[Hepatotoxicity induced by valproic acid in adults. Report of 3 cases]

Valproic acid is a useful antiepileptic drug, with occasional gastrointestinal side effects. Hepatotoxicity is the most serious adverse reaction and, although rare, it can be fatal. Risk factors for hepatotoxicity are an age of less than two years, polytherapy and mental retardation; it has been rarely reported in adults. We report three mentally retarded adult patients receiving polytherapy, who developed valproic acid induced hepatotoxicity. Two patients had a symptomatic hepatitis with a concomitant paradoxical increase in seizure frequency and one an asymptomatic alteration of hepatic function tests. After discontinuing the drug, the hepatitis subsided. We conclude that hepatotoxicity must be considered as a possible side effect of valproic acid and we suggest some recommendations for its early detection.

Pharmacological profile of new thioperamide derivatives at histamine peripheral H1-, H2-, H3-receptors in guinea-pig

The recent availability of potent and selective ligands, namely R-(alpha)-methylhistamine and thioperamide, led to conclusive progresses as regards histamine H3-receptor knowledge. The aim of this work is to investigate by in vitro tests the pharmacological properties of new amino and methyl derivatives of the H3-antagonist thioperamide. Such original compounds, developed by the modulation of the thioperamide imidazolyl moiety, were assayed at guinea-pig ileal contractile H1-, atrial chronotropic H2- and enteric neuronal H3-receptors. None of the drugs exhibited interaction with H1 or H2 sites. On electrically stimulated ileum, two of the thioperamide methyl derivatives competitively antagonized the inhibitory effect of the H3-agonist R-(alpha)-methylhistamine. On the basis of the Schild analysis, the more active isomer (compound IV) displayed an affinity at H3-receptors only five times lower than thioperamide. These results could contribute to elucidate further the structural features required to develop potent and selective H3-antagonists. On the other hand, to prove the hypothesized apparent heterogeneity between peripheral and central H3-sites, as emerged by pharmacological and binding studies, autoradiographic investigations are in progress.

An approach to histologically diagnosed gallbladder carcinoma following cholecystectomy for presumed benign disease

Five cases of gallbladder adenocarcinoma treated at Surgical Department 2, Maciel Hospital, Montevideo, Uruguay, in a period ranging from 1985 to 1989 and follow-up to date are reported. All cases were first diagnosed by microscopic examination of the gallbladder, which had been removed for presumed benign disease; there were no intramucosal carcinomas, and 60% of the cases were classified as Nevin's stage II (submucosal and muscularis). Based on the pattern of spread (mainly direct hepatic infiltration, as well as venous and lymphatic involvement), our radical surgical treatment of gallbladder carcinoma includes cholecystectomy, extended lymphatic clearance (along the porta hepatis or R1, pre- and retroduodenopancreatic and hepatic artery R2, and celiac axis R3), and medial hepatectomy (segments, IV, V, and VIII according to Couinaud). Simple cholecystectomy is the treatment of choice in mucosal (T1) neoplasms; otherwise, histologically diagnosed gallbladder carcinoma following cholecystectomy for presumed benign disease calls for reoperation to achieve lymph node dissection and hepatic resection. Overall 2- and 3-year survival was 100% and 80%; mean survival was 50 months. Medial hepatectomy was selected according to gallbladder carcinoma patterns of spread and failures, and entails resection of the parenchyma most frequently involved without compromising liver function, in a quick and safe surgical procedure.

Gene geography of South America: testing models of population displacement based on archeological evidence

Gene frequencies for 13 marker systems are used to construct synthetic gene frequency maps of South America. The surfaces generated using the first three principal components exhibit clines which validate models of population displacement based on archeological data and a previous analysis of craniometrical variation.

HPLC detection of thioperamide from biological samples and its determination in rat blood and brain after systemic administration

Thioperamide is a potent and selective antagonist on histamine H3 receptors. A method for its isolation and quantitation by HPLC from rat plasma and brain samples has been developed. Using this technique, thioperamide concentrations in rat plasma and brain were measured after systemic administration, in order to evaluate its persistence in blood and its ability to cross the blood-brain barrier. We observed that, at a dose of 60 mg/Kg, thioperamide undergoes a slow elimination from plasma, with a half-life of 10 hours, and can readily cross the blood-brain barrier.

4-(1,2-Benzisothiazol-3-yl)alkanoic and phenylalkanoic acids: synthesis and anti-inflammatory, analgesic and antipyretic activities

Continuing their studies on benzisothiazolyl derivatives, Authors refer to the preparation and pharmacological properties of 4-(1,2-benzisothiazol-3-yl) alkanoic and phenylalkanoic acids. All substances were tested for anti-inflammatory, analgesic and antipyretic properties. As reference compounds, 1,2-benzisothiazolin-3-one and 4-(3-oxo-1,2-benzisothiazolin-3-yl) phenylacetic acid, as prototypes of benzisothiazolinonic derivation. Ibuprofen, as a prototype of substituted arylalkanoic acids, and Phenylbutazone were used. Analysis of the data leaded to the following conclusions. Introduction of the aryl moiety, passing from benzisothiazolylalkanoic to benzisothiazolyl-phenylalkanoic structures, produced a remarkable increase of activity. 2-[4-(1,2-benzisothiazol-3-yl)phenyl] propionic and 2-[4-(1,2-benzisothiazol-3-yl)phenyl]butyiric acids showed anti-inflammatory, analgesic and antipyretic properties comparable to those of Ibuprofen. Substantial differences in variations in activities were observed comparing the properties of benzisothiazolylphenylalcanoic acids with those of the benzisothiazolinonic series, object of preceding studies.

[Sneddon syndrome. Presentation of 2 cases]

Sneddon syndrome is a systemic non inflammatory arteriopathy characterized by the association of livedo reticularis, thrombotic cerebrovascular disease, coronary artery disease and hypertension. Middle age females are usually affected. It should be considered in the differential diagnosis of acute ischemic attacks in younger patients. It has been related to the antiphospholipid antibody syndrome. Treatment is based on control of hypertension and cardiovascular risk factors along with antiplatelet agents. Two cases meeting the clinical criteria outlined above are reported.

Anomalous responses to histamine stimulation of guinea-pig oesophageal muscularis mucosae

The incomplete tachyphylaxis of the contractile response to the H1-stimulants observed on guinea-pig oesophageal muscularis mucosae seems to be H2- and H3-antagonist as well as atropine- and tetrodotoxin-resistant. Lidocaine and eserine partially prevented this process probably by a mechanism independent of their main activity. The dualistic antagonism exerted by mepyramine and methysergide on reproducible histamine responses could be explained by a kinetic condition of "hemi-equilibrium state" together with changes of drug-receptor interaction and by non-specific properties of methysergide. On the whole, the present data indicate that the role of histamine in this tissue has still to be defined.

The commercially available restriction enzyme BspHI is blocked by overlapping methylation

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Human IgM monoclonal antibody 16.88: pharmacokinetics and distribution in mouse and man

Human IgM monoclonal antibody (MAb) 16.88 recognizes an antigen strongly expressed by colon cancer tissue. We used 131I-labelled 16.88 for biodistribution and pharmacokinetic studies in nude mice bearing WiDr or NIH:OVCAR-3 xenografts. Serum half-life was 8 h. Maximum tumour uptake was between 1 and 8 h after administration and amounted to, respectively, 3% and 1% of the injected dose g-1 for WiDr and NIH:OVCAR-3 tumours. Half-lives in these tumours were approximately 24 h. Tumour to normal colon uptake ratios increased from 2.3 at 24 h to 17 at 5 days after injection. Simultaneously, pharmacokinetic studies were performed in patients with advanced colon cancer reactive with 16.88. They were injected with 5 mCi 131I-16.88 by intravenous infusion over 2 h. Serum half-life was 20 h with greater than 90% of the 131I bound to 16.88. Within 40 h 50% of the injected dose was excreted as free 131I in the urine. In one patient an accelerated clearance was found, possibly caused by pre-existing antibodies reacting with 16.88. None of the patients showed an immune response against 16.88 antibody. Immunoscintigraphy showed positive tumour localization in the majority of the patients, best visualized at later days. We conclude that 16.88 has tumour localization properties while its human origin accounts for the lack of immunogenicity.

Craniometrical variation among South American prehistoric populations: climatic, altitudinal, chronological, and geographic contributions

The independent contributions of climate, altitude, chronology, and geographic location of archeological sites to craniometrical variation are analyzed in a sample of 1,119 skulls from South America. Geographic location is responsible for the highest proportion of craniometrical variation, followed by climate and altitude. It is concluded that geographic isolation has partially prevented gene flow from counterbalancing craniometrical microdifferentiation produced by founder effect.

[The rupture of surgical gloves in a general hospital]

We studied the incidence of rupture of surgical gloves used at a general hospital: A) new gloves (n = 114); B) gloves used at a major general, gynecological or urological operation (n = 258), and C) recirculating surgical gloves (n = 86). A special techniques based on transmission of an electrical signal through the rupture was used to identify rupture. Rupture was present in 8.8, 28 and 26% of surgical gloves in groups A, B and C, respectively. Type of surgery or surgeon involved did not influence rupture of gloves in group A. However, rupture increased in relation to the duration of surgery (40% incidence in operations lasting more than 90 min). Our results suggest the need for better quality control of new surgical gloves and glove change after 90 min of operation.

[Importance and characteristics of burns in a pediatric emergency service]

The purpose of this study was to describe the magnitude and some relevant aspects of children with burn injuries as seen at the emergency room of a metropolitan hospital at Santiago, Chile, from a random sample of 22,430 consultations from a total of 137,220. Two hundred and thirty seven burn injuries were detected corresponding to 5.2% of all surgical consultations and 1.1% from the whole sample, 56.5% occurring in males, 73.4% of the affected patients were under 5 years of age, 72% of lesions were caused by hot liquids, 51.6% affected the upper limbs and 4.5% were considered to require admission to hospital wards. Consultations most frequent in july (winter) the lesser incidence occurring in february (summer). Preventive programs addressed to burn injuries should cover children under 5 years of age and should be specially focussed on winter and safe handling of hot liquids.

H2-antagonists: synthesis and activity of 2-amino-5-thiazolyl derivatives

2-Amino- and 2-guanidinothiazole derivatives having in position 5 a methylthioalkyl side-chain with urea-equivalent moieties were prepared for comparison with H2-antagonists of cimetidine and tiotidine series. Examination of the pharmacological results obtained from experiments on guinea pig atria and in cat gastric fistula, suggests some general observations about the structure-activity relationship of the compounds synthesized. The activity trend of these products is different from that of H2-imidazole antagonists while it is similar to that of the tiotidine series. Unlike the tiotidine similar compounds, the 2-guanidino-5-thiazolyl derivatives are less potent than the corresponding 2-amino-5-thiazolyl products. The activity of the latter ones is reduced in comparison to that of tiotidine or cimetidine.

[4-(3-Oxo-1,2-benzisothiazolin-2-yl)alkanoic, phenyl and phenoxyalkanoic acids: synthesis and anti-inflammatory, analgesic, and antipyretic properties]

Based on previous observations, the preparation, some physicochemical (partition coefficient, pKa) and pharmacological properties of 4-(3-oxo-1,2-benzisothiazolin-2-yl)alkanoic, benzoic, phenyl, phenoxyalkanoic acids and of some of their functional derivatives are reported. All new compounds were biologically examined for their antiphlogistic, analgesic and antipiretic actions, in comparison with those of 1,2-benzisothiazolin-2-one and with those of ibuprofen as the antiphlogistic, analgesic, antipyretic arylalkanoic prototype. Structure-activity relationships showed that the 1,2-benzisothiazolin-2-one and its new alkanoic and arylalkanoic derivatives have strong actions which are however specific for some of the tested pharmacological properties. From this point of view, the synthesized substances have a narrow spectrum of activity, if compared with ibuprofen which is at the same time an antiphlogistic, analgesic and antipiretic substance. The antiphlogistic and antipyretic activities of 4-(3-oxo-1,2-benzisothiazolin-2-yl)benzoic, phenylacetic and phenylmethylacetic acids and the antipyretic and analgesic actions of 3-oxo-1,2-benzisothiazolin-2-ylacetic acid, which are comparable or higher in "potency" than those of ibuprofen, are noteworthy.

Effect of oestradiol delivered from a perioviducal device on ovum transport in mice

Silastic devices impregnated with oestradiol and blank devices were placed around both oviducts and around skeletal muscle bundles in the forelegs to attain local and systematic delivery, respectively. Another group of mice received an oestradiol-impregnated device around one oviduct and a blank device in the contralateral oviduct. Implantation of blank devices around the oviducts and in the forelegs did not alter ovum transport. Devices impregnated with oestradiol placed around both oviducts produced a dose-dependent delay of ovum transport, which was more pronounced than the effect of devices located in the forelegs. Oviducts receiving an oestradiol-loaded device had a larger retention of ova than did the contralateral oviducts receiving a blank device. These results demonstrate a direct action of oestradiol upon the oviduct to delay ovum transport in the mouse.

Peopling of Andean South America

Archeological, craniometrical, and genetic information is utilized to reconstruct possible migration routes used in the peopling of Andean South America. Special emphasis is given to the elaboration of craniometrical isoline maps and its application in testing models of population displacement based on archeological data. A genetic distance analysis among linguistic groupings complements the conclusions based on archeological and craniometrical information.

Air pollution impact on phagocytic capacity of peripheral blood macrophages and antioxidant activity of plasma among school children

Peripheral blood macrophages of school children from downtown Santiago, Chile--a highly polluted city--exhibited a lower phagocytic index with higher percentage of killing than those of the rural village of María Pinto. These findings were observed concomitantly with a lower antioxidant activity of plasma in Santiago students. No differences were observed in serum immunoglobulins (IgA, IgG, and IgM), secretory IgA in saliva, and complement component C3. White blood cell count was higher in María Pinto residents than in Santiago students, including those cells with phagocytic capacity. It is suggested that particulate air pollution may enhance macrophage activity with impairment of the antioxidant capacity of plasma.

[Synthesis and analgesic activity of 4-(3-oxo-1,2-benzoisothiazoline-2-yl)phenylalkanoic derivatives]

The synthesis of a new series of 4-(3-oxo-1,2-benzisothiazolin-2-yl)phenylalkanoic compounds and some of their functional derivatives is described. The compounds, on the basis of data obtained from 1,2-benzisothiazolin-3-one derivatives, were biologically examined mainly for their antiphlogistic and analgesic actions. Results obtained, in analyzing the relationship between structure and pharmacological actions, suggest that both 4-(3-oxo-1,2-benzisothiazolin-2-yl)-phenyalkanoic acids and o-sulphobenzimido alkanoic esters are endowed with pain-killing effects comparable in potency and efficacy with phenylbutazone.

[3-Benzyl-1,2-benzoisothiazoles: spasmolytic properties of the aminoalkyl derivatives]

The synthesis and chemical and pharmacological properties of 3-benzyl-1,2-benzisothiazoleaminoalkyl derivatives are reported. These compounds were studied because 4-dimethyl-2-phenyl-2-(1,2-benzisotiazol-3-yl)-butyramide and N,N-dimethyl-3-phenyl-3-(1,2-benzisothiazol-3-yl)propylamine were recently found to have antispasmodic properties. Most of the compounds studied aspecifically inhibited the contracturant effects of acetylcholine, histamine and BaCl2. Three of them showed mixed antagonism (competitive and non-competitive) versus acetylcholine and histamine, showing both antimuscarinic and antihistaminic properties. However the antimuscarinic action prevailed over the others, as shown by pA2 and pD'2 calculated values. On the basis of the results obtained, the structure-activity relationships is discussed.

[Specificity of the resistance exhibited by peritoneal macrophages of rats immunized against rubeola virus]

Peritoneal macrophages in rats with no immunization against rubella virus and inoculted with bovine infectious rhinotracheitis virus are prone to suffer from a cytopathogenic effect with formation of inclusion bodies, and lysis, succeeding in reisolating the virus. The resistance of peritoneal macrophages of rats inoculated against rubella virus in nonspecific, since such resistance continues to show when macrophages interact with bovine infectious rhinotracheitis virus. The results support evidence that in the Inflammatory process suffered by rubella virus-inoculated rats, a cell immunity develops and macrophages are some of the cells performing the response.

[In vitro study of the interaction of rubeola virus with the peritoneal macrophages of unimmunized and immunized rats]

In vitro peritoneal macrophage cultures of rats with no immunization against rubella virus and inoculated with these viral agents are prone to permit its intracellular proliferation and suffer a cytopathogenic effect and lysis. Peritoneal macrophages of immune rats do not permit intracellular proliferation and prevent harmful viral action. In the in vivo studies, peritoneal macrophages of non-immune rats eventually show a resistance to rubella virus during the infection. Our results suggest that macrophages require the co-operation of other elements involved in the living animal immunity in order to show resistance to rubella virus.

Attempts to convert lepromatous into tuberculoid-type leprosy with blood lymphocyte extracts from sensitized donors

Two groups of lepromatous patients (L type of leprosy) were injected intramuscularly and respectively with the Lawrence's transfer factor (LTF) or a ribonucleic acid (RNA) extracted from viable blood lymphocytes of healthy donors hypersensitive to lepromin (48–72 hr and 20–30 days), tuberculin (PPD), toxoplasmin and histoplasmin. Each patient received a single dose of LTF or RNA obtained from 10⁹ lymphocytes and was carefully observed for a period of 4 months. Histopathology of skin lesions and of lymph nodes were repeatedly performed. The results of intradermal tests with antigens were read at different times up to 120 days after the injection of LTF and RNA. Delayed cutaneous reaction to some antigens was induced in three patients injected with LTF and in two others injected with RNA. The lepromin reaction read at the end of 48–72 hr and after 20–30 days remained negative in all patients during 120 days of observation. Clinical and histopathologic signs of transformation into tuberculoid leprosy could not be observed in the eight patients tested.