底蜕膜间充质干细胞分化为多巴胺能样神经元

目的 探讨人胎盘底蜕膜间充质干细胞体外向多巴胺能样神经元分化的潜能,并优化诱导方案.方法 体外分离培养底蜕膜间充质干细胞,用表皮生长因子(EGF)+人碱性成纤维细胞生长因子(bFGF)+ B27添加剂和人音猬因子(SHH)+成纤维细胞生长因子8(FGF8)+forskolin+脑源性神经营养因子(BDNF)分两个阶段对其进行诱导;免疫细胞化学先后检测干细胞标记nestin和CD133、成熟神经元标记神经元特异性烯醇化酶(NSE)、神经胶质细胞标记胶质原纤维酸性蛋白(GFAP)、多巴胺能神经元标记酪氨酸羟化酶(TH)的表达;Western blot验证诱导后TH蛋白的表达;高效液相色谱-电化学检测诱导前后多巴胺的分泌.结果 经第一阶段诱导后,细胞形成漂浮生长的神经球,nestin和CD133均呈阳性表达;第二阶段诱导后,出现明显的神经元样形态,NSE、GFAP和TH均阳性表达,Western blot也显示TH蛋白的表达,多巴胺分泌量相比诱导前明显增加(P＜0.001).结论 底蜕膜间充质干细胞体外可分化为多巴胺能样神经元,可能成为帕金森病干细胞移植治疗新的种子细胞来源.     

绿色荧光蛋白基因腺病毒载体转染兔骨髓间充质干细胞的实验*

背景：以骨髓间充质干细胞作为种子细胞,把干细胞和基因治疗结合起来是研究中枢神经系统损伤和肿瘤治疗新的思路和趋势。 目的：观察腺病毒载体绿色荧光蛋白基因(Ad-GFP)在兔骨髓间充质干细胞转染和表达的量效关系及对细胞生物学特性的影响,探讨用该载体构建基因修饰骨髓间充质干细胞的可行性。 设计、时间及地点：随机分组设计,对比观察,于2008-08/2009-03在南方医科大学完成。 材料：新西兰大白兔,雌雄不拘,质量2.0~3.0 kg。 方法：体外分离培养兔骨髓间充质干细胞,流式细胞仪检测细胞免疫表型,293细胞包装制备病毒,以不同滴度的Ad-GFP(1×103~1×1010 PFU/mL)转染骨髓间充质干细胞,细胞计数法分析转染率。 主要观察指标：倒置显微镜观察细胞形态学改变,CCK8法检测细胞增殖活性,用血清撤离加入β-巯基乙醇诱导感染Ad-GFP BMSCs向神经样细胞的定向分化。 结果：3~6代骨髓间充质干细胞表面标志CD34、CD45阴性,而CD29、CD44阳性。当病毒滴度为1×107 PFU/mL时感染率为55%,1×109,1×1010 PFU/mL感染率均为85%,但1×1010 PFU/mL时出现细胞病理现象,7 d荧光表达最强,28 d仍可见荧光表达。感染Ad-GFP的骨髓间充质干细胞经β-巯基乙醇诱导可分化为神经元样细胞,神经元特异性烯醇化酶表达阳性。 结论：合适滴度的Ad-GFP可以高效感染骨髓间充质干细胞,对细胞的生物学特性影响较小,不影响诱导分化功能,骨髓间充质干细胞可以作为Ad-GFP载体系统进行基因治疗研究的种子细胞。     

人脐带间充质干细胞在3种不同培养体系中的生长状况及腺病毒感染效率*☆

背景：目前所报道的脐带间充质干细胞体外培养条件及培养效率不尽相同,尚缺乏统一标准。而且由于不同来源的间充质干细胞生物学特征尚有一定差异,因此建立脐带间充质干细胞简便、高效的培养体系十分必要。 目的：观察人脐带来源的间充质干细胞在体外不同培养体系中的生长状态,以及不同腺病毒感染的效率。 方法：采用胶原酶消化法从正常足月新生儿脐带中分离出间充质干细胞,贴壁法纯化培养,细胞贴壁后利用低糖DMEM,MesenPRO RS™ Medium和STEMPRO® MSC SFM这3种培养体系进行体外扩增。取对数生长期的第3~5脐带间充质干细胞,应用腺病毒Ad5-EGFP,Ad5/11-EGFP,Ad5/35-EGFP分别以感染复数=1,10,100进行感染,分别于感染后24,56,72 h倒置荧光显微镜观察病毒感染及绿色荧光表达情况。 结果与结论：使用低糖DMEM培养的细胞初期融合时间长,STEMPRO® MSC SFM培养的细胞虽然连接紧密,但消化传代后不易贴壁,而MesenPRO RS™ Medium培养的细胞在相同时间内能达到较高的细胞密度,更适于脐带间充质干细胞的体外扩增。Ad5/35-EGFP感染脐带间充质干细胞的效率明显高于其他两种腺病毒,但可导致细胞凋亡;腺病毒Ad5/11-EGFP对脐带间充质干细胞的感染效率较佳,随着感染复数的升高,所表达的荧光强度也逐渐增大。     

携带肾上腺髓质素基因腺病毒体外转染骨髓间充质干细胞及其蛋白的表达

背景：肾上腺髓质素具有促进骨髓间充质干细胞增殖、生长及减少凋亡等作用。 目的：观察携带肾上腺髓质素基因的腺病毒体外转染骨髓间充质干细胞及其蛋白的表达。 方法：培养293A细胞,并扩增携带肾上腺髓质素基因的腺病毒(Ad-ADM),实验分为对照组、空载体组和Ad-ADM转染组,3组分别于细胞长满至50%~60%时加入等量的无血清L-DMEM、Ad-lacZ和Ad-ADM,噬斑法检测扩增后腺病毒的滴度;贴壁法体外分离、扩增培养大鼠骨髓间充质干细胞;Ad-GFP体外感染骨髓间充质干细胞后检测转染效率;RT-PCR检测Ad-ADM转染后肾上腺髓质素mRNA的表达。 结果与结论：病毒扩增后噬斑试验测定Ad-ADM的病毒滴度为1.1×109 pfu/mL。Ad-ADM感染骨髓间充质干细胞后,肾上腺髓质素mRNA的表达明显增加,对照组、空载体组未见ADM mRNA表达;量化结果表明其表达量从第1天开始逐渐增加,第7天达高峰,在11 d时仍可检测其表达。提示腺病毒对骨髓间充质干细胞有较高的转染效率。感染Ad-ADM后,骨髓间充质干细胞可有效表达肾上腺髓质素。     

Nurr1对小胶质细胞联合神经干细胞共培养促进神经干细胞向多巴胺神经元分化作用研究

目的探讨联合过表达核受体相关因子1(Nurr1)基因的小胶质细胞(MG)和神经干细胞(NSC)共培养对神经干细胞向多巴胺神经元分化的影响。方法原代培养SD大鼠神经干细胞和小胶质细胞,并过表达Nurr1基因。CCK-8法检测Nurr1过表达对神经干细胞以及小胶质细胞活率的影响。Transwell系统共培养神经干细胞和小胶质细胞,实验分为NSC组、NSC+MG组和N(NSC+MG)组。ELISA检测共培养后第3天、第6天和第9天各组脑源性神经营养因子(BDNF)、血小板源性神经营养因子(PDNF)和胶质细胞源性神经营养因子(GDNF)表达变化;RT-PCR和Western Blot检测各组第9天酪氨酸羟化酶(TH)、多巴胺转运蛋白(DAT)DAT和Nurr1的表达变化;细胞免疫荧光鉴定神经干细胞的分化,并对TH和DAT阳性细胞计数,计算各组神经干细胞向多巴胺神经元的分化效率。结果原代培养小胶质细胞以及神经干细胞并成功过表达Nurr1基因。CCK-8法检测结果表明,Nurr1过表达对神经干细胞以及小胶质细胞活率无明显影响。ELISA检测结果表明,N(NSC+MG)组在不同时间点神经营养因子(BDNF、PDNF和GDNF)表达量明显高于其他各组(P0.05)。RT-PCR和Westen Blot检测结果表明,N(NSC+MG)组TH、DAT和Nurr1的表达水平明显高于其他各组(P0.05)。细胞免疫荧光鉴定结果表明,N(NSC+MG)组TH阳性细胞率明显高于其他各组(P0.05)。结论Nurr1基因可促进神经干细胞和小胶质细胞共培养系统神经营养因子的分泌。过表达Nurr1基因的神经干细胞和小胶质细胞共培养可促进神经干细胞向多巴胺神经元的分化。     

Ad-GFP修饰的间充质干细胞在肺气肿大鼠体内向肺部的定向迁移★

背景：近些年来应用相关干细胞及生长因子促进肺再生修复肺气肿病变的研究逐渐成为热点，那么通过干细胞携带相关外源生长因子基因能否更好的修复肺气肿病变值得关注。 目的：观察携带绿色荧光蛋白基因的腺病毒(adenovirus vecto rmediated green fluorescence protein，Ad-GFP)转染骨髓间充质干细胞的效率、对细胞增殖的影响，及携带目的基因的间充质干细胞尾静脉移植在肺气肿大鼠肺部的定居情况。 方法：采用密度梯度离心结合贴壁培养法分离、培养间充质干细胞，流式细胞仪鉴定；在不同感染复数时，激光共聚焦显微镜检测转染效果及转染效率，MTT法检测转染48 h的细胞活性；Wistar大鼠16只，随机分为模型组和对照组，每组8只，采用单纯被动烟熏法制备肺气肿大鼠模型。通过尾静脉移植Ad-GFP修饰的间充质干细胞，于24 h后取大鼠肺组织做快速冰冻切片，在荧光显微镜下观察间充质干细胞在肺部的分布情况。 结果与结论：实验成功获得大鼠间充质干细胞，Ad-GFP成功转染间充质干细胞，且在MOI=200时，转染效率达到88.42%。在不同MOI下，Ad-GFP转染间充质干细胞对细胞增殖无影响(P > 0.05)。移植24 h后，模型组大鼠及对照组大鼠肺部可见到发绿色荧光的间充质干细胞，且模型组荧光强度明显强于对照组(P < 0.05)。提示导入目的基因可能不会影响骨髓间充质干细胞增殖和归巢特性。     

人脐带间充质干细胞体外扩增和向神经元样细胞定向诱导分化的研究

目的探讨人脐带间充质干细胞(MSCs)的体外分离、纯化、扩增和向神经元样细胞的定向诱导分化,以期为脐带MSCs的神经移植提供理论依据。方法无菌条件下收集剖宫产新生儿脐带,酶消化法获取MSCs,进行培养。用流式细胞仪检测MSCs的表面标志。取扩增3,5,10代的MSCs分别向神经元样细胞诱导,用免疫组化和RT-PCR法检测神经元样细胞特异性标志。结果脐带富含MSCs,且脐带MSCs(UCMSCs)强表达CD13、29、CD44、CD105,弱表达CD106,不表达CD34、CD11a、CD14、CD33、CD45。神经条件培养基诱导后的细胞平均有70%左右呈现典型的神经元样表型。免疫组化法检测发现不同代数的MSCs经诱导后均表达nestin,NSE,NeuN,NF-M,弱表达GFAP。RT-PCR显示诱导后NSEmRNA表达增加。结论MSCs存在于人脐带中,并且在体外有较强的增殖能力,特定条件下能够分化为神经元样细胞。     

重组腺病毒介导增强型绿色荧光蛋白基因转染兔骨髓间充质干细胞

背景：目前仍没有合适的标记方法追踪观察兔骨髓间充质干细胞组织修复及基因治疗的效果。 目的：观察重组腺病毒介导增强型绿色荧光蛋白基因在兔骨髓间充质干细胞中的表达,及转染后干细胞活性的变化,以寻找稳定标记兔骨髓间充质干细胞的方法。 设计、时间及地点：细胞学体外观察,于2008-03/05在南京市第一医院骨科干细胞实验室完成。 材料：健康2月龄纯种新西兰大白兔4只,由南京医科大学实验动物基地提供。重组腺病毒Ad5/F35-EGFP为北京本元正阳基因有限公司产品。 方法：用密度梯度离心法分离纯化兔骨髓间充质干细胞,贴壁法纯化扩增。取传至第4代细胞,流式细胞仪检测细胞标志的表达,消化离心重悬后进行计数,平均分成5组,每组细胞数5.0×105个,接种于25 m2培养瓶,空白组加入50 μL的PBS液,剩余4组加入重组腺病毒Ad5/F35-EGFP进行转染,感染复数(MOI)分别为10,20,50,100,继续传代培养。 主要观察指标：骨髓间充质干细胞的生长状态及表面标志鉴定,转染后骨髓间充质干细胞增强型绿色荧光蛋白的表达及活性变化。 结果：原代培养48 h后见细胞贴壁,8 d时细胞铺满瓶底80%以上,绝大多数呈梭形,传代后细胞增殖速度加快,三四天即可传代,第4代细胞CD29和CD44呈阳性表达,CD34与CD45呈阴性表达。转染后24 h可见绿色荧光,7 d时荧光最强,细胞转染率与感染复数值的呈线性增长关系,至49 d时仍可见绿色荧光。转染后0,7,14,28,49 d,感染复数=50组的骨髓间充质干细胞数量均与空白组基本相似(P均> 0.05),即转染后细胞增殖能力无明显变化。 结论：重组腺病毒载体能高效标记骨髓间充质干细胞,感染复数为50时较为理想,增强型绿色荧光蛋白基因可持续表达49 d,且标记后不影响骨髓间充质干细胞的增殖活性。     

人骨髓间充质干细胞向多巴胺神经元分化的体外研究

目的探讨人骨髓间充质干细胞(hMSC)向神经元和多巴胺神经元分化的潜能。方法分离和纯化hMSCs;在体外以WHI-P131预处理和碱性成纤维细胞生长因子预诱导后,全反式维甲酸和胶质细胞源性神经营养因子联合诱导hMSCs向神经元和多巴胺神经元分化。光镜下观察其分化过程中hMSCs的形态变化,免疫组化检测诱导前后细胞是否表达神经元和多巴胺能神经元标志蛋白。结果诱导后的hMSCs能分化成为具有典型神经元形态的细胞,并明显表达抗人神经巢蛋白(nestin)[(54.2±3.7)%]和神经元特异性烯醇化酶(NSE)[(77.0±5.7)%],低表达胶质纤维酸性蛋白(GFAP)[(8.8±2.4)%];对照组细胞这些表达均为阴性;而且相当部分hMSCs表达酪氨酸羟化酶(TH)[(36.5±15.8)%]和多巴胺转运体(DAT)[(26.0±14.2)%]。结论在适当条件下,hMSCs可分化成为神经元样细胞和多巴胺神经元样细胞。     

脐带间充质干细胞的分离培养及诱导分化为多巴胺能样神经元

目的 探索脐带间充质于细胞(MSCs)的分离培养及将其诱导分化为多巴胺能神经元的方法.方法 分离脐带间充质组织,Ⅳ型胶原酶消化分离脐带MSCs,原代培养于含10%FBS的DMEM/F12培养基中,观察细胞形态并应用流式细胞仪检测细胞表面标志物和细胞周期,CCK8法绘制细胞生长曲线;采用二步法诱导分化P3代脐带MSCs,培养3、6、9 d后终止诱导,应用免疫荧光染色和Wcstern blotting检测分化后细胞酪氨酸羟化酶(TH)、神经元特异性烯醇化酶(NSE)的表达.结果 分离培养的脐带MSCs形态呈相对均一的成纤维样细胞,平行排列或旋涡状生长.P3代细胞CD29、CD44、CD73、CD90、CD105、CD166表达阳性,而CD34、CD45、CD19、CD31、HLA-DR表达阴性.对数生长期细胞倍增时间为48 h,处于G0～G1期细胞占91.13%;诱导分化后细胞多数为两级,形态与神经元相似,免疫荧光染色检测结果显示诱导9 d时细胞NSE、TH染色阳性率分别为19.5%和8.9%,Weston blotting检测结果显示诱导6 d时细胞NSE表达明显,TH仅有弱表达,诱导9 d时TH、NSE均表达明显.结论 脐带间充质组织中能分离出MSCs,且能分化成多巴胺能神经元.

Abstract：

Objective To investigate the methods of isolation of human umbilical cord mesenchymal stem cells (MSCs) in Wharton' s jelly and the differentiation of MSCs into dopaminergic neurons. Methods The umbilical cord mesenchymal tissue was scraped off from the Wharton's jelly,and then, collagenase Ⅳ was employed to isolate the MSCs. The isolated cells were primarily cultured in DMEM/F12 medium containing 10% FBS. Inverted microscopy was used to observe the cytomorphology, and flow cytometry was employed to detect the cell surface antigens and the cell cycle.We evaluated the cell viability using CCK8 kit. Two-step method was employed to induce the MSCs of the P3 generation to differentiate into dopaminergic neurons, and immunocytochemistry and Western blotting were used to detect the expressions of neuron specific enolase (NSE) and tyrosine hydroxylase (TH) 3, 6 and 9 d after the induction. Results The isolated MSCs showed fibroblast-like shape, with parallel arrangement and vortex-like growth. MSCs of the P3 generation expressed CD73, CD29, CD44and CD105, but did not express CD34, CD45, CD106 and HLA-DR. The doubling time in the exponential phase was at the 48th h of culture, and 91.13% cells were under G0-G1. These cells had similar morphology of the neurons. The immunocytochemical assay showed that the NSE and TH positive rates were 19.5% and 8.9% on the 9th d of induction; and Western blotting showed that MSCs obviously expressed NSE and weakly expressed TH.Conclusion MSCs can be isolated from the umbilical cord mesenchymal tissue, and be induced to differentiate into dopaminergic neurons in vitro.     

Epilepsy and anomalies of neuronal migration: MRI and clinical aspects

Neuronal migration disorders are the result of disturbed brain development. In such disorders, neurons are abnormally located. In diagnosing these conditions, magnetic resonance imaging is superior to any other imaging technique. This enables us to improve our knowledge of the clinical correlates of neuronal migration. With reference to migrational disorder, a retrospective study of all 303 patients with epileptic seizures referred for magnetic resonance imaging during a 3-year period was performed, 13 patients (aged 12-41, mean age 27) were identified. They represent 4.3% of the entire study group. Of the patients with known epilepsy, 6.7% and of the mentally retarded, 13.7% had migrational disorders. Four patients had schizencephaly as the dominant finding, one was classified as hemimegalencephaly, 2 had isolated heterotopias, and 6 had localized pachy- and/or poly-microgyria. The clinical pictures are complex. Ectopias of grey matter are recognised foci of epilepsy, but from an epileptological and a clinical viewpoint little attention has been given to these disorders. The present study shows that malmigration is not rare in epilepsy patients, especially not in the mentally retarded.     

Classification of methods in transcranial Electrical Stimulation (tES) and evolving strategy from historical approaches to contemporary innovations

Transcranial Electrical Stimulation (tES) encompasses all methods of non-invasive current application to the brain used in research and clinical practice. We present the first comprehensive and technical review, explaining the evolution of tES in both terminology and dosage over the past 100 years of research to present day. Current transcranial Pulsed Current Stimulation (tPCS) approaches such as Cranial Electrotherapy Stimulation (CES) descended from Electrosleep (ES) through Cranial Electro-stimulation Therapy (CET), Transcerebral Electrotherapy (TCET), and NeuroElectric Therapy (NET) while others like Transcutaneous Cranial Electrical Stimulation (TCES) descended from Electroanesthesia (EA) through Limoge, and Interferential Stimulation. Prior to a contemporary resurgence in interest, variations of transcranial Direct Current Stimulation were explored intermittently, including Polarizing current, Galvanic Vestibular Stimulation (GVS), and Transcranial Micropolarization. The development of these approaches alongside Electroconvulsive Therapy (ECT) and pharmacological developments are considered. Both the roots and unique features of contemporary approaches such as transcranial Alternating Current Stimulation (tACS) and transcranial Random Noise Stimulation (tRNS) are discussed. Trends and incremental developments in electrode montage and waveform spanning decades are presented leading to the present day. Commercial devices, seminal conferences, and regulatory decisions are noted. We conclude with six rules on how increasing medical and technological sophistication may now be leveraged for broader success and adoption of tES.     

Hepatic Considerations in the Use of Antiepileptic Drugs

Summary: Virtually all of the major antiepileptic drugs (AEDs) can cause hepatotoxicity, although fatal hepatic reactions are rare. The mechanisms, incidences, and risk profiles for such reactions differ from drug to drug. With carbamazepine and phenytoin, hepatotoxicity may be due to drug hypersensitivity. Although the profiles of patients at risk have not been well-defined for these two antiepileptic drugs, it would appear from reports in the literature that older adolescents and adults are at higher risk than children of developing serious or fatal hepatotoxicity. Once hepatotoxicity develops, mortality rates are 10–38% with phenytoin and 25% for carbamazepine. The risk profile for valproate fatal hepatotoxicity has been more clearly defined. Those at primary risk of fatal hepatic dysfunction are children under the age of 2 years who are receiving multiple anticonvulsants and also have significant medical problems in addition to severe epilepsy. The risk is considerably lower for patients over the age of 2 years on valproate monotherapy. In contrast to the risk profile with other AEDs, adults receiving valproate as monotherapy have the lowest risk of hepatotoxicity. Fatal hepatic dysfunction coincident with valproate may be the result of aberrant drug metabolism. Concomitant use of AEDs that induce microsomal P450 enzymes (e.g., phenytoin and phenobarbital) may enhance the production of a toxic metabolite, and hence the greater risk of hepatotoxicity with polypharmacy.     

Vascular Malformations and Epilepsy: Clinical Considerations and Basic Mechanisms

Summary: Vascular malformations (VMs) are associated with epilepsy. The natural history of the various VMs, clinical presentation, and tendency to provoke epilepsy determine treatment strategies. Investigations have probed the mechanisms of epileptogenesis associated with these lesions. Electrophysiologic changes are associated with epileptogenic cortex adjacent to VMs. Putative pathophysiologic mechanisms of epileptogenesis include neuronal cell loss, glial proliferation and abnormal glial physiology, altered neurotransmitter levels, free radical formation, and aberrant second messenger physiology.     

Neonatal Seizures: Problems in Diagnosis and Classification

Summary: The clinical identification of neonatal seizures is critical for the recognition of brain dysfunction; however, diagnosis is often difficult because of the poorly organized and varied nature of these behaviors. Current classification systems are limited in their ability to communicate motor, autonomic, and electroencephalo-graphic features of seizures precisely and to provide a basis for uniform effective diagnosis, therapy, and determination of prognosis. Recent investigations of neonates, utilizing bedside electroencephalographic/polygraphic/ video monitoring techniques, have provided the basis for improved diagnosis and classification of seizures in the newborn. These studies have demonstrated that not all clinical phenomena currently considered to be seizures require electrocortical epileptiform activity for their initiation or elaboration. In addition, the specific clinical character of the phenomena considered to be seizures, the clinical state of the infant, and the character of the EEG indicate the probable pathophysiological mechanisms involved and suggest probable etiologies, prognosis, and therapy. Similarities between animal models that demonstrate reflex physiology and neonates with motor automatisms and tonic posturing suggest that these clinical behaviors may not be epileptic in origin but, rather, primitive movements of progression and posture mediated by brainstem mechanisms. Although not all clinical behaviors currently considered to be neonatal seizures may have similar pathophysiological mechanisms, they are clinically significant because they all indicate brain dysfunction.     

Valproate Monotherapy in the Management of Generalized and Partial Seizures

Summary: For decades, therapeutic tradition has promoted the concept of polypharmacy in the management of epilepsy. In recent years, however, studies have shown that, for most patients, monotherapy can provide comparable or better seizure control than administration of multiple anticonvulsants, while diminishing the potential for adverse reactions, drug interactions, and poor compliance. Valproate is an important monotherapeutic agent that is highly effective in the control of idiopathic primary and secondarily generalized epilepsies, and partial seizures that do not generalize. Comparative studies have found that valproate is at least as effective as phenytoin and carbamazepine in the treatment of generalized and partial seizures. Given the similar efficacy, other factors such as pharmacokinetics and side effects may therefore determine anticonvulsant selection for monotherapy.     

Carbamazepine Efficacy and Utilization in Children

Summary: Carbamazepine is effective for preventing partial and generalized tonic-clonic seizures in children. Although absence epilepsies are more common in children than adults, an estimated 80% of children with epilepsy have seizure types or epilepsies that are potentially responsive to carbamazepine. The differential diagnosis of ictal staring is an especially important issue in children because absence and atypical absence seizures are more prevalent in children than adults. Age-related pharmacokinetic differences and drug interactions are major considerations in children. On average, children have higher clearance rates of carbamazepine, shorter half-lives, and higher ratios of carbamazepine-10, 11-epoxide to carbamazepine than adults. In addition, children with severe epilepsy are more likely to require multiple-drug therapy, which can lead to complex drug interactions. When carbamazepine is administered along with valproate, drug protein binding interactions can cause intermittent side effects.     

Un nouveau cadre conceptuel de travail pour la psychiatrie

In an attempt to place psychiatric thinking and the training of future psychiatrists more centrally into the context of modern biology, the author outlines the beginnings of a new intellectual framework for psychiatry that derives from current biological thinking about the relationship of mind to brain. The purpose of this framework is twofold. First, it is designed to emphasize that the professional requirements for future psychiatrists will demand a greater knowledge of the structure and functioning of the brain than is currently available in most training programs. Second, it is designed to illustrate that the unique domain which psychiatry occupies within academic medicine, the analysis of the interaction between social and biological determinants of behavior, can best be studied by also having a full understanding of the biological components of behavior.