Mitochondrial 3243 BP mutation: a case report.

Mitochondrial DNA (mtDNA) gene defects may play a role in the development of maternally inherited diabetes mellitus and deafness (MIDD). Mutation in the mitochondrial gene at position 3243 was recently identified in several pedigrees of diabetes mellitus and deafness. As the mitochondria play an important role in glucose-stimulated insulin secretion in pancreatic beta-cells, we therefore searched for this mutation in a non-consanguineous family with MIDD from Southern Italy. The mitochondrial 3243 bp mutation of the tRNALEU (UUR) gene was identified in one subject with deafness and Type 1B diabetes mellitus and in his mother. The mother was affected by Type 2 diabetes mellitus, deafness and cardiomyopathy. Our study points out the variable phenotypic expression of this mitochondrial mutation. This may suggest the presence of other mitochondrial or nuclear mutations required to modulate the phenotype.

Pain, analgesia, and stress: an integrated view.

The different theories on the neuroanatomical substrate of pain have been revised in the frame of new concepts on the intercellular communication in the central nervous system. In fact, it has recently been proposed that two kinds of electrochemical transmission exist in the brain: the first one, called wiring transmission (WT), uses neuronal chains (neuronal plasma membranes and synaptic contacts), whereas the second one, called volume transmission (VT), uses the extracellular fluid as physical substrate. The old concept of a separate system of afferents and central cells that constitute the pain mechanism is no more longer tenable. To reach a better understanding of the psychophysiological basis of pain, we should consider a view where WT and VT cooperate within neuronal systems functionally affected by the pervading modulatory action of endocrine signals.

Recent acquisitions in pain therapy: meclofenamic acid.

A better utilization of nonsteroidal anti-inflammatory drugs (NSAIDs) is possible today based on recent pharmacodynamic and pharmacokinetic studies. The analgesic action of these drugs may take place in the central nervous system (CNS). The analgesic action with a lower dose occurs earlier than the anti-inflammatory action. Some NSAIDs cause an increased level of plasmatic bendorphines in humans. NSAIDs not only have antiprostaglandin action, but also may block the release of substance P. The NSAIDs may be useful for headache, dysmenorrhea, rheumatic disease and in cancer pain therapy. For the safe use of NSAIDs the previous anamnestic and clinical features of the patient must be considered, and a high therapeutic level must be satisfied. Considering this goal, the authors examine pharmacologic and clinical behavior of meclofenamic acid.

Clomipramine compared with pentazocine as a unique treatment in postoperative pain.

Forty patients who underwent laparotomy for hysterectomy were administered either clomipramine or pentazocine for the treatment of postoperative pain. Both drugs were similarly effective during the eight hours of observation. The results of this study indicate that clomipramine, often used in chronic pain as an adjuvant drug, exerts as well as analgesic effect in acute pain.

Presence of 5-HT-positive neurons in the medial nuclei of the solitary tract.

The main serotoninergic groups have been described in the midbrain raphe; in the region of the solitary tract, serotonin (5-HT) has been localized in varicose processes and terminals. This study shows the presence of serotoninergic neurons located in the medial nuclei of the solitary tract of intracisternally injected rats, and describe the mapping, the morphological and morphometrical characteristics of these neurons in young and old rats. In old rats the number of these neurons is approximately double the amount detected in young rats. The suggestions on the functional meaning of these findings are discussed.