Study of the connections of supposed diencephalic connections of the limbic system of the lizard using the technic of axonal transport of horseradish peroxidase

Connections of the anterior thalamic (n. dorsolateralis anterior, n. dorsomedialis) and habenular nuclei in lizards Ophisaurus apodus were studied by means of HRP administration into these nuclei. It was shown that all nuclei have overlapping locations of afferent sources (basotelencephalic structures, nuclei of anterior and hippocampal commissures, lateral area of the hypothalamus, superior raphe nucleus) and overlapping projectional zones (mammillary complex, ventral tegmental area). Besides common connections, specific ones for separate nuclei were revealed: for n. dorsolateralis anterior-reciprocal connection with dorsolateral hypothalamic nucleus, for habenular nuclei-projection to the interpeduncular nucleus, for n. dorsomedialis-projection to the dorsal hypothalamic area. No mammillary afferents were found for the anterior thalamic nuclei. All the nuclei studied are considered as diencephalic relay links of pathways which can be compared with dorsal (for habenular nuclei) and ventral (for anterior thalamic nuclei) pathways of the limbic system in mammals.     

Advance of SPECT: differential diagnosis and evaluation of pathophysiology of neurodegenerative disorders]

Development of the new radiopharmaceuticals and the statistical analysis techniques for the brain SPECT were reviewed. Both 123I-beta-CIT and 123I-FPCIT SPECT demonstrate the neuronal degeneration of the presynaptic dopaminergic system. The preclinical trials are on-going for the differentiation between essential tremor and Parkinsonian patients. 123I-iomazenil was approved by the Japanese Minister of Health, Labour and Welfare in Aril 2004, only for the use of epileptic patients considered surgical treatment. Both SPM and 3D-SSP are powerful techniques for statistical analysis of the brain perfusion SPECT. They are helpful for the detection of the functional alteration in neurodegenerative disorders, and useful for the differentiation between the Parkinsonian patients, including PD, MSA, PSP and CBD. Hypoperfusion in the posterior cingulated cortex can be also easily demonstrated by these techniques in Alzheimer's disease. 3D-SRT is a technique using the anatomical standardization and ROI template consisting 636 ROIs for the whole brain. Although this technique was originally developed for the evaluation of the acetazolamide test, it can be used for the evaluation of the perfusion pattern in neurodegenerative disorders.     

阿尔马尔治疗原发性震颤30例临床观察

目的 观察阿尔马尔治疗原发性震颤的疗效和安全性。方法 采用多中心开放试验，对30例原发性震颤患者给予阿尔马尔10mg，每日一次，共4周。对疗效不好者，从第3周开始增加剂量至15mg每日一次，总计6周。于治疗前及治疗后第2，4，6周进行症状评分。结果 阿尔马尔治疗原发性震颤的总有效率为73．4％，而且对正常的血压和心率无明显影响，不良反应轻微。结论 阿尔马尔是治疗原发性震颤的有效药物，服用方便而且安全。     

Analysis of clinico-social features of epilepsy

The authors studied 286 patients with epilepsy with disease onset past the age of 20 years (176 males, 110 females) from the urban and rural populations. In 57% of cases the aetiology of epilepsy was undetermined. Among the known aetiological factors head trauma accounted for 15.5% of cases, inflammatory processes in the central nervous system for 4.5%, alcoholism for 7%, vascular lesions for 6%, tumours for 5.2%, degenerative and atrophic changes for 1.5%. Over 40% of patients had had attacks for up to 15 years and over 18% for over 20 years. In 80% of cases grand mal seizures occurred, and in 33% of these cases more than 12 attacks occurred annually. Six cases of status epilepticus were observed with 2 deaths. The attacks were precipitated by menstruation, alcohol abuse, infection, stressed, television watching. Among the signs accompanying or following the seizures tongue biting and urination prevailed. Neurological signs were demonstrated in 21% of cases, encephalopathy in 65%, other psychic disturbances in 9.5%. Systematic treatment was received by 75% of the patients (over 80% in urban population), and therapy with multiple drugs was most frequent. Drug-resistant epilepsy was found in 34% of cases. The patients from the rural population had a lower educational level and had more children. About 70% of the patients were in employment.(ABSTRACT TRUNCATED AT 250 WORDS)     

维思通治疗首发精神分裂症的疗效观察

目的 初步研究在门诊应用维思通治疗首发精神分裂症疗效和安全性。方法 ２８例病人用维思通治疗８周,用ＰＡＮＳＳ评定疗效,ＥＳＲＳ和实验室检查评价不良反应。结果 维思通对“阳性亚型”疗效较好,对阴性分裂闰状也有效,不良反应有轻度锥体外系反应,其他不良反应少见。结论 维思通对首发精神分裂症疗效较好,适合依从性好的病人在门诊中使用。     

Sources of unreliability of DSM-III Axis IV

Lists of stressors recorded for 159 adolescents and rated by two judges showed poor agreement on stressor identification but good concordance for the most severe stressor identified for each patient. Good agreement was also found for a short checklist of chronic stressors. When individual stressors were rated by four judges for 27 patients, global Axis IV ratings were largely determined by the rating of the most severe event. Those results suggest that Axis IV can be made more reliable and easier to use by concentrating on the identification of severe events.     

Clinicopathological validation study of four sets of clinical criteria for vascular dementia.

OBJECTIVE: The authors' goal was to validate the clinical criteria for vascular dementia of the State of California Alzheimer's Disease Diagnostic and Treatment Centers (ADDTC), the National Institute for Neurological Disorders and Stroke-Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN), DSM-IV, and ICD-10. METHOD: Sensitivity and specificity were assessed by comparing the clinical with the neuropathological diagnosis of 89 autopsied patients with dementia from a geriatric and psychiatric hospital. All cases were reviewed by a clinician and a neuropathologist who were blind to each other's findings. RESULTS: Neuropathologically there were 20 cases of vascular dementia, 23 cases of mixed dementia, and 46 cases of Alzheimer's disease among the autopsied patients. The sensitivity was 0.50 for DSM-IV criteria for vascular dementia, 0.70 for ADDTC criteria for possible vascular dementia, 0.55 for NINDS-AIREN criteria for possible vascular dementia, 0.20 for ICD-10 criteria for vascular dementia, 0.25 for ADDTC criteria for probable vascular dementia, and 0.20 for NINDS-AIREN criteria for probable vascular dementia. Specificity was 0.84, 0.78, 0.84, 0.94, 0.91, and 0.93, respectively. The proportion of cases clinically classified as vascular dementia ranged from 0% to 13% for neuropathologically confirmed cases of Alzheimer's disease and 9% to 39% for neuropathologically confirmed cases of mixed dementia. There was no statistically significant relationship between the neuropathological diagnosis and three of the clinical criteria sets studied (ICD-10 criteria for vascular dementia and ADDTC and NINDS-AIREN criteria for probable vascular dementia). CONCLUSIONS: Clinical criteria for vascular dementia are not interchangeable. The ADDTC criteria for possible vascular dementia are the most sensitive for the detection of vascular dementia; however, the DSM-IV criteria for vascular dementia and the NINDS-AIREN criteria for possible vascular dementia may be more effective in excluding mixed dementia. Given their inability to detect the vast majority of cases of vascular dementia, the ICD-10 criteria for vascular dementia and the ADDTC and NINDS-AIREN criteria for probable vascular dementia should be revised.     

Effect of pleasant odors on mood of males at midlife: Comparison of African-American and European-American men

The purpose of this study was to determine if daily use of colognes could elevate mood in middle-aged men. Sixty men ranging in age from 40 to 55 years participated in the study. Half were European-American and half were African-American. Mood ratings were obtained twice daily for 12 days using the Profile of Mood States questionnaire (POMS). The first 2 days of the experiment were used as baseline information to establish each man's mood prior to the administration of the colognes. The following 10 days of the study consisted of two conditions of 5 days each, the fragrance condition and the placebo condition. Main effects of condition (baseline, fragrance, placebo) were found for all POMS factors including tension, depression, anger, vigor, fatigue, and confusion, as well as for the Total Mood Disturbance score (TMD). The scores for the fragrance condition were significantly better than those for the baseline condition for tension, depression, anger, fatigue, and confusion factors, as well as for the TMD. Also, the scores for the fragrance condition were significantly better than those for the placebo condition for all factors and the TMD. There was a main effect for race, with European-American subjects having significantly worse scores for tension and fatigue and significantly better scores for depression than African-American subjects. An interaction was present between race and condition for the depression, vigor, and confusion factors. The main conclusion of this study was that use of pleasant odors improved the mood of males at midlife.     

Accuracy of four clinical diagnostic criteria for the diagnosis of neurodegenerative dementias.

OBJECTIVE: To evaluate the inter-rater reliability and validity of clinical diagnostic criteria for neurodegenerative dementias. BACKGROUND: Inter-rater accuracy of the diagnosis of AD has been explored, but there are few accuracy studies for progressive supranuclear palsy (PSP) and frontotemporal lobe dementia (FTD). Furthermore, there have been no simultaneous accuracy studies in a mixed sample of patients with cortical and subcortical neurodegenerative processes. METHODS: Four experienced clinicians reviewed first-visit clinical data abstracted from the records of 40 pathologically diagnosed demented subjects. They were asked to apply the NINCDS-ADRDA criteria for AD, the NINDS-SPSP clinical criteria for PSP, the Lund and Manchester criteria for FTD, and the Consensus Guidelines for the Clinical Diagnosis of Dementia with Lewy Bodies (DLB). Results: The generalized K for AD was 0.73, for PSP 0.82, for FTD 0.75, and for DLB 0.37. The K pool test showed a statistically significant difference between DLB and the other disease processes, and no differences were observed among AD, FTD, and PSP. The mean sensitivity for AD was 95%, for PSP 75%, for FTD 97%, and for DLB 34%. The mean specificity for AD was 79%, for PSP 98.5%, for FTD 97%, and for DLB 94%. CONCLUSIONS: We found improved inter-rater reliability for the diagnosis of AD among clinicians compared with earlier studies. Similarly, there was a near-perfect and substantial inter-rater agreement for the diagnosis of PSP and FTD. The sensitivity for the diagnosis of AD was high, although clinicians overdiagnosed this condition. However, there was a reasonable accuracy for the diagnosis of PSP and FTD. Heterogeneity of the clinical presentation of DLB significantly affected inter-rater agreement and accuracy. The use of multiple diagnostic criteria for cortical and subcortical dementia increases the level of clinical diagnostic accuracy.     

Survey of attitudes of nurses working with AIDS patients

This article reports the results of a ten-question anonymous survey given to nurses at Westchester County Medical Center in July 1983 and January 1984 concerning attitudes about caring for AIDS patients. Two-thirds of the responding nurses reported that they had friends or family express concern about associating with hospital personnel who have contact with AIDS patients. Other questions showed that between one fourth and one half of nurses have a fear of caring for homosexual men and male prisoners because of their awareness about AIDS. One half of the nurses believe that AIDS can be transmitted to hospital personnel because of contact with patients despite precautions. The fear of caring for patients with AIDS as compared to caring for patients with hepatitis, a more contagious but less serious disease than AIDS, was highest in the intensive care unit staff. Eighty-five percent of the health care personnel responding believed that pregnant nurses should not care for AIDS patients and one half of the nurses responding indicated that they would ask for a transfer if they had to care for AIDS patients on a regular basis. The implication of these findings for future treatment programs, medical and nursing education and psychologic support for staff are discussed.     

Post mortem degradation of nucleosides in the brain: comparison of human and rat brains for estimation of in vivo concentration of nucleosides

There is an increasing attention paid for nucleoside metabolism and changes of nucleoside concentrations in human brain because of its pathological and physiological relevance. In order to determine the post mortem degradation of nucleosides and nucleoside metabolites, the concentrations of four nucleosides and three nucleobases were measured in rat and neurosurgical human cerebral cortical samples with 30s to 24h post mortem delay. Adenosine degradation coefficient (a multiplying factor for calculating concentrations of investigated substances for the living state) was 0.886 for human brain at 2 h post mortem time, while it was 1.976 for rats. Hypoxanthine, an adenosine degradation product had coefficients 0.564 for human brain and 0.812 for the rat brain. We provide data and degradation coefficients for the concentrations of adenosine, guanosine, inosine, uridine, uracil, hypoxanthine and xanthine with 2, 4, 6 and 24 h post mortem delay. We also report a method how to validate human neurosurgical brain samples in terms of sample preparation and statistical analysis.     

Dynamics of the efferent regulation of muscle contraction. Analysis of transition processes: frequency of efferent stimulation--muscle length

Transition processes of the length changes were studied in the ankle extensors of anesthetized cats. The processes were evoked under isotonical conditions by step changes in frequency of distribution stimulation of the efferents supplying these muscles. The system dynamics was essentially nonlinear because the time constants of the processes were dependent on amplitudes and sign of the input signal. The time constants abruptly decreased when the sign of the length changes alternated from minus to plus and continuously decreased when amplitude of the transition process rose in the absolute value. The time constants for the transition processes were 1.15 +/- 0.09 s for soleus shortening and 0.40 +/- 0.07 s for its lengthening. The same parameters in fast muscles were 0.51 +/- 0.085 for shortening and 0.21 +/- 0.04 s for lengthening. These time constants are very close to the parameters of the transition processes: external load-muscles length. The observed properties of the muscles are discussed for their functional significance.     

Histochemical characteristics of mandibular muscles of monkeys

Histochemical profiles were obtained for several jaw closing muscles and for one jaw opening muscle. The jaw closing muscles were found to vary widely in their percentages of fast glycolytic (FG) fibers, fast oxidative glycolytic (FOG) fibers, and slow oxidative (SO) fibers. The masseter and the posterior portion of the temporalis muscles had high percentages of fast-contracting fibers (FG and FOG), whereas the medial pterygoid, zygomaticomandibularis (ZMM), and anterior portion of the temporalis muscles were composed largely or entirely of SO fibers. We conclude that the mandibular muscular system, like the limb muscular systems, contains both muscles which are well suited for strong phasic contractions and muscles which are well suited for the production of tonic, low force, vernier contractions. The high degree of compartmentalization of the temporalis muscle may provide a model for studying the distribution of proprioceptors within such a muscle and for studying the role which these receptors play in the control of vernier contractions.     

Cases of mild dementia in the community: Improving efficacy of case finding by concurrent use of pairs of screening tests

In a previous study, combinations of two short screening tests for dementia appeared to have clear advantages over the use of one test both for the efficacy of case detection and for the comparability of studies. In the present study these results were replicated using different sampling rules for the first and second phases of the screening procedure. Preferences for specific test combinations are discussed.     

Outcomes of neuropsychological interventions of stroke

The reported prevalence of cognitive deficits within the first month of stroke ranges widely from 10% to 82%, depending primarily on the criteria used to define cognitive impairment and on the selected patient population. These cognitive defects progress toward impairment over a course of time if left untreated. Among the most common cognitive deficits are the attentional, the visuoperceptual, the memory and executive function deficits. As these impairments are being increasingly recognized in the scientific communities, more and more studies are being devoted to the outcomes of various therapies for these disorders. In this review, we focus on the outcomes of various therapies for these cognitive disorders over time. We reviewed all the possible medical databases using key words for individual cognitive deficit treatment outcomes. All the possible studies including randomized controlled trials, pre-post design studies, case series and single case reports were included in this study. On the basis of present literature review, we conclude that the evidence is definitively positive only for outcomes of attentional and visuoperceptive skill deficits. On the other hand, there have been very few studies to conclude for effectiveness of various therapies for memory and executive function outcomes.     

Pharmacologic implications of neurobiological models of schizophrenia

The dopamine model of schizophrenia has been supplanted by several additional models in order to account for genetic findings, risk factors, course of illness, and the diversity of symptom domains. The increasing number and complexity of potential models for this heterogeneous disorder offer new targets for pharmacologic treatment that differ in their appropriate time points for intervention and in their potential effects on the course of illness. This article reviews relevant neurodevelopmental, biochemical, and neurodegenerative models with respect to potential pharmacologic opportunities.     

Prevention of neurodevelopmental sequelae of jaundice in the newborn

Although its cause, jaundice in the newborn, is extremely common, the disabling neurological disorder kernicterus is very rare. Kernicterus may be prevented by selecting those infants who are at risk of extreme jaundice or who may be particularly vulnerable to bilirubin neurotoxicity. Because the tools for achieving that goal are inadequate, a secondary strategy is needed. This involves a plan for emergency treatment of severely jaundiced infants, in particular those who present with neurological symptoms. In this paper I review the strategies for preventing extreme jaundice, and for reversing neurotoxicity in those infants for whom the principal strategies fail. Briefly, the tools for prevention include measurement of bilirubin while the infant is staying in the maternity unit, plotting the value on an hour-specific chart, assessing other risk factors for jaundice, and educating the parents. Emergency treatment should include immediate, high-irradiance phototherapy, consideration of intravenous immune globulin, and preparation for an exchange transfusion.     

吲哚布芬在抗血小板治疗中的临床应用

血栓栓塞性疾病严重威胁着人类的生命健康和生活质量,而抗血小板治疗是治疗血栓栓塞性疾病的重要手段,其中吲哚布芬作为一种抗血小板药物,对于治疗及预防血栓栓塞性疾病有一定的疗效。现就吲哚布芬对高危患者血栓栓塞事件的二级预防作用及其他血栓栓塞性疾病的治疗价值,对移植血管或介入术后冠状动脉通畅性的维持作用方面做一综述,以期指导临床。     

A family study of alcohol dependence: coaggregation of multiple disorders in relatives of alcohol-dependent probands

BACKGROUND: Alcohol dependence tends to aggregate within families. We analyzed data from the family collection of the Collaborative Study on the Genetics of Alcoholism to quantify familial aggregation using several different criterion sets. We also assessed the aggregation of other psychiatric disorders in the same sample to identify areas of possible shared genetic vulnerability. DESIGN: Age-corrected lifetime morbid risk was estimated in adult first-degree relatives of affected probands and control subjects for selected disorders. Diagnostic data were gathered by semistructured interview (the Semi-Structured Assessment for the Genetics of Alcoholism), family history, and medical records. Rates of illness were corrected by validating interview and family history reports against senior clinicians' all sources best estimate diagnoses. Sex, ethnicity, comorbidity, cohort effects, and site of ascertainment were also taken into account. RESULTS: Including data from 8296 relatives of alcoholic probands and 1654 controls, we report lifetime risk rates of 28.8% and 14.4% for DSM-IV alcohol dependence in relatives of probands and controls, respectively; respective rates were 37.0% and 20.5% for the less stringent DSM-III-R alcohol dependence, 20.9% and 9.7% for any DSM-III-R diagnosis of nonalcohol nonnicotine substance dependence, and 8.1% and 5.2% for antisocial personality disorder. Rates of specific substance dependence were markedly increased in relatives of alcohol-dependent probands for cocaine, marijuana, opiates, sedatives, stimulants, and tobacco. Aggregation was also seen for panic disorder, obsessive-compulsive disorder, posttraumatic stress disorder, and major depression. CONCLUSIONS: The risk of alcohol dependence in relatives of probands compared with controls is increased about 2-fold. The aggregation of antisocial personality disorder, drug dependence, anxiety disorders, and mood disorders suggests common mechanisms for these disorders and alcohol dependence within some families. These data suggest new phenotypes for molecular genetic studies and alternative strategies for studying the heterogeneity of alcohol dependence.     

Evidence of treatment for depressive episodes of bipolar disorder

In recent years, many papers on the treatment of the depressive phase of bipolar disorder (bipolar depression), especially bipolar I disorder, with high-level evidence, have been reported. The results of meta-analyses have also been reported for some medications. In the pharmacotherapy for bipolar depression, quetiapine (300 mg/day), lithium (more than 0.8 mEq/L), olanzapine (5-20 mg/day) and lamotrigine (200 mg/day) are effective, with high-level evidence. The combination of lithium and lamotrigine is also effective for bipolar depression. There is no evidence for effectiveness of the combination of mood stabilizers and antidepressants for bipolar depression. This paper presents the evidence data of quetiapine, lithium, olanzapine, lamotrigine, carbamazepine, valproate, aripiprazole, antidepressants, a combination of medications, and electroconvulsive therapy for bipolar depression, based on large-size randomized controlled studies and meta-analyses. The first-line medications for bipolar depression in the practice guidelines published for the last three years are also included.