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Corticotropin-releasing factor receptors 1 and 2 in anxiety and depression.

Corticotropin-releasing factor (CRF) and its related family members are implicated in stress-related disorders such as anxiety and depression. Recently, two new members of this neuropeptide family have been discovered in the brain: urocortin II (also known as stresscopin-related peptide) and urocortin III (also known as stresscopin). These urocortins are selective agonists for the CRF(2) receptor, show a distinct neuroanatomical localization and are involved in stress-coping responses such as anxiolysis. Thus, CRF, the urocortins and their receptors form an intricate network in the brain involved in the acute phase as well as the recovery phase of the stress response.

Animals↗

31P MRS evaluation of fatigue in anterior tibial muscle in postpoliomyelitis patients and healthy volunteers.

Changes in concentration of high energy phosphates and pH were studied during rest, exercise and subsequent recovery in the anterior tibial muscle of 10 patients with late effects of poliomyelitis and 10 age- and sex-matched healthy volunteers using 31P MRS. The exercise was dynamic and isometric, and the force levels were individually adapted to each subject and stepwise increased. In general, there were no differences in metabolite changes between the groups, except for lower Pi and Pi/PCr for the volunteers during the recovery phase, also reflected by shorter recovery half-time for Pi. The interindividual variation was much higher for the patient group. Some of the patients showed deviating results probably because of differences in muscle fibre type.

Adenosine Triphosphate↗

Consequences of Citrobacter rodentium infection on enteroendocrine cells and the enteric nervous system in the mouse colon.

We tested the hypothesis that Citrobacter rodentium infection leads to changes in the mucosal enteroendocrine signalling and the enteric nervous system and that the host's immune response contributes to these changes. Enteroendocrine cells, serotonin (5-HT) reuptake transporter (SERT), 5-HT release, and inducible nitric oxide synthase (iNOS) expression were assessed in the colon of infected wild-type or severe combined immunodeficient (SCID) mice. Immunoreactivity for iNOS and neuropeptides were examined in the submucosal and myenteric plexuses. Mice were orogastrically infected with C. rodentium and experiments were conducted during the injury phase (10 days) and the recovery phase (30 days). 5-HT and somatostatin enteroendocrine cells and SERT were significantly reduced 10 days after infection, with numbers returning to control values at 30 days. 5-HT release was increased at 10 days. Changes to the mucosal serotonin signalling system were not observed in SCID mice. iNOS immunoreactivity was increased in the submucosa and mucosa at 10 days and returned to baseline levels by 30 days. No differences were observed in neuropeptide or iNOS immunoreactivity in the enteric plexuses following infection. The host's immune response underlies changes to enteroendocrine cells, SERT expression and 5-HT release in C. rodentium infection. These changes could contribute to disturbances in gut function arising from enteric infection.

Animals↗

Serum antibodies against gangliosides and Campylobacter jejuni lipopolysaccharides in Miller Fisher syndrome.

Seven patients with Miller Fisher syndrome (MFS), six in the acute phase and one in the recovery phase, were investigated for serum antibodies against gangliosides and purified lipopolysaccharides (LPS) from different strains of Campylobacter jejuni, including the MFS-associated serotypes O:2 and O:23. Immunoglobulin G antibodies against gangliosides GT1a and GQ1b were found in five of six patients in the acute phase of disease. Three of these patients also displayed antibodies to ganglioside GD2, a finding not previously reported for MFS. All anti-GT1a- and anti-GQ1b-seropositive patients showed antibody binding to C. jejuni LPS, predominantly to O:2 and O:23 LPS. Antibody cross-reactivity between gangliosides GT1a and GQ1b and O:2 and O:23 LPS was demonstrated by adsorption studies. This cross-reactivity between gangliosides and C.jejuni LPS, which is obviously due to oligosaccharide homologies, may be an important pathogenetic factor in the development of MFS after C. jejuni infection.

Adult↗

Wrist kinematics during pitching. A preliminary report.

A computerized hand and wrist motion analysis system was modified to capture data at a rate of up to 1000 Hz. Using this system, wrist flexion and extension data were collected on five right-handed professional pitchers (75 pitches). A wrist position versus time graph was generated for each pitch. The pitch data produced a reproducible analysis of motion for the majority of the pitches regardless of pitcher. Based on the graphic display of data points, four phases of wrist motion during a pitch were identified. The first phase is the cocking phase, or the motion of the wrist as it moves into maximum extension. This is then followed by the most explosive phase, the acceleration phase, which represents ball propulsion. At ball release, the wrist progresses through flexion and there is a consistent decrease in wrist velocity, known as the deceleration phase. Finally, there is the recovery phase, or the return of the wrist toward neutral. Average values for wrist range of motion, length of phase, and angular velocity (degrees per second) were calculated for each phase of the pitch. This study represents a major step toward quantifying motion of the wrist during a pitch. The ability to quantify this motion may prove valuable in the assessment of throwing athletes after injury and rehabilitation.

Acceleration↗

[The usefulness of system analysis to reduce the anaesthetic risk (author's transl)].

The attempt is made to increase the safety of anaestesia by the method of categorizing separate risk factors. It is very important to minimize these risk factors, but I do not think this is the way to do it. I propose to tackle this problem by the method of systems analysis. Systems analysis would also result in a certain levelling out of the demands made on both the staff and the equipment of an anesthesiology department and help to build a bridge between us and our industrial supplies. Systems analysis rejects the examination of separate risk factors in order to study the system as a whole and the functional cohesion of the various elements within it. In anesthesia, there are 3 different systems to be studied: the induction phase, the phase of true anesthesia, the recovery phase. The induction phase is discussed in this paper as an example of the thought processes and steps involved in a study by means of systems analysis.

Anesthesia↗

Ventilatory responses and entrainment of breathing during rowing.

The purpose of this investigation was to investigate the hypothesis that respiration was coupled with the mechanics of the rowing stroke. In the first part of the study, physiologic responses during incremental exercise on the variable-resistance rowing ergometer were compared in 16 untrained female subjects (U), 17 collegiate female rowers (C), and 21 elite oarswomen (E). Minute ventilation (VE) and frequency of respiration (fR) were examined on a log scale as their relationship with oxygen consumption (VO2) was exponential. The slopes for log VE/VO2 were similar for collegiate (0.65 +/- 0.02) and elite (0.59 +/- 0.01) rowers, but the slope was significantly higher for the untrained (0.87 +/- 0.01) subjects (P less than 0.001). Elite rowers utilized a higher tidal volume (VT) response per VO2 (0.68 +/- 0.04 vs 0.30 +/- 0.05; P = 0.01) and lower log fR response per VO2 (0.27 +/- 0.02 vs 0.50 +/- 0.03; P = 0.01) compared with collegiate rowers. The ratio of fR/strokes per minute (SPM) averaged 1.5 in E athletes but varied in the U and C groups. In the second part of the study, pattern and timing of respiration were recording using an inspiratory pneumotachygraph, analyzed, and compared with specific phases of the rowing stroke in ten untrained subjects and nine elite rowers. The ratio of inspiratory time (T1)/total respiratory time (TTOT) decreased during the drive phase and increased during the recovery phase in both untrained subjects and elite rowers.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Comparative clinical studies of vecuronium, atracurium and pancuronium].

The new relaxants vecuronium (Norcuron) and atracurium (Tracrium) have been compared with pancuronium (Pavulon) with respect to onset and duration of action and intubating conditions under clinical situations. A variant of the balanced anaesthesia technique with flunitrazepam, fentanyl and N2O/O2 was used. The following doses were considered equipotent (mg/kg body weight): vecuronium 0.07/0.10; atracurium 0.35/0.50; pancuronium 0.08/0.115. The degree of neuromuscular block was assessed in a semiquantitative manner, using the train of four. No difference between the three relaxants in onset of action was found. After the high doses, however, full paralysis developed 60 s earlier. The same is true of intubating conditions. Good or very good intubating conditions were obtained in the majority of cases 3 minutes after injection of the drug. Following the higher dose, good intubating conditions are achieved approximatively 1/2-1 min sooner. Both new relaxants allow for relatively rapid intubation without the inconvenience of a long duration of action. After a low initial dose the following time for recovery to 25% was noted (means +/- S.D., min): vecuronium 20.3 +/- 7.0; atracurium 28.0 +/- 3.1; pancuronium 53.3 +/- 14.8. The early recovery phase (from 5% to 25% recovery) was 6.1 +/- 2.4 after vecuronium, 8.3 +/- 1.7 after atracurium, 17.2 +/- 10.8 after pancuronium. There is a good correlation between our semiquantitative results, using the train of four, and quantitative recordings of muscle contractions reported in the literature. Both drugs show no cumulative effect after five repeated administrations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Objectivity, validity and reliability of determination of recovery times following exhaustion trials in heavy dynamic muscle work from time series of heart rate].

Records of heart rate after 152 experiments with exhaustion of three male subjects were rated by three experts to determine the end of the recovery phase. Inter-rater-reliability of recovery times vary between 0.87-0.97 according to the method of calculation. An algorithm for the identification of the end of recovery is developed by approximation of the expert-ratings. The corresponding rater-reliability of the algorithm is 0.9. A stepwise multiple regression shows, that most of the variance of recovery times is explained by heart rate at the end of the working phase (63.8%) and by the conditions of the rest phase (18.9%), whereas the stress conditions in the working phase, as type (10.6%), level (20%) and duration (0%) of stressors are concerned, have less explanatory value. These results differ from the literature. The differences are discussed with respect to different criteria for "fatigue" and "recovery".

Adult↗

Neuromuscular and cardiovascular effects of atracurium in ponies anesthetized with halothane.

Atracurium besylate, a recently developed, intermediate-duration acting, neuromuscular-blocking agent, was given to 15 halothane-anesthetized ponies to produce surgical relaxation (95% to 99% reduction of hoof twitch). All 15 ponies were given 3 injections; 8 of the 15 ponies were given 2 additional injections. Initial dosage of 0.11 +/- 0.01 mg/kg (mean +/- SD) and all subsequent injections of 0.052 mg/kg produced desired relaxation. Paralysis phase (maximum twitch reduction to 10% twitch recovery) lasted 24 +/- 5 minutes for the initial injection. Paralysis from subsequent injections lasted for a slightly shorter time. Recovery phase (10% to 75% twitch recovery) was similar for all injections (initial and repeated) and lasted approximately 11 minutes. Cardiovascular side effects were not seen. Reversal of effects of atracurium with administration of 0.5 mg of edrophonium/kg was achieved when the evoked digital extensor tension (twitch height) had returned to 95% of base line after the last atracurium injection. Edrophonium caused systolic blood pressure to increase 121% +/- 7% of base-line pressure, which was 133 +/- 18 mm of Hg. Heart rate changed to 93% +/- 9% of base line after edrophonium was given, which was 49 +/- 7 beat/min, but this change did not occur until after the blood pressure increased. Recovery to standing was smooth and strong. Five ponies stood on their first attempt to rise, 5 on the 2nd attempt, 2 on the 3rd, and 1 on the 4th. Seven ponies stood within 30 minutes after transportation to the recovery stall, 7 within an hour.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia↗

Technetium-99 m sestamibi imaging in patients with subacute thyroiditis.

To determine if subacute thyroiditis (SAT) is associated with changes in the regional perfusion of the thyroid gland, we performed Tc-99 m sestamibi scans on eleven patients with SAT who had painful goiter and clinical thyrotoxicosis. Eleven patients had Tc-99 m pertechnetate and Tc-99 m sestamibi scintigraphy during the acute stage of SAT. The thyroid uptake ratio of sestamibi was compared with the laboratory data and color Doppler ultrasonography. Tc-99 m pertechnetate scintigraphy in the thyroid was markedly reduced during the acute stage of SAT. Conversely, Tc-99 m sestamibi showed diffuse increased uptake in the thyroid region, suggesting increased perfusion. On the other hand, there was near absence of vascularization in the acute phase and slight increase in the recovery phase by color Doppler ultrasonography. The clearance rate of Tc-99 m sestamibi during the early phase (from 10 min to 1 h) was decreased in the acute stage of SAT. The sestamibi uptake ratio correlated with serum immunosuppressive acidic protein (IAP) in the acute stage of SAT and the sestamibi uptake ratio in the recovery stage of SAT was correlated with serum thyrotropin levels. Tc-99 m sestamibi uptake in the early phase in the acute stage of SAT may reflect the inflammatory process associated with SAT.

Adult↗

Staphylococcus aureus ClpC is required for stress resistance, aconitase activity, growth recovery, and death.

The ability of Staphylococcus aureus to adapt to various conditions of stress is the result of a complex regulatory response. Previously, it has been demonstrated that Clp homologues are important for a variety of stress conditions, and our laboratory has shown that a clpC homologue was highly expressed in the S. aureus strain DSM20231 during biofilm formation relative to expression in planktonic cells. Persistence and long-term survival are a hallmark of biofilm-associated staphylococcal infections, as cure frequently fails even in the presence of bactericidal antimicrobials. To determine the role of clpC in this context, we performed metabolic, gene expression, and long-term growth and survival analyses of DSM20231 as well as an isogenic clpC allelic-replacement mutant, a sigB mutant, and a clpC sigB double mutant. As expected, the clpC mutant showed increased sensitivity to oxidative and heat stresses. Unanticipated, however, was the reduced expression of the tricarboxylic acid (TCA) cycle gene citB (encoding aconitase), resulting in the loss of aconitase activity and preventing the catabolization of acetate during the stationary phase. clpC inactivation abolished post-stationary-phase recovery but also resulted in significantly enhanced stationary-phase survival compared to that of the wild-type strain. These data demonstrate the critical role of the ClpC ATPase in regulating the TCA cycle and implicate ClpC as being important for recovery from the stationary phase and also for entering the death phase. Understanding the stationary- and post-stationary-phase recovery in S. aureus may have important clinical implications, as little is known about the mechanisms of long-term persistence of chronic S. aureus infections associated with formation of biofilms.

Acetates↗

Multislice and multicoil phase-sensitive inversion-recovery imaging.

Phase-sensitive inversion-recovery (PSIR) imaging may provide enhanced T(1) contrast. However, clinical implementation of PSIR imaging is hindered because image reconstruction with this method often lacks robustness and requires manual intervention, particularly for data acquired in multiple slices and with phased-array coils. In this paper, a new algorithm suitable for automatic PSIR image reconstruction of multislice and multicoil data is presented. This algorithm phase corrects by region-growing, employing both the magnitude and the phase information of image pixels. Specifically, phase gradients of the original complex image are first calculated and then used to determine the sequence of the region-growing. The signal direction relating to the phase error for each pixel is then determined during the region-growing using both the magnitude and the phase of the previously determined pixels that are located within a boxcar neighborhood of the pixel. Finally, the intrinsic intercoil and interslice correlation is exploited to ensure consistency in the global polarity of all of the PSIR images. The results are demonstrated with in vivo human brain images acquired at 3 Tesla with an eight-channel phased-array coil.

Algorithms↗

A Leishmania donovani gene that confers accelerated recovery from stationary phase growth arrest.

We have isolated a gene, LdGF1, from the protozoan parasite Leishmania donovani. Overexpression of this gene confers a strong selective advantage in liquid culture after stationary phase growth arrest. We could show that recombinant L. donovani or Leishmania major, when overexpressing LdGF1, recover faster from a stationary phase growth arrest than control parasite strains. While no advantage of LdGF1 overexpression could be observed in log phase cultures or after a hydroxyurea-induced S-phase growth arrest, recovery from a cell cycle arrest due to serum deprivation was faster in LdGF1-overexpressing strains. This was found to be due to an accelerated release from a G(1) cell cycle arrest. By contrast, in a BALB/c mouse infection system, overexpression of LdGF1 in L. major resulted in reduced virulence. We conclude that increased levels of LdGF1 are beneficiary during recovery from G(1) cell cycle arrest, but pose a disadvantage inside a mammalian host. These results are discussed in the context of the observed loss of virulence during in vitro passage of Leishmania parasites.

Animals↗

[Sevoflurane in obstetric anesthesia].

In obstetrics, general anaesthesia is increasingly being replaced by peridural anaesthesia. The cases where general anaesthesia is still used are those involving increased risk. It is therefore not surprising that, for example, maternal mortality in cases of caesarian section under general anaesthesia has not decreased. Indeed, large-scale statistical analyses in the USA and the UK show an increase in relative risk. For this reason, continuing efforts have to be made to improve obstetric general anaesthesia. Inhalational anaesthetics have an important role to play, as they represent the only acceptable compromise between the dangers of maternal awareness and neonatal depression. We used literature data and our own experience of urgent caesarian sections to investigate whether the new inhalational anaesthetic sevoflurane is suitable for this purpose. In a comparison of sevoflurane and peridural anaesthesia, there was no difference in outcome for the child and the maternal results showed only the expected procedure-specific differences in circulatory parameters and early postoperative analgesia requirement. A second study involving continuous pEEG monitoring (SEF90) showed advantages of sevoflurane over isoflurane in the initial phase of surgery and in the recovery phase. However, the value of sevoflurane in obstetric anaesthesia will have to be confirmed in more extensive studies.

Anesthesia, Epidural↗

Load- and cadence-dependent modulation of somatosensory evoked potentials and Soleus H-reflexes during active leg pedaling in humans.

Modulation of transmission in group I muscle afferent pathways to the somatosensory cortex and those to the alpha-motoneuron were investigated during active leg pedaling. Cerebral somatosensory evoked potentials (SEPs) and Soleus (Sol) H-reflexes following posterior tibial nerve stimulation were recorded at four different pedaling phases. The subjects were asked to perform pedaling at three different cadences (30, 45 and 60 rpm with 0.5 kp, cadence task; C-task) and with three different workloads (at 45 rpm with 0.0, 0.5 and 1.0 kp, load task; L-task). In both C- and L-tasks, Sol H-reflexes were modulated in a phase-dependent manner, showing an increase in the power phase and a decrease in the recovery phase. In contrast, the early SEP (P30-N40) components were modulated in a phase-dependent manner when the cadence and load were low. When focusing on the power phases, significant cadence- and load-dependent modulations of the P30-N40 were found, and inversely graded with the cadence and load. The H-reflex was found to be significantly decreased at the highest cadence, i.e., cadence-dependent modulation. In contrast, the H-reflex during the L-task was found to be proportional to the load. The correlation analysis between the size of H-reflex and the amount of background (BG) electromyographic (EMG) activity demonstrated that the H-reflex in the power phase did not depend on the BG EMG in either C- or L-task. These findings suggested that transmission of muscle afferents along the ascending pathways to the cerebral cortex and the spinal cord is independently controlled in accordance with the biomechanical constraints of active pedaling.

Adult↗

Emotional responding to biological challenge as a function of panic disorder and smoking.

The present investigation evaluated anxious and fearful responding to bodily sensations as a function of panic disorder (PD) and smoking status. Participants completed a voluntary hyperventilation procedure that elicits panic-relevant bodily sensations. Psychophysiological data were collected throughout the study procedures. Assessments of anxiety and bodily distress were conducted pre-challenge baseline, post-hyperventilation, and during a recovery period following the challenge. Results indicated that smokers with PD reported greater levels of anxiety and bodily distress than smokers without PD and than nonsmokers with PD at the post-challenge assessment and recovery period. No differences in autonomic responding were evident during the challenge or in the recovery phase. In terms of rate of recovery, the linear decrease in anxiety, but not bodily distress, was significantly more steep for nonsmokers with PD than for smokers with PD. These findings are discussed in relation to better understanding the potential role that smoking may play in terms of anxious and fearful responding to bodily sensations.

Adult↗

Effect of increased scrotal temperature on sperm production in normal men.

OBJECTIVE: To determine whether application of polyester-lined athletic supports to bring the testes closer to the abdomen increases scrotal temperature and decreases sperm production. DESIGN: Prospective clinical study. SETTING: University academic medical center. PATIENT(S): Twenty-one healthy male volunteers. INTERVENTION(S): The study consisted of a pretreatment period of 6 weeks, a treatment phase of 52 weeks, and a recovery phase until return to normal sperm production. During the treatment phase, the men wore polyester-lined athletic supports (single layer, double layer, or double layer impregnated with aluminum) throughout the day. MAIN OUTCOME MEASURE(S): Semen parameters and sperm function tests. RESULT(S): In all three groups of subjects, scrotal temperature was consistently increased by 0.8 to 1 degree C while the subjects were wearing the athletic supports. Mean sperm concentration; sperm motility, morphology, and viability; sperm hyperactivation; and ability of spermatozoa to penetrate zone-free hamster oocytes were not affected by the increase in scrotal temperature. CONCLUSION(S): The increase in scrotal temperature induced by polyester-lined athletic supports was insufficient to cause significant suppression of spermatogenesis or alteration of sperm function.

Adult↗