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Biomedical subjects

Z Ying

Publications and source records attributed to Z Ying.

At least 37 records · Page 2Linked to original sources
PubMed2001

Therapeutic advantage of (90)yttrium- versus (131)iodine-labeled PAM4 antibody in experimental pancreatic cancer.

OBJECTIVES: Radioimmunotherapy studies using (131)I-PAM4 have demonstrated significant antitumor effects in mice bearing human pancreatic cancer xenografts. For several reasons (90)Y has been proposed as a more effective radionuclide for radioimmunotherapy of pancreatic cancer. The present study examined whether one radionuclide was more efficacious than the other in tumor-bearing mice. METHODS: Athymic nude mice bearing CaPan1 xenograft tumors ( approximately 1.0 cm(3)) were given increasing doses of either (90)Y-PAM4 or (131)I-PAM4 up to their respective maximal tolerated doses [MTDs (260 and 700 microCi, respectively)]. RESULTS: (90)Y-PAM4 provided significantly greater growth inhibition than the (131)I-PAM4 (P < 0.035). Median survival time for the untreated mice was 6 weeks, whereas median survival times for the (131)I-treated mice and (90)Y-treated mice at their respective MTDs were 17.5 weeks and >26 weeks (the end of the study period), respectively. Within the (131)I-PAM4-treated group, two of eight mice were responders (>50% decrease in tumor size) for a median of 14 weeks. At the end of the study (26 weeks), 1 mouse was alive with no sign of tumor. All of the (90)Y-PAM4-treated mice were responders with a median duration of response of 20 weeks. Six of the seven mice were alive at week 26, with four mice having no evidence of disease. CONCLUSIONS: These data demonstrate the advantage of (90)Y over (131)I as the radionuclide for PAM4-targeted radioimmunotherapy of xenografted pancreatic cancer. Furthermore, the duration and extent of the antitumor response suggests that multiple treatment cycles of (90)Y-PAM4 may provide an effective therapeutic for the control of pancreatic cancer.

Animals↗
PubMed2000

Anti-oxidant vitamins reduce normal tissue toxicity induced by radio-immunotherapy.

Our purpose was to determine whether the administration of anti-oxidant vitamins could reduce dose-limiting toxicity from radio-immunotherapy (RAIT) and thereby allow higher escalation of RAIT doses. Lipophilic vitamins A and E were administered i.p. and hydrophilic vitamin C was administered i.m. for 14 days (3 days pre-RAIT through 11 days post-RAIT) alone or with bone marrow transplantation (BMT) to either BALB/c mice for toxicity studies or to nude mice bearing s.c. GW-39 human colonic cancer xenografts for therapy studies. The maximal tolerated dose (MTD) of RAIT ((131)I-MN14 anti-CEA IgG) that results in no lethality was determined for mice that did not receive vitamins or BMT and those that did receive one or both interventions. Body weight, peripheral white blood cell (pWBC) and platelet (PLT) counts and tumor growth were also measured. Administration of vitamins (equivalent of 3.5 IU/day vitamin A, 0.107 IU/day vitamin E and 4.0 mg/day ascorbic acid) to mice along with BMT increased the MTD by 42% and reduced body weight loss associated with RAIT. Vitamins also reduced the magnitude of RAIT-induced myelosuppression. As early as day 7 after RAIT, vitamins increased WBC counts following both a 400 microCi and a 500 microCi dose. On day 14 after the 400 microCi dose of RAIT (day 7 post-BMT), the additive effect of BMT and vitamin could be detected. Tumor growth was not adversely affected by vitamin administration.

Animals↗
PubMed2000

Comparison of diagnostic markers with repeated measurements: a non-parametric ROC curve approach.

In this paper we study a class of non-parametric statistics for comparing diagnostic markers with repeated measurements. Using adapted definitions of specificity and sensitivity, we suggest methods to compare the average of sensitivities across all specificities or a range of specificities. The theory allows for correlations introduced by the fact that markers may be obtained from the same patient at multiple visits and that both markers being compared may be obtained from the same patient. Results of the Monte Carlo simulations and an example from a breast cancer setting are provided.

Biomarkers, Tumor↗
PubMed2000

Plasma FLT3-L levels predict bone marrow recovery from myelosuppressive therapy.

BACKGROUND: During the recovery period after anticancer myelosuppressive therapy, hematopoietic progenitor cells become mitotically active in order to replenish the bone marrow compartment and remain hyperproliferative even after normalization of peripheral white blood cells and platelets. At this stage, the progenitors are more radiosensitive and chemosensitive. Dosing patients with additional cytotoxic therapy during this phase will likely result in more severe toxicity. For example, the authors have noted that the red bone marrow (RM) dose resulting from radioantibody therapy does not correlate with observed bone marrow toxicity. Several patients given similar RM doses had Grade 3 or 4 toxicity, whereas others had Grade 0-2 toxicity even though their white blood cell (WBC) and (PLT) counts were normal at the time of dosing. The goal of these studies was to establish a noninvasive predictive marker of bone marrow activity that could determine stem cell and progenitor cell recovery from previous myelosuppressive therapy. METHODS: A retrospective study was conducted to quantitate plasma levels of 5 cytokines regulating hematopoiesis, namely, 2 stimulatory fms-like tyrosine kinase (FLT3-L) and stem cell factor (SCF) and 3 inhibitory growth factors tumor necrosis factor-alpha (TNFalpha), tumor growth factor-beta, and macrophage inflammatory protein (MIP-1alpha), by immunoassay in 43 patients enrolled in clinical trials at Garden State Cancer Center in Belleville, New Jersey. All patients had had previous chemotherapy with a duration of 1-24 months. The serum cytokine values were correlated with the magnitude of leukopenia or thrombocytopenia following a single dose of radioantibody as the cytotoxic therapy. RESULTS: Plasma FLT3-L levels predicted excess platelet toxicity in 13 of 16 patients (mean = 225 +/- 106 pg/mL) and resulted in a false-positive in only 3 of 27 other patients (mean = 80 +/- 41 pg/mL). Plasma FLT3-L > 135 pg/mL resulted in 81% sensitivity and 89% and 86% specificity and accuracy, respectively, for predicting excess toxicity caused by additional cytotoxic therapy. The positive likelihood ratio was 7.5 (95% confidence interval, 2.5-22.5) and the negative likelihood ratio was 0.19 (95% confidence interval, 0.05-0.67). CONCLUSIONS: Elevated plasma FLT3-L in patients who previously received chemotherapy is a predictive measure of the stage of recovery of the bone marrow compartment. FLT3-L seems to identify the likelihood that the patient will experience Grade > or = 3 thrombocytopenia if additional cytotoxic therapy is administered. Knowledge of bone marrow activity should permit therapy that is more aggressive by establishing the earliest possible time for dosing with any cytotoxic agent for which myelosuppression is the dose-limiting toxicity.

Antineoplastic Agents↗
PubMed2000

NMDAR1 receptor proteins and mossy fibers in the fascia dentata during rat kainate hippocampal epileptogenesis.

We examined the time course of NMDAR1 (NR1) immunoreactivity (IR) in the rat inner molecular layer of the dentate gyrus following unilateral intrahippocampal (hilar) kainic acid (KA) lesions and compared them to progressive aberrant mossy fiber (MF) sprouting into the inner molecular layer (IML). The results demonstrated that NR1 receptors in the IML of the KA side were decreased as early as 3 days after KA-induced denervation, then significantly increased at postinjection day (PID) 7. The densities of NR1 IR in the IML continued to increase up to 5 months. By comparison, MF sprouting did not occur significantly in the IML until PID 17, 10 days after NR1 IR was significantly increased. Recurrent MF-IML neoinnervation significantly increased on days 17, 60, and 150. This progressive MF innervation was significantly correlated with NR1 increases. These results suggest that NR1 receptors were decreased soon after KA-induced deafferentation of granule cell dendrites in the IML; however, they were replaced by new NR1 receptors at increased densities in the granule cell dendrites, which may have released neurotrophic factors to stimulate growth cones of MFs to reinnervate the IML. The progressive increases of NR1 and MFs in the IML suggest that such neosynaptogenesis would contribute monosynaptic recurrent excitatory mechanisms for focal hippocampal hyperexcitability and seizure onsets.

Animals↗
PubMed2000

Regulation of tumour drug delivery by blood flow chronobiology.

The chronobiology of various physiological phenomena that impact tumour drug delivery has not been established. Since the delivery of therapeutic agents is directly influenced in part by tumour vascular volume (VV), vascular permeability (VP) and local blood flow (BF), we have performed a series of studies to assess the natural rhythms of these functions in tumour and normal tissues. Preliminary results by Hori et al. Cancer Res 1992, 52, 912-916, have demonstrated fluctuations in tumour blood flow in subcutaneous (s.c.) rat tumours with a higher rate at 15-21 h after light onset (HALO) compared with 3-9 HALO. We used the GW-39 and LS174T human colon carcinoma xenografts grown s.c. in nude mice for these studies. VV, VP and BF were determined at 3, 7, 10, 13, 17, 20 and 23 HALO. In separate studies, dosing with a small therapeutic agent ([3H]-5-fluorouracil (5-FU)) or a macromolecule ([131I]-131-MN-14-anti carcinoembryonic antigen (CEA) immunoglobulin G (IgG)) was done at 10 and 17 HALO and 3, 10 and 17 HALO, respectively, and tissue and tumour uptake was determined in each group. Well-defined peaks and nadirs were observed for all three vascular functions. The peaks for VV and VP were similar in tumour and normal tissue whereas BF rate had a unique rhythm in tumour. Using cosinor analysis of the BF rate, we have found that the acrophase (peak) for tumour BF occurs at approximately 17 HALO in both tumour xenografts, while maximal liver, lung and kidney BF occurred at 10-13 HALO. Tumour BF rate ranged from the lowest value of 1.34+/-0.54 microliter/g/min at 20 HALO to the highest value of 2.79+/-0.57 microliter/g/min at 17 HALO. Liver BF rate ranged from 4.1+/-1.1 microliter/g/min at 3 HALO to 10.22+/-1.31 microliter/g/min at 10 HALO, and was 5.83+/-1.37 microliter/g/min at 17 HALO. Thus, the rhythm of tumour and normal tissue BF are different, creating a window of opportunity when tumours can be targeted with a therapeutic agent. At 3 h postinjection, the %ID/g of 5-FU in tumour at 10 HALO was 0.14+/-0.09 and at 17 HALO was 0.32+/-0.12 (P<0.02). In liver at 10 HALO, uptake was 0.13+/-0.06 and at 17 HALO was 0. 07+/-0.03 (P<0.05). At 24 h postinjection, the %ID/g of [131I]-MN-14 IgG in tumour at 10 HALO was 11.50+/-1.58 and at 17 HALO was 1. 5-fold higher at 16.96+/-2.35 (P<0.001). In liver at 10 HALO, uptake was 6.47+/-0.49 and at 17 HALO was 30% lower at 4.48+/-0.81 (P<0.01). These results suggest that small shifts in the chronobiology of BF in tumour and in normal tissue can have a sizeable impact on the distribution of chemotherapeutics and antibody-based drugs.

Animals↗
PubMed2000

Multiple paths of sugar-sensing and a sugar/oxygen overlap for genes of sucrose and ethanol metabolism.

The two-fold purpose of this work is, first, to review current hypotheses for multiple paths of sugar-sensing in an oxygen-responsive context, and second, to present evidence for the extent of sugar/oxygen overlap regulating genes for sucrose and ethanol metabolism. Current data indicate that sugar signals in plants may be initiated by (a) hexokinases, (b) membrane sensors, (c) acetate and/or respiratory metabolites, and (d) other signals and/or crosstalk. Responses may also involve concurrent input along transduction paths by effectors such as energy charge, P status, and phytohormones. Prime candidates for initiation and/or integration of such signal integration include SNF1- and SCF-like, multi-enzyme complexes. In addition, different paths of sugar signal transduction may be linked to contrasting roles of responsive genes during feast, famine or pathogen attack. Oxygen can potentially alter sugar signals at several points, so its influence on feast and famine responses was initially tested with genes for sucrose metabolism in maize root tips. The Sus1 and Sh1 sucrose synthases in maize (typically up-regulated by carbohydrate abundance and deprivation, respectively) showed parallel responses to hypoxia (3% O2 [0.03l l-1 O2]) and anoxia (0% O2 [0l l-1 O2]) that were consistent with involvement of similar signals. In contrast, the differential sugar-responses of the lvr1 and lvr2 invertases were not evident under low oxygen, and both genes were rapidly repressed. A third response was evident in the marked, sugar-regulation of an oxygen-responsive Adh1 gene for alcohol dehydrogenase, which was sensitive to sugar availability from deficit to abundance, regardless of oxygen status (anaerobic to fully aerobic [40% O2 (0.04l l-1 O2)]. A clear interface is thus evident between sugar and oxygen signals, but this varies markedly with the genes involved and probable differences in respective transduction paths.

Carbohydrate Metabolism↗
PubMed2000

Epileptogenicity correlated with increased N-methyl-D-aspartate receptor subunit NR2A/B in human focal cortical dysplasia.

PURPOSE: Human cortical dysplasia (CD) is a frequent cause of medically intractable focal epilepsy. The neurotransmitter mechanisms of epileptogenicity in these lesions have been attributed to changes in various glutamate receptor subtypes. Increased N-methyl-D-aspartate (NMDA) receptor (NR) 2A/B coassembled with NR1 subunits has been shown in focal epileptic CD. The purpose of this study is to correlate in situ CD epileptogenicity and the expression of various glutamate receptor subtypes. METHODS: The histopathological, morphological, and immunocytochemical findings in cortical tissue resected from five patients with medically intractable epilepsy and CD were correlated with electroencephalographic data recorded from subdural grids. The NMDA antibodies identified subunits NR1 (splicing variants 1a, 1b, 2a, and 2b) and NR2A/B. RESULTS: Epileptogenic specimens displayed the following common features: (a) widespread histological abnormalities of horizontal and columnar dyslamination, neurons with inverted polarity, and more extensive dendritic changes; (b) significantly higher NR2A/B immunoreactivity in both the dysplastic somata and all their dendritic processes; and (c) no statistically significant change in NR1 subunit expression but a more pronounced staining of the apical dendrites in highly epileptogenic cortex. These abnormalities were either absent or minimal in resected specimens that did not show evidence of severe in vivo epileptogenicity. CONCLUSION: These studies provide direct evidence for a major contribution of the NR2A/B subunit in CD-induced epileptogenicity.

Adolescent↗
PubMed2000

Brain plasticity and cellular mechanisms of epileptogenesis in human and experimental cortical dysplasia.

PURPOSE: The cellular mechanisms that may contribute to epilepsy in resected human cortical dysplasia (CD) were compared with the in utero radiated rat CD model. In human and rat focal hippocampal epilepsy, postsynaptic N-methyl-D-aspartate receptors are up-regulated and presynaptic axon collaterals hyperinnervate them. We hypothesized that in both human and rat CD: (a) the N-methyl-D-aspartate receptor subunits NR1 and NR2A/B would be increased and coassembled, and (b) aberrant axons would be in regions of CD. METHODS: Tests for presynaptic and postsynaptic changes in human and rat CD included the following: (a) cytology, (b) immunocytochemistry, (c) coimmunoprecipitation, (d) double-labeled immunofluorescence, and (e) Timm histochemistry of hippocampal mossy fibers. Within-patient comparisons were made between epileptic tissue, identified by subdural electro-encephalographic seizure onsets, and nonepileptic tissue remote from the focus but within the therapeutic resection. Rats were radiated at embryonic day 17, and offspring were studied postnatally. Statistical comparisons were made against normal rats matched for age and tissue processing. RESULTS: In focal CD patients, NR2A/B subunits and their coassemblies with NR1 were increased significantly more than for the remote nonepileptic cortex. Confocal microscopy showed that NR1-NR2A/B colabeled single dysplastic neurons in both human and rat. In CD rats, mossy fibers innervated the anomalously oriented hippocampal neurons. CONCLUSIONS: Human epileptic CD exhibits a spectrum of abnormal cell orientations and laminations that must require plastic axodendritic changes during development. These altered circuits and receptors could account for the seizures and cognitive deficits found in patients with CD. The radiated rat CD model with cortical dyslaminations and NR2A/B subunit increases would allow the development and testing of drugs targeted at only the NR2A/B subunit or at decoupling the NR1-NR2 coassembly, which could provide a specific antiepileptic drug for dysplastic circuits without inducing general depression of all brain neurons.

Abnormalities, Radiation-Induced↗
PubMed1999

Rubisco small and large subunit N-methyltransferases. Bi- and mono-functional methyltransferases that methylate the small and large subunits of Rubisco.

Ribulose-1,5-bisphosphate carboxylase/oxygenase (Rubisco)is methylated at the alpha-amino group of the N-terminal methionine of the processed form of the small subunit (SS), and at the epsilon-amino group of lysine-14 of the large subunit (LS) in some species. The Rubisco LS methyltransferase (LSMT) gene has been cloned and expressed from pea and specifically methylates lysine-14 of the LS of Rubisco. We determine here that both pea and tobacco Rubisco LSMT also exhibit (alpha)N-methyltransferase activity toward the SS of Rubisco, suggesting that a single gene product can produce a bifunctional protein methyltransferase capable of catalyzing both (alpha)N-methylation of the SS and (epsilon)N-methylation of the LS. A homologue of the Rubisco LSMT gene (rbcMT-S) has also been identified in spinach that is closely related to Rubisco LSMT sequences from pea and tobacco. Two mRNAs are produced from rbcMT-S, and both long and short forms of the spinach cDNAs were expressed in Escherichia coli cells and shown to catalyze methylation of the alpha-amino group of the N-terminal methionine of the SS of Rubisco. Thus, the absence of lysine-14 methylation in species like spinach is apparently a consequence of a monofunctional protein methyltransferase incapable of methylating Lys-14, with activity limited to methylation of the SS.

Amino Acid Sequence↗
PubMed1999

Decreased calmodulin-NR1 co-assembly as a mechanism for focal epilepsy in cortical dysplasia.

The NMDA receptor is one of the ionotropic glutamate receptors essential for excitatory neurotransmission. The NMDAR1 subunit is inactivated by direct interaction with calmodulin. The protein levels of calmodulin, NMDAR1 and their complex were quantified in tissue resected from epileptogenic and non-epileptogenic cortical areas as determined by chronic subdural electrode recordings from three patients (aged 6, 14 and 18 years) with focal epilepsy associated with cortical dysplasia. In all patients, the co-assembly of calmodulin and NMDAR1 was decreased in epileptogenic dysplastic cortex compared with normal appearing non-epileptogenic cortex, while there was no significant difference in the total protein levels of calmodulin or NMDAR1 between the two EEG groups. These results suggest that decreased calmodulin-NMDAR1 co-assembly is a cellular mechanism that contributes to hyperexcitability in dysplastic cortical neurons and in focal seizure onsets.

Adolescent↗
PubMed1999

Selective coexpression of NMDAR2A/B and NMDAR1 subunit proteins in dysplastic neurons of human epileptic cortex.

NR1 and NR2 are the two gene families for the NMDA receptor. In vitro studies show that while NR2 alone is nonfunctional, NR1 alone produces weak currents to glutamate or NMDA. We previously showed by immunocytochemistry (ICC) that in normal appearing, nonepileptic human cortical neurons, only NR1 and not NR2 proteins were expressed, in contrast to the presence of both NR1 and NR2 in normal rat cortical neurons. We also showed, in dysplastic epileptic cortex, that both NR1 and NR2 were highly expressed using ICC on adjacent 30-microm sections. However, the relative coexpressions of NR1 and NR2 proteins in single neurons in single sections of human epileptic cortex were unknown. In this study, we used double-labeled immunofluorescence and confocal microscopy to examine the distribution and coexpression of subunit proteins for NR1 and NR2A/B in both nondysplastic (control comparison) and dysplastic regions of human brain resected for the treatment of intractable epilepsy (11 patients). In nondysplastic regions, cortical neurons did not have immunoreactivity (ir) for NR2A/B, whereas NR1-ir was abundant. By contrast, dysplastic neurons in the regions with epileptic cortical dysplasia showed intense NR2A/B-ir in the somata and their dendritic processes. These same NR2A/B-ir dysplastic neurons were colabeled by NR1. These results demonstrate directly that dysplastic neurons express both NR2A/B and NR1 proteins, whereas nondysplastic cortical neurons express only NR1 proteins. Selective coexpression of NR2A/B and NR1 in dysplastic neurons suggests that NR2A/B may form heteromeric NR1-NR2 coassemblies and hyperexcitability in dysplastic neurons that could contribute to focal seizure onset.

Animals↗
PubMed1999

Chronotolerance of experimental radioimmunotherapy: clearance, toxicity, and maximal tolerated dose of 131I-anti-carcinoembryonic antigen (CEA) IgG as a function of time of day of dosing in a murine model.

The temporal variation in bone marrow proliferation has been used to help define the optimal time of day to dose with approximately 30 chemotherapeutic agents, so that treatment efficacy is maximised and toxicity is minimised. Since myelosuppression is also the dose-limiting toxicity for most forms of radioimmunotherapy, we hypothesised that time of day of administration might also influence tolerance for radioantibody therapy. Bone marrow proliferative activity in BALB/c mice was determined using cell cycle analysis of propidium iodide-stained bone marrow samples collected at 3 h intervals. Myelosuppression was determined at weekly intervals after a therapeutic dose of 131I-NP-4 anti-CEA (carcinoembryonic antigen) intact IgG at either 0900 h (2 h after light onset [HALO]), 1300 h (6 HALO) or 1600 h (9 HALO). The highest bone marrow proliferative activity was noted between 20 HALO (0300 h) and 4 HALO (1100 h), and the lowest activity could be measured at 10-13 HALO (1700-2000 h). Seven days after a maximal tolerated dose (MTD) of radioantibody, granulocyte reduction was 50% at both 2 and 6 HALO and only 32% at 9 HALO (P < 0.003). Fourteen days after radioantibody therapy, an 87% granulocyte suppression was observed in mice treated at 2 HALO and only a 64% granulocyte loss was noted in the 9 HALO treated group (P < 0.001). The 2 HALO group recovered earlier than the 9 HALO group (P < 0.013; 22% loss from the 2 HALO dose and 40% loss from the 9 HALO dose) on day 28 post-radioimmunotherapy. The difference in magnitude of neutropenia, rather than duration, was critical for establishing the MTD. A 30% increase in the MTD was possible if mice were dosed at 9 HALO (320 microCi) versus 2 HALO (240 microCi). These studies suggest that principles of chronobiology may govern the magnitude of toxicity and the highest dose tolerated in radioantibody therapy in the same way that it does for cytotoxic drug therapy.

Animals↗
PubMed1999

NMDA-receptors 1 and 2A/B coassembly increased in human epileptic focal cortical dysplasia.

PURPOSE: This study was designed to quantify the relation between expressions of NMDA receptor (NMDAR) subunits (1 and 2A/B) and the epileptogenicity in human focal cortical dysplasia. METHODS: Immunoblotting and immunoprecipitation were used to quantify these receptor subunits in tissue resected from EEG-verified epileptic and distal nonepileptic frontal cortical areas in each of three patients as determined by chronic subdural electrode recordings. In each patient, adjacent sections were immunostained to verify that the numbers of dysplastic neurons were greater in epileptic than in nonepileptic cortex. RESULTS: In all patients, NMDAR2A/B expressions and their coassemblies with NMDAR1 were increased in epileptic dysplastic cortex compared with the relatively normal appearing nonepileptic cortex. For all three patients, there were no significant differences in NMDAR1 protein expressions between the two EEG groups. CONCLUSIONS: These results suggest that increased NMDAR1-NMDAR2A/B coassembly contributes to hyperexcitability in dysplastic cortical neurons and focal seizure onsets.

Adolescent↗
PubMed1999

Hippocampal chemical anatomy in pediatric and adolescent patients with hippocampal or extrahippocampal epilepsy.

We determined whether age or seizure types were associated with hippocampal neuron loss, mossy fiber (MF) and GABAergic synaptic reorganizations or postsynaptic receptor densities. Children and adolescents were grouped into: (1) nonhippocampal sclerosis (non-HS; n = 11) and (2) hippocampal sclerosis (HS; n = 11). The most important results showed that: (1) regardless of the etiology of the seizures, there were greater cell losses in Ammon's horn with older ages in years; in the non-HS group, cell losses were greater with the older ages or with longer epilepsy durations; however, in the HS patients, the cell losses were not related to the patients' ages or epilepsy durations; (2) in both HS and non-HS, CA1 had greater cell losses than CA4; (3) in HS, CA1 and CA4 had greater cell losses than those in non-HS; (4) in non-HS, MF sprouting was greater with ages or with longer epilepsy durations; by contrast, in HS, MF sprouting was not related to the patients' age or epilepsy duration; (5) densities for AMPA GluR1, GABA-Abeta and for GABA axonal terminals were positively increased with age. These findings support the hypothesis that hippocampal cell losses and aberrant synaptic reorganizations are greater in the hippocampi of adolescents than in children, even for non-HS pathologies.

Adolescent↗
PubMed1999

Focal cortical dysplasia in children.

Cortical dysplasia (CD) is now recognized as one of the major causes of pediatric focal neocortical epilepsy, and surgical procedures have been considered early in life. However, the mechanisms involved in seizure generation and intractability in these patients are still unknown. We analyzed with immunocytochemistry for various antibodies the brain tissue from 4 children (10 months to 6 years old) with focal epilepsy due to focal CD in order to study the inhibitory and excitatory circuits in dysplastic areas. Our group had similar histopathological and clinical characteristics. In all patients we found areas of cortical disorganization with dysplastic neurons and balloon cells. We studied distributions of glial cells with glial fibrillary acidic protein (GFAP) and neurons with microtubule-associated protein 2 (MAP-2). Gliosis was present in all cases, and GFAP stained also some balloon cells. Dysplastic neurons were darkly stained by MAP-2, and we also found balloon cells weakly stained with MAP-2 in the same areas where GFAP was positive, suggesting coexpression of neuronal and glial markers in some of these cells. There was an increased expression of glutamate receptors, especially GluR2/3, but also N-methyl-D-aspartate receptors in dysplastic cortex. The inhibitory circuit does not seem to be decreased, rather we notice an increased amount of glutamate-decarboxylase-positive terminals around some of the big neurons. We discuss the possible role of these findings as mechanisms of epilepsy.

Cerebral Cortex↗
PubMed1999

Predictors of an acute antidepressant response to fluoxetine and sertraline.

Sertraline and fluoxetine have different pharmacologic and pharmacokinetic profiles which may be of clinical relevance in the determination of response in different subtypes of depression. A randomized, double-blind, 6-week study comparing sertraline (50-100 mg/day) with fluoxetine (20-40 mg/day) in 286 outpatients with major depression, who had demonstrated comparable efficacy and tolerability for the two drugs, was analysed by subgroups of patients at baseline with melancholia, severe depression, single depressive episode, multiple depressive episodes, high anxiety, low anxiety, psychomotor retardation and psychomotor agitation. Multiple logistic regression with regressors including treatment-by-subgroup variables revealed that, within certain subgroups, the efficacy might differ substantially from that of the whole treatment group. However, the only treatment-by-subgroup interaction term that was significant was anxiety (P < 0.05). There was no evidence of interaction in single or recurrent episode subgroups, and these were not included in subsequent analyses. Subsequent two-sample statistical comparison tests of response (i.e. Hamilton Depression Scale reduction > or = 50%) rates at study endpoint between treatment groups demonstrated that patients with melancholic depression and those with symptoms of psychomotor agitation yielded a significantly greater proportion of responders with sertraline compared to fluoxetine (P < 0.05). Response rates in sertraline- and fluoxetine-treated patients, respectively, were: overall study 59%, 51%; melancholia 59%, 44%; severe depression 59%, 41%; low anxiety 71%, 55%; high anxiety 47%, 48%; psychomotor retardation, 48%, 46%; and psychomotor agitation 62%, 39%. Multiple logistic regression adjusting for possible confounding factors, that included a treatment by anxiety interaction term, also led to similar findings. In particular, the analysis showed that significant differences existed in favour of sertraline in patients with low anxiety in the melancholia and severe depression subgroups (P < 0.05), indicating that these characteristics predicted a superior response to 6 weeks of treatment with sertraline relative to fluoxetine. Sertraline also demonstrated advantages over fluoxetine on parameters such as sleep and weight disturbance in severely depressed patients, and sleep disturbance, weight, cognitive disturbance and retardation in melancholic patients.

Adult↗