Toxic effects of 1,3,5-trinitrobenzene (TNB) in male and female rats were evaluated by feeding powdered certified laboratory chow diet supplemented with varied concentrations of TNB (0, 50, 200, 400, 800 and 1200 mg kg-1 diet) for 14 days. Food intake by female rats in 400, 800 and 1200 mg TNB diet groups was reduced and resulted in a significant decrease in absolute body weights (BW). Food and water consumption by male rats in high-dose groups (800 and 1200 mg TNB kg-1 diet) was also reduced and resulted in a significant decrease in body weight. The calculated average TNB intake (from 1200 mg TNB kg-1 diet) was 92 mg kg-1 BW day-1 for male rats and 80 mg kg-1 BW day-1 for females. A decrease in testicular weight in males and an increase in spleen weight of both sexes in high-dose groups was noted. In addition, histopathological examinations revealed that the susceptible organs for TNB toxicity were kidney (hyaline droplets), spleen (extramedullary hematopoiesis), brain (hemorrhage, malacia and gliosis) and testes (seminiferous tubular degeneration). Hematology and clinical chemistry studies indicated a decrease in red blood cell count and hematocrit, a decrease in alkaline phosphatase, an increase in Heinz bodies and increased methemoglobin concentration as compared to controls in both sexes. A lowest observed adverse effect level of 4.41 mg TNB kg-1 BW day-1 was established based on the findings of this study.

Anemia↗

PubMedDate not supplied

Carcinogenic evaluation of 2,3-dimethyl-2,3-dinitrobutane via the mouse skin bioassay.

Female SENCAR mice initiated with 2,3-dimethyl-2,3-dinitrobutane (DMDNB) and promoted with 12-O-tetradecanoylphorol-13-acetate (TPA) via the SENCAR mouse skin bioassay did not exhibit a significant increase in skin tumors. The mice received 20 mg kg-1 DMDNB divided into six intragastric doses over 2 weeks and were promoted three times per week for 20 weeks.

Animals↗

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Carcinogenicity bioassay of 4-chloromethylbiphenyl (4CMB), 4-hydroxymethylbiphenyl (4HMB) and benzyl chloride (BC) on mouse skin: interim (7 month) report.

4CMB, 4HMB, BC of benzo[a]pyrene (BP, positive control) dissolved in toluene have been applied twice weekly to the shaved dorsal region of groups of 20 Alderley Park Swiss albino mice. After 7 months of treatment, 6/20 of the BP test group were confirmed as having developed squamous cell carcinoma of the skin. However, none of the animals in the test groups appeared to have been affected by the test chemicals. This interim observation was supplemented by intercurrent sacrifice of 1 animal from each of the test groups, followed by histopathological examination of sections of the subcutaneous tissue. No neoplastic changes were discerned.

Animals↗

PubMedDate not supplied

Lithium, creativity, and manic-depressive illness: review and prospectus.

Explore the source record for details and available documents.

Aged↗

PubMedDate not supplied

Iris involvement in primary intraocular lymphoma: report of two cases and review of the literature.

Non-Hodgkin's lymphoma involves ocular tissues either as a primary tumor or as secondary metastasis from systemic disease. Diagnosis is based on the identification of malignant cells in the eye by biopsy. Although primary intraocular lymphoma cells have been identified in the optic nerve, ciliary body, and iris of a small number of patients by histopathology, these sites of infiltration have rarely been observed on clinical examination. We studied clinical and histopathological findings of two patients with iris infiltration by primary intraocular lymphoma and reviewed the findings of 163 cases reported in the literature.

Biopsy↗

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Morphologic and immunohistochemical observation of otosclerotic stapes: a preliminary study.

Stapes with otosclerotic lesions obtained during stapedectomies were examined with light microscopy, histochemistry, immunochemistry, and electron microscopy to elucidate the cellular mechanism(s) involved in this disease process. Three types of lesions were identified: cellular (spongiotic), fibrotic, and sclerotic. The cellular type is characterized by monocyte, macrophage, osteoblast, and osteoclast recruitment and their activation. Macrophage recruitment is an early event of otosclerosis. The fibrotic type is characterized by extensive fibrosis of the bone, and the sclerotic type is characterized by a paucity of bone cells. Cytochemical results showed a large accumulation of granular substances positive for periodic acid-Schiff stain along the edge of the marrow spaces coinciding with ultrastructural calcospherite deposits, suggesting that glycosaminoglycans are involved in the mineralization process. Acid phosphatase is largely localized in the osteoclasts, but a sporadic diffusion of this enzyme was observed in the demineralizing front of the preotosclerotic lesion. Immunoglobulin G and complement C3 were colocalized in pericapillary tissue, suggesting deposit of immune complex in the spongiotic lesion. This finding indicates a possibility that immune mechanisms are involved in otosclerosis.

Acid Phosphatase↗

PubMedDate not supplied

Ophthalmic manifestations of HIV: an update.

A variety of ocular disease processes have been identified in HIV-antibody positive persons, especially in people with AIDS. The most common sight-threatening disease in this population is cytomegalovirus (CMV) retinitis. Effective therapies are available to treat CMV retinitis. However, such therapies carry potentially challenging toxicities. Highly active antiretroviral therapy (HAART) has improved immune system functioning in many of its adherents, decreasing the incidence and improving the clinical course of CMV retinitis. However, a recent phenomenon associated with HAART, immune recovery uveitis (IRU), has been noted with additional, often problematic ocular manifestations in many persons with CMV retinitis. Periodic ophthalmic examination is prudent for all persons with HIV and especially for people with AIDS.

AIDS-Related Opportunistic Infections↗

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The effect of pentoxifylline on current perception thresholds in patients with diabetic sensory neuropathy.

Diabetic peripheral neuropathy is a common, painful, and disabling condition that is known to occur by two mechanisms: hyperglycemia and arterial blood flow occlusion. Pentoxifylline (Trental) functions by improving erythrocyte flexibility in blood vessels, which could increase the delivery of oxygen to occluded nerve vessels. This 1-year clinical trial was aimed at ascertaining the effects of pentoxifylline on diabetic sensory neuropathy. Fifty patients with type I or II diabetes were evaluated in a randomized, double-blind, parallel group and placebo-controlled study. Pentoxifylline effectiveness was evaluated by measuring glycated hemoglobin, blood pressure and current perception threshold (CPT). The CPT results showed no statistically significant effect of pentoxifylline on mean nerve sensory perception thresholds in ankle and toe at 5, 250 and 2000 Hz. There were no significant changes in glycated hemoglobin or in systolic and diastolic blood pressure during the trial. Thus, glycated hemoglobin and blood pressure did not explain the lack of pentoxifylline effect on diabetic neuropathy. In conclusion, pentoxifylline appears not to add benefits to the clinical treatment of diabetic sensory neuropathy of the lower extremity.

Adult↗

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Aggressive epithelioid hemangioendothelioma of the lower extremity: a case report and review of the literature.

A case of epithelioid hemangioendothelioma (EHE) of the left lower extremity in a 50-year-old male is discussed. The neoplasm presented as a tan-purple, painful mass involving the fourth digit of the left foot. Following an excisional biopsy and partial amputation of the fourth digit, the lesion recurred with a multifocal distribution. A physical exam following the recurrence demonstrated multiple palpable lymph nodes in the left inguinal region. A complete amputation of the fourth digit was performed in conjunction with local excisions of the remaining lesions. Additionally, an inguinal lymphadenectomy was performed for staging purposes. Histologically, the tumor was predominantly composed of epithelioid endothelial cells forming nests, cords, and sheets and occasionally forming irregular, primitive vascular structures. Less commonly, nests of tumor cells assumed a spindled morphology. Patches of necrosis and hemorrhage were apparent throughout the neoplasm. There was minimal atypia and mitoses were not identified. Immunohistochemical stains for CD34, CD31, and Ulex europaeus antigens were positive in tumor cells. This case illustrates the potential aggressive behavior of this rare neoplasm and argues against the designation "tumor of low-grade malignancy" with which it is commonly attributed.

Foot Diseases↗

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Spirituality and quality of life in gynecologic oncology patients.

PURPOSE: The inclusion of spiritual well-being in healthcare assessments can provide insight into patients' needs and coping resources. This study explored the relationship between spiritual well-being and quality of life (QOL) in gynecologic oncology patients in an attempt to clarify the significance of spiritual well-being in the assessment process. DESCRIPTION OF STUDY: Eighteen women with gynecologic cancer completed a self-administered questionnaire that obtained sociodemographic, medical, spiritual, and functional information. The Spiritual Well-being Scale was used to assess spiritual well-being, and the Functional Living Index: Cancer (FLIC) measured QOL. Data were analyzed using descriptive statistics, comparison of means, and analysis of variance. RESULTS: Patients with gynecologic cancers other than ovarian reported a better QOL and a higher degree of spiritual, existential, and religious well-being. Older patients consistently reported higher degrees of spiritual well-being and QOL than did younger patients. Married patients consistently reported higher degrees of spiritual well-being than patients who were not married (never married or separated). Catholic patients scored higher in degrees of religious and spiritual well-being as well as in FLIC scores than other patients. CLINICAL IMPLICATIONS: Health professionals do not generally assess spiritual well-being in their evaluations of patients' needs. The findings from this study support the inclusion of spirituality as part of routine patient assessment and intervention. Clinical intervention that would increase a patient's level of spiritual awareness and his or her level of comfort associated with a personal perspective on death could help decrease the patient's level of psychosocial distress. Despite the medical establishment's bias to the contrary, religion and spirituality are positively associated with both physical and mental health and may be particularly significant to terminally ill patients. The curricula of medical, nursing, and other health schools should be redesigned appropriately.

Activities of Daily Living↗

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The relationship of attachment theory and perinatal loss.

Perinatal loss has recently received attention in the literature that presents it as different from other types of losses. Perinatal loss, or the loss of an infant due to miscarriage, stillbirth, or neonatal death, is a significant problem that may be best understood when viewed through the framework of attachment theory. Recent advances in medical technology, including prenatal diagnostic procedures and resulting decisions have influenced issues of both perinatal attachment and loss, and have provided challenges for the clinician. This article presents a review of current theories and research on attachment and perinatal loss, and discusses how knowledge gained from this research may be integrated into clinical practice.

Bereavement↗

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A prokinetic approach to treatment of gastroesophageal reflux disease.

Currently available medications for gastroesophageal reflux disease (GERD) vary in mechanisms of action from neutralization or suppression of gastric acid to improving underlying upper gastrointestinal dysmotility. This article reviews the clinical efficacy of pharmacological agents used to treat GERD and provides a rationale for considering a primary prokinetic approach to antireflux treatment which will be applicable to many patients. Treatment trials in acute GERD have demonstrated unexpectedly prolonged maintenance of high esophageal pH with tablet and liquid antacid formulations. However, there are no well-designed placebo-controlled trials of antacids for esophageal mucosal healing. H2 receptor antagonists (H2RAs) at conventional doses relieve reflux symptoms in at least 50% of reported series of GERD patients, and they can also provide endoscopic healing in 27-45% of the cases. Therapy with more potent acid-suppressive agents such as proton pump inhibitors (PPIs) may lead to improved symptomatic relief and to superior healing compared with H2RA therapy, especially in those patients with more advanced erosive esophagitis. Promotility agents, particularly cisapride, offer symptom relief and healing rates which are quite similar to standard H2RA treatment. GERD tends to be a chronic and relapsing condition. Cisapride has been shown to be quite effective in maintaining remission in GERD patients, including endoscopic remission in the lesser degrees of esophagitis. This may be accomplished with relatively low and cost-effective dosing in many individuals. For the small proportion of patients who manifest severe grades of esophagitis, PPI therapy is associated with lower relapse rates than either H2RA or prokinetic treatment. Overall, a strong case can be made for the empirical selection of promotility therapy for the large numbers of GERD patients who do not have documented severe erosive disease.

Anti-Ulcer Agents↗

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Dental caries and microbial acid production in twins.

OBJECTIVE: To determine the relative contribution of genetic and environmental stimuli on dental caries traits and microbial acid production in a twin model. METHODS: Dental caries examinations and microbial acid production assays were performed on 388 pairs of twins 1.5-8 years old from the city of Montes Claros, Brazil. Genotyping 8 polymorphic DNA markers determined zygosity. Caries exams followed NIDCR criteria modified to distinguish white spot lesions from cavitated lesions. Surface-based caries prevalence rates (SBCPR) were computed and lesion severity was determined by a weighted index (LSI). Biofilm samples were collected from the tongue using a lactic acid indicator swab. Assay scores were categorized based on acid formation as 1 = low, 2 = medium, and 3 = high. Heritability analyses were performed using the SOLAR software package. RESULTS: Heritability estimates for SBCPRs, LSI and for microbial acid production were H = 76.3 (p < 0.001), H = 70.6 (p < 0.001), H = 16.2 (p = 0.0078), respectively. Treating microbial acid production as a covariate in the SBCPR and LSI models did not significantly alter the heritability estimates, i.e. H = 76.5 (p < 0.001) and H = 70.8 (p < 0.001), respectively. CONCLUSIONS: These results suggest that variation in dental caries surface traits has a significant genetic contribution and that microbial acid production is modulated by the environment.

Acids↗