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PubMed1998

Changes in temporal acuity with age and with hearing impairment in the mouse: a study of the acoustic startle reflex and its inhibition by brief decrements in noise level.

Temporal acuity for brief gaps in noise was studied in mice of different ages (1-36 months) from strains with differing susceptibility to age-related hearing loss, using reflex modification audiometry. Prepulse inhibition of the acoustic startle reflex (ASR) increased with gap depth (GD: 10-40 dB in 70 dB SPL noise) and lead time (LT: 1-15 ms). The increase in inhibition with LT followed an exponential function in which the two parameters, asymptotic inhibition (AINH) and the time constant (tau), were both affected by GD. AINH rapidly declined from 1 to 6 and then to 18 months of age in C57BL/6J mice with progressively severe hearing loss, but first increased with maturation and then gradually declined beyond 6-12 months of age in CBA/CaJ and CBA x C57BL Fl-hybrid mice, which show no apparent change in sensory function at these ages. In contrast, tau was unaffected by hearing loss or by age, this suggesting that age-related changes in this form of temporal acuity occur because of a reduction in the efficiency with which gaps are centrally processed, not from any reduced ability to follow their rapid shift in noise level.

Age Factors↗

PubMed1991

Anorectal sensory and motor function in neurogenic fecal incontinence. Comparison between multiple sclerosis and diabetes mellitus.

We measured anorectal sensory and motor function in 11 patients with multiple sclerosis and fecal incontinence, 11 continent patients with multiple sclerosis, 10 diabetics with fecal incontinence, and 12 healthy control subjects. The threshold volume at which patients with multiple sclerosis and fecal incontinence experienced rectal sensation was higher than that in healthy controls (42.7 +/- 6.2 mL vs. 13.3 +/- 2.8 mL; P less than 0.01) and was similar to that in incontinent diabetics (36.5 +/- 5.7 mL). Patients with multiple sclerosis and incontinent diabetics also showed increased thresholds of phasic external sphincter contraction compared with controls (P less than 0.05). Diabetics with incontinence had reduced resting and maximal voluntary anal sphincter pressures compared with controls (P less than 0.05), whereas patients with multiple sclerosis and incontinence showed only decreased maximal voluntary anal sphincter pressures (P less than 0.01 vs. controls and diabetics). Incontinent patients with multiple sclerosis also required smaller volumes of rectal distention to inhibit internal sphincter tone compared with diabetics and controls (P less than 0.01). Decreased maximal voluntary squeeze pressures were less severe in continent patients with multiple sclerosis than in incontinent patients with multiple sclerosis. We conclude that impaired function of the external anal sphincter and decreased volumes of rectal distention to inhibit the internal anal sphincter or both may contribute to fecal incontinence in multiple sclerosis. In addition, increased thresholds of conscious rectal sensation in some incontinent patients with multiple sclerosis and diabetes mellitus may contribute to fecal incontinence by impairing the recognition of impending defecation.

Adult↗

PubMed1993

[Structure and immunohistochemistry of the hypophysis of Alosa fallax nilotica during the reproductive migratory cycle].

The Pituitary of the Alosa fallax nilotica consists of a pars distalis, a pars intermedia and a pars nervosa. The pars distalis is divided into rostral and proximal. The pars nervosa extends also into proximal pars distalis. The rostral pars distalis, on the contrary in primitive Teleostei, has organized into cellular cords defining cavities or intercommunicating follicles. These latter finish into the oral adenohypophysial duct, which don't open in pharyngeal cavity. The cords contain three cell types: the columnar cells LTH, TSH cells and basal cells not yet functionally determined. The cord cells are separated from follicle cavity by an one layer of flat degranulated cells. The LTH cell, the chief cell type, together the TSH and basal cells shows evident cytologic differences in organelles of synthesis and secretion during the various stages of the reproductive migration. Besides globular and baton-shape projections are underlined in the apical cytoplasm of LTH cells. These structure, extending into follicle cavity, seem to dispatch sensory function probably. The proximal pars distalis consists of compact cords of gonadotropic cells (particularly active during the stage of migration from rivers to the sea) with inserted orangiophilic cells (probably STH) and phloxine cells: these latter cells are chiefly arranged at the periphery and immunocytochemical positive for the antibodies against ACTH. The pars intermedia contains cord of ACTH cells, particularly manifest during the periods of transit from sea water to fresh water and on the contrary, they are characterized by positive-ACTH dense granules. On the ground of ultrastructural aspects of vesicles, the pars nervosa shows three types of nervous fibers which correlate with neurosecretory hypothalamus and catecholaminergic dopaminergic fibers. The Authors think of underlining particularly that the all cells of rostral pars distalis and chiefly the LTH cells are involved significantly in the regulation of reproduction and hydro-mineral metabolic equilibrium.

Animals↗

PubMed1995

Long-term follow-up of olfactory loss secondary to head trauma and upper respiratory tract infection.

OBJECTIVE: To determine the extent to which olfactory function can improve after loss induced by head trauma or a previous upper respiratory tract infection (URI) and the time for this improvement for more effective patient counseling. DESIGN: Patients initially evaluated at the University of Cincinnati (Ohio) Taste and Smell Center were reevaluated for olfactory loss with the University of Pennsylvania (Philadelphia) Smell Identification Test 1 to 5 years after initial testing. Changes in score on this test were used to indicate improvement in sensory function. Subjective information on olfactory ability and olfactory symptoms was also collected. SETTING: University-based tertiary care center. PATIENTS AND OTHER PARTICIPANTS: Forty-one patients with olfactory loss induced by head trauma (20) or previous URI (21). RESULTS: Seven (35%) of 20 patients with head trauma improved on the smell test by 4 points or more. Fourteen of 21 (67%) patients with a previous URI had improved scores of this magnitude or more. A statistically significant correlation was noted between the amounts of improvement and length of follow-up for URI patients. Thirteen of these patients also reported improved olfactory function. CONCLUSION: These findings for patients with head trauma are consistent with other reports of recovery of (or improvement in) olfactory function after trauma-induced loss. For patients with previous URI, these data indicate that improvement in olfactory function occurs, but the improvement may take several years.

Adult↗

PubMed2003

Testing of visceral sensitivity.

Under normal circumstances most of the visceral input to the central nervous system is not perceived consciously. Visceral hypersensitivity associated with altered reflex activity seems to be a common pathophysiological mechanism in functional gastrointestinal disorders. Investigation of visceral sensitivity in humans is based on distension tests using barostat, or tensostat more recently. Tensostat may allow better standardization of distending stimuli, regardless of the capacity or compliance of the organ being tested. Other techniques include transmucosal electrical nerve stimulation, and chemical or thermal stimulation. Measurement of the responses to gut stimuli is based on the evaluation of conscious perception or objective responses, such as reflex activity or central processes. Recently, the assessment of the central responses has become available due to a variety of new brain imaging techniques. Several factors are thought to influence the results of visceral sensitivity studies: age, gender, physiological factors (postprandial testing) as well as psychological factors (stress, hypnosis, hypervigilance phenomenon). Technical conditions for performing tests like distension protocols may considerably affect the perception of sensory thresholds. Various mediators and pharmacological agents, in particular those acting on serotonin receptors, affect the sensory function of the gastrointestinal tract, and some of them have therapeutic potential in the treatment of visceral hypersensitivity.

Animals↗

PubMed1988

Hemispherectomy and diaschisis: rapid improvement in cerebral functions after right hemispherectomy in a six year old child.

Neuroradiological, neurological, and neuropsychological studies before and after hemispherectomy for seizures of a six year old boy with left hemiplegia at birth revealed striking postoperative improvement. Seizures ceased and have not recurred. Preoperative EEC studies from seven months of age revealed increasing pathological involvement of the left as well as right hemisphere. Postoperatively, normal tracings over the left hemisphere documented marked and continuing improvement. In contrast to markedly subnormal preoperative WISC-R IQs, retest at 19 months postoperatively showed WISC-R IQs within the normal range, with similar improvement in other tests of cognitive, motor and sensory functions. The arrest and reversal of the preoperative pattern of increasing deterioration and disappearance of pathological involvement of left as well as right hemisphere functions following surgery is consistent with the disappearance of diaschisis as described by von Monakow in 1914, and has conceivably significant clinical as well as theoretical implications.

Journal Article↗

PubMed2004

Low-severity metacarpal and phalangeal fractures treated with miniature plates and screws.

INTRODUCTION: The results reported in the literature of metacarpal and phalangeal fractures treated with miniature plates and screws are scarce and contradictory. The aim of our study was to evaluate the functional results after low-severity metacarpal and phalangeal fractures treated by miniature plates and screws. MATERIALS AND METHODS: We retrospectively reviewed 44 patients of a consecutive series with 56 low-severity metacarpal and/or phalangeal fractures stabilized with miniature plates and screws with a mean follow-up of 24 months to assess objective and subjective outcomes and complications. The objective assessment included measurement of the range of motion (ROM) of the involved finger, prehension, sensory function and strength. The subjective evaluation assessed the impairment and pain felt by the patient. RESULTS: At the final check-up, average total active movement of the involved digit was 256 degrees (range 175 degrees -260 degrees ), and average score for prehension was 49.3 (range 30-50), with 41 patients with a full score. The Jamar test pointed to a significant reduction in grip strength (-5.2%) of the injured hand compared with the other hand. Average subjective impairment score for all the fractures was 15.5 (range 10-16), with 39 patients having a score between 16 and 14 (no impairment). Fracture reduction was anatomic in 42 fractures (75%), satisfactory in 11 (19.6%) and unsatisfactory in 3 (5.4%). There were no contractures, non-unions, infections or tendon ruptures. Twenty patients (45%) presented with one or more complications in 23 fractures (41.1%). CONCLUSION: These very favourable results suggest that miniature plates and screws are a possible choice in the treatment of these fractures.

Adolescent↗

PubMed2000

Nicotinic systems in central nervous systems disease: degenerative disorders and beyond.

Advances in the understanding of the structure, function, and distribution of central nervous system (CNS) nicotinic receptors has provided the impetus for new studies examining the role(s) that these receptors and associated processes may play in CNS functions. Further motivation has come from the realization that such receptors are changed in degenerative neurologic diseases such as Alzheimer's disease (AD) and Parkinson's disease (PD). Ongoing investigations of the molecular substructure of CNS nicotinic receptors and their pharmacology have begun to open up new possibilities for novel CNS therapeutics with nicotinic agents. Exploiting these possibilities will require understanding of the role(s) that these receptor systems play in human cognitive, behavioral, motor, and sensory functioning. Clues from careful studies of human cognition and behavior are beginning to emerge and will provide direction for studies of potentially therapeutic novel nicotinic agents. Modulation of these receptors with the ultimate goal of producing therapeutic benefits is the goal of these investigations and drug development. This paper will review studies from our laboratory and others that point to the importance of CNS nicotinic mechanisms in normal human cognitive and behavioral functioning as well as their role in disease states. In addition, this paper will examine potential clinical applications of nicotine and/or nicotinic agonists in a variety of CNS disorders with particular emphasis on structural brain disease including: movement disorders such as Parkinson's disease and Tourette's syndrome, cognitive/behavioral disorders such as Alzheimer's disease, attention deficit/hyperactivity disorder, and schizophrenia, and other more speculative applications. Important results from early therapeutic studies of nicotine and/or nicotinic agonists in these disease states are presented. For example, recent studies with nicotine and novel nicotinic agonists such as ABT-418 by our group in AD patients suggest that nicotinic stimulation can improve the acquisition and retention of verbal information and decrease errors. Preliminary results from a series of studies examining the acute and subchronic quantitative effects of nicotine on cognitive and motor functioning in Parkinson's disease suggest that acute nicotine administration and stimulation improves some aspects of cognitive and motor performance and may improve the processing speed of more complex tasks. The most likely near-term applications of novel nicotinic agonists in CNS disorders are likely to be in those disorders that are degenerative in nature, e.g. Parkinson's disease and Alzheimer's disease, or other movement disorders such as Tourette's syndrome. The most likely direct therapeutic role for nicotinic agonists is as augmentation therapy in combination with other agents rather than as monotherapy, except early in disease states or as a prophylactic or preventative treatment.

Animals↗

PubMed1993

Sensorimotor and perceptual function of muscle proprioception in microgravity.

Adaptive properties of the human proprioceptive systems were studied during the French-Soviet orbital flight (Aragatz mission, December 1988). The present space experiment investigated the hypothesis that the modifications of both biomechanical and physiological conditions occurring under microgravity involve considerable reorganization of body perception and postural control. The proprioceptive information originating in muscles is known to contribute, together with visual, vestibular, and sole cutaneous information to postural regulation. Moreover, by specifically activating the proprioceptive channel, muscle vibration is able to elicit both illusory movement sensations and postural responses. This experimental tool was used in microgravity in order to test various aspects of muscle sensory function. Ankle flexor and extensor vibration was applied under different experimental conditions. Quantitative analysis of motor responses was carried out on leg muscle EMG, goniometric, and kinesigraphic recordings. Joystick recordings and astronauts' comments were used to describe the kinaesthetic sensations. The main results were as follows: 1) Under microgravity, the sensitivity of muscle receptors remains unchanged. 2) During the flight, the tonic vibration reflexes (TVR) increased significantly in flexor muscles, which exhibited a sustained tonic activity. 3) The whole-body postural responses normally induced by ankle flexor muscle vibration were suppressed, whereas they remained unchanged or were only reduced when vibrations were applied to the ankle extensor muscles. In all cases, the postural response velocity decreased. 4) A disfacilitation of the vibration-induced postural illusions was observed to occur during long-term exposure to microgravity. These illusions became atypical however. For example: body lift illusion could be induced by tibialis anterior muscle vibration, whereas it was never induced in the controls. The characteristics of the illusory body movements described under normal gravity can be restored by artificially increasing the axial foot support forces during the flight. In conclusion, these data suggest that a functional reorganization of the proprioceptive information processing occurs in microgravity, affecting both perceptual and motor aspects of behavior. It is possible that these proprioceptive adaptations may be partly attributable to the new whole-body propulsive foot functions imposed by exposure to weightlessness and to the adaptation of motor behavior to the third dimension of space.

Adaptation, Physiological↗

PubMed2004

Urinary incontinence and its association with death, nursing home admission, and functional decline.

OBJECTIVES: To determine whether urinary incontinence (UI) is an independent predictor of death, nursing home admission, decline in activities of daily living (ADLs), or decline in instrumental activities of daily living (IADLs). DESIGN: A population-based prospective cohort study from 1993 to 1995. SETTING: Community-dwelling within the United States. PARTICIPANTS: Six thousand five hundred six of the 7,447 subjects aged 70 and older in the Asset and Health Dynamics Among the Oldest Old study who had complete information on continence status and did not require a proxy interview at baseline. MEASUREMENTS: The predictor was UI, and the outcomes were death, nursing home admission, ADL decline, and IADL decline. Potential confounders considered were comorbid conditions, baseline function, sensory impairment, cognition, depressive symptoms, body mass index, smoking and alcohol, demographics, and socioeconomic status. RESULTS: The prevalence of UI was 14.8% (18.5% in women; 8.5% in men). At 2-year follow-up, subjects incontinent at baseline were more likely to have died (10.9% vs 8.7%; unadjusted odds ratio (OR)=1.29, 95% confidence interval (CI)=1.02-1.64), be admitted to a nursing home (4.4% vs 2.6%, OR=1.77; 95% CI=1.18-2.63), and to have declined in ADL function (13.6% vs 8.1%; OR=1.78, 95% CI=1.36-2.33) and IADL function (21.2% vs 13.8%; OR 1.69, 95% CI 1.39-2.05). However, after adjusting for confounders, UI was not an independent predictor of death (adjusted OR (AOR)= 0.90, 95% CI=0.67-1.21), nursing home admission (AOR=1.33, 95% CI=0.86-2.04), or ADL decline (AOR=1.24, 95% CI=0.92-1.68). Incontinence remained a predictor of IADL decline (AOR=1.31; 95% CI=1.05-1.63), although adjustment markedly reduced the strength of this association. CONCLUSION: Higher levels of baseline illness severity and functional impairment appear to mediate the relationship between UI and adverse outcomes. The results suggest that, although UI appears to be a marker of frailty in community-dwelling elderly, it is not a strong independent risk factor for death, nursing home admission, or functional decline.

Activities of Daily Living↗

PubMed2004

Sympathetic, sensory, and nonneuronal contributions to the cutaneous vasoconstrictor response to local cooling.

Previous work indicates that sympathetic nerves participate in the vascular responses to direct cooling of the skin in humans. We evaluated this hypothesis further in a four-part series by measuring changes in cutaneous vascular conductance (CVC) from forearm skin locally cooled from 34 to 29 degrees C for 30 min. In part 1, bretylium tosylate reversed the initial vasoconstriction (-14 +/- 6.6% control CVC, first 5 min) to one of vasodilation (+19.7 +/- 7.7%) but did not affect the response at 30 min (-30.6 +/- 9% control, -38.9 +/- 6.9% bretylium; both P < 0.05, P > 0.05 between treatments). In part 2, yohimbine and propranolol (YP) also reversed the initial vasoconstriction (-14.3 +/- 4.2% control) to vasodilation (+26.3 +/- 12.1% YP), without a significant effect on the 30-min response (-26.7 +/- 6.1% YP, -43.2 +/- 6.5% control; both P < 0.05, P > 0.05 between sites). In part 3, the NPY Y1 receptor antagonist BIBP 3226 had no significant effect on either phase of vasoconstriction (P > 0.05 between sites both times). In part 4, sensory nerve blockade by anesthetic cream (Emla) also reversed the initial vasoconstriction (-20.1 +/- 6.4% control) to one of vasodilation (+213.4 +/- 87.0% Emla), whereas the final levels did not differ significantly (-37.7 +/- 10.1% control, -37.2 +/- 8.7% Emla; both P < 0.05, P > 0.05 between treatments). These results indicate that local cooling causes cold-sensitive afferents to activate sympathetic nerves to release norepinephrine, leading to a local cutaneous vasoconstriction that masks a nonneurogenic vasodilation. Later, a vasoconstriction develops with or without functional sensory or sympathetic nerves.

Adrenergic Antagonists↗

PubMed2005

Neurologic preservation by Na+-H+ exchange inhibition prior to 90 minutes of hypothermic circulatory arrest.

BACKGROUND: The effects of pretreatment with cariporide (HOE 642 Aventis Pharma, Strasbourg-Cedex, France), a Na+-H+ exchanger (NHE) blocker, were studied in a cerebral ischemia-reperfusion model of hypothermic arrest. METHODS: Fifteen Yorkshire-Duroc pigs (37.1 +/- 4.2 kg) underwent femoral-jugular bypass and 90 minutes of deep hypothermic circulatory arrest at 19 degrees C. Ten animals were untreated, whereas 5 received 5 mg/kg of intravenous cariporide before cooling. After rewarming and off cardiopulmonary bypass, the pigs were weaned from anesthesia and followed for 24 hours. A standardized neurologic scoring system assessed brain functional recovery. Biochemical markers were used to analyze cellular injury. Control studies without circulatory arrest were done in 2 animals that underwent similar cooling and rewarming. RESULTS: Neurologic recovery was rapid and complete in the nonischemic controls and in all pretreated animals. Conversely, at 24 hours, all untreated pigs exhibited a cloudy or stuporous level of consciousness, abnormal positioning, and with only one exception, could not sit or stand. The gradation of neurologic score (evaluating central nervous system, motor and sensory functions, respiration condition, level of consciousness, and behavior) was 0 +/- 0 (0 = normal, 500 = brain death) in the treated group, compared with 124 +/- 59 in the untreated animals. Biochemical analysis showed every variable of whole-body injury (including conjugated dienes (p < 0.05), serum aspartate amino transferase (p < 0.01), creatine kinase p < 0.001) and endothelin-1 (p < 0.001) to be higher in the untreated group. CONCLUSIONS: NHE function alters experimental brain ischemia-reperfusion damage. These observations imply that NHE inhibition therapy before ischemia may improve neurologic protection in adult and infant patients undergoing cerebral ischemia during procedures that use hypothermic circulatory arrest.

Animals↗

PubMed2005

Human melanocyte biology, toxicology, and pathology.

The human melanocytes of the skin, hair, eyes, inner ears, and covering of the brain provide physiologic functions important in organ development and maintenance. Melanocytes develop from embryonic neural crest progenitors and share certain traits with other neural crest derivatives found in the adrenal medulla and peripheral nervous system. The distinctive metabolic feature of melanocytes is the synthesis of melanin pigments from tyrosine and cysteine precursors involving over 100 gene products. These complex biochemical mechanisms create inherent liabilities for melanocytic cells if intracellular systems necessary for compartmentalization, detoxification, or repair are compromised. Melanocyte disorders may involve pigmentation, sensory functions, autoimmunity, or malignancy. Environmental factors such as ultraviolet radiation and chemical exposures, combined with heritable traits, represent the principal hazards associated with melanocyte disorders.

Autoimmunity↗

PubMed1980

Axon reflex in ocular injury: sensory mediation of the response of the rabbit eye to laser irradiation of the iris.

Laser irradiation of the rabbit iris produces an injury response consisting of prolonged miosis, uveal vasodilation and a transient rise of intraocular pressure (IOP) accompanied by a breakdown of the blood-aqueous barrier. This response has hitherto been attributed partly to prostaglandin (PG) mediation and partly to mediation by a non-cholinergic nervous pathway thought to be sensory in fuction. Responses of the rabbit eye to laser irritation were examined at specified intervals after diathermic coagulation of the epigasserian nerve tract. Both the intensity of the pupillary constriction and the increase in IOP were almost unaltered at 90 minutes but progressively decreased until at 4 days there was essentially no response to high energy laser irradiation in the denervated eye. It was evident that manifestation of the response is largely dependent upon the presence of intact and functional sensory nerves, and it is proposed that endogenous PGs exert some, if not all of their effects via sensory nerve endings. It is suggested that those terminals which are directly stimulated, whether by laser irradiation or by PGs formed during the injury, release some mediator to cause pupillary constriction. From thes terminals impulses pass orthodromically and antidromically by axon reflex to release further mediator from terminals in the region of the ciliary vessels or the major arterial circle. In this way the response is propagated and augmented.

Animals↗

PubMed1995

Adenosine triphosphate deficiency: a genre of optic neuropathy.

PURPOSE: To offer clinical evidence that deficiency of vitamin B12 may adversely affect the neuronal function of patients who also have the 14,484 mitochondrial DNA mutation associated with Leber's hereditary optic neuropathy (LHON). METHODS: A case of a 27-year-old man with vitamin B12 deficiency and the 14,484 mitochondrial DNA mutation is presented and the literature on causes of some metabolic optic neuropathies reviewed. RESULTS: Visual loss and neurologic symptoms of vitamin B12 deficiency occurred together, at a time when the level of vitamin B12 was subnormal. Vision and other sensory functions began to improve within 2 months of vitamin therapy, and normal vision eventually was restored. CONCLUSIONS: The relatively prompt improvement and the eventual complete recovery of vision following vitamin replacement therapy suggest that the subnormal level of vitamin B12 precipitated visual loss. Given the clinical similarities of subnormal vitamin B12, LHON, and nutritional/tobacco amblyopia, deficiency of adenosine triphosphate might be a unifying etiology for several types of optic neuropathy. This energy hypothesis provides a theoretical basis for the enigmatic phenomena of centrocecal scotomata and recovery of visual function after prolonged blindness.

Adenosine Triphosphate↗

PubMed1990

A comparison of the effects of intrathecal fentanyl and lidocaine on established postamputation stump pain.

Eight patients with established lower limb postamputation stump pain were given lumbar intrathecal fentanyl 25 micrograms and lidocaine 70 mg 2 weeks apart in an attempt to better understand the role of peripheral and central mechanisms in this condition. Baseline pain was recorded and then analgetic and side effects and their duration were assessed. Three self-administered questionnaires with appropriate psychometric proprieties were given to the patients. Intrathecal fentanyl always abolished the pain. Its onset was rapid being heralded within 1-2.5 min by a pleasant sensation of warmth involving the lower trunk and legs. Analgesia was complete by 5-10 min and had a median duration of 8 h. The patients had a sense of well being and were unable to elicit discomfort by pain aggravating maneuvers. Normal motor and sensory functions were retained. Pruritus was the only adverse effect unique to intrathecal fentanyl. Intrathecal lidocaine usually relieved the discomfort but was unable to abolish it in 3 of 8 patients despite adequate neural blockade. Its onset of action was slower and duration of effect shorter than fentanyl. Intrathecal fentanyl provided profound analgesia associated with normalization of stump sensations and euphoria, probably due to a segmental spinal action. The effects of lidocaine were inferior to fentanyl due to the associated motor and sensory paralyses as well as the absence of euphoria. This study suggests that, while peripheral mechanisms played a role, central mechanisms involving the spinal cord were more important in the modulation of established stump pain in the 8 subjects evaluated.

Adult↗

PubMed2006

Sympathetic sudomotor disturbance in early type 1 diabetes mellitus is linked to lipid peroxidation.

The present study was performed to determine whether increased lipid peroxidation, as assessed from malondialdehyde (MDA) excretion, is associated with deterioration in peripheral nerve function in early type 1 diabetes mellitus. These parameters were measured annually for 3 years in 36 patients who entered the study less than 2 years after the diagnosis of diabetes. Malondialdehyde excretion was 1.51 +/- 0.20 micromol/g creatinine in the controls, and 2.43 +/- 0.21, 2.39 +/- 0.22, and 1.93 +/- 0.21 micromol/g creatinine at the first, second, and third evaluations, respectively (P < .005). The increased MDA was seen only in the female participants. Malondialdehyde excretion was increased in those with high vs low hemoglobin Alc across all years (P < .05). Malondialdehyde excretion correlated negatively with sudomotor function below the waist. The mean sweat production from the 3 evaluations correlated with mean MDA excretion across all years in the proximal leg (r = -0.42, P < .005) and distal leg (r = -0.40, P < .01). Below the waist, sweating correlated with MDA (r = -0.40, P < .01) as did total sweat (r = -0.38, P < .01). The response amplitudes of the peroneal nerves correlated negatively with MDA excretion (for the mean values at the second 2 evaluations, P < .005, r = -0.45). Tests of sensory function correlated inconsistently with MDA excretion. In summary, lipid peroxidation, as assessed from malondialdehyde excretion, is associated with sudomotor dysfunction in early diabetes.

Adolescent↗

PubMed1990

[Functional changes in the lower urinary tract after irradiation of cervix carcinoma].

104 patients submitted to primary irradiation for cervix carcinoma were examined by means of urodynamic methods of diagnosis in order to investigate the functional changes of the lower urinary tract induced by therapy. 34 patients could be examined prior to therapy, 19 and 12 patients, respectively, were examined six and 18 months on an average after the treatment. Another group of 70 patients had retrospective check-up examinations with average intervals of five and ten years. Hydronephrosis occurred only as a late result after more than six years in 12% of the irradiated women. The incidence of residual urine, significant bacteriuria, and disturbed sensory function of the bladder was not important. All patients were incontinent two years after the irradiation; 60% of the cases of incontinence were due to the bladder and 40% to the urethra. The increase of urgency incontinence is possibly caused by a radiofibrotic reaction of the bladder, as is shown by correspondent cystometric alterations: the bladder tonicity increased, whereas the bladder capacity decreased. These alterations were only partially reversible. The stress incontinence, however, was found already before the treatment. The maximum urethral closing pressure, which often indicates incontinence due to the urethra, was not modified by the irradiation. An increased stress incontinence, probably caused by advanced age, was found only after six years or later. The problems resulting from functional changes should be taken into consideration in the course of post-therapeutic care, i.e. the patients concerned should be given instructions for a regular bladder training.

Brachytherapy↗