University of Kentucky Sanders-Brown healthy brain aging volunteers: donor characteristics, procedures and neuropathology

Cognitively intact elderly research volunteers at the University of Kentucky have been recruited, followed longitudinally, and autopsied with extensive neuropathological evaluations since 1989. To date, the cohort has recruited 1,030 individuals with 552 participants being actively followed, 363 deceased, and 273 autopsied. An extensive database has been constructed with continuous updates that include textured clinical, neuropsychological, neuroimaging, and pathological information. The history, demographics, clinical observations, and pathological features of this research cohort are described. We also explain some of the evolving methodologies and the academic contributions that have been made due to this motivated group of older Kentuckians.     

Viral infections of the autonomic nervous system and its target organs: Pathogenetic mechanicsms

The possibility that viruses can infect the peripheral autonomic nervous system (ANS) and cause a variety of acute, chronic or recurrent diseases, including such disorders as peptic ulcer, is proposed. By altering the functional activity of autonomic neurons or by seeding the target organs of these neurons with virus, infection of the ANS may produce a broad spectrum of clinical manifestations. Whether these manifestations are anatomically circumscribed or widespread will depend upon the route by which autonomic infection is acquired as well as the character of interaction between the virus and the infected autonomic neuron. In addition, it is proposed that autonomic ganglia may serve as reservoirs of latent viruses, insuring their preservation and intermittent transmission in the human community.     

Production of Chemotactic Factor and Lymphotoxin by Human Leukocytes Stimulated with Herpes Simplex Virus

Peripheral blood leukocytes (PBL) of 41 subjects were tested for their ability to be stimulated by herpes simplex virus antigens as measured by [(3)H]thymidine incorporation and lymphokine production (i.e., lymphocyte-derived chemotactic factor and lymphotoxin). The PBL of seronegative subjects failed to respond to viral antigens as measured by stimulation or lymphokine production. In contrast, PBL from seropositive subjects without clinical lesions of herpes labialis were stimulated by herpes simplex virus antigens and produced lymphokines. PBL from seropositive patients with clinical lesions of herpes labialis also produced lymphokines, but [(3)H]thymidine incorporation was slightly depressed. These findings suggest that lymphocytes from patients with a recent herpes simplex virus infection may respond less vigorously to in vitro stimulation by herpes antigens, but our study fails to show any basic defect in the responsiveness of the lymphocytes to account for recurrent herpetic episodes.     

Association of antiepileptic drugs, vitamin D, and calcium supplementation with bone fracture occurrence in epilepsy patients

The aim of this study is to determine whether calcium and vitamin D supplementation reduces the risk of bone fractures in adult epilepsy patients. Records were obtained on 7716 patients with epilepsy prescribed antiepileptic drugs (AED) from the Veteran Affairs Hospital in Lexington, Kentucky. We performed a single center, retrospective cohort study to examine the proportion of fractures in 3303 patients on AED who took supplements compared to patients on AED not taking supplements. Patients prescribed long-term AEDs taking calcium and vitamin D were as likely to have fractures as those who did not take these supplements (11.7% vs. 9.9%, χ² = 0.59, p = 0.44). Phenytoin use was associated with a statistically significant increased risk of fractures OR = 1.55 (1.10-2.24). Thus, in this group of patients with epilepsy on AED, bone fractures were not prevented in individuals taking calcium and vitamin D supplementation.     

Medication-related dizziness in the older adult

With increased medication use among the older adult population, adverse drug events and polypharmacy can be significant causes of dizziness in the elderly. The evidence evaluated in this review is helpful in clinical practice but requires an additional detailed investigation into the agents discussed to understand the risk/benefit ratio associated with medications. Examples of medications highly associated with dizziness in older adults and discussed in this review include cardiovascular and central nervous system agents. Several other medication classes associated with dizziness are among the medications most commonly used by older patients.     

Relevance of skin phototyping to a Korean population

We have determined skin phototype by a self-reporting questionnaire proposed by Fitzpatrick in 128 Korean medical students. We also measured the minimal erythema dose (MED), minimal melanogenic dose and investigated their relationship to phototype. A questionnaire of skin phototypes revealed that 13.3% of the students are skin phototypes I and II. Based on MEDs, we demonstrated that 14.8% of the students fall into the UV-sensitive group as defined by an MED of less than 40 mJ/cm² which is the upper range of MED of phototypes I and II in a white population. The skin phototypes did not show a positive correlation to MEDs and only 2.3% of students classified as skin phototypes I and II showed an MED below 40mJ/cm². This study indicates that the skin phototyping method proposed by Fitzpatrick does not reliably predict UV-sensitive individuals within the Korean population.     

实验性变态反应性脑脊髓炎T淋巴细胞增殖和肿瘤坏死因子—α变化的意义

目的：探讨实验性变态反应性脑脊髓炎（EAE）T淋巴细胞增殖和肿瘤坏死因子（TNF）－α变化的意义。方法：观察Lewis大鼠主动免疫性EAE临床症状,T淋巴细胞增殖以及血清TNF－α水平,结果：EAE临床发病过程中,T淋巴细胞增殖活跃,血清TNF－α水平异常升高,并与临床症状呈正相关。结论：研究表明：EAE时,TI林巴细胞增殖旺盛和TNF－α生成增多。进而导致血脑屏障的破坏,炎细胞浸润,从而诱发EAE。