[Therapeutic percutaneous ablation of the bundle of His].
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Biomedical subjects
Publications and source records attributed to M Møller.
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By means of immunocytochemistry retinal S-antigen is selectively demonstrated in retinal photoreceptor cells of the rat and in pinealocytes of the hedgehog, rat, gerbil and cat. Brain areas surrounding the pineal organ are immunonegative. The immunoreactive material is evenly distributed in the perikarya of the cells. Occasionally, inner segments of retinal photoreceptors and processes of pinealocytes are also stained. The outer segments of retinal photoreceptors display a strong immunoreaction. In both pinealocytes and retinal photoreceptors the intensity of the immunoreaction varied considerably among individual cells. The immunocytochemical demonstration of retinal S-antigen in mammalian pinealocytes indicates that these cells still bear characteristics of photoreceptors. This finding is in accord with the concept that mammalian pinealocytes are derived from pineal photoreceptor cells of poikilothermic vertebrates.
By use of the indirect peroxidase-antiperoxidase immunohistochemical technique, nerve terminals exhibiting vasoactive intestinal polypeptide (VIP)-like-immunoreactivity were demonstrated in the pineal gland of the Mongolian gerbil (Meriones unguiculatus). Incubation of the superficial pineal gland of the gerbil with 60 pM of 125I-VIP showed that the gland exhibited saturation kinetics, and about 80% of the bound 125I-VIP could be displaced by adding a surplus of cold VIP. Incubation of unfixed, 0.1% and 4% paraformaldehyde-fixed cryostat sections of the gerbil forebrain with 125I-VIP also exhibited saturation kinetics, and displacement was possible by adding a surplus of the cold tracer. Receptor autoradiography on cryostat sections that had been incubated for 60 min with 125I-VIP showed a large number of grains over cortical areas, especially over the pyramidal layer of the hippocampus and the granular layer of the dentate gyrus. A prominent labelling of the pineal gland was also observed. The presence of VIP-like-immunoreactive nerve terminals and receptors for this molecule in the pineal gland of the Mongolian gerbil supports the biochemical studies demonstrating a stimulatory function of this molecule in the synthesis of melatonin.
Direct synaptic innervation of pinealocytes was observed in the superficial pineal gland of the Mongolian gerbil (Meriones unguiculatus) by electron microscopy. This innervation consisted of nerve fibres terminating in boutons with clear transmitter vesicles with a diameter of 40-60 nm. The boutons made synaptic junctions with the cell membrane of the pinealocyte displaying thickenings of both the pre- and postsynaptic membranes. Such boutons persisted in the gland 1 week after removal of both superior cervical ganglia. In contrast, all the sympathetic boutons containing transmitter vesicles with a small dense core disappeared after ganglionectomy. This direct synaptic innervation reveals a neuronal character of the pinealocyte and might underlie reports of action potentials in electrophysiological recordings from the gland.
Mongolian gerbils were injected into the vitreous body of the left eye with either horseradish peroxidase or horseradish peroxidase coupled to wheat germ agglutinin. After survival times ranging from 6 to 48 hours, the animals were sacrificed and perfused with glutaraldehyde. Cryostat sections were cut through the brains and reacted for peroxidatic activity. Labelled perikarya were observed in the dorsal nucleus of the lateral geniculate body, the medial and lateral nuclei of the optic tract, the pretectal nuclei and the superior colliculus. These results indicate the presence of an efferent innervation of the retina from the brain via the optic nerve in the Mongolian gerbil.
Hemifacial spasm is usually an isolated symptom resulting from facial nerve root compression. Three patients had, in addition, tinnitus, hearing loss, facial sensory loss, diminished gag reflex, dysphagia, and dysarthria. Acoustic reflexes were abnormal, and facial nerve conduction studies showed evidence of ephaptic transmission and ectopic excitation. Brain CT and metrizamide cisternography were normal. Surgical exploration showed compression of cranial nerve roots by posterior inferior cerebellar artery branches. After decompression, symptoms abated, and electrical signs of hemifacial spasm disappeared. Vascular compression of nerve roots in the cerebellopontine recess may cause multiple cranial neuropathy.
68 of a group of 2745 consecutive pregnant women had group B streptococci in their urine. In this group primary rupture of the membranes and premature delivery occurred in 35% and 20% respectively. In women without group B streptococci 15% had primary rupture of the membranes and premature delivery occurred in 8.5%. Group B streptococcal sepsis occurred in five infants, all had mothers with positive urine culture. Women with group B streptococci in their urine seem to have a significantly increased risk of primary rupture of the fetal membranes and premature delivery.
A retrospective study was carried out to assess the incidence of cardiomyopathy in western Denmark (Jutland and Funen) (population 2 798 000) during a two year period (1980-81). The WHO/ISCF classification was strictly followed, and rigid criteria for exclusion and inclusion of patients were adopted. Thus cases in which specific heart muscle disorders (myocarditis, alcoholic heart disease, hypertension etc) were merely suspected were excluded. Forty one patients had dilated cardiomyopathy (overall incidence 7.3/10(6) population/year) and 20 hypertrophic cardiomyopathy (overall incidence 3.6/10(6) population/year). In men aged 40-59 years the occurrence of dilated cardiomyopathy was 23.4/10(6) population/year. Only one case of Löffler's endomyocardial disease was diagnosed during the study period. Since the investigation was retrospective and was a study of diseased persons and not a population, and since a specific set of criteria for exclusion and inclusion was rigidly applied, the results represent the minimum frequency of these diseases.
An interference filter combination for contrast enhancement of the brownish, peroxidase-activated, 3,3'-diaminobenzidine tetrahydrochloride reaction product has been developed. This filter combination allows transmission of light in two narrow bands, representing those of the primary colors green (480-500 nm) and red (575-585 nm) as well as a broader band between 385-430 nm. The visual contrast enhancement of horseradish peroxidase-containing neurons caused by the interference filters was excellent. In particular, intracellular details were prominent in the presence of the interference filters compared with different blue absorption filters. The contrast enhancement was evaluated by microdensitometry of an Agfapan 25 emulsion onto which peroxidase-containing neurons in noncounterstained sections were exposed. The microdensitometry showed a neuron to background contrast enhancement of 30% compared to neutral gray filters and of 11% compared to a Kodak Wratten 80A blue absorption filter. The interference filters are available from the Laboratory of Technical Optics, the Technical University of Copenhagen, Building 307, Lundtoftevej 100, DK-2800 Lyngby, Denmark (order: DAB-interference filters, 30 mm). The interference filter principle can be used for contrast enhancement of other compound colors.
For TCAs there is a strong rationale for drug level monitoring in clinical therapy. Therapeutic drug concentration ranges have been established in controlled studies with NT, imipramine, and AT. It has been shown that by appropriate choice of antidepressant and close monitoring of drug levels, treatment with antidepressants in elderly and other risk patients can be carried out effectively and safely, reducing the use of electroconvulsive therapy. Finally, the practical clinical use of antidepressant concentration measurements is now feasible and not expensive, and the analytical procedures can be established in most hospital settings. On the basis of these premises the following can be concluded: Plasma level monitoring should be used as a routine for imipramine, NT, and AT. Further plasma level studies on other antidepressants and in overdose cases should be initiated. Plasma level monitoring is indispensable in clinical research on antidepressants (trials, new drugs, toxicology). Pharmacokinetic considerations may be useful to determine which receptor effects are clinically relevant in therapy and toxicology.
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Nerve fibers connecting the brain with the pineal gland of the Mongolian gerbil (central pinealopetal fibers) were investigated by means of light and electron microscopy. Several myelinated fibers penetrate from the brain into the deep pineal gland, extend further into the pineal stalk and continue to the superficial portion of the pineal gland. In the centripetal direction these fibers were traced to the stria medullaris and to the habenular nuclei, where they turned laterad and then occupied a position immediately ventral to the optic tract. As shown in electron micrographs, lesions of the habenular area led to degeneration of myelinated fibers and nerve boutons in the deep pineal gland, the pineal stalk and the superficial pineal gland. Only boutons containing clear transmitter vesicles (devoid of a dense core) were observed to degenerate after the habenular lesions. On the other hand, removal of the superior cervical ganglia resulted in degeneration of boutons containing small (40 to 60 nm in diameter) dense-core vesicles. Several of the nerve fibers that penetrate into the deep pineal directly from the brain (central fibers) exhibited a positive reaction for acetylcholinesterase (AChE). AChE-positive perikarya were located in the projections of the stria medullaris, the lateral portions of the deep pineal, the area of the posterior commissure, and the periventricular gray of the mesencephalon. Such perikarya were found neither in the pineal stalk nor in the superficial pineal gland. These results present anatomical evidence that the pineal organ of the Mongolian gerbil receives multiple nervous inputs mediated by peripheral autonomic (i.e., sympathetic) nerve fibers, on the one hand, and by central fibers, on the other.
The location of perikarya and nerve fibers projecting via the habenular and posterior commissures from the brain into the pineal organ of the Mongolian gerbil was investigated by the use of the retrograde horseradish peroxidase (HRP)-tracing method. After microiontophoretic or hydraulic injection of the tracer into the superficial pineal gland via a glass micropipette, and after survival periods of 6 to 48 h, the animals were transcardially perfused and the brains processed for the histochemical demonstration of the enzyme. In the pineal stalk 15 to 20 nerve fibers, including 4 to 7 myelinated elements, were traced back to the brain. HRP-labeled perikarya were located in the medial and lateral habenular nuclei as well as in the nucleus of the posterior commissure. Few fibers projected rostrally to perikarya in the paraventricular nucleus of the hypothalamus. A striking and persistent finding was the labeling of fibers that, in the habenular area, bent laterad and continued ventral to the optic tract. These fibers originated from perikarya located in the dorsal nucleus of the lateral geniculate body. These results strongly suggest a central innervation of the pineal organ in the Mongolian gerbil originating from hypothalamic and limbic areas of the brain as well as from the optic system.
Cardiovascular effects of the tetracyclic antidepressant drug mianserin were examined in a prospective study including ten elderly depressed patients (age 60-77 years). During 1 week on placebo and 5 weeks on mianserin, 60 mg per day, orthostatic blood pressure testing, recording of standard electrocardiogram, 24-h electrocardiographic recording and systolic time intervals were carried out along with frequent monitoring of plasma levels of mianserin (13-57 micrograms/l) and the primary metabolite desmethylmianserin (7-27 micrograms/l). Mianserin caused a significant increase in orthostatic systolic blood pressure drop, and this correlated well with the plasma mianserin levels (rs = 0.70). There were no significant changes in supine blood pressure or in orthostatic changes in heart rate. No cardiac conduction disturbances or arrhythmias were provoked, but mianserin caused changes in systolic time intervals indicating impairment of left ventricular contractility and performance. Like tricyclic antidepressants mianserin should thus be used with caution in patients with latent or overt cardiovascular disease.