Relationships of plasma tryptophan availability to course of illness and clinical features of alcoholism: a preliminary study

Rationale: Serotonergic (5-HT) mechanisms may be involved in impulse control (including anti-social behavior) across psychiatric syndromes. Age of onset may differentiate alcoholics on psychopathological characteristics associated with impulse control, especially mood disturbance, hostility, and a broad range of antisocial behaviors. Thus, there may be a predictable relationship between markers of 5-HT function and age of onset-related characteristics. Objective: We tested the hypothesis that there would be a predictable relationship between the ratio of plasma tryptophan to large neutral amino acids (i.e. TRYP/LNAA ratio), a marker of 5-HT function, age of onset and related psychopathological characteristics associated with impulse control. Methods: Fifty-eight male and female DSM-IV diagnosed alcoholics attending an outpatient treatment center completing a comprehensive psychopathological assessment, and from whom blood samples were obtained. Results: Plasma TRYP/LNAA ratio was positively correlated with symptoms of dysphoria, and negatively associated with harm avoidance on Cloninger’s Temperament and Character Inventory. Low tryptophan availability was associated with antisocial-type personality characteristics. Interestingly, the few (nine) subjects who had both early onset alcoholism and antisocial personality disorder had a higher plasma tryptophan but similar TRYP/LNAA ratio to the others. Conclusions: These data suggest that a low plasma TRYP/LNAA ratio is associated with susceptibility to anxiety, antisocial-type personality characteristics, and an early age of onset for alcoholism. In contrast, a high plasma TRYP/LNAA ratio is associated with a later onset of alcoholism and dysphoria. Received: 26 May 1998/Final version: 24 November 1998     

Prevalence of self-reported back pain in school children: A study of sociodemographic differences

The study considers the prevalence of back pain experienced in a nationwide random sample of 2173 Icelandic school children aged 11–12 and 15–16. The study found a 20.6% prevalence of at least weekly back pain. The prevalence of back pain was significantly more frequent among the older children. No gender or class difference was found in the overall sample. Older children from rural areas have significantly more back pain than those living in the city. The need for a thorough epidemiological investigation of the association of back pain in children is emphasized.     

Knee pain and its associations with age,sex, obesity,occupation and living conditions in rural inhabitants of Japan

Factors associated with knee pain were investigated using 871 self-administered questionnaires (405 men and 466 women) from residents aged over 30 years in a rural area of Japan. The prevalence of knee pain increased with age, particularly in women over 50. It was significantly higher in women than in men. Body mass index (BMI) was significantly related to knee pain in women, though not in men. With reference to occupational factors, frequent heavy lifting on the job was significantly associated with knee pain in both men and women, whereas job-related standing and walking showed no such relationship. As for living conditions, residence on rather steep mountain slopes and the habit of sitting on Japanese tatami mats were significant factors related to knee pain in men, but not in women. There was no association of knee pain with the style of toilet (Japanese or Western). After controlling for all significant factors by multiple logistic regression analysis, age, heavy lifting, and residence on steep slopes were found to be independent factors related to knee pain in men; and age, BMI, and heavy lifting were the factors in women.     

Epilepsies with astatic seizures of late onset.

In 17 patients with a long course of epilepsy astatic seizures became apparent after the age of 14 years. In the patients' childhood astatic seizures had not been observed. The patients suffered from epilepsies with absences and awakening grand mal or psychomotor fits and sleeping grand mal. The EEG revealed spike-wave variant and spike-and-wave complexes as in the Lennox-Gastaut syndrome. Age dependency of Lennox-Gastaut syndrome is discussed. The described type of epilepsy can be understood as a "Lennox-Gastaut syndrome of late onset".     

Contributions of chronological age,age at menarche and menopaus and of anthropometric parameters to axial and peripheral bone densities

Bone mineral density (BMD) was measured in 128 normal postmenopausal women at different skeletal sites: lumbar spine and proximal femur, using dual-energy X-ray absorptiometry (DXA), and the cancellous and cortical envelopes of the distal third of radius and tibia, using precise low-dose quantitative computed tomography (QCT). Multivariate analysis included chronological age, ages related to menstrual history (menopause and menarche) and anthropometric factors, e.g. height and weight, as independent predictive variables. Weight is a much-studied predictor of bone density. At sites of high bone turnover, i.e. cancellous envelope, the effect of weight appeared overshadowed by estrogen-related parameters: age-past-menopause was the first predictor of BMD in the cancellous compartment of radius and in Ward's triangle, and the number of reproductive years was the strongest predictor of BMD in the cancellous compartment of tibia and in the spine (L2–4). This suggests that in addition to menopause, the length of menstrual life should be considered as an explanation for the variations in current bone mass in postmenopausal women.At the cortical level of radius, the effect of chronological age was predominant. At the cortical level of tibia, height and weight were the best predictors of BMD.We conclude that the influence of parameters related to menstrual history is predominant in sites with mainly cancellous tissue and that anthropometric factors constitute the best predictors of BMD in the cortical sites of weight-bearing bones.     

Effect of age on levels of diazepam in plasma and brain of rats

Summary The pharmacokinetics and distribution in brain and cerebellum of diazepam after a single dose were studied in middle aged (6 months) and old (18 months) rats. Following the single intravenous bolus of 5 mg/kg diazepam was eliminated more slowly in old rats (T _1/2()=3.1h) than in middle aged rats (1.4 h). This was due to an increase in the apparent volume of distribution Vd from 11.0 l/kg (control rats) to 29.5l/kg. Concentrations of diazepam in brain and cerebellum were in the same range (0.5–1.1 ng/mg) in both groups after this dose. We conclude that the distribution of diazepam is age-dependent which might be due to an altered body composition.     

Steady-state kinetics of imipramine in patients

Steady-state plasma level kinetics were studied in 76 patients given imipramine (IP) 150 to 225 mg/day for 2–5 weeks. IP was given in three divided doses at 8.00 a.m., 1.00 p.m. and 5.00 p.m. Plasma concentrations of IP and its active metabolite desipramine (DMI) were determined by quantitative in situ thin-layer chromatography. The plasma levels of IP and DMI showed pronounced flucutations throughout the day with a ratio of about 2 between highest and lowest level. Patients with steady-state levels of IP and/or DMI below 50 g/l reached this within 1 week of treatment. Patients with higher steady-state levels reached steady-state concentrations within 2–3 weeks. There were some intraindividual fluctuations in plasma levels from week to week after steady state had been reached (coefficient of variation: 10–20%). Interindividually, the steady-state levels corrected to a dose of 3.5 mg/kg per day varied considerably: IP: 6–356 g/l, DMI: 24–659 g/l and IP+DMI: 58–809 g/l. The steady-state plasma levels showed a skew distribution that became normal by logarithmic transformation. The IP/DMI ratio ranged from 0.07 to 5.5 with a median value of 0.47. Compared to data from amitriptyline treated patients the IP/DMI ratios had significantly lower median value and larger variation than the corresponding plasma level ratios of amitriptyline/nortriptyline. Several statistically significant differences in steady-state levels between age groups were found. For IP: Women aged 30–39 had lower levels than women aged 20–29, 40–49, and 50–59, and men aged 50–59 and 60–65; men aged 30–39 had lower levels than men aged 60–65. For DMI: Women aged 30–39 had lower levels than women aged 50–59.     

51例老年子宫内膜癌临床分析

目的 :分析老年子宫内膜癌的临床特点、病理类型及处理方法 ,以期进一步指导临床治疗。方法 :对 131例子宫内膜癌患者中≥ 6 0岁 5 1例 (老年组 )进行回顾性研究并与同期≤ 5 0岁的 35例 (中青年组 )做对照分析。全部手术切除的标本均经病理检查确诊。结果 :老年组与中青年组临床分期 ,Ⅱ期以上的分别为 2 9 4 %(15 / 5 1)和 11 4 %(4/ 35 ) ;组织分级G2 -G3分别为 6 8 6 %(35 / 5 1)和 45 7%(16 / 35 ) ;子宫肌层浸润深度大于 1/ 2的分别为 43 1%(2 2 / 5 1)和 2 0 0 %(7/ 35 ) (P <0 0 1) ;5年存活率分别为 6 6 6 %和 91 4 %(P <0 0 5 )。结论 :老年子宫内膜癌的预后较中青年妇女的子宫内膜癌差 ,与临床分期晚和组织分化差有关。     

≤30岁女性乳腺癌患者的临床病理特征和预后

目的探讨≤30岁青年女性乳腺癌患者的临床病理特征与预后的关系.方法应用回顾性研究及统计学分析的方法,研究1988年1月1日～2002年12月31日间169例30岁及以下女性乳腺癌的临床特点、病理特征及其对预后的影响因素.结果≤30岁女性乳腺癌总的3,5,10年生存率分别为64.4%、55.9%和53.4%,平均生存时间为(110.39±9.22)个月.单因素分析显示,其预后与患者是否结婚、是否处于妊娠哺乳期以及肿瘤的病理分期、肿瘤大小、淋巴结转移情况有相关性.结论患者是否结婚、是否处于妊娠哺乳期及肿瘤的病理分期是影响30岁及以下女性乳腺癌患者术后生存的独立因素.     

中青年与老年非吸烟女性肺癌危险因素的比较研究

目的 分析比较中青年和老年非吸烟女性肺癌的危险因素。方法 于1992年2月～1993年12月，在上海市区完成了一项大规模全人群女性肺癌病例对照研究，共调查了非吸烟女性肺癌病例504例及人群对照601例。根据年龄把研究对象分为两组，35～54岁和55～69岁组，并分析比较两组的结果。单因素分析采用Mantel—Haenszel分层分析法，进一步调整混杂因素采用多变量logistic回归模型。结果分析结果显示，中青年组危险因素是做饭时眼和喉烟雾刺激感，最高一组比数比为3．40；其次是肺癌家族史，比数为5．80。而保护因素是饮茶(OR：0．40)和活产次数(5次及以上组OR：0．39)。老年组的危险因素主要是：高身体指数(最高一组OR：1．69)、工作场所被动吸烟史(OR：1.55)、厨房在卧室内(OR：1．50)、做饭时厨房内烟雾较多(OR：2．43)、菜油为主要食用油(OR：1.94)等。此外。肺结核病史和肺癌家族史可能增加老年女性患肺癌的危险性。保护因素是维生素C(最高一组OR：0．45)，趋势检验有统计学意义。中青年组和老年组肺癌的结果比较表明，无论是危险因素还是保护因素，两者都有不同。结论 中青年和老年非吸烟女性肺癌的病因可能存在一定的差异。