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Journal Article 2007; 28(6): 723-726 PubMed PMID: 18063944 Citation  Keywords:  Consciousness:physiology, Cortical Synchronization:psychology, Dissociative Disorders:complications, Humans, Perception:physiology, Perceptual Disorders:complications, Schizophrenia:complications, Schizophrenic Psychology,.   

: At this time is thought that binding of synchronized and distributed activity is crucial for the mechanism of consciousness. There are suggestive findings that disturbances in this feature binding produce disintegration of consciousness in schizophrenia. It leads to disturbances in reflection of the self and dissociated psychic fragments may be experienced as parts of the external world. Disturbances in the feature binding that lead to disintegration in neural communication among some parts of the brain thus seem to be a neurophysiological counterpart of psychological dissociative processes related to stress response and cognitive, affective and neuroendocrine dysregulation....

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Comparative Study 2007; 28(6): 868-874 PubMed PMID: 18063940 Citation  Keywords:  Adult, Case-Control Studies, Cerebrum:physiopathology, Depressive Disorder:complications, Dissociative Disorders:complications, Electroencephalography, Epilepsy, Complex Partial:complications, Female, Functional Laterality:physiology, Galvanic Skin Respon.   

OBJECTIVES: Recent evidence indicates frequent EEG abnormalities in dissociated patients. This evidence is in agreement with findings that in certain psychiatric patients, psychosensory symptoms of epileptogenic nature, the so-called complex partial seizure-like symptoms occur. With respect to these findings, a hypothesis examined in this study states that increased level of experienced traumatic stress and dissociation in pathological conditions such as schizophrenia or depression relates to increased score of complex partial seizure-like symptoms. Also is suggested that the complex partial seizure-like symptoms might be related to unilateral hemispheric electrophysiological dysfunction, stress and dissociation.

PARTICIPANTS AND METHODS: Psychometric assessment of dissociation, stress and measurement of right-left asymmetry of bilateral EDA in patients with schizophrenia (N=34) and depression (N=41) in comparison to healthy controls (N=36).

RESULTS: Results indicate that increased traumatic stress and dissociation in both groups of patients significantly relate to increased level of complex partial seizure-like symptoms, and may cause the right-left EDA asymmetry.

CONCLUSIONS: The data suggest relationship between left-hemispheric asymmetry and sympathetic over-activation in schizophrenia, and between right-hemispheric asymmetry with sympathetic under-activation in depression....

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Journal Article 2007; 28(6): 854-860 PubMed PMID: 18063937 Citation  Keywords:  Animals, Antipsychotic Agents:pharmacology, Clozapine:pharmacology, Dose-Response Relationship, Drug, Glucose:pharmacology, In Vitro Techniques, Insulin:secretion, Islets of Langerhans:drug effects, Male, Rats, Rats, Wistar, Statistics, Nonparametric,.   

OBJECTIVES: Treatment with the atypical antipsychotic clozapine is frequently associated with metabolic side-effects such as weight gain, lipid abnormalities and diabetes mellitus. Since insulin is a hormone that is involved in both the regulation of body weight, as well as in lipid metabolism and glucose regulation, an effect of clozapine on insulin secretion and/or on insulin action - at least in part - might explain its capability to induce these side-effects. The aim of this study was therefore to examine the influence of clozapine on insulin release in vitro.

METHODS: The effect of clozapine in three different concentrations, 10(-6), 10(-5) and 10(-4) M, was investigated on both basal (i.e. 3.3 mM glucose) and glucose-stimulated (i.e. 16.7 mM glucose) insulin release, using isolated rat islets of Langerhans.

RESULTS: The presence of clozapine in the concentrations of 10(-6), 10(-5) and 10(4 )M significantly increased basal insulin release compared to the control after 4 h (but not after 1 h) of incubation. As regards the glucose-stimulated insulin release, the presence of clozapine in the concentrations of 10(-5) and 10(-4) M, but not in that of 10(-6) M, significantly inhibited the glucose-stimulated insulin release compared to the control after both 1 and 4 h of incubation.

CONCLUSION: This study demonstrates that the atypical antipsychotic clozapine exerts dual effects on insulin release in vitro, through stimulating basal insulin release and inhibiting glucose-stimulated insulin release. Both these effects of clozapine on insulin release may contribute to its disadvantage inducing metabolic side-effects....

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Journal Article 2007; 28(6): 775-780 PubMed PMID: 18063935 Citation  Keywords:  Acetylation:drug effects, Apoptosis:drug effects, Cell Proliferation:drug effects, Dose-Response Relationship, Drug, Down-Regulation, Enzyme Inhibitors:pharmacology, Histone Deacetylase Inhibitors, Histones:metabolism, Humans, Immunohistochemistry, Multip.   

: The expression of vascular endothelial growth factor receptor 1(VEGFR-1) in human multiple myeloma KM3 cells in vitro, effects of valproic acid (VPA), as a histone deacetylase inhibitor, on cell proliferation and apoptosis and the underlying molecular mechanism were investigated. The effects of VPA on the growth of KM3 cells were studied by MTT assay. The apoptosis rate was determined with flow cytometry. The mRNA level of VEGFR was determined by RT-PCR; and immunocytochemistry was used to detect the protein level of ac-H4 and VEGFR. VPA inhibited proliferation of KM3 cells in a time- and dose-dependent manner. Treatment with VPA (4, 2, 1 and 0.5 mmol/L) for 48h, the apoptosis rates of KM3 cells were (13.27+/-3.54)%, (22.13+/-1.20)%, (24.41+/-2.23)% and(40.62+/-4.28)% respectively. The expression of VEGFR-1 in KM3 cells were decreased in VPA-treated group by the immunochemistry and RT-PCR, whereas the acetylated histone H4(ac-H4) accumulated. It suggested VPA could decrease the expression of VEGFR-1 in KM3 cells, and it might play an important role in regulating the proliferation and apoptosis of multiple myeloma cell line KM3 cells. These results provide the framework for clinical trials....

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Clinical Trial 2007; 28(6): 727-733 PubMed PMID: 18063933 Citation  Keywords:  Acromegaly:drug therapy, Adult, Antineoplastic Agents:administration & dosage, Blood Glucose:metabolism, Delayed-Action Preparations, Drug Administration Schedule, Female, Follow-Up Studies, Homeostasis:drug effects, Human Growth Hormone:blood, Humans, In.   

OBJECTIVE: To evaluate the short-term effects of Lanreotide Autogel on insulin sensitivity markers among acromegalic patients with pituitary tumors.

DESIGN: Prospective clinical trial with six months of follow-up.

SETTING: A tertiary endocrinology clinic.

MATERIALS AND METHODS: Naïve patients (patient No. 1 and patient No. 3) and patients who experienced prior somatostatin analogue treatment (patient No. 2, patient No. 4, and patient No. 5) were included. Before and after 6 months of Lanreotide Autogel therapy, insulin sensitivity in each subject was determined using homeostasis model assessment of insulin resistance and beta-cell function formula. Euglycemic hyperinsulinemic clamp test was also performed to evaluate whole insulin sensitivity and was indicated as an 'M' index.

RESULTS: All patients experienced reduction in their HOMA-beta. We noted major HOMA-beta decreases accompanied by pronounced increases in M indices for patients Nos. 1, 2 and 3 (1.03 vs. 8.22, 2.98 vs. 4.70, and 5.09 vs. 13.09, respectively). The increases in M indices of these patients were with marked decreases in GH levels (34.20 vs. 15.30 microg/l, 4.25 vs. 0.74 and 5.0 vs. 0.66 ng/mL, respectively). Minor decline in HOMA-beta and worsened M index and almost stable GH were observed in patients Nos. 4 and 5. Except for patient No. 3, all participants showed declining HOMA-IR.

CONCLUSIONS: Short-term Lanreotide Autogel treatment has been observed to improve M indices of acromegalic patients whose GH levels exhibited marked reduction. This amelioration seemed to be related to decreases in GH levels rather than to a direct drug effect....

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Case Reports 2007; 28(6): 734-738 PubMed PMID: 18063929 Citation  Keywords:  Aorta, Abdominal:abnormalities, Aortic Diseases:complications, Child, Child, Preschool, Constriction, Pathologic, Female, Glioma:complications, Humans, Hypertension, Renovascular:complications, Hypertrophy, Left Ventricular:complications, Mutation, Neurof.   

OBJECTIVES: Neurofibromatosis von Recklinghausen type 1 (NF1) is an autosomal dominant neurocutaneous disorder affecting one in 3 000-4 000 individuals. Mid-aortic syndrome (MAS) is a rare condition characterized by segmental narrowing of abdominal aorta and stenosis of its major branches - mainly renal arteries, including manifestation of renovascular hypertension. MAS can be caused by different diseases, including NF1.

MAIN FINDINGS: A 9 years old girl with primary diagnosis of NF1 combined with renovascular hypertension due to MAS, suffered of bilateral optic and chiasm glioma, pubertas praecox, speech disorder, light mental retardation and scoliosis. We have found a mutation in exone 34 of the NF1 gene (17q11.2). Her father has been also diagnosed with NF1 and hypertension developed at early age. He has the same mutation in exone 34 of NF1 gene. The girl is currently treated with conservative antihypertensive medication with positive effect. Bilateral optic and chiasm glioma are asymptomatic at the time and they had been without progress over period of time. Any vascular surgery, neurosurgical and oncological therapy are not indicated at the present time.

CONCLUSION: This article is a summary of clinical findings in patient with NF1 due to NF1 gene mutation in exone 34. It confirms the importance of complex multidisciplinar approach to examination and taking care of NF1 patients and their families....

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Case Reports 2007; 28(6): 739-744 PubMed PMID: 18063928 Citation  Keywords:  Adolescent, Antibodies:blood, Antioxidants:therapeutic use, Biomarkers, Diet Therapy, Enterobacteriaceae:immunology, Enterobacteriaceae Infections:complications, Fatigue Syndrome, Chronic:etiology, Female, Humans, Immunoglobulins, Intravenous:therapeutic .   

: There is now evidence that chronic fatigue syndrome (CFS) is accompanied by an increased translocation of endotoxins from gram-negative enterobacteria through the gut wall, as demonstrated by increased prevalences and median values for serum IgM and IgA against the endotoxins of gram-negative enterobacteria. This condition can also be described as increased gut permeability or leaky gut and indicates intestinal mucosal dysfunction (IMD). Here we report a case of a 13 year old girl with CFS who showed very high values for serum IgM against the LPS of some enterobacteria and signs of oxidative and nitrosative stress, activation of the inflammatory response system, and IgG3 subclass deficiency. Upon treatment with specific antioxidants and a "leaky gut diet", which both aim to treat increased gut permeability, and immunoglobins intravenously, the increased translocation of the LPS of gram negative enterobacteria normalized and this normalization was accompanied by a complete remission of the CFS symptoms....

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Journal Article 2007; 28(6): 832-840 PubMed PMID: 18063922 Citation  Keywords:  Autonomic Nervous System:physiopathology, Cardiovascular Diseases:complications, Depressive Disorder:complications, Humans, Hypothalamo-Hypophyseal System:physiopathology, Inflammation:complications, Pituitary-Adrenal System:physiopathology, Psychology,.   

: Depressive disorders and cardiovascular disease are inter-connected by a whole range of pathophysiological mechanisms. Three biological mechanisms are fundamental: activation of the hypothalamus-hypohysis-adrenal axis with a subsequent increase in sympathetic-adrenal system activity, decrease in vagal tone with a decrease in heart rate variability, and alterations of thrombogenesis with increased platelet aggregability. Behavioural mechanisms and psycho-social factors are also integral to this common pathophysiology. Recently, research has focused mainly on studying various forms of stress, as well as changes and possibilities of influencing the autonomous vegetative system. Temporal aspects of the incidence and development of depressive episodes in relation to cardiovascular disease and subsequent cardiovascular morbidity and mortality are being studied, as well as general mortality risk factors. These findings are important for clinical practice. It is evident that in patients with untreated depressive disorder, the risk of developing cardiovascular disease is significantly higher than in patients suffering from a depressive disorder being treated with anti-depressants. From the data published so far, it may be surmised that depressive disorders in patients with cardiovascular disease may be reliably and safely treated with anti-depressants that act as inhibitors of serotonin re-uptake....

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