Enhancement of antipsychotic-like properties of the dopamine D2 receptor antagonist, raclopride, by the additional treatment with the 5-HT2 receptor blocking agent, ritanserin, in the rat

The effects of 5-HT2 receptor blockade on the ability of a dopamine (DA) D2 receptor antagonist to produce suppression of conditioned avoidance response (CAR) and to produce catalepsy in rats were examined. It was found that ritanserin (2 mg kg-1 s.c.) enhanced the raclopride (0.1 mg kg-1 s.c.)-induced suppression of CAR without affecting raclopride-induced catalepsy at either maximal (4 mg kg-1 s.c.) or submaximal (0.2 mg kg-1 s.c.) doses. Considering the CAR performance as an index of mesocorticolimbic dopaminergic functions, it is concluded that 5-HT2 receptor blockade confers a limbic profile on the DA D2 receptor antagonist.

Laboratory values, symptoms and survival in an 80-year-old population

Medical, psychological and sociological factors were related to laboratory values in an 80-year-old population encompassing 211 persons. 21% of the men and 17% of the women had elevated ESR. 36% had elevated blood glucose (7% had diabetes). 13% of the men and 7% of the women had anaemia. Persons with anaemia generally had a lower quality of life compared with non-anaemic persons. Low haemoglobin, elevated ESR and low serum iron were all associated with impaired subjective and objective health. There were no significant correlations between the laboratory data and psychological and social parameters. The survival over 5 years was significantly decreased for those with anaemia, elevated ESR, high white blood count, high blood glucose, low serum iron or deviating serum potassium.

Pancreastatin immunoreactivity in favourable childhood neuroblastoma and ganglioneuroma

Neuroblastoma and its benign counterpart, ganglioneuroma, are tumours of the sympathetic nervous system, and known to produce and release various regulatory peptides. In this study, pancreastatin, a 52 amino acid regulatory peptide derived from chromogranin A, was analysed in plasma and tumour tissue from 15 children with neuroblastoma and one with ganglioneuroma. Detectable pancreastatin immunoreactivity (> 1.9 pmol/l) was found in plasma in 13 of 15 children with highest concentrations in samples from children with favourable outcome (P < 0.05). In tumour tissue, non-metastatic tumours showed higher concentrations of pancreastatin immunoreactivity (P < 0.05). However, the highest concentrations were detected in tumours from children with favourable prognosis, regardless of clinical stage at presentation (P < 0.01). Serial plasma samples from one child with neuroblastoma and one with ganglioneuroma were investigated and showed significant systemic release of pancreastatin immunoreactivity during surgical manipulation of tumours with high pancreastatin concentrations. It is concluded that pancreastatin immunoreactivity may be detected in plasma samples and tumour extracts from children with neuroblastoma and ganglioneuroma. Systemic release during surgery implied tumour origin of elevated plasma pancreastatin. Furthermore, higher pancreastatin concentrations correlate with tumour differentiation, localised clinical stage and a favourable outcome for children with these tumours. It is suggested that pancreastatin in plasma and tumour tissue may be utilised as a marker indicating favourable tumour behaviour.

Medical, psychological, and sociological aspects of drug treatment in 80-year-olds

The use of drugs was related to medical, psychological, and sociological parameters in an 80-year-old population. Use of drugs on the whole, as well as the use of specific drug categories such as digitalis, diuretics, other cardiovascular drugs, hypnotics, sedatives, analgesics and laxatives were related to an impaired quality of life. However, the use of vitamins and herbal pills was not related to an impaired quality of life. Use of hypnotics was related to neuroticism and to depressed mood. Persons using digitalis, diuretics and other cardiovascular drugs felt more lonely and had a stronger feeling of loneliness. According to a discriminant analysis, five questions could identify 70% of the persons using drugs. These questions were: frequency of visits to the doctor, subjective health, smoking (smokers used fewer drugs), feeling of loneliness, and objective health.

Contrasting cardiovascular responses from intrathecal administration of epinephrine and norepinephrine in conscious rats: role of alpha 1- and alpha 2-adrenoceptors

In conscious rats, intrathecal (i.t.) administration of norepinephrine (NE) produced pressor responses, whereas i.t. epinephrine (Epi) caused depressor responses at low doses (0.1-1 microgram) and pressor responses at a higher dose (10 micrograms). Epi administered i.t. produced bradycardia; however, NE caused tachycardia at low doses and bradycardia at high doses. The cardiovascular responses were dissimilar to those observed after intravenous (i.v.) administration of these doses of NE and Epi. When [3H]NE or [3H]Epi (1.0 microgram, 10 mCi) was injected i.t., minimal radioactivity was detected in peripheral blood (PB) samples, indicating that the effects of i.t.-injected catecholamines on blood pressure (BP) and heart rate (HR) are due to stimulation of central spinal adrenoceptors and not to peripheral effects after leakage. Pretreatment with i.t. administration of the alpha 1-antagonist prazosin (1.0 microgram) attenuated pressor responses and tachycardia produced by i.t. NE (1.0 microgram), whereas i.t. pretreatment with the alpha 2-antagonist yohimbine (10 micrograms) counteracted depressor responses and bradycardia produced by i.t. Epi. Therefore, these spinally released catecholamines appear to produce opposite cardiovascular effects whereby sympathetic preganglionic neurons are excited by NE through spinal alpha 1-adrenoceptors and are inhibited by Epi through spinal alpha 2-adrenoceptors.

Physicians and alternative medicine--an investigation of attitudes and practice

In the present paper, the attitudes of three different groups of physicians toward treatment with alternative medicine have been investigated. One of the groups studied consisted of randomly selected licensed physicians from the Swedish National Board of Health and Welfare. The other two groups comprised two different associations of physicians involved with alternative medicine. One third of the former groups were positively disposed toward one or more of the alternative medical technologies, while the latter groups were more positive toward alternative medicine in general. Attitudes, along with motives for such interest, varied depending on the orientations of the different interest groups. The most common motives for expressing interest in alternative medicine included a feeling of clinical powerlessness in the face of certain problems for which patients consult a physician, and a dissatisfaction with the scientific approach of academic medicine. A minority stated that their interest in alternative medicine pre-dated their medical education. Physicians' interest in alternative medicine can be understood both as a critical reaction to academic medicine and as evidence that some alternative medical technologies are effective. Hence there is a need to determine whether there are shortcomings to be found in academic medical education and scientific ideals, and also to assess alternative medical technologies at regular intervals.

Ethics and preventive medicine

Today different issues of medical ethics are in focus of the debate. A theoretical sequence starting at a "prepathogenic" level, ending in terminal care, is delineated to clarify the different characteristics of medical interventions. In this article we will discuss some ethical problems concerning interventions in the first parts of this sequence. Preventive measures at the population level are contrasted to the situation when the patient feels ill and calls for an intervention. Certain elements of paternalism are often interwoven in preventive medicine and health promotion.-The field of preventive medicine calls for a vivid theoretical and ethical discussion, which can mean better opportunities for effective prevention.

Studies on an idiopathic syndrome in the brown hare (Lepus europaeus P.) and mountain hare (Lepus timidus L.) in Sweden, with special reference to hepatic lesions

At routine post mortem examinations performed at the National Veterinary Institute (NVI), Uppsala, Sweden, during November 1983-May 1984, a syndrome principally characterized by an acute hepatosis was found in 85 out of 177 brown hares (Lepus europaeus P.). The hepatic lesions consisted of periportal or extensive necrosis and haemorrhages. Concomitant changes in other organs were tubular necrosis in the kidneys, acute catarrhal enteritis, severe congestion, oedema and haemorrhages of the lungs, hyperemia of the spleen, and in some cases jaundice. A supplementary retrospective study of liver sections from another 388 brown hares and 202 mountain hares (Lepus timidus L.), autopsied at NVI during 1980-1985, revealed 35 additional cases of the acute hepatosis, 32 being in brown hares and 3 in mountain hares. The histopathology of the liver lesions may suggest a toxic etiology.

Locus coeruleus neurons show reduced alpha 2-receptor responsiveness and decreased basal activity in spontaneously hypertensive rats

Previous studies have indicated that brain noradrenaline (NA) neurons in spontaneously (genetically) hypertensive rats (SHR) are implicated in the development of hypertension. Thus, a number of biochemical aberrations in the metabolism of NA in the SHR brain have been detected although the data are not in total agreement. We report here experiments utilizing single cell recording techniques which show directly a reduction in neuronal activity of brain NA neurons in the locus coeruleus (LC) of SHR. This reduction develops gradually with age and in parellel with the increased blood pressure (BP), but is not altered by acute alterations in BP. The SHR were found to display an increased intraneuronal monoamine oxidase (MAO) activity as well as a specifically reduced sensitivity of inhibitory alpha 2-receptors within the LC. It is suggested that in SHR the LC system, in spite of a reduced basal activity displays increased responsiveness to sensory stimuli, a phenomenon that may contribute to the development of hypertension.

Dorsal noradrenergic bundle lesions fail to alter opiate withdrawal or suppression of opiate withdrawal by clonidine

Previous work has shown that clonidine effectively suppresses many of the signs of opiate withdrawal. The present study was designed to test the hypothesis that the suppression of opiate withdrawal by clonidine is mediated by forebrain noradrenergic projections of the locus coeruleus. Two groups of 24 rats each were subjected to either a 6-hydroxydopamine lesion of the dorsal noradrenergic bundle (Lesion group) or a sham, vehicle injection (Sham group). All rats were made dependent on morphine by subcutaneous implantation of one 75 mg silastic morphine pellet for three days followed by 3 more days with two additional 75 mg pellets. Following removal of the morphine pellet, withdrawal was precipitated in all rats by subcutaneous injection of 4 mg/kg of naloxone. Pretreatment 10 min. before withdrawal with clonidine (0.1 or 0.2 mg/kg) produced a significant attenuation of withdrawal signs as compared to saline injected rats; this effect was equally significant in both sham and lesion groups. Lesions of the locus coeruleus had no effect on withdrawal, nor did they affect the ameliorating action of clonidine. These results substantiate the observation that clonidine can effectively attenuate signs of opiate withdrawal in the rat, but fail to support the hypothesis that these effects are mediated by the forebrain projections of the locus coeruleus.

Emerging aspects of the adrenergic nervous systems

The present paper reviews some recent experiments with relevance to the functional significance of brain noradrenergic systems with bearing on three clinically relevant topics: 1. The withdrawal and abstinence reactions after the antihypertensive agent clonidine as well as after opiates. 2. The mental reactions associated with alterations in blood volume and acid-base balance. 3. The central actions and side-effects of beta-adrenoceptor blocking agents. The available evidence indicates that central NA neurons may serve a function within the CNS analogous to that of the peripheral sympathetic nerves, i.e. to alert and alarm the individual to significant events in the external and internal environment. Thus, the largest brain NA system, which emanates from locus coeruleus and innervates vast regions of the neuroaxis, is largely activated in the same situations and by the same mechanisms (e.g. blood-volume and chemoreceptors) as the sympathetic system, and may provide part of the central machinery for the anxiety reaction associated with hypercapnia as well as the withdrawal reactions after clonidine or morphine. Some, but not all centrally active beta-adrenoreceptor blocking agents were found to affect the activity of brain NA systems. This result suggests that there may be significant differences with respect to the clinical, central side effects of these drugs.

An orientation scale for geriatric patients

An assessment scale consisting of 10 questions was constructed from an initial 20 questions. The scale encompassed orientation to time, place and person and was intended for geriatric patients and patients suffering from psychogeriatric disorders who had been institutionalized for at least 14 days. The reliability according to the Kuder-Richardson formula number KR20 was 0.83 and the test-retest reliability was 0.84. The scale differentiated between patients with senile dementia and/or cerebral arteriosclerosis and patients without such disorders.

Future nursing homes in Sweden -- users' opinion

The purpose of this study was to gather knowledge in order to provide a basis for the future planning of local nursing homes in Sweden. A total of 306 patients, residents and staff of six nursing homes and four old age homes were interviewed. The interview was combined with questions regarding a model for the design of a nursing home. The subjects were found to have opinions on the designs on the design which, in some cases, differed significantly from what is generally assumed to be true today in Sweden.

Some methods of assaying inhibitors of cell proliferation

Inhibition of cell proliferation by leucocyte extracts containing the granulocytic chalone has been monitored in various ways. Target cells were rat bone marrow cells and chloroleukaemia cells cultured on cover glasses, as well as mouse marrow cells cultured in vivo and in vitro in diffusion chambers. Provided that the technique is optimized, the in vitro rat cell assays yielded reliable results with different types of radioactive DNA precursors. With the diffusion chamber techniques cells synthesizing DNA were killed specifically by hydroxyurea, rather than labelling them with e.g. 3H-thymidine. Inhibition of proliferation then showed up as a decreased cell killing, as compared with the controls. Inhibition of proliferation of both progenitor and transit cells could be demonstrated in this way, without interference by added thymidine.