Manic episodes are associated with grey matter volume reduction - a voxel-based morphometry brain analysis.

OBJECTIVE: To investigate whether the lifetime number of affective episodes or illness duration is associated with changes in local grey matter volume, in patients with bipolar I disorder without comorbid conditions. METHOD: Magnetic resonance imaging scans of 55 patients with bipolar I disorder were analysed using VBM. RESULTS: Smaller grey matter volume in the inferior frontal gyri of the dorsolateral prefrontal cortices (DLPFC) correlated significantly to the lifetime number of manic episodes. No association between local grey matter volume and the lifetime number of depression episodes or illness duration was found. CONCLUSION: We found strong evidence for a linear correlation between a decrease in DLPFC volume and the lifetime number of manic episodes in patients with bipolar I disorder. Interestingly, DLPFC is known to be important for executive functions and the findings in this study might hence be linked to the executive cognitive deficits associated with bipolar disorder.

A history of childhood attention-deficit hyperactivity disorder (ADHD) impacts clinical outcome in adult bipolar patients regardless of current ADHD.

OBJECTIVE: The occurrence of comorbid attention-deficit hyperactivity disorder (ADHD) might have an impact of the course of the bipolar disorder. METHOD: Patients with bipolar disorder (n = 159) underwent a comprehensive evaluation with respect to affective symptoms. Independent psychiatrists assessed childhood and current ADHD, and an interview with a parent was undertaken. RESULTS: The prevalence of adult ADHD was 16%. An additional 12% met the criteria for childhood ADHD without meeting criteria for adult ADHD. Both these groups had significantly earlier onset of their first affective episode, more frequent affective episodes (except manic episodes), and more interpersonal violence than the bipolar patients without a history of ADHD. CONCLUSION: The fact that bipolar patients with a history of childhood ADHD have a different clinical outcome than the pure bipolar group, regardless of whether the ADHD symptoms remained in adulthood or not, suggests that it represent a distinct early-onset phenotype of bipolar disorder.

Obesity and nocturnal gastro-oesophageal reflux are related to onset of asthma and respiratory symptoms.

Several studies have identified obesity as a risk factor for asthma in both children and adults. An increased prevalence of asthma in subjects with gastro-oesophageal reflux (GOR) and obstructive sleep apnoea syndrome has also been reported. The aim of this investigation was to study obesity, nocturnal GOR and snoring as independent risk factors for onset of asthma and respiratory symptoms in a Nordic population. In a 5-10 yr follow-up study of the European Community Respiratory Health Survey in Iceland, Norway, Denmark, Sweden and Estonia, a postal questionnaire was sent to previous respondents. A total of 16,191 participants responded to the questionnaire. Reported onset of asthma, wheeze and night-time symptoms as well as nocturnal GOR and habitual snoring increased in prevalence along with the increase in body mass index (BMI). After adjusting for nocturnal GOR, habitual snoring and other confounders, obesity (BMI >30) remained significantly related to the onset of asthma, wheeze and night-time symptoms. Nocturnal GOR was independently related to the onset of asthma and in addition, both nocturnal GOR and habitual snoring were independently related to onset of wheeze and night-time symptoms. This study adds evidence to an independent relationship between obesity, nocturnal gastro-oesophageal reflux and habitual snoring and the onset of asthma and respiratory symptoms in adults.

Comparison of the sensitivities of Salmonella typhimurium strains TA102 and TA2638A to 16 mutagens.

The qualitative and quantitative sensitivity of the genetically related, histidine-auxtrophic Salmonella typhimurium strains TA102 and TA2638a to 16 compounds was examined. The compounds were mainly cross-linking and oxidising mutagens, the effects of which were known to be detected by strain TA102 preferentially or by a combination of Escherichia coli WP2 (pkM101) and uvrA/pkM101. The morphology and number of spontaneous revertants was also compared. Fourteen of the 16 compounds caused reversion in both strains. Bleomycin and streptomycin induced reversion in strain TA102 but not TA2638a. The greater sensitivity of TA102 to these compounds may be associated with the extrachromosomal location of the target genes. The overall quantitative sensitivity of the two strains was similar for the other compounds. The number of compounds that caused reversions at lower doses or produced greater proportional increases were the same in TA102 as in TA2638a. The spontaneous number of revertants, without and with metabolic activation, respectively, was 98 and 130 for TA2638a and 322 and 465 for TA102. Strain TA2638a formed larger, more uniform colonies than TA102. The present results together with those of previous studies indicate a high degree of concordance between the sensitivity of strains TA102 and TA2638 for the detection of mutagens. The uniform colony size and lower spontaneous reversion frequency seen with strain TA2638a compared with TA102 would make it more reliable and convenient for routine testing. It is concluded that strain TA2638a should be considered as an alternative to TA102 and included, as well as the two E.coli strains, in the set of bacterial strains used in the standard test battery for mutagenicity testing.

Estimation of glomerular filtration rate and evaluation of renal function in ferrets (Mustela putorius furo).

Three methods of determining glomerular filtration rate (GFR) were performed in adult ferrets, 9 months to 7 years old. Endogenous creatinine clearance was determined, using serum and urine creatinine values obtained during 24- and 48-hour collection periods from 27 ferrets housed in metabolic cages. Creatinine and radiolabeled inulin were administered to 12 female ferrets by constant IV infusion during isoflurane-induced anesthesia. Serial 20-minute urine collections, together with serum samples obtained at the midpoint of urine collection, provided measures for clearance calculations of these substances. Mean +/- SD endogenous creatinine clearance in ferrets for metabolic cage collections was 2.50 +/- 0.93 ml/min/kg of body weight. There were no significant differences between the 24- and 48-hour clearance rates. Mean inulin clearance was 3.02 +/- 1.78, and mean exogenous creatinine clearance was 3.32 +/- 2.16 ml/min/kg. Analysis of variance, using least-squared means adjustment, did not yield any significant differences between inulin and exogenous creatinine clearance rates. Exogenous creatinine clearance-to-inulin clearance ratio was 0.99 +/- 0.46, and there was significant correlation between the 2 methods (r = 0.82, P = 0.0001). Significant body temperature effects on inulin or exogenous creatinine clearance were not found. Infused inulin clearance, the generally preferred method for GFR calculation in mammalian species, was significantly (P = 0.0069) higher in younger (3.65 ml/min/kg) vs older ferrets (2.29 ml/min/kg). Results of this study indicate that inulin clearance is an adequate measure of GFR in ferrets as it is in other species. Compared with inulin clearance, exogenous creatinine clearance also provides a reliable estimate of GFR in ferrets.

Functional islet cell tumor in six ferrets.

Functional islet cell tumor was diagnosed in 6 ferrets. Prominent clinical signs included weight loss, hind limb weakness, ptyalism, and tremors. The diagnosis was made on the basis of 2 or more of the following methods and confirmed by histologic examination of biopsied tissue: hypoglycemia on routine serum biochemical analysis, clinical signs of hypoglycemia, simultaneous development of hypoglycemia (44 +/- 9.9 mg/dl; mean +/- SD), and hyperinsulinemia (58 +/- 18.4 microU/ml; mean +/- SD) after food was withheld for 4 hours. Surgical resection of affected tissue was associated with clinical improvement in all cases. Foci of metastasis were found in 1 ferret. Diazoxide was unsuccessful in controlling persistent postsurgical hypoglycemia in 2 ferrets. Additional functional islet cell tumors were identified in 5 of 6 ferrets at necropsy. Functional islet cell tumors are important neoplasms of older ferrets. Preventive health programs for ferrets > 3 years old should include monthly weight determinations and biannual CBC and serum biochemical analysis.

Clostridium difficile typhlitis associated with cecal mucosal hyperplasia in Syrian hamsters.

A sudden increase in mortality occurred in a closed breeding colony of Syrian hamsters (Mesocricetus auratus). The colony consisted of approximately 40 hamsters, 8 of which were affected. Four adult males died suddenly. One pregnant female and one weanling died after having been observed as depressed for 1 day and 2 weeks respectively. One weanling and one adult male were euthanized. All affected hamsters had signs of diarrhea. At necropsy, hemorrhagic fluid-filled ceca were noted in five of eight animals. Clostridium difficile cytotoxin B was present in high titers [10(-3) to 10(-8)] in cecal contents of six of six animals tested, whereas C. difficile culture yielded positive results in only one of six animals. Histopathologically, findings consistent with Clostridium-induced typhlitis including necrosis, epithelial denudation, vascular congestion, and hemorrhage were present in six of six ceca evaluated. In addition, signs of a more chronic disease process included cecal mucosal hyperplasia in five of six hamsters. A silver stain of cecal hyperplastic mucosa for intracellular organisms including Campylobacter-like organisms was negative in all affected hamsters. Antibiotics had not been administrated to any hamster in this colony, nor had the affected animals been experimentally manipulated. Testing for antibiotic residues in the feed was negative, and C. difficile was not isolated from feed, water, or feces of unaffected hamsters. Thus C. difficile-induced typhlitis should be included in the differential diagnosis of deaths in hamsters which have no clinical histories of prior antibiotic administration or experimental manipulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Gastric nitrite processing in the surgically altered maximal and minimal bile reflux ferret model.

Ingested nitrate and nitrite have been shown to contribute to endogenous, N-nitroso compound formation in man and experimental animals. N-nitroso compounds have long been suspected of contributing to higher levels of gastric cancer in various populations. Reconstructive gastric surgery to treat ulcers is accompanied by a change in bile reflux, gastritis and an increased incidence of gastric cancer in humans. To evaluate possible connections between gastric nitrite processing, reconstructive surgery and gastric cancer, the surgically altered domestic ferret, Mustela putorius furo, was used as an experimental model. The aim of the study was to determine if surgery would alter the stomach in a way which would increase gastric nitrite concentration, and thereby enhance the likelihood of gastric N-nitroso compound formation. Three groups of ferrets, one control group (n = 6) and two groups of surgically altered ferrets, one to simulate maximal bile reflux (MABR, n = 6), and the other to model minimal bile reflux (MIBR, n = 7), were studied. Each group's response to an exogenously administered dose of sodium nitrite did not differ significantly with respect to rate of gastric nitrite absorption, with half-lives in the 13-min range. Permeability of gastric mucosa to nitrite did not differ between controls and MIBR ferrets. Mean doubling time of gastric nitrate appeared slowed in surgically altered ferrets. Mean rate of gastric emptying was the same in the three groups, but appeared delayed initially in MIBR ferrets. Thiocyanate concentrations, pH and HCl secretion, all parameters which have been shown to affect gastric nitrite processing, did not differ significantly between groups. Gastric mucosal endoscopic biopsies obtained at 6-month intervals showed no clear difference in degree of mucosal inflammation and/or dysplasia in the three groups. These findings indicate that gastric mucosal neoplasia has not occurred in this model and that changes in parameters favoring gastric N-nitrosation, even if relevant to the disease process, are not apparent at this time.

The effect of lead on cholinergic contractile function in the rat forestomach.

Previous studies have demonstrated that subchronic exposure to lead in rats slows gastric emptying. Therefore, the isometric contractile response of the forestomach from lead-treated rats was examined in vitro. Male Wistar rats were fed 4% lead acetate in their diet (NIH-07); controls were pair-fed. After 7 weeks, blood lead levels reached 180-389 micrograms/dl. The forestomach was dissected and suspended in buffer which for lead-treated rats contained 1.2 X 10(-5) M lead acetate. Subchronic lead exposure had no effect on the maximum tonic contraction induced by KCl, methacholine or serotonin. However, lead-treated tissue showed enhanced sensitivity to methacholine with a reduction in EC50 to 59.7% of control. This effect was not observed in control tissue exposed to lead (1.2 X 10(-5) M) only in vitro. Higher in vitro concentrations of lead (16 X 10(-5) M) produced an increase in methacholine EC50. Physostigmine-induced increase in tension was also significantly greater in tissue from lead-treated rats. Electric field stimulation, which produced a contraction attributable to postganglionic acetylcholine release, was unaltered in lead-treated tissue. These results indicate that lead intoxication did not impair the contractile apparatus of the forestomach smooth muscle. The lack of net effect on activation of intramural cholinergic neurons, despite the enhanced sensitivity to a cholinergic agonist, may indicate reduction in acetylcholine release in lead-treated tissue.

The effect of chronic ingestion of lead on gastrointestinal transit in rats.

GI symptoms such as constipation and abdominal colic are signs of lead poisoning in man, but mechanisms of these effects have not been elucidated. To evaluate GI transit, male Wistar rats were dosed with 1% lead or 0.7% sodium acetate in their diet (AIN-76A). After 7 weeks, lead-treated animals exhibited decreased hematocrit, increased 24-hr urinary excretion of delta-ALA, increased kidney/body weight ratio, and decreased body weight. Blood-lead concentrations were elevated to 196 +/- 57 micrograms/dl. Lead treatment, however, did not result in change in GI transit of a nonabsorbable marker, 51Cr, 15 min or 6 hr after po administration. There was also no change in fecal percentage water content. Since in control animals the semipurified diet AIN-76A markedly decreased fecal excretion rate of 51Cr compared to a cereal-based diet, NIH-07, the latter was used in subsequent experiments. Rats fed 2 or 4% lead acetate in NIH-07 for 8 weeks exhibited renal and hematologic toxicity as in the initial experiment. Weight gain was impaired in the 4% group compared to pair-fed controls. No significant differences were observed in the 1-hr gastric emptying or the fecal excretion of 51Cr in the 2 or 4% lead-treated animals, although there was a trend for slower transit in rats receiving the higher dose. These observations indicate that concentrations of lead sufficient to induce renal and hematologic toxicity in rats do not substantially affect GI transit.