Time of sunrise and hours with daylight may have an effect on the seasonality and diurnal variation of heart attack

Background The time of onset of myocardial infarction shows seasonal and daily variation. We aimed to investigate whether the number of hours with daylight has an effect on the seasonal variation of heart attack, and whether the time of sunrise has an effect on the diurnal rhythm of myocardial infarction. Methods We carried out a retrospective database study covering all patients admitted to any acute care hospital with the diagnosis of myocardial infarction in Hungary between January 2004 and December 2005 （n=32 329）. Data were collected from the National Health Insurance Fund Administration （OEP） according to the International Classification of Diseases （ICD 121, 122） and National Meteorology Service （OMSZ）. In case of patients who occurred in the database several times the events have been considered as a separate case. Results With consideration to seasonal variation, the peak period of heart attack was found in the spring, with the lowest number of events in the summer. The number of hours with daylight showed a weak negative correlation with the occurrence of myocardial infarction （r=-0.108, P 〈0.05）. With respect to diurnal variation, the peak period of daily events was between 6-12 in the morning （35.57%）. We have found a positive correlation between the time of sunrise and sunset and the occurrence of myocardial infarction （P 〈0.01）. Conclusion Based on our findings, the number of hours with daylight and the time of sunrise may be connected with the chances of having heart attack; however other factors, such as high blood pressure, diabetes or smoking may also have an influence.     

Localizing and lateralizing value of behavioral change in childhood partial seizures

OBJECTIVE: To describe clinical characteristics as well as localizing and lateralizing value of behavioral change (BC) at the onset of childhood seizures. METHODS: Five hundred forty-one videotaped seizures of 109 consecutive patients < or = 12 years with partial epilepsy and postoperatively seizure-free outcome were analyzed. Behavioral change (the first clinical feature of a certain seizure with a sudden change in the child's behavior) was evaluated by two independent investigators. RESULTS: Thirty-three (30%) patients showed BC at least once during their seizures. Behavioral changes appeared in arrestive form in 19 and with affective activities in 18 children; four patients produced both kinds of BCs, separately. Arrest-type BC happened in 16 of 50 children with right- and 3 of 59 patients with left-sided seizure onset zone (p < 0.001). Affective-type BC was observed in 17 of 67 temporal lobe epilepsy patients while it happened in only 1 of 42 children with extratemporal lobe epilepsy (p = 0.001). CONCLUSIONS: Arrest-type BC lateralizes to the right hemisphere, while affective-type BC localizes to the temporal lobe in childhood partial seizures. Type of BCs can add important information to the presurgical evaluation of young children with refractory partial epilepsy.     

Peri-ictal vegetative symptoms in temporal lobe epilepsy

We investigated peri-ictal vegetative symptoms (PIVS) in 141 patients with adult temporal lobe epilepsy (TLE) and assessed frequency, gender effect, and lateralizing value of peri-ictal autonomic signs. We recorded abdominal auras in 62%, goosebumps in 3%, hypersalivation in 12%, spitting in 1%, cold shivering in 3%, urinary urge in 3%, water drinking in 7%, postictal nose wiping (PNW) in 44%, and postictal coughing in 16%. At least one vegetative sign appeared in 86% of the patients. The presence of PIVS did not have a significant lateralizing value. PNW occurred in 52% of women and in 33% of men, whereas any PIVS was present in 93% of women and 77% of men. In summary, contradictory to previous studies, the presence of PIVS has no lateralizing value, which may be linked to a low frequency of occurrence of PIVS. PIVS, especially PNW, occurred more frequently in women, supporting the gender differences in epilepsy.     

Vulvar intraepithelial neoplasia

HPV infections of the lower genital tract are associated with the increasing incidence of vulvar intraepithelial neoplasia. The new classification divides vulvar intraepithelial neoplasia according to its incidence into two groups: usual and differentiated type. The usual type occurs mainly in young women and is associated with HPV infection, the differentiated type is HPV-negative and occurs in older women. The diagnosis is based on biopsy from a suspicious lesion. The standard treatment involves surgical excision. Topical treatment is now being preferred in young women in order to preserve appearance of the genitalia and sexual function. The high risk of recurrence is the reason for strict monitoring of patients after treatment completion.     

PET-CT Imaging and Reality

The spectrum of human diseases caused by members of the Aspergillus genus is extensive. It ranges from allergic reactions to colonization of preexisting pulmonary cavities to invasion and destruction of lung parenchyma with pyemic spread to brain, skin, and other organs, causing rapid death. The immune status of the host is a crucial factor in determining the phenotype and severity of the disease. In this case report Chronic Necrotizing Pulmonary Aspergillosis (CNPA), a rare, locally- or semi-invasive variant of pulmonary Aspergillosis, mimicking lung metastasis is presented. The 60-year-old male patient had earlier received multiple cycles of systemic chemotherapy due to colorectal carcinoma. Our case report focuses on the benefits and the possible disadvantages of PET-CT imaging in CNPA.     

Inactivation of the maternal fragile X gene results in sensitization of GABAB receptor function in the offspring

Fragile X syndrome is an X-linked disorder caused by the inactivation of the FMR1 gene, with symptoms ranging from impaired cognitive functions to seizures, anxiety, sensory abnormalities, and hyperactivity. Although fragile X syndrome is considered a typical Mendelian disorder, we have recently reported that the environment, specifically the fmr1(+/-) or fmr1(-/-) [H or knockout (KO)] maternal environment, elicits on its own a partial fragile X-like phenotype and can contribute to the overall phenotype of fmr1(-/0) (KO) male offspring. Genetically fmr1(+/0) (WT) males born to H females (H(maternal) > WT(offspring)), similar to KO male offspring born to H and KO mothers (H > KO and KO > KO), exhibit locomotor hyperactivity. These mice also showed reduced D(2) autoreceptor function, indicating a possible diminished feedback inhibition of dopamine (DA) release in the nigrostriatal and mesolimbic systems. The GABAergic system also regulates DA release, in part via presynaptic GABA(B) receptors (Rs) located on midbrain dopaminergic neurons. Here, we show that the locomotor inhibitory effect of the GABA(B)R agonist baclofen [4-amino-3-(4-chlorophenyl)-butanoic acid] is enhanced in all progeny of mutant mothers (H > WT, H > KO, and KO > KO) compared with WT > WT mice, irrespective of their own genotype. However, increased sensitivity to baclofen was selective and limited to the locomotor response because the muscle-relaxant and sedative effects of the drug were not altered by the maternal environment. These data show that GABA(B)R sensitization, traditionally induced pharmacologically, can also be elicited by the fmr1-deficient maternal environment.     

Validation and use of a computer-assisted counting procedure to quantify BrdU-labeled proliferating cells in the early postnatal mouse hippocampus

The dentate gyrus is one of the few brain regions that show proliferation of neuronal precursors postnatally and in adult life. Proliferation in the dentate gyrus has been shown to be influenced by exercise, stress and drugs such as antidepressants. Traditionally, proliferation studies rely on the time consuming and subjective manual count of labeled cells. Here we adapted the Metamorph software to automatically count cells labeled in the S phase in the developing dentate gyrus of mice. The validity of the computer-assisted method was established by showing an outcome similar to that obtained with the established manual counting procedure. In addition, by using a genetically modified mouse line with increased proliferation, the ability of the computer-assisted method to detect changes in proliferation was demonstrated.     

Substance P neurokinin 1 receptor activation within the dorsal raphe nucleus controls serotonin release in the mouse frontal cortex

Preclinical studies suggest that substance P (SP) neurokinin 1 (NK1) receptor antagonists are efficient in the treatment of anxiety and depression. This therapeutic activity could be mediated via stimulation of serotonin (5-HT) neurons located in the dorsal raphe nucleus (DRN), which receive important SP-NK1 receptor immunoreactive innervations. The present study examined the effects of intraraphe injection of SP on extracellular 5-HT levels in the frontal cortex, ventral hippocampus, and DRN by using intracerebral microdialysis in conscious mice. Intraraphe SP injection dose dependently decreased cortical 5-HT release, whereas no effects were detected in the ventral hippocampus. Cortical effects were blocked by the selective NK1 receptor antagonist N-[[2-methoxy-5-[5-(trifluoromethyl)tetrazol-1-yl]phenyl]methyl]-2-phenylpiperidin-3-amine (GR205171) and completely dampened in mice lacking NK1 receptors. Furthermore, genetic (in knockout 5-HT1A(-/-) mice) or pharmacological inactivation of 5-HT1A autoreceptors blocked cortical responses to SP. Contrasting with its cortical effects, intraraphe SP injection increased 5-HT outflow in the DRN in wild-type mice; this effect was potentiated by a local perfusion of the selective 5-HT1A antagonist N-[2-[4-(2-methoxyphenyl)-1-piperazinyl]ethyl]-N-2-pyridinylcyclohexanecarboxamide (WAY100635). Finally, SP-induced changes in frontal cortex and DRN dialysate 5-HT levels were blocked by the DRN perfusion of the alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA)/kainate ionotropic receptor antagonist 6,7-dinitroquinoxaline-2,3-dione (DNQX). These data support the hypothesis that SP-induced over-activation of 5-HT1A autoreceptors within the DRN limits cortical 5-HT release. A better knowledge of the complex relationship between tachykininergic, serotonergic, and glutamatergic systems within the DRN might help better understand the pathophysiology and subsequent treatment of depression.