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PubMed1990

Rapid cycling bipolar affective disorder. II. Treatment of refractory rapid cycling with high-dose levothyroxine: a preliminary study.

Eleven patients with rapid cycling bipolar affective disorder whose symptoms were refractory to their current medication regimen were entered into an open trial of high-dose levothyroxine sodium added to a stable regimen of those medications. At baseline, all patients exhibited a rapid cycling pattern and were evaluated prospectively through at least one affective episode. Levothyroxine was added to the baseline medication regimen, and the dosage was increased until clinical response occurred or until side effects precluded further increase. While patients were taking levothyroxine, scores on both depressive and manic symptom rating scales decreased significantly compared with baseline. This improvement was due to the clear-cut response of depressive symptoms in 10 of 11 patients, with manic symptoms responding in five of the seven patients who exhibited them during baseline evaluation. Four patients then underwent single- or double-blind placebo substitution; three patients relapsed into either depression or cycling. Treatment response did not depend on previous thyroid status. In 9 of 10 responsive patients, supranormal circulating levels of free thyroxine were necessary to induce clinical response. Side effects were minimal, and there were no signs or symptoms of levothyroxine-induced hypermetabolism.

Adult↗

PubMed1990

Rapid diagnosis of Pneumocystis carinii infection in AIDS by cytocentrifugation and rapid hematoxylin-eosin staining.

Pneumocystis carinii pneumonia (PCP) is the major pulmonary complication in patients with the acquired immunodeficiency syndrome. While fiberoptic bronchoscopy with bronchoalveolar lavage (BAL) and transbronchial biopsy (TBBX) is regarded as the procedure of choice to identify PCP, these techniques, particularly TBBX, pose potential risks to the already compromised patient. To reduce the duration of bronchoscopy and, hence, lessen the chance for complications, we describe a rapid technique to identify PCP in BAL fluid by cytocentrifugation and hematoxylin-eosin staining. By this method, PCP can be easily diagnosed within 10 min. The sensitivity of this rapid diagnostic procedure is 95.7%, and the specificity is 100%.

Acquired Immunodeficiency Syndrome↗

PubMed2004

3' rapid amplification of cDNA ends (RACE) walking for rapid structural analysis of large transcripts.

The 3' rapid amplification of cDNA ends (3' RACE) is widely used to isolate the cDNA of unknown 3' flanking sequences. However, the conventional 3' RACE often fails to amplify cDNA from a large transcript if there is a long distance between the 5' gene-specific primer and poly(A) stretch, since the conventional 3' RACE utilizes 3' oligo-dT-containing primer complementary to the poly(A) tail of mRNA at the first strand cDNA synthesis. To overcome this problem, we have developed an improved 3' RACE method suitable for the isolation of cDNA derived from very large transcripts. By using the oligonucleotide-containing random 9mer together with the GC-rich sequence for the suppression PCR technology at the first strand of cDNA synthesis, we have been able to amplify the cDNA from a very large transcript, such as the microtubule-actin crosslinking factor 1 (MACF1) gene, which codes a transcript of 20 kb in size. When there is no splicing variant, our highly specific amplification allows us to perform the direct sequencing of 3' RACE products without requiring cloning in bacterial hosts. Thus, this stepwise 3' RACE walking will help rapid characterization of the 3' structure of a gene, even when it encodes a very large transcript.

DNA Primers↗

PubMed1989

Rapid Ag+-induced release of Ca2+ from sarcoplasmic reticulum vesicles of skeletal muscle: a rapid filtration study.

Using a rapid filtration method, we show that Ag+ is able to trigger Ca2+ release from sarcoplasmic reticulum vesicles at a rate as fast as that induced by Ca2+ itself. The Ag+ concentration dependence of the rate constant of Ca2+ release presents a bell shape, similar to that of Ca2+-induced Ca2+ release, with a maximum at 30 microM free Ag+. The rapid phase of Ca2+-release induced by Ag+ is activated by millimolar ATP and inhibited by 5 microM ruthenium red. Moreover, micromolar Ca2+ produces a shift of the Ag+ concentration dependence of the Ca2+ release rate. All these results suggest that Ag+ acts on the same sites as Ca2+ to regulate the release of Ca2+.

Adenosine Triphosphate↗

PubMed1988

Rapid transducin deactivation in intact stacks of bovine rod outer segment disks as studied by light scattering techniques. Arrestin requires additional soluble proteins for rapid quenching of rhodopsin catalytic activity.

In photoreceptors of the living retina both activation and deactivation of transducin must occur in less than 1 s. In ROS preparations used for in vitro studies, however, deactivation takes minutes. This is due to the fact that activated transducin is released into the free aqueous space, whereby GTPase activity and consequent deactivation of the protein are slowed down, and due to the dilution of soluble ROS proteins involved in the quenching of rhodopsin activity. In this paper, using a convenient, non-invasive light scattering assay, we demonstrate that in an intact stack of disks, where active transducin stays membrane associated and is rapidly deactivated, the activity of rhodopsin can also be quenched in the time range of seconds when soluble ROS proteins are supplemented. Arrestin, the 48 kDa protein of the photoreceptor, is one of the proteins required for rapid recovery, however, it requires the synergistic action of other soluble proteins (besides rhodopsin kinase) in order to exert its effect: When arrestin is included in the reaction mixture without the 'helper protein(s)', it cannot speed recovery, and when a mixture of soluble proteins is added which lacks arrestin, there is also no effect. The nature and identity of this (these) helper protein(s) are still unclear.

Animals↗

PubMed1990

Evaluation of thyroid function in patients with rapid-cycling and non-rapid-cycling bipolar disorder.

The problem of whether rapid-cycling (RC) bipolar disorder is more frequently associated than non-rapid-cycling (NRC) bipolar disorders with thyroid dysfunction was investigated in two groups of 11 women matched for age and therapy. Seven patients in each group were under chronic lithium therapy. Both RC and NRC patients, as compared to euthyroid controls, showed a reduction in mean total and free thyroid hormone concentrations, subnormal values of free thyroxine being found in four RC and three NRC patients. No patient had supranormal baseline thyroid stimulating hormone (TSH) values, but an exaggerated TSH response to thyrotropin releasing hormone was found in three RC and two NRC patients: all these patients had been receiving lithium therapy for more than one year. No differences in the prevalence of goiter and thyroid-directed autoantibodies were observed in the two groups. These data confirm that bipolar disorder, especially during treatment with lithium, is associated with at least subclinical hypothyroidism, and suggest that RC patients do not differ from NRC patients in the prevalence of spontaneous or lithium-induced thyroid hypofunction. Lithium-induced hypothyroidism is likely to be related to the length of treatment.

Adult↗

PubMed1985

Rapid methods in clinical microbiology. Rapid methods. Overview and prospects for the future.

The field of infectious diseases covers many entities that can be considered true medical emergencies. Included are meningitis, brain abscess, spinal epidural abscess, epiglottitis, pneumonia, bacteremia, endocarditis, certain intraabdominal infections, gas gangrene, and necrotizing fasciitis. Because emergencies related to infectious agents are potentially the most readily reversible of all medical emergencies, it behooves us to diagnose them as rapidly and specifically as possible so that appropriate life-saving therapy may be begun expeditiously. This article reviews and summarizes the presentations of others in this issue and presents views on future prospects in the rapid diagnosis of infectious diseases.

Bacterial Infections↗

PubMed2003

Use of a whole blood rapid panel test for heart-type fatty acid-binding protein in patients with acute chest pain: comparison with rapid troponin T and myoglobin tests.

PURPOSE: We sought to determine the clinical utility of a newly developed qualitative test to measure heart-type fatty acid-binding protein levels in blood for the early identification of myocardial infarction. METHODS: We measured heart-type fatty acid-binding protein levels in 371 consecutive patients with acute chest pain and suspected myocardial infarction, and compared the performance of this test with those of troponin T and myoglobin tests. Levels of heart-type fatty acid-binding protein >or=6.2 ng/mL were considered as positive results. RESULTS: A final diagnosis of acute myocardial infarction was made in 181 patients (49%). Of the 68 patients who presented within 2 hours of the onset of symptoms, 37 (54%) had a final diagnosis of myocardial infarction. The sensitivity of the rapid heart-type fatty acid-binding protein test was 89% (33/37), significantly higher than for troponin T (22% [8/37]; P<0.001) and myoglobin (38% [14/37]; P<0.001). However, the specificity of troponin T (94% [29/31]) was significantly better than for heart-type fatty acid-binding protein (52% [16/31]; P= 0.002) within 2 hours. The area under the receiver operating characteristic curve for heart-type fatty acid-binding protein levels was greater than that for myoglobin (0.72 vs. 0.61, P = 0.01) among patients who presented within 2 hours. CONCLUSION: A novel whole blood rapid heart-type fatty acid-binding protein test can be useful in the early evaluation of patients who present with acute chest pain.

Acute Disease↗

PubMed2001

Can the API (RAPID) Coryne system be used for identification of rapidly growing mycobacteria?

Fifty-six strains of rapidly growing mycobacteria (RGM) and 14 strains of aerobic actinomycetes as quality controls (QC) were tested in the API (RAPID) Coryne system version 2. Both groups yielded codes with low identification scores, considerable overlaps, and similar diagnoses. No species-specific codes were observed. Thus, the system would not be useful for the identification of RGM.

Actinomycetales↗

PubMed2001

The organization of rapid eye movement activity during rapid eye movement sleep is further impaired in very old human subjects.

Rapid eye movement activity (REMA) during rapid eye movement (REM) sleep was studied in seven very old ('old-old') subjects. Beyond global quantitative features (REMA density), we evaluated the organizational aspects of REMA, that is its occurrence in burst mode, which were compared to a group of younger elderly subjects ('young-old'). REMA density in 'old-old' subjects is not significantly different from that of 'young-old' subjects. The same lack of difference in the two groups is found for the number of REMA bursts. By contrast, the duration of REMA bursts is reduced in the 'old-old' subjects, as well as the 'burst state-to-burst-state' probability, i.e. the probability for successive inter-REMA time intervals to be part of the same REMA burst. Our results clearly show that the trend towards an impairment of REMA organizational aspects continues with aging. This is consistent with the hypothesis that sleep disorganization keeps worsening with age. However, it is of interest to observe that the capability of producing REMA bursts is preserved despite aging.

Age Factors↗

PubMed1999

The organization of rapid eye movement activity during rapid eye movement sleep is impaired in the elderly.

Rapid eye movement activity (REMA) during rapid eye movement activity (REM) sleep was studied in eight elderly subjects and six young adults as a control group. Beyond global quantitative features (REMA density), we evaluated the organizational aspects of REMA, that is its occurrence in burst mode, still largely unknown in the aged. REMA density in the elderly is not significantly different than that of young adults. By contrast, the duration of REMA bursts is reduced in the elderly, as well as the 'burst state-to-burst-state' probability, i.e. the probability for successive inter-REMA time intervals to be part of the same REMA burst. These results show that global aspects of the quantitative features of REMA are preserved in the elderly, whereas their organizational aspects are impaired. These data are consistent with the hypothesis that aging is associated with a difficulty in maintaining physiological processes over time.

Adult↗

PubMed2001

Ultradian rhythms of alternating cerebral hemispheric EEG dominance are coupled to rapid eye movement and non-rapid eye movement stage 4 sleep in humans.

Objective: To replicate the left minus right (L-R) hemisphere EEG power shifts coupled to rapid eye movement (REM) and non-rapid eye movement (NREM) sleep observed in 1972 by Goldstein (Physiol Behav (1972) 811), and to characterize the L-R EEG power spectra for total EEG, delta, theta, alpha and beta bands.Background: Ultradian alternating cerebral hemispheric dominance rhythms are observed using EEG during both waking and sleep, and with waking cognition. The question of whether this cerebral rhythm is coupled to the REM-NREM sleep cycle and the basic rest-activity cycle (BRAC) deserves attention.Methods: L-R EEG signals for ten young, normal adult males were converted to powers and the means were normalized, smoothed and subtracted. Sleep hypnograms were compared with L-R EEGs, and spectra were computed for C3, C4 and L-R EEG powers.Results: Significant peaks were found for all C3, C4 and L-R frequency bands at the 280-300, 75-125, 55-70 and 25-50 min bins, with power dominating in the 75-125 min bin. L-R EEG rhythms were observed for all bands. Greater right hemisphere EEG dominance was found during NREM stage 4 sleep, and greater left during REM for total EEG, delta and alpha bands (Chi-squares, P<0.001). Theta was similar, but not significant (P=0.163), and beta was equivocal.Conclusions: Earlier ultradian studies show that lateral EEG and L-R EEG power have a common pacemaker, or a mutually entrained pacemaker with the autonomic, cardiovascular, neuroendocrine and fuel-regulatory hormone systems. These results for L-R EEG coupling to sleep stages and multi-variate relations may present a new perspective for Kleitman's BRAC and for diagnosing variants of pathopsychophysiological states.

Journal Article↗

PubMed2006

Rapid maxillary expansion and surgically assisted rapid maxillary expansion effects on nasal volume.

The purpose of this study was to compare the effects of rapid maxillary expansion (RME) and surgically assisted rapid maxillary expansion (SARME) on nasal volume using acoustic rhinometric methods. Two groups of subjects were used in the study. Group 1 consisted of 10 subjects (mean age 12.30 +/- 0.82 years) who were treated with RME, and group 2 consisted of 10 subjects (mean age 18.70 +/- 2.54 years) who were treated by SARME. In both groups, all cases had a maxillary width deficiency with bilateral crossbites. Nasal volume records were taken by the same otorhinolaryngologist with an AR device. AR recordings were performed for each patient with and without the use of a decongestant. The first record was taken before expansion, and the second record was taken at the end of retention. The data for both groups were evaluated using Wilcoxon signed rank test and Mann-Whitney U-test. The nasal volume showed a significant increase in both the RME and the SARME groups (P < .05). The measurement with the use of decongestant was similar to that without use of decongestant on the both groups (P < .05), but the different increments in nasal volume between the RME and the SARME groups were not statistically significant. Although the mean ages between the RME and the SARME groups were different, the increase in nasal volume was similar in both groups.

Adolescent↗

PubMed1999

Colony-stimulating factors in rapid eye movement sleep and non-rapid eye movement sleep regulation.

Although several cytokines are known to be somnogenic, no study has been conducted to examine whether colony-stimulating factors (CSF) affect sleep. Therefore, we studied the effects of granulocyte-macrophage CSF (GM-CSF) and macrophage CSF (M-CSF) on sleep in rats and their possible mechanism of action. At the dose of 10 pmol, GM-CSF or M-CSF significantly increased both non-rapid eye movement and rapid eye movement (REM) sleep or REM sleep only when infused intracerebroventricularly during the dark period. When injected locally in the hypothalamus, GM-CSF and M-CSF increased nitric oxide (NO) production. Thus, NOergic neural signals in the hypothalamus may take part in the somnogenic action of CSF.

Animals↗

PubMed2004

Dreaming during non-rapid eye movement sleep in the absence of prior rapid eye movement sleep.

STUDY OBJECTIVES: There is a long-standing controversy surrounding the existence of dream experiences during non-rapid eye movement (NREM) sleep. Previous studies have not answered the question whether this "NREM dream" originates from the NREM sleep mechanism because the subject might simply be recalling experiences from the preceding rapid eye movement (REM) sleep. METHODS: We scheduled 11 healthy men to repeat 20-minute nap trials separated by 40-minute periods of enforced wakefulness across a period of 3 days. At the end of the nap trial, each participant answered questions regarding the formal aspects of his dream experiences during the nap trial, using the structured interviews. RESULTS: We obtained a total of 172 dream reports after naps containing REM sleep (REM naps) and 563 after naps consisting of only NREM sleep (NREM naps). Dream reports from NREM naps were less remarkable in quantity, vividness, and emotion than those from REM naps and were obtained more frequently during the morning hours when the occurrences of REM sleep were highest. CONCLUSIONS: These results suggest that the polysomnographic manifestations of REM sleep are not required for dream experiences but that the mechanisms driving REM sleep alter experiences during NREM sleep in the morning. A subcortical activation similar to REM sleep may occur in human NREM sleep during the morning when REM sleep is most likely to occur, resulting in dream experiences during NREM sleep.

Adult↗

PubMed1997

[Rapid detection of Shiga-like toxin gene in feces with rapid-cycle polymerase chain reaction].

A rapid detection for Shiga-like toxin in feces was developed with the nucleic acid extraction method by silicondioxide-guanidine thiothianate and rapid-cycle polymerase chain reaction by RapidCycler (model 1002; Idaho Technology, RC-PCR here after). Twenty-two fecal samples that were collected from patients with diarrhoea caused by E. coli O157:H7 and frozen for 6 months were examined directly by RC-PCR, conventional PCR assay using by ThermalCycler 9600-R (Roche, TC-PCR here after) and by the culture method using tellurite-cefixime sorbitol MacConkey (direct method). These examinations were done also after being injected into TCV-TSB and incutated at 35 degrees C overnight (indirect method). The sensitivity of RC-PCR and TC-PCR using a diluted suspension of broth enriched at 35 degrees C overnight were 4.1 pg and 410 fg, respectively. Positive results in the direct method were obtained in 7 for RC-PCR, 10 for TC-PCR and 5 for culture. Positive results on indirect assay were obtained in 9 for RC-PCR, 9 for TC-PCR and 7 for culture. It was demonstrated that the RC-PCR assay was able to detect Shiga-like toxin gene in feces in less than 90 minutes after being received at the laboratory.

Bacterial Toxins↗

PubMed1990

Towards a more rapid diagnosis of rapidly progressive glomerulonephritis.

An attempt was made to provide simple practical guidelines to alert general practitioners to the diagnosis of rapidly progressive glomerulonephritis and lead to early referral to hospital. The duration of illness before referral to this hospital and its effect on outcome in patients with crescentic nephritis were assessed retrospectively from the case notes of 24 patients referred over two years. Four patients had Goodpasture's syndrome, 11 Wegener's granulomatosis, seven microscopic polyarteritis, and two idiopathic progressive glomerulonephritis. The duration of symptoms before referral to the local hospital was similar in the four groups of patients and varied from one week to 28 months (mean 10 months). The duration of stay in the local hospital was two, nine, 11, and 180 days in the patients with Goodpasture's syndrome and a mean of four days (range one to eight) in those with Wegener's granulomatosis and 10 days (one to 18 days) in those with microscopic polyarteritis. In the local hospital the diagnosis was based on the results of renal biopsy and detection of antibodies to glomerular basement membrane in two patients with Goodpasture's syndrome and on the results of renal biopsy in seven of the other patients aided by the detection of antibodies to the cytoplasm of neutrophils (ANCA) in 10. Three of the 24 patients died and four required maintenance haemodialysis. Patients who present to their general practitioners with persistent non-specific symptoms should have a urine dipstick test and then blood tests and emergency referral to hospital if necessary. Hospital physicians should be aware of the speed and accuracy with which current assays can confirm a diagnosis of rapidly progressive glomerulonephritis.

Adult↗

PubMed1999

Thoracic aorta: rapid black-blood MR imaging with half-Fourier rapid acquisition with relaxation enhancement with or without electrocardiographic triggering.

PURPOSE: To evaluate and compare findings for thoracic aortic disease with three black-blood magnetic resonance (MR) pulse sequences: half-Fourier rapid acquisition with relaxation enhancement (RARE), with and without electrocardiographic (ECG) triggering, and ECG-triggered turbo spin echo (SE). MATERIALS AND METHODS: Axial black-blood MR images of the chest acquired at 1.5 T with a phased-array coil were obtained in 38 consecutive patients referred for evaluation of thoracic aortic disease. ECG-triggered and nontriggered half-Fourier RARE images were compared with T1-weighted ECG-triggered turbo SE images. Two readers independently scored images for each of the following parameters: ghosting artifacts; clarity of the mediastinum, cardiac chambers, and aortic wall; conspicuity of abnormality; intraluminal signal void uniformity; and overall image quality. RESULTS: Both half-Fourier RARE sequences outperformed the turbo SE sequence for all measured parameters. Scores for the ECG-triggered half-Fourier RARE sequence were significantly (P < .05) higher than those for the nontriggered version for clarity of the mediastinum and aortic wall, conspicuity of any abnormality other than aortic dissection, and overall image quality. Mean acquisition times for the ECG-triggered (48 seconds) and nontriggered (30 seconds) sequences were significantly shorter than that for the turbo SE sequence (2 minutes 20 seconds). CONCLUSION: Rapid black-blood half-Fourier RARE sequences, with or without ECG triggering, can replace ECG-triggered turbo SE sequences for evaluation of thoracic aortic disease.

Adult↗