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Selected AbstractsRole of interleukin-1, in postoperative cognitive dysfunctionANNALS OF NEUROLOGY, Issue 3 2010Mario Cibelli MD Objective: Although postoperative cognitive dysfunction (POCD) often complicates recovery from major surgery, the pathogenic mechanisms remain unknown. We explored whether systemic inflammation, in response to surgical trauma, triggers hippocampal inflammation and subsequent memory impairment, in a mouse model of orthopedic surgery. Methods: C57BL/6J, knock out (lacking interleukin [IL]-1 receptor, IL-1R,/,) and wild type mice underwent surgery of the tibia under general anesthesia. Separate cohorts of animals were tested for memory function with fear conditioning tests, or euthanized at different times to assess levels of systemic and hippocampal cytokines and microglial activation; the effects of interventions, designed to interrupt inflammation (specifically and nonspecifically), were also assessed. Results: Surgery caused hippocampal-dependent memory impairment that was associated with increased plasma cytokines, as well as reactive microgliosis and IL-1, transcription and expression in the hippocampus. Nonspecific attenuation of innate immunity with minocycline prevented surgery-induced changes. Functional inhibition of IL-1,, both in mice pretreated with IL-1 receptor antagonist and in IL-1R,/, mice, mitigated the neuroinflammatory effects of surgery and memory dysfunction. Interpretation: A peripheral surgery-induced innate immune response triggers an IL-1,-mediated inflammatory process in the hippocampus that underlies memory impairment. This may represent a viable target to interrupt the pathogenesis of postoperative cognitive dysfunction. ANN NEUROL 2010;68:360,368 [source] Tumor R2* is a prognostic indicator of acute radiotherapeutic response in rodent tumorsJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 4 2004Loreta M. Rodrigues MSc Abstract Purpose To test the prognostic potential of tumor R2* with respect to radiotherapeutic outcome. Blood oxygenation level dependent (BOLD) MRI images are sensitive to changes in deoxyhemoglobin concentration through the transverse MRI relaxation rate R2* of tissue water, hence the quantitative measurement of tumor R2* may be related to tissue oxygenation. Methods and Materials Tumor growth inhibition in response to radiation was established for both GH3 prolactinomas and RIF-1 fibrosarcomas with animals breathing either air or carbogen during radiation. In a separate cohort, the baseline R2* and carbogen (95% O2, 5% CO2)-induced ,R2* of rat GH3 prolactinomas and murine RIF-1 fibrosarcomas were quantified using multigradient echo (MGRE) MRI prior to radiotherapy, and correlated with subsequent tumor growth inhibition in response to ionizing radiation, while the animals breathed air. Results A radiation dose of 15 Gy caused pronounced growth delay in both tumor models and transient regression of the GH3 prolactinomas. When the animals breathed carbogen during radiation, the growth delay/regression was enhanced only in the GH3 prolactinomas. The GH3 prolactinomas, which exhibit a relatively fast baseline R2* and large ,R2* in response to carbogen breathing prior to radiotherapy, showed a substantial reduction in normalized tumor volume to 66 ± 3% with air breathing and 36 ± 5% with carbogen seven days after 15 Gy irradiation. In contrast, the effect of 15 Gy on the RIF-1 fibrosarcomas, which give a relatively slow baseline R2* and negligible ,R2* response to carbogen prior to treatment, showed a much smaller growth inhibition (143 ± 3% with air, 133 ± 12% with carbogen). Conclusion Quantitation of tumor R2* and carbogen-induced ,R2* by MGRE MRI provides completely noninvasive prognostic indicators of a potential acute radiotherapeutic response. J. Magn. Reson. Imaging 2004;19:482,488. © 2004 Wiley-Liss, Inc. [source] Motivation for Alcohol Becomes Resistant to Quinine Adulteration After 3 to 4 Months of Intermittent Alcohol Self-AdministrationALCOHOLISM, Issue 9 2010Frederic W. Hopf Background:, Continued consumption of alcohol despite deleterious consequences is a hallmark of alcoholism and represents a critical challenge to therapeutic intervention. Previous rat studies showed that enduring alcohol self-administration despite pairing alcohol with normally aversive stimuli was only observed after very long-term intake (>8 months). Aversion-resistant alcohol intake has been previously interpreted to indicate pathological or compulsive motivation to consume alcohol. However, given the time required to model compulsive alcohol seeking in previous studies, there is considerable interest in developing more efficient and quantitative rodent models of aversion-resistant alcohol self-administration. Methods:, Outbred Wistar rats underwent 3 to 4 months or approximately 1.5 months of intermittent, home-cage, two-bottle access (IAA) to 20% alcohol (v/v) or water. Then, after brief operant training, the effect of the bitter-tasting quinine (0.1 g/l) on the motivation to seek alcohol was quantified via progressive ratio (PR). Motivation for quinine-adulterated 2% sucrose under PR was assayed in a separate cohort of 3 to 4 months IAA rats. The effects of quinine on home-cage alcohol consumption in IAA rats and rats with continuous access to alcohol were also examined. Finally, a dose,response for quinine taste preference in IAA and continuous-access animals was determined. Results:, Motivation for alcohol after 3 to 4 months IAA, measured using an operant PR procedure, was not altered by adulteration of alcohol with 0.1 g/l quinine. In contrast, after 3 to 4 months of IAA, motivation for sucrose under PR was significantly reduced by adulteration of sucrose with 0.1 g/l quinine. In addition, motivation for alcohol after only approximately 1.5 months IAA was significantly reduced by adulteration of alcohol with 0.1 g/l quinine. Furthermore, home-cage alcohol intake by IAA rats was insensitive to quinine at concentrations (0.01, 0.03 g/l) that significantly reduced alcohol drinking in animals with continuous access to alcohol. Finally, no changes in quinine taste preference after 3 to 4 months IAA or continuous access to alcohol were observed. Conclusions:, We have developed a novel and technically simple hybrid operant/IAA model in which quinine-resistant motivation for alcohol is evident after an experimentally tractable period of time (3 to 4 months vs. 8 months). Quinine dramatically reduced sucrose and water intake by IAA rats, indicating that continued responding for alcohol in IAA rats despite adulteration with the normally aversive quinine might reflect maladaptive or compulsive motivation for alcohol. This model could facilitate identification of novel therapeutic interventions for pathological alcohol seeking in humans. [source] Differential Central NOS-NO Signaling Underlies Clonidine Exacerbation of Ethanol-Evoked Behavioral ImpairmentALCOHOLISM, Issue 3 2010Tara S. Bender Background:, The molecular mechanisms that underlie clonidine exacerbation of behavioral impairment caused by ethanol are not fully known. We tested the hypothesis that nitric oxide synthase (NOS)-derived nitric oxide (NO) signaling in the locus coeruleus (LC) is implicated in this phenomenon. Methods:, Male Sprague,Dawley rats with intracisternal (i.c.) and jugular vein cannulae implanted 6 days earlier were tested for drug-induced behavioral impairment. The latter was assessed as the duration of loss of righting reflex (LORR) and rotorod performance every 15 minutes until the rat recovered to the baseline walk criterion (180 seconds). In a separate cohort, we measured p-neuronal NOS (nNOS), p-endothelial NOS (eNOS), and p-ERK1/2 in the LC following drug treatment, vehicle, or NOS inhibitor. Results:, Rats that received clonidine [60 Ig/kg, i.v. (intravenous)] followed by ethanol (1 or 1.5 g/kg, i.v.) exhibited synergistic impairment of rotorod performance. Intracisternal pretreatment with nonselective NOS inhibitor N, -nitro- l -arginine methyl ester (l -NAME, 0.5 mg) or selective nNOS inhibitor N -propyl- l -arginine (1 ,g) exacerbated the impairment of rotorod performance caused by clonidine,ethanol combination. Exacerbation of behavioral impairment was caused by l -NAME enhancement of the effect of ethanol, not clonidine. l -NAME did not influence blood ethanol levels; thus, the interaction was pharmacodynamic. LORR caused by clonidine (60 ,g/kg, i.v.),ethanol (1 g/kg, i.v.) combination was abolished by selective inhibition of central eNOS (l -NIO, 10 ,g i.c.) but not by nNOS inhibition under the same conditions. Western blot analyses complemented the pharmacological evidence by demonstrating that clonidine,ethanol combination inhibits phosphorylation (activation) of nNOS (p-nNOS) and increases the level of phosphorylated eNOS (p-eNOS) in the LC; the change in p-nNOS was paralleled by similar change in LC p-ERK1/2. NOS inhibitors alone did not affect the level of nitrate/nitrite, p-nNOS, p-eNOS, or p-ERK1/2 in the LC. Conclusions:, Alterations in NOS-derived NO in the LC underlie clonidine,ethanol induced behavioral impairment. A decrease in nNOS activity, due at least partly to a reduction in nNOS phosphorylation, mediates rotorod impairment, while enhanced eNOS activity contributes to LORR, elicited by clonidine,ethanol combination. [source] Dietary Zinc Supplementation Throughout Pregnancy Protects Against Fetal Dysmorphology and Improves Postnatal Survival After Prenatal Ethanol Exposure in MiceALCOHOLISM, Issue 4 2009Brooke L. Summers Background:, We have previously demonstrated that ethanol teratogenicity is associated with metallothionein-induced fetal zinc (Zn) deficiency, and that maternal subcutaneous Zn treatment given with ethanol in early pregnancy prevents fetal abnormalities and spatial memory impairments in mice. Here we investigated whether dietary Zn supplementation throughout pregnancy can also prevent ethanol-related dysmorphology. Methods:, Pregnant mice were injected with saline or 25% ethanol (0.015 ml/g intraperitoneally at 0 and 4 hours) on gestational day (GD) 8 and fed either a control (35 mg Zn/kg) or a Zn-supplemented diet (200 mg Zn/kg) from GD 0 to 18. Fetuses from the saline, saline + Zn, ethanol and ethanol + Zn groups were assessed for external birth abnormalities on GD 18. In a separate cohort of mice, postnatal growth and survival of offspring from these treatment groups were examined from birth until postnatal day 60. Results:, Fetuses from dams treated with ethanol alone in early pregnancy had a significantly greater incidence of physical abnormalities (26%) compared to those from the saline (10%), saline + Zn (9%), or ethanol + Zn (12%) groups. The incidence of abnormalities in ethanol + Zn-supplemented fetuses was not different from saline-treated fetuses. While ethanol exposure did not affect the number of fetal resorptions or pre- or postnatal weight, there were more stillbirths with ethanol alone, and cumulative postnatal mortality was significantly higher in offspring exposed to ethanol alone (35% deaths) compared to all other treatment groups (13.5 to 20.5% deaths). Mice supplemented with Zn throughout pregnancy had higher plasma Zn concentrations than those in un-supplemented groups. Conclusions:, These findings demonstrate that dietary Zn supplementation throughout pregnancy ameliorates dysmorphology and postnatal mortality caused by ethanol exposure in early pregnancy. [source] ,2A -Adrenergic Receptor Signaling Underlies Synergistic Enhancement of Ethanol-Induced Behavioral Impairment by ClonidineALCOHOLISM, Issue 3 2009Tara Summer Bender Background:, We tested the hypothesis that central ,2A -adrenergic receptor (,2AAR) signaling plays a key role in clonidine-ethanol evoked synergistic behavioral impairment. Methods:, Male Sprague-Dawley rats, with intracisternal and jugular vein cannulae implanted 6 days earlier, were tested for drug-induced behavioral impairment. The latter was assessed as the duration of loss of righting reflex (LORR) and rotorod performance every 15 minutes until the rat recovered to the baseline walk criterion (180 seconds). In a separate cohort, c-Fos expression in locus coeruleus (LC) and cerebellum was determined as a marker of neuronal activity following drug treatment. Results:, Rats that received clonidine (60 ,g/kg, i.v.) followed by ethanol (1 g/kg, i.v.) exhibited synergistic impairment of rotorod performance and LORR. The mixed ,2AAR and I1 -imidazoline receptor agonist clonidine (30, 60, and 90 ,g/kg) synergistically and dose-dependently enhanced behavioral impairment elicited by ethanol (1 g/kg). Possible involvement of I1 -imidazoline receptors was ruled out because selective I1 -agonist rilmenidine (300 ,g/kg, i.v.) did not cause behavioral impairment alone or enhance ethanol-evoked behavioral impairment. Pharmacological blockade of central ,2AAR (RX821002, 0.3 mg i.c.) abolished the synergy between clonidine and ethanol; the behavioral response caused by the drug combination was similar to that caused by ethanol alone. Conversely, involvement of central ,2BAR in the interaction was ruled out because blockade of central ,2BAR (ARC-239) independently evoked a strong sedative effect. Clonidine (60 ,g/kg) or ethanol (1 g/kg) alone increased, but their combination decreased, c-Fos levels in LC, while inconsistent c-Fos responses were observed in cerebellum. Conclusions:, Central ,2AAR, but not I1 -imidazoline or ,2BAR, signaling is implicated in the synergistic enhancement of ethanol-evoked behavioral impairment by clonidine. Although the mechanism of c-Fos response remains to be investigated, this neurochemical response highlights the LC as a neuroanatomical target for clonidine-ethanol behavioral interaction. [source] Validation of connective tissue growth factor (CTGF/CCN2) and its gene polymorphisms as noninvasive biomarkers for the assessment of liver fibrosisJOURNAL OF VIRAL HEPATITIS, Issue 9 2009E. Kovalenko Summary., Clinical and experimental studies have demonstrated that connective-tissue growth factor (CTGF) expression is increased in fibrotic human liver and experimental animal models of liver fibrogenesis. CTGF has been linked to transforming growth factor-beta (TGF-,) pathways in fibroproliferative diseases and specific polymorphisms within the CTGF gene may predispose for fibrosis in systemic sclerosis. As CTGF is detectable in various human fluids (serum, plasma and urine), it may provide information about fibrotic remodelling processes and reflect hepatic TGF-, bioactivity. We established a novel ELISA for the measurement of serum CTGF and tested its clinical value in patients with chronic hepatitis C virus (HCV) infection and chronic liver disease (CLD). HCV infected patients (n = 138) had significantly higher serum CTGF levels than healthy controls. CTGF was linked to the histological degree of liver fibrosis. To expand the results to other aetiologies, a separate cohort of CLD patients (n = 129) was evaluated, showing higher serum CTGF than healthy controls and again an association with advanced stages of liver cirrhosis (Child B and C). Although independent of the underlying aetiology, serum CTGF was most powerful in indicating fibrosis/advanced disease states in HCV-related disorders. The genotyping of six polymorphisms (rs6917644, rs9399005, rs6918698, rs9493150, rs2151532 and rs11966728) covering the CTGF locus in 365 patients suffering from chronic hepatitis C revealed that none of these polymorphisms showed a genotypic or allelic association with the severity of hepatic fibrosis. Taken together, serum CTGF is suitable for determination of hepatic fibrosis and most powerful in patients with chronic HCV infection. [source] Prediction of respiratory insufficiency in Guillain-Barré syndromeANNALS OF NEUROLOGY, Issue 6 2010Christa Walgaard MD Objective Respiratory insufficiency is a frequent and serious complication of the Guillain-Barré syndrome (GBS). We aimed to develop a simple but accurate model to predict the chance of respiratory insufficiency in the acute stage of the disease based on clinical characteristics available at hospital admission. Methods Mechanical ventilation (MV) in the first week of admission was used as an indicator of acute stage respiratory insufficiency. Prospectively collected data from a derivation cohort of 397 GBS patients were used to identify predictors of MV. A multivariate logistic regression model was validated in a separate cohort of 191 GBS patients. Model performance criteria comprised discrimination (area under receiver operating curve [AUC]) and calibration (graphically). A scoring system for clinical practice was constructed from the regression coefficients of the model in the combined cohorts. Results In the derivation cohort, 22% needed MV in the first week of admission. Days between onset of weakness and admission, Medical Research Council sum score, and presence of facial and/or bulbar weakness were the main predictors of MV. The prognostic model had a good discriminative ability (AUC, 0.84). In the validation cohort, 14% needed MV in the first week of admission, and both calibration and discriminative ability of the model were good (AUC, 0.82). The scoring system ranged from 0 to 7, with corresponding chances of respiratory insufficiency from 1 to 91%. Interpretation This model accurately predicts development of respiratory insufficiency within 1 week in patients with GBS, using clinical characteristics available at admission. After further validation, the model may assist in clinical decision making, for example, on patient transfer to an intensive care unit. ANN NEUROL 2010;67:781,787 [source] Normalization of A2A and A3 adenosine receptor up-regulation in rheumatoid arthritis patients by treatment with anti,tumor necrosis factor , but not methotrexateARTHRITIS & RHEUMATISM, Issue 10 2009Katia Varani Objective To investigate A1, A2A, A2B, and A3 adenosine receptors in lymphocytes and neutrophils from patients with early rheumatoid arthritis (ERA) as well as from RA patients treated with methotrexate (MTX) or anti,tumor necrosis factor , (anti-TNF,), as compared with those in age-matched healthy controls, and to examine correlations between the status and functionality of adenosine receptors and TNF, release and NF-,B activation. Methods Adenosine receptors were analyzed by saturation binding assays and Western blot analyses. We investigated the potency of typical A2A and A3 agonists in the production of cAMP in control subjects, ERA patients, and RA patients treated with MTX or anti-TNF,. In a separate cohort of RA patients, TNF, release and NF-,B activation were evaluated in plasma and nuclear extracts, respectively. Results In ERA patients, we found a high density and altered functionality of A2A and A3 receptors. The binding and functional parameters of A2A and A3 receptors normalized after anti-TNF,, but not MTX, treatment. TNF, release was increased in ERA patients and in MTX-treated RA patients, whereas in anti-TNF,,treated RA patients, release was comparable to that in the controls. NF-,B activation was elevated in ERA patients and in MTX-treated RA patients. Anti-TNF, treatment mediated decreased levels of NF-,B activation. Conclusion A2A and A3 receptor up-regulation in ERA patients and in MTX-treated RA patients was associated with high levels of TNF, and NF-,B activation. Treatment with anti-TNF, normalized A2A and A3 receptor expression and functionality. This new evidence of A2A and A3 receptor involvement opens the possibility of exploiting their potential role in human diseases characterized by a marked inflammatory component. [source] Professional socialization: The key to survival as a newly qualified nurseINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 2 2007Higher DiplomaArticle first published online: 29 MAR 200, MSc (Nursing), Mary Mooney RGN The impact and prevalence of professional socialization in nursing has been written about extensively. Despite the many positive developments that have taken place in nursing within the past decade, the role of professional socialization remains heavily weighted and is of particular significance to those nurses who are newly qualified. The account given by newly registered nurses in this study demonstrates that their ability and willingness to become professionally socialized determines their ease of survival at clinical level. Twelve newly qualified Irish nurses, from two separate cohorts, were interviewed to ascertain their perceptions of becoming newly qualified nurses. A grounded theory approach was used and data were analysed using thematic analysis. A category that emerged was linked very strongly with professional socialization. The respondents did not refer to professional socialization per se, but through the coding process this emerged as the linchpin of the discussion. [source] TOOTH WHITENING IN CHILDRENJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 6 2005K.J. Donly ABSTRACT Objective: This clinical study evaluated the efficacy and tolerability of tooth whitening in children and adolescents, using a marketed, tray- based tooth-whitening system and a disposable polyethylene strip system. Materials and Methods: A study population of 106 children and adolescents, ages 11 to 18 years, participated in this study. There were 61 girls and 45 boys, with a mean age of 14.7 years. Subjects were divided into two experimental treatment groups, the groups being balanced with respect to demographic characteristics and baseline tooth color. All subjects had to have all permanent anterior teeth erupted, a baseline Vita shade (Vita Zahnfabrik, Bad Säckingen, Germany) score of A2 or darker, and the desire to whiten their teeth. One experimental group included 71 subjects who used a 6.5% hydrogen peroxide strip system (Crest Whitestrips Professional Strength, Procter & Gamble, Mason, OH, USA) for 30 minutes twice daily. The other experimental group included 35 subjects who used a 10% carbamide peroxide tray system (Opalescence, Ultradent Products, South Jordan, UT, USA) overnight. Subjects who had previously vital bleached their teeth, exhibited apparent caries or periodontal problems, had orthodontic appliances or anterior restorations, or reported dentin hypersensitivity were excluded. The study population was treated in two separate cohorts, by two independent investigations, to minimize the effects of examiner bias. Digital images were collected for all subjects at baseline, 2 weeks, and 4 weeks, with the maxillary and mandibular arches being treated separately for 4-week intervals. An oral examination was conducted at baseline and at all recall intervals. Subjects reported any adverse events in interviews. Color change was calculated from digital images where L* indicated lightness, a* redness, and b* yellowness. Comparisons between the two experimental groups were made using a two-sided analysis of covariance with a 5% significance level. Results: Both experimental systems exhibited significant (p < .001) tooth-whitening improvement relative to the baseline. Color change was greater in the maxillary teeth than in the mandibular teeth for both systems evaluated. The color change for maxillary teeth was not significantly different between the two systems evaluated; however, the tray system demonstrated significantly (p < .05) greater toothwhitening effectiveness for the mandibular teeth. Both treatment regimens were well tolerated. Minor tooth sensitivity and oral irritation were the most commonly reported adverse events, being reported by 49% of the subjects assigned to the strip group and 43% of the subjects in the tray group. All reported that adverse events were relieved immediately upon discontinuance of product use. Conclusion: The 6.5% hydrogen peroxide gel strips and the 10% carbamide peroxide gel delivered overnight in customized trays effectively whitened teeth, and both treatment regimens were well tolerated. 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