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Biomedical subjects

J Levine

Publications and source records attributed to J Levine.

At least 109 records · Page 6Linked to original sources
PubMed1998

Clinico-tremorgraphic features of neuroleptic-induced tremor.

Instrumental tremorgrams have been used to improve the diagnostic accuracy of various movement disorders, including tardive akathisia. The aim of the present work was to evaluate their place in the diagnosis of neuroleptic-induced tremor and to determine whether they can help to differentiate this disorder from other neuroleptic-induced movement disorders and from other types of tremor. Fourteen psychiatric patients treated with various neuroleptic medications were diagnosed as having neuroleptic-induced tremor on the basis of clinical criteria. They underwent accelerometric recordings following diagnosis. All patients demonstrated upper-limb tremor; four also had involvement of the lower limbs, jaw or tongue. Most demonstrated both resting and postural tremor, the latter being the more prominent. The tremor was mainly rhythmic, regular and sinusoidal. It did not significantly interfere with activities of daily living in the majority of patients, but four did exhibit some degree of impairment. Repeated accelerometric recordings showed constant and regular waveforms and frequencies (between 4 and 7 Hz) in each patient. We conclude that the presence of repeated constant waveforms and frequencies on accelerometric tracings may serve as confirmation of the diagnosis of neuroleptic-induced tremor. In light of the findings of this and other studies, we suggest that tremorgrams may be helpful in differentiating neuroleptic-induced tremor from other neuroleptic-induced movement disorders (e.g., tardive dyskinesia and tardive akathisia) and from psychogenic tremor. Although these techniques may also assist in the differentiation of neuroleptic-induced tremor from some tremor disorders (e.g., asterixis or ataxic tremor), their overall potential to distinguish it from other types of organic tremor is more limited.

Adult↗
PubMed1998

Fecal hydrogen sulfide production in ulcerative colitis.

OBJECTIVE: Sulfide, a product of sulfate-reducing bacteria, has been proposed to play an etiologic role in ulcerative colitis. Ulcerative colitis feces have increased numbers and activity of sulfate-reducing bacteria, but only modestly increased sulfide. However, fecal sulfide exists largely in the volatile, highly toxic H2S form that moves rapidly from feces to surrounding gas. Our aim was to quantify the fecal release of H2S and other volatiles (CO2, H2, CH4, methanethiol, and dimethylsulfide). METHODS: Fecal samples from 25 subjects with ulcerative colitis and 17 controls were incubated in 4-L containers, and gas release was assessed at intervals over 24 h. RESULTS: H2S release by ulcerative colitis feces was elevated 3-4-fold at every measurement point compared with normal feces (p < 0.003 at 24 h). The only other significant difference was increased CO2 release by ulcerative colitis feces at 1 h. Supplementation of fecal homogenates with sulfur-containing substrates showed that organic compounds (mucin, cysteine, taurocholate) provided more readily utilizable substrate for H2S production than did sulfate. CONCLUSIONS: Increased H2S release is a relatively localized metabolic aberration of ulcerative colitis feces. This increased H2S may reflect abnormalities of the fecal bacteria and/or substrate availability.

Adolescent↗
PubMed1998

Molecular characterization of the men1 tumor suppressor gene in sporadic pituitary tumors.

Anterior pituitary tumors arise sporadically, and also as part of the inherited multiple endocrine neoplasia type 1 (MEN 1) syndrome. To investigate the role of the recently isolated men1 gene in sporadic pituitary tumorigenesis, the complete coding sequence was screened for mutations in 45 sporadic anterior pituitary tumors, including 14 hormone-secreting tumors and 31 nonsecreting tumors, by dideoxy fingerprinting and sequence analysis. No pathogenic sequence changes were found in the men1 coding region. The men1 gene was expressed in 43 of these tumors with sufficient RNA, including one tumor with loss of heterozygosity (LOH) for several polymorphic markers on chromosomal region 11q13. Furthermore, both alleles were expressed in 19 tumors in which the constitutional DNA was heterozygous for intragenic polymorphisms. Thus, inactivation of the men1 tumor suppressor gene, by mutation or by imprinting, does not appear to play a prominent role in sporadic pituitary adenoma pathogenesis.

Gene Expression Regulation, Neoplastic↗
PubMed1998

Anatomic site and interanimal variability in morphologic characteristics of bottlenose dolphin (Tursiops truncatus) skin likely to affect dermal absorption studies.

OBJECTIVE: To investigate anatomic site and interanimal variability in dolphin skin for use in development of models for cutaneous absorption studies. SAMPLE POPULATION: Skin from 30 healthy free-ranging bottlenose dolphins (17 males and 13 females grouped by age) and 10 captive males between 13 and 19 years old. PROCEDURE: Biopsy specimens were collected from the 10 male dolphins at 3 anatomic sites and from the 30 dolphins at 1 site; specimens were evaluated by light microscopy. Stratum externum thickness, minimal depth to the vasculature, and maximal epidermal depth were measured at 4 locations on 4 sequential sections. Comparisons of replicate measurements for 3 skin characteristics were made within and among anatomic sites, between dolphins of the same sex and approximate age, and across males and females of various ages. RESULTS: The stratum externum in male dolphins was thicker. Differences attributable to age and anatomic site were not significant. Variation attributable to differences in stratum externum thickness between dolphins was significant. Differences among body sites within the same dolphin were significant but were not consistent from dolphin to dolphin. Mean stratum externum thickness was not different between males of the 2 cohorts, but mean maximal epidermal depth and mean minimal depth to the vasculature were different. Variances within the 2 male cohorts were not significantly different. CONCLUSIONS: Studies affected by stratum externum thickness should eliminate the effect attributable to sex difference by using dolphins of the same sex or grouping analytical data by sex. Precision could be improved without increasing the total number of dolphins by collecting more than 1 sample/dolphin.

Animals↗
PubMed1997

Incorporation of norvaline at leucine positions in recombinant human hemoglobin expressed in Escherichia coli.

We report here a novel finding that norvaline can be incorporated in place of leucine in recombinant human hemoglobin expressed in Escherichia coli. The presence of the norvaline was confirmed by several analytical methods such as amino acid analysis, peptide mapping, electrospray mass spectrometry, and Edman protein sequencing. It appears that substitution is distributed across both the beta- and di-alpha-globins in purified recombinant hemoglobin. The level of misincorporation correlated with the ratio of the free norvaline/leucine pool available in the cell culture. This suggests that the incorporation of norvaline for leucine occurs through misaminoacylation of tRNALeu, similar to the misincorporation of norleucine for methionine found in many recombinant proteins expressed in E. coli.

Amino Acid Sequence↗
PubMed1997

Wound healing is accelerated by agonists of adenosine A2 (G alpha s-linked) receptors.

The complete healing of wounds is the final step in a highly regulated response to injury. Although many of the molecular mediators and cellular events of healing are known, their manipulation for the enhancement and acceleration of wound closure has not proven practical as yet. We and others have established that adenosine is a potent regulator of the inflammatory response, which is a component of wound healing. We now report that ligation of the G alpha s-linked adenosine receptors on the cells of an artificial wound dramatically alters the kinetics of wound closure. Excisional wound closure in normal, healthy mice was significantly accelerated by topical application of the specific A2A receptor agonist CGS-21680 (50% closure by day 2 in A2 receptor antagonists. In rats rendered diabetic (streptozotocin-induced diabetes mellitus) wound healing was impaired as compared to nondiabetic rats; CGS-21680 significantly increased the rate of wound healing in both nondiabetic and diabetic rats. Indeed, the rate of wound healing in the CGS-21680-treated diabetic rats was greater than or equal to that observed in untreated normal rats. These results appear to constitute the first evidence that a small molecule, such as an adenosine receptor agonist, accelerates wound healing in both normal animals and in animals with impaired wound healing.

Adenosine↗
PubMed1997

Immediate effects of chlorpromazine and perphenazine following neuroleptic washout on word association of schizophrenic patients.

Reaction time and idiosyncrasy of word associations were examined in 30 schizophrenic patients, 2 h after administering a single dose of chlorpromazine, perphenazine or placebo. These patients were in the acute phase of their illness following 72 h cessation of oral neuroleptic treatment administered for 1-2 weeks. There was a statistically significant reduction in reaction times after administering perphenazine as compared to the placebo. Chlorpromazine showed some reduction in reaction times that was not statistically significant. Further study is needed to examine the relationship between such changes and other parameters, such as the patients' symptomatology and their social competence. Since many schizophrenic patients exhibit low or partial compliance, including patterns of intermittent taking of medication with a few days cessation, studies using such a model of a single dose of neuroleptic following several days withdrawal, may have clinical relevance. Another finding was a correlation between reaction time and the number of uncommon word associations produced. This correlation was beyond drug effect. Further study is needed to find out if such a correlation characterizes schizophrenic patients only.

Adolescent↗
PubMed1997

Inositol treatment of autism.

Recent studies suggest that serotonin reuptake inhibitors are helpful in at least some symptoms of autism. Inositol is a precursor of the second messenger for some serotonin receptors, and has been reported effective in depression, panic disorder and obsessive-compulsive disorder. However a controlled double-blind crossover trial of inositol 200 mg/kg per day showed no benefit on 9 children with autism. Since biochemical studies could evaluate inositol in children already receiving serotonin reuptake inhibitors.

Autistic Disorder↗
PubMed1997

Controlled trials of inositol in psychiatry.

Inositol is a simple polyol precursor in a second messenger system important in the brain. Cerebrospinal fluid inositol has been reported as decreased in depression. A double-blind controlled trial of 12 g daily of inositol in 28 depressed patients for four weeks was performed. Significant overall benefit for inositol compared to placebo was found at week 4 on the Hamilton Depression Scale. No changes were noted in hematology, kidney or liver function. Since many antidepressants are effective in panic disorder, twenty-one patients with panic disorder with or without agoraphobia completed a double-blind, placebo-controlled, four week, random-assignment crossover treatment trial of inositol 12 g per day. Frequency and severity of panic attacks and severity of agoraphobia declined significantly with inositol compared to placebo. Side-effects were minimal. Since serotonin re-uptake inhibitors benefit obsessive compulsive disorder (OCD) and inositol is reported to reverse desensitization of serotonin receptors, thirteen patients with OCD completed a double-blind controlled crossover trial of 18 g inositol or placebo for six weeks each. Inositol significantly reduced scores of OCD symptoms compared with placebo. A controlled double-blind crossover trial of 12 g daily of inositol for a month in twelve anergic schizophrenic patients, did not show any beneficial effects. A double-blind controlled crossover trial of 6 g of inositol daily vs. glucose for one month each was carried out in eleven Alzheimer patients, with on clearly significant therapeutic effects. Antidepressant drugs have been reported to improve attention deficit disorder (ADDH) with hyperactivity symptomatology. We studied oral inositol in children with ADDH in a double-blind, crossover, placebo-controlled manner. Eleven children, mean age 8.9 +/- 3.6 years were enrolled in an eight week trial of inositol or placebo at a dose of 200 mg/kg body weight. Results show a trend for aggravation of the syndrome with myo-inositol as compared to placebo. Recent studies suggest that serotonin re-uptake inhibitors are helpful in at least some symptoms of autism. However a controlled double-blind crossover trial of inositol 200 mg/kg per day showed no benefit in nine children with autism. Cholinergic agonists have been reported to ameliorate electroconvulsive therapy (ECT)-induced memory impairment. Inositol metabolism is involved in the second messenger system for several muscarinic cholinergic receptors. Inositol 6 g daily was given in a crossover-double-blind manner for five days before the fifth or sixth ECT to a series of twelve patients, without effect. These results suggest that inositol has therapeutic effects in the spectrum of illness responsive to serotonin selective re-uptake inhibitors, including depression, panic and OCD, and is not beneficial in schizophrenia, Alzheimer's ADDH, autism or ECT-induced cognitive impairment.

Adult↗
PubMed1997

Valsartan, a new angiotensin II antagonist for the treatment of essential hypertension: efficacy, tolerability and safety compared to an angiotensin-converting enzyme inhibitor, lisinopril.

OBJECTIVE: To compare the efficacy, safety and tolerability of valsartan to an angiotensin-converting enzyme (ACE) inhibitor, lisinopril, and placebo in patients with mild-to-moderate essential hypertension. DESIGN: A total of 734 men and women were randomised in this multicentre, double-blind, optional titration, parallel group trial. Volunteers received valsartan 80 mg (n = 364), lisinopril 10 mg (n = 187) or placebo (n = 183) daily for 4 weeks, with subsequent titration of dose depending on response to treatment (valsartan 80 mg titrated to valsartan 160 mg once daily or valsartan 80 mg twice daily, lisinopril 10 mg titrated to lisonopril 20 mg once daily). Patients were assessed at 4, 8 and 12 weeks. MAIN OUTCOME MEASURES: The primary variable was change from baseline in mean sitting diastolic blood pressure (SDBP). Other efficacy variables included sitting systolic blood pressure (SSBP) and percentage of 'successful' responders (SDBP <90 mm Hg or > or =10 mm Hg reduction from baseline). RESULTS: All active treatment groups were shown to demonstrate significant reductions in SDBP compared to placebo at endpoint of therapy (least mean square reduction from baseline: valsartan 80/160 mg: -5.25 mm Hg (Cl -7.17, -3.34, P< 0.001); valsartan 80/80 mg twice daily: -5.63 mm Hg (Cl -7.51, -3.75, P< 0.001); lisinopril 10/20 mg: -6.93 mm Hg, (Cl -8.81, -5.05, P< 0.001). There were no statistically significant differences between the active treatment groups at endpoint of therapy. In patients requiring titration to a higher dose (placebo n = 142, valsartan 80/80 twice daily n = 124, valsartan 80/160 n = 114, lisinopril 10/20 n = 120), there were no significant treatment differences between valsartan 160 mg given as a single daily dose or as 80 mg twice daily (P = 0.658). Both valsartan and lisinopril produced similarly high percentages of 'successful' responders at endpoint of therapy. A somewhat higher frequency of drug related cough was observed in lisinopril treated patients (8%) compared to valsartan (1.1%) or placebo (0.5%). CONCLUSIONS: Valsartan 80 mg daily, with titration to 160 mg daily as required, provides similar antihypertensive efficacy to lisinopril 10 mg daily with titration to 20 mg daily. Valsartan provides a new antihypertensive agent with comparable efficacy to lisinopril and appears to be associated with a reduced incidence of cough.

Adult↗
PubMed1997

Medicated chronic schizophrenic patients do not demonstrate left turning asymmetry.

Twenty-seven medicated chronic schizophrenic female patients were tested for right or left turning behavior. No substantial right or left asymmetry was found, nor did the addition of the indirect dopaminergic agonist amantadine influence these results. Previous studies demonstrated left circling preference in chronic unmedicated schizophrenics and it seems that this previous finding is abolished by neuroleptic treatment. However, our patients were all females and further research with a heterogenous group of schizophrenic patients is needed.

Adult↗
PubMed1997

Side effect profile of azathioprine in the treatment of chronic schizophrenic patients.

Various findings suggest auto-immune changes in schizophrenia. We have recently demonstrated that platelets from schizophrenic patients bear autoantibodies (PAA) which cross-react with brain antigens. Accordingly, treatment of schizophrenia with an immunosuppressant might be of potential benefit. In a recent case study, a chronic schizophrenic patient treated with azathioprine has demonstrated a clear psychiatric improvement preceded by a decrease in PAA level. A phase I study designed for assessing side-effects of short-term azathioprine treatment in a group of schizophrenic patients is described here. From a group of 40 chronic non-responsive patients, 14 patients demonstrating high PAA level have entered the study and 11 have complied all along. Two groups were tested in parallel. In the first (6 patients) 150 mg/day was given for 7 weeks while in the second (5 patients) the same regimen was given for two periods of 7 weeks with an interval of 6 weeks. Blood biochemistry and cell count, as well as determination of PAA were carried out weekly, starting 3 weeks before the trial and continuing up to 7 weeks after the treatment. Two out of 11 patients developed leucopenia in week 4. No other side-effects were recorded in any of the patients. A substantial reduction in PAA was observed in 3 out of 6 patients in group I and 4 out of 5 in group II. Two patients showed improvement of psychiatric symptomatology. Our results demonstrate that short-term azathioprine treatment induces transient leucopenia in 18% of the patients receiving the drug, much alike the percentage reported for other patient populations.

Adult↗
PubMed1997

Use of carbamylated hemoglobin concentration to differentiate acute from chronic renal failure in dogs.

OBJECTIVE: To determine usefulness of carbamylated hemoglobin (CarHb) concentration for differentiation of acute renal failure (ARF) from chronic renal failure (CRF) in dogs. SAMPLE POPULATION: Samples from dogs with ARF or CRF and from nonazotemic control dogs. PROCEDURE: CarHb concentration was determined in heparinized blood samples by measuring the micrograms of valine hydantoin (VH) per gram of hemoglobin (Hb), using a high-performance liquid chromatography assay, in which carbamyl valine is converted to VH via acid hydrolysis. RESULTS: CarHb concentration was significantly higher in dogs with ARF and CRF, compared with values in control dogs (ARF vs control, P < 0.05; CRF vs control, P < 0.001). Furthermore, CarHb concentration was significantly (P < 0.001) higher in dogs with CRF, compared with that in dogs with ARF. Carbamylated hemoglobin concentration did not correlate with serum urea nitrogen or creatinine concentration. Using a cutoff value of 100 micrograms of VH/g of Hb, the sensitivity and specificity of CarHb concentration for differentiating ARF from CRF was 96.1 and 84.2%, respectively. CONCLUSIONS: CarHb concentration was useful in the differentiation of ARF from CRF in the dogs of this study. CLINICAL RELEVANCE: CarHb concentration may be used to increase the accuracy of identifying ARF, so that early, aggressive management can be instituted, thereby increasing the chance of recovery.

Acute Kidney Injury↗
PubMed1996

Is pathology examination of disc specimens necessary after routine anterior cervical discectomy and fusion?

STUDY DESIGN: A retrospective chart review was performed from 1990-1994. OBJECTIVES: To evaluate the outcome of pathologic examination of cervical disc specimens submitted after anterior cervical discectomy. SUMMARY OF BACKGROUND DATA: This study is the first to review the outcome of pathologic examination of disc specimens after anterior cervical discectomy and fusion. METHODS: Charts were reviewed based on the procedure code of anterior cervical fusion and the main diagnoses of cervical disc and spondylosis. The following data were recorded for each patient: symptoms, examination, diagnostic studies, operative procedure, operative findings, and pathology report. Statistical analysis was performed. RESULTS: Five hundred six disc levels in 394 patients were reviewed. All patients had symptoms and examination results consistent with cervical radiculopathy. All patients had cervical radiographs and some combination of myelography, computed tomography, or magnetic resonance imaging. Findings at the time of surgery included the presence of either a herniated disc or degenerative spondylitic changes. The pathologic examination results of all specimens reported fibrocartilaginous tissue consistent with disc material with the presence of degenerative changes. No infectious, benign, or malignant process was identified at the time of surgery or on gross and histologic examination of any of the disc specimens. Using confidence intervals (95%) for exact proportions and given 500 negatives, the chance the next occurrence would be positive would be 0.0060 or 0.60% or six of 1000. CONCLUSIONS: This study shows that if the symptoms, physical examination, radiographic diagnostic studies, and surgical findings are consistent with those of cervical disc herniation of spondylosis, the chance of an unexpected, clinically important pathologic finding within the disc specimen is extremely small. The time and expense involved in routine pathologic examination of cervical disc specimens can be avoided.

Cervical Vertebrae↗