Serotonin function in schizophrenia: effects of meta-chlorophenylpiperazine in schizophrenic patients and healthy subjects

This study examined serotonin (5-hydroxytryptamine; 5HT) receptor responsivity in 22 chronic schizophrenic patients and 17 healthy control subjects. The 5HT agonist meta-chlorophenylpiperazine (MCPP) was used as a probe of serotonergic function. MCPP (0.35 mg/kg) or placebo was administered orally after a 3-week drug-free period in a randomized double-blind design. Hormonal (adrenocorticotropic hormone and prolactin), temperature, and behavioral responses and MCPP blood levels were assessed for 210 minutes after administration of the capsules. The schizophrenic patients had blunted temperature responses compared with those of the healthy control subjects: MCPP raised body temperature in the control subjects, but not in the patients. Behavioral responses also differed in the two groups: MCPP increased the total Brief Psychiatric Rating Scale (BPRS) score in the control subjects and tended to decrease it in the patients. In patients, MCPP decreased the BPRS psychosis subscore. Hormonal responses did not differ significantly in the two groups. These findings suggest that further exploration of 5HT function in schizophrenia is warranted.

Agitation and postdexamethasone cortisol levels in Alzheimer's disease

The clinical correlates of hypothalamic-pituitary-adrenal (HPA) functioning were examined in 29 patients with probable Alzheimer's disease. The 8:00 a.m. postdexamethasone cortisol levels of these patients were highly correlated with higher agitation scores but not with the degree of depressed mood or memory impairment. The possible neural basis for the association between hypercortisolism and behavioral disturbance in Alzheimer's disease warrants further exploration and replication.

[An analysis of the organization, profile of the clientele and pathologies managed in the urology division of the Public Assistance-Hospital of Paris. A 15-day cross-sectional survey of 10 services]

A cross-sectional study was carried out in ten urology departments over a two-week period. Three categories of data were collected concerning socio-economic status and epidemiological profiles and management of the patients. The results are presented with comparative analysis of performance of the clinics, and the epidemiological data are analysed with reference to the inpatient case mix.

Nocturnal growth hormone secretion in schizophrenic patients and healthy subjects

Plasma growth hormone concentrations were measured at hourly intervals between 10 p.m. and 8 a.m. the next morning in 15 drug-free chronic schizophrenic male inpatients and 14 healthy males. Growth hormone secretion was significantly lower in the patients as compared with the controls. Growth hormone release peaked around 1 a.m. in the controls, but a growth hormone peak was absent in the patient group. Increased dopamine activity, increased serotonin activity, or both could explain the absence of a nocturnal growth hormone surge in the schizophrenic patients.

Growth hormone responses to intravenous clonidine challenge correlate with behavioral irritability in psychiatric patients and healthy volunteers

To explore the relationship between central noradrenergic receptor responsivity and indices of impulsive aggression, growth hormone responses to infusions with the alpha 2-adrenergic receptor agonist clonidine (GH[CLON]) and responses on the Buss-Durkee Hostility Inventory (BDHI) were examined in healthy male volunteers and male patients with major affective or personality disorder. GH[CLON] values were found to correlate significantly with the BDHI "Irritability" subscale in all subjects, but especially in healthy volunteer and personality disorder patients. GH[CLON] values did not correlate with the BDHI "Assault" subscale. These results suggest a role for central alpha 2-adrenergic receptor responsivity in the personality trait characterized by behavioral irritability, but not overt assaultiveness, in humans.

Laparoscopic cholecystectomy

Traditional gall bladder surgery results in an abdominal incision requiring management of pain, possible ileus, a hospital stay of 5 to 7 days, and a six week recovery period. This type of surgery carries with it the risks of both surgery and anaesthesia and can have a high monetary cost for both the patient and the hospital. Laparoscopic cholecystectomy results in four, 1 to 3 cm incisions, that appear to produce less pain and no ileus. Hospitalization is 24 to 48 hours and complete recovery and return to work can occur within two weeks. This surgery is a safe and economical alternative to traditional surgical methods.

Treatment of rheumatoid arthritis with higher dose intravenous methotrexate

A pilot study evaluated intravenous methotrexate (MTX) (initial dose 40 mg/m2; final dose, 26 mg/m2), weekly for 12 weeks in 10 patients with rheumatoid arthritis who failed oral MTX. Statistically significant differences were noted for all the response variables examined: joint count (p = 0.0017), morning stiffness (p = 0.014), global assessment (patient, p = 0.0032, physician, p = 0.029), Arthritis Impact Measurement Scale (p = 0.0004), erythrocyte sedimentation rate (p = 0.012), grip strength (right p = 0.044, left p = 0.011). All 7 patients who completed the 12-week treatment period fulfilled the predetermined criteria for response. Intravenous MTX at these doses has potential efficacy in this patient group.

Epidemiology of immunoglobulin E levels in a defined population

Age-adjusted geometric mean IgE levels in 621 older subjects were higher in men (26.3 kU/L) than in women (19.1 kU/L), and decreased with age. The higher levels in men were largely a result of a strong positive association with cigarette smoking. Among allergic conditions, a personal history of asthma was associated with the highest IgE levels. In multiple linear regression models in men, cigarette smoking was the single strongest correlate of IgE levels, while a personal history of allergy was the strongest correlate in women. Our results suggest important nonallergic as well as allergic determinants of IgE levels in populations.

Metabolism, disposition, and pharmacokinetics of a potent anticonvulsant, 4-amino-N-(2,6-dimethylphenyl)benzamide (LY201116), in rats

The metabolism, disposition, and pharmacokinetics of 4-amino-N-(2,6-dimethylphenyl)benzamide (LY201116) have been studied in rats. 14C-LY201116 was well absorbed (approximately 94%) from the gastrointestinal tract following oral administration. Of the dose administered, 64.5% was excreted in the urine and 29% in the bile; with the majority being excreted during the first 24 hr. Peak plasma levels of LY201116 were observed at 0.75 hr, whereas peak plasma concentrations of radioactivity were seen at 2 hr after dosing. Maximum levels of radioactivity were observed at 2 hr in all of the tissues studied. The elimination of radioactivity from the tissues was monophasic with a mean half-life of 3.4 hr. Biotransformation of LY201116 in rats was investigated by quantitating and isolating metabolites from urine and plasma. The major route of metabolism was N-acetylation to form 4-(acetylamino)-N-(2,6-dimethylphenyl)benzamide (ADMP), and subsequent hydroxylation to form 4-(acetylamino)-N-(2-hydroxymethyl-6-methylphenyl)benzamide (HADMP). Two hr after oral dosing with 14C-LY201116, ADMP and HADMP comprised 92% of the total radioactivity in the plasma. The major urinary metabolite, accounting for 63% of the radioactivity in the urine, was HADMP. The elimination of LY201116 from the systemic circulation following iv administration was monophasic, with a terminal t1/2 of 9.4 min. The volume of distribution was 911 ml/kg and the plasma clearance was 66.9 ml/min/kg.

Peripheral arterial disease in large vessels is epidemiologically distinct from small vessel disease. An analysis of risk factors

The authors used noninvasive techniques, including flow velocity by Doppler ultrasound, to accurately assess and distinguish between large and small vessel peripheral arterial disease in a population study in southern California, 1978-1981. In 565 men and women aged 38-82 years, there were 69 cases of large vessel peripheral arterial disease, 19 of which were severe, and 90 cases of isolated small vessel peripheral arterial disease. In cross-sectional multivariate analysis in men, large vessel peripheral arterial disease was significantly associated with age, pack-years of cigarettes smoked, systolic blood pressure, fasting plasma glucose, and marginally with obesity. Similar analysis in women revealed significant associations only for age and systolic blood pressure, although the associations for pack-years of cigarettes, obesity, and low density lipoprotein cholesterol were suggestive. By contrast, isolated small vessel peripheral arterial disease was not significantly associated with any of the major cardiovascular disease risk factors, including two measures of carbohydrate metabolism, fasting plasma glucose and glycosylated hemoglobin. These findings, coupled with our earlier report that large vessel peripheral arterial disease but not isolated small vessel peripheral arterial disease was independently predictive of subsequent mortality, suggest that large vessel peripheral arterial disease and isolated small vessel peripheral arterial disease are epidemiologically, as well as pathophysiologically, distinct entities.

Determinants of internal migration in Israel: expected returns and risks

"A multinomial logit model of place-to-place migration focusing on economic, geographic and demographic factors is applied to empirical data on inter-regional migration in Israel in 1980. It explains 75% of the (cross-sectional) variance in the data. The results presented in this paper depart from previous empirical work due to its industrialized context and its focus on risk aversion as a determinant of the migration decision. The results support the Harris-Todaro (1970) hypothesis, and indicate that regional similarities in the structure of industrial employment promote migration."

Effect of fibrin sealant on the tensile strength of rat visceral pleura

Post mortem studies of rat lungs showed that application of fibrin sealant augments the tensile strength of the lung/visceral pleura by approximately 100 mmHg, thus impeding air leakage.

Correlates of change in postmenopausal estrogen use in a population-based study

During the late 1970s, there was a dramatic reduction in postmenopausal estrogen use in the United States, which may have reflected concern over a well-publicized postmenopausal estrogen-endometrial cancer link. The authors studied 310 postmenopausal women in a defined population over the period 1974-1981 to evaluate whether hysterectomy and certain other characteristics predicted change in postmenopausal estrogen use status during this period and, as a secondary issue, whether women who subsequently began postmenopausal estrogen use had different characteristics prior to use, an important question in the evaluation of the relation of postmenopausal estrogen use to morbidity and mortality from cancer, cardiovascular disease, or other diseases in observational studies. The only strong predictor of whether postmenopausal estrogen use would be discontinued was the presence of an intact uterus. Women who discontinued postmenopausal estrogen use were also somewhat older and heavier than those who continued, but were otherwise quite similar on a wide range of variables, including risk factors for and the presence of various chronic diseases. Similarly, the absence of a uterus was the only strong predictor of the initiation of postmenopausal estrogen use. Thus, concern about a possible postmenopausal estrogen-endometrial cancer link appeared to have been the major determinant of change in postmenopausal estrogen use in this time period. In the secondary analysis, variables other than hysterectomy did not discriminate between women who initiated postmenopausal estrogen use versus those who did not report use of postmenopausal estrogens, suggesting that a broad range of other characteristics was not a priori different in these two groups.

Regional distribution of fast and slow geniculo-cortical relay cells (GCR-cells) within the rat's dorsal lateral geniculate nucleus (LGNd)

Unit activity of 135 GCR-cells in rat's LGNd was recorded extracellularly using micropipettes filled with trypan blue for subsequent marking of recording sites. The latencies of responses to electrical stimulation of the optic chiasma (OX) were mapped, and in accordance with Fukuda (1973) each GCR-cells was classified as fast or slow. Fast cells predominate in the rostroventromedial subregion and slow cells in the caudal part. Both fast and slow subtypes were found in the remaining rostrodorsolateral zone where slow cells made up two thirds of the subsample. The results fit the suggestion that in the LGNd of rats a fast retino-geniculate pathway relays in the ventromedial region, whereas slow pathways exist in the caudal as well as in the dorsolateral zone.

The prevalence of peripheral arterial disease in a defined population

Because patients with peripheral arterial disease (PAD) may be asymptomatic or may present with atypical symptoms or findings, the true population prevalence of PAD is essentially unknown. We used four highly reliable, sophisticated noninvasive tests (segmental blood pressure, flow velocity by Doppler ultrasound, postocclusive reactive hyperemia, and pulse reappearance half-time) to assess the prevalence of large-vessel PAD and small-vessel PAD in an older (average age 66 years) defined population of 613 men and women. A total of 11.7% of the population had large-vessel PAD on noninvasive testing, and nearly half of those with large-vessel PAD also had small-vessel PAD (5.2%). An additional 16.0% of the population had isolated small-vessel PAD. Large-vessel PAD increased dramatically with age and was slightly more common in men and in subjects with hyperlipidemia. Isolated small-vessel PAD, by contrast, was essentially unrelated to sex, hyperlipidemia, or age, although it was somewhat less common before age 60. Intermittent claudication rates in this population were 2.2% in men and 1.7% in women, and abnormalities in femoral or posterior tibial pulse were present in 20.3% of men and 22.1% of women compared with the noninvasively assessed large-vessel PAD rate of 11.7%. Thus assessment of large-vessel PAD prevalence by intermittent claudication dramatically underestimated the true large-vessel PAD prevalence and assessment by peripheral pulse examination dramatically overestimated the true prevalence.

The sensitivity, specificity, and predictive value of traditional clinical evaluation of peripheral arterial disease: results from noninvasive testing in a defined population

In a companion article we have reported the prevalence, in an older, defined population, of traditional assessments (intermittent claudication and abnormal pulse examination) of peripheral arterial disease (PAD) as compared with the results of highly accurate noninvasive testing. In this article we report the sensitivity, specificity, and positive and negative predictive values for claudication and abnormal pulses for the diagnosis of large-vessel and small-vessel PAD as determined by noninvasive testing. Claudication and abnormal pulses were completely unrelated to isolated small-vessel PAD. In contrast, both claudication and abnormal pulses were significantly correlated with large-vessel PAD. Claudication and an abnormal femoral pulse showed a high specificity and positive predictive value but a low sensitivity for large-vessel PAD. Conversely, an abnormal dorsalis pedis pulse showed a good sensitivity but low specificity and positive predictive value. The best single discriminator was an abnormal posterior tibial pulse, which had high sensitivity, specificity, and positive predictive value. Various combinations of claudication and pulse abnormalities revealed a good sensitivity for broader criteria but at the expense of specificity, whereas stricter criteria had a good specificity and positive predictive value but a poor sensitivity. No combination was superior to an abnormal posterior tibial pulse alone.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigen overlay technique for line immunoelectrophoresis and crossed-line immunoelectrophoresis of thermolabile antigens

A simple antigen overlay technique for line immunoelectrophoresis and crossed-line immunoelectrophoresis is described. A blind gel is overlaid with antigen-impregnated filter paper instead to mix antigens with molten agarose and to pour them in a uniform sample gel. This makes it easier in line and crossed-line immunoelectrophoresis comparison of different antigen samples, simplifying technique as compared with the conventional method. Moreover, this technique is designated to obtain reproducible patterns from thermolabile proteins since they are unaffected by being heated.

Psychophysical tuning functions for brief stimuli: preliminary report

Observations from clinical and research applications of brain stem evoked response audiometry and electrocochleography have suggested that tone bursts of only a few milliseconds' duration can elicit frequency specific responses. Because such brief stimuli are not perceived as being total, the extent to which the auditory system can "tune" to such stimuli was questioned. In order to investigate this question, psychophysical tuning functions were determined for brief tone bursts (i.e., 1. to 2 msec. duration). The results suggest that in working near normal thresholds (and therefore at relatively low sound pressure levels), brief tone bursts do yield rather frequency specific information. However, the range of sound pressure levels of the stimulus for which the tuning is resonably sharp is limited. the tuning functions show signs of deterioration, particularly in the "tip region," with only modest increases in the sound pressure level above threshold (i.e., typically with 20 dB.). Differences also may be seen between tuning functions for these very brief tone bursts, which in turn are characterized by a so-called click pitch, and those of stimuli long enough to have tonal pitch (i.e., 20 msec.). Finally, tuning functions also were examined for click stimulation, which also revealed some degree of tuning at relatively low levels of stimulation.