Analysis of polymorphisms in the alpha-subunit of the olfactory G-protein Golf in lithium-treated bipolar patients

OBJECTIVE

This study examines the alpha-subunit of the olfactory G-protein (G(olf)) as a possible candidate gene for bipolar disorder. The alpha-subunit of the G(olf) gene maps to a region on chromosome 18p that has been implicated in several linkage studies as a potential site of a bipolar disorder susceptibility loci.

METHODS

We investigated whether two polymorphisms in the alpha-subunit of the G(olf) gene (A-->G in intron 3 and T-->G in intron 10) are associated with bipolar disorder in a sample of 149 bipolar patients under lithium treatment compared with 139 healthy controls using haplotype analysis.

RESULTS

There was no evidence for an association between the investigated polymorphisms in the G(olf) gene and bipolar disorders, as well as to response to lithium treatment or common side effects, like hand tremor, weight gain and cognitive dysfunction.

CONCLUSION

The results of the present study do not support the hypothesis that the G(olf) gene is a major susceptibility factor for bipolar disorders.

A statistical comparison of denture sanitation using a commercially available denture cleaner with and without microwaving

Polymethyl-methacrylate dentures, worn by patients for periods ranging from 12 days to 48 years, were cultured and found to be heavily contaminated with a variety of microorganisms both externally and internally. A commercially available denture sanitizer, used as prescribed by the manufacturer, was ineffective at decontaminating the dentures. This study examined the effectiveness of this denture sanitizer when used in combination with a microwaving procedure. Statistical methods were used to compare the decontamination results of the denture sanitizer applied with and without microwaving. The statistical results indicated that the dentures were decontaminated most effectively when the denture sanitizer was used in conjunction with a two-minute microwave procedure.

Therapeutic effect of sulphated hyaluronic acid, a potential selectin-blocking agent, on experimental progressive mesangial proliferative glomerulonephritis

The initial event in the process of leukocyte infiltration is characterized by leukocyte rolling on the surface of the endothelium, which is mediated by selectins. P- and L-selectin bind to the sulphated sugar chains of their natural ligands, including sulphated glycolipids such as sulphatide. Recently, it has been demonstrated that sulphated glycolipids and sulphated oligosaccharides interfere with selectin binding pathways. This study synthesized sulphated hyaluronic acid (SHA), which is a potential selectin-blocking agent, and examined its therapeutic effect on the experimental progressive mesangial proliferative glomerulonephritis induced by anti-Thy-1 monoclonal antibody (1-22-3 MAb) after unilateral nephrectomy. The selectin-inhibitory effect of SHA in vitro was confirmed. SHA inhibited the binding of P- and L-selectin to sulphatide, which is a glycolipid ligand for P- and L-selectin, at a concentration of 1.5 micro g/ml and 100 micro g/ml. Immunohistochemical examination showed that P-selectin was up-regulated in the glomeruli in the 1-22-3 MAb nephritis model, while the ligands for L-selectin were not detected in the glomerular tufts. A single administration of SHA ameliorated proteinuria and glomerular leukocyte infiltration in 24 h after the injection of anti-Thy-1 MAb. Anti-P-selectin MAb, but not anti-L-selectin MAb, inhibited proteinuria and glomerular leukocyte infiltration. To examine further the therapeutic effect of SHA on chronic glomerulonephritis, SHA was administered daily from day 3 to day 14 in this model. Proteinuria and glomerular leukocyte infiltration were significantly diminished in SHA-treated rats on day 14. These results suggest that SHA ameliorated rat progressive mesangial proliferative glomerulonephritis by inhibiting P-selectin-dependent leukocyte infiltration in glomeruli. Sulphated oligosaccharides may be beneficial for the therapy of mesangial proliferative glomerulonephritis.

[Galstena therapy of some hepatobiliary diseases]

Galstena was given to 10 patients with chronic cholecystitis, 15 patients with chronic hepatitis and 15 patients with fatty degeneration of the liver for 30 days in a dose 10 drops 3 times a day 30 min before meal. The effect of the drug was assessed in relation to biliary inflammation and motility, inflammation and metabolism in a hepatic cell. It was found that galstena improves motor function of the biliary tract and exocrine function of the liver, reduces activity of mesenchymo-inflammatory syndrome and fatty degeneration of the liver.

Iron therapy in iron deficiency anemia in pregnancy: intravenous route versus oral route

OBJECTIVE

The aim of this study was to compare intravenous iron sucrose versus oral iron sulfate in anemia at 6 months of pregnancy.

STUDY DESIGN

A random, prospective, open study with individual benefit was performed involving 50 patients with hemoglobin levels between 8 and 10 g/dL and a ferritin value of <50 microg/L. In the intravenous group (IV group), the iron dose was calculated from the following formula: Weight before pregnancy (kg) x (120 g/L - Actual hemoglobin [g/L]) x 0.24 + 500 mg. The oral group (PO group) received 240 mg of iron sulfate per day for 4 weeks. Treatment efficacy was assessed by measurement of hemoglobin and reticulocytes on days 8, 15, 21, and 30 and at delivery and of ferritin on day 30 and at delivery. The baby's birth weight and iron stores were noted. Results were expressed as median +/- interquartile range. Mann-Whitney and Wilcoxon tests were used for the analysis, with P <.05 considered significant.

RESULTS

An increase in hemoglobin was observed, rising from 9.6 +/- 0.79 g/dL to 11.11 +/- 1.3 g/dL on day 30 in the IV group and from 9.7 +/- 0.5 g/dL to 11 +/- 1.25 g/dL on day 30 in the PO group (not significant). On day 30 (P <.0001) and at delivery (P =.01) ferritin was higher in the IV group. A mean higher birth weight of 250 g was noted in the IV group (not significant).

CONCLUSION

Iron sucrose appears to be a treatment without serious side effects indicated in correction of pregnancy anemia or iron stores depletion.

Results of dental amalgam removal and mercury detoxification using DMPS and neural therapy

Sixty consecutive patients who had undergone replacement of dental amalgam fillings and a protocol of nutritional support and heavy metal detoxification using dimercapto-propanyl-sulfate and neural therapy were surveyed. A questionnaire was mailed to the patients and 42 responded, resulting in a response rate of 70%. The reasons for undergoing treatment were many, ranging from a patient's desire to avoid potential health problems in the future to treatment of serious current disease. Although medical diagnoses were made when possible before treatment, this survey studied only the patients' estimations of their most distressing symptoms and their evaluations of response to treatment. The most common complaints were problems with memory and/or concentration; muscle and/or joint pain; anxiety and insomnia; stomach, bowel, and bladder complaints; depression; food or chemical sensitivities; numbness or tingling; and eye symptoms, in descending order of frequency. The most distressing symptoms were headache and backache, fatigue, and memory and concentration problems. Headache and backache responded best to treatment, but all symptoms showed considerable improvement on average. Of the respondents, 78% reported that they were either satisfied or very satisfied with the results of treatment, and 9.5% reported that they were disappointed.

Interventions for preventing blood loss during the treatment of cervical intraepithelial neoplasia

OBJECTIVES

Good surgical technique and other interventions can reduce immediate and long-term blood loss which is a common complication of surgery for cervical intra-epithelial neoplasia. The objective of this review was to assess the effect of interventions to reduce blood loss due to surgery for cervical intra-epithelial neoplasia.

SEARCH STRATEGY

We searched the Cochrane Gynaecological Cancer Group trials register.

SELECTION CRITERIA

Randomised and quasi-randomised trials of vasopressin, tranexamic acid, haemostatic sutures or Monsel's solution in women who have had surgery for intra-epithelial neoplasia.

DATA COLLECTION AND ANALYSIS

Two reviewers independently abstracted data.

MAIN RESULTS

Seven trials were included. Vasopressin had a beneficial effect on peri-operative bleeding. Prophylactic tranexamic acid reduced haemorrhage after knife and laser cone biopsy. Packing with Monsel's solution resulted in less peri-operative blood loss and secondary haemorrhages than routine suturing. Elective suturing also appeared to increase the risk of amenorrhoea and dysmenorrhoea. Vaginal packing increased satisfactory colposcopy rates at follow-up and reduced post-surgical stenosis.

REVIEWER'S CONCLUSIONS

Bleeding associated with surgery of the cervix appears to be reduced by vasopressin, which is used under local rather than general anaesthetic. Tranexamic acid appears to be beneficial after knife and laser cone biopsy. There are not enough data to assess the effects on primary haemorrhage. There is some evidence that haemostatic suturing has an adverse effect on blood loss, cervical stenosis and satisfactory colposcopy.

[Spermatogenesis in rats given potable sulfated mineral water in the early postradiation period]

Rat experiments have shown that course intake (21 days) of sulphate sodium-magnesium-calcium water with sulphate concentration 2.6 mg/l and mineralization 3.1 g/l in early postradiation period (1-2 Gy) inhibits development of dystrophic and destructive processes in spermatogenic epithelium of the testes and maintains spermatogenesis at higher level than control.

Sulfated carbohydrate compounds prevent microbial adherence by sexually transmitted disease pathogens

Heparan sulfate (HS) serves as a receptor for adherence of herpes simplex viruses, Chlamydia trachomatis, Neisseria gonorrhoeae, and, indirectly, human immunodeficiency virus. Using primary human culture systems, we identified sulfated carbohydrate compounds that resemble HS and competitively inhibit infection by these pathogens. These compounds are candidates for intravaginal formulations for the prevention of sexually transmitted diseases.

Effects of sodium sulfate on acute N-(3,5-dichlorophenyl)succinimide (NDPS) nephrotoxicity in the Fischer 344 rat

The agricultural fungicide N-(3,5-dichlorophenyl)succinimide (NDPS) induces acute polyuric renal failure in rats. Results of previous studies have suggested that NDPS may induce nephrotoxicity via conjugates of NDPS metabolites. Thus, the purpose of this study was to examine if administered sodium sulfate could alter NDPS nephrotoxicity. Male Fischer 344 rats (four rats per group) were administered a single intraperitoneal (i.p.) injection of sodium sulfate (0.035, 0.07, 0.35 or 3.5 mmol/kg) or sodium chloride (7.0 mmol/kg) 20 min before NDPS (0.2, 0.4 or 0.8 mmol/kg) or NDPS vehicle (sesame oil, 2.5 ml/kg) and renal function monitored at 24 and 48 h. High dose sodium sulfate (3.5 mmol/kg) markedly attenuated NDPS nephrotoxicity, while sodium chloride had no effect on NDPS-induced renal effects. NDPS nephrotoxicity was also attenuated by a pretreatment dose of 0.35 mmol/kg sodium sulfate, while 0.07 mmol/kg sodium sulfate pretreatment potentiated NDPS 0.2 mmol/kg to produce nephrotoxicity without markedly attenuating NDPS 0.4 mmol/kg to induce renal effects. A dose of 0.035 mmol/kg sodium sulfate did not potentiate NDPS 0.2 mmol/kg to induce nephrotoxicity. These results suggest that sulfate conjugates of NDPS metabolites might contribute to NDPS nephrotoxicity.

Treatment of bovine mastitis with houttuynin sodium bisulphate

Houttuynin sodium bisulphate (HSB), alpha hydroxyl-capryl-ethyl-sodium-sulphonate, is a product formed by reacting sodium bisulphate with houttuynin, which is obtained from a medicinal herb Houttuynia cordata Thunb. From HBS an aqueous intramammary solution was made for the treatment of bovine clinical mastitis. A total of 104 acute and subacute mastitis cases were randomly assigned into two groups with 52 cases in each group: 1. an HSB group in which 80 mg HSB was infused into an affected gland; and 2. a PS group in which intramammary administration of 800,000 i.u. penicillin G in combination with 1 g of streptomycin (PS) was conducted. The treatments were administered twice daily until the inflammatory signs were eliminated and mammary secretion became normal. In acute mastitis, 88.2% (15 of 17) were clinically cured and 52.9% (nine of 17) microbiologically cured by HSB; in the PS group, 90.0% (18 of 20) were clinically cured and 55.0% (11 of 20) microbiologically cured. In subacute cases, the clinical and microbiological cure rates were 94.3% (33 of 35) and 45.7% (16 of 35) respectively, in the HSB group; and in the PS group the clinical and microbiological cure rates were 93.7% (30 of 32) and 43.8% (14 of 32), respectively. No statistically significant difference was found between HSB and PS groups in the treatment of acute as well as subacute mastitis. In addition, an inhibitory effect was found on the growth of lactic streptococcus in the milk collected within 48 h of intramammary treatment with penicillin G in combination with streptomycin. However, for HSB, a mild inhibitory effect on lactic streptococci was detected in the milk within 12 h of treatment.

[Choleretic and cholagogic effect of sulphuric sulfate water from the springs of Tobiano in cholestasis in alcohol related liver diseases]

Twenty male alcoholics (age: 40-60 years) abstinent for 2 weeks and affected by liver steatosis with positive laboratory indexes of biliary stasis (increased levels of total and free bilirubin, gamma glutamil transpeptidase and hepatic alkaline phosphatase) were treated for 3 weeks with 500 ml/day p.o. of placebo (aqua fontis) (Group I:N. 10) or sulfureous sulfate calcic water of the "Pergoli" spring-Tabiano (Parma, Italy) (Group II: N. 10). The abovementioned laboratory indexes of biliary stasis were measured in groups I and II before and after water treatments and were compared to values obtained in 10 age-matched normal male subjects. In addition, both before and after water treatments, alcoholic patients underwent a double blind test, where individual sensations of itch were scored. Finally, in order to establish the effect of water treatments on gallbladder contraction, the bidimensional areas at maximal longitudinal and transverse diameters were echographically evaluated in alcoholics before (time 0) and 20, 40 and 60 minutes after drinking in 10 minutes a 500 ml load of placebo (Group I) or Pergoli water (Group II). The results showed a significant reduction in the measured gallbladder area in group II alcoholics, but not in patients of group I. Furthermore, three weeks of treatment with Pergoli water significantly reduced to normal total and direct bilirubin levels, the enzyme markers of biliary stasis and the subjective sensation of itch. These parameters did not change in alcoholics of group I after placebo treatment. These data demonstrate that the oral administration of sulfureous sulfate calcic water Pergoli exerts a cholagogue activity in humans. The cholagogue activity together with the wellknown choleretic effect of this water argue in favor of the possibility for its use as support treatment to the therapy of biliary stasis in alcoholism.

Combined dapsone and clofazimine intoxication

We report clinical findings and pharmacokinetic data regarding a combined dapsone and clofazimine intoxication in a man, who ingested 50 tablets of dapsone (100 mg) 20 capsules of clofazimine (100 mg) and two tablets of rifampicin (600 mg). Oral administration of activated charcoal (50 grams) and sodium sulphate (20 grams) after gastric lavage resulted in an elimination half-life in plasma of 11.1 and 10.8 h for dapsone and its main metabolite, monoacetyldapsone, respectively. A rapid initial decrease of the plasma concentration of clofazimine was observed after gastric lavage and administration of activated charcoal and sodium sulphate. 15 h after this treatment, clofazimine plasma levels remained relatively constant. Dapsone-induced methaemoglobinaemia (48% at admission) was treated successfully with methylene blue.

Zinc supplementation and amino acid-nitrogen metabolism in patients with advanced cirrhosis

Zinc deficiency is common in cirrhosis and has been involved in the altered nitrogen metabolism. In this study, we measured the effects of zinc supplementation on the dynamics of amino acid-derived urea synthesis in cirrhosis with mild or latent encephalopathy. The hepatic conversion of amino acids into urea was studied in eight patients with advanced cirrhosis under controlled conditions of substrate availability (continuous alanine infusion), before and after 3-month oral zinc sulfate supplementation (600 mg/d). Eight more patients, matched for hepatocellular failure and encephalopathy, served as controls. Plasma zinc levels were reduced in all patients and returned to normal after oral zinc. The alanine-stimulated urea nitrogen synthesis rate in relation to alpha-amino-N concentration--the functional hepatic nitrogen clearance--increased by 25% after zinc supplementation, i.e., more urea was produced at any alpha-amino-N concentration. Basal and alanine-induced glucagon decreased by 50%, and the ammonia response to alanine decreased by 30%. Psychometric tests improved, as did routine and dynamic liver function tests and the Child-Pugh score. Also, the plasma concentration of lipid peroxides was reduced by zinc. No significant changes were observed in the control group. Our data indicate that long-term oral zinc speeds up the kinetics of urea formation from amino acids and ammonia. Changes in the hormonal drive and/or the antioxidant activity of zinc might be involved in the general improvement in liver function, whereas the beneficial effects on encephalopathy might stem from decreased ammonia.

Case report: successful treatment with cimetidine and zinc sulphate in chronic mucocutaneous candidiasis

The authors evaluated the clinical efficacy of a treatment with cimetidine and zinc sulphate in a patient with chronic mucocutaneous candidiasis. Cimetidine was given at a dose of 400 mg three times daily; zinc sulphate at a dose of 200 mg daily, then adjusted to maintain blood zinc levels at the upper normal range. This treatment lasted 16 months. An impressive and significant reduction of the infectious events and an increased CD4 (helper/inducer) cell counts were observed. The authors conclude that this combined immunopotentiating treatment is safe and inexpensive to treat immunodeficiency disorders.

Reversibility of cerebral ventricular enlargement in anorexia nervosa, demonstrated by quantitative magnetic resonance imaging

OBJECTIVE

To determine the reversibility of the loss of brain parenchyma and ventricular enlargement in patients with anorexia nervosa after refeeding.

STUDY DESIGN

Quantitative magnetic resonance imaging was performed on three groups of subjects: (1) 12 female adolescents hospitalized with anorexia nervosa, (2) the same 12 patients after nutritional rehabilitation, a mean of 11.1 months later, and (3) 12 healthy age-matched control subjects. Sixty-four contiguous coronal magnetic resonance images, 3.1 mm thick, were obtained. With a computerized morphometry system, lateral and third ventricular volumes were measured by a single observer unaware of the status of the patient.

RESULTS

On admission, patients were malnourished and had lost an average of 11.7 kg (body mass index, 14.3 +/- 2.0 kg/m2). After refeeding, they gained an average of 9.7 kg (body mass index, 17.9 +/- 1.5 kg/m2). Total ventricular volume decreased from 17.1 +/- 5.5 cm3 on admission to 12.4 +/- 3.0 cm3 after refeeding (p < 0.01) and returned to the normal range. The degree of enlargement of the third ventricle was greater than that of the lateral ventricles. There was a significant inverse relationship between body mass index and total ventricular volume (r = -0.63; p < 0.05).

CONCLUSION

In patients with anorexia nervosa, cerebral ventricular enlargement correlates with the degree of malnutrition and is reversible with weight gain during long-term follow-up.

Successful medical treatment of severely decompensated Wilson disease

Delayed response to medical treatment sometimes leads to unnecessary liver transplantation in patients with severely decompensated Wilson disease. We report the course of five patients (mean age 13.4 years, range 11 to 15 years) with severely decompensated Wilson disease who were successfully treated medically. Prothrombin time improved after a minimum of 1 month and returned to normal within 3 months to 1 year or more.

Effects of short-term zinc supplementation on cellular immunity, respiratory symptoms, and growth of malnourished Equadorian children

OBJECTIVE

To assess the effect of zinc supplementation on respiratory tract disease, immunity and growth in malnourished children.

DESIGN

A randomized double-blind placebo-controlled trial.

SETTING

A day-care center in Quito, Ecuador.

SUBJECTS

Fifty children (12-59 months old) recruited by height-for-age and weight-for-age deficit.

INTERVENTIONS

Twenty-five children (supplemented, S group) received 10 mg/day of zinc as zinc sulfate, and 25 (nonsupplemented, NS group) received a placebo during 60 days. All were also observed during a 60-day postsupplementation period. Two children of the S group dropped out. Daily the clinical presence of cough, respiratory tract secretions, and fever, was recorded. On days 0,60 and 120, the cutaneous delayed-type hypersensitivity (DTH) to multiple antigens, and anthropometric parameters were assessed. On days 0 and 60 serum zinc levels were also measured.

RESULTS

On day 60, DTH was significantly larger (20.8 +/- 7.1 vs 16.1 +/- 9.7 mm), and serum zinc levels were significantly higher (118.6 +/- 47.1 vs 83.1 +/- 24.5 micrograms/dl) in the S group than in the NS group (P <0.05 for each). The incidence of fever [relative risk (RR): 0.30, c.i. = 0.08- 0.95, P =0.02], cough (RR): 0.52, c.i. = 0.32-0.84, P = 0.004) and upper respiratory tract secretions (RR):0.72, c.i. = 0.59-0.88, P = 0.001) was lower in the S group than in the NS group at day 60. At the end of the postsupplementation observation period (day 120), the incidence of fever and upper respiratory tract secretions was the same in both the S and NS groups. The incidence of cough was higher at day 120 in the S group than in the NS group (RR): 2.28, c.i. = 1.37-3.83, P = 0.001).

CONCLUSIONS

This study supports a role for zinc in immunity, and immunity to respiratory infections, while pointing out the need for larger studies.

Effects of hydrogen peroxide-containing bleaching agents on the morphology of human enamel

The effects of four bleaching agents (Opalescence, HiLite, 30% hydrogen peroxide, and 30% hydrogen peroxide mixed with sodium perborate) and 37% phosphoric acid on the external surface of human enamel were examined with the scanning electron microscope. The materials were applied to the enamel surfaces of 60 specimens obtained from 10 teeth. Each test agent was applied to one specimen from each tooth. One specimen of each tooth was left untreated. Comparison to the untreated control surfaces revealed that enamel exposed to the bleaching agents underwent slight morphologic surface alterations. The enamel surfaces treated with phosphoric acid, in contrast, showed severe morphologic alterations.