Age-matched Normal Subjects Research Articles

Oxidative stress in urogenital tuberculosis patients: a predisposing factor for renal stone formation—amelioration by vitamin E supplementation

Background Previous studies have shown that urogenital tuberculosis (GuTb) patients treated or untreated with regular anti-Tb regimen excrete comparatively high levels of urinary stone forming constituents than normal subjects. Enhanced oxidative stress is also considered as a prime factor that accelerates urolithiasis. The present study was aimed to determine antioxidant status and lipid peroxidation of these individuals in order to assess their risk for kidney stone formation. Methods GuTb patients and age-matched normal subjects were divided into four groups: I: normal subjects ( n=60), II: GuTb patients a day before treatment ( n=72), III: GuTb patients after treatment with isoniazid (300 mg), rifampicin (450 mg) and pyrazinamide (1.5 g) per day for 60 days ( n=42), and IV: GuTb patients supplemented with vitamin E (200 mg/day) along with regular chemotherapy for 60 days ( n=30). Blood was collected and tested for various markers of oxidative stress. Results Increased levels of lipid peroxidation, protein carbonyls (PCO), advanced oxidative protein products (AOPP) and reduced antioxidant defenses by impairment in enzyme activities like superoxide dismutase, catalase, glutathione peroxidase, reduced glutathione and decreased plasma concentrations of non enzymatic antioxidants like vitamins C and E were observed in the treated and untreated GuTb patients. Conclusions These biochemical disparities may lead to membrane disintegrity, which is favorable for retention of mirolithis. Advocation of vitamin E enhanced the antioxidant status of the plasma, thereby preventing membrane injury, consequently reducing the risk of stone formation in urogenital tuberculosis patients, who were treated with their routine anti-tuberculosis drug regimen.

Clinical correlation of brain MRI and MRS abnormalities in patients with Wilson disease.

The progression of Wilson disease (WD), a disorder of copper metabolism, can be arrested by chelation therapy. However, neurologic deficits may persist despite adequate treatment. MRI is used to assess patients with WD, but previous attempts to correlate clinical progression with the investigation findings have often been unsuccessful. To identify MR visible markers that could help stratify disease severity and to clarify the mechanism of persistent neurologic deficit after treatment. MRI and proton MR spectroscopy (1H-MRS) were performed in 17 patients with WD. MRI was assessed semiquantitatively and used to locate volumes of interest (voxels) in the striatum for 1H-MRS. MRI showed abnormalities predominantly confined to those patients with neurologic features of WD. The 1H spectra demonstrated a reduction of N-acetylaspartate and N-acetylaspartylglutamate (2.05 mM; p < 0.01) in those patients with neurologic features but not in patients without clinical neurologic involvement (0.42 mM; p > 0.1) in comparison with age-matched normal control subjects. Choline was also reduced in both patient groups (0.08 mM; p < 0.01) compared with age-matched controls. There may be a biochemical correlate of tissue-specific dysfunction in patients with Wilson disease who develop neurologic features. These changes appear to be present despite prior clinical improvement and may imply a need for additional treatment.

Unbiased scarpa’s ganglion neuronal count using stereology in ototoxicity

Objectives: To obtain unbiased stereologic estimates of the vestibular ganglion neuronal number from 7 subjects with a history of gentamicin (n = 3) and streptomycin (n = 4) aminoglycoside ototoxicity, and compare the results with those from normative age-matched controls. Methods: Specimens from the archival temporal bone collection from subjects with a history of aminoglycoside toxicity were used. Normative age-matched controls were used. Estimates were obtained using the optical fractionator unbiased stereologic technique. The group means were compared using unpaired, 2-tailed student t test. Significance was set at 0.05. Results: The average total number of vestibular ganglion neurons in the aminoglycoside group was 20,733 (CV = 0.073). The average total number of vestibular ganglion neurons in the age-matched normal subjects was 24,902 (CV = 0.109). The vestibular ganglion neuronal count was significantly reduced in the aminoglycoside group ( P = 0.0039). Conclusion: This study uses an unbiased stereologic technique to demonstrate a significant decline in the number of vestibular ganglion neurons in patients with a documented history of streptomycin and gentamicin ototoxicity. The decline may be secondary to deafferentation or to a direct effect of aminoglycosides on the ganglion.

Retinal venous pulsation in glaucoma and glaucoma suspects

Purpose To determine whether changes in central retinal vein pulsation characteristics occur in glaucoma, and how these are related to indices of glaucoma severity. Design A large, consecutive, prospective, case-controlled study. Participants Ninety-four consecutive glaucoma patients and 105 glaucoma suspects seen in a tertiary referral clinic were examined. Forty-one age-matched normal subjects also were examined. Methods The presence or absence of spontaneous venous pulsation was observed in these 3 groups. The ophthalmodynamometric force (ODF) required to induce venous pulsation at the optic disc was measured in those without spontaneous pulsation. Optic disc photographs were obtained and visual field testing was performed for all subjects. Main outcome measures The prevalence of spontaneous venous pulsation between these 3 groups was compared. The relationship between ODF and visual field mean deviation, neuroretinal rim area, age, intraocular pressure (IOP), gender, and diagnosis of glaucoma was investigated using linear mixed models fitted by Gibb's sampling. Results Significantly fewer (chi-square, 27.7; P<0.001) glaucoma patients (54%) were observed to have spontaneous venous pulsation than suspects (75%) or normals (98%). A worse visual field mean deviation was shown to be the most significant predictor of a higher ODF ( P<0.000), with younger age ( P<0.000) also predictive of a higher ODF. A strong relationship between ODF and mean deviation was found in the glaucoma patients ( r = 0.59; n = 52; P<0.001). Conclusions Spontaneous venous pulsation is less common in glaucoma. The ODF required to induce venous pulsation is increased in glaucoma, and this ODF is greater in those with more severe field loss.

Dendritic Cells from Chronic Lymphocytic Leukemia Patients Are Normal Regardless of Ig V Gene Mutation Status

Patients with B-type chronic lymphocytic leukemia (B-CLL) segregate into 2 subgroups based on the mutational status of the immunoglobulin (Ig) V genes and the patients in these subgroups follow very different clinical courses. To examine whether dendritic cells (DCs) generated from CLL patients can be candidates for immune therapy, we compared the phenotypic and functional capacities of DCs generated from patients of the 2 CLL subgroups (normal age-matched subjects [normal-DCs]). Our data show that immature DCs from B-CLL patients (B-CLL-DCs) have the same capacity to take up antigen as those from normal controls. Furthermore, B-CLL-DCs generated from the 2 CLL subgroups up-regulated MHC-II, CD80, CD86, CD83, CD40, and CD54 and down-regulated CD206 in response to stimulation with a cocktail of cytokines (CyC) and secreted increased levels of tumor necrosis factor alpha, interleukin (IL)-8, IL-6, IL-12 (p70), and RANTES in a manner typical of mature normal-DCs. Interestingly, CD54 was significantly more up-regulated by CyC in B-CLL-DCs compared with normal-DCs. Except for CD54, no significant differences in surface molecule expression were observed between normal-DCs and B-CLL-DCs. B-CLL-DCs from both subgroups, including 6 patients with VH1-69, that usually fare poorly, presented tetanus toxoid to autologous T cells in vitro similar to normal- DCs. Our data show that DCs generated from the B-CLL subgroup with unmutated Ig V genes are functionally normal. These results are very promising for the use of DCs from patients with poor prognosis for immunotherapy.

Evaluation of a satisfied bilateral scleral expansion band patient

Purpose: To measure accommodation subjectively and objectively in a satisfied bilateral scleral expansion band patient. Setting: University of Houston, College of Optometry, Houston, Texas, USA. Methods: One bilateral scleral expansion patient (age 50 years), 9 age-matched normal presbyopic control subjects (age range 48 to 52 years), and 1 normal control subject (age 27 years) participated. The scleral expansion patient had a complete eye examination, corneal topography, and wavefront measurements 19 months postoperatively. Accommodation was measured subjectively with the push-up technique, minus to blur, and dioptric range of clear vision. Accommodation was determined objectively by measuring the accommodative responses to negative lenses and pilocarpine 6% with a Hartinger coincidence refractometer and to real targets with a dynamic infrared optometer. Results: Distance and near acuity of 20/20 was achieved with +1.00 diopter (D) in the left eye, +0.50 D in the right eye, and a near add of +2.25 D. Corneal topography and ocular aberration measurements revealed no suggestion of optical multifocality. Subjective measurements resulted in accommodative amplitudes of 1.50 to 4.00 D, and objective measurements resulted in amplitudes of 0.25 to 1.33 D. The PowerRefractor showed an accommodative response of 0.50 D to stimuli of 1.00 to 4.00 D and strong pupillary constriction with accommodative effort compared with the control. Conclusions: No increase in accommodative amplitude above normal age-matched controls was found. Patient satisfaction may have come from the high expectations this patient had for a positive surgery outcome.

Quantitative assessment of structural damage in eyes with localized visual field abnormalities

Purpose To evaluate the pattern of structural damage in the macula and peripapillary retinal nerve fiber layer (RNFL) using optical coherence tomography (OCT) and scanning laser polarimetry (SLP-VCC) in glaucomatous eyes with localized visual field defects. Design Prospective, cross-sectional analysis. Methods Complete examination, automated achromatic perimetry (AAP), Stratus OCT imaging (512 A-scans) of the peripapillary retina and macula, and SLP-VCC imaging of the peripapillary RNFL were performed. Thickness values in the retinal segments associated with the visual field defect (glaucomatous segments) were compared with corresponding segments across the horizontal raphe (nonglaucomatous segments) and age-matched normal controls. Results Forty eyes of 40 patients (20 normal, 20 glaucomatous) were enrolled (mean age, 71 ± 10 years; range, 50 to 89). Mean RNFL thickness using SLP-VCC and OCT in the nonglaucomatous segments of glaucomatous eyes (54.0 ± 9.7 μm, 64.7 ± 19.0 μm) were significantly ( P = .009, <0.0001) reduced compared with the thickness measurements in the corresponding segments of age-matched normal subjects (62.5 ± 9.2 μm, 105.6 ± 19.0 μm) respectively. No significant ( P = .4) differences in the macular thickness measurements were observed between nonglaucomatous (239.0 ± 19.4 μm) and normal segments (243.5 ± 15.0 μm). Compared with age-matched controls, RNFL thickness in the nonglaucomatous segment was abnormal in 15 of 20 patients (75%) with SLP-VCC and in 18 of 20 patients (90%) with OCT. Macular thickness in the nonglaucomatous segment was abnormal in 11 of 20 patients (55%). Conclusions Diffuse RNFL and retinal ganglion cell loss is present in eyes with localized visual field abnormalities. Detection of localized changes in macular thickness is limited by measurement overlap among normal and glaucomatous eyes.

Computerized recognition of Alzheimer disease-EEG using genetic algorithms and neural network

We propose an automatic recognition method of Alzheimer's disease (AD) with single channel EEG recording using combined the genetic algorithms (GA) and the artificial neural network (ANN). Five min of the resting spontaneous EEG and the ERP in an auditory oddball task were recorded at P4 site in 16 early AD patients and 16 age-matched normal subjects. EEG and ERP were analyzed to compute their 28 statistical and 2 nonlinear features as well as 88 spectral features and 10 ERP features, to make a feature pool for each 30-s segment of the recording data. The combined GA/ANN was applied to find the minimal set of the dominant features from the feature pool that are most efficient to classify into two groups automatically. The effective 35 features were found and used as inputs of the artificial neural network. The recognition rate of ANN fed by these input was 81.9% for untrained data set. These results suggest that the combined GA/ANN approach may be useful for early detection of AD and that single channel EEG data might be enough to recognize AD. This approach could be extended to a reliable classification system using EEG recording that can discriminate between groups.

Plasma aldosterone concentration in the patient with diabetes mellitus Rapid Communication

Vascular injury at the microvascular and macrovascular levels plays a crucial role in the patient with diabetes mellitus. Evidence for renin-system activation in many patients with type 1 diabetes mellitus has raised the possibility that aldosterone-widely recognized as a contributor to vascular injury-could play a role. We examined the state of the renin-angiotensin-aldosterone system (RAAS) in 58 subjects with type 1 diabetes mellitus and 64 age-matched normal control subjects. All studies were performed on a fixed sodium (200 mmol/day) and potassium (100 mmol/day intake), and samples were drawn at 8:00 a.m. to avoid the influence of circadian rhythms. The patient with diabetes mellitus showed an increase in plasma renin activity (PRA) (P < 0.01), plasma angiotensin II concentration (P < 0.01), and plasma aldosterone concentration (P < 0.001). A striking influence of the angiotensin receptor blocker, candesartan, on plasma aldosterone concentration in the patients with diabetes mellitus suggested strongly that renin-system activation is responsible for the elevated plasma aldosterone concentration. Pharmacologic interruption of the effects of aldosterone at the tissue level could be especially useful in patients with diabetes mellitus. The dose of agents that block the renin-angiotensin system (RAS) should be adjusted to maximize the fall in plasma aldosterone concentration.

Physiological Comparison between Female University Ballet and Modern Dance Students

Generally, dance is an activity in which performers desire lower body weights in order to increase their ability to perform or to enhance their aesthetic appeal. Modern, or contemporary dance, requires far more movement of the upper body and more floor work than ballet. Since both forms of dance have apparent differences in training regimes, it was thought that there might be differences in some physiological factors that might ultimately influence the overall health of these athletes. Therefore, this study compared the aerobic capacity, body composition, and bone mineral density of female university ballet and modern dancers. Seventeen university dance students volunteered to participate in the study, ten ballet dancers, and seven modern dancers. Maximal aerobic capacity was assessed on a treadmill using the Bruce protocol, while total and regional body composition and bone mineral densities (total, hip, and spine) were measured by dual energy x-ray absorptiometry (DEXA, Lunar DPX-IQ). There were no statistically significant differences between the two groups of dancers for any of the measured physiological parameters. The VO2max of the ballet dancers was 40.8 ±1.6 ml·kg-1·min-1 compared to the modern dancers 39.2 ±1.9 ml·kg-1·min-1. Total body fat of the ballet dancers was 19.8 ± 1.5% while the modern dancers were measured at 19.3 ± 1.4%. The bone mineral density for the total body, total hip, and L2-L4 of the spine for the ballet dancers was 1.165 ± 0.002 g/cm2, 1.082 ± 0.004 g/cm2, and 1.183 ± 0.004 g/cm2, respectively, while the modern dancers were measured at 1.170 ± 0.002 g/cm2, 1.107 ± 0.003 g/cm2, and 1.231 ± 0.004 g/cm2, respectively. These finding suggest that no differences exist between the physiological profiles of university modern and ballet dancers. Even though the dancers had lower percentages of body fat than the average female university student, the dancers were not low enough to be considered at increased risk for any major health problems. Also, the dancers low body weights and lower percentages of body fat did not seem to affect bone mineral densities, since both groups of dancers had values that were about 10% better than age-matched normal subjects. Finally, although both groups perform rigorous training regimens, their aerobic capacities were lower than other elite female athletes but higher than the average published norms for this age group.

The Effects of Darkness on Retrobulbar Hemodynamics in Patients with Early Stages Retinitis Pigmentosa

To investigate the retrobulbar hemodynamic changes occurring in light and darkness in patients with early stages retinitis pigmentosa (RP). Eleven early stages RP patients were enrolled in the study. The peak systolic velocity (PSV), end-diastolic velocity (EDV), pulsatility index (PI) and resistivity index (RI) of the ophthalmic artery (OA) and central retinal artery (CRA) were measured by color Doppler imaging in light and darkness. The results were compared with that of 10 age-matched normal subjects. PSV and EDV of the OA did not show significant differences in both groups. However, PSV and EDV of the CRA in RP patients decreased significantly in darkness (p = 0.001, p < 0.001, respectively). In addition, we found a significant increase in RI of the CRA in RP patients in darkness (p = 0.003). On the contrary, PSV and EDV of the CRA in control subjects showed a significant increase (p = 0.002, p < 0.001, respectively) and RI showed a significant decrease in darkness (p = 0.004). Darkness causes a decreased blood flow in the CRA in early stages of RP.

The effects of cyclopentolate on intraocular pressure and retrobulbar hemodynamics in patients with pseudoexfoliation syndrome and pseudoexfoliation glaucoma.

To evaluate the changes of intraocular pressure (IOP) and retrobulbar hemodynamics after cyclopentolate administration in patients with pseudoexfoliation syndrome and pseudoexfoliation glaucoma. Eighteen patients with pseudoexfoliation syndrome and 18 patients with pseudoexfoliation glaucoma were enrolled in the study. After baseline measurements of IOP, the peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistivity index (RI) of the ophthalmic, central retinal, and posterior ciliary arteries were investigated by color Doppler imaging. Then, 1% cyclopentolate was instilled in one eye of each subject. After 45 minutes of instillation of the cyclopentolate, the measurements of IOP and retrobulbar blood flow velocities were repeated. The results were compared with those of 20 age-matched normal subjects. Neither IOP nor retrobulbar blood flow velocities changed significantly in control subjects after cyclopentolate administration. IOP increased significantly after cyclopentolate instillation in pseudoexfoliation syndrome (p=0.004). Retrobulbar blood velocities did not change significantly after the cyclopentolate in this group. In pseudoexfoliation glaucoma group, it was observed that basal mean IOP showed a statistically significant increase after cyclopentolate drop (p=0.002). Although blood flow velocities of ophthalmic artery did not change significantly, PSV and EDV of the central retinal and posterior ciliary arteries decreased significantly (p<0.05) and RI of the posterior ciliary artery increased significantly (p=0.01) after cyclopentolate instillation. On the basis of our findings, pseudoexfoliation appears to be a predictive factor for an IOP rise after cyclopentolate. In pseudoexfoliation glaucoma patients, an increase of IOP after cyclopentolate could lead to a decreased retrobulbar blood flow. IOP must be rechecked after cyclopentolate administration in these patients to avoid further damage to the ganglion cells. (Eur J Ophthalmol 2004; 14: #-400).

Comparison of left atrial volume and function after linear ablation and after cardioversion for chronic atrial fibrillation

Several techniques for treatment of atrial fibrillation (AF) have been developed, including the direct placement of radiofrequency for lesions at open heart surgery. Detailed evaluation of left atrial (LA) function has not been performed after these procedures and has not been compared in patients with chronic AF. We compared the atrial function of patients with sustained sinus rhythm (SR) after linear ablation with a group who underwent direct-current cardioversion and a group of normal controls to investigate the measurable deleterious effects, if any, on atrial function after the surgical procedure. Twenty-one consecutive patients who had maintained SR for >6 months after a linear radiofrequency ablation (LRFA) procedure were studied. As control subjects, we examined 33 patients with chronic AF successfully restored to SR by cardioversion who maintained SR for >6 months and 42 age-matched normal subjects. LA function was decreased in both the LRFA and cardioverted AF groups compared with normal controls. The parameters of LA function, atrial fraction, LA ejection fraction, and the A′ velocity were lowest in the LRFA group, intermediate in the cardioverted AF group, and highest in the normal controls (LA function: 15.8 ± 10%, 26 ± 10%, 33 ± 7%; p = 0.0001; LA ejection fraction: 31 +13%, 41 ± 12%, 51 ± 9%; p = 0.0001; A′ velocity: 4.2 ± 1.4, 7.6 ± 2.2, 9.5 ± 1.9 cm/s; p = 0.0001). LA volumes were increased in the LRFA and cardioverted AF groups compared with normals (62.8 ± 22 vs 70.6 ± 17 vs 38.7 ± 9.8 ml; p = 0.0001). Thus, although LA function is restored and maintained after LRFA has been performed during open heart surgery, LRFA use is associated with a measurable decrease in LA function over and above that found after conventional cardioversion.

Assessment of Myocardial Creatine Concentration in Dysfunctional Human Heart by Proton Magnetic Resonance Spectroscopy

Creatine depletion in the non-viable infarcted human heart was previously demonstrated with proton magnetic resonance (MR) spectroscopy (1H MRS). In the present study, we assessed total creatine (CR) in human hearts with non-ischemic dysfunctions such as cardiomyopathy. Using cardiac-gated 1H MRS with MR image-guided PRESS localization, we measured septal CR in healthy and diseased human hearts. Fifteen patients with chronic heart failure (CHF, left ventricular ejection fraction < 45%) and 14 age-matched normal subjects were examined. Myocardial CR was significantly (p < 0.001) lower in failing hearts (15.1+/-SD 5.0 micromol/g wet weight, range 8.0-22.9) than in normal hearts (27.6+/-4.1 micromol/g wet weight, range 20.8-36.2). Myocardial CR concentrations in six heart failure patients with plasma B-type natriuretic peptide (BNP) levels of > 200 pg/ml (11.5+/-0.9 micromol/g wet weight, range 9.9-12.3) were significantly lower than those in four heart failure patients with plasma BNP levels of < 200 pg/ml (19.8+/-2.5 micromol/g wet weight, range 17.7-22.9, p < 0.001). Thus, our study showed that myocardial CR was decreased in non-ischemic dysfunctional hearts. Noninvasive measurements of myocardial CR by 1H MRS may be useful in the assessment of the severity of heart failure.

Sleep polygraphy in Angelman syndrome.

Sleep disturbances are frequent in Angelman syndrome (AS); however, beside the few studies which have investigated sleep disorders in AS by means of questionnaires, to our knowledge, no systematic polysomnographic recordings have been carried out in AS patients. The present study represents the first attempt to study sleep patterns of AS by polysomnography, to evaluate the influences of sleep on the paroxysmal electroencephalogram (EEG) patterns of AS and to assess the eventual age-related changes of sleep architecture and of sleep EEG abnormalities in children and adolescents with AS. Fifteen children with AS (7 males and 8 females, mean age 7.2 years, range 3-16 years), attending the Sleep Center of the Department of Child Neurology and Psychiatry of the University of Rome 'La Sapienza' and the Sleep Research Centre of the Oasi Institute (IRCCS) of Troina were included and subdivided into two subgroups by age: subgroup 1, aged 3-5 years, and subgroup 2, aged 9-17 years. Two control groups of age-matched normal subjects were also included: one aged less than 8 years and another aged more than 8 years; additionally, two other groups of age-matched children with epilepsy and mental retardation of different origin, one aged less and one aged more than 9 years were taken into consideration. The statistical comparison between the sleep parameters obtained from the patients and those from the other groups was carried out by means of the non-parametric Kruskal-Wallis ANOVA and the Mann-Whitney U test. The most frequent EEG abnormality found in AS patients appeared to be the 2-3 c/s poorly defined spike/waves complexes. This pattern was influenced by sleep stages; the duration of the runs showed an increasing length with sleep deepening from sleep stage 1 to slow-wave sleep (SWS). Moreover, the 2-3 c/s bursts activity present in sleep stage 2 showed a slowing to 1-2 c/s during SWS. Regarding sleep architecture, in subjects with AS aged <8 year there was a significant reduction in sleep efficiency as compared to normal controls, while the percentage and duration of REM sleep was significantly lower and the percentage of SWS was significantly higher. REM sleep time was reduced in AS subjects aged >8 years than in normal controls. The comparison between AS groups and mental retardation with epilepsy groups did not show significant differences. Similarly to other types of genetically determined mental retardation syndromes, also subjects with AS seems to show important abnormalities of their sleep polysomnographic patterns. This is the first study which reports, in detail, these abnormalities and opens a new path for further insight into the knowledge of additional sleep-related disturbances which are reported in sleep questionnaires by the caregivers of AS subjects.

Static balance impairment and its change after pallidotomy in Parkinson's disease.

We compared postural sway parameters during a 1-minute quiet stance in 28 patients with idiopathic Parkinson's disease (PD) in off phase with those in 17 age-matched normal subjects and investigated differences in the sway parameters before and after unilateral pallidotomy in 16 PD patients. The PD patients showed larger sway area (SA) and longer total sway path length (SPL) compared with normal subjects. Total SPL after subtraction of tremor effect did not differ from that in normal subjects. The shift of the mean center of foot pressure (CFP) position from the first 30 seconds to the last 30 seconds showed that the CFP tended to move forward in PD patients compared with normal subjects and to move laterally more in PD patients than normal subjects, especially in those with less severity (Unified Parkinson's Disease Rating Scale, motor score < 40). After the operation, there was little change in either SA or lateral movement of CFP, but forward movement of CFP and total SPL tended to be normalized, along with an improvement of major parkinsonian symptoms. From these results, it is concluded that SPL elongation significantly involves tremor effect, forward movement of CFP in PD derives from basal ganglia dysfunction, and SA enlargement and large lateral movement of CFP may be caused partly by compensatory movements or by dysfunction outside the basal ganglia circuitry.

Evidence of oxidative stress in the circulation of ovarian cancer patients

Background: Ovarian cancer is the leading cause of death due to gynecological malignancies among women. The extent of free radical induced oxidative stress can be exacerbated by the decreased efficiency of antioxidant mechanisms. The present study was conducted to investigate the extent of oxidative stress and the levels of antioxidants in the circulation of ovarian cancer patients. Methods: Plasma thiobarbituric acid reactive substances (TBARS) and conjugated dienes (CD) and the levels of antioxidants such as superoxide dismutase (SOD), catalase (CAT), vitamin C and vitamin E were estimated in the circulation of 30 ovarian cancer patients and an equal number of age-matched normal subjects as control. Results: Significantly increased concentrations of plasma TBARS and CD and significantly lowered levels of SOD, CAT, vitamin C and vitamin E were observed in ovarian cancer patients as compared with normal subjects. Conclusion: The low levels of SOD, CAT, vitamin C and vitamin E in the plasma of ovarian cancer patients may be due to their increased utilization to scavenge lipid peroxides as well as their sequestration by tumor cells. Increased levels of lipid peroxidation may be due to excessive oxidative stress caused by incessant ovulation or epithelial inflammation.

Proton magnetic resonance spectroscopy can detect creatine depletion associated with the progression of heart failure in cardiomyopathy

ObjectivesThis study noninvasively examined total creatine (CR) of the myocardium in dilated cardiomyopathy (DCM) or hypertrophic cardiomyopathy (HCM) using proton magnetic resonance spectroscopy (1H-MRS). BackgroundAbnormalities in CR metabolism in failing hearts have been reported. A biochemical study suggested that myocardial metabolic changes are very similar in DCM and HCM despite the different heart failure (HF) mechanisms. MethodsUsing cardiac-gated 1H-MRS with magnetic resonance image (MRI)-guided point-resolved spectroscopy (PRESS) localization, we quantitatively measured septal CR. Patients with either DCM (n = 11) or HCM (n = 7) and age-matched normal subjects (n = 14) were examined. ResultsMyocardial CR was significantly lower in DCM patients (16.1 ± 4.5 μmol/g wet weight [range 10.2 to 22.9], p < 0.05) than that in subjects with normal hearts (27.6 ± 4.1 μmol/g [range 21.4 to 36.2]). Myocardial CR in HCM patients (22.6 ± 8.1 μmol/g [range 12.2 to 34.5]) was significantly lower than that in subjects with normal hearts (p < 0.05) but was significantly higher than that in DCM patients (p < 0.05). In 18 patients with either DCM or HCM, myocardial CR correlated positively with left ventricular ejection fraction (LVEF) (y = 0.22x + 9.8, r = 0.73, p = 0.0006) but correlated negatively with plasma B-type natriuretic peptide (BNP) levels (y = −0.012x + 22.4, r = −0.54, p = 0.022). ConclusionsThis study showed that 1H-MRS can noninvasively detect CR depletion associated with the severity of HF in cardiomyopathy.

Antibodies against astrocyte M1 and M2 muscarinic cholinoceptor from schizophrenic patients' sera

We demonstrated the presence of circulating antibodies from schizophrenic patients able to interact with cultured astrocytes activating muscarinic acetylcholine receptors (mAChRs). Sera and purified IgG from 15 paranoid schizophrenic and 15 age-matched normal subjects were studied by indirect immunofluorescence (IFI), flow cytometry, dot blot, enzyme immunoassay (ELISA), and radioligand competition assays. Astrocyte membranes and/or a synthetic peptide, with identical amino acid sequence of human M(1) and M(2) mAChR, were used as antigens. By IFI and flow cytometry procedures, we proved that serum purified IgG fraction from schizophrenic patients, reacted to astrocyte cell surface. The same antibodies were able to inhibit the binding of the specific mAChR radioligand (3)H-QNB. Using synthetic peptide for dot blot and ELISA, we demonstrated that these antibodies reacted against the second extracellular loop of human cerebral M(1) and M(2) mAChR. Also, the corresponding affinity-purified antipeptide antibody displayed an agonistic-like activity associated to specific M(1) and M(2) mAChR activation, increasing inositol phosphates accumulation and decreasing cyclic AMP production, respectively. This article gives support to the participation of an autoimmune process in schizophrenia disease.

Improvement of Cerebral Blood Flow by Olprinone, a Phosphodiesterase-3 Inhibitor, in Mild Heart Failure

Cerebral blood flow (CBF) is reduced in heart failure (HF). For the treatment of acute HF, a phosphodiesterase-3 inhibitor, olprinone (OL), yields an increase in myocardial contractility and a decrease in arterial afterload. During a 15-min intravenous infusion of OL (0.2 µg/kg/min), regional CBF at 6 sites of each cerebral cortex was examined using technetium-99m-ethylcysteinate dimer brain SPECT in 18 HF patients and 7 age-matched normal subjects. The baseline CBF was significantly reduced in HF (43.0 ± 3.9 ml/min/100 g) compared to that in normal subjects (48.0 ± 4.6 ml/min/100 g, p < 0.01). The baseline CBF showed a significant negative correlation with the increase in CBF during the OL infusion in HF (r = –0.38, p < 0.01) and normal subjects (r = –0.65, p < 0.01). The percent increase in CBF was significantly greater in HF (13.7%) than in normal subjects (9.8%, p < 0.046). In patients with HF, the CBF of the cerebral cortex was decreased, but was increased by OL infusion.