Cerebrospinal fluid (CSF) concentrations of the serotonin and dopamine metabolites, 5-hydroxyindoleacetic acid (5HIAA) and homovanillic acid (HVA), respectively, were measured in a group of 17 children with Autistic Disorder (DSM-III-R). The group means observed for 5HIAA (135 +/- 91 nmol/L) and HVA (502 +/- 324 nmol/L) in the autistic children were not significantly different from those seen in the control group of 15 nonneurologically impaired children (5HIAA, 122 +/- 120 nmol/L; HVA 401 +/- 378 nmol/L). These data suggest that consistent, marked alterations in central serotonin and dopamine turnover are not present in the autistic subjects studied. Although studies to date have found little or no alteration in CSF 5-HIAA in autism, the various reports of CSF HVA are not entirely congruent. Although this study is consistent with most previous studies in not finding a group difference in CSF HVA, the possibility of increased CSF HVA in autism cannot be ruled out.

Autistic Disorder↗

PubMedDate not supplied

Autonomic dysfunction, peripheral neuropathy, and depression.

A 15-year-old boy with diarrhea, dizziness, dysesthesias, and depression is described. On admission, his blood pressure was 110/84 reclining but less than 40 systolic while standing. Vibratory sensation and nerve conduction velocities were decreased in his lower extremities. CSF protein concentration was normal but sural nerve biopsy demonstrated generalized demyelination. Extensive toxicologic and metabolic screening proved unremarkable. Norepinephrine concentrations in plasma and urine, and CSF concentration of 3-methoxy-4-hydroxy phenylglycol (MHPG) were markedly reduced. The patient demonstrates a combination of autonomic dysfunction, peripheral neuropathy, and affective disorder. This collection of clinical and neurochemical findings represents a previously unreported entity involving a defect of both central and peripheral noradrenergic systems.

Adolescent↗

PubMedDate not supplied

A role for platelet release of serotonin in the initiation of contact sensitivity.

Finding contact sensitivity (CS) responses that were fairly normal in ear swelling, and in serotonin (5-HT) dependence in mast-cell-deficient mice, led to experiments to determine whether platelets supplemented mast cells as a source of 5-HT in CS. Severe depletion of platelets, and consequently blood 5-HT, with antiplatelet antibody, strongly inhibited CS, especially in mast-cell-deficient mice, suggesting that platelets supplemented mast cells. Furthermore, human platelets sensitized in vitro with anti-(tri-nitro-phenyl) IgE, and transferred intravenously together with isolated late-acting effector T cells, provided CS initiation due to local 5-HT release. Similar, IgE-dependent in vitro release of 5-HT was C dependent. These findings establish the importance of antigen-specific platelet release of 5-HT in CS initiation.

Amphetamine↗

PubMedDate not supplied

Peripheral nerve sheath tumor of the diaphragm with osseous differentiation in a one-year-old dog.

A 12-month-old, spayed female German shepherd dog was referred to the Veterinary Teaching Hospital for repair of a diaphragmatic hernia. Abdominal exploration revealed an intact diaphragm, but thoracic exploration revealed a large mass originating from the diaphragm. Resection of the mass was incomplete and required reconstruction of the diaphragm. On histopathology, the mass was composed mainly of spindle-shaped cells with occasional areas of osseous and chondroid tissue. The tumor was diagnosed as a peripheral nerve sheath tumor (PNST) with chondro-osseous differentiation. The dog was released four days after surgery; however, she began having difficulty breathing seven days after discharge, and the owners elected euthanasia. A necropsy was not performed. This is the first known report of a PNST originating in the diaphragm of a dog.

Animals↗

PubMedDate not supplied

Hospitalization for ambulatory care-sensitive conditions: a method for comparative access and quality studies using routinely collected statistics.

BACKGROUND: Appropriate and timely provision of ambulatory care is an important factor in maintaining population health and in avoiding unneccessary hospital use. This article describes conditions for which hospitalization rates have a strong and inverse relationship to access to high-quality ambulatory care. METHODS: Three panels of Canadian physicians following different consensus techniques selected conditions for which the relative risk of hospitalization is inversely related to ambulatory care access. PRINCIPAL FINDINGS: All panels identified asthma, angina pectoris, congestive heart failure, otitis media, gastric ulcer, pelvic inflammatory disease, malignant hypertension, and immunization-preventable infections as ambulatory care-sensitive admissions. These conditions strongly overlap with lists developed for similar purposes in the U.S. and England. INTERPRETATION: Ambulatory care-sensitive conditions represent an intermediate health outcome. They are distinct from inappropriate hospitalizations. They may be useful for measuring the impact of health care policy, and for performance measurement or audit.

Ambulatory Care↗

PubMedDate not supplied

Concentration of intrathecal 3H-labeled metrizamide in normal dog brain: age-related differences.

Responses to intrathecal metrizamide in dogs were found to be age-related: Adult dogs had seizures; 7-week-old dogs appeared stuporous; 6-day-old dogs were clinically unaffected. The brain metrizamide concentrations 4, 6, and 20 hr after intrathecal injection correlated directly with the occurrence and severity of neurotoxic symptoms. Age-related differences in brain metrizamide concentration may be explained by two factors. The first is the failure of current clinical guidelines to adjust the recommended dosage of metrizamide to reflect differences among age groups in brain weight rather than body weight. This error resulted in lower doses/gram of brain weight being given to the puppies. However, the large differences in brain metrizamide concentrations among the three groups of dogs could not be explained solely by differences in the dose. A second factor, physiologic age-related differences in brain penetration, is believed to be operative. The precise nature of these differences is unclear.

Aging↗