Nitric oxide as a physiopathological factor in neuropsychiatric disorders

The dominant research subject on schizophrenia, mood disorders, autism and other central nervous system diseases has been related to neurotransmitter system abnormalities. For example, the dopamine hypothesis states that schizophrenia is the result of dopaminergic hyperactivity. The therapeutic approach has also been directed towards finding agents which will modulate or regulate these neurotransmitter systems at any step. There is substantial and mounting evidence that subtle abnormalities of reactive oxygen species (ROS) and nitric oxide (NO) may underlie a wide range of neuropsychiatric disorders. NO has chemical properties that make it uniquely suitable as an intracellular and intercellular messenger. It is produced by the activity of nitric oxide synthases which are present in peripheral tissues and in neurons. On the other hand, NO is known to be an oxygen radical in the central and peripheral nervous systems. NO has been implicated in a number of physiological functions such as noradrenaline and dopamine releases, memory and learning and certain pathologies such as schizophrenia, bipolar disorder and major depression. Evidence has been considered here for the proposal that an abnormality of NO metabolism may be a contributory factor in some neuropsychiatric disorders. The direct evidence for NO abnormalities in schizophrenia and other psychiatric disorders remains relatively limited to date, although there are some clinical and experimental studies. The suggestion that NO and other ROS may play a role in some neuropsychiatric disorders clearly has important implications for new treatment possibilities. The primary objective of the present review was to summarize and critically evaluate the current knowledge regarding a potential contribution of NO to the neuropathophysiology of schizophrenia as well as other neuropsychiatric disorders.     

Seprafilm may ease colostomy reversal

HYPOTHESIS: In this study, we aimed to investigate whether the use of a sodium hyaluronate and carboxy-methylcellulose-based antiadhesive membrane (Seprafilm, Adhesion Barrier; Genzyme Corp, Cambridge, Mass) is associated with fewer adhesions around the pelvis and rectal pouch. DESIGN, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Forty Wistar albino female rats were divided into 4 equal groups. Each rat underwent segmental left-sided colonic resection and end colostomy. The groups were as follows: group 1, colostomy alone (control group); group 2, colostomy and Seprafilm application around distal rectal pouch; group 3, colostomy and Seprafilm application beneath laparotomy incision; and group 4, colostomy and application of Seprafilm on both rectal pouch and laparotomy incision. All animals were operated on the 21st day and intra-abdominal adhesions were evaluated. RESULTS: The results were assessed by analysis of variance and Tukey multiple comparison tests. Intra-abdominal adhesions were significantly (P<.05) reduced in groups 2 through 4 compared with the control group, whereas no statistically significant difference was observed between these 3 groups. CONCLUSIONS: The use of Seprafilm during the initial step of the Hartmann colostomy reduced intra-abdominal adhesions on the reversal. This result might be beneficial in the prevention of adhesion-related difficulties during second operation and its application beneath laparotomy incision seems to be sufficient to ensure this effect.     

Relationship between alexithymia, dissociation and anxiety in psychiatric outpatients from Turkey

Several studies have examined the relationship between dissociation and alexithymia. In this study, the objective was to investigate whether there was a relationship between alexithymia, dissociation and state and trait anxiety in psychiatric outpatients. The evaluations of psychiatric outpatients (n=154) were based on the Toronto Alexithymia Scale, the Dissociative Experiences Scale and the State and Trait Anxiety Index. The data were analyzed using chi2 test and multiple covariance analyses. Subjects with alexithymia (46.8%) were significantly less educated and showed higher state and trait anxiety. The mean Toronto Alexithymia Scale total score of the female and male patients was similar. The mean Dissociative Experiences Scale score of the study group was 10.8 (sd=9.8, ranged 0 to 45). A multivariate analysis of covariance showed that state and trait anxiety was a significant covariant for the Toronto Alexithymia Scale-Difficulty Identifying Feelings subscale. Only the trait anxiety was a significant covariant for the Toronto Alexithymia Scale-Difficulty Expressing Feelings subscale. The overall main effect of dissociation was not significant on the Toronto Alexithymia Scale total and subscales. These data suggest that dissociation is fundamentally a different construct from alexithymia, while state and trait anxiety are closely related to alexithymia.     

Differentiation of promyelocytic leukaemia: alterations in Fas (CD95/Apo-1) and Fas ligand (CD178) expression

The survival of leukaemic blasts contributes to the pathological mechanism of acute promyelocytic leukaemia (APL). While treatment of APL using retinoic acid (RA) is a model of differentiation therapy, little is known about possible effects of this treatment on the Fas/FasL system. Investigation of APL cells from patients undergoing differentiation therapy with RA and of promyelocytic HL-60 and monoblastic U-937 cells cultured with RA revealed a reduction of surface expression of both Fas and its ligand. Accordingly, the sensitivity of the cells to anti-Fas-induced apoptosis decreased proportionally and the reduced expression of FasL resulted in a decreased ability of the leukaemic cells to induce apoptosis in T cells. Our findings demonstrate that there are significant changes in Fas and FasL expression during RA treatment of APL, which probably have consequences for the interaction between host immune and leukaemia cells, and thus may be involved in the beneficial effects of differentiation therapy.     

Cholelithiasis in cervico-oculo-acoustic (Wildervanck's) syndrome

An unusual case of cholelithiasis in an 18–month-old boy with cervico-oculo-acoustic (Wildervanck's) syndrome is presented. Our patient had Duane's retraction syndrome, Klippel-Feil anomaly and congenital deafness. To our knowledge this is the first case in which a probable association between cholelithiasis and Wildervanck's syndrome has been recorded. On the other hand, the presence of mutual malformations and anomalies such as scoliosis, ventricular septal defect, ectopic kidney, hydrocephalus, hypoplastic thumb and growth retardation seems to suggest that Wildervanck's syndrome is a clinical variant of Klippel-Feil sequence.