Meningeal carcinomatosis in a patient with Crohn's disease.

Leptomeningeal carcinomatosis, also known as carcinomatous meningitis, is defined by spreading of neoplastic cells to the meninges and ventricles, and is a form of cancer dissemination. In this case, a patient with inflammatory bowel disease had developed a neoplastic process that spread to the meninges. A 49-year-old woman developed an abdominal pain, and was diagnosed the same month with Crohn's disease, complicated with intestinal perforation, for which she was hospitalized. Pathological examination revealed acute phase-terminal ileitis. She undergone many hospitalizations during which she was suspected to have celiac disease, inflammatory bowel disease, and tuberculous meningitis, as well as femoral head necrosis after she had been unsuccessfully treated with Prednisone for Crohn's disease. After she developed peripheral bilateral facial paresis, bilateral hypoacusia, hypotonia, tetraparesis and diminished osteotendinous reflexes at the legs, the patient was admitted in our department. Several lumbar punctures were performed but no specific disease could be detected. The MRI performed showed pachymeningeal and leptomeningeal inflammation. Tuberculous meningitis was taken into consideration and the patient was transferred into an Infectious Disease Department where this diagnostic was infirmed. The patient was retransferred into the Department of Neurology where after an episode of hematemesis she had a cardiac arrest and deceased. Inflammatory bowel disease may involve different segments of the intestine, and may be accompanied by a variety of conditions, such as neurologic findings, osteoarticular manifestations and also may be the starting point of a neoplastic process. The patient had an inflammatory bowel condition, which by the time it was appropriately diagnosed as being Crohn's disease, a neoplastic process spread to the meninges, causing multiple cranial nerve palsy, tetraparesis, along other neurological manifestations.

Environmental factors and cardiovascular risk in young individuals.

UNLABELLED: Normal endothelial function alters physiologically with aging. Intervention of environmental factors precipitates and accelerates endothelial dysfunction progression, correlated with cardiovascular risk. AIM: To study the impact of environmental factors (smoking, nutritional habits, stress, physical activity) on the imbalance of the endothelial commuting threshold. METHODS: The questionnaire method was applied in order to identify and quantify the presence of environmental factors; an anthropometrical physical exam was performed; metabolic profile (insulin resistance HOMA-IR, lipid parameters) was assessed. Arterial elasticity was assessed with Complior (Artech Medical). RESULTS: The studied lot (n=80, 21.16 +/- 2.43 years) comprised young medicine students and showed a high incidence of: smoking (31.25%), unhealthy nutritional habits (60%), stress (60%), sedentary lifestyle (25%). The odds for endothelial function alteration were significant only in subjects who associated stress and smoking (OR=8.18, p=0.0006); in the same group, there was noticed the tendency for metabolic profile alteration, meaning insulin resistance (OR=1.19, p=ns). The association stress-smoking did not significantly influence the unhealthy nutritional habits (p=ns, OR=2.39), lipoprotein anomalies (TC > or = 190 mg/dL: p=ns, OR=0.98; LDL > or = 130 mg/dL: p=ns, OR=3.53), or the sedentary lifestyle (p=ns, OR=0.80). CONCLUSIONS: The main environmental factors which determine endothelial function imbalance in young ages are smoking and occupational stress. It is a positive stress which does not lead to significant metabolic anomalies or lifestyle changes. Though, this kind of stress leads to an unhealthy behavior: smoking. The association stress-smoking is essential in endothelial function alteration in young subjects. Primary cardiovascular prevention must focus drastically on unhealthy behaviors correction to reduce cardiovascular risk in young individuals.

Mixed tumor: mucinous papillary cystadenocarcinoma associated with arrhenoblastoma.

A case of a 41-year old woman with an enlargement of the inferior part of the abdomen is presented. An echographic examination established the diagnosis of a right ovarian cyst. During the operation, a 14-cm (5 1/2") tumor, presenting a large ruptured cyst and solid mass, was found. From the cystic activity, a viscous fluid was oozing. On the left ovary, a 4 cm (1 1/2") cyst was also found. Within this case report, we underline the unusual association of a mucinous papillary cystadenocarcinoma with an arrhenoblastoma in the right ovary together with the presence of an cystadenoma in the left ovary.

Morphotypic aspects in the cryptorchidic child.

The morphotype of 40 children with cryptorchidism (18 bilateral, 22 unilateral), selected by complex endocrine examination, was assessed in relation to age and clinical form of cryptorchidism. The morphotype was established on the basis of 9 anthropometric parameters (weight, stature, pube-ground distance, a-a, thr-thr, thoracic, abdominal, hips and cephalic circumferences). The malformed lot consists of 28 children with common and 12 with symptome cryptorchidism (5 adiposogenital, 3 male Turner's syndrome and 3 with gonadal dysgenesis). In the child with symptom cryptorchidism, the morphogram reveals, irrespective of age, a morphotype which corresponds in point of absolute dimensions and proportions, to the somatotype in which cryptorchidism as a symptome is included. The child with common cryptorchidism has irrespective of age, a normal or short stature and is underweight. Compared to the stature, the head is small, the lower limbs are short, the trunk is long and the hips are well developed. In our series of common cryptorchid child, the most marked statural deficit was found between 11 and 15 years as well as under the age of 6.

Sympathetic hyperfunction syndrome.

Vegetative troubles induced by sympathetic hyperfunction are presented and an attempt is made to systematize them. Functional tachycardia or premature beats in neurocirculatory asthenia, symptoms of sympathetic irritation in cervical radicular syndrome, hyperkinetic syndrome with positive exercise test, long Q--T syndrome, the classic troubles of sympathetic origin in pheochromocytoma and "the vegetative storm" in cerebral damages or excessively stressful situations may be included in the sympathetic hyperfunction syndrome. Of greater clinical interest is the cervical radicular syndrome with sympathetic irritation, which is presented in details, with reappraisal of some morphofunctional data that must be taken into account in clinical reasoning.

Studies concerning the effects of a pineal peptide extract on collagen metabolism.

The effects of Crinofizin (Cfz), cortisone, triiodothyronine (T3) and methylthiouracil (MTU), alone or in association with one another, on collagen metabolism of impuberal and adult rabbits were tested. These effects were assessed by the hydroxyprolinuria (Hyp) assay corroborated with observations regarding mortality, body weight, diuresis and excretion of nitrogenous substances. Cfz given alone stimulated weight gain and did not alter characteristically the Hyp. Cortisone and T3 given in various doses and ways without Cfz induced general phenomena of the antianabolic or catabolic type, affecting characteristically the Hyp, which was low after administration of cortisone and increased after T3; association of Cfz to both cortisone and T3 had general protecting and corrective effects and brought Hyp towards or at normal values. Chronic administration of MTU with or without Cfz did not have significant effects. The corrective value of Cfz by anabolic and anti-catabolic actions on collagen metabolism disturbed by cortisone or T3 in excess is discussed.

Effects of crinofizin administration in experimental diseases with protein anabolism disorders. Studies in the rat.

The effects of the treatment with Crinofizin, a pineal peptide extract, on certain parameters of the protein metabolism, altered in rat by prolonged deficiency of endogenous insulin (study on animals with streptozotocinic diabetes) or by administration of large doses of cortisone, were studied. The results demonstrated the anabolic effects of the pineal extract treatment which improved the diabetic syndrome and counteracted some catabolic effects subsequent to insulin deficiency, such as weight loss and decrease in the nucleic acid concentration in the liver, or to cortisone excess, such as nitrogen loss. The data obtained open new prospects for the use of Crinofizin in the management of degenerative endocrine diseases through anabolizing hormones failure or catabolizing hormones excess.

The inhibitory effect of crinofizin (pineal peptide extract) on adrenalin-induced hyperglycemia in rabbits.

The effect of crinofizin--a pineal peptide extract with clinical use--on adrenalin hyperglycemia was tested in the rabbit. Administered subcutaneously one hour before an i.v. hyperglycemic dose of adrenalin, crinofizin significantly reduced the hyperglycemic effect of this hormone. The results reveal the functional antagonism between adrenalin and hypoglycemic pineal peptide(s) called "pinealine".

Immunoreactive insulin (IRI) dynamics in GH-deficient patients following intravenous glycine loading.

In hypopituitary short-statured patients glycine intravenous injection (250 mg/kg of body weight) provokes a mild and inconstant stimulation of IRI release followed by a significant fall down. Though insiginificant (P 0.064), the prevalence of IRI responsive individuals to glycine in the patients group of idiopathic etiology could be of pathophysiological importance.

Identification of Duchenne muscular dystrophy carriers. Electron microscopical investigation of skeletal muscle.

In order to identify a subclinical dystrophy, muscle biopsy specimens from 15 mothers of boys with Duchenne muscular dystrophy were studied by electron microscopy. Genetic investigations and biochemical determinations were not conclusive for a diagnosis of the carrier state. The fine structural lesions were sufficient to vertify the diagnosis of a subclinical dystrophy, and our findings were in agreement with other investigators. However, original intranuclear filamentous formations were noted in one case.

Potassium and sodium ions in the glycerinated skeletal muscle. Distribution changes induced by adenosine triphosphate and nondissociable anesthetic substances.

Investigation of the ionic behavior of glycerinated muscle fibers showed that the residual structures of this biologic cellular material, lacking functional membranes, are able to discriminate between alkaline ions. The characteristics of the ionic selectivity of the glycerinated fibers change with their functional state and with the presence in the medium of certain nonionic substances. Among the more important features of ionic distribution between the membrane-free fibers and the medium are the following: (1) There is evident adsorption of potassium on the fibers, in the absence of ATP. (2) This adsorption increases in contraction and decreases in relaxation. (3) At high ionic concentrations, in contrast to what occurs at low potassium concentrations, the glycerinated muscle prefers sodium to potassium, but even under these conditions both ions are accumulated in the fibers to far greater levels than in the medium. This strongly suggests a Donnan ionic equilibrium developing parallel to the adsorption process. (4) Nonionic substances of the general anesthetic group markedly alter the ionic selectivity of the glycerinated fibers, probably by their action on the water's physical state. A mechanism is proposed for the observed ionic adsorption specific of the muscle-a mechanism in which actin-myosin coupling plays the cardinal adsorption role. In the general interpretation of the data a synthetic concept is advanced according to which an entire set of processes and factors concurs with the distribution of ions between the muscle and the medium.