Polycyclic and nitro musks in indoor air: a primary school classroom and a women's sport center.

UNLABELLED: Indoor air gas and particulate-phase samples (PM(2.5) ) were collected from a primary school classroom and a women's sport center because children are one of the sensitive population subgroups and women are frequent users of personal care products in addition to the high level of activity in this specific microenvironment. PM(2.5) was collected with a Harvard impactor, and polyurethane foam was used for the gas phase. Samples were ultrasonically extracted, concentrated, and analyzed with a GC-MS. The mean gas-phase concentrations in the classroom ranged from 0.12 ± 0.2 ng/m(3) for MK to 267 ± 56 ng/m(3) for HHCB, while it was from 0.08 ± 0.10 ng/m(3) for AHMI to 144 ± 61 ng/m(3) for HHCB in the sports center. Particulate-phase average concentrations in the sports center ranged from 0.22 ± 0.11 ng/m(3) for ATII to 1.34 ± 071 ng/m(3) for AHTN, while it ranged from 0.05 ± 0.02 ng/m(3) (musk xylene) to 2.50 ± 0.94 ng/m(3) (HHCB) in the classroom. Exposure-risk assessment showed that inhalation route is most probably far less significant than the dermal route; however, it should be noted that the exposure duration covered in this study was not the larger fraction of the day. PRACTICAL IMPLICATIONS: Synthetic musk compounds (SMCs) are found everywhere because their use in household and personal care products (laundry detergents, carpet cleaners, cleaning agents, fabric softener soaps, shampoos, cosmetics, etc.) has been increasing. These compounds are semi-volatiles that may result in direct and indirect exposures through inhalation route. Although SMCs were found to be dominant in the gas phase, exposure via inhalable particles may be important as we found several compounds in the particulate phase (PM(2.5)).

Female-to-male transsexual with 47,XXX karyotype.

BACKGROUND: There are few reports describing chromosomal abnormalities in transsexuals. In rare cases, transsexualism and sexual chromosomal multiplicity coexist. Six cases of male-to-female transsexuals with 47,XYY chromosomal pattern have been previously reported. We have not encountered any female transsexual cases with 47,XXX karyotype in the literature. METHODS: A 21-year-old female patient came to our outpatient department with depressive symptoms and suicidal thoughts. On psychiatric interview, she reported that she had feelings of discomfort with her gender identity and had desired to be male since her childhood. Then, we performed cytogenetic investigation using blood culture and G chromosome banding. RESULTS: Histology and DNA histograms of the patient revealed a chromosomal pattern of 47,XXX. CONCLUSIONS: We conclude that sexual chromosomal abnormalities in some transsexuals may cause a vulnerability to development of a gender identity disorder.

Transient frontal hypoperfusion in Tc-99m hexamethylpropyleneamineoxime single photon emission computed tomography imaging during alcohol withdrawal.

BACKGROUND: Regional brain perfusion in patients during alcohol-withdrawal has been relatively less studied with brain SPECT technique. In this study, the hypothesis that possible regional cerebral blood flow (rCBF) alterations due to alcohol withdrawal might be transitory in a homogenous group of alcoholic patients in terms of their physical-nutritional and cognitive functional conditions was investigated. METHODS: Fifteen right-handed male inpatients with alcohol-withdrawal, diagnosed according to DSM-IIIR criteria, and 6 male physically-mentally healthy control subjects were included in the study. The first Technetium 99m-hexamethylpropyleneamineoxime (Tc-99m-HMPAO) brain SPECT investigation was performed on the day of admission in nonmedicated conditions and the second one was performed after all the withdrawal symptoms had subsided in the patients. As an indicator of the change in the brain perfusion, a relative perfusion index was used and the relative tracer activity was expressed as the ratio of mean cortical region of interest activity to mean the whole cortical brain activity. RESULTS: We found significantly reduced left frontal and right frontal, parietal and temporal rCBF values in the patients during the alcohol-withdrawal compared to those of their remitted state while they were not different from in the control group (p < 0.05). CONCLUSIONS: Our data indicate that the alterations in rCBF during the alcohol-withdrawal are more pronounced both in the frontal cortex and in overall right hemisphere regions. Furthermore, the frontal hypoperfusion may be transitory with recovery from alcohol-withdrawal whereas temporal hypoperfusion may continue after recovery probably depending on the previously administered high-dose benzodiazepines.

Effects of olanzapine and haloperidol on serum prolactin levels in male schizophrenic patients.

It has been proposed that new atypical antipsychotics cause minimal prolactin (PRL) elevation compared to traditional antipsychotic agents because they spare dopamine blockade within the brain's tuberoinfundibular tract. The aim of this study was to compare the effects of olanzapine and haloperidol on PRL secretion in male schizophrenic patients. Twenty-nine male schizophrenic inpatients were included in the study. Fifteen of them were given olanzapine in a fixed dose of 10 mg/day PO and 14 of them were given haloperidol in a fixed dose of 10 mg/day PO for 6 weeks after a 2-week drug washout period. Fifteen age-matched healthy control subjects were used as control group. PRL levels were measured both before and after the 6-week treatment period in the patients. At the end of the 6th week, the PRL values observed with olanzapine treatment were significantly less than those observed with haloperidol, but not different from those of the controls. There was a significant positive correlation between the PRL values and the severity of extrapyramidal side effects in only the haloperidol group after the six week's treatment period. Our data indicate that short-term olanzapine treatment at doses of 10 mg/day PO causes minimal elevations in PRL secretion in male schizophrenic patients in contrast to haloperidol. This finding is consistent with the previous reports and may be attributed to olanzapine's differential effects on dopamine neurotransmission.

Effects of short and long-term lithium treatment on serum prolactin levels in patients with bipolar affective disorder.

1. In this study, the authors sought to test the hypothesis that Li (lithium) treatment can induce alterations in PRL (prolactin) secretion in euthymic bipolar patients compared to controls and that short and long-term administration can lead to prolactin changes different from each other. 2. Twenty euthymic bipolar male patients on long-term lithium carbonate treatment for more than 6 months and 15 euthymic male bipolar patients on short-term Li treatment for shorter than 6 months who met DSM-IV criteria for bipolar affective disorder were included in the study. Seventeen age-matched healthy control males were chosen among the hospital staff. The mean +/- SD duration of Li use was 68.93+/-46.31 months in the long-term lithium-treated group and 4+/-3.42 months in the short-term lithium-treated group. 3. Serum PRL values in the long-term Li-treated group were significantly lower than those of the control group, while there was no significant difference in PRL values between the short-term Li-treated group and the control group. 4. Our study documents that short-term (<6 months) Li treatment does not induce any significant changes in PRL release in bipolar patients compared to normal control subjects while long-term Li treatment (>6 months) leads to lower PRL release compared to the controls. Furthermore, PRL has wide intra-interindividual and circadian variations Li-PRL relationship seems to be very complex and probably depends on various interactions among dopamine, serotonin and PRL. Therefore, further studies are needed to confirm the data.

Changes in platelet monoamine oxidase and plasma dopamine-beta-hydroxylase activities in lithium-treated bipolar patients.

The activity of monoamine oxidase (MAO) and dopamine-beta-hydroxylase (DBH), enzymes involved in monoamine metabolism, were studied in 29 bipolar patients (mean age = 33.12 years, SD = 7.27) who were treated with lithium carbonate and in 20 healthy volunteers (mean age = 30.05 years, SD = 6.04). Platelet MAO activity was higher after lithium withdrawal, whereas plasma DBH activity was lower in remitted euthymic bipolar patients compared with normal volunteers. During lithium treatment, platelet MAO activity decreased and plasma DBH activity increased compared with the lithium-withdrawal values. It was also observed that the activities of these enzymes in the bipolar patients during lithium treatment did not differ from those in the volunteers. Thus, platelet MAO and plasma DBH activities differed in unmedicated patients with bipolar affective disorder from those of healthy subjects. Treatment with lithium appeared to have a normalizing effect on MAO and DBH activity levels.

Changes in regional cerebral blood flow demonstrated by single photon emission computed tomography in depressive disorders: comparison of unipolar vs. bipolar subtypes.

Single photon emission tomography (SPECT) with 99mTc-HMPAO was used to compare regional cerebral blood flow (rCBF) in patients with unipolar and bipolar depression. The study group consisted of 10 unipolar depressed patients and seven bipolar depressed patients who met the DSM-III-R criteria for major depressive disorder (MDD). Nine physically and mentally healthy volunteers served as control subjects. SPECT images were obtained in the patients at two time points: (1) during the major depressive episode before patients had received medication; and (2) at the beginning of the remitted state while patients were receiving antidepressant medication. During the depressive episode, unmedicated unipolar depressed patients showed relatively increased left frontal rCBF compared both with the control subjects and the bipolar patients (P < 0.05). No significant differences in rCBF emerged between the bipolar patients and the control subjects. The data suggest that unipolar depressed patients, unlike bipolar patients, have relatively increased rCBF in the left frontal lobes during the depressive episode, but these differences tend to disappear during the period of remission.

The link between symptoms of office building occupants and in-office air pollution: the Indoor Air Pollution Index.

The lack of an effective indoor air quality (IAQ) metric causes communication concerns among building tenants (the public), building managers (decision-makers), and IAQ investigators (engineers). The Indoor Air Pollution Index (IAPI) is developed for office buildings to bridge this communication discord. The index, simple and easily understood, employs the range of pollutant concentrations and concentrations in the subject building to estimate a unitless single number, the IAPI, between 0 (lowest pollution level and best IAQ) and ten (highest pollution level and worst IAQ). The index provides a relative measure of indoor air pollution for office buildings and ranks office indoor air pollution relative to the index distribution of the US office building population. Furthermore, the index associates well with occupant symptoms, percentage of occupants with persistent symptoms. A tree-structured method is utilized in conjunction with the arithmetic mean as the aggregation function. The hierarchical structure of the method renders not only one index value, but also several sub-index values that are critical in the study of an office air environment. The use of the IAPI for IAQ management is illustrated with an example. The decomposition of the index leads to the ranking of sampled pollutants by their relative contribution to the index and the identification of dominant pollutant(s). This information can be applied to design an effective strategy for reducing in-office air pollution.

A technetium-99m hexamethylpropylene amine oxime brain single-photon emission tomography study in adolescent patients with major depressive disorder.

We have not encountered any brain single-photon emission tomography (SPET) study performed in adolescent depressed patients in the literature. Therefore, we used technetium-99m hexamethylpropylene amine oxime (99mTc-HMPAO) brain SPET in adolescent patients with major depressive disorder (MDD) to examine the possible changes in cerebral perfusion and the possible association between perfusion indices and clinical variables. Fourteen adolescent out-patients (nine females, five males; mean+/-SD age: 13.11+/-1.43 years; range: 11-15 years) fulfilling the DSM-IV criteria for MDD and 11 age-matched healthy control subjects (six females, five males; mean+/-SD age: 13.80+/-1.60 years; range: 12-15 years) were included in the study. 99Tc-HMPAO brain SPET was performed twice in the patient group and once in the control group. The first SPET investigation was performed under non-medicated conditions and the second was performed after depressive symptoms had subsided. A relative perfusion index (PI) was calculated as the ratio of regional cortical activity to the whole brain activity. We found significant differences between the PI values of the untreated depressed patients and those of the controls, indicating relatively reduced perfusion in the left anterofrontal and left temporal cortical areas. No significant differences in regional PI values were found between the remitted depressed patients and the controls. Our study suggests that adolescent patients with MDD may have regional cerebral blood flow deficits in frontal regions and a greater anterofrontal right-left perfusion asymmetry compared with normal subjects. The fact that these abnormalities in perfusion indices have a trend toward normal values with symptomatic improvement suggests that they may be state-dependent markers for adolescent MDD.

Plasma levels of beta-endorphin, adrenocorticotropic hormone and cortisol during early and late alcohol withdrawal.

Endogenous opioid peptides are thought to participate in the phenomena of alcohol tolerance and withdrawal. Since in the pituitary gland, beta-endorphin (beta-EP) and adrenocorticotropic hormone (ACTH) are produced from the same precursor molecule, pro-opiomelanocortin, it may be expected that alterations in plasma ACTH and cortisol levels should parallel changes in plasma beta-EP levels during alcohol withdrawal. The aim of the present study was to investigate the alterations of beta-EP, ACTH and cortisol secretion patterns in alcohol-dependent patients with heavy intake in the early withdrawal period and, if any, whether these changes remained stable on long-term withdrawal. Twenty-two hospitalized male patients (mean age +/- SD: 43.45 +/- 9.22 years, mean daily amount of alcohol +/- SD: 421.59 +/- 116.57 g) who were diagnosed to have alcohol withdrawal and 20 age-matched healthy men (mean age +/- SD: 38.35 +/- 7.63 years) were included in the study. Morning and night levels of plasma beta-EP, ACTH and cortisol were measured in the patients during the early (first week) and late (fourth week) withdrawal periods following alcohol cessation, and only once in the control subjects. It was found that both morning beta-EP and morning ACTH levels were reduced during both early and late withdrawals, whereas cortisol levels were increased in early withdrawal and normalized towards the late withdrawal period. The finding that beta-EP deficiency continued despite withdrawal symptoms subsiding in patients suggests that their beta-EP deficiency is independent of the withdrawal syndrome and that reduced beta-EP activity may be a trait contributing to alcohol craving.

Investigation of the hypothalamo-pituitary-adrenal axis (HPA) by 1 microg ACTH test and metyrapone test in patients with primary fibromyalgia syndrome.

Primary fibromyalgia syndrome (PFS) is characterized by widespread chronic pain that affects the musculoskeletal system, fatigue, anxiety, sleep disturbance, headache and postural hypotension. The pathophysiology of PFS is unknown. The hypothalamic-pituitary-adrenal (HPA) axis seems to play an important role in PFS. Both hyperactivity and hypoactivity of the HPA axis have been reported in patients with PFS. In this study we assessed the HPA axis by 1 microg ACTH stimulation test and metyrapone test in 22 patients with PFS and in 15 age-, sex-, and body mass index (BMI)- matched controls. Metyrapone (30 mg/kg) was administered orally at 23:00 h and blood was sampled at 08:30 h the following morning for 11-deoxycortisol. ACTH stimulation test was carried out by using 1 microg (iv) ACTH as a bolus injection after an overnight fast, and blood samples were drawn at 0, 30 and 60 min. Peak cortisol level (659.4 +/- 207.2 nmol/l) was lower in the patients with PFS than peak cortisol level (838.7 +/- 129.6 nmol/l) in the control subjects (p < 0.05). Ten patients (45%) with PFS had peak cortisol responses to 1 microg ACTH test lower than the lowest peak cortisol detected in healthy controls. After metyrapone test 11-deoxycortisol level was 123.7 +/- 26 nmol/l in patients with PFS and 184.2 +/- 17.3 nmol/l in the controls (p < 0.05). Ninety five percent of the patients with PFS had lower 11-deoxycortisol level after metyrapone than the lowest 11-deoxycortisol level after metyrapone detected in healthy controls. We also compared the adrenal size of the patients with that of the healthy subjects and we found that the adrenal size between the groups was similar. This study clearly shows that HPA axis is underactivated in PFS, rather than overactivated.