High-performance liquid chromatographic determination of pirprofen and five of its metabolites in human plasma without hydrolysis and in human urine before and after chemical hydrolysis

Selective high-performance liquid chromatographic methods for the simultaneous determination of pirprofen and five of its metabolites either in plasma or in urine before and after chemical hydrolysis were developed. After addition of an internal standard and a buffer, the compounds were extracted from plasma using reversed-phase C18 Bond-Elut columns and from urine using pre-packed silica Extrelut 1 columns, back-extraction into sodium hydroxide and acidification of the alkaline phase before injection. Pirprofen, its five metabolites and the internal standard were separated using a linear elution gradient chromatographic system and wavelength programming. The analysis of spiked samples demonstrated the good accuracy and precision of the methods with limits of quantitation of 100 or 200 ng/ml for the different compounds in plasma, 200 or 360 ng/ml in urine without hydrolysis and 1 or 1.8 micrograms/ml in urine after chemical hydrolysis.

Factors influencing breastfeeding behaviour

The influence of nine socio-demographic factors (family size; child spacing; socio-economic status; mother's employment, education, age and weight; birth weight; and father's education) on the duration of exclusive breastfeeding was studied in a group of urban mothers. Only a small fraction (15%) of the wide variability in breastfeeding behaviour could be related to these factors. Educated mothers alone started artificial feeds significantly earlier (p less than 0.05). Our findings suggest that the decision to breastfeed is largely an individual one and not related in any simple way to the easily measurable characteristics.

Factors associated with the course and outcome of schizophrenia in India. Results of a two-year multicentre follow-up study

The paper describes the two-year follow-up results from 323 out of 386 patients fulfilling a modified version of Feighner's criteria for diagnosis of schizophrenia, in Lucknow, Vellore, and Madras. There was remission in 66% of cases. Short duration of illness, consistent compliance with medication, positive attitudes of relatives and neighbours, absence of economic difficulties, increase in religious activities on the part of patients, a rural background, and a non-schizoid pre-morbid personality were associated with good outcome. Features of depression, dangerous behaviour, and absence of agitation were associated with poor outcome.

Neural and glandular localisation of substance P in Echinostoma caproni (Trematoda-Digenea)

Immunocytochemical studies using antibodies against various peptides were performed on Echinostoma caproni. Only the presence of substance P or a related peptide was clearly demonstrated in this digenetic trematode. In the central nervous system, substance P-immunoreactive neurons were few and constituted two populations according to their size. Labelled axons were observed in the ventral and dorsal nerve cords. Scarce, small neurons and fibres were detected in the peripheral nervous system. The comparative study of 6- and 14-day-old worms showed an overall increase in substance P-immunoreactive nerve structures in the latter. Strong immunoreactivity for substance P was found in prostate cells from 14-day-old worms, whereas none was observed in 6-day-old worms. Thus, positive immunoreactivity seemed to be related to sexual maturity.

[Mood and insulin-dependent diabetes. Value of the Von Zerssen test]

At the end of a week of education, 120 diabetics (I.D.D.M.) checked the list of items from the Von Zerssen's test. This self evaluation test classifies the mood in to depression (13%), anxiety (27%), normal (39%) and euphoria (21%). The ages of the patients and the duration of their diabetes were irrelevant to the results. But, according the type of diabetes, the results become: discovery of I.D.D.M.: depression (4%), anxiety (35%), normal (35%), euphoria (26%); I.D.D.M. (former N.I.D.D.M.): depression (16%), anxiety (28%), normal (31%), euphoria (25%); I.D.D.M. ancient: depression (15%), anxiety (23%), normal (45%), euphoria (17%).

Isoenzyme analysis of Echinostoma liei: comparison and hybridization with other African species

Isoenzyme analysis was carried out on the laboratory strain of Echinostoma liei. The results were compared with those from a preliminary study on Echinostoma caproni, Echinostoma togoensis, and Echinostoma sp. (A. Voltz, J. Richard, B. Pesson, and J. Jourdane, 1986, Annales de Parasitologie Humaine et Comparée, 61, 617-623). Isoelectrofocusing showed characteristic phenotypes for phosphoglucomutase (PGM, EC 5.4.2.2) and glucosephosphate isomerase (GPI, EC 5.3.1.9). The four experimental strains were monomorphic. Their genotypes were defined. Isoenzyme analysis of F1-hybrids and their F2 descendants indicated the subunit structure of both isoenzymes and showed that they were encoded by independent genes. Finally, it also suggested that the four strains corresponded to variants of the same species.

Cataract surgery on leprosy patients

All patients who had cataract surgery at the Schieffelin Leprosy Research and Training Centre, Karigiri, India, between January 1979 and April 1985 were studied to find out the outcome of that surgery. These patients included 291 leprosy cases and 89 nonleprosy cases. Postoperative complications were slightly higher among leprosy patients compared to the nonleprosy cases. Visual recovery was marred by preoperative corneal opacities in some of the leprosy patients. Eyes with chronic insidious type of iridocyclitis did not produce any devastating results postoperatively. Patients whose skin smears were still positive for leprosy bacilli did not show any major complication. All leprosy patients should be offered the benefit of cataract surgery for restoring sight because blindness in leprosy would mean a double handicap if they are already suffering from insensitive, deformed hands and feet.

Accuracy of rotavirus diagnosis: modified genome electrophoresis versus electron microscopy

530 human faecal samples were examined for the presence of rotavirus by electron microscopy (EM) and by a modified electrophoretic analysis of viral genome (PAGE). 516 stools gave identical results by both methods (97.4% agreement). The proportion of EM+, PAGE- samples (1/530) was significantly lower than the proportion of EM-, PAGE + samples (13/530) (P less than 0.01 with McNemar test). Relative sensitivity was 99.6% for PAGE and 95% for EM. False positive results could be excluded for each method because of the characteristic morphology of rotavirus particles (EM) and specificity of rotavirus electrophoretypes (PAGE). Discrepant cases were reexamined whenever possible and the causes of misdiagnosis are discussed.

A genetic comparison between natural and laboratory strains of Echinostoma (Trematoda) by isoenzymatic analysis

A comparative isoenzyme study between a natural population of Echinostoma caproni and 2 strains of E. caproni and E. togoensis, maintained for a long time in the laboratory led to the following conclusions. (1) The natural E. caproni population showed polymorphism of associated PGM and GPI genotypes. Some zymograms were identical to those of experimental strains. Allelic frequencies show that the natural population is panmictic according to the Hardy-Weinberg equilibrium. (2) The laboratory strains were monomorphic, and interbreeding produced double-heterozygous F1 progeny, identical to those of the natural population.

Renal disease in adult Indians: a clinicopathological study of 2,827 patients

Nephrotic syndrome was the commonest clinical presentation among 2827 consecutive adult Indian patients from whom adequate kidney biopsies were obtained for suspected renal disease. In 83 per cent of cases the nephrotic syndrome was due to minimal change disease, focal segmental glomerulosclerosis, mesangiocapillary glomerulonephritis, membranous usually secondary to tuberculosis or leprosy, was present in only 34 patients. Acute nephritis, the next most frequent clinical presentation, was due to diffuse endocapillary proliferative, crescentic or mesangial proliferative glomerulonephritis in 88 per cent of cases, almost half of whom had elevated serum streptococcal antibody titres. Eosinophilia showed a highly significant association with diffuse endocapillary proliferative and mesangiocapillary glomerulonephritis. Idiopathic IgA nephropathy was present in only 10, and antiglomerular basement membrane antibody disease in only one, of the 238 patients whose biopsies were studied by immunofluorescence. Complications of pregnancy accounted for 70 per cent of cases of cortical necrosis. Acute gastroenteritis, septicaemia, abortions, snake bite and allopathic and indigenous medicines were important causes of acute tubular necrosis.

[On medical responsibility in geriatric psychiatry]

In recent years, three new disciplines have progressively emerged, namely geriatric psychiatry, psycho-geriatrics and psycho-gerontology. At this time, problems of responsibility in geriatric psychiatry have tended to make physicians hesitate between two extremes: one the one hand, a refusal to take seriously the care of the elderly mentally ill, and on the other hand, a tendency towards activism and a medical ideology characterized by globalization and reductionism. It must be said, in the physician's favour, that, not only had he to learn to free himself from the ideological strangle-hold of a pseudo-scientific line of thought, but also he was having to cope with the reemergence of his own existential preoccupations as a result of his own contact with the elderly patient. It is in this difficult endeavour that a number of situations are described and discussed; these situations are of interest to psychiatry in general from the point of view of medical responsibility. Some of these are to do with the use the physician makes of concepts he has created and diffused without controlling their implementation. Others cast doubt on care management. Finally, others enable us to question more effectively the current drift in thinking amongst professionals and consumers.

Differential effects of selective lesions of cholinergic and dopaminergic neurons on serotonin-type 1 receptors in rat brain

Serotonin (5-HT)-type1 (abbreviated as a subscript 1) receptor binding sites are discretely distributed in rat brain. High densities of [3H]5-HT1 binding sites are especially located in areas enriched with cholinergic and dopaminergic innervation, such as the substantia innominata/ventral pallidum, striatum, septal nuclei, hippocampus and substantia nigra. The possible association of [3H]5-HT1 binding sites with cholinergic or dopaminergic cell bodies and/or nerve fiber terminals was investigated by selective lesions of the substantia innominata/ventral pallidum-cortical and septohippocampal cholinergic pathways and the nigrostriatal dopaminergic projection. [3H]5-HT1 receptor binding sites are possibly located on cholinergic cell bodies in the ventral pallidum-cortical pathway since [3H]5-HT1 binding in the substantia innominata/ventral pallidal area was markedly decreased following kainic acid lesions. Fimbriaectomies markedly decreased [3H]5-HT1 binding in the hippocampus, suggesting the presence of 5-HT1 binding sites on cholinergic nerve fiber terminals in the septohippocampal pathway. Lesions of the nigrostriatal dopaminergic projection did not modify [3H]5-HT1 binding in the substantia nigra and the striatum, suggesting that 5-HT1 receptors are not closely associated with dopaminergic cell bodies and nerve terminals in this pathway. These results demonstrate differential association between 5-HT1 receptors and cholinergic and dopaminergic innervation in rat brain.