Gaucher's disease and acquired coagulopathy.
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Biomedical subjects
Publications and source records attributed to C Morse.
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The prevalence of substance abuse and coexisting DSM-III psychiatric disorders was evaluated in 111 juvenile offenders. As expected, a high rate of conduct disorder (91%) was present in both substance abusing and nonsubstance abusing juvenile offenders. However, significantly higher rates of attention deficit disorder and aggressive subtype of conduct disorder were present in those offenders who abused drugs and alcohol (54%). Excluding all conduct and oppositional disorder diagnoses, 39% of substance abusers versus 14% of the nonsubstance abusers demonstrated comorbid psychiatric diagnoses. These findings suggest that careful psychiatric evaluation of juvenile substance abusers may be necessary to optimize treatment planning.
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The relative predictive significance of attention deficit disorder (ADD) and aggressive behavior for consequent substance abuse was examined in 114 juvenile offenders. ADD, aggressivity, and substance abuse were assessed according to DSM-III criteria. Results from logistic regression indicate that aggressivity, but not an ADD diagnosis, significantly predicts substance abuse. Therefore, previously reported associations between ADD and substance abuse may be confounded by concurrent symptoms of aggression.
The present investigation examined the production of urinary 6-sulphatoxy melatonin (aMT.6S) during the early follicular and late luteal (premenstrual) phases in healthy, normal women and in patients with premenstrual syndrome (PMS). There was no significant difference in levels of aMT.6S on either day 6 or 26 of the menstrual cycle between control subjects and those with PMS. There also was no significant change in urinary aMT.6S levels within the menstrual cycle. These findings do not support an involvement of melatonin in the development of PMS symptomatology and are not supportive of the proposed role of melatonin in regulating ovulation in humans. However, our analysis of 12-hr urine samples may have been insensitive to small, yet possibly biologically significant, changes in the amplitude and period of melatonin excretion during the early hours of the morning.
The process of signal transduction by interleukin 1 (IL-1) or tumor necrosis factor alpha (TNF alpha) for the production of hematopoietic growth factors by cultured fibroblasts was studied using inhibitors for protein kinase C, cyclic nucleotide-dependent protein kinases, calmodulin-dependent protein kinases, and the Na(+)-H+ antiport system. The protein kinase C inhibitor H-7 was shown to inhibit both IL-1 beta- and TNF alpha-induced granulocyte-macrophage colony-stimulating activity (GM-CSA) production and release from cultured fibroblasts in a dose-dependent manner, with 40 microM H-7 demonstrating maximum suppression of the GM-CSA response. In addition, 100-200 nM staurosporine, a more potent inhibitor of protein kinase C, also completely suppressed GM-CSA from IL-1 beta- and TNF alpha-induced fibroblasts. In contrast, a potent inhibitor of cyclic nucleotide-dependent protein kinases, HA1004, showed no effect when used at 10-40 microM. In addition, an inhibitor of calmodulin-induced protein kinases, W-7, also showed no effect when used at 10-30 microM. Prior incubation with H-7 did not inhibit the ability of fibroblasts to subsequently respond to IL-1 beta or TNF alpha, nor did H-7 directly inhibit the granulocyte-macrophage colony-forming assay. Both dibutyryl cyclic adenosine monophosphate (10-30 microM) and forskolin (1-100 nM), activators of adenylate cyclase, in the presence or absence of the phosphodiesterase inhibitor isobutylmethylxanthine, failed to stimulate a GM-CSA response from cultured fibroblasts, indicating a lack of effect of cyclic nucleotide-dependent protein kinases. Furthermore, the addition of H-7 30 min after induction with IL-1 beta or TNF alpha showed little effect on the synthesis of GM-CSA by cultured fibroblasts, indicating that the signal transduction process probably occurred within the first 30 min of ligand-receptor interaction. Finally, amelioride, an inhibitor of the Na(+)-H+ antiport, was shown to inhibit IL-1 beta-induced GM-CSA in a dose-dependent manner.
Lactoferrin (Lf) is a negative regulator of myelopoiesis which operates by suppressing the release from mononuclear phagocytes of GM colony-stimulating factor (GM-CSF) or monokines which can then induce the release of GM-CSA from accessory cells. In this study, endotoxin-depleted, purified iron-saturated human Lf was assessed for its effect on the production of interleukin-1 by cultured monocytes and their subsequent effect on colony-stimulating factor release from cultured fibroblasts. Monocytes were grown with or without Lf and Lf that had previously been incubated with monoclonal anti-Lf. The monocyte-conditioned medium was then either assayed for the presence of interleukin-1 (IL-1) with an enzyme-linked immunosorbent assay or for its ability to stimulate fibroblasts to release growth factors for CFU-GM, BFU-E, or CFU-Mix colonies. In the presence of Lf (10(-7) or 10(-8) mol/L), GM colony-stimulating activity (GM-CSA) was suppressed by 31% to 73%, whereas stimulating activities for BFU-E and CFU-mix colony formation were suppressed by 93% to 100%. Antibody to Lf completely abrogated the suppressive effects observed with Lf, whereas antibody to IL-1 ablated the induction by monocyte-conditioned medium of CSA release by fibroblasts. Lf at 10(-7) and 10(-8) mol/L also reduced IL-1 synthesis by cultured monocytes from 60% to 77%. The inhibitory effects of Lf were only observed when Lf was added before adherence of the monocytes for culture. If Lf was added at the time of adherence or after adherence, no suppression was observed. We conclude that the inhibition of GM-CSA production/release by Lf is mediated through inhibition of the synthesis/release of IL-1 by mononuclear phagocytes. This inhibition of IL-1 prevents accessory cells from producing and/or releasing GM-CSA.
The present study investigated whether administration of percutaneous estradiol for the 7 days encompassing menstruation (the paramenstruum) would be effective in alleviating menstrual migraine. The study was a double-blind cross-over placebo comparison of percutaneous estradiol in gel form. Twenty-two women who suffered from regular recurring menstrual migraine were studied during 2 assessment menstrual cycles, 4 treatment cycles (2 of estradiol gel, 2 of placebo gel), and 1 follow-up (no treatment) cycle. Women completed daily records of the occurrence and severity of migraine and medication used. Eighteen women completed the study. There was a significant reduction in the frequency of migraine in the paramenstruum and in the amount of medication taken during use of percutaneous estradiol. Women expressed a significant preference for continuation of therapy with percutaneous estradiol.
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The role of psychological factors in IVF is complex. Psychological issues intertwine with physical ones, often with additive effects. The very diagnosis of infertility is likely to cause stress. In addition, the many investigations and procedures may have compounded distress. There are probably a small number of patients in whom psychological factors may induce infertility. But in the majority, psychological factors may exacerbate infertility and influence the patient's and partner's responses. Mental, sexual, marital and social adjustment may all be affected. The procedure of IVF is likely to have a further impact. A pilot study of couples entering an IVF programme revealed the women to be highly anxious and to conform strongly to feminine stereotypes. Many had received psychiatric help in the past. The idiopathic group appeared to cope less well with stress and had higher anxiety and neuroticism scores. Follow-up revealed that IVF had a profound impact on many of the women. Most had received no counselling in the interim. In those who completed questionnaires at follow-up, a differential effect was observed between the organic and idiopathic groups. State anxiety fell in the idiopathic group but so did marital adjustment. The clinician is advised to incorporate consideration of the psychological aspects of IVF into every aspect of the programme. The addition of a psycho-social team may assist the gynaecologist in this and help the couple to make an optimal adjustment.
An alternatives-oriented, school-based drug abuse prevention program, Positive Alternatives for Youth (PAY), was evaluated over a 2-year period. Using a random-assignment, pretest-posttest control group design, 135 PAY students and 106 control group students were assessed on several attitudinal and behavioral measures of drug use. During the first year significant differences were detected between PAY and control students. Fewer differences were found in the second year, although a special analysis showed evidence of impact on PAY students rated as more involved in program activities. Reasons for specific results are discussed and implications are drawn for the alternatives approach and the field of drug abuse prevention.
Alcohol and marijuana use were compared in 97 regular marijuana users who had used marijuana for 6-8 years. Although onset of alcohol use had occurred 3 years before marijuana use, current usage patterns of the two drugs were similar. Nine subjects met criteria for marijuana abuse and 9 met criteria for alcoholism. Although both drugs were used frequently by these subjects, most reported few or no problems from their use.
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A double-blind randomised crossover trial of oral micronised progesterone and placebo had demonstrated that progesterone had beneficial effects over placebo for some mood and physical premenstrual symptoms. A further trial using identical methodology was carried out to assess whether dydrogesterone would have the same beneficial effects. Prospective assessment confirmed the presence of a premenstrual syndrome in 30 women. Of these, six withdrew during the 4 months of the study. Twenty-four women completed the double-blind crossover protocol. All women were interviewed premenstrually before treatment and in each month of treatment. They completed the Moos Menstrual Distress Questionnaire, Beck Depression Inventory, Spielberger State Anxiety Inventory, Mood Adjective Checklist and a Daily Symptom Record. Analysis of data found an overall beneficial effect of being treated for most variables. Further analysis showed that the most major effects occurred in the first 2 treatment months. This study could find no evidence that dydrogesterone was more effective than placebo in treating premenstrual complaints.
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