CT and EEG investigations in 100 patients with multiple sclerosis (MS)

100 MS patients were followed up for an average of 5 years. We considered age at onset, duration of the disease, number of attacks, neurological and psychic status, CT and EEG findings and tried correlating the last two with all the previous factors. In remission the most frequent CT abnormality was diffuse atrophy. In acute exacerbations there were 3 possibilities: normality, hypodensity and, much more rarely, hyperdensity with pseudotumoral patterns. A normal CT and short duration of disease were positively correlated with a small number of attacks. There were no positive correlations between CT findings, age at onset and neurological and psychic status. EEG, like CT, may show no changes in a high percentage of cases but there is scant correlation between the two.

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Sommario 100 soggetti affetti da Sclerosi Multipla sono stati seguiti per un periodo medio di 5 anni. Abbiamo indagato l'età di inizio, la durata della malattia, il numero di poussées, il quadro neurologico e psichico, i reperti TC ed EEG. Gli ultimi due parametri sono stati correlati con tutti i precedenti. In fase stabilizzata le alterazioni TC più frequenti sono risultate le atrofie diffuse. In fase acuta sono state riscontrate 3 possibilità: reperto negativo, ipodensità e, molto più raramente, iperdensità con quadri pseudotumorali. Correlazioni positive sono state riscontrate tra normalità TC e durata breve della malattia da un lato e numero scarso di poussées dall'altro. Invece non sono risultate correlazioni positive tra reperti TC, età di inizio della malattia ed obiettività neurologica e psichica. Anche l'EEG, come la TC, è risultata alterata in un'alta percentuale di casi; dalle correlazioni EEG-TC è risultato però che la concordanza di tali alterazioni è stata piuttosto scarsa.

     

Pancreatic enzyme secretion: nonspecific stimulation by duodenal mucosal extracts

Felber et al. (Lancet 2: 185-188, 1974) reported that duodenal extracts obtained from rats fed a given meal induced the specific secretion of related pancreatic enzymes. Such an observation challenges the generally accepted theory of parallel secretion of pancreatic enzymes. Although these experiments were faithfully reproduced, no induction of specific enzyme secretion could be obtained. Moreover, comparison of the secretagogue potency of different preparations of duodenal extract, both in vivo (anesthetized rat) and in vitro (pancreatic lobules), demonstrated that in the original extraction procedure most of the secretagogue activity was lost. Finally, even the fully active extract failed to induce specific enzyme secretion. It is therefore unlikely that duodenal extracts from rats fed a specific meal can induce selective secretion of the related enzyme.     

Removal of T cells from bone marrow for transplantation: a monoclonal antilymphocyte antibody that fixes human complement

Graft-versus-host disease is one of the major problems in clinical bone marrow transplantation. Many experiments in animals have shown that it could be greatly reduced if mature T lymphocytes were removed from the donor marrow. Here we describe a new rat monoclonal antibody, CAMPATH 1, which is suitable for depleting lymphocytes from human marrow grafts. CAMPATH 1 is an IgM that fixes human complement. It binds to both T and B lymphocytes and some monocytes but not to other hemopoietic cells. When peripheral blood mononuclear cells were treated with CAMPATH 1 and complement, more than 99% of lymphocytes were killed and viable T cells could no longer be detected. Under these conditions, in vitro multipotential erythroid and myeloid colony-forming cells were unaffected. As well as being used for in vitro treatment of bone marrow to remove T cells, CAMPATH 1 could potentially be applied to other experimental and clinical situations where depletion of lymphoid cells is required, including serotherapy to achieve immunosuppression for organ transplants or to treat lymphocytic leukemias.     

UT2 Practical Applications of the Health Utilities Index

The Health Utilities Index is designed to describe and to quantify the health status and the health-related quality-of-life (HRQOL) of subjects. This validated and reliable instrument has been employed by over 100 research groups worldwide and exists in three formats (face-to-face interview, telephone interview and self-administration). Translations into several languages are also available. As a generic preference-weighted system, the Health Utilities Index not only measures and describes health status, but also provides a quantitative measure of HRQOL as a single summary score based on community preferences for health status. The score, founded on utility theory and anchored to the conventional 0–1 (dead–healthy) scale, is appropriate as a quality-weight in the calculation of quality-adjusted life-years (QALY's). Given that QALYs have been recognized as a universal measure for use in cost-effectiveness/cost-utility analyses and are recommended in the reporting and monitoring of population health, this instrument has wide ranging applications in outcomes and health economic research. This workshop will provide an introduction to the Health Utilities Index and focus on its practical application. We will describe our experiences as they relate to issues such as frequency and mode of administration, patient recall, compliance, sample size considerations, data analysis and interpretation. Citing previous studies, this workshop will demonstrate how the Health Utilities Index can be utilized in prospective clinical research, patient surveys and as a means for developing utility estimates in retrospective health economic models. Researchers and analysts involved in quality-of-life and health economic evaluations will gain a working knowledge of the Health Utilities Index and an appreciation of its diversified use as a generic HRQOL instruments.     

Effect of bestatin and thiorphan on [Met5]enkephalin-Arg6-Phe7-induced analgesia

We investigated the effect of bestatin, a specific inhibitor of aminopeptidase and thiorphan, a specific inhibitor of enkephalinase A, on the analgesic effect induced by the intracerebral injection of heptapeptide [Met5]enkephalin-Arg6-Phe7 (MEAP) in cannulated rats. In contrast with the results obtained when [Met5]enkephalin (ME) was used, bestatin clearly potentiated the analgesic effect of MEAP, but thiorphan was totally ineffective. These observations indicate that the predominant inactivating mechanism for MEAP is the action of an aminopeptidase whereas this enzyme seems to be little involved in the catabolism of ME. The existence of two different catabolic pathways for MEAP and ME suggests that MEAP may act not only as a precursor of ME but also as an independent neuromodulator.