[Nelson syndrome: a rare cause of generalized hyperpigmentation of the skin]. / Síndrome de Nelson: una causa infrecuente de hiperpigmentación cutánea generalizada.

Nelson syndrome is a rare cause of generalized mucocutaneous hyperpigmentation. Its clinical manifestations are due to excessive secretion of adrenocorticotropic hormone from a pituitary adenoma, which develops after bilateral therapeutic adrenalectomy. As this operation has fallen into disuse, Nelson syndrome is now extremely rare and difficult to recognize. We present a very severe case of generalized hyperpigmentation due to Nelson syndrome in a 37-year-old woman.

Nd:YAG laser and photodynamic therapy for esophageal and endobronchial tumors under general and local anesthesia. Effects on arterial blood gas levels.

STUDY OBJECTIVE: Our objective was to determine the respiratory and acid-base metabolism response to endoscopic laser surgery for obstructive tumors, as related to the duration and different types of endoscopy, anesthesia, and laser treatment. DESIGN: The design was a case-control, cohort analytic, nonrandomized controlled survey of case series before and after endoscopic procedures. SETTING: A referral-based surgery and oncology practice at one hospital's laser center. PATIENTS: We studied a sequential sample of 82 patients in the age range from 35 to 92 years, with malignant and benign, primary and metastatic, partially and completely obstructing esophageal (15 patients) and endobronchial (67 patients) tumors. INTERVENTIONS: A total of 229 diagnostic, laser treatment, and follow-up endoscopic procedures was performed under general or local anesthesia (46 esophagoscopies and 183 bronchoscopies). The latter group consisted of 29 cases of general and 154 cases of local topical anesthesia. The last group involved 37 diagnostic and toilet bronchoscopies, 86 cases of YAG-laser tumor ablation, and 31 cases of PDT. MEASUREMENTS AND MAIN RESULTS: Direct-reading electrode measurements of arterial blood, sampled before and immediately after the endoscopic procedure, revealed statistically significant (p less than 0.001) increases in PaCO2 (200 of 229 cases) and decreases in pH (195 of 229 cases) and PaO2 (215 of 229 cases). These findings were similar after bronchoscopy and esophagoscopy, general and local anesthesia (only the decrease in pH was less pronounced in the latter case), and explorative endoscopies and different laser treatments and did not correlate with the total duration of the procedure within the wide time range of 7 to 210 minutes. The initial preoperative level of PaCO2 was considerably higher and the level of PaO2 was significantly lower in patients with endobronchial tumors, as compared to patients with esophageal cancer. A strong, inverse linear relationship was found between the perioperative changes in PaO2 and its initial level and between PaCO2 and pH changes. CONCLUSIONS: The PDT for esophageal and endobronchial malignancies is no more harmful for acid-base metabolism and respiratory functions than YAG-laser tumor ablation or any other common, nonlaser endoscopic procedure.

Photodynamic therapy to treat tumors of the extrahepatic biliary ducts. A case report.

The poor survival rate of patients with extrahepatic bile duct tumors is well documented. Over the course of 4 years, we treated a white woman with diabetes diagnosed with histologically proven adenocarcinoma of the common bile duct with six injections of dihematoporphyrin ether followed by seven photodynamic therapy treatments to the biliary duct. As of July 1989, the patient was still alive, was not jaundiced, and had a Karnofsky performance status of 70. No changes occurred in any blood chemistry value from the time of injection to the time of photodynamic therapy. Of the transient elevations of some blood chemistry values and the white blood cell count, which occurred within 24 to 48 hours after photodynamic therapy, only those of alanine aminotransferase, aspartate aminotransferase, and amylase were significant.

[Biochemical properties of aging of rat periodontium]. / Biokhimicheskaia kharakteristika parodonta krys raznogo vozrasta.

The content of proteins and nucleic acids and activity of acid and alkaline proteases, RNases, phosphatases and alpha-amylase were studied in the gum and alveolar bone or rats at the age of 1, 3, 6, 12, 18 and 24 months. It is found that a degree of periodontal atrophy strongly and directly correlates with the age of rats. The concentration of DNA and RNA in alveolar bone and of RNA in gum decreases with the age. The hydroxyproline content of periodontal tissues continuously increases till the age of 18th month and then considerably decreases. The activity of trypsin-like proteases, cathepsins and alkaline RNase in periodontal tissues increases reaching the maximum at the age of 6-18 months, and the activity of alkaline phosphatase decreases in the process of aging.

[Method for determining peroxidase activity]. / Opredelenie peroksidaznoi aktivnosti v biologicheskom materiale.

The spectrophotometric method is described for the peroxidase activity determination which is based on the oxidation of guaicol and potassium iodide. Optimal conditions were elaborated for these two most sensitive substrates. The method may be applied for the quantitative peroxidase determination in different human biological fluids, in particular saliva and blood serum.

[Various features of peroxidase in human saliva]. / Nekotorye svoìstva peroksidazy sliuny cheloveka.

Optimal conditions are determined for isolation and purification of peroxidase (EC 1.11.1.7) from the mixed human saliva by gel-filtration and ion chromatography. Such properties as pH and temperature optima, molecular weight, Km, amino acid composition, the effect of activators and inhibitors (purified saliva peroxidases and commercial preparation of horse-radish peroxidase "Reanal", Hungary) are studied with the use of different substrates. The data obtained are necessary to optimize production processes of isolation, storage and methods of the experimental and clinical application of peroxidases of different origin.

[The dynamics of intravascular thrombocyte aggregation in photodynamic exposure]. / Dinamika vnutrisosudistoi agregatsii trombotsitov pri fotodinamicheskom vozdeistvii.

The alterations taking place in the microvessels of the rat mesentery and liver under a photodynamic effect, were studied. Excitation of a photosensitizer injected preliminarily in the organism led to aggregation of thrombocytes in the lumen of hepatic and mesenteric microvessels until a complete obturation of the lumen. The dependence of the thrombocyte aggregate size on the duration of the photodynamic effect had a linear character whereas the photodynamic effect depended on the dosage of the photosensitizer. The level of fluorescence from the surface of the liver was found to decrease from the beginning of the photodynamic effect and become stable in hemostasis.

[Enzymatic mechanisms for antimicrobial protection of the oral cavity]. / Fermentativnye mekhanizmy antimikrobnoi zashchity rotovoi polosti.

Data on the role of oral lysozyme, ribonuclease, deoxyribonuclease and peroxidase in antimicrobial defense of the macroorganism are reviewed. The biochemical and physiological properties of the enzymes secreted by salivary glands and released from emigrating leukocytes are discussed. Spectra of antimicrobial action of the enzymes and participation of these enzymes in maintaining the stability of oral biocenosis are described as well as the regulation of these enzymatic activities and the pathogenetic significance of impairments in their secretion. The most perspective aspects of the problems discussed are outlined for further investigation.

[Isolation and properties of 2 kallikreins from human saliva]. / Vydelenie i svoistva dvukh kallikreinov sliuny cheloveka

Two kallikreins (K-I and K-II) were purified from mixed, parotid and submandibular human saliva. The kallikreins were separated by chromatography on CM-cellulose. The pH optima of activity were at pH 9.3 and pH 9.6-9.8; Km for BAEE was 1.10-3M and 4.10-3M, respectively. The esterase activity of K-I and K-II was inhibited by trasylol-like inhibitors, while the plant and synthetic inhibitors of trypsin were uneffective. In dog, rabbit and rat the hypotensive effect of K-II and its action upon the permeability of rabbit skin was 4-5 fold higher than the effects of K-I. Ki and K-II did not alter the arterial blood pressure in guinea pig.

[Role of peroxidase in the pathogenesis of parodontosis]. / Rol' peroksidazy v patogeneze parodontoza.

In order to study the role of peroxidase in pathogenesis of periodontosis clinical observations were carried out in 132 patients with inflammatory-dystrophic form of periodontal disease and eight species of laboratory and domestic animals were used in experiments. In the patients studied a distinct increase in peroxidase activity was observed in mixed saliva and in gum tissues, which correlated with the severity of the periodontal disease. Inflammatory-dystrophic impairment of cat periodontium was accompanied by an increase in the peroxidase activity only in gum and alveolar process tissues; cats are characterized by the highest amounts of exogenous peroxidase in oral tissues as compared with other laboratory animals. High amounts of exogenous peroxidase did not affect the periododontal tissues of rats during long-term experiments. The main protective effects of the enzyme were as follows: bacteriostatic influence on streptococci in oral cavity and inhibition of leukocyte emifration. Estimation of the peroxidase activity in saliva may be considered as a diagnostic test for periodontosis and may be used to monitore the course of treatment.

[Source of enzymes of mixed human saliva]. / Proiskhozhdenie fermentov smeshannoi sliuny cheloveka.

Production of enzymes was studied in parotid, submandibular and mucosal salivary glands as well as in exfoliated epithelial cells, emigrating leukocytes and in dental bacterial plaque. alpha-Amylase and iodide peroxidase were mainly secreted into mixed saliva by parotid and submandibular glands. Alkaline phosphatase was produced mainly by mucosal salivary glands. These glands secreted also about one half of alkaline and acid proteases, acid phosphatase, both ribonucleases, lysozyme, alkaline peroxidase and lactate dehydrogenase. Role of leukocytes and epithelial cells as well as bacterial plaque was relatively negligible in formation of mixed saliva enzymes.

[Role of salivary kallikrein in the pathogenesis of periodontosis]. / Rol' kallikreina sliuny v patogeneze parodontoza

In patients with parodontosis the distinct increase in salivary kallikrein secretion was found. In Wistar rats the intensity of age atrophy of alveoli dentalis correlated with BAEE-esterase activity of mixed saliva. Desalivation considerably decreased the rate of age atrophy of parodontosis in rats. Salivary kallikrein, penetrating in active form into parodontal tissues, caused the pronounced vasodilation in dogs and golden hamsters. By means of kallikrein preparations an intensive inflammatory-dystrophical process was reproduced in parodontal tissues of Wistar rats. The local treatment of patients with parodontosis by kallikrein inhibitors was found to be especially effective.

[Role of salivary ribonuclease in pathogenesis of periodontosis]. / Rol' ribonukleazy sliuny v patogeneze parodontoza

In patients with periodontal disease a distinct increase in secretion of salivary acidic and alkaline RNAases was found. The RNAases activity in mixed saliva correlated with the intensity of degradation of periodontal tissues during loss of alveolar layer in aged Wistar rats and the spontaneous periodontal disease in cats. In experiments with golden hamsters salivary RNAase was found to penetrate through mucosa in active form. The purified salivary RNAase inhibited the protein biosynthesis in rabbit gingiva. Intensive atrophic alterations were produced in periodontal tissues of Wistar rats by means of purified salivary RNAase.