Use of cholinesterase inhibitors in Alzheimer disease

According to the cholinergic theory of Alzheimer's disease, the cognitive failure depends on a deficit in acetylcholine. The study reported above examines the efficacy and tolerability of cholinesterase inhibitors, such as tetrahydroamino acridine (THA), for the management of this pathology.     

An analysis of the reliability of 2 types of enteral nutrition pumps

The main advantages of infusion pumps are their enhanced accuracy and safety in providing enteral nutrition. We proposed to observe pumps reliability in connection with a variety of factors such as the type of pump used, the administration rate and the energy density of the diets used. An experimental design was prepared with two types of enteral nutrition pumps-VP, volumetric pump, and PP, peristaltic pump. The clinical simulation was done by connecting the enteral nutrition equipment to a graduated dosing system, making hourly measurements of the volume infused. The Reliability Index (RI) used was the ratio between the volume infused by the pump and the regulated dose (Vi/Do). Five volumetric pumps (FLEXIFLO COMPANION) and five peristaltic pumps (FLEXIFLO II) were selected at random from a single commercial outlet. Each was used for twenty-three hours, without interruption, to infuse five types of diet with different energy densities (D1:2 Kcal/ml, D2: 1.5 Kcal/ml, D3: 1.25 Kcal/ml, D4: diet with fibre, and D5: reconstituted powder diet) at three different flow rates (40, 80 and 120 ml/h), to provide fifteen experimental conditions with each pump. Reliability was maintained for both types of pump within the margin of error claimed by the manufacturer (+/- 10%) except in the first hour of infusion (RI = 71.4%). Comparison of the overall RI between the two pump types revealed significant differences, with an RI below the reference range for the VP only during hour 23 (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)     

Scleromyxedema (papular mucinosis): a surgical perspective

OBJECTIVE: To study the expression of adrenomedullin, a potent vasodilator peptide originally isolated from a pheochromocytoma, in ectopic ACTH-secreting tumors. METHODS: Tumor tissue concentrations of adrenomedullin, calcitonin gene-related peptide, neuropeptide Y, endothelin-1, corticotropin-releasing hormone and ACTH were measured in three ectopic ACTH-secreting tumors by RIA. The expression of adrenomedullin mRNA was examined by northern blot analysis of tissue from one of the tumors. RESULTS: Immunoreactive adrenomedullin was detected in tumor tissues of three ectopic ACTH-secreting tumors (0.60-18.5 pmol/g wet weight). Calcitonin gene-related peptide, neuropeptide Y, endothelin-1 and corticotropin-releasing hormone were also detected in the tumor tissues. The tumor tissue concentrations of immunoreactive adrenomedullin were comparable to those of these four peptides, but much lower than those of ACTH. Northern blot analysis showed the expression of adrenomedullin mRNA in one tumor from which sufficient tissue was available for such study. The plasma concentration of immunoreactive adrenomedullin was increased in one patient (41.3 pmol/l, control 13.5 +/- 3.6 pmol/l, mean +/- S.D., n = 12). CONCLUSIONS: These results suggest that adrenomedullin is produced by ectopic ACTH-secreting tumors, together with other neuropeptides, and raise the possibility that adrenomedullin is related to the pathophysiology of these tumors.     

Identification and characterization of differentiating soluble antigens of sheep and goat poxviruses

Soluble antigens of sheep and goat poxviruses (SPV, GPV) were isolated and purified from scab suspensions prepared from lesions of experimentally infected homologous hosts. The soluble antigens were then subjected to sequential ammonium sulphate precipitation. All the obtained fractions reacted in counter immunoelectrophoresis (CIE) with both the antisera against SPV and GPV except the fraction obtained at 30% saturation level (30% SSPV), which did not react with antiserum against GPV. This differentiating soluble SPV antigen was found to consist of 210 K proteins in exclusion chromatography. The 210 K proteins contained 3 polypeptides of 100, 35 and 17 K in polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulphate (SDS-PAGE). The study thus gave an evidence that the SPV-specific proteins are of a higher molecular mass nature.     

The whispered voice: the best test for screening for hearing impairment in general practice?

Hearing loss is an important health problem in the elderly which sometimes leads to social isolation. In a study with 62 patients, the diagnostic value of four simple tests for screening for hearing loss in general practice was examined. When paying attention to the loudness of the whispering, the whispered voice test can be a valuable test for assessment of hearing loss in general practice.     

MIXING POLYMERS OF DIFFERENT VISCOSITIES

The mixing of viscous polymers of dissimilar viscosities undergoing an overall shear is considered. Data are presented to illustrate the effects of component viscosity ratio and relative volume fraction on the quality of mixing. Experiments and analysis are based upon the geometry suggested by a tumbled mixture of polyethylene pellets in the hopper of an extruder. For a system in which the viscosity of the initially disperse phase exceeds that of the major component, deformation is modelled as the elongation of circular cylinders resulting from heightened shear stresses and discontinuous normal stresses at the component interface. In fluids as viscous as the polymers considered, these stresses are strongly dependent upon the cross-sectional area of the mixing channel, and the interaction between elongating drops is modelled as a decreasing effective cross-sectional area. 1t is shown that the interaction between neighboring drops is sufficiently strong that at a certain drop length the disperse phase begins to behave as if it were present continuously across the mixing channel; in other words, the disperse phase and suspending medium behave at large strains like high-modulus reinforcing fibers in a lower-modulus solid matrix. This critical drop length is surprisingly small, ranging from 2 to 8 times the nominal linear dimension of the undeformed drop in the systems considered. For a system in which the major component is more viscous than the disperse drops, such a condition of substantially equal strain is shown to exist throughout the mixture.     

Ablation of mediastinal parathyroid adenomas by superselective embolization of the internal mammary artery with alcohol

Two young patients (20 and 21 years) had recurrent hyperparathyroidism following neck exploration. Non-invasive investigations failed to localize a parathyroid adenoma. In both cases selective catheterization of the internal mammary arteries combined with digital angiography demonstrated hypervascular mediastinal adenomas. Using a coaxial catheterization technique (Tracker 18 and 10), both branch arteries of the internal mammary supplying the adenoma were selectively catheterized. In one case absolute alcohol and the other a mixture of Lipiodol and absolute alcohol were used to effect the ablation. The procedures were uneventful and serum calcium levels have subsequently returned to within normal limits. The follow-up in these two cases extends to 2 1/2 years in one and 10 months in the other case.