The dynamic changes of zinc transporter 8 autoantibodies in Czech children from the onset of Type 1 diabetes mellitus.

AIMS: The prevalence of autoantibodies to zinc transporter 8 (ZnT8) in Czech children at the onset of Type 1 diabetes mellitus and dynamic changes in ZnT8 autoantibody levels during disease progression were studied. The value of ZnT8 autoantibody measurements in diagnosis of Type 1 diabetes was assessed. METHODS: Serum samples from 227 children with newly diagnosed Type 1 diabetes and from 101 control children without diabetes were analysed in a retrospective cross-sectional study. One hundred and seventy-one samples from 116 of the patients with diabetes were analysed in a follow-up study at (median) intervals of 1, 3, 5 and 10 years after onset of Type 1 diabetes. ZnT8 autoantibodies were measured using a bridging enzyme-linked immunosorbent assay, while antibodies to glutamic acid decarboxylase, insulinoma antigen 2 and insulin were measured by radioimmunoassays. RESULTS: ZnT8 autoantibodies were detected in 163/227 (72%) of children at Type 1 diabetes onset and in 1/101 (1%) of the control subjects. Sixteen out of 227 (7%) patients with Type 1 diabetes were antibody negative based on three antibodies (glutamic acid decarboxylase, insulinoma antigen 2 and insulin). This false-negative rate was reduced to 10/227 (4.4%) (P < 0.05) after inclusion of ZnT8 autoantibody measurements. Of the children, 142/227 (63%) were positive for at least three antibodies and the most common combination was insulinoma antigen 2, glutamic acid decarboxylase and ZnT8. ZnT8 autoantibody levels decreased over time after Type 1 diabetes onset and the presence and level of ZnT8 autoantibodies correlated with IA-2 autoantibodies. CONCLUSIONS: A ZnT8 autoantibody enzyme-linked immunosorbent assay showed 72% disease sensitivity and 99% specificity at Type 1 diabetes onset. Measurements of ZnT8 autoantibodies are important for Type 1 diabetes diagnosis and should be included in the panel of autoantibodies tested at the onset of Type 1 diabetes.

Agomelatine improves sleep in a patient with fatal familial insomnia.

A young patient with FFI was started on agomelatine 25 mg to medicate nocturnal insomnia. Under this treatment sleep efficiency was improved, slow wave sleep was high and awakenings during sleep period time were far less than before. Clinically the patient was less restless during nighttime.

Analysis of optical recording stability using wavelet entropy of action potentials.

A method based on wavelet entropy is presented for analysis of optically recorded action potentials to assess stability of the experiment. The action potentials are recorded using fluorescent voltage-sensitive dye di-4-ANEPPS by optical means. The acquired signals are preprocessed using averaging with filtered residue method and decomposed by continuous wavelet transform. Entropy is then computed using the wavelet coefficients. Wavelet entropy helps to detect possible amplitude and frequency changes in the signals caused by photo-bleaching.

[Long-term follow-up of the health status of opiate abusers treated with methadone--pilot study]. / Pilotní studie k dlouhobému sledování zdravotního stavu abuzéru závislých na opiátech lécených metadonem.

BACKGROUND: Examination of the health status of patients abusing opiates can be substantiated by their high morbidity. The aim of the work was to describe the actual health status and the extent and seriousness of the affliction before the substitution therapy with opioid receptors agonist--methadone. METHODS AND RESULTS: The group of drug abusers consisted of 101 persons (average age was 28.5 years, within the range of 20 to 47 years, 77 men and 24 women). Among the pathological findings, values of the levels of hepatic enzymes ALT, AST (35 and 31%), GMT (9%), low haemoglobin levels (24%) and elevated values of IgM (38%) and CRP (25%) belonged to the most frequent ones. Because of the simultaneously positive tests for hepatitis (C and B, 70% and 61%), the alteration is fully obvious. Low testosterone levels in males (63%) indicate the dysfunction of the hypothalamus-hypophysis-gonadas axis. Increased values of thyroxin (14%), P (20%) and atherogenity index (19%) remain unexplained. Several other laboratory-biochemical parameters remained within the physiological range. Imaging methods revealed hepatomegaly in 28% and splenomegaly in 27%, echotexture indicating steatosis was found in 15% of studied persons. CONCLUSIONS: In chronic drug abusers before the onset of the substitution therapy, it is possible to expect frequent alterations, namely that of hepatic functions, positive test for hepatitis B and C, alteration of immunoglobulines level and testosterone deficits (in males).

Sleep and sleep-wake cycle in an 81-year-old patient with de novo ultra-rapid cycling bipolar disorder.

This is a case report of an 81-year-old man who developed de novo bipolar disorder with ultrarapid cycling at the age of 80. Mood was self-rated daily over a period of ten weeks; in addition, polysomnographic and motor activity recordings were performed during a drug-free baseline period. Both depressive and hypomanic episodes had an average duration of about 30 hours; the affective cycle was thus independent from the sleep-wake cycle. When mood shifts occurred during nighttime, sleep was different in nights following depression than in nights following hypomania. Positron emission tomography revealed a moderate bilateral frontal hypermetabolism in the hypomanic phase and yielded normal findings for the depressive stage. In contrast to what is usually expected in ultra-rapid cycling bipolar disorder, this case demonstrates an unusual sleep-unrelated cycle duration in the oldest reported patient so far.

[Temporal correlations between nocturnal spontaneous erections and sleep stages]. / Zeitliche Zusammenhänge zwischen nächtlichen Spontanerektionen und Schlafstadien.

Early investigations on nocturnal penile tumescence (NPT) reported a close association with REM sleep; later, a less close coupling was observed under certain conditions e.g. in major depression. This supports the hypothesis that partly different mechanisms are involved in the regulation of both phenomena. In the present study, 45 male subjects suffering from erectile dysfunction were examined. Sleep was polysomnographically recorded during two consecutive nights, including registration of penile tumescence and rigidity by means of the RigiScan device. We analyzed the temporal relationship between erectile "events" and REM sleep and found that of the total of event duration, only 43% coincided with REM sleep. The majority of erections started within a range of a few minutes before or after the onset of the REM period. The data demonstrate that in patients suffering from erectile dysfunction, the coupling between NPT and REM sleep is not as close as initially presumed. This may partly reflect an abnormality characteristic for this disorder. The observations contribute to the hypothesis that the neurophysiological mechanisms governing nocturnal penile tumescence are to some degree independent from those involved in REM/NonREM sleep regulation.

Lymphocyte subpopulations in peripheral blood and malignant effusions of cancer patients.

The percentage of total T lymphocytes and helper and suppressor cells was determined in the peripheral blood and pleural and abdominal effusions of patients with advanced cancer. The ratio of helper to suppressor cells in the peripheral blood and in the effusions was calculated in each case. The percentage of total T lymphocytes and suppressor cells was found to be in a normal range. The percentage of helper cells in patients' peripheral blood and in ascites was slightly lower than normal. However, the percentage of helper cells in the pleural effusion was significantly higher than in the blood. The ratio of helper to suppressor cells in the pleural effusion was 1.46, compared to 0.82 in the blood (P less than 0.01). In patients with ascites the ratio in the blood was 1.05 and in the effusion 1.28. The ratio of helper to suppressor cells of all patients in the peripheral blood was 0.94, as compared to 1.36 in the effusion fluid (P less than 0.05). The imbalance in the T cell subsets found is most probably due to immunodepressions in the peripheral blood and immune reactivity in the effusions.