Gonadal hormonal activity in males with chronic alcoholic intoxication

Study of the hormonal activity of the gonads of 97 males suffering from chronic alcoholism was undertaken to investigate the effects on hormonal secretion. An increased synthesis of androgens and estrogens was noted. The regularity of this increased with the duration of alcoholism. It is thought that the increased synthesis of sex hormones in chronic alcoholism is a defense adaptation directed to reducing the unfavorable effects of high concentration of alcohol in the blood. Alcoholism treatment involving teturam along with abstinence of alcohol caused a decrease in the functional activity of gonads, indicating the reversibility of this effect. The nature of functional alteration in the synthesis of sex hormones shows that it plays an essential role in the genesis of sexual impotence in alcoholism, through dyshormonal disruption of the endocrinal system.     

Origin of tonic electrical activity patterns in the diaphragm of the fetal lamb

The respiratory pattern generator in fetal and postnatal life activates the phrenic nucleus and diaphragm muscle with phasic bursts of activity. In the fetus, diaphragmatic activity is also characterized by tonic activity patterns of unknown origin. We have examined whether such activity is diaphragmatic, or radiated from nearby ribcage muscles, by placing two sets of electrodes side-by-side in the costal portion of the diaphragm in five fetuses. The rationale for this approach is that if tonic activity, radiates to the diaphragm it should be recorded by both sets of electrodes and there should be no delay between the action potentials from each set of electrodes. Of 24 single tonic units identified, 15 were recorded from only one of the two sets of electrodes in the diaphragm. In the 9 tonic units recorded from both sets of electrodes, there was a time delay between the appearance of the action potentials in the two recordings (mean +/- S.E.M. 1.6 +/- 0.2 ms). This is the expected conduction delay along the muscle fibres separating the two electrodes. Since tonic diaphragmatic activity persisted in fetuses with the spinal cord transected rostral or caudal to the phrenic nucleus, we conclude that the spinal cord alone is sufficient to produce the tonic activity recorded from the fetal diaphragm but that the brain may also generate such activity.     

MRI of the pituitary adenomas with reference to the hormonal activity

Many studies in Magnetic Resonance Imaging (MRI) of pituitary adenomas are already performed. However, few reports exist about MRI findings of pituitary adenomas with reference to the hormonal activity, therefore, we evaluated this problem on the viewpoint of the signal intensity in MRI and pathological features. Fifteen patients with growth hormone producing adenoma (GH-group), 6 patients with prolactin producing adenoma (PRL-group), 15 patients with endocrinologically non-functioning adenoma (Null-group) and 9 cases with normal pituitary gland (normal control group) were examined. Signal intensity values in adenoma (or anterior lobe in normal control group) and in pons as standard value were measured in each cases, then their rates were calculated as signal intensity ratio (SIR). In 24 cases (14 in GH-group, 3 in PRL-group, 7 in Null-group), cellular density were examined with surgically resected specimens. In the T1-weighted images (T1 WIs), PRL-group and Null-group presented more hypointense tendency than normal control group. In the T2-weighted images (T2 WIs), only Null-group presented more hyperintense tendency than other groups. But significant correlation was not observed between SIR and cellular density.     

Upper airway muscle activity in normal women: influence of hormonal status

Obstructive sleep apnea is a disorder with a strong male predominance. One possible explanation could be an effect of female hormones on pharyngeal dilator muscle activity. Therefore, we determined the level of awake genioglossus electromyogram (EMGgg) and upper airway resistance in 12 pre- and 12 postmenopausal women under basal conditions and during the application of an inspiratory resistive load (25 cmH2O . l-1 . s). In addition, a subgroup of eight postmenopausal women were studied a second time after 2 wk of combined estrogen and progesterone replacement in standard doses. Peak phasic and tonic genioglossus activity, expressed as a percentage of maximum, were highest in the luteal phase of the menstrual cycle (phasic 23.9 +/- 3.8%, tonic 10.2 +/- 1.0%), followed by the follicular phase (phasic 15.5 +/- 2.2%, tonic 7.3 +/- 0.8%), and were lowest in the postmenopausal group (phasic 11.3 +/- 1.6%, tonic of 5.0 +/- 0.6), whereas upper airway resistance did not differ. There was a weak but significant positive correlation between progesterone levels and both peak phasic (P < 0.05) and tonic (P < 0.01) EMGgg. Finally, there was a significant increase in EMGgg in the postmenopausal group restudied after hormone therapy. In conclusion, female hormones (possibly progesterone) have a substantial impact on upper airway dilator muscle activity.     

Absence of tonic electromyographic activity during sleep in normal and spastic nonmimetic skeletal muscles in man

An electromyographic study of nonmimetic skeletal muscles was carried out in 8 normal adults and 4 patients with spastic hemiparesis during all stages of sleep for a total of 21 nights. All normal subjects showed absence of tonic electromyographic activity in all nonmimetic skeletal muscles in all stages of sleep. Also, during quiet, relaxed wakefulness, tonic muscle discharges disappeared in the normal subjects. Three patients with upper motor neuron spasticity demonstrated results during sleep similar to those obtained in the normal subjects. In the fourth patient, tonic muscle discharges persisted into stage 2 non-REM sleep, disappeared within 30 to 240 seconds following the onset of stage 2 sleep, and were absent during stages 3 and 4 sleep and REM sleep.     

p-Chloroamphetamine: Effects on tonic immobility, activity, and temperature in chickens.

The effects of parachloroamphetamine (PCA) on tonic immobility (TI) duration, activity, and temperature in 216 Production Red chickens were examined in 6 experiments. 10 or 15 mg/kg PCA ip produced a significant attenuation of TI duration. Involvement of norepinephrine or dopamine in this effect was considered questionable, since catecholamine synthesis inhibition with alpha-methylparatyrosine did not alter PCA attenuation of TI duration. However, serotonin synthesis inhibition with parachlorophenylalanine produced a blockade of the PCA effect on TI when Ss were tested 60 min after PCA. A competing response interpretation of the PCA effect in terms of enhanced motor activity was ruled out, since, in contrast to the hyperactivity observed in mammals, PCA produced a decrease in both open-field and stabilimeter activity. A PCA-induced decreased in core temperature was observed in Exp VI. Together with previous findings, results suggest a mammalian–avian reversal in drug effects. (57 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contribution of tonic chemoreflex activation to sympathetic activity and blood pressure in patients with obstructive sleep apnea

BACKGROUND: Muscle sympathetic nerve activity (MSNA) is increased in patients with obstructive sleep apnea (OSA). We tested the hypothesis that tonic activation of excitatory chemoreceptor afferents contributes to the elevated sympathetic activity in OSA. METHODS AND RESULTS: Using a double-blind, randomized, vehicle-controlled design, we examined the effects of chemoreflex deactivation (by comparing effects of breathing 100% oxygen for 15 minutes with effects of breathing room air for 15 minutes) on MSNA, heart rate, blood pressure, and minute ventilation in 14 untreated patients with OSA and in 12 normal subjects matched for age and body mass index. All control subjects underwent overnight polysomnography to exclude the existence of occult OSA. Baseline MSNA was markedly elevated in the patients with OSA compared with the control subjects (44+/-4 versus 30+/-3 bursts per minute; P=.01). In both control subjects and patients with OSA, heart rate decreased during administration of 100% oxygen but did not change during administration of room air. By contrast, both MSNA (P=.008) and mean arterial pressure (P=.02) were significantly reduced during chemoreflex deactivation by 100% oxygen only in patients with OSA but not in control subjects. CONCLUSIONS: Tonic activation of excitatory chemoreflex afferents may contribute to increased efferent sympathetic activity to muscle circulation in patients with OSA.     

Benign paroxysmal tonic upward gaze syndrome

INTRODUCTION: The benign paroxysmal tonic upward gaze syndrome (BPTUG) is a rare condition. We present two new cases analyzing the clinical, genetic, evolution and therapeutic aspects. CLINICAL CASES: Case 1. A 2 year-old girl with no family history of similar disorders started, at the age of 6 months, to have episodes of upward deviation of gaze with hyperextension of the neck and vertical nystagmus of fixation, increased by nervousness and episodes of fever. Some episodes caused the patient to fall in spite of there being no alteration of consciousness. Case 2. From the age of five months a 1 year-old girl with no significant personal or family history had episodes of ocular deviation upwards with forward inclination of the head to correct her gaze and slow motor development from the age of five months. RESULTS: Complementary studies were normal in both patients. As in the cases described in the literature, our cases had no family history and were not sensitive to Dopa. To date 11 children have been described in the literature and few familial cases seen with dominant autosomal inheritance. CONCLUSIONS: Our patients had a non-epileptic paroxystic phenomenon known as BPTUG syndrome. This condition starts during the first year of life, has a benign course and the episodes have ceased by the age of four years. We believe it is important to consider the differential diagnosis with epileptic phenomena, evaluate the response to L-Dopa and bear in mind that this syndrome may be the clinical expression of several different conditions. Although the course is usually benign, it may later be associated with other signs of neurological problems which should be taken into account.     

Decreased nitric-oxide synthase activity causes impaired endothelium-dependent relaxation in the postischemic heart

Endothelial nitric-oxide synthase (eNOS) is an important regulator of endothelial function and vascular tone in biological tissues. While endothelial dysfunction occurs following ischemia and has been attributed to altered NO. formation, the biochemical basis for this dysfunction is unknown. Therefore, studies were performed to determine the effects of myocardial ischemia and reperfusion on eNOS in isolated rat hearts subjected to periods of global ischemia or ischemia followed by reperfusion. eNOS activity was assayed by L-[14C]arginine to L-[14C]citrulline conversion and alterations in the amount and distribution of eNOS determined by Western blotting and immunohistochemistry. While activity was preserved after 30 min of ischemia with a value of 1.1 +/- 0.1 pmol x min-1 x mg of protein-1, it decreased by 77% after 60 min and became nearly undetectable after 120 min. Reperfusion resulted in only a partial restoration of activity. The decline in activity with ischemia was due, in part, to a loss of eNOS protein. Hemodynamic studies showed that the onset of impaired vascular reactivity paralleled the loss of functional eNOS. Subjecting isolated eNOS to conditions of acidosis, which occur during ischemia, followed by restoration of pH as occurs on reperfusion, caused a combination of reversible and irreversible loss of activity similar to that seen in ischemic and reperfused hearts. Thus, loss of endothelial function following ischemia is paralleled by a loss of eNOS activity due to a combination of pH-dependent denaturation and proteolysis.     

Duodenal atresia in dizygotic twins

The authors report duodenal atresia occurring in both members of dizygotic twins who showed no signs of Down's syndrome, and both had normal chromosomal constitutions. They both had the two unlinked end type of atresia in the second portion of the duodenum, and direct end-to-end duodenoduodenostomy was carried out. Their postoperative courses were smooth, and both babies were discharged 32 days after birth. Their mother underwent pituitary adenoma removal and partial parathyroidectomy for multiple endocrine neoplasia (MEN-type I). She had been given hormonal supplement therapy after surgery and became pregnant after exogenous gonadotropin therapy. Environmental factors may be responsible for some cases of duodenal atresia.     

Duodenal obstruction from chronic pancreatitis

The fibrosclerosing process of the pancreas in the chronic pancreatitis may constrict not only the pancreatic duct but also the bile duct, splenoportal venous system and duodenum. In our retrospective study we analysed 24 patients with duodenal obstruction associated with chronic pancreatitis. Duodenal obstruction was suspected whenever repeated vomiting occurred or large volumes of nasogastric aspirate were obtained. The diagnosis was confirmed by barium meal and endoscopic examination. Duodenal obstruction was relieved by gastrojejunostomy in eight patients, gastrojejunostomy and vagotomy in eight patients, gastroduodenostomy and vagotomy in two patients, vagotomy with Finney pyloroplasty in one patient, duodenoplasty with vagotomy in one patient and Whipple procedure in four patients. We concluded that vagotomy and gastroenterostomy are the procedures of choice. Bypass surgery is helpful to relieve the obstruction of the common bile duct and pancreatic duct. Whipple procedure should be reserved for the small duct form of chronic pancreatitis and for the cases in which there is high suspicion of malignancy.     

Gin and tonic and reactive hypoglycemia: what is important-the gin, the tonic, or both?

STUDY OBJECTIVES: To assess the short- and long-term effects of balloon dilatation using a fiberoptic bronchoscope in the management of benign tracheobronchial stenosis (TBS). Treatment strategies have included open surgical resection or endoscopic techniques. The endoscopic techniques have included Nd:Yag laser, cryotherapy, stent placement, rigid bronchoscopy, and balloon dilation (BD). DESIGN: Prospective sequentiality study. SETTING: Tertiary care academic hospital. PATIENTS: This study consisted of 14 patients, ages ranging from 35 to 72 years, whose symptoms of dyspnea, cough, or wheeze were attributable to a TBS. INTERVENTION: This study describes the use of flexible fiberoptic bronchoscopy (FFB) with a balloon catheter for airway dilation. Each patient underwent FFB, in which a balloon catheter was threaded over the guidewire and positioned across the stenosis. Under direct visualization, the balloon was inflated for 30 to 120 s. Repeat inflation-deflation cycles were done if airway narrowing remained after the initial attempt. RESULTS: Seven patients had TBS following lung transplantation, three after sleeve resection, two following irradiation therapy, and two due to fibrosing mediastinitis. All patients had initial success: increased airway dimensions and symptom relief. Ten patients had successful airway dilation after one session. Of the four patients who required multiple sessions, one had cryotherapy and in each of the others an airway stent was placed. CONCLUSIONS: BD offers immediate symptom relief and can be used in conjunction with Nd:Yag laser, cryotherapy, stent placement, or mechanical dilation with a rigid bronchoscope. The advantages of FFB with BD include operator familiarity, patient safety, and avoidance of general anesthesia.     

Atropine poisoning after drinking Indian tonic water

After 13.5 years in vivo a 2-0 Terylene frontalis loop was excised because of an insufficiency. Histology showed a persisting giant cell reaction while lymphocytes were almost totally absent. The fibrils of the suture seemed to be intact. However, they were separated by ingrowing connective tissue which, on theoretical grounds, should improve the function of the frontal muscle on the upper eyelid. Therefore, insufficiency of the loop was probably caused by the (subclinical) foreign body reaction or the long-lasting mechanical stress leading to tissue damage.     

Postnatal testicular secretions partially restore the disturbances in reproductive activity caused by prenatal hormonal manipulation

A new method of local gentamicin administration was tested in the bullfrog inner ear to achieve ototoxic-induced hair cell destruction. Gelfoam pledgets soaked with known amounts of gentamicin were inserted into the perilymphatic cisterna of the bullfrog through a ventral surgical approach. A dose of 1.20 mg gentamicin, consistent with a perilymphatic concentration of 65 microg/ml, resulted in the desired ototoxic-induced hair cell damage, that is, complete hair cell destruction with minimal disruption of other components of the sensory epithelium. This study demonstrates that this is a useful and simple method to investigate the process of vestibular ototoxicity and hair cell regeneration, including aspects of hair cell destruction and repair.     

Habituation and tonic immobility in domestic chickens

The habituation of tonic immobility in chickens was examined in six studies. It was shown that repeated elicitation of immobility, and not just handling, was responsible for reduced response durations after multiple exposures to manual restraint. Habituation was a function of the number of stimulus presentations and, in addition, proved surprisingly durable, with diminished reactions using lasting at least 2.5 mo. Strain differences were found in the number of trials required to reach a criteria of habituation, and habituation proceeded faster when immobility termination was self-paced as opposed to experimenter induced. Also, massed trials produced robust sensitization effects rather than diminished responsiveness.     

Duodenal tuberculosis: a difficult diagnosis

BACKGROUND: The polymorphous clinical presentation of tuberculosis located in the duodenum may mislead diagnosis. CASE REPORT: A 69-year-old man had duodenal stenosis associated with calculous common bile duct obstruction. Crohn's disease was initially diagnosed and the patient was treated with corticosteroids. Two months later, the diagnosis was rectified when pulmonary tuberculosis developed. DISCUSSION: This case emphasizes the lack of specific clinical, radiological, endoscopic and histological signs of duodenal tuberculosis.