Melatonin and Glycine Reduce Uterus Ischemia/Reperfusion Injury in a Rat Model of Warm Ischemia.

Ischemia/reperfusion injury (IRI) remains a significant problem to be solved in uterus transplantation (UTx). Melatonin and glycine have been shown to possess direct cytoprotective activities, mainly due to their antioxidative and anti-inflammatory properties. The aim of this study was to investigate the protective effects of melatonin and glycine and their combination on IRI in a rat model of warm ischemia. In this study, Sprague-Dawley rats were assigned to eight groups, including sham and IRI (n = 80). Melatonin and glycine alone or their combination were administered prior to 1 h of uterus ischemia followed by 1 h of reperfusion. Melatonin (50 mg/kg) was administered via gavage 2 h before IRI and glycine in an enriched diet for 5 days prior to intervention. Uterus IRI was estimated by histology, including immunohistochemistry, and biochemical tissue analyses. Histology revealed that uterus IRI was significantly attenuated by pretreatment with melatonin (p = 0.019) and glycine (p = 0.044) alone as well as their combination (p = 0.003). Uterus IRI led to increased myeloperoxidase expression, which was significantly reduced by melatonin (p = 0.004), glycine (p < 0.001) or their combination (p < 0.001). The decline in superoxide dismutase activity was significantly reduced in the melatonin (p = 0.027), glycine (p = 0.038) and combined treatment groups (p = 0.015) when compared to the IRI control group. In conclusion, melatonin, glycine and their combination significantly reduced oxidative stress-induced cell damage after IRI in a small animal warm ischemia model, and, therefore, clinical studies are required to evaluate the protective effects of these well-characterized substances in uterus IRI.

[Efficacy of subgingival glycine air polishing on the treatment of moderate-mild peri-implantitis].

PURPOSE: To evaluate the efficacy of subgingival glycine air polishing (GPAP) in the treatment of moderate-mild peri-implantitis. METHODS: Twenty-five patients with peri-implantitis were randomly recruited according to the inclusion and the exclusion criteria. They were divided into conventional scaling treatment group and GPAP treatment group. Periodontal clinical indicators were recorded before treatment(baseline level) and 6 months after treatment. The indicators included modified plaque index (mPLI), bleeding on probing (BOP), modified sulcus bleeding index (mSBI), probing pocket depth (PPD) and attachment level (AL). A periodontal probe (PCP 12) was used for all examinations. SPSS 21.0 software package was used for statistical analysis. RESULTS: At the baseline level, clinical periodontal parameters were similar between the experimental group and the control group. Six months after treatment, the overall clinical periodontal index was below the baseline, with significant difference (P＜0.05) compared with the baseline and between the two groups. CONCLUSIONS: GPAP can improve the efficacy and comfort during treatment of moderate-mild peri-implantitis. However, this improvement may just be short-term, and the long-term efficacy may need a long-term follow-up of larger samples.

[Efficacy of subgingival glycine air polishing on patients with early peri-implant diseases].

Objective: To compare the clinical efficacies of subgingival glycine air polishing and ultrasonic scaling combined with 0.12% chlorhexidine rinsing on patients with early peri-implant diseases (peri-implant mucositis and early peri-implantitis). Methods: Twenty-two systemically healthy patients with totally 42 implants and early peri-implant diseases, were recruited in this study. The patients were randomly divided into the test group and the control group. Patients in the test group were treated with subgingival glycine air polishing and patients in the control group were treated with ultrasonic scalers combined with 0.12% chlorhexidine rinsing. Periodontal parameters such as probing depth, bleeding index, plaque index and clinical attachment loss, at baseline and 2 months after treatment, respectively, were collected and compared between the test and control groups. Results: For the natural teeth, the parameters of probing depth, bleeding index, plaque index and attachment loss in the two groups were significantly improved after treatments (medians were 0.48 mm vs 0.22 mm, 1.00 vs-0.13, 0.38 vs 0.50, 0.48 mm vs 0.22 mm, respectively for test and control group). There was no statistical difference of median between the two groups after treatment except for that of the attachment loss (medians, 0.48 mm vs 0.22 mm, P=0.034). For the implants, differences of parameters in the two groups at baseline were insignificant. After treatments, the probing depths significantly decreased by 0.67 mm and 0.33 mm in the test group and the control group, respectively. The inter-group differences, however, were insignificant. Significant difference of the bleeding index after treatment was found in the test group (P=0.019), but not in the control group. No adverse reactions were found on patients in the two groups after treatments. Conclusions: Efficacy of subgingival glycine air polishing and ultrasonic scaling combined with 0.12% chlorhexidine rinsing is competitive on patients with early peri-implant diseases. However, the former treatment may be more effective oncontrolling the early peri-implant inflammation.

New approaches to target glycinergic neurotransmission for the treatment of chronic pain.

Inhibitory glycinergic neurotransmission in the spinal cord dorsal horn plays an important role in regulating nociceptive signalling by inhibiting neuronal excitation. Blocking glycinergic transmission in the dorsal horn causes normally innocuous stimuli to become painful (allodynia) and increases sensitivity to noxious stimuli (hyperalgesia). Loss of inhibitory signalling is thought to contribute to the development of pathological pain. Management of neuropathic pain with current therapeutics is challenging and there is a great need for more effective treatments. Preclinical studies using drugs that increase glycinergic signalling by potentiating glycine receptor activity or inhibiting transporter activity suggest that targeting this system is a good therapeutic strategy. The spatially restricted expression of glycine receptors and transporters is an advantage for targeting specific pathologies such as pain. However, until recently there have been few pharmacological modulators identified and most of which do not specifically target glycinergic signalling. This mini-review provides an overview of recent advances in the development of therapeutics and novel approaches that aim to increase glycinergic neurotransmission for the treatment of persistent pain.

Update on New and Emerging Treatments for Schizophrenia.

Although there has been more than 50 years of development, there remains a great need for better antipsychotic medications. This article looks at the recent advances in treatment of schizophrenia. New hypotheses have been suggested that may replace or complement the dopamine hypotheses. The article explores the different novel drugs that impact some of the key neurotransmitter systems currently. Phosphodiesterase 10A inhibitors and α-7 neuronal nicotinic acetylcholine receptor modulators constitute the majority. The marketing of these medications eventually may result in change about how schizophrenia is treated.

Glutamatergic NMDA Receptor as Therapeutic Target for Depression.

Major depressive disorder (MDD) affects approximately 121 million individuals globally and poses a significant burden to the healthcare system. Around 50-60% of patients with MDD respond adequately to existing treatments that are primarily based on a monoaminergic system. However, the neurobiology of MDD has not been fully elucidated; therefore, it is possible that other biochemical alterations are involved. The glutamatergic system and its associated receptors have been implicated in the pathophysiology of MDD. In fact, the N-methyl-d-aspartate (NMDA) receptor, a glutamate receptor, is a binding or modulation site for both classical antidepressants and new fast-acting antidepressants. Thus, this review aims to present evidence describing the effect of antidepressants that modulate NMDA receptors and the mechanisms that contribute to the antidepressant response.

Pharmacological treatment of negative symptoms in schizophrenia.

Effective treatment of negative symptoms is one of the most important unmet needs in schizophrenic disorders. Because the evidence on current psychopharmacological treatments is unclear, the authors reviewed the findings published to date by searching PubMed with the keywords negative symptoms, antipsychotics, antidepressants, glutamatergic compounds, monotherapy and add-on therapy and identifying additional articles in the reference lists of the resulting publications. The findings presented here predominantly focus on results of meta-analyses. Evidence for efficacy of current psychopharmacological medications is difficult to assess because of methodological problems and inconsistent results. In general, the second-generation antipsychotics (SGAs) do not appear to have good efficacy in negative symptoms, although some show better efficacy than first-generation antipsychotics, some of which also demonstrated efficacy in negative symptoms. Specific trials on predominant persistent negative symptoms are rare and have been performed with only a few SGAs. More often, trials on somewhat persistent negative symptoms evaluate add-on strategies to ongoing antipsychotic treatment. Such trials, mostly on modern antidepressants, have demonstrated some efficacy. Several trials with small samples have evaluated add-on treatment with glutamatergic compounds, such as the naturally occurring amino acids glycine and D-serine and new pharmacological compounds. The results are highly inconsistent, although overall efficacy results appear to be positive. The unsatisfactory and inconsistent results can be partially explained by methodological problems. These problems need to be solved in the future, and the authors propose some possible solutions. Further research is required to identify effective treatment for the negative symptoms of schizophrenia.

Treatment of peri-implant mucositis using a glycine powder air-polishing or ultrasonic device: a randomized clinical trial.

AIM: To evaluate the clinical treatment effects of a glycine powder air-polishing or ultrasonic device on peri-implant mucositis. MATERIALS AND METHODS: Thirty-seven patients with one implant diagnosed with peri-implant mucositis (probing depth ≥4 mm (0.2N) and bleeding on probing (BOP) (primary outcome)) were randomly assigned to treatment with either glycine powder air-polishing (GPAP) or ultrasonic (US) debridement. Treatment was performed at baseline and at 3 and 6 months. Professional supra gingival cleaning was performed at 9 and 12 months. Oral hygiene instructions were reinforced at each visit. RESULTS: At 12 months there was a statistically significant reduction in mean plaque score, bleeding on probing and number of periodontal pockets ≥4 mm within the treatment groups compared to baseline. The percentages of diseased sites were significantly reduced for both groups. CONCLUSIONS: Treatment with a glycine powder air-polishing or an ultrasonic device is effective in non-surgical treatment of peri-implant mucositis.

Helicobacter pylori and anemia with pregnancy.

SUBJECTS AND METHODS: Study was conducted in Ain Shams University hospitals on 100 pregnant women with iron-deficiency anemia (IDA), including 50 cases infected with Helicobacter pylori (H. pylori) and 50 cases negative for H. pylori infection. Cases with symptomatic gastritis or hyperemesis gravidarum were not included in the study, obstetric history, sociodemographic and dietary variables were also assessed. Hemoglobin level, serum iron, serum ferritin, total iron binding capacity (TIBC), H. pylori serum antibody, stool analysis to exclude parasitic infection causing IDA, occult blood in stool and ultrasound for the fetus to ensure its cardiac pulsations and to exclude any associated abnormality were all done for all patients. Iron therapy in a fixed dose was given to all patients for 1 month. Response was estimated and statistical comparison was done between both groups. Eradication of H. pylori was done in positive cases by triple therapy in the second trimester and iron therapy was given after treatment in the same dose for another month. Their response to treatment after eradication was compared to their response to iron therapy prior to H. pylori eradication. RESULTS: Hb levels, serum iron, serum ferritin were lower and TIBC was higher in H. pylori-infected cases than negative ones. The average rise of Hb in cases negative to H. pylori was higher than those positive to H. pylori. After comparing response of cases infected with H. pylori to iron therapy before and after eradication of H. pylori, it was found that rise of Hb was higher after treatment than before eradication of H. pylori. CONCLUSION: Response to iron therapy in cases of iron deficiency anemia in patients without H. pylori infection was better than those infected with H. pylori. H. pylori eradication in the infected cases increased their response to iron therapy.

A paradigm shift in mechanical biofilm management? Subgingival air polishing: a new way to improve mechanical biofilm management in the dental practice.

In the past few years indications for the use of the air polishing technology have been expanded from supragingival use (airflow) to subgingival air polishing (perioflow) by the development of new low-abrasive glycine-based powders and devices with a subgingival nozzle. Several studies on the subgingival use of air polishing have been completed. On 7 June 2012, during the Europerio 7 Congress in Vienna, a consensus conference on mechanical biofilm management took place aiming to review the current evidence from the literature on the clinical relevance of the subgingival use of air polishing and to make practical recommendations for the clinician. Bernita Bush (Bern), Prof Johannes Einwag (Stuttgart), Prof Thomas Flemmig (Seattle), Carmen Lanoway (Munich), Prof Ursula Platzer (Hamburg), Prof Petra Schmage (Hamburg), Brigitte Schoeneich (Zurich), Prof Anton Sculean (Bern), Dr Clemens Walter (Basel), and Prof Jan Wennström (Gothenburg) discussed under the moderation of Klaus-Dieter Bastendorf and Christian Becker (both ADIC Association for Dental Infection Control) the available clinical studies to reach a consensus on available clinical evidence. This paper summarizes the main conclusions of the consensus conference and points to the clinical relevance of the findings for the dental practitioner.

Glycine ameliorates liver injury and vitamin D deficiency induced by bile duct ligation.

BACKGROUND: Patients with chronic liver disease had lower serum concentrations 25-hydroxyvitamin D (25OHD). Glycine, a nonessential amino acid, exerts anti-inflammatory, cytoprotective, and immunomodulatory properties. This study aimed to establish a tandem mass spectrometry assay to measure 25OHD in guinea pigs serum and to investigate the effects of glycine against the liver damage induced by bile duct ligation (BDL). METHODS: BDL was performed on male guinea pigs. Glycine, alanine, serine or tyrosine was given by intraperitoneal injection. The animals were sacrificed and examined at 7 and 14 days after BDL. Serum concentrations of total bilirubin and aminotransferase were measured. Serum concentrations of 25OHD2 and 25OHD3 were measured by API 5000 mass spectrometer. In addition, oxidative stress was assessed by serum ischemia-modified albumin (IMA) and hepatic malondialdehyde (MDA), and apoptosis by hepatic caspase 3 activities. RESULTS: Serum 25OHD concentrations were decreased around 50% in the BDL group at days 7 and 14 post ligation, compared to sham (mean 65.3 ng/ml, p<0.005). Glycine but not other amino acid treatment blunted the reduced serum 25OHD (52.6 ng/ml, p<0.05) resulting from BDL. The concentrations of 25OHD were negatively associated with concentrations of IMA (r=-0.305, p<0.05) and caspase 3 (r=-0.562, p<0.0001). At day-14 post ligation, glycine treatment also ameliorated liver damage indicated by serum AST (p<0.005), ALT (p<0.05) and hepatic caspase 3 activities (p<0.05) and oxidative stress. CONCLUSION: Our results indicate that glycine may protect against BDL-induced liver injury through attenuation of oxidative stress, apoptosis and the vitamin D deficiency.

Glycine treatment of the risk syndrome for psychosis: report of two pilot studies.

Patients meeting criteria for the risk syndrome for psychosis have treatment needs including positive and negative symptoms and cognitive impairment. These features could potentially respond to NMDA glycine-site agonists. The present objective was to determine which symptoms or domains of cognition promise to show the greatest response to glycine in risk syndrome patients. We conducted two short-term pilot studies of glycine used without adjunctive antipsychotic medication. In the first trial, 10 risk syndrome subjects received open-label glycine at doses titrated to 0.8 g/kg/d for 8 weeks, followed by discontinuation and 16 weeks of evaluation for durability of effects. In the second, 8 subjects were randomized to double-blind glycine vs. placebo for 12 weeks, followed by open-label glycine for another 12 weeks. Patients were evaluated every 1-2 weeks with the Scale Of Psychosis-risk Symptoms (SOPS) and before and after treatment with a neurocognitive battery. Within-group and between-group effect sizes were calculated. Effect sizes were large for positive (open-label within-group -1.10, double-blind between-group -1.11) and total (-1.39 and -1.15) symptoms and medium-to-large (-0.74 and -0.79) for negative symptoms. Medium or large effect sizes were also observed for several neurocognitive measures in the open-label study, although data were sparse. No safety concerns were identified. We conclude that glycine was associated with reduced symptoms with promising effect sizes in two pilot studies and a possibility of improvement in cognitive function. Further studies of agents that facilitate NMDA receptor function in risk syndrome patients are supported by these preliminary findings.

Multidrug donor preconditioning protects steatotic liver grafts against ischemia-reperfusion injury.

BACKGROUND: Graft dysfunction of steatotic livers (SL) still remains a major challenge in liver transplantation. Different mechanisms are thought to be involved in the impaired tolerance of SL to ischemia-reperfusion injury. Thus, different pharmacologic strategies may need to be combined to effectively protect SL and to reduce graft dysfunction after transplantation. Therefore, we analyzed the effectiveness of a multidrug donor preconditioning (MDDP) procedure to protect SL from cold ischemia-reperfusion injury. METHODS: Liver steatosis was induced by a high-carbohydrate, fat-free diet. A total of 24 Sprague-Dawley rats were divided into 3 groups (n = 8 each), including a control group with nonsteatotic livers (Con), a vehicle-treated SL group (SL-Con), and a SL group undergoing MDDP (SL-MDDP), including pentoxyphylline, glycine, deferoxamine, N-acetylcysteine, erythropoietin, melatonin, and simvastatin. MDDP was applied before liver perfusion with 4°C histidine-tryptophan-ketoglutarate (HTK) solution and organ harvest. After 24 hours of cold storage in HTK, postischemic reperfusion was performed in an isolated liver reperfusion model using 37°C Krebs-Henseleit bicarbonate buffer. RESULTS: After 60 minutes of reperfusion, SL showed a significant reduction of bile flow as well as a marked increase of liver enzyme levels and apoptotic cell death compared with Con. This was associated with an increased malondialdehyde formation, interleukin-1 production, and leukocytic tissue infiltration. MDDP completely abolished the inflammatory response and was capable of significantly reducing parenchymal dysfunction and injury. CONCLUSIONS: MDDP decreases SL injury after cold storage and reperfusion. The concept of MDDP as a simple and safe preoperative regime, thus may be of interest in clinical use, expanding the donor pool from marginal donors.

Randomized controlled trial assessing efficacy and safety of glycine powder air polishing in moderate-to-deep periodontal pockets.

BACKGROUND: Supragingivally applied glycine powder air polishing (SupraGPAP) has been shown to remove biofilms in shallow periodontal pockets. This study assesses efficacy and safety of subgingivally applied glycine powder air polishing (SubGPAP) in moderate-to-deep periodontal pockets. METHODS: Patients with chronic periodontitis and intraoral Porphyromonas gingivalis (P. gingivalis) and Tannerella forsythia who completed initial therapy were randomly assigned to receive SubGPAP in periodontal pockets with probing depths of 4 to 9 mm, SupraGPAP in all other shallow periodontal sites, and at mucous membranes followed by removal of calculus using curets (full-mouth GPAP) or scaling and root planing followed by coronal polishing (SRP). Patients rinsed with 0.12% chlorhexidine gluconate after debridement, and twice daily, for 2 weeks. RESULTS: All 30 patients enrolled completed the baseline, day 10, and day 90 visits. SubGPAP resulted in significantly lower total viable bacterial counts in moderate-to-deep pockets when compared to SRP immediately after debridement and at day 10 (P <0.05). Total P. gingivalis counts in the oral cavity were significantly reduced after full-mouth GPAP compared to SRP at day 90 (P <0.05). Patients' comfort levels were high for both treatments. There were no adverse events related to full-mouth GPAP. CONCLUSIONS: The results indicate that SubGPAP is more efficacious in removing subgingival biofilm in moderate-to-deep periodontal pockets than SRP. Furthermore, full-mouth GPAP may result in a beneficial shift of the oral microbiota and appears to be well tolerated.

Prophylactic glycine administration attenuates pancreatic damage and inflammation in experimental acute pancreatitis.

BACKGROUND/AIMS: Acute pancreatitis (AP) is characterized by premature zymogen activation, systemic inflammatory response resulting in inflammatory infiltrates, sustained intracellular calcium, neurogenic inflammation and pain. The inhibitory neurotransmitter and cytoprotective amino acid glycine exerts a direct inhibitory effect on inflammatory cells, inhibits calcium influx and neuronal activation and therefore represents a putative therapeutic agent in AP. METHODS: To explore the impact of glycine, mild AP was induced in rats by supramaximal cerulein stimulation (10 µg/kg BW/h) and severe AP by retrograde injection of sodium taurocholate solution (3%) into the common biliopancreatic duct. 100/300 mmol glycine was administered intravenously before induction of AP. To elucidate the effect of glycine on AP, we determined pathomorphology, pancreatic cytokines as well as proteases, serum lipase and amylase, pancreatic and lung MPO activity and pain sensation. RESULTS: Glycine administration resulted in a noticeable improvement of pathomorphological alterations in AP, such as a reduction of necrosis, inflammatory infiltrates and cytoplasmic vacuoles in cerulein pancreatitis. In taurocholate pancreatitis, glycine additionally diminished pancreatic cytokines and MPO activity, as well as serum lipase and amylase levels. CONCLUSIONS: Glycine reduced the severity of mild and much more of severe AP by attenuating the intrapancreatic and systemic inflammatory response. Therefore, glycine seems to be a promising tool for prophylactic treatment of AP. and IAP.

Efectos de la glicina sobre los trastornos de conducción del nervio auditivo en pacientes diabéticos tipo 2 con otoneuropatía / Effects of glycine on auditory evoked potentials among diabetic patients with auditory pathway neuropathy

Background: Glycine inhibits the formation of advanced glycation end products that may cause central and peripheral neuronal damage, affecting also the auditory nerve. Aim: To evaluate the effect of glycine on auditory nerve conduction and hearing level among patients with type 2 diabetes mellitus and auditory neuropathy. Material and Methods: Twenty grams of oral glycine per day were administered during 6 months to 28 type 2 diabetic patients aged 58 ± 6 years, with auditory pathway neuropathy. Hearing tests and evoked otoacustic potentials were performed regularly. Fifteen diabetic patients aged 49 ± 8 years, without auditory nerve neuropathy did not receive glycine and were followed as a control group. Results: Among patients receiving glycine, a significant improvement in left ear audiometry at 125, 250 and 500 Hz and right ear audiometry at 500 Hz, was observed. Waves I, III and V (p= 0.02) of evoked otoacustic potentials improved significantly in the left ear and wave I in the right ear. Among controls, waves V and III of evoked otoacoustic potentials had a significant impairment in the left ear. Conclusions: There was an improvement in auditory evoked potentials in patients receiving glycine and an impairment in untreated control patients.

Transurethral resection of prostate: a comparison of standard monopolar versus bipolar saline resection.

INTRODUCTION: Transurethral resection syndrome is an uncommon but potentially life threatening complication. Various irrigating solutions have been used, normal saline being the most physiological. The recent availability of bipolar cautery has permitted the use of normal saline irrigation. MATERIAL AND METHODS: In a randomized prospective study, we compared the safety and efficacy of bipolar cautery (using 0.9% normal saline irrigation) versus conventional monopolar cautery (using 1.5% glycine irrigation). Pre and postoperative hemoglobin (Hb) and hematocrit values were compared. Hemodynamics and arterial oxygen saturation were monitored throughout the study. Safety end points were changes in serum electrolytes, osmolarity and Hb/PCV (packed cell volume). Efficacy parameters were the International Prostate Symptom Score (IPSS) and Qmax (maximum flow rate in mL/sec) values. RESULTS: Mean preoperative prostate size on ultrasound was 60 +/- 20cc. Mean resected weight was 17.6 +/- 10.8 g (glycine) and 18.66 +/- 12.1 g (saline). Mean resection time was 56.76 +/- 14.51 min (glycine) and 55.1 +/- 13.3 min (saline). The monopolar glycine group showed a greater decline in serum sodium and osmolarity (4.12 meq/L and 5.14 mosmol/L) compared to the bipolar saline group (1.25 meq/L and 0.43 mosmol/L). However, this was not considered statistically significant. The monopolar glycine group showed a statistically significant decline in Hb and PCV (0.97 gm %, 2.83, p < 0.005) as compared to the bipolar saline group (0.55 gm % and 1.62, p < 0.05). Patient follow- up (1,3,6 and 12 months postoperatively) demonstrated an improvement in IPSS and Qmax in both the groups. CONCLUSION: We concluded that bipolar transurethral resection of prostate is clinically comparable to monopolar transurethral resection of prostate with an improved safety profile. However, larger number of patients with longer follow up is essential.

Transurethral resection of prostate: a comparison of standard monopolar versus bipolar saline resection

INTRODUCTION: Transurethral resection syndrome is an uncommon but potentially life threatening complication. Various irrigating solutions have been used, normal saline being the most physiological. The recent availability of bipolar cautery has permitted the use of normal saline irrigation. MATERIAL AND METHODS: In a randomized prospective study, we compared the safety and efficacy of bipolar cautery (using 0.9 percent normal saline irrigation) versus conventional monopolar cautery (using 1.5 percent glycine irrigation). Pre and postoperative hemoglobin (Hb) and hematocrit values were compared. Hemodynamics and arterial oxygen saturation were monitored throughout the study. Safety end points were changes in serum electrolytes, osmolarity and Hb/PCV (packed cell volume). Efficacy parameters were the International Prostate Symptom Score (IPSS) and Qmax (maximum flow rate in mL/sec) values. RESULTS: Mean preoperative prostate size on ultrasound was 60 ± 20cc. Mean resected weight was 17.6 ± 10.8 g (glycine) and 18.66 ± 12.1 g (saline). Mean resection time was 56.76 ± 14.51 min (glycine) and 55.1 ± 13.3 min (saline). The monopolar glycine group showed a greater decline in serum sodium and osmolarity (4.12 meq/L and 5.14 mosmol/L) compared to the bipolar saline group (1.25 meq/L and 0.43 mosmol/L). However, this was not considered statistically significant. The monopolar glycine group showed a statistically significant decline in Hb and PCV (0.97 gm percent, 2.83, p < 0.005) as compared to the bipolar saline group (0.55 gm percent and 1.62, p < 0.05). Patient follow- up (1,3,6 and 12 months postoperatively) demonstrated an improvement in IPSS and Qmax in both the groups. CONCLUSION: We concluded that bipolar transurethral resection of prostate is clinically comparable to monopolar transurethral resection of prostate with an improved safety profile. However, larger number of patients with longer follow up is essential.

[Effects of glycine on auditory evoked potentials among diabetic patients with auditory pathway neuropathy]. / Efectos de la glicina sobre los trastornos de conducción del nervio auditivo en pacientes diabéticos tipo 2 con otoneuropatía.

BACKGROUND: Glycine inhibits the formation of advanced glycation end products that may cause central and peripheral neuronal damage, affecting also the auditory nerve. AIM: To evaluate the effect of glycine on auditory nerve conduction and hearing level among patients with type 2 diabetes mellitus and auditory neuropathy. MATERIAL AND METHODS: Twenty grams of oral glycine per day were administered during 6 months to 28 type 2 diabetic patients aged 58 ± 6 years, with auditory pathway neuropathy. Hearing tests and evoked otoacustic potentials were performed regularly. Fifteen diabetic patients aged 49 ± 8 years, without auditory nerve neuropathy did not receive glycine and were followed as a control group. RESULTS: Among patients receiving glycine, a significant improvement in left ear audiometry at 125, 250 and 500 Hz and right ear audiometry at 500 Hz, was observed. Waves I, III and V (p= 0.02) of evoked otoacustic potentials improved significantly in the left ear and wave I in the right ear. Among controls, waves V and III of evoked otoacoustic potentials had a significant impairment in the left ear. CONCLUSIONS: There was an improvement in auditory evoked potentials in patients receiving glycine and an impairment in untreated control patients.

Antipsychotic drug development.

Schizophrenia typically manifests itself with a wide array of symptoms--positive, negative, cognitive, and affective--and may also involve neurodevelopmental and neurodegenerative aspects. Each of these symptom dimensions may be derived from pathology at one or more receptor types, localized in different regions of the brain. The absence of a single therapeutic target for schizophrenia has therefore prompted the de-emphasis of selective "magic bullets" and a critical re-examination of the intramolecular polypharmacy afforded by antipsychotics. In this chapter, we present a review of some of the receptor targets that are currently thought to mediate symptoms of schizophrenia, and discuss their possible implications for future antipsychotic drug development. Therapeutic strategies for schizophrenia that successfully exploit the multifunctionality of antipsychotics will take into account the entire receptor activity "portfolio" of the agent and provide a total therapeutic response that, like the elephant of the Buddhist parable, is greater than the sum of its parts.