The hypnic ("alarm clock") headache syndrome

Dipeptidyl peptidase IV (DPP IV, CD 26) is an integral membrane serine protease exhibiting a well characterized exopeptidase activity. The present study shows that DPP IV also possesses a novel gelatinase activity and therefore endopeptidase activity, which was directly demonstrated by gelatin zymography. Protease inhibitor profile analysis showed that the endo- and exopeptidase activities of DPP IV share a common active site. Substrate specificity was detected for denatured collagen types I, II, III and V suggesting that DPP IV might contribute to collagen trimming and metabolism. On the basis of these data we propose that DPP IV and the recently sequenced gelatinolytic seprase (FAPalpha) represent a new subfamily of gelatinolytic integral membrane serine proteases.     

The relationship of message unity ("pull") to the recipient's response potential.

"The hypothesis is that response potential is a function of message unity." It was tested by sending messages to potential buyers of vitamins and having them respond to a questionnaire. The messages were classified into 3 groups according to message unity. The results of this research, used as the basis for an MA thesis, verified the hypothesis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethical aspects to be considered in brain banking

OBJECTIVE: To investigate MRI and proton spectroscopy changes in five patients with HIV associated dementia complex (HADC) treated with antiretroviral therapy. METHODS: Three markers were evaluated: (1) CSF/intracranial volume ratio; (2) T2 weighted signal ratio between parieto-occipital white and subcortical grey matter; and (3) metabolite ratios from long echo time (TE=135 ms) single voxel proton spectra of parieto-occipital white matter. RESULTS: Spectroscopic changes indicated initial increases in N-acetyl/(N-acetyl + choline + creatine) ratio (NA/(NA+ Cho+Cr)) and progression of atrophy after initiation of antiretroviral therapy in four of five patients. When the neurological status of the patients subsequently deteriorated (two of five patients), the NA/(NA+Cho+Cr) ratio also declined. CONCLUSIONS: Spectroscopic changes mirror reversible neuronal dysfunction. These objective, non-invasive techniques may be used for monitoring the neurological effects of antiretroviral drug therapy in patients with HADC.     

Determination of clonazepam ("Rivotril" or "Ro 5-4023") in plasma by gas chromatography using an internal standard

A method has been developed for gas-chromatographic determination of clonazepam ("Rivotril" or "Ro 5-4023") in plasma, using methyl-clonazepam ("Ro 4082") as an internal standard. Following extraction of the benzodiazepines and hydrolysis, the benzophenones are analyzed by gas-chromatography, using a glass column filled with 3% OV 225 on Gas Chrom Q and a 63Ni electron-capture detector. The technique has good selectivity. The limit of sensitivity is less than 1 ng/ml of plasma. Using this method the plasma kinetics of clonazepam may be studied in man and the correlations between plasma levels and therapeutic activity investigated. It is also available for toxicological analysis, as well as pharmacovigilance purpose. The same internal standard and a similar method can also be used for the determination of flunitrazpem ("Rohypnol" or "Ro 5-4200") and its major metabolite (N-desmethyl-flunitrazepam) in plasma.     

Pre-toxic adrenocortical adenoma ("pre-Cushing syndrome"): role of 17-hydroxyprogesterone dosage under ACTH analog stimulation. Apropos of a case

We report on a case of a 63-year-old male patient who presented with an adrenal incidentaloma corresponding to a pre-toxic adrenocortical adenoma ("pre-Cushing's syndrome"). Nycthemeral cortisol cycle and free urinary cortisol were within the normal range. Basal ACTH and dehydroepiandrosterone sulfate levels were decreased and the 17-hydroxyprogesterone (17OHP) response under ACTH stimulation (tetracosactide) was increased. The ACTh test appears mandatory in the incidentaloma work-up to order to identify the pre-toxic adenomas. Its elevation reflects likely intra-tumoral enzymatic defects. Pre-Cushing's syndrome therapeutic management is still debated. No surgery was performed in our patient. A 3-year follow-up did not show overt Cushing's syndrome features.     

Bovine progressive degenerative myeloencephalopathy ("Weaver syndrome") in brown Swiss x Braunvieh cattle: reproductive occurrences, results of embryo transfer

In the time between 1989 and 1991 seven Brown Swiss heifers, which had clinical signs of the Weaver syndrome were kept at the Bavarian Institute of Animal Breeding in Grub. This was in order to investigate this hereditary trait further. The number of animals carrying this genetic defect was increased by means of embryo transfer. Both cycle observations and ovary controls by means of rectal palpation resulted largely in physiological data and findings. All seven animals responded to superovulation treatment which was induced by sequential doses of p-FSH (32 mg) or of a single dose of 2,000 IU PMSG. The donors were flushed a total of 32 times without problem. On average 5.3 ova were recovered, 2.8 of which were viable and suitable for transfer. These are statistically only 50% of the normal value in a routine ET programme. Following the transfer of fresh and frozen embryos the pregnancy rate was 53%. There was only one abortion observed from 48 pregnancies.     

Pain pattern in pregnancy and "catching" of the leg in pregnant women with posterior pelvic pain

STUDY DESIGN: A cross-sectional study of symptoms and signs in pregnant women. OBJECTIVES: To describe the clinical appearance of back pain in pregnancy and the relation between pain distribution and symptoms in women with posterior pelvic pain, in order to shed light on etiologic factors. SUMMARY OF BACKGROUND DATA: Back pain is common in the general population. During pregnancy, it is even more common, and back pain is experienced by about 50% of pregnant women. In the pregnant woman, differentiation between common low back pain and posterior pelvic pain is believed to be essential because these symptoms should be treated in different ways. METHODS: The women were interviewed with a questionnaire. Those with back symptoms completed a pain drawing and were examined by an orthopedic surgeon. Based on the symptoms and findings, the women were divided into three groups: thoracic pain, lumbar pain, and posterior pelvic pain. RESULTS: Of 335 pregnant women, 51% had back pain at the time of examination. The pain was more widespread compared with common low back pain. Seventy-one percent of the 171 patients examined by the orthopedic surgeon had a positive posterior pelvic pain test. These women more often had pain in the gluteal and posterior thigh regions. A "catching" feeling of the leg was described when walking by 44 of 122 these women, whereas only 1 of 49 women without a posterior pelvic pain test had such symptoms. CONCLUSIONS: The higher prevalence of back pain in pregnancy may be due to several factors. In women with posterior pelvic pain, there is a specific symptom-a catching of the leg when walking. The most probable explanation for the catching is that local nociception disturbs muscular function in women with posterior pelvic pain because changes in the sacroiliac joint range of motion, which is very small, cannot cause this symptom.     

Shifts in attention biases in response to acute pain induction: Examination of a model of "conversion" among repressors.

Unlike most people, those who are characterized by a repressive coping style report high levels of physical (sensory) pain but low levels of emotional distress (affective pain), which is a discrepancy that may suggest a “conversion” process. In two studies, we tested an attention allocation model, proposing that repressors direct attention away from threatening negative affective information and toward nonthreatening physical pain information during emotionally arousing (painful) situations. In Study 1, 84 participants underwent a cold pressor and then recovered. Repressors reported greater pain during recovery than low- and high-anxious participants, but they reported lower distress than high-anxious participants. Repressors reported significant and large discrepancies between high pain and low distress, whereas these differences were less pronounced for other groups. In Study 2, 77 participants underwent an ischemic pain task while performing a modified dot-probe task with sensory and negative affective pain words as stimuli. Repressors showed increasing biases away from affective pain words and toward sensory pain words as the pain task continued, whereas low- and high-anxious participants did not show these shifts in attention. The results support the notion that conversion among repressors may involve a process by which attention is directed away from emotional distress during noxious stimulation and is focused instead on sensory information from pain. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The clinical syndrome associated with antiphospholipid antibodies. A diagnosis to be confirmed after a long follow-up

A clinical case of syndrome of antiphospholipid antibodies is reported. The patient is a 10-year-old girl with thrombophlebitis of the right leg associated with the presence of lupus-like anticoagulant antibodies. No secondary pathologies were found. It is not possible, anyway, to make a definitive differential diagnosis between primary and secondary forms of syndrome of antiphospholipid antibodies because of intermediate situations where antiphospholipid antibodies are associated with 2 or 3 ARA criteria for the diagnosis of lupus (lupus-like syndrome). A long term follow-up is therefore necessary.     

Factors to be considered in the evaluation of bioavailability and bioequivalence of topical formulations

In this paper, an attempt is made to find functional definitions of bioavailability and bioequivalence for topical products and to examine critical factors that influence topical bioavailability and bioequivalence. A physical model approach for quantifying the problem and increasing our understanding is presented here. The key assumptions are (1) that the target site is in the lower epidermis (basal layer) or in the dermis, and (2) that it is the thermodynamic activity (i.e., the free drug concentration, C*, of the active drug species) at the target site that is the true correlate of drug effectiveness. Studies initiated to implement the physical model approach involved first validating a 'three-tiered' model for finite dose drug uptake/transport in skin with experimentally determined input parameters (partition coefficient, K, and steady-state permeability coefficients, P, for the stratum corneum, viable epidermis, and dermis). Hydrocortisone was used as the model drug with hairless guinea pig skin as the model membrane. The physical model is used to show, via the C* concept, how formulation factors may influence bioavailability and bioequivalence. Finally, a method is presented for predicting the efficacy of topical formulations employing appropriate in vitro data and physical model calculations.     

The use of clemastine ("Tavegil'') administered parenterally in acute allergic episodes

A case is reported in which anticoagulant therapy for thrombophlebitis and pulmonary embolism produced bilateral massive intrarenal hematomas (pseudotumors). The role of radiologic investigation (nephrotomography, renal scan and selective high dose arteriography) was found to identify and localize the intrarenal hematomata and exclude underlying renal pathology. Although an abnormal kidney is more likely to bleed, this case presentation demonstrates that even carefully monitored anticoagulation within the therapeutic range can induce massive intrarenal hemorrhage in previously normal kidneys. The renal architecture returned to normal on late follow-up examination on simple conservative management.     

Antioxidant and free radical scavenging effects in extracts of the medicinal herb Achyrocline satureioides (Lam.) DC. ("marcela")

Achyrocline satureioides (Lam.) DC. (Compositae) is a medicinal herb used in Argentina, Uruguay, Brazil and Paraguay for its choleretic, antispasmodic and hepatoprotective properties. The presence of the flavonoid quercetin and its derivatives, and of different phenolic acids such as caffeic, chlorogenic and isochlorogenic acids in the aerial parts of this plant has led us to study the antioxidant activity of its extracts using different bioassays. The inhibition of luminol-enhanced chemiluminescence by the aqueous and methanolic extracts was used to show that their total reactive antioxidant potential index (TRAP; in microM Trolox equivalents) was 91.0 +/- 15.4 and 128.1 +/- 20.1 microM, respectively, while the total antioxidant reactivity index (TAR) was calculated to be 1537 +/- 148 and 1910 +/- 171 microM. Only the methanolic extract was capable of reducing iron (II)-dependent DNA damage. Lipid peroxidation was assessed by two different methods. The aqueous extract reduced hydroperoxide-initiated chemiluminescence in rat liver homogenates at all concentrations in a dose-dependent manner, with a calculated IC50 = 225 micrograms/ml, while the methanolic extract was only effective at higher concentrations (100 and 1000 micrograms/ml). Both aqueous and methanolic extracts were capable of reducing the production of thiobarbituric acid reactive substances (TBARS) in rat liver homogenates, with an IC50 > 1000 micrograms/ml. The results obtained suggest that the extracts of A. satureioides possess significant free radical scavenging and antioxidant activity in vitro, a fact that should encourage future in vivo studies.     

Normal time course of auditory recognition in schizophrenia, despite impaired precision of the auditory sensory ("echoic") memory code.

Prior studies have demonstrated impaired precision of processing within the auditory sensory memory (ASM) system in schizophrenia. This study used auditory backward masking to evaluate the degree to which such deficits resulted from impaired overall precision versus premature decay of information within the short-term auditory store. ASM performance was evaluated in 14 schizophrenic participants and 16 controls. Schizophrenic participants were severely impaired in their ability to match tones following delay. However, when no-mask performance was equated across participants, schizophrenic participants were no more susceptible to the effects of backward maskers than were controls. Thus, despite impaired precision of ASM performance, schizophrenic participants showed no deficits in the time course over which short-term representations could be used within the ASM system. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Open-heart surgery in a growing geriatric population: patient selection and risk factors to be considered

AIMS: This report describes our experience with cardiac surgery in elderly patients and aims to ascertain predictors of poor outcome. PATIENTS: Five hundred and ninety-eight (598) consecutive patients aged 75 years and older underwent cardiac surgery at the Department of Cardiothoracic Surgery, University Hospital of Lund, Sweden, between January 1980 and December 1993. There were 324 men (54%) and 274 women (46%); their age varied between 75 and 91 years (mean age +/- SD, 77.8 +/- 2.6 years). One hundred and twenty-nine patients underwent aortic, mitral or combined valve replacement, 273 patients underwent exclusive coronary revascularization (CABG) alone and 109 underwent a surgical procedure which included valve replacement and concomitant CABG. The remainder (87 patients) underwent other, more complex surgical procedures. RESULTS: The 30-day or in-hospital mortality rate was 5.5% (0.8% for valve replacement, 5.1% for CABG, 5.5% for valve replacement with concomitant CABG, and 12.6% for other procedures). Concomitant severe diseases occurred in 34.9% of the patients. All surviving patients were evaluated during June 1994. None of the patients was lost to follow-up. The 566 long-term survivors have been followed for an average of 23.0 months (median 21; range 1-53 months). Late mortality was 12.0% in the 566 hospital survivors. Only 17 patients experienced late complications (after hospital discharge), as an adverse effect linked to heart surgery.