Secretion by parafollicular cells beginning at birth: ultrastructural evidence from developing canine thyroid

The ultrastructure of developing canine parafollicular cells has been examined. The hypothesis that secretion is relatively inactive prior to birth but very active at and following birth was tested. Parafollicular cells develop and accumulate characteristic secretory granules prior to birth. However, there is little or no evidence of exocytosis at this time. At birth and during the neonatal period, but not in adult thyroids, signs of exocytosis of granular contents by parafollicular cells are abundant. Just prior to the expected date of birth and before evidence of exocytosis appears, parafollicular cells accumulate intracisternal granules within rough endoplasmic reticulum. These observations are consistent with the view that parafollicular cells first become actively secretory around the time of birth and are more active at this time than in early fetal or later adult life.     

Diabetes mellitus in dogs: a study of the critical difference for canine serum fructosamine

The purpose of this study was to calculate the critical difference between two analytical measurements of serum fructosamine concentration in dogs. The critical difference can be used to judge whether the difference between two consecutive analytical results from the same animal is due to natural variation. Blood samples from 15 apparently clinically healthy beagle dogs were collected once a week for six consecutive weeks. The serum fructosamine concentration was measured by the reduction test with nitroblue tetrazolium and the critical difference was calculated from the component of variance for weeks within dogs (sigma2s) and the residual variance (sigma2e). The critical difference between two consecutive analytical results was 33.5 micromol/litre.     

Refined mapping of a gene responsible for Fukuyama-type congenital muscular dystrophy: evidence for strong linkage disequilibrium

Fukuyama-type congenital muscular dystrophy (FCMD), the second most common form of childhood muscular dystrophy in Japan, is an autosomal recessive severe muscular dystrophy associated with an anomaly of the brain. After our initial mapping of the FCMD locus to chromosome 9q31-33, we further defined the locus within a region of approximately 5 cM between loci D9S127 and CA246, by homozygosity mapping in patients born to consanguineous marriages and by recombination analyses in other families. We also found evidence for strong linkage disequilibrium between FCMD and a polymorphic microsatellite marker, mfd220, which showed no recombination and a lod score of (Z) 17.49. A "111-bp" allele for the mfd220 locus was observed in 22 (34%) of 64 FCMD chromosomes, but it was present in only 1 of 120 normal chromosomes. This allelic association with FCMD was highly significant (chi 2 = 50.7; P < .0001). Hence, we suspect that the FCMD gene could lie within a few hundred kilobases of the mfd220 locus.     

The natural history of asymptomatic carotid artery disease

PURPOSE: The purpose of this article is to determine the natural history of carotid artery disease among asymptomatic patients with cervical bruits or other risk factors for stroke and to study the value of duplex ultrasonography in predicting future neurologic events. METHODS: Two hundred forty-two asymptomatic, unoperated patients, referred for evaluation of asymptomatic carotid artery disease, were followed prospectively with duplex ultrasonography. RESULTS: Fifteen ischemic strokes (6.2%) and 20 transient ischemic attacks (TIA) (8.3%) occurred in 34 patients during a mean follow-up of 27.4 months. Annual stroke, TIA, and combined event rates were 2.7%, 3.6%, and 6.2%, respectively. Although patients with 80% to 99% lesions had a 20.6% annual event rate, most events occurred contralateral to these lesions; the vessel-specific annual event rate for 80% to 99% disease was 5.1%. Only one of 15 strokes occurred ipsilateral to an 80% to 99% stenosis. Echolucent plaques were associated with TIA and stroke (5.7% annual vessel event rate vs 2.4% for echogenic plaques, p = 0.03). Disease progression was highly correlated with TIA and stroke (p < 0.0001), but it usually occurred in association with rather than before ischemic events, thus proving more useful in explaining pathogenesis than in predicting future events. There was no association between aspirin use and TIA, but patients taking aspirin had a threefold higher annual stroke rate (1.6% vs 4.8%, p = 0.027). CONCLUSIONS: This study, while confirming significant risk for asymptomatic patients with critical stenosis or echolucent plaque, demonstrates the importance of contralateral disease and the absence of orderly progression from minimal disease through high-grade stenosis to symptomatic cerebral ischemia. TIA and stroke commonly occur in association with abrupt, unpredictable, quantum changes in carotid artery disease.     

Microbial immunology: a new mechanism for immune subversion

The number of mechanisms that have evolved in microbes to subvert the immune response seems limitless. Tubercle bacilli have found a novel way to coat themselves with the C3 complement protein and invade macrophages by interactions with complement receptors.     

Carotid endarterectomy for asymptomatic carotid artery stenosis: patients with severe bilateral disease a high risk subgroup

Carotid endarterectomy if advised for asymptomatic disease must be associated with a low peri-operative morbidity and mortality and satisfactory long-term results. Over a 12 year period between 1978-1989 181 carotid endarterectomies were performed on 163 patients with asymptomatic carotid artery stenosis. There were 112 males and 51 females with a mean age of 64.9 years. All patients had a high-grade lesion (> 70% stenosis). The combined operative mortality and stroke rate was 2.8%. On long-term follow up six patients suffered a stroke. Only one patient however sustained a stroke in the same territory as the previously operated carotid artery. Four years following surgery 78% of patients were alive. Carotid restenosis or occlusion occurred in 8.3% of the remaining patients, all of whom were asymptomatic. All the immediate postoperative strokes occurred in patients with severe bilateral carotid artery disease. These patients with severe bilateral disease appear to constitute a high risk sub-group for peri-operative stroke. The role of 'normal pressure-hyperperfusion breakthrough' syndrome as the presumed aetiology of two of the postoperative cerebral haemorrhages is discussed.     

Profile of some risk factors for coronary heart disease in a developing country: Nigeria

We examined visual evoked potentials and pattern electroretinograms in a patient with Tolosa-Hunt syndrome associated with optic nerve involvement. The 82-year-old woman developed unilateral painful ophthalmoplegia and visual loss in the right eye. Magnetic resonance imaging showed an abnormal soft-tissue area in the right cavernous sinus and the right orbital apex. Symptoms responded rapidly to treatment with corticosteroid. Visual evoked potentials to flash and pattern stimuli were both remarkably reduced and delayed in the right eye in the acute stage; however they improved to almost normal after steroid therapy. The pattern electroretinogram recorded in the acute stage was normal bilaterally. These results indicate that optic nerve involvement in Tolosa-Hunt syndrome can be mild and reversible.     

Carotid endarterectomy for asymptomatic carotid stenosis: a meta-analysis

OBJECTIVE: To assess the value of carotid endarterectomy for prevention of stroke in patients with asymptomatic carotid stenosis. DESIGN: Systematic review and meta-analysis of randomised controlled trials in patients with asymptomatic carotid stenosis in which subjects were allocated to carotid endarterectomy or to medical treatment alone. SUBJECTS: Five trials enrolled 2440 patients with stenosis >/ 50%. MAIN OUTCOME MEASURES: Stroke ipsilateral to the stenosis, all strokes, and perioperative complications (stroke or death). RESULTS: In patients who underwent carotid endarterectomy (n=1215) there was a significant reduction in the odds of ipsilateral stroke plus perioperative stroke or death (odds ratio 0.62; 95% confidence interval 0.44 to 0.86), corresponding to a 2% absolute risk reduction over about 3.1 years. The prevalence of stroke in any location was also reduced (0.68; 0.51 to 0.9) in patients undergoing carotid endarterectomy. During the immediate postoperative period there was an increased prevalence of stroke or death among such patients (4.51; 2.36 to 8.64). CONCLUSION: Carotid endarterectomy in patients with asymptomatic carotid stenosis unequivocally reduces the incidence of ipsilateral stroke, though the absolute benefit is relatively small. Given the modest benefit of surgery for unselected patients with asymptomatic carotid artery stenosis carotid endarterectomy cannot be routinely recommended for these patients pending reliable identification of high risk subgroups, and medical management is a sensible alternative for most patients.     

Murine leishmaniosis: a paradigm for the importance of T helper 1 and T helper 2 cells

The murine model of leishmaniosis is a prototypic example for the critical role played by T helper cells in immunity to pathogens. Cytokines, such as interleukin-12 and interleukin-4, are the major regulatory factors for differentiation of naive T helper cells into T helper 1 and T helper 2 cells, respectively. T helper 1 cells, which are cellular immune mechanisms involving gamma interferon production, are associated with protection against murine leishmaniosis. Loss of T helper 1 activity (i.e., reduced gamma interferon production and lack of macrophage activation) leads to a fatal progressive course of murine leishmaniosis. Knowledge of the murine model of leishmaniosis is now contributing to studies of infectious diseases in humans, livestock and companion animals. Greater insight into the pathogenesis, diagnosis and therapy of infectious diseases will be gained from the analysis of cytokine-dependent regulation of T helper responses during infection. In particular, the development of prophylactic and therapeutic vaccines will benefit significantly from these studies.     

Identification of body parts in Alzheimer's disease: evidence for a body schema hypothesis

This study examined the ability of patients with Alzheimer's Disease (AD) to perform a Body Part Identification (BPI) task, and also explored the relationship between BPI, intellectual level, severity of cognitive impairment and the general insight of patients into their disorder. The results showed that although AD patients are not always impaired on BPI, the degree of impairment correlates with the level of cognitive impairment measured using the Mini-Mental State Examination. The study also showed that BPI is not, however, associated with level of insight into their illness. Taken together these results provide support for the existence of a body schema that can be disrupted by AD, but is independent of the degree of insight into the illness.     

The organization of arithmetic facts in memory: evidence from a brain-damaged patient

We report a single case study of a brain-damaged patient with impaired arithmetic performance. Three principal findings are presented: First, in a task involving production of answers to simple arithmetic problems, the patient's performance was far better for subtraction than for addition or multiplication. Second, in all arithmetic operations performance was generally much better for problems potentially solvable by rule (e.g., 5 + 0) than for problems requiring retrieval of specific facts (e.g., 5 + 3). Third, the dissociation between subtraction and the other arithmetic operations obtained in the production task was not observed in a verification task. The implications of these findings for claims concerning the organization of stored arithmetic facts are discussed.     

Implicit learning in Parkinson''s disease: evidence from a verbal version of the serial reaction time task

Reinvestigation of the root of Rhinacanthus nasutus afforded, in addition to rhinacanthin-A to -D reported previously, two new dimethyldihydropyranonaphthoquinone esters (5, 6) and eight new 2-hydroxy-1,4-naphthoquinone esters (7-14) were isolated. The stereochemistry of rhinacanthin-A was determined as the R configuration. Compounds rhinacanthin-G to -N, belong to a class of 2-hydroxy-3-(3-hydroxy-2,2-dimethylpropyl)-1,4-naphthoquinone esters, and so far have been isolated only in this plant. Their biosynthesis is also discussed.