Causality of parenchymal and vascular changes in rats with experimental thiamine deficiency encephalopathy

The causality of vascular and parenchymal damage to the central nervous system (CNS) was examined in rats with thiamine deficiency. Male Sprague-Dawley rats were divided into two groups; one was given a thiamine-deficient diet (TDD) and injected intraperitoneally with 10 micrograms/100 g bodyweight pyrithiamine (PT) in order to analyze morphometrically the topographical and sequential relationship between vascular and parenchymal changes and vasodilatation, and the other was given a TDD and 50 micrograms/100 g bodyweight PT in order to determine hemorrhagic sites using serial sections. Histological examination showed that spongiotic change occurred selectively in the inferior colliculus (100%) from day 19, and thereafter in the thalamus (95%), mammillary body (50%) and nuclei olivaris and vestibularis of the pons (25%), with or without hemorrhage. Simultaneously, glycogen accumulation was also observed in these regions at a frequency similar to that of hemorrhage. Ultrastructurally, however, hydropic swelling of astrocytic and neuronal processes without glycogen accumulation was observed as early as day 9 in the inferior colliculus, at which time an increase of glial fibrillary acidic protein-positive processes was also recognized. The superior colliculus was completely spared. From day 22 vasodilatation of the inferior colliculus occurred, concomitantly with bodyweight loss and neurological symptoms. Twenty-two examined hemorrhages, which occurred in the thalamus and inferior colliculus, were distributed along the arterioles or capillaries on the arterial side. In conclusion, the morphological CNS changes caused by thiamine deficiency with administration of low-dose PT in rats begin as hydropic swelling of neuronal and astrocytic processes, followed by hemorrhage and, thereafter, by vasodilation. The predilection for hemorrhage on the arterial side without parenchymal changes suggests that petechial hemorrhage is not simply secondary to parenchymal changes, but is due to hemodynamic change resulting from thiamine deficiency-induced vascular dysfunction.     

Reversible malabsorption of folic acid in the elderly with nutritional folate deficiency

The question of the point of impact of the electric current in the galvanic vestibular test is not solved. An important feature is that, after destruction of both the vestibular end organs, a galvanic nystagmus can still be provoked. The effect of a direct current on the spontaneous nystagmus following partial or total destruction of the vestibular end organs was investigated. The frequency of the spontaneous nystagmus diminishes when the electric stimulus causes an eye movement in the same direction as the fast phase of the nystagmus, the frequency increases when the polarity of the electric stimulation is reversed. Simultaneous application of torsion-swing and electric stimulation causes a summation of the separate effects. Our findings confirm the conculsions drawn by Ledoux (4, 5) from his findings in frogs.     

Reversible brain MRI changes in acyclovir neurotoxicity

This case report shows reversible brain MRI changes probably associated with acyclovir toxicity. So far, neuroimaging in acyclovir toxicity had been negative or uninformative. A 12-year-old girl developed focal secondary generalizing epileptic fits following 4 weeks of prophylactic administration of acyclovir (3 x 10 mg/kg body weight/day i.v.) on day +22 after allogeneic peripheral blood stem cell transplantation for CML. Infective causes were excluded. Brain MRI demonstrated multiple gadolinium-enhancing areas with impairment of the blood-brain barrier in cortical and subcortical regions. Clinical symptoms and neuroimaging pathology resolved completely within 9 days of acyclovir withdrawal.     

Bilateral experimental muscle pain changes electromyographic activity of human jaw-closing muscles during mastication

The effects of bilateral experimental muscle pain on human masticatory patterns were studied. Jaw movements and electromyographic (EMG) recordings of the jaw-closing muscles were divided into multiple single masticatory cycles and analyzed on a cycle-by-cycle basis. In ten men simultaneous bilateral injections of hypertonic saline (5%) into the masseter muscles caused strong pain (mean+/-SE: 7.5+/-0.4 on a 0-10 scale), significantly reduced EMG activity of jaw-closing muscles in the agonist phase, and significantly increased EMG activity in the antagonist phase. Nine of the subjects reported a sensation of less intense mastication during pain. Injections of isotonic saline (0.9%) did not cause pain or significant changes in masticatory patterns. The influence of higher brain centers on conscious human mastication can not be discarded but the observed phase-dependent modulation could be controlled by local neural circuits and/or a central pattern generator in the brain stem which are capable of integrating bilateral nociceptive afferent activity.     

Phenotypic changes in the regenerating rabbit bladder muscle. Role of interstitial cells and innervation on smooth muscle cell differentiation

It was not Julius Caesar who was born by Caesarean section, as generally assumed, but Scipio Cornelius Africanus, who subdued Spain 100 years before Caesar's time. In chambers with walls of porphyrite, the Byzantine empresses used to give birth to the heirs to the throne. In England, the infertility of Queen Anne, who suffered from porphyria, led to the succession of the Protestant House of Hannover following the Catholic Stuarts. Christina of Sweden, called 'queen of baroque, rebel and scholar', was born in the 'caul'. At the age of 39 years, Johanna of Pfirt, married to Albrecht the Lame, secured the continuation of the Habsburg dynasty by giving birth to Rudolf the Founder. Maria Theresia, who had 16 children, was called 'mother-in-law of Europe'. She was delivered of her first child at the age of 19. The death of her sister Maria-Anna in childbed was one of the reasons why Gerard van Swieten was called to Vienna. Elisabeth of Württemberg, first wife of Franz I of Austria, died, not as a consequence of. but after a forceps operation carried out by Johann Lukas Bo?r. In England, Princess Charlotte, daughter of George IV, and her baby son died at the delivery; Sir Richard Croft, who had not used the forceps, committed suicide after this tragic incident. Being the next in succession, Victoria ascended the throne. The term 'narcose au chloroforme' (first used by James Young Simpson) was changed to 'narcose à la reine' after this method had been used at the birth of Victoria's eighth child by John Snow. It was Queen Victoria, who passed on haemophilia in European dynasties. When Marie Louise of Habsburg had her first child, Napoleon's son, the later Duke of Reichstadt, Antoine Dubois had to perform a turning of the transverse presentation and use the forceps on the head following after. The birth of Napoleon himself was a case of precipitate labour. Johann Klein, the successor of Bo?r, applied the forceps when Archduchess Sophie was delivered of her first child, the later Emperor Franz Joseph I of Austria, the first of the four 'salt princes'. The later Emperor Wilhelm II of Prussia was delivered by Eduard Arnold Martin the Elder, the obstetrician of Princess Victoria, the eldest daughter of Queen Victoria; the breech presentation became even more complicated by the raised arms of the child. Both latter monarchs had been 'asphyctic' after their birth. Johann Wolfgang von Goethe was also among those who were apparently dead after their birth.     

Functional alterations of cardiac subcellular structures during energy deficiency in relation to the metabolic state of the heart muscle cell

The functional behaviour of membrane systems of the cardiac cell during oxygen deficiency was analyzed and the alterations were related to the metabolic state of the tissue as an index of injury. 1. The retention function of the cell membrane for proteins. With increasing energy deficiency the cardiac sarcolemma loses its ability to retain macromolecules (myoglobin, enzymes) within the cell. Close correlations exist between protein release and oxygen supply as well as ATP content of the tissue. 2. Function of isolated mitochondria after ischemia. In parallel with a strong impairment of oxidative phosphorylation (decrease of QO2, RCI values, phosphorylation rates) the Ca++-transporting activity of mitochondria is continuously depressed with decreasing myocardial ATP. 3. Function of isolated sarcoplasmic reticulum after ischemia. With breakdown of high energy phosphates during ischemia rate and extent of Ca++ binding with decrease markedly.     

Retinal abnormalities in experimental vitamin E deficiency

Physiological and biochemical studies have been carried out longitudinally over a period of 12 months in vitamin E deficient and control rats to gain an understanding of the mechanism whereby vitamin E conserves normal retinal function. Electroretinographic studies indicated that the primary effect of vitamin E deficiency was on the photoreceptors. Ultrastructural studies, however, did not show any morphological changes to the photoreceptors which could explain receptor dysfunction. A 30-40% loss of vitamin A (retinol) was found to be associated with vitamin E deficiency. This could be corrected by repletion with vitamin E, but there was no associated improvement in visual function. An irreversible loss of the long-chain polyunsaturated fatty acids from the retina, increased lipid peroxidation and alterations in membrane fluidity were also detected during vitamin E deficiency. We suggest that a deficiency of vitamin E leads to changes in the membrane microenvironment, which could affect photo transduction by either impairing the ability of rhodopsin to undergo conformational changes to the active form, or by disrupting the hyperpolarising and depolarising processes of the photoreceptors.     

Reversible metabolic myopathy in biotinidase deficiency: its possible role in causing hypotonia

A 5-year-old girl diagnosed with biotinidase deficiency at 9 months of age demonstrated limb and axial hypotonia which improved on biotin therapy. In this patient, electromyographic (EMG) studies prior to treatment were compatible with a mild myopathic process. Serial EMGs performed on biotin therapy demonstrated a gradual resolution of the myopathy. This is the first documented case of a reversible myopathy in a patient with biotinidase deficiency, which may contribute to the clinical findings of hypotonia.     

Cadmium and cardiac muscle cell - biomarkers of oxidative stress - experimental work

OBJECTIVE: To study in several tissues (heart, kidney and liver) of Halobatrachus didactylus the cellular response induced by an acute exposure to a sublethal cadmium concentration. DESIGN: Fifteen species of H. didactylus (marine teleost) were divided in to three groups: CTRL: control group, the fish were injected with a saline solution; 24 H: 1 mg/kg of cadmium chloride was injected and the fish were sacrificed after 24 hours; 7 D: the fish were subjected to the same cadmium concentration and sacrificed 7 days after injection. INTERVENTIONS: Superoxide dismutase--SOD (McCord & Fridovich, 1969) and catalase--CAT (Clairborne, 1985) activities were determined in the cytosolic and mitochondrial fractions of these three tissues. The lipid degradation products were also determined by the tiobarbithuric acid (TBA) test. MEASUREMENTS AND RESULTS: Cadmium induced an increase in SOD activity in both fractions (cytosolic and mitochondrial) of these H. didactylus tissues. The highest levels of activity observed were located at mitochondrial fraction and in the heart. There was a significant increase in CAT activity in both liver and heart tissue fractions after cadmium exposure. The highest values were observed in the liver. The kidney presented a different response: there was a rise in CAT activity only in the mitochondrial fraction after seven days of exposure. There were no significant changes in lipid degradation products in any of these tissues after cadmium exposure. CONCLUSIONS: The two antioxidant enzymes studied in the heart, kidney and liver of H. didactylus demonstrated a high sensitivity to oxidative stress induced by cadmium and presented a high potential as cellular biological makers. The results indicate membrane lesion caused by lipid peroxidation did not occur, which suggests an efficient response of the cellular protection mechanisms against cadmium cytotoxicity.     

Intravenous repletion of phosphorus deficiency in the chronic renal failure patients with severe hypophosphatemia

Severe hypophosphatemia is a potentially life-threatening medical condition and might lead to a fatal outcome in critically ill patients. The situation is further complicated by the co-morbid renal failure. We evaluated the efficacy and safety of the intravenous phosphate repletion in 15 renal failure patients with severe hypophosphatemia. Six patients with advanced renal failure and nine patients under maintenance hemodialysis, 7 males and 8 females, aged between 42 and 83 years old, were found to have serum phosphate level < 1.2 mg/dL from various medical conditions and were treated with intravenous phosphate infusion. The phosphate solution prepared from sodium dihydrogen phosphate (NaH2PO4), containing 13 mg/ml phosphate and 0.5 meq/ml sodium, in the dosage 2.5-3.0 mg phosphate/Kg body weight, was administered through the central venous lins every 6-8 hours. The infusion was discontinued once serum phosphate level reached 5.0-5.5 mg/dL. Serum ionized calcium, phosphate and intact parathyroid hormone levels were serially followed at different intervals, respectively. The hemodialyzed uremic patients received their dialysis treatment as scheduled. All patients survived the hypophosphatemic period and regained normal phosphate levels after repletion. The amount of phosphate administered to reach the target level ranged between 3438 and 9150 mg and the duration of treatment varied between six and seventeen days. Hypocalcemia (< 4.2 mg/dL) was noted at eight occasions during the whole treatment period but none was symptomatic. Eleven patients recovered from the offending illness. However, four patients expired due to reasons not directly consequent to and temporally remote from hypophosphatemia. We conclude that prompt repletion of severe hypophosphatemia and phosphate deficiency with relatively slower rate of NaH2PO4 solution intravenous infusion is a safe and effective mode of treatment for renal failure and uremic patients. The longer treatment period allowed the administered minerals full equilibration. The risk of hyperkalemia is avoided and the sodium/volume load can be eliminated by dialysis.     

Exacerbated immune stress response during experimental magnesium deficiency results from abnormal cell calcium homeostasis

The aim of this study was to assess the potential mechanism underlying the enhanced inflammatory processes during magnesium deficit. In this study, exacerbated response to live bacteria and platelet activating factors was shown in rats fed a magnesium-deficient diet. Peritoneal cells from these animals also showed enhanced superoxide anion production and calcium mobilising potency following in vitro stimulation. The latter effect occurred very early in the course of magnesium deficiency. These studies first showed that an abnormal calcium handling induced by extracellular magnesium depression in vivo may be at the origin of exacerbated inflammatory response.     

Reversible changes of motor cortical outputs following immobilization of the upper limb

Dopa-responsive dystonia (DRD) is no longer a rare oddity. For the clinician, DRD poses a diagnostic challenge as its clinical presentation can be quite diverse. Marked and sustained response to L-dopa is the most crucial and absolute hallmark in confirming a diagnosis. Absence of degenerative nigral cell loss underlies the remarkable L-dopa response. The broadening spectrum of the clinical presentations, progress in molecular genetics with evidence of incomplete penetrance and phenotypic variability, biochemistry, utility of nuclear imaging in differential diagnosis, and treatment are discussed. I propose the concept of DRD as a syndrome, defined as selective nigrostriatal dopamine deficiency caused by genetic defects in dopamine synthesis without degenerative cell loss. I further propose the term DRD-plus, defined as inherited metabolic disorders which have symptomatic features of DRD, and those features not seen in DRD as well.     

Deficient muscle carnitine transport in primary carnitine deficiency

The effects of conditions that either increase or decrease heart rate on the pharmacological properties of adenosine receptors in cultured rat myocytes were examined. Levels of A1 adenosine receptors, following prolonged treatment with electrical stimulation (ES) or the antiarrhythmic drug amiodarone, were determined using radioligand binding with the specific A1 receptor antagonist [3H]1,3-dipropyl-8-cyclopentylxanthine (CPX). The effects of lowering temperature were also explored. Exposure to amiodarone for 4 days reduced the density of A1 receptors by 19% (from 24.7 +/- 0.4 to 20.09 +/- 0.3 fmol/dish) and inhibited the rate of contraction by 60% (from 188 +/- 16 to 76 +/- 30 beats/min), without changing the receptor affinity, protein content, creatine kinase (CK) activity or cell number. Electrical stimulation at 25 degrees C elevated the density of A1 adenosine receptors by 185% (from 4.1 +/- 0.4 to 11.69 +/- 2.1 fmol/dish). Four days of reduced temperature (from 37 degrees C to either 30 or 25 degrees C) lowered the density of A1 adenosine receptors by 69 or 86%, respectively (from 24.1 +/- 1.2 to 7.4 +/- 0.4 or 3.4 +/- 0.3 fmol/dish), with no significant change in the receptor affinity, activity of CK, or lactate dehydrogenase (LDH), protein content or cell number. The observed up- and down-regulation of A1 adenosine receptors in primary myocyte cultures in response to conditions that exogenously alter the rate of contraction, is indicative of the role of adenosine receptors in adaptation of heart cells to stress.     

Gastrointestinal metabolism of cadmium in experimental iron deficiency;

The average gastrointestinal uptake 4 h after an intragastric dose of 400 nmol of cadmium chloride labeled with 109CdCl2 in iron-deficient mice, 25%, was significantly greater than the result, 16%, in iron-normal animals, and more cadmium entered the body of the former, 3.8%, than the latter, 2% (P less than 0.05). Between 4 and 72 h, gastrointestinal radioactivity declined without further increase in body activity; however, more radiocadmium remained in the duodenum of iron-deficient than iron-normal animals (P less than 0.05). The radiocadmium sequestered in the duodenum was bound to a protein with a molecular weight of about 12,000. After subcutaneous injection of radiocadmium, the rate of excretion of radioactivity from the body was similar in iron-normal and iron-deficient mice; however, a greater proportion of the injected dose accumulated in the duodenum of the iron-deficient animals (P less than 0.05). Thus, the intestinal adapative response to iron deficiency may enhance cadmium toxicity, whereas sequestration and subsequent excretion of cadmium by the intestinal mucosa serves to protect the body against toxic effects. The duodenum, particularly in iron-deficient mice, is especially vulnerable to the toxic effects of cadmium.     

Ultrastructural changes in the liver in experimental diffuse peritonitis

Experiments were performed to detect "alkali" and "acid" carboxypeptidases in 39 enzymic preparations from fungi, yeast, actinomyces, bacteria and algae. Distribution of both types of carboxypeptidases is different: they are absent in the six of the studied sources, there are no "acid" carboxypeptidases in 11 sources and no "alkali" in nine ones. The largest amount of carboxypeptidases is in the objects from fungi and actinomycetes, the least, in those from bacteria and algae. There is no correlation between synthesis of these enzymes by one microorganism. Thus, fungi produce mainly "acid" enzymes, and actinomycetes only "alkali" ones. Asp. oryzae and Asp. flavus are powerful producers of the former, Streptomyces griseus of the latter. Specific activities 15-20 times as high as all the already studied ones are obtained for the preparations isolated from Str. griseus (protezym, proteinase-1, proteinase-3, crystal line complex of proteases). Carboxypeptidase of Str. griseus is relatively stable in comparison with "acid" ones in purification and concentration.