Food and food additives hypersensitivity in adult asthmatics. III. Adverse reaction to sulfites in adult asthmatics

To improve the survival rate of patients with esophageal cancer, several protocols of a preoperative combination of chemotherapy and radiotherapy, known as chemoradiation therapy, have been developed, recently characterized by the combination of 5-fluorouracil (5-FU), cisplatin, and radiation. Although some of these combinations have been demonstrated to be effective, the optimal chemoradiation dose and schedule are not yet precisely established. Recent investigations have elucidated that the radiosensitizing effects of cisplatin are able to be achieved more effectively by the daily administration of cisplatin before each fraction of radiation. Based on these investigations, we report herein the case of a patient with esophageal cancer with direct invasion to the trachea, in whom a complete response was achieved by the continuous administration of 5-FU, 600 mg/m2 per day, from days 1-5 combined with the daily administration of low-dose cisplatin, 10 mg/m2 per day before each fraction of radiation, given as 2Gy each time, throughout the entire treatment period of 3 weeks beginning on day 1. The benefits of our preoperative chemoradiation therapy included no severe side effects, down-staging and resectability of the tumor, as well as a pathological complete response, which could prolong the survival time. Our experience of this case prompts us to recommend the concurrent daily preoperative chemoradiation therapy for patients with locally advanced esophageal cancer.     

Calcific tendinitis in the posterior proximal thigh as a self-limited condition: pathogenic role of inflammatory responses

OBJECTIVE: Calcific tendinitis occurs rarely in the posterior proximal thigh. We investigated whether it is self-limited and how the natural course of the disease progresses. METHODS: We treated 6 patients with no surgical intervention, and analyzed laboratory and radiological findings in the followup period of more than one year (average followup, 2.5 yrs). RESULTS: Although tendinitis was severe, rapid relief was observed within 2 weeks (average 5 days). Radiological features including extraskeletal calcifications did not change within 2 weeks, and then improved by 6 weeks. Four of 6 cases showed abnormal laboratory variables. All elevated white blood cell counts and C-reactive protein levels improved within one week with clinical resolution. In comparison with time course of the symptoms, changes in the radiological findings over time appeared not to be parallel with the clinical course, but laboratory progression appeared to correspond well with clinical resolution. CONCLUSION: Inflammatory responses to hydroxyapatite crystals may play a role in the pathogenesis of symptoms of calcific tendinitis in the posterior proximal thigh, most of which are self-limited.     

The effect of supplemental propionate on insulin responsiveness to glucose and tissue responsiveness to insulin in relation to feeding in sheep

BACKGROUND: Very little is known about the pharmacokinetics of neuroleptic drugs in breast-feeding mothers and their infants or about possible adverse effects in the infants. METHOD: Twelve mothers who breast-fed their infants were prescribed haloperidol, chlorpromazine or trifluoperazine. Two methods, enzyme immunoassay (EIA) and high performance liquid chromatography (HPLC) were used to assay these drugs in samples from mothers, but infants' samples were assayed only by the more sensitive EIA. Repeated clinical and developmental assessments of the breast-fed infants were carried out up to 30 months of age. The control subjects were 18 bottle-fed infants whose mothers were also prescribed neuroleptic or mood-stabilizing drugs. RESULTS: The total concentrations of neuroleptic drugs and their principal metabolites in maternal plasma were correlated with concentrations in fore-milk. Infants were ingesting up to 3% of the maternal daily dose per kg body weight and small amounts of the drugs were detected in infants' plasma and urine. Concentrations of haloperidol in the adult range were found in plasma from 2 of 5 infants assayed by EIA but there was no evidence of any acute or delayed adverse effects. Three other breast-fed infants whose mothers were prescribed both haloperidol and chlorpromazine showed a decline in their developmental scores from the first to the second assessment at 12-18 months. CONCLUSION: More extensive longitudinal studies are needed but, in the meantime, there appears to be grounds for caution if breast-feeding mothers are prescribed doses of single or two neuroleptic drugs at the upper end of their recommended ranges.     

Demonstration of two anomalous bypasses in concealed Wolff-Parkinson-White syndrome

Two patients with a history of paroxysmal supraventricular tachycardia but no evidence of the Wolff-Parkinson-White syndrome in the conventional electrocardiograms were studied utilizing atrial and ventricular extrastimuli. The evidence obtained in these patients was consistent with a concealed Wolff-Parkinson-White syndrome. In one patient, ventricular extrastimuli revealed three different responses in the curve of ventriculoatrial conduction, depending upon the interval of stimulus. In the other patient, intracardiac recordings, including the left atrial potential, showed that paroxysmal supraventricular tachycardia was induced by an impulse via an anomalous bypass which diverged from the main bypass or stemmed independently from the left ventricle and was maintained by impulses via the main bypass which lay between the left ventricle and the left atrium. The mechanisms for initiation of the paroxysmal supraventricular tachycardia were discussed.     

Cognitive test performance among nondemented elderly African Americans and whites

We examined the neuropsychological test performance of a randomly selected community sample of English-speaking non-Hispanic African American and white elders in northern Manhattan. All participants were diagnosed as nondemented by a neurologist, whose assessment was made independent of neuropsychological test scores. African American elders obtained significantly lower scores on measures of verbal and nonverbal learning and memory, abstract reasoning, language, and visuospatial skill than whites. After using a stratified random sampling technique to match groups on years of education, many of the discrepancies became nonsignificant; however, significant ethnic group differences on measures of figure memory, verbal abstraction, category fluency, and visuospatial skill remained. Discrepancies in test performance of education-matched African Americans and whites could not be accounted for by occupational attainment or history of medical conditions such as hypertension and diabetes. These findings emphasize the importance of using culturally appropriate norms when evaluating ethnically diverse elderly for dementia.     

A streptavidin mutant with altered ligand-binding specificity

The biotin-binding site of streptavidin was modified to alter its ligand-binding specificity. In natural streptavidin, the side chains of N23 and S27 make two of the three hydrogen bonds with the ureido oxygen of biotin. These two residues were mutated to severely weaken biotin binding while attempting to maintain the affinity for two biotin analogs, 2-iminobiotin and diaminobiotin. Redesigning of the biotin-binding site used the difference in local electrostatic charge distribution between biotin and these biotin analogs. Free energy calculations predicted that the introduction of a negative charge at the position of S27 plus the mutation N23A should disrupt two of the three hydrogen bonds between natural streptavidin and the ureido oxygen of biotin. In contrast, the imino hydrogen of 2-iminobiotin should form a hydrogen bond with the side chain of an acidic amino acid at position 27. This should reduce the biotin-binding affinity by approximately eight orders of magnitude, while leaving the affinities for these biotin analogs virtually unaffected. In good agreement with these predictions, a streptavidin mutant with the N23A and S27D substitutions binds 2-iminobiotin with an affinity (Ka) of 1 x 10(6) M-1, two orders of magnitude higher than that for biotin (1 x 10(4) M-1). In contrast, the binding affinity of this streptavidin mutant for diaminobiotin (2.7 x 10(4) M-1) was lower than predicted (2.9 x 10(5) M-1), suggesting the position of the diaminobiotin in the biotin-binding site was not accurately determined by modeling.     

Solubility of BaS in BaO-BaF2 slag and the Influence of FeOx,SiO2, Cr2O3, BaCI2, CaO,and MgO on the sulfide capacity of this system

The influence of SiO₂, FeO_x, Cr₂O₃, BaCl₂, CaO, and MgO on the sulfide capacity of the BaO-BaF₂ system was measured at 1473 K, using a gas-slag-metal equilibration technique. It was found that the substitution of BaF₂ by SiO₂, FeO_x, Cr₂O₃, and BaCl₂ decreases the sulfide capacity of the BaO-BaF₂ system. Similar results were obtained for the carbonate capacity. The CaO-saturated BaO-BaF₂ flux, however, was found to have slightly higher sulfide and carbonate capacities than the pure BaO-BaF₂ flux. The solubility of CaO increased with increasing BaF₂ content and was 18 mol pet in BaF₂ at 1473 K. The solubility of MgO in the BaO-BaF₂ system at the same temperature is very low, and it has no effect on the sulfide and carbonate capacities. The solubility of BaS in the BaO-BaF₂ system was also measured at 1473 K and had its maximum for the slag containing 40 mass pet BaO. The activity of BaO in the system was calculated from those data. IVAN P. RACHEV, formerly Graduate Student, Department of Metallurgy, The University of Tokyo.