Expression of genes associated with dedifferentiation and cell proliferation during pancreatic regeneration following acute pancreatitis.

Pancreatic gene expression was analyzed in the rat during taurocholate-induced pancreatitis, with emphasis on the postacute phase where regeneration occurs. Increased expression of cellular oncogenes c-myc and H-ras followed a pattern typical of tissular regeneration. The c-myc protein was immunolocalized to acinar cells, in which amylase expression was concomitantly decreased. Such modifications in the program of gene expression and the presence of numerous mitotic figures confirmed participation of acinar cells in regeneration. There was, on the contrary, no evidence of duct cell proliferation and pancreatitis did not influence the expression of two mRNAs encoding ductal proteins. Expression of villin, which is a marker of the embryonic pancreas, increased by five times during pancreatic regeneration. The protein was localized to the tubular complexes, suggesting that cells forming those structures had returned to a protodifferentiated stage in which they should have recovered pluripotency. They might therefore supply the pancreas with any cell type needed to reconstitute functional parenchyma.


Effect of total extrinsic denervation and atropine on HCl-stimulated pancreatic exocrine secretion and CCK release in conscious dogs.

In 10 dogs with pancreatic fistulas, we studied the effect of extrinsic pancreatic innervation and atropine on protein and bicarbonate secretion and cholecystokinin (CCK) release after intraduodenal perfusion with HCl. Before and after extrinsic denervation of the pancreas, the dogs were given 0.05 M HCl in increasing doses (1.5-48 mmol/h). Tests were repeated with atropine. Increasing doses of HCl resulted in a dose-dependent release of protein and bicarbonate output in both the intact and the denervated pancreas. However, pancreatic denervation significantly decreased pancreatic secretion in response to low loads but not to high loads of HCl. HCl-stimulated CCK release was not altered by pancreatic denervation. In the intact pancreas, atropine significantly reduced bicarbonate and protein response to low loads but not to high doses of HCl. In the denervated gland, atropine had no further inhibitory effect on exocrine pancreatic secretion. Furthermore, atropine showed no influence on HCl-stimulated CCK release under either condition.


Selective reduction by the 5-HT antagonist amperozide of alcohol preference induced in rats by systemic cyanamide.

This investigation was undertaken to determine the effect of a unique psychotropic agent on the volitional drinking of alcohol induced pharmacologically in the rat by an inhibitor of aldehyde dehydrogenase. Following administration of cyanamide in a dose of 10 mg/kg twice daily for 3 days, the pattern of drinking of ethyl alcohol was determined in each of 12 Sprague-Dawley rats by means of a standard preference test for 3-30% alcohol vs. water. Then, each rat was offered water and its maximally preferred concentration of alcohol, which ranged from 7-15%. After a 4-day predrug test, either the saline control vehicle or the diphenylbutylpiperazinecarboxamide derivative, amperozide, was administered subcutaneously. The injections of amperozide were given b.i.d. at 1600 and 2200 h over 3 days in a dose of 0.5, 1.0, or 2.5 mg/kg. The intake of alcohol during the sequence of amperozide injections was significantly reduced in a dose-dependent manner in terms of both absolute g/kg and proportion of alcohol to water intake, whereas the saline control vehicle was without any effect on alcohol consumption. Although the highest dose of amperozide reduced the total intake of fluid due to the sharp decline in alcohol drinking, neither the consumption of food nor level of body weight was affected by any dose of the drug either during or after its administration. Because amperozide acts centrally on the synaptic activity of dopaminergic and serotonergic neurons in limbic system structures, it is envisaged that the drug ameliorates the aberrant drinking of alcohol by virtue of a direct effect on either one or both of these classes of neurons.(ABSTRACT TRUNCATED AT 250 WORDS)


Ethanol and delta-sleep-inducing peptide: effects on brain monoamines.

The brain content of dopamine (DA) and its metabolites [dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA)] were the same in rats with different immobilization times in forced swimming test, while the serotonin (5-HT) concentration was higher in high active (HA, immobilization < 2 min) than low active (LA, immobilization > 5 min) animals. Ethanol (2 g/kg, PO) tended to increase the DA level in the striatum and nucleus accumbens in LA rats and decrease the 5-HT and 5-hydroxyindoleacetic acid (5-HIAA) concentration in HA rats. delta-Sleep-inducing peptide (DSIP) injection reduced the level of 5-HT in the medial prefrontal cortex (MFC) in both groups, did not affect the concentration of DA or DOPAC, but increased HVA in the striatum of HA rats. DSIP injected before ethanol administration augmented the ethanol effects on 5-HT in the MFC and attenuated the action of ethanol on 5-HIAA in the nucleus accumbens. A relationship between the different levels of voluntary alcohol consumption and sensitivity to stress among LA and HA rats and the differences in DA and 5-HT concentrations is suggested. The use of LA and HA rats in developing models for testing of stress-shielding compounds is also described.


Effects of drugs on the temporal distribution of schedule-induced polydipsia in rats.

Drinking was induced in food-deprived rats by a fixed-time 1-min schedule of food presentation. With three rats, d-amphetamine (0.25, 0.5, 1.0, and 2.0 mg/kg) led to a dose-related increase in licking early in the interfood intervals, the peak of the temporal distribution of licking being shifted to earlier values. These effects were seen even when d-amphetamine had no effect on overall rates of licking and drinking. With another three rats, however, diazepam (0.5, 1.0, 2.0, and 4.0 mg/kg) did not shift the peak of the temporal distribution of licks in interfood intervals, even at doses that produced small increases in overall rates of licking and drinking. However, diazepam did reduce the peak of the distributions of licks at doses that did not decrease water intake and licks per minute.


Behavioral effects of amphetamine and apomorphine after striatal lesions in the rat.

It is well established that denervation of the dorsal striatum by its dopaminergic afferents attenuates the stereotyped response to d-amphetamine, which can be considered as an extreme form of motor activation. However, it is difficult to sustain the view that this structure serves primary motor control function because the role of dopamine in the striatum remains difficult to understand. In this study, we compared the effects of two dopaminergic agonists, d-amphetamine and apomorphine, after dorsal striatal lesions with ibotenic acid using a computerized scoring of the behavior. Although d-amphetamine- and apomorphine-induced locomotor activity was no different between lesioned and nonlesioned rats in photobeam activity cages, the structure of their behavioral pattern was quite different. Freezing, a usual response after d-amphetamine, was blocked by the lesion. Lesioned rats exhibited less standing than nonlesioned after d-amphetamine, apomorphine, or saline treatment. Moving was increased in lesioned rats after a low dose of d-amphetamine (0.5 mg/kg) or apomorphine (0.5 mg/kg), while d-amphetamine induced in the same rats an increase of rearing. Stereotyped behavior after both drugs at high doses was not affected by striatal lesion. These results indicate that the dorsal striatum is not involved only in the control of stereotypy, as has been suggested using 6-hydroxydopamine lesions, but also plays a major role in the mediation of behavioral activation in response to stimulant drugs.


Effects of angiotensin II on behavioral responses of defensive burying paradigm in rats.

The effects of angiotensin II (ATII) administered intracerebroventricularly in male Wistar rats in doses of 0.1, 0.5, and 1.0 micrograms, as well as of ATII (1.0 micrograms) + saralasin (SAR, an analog ATII) (5.0 micrograms), on behavioral responses of the defensive burying paradigm were studied. ATII-treated animals displayed significantly less defensive burying behavior (less time spent in defensive burying and less frequent burying than in vehicle-treated rats) in a dose-dependent manner. SAR at a dose of 5 micrograms did not affect burying behavior significantly; it also did not modify the inhibition effects of ATII on behavioral responses of the defensive burying test. These results provide evidence that ATII can exert anxiolytic actions on central transmitter systems mediating conditioned fear-related behaviors (i.e., defensive burying). The present study suggests that the defensive burying animal model is a rather sensitive test fulfilling the pharmacological criteria of dose-dependent sensitivity for studying the central effects of neuropeptides (e.g., ATII).


Changes in spontaneous behavior in the dog following oral administration of L-deprenyl.

An open-field activity test was developed for studying the effect of a single oral dose (range of 0.1-5 mg/kg) of L-deprenyl on spontaneous behavior in the dog. A computer program was used to quantify observations of locomotor activity, directed sniffing, urination, grooming, inactivity, jumping, rearing, and vocalization during a 10-min baseline and posttreatment session. Three dose-dependent behavioral changes were observed: an overall decrease in directed sniffing, an increase in total locomotor activity in females, and a decrease in frequency of urination in males. These effects were only seen at the dose levels of 2 mg/kg or higher. Computer-assisted tracings of behavioral patterns showed increased stereotypical behavior and decreased exploratory behavior at the high-dose levels. These behavioral effects are most likely due to either increased levels of phenylethylamine resulting from inhibition of monoamine oxidase B and/or the production of amphetamines as a result of the metabolism of L-deprenyl.


Further evidence for enigmas in adaptation mechanisms for the DOI-induced behaviors.

The acute and chronic effects of the 5-hydroxytryptamine2/1C (5-HT2/1C) receptor agonist (+/-)-1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane (DOI) and the antagonist ketanserin were evaluated on the DOI-induced 5-HT2 receptor-mediated ear-scratch response (ESR) in mice. A challenge dose of DOI (2.5 mg/kg) administered 24 h following its first injection reduced the ESR frequency by 80-97%. The ESR score attained first injection value when the time lag between the first and the second injection was greater than 72 h. On the other hand, a single administration of ketanserin (1.0 mg/kg) caused no significant effect at 24 or 48 h but significantly reduced (51%, p < 0.05) the DOI-induced ESR 120 h following its injection. Chronic once-daily DOI injections reduced the ESR score by 80-97% throughout the treatment regimen. Following cessation from chronic treatment, the DOI-induced ESR frequency returned to control levels in a time-dependent manner. Repeated ketanserin administration significantly reduced the DOI-induced ESR score by 46% when tested 24 or 48 h following cessation of antagonist administration but had no effect at 78 h. Recently, we reported that 48 h following either a single DOI injection or termination from repeated DOI or ketanserin administration the DOI-induced head-twitch response (HTR) in mice exhibited supersensitivity. Thus, it appears that the DOI-induced behaviors exhibit differential adaptation mechanisms following either agonist or antagonist exposure. These studies further support our hypothesis that serotonergic drugs may have the ability to change independently the 5-HT-receptor sensitivity (signal transduction) and receptor density in the same or opposite directions.(ABSTRACT TRUNCATED AT 250 WORDS)


Unilateral, but not bilateral, locus coeruleus lesions facilitate recovery from sensorimotor cortex injury.

This study investigates the role of the locus coeruleus in recovery from sensorimotor cortex injury. Unilateral locus coeruleus lesions given 2 weeks prior to unilateral sensorimotor cortex injury facilitate subsequent motor recovery compared to animals with only a sensorimotor cortex injury, while bilateral locus coeruleus lesions severely retard motor recovery. The results suggest that recovery of function from the cortical injury is facilitated as long as a sufficient amount of the noradrenergic system remains intact, perhaps to provide a basis for compensatory sprouting. The results also suggest that recovery does occur in the absence of the locus coeruleus, indicating that the noradrenergic system is not necessary for recovery to occur after the cortical injury.


Rodent model of nicotine abstinence syndrome.

Few animals models are currently in use for the recognized clinical problem of nicotine dependence and abstinence. This study introduces a rapid and convenient model using the rat. Sixteen male rats were rendered nicotine dependent by 7 days of continuous subcutaneous infusion of either 3 mg/kg/day (n = 8) or 9 mg/kg/day (n = 8) nicotine tartrate salt; 8 control rats were infused with saline alone. Rats were observed for 15 min before, during, and after the drug infusion period using a tally sheet modified from a standard checklist of opiate abstinence signs. There were few signs observed in any group at baseline and at the end of the infusion period. However, nicotine-infused rats showed a significant, dose-related increase over the control group at 16 h after the end of infusion, largely subsiding by 40 h. The most frequently observed signs during withdrawals included: teeth-chattering/chews, writhes/gasps, ptosis, tremors/shakes, and yawns. A significant drop in locomotor activity and increase in weight gain following termination of nicotine infusion provided additional evidence of an abstinence syndrome. This syndrome was alleviated by SC administration of 0.4 mg/kg nicotine tartrate.


Serial injections of MK 801 (Dizocilpine) in neonatal rats reduce behavioral deficits associated with X-ray-induced hippocampal granule cell hypoplasia.

MK 801 (NMDA antagonist) has been shown to protect newborns from hypoxia-induced brain damage. Here, we determined if (+)-5-methyl-10,11-dihydroxy-5h-dibenzo (a,d)cyclohepten-5,10-imine (MK 801) could attenuate behavioral deficits associated with early radiation-induced hypoplasia of fascia dentata granule cells. We pretreated neonatal rats (n = 20) with MK 801 (0, 0.1, or 0.2 mg/kg, IP) before each of eight fractionated, head-only doses of X-rays (13 Gy total) administered during the first 16 days postpartum. Other rats (n = 18) received the same drug treatments but were sham irradiated. At age 16 months, water-escape latencies to a submerged platform were measured in a water maze. Irradiated rats with hippocampal damage exhibited impaired learning (longer latencies to find the platform) than did sham-irradiated subjects. Moderate doses of MK 801 (0.1 mg/kg) facilitated the learning of the water maze by irradiated subjects but did not enhance the number of their fascia dentata granule cells. Higher doses (0.2 mg/kg) of MK 801 provided no behavioral benefits. In fact, this dose significantly impaired the learning of the water maze by sham-irradiated rats and potentiated the granule cell hypoplasia observed in irradiated subjects. Thus, early MK 801 treatment produces dose-dependent behavioral protection for rats with radiation-induced hippocampal damage. Future studies may reveal the neurophysiological and neuroanatomic substrates of this behavioral recovery.


Strain and sex differences in amphetamine-induced rotation.

Studies of rotational behavior in female rats have investigated Fischer, Sprague-Dawley, Madison, WI, and Holtzman strains. The present study of amphetamine-induced rotational preference looked at the most widely used of the pigmented strains, Long-Evans hooded rats, examining rotation in females and comparing rotational magnitude and direction to males of the same strain. We corroborate in Long-Evans animals the greater rotation of females, but our findings oppose the right-sided female and left-sided male rotational preferences reported in earlier studies. Only female rats in this experiment had a significant directional bias, and it was to the left. This result strongly points to the importance of strain in the lateralization expressed by rotation.


Acute and chronic morphine administration in swine.

Functional responses to acute and chronic morphine administration in domestic swine were examined and correlated with pharmacokinetic profiles. Acute effects of morphine sulfate were monitored in pigs for 24 h and the chronic actions of morphine alkaloid were monitored for 21 days. Serum morphine levels, nociception, locomotor activity, respiratory rate, body temperature, and body weight were monitored during all studies. To assess nociception in a large laboratory animal, a portable thermal stimulating device was constructed. Morphine sulfate administered IV and SC had a half-life of approximately 1 h whereas delayed-release morphine alkaloid delivered SC had a half-life of 28 h. The degree of antinociception paralleled decline in blood morphine levels for both SC- and IV-administered animals. Tolerance occurred to both antinociception as well as weight gain despite morphine levels remaining constant over the 21-day period. Morphine dependence was demonstrated by precipitation of an abstinence syndrome using naloxone. Animals in withdrawal displayed consistent signs, including wet-dog shakes, posture changes, vocalization, and salivation. Collectively, these results indicate that swine may be reliably employed as a model to study the actions of morphine and opiate-like compounds.


Effects of central administration of kynurenic acid on spontaneous locomotor activity in the kindled rat: a multivariate approach using the automated Digiscan monitoring system.

Changes in spontaneous motor activity in kindled hooded rats were measured following intracerebroventricular administration of three doses of kynurenic acid (65, 39, and 6.5 micrograms, dissolved in 3.3 microliters isotonic saline). Behavior was measured in the automated Digiscan system on every third day during 13 days of drug administration to assess initial behavioral impairment and the development of tolerance. Activity data were collected beginning 5 min after drug administration for six consecutive 5-min samples. The results revealed a suppressive effect of central administration of kynurenic acid on the pattern of spontaneous locomotor activity and showed the development of behavioral tolerance. Initially, the degree of suppression was dose related, but as tolerance developed group differences were minimized. Most measures returned to predrug levels by day 13 except vertical movement, which remained suppressed in the 65-micrograms group throughout testing. This measure may have been more sensitive to the subtle and long-lasting motor impairments resulting from kynurenic acid.


Sensitization and individual differences to IP amphetamine, cocaine, or caffeine following repeated intracranial amphetamine infusions.

Rats that have a high locomotor response to novelty (HR) sensitize more readily to IP-administered amphetamine than rats with a low locomotor response (LR) to novelty. This experiment compared sensitization in HR and LR rats following amphetamine (3.0 micrograms/side for 5 days) infused bilaterally into either the nucleus accumbens (NACC), ventral tegmental area (VTA), or the medial frontal cortex (MFC). The subsequent locomotor response to IP-administered d-amphetamine sulfate (1 mg/kg), cocaine HCl (15 mg/kg), and caffeine benzoate (20 mg/kg) was also examined. No differences were observed between HR and LR rats following amphetamine infusion into either the MFC, NACC, or VTA. However, HR rats showed greater locomotor activity compared to LR rats following either IP amphetamine, cocaine, or caffeine for subjects cannulated in the NACC, MFC, or the VTA. Repeated infusions of amphetamine into the VTA increased the locomotor response to both IP amphetamine and cocaine, but not to IP caffeine, while repeated infusions of amphetamine into the NACC or MFC had no effect on locomotor response to any drug subsequently administered IP. The results support previous findings that changes induced by intra-VTA infusions, but not intra-NACC or MFC infusions, of amphetamine induce sensitization to IP-administered amphetamine and cocaine. Findings from the present experiment indicate the ability of the dopamine cell body region, but not the dopamine terminal fields, to produce locomotor sensitization to amphetamine and cocaine. The results from the present experiment also indicate the lack of localization to one of studied regions of individual differences.(ABSTRACT TRUNCATED AT 250 WORDS)


8-OH-DPAT in the midbrain central gray inhibits lordosis behavior.

Sexually receptive female rats were infused intracranially with 500-2,000 ng 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT) into the midbrain central gray (MCG), in the vicinity of the dorsal raphe nucleus (DRN), or directly into the DRN. When cannulae were located within the DRN, there was little evidence of change in lordosis behavior but a decrease in locomotor activity was commonly observed. In contrast, when cannulae were located anterior, ventromedial, or lateral to the DRN inhibition of lordosis behavior was rapid and robust. Both the lordosis-to-mount ratio (L/M) and the quality of the lordosis reflex were reduced following the infusion. The MCG receives lordosis-facilitating input from the ventromedial nucleus of the hypothalamus and from ascending sensory pathways and contributes information to descending motor systems involved in the lordosis response. Thus, the MCG is a critical link in the completion of the estrogen-dependent lordosis reflex. The present results suggest that 5-hydroxytryptamine1A receptors in the MCG prevent the completion of this reflex.


Peripheral serotonin is an incomplete signal for eliciting satiety in sham-feeding rats.

Peripheral administration of serotonin [5-hydroxytryptamine (5-HT)] to rats equipped with gastric cannulae reduced their 30-min consumption of sweetened milk after overnight deprivation whether the cannulae were closed (real feeding) or open (sham feeding). The anorectic action of 5-HT (1.6, 4.0, and 10.0 mumol/kg, IP) in sham feeding was dose-related, rapid in onset, and persisted during the 30-min testing session. However, 5-HT failed to elicit resting--the terminal behavioral phase of satiety--in sham-feeding rats. Direct comparison of the effects of 4.0 mumol/kg 5-HT under both feeding conditions established that this dose promoted resting only when rats fed with their cannulae closed. The actions of 5-HT on feeding and resting were behaviorally selective because serotonergic treatment did not retard the beginning of feeding, alter sham drinking of water, or reduce investigation by food-deprived rats of a novel object in an open field. Together, the results suggest that 5-HT exerts separate actions to inhibit feeding and accelerate the process of satiation as marked by resting. However, peripheral 5-HT is inadequate as a signal for modulating satiety in the absence of postingestive stimuli.


Enhanced social interactions in rats following chronic, centrally infused oxytocin.

Most studies investigating the behavioral effects of centrally administered oxytocin (OT) have been confined to single acute injections followed by brief behavioral observations lasting up to 90 min. The present study examines the behavioral effects of chronic, centrally administered OT in male rats observed continuously for prolonged periods of time. Either artificial cerebrospinal fluid or OT was centrally infused (via osmotic minipump) to gonadally intact male rats. Behavioral observations were made on males paired with either ovariectomized or estrous females during a 6-h time period. Most striking was the observation that durations of physical contact were doubled in pairs containing OT-infused males, even in the absence of sexual interactions. Also, OT-infused males showed significantly higher levels of anogenital sniffing of females and autogrooming; however, sexual interactions were unaffected by chronic OT. Chronic OT had no effect on body temperature, analgesia, or exploratory behavior in an open field. These findings suggest that chronic OT in male rats has behavioral effects that may significantly enhance adult social (nonsexual) interactions, possibly through alterations in olfactory and somatosensory information processing.


5-HT3 receptor antagonists block cocaine-induced locomotion via a PCPA-sensitive mechanism.

We report results in rats pretreated with (+/-)-zacopride (0.03 mg/kg, IP), ICS 205-930 (0.1 mg/kg, IP), and MDL 72222 (1.0 mg/kg, IP) 15 min before challenge with (-)-cocaine (10.0 mg/kg, IP). At a dose of 10 micrograms/kg, zacopride significantly inhibited (approximately 50%) cocaine-induced locomotion. We also investigated whether or not 5-hydroxytryptamine3 (5-HT3) antagonists block the cocaine binding site on the dopamine transporter and/or affect the ability of dopamine to regulate this binding site. In well-washed striatal membranes, neither zacopride nor ICS 205-930 (10(-9)-10(-5) M) inhibited [3H]2 beta-carbomethoxy-3 beta-(4-fluorophenyl)tropane ([3H]WIN 35,428) (0.3 nM) binding. Furthermore, neither of these compounds affected the ability of dopamine to block WIN 35,428 binding. To determine if 5-HT is required for the 5-HT3 antagonist effect, we examined the interaction between cocaine and zacopride in rats pretreated with p-chlorophenylalanine (PCPA) (3 days x 100 mg/kg/day). PCPA pretreatment shifted the cocaine dose-response curve to the right and blocked the ability of zacopride to reverse cocaine-induced activity.


Central effects of monosodium glutamate on feeding behavior in adult Long-Evans rats.

Monosodium glutamate (MSG) is known as a neurotoxic molecule when injected neonatally in rats, where it produces a marked decrease in food intake and an increase in adipose tissue mass. But, in adult rats subcutaneous injections of MSG produce a small, dose-dependent increase in food intake. It is not known if this action is centrally or systemically mediated. Therefore, the feeding pattern of adult rats injected intracerebroventricularly with MSG was measured. Seven days after installation of a cannula in the right lateral ventricle, rats were injected either with artificial cerebrospinal fluid or twice with 3 mg/brain MSG within a 3-day interval. The feeding pattern was recorded via a complete computerized system during 24 h. Feeding behavior was significantly modified by MSG treatments. These effects were observed immediately after drug injections, that is, upon the first meal, as well as during the 24 h that followed. For the first meal, modifications in meal size (+285%; p = 0.0001), meal duration (x10; p = 0.0005), postmeal interval (x4; p = 0.0005), and the satiety ratio (-50%; p = 0.01) were observed. During the 24-h postinjection period, modifications in meal number (-3; p = 0.0007), total amount of food eaten (+21%,; p = 0.007), time spent eating (+40%; p = 0.007), meal duration (+53%; p = 0.005), and meal size (+44%; p = 0.01) were noted. When the two MSG injections were compared, differences were also noted. For the first meal, postmeal interval (-50%; p < 0.005) and satiety ratio (-50%; p < 0.005) were decreased after the second injection.(ABSTRACT TRUNCATED AT 250 WORDS)


Differential effects of mesocortical, mesolimbic, and mesostriatal dopamine depletion on spontaneous, conditioned, and drug-induced locomotor activity.

Groups of rats with 6-hydroxydopamine (6-OHDA) lesions of either the medial prefrontal cortex (PFC), nucleus accumbens (NAC), or caudate putamen (CPu) were given daily tests for locomotor activity in photocell cages while food deprived. Two separate groups of NAC-lesioned rats were prepared with either large [NACT (90% NAC dopamine depletion)] or partial [NACP (67% NAC dopamine depletion)] lesions. NACT rats were spontaneously hypoactive whereas NACP rats were hyperactive compared with sham-operated controls. PFC-lesioned rats were also hyperactive compared to their respective controls. Spontaneous locomotor activity in CPu-lesioned rats did not differ from shams. When daily food supplements were paired with the photocell cages, all subjects developed a conditioned locomotor response. During the first few days of conditioning, the response to this conditioning procedure was markedly greater in the NACP group whereas the response in the NACT group was unaffected initially and actually enhanced during the latter days of testing. The locomotor response to the conditioning procedure was unaffected in either the PFC- or CPu-lesioned groups. Both the NACT and NACP lesions attenuated the locomotor response to 1.5 mg/kg d-amphetamine sulphate IP, and the NACT group showed a supersensitive response to 0.1 mg/kg apomorphine HCl SC. PFC or CPu 6-OHDA lesions did not alter the response to either drug. These results differentiate the role of PFC, NAC, and CPu dopamine in spontaneous, conditioned, and drug-induced locomotor activity and further implicate dopaminergic mechanisms of the NAC in the magnitude of the behavioural response to incentive stimuli.


Effect of food deprivation and refeeding on the concentration of vasopressin and oxytocin in discrete hypothalamic sites.

Recent evidence has implicated hypothalamic peptides, such as arginine vasopressin (AVP) and oxytocin (OT) in the control of feeding behavior. In this study, we investigated the impact of food deprivation (48 h) and subsequent refeeding (6 h) on the concentration of AVP and OT in discrete hypothalamic areas, as well as in the neurohypophysis. We also estimated in these rats certain peripheral measures, including hydroelectrolytic parameters, plasma and urine AVP, and plasma corticosterone. The results of this study revealed that food deprivation for 48 h produced little change in OT concentration in the various hypothalamic nuclei studied, including the paraventricular and supraoptic nuclei, with the exception of the median eminence (ME), where a significant decline (-36%; p < 0.05) was detected. This effect was not significantly reversed by 6 h of refeeding. With respect to AVP concentration, food deprivation caused a reliable decline exclusively in the parvocellular subdivision of the paraventricular nucleus (pPVN; -45%; p < 0.01) and in the supraoptic nucleus (SON; -45%; p < 0.01). No change in AVP was detected in the ME or in most other hypothalamic nuclei examined. Refeeding for 6 h actually potentiated the effect of food deprivation, decreasing further from baseline the content of AVP in the pPVN and SON. The only other hypothalamic area to exhibit a change in AVP content was the ventromedial nucleus, where AVP level increased (p < 0.001) after deprivation and declined to normal after 6 h of refeeding. The content of AVP and OT in the neurohypophysis was unaffected by food deprivation and subsequent refeeding.(ABSTRACT TRUNCATED AT 250 WORDS)


Acute effects of marijuana on cognition: relationships to chronic effects and smoking techniques.

A double-blind, placebo-controlled study assessed acute effects on human cognition of marijuana smoking involving long or short durations of inhalation and breath holding. During eight test sessions, 48 adult, male volunteers completed standardized, pencil-and-paper tests of educational development and ability, as well as computerized tests of learning, associative processes, abstraction, and psychomotor performance. Marijuana impaired all capabilities except abstraction and vocabulary. These impairments were more pervasive than those associated with heavy, chronic marijuana use in a previous study involving the same tests, but showed some similarities. Marijuana altered associative processes, encouraging more uncommon associations. Marijuana-induced impairment in learning pairs of words was influenced by associative relationships between the words. There were a few hints that prolonged breath holding increased marijuana's effects under some test conditions, but in general it did not. Prolonged breath holding itself affected performance in four tests, regardless of whether subjects smoked marijuana or placebo. Whether physiological or psychological factors (e.g., exposure to carbon monoxide in smoke or subjects' expectations) produced these effects could not be determined.


Vagally mediated feeding responses to phloridzin infusion in the rabbit.

Rabbits were infused with the plant glycoside, phloridzin, which blocks absorption of glucose across a number of bodily tissues. Feeding was dramatically increased in the first 0.5 h following phloridzin infusion into either the duodenum or the hepatic-portal vein of intact rabbits. Food intake covaried inversely with glycemic levels after phloridzin infusion into the hepatic-portal vein, but rabbits did not show a systematic relationship between blood glucose levels and food intake following duodenal infusion of phloridzin. When administered into the general circulation via the jugular vein, phloridzin did not elicit feeding. Finally, vagotomized rabbits did not show the hyperphagic response to phloridzin that was observed in intact rabbits. It was concluded that the feeding response to phloridzin is vagally mediated and appears to be induced by glucose transport inhibition at some peripheral site.


Analgesic actions of local anesthetics and cobalt chloride in the rat brain stem.

A low-intensity thermally evoked tail avoidance reflex (LITETAR) was used to study changes in nociceptive response produced by local anesthetics and cobalt chloride microinjected into the dorsal posterior mesencephalic tegmentum (DPMT) of conscious rats. Dose-related prolongation of the LITETAR (e.g., analgesia) was observed when lidocaine, cocaine, and bupivacaine were administered into the DPMT. Analgesic actions were also demonstrated when cobalt chloride was microinjected into the DPMT. The analgesic actions of these different neuronal suppressants provide support for the hypothesis that there exists tonic activity of hyperalgesic processes in the rat brain stem.


Orally administered cyclo(His-Pro) reduces ethanol-induced narcosis in mice.

Cyclo(His-Pro) (cHP) is an endogenous, enzymatically resistant, biologically active peptide. We examined its ability to be absorbed after oral administration. cHP radioactively labeled with 125I (I-cHP) was fed to adult mice, and blood and tissue samples were taken 15-90 min later. Radioactivity quickly appeared in blood at levels about one half to one fourth those previously found after IV injection. The highest concentrations were in the kidney and liver, but the testes, muscle, lung, and brain also contained more radioactivity than was accounted for by their vascular spaces. Between 25-32% of the radioactivity recovered from blood 30 min after feeding eluted on high-performance liquid chromatography in the position of intact peptide. Oral cHP reversed ethanol-induced narcosis, an effect previously found to occur within the brain. These results show that cHP can be absorbed orally in amounts sufficient to affect the CNS.


Distinguishing effects of cocaine i.v. and SC on mesoaccumbens dopamineand serotonin release with chloral hydrate anesthesia.

The effect of i.v. cocaine (0.5 and 1.0 mg/kg) was studied on synaptic concentrations of dopamine (DA) and serotonin [5-hydroxytryptamine (5-HT)] in the mesoaccumbens nerve terminal, the nucleus accumbens (NAcc), in chloral hydrate-anesthetized, male Sprague-Dawley rats (Rattus norvegicus) with in vivo electrochemistry (voltammetry). In further in vivo voltammetric studies, the effects of SC cocaine on synaptic concentrations of DA and 5-HT were studied in the chloral hydrate-anesthetized paradigm in two neuroanatomic substrates, NAcc and mesoaccumbens somatodendrites, the ventral tegmental area (VTA-A10), in a dose-response fashion (10, 20, and 40 mg/kg) in six separate studies. Moreover, in two additional in vivo voltammetric studies, again using the chloral hydrate-anesthetized paradigm, the impulse flow blocker, gamma-butyrolactone (gamma-BL) (750 mg/kg, IP), was studied alone and in combination with SC cocaine (20 mg/kg) to determine whether or not cocaine can act by presynaptic releasing mechanisms for DA and 5-HT. The results show that IV cocaine concurrently and significantly increased DA and 5-HT release in the NAcc (p < 0.001, p < 0.0005, respectively) at both doses tested. Moreover, IV cocaine effects on DA and 5-HT release were significantly and positively correlated (p < 0.01). On the other hand, SC cocaine concurrently and significantly decreased DA and 5-HT release in NAcc (p < 0.0001) and VTA (p < 0.0001) at each separate dose tested. SC cocaine effects on DA and 5-HT release were significantly and positively correlated across dose and neuroanatomic substrate (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)


The CCK-A receptor antagonist, devazepide, blocks the anorectic action of CCK but not peripheral serotonin in rats.

A role has been proposed for cholecystokinin (CCK)-A-type receptors in mediating the anorectic action produced by serotonergic stimulation in rats. We examined the effect of pretreatment with the CCK-A antagonist devazepide (DVZ) on anorexia produced by peripheral administration of serotonin [5-hydroxytryptamine (5-HT)] or CCK-8 in 3-h food-deprived rats consuming a 30-min test meal of sweetened mash. The anorectic effect of CCK-8 (4.0 nmol/kg, IP) was antagonized in a dose-dependent manner by DVZ (0.03, 0.10, and 0.30 mumol/kg, IP), with even the lowest dose producing a significant reversal. Under identical testing conditions, a supramaximal dose of DVZ (.75 mumol/kg) did not attenuate the reductions in food intake produced by either a moderate (4.0 mumol/kg) or a high dose (10.0 mumol/kg) of 5-HT. These data confirm established findings that the anorectic action of peripheral CCK depends upon CCK-A receptors. However, peripherally administered 5-HT reduces food intake independently of CCKergic function.


Effect of oxiracetam on scopolamine-induced amnesia in the rat in a spatial learning task.

The effects of the nootropic agent 4-hydroxy-2-oxopyrrolidinoacetamide (oxiracetam) on memory and performance impairments induced by scopolamine were evaluated in the Morris water maze task. No effect was seen on the performance of rats when treated with oxiracetam (30 mg/kg, IP) alone. Task performance of scopolamine (0.2 mg/kg, SC)-treated rats was impaired as compared to that of control animals. The behavioral deficits expressed in the task by scopolamine treatment were attenuated by the same dose of oxiracetam.


Estradiol modulation of the hyperphagia induced by the 5-HT1A agonist, 8-OH-DPAT.

Ovariectomized rats were primed with sesame oil or estradiol benzoate followed 48 h later by either sesame oil or progesterone. Four hours later, rats were treated with either saline or 0.25 mg/kg 8-hydroxy-2-9(di-n-propylamino)tetralin (8-OH-DPAT). Rats were allowed to eat for 4 h after this final treatment. Animals in all hormonal conditions showed hyperphagia following 8-OH-DPAT. However, the hyperphagia was significantly attenuated by pretreatment with estradiol benzoate. There was no effect of progesterone on the hyperphagic response. These results suggest that previous findings of an estrous cycle modulation of the hyperphagic response to 8-OH-DPAT arise from the modulatory effects of estradiol, and not progesterone, during the female reproductive cycle.


Serotonergic drugs do not substitute for clozapine in clozapine-trained rats in a two-lever drug discrimination procedure.

The atypical neuroleptic clozapine has been shown to have cue properties in two-lever drug discrimination procedures. Although it has been demonstrated that clozapine acts at several types of receptors in vitro and in vivo, including dopamine, serotonin [5-hydroxytryptamine (5-HT)], and acetylcholine receptors, the mechanism of action for its discriminative stimulus properties has not yet been determined. The present study examined the effects of haloperidol (D2 dopamine antagonist), ritanserin (5-HT2 antagonist), 1-alpha H,3-alpha,5-alpha H-tropan-3yl-3,5-dichlorobenzoate (MDL 72222) (5-HT3 antagonist), and buspirone (5-HT1A agonist) in stimulus substitution tests with rats trained to discriminate clozapine (5.0 mg/kg, IP) from vehicle in a two-lever drug discrimination procedure under a fixed ratio 30 schedule of food reinforcement. Analysis of the results revealed that, while clozapine produced dose-dependent responding on the clozapine lever, haloperidol and the three serotonin drugs failed to produce full substitution for clozapine at any of the doses tested. These results suggest that the discriminative stimulus properties are not mediated by D2 dopamine receptor blockade, antagonism at 5-HT2 or 5-HT3 receptors, or agonistic activity at 5-HT1A receptors. The neural basis of clozapine's discriminative stimulus properties has not yet been determined.


Devazepide antagonizes the inhibitory effect of cholecystokinin on intake in sham-feeding rats.

3S(-)-N-(2,3-Dihydro-1-methyl-2-oxo-5-phenyl-1H-1,4-benzodiazepine-3-yl) -1H-indole-2-carboxamide (devazepide), a potent and selective cholecystokininA (CCKA) antagonist, has been shown to reverse the inhibitory effect of exogenously administered CCK-8 on food intake. In all tests, however, the inhibition of food intake could have been due not only to the CCK-8 administered but also to synergistic interactions between administered CCK-8 and endogenous satiety signals, such as glucagon or CCK released from the small intestine, elicited by the postingestive effects of the test diet. To eliminate these possible interactions, we investigated the effect of devazepide on the inhibitory effect of CCK-8 on the intake of a milk diet during 30 min of sham feeding, a procedure that minimizes or eliminates the postingestive satiating effect of food. Under these conditions, devazepide was a potent antagonist of the inhibitory effect of CCK-8 (16 mumol/kg, IP): The approximate ED50 was 625 ng/kg (1.3 nmol/kg) and the threshold dose was between 62.5 and 625 ng/kg.


A versatile one-stage neurovascular flap for fingertip reconstruction: the dorsal middle phalangeal finger flap.

The dorsal middle phalangeal finger flap is an extremely reliable flap that is indicated for fingertip injuries which require sensory reconstruction. This flap originates from the dorsum of the middle phalanx of the finger and is elevated with a vascular pedicle of the digital artery and the dorsal branch of the digital nerve. After transfer of the flap to the injured site, epineural neurorrhaphy is done between the digital nerve and the dorsal sensory branch of the flap. This flap can be thought of as an island flap of the innervated cross-finger flap that provides excellent sensory recovery and aesthetic improvement. We used this flap in a series of eight consecutive patients and were able to follow up seven patients for longer than 6 months (mean follow-up time 10.7 months). All patients achieved measurable two-point discrimination, with an average of 4.9 mm in the moving two-point discrimination. In this study, we report our consecutive series of the dorsal middle phalangeal finger flap and its versatile utility.


Osteoid osteoma of the distal phalanx of the finger: a diagnostic challenge.

Osteoid osteomas of the distal phalanx of fingers are uncommon. An extensive review of the literature indicates that the diagnosis of osteoid osteoma of the distal phalanx is often delayed for several months to years (average 34.3 months). Pain is the most common finding (92 percent), followed by swelling and clubbing (75 percent). Relief of pain by aspirin was indicated in 10 patients (42 percent). Multiple operations were done in 7 patients prior to the appropriate diagnosis and treatment. A typical case report is presented to illustrate the difficulties in diagnosis and treatment of this benign bone tumor. A better awareness of this tumor may prevent unwanted delays in diagnosis and unnecessary operations.


The effect of denervation on soft-tissue infection pathophysiology.

Pressure is the sine qua non in the etiology of pressure sores; however, ischemia, denervation, edema, and infection also have been implicated. The role of denervation in tissue infection was studied in an isolated in vivo ovine flap model. Twenty-six adult ewes, divided into three groups, had 29 island pedicle flaps raised on their buttocks. In group I, the cutaneous nerve remained intact, while group II had its nerve divided acutely. Group III had prolonged denervation, where the nerve was divided 7 days before flap elevation. All flaps received intradermal inoculations of 10(7) Staphylococcus aureus. Ninety-six hours later, quantitative bacteriology showed counts of 10(7), 10(7), and 10(9) colony-forming units (CFU) per gram of tissue in groups I, II, and III, respectively. Septic foci were larger in group III, and there was a significant increase in tissue edema between groups I and III. A 25-fold increase in bacterial counts seen in the prolonged denervation group may help explain why neurologically injured patients are more susceptible to infection and pressure ulcerations.


The peripheral nerve allograft in the primate immunosuppressed with Cyclosporin A: I. Histologic and electrophysiologic assessment.

Nerve regeneration across peripheral nerve allografts and control autografts in primates immunosuppressed with Cyclosporin A was quantitatively evaluated by electrophysiologic and histologic methods. Twelve cynomolgus monkeys received 3-cm autografts and allografts in contralateral ulnar nerves. They were immunosuppressed with Cyclosporin A at 25 mg/kg per day or placebo vehicle. Morphometric analysis of nerve graft and distal nerve segments was assessed at 1 year after engraftment. Quantitative electrophysiologic studies were performed percutaneously at 6 and 12 months, and compound action potentials were measured directly across the nerve grafts at 1 year. Excellent regeneration was seen across autografts and allografts in Cyclosporin A-treated and placebo-treated recipients.


The peripheral nerve allograft in the primate immunosuppressed with Cyclosporin A: II. Functional evaluation of reinnervated muscle.

Isometric contractile function was evaluated in primates receiving peripheral nerve allografts and autografts. Twelve adult male cynomolgus monkeys received both sural nerve allografts and autografts to the ulnar nerve in opposite forearms. Half the animals received Cyclosporin A (CsA) immunosuppression (25 mg/kg per day); the remaining animals received placebo. One year following nerve engraftment, isometric contractile muscle function was evaluated in reinnervated abductor digiti quinti and intact abductor pollicis brevis muscles. Maximal twitch tension (Pt), tetanic tension (P(o)), time to peak tension (tpt), rate of rise of twitch tension (DP/dt), and muscle fatigue were evaluated at optimal muscle length (L(o)). All reinnervated muscles distal to nerve autografts and allografts in both Cyclosporin A-immunosuppressed and placebo-treated animals generated equivalent maximal twitch tension, tetanic tension, and time to peak tension, with no significant difference between groups (p > 0.05 by ANOVA). There was a tendency toward increased muscle fatiguability in Cyclosporin A-treated animals (p > 0.05). However, the rate of rise of twitch tension was significantly faster in the reinnervated and intact muscles of Cyclosporin A-treated primates (p < 0.05). Evidence of excellent functional reinnervation across nerve allografts and autografts similar to that seen in histologic and electrophysiologic studies was noted. Cyclosporin A immunosuppression did not significantly enhance recovery of muscle function distal to nerve allografts in this model.


Primary cutaneous cryptococcosis as the presenting manifestation of AIDS.

Presented is a case of primary cutaneous cryptococcosis, presenting as a papular facial lesion with subsequent ulceration, as the initial manifestation of AIDS. This unusual condition must be considered in the workup of unexplained or therapeutically unresponsive skin lesions. If it is diagnosed in an ostensibly "healthy" individual, evaluation for evidence of immunosuppression, and its underlying cause, must be undertaken.


Mixed heterotopic gastrointestinal and respiratory cyst of the lip: case report and review of the literature.

A congenital heterotopic gastrointestinal and respiratory cyst arising from the upper lip is reported. The lesion was excised directly with a satisfactory aesthetic result. Long-term follow-up is recommended because of a report of recurrence of this type of lesion after 13 years.


Spontaneous regression of subcutaneous metastasis of cutaneous melanoma.

A case is presented of a 44-year-old Caucasian man who was operated on in October of 1988 for a cutaneous melanoma in his trunk and who in the space of 1 year manifested a single subcutaneous nodule compatible with a metastasis of melanoma by fine-needle aspiration biopsy. No other abnormal findings were revealed by physical and instrumental examinations. During the subsequent hospitalization, we witnessed (in conjunction with the occurrence of painful symptoms in the hands of an inflammatory nature) the total, progressive, spontaneous regression of the metastasis, which was confirmed by the clinic and the tests. After 15 months of follow-up, the patient has not shown any further signs of illness.


Papillary adenoma of the nipple.

Papillary adenoma of the nipple is a benign condition of the nipple that can be confused clinically with adenocarcinoma metastatic to the skin or Paget's disease. Deep biopsy of the nipple is necessary to make a histologic diagnosis. Complete excision of the nipple and the subareolar tissue is sufficient to effect a cure.


Hook nail deformity repaired using a composite toe graft.

The hook nail deformity is caused by loss of fingertip bone and soft tissue. Healing can result in a volarly displaced distal nailbed and a tight tip with inadequate padding and a poor cosmetic appearance. A composite graft from the second toe placed beneath the released nailbed gives good support and improved pulp substance. The technique of the composite toe graft has been performed in nine patients. All grafts were 100 percent viable, but one patient required a second graft for additional tip bulk. There has been no donor-site morbidity in the follow-up of 1 month to 2 years.


Permanent lip augmentation employing polytetrafluoroethylene grafts.

There is a paucity of literature regarding aesthetic enhancement of the lips. This is due to the lack of reliable techniques employing autogenous tissue and the reluctance on the part of surgeons to use an alloplastic implant in this anatomic region, which is superficial, subject to trauma, and must conform to innumerable geometric shapes. The ideal lip augmentation procedure should provide for a predictable, permanent enlargement without visible scars or donor-site deformity, can be customized to the particular patient's anatomy, and can be reversed if so desired. A series of 21 alloplastic lip implants employing polytetrafluoroethylene with a mean follow-up of 14.33 months is presented. The overall complication rate was 9.52 percent. Permanent lip augmentation can be achieved with alloplastic sheet grafts of polytetrafluoroethylene in a safe and predictable fashion. Stiffness of the lips develops with progressive thickness of the grafts. Grafts exceeding 3 mm in thickness should be avoided.


The pronator quadratus muscle flap: coverage of the osteotomized radius following elevation of the radial forearm flap.

Skin-graft take following elevation of the osteocutaneous radial forearm flap has been shown to be difficult. The pronator quadratus muscle flap can be elevated to cover the exposed osteotomized radius and flexor carpi radialis and brachioradialis tendons. This technique is technically easy to perform and may significantly reduce donor-site wound-healing problems.


Transiliac and retroperitoneal approach for coverage of sacrogluteal defects with inferiorly based rectus abdominis musculocutaneous flaps.

An inferiorly based rectus abdominis musculocutaneous flap is transferred to the sacrogluteal region through a transiliac approach. This technique is a simple and safe alternative to obtain a short pathway from the anterior abdomen to the sacral area.


Alterations in skin properties during rapid and slow tissue expansion for breast reconstruction.

This study comprises 23 women who had had mastectomies because of breast cancer. They were randomly divided into two groups when they were admitted for breast reconstruction by tissue expansion. The first group was expanded rapidly, i.e., every day, and the other group was expanded slowly, i.e., every week. There were no other differences in the treatment between the two groups. Three months after completion of expansion, the expander was replaced by a permanent prosthesis. The follow-up time was up to 6 months after the second operation. Three different parameters--distensibility, elasticity, and hysteresis--were measured noninvasively on the breast skin and at a control site on several occasions throughout the treatment. During the treatment period there were no differences in skin properties between rapidly and slowly expanded patients. Of the three parameters, distensibility showed the most prominent changes: decreasing during the expansion period, increasing after the expander had been replaced by a permanent prosthesis, and decreasing during the following 6 months. Elasticity did not change significantly, except decreasing after insertion of the permanent prosthesis, and the hysteresis increased at the same time. These findings indicate that tissue expansion alters breast skin only to a small extent and that the mechanical resistance sometimes encountered during tissue expansion is due to deeper structures such as underlying muscles or capsule formation.


Holoprosencephaly and midline facial anomalies: redefining classification and management.

Holoprosencephaly encompasses a series of midline defects of the brain and face. Most cases are associated with severe malformations of the brain which are incompatible with life. At the other end of the spectrum, however, are patients with midline facial defects and normal or near-normal brain development. Although some are mentally retarded, others have the potential for achieving near-normal mentality and a full life expectancy. The latter patients do not fit clearly into the previously defined classification system. Proposed is a new classification focusing on those patients with normal or lobar brain morphology but with a wide range of facial anomalies. The classification aids in planning treatment. Coupled with CT scan findings of the brain and a period of observation, patients unlikely to thrive can be distinguished from those who will benefit from surgical intervention. Repair of the false median cleft lip and palate may suffice in patients with moderate mental retardation. Patients exhibiting normal or near-normal mentality with hypotelorbitism and nasomaxillary hypoplasia can be treated with a simultaneous midface advancement, facial bipartition expansion, and nasal reconstruction.


The use of scapular and parascapular flaps for cheek reconstruction.

This is a retrospective review of our experience with microvascular transfer of scapular and parascapular flaps for the correction of lateral facial contour deficiencies. Twenty-eight patients with congenital (n = 8) and acquired (n = 20) defects were treated with 30 flaps; two patients had bilateral flaps. The etiology of the defects included hemifacial microsomia (n = 2), oblique facial cleft (n = 1), Romberg's hemifacial atrophy (n = 5), neoplasm (n = 4), irradiation (n = 8), trauma (n = 4), tumor excision (n = 4), facial lipodystrophy (n = 2), and silicone granuloma (n = 2). The follow-up evaluation was from 2 to 13 years, with an average of 6 years. Fabrication of a facial moulage was part of the preoperative planning for each patient. These were compound flaps, including skin, deepithelialized skin, fat, fascia, and bone, if necessary. All flaps were constructed with an intact skin paddle for postoperative monitoring. Based on dissections and anatomic findings at operation, several variations in the level of emergence of the circumflex scapular artery from the triangular space and its branching patterns were noted. All flaps survived; changes in the patients' weights were reflected in the flaps. Twelve patients required secondary procedures: excision of skin monitor islands, scar revisions, debulking, or flap resuspension to the malar region. Bone grafts or alloplastic implants were necessary in four patients in whom the malar eminence could not be adequately corrected by transfer of a flap. The deepithelialized scapular/parascapular flap is preferred for correction of large lateral facial defects.


Contralateral injections of botulinum A toxin for the treatment of hemifacial spasm to achieve increased facial symmetry.

Six patients noted facial asymmetry after botulinum toxin injection for hemifacial spasm. Each patient was injected on the side contralateral to the spasms with 10 to 15 IU over the zygomatic major and minor muscles. Each patient noted improvement in facial symmetry in the resting position and dynamic facial movements. Five of the six patients desired this approach with subsequent injections. This injection method variation proved helpful in the managing of hemifacial weakness created by botulinum A toxin for this condition.


Long-term follow-up of the effectiveness and safety of inferior turbinectomy.

The long-term effectiveness and safety of inferior turbinectomy were assessed in 186 patients who were interviewed and examined 10 to 15 years after surgery (mean 12.3 years). Relief of nasal obstruction was reported by 82 percent of the patients; rhinoscopy showed wide, clean nasal airways in 88 percent. Rhinorrhea was still a problem for 34 percent of patients, and 19 percent were receiving medical treatment for this symptom. Smell acuity had improved in 52 percent of the patients. Before turbinectomy, 32 patients had suffered from bronchial asthma; postoperatively, there was an improvement in 16, and no change in 13; 3 patients reported exacerbation of asthmatic attacks. Atrophic changes of the nasal mucosa and chronic purulent infection were not observed in any of the patients.


Hypertrophic sternal scars: silicone gel sheet versus Kenalog injection treatment.

A prospective, randomized trial was designed to compare the standard Kenalog injection of established hypertrophic sternal scars with topical silicone gel sheets (Spenco). Fourteen poststernotomy cardiac patients with symptomatic scars were randomized to treatment in one-half of the scar with Kenalog injection. Simultaneously, the other half of the scar received the silicone gel sheet. The standard Kenalog injection used was 40 mg/ml x 1 cc, mixed with 1 cc of 1% Xylocaine with epinephrine. The gel sheets were worn continuously for 12 hours for 12 weeks. Pretreatment and posttreatment photographs were compared for color and appearance by blindfolded observers. Scar measurements (length, width, and height) were taken weekly in each area, and the patients were asked to rank their symptoms within each half as worse, the same, or better. The primary outcome of patient preference was analyzed sequentially, and the recruitment was terminated after 11 patients had completed the study, 10 of whom favored the silicone gel treatment (p < 0.05). Three patients remained in the treatment phase at the time of termination and completed the study subsequently. For the total sample of 14 subjects, 11 preferred the silicone gel, 1 expressed no preference, and 2 preferred the injection. The average time to improvement was 3.9 +/- 0.62 days (gel) versus 6.8 +/- 1.86 days (Kenalog). This study demonstrates that silicone gel sheets provide earlier symptomatic relief and a more aesthetic scar and are the preferred treatment of patients with symptomatic hypertrophic sternal scars.


Hypertrophic scar: an interruption in the remodeling of repair--a laser Doppler blood flow study.

Soft-tissue dermal loss does not regenerate; instead, it is replaced with scar. The extent of scarring is directly related to the severity of tissue loss (in terms of volume and depth). Commonly, an acute dermal loss will heal with excessive scar, hypertrophic scar. A hypertrophic scar is elevated but is contained within the boundaries of the initial injury. Hypertrophic scars have a reddish appearance, indicating an elevated local circulation. A laser Doppler blood flow monitor was employed to measure blood flow changes in healed wounds. It was speculated that local circulation in a developing hypertrophic scar would be elevated. Patients with recently healed wound sites were monitored and exhibited an average blood flow reading of 365 +/- 325 mV (n = 131). This average value, ranging from 98 to 1450 mV, was 18 times greater than the average reading from normal skin, which was 43 +/- 13 mV (n = 212). Blood flow declined to 32 +/- 21 mV (n = 7) at 16 to 18 weeks (74 percent of normal skin values) in healed wounds that developed normal scar. However, a closed wound that developed into a hypertrophic scar had a blood flow reading of 148 +/- 78 mV (n = 59) at 16 to 18 weeks. This value was three times greater than in normal skin and four times greater than in normal scar. At 38 to 50 weeks postinjury, hypertrophic scar remained elevated (102 +/- 34 mV; n = 10). Hypertrophic scars sustain an elevated blood flow.(ABSTRACT TRUNCATED AT 250 WORDS)


Attitude of schizophrenics to computer videogames.

We investigated the initial attitude of 10 chronic, defected schizophrenic patients to a computer videogame session. Six of them enjoyed the experience and wanted to repeat it. Cooperation and performance were compared by means of videogames and a standard psychometric test (WAIS). Videogame performance correlated with the execution test IQ more than with the verbal test IQ. Computer games could be useful in these patients for evaluation of attitudes and responses, psychologic testing, motivation and reward.


Determinants of recall of parental rearing behavior. The influence of age or loss of parents by separation or death.

In a study of 562 psychiatric inpatients and 251 healthy controls, relationships between age of proband and related life events (divorce of parents, death of a parent) and the perceived parental rearing have been investigated. The inverse relationships obtained could be explained by the higher number of divorced parents among younger subjects with negatively experienced parental rearing practices on the one hand and an idealization of the parents who had died on the other hand. In psychiatric patients these relationships and differences were more pronounced pointing to the importance of parental rearing as a vulnerability factor for mental problems during adulthood. The necessity to control for age in studies of perceived parental rearing became obvious by the present results.


The Symptom Check List SCL-90-R and its ability to discriminate between dysthymia, anxiety disorders, and anorexia nervosa.

The factorial and discriminative validity of the Hopkins Symptom Check List SCL-90-R were examined in the light of criticism that clinical self-rating scales primarily express a general distress factor. In a population of 899 psychosomatic patients, high intercorrelations were found between the individual dimensions of the SCL-90-R. A subsequent Principal Components Analysis obtained 9 factors which were markedly less interdependent than those in the original version. The ability of the questionnaire to distinguish between patients with dysthymia, anxiety disorders and anorexia nervosa was examined. The average hit rate in the discriminant analysis was 67% using the original version and 74% with the proposed new factorial structure of the SCL-90-R, confirming the discriminative validity of the inventory. The present results as well as earlier studies suggest that the factor 'anxiety' should be included in the factor 'phobic anxiety', the factors 'paranoid ideation' and 'psychoticism' should be reformulated, and a new factor 'sleep disturbances' should be added to the original version of the SCL-90-R.


Chronic psychoses and rehabilitation: an ecological perspective.

Traditional explanatory models, based on core psychological deficits, vulnerability-stress models or distinctions between negative and positive symptoms, may not be sufficient to understand the phenomenon of chronicity. This linear thinking, looking for monocausal explanations, should be replaced by exploring multicausal and circular processes over time, including the individual ecological context of a given patient. Thus, chronicity appears to result much more from endless loops and irreversible bifurcations in its dynamics over time than to be a stable state. Furthermore, the current views on psychopathology and prognosis need to be fundamentally reexamined in the light of this new way of thinking. For understanding and treatment of chronic psychoses, this ecological perspective implies programs which do not focus only on the patient, but look for 'ecological niches' and interventions favoring synergetics and self-organization within the social networks and at the worksite of a given patient. A recently implemented five-step program for vocational rehabilitation and the corresponding research plan will be presented and discussed.


The Capgras syndrome in paranoid schizophrenia.

Capgras syndrome is characterized by a delusion of impostors who are thought to be physically similar but psychologically distinct from the misidentified person. This syndrome is generally thought to be relatively rare. Most of our knowledge about Capgras syndrome derives from single case studies and small series of cases usually from diagnostically heterogeneous groups. In this article, a series of 31 patients suffering from both paranoid schizophrenia and Capgras syndrome is described. Issues pertaining to the phenomenology of Capgras syndrome, the possible relation between Capgras syndrome and other delusional misidentification syndromes, and a neurobiological hypothesis aimed at explaining Capgras syndrome are discussed.


Cycloid psychosis and affective disorder: borderland cases.

A subsample of untreated cycloid psychoses satisfying the requirements for major affective disorder according to DSM-III was compared with a subsample of cycloid psychoses getting other DSM-III diagnoses. The concept of cycloid psychosis applied thus was wider than permitted by the criteria stipulated by Perris and Brockington with respect to the prominence of the mood component. Since it could be demonstrated that no decisive differences prevailed with respect to frequencies of single features tested, a modified discriminant analytic procedure was applied. In this analysis, 76% of cases were correctly assigned. On average affective cases were more similar to the score profile derived from the nonaffective group than nonaffective cases were to the same profile, i.e. to themselves. Symptomatologically the affective cases had their main point in a distinctive confusion syndrome.


The predictive value of thought disorder in manic psychosis.

Twenty-two patients with mania were evaluated for a variety of psychiatric phenomena. These items along with demographic data were used to predict relapse over a 36-month period in a multiple regression model. Formal thought disorder at the onset of illness was a strong predictor of relapse (F = 39, p < 0.001). The quality of the thought disorder was the most significant prognostic indicator. The predictive value of negative thought disorder was not enhanced by the addition of other symptomatic or demographic variables.


AIDS and the ethics of medical care and treatment. Institute of Medical Ethics Working Party on the Ethical Implications of AIDS.

HIV infection and AIDS have accelerated a trend from paternalism to partnership in relationships between clinicians and patients. Partnership is based on respect for autonomy and is expressed through open dialogue; its moral aims are summed up in the concept of mutual empowerment. This has practical implications for clinical care and treatment, which are discussed here with particular reference to mental impairment or incapacity, unhelpful, harmful or unorthodox therapies, and discontinuing life-prolonging treatment.


Wegener's granuloma. A series of 265 British cases seen between 1975 and 1985. A report by a sub-committee of the British Thoracic Society Research Committee.

In order to describe the British experience of Wegener's granulomatosis Hospital Activity Analysis was used to collect cases diagnosed in England, Wales and Scotland between 1975 and 1985. Where possible clinical details, histological material and chest radiographs were obtained. Two hundred and sixty five patients were considered to have Wegener's granulomatosis. In 109 a single pathologist confirmed the diagnosis by finding both granulomas and vasculitis in biopsy material. The diagnosis was made on clinical grounds or clinical grounds together with histological diagnosis in the local hospital in 156 patients. Wegener's granulomatosis was confined to the lung or upper respiratory tract in 22 per cent of patients and renal disease occurred in 58 per cent. Laboratory tests showed a pattern of mild anaemia, polymorph leucocytosis, eosinophilia and an elevated ESR and hypergammaglobulinaemia, with no specific pattern of changes. Histological confirmation was most frequently obtained by examination of nasal biopsy specimens, but multiple biopsies were often required. Renal biopsies showed focal proliferative glomerulonephritis but granulomatous glomerulonephritis was uncommon. Of available chest radiographs 61 per cent were abnormal, large opacities being most common. Small irregular opacities were found less often and other abnormalities were uncommon. Treatment varied widely and 10 per cent of patients received no drug therapy. This large series illustrates that even without specific treatment, patients with Wegener's granulomatosis can survive for several years and with modern treatment survival for more than a decade is possible. Conclusions about the effectiveness of the various therapies cannot be drawn from this retrospective study. Renal failure and disseminated vasculitis were the commonest causes of death; death was considered to result from complications of treatment with cytotoxic drugs or prednisolone in 6 per cent of patients.


Clinical and histological spectrum of osteomalacia among Asians in south London.

In a prospective study of 175 adult Asian patients attending a medical out-patient clinic we found a spectrum of metabolic bone disease. Twenty-four patients (13.5 per cent) had definite osteomalacia, of whom 11 (6 per cent) had severe clinical osteomalacia on the basis of associated symptoms and radiological signs. Fifteen (8.5 per cent) had borderline osteomalacia, while the remaining 136 (78 per cent) had normal bone biopsy, or were presumed to be normal. This histological spectrum was paralleled by the increasing prevalence of musculoskeletal symptoms (thigh pain, change in gait and difficulty rising from seated position) attributable to osteomalacia. Multivariate analysis showed that the major determinant of osteomalacia in Asians in South London was vegetarian diet. Increasing severity of bone disease was associated with increasingly strict vegetarian practice, which accounted for the excess risk of females, Hindus, and Asians originating from East Africa. Covering skin when outdoors also contributed to the female excess risk, and suggested a role for reduced solar exposure. Clinically significant osteomalacia is underdiagnosed in the Asian population, but evidence of dietary adaptation suggests this problem may diminish with time.


Haemodynamic studies during the management of severe tetanus.

Detailed invasive haemodynamic studies were performed in 27 of 32 patients with severe tetanus. Nineteen had severe uncomplicated tetanus and eight had associated major complications, chiefly infection and pulmonary complications. The results were compared with those obtained from 15 healthy male volunteers who served as controls. There were two deaths in 32 patients (mortality 6.25 per cent). Severe tetanus without major complications was characterized by a high output hyperkinetic circulatory state with tachycardia (heart rate 131 (19.2) beats/minute), increased stroke volume index (43.1 (10.7) ml/m2), increased cardiac index (5.48 (0.94) l/min/m2) and a normal left ventricular stroke work index (60.5 (15.9) g/m/m2). Volume loading demonstrated a significant haemodynamic response and increased vascular capacitance. Even so the maximum percent rise from baseline values of these indices after volume load was significantly higher in controls (p < 0.001). Autonomic cardiovascular disturbances affected both sympathetic and parasympathetic activity. Hypertension and tachycardia alternating with hypotension and bradycardia were related to sudden fluctuations in systemic vascular resistance. Our studies suggested some degree of myocardial dysfunction in patients with severe uncomplicated tetanus. The haemodynamics of severe tetanus were masked and altered by complicating infection, pneumonia, and atelectasis.


The immunogenetics of early nephropathy in insulin-dependent diabetes mellitus: association between the HLA-A2 antigen and albuminuria.

One-hundred and seventy-two normotensive, insulin-dependent diabetic patients without clinical proteinuria (Albustix negative) were typed for the major histocompatibility complex class I (HLA-A, -B) and class II (HLA-DR) antigens. Urinary albumin excretion was measured as the albumin:creatinine ratio (UA/UC, mg/mmol) in an early morning sample. Patients expressing the HLA-A2 antigen had significantly higher UA/UC values than those not expressing the antigen. The observed ratio of geometric means was 1.77 (95 per cent confidence interval (CI) 1.18-2.67; p < 0.01); the relative risk of microalbuminuria (UA/UC > 3.0 mg/mmol) associated with expression of HLA-A2 was 2.52 (95 per cent CI 1.11-5.73; p < 0.05). There was no significant association between UA/UC and HLA-B8, -B15, -DR3, -DR4 or other antigens. Patients were re-studied after a mean period of 5.3 years: multiple linear regression analysis showed that the UA/UC at this time was positively related to the initial glycosylated haemoglobin level (p < 0.01) and expression of the HLA-A2 antigen (p < 0.05), but not to blood pressure or creatinine clearance. Fifteen patients developed macroalbuminuria at follow-up (UA/UC > 45.5 mg/mmol). Compared with a group matched for age, sex, duration of diabetes, and glycosylated haemoglobin who did not develop macroalbuminuria, macroalbuminuric patients had a higher frequency of HLA-A2 (p < 0.01). The odds ratio of progressing to macroalbuminuria associated with HLA-A2 had a 95 per cent CI of 1.71 to infinity. We conclude that an immunogenetic factor may play a role in the development of early diabetic nephropathy and that the risk associated with expression of the HLA-A2 antigen is independent of metabolic control and blood pressure.


A study of neuropathy in HIV infection.

A prospective study of possible aetiological factors for neuropathy associated with HIV infection was performed in 80 patients and 28 homosexual controls. At entry to the study twelve patients (15 per cent) had evidence of a generalized neuropathy not due to any other cause and a further three patients developed symptomatic neuropathy during a mean (SD) follow-up of 20 (7.5) months. All but two of these neuropathies were of the distal symmetrical sensory type. Electrophysiology was consistent with an axonal pathology and nerve biopsy confirmed this as the major pathological change. Warming threshold was the diagnostic test most frequently abnormal, sometimes in the absence of other electrophysiological abnormalities. No association was seen with opportunistic infection (cytomegalovirus, herpes simplex, Pneumocystis pneumonia, toxoplasmosis, Cryptococcus infection or tuberculosis). HIV proviral DNA could not be detected in paraffin sections of peripheral nerve in six patients with neuropathy. The presence of the neuropathy did not show significant correlation with depression of the number of CD4+ T cells in the blood, impaired T cell function tests, or IgG, IgM, or IgA levels. Immune complexes containing C1q, but not those containing IgG, IgM, IgA or C3c, were significantly more common among neuropathic patients (p = 0.01).


[The cytogenetic effect in peripheral blood lymphocytes as an indicator of the effect on man of factors of the Chernobyl accident].

The data obtained confirm the possibility of both individual and population cytogenetic indication of the effect of low intensity radiation, exceeding the background level, and exhibit a positive correlation with the radio-ecological situation formed. The cytogenetic effect, that indicates the disturbance of the genome stability, might be considered as an indicator of a high probability of occurrence of pathologies, with a genetic component, in the subpopulations under study, compared to spontaneous level.


[The biological effect of low-level radiation doses on the morphological composition of the peripheral blood in children].

Examination of 339 children at the age of 2 to 12 years, living in the caesium contaminated region (from 2 to 5 Ci/km2) has revealed that total radioactivity of their urine is, on the average, twice as high as that of children living in "pure" regions. Quantitative and qualitative changes were observed in the erythroid series, neutrophilic leukocytes, eosinophils and B-lymphocytes of the peripheral blood of children subjected to long-term low-level irradiation. It should be noted that the character and direction of these changes were a function of the children's age and the level of total radioactivity of their urine.


[The ultrastructural organization of spruce needles of different ages exposed to radiation].

The ultrastructure of mesophyll cells of spruce needle of different age within the region of Chernobyl catastrophe has been investigated. The quantitative characteristics of chloroplasts are shown to be a function of the absorbed dose rate. The effect of ionizing radiation on the processes of needle tissue ageing is discussed.


[The possibility of using the preparation MIGI-K in districts exposed to radioactive contamination following the accident at the Chernobyl AES].

A preparation from mussels, MIGI-K, used as an additive to the diet of people working at the Chernobyl power plant has proved to be efficient in increasing the total resistance of the body, including the resistance to ionizing radiation. In experiments with animals, MIGI-K has been shown to accelerate excretion of 45Ca and 86Rb from the body. The combination of these properties of MIGI-K permits us to consider it an efficient drug to be used within the regions affected by the Chernobyl disaster.


[Evaluation of the effect of the radioactive contamination of hydrobionts in the 30-kilometer control zone of the accident at the Chernobyl AES].

A study was made of hydrobionts, particularly fishes, living within the thirty-kilometer control zone of Chernobyl NPP and northern part of the Kiev basin, after the disaster. Out of 31 fish species living in the NPP cooling pond some were identified which were mostly affected by radioactive contamination. They were predators belonging, with respect to reproduction and development, to a lithophilous group. Peculiarities of reproduction of Hypophthalmichthys molitrix kept in stews of the cooling pond before the accident were studied. After a three-year exposure to ionizing radiation (cumulative dose of 8-9 Gy) no reduction in the reproductive capacity of mature fishes was observed.


[Results of the cytogenetic examination of the people taking part in the clean-up of the accident at the Chernobyl AES].

Chromosome preparations from peripheral blood cells of 117 subjects who took part in liquidation of Chernobyl NPP accident consequences in 1986 have been investigated. The number of chromosome aberrations has been shown to increase considerably. A short-term exposure has been found to be 5-7 times more effective than long-term one.


[The modifying action of calcium antagonists on postirradiation thymidinemia].

Single and long-term per os administration of verapamil, a calcium antagonist, changes the thymidine content of nonirradiated mouse blood. The changes observed depend upon verapamil concentration in the blood. The postirradiation thymidinemia level is the lowest in animals exposed at the time when the thymidine content was minimized by the agent administered.


[The formation of DNA-protein cross-links in response to gamma radiation, UV irradiation and chemical agents].

The present paper deals with the damages that are induced by numerous agents, such as gamma-radiation, UV-radiation, visible fluorescent light radiation, and a wide range of chemical agents, and lead to the formation of DNA-protein cross-links. This is the most unknown and obscure type of damage to cells. It is, however, well known that these damages are reparable.


[The effect of ionizing radiation on the phospholipid content of fetal and maternal liver mitochondria at different stages of pregnancy].

A single exposure of pregnant rats to 1 and 2 Gy radiation on days 3, 13 and 17 of reception changes the phospholipid content in membranes of liver mitochondria of fetus and maternal body. The changes are particularly pronounced on day 3 of reception: as the embryo grows the decline in the phospholipid content from the control level decreases.


[The combined action of microwave irradiation and hypoxia on the biogenic amine content of the blood in guinea pigs in anaphylactic shock].

The repeated effect of microwave radiation on guinea pigs was shown to arrest the anaphylactic shock and the related changes in histamine, epinephrine and norepinephrine content in the blood. The long-term adaptation of animals to hypoxia prevented this effect.


[The ciliated epithelium of the rat trachea is sensitive to gamma-irradiation in very low doses].

As early as 5-7 min after the start of exposure of tissue preparations from rat trachea ciliated epithelium to gamma-radiation at a dose rate of 19 mGy/h, the ciliary motion rate increased periodically. The phenomenon of increasing the ciliary motion occurred more frequently in time; the intervals between two frequency drops became longer and the mean frequency level higher. The reverse sequence of the events was observed during the postirradiation period. The same regularities, but less expressed, were observed after irradiation at a dose rate of 1.8 mGy/h.


[The radioprotective effect of hypoxia on clonogenic cells of rat bone marrow stroma (KOE-F)].

A comparative study was made on the survival rate of cell-precursors of haemopoietic stroma, that form, in a rat bone marrow culture, colonies (clones) of fibroblasts (CFU-F) after gamma-irradiation of animals in the air or in a gas hypoxic mixture, containing 8% of O2 (GHM-8). Irradiation in GHM-8 was shown to increase the survival rate of CFU-F by 1.7 times (as compared to exposure in the air) as estimated by the total number of colonies that are formed in a culture; the radioprotective effect of GHM-8 was more pronounced for CFU-F which form dense colonies: DMF for dense and loose clones was 2.4 and 1.6 respectively.


[Characteristics of the dynamics of hematopoietic precursor cells cloned in diffusion chambers and recorded in experiments on mice and dogs irradiated in median lethal doses].

In experiments with mice and dogs irradiated with LD50, it was shown the postirradiation depopulation of haemopoietic polypotent (CFUs) cell-precursors in mouse bone marrow was more pronounced than that of granulocytic and macrophagal cells (CFUdc). The rate of repopulation of CFUs during the first week was higher than that of CFUdc (T1/2 was 2.5 and 8.8 days respectively). In dogs, one could notice a partial change in the colony formation, a prolonged plateau period in the postirradiation CFUdc dynamics, and a coincidence in time with cellularity restoration in the bone marrow and peripheral blood leukocytes. It is suggested that in conditions of heterogeneous incubation in diffuse chambers, the haemopoietic cell-precursors are more mature than in the syngeneic system. The method of CFUdc determination has proved to be ineffective in estimating the onset and intensity of the postirradiation haemopoiesis recovery in dogs. The study of the bone marrow CFUdc population may, however, be used in intact animals to predict the probability of their death after irradiation within the median lethal dose range.


[Enzymes protecting the erythrocyte membrane during the combined exposure to an antioxidant complex and acute irradiation].

The data are presented concerning the effect of ionizing radiation on the hemolytic process and the influence of an antioxidant vitamin complex on the pentosephosphate metabolism and glutathione reductase activity after gamma-irradiation. The antioxidant vitamin complex has been shown to produce a favourable effect on the erythrocyte membrane stability in correcting the radiation-induced changes.


[The modifying action of Sophora japonica and an antioxidant vitamin complex on acute radiation injury to the body].

In experiments with mongrel male rats exposed to whole-body gamma-radiation (7, 9 and 11 Gy) the radioprotective effect of enterally administered Sophora japonica and its combination with an antioxidant vitamin complex was investigated. The radioprotective agents applied were shown to produce a synergistic effect.


[An experimental approach to determining the protective properties of drugs against ionizing radiation in low and sublethal doses].

In experiments with mice, the efficiency of radioprotective agents against acute gamma-irradiation with nonlethal and low doses (0.5-4 Gy) was estimated by nine parameters. The treatment with cystamine, cysteamine and riboxine prior to irradiation (< 2 Gy) did not influence the postirradiation values of the parameters under study. With a dose of up to 4 Gy, the effect of riboxine was noted. The determinations of the number of aberrant mitoses, cellularity and mitotic activity of the bone marrow have proved to be most informative. The data obtained are discussed with due regard for the specific effect of low-level radiation and mechanisms of the protective action of the agents under study.


Meta-analysis of diabetes patient education research: variations in intervention effects across studies.

Data from a previously reported meta-analysis of diabetes patient education literature were reanalyzed to determine the influence of study/subject characteristics, such as study quality and age of subjects, on patient outcomes. Patient knowledge and self-management skills, weight loss, glycosylated hemoglobin levels, and psychological outcomes were analyzed as outcome variables. Seventy-three relevant published and unpublished studies were located. Patient education appeared to be more effective in younger patients, particularly for the knowledge outcome. For all patients, glycosylated hemoglobin levels improved between 1 and 6 months postintervention, but decreased to 1-month levels after 6 months. Length of the educational intervention did not appear to influence outcomes. More rigorous, experimental research designs tended to produce more conservative effect size estimates. Implications for diabetes patient education are discussed.


A coercive interactional style as an antecedent to aggression in psychiatric patients.

As with society at large, violence in psychiatric settings is a serious clinical problem. Despite a great deal of attention, however, very little is currently known about the underlying theory or interventions to reduce aggression and violence in hospital settings. In this study, some psychiatric patients were viewed as having a general, aggressive, interactional style, motivated by the traits of Intimidation and Interpersonal Control, which when combined were labeled Coercion. A causal model in which violence and aggression were hypothesized to be predicted by a coercive interpersonal style and negatively predicted by an accommodating interpersonal style was tested. These interpersonal styles were proposed to mediate antecedent variables, that is, history of violence, psychiatric diagnoses, and length of hospitalization. Data were collected in two hospitals on psychiatric patients (N = 156) and analyzed using multiple regression techniques. The results of theoretical model testing suggested that 60% of the variance in Aggression was explained by four model variables: (a) Intimidation and Interpersonal Control (Coercion) (beta = .44), (b) Length of Hospitalization (beta = .26), (c) History of Violence (beta = .27), and (d) Bipolar Affective Syndrome (beta = .21). The implications for clinical care are discussed.


[The role of fat-soluble vitamins A and E in preventing the biological effects of ionizing radiation in rat tissues].

The lipid peroxidation level and the antioxidant system status have been studied by the amount of alpha-tocopherol and the antioxidant activity of homogenates in the brain, liver, heart and somatic muscle of rats given Vitamins A and E, as physiological additives, before and after gamma-irradiation. It has been shown that a new dynamic balance between the parameters under study is rapidly set up after irradiation, which represents a mechanism of rapid adaptation. The radioprotective effect of alpha-tocopherol is more pronounced than that of Vitamin A (particularly in the brain). In most cases, Vitamin A produces, upon irradiation, an unfavourable effect on antioxidative homeostasis.


The effect of diet consistency on food intake of anorectic tumor-bearing rats.

Delayed gastric emptying has been shown to occur in cancer patients complaining of anorexia and early satiety. Given that liquids are emptied from the stomach faster than solid food, the present study was undertaken to determine if diet consistency would affect food intake of hypophagic rats implanted with the Walker 256 carcinosarcoma. By Day 15 of tumor-growth, caloric intake of tumor-bearing animals was 20% less than controls. The caloric intake of tumor-bearing animals fed a liquid diet was not significantly different from animals fed a solid diet. Furthermore, a delay in gastric emptying was not seen in this animal model of tumor-induced anorexia.


[The electronic structure and radiorprotective activity of a series of substituted iminodihydrofurans].

Compounds that increase the survival rate of lethally exposed hybrid (CBA x C57B1/6)F1 mice have been revealed within the series of iminodihydrofurans. The quantum-chemical estimates, made by the MNDO method, show that substances which are capable of donor-acceptance interaction with DNA nucleotides and have the energy of donor orbitals, comparable with the electron structure of nucleotides, possess radioprotective efficacy.


Women's perceptions of cesarean and vaginal delivery: another look.

Perception of the birth experience was examined in a sample of 106 women who had unplanned cesarean deliveries, 113 who had planned cesarean deliveries, and 254 who had vaginal deliveries. Vaginally delivered women had more positive perceptions than their unplanned cesarean counterparts (p < .001). There were no differences in perceptions between the unplanned and planned cesarean groups, or between the planned cesarean and vaginal groups. General anesthesia for cesarean delivery was associated with more negative perceptions than regional anesthesia, and regional anesthesia for vaginal delivery was associated with more negative perceptions than no or local anesthesia. Pain intensity and physical distress were negatively correlated with perceptions.


[Mathematical modeling of the dynamics of the intestinal epithelium in non-irradiated and irradiated mammals].

A mathematical model has been developed to describe the dynamics of the crypt-villus system of the small intestine epithelium in nonirradiated and chronically irradiated mammals. The model involves the chalone mechanism of regulation of crypt cell reproduction and represents a system of nonlinear differentiation equations. The model presents the dynamics of the small intestine epithelium in nonirradiated animals, including stable fluctuations of the concentrations of crypt and villus cells (the limited cycle), and simulates quantitatively the impairment of the intestinal epithelium in small laboratory animals subjected to long-term irradiation.


Developing the construct of role integration: a narrative analysis of women clerical workers' daily lives.

There is a gap in nurses' knowledge about how women integrate their multiple roles on a daily basis amidst the economic, social, political, and cultural contingencies of their environments. Quantitative results from a triangulated study of work, maternal, and spousal role experiences of 87 women clerical workers from five ethnic/racial groups indicated that role integration was important in predicting health outcomes. This prior work is extended in this article with an indepth secondary analysis of the qualitative interview data from the same study to develop a theoretical understanding of the construct of role integration. Using techniques of narrative analysis, a theoretical framework was derived to identify and relate aspects, processes, and patterns of role integration as they are experienced in women's everyday lives. Concepts are identified, defined, and visually represented, propositions are elaborated, and implications for further research and practice are suggested.


[The hematopoietic system during chronic irradiation with high dose rates (mathematical modeling)].

Mathematical models have been developed to describe dynamics of some haemopoietic compartments in mammals subjected to long-term irradiation. Within the framework of the models developed an equation has been obtained for a critical dose-rate (Ncr) of chronic irradiation, leading to complete depletion of certain haemopoietic compartments, that helps to prognose the dangerous Ncr values without preliminary experiments.


Knowledge of, attitudes toward, and barriers to pharmacologic management of cancer pain in a statewide random sample of nurses.

The knowledge of, attitudes toward, and perceived barriers to pharmacologic management of cancer pain were examined in a random statewide sample of nurses (N = 790), using an 82-item questionnaire. Although only 7% of the nurses reported working in oncology settings, 59% of the nurses reported having worked with patients with cancer in the last 6 months. The scores on the knowledge test ranged from 11% to 93% correct, with a mean percent correct of 56.4% (+/- .92). Nurses reported relatively liberal attitudes toward pain management, yet also reported believing that 22% of patients over report pain. Results are discussed with respect to implications for practice and education.


Meta-analysis for descriptive research.

Although nurses have begun to use meta-analysis, a review of the nursing literature demonstrates that its use has not been maximized. Meta-analysis can be employed to synthesize descriptive as well as experimental research, yet attention in nursing has focused almost exclusively on meta-analysis techniques for, and meta-analytic studies of, experimental research. Furthermore, nursing literature has emphasized use of the effect size index (d) rather than the correlation index (r); the latter may, in some cases, be the more suitable metric, particularly with meta-analysis of correlational studies. An argument is made for the value of meta-analysis as a technique for integrating descriptive research, and an overview of different meta-analytic approaches to data analysis using the correlational index with descriptive research is provided.


Nursing intervention studies require outcome measures that are sensitive to change: Part One.

In selecting an outcome measure for a study evaluating a nursing intervention, the criterion of sensitivity to change should predominate. Researchers commonly justify their choice of outcome measures for experiments based on such psychometric criteria as high internal consistency reliability and patterns of correlations reflecting convergent and discriminant validity. Although such criteria are appropriate for measures to assess individual differences, they are insufficient when the measures will be used for intervention studies. Researchers may need to develop new measures that are tailored for experimental studies if existing measures are valid mainly for the assessment of individual differences. In this first portion of a two-part article, three of seven factors to consider in selecting an outcome measure for an intervention study are outlined and recommendations for application of principles of reliability and validity in the context of sensitivity to change are given.


Increased asthma admission rates in Asian patients: Blackburn 1987.

Asthma admissions for ages 1-44 for the year 1987 were studied to test the clinical impression that asthma admissions in ethnic Asians were more frequent than expected. Data on admissions was obtained from HAA statistics and from ward admission books. Population data was obtained from the 1981 Census with OPCS revisions and local epidemiological data of Asian births and new immigrant numbers. Admission rates per 1000 population were derived. Admissions were increased in Asian patients aged 1-4 years (odds ratio 1.18; 95% confidence interval 0.85-1.64) and 15-29 years (odds ratio 1.57; 95% confidence interval 0.83-2.98), but these increases were not significant. Admissions were significantly increased in Asian patients aged 5-14 (odds ratio 2.03; 95% confidence interval 1.32-3.12; 0.01 > P > 0.001) and 30-44 years (odds ratio 5.85; 95% confidence interval 3.66-9.35; 0.001 > P). The increased admission rate in Asians was not due to increased readmissions in the Asian ethnic group. The data supports the view that the difference in Asian admission rate may be due to a truly increased asthma prevalence in the Asian ethnic group.