ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

Lactulose, a synthetic disaccharide, which is neither absorbed nor metabolized in the upper intestinal tract of normal man, is degraded by bacteria in the intestinal tract with the production of acidified bowel contents. This agent appears to be effective therapy in chronic portalsystemic encephalopathy but has not been studied in acute hepatic encephalopathy. In preliminary uncontrolled studies we have treated 24 episodes of acute nitrogenous hepatic coma with lactulose and compared our results to 24 retrospectively matched episodes of encephalopathy treated with neomycin. The two groups were similar in type, severity, and laboratory features of the disease. Lactulose was administered in doses of 100 to 200 ml/day, usually following a large loading dose which functions as a cathartic. Neomycin dosage ranged from 3 to 12 gm daily.Lactulose effectively reversed the coma in 20 of the 24 episodes (83 per cent). Neomycin was effective treatment in 23 of the 24 episodes (96 per cent). This difference was not statistically significant. Improvement in arterial ammonia levels, in electroencephalograms, and in other measures of encephalopathy was similar in the two groups. Recovery from encephalopathy appeared slightly faster with lactulose than with neomycin but such a difference between nonrandomized groups is of doubtful clinical importance. Prospective randomized controlled trials of lactulose in acute hepatic encephalopathy are required to establish the efficacy of this form of therapy.

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

An analysis of 45 children attending Niv School for Deaf Children in Beersheva showed the preponderance of hereditary deafness as the cause of sensorineural deafness in this region. Seventy-three per cent of the cases were considered to be familial. An extremely high incidence was observed among children of Moroccan origin, accounting for 82 per cent of the cases of familial deafness and 58 per cent in the nonfamilial group. More than a third of the children were found to have additional congenital defects. It is concluded that a detailed clinical examination and family history are of prime importance in the evaluation of deaf children.

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

The beneficial action of acetazolamide in the treatment of hypokalemic periodic paralysis was studied in three patients, a woman and two of her sons. All three subjects showed a disturbed electromyogram with a lack of functioning motor units, even when no weakness of the muscle was observed. Bicarbonate-induced alkalosis caused aggravation of the electromyographic pattern. In one subject a paralytic attack was observed during alkalosis, which was abolished with intravenous acetazolamide. A similar beneficial action on previously disturbed electromyographic pattern was observed during ammonium chloride infusion. After one week of treatment with acetazolamide the electromyographic records were found to be almost normal in all three subjects. The effect of acetazolamide on these three patients could not be explained by its action on serum potassium levels, which did not change. It appears that the acidosis caused by acetazolamide has a beneficial effect on the disturbed muscle excitability found in these patients.

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

Carbohydrate metabolism was studied in a family (a mother and her three sons) suffering from hypokalemic periodic paralysis. The levels of insulin, growth hormone, and 11-oxycorticosteroid were found to be normal. Glucose load did not induce hypokalemia, nor did it cause muscle weakness. Electromyographic examinations performed in three of the patients showed a paucity of functioning motor units in each patient. The disturbed EMG improved considerably during acetazolamide treatment and in response to an ammonium chloride load.

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

It has previously been shown that oral or intravenous ethanol lowers the serum folate level as determined by theLactobacillus caseiassay. To exclude an assay artifact, similar changes were sought with a new radioassay for serum folate. Serial serum folate levels were determined by both theL. caseiassay and the radioassay in three normal volunteers during and following short-term ingestion of ethanol, and the results were compared to control regimens during which no ethanol was ingested. In all subjects the serum folate level fell during ethanol ingestion and rose after ethanol intake was stopped. The degree of the ethanol-induced fall in serum folate level seemed to correlate with the amount of ethanol consumed. The results of the radioassay essentially paralleled those of theL. caseiassay, indicating that the fall in serum folate level induced by ethanol is not an artifact of the microbiological assay. Although alternate mechanisms remain to be excluded, it is possible that ethanol interferes with the formation of and/or the release of N-5-methyltetrahydrofolic acid, the main folate metabolite in the serum of fasting subjects.

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

In a group of 90 diabetics, an increased serum activity (+137 per cent, p<0.001) of the lysosomal enzyme acid phosphatase was found. The increase was moderate (+55 per cent, p<0.01) in uncomplicated diabetics with slightly elevated glycemia (148 ± 24 mg glucose/100 ml), while it was more accentuated (about twice normal, p<0.001) in diabetics with either vasculopathies (micro- or macroangiopathy) or marked hyperglycemia (343 ± 108 mg glucose/100 ml). Serum aspartate and alanine aminotransferases were normal. Thus, acid phosphatase in diabetes behaves similarly to other lysosomal enzymes: beta-glucuronidase and N-acetyl-beta-glucosaminidase. This is a further evidence of lysosomal enzyme activation in diabetes, apparently linked to both the degree of metabolic decompensation and the presence of vasculopathies. Since acid phosphatase, unlike beta-glucuronidase and N-acetyl-beta-glucosaminidase, is not concerned with degradation of mucopolysaccharides and glycoproteins, the higher activity found in vasculopathic diabetics would indicate that in these patients the activation process is not restricted to the enzymes capable of degrading the aforementioned compounds, which accumulate in the walls of diseased vessels, but involves a variety of lysosomal hydrolases.

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

Diffuse myelofibrosis was shown by bone marrow biopsy in a patient presenting with bone pain, anemia, thrombocytopenia, and a leukoerythroblastic blood picture. Numerous investigations failed to elicit an alternate etiology for these changes and, in the absence of splenomegaly, a diagnosis of acute myelofibrosis was made. The clinical course was rapidly downhill. A second marrow biopsy yielded a single group of suspicious malignant cells on a touch print preparation. Subsequent mediastinal fluoroscopy revealed paraesophageal masses. The patient failed to respond to chemotherapy, and expired five weeks after the onset of symptoms. At autopsy, bronchogenic carcinoma was found with extensive visceral and marrow metastases. This experience demonstrates the need for careful search for cancer in the patient found to have myelofibrosis.

ISSN:0002-9629    

出版商:OVID    

年代:1973

数据来源: OVID