摘要:

SummaryEmergency treatment of acute thromboembolic stroke by lysis of the occlusive arterial clot has received increasing attention in recent years. Development of newer thrombolytic agents combined with an enhanced appreciation of the time course of reversible cerebral ischemia have led to further clinical and laboratory exploration of this approach to stroke treatment, which had previously been believed to be unsafe. Recent studies suggest that very early recanalization of cerebral arteries can be achieved with acceptable risks using either local arterial or intravenously administered thrombolytic agents. While most published reports have suggested clinical benefit, definitive proof of sustained clinical efficacy, as measured by overall functional outcome and compared to concurrent controls, remains to be established.

ISSN:0362-5664    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

SummaryIn a recent randomized, double-blind, placebo-controlled crossover trial, we demonstrated efficacy of 4-aminopyridine (4-AP) in improving disability of patients with multiple sclerosis (MS). Here we describe the relationship between dosage, serum level, efficacy, and safety of intravenously and orally administered 4-AP in the same group of 70 MS patients. After both intravenous and oral administration there was a significant relationship between serum levels and 4-AP doses used (p < 0.001 and p < 0.01, respectively). The use of 4-AP in oral doses three times a day showed a large variation and fluctuation in serum levels. After 12 weeks of oral treatment (maximum daily dosage 0.5 mg/kg body weight), a statistically significant improvement was found for the smooth pursuit gain of the eye movements (estimated effect 0.14, 95% confidence interval 0.06–0.23, p < 0.001). The amount of improvement was significantly related to 4-AP serum levels (p = 0.0013). Side effects after intravenous 4-AP occurred frequently and were very troublesome (pain in infusion arm, dizziness). Side effects during oral treatment (dizziness, pares-thesias) were very mild and occurred 30–45 min after intake of the medication and could be related to high serum levels.

ISSN:0362-5664    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

SummaryReports of efficacy of botulinum toxin for cervical dystonia have relied on subjective reports of improvement or various clinical rating scales. We studied 19 patients with cervical dystonia using Turns analysis to determine if quantitative EMG measures of muscle activity changed following botulinum toxin injections. Before and after botulinum toxin injections, six muscles were evaluated bilaterally. Quantitative EMG analysis of active muscles injected with botulinum toxin showed a significant decline in muscle activity after botulinum toxin (F = [1,41] 55.0; p < 0.001). Significant reductions in quantitative EMG parameters were also noted in noninjected active muscles after botulinum toxin treatment (F = [1,51] 59.15; p < 0.001). The sum of EMG activity for all active muscles was calculated for each subject and showed a significant reduction after botulinum toxin injection [MANOVA: (F = [1,5] 5.69; p < 0.05]. Quantitative EMG assessment provides an objective measure of response to botulinum toxin. Decreased muscle activity in noninjected muscles may result from toxin diffusion or reflect relaxation of muscles only secondarily involved in cervical dystonia.

ISSN:0362-5664    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

SummaryMitochondrial benzodiazepine receptors (MBR) are sensitive to anxiety and stress. The aim of the present study was to investigate whether platelet MBR are altered in untreated obsessive-compulsive disorder (OCD) patients and whether chronic treatment with clomipramine (CMI) regulates these receptors. MBR were assessed in 13 drug-free OCD patients as compared with 15 healthy controls. Seven of the 13 patients were treated with CMI (200–300 mg/day). The density and affinity of the receptors to their ligand [3H]PK 11195 in OCD patients and controls were not affected by the CMI treatment despite the clinical improvement. It seems that, in contrast to generalized anxiety disorder, OCD is not associated with alterations in platelet benzodiazepine receptors.

ISSN:0362-5664    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

SummaryThirty-six healthy volunteers, 19 men and 17 women, were selected to study the possible influence of carbamazepine on Li+ ratio in vitro. The study used within-Ss design. The procedure for preparing and calculating Li + ratio in vitro followed Pandey's method. Twenty milliliters of blood was withdrawn from each subject, and divided evenly into three test tubes containing sodium heparin. Test tube 1 (control) went through the regular Pandey's method; test tube 2 went through the same procedure, except both the loading and incubation media contained 35 μmol/L of carbamazepine. The result showed that carbamazepine did not significantly alter Li+ ratio in vitro. The neurotoxicity resulting from lithium-carbamazepine combination might be related to carbamazepine alone or preexisting physical conditions or interactions not related to Li+ ratio.

ISSN:0362-5664    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

SummaryThe ability of phencyclidine (PCP) to model schizophreniform psychosis is believed to be related to its ability to produce both hypoglutamatergia and hyperdopaminergia. As such, identification of PCP-stimulated behaviors may be important for the development of animal models of schizophrenia. In this study, MK-801 {( + )-5-methyl-10,11-dihydro-5H-dibenzo[a,d]cycloheptane-5, 10-imine maleate}, a high-affinity PCP analogue, was administered to mice in order to stimulate “PCP behaviors.” These PCP behaviors were compared with behaviors stimulated by apomorphine, a dopamine agonist. Stereotyped behavior was assessed by both visual observations and automated measurements. Visual observations showed highly intense gnawing and sniffing in apomorphine-treated mice and the absence of gnawing in MK-801-treated mice. Automated stereotypic measures showed that, compared with vehicle-treated controls, there were frequent dissociations between MK-801 and apomorphine. Conceivably, a compound that attenuates PCP-stimulated behaviors while sparing apomorphine-stimulated behaviors would possess both antipsychotic efficacy and be devoid of undesirable side effects associated with dopamine blockade.

ISSN:0362-5664    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

SummaryThe capacity of peripheral blood mononuclear cells (PBMCs) of anorexia nervosa (AN) patients to produce interleukin-1 (IL-1), interleukin-2 (IL-2), and interleukin-3-like activity (IL-3-LA) was studied. A significantly lower (−49%, p < 0.005) capacity to synthesize IL-2 and an almost significantly impaired ability (−35%, p = 0.058) to release IL-3-LA by PBMCs of AN patients was found, as compared with cells of the control group. IL-1 production, either spontaneous or after stimulation with lipopolysaccharide (LPS), did not differ significantly between AN patients and healthy subjects. The lessened capacity to produce IL-2 was accompanied by an enhanced stimulatory activity of the patient sera on the production of this cytokine by PBMCs of healthy subjects. It is therefore suggested that the serum of AN patients contains a stimulatory factor or factors for cytokine production that compensates for the lower production of cytokines by AN PBMCs. Such a compensatory mechanism may explain why AN patients do not have an higher susceptibility to infections.

ISSN:0362-5664    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

SummarySome investigators have proposed that Parkinson's disease (PD) patients often exhibit a worsening of tremor before the emergence of levodopa-induced dyskinesia (LDD). It is not clear, however, whether the presence of tremor depends on the severity of dyskinesia, nor is the precise time course of tremor relative to dyskinesia well understood. This report describes an objective study of the relationship between postural tremor and dyskinesia in eight PD patients who showed signs of choreoathetoid hand movements after a single dose of levodopa. Spectral analysis of sustained hand force provided an objective and sensitive method of detecting worsening of tremor in patients with LDD. Severity of clinical symptoms was highly correlated with severity of dyskinesia. Six of the patients exhibited increased tremor amplitude within 45 min of exposure to levodopa, with two of the six patients experiencing bilateral and four of the six having unilateral worsening of postural tremor. Tremor was more severe on the side with the more severe dyskinesia. These findings provide objective support for the notion that dyskinesia and postural tremor may stem from a common pathophysiologic mechanism.

ISSN:0362-5664    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

SummaryMK-801, a noncompetitive antagonist of the N-methyl-D-aspartate (NMDA) receptor complex that binds with high-affinity to the phencyclidine (PCP) binding site, stimulated an outbred strain of NIH Swiss mice to display discrete episodes of explosive jumping behavior, designated as “popping.” The episodes of this behavior were characterized with respect to their dose dependency, latency, and duration. The number of mice displaying this behavior increased with increasing doses of MK-801. The intensity of the popping behavior was sensitive to dose-dependent inhibition by haloperidol, a conventional antipsychotic medication, and clozapine, an atypical antipsychotic medication. In view of PCP's ability to precipitate a schizophreniform psychosis in humans, the behavior may serve as a useful preclinical paradigm for the screening of potentially novel antipsychotic medications.

ISSN:0362-5664    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

SummaryComa, hemiparesis, unilateral optic neuropathy, and anosmia manifested in a patient with leukemia after he received only three courses of intravenous high-dose cytosine arabinoside (ARA-C). The patient's mental status returned to normal after several days, and his hemiparesis resolved. However, the visual loss persisted, and near complete visual loss in the other eye ensued over the following month. Severe bilateral optic atrophy appeared as the visual loss progressed. Anosmia became evident after resolution of the coma and did not improve. The patient had previously had a thoracic myelop-athy 2 weeks after receiving low-dose i.v. ARA-C. The neurotoxicity of high-dose i.v. ARA-C may arise at much lower cumulative doses than has been reported. In addition to cerebellar dysfunction and somnolence, high-dose i.v. ARA-C may produce optic neuropathy, anosmia, and hemiparesis.

ISSN:0362-5664    

出版商:OVID    

年代:1993

数据来源: OVID