Recurrent Meesmann''s corneal epithelial dystrophy after penetrating keratoplasty

Endoscopic treatment of chronic pancreatitis has drawn benefits from endoscopic procedures previously described for the main bile duct. Endotherapy is developing throughout the world. Cyst drainage procedures certainly represent the largest step forward in that non-surgical approach, whatever it is either direct (through the stomach or the duodenum) or indirect through the papilla in the duodenum. This procedure gives similar results to surgery with a lower morbidity. Pancreatic duct drainage associated with stone clearance is feasible and provides good results which have not yet been compared with those obtained thanks to surgery. Nonetheless, when the duct is not widely dilated it has been proven to be a satisfactory alternative to surgery. By contrast, chronic cholestasis does not appear to be a good indication of endotherapy.     

The physiological characteristics of genetic predisposition to catalepsy in rats depending on the stage of selection

Male rats with a genetic predisposition to cataleptic reactions revealed a reduced motor activity and a diminished activation of mineralocorticoid and testosterone synthesis in response to a mild stress as compared with the Wistar rats. The reactions, however, were exactly opposite in the Wistar rats with signs of cataleptic features. The data obtained suggest that, when creating genetic animal models of human diseases, the initial stages of breeding should correspond to early stages of the disease whereas advanced stages of breeding are similar to later, chronic phases of the disease.     

SV40 large T antigen with c-Jun down-regulates myelin P0 gene expression: a mechanism for papovaviral T antigen-mediated demyelination

Expression of myelin proteins has been shown to be altered in transgenic mice that express papovaviral large tumor (T) antigens. This paper analyzes the effect on P0 gene expression in secondary Schwann cells transfected with the SV40 T antigen gene and in Schwann cells immortalized by T antigen. In secondary Schwann cells, both T antigen and c-Jun are required for significant inhibition of the P0 promoter; expression of only one of the proteins is insufficient for repression of the P0 gene. T antigen, c-Jun (p39), and c-Jun-related protein (p47) form an immunoprecipitable complex in SV40 immortalized Schwann cell lines, and T antigen and c-Jun bind independently and as a complex to the P0 promoter. Our data suggest that the probable molecular mechanism underlying the hypomyelination observed in transgenic animals expressing T antigen may be due to the repression of the P0 gene by T antigen and c-Jun.     

Postoperative complications in proximal stomach resection

During 20 years (1972-1994) the authors carried out proximal resections of the stomach in 106 patients for cancer of proximal part of the stomach extended to the esophagus. Morphological verification data are presented. Total lethality rate made up 20.8%. It decreased with gaining of experience and improvement in selection of patients (1972-1982--29.6%, 1983-1994--17.7%). The most common complication in postoperative period was exudative pleuritis: in 16% of operated patients insufficiency of sutures of the esophagogastric anastomosis was observed. For prophylaxis of suture insufficiency pyloroplasty by Heineke-Mikulich and continuous (to 4-5 days) naso-gastral drainage were of principal significance. Great importance was attached to establishment of the anastomosis by the method developed by the authors. The results of the operations depend also on the operative approach: two-stage combined approach (laparotomy, thoracotomy) brings the least lethality.     

The clinical aspects of hydrocephalus in children

The removal of tooth structure during preparation results in varying degrees of pulpal hyperemia. The ability of the pulpal tissue to respond either by recovery or degeneration depends in part upon the adequacy and fit of the provisional restoration. The response of the gingival tissue also depends on a large degree on the success of the temporary coverage. Provisional restorations are commonly given less attention and importance thereby biologic, mechanical, and esthetic considerations are not adequately met. Since a provisional restoration must be made or improvised during the same appointment in which the abutment teeth are prepared, costly chairside time most often leads to an unacceptable restoration. Failures such as color instability, color incompatibility, inappropriate anatomic contours, fractures, occlusal disharmony, changes in tooth position, gingival inflammation, and unhealthy periodontal conditions are usually encountered. A technique of fabricating an exacting provisional restoration with compliance to optimum quality is presented.     

Effect of pH on tobacco anionic peroxidase stability and its interaction with hydrogen peroxide

The dendritic localization of mRNAs has been proposed to underlie the structural and functional polarity of neurons, as well as certain aspects of synaptic plasticity. Even though there is no conclusive evidence that such a localization is a physiological requirement, studies of mRNA localization in relation to function in other cell types and recent experiments on synaptic plasticity suggest that this proposal may be correct.     

Combined use of left atrial transesophageal pacing and cordarone in atrial flutter

AIM: To investigate the effectiveness of superfrequent transesophageal left atrial stimulation (TLAS) and its combination with cordarone in management of atrial flutter (AF). MATERIALS AND METHODS: 650 patients with paroxysmal AF underwent TLAS. The paroxysm duration varied from 1 hour to 1 month. In 312 patients TLAS was performed prior to treatment with antiarrhythmic drugs (group 1), in 338 patients--after intravenous administration of cordarone (group 2). RESULTS: Superfrequent TLAS has restored sinus rhythm (SR) in 85(27.2%) and 169(50%) patients of groups 1 and 2, respectively (p < 0.001). TLAS promoted conversion of AF in atrial fibrillation (AFi) in 185(59.3%) and 159(47.1%) patients of groups 1 and 2, respectively (p < 0.01). Moreover, SR recovered 24-48 hours after TLAS in 87(27.9%) and 64(18.9%) patients of groups 1 and 2 respectively (p < 0.01). Sinus rhythm recovered in a total of 172(55.1%) and 233(69.0%) patients, AF was converted to AFi in a total of 88(31.4%) and 95(28.1%) patients (p > 0.05) of groups 1 and 2, respectively. TLAS was uneffective in 42(13.5%) and 10(2.9%) patients of groups 1 and 2, respectively. CONCLUSION: Superfrequent TLAS is a highly effective and non-invasive modality in the treatment of paroxysmal AF. It promotes recovery of SR. In some patients TLAS induces AFi which is more controllable by medication as regards the heart rate. Cordarone contributes to the response to TLAS in patients with paroxysmal AF.     

Changes in the impulse activity of neurons of the human thalamic ventrolateral nucleus during voluntary movement

Functional differences were revealed in evoked activity of two types (A and B) of units of the human thalamic ventro-lateral nucleus (VL). Collective activities of these polyfunctional neurons were selectively related to triggering and execution phases of movement. Common character of dynamics of the responses seems to be due to similar polyfunctional nature as well as to the functional role of these two complementary elements in the motor signal transmission. The collective activities reflect in the VL the integrative processes related to processing and programming of generalised parameters of motor signals, but unrelated to performance of a concrete motor act.     

Asthmatic exacerbations and environmental pollen concentration in La Comarca Lagunera (Mexico)

In order to determine the correlation between the concentration of environmental pollen and the frequency of asthmatic exacerbations in La Comarca Lagunera (México), a study in a cohort of a 104 diagnosed patients suffering allergic asthma was carried out monitoring monthly from July '93 to July '95 in order to register the existence of asthmatic exacerbations. Environmental samples were taken weekly during the same period of time through a PST high volume collector (Andersen Samplers Inc). The above mentioned samples were processed under acetolysis technics and the pollen grain count under light microscopy. Linear correlation measures were made between the rates of asthmatic exacerbations and the concentration of pollen grain in m3 of air by means of a statistical computer program SAS. There was a 1469 persons/month follow up ('X 15.5) and the correlation between the rates of asthmatic exacerbations and the concentration of environmental pollen was relevant (r = 0.63, r2 = 0.39, p < 0.01). The correlation increased (r = 0.70, r2 = 0.49 and p < 0.01) when the asthmatic exacerbations associated to infectious disease in the upper respiratory system were restricted. The conclusion reached is that the concentration of environment pollen has influence in the development of asthmatic exacerbations in patients with allergic asthma.     

Quantitation of bacteria in blood of typhoid fever patients and relationship between counts and clinical features, transmissibility, and antibiotic resistance

Salmonella typhi was isolated from 369 and Salmonella paratyphi A was isolated from 6 of 515 Vietnamese patients with suspected enteric fever. Compared with conventional broth culture of blood, direct plating of the buffy coat had a diagnostic sensitivity of 99.5% (95% confidence interval [CI], 97.1 to 100%). Blood bacterial counts were estimated by the pour plate method. The median S. typhi count in blood was 1 CFU/ml (range, <0.3 to 387 CFU/ml), of which a mean of 63% (95% CI, 58 to 67%) were intracellular. The mean number of bacteria per infected leukocyte was 1.3 (interquartile range [IQR], 0.7 to 2.4) CFU/cell (n = 81). Children (< 15 years old; n = 115) had higher median blood bacterial counts than adults (n = 262): 1.5 (range, <0.3 to 387) versus 0.6 (range, <0.3 to 17.7) CFU/ml (P = 0.008), and patients who excreted S. typhi in feces had higher bacteremias than those who did not: a median of 3 (range, <0.3 to 32) versus 1 (range, <0.3 to 68) CFU/ml (P = 0.02). Blood bacterial counts declined with increasing duration of illness (P = 0.002) and were higher in infections caused by multidrug-resistant S. typhi (1.3 [range, <0.3 to 387] CFU/ml; n = 313) than in infections caused by antibiotic-sensitive S. typhi (0.5 [range, <0.3 to 32] CFU/ml; n = 62) (P = 0.006). In a multivariate analysis this proved to be an independent association, suggesting a relationship between antibiotic resistance and virulence in S. typhi.