Oxidative stress related markers in the “VITA” and the centenarian projects

Oxidative stress seems to play an important role in the pathophysiology of Alzheimer's disease (AD). At present there are no easily accessible biochemical markers for AD. We performed activity assays for platelet MAO-B and erythrocyte Cu/Zn-SOD as well as Western blotting for these two proteins. Moreover, we assessed plasma lactoferrin and performed RFLP-analysis for the MAO-B-intron-13-polymorphism in patients from the Vienna-Transdanube Aging (VITA) and from the so called centenarian project. The first one, VITA, is a community-based cohort study of all 75 years old inhabitants of a geographical region of Vienna. The centenarian project investigates chronic care in-old patients suffering from AD. In both sexes platelet MAO-B activity increased significantly in the AD group, and Cu/Zn-SOD activity decreased, but the latter effect was significant only in females. No significant difference was found regarding plasma lactoferrin. No correlation was found between MAO-Bi13 and MAO-B platelet activity or allele MAO-Bi13 and disease frequency. These results point to the possibility that a combination of MAO-B and SOD activity levels might be useful tools for an early diagnosis of AD.

Schizophrenie als Diskonnektionssyndrom

Aside from characteristic psychopathological symptoms, cognitive deficits are a core feature of schizophrenia. These deficits can only be addressed within the context of widespread functional interactions among different brain areas. To examine these interactions, structural equation modeling (SEM) was used for the analysis of fMRI datasets. In a series of studies, both in antipsychotic-treated and drug-free schizophrenic patients, a pattern of enhanced thalamocortical functional connectivity could be observed as an indicator for possible disruptions of frontostriatal thalamocortical circuitry. Moreover, drug-free patients and those receiving typical antipsychotic drugs were characterized by reduced interhemispheric corticocortical connectivity. This difference relative to normal controls was less in patients under atypical antipsychotic drugs. The results could be interpreted as a beneficial effect of atypical antipsychotic drugs on information processing in schizophrenic patients. The present findings are consistent with the model of schizophrenia as a disconnection syndrome and earlier concepts of "cognitive dysmetria" in schizophrenia.

Life-threatening hemorrhage in neonates: management with recombinant activated factor VII

OBJECTIVE

Massive hemorrhage with shock is a common problem for the intensivist. The use of recombinant activated factor VII (rFVIIa), known as efficient treatment for hemophilia, has been reported to control severe bleeding episodes in critically care patients, but never in preterm neonates.

DESIGN

Case report (two cases) and review of the literature.

SETTING

Neonatal intensive care unit, university teaching hospital.

PATIENTS

Two preterm neonates with life-threatening hemorrhages, from the liver and spleen in one patient and from the lung in the other.

INTERVENTION

Intravenous administration of 150/200 microg/kg of rFVIIa (Novoseven, NovoNordisk, Copenhagen, Denmark).

MEASUREMENTS AND RESULTS

Complete hemostasis 10 min after the second bolus in the two patients.

CONCLUSION

For the intensivist, the successful use of rFVIIa in these patients and others lacking pre-existing coagulopathies points to rFVIIa as a novel therapeutic approach for patients presenting with massive life-threatening hemorrhage.

Long-term effects of the substituted benzamide derivative amisulpride on baseline and stimulated prolactin levels

In the present study, we investigated the long-term effects of treatment with amisulpride, a substituted benzamide derivative, as compared with the effects of treatment with flupenthixol, a thioxanthene, on the prolactin levels in schizophrenic patients. After completing 6 weeks of medication with either amisulpride or flupenthixol, the patients entered a long-term maintenance treatment with amisulpride 200-600 mg/day or flupenthixol 5-15 mg/day for a maximum of 12 months with a subsequent drug-free follow-up until month 15. Eighteen initially included patients were still participating in the study at month 6. In the flupenthixol group, only 1 patient treated reached month 12, and none of the patients reached month 15. For the amisulpride treatment group, months 12 and 15 were completed by 9 and 6 patients, respectively. After 1, 3, 6, and 12 months of treatment, and finally 3 months after cessation of treatment, the basal and thyrotropin-releasing hormone-stimulated secretions of prolactin were investigated. The prolactin plasma levels were elevated in both treatment groups during the course of maintenance treatment with a maximum effect at month 1. Flupenthixol treatment initially raised the prolactin levels about two- or threefold, and a subsequent decline during months 3 and 6 occurred. However, only the changes for month 1 reached the level of a statistical trend. The prolactin secretion was initially increased over tenfold by amisulpride. The prolactin levels at months 1, 3, 6, and 12 were significantly elevated as compared with the baseline values. A continuous decline of prolactin levels in both treatment groups occurred over the course of the next months. The prolactin response after the thyrotropin-releasing hormone challenge was not significantly changed over the long-term course. Notably, in the amisulpride group, 3 months after cessation of treatment at month 12, the elevated levels of prolactin returned to baseline at month 15. In summary, amisulpride demonstrated more pronounced effects than flupenthixol on the prolactin levels. However, the findings indicate also that treatment with amisulpride at clinically effective doses can be achieved at significantly lower prolactin levels during the long-term maintenance phase than during the prior acute phase.

[Predictive value of teller Acuity Card Test (TACT) and comparison of recognition and grating acuities in premature children with and without residua of Retinopathy of Prematurity (ROP)]

BACKGROUND

The aim of the study was to evaluate the predictive value of grating acuity as measured by the TAC Test (TACT) at the age of 6 months corrected age and to compare grating and recognition acuities in eyes with and without ROP residua at an age of three to seven years.

PATIENTS AND METHODS

The development of visual acuity between 6 months and 3 - 7 years (4.5 years median) was evaluated in 87 eyes of 44 premature children born between the 24 th and 36 th week of gestation, with a birthweight ranging from 550 to 2580 g. Thirteen eyes reached threshold: ROP disease and underwent cryocoagulation. Grating acuity was measured with the TACT at 6 months corrected age and every half year up to three to seven years (median 4.5 years). Recognition acuity was measured with the Sheridan-Gardiner Test (SGT) at 4.5 years (median). TACT-results at 6 months corrected age and 3 - 7 years were compared for the group of patients with normal posterior pole and patients with ROP residua. Furthermore, SGT scores and TACT scores were compared at the 4.5 years follow-up. A visual acuity of >/= 0.1 (3 cy/ degrees ) and >/= 0.4 (13 cy/ degrees ) was considered favourable at the age of 6 months corrected age and 3 - 7 years, respectively.

RESULTS

The TACT scores ranged from < 0.03 to 0.2 (< 1.0 to 6.5 cy/ degrees ) at 6 months and from < 0.05 to 2.0 (< 1.6 to 57 cy/ degrees ) at 3 - 7 years. In 77 % of cases the TACT scores at 6 months had predictive value for the further TACT scores and in 78 % for the optotype acuity. There was no difference between eyes with normal posterior pole and eyes with ROP residua concerning the predictive value of non favourable optotype acuity.

CONCLUSIONS

Testing grating acuity at 6 months corrected age allows to roughly predict both grating and recognition acuities at the age of 3 - 7 years. No difference between patients with normal posterior pole and patients with ROP residua was found.

Congenital nemaline myopathy due to ACTA1-gene mutation and carnitine insufficiency: a case report

A premature boy with a congenital form of nemaline myopathy due to mutation in the ACTA1-gene showed decreased carnitine levels in the eighth week of life. After sufficient oral carnitine substitution he improved gradually. In the first 15 months of life he made good progress; he reached full head control, learned to sit unsupported and was able to raise objects. At that time the carnitine levels were normal without substitution. Nemaline myopathy is clinically and genetically heterogenous. The pathogenesis of the muscle weakness is poorly understood. Disturbances of carnitine metabolism in this group of patients as one possibility are conceivable. Further investigations of carnitine metabolism in patients with nemaline myopathy may shed light on the pathogenesis of this entity.

Functional magnetic resonance imaging research in psychiatry

Advanced functional imaging techniques now make it possible to study in vivo the relationship between altered cerebral activation patterns and the psychopathologic and cognitive features of psychiatric disorders. Functional MR imaging (fMRI) offers new approaches to research questions in psychiatry that could not have been addressed earlier by positron emission tomography and single photon emission CT. Basic features of the biology of psychiatric disorders now can be elucidated by means of fMRI. Study designs involving fMRI capitalize on the technique's enhanced spatial and temporal resolution, noninvasive nature, and absence of radiation exposure.