Dose-effect study of levomepromazine on psychomotor and memory tasks in healthy volunteers

The effects of single doses of levomepromazine (3, 6 and 12 mg) on psychomotor skills and memory tasks, as well as haemodynamic and pupil diameter parameters, were assessed in 12 normal volunteers. Each subject was given three of the four treatments, at a weekly interval in a double-blind crossover randomized balanced incomplete-block design. The three doses and a placebo were monitored using a battery of tests including critical flicker fusion (CFF), choice reaction time (CRT), subjective ratings and memory tasks before, 3 and 6 hours after drug intake. Supine standing blood pressure and pupil diameter were recorded at the same times. Compared to placebo, levomepromazine impaired both subjective and objective vigilance measures in a dose-related manner, with 3 mg affecting only some subjective ratings, while 12 mg impaired most objective and subjective vigilance evaluations with a moderate effect on memory tasks (i.e. anterograde amnesia). Pupil diameter was reduced by the evaluations with a moderate effect on memory tasks (i.e. anterograde amnesia). Pupil diameter was reduced by the three doses. In conclusion, levomepromazine at low doses induced a sedative effect the intensity and duration of which are compatible with its use as an hypnotic.     

Bedeutung der Spermaqualität für die in-vitro-Fertilisation

Ohne Zusammenfassung     

Effects of granulosa cells and gonadotrophins on maturation of rabbit oocytes in vitro

Rabbit oocyte maturation was induced by i.v. injection of 100 mU/HCG. Six hours later the animals were sacrificed, their granulosa cells cultured 7-10 days and their oocytes incubated in different media for 5-6 h. The oocytes were then examined microscopically. The appearance of a polar body was taken as an indication that maturation had progressed. The results presented show that maturation of rabbit oocytes can be inhibited by granulosa cells in vitro (OMI = oocyte maturation inhibitor), the activity of OMI is influenced by gonadotrophins and cumulus cells have a facilitatory effect on OMI. The results give the first indication that OMI exists in rabbits and may contribute to the discussion about the existence of OMI in other species (e.g. the pig).     

ROLE OF LEFT VENTRICULAR FUNCTION EVALUATION IN NON SPECIFIC ECG ABNORMALITY

A total of 373 subjects [367 service persons and 6 civilians) with ECG abnormality were evaluated with maximal TMT exercise, 86 (23%) of them showing positivity. Subsequent assessment including radionuclide ventriculography and coronary arteriography wherever necessary revealed coronary artery disease in 31 (8.3%). The remaining 55 were further evaluated by 2D and M-Mode echocardiography for exclusion of any other cardiac disease responsible for the ECG abnormality as well as for assessment of LV performance. Seven subjects showed minor structural cardiac anomalies – MVP in 5 and HOCM in 2. The remaining 48 showed no significant difference in the measurements of LV posterior wall and IV septal wall thickness, mitral septal separation, mitral valve excursion velocities, LV end-systolic/end-diastolic internal diameters and calculated percent fractional shortening, LV end-diastolic, end-systolic and stroke volumes as well as ejection fraction, on comparison with 20 age matched controls. These 48 service persons, thus evaluated were considered to have no organic heart disease or cardiac function impairment and were cleared for all strenuous duties including flying of sophisticated aircrafts or posting to high altitudes.KEY WORDS: LV systolic function, Non-specific ECG abnormality     

PERIPARTUM CARDIOMYOPATHY AND ANAESTHESIA (A Case Report)

Anaesthetic management for caesarean section in a case of peripartum cardiomyopathy is reported. Various anaesthetic problems in such a case are discussed.KEY WORDS: General anaesthesia, Peripartum cardiomyopathy, Lower segment caesarean section     

Sensitivity and specificity of two-dimensional echocardiography in detection of impaired left ventricular function

The purpose of the study was to determine the sensitivity andspecificity of two-dimensional echocardio graphy (2dE) in thedetection of impaired left ventricular function, compared withcineventriculography (CVG). Apical two-dimensional echocardiogramswere performed in 110 patients undergoing heart catheterizationfor the evaluation of clinically suspected coronary heart disease(50 patients), valvular heart disease (38 patients) and congestivecardiomyopathy (22 patients). The left ventricle was scannedin the RAO equivalent view; cineventriculograms were filmedin the 30° RAO projection. Left ventricular volumes at end-diastole(EDV) and end systole (ESV) were determined using a disc method;stroke volume (SV) and ejection fraction (EF) were calculated.Based on normal values, the sensitivity, specificity, and predictive accuracy were determined for two dimensional echocardiography. For ED V the sensitivity was 80%, specificity 88% and (+) predictiveaccuracy 86%. The left ventricular ejection fraction was 57.8±17.2%with CVG and 53.8±15.6% with 2dE in patients with coronaryheart disease, 24.9±10.5% with CVG and 25.2±ll.l%with 2dE in patients with congestive cardiomyopathy, and 61.1±13.9% with CVG and 54.2±9.l% with 2dE in patients withvalvular heart disease. Sensitivity was 81%, specificity 100%,and (+) predictive accuracy 100%. The study demonstrates that impaired left ventricular functioncan be detected by 2dE with high sensiti vity and specificity.Thus, 2dE seems to be a suitable screening method for evaluationof left ventricular function.     

In vivo and in vitro development of serotonergic neurons

The monoamines are one of the earliest developing neurotransmitter systems in the mammalian brain. The first part of this paper describes the normal ontogeny of the serotonergic (5-HT) system in the rat brain as studied using long survival 3H-thymidine autoradiography (time of neuronal genesis, time of origin) and the Falck-Hillarp histofluorescence method, electron microscopy, and immunocytochemistry (anti-5-HT). Due to their early ontogeny relative to other brain regions, 5-HT neurons (as well as monoamine neurons in general) have been suggested to exert some type of "trophic" influence on brain development. Results of pharmacological experiments designed to inhibit 5-HT synthesis in the embryonic rat brain by maternal treatment with p-chlorophenylalanine (pCPA) at a time when this monoamine might exert such an influence are discussed with regard to effects on the time course of neuronal genesis (time of origin) of 5-HT neurons and their target cells. These results, which prompted us to propose that 5-HT might act as a "differentiation signal" for certain of its target cells, are now discussed in light of our more recent immunocytochemical-autoradiographic studies (anti-5-HT, 3H-thymidine) which morphologically demonstrate close associations between developing 5-HT neurons and proliferating neuroepithelial cells in the embryonic brain. Postnatal studies using this immunocytochemical-autoradiographic method also provide evidence for interactions of 5-HT axons with proliferating glioblasts in the developing cerebellum and with immature granule cells and their precursors in the hippocampus. These findings, in conjunction with the results of our pCPA experiments, further enhance the possibility that 5-HT neurons could exert an epigenetic influence on the development of less differentiated cells with which they come into contact. Finally, preliminary studies using dissociated cell cultures containing 5-HT neurons suggest that interactions between 5-HT neurons and glial elements may be important for the differentiation of these neurons in vitro. Whether 5-HT neurons in turn influence the development of glial or neuronal cells in these cultures remains to be determined. These studies are evaluated with regard to a possible pre-transmission role for 5-HT during key phases of neuronal and glial genesis.     

Native American cancer survivors

This paper provides a brief review of cancer survival data for both Native American men and women, information about cancer survivor support groups, survivor resources, and some examples of how cancer is perceived by some Native Americans.