. In addition, while patients treated conservatively died as a consequence of early acute respiratory failure, the main cause of death in the ICU-treated patients was unexpected cardiac arrest, probably related to overactivity of the autonomic nervous system. We conclude that to ensure a high survival rate in patients with tetanus, the treatment must be performed according to established protocol in an ICU.

Effect of ascorbic acid on the hepatotoxicity due to the daily intake of nitrate, nitrite and dimethylamine

It is known that nitrates, nitrites and dimethylamine may react in the gastro-intestinal tract synthesizing the powerful hepatotoxic and carcinogenic dimethylnitrosamine. The purpose of this study was to investigate hepatotoxicity due to the daily intake of nitrates and nitrites administered to rats during 14 weeks together with dimethylamine in drinking water, and to evaluate the protecting effect of ascorbic acid against the hepatotoxicity of the presumably endogenous formed dimethylnitrosamine. The toxicity criteria studied were weight of liver (absolute and relative), free and total bilirubin, alkaline phosphatase and pyruvic glutamic transaminase, all in the form of serum, and histopathologic tests of the liver. The results gave evidence of hepatotoxicity induced by the intake of nitrate, nitrite and dimethylamine all together, and not through the only intake of nitrate or nitrite or of amine. Daily doses of ascorbic acid [(211 +/- 40) and (18 +/- 4) mg/kg] seemed to hinder hepatotoxicity according to the criteria under investigation.

The effect of wheat bran on the excretion of cadmium in rats

The influence of wheat bran as a source of dietary fibre on the excretion of ingested cadmium from diet was studied. The cadmium contents in the diets, faeces, urine, liver, kidney and spleen were determined, as well as the weight gains, the relative weights of the cited organs, and the levels of alkaline phosphatase in serum. No evidence is provided that an increasing portion of wheat bran in the diets induced an increase in cadmium excretion. Changes in the studied toxicity parameters were not found.

Alprazolam compared to clobazam and placebo in anxious outpatients

In this double-blind study we compared alprazolam, clobazam, and placebo for the treatment of outpatients suffering from generalized anxiety disorder. At the end of the treatment, the three groups were significantly improved without showing differences among them. However, both active-drug groups were much improved at the end of week 1 in contrast to the placebo group. We were unable to find any difference on efficacy evaluations between alprazolam and clobazam, but alprazolam reached a consistently better outcome on some ratings compared to placebo. Although benzodiazepines share many common properties, it is necessary to identify selected groups of patients that can be helped by specific compounds or even placebo.

[Zinc and copper levels in Chilean infants]

Zinc and copper levels were determined by atomic absorption spectrophotometry, in the hair and plasma of 81 Chilean infants of both sexes, comprised within an age range of two to 36 months, after routine clinical examination at a Peripheral Health Service. The children were eutrophic, free from chronic pathologies, and their birth weights were over 2,500 grams. The infants were distributed within seven age groups and the mineral levels found were correlated mainly with age and sex.

A probable monogenic form of polyostotic fibrous dysplasia

A 37 year-old female patient with polyostotic fibrous dysplasia (PFD) is described. She presented the typical "café au lait" spots and severe bone involvement including a maxillary osteosarcoma. The father, four sibs, two nephews, two paternal aunts and two paternal first cousins were clinically examined, and seven of them also radiologically evaluated. "Café au lait" spots were found in the father, three sibs, one nephew, one aunt and one first cousin. Although no definite PFD bone lesions, mild radiological abnormalities were found in the father, three sibs and one nephew. These findings were interpreted as the variable expression of a pleiotropic gene. The present observation and three previous familial cases of this entity strongly suggest the existence of a form of PFD determined by an autosomal dominant gene.

The toxicity of the daily intake of nitrite and dimethylamine

It is known that sodium nitrite and dimethylamine are toxic compounds, which may react to form dimethylnitrosamine in the gastro-intestinal tract, a much more toxic compound and a powerful cancerogen. The aim of the present work is the investigation of toxicity in young rats, caused by daily intake of sodium nitrite, administered together with dimethylamine during 30 days. The indicators examined were: histopathological analysis of the liver and kidney, transaminase in blood serum, variations in body weight and relation of weight liver/body weight. The method of analysis used to determine transaminase was that reported by Reintman and Frankel in 1957. The statistical method employed was the test of multiple comparisons based on the total ranges of Cruskal-Wallis. The results show that either significant differences were found (alpha = 0,05) among the groups (including the control), nor was necrosis observed or forming of tumors in the organs under investigation. Therefore, the doses administered does not seem to be toxic under the conditions of the experiment. Some signs of toxicity found in the group which was severely treated (10 mg of sodium nitrite and 20 mg of dimethylamine) appeared only in a few animals and it is necessary to verify the same in experiments with more animals and over a longer period of treatment.

Tetanus in the adult: intensive care and management experience with 233 cases

Over a period of 10 years, 233 adult patients were treated for severe tetanus in this ICU. Criteria of severity, clinical patterns, and a detailed plan of treatment are outlined. The authors emphasize that such treatment implicates the permanent availability of trained personel in handling cardiorespiratory emergencies as well as prolonged mechanical ventilatory assistance in a specially designed environment (ICU). The form of therapy described herein seems to be the best currently available management regime, inasmuch as it can be expected to reduce significantly the notoriously high mortality associated with severe tetanus. Although this therapy is very expensive and time consuming, this is the price to be paid when the life of one of these patients is endangered. Complications are usually bizarre and unexpected. The authors found a high incidence of infectious respiratory complications, probably related to a change in the tracheal flora secondary to antibiotic therapy and a less than ideal care of tracheostomies. Unexpected cardiac arrest was the most common cardiovascular complication and also the most common cause of death; in the majority of these cases, a satisfactory explanation for this complication was not found, but it could have been related to overactivity of the autonomic nervous system.

Bedside pulmonary angiography in the critically ill patient

A simple technique to perform pulmonary angiography at the bedside in critically ill patients is presented. A central venous pressure catheter placed into the right ventricle or in the main pulmonary artery allows manual contrast injection into the vascular pulmonary tree which can be satisfactorily visualized by means of a "penetrated" chest x-ray film. The method discussed herein presents evidence of usefulness in establishing the differential diagnosis of acute pulmonary embolism in patients who cannot be mobilized or in those institutions where facilities of catheterization-angiographic laboratory are not available.

[Treatment of amebic hepatic abscess with tinidazole]

The patients reviewed in this study are thirty individuals with acute amoebic hepatic abscess. They were given tinidazol, two grams a day in one dose, for three days, with the object of ascertaining if this would be adequate treatment and without important side effects. The clinical diagnosis was confirmed by X-rays of the thoraz and abdomen, laboratory studies and liver scans. This latter as well as the laboratory tests were repeated at 10 and 20 days. Several of the patients were considered to be gravely ill. In 43% of the patients there was hepatomegaly grade II or II, in 30% there was jaundice, in 64% the abscess was very large and in 30% there were several abscesses. In keeping with the guide lines previously agreed on, 28 patients were cured, or that is 93%. There were no important side effects.

[Recording of conduction tissue potentials in intraventricular conduction disorders. (apropos of 147 patients)]

147 patients, 31 controls and 116 patients with intraventricular conduction disturbances, have been submitted to an endocardial investigation: HR lengthening in case of bundle-branch block indicates a low diffusion of the conduction disturbances and has a pejorative signification. The most important legthenings of this interval have been observed in the cases with delay in the common trunk of His bundle: -- In case of trunkular delay, 66% of the patients have a HR interval longer than 80 msec, and the average value of HR is 82 msec. -- In the absence of obvious trunkular delay, 8% of the patients only have a HR interval longer than 80 msec, with an average value of 67 msec. For these latter patients no branch potential was recorded. -- In some cases one is certain of the presence of a conduction disturbance of both branches and the HR value then never exceeded 60 msec. -- Branch potential recording makes it possible to determine the site of the conduction disturbance of the branch and show mild variations of the HR interval and of both components.