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1.
Carcinogenesis ; 29(5): 926-31, 2008 May.
Artículo en Inglés | MEDLINE | ID: mdl-18192685

RESUMEN

INTRODUCTION: Severity of mucosal inflammation is shown to be associated with Barrett's esophagus (BE) development in animals. It has therefore been postulated that a strong pro-inflammatory host response predisposes to BE. AIM: To determine the impact of cytokine gene polymorphisms on the development of BE. METHODS: The multiplex SNaPshot method was used to determine interleukin (IL)-12B (A+1188C), IL-10 (C-592A, C-819T, A-1082G), IL-8 (A-251T), IL-6 (G-174C) and IL-2 (G-330T) gene polymorphisms in 255 patients with BE and 247 patients with reflux esophagitis (RE). RESULTS: The presence of the IL-12B C-allele, which is associated with increased IL-12p70 expression, was more frequently observed in BE than in RE patients [odds ratio (OR) 1.8; 95% confidence interval (CI) 1.2-2.7; P = 0.007). The risk of BE was increased in patients in whom the IL-12B C-allele coincided with a hiatal hernia (OR 2.9; 95% CI 1.32-6.58; P = 0.008). The IL-10(-1082) GG genotype, which is associated with higher IL-10 levels, was also associated with a decreased risk of BE when it was associated with the IL-12B C-allele, indicating IL-10-dependent down-regulation of IL-12p70 expression. A combination of the IL-12B AA genotype and the IL-10 AA or AG genotypes was associated with RE (OR 1.4; 95% CI 1.05-1.85; P = 0.011). CONCLUSION: A genetic profile predisposing to a strong pro-inflammatory host response, mediated by IL-12p70 and partially dependent on IL-10, is associated with BE. This risk further increases when this genotype coincides with a hiatal hernia, suggesting that exposure to gastroesophageal reflux in the presence of a pro-inflammatory genetic background is a driving force in the development of BE.


Asunto(s)
Esófago de Barrett/genética , Citocinas/genética , Inflamación/genética , Anciano , Endoscopía , Femenino , Genotipo , Hernia Hiatal/genética , Humanos , Interleucina-10/genética , Interleucina-12/genética , Interleucina-2/genética , Interleucina-6/genética , Interleucina-8/genética , Masculino , Persona de Mediana Edad , Membrana Mucosa/fisiopatología , Polimorfismo Genético , Población Blanca
2.
J Neurol Neurosurg Psychiatry ; 74(3): 294-8, 2003 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-12588911

RESUMEN

OBJECTIVES: To examine the validity of [(123)I]beta-CIT SPECT for monitoring the progression of dopaminergic degeneration in Parkinson's disease; to investigate the influence of short term treatment with D(2)receptor agonists on striatal [(123)I]beta-CIT binding; and to determine the sample size and frequency of SPECT imaging required to demonstrate a significant effect of a putative neuroprotective agent. METHODS: A group of 50 early stage Parkinson's disease patients was examined. Two SPECT imaging series were obtained, 12 months apart. The mean annual change in the ratio of specific to non-specific [(123)I]beta-CIT binding to the striatum, putamen, and caudate nucleus was used as the outcome measure. RESULTS: A decrease in [(123)I]beta-CIT binding ratios between the two images was found in all regions of interest. The average decrease in [(123)I]beta-CIT binding ratios was about 8% in the whole striatum, 8% in the putaminal region, and 4% in the caudate region. Comparison of scans done in nine patients under two different conditions-in the off state and while on drug treatment-showed no significant alterations in the expression of striatal dopamine transporters as measured using [(123)I]beta-CIT SPECT. Power analysis indicated that to detect a significant (p < 0.05) effect of a neuroprotective agent with 0.80 power and 30% of predicted protection within two years, 216 patients are required in each group when the effects are measured in the whole putamen. CONCLUSIONS: [(123)I]beta-CIT SPECT seems to be a useful tool to investigate the progression of dopaminergic degeneration in Parkinson's disease and may provide an objective method of measuring the effectiveness of neuroprotective treatments. Short term treatment with a D(2)agonist does not have a significant influence on [(123)I]beta-CIT binding to dopamine transporters. If the latter finding is replicated in larger groups of patients, it supports the suitability of [(123)I]beta-CIT SPECT for examining the progression of neurodegeneration in patients being treated with D(2)receptor agonists.


Asunto(s)
Cocaína/análogos & derivados , Degeneración Nerviosa/patología , Enfermedad de Parkinson/diagnóstico por imagen , Enfermedad de Parkinson/patología , Radiofármacos , Tomografía Computarizada de Emisión de Fotón Único , Antiparkinsonianos/uso terapéutico , Benzotiazoles , Núcleo Caudado/diagnóstico por imagen , Núcleo Caudado/metabolismo , Núcleo Caudado/patología , Cuerpo Estriado/diagnóstico por imagen , Cuerpo Estriado/metabolismo , Cuerpo Estriado/patología , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Enfermedad de Parkinson/tratamiento farmacológico , Enfermedad de Parkinson/metabolismo , Pergolida/uso terapéutico , Pramipexol , Putamen/diagnóstico por imagen , Putamen/metabolismo , Putamen/patología , Receptores de Dopamina D2/metabolismo , Reproducibilidad de los Resultados , Tiazoles/uso terapéutico , Resultado del Tratamiento
3.
Mov Disord ; 16(6): 1033-40, 2001 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-11748734

RESUMEN

Tremor is one of the clinical hallmarks of Parkinson's disease (PD). Although it is accepted that other classic symptoms of PD such as rigidity and bradykinesia result from a degeneration of the nigrostriatal system and subsequent reduction in striatal dopamine, the pathophysiology of resting tremor remains unclear. The majority of recent single photon emission computed tomography (SPECT) and positron emission tomography (PET) studies, using various radioligands, demonstrated significant correlation between striatal radioligand bindings and the degree of parkinsonian symptoms such as rigidity and bradykinesia, but not tremor. We investigate the relationship between the degeneration of the nigrostriatal pathway and the appearance of resting tremor, taking into account the possible interference of rigidity with the resting tremor. Thirty early and drug-naïve PD patients were examined. Tremor and rigidity of the arms were assessed using UPDRS, and the power of tremor was estimated using spectral analysis of tremor peaks. [(123)I]beta-CIT SPECT was used to assess degeneration of the dopaminergic system in PD patients. A comparison between asymmetry indices showed that in terms of both tremor and rigidity, the most affected arm corresponded significantly with the contralateral striatum, having the largest reduction in radioligand binding. Furthermore, tremor power accounted for a significant part of variance in the contralateral striatum, suggesting a relationship between this PD symptom and the degeneration of the dopaminergic system. Further, the degree of tremor was reduced with increasing rigidity. However, correcting for the influence of rigidity, the significant contribution of tremor in the variance in the contralateral striatal [(123)I]beta-CIT binding disappeared. When the confounding influence of rigidity is taken into account, no significant direct relationship between dopaminergic degeneration and the degree of tremor could be found. Other pathophysiological mechanisms should be similarly investigated in order to further our understanding of the origin of resting tremor in PD.


Asunto(s)
Cocaína , Radioisótopos de Yodo , Rigidez Muscular/fisiopatología , Enfermedad de Parkinson/fisiopatología , Tomografía Computarizada de Emisión de Fotón Único , Temblor/fisiopatología , Adulto , Cocaína/análogos & derivados , Cuerpo Estriado/diagnóstico por imagen , Dominancia Cerebral , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/diagnóstico por imagen , Radiofármacos , Índice de Severidad de la Enfermedad , Tomografía Computarizada de Emisión de Fotón Único/métodos
4.
Ann Neurol ; 50(1): 34-41, 2001 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-11456307

RESUMEN

By the time a clinical diagnosis of Parkinson's disease (PD) is made, a significant loss of dopaminergic neurons has already occurred. Identifying patients in the period between the presumed onset of dopaminergic cell loss and the appearance of clinical parkinsonism may be of major importance in the development of effective neuroprotective treatment strategies. In an effort to develop a feasible strategy to detect preclinical PD, a combination of olfactory processing tasks, including odor detection, odor identification, and odor discrimination was used to select groups of hyposmic and normosmic individuals from a total of 250 relatives (parents, siblings, or children) of subjects with PD. Single photon emission computed tomography (SPECT) with [123I]beta-CIT as a dopamine transporter ligand was used to assess nigrostriatal dopaminergic function in 25 hyposmic and 23 normosmic relatives of PD patients. An abnormal reduction in striatal dopamine transporter binding was found in 4 out of 25 hyposmic relatives of PD patients, two of whom subsequently developed clinical parkinsonism, and in none of the 23 normosmic relatives. These observations demonstrate that subclinical reductions in dopamine transporter binding can be detected in asymptomatic relatives of sporadic PD patients by means of [123I]beta-CIT and SPECT. The results further indicate that olfactory deficits may precede clinical motor signs in PD.


Asunto(s)
Dopamina/fisiología , Trastornos del Olfato/genética , Enfermedad de Parkinson/diagnóstico por imagen , Enfermedad de Parkinson/fisiopatología , Anciano , Humanos , Persona de Mediana Edad , Nortropanos , Enfermedad de Parkinson/genética , Factores de Riesgo , Análisis y Desempeño de Tareas , Tomografía Computarizada de Emisión de Fotón Único
5.
Infect Control Hosp Epidemiol ; 22(5): 284-8, 2001 May.
Artículo en Inglés | MEDLINE | ID: mdl-11428438

RESUMEN

OBJECTIVE: To study the presence of bacterial factors in clinical isolates of Acinetobacter species in order to identify markers of epidemic potential. DESIGN: Case-control study. METHODS: Forty-six isolates of Acinetobacter species, including 23 epidemic and 23 sporadic strains from different outbreaks in nine European countries, were compared for the presence of the following factors: hemagglutination, presence of capsules and fimbriae, binding to salivary mucins, resistance to drying, and antibiogram typing. Genotyping of all strains was performed by amplified fragment-length polymorphism (AFLP). RESULTS: All outbreak strains except two (91%) were identified as Acinetobacter baumannii. Binding to salivary mucins and resistance to antibiotics were significantly associated with epidemic behavior. Antibiogram typing showed clustering of predominantly A baumannii strains within one group, and these strains were significantly more resistant to antibiotics than sporadic strains. AFLP genotyping revealed a great heterogeneity among the different European Acinetobacter strains. Cluster analysis of AFLP fingerprints showed several small clusters of different A baumannii outbreak strains. AFLP genotyping could not identify a common epidemic marker within the strains studied. CONCLUSIONS: Antibiogram typing can be used in routine clinical laboratories as a screening method to recognize potentially epidemic A baumannii strains. Several other factors were found, both in different outbreaks as well as in sporadic Acinetobacter isolates. These characteristics were unable to predict epidemic behavior and therefore cannot be used as discriminative epidemic markers. AFLP genotyping demonstrated no common clonal origin of European epidemic A baumannii strains. This indicates that any clinical A baumannii isolate with resistance to multiple antibiotics can be a potential nosocomial outbreak strain.


Asunto(s)
Infecciones por Acinetobacter/epidemiología , Acinetobacter/clasificación , Acinetobacter/efectos de los fármacos , Acinetobacter/genética , Infecciones por Acinetobacter/tratamiento farmacológico , Infecciones por Acinetobacter/microbiología , Técnicas de Tipificación Bacteriana , Estudios de Casos y Controles , Farmacorresistencia Microbiana , Genotipo , Humanos , Modelos Logísticos , Pruebas de Sensibilidad Microbiana , Factores de Riesgo
7.
Mov Disord ; 16(1): 41-6, 2001 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-11215591

RESUMEN

Olfactory dysfunction is a common finding in patients with Parkinson's disease (PD). As most studies reported on odor identification in more advanced and treated PD, we administered an odor detection, discrimination, and identification test to a heterogeneous, partly de novo, group of patients. Forty-one non-demented PD patients, 24 of whom had untreated early PD, and 18 healthy controls, were examined. Odor identification and discrimination data were corrected for odor detection scores. PD patients scored significantly lower on all olfactory tests. Interestingly, the subgroup of de novo patients with early PD also showed significant olfactory disturbances compared with healthy subjects. Within the PD group, using multiple regression analysis, we found a significant, negative correlation between odor discrimination measures and disease The present study is the first to describe decreased performance of PD patients on odor discrimination, in addition to the already well-established deficits in odor detection and identification. Furthermore, odor discrimination measures were related to disease severity, possibly indicating that at least some aspects of olfactory dysfunction in PD may be secondary to ongoing degenerative processes in PD. As significant olfactory impairments were found in early, de novo PD, olfactory tests may be useful in the early diagnosis of PD.


Asunto(s)
Agonistas de Dopamina/uso terapéutico , Trastornos del Olfato/complicaciones , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/tratamiento farmacológico , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos del Olfato/diagnóstico , Enfermedad de Parkinson/diagnóstico , Índice de Severidad de la Enfermedad , Factores de Tiempo
8.
J Clin Microbiol ; 39(1): 8-13, 2001 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-11136740

RESUMEN

Forty-eight clinical Acinetobacter isolates with different epidemic behavior were investigated for the presence of integrons and plasmids and for antibiotic susceptibility. Integrons were demonstrated in 50% of the strains by an integrase gene PCR. Epidemic strains of Acinetobacter baumannii were found to contain significantly more integrons than nonepidemic strains. Also, the presence of integrons was significantly correlated with simultaneous resistance to several antibiotics. Plasmids were detected in 42% of the strains. However, there was no significant correlation between the numbers of plasmids and integrons in Acinetobacter species strains, no significant difference in the number of plasmids between epidemic and nonepidemic A. baumannii strains, and no significant correlation between the presence of plasmids and antibiotic resistance. Hence, it is likely that integrons play an important role in antibiotic resistance and thereby in the epidemic behavior of A. baumannii. Because the integrase gene PCR identified almost three-quarters of the epidemic A. baumannii isolates (17 of 23), this seems to be a rapid and simple technique for the routine screening and identification of clinical A. baumannii isolates with epidemic potential.


Asunto(s)
Infecciones por Acinetobacter/microbiología , Acinetobacter/clasificación , Brotes de Enfermedades , Integrasas/genética , Reacción en Cadena de la Polimerasa/métodos , Acinetobacter/efectos de los fármacos , Acinetobacter/genética , Infecciones por Acinetobacter/epidemiología , Antibacterianos/farmacología , Proteínas Bacterianas/genética , Secuencia de Bases , Farmacorresistencia Microbiana/genética , Humanos , Pruebas de Sensibilidad Microbiana , Plásmidos/genética
9.
J Clin Microbiol ; 38(11): 4131-6, 2000 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-11060080

RESUMEN

In 1998, an outbreak of systemic infections caused by Bacillus cereus occurred in the Neonatal Intensive Care Unit of the University Hospital Vrije Universiteit, Amsterdam, The Netherlands. Three neonates developed sepsis with positive blood cultures. One neonate died, and the other two neonates recovered. An environmental survey, a prospective surveillance study of neonates, and a case control study were performed, in combination with molecular typing, in order to identify potential sources and transmission routes of infection. Genotypic fingerprinting by amplified-fragment length polymorphism (AFLP) showed that the three infections were caused by a single clonal type of B. cereus. The same strain was found in trachea aspirate specimens of 35 other neonates. The case control study showed mechanical ventilation with a Sensormedics ventilation machine to be a risk factor for colonization and/or infection (odds ratio, 9.8; 95% confidence interval, 1.1 to 88.2). Prospective surveillance showed that colonization with B. cereus occurred exclusively in the respiratory tract of mechanically ventilated neonates. The epidemic strain of B. cereus was found on the hands of nursing staff and in balloons used for manual ventilation. Sterilization of these balloons ended the outbreak. We conclude that B. cereus can cause outbreaks of severe opportunistic infection in neonates. Typing by AFLP proved very useful in the identification of the outbreak and in the analysis of strains recovered from the environment to trace the cause of the epidemic.


Asunto(s)
Infecciones por Bacillaceae/epidemiología , Infecciones por Bacillaceae/microbiología , Bacillus cereus/clasificación , Brotes de Enfermedades , Contaminación de Equipos , Unidades de Cuidado Intensivo Neonatal , Ventiladores Mecánicos/microbiología , Bacillus cereus/genética , Bacillus cereus/aislamiento & purificación , Técnicas de Tipificación Bacteriana/métodos , Portador Sano/epidemiología , Estudios de Casos y Controles , Desinfección/métodos , Humanos , Recién Nacido , Personal de Enfermería en Hospital , Polimorfismo de Longitud del Fragmento de Restricción , Respiración Artificial/métodos , Factores de Riesgo
10.
J Neurol ; 247 Suppl 2: II103-9, 2000 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-10991655

RESUMEN

Parkinson's disease (PD) is an idiopathic disease caused by necrosis and apoptosis of dopaminergic cells in the brainstem, which are probably induced by oxidative stress. Current therapeutic strategies comprise symptomatic and restorative treatment. Neuroprotective treatment, however, is close to becoming reality. As neuroprotective therapy may be of particular benefit to the preclinical and/or very early PD patients, identifying patients in the early stages of the disease is a priority. Both [18F]dopa positron emission tomography (PET) and [123I]beta-CIT single photon emission computed tomography (SPECT) imaging may be useful tools in diagnosing early (preclinical) PD. As screening the whole population for preclinical PD is not realistic, one has to select subjects with a high risk for this disease. Olfactory disturbances, subtle neurocognitive dysfunction, visuomotor control abnormalities and, to a lesser degree, mood and personality disorders, have lately been suggested to precede or accompany early clinical motor hallmarks of PD. In an epidemiological study, 500 first-degree relatives of PD patients were assessed for these signs and symptoms, and [123I]beta-CIT SPECT was performed on patients in the top 10% and the bottom 10% with regard to sense of smell. In this report, the study design and initial data from this ongoing study will be presented.


Asunto(s)
Trastornos del Olfato/diagnóstico , Enfermedad de Parkinson/diagnóstico , Humanos , Trastornos del Olfato/fisiopatología , Enfermedad de Parkinson/fisiopatología
11.
Eur J Neurosci ; 12(8): 3033-43, 2000 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-10971644

RESUMEN

The ability of CGP 3466B to attenuate the behavioural and morphological consequences of experimentally induced cell death was investigated in a recently updated animal model of Parkinson's disease. 6-Hydroxydopamine was infused bilaterally into the substantia nigra pars compacta of rats that were pretreated with desimipramine. Treatment with CGP 3466B (0.0014-1.4 mg/kg, injected subcutaneously) or its solvent was begun 2 h after the 6-OHDA injection, and maintained twice daily for 14 days. After a washout period of 14 days, changes in motor behaviour were evaluated, using the open field test (analysis of normal and abnormal stepping, e.g.) and the paw test (analysis of retraction time of limbs). Changes in learning and memory were evaluated with the help of the Morris water maze task. Following immunocytochemical staining of tyrosine hydroxylase, the extent of the lesion was quantified using a computerized system. CGP 3466B prevented all deficits produced by 6-hydroxydopamine (6-OHDA), though at different doses. It prevented: abnormal stepping (0.0014-0.014 mg/kg); increased forelimb and hindlimb retraction time (0.014-0.14 mg/kg and 0.0014-0.14 mg/kg, respectively); delayed learning (1.4 mg/kg); and reduced tyrosine hydroxylase immunoreactivity in the substantia nigra (0.0014-0.014 mg/kg). CGP 3466B (0.0014-0.14 mg/kg) induced no deficits in sham-treated rats. CGP 3466B (1.4 mg/kg), however, did not show any benefit on motor deficits in 6-OHDA-lesioned rats, and induced abnormal movements and decreased the tyrosine hydroxylase immunoreactivity in the substantia nigra pars compacta and the ventral tegmental area of sham-lesioned animals. It is concluded that CGP 3466B prevents all 6-OHDA-induced behavioural and immunocytochemical deficits, though at different doses. CGP 3466B is suggested to be a valuable agent for inhibiting the dopaminergic degeneration in patients with Parkinson's disease.


Asunto(s)
Conducta Animal/efectos de los fármacos , Oxepinas/farmacología , Pargilina/análogos & derivados , Enfermedad de Parkinson Secundaria/tratamiento farmacológico , Propilaminas/farmacología , Sustancia Negra/patología , Animales , Anticuerpos , Apoptosis/efectos de los fármacos , Peso Corporal , Desnervación , Dopamina/fisiología , Conducta Exploratoria/efectos de los fármacos , Marcha/efectos de los fármacos , Masculino , Aprendizaje por Laberinto/efectos de los fármacos , Degeneración Nerviosa/inducido químicamente , Degeneración Nerviosa/tratamiento farmacológico , Degeneración Nerviosa/patología , Neuronas/enzimología , Oxidopamina , Pargilina/farmacología , Enfermedad de Parkinson Secundaria/inducido químicamente , Enfermedad de Parkinson Secundaria/patología , Ratas , Ratas Wistar , Sustancia Negra/efectos de los fármacos , Sustancia Negra/fisiopatología , Simpaticolíticos , Tirosina 3-Monooxigenasa/análisis , Tirosina 3-Monooxigenasa/inmunología
12.
J Clin Microbiol ; 38(9): 3463-6, 2000 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-10970405

RESUMEN

Amplified fragment length polymorphism (AFLP) fingerprinting of clinical isolates of Chlamydia trachomatis serovars D, E, and F showed a low percentage of genetic heterogeneity, but clear differences were found. Isolates from index patients and partners had identical AFLP patterns and AFLP markers. Characterization of these AFLP markers could give more insight into the differences in virulence and clinical course of C. trachomatis infections.


Asunto(s)
Infecciones por Chlamydia/microbiología , Chlamydia trachomatis/clasificación , Chlamydia trachomatis/genética , Dermatoglifia del ADN/métodos , Variación Genética , Porinas , Sistema Urogenital/microbiología , Proteínas de la Membrana Bacteriana Externa/genética , Chlamydia trachomatis/aislamiento & purificación , Femenino , Enfermedades Urogenitales Femeninas/microbiología , Humanos , Masculino , Enfermedades Urogenitales Masculinas , Reacción en Cadena de la Polimerasa/métodos , Polimorfismo Genético , Serotipificación
14.
Psychopharmacology (Berl) ; 146(3): 328-34, 1999 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-10541734

RESUMEN

RATIONALE: SKF 83959 acts as a D(1) antagonist in vitro but has been claimed to induce anti-parkinsonian effects after acute administration in MPTP-treated marmosets. OBJECTIVE: The aim of the present study was to evaluate the therapeutic and undesired effects of sub-chronic administration of SKF 83959 in bilaterally MPTP-treated rhesus monkeys and to compare these effects with the effects of l-dopa and the dopamine agonist SKF 82958. METHODS: MPTP was given in the left carotid artery (2.5 mg) and 6 weeks later, the right carotid artery (1.25 mg). The monkeys (n = 4) had previously been treated chronically with l-dopa (22 days, 10 mg/kg) and SKF 82958 (22 days, 1 mg/kg). Three months after the last administration of SKF 82958, SKF 83959 was given in a dose of 0.5 mg/kg from day 1 to day 15 and in a dose of 1.0 mg/kg from day 16 to day 18. RESULTS: SKF 83959 increased goal-directed limb movements in all animals, including those unresponsive to l-dopa. This therapeutic effect did not diminish during treatment. With respect to body displacement and undesired effects, a large variation in the response to SKF 83959 was found: a large increase in body displacement co-occurred with oro-facial dyskinesia (n = 2), whereas a small increase in body displacement co-occurred with dystonia (n = 2). In contrast to the undesired effects of l-dopa, the dyskinetic effects of SKF 83959 were primarily limited to the first treatment day. Unlike l-dopa and SKF 82958, SKF 83959 did not induce epileptoid behaviour. CONCLUSION: Sub-chronic administration of SKF 83959 induced both clear-cut therapeutic effects that remained stable in time, and a limited number of dyskinetic effects that wore off during the treatment. The dopamine D(1) antagonist SKF 83959 may be considered as an alternative treatment in Parkinson's disease, especially in those patients who do not respond to L-dopa.


Asunto(s)
Antiparkinsonianos/uso terapéutico , Antagonistas de Dopamina/uso terapéutico , Discinesia Inducida por Medicamentos/etiología , Enfermedad de Parkinson/tratamiento farmacológico , Receptores de Dopamina D1/antagonistas & inhibidores , Animales , Levodopa/uso terapéutico , Levodopa/toxicidad , Intoxicación por MPTP/tratamiento farmacológico , Macaca mulatta , Masculino
15.
J Hosp Infect ; 42(4): 295-302, 1999 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-10467543

RESUMEN

Between August and November 1997, a nosocomial outbreak caused by gentamicin-resistant Klebsiella pneumoniae occurred in the Neonatal Intensive Care Unit (NICU) of our hospital. Thirteen neonates became colonized and three of them became infected. Comparison of the isolates by amplified fragment length polymorphism (AFLP) revealed clonal similarity for isolates of eight neonates (homology > 90%). Cultures from environmental specimens were negative for gentamicin-resistant K. pneumoniae. A case-control study was conducted to identify risk factors associated with acquisition of gentamicin-resistant K. pneumoniae. Risk factors were low gestational age and birth weight. These neonates need more care and handling and may therefore, be more at risk of colonization. Length of stay on the NICU was significantly longer for cases, but mean time until colonization (6.3 days) was shorter than the total stay for controls (9.5 days). No single member of the medical or nursing staff was significantly more involved with cases than with controls. The outbreak was stopped by replacing gentamicin by amikacin as the antibiotic of first choice whenever the use of an aminoglycoside antibiotic was indicated.


Asunto(s)
Infección Hospitalaria/epidemiología , Brotes de Enfermedades , Gentamicinas/antagonistas & inhibidores , Unidades de Cuidado Intensivo Neonatal , Infecciones por Klebsiella/epidemiología , Klebsiella pneumoniae/efectos de los fármacos , Amicacina/uso terapéutico , Antibacterianos/antagonistas & inhibidores , Antibacterianos/uso terapéutico , Estudios de Casos y Controles , Infección Hospitalaria/tratamiento farmacológico , Infección Hospitalaria/microbiología , Brotes de Enfermedades/estadística & datos numéricos , Farmacorresistencia Microbiana , Hospitales Universitarios , Humanos , Recién Nacido , Infecciones por Klebsiella/tratamiento farmacológico , Infecciones por Klebsiella/microbiología , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/aislamiento & purificación , Países Bajos/epidemiología , Política Organizacional , Polimorfismo de Longitud del Fragmento de Restricción , Factores de Riesgo
16.
Eur J Pharmacol ; 375(1-3): 75-86, 1999 Jun 30.
Artículo en Inglés | MEDLINE | ID: mdl-10443566

RESUMEN

Patients suffering from Parkinson's disease display severe and progressive deficits in motor behavior, predominantly as a consequence of the degeneration of dopaminergic neurons, located in the mesencephalon and projecting to striatal regions. The cause of Parkinson's disease is still an enigma. Consequently, the pharmacotherapy of Parkinson's disease consists of symptomatic treatment, with in particular L-dihydroxyphenylalanine (L-DOPA) and/or dopamine receptor agonists. These induce a dramatic initial improvement. However, serious problems gradually develop during long-term treatment. Therefore, a more rational, c.q. causal treatment is needed which requires the introduction of compounds ameliorating the disease process itself. The development of such compounds necessitates (1) more information on the etiopathogenesis, i.e., the cascade of events that ultimately leads to degeneration of the dopaminergic neurons, and (2) brain imaging methods, to estimate the extent of the degeneration of the dopaminergic neurons in the living patient. This is not only important for the early diagnosis, but will also allow to monitor the effectiveness of alleged neuroprotective compounds on a longitudinal base. In this paper, etiopathogenic mechanisms are highlighted along the line of the oxidative stress hypothesis and within this framework, attention is mainly focused on the putative role of glutathione, dopamine auto-oxidation and phase II biotransformation enzymes. Especially, drugs able to increase the activity of phase II biotransformation enzymes seem to elicit a broad-spectrum (neuro)protective response and look very promising leads for the development of neuroprotective treatment strategies in Parkinson's disease. New developments in brain imaging methods (single photon emission computed tomography (SPECT) and positron emission tomography (PET)) to visualize the integrity of the striatal dopaminergic neurons in humans are highlighted as well. Especially, the introduction of radioligands that bind selectively to the dopamine transporter seems to be a significant step forward for the early diagnosis of Parkinson's disease. Performing these brain imaging studies with fixed time intervals does not only create the possibility to follow the degeneration rate of the dopaminergic neurons in Parkinson's disease but also provides the opportunity to estimate therapeutic effects of putative neuroprotective agents in the individual patient.


Asunto(s)
Encéfalo/efectos de los fármacos , Diagnóstico por Imagen/métodos , Fármacos Neuroprotectores/uso terapéutico , Enfermedad de Parkinson/tratamiento farmacológico , Dopamina/metabolismo , Humanos , Fármacos Neuroprotectores/farmacología , Estrés Oxidativo/efectos de los fármacos , Estrés Oxidativo/fisiología , Enfermedad de Parkinson/diagnóstico , Enfermedad de Parkinson/etiología , Resultado del Tratamiento
17.
Synapse ; 34(1): 77-80, 1999 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-10459174

RESUMEN

Both iodine-123-labeled beta-CIT (2beta-carbomethoxy-3beta-(4-iodophenyl)tropane) and nor-beta-CIT (2beta-carbomethoxy-3beta-(4-iodophenyl)nortropane) have shown to be suitable radioligands for imaging serotonin (5-HT) transporters. [(123)I]nor-beta-CIT has the highest in vitro affinity for 5-HT transporters among beta-CIT analogs reported so far. However, no direct comparison-studies of these two radiotracers as to their in vivo binding to 5-HT transporters have been reported so far. Therefore, it is still unclear which of the two radiotracers is more suitable for single photon emission computed tomography (SPECT) imaging of 5-HT transporters. The purpose of this study was to compare directly in a controlled design the in vivo [(123)I]beta-CIT and [(123)I]nor-beta-CIT binding to 5-HT transporters under the same conditions in rats with the focus on brain kinetic characteristics by means of a two-compartment analysis. We observed that [(123)I]beta-CIT has a higher binding potential and faster kinetics for 5-HT transporters than [(123)I]nor-beta-CIT, suggesting that [(123)I]beta-CIT may be a more suitable radioligand than [(123)I]nor-beta-CIT for imaging 5-HT transporters with SPECT.


Asunto(s)
Química Encefálica/efectos de los fármacos , Proteínas Portadoras/metabolismo , Cocaína/análogos & derivados , Glicoproteínas de Membrana/metabolismo , Proteínas de Transporte de Membrana , Proteínas del Tejido Nervioso , Serotonina/metabolismo , Animales , Encéfalo/diagnóstico por imagen , Cocaína/metabolismo , Radioisótopos de Yodo , Cinética , Masculino , Modelos Neurológicos , Unión Proteica , Ratas , Ratas Wistar , Proteínas de Transporte de Serotonina en la Membrana Plasmática , Tomografía Computarizada de Emisión de Fotón Único
18.
Infect Immun ; 67(6): 3040-6, 1999 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-10338517

RESUMEN

The vacA and cagA geno- and phenotypes of two mouse-adapted strains of Helicobacter pylori, SS1 and SPM326, were determined. The SS1 strain, which had the cagA+ and vacA s2-m2 genotype, induced neither vacuole formation in HeLa cells nor interleukin-8 (IL-8) production in KATO III cells. In contrast, H. pylori SPM326, with the cagA+ and vacA s1b-m1 genotype, induced vacuoles as well as IL-8 production in vitro. Furthermore, a spontaneous mutant of SPM326, which produced a vacuolating cytotoxin but was not able to induce IL-8 production (SPM326/IL-8(-)), was detected. C57Bl/6 and BALB/c mice were infected with these three strains to investigate the colonization pattern and the effect on the immune response in vivo. The SS1 strain colonized the stomachs of all mice in large numbers which remained constant over time. Colonization with the SPM326/IL-8(+) and SPM326/IL-8(-) strains was lesser, or even absent, and decreased over time. At 5 weeks postinoculation all three H. pylori strains induced a mild increase of neutrophil count in the gastric corpus of C57Bl/6 mice, which disappeared by 12 weeks. At both 5 and 12 weeks postinoculation C57Bl/6 mice colonized with SPM326/IL-8(+) showed an increased expression of major histocompatibility complex (MHC) class II antigen in the cardia which was accompanied by an increased number of T cells. C57Bl/6 mice that were infected with SS1 and SPM326/IL-8(-) did not show chronic inflammation. BALB/c mice colonized with SS1 and SPM326/IL-8(-) also showed an increase in neutrophil count at 5 weeks, which normalized again by 12 weeks postinoculation. At this time point SS1-infected mice showed inflammation in the corpus and antrum. At these sites an increased expression of MHC class II antigens and an increased number of T cells were observed. Although small lymphoid follicles were already observed 5 weeks after inoculation with SS1, their incidence as well as their number was increased at 12 weeks. These results show that inflammation induced by H. pylori depends both on the bacterial strain and the host.


Asunto(s)
Antígenos Bacterianos , Gastritis/microbiología , Infecciones por Helicobacter/inmunología , Helicobacter pylori/inmunología , Animales , Proteínas Bacterianas/genética , Proteínas Bacterianas/inmunología , Toxinas Bacterianas/genética , Toxinas Bacterianas/inmunología , Citotoxinas/genética , Citotoxinas/inmunología , Femenino , Gastritis/inmunología , Gastritis/patología , Genotipo , Células HeLa , Infecciones por Helicobacter/microbiología , Infecciones por Helicobacter/patología , Helicobacter pylori/genética , Helicobacter pylori/patogenicidad , Humanos , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL , Fenotipo , Especificidad de la Especie , Estómago/microbiología , Vacuolas
19.
Eur J Pharmacol ; 364(1): 33-41, 1999 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-9920182

RESUMEN

So far, no clear correlation has been found between the effects of dopamine D1 receptor agonists on motor behavior in primate models of Parkinson's disease and their ability to stimulate adenylate cyclase in rats, the benzazepine SKF 83959 (3-methyl-6-chloro-7,8-hydroxy-1-[3-methylphenyl]-2,3,4,5-tetrahydro-]H- 3-benzazepine) being the most striking example. Since this discrepancy might be attributed to: (A) the different species used to study these effects or (B) the interaction of SKF 83959 with other catecholamine receptors, the aims of this study were: (1) to study the ability of SKF 83959 to stimulate adenylate cyclase in cultured human and monkey glial cells equipped with dopamine D1 receptors and (2) to evaluate the affinity for and the functional interaction of SKF 83959 with other catecholamine receptors. Binding studies revealed that SKF 83959 displayed the highest affinity for the dopamine D1 receptor (pKi=6.72) and the alpha2-adrenoceptor (pKi=6.41) and moderate affinity for the dopamine D2 receptor and the noradrenaline transporter. In monkey and human cells, SKF 83959 did not stimulate cyclic adenosine monophosphate (cAMP) formation to a significant extent, but antagonized very potently the dopamine-induced stimulation of cAMP formation in both cell types. The compound stimulated basal dopamine outflow and inhibited depolarization-induced acetylcholine release only at concentrations > 10 microM. Finally, SKF 83959 concentration dependently increased electrically evoked noradrenaline release, indicating that it had alpha2-adrenoceptor blocking activity and interfered with the noradrenaline transporter. In conclusion, SKF 83959 is a potent dopamine D1 receptor and alpha2-adrenoceptor antagonist. Thus, the anti-parkinsonian effects of SKF 83959 in primates are not mediated by striatal dopamine D1 receptors coupled to adenylate cyclase in a stimulatory way.


Asunto(s)
2,3,4,5-Tetrahidro-7,8-dihidroxi-1-fenil-1H-3-benzazepina/análogos & derivados , Agonistas de Dopamina/farmacología , Antagonistas de Dopamina/farmacología , Glicoproteínas de Membrana , Proteínas de Transporte de Membrana , Proteínas del Tejido Nervioso , Neuroglía/efectos de los fármacos , Receptores de Dopamina D1/efectos de los fármacos , Simportadores , 2,3,4,5-Tetrahidro-7,8-dihidroxi-1-fenil-1H-3-benzazepina/farmacología , Acetilcolina/metabolismo , Animales , Encéfalo/efectos de los fármacos , Encéfalo/metabolismo , Proteínas Portadoras/metabolismo , Células Cultivadas , AMP Cíclico/biosíntesis , Dopamina/metabolismo , Dopamina/farmacología , Proteínas de Transporte de Dopamina a través de la Membrana Plasmática , Estimulación Eléctrica , Humanos , Técnicas In Vitro , Macaca mulatta , Masculino , Neuroglía/metabolismo , Norepinefrina/metabolismo , Proteínas de Transporte de Noradrenalina a través de la Membrana Plasmática , Ratas , Ratas Wistar , Receptores Adrenérgicos/efectos de los fármacos , Receptores Dopaminérgicos/efectos de los fármacos , Especificidad de la Especie
20.
Behav Pharmacol ; 10(2): 163-73, 1999 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-10780829

RESUMEN

The goal of this study was to evaluate the validity of the pretreated, unilaterally MPTP-treated monkey as an animal model of Parkinson's disease (PD). For that purpose, a detailed ethogram was developed and assessed in four male rhesus monkeys that had received MPTP (2.5 mg) in the carotid artery contralateral to the dominant limb. Subsequently, the behavioural effects of the dopamine D2 agonist quinpirole and the dopamine D1 agonist SKF 81297 were studied. The ethogram was found to allow a clear-cut and objective separation of drug-induced behaviours into therapeutic and undesired effects in the MPTP-treated monkeys. Saline-treated monkeys predominantly displayed ipsilateral goal-directed fore-limb movements, and distinct types of ipsilaterally directed rotations. Although quinpirole and SKF 81297 increased motor behaviours, such as body displacement, contralateral fore-limb movements and contralateral rotational behaviours, assessment of the new detailed ethogram revealed that this increase was completely due to the activation of abnormal, non-goal-directed behaviours, such as dyskinetic fore-limb movements, pivoting and shuffling. Moreover, the new ethogram made clear that the drug treatments induced not only dyskinesia and dystonia, but also epileptoid behaviour, which was confirmed by EEG analysis. In summary, the detailed behavioural analysis showed that this model does not adequately predict the clinical effects of the D2 agonist. It is concluded that the pretreated, unilaterally MPTP-treated monkey is not a valid model to predict the therapeutic and undesired effects of dopaminergic drugs in humans.


Asunto(s)
Benzazepinas/uso terapéutico , Agonistas de Dopamina/uso terapéutico , Intoxicación por MPTP/tratamiento farmacológico , Intoxicación por MPTP/psicología , Enfermedad de Parkinson Secundaria/inducido químicamente , Enfermedad de Parkinson Secundaria/tratamiento farmacológico , Quinpirol/uso terapéutico , Receptores de Dopamina D1/agonistas , Receptores de Dopamina D2/agonistas , Animales , Brazo/fisiología , Conducta Animal/efectos de los fármacos , Discinesia Inducida por Medicamentos/tratamiento farmacológico , Discinesia Inducida por Medicamentos/psicología , Distonía/tratamiento farmacológico , Distonía/psicología , Electroencefalografía/efectos de los fármacos , Macaca mulatta , Masculino , Actividad Motora/efectos de los fármacos , Movimiento/efectos de los fármacos , Enfermedad de Parkinson Secundaria/psicología , Reproducibilidad de los Resultados
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