To explore the correlations between short-term neurophysiological events initiated by over-activation of acetylcholine receptors, and long-lasting changes in brain function, we combined electrophysiology and PCR-based measurements in hippocampal slices or live mice subjected to stress or drug-induced cholinergic activation. Our findings reveal a common cascade of neuronal events resulting in delayed suppression of cholinergic transmission.

Animals↗

PubMedDate not supplied

Reduction of the volume of stored platelet concentrates for use in neonatal patients.

Premature infants and neonatal patients who require platelet transfusions may develop circulatory overload when administered a 50-ml unit of platelet concentrate. We evaluated the influence of centrifugation and resuspension steps used to reduce the volume of stored platelet concentrates on platelet properties by in vitro methods and by determining post-transfusion increments in neonatal patients. In vitro studies were conducted with platelet concentrates stored at 20 to 24 degrees C for 1 and 5 days in CLX (Cutter) and PL732 (Fenwal) containers and for 1 and 2 days in PL146 containers (Fenwal). With platelets stored in any of the three containers, platelet morphology, mean platelet volume, hypotonic stress response, synergistic aggregation, and platelet factor 3 activity were not affected by the processing steps. The centrifugation and resuspension steps did not cause an enhanced discharge of lactate dehydrogenase from platelets. Similar results were obtained when the platelet concentrates were stored on either a flatbed or an end-over-end tumbler agitator. The in vitro platelet recovery following volume reduction was at least 85 percent. In vivo studies were conducted with platelets stored in the PL732 and PL146 containers. Infusion of platelet concentrates after volume reduction produced a mean corrected increment of 18,947 +/- 14,824 when platelets were stored in the PL146 container and 16,178 +/- 15,699 when platelets were stored in the PL732 container. These results indicate that the volume of stored platelet concentrates can be reduced in a manner which maintains platelet properties.

Blood Platelets↗

PubMedDate not supplied

Platelet viability following storage for 5 days. Influence of holding whole blood for 8 hours at 20 to 24 degrees C before concentrate preparation.

Regional blood centers frequently need to hold units of whole blood at 20 to 24 degrees C for several hours after phlebotomy so that sufficient platelet concentrates can be prepared to meet the increasing need. We have evaluated the in vivo viability and in vitro properties of platelets that were prepared from whole blood drawn into citrate-phosphate-dextrose-adenine (CPDA-1) either immediately after phlebotomy or after an 8-hour hold at 20 to 24 degrees C. Platelet concentrates were stored for 5 days at 20 to 24 degrees C in polyolefin containers (PL 732, Fenwal) with end-over-end tumbler agitation. The autologous in vivo recovery (mean +/- SD) and one-half disappearance of 51Cr-labeled platelets prepared immediately after phlebotomy were 44.4 +/- 9.4 percent and 4.0 +/- 0.5 days, respectively. Platelets prepared after the delay of 8 hours showed a recovery of 44.5 +/- 8.4 percent and a one-half disappearance of 4.1 +/- 0.4 days. After 5 days of storage, platelet concentrates showed a mean pH of 7.21 +/- 0.20 when prepared immediately after phlebotomy, and of 7.22 +/- 0.15 when prepared after an 8-hour delay. Mean morphology scores were 280 +/- 33 and 302 +/- 27 for platelets from units prepared immediately after phlebotomy or after a holding period of 8 hours, respectively. Platelets underwent synergistic aggregation after 5 days of storage, independent of the length of time that the units of whole blood were held prior to centrifugation. These studies indicate that platelet concentrates prepared from units of whole blood held initially for 8 hours can be stored for 5 days at 20 to 24 degrees C and survive satisfactorily in vivo and retain in vitro characteristics.

Blood Platelets↗

PubMedDate not supplied

Foreign-body synovitis mimicking septic arthritis of the knee.

Three cases are presented of recurrent synovitis of the knee in children caused by the presence of foreign material. There was no clear history of trauma. Arthroscopy is a useful method providing early diagnosis and simultaneous treatment of this condition.

Adolescent↗

PubMedDate not supplied

Outcome of pregnancy in class A1 and A2 gestational diabetic patients delivered beyond 40 weeks' gestation.

The charts of all diabetic women and their infants delivered during the years 1983-1988 in our department were reviewed. The test group included consecutive gestational diabetic women class A1 (n = 65) and class A2 (n = 59), who delivered beyond 40 weeks of gestation. The mean gestational age at delivery was 40.90 weeks (range, 40.0 to 42.57) in class A1 and 40.49 weeks (range, 40.0 to 42.28) in class A2 patients. The first control group matched for age, parity, and presentation included 65 gestational diabetic patients class A1 and 59 A2 who delivered prior to 40 weeks' gestation. The second control group matched for age, parity, and presentation included 124 nondiabetic patients who delivered beyond 40 weeks of gestation (mean, 41.04 +/- 0.83 weeks). By allowing the pregnancies of gestational diabetic patients class A1 and class A2 to proceed beyond 40 weeks of gestation, we did not increase the incidence of perinatal mortality and morbidity rate. The cesarean section rate was low (10.76% in class A1 and 22.03% in class A2). We suggest that not only elective intervention prior to 40 weeks of gestation is to be avoided, but an attempt should be made to allow the gestational diabetics class A1 and class A2 to proceed to spontaneous labor.

Apgar Score↗

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Sex differences in vulnerability and maladjustment as a function of parental investment: an evolutionary approach.

Sex differences in aspects of mental health are examined as a function of uneven parental investment in children. Relative vulnerability is a new construct mediating the influence of parental investment on mental health. Couples (129) in three stages of the family life cycle are measured by scales for parental investment, relative vulnerability, anxiety, depression, and ten psychosomatic syndromes. Results show a path of positive correlations from the parent's sex to level of parental investment, to level of relative vulnerability, and to levels of anxiety and depression. Women invest more than men, and hence they are more vulnerable, anxious, and depressed. They reach the summit of their vulnerability while they have three young children. Relative vulnerability was found to have positive effects along with the negative ones and to affect women in different ways than it does men. Results are interpreted in terms of different parental strategies selected by evolution for each sex.

Adaptation, Psychological↗

PubMedDate not supplied

Regenerative activity in apical dendrites of pyramidal cells in neocortex.

In intracellular recordings from three neocortical pyramidal cells in vitro, intracellular dye injection identified the impalement site as the primary trunk of the apical dendrite. Dendritic recordings displayed two types of regenerative events: relatively fast, low-threshold spikes with amplitudes of 12-69 mV, and slower, higher-threshold spikes up to 80 mV in amplitude. This distinctive dendritic firing pattern was also encountered in six recordings without dye-filled electrodes. Fast spike frequency was extremely sensitive to small changes in membrane potential at the recording site. In one recording, the fast spikes were blocked by 1 microM TTX, while slow events were spared. A computational model of a pyramidal cell was constructed to assist in interpreting the recordings. Simulations suggested that the fast spikes were generated primarily by active Na+ conductance concentrated at a distance from the impalement site, probably in the region of the soma. The low threshold of the fast spikes suggested that Na+ channels also exist in the apical dendrites, where they have a relatively low density. The data strongly imply that there are Ca2+ channels in the apical dendrites.

Action Potentials↗

PubMedDate not supplied

Effects of botulinum toxin A on upper limb spasticity in children with cerebral palsy.

OBJECTIVE: Botulinum toxin A inhibits presynaptic release of acetylcholine at the neuromuscular junction and has reportedly been successful in the treatment of spastic disorders. This prospective study attempted to determine whether botulinum toxin A injection resulted in clinically measurable gains for 4 mo. DESIGN: Measurements were obtained from 32 children (range, 1-18 yr; average age, 6.9 yr) with hemiplegic or quadriplegic cerebral palsy before and at 1, 3, and 4 mo after botulinum toxin A injections. Spasticity was measured using the Modified Ashworth Scale for 12 different joints. RESULTS: Results showed that spasticity as measured by Ashworth scores for elbow and wrist extension clearly declined (P < 0.02) by 1 mo after botulinum toxin A injection, and diminished spasticity continued for 3-4 mo. Caregivers reported improvement in subjectively rated management, appearance, and function. However, patient response to botulinum toxin A injection was not predictable. Age had no significant relationship to gains. CONCLUSIONS: Further research is needed on the use of botulinum toxin A to diminish spasticity and improve function.

Adolescent↗

PubMedDate not supplied

Comparison of delusions among schizophrenics in Austria and in Pakistan.

One of the central purposes of cross-cultural psychiatry is to scrutinize the sociocultural influences on the phenomenology of psychiatric diseases. On the other hand it is possible to lay bare a nucleus of symptoms, common to all cultures, which, independently of all influences, occupies a central position for an understanding of the disease considered. In this study an attempt was made to approach this problem by means of investigating the contents of delusion of schizophrenic patients in Austria and Pakistan. The contents of delusion among 126 Austrian and 108 Pakistani patients diagnosed as having schizophrenia according to DSM-III-R (art. 295) were compared following the classification of Huber and Gross. Additionally the kind of persecution and the type of the persecutor were registered. However it appeared that only a few contents of delusion are frequent in both countries. In both countries persecution was the most frequently mentioned content of delusion. The comparison of the contents of delusion revealed significantly higher frequencies of delusions of grandeur, guilt and religious delusions in Austrian patients. Significant differences could also be found with the kind of persecution and the persecutor's type. Cultural factors seem to have a decisive influence on shaping the contents of delusion.

Adult↗

PubMedDate not supplied

Dementia in Parkinson's disease.

The prevalence of dementia, assessed on the basis of the Wechsler scale (WAIS), was determined in a group of 88 patients with idiopathic Parkinson's disease (PD) lasting longer than 4 years. In this group, 19 patients (22%) were diagnosed as demented. They were significantly older at the time of evaluation (72.9 +/- 8.1 vs. 63.6 +/- 11.9), and also at the onset of the disease (61.1 +/- 10.6 vs. 54.4 +/- 12.1) than nondemented patients. Their parkinsonism, as judged on the base of the Activity of Daily Living Scale, was more pronounced (57.4 +/- 13.7 vs. 73.3 +/- 15.6) and they developed psychotic side-effects of L-DOPA treatment (53% vs. 9%) more often. A weak negative correlation between age and intellectual quotient (IQ) was found, and a much stronger positive correlation between education and IQ. 25 patients of those diagnosed previously as non-demented were reassessed for dementia after another 5 years of disease. Only two of them were found demented. Both died and an immunohistochemical study of their brains was performed. In the 2 cases we found neuropathological features of both PD (Lewy bodies) and Alzheimer's disease (AD)--neurofibrillary tangles (NFT) and senile plaques (SP). This finding may support the hypothesis that, at least in some cases, dementia in PD could be due to an accompanying AD.

Adult↗

PubMedDate not supplied

Nephrotic syndrome in a 3-year-old boy.

Explore the source record for details and available documents.

Child, Preschool↗

PubMedDate not supplied

[Botulinum toxin in the treatment of focal dystonias: own experience with botulinum toxin].

During the last 5 years, 75 patients with focal dystonias were longitudinally treated with injections of botulinum toxin A. Each patient received 2-6 injections. The improvement was assessed after each injection and estimated as significant after 68.47% of injections, as mediocre after 23.42% of injections and none after 8.11% of the injections. The most significant improvement was obtained in patients with blepharospasm and hemifacial spasm, the worst effect was obtained in spasmodic torticollis. Varying responses were observed following repeated injections of botulinum toxin, the clinically assessed improvement did not decrease after successively applied doses. Side-effects occurred after 18% of the injections and were mostly mild and disappeared after short time. This study confirms the usefulness of botulinum toxin, which is an effective and safe treatment of focal dystonias.

Anti-Dyskinesia Agents↗

PubMedDate not supplied

[Rubral tremor of Holmes, rare case of pathological tremor: case report].

The authors present a very rare case of Holmes tremor (previously known as rubral or midbrain tremor). In all described till now cases the tremor was due to a known and revealed in laboratory or neuroimaging cause. We present an unusual case of a 42-year old woman with unilateral tremor of right extremities (mostly proximal part of upper extremity) which started abruptly 3 years ago. She had no suffer any serious disease before the onset of symptoms and her family history was also negative. The tremor was present at rest but accelerated during specific postures and active movements. The laboratory tests including: copper and ceruloplasmin concentrations, blood analysis for acanthocytes, evoked potentials, EEG, CT, MRI, MRA and SPECT did not reveal any significant changes. Treatment attempts with neuroleptics, clonazepam, L-dopa, valproic acid, biperiden were almost completely ineffective except local injections of botulinum toxin (Botox, Allergan, 150 U) into the muscles of right arm girdle which moderately alleviated tremor. We did not find any underlying pathology as a cause of tremor, clinically the same as symptomatic cases described in literature. We suggest the possibility of idiopathic origin of tremor in our case, although a very small size of lesion (f.i. ischaemic) could be undetectable in the described tests.

Adult↗

PubMedDate not supplied

[Dystonia in multiple sclerosis].

Two cases of involuntary movements of the type of segmental dystonia were observed in patients with a history of multiple sclerosis since many years. The reports on dystonic involuntary movements in multiple sclerosis are scant but, together with the present cases, they suggest that dystonia may be a sign of multiple sclerosis, although a rare one.

Adult↗