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51.
Electrophysiological and cytofluorometric data suggest that doses of amphetamine which enhance locomotor activity and promote focused stereotypies produce pronounced effects on serotonin pathways in the CNS. However, the biochemical evidence regarding changes in serotonergic function produced by moderate doses of this drug is inconsistent. Therefore, the present study was designed to further examine the effects of amphetamine (1–5 mg/kg) on regional brain serotonin and its metabolite and to compare these effects to behaviorally comparable doses of methylphenidate and apomorphine. At doses which produce a multiphasic behavioral response pattern, including a stereotypy phase consisting primarily of repetitive head movements and occasional oral stereotypies, amphetamine (3 mg/kg) and methylphenidate (30 mg/kg) increased levels of 5HIAA in striatum and frontal cortex, two brain regions which receive serotonergic projections from the dorsal raphe nucleus. In contrast, these drugs decreased or had no effect on 5HIAA levels in hippocampus, a brain region which receives its serotonergic innervation from the median raphe nucleus. A moderate dose of apomorphine (0.5 mg/kg) produced a comparable pattern of neurochemical effects. These data are consistent with electrophysiological and cytofluorometric data suggesting enhanced dorsal raphe serotonergic function following amphetamine-like stimulants. Pretreatment of animals with -methyltyrosine at a dose sufficient to prevent the locomotor stimulation and stereotypy promoted by amphetamine, or by haloperidol, failed to prevent the amphetamine-induced increase in 5HIAA, indicating that these serotonergic effects are not secondary to the amphetamine facilitation of dopaminergic transmission. The results of this study suggest that serotonin may play a modulatory role in the behavioral effects of amphetamine-like stimulants which is dependent for its expression on an intact dopamine system.Abbreviations DA
dopamine
- AMPH
S(+)amphetamine
- 5HT
serotonin
- MP
methylphenidate
- APO
apomorphine
- 5HIAA
5-hydroxyindoleacetic acid
- MT
-methyltyrosine
- DOPAC
3,4-dihydroxyphenylacetic acid
- HVA
homovanillic acid
- HAL
haloperidol 相似文献
52.
J M Lerais J C Baudrillard J F Durot P Segal M O Tellart C Wallays F Auquier O Toubas J Petit 《Journal de radiologie》1986,67(3):201-207
Two patients with true synovial cysts in atypical sites (internal compartment of knee and inguinal hollow) were investigated by radioarthrography, ultrasound and computed tomography imaging. The cyst in the hip region originated from a dilated serous bursa of the iliopsoas muscle that did not communicate or was no longer in communication with the joint. In contrast, the cyst of the knee appeared to be a lateral synovial capsule hernia. Positive diagnosis in both cases was dependent on combined ultrasound-CT scan imaging, this eliminating a tumor (sarcoma) of soft tissues. However, affirmation of the synovial origin (mesothelial covering of the wall) of the lesion was obtained by histology only, this allowing differentiation from a "capsular" (fibrous wall) cyst, which probably provokes similar ultrasound and CT scan images. 相似文献
53.
D Segal 《Int J Health Serv》1984,14(3):379-396
In American medical schools, the period of time between the announcement of internships and graduation is known as FYBIGMI, for "Fuck You Brother I Got My Internship." At University Medical School (pseudonym), as at most American medical schools, this period culminates in an elaborate musical comedy (attended by faculty and relatives) in which faculty are abused, patients are represented in terms of stigmatized stereotypes, and the students demonstrate a profane familiarity with cultural taboos. Using the analytic methods of cultural anthropology, this examination of the FYBIGMI performance at U.M.S. focuses primarily on the seniors' presentation of their newly acquired professional identity, which is constituted in the skits by recurring oppositions to socially stigmatized, medically self-destructive patients. In this oppositional logic, racial stereotypes play a particularly large role. In addition, the seniors establish their new social status by inverting their relationship to their (former) supervisors on a personal basis, and by confronting the audience with their professional ability to treat cultural taboos with profane familiarity. The FYBIGMI theatrical, and its representation of professional identity, is analyzed in relation to a proposed model of the underlying structure of the process of medical education, that is, an escalating dialectic of intimidation and self-congratulation. 相似文献
54.
55.
Tabatabai M Segal R Amidi M Caines M Kirimli B Stremple JF 《Journal of neurosurgical anesthesiology》1990,2(4):266-271
The perioperative changes in the serum concentration of creatine phosphokinase (CPK) and its isoenzymes MM, MB, and BB and of lactic dehydrogenase (LDH) and its isoenzymes LDH1 to LDH5 were determined during craniotomy in order to distinguish operation-induced changes in these enzymes from those due to acute myocardial infarction and malignant hyperthermia. Twenty-eight male patients, 29 to 76 years of age (mean +/- SD = 58 +/- 13.2 years), undergoing craniotomy for tumor reseaction (n = 26) or cerebral artery aneurysm clipping (n = 2) were included in this study. Ten serial blood samples were obtained from each patient: one sample before and another after induction of anesthesia, and eight samples after the incision, over a period of 70 h. The preinduction serum CPK level of 97 +/- 32 U/L (mean +/- SD) increased gradually and significantly and reached the peak level of 542 +/- 116 U/L 34 h after incision (p <0.05). Whereas all of the CPK isoenzymes increased in terms of U/L after incision, only the MM fraction (expressed as percent of total CPK) increased, and the MB and BB fractions (expressed as percent of total CPK) decreased. The preinduction serum LDH level of 150 +/- 42 U/L (mean +/- SD) increased gradually after incision and reached the peak level of 210 +/- 32 U/L 58 h after incision (p <0.05). LDH2 as a percent of total LDH decreased significantly, but the LDH1/LDH2 ratio did not change. LDH4 and LDH5, as percents of total LDH, increased significantly. The large increases in total serum CPK and the concomitant decrease in MB percent after craniotomy may minimize and/or mask the percentage increase in the MB level following acute myocardial infarction. The perioperative serum CPK level as a marker in the diagnosis of malignant hyperthermia should be interpreted in light of the present results and in conjunction with clinical symptomatology. 相似文献
56.
Acetabular fractures. Clinical outcome of surgical treatment 总被引:16,自引:0,他引:16
Liebergall M Mosheiff R Low J Goldvirt M Matan Y Segal D 《Clinical orthopaedics and related research》1999,(366):205-216
Sixty patients with acetabular fractures were treated surgically. All fractures were a result of high energy trauma, most with significant associated injuries. Fifty-three of the patients were followed up for at least 2 years. Clinical outcome was analyzed clinically using the Harris hip score and radiographically. In 41 (77.4%) of the patients, the surgical procedure was judged successful (Harris hip score greater than 80 points). Three factors were found to be statistically significant predictors of such an outcome: patient age younger than 40 years; simple fractures based on the classification of Letournel and Judet; and absence of damage to the femoral head. Possible influential factors that were not found to be statistically significant in this population included additional injuries, immediate complications, quality of reduction, heterotopic ossification, ipsilateral femoral fracture, and sciatic nerve damage. Open reduction and internal fixation of the displaced acetabular fracture, although a demanding procedure, can result in a satisfactory clinical outcome given a consistent approach with a dedicated team. 相似文献
57.
BACKGROUND: Cost reduction has become an important fiscal aim of many hospitals and anesthetic departments, despite its inherent limitations. Volatile anesthetic agents are some of the few drugs that are amenable to such treatment because fresh gas flow rate (FGFR) can be independent of patient volatile anesthetic agent requirement. METHODS: FGFR and drug use were recorded at the temporal midpoint of 2,031 general anesthetics during a 2-month preintervention period. Staff and residents were provided with their preintervention individual mean FGFR, their peer group mean, and educational material regarding volatile agent costs and low-flow anesthesia. FGFR and drug use were remeasured over a 2-month period (postintervention) immediately after this information (N = 2,242) and again 5 months later (delayed follow-up), for a further 2-month period (N = 2,056). RESULTS: For all cases, FGFR decreased from 2.4+/-1.1 to 1.8+/-1.0 l/min (26% reduction) after the intervention and increased to 1.9+/-1.1 l/min (5% increase of preintervention FGFR) at the time of delayed follow-up. Use of more expensive volatile agents (desflurane and sevoflurane) increased during the study period (P < 0.01). In a subgroup of 44 staff members with more than five cases in all study periods, 42 members decreased their mean FGFR after intervention. At delayed follow-up, 30 members had increased their FGFR above postintervention FGFR but below their initial FGFR. After accounting for other predictors of FGFR, the effectiveness of the intervention was significantly reduced at follow-up (28% reduction), but retained a significant effect compared to preintervention FGFR (19% reduction). CONCLUSIONS: Although individual feedback and education regarding volatile agent use was effective at reducing FGFR, effectiveness was reduced without continued feedback. Use of more expensive volatile agents was not reduced by education regarding drug cost, and actually increased. 相似文献
58.
Avascular necrosis after treatment of DDH: the protective influence of the ossific nucleus 总被引:4,自引:0,他引:4
Segal LS Boal DK Borthwick L Clark MW Localio AR Schwentker EP 《Journal of pediatric orthopedics》1999,19(2):177-184
We retrospectively reviewed the results of open or closed reduction for developmental dysplasia of the hip (DDH) in 49 children younger than 12 months old, who had 57 hip dislocations. Group A (18 hips) developed partial or complete avascular necrosis (AVN), and group B (39 hips) did not develop AVN. Thirty-eight hips were treated by closed reduction, and 17 had open reduction. One patient with bilateral hip dislocation initially had closed reductions followed by bilateral open reduction 3 months later. With the numbers available for study, there was no significant difference in the occurrence of AVN with respect to variables such as preliminary traction, closed versus open reduction, Pavlik harness use, and age at the time of operative intervention. However, the presence of the ossific nucleus before reduction, detected either by radiographs (p < 0.001) or ultrasonography (p = 0.033) was statistically significant in predicting AVN. Only one (4%) of 25 hips with an ossific nucleus developed AVN, whereas 17 (53%) of 32 hips without an ossific nucleus before reduction developed AVN. Our results suggest that the presence of the ossific nucleus before closed or open reduction for DDH may decrease the risk of AVN. 相似文献
59.
Rationale: We have previously shown that during the acute response to amphetamine, a stimulant that released dopamine, behavioral sensitivity
to the drug undergoes dynamic changes, as evident in the altered behavioral profile expressed to the subsequent administration
of a low dose of the drug. Objective: The present studies were designed to determine if these dynamic changes in sensitivity occur with amphetamine-like stimulants
that act primarily by blocking dopamine uptake. Methods: Groups of animals were primed with 40 mg/kg cocaine or 30 mg/kg methylphenidate, then during the acute response, a low, locomotor-stimulant
dose of amphetamine (1.5 mg/kg) was administered to probe for changes in sensitivity. Conversely, to determine whether the
manifestation of the increased responsivity is idiosyncratic to amphetamine, animals were also primed with amphetamine (4
mg/kg), then probed with low doses of cocaine (10 and 20 mg/kg) or methylphenidate (10 mg/kg). Parallel microdialysis studies
were performed to assess the caudate-putamen and nucleus accumbens extracellular dopamine responses. Results: Priming with the uptake blockers each resulted in a stereotypy response to the subsequent low-dose amphetamine probe. Likewise,
after priming with amphetamine, the uptake blockers each induced a pronounced stereotypy response. In each case, these changes
in behavioral responsivity were expressed in the absence of corresponding changes in the probe-induced regional dopamine responses.
Conclusions: Dynamic changes in behavioral sensitivity during the response to acute stimulant administration are a characteristic common
to both dopamine releasers and uptake blockers. These rapid changes in sensitivity may contribute to the behaviors associated
with binge patterns of drug abuse.
Received: 5 April 1999 / Final version: 28 May 1999 相似文献
60.
Segal IE 《Proceedings of the National Academy of Sciences of the United States of America》1993,90(11):4798-4805
Key predictions of the Hubble law are inconsistent with direct observations on equitable complete samples of extragalactic sources in the optical, infrared, and x-ray wave bands-e.g., the predicted dispersion in apparent magnitude is persistently greatly in excess of its observed value, precluding an explanation via hypothetical perturbations or irregularities. In contrast, the predictions of the Lundmark (homogeneous quadratic) law are consistent with the observations. The Lundmark law moreover predicts the deviations between Hubble law predictions and observation with statistical consistency, while the Hubble law provides no explanation for the close fit of the Lundmark law. The flux-redshift law F [symbol, see text] (1 + z)/z appears consistent with observations on equitable complete samples in the entire observed redshift range, when due account is taken of flux limits by an optimal statistical method. Under the theoretical assumption that space is a fixed sphere, as in the Einstein universe, this law implies the redshift-distance relation z = tan2(r/2R), where R is the radius of the spherical space. This relation coincides with the prediction of chronometric cosmology, which estimates R as 160 +/- 40 Mpc (1 parsec = 3.09 x 10(16) m) from the proper motion to redshift relation of superluminal sources. Tangential aspects, including statistical methodology, fundamental physical theory, bright cluster galaxy samples, and proposed luminosity evolution, are briefly considered. 相似文献