Acquired stuttering: a motor programming disorder?

Acquired stuttering (AS) can follow unilateral right, left or bilateral hemispheric lesion, and can, but not necessarily, coexist with aphasia. In this paper we experimentally tested motor programming skills in a patient with AS of vascular origin. Motor programming consists in the structuration of the whole sequence of response prior to the onset of the first response element of a sequence of responses. Chronometric studies have shown that the time to initiate a sequence of manual responses is a function of the characteristics of the forthcoming sequence of responses. In our patient, reaction times involving single motor responses performed by right hand were within normal limit. On the contrary, when the task required a sequence of motor responses, there was a consistent difficulty in following the sequence: moreover, in the few correct sequences, reaction time analysis showed a lack of motor programming. It is suggested that AS could be the speech epiphenomenon of a more generalized disturbance of motor programming.

B- and T-cell non-Hodgkin's lymphomas with large multilobated cells: morphological, phenotypic and clinical heterogeneity

Ten cases of non-Hodgkin's lymphomas, mainly composed of large multilobated cells, have been studied. Our results are consistent with the view that they represent a somewhat heterogeneous group of lymphoid tumours displaying different morphological, clinical and immunophenotypic features. In B-cell type the large multilobated cells were histologically characterized by prominent nucleoli and distinctly basophilic cytoplasm whereas in the T-cell type they had indistinct or small nucleoli and ill-defined weakly eosinophilic cytoplasm. These differential features between B- and T-cell type were confirmed by electron microscopy. From a clinical standpoint B-cell type was characterized by a constant involvement of lymphoid tissues (lymph nodes and/or Waldeyer's ring); T-cell type showed, on the contrary, a more frequent involvement of extra-lymphoid sites (mainly bone and subcutaneous tissues). Our study provides some morphological features that may be helpful for a correct differential diagnosis in this heterogeneous group of non-Hodgkin's lymphomas.

Characterization of phosphate residues on thyroglobulin

Follicular 19 S thyroglobulin (molecular weight 660,000) from rat, human, and bovine thyroid tissues contains approximately 10-12 mol of phosphate/mol of protein. These phosphate residues can be radiolabeled when rat thyroid hemilobes, FRTL-5 rat thyroid cells, or bovine thyroid slices are incubated in vitro with [32P]phosphate. Thus labeled, the [32P]phosphate residues comigrate with unlabeled 19 S follicular thyroglobulin on sucrose gradients and gel filtration columns; are specifically immunoprecipitated by an antibody preparation to rat or bovine thyroglobulin as appropriate; and co-migrate with authentic 19 S thyroglobulin when subjected to analytic or preparative gel electrophoresis. Tunicamycin prevents approximately 50% of the phosphate from being incorporated into FRTL-5 cell thyroglobulin. Approximately one-half of the phosphate in FRTL-5 cell or bovine thyroglobulin can also be released by enzymatic deglycosylation and can be located in Pronase-digested peptides which contain mannose, are endo-beta-N-acetylglucosaminidase H but not neuraminidase-sensitive, and release a dually labeled oligosaccharide containing mannose and phosphate after endo-beta-N-acetylglucosaminidase H digestion. The remainder of the phosphate is in alkali-sensitive phosphoserine residues (3-4/mol of protein) and phosphotyrosine residues (approximately 2/mol of protein). This is evidenced by electrophoresis of acid hydrolysates of 32P-labeled thyroglobulin and by reactivity with antibodies directed against phosphotyrosine residues. The phosphoserine and phosphotyrosine residues do not appear to be randomly located through the thyroglobulin molecule since approximately 75-85% of the phosphotyrosine and phosphoserine residues were recovered in a approximately 15-kDa tryptic peptide or a approximately 24-kDa cyanogen bromide peptide, each almost devoid of carbohydrate. 31P nuclear magnetic resonance studies of bovine thyroglobulin confirm the presence and heterogeneity of the phosphate residues on thyroglobulin preparations.

Treatment of descending thoracic aneurysm with an intraaortic occluder

Elective treatment of descending thoracic aneurysms involves direct surgery, with Dacron graft replacement of the diseased aortic segment. When the patient's condition contraindicates major surgery, however, the surgeon should consider using an extraanatomic approach-implanting an ascending aorta-to-abdominal aorta Dacron bypass graft in a ventral position and leaving the diseased segment undisturbed. After such a procedure, the descending thoracic aorta must be excluded from the normal circulation. For this purpose, we have designed an intraaortic occluding technique in which an umbrella-like device is implanted immediately distal to the left subclavian artery. This technique has proved safe and uncomplicated in canine experiments and is ready for clinical trials.

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Since Jensen (1963), the phenomenon of "contrafreeloading" corresponds to the fact that animals which have been conditioned to perform a task (by skinnerian conditioning for instance) continue to behave as they have been taught to even when a more simple and effortless solution is made available to them (for instance free access to abundant food in skinnerian situation). This behaviour has been considered as an exception to the "law of the least effort" (Tolman, 1955). To explain it, two types of theories have been put forward. The first one assumes the existence of positive reinforcers connected with the acquired activity, the other one of aversive stimulus connected with the most effortless solution (such as neophobia in the case of cup of abundant food). A reconsideration of the analysis of operant behaviour has led us to take into account the localisation of reinforcing agents and to integrate it in our experiments. The results that have been obtained cannot be accounted for by the theories mentioned above.

The effect of prolonged administration of CGS 10078B on systemic and regional haemodynamics in normotensive and spontaneously hypertensive rats

The effects of 3 weeks treatment with CGS 10078B (30 mg/kg orally) on systemic and regional haemodynamics and cardiac mass were studied in normotensive Wistar-Kyoto (WKY) and spontaneously hypertensive (SHR) rats. The significant decrease in mean arterial pressure (MAP) (174 +/- 3 versus 156 +/- 4 mmHg, P less than 0.002) in SHR was associated with a significantly slower heart rate. No significant alteration in systemic haemodynamics was observed in WKY rats. The reduced MAP in SHR was related to the preserved blood flow to the vital organs, and therefore reduced renal and cerebrovascular resistances. Left ventricular mass index was reduced in both rat strains of treated animals. Therefore, the reduced MAP and heart rate in the SHR without haemodynamic changes in the WKY indicates that CGS 10078B was an effective antihypertensive agent that decreased cardiac mass in rats through mechanisms that may be dissociated from their haemodynamic effects.

Hemodynamic effects of a new alpha- and beta-adrenergic receptor inhibitor with calcium entry blocking effects (CGS 10078B) in WKY and SHR rats

The immediate acute hemodynamic effects of CGS 10078B, a new agent with combined alpha- and beta-adrenergic antagonist with slow channel calcium entry blocking effects, were studied in normotensive Wistar-Kyoto (WKY) and spontaneously hypertensive (SHR) rats. Heart rate (HR), mean arterial pressure (MAP), cardiac index (CI), total peripheral resistance index (TPRI), and regional hemodynamic measurements were determined before and two hours after its administration (10 mg/kg, gavage) using the combined radioactive reference sample and microsphere techniques (85SR and 141Ce). The agent significantly reduced MAP (168 +/- 5 to 158 +/- 5 mm Hg; p less than 0.02) after 20 minutes without changing HR in SHR. After two hours MAP, HR, and Cl were significantly reduced without change in TPRI. Only Cl decreased (p less than 0.05) in WKY, presumably from its beta receptor antagonist effects. Blood flow to the major organs (eg, heart, brain, and kidneys) was maintained in both groups of rats. These hemodynamic effects reflect the combined actions of this new agent and suggest its potential value for the treatment of hypertension.

[Howie's antithrombin activity and thrombin inhibitors in the nephrotic syndrome]

A prospective study was carried out on a group of 28 patients affected by nephrotic syndrome in order to compare the antithrombin activity, measured by the technique of Howie, the antithrombin III, measured with chromogenic substrate and by radial immunodiffusion, the alpha 2-macroglobulin and the alpha 1-antitrypsin. An increased level of alpha 2-macroglobulin and of the antithrombin activity, measured by the technique of Howie and a reduction of the level of antithrombin III and of alpha 1-antitrypsin was observed. It is suggested that the increased antithrombin activity is related to the increase of alpha 1-antitrypsin was observed. It is suggested that the increased antithrombin activity is related to the increase of alpha 2-macroglobulin concentration in spite of the simultaneous decrease of antithrombin III.

Immediate hemodynamic changes produced by urapidil in normotensive and spontaneously hypertensive rats

The immediate effects on regional and systemic hemodynamics of urapidil (1 mg/kg IV), a recently synthesized vasodilator with a possible combined central and peripheral action, were studied in spontaneously hypertensive (SHR) and normotensive (WKY) rats. Maximal decrease in mean arterial pressure was achieved within the first minute after injection (154 +/- 4 vs 113 +/- 6 mm Hg in SHR and 111 +/- 4 vs 82 +/- 4 mm Hg in WKY, p less than 0.01). This effect was accompanied by a transient (10 min) significant increase in heart rate in both strains. There was a significant fall in total peripheral resistance (0.43 +/- 0.02 vs 0.30 +/- 0.02 U/kg in WKY and 0.62 +/- 0.03 vs 0.43 +/- 0.03 U/kg in SHR, p less than 0.01) and rise in cardiac index 15 min after drug injection (371 +/- 9 vs 425 +/- 12 ml/min/kg in WKY and 395 +/- 8 vs 432 +/- 112 ml/min/kg in SHR, p less than 0.01). Organ vascular resistance decreased significantly in all the organs of /KY and most of the organs of SHR rats. However, a significant increase in blood flow was observed only in skeletal muscle. The data indicate that urapidil is a potent hypotensive agent. The pressure fall is mediated through a decreased total peripheral resistance that is distributed through all circulations. The increased cardiac output and heart rate are most likely reflexly induced.

[Epidemiological study on tremor in the aged]

203 hospitalized old-aged patients were examined for the presence of tremor. This physical sign was found in 58.6% of cases. By far the largest diagnostic category resulted that of essential tremor: 46.7% of all patients investigated and 77.8% of all cases of tremor. The frequency of this type of tremor was found to increase proportionally to age. The conclusion is drawn that also tremor, as well as other neurological signs frequently demonstrable in "normal" old people (for example, the so-called primitive reflexes), should be inscribed in the group of the phenomena due to the ageing process itself.

Nucleic acid-protein interactions. Degradation of double-stranded RNA by glycosylated ribonucleases

1. Extensively glycosylated ribonucleases, like the enzymes from pig and horse pancreas, show a much higher activity on double-stranded RNAs than similarly charged, carbohydrate-free RNAases under stranded assay conditions (relatively high salt concentrations). Glycosylated pig and horse pancreas RNAases also show a larger destabilizing effect on double-stranded poly[d(A-T)] X poly[d(A-T)], than that displayed by bovine RNAase A under these conditions. Both activities show a similar dependence on the ionic strength of the medium. 2. A partial enzymic removal of the heterosaccharide side chains from pig and horse RNAases reduces but their degradative activity on double-stranded RNA and their destabilizing action on poly[d(A-T)] X poly[d(A-T)]. 3. These results are tentatively correlated with a modification of the microenvironment of the enzyme protein caused by its extensive glycosylation.

Influence of sodium on experimental renovascular hypertension in rats

1. Rats on normal sodium diet (group 1) and on chronically maintained low sodium diet (group 2) were studied during a control period, after clipping the renal artery (two-kidney, one-clip hypertension) and after nephrectomy (one-kidney, one-clip hypertension). 2. The low sodium diet neither prevented the development nor changed the severity of two-kidney, one-clip hypertension, and the latter was not accompanied by an increase in plasma renin activity. 3. After nephrectomy arterial pressure further increased and plasma renin activity decreased in group 1, and both remained unchanged in group 2. 4. Blood volume was the same in both groups 10 days before and 10 days after nephrectomy. 5. Sodium does not seem to be 'necessary' in the two-kidney, one-clip hypertension although it may play an enhancing role in the one-kidney model.

[Analysis of deoxyribonuclease I and II activity as a function of ionic strength and pH]

The action of deoxyribonucleases I and II has been studied as a function of ionic strength and pH, in the light of the theory of the ionic control of biochemical reactions (P. Douzou and P. Maurel (1977) Proc. Nat. Acad. Sci. USA, 74, 1013-1015). The pattern of DNA degradation by the two enzymes fits the general principles of the theory. However, the activity of DNAase II, a dimeric, basic protein (pI = 10,2) appears to be scarcely modulated by variables such as ionic strength and pH. This is reminiscent of what was elsewhere observed with the system double stranded RNA-seminal RNAase (also a very basic, dimeric enzyme), and could, therefore, tentatively be correlated with the dimeric and/or the very basic nature of the enzyme protein.

'Isolated' pulmonary valve stenosis as part of more widespread cardiovascular disease

In 25 patients aged 6 days to 9 years presenting as 'isolated' pulmonary valve stenosis, histology of the myocardium of right and left ventricles, coronary arteries, and ascending aorta has shown abnormality in one or all these areas. Myocardial necrosis, old and recent, unrelated to coronary occlusion was frequent. Myocardial 'dysplasia' involving both ventricles, and resembling hypertrophic cardiomyopathy (HOCM, ASH) was found in 10 and a relation of this to myocardial injury in the fetus is postulated. Varying degrees of coronary occlusion were frequently seen in both right and left coronary arteries. The histology of the ascending aorta was abnormal showing 'higgledy-piggledy' disorder of smooth muscle components in 12 (48%). In a different series of 53 patients who had pulmonary valvotomy for apparent 'isolated' pulmonary valve stenosis there were 14 with clinical evidence of left ventricular abnormality consistent with the pathological changes described, 2 with the same aortic histological changes, and 2 with macroscopical left ventricular hypertrophy. Two of them developed classical hypertrophic cardiomyopathy years later. It is suggested that when pulmonary valve stenosis presents with a thick tricuspid poorly mobile valve, particularly in infants or in patients with evidence of other congenital stigmata, it may be part of a more widespread cardiovascular abnormality. This should be recognized and considered in the evaluation of surgical patients and late survivors who may show unexpected clinical features.

Accessory thyroid in the anterior mediastinum: case report

A case of accessory thyroid in the anterior mediastinum, physically separated from the thyroid gland, is reported. The mediastinal thyroid was incidentally discovered during the preoperative evaluation of a patient with breast carcinoma. The extreme rarity of the case is outlined.