Immunohistochemistry of catecholamines in the hypothalamic–pituitary–adrenal system with special regard to fatal hypothermia and hyperthermia

Catecholamines are involved in various stress responses. Previous studies have suggested applicability of the postmortem blood levels to investigations of physical stress responses or toxic/hyperthermic neuronal dysfunction during death process. The present study investigated cellular immunopositivity for adrenaline (Adr), noradrenaline (Nad) and dopamine (DA) in the hypothalamus, adenohypophysis and adrenal medulla with special regard to fatal hypothermia (cold exposure) and hyperthermia (heat stroke) to examine forensic pathological significance. Medicolegal autopsy cases (n = 290, within 3 days postmortem) were examined. The proportions of catecholamine (Adr, Nad and DA)-positive cells (% positivity) in each tissue were quantitatively estimated using immunostaining. Hyperthermia cases (n = 12) showed a lower neuronal DA-immunopositivity in the hypothalamus than hypothermia cases (n = 20), while Nad- and DA-immunopositivities in the adrenal medulla were higher for hyperthermia than for hypothermia. Rates of Nad-immunopositivity in the adrenal medulla were very low for hypothermia. No such difference between hypothermia and hyperthermia was seen in the adenohypophysis. In hypothermia cases, cellular Nad-immunopositivity in the adrenal medulla correlated with the Nad level in cerebrospinal fluid (r = 0.591, p < 0.01). These observations suggest a characteristic immunohistochemical pattern of systemic stress response to fatal hypothermia and hyperthermia, involving the hypothalamus and adrenal medulla.     

School based screening for tuberculosis infection in Norway: comparison of positive tuberculin skin test with interferon-gamma release assay

Background

In Norway, screening for tuberculosis infection by tuberculin skin test (TST) has been offered for several decades to all children in 9th grade of school, prior to BCG-vaccination. The incidence of tuberculosis in Norway is low and infection with M. tuberculosis is considered rare. QuantiFERON^®TB Gold (QFT) is a new and specific blood test for tuberculosis infection. So far, there have been few reports of QFT used in screening of predominantly unexposed, healthy, TST-positive children, including first and second generation immigrants. In order to evaluate the current TST screening and BCG-vaccination programme we aimed to (1) measure the prevalence of QFT positivity among TST positive children identified in the school based screening, and (2) measure the association between demographic and clinical risk factors for tuberculosis infection and QFT positivity.

Methods

This cross-sectional multi-centre study was conducted during the school year 2005–6 and the TST positive children were recruited from seven public hospitals covering rural and urban areas in Norway. Participation included a QFT test and a questionnaire regarding demographic and clinical risk factors for latent infection. All positive QFT results were confirmed by re-analysis of the same plasma sample. If the confirmatory test was negative the result was reported as non-conclusive and the participant was offered a new test.

Results

Among 511 TST positive children only 9% (44) had a confirmed positive QFT result. QFT positivity was associated with larger TST induration, origin outside Western countries and known exposure to tuberculosis. Most children (79%) had TST reactions in the range of 6–14 mm; 5% of these were QFT positive. Discrepant results between the tests were common even for TST reactions above 15 mm, as only 22 % had a positive QFT.

Conclusion

The results support the assumption that factors other than tuberculosis infection are widely contributing to positive TST results in this group and indicate the improved specificity of QFT for latent tuberculosis. Our study suggests a very low prevalence of latent tuberculosis infection among 9th grade school children in Norway. The result will inform the discussion in Norway of the usefulness of the current TST screening and BCG-policy.

     

Burn out – slow down?

The article focuses on multitasking and virtual mobility in young people’s everyday life. The author demonstrates how paradoxes of a digital high speed society massively influence both the educational sphere and young people’s leisure time and encourage thinking about strategies concerning the work-life balance and burnout prevention in young target groups.     

Presynaptic regulation of the electrically evoked release of endogenous dopamine from the isolated neurointermediate lobe or isolated neural lobe of the rat pituitary gland in vitro

Summary Isolated neurointermediate lobes (NILs) or isolated neural lobes (NLs) of the rat pituitary gland were incubated in Krebs-HEPES solution which contained pargyline and the dopamine uptake inhibitor GBR 12921. The release of endogenous dopamine was determined by HPLC with electrochemical detection. Electrical stimulation of the pituitary stalk induced a frequency-dependent release of dopamine.The release of dopamine from the combined NIL evoked by stimulation at 15 Hz was increased by 130% in the presence of the dopamine D2 receptor antagonist, (–)-sulpiride; the (+)-enantiomer of sulpiride had virtually no effect. When the stimulation frequency was 3 Hz (–)-sulpiride caused an increase in dopamine release by 230%. A similar increase was observed in the presence of domperidone, another dopamine D2 receptor antagonist.The dopamine receptor agonists, apomorphine and quinpirole, had no significant effects on the evoked release of dopamine indicating that under the present incubation conditions endogenous dopamine may have been maximally activating the autoinhibition. However, in the presence of 1 mol/l (–)-sulpiride, apomorphine as well as quinpirole reduced the evoked release of dopamine in a concentration-dependent manner.The dopamine D1 receptor selective antagonist, SCH 23390, had no effect on the evoked release of dopamine at a concentration of 1 mol/1. Only at a concentration of 10 mol/l did SCH 23390 cause a small increase in dopamine release; this effect was, however, abolished in the presence of 1 mol/1(–)-sulpiride.In the presence of 1 mol/l (–)-sulpiride neither clonidine, yohimbine, 5-methoxytryptamine nor metitepine significantly affected the release of dopamine from the NIL evoked by stimulation at 3 Hz.In the NL, the release of dopamine is inhibited by endogenous opioids. For this reason, naloxone 1 or 10 mol/1 was present in the experiments on isolated NLs. Domperidone and (–)-sulpiride, but not (+)-sulpiride, increased the release of dopamine from the NL evoked by electrical stimulation at 15 Hz by about 90%. SCH 23390 caused a significant increase in dopamine release at 10 mol/l, but not at 1 mol/lIn conclusion, the release of endogenous dopamine from the neurons terminating in the intermediate and neural lobe of the pituitary gland is inhibited via dopamine receptors of the D2 type.Abbreviations DOPAC dihydroxyphenylacetic acid - 5-HT 5-hydroxytryptamine - HPLC high performance liquid chromatography - IL intermediate lobe - NIL neurointermediate lobe - NL neurallobe Send offprint requests to K. Racké at the above address     

Kostenerstattung für Neue Behandlungsmethoden im Rahmen der Gesetzlichen Krankenversicherung – Rechtsprechung des BSG im Wandel

Ohne Zusammenfassung     

Das Atemnebengeräusch der bronchopneumonischen Maus

Zusammenfassung Bei allen in eigenen Versuchen beobachteten Bronchiopneumonien der verschiedensten Ätiologie läßt die weiße Versuchsmaus ein leises Atemgeräusch hören. Es kann durch ein tonloses ge nachgeahmt werden. Es ist mit dem vonNelson beschriebenen fälschlicherweise mit Zwitschern übersetzten Laut der Mäuse, die am Mäusekatarrh erkrankt sind, identisch.     

Zur Frage der Kreislauf- und Atmungsregulation bei exogener Hyperthermie

Zusammenfassung An Hunden in Urethan-Morphinnarkose, die durch heiße Bäder überhitzt wurden (Rectaltemp. von 38–40°), kommt es. trotz hochgradigen Absinkens der alveolaren CO₂-Spannung nicht zu einem Blutdruckabfall, sondern meist sogar zu einem Blutdruckanstieg.Es wird durch Prüfungen der Erregbarkeit der medullären Zentren gezeigt, daß diese zentrale Tonussteigerung nicht auf einer verstärkten Erregbarkeit des Kreislaufzentrums gegenüber CO₂ beruhen kann.Auch die Atemvolumensteigerung beim Hecheln beruht nicht auf einer Empfindlichkeitssteigerung des Atemzentrums gegenüber Kohlensäure.