Is donor age an important determinant of graft survival?
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Adolescent↗
Biomedical subjects
T Lindquist
Publications and source records attributed to T Lindquist.
Effect of alcoholism on the incidence of lactate-induced panic attacks.
BACKGROUND: Chronic alcohol use is associated with higher than expected rates of panic disorder. METHODS: To study the relationship between alcoholism and panic disorder, we administered the panicogenic agent, sodium lactate, to 26 alcoholics with either panic disorder or frequent panic attacks (ALCPAN), 20 nonalcoholics with panic disorder (PAN), 14 alcoholics without a history of panic attacks, and 14 healthy volunteers. RESULTS: PAN were significantly more likely to have a lactate-induced panic attack (65%) than ALCPAN (23%). ALCPAN who had the onset of panic attacks prior to alcoholism also had a reduced frequency of lactate-induced panic attacks (26.7%) compared to PAN. CONCLUSIONS: There is a reduced incidence of lactate-induced panic attacks in ALCPAN. This reduction does not appear to be explained by the relative onset of panic attacks to alcoholism. The role of excessive alcohol consumption in the decreased frequency of lactate-induced panic attacks seen in ALCPAN needs further study.
Adult↗
Lack of neurotoxic effect of diethylpropion in crack-cocaine abusers.
Dopamine agonists have been used with some success in treating cocaine addiction. However, both cocaine and psychostimulants have been reported to produce neurotoxic effects. We evaluated the effect of the stimulant diethylpropion on cognitive performance in a double-blind, placebo-controlled trial. Forty-six abstinent crack-cocaine users received either placebo, 25-mg, 50-mg, or 75-mg doses of diethylpropion. Patients were tested at baseline and again after 9-14 days of medication. There were no differences between placebo and medication groups on any test, indicating that, within the time frame studied, diethylpropion does not produce neurotoxic effects that can be detected with standardized neuropsychological tests.
Adult↗
Predicting premorbid functioning in crack-cocaine abusers.
The Wide Range Achievement Test (Revised) (WRAT-R) reading test, demographic variables and drug use severity were used to develop prediction equations to estimate premorbid ability in 92 cocaine abusers. WRAT-R reading was correlated significantly with full scale, verbal and performance IQ. Stepwise regression indicated that only WRAT-R reading score and age accounted for 23% of the variance in Full Scale IQ (FSIQ) and 28% in Verbal IQ (VIQ). Abstinence and severity of use variables did not correlate with nor predict IQ. Actual and predicted IQ scores were correlated significantly and did not differ based on within group t-tests. Thus, these formulas accurately estimate premorbid functioning in cocaine-dependent research patients with FSIQs in the average to low average range, replicating the results in normal adults with average IQs.
Adolescent↗
Diethylpropion pharmacotherapeutic adjuvant therapy for inpatient treatment of cocaine dependence: a test of the cocaine-agonist hypothesis.
Fifty cocaine-dependent patients completed a 2-week double-blind, double-dummy, parallel-group comparison of four dosage levels of diethylpropion and placebo. This clinical trial was designed to evaluate both diethylpropion's ability to attenuate cocaine cue-induced craving and its potential for development as a medication with cocaine-agonist properties. The results indicated that diethylpropion was not superior to placebo and confirmed earlier reports that craving for cocaine diminishes over the course of an inpatient hospitalization. Moreover, the results showed that the cocaine cue-induced craving paradigm employed is effective in stimulating craving for cocaine. Medications that are effective in attenuating this type of "conditioned" craving may have relevance to the breaking of the cycle of relapse and long-term treatment of cocaine dependence. Diethylpropion may not be an appropriate candidate for future medication development because of its lack of obvious therapeutic efficacy and the emergence of a significant number of side effects. However, a cocaine-agonist medication strategy may be appropriate for a subgroup of cocaine-dependent patients with coexisting attention deficit-hyperactivity disorder.
Adult↗
Effect of chloride or glucose on the incidence of lactate-induced panic attacks.
OBJECTIVE: This study was designed to test the hypothesis that the addition of chloride to a lactate infusion would reduce the frequency of panic attacks. METHOD: The subjects included 14 healthy volunteers and 20 patients meeting the DSM-IV criteria for panic disorder. All subjects received an infusion of lactate dissolved in 0.9% sodium chloride and an infusion of lactate dissolved in 5% dextrose in water on separate days in a random-order, double-blind procedure. Blood pressure, heart rate, and panic symptoms were measured at 3-minute intervals during the infusions. The occurrence of panic attacks was ascertained through the subjects' reports of losing control, panicking, or "going crazy" and the presence of at least four Research Diagnostic Criteria symptoms of a panic attack. RESULTS: Fifteen (75%) of the patients with panic disorder reported a panic attack during one of the infusions or both; no healthy volunteers had a panic attack. The patients with panic disorder were significantly more likely to have a panic attack during the lactate/sodium chloride infusion than during the infusion of lactate/5% dextrose in water. The number of panic attack symptoms reported at 3-minute intervals did not differ between the two types of infusion. CONCLUSIONS: The coadministration of glucose resulted in a reduced sensitivity to the panicogenic effects of lactate. The hypothesis that adding chloride to the infusion would reduce the frequency of lactate-induced panic attacks was not supported.
Blood Glucose↗
Nimodipine pharmacotherapeutic adjuvant therapy for inpatient treatment of cocaine dependence.
Recent preclinical studies suggest utility for voltage-sensitive calcium channel blockers (VSCCBs) in the treatment of cocaine addiction. The following double-blind placebo-controlled study examined the role of the VSCCB nimodipine in attenuating cocaine craving in 66 recently abstinent cocaine-dependent patients on an inpatient substance abuse treatment unit utilizing an intensive 12-step milieu-oriented psychosocial therapy. While the medication was well tolerated, the dose of nimodipine used in this study (90 mg q.d.) was not superior to placebo in reducing background or cue-induced cocaine craving over the 3 weeks of the study. There was the suggestion that nimodipine might attenuate the severity of some cocaine-induced brain deficits, as detected by evaluation of smooth pursuit eye movement function. A rationale for evaluating higher doses of nimodipine for the treatment of cocaine addiction is presented. As nimodipine might have anticraving and mood-stabilizing properties and cardio- and neuroprotective properties in the face of cocaine intoxication and might possibly even reverse some cocaine-induced brain deficits, further investigation of the role of nimodipine (and other VSCCBs) in cocaine addiction appears an attractive avenue of future medication development.
Calcium Channel Blockers↗
Abstinent alcoholics exhibit an exaggerated stress response to 2-deoxy-D-glucose challenge.
Chronic excessive alcohol consumption can significantly disturb the hypothalamic control of glucose metabolism; however, the mechanism and clinical significance of this disturbance are poorly understood. We used 2-deoxy-D-glucose (2-DG), which produces intracellular glucoprivation, to compare neurochemical, physiological, and behavioral responses to glucoprivic stress between alcoholics abstinent for 3 weeks and healthy volunteers. Twenty-six male alcoholics and 15 male healthy volunteers received intravenous infusions of placebo, 12.5 mg/kg, and 25.0 mg/kg of body weight of 2-DG over 30 min on three separate days, following a random-ordered, double-blind procedure. Minimal effects were observed following administration of the 12.5 mg/kg of body weight dose of 2-DG. Following 25.0 mg/kg, alcoholics showed both exaggerated ACTH and cortisol responses and greater increases in caloric intake when compared with controls. Although anxiety, desire to consume alcohol, plasma progesterone, and sympathetic and adrenal medullary activity all increased following 2-DG, these responses did not differ between alcoholics and controls. The present findings suggest certain specificity for the exaggerated hypothalamic and adrenocortical responses to mild glucoprivic stress in 3-week-abstinent alcoholics.
Adrenocorticotropic Hormone↗
Tracheoplasty using titanium reconstructive plates with strap-muscle flap.
The reasons for unsuccessful decannulation after a laryngotracheoplasty may be multifactorial depending on the techniques used. Excessive granulation tissue may develop, necessitating further adjunctive procedures. Cartilaginous grafts may get infected, resorb, or collapse into the tracheal lumen. Bulky regional skin-muscle flaps may dehisce under tension or collapse into the tracheal lumen. Medial migration of the split ends of the anterior cartilaginous tracheal rings ensues with subsequent restenosis. Donor-site morbidity may compound these problems as well. During a 2.5-year period, we have performed laryngotracheoplasty on nine patients with 60% to 100% tracheal stenosis using titanium reconstruction plates. The split anterior tracheal wall is fixed by the plates in its expanded position. A neurovascularized strap-muscle flap is used to reconstruct the anterior tracheal wall. The flap becomes epithelialized with squamous epithelium within 3 weeks. Successful decannulation was possible in seven of the nine (78%) patients with no further respiratory problems. Of these, six required no further procedures. This technique offers a viable simple alternative to other methods of laryngotracheoplasty without the need for donor cartilage grafts or thick bulky skin-muscle flaps.
Adolescent↗
Pharmacologic maintenance of abstinence in patients with alcoholism: no efficacy of 5-hydroxytryptophan or levodopa.
Pharmacologic enhancement of central nervous system serotonin and dopamine functions has been postulated to improve maintenance of abstinence in patients with alcoholism. To test this hypothesis, patients with alcoholism who completed a 42-day inpatient treatment program were randomized to be administered, in a double-blind fashion, either 5-hydroxytryptophan and carbidopa, levodopa and carbidopa, or placebo for 1 year. Eight of 31 patients who entered the analysis remained abstinent from alcohol for 1 year; however, there was no significant effect of the treatment condition on maintenance of abstinence. Baseline psychologic measures showed that patients who abstained from alcohol had more education and higher scores on memory function tests. Measures of cerebrospinal fluid obtained before the start of the study indicated that all patients who had higher concentrations of the dopamine metabolite homovanillic acid relapsed, suggesting that further research is needed to elucidate the role of dopamine in alcoholism.
5-Hydroxytryptophan↗
The oxidation of p-phenetidine by horseradish peroxidase and prostaglandin synthase and the fate of glutathione during such oxidations.
The oxidation of p-phenetidine by horseradish peroxidase and prostaglandin synthase was investigated. The existence of a free radical intermediate formed during enzymatic oxidation was supported by a ratio of hydrogen peroxide: p-phenetidine consumed of 1:2 in the horseradish peroxidase system. Furthermore in both enzyme systems a rapid oxidation of added glutathione was observed and in the presence of the thiol there was a decreased removal of p-phenetidine. This suggests the reduction of a p-phenetidine radical by glutathione generating p-phenetidine and a thiyl radical. The latter react with oxygen and a rapid oxygen uptake was observed during enzymic oxidation in the presence of thiols. That p-phenetidine radicals were produced during horseradish peroxidase catalyzed oxidation of p-phenetidine was supported by experiments using the spin probe OXANOH. This was oxidized to its stable free radical form (OXANO.) in an enzyme- and substrate-dependent reaction and the EPR signal obtained was not decreased by SOD (80 micrograms/ml) or benzoate (10-100 mM). TLC characteristics of the products of the oxidation of p-phenetidine by both enzymes were almost identical inferring a similar mechanism of oxidation. Two of the metabolites were characterized by mass spectrometry and by comparison with reference compounds prepared by chemical oxidation. One metabolite was identified as 4,4'-diethoxyazobenzene, which further supports a radical mechanism, and the other was a p-phenetidine trimer which could exist in both oxidized and reduced forms. On the basis of these observations a mechanism for the oxidation of p-phenetidine and the fate of glutathione during such oxidations is proposed.
Aminophenols↗
Three-dimensional CT and MR imaging in congenital dislocation of the hip: clinical and technical considerations.
Three-dimensional (3D) CT and 3D magnetic resonance (MR) imaging were performed in four patients with congenital dysplasia of the hip. Two patients were studied by 3D CT and two by 3D MR. Prior to volume segmentation, two-dimensional (2D) MR image preprocessing was used to correct for nonuniform signal intensity distribution from local variations in field strength and coil response. An unsharp mask of the original MR scan was computed by extreme blurring of the image to suppress the details of the object. The unsharp mask was divided into the image on a pixel-by-pixel basis. For improved object contrast first and second echo images were combined in a 1:2 ratio. To add an additional feature for volume segmentation, 2D MR image homogeneity was computed based on 3 X 3 pixel neighborhoods. Volume segmentation was performed using one feature for CT, i.e., attenuation range, and two features for MR, i.e., signal intensity and image homogeneity range. Three dimensional CT and 3D MR demonstrated the 3D relationships of femoral heads and acetabula. Three-dimensional CT was limited to patients who had ossified femoral heads, whereas 3D MR demonstrated the cartilaginous femoral head. The extent of acetabular coverage on which the mode of therapy is based was shown. Three-dimensional MR permitted imaging without gonadal irradiation. The 2D MR image preprocessing described here should provide even better results in objects with greater contrast, i.e., nonosseus structures, and those of larger size with relation to image degradation from partial volume effect.
Child↗
Three-dimensional digital displays in congenital dislocation of the hip: preliminary experience.
Four patients with congenital dislocation of the hip (CDH) were studied on a research basis with three-dimensional computed tomography (3-D CT) or, alternatively, with three-dimensional magnetic resonance imaging (3-D MR). 3-D CT and 3-D MR proved useful in demonstrating the extent of anterior and posterior acetabular coverage. 3-D CT was limited to patients greater than 6 months of age with ossified femoral heads. 3-D MR, in contrast to 3-D CT, demonstrated the cartilaginous femoral head in children less than 6 months of age, while avoiding gonadal irradiation. Both 3-D CT and 3-D MR appear promising in confirming the diagnosis and facilitating the choice of treatment modality in the child with complicated CDH.
Child, Preschool↗