Obsessive-compulsive disorder, depression, and the dexamethasone suppression test

Five of 29 obsessive-compulsive disorder patients were dexamethasone suppression test (DST) nonsuppressors, all of whom met standard Hamilton Depression Rating scale criteria for at least mild depression. None of 24 nondepressed obsessive-compulsive disorder patients had an abnormal DST. The relationship of the DST to specificity of psychiatric diagnoses is discussed.     

Technique and early clinical results of endoscopic variceal ligation (EVL)

Summary Endoscopic variceal ligation (EVL) is a new technique designed to be used instead of sclerotherapy. Small elastic O rings ligate varices resulting in their strangulation and eradication. During a 12-month period, EVL was employed in 53 consecutive patients, of whom 36 (68%) had alcoholic cirrhosis 17 were Child-Pugh class A, 22 class B, and 14 class C. Varices were graded from I to IV and repeat treatments were given at 1–2 week intervals until the varices were eliminated. At follow-up ranging from 6–18 months (mean 11.5), 217 EVL treatment sessions had been performed. Of the 13 patients (24%) who died during the study, 11 died during the index hospitalization. Active bleeding was controlled in 19 of 21 patients (90%). Of 40 survivors 13 patients (33%) had 1–2 (mean 1.4) recurrent variceal bleeds while 34 patients had repeat EVL treatment. Elimination of distal varices was achieved in 26 and 7 had reduction of varices from grade III–IV to grade I–II or less. Eradication required a mean of 4.4 EVL sessions in Child's A and B patients and 7.0 sessions in Child's C patients (P<0.025). No significant treatment-related complications were observed. EVL appears to control active bleeding, is associated with a low incidence of non-bleeding complications, and may be used as an alternative to sclerotherapy.     

Interleukin-10 inhibits IgE-mediated nitric oxide synthase induction and cytokine synthesis in normal human keratinocytes

Human keratinocytes (HK) generate nitric oxide (NO) and proinflammatory mediators following activation with either IgE/anti-IgE immune complexes or a combination of lipopolysaccharide (LPS) and interferon-γ (IFN-γ). Recently, interleukin-10 (IL-10) has been shown to down-regulate various inflammatory responses and to be secreted by lymphocytes and dendritic cells during skin inflammatory reactions. We show here that IL-10 down-regulates the production of tumor necrosis factor (TNF)-α and IL-6 by activated HK. Also, induction of inducible nitric oxide synthase (iNOS) expression in HK by IgE/anti-IgE or LPS/IFN-γ is significantly reduced by the addition of IL-10. This effect is dose dependent and correlates with reduction of iNOS mRNA production and enzyme level. Therefore, IL-10 down-regulates NO-mediated HK inflammatory responses and may thus participate in the regulation of the skin immune network.     

Endoscopic sclerotherapy as compared with endoscopic ligation for bleeding esophageal varices.

BACKGROUND. Endoscopic sclerotherapy is an accepted treatment for bleeding esophageal varices, but it is associated with substantial local and systemic complications. Endoscopic ligation, a new form of endoscopic treatment for bleeding varices, may be safer. We compared the effectiveness and safety of the two techniques. METHODS. In this randomized trial we compared endoscopic sclerotherapy and endoscopic ligation in 129 patients with cirrhosis who had proved bleeding from esophageal varices. Sixty-five patients were treated with sclerotherapy, and 64 with ligation. Initial treatment for acute bleeding was followed by elective retreatment to eradicate varices. The patients were followed for a mean of 10 months, during which we determined the incidence of complications and recurrences of bleeding, the number of treatments needed to eradicate varices, and survival. RESULTS. Active bleeding at the first treatment was controlled by sclerotherapy in 10 of 13 patients (77 percent) and by ligation in 12 of 14 patients (86 percent). Slightly more sclerotherapy-treated patients had recurrent hemorrhage during the study (48 percent vs. 36 percent for the ligation-treated patients, P = 0.072). The eradication of varices required a lower mean (+/- SD) number of treatments with ligation (4 +/- 2 vs. 5 +/- 2, P = 0.056) than with sclerotherapy. The mortality rate was significantly higher in the sclerotherapy group (45 percent vs. 28 percent, P = 0.041), as was the rate of complications (22 percent vs. 2 percent, P less than 0.001). The complications of sclerotherapy were predominantly esophageal strictures, pneumonias, and other infections. CONCLUSIONS. Patients with cirrhosis who have bleeding esophageal varices have fewer treatment-related complications and better survival rates when they are treated by esophageal ligation than when they are treated by sclerotherapy.     

Babesia bovis : identification of immunodominant merozoite surface proteins in soluble culture-derived exoantigen

Babesia bovis merozoite proteins presenting as exoantigens in in vitro culture supernatants have been characterized. Bovine antisera to B. bovis exoantigens were used to immunoprecipitate [³⁵S]-methionine metabolically labeled or lactoperoxidase-catalyzed radioiodinated B. bovis merozoite proteins. A total of 24 metabolically labeled proteins ranging in molecular weight from 24,000 to 225,000 Da and 9 radioiodinated proteins with molecular weights varying between 24,000 and 225,000 Da were identified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Monoclonal antibodies to B. bovis merozoite surface proteins were also used to immunoprecipitate metabolically labeled exoantigens directly from in vitro culture supernatants. These results demonstrate epitopes from at least nine merozoite surface proteins present in the exoantigen fraction, among which are the recently characterized major surface antigens 1 and 2, rhoptry-associated protein 1, and spherical body protein 2. Received: 1 April 1997 / Accepted: 6 May 1997     

Point mutations in the P30 domain of the gag gene of Moloney murine leukemia virus

A series of point mutations in the P30 domain of the Moloney murine leukemia virus gag gene was generated by bisulfite treatment of heteroduplex DNAs containing a single-stranded region in the gag gene. One virus bearing such a mutation exhibited a coordinate defect in gag and pol function, and was similar to previously described deletion mutants with alterations in this gene. One mutant virus displayed a different phenotype: it could assemble virion particles and provide pol function, but the particles were defective in the early stages of infection. The continued concordance of the mutants' failure or ability to both assemble virions and provide pol lends further support to the proposal that similar parts of the gag gene are required for these two processes.     

Bulimia in male patients

Bulimia is not exclusively a disorder of women. Twelve men with bulimia were evaluated and found to have demographic variables and eating behaviors similar to those of female bulimia patients. Eleven of the 12 men were binge eating more than once a day, and ten of the 12 also self-induced vomiting on a regular basis. Three patients had initiated bulimic behavior in association with athletic training. Eight patients followed through with treatment referrals and responded favorably to therapy.     

Impaired recruitment of the hippocampus during conscious recollection in schizophrenia

Poor attention and impaired memory are enduring and core features of schizophrenia. These impairments have been attributed either to global cortical dysfunction or to perturbations of specific components associated with the dorsolateral prefrontal cortex (DLPFC), hippocampus and cerebellum. Here, we used positron emission tomography (PET) to dissociate activations in DLPFC and hippocampus during verbal episodic memory retrieval. We found reduced hippocampal activation during conscious recollection of studied words, but robust activation of the DLPFC during the effort to retrieve poorly encoded material in schizophrenic patients. This finding provides the first evidence of hippocampal dysfunction during episodic memory retrieval in schizophrenia.     

Changes in striatal cholinergic, gabaergic, dopaminergic and serotoninergic biochemical markers after kainic acid-induced thalamic lesions in the rat

Summary Kinetic parameters of³H-choline,³H-GABA and³H-dopamine (DA) uptakes in striatal homogenates containing nerve endings were determined 2 to 3 weeks after kainic acid injection into the ipsilateral centre médian-parafascicular complex area of the thalamus in the rat. Results showed a marked decrease in³H-choline uptake concomitant with a selective decrease in Vmax. Data also showed a large decrease in³H-GABA uptake resulting from a decreased affinity of uptake sites for their substrate. These data were asociated with the previously described decrease in choline acetyltransferase and increase in glutamic acid decarboxylase apparent activity, respectively. An apparent marked increase in³H-DA uptake was likewise measured, mainly related to an increase in Vmax. Determination of serotonin (5HT) and 5-hydroxyindole acetic acid (5HIAA) endogenous contents showed in the deafferented striatum a decrease in 5HT concentrations associated with an increase in 5HIAA levels. Taken together, all these changes in neurotransmitter markers suggest that, directly through the thalamostriatal pathway or indirectly, the thalamus can exert a complex influence on striatal cholinergic and GABAergic neuronal functions as well as on the activity of dopaminergic and serotoninergic striatal afferent fibers.