HD Subjects Research Articles

Characteristics of processing for trait adjectives in depressive persons: an event-related potential study.

Event-related potentials (ERP) following emotive words were investigated in 22 healthy subjects with high (HD) or low (LD) depressive scores. The ERP was recorded following a visual presentation of emotive adjectives. The adjectives presented included words that subjects felt to be fit or unfit to their own character or traits, and that they perceived as positive or negative. The latency of P300 (P1) for negative words was significantly longer than that for positive words at Pz in HD subjects. The N400 (N1) in HD subjects showed a longer latency than that in LD subjects (p<0.01) at Cz and Pz. However, there was no difference in amplitude between the fit and unfit category, nor in the positive or negative category of words between the LD and HD groups. The present study suggests that an excessive level of cognitive processing in response to passive stimulation by non-specific emotive words occurs in normal subjects with a depressive condition.

Genetic and epigenetic factors in autoimmune reactions toward cytochrome P4502E1 in alcoholic liver disease

Autoimmune reactions are often associated with alcoholic liver disease; however, the mechanisms responsible are largely unknown. This study investigates the potential role of the immune response against hydroxyethyl free radical (HER)-derived antigens and of polymorphisms in immunoregulatory genes in the development of anti-cytochrome P4502E1 (CYP2E1) autoantibodies in alcohol abusers. Immunoglobulin G (IgG) recognizing human CYP2E1 and HER-derived epitopes were measured by microplate immunosorbent assay in the sera of 90 patients with alcoholic fibrosis/cirrhosis (ALD), 37 heavy drinkers without liver disease or steatosis only (HD), and 59 healthy subjects. Single nucleotide polymorphisms in the interleukin 10 (IL-10) promoter and in exon 1 of the cytotoxic T-lymphocyte antigen-4 (CTLA-4) gene were genotyped by polymerase chain reaction-restriction fragment length polymorphism analysis. The titers and frequency of anti-CYP2E1 autoantibodies were significantly higher in ALD than in HD subjects or controls. ALD patients with anti-HER IgG had higher titers and a 4-fold increased risk (OR: 4.4 [1.8-10.9]) of developing anti-CYP2E1 autoantibodies than subjects without anti-HER antibodies. The mutant CTLA-4 G allele, but not the IL-10 polymorphism, was associated with an enhanced risk of developing anti-CYP2E1 IgG (OR: 3.8 [1.4-10.3]). CTLA-4 polymorphism did not influence antibody formation toward HER-antigens. ALD patients with concomitant anti-HER IgG and the CTLA-4 G allele had a 22-fold higher (OR: 22.9 [4.2-125.6]) risk of developing anti-CYP2E1 autoreactivity than subjects negative for these factors. In conclusion, antigenic stimulation by HER-modified CYP2E1 combined with an impaired control of T-cell proliferation by CTLA-4 mutation promotes the development of anti-CYP2E1 autoantibodies that might contribute to alcohol-induced liver injury. (H EPATOLOGY 2003;37:410-419.)

No Effect of Transfusion Transmitted Virus Viremia on the Distribution and Activation of Peripheral Lymphocytes in Hemodialyzed Patients

Aim: We aimed to examine the distribution and activation of peripheral T cells in TTV positive (n = 32) and negative (n = 17) hemodialyzed patients. The control group (n = 20) consisted of healthy blood donors. Method: TTV-DNA was detected by seminested PCR. CD3, CD4, CD8, CD19, CD56, CD3/HLA-DR, CD3/CD69 and the Th1/Th2 ratio of T cells were analyzed by flow cytometry. Circulating IFN-γ, IL-2, IL-4, IL-6, IL-10, IL-13, TNF-α, TGF-β levels were measured by ELISA in the sera. Results: There was no difference between the CD3, CD4, CD8 and CD19 values of HD subjects. In addition, the expression of both activation markers, HLA-DR and CD69, was significantly elevated in the TTV-positive and -negative HD groups compared to the controls, but not showing any difference from each other. The measurements of intracellular cytokines showed the enhanced occurrence of INF-γ + CD4 T cells, and decreased appearance of IL-4 + CD4 lymphocytes in the HD groups without any significant difference between the TTV virus positive and negative patients. In addition, HD also elevated the expression of IL-10 in CD4 and CD8 (Th2) cells. There were only two significant changes in the levels of circulating cytokines: (a) IL-2 increased; (b) IL-13 decreased in both groups of HD patients compared to the controls, independently of TTV positvity or negativity. Conclusions: We assume that transfusion-transmitted virus does not cause any specific change in the distribution and activation of lymphocytes in the peripheral blood of hemodialyzed patients. Hemodialysis itself, however, results in a significant activation of peripheral T cells with the domination of increased production of Th1 type cytokines, IFN-γ, IL-2, in contrast to the decreased synthesis of Th2 type cytokines, IL-4 and IL-13. Furthermore, the increased expression of IL-10 in the CD4 and CD8 cells of HD patients can be the sign of a contraregulatory Th2 activation as an answer on the Th1 effect.

Significant Elevations in Serum Mannose-Binding Lectin Levels in Patients with Chronic Renal Failure

Background/Aims: Mannose-binding lectin (MBL), a liver-derived C-type serum lectin, activates the complement cascade through the lectin pathway. Since the complement system contributes to the host defense against infections and mediates inflammatory processes including atherosclerosis, and since chronic renal failure (CRF) patients are prone to the development of infectious complications and cardiovascular disease, we focused on serum MBL levels in CRF patients who were either uremic, or who were receiving hemodialysis treatment. Methods: MBL levels were measured in the sera of subjects with CRF before they began dialysis treatment (pre-HD patients; n = 23) and in the sera of subjects who were receiving maintenance hemodialysis (HD patients; n = 178), by ELISA using polyclonal anti-rabbit IgG and a monoclonal antibody directed against MBL (3E7). Results: Mean levels (± SD) of serum MBL were significantly higher in pre-HD subjects (4.343 ± 2.533 µg/ml, p < 0.05) and in HD subjects (8.897 ± 4.920 µg/ml, p < 0.05), than in healthy controls (1.452 ± 0.692 µg/ml). Levels were also significantly higher in HD subjects than in pre-HD subjects (p < 0.05). Conclusions: Elevated serum MBL levels in patients with CRF might have significantly influence pathologic conditions such as alterations of the immune system and acceleration of atherogenesis.

Quality of Life and Risk for Malnutrition in a Group of Older Adults

LEARNING OUTCOME: To describe associations between quality of life and factors associated with risk of malnutrition in adult meal program participants. Quality of life is an important outcomes measure for health care. There has been little empirical research to characterize relationships between quality of life and factors associated with malnutrition in older adults. To investigate such relationships, all participants in the Title III-C meals programs age 60 and over in Pepin County, Wisconsin, were asked to complete a questionnaire during a 1-month period in the spring of 1996. The instrument included the Nutrition Screening Initiative Determine Checklist, quality of life (QOL) and quality of health (QOH) scales, the Geriatric Depression Scale (GDS), and scales to evaluate functional status, food security, social satisfaction, and food satisfaction. Sociodemographic data were also obtained. The response rate was 86%, with 155 usable questionnaires; n=108 and 47 for congregate (C) and home-delivered meal (HD) participants, respectively. Ages (x̄±SD) for C were 78.1±7.3 and for HD 81.4±7.5, P<0.01. Independent of age, HD subjects had significantly lower QOL scores than did C ( P<0.01) and were at greater nutritional risk, with Determine Checklist scores of (x̄±SD, P<0.05) 4.2±2.8 and 3.9±2.8, respectively. HD also reported poorer functional status ( P<0.001)and QOH ( P<0.05) and had higher GDS scores ( P<0.05) than did C. Spearman correlation coefficients computed for QOL and scales indicated that QOH was positively correlated with QOL, while GDS score, lower functional status, greater food insecurity and lesser enjoyment of food were negatively correlated with QOL.

Free thyroxine concentrations in serum measured by equilibrium dialysis in chronic renal failure

The serum concentration of free thyroxine (FT4) is often low in patients with chronic renal failure (CRF) with low serum concentrations of triiodothyronine (T3). We evaluated the serum FT4 concentration by using both an equilibrium dialysis RIA kit (D-FT4) and a labeled-antibody kit (M-FT4) in two different groups of CRF patients, undergoing chronic hemodialysis (HD, n = 145) or not (non-HD, n = 30), and in a group of normal healthy subjects (n = 58). Thyroid peroxidase antibodies and thyroglobulin antibodies were not detected in any patient. Serum FT4 concentrations (mean +/- SD, pmol/L) by the D- and M-FT4 assays were, respectively, 21.5 +/- 4.6 and 16.6 +/- 2.0 in the healthy subjects, 17.8 +/- 4.3 and 13.9 +/- 3.6 in the non-HD patients, and 16.9 +/- 4.9 and 10.7 +/- 1.9 in the HD patients. By the D-FT4 assay, results for both CRF groups were significantly different from those for the healthy group (P <0.01), as were the results for each pair of groups by the M-FT4 assay (P <0.01). FT4 values were reported as being within the healthy reference range by D-FT4 in 73 of 113 HD subjects who had low T3 and low M-FT4 values. Serum FT4 concentrations measured by both assay kits showed a significant inverse correlation with the serum concentration of creatinine (P <0.01), but the serum concentrations of sex-hormone-binding globulin did not differ significantly among the three groups. Our results indicate that the low FT4 concentration measured by D-FT4 in patients with CRF, particularly those on HD, probably reflects the actual, mild nonthyroidal illness of renal failure.

Nutrttional Risk In Home-delivered And Congregate Meal Program Participants In Wisconsin

Reduced nutritional status in older adults increases risks, severity, and complications of disease and leads to more frequent or longer hospital stays. To evaluate the prevalence of nutritional risk and risk factors in Wisconsin's elderly meal program participants, Nutrition Screening Initiative DETERMINE Checklists were distributed by meal program staff and volunteers and completed by 15,438 congregate meal (C) and 5,343 home-delivered meal participants (HD) in 74 counties. Data were obtained on age, gender, and whether or not subjects lived alone. The age of the respondents was (mean±SD) 77.7±8.1 years, range 60–105. HD were significantly older than C, at 81.1±8.1 and 76.5±7.8 years, respectively (p<0.001). For all risk indicators, except one to detect high alcohol intake, the proportion of HD subjects indicating presence of the risk indicator was significantly greater than that of C subjects (p<0.05). These differences remained after controlling for age. The greatest between-group differences were seen in the items which screened for eating alone, taking multiple medications, and physical disability. Although less frequently reported in both groups, HD were twice as likely as C to have oral/dental problems affecting food intake, and insufficient funds with which to purchase food. Subjects were classified into risk categories by totalling corresponding points for pertinent risk indicators. Of HD, 46.5% were at high risk, 36.7% at moderate, and 16.9% at low risk. The respective percentages for C were 19.8, 30.9, and 49.3. Between-group differences were statistically significant (p<0.05). While the elderly meal program population is not representative of the population of older adults as a whole, the proportions of those at high risk are substantial. Since participation in meal programs presumably reduces nutritional risk, these findings underscore the importance of such programs and demonstrates the need for targeted nutrition interventions to reduce nutrition risk among program participants.

Auditory P300 in young alcoholics: regional response characteristics.

An auditory oddball paradigm was used to record the P300 component of the event-related potential (ERP) in a group of medication-free, chronic male alcoholics (n = 51, mean = 32.2) and a control group (n = 25, mean = 27.2). Each subject received a binaurally presented series of high (1600-Hz)- and low (600-Hz)-frequency tones. The designation of the rare tone (0.125 probability) was alternated across subjects. When the subject detected the rare tone, he made a button press as quickly as possible to record his reaction time. Scalp recordings using the entire 10/20 System, as well as interpolated placements, were made from 31 electrodes. For purposes of statistical analyses, five regional electrode groups were created: F (frontal), C (central), P (parietal), O (occipital), and T (temporal). The results of MANOVA indicated that control P300 amplitudes were significantly greater than those of the alcoholics in all five regions, whereas there were no P300 latency differences between groups in any region. Regional response differences between the groups were also compared with measures of surface energy (SE) (Wang et al., 1994). SE is a recently developed, reference-free global field measure that uses the entire scalp potential field and treats potentials at different positions differently. SE was significantly reduced in the alcoholics compared with the controls in both the C (p < 0.0003) and P (p < 0.0006) regions, although there were no differences in its distribution.(ABSTRACT TRUNCATED AT 250 WORDS)

Acoustic Analysis of Speech Timing in Huntington′s Disease

Duration measurements at the acoustic speech signal of sentence utterances including syllable lengths, vowel durations, and voice-onset-time (VOT) were performed in 13 subjects with Huntington′s disease (HD) and in 12 control speakers. First, all 13 HD subjects presented with increased variability of utterance duration and/or VOT. Second, a subgroup had reduced speech tempo concomitant with overproportional lengthening of short vowels. Presumably, these deviations result from slowed movement execution (bradykinesia) and delayed between-movement transitions. Third, durational parameters of phonetic timing, e.g. stress contrast, were largely unimpaired. In a further patient (HD14) severely reduced articulatory accuracy did not allow acoustic measurements. He presented with truncated, barely intelligible, diphthongized sentence utterances. A slight tendency for these deviations could be noted in two of the HD subjects who underwent acoustic analysis. Since all three subjects had a rather long disease duration, this constellation might represent an advanced stage of HD dysarthria into which the other syndromes ultimately will develop.

Interdialytic Fluid Gains in Diabetic Patients Receiving Hemodialysis Treatment

• Objective: The objectives of this study were (1) to compare fluid gains of diabetic patients with those of age- and gender-matched controls and (2) to determine if type of diabetes is a factor in higher interdialytic fluid weight gains. • Design: The interdialytic fluid weight gains of diabetic and nondiabetic subjects were monitored for 1 month. • Setting: Study subjects were selected from those patients receiving HD therapy at the Northwest and Elliot Bay Kidney Centers in Seattle, WA. • Patients: A sample of diabetic and nondiabetic HD patients was chosen. Diagnoses of polycystic kidney disease, congestive heart failure, and advanced liver disease excluded patients as subjects due to the abnormal tissue and fluid weight gains that accompany these conditions. Forty-six diabetic HD patients were matched with 53 nondiabetic HD patients for age (within 10 years) and gender. • Measurements: Interdialytic fluid weight gains (IWG) of these 99 subjects were monitored for 1 month. • Main results: The diabetic group exhibited no significant differences from the nondiabetic group in IWG expressed as a percentage of dry body weight nor in the average IWG or the number of times that the IWG exceeded 1.5 kg. Eighty-eight percent of the diabetic subjects and 86% of the nondiabetic subjects exceed the fluid gain guideline of 1 .5 kg. • Conclusions: The researchers conclude that diabetic HD patients do not gain more fluid between dialysis treatments than nondiabetic HD patients. The fact that the majority of HD subjects, regardless of diabetes, gained more than the recommended 1.5 kg between dialyses warrants more attention. Therefore, future research should review the guidelines for interdialytic fluid gain to ensure both medical appropriateness and assistance in patient compliance with regard to fluid restriction. © 1993 by the National Kidney Foundation, Inc.

The subcortical dysfunction hypothesis of memory deficits in depression: neuropsychological validation in a subgroup of patients.

The subcortical dysfunction hypothesis of verbal learning and memory deficits in depression was evaluated by comparing the memory test profiles of unipolar depressives (n = 40) and bipolar depressives (n = 9) with those of patients with a prototypical subcortical dementia (Huntington's disease, HD), patients with a prototypical cortical dementia (Alzheimer's disease, AD), and normal controls. In a discriminant function analysis that well-differentiated the HD, AD, and normal subjects, it was found that 28.6% of the depressed patients were classified as HD patients (DEP-HD subjects), 49.0% were classified as normals (DEP-N subjects), none were classified as AD patients, and 22.4% were not well-classified. The DEP-HD group closely resembled the HD group on additional indices of verbal learning and memory, and differed from the DEP-N group, which strongly resembled the normal control group. DEP-N patients also performed significantly better than DEP-HD patients on a number of other neuropsychological tests (e.g., WAIS-R Digit Symbol, category fluency, Trail Making Test Part B). The findings provide support for the subcortical dysfunction hypothesis, but only for a subgroup of depressed patients. Implications for differentiating depressive "pseudodementia" from AD are discussed.

Regulation of interleukin-2 and interferon-γ gene expression in renal failure

Regulated expression of interleukin-2 (IL-2) and interferon-gamma (IFN-gamma) genes, induced in cultured peripheral blood mononuclear cells from patients with end-stage renal disease on hemodialysis (HD; N = 13) or peritoneal dialysis (PD; N = 13), was compared to that of 32 normal donors. Culture conditions were chosen that measure the transient, phytohemagglutinin-induced expression of IL-2 and IFN-gamma messenger RNA (mRNA), as well the intactness of post-transcriptional and suppressor T cell-dependent mechanisms that control this expression. The latter was achieved by analyzing the superinduction of IL-2 and IFN-gamma mRNA occurring upon culture with cycloheximide or after low-dose gamma-irradiation, respectively. HD subjects showed a complete loss of inducibility of the IL-2 gene, concomitant with decreased inducibility of IFN-gamma mRNA. In PD subjects, by contrast, expression of IL-2 mRNA was as vigorous as in normal donors, while IFN-gamma mRNA was even more strongly inducible. This difference in gene inducibility is caused by a lack of T cell function in HD subjects. The defect in IL-2 gene expression in HD subjects, occurring most likely at transcription, may underly their impaired immune function.

血漿および尿の極微弱発光スペクトル分析と生体情報計測への応用

We describe here the study of biomedical measurements utilizing spectral analysis of ultraweak photon emission from human blood plasma and urine. It has been suggested that detection of ultraweak photon emission intensity of plasma, urine or other kind of biological materials provides information regarding to physiological condition of vital system; especially it reflects the states of oxidative stress of the body. In this experiment, we characterized emission spectra of plasma and urine, and examined the comparison between those from hemodialysis patients (HD) and normal subjects. In addition, the spectral properties of isolated serum lipoprotein were studied. Spectral analysis was carried out by the filter-differential type biophoton spectral analyzer covering the wavelength region of 450-850nm. In the experimental results, spectral change of normal plasma was observed at the auto-oxidation process, with prominent emission peak around 670nm. Difference of spectral distribution between HD and normal subjects was observed at 400-700nm region, and significant difference appeared at 600-700nm region. It is suspected that this wavelength region represents the states of oxidative stress of the body significantly.

Alterations in alveolar clearance after 4-ipomeanol-induced necrosis of Clara and ciliated cells in the terminal bronchiole of the rat

The administration of 4-ipomeanol, [0, 10 (LD), and 25 (HD) mg/kg, ip], to rats resulted in dose-dependent degeneration and necrosis of the nonciliated (Clara) and ciliated epithelial cells of the terminal bronchioles. More extensive necrosis of the terminal bronchiolar epithelium, with exposure of the basement membrane, was produced in the HD group. Repair of the terminal bronchiolar epithelium was complete within 10 days. Alveolar clearance of 51Cr labeled polystyrene latex microspheres was analyzed through 40 days postinstillation by nonlinear regression for a double exponential model. Alveolar clearance during phase 1 (Days 2 to 6) was delayed and significantly decreased in both the LD and HD groups. Alveolar clearance during phase 2 (Days 10 to 40) was significantly decreased only in the HD group. The decreased alveolar clearance in HD subjects was long term and did not correlate with the return of morphologically normal appearing Clara and ciliated cell structure.