Quantitative effects of nefiracetam on spatial learning of rats after cerebral embolism

Recent studies have shown that nefiracetam ameliorates cognitive dysfunction because of ischemia when behavioral testing occurs during treatment. We sought to determine if there was a persistent effect after treatment, by testing spatial learning of embolized rats after nefiracetam therapy.

METHODS

Male Sprague Dawley rats (250 to 300 g) were divided into 3 categories. The control group (n = 5) underwent no surgery or cerebral embolism. The vehicle group (n = 12) was anesthetized with halothane, underwent surgery, injected with intracarotid microspheres, and given orally 5 mL/kg of the vehicle (0.5% aqueous sodium carboxymethyl cellulose) for 21 days. The nefiracetam group (n = 12) was embolized and treated orally with 30 mg/kg nefiracetam (6 mg/mL in vehicle) for 21 days. Outcome was determined with visual spatial learning after the end of treatment.

RESULTS

Embolization caused a significant impairment in visual spatial learning, which nefiracetam completely ameliorated (group main effect, F(2,444) = 6.4, P = .002). Mean latency to the escape was 35 +/- 6 seconds for the vehicle group versus 18 +/- 4 seconds for the nefiracetam group, after 4 days of testing. This effect persisted after a further interval of 10 days (retention test). A reversal test (to assess working memory for new information) yielded mean latencies of 26 +/- 6 seconds for the control group, 49 +/- 5 seconds for vehicle, and 25 +/- 4 seconds for nefiracetam (group main effect, F(2,109) = 8.0, P = .0005, Newman-Keuls, P < .05), showing that both the control and nefiracetam groups were different from the vehicle group.

CONCLUSION

Nefiracetam therapy improves the learning behavior of embolized rats. The results are not caused by an activating effect of the drug because the animals are tested after the treatment period is over and because the beneficial effect is seen using the delayed retention test. Finally, working memory is markedly preserved by nefiracetam, an effect observed several weeks after treatment.

Phase II study of irinotecan based fourth-line chemotherapy for gefitinib therapy-failed non-small cell lung cancer (NSCLC)

18164

Background: Despite the undoubted gains from EGFR TK inhibitor therapy as 2nd or 3rd line chemotherapy, most of them will relapse during treatment. Among these patients, they might be young, with good performance status, and their disease is expressed with only minor symptoms. The objectives of this study were to evaluate the antitumor efficacy and safety of irinotecan based regimen as 4th line therapy for refractory or recurrent to gefitinib treatment. We report our experience with irinotecan-based 4th line chemotherapy. Methods: Eligibility required proven NSCLC refractory or recurrent after 3rd line chemotherapy(gefitinib), measurable lesions by RECIST, and ECOG PS 0–1. Irinotecan (60mg/m2, day 1,8,15) and/or cisplatin (60 mg/m2, day 1) were administered every four week for at least 2 course. We analyzed for time to tumor progression (TTP) for first, response rates and toxicities. Results: Since June 2004, 17 patients (consisting of 9 with squamous cell, 7 with adeno-, and 1 with NSCLC not further specified) with a median age of 61 years were enrolled, with 1 drop out during treatment. Chemotherapy was administered for a median 2 courses (range 2–6). Median TTP was 91 (range 35–210) days. Two pts achieved a PR and 5 pts a SD. Disease control rate was 41.2%. Response rate was 11.8%. Toxicity of grade 3 or 4 consisted of neutropenia (35.3%), anemia (29.4%), thrombocytopenia (17.7%), nausea (17.6%), and diarrhea (23.5%). There were no treatment related deaths. Conclusions: This irinotecan based chemotherapy for EGFR TK inhinbitor therapy failed NSCLC patients showed promising efficacy with tolerable toxicity. Irinotecan based chemotherapy may be considered a potential therapeutic option for 4th line chemotherapy in well selected patients.

No significant financial relationships to disclose.

Low SER versus high SER thoracic radiotherapy in the management of limited-stage small cell lung cancer

18170

Background: Patients with small-cell lung cancer account for about 20% of all lung cancer patients, with only one third of the patients presenting with limited disease. Although the combinations of chemo and radiation therapy have improved the prognosis substantially, the optimal chemoradiotherapy remains controversial in LD-SCLC. There are many reports that the overall duration of the chemoradiotherapy package is the most relevant predictor of the outcome. Therefore we tested SER beginning with the start of any treatment until the end of radiotherapy in patients with LD-SCLC. Methods: We enrolled the patients who were diagnosed as SCLC histologically in Korea University Medical Center from 2003 to 2006. All of them presented with limited disease. We divided them into two groups; the low SER (within 60 days of SER) and the high SER group (over 60 days). The patients were treated with thoracic radiotherapy and platinum based topoisomerase inhibitor. Overall survival was analyzed with a Cox model adjusted for performance and the chemotherapy regimen. Results: Of 29 patients, 16 patients were in low SER and 13 patients were in high SER. Low SER, as compared with high SER, significantly prolonged survival rate (p=0.028). We evaluated the radiation effect by the time between the start of chemotherapy and the start of radiotherapy, below 30 days and above 30 days, but there were no statistically comparable difference in there survival time between the two groups (p=0.176). The survival times of the patients were increased by 3.094 times in the low SER (95% C.I, 1.083 to 8.840, p=0.028) and by 6.901 times in ECOG groups 0 or 1 compared with group 2 (95% C.I, 1.563 to 30.468, p=0.018). There were no statistically significant increases in the side effects: pneumonitis, esophagitis, and BM suppressions. Conclusions: The cumulative survival of the patients in the low SER group is higher than for patients in the high SER group. The SER may facilitate a more rational design of combined-modality treatment in rapidly proliferating tumors.

[Table: see text]

No significant financial relationships to disclose.

The local prevalence of COPD by post-bronchodilator GOLD criteria in Korea

OBJECTIVE

Chronic obstructive pulmonary disease (COPD) is a disease characterised by not fully reversible airflow limitation. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) committee decided to diagnose COPD using post-bronchodilator spirometry values. We aimed to examine the prevalence and risk factors of COPD in Ansan, an industrialised city of Korea, by using the post-bronchodilator GOLD criteria. We then investigated the implications of brenchodilation on the prevalence of COPD.

DESIGN

A total of 3642 participants in the Korean Health and Genome Study were interviewed about age, income, smoking status and respiratory symptoms and completed pulmonary function tests, including postbronchodilator spirometry.

RESULTS

COPD prevalence by post-bronchodilator spirometry was 3.7% (134/3642), which was significantly different from that estimated using pre-bronchodilator criteria (7.7%, 282/3642). Exclusion of subjects with significant bronchodilator response (BDR) significantly lowered the prevalence of COPD to 3.3% (117/3572), compared with including subjects with post-bronchodilatory residual obstruction with significant BDR. Prevalence was associated with old age, smoking history, male sex and respiratory symptoms.

CONCLUSION

COPD prevalence by post-bronchodilator GOLD criteria was 3.7%, which was much lower than that of pre-bronchodilator criteria. The bronchodilator reversibility test substantially affects estimations of COPD prevalence.

Filtration application from recycled expanded polystyrene

Water-in-oil emulsion with drop size less than 100 mum is difficult to separate. Coalescence filtration is economical and effective for separation of secondary dispersions. Coalescence performance depends on flow rate, bed depth, fiber surface properties, and drop size. The amount of surface area of the fibers directly affects the efficiency. A new recycling method was investigated in the previous work in which polystyrene (PS) sub-mum fibers were electro-spun from recycled expanded polystyrene (EPS). These fibers are mixed with micro glass fibers to modify the glass fiber filter media. The filter media are tested in the separation of water droplets from an emulsion of water droplets in oil. The experimental results in this work show that adding nanofibers to conventional micron sized fibrous filter media improves the separation efficiency of the filter media but also increases the pressure drop. An optimum in the performance occurs (significant increase in efficiency with minimal increase in pressure drop) with the addition of about 4% by mass of 500 nm diameter PS nanofibers to glass fibers for the filters.

Geographical difference in the prevalence of isolated systolic hypertension in middle-aged men and women in Korea: the Korean Health and Genome Study

To compare geographical difference in the prevalence of isolated systolic hypertension (ISH) in between urban (Ansan) and rural (Ansung) Korean adults aged 40-69 years, 4351 men and 4604 women enrolled in the Korean Health and Genome Study were analysed. Information was collected regarding gender, alcohol intake, smoking status, household income, occupation, and years of education by trained interviewers. Eligible subjects included untreated hypertensive and normotensive subjects. ISH was defined as a systolic blood pressure (SBP) > or = 140 mmHg and diastolic BP <90 mmHg. The overall age-adjusted prevalence of ISH was 4.1%. The prevalence of ISH in Ansung (5.7%) was higher than in Ansan (2.5%, P < 0.05). Also it increased with increments of age, from 1.0 to 12.8% in Ansung (P < 0.05) and from 0.3 to 13.0% in Ansan (P < 0.05). In those with body mass index (BMI) > or = 30.0 kg/m2 in Ansung, the prevalence of ISH in women was twice as much as in men. The prevalence of ISH in obese men and women with a waist-hip ratio > or =1.0 and > or = 0.85, respectively, was more than that of nonobese men and women in both areas. In Korea, because of industrialization, the age distribution was skewed and the Korean population in rural areas is more aged. ISH will become a truly major health problem in rural area, because ISH is related to age, BMI and waist-hip ratio. Therefore, the Korean government will be required to institute different policies in the hypertension management to target populations in rural and urban areas.

C-reactive protein level as an independent risk factor of metabolic syndrome in the Korean population. CRP as risk factor of metabolic syndrome

Interrelationship between C-reactive protein (CRP) and metabolic syndrome (MS) was evaluated in a community-based cohort of 9773 Koreans aged 40-69 years. Metabolic syndrome was defined by criteria of the National Cholesterol Education Program. CRP was measured by validated high-sensitivity assay. The median CRP level was 1.4 mg/1, and significantly increased as the number of components of MS increased (P trend <0.001). CRP levels were significantly but marginally correlated with waist circumference (r=0.18), triglyceride (r=0.14), blood pressure (r=0.11), HDL-cholesterol (r=-0.10), and fasting glucose (r=0.09) (all P values<0.01). Odds ratios of the highest quartile of CRP for each component of MS; i.e., waist circumference, triglyceride, glucose metabolism, blood pressure, and HDL-cholesterol were 2.36, 1.79, 1.70, 1.32 and 1.28, respectively. The highest quartile of CRP was independently associated with 1.72-fold increased risk of MS in our logistic regression model adjusted for age, sex, BMI, and smoking. This study demonstrated that CRP is a strong associating factor of MS in Korean population. We recommend further evaluation of CRP levels in the other Asian ethnic groups to establish biological plausibility as the risk factor for MS in all ethnic groups.

Prevalence and correlates of orthostatic hypotension in middle-aged men and women in Korea: the Korean Health and Genome Study

To examine the prevalence and correlates of orthostatic hypotension (OH) in middle-aged adults enrolled in the Korean Health and Genome Study. Participants were 8908 individuals aged 40-69 years. Supine blood pressure (BP) was measured three times at 30-s intervals after at least 5 min of rest in the supine position and single standing BP was measured at 0 and 2 min after standing, respectively. OH was defined as a reduction in systolic BP or diastolic BP > or = 20 and 10 mmHg, respectively. The prevalence of OH at 0 and 2 min after standing was 12.3 and 2.9%, respectively. At 0 min of standing, OH frequency increased significantly with age from 6.4% in those aged 40-44 years to 23.1% in those aged 65-69 (P < 0.001). After adjustment for age and other characteristics, hypertension was associated with a 1.7-fold excess in the odds of OH in men and a 1.6-fold excess in women (P < 0.001). In contrast, an increase in body mass index (BMI) on the order of 5 kg/m2 was associated with a 20-30% reduction in the odds of OH (P < 0.001). Diabetes in women was also associated with a 1.4-fold excess in the odds of OH (P < 0.05). An increase in triglyceride by 136 mg/dl in men was associated with an increase in the odds of OH (P < 0.05). In conclusion, the prevalence and correlates of OH other than diabetes and triglycerides were notably similar in men and women. While the association between hypertension and OH has been observed elsewhere, low BMI in Korean adults with OH may be an important marker for subclinical morbidity or coexisting risk factors that need to be identified.

Urinary concentration of transforming growth factor-beta-inducible gene-h3(beta ig-h3) in patients with Type 2 diabetes mellitus

AIMS

The expression of TGF beta-inducible gene h3(beta ig-h3) has been used to assess the biological activity of TGF beta in the kidney. In this study, we investigated whether the urinary concentration of beta ig-h3 is associated with diabetic nephropathy in patients with Type 2 diabetes mellitus. We also evaluated the relationship between the urinary concentration of beta ig-3 and proteinuria and microalbuminuria (AER) in a normal healthy population and in Type 2 diabetes patients.

METHODS

Four hundred and seventy-nine Type 2 diabetic patients without non-diabetic kidney diseases and 528 healthy control subjects were enrolled. The study subjects were divided into five groups: a non-diabetic healthy control group with normal ACR (n = 443), a non-diabetic healthy control group with microalbuminuria (n = 85), a normoalbuminuric diabetic group (n = 198), a microalbuminuric diabetic group (n = 155) and an overt proteinuria group (n = 126). Urinary levels of beta ig-h3 were measured by enzyme-linked immunosorbent assay.

RESULTS

(i) Urinary excretion of beta ig-h3 was significantly higher in the diabetic groups than in the controls, even in the normoalbuminuric stage (25.02 +/- 8.84 vs. 18.67 +/- 6.56, P = 0.03). In diabetic patients, urinary beta ig-h3 levels increased significantly as diabetic nephropathy advanced (25.02 +/- 8.84 vs. 34.06 +/- 24.55 vs. 169.63 +/- 57.33, P < 0.001). (ii) Proteinuria was found to be significantly correlated with urinary beta ig-h3 (healthy control; r = 0.137, P = 0.019, diabetic patients; r = 0.604, P < 0.001). ACR was also found to be significantly related with urinary beta ig-h3 in diabetic patients (r = 0.383, P = 0.006). (iii) In diabetic patients, urinary beta ig-h3 was significantly related with systolic and diastolic blood pressure (systolic blood pressure: r = 0.436, P = 0.024; diastolic blood pressure, r = 0.365, P = 0.042), total cholesterol and HbA(1c) (cholesterol: r = 0.169, P = 0.03, HbA(1c); r = 0.387, P = 0.044). Logistic regression analyses showed that urinary beta ig-h3 was associated with a significant increase in the risk of microalbuminuria and proteinuria in diabetic patients.

CONCLUSIONS

Longitudinal monitoring of urinary beta ig-h3 may improve the likelihood of detecting diabetic nephropathy at an earlier stage and beta ig-h3 could be a sensitive marker of diabetic kidney disease progression.

The effect of wettability on drop attachment to glass rods

The coalescence of droplets in fibrous filters depends on many parameters such as wettability, filter depth, flow velocity, and filter materials. The objective of this work is to determine the effect of the wettability on the coalescence mechanism. Experimental results from tests on coated glass rods are presented. Three different silanes are deposited on the glass rod surfaces to change the surface wettability. Flow of water-in-oil emulsion past the glass rods is observed. When the rod surface is wetting the dispersed phase coats the rod. When the surface is nonwetting the drops do not stick easily to the surface and do not coat it but slide around to the downstream side, where they are dragged off the rod. Such behavior is important in understanding the performance of coalescing filter media.

Comparative diagnostic utility of 1H MRS and DWI in evaluation of temporal lobe epilepsy

OBJECTIVE

To compare the ability of diffusion-weighted MRI (DWI) and (1)H MRS to lateralize to the temporal lobe of seizure onset and to predict postoperative seizure control in patients with temporal lobe epilepsy (TLE).

METHODS

Forty TLE patients who subsequently underwent epilepsy surgery and 20 normal subjects were studied with (1)H MRS and DWI. Medial parietal and temporal lobe N-acetylaspartate (NAA)/creatine (Cr) ratios and hippocampal and temporal stem apparent diffusion coefficients (ADC) were obtained. Lateralization to either temporal lobe with each MR measurement was based on the threshold values derived from +/-1-SD right/left ratios of normal subjects.

RESULTS

Temporal lobe NAA/Cr lateralized to the operated temporal lobe in 18 of 40 (45%), hippocampal ADC in 32 of 40 (80%), and temporal stem ADC in 26 of 40 (65%) patients. Almost all of the cases that lateralized to the surgical side with NAA/Cr ratios (94%) had an excellent postoperative seizure control (p = 0.01). Lateralization to the side of surgery was not associated with surgical outcome with hippocampal and temporal stem ADC (p > 0.05).

CONCLUSION

(1)H MRS and DWI complement each other in the clinical setting. DWI more frequently lateralized to the operated side, and (1)HMRS was a better predictor of postoperative seizure control.

Randomized trial of brief family interventions for general populations: adolescent substance use outcomes 4 years following baseline

This study examined the long-term substance use outcomes of 2 brief interventions designed for general population families of young adolescents. Thirty-three public schools were randomly assigned to 3 conditions: the 5-session Preparing for the Drug Free Years Program, the 7-session Iowa Strengthening Families Program, and a minimal contact control condition. The pretest involved 667 6th graders and their families. Assessments included multiple measures of initiation and current use of alcohol, tobacco, and marijuana. Pretest data were collected in the 6th grade and the reported follow-up data were collected in the 10th grade. Significant intervention-control differences in initiation and current use were found for both interventions. It is concluded that brief family skills-training interventions designed for general populations have the potential to reduce adolescent substance use and thus have important public health implications.

Prevalence, awareness, treatment, control and risk factors of hypertension in Korea: the Ansan study

OBJECTIVES

To determine prevalence, awareness, treatment, and control of hypertension, and its risk factors in an urban Korean population.

DESIGN AND SETTING

A cross-sectional survey in Ansan-city, Korea.

SUBJECTS AND METHODS

Population-based samples of people aged 18-92 years in Ansan-city, Korea, were selected, yielding 2278 men and 1948 women, and their blood pressures were measured using a highly standardized protocol. Hypertension was defined as a systolic BP > or = 140 mmHg or diastolic BP > or = 90 mmHg or reported treatment with antihypertensive medications, and subclassified according to 1999 WHO-ISH guidelines. Isolated systolic hypertension (ISH) defined as a systolic BP > or = 140 mmHg and diastolic BP < 90 mmHg was also examined. Data were stratified by age and sex.

RESULTS

The overall prevalence of hypertension in this study was 33.7%. Among these, 64.9% had Grade 1 hypertension, 22.5% Grade 2, and 12.5% Grade 3. Age-specific prevalence of hypertension increased progressively with age, from 14.19% in 18 to 24 year-olds to 71.39% in those 75 years or older. Hypertension prevalence was significantly higher in men (41.5%) than in women (24.5%) (P < 0.001). Isolated systolic hypertension had significantly lower prevalence (4.33%) within the population, although in the elderly aged 55 years or more it rose by 11.13%. Overall, 24.6% of hypertensive individuals were aware that they had high blood pressure, as much as 78.6% were being treated with antihypertensive medications, and 24.3% were under control. Hypertension awareness as well as treatment and control rates varied by sex, with women higher in all three rates. Multivariate analysis revealed that age, body mass index and abdomen circumference were significantly associated with prevalence of hypertension both in men and women.

CONCLUSIONS

Hypertension is highly prevalent in Korea. Despite the high rate of treatment, the rates of awareness and control are relatively low, suggesting the nationwide demand for preventing and controlling high blood pressure in Korea in order to avert an epidemic of cardiovascular disease.

Randomized trial of brief family interventions for general populations: adolescent substance use outcomes 4 years following baseline

This study examined the long-term substance use outcomes of 2 brief interventions designed for general population families of young adolescents. Thirty-three public schools were randomly assigned to 3 conditions: the 5-session Preparing for the Drug Free Years Program, the 7-session Iowa Strengthening Families Program, and a minimal contact control condition. The pretest involved 667 6th graders and their families. Assessments included multiple measures of initiation and current use of alcohol, tobacco, and marijuana. Pretest data were collected in the 6th grade and the reported follow-up data were collected in the 10th grade. Significant intervention-control differences in initiation and current use were found for both interventions. It is concluded that brief family skills-training interventions designed for general populations have the potential to reduce adolescent substance use and thus have important public health implications.

Randomized trial of brief family interventions for general populations: adolescent substance use outcomes 4 years following baseline

This study examined the long-term substance use outcomes of 2 brief interventions designed for general population families of young adolescents. Thirty-three public schools were randomly assigned to 3 conditions: the 5-session Preparing for the Drug Free Years Program, the 7-session Iowa Strengthening Families Program, and a minimal contact control condition. The pretest involved 667 6th graders and their families. Assessments included multiple measures of initiation and current use of alcohol, tobacco, and marijuana. Pretest data were collected in the 6th grade and the reported follow-up data were collected in the 10th grade. Significant intervention-control differences in initiation and current use were found for both interventions. It is concluded that brief family skills-training interventions designed for general populations have the potential to reduce adolescent substance use and thus have important public health implications.

The relationship between quantitative T2 relaxometry and memory in nonlesional temporal lobe epilepsy

PURPOSE

We investigated the relationship between preoperative quantitative magnetic resonance imaging (MRI) T2 relaxometry and volumetry of the hippocampi and pre- and postoperative verbal memory in temporal lobectomy patients who had nonlesional temporal lobe epilepsy.

METHODS

Pre- and postoperative memory data based on the Logical Memory (LM) subtest of the Wechsler Memory Scale-Revised (WMS-R) and the 30-min delayed recall trial of the Rey Auditory Verbal Learning Test (AVLT) were obtained from 26 left and 15 right temporal lobectomy patients. Coronal MRI T2 maps were generated for these 41 temporal lobectomy patients as well as 61 control patients. Hippocampal T2 relaxation times and hippocampal volumes, converted to z scores using control group data, were correlated with neuropsychological performance in the patients.

RESULTS

In left temporal lobe-onset patients, high T2 in the left hippocampal body predicted higher LM performance after surgery. Asymmetrically high T2 in the left hippocampal body (i.e., the right-minus-left difference), compared with the right hippocampal body, also predicted higher LM performance after surgery. In right temporal lobe-onset patients, high T2 in the left hippocampal body predicted relatively lower AVLT performance after surgery. Multiple regression analysis in left temporal-onset patients revealed that high T2 in the left hippocampal body together with higher preoperative LM performance predict higher postoperative LM performance.

CONCLUSIONS

Our findings suggest that elevated (i.e., abnormal) hippocampal T2 signal is associated with memory ability (or hippocampal functional capacity) independent of MRI-determined hippocampal atrophy. Therefore, our findings support the use of quantitative T2 relaxometry as an independent predictor of verbal memory outcome in both left and right TLE patients who are candidates for temporal lobectomy.

The prevalence and awareness of hypertension and the relationship between hypertension and snoring in the Korean population

BACKGROUND

Hypertension is the most important, and yet modifiable, risk factor for cardiovascular diseases. But in many countries, hypertension remains poorly controlled. Moreover, sleep apnea syndrome has shown that it is correlated with hypertension. The purpose of this study was to investigate the prevalence, awareness and control of hypertension among the Korean people and to evaluate the relationship between hypertension and snoring.

METHODS

A total of 640 subjects living in Ansan, a regional city in Korea, were selected randomly, and trained nursing students investigated their age, sex, medical history, blood pressure, body mass index (BMI) and snoring score. Blood pressures were measured three times with a 10-minute interval and then averaged. The degree of snoring was estimated using a questionnaire. We divided the subjects into hypertensive (BP > or = 140/90 mmHg) versus normotensive group and snorer versus non-snorer group, and correlated hypertension with snoring.

RESULTS

Of 640 subjects, 311 were male. The mean age was 39.7 +/- 14.6 years (18-77 years), the mean BMI (body mass index) was 22.4 +/- 3.0 kg/m2. The mean systolic and diastolic blood pressure was 121 +/- 15.7 mmHg and 79.5 +/- 11.6 mmHg. The prevalence and awareness of hypertension were 22.2% and 16.9%, respectively, and the prevalence of snoring was 35.2%. With the increment of age, in the male, the prevalence of hypertension and snoring were higher, and the snorer group showed a higher risk of hypertension than the non-snorer group (Odds ratio 2.32, CI = 1.56-3.39, p = 0.0001).

CONCLUSION

In Korea, the prevalence of hypertension was similar to that in the western countries, but the awareness of hypertension was much lower compared with western countries. The prevalence of hypertension was higher in the snorer group, so more research on the correlation between the two conditions should be advanced in the future.

Side of symptomatic annular tear and site of low back pain: is there a correlation?

STUDY DESIGN

A retrospective chart review.

OBJECTIVES

To report the correlation between the side of a concordantly painful, post-discography computer tomography (CT) visualized, annular tear, and the side of a patients' low back pain.

SUMMARY OF BACKGROUND DATA

An annular fissure extending from the nucleus to the outer one-third of the annulus is thought to be the nociceptive source stimulated during provocative lumbar discography. To our knowledge, there are no studies that have attempted to delineate whether the side of the annular tear correlates with the side of the patient pain.

METHODS

One hundred and one post-discography CT scans, performed on patients with single level, concordantly painful, and fissured discs identified during lumbar discography, were randomly obtained from the archived and current files of the Penn Spine Center's film library. These were reviewed by both the lead author and a spine radiologist, both of who were blinded to the side of the patients pain, to determine which scans demonstrated clearly definable tears extending to the outer one-third of the annulus. Statistical analysis via the exact method was used to determine the correlation between the side of the patients tear and the side of the patients pain.

RESULTS

Forty post-discography CT scans met the inclusion criteria. There was a random correlation between the side of the patients concordantly painful annular tear and the side of the patients pain.

CONCLUSIONS

The results of this study raise several questions regarding the embryologic development of the intervertebral disc and its somite, neurologic transmission of discogenic pain, distribution of chemical inflammagens, validity of discography, technique of ESI, and technique and validity of IDET.

Immunohistochemical study on the distribution of six members of the Kv1 channel subunits in the rat cerebellum

Voltage-gated K(+) (Kv) channels are critical for a wide variety of processes, and play an essential role in neurons. In the present study, we have demonstrated a unique pattern of expression of the six Kv1 channel subunits in the rat cerebellum, for the first time. The greatest concentration of Kv1.2 was found in the basket cell axon plexus and terminal regions around the Purkinje cells. Relatively weak immunoreactivity for Kv1.1 was also found in this area. The somatodendritic Purkinje cell areas were intensely stained with anti-Kv1.5 antibodies. In the cerebellar nuclei, the cell bodies of cerebellar output neurons showed strong Kv1.5 and Kv1.6 immunoreactivities in the nucleus medialis, interpositus and lateralis. Interestingly, Kv1.2 immunoreactivity was found in some neurons with their processes. Our immunohistochemical results may support the notion that the formation of heteromultimeric Kv channels possibly represents an important contribution to the generation of Kv channel diversity in the brain, especially in the cerebellum.

Immunohistochemical study on the distribution of the voltage-gated potassium channels in the gerbil hippocampus

The differential expression of specialized voltage-gated potassium (Kv) channel subtypes probably reflects the wide range of functions in the nervous system. In the present study, we investigated the distribution of six Kv1 channel subtypes in the gerbil hippocampus by immunohistochemistry. Immunoreactivities for Kv1.1, Kv1.2, Kv1.4 and Kv1.6 were observed in the pyramidal cells of the CA1-CA3 areas. In addition, many medium- to large-sized interneurons located within stratum pyramidals, stratum oriens, and stratum radiatum of CA1-CA3 were strongly immunoreactive for Kv1.4. Although there was some overlap, our results were quite different from the previous studies described in the rat and mouse hippocampus, in that we observed intense staining mainly in the cell bodies of the pyramidal cells and granule cells. As a whole, the present study has clearly shown Kv1 channel distributions in the gerbil hippocampus, which were variant between species and therefore more or less functionally significant. This study may provide useful data for the future investigations on the pathological conditions such as ischemia and epilepsy.

Modeling factors influencing enrollment in family-focused preventive intervention research

The reported study tests an extension of a previously supported model of family context and health belief predictors of parental inclination to enroll in preventive interventions. The extended model addresses limitations in the prior investigation; it examines the role of intervention-related beliefs and inclinations on actual enrollment in a skills training intervention research project. Model testing was conducted with a sample of 635 parents of 6th graders who completed a prospective participation factor survey and were recruited for an intervention research project 6 months later. The model fit was strong and all but one of the primary hypothesized effects were supported. Notably, both stated inclination to enroll in an intervention and in the research project had significant positive effects on actual project enrollment occurring 6 months later. Perceived intervention benefits and barriers had significant effects on both types of stated inclination to enroll. Examination of modification indices for the model suggested an additional path linking educational attainment with actual enrollment.

Immunocytochemical study on the distribution of p53 in the hippocampus and cerebellum of the aged rat

A role for p53-mediated modulation of neuronal viability has been suggested by the finding that p53 expression is increased in damaged neurons in models of ischemia and epilepsy. P53 gene upregulation precedes apoptosis in many cell types, and a potential role for this molecule in apoptosis of neurons has already been demonstrated in Alzheimer's disease. Recent studies suggest that p53-associated apoptosis may be a common mechanism of cell loss in several important neurodegenerative diseases. In the present study, we examined changes in p53-immunoreactive (IR) neurons in the brains of aged rats for the first time employing immunocytochemical and in situ hybridization methods. P53-IR neurons were found in the CA1 region of hippocampus, septal region and cerebellum in the aged rats, but there was no p53-IR cell in the brains of adult rats. In the hippocampus of the aged rat, p53-IR cells predominated in the stratum oriens and pyramidal layers, while the molecular layer contained relatively few p53-IR cells. The most prominent population of immunoreactive labeling in cerebellar cortex was localised within the cell bodies of Purkinje cells and dendrites in molecular layers. Upregulation of p53 in the Purkinje cells observed in this study suggests that significant loss of Purkinje cells with aging may be regulated with several apoptosis-controlling factors including p53 and oxidative stress mechanism. Further investigations are required to establish whether direct functional relations exist between p53 and the apoptotic neuronal death in normal aging or Alzheimer brains.

Reducing adolescents' aggressive and hostile behaviors: randomized trial effects of a brief family intervention 4 years past baseline

OBJECTIVE

To examine the long-term effects of a brief family intervention on aggressive and hostile behaviors of adolescents in the general population.

DESIGN

Randomized trial including 22 public schools assigned to the Iowa Strengthening Families Program or a control condition. Analyses supported sample representativeness and failed to show differential attrition effects 4 years after baseline.

INTERVENTION

Seven-session intervention for parents and their sixth-grade children.

MEASURES

The multi-informant, multimethod measures included independent observer ratings of adolescent aggressive and hostile behaviors in adolescent-parent interactions, family-member report of aggressive and hostile behaviors in those interactions, and adolescent self-report of aggressive and destructive conduct across settings. Data were collected during the 6th (preintervention and postintervention), 7th, 8th, and 10th grades.

RESULTS

All measures showed a generally positive trend in intervention-control group differences over time. During 10th grade, significant intervention-control differences were found for adolescent self-report of aggressive and destructive conduct (P =. 01), with relative reduction rates ranging from 31.7% to 77.0%. Significant differences were shown for observer-rated aggressive and hostile behaviors in adolescent-parent interactions (P =.01); differences in family member reports of those behaviors were not significant. Supplemental analyses of both interactional behavior measures, specific to parent sex, indicated significant experimental group differences in interactions with mothers (P =.04 for both measures) but not with fathers.

CONCLUSIONS

Brief family competency-training interventions designed for general populations can reduce aggressive and hostile behaviors in adolescents' interactions with parents and adolescent aggressive behaviors outside of the home setting. Thus, this type of intervention has important public health implications. Arch Pediatr Adolesc Med. 2000;154:1248-1257.

Immunohistochemical study on the distribution of the voltage-gated calcium channel alpha(1B) subunit in the mature rat brain

Many neuronal processes are regulated by calcium influx through voltage-gated calcium channels. Among these calcium channels, the N-type channel has been shown to play a significant role in the regulation of neurotransmitter release. This present report has demonstrated the distribution of the alpha(1B) subunit of the N-type calcium channel in the mature rat brain. The most striking findings were the highest immunoreactivity in the CA1 region of the hippocampus and the clear demarcation in the thalamus. Characteristic patterns of distribution were noted in the cerebral cortex, hippocampus, caudate-putamen, thalamus, and cerebellum. In the cerebral cortex, strong staining was seen in layers II-III and V. In the basal ganglia, the staining intensity was high in the caudate-putamen, whereas there was no immunoreactivity in the globus pallidus. Although the staining intensity was relatively low compared to that of the forebrain, moderate alpha(1B)-IR was found in the dorsal cochlear nucleus and mesencephalic trigeminal nucleus. The detailed features of this study will extend our current knowledge of alpha(1B) subunit distribution in terms of the number of neuroanatomical areas examined, by investigating alpha(1B) subunit protein expression, for the first time.

Synergistic combinatorial stroke therapy: A quantal bioassay of a GABA agonist and a glutamate antagonist

We sought to prolong the window for stroke treatment using synergistic combinatorial therapy. We used the intraluminal filament occlusion model in rats to cause focal cerebral ischemia and a quantal bioassay to measure efficacy. The GABA agonist muscimol and the glutamate antagonist MK-801 were used alone and in combination at various times after ischemia onset. At progressively longer treatment delay intervals (30, 60, 75, 120, 240, and 360 min), higher doses of the single drugs were required to achieve neuroprotection. In contrast, the combination 1.0 mg/kg muscimol plus 0.5 mg/kg MK-801 was effective at all delay intervals studied except the longest (P < 0.05 at each time). After 240 min from ischemia onset, the combination was more effective than either single agent (P < 0.05 for each drug dose), suggesting synergism. The neuroprotective effect could not be demonstrated using morphometry. The treatment effects were probably not due to hypothermia because brain temperatures recorded in awake, unregulated subjects remained normo- or slightly hyperthermic following all treatments. Awake subjects kept on a heating pad exhibited mild brain hyperthermia. The combination caused a drop and MK-801 caused a significant increase in mean arterial blood pressure (main effects F(5,172) = 29, P < 0.0001). The combination of a GABA agonist and glutamate antagonist appears to possess synergistic neuroprotective effects when treatment is delayed up to 240 min following the onset of cerebral ischemia. Temperature regulation causes hyperthermia in awake subjects. The quantal bioassay is one method suitable for studies of synergistic stroke therapy.

Immunohistochemical study on the distribution of neuronal voltage-gated calcium channels in the rat cerebellum

Many neuronal processes are regulated by calcium influx through voltage-gated calcium channels (VGCCs), including protein phosphorylation, gene expression, neurotransmitter release, and firing patterns of action potential. In the present study, we have used anti-peptide antibodies directed against a unique sequence in rat alpha(1A), alpha(1B), alpha(1C) and alpha(1D) subunits of VGCCs to determine their cellular distribution in normal rat cerebellum. Throughout the molecular layer, immunoreactivity for alpha(1B) and alpha(1D) subunits were found in the cell bodies of basket and stellate cells as well as in the neuropil. In the Purkinje cells, only alpha(1C)-IR was observed in the dendritic branches of Purkinje cells, whereas immunoreactivity for alpha(1B) and alpha(1D) subunits were rarely found in the cell bodies of Purkinje cells. Immunoreactivity for the alpha(1A), alpha(1B,) and alpha(1D) subunits were strong in the granule cell bodies, whereas alpha(1C)-IR was not prominent in the cell bodies. In the cerebellar nuclei, a distinct band of punctate immunoreactivity for the alpha(1A), alpha(1B), alpha(1C), and alpha(1D) subunits were observed. The overall results of the above localization study showed clearly that the alpha(1A), alpha(1B,) alpha(1C) and alpha(1D) pore forming subunits of VGCCs have differential distribution in the rat cerebellum. The present studies may provide useful data for such future investigations to understand the role of calcium channels in neurological pathways.

Assessing a public health approach to delay onset and progression of adolescent substance use: latent transition and log-linear analyses of longitudinal family preventive intervention outcomes

This study examined the effects of the Iowa Strengthening Families Program (ISFP) and the Preparing for the Drug-Free Years program (PDFY) on young adolescent transitions from nonuse of substances to initiation and progression of substance use. Analyses incorporated 3 waves of data collected over a 2.5-year period from 329 rural young adolescents. Outcomes were analyzed by using log-linear models that incorporated substance use status frequencies derived from latent transition analyses. Effects on delayed substance use initiation were shown for both the ISFP and the PDFY at a 2-year follow-up. Also at this follow-up, the PDFY showed effects on delayed progression of use among those previously reporting initiation.

Region-specific changes of NOS-IR cells in the basal ganglia of the aged rat

Nitric oxide (NO) is a free radical postulated to act as a neurotransmitter, neuromodulator, or second messenger molecule in the central nervous system. Several findings suggest that NO production may be decreased in the aged rats. In the present study, we investigated regional discrepancies in changes with aging in the number of nitric oxide synthase-immunoreactive (NOS-IR) cells in the basal ganglia of the aged rat by immunocytochemistry. The number of NOS-IR neurons in the striatum and substantia innominata of the aged rat decreased. In contrast, the number of NOS-IR neurons in the subthalamic nucleus increased in the aged rat. On the other hand, the number of NOS-IR neurons in the nucleus accumbens and olfactory tubercle did not change. Taken together, important functional changes can be caused by the region-specific changes of NOS-IR neurons in the basal ganglia with aging.

Neurophysiologic basis of functional neuroimaging: animal studies

Functional neuroimaging adds metabolic or biochemical information to that obtained with anatomic imaging, allowing localization of a neural function. Positron emission tomography and single photon emission tomography make use of radioactive tracers tagged to a molecule which can indicate glucose metabolism, oxygen consumption, or blood flow. Functional magnetic resonance imaging uses the different magnetic properties of oxyhemoglobin and deoxyhemoglobin to identify areas of increased blood flow, which, in turn, reflects neuronal activation. Magnetic resonance spectroscopic imaging, with magnetically labeled molecules, can be used to follow biochemical pathways. Functional neuroimaging is based on the experimental data that neuronal activation leads to increased metabolism. Uptake of glucose and oxygen increases to meet increased energy needs. The fractionally increased glucose appears to be taken up mostly by glia, which metabolize it through glycolysis. The end product, lactate, is released for neuronal uptake and subsequent oxidative phosphorylation. To meet these metabolic needs, blood flow increases to such an extent that overall capillary oxyhemoglobin concentration increases. This changes the magnetic signal in the region and permits functional magnetic resonance imaging studies. Recent data suggest that there is an initial decrease in the concentration of oxyhemoglobin which may be more spatially specific to the area of neuronal activation. Further refinements in functional neuroimaging will lead to improved understanding of the normal functional anatomy of the brain and will shed further light on the pathophysiology of many neurologic disorders.

Effect of ganaxolone in a rodent model of cerebral hematoma

BACKGROUND AND PURPOSE

Therapy with gamma-aminobutyric acid (GABA) agonists appears to improve outcome after experimental hematoma but with unacceptable side effects. We looked to synthetic GABA agonists, or positive GABA modulators, widely developed as anticonvulsants and anxiolytics, to find compounds that may be effective. Ganaxolone is a synthetic neuroactive steroid that positively modulates GABA. We sought to determine whether ganaxolone was beneficial using a model of intracerebral hematoma.

METHODS

We stereotaxically injected varying doses of bacterial collagenase into the caudate nucleus of rats to induce blood-brain barrier failure and hematoma formation. Four hours later, we administered intravenously 15 or 30 mg/kg ganaxolone (n=23 each group), 20 mg/kg pregnanolone (n=21), or vehicle (n=30). Forty-eight hours after collagenase injection, we rated each animal using a standard rodent neurological examination. The ratings were compared with the amounts of injected collagenase using the quantal bioassay procedure. Other sets of animals were tested later for visuospatial learning. Brains were then prepared for histomorphometry, and brain volumes were estimated.

RESULTS

We found that ganaxolone 30 mg/kg significantly increased the ED(50) in the bioassay, for a potency ratio of 1.8+/-0.41 compared with vehicle (P<0.05). Ganaxolone 15 mg/kg and pregnanolone did not affect neurological outcome. Ganaxolone 30 mg/kg did not clearly improve visuospatial learning several weeks after hemorrhage. Ganaxolone exhibited a weak effect on cerebral volumes 48 hours after stroke, but 3 months after hemorrhage no such effect could be detected.

CONCLUSIONS

Ganaxolone improves neurological outcome 48 hours after intracerebral hematoma but not visuospatial learning several weeks after intracerebral hematoma. Histological evidence of damage was reduced at 48 hours but not at 3 months.

Reactive astrocytes express p53 in the spinal cord of transgenic mice expressing a human Cu/Zn SOD mutation

In a previous study, we reported increased NOS expression in the astrocytes in the spinal cord of SOD mutant transgenic mice that are used as ALS animal model. Recently, Messmer and Brune suggested that nitric oxide-induced apoptosis is intimately related with p53-dependent signaling pathway, and de la Monte et al. reported increased p53-immunoreactivity in the spinal cord of ALS patients. In the present study, we performed immunocytochemical studies to investigate the changes of p53-immunoreactivity in the brains of the mutant transgenic mice expressing a human Cu/Zn SOD mutation. Immunocytochemistry showed intensely stained p53-IR glial cells with the appearance of astrocytes in all levels of the spinal cord of the mutant transgenic mice, but no p53-IR glial cells were observed in the spinal cord of the control mice. P53-IR astrocytes were also detected in the brain stem of the mutant transgenic mice. In the medulla, they were observed in the medullary reticular formation, hypoglossal nucleus, vestibular nucleus, dorsal motor nucleus of the vagus and nucleus ambiguus. In the pons, their presences were noted in the pontine reticular formation, and trigeminal and facial nuclei. In the midbrain, astrocytes were detected in the mesencephalic reticular formation, red nucleus and periaqueductal gray matter. In the cerebellum, intensely stained p53-IR astrocytes were detected in the intracerebellar nuclei. In contrast to the mutant transgenic mice, no p53-IR astrocytes were detected in the brain stem and spinal cord of the control mice. Further multidisciplinary investigations involving p53-mediated cellular damage and pathogenesis of ALS are needed to clarify the importance of these results.

Modeling long-term parent outcomes of two universal family-focused preventive interventions: one-year follow-up results

The present investigation extended prior work by R. Spoth, C. Redmond, and C. Shin (1998). These researchers reported findings that 2 universal family-focused preventive intervention programs each had direct effects on a proximal parenting outcome (intervention-targeted parenting behaviors) and indirect effects on 2 global and distal outcomes (parent-child affective quality and general child management) at posttesting. A replication of the previously tested parenting outcome model was conducted with 1-year follow-up data and procedures identical to those used in the earlier study. Results of the present study (N = 404 families) indicate that statistically significant effects on parenting outcomes were sustained through a 1-year period following the posttest.

The lived experience of Korean immigrant women acculturating into the United States

Immigration to a different country and a new way of life affects immigrants in many different ways. The changes that occur can influence the way they live and think as well as their personal health. This is especially true with Korean women. However, we still do not have sufficient knowledge about how these women adjust to their new environments. The rate of Korean immigration to the United States has gradually increased since 1965. According to Bouvier and Arnold, the Korean immigrant population is estimated to reach 1.3 million in the year 2000. Korea ranks fourth in number of emigrants, closely following the Philippines, China, and Vietnam. Research reveals that approximately 45% of recent emigrants are women, and this percentage is rapidly increasing. Research concerning this population's lives, their process of acculturation, and, above all, their health and well-being is lacking greatly in quantity and quality. This study demonstrates that the change of women's roles, due to their process of acculturation, cannot be considered separate from their well-being. For this study, 6 Korean women immigrants living in New York were chosen to provide information. The participants volunteered under the condition that their privacy and confidentiality would be protected. A pattern of acculturation experience was revealed in four successive, principal stages: dreams, conflicts, renunciation, and remorse. Hopefully, the following descriptive data will provide knowledge for implementing qualitative care requirements for Korean women immigrants in the United States.