Calcinosis and metastatic calcification due to vitamin D intoxication. A case report and review.

Vitamin D, a fat-soluble vitamin, can be associated with significant morbidity when prescribed in large doses. We describe a hypoparathyroid patient with vitamin D intoxication who developed painful periarticular calcinosis, nephrocalcinosis with hypertension and chronic renal failure in addition to band keratopathy and hearing loss. He was treated with combination therapy including prednisone, phosphate-binding antacid, phenytoin and disodium etidronate. After 20 months of follow-up there was a significant reduction of periarticular calcinosis, but no improvement in renal function, band keratopathy or hearing loss and possible calcification of the ossicles. The clinicopathologic features of metastatic calcification and the various treatment modalities are reviewed.     

Acute renal failure due to rhabdomyolysis associated with use of a straitjacket in lysergide intoxication.

Acute renal failure is a known sequel to rhabdomyolysis, both traumatic and non-traumatic. Two patients who had been placed in straitjackets after taking lysergide (LSD) developed acute renal failure and rhabdomyolysis. One subsequently died. The rhabdomyolysis probably resulted from a combination of severe restraint and the violent movements induced by the drug. The use of straitjackets cannot be considered to be completely safe in such cases.     

The influence of ethnic differences upon human responses due to thermal environment

1. 1. The influence of ethnic differences is discussed with reference to the following issues.

2. 2. It has been found that total numbers of active sweat glands increase in tropical populations compared with people from northern latitudes.

3. 3. It has also been observed that the active sweat glands of Eskimos are fewer than those of Caucasians.

4. 4. The rate of the evaporated sweat loss was calculated by measuring body weight loss and it was found that the evaporated sweat loss of Caucasians is larger than that of Japanese in the same climate.

5. 5. Meteorological factors might have been responsible for the smaller loss in Japanese compared with that of Japanese-Americans.

6. 6. Under the same experimental conditions, it was observed that there were little or no differences between the Caucasians and Negros.

Bacterial resistances to mercury and copper.

Heavy metals are toxic to living organisms. Some have no known beneficial biological function, while others have essential roles in physiological reactions. Mechanisms which deal with heavy metal stress must protect against the deleterious effects of heavy metals, yet avoid depleting the cell of a heavy metal which is also an essential nutrient. We describe the mechanisms of resistance in Escherichia coli to two different heavy metals, mercury and copper. Resistance of E. coli to mercury is reasonably well understood and is known to occur by transport of mercuric ions into the cytoplasmic compartment of the bacterial cell and subsequent reductive detoxification of mercuric ions. Recent mutational analysis has started to uncover the mechanistic detail of the mercuric ion transport processes, and has shown the essential nature of cysteine residues in transport of Hg(II). Resistance to copper is much less well understood, but is known to involve the increased export of copper from the bacterial cell and modification of the copper; the details of the process are still being elucidated. Expression of both metal resistance determinants is regulated by the corresponding cation. In each case the response enables the maintenance of cellular homeostasis for the metal. The conclusions drawn allow us to make testable predictions about the regulation of expression of resistance to other heavy metals.     

Paresis and death in elk (Cervus elaphus) due to lichen intoxication in Wyoming

During February-April 2004, an estimated 400-500 free-ranging elk (Cervus elaphus) developed paresis, became recumbent, and died or were euthanized in the Red Rim Wildlife Habitat Management Area (RRWHMA), Wyoming, USA. Elk were found in sternal recumbency, alert and responsive, but unable to rise. Their condition progressed to lateral recumbency followed by dehydration, obtundation, and death. Gross lesions were limited to degenerative myopathy, with pallor and streaking in skeletal muscles. Microscopically, affected muscles had degenerative lesions of varying duration, severity, and distribution, some with early mineralization and attempts at regeneration. Diagnostic testing ruled out common infectious, inflammatory, toxic, and traumatic causes. Tumbleweed shield lichen (Xanthoparmelia chlorochroa) was found in the area and in the rumen of several elk. This lichen was collected and fed to three captive elk. Two of these elk exhibited signs of ataxia, which rapidly progressed to weakness and recumbency after 7 and 10 days on this diet, respectively, and a degenerative myopathy, consistent with lesions observed in the elk affected at RRWHMA, was observed. All remaining elk migrated from the RRWHMA during the spring and no subsequent losses have been documented.     

Arsenic and cancer.

Palmar and plantar keratoses developed in seven patients many years after ingeston of trivalent inorganic arsenic. Six had basal cell carcinoma (superficial multicentric type in five), carcinoma "in situ" or squamous cell carcinoma of the skin. Two had systemic carcinoma--one, bilateral breast adenocarcinoma and one, carcinoma of the colon. From these observations and from the findings of a review of the literature, there seems no question that long-term arsenic ingestion can cause palmar and plantar keratoses and skin cancer, particularly basal cell carcinoma of the superficial multicentric type, usually on the torso. It is suspected but not proved to cause other cancers. Although over the last 50 years general exposure to arsenic has greatly decreased, particularly that from insecticides, this element is still found occasionally in drinking water (naturally or as a smelter byproduct), in certain foods and in cigarette smoke.     

Salade malade: malignant ventricular arrhythmias due to an accidental intoxication with Aconitum napellus

Intoxication with Aconitum napellus is rare in our regions. Aconite alkaloids can cause ventricular arrhythmia by a prolonged activation of sodium channels. Because the margin of safety is low between the analgesic and toxic dose, intoxication is not rare when Aconite is used in herbal medicine. We present a case in which a 39-year-old male was accidentally intoxicated with Aconite. Even though no antidote or adequate therapy is available he was successfully resuscitated. (Neth Heart J 2008;16: 96-9.)     

Disruption of Elements Uptake due to Excess Chromium in Indian Medicinal Plants

Chromium and its compounds may cause disturbance in the nutrient level of the plants. Iron, manganese, copper, and zinc are essential nutrient elements and required for balanced growth and development of plants, but chromium uptake sometimes disturbed their concentration in plants. Therefore, in the present paper, an effort has been made to observe the effect of different levels of Cr on nutrient uptake of Phyllanthus amarus and Solanum nigrum, the medicinally important plants of indigenous systems of medicine having hepatoprotective and diuretic properties. The study revealed that Cr causes significant changes in nutrient uptake as compared to control plants. Besides, Cr-treated plants showed growth depression and decrease in fresh and dry weight too. With the increase in Cr supply, accumulation of Cr in roots was increased significantly. Concentration of manganese and zinc was also increased. However, copper concentration in both the plants seemed less affected by Cr.     

The protective effect of L-carnitine against hippocampal damage due to experimental formaldehyde intoxication in rats

We investigated the protective effects of L-carnitine on hippocampus tissue damage in rats during experimental formaldehyde (FA) intoxication. Male Wistar albino rats were assigned into four groups: (1) control (C), (??2) formaldehyde (FA), (3) formaldehyde + 0.5 g/kg of L-carnitine (FA + 0.5 LC) (4) formaldehyde + 1 g/kg L-carnitine (FA + 1 LC). At the end of the 14 day trial period, animals were sacrificed by decapitation under anesthesia. The hippocampus tissue samples were extracted to measure MDA, GSH and SOD activity. Neuronal degeneration was assessed based on histopathological (hematoxylin and eosin) and immunohistochemical (anti-ubiquitin) examination. To detect oxidative stress, specimens were reacted with anti-Cu/Zn-SOD antibody. After administering L-carnitine with FA to the animals, the activities of SOD and GSH increased, but the levels of MDA decreased in hippocampus tissue. Neuronal degeneration was observed in the FA group. L-carnitine administration reduced neuronal degeneration and histological structure was similar to controls. After FA application, degenerated hippocampus neurons were stained with anti-ubiquitin and Cu/Zn-SOD antibodies; weakly positive staining was observed in L- carnitine-treated groups. L-carnitine may be useful for preventing oxidative damage in the hippocampus tissue due to formaldehyde intoxication.