Numbness of the chin, sometimes an ominous sign

Delirium was demonstrated after cataract surgery in a 64-year-old man (case 1). The patient struck his head against the floor; thereafter an extradural hematoma was found and extracted. Postoperative delirium was also noted in a 58-year-old woman (case 2) and in a 26-year-old woman (case 3) with rhegmatogenous retinal detachment. All 3 patients recovered from their psychiatric complications within 1 month.     

Immune complexes from sera of patients with juvenile rheumatoid arthritis reveal novel 40 and 60 kd bands

OBJECTIVE: Immune complexes (IC) have been detected in the majority of sera of patients with juvenile rheumatoid arthritis (JRA). Our aim was to determine the possible constituents of these IC. METHODS: One hundred and four sera from patients with JRA were separated on a Sepharose 4B column to which were bound F(ab')2 fragments of goat anti-human IgM antibody to separate IgM-containing IC. The column was sequentially eluted with 1 M ammonia and 0.1 M glycine-HCl buffer, pH 3. The eluted material was treated with sodium dodecyl sulfate (SDS) and simultaneously reduced with 2-mercaptoethanol. Individual components were then separated by SDS-gradient polyaclylamide gel electrophoresis and were transferred to nitrocellulose by Western blotting. The nitrocellulose strips were overlaid with the patient's own serum and developed with specific antiserum to human IgM and IgG. RESULTS: Four bands were noted in the majority of JRA patients, including a band in the 70-80 kD area to the IgM heavy chain and in the 50 kD area to the IgG heavy chain. Additional bands specific for JRA patients' sera were noted in the 40 kD and 60 kD areas. Overall, 61 of 104 sera demonstrated all four bands; 78 showed the 40 kD band and 73 the 60 kD band. CONCLUSION: These IC were previously shown to contain IgM rheumatoid factor (RF), IgG-RF, and IgG in addition to the 40 and/or 60 kD constituents present in the isolates. Preliminary studies on these constituents suggest the possibility of the 60 kD band being the human 60 kD mitochondrial heat shock protein. Further investigations of these immune complex components may aid in the understanding of the pathophysiology of JRA.     

Estrogenic properties of 3,9-dihydroxybenz[a]anthracene, a potential metabolite of benz[a]anthracene

The estrogen receptor binding properties of 3,9-dihydroxybenz[a]anthracene (3,9-diOHBA) were determined in uterine cytosol of immature Sprague-Dawley rats by competitive binding experiments with [3H]estradiol and sucrose density centrifugation. 3,9-DiOHBA inhibited estradiol binding to the 8S binding protein at a concentration (1.2 X 10(-5) M) approximately equal to that of nafoxidine-HCl (3 X 10(-5) M) required to inhibit estradiol-specific binding, and bioassay for estrogenic activity substantiated this finding.     

Teaching medical students about mental handicap

The care and management of mental handicap is a relatively increasing problem, and medical responsibilities for the prevention, detection, treatment and management of mental handicap are undergoing significant changes in emphasis. The present paper examines the current position of undergraduate medical training in this field in medical schools in the United Kingdom and in Eire. Although there are considerable training variations between different schools, the over-all style of presentation is not thought to facilitate appropriate learning in this subject for future doctors. There is a suggestion that medical students themselves would welcome more attention to this field. Greater co-ordination is needed within existing teaching programmes. The appointment of senior academics with multiple departmental attachments and a major commitment to the subject of mental handicap may be a valuable step forward.