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Suriclone enhances the actions of chlorpromazine on human psychomotor performance but not on memory or plasma prolactin in healthy subjects.

Twelve healthy subjects received single oral doses of 0.4 mg suriclone (SU), 7.5 mg zopiclone (ZO) and placebo, alone and together with 50 mg chlorpromazine (CP), double blind and crossover, in Latin square order, at one-week intervals. Performance tests administered before and 1.5, 3.5 and 6 h after drug intake included digit symbol substitution and simulated driving combined in a "Global test", flicker fusion frequency, body balance and memory and subjective assessments. Changes from baseline were examined statistically. Performance and memory data were analysed from only 11 subjects. Compared to placebo, SU minimally affected "global" performance, although it slowed reactions and tended to impair digit substitution. ZO impaired "global" performance at 1.5 h, affected performance in several separate tests, and produced subjective muzziness. CP did not impair "global" performance, although it did impair digit substitution and render the subjects drowsy, weak and dreamy. The combinations SU + CP and ZO + CP definitely impaired "global" performance more than CP alone. This difference was also found in most objective tests but less so in the subjective tests. CP and its combinations produced similar increases in plasma prolactin. Active drugs and their combinations variably lowered blood pressure and increased heart rate, and one subject collapsed after CP. The treatments irregularly impaired spatial memory and learning acquisition. No pharmacokinetic interactions were seen in the plasma levels of suriclone, zopiclone and chlorpromazine. The impairment of performance after these combinations resembles that previously encountered after 2.5 mg lorazepam, or 15 mg diazepam + 100 mg remoxipride.

Adult↗

Clinical and neurobiological findings in children suffering from tic disease following treatment with tiapride.

Tiapride, a substituted benzamide derivative, possesses good clinical antidyskinetic properties due to its DA2-blocking activities. It has been shown to be clinically effective in the treatment of tic disease in children. In order to study tiapride's antidyskinetic properties in the treatment of the tic syndrome in children, we conducted a simple, placebo-controlled study on 10 children followed by a double-blind crossover study on 17 children. Tiapride was shown to have a positive therapeutic effect on tics in children; whereas it has no adverse effects on neuropsychologically measurable cognitive performances in children. Neurophysiological parameters such as the EEG frequency analysis and sensory evoked potentials were not affected by tiapride, nor was the neurosecretory, hypothalamic-hypophyseal regulation of the sex hormones, thyroid stimulating hormone, growth hormone, or thyroid hormone impaired. The hyperprolactinemia caused by tiapride's dopaminergic properties was moderate and restricted to the duration of therapy.

Adolescent↗

Genetic recombination of Xenopus laevis 5 S DNA in bacteria.

The behavior in genetic recombination of Xenopus laevis 5 S DNA has been examined, with particular emphasis on the role of 15-base-pair tandem repeats in the A + T-rich spacer. Fragments of 5 S DNA were introduced into Escherichia coli cells as inserts in the recombination vectors, lambda rva and lambda rvb. Intermolecular recombinants were selected in which, because of properties of the phage vectors, the crossover event must have occurred within the 5 S DNA inserts. Inserts from individual recombinants have been characterized in detail. The effects of varying the number (n) of 15-base-pair repeats and the recombination capabilities of the phage and host have been investigated. In these crosses, unequal crossovers can occur, yielding inserts different in size from the parental inserts. When the number of 15-mers is large (n = 12 or 20), most of the unequal crossovers have occurred within the 15-mers, resulting in an altered n value, although other homologies within the 5 S DNA sequence can also support unequal events. Increasing n in the parental inserts modestly increases the overall frequency of recombination and the percentage of altered inserts. We conclude that, in a bacterial setting, the 15-base-pair repeats stimulate recombination only slightly by allowing alternative registers for heteroduplex formation. The degree of stimulation observed is less than predicted by one simple model.

Animals↗

Endurance testing for evaluation of antianginal therapy with amlodipine, a calcium channel blocking agent.

The utility of using an endurance test as well as a maximal exercise test to assess the effect of amlodipine, a dihydropyridine calcium antagonist, was evaluated in 16 patients with angina pectoris. Amlodipine, 10 mg/day, was compared with placebo in a double blind crossover study. After a 2 week single blind placebo period, patients entered a double blind crossover phase alternating between 4 weeks of placebo and 4 weeks of amlodipine. The two 4 week periods were separated by a 1 week single blind placebo washout period. The efficacy of drug therapy was assessed by frequency of angina, nitroglycerin consumption, peak oxygen consumption during a maximal treadmill exercise test and endurance time during a separate exercise test performed at 70% of the peak work capacity determined before randomization. There was a reduction in angina frequency during the double blind placebo and amlodipine studies (single blind placebo 14 +/- 2 episodes/2 weeks, double blind placebo 7 +/- 2 episodes/2 weeks [p less than 0.005], amlodipine 6 +/- 3 episodes/2 weeks, [p less than 0.005]), whereas nitroglycerin consumption was reduced with amlodipine (single blind placebo 12 +/- 4 tablets/2 weeks, double blind placebo 8 +/- 3 tablets/2 weeks, amlodipine 5 +/- 3 tablets/2 weeks [p less than 0.01]). Amlodipine produced a significant increase in peak oxygen consumption (single blind placebo 18.7 +/- 1.1 ml/kg per min, double blind placebo 18.2 +/- 1.8 ml/kg per min, amlodipine 20.4 +/- 1.6 ml/kg per min [p less than 0.05]) and endurance time (single blind placebo 15.2 +/- 1.5 min, double blind placebo 15.8 +/- 2.1 min, amlodipine 20.2 +/- 2.5 min [p less than 0.005]).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Effect of salbutamol on smoking related cough.

Smokers have an increased prevalence of chronic cough and may complain of exacerbation of cough when attempting smoking cessation. We investigated the use of smokers cough as a model for testing anti-tussive agents. The effect of salbutamol was compared with placebo in healthy adult smokers. In a randomised double blind crossover study the effect of 400 microg salbutamol via MDI plus spacer versus placebo was studied. Cough was assessed before and after the first cigarette of the day (received at 20 minutes) and throughout the day. Cough frequency, citric acid cough challenge, change in cough symptoms and peak flow were recorded. Salbutamol reduced the mean cough frequency between 0 and 20 min. A mean of 4.5 compared to 6 on placebo (p<0.05). A significant reduction in cough followed cigarette consumption in those on placebo. Mean pre-cigarette 6 compared to 3.9 post-cigarette (p<0.02). The citric acid concentration causing two coughs (C2) at 60 min increased on salbutamol. Geometric mean 278.8 compared to 190.4 mM on placebo (p<0.03). Cough frequency is reduced in smokers following a cigarette. The reduction in cough frequency and evoked cough after salbutamol suggests that beta agonists have modest activity in smoking related cough and that smokers cough represents a sensitive model to test anti-tussive activity.

Adult↗

Effects of propafenone and 5-hydroxy-propafenone on hKv1.5 channels.

1. The goal of this study was to analyse the effects of propafenone and its major metabolite, 5-hydroxy-propafenone, on a human cardiac K+ channel (hKv1.5) stably expressed in Ltk- cells and using the whole-cell configuration of the patch-clamp technique. 2. Propafenone and 5-hydroxy-propafenone inhibited in a concentration-dependent manner the hKv1.5 current with K(D) values of 4.4+/-0.3 microM and 9.2+/-1.6 microM, respectively. 3. Block induced by both drugs was voltage-dependent consistent with a value of electrical distance (referenced to the cytoplasmic side) of 0.17+/-0.55 (n=10) and 0.16+/-0.81 (n=16). 4. The apparent association (k) and dissociation (l) rate constants for propafenone were (8.9+/-0.9) x 10(6) M(-1) s(-1) and 39.5+/-4.2 s(-1), respectively. For 5-hydroxy-propafenone these values averaged (2.3+/-0.3) x 10(6) M(-1) s(-1) and 21.4+/-3.1 s(-1), respectively. 5. Both drugs reduced the tail current amplitude recorded at -40 mV after 250 ms depolarizing pulses to +60 mV, and slowed the deactivation time course resulting in a 'crossover' phenomenon when the tail currents recorded under control conditions and in the presence of each drug were superimposed. 6. Both compounds induced a small but statistically significant use-dependent block when trains of depolarizations at frequencies between 0.5 and 3 Hz were applied. 7. These results indicate that propafenone and its metabolite block hKv1.5 channels in a concentration-, voltage-, time- and use-dependent manner and the concentrations needed to observe these effects are in the therapeutical range.

Adrenergic beta-Antagonists↗

The laxative effects of lactulose in normal and constipated subjects.

We compared lactulose syrup to a placebo (5% sucrose syrup) in 42 normal and 24 chronically constipated volunteers. The study in normal subjects was double-blind and had a crossover design of two dose levels, 30 and 60 ml/day, whereas the study in constipated subjects was a double-blind parallel study of 60 ml/day dose. Lactulose syrup produced clinically and statistically significant increases in the frequency, weight, volume, and water content of stools and produced stools of softer consistency compared to baseline values, as well as to a sucrose-treated control group in both normal and constipated subjects. The study in normals suggests that the laxative effects are dose-related. Adverse effects reported were tolerable and were extensions of the pharmacologic effects of the drug. We concluded that lactulose is an effective laxative that affects the character of the colonic fecal content, thereby inducing evacuation of feces in people with constipation.

Adolescent↗

Multiphoton transitions between energy levels in a current-biased Josephson tunnel junction.

The escape of a current-biased Josephson tunnel junction from the zero-voltage state in the presence of weak microwave radiation is investigated experimentally at low temperatures. The measurements of the junction switching current distribution indicate the macroscopic quantum tunneling of the phase below a crossover temperature of T small star, filled approximately 280 mK. At temperatures below T small star, filled we observe both single-photon and multiphoton transitions between the junction energy levels by applying microwave radiation in the frequency range between 10 and 38 GHz to the junction. These observations reflect the anharmonicity of the junction potential containing only a small number of levels.

Journal Article↗

The differential effects of halothane and isoflurane on electroencephalographic responses to electrical microstimulation of the reticular formation.

Isoflurane and halothane cause electroencephalographic (EEG) depression and neuronal depression in the reticular formation, a site critical to consciousness. We hypothesized that isoflurane, more than halothane, would depress EEG activation elicited by electrical microstimulation of the reticular formation. Rats were anesthetized with either halothane or isoflurane and stimulating electrodes were positioned in the reticular formation. In a crossover design, anesthetic concentration was adjusted to 0.8 and 1.2 minimum alveolar concentration (MAC) of halothane or isoflurane and electrical microstimulation was performed and the EEG responses were recorded. Microstimulation increased the spectral edge and median edge frequencies 2-2.5 Hz at 0.8 MAC for halothane and isoflurane and 1.2 MAC halothane. At 1.2 MAC isoflurane, burst suppression occurred and microstimulation decreased the period of isoelectricity (24% +/- 19% to 8% +/- 7%; P < 0.05), whereas the spectral edge and median edge frequencies were unchanged. At anesthetic concentrations required to produce immobility, the cortex remains responsive to electrical microstimulation of the reticular formation, although the EEG response is depressed in the transition from 0.8 to 1.2 MAC. These data indicate that cortical neurons remain responsive to synaptic input during isoflurane and halothane anesthesia.

Anesthetics, Inhalation↗

Influence of frequent sugar intakes on experimental gingivitis.

Few studies have investigated directly the possible role of dietary sugar in the etiology of periodontal disease, although an association between the amount of plaque formed and the frequency of sugar intake has been demonstrated. The purpose of this study was to examine the influence of frequent sugar intakes on experimental gingivitis in young adults. Twenty male dental students took part in a single blind crossover study which involved two 3-week experimental periods with random allocation to high or low sugar diets. The experimental site was the lower anterior area. The labial aspects of the lower anterior teeth were examined at baseline and Weeks 1, 2 and 3. Inflammation was assessed by recording bleeding on probing at 12 sites at 2 levels of severity--"pin prick" and "excess." In addition gingival crevicular fluid flow was recorded and plaque amount was assessed. At 3 weeks significantly higher bleeding scores at the two designated levels were found with the high sugar diet but no significant differences were observed with crevicular fluid flow and plaque amount. It was concluded that frequent sugar intakes result in increased gingival inflammation in experimental gingivitis, as measured by gingival bleeding on probing.

Adult↗

[Moderate rise of transaminases in asymptomatic patients. An etiologic approach from the primary care viewpoint].

OBJECTIVE: To discover the frequency of presentation, the aetiological distribution and clinical importance of a moderate rise in transaminases, which were found by chance in patients free from hepatic symptomology who were attending primary care clinics. DESIGN: Descriptive study of a crossover type. SETTING: La Victoria Health Centre in Valladolid. PATIENTS: The patients attended at any of the six general medical clinics between january and june 1993, in whom a moderate rise in transaminases was detected by chance and confirmed after a one-month interval. MEASUREMENTS AND MAIN RESULTS: Hepatic function tests were performed on 1,285 patients, in 212 of whom biochemical function was found to be disturbed. 137 of these 212 were studied in line with a diagnostic procedure worked out in collaboration with the Area specialist, after 75 had been eliminated for various reasons. The following aetiological distribution was observed: Viral 37.2% (Anti VHC + 30.7%, Ag HBs + 6.5%), ethylic 35.03%, metabolic 15.32% and medicinal 8.77%. Hemochromatosis was diagnosed in 2 patients; and a possible aetiology could not be established in 3. It was possible to perform a biopsy on 11 patients, with the suspected aetiology being confirmed in all of them. CONCLUSIONS: The likelihood of the primary care doctor correctly diagnosing hepatic illnesses is high, given that we could establish an aetiology in 97% of cases. The most common aetiologies were viral and ethylic.

Adult↗

Critical exponent crossovers in escape near a bifurcation point.

In periodically driven systems, near a bifurcation (critical) point the period-averaged escape rate Wmacr; scales with the field amplitude A as |ln(Wmacr;| proportional, variant (A(c)-A)(xi), where A(c) is a critical amplitude. We find three scaling regions. With increasing field frequency or decreasing |A(c)-A|, the critical exponent xi changes from xi=3/2 for a stationary system to a dynamical value xi=2 and then again to xi=3/2. Monte Carlo simulations agree with the scaling theory.

Journal Article↗

[Heterogeneity in breakpoint location of duplication in Japanese Charcot-Marie-Tooth disease type 1A].

The crossover breakpoints for CMT1A are located in the CMT1A-REP repeat flanking a 1.5 Mb region of chromosome 17p11.2-12. We analysed the relationship between the breakpoint locations and clinical phenotypes in 21 Japanese patients with CMT1A duplication. The CMT1A-REP region was divided in 5 regions, A, B, C, D and E, based on restriction site differences between the proximal and distal CMT1A-REP repeats (Kiyosawa et al., HMG, 1995). The breakpoint location within the CMT1A-REP was heterogeneous, the frequency distribution of which was hightest in the B/C region and similar to that in Caucasian patients. The clinical phenotypes, such as foot deformity, muscular weakness and atrophy, sensory impairment and electrophysiologic finding, were extensively variable among the CMT1A patients with PMP22 gene duplication. The location of breakpoints was not related to the clinical phenotypes, suggesting that there is a factor other than the location of the crossover breakpoint, which influences phenotypic manifestation of CMT1A.

Adult↗

Microsatellite marker analysis of an anther-derived potato family: skewed segregation and gene-centromere mapping.

Segregation patterns of polymorphic simple sequence repeat (SSR) primer pairs were investigated in monoploid potato families derived from anther culture. A total of 14 primers developed from the sequences in the database, as well as from a genomic library of potato, was used. Distorted segregation was observed for seven (50%) polymorphic loci among monoploids derived from an interspecific hybrid. Similar distortion was observed for only one of five loci that could be contrasted between the two monoploid families. Segregation distortion was less common in the sexually derived backcross population between the interspecific hybrid and either of its parents. One locus could be putatively linked to a lethal allele because it showed distorted segregation in both monoploid families, a group of 70 heterozygous diploids derived from unreduced gametes through anther culture, and a backcross population. These diploids were used to map the polymorphic SSR markers with respect to the centromeres using half-tetrad analysis. The majority of the SSR loci mapped more than 33 cM from the centromere, suggesting the occurrence of a single crossover per chromosome arm.

Alleles↗

Prospective, randomized comparison of high-frequency oscillation and conventional ventilation in candidates for extracorporeal membrane oxygenation.

OBJECTIVE: To compare the safety and efficacy of high-frequency oscillation (HFO) with conventional ventilation in the treatment of neonates with respiratory failure. DESIGN: We conducted a multicenter, prospective, randomized trial. Patients were stratified according to pulmonary diagnosis and then were randomly selected for conventional ventilation or HFO. A balanced crossover design offered patients who met criteria of treatment failure a trial of the alternative mode of ventilation. SETTING: Four tertiary, level 3 neonatal intensive care units accepting regional referrals for extracorporeal membrane oxygenation. PATIENTS: Neonates were eligible for enrollment if their gestational age was > 34 weeks, their birth weight was > or = 2 kg, they were < 14 days of age, they required fractional inspired oxygen > 0.50 and a mean airway pressure > 0.98 kPa (10 cm H2O) to support adequate oxygenation, and they required a peak inspiratory pressure > 2.9 kPa (30 cm H2O) and a rate > 40 breaths per minute to support adequate ventilation. Exclusion criteria were lethal congenital anomalies, profound shock, need for cardiopulmonary resuscitation, and failure to obtain consent. MAIN RESULTS: Of 79 patients studied, 40 were assigned to conventional ventilation and 39 to HFO. Neonates randomly assigned to HFO required higher peak pressure (3.8 +/- 0.5 vs 3.3 +/- 0.8 kPa, 39 +/- 5 vs 34 +/- 8 cm H2O; p = 0.004) and more often met extracorporeal membrane oxygenation criteria (67% vs 40%; p = 0.03) at study entry than did those given conventional ventilation. Twenty-four patients (60%) assigned to conventional ventilation met treatment failure criteria compared with 17 (44%) of those assigned to HFO (not significant). Of the 24 patients in whom conventional ventilation failed, 15 (63%) responded to HFO; 4 (23%) of the 17 in whom HFO failed responded to conventional ventilation (p = 0.03). There were no differences between the two groups with respect to outcome, need for extracorporeal membrane oxygenation, or complications. CONCLUSIONS: We conclude that HFO is a safe and effective rescue technique in the treatment of neonates with respiratory failure in whom conventional ventilation fails.

Extracorporeal Membrane Oxygenation↗

Moderate therapeutic efficacy of positron emission tomography-navigated repetitive transcranial magnetic stimulation for chronic tinnitus: a randomised, controlled pilot study.

BACKGROUND: Tinnitus has been shown to respond to modulations of cortical activity by high-frequency and low-frequency repetitive transcranial magnetic stimulation (rTMS). OBJECTIVE: To determine the tinnitus-attenuating effects of a 2-week daily regimen of rTMS, navigated to the maximum of tinnitus-related increase in regional cerebral blood flow. METHODS: Six patients with chronic tinnitus were enrolled in this sham-controlled crossover study and treated with 2x2 weeks of suprathreshold 1 Hz rTMS (30 min) applied to the region with maximal tinnitus-related increase in regional cerebral blood flow delineated by functional imaging with [15O]H2O positron emission tomography and a control area. Tinnitus-related distress was assessed before and after each treatment and 2 weeks after the end of the 4-week course of stimulation using a validated tinnitus questionnaire. Additional self-assessment scores of tinnitus change, loudness and annoyance were obtained. RESULTS: In five of six patients, rTMS induced greater reduction of the tinnitus questionnaire score than sham stimulation. In two patients, all parameters measured (tinnitus change score, tinnitus loudness, tinnitus annoyance) showed unequivocal improvement. At the group level, the degree of response in the tinnitus questionnaire score was correlated with tinnitus-associated activation of the anterior cingulate cortex. Two weeks after the final stimulation, tinnitus had returned to baseline in all patients but one. CONCLUSION: Tinnitus can be attenuated by low-frequency rTMS navigated to each person's maximum tinnitus-related cortical hyperactivity. The effects are only moderate; interindividual responsiveness varies and the attenuation seems to wear off within 2 weeks after the last stimulation session. Notably, tinnitus-related anterior cingulate cortex activation seems to predict the response to rTMS treatment.

Aged↗

The relative antihistaminic and psychomotor effects of hydroxyzine and cetirizine.

Twelve healthy subjects with atopy received single doses of hydroxyzine, 25 mg, its metabolite cetirizine, 10 and 20 mg, and placebo in a four-way crossover study randomized by Latin square design. Skin wheal response to histamine, psychomotor effects, and serum concentrations of each drug were measured for 36 hours after each dose. Central nervous system (CNS) effects were measured with critical flicker frequency, Stroop word testing, and visual analog scales. All three active treatments (cetirizine, 10 mg, cetirizine, 20 mg, and hydroxyzine) produced an equivalent suppression of skin wheal response to histamine that was significantly greater than placebo (P less than 0.01). Hydroxyzine produced a significant change compared with placebo in all three CNS parameters. Neither cetirizine, 10 mg, nor cetirizine, 20 mg, produced any significant change in CNS parameters. Both the intensity and time course of CNS effects were related significantly (P less than 0.05) to hydroxyzine concentrations. The CNS changes measured after oral hydroxyzine are the result of the parent drug, whereas its metabolite cetirizine when administered alone produced significant antihistaminic effects without CNS changes.

Adult↗

A randomized double-blind placebo-controlled crossover trial of the efficacy of L-arginine in the treatment of interstitial cystitis.

OBJECTIVES: To determine, in a double-blind placebo-controlled crossover study, whether L-arginine improves the symptoms of interstitial cystitis (IC), a chronic condition in which nitric oxide (NO) may be important, as previous open pilot studies suggested that L-arginine reduced the pain and frequency associated with IC. PATIENTS AND METHODS: Patients fulfilling the standard diagnostic criteria for IC were randomized to receive L-arginine (2.4 g/day) or placebo for one month. After a 2-week 'washout' period they received the other medication. Patients were assessed at each stage using a validated symptom index, a voiding diary, urine analysis and records of adverse events. Patients were asked about overall efficacy at the close of the study. The results were compared using a t-test, with significance indicated at P<0.05. RESULTS: Sixteen (16) patients (mean age 51.3 years) were enrolled; the mean duration of IC was 5.4 years, the IC symptom index score 29.1, their nocturnal frequency 3.5 (voided volume 182 mL) and daytime frequency 12.7 (124 mL). Patients on placebo showed no differences in any recorded variable over the baseline values. L-arginine caused a statistically significant reduction in the overall symptom score of 2.2 over baseline, but there was no difference in voided volume, frequency or nocturia. As there was no significant difference for any variable between L-arginine and placebo, this reduction in score should be regarded with caution. Three patients withdrew because of side-effects (severe headaches, night sweats and flushing). CONCLUSION: Oral L-arginine produces a statistically significant improvement in the IC symptom index in patients with IC, but the effect is small. This effect may not be clinically significant as there were no improvements in the other variables assessed and no significant difference between the response to L-arginine and placebo. From these results the use of L-arginine cannot be recommended for treating IC.

Adult↗