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PubMed1976

Ethylene imine poisoning. A case report.

A case is described of accidental inhalation of ethylene imine vapour in a chemical worker. This resulted in glottic oedema which required tracheostomy. Artificial respiration was needed because of failure to maintain adequate arterial oxygen levels. The patient developed profuse salivation and sputum production. Endoscopy showed that the mucosal surfaces of the pharynx, trachea and major bronchi were destroyed. The patient was treated with steroids and antibiotics for pulmonary infection. Recovery was slow but he was eventually able to leave hospital. He was later readmitted with recurrent infection and developed acute airway obstruction from which he died. Post-mortem examination shoed extensive destruction of the mucosal lining with erosion and collapse of the cartilages. This was the cause of death. Previous reports of ethylene imine poisoning are reviewed. This appears to be the third fatal case.

Accidents, Occupational↗
PubMed1987

A simplified dosage schedule of metrifonate in the treatment of Schistosoma haematobium infection in Somalia.

We have carried out an open clinical study in Somalia to evaluate the efficacy and safety of a simplified dosage schedule of metrifonate in the treatment of Schistosoma haematobium infection. The doses used were: I. 10 mg X kg-1 once daily for 3 days II. 5 mg X kg-1 thrice daily for one day III. 7.5 mg X kg-1 thrice daily for one day. We screened a total of 550 subjects in four villages for egg excretion in urine, and selected patients with more than 200 eggs per 10 ml of urine. In the initial phase of the study eight patients were assigned to each of the three dose schedules. In an extended study 38 additional patients were treated with regimen II which gave the best outcome in the initial study. Dosage Schedules I and III turned out to be toxic, and none of the patients was treated with all three doses. Adverse effects, such as abdominal colic, nausea, salivation, dizziness, and headache, were seen in almost all the patients in those two groups. Two patients from Group I reported that they fainted within 2 h after the second dose. None of the patients in Group II reported adverse effects. After 4-6 weeks follow-up, egg reduction was 96-100% for Groups I and II and the cure rate was around 60%. This study has shown that a shorter course of treatment with metrifonate might be equally effective and safer than the recommended dosage schedule with three doses of 7.5-10 mg X kg-1 fortnightly.

Colic↗
PubMed1989

Secretion by the mandibular gland of the red kangaroo (Macropus rufus) during isoprenaline infusion.

Intracarotid infusion of isoprenaline, either alone or in combination with acetylcholine infusion was used to stimulate salivation by the mandibular glands of anaesthetized red kangaroos. Isoprenaline alone (0.20-1.25 eta mol.kg-1.min-1) elicited flow rates ranging from 0.014 to 0.239 ml.min-1 (1.21-28.1 microliters.g gland-1.min-1). Salivary concentrations of sodium, chloride, phosphate and urea were negatively correlated with flow, whereas potassium, calcium, magnesium, hydrogen ion, bi-carbonate, protein, and osmolality were poorly correlated with flow. Relative to cholinergic saliva produced at equivalent flow rates, isoprenaline-evoked saliva had higher osmolality, saliva/plasma urea ratios and concentrations of protein, potassium, magnesium, bicarbonate, and phosphate, but lower sodium, chloride and hydrogen ion levels. At a steady salivary flow (0.5 ml.min-1), superim-position of isoprenaline infusion (0.15 eta mol.kg-1.min-1) on a pre-existing acetylcholine infusion reduced the rate of acetylcholine administration necessary to maintain flow, increased osmolality and the concentrations of protein, urea, potassium, calcium, magnesium, bicarbonate and phosphate and decreased sodium, chloride and hydrogen ion in the saliva. Salivary amylase activity was low and highly variable and the amylase activity/protein ratio fell substantially during isoprenaline stimulation. These results support the conclusion that the enzyme is of extrinsic origin. The response of the kangaroo mandibular gland to isoprenaline stimulation was very similar to that reported for rat mandibular gland, suggesting that the same ion transport phenomena underlie mandibular secretion in both species and probably in therian mammals generally.

Acetylcholine↗
PubMed1987

Acute selenium poisoning of a 2-year-old child.

After ingestion of an unknown amount of a gun blueing compound containing selenious acid (11 ml from the bottle fluid were missing, equivalent to 2.9 g Se) a 2-year-old girl suffered from continuous hyper-salivation, vomiting, diarrhoea, restlessness and muscle spasm. Blood pressure and pulse rate were increased. Symptomatic treatment was performed by parenteral fluid administration. The plasma Se concentration was increased to 20 times normal 5 h after ingestion. Erythrocyte Se exceeded plasma Se, 24 h after intoxication. Urinary Se excretion decreased parallel to the plasma Se concentration. Ten weeks later, the Se content of hair had risen to 10 times normal. The plasma glutathione peroxidase activity showed only a slight increase during the first 36 h, erythrocyte glutathione peroxidase, catalase and superoxide dismutase activities were not significantly altered. The child fully recovered.

Child, Preschool↗
PubMed1996

Postganglionic cholinergic dysautonomia with incomplete recovery: a clinical, neurophysiological and immunological case study.

A 26-year-old man presented with signs and symptoms of marked postganglionic cholinergic autonomic dysfunction manifested by non-reacting dilated pupils, paresis of accommodation, decreased salivation, dry skin, atony of the bladder, erectile impotence and complete gastrointestinal paresis. Standard neurophysiological tests for myelinated sensory and motor fibre function and quantitative methods to examine unmyelinated parasympathetic, sympathetic and afferent fibres were performed: parasympathetic function was measured by heart rate variation tests. Sympathetic cutaneous vasoconstrictor responses induced by deep inspiration were examined with laser Doppler flowmetry. Cutaneous nociceptive C-fibre function was assessed by measurement of axon reflex vasodilatation and flare size induced by histamine iontophoresis. The findings confirmed that the abnormalities were restricted exclusively to the cholinergic postganglionic autonomic systems. All other functions were completely preserved. Modern neurophysiological methods of testing sympathetic and afferent small fibre function might help in the diagnosis of cholinergic postganglionic dysautonomia in the early stages. The specificity of the dysfunction argues in favour of an immunological pathogenesis. However, antibody screening including acetylcholine receptor antibodies and voltage-gated calcium channel antibodies gave negative results. Whatever autoimmunological mechanism might be involved, the postulated antibodies act highly specifically on unknown structures of the cholinergic postganglionic autonomic neurons.

Adult↗
PubMed1978

Biofeedback in the treatment of gastrointestinal disorders.

A wide range of secretory (salivation, gastric acid and bile secretion) and motor functions (rumination, esophageal and anal sphincter contraction, gastric and colonic motility) have been successfully modified using operant conditioning procedures or biofeedback training. The clinical syndromes to which these studies have been addressed include rumination, reflux esophagitis, hypersecretion of acid associated with peptic ulcer, irritable bowel syndrome, and fecal incontinence. The available evidence strongly suggests that biofeedback is effective and is the treatment of choice for some types of fecal incontinence, and the evidence supports the effectiveness of operant conditioning for the treatment of intractable rumination in infants or retarded individuals. There is suggestive evidence that a nonspecific biofeedback technique, EMG biofeedback for skeletal muscle relaxation, may contribute to the healing of peptic ulcers, but the data are so far inconclusive. Biofeedback approaches to the treatment of other clinical syndromes are at the investigational stage only, and no predictions can be made regarding their efficacy.

Biofeedback, Psychology↗
PubMed1981

Toxicologic evaluation of diisopropyl methylphosphonate and dicyclopentadiene in cattle.

Diisopropyl methylphosphonate (DIMP), and dicyclopentadiene [3a,4,7,7a-tetrahydro-4,7-methyanoindene] (DCPD), were found as contaminants of groundwater in Colorado. Since there was a potential for cattle to be exposed to these chemicals by drinking well water, a study of their effects was initiated. Eight-to-ten week old calves were given a single dose of either DIMP at 62.5, 125, 250, 500 and 1000 mg/kg of body weight (b.w.) or DCPD at 250, 500, 1000 or 2000 mg/kg of b.w. The calves given DIMP developed tympanitis and ataxia, followed by depression, prostration, and death within two hr after dosing. A slight but significant increase in activated partial thromboplastin time was the only change observed in any of the clinical pathologic parameters. The only gross pathologic changes were acute gastroenteritis with hemorrhages in calves given 1000 mg/kg of b.w. Mild signs of intoxication, ataxia and excess salivation, were observed in calves given 250 mg of DCPD/kg of b.w. At higher doses, these signs were intensified; in addition, calves fell and, while prostrate, exhibited running movements and tonic, clonic spasms. The severity of the signs observed increased as the dose of DCPD increased. All calves given 2000 mg/kg of b.w. and one calf given 1000 mg/kg of b.w. died before seven days after dosing. The only clinical pathologic changes found were increased serum levels of creating phosphokinase, glutamic-oxalacetic transaminase, and glutamic pyruvic transaminase. The only consistent gross pathologic change was congestion in a variety of tissues in calves given 2000 mg/kg of b.w. A variety of histologic changes were observed in tissues from calves treated with both chemicals. However, these changes were not consistent for any one dose level and were not dose dependent. DIMP was slightly toxic for calves, since no signs of intoxication were observed at doses less than 1000 mg/kg of b.w. DCPD exerted detrimental effects on calves at 250 mg/kg of b.w. and was classified as moderately toxic.

Alanine Transaminase↗
PubMed1989

Degeneration and regeneration in the superior cervical sympathetic ganglion after Latrodectus venom.

The effects of the venom of the spider Latrodectus mactans hasselti on the superior cervical ganglion were studied in the guinea pig. Under anaesthesia the ganglion was bathed in venom solution for 15 min. Shortly afterwards animals salivated profusely and later developed unilateral ptosis and enophthalmos. Postoperative survival times ranged from 15 min to 10 weeks. Electron microscopy showed acute swelling of preganglionic cholinergic nerve terminals, followed by degeneration with separation of synapses. Other ganglionic elements appeared to be undamaged, although after detachment of synapses the dendritic postsynaptic specializations were reduced in number. Recovery was very rapid; axon growth cones were identifiable at 18 h and synapse reformation was well established by 2 weeks. With longer survival times there was progressive restoration of normal morphology such that by 8 weeks regeneration appeared complete. These experiments indicate that the preganglionic cholinergic nerve terminals are selectively affected by Latrodectus venom and have a considerable capacity for appropriate regeneration.

Animals↗
PubMed1989

Immunology of interactions between ticks and laboratory animals.

There is good reason to believe that the resistance to ixodid ticks acquired by guinea pigs, rabbits and mice is immunologically mediated. One proposed mechanism for this resistance, which may well be common to all these laboratory animals, involves cutaneous hypersensitivity reactions. Basophils accumulate at tick attachment sites in the skin of resistant animals and degranulate in response to tick salivary antigens, releasing histamine and other mediators. The mediators may directly cause ticks to cease salivating and feeding and then to detach, or they may induce reflex grooming reactions by the host, leading to the removal of ticks from the itching skin. There are gaps in the evidence supporting this hypothesis, and it is likely that other modes of tick resistance remain to be described. However, it should be recognized that, although there have been a few details added to the story in the last fifty years, William Trager's original classic observations and conclusions still stand as the core of the current dogma.

Animals↗
PubMed1979

Opposite effects of naloxone on substance P-induced changes in brain DOPA synthesis and in locomotor activity in rats.

Intracerebroventricular injection of substance P (SP) enhanced the synthesis of dopamine and noradrenaline (measured as increase in DOPA formation after inhibition of the aromatic L-amino-acid decarboxylase) in rat brain. These biochemical effects were blocked in most brain regions by pretreatment with naloxone. SP also induced vasodilation, salivation and increased locomotor activity. These effects were not antagonized, but, in the case of locomotor activity, potentiated by naloxone. The data suggest the existence of specific SP-containing neuronal pathways for behavior, which pathways are not related to those regulating the synthesis of brain catecholamines.

Animals↗
PubMed1984

Relationship between swallow rate and salivary flow.

Recent studies indicate that swallow-induced, primary peristalsis is a major determinant of normal esophageal acid clearance. However, factors that regulate the rate of spontaneous swallowing in normal subjects are incompletely understood. We postulated that the rate of salivary flow influences the rate of spontaneous swallows. To test this hypothesis, we did a total of 60 studies measuring salivary flow or the rate of spontaneous swallowing in 10 healthy volunteers, age 10-30 years. Saliva was collected by expectoration. Swallow rate was recorded by a small, transnasal catheter stationed in the pharynx and also, in some circumstances, by cervical electrodes. On separate sessions, we evaluated the effect of five test manipulations on salivary flow and swallowing rate, respectively. The test manipulations consisted of: (1) pharyngeal intubation, (2) sucking of a dummy lozenge, (3) sucking of a peppermint lozenge, (4) bethanechol injection (5 mg subcutaneously), and atropine administration (12 micrograms/kg intravenously). Pharyngeal intubation caused a small, but significant increase in the rate of salivation and spontaneous swallows. Sucking of a peppermint lozenge caused a sixfold increase in salivary flow while nearly doubling the swallowing rate whereas the dummy lozenge caused only a modest increase in salivary flow and swallowing. Cholinergic stimulation by bethanechol elicited a substantial increase in salivary flow and swallowing rate. In contrast, atropine caused a significant decrease in both salivary flow and swallowing. We conclude that in awake, normal subjects the rate of spontaneous swallows is influenced directly by salivary flow. Because oral lozenges substantially increase both swallowing rate and salivary flow, such agents merit investigation as a potentially useful ancillary treatment for the relief of heartburn.

Adolescent↗
PubMed1991

Facial pain. IV. A prospective study of 1052 patients with a view of: precipitating factors, associated symptoms, objective psychiatric and neurological symptoms.

In a prospective material of 1052 patients the precipitating factors, associated symptoms, psychological and neurological deficits have been examined. Mastication and talking are the most frequently occurring precipitating factors, 76% as regards Neuralgia, with typical starting difficulties. As regards Non-neuralgiform Pain 24%, with precipitation late in the masticatory process. There were trigger zones in 50% of the cases of Typical Trigeminal Neuralgia and in 9% of the patients with Non-neuralgiform Pain. In a series of cases the jaw joint is perceived as a trigger zone. Cold precipitates pain in 48%-39%. Other precipitating factors are much more rare--psychological stress in 15% of the patients with Non-neuralgiform Pain, however. "Vegetative" associated symptoms were relatively frequent, lacrimation occurred in 31% of the cases of Typical Trigeminal Neuralgia and in 20% of the cases of Non-neuralgiform Pain. Rhinorrhea and salivation were less frequent. In terms of figures migrainoid associated symptoms had no connection with vegetative associated symptoms or with pain in the eye. In 11% of the patients pain occurred most frequently during the night and in 20% the frequency of pain was the same day and night. About 1/3 of the patients with Neuralgia experienced seasonal variations. Tenderness of foramina is a symptom of no significance. Very few patients had primary sensory loss. No eye or ear symptoms have been found which may be referred to as the patho-anatomical basis of the pain. About 1/3 of the patients with Non-neuralgiform Pain had psychological symptoms whereas hardly any patients with Neuralgia had them. MMPI test performed on a small matched material showed no difference between Neuralgia and Non-neuralgiform Pain. In material B an examination has been made of the jaw joint arthrosis symptoms. A restriction of the diagnosis of arthrosis has had the effect that it must be recognized that patients with facial pain do not have the high frequency of jaw joint diseases previously assumed. As was also the case in a series of normal material previously published, between 1, 5 and 1, 3 of the patients with Neuralgia had jaw joint arthrosis which was due to old age. This study has not revealed any connection between previous diseases, the onset of pain, the character and course of the pain, the character of the attack, the localization of pain, precipitating factors, associated symptoms and symptoms of loss on the one hand and the patho-anatomical substratum on the other.

Arousal↗
PubMed1994

The mechanism of histamine release induced by pilocarpine from different tissues: studies on rat peritoneal mast cells.

Pilocarpine releases histamine from mast cells of cat submandibular gland and rat liver. In the salivary gland, histamine is released into the saliva and venous outflow. Atropine blocks the salivation, but not histamine release from the submandibular gland into the blood. Histamine release from the gland could be due to a direct action of pilocarpine on tissue mast cells or to an indirect action of mediators (acetylcholine and peptides). These hypotheses were further investigated in our present studies on rat peritoneal mast cells. Our results show: (1) histamine release from rat peritoneal mast cells induced by pilocarpine (ED50 = 1.7 x 10(-2) mol/l) occurs at 1000-fold higher concentrations than by substance P (ED50 = 1.7 x 10(-5) mol/l) and in 6.5-fold higher concentrations than by atropine (ED50 = 2.6 x 10(-3) mol/l), (2) pilocarpine injected directly into the rat peritoneal cavity causes histamine release from peritoneal mast cells in 1.8-fold higher concentrations than from isolated rat peritoneal mast cells. These results would support the hypothesis that histamine release from cat submandibular gland is caused by peptidergic co-transmission during the stimulation of the organ.

Animals↗
PubMed1981

Toxicity of Leucaena leucocephala for steers in the wet tropics.

Brahman crossbred steers grazed Leucaena leucocephala (cv Peru) for 0, 1/2, 1 1/2, 2 1/2, 3 1/2, 4 1/2, 5 1/2, or 6 1/2 days per week grazing Buffel grass (Cenchrus ciliaris) for the 1 1/2, remainder, for at least 50 weeks. Animals grazing Buffel grass only or Leucaena for 1/2 day only grew faster than all other groups in the wet season (0.75 dg/day) but not in the dry season (0.44 dg/day) and had normal thyroxine concentrations in blood. All other groups grew more slowly, had reduced blood thyroxine, fatter carcasses and in some cases showed alopecia, excessive salivation and goitre; 1 steer died. Poorest growth rates in the wet season (0.44 dg/day) were achieved with signs occurred with 4 1/2, 5 1/2 or 6 1/2 days of Leucaena. The frequent observation of toxicity of Leucaena when grazed by cattle under irrigated or wet tropical conditions suggests that its use as a browse legume under these conditions needs further examination.

Animals↗
PubMed1991

Effects of 5-HT3 receptor antagonists on behavioural measures of naloxone-precipitated opioid withdrawal.

The effect of the selective 5-HT3 receptor antagonists, ondansetron and MDL 72,222, against various behaviours elicited by naloxone-precipitated morphine withdrawal were examined. Rats made dependent upon morphine by the subcutaneous implantation of a 75 mg pellet, when challenged with naloxone (0.5 mg/kg SC), 3 or 4 days later exhibited a wide range of behaviours including wet dog shakes, paw shakes, salivation and a marked weight loss. Pre-treatment with ondansetron (0.01-1 mg/kg SC) or MDL 72,222 (1-3 mg/kg SC) failed to affect the incidence of these responses except weight loss, which was attenuated by both treatments. At doses similar to and below those required to elicit the withdrawal syndrome, naloxone produced a single-trial place aversion in morphine dependent rats. The place aversion produced by naloxone (0.05 mg/kg SC) was antagonized by pre-treatment of ondansetron (0.1-1 mg/kg SC) and MDL 72,222 (1 mg/kg SC) prior to conditioning. Chlordiazepoxide (10 mg/kg IP) but not gepirone (3-10 mg/kg SC) was similarly effective. It is concluded that 5-HT3 antagonists may attenuate some but not all behavioural signs associated with morphine withdrawal. Reasons for this apparent selectivity are discussed.

Animals↗
PubMed1995

Comparison of 7-nitroindazole with other nitric oxide synthase inhibitors as attenuators of opioid withdrawal.

Previously, we demonstrated that two nonselective inhibitors of nitric oxide synthase (NOS), L-NG-nitroarginine (L-NNA) and L-NG-nitroarginine methyl ester (L-NAME), reduced some signs of morphine withdrawal in rats. The present work extended these studies to include 7-nitroindazole (7-NI), an inhibitor specific for cerebral NOS, and N(5)-(1-iminoethyl)-L-ornithine (L-NIO), a potent inhibitor of endothelial NOS. Behavioral effects of these four NOS inhibitors and clonidine, an alpha 2-adrenoceptor, agonist, on morphine withdrawal in rats were assessed. Rats received one 75-mg morphine pellet subcutaneously (SC). Three days later, NOS inhibitors were administered IP 1 h before withdrawal was precipitated with naloxone (0.5 mg/kg, SC) and scored. 7-NI, L-NIO, L-NAME and L-NNA produced dose-related decreases in weight loss, diarrhea, wet dog shakes and grooming. 7-NI also reduced mastication, salivation and genital effects. Clonidine produced effects similar to 7-NI. In awake, morphine-naive and morphine-dependent rats not subjected to withdrawal, 7-NI was the only NOS inhibitor that did not increase blood pressure. Because 7-NI attenuated more signs of opioid withdrawal than L-NNA, L-NAME or L-NIO without causing hypertension, 7-NI appears to warrant further testing as a potential candidate for human use.

Analysis of Variance↗
PubMedDate not supplied

Effects of Betel chewing on the central and autonomic nervous systems.

Betel chewing has been claimed to produce a sense of well-being, euphoria, heightened alertness, sweating, salivation, a hot sensation in the body and increased capacity to work. Betel chewing also leads to habituation, addiction and withdrawal. However, the mechanisms underlying these effects remain poorly understood. Arecoline, the major alkaloid of Areca nut, has been extensively studied, and several effects of betel chewing are thought to be related to the actions of this parasympathomimetic constituent. However, betel chewing may produce complex reactions and interactions. In the presence of lime, arecoline and guvacoline in Areca nut are hydrolyzed into arecaidine and guvacine, respectively, which are strong inhibitors of GABA uptake. Piper betle flower or leaf contains aromatic phenolic compounds which have been found to stimulate the release of catecholamines in vitro. Thus, betel chewing may affect parasympathetic, GABAnergic and sympathetic functions. Betel chewing produces an increase in heart rate, blood pressure, sweating and body temperature. In addition, EEG shows widespread cortical desynchronization indicating a state of arousal. In autonomic function tests, both the sympathetic skin response and RR interval variation are affected. Betel chewing also increases plasma concentrations of norepinephrine and epinephrine. These results suggest that betel chewing mainly affects the central and autonomic nervous systems. Future studies should investigate both the acute and chronic effects of betel chewing. Such studies may further elucidate the psychoactive mechanisms responsible for the undiminished popularity of betel chewing since antiquity.

Animals↗
PubMed1994

[A retrospective examination of the acceptance of removable appliances].

In order to study the subjective attitudes of patients and their parents to orthodontic treatment questionnaires were handed out to both groups. One hundred and forty five patient questionnaires and those answered by 114 parents formed the base of the study. The majority of the patients were only able to provide partial answers to precise questions about their treatment. Speech impairment, pressure, and salivation were given as being the most vexatious aspects of the treatment. The majority of the patients and the majority of parents favored removable appliances over fixed appliances. The patients' social environment did not negatively influence their attitude to orthodontic treatment.

Adolescent↗