Lymphocyte glutathione peroxidase activity during exacerbations in multiple sclerosis

Glutathione peroxidase, one of the major antioxidants in the human brain, has been found to have decreased activity in patients suffering from multiple sclerosis (MS). This study compares the activity of lymphocyte glutathione peroxidase (L-GSH-px) in MS patients suffering from acute relapses with clinically stable MS patients and with control patients referred with nondemyelinating neurological diseases. All three groups showed an increase of mean enzymatic activity (MEA) during the observation period. The highest MEA in this study was observed in the MS groups. However, there were no significant differences in the L-GSH-px activity in the three groups. These results are not in accordance with previous investigations, and the need for further research in this field is emphasized.

Glutathione peroxidase in early and advanced Parkinson's disease

A defective antioxidant scavenging system plays a major role in one of the theories of the pathogenesis of Parkinson's disease. The aim of this study was to investigate whether there is a general difference in antioxidant activity between early and advanced cases of Parkinson's disease. Twenty five recently diagnosed patients, without any clinical fluctuations (group A), and 25 patients in a late phase of the disease with severe fluctuations in response to levodopa therapy (group B) were included in the study. Erythrocyte glutathione peroxidase was determined as a measure of antioxidant activity and significantly lower values were found in group B than in group A. Regression analyses in groups A and B showed significant correlation between glutathione peroxidase and duration of disease, but not between glutathione peroxidase and age of patients.

Intermittent prophylaxis in febrile convulsions: diazepam or valproic acid?

In an open, prospective, randomized, and hospital-based study, comprising 219 consecutive children, 169 were given intermittent prophylaxis for one year, receiving either diazepam or valproic acid after their first febrile convulsion. Children admitted on odd dates (n = 89) were given rectal diazepam in solution every 12 h, whenever the temperature was 38.5 degrees C or more. Children admitted on even dates (n = 80) were given valproic acid as suppositories at times of fever. Twenty-three children in the diazepam group had a recurrence within 1 year versus 14 in the valproic acid group. On an intention-to-treat basis the 12-month recurrence rates in the 2 groups were similar, 27% vs 20%. The latter is well below figures for untreated controls from Denmark (32%), suggesting that intermittent valproic acid at times of fever may be effective, but further studies are needed. The number of complex recurrences, however, were significantly higher in the valproic acid group than in the diazepam group. Parental non-compliance was a major problem, and in the 2 study groups only 5 and 12 children, respectively, with recurrences were treated adequately. Sixty-nine children receiving diazepam had side-effects vs 37 receiving valproic acid. None were serious.

High dose antioxidant supplementation to MS patients. Effects on glutathione peroxidase, clinical safety, and absorption of selenium

High-dose antioxidant supplementation has recently been recommended for multiple sclerosis (MS) patients. This study tests the clinical safety, the glutathione peroxidase (GSH-px) activity, and the absorption of selenium during such supplementation. Eighteen MS patients were given 6 tablets especially made for this study, equivalent to 6 mg sodium selenite, 2 g vitamin C, and 480 mg vitamin E a day for five wk. GSH-px, which was lower than in non-MS controls before the start of treatment, increased fivefold during 5 wk of treatment. Side effects were scarce. Ten MS patients were subjected to a 24-h selenium absorption study after ingestion of 2 active tablets, equivalent to 2 mg sodium selenite. Selenium, which was low initially, increased 24% during the first 3 h and then stabilized. It is concluded that the tested antioxidant treatment seems to be safe and that MS patients have low GSH-px, which may be increased by the tested antioxidant treatment.

[Results of thoracoscopy in localized lung and chest wall diseases]

On the basis of 109 thoracoscopic examinations--out of a total number of 1,014 thoracoscopies performed between 1981 and 1986 at our Department--carried out to investigate localised disorders of the lungs and wall of the chest, the diagnostic effectiveness of the method for this indication has been examined. The lesions involved were 59 pulmonary foci, and 50 localised changes involving the wall of the chest, thoracic spine or diaphragm. With the aid of thoracoscopy, the diagnosis proved possible in 83% of the disorders of the chest wall, in comparison with only 46% in the case of the pulmonary lesions, since the focus is often not sufficiently sub-pleural in location, or else pleural adhesions that presented impaired the view. On the basis of the high diagnostic yield in localised diseases of the thoracic wall, thoracoscopy should be considered for this indication in particular, when clarification of the situation is not possible with radiological procedures, and surgery appears unnecessary or not feasible.

[Pleurodesis with tetracycline hydrochloride]

Malignant pleural effusion is a common complication of malignant disease requiring drainage and palliative sclerosing therapy in the vast majority of cases. Tetracycline in conjunction with thoracoscopic drainage is currently considered as the optimal sclerosing agent due to its high efficacy, good patient tolerance, simple and repeatable applicability and low cost of treatment. Traditional and more recent agents like fibrin-sealant may give similar results, but do not achieve a favourable all-round-properties. The relevant data from the literature are reviewed, our own results are presented. An explicit description of pleurodesis is given, also a brief discussion of possible mechanisms of action of sclerosing agents. Concepts are suggested for positioning pleurodesis in the general therapeutic approach to various tumours. The concept of pleurodesis can be similarly successful and safely applied on malignant pericardial effusion (pericardesis).

[Diagnostic thoracoscopy in mediastinal space-occupying lesions]

Thoracoscopy is a helpful and safe procedure for diagnosing a variety of mediastinal masses if adequate information cannot be obtained out due to biological risk or patient non-compliance. An explicit description of thoracoscopic technique is given along with case reports demonstrating the efficiency of the method.

[Pleurodesis with tetracycline hydrochloride in spontaneous pneumothorax]

Treatment of spontaneous pneumothorax aims at avoiding relapses besides achieving immediate reexpansion of the lung. Thoracoscopy should definitely occupy a well-established position in the diagnostic and therapeutic step-by-step schedule. On the one hand, it enables local treatment methods, and on the other it helps in arriving at a decision with regard to the operation. If conditions permit, pleurodesis should be effected via the intrapleural rubber-tube drain, tetracycline hydrochloride having proved very suitable for this purpose. A retrospective review is given on the experiences with thoracoscopy and pleurodesis on the basis of own cases.

The role of computerized modeling and simulation in the development of life support system technologies

Using conventional means of process development, it would take decades and hundreds of millions of dollars to develop technology for recycling of water and solid waste for lunar missions within the next thirty years. Since we anticipate neither that amount of time nor level of funding, new methodologies for developing life support systems (LSS) technologies are essential. Computerized modeling and simulation (CMAS) is a tool that can greatly reduce both the time and cost of technology development. By CMAS, we refer to computer methods for correlating, storing and retrieving property data for chemical species and for solving the phenomenological equations of physical/chemical processes (i.e., process conditions based on properties of materials and mass and energy balances, equipment sizing based on rate processes and the governing equations for unit operations). In particular, CMAS systems can be used to evaluate a LSS process design with minimal requirements for laboratory experimentation. A CMAS model using ASPEN PLUS is presented for a vapor compression distillation (VCD) system designed for reclaiming water from urine.

Cluster headache-like headaches: a symptomatic feature? A report of three patients with intracranial pathologic findings

This report concerns three patients with cluster headache-like headaches associated with intracranial pathologic findings. The question whether the occurrence of cluster headache-like headaches may be a symptomatic feature is still not solved. In two of the three presented cases the cluster headache-like headaches disappeared when the intracranial abnormalities were treated.

[New methods in the radiotherapy of bronchial carcinoma. Endobronchial small-field irradiation using the iridium-129 high-dose afterloading technic in combination with the neodymium-YAG laser]

106 patients with inoperable malignant tumours constricting the central bronchial tree underwent endobronchial small-field radiotherapy with iridium-192 at high dose between June 1983 and September 1985. Treatment was performed using the computer-guided after-loading technique and a flexible bronchoscope under local anaesthesia. In complete occlusion of a bronchus by the tumour, a neodymium YAG-laser was applied (57 patients) to allow insertion of the after-loading probe. Endoscopy showed tumour regression in 75% of the patients, accompanied by clinical improvement. Pulmonary function tests, arterial blood gas analyses and pulmonary perfusion scans yielded a highly significant improvement of data after treatment. The procedure also proved effective upon exhaustion of external radiation. Apart from its positive palliation, endobronchial small-field radiotherapy using high doses of iridium-192 also has a curative effect, thus opening up a new approach to the therapy of advanced bronchial carcinoma.

Prostaglandins and thromboxane: tert.-butyldimethylsilyl ethers as derivatives for their analyses by gas chromatography-mass spectrometry-selected ion monitoring

tert.-Butyldimethylsilyl ethers of eighteen prostaglandins (PGs) and thromboxane have been analyzed by combined packed-column or fused-silica capillary gas chromatography-mass spectrometry (GC-MS). Except for thromboxane B2 and PGs of the 3 series the [M - 57] ion, the loss from the molecular ion of the tert.-butyl radical, is generally the major peak in the spectra of PGs. This high abundance of large fragments provides suitable criteria for the employment of these derivatives in GC-MS selected ion monitoring for rapid quantity estimation of PGs from biological samples. PGs from rat stomach fundus were rapidly quantitated in a single chromatogram using this procedure.

Determination of prostaglandins and thromboxane as their pentafluorobenzyl-trimethylsilyl derivatives by electron-capture gas chromatography

The optimization of the parameters affecting the chromatographic properties and separation of prostaglandin pentafluorobenzyl derivatives by gas chromatography using electron-capture detection is described. The effects of composition and flow-rate of carrier gas, temperatures of detector and column, and nature of stationary phases on the detector response to different pentafluorobenzyl (both oxime and ester) trimethylsilyl ether derivatives of prostaglandins were systemically examined. The stability of some selected prostaglandin derivatives at -20 degrees C was also determined. After standardizing these parameters, prostaglandins and related compounds from biological samples, e.g. semen, rat aorta, dog serum and trout gill were successfully analyzed. Identification of prostaglandins was confirmed by gas chromatography-mass spectrometry.

Dietary trilinoelaidate: effects on metabolic parameters related to EFA metabolism in rats

To study the effects of dietary trilinoelaidate (tt18:2) on metabolic parameters, as they relate to essential fatty acid metabolism, a diet containing "adequate" linoleic acid with incremental isocaloric ttl8:2 supplementation was formulated. This diet was fed to rats for 11 weeks and oxygen (O2) consumption, insensible water loss (IWL), growth parameters and liver fatty acid composition evaluated at specified time intervals. The results showed that while an essential fatty acid deficient diet (hydrogenated tallow) increased IWL and decreased body weight gains, O2 consumption remained unaltered. Dietary tt18:2, while accumulating in liver lipids, apparently inhibiting delta 6 desaturase, as evidenced by 18.2/20.4 ratios, did not alter O2 consumption of IWL. At the highest level of tt18:2 fed (2.5 weight percent of dietary fat) there was a noticeable decrease in body weight gains by the 11th week; organ weights, however, were not affected. While the increased consumption of dietary trans fatty acids has raised questions regarding their potential biologically detrimental effects, the present study indicated that gross metabolic alterations related to classical essential fatty acid deficiency symptoms are not precipitated in the rat by tt18:2 levels comparable to those consumed in a normal human diet.

Extraction and purification of prostaglandins and thromboxane from biological samples for gas chromatographic analysis

An efficient extraction procedure for the isolation of prostaglandins (PGs) from biological samples for their subsequent quantification by gas chromatography-electron capture detection (GC-ECD) is described. PGs were extracted from lung, kidney, spleen and stomach fundus into ethyl acetate at different pHs. The highest recovery and least extraction of contaminating pigments was obtained at pH 4.5. Pigments and other contaminants are removed by thin layer chromatography using a solvent system chloroform-isopropyl alcohol-ethanol-formic acid (45:5:0.5:0.3). The isolated PGs were determined by GC-ECD after appropriate derivatization. The overall recovery of PGs using this procedure is 60%.

Metabolism of trans fatty acids with emphasis on the effects of trans, trans-octadecadienoate on lipid composition, essential fatty acid, and prostaglandins: an overview

Information concerning the metabolism of trans isomers of dietary unsaturated fatty acids is presented. Dietary trans-octadecenoic and trans,trans-octadecadienoic acids are apparently absorbed, activated, oxidized, and acylated into ester lipids much like saturated fatty acids although differences have been observed with regard to their metabolism by different organs. Because of the important role of linoleic acid as the principal precursor of cyclic endoperoxides, prostaglandins and leukotrienes, the potential deleterious effects of trans isomers of this acid are discussed. High levels of dietary trans,trans lineoleate can impair delta 6 desaturase activity and decrease prostaglandin production in rats on experimental diets.

A new prostaglandin, C22-PGF4 alpha, synthesized from docosahexaenoic acid (C22:6n3) by trout gill

The concentrations of prostaglandins PGE3 and PGF3 alpha were 214 and 1500 ng/g wet trout gill tissue, respectively. A new prostaglandin, tentatively identified by gas chromatography/mass spectrometry as C22-PGF4 alpha (590 ng/g wet tissue) was discovered. This was synthesized from docosahexaenoic acid.

Prostaglandin E1 and E2 in bovine semen: quantification by gas chromatography

Prostaglandins PGE1 and PGE2 extracted from bovine semen, purified via silicic column chromatography were quantified by gas chromatography as their methoxime methyl ester trimethylsilyl ether derivatives. The PGE2 and PGE2 concentrations of 19 bovine semen samples ranged from 395 +/- 225 and 487 +/- 407 ng/ml, respectively. A constant 1:1 ratio between PGE1 and PGE2 was observed. There was not relationship between PGE and sperm motility, but high sperm counts were generally associated with decreased PGE levels. The direct precursors of PGE1 and PGE2, i.e. 20:3n6 and 20:4n6, occurred in low concentrations compared to other related unsaturated fatty acids, i.e. 18:2n6 and 22:5n6 of the n-6 family.

Prostaglandins and their precursors in tissues from rats fed on trans, trans-linoleate

Feeding trans,trans-9,12-linoleate to rats as 50 and 100% of the dietary fat decreased the concentrations of n-6 fatty acids, i.e. 18:2, 20:3 and 20:4, in heart, kidney, lung, adipose tissue and platelets of rats. The concentrations of prostaglandin products prostaglandins E1, E2 and F2 alpha in serum were significantly decreased in rats receiving high concentrations of dietary trans, trans-linoleate.

Mode of action of dantrolene sodium in spasticity

The mode of action of dantrolene sodium was studied in 11 multiple sclerosis patients with spastic paresis of the legs by measurements of changes in electromyographic and mechanomyographic proprioceptive reflex responses and in voluntary power. Dantrolene sodium 0.5 mg per kg body weight given intravenously clearly reduced monosynaptic reflex twitch tension, but voluntary power only moderately so. The electromyographic reflex responses were unchanged or slightly increased. The mode of action of the drug on spindle function is discussed on the basis of the present findings and the literature. It is concluded that dantrolene sodium does not reduce spindle stretch sensitivity, but probably reduces activity in group II and tonic 1a afferent fibers.

Depression of spasticity by alpha-adrenergic blockade

In spastic patients the alpha-adrenergic blocking drug thymoxamine (Opilon Forte) was found capable of depressing most propioceptive reflex parameters within 1 min after intravenous administration. The action seems to be of CNS origin, probably exerted as a depression of spindle stretch sensitivity through descending alpha-adrenergic bulbospinal pathways, but an additional action on the mechanism of presynaptic inhibition is likely. With oral administration, the drug is also capable of depressing distressing clonus, and it is concluded that it deserves further testing as a spasmolytic.

Clonus depression by propranolol

Propranolol administered i.v. to spastic patients was found to be capable of depressing clonus. The drug exerts its action on the spinal cord but does not influence dynamic spindle activity or alpha-motoneurone activity as tested by the T (Achilles tendon) and H reflexes. It may disinhibit the tonic stretch reflex. Thus, clonus is dependent not only on dynamic spindle activity but also on another, probably inhibitory, mechanism.

Central effect of bladder filling and voiding

In normal subjects and in patients with spasticity and/or urological complaints changes in somatic muscle reflexes associated with filling of the urinary bladder were observed. Two different patterns of reflex changes occurred. One pattern was associated with easy initiation of voiding: it consisted of increasing H and T reflexes and decreasing flexor reflexes with concomitant decreasing sphincter muscle activity. The other pattern was associated with difficulty in initiation of voiding: it consisted of increasing flexor relfexes including sphincter muscle activity and decreasing H and T reflexes. The importance of these reflex patterns in disturbances of micturition is discussed. During voiding, decreasing flexor relfexes with increasing H and T reflexes occur as the general pattern.