Chronopharmacokinetics of 5-methoxypsoralen.

Diurnal variations in drug pharmacokinetics are a well known phenomenon. Chronopharmacology studies now appear to be attracting increasing interest with a view to establishing an optimum therapeutic prescription. In order to determine possible chronobiological variations of 5-methoxypsoralen (5-MOP) pharmacokinetic, 5-MOP blood concentrations were quantified in 8 healthy subjects after drug ingestion at different times during the day.

Biosynthesis of endothelium-derived relaxing factor: a cytosolic enzyme in porcine aortic endothelial cells Ca2+-dependently converts L-arginine into an activator of soluble guanylyl cyclase.

In the presence of porcine aortic endothelial cytosol, soluble guanylyl cyclase purified from bovine lung was activated by L-arginine up to 2.5-fold, with an EC50 of about 6 microM. This activation was dependent on NADPH and Ca2+.

Polyneuropathy: an unusual extraintestinal manifestation of Crohn's disease.

Among the extraintestinal complications of Crohn's disease, neuropathy seems to be rare, and is only exceptionally reported in the literature. The authors present the report of a patient followed over a 12-year period who developed polyneuropathy with a parallel course to Crohn's disease. There was no evidence of any other underlying condition.

Gastroduodenal ulcer incidence in patients with venous thromboembolism.

The presence of peptic ulcer disease implies a high risk of bleeding in patients on heparin therapy. We reviewed our experience with 166 consecutive patients admitted because of venous thromboembolism. Of these 166 patients, 29 were referred for upper gastrointestinal endoscopy in order to detect the presence of any lesion that might contraindicate heparin therapy.

Malignant angioendotheliomatosis. Reclassification as an angiotropic lymphoma.

A 70-year-old woman with chronic edema of the lower limbs was diagnosed as having a "malignant angio-endotheliomatosis," because histologic examination showed a strict intravascular location of a malignant proliferation. Immunochemical studies actually disclosed the lymphomatous origin of malignant cells. The recent literature regarding the nosology of this rare condition is reviewed.

[Atypical tapetoretinal degeneration simulating a neurologic syndrome].

We report the case of a 57-year-old woman with progressive bilateral visual acuity loss, presumed during ten years to be secondary to a neurological disease. Ophthalmological examination showed for both eyes pallor of the optic discs and arteriolar narrowing. Periphery was normal, without pigment clumping.

[Usefulness of microscopic study of the duodenal bile in the diagnosis of pancreatitis of unknown cause].

In spite of the numerous causes of acute pancreatitis reported, among which the most frequent are biliary lithiasis and alcoholism, the etiology remains obscure in many patients, being termed idiopathic in these cases. The presence of microcalculi in the bile juice has been described as a cause of some pancreatitis initially labeled as of unknown cause. We studied the duodenal bile juice of 22 patients who were admitted on various occasions for acute pancreatitis, in whom the etiology could not be clarified in spite of the anamnesis and explorations.

[Bartter's syndrome, diffuse articular chondrocalcinosis and nephrogenic hypomagnesemia in an adult].

Bartter's syndrome, chondrocalcinosis and nephrogenic hypomagnesemia in an adult. Bartter's syndrome, chondrocalcinosis and nephrogenic hypomagnesemia in an adult. Bartter's syndrome, initially described in children, becomes a controversial entity when it is observed in adults, as it cannot be dissociated easily from the pseudo Bartter's syndrome caused by an abuse of diuretics or provoked by surreptitious vomiting.

[Emergency endoscopic sclerosis in active hemorrhage caused by esophageal varices: analysis of 31 cases].

We have reviewed our experience in urgent endoscopic sclerosis of bleeding esophageal veins in most patients (67.7%) secondary to alcoholic liver cirrhosis. Through the flexible gastroscope, 1% of polydocanol was injected intra and periveinaly for sclerosis.

[Epikeratophakia: reflections apropos of several personal cases].

About some personal cases, the author explains the epikeratophakia technic, indications; complications, advantages and results.

[The kidney in Still's disease in adults].

Renal involvement during Still's disease in the adult is rarely mentioned in the literature. Proteinuria and hematuria are frequently reported during systemic involvement in the disease but, conversely, observations including an anatomical account of the kidney are rare: amyloidosis is mentioned the most often (5 compatible cases), while other cases are more disparate: non specific glomerulitis (4 cases), glomerulonephritis with mesangial deposition of IgA (2 cases), tubulo-interstitial nephritis; these different non specific aspects may correspond to an immune complex disease. The apparent rarity of renal investigations is a factor in marking out Still's disease in the adult from other systemic diseases.

[Biliary peritonitis after hepatic biopsy: favorable course with conservative medical treatment].

In a 53-year-old woman a percutaneous liver biopsy was performed with tru-cut to study persistent hypertransaminasemia. The patient did not present extrahepatic cholestasis. Immediately after biopsy the patient had a picture of biliary peritonitis that evolved favorably with conservative medical treatment, including hemodynamic resuscitation, antibiotic therapy, analgesic treatment and monitoring by the resuscitation service.

Successive legionellosis in the course of lymphomatoid granulomatosis.

A 75-year-old male presented with typical cutaneous lesions and pulmonary involvement due to lymphomatoid granulomatosis. A legionellosis was associated with this condition. Though the radiological findings in lymphomatoid granulomatosis are suggestive, they are not specific, and set a difficult problem in distinguishing the two conditions.

Dermatological autoimmune diseases and the multiple autoimmune syndromes.

The association of autoimmune pathologies with cutaneous diseases has received little attention, except for their association by twos. The combination of at least three autoimmune diseases in a same patient has recently been defined as a Multiple Autoimmune Syndrome (MAS). The purpose of this article is to define the place of dermatological autoimmune conditions (vitiligo, alopecia areata, pemphigus, bullous pemphigoid, dermatitis herpetiformis) among the MAS and to stress the clinical aspects that may aid dermatologists in the care of their patients.

Evaluation of the effect of heparin and tetracycline on the cohesion of the dermal-epidermal junction.

In an attempt to demonstrate the effect of tetracycline or heparin therapy on the dermo-epidermal junction, the suction blister time was measured at the beginning and at the end of the study in 18 female Sprague-Dawley hairless rats, using the suction blister method. Suction blister time was defined as the time taken for the first sign of a vesicle to appear in the hole in the diaphragm of a suction chamber. 200 IU heparinate calcium was administered daily for 6 days in 6 rats.

[Recurrent rhabdomyolysis and deficiency of carnitine palmityl transferase. Evidence of the responsibility of a mutant in 2 brothers].

In two brothers who had been presenting since childhood with intermittent muscular attacks and myoglobinuria after sustained efforts, muscle carnitine palmityl transferase (CPT) activity was undetectable by the backward hydroxamate colorimetric method. Such a total deficiency could not easily fit in with the clinical features (normal muscular activity outside sustained efforts), with the normal results obtained at electromyography and with the moderate fatty overload detected at muscle biopsy. In order to elucidate these apparently discordant findings, another CPT measurement method, the forward optimized isotopic technique, was used.

[Denny-Brown sensory neuropathy disclosing a bilateral ovarian adenocarcinoma].

The authors report the case of a 76 year-old woman examined because of occurrence of a paraneoplastic sensory neuropathy. Three months later, she developed a left inguinal adenopathy, metastasis of a bilateral ovarian adenocarcinoma. This case of particular interest in view of the way the neoplasm was discovered.