Prostacyclin release in the coronary circulation during sustained stimulation in in vitro and in in vivo experimental systems

Prostacyclin release from rat isolated perfused hearts and from dog coronary circulation was studied by measuring immunoreactive 6-keto-PGF1 alpha (6-keto-PGF1a) in heart perfusate and in plasma obtained from the great cardiac vein respectively. Continuous infusion of arachidonic acid at constant concentration in isolated perfused hearts induced an increased prostacyclin release. This release showed a rapid peak within 10 min and a subsequent decrease. Low-flow ischemia induced an increased perfusate concentration of 6-keto-PGF1a but, considering the decreased flow, prostacyclin release was actually reduced. During the whole period of ischemia (60 min) prostacyclin release was constant. In open-chest anesthetized dogs 6-keto-PGF1a concentration in the great cardiac vein was increased after ligation of the left anterior descending coronary artery. A prolonged period of coronary occlusion (4.5 hours) resulted in a progressive rise of prostacyclin release. 6-keto-PGF1a determinations in the femoral vein and in the aorta did not show relevant variations during the observation period.     

Changes in depressive symptomatology in Austria

A study of psychopathological manifestations of depressive in-patients, treated in the Salzburg psychiatric clinic in the last ten years, showed a masked shift of symptoms. The shift is away from guilt-feelings as well as away from religious content to a more general moral one. Also noted was a definite increase in feelings on insufficiency and hypochondric ideas. A comparison with tendencies in the Maghreb areas, in which a shift from the masked-somatic symptoms toward guilt-depression is reported, our results show here in Europe a renewed tendency of a shift from guilt-depression to hypochondric or anxiety-depression.     

Psychological factors in falls in elderly patients

This article recognizes the high incidence and prevalence of falls in the elderly. Psychological factors can play a definite role as part of the etiology. The fall can be a depressive signal or a cry for help from a demoralized elderly patient. The authors stress the importance of recognizing the depressive syndrome of the elderly. Psychological consequences of the falls are reviewed at three different levels. For the elderly, the consequences are frequently a fear that can lead to a sharp decrease in functional capacity. For the family, the fall can lead to the institutionalization of the elderly or a very restrictive surveillance. For the family physician, the fall is frequently perceived as an emergency that leads to immediate unwarranted admission. A rational approach, with education and guidelines, is proposed and can render this traumatic experience less dramatic at these three different levels.     

Ethnic heterogeneity in allele variation in the DRD4 gene in schizophrenia

The goal of the present study was to use a meta-analysis on previous studies plus our own unpublished data to confirm and extend findings which indicate that the variation in the dopamine D4 receptor (DRD4) gene is best represented by a mixture of two different ethnic groups. The genotype distribution was divided into either a long or short form using a mixture analysis of normal controls of different ethnic origins under the assumption that there is a single major gene. The meta-analysis was based on the data from 19 independent samples, 18 association studies, and from our own unpublished data, including a total of 1431 schizophrenic patients (sporadic cases 1309, familial cases 122) and 1439 controls. No significant genotype differences were noted between patients and controls for the whole sample. However, reorganization of the studies into different groups by the geographical origin of samples revealed significant ethnic heterogeneity. In addition, there was a significant association between the long form of DRD4 gene and schizophrenia in Caucasians, especially those with familial schizophrenia.     

Mental health problems in the elderly in residential care in Greece--A pilot study

The aim of this study is to examine the mental health problems of older adults living in a residential home in a Greek rural area. A sample of 40 residents was compared with 40 matched controls attending a community open care centre for the elderly (OCCE). The following measures were used: Mini International Neuropsychiatric Interview (MINI), Geriatric Depression Screening Scale (GDSS), and the Mini Mental State Examination (MMSE). The group of the residents had a lower educational level and presented with a higher prevalence of depression and suicidality. Suicidal ideation was not significantly correlated to any of the examined independent social or psychological factors and was persistent during a period of two years follow-up. It is possible that, especially in rural areas, admission in the institution is per se a traumatic event precipitating suicidality. The issues of effective psychological care for older adults in residential care are discussed.     

Community psychiatry in border settlements in Israel

Summary An analysis of our work during two years in a community mental health clinic serving a small town and an agricultural area near the northern border of Israel was presented. The clinic was staffed by a team of psychiatrists, psychologists and social workers who came to the area for one and a half days every week from a university psychiatric hospital in the center of the country. Only the nurse was a resident of the clinic was an attempt to provide a border population with expert psychiatric services which had previously been lacking, while maintaining a close connection with the central psychiatric hospital. All this was done on a relatively low budget. In spite of the difficult working conditions, an ambulatory team, travelling to the place and serving a wide area which was often under emergency conditions, was able to do effective work. A total number of 485 patients was seen during the two years, only 60 of whom were hospitalised, and very few were referred for private psychotherapy.The success of the clinic's operation can be explained by appropriate initial classification of referrals, concentration on short term therapy, close cooperation between the team members and effective interaction with the relevant agencies in the community. The clinic handled patients from two population groups (the town of Kiryat Shmona and the villages of the area), which differed considerably from demographic, social and therapeutic points of view.     

Reasoning in believers in the paranormal

Reasoning biases have been identified in deluded patients, delusion-prone individuals, and believers in the paranormal. This study examined content-specific reasoning and delusional ideation in believers in the paranormal. A total of 174 members of the Society for Psychical Research completed a delusional ideation questionnaire and a deductive reasoning task. The reasoning statements were manipulated for congruency with paranormal beliefs. As predicted, individuals who reported a strong belief in the paranormal made more errors and displayed more delusional ideation than skeptical individuals. However, no differences were found with statements that were congruent with their belief system, confirming the domain-specificity of reasoning. This reasoning bias was limited to people who reported a belief in, rather than experience of, paranormal phenomena. These results suggest that reasoning abnormalities may have a causal role in the formation of unusual beliefs. The dissociation between experiences and beliefs implies that such abnormalities operate at the evaluative, rather than the perceptual, stage of processing.     

Decrease in neuronal density in the cerebral cortex in multiple system atrophy

The presence of argyrophilic oligodendroglial cytoplasmic inclusions (GCIs) is a pathognomonic feature of multiple system atrophy (MSA), which has established MSA as a nosological entity, and serves as a diagnostic criterion. As a neurodegenerative disease, MSA exhibits neuronal degeneration and loss from several regions of the central nervous system. Recent mapping studies of the distribution of GCIs have shown their presence in regions of the brain previously thought not to be affected in MSA, for example the cerebral cortex. This study has used stereological techniques to establish whether neuronal loss is related to the presence of GCIs in three regions of the cerebral cortex. In the prefrontal cortex, in which GCIs are sparse, there is no significant difference in either neuronal or glial cell numerical density in MSA cases compared to controls. However in two cortical regions which are both GCI rich, the anterior central gyrus and the supplementary motor cortex, there is a marked reduction in neuronal density of 18.7% and 21.4% respectively, which is statistically significant only in the supplementary motor cortex. In both of these regions there is a concomitant increase in glial cell numerical density which results in a significant change in the ratio of neurons to glial cells. These results indicate that there is a regional reduction in the neuronal density in the cortex in multiple system atrophy which is associated with the presence of GCIs.     

Free condoms in youth clubs in Copenhagen

As a step to limit the spread of AIDS, condoms were supplied free of charge in Copenhagen in youth clubs in connection with personal advice. A representative group of young people (N = 745) and of social workers in these clubs (N = 130) were asked to complete a structured questionnaire. The investigation revealed that the young were well informed about AIDS and its prevention, but despite this, they comprise a relative risk group with regard to the spread of AIDS due to high numbers of partners and poor habits with regard to the use of condoms. The campaign was well received by both the young and the young club social workers. There was an obvious need for a continuation of such a campaign. It is concluded that youth clubs are a good forum for AIDS information.     

Headache in men: forgotten in practice and ignored in research

In general practice, the sex-specific consultation rate for headache is only slightly lower for men than it is for women. Headache is 2 to 3 times more common in women than it is in men, and women outnumber men in general practice by 2-fold. However, in headache practice they seem to outnumber men by 4- to 5-fold, suggesting a specific barrier to seeking specialty care. Although there is extensive literature specifically concerning headache in women, a PubMed search did not reveal any publications specifically addressing the problem in men, with the exception of cluster headache, a well-known headache condition that is more frequent in men. As a first attempt at filling this void, we analyzed the headache features, associated symptoms, and precipitating, aggravating, and relieving factors in 100 randomly selected men from a headache practice. Our results indicate that headache is a significant medical problem in men, and they seem to be underrepresented when it comes to seeking expert headache care.     

Developmental changes in serotonin actions in rat hippocampus

Intracellular activity was recorded from neurons in immature rat hippocampal slices. The presence of intrinsic inhibitory synaptic potentials as well as responses to serotonin were assessed in slices of 1, 2 or 3 postnatal weeks of age. Young (1 week) cells had only a marginal hyperpolarizing response to serotonin and no detectable intrinsic inhibitory synaptic potentials. At 2 weeks of age neurons already expressed a fast IPSP (inhibitory postsynaptic potential). The responses to serotonin were different from those of adult cells in that they involved primarily a large decrease in input resistance with only small potential changes. In cells of this age serotonin caused a marked increase in spontaneous IPSP discharges and a blockade of a slow afterhyperpolarization. In 3-week-old rats the fast and slow components of the IPSP were present as in adult and the responses to serotonin included a large hyperpolarization associated with an increase in K conductance, a blockade of slow afterhyperpolarization and a blockade of a slow IPSP, as seen in adult cells. These results indicate that the complex pattern of reactivity to serotonin is differentially regulated in the developing brain.     

Apoptosis in non-astrocytic brain tumours in children

Apoptosis is a process of great significance in cell biology. It plays a crucial role in both physiological and pathological conditions. An example is a tumour growth that is based on a subtle balance between cell division and cell death. Previously necrosis was considered to be the major type of cell death in tumours. Many recent investigations have focused on apoptosis, a phenomenon of great importance, and it is this type of cell death that is frequently "chosen" by a moribund cell. The objects of our interest were central nervous system (CNS) tumours, in which we estimated the number of apoptotic cells and sought for any correlation between the intensity of apoptosis and other markers of proliferation. Therefore, we studied CD34, the marker of angiogenesis, and Ki67, the marker of cell proliferation. We investigated 19 medulloblastomas and 15 ependymomas, among which 6 were anaplastic. We used in-situ labelling of DNA fragments to detect apoptosis in paraffin-embedded tissues. The mean value of the apoptotic ratio (AR) for all examined brain tumours was 0.012 with a standard deviation (SD) of 0.032, for medulloblastomas 0.021 (SD 0.04), for ependymomas 0.001 (SD 0.002) and for anaplastic ependymomas 0.004 (SD 0.003).     

Mutations in MCT1 cDNA in patients with symptomatic deficiency in lactate transport

We identified 5 patients with subnormal erythrocyte lactate transport plus symptoms and signs of muscle injury on exercise and heat exposure. All had transport rates below the 95% envelope for normals. Three cases had rates 40-50% of mean normal. One was found to have a missense mutation in monocarboxylate transporter 1 (MCT1), the gene for the red cell lactate transporter (also expressed in skeletal muscle), at a conserved site, which was not mutated in a cohort of 90 normal humans. The other 2 cases had a different missense mutation (at a nonconserved site), which was also not mutated in the normal cohort. All 3 patients were heterozygotes. We presume that these mutations are responsible for their subnormal lactate transport, and hence their muscle injury under environmental stress; homozygous patients should be more seriously compromised. The other 2 cases had lactate transport rates 60-65% of mean normal, and their MCT1 revealed a third mutation, which proved to be a common polymorphism in the normal cohort. These 2 patients may be physiologic outliers in lactate transport, with their muscle damage arising from some other genetic defect.     

Problem in society,problem in psychiatry

Societal problems are fundamental in fostering a clearer understanding of psychiatric epidemiology.We illustrate this by juxtaposing the findings of high rates of psychosis in the population of Caribbean origin in Britain with their dissatisfaction with mental health services in general.The problem in psychiatry is therefore mirrored by a problem in society which have similar bases in terms of relationships with institutional structures in Britain. The origins of psychiatry and the concept of schizophrenia are discussed with a view to identifying the historical and cultural influences which informed their genesis.An exploration of the assumptions which have informed psychiatric diagnosis and treatment and the factors that contribute to social inequality must be considered together in mounting appropriate research and clinical responses to the problems of this population in Britain. These findings in Britain therefore have important implications for the understanding of psychiatry as a socio-cultural as well as scientific practice and consequently for the categorization of mental illness.     

Seasonal fluctuation in birthweight in schizophrenia

The birthweights of 450 schizophrenic patients born in 1971-1978 were compared with those of individually matched controls from the same birth cohort. Schizophrenics born in the second quarter of the year (April to June) had a significantly lower birthweight than their controls and this was not attributable to differences in the duration of gestation. Analogous proband/control differences were not found in 301 patients with affective psychoses, but there was a similar, much smaller, seasonal fluctuation in birthweight in the general population. These findings may be a clue both to the genesis of the "season of birth effect" and to the identity of the intrauterine influences contributing to the aetiology of schizophrenia. Folate deficiency may be implicated.     

Kynurenine metabolism in plasma and in red blood cells in Parkinson's disease

Substantial evidence indicates that neuroactive kynurenine metabolites play a role in the normal physiology of the human brain, and are involved in the pathology of neurodegenerative disorders such as Parkinson's disease (PD). A sidearm product of the pathway, kynurenic acid (KYNA), which is synthesized by the irreversible transamination of kynurenine (KYN) by kynurenine aminotransferases (KAT I and KAT II), is an excitatory amino acid receptor antagonist. In the present study we measured the level of KYNA and the activities of the biosynthetic enzyme isoforms KAT I and KAT II in the plasma and in the erythrocytes (RBC) of 19 PD patients and 17 age-matched controls. The KAT I and KAT II activities were significantly lower in the plasma of PD patients, followed by a tendency to a decrease in plasma KYNA. An elevated KYNA level correlated with a significant increase in KAT II activity in the RBC of PD patients. These data support the contribution of an altered KYNA metabolism in the RBC to the pathogenesis of PD. The increased activity of KAT II in correlation with the elevated KYNA level in the RBC may mediate a consecutive protective response against excitatory neurotoxic effects.     

Flicker-induced nystagmus in a ganzfeld situation in monkeys

The possibility that flicker-induced nystagmus (FIN) is a form of optokinetic nystagmus evoked by an apparent motion effect was explored in six rhesus monkeys. FIN was elicited by stroboscopic stimulation of one or both eyes directly (heterogeneous field condition), and through a diffuser which approximates a Ganzfeld situation (homogeneous field condition). FIN and afterresponses (FIAN) were easily obtained with monocular stimulation and, in fact, were enhanced in the homogeneous field condition as shown by a shorter latency and higher frequency of FIN, and by longer and more prevalent FIAN with additional reversals. The magnitudes of FIAN were greater following longer stimulation. The build-up period and mean peak frequency were interdependent in the heterogeneous but not in the homogeneous field condition. Binocular flicker, particularly in the latter situation, resulted in a preponderance of FIN to the right, a response characteristic of right eye stimulation. Similarly, in some animals, the response and afterresponses were stronger on flickering the right eye. The results demonstrate that apparent motion does not play a role in the initiation and/or propagation of FIN and FIAN. The enhancement obtained in the Ganzfeld situation suggests the opening of a negative feedback loop which may operate during direct stimulation. The “reafference principle” could explain the relationship of the build-up period and mean peak frequency in the two stimulus conditions. The asymmetric responses obtained in this study reflect a lateralization of function. FIN, as an unlearned form of behavior, could be useful as a model for elucidating the mechanism of such a bias.     

Incidence of sudden unexpected death in epilepsy in community-based cohort in China

ObjectiveSudden unexpected death in epilepsy (SUDEP) is associated with the high premature mortality observed among people with epilepsy. It is, however, considered a rare event in China, probably because of lack of awareness and limitation of studies in the country. We aimed to provide some initial estimation of the burden of SUDEP in China.MethodsWe established a large Chinese community-based cohort of people with epilepsy between January 2010 and December 2011. For any participant who died during follow-up, detailed information on cause of death was obtained using a specifically designed Verbal Autopsy Questionnaire. All cases were reviewed by a multidisciplinary expert panel and reinvestigated if necessary. Sudden unexpected death in epilepsy incidence rates were estimated and case details provided.ResultsThe cohort consisted of 1562 people and during a median 5 years follow-up, 72 deaths were reported. The all-causes death incidence was 11.23 (95% CI 8.86–14.07) per 1000 person-years. Fifteen died suddenly and unexpectedly in a reasonable state of health in the week preceding death. We recorded detailed information of these 15 deaths. Thirteen were considered to be probable SUDEP and two possible SUDEP. The incidence of probable SUDEP was 2.03 (95% CI 1.13–3.38) per 1000 person-years, and the incidence of all suspected (probable and possible) SUDEP was 2.34 (95% CI 1.36–3.77) per 1000 person-years.SignificanceThe incidence of SUDEP was relatively high among Chinese people with epilepsy when compared with that in previous community-based studies from high-income countries. The burden of SUDEP in China requires further assessments.     

Age-related changes in sleep-wake rhythm in dog

To investigate a sleep-wake rhythm in aged dogs, a radio-telemetry monitoring was carried out for 24 h. Electrodes and telemetry device were surgically implanted in four aged dogs (16-18 years old) and four young dogs (3-4 years old). Electroencephalogram (EEG), electromyogram (EMG) and electrocardiogram (ECG) were recorded simultaneously as parameters to determine vigilance states and an autonomic nervous function. Wakefulness, slow wave sleep (SWS) and paradoxical sleep (PS) were identified according to the EEG and EMG pattern. We also examined whether absolute powers and the low frequency-to-high frequency ratio (LF/HF) derived from the heart rate variability power spectrum could detect shifts in autonomic balance correlated with aging. The aged dogs showed a marked reduction of PS and a fragmentation of wakefulness in the daytime and a sleep disruption in the night. The pattern of 24 h sleep and waking was dramatically altered in the aged dog. It was characterized by an increase in the total amount of time spent in SWS during the daytime followed by an increasing of time spent in wakefulness during the night. Furthermore, LF/HF ratio showed a very low amplitude of variance throughout the day in the aged dog. These results suggest that the aged dog is a useful model to investigate sleep disorders in human such as daytime drowsiness, difficulties in sleep maintenance. The abnormality in sleep-wake cycle might be reflected by the altered autonomic balance in the aged dogs.