Epithelial V-like antigen (EVA), a novel member of the immunoglobulin superfamily, expressed in embryonic epithelia with a potential role as homotypic adhesion molecule in thymus histogenesis.

Thymus development depends on a complex series of interactions between thymocytes and the stromal component of the organ. To identify regulated genes during this codependent developmental relationship, we have applied an RNA fingerprinting technique to the analysis of thymus expansion and maturation induced in recombinase-deficient mice injected with anti-CD3 antibodies. This approach led us to the identification of a gene encoding a new member of the immunoglobulin superfamily, named epithelial V-like antigen (EVA), which is expressed in thymus epithelium and strongly downregulated by thymocyte developmental progression. This gene is expressed in the thymus and in several epithelial structures early in embryogenesis. EVA is highly homologous to the myelin protein zero and, in thymus-derived epithelial cell lines, is poorly soluble in nonionic detergents, strongly suggesting an association to the cytoskeleton. Its capacity to mediate cell adhesion through a homophilic interaction and its selective regulation by T cell maturation might imply the participation of EVA in the earliest phases of thymus organogenesis.

Chronic cluster headache: response to lithium treatment.

A clinical trial of lithium carbonate was undertaken in a group of 20 patients suffering from chronic cluster headache. Blood levels of lithium were determined at regular intervals to monitor the therapeutic dosage. Lithium was found to be an effective prophylactic agent for chronic cluster headache patients. The effectiveness of lithium was evident in less than a week after the beginning of treatment. It is not clear in what way lithium may act on cluster headache.

Neurological and pharmacological evaluation of a case of stiff-man syndrome.

A typical case of stiff-man syndrome was studied neurophysiologically and pharmacologically focusing the attention on a central disorder, either spinal or suprasegmental. The results support the hypothesis that a gamma type of hypertonia is one of the causes of the stiff-man syndrome, ruling out the participation of the Renshaw circuits. The syndrome should be considered a central disorder of the descending pathways that control and modify gamma activity and the startle reaction mechanisms, especially affecting the circuits that use Gabaergic mediators.

5-OH-Tryptophane in migraine: clinical and neurophysiological considerations.

The clinical effects of the protracted treatment with 5-OH Tryptophane (5-HTP) of some patients with chronic migraine are compared with other patients with acetylsalicylic acid. The pain threshold was neurophysiologically determined in migraneous on patients whose response to 5-HTP therapy was specially good. The results with 5-HTP can be accounted for by an action of the substance on the serotonin turnover with activation of the serotoninergic antinociceptive system.

Course of chronic cluster headache.

A follow-up study (3.2 years) of 56 patients with chronic cluster headache who had had no remissions for at least a year. They were treated with lithium carbonate, methysergide and prednisone singly and in combination. An assessment of the therapeutic benefits is followed by a discussion on the course of chronic cluster headache.

Monoamine oxidase activities in patients with migraine or with cluster headache during the acute phases and after treatment with L-5-hydroxytryptophan.

The results of a study of the activity of platelet monoamine oxidase (MAO) in patients with migraine or with "Cluster headache" during the acute phases and after treatment with L-5-hydroxytryptophan are presented. MAO levels are higher in migraine subjects than in normals. There is, also, a clear difference between basal MAO levels in migraine sufferers and in Cluster Headache sufferers. The treatment with L-5-hydroxytryptophan tend to normalize MAO activity in the migraine patients, but does not change the MAO activity in cluster headache patients.

[Tiapride in the treatment of chronic headache (author's transl)]. / La tiapride nella terapia delle cefalee croniche.

The therapeutic efficacy of tiapride in chronic headache (300 mg/day orally during 30 days) was studied in a doubleblind trial in a group of 50 patients, 40 of them with so-called "mixed headache", and 10 with classical migraine. The results were subjected to statistical analysis. 65% of treated patients had clinical benefit in the intensity and frequency of headaches. The mode of action of this drug is discussed, together with the involvement of several monoaminergic systems in the genesis of headache. The action of tiapride appears to be indirectly dopaminomimetic as it operates by a blockade of dopaminergic inhibitors receptors.

Five cases of Creutzfeldt-Jakob disease: a clinical-pathological contribution.

Clinico-pathological features are reported in five cases of Creutzfeldt-Jakob disease. In three cases only the brain was examined while in the other two a complete autopsy was performed. In one case a brain biopsy was performed and in other two a piece of cerebral cortex was taken within three hours after death; the brain material was frozen and sent for inoculation in monkeys to Dr. Gajdusek of NINDS-Bethesda, with positive results in two. From the clinical point of view our cases may be classified as follows: two as "classic" type; one as "amaurotic" type; and the last two as "ataxic-amyotrophic" forms according to Alemà and Brion (see text). All five patients were females from 56 to 73 years of age. The duration of the disease ranged from 3 to 7 months. From the histological point of view, in the two "classic" cases the outstanding features was the neuronal loss in all cortical mantle, mainly in the fronto-parietal cortex; furthermore in one there was severe and diffuse spongiform state. In the "amaurotic" case the three types of lesion were mainly localized in the occipital cortex. In the two "ataxic-amyotrophic" forms the neuronal loss was particularly evident in the cerebellar cortex and especially in the granular layer. The Kuru plaques were seen especially in the cerebellum in four of the five cases examined. The aim of our study is to contribute to the epidemiology of this disease.

Endocrinological responses in cluster headache.

Growth hormone and prolactin levels and their response to various stimuli were studied in patients with cluster headache. All the endocrine responses evaluated were normal.