Small skin blood vessel occlusions by cryoglobulin aggregates in ulcerative lesions in IgM-IgG cryglobulinemia

The skin biopsy specimens from six patients with primary mixed IgM-IgG cryoglo-bulinemia were examined by immunofluorescence, light and electron microscopy. The biopsy taken from the involved skin of one patient with leg ulcers revealed small blood vessel occlusions by cryoglobulin aggregates. Since a similar finding was not observed in the biopsy material taken from the other five patients who had no ulcerative skin lesions, it seems that the cryoglobulin aggregates play a role in the development of the skin ulcerations in primary mixed IgM-IgG cryoglobulinemia.     

A novel molecular marker of pituitary tumor transforming gene involves in a rat liver regeneration

BACKGROUND: Pituitary tumor transforming gene (PTTG), homologous to a mammalian securin, plays a pivotal role in cell transformation, however, its biological function(s) in normal tissues is not fully understood. Because the liver is a regenerative organ, the relevant biological function of PTTG in the liver would be more feasible to understand PTTG. Also, PTTG may be involved in the liver regeneration. MATERIALS AND METHODS: Expressions of rat hepatic PTTG messengerRNA (mRNA) and cellular immunoreactivities during the cell proliferative period of the liver regeneration both in vitro and in vivo were tested. RESULTS: PTTG expression of the rat primary hepatocyte was stimulated by HGF in a dose dependent manner, and was suppressed when hepatocyte proliferation was inhibited by transforming growth factor-beta1. A positive PTTG immunoreactive co-localizing with 5-bromo-2'-deoxyuridine (BrdU) in the hepatocyte nucleus was found and there was a concurrent sister chromatin itself by the immunofluorescent labeling of PTTG with cytokeratin 18 (CK18). DISCUSSION: Since the correlation of PTTG mRNA expression, cell proliferation and immunoreactivity were observed in primary rat cultured hepatocytes, PTTG may be a novel marker of cell proliferation both in vitro and in vivo liver regeneration.     

Mixture of essential fatty acids lowers test anxiety

Test anxiety is an incapacitating academic syndrome. This study shows that administration of a polyunsaturated fatty acid mixture of omega-3 and -6 can improve the behavioral variables associated with this type of anxiety, i.e. appetite, mood, mental concentration, fatigue, academic organization and poor sleep, as well as lowering elevated cortisol level, with a corresponding reduction of anxiety.     

Asymmetrical Cognitive Deterioration in Demented and Parkinson Patients

Patients with Parkinson's disease and patients with dementia showed greater deterioration on functions attributed to the right cerebral hemisphere, than on functions attributed to the left. Relative to matched controls, Parkinson patients were significantly impaired on right hemisphere tests, but did not differ on left hemisphere tests. Demented patients were significantly deficient on all tests, but right decline was greater than left.Ninety-six patients were tested: 32 diagnosed as senile or presenile dementia, 32 Parkinson patients, and 32 non-neurological patients matched for age, sex and education. Functional performance was assessed by a battery of validated tests for left and right hemisphere cognitive functions. Patients were defined with two scores based on the results of the test: Cognitive Laterality Quotient (CLQ) reflecting the averaged performance on the left hemisphere tests, subtracted from the average performance on right hemisphere tests, and Cognitive Performance Quotient (CPQ), reflecting the total level of performance of both hemispheres. These measures defined a characteristic cognitive profile for each group.     

In vivo atrial excitability and anti-arrhythmic drugs

The threshold of excitability of the atrial muscle was studied in the in vivo beating canine heart. Unipolar cathodal and anodal strength-interval curves were constructed and found to be dissimilar in shape. It was found that at any interval within the relative refractory period of the atrium, as in the ventricle, there is a wide range of current levels delineated by an upper (Tu) and lower (Tl) limit of threshold which can stimulate the atrial myocardium. Within these limits the threshold varies spontaneously and can be reduced to Tl level by a run of extrasystoles.Such Tu and Tl curves were repeatedly determined following administration of therapeutic doses of quinidine, procaine amide or lidocaine. It was observed that all three drugs prolonged the refractory period. The Tu values increased following each of the drugs, and mostly after quinidine, while the Tl curve was less affected by quinidine. It is suggested that the exit block thus produced is the principal mechanism whereby quinidine depresses atrial disrhythmias.     

The treatment of schizophrenia: from premorbid manifestations to the first episode of psychosis

To achieve the best therapeutic results in schizophrenia--like most other disorders--primary prevention is preferable to early and prompt treatment, which, in turn, is preferable to treatment of chronically established illness. Unfortunately, there currently exist no accurate markers that can provide information regarding the future course of illness and guide treatment in asymptomatic or mildly symptomatic individuals. Therefore, most treatment efforts are currently focused on patients who have already experienced their first psychotic episode. This paper reviews the efforts to identify accurate markers heralding psychotic illness, as well as treatment considerations in the early phase of the disease.     

Learned irrelevance is disrupted in first-episode but not chronic schizophrenia patients

Learned irrelevance (LIrr) is a pre-exposure effect in which uncorrelated presentations of a conditioned stimulus (CS) and an unconditioned stimulus (US) retard subsequent CS-US association. LIrr is closely related to the phenomenon of latent inhibition (LI). LI refers to the retarding effects of inconsequential stimulus pre-exposure on subsequent conditioning to that stimulus, and is considered to reflect the organism's capacity to ignore irrelevant stimuli. LI is disrupted in schizophrenia patients, due to faster learning of the association between the preexposed CS and the US. A new within-subject target-recognition LIrr procedure was applied. The target was either cued by a priming signal or appeared at random, and priming signals were novel or preexposed cues. Schizophrenia patients were compared to age- and sex-matched control subjects. Normal subjects (n = 24) have shown robust LIrr, namely, faster cue-target associations of novel compared to preexposed cues. Schizophrenia patients at the early stages of their first episode (n = 7) showed LIrr disruption, namely, cue-target associations to preexposed cues were as fast as for novel cues. Chronic patients during an acute phase (n = 18) did not show LIrr as they failed to learn the cue-target association. In addition to the LIrr paradigm the same subjects were tested in a covert-orientation task. No differences were observed between the groups on this task. The possible advantages of the new LIrr paradigm are discussed.     

Seizure clustering: risks and outcomes

PURPOSE: Patients with epilepsy often experience seizures in clusters. In this preliminary study, we examined the prevalence of self-reported clustering and identified potential risk factors and outcomes associated with reported clustering for further analysis in an ongoing prospective diary study. METHODS: Detailed intake questionnaires were administered. Subjects reporting their typical seizure pattern to be three or more seizures within a 24-h period were classified as clusterers. Magnetic resonance imaging (MRI) and EEG data were obtained, and epilepsy was classified by International League Against Epilepsy (ILAE) criteria. All subjects completed Beck Anxiety and Depression Inventories, and Quality of Life in Epilepsy testing. RESULTS: Overall, 29% of subjects reported typical seizure clustering. Extratemporal lobe epilepsy [p = 0.02; OR, 3.0 (1.1-7.8)] was significantly associated with reported seizure clustering. Remote symptomatic epilepsy was associated with clustering [p = 0.03; OR, 2.3 (1.1-4.3)], particularly in association with a history of head trauma with loss of consciousness before epilepsy onset [p = 0.003; OR, 4.2 (1.6-11.1)], although this analysis was limited. Reported clustering was significantly associated with a history of convulsive status epilepticus (SE) [p = 0.029; OR, 3.0 (1.1-8.3)], other seizure-related hospitalization [p = 0.006; OR, 5.3 (1.5-17.6)], and worse seizure control (p = 0.004). Quality-of-life measures were not significantly associated with reported clustering. CONCLUSIONS: These preliminary results identify extratemporal epilepsy and possibly head trauma as potential risk factors for reported seizure clustering and indicate a significant association between reported clustering and convulsive SE. Additionally, seizure clustering appears to be a marker for more intractable epilepsy. The ongoing diary study will refine the definition of seizure clustering and further evaluate specific predictors of poor and favorable outcomes of clustering.     

Special education needs of children with newly diagnosed epilepsy

Children with epilepsy often experience poor social and educational outcomes. This study aimed to determine the timing of services with respect to the onset of seizures. It also aimed to identify the aspects of childhood epilepsy (type of epilepsy, etiology, seizure control, and treatment) that are associated with the use of special education services. As part of a prospective community-based study, 613 children were recruited when first diagnosed with epilepsy. Mean age at first seizure was 5 years 11 months (SD 4, range 1mo to 15y 8mo). Parents were interviewed 5 years after children were first diagnosed with epilepsy (n=542; 276 [51%] males). Children's mean age at time of interview was 11 years 10 months (SD 4y 1mo, range 5y 8mo to 21y 8mo). Etiology was classified as idiopathic (n=181, 33.4%), cryptogenic (n=261, 48.2%), and remote symptomatic (n=100, 18.5%). Service use was reported in 315 (58%) children. Compared with neurologically intact children (i.e. cryptogenic and idiopathic etiology; n=415, 77%), children with a remote symptomatic etiology and/or an epileptic encephalopathy (n=127, 23%) received services more frequently (88% vs 49%, p<0.001). In the former group, services were initiated for 66 (15%) children before their first seizure; according to age at onset, services were initiated before the first seizures in 12/164 (7.3%) if <5 years, 34/171 (19.9%) if 5-9 years, and 20/80 (25%) if >10 years. A large proportion of children with epilepsy, even if neurologically otherwise normal, receive special education services. Initiation of services often precedes onset of seizures even in neurologically intact children. This suggests that behavioral and cognitive abnormalities may predate the onset of epilepsy and are not necessarily the direct consequences of epilepsy.     

Comments on risk for schizophrenia

Recent developments have significantly furthered understanding of genetic and environmental factors affecting risk for schizophrenia. Environmental effects, such as immigration, living in a city, and substance abuse have been found to be associated with later schizophrenia. Although the highest risk for schizophrenia is still having a monozygotic twin with schizophrenia (50%), the candidate genes claimed to be associated to date only yield a very small excess risk and all of these effects (environmental and genetics) increase the risk for schizophrenia by only 2-3 fold. Thus, given the low prevalence of the disorder in the general population (0.5-1%), they are not practical in predicting future illness. One possible strategy to make the currently known risk factors for schizophrenia more useful clinically is based on findings indicating that many of the genetic and environmental risks cited above are not specific for schizophrenia, but increase risk for psychopathology in general. As up to 50% of the general population will be affected during their lifetime by a condition defined in DSM IV as psychopathology, due to this much higher base rate, factors increasing risk by 2-3 fold might become clinically relevant.