Effect of peritoneal fluid and serum from patients with endometriosis on mouse embryo in vitro development

BACKGROUND

The adverse effects on early embryo development as caused by peritoneal fluid exudate and serum from endometriosis patients have been shown, but the underlying mechanism and clinical significance remain unknown.

METHODS

Peritoneal fluid (PF) and serum (S) from patients with minimal to mild endometriosis (Group A, n = 12), moderate to severe endometriosis (Group B, n = 6), and others including tubal ligation and uterine myoma (Group C, controls n = 6) were obtained during laparoscopy. Two-cell mouse embryos were cultured at 37 degrees C in 5% CO2, 95% air with supplementation of 10%PF + 1%BSA, 10%S and 10%S + 10%PF in HTF medium. The percentage of progression to the blastocyst stage at 72 and 96 hours was observed and compared among the three groups.

RESULTS

Serum and peritoneal fluid from infertile patients with moderate to severe endometriosis appeared to be embryotoxic to the in vitro development of two-cell mouse embryos, but no significant differences were found between minimal to mild endometriosis and group C patients.

CONCLUSIONS

These data suggest that the production of embryotoxic factor(s) is related to the clinical stage, and may be derived from endometriotic implants. The correlation of the embryotoxic effect of the peritoneal fluid with that of the serum indicates that embryotoxic factor(s) may enter the systemic circulation and impede early embryogenesis in the reproductive tract. The nature and mechanism of this result demand further study.

Time course of cholinergic and monoaminergic changes in rat brain after immunolesioning with 192 IgG-saporin

192 IgG-saporin, an immunotoxin targeted at the low affinity NGF receptor, was infused into the lateral ventricle of rat brain. Three days and one week post lesion, choline acetyltransferase activity was markedly decreased in cortex, hippocampus, olfactory bulbs, and septum (brain regions innervated by the cholinergic neurons of the basal forebrain) with no change in cerebellum, striatum or pons. Measurement of monoamine levels revealed increases in HVA, DOPAC and dopamine, primarily in the olfactory bulbs at the 28-day time point only, suggesting a compensation for cholinergic inactivity. High levels of basal forebrain cholinergic lesioning can be obtained with this immunotoxin with minimal or no effects on monoaminergic or other cholinergic systems.

Differential effects of bFGF and IGF-I on matrix metabolism in calf and adult bovine cartilage explants

The effects of basic fibroblast growth factor (bFGF) and insulin-like growth factor-I (IGF-I) on cell and matrix metabolism in calf and adult bovine cartilage explants were examined. In calf cartilage, bFGF elicited dose-dependent and bi-directional effects on mitotic activity and anabolic processes. Addition of bFGF at 3 ng/ml stimulated cell mitotic activity (total DNA) and synthesis of proteoglycan ([35S]sulfate incorporation), protein ([3H]proline incorporation), and collagen (formation of [3H]hydroxyproline), and resulted in a slight increase in proteoglycan deposition compared to basal medium. However, 30-300 ng/ml of bFGF inhibited mitotic activity and synthetic processes, accelerated [35S]proteoglycan release compared to basal medium, and resulted in an inhibition of proteoglycan deposition during the culture period. In contrast, treatment of adult cartilage with 3-300 ng/ml of bFGF did not affect the DNA content but did stimulate synthetic processes in a dose-dependent manner. Basic FGF also had bidirectional effects on matrix catabolism in adult cartilage, with 3 ng/ml accelerating [35S]proteoglycan release, but 30-300 ng/ml of bFGF resulting in release rates comparable to that in basal medium. Nonetheless, even with maximal bFGF stimulation, adult bovine cartilage suffered a net loss of proteoglycan during culture. Addition of 3-300 ng/ml of IGF-I to either calf or adult bovine cartilage stimulated synthetic processes and shifted the metabolic balance toward a net deposition of proteoglycan. Neither bFGF nor IGF-I altered the low basal rate of [3H]hydroxyproline release from either calf or adult bovine cartilage. Thus, (i) the regulatory effects of bFGF and IGF-I on bovine articular cartilage appear age-dependent, and (ii) bFGF is capable of promoting either anabolic or catabolic processes, and may therefore serve a dual role in the regulation of cartilage metabolism.

The menarcheal age of Chinese girls

The menarcheal age of Chinese girls was analysed based on a national survey in 1985. A total of 162,902 girls, aged 7-22 years, of Han nationality and 34,232 girls, aged 7-18, of 27 minority nationalities were sampled. Data were further subdivided into urban and rural areas. It was found that the curves of menstruating percentage in each of the subgroup were in long sigmoid shapes. The menstruating rate (MR) of Han girls was higher than that of the minority girls in almost every age group. The median menarcheal age (MMA) of Han girls was significantly lower than that of the minority girls. In Han nationality the urban girls showed higher MR and lower MMA than the rural girls. The influence of hereditary, cultural and economical factors on menarcheal age in Chinese girls is discussed. The data of this study were also compared with research reports from other world literature.

Intraarticular morphine, bupivacaine, and morphine/bupivacaine for pain control after knee videoarthroscopy

Evidence has accumulated that opioids can produce potent antinociceptive effects by interacting with opioid receptors in peripheral tissues. This study sought to compare the effects of morphine with those of bupivacaine administered intraarticularly upon pain following arthroscopic knee surgery. In a double-blind, randomized manner, 33 patients received either morphine (1 mg in 20 ml NaCl; n = 11), bupivacaine (20 ml, 0.25%; n = 11), or a combination of the two (n = 11) intraarticularly at the completion of surgery. After 1, 2, 3, and 4 h and at the end of the 1st and 2nd postoperative days, pain was assessed by a visual analogue scale, and supplemental analgesic requirements were recorded. Pain scores were significantly greater in the morphine group than in the other two groups at 1 h. There were no significant differences at 2 and 3 h. From 4 h until the end of the study period, pain scores were significantly greater in the bupivacaine group than in the other two groups. Analgesic requirements were significantly greater in the morphine group than in the other groups at 1 h but were significantly greater in the bupivacaine group than in the other groups throughout the remainder of the study period. We conclude that intraarticular morphine produces an analgesic effect of delayed onset but of remarkably long duration. The combination of these two drugs results in satisfactory analgesia throughout the entire observation period.

Developmental perspective of pulse rate, blood pressures and vital capacity in Chinese children

Physiological development in Chinese children was analysed based on a national survey sample. Close to half a million children and adolescents, aged 7-18 years, from Han and 27 minority nationalities were assessed for pulse rate, systolic and diastolic blood pressure, and forced vital capacity in these 12 age groups. The factors of age, sex, race, and region (urban/rural, north/south) were analysed. P95 hypertension screening standard was established for each age group. These results were compared with research reports from world literature.

Immunological study in three families of juvenile ankylosing spondylitis

Three patients, all exhibiting symptoms before 15 years of age, were diagnosed as juvenile ankylosing spondylitis (JAS) by stigma of JAS. The families of these three patients--a total of fifteen first-degree relatives--had clinical, radiologic and laboratory examinations. All three patients and four family members (26%) had positive HLA-B27 and ankylosing spondylitis (AS). Five (33%) of these three family members had positive HLA-B27 but were asymptomatic; six members(40%) were HLA-B27 negative and symptom-free. A high positive rate of HLA-B27 was found among the patients (100%) and the family members (60%). The rheumatoid factor, antinuclear antibody, and anti-native DNA antibody were negative for all patients and family members. Significant elevation of IgG, IgA, and C3 were noted in the AS group. The CD3 cell was lower, and the ratio of CD4/CD8 was decreased in the AS group. Lympho-proliferative responses to phytomitogens (Con A, LPS and PHA) were also done in our study. There was no significant difference in Con A and LPS stimulation index among the AS group, symptom-free family members and normal controls.

Secular change in the growth and development of Han children in China

This paper reports the secular change in physical growth and development of Han children in 12 Chinese metropolitan cities including Beijing, Tianjing, Shanghai, Jinan, Harbin, Shenyang, Changchun, Nanjing, Hangzhou, Wuhan, Guangzhou, and Chengdu. Based on a recent national survey of 14,688 healthy schoolchildren, aged 7-18 years, and together using the historical records of healthy schoolchildren as secondary data source, this study found a secular change in the growth and development of Chinese children and youth. In every decade between the 1950s and 1985 the average height increased by 2.66 cm (range 1.78-3.77) for boys and 2.40 cm (range 1.72-3.76) for girls, and the average weight increased by 1.64 kg (range 1.28-2.63) for boys and 1.14 kg (range 0.63-2.01) for girls in the 12 cities. In the last decade from the 1970s to 1985, the height and weight increments were highest in Beijing, Jinan, Shenyang and Shanghai. In addition, the increments were higher during the peak growth years than during other periods of growth. In the 30 years studied, the ages of maximum growth velocity were advanced, and they were 1 or 2 years earlier in 1985 than in the 1950s in most cities. When compared with the data from the 1930s the results indicate that, during the last half-century, height increased by 1.12-2.66 cm per decade for boys and 1.42-2.67 cm/decade for girls, while weight increased by 0.56-1.27 for boys and 0.65-1.18 kg for girls in Beijing, Shanghai, Nanjing, Hanzhou and Guangzhou.

Physical growth of Chinese school children 7-18 years, in 1985

Physical development in Chinese school children was analysed based on a national survey in 1985. Close to half a million children and adolescents, aged 7-18, from Han ethnic group and 27 minority ethnic groups were assessed for height, weight, sitting-height, chest circumference, biacromial and biiliac diameters. Growth in Han children was greater than that in minority ethnic group children. The growth differences among minority ethnic groups were large. Growth in urban children was greater than that in rural children except in a few age groups of girls. A significant difference in children's growth was found between northern and southern divisions of China, it being greater in the north. The growth curves of physical characteristics demonstrated systematic regularity. Finally, the results of this study were compared with research reports from other world literature.

Cognitive neuropsychophysiology of thought imagery versus imagination imagery

The present study was designed to measure patterns of cortical activation during two types of mental imagery: "thought imagery" and "imagination imagery." Topographic cortical power spectrum (CPS) analyses were conducted for 10 subjects during four experimental conditions. EEG was recorded from right and left hemispheres at frontal, temporal, parietal, and occipital leads. Subjects gave rating of visual vividness and quasisensory subjective experience after each imagery condition. Examination of subjects' ratings revealed that they reported significantly greater visual vividness and quasisensory experiences during the imagination imagery condition, as compared to the thought imagery condition. Topographic CPS analyses showed significant individual differences in patterns of brain activation, which were reliable across conditions. Individual differences in lateralization of brain activity were found in terms of an anterior-posterior gradient. Within-subject analyses showed CPS changes as a function of condition. Three major patterns of CPS changes across condition were delineated.

Individual differences in human topographic EEG power: hemodynamic and psychological predictors

Cortical power spectrum (CPS), a derivative of quantitative EEG, has been studied in human development and varieties of brain functions and dysfunctions. From the EEG literature, consistently a high degree (e.g. 6-15x in alpha amplitude) of individual differences in CPS densities is noted. This study examined the potential biopsychological factors contributing to such a wide range of individual differences in CPS. A set of significant inverse functions between systolic blood pressure and differential topographic CPS densities was observed, indicating that hemodynamic baroreceptor regulatory function may partially account for the individual differences in CPS densities. Furthermore, the trait measure of perceptual factor (reducer-augmenter) was correlated positively with other parameters of CPS densities. These results suggest that hemodynamic and psychological factors are predictive of the individual differences in EEG magnitudes.

Double uterus with an obstructed hemivagina and ipsilateral renal agenesis: report of 5 cases and a review of the literature

Maldevelopment of the Müllerian duct system can result in various uterine, vaginal, and renal abnormalities. Complete or partial absence of Müllerian duct fusion and/or canalization results in a septate, bicornuate or didelphys uterus with various types of hemivaginal obstruction. In addition, unilateral renal agenesis is a common association. Five patients with uterine anomalies and an obstructed hemivagina are described according to the complete or incomplete obstruction between the double vagina and uterus. Early and accurate diagnosis is important, but difficult, due to the variable clinical pictures. Sonographic evaluation can provide valuable diagnostic information. Early diagnosis and excision of the obstructed vaginal septum can completely relieve the symptoms and prevent further sequelae.

A reassessment of methylcholanthrene transformation in the C3H10T1/2 cell culture system

We previously demonstrated that four tumorigenic methylcholanthrene (MCA) transformed cell lines derived from C3H10T1/2 cells each contain a common G34----T nucleotide alteration in the c-Ki-ras gene. In contrast, a non-tumorigenic MCA transformant does not contain this mutation. We have now examined 75 newly isolated MCA transformants of C3H10T1/2 cells for their degree of morphological transformation, the presence of the c-Ki-ras G34----T mutation, colony formation in soft agar, and tumorigenicity in nude mice. Although many of these new MCA transformants exhibit morphological characteristics indistinguishable from previously isolated tumorigenic MCA transformants, none contain the G34----T mutation in the c-Ki-ras gene. Only one newly isolated MCA transformant can grow in soft agar. Of 14 tested, none of the new MCA C3H10T1/2 transformants are tumorigenic in nude mice.

Hypnotizability does not predict outcome of behavioral treatment in pediatric headache

Several adult studies suggest that recurrent headache patients who are highly hypnotizable benefit most from behavioral treatment. We examined the relationship between intrinsic patient factors and clinical outcome in 100 children and adolescents with recurrent headache who were enrolled in our behavioral treatment program. We found no correlation between age, sex, headache type, hypnotizability, and clinical outcome.

Tumorigenic methylcholanthrene transformants of C3H/10T1/2 cells have a common nucleotide alteration in the c-Ki-ras gene

The polymerase chain reaction was used to amplify DNA surrounding the codon 12 region of the c-Ki-ras gene from C3H/10T1/2 cells and from a number of 3-methylcholanthrene (MCA)-transformed derivatives of these cells. Sequence analysis demonstrated that tumorigenic MCAC116/39 cells, known by DNA-mediated transfection to contain an activated c-Ki-ras oncogene, had a G----T transversion in the first position of codon 12 of this gene, resulting in a Gly12----Cys mutation. A combination of polymerase chain-reaction amplification and oligonucleotide hybridization demonstrated that three additional tumorigenic MCA transformants of C3H/10T1/2 cells had an identical mutation in the c-Ki-ras gene. In contrast, this mutation was not present in an MCA-induced C3H/10T 1/2 transformant that was not tumorigenic. The molecular specificity of this MCA-induced mutation resulting in C3H/10T1/2 tumorigenic transformants should provide an excellent system in which to study the roles of transcription, replication, repair, and exogenous factors in the establishment and expression of transformation and tumorigenicity.

Analysis of headache in a Chinese patient population

One hundred and fifty patients with headache were studied by initial interview, before beginning treatment in the pain clinic. The McGill Pain Questionnaire (MPQ) for Headache and a Bakal Topographic Chart were translated into Chinese and employed to assess the characteristics of the headache. The series included significantly more women than men. The elderly were in low proportion, but teenagers were a significant proportion. Women tended to report a longer headache history than men. Topographically, 50% of patients had bilateral temporal headache, and 18% had unilateral headache, more on the right than on the left. Most of the patients were considered to belong to tension headache and mixed headache types (40% and 26%, respectively). Major aggravators resulting in headache hypersensitivity were overwork, fatigue, insomnia, poor sleep, stress, and tension. Analgesics were the primary means of relief reported in 46% of the patients, while resting and sleeping (44% and 27% respectively) were also found to be significant relief factors. In the McGill Pain Questionnaire, specific subclasses of miscellaneous dimension and sensory description. Chinese patients used different classes and far fewer MPQ words than patients reported in the western literature.

Radical hysterectomy with pelvic lymph node dissection for treatment of cervical cancer: a clinical review of 954 cases

Nine hundred fifty-four patients, who received a radical hysterectomy and a bilateral pelvic lymphadenectomy, were included in this study which ran from January 1971 to December 1986. The subjects, by in large, ranged in age from 41 to 60. Of these cases, 62.5% were in clinical stage IB, while 26.2% were in stage IIA. Urinary tract fistula formations occurred in 2.4% of the cases and substantially decreased from 6.1% during 1971-1978 to 0.9% in the subsequent period from 1979 to 1986. The operative mortality rate was 0.4%. The follow-up included 438 cases that came from 1971 to 1981, and each was evaluated over a period of 5 years. Of these cases, 28 patients were lost during the follow-up period and were presumed to have died from cancer. The absolute 5-year survival rates for the patients in stage IB, stage IIA, and IIB were 86.1, 71.7, and 60.1%, respectively. The respective 5-year survival rates for patients with stage IB LN(-) and LN(+), i.e., without or with lymph node metastasis, were 87.7 and 73.1%. The survival rates for patients with stage IIA LN(-) and LN(+) were 79.8 and 40.9%, respectively. In retrospect, the 5-year survival rates seem to be related to age, parametrial involvement, and histological type. This study shows that because of improving surgical techniques and anesthesia, acceptable operative morbidity and mortality, as well as favorable 5-year survival rates, radical surgery seems to be the treatment of choice for patients with early invasive uterine cervical, and especially for younger women.

A test of the multiple connections model of reading acquisition

Within the framework of Society of Mind Theory (Minsky, 1986), learning to read is conceptualized as a process of creating new communication links or neural connections between an existing visual society and an existing linguistic society. Four visual-linguistic connections may become functional: letter-phonemic code, whole word-semantic code, whole word-name code, letter sequence-aural syllabic code. The hypothesis was tested that more than one of these visual-linguistic connections must be taken into account in predicting reading achievement. Results showed that the combination of the composite letter-phoneme variable and the composite whole word-semantic code variable accounted for significantly more variance in oral reading than did either single variable at the end of the first grade. Groups with large absolute discrepancy (1 or more standard scores) or small absolute discrepancy (1/3 standard score or less) on corresponding visual and linguistic skills differed significantly in both oral (whole word-semantic code composite) and silent reading (whole word-semantic code and letter sequence-aural syllabic code composites). There was a relationship between the number of large discrepancies and reading achievement. Results are discussed in reference to neuropsychological models of connectionism (Rumelhart & McClelland, 1986) and working brain systems (Luria, 1973).

A continuum of transformed phenotypes in C3H/10T1/2 derivatives

Two-stage transformants have been isolated from C3H/10T1/2 cells exposed to UV-irradiation followed by treatment with TPA. These UV-TDTx cells form foci in co-culture with C3H/10T1/2 cells only in the presence of TPA. In the absence of TPA, UV-TDTx cells are indistinguishable from control C3H/10T1/2 cells in co-cultures. Single-step transformants of C3H/10T1/2 cells isolated after exposure to high doses of chemical carcinogens, however, show TPA-independent focus formation in co-culture with C3H/10T1/2 cells. We now show that three independently isolated two-stage UV + TPA transformants as well as a single-step, high dose methylcholanthrene (MCA) transformant (MCATx1e) isolated in our laboratory are anchorage-dependent and non-tumorigenic. In contrast, another single-step, high dose MCA transformant (MCACl#16/39) known to contain an activated c-Ki-ras gene shows TPA-independent focus formation in mixed culture with C3H/10T1/2 cells, anchorage independence and tumorigenicity. Analysis of UV-TDTx:C3H/10T1/2 and MCACl#16/39:C3H/10T1/2 somatic cell hybrids indicates that a similar percentage of hybrids of each cell type are able to form foci in co-culture with C3H/10T1/2 cells. However, focus-forming UV-TDTx:C3H/10T1/2 hybrids remain dependent on TPA for focus formation in mixed culture.

Neural perspectives of cerebral correlates of giftedness

Giftedness is defined as some special endowment or propensity for creativity, skill, and eminent achievement, found in relatively few individuals among the population. A high order of mental power (IQ), creativity, and motivation (task commitment) appear to be the most universally recognized attributes of the gifted. This report summarizes current knowledge of the cerebral correlates of intelligence and creativity, including physiological measures of EEG, cortical power spectrum, brain evoked potentials, and positron emission tomography. Controversy, debates, contentions, formal hypotheses, and research issues are considered. We are especially interested in the formulation of the deterministic function of EEG-brain dynamics. A CHAOS modeling on hierarchy of cognitive organization and cerebral processing in the gifted is suggested.

Nonsudorific skin potential level: current hypothesis and psychophysiological significance

Skin potential level has two mechanisms of generation: that due to sweat gland activity (sudorific) and that due to other causes (nonsudorific). These mechanisms have, in the past, been frequently confounded. This paper addresses the importance of discriminating between the two mechanisms and describes two kinds of nonsudorific skin potentials. There is reason to except nonsudorific skin potential level to be an important factor in embryogenesis, tissue regeneration and atypical growth. Early work that associated these potentials with changes in consciousness (e.g., sleep and hypnosis) is inconclusive. The literature concerning physiological and psychological correlates of skin potential levels that have been attributed to nonsudorific mechanisms is reviewed, and the methodological problem of measuring these potentials is considered.

Effects of chitin synthesis inhibitors on incorporation of nucleosides into DNA and RNA in a cell line from Manduca sexta (L)

Five putative chitin synthesis inhibitors (CSI) were tested to determine if they inhibited nucleoside incorporation into acid precipitable material in a cell line from Manduca sexta (L.). The results varied. Diflubenzuron (DFB) (100 micron) inhibited cytidine incorporation by 38%; EL-494 (100 micron) inhibited adenosine incorporation by 43%; Bay Sir 8514 (100 micron) inhibited uridine incorporation by 24%. Superdiflubenzuron (100 micron) was the worst inhibitor overall (18-22%) for the benzoylphenyl urea CSI. The triazine CSI, CGA 19255, was the best inhibitor tested with 60% inhibition for cytidine and 49% for adenosine incorporation into DNA and RNA. Examination of cells incubated with diflubenzuron by scanning electron microscopy revealed distinct external morphological changes. Transmission electron microscopy showed that crystalline structures accumulated in the cytoplasm of cells treated with DFB. The crystalline structures were assumed to be diflubenzuron and they persisted even after diflubenzuron was removed from the medium.

Behavior of myc and ras oncogenes in transformation of rat embryo fibroblasts

The requirements for transformation of rat embryo fibroblasts (REFs) by transfected ras and myc oncogenes were explored. Under conditions of dense monolayer culture, neither oncogene was able to transform REFs on its own. However, the introduction of a ras oncogene together with a selectable neomycin resistance marker into REFs allowed killing of the normal nontransfected cells and the outgrowth of colonies of ras transformants, 10% of which survived crisis and became tumorigenic. These cells expressed greater than 10-fold-higher levels of ras p21 than tumorigenic cells cotransfected with ras and myc oncogenes. The myc oncogene similarly was unable to induce tumorigenic conversion of REFs unless especially refractile colonies of oncogene-bearing cells, produced by use of a cotransfected selectable marker, were picked and subcultured. Tumorigenic conversion of REFs by single transfected oncogenes appears to require special culture conditions and high levels of gene expression.

Psychological preparation influences nitrous oxide analgesia: replication of laboratory findings in a clinical setting

In an earlier laboratory study, administration of 33% nitrous oxide yielded lower, not higher, pain thresholds when combined with appropriately altered expectations of enhanced creativity and sensitivity. The present study was undertaken in an attempt to replicate this finding in a group of clinical dental patients. It was expected that anxiety would play a significant role in our findings. The present study experimentally confirms that controlled psychological preparation of the clinical subject prior to administration of conventional dental dosages of nitrous oxide can significantly modify the perception of tooth pulp pain, neutralizing and even reversing its analgesic efficacy without increasing anxiety.

Sex differences in brain organization: implications for human communication

This article reviews current knowledge in two major research domains: sex differences in neuropsychophysiology, and in human communication. An attempt was made to integrate knowledge from several areas of brain research with human communication and to clarify how such a cooperative effort may be beneficial to both fields of study. By combining findings from the area of brain research, a communication paradigm was developed which contends that brain-related sex differences may reside largely in the area of communication of emotion.

Tonic pain inhibits phasic pain: evoked cerebral potential correlates in man

In a sample of 10 healthy volunteers phasic pain ratings and evoked cerebral potentials (EPs) elicited by brief electrical skin stimuli were investigated in periods before, during, and after contralateral tonic ischemia pain. In all subjects the phasic pain ratings and the late EP components P80-N150 and N150-P260 were depressed under concurrent tonic pain. The magnitude of the mean reduction (31%, 40%, and 26%) is comparable to morphine analgesia. The early EP components with latencies below 80 ms, which are considered to be correlates of mechanosensitivity, were not influenced. The findings of tonic pain inhibiting phasic pain are discussed on the basis of changes in attention as well as of pain-specific physiological mechanisms like diffuse noxious inhibitory control.

A pain microcomputer system for clinical and laboratory investigation

This report describes the design and use of a mobile "Pain Microcomputer System" (PMS). As a mobile clinical and laboratory research tool the PMS integrates four functions: (1) psychophysical measurement of behavioral pain responses; (2) psychophysiologic recording, including brain evoked potentials, cortical power spectrum analysis, EKG and EMG; (3) data acquisition, analysis and display; (4) peripheral communications via modem allows interaction with larger computers for more complex data analyses, extensive graphics, etc. A word processor disk facilitates writing of scientific and clinical reports. Present and future capabilities of the system for comprehensive pain research and patient care are discussed.

Analgesic action of intravenous diazepam

Intravenous diazepam is commonly used in clinical dentistry to produce sedation for dental procedures. Its chief benefit seems to derive from its sedative and amnesic properties. The literature contains conflicting reports about the direct analgesic effects of the drug. In the present study, we observed significant increases for conventional pain threshold measures in response to electric tooth pulp stimulation and decreased sensitivity to a fixed painful stimulus when diazepam was administered intravenously using clinical criteria for conscious sedative dosages. The data support the possibility that intravenously administered diazepam in conscious sedative doses may have some analgesic action in addition to its better documented sedative and amnesic properties.

Cognitive reversal of expected nitrous oxide analgesia for acute pain

In a laboratory experiment, the expected analgesic action of 33% nitrous oxide was reversed by creating the expectancy of heightened awareness of bodily sensations. Pain threshold and tolerance of electrical tooth-pulp stimulation were significantly reduced. Results from a control study gave us a basis for comparison of changes in the verbal expression of pain when nitrous oxide was administered without introducing expectancies beyond those already held by the subjects. Contrasting results from the experimental and control studies confirm the powerful role of mental processes in mediating pain experience.

Analgesic effects of nitrous oxide with controlled painful stimuli

This study was designed to provide statistical estimates of the effects of N2O on pain and anxiety associated with tooth-pulp shock in a clinical and in a laboratory setting. Amounts of electric stimulation needed to first feel sensation, amounts to feel pain, and pain tolerance were measured. N2O had a significant effect on raising levels of absolute sensation, pain threshold, and pain tolerance in response to increasing electrical stimulation of teeth. These effects were noted when N2O and pulp stimulation were delivered in a clinical dental setting or in a pain-research laboratory. Subjects also decreased their evaluation of the intensity of the same stimulus as N2O was inhaled at various concentrations; their aversion to the same stimulus tended to be influenced by N2O to a greater extent than perceived intensity. Anxiety levels were reduced to a statistically significant degree.

Microcomputer analysis of cortical power spectrum: calibration and correlates of behavioral artifacts

Cortical power spectrum (CPS) is a quantitative estimate of EEG spectral power density. The CPS provides suitably precise data for quantification and statistical inference compared to the qualitative evaluation of EGG when interpreted by clinicians or researchers. In the past decade, the CPS has been applied to the studies of cognitive functions, memory, psi phenomena, speech laterality, and states of consciousness including coma, sleep, anesthesia, pathophysiology and pain state. However, few systematic evaluations of CPS methodology have been reported, rendering cross-laboratory comparisons difficult and external validity of experimental results uncertain. This report first describes a calibration procedure employing a microcomputer system for measuring the functional relationship between input signals and output cortical powers. Second, we examine controlled behavioral artifact effects on the CPS. The behavioral artifacts observed in the CPS can provide a measurement anchor for less ambiguous interpretation of CPS experiments conducted in clinical or laboratory settings.

Cortical power spectral analysis of acute pathophysiological pain

In the past decade, advances in quantitative EEG methods, such as the analysis of cortical power spectrum, have proven a useful tool for observing changes in brain activity as a function of physiological and behavioral states. The cortical power spectrum (CPS) is a computer-derived analysis of brain electrical activity using mathematical principles of Fast Fourier Transform function. The total energy output of specific cortical areas can be estimated over time, as a function of EEG spectral frequencies. This report describes the study of CPS in pathophysiological pain patients, using acute dental pain as a model. Seven "walk-in" acute pain patients in an emergency dental clinic were recorded during 10 min of pain, before treatment. Approximately one week later, 10 min recordings during nonpain states were obtained as control. Subjective pain scales and other psychological measures were administered to all subjects before and after recording on each visit. Each 10 min stage of continuous CPS recording consisted of 10 spectra per stage, 6 epochs/spectrum, and 10.24 sec/epoch; each spectrum was stored, averaged, transformed, displayed, printed, and plotted by the Pain Microcomputer System. Results show significant cortical power reduction along all frequency bands (0.5-50 Hz) when pain-states are compared to nonpain states. The magnitude of reduction also appears to correspond to subjective pain report. Analysis for rank order may be inversely related to subjective painfulness, indicating that pain and alpha-desynchronization are closely associated. This study demonstrates that the brain activity of clinical pain patients can be measured. The feasibility of developing a pathophysiological objective pain measuring system is discussed.

Opiate analgesia and its antagonism in dental event-related potentials: evidence for placebo antagonism

The analgesic effects of the synthetic opiate fentanyl citrate (0.1 mg) on subjective pain reports (SPR) and late-wave event-related potentials (ERP) recorded during painful dental stimulation were examined in human subjects. Such waves have been shown to reflect the contribution of cognitive variables, such as expectancy and belief, to perception. In addition, the study was intended to demonstrate a dose-related narcotic antagonism with injection of naloxone (1.2 or 0.4 mg) or normal saline (double-blind) following IV fentanyl administration. Fentanyl reduced both ERP waveform amplitudes and SPR as have previously studied analgesic agents, such as nitrous oxide, acupuncture, and aspirin. Naloxone injection reversed both ERP and SPR changes, but surprisingly, a reversal of narcotic analgesia equal to that of 0.4 mg naloxone was seen with saline injection. By chance, all subjects were health-science students or professionals who were knowledgeable in opiate pharmacology, and so placebo reversal was hypothesized. Alternatively, it was hypothesized that fentanyl cleared more rapidly than predicted, thus, producing apparent reveal. In a second experiment involving similarly knowledgeable subjects with identical procedures and testing intervals, subjects received 0.1 mg fentanyl, but no reversal injection. The fentanyl effect was constant across this time period. The data, thus, support the hypothesis where the subjects were knowledgeable in opiate pharmacology, was placebo opiate antagonism.

Pain in clinical and laboratory contexts

Subjects served as their own control when tooth pulp shock was delivered in laboratory and clinical situations. Significantly heightened pain was observed in the clinical dental setting. The dental setting proved more anxiety-provoking and associated with reduced tolerance for pain, suggesting that cognitive contexts of a dental setting may elicit heightened subjective pain responses.

Effect of nitrous oxide concentration on event-related potentials during painful tooth stimulation

Effects of inhaling three levels of nitrous oxide in oxygen on event-related brain potentials (ERPs) and pain report were examined in 10 volunteers undergoing painful electrical stimulation of tooth pulp. Previous work by the authors demonstrated that inhalation of nitrous oxide 33 per cent in oxygen, iv injection of 0.1 mg fentanyl, oral administration of 975 mg aspirin, and electrical acupunctural stimulation all reduced ERP amplitudes obtained a vertex during painful tooth pulp stimulation. The authors report here the demonstration of a dose-response relationship between increasing concentrations of nitrous oxide in oxygen and measures of ERP amplitude and pain report. Subjects inhaled room air, nitrous oxide 25 per cent, 37 per cent, and 50 per cent in oxygen while ERPs were recorded and pain reports were given. The procedure was repeated on three separate days with each subject experiencing all levels of treatment on each day. Analyses of variance revealed that both ERP amplitude and pain report significantly decreased as dosage increased, and a significant linear trend was observed for the positive-going ERP wave-form deflection between 160 and 240 ms. Pain report scores decreased significantly (P less than 0.001) and proportionally as dosage increased, but there was not a significant linear trend. Inhalation of nitrous oxide in oxygen increased peak latency for the negative component at 50 ms and the positive component at 90 ms but not for later components. These outcomes demonstrate that amplitude measures of the vertex ERP obtained with dental dolorimetry correlate consistently with pain and analgesia. Simultaneous assessment of brain electrical activity and subjective report appears to be a useful approach for the assessment of analgesia in humans.

Cortical power spectrum analysis of hypnotic pain control in surgery

Cortical power spectrum (CPS) of brain potentials was recorded from the scalp between prefrontal and parietal regions in both right hemisphere (RH) and left hemisphere (LH). A pattern of laterality shift in CPS occurred at different stages during an extensive oral surgery, performed under hypnosis, in a young female patient. Video and audio recordings as well as psychophysiological recordings were obtained through the following 6 stages: Baseline, Hypnosis, Surgery (1 hr, no cortical recording), Immediate Postsurgery Procedure, Hypnotic Re-experience, Hypnotic Rest, and Posthypnotic Baseline. Indications of anxiety and pain scores were reported in writing by the patient through verbal command by the hypnotist. In each stage, 10 min of CPS (10 spectrum/stage, 8 epochs/spectrum, 6 seconds/epoch) were analyzed by a PDP-11 computer. The results of CPS analysis demonstrated significant large total power reduction at different stages. There was significant correlation between both hemispheres at baseline, but dissociation of hemispheric power output occurred during hypnosis stages. LH was more dominant than RH during baseline and presurgery hypnosis, but both were leveled-off immediately following the surgery procedure. However, RH became more dominant during all postsurgery hypnosis stages. Interestingly, this pattern shifted back to the original relationship during the posthypnotic baseline stage. Specific changes of spectral power in theta and alpha of EEG activities in both hemispheres also occurred in conjunction with hypnosis.

Aspirin analgesia evaluated by event-related potentials in man: possible central action in brain

The mechanism of aspirin analgesia is still unclear, but it is generally assumed that aspirin exerts its analgesic effect mainly on peripheral nociceptors. In this study, we demonstrate possible brain effects of 975 mg aspirin in man. When brain electrical potentials evoked by painful electrical tooth shocks were examined, aspirin was observed to significantly reduce the amplitude of the late waveform components, but it did not affect the earlier components. Since our earlier findings suggest that early waveform components reflect the energy transmission and the late components manifest the brain activities in an individual's perception of painful information, we postulate that aspirin may act centrally in pain processing.

Effects of intrasegmental electrical acupuncture on dental pain: evaluation by threshold estimation and sensory decision theory

The effect of 80 min of low frequency (2 Hz) electric acupunctural stimulation at facial sites on the perception of induced dental pain was evaluated using both pain threshold and sensory decision theory (SDT) procedures. The demonstration of a 187% increase in threshold over a 20 min period of acupunctural stimulation replicated earlier work by Swedish investigators. SDT analyses indicated that the threshold increase reflected a relatively pure sensory change with no significant modification of response bias. However, subjects were able to perceive some of the stimuli presented below threshold level following acupuncture, thus indicating that the threshold concept has been an inadequate description of the phenomenon. This study demonstrated that intrasegmental analgesic stimulation is more efficacious than the extrasegmental meridian point stimulation used in our earlier studies. Possible mechanisms for the observed effect were discussed.

Hormonal regulation of trehalose metabolism in the blowfly Phormia Regina Meig.: effects of cardiacectomy and allatectomy at the subcellular level

1. Kinetic properties of adult Phormia fat body glycogen synthetase were studied and compared to other animals. The KM for UDPG is 2.82 mM, decreasing to 0.58 mM in the presence of G-6-P. 2. The specific activity of fat body glycogen synthetase shows a reduction of 30% within 2 days after allatectomy. 3. Fat body T-6-P synthetase activity decreases to 70% of the control value after cardiacectomy. 4. Corpus cardiacum homogenate fails to induce higher T-6-P synthetase activity in cell-free preparations from cardiacectomized flies. 5. Interactions between corpus cardiacum and corpus allatum in regulating carbohydrate metabolism are discussed.