Cerebral ischemia in patients with hepatitis C virus infection and mixed cryoglobulinemia

We describe two women (ages 35 and 36 years) with cerebral ischemia, hepatitis C virus, and mixed cryoglobulinemia. One patient (case 1) was in otherwise good health when left parietal cerebral infarction developed, and she was found to have narrowing of the supraclinoid internal carotid artery siphon, anterior cerebral artery A1, and middle cerebral artery M1 segments bilaterally. Subsequent evaluation revealed abnormal liver enzymes, mixed cryoglobulinemia (type III), hypocomplementemia, and a high positive test result for rheumatoid factor. In the other patient (case 2), cerebral ischemia and seizures developed in the setting of previously documented mixed cryoglobulinemia (type II), membranoproliferative glomerulonephritis, and hypocomplementemia. In this patient, a brain biopsy demonstrated cerebral infarction. Hepatitis C virus infection was confirmed in both patients by polymerase chain reaction detection of hepatitis C virus RNA. These two cases document the occurrence of cerebral ischemia in patients with hepatitis C virus infection and mixed cryoglobulinemia. Testing for hepatitis C virus and cryoglobulins should be considered in selected patients with cerebral ischemia of inobvious cause.     

The role of dornase alfa in the treatment of cystic fibrosis

For morphometric studies, sections have been stained with the Luxol fast blue-PAS-Hematoxylin (LPH) staining method after secondary fixation with chromic acid followed by embedding in Celloidin to measure the area of nerve cells or axons with the help of an image analyzer and a microscope. However, the manufacture of Celloidin has been suspended in Japan. Therefore, we studied the use of Shiojirin E-10 (10% nitrocellulose ether alcohol solution) as a substitute embedding material, and compared it with Celloidin from the viewpoint of tissue shrinkage and staining characteristics. Regarding the shrinkage ratio of LPH-stained sections of human cauda equina, there was no practical difference in the axonal areas (p < 0.01) between Celloidin sections (4.31 +/- 2.55 microns2) and Shiojirin E-10 sections (4.14 +/- 2.20 microns2). Regarding staining characteristics, we introduced a hue analysis method using computerized digital signals converted from pictures of stained sections taken by a videocamera. For the evaluation of hue, we examined the H-E sections of mouse liver and kidney, and the LPH sections of the human cauda equina. The hematoxylin hues of the H-E sections were 295 degrees for Celloidin and 294 degrees for Shiojirin E-10. Eosin hues of the E-E sections were 320 degrees for both embedding material. The axonal hues of the LPH stain were 254 degrees for Celloidin and 251 degrees for Shiojirin E-10. Myelin sheath hues were 224 degrees for both embedding material. According to our results, Shiojirin E-10 can be substituted for Celloidin from the qualitative and quantitative viewpoints in the morphologic studies.     

The role of adenosine in the central nervous system

Adenosine is one of the normal elements in body fluid including extracellular fluid within the CNS. Its normal level is 0.03-0.3 mumol/L. When ATP's metabolism loses balance, for example, during ischemia, the level of adenosine increases dramatically, may reach as much as 1000 times of the normal. Adenosine plays many physiological and pathological roles in CNS via its receptors. It is recognized as an inhibitory neuromodulator playing a neuroprotective role in CNS.     

Effects of intravenous administration of sodium hyaluronate on carpal joints in exercising horses after arthroscopic surgery and osteochondral fragmentation

OBJECTIVE: To evaluate the effects of arthroscopic surgery, osteochondral fragmentation, and treatment with IV administered hyaluronate on histologic, histochemical, and biochemical measurements within the carpal joints of horses. ANIMALS: 12 clinically normal horses, 2 to 7 years of age. PROCEDURE: Horses had an osteochondral fragment created at the distal aspect of the radiocarpal bone of 1 randomly chosen middle carpal joint to simulate osteochondral fragmentation. Horses were treated with 40 mg of hyaluronate or saline solution (placebo) intravenously once a week for 3 consecutive weeks (days 13, 20, and 27 after surgery). Treadmill exercise proceeded 5 days per week beginning 15 days, and ending 72 days, after surgery. Clinical evaluations were performed at the beginning and end of the study. Synovial fluid samples were obtained aseptically from both middle carpal joints on days 0, 13, 20, 27, 34, and 72 after surgery, and total protein, inflammatory cell, hyaluronate, glycosaminoglycan, and prostaglandin E2 concentrations were measured in each sample. All horses were euthanatized on day 72. Synovial membrane and articular cartilage were obtained for histologic evaluation. Articular cartilage samples were also obtained aseptically for determining glycosaminoglycan content and chondrocyte synthetic rate for glycosaminoglycans. RESULTS: Horses treated with hyaluronate intravenously had lower lameness scores (were less lame), significantly better synovial membrane histologic scores, and significantly lower concentrations of total protein and prostaglandin E2 within synovial fluid 72 days after surgery, compared with placebo-treated horses. Treatment with intravenously administered hyaluronate had no significant effects on glycosaminoglycan content, synthetic rate or morphologic scoring in articular cartilage, or other synovial fluid measurements. CONCLUSION: Intravenously administered hyaluronate appears to alleviate signs of lameness by interacting with synoviocytes, and by decreasing production and release of inflammatory mediators.     

Parenting behaviors and parent-child relationships: correlates of peer victimization in kindergarten?

This study examined features of parenting behavior and the parent-child relationship as correlates of peer victimization in young children. A sample of 197 kindergartners (94 girls and 103 boys) and their primary caregivers were videotaped in their homes while engaging in multiple interactional tasks, and peer victimization data were gathered on children as they began kindergarten. The video-recorded interaction data were used to create measures of parenting behavior (e.g., intrusive demandingness, responsiveness) and relationship quality (i.e., intense closeness), which were examined as predictors of peer victimization. High intrusive demandingness and low responsiveness were associated with peer victimization in both boys and girls, and parent-child relationships characterized by intense closeness were associated with higher levels of peer victimization in boys. Results are discussed in terms of the role that caregiver socialization plays in the development of child behaviors that may increase children's risk for peer victimization.     

Diabetic retinopathy

Nonproliferative diabetic retinopathy may cause visual loss when associated with macular edema or macular ischemia (secondary to retinal capillary nonperfusion). Proliferative diabetic retinopathy may cause severe visual loss if complicated by vitreous hemorrhage or traction detachment of the macula. Patients with diabetes benefit from collaboration between the internist and ophthalmologist. Tighter control of blood glucose levels and lower blood pressure reduce the risk of progression of diabetic retinopathy. Regular dilated eye examinations and appropriate intervention with laser or vitrectomy surgery help to preserve vision in patients with established macular edema or proliferative diabetic retinopathy.     

Stroke prevention in non-rheumatic atrial fibrillation

The aim of this study was to appreciate the accuracy of the technique for sensitivity test for M. tuberculosis. We have tested the same bacterial strains (101) using the same drugs concentrations, by absolute concentration method, and we have compared the results obtained in two different laboratories. The concordance of the obtained results (94.05% for SM, 97.03% for INH, 99.01% for RMP, 100% for EMB) is in the limits of reproducibility obtained by other authors. The obtained results show a good technique for sensitivity test in the two laboratories.     

3H-morphine-6beta-glucuronide binding in brain membranes and an MOR-1-transfected cell line

Morphine-6beta-glucuronide (M6G) is a potent morphine metabolite. In an effort to further explore its mechanisms of action, we synthesized 3H-M6G of high specific activity and examined its binding. Although its affinity toward traditional mu receptors is similar to morphine in binding assays in brain and in Chinese hamster ovary cells stably transfected with MOR-1, M6G is >100-fold more potent than morphine in analgesic assays. This apparent discrepancy cannot be explained by differing intrinsic activities of the two drugs because both agents are partial agonists with similar efficacies in adenylyl cyclase assays in the transfected cell lines. Behavioral studies have implied the possibility of a distinct M6G receptor. Detailed binding studies in brain tissue reveal evidence for heterogeneity. Nonlinear regression analysis of 3H-M6G saturation studies reveals two components. The lower-affinity component (K(D) = 1.93 +/- 0.6 nM) corresponds to labeling of traditional mu receptors. In addition, 3H-M6G labels another site of low abundance with very high affinity (K(D) = 68 +/- 7 pM). Competition studies indicate that both sites are relatively mu selective. However, several compounds clearly distinguish between the two sites. These binding studies support the concept of a unique M6G receptor responsible for its analgesic activity.     

Population dynamics of Aeromonas spp. in an urban river watershed

Density of Aeromonas spp. at one site in the Buffalo River and at four sites on its upstream tributaries was followed from June 1992-June 1993. Membrane filtration counts of Aeromonas during the summer ranged between 18 and 4000 ml-1, which were one to two logs higher than faecal coliform and faecal streptococci densities. Aeromonas spp. in the Buffalo River, and faecal coliforms, faecal streptococci, and the heterotrophic plate count throughout the watershed, increased by approximately one log during summer rainstorms. However, Aeromonas spp. increased only by a factor of two during rainstorms at the upstream sites. Aeromonas spp. showed a strong positive correlation with both indicator bacteria and total suspended solids at the upstream sites during the summer but not the winter. Correlations between Aeromonas and indicator bacteria remained strong in the Buffalo River during the winter, signifying that different conditions exist in the Buffalo River and its upstream tributaries. The strong correlation between Aeromonas spp. and indicator bacteria in the Buffalo River suggest that, in the absence of media capable of the quantitative recovery of potentially pathogenic aeromonads, standard faecal coliform analyses may adequately assess public health risks from Aeromonas spp. in an urban river used for recreational purposes.