Electronic aspects of spinal-cord stimulation in multiple sclerosis

Patients receiving chronic spinal-cord stimulation in the management of multiple sclerosis have been stimulated at a frequency of 33 Hz, with pulses whose duration has been varied between 0·05 ms and 2·0 ms. Measurements on the stimulating pulses show that the energy requirement was at a minimum when the pulse duration was 0·2 ms. The current and energy requirements of different patients using 0·2 ms pulses vary over a large range but measurement of the current requirement of a particular patient can be a useful observation in predicting his response to treatment: low current requirements are often associated with a good response and high currents with a poor response to treatment. The use of 0·2 ms pulses of the amplitude we have used meets the safety requirements established by other workers and our results indicate that this pulse duration is optimal in terms of safety requirements, as well as energy requirements.     

Effects of dopamine agonists on hypothalamic defensive attack in cats

The effects of methamphetamine (MAT) and apomorphine (APO), dopamine agonists, were studied in 16 cats to evaluate their effects on threshold for defensive attack behavior elicited by electrical stimulation of the ventromedial hypothalamic nucleus (VMH). Directed attack and hissing were selected from elementary responses as constituting a defensive attack. Hissing threshold was measured in two situations, one with human provocation and the other without provocation. MAT administered systemically lowered the thresholds for all three types of responses in a dose-related manner (0.5, 1.0, and 3.0 mg/kg). The effects of 1.0 mg/kg of APO were almost identical to those observed with 0.5 or 1.0 mg/kg of MAT. These results suggest that MAT-induced aggressive behavior may be mediated by a dopamine-induced increase in the excitability of the VMH.     

Differential fos activation in virgin and lactating mice in response to an intruder

Lactating (L) mice display fierce aggression towards novel, male mice, while virgin (V) mice do not. This study compares patterns of brain activation in V and L mice in response to a novel intruder using immunohistochemical detection of Fos (Fos-IR). Animals were sampled 120 min after either a sham or real 10 min test with a male intruder. L mice were aggressive towards intruders, but V mice were not. In general, Fos-IR for both groups increased with exposure to an intruder, with L mice showing higher increases in Fos-IR than V mice. In only medial preoptic nucleus and ventral portion of bed nucleus of stria terminalis (BNST) was Fos-IR significantly increased in both groups with testing. In V mice, testing resulted in Fos-IR increases in an additional 10 regions examined that did not reach significance in L mice, including lateral septum, lateral and medial preoptic areas, and anterior hypothalamus. Fos-IR also increased with testing in nine regions unique to L mice, including the mitral and granular layers of accessory olfactory bulb, regions of the amygdala, dorsal BNST, and caudal portions of the hypothalamic attack area. These increases in Fos-IR with testing suggest alterations in the circuitry governing response to pheromonal cues and imply some commonalities between the circuitries governing maternal aggression and intermale aggression. These results support the hypothesis that pregnancy and lactation induce substantial changes in brain circuitry and function; changes that enable maternal defense of offspring by altering the neural response to an intruder male.     

Taste preferences induced by trains of rewarding lateral hypothalamic stimulation of differing durations

The question of whether prolonged stimulation of the lateral hypothalamic area (LH) simply diminishes in rewarding effect or becomes aversive was tested in 32 rats using a taste preference technique. The animals were allowed to drink novel, coffee-flavoured water for 10 min, and then received 60 trains of LH stimulation with differing durations, at an intensity proven to be rewarding at 0.5 sec duration. In a test 24 hours later, those animals that had been stimulated with 1 or 5 sec trains showed a shift in preference from tap water to coffee water, but those stimulated with 10 sec trains did not. The results show that prolonged stimulation not only loses its positive reinforcement effect but becomes negative.     

Membrane attack complex of complement and 20 kDa homologous restriction factor (CD59) in myocardial infarction

In order to investigate the mechanism of deposition of the complement membrane attack complex (MAC) in cardiomyocytes in areas of human myocardial infarction, the 20 kDA homologous restriction factor of complement (HRF20; CD59) and complement components (C1q, C3d and MAC) were analysed immunohistochemically using specific antibodies. Myocardial tissues obtained at autopsy from nine patients who died of acute myocardial infarction were fixed in acetone and embedded in paraffin. The ages of the infarcts ranged from about 3.5 h to 12 days. In cases of myocardial infarction of 20 h or less, MAC deposition was shown in the infarcted cardiomyocytes without loss of HRF20. Where the duration was 4 days or more, the cardiomyocytes with MAC deposition in the infarcted areas also showed complete loss of HRF20. Outside the infarcts, HRF20 in the cardiomyocytes was well preserved without MAC deposition. The present study suggests that the initial MAC deposition in dead cardiomyocytes can occur as a result of degradation of plasma-membrane by a mechanism independent of complement-mediated injury to the membrane. Loss of HRF20 from dead cardiomyocytes may not be the initial cause of MAC deposition, but may accelerate the deposition process of MAC in later stages of infarction.     

Clinical and laboratory parameters in predicting chronic urticaria duration: a prospective study of 139 patients

BACKGROUND: Despite the disabling nature of chronic urticaria (CU), little is known about the disease's duration or the efficacy of adopting aggressive therapeutic regimens such as cyclosporine A. OBJECTIVES: The aim of this study was to evaluate whether parameters such as angioedema, autologous serum test, anti-thyroid antibodies, and total IgE could predict both CU duration and severity. PATIENTS AND METHODS: One hundred and thirty-nine patients suffering from CU were prospectively followed over a 5-year period for disease duration, severity and the presence of angioedema. Also investigated was the association between these clinical parameters and the subsequent detection of autologous serum test, anti-thyroid antibodies, and total IgE. RESULTS: CU lasted over 1 year in more than 70% of cases and in 14% it still existed after 5 years. Angioedema co-existed or appeared during the course of CU in 40% of patients and was associated with disease duration. Autologous serum test and anti-thyroid antibodies were found positive in 28 and 12% of patients, respectively, compared to none of normal individuals, P = 0.001. CU duration was associated with the presence of both autologous serum test and anti-thyroid antibodies; however, autologous serum test and not anti-thyroid antibodies was found in association with CU severity. CONCLUSION: We demonstrate for the first time that CU duration is associated with clinical parameters such as severity and angioedema, and with laboratory parameters such as autologous serum test and anti-thyroid antibodies. The ability to predict CU duration may facilitate decisions regarding the possible early initiation of cyclosporine A as a means by which to reduce disease severity and duration.     

抗胸腺细胞血清性肾炎模型大鼠肾小球中C5b-9的沉积及NO、TNFα含量分析

目的: 探讨抗胸腺细胞血清性肾炎(ATSN)大鼠肾小球内C5b-9复合物的沉积与某些炎症介质和细胞因子如:一氧化氮(NO)和肿瘤坏死因子α(TNFα)的含量情况。 方法: 大鼠一次性静脉注射抗胸腺细胞抗血清(ATS)建立ATSN模型,定期对ATSN大鼠肾小球中的补体C5b-9复合物进行免疫组化染色定位、显微图像扫描半定量分析;并对有C5b-9包绕的肾小球系膜细胞(MC)进行计数。测定ATSN大鼠肾中诱生型NO合酶(iNOS) mRNA的表达、尿液中NO的代谢产物(NO^-₂／NO^-₃)及TNFα的排泄量。 结果: ATSN模型大鼠肾小球MC先溶解坏死后继发增生,病变早期(溶解时相)补体C5b-9复合物主要定位于肾小球系膜区及MC表面;随着病程的进展,被C5b-9包绕的MC逐渐减少, 病程初期ATSN大鼠肾小球MC有明显的 iNOS mRNA表达, 尿液中NO^-₂／NO^-₃ 和TNFα的排泄量也明显增加。在ATSN病变的增生阶段(一般7 d后),上述指标的变化逐渐趋缓。 结论: ATSN模型大鼠肾小球中MC逐渐溶解与补体C5b-9沉积及NO和TNFα的合成与释放有一定关系。     

β-Adrenoceptor blocking effects and plasma levels of bornaprolol and propranolol in man

Summary The -adrenoceptor blocking effects and pharmacokinetics of bornaprolol (FM 24), a new -adrenoceptor blocking agent, have been compared with those of propranolol and a placebo in a double-blind trial in 6 healthy volunteers. Heart rate, systolic and diastolic blood pressures and peak expiratory flow rate were measured at rest and at the end of 3 min vigorous exercise on a bicycle ergometer, before and 2, 24 and 48 h after single oral doses of bornaprolol (120, 240 and 480 mg) and propranolol (40, 80 and 160 mg). Plasma renin activity at rest and the plasma concentrations of the two drugs were determined. Bornaprolol significantly reduced resting heart rate, dose-dependently lowered exercise-induced tachycardia and decreased peak expiratory flow rate and plasma renin activity. In addition, exercise-induced tachycardia was significantly reduced by bornaprolol up to 48 hours after drug intake (pharmacodynamic half-life approximately 63–86 h) and there was a correlation between this reduction and the log plasma bornaprolol concentration over the 48-h period. Thus, bornaprolol behaved in man as a non-cardioselective and long-lasting -adrenoceptor blocking drug, probably devoid of intrinsic sympathomimetic activity.     

Neuropsychological evaluation in transient ischaemic attack and minor stroke

Summary Two groups of patients with transient ischaemic attack and minor stroke without detectable haemodynamic stenotic lesions were evaluated by neuropsychological tests and compared with a control group. The mean values of the scores adjusted for age and educational background demonstrated that (a) the patients with transient ischaemic attack did not have a worse performance than normal subjects in any of the tests, (b) the patients with minor stroke had a worse performance than normals, particularly in Rey's figure-copying test (P<0.025), and (c) the latter test was not affected by educational background or age of the subjects. The results are discussed with reference to other case series, and the importance of age and cerebral damage in causing intellectual impairment evaluated by neurophysiological tests is stressed.     

网络成瘾和睡眠时长在青少年受校园欺凌与抑郁间的链式中介作用

目的 探索青少年网络成瘾和睡眠时长在受校园欺凌与抑郁关系之间的中介作用,为青少年抑郁的预防干预提供依据。 方法 使用青少年健康相关危险行为问卷及CES - D抑郁量表,采用多阶段整群抽样法抽取徐州市4 190名青少年进行问卷调查。结果 在控制人口学等变量后,受校园欺凌、网络成瘾、睡眠时长对抑郁均有预测作用（r = 0.283,P＜0.01;r = 0.331,P＜0.01;r = - 0.184,P＜0.01）。路径分析表明,网络成瘾在受校园欺凌和青少年抑郁之间起中介作用;网络成瘾和睡眠时长在受校园欺凌和青少年抑郁间起链式中介作用。结论 受校园欺凌不仅直接影响青少年抑郁,还通过网络成瘾和睡眠时长的链式中介作用间接影响青少年抑郁。可通过减少青少年网络使用和提高睡眠时长来降低受校园欺凌对青少年抑郁的影响。