NV Group Research Articles

Viability of Vitrified Biopsied Bovine Embryos After In-Straw Dilution

The objective of the present study was to evaluate the viability of vitrified biopsied bovine embryos. Bovine embryos ranging from the compacted morula to blastocyst stage on day 7 (day 0=day of estrus) were collected from donor females, biopsied for sexing, and vitrified with ethylene glycol (EG) 25% (v/v), dimethylsulfoxide (DMSO) 25% (v/v) and 0.3% (w/v) bovine serum albumin dissolved in PBS using 0.25-ml straws. We assessed the concentrations of cryoprotectants in the straw after in-straw dilution, and the percentages (v/v) were 6.9–7.7% for EG and 2.8–3.3% for DMSO. The pregnancy rate of vitrified-warmed embryos in the in-straw dilution group (ISD group) was 57.9% when embryos were expelled from the straws after diluting the cryoprotectant in the straws, and that the survival of vitrified-warmed embryos were observed before transfer. In contrast, the pregnancy rate in the directly transfer group (DIR group) was 62.5% when embryos were transferred directly to recipients without expelling embryos from the straws. There were no differences among the pregnancy rates of the ISD group, the DIR group and the non-vitrified biopsied embryos (NV group) (56.3%). These results suggest that it was possible to warm the vitrified-biopsied bovine embryos on farms and to transfer them immediately to recipients, yielding a practical pregnancy rate.

Sudden Sensorineural Hearing Loss: Subclinical Viral and Toxoplasmosis Infections as Aetiology and How They Alter the Clinical Course

Aim: To explore in a prospective study the evidence of certain viral and toxoplasmosis infections in sudden sensorineural hearing loss (SSHL). Methods: 84 consecutive patients with SSHL meeting certain criteria. All patients were assessed for specific IgM antibodies against cytomegalovirus, herpes simplex virus, toxoplasma and Epstein-Barr virus. All were treated with intravenous steroids and assigned to two groups: 76 IgM negative (NV group) and 8 IgM positive (no history of acute infection – V group). Results: The mean hearing level at presentation was 86.5 dB HL (median, 100) in the V group and 60.7 dB HL (median, 61) in the NV group. The difference was statistically significant (p = 0.003). The mean hearing level following treatment was 81.8 dB HL (median, 88) in the V group and 48.7 dB HL (median, 39) in the NV group. The difference was statistically significant (p = 0.004). There was a considerable improvement in hearing after treatment only in the NV group (p < 0.000001). Conclusions: Recent subclinical viral or toxoplasmosis infections may be involved in the pathogenesis of SSHL (in approx. 10% of cases), suggesting that SSHL is not a single disease. When certain viruses or toxoplasmoses are involved, the hearing is much worse in comparison to patients with no such indication of infection. An alteration in treatment dosage or method of steroid administration may be needed in such cases.

Relationship Between Sleep-Disordered Breathing and Iris and/or Angle Neovascularization in Proliferative Diabetic Retinopathy Cases

To investigate whether sleep-disordered breathing is a risk factor for iris and/or angle neovascularization in patients with proliferative diabetic retinopathy (PDR). Cross-sectional comparative case series. One hundred fifty-one consecutive patients with PDR who underwent surgery in our hospital were divided based on the presence of iris and/or angle neovascularization (NV group, 37 patients) or absence of NV (non-NV group, 114 patients). Pulse oximetry was conducted during the night and the mean SpO(2), 4% oxygen desaturation index (4% ODI times/hour), the lowest SpO(2)% during sleep (lowest SpO(2)), and the cumulative percentage of time at SpO(2) <90% in analysis times (CT90%) were calculated. When the 4% ODI exceeded 5 times/hour, sleep-disordered breathing was diagnosed. The results were compared between the 2 groups. Preoperative systemic parameters also were analyzed by logistic regression to clarify risk factors for the NV group. A mean total of 50% (62% of the NV group and 46% of the non-NV group) was diagnosed with sleep-disordered breathing. The mean SpO(2) and lowest SpO(2) did not differ significantly between the 2 groups; the 4% ODI (12.3 vs 6.6) and CT90% (3.8 vs 1.7) were significantly higher in the NV group (P=.02, for both comparisons). Logistic regression analysis identified insulin therapy (odds ratio [OR], 3.01; 95% confidence interval [CI], 1.26∼7.20; P=.01); and 4% ODI (OR, 1.09; CI, 1.01∼1.16; P=.02) as risk factors for the NV group. In patients with PDR, nocturnal intermittent hypoxia/reoxygenation resulting from sleep-disordered breathing may be a risk factor for iris and/or angle neovascularization.

Larger tidal volume increases sevoflurane uptake in blood: a randomized clinical study

The rate of uptake of volatile anesthetics is dependent on alveolar concentration and ventilation, blood solubility and cardiac output. We wanted to determine whether increased tidal volume (V(T)), with unchanged end-tidal carbon dioxide partial pressure (P(ET)CO(2)), could affect the arterial concentration of sevoflurane. Prospective, randomized, clinical study. ASA physical status (2) and II patients scheduled for elective surgery of the lower abdomen were randomly assigned to one of the two groups with 10 patients in each: one group with normal V(T) (NV(T)) and one group with increased V(T) (IV(T)) achieved by increasing the inspired plateau pressure 0.04 cmH(2)O/kg above the initial plateau pressure. A corrugated tube added extra apparatus dead space to maintain P(ET)CO(2) at 4.5 kPa. The respiratory rate was set at 15 min(-1), and sevoflurane was delivered to the fresh gas by a vaporizer set at 3%. Arterial sevoflurane tensions (P(a)sevo), F(i)sevo, P(ET)sevo, P(ET)CO(2), P(a)CO(2), V(T) and airway pressure were measured. The two groups of patients were similar with regard to gender, age, weight, height and body mass index. The mean P(ET)sevo did not differ between the groups. Throughout the observation time, arterial sevoflurane tension (mean ± SE) was significantly higher in the IV(T) group compared with the NV(T) group, e.g. 1.9 ± 0.23 vs. 1.6 ± 0.25 kPa after 60 min of anesthesia (P<0.05). Ventilation with larger tidal volumes with isocapnia maintained with added dead-space volume increases the tension of sevoflurane in arterial blood.

335 EFFECT OF MEM VITAMINS AND FORSKOLIN ON IN VITRO EMBRYO PRODUCTION AND SOPS-VITRIFICATION ABILITY OF IN VITRO DERIVED PORCINE BLASTOCYSTS

The aims of this study were, first to investigate the effect of minimum essential medium (MEM) vitamins (VITs) during IVM of porcine oocytes on in vitro embryo production of porcine embryos and second, to determine if the addition of VITs during IVM and the chemical delipidation with forskolin improve the vitrification ability of in vitro-derived porcine blastocysts. COCs were divided in two groups and matured in NCSU-23 for 44 h with 0.05% VITs (V group) or without VITs (NV group). Matured oocytes were inseminated with frozen-thawed spermatozoa. Presumptive zygotes were cultured for 16 h to assess IVF parameters (N = 767) or for 6 days (N = 2858) to evaluate the in vitro embryo development (Day 0 = day of IVF). On Day 5, some embryos from NV and V groups were cultured for 24 h with 10 μM forskolin (NVF and VF groups). The remaining embryos were cultured without forskolin (NVNF and VNF groups). On Day 6, embryos from the four experimental groups were assessed for blastocysts formation and some blastocysts (N = 414) were vitrified using superfine open pulled straws (SOPS). Vitrified blastocysts were warmed (one-step dilution method) and cultured for 24 h to assess their viability. Blastocysts with totally or partially reformed blastocoel cavity and normal or excellent morphology were considered viable. Five replicates of a 2 × 2 factorial design were conducted. Data was analyzed with the MIXED procedure. The threshold for significance was set at P &lt; 0.05. Results are expressed as least squares means ± SEM. No differences were observed in the maturation of COCs treated with VITs (92.7 ± 1.3%) and non-treated COCs (94.3 ± 1.3%). The NV and V maturation groups showed similar penetration (83.0 ± 3% and 82.6 ± 3%, respectively) and monospermy (48.9 ± 6%, and 48.3 ± 6%, respectively) rates. The rate of monosermic oocytes related to the total of analyzed oocytes was similar for NV (38.1 ± 3.7%) and V (38.4 ± 3.7%) groups. The values of cleavage rate on Day 2 were similar for NV (66.7 ± 1.5%) and V (69.6 ± 1.6%) embryos. The addition of VITs to IVM medium improved (P &lt; 0.01) up to 10 points the blastocysts formation rate, but the addition of forskolin at Day 5 did not affect this parameter. The V group showed a higher (P &lt; 0.01) blastocysts rate (45.1 ± 2.5%) than the NV group (38.4 ± 2.3%).The addition of VITs did not affect the survival of in vitro-derived blastocysts after SOPS-vitrification on Day 6. However, the blastocysts cultured for 24 h with forskolin showed higher (P &lt; 0.05) viability (44.0 ± 7.9%) after vitrification and warming than those embryos cultured without forskolin (34.1 ± 7.8%). In conclusion, the addition of MEM vitamins to IVM medium improves the blastocysts formation rate and the chemical delipidation with forskolin improve the cryosurvival of SOPS-vitrified porcine in vitro-derived blastocysts. This study was supported by the Seneca foundation of Murcia (GERM 04543/07), MICINN (AGL2009-12091 and RC-2007), and CARM (2I05SU0012).

Mechanical Evaluation of the Influence of Different Suture Methods on Temporal Skin Healing

The progress of wound healing is mainly investigated using histological analyses. The study of mechanical recovery of healing wound is lacking. To evaluate the temporal mechanical strength of healing skin after the use of different suture methods. The dorsum of each of 36 Sprague-Dawley rats was divided into four regions, and 2-cm-long cuts were randomly made in three regions and closed using three suture methods. The size of all suture material was 4/0. The suture methods included full-thickness skin sutures with nylon (N group), degradable polyglactin 910 sutures in the dermis (V group), and nylon sutures in the epidermis with polyglactin sutures in the hypodermis (NV group). After 1, 2, 4, and 6 weeks, the sutured sites were harvested for tensile testing and recovery index. The V and NV groups had greater recovery indices than did the N group after 2 weeks, but the V and N groups reached almost full recovery and had greater recovery than the NV group 6 weeks after wounding. Recovery strengths increased rapidly between 4 and 6 weeks in the V and N groups. These results are helpful for suture method selection and management of wound healing.

Clara cell secretory protein (CC16) as a peripheral blood biomarker of lung injury in ventilated preterm neonates

The aim of this study was to assess the serum concentrations of Clara cell secretory protein (CC16) in association with acute and chronic lung injury in mechanically ventilated preterm neonates. Thirty-five preterm neonates (gestational age [GA] <or=31 weeks) with acute respiratory failure were enrolled. Of these, 23 neonates requiring ventilatory support within 2 h after birth comprised the mechanically ventilated group (MV group), and 12 neonates who were not ventilated made up the nonventilated group (NV group). Serum CC16 was measured (using enzyme-linked immunosorbent assay [ELISA]) within 2 h (T0) and at 72 h (T1) after birth, at day 14 of life (T2) and at 36 weeks postmenstrual age (T3). The median CC16 concentrations were significantly higher in the MV group compared to the NV group at all times. Analysis with respect to differences observed in the group characteristics showed that GA, Apgar score at 5 min and mechanical ventilation were significant covariates of serum CC16 at T0. All neonates in the NV group and 18 cases in the MV group, respectively, survived discharge. Ventilated survivors with later bronchopulmonary dysplasia (BPD; oxygen requirement at T3, n = 7) had significantly higher CC16 at all times compared to nonventilated neonates. Elevated serum CC16 levels at T2 were predictive of BPD development. In conclusion, our results show that serum CC16 increases significantly in preterm neonates ventilated early after birth and remains high in those with later BPD. Further research is needed to validate the usefulness of CC16 as a peripheral blood biomarker of acute and chronic lung injury.

Role of polymorphonuclear neutrophils (PMNs) and NK cells in the protection conferred by different vaccines against Chlamydophila abortus infection

Ovine enzootic abortion (OEA) is caused by Chlamydophila abortus, an intracellular bacterium which acts by infecting the placenta, causing abortion in the last term of gestation. The main prevention strategy against OEA is the vaccination of flocks. An effective vaccine against C. abortus must induce a Th1-like specific immune response, which is characterized by the early production of IFN-γ and the activation of CD8 +T cells. Moreover, vaccine effectiveness could be modulated by the functioning of the innate immunity. The purpose of this study was to ascertain how polymorphonuclear neutrophils (PMNs) and NK cells might influence vaccine-induced protection. The live attenuated 1B vaccine and two inactivated experimental vaccines, adjuvated with aluminium hydroxide (AH) or QS-21 (QS), were used in PMN-depleted or NK cell-depleted mice. For PMN depletion, RB6-8C5 monoclonal antibody, which recognizes GR1 +receptors (Robben, P.M., LaRegina, M., Kuziel, W.A., Sibley, L.D. 2005. Recruitment of Gr-1 + monocytes is essential for control of acute toxoplasmosis. The Journal of Experimental Medicine 201, 1761–1769.) was used, while for NK cell-depletion the anti-asialo GM1 polyclonal antibody was used. The depletion of PMNs caused 100% mortality in non-vaccinated mice (NV) and 60% mortality in the AH-vaccinated mice by day 10 p.i., while both groups showed a significant increase in their bacterial burden in the liver by day 4 p.i. The depletion of NK cells caused mortality only in the NV group (50% by day 10 p.i.), although this group and the 1B vaccinated mice showed an increased bacterial burden in the liver at day 4 p.i. Our results suggest that the importance of PMNs in inactivated vaccines depends on the adjuvant chosen. The results also demonstrated that the importance of NK cells is greater in live vaccines than in inactivated vaccines.

Long-standing Bullous Keratopathy Is Associated with Peripheral Conjunctivalization and Limbal Deficiency

To investigate whether peripheral corneal neovascularization in bullous keratopathy (BK) is due to conjunctivalization, a sign of limbal stem cell deficiency. Observational case-control study. Sixteen BK patients. Patients were divided into 2 groups: BK without peripheral neovascularization [NV(-) group; 5 patients, 5 eyes] and BK with neovascularization [NV(+) group; 11 patients, 13 eyes]. Evidence of conjunctivalization was evaluated by periodic acid-Schiff staining of impression cytology samples from the peripheral vascularized cornea. The 2 groups' durations of disease also were compared. Penetrating keratoplasty (PK) was performed in all 16 cases, and the 2 groups' durations of reepithelialization after PK were compared. Presence of goblet cells using impression cytology, duration of BK, and duration of postoperative reepithelialization. Goblet cells were found on the peripheral corneal surface in all eyes in the NV(+) group. However, all eyes in the NV(-) group were negative for goblet cells (P<0.0001). Duration of disease was 14.4+/-5.4 months in the NV(-) group and 66.2+/-65.5 months in the NV(+) group (P = 0.030). Duration of postoperative epithelialization was 6.2+/-2.2 days in the NV(-) group and 28.8+/-36.5 days in the NV(+) group (P = 0.046). Conjunctivalization of the peripheral cornea and delayed postoperative epithelialization in BK patients with NV suggest the presence of limbal stem cell deficiency in such patients. Patients with long-standing disease were found to be more prone to neovascularization. For this reason, early surgery may lead to a better surgical outcome.

Effects of diuretic-induced hypovolemia/isosmotic dehydration on cardiorespiratory responses to hyperthermia and its physical treatment in rabbits

Under conditions of heat stress and hyperosmotic dehydration, both animals and humans reduce thermoregulatory evaporation and regulate deep body temperature at elevated levels. Regarding the mechanisms, the main role in producing these thermoregulatory changes during dehydration is attributed to the increased osmolality of body fluids, although the role of the decreased plasma volume without changes in plasma osmolality (hypovolemia/isosmotic dehydration) has not been so far investigated. There are also controversial experimental results regarding the effects of dehydration on heat stress-induced cutaneous vasodilation. Therefore, this paper studied the effects of hypovolemia/isosmotic dehydration on cardiorespiratory responses to hyperthermia and its physical treatment in 17 anaesthetized adult rabbits. The animals were divided into two groups: normovolemic group (NV; n = 10) and hypovolemic group (HV; n = 7). In the HV group, hypovolemia/isosmotic dehydration (decrease in plasma volume by 16.1 ± 1.2%) was induced by furosemide (5 mg kg−1 i.v.) without change in measured plasma Na+ concentration. Hyperthermia (the rise in body temperature (BT) to 42°C by a gradual body surface heating) caused significant increase in minute ventilation (VE) in both groups. However, VE values were significantly higher in the HV rabbits compared to the NV animals despite the lower breathing frequency (p < 0.05). The panting was absent in the HV rabbits at the BT of 42°C, unlike the NV animals. From cardiovascular variables, the vasoconstrictor response in visceral (mesenteric) region during hyperthermia in hypovolemic/isosmotic animals was attenuated (p < 0.05), whereas the heat stress-induced cutaneous vasodilation was not influenced by hypovolemia. Recovery of the BT by body surface cooling was accompanied by further increase in VE in the NV group, whereas VE decreased (p < 0.05) in the HV animals. Cooling led to recovery of the cardiovascular parameters. There were found no significant cardiorespiratory differences between the groups (NV:HV) during cooling. The lower frequency of breathing and attenuation of the mesenteric vasoconstriction during exogenous hyperthermia are present not only during hyperosmotic dehydration induced by water deprivation, but they also occur under conditions of furosemide-induced isosmotic dehydration/hypovolemia in rabbits. The heat stress-induced cutaneous vasodilation regarding its biological importance was not influenced by hypovolemia/isosmotic dehydration. Therefore, it is suggested that hypovolemia alone is sufficient to produce described respiratory, thermoregulatory and cardiovascular changes in dehydrated rabbits during exogenous hyperthermia, whereas hyperosmolality is not a requisite.

Neurotomie vestibulaire vs. labyrinthectomie chimique dans la maladie de Menière invalidante

To evaluate the efficiency on the vertigos and the impact on the audition of the vestibular neurotomy (VN) and the chemical labyrinthectomy (CL) in patients with severe Menière's disease, in order to determine the precise place for each technique in treatment algorithm. Retrospective study of 71 VN (performed between 1986 and 2003) and 35 CL (performed between 1997 and 2003). These two treatments both aim at obtaining a vestibular deafferentation in order to free definitely the patient of vertigo manifestations. Vestibular results have been assessed by caloric tests performed before and 6 months after treatment. Subjective success was evaluated by searching for recurrent attacks of vertigo and by the AAO-HNS (American Academy of Otolaryngology-Head and Neck Society) scale of subjective evaluation of vertigos (follow-up of 6.4 years after VN and 2.4 years after CL). Pure tone audiometry before treatment and then 6 months later was performed. Complications of two types of treatment were recorded and evaluated. In 90% of the cases after VN and 86% of the cases after CL, caloric tests indicated a strong vestibular hyporeflexy (hypovalence > 90%). Attacks of vertigo reoccurred in 5.6% of the cases when the hyporeflexy was strong and 85.7% of the cases when it was weak. The quality of the vestibular results on vertigo depends on the degree of hypovalence after treatment. An improvement of the AAO-HNS scale have been obtained in 93% of the cases in the NV group and in 81% of the cases in the LC group. Attacks of vertigo were recurrent in 7% of the patients operated on by VN and 11.4% of the patients treated by CL. Mean pure tone auditory thresholds changed from 50.24 dB HL to 55.64 dB HL (p=0.003) in the VN group and from 69.11 dB HL to 74.51 dB HL (p=0.41) in the CL group. Comparison of the variations of the mean pure tone auditory thresholds before treatment and 6 months after the end of the treatment doesn't show any significant difference between the 2 groups (p > 0.05). Impairment of the audition superior to 20 dB HL was observed in 8.5% of the patients of each group. The auditive results are similar in the 2 groups. These two methods of treatment can not be strictly compared due to several bias in this study. Indeed more patients were treated by VN with a longer follow-up and only the patients with a class C or D audition according to the criteria of the AAO-HNS could be treated by CL. The VN provides a better control of the vertigos than the CL which is an efficient method of treatment in invalidating Meniere's disease. In all the cases, the quality of the results on vertigos depends on the degree of hypovalence after treatment. The auditive results are similar. Since the results of the two treatments are similar, the simplicity of CL encourages us to broaden the indications and to modify the place of the VN in the therapeutic algorithm of Menière's disease.

Is proprioception calibrated during visually guided movements?

In the present study, a visuomotor adaptation paradigm was used to determine whether proprioception is calibrated during visually guided movements. A full vision group (FV) was given vision of a cursor representing hand position and was asked to aim towards visible targets. A no vision group (NV) performed the same task without vision of the cursor and was given knowledge of results (KR) after movement completion. A directional bias was introduced between the location of the cursor and the location of the hand in an adaptation phase, which resulted in a deviation to the right of the intended target. Of interest was whether participants would still show rightward deviations in a post-test series of trials in which vision was removed (aftereffects). The NV group presented strong aftereffects. However, the FV group only showed modest aftereffects early in the post-test, which rapidly decayed over the course of the post-test. Further analyses showed that the presence of those early aftereffects was due to an offline influence of vision on movement planning.

Immunohistochemical demonstration of c-fos protein in neurons of the medulla oblongata of the musk shrew (Suncus murinus) after veratrine administration.

We subcutaneously injected 0.5 mg/kg veratrine into the musk shrew (Suncus murinus), observed the presence or absence, latency, and the incidence of vomiting in each animal for 90 min, and selected animals that frequently vomited (FV group) and those that did not vomit (NV group). Subsequently, animal brains were removed, and the induction of c-fos protein (Fos) was immunohistochemically examined to evaluate neuronal activity in the medulla oblongata. The distribution of Fos-positive neurons in the medulla oblongata was similar between FV and NV groups, with numerous neurons along the entire length of the nucleus of the solitary tract and in the ventrolateral reticular formation. Both veratrine-injected groups showed higher numbers of positive neurons than the saline administered group. However, while the FV group showed a high concentration of positive neurons in the dorsal-dorsomedial reticular formation of the nucleus ambiguus in the rostral medulla, the NV group showed few positive neurons in this area. Fos activity in neurons in this area appeared to be higher in animals with a higher incidence of vomiting.

Immunologic responses of domestic and bighorn sheep to a multivalent Pasteurella haemolytica vaccine.

The efficacy of a Pasteurella haemolytica vaccine (serotypes A1, A2, and T10) to induce humoral antibodies and alter colonization of the upper respiratory tract by related P. haemolytica spp. strains was evaluated in 10 bighorn (Ovis canadensis canadensis) and 10 domestic (Ovis aries) sheep. Sheep of each species were divided into five pairs based on age and history of respiratory disease. One sheep in each pair was vaccinated twice 2 wk apart with 2 ml of vaccine (VAC group) and the remaining animals (NV group) were injected with 2 ml of sterile saline. Mild, transient lameness was the only observed adverse effect. Blood sera from the sheep were tested for agglutinating antibodies against whole cells of A1, A2, and T10 and for leukotoxin neutralizing antibodies. Antibody titers were expressed as the reciprocal log2 of the highest reactive dilutions. Domestic sheep > 1-yr-old and two bighorn sheep with a history of A1 infection had higher titers throughout the study against A1 cells than domestic sheep < 1-yr-old and bighorns without a history of A1 infection. Both domestic and bighorn sheep had log2 titers of 8 to 12 against A2 cells and 6 to 12 against T10 cells during this time. Bighorn sheep in the VAC group had 2 to 32 fold titer increases for A1 cells by 2 wk post-vaccination (PV) compared to 0 to 2 fold increases in VAC domestic sheep. Two to 16 and 0 to 8 fold increases in antibodies titers to A2 and T10 cells, respectively, were detected in sera of both VAC groups. Sera of bighorn sheep with a history of respiratory disease and all domestic sheep had log2 leukotoxin neutralizing antibody titers of 4 to 14 in contrast to < or = 2 in sera of bighorn sheep without a history of respiratory disease. Neutralizing antibody titers of two bighorns without a history of respiratory disease in the VAC group increased from log2 0 to 5 in one and from 0 to 9 in the other 2 wk PV. Antibody increases in these animals were no longer evident at 16 wk PV while titers of animals with histories of disease remained relatively stable. The types and numbers of Pasteurella spp. isolated from nasal and pharyngeal swabs varied throughout the study without conclusive evidence of suppression of colonization. Although the animals were not experimentally challenged to determine the efficacy of the vaccine, one VAC and one NV bighorn sheep died following introduction of an A2 P. haemolytica strain when leukotoxin neutralizing antibodies had returned to pre-vaccination levels. This vaccine appeared to be safe for use in bighorn sheep and stimulated moderate but transient increases in antibody levels which should provide some protection against naturally occurring disease. A vaccine which would induce production of high and maintained antibodies against multiple strains of P. haemolytica would be valuable for use in bighorn sheep maintained in captivity or when captured for relocation.

Twenty-Four Hour Cortisol Release Profiles in Patients With Alzheimer’s and Parkinson’s Disease Compared to Normal Controls: Ultradian Secretory Pulsatility and Diurnal Variation

Endocrine abnormalities of the hypothalamic-pituitary-adrenal (HPA) system in patients with Alzheimer’s disease (AD) and Parkinson’s disease (PD) have been described repeatedly. However, no data are available on the diurnal cortisol secretory pattern in these major neurodegenerative disorders. Therefore, we studied 24-h pulsatile cortisol secretion in 12 patients with AD and 12 patients with PD compared to 10 normal community- and age-matched volunteers (NV). Twenty-four hour blood sampling was performed from 1800 h to 1800 h at 15-min intervals. Cortisol half-life, number of cortisol secretory bursts/24-h, interpulse interval, mass of cortisol secreted per burst, amplitude of cortisol secretory bursts, pulsatile cortisol production rate, 24-h mean, and integral cortisol concentrations were calculated by applying deconvolution analysis. Furthermore, the relative diurnal variation and the quiescent period were determined. Patients with AD and PD were found to have significantly higher total plasma cortisol concentrations (24-h pulsatile cortisol production rate: AD + 56%; PD + 52%/24-h integrated cortisol: AD + 37%; PD + 29%) compared to NV. This sustained hypercortisolism is due to a higher mass of cortisol secreted per burst (AD + 62%; PD + 79%), but not to increased cortisol half-life or secretory pulse frequency or amplitude. Despite these similarities between AD and PD patients, relative diurnal variation of cortisol secretion was significantly decreased in patients with PD (−22%), whereas the pattern of secretory curves was not different between NV and AD patients. This observation was indirectly supported by a reduction of the quiescent period in patients with PD (−74 min) compared to the NV and AD group. Based on these results and recently published animal data, we hypothesize that decreased expression of hippocampal mineralocorticoid receptors (MR) may account for the flattened diurnal cortisol secretory curve observed in PD patients, whereas the intact diurnal profile in AD patients may be due to a relative increase in MR compensating for the hippocampal neuronal loss commonly occurring in this disorder.

Cognitive determinants of verbal underachievement at secondary school level

Children whose non‐verbal cognitive ability markedly exceeds their verbal cognitive ability (discrepant, D group) as measured in cognitive abilities tests (CATs) were compared with non‐discrepant children individually matched on either verbal (V group) or non‐verbal (NV group) CAT scores. 66 children from year 7 (11/12 years) and 60 from year 10 (14/15 years) were selected on this basis in a semi‐rural comprehensive school. The scores of the D and V groups were essentially the same on single word reading tests, spelling and the pig latin tests of phonological awareness, while the NV group was superior on these tests. The D group was not worse than the V group on any test and was significantly better than it (and not different from the NV group) on oral syntax, block design from the WISC‐R, and vocabulary (BPVS). The verbal CAT is a good predictor of GCSE (as was confirmed in this study) and regression analysis showed that it is determined to a large extent by basic logical ability (assessed by nvCAT scores) and by reading skill; however, there is also a significant contribution from syntactical understanding. It is pointed out that discrepant pupils are not necessarily reading‐retarded with respect to chronological age and need to be identified and targeted if they are to reach the potential level of achievement predicted by their nvCAT scores.

Comparing Wall Motion Quantification Methods by Numerical Classification

Quantitative left ventriculography has been studied for many years as a method for assessing left ventricular function. All currently used quantitative left ventriculography methods evaluate functional status based on different assumptions concerning the time course of contraction, shape of the ventricular silhouette, and/or fixed points of reference. Commonly, analyses are performed using only end-diastolic (ED) and end-systolic (ES) frames. However, myocardial infarction manifests itself not only in spatial parameters, e.g., area of affected myocardium, but also in temporal parameters, e.g., deviation from a synchronous contraction during systole. ED/ES comparisons omit information contained in other frames of the cardiac cycle. Therefore, each single method has a limited reliability or usefulness. The present study used several quantitative methods, fitted curvatures, correlation coefficients of the percentage of radial shortening from end diastole to end systole, and Fourier coefficients of the polar coordinates of the endocardial contour points. Features were derived from a sequence of ventriculograms of a whole cardiac cycle from patients with anterior myocardial infarction (AMI group) and without (NV group) to address three major goals: (1) Determine features derived from LV-grams that discriminate between the two patient groups and do so with the highest accuracy, "recognition rate," or lowest error rates; (2) compare the accuracy of features generated by different quantitative methods; and (3) group features generated by the different quantitative methods to achieve higher accuracy. The discriminant capabilities of several feature sets were tested on a patient sample containing 102 patients (63 patients with AMI, 39 patients with no infarction) using numerical classification. The numerical classification had a Supervised Learning design with two cardiologists assigning the patients to the two patient groups. Each quantification method showed a characteristic pattern for detecting pathologic or normal wall motion. Combining features generated by different extraction methods into one feature set improved the correct classification rates.

Efficacy of Prophylactic Endoscopic Variceal Sclerotherapy in Patients with Hepatocellular Carcinoma

Abstract: A setrospective study to determine the influence of prophylactic endoscopic sclerotherapy on the survival rate of patients with hepatocellular carcinoma complicated by esophageal varices was conducted. The subjects included 132 patients without esophageal varices at the time of diagnosis (NV group), 37 patients with hepatocellular carcinoma for whom prophylactic sclerotherapy had been performed for risky esophageal varices (PS group) and 26 patients with hepatocellular carcinoma and risky varices for whom prophylaxis was not performed (NPS group). Multiple regression analysis was used to identify factors affecting the survival rate of the 132 patients without esophageal varices. A tumor embolus in the primary branch or main trunk of the portal vein adversely affected long‐term survival in these patients. The patients were further divided into 2 subgroups, namely those with (Vp3) and without (Vp0‐Vp2) tumor emboli in the main trunk and primary branch of the portal vein. In the Vp0– Vp2 emboli subgroup, the patients who received prophylactic sclerotherapy and the patients without varices had similar survival rates. Patients without prophylactic sclerotherapy had a significantly shorter survival rate than the group without varices and the prophylactic sclesotherapy group (p&lt;0.01 and p&lt;0.05). A significant bleeding rate was observed in the group without prophylaxis and not in the group with prophylaxis. However, in the Vp3 subgroup, the survival rate in each group was identical. Thus prophylactic variceal sclerotherapy is indicated for patients with hepatocellular carcinoma who do not have tumor emboli in the main trunk or primary branch of portal vein.

FUNCTIONAL UTILIZATION OF SPEECH IN GROUP PROBLEM SOLVING

The present study is a genetic approach to the analysis-synthesis process that characterizes structural cognition of humans. It is hypothesized that interactions in the group situation would systematize the complex analysis-synthesis process and create internal structural systematic cognition in each individual.The subjects solved the task of combinating random figures.(FIG. 1-1). The systematic solution of this task needs to differentiate following two levels of analysis-synthesis process and to systematize them (i) analysis-synthesis on each figure,(ii) analysis-synthesis on the relation of all six figures.In the first experiment, the subjects were divided into three groups:(1) 10 individuals who were instructed to verbalize about each figure (V group), 10 individuals without such an instruction (NV group), and (3) 9 pairs who were instructed to work together but were not asked to verbalize (G group). V group committed less errors and got the solution suddenly and “by insight”. In the other hand, NV group made more errors and reached the criterion gradually and “by trial and error” (TABLE 1-1, FIG. 1-3). It took much time for V group to do every trial at the early stages of the task, but it rapidly decreased. But NV group performed rapidly and monotonously through all the stage of the task.(FIG. 1-4). In G group there were more verbalization and more “momentary inhibition of directly reinforced response” (making response time larger) through all the stage of the task than in NV group. It is suggested that the origins of V's behaviors can be found in group interactions.In the second experiment, what interrelations in the group would create such interactions were examined. One group that consisted of individuals was compared with three groups that had different interrelations. I group (individual group) were given the same instructions as NV in the first experiment. Gc (control) were instructed only to work together. Gd (decision group) were told to present cards after a decision by the pair. Gv (verbalization group) were told to present cards and to name each of them together. All three pair groups committed less errors than I group (TABLE 2-1). But Gc's behavior patterns were similar to the I's. They were apt to present cards monotonously and hastily without any agreements and inhibitions from their partners and without verbalizations. Gd took much time at all stages of the task (TABLE 2-3) and had more inhibitions. They often uttered “wait a. moment” to their or to themselves. Though the rate of their verbalization of figures was about a half of Gv's, but more than Gc and I. Gv's regulatory response time per every trial showed the same decreasing pattern as in V (FIG 2-1).Thus different inderactions led to different performances and it is showed momentary inhibition has a relation to verbalization. But how the elements of interactions had relations to systematization of the analysis-synthesis process was not directly revealed. This should be examined in the future by corrected procedures.