Neuroendocrine responses in chronic schizophrenia: Evidence for serotonergic dysfunction

Neuroendocrine and mood responses to a 60 mg oral dose of the serotonin-releasing agent, fenfluramine, were assessed in ten neuroleptic-free, chronic schizophrenic patients and in age- and sex-matched normal control subjects. The prolactin (PRL) response to fenfluramine was significantly blunted in the schizophrenic subjects. Growth hormone and cortisol levels were not differentially affected by the challenge. There was no significant effect of fenfluramine on mood in either group. The blunted PRL response in the schizophrenic group suggests serotonergic dysfunction; possible mechanisms of this finding and implications for treatment are considered.     

FDA and AAPS Report of the Workshop on Principles and Practices of In Vitro Percutaneous Penetration Studies: Relevance to Bioavailability and Bioequivalence

Pharmaceutical Research -     

The roles of serum myoglobin,total CPK,and CK-MB isoenzyme in the acute phase of myocardial infarction

Frequent blood samples were drawn for determination of serum myoglobin, creatine phosphokinase (CPK), and the MB isoenzyme of CPK (CPK-MB) in patients with acute myocardial infarction (AMI). Significantly elevated levels of myoglobin were present 1.5 hours following onset of chest pain and predated elevations of CPK and CPK-MB by 3 hours. No evidence of the previously described “staccato” phenomenon was found. Due to very frequent blood sampling, a detailed picture of the evolution over time of the above indices was obtained. Significant differences were found in the biochemical profile of anterior wall infarction and diaphragmatic wall MI. A time-sensitivity curve (showing sensitivity of the assay at each time following onset of symptoms) was obtained for myoglobin, CPK, and CPK-MB. It appears that myoglobin is the most sensitive biochemical indicator of AMI in its early phase and since it decreases rapidly back to normal values, it can serve as an invaluable aid in the diagnosis of reinfarction and infarct extension. CPK-MB is a less sensitive indicator of MI but has the advantage of greater specificity.     

Central thyrotropin-releasing hormone elicits systemic hypoglycemia in mice

Thyrotropin-releasing hormone (TRH), injected into the central nervous system (CNS) in rats, has been shown to elicit systemic hyperglycemia. In the present study, central TRH administration significantly decreased the plasma glucose in mice. The hypoglycemic response could be blocked by pretreatment with the muscarinic cholinergic antagonist, atropine methyl bromide, or the diabetogenic β-cytotoxin, alloxan, implicating the involvement of the parasympathetic system and insulin-secreting cells in the endocrine pancreas. The role of TRH in the CNS in the autonomic regulation of glucose homeostasis is discussed.     

The surgical treatment of atelectatic ears and retraction pockets in children and adults

Summary Eighty-four ears which underwent tympanoplasty because of an atelectasis of the tympanic membrane were followed up. Thirty-six involved children (4–13 years old). On the average, 50–55 months of postoperative follow-up showed that atelectasis, once operated, shared the same pattern and prognosis in the children as in the adults.     

Missing stapes and stapes-replacing prosthesis

Our study of 205 ears with missing stapes, secondary to some type of chronic ear disease, showed that only 40% of such ears are suitable for ossiculoplasty. The remaining 60% are unsuitable because of a fixed footplate, severe atelectasis, hearing better than 25 dB (these patients do not need the operation), or poor discrimination. A new stapes replacement prosthesis (SRP), which we term Tabor, is described for use where indicated. The prosthesis has two parts: The lower part (or base) is made of a broad inorganic, biocompatible material (Teflon). This part fits and covers most of the footplate, ensuring maximal stability. The upper part of the prosthesis is made of autograft or homograft bone--usually a malleus head--the contact of which with the drum prevents extrusion. In twelve out of fourteen ears insertion of this prosthesis was successful; the average postoperative air conduction went from 56 dB to 29 dB, leaving an average air-bone gap of 16 dB. The bone conduction also improved, from an average of 20 dB to 13 dB.     

External auditory canal dysplasia: CT evaluation

Dysplasias of the external auditory canal can be evaluated with high resolution CT using proper technique. Images are studied to determine the type of atresia (membranous or bony) nnd the thickness of the associated atretic plate (if present). Other findings sought include the degree of pneumatization, the status of the fenestrae, the size of the tympanic cavity, and the location of both the mandibular condyle and the facial nerve canal.     

Protective effect of albuterol delivered via a spacer device (Babyhaler®) against methacholine induced bronchoconstriction in young wheezy children

Nine young asthmatic children aged 2–5 years underwent methacholine challenge after placebo or albuterol administered by metered dose inhaler through a spacer device (Babyhalere®)* with a face mask in a double-blind, cross-over, randomized study. The methacholine challenge was performed using chest auscultation to define the provocative concentration of methacholine that causes wheezing (PCW). The PCW increased from a geometric mean of 0.28 mg/mL after placebo to 3.59 mg/mL after albuterol (P < 0.0001). The protective effect of albuterol against methacholine-induced bronchospasm was 3.7 ± 1.2 doubling doses. We conclude that administration of drugs from a metered dose inhaler through the Babyhaler® with a face mask is effective. Albuterol causes a major reduction in the bronchial hyperreactivity in young wheezy children shortly after administration. Pediatr Pulmonol. 1994; 17:281–284. © 1994 Wiley-Liss, Inc.