ASPP2 deficiency causes features of 1q41q42 microdeletion syndrome

Chromosomal abnormalities are implicated in a substantial number of human developmental syndromes, but for many such disorders little is known about the causative genes. The recently described 1q41q42 microdeletion syndrome is characterized by characteristic dysmorphic features, intellectual disability and brain morphological abnormalities, but the precise genetic basis for these abnormalities remains unknown. Here, our detailed analysis of the genetic abnormalities of 1q41q42 microdeletion cases identified TP53BP2, which encodes apoptosis-stimulating protein of p53 2 (ASPP2), as a candidate gene for brain abnormalities. Consistent with this, Trp53bp2-deficient mice show dilation of lateral ventricles resembling the phenotype of 1q41q42 microdeletion patients. Trp53bp2 deficiency causes 100% neonatal lethality in the C57BL/6 background associated with a high incidence of neural tube defects and a range of developmental abnormalities such as congenital heart defects, coloboma, microphthalmia, urogenital and craniofacial abnormalities. Interestingly, abnormalities show a high degree of overlap with 1q41q42 microdeletion-associated abnormalities. These findings identify TP53BP2 as a strong candidate causative gene for central nervous system (CNS) defects in 1q41q42 microdeletion syndrome, and open new avenues for investigation of the mechanisms underlying CNS abnormalities.

Survey: interpolation methods for whole slide image processing

Evaluating whole slide images of histological and cytological samples is used in pathology for diagnostics, grading and prognosis . It is often necessary to rescale whole slide images of a very large size. Image resizing is one of the most common applications of interpolation. We collect the advantages and drawbacks of nine interpolation methods, and as a result of our analysis, we try to select one interpolation method as the preferred solution. To compare the performance of interpolation methods, test images were scaled and then rescaled to the original size using the same algorithm. The modified image was compared to the original image in various aspects. The time needed for calculations and results of quantification performance on modified images were also compared. For evaluation purposes, we used four general test images and 12 specialized biological immunohistochemically stained tissue sample images. The purpose of this survey is to determine which method of interpolation is the best to resize whole slide images, so they can be further processed using quantification methods. As a result, the interpolation method has to be selected depending on the task involving whole slide images.

Surface morphology of as grown and annealed bulk GaN crystals

GaN single crystals have been grown from Ga solution. The crystals grow in the form of platelets with their basal plane perpendicular to the c-axis. The two opposite crystal surfaces are not equivalent since one is N- and the other Ga-terminated. Atomic force microscopy has been applied to study surface morphology on both surfaces. It was found that one side is atomically flat. The other side consists of pyramid-like structures about 25 nm in size.

The influence of annealing in an NH3+H2 atmosphere in the temperature range from 600°C to 900°C was investigated. Depending on crystal face the results were drastically different. It was found that on the rough side, annealing yields an atomically flat surface with terraces of monolayer height. The size of the terraces depends on the temperature of the annealing. On the originally flat side the surface becomes rougher after annealing. The transformation of surface morphology begins at temperatures below 700°C. Preliminary results of annealing in a hydrogen atmosphere are also reported. These findings are crucial for the understanding and development of GaN homoepitaxy.

Elevated percentage of HLA-DR⁺ and ICAM-1⁺ conjunctival epithelial cells in active Graves' orbitopathy

Background

To evaluate if conjunctival epithelial cells’ expression of HLA-DR and ICAM-1 could be helpful as early topical markers of inflammation in Graves’ orbitopathy (GO).

Methods

The ocular examination evaluated a clinical activity score (CAS) by assessment of clinical features, (e.g., eyelid or conjunctival inflammation, lid width, lid closure, proptosis, ocular motility). Conjunctival epithelial cell specimens for flow-cytometric evaluations of ICAM-I and HLADR expression were collected by impression cytology from ten eyes with active GO (CAS ≥ 4 and duration ≤ 12 months), from 15 eyes with Graves’ disease (GD) without active GO (CAS 0–2) and from 15 normal specimens without any ocular disorders.

Results

The percentage of HLA-DR + conjunctival epithelial cells was significantly elevated in patients with active GO comparing to GD without active GO and healthy controls, 10.7 % (8.5–17.7) and 7.78 % (3.92–10.1) (p < 0.05) vs. control 4.89 % (3.5–5.5) (p < 0.005), respectively. The expression of ICAM − 1+ conjunctival epithelial cells was greater only in patients with GO vs. controls, 5.5 % (4.8–7.03) and 1.46 % (0.69–2.51) (p < 0.005), respectively.

Conclusion

The percentage of HLA-DR⁺ and ICAM-1⁺ conjunctival epithelial cells in patients with the active GO may serve as a topical inflammation marker in Graves’ orbitopathy.

Flow cytometric analysis of HLA-DR antigen in conjunctival epithelial cells of patients with cystic fibrosis

PURPOSE

Cystic fibrosis (CF) is an autosomal-recessive genetic disorder. The disease affects all secretory epithelia including the eye and belongs to the group of ocular surface epithelial diseases, termed keratoconjunctivitis sicca that develop in dry eye. In the pathogenesis of dry eye, inflammation plays a crucial role. The aim of this study was to investigate the expression of HLA-DR on conjunctival epithelial cells from patients with CF.

MATERIALS AND METHODS

Twenty-five patients with CF and 25 normal subjects underwent ocular examination. Tear film break-up time (TBUT), Schirmer test, lissamine green staining, and conjunctival impression cytology were carried out. Cells were processed for flow cytometry, by using monoclonal antibodies to HLA-DR.

RESULTS

The Schirmer test and TBUT scores were significantly lower in CF patients compared with controls. A significant increase of HLA-DR expression on epithelial cells was found in patients with CF compared with normal eyes. The Schirmer and TBUT test were positively correlated with HLA-DR expression for the percentage of cells.

CONCLUSION

These results suggest that conjunctival epithelial cells play an important proinflammatory role in ocular changes in CF patients. Our findings confirm the presence of an inflammatory background and the immune nature of this disease. HLA-DR measurement might be a useful method for monitoring of inflammatory processes in the conjunctiva and could be helpful in the use of anti-inflammatory drugs in the treatment of ocular findings in CF patients.

Evaluation of mCD14 expression on monocytes and the blood level of sCD14 in patients with generalized aggressive periodontitis

PURPOSE

Lipopolysaccharides (LPS), a major component of the cell membrane of gram-negative bacteria, are the main stimulants of the host immune response, initiating inflammatory changes and responsible for periodontal tissue destruction. The mCD14, which is found primarily on monocytes and macrophages, is the key membranous receptor involved in LPS binding. CD14 is also present in the serum as a soluble form (sCD14) released due to shedding from monocytes. The aim of the study was to assess CD14 expression on peripheral blood monocytes in patients with generalized aggressive periodontitis (GAP). The level of sCD14 was also determined in the serum of GAP patients.

MATERIAL AND METHODS

The study group consisted of 16 patients with generalized aggressive periodontitis, the control group had 13 systemically and periodontally healthy subjects. The expression of mCD14 was determined by flow cytometry and expressed as mean intensity of fluorescence (MIF). Serum sCD14 level was examined with ELISA method.

RESULTS

The expressions of mCD14 on monocytes in GAP patients and control subjects were comparable. No statistically significant differences were noted in the mean serum sCD14 level between GAP and control subjects.

CONCLUSIONS

As periodontitis is a local disorder affecting a small fragment of the oral cavity it seems likely that chronic bacterial infection existing there is not reflected in the peripheral parameters.

Intraabdominal pressure after rectal resections

The mean correlation curves of the intraabdominal pressure over time were evaluated by regression analysis (value 0.05) in both groups. The curves had a rising character in both groups, but in the control group the curve rose more steeply and reached a higher level than the curve of studied group. The onset of peristalsis, first flatus and stool took a shorter time in the studied group. (Tab. 1, Fig. 5, Ref. 5.)

Significance of a prolonged postoperative bowel paralysis in complete dehiscence of laparotomy wound

We performed 910 laparotomies in the years 1998-1999. Complete dehiscence of a laparotomy wound was observed in 18 cases. We compare the duration of postoperative bowel paralysis in patients with and without eventration. The statistical comparison of the two groups was performed with the Wilcoxon test, the level of significance was set to 5%. We have found that the duration of postoperative bowel paralysis was significantly longer in the group of patients with eventration. (Tab. 4, Ref. 5.).

Peripheral blood T, B lymphocytes and NK cells in primary biliary cirrhosis

Primary biliary cirrhosis (PBC) is an autoimmune disease with progressive destruction of the bile ducts and cholestasis. The most of epithelial cells in the bile ducts has molecule MHC I and II class expression which induced intensive immunological reaction and produced antimitochondrial autoantibodies (AMA). It leads to the destruction of own cells in PBC. The main part in the development of the disease have T cells, B cells, and NK cells. We analyzed subpopulation of lymphocytes in peripheral blood in 16 patients with PBC by flow cytometry. We noted statistically significant increase of NK CD16+ + CD56+ cell value and activated T CD3+ + HLA DR+ cell value in peripheral blood in PBC. Slightly increase in the value of CD4+ cells and slightly decreased CD8+ cell value were observed. However, the CD4/CD8 ratio was elevated statistically and it was 2.3 (healthy subjects--1.7). Lymphocyte T and B subpopulations remained normal. The results showed that the main role in PBC is played by NK cells and activated T cells.

[Acute necrotizing pancreatitis--a constant surgical problem]

The treatment of each patient admitted for the diagnose of acute pancreatitis requires a very individual approach. It is necessary to consider the possibility of severe complications. Currently, there is no specific therapeutic measure to prevent the development of pathogenic processes. In addition to all modes of supportive therapy and surgical sanatation of the local finding, it is necessary to retain the energetic intake by means of parenteral and enteral modes of nutrition provision.

[Fournier's gangrene]

Fournier's gangrene, although bearing the eponymous name of J.A. Fournier, was first reported by Baurienne in 1764 and 1883. His description was characterized by an abrupt onset of a rapidly progressive gangrene of the scrotum in otherwise healthy young males with an absence of a specific causative agent. Today, the frontiers of Fournier's gangrene have expanded to include all cases of necrotizing fasciitis of the perineum and external genitalia males and females from all age groups. All the patients were treated with antibiotics, surgical debridement and frequent wound dressings with hypertonis saline, hydrogen peroxide, colostomy and epicystostomy.

[Neurogennic blastoma of the retroperitoneum in the abdominal cavity]

Two statistically irrelevant case histories of abdominal dissemination of malignant neuroblastoma with the retroperitoneum confirm the preference of an active surgical approach even in onstensible hopeless malignant disseminations of unknown origin. Via the achievement of extensive cytoreduction, the terrain become ready for subsequent complex therapy, with the possibility of Sugarbaker's operation (peritonectomia) with hypertermic intraperitoneal intraoperative chemotherapy.

[Autoimmune thrombocytopenia in chronic liver disease]

Thrombocytopenia (TP) often accompanies chronic liver diseases. The causes are numerous and include impaired production of blood platelets, spleen sequestration, and the immune factors, e.g. antiplatelet autoantibodies. ELISA (GTI-PAKPLUS) examinations were conducted in order to estimate the rate of autoimmune thrombocytopenia occurrence in patients with thrombocytopenia in the course of chronic hepatitis (10 patients) and liver cirrhosis (20 patients). Blood platelet activity was also evaluated as well as the expression of platelet glycoproteins (GPIIb, GPIIIa, and GPIX) in platelets of the patients and the controls. It was observed that autoimmune TP occurred in 30% of patients with liver cirrhosis and in 10% of patients with chronic hepatitis, in which anti-GPIIb/IIIa, GPIa/IIa, and HLA class I antibodies were detected. In all patients there occurred significant/marked platelet activation with CD61P expression. Thrombocytopenia in patients showed a similar activity after thrombin stimulation to that in healthy individuals. Expression on GPIIb platelet receptors was markedly increased and GPIX decreased in patients in comparison to the controls. There was no correlation between the occurrence of certain types of anti-platelet autoantibodies and the expression of GP on thrombocytes in these patients.

Activation of blood platelets in chronic hepatitis and liver cirrhosis P-selectin expression on blood platelets and secretory activity of beta-thromboglobulin and platelet factor-4

BACKGROUND/AIMS

Blood platelets are cells that quite often undergo damage in chronic liver diseases. Endotoxemia and hyperkinetic circulation influence platelets in an active manner. The role of platelets in the development of hepatitis and liver fibrosis is speculative. The aim of the study was to determine the influence of chronic liver diseases on platelets morphologic parameters, their secretory activity and P-selectin expression.

METHODOLOGY

The examination was completed in the group of 29 patients with chronic hepatitis and 27 with liver cirrhosis of postinflammatory etiology (HBV, HCV). Liver biopsies were carried out in all patients. Thirty-two healthy individuals were the control group. Platelets morphological parameters (number, volume, platelet crit, micro- and macrothrombocyte fraction) were estimated. beta-thromboglobulin concentration and platelet factor 4 in blood serum as well as P-selectin expression on resting platelets and after thrombin activation were also examined.

RESULTS

Number, volume, and platelet crit decreased with the advancement of a liver disease. Megathrombocyte fraction increased inversely with the severity of liver damage. The concentration of beta-thromboglobulin and platelet factor 4 alpha-granule contents in blood serum was higher 2- and 7-times, respectively than in healthy controls. P-selectin expression on resting platelets was considerably higher. After stimulation with thrombin, P-selectin expression was equal (chronic hepatitis) or higher (liver cirrhosis) than in the control.

CONCLUSIONS

There are changes of platelet morphological parameters, with accompanying megathrombocyte fraction increase that occur in chronic liver diseases. Thrombocytes in chronic liver diseases and liver cirrhosis are more activated. Platelet sensitivity to stimuli in these ailments is higher (liver cirrhosis) than in the healthy controls.

[Use of oxygen therapy during labour and acid-base status in the newborn]

The effect of supplemental maternal oxygen therapy on acid-base status has for years been a subject of controversies. There is still no general agreement about oxygen administration in pregnancy or in labour. Many clinicians believe that in normal pregnancy maternal oxygen treatment has merely negligible, if any, influence on the foetus. Maternal oxygen therapy has frequently been suggested when oxygen supply to the foetus was insufficient, viz. in antepartum or intrapartum hypoxia. The aim of this study was to determine whether a brief maternal hyperoxygenation during caesarean section or during the second stage of normal delivery affects cord blood acid-base status measured at birth. Patients with uneventful term pregnancy admitted to the delivery room in spontaneous labour or indicated for elective caesarean section were matched and prospectively ascribed to the control or treatment group. The latter received 60% oxygen for ca. 10 min at 15 L/min by a face mask. We studied 41 normal term infants of healthy mothers (24 from caesarean sections, the remaining 17 delivered vaginally). The control group consisted of normal newborns chosen according to the same criteria except that their mothers had no oxygen supplementation. Immediately after delivery, umbilical cord paired blood samples were drawn. Arterial and venous specimens were analysed for blood gases and acid-base balance parameters. Statistical analysis assisted by computer software was performed using Mann-Whitney U test. A p value < 0.05 was considered significant. All tested parameters related to the acid-base status and blood gases were similar in the treatment and control groups. Concluding, a short period of maternal hyperoxygenation either in the second stage of vaginal spontaneous delivery or during caesarean section did not affect umbilical cord blood acid-base status measured at birth.

[Hematologic parameters in the cord blood labor complicated by meconium-stained amniotic fluid]

The aim of our study was to compare hematological values of the cord blood in the presence and absence of meconium-stained amniotic fluid (MSAF). MSAF was associated with decreased total platelet count, increased values of platelet distribution width and red blood cell distribution width. The mean nucleated red blood cells was significantly higher in meconium group. The values of red blood cells, white blood cells, reticulocytes counts and their fractions (HFR,MFR,LFR,IFR) were no different in cord blood of neonate exposed to meconium and in those who were not. These findings can suggest that MSAF contribute to fetal infection rather than hypoxia.

High-resistance MDCK-C7 monolayers used for measuring invasive potency of tumour cells

We describe an electrophysiological method for evaluating the intrinsic invasive potency of tumour cells using renal cells as an in vitro assay system. A high-resistance clone of Madin-Darby canine kidney cells (MDCK-C7) was grown to confluency in a filter cup. Transepithelial electrical resistance across the MDCK-C7 monolayer was measured in a commercially available electrode chamber. After a transepithelial electrical resistance of about 4,000 omega cm2 had been reached, human melanoma or pancreatic carcinoma cells were co-cultivated with the MDCK-C7 monolayer. Both carcinoma cell lines induced resistance breakdown measured after 24 h or later depending on seeding density and cell type. Seeding carcinoma cells on the basolateral surface of MDCK-C7 cells caused a similar decrease in transepithelial resistance of the MDCK-C7 monolayer. Resistance breakdown indicates opening of tight junctions prior to tumour cell invasion. In conclusion, the high-resistance MDCK-C7 cell clone could serve as a valuable biological assay system to determine electrically the metastatic potency of tumour cells in vitro.

Perineural spread of squamous cell carcinoma of the lip: the importance of follow-up and collaboration

Perineural spread (PNS) of mucosal squamous cell carcinoma of the head and neck region occurs with a reported frequency of 2% to more than 27%. Patients previously diagnosed with and treated for head and neck cancer should be closely followed by both their physician and their dentist in order to facilitate the coordination of care. This case history demonstrates the results that can occur when a team approach to head and neck cancer is not followed, especially in a patient who is an infrequent and somewhat reluctant health care utilizer. Despite mandibular pain, the patient, who had a history of a carcinoma of the lower lip and had developed PNS, was not referred to a dentist. In patients with a previous history of squamous cell carcinoma, sensory and/or motor changes must be closely monitored when there is a suspicion of PNS. The outcome of this case supports improved collaborations between physicians and dentists in following head and neck cancer patients.

[The evaluation of lymphocyte subpopulation by flow cytometry in healthy children]

Seeing that amount of experiences concerning the cytometry of lymphocyte subpopulation in particular age ranges is very low we considered that undertaking this subject is useful. By the method of flow cytometry 49 children at the age from 2 months to 15 years were studied. According to the results of our studies we found, starting from the third year of life decrease of mean percentage values of cells CD19+, progressive in relation to the age, increase of mean percentage values of cells CD2+, increase of percentage values of cells CD8+ and cells CD56++ and the decrease of mean values of the indicator Th/Ts. Remaining CD3, CD4 did not show any statistically significant differences in investigated age ranges. Determined by the method of flow cytometry the percentage and complete values of lymphocyte subpopulations in peripheral blood in investigated age ranges can make the reference values in the assessment of immunological state.

Palmtop computer residency log

This pilot study explored the usefulness of portable electronic organizers (palmtop computers) to log residents' clinical activity. Nine residents were randomly assigned palmtops, 18 continued using a nonautomated system (paper log). After 8 months, resident compliance, frequency of data entry, and submission of log data were better in the palmtop group. Data are easily transferred from the palmtop to a desktop computer data base to generate reports. Start-up costs are comparable to other automated systems, and ongoing costs are minimal. The palmtop log appears to be a viable alternative to the paper log.

Distribution of Helicobacter pylori colonisation and associated gastric inflammatory changes: difference between patients with duodenal and gastric ulcers

AIMS

To determine the gastric distribution of Helicobacter pylori in patients with duodenal and gastric ulcers; and to examine the mucosal inflammatory response.

METHODS

Patients with newly diagnosed, uncomplicated duodenal and gastric ulcers were endoscoped and two biopsy specimens each taken from the antrum and the body. Specimens were evaluated blind by one pathologist to determine H pylori activity (scored 0-3) and inflammatory changes (according to the Sydney classification).

RESULTS

Adequate biopsy material was obtained from 40 and 44 patients with gastric and duodenal ulcers, respectively. Although antral colonisation with H pylori was more common in the antrum of the latter, the organism was equally likely to be found in the body of both sets of patients; the density of colonisation was higher in those with gastric ulcers. Active gastritis and mucosal atrophy were more common in the body of those with gastric ulcers; intestinal metaplasia was also more common in the antrum of these patients.

CONCLUSIONS

Gastritis in patients with duodenal ulcers is mainly antral, but the incidence of gastric body colonisation with H pylori seems to be the same in patients with either type of ulcer. There is, however, a significant difference in colonisation density. The cause and importance of this are not obvious and may be related to either host or organism factors.

Abdominal tuberculosis: still a potentially lethal disease

The findings in a 4-yr survey of 82 patients with abdominal tuberculosis are described and compared with those encountered in previous surveys. Fourteen cases of intestinal, 11 of mesenteric-lymphnodal, and 57 of peritoneal tuberculosis were identified. The disease occurred essentially in patients living under worsening socioeconomic conditions, and 51 of them had associated pulmonary tuberculosis. Symptoms and clinical findings were again nonspecific, but newer imaging, endoscopic, and other invasive procedures were helpful in establishing a definite diagnosis. In addition, adenosine deaminase determination showed great promise as a noninvasive diagnostic procedure in patients with tuberculous ascites. The six hospital deaths in the series highlight the hazard of potentially lethal delays in early diagnosis and treatment, even in centers with a high awareness of the disease.

Helicobacter pylori prevalence in non-ulcer dyspepsia--ethnic and socio-economic differences

Helicobacter pylori is an important cause of gastritis and a number of therapeutic trials suggest that it may be important in the genesis of duodenal ulcer recurrence. The reported prevalence of gastric colonisation by the organism varies considerably. The aim of this cross-sectional survey was to determine its prevalence in non-ulcer dyspeptics and to determine whether this is influenced by age, race, sex, socio-economic status, educational level and the number of persons sharing accommodation. One hundred and sixty-nine patients underwent endoscopy; biopsy specimens were taken from the antrum and H. pylori status was determined histologically. Gastric colonisation was found in 106 patients (63%). The prevalence showed a marked ethnic difference: 40% in whites and 71% in coloureds (P < 0.001). The ethnic groups were characterised by significant differences in socio-economic status (P < 10(-6)), educational level (P < 10(-6)), number of persons sharing accommodation (P < 10(-6)) and age (P < 0.001). These same differences were found when comparing the H. pylori-positive and negative groups, but were less marked and could be attributed to the marked differences between ethnic groups. We conclude that H. pylori prevalence differs between the ethnic groups studied. This may be because of varying degrees of exposure risk.

N-ethoxycarbonyl-2-ethoxy-1,2-dihydroquinoline, an irreversible receptor inactivator, as a tool for measurement of α2-adrenoceptor occupancy in vivo

In rats treatment with N-ethoxycarbonyl-2-ethoxy-1,2-dihydroquinoline (EEDQ) induces a dose-dependent decrease in the number of alpha 2-adrenoceptors. Prior injection of alpha-adrenergic agents such as yohimbine and clonidine protect alpha 2-adrenoceptors against the effects of EEDQ. The ED50 values for yohimbine and clonidine were 10.27 and 5.83 mumol/kg, respectively.

Triple therapy with sucralfate is as effective as triple therapy containing bismuth in eradicating Helicobacter pylori and reducing duodenal ulcer relapse rates

Duodenal ulcer relapse rates after therapy with sucralfate or bismuth are lower than those after H2-receptor antagonist therapy. This may be mediated by an antibacterial effect of these drugs on Helicobacter pylori. Bismuth has become an integral part of 'triple therapy' because of its documented anti-H. pylori effect. In vitro and clinical data suggest that sucralfate may also have an anti-H. pylori effect. The aim of this randomized, prospective therapeutic trial was to compare the efficacy of triple therapy containing bismuth with that containing sucralfate and to determine the effect of therapy with these combinations on duodenal ulcer relapse. Forty H. pylori-positive duodenal ulcer patients were healed with omeprazole and randomized to receive either 1 g sucralfate four times daily or 120 mg bismuth compound four times daily. All patients received 400 mg metronidazole three times daily and either 250 or 500 mg tetracycline four times daily for 7-14 days. Thirty-five patients could be analysed. Overall eradication rates did not differ in the treatment groups (10 of 17 eradicated with sucralfate and 11 of 18 with bismuth). Relapse rates were significantly lower in the eradicated group (1 of 21 compared with 8 of 14 in the non-eradicated group) and did not differ between treatment groups in those patients not eradicated. A triple therapy regimen utilizing sucralfate appears to be as effective as the bismuth-containing regimen.

Acid secretory responses and parietal cell sensitivity following duodenal ulcer healing with omeprazole, sucralfate, and Maalox

Acid secretory responses and parietal cell sensitivity (PCS) have been studied in 21 duodenal ulcer patients before and after successful treatment with omeprazole (n = 7), sucralfate (n = 7), or Maalox (n = 7). The second study was carried out 3 days after documented healing and withdrawal of treatment in the sucralfate- and Maalox-treated groups and 14 days after documented healing and withdrawal of treatment in the omeprazole-treated patients. Acid output (mmol/hour) was measured as basal secretion, and in response to 0.1 microgram/kg/hour pentagastrin (low-dose) and 6.0 micrograms/kg/hour pentagastrin (high-dose) stimulation. PCS was calculated as the ratio of low dose:high dose acid output (expressed as a percentage). Ulcer healing with sucralfate resulted in significant (p less than 0.05) decreases in low-dose acid output from 36.4% (13.2-51.0) (median [range]) to 8.4% (3.2-45.4) mmol/hour and PCS from 69.1% (44.9-91.4) to 22.0% (16.0-85.6), whereas no significant decreases in any of the measured parameters were noted following ulcer healing with Maalox. Ulcer healing with omeprazole resulted in significant (p less than 0.05) decreases in basal acid output from 6.3 (1.5-22.9) (median [range]) to 2.2 (0-6.9) mmol/hour, and low-dose acid output from 31.0 (6.0-58.0) to 23.0 (1.4-44.8) mmol/hour. These findings suggest that acid secretory responses following ulcer healing vary according to the therapeutic agent used.

Effect of repeated treatment with antidepressant drugs and electroconvulsive shock (ECS) on the D2 dopaminergic receptor turnover in the rat brain

The effect of repeated treatment with citalopram, (+)oxaprotiline, (-)oxaprotiline, imipramine and ECS on the turnover of dopamine D2 receptors in the rat brain was measured using an N-ethoxycarbonyl-2-ethoxy-1,2-dihydroquinoline (EEDQ)-induced irreversible receptor inactivation method. Repeated treatment with citalopram and ECS, but not with (+) and (-) enantiomers of oxaprotiline and imipramine, significantly decreased the turnover of D2 receptors in the striatum. Neither of the applied repeated treatments changed the turnover of D2 receptors in the limbic system. The results suggest that changes in the turnover of D2 dopamine receptors in striatum may participate in the mechanism of antidepressant action of ECS and citalopram, but not that of (+) or (-)oxaprotiline or imipramine.

Lymphocytic gastritis in nonulcer dyspepsia

The prevalence of lymphocytic gastritis, a specific form of chronic gastritis characterized by infiltration of gastric superficial epithelium with T lymphocytes, has been established in nonulcer dyspepsia. Among a population sample of 586 patients at risk for gastric carcinoma, 0.83% of patients with nonulcer dyspepsia and 1.63% of patients with chronic active gastritis showed lymphocytic gastritis. Among routine gastric biopsies from 5130 patients, only five cases met histological and immunohistochemical criteria of lymphocytic gastritis.

Percutaneous endoscopic gastrostomy. Indications, technique and complications at Groote Schuur Hospital

Percutaneous endoscopic gastrostomy (PEG) is a relatively new technique in South Africa. It is useful in the management of patients with neurological and oropharyngeal disorders in whom long-term feeding is necessary. The PEGs inserted in patients at Groote Schuur Hospital between June 1986 and March 1990 as part of an on-going study to evaluate this procedure are reported.

The turnover of rat cortical alpha 1-adrenoceptors is not modified by repeated electroconvulsive treatment

The effect of repeated treatment with electroconvulsive shock (ECS) on the turnover of cortical alpha 1-adrenoceptors in rats was measured using the N-ethoxycarbonyl-2-ethoxy-1,2-dihydroquinoline (EEDQ)-induced irreversible receptor inactivation method. Repeated treatment with ECS did not affect parameters (the synthesis rate constant r, the degradation rate constant k) of alpha 1-adrenoceptor turnover. Because increase in the density of alpha 1-adrenoceptors in the ECS-treated group disappears later during measurement of turnover, several calculation possibilities were discussed. The present data confirm that repeated treatment with ECS produces a short-lasting up-regulation of cortical alpha 1-adrenoceptors, but does not affect the turnover of this receptor type.

Role of dopaminergic neurons in denervation-induced alpha 1-adrenergic up-regulation in the rat cerebral cortex

The density of [3H]prazosin binding to alpha 1-adrenoceptors in the rat cortex was measured after selective and mixed noradrenergic or dopaminergic lesions. DSP-4 produced a selective noradrenergic lesion and increased the density of alpha 1-adrenoceptors. 6-Hydroxydopamine produced a selective dopaminergic lesion (after desipramine protection of noradrenergic neurons) and a mixed noradrenergic and dopaminergic lesion that did not change the cortical alpha 1-adrenoceptor binding. On the basis of the results obtained, a hypothesis is put forward that the central dopaminergic system controls the denervation-induced cortical alpha 1-adrenoceptor up-regulation.

Dry beriberi: unusual complication of prolonged parenteral nutrition

An adult with Crohn's disease on home total parenteral nutrition (TPN) for 8 months presented with peripheral neuropathy and ataxia. The patient was found to be deficient of thiamine. A prompt symptomatic response to intravenous thiamine suggests that the patient had the chronic form of dry beriberi. To our knowledge, this variety of beriberi in a patient on TPN has not previously been reported.