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PubMed2003

A comparison between dually diagnosed inpatients with and without Axis II comorbidity and the relationship to treatment outcome.

UNLABELLED: The presence of a personality disorder (PD) has been associated with certain types of poor treatment outcomes in patients with substance use disorders (SUDs). The purpose of this study was to determine the prevalence of comorbid PDs in psychiatrically hospitalized adults with both non-SUD Axis I disorders and SUDs, and to assess the relationship between Axis II psychopathology and degree of pretreatment addiction severity and treatment outcome. METHOD: One hundred consecutive inpatients admitted to a mixed dual diagnosis inpatient unit were assessed using semistructured interviews for SUDs, non-SUD Axis I disorders, and PDs. Pretreatment severity was assessed using a modified version of the Addiction Severity Index (ASI). Outcome measures were assessed both during hospitalization and at an initial follow-up appointment after discharge. Statistical analyses were performed comparing dually diagnosed patients with and without Axis II psychopathology. RESULTS: A significant number (53%) of the patients met criteria for at least one personality disorder. Of the PDs, Cluster B PDs were the most prevalent, particularly borderline personality disorder (74%) and antisocial personality disorder (66%). Dually diagnosed patients without an Axis II diagnosis had less severe pretreatment severity measures. During hospitalization, patients with Axis II disorders had higher levels of psychopathology on the Brief Symptom Inventory (BSI) subscales of sensitivity and hostility. However, there was no difference in overall degree of global improvement during hospitalization. During follow-up, patients with Axis II disorders were significantly less likely to be compliant in attending their initial follow-up appointment. CONCLUSIONS: Dual diagnosis inpatients with PDs appear to improve as much as patients without PDs during their inpatient hospitalizations; however, they appear to be less likely to be compliant with attending their initial follow-up appointment.

Adult↗
PubMed2003

Glucose degradation products increase apoptosis of human mesothelial cells.

BACKGROUND: The heat sterilization of glucose solutions for peritoneal dialysis (PDS) induces the formation of glucose degradation products (GDPs), a phenomenon amplified by lactate and neutral pH. In the new three-compartment bag (3CB) PDS, a glucose solution at pH 3 is kept apart from the buffer until use, and the final solution delivers glucose concentrations that are similar to traditional PDS (TPD), with pH 6 and a lower content of GDPs. As GDPs have oxidant activity that may favour apoptosis, we investigated mesothelial cell apoptosis modulation by 12 h cultures in media supplemented with: (i) two relevant GDPs, methylglyoxal (MGly) and formaldehyde (For) in time and dose-dependence assays, (ii) GDPs at concentrations detected in TPD and 3CB, and (iii) commercial TPD and 3CB PDS, both with 1.36% glucose. METHODS: Apoptosis was evaluated by terminal 3' uridine labelling. Key proteins involved in the apoptotic pathway were investigated by reverse transcription polymerase chain reaction (RT-PCR) mRNA expression and immunoperoxidase staining (caspase 9, tumour suppressor protein p53, inducible cyclooxygenase COX-2). RESULTS: The apoptotic effects of MGly and For were dose and time dependent. GPDs at concentrations detected in TPD induced greater transcription and translation of apoptotic pathway proteins (caspase 9, p53 and COX-2) than GPDs in 3CB. This resulted in a higher apoptotic rate, which was not influenced by addition of sterile glucose. A similar enhancement of apoptosis was detected when mesothelial cells were incubated with TPD, whereas incubation in 3CB PDS resulted in less enhanced apoptosis. The 12 h incubation effect of PDS on cultured mesothelial cells was not related to advanced glycosylated end-product formation. CONCLUSIONS: As the rate of mesothelial cell apoptosis is lower in 3CB than in TPD solutions, the 3CB appears to provide improved biocompatibility.

Adult↗
PubMed1988

Calcium release from isolated sarcoplasmic reticulum due to 4,4'-dithiodipyridine.

The effects of SH reagents on Ca2+ release from sarcoplasmic reticulum (SR) vesicles were examined by the tracer method using 45Ca2+. Among the various SH reagents tested, 4,4'-dithiodipyridine (PDS) was found to induce Ca2+ release most specifically from the heavy fraction of SR vesicles. Further, the following results were obtained. (i) PDS bound covalently to proteins in the SR membrane and induced Ca2+ release. (ii) The Ca2+ release was further enhanced by ATP and caffeine, but inhibited by procaine, ruthenium red and various divalent cations. (iii) PDS enhanced the Ca2+ release in the whole range of Ca2+ concentrations tested. (iv) Choline permeability was also enhanced by PDS. Further, the electrical conductance of the Ca2+-induced Ca2+ release channels was studied by incorporating them into lipid bilayers and it was found that PDS increased the probability of opening of the channels. These results suggest that PDS binds to certain SH groups of the Ca2+-induced Ca2+ release channels in the SR membrane and thus induces Ca2+ release.

Animals↗
PubMed1999

Patient decision support intervention: increased consistency with decision analytic models.

BACKGROUND: Patient Decision Support (PDS) tools assist patients in using medical evidence to make choices consistent that are with their values and in using evidence about consequences of medical alternatives. OBJECTIVE: To evaluate a PDS intervention for perimenopausal hormone replacement therapy. We assessed the impact of the PDS on (1) consistency between the decision to take estrogen replacement therapy (ERT) or progesterone/estrogen replacement therapy (PERT) and the expected utility of treatment and (2) likelihood to take ERT and PERT pre- and postintervention. DESIGN: Content of the PDS was standardized. Randomized trial of three intensities of intervention: (1) brochure; (2) lecture/discussion; and (3) active decision support. SUBJECTS: Participants were perimenopausal community volunteers between the ages of 40 and 65 (n = 248). MEASURES: (1) Consistent with values (correlation between expected utility (EU) and likelihood of taking hormones); and (2) Likelihood to take hormone replacement therapy. RESULTS: (1) The brochure group was less consistent with the decision analytic model than the lecture/discussion and active decision support groups. (2) Influence on decisions: PDS tools increased the number of women certain about whether or not to take hormones. There were no differences among experimental groups. Of 99 women uncertain about ERT pre-PDS, 65% changed. Twenty-one (32%) decided against ERT and 44 (68%) decided for ERT. (3) More intensive interventions produced modest gains in a normative direction. CONCLUSIONS: PDSs using any of 3 formats reduce uncertainty and assist women to make informed decisions. Increased consistency with decision analytic models appears to be driven by better estimates of likelihood of outcomes.

Adult↗
PubMed1999

Iris transillumination defects in the pigment dispersion syndrome as detected with infrared videography: a comparison between a group of blacks and a group of nonblacks.

BACKGROUND: Infrared image analysis has been reported to be the most sensitive method to detect iris transillumination defects (ITDs) associated with the pigment dispersion syndrome (PDS). Although a common sign of PDS in patients with lighter irides, ITDs that are demonstrated with standard slit lamp examination are frequently absent in blacks with the disease. This absence may lead to confusion in diagnosis; therefore improved methods of evaluation could be beneficial. Although infrared image analysis has been investigated in nonblacks, it has not been applied to a group of blacks with the condition. METHODS: Six blacks (11 eyes, all irides brown) with PDS and eight nonblacks (15 eyes, 10 blue irides, 5 brown irides) with PDS underwent analysis. ITDs were searched for with traditional slit lamp examination and with infrared videography. RESULTS: Among the blacks, 2 of 11 eyes (18%) showed ITDs via infrared analysis, a frequency that was significantly lower (p < 0.001) than the frequency exhibited among the nonblacks (100%) when examined with the same technique. Standard slit lamp examination also showed a significantly lower frequency of ITDs among the blacks compared to the nonblacks (p < 0.001). Infrared videography detected ITDs at least one grade higher in 1 of 11 eyes (9%) among the black group and in 7 of the 15 eyes (47%) among the nonblacks. Using the Wilcoxon signed ranks test, the difference in the ability of infrared videography to detect and rank the iris defects in the nonblack PDS group was significantly greater when compared to standard slit lamp examination (p = 0.011), but infrared analysis did not increase detection or change the mean ranking of those in the black group (p = 0.317). CONCLUSION: In this group of patients, infrared videography did not significantly improve the detection and visibility of ITDs in blacks, as it did in the nonblacks. The frequency that ITDs were detected with standard slit lamp examination and with infrared videography was significantly greater in the group of nonblacks compared to the blacks who exhibited PDS.

Adolescent↗
PubMed1993

Teaching skills improvement programmes in US internal medicine residencies.

The prevalence and nature of resident teaching skills improvement programmes (TSIP) are unknown. Although residents perceive themselves as important teachers of students, there is little information on how programme directors (PDs) view residents as teachers. A comprehensive questionnaire was sent to all 428 US internal medicine PDs in December 1990, of which 60% (n = 259) responded. Of the 259 responding programmes, only 20% (n = 51) had TSIPs. Characteristics of TSIPs were not uniform. Mean instructional time was 9 hours (range, 1-24 hours). The teacher most frequently utilized to develop and facilitate the TSIP was the PD. PDs from residencies with a TSIP indicated more strongly than PDs without a TSIP that residents contributed to students' learning. Fifty-one per cent of TSIPs required residents to attend. Evaluation/feedback as a teaching method was the most common topic covered in TSIPs. Long-term assessment of teaching skills after programme participation was done in 15% of TSIPs. Although PDs value the resident's role as teacher, current TSIPs in internal medicine residencies are few in number and lack standardization. PDs' attitudes probably influence whether residents are taught teaching skills and whether teaching skills are evaluated. Further investigation of appropriate curriculum for TSIPs and assessment of long-term effectiveness of TSIPs are needed.

Education, Medical, Undergraduate↗
PubMed2005

Role of duplex Doppler and power Doppler sonography in transplanted kidneys with acute renal parenchymal dysfunction.

The limited work published on the comparison of power Doppler sonography (PDS) and duplex Doppler sonography (DDS) in the assessment of acute renal allograft dysfunction has shown contradictory results. We compared the role of DDS and PDS in renal transplant recipients developing acute renal parenchymal dysfunction and correlated these findings with kidney biopsy, which was taken as the gold standard. Thirty post-renal transplant patients with acute graft dysfunction underwent Doppler sonography, DDS and PDS using an HDI 5000 ATL machine. Patients who developed graft dysfunction as a result of vascular, obstructive or other non-parenchymal causes were excluded. All patients underwent an allograft biopsy within 72 h of the sonography. Based on the biopsy findings, 24 patients were categorized as having acute rejection, and six patients as having no rejection. The overall sensitivity, specificity and accuracy of DDS for evaluation of graft dysfunction were 54.17, 33.33, and 50.00%, respectively, and that for PDS were superior with 87.50, 33.30, and 76.67%, respectively. The low specificity can be partially attributed to the small number of cases without rejection in our study population. We conclude that PDS is superior to DDS in screening patients with acute parenchymal renal dysfunction post-transplant. However, a normal PDS examination does not exclude the presence of acute rejection. Power Doppler sonography is a useful screening test for diagnosing acute rejection but a renal allograft biopsy remains the gold standard for diagnosis of this condition.

Adolescent↗
PubMedDate not supplied

Polydioxanone sternal sutures for prevention of sternal dehiscence.

BACKGROUND: Sternal dehiscence and wound instability are troublesome complications following median sternotomy. Classic sternal approximation with stainless steel wires may not be the ideal approach in patients predisposed to these complications. We tested the efficacy of polydioxanone (PDS) suture in sternal closure and in prevention of complications in comparison to steel wires in high-risk individuals. METHODS: Three hundred sixty-six patients undergoing elective cardiac surgery with full median sternotomy and having body surface area (BSA) less than 1.5 m(2) were randomly assigned to receive PDS (n = 181) or stainless steel (SS, n = 185) sternal approximation. The study was focused on aseptic sternal complications, namely bone dehiscence and superficial wound instability. RESULTS: Both bone dehiscence and superficial wound instability were less frequent in the PDS Group (4 and 3 cases in the SS Group, respectively, vs. no cases in the PDS Group). Cox proportional hazards regression model in the whole study population identified female sex, chronic renal insufficiency, diabetes, advanced age, lower sternal thickness, osteoporosis, corticosteroid therapy, and prolonged CPB or ventilation times as predisposing factors to any of the two studied sternal complications. DISCUSSION: Data suggest that PDS suture can protect against development of aseptic sternal complications following median sternotomy in high-risk patients with little body mass. The adoption of PDS in other subsets of patients, i.e., obese individuals, is to be questioned.

Aged↗
PubMed2005

The role of case mix in the relation of volume and outcome in phacoemulsification.

BACKGROUND/AIM: The authors previously demonstrated a decrease in complication rate with an increase in volume of cases performed by a surgeon. All studies of volume and outcome are potentially hampered by the issue of case mix, in that some lower volume surgeons may in fact do fewer cases because they have more complex patients. This study was designed to assess the influence of case mix on the volume-outcome relation in phacoemulsification surgery that had previously been demonstrated. METHODS: This study took place wholly in Sunderland Eye Infirmary. 667 cases from between 1996 and 2001 were randomly selected from the operative lists of the six surgeons involved in a previous study. The case complexity was assessed using a potential difficulty score (PDS) devised from preoperative data predictive of potential surgical difficulty. The PDS was validated by a retrospective analysis of a sample of 100 cases. RESULTS: 528 complete sets of notes were retrieved. The overall PDS scores ranged from 1 to 6. There was a difference between the proportions of patients with each PDS value (p=0.015) in the two groups, which suggested that the low volume surgeons were doing potentially more difficult cases. The median PDS for each volume group were the same (=1.0). Retrospective validation analysis of the PDS score revealed higher mean and median values in complicated cases compared to uncomplicated cases. CONCLUSION: This follow up study re-emphasises the importance of case mix adjustment in comparative assessment of healthcare quality. These results may explain in part the trend previously demonstrated of lower complication rates for higher volume surgeons.

Chi-Square Distribution↗
PubMed1987

Receptor-mediated internalization and secretion of cholecystokinin into rat pancreatic duct fluid.

We measured cholecystokinin (CCK) in pancreatic duct secretions (PDS) after infusion of different amounts of CCK-8 (the C-terminal octapeptide of cholecystokinin) into rats. Injection of 23, 46, and 92 ng of CCK-8 increased immunoreactive cholecystokinin in PDS by 3-, 13-, and 28-fold above basal levels within 30 min. Continuous intravenous infusion of CCK-8 (50 ng/min) into rats for 30 min, followed by a 30-min rest period, and then a final infusion of peptide for another 30 min increased CCK in PDS only during the final period by 12-fold to 500 pg/30 min. Neither gastrin nor oxidized CCK-8 were detected in PDS after intravenous infusion of each peptide. Administration of proglumide (ip), a CCK receptor antagonist, during continuous CCK infusion significantly reduced immunoreactive CCK levels in PDS to 2% of the control group (P less than or equal to 0.01). CCK was also rapidly internalized into dispersed pancreatic acinar cells in a temperature-dependent fashion, and this process was inhibited by proglumide. The above data suggest that CCK in PDS reflects a peptide-specific process that is receptor mediated. We propose that circulating cholecystokinin binds to specific receptors on pancreatic acinar cells, is internalized, and is then secreted into pancreatic duct fluid.

Animals↗
PubMed2004

The Cl-/HCO3- exchanger pendrin in the rat kidney is regulated in response to chronic alterations in chloride balance.

Pendrin (Pds; Slc26A4) is a new anion exchanger that is believed to mediate apical Cl(-)/HCO(3)(-) exchange in type B and non-A-non-B intercalated cells of the connecting tubule and cortical collecting duct. Recently, it has been proposed that this transporter may be involved in NaCl balance and blood pressure regulation in addition to its participation in the regulation of acid-base status. The purpose of our study was to determine the regulation of Pds protein abundance during chronic changes in chloride balance. Rats were subjected to either NaCl, NH(4)Cl, NaHCO(3), KCl, or KHCO(3) loading for 6 days or to a low-NaCl diet or chronic furosemide administration. Pds protein abundance was estimated by semiquantitative immunoblotting in renal membrane fractions isolated from the cortex of treated and control rats. We observed a consistent inverse relationship between Pds expression and diet-induced changes in chloride excretion independent of the administered cation. Conversely, NaCl depletion induced by furosemide was associated with increased Pds expression. We conclude that Pds expression is specifically regulated in response to changes in chloride balance.

Ammonium Chloride↗
PubMed1990

Epileptiform activity in the hippocampus produced by tetraethylammonium.

1. The epileptiform discharges in the CA3 region of the rat hippocampal slice produced by bath application of the potassium channel blocker tetraethylammonium (TEA) were investigated. The effects of a convulsant (5 mM) and subconvulsant (0.5 mM) concentration of TEA on the mossy fiber-evoked synaptic currents were studied by the use of voltage-clamp techniques to determine whether TEA, like 4-aminopyridine (4-AP), another potassium channel blocker and convulsant, increased both inhibitory and excitatory components of the synaptic response. 2. At extracellular potassium concentrations of 2.5 mM, TEA (5 mM) was found to produce spontaneously occurring epileptiform discharges that could be recorded extracellularly. The intracellular correlate of the epileptiform discharge, the paroxysmal depolarizing shift (PDS), could be reversed in polarity by depolarizing the membrane and was associated with a large increase in membrane conductance. These results suggest that a synaptically mediated potential underlies the generation of the epileptiform discharge. 3. The reversal potential for the PDS was dependent on the time, relative to the extracellularly recorded field discharge, at which the measurement was made. In current clamp the mean reversal potential of the PDS measured at the midpoint of the extracellular discharge was -3.3 +/- 2.9 (SE) mV (n = 9). The reversal potential of the PDS was considerably more negative when measured either before or after the midpoint of the extracellular discharge, suggesting the presence of an inhibitory synaptic component. In voltage clamp similar results were obtained and a large conductance change was found to be associated with the PDS. These results suggest that the synaptic conductance associated with the PDS has both inhibitory and excitatory components. 4. TEA increased significantly the mossy fiber-evoked, early-inhibitory conductance. A convulsant concentration (5 mM) increased the conductance measured 15 ms after the stimulus from 39.7 +/- 8.7 to 87.2 +/- 8.0 nS (n = 6). The reversal potential associated with the conductance depolarized from -68.3 +/- 3.4 to -58.3 +/- 4.0 mV after 5 mM TEA. A subconvulsant concentration of TEA (0.5 mM) also increased the conductance of the mossy fiber-evoked response at 15 ms after the stimulus from 49.5 +/- 3.1 to 63.1 +/- 6.1 nS (n = 4) without an associated shift in reversal potential. 5. The late-inhibitory component of the mossy fiber-evoked response, when present, was increased by 5 mM TEA and unchanged by 0.5 mM TEA. 6. The excitatory mossy fiber-evoked synaptic current was studied in the presence of picrotoxin and was found to be increased and prolonged by 5 mM TEA.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1983

Behaviour of synthetic absorbable sutures with and without synergistic enteric infection.

The behaviour of synthetic absorbable sutures, polyglycolic acid (PGA) and polydioxanone (PDS), has been tested in an experimental guinea pig model utilising synergistic enteric bacteria. Braided PDS gave a wound sepsis rate of 42%, monofilament PDS 36%, and PGA 26%, while sepsis rate in the controls was 30%. The dissolution characteristics of PGA and monofilament PDS appeared to be unaffected by the presence of infection, while that of braided PDS was significantly increased. Braided PDS also showed more rapid dissolution characteristics than PGA.

Animals↗
PubMed1998

Intensive medical therapy versus coronary angioplasty for suppression of myocardial ischemia in survivors of acute myocardial infarction: a prospective, randomized pilot study.

BACKGROUND: Patients who have inducible ischemia after acute myocardial infarction (AMI) generally undergo coronary angiography with the intent to revascularize. Whether this approach is superior to intensive treatment with anti-ischemic medications is unknown. METHODS AND RESULTS: We performed a prospective, randomized pilot study comparing intensive medical therapy with coronary angioplasty (PTCA) for suppression of myocardial ischemia in 44 stable survivors of AMI. Myocardial ischemia was quantified with adenosine 201Tl tomography (SPECT) performed 4.5+/-2.9 days after AMI. All patients at baseline had a large total (>/=20%) and ischemic (>/=10%) left ventricular perfusion defect size (PDS). SPECT was repeated at 43+/-26 days after therapy was optimized. The total stress-induced PDS was comparably reduced with medical therapy (from 38+/-13% to 26+/-16%; P<0.0001) and PTCA (from 35+/-12% to 20+/-16%; P<0.0001). The reduction in ischemic PDS was also similar (P=NS) in both groups. Cardiac events occurred in 7 of 44 patients over 12+/-5 months. Patients who remained clinically stable had a greater reduction in ischemic PDS (-13+/-9%) than those who had a recurrent cardiac event (-5+/-7%; P<0.02). Event-free survival was superior in the 24 patients who had a significant (>/=9%) reduction in PDS (96%) compared with those who did not (65%; P=0.009). CONCLUSIONS: In this small pilot study, intensive medical therapy and PTCA were comparable at suppressing ischemia in stable patients after AMI. Sequential imaging with adenosine SPECT can track changes in PDS after anti-ischemic therapies and thereby predict subsequent outcome. Corroboration of these preliminary findings in a larger cardiac-event trial is warranted.

Adrenergic beta-Antagonists↗
PubMed2003

The evaluation of retinal nerve fiber layer in pigment dispersion syndrome and pigmentary glaucoma using scanning laser polarimetry.

PURPOSE: To measure the retinal nerve fiber layer thickness in patients with pigment dispersion syndrome (PDS) using scanning laser polarimetry and to compare these measurements with those of normal subjects and patients with pigmentary glaucoma (PG). METHODS: Age-, sex-, and refractive error-matched subjects--18 patients with PDS, 18 patients with PG, and 20 healthy subjects--were evaluated by scanning laser polarimetry (Nerve Fiber Analyzer [NFA] GDx). The NFA did not have a compensator for corneal polarization. One randomly selected eye from each patient was included in the statistical analysis. The NFA measurements of patients with PDS and PG and healthy subjects were compared statistically using analysis of variance, Tukey multiple comparisons, chi-square, and independent t-tests. RESULTS: The mean values for average thickness, superior and inferior maximum, superior and inferior average, ellipse average thickness, and superior integral were found to be lower in the patients with PDS (p < 0.02) and PG (p < 0.005) compared to the normal subjects. The mean values for maximum modulation, superior ratio, inferior ratio, and superior/nasal ratio in PDS were in between those of the PG and control groups (p > 0.05). The ellipse modulation was significantly lower in the PG group when compared to the other two groups (p < 0.03). CONCLUSIONS: Retinal nerve fiber loss is present to some extent in patients with PDS and this loss is not age or sex dependent. Parameters of modulation might be more representative of significant damage of the nerve fiber layer.

Adult↗
PubMed1996

The effects of testosterone and dihydrotestosterone on hypothalamic regulation of growth hormone secretion.

Testosterone (T) administration to pubertal boys increases spontaneous GH secretion. It is not known whether this occurs via pituitary or hypothalamic mechanisms. We evaluated the GH secretion of 12 boys, aged 13.67 +/- 0.37 yr (mean +/- SE), diagnosed with constitutional delay in growth and adolescence. The evaluation was made both before and after 3 months of treatment with T or the nonaromatizable androgen, 5 alpha-dihydrotetosterone. Serum for determination of spontaneous GH secretion was sampled every 20 min for 24 h. Pituitary responsiveness was assessed by the administration of GHRH with sampling of GH at intervals for the next 2 h. This was also done with pyridostigmine (PDS) pretreatment to assess the effects of somatostatin. The dose of androgen used was 80 mg/m2 month. All tests were then repeated during treatment. Spontaneous GH secretion was analyzed by the Cluster method. The response to GHRH was measured as the area under the curve. Somatostatin effects were quantified as the difference in responsiveness between the two GHRH tests performed at each admission: one without prior PDS administration and one in which somatostatin was blocked by PDS. Treatment with T increased mean spontaneous GH secretion from 2.25 +/- 0.34 micrograms/L before treatment to 6.77 +/- 0.69 micrograms/L (mean +/- SE; P < 0.001) and mean spontaneous peak height from 5.62 +/- 1.05 to 17.21 +/- 1.52 micrograms/L (mean +/- SE; P < 0.001). No significant differences between pretreatment and treatment evaluations for any spontaneous GH secretory parameters were seen in 5 alpha-dihydrotestosterone-treated patients, except that maximum peak height was decreased after treatment (P < 0.02). In T treated patients, the GHRH stimulation tests without prior PDS administration changed from 84.14 +/- 34.54 total micrograms/L before to 102.3 +/- 35.82 total micrograms/L (mean +/- SE; P = NS) after androgen treatment. PDS pretreatment produced an increase in responsiveness to GHRH over the test without PDS pretreatment. This increase was 127.03 +/- 35.68 total micrograms/L before T treatment; after T treatment, this increase was 78.38 +/- 57.6 total micrograms/L (mean +/- SE; P = NS). T treatment, via an estrogen-dependent mechanism, caused increased GH pulse amplitude, thereby increasing the mean serum GH concentration. This increase was not the result of increased pituitary responsiveness or decreased somatostatin tone. This indicates that T exerted its effect on GH via increased GHRH pulse amplitude.

Adolescent↗
PubMed2001

Anomalous anatomy of speech-language areas in adults with persistent developmental stuttering.

OBJECTIVE: The major aim of this study was to determine whether adults with persistent developmental stuttering (PDS) have anomalous anatomy in cortical speech-language areas. The major postulate was that anomalous cerebral dominance, reflected by anomalous cortical anatomy in various regions, may put an individual at increased risk for the development of stuttering. METHODS: Adults with PDS (n = 16) and controls (n = 16) matched for age, sex, hand preference, and education were studied. Volumetric MRI scans were completed. Frontal (pars triangularis, pars opercularis) and temporo-parietal areas (planum temporale, posterior ascending ramus) were measured in the left and right hemispheres and interhemispheric asymmetries were computed. Gyral variants were assessed within these perisylvian cortical speech-language areas. RESULTS: The right and left planum temporale were significantly larger in the adults with PDS (p = 0.045), and the magnitude of the planar asymmetry was reduced (p = 0.003). Some gyral variants were unique to the adults with PDS, including a second diagonal sulcus and extra gyri along the superior bank of the sylvian fossa. In addition, anatomic subgroups emerged based on sex and hand preference. Overall, the adults with PDS had significantly more gyral variants (mean = 4.19) than controls (mean = 1.31, p < 0.0005). CONCLUSIONS: These results provide strong evidence that adults with PDS have anomalous anatomy in perisylvian speech and language areas. No one anatomic feature distinguished the groups, but multiple loci within a widely distributed neural network differed between groups. These results provide the first evidence that anatomic anomalies within perisylvian speech-language areas may put an individual at risk for the development of stuttering.

Adult↗
PubMed1989

Influence of immunosuppressants against Dirofilaria immitis infection in dogs.

Two immunosuppressive drugs, azathiopurine (AZP) and prednisolone (PDS), were examined on dogs experimentally infected with Dirofilaria immitis in order to estimate the involvement of immunological assail in rejecting the parasite by the host. AZP was orally administered to 3 dogs daily at a dosage of 1-10 mg/kg for a period from 3 days before infection until the end of the experiment. The dose was then varied and transiently ceased according to the severity of the side effects. PDS was subcutaneously administered daily to 2 dogs. They were administered 10 mg/kg of PDS from 3 days before infection to day 15 and 5.0-8.5 mg/kg from day 60 after infection to day 70. The serum D. immitis-specific antibody level assessed by an indirect hemagglutination test was steadily decreased in the AZP-medicated dogs. However, in the PDS-medicated dogs, the antibody titer was decreased until day 32 and, thereafter, was recovered. When all dogs were sacrificed between days 145-148, an average recovery rate of worms in both the AZP- and PDS-medicated dogs was 52.5% and 49.6%, respectively, while the controls showed 42.5%. The statistical analysis revealed no significant difference among the groups, indicating that the administration of AZP and PDS was not effective in protecting the larvae from the host's immune attack.

Animals↗