Striatal D(2) receptor occupancy in bipolar patients treated with olanzapine.

We explored the relationship between striatal dopamine-2 (D(2)) receptor occupancy and extra-pyramidal symptoms (EPS) in bipolar patients receiving olanzapine. Seventeen patients with a DSM-IV diagnosis of bipolar disorder were treated with 5-45 mg/day olanzapine for at least 14 days. After that period, D(2) receptor occupancy was determined using Iodobenzamide (IBZM) and SPECT. EPS were assessed by the Simpson-Angus Scale (SAS) and Barnes-Akathisia Scale (BAS). We found a dose-dependent increase in occupancy: 5 mg led to 28-50%, 10 mg to 40-68%, 15 mg to 69%, 20 mg to 57-66%, 30 mg to 66% and 45 mg to 80% D(2) receptor occupancy; and a significant correlation between plasma levels and occupancy (R(2)=.55, P=.001). Similar to schizophrenic patients, bipolar patients did not exhibit EPS at D(2) occupancy levels of 28 to 80%. Although we did not find an increased vulnerability for acute EPS in bipolar patients receiving olanzapine at clinical relevant doses, this needs to be replicated with larger sample sizes.     

Reduced serotonin-1A receptor binding in social anxiety disorder.

BACKGROUND: Results from studies in serotonin-1A (5-HT1A) knockout mice and previous positron emission tomography (PET) studies in humans imply a role for 5-HT1A receptors in normal state anxiety as well as in certain anxiety disorders. The objective of this study was to investigate 5-HT1A receptor binding potential (BP) in social anxiety disorder (SAD). METHODS: Using PET and [carbonyl-11C]WAY-100635, we compared a homogeneous group of 12 unmedicated, male SAD patients with 18 healthy control subjects (HC). A multivariate ANOVA with all regional BP values as dependent variables, age and four radiochemical variables as covariates was performed. RESULTS: We found a significantly lower 5-HT1A BP in several limbic and paralimbic areas but not in the hippocampus (p = .234) of SAD patients. The difference in 5-HT1A binding was most significant in the amygdala (-21.4%; p = .003). There was also a more than 20% lower 5-HT(1A) BP of SAD patients in the anterior cingulate cortex (p = .004), insula (p = .003), and dorsal raphe nuclei (p = .030). CONCLUSIONS: The lower 5-HT1A binding in the amygdala and mesiofrontal areas of SAD patients is consistent with 1) preclinical findings of elevated anxiety in 5-HT1A knockout mice, 2) a previous PET study in healthy volunteers showing an inverse correlation between 5-HT1A BP and state anxiety, and 3) another human PET study in patients with panic disorder showing reduced 5-HT1A binding, thus corroborating the potential validity of 5-HT1A receptors as targets in the treatment of human anxiety disorders.     

Anatomy of the posterior urethra]

The short section of the urethra that passes through the urogenital diaphragm is termed the membranous urethra. It is accompanied by several vessels and nerve fibers. In surgery on the membranous urethra the perineal body is of crucial importance, and precise knowledge of the course of the urethra through the pelvic floor is essential. Furthermore, the relationship between the membranous urethra and its accompanying structures is of great importance. These include the branches of the internal pudendal artery, the prostatic venous plexus and the cavernous nerves coursing ventrally from the pelvic plexus. The nerves supplying the membranous urethra were studied in fetuses with the help of a magnifying lens. The results of the dissections are documented by histological sections, photographs and paintings.     

Tumorigenicity study in Syrian hamsters fed areca nut together with nitrite

In order to evaluate the effect of concurrent administrationof areca nut and sodium nitrite, a long-term feeding study wasconducted with 120 Syrian hamsters. The animals were dividedinto four treatment groups, each consisting of 15 males and15 females, and received 2 g/kg diet of sodium nitrite (groupI), 20 g/kg diet of powdered areca nut (group II), 2 g/kg dietof sodium nitrite plus 20 g/kg diet of areca nut (group III)or powdered diet only (group IV) throughout their lifetime.Urine samples from all groups were analysed for N-nitrosonipecoticacid (NNIP), a major urinary metabolite of areca-nut-derivednitrosamines. NNIP was only detected in the urine of hamstersfed nitrite plus areca nut (concentration: 1.9±0.9 ng/mlurine), indicating that areca nut alkaloids underwent in vivonitrosation to form arecanut-specific nitrosamines. The totaltumour response was not significantly elevated in groups IIand III. Hamsters of group III had a markedly, but also insignificantlyhigher frequency of malignant tumours than those of the othergroups, with a statistically significant increase in malignantlymphomas in the males. Although limited by the low number ofanimals per group, these results indicate that exposure to nitritetogether with areca nut constituents appears to enhance therisk of developing malignancies.     

A pilot study of pulmonary rehabilitation in primary care.

Pulmonary rehabilitation is an effective intervention for patients with chronic obstructive pulmonary disease (COPD). It is usually available only through selected hospitals. A pilot study was undertaken to see if pulmonary rehabilitation performed by the primary health care team in one practice was feasible. Fourteen patients were recruited; 13 completed the programme and one year of follow-up. The programme was well received by patients and staff. There were not enough suitable patients among a practice list of 10,500 to justify the running of this programme for a single practice; one primary care group would suffice