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[Selenium toxicity in domestic animals].

The earliest written report of selenium poisoning is thought to be the description by Marco Polo of a necrotic hoof disease of horses that occurred in China in 13. century. However recognition of Se as toxic principle come in the early 1930s. Severity of Se poisoning depends on chemical forms of the element, species of animals and routes of administration. The soluble Se salts (Na2SeO3 and Na2SeO4) appear to be among the more toxic compounds; the Se inherent in grains and selenoamino acids (selenomethionine and selenocystine) appear to have relative moderate toxicity; the poorly soluble forms (e.g., elemental Se, Na2Se, SeS2 and diphenyl selenide) are among the least toxic of the Se compounds. In general, toxicity of Se compounds are substantially less when they are administered orally than when they are given parenterally. Rosenfeld and Beath described three clinical types of Se intoxication: acute selenosis, subacute selenosis (i.e., blind staggers type), and chronic selenosis (i.e., alkali disease type). Acute poisoning occurs when high Se content plants are consumed in large quantities within short period. Accidental acute poisoning occurs as consequence of errors in formulation of a Se supplemented diet. The most characteristic sign of acute selenosis is garlic breath due to the pulmonary excretion of volatile Se metabolites. Other signs include lethargy, excessive salivation, vomiting, dyspnea, muscle tremors and respiratory distress. Pathological findings are: congestion of the liver and kidney, fatty degeneration and focal necrosis of the liver, endocarditis and myocarditis. Subacute selenosis ("blind staggers") occurs as a consequence of exposure to large doses of Se over a longer period of time and manifests with neurological signs (e.g., blindness, ataxia, disorientation) and respiratory distress. This form of selenosis is most frequently observed in grazing animals that have consumed Se-accumulated plants. Chronic selenosis ("alkali disease") comes about when animals consume moderate levels of Se (more than 5 mg/kg and less than 40 mg/kg) for period of weeks or months. The usual clinical signs of chronic selenosis in horses, cattle and swine are: loss of hair (horses and cattle lose long hair from the mane and tails), emaciation, hoof lesions and lameness. In advanced cases liver cirrhosis, atrophy of the heart and anemia occur. In swine symmetrical poliomyclomalacia of cervical and lumbal/sacral spinal cord segment has been seen. Sheep seen to be more tolerant and get milder form of the disease. They lose appetite and have reduced gain. In growing chicks reduced gain and feed intake, rough feathers, and characteristics of nervousness has been observed. Reduced egg production, embryonic deformations and reduced hatchability has been observed in hens.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

[The present status and perspectives of the University of Zagreb Medical School].

Ranked as the leading school of medicine in Croatia, University of Zagreb School of Medicine has succeeded to maintain the continuity of the high quality teaching process despite of the heritage of the socialist educational system and the harsh times of war. With the introduction of the six-year curriculum, where the "problem-solving" method is given prominence to, the school has fulfilled its requirements to meet the European standards of medical education. Teaching of the basic medical sciences is faced predominantly with the problems of obsolete equipment, whereas the quality of the education of the clinical subjects has not yet reached the desirable standards in all segments. Scientists from the University of School Zagreb of Medicine contribute to the overall scientific output of the Republic of Croatia with 10 to 20%, in addition to appearance of significant number of papers published in the international periodicals. According to the latest faculty roster, the number of full professors with teaching appointments is much too excessive. The University of Zagreb School of Medicine sees its main goal in the improvement of the quality of the teaching process. This goal is to be accomplished through introduction of the new courses (molecular biology, neuroscience, emergency medicine, ecology, medical economy etc.), improvement of the teaching methods, as well as through high standards of teaching the elective courses. Overall number of exams is also to be reduced in due time, whereas the future curriculum should provide a comprehensive medical teaching, with students actively participating in the teaching process through the first-hand experience with patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Croatia↗

[Critical analysis of the immunosuppressive activity and of the toxicity of cyclosporine metabolites].

Cyclosporin A (CyA) is intensively metabolized by the hepatic cytochrome P450 III monooxygenases A systems in the human liver. Among about twenty metabolites, only twelve of which have been identified, and found in the blood of treated patients. The major metabolic pathways are hydroxylation and N-demethylation of the various amino-acids of the parent compound. Quantitatively, and although there are some differences depending on whether one refers to the residual concentration or to the Area Under Curve (AUC), major metabolites are always, in decreasing significance, M17, M1, M18, and M21. Metabolite/CyA ratio is subjected to numerous variations from one patient to another which can be explained by pharmacogenetics, but can also be affected by the type of graft, the hepatic performance status, and related treatments. Be that as it may, it is metabolites 17 and 1 which are especially present in the blood in large quantities. In fact, if one considers the relative percentage of metabolites in comparison with CyA, expressed in blood AUC, values of 79, 39, 21 and 15% are noticed for M17, M1, M18, and M21, respectively. These percentage become 170, 65, 16 and 10% if one refers to residual concentration. In the aggregate, these results may be extrapolated to the tissues and it has been shown that, excepting the liver which contains high M17 concentrations, metabolites overall appear in equal or lower levels than CyA. They are widely diffused throughout the tissues and the highest levels are found in the liver and kidneys, then in fats and pancreata.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Brain aging and dementia].

It is common knowledge that the base of the demographic pyramide is turning upwards as a consequence of the constant growing of the elderly population. This phenomenon worries everybody from families to government agencies. As a consequence, neuroscientists have been asked to cooperate for a better understanding of the problem related with the aging of the nervous system. Essentially they try to better grasp the mechanism of aging and their deleterious effects on the brain and how to fight the diseases of the nervous system with particular affinity for the aged people. We know that brain goes through morphological and biochemical changes with the passing of the years; it loses weight, microscopic changes occur and the activity of many neurotransmitters diminishes. In this context it is strange that some people still argue against the enfeeblement of the mental faculties with aging. Of all diseases of the nervous system tormenting the aged, the most common are depression and dementia. Most cases of depression and some forms of dementia are treatable but Alzheimer's disease, which afflicts a considerable percentage of old people, leading to greater psychological decline and leaving doctors helpless to halt it's unavoidable progress, is certainly the most dreaded old age mental sickness. The etiology of Alzheimer's disease is unknown. Under these circumstances several possibilities are investigated: genetic, infectious and toxic. Lately, investigators have focused their attention on amyloid, constitutive substance of the senile plaques one of the characteristic structural changes of the diseased brain. Nowadays there are studies on the relation between amyloid and a protein considered to be its precursor which has been found outside the nervous system.(ABSTRACT TRUNCATED AT 250 WORDS)

Aging↗

[Potential for spread of HIV in Japan].

Beginning 3 years ago, rapid spread of HIV was observed in Thailand with consequent serious problems in the public. HIV initially spread among i.v. drug abusers and then invaded prostitutes. Sero-surveillance estimates that there are 300,000 HIV positives in all of Thailand. Thai authorities warn that 4 million persons may be infected by the year 2000. In Japan, the cumulative number of HIV positives is reported as 453 excluding hemophiliac cases. However, the reported figures are assumed to be only a part of the actual figure. WHO estimates there may be 20,000 HIV positives in Japan. From the epidemiological surveillance, incidence of HIV positives even in the risk groups is extremely low in Japan. HIV positives in blood donors is merely 0.31 per 100,000. The question is whether AIDS will continue to be a less serious problem in Japan? Examination of blood or a voluntary basis may not tell the real situation of HIV positives in Japan. There is a real concern regarding HIV positives in female foreign visitors who made up 86 per cent of all female positives in Japan. These females are suspected to be professionals engaged in sex business in Japan. A hypothetical simulation indicates they may possibly infect 60,000 people per year. On the other hand, contact between Japanese travellers visiting Thailand and Thai prostitutes is also possible. Using the figure of 230,000 males visiting Thailand in 1990, hypothetical simulation revealed that 690 may become infected per year which is 1/50 of those calculated to be infected inside Japan.(ABSTRACT TRUNCATED AT 250 WORDS)

Forecasting↗

[Treatment of hypertension in arteritic patients].

The treatment of hypertension in arteritic patients must take account of several parameters: respective severity of hypertension and of arteriopathy, possibility of other sites of atherosclerosis and supposed cause of hypertension. The association of essential hypertension and of an arteriopathy does not sum up all possibilities. Hypertension may be purely systolic, due to decreased compliance. A stenosis of the renal arteries is also worth evoking in the context of an already symptomatic atherosclerotic disease. For the confirmation of the latter hypothesis, Doppler associated to echography may be an alternative to the intravenous or intra-arterial opacification of the renal arteries. In case of moderate hypertension (diastolic pressure ranging from 90 to 104 mmHg), non-medicamentous treatments should be preferred: low-sodium diet, suppression of tobacco and other risk factors, weight loss. Beta-blockers, whatever their class, reduce the walking distance in case of intermittent claudication. Though not formally contraindicated, especially when their use is justified by an associated coronary insufficiency, they are not advised in hypertensive arteritic patients. On the other hand, captopril allows both reducing blood pressure and preserving the walking distance. However, a prerequisite to the possible use of agents inhibiting the conversion enzyme is the preliminary search for a stenosis of the renal arteries. In fact, when these medications are carelessly used in case of bilateral stenosis or of stenosis on a functionally single kidney, they entail a risk of renal failure or of thrombosis of the stenosed renal artery. Calcium inhibiting agents are also anti-hypertensive substances of choice in hypertensive arteritic subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Arteritis↗

[Plea for benzodiazepines or is there a future for benzodiazepines in psychiatry?].

Thirty years ago chlordiazepoxide was used in psychiatry for the first time. Benzodiazepines, a therapeutic class with a large spectrum of activities, are now used regularly by 5 to 15% of adults. In France 15% of prescriptions include at least 1 benzodiazepine and 5 compounds of this class appear among the 30 most frequently prescribed of state reimbursed medications. In a developing country like Tunisia sales of psychotropic drugs increased by 84% between 1984 and 1987, benzodiazepines representing half of the prescriptions. Criticisms were voiced as early as in the years 1970. Ralph Nader himself led a campaign against those drugs used in suicidal attempts, provoking car accidents and industrial injuries, memory deficits and dependence. Later, several side effects were pin-pointed: amnesia, which has been used with criminal intent in a few dramatic cases; in fact it should be differentiated from the cognitive troubles resulting from anxiety itself; tolerance: for instance in drug addicts using high doses; it concerns only some effects of the drug; dependence: which remains rare when contrasted with the large consumption of benzodiazepines; withdrawal reaction should be differentiated from teh relapse of anxiety once the drug has been discontinued. In the public opinion one is supposed to bear any pain--and never complain--when it is psychic and not somatic. Benzodiazepines that alleviate psychic pain were considered with spite and then grudge, to use the terminology of erotomania. Actually, benzodiazepine treatment should be a part of a larger therapeutic program taking into account the characteristics of each individual patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Benzodiazepines↗

[Effect of long-term methotrexate-induced neutropenia on experimental periodontal lesion in rats].

The purpose of the present study was to investigate histologically and histometrically the effect of a long-term methotrexate-induced neutropenia on the periodontal lesion in rats. Forty rats were used in this study. The control side (the interdental area between the left maxillary 1st and 2nd molars) of the rats received no treatment. In the experimental side (the interdental area between the right maxillary 1st and 2nd molars) of the same animals, a suturing nylon thread was inserted into the interdental space between these two molars for 3 weeks to produce a slight inflammation of the gingival tissue. Then, the animals were divided equally into Group A and Group B. Group A received no injection of methotrexate, whereas Group B was injected with 1.0 mg/kg of methotrexate 3 times per week for 1 to 9 weeks. Animals of both groups were killed at 1, 3, 5, 7, and 9 weeks. During the sacrifice, peripheral blood was taken from all animals. White blood cells and neutrophils were counted and the periodontal tissues were examined by light microscopy. 1. Blood findings In Group A, the white blood cell count and neutrophil count did not show any changes for 9 weeks. In Group B, however, the white blood cell count and neutrophil count decreased at 3 to 9 weeks. 2. Histological findings In Group A, the control side did not show any changes for 9 weeks, but the experimental side showed a slight gingival inflammation and a moderate alveolar bone resorption at 7 and 9 weeks. In Group B, the control side was similar to that in Group A for 9 weeks, but the experimental side displayed a slight gingival inflammation and a severe alveolar bone resorption at 7 and 9 weeks. 3. Histometrical findings In Groups A and B, the control sides did not show any changes for 9 weeks in the gingival ressection. However, in both groups, the experimental sides showed an increased gingival ressection from 1 to 9 weeks. In the experimental sides, the gingival ressecion between these two groups did not show any differences statistically. In Groups A and B, the control sides did not show any changes for 9 weeks in alveolar bone loss. However, in both groups, the experimental sides showed increasing alveolar bone loss from 1 to 9 weeks. In the experimental sides, the alveolar bone loss in Group B at 7 and 9 weeks was significantly severer (p less than 0.01) than that in Group A for the same weeks.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

[Epidemiology of rabies in the Czech Republic].

In 1976 to 1988 on average some 4,323 +/- 482 subjects in the Czech Republic (i.e. 42.6 +/- 7.6/100,000 population) had contact with rabid or suspect animals, i.e. with dogs (73.3%), cats (15.9%), foxes (4.2%), other wild beasts (1.4%) and other animals (6.2%). Data on contact with suspect animals reported from different regions varied greatly. Post-exposition prophylaxis was started on average in 25% of the exposed subjects after contact with dogs in 44.5%, with cats in 24.7%, foxes in 12.6% and with other animals in 18.1% of the treated subjects. Groups of subjects exposed to the same animal (most frequently a cat or dog) or consumption of meat of infected animals accounted for 8% of all vaccinated subjects. During the period between 1974 and 1988 3,852 (22.9%) of exposed 16,845 subjects were treated in anti-rabies centres. From a group of 5,499 subjects 4,013 (73.0%) were injured: 1203 (21.9%) by a known (296, i.e. 5.4% by a rabid) and 2,810 (51.1%) by an unknown animal and the remainder of 1,486 subjects were exposed to suspect animals without being injured--in 1,154 cases (21.0%) to a known (958, i.e. 17.4% positive) and in 232 cases (6.0%) to unknown animals. Foxes accounted in indication for post-exposure prophylaxis for less than 10% and injured only for 1.1% of the vaccinated subjects. In anti-rabies centres most frequently subjects of productive age (44.7%) and school age (24.8%) were treated. The male/female ration was 3:2. Prophylaxis was started within 48 hours after exposure in 45% of the subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[A short revision of the species group Pegomya acklandi, with description of a new species (Anthomyiidae, Diptera)].

A key to 1 Japanese and 18 Chinese species of the Pegomya acklandi group, including 1 new species, is given below: 1(4) Apical border of the lateral lobe of 5th sternite with an angular notch. 2(3) Hairs on the basal part of surstylus rather thick and numerous; inner side of the twig of surstylus with a tubercle; apex of postgonite hook-like. ... Pegomya densipilosa Li et Deng, 1984. 3(2) Basal part of surstylus with sparse hairs; postgonite bluntly rounded at the apex ... P. rhagolobos Li et Deng, 1984. 4(1) No angular notch on the apical border of the lateral lobe of 5th sternite. 5(10) Aedeagus of fork type. 6(9) Lateral lobe of the 5th sternite with an arch of long setae. 7(8) Arch of long setae of the lateral lobe of 5th sternite in 2 rows and the apex extremely expanded; acrophallus with a hook bent to the paraphallus at the distal end; A3 twice as long as its width ... P. semiannula Li et Deng, 1984. 8(7) Lateral lobe of 5th sternite cone-shaped; acrophallus pointed apically and slightly curved; A3 as long as its width ... P. laterisetiata Deng et Li, 1988. 9(6) Setae on the lateral lobe of 5th sternite rather sparse and short; a strong seta behind the cerca; acrophallus with a small hook at the distal end; A3 as long as its width ... P. unimediseta Deng et Li, 1988.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Effect of adriamycin on the mandibular condyles of growing rats].

The purpose of the present study was to investigate histologically and ultrastructurally the effect of adriamycin on the mandibular condyles of growing rats. Eighty rats, one day old, were used. The animals of Group 1 (Control Group) were given distilled water once a day for five days by intraperioneal injections, and the animals of Group 2, Group 3 and Group 4 were given 0.6 mg, 0.9 mg and 1.2 mg of adriamycin/kg (total amount: 3 mg/kg, 4.5 mg/kg, 6 mg/kg), respectively, once a day for five days. At 1, 4, 7 and 10 days after the last injection, the left mandibular condyles were examined histologically. At 1 and 4 days, the right mandibular condyles were examined ultrastructurally. 1. Light Microscopic Observation. 1) Group 2. At 1 and 4 days, the condyles did not differ significantly from those of Group 1. At 7 and 10 days, the zone of differentiation decreased in thickness as compared with those of Group 1. 2) Group 3. At 1 and 4 days, the zones of articular surface, proliferation and differentiation showed decreased in cell number and in thickness as compared with those of Group 1. At 7 and 10 days, the zones of articular surface and proliferation showed the recovery, although it was not complete. However, the zone of differentiation still decreased in cell number and in thickness. The zone of hypertrophy showed an increase in thickness. 3) Group 4. At 1 and 4 days, the zones of articular surface, proliferation and differentiation were almost similar in cell number and in thickness to those of Group 3 at 1 and 4 days. There was an irregularity in cell shape in the zone of proliferation. At 7 and 10 days, the zone of proliferation decreased in thickness and the zone of differentiation decreased in cell number and in thickness. The zone of hypertrophy was greatly thinned. 2. Electron Microscopic Observation. 1) Group 1. At 1 day, the zone of articular surface was composed of fibroblasts and collagen fibrils, and the zone of proliferation contained many oval mesenchymal cells. The zone of differentiation consisted of both differentiating chondrocytes and cartilage matrix, and the zone of hypertrophy consisted of both enlarged chondrocytes and cartilage matrix. At 4 days, all zones were similar to those of the condyle of this group at 1 day. 2) Group 4. At 1 day, the zone of articular surface showed decreased number of collagen fibrils.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

[Exposure distribution and total risk in intraoral source radiography].

Exposure distribution was measured and total risk for individual was estimated in intraoral source radiography. Equipment used was a stat Oralix (Philips). Film dosimetry was employed to obtain exposure distribution in oral mucosa and skin surface of head and neck region. A thermoluminescence dosimeter and an ionizing chamber were used to measure organ doses. Total risk was estimated on the basis of these doses. Conclusions 1. Exposure distribution 1) Oral mucosa Examination of upper jaw showed that exposure in palate was distributed between 100 mR near incisive papilla at hard palate and 1800 mR at the rear part of hard palate. Isodose curves were aligned at practically equal intervals from 100 mR to 600 mR. Curve of maximum dose 1800 mR ran forward in the vicinity of both second molars. Its pattern was not symmetrical on right and left side. Exposure in buccal region was distributed between 50 mR in the front part and 600 mR in the rear part. On both the surface of tongue and the inner side of mandible, low-exposure regions existed in the vicinity of the midline. Zones of higher exposure were to be found on right and left side. Examination of low jaw showed that isodose curves between 50 mR and 1000 mR were observed in right and left side of palatal area. Exposure in buccal region was distributed between 60 mR and 600 mR. Exposure at the center of tongue was 1800 mR, but it decreased to 1000 mR at the tip of tongue. High exposure was observed on both sides of tongue and mandible. Examination of lateral jaw showed that maximum exposure 1800 mR occurred on the side of radiation objective. In all three examinations, levels of exposure in oral mucosa were higher in the rear than in the front. Furthermore, exposure distribution was not symmetrical on right and left side. These results coincided with measurements of spatial patterns of x-ray intensity. In all examinations, lead-lining of applicator reduced exposure effectively. 2) Skin surface of head and neck region Examination of upper jaw showed that isodose curve of 10 mR ran through root of nose, eyelid, earlobe and mandibular angle ultimately to reach low lip. Curve of maximum exposure 100 mR was located in cheek region. Examination of low jaw showed that isodose curve of 10 mR descended through upper lip and earlobe ultimately to reach to lower part of thyroid gland. Curve of maximum exposure 100 mR was found in cheek region.(ABSTRACT TRUNCATED AT 400 WORDS)

Humans↗

[Histogenetic considerations on mucinous cystomas of the ovary based on histochemical and immunohistochemical findings].

Mucinous cystomas of the ovary, according to a new proposed classification (I.A.P., Dublin 1988), are classified in three types: endocervical, intestinal and mixed. Their histogenesis is still controversial, thus requiring further investigations. There are two main theories on this matter: a teratomatous theory based on the assumption that the mucinous cystoma is allegedly a teratoma having a monophyletic development where only the endodermal gastrointestinal component remains. The second theory, currently the most widely accepted one, maintains that mucinous cystomas derive from Muller duct residues or, more generally, from introflections of the coelomic epithelial lining through a Muller-type metaplastic process. Some authors also accept both theories. A group of 117 mucinous cystomas were investigated by histochemical methods (PB/KOH/PAS; PAT/KOH/Bh/PAS), to demonstrate the presence of O-acetylated sialomucin variants in goblet cells of intestinal type component. Endocervical type mucinous cystomas have always presented as PB/KOH/PAS negative, whereas mixed type mucinous cystomas presented as positive according to the following percentage: benign forms, 31%; borderline, 67%; malignant, 50%. These data should confirm the hypothesis that intestinal type cystomas may derive from the surface coelomic epithelium of the ovary, through a gastrointestinal metaplastic process. This hypothesis is further supported by the data obtained from the observation on two cases of intestinal metaplasia of endocervical glands, kindly supplied by Dr. Trowell. In one of them, a weak O-acetylated sialomucin secretion was identified, in addition to the presence of argentaffin cells. Furthermore, out of 38 adenocarcinomas of the endometrium and 15 adenocarcinomas of the endocervix, one case of endocervical adenocarcinoma was found, characterized by a mucous secretion rich in O-acetylated sialomucins. Moreover, immunohistochemically, by means of anti-chromogranin A monoclonal antibodies, endocrine cells were found in benign, borderline and malignant mucinous cystomas of mixed type. These data do not seem to confirm the assumed correlation between neuroendocrine cell presence and biologic behaviour of the neoplasm nor do they clarify tumor histogenesis. Another immunohistochemical study with BD5 monoclonal antibody demonstrated that this marker was present in the intestinal type epithelium of mixed mucinous cystomas. The histogenetic teratomatous hypothesis of ovarian mucinous cystomas was confirmed by reviewing 100 ovarian teratomas, in which O-acetylated sialomucins were found in the epithelial component of one mucinous carcinoid and in the intestinal type epithelium of 9 mature cystic teratomas.(ABSTRACT TRUNCATED AT 400 WORDS)

Cystadenoma↗

[Biosynthesis of opioid peptides].

The endogenous opioid peptides all contain the enkephalin sequence Tyr-Gly-Gly-Phe-Met and Tyr-Gly-Gly-Phe-Leu at their aminoterminus. Three distinct families of these peptides (endorphins, enkephalins and dynorphins) are present in different neuronal pathways within the central nervous system. Molecular genetics have shown that these three families of opioid peptides are derived from three distinct precursors. Pro-opiomelanocortin gives rise to the endorphins, as well as adrenocorticotropic hormone (ACTH) and the melanotropic hormones (MSH's). [Met] enkephalin, [Leu] enkephalin and the related heptapeptide [Met] enkephalin-Arg6-Phe7 and octapeptide [Met] enkephalin-Arg6-Gly7-Leu8 are derived from proenkephalin. The third family is derived from prodynorphin and includes dynorphin A, dynorphin B (also known as rimorphin) and alpha- and beta-neo-endorphin. The structure of the genes coding for these precursors are similar, suggesting the possibility of one common ancestral gene. The most common scheme for enzymatic maturation of precursors proposes the action of a trypsin-like endopeptidase followed by a carboxypeptidase B-like exopeptidase. However, we have provided evidence that this combination of trypsin-like and carboxypeptidase B-like enzymes may not be the only mechanism for liberating enkephalin from low molecular weight enkephalin-containing peptides. Indeed, endo-oligopeptidase A, an enzyme, known to hydrolyze the Phe5-Ser6 bond of bradykinin and the Arg8-Arg9 bond of neurotensin, has been shown to produce, by a single cleavage, [Leu] enkephalin or [Met] enkephalin from small enkephalin-containing peptides, (Camargo et al., 1987, J. Neurochem. 48, 1258-1263).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[A central mechanism augments ventilation of the dependent lung on the lateral decubitus position].

Spontaneously increased ventilation of the dependent lung on the lateral decubitus position compensates for the gravitational shift of the pulmonary blood flow to this side. The present study indicates that the hemilateral predominant ventilation is centrally controlled, though it has previously been attributed to the peripheral mechanisms with simple changes in the mechanical properties between the two lungs. A series of chest roentgenograms taken at every 0.3 seconds during normal breathing in healthy 6 volunteers showed that the diaphragmatic movement was significantly larger on the dependent side (20.4 +/- 7.5 mm, M +/- SD) than on the other (12.1 +/- 4.4 mm). Thoracic or mediastinal movement was minimal on either side. Expired minute ventilation (VE), peak inspiratory pressure (PIP)and airway occlusion pressure (P0.1) were measured on each of the lungs separated with an endobronchial tube in 14 subjects. At light levels of halothane anesthesia (0.2-0.4% in oxygen). VE of the dependent lung was larger than that of the nondependent lung by 56%. PIP and P0.1 were also larger on the dependent side by 61% and 36%, respectively. At deeper levels of anesthesia (halothane 1.4-2.2%), the predominant ventilation of the dependent lung was absent and VE, PIP or P0.1 no longer differed significantly between the lungs. Augmented P0.1 on the dependent side seemed to be essential to produce larger PIP and VE. It is considered that the more widely stretched diaphragm on the dependent side sends stronger muscle afferent signals to increase excitability of the phrenic neurons producing augmented inspiratory driving force.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Epidemiologic surveillance in leprosy control programs].

Epidemiological surveillance of leprosy has to be very particular. As a matter of fact, leprosy is a long lasting disease which occurs for preference in developing countries where means of surveillance are said to be rudimentary and of poor reliability. Moreover initial stage of the disease is always undeterminated and its mean duration depends on clinical forms. Epidemiological and operational constraints are closely related together and must be included in an original surveillance program. The incidence rate is infered from the detection rate ratified by rates of: new monomacular cases, new cases with deformities and ratio multibacillary forms/pancibacillary forms. Prevalence rate is a very important operational indicator. Leprosy must be constantly registered and notified by every people in charge of collecting epidemiological data whether this epidemiological collection is exhaustive or selective. (Selectivity based on morbidity or on health centers in charge of surveillance). It is necessary to repeat transversal domiciliary surveys, in order to obtain necessary information for the knowledge of incidence and prevalence rate determinator. This gives also the possibility to correct the incidence and detection rates outside of the area of influence of health centers. Methodology of surveillance depends not only on epidemiological but also on clinical and operational informations (case holding problems). Feedback of results must be decentralized. In this respect, epidemiological surveillance of leprosy appears to be more interesting than its own purpose.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

[Arthroscopic shoulder surgery].

In the field of orthopedic surgery, arthroscopic surgery has become widespread since its first development by Dr. Watanabe in 1950. Arthroscopic surgery for the knee joint is now a common procedure, but this surgery is not so common when the procedure involves the shoulder joint. Although using arthroscopic surgery is not so common on the shoulder joint, there are several benefits by utilizing arthroscopy in such cases. Some of the benefits are; minimal scar formation, no functional limitation of the deltoid muscle, and a quick recovery time. So it is believed that due to these benefits, shoulder arthroscopy will become common in the future. The glenohumeral joint and subacromial bursa are the area of shoulder where arthroscopic surgery proves to be useful. In the glenohumeral joint, it is possible to see the biceps tendon, glenoid surface, humeral head, labrum, glenohumeral ligament, subscapularis tendon, supraspinatus tendon, infraspinatus tendon, teres minor, and rotator interval. In the subacromial bursa, it is possible to see the acromion, coracoacromial ligament, acromioclavicle joint, and the bursal side of the cuff. For recurrent anterior dislocation of the shoulder, Caspari's method is the arthroscopic Bankart repair. This is the multiple suture technique for a detached labrum-anteroinferior glenohumeral ligament complex from glenoid neck by using Caspari's suture punch. This is the anatomical repair for anterior instability. Superior labral injuries of the shoulder are usually caused by trauma or over use.(ABSTRACT TRUNCATED AT 250 WORDS)

Arthroscopy↗

[The heart in systolic hypertension].

Among the various forms of systolic hypertension, the primary hyperkinetic heart syndrome (overactivity of the cardiac beta-receptors) and the systolic hypertension in the elderly are the more interesting ones. The former, although involving subjects in the second or third decade of life, is a separate entity from the hyperdynamic phase of primary hypertension. Beta-adrenergic blockade, even at very long-term, is able to normalize all the major features of the syndrome (systolic hypertension, high cardiac output and systolic ejection rate, and variability of the repolarization phase of the electrocardiogram related to changes in the cardiac adrenergic tone). Beta-blockade is not curative and the syndrome reappears as soon as treatment is interrupted. It is a sort of clinical experimental model allowing the following deductions: high cardiac output is able to cause systolic hypertension; its persistence does not promote the development of an elevated systemic vascular resistance; although exposed to some of the stimuli that promote cardiac hypertrophy, such as increased stress of the ventricular wall, very prolonged adrenergic stimulation, activation of the renin system, the syndrome does not evolve towards ventricular hypertrophy. Regarding isolated systolic hypertension in the elderly, the so called de novo and "burned out" hypertension, are currently indicated as the two forms that characterize patients in the seventh and eighth decades of life. Both are interpreted as due to a loss of capacitance of the arterial system. It follows that the great vessels do not propel blood during diastole, thus increasing the hemodynamic burden on the left ventricle, prolonging diastole and delaying relaxation.(ABSTRACT TRUNCATED AT 250 WORDS)

Heart↗