[Status and development in life insurance medicine in Belgium].
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Biomedical subjects
Publications and source records attributed to E Jacobs.
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The case of a 21-yr-old man, who died in cachexia after 2 yr of intermittent abdominal pain, bouts of diarrhea, and anorexia, is reported. Laboratory tests performed shortly before death disclosed signs of malabsorption. Radiologic examination of the gastrointestinal tract showed a coarse mucosal relief in the upper jejunum and a tubular aspect in the rest of the small bowel. There was no dilatation of the loops. Autopsy revealed severe to complete atrophy with fibrosis of the outer muscle layer of the entire small bowel, extending from the pylorus to the ileocecal valve. The only other lesion discovered was a moderate portoportal fibrosis of the liver. The patient's brother had died a few months earlier after 2.5 yr of similar symptoms. An upper gastrointestinal series had shown dilatation of the stomach with fluid retention and a tubular aspect of the small bowel with generalized widening of the loops. No autopsy was performed. There was a high degree of consanguinity on the mother's side. Family history revealed no other evidence of possible genetic factors in the disease.
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The Rhodospirillum rubrum pyridine dinucleotide transhydrogenase system is comprised of a membrane-bound component and an easily dissociable soluble factor. Active transhydrogenase complex was solubilized by extraction of chromatophores with lysolecithin. The membrane component was also extracted from membranes depleted of soluble factor. The solubilized membrane component reconstituted transhydrogenase activity upon addition of soluble factor. Various other ionic and non-ionic detergents, including Triton X-100, Lubrol WX, deoxycholate, and digitonin, were ineffectual for solubilization and/or inhibited the enzyme at higher concentrations. The solubilized membrane component was significantly less thermal stable than the membrane-bound component. None of the pyridine dinucleotide substrate affected the thermostability of the solubilized membrane-bound component, whereas NADP+ and NADPH afforded protection to membrane-bound component. NADPH stimulated trypsin inactivation of membrane-bound component to a greater extent that NADP+, but inactivation of solubilized membrane component was stimulated to the same extent by both pyridine dinucleotides. The solubilized membrane component appears to have a slightly higher affinity for soluble factor than does the membrane-bound component.
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Herpes simplex infections of the perianal skin and anal canal are not uncommon, as evidenced by the present series of 16 cases, but have rarely been reported in the literature of the past. They are caused by the HSV-2 virus, which is also associated with genital lesions. There is abundant evidence that anogenital herpes is a venereal disease. Anal herpes is most commonly transmitted by anal intercourse. When the infection is present inside the anal canal, especially in a primary attack, the pain can be quite dibilitating. The diagnosis can usually be made on clinical grounds by recognizing the typical vesicles or aphthous ulcers, together with inguinal lymphadenopathy. The disease is self-limiting, but may be recurrent. Asymptomatic homosexuals may represent a large reservoir of the disease, which appears to be on the increase in our society. Cytology, immunofluorescence, viral cultures and serologic tests can be used for laboratory confirmation of the diagnosis. Newer methods of treatment with vaccine containing heat-inactivated virus, and use of photoinactivation following topical application of heterotricyclic dyes, show promise.
110 patients with far advanced head and neck squamous or testicular carcinoma were treated with bleomycin given by intravenous (i.v.) or intramuscular (i.m.) injection according to a randomized assignment. While responses were observed more frequently in patients treated by the intramuscular route, no superiority can be attributed clearly to intramuscular therapy. Responses were seen in 6.2% of head and neck squamous carcinoma patients (5/81; i.m. 3/38, 8%; i.v. 2/41, 5%) while 14% of testicular tumors responded (4/29; i.m. 4/13, 29%; i.v. 0/16, 0%). Toxicity was, in general, manageable.
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