The exfoliation syndrome in cognitive impairment of cerebrovascular or Alzheimer's type

The prevalence of exfoliation syndrome was studied in 39 patients suffering from dementia and cognitive impairment; a positive finding of exfoliation was detected in 11/39 of these patients. A comparison with an age-matched population survey showed that the prevalence of ocular exfoliation and the relative risk were significantly elevated. These results suggested that lesions related to the exfoliative process might be located also in the brain of patients suffering from dementia and cognitive impairment.     

Increased incidence of dyskinesias and other behavioral effects of re-exposure to neuroleptic treatment in social colonies of Cebus apella monkeys

RATIONALE: Typical neuroleptic medications are still administered to as many as 40% of patients receiving antipsychotic treatment in the US. Intermittent administration or interruption of long-term neuroleptic medication for schizophrenia may increase the incidence of human tardive dyskinesias, and similarly may produce increasingly marked motor side-effects, parkinsonism, and other behavioral pathologies in non-human primates. OBJECTIVES AND METHODS: Given these similarities, we addressed the issue of prolonged and intermittent typical neuroleptic treatment and dopaminergic function during a 5-year, multi-phase study with social colonies of Cebus apella monkeys. In the previously reported phase 1, we examined the effects of 48 weeks of exposure to, followed by withdrawal from, fluphenazine decanoate (FPZ). Phase 3 reported here examined the effects of 18 weeks of re-exposure to FPZ in these same monkeys, 91 weeks after discontinuation of their phase 1 FPZ treatment. RESULTS: Analysis of blood plasma FPZ indicated levels of 0.22+/-0.08 ng/ml for the six injections during the re-exposure period (n=54), comparable to the 0.24+/-0.07 ng/ml levels measured during our original treatment with this dose. Acute dyskinesias and dystonias increased by 300% upon re-exposure to FPZ; 15 of 18 FPZ-treated animals exhibited oral-buccal dyskinesias and all exhibited torticollis or retrocollis. Retreatment with FPZ was also associated with highly significant reductions in Self- and Environment-Directed Behavior and Directed Affiliation, effects similar to those seen during the original phase 1 FPZ treatment. Although FPZ re-treatment was associated with a significant reduction in Directed Aggression (an effect that was more robust than that observed during phase 1), in phase 3, we again observed an increase in Directed Aggression during early drug discontinuation when animals were in a stress-inducing situation. CONCLUSIONS: These results both support our phase 1 conclusion that typical neuroleptic medications may contribute to negative symptoms of schizophrenia and provide additional evidence for the possibility of increased aggression in stressful situations when medication is discontinued. Additionally, the results indicate that intermittent treatment with typical neuroleptics may dramatically increase the incidence of dystonias and dyskinesias.     

The critical role of patient follow-up after receiving a diagnosis of prostatic intraepithelial neoplasia

With the increasing incidence of prostatic intraepithelial neoplasia being found at the time of prostate biopsy and the association of prostatic intraepithelial neoplasia to coexisting prostate cancer and/or the future development of prostate cancer, patient compliance in following post-biopsy follow-up instructions for re-biopsy is becoming more significant in the detection of prostate cancer at an earlier and, therefore, potentially curable stage. During a 3-y period, we reviewed the charts of 130 patients who received an initial diagnosis of prostatic intraepithelial neoplasia after undergoing transrectal ultrasound of the prostate with biopsy. It is our policy to inform the patient of their diagnosis of prostatic intraepithelial neoplasia at the time of the initial biopsy and to recommend a repeat biopsy in 6-12 months. Patients are informed of the diagnosis of prostatic intraepithelial neoplasia verbally and in writing. In addition, a letter is sent to their referring physician with the re-biopsy recommendation. Thirty-nine of 130 patients (30%) were seen for re-biopsy within the specified time. An additional 36 patients (27.69%) were re-biopsied between 12 and 18 months after the initial diagnosis of prostatic intraepithelial neoplasia. An additional 11 patients (7%) were re-biopsied more than 18 months after their initial diagnosis. Forty-four patients failed to return for re-biopsy. Overall, patient follow-up within the desired protocol was poor and must be improved upon to prevent any delays in the diagnosis of prostate cancer. Prostate Cancer and Prostatic Diseases (2001) 4, 63-66     

Status of functional outcomes for stroke survivors

In the past, it has taken several years to accumulate a sufficient number of subjects in the community-based studies to arrive at generalized conclusions. With an ongoing database, such as resides at CFAR-UDSMR, it is possible to collect a large number of cases within a relatively short period of time. Further, it is relatively easy to perform continuous monitoring in order to determine trends that may be occurring as a result of the changing scenes in health care delivery. It has been possible to uncover patterns of scoring the functional status of patients that reveal a consistent picture of an underlying biology of disability and predictable characteristics in patients' courses through the rehabilitation process. Newer analytic methods have allowed one to predict expected recovery patterns. This new information will allow one to better measure and manage outcomes, to improve the quality of care, to improve cost-effectiveness, and to better manage financial risk. These are the tools necessary for clinicians to incorporate into practice, as expectations with respect to outcomes and reimbursement for health care are changing. All of the marks associated with FIM and UDSMR belong to the Uniform Data System for Medical Rehabilitation, a division of UB Foundation Activities, Inc.     

Novel approaches; improved diagnostics and therapeutics with DNA microarrays. II. Applications

The most important (future) applications of DNA microarrays in medicine are based on three different molecular analyses: gene expression analysis, genotyping with a specific type of microarray (single nucleotide polymorphism chip (SNP chip)), and DNA sequencing to search for a well-known mutation in a certain gene. With gene expression analysis one can obtain a 'molecular signature' of a tissue by allowing tissue RNA to react with a DNA microarray. This information may help to refine disease classifications, to guide the choice of therapy and to find new therapeutic targets. Genotyping utilizes genomic DNA that, after digestion, reacts with a SNP chip to obtain an individual SNP pattern. An SNP is a change of a single base pair within a gene sequence that can sometimes influence the function of the gene product. SNPs are considered to be variations in the genome and should be distinguished from mutations. These variations can for instance provide information about the probability of a certain disease, or the effectiveness or side effect of a certain drug. Sequencing well characterized genes to search for mutations is used to screen for genetic abnormalities. This process can be accelerated with the aid of oligonucleotide arrays. With this tool an individual's risk of developing certain forms of cancer or monogenetic diseases can be estimated.     

淫羊藿苷对快速老化小鼠SAMP10学习记忆能力 以及胆碱能系统活性的影响

目的:探讨淫羊藿苷(ICA)对快速老化小鼠SAMP10的学习记忆能力以及胆碱能系统的影响.方法:采取8月龄快速老化小鼠SAMP10为实验对象,随机分为模型SAMP10组,阳性药多奈哌齐组(1 mg· kg-1),ICA低、中、高剂量(50,100,200 mg·kg-1)组,每组12只,以12只同月龄抗快速老化小鼠SAMR1为正常对照.灌胃给药30 d,通过Morris水迷宫、SMG-2迷宫、小鼠跳台仪检测ICA对SAMP10学习记忆能力的影响,通过比色法测定皮层中乙酰胆碱酯酶(AChE)的活力,采用酶联免疫吸附测定法检测乙酰胆碱(ACh)、乙酰胆碱转移酶(ChAT)以及M-胆碱能受体结合力(MCBC)来探讨ICA对SAMP10小鼠胆碱能系统的作用.结果:ICA可以改善SAMP10小鼠的空间探索能力以及定位航行能力,缩短SAMP10小鼠在SMG-2迷宫的潜伏期,提高其在跳台实验中的被动反应能力,增加SAMP10小鼠大脑皮层ACh的含量,提高SAMP10小鼠皮层中MCBC以及ChAT的活性,但对SAMP10小鼠皮层中的AChE活性作用不明显.结论:不同剂量的淫羊藿苷可不同程度的改善SAMP10小鼠的学习记忆能力,其作用机制可能与对胆碱能系统的影响有关.     

Response properties of cochlear nucleus neurons in monkeys

Much of what is known about how the cochlear nuclei participate in mammalian hearing comes from studies of non-primate mammalian species. To determine to what extent the cochlear nuclei of primates resemble those of other mammalian orders, we have recorded responses to sound in three primate species: marmosets, cynomolgus macaques, and squirrel monkeys. These recordings show that the same types of temporal firing patterns are found in primates that have been described in other mammals. Responses to tones of neurons in the ventral cochlear nucleus have similar tuning, latencies, post-stimulus time and interspike interval histograms as those recorded in non-primate cochlear nucleus neurons. In the dorsal cochlear nucleus, too, responses were similar. From these results it is evident that insights gained from non-primate studies can be applied to the peripheral auditory system of primates.     

三甲医院临床医师及药师的药物流行病学认知度调查

摘 要 目的:了解临床医师及药师对药物流行病学的认知度,为推进药物流行病学知识普及和应用研究提供建议。方法：采用便利抽样的方法,用自行设计的调查问卷对浙江、山东、河南、甘肃、四川五省共17所三甲医院的376名临床医师及药师进行问卷调查。结果：在抽查的临床医师和药师中,药物流行病学的知晓率为72.9%,有27.1%的被调查者从未听说过药物流行病学,而在实践中应用过药物流行病学方法的也只有19.1%。多因素Logistic回归分析结果显示,影响知晓率的因素为年龄越大(OR=2.262,95%CI:1.630～3.140）和学历越高（OR=1.858,95%CI:1.305～2.646）知晓率越高,在校期间学习过相关知识者的知晓率比没有学习者高(OR=11.463,95%CI:5.599～23.467）。结论：三甲医院临床医师和药师对药物流行病学的知晓和应用情况不理想,应加强药物流行病学知识的宣传和普及,提高临床医师及药师对药物流行病学的认知度以及临床上的应用,推动药物流行病学研究的进展。