Relative right versus left frontal EEG in neonates

Although infants have been noted to have greater relative right or left frontal EEG as early as the neonatal period, other ways in which these newborns differ have not been reported. In this study, 48 newborns were divided on the basis of greater relative right versus greater relative left frontal EEG to determine whether these groups differed in other ways at the neonatal period including behavior, physiology, and biochemistry. We also were interested in whether these EEG patterns were related to any prenatal maternal variables including mood states (depression, anxiety, anger) and biochemistry as well as fetal activity. The greater relative right frontal EEG newborns had mothers with lower prenatal and postnatal serotonin and higher postnatal cortisol levels. The mothers of the greater relative right frontal EEG newborns also had greater relative right frontal EEG activation and lower vagal tone. The greater relative right frontal EEG newborns themselves had elevated cortisol levels, showed a greater number of state changes during sleep/wake behavior observations, and performed less optimally on the Brazelton Neonatal Behavior Assessment (T. B. Brazelton, 1973) including the habituation, motor, range of state, excitability, and depressive symptoms scales. These data suggest that greater relative right frontal EEG newborns may be at greater risk for developmental problems than those with greater relative left frontal EEG activation. In addition, a discriminant function analysis correctly classified 67% of the newborns' EEGs by prenatal maternal variables, suggesting that these might be used to target pregnant women for prenatal intervention.     

The diagnosis of recent herpes simplex virus type 2 genital infections by the simplex-2 test.

The prevalence of complement-fixing (CF) antibody against the AG-4 early antigen of herpes simplex virus (HSV) type 2 (HSV-2) was determined in patients with culture confirmed HSV-2 genital herpes and control groups using a commercial HSV-2 early antigen (Simplex-2; Gene Link Australia Ltd). Eighty seven per cent of 39 sera collected between 14 and 28 days after confirmed primary and recurrent HSV-2 infection were positive. In acute sera collected between 2-10 days after onset the Simplex-2 test was negative in all 90 patients with presumed primary infection but positive in 53% of 230 sera from recurrent infection. A specificity of 90-94.5% was obtained by testing 36 patients with recent proven HSV-1 infection and 331 control group patients. The Simplex-2 test may be useful in some cases of culture-negative, clinically suspected genital HSV-2 lesions only when sera are collected between 14-28 days after primary and recurrent infection. Its lack of specificity makes it unsuitable for the routine diagnosis of recent HSV-2 infection in the general population.     

Role of Peripheral Adrenergic Responsiveness in the Development of DOCA/NaCl Hypertension in Rats

Alterations in - and -adrenergic responsiveness were investigated prior to and during the development of hypertension in rats treated with desoxycorticosterone acetate and NaCl (DOCA/ NaCl). The DOCA/NaCl rats became noticeably hypertensive (> 150 mm Hg) six weeks after the initiation of treatment. Prior to the development of hypertension, a reduced in vivo and in vitro - and an enhanced -adrenergic responsiveness of the DOCA/NaCl group resulted. At 2 and 12 weeks of the study, the dipsogenic response to isoproterenol was significantly attenuated in the DOCA/NaCl rats, whereas no difference in the dipsogenic response to 24 hour water deprivation was observed between control and DOCA/NaCl rats. Isoproterenol-induced relaxation of aortic smooth muscle from the DOCA/NaCl treated rats was significantly reduced at 4 weeks and further attenuated at 12 weeks of the study. However, aortic smooth muscle sensitivity to norepinephrine stimulation was significantly increased at 4 and 12 weeks of the study. These results suggest that alterations in both in vivo and in vitro - and -adrenergic responsiveness occur prior to establishment of hypertension of the DOCA/NaCl rats and that these alterations may have a role in the early stages of the development of this form of hypertension.     

Chemonucleolysis. A ten-year retrospective study

An 11.8-year median follow-up evaluation of 42 "ideal" patients who had chemonucleolysis was obtained by examination, questionnaire, and roentgenograms. The excellent and good rating of this group was 81%, as compared to the total of 135 patients previously evaluated at 42 months and showing 85.2%. No complications were noted. Disc space rewidening, after initial narrowing, was observed in eight patients and 26% of all discs injected. While all who showed rewidening had excellent results, widening was not necessary to achieve an excellent rating. Marked narrowing and sclerosis of intervertebral margins were seen in many excellent and good clinical results. Chemonucleolysis represents a viable option as definitive treatment for a herniated nucleus pulposus in carefully selected patients.     

Single sperm typing demonstrates that reduced recombination is associated with the production of aneuploid 24,XY human sperm

To account for the increased proportion of paternal nondisjunction in 47,XXY males as compared to other trisomies, it has been suggested that the XY bivalent, with its reduced region of homology, is particularly susceptible to nondisjunction. Molecular studies of liveborn Klinefelter syndrome (47,XXY) individuals have reported an association between the absence of recombination in the pseudoautosomal region and nondisjunction of the XY bivalent. In this study we examined single sperm from a normal 46,XY male to determine if there is any alteration in the recombination frequency of aneuploid disomic 24,XY sperm compared to unisomic sperm (23,X or Y). Two DNA markers STS/STS pseudogene and DXYS15 were typed in sperm from a heterozygous man to determine if recombination had occurred in the pseudoautosomal region. Individual unisomic sperm (23,X or Y) were isolated using a FACStar(Plus) flow cytometer into PCR tubes. To identify disomic 24,XY sperm, 3-colour FISH analysis was performed with probes for chromosomes X,Y and 1. The 24,XY cells were identified using fluorescence microscopy, each disomic sperm was scraped off the slide using a glass needle attached to a micromanipulator and then put into a PCR tube. Hemi-nested PCR analysis of the two markers was performed to determine the frequency of recombination. A total of 329 unisomic sperm and 150 disomic sperm have been typed. The frequency of recombination between the two DNA markers was 38.3% for the unisomic sperm, similar to frequencies previously reported. The 24,XY disomic sperm had an estimated recombination frequency of 25.3%, however, a highly significant decrease compared to the unisomic 23,X or 23,Y sperm (chi(2) = 10.7, P = 0.001). This direct analysis of human sperm indicates that lack of recombination in the pseudoautosomal region is a significant cause of XY nondisjunction and thus Klinefelter syndrome. Copyright Wiley-Liss. Inc.     

A severe case of hyperemesis gravidarum necessitating prolonged total parenteral nutrition

A patient with severe hyperemesis gravidarum persisting throughout pregnancy is described. She had marked abnormalities of liver function and failed to respond to conservative management. Total parenteral nutrition was used to maintain her nutritional status as well as that of the foetus. Her vomiting continued and was complicated by severe oesophagitis. On delivery her symptoms settled, but she later developed an oesophageal stricture. Changes in liver function tests are described.     

急性心肌梗死早期QT间期JT间期离散度与近期严重心律失常的关系

目的 :探讨AMI早期QT间期离散度、JT间期离散度与严重心律失常的关系。方法 :测定 46例AMI患者心梗发生后第 3d的QT间期离散度 (QTd)和JT间期离度 (JTd)。并与30例正常人的对照组比较。结果 :AMI组QTd、JTd、QTcd较对照组显著增大 (P <0 0 1 )。住院期间严重室性心律失常发生组 (1 8例 )的QTd、JTd、QTcd较无严重室性心律失常组 (2 8例 )明显增大 (P <0 0 1 ) ,且发生室颤的 9例患者QTd、JTd、QTcd比无室颤的明显增大 (P <0 0 1 )。结论 :早期测定AMI患者QTd、JTd、QTcd对患者近期严重室性心律失常的发生有预测意义     

Gabapentin (neurontin) and S-(+)-3-isobutylgaba represent a novel class of selective antihyperalgesic agents

1. Gabapentin (neurontin) is a novel antiepileptic agent that binds to the α₂δ subunit of voltage-dependent calcium channels. The only other compound known to possess affinity for this recognition site is the (S)-(+)-enantiomer of 3-isobutylgaba. However, the corresponding (R)-(−)-enantiomer is 10 fold weaker. The present study evaluates the activity of gabapentin and the two enantiomers of 3-isobutylgaba in formalin and carrageenan-induced inflammatory pain models.
2. In the rat formalin test, S-(+)-3-isobutylgaba (1–100 mg kg⁻¹) and gabapentin (10–300 mg kg⁻¹) dose-dependently inhibited the late phase of the nociceptive response with respective minimum effective doses (MED) of 10 and 30 mg kg⁻¹, s.c. This antihyperalgesic action of gabapentin was insensitive to naloxone (0.1–10.0 mg kg⁻¹, s.c.). In contrast, the R-(−)-enantiomer of 3-isobutylgaba (1–100 mg kg⁻¹) produced a modest inhibition of the late phase at the highest dose of 100 mg kg⁻¹. However, none of the compounds showed any effect during the early phase of the response.
3. The s.c. administration of either S-(+)-3-isobutylgaba (1–30 mg kg⁻¹) or gabapentin (10–100 mg kg⁻¹), after the development of peak carrageenan-induced thermal hyperalgesia, dose-dependently antagonized the maintenance of this response with MED of 3 and 30 mg kg⁻¹, respectively. Similar administration of the two compounds also blocked maintenance of carrageenan-induced mechanical hyperalgesia with MED of 3 and 10 mg kg⁻¹, respectively. In contrast, R-(−)-3-isobutylgaba failed to show any effect in the two hyperalgesia models.
4. The intrathecal administration of gabapentin dose-dependently (1–100 μg/animal) blocked carrageenan-induced mechanical hyperalgesia. In contrast, administration of similar doses of gabapentin into the inflamed paw was ineffective at blocking this response.
5. Unlike morphine, the repeated administration of gabapentin (100 mg kg⁻¹ at start and culminating to 400 mg kg⁻¹) over 6 days did not lead to the induction of tolerance to its antihyperalgesic action in the formalin test. Furthermore, the morphine tolerance did not cross generalize to gabapentin. The s.c. administration of gabapentin (10–300 mg kg⁻¹), R-(−) (3–100 mg kg⁻¹) or S-(+)-3-isobutylgaba (3–100 mg kg⁻¹) failed to inhibit gastrointestinal motility, as measured by the charcoal meal test in the rat. Moreover, the three compounds (1–100 mg kg⁻¹, s.c.) did not generalize to the morphine discriminative stimulus. Gabapentin (30–300 mg kg⁻¹) and S-(+)-isobutylgaba (1–100 mg kg⁻¹) showed sedative/ataxic properties only at the highest dose tested in the rota-rod apparatus.
6. Gabapentin (30–300 mg kg⁻¹, s.c.) failed to show an antinociceptive action in transient pain models. It is concluded that gabapentin represents a novel class of antihyperalgesic agents.