Antinuclear Antibody Profile in Italian Patients with Connective Tissue Diseases

In the present work we report data on the specificity of antinuclear antibodies (ANA) in a large series of Italian patients suffering from a broad spectrum of connective tissue diseases (CTD), by using a series of homogeneous and validated techniques.

The present study confirms, on the one hand, generally accepted concepts, i.e. that certain autoantibodies are strictly associated to certain disease states (such as anti-PCNA and anti-Sm in systemic lupus erythematosus, Jo1 in polymyositis, and ACA and Scl-70 in scleroderma); the presence of 'marker' antibodies is, however, restricted to a relative minority of CTD patients. The application of a new methodological approach that considers the entire profile of ANA can greatly augment their diagnostic relevance and may provide useful indications for their interpretation, allowing us to establish for the first time the diagnostic usefulness not only of marker autoantibodies but also of certain associations between non-marker autoantibodies. Finally, the application of a more appropriate and powerful statistical tool (multiple correspondence analysis) has further emphasized the clear relationship existing between antibody specificities and certain disease states.

[Hypotonic cerebral palsy. Which treatment?]

BACKGROUND

Aim of this study is to verify whether tonus neurophysiological and communicative-relational aspects in hypotonic subjects can be recovered by psychomotor therapy.

METHODS

This case series includes two randomized groups of children with central hypotonia observed at the Department of Child Neuropsychiatry of the Gaslini Institute of Genova from February 1992 to December 1996. The 1st group includes 6 subjects treated in a local rehabilitation service only by kinesitherapy. The 2nd group includes 6 children undergoing psychomotor treatment in our Department, where all the 12 cases underwent periodical controls.

RESULTS

Tonus physiological aspects equally improved in the two groups, whereas the improvement of the communication aspect was more marked in the second.

CONCLUSIONS

The conclusion is drawn that psychomotor therapy seems more appropriate for a global recovery of the hypotonic child.

[Psychomotor treatment of cranial injuries in childhood. Two cases of apallic syndrome]

In this paper the authors aim to assess the results of psychomotor treatment of 5 patients with cranial injuries admitted to the Division of Infantile Neuropsychiatry at Gaslini Hospital from 1983 to 1985 and to evaluate the role of this treatment in a pathology with multiple, complex functional disorders. Evolution was excellent in 3 out of 5 patients who presented level 1-3 coma with limited post-traumatic sequelae (epilepsy and dysfunction of the left side in A.D., epilepsy and learning disorders in C.F., motor impairment and learning disorders in V.D.) Effective control was achieved in epileptic patients together with a good recovery in those with learning handicaps. Only slight fine motor disorders remained in the case (A.D.) with left hemiparesis. The two cases with level 5 coma that developed into apallic syndrome both attained full postural and motor autonomy, although a slight paretic deficit remained in the left side in one case (V.A.) and vague cerebellar signs in the other (G.D.). Moreover, despite continuing residual difficulties involving concentration and instability of attention, together with slight affective and emotional problems, both girls acquired satisfactory knowledge and responsibility regarding their own psychomotor status and achieved good personal autonomy and a stable ego structure. These results appear to confirm the hypothesis that psychomotor treatment is an effective method of achieving an adequate recomposition of the psychophysical and functional unit of body, damaged by injury.

[Rehabilitative treatment of severe sensory disorders. Description of 2 cases]

The aim of the work has been to verify the efficacy of a psychomotor rehabilitative treatment undertaken at a late age in two children with multiple handicaps: sensorial (visual and hearing impairment), motor (apostural-akinetic stage) and relational (autistic behavior).

METHODS

Salvatore C, and Ivan S., admitted to the "G. Gaslini" Institute after discharge from an Institution for homeless infants, were affected by prenatal rubella sequelae. They were taken in charge at age 11 and 24 months.

TREATMENT

manipulation and body-to-body interaction to reassure the children, relieve their feelings of fright and reduce the stereotyped behaviour; stimulation of the acquisition of the body-image; strengthening of the unimpaired sensorial skills and of the residual auditory and visual possibilities; postural and motor stimulation, following the autogenetic development; stimulation to achieve spatial organization and orientation; adjusting of interventional and relation modalities common to all the persons interacting with the children.

RESULTS

we obtained a significant reduction of stereotyped behaviour and progressive improvement of the active research of productive interaction with the environment in both children; Salvatore C. was able to walk with little aid after one year of treatment; furthermore he reached a lively and organized motility, supported by a motivational drive. Ivan S. was able to walk with bilateral help after 4 months of treatment; the cognitive development improved at a slower pace; the child became able to reach for objects but used them only in stereotyped or elementary activities. From this observation it seems possible to confirm our hypothesis that psychomotor education is useful even if undertaken lately and in the absence of a supporting family.(ABSTRACT TRUNCATED AT 250 WORDS)

[Effects of early rehabilitative treatment on neurological development and cognitive and perceptual-motor functions of preterm infants at risk]

Longterm effects of early rehabilitative treatment are evaluated in 37 premature infants at neurological risk. The late neurological and psychomotor development of this group of children (experimental group) is compared with that of another 35 at risk premature infants (control group), who received only conventional follow-up care. The two groups do not differ in birth-weight, gestational age, sex and neonatal disorders. At 6 years of age the children of the experimental group have a significantly better neurological status and score higher than the control group, on mean mental indices. They also have lower incidence of neurodevelopmental sequelae (learning disabilities and behaviour problems). However children both in the experimental group and the control group have poor visual-motor integration. Similar results are found also in children, who were low-risk premature infants and who have normal intelligence. Our data suggest that a prescribed early rehabilitative treatment for high-risk preterm infants appears enhance the quality of late development. Treated children have the greatest improvement in all measured outcomes at 6 years (included neurological status, motor and overall development), but do not achieve the same level of neurological and behavioral development as full-term control children. One might question whether the latter finding indicate limited efficacy of early treatment or rather the need to consider separate series of norms for the preterm infant in assessing its outcome. This question requires additional follow-up studies.

The reaction of horse-liver alcohol dehydrogenase with glyoxal

Horse liver alcohol dehydrogenase was reacted with glyoxal at different pH values ranging from 6.0 to 9.0. At pH 9.0 the enzyme undergoes a rapid activation over the first minutes of reaction, followed by a decline of activity, which reaches 10% of that of the native enzyme. Chemical analysis of the inactivated enzyme after sodium borohydride reduction shows that 11 argi-ine and 11 lysine residues per mole are modified. At pH 7.7 the enzyme activity increases during the first hour of the reaction with glyoxal and then decreases slowly. Chemical analysis shows that 4 arginine and 3 lysine residues per mole are modified in the enzyme at the maximum of activation. At pH 7.0 the enzyme undergoes a 4-fold activation. Chemical analysis shows that in this activated enzyme 3 lysine and no arginine residues per mole have been modified. Steady-state kinetic analysis suggests that the activated enzyme is not subjected to substrate inhibition and that its Michaelis constant for ethanol is three times larger than that of the native enzyme. The possible role of arginine and lysine residues in the catalytic function of liver alcohol dehydrogenase is discussed.