Erythrocyte phosphoglucomutase activity of bipolar I patients currently using lithium or carbamazepine.

Lithium has been used for the last five decades to treat bipolar disorder, but the molecular basis of its therapeutic effect is unknown. Phosphoglucomutase is a key enzyme in the metabolism of glycogen. In yeast, rabbit and human HEK293 cells, it is inhibited by lithium in the therapeutic concentration range. We measured the phosphoglucomutase activity in erythrocytes and the inhibitor constant for lithium in a population of healthy subjects and compared them to those of bipolar patients treated with lithium or carbamazepine. The specific activity of phosphoglucomutase measured in vitro in erythrocytes from control subjects presented a normal distribution, with the difference between the lowest and the highest activity being approximately 2-fold (0.53-1.10 nmol mg Hb-1 min-1). Comparison of phosphoglucomutase activity in untreated bipolar patients and control subjects showed no significant difference, whereas comparison between bipolar patients treated with carbamazepine or lithium revealed significantly lower mean values in patients treated with carbamazepine (747.3 +/- 27.6 vs 879.5 +/- 35.9 pmol mg Hb-1 min-1, respectively). When we studied the concentration of lithium needed to inhibit phosphoglucomutase activity by 50%, a bimodal distribution among the population tested was obtained. The concentration of LiCl needed to inhibit phosphoglucomutase activity by 50% was 0.35 to 1.8 mM in one group of subjects and in the other it was 3 to 4 mM. These results suggest that phosphoglucomutase activity may be significant in patients with bipolar disorder treated with lithium and carbamazepine.

Erythrocyte phosphoglucomutase activity of bipolar I patients currently using lithium or carbamazepine

Lithium has been used for the last five decades to treat bipolar disorder, but the molecular basis of its therapeutic effect is unknown. Phosphoglucomutase is a key enzyme in the metabolism of glycogen. In yeast, rabbit and human HEK293 cells, it is inhibited by lithium in the therapeutic concentration range. We measured the phosphoglucomutase activity in erythrocytes and the inhibitor constant for lithium in a population of healthy subjects and compared them to those of bipolar patients treated with lithium or carbamazepine. The specific activity of phosphoglucomutase measured in vitro in erythrocytes from control subjects presented a normal distribution, with the difference between the lowest and the highest activity being approximately 2-fold (0.53-1.10 nmol mg Hb-1 min-1). Comparison of phosphoglucomutase activity in untreated bipolar patients and control subjects showed no significant difference, whereas comparison between bipolar patients treated with carbamazepine or lithium revealed significantly lower mean values in patients treated with carbamazepine (747.3 ± 27.6 vs 879.5 ± 35.9 pmol mg Hb-1 min-1, respectively). When we studied the concentration of lithium needed to inhibit phosphoglucomutase activity by 50 percent, a bimodal distribution among the population tested was obtained. The concentration of LiCl needed to inhibit phosphoglucomutase activity by 50 percent was 0.35 to 1.8 mM in one group of subjects and in the other it was 3 to 4 mM. These results suggest that phosphoglucomutase activity may be significant in patients with bipolar disorder treated with lithium and carbamazepine.

New indications in the approach to the pendulous abdomen.

The appearance of the superficial liposuction technique has permitted the surgeon to advance in his indications for treating localized lipodystrophy, without skin resection. With the cutaneous retraction phenomenon that follows superficial liposuction, pendulous abdomen, which was once treated by classical dermolipectomies, can now be treated with liposuction alone, obtaining satisfactory results. The authors recommend this form of treatment for patients with pendulous abdomen and with good skin quality, with few or no stretch marks, and with little or no diastasis of the rectoabdominal musculature.

Postoperative complications in the treatment of chagasic megaesophagus.

The postoperative complications of Chagasic megaesophagus were studied in 250 Chagasic patients referred to the Gastroenterology Clinic of Hospital das Clinicas, Federal University of Minas Gerais, Belo Horizonte, Brazil. The treatment was balloon dilatation in 45 (18.0%), myotomy and cardioplasty in 63 (25.2%), Merendino's surgery in 139 (55.6%), esophagogastroplasty in 2 (0.8%) and esophagocoloplasty in 1 (0.4%). There were 125 (50%) early and 30 (12%) late postoperative complications, and in 65 patients (26%) recurrent dysphagia was noted: nineteen (7.6%) after myotomy and cardioplasty, 9 (3.6%) after Merendino's operation and 37 (14.8%) after balloon dilatation. Eighty-five patients (34%) needed reoperations either to correct recurrent dysphagia (56 patients, 22.4%) or to treat other complications (29 patients, 11.6%). The reoperations to correct the 19 recurrences after myotomy and cardioplasty were Merendino's operation (12 patients, 4.8%), forceful dilatation (1 patient, 0.4%), forceful dilatation followed by Merendino's (2 patients, 0.8%), another myotomy (2 patients, 0.8%), myotomy followed by Merendino and balloon dilatation (1 patient, 0.4%) or esophagogastroplasty (1 patient, 0.4%). The recurrences after dilatation were treated by myotomy (15 cases, 6%), Merendino's operation (12 cases, 4.8%) and myotomy followed by Merendino's (3 cases, 1.2%). After Merendino seven reoperations (2.8%) were done: reduction of interposed loop (6 cases, 2.4%) and esophagocoloplasty (1 case, 0.4%). The time elapsed between the first operation and reoperation or dilatation varied from a few weeks to 18 years.(ABSTRACT TRUNCATED AT 250 WORDS)