Antidepressant treatment of pathologic laughing or crying in elderly stroke patients

Pathologic laughing or crying (PLC), a complication of many neurologic disorders, involves behavior that is either inappropriate to the context or to the patient's subjective feeling state. It is due to a dysregulation of the motoric components of emotional experience. PLC is distinct from, but often associated with, major depression. The relatively few reports on treatment of PLC are primarily with tricyclic antidepressants. We report the effective treatment of PLC due to stroke in three patients with nortriptyline or fluoxetine. The cases also illustrate the broad spectrum of depressive symptoms (from none to a major depression) seen in patients with PLC. We discuss treatment implications and directions for future research.     

Resting metabolic rate in subjects with paraplegia: the effect of pressure sores

OBJECTIVE: To determine the overall effect of paraplegia and pressure sores on resting metabolic rate. DESIGN: Unblinded, case-control study using a convenience sample. SETTING: Hospital primary care setting. PATIENTS: Fourteen individuals with paraplegia and pressure sores (PS-Para), 24 with paraplegia in good health (NPS-Para), and 23 non-spinal cord injury (SCI) controls. MAIN OUTCOME MEASURES: The planned outcome measures consisted of resting metabolic rate, percent of predicted resting metabolic rate, resting metabolic rate per kilogram body weight, and resting metabolic rate per meter squared body surface area. Post hoc analyses were used to identify the effect of completeness of lesion, smoking, and pressure sores on percent of predicted resting metabolic rate and resting metabolic rate per kilogram body weight. RESULTS: Percent of predicted resting metabolic rate and resting metabolic rate per kilogram body weight were significantly higher in the PS-Para group than in the NPS-Para or control groups (115% +/- 4% vs 100% +/- 2% or 107% +/- 2%, p < .05) and (25.9 +/- 1.2 vs 21.4 +/- 0.6 or 22.5 +/- 0.4 kcal/kg, p < .05, respectively). The resting metabolic rate per meter squared body surface area was significantly higher in the PS-Para group than in NPS-Para group (973 +/- 39 vs 874 +/- 20kcal/m2, p < .05). In the PS-Para group, current smokers had significantly higher resting metabolic rate per kilogram body weight than nonsmokers (27.3 +/- 1.7 vs 24.0 +/- 1.4kcal/kg, p < .01). Controlling for the effects of smoking in a multiple regression model, those in the PS-Para group had significantly (p < .001) greater percent of predicted resting metabolic rate and resting metabolic rate per kilogram body weight than those in the NPS-Para group. CONCLUSIONS: These findings indicate that individuals with SCI may have a decreased percent of predicted resting metabolic rate and those with pressure sores may have a hypermetabolic state. This hypermetabolic state is significantly higher than that resulting from smoking. Because ordinary prediction equations for energy expenditure may not be accurate when applied to subjects with paraplegia and pressure sores, quantification of energy needs by indirect calorimetry is recommended.     

Mouse lung epithelial cell lines--tools for the study of differentiation and the neoplastic phenotype

Several dozen lung epithelial cell lines have been established in culture over the past 20 years from normal lung explants and their spontaneous transformants, and from lung tumors that arose spontaneously or were induced with chemicals, viruses, or oncogenic transgenes. To provide information from which to choose appropriate lines for investigating problems in lung cell biology and pulmonary neoplasia, this review describes the origins of these lines and some of their characteristics. These include growth, morphology, tumorigenicity, ability to metastasize, xenobiotic metabolism, mutational status, signal transducing activities, cytogenetics, ability to form domes, and electric conductance. In addition to collecting this information in a single place for the first time, we describe previously unpublished apoptosis features of some of these lines. An increasing number of investigations are beginning to use these lines and this review contains references into 1997.     

AIDS Clinical Trials Group Study 094: a phase I/II trial of ABV chemotherapy with zidovudine and recombinant human GM-CSF in AIDS-related Kaposi''s sarcoma

The aim of this study was to evaluate psychosocial quality of life after heart transplantation. We examined 29 patients (25 M and 4 F), average age was 43.5 y (18-62 y). The age at time of heart transplantation was 43 years (17-55 y). The time after heart transplantation was 3.3 year (0.3-9 y). Spielberger's Questionnaire of Anxiety, Knobloch's inventory of neuroticism, Freiburg's Personality Inventory and Quality of Life Inventory were used, 33% of patients demonstrated increasing frequency and 29% of patients increasing intensity of neurotic symptoms. 23% of patients presented increasing levels of anxiety (as a state). The personality dimensions (depression, excitability and low emotional stability) displayed high frequency. The results showed that patients were more satisfied with family support, with sexual activities, and less satisfied with financial situation, social activities, social isolations, sleep, memory, excitability, fatigue. 41.5% of patients returned back to work. The results indicate that these psychosocial factors play an important role in quality of life after heart transplantation. That is why if is necessary to dedicate an increasing attention to them. (Tab. 1, Fig. 6, Ref. 14.)     

Social patterns of road accidents to children: some characteristics of vulnerable families

A method based on graphite furnace atomic absorption spectrometry (GFAAS) was developed for determining platinum in wine. Wine samples were prepared by microwave acid digestion or dry mineralization. The method of standard addition was used for Pt determination in untreated wine samples and mineralized samples. Analyte modifiers and furnace conditions were optimized. Effects of cations (Mg2+, Ca2+, K+, Na+, and NH4+) and anions (PO4(3)-, SO4(2)-) were tested separately and in combination. Analytical characteristics of the method were optimized for analyte recovery and signal enhancement. Recoveries ranged from 92.5 to 102%, and precision reproducibility relative standard deviation varied from 7.5 to 10%. Red, rosé, and white wines from France were analyzed. Platinum levels found in most wines were very low (< 10 micrograms/L).     

Characterization of the enzymatic and nonenzymatic reaction of 13-oxooctadecadienoic acid with glutathione

The enzymatic oxygenation of linoleic acid leads to the production of 13-hydroxyoctadecadienoic acid (13-HODE). Subsequent dehydrogenation of 13-HODE by the NAD(+)-dependent 13-HODE dehydrogenase results in the formation of the 2,4-dienone 13-oxooctadecadienoic acid (13-OXO). These oxidized derivatives of linoleic acid have been shown to be involved in several cellular regulatory processes. In the present study, we have examined the enzymatic and nonenzymatic reaction of 13-OXO with glutathione (GSH) and N-acetylcysteine (N-AcCySH). Nonenzymatic reaction rates were determined spectrophotometrically and exhibited a pH optimum of 9.0 which is consistent with attack of a thiolate anion. Product formation was evaluated by reverse-phase HPLC which showed formation of one major product upon reaction with either GSH or N-AcCySH. The HPLC-purified products were examined by FAB MS as well as one- and two-dimensional NMR. The products, with either GSH or N-AcCySH, were found to consist of an equal mixture of two diastereomers arising from addition of a thiolate to the 9 position of 13-OXO. Using GSH as the thiol, the reaction was also shown to be catalyzed by rat glutathione transferase 8-8. In the case of the enzymatic reaction there is stereoselective product formation. Furthermore, submicromolar concentrations of the 13-OXO-GSH conjugate were shown to significantly inhibit glutathione transferase activity in HT-29 homogenates. These investigations provide insight into the potential metabolic disposition of linoleate oxygenation products.     

Mucosal addressin cell adhesion molecule-1 (MAdCAM-1). Its binding motif for alpha 4 beta 7 and role in experimental colitis

The integrin alpha 4 beta 7 and mucosal addressin cell adhesion molecule-1 (MAdCAM-1) are molecules involved in the normal recirculation of lymphocytes between the blood and the gastrointestinal tract. These molecules may play a complementary and significant role in animal models of colitis. We have investigated the structural interaction between alpha 4 beta 7 and MAdCAM-1. Site-directed mutagenesis studies of the MAdCAM-1 molecule has led to the identification of the amino acid residue (LDT) in the loop between beta strands C and D of the Ig-superfamily-like folds being involved in the adhesive and cell activation functions of MAdCAM-1 with alpha 4 beta 7.     

Assessment of nutritional status in CAPD patients: serum albumin is not a useful measure

INTRODUCTION: In CAPD patients serum albumin is frequently used as an index of nutritional status, although it is recognized that hypoalbuminaemia may be caused by many factors. We have further examined the relationship between serum albumin and nutrition. METHODS: Nutritional status was assessed by biochemistry, anthropometry, mid-arm muscle circumference, muscle strength (hand grip and back), and lean body mass (from anthropometry, creatinine kinetics and bioimpedance) in a group of 76 stable CAPD patients. Correlations between biochemical and nutritional parameters were sought and data were compared between patient groups defined by serum albumin (> or = 37 vs < 37 g/l on two occasions 2 months apart) and separately according to subjective global assessment score (normal nutrition, A vs mild to moderate, B, and severe, C, malnutrition). RESULTS: In patients with a low SGA score, actual body weight, body mass index, mid-arm muscle circumference, lean body mass, subscapular skinfold thickness, hand grip strength (males and females) and iliac and triceps skinfold thicknesses and back strength (females only) were all significantly less than in patients with a normal SGA score. In contrast, none of these variables differed in either gender when patients were compared according to serum albumin. Serum albumin was correlated with serum creatinine (r = 0.45, P = 0.01), daily urine protein excretion (r = -0.42, P = 0.02) and uncorrected weekly creatinine clearance (r = -0.39) in females, but not with any index of body composition in either gender. CONCLUSION: Whilst SGA identified a patient group with significantly abnormal body mass, muscle mass and muscle strength, serum albumin did not. Serum albumin is not a useful marker of malnutrition in stable patients on CAPD.