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[The treatment of imported Plasmodium falciparum malaria with halofantrine. Apropos of 59 case reports (corrected and republished article orginally printed in Med Trop (Mars) 1990 Jan-Mar;50(1):113-7)].

59 cases of Plasmodium falciparum malaria fever occurring in non-immune Caucasian subjects having got a correct chemoprophylaxis by chloroquine were treated by halofantrine (HALFAN). They were given 1500 mg divided in 3 doses of 500 mg every 6 hours from D1 to D8. All them were back from a malarial highly endemic zone with chloroquine resistance. Analysis of the main biological and clinical efficiency parameters displayed very satisfactory results: disappearances of fever (mean 22 H) and parasitemia (mean 36 H) are short. After two months of monitoring, no malaria recrudescence was noted. With an efficacy of 10 p.c. associated to a noticeable clinical and biological tolerance Halofantrine is a first-class treatment of chloroquine resistant malaria fever.

Adolescent

Atrioventricular nodal function in the immature canine heart [corrected and republished article orginally printed in Pediatr Res 1987 Nov;22(5):616-20].

Previous studies have suggested that the atrioventricular nodal functional refractory period in the neonate is equal to or shorter than that of the ventricle, providing little or no protection to the ventricle against rapid atrial rates and allowing closely coupled atrial beats to fall within the ventricular vulnerable period. We evaluated atrioventricular node function in 21 mongrel neonatal puppies, 3-15 days old, and 15 adult dogs utilizing intracardiac His bundle recording and stimulation techniques. The mean atrioventricular nodal functional refractory period (173.1 +/- 20.0 ms) exceeded both the ventricular effective refractory period (139.5 +/- 14.3) and ventricular functional refractory period (163.3 +/- 14.5) in the neonates. Furthermore, the atrioventricular node was the site of limiting antegrade conduction in all neonates. No ventricular arrhythmias were induced by atrial extrastimulation in any of the neonates. The site of conduction delay during atrial extrastimulation was confined to the atrioventricular node in 15/16 neonates (94%) while 1/16 (6%) had combined nodal and infranodal delay. The neonates developed Wenckebach, at significantly faster heart rates than the adults, but both groups developed Wenckebach at approximately twice the resting heart rate. Retrograde conduction was a consistent finding in the neonates. However, antegrade Wenckebach occurred at a significantly faster heart rate than retrograde Wenckebach suggesting different functional properties. Our data suggest that in the neonatal canine, the atrioventricular node functional refractory period is longer than both the ventricular effective refractory period and ventricular functional refractory period. Furthermore, the degree of protection offered by the neonatal atrioventricular node to the ventricle appears to be comparable to that of the adult.

Animals

The substance P receptor antagonist CP-96,345 interacts with Ca2+ channels.

The nonpeptide substance P receptor antagonist CP-96,345 was found to displace binding to Ca2+ channel binding sites labelled with either [3H]desmethoxyverapamil or [3H]diltiazem and to enhance [3H]nitrendipine binding. Unlike the substance P receptor antagonist activity of CP-96,345, these effects on Ca2+ channel binding sites were neither stereoselective nor species-dependent. It is concluded that CP-96,345 may act as an antagonist of L-type Ca2+ channels in addition to being a potent NK1 receptor (substance P) antagonist.

Animals

Single channel kinetics of a glutamate receptor.

The glutamate receptor-channel of locust muscle membrane was studied using the patch-clamp technique. Muscles were pretreated with concanavalin A to block receptor-channel desensitization, thus facilitating analysis of receptor-channel gating kinetics. Single channel kinetics were analyzed to aid in identification of the molecular basis of channel gating. Channel dwell-time distributions and dwell-time autocorrelation functions were calculated from single channel data recorded in the precence of 10-4M glutamate. Analysis of the dwell time distributions in terms of mixtures of exponential functions revealed there to be at least three open states of the receptor-channel and at least four closed states. Autocorrelation function analysis showed there to be at least three pathways linking the open states with the closed. This results in a minimal scheme for gating of the glutamate receptor-channel, which is suggestive of allosteric models of receptor-channel gating.

Animals

Residential mobility during pregnancy for mothers of infants with or without congenital cardiac anomalies: a reprint.

Maternal residence at time of delivery is sometimes used as a proxy for residence during early pregnancy to estimate environmental exposures. Residential addresses during time of conception through the first trimester were obtained from mothers of 152 infants with congenital cardiac anomalies and 175 controls, and they were compared with the addresses at delivery abstracted from birth certificates. An estimated 24.8% (95% CI = 20.3, 29.9) of women moved between the time of conception and delivery, and the percentage of cases and controls who moved was similar. Use of address at time of delivery may reduce the likelihood of finding an association between a congenital malformation and a maternal environmental exposure.

Adult

A survey of the monosodium glutamate content of foods and an estimation of the dietary intake of monosodium glutamate.

The MSG contents of a wide range of manufactured foods (over 200 samples) were measured using the AOAC Procedure (ion-exchange chromatography followed by formol potentiometric titration). The results obtained were used, in conjunction with published data on UK food consumption, to calculate tentative estimates of the dietary intake of MSG for specific groups of the UK population.

Adolescent

Duplex ultrasonographic insonation and visualization of intracerebral arteries.

Until now, clinical, noninvasive interrogation of intracranial vessels has consisted only of insonation via transcranial Doppler. Such devices have utilized a 2.0 MHz, continuous wave probe with Doppler spectral waveform display. Clincial aapplication of these techniques has required precise location of cranial "windows" and has been hampered by the extreme anatomic variability of both cranial bony structures and intracerebral arteries. The lack of simultaneous intracranial arterial visualization has limited the clinical pplicability of transcranial Doppler technology. Recently, the authors have utilized a 2.25 MHz curved phased array probe with a pulsed Doppler to image and insonate simultaneously the intracerebral arteries. Colorflow imaging of both near- and far-field regions is the necessary first step for vessel localization and identification. Once this is accomplished, the image of each artery in turn is amplified and gray scale tuning is employed to permit direct visualization of the arterial walls and lumen. Pulsed Doppler waveform analysis is perfomred simultaneously and along the entire visible artery length. In this manner the arteries of both right and left hemispheres are examined in detail. We have found the duplex technique to be superior to the use of Doppler alone in the examination on intracerebral vessels. The ability to visualize and insonate simultaneously eliminates the uncertainty caused by anatomic variation. These advantages, long applied to the evaluation of peripheral vessels, are now available for use in the diagnosis of intracranial arterial disease.

Adult

Evidence for a 5-HT1-like receptor mediating the amplifying action of 5-HT in the rabbit ear artery.

1. The nature of the 5-hydroxytryptamine (5-HT) receptors which amplify the vasoconstrictor effect of methoxamine was examined in the rabbit isolated perfused ear artery with intact endothelium. Indices of amplification were leftward shifts of methoxamine dose-response (DR) curves produced by 5-HT (0.3 microM) (Method I), and the appearance of vasoconstrictor responses to 5-HT receptor agonists when methoxamine was present in a near-threshold concentration (Method II). 2. The amplifying effect of 5-HT (Method I) was unaffected by prazosin (0.08 microM), was partly depressed by 5-HT2-receptor antagonists in high concentrations (ketanserin 0.5 microM, LY53857, 1.0 microM), and was abolished by a non-selective antagonist of 5-HT1 and 5-HT2 receptors (methiothepin, 0.01 microM). 3. Amplifying potencies of agonists assessed by both Methods I and II were in the order 5-carbox-amidotryptamine (5-CT) greater than 5-HT greater than alpha-methyl 5-HT. The potency of sumatriptan (assessed by Method II only) was intermediate between those of 5-HT and alpha-methyl 5-HT. 4. Ketanserin and LY53857 inhibited the amplifying action of 5-CT to about the same extent as that of 5-HT. 5. The amplifying potencies of the agonists are in marked contrast to the reported contractile potencies in the rabbit aorta where the receptor is 5-HT2, but are almost identical with reported contractile potencies in the dog saphenous vein where the receptor is 5-HT1-like. 6. It is concluded that a 5-HT,-like receptor mediates the amplifying interaction between 5-HT and methoxamine in the rabbit ear artery which can be weakly blocked by ketanserin and LY53857.7. Since 5-CT was equipotent when applied separately to the intimal and adventitial surfaces of the artery, it is suggested that the 5-HT,-like receptors are distributed uniformly across the artery wall.

Acetylcholine

[Histochemical study of elastic system fibers of the walls of normal and pathological saphenous veins].

Normal, varicose and phlebitic saphenous veins were studied by histochemical methods to establish the qualitative variations of their structural components. The histologic preparations were stained by hematoxylin-eosin Gomori's trichrome, orcinol-neofuchsin and resorcin-fuchsin. Normal saphenous vein showed two layers of smooth muscle cells--an internal circular and an external longitudinal. The components of the elastic system were found in the three layers. Elastic fibers were present in the adventitia under an elongated and wavy conformation. In the media they were present in the external portion. Elaunin fibers were found in the media and intima. The oxytalan fibers were not consistently found. The media and intima of varicose veins showed contracted smooth muscle cells associated with fragmented elastic fibers and augmentation of elaunin fibers. In cases of thrombophlebitis the same alterations observed in varicose veins were found together with a decrease of elastic system fibers in the media and intima. The muscle cells showed a loss of their morphologic characteristics.

Contractile Proteins

Combination of an antiandrogen and a 5 alpha-reductase inhibitor: a further step towards total androgen blockade?

While the elimination of androgens of testicular origin can be easily achieved by orchiectomy or medical castration with LHRH agonists, the action of adrenal androgen precursors which are converted into the active androgen 5 alpha-dihydrotestosterone (DHT) in the prostatic tissue itself can be partially neutralized by antiandrogens which compete with DHT for binding to the androgen receptor. In order to increase the efficiency of androgen blockade, we have used 4-MA, an inhibitor of 5 alpha-reductase, the enzyme which converts testosterone into DHT, to reduce intracellular DHT concentrations and thus facilitate the action of the antiandrogen Flutamide. The present data show that the inhibitory effects of 4-MA (17 beta, N,N-diethylcarbamoyl-4-methyl-4-aza-5 alpha-androstan-3-one) and of the antiandrogen Flutamide are additive on prostatic growth and on androgen-sensitive prostatic binding protein mRNA levels in the rat, thus clearly suggesting that such a combination could provide the basis for a further improvement in the therapy of prostate cancer.

5-alpha Reductase Inhibitors

Ambulatory care. An objective assessment.

Budget constraints, loss of staff, and the inability of administrators to define nursing needs in the outpatient department lead to the development of a tool to define the role of the healthcare provider in the outpatient department. The author discusses the tool's use in categorizing and quantifying nursing activities. Administrators in ambulatory care now have an opportunity to use this readily adaptable method in their outpatient areas to assist in developing quality, cost-effective nursing.

Ambulatory Care

Diastolic coronary artery narrowing due to left ventricular dilatation.

A 56 year old man with a large anterior myocardial infarction and diffuse left ventricular hypocontractility and dilatation was found to have narrowing of the distal part of the left anterior descending coronary artery in diastole. This most unusual finding was ascribed to diastolic compression of the vessel by the enlarged left ventricle. Only 3 similar cases have been found in the literature up to now.

Cardiomyopathy, Dilated