Efficacy and tolerability of moclobemide in bulimia nervosa: a placebo-controlled trial.

A 6-week double-blind placebo-controlled trial was carried out to examine the efficacy and tolerability of moclobemide, a monoamine oxidase type A selective and reversible inhibitor, in the treatment of bulimia nervosa. Patients were admitted to the study even if they were unable to adhere to a tyramine-free diet. Fifty-two normal-weight women (age range 18-40 years) suffering from bulimia nervosa (DSM-IV criteria) completed the trial. Particular emphasis was placed on evaluating the incidence of hypertension and other side-effects in chronically treated patients. At the usual antidepressant dose of 600 mg, moclobemide was not significantly superior to placebo in the reducing the weekly number of binge eating episodes or in improving several measures of eating attitudes and behaviour (BITE, EDI, TFEQ) in normal-weight bulimia nervosa. The dropout rate was relatively low (29%), and the side-effects were limited and equally distributed between the two treatment groups. No patient experienced a hypertensive crisis during the study and no serious side-effect was detected. The study indicates that moclobemide 600 mg pro die is not efficacious in bulimia nervosa, but it can be safely administered, even to young subjects, at a very high risk of consuming large amounts of tyramine-rich foods without dietary restrictions.

Internal electron transfer and structural dynamics of cd1 nitrite reductase revealed by laser CO photodissociation.

Laser photolysis techniques have been employed to investigate the internal electron transfer (eT) reaction within Pseudomonas aeruginosa nitrite reductase (Pa-NiR). We have measured the (d1--> c) internal eT rate for the wild-type protein and a site-directed mutant (Pa-NiR H327A) which has a substitution in the d1-heme binding pocket; we found the rate of eT to be fast, keT = 2.5 x 10(4) and 3.5 x 10(4) s-1 for the wild-type and mutant Pa-NiR, respectively. We also investigated the photodissociation of CO from the fully reduced proteins and observed microsecond first-order relaxations; these imply that upon breakage of the Fe2+-CO bond, both Pa-NiR and Pa-NiR H327A populate a nonequilibrium state which decays to the ground state with a complex time course that may be described by two exponential processes (k1 = 3 x 10(4) s-1 and k2 = 0.25 x 10(4) s-1). These relaxations do not have a kinetic difference spectrum characteristic of CO recombination, and therefore we conclude that Pa-NiR undergoes structural rearrangements upon dissociation of CO. The bimolecular rate of CO rebinding is 5 times faster in Pa-NiR H327A than in the wild-type enzyme (1.1 x 10(5) M-1 s-1 compared to 2 x 10(4) M-1 s-1), indicating that this mutation in the active site alters the CO diffusion properties of the protein, probably reducing steric hindrance. CO rebinding to the wild-type mixed valence enzyme (c3+d12+) which is very slow (k = 0.25 s-1) is proposed to be rate-limited by the c --> d1 internal eT event, involving the oxidized d1-heme which has a structure characteristic of the fully oxidized and partially oxidized Pa-NiR.

Circannual rhythm of free fatty acids and diacylglycerols in 5-day-old rat cerebrum during pentylenetetrazol-induced convulsions.

Free fatty acids (FFA) and diacylglycerol (DG) content and composition in the cerebrum of 5-day-old rats were studied after pentylenetetrazol (PTZ)-induced convulsions. A threefold increase in brain FFA was observed 30 min after PTZ injection in experiments carried out in spring. In contrast, a 50% decrease in FFA content was observed during summer. These changes were accounted for by saturated and monoenoic fatty acids, whereas arachidonic and docosahexaenoic acids were not affected during the convulsive episode in either season. The effect of PTZ on brain DG was much smaller than it was on FFA, and less sensitive to seasonal influence. However, DG released in the summer was significantly less enriched in arachidonic acid than in the spring. Levels of FFA and DG in untreated animals were found to be subject to a circannual rhythm. Both the levels of FFA and their degree of unsaturation (unsaturated fatty acids/total FFA) were highest in summer and lowest in winter, whereas the opposite was true for DG. Circannual variations in these metabolites may be the manifestation of a programmed biological calendar regulating enzymes of brain lipid metabolism in homeotherms that under natural conditions must adapt to changing environmental temperatures.

Femoral nerve neuropraxia secondary to repetitive trauma in a patient with juvenile lumbar osteochondrosis: differential diagnosis of an osteolytic lesion with a neurologic deficit. Report of a case.

Femoral nerve neuropraxia occurred secondary to repetitive trauma at the second to third lumbar levels in a 17-year-old boy with juvenile lumbar osteochondrosis.

Stimulation of free fatty acid and diacylglycerol accumulation in cerebrum and cerebellum during bicuculline-induced status epilepticus. Effect of pretreatment with alpha-methyl-p-tyrosine and p-chlorophenylalamine.

The pool size and composition of free fatty acids (FFA) and diglycerides (DG) from the cerebrum and cerebellum of rats undergoing bicuculline-induced seizures were studied. A fourfold increase in cerebral FFA occurred 3-4 min after bicuculline injection; arachidonic and stearic acids were the principal fatty acids accumulated. Cerebellar FFA also increased, but to a lesser extent. An increased production of arachidonic acid took place in the cerebrum as a function of time after bicuculline injection. Other fatty acids produced were oleic, palmitic, and docosahexaenoic acids. A twofold increase in cerebral arachidonic acid was seen at the time of the first generalized tonic-clonic convulsion. However, a 13- to 17-fold increase in arachidonic acid was seen approximately 5-6 min after bicuculline injection. The rise in other FFA was much smaller. Stearoyl- and arachidonoyl-DG were also accumulated. The drug alpha-methyl-p-tyrosine was found to (a) potentiate the bicuculline-stimulated release of cerebellar FFA, and (b) inhibit by 70% the production of stearoyl- and arachidonoyl-DG in the cerebrum and cerebellum. Basal production of FFA was stimulated by p-chlorophenylalanine, but the drug had no effect on the bicuculline-induced changes. Hydrolysis of phospholipids enriched in stearoyl-arachidonoyl groups, such as phosphatidylinositol of excitable membranes, may be stimulated during seizures.

Arachidonic acid and arachidonoyl-diglycerols increase in rat cerebrum during bicuculline-induced status epilepticus.

Bicuculline-induced status epilepticus was found to be associated with increased amounts of free fatty acids and diacylglycerols in the rat cerebrum. The predominant fatty acid in both lipid pools was arachidonic acid. The accumulation of arachidonoyl-diglycerols decreased at the time of and during behavioral seizures induced by bicuculline, while the amount of free arachidonic acid appeared to increase. We propose a metabolic relationship between these lipids to explain the described changes. The similarities between the composition of the lipid pools and the fatty acid composition of phosphatidylinositol support the hypothesis that these changes may be a result of a convulsion-activated degradation of this phospholipid from excitable membranes.