Does night-time cortisol excretion normalize in the long-term course of depression?

INTRODUCTION: While there is extensive literature on HPA system activity in acutely depressed patients, there is only limited information about the presence of hypercortisolemia during the interepisode interval of affective disorders. We hypothesized an increase in HPA system activity in depressed patients compared to controls, and proposed that night-time cortisol excretion during follow-up will depend on clinical outcome. METHODS: We measured night-time cortisol excretion in 27 patients during an acute episode of major depression as well as a 20-week follow-up. 40 healthy subjects served as control group. RESULTS: During the acute episode depressed patients showed increased levels of night-time cortisol excretion compared to healthy controls. Both, patients with full and sustained remission (n=8) as well as patients with incomplete remission or relapse (n=19) showed declining cortisol excretion in night-time urine during follow-up. At the end of follow-up cortisol excretion did not differ between patients with affective disorder and healthy controls. DISCUSSION: Irrespective of residual depressive symptoms, HPA system activity declines after the generally investigated acute depressive episode.

Different modes of action of the imidazoline compound RX871024 in pancreatic beta-cells. Blocking of K+ channels, mobilization of Ca2+ from endoplasmic reticulum, and interaction with exocytotic machinery.

The imidazoline compound RX871024 glucose-dependently potentiates the release of insulin in pancreatic islets and beta-cell lines. This activity of the compound is not related to its action by stimulating alpha 2-adrenoceptors and I1- and I2-imidazoline receptors. There are at least three modes of action of RX871024 in beta-cells: (1) RX871024 blocks the ATP-dependent, Ca(2+)-activated, and delayed rectifier K+ channel activity; (2) RX871024 causes mobilization of Ca2+ from thapsigargin-sensitive intracellular stores, the effect probably controlled by cytochrome P450; and (3) the stimulatory activity of RX871024 on insulin release involves interaction of the compound with the exocytotic machinery, unrelated to the changes in membrane potential and cytoplasmic-free Ca2+ concentration, whereas protein phosphorylation plays an important role in this process. The maximal insulinotropic effect of RX871024 is much higher than that of the sulfonylurea glibenclamide. RX871024 stimulates insulin release and normalizes blood glucose levels in rats in vivo without affecting blood pressure and heart rate.

No major effect of orciprenaline and propranolol upon ACTH-induced cortisol secretion.

Preclinical research suggests adrenal beta-adrenergic receptors to be involved in the regulation of steroid synthesis. In a group of healthy male volunteers, we compared ACTH-induced cortisol and dehydroepiandrosterone (DHEA) secretion after pre-treatment with orciprenaline, propranolol or placebo. Neither baseline nor ACTH-induced steroid secretion differed between these conditions. Our data do not support the hypothesis that the adrenal beta-receptor plays a major role in steroid secretion in humans.

Increased platelet aggregability in major depression?

There is compelling evidence that depression constitutes an independent risk factor for cardiovascular morbidity and mortality. As exaggerated platelet reactivity is associated with an increased risk of intra-arterial thrombus formation, we studied platelet aggregability in patients with major depression both before and after 5 weeks of anti-depressant therapy as well as in healthy control subjects. Twenty-two depressed patients and 24 healthy control subjects participated in the study. Washed and rediluted platelets were stimulated with the agonists collagen and thrombin in three concentration steps. Depression was associated with a higher aggregability after stimulation with thrombin in the intermediate concentration and with collagen at the low concentration, with ceiling effects for the other concentrations. After 5 weeks of anti-depressant therapy, aggregability was somewhat less exaggerated, although this effect did not reach statistical significance. We thus conclude that major depression is associated with increased platelet aggregability, which seems to persist even under a marked improvement in depressive symptomatology. This effect may contribute to the increased cardiovascular morbidity in depressed patients.

Managing latex allergies in the dental office.

The consequences of latex allergy can be serious. This paper details the types of allergic reactions and management strategies for both dental workers and patients.

The Topological Effects of Smoothing.

Scientific data sets generated by numerical simulations or experimental measurements often contain a substantial amount of noise. Smoothing the data removes noise but can have potentially drastic effects on the qualitative nature of the data, thereby influencing its characterization and visualization via topological analysis, for example. We propose a method to track topological changes throughout the smoothing process. As a preprocessing step, we oversmooth the data and collect a list of topological events, specifically the creation and destruction of extremal points. During rendering, it is possible to select the number of topological events by interactively manipulating a merging parameter. The result that a specific amount of smoothing has on the topology of the data is illustrated using a topology-derived transfer function that relates region connectivity of the smoothed data to the original regions of the unsmoothed data. This approach enables visual as well as quantitative analysis of the topological effects of smoothing.

Visual Steering and Verification of Mass Spectrometry Data Factorization in Air Quality Research.

The study of aerosol composition for air quality research involves the analysis of high-dimensional single particle mass spectrometry data. We describe, apply, and evaluate a novel interactive visual framework for dimensionality reduction of such data. Our framework is based on non-negative matrix factorization with specifically defined regularization terms that aid in resolving mass spectrum ambiguity. Thereby, visualization assumes a key role in providing insight into and allowing to actively control a heretofore elusive data processing step, and thus enabling rapid analysis meaningful to domain scientists. In extending existing black box schemes, we explore design choices for visualizing, interacting with, and steering the factorization process to produce physically meaningful results. A domain-expert evaluation of our system performed by the air quality research experts involved in this effort has shown that our method and prototype admits the finding of unambiguous and physically correct lower-dimensional basis transformations of mass spectrometry data at significantly increased speed and a higher degree of ease.

Interactive Retro-Deformation of Terrain for Reconstructing 3D Fault Displacements.

Planetary topography is the result of complex interactions between geological processes, of which faulting is a prominent component. Surface-rupturing earthquakes cut and move landforms which develop across active faults, producing characteristic surface displacements across the fault. Geometric models of faults and their associated surface displacements are commonly applied to reconstruct these offsets to enable interpretation of the observed topography. However, current 2D techniques are limited in their capability to convey both the three-dimensional kinematics of faulting and the incremental sequence of events required by a given reconstruction. Here we present a real-time system for interactive retro-deformation of faulted topography to enable reconstruction of fault displacement within a high-resolution (sub 1m/pixel) 3D terrain visualization. We employ geometry shaders on the GPU to intersect the surface mesh with fault-segments interactively specified by the user and transform the resulting surface blocks in realtime according to a kinematic model of fault motion. Our method facilitates a human-in-the-loop approach to reconstruction of fault displacements by providing instant visual feedback while exploring the parameter space. Thus, scientists can evaluate the validity of traditional point-to-point reconstructions by visually examining a smooth interpolation of the displacement in 3D. We show the efficacy of our approach by using it to reconstruct segments of the San Andreas fault, California as well as a graben structure in the Noctis Labyrinthus region on Mars.

Insulin-like growth factor-I (IGF-I) serum concentrations in depressed patients: relationship to saliva cortisol and changes during antidepressant treatment.

INTRODUCTION: The present study was designed to test the hypothesis that total and free insulin-like growth factor-I (IGF-I) serum concentrations in depressed patients are related to hypothalamus-pituitary-adrenal (HPA) system activity and show a longitudinal decline in patients responding to treatment as well as to declining HPA system activity. METHODS: We measured total and free IGF-I as well as IGF-binding protein-3 in 77 depressed patients after wash-out of pre-medication and again after 28 or 35 days of treatment with paroxetine or amitriptyline. RESULTS: Total but not free IGF-I serum concentrations are related to saliva cortisol concentrations in drug-free depressed patients. In responders to both amitriptyline and paroxetine, total IGF-I serum concentrations declined during treatment. DISCUSSION: Our findings show IGF-I to be related to HPA system activity and to decline in responders to treatment while serum concentrations of the biologically active free IGF-I are neither related to HPA system activity nor do they change during the course of treatment. Our data do not support the hypothesis that free IGF-I may play a major role in physical disturbances in depressed patients.

[A gradual method for a more physiological hormonal contraception]. / Eine Stufenmethode für eine mehr physiologische hormonale Kontrazeption

The multiple physiologie stages of method by oral hormonal anticonception was reported, which have been in use in combination. Since 1969 about 362 women at the average age of 27,5 years received 10281 cycles, that means in an average cycles from 28,4 days, the stage method from 11/10 days or 7-7-7 days rhythmus.

PIP: 362 women (average age, of 27.5 years) were administered oral hormonal contraceptives (Ovosiston and Non-Ovlon) in a stage administration for a total of 10,281 months (average of 28.4 months). 40 women used them up to 5 years and 90 up to 4 years. The preparations were taken either in a sequence of 11-10 days or 7-7-7 days. Menstruations came normally every 28 days + 2 days and lasted 3-4 days. Contraceptive efficiency stood at 1.4 pregnancies/100 woman-years for the stage method as compared with .8/100 for the single dose method. Complications were minimal.

[Clinical experiences with percutaneous digitoxin therapy in pregnant women with varicose veins]. / Klinische Erfahrungen mit der perkutanen Digitoxintherapie bei Schwangerschaftsvarizen

It is reported on the clinical recommendations in a cutaneous treatment with "Digitoxinpasta" in varicose veins of pregnant women. The patients' arrangement in groups and the valuation of the result of the treatment was done after clinical aspects. The rate of failures (12%) ranges in tolerable limits. Neither a "Digitoxinbradycardy" or signs of overdosage were found in the electrocardiogram.

[Endometrial-smear cytology using an intrauterine pessary for the early recognition of corpus uteri carcinoma]. / Endometriumabdruckzytologie mit Intrauterinpessar zur Korpuskarzinom-Früherkennung.

An additional way for screening of the carcinoma of the endometrium was described reporting about 340 patients with IUD. --The cytology of the endometrium taken from the IUD was compared with the histology of the endometrium. It is reported about conclusions for practical work.

[Early gynecological complications as the result of legal abortion]. / Gynäkologische Frühkomplikationen als Folge legaler Schwangerschaftsunterbrechungen.

PIP: Gynecological complications occurring during the 7-day hospitalization following therapeutic abortion are studied on the basis of a series of 1234 patients treated between March 1965 and March 1969 in Berlin. There were 3 cases of complications due to preexistent disease (usually the indication for abortion) and 13 cases of nongenital complications (thrombophlebitis, thromboembolism, pneumonia, pyelitis). Gynecological complications included uterine perforation (13 cases), cervical tears (26 cases), uterine hemorrhage (18 cases), placental retention (12 cases), and inflammation (90 cases). Complications occurred less frequently with vacuum extraction (7.9%) than with classical instrumental methods (18.8%), and less frequently before the 12th week of pregnancy (14.7%) than thereafter (36.6%). To these complications must be added those which occur after the 1st postoperative week. The relatively high complication rate should be an incentive for the improvement of contraceptive services and technology.^ieng

[Changes in the vaginal flora caused by supporting pessary treatment in pregnancy]. / Untersuchungen über Veränderungen der Vaginalflora bei Stützpessarbehandlung in der Schwangerschaft.

200 pregnant women with supporting pessary treatment because of cervical insufficiency were compared with one of normal pregnancies concerning microbiological findings and puerperal morbidity. -- 5,5% of the women in the supporting pessary group had pathogenic organisms in their cervix before first amnioscopy, compared to 2% in the control group. The different results of cultural microbiologic examinations in both groups depend on type and duration of birth as well as time of amnion rupture. Women with premature rupture of the membranes (31,0%) had more pathogenic organisms than women with rupture (2,5%) in time. There was no higher infection morbidity compared to the control group.

[Hormonal contraception and hypertension]. / Hormonale Kontrazeption und Hypertonie.

PIP: It can be estimated that women using hormonal contraceptives develop hypertension at a rate of 1% to 2%. This occurs within 6 to 12 weeks after beginning the contraceptive. As for the extent of the elevation, it varies from slight elevations of systolic and/or diastolic pressure up to serious, even malignant hypertension including nephrosclerosis. Although the latter is rare, it underlines the importance of keeping careful check on women taking these pills. After cessation of the pill the blood pressure drops in a greater or lesser proportion of the women within 3 to 6 months. Some authors say 8-12 months. No antihypertensive therapy is required for this. The blood pressure elevation correlates regularly with parallel changes in the renin-angiotensin-aldosterone-system. This is caused mainly by the estrogen component of the hormonal contraceptive. It is manifested by overproduction of angiotensinogen in the liver with subsequent elevation of angiotensin II. Finally there is a sharp vasoconstriction and increase in aldosterone production which cause systemic blood pressure elevation. It can be postulated that sodium retention, and genetic predisposition to react to elevation of the whole-body sodium content by an increase in blood pressure, are determining for the pathogenesis of this condition. The appropriate conclusions should be drawn as concerns the prescription of hormonal ocntraceptives in medical practice.^ieng

[A cubical support pessary within the scope of complex therapy of threatening prematurity]. / Ein kubisches Stützpessar im Rahmen komplexer Behandlung der drohenden Frühgeburt.

Report about experience with a cubic supperting pessary for the prophylaxis and therapy in cervixinsufficiency or inpending premature delivery. The indication, selection, evaluation of riscfactors and the application of a complex therapy are discussed.--Information on therapeutic results and a first conclusion concerning the longtime incorporation of pessaries during pregnancy and the questions related to this. For the period under review, in which intensive prophylactic measures were carried out, a considerable decrease in premature deliveries could be achieved in the territory of pregnancy care center attached to our hospital.

[1st results with a new suction curettage system]. / Erste Ergebnisse mit einem neuen Saugkürettensystem

The point is a self-developed Suction-curette-system, consisting of a suction-curette of diametres of 3, 4, 5, 6, 7 und 8 mm, a cervicometer and a filter. Effectivity and histological evidence of 1. Suction-curettage after hysterectomy 2. Suction-curettage before hysterectomy in full-narcosis 3. Suction-curettage without full-narcosis were examined. Advantages of this method are discussed.