Ultrastructural evidence of dopaminergic input to enkephalinergic neurons in rat neostriatum

The synaptic relationship between neuronal structures reacting with antibodies to tyrosine hydroxylase (TH) and Leu- or Met-enkephalin (ENK) was studied by the 'mirror technique' in adjacent sections of rat neostriatum. TH-immunoreactive (TH-IR) axonal boutons surrounding the neural perikarya and proximal dendrites of ENK-immunoreactive (ENK-IR) neurons were very thin (0.1-0.4 micrograms). They contained many small clear vesicles and sometimes had symmetrical membrane specializations. This provides morphological evidence for catecholaminergic, presumably dopaminergic inputs to rat striatal enkephalin neurons.     

运用双杂交系统探寻与内皮素A型受体相互作用的蛋白质

目的：运用酵母双杂交系统寻找与内皮素Ａ型受体（ｅｎｄｏｔｈｅｌｉｎｔｙｐｅＡｒｅｃｅｐｔｏｒ，ＥＴａＲ）相互作用的蛋白质，为探讨心血管等疾病的致病机理及采取相应的治疗策略提供理论依据，方法：首先将ＥＴＶＲ胞内区ｃＤＮＡ片段克隆入ｐＧＢＴ９质粒载体中，得到的重组质粒ｐＧＢＴ９－ＥＴｖＲ转化酵母菌ＨＦ７Ｃ，然后将鼠胚胎文加质粒转化到ＨＦ７Ｃ（ｐＧＢＴ９－ＥＴｖＲ）中，用Ｔｒｐ＾－Ｌｅｕ＾－Ｈｉｓ＾－营     

Problematic resident-patient relationships

OBJECTIVES: The objectives of the study were to identify the characteristics of a problematic doctor-patient relationship from the perspective of primary care patients who are cared for by medical residents and to determine whether patients' perception of the relationship is a function of their demographic, clinical, or social attributes. DESIGN: Cross-sectional survey. SETTING: An adult primary care practice in an academic medical center. PATIENTS: One hundred fifty-one patients whose primary care physicians were senior internal medicine residents. MEASUREMENTS AND MAIN RESULTS: Patients completed a questionnaire addressing several aspects of their doctor-patient relationship, the general health perception item on the SF-12, and items on social support from the Duke Social Support and Stress Scale. By design of the study, approximately half of the patients had been identified by their physicians as being in problematic relationships (n = 74) and half as being in satisfying relationships (n = 77). Among patients in relationships described as satisfying by their resident, 10% viewed the relationship as problematic. Of the patients involved in relationships described as problematic by the resident, 23% viewed their relationship as problematic (P = .03). Patients who rated the relationship as problematic were much more likely to also report low social support compared to patients involved in relationships described as satisfying (76% vs 16%; P < .001). Compared to residents involved in relationships described as satisfying by their patients, residents in problematic relationships were more likely to be described as being less accessible and less capable of handling medical complaints (P < . 001). CONCLUSIONS: Patients were more likely to describe the doctor-patient relationship as problematic if they felt that the resident was less accessible or less capable of handling medical complaints, or if they had low self-perceived social support.     

儿童少年行为问题中的遗传-家庭亲密度交互作用研究

目的研究儿童少年行为问题的影响因素中，遗传因素与家庭亲密度之间是否存在交互作用。方法分别采用Achenbach儿童行为量表和家庭环境量表中文版亲密度分量表对多级随机抽样的64对双生子进行评定，并分析遗传因素与家庭亲密度之间的关系。结果双生子的家庭亲密度为（6．66±1．91），低于中国常模（P〈0．001）。不同卵性双生子家庭亲密度的差异无统计学意义（P〉0．05）；在低亲密度及高亲密度家庭环境中，儿童少年的行为问题遗传度分别为0．88和0．75，前者的遗传度高于后者。结论双生子家庭亲密度低于非双生子家庭；儿童少年行为问题的遗传因素与家庭亲密度之间可能存在交互作用。     

Retrospective assessment of potential interaction between levofloxacin and warfarin

Objective There is currently a controversy regarding interactions between levofloxacin and warfarin. The aim of this study was to determine the clinical relevance of this interaction in our setting. Setting A university hospital in Barcelona, Spain. Methods We carried out a retrospective evaluation of all patients hospitalized in our hospital during the period 2000–2005, selecting all those concomitantly treated with levofloxacin and warfarin for the study. The following data were compiled: demographic information, concomitant medication, comorbid conditions, and relevant analytical parameters, particularly the international normalized ratio (INR), including values taken before, during, and after concomitant administration of the two study drugs. Patients for whom INR values during concomitant administration were not available were excluded. Differences in INR before and during the potential interaction, and before and after the interaction were analyzed with the Wilcoxon t test using SPSS (V12.0). In addition, patients were stratified according to presence or not of toxic habits (smoking/alcohol consumption) to investigate the possible impact of these factors on the interaction under study. Results Among the 30 patients identified, 9 were excluded because INR data during concomitant administration of warfarin and levofloxacin were not available. Statistical analysis demonstrated significant increase in INR (P = 0.001) following addition of levofloxacin to warfarin therapy. Conclusions. The results of this study reaffirm the hypothesis that concomitant administration of levofloxacin and warfarin leads to INR increase; hence close monitoring of INR is advisable when patients are prescribed this combination of drugs. This paper has not been submitted elsewhere in similar form, and all authors have contributed significantly to the publication. All authors are aware of the submission and agree with it.     

Emanuel Miller Lecture Developmental Risks (Still) Associated with Early Child Care

In the mid to late 1980s a major controversy erupted when Belsky's (1986, 1988. 1990) analysis of research produced the conclusion that early and extensive nonmaternal care carried risks in terms of increasing the probability of insecure infant-parent attachment relationships and promoting aggression and noncompliance during the toddler, preschool, and early primary school years. Widespread critiques of Belsky's analysis called attention to problems associated with the Strange Situation procedure for measuring attachment security in the case of day-care reared children and to the failure of much of the cited research to take into consideration child-care quality and control for background factors likely to make children with varying child-care experiences developmentally different in the first place. In this lecture, research concerning the developmental effects of child care and maternal employment initiated in the first year of life that has emerged since the controversy broke is reviewed. Evidence indicating that early, extensive, and continuous nonmaternal care is associated with less harmonious parent-child relations and elevated levels of aggression and noncompliance suggests that concerns raised about early and extensive child care 15 years ago remain valid and that alternative explanations of Belsky's originally controversial conclusion do not account for seemingly adverse effects of routine nonmaternal care that continue to be reported in the literature.     

Integration of information from both eyes by single neurons of nucleus rotundus, ectostriatum and lateral neostriatum in the zebra finch (Taeniopygia guttata castanotis Gould)

Although the optic nerve in birds crosses completely, visual information from the ipsilateral eye also reaches the ectostriatum, the telencephalic statibon of the tectofugal pathway, by recrossing fibers. These recrossing projections connect the contralateral tectum opticum with the ipsilateral nucleus rotundus, which in turn projects to the ectostriatum. The ectostriatum itself projects to the overlying lateral neostriatum, an area which serves an important role in sexual imprinting. This study shows that contralateral and ipsilateral information converges on single neurons within the nucleus rotundus, the ectostriatal region and the lateral neostriatum. In the three brain areas almost all isolated neurons exhibited responses to contralateral as well as bilateral visual stimuli. The number of neurons responding to ipsilateral stimuli increases from nucleus rotundus to the lateral neostriatum. We did not find any neurons driven exclusively by ipsilateral stimuli. The strength of ipsilateral responses is rather weak within the nucleus rotundus and ectostriatum, but shows a sharp increase in the lateral neostriatum. For most neurons of nucleus rotundus and ectostriatum, an additional ipsilateral stimulus did not significantly affect the response to a contralateral one. In contrast, a strong excitatory effect can be found in the neostriatum. The results are in agreement with previous evoked-potential studies and give new insights on the integration of ipsilateral and contralateral stimuli in zebra finch tectofugal visual pathway.     

Parameters influencing polymer particle layering of the dry coating process

The dry coating process is an emerging coating technology using neither organic solvents nor water. In contrast to liquid-borne coatings, coating material application and film formation are divided into two phases, the coating phase where the powdery coating material is applied together with the liquid plasticizer, and the curing phase. In this study the coating phase was characterized with respect to the forces acting between the polymer particles during material application. Atomic force microscopy was conducted measuring the interparticle forces which were related to the coating efficiency. The influence of different liquid additives on the interparticle forces and the coating efficiency were evaluated. HPMCAS was used as enteric resistant polymer, triethylcitrate (TEC), Myvacet (diacetylated monoglyceride) and a mixture of both as liquid additives. Interparticle forces were found to be similar when using TEC or a mixture of TEC and Myvacet. In contrast, interparticle forces were higher when using solely Myvacet. This is attributed to the fact that Myvacet does not penetrate into the polymer without TEC which is acting as a penetration enhancer. As Myvacet remains predominantly on the particle surface, capillary forces act between the particles explaining high interparticle forces. The highest interparticle force determined by AFM is in accordance to the highest coating efficiency which has been found for the corresponding coating formulation containing HPMCAS and Myvacet. Consequently, it is demonstrated that the ability of the liquid to remain on the surface of the polymer and to build up capillary forces is crucial for the material application.     

The effects of moclobemide on the pharmacokinetics of the 5-HT1B/1D agonist rizatriptan in healthy volunteers

AIMS: The new 5-HT1B/1D agonist rizatriptan (MK-0462) has recently been registered for the treatment of migraine. Its primary route of metabolism is via monoamine oxidase-A (MAO-A). Antidepressants such as the MAO-A inhibitor moclobemide may be used in patients with chronic headache syndromes. Hence, this study aimed to investigate the interactions between rizatriptan and moclobemide. METHODS: In a double-blind, randomized, placebo-controlled, two-period cross-over study 12 healthy, young volunteers (six males, six females) were treated with moclobemide (150 mg twice daily) or placebo for 4 days. On the fourth day, a single dose of rizatriptan (10 mg) was administered, and subsequently blood and urine samples were collected for assay of rizatripan and N-monodesmethyl rizatriptan. Plasma concentrates of 3,4-dihydroxyphenylglycol (DHPG), a marker of MAO-A inhibition, were also assessed. Supine and standing blood pressure were measured regularly. RESULTS: Both treatments were well tolerated. During moclobemide, the increase in supine diastolic blood pressure following rizatriptan administration was augmented. Inhibition of MAO by moclobemide was inferred from a persistent decrease in DHPG level (43% on average). When rizatriptan was coadministered with moclobemide, the area under the plasma drug concentration-time profiles for rizatriptan and its N-monodesmethyl metabolite increased 2.2-fold (90% CI, 1.93-2.47) and 5.3-fold (90% CI, 4.81-5.91), respectively, when compared with placebo. Peak plasma drug concentrations for rizatriptan and its n-monodesmethyl metabolite increased 1.4-fold (90% CI, 1.11-1.80) and 2.6-fold (90% CI, 2.23-3.14), respectively, and half-lives of both were prolonged. CONCLUSIONS: Moclobemide inhibited the metabolism of rizatriptan and its active N-monodesmethyl metabolite through inhibition of MAO-A. Thus, moclobemide may considerably potentiate rizatriptan action. Concurrent administration of moclobemide and rizatriptan is not recommended.     

Improving the nurse‐patient relationship: a multi‐faceted approach

Aim: A Corporate Education Session was held to provide concrete strategies for overcoming several specific barriers in the daily nurse‐patient relationship that negatively affect the patient, nurse, or both, and to provide the latest information about best practice as it affects nurses in renal care. Methodology: The session was led by a moderator who presented three video case studies to the audience. Communication strategies for recognising and overcoming nurse‐patient communication barriers were presented. The audience expressed their views about each case study using voting pads, and a panel of experts addressed the comments of the audience and discussed guidelines for best practice in renal care. The panel comprised three experienced renal nurses, a senior nephrologist, and an expert in social interaction. Conclusions: Optimal treatment of patients with renal disease should include early treatment of anaemia, adequate levels of dialysis, and a multidisciplinary approach, responding to both the medical and the social needs of the patient.