Effect of naloxone on the neuropsychiatric symptoms of a woman with partial adrenal 21-hydroxylase deficiency.

A woman with a schizophreniform syndrome, drug-induced dyskinetic movements, and partial adrenocortical 21-hydroxylase deficiency was given short-term treatment with naloxone, which ameliorated the psychiatric symptoms and eliminated the dyskinetic movements.

Multiple telangiectases preceding the appearance of undifferentiated bronchogenic carcinoma.

A patient with undifferentiated bronchogenic carcinoma, which was preceded by skin manifestations, namely telangiectases on the palms, soles, fingers, toes, lips and tongue, is described. It is possible that these multiple vascular lesions are one of the cutaneous markers of internal malignancy.

Spondyloenchondrodysplasia. Enchondromatomosis with severe platyspondyly in two brothers.

Two brothers affected by enchondromatosis with marked involvement of the spine including platyspondyly were followed for 12 years. Both brothers were of short stature and normal intelligence. Vertebral involvement in multiple enchondromatosis is very rare. To our knowledge, marked generalized platyspondyly has not been described in the literature as part of this condition. At present, this form cannot be placed within any previously described category. A new term--spondyloenchondrodysplasia--is proposed for this condition which may either be a subform of multiple enchondromatosis or an entirely different and distinct entity.

In vitro studies of the effect of methadone on natural killer cell activity.

Heroin addicts are reported to have numerous immunological abnormalities. The purpose of this study was to determine whether methadone, a long-acting synthetic opioid agonist used in the maintenance treatment of heroin addiction as well as in the treatment of chronic pain, alters natural killer (NK) cell cytotoxicity activity. We incubated human peripheral mononuclear cells with a wide concentration range (1 x 10(-13) to 1 x 10(-3) M) of (-) methadone, the active enantiomer of methadone, or with (+) methadone, the inactive enantiomer, prior to and during an assay of NK activity. We found no effect of methadone at concentrations of 1 x 10(-13) to 1 x 10(-5) M, but higher concentrations (1 x 10(-4) to 1 x 10(-3) M) of either enantiomer of methadone caused a significant reduction in NK activity. We conclude that methadone concentrations that are normally achieved in the plasma during methadone maintenance treatment or during chronic pain management, and much higher concentrations, have no effect on NK activity in vitro.

The Dyggve-Melchio-Clausen syndrome.

Two families with Dyggve-Melchior-Clausen syndrome are reported. In the first family, Jews from Morocco, six of 10 siblings are affected. In the second family, a consanguineous marriage of Arabs from Gaza, two of three children are affected. A description of the skeletal changes in patients ranging in age from 4 to 25 years is presented. The radiologic signs of generalized platyspondyly with double humped end plates and the lace-like appearance of thickened iliac crests are pathognomonic and distinctive of the syndrome. The diagnostic features of the disease are compared to those of Morguio's disease, spondyloepiphyseal dysplasia tarda, and spondylometaphyseal dysplasia.

Natural killer cell activity and lymphocyte subsets in parenteral heroin abusers and long-term methadone maintenance patients.

We studied natural killer (NK) activity and lymphocyte subsets in 11 active parenteral heroin abusers, 11 long-term methadone-maintained former heroin abusers and 11 apparently healthy individuals. All subjects were males aged 23 to 49 and none had active infectious or inflammatory diseases. All current or former heroin abusers were seronegative for antibody to human immunodeficiency virus. The methadone maintenance patients were socially rehabilitated and had not abused drugs parenterally for at least 10 years. NK activity was determined by a standard Cr-release cytotoxicity assay using K562 cells as targets, and lymphocyte subsets were determined by direct immunofluorescence using flow cytometry. At all three effector-target ratios (100:1, 50:1 and 25:1), NK activity was reduced significantly (P less than .01) in parenteral heroin abusers compared with methadone maintenance patients and apparently healthy individuals. The latter two groups did not differ from each other. Parenteral heroin abusers also had higher absolute numbers of CD2, CD3, CD4 and CD8-positive cells. These data support our hypothesis that significant abnormalities of cellular immunity in parenteral heroin abusers can be normalized by successful long-term methadone treatment.