Neuron-specific enolase and its mRNA are highly expressed in large congenital nevi: a study using immunocytochemistry, biochemical assay, and in situ hybridization

The malignant transformation of congenital nevocellular nevi, both large and small, is controversial and presents problems in management. The size of the lesion is taken to indicate potential malignant transformation, but this is an arbitrary scale. A more reliable biological indicator is needed to help predict the lesions at risk. Following the localization of neuron-specific enolase to most cells of the diffuse neuroendocrine system and their neoplasms (including benign and malignant melanocytic lesions), it has been suggested that its level is related to tumor activity. In a prospective trial, the presence of neuron-specific enolase immunoreactivity, its concentration, and gene expression in nevus cells were studied in 31 congenital melanocytic nevi of various sizes (1.5 cm to bathing trunk) using immunocytochemistry, biochemical assay, and in situ hybridization. Twenty-five of the 31 congenital nevi were immunoreeactive to neuron-specific enolase antiserum, with stronger immunostaining in the larger lesions. There is an apparent linear relationship between the size of the nevi and the level of neuron-specific enolase (expressed as nanograms per milligram protein). Neuron-specific enolase mRNA was highly expressed in most of the large congenital nevi (greater than 15 cm in diameter), as revealed by autoradiography following in situ hybridization. Our results show that neuron-specific enolase and its mRNA are expressed to a greater extent in large congenital nevi compared with the smaller lesions. This might prove to be a useful indicator of those lesions at risk of malignant transformation.

Expression of tachykinins by ileal and lung carcinoid tumors assessed by combined in situ hybridization, immunocytochemistry, and radioimmunoassay

Mid-gut carcinoid tumors have been shown to produce substance P, a tachykinin. A recent addition to this family of peptides is neurokinin A which is cleaved from the same precursor as substance P; beta-pre-pro-tachykinin. The authors have examined mid-gut and pulmonary carcinoid tumors for the presence of the two tachykinins, using immunocytochemical study and radioimmunoassay, and have applied the techniques of in situ hybridization and Northern blot analysis to investigate the expression of mRNA for beta-pre-pro-tachykinin. All gut tumors (n = 8) and three of the six lung tumors examined were found by immunocytochemical study to contain both tachykinins or neurokinin A alone. Chromatographic analysis of tumor extracts suggests that this peptide is being detected as a separate molecule and/or as the C-terminal portion of a larger, uncleaved form. Three of the cases positive for tachykinins showed no detectable serotonin immunoreactivity. Strong hybridization signals for beta-pre-pro-tachykinin mRNA were seen in all but one of the cases studied which contained tachykinin immunoreactivity. Intact mRNA and positive hybridization was found by Northern blot analysis in two mid-gut tumors. Concentrations of tachykinins were found by radioimmunoassay to be higher in mid-gut tumors (substance P 27.2 +/- 19.7 pmol/g; neurokinin A 31.8 +/- 24.2 pmol/g; mean +/- SEM, n = 5) than in lung cases (substance P mean 0.8, range 0.5-1.0 pmol/g; neurokinin A mean 11.0, range 10.0-12.0 pmol/g; n = 3). These results show that mid-gut and pulmonary carcinoid tumors produce tachykinins, which are detected, in some cases, where no serotonin immunoreactivity can be found, possibly because of a high rate of amine secretion. Screening for tachykinins may prove to be a useful diagnostic adjunct for these tumors.

Detection of human probombesin mRNA in neuroendocrine (small cell) carcinoma of the lung. In situ hybridization with cRNA probe

The production of human bombesin (gastrin-releasing peptide), a peptide with mitogenic action, is a recognized feature of neuroendocrine (small cell) carcinoma of the lung. However, immunostaining of bombesin is not always possible in these tumors, probably because of poor storage mechanisms or rapid release of hormone. Molecular biological analysis of the gene encoding human bombesin has revealed the DNA sequence of human pro-bombesin. We have used in situ hybridization to study the expression of the human bombesin gene at the cellular level in small cell carcinoma of the lung. Probombesin cDNA was subcloned in pSP64 vector, linearized with Bam HI and transcribed in the presence of phosphorus 32(32P)-cytosine triphosphate (CTP) and SP6 polymerase. The cRNA probe was applied to tissue sections (from six cases of small cell carcinoma of the lung, freshly fixed in 4% paraformaldehyde), cell culture preparations (two different cell lines of small cell carcinoma), and cytologic specimens (smears of cells from three different cases of small cell carcinoma). Hybridization of probombesin mRNA was detected in tumor cells in all samples. Specificity of the signal was determined by control experiments, including the use of a probe which has a sequence identical to probombesin mRNA. Our results provide evidence for the expression of the bombesin gene in small cell carcinoma of the lung at a cellular level and show that probombesin mRNA is highly expressed in these tumors.

Ferriprotoporphyrin IX mediated oxygen activation/insertion reactions: the anerobic reduction of the aniline-Fe3+-microperoxidase-8 complex by NADH

A spectrophotometric study of the reduction of the Fe3+ microperoxidase-8-aniline (Fe3+-MP-8-An) complex has been carried out. Addition of NADH to a solution of Fe3+-MP-8-An under strictly anerobic conditions results in the formation of a species with lambda max = 414 nm (Fe3+-MP-8-An lambda max 407 nm). The kinetics of formation of this species show an induction period (tau) which follows saturation kinetics with respect to [aniline] with Km(app) = 2.2 x 10(-3) mol dm-3, i.e., close to that obtained in the preceding paper from O2 consumption kinetics mediated by MP-8. Addition of an anerobic solution of the NADH reduced MP-8-An complex, to a saturated O2 solution at pH 12 in the presence of 0.5 mM NADH and aniline 10 mM results in the virtual elimination of the induction phase, which has previously characterized O2 consumption kinetics in ferriprotoporphyrin IX oxygen activation systems. The Arrhenius activation energy for the reduction of the Fe3+-MP-8-An complex is close to that observed for the first reductive step in the cyt P-450 O2 activation cycle. Anerobic reduction of Fe3+-MP-8 by sodium dithionite in 20% MeOH/Aq at pH 8 followed by anerobic titration of the Fe2+-MP-8 (lambda max 420.5 nm) with aniline at pH 12 gives rise to a species lambda max 415 with KD for the process = 4.4 x 10(-3) mol dm-3 (+/- 1.2 x 10(-3) mol dm-3).

A comparison of clinical and judicial procedures for reviewing requests for involuntary medication in New York

The Rivers v. Katz decision substituted judicial review for administrative review of requests for involuntary medication of patients in New York State mental hospitals. This change, prompted by concern for the rights of involuntarily committed patients, did not delay or diminish the use of involuntary medication in a large state hospital. Advantages of judicial review include a better understanding by clinicians of the legal basis for involuntary medication and greater patient participation in the review procedure. Disadvantages include lack of an independent clinical review and increased costs.

[Acquired systemo-pulmonary fistula after pleurectomy responsible for a continuous thoracic murmur]

Systemo-pulmonary fistulae are rare. The case of a 27 year-old man, hospitalized for exploration of a continuous thoracic murmur, is reported. A right pleurectomy had been performed 2 years previously because of a recurrent spontaneous pneumothorax, and no murmur was present at that time. Angiography showed a systemo-pulmonary fistula with the right internal mammary artery and branches of the right axillary artery as afferent vessels, and the right pulmonary arteries and veins as efferent vessels. Blood gases measurements demonstrated a left-right shunt. The acquired nature of the fistula was suspected because of the history of right pleurectomy and the acquired nature of the murmur. There was no indication for surgery because of the complexity of the fistula and the absence of symptoms.

Pelvic-floor musculature exercises in treatment of anatomical urinary stress incontinence

The purpose of this study was to investigate the effects of pelvic-floor musculature exercises in the treatment of women with anatomical urinary stress incontinence. Fourteen female subjects, ranging in age from 33 to 67 years, participated in a four-week pelvic-floor musculature exercise program. Subjects underwent a pretraining urodynamic evaluation and were reexamined after four weeks of exercise training. Paired t tests of subjects' pretraining and posttraining values of bladder capacity, functional urethral length, and static urethral pressure profile showed no significant differences. Multivariate regression analysis demonstrated that the covariates of weight, motivation, and age did not significantly influence subjects' bladder capacity, functional urethral length, or static urethral pressure profile. Nine of the 14 subjects had a negative result on the posttraining urinary stress test (R = 0, p less than .01). The urinary stress test result was the only variable to change significantly from pretraining to posttraining measurements. All subjects reported posttraining improvement in control of urinary incontinence. A short-term exercise program for pelvic-floor musculature produced positive changes in subjects with anatomical urinary stress incontinence.

Primary thalamic and caudate hemorrhage in term neonates presenting with seizures

Two previously well term neonates who presented with seizures are described: one with thalamic hemorrhage and the other with thalamic and caudate hemorrhage. These 2 patients were the only neonates found with thalamic hemorrhage in a review of 54 term infants with intracranial hemorrhage at The Hospital for Sick Children over a 10 year period (1976-1986). Partial seizures occurred at 5 and 7 days after birth and were easily controlled. Prognosis was generally good in these 2 patients, as well as in 4 previously reported patients.

Spinal cord birth injury: value of computed tomographic myelography

The value of myelography in the assessment of spinal cord injury in the early neonatal period has not been documented, although this study has been recommended frequently in the literature. Eight neonates are reviewed who presented with the clinical features of spinal cord injury and who had myelography performed. Clinical features included difficult delivery, absent respiration, flaccid paralysis, sensory level, and neurogenic bladder. Myelography revealed that 7 patients had the early changes of swollen cord and 1 patient had the late changes of cord atrophy. None of the neonates had surgical intervention. One neonate died at 3 days of age, while 2 others died after prolonged ventilation. Of the 5 infants who survived, 3 still require ventilation and have spastic quadriparesis, 1 has almost recovered completely and 1 had spontaneous respiration and limb movement but brisk deep tendon reflexes when last examined at 1 month of age. Myelography, which was performed in the early neonatal period in our infants, was abnormal in all patients. Myelography is useful in confirming the diagnosis, outlining the level and extent of the lesion, and excluding extramedullary compression. Myelography may assist in the assessment of prognosis but did not alter management in our patients.

The effect of Goldmann applanation tonometry on automated static threshold perimetry

Automated static threshold perimetry was performed in both eyes of 10 normal and 12 ocular hypertensive subjects treated with a topical beta-blocker, before and after Goldmann applanation tonometry of their right eyes. Both objective statistical comparison and subjective evaluation of the resultant visual fields showed no detrimental effect on visual field test results after applanation tonometry.

Neurogenic arthrogryposis multiplex congenita: clinical and muscle biopsy findings

Thirteen cases of arthrogryposis multiplex congenita without evidence of spinal muscular atrophy, congenital muscular dystrophy, or structural myopathy were reviewed. Family history, consanguinity, pregnancy, delivery, number and severity of contractures, and outcome were evaluated. Laboratory investigations had been performed and a biopsy of muscle from an affected limb had been examined histochemically and by electron microscopy. Five biopsies showed fiber type 1 predominance and three had type 2 predominance. Patterns of fiber-type predominance may have resulted from altered neural influence leading to impaired maturation of type 1 or 2 motor units. Nine patients had been followed up for 3-8 years. Two were still not walking at age 8 years. For the 6 who were walking, the mean age at ambulation was 4.7 years. There was no deterioration in power. Muscle biopsy is recommended in arthrogryposis multiplex congenita. Identification of a probable neurogenic arthrogryposis multiplex congenita is important because the condition is not progressive and is apparently not transmitted genetically.

Contrast sensitivity after penetrating keratoplasty

Contrast sensitivity testing in the corneal transplant patient may enhance our assessment of visual performance, which is traditionally evaluated using Snellen acuity only. To evaluate contrast sensitivity function after penetrating keratoplasty, we studied 29 patients with anatomically successful corneal grafts and a best corrected visual acuity of 20/50 or better. Graft patients were compared with an age-matched control group including persons with comparable visual acuities without ocular disease. In addition to a complete ophthalmic examination, all subjects underwent contrast sensitivity testing using a computer-generated sinusoidal grating system as well as a commercially available contrast sensitivity wall chart. Data indicate that, despite comparable Snellen visual acuity, the contrast sensitivity curves for graft patients were depressed overall compared with those of normal subjects except at the lowest spatial frequency. However, comparison of grafted eyes to contralateral eyes with corneal disease in a small subset of patients with bilateral disease shows a trend toward higher contrast sensitivity values in the eyes that had been operated on. These data suggest that despite an improvement in contrast sensitivity with penetrating keratoplasty, an eye with a corneal transplant is not entirely normal from a visual standpoint. Nonacuity parameters may be important indexes for assessing real-world visual function in the graft patient, although the clinical role of these tests is not yet completely defined.

[Fitness for sports of patients with Wolff-Parkinson-White syndrome]

The fitness of patients with Wolff-Parkinson-White syndrome to indulge in sporting activities is a practical cardiology problem. The major risk is sudden death due to atrial fibrillation deteriorating to ventricular fibrillation. This risk is small or even theoretical, but signing a fitness certificate engages the clinician's responsibility. Non invasive complementary examinations are useful. Echocardiography may detect a heart disease that would preclude any sport. Exercise tests explore the behaviour of the accessory pathway and rarely trigger off arrhythmias. Holter recordings mainly investigate disorders of the atrial rhythm. The decision concerning fitness may be based on clinical symptoms. Exercise-induced tachycardia is a classical contra-indication to competitive sports. In patients whose tachycardia is unrelated to exercise, fitness may be discussed according to the results of exercise tests and of the electrophysiological study. A refractory period which would be considered as rather prolonged at rest does not protect against fast ventricular rate during passage to atrial fibrillation. If pre-excitation disappears during the exercise test in an asymptomatic patient, then competitive sports can be authorized without limitations. If not, only surgical excision or fulguration would provide full protection against a potentially dangerous fibrillation. It is concluded that Wolff-Parkinson-White syndrome contra-indicates competitive sports in most cases. Games played outside competitions remain possible in the absence of symptoms or when arrhythmias are well controlled by medical treatment.

Effect of isomers of swainsonine on glycosidase activity and glycoprotein processing

The chemical synthesis of swainsonine [(1S,2R,8R,8 alpha R)-trihydroxyindolizidine] from trans-1,4-dichloro-2-butene was previously described [Adams, C. E., Walker, F. J., & Sharpless, K. B. (1985) J. Org. Chem. 50, 420-424]. A modification of that synthesis provided two other isomers, referred to here as "Glc-swainsonine" [(1S,2S,8R,8 alpha R)-trihydroxyindolizidine] and "Ido-swainsonine" [(1S,2S,8S,8 alpha R)-trihydroxyindolizidine]. To determine whether these new compounds had biological activity, they were compared to swainsonine as inhibitors of a number of commercially available glycosidases. While swainsonine is a potent inhibitor of jack bean alpha-mannosidase but does not inhibit other glycosidases, its two isomers were inactive on alpha-mannosidase but did inhibit other enzymes. Thus, Glc-swainsonine was an inhibitor of the fungal alpha-glucosidase amyloglucosidase, and this inhibition was of a competitive nature (Ki = 5 X 10(-5) M) with respect to the substrate p-nitrophenyl alpha-D-glucopyranoside. This alkaloid also inhibited beta-glucosidase, but much less effectively than alpha-glucosidase. On the other hand, Ido-swainsonine was more effective toward beta-glucosidase than toward alpha-glucosidase, and this inhibition was also of a competitive nature. None of these inhibitors were effective against beta-mannosidase or alpha- or beta-galactosidase. Glc-swainsonine was also tested against the glycoprotein processing glycosidases. Surprisingly, in this respect, the alkaloid was like swainsonine in that it inhibited mannosidase II but had no effect or only slight effect on glucosidase I, glucosidase II, and mannosidase I. Glc-swainsonine also inhibited glycoprotein processing in cell culture.(ABSTRACT TRUNCATED AT 250 WORDS)

Late-onset hexosaminidase A and hexosaminidase A and B deficiency: family study and review

Five children from two non-consanguineous Asian families with juvenile-onset hexosaminidase deficiency are presented. Two have juvenile Tay-Sachs disease with hexosaminidase A deficiency and three have juvenile Sandhoff disease with hexosaminidase A and B deficiency. The contributing factors in the spectrum of the hexosaminidase deficiency disease are outlined, and previously reported cases of late-onset Tay-Sachs and Sandhoff disease are reviewed. The heterogeneity of the effects of hexosaminidase deficiency is discussed, with the recommendation that the diagnosis be considered, in its various forms, when there is no other obvious explanation.

Review of the 12 years' activity of the International Committee for Prevention and Treatment of Depression

The recognition and treatment of depressive states, as well as their prevention, call for special knowledge and experience. Therefore it was considered desirable that practising physicians with no specialised knowledge of psychiatry should be given more extensive opportunity for post-graduate instruction in the diagnosis and management of depression and also that they should be in a position to collaborate more closely with psychiatrists. Hence the idea of establishing an international committee, the members of which would in their turn set up national committees with the aim of promoting and intensifying post-graduate instruction in their respective countries.

[Evaluation of post-infarction disorders of left ventricular contraction by echocardiography and scintigraphy of the cardiac cavities]

The comparison in 36 patients of two-dimensional echocardiography and scintigraphy of the cardiac cavities in the steady state with left cineventriculography selective for the evaluation of anomalies in left ventricular contraction post infarction shows good agreement between these techniques for the detection of major segmental anomalies, a higher sensitivity being found for echocardiography in dyskinesis. The overall rejection fraction calculated by two-dimensional echocardiography is correlated with the ejection fraction calculated in left cineventriculography (r = 0.57; p less than 0.001). The same is true of the overall ejection fraction obtained by cavitary scintigraphy (r = 0.62; p less than 0.01). The indices of residual myocardium in the anterior wall (IRM ant) and the posterior wall (IRM post) calculated in apical echographic section for the two cavities and in left cineventriculography (oblique anterior right) are also well correlated (IRM ant: r = 0.70 and p less than 0.001; IRM post: r = 0.46 and p less than 0.01). The determination of these parameters as well as the percentage of shortening of the left ventricular small axis measured by echocardiography TM, to the smallest value, permits a valid assessment of ventricular function and makes it possible to avoid coronaroventriculography when this function is too impaired.

Atrial septal aneurysm--a potential cause of systemic embolism. An echocardiographic study

Atrial septal aneurysm is an uncommon condition. Between 1981 and 1984 10 cases of atrial septal aneurysm were diagnosed by real time cross sectional echocardiography performed in 4840 patients. The aneurysm was associated either with mitral valve prolapse (three patients) or with atrial septal defect (three patients) or occurred in isolation (four patients, two of whom had had a previous embolic event leading to the diagnosis of atrial septal aneurysm by cross sectional echocardiography). During cross sectional echocardiography the aneurysm appeared as a localised bulging of the interatrial septum, which was best seen in the subcostal four chamber view and in the parasternal short axis view at the level of the aortic root. The aneurysm either protruded into only the right atrium (five patients) or moved backwards and forwards between the right and the left atria during the cardiac cycle (five patients). This motion pattern might be related to changes in the interatrial pressure gradient. The two patients who had had a systemic embolism were given anticoagulant treatment, but none underwent surgery. It is concluded that the true prevalence of atrial septal aneurysm might have been underestimated before the routine use of cross sectional echocardiography, that cross sectional echocardiography enables definitive diagnosis of this condition by a non-invasive technique, and that an atrial septal aneurysm should be suspected and looked for by cross sectional echocardiography after an unexplained systemic embolism.

Gastrointestinal hormones in anorexia nervosa

A study was undertaken of fasting and post-prandial blood levels of glucose and a number of gastrointestinal hormones in patients with anorexia nervosa. After an overnight fast their blood levels of glucose, insulin and pancreatic glucagon were significantly lower than those of age-sex matched healthy volunteers. There were no significant differences in the levels of gastrin, total glucagon-like immunoreactivity, vasoactive intestinal polypeptide, pancreatic polypeptide, secretin and gastric inhibitory polypeptide. Serial blood samples were taken for up to two hours after the ingestion of a standard mixed meal (450 kcal) and these showed a significant glucose intolerance, a reduced and delayed insulin response, and a reduced release of gastric inhibitory polypeptide, as compared with the controls. There was an increased release of pancreatic polypeptide but the difference in the post-prandial hormone profile between patients and controls for gastrin did not reach statistical significance.

Evaluation of Sch 29482 in experimental syphilis and comparison with penicillin G benzathine in disseminated disease and localized infection

The present study was designed to assess the in vivo activity of Sch 29482, a new penem antibiotic, against disseminated and localized Treponema pallidum infections in rabbits. Animals were inoculated either intravenously or intradermally. Randomized groups then received 25 or 50 mg of Sch 29482 per kilogram of body weight twice a day for 7 days, two weekly injections of 200,000 U of penicillin G benzathine for comparative purposes, or no antibiotic therapy. In both infection models, striking differences were noted between the untreated control rabbits and rabbits receiving penicillin G benzathine or high-dose Sch 29482. Intravenously infected rabbits did not develop disseminated lesions or orchitis, and chancres produced by intradermal infection regressed and healed rapidly after both treatment regimens. Infectivity studies also suggested that high-dose Sch 29482 and penicillin G benzathine were effective since the testes and lymph nodes of treated animals were free of infectious organisms. Treatment of animals with the lower dose of Sch 29482 represented borderline or suboptimal therapy, with a failure rate of one in four for each infection model.

The nature of heme-aniline interactions during hemin-mediated oxygen activation and insertion reactions

The interaction of aniline with hemin during oxygen activation and insertion mediated by the metalloporphyrin has been studied by a combined theoretical, semiempirical, and experimental approach. Results indicate that association is via a planar pi bonding interaction between the aromatic pi electrons of the amine and tetrapyrrole ring system. The effect of very high concentrations of hydroxyl radical scavengers on the system is discussed.

The effects of ice massage on delayed muscle soreness

The following hypotheses were tested in the present study: (1) cryotherapy would reduce delayed muscle soreness (DMS) in eccentrically exercised muscles; (2) early cold treatment would reduce this soreness more than later postexercise treatment times; and (3) joint range of motion (ROM) would be inversely related to the subjective soreness ratings. Subjective sensations of muscular soreness and changes in elbow joint ROM were assessed in 30 subjects at 0, 24, 48, and 72 hours following eccentric-biased exercise in the elbow flexors. Cold treatments were applied immediately, 24 or 48 hours following a single exercise session. In response to the eccentric exercise, significant muscle soreness increases and elbow ROM decreases were observed in all exercised muscles from 24 to 48 hours postexercise. No differences in muscle soreness or elbow ROM changes were observed between treated and untreated arms except for one. Subjects treated at 24 hours postexercise reported greater soreness in their arms compared to untreated arms just prior to treatment (24 hour postexercise). The results do not support the efficacy of cold in reducing DMS. A negative correlation between muscle soreness and elbow ROM at 48 and 72 hours postexercise indicated that an increase in soreness was associated with a decrease in ROM.

[Biological profile in acute coronary insufficiency: study of blood myoglobin, enzymes and inflammatory proteins]

17 patients admitted to an intensive coronary care unit for premonitory syndrome or acute myocardial infarction were divided into four groups (premonitory syndrome, non-transmural infarction, transmural infarction with and without inflammation) on the basis of electrocardiographic findings and total CK activity. Serum levels of CK and CK2, myoglobin, ASAT and ALAT, LDH, haptoglobin, CRP and alpha-1 acid glycoprotein were determined daily for ten days. Patients with premonitory syndrome had no significant increase in markers of cytolysis or myoglobin. In acute myocardial infarction, regardless of clinical type, time course of peak values for biologic factors assayed was as follows: D0: myoglobin; D1: CK and CK2; D0 to D2: ASAT; D2 to D5: LDH and CRP; D5 to D6: ALAT; D4 to D7: haptoglobin and alpha-1 acid glycoprotein. These parameters may increase with size of myocardial necrosis and association with an inflammatory syndrome (CK, LDH, CRP and alpha-1 acid glycoprotein). They may be predictive of poor prognosis (LDH at peak CK concentrations). Some determinations, both more difficult to perform and less specific, have a particular value: prompt diagnosis of myocardial necrosis and detection of early repeat infarction by myoglobin assay, retrospective diagnosis by inflammatory protein assays when total CK has returned to normal.

H2O2-and alkyl hydroperoxide-supported para hydroxylation of aniline by alkaline hematin

Under alkaline conditions and in the presence of reductant, NADH or NADPH, and molecular oxygen, hemin catalyzes the regiospecific para-hydroxylation of aniline to form p-aminophenol [P. A. Adams, D. A. Baldwin, and M. C. Berman, J. Chem. Soc. (Lond) Chem. Commun. 856 (1979); P. A. Adams and M. C. Berman, J. Inorg. Biochem. 17, 1 (1982)]. The reaction has now been studied in the presence of H2O2 and alkyl hydroperoxides and in the absence of oxygen and reductant. Results indicate that the H2O2- and alkyl hydroperoxide-supported processes proceed via different mechanisms involving, on the one hand, the hydroperoxide anion (HO2-) and on the other, the undissociated alkyl hydroperoxide molecule (ROOH). The addition of superoxide dismutase to the reaction had no effect, unlike the NADH/O2 supported reaction where the enzyme completely inhibits reaction. Similarities between the hemin-mediated peroxide-supported reactions reported here, and the cytochrome P-450-mediated peroxide-supported reactions reinforce our earlier contentions that the alkaline hemin system appears to be a good model for the in vivo activation of oxygen by hemoproteins.

[Treatment of therapy-resistant depressions. Results of combined infusion treatment]

230 patients with therapy-resistant depression were given intravenous drip infusion treatment with clomipramine (a predominantly serotonin-uptake inhibitor) and maprotiline (a predominantly noradrenaline-uptake inhibitor), preceded by a five-day tranquilizing regimen with a neuroleptic drug. During the treatment period of 10-20 days the patients were given one infusion daily, while later both antidepressants were taken orally. The neuroleptic drug was given at night from the start of the infusion phase to the end of hospitalization. After four weeks' treatment 68% of the endogenous depressives and 54% of the exhaustion depressives had completely remitted. In patients who fail to respond the infusion regimen can be repeated after carefully rechecking the patient's diagnosis. After discharge and resumption of work the antidepressants should be reduced stepwise. A prerequisite for success in the management of refractory depression is the combination of drug administration with adequate psychotherapeutic and physiotherapeutic measures. The infusion regimen is relatively easy to administer, can be given on an outpatient basis and could be the treatment of choice in the future not only for treatment-resistant depression but also for patients whose depressive state requires rapidly effective antidepressive measures. In view of the encouraging experience obtained to date with this treatment, the World Health Organization is conducting an international collaborative research project involving 12 psychiatric centres to elucidate the effectiveness of intravenous infusion therapy in different races with different dietary habits and varying climatic conditions.

Family study of congenital hydrocephalus

This study concerned 74 patients with uncomplicated congenital hydrocephalus who were born in Northern Ireland between 1974 and 1977. Three of their 159 sibs (1.89 per cent) were also themselves hydrocephalic, which represents a recurrence risk of 26 times the population incidence. There was a smaller but significant increase of congenital hydrocephalus among first-cousins; three of 846 (0.35 per cent) first-cousins were affected, five times the population frequency. The occurrence of neural-tube defects among sibs and cousins was similar to that for the general population. For the purpose of genetic counselling, this study indicates that once X-linked inheritance has been excluded in uncomplicated congenital hydrocephalus, the over-all empirical risk of recurrence is approximately one in 50; or one in 40 after an affected male and one in 80 after a female index patient.

[Management of treatment-resistant depression without ECT (author's transl)]

Intravenous infusions of clomipramine and maprotiline, preceded by a five-day tranquilising regimen with a neuroleptic drug, were given to 177 patients with treatment-resistant depression. During the treatment period of 10-20 days the patients were given one infusion daily followed by both antidepressants taken orally. The neuroleptic drug was given at night, from the start of the infusion phase to the end of hospitalisation. After four weeks 66% of the endogenous depressions and 53% of the exhaustion depressions had completely regressed. In patients who failed to respond the infusion regimen can be repeated, if necessary with nomifensin (Alival) instead of clomipramine (Anafranil) and maprotiline (Ludiomil) in order to achieve the desired improvement without ECT. In addition to careful diagnosis, a prerequisite for likely success in the management of treatment-resistant depression is the combination of drug administration with adequate psychotherapeutic and physiotherapeutic measures. The infusion regimen is relatively easy to undertake, can also be used on an out-patient basis and could be the treatment of choice in the future, not only for treatment-resistant depressions but also for patients whose depressive state requires rapidly effective antidepressive measures.

Immunoreactive somatostatin release from rat spinal cord in vitro

A calcium-dependent release of immunoreactive somatostatin from rat spinal cord in vitro in response to two depolarising stimuli (60 mM KCl and 75 micrometer veratrine) has been demonstrated. Released somatostatin immunoreactivity comprised 0.53% of total tissue content, showed parallelism when serial dilutions were compared to the immunoassay dose-response curve and eluted similarly to synthetic somatostatin on Sephadex G-25 (f) chromatography. These results provide further evidence for a neurotransmitter or neuromodulator role for somatostatin in mammalian spinal cord.

Dimensional preferences in middle and old age

Dimensional preferences in 40 middle-aged (M = 41.62 years) and 40 elderly (M = 72.22 years) females were assessed using a dimensional choice task. Significant age differences in reaction times of choice but not in number of dimensional choices were obtained. There was a perfect rank-order correspondence between the two age groups in dimensional choices with form being the most preferred and color the least preferred perceptual dimension.

Endobronchial polyposis secondary to thermal inhalational injury

A 28-year-old man who sustained inhalational injury in a house fire developed symptoms of chronic cough and hemoptysis requiring bronchoscopy. Two months after the initial injury, numerous endobronchial polyps were found in the trachea and throughout the bronchial tree. His symptoms have subsequently improved over a six-month period while receiving steroid therapy. To our knowledge, this delayed complication of inhalational burn injury has not been previously reported.

17beta-oestradiol and Enovid mammary tumorigenesis in C3H/HeJ female mice: counteraction by concurrent 2-bromo-alpha-ergocryptine

Chronic administration of 17beta-oestradiol (via drinking water) or the oral contraceptive Enovid (norethynodrel and mestranol) (0-1 mg injected s.c. twice weekly) to nulliparous C3H/HeJ female mice, beginning at one month of age and terminating at 20 months (17beta-oestradiol) or 22 months (Enovid), significantly increased the incidence of mammary tumours over solvent-treated controls. Concurrent treatment of the steroid-treated mice with 2-bromo-alpha-ergocryptine (CB-154) (0-1 mg s.c. injected daily) significantly reduced mammary tumour incidence and mammary hyperplastic nodule development to the control level. CB-154 is an efficacious inhibitor of pituitary prolactin secretion. These results demonstrate that steroid-induced mammary gland dysplasias can be sharply reduced by chronic CB-154 treatment, and suggest that some of the mammary tumorigenic activities of oestrogenic steroids in C3H mice are mediated via an increased secretion of pituitary prolactin.

The effects of stimulability on the articulation of /s/ relative to cluster and word frequency of occurrence

This study investigated the effects of stimulability on the articulation of cluster nested /s/ in high- and low-frequency clusters and words. A good stimulability group and a poor stimulability group of /s/-defective seven-year-old children were investigated. Statistical analysis did not reveal significant differences between the articulatory performances of the two groups on words or clusters occurring with high or low frequency. Subjects in the good stimulability group obtained significantly fewer errors on the test stimuli than did subjects in the poor stimulability group. Correlational analyses indicated that stimulability was positively correlated with correct numbers of /s/ productions in both clusters and words occurring with both high and low frequency. Subjects' spontaneous /s/ errors on the Templin-Darley screening test were not found to be correlated with their stimulability scores or their imitative /s/ productions in words and clusters occurring with high or low frequencies.