Tolerance evaluation of overdosed dietary levels of 25-hydroxyvitamin D3 in growing piglets.

Forty-eight, cross-bred (GL × LW × P) piglets were used in a 42-day tolerance trial to assess the effects of feeding diets supplemented with vitamin D or increasing levels of 25-hydroxyvitamin D3 (25-OH-D3 ). Six-week-old piglets (24 castrate males, 24 females) were used. Two replicate groups of 6 piglets were randomized by weight and allocated to four dietary treatments. The control group (T1) was supplemented with 50 µg vitamin D3 /kg feed. The experimental groups received 25-OH-D3 at the recommended dose (T2: 50 µg/kg = 1x), at 250 µg/kg (T3: 5x) or at 500 µg/kg (T4: 10x) respectively. Feed intake and daily weight gain were measured weekly, and the animals were examined by a veterinarian daily. After 42 days, body mass, blood, urine, bone and tissue samples were analysed and a pathology examination conducted. Dietary treatments had no significant effect on final body mass or daily weight gain. The 25-OH-D3 plasma concentration in T1 was 17 ± 3 ng/ml (mean ± SD) while the respective values of the experimental groups were significantly increased in T2, T3 and T4. Tissue concentrations of 25-OH-D3 were higher in liver and muscle for T3 and T4 and in skin for T4 than in T1. However, neither gross pathology nor histology, nor blood and urine characteristics, nor bone parameters were affected by dietary treatments. Weight of organs as well as dry matter, ash and calcium content of kidneys remained unaffected by dietary 25-OH-D3 intake. Furthermore, no changes were observed for general indicators of health. The results of this study demonstrated that feeding piglets with 25-OH-D3 at 5 or 10 times the recommended level had no adverse effects on any of the biological parameters measured. It was concluded that 25-OH-D3 can be regarded as a supplement with a very high safety margin when used at the recommended level.

Lanthanum salts improve bone formation in a small animal model of post-menopausal osteoporosis.

Two different lanthanum salts, lanthanum carbonate (LaCO(3)) and Lancer(®), a lanthanide citrate mixture, were tested for their effects on bone metabolism in a small animal model for post-menopausal osteoporosis. Forty female outbred Wistar Han rats, sham-operated (SHAM, positive control, n = 10) or ovariectomized (OVX, n = 30) at 4 months of age, were allotted into following groups (n = 10/group): (i) SHAM, (ii) OVX control (negative control), (iii) OVX + LaCO(3) (1.74 g/kg feed) and (iv) OVX + Lancer(®) (8 g/kg feed). Effects on bone were investigated by bone markers [osteocalcin (Oc) in serum and excretion of pyridinoline (PYD) in urine] and by physical parameters of bone structure and bone composition (bone mass, calcium, phosphorus and magnesium content in bone crude ash). Bone micro-architecture and bone mineral density were evaluated by peripheral quantitative computed tomography and micro-computed tomography (µCT). The animal model could be validated by differences between OVX control and SHAM. Body mass and feed intake were the same among the four groups. Oc was clearly increased in the two experimental groups (p < 0.001) vs. SHAM and OVX control. Bone mass and calcium content in bone ash were significantly higher than in OVX control. The Ca/P ratio in bone ash of the two lanthanide groups did not differ from SHAM. Bone-protecting effects of lanthanides were clearly demonstrated by an increased trabecular density which is the region of interest for osteoporotic bone loss. A 3D imaging of bone micro-architecture by µCT visualized descriptively the positive effects of lanthanides on bone formation. The results of this study demonstrate an improvement of bone formation and bone-protecting effects of lanthanides in the OVX rat. Thus, lanthanum salts suggest a prevention of post-menopausal bone loss and may be of benefit in experimental osteopenia following ovariectomy.

Kinetic equation of linear fractional stable motion and applications to modeling the scaling of intermittent bursts.

Lévy flights and fractional Brownian motion have become exemplars of the heavy-tailed jumps and long-ranged memory widely seen in physics. Natural time series frequently combine both effects, and linear fractional stable motion (lfsm) is a model process of this type, combining alpha-stable jumps with a memory kernel. In contrast complex physical spatiotemporal diffusion processes where both the above effects compete have for many years been modeled using the fully fractional kinetic equation for the continuous-time random walk (CTRW), with power laws in the probability density functions of both jump size and waiting time. We derive the analogous kinetic equation for lfsm and show that it has a diffusion coefficient with a power law in time rather than having a fractional time derivative like the CTRW. We discuss some preliminary results on the scaling of burst "sizes" and "durations" in lfsm time series, with applications to modeling existing observations in space physics and elsewhere.

Effect of gamma subunit carboxyl methylation on the interaction of G protein alpha subunits with beta gamma subunits of defined composition.

A baculovirus expression system was used to determine the contribution of carboxyl methylation of specific G protein gamma subunits to the interaction between alpha and beta gamma subunits. beta gamma subunits were carboxyl methylated by a membrane bound methyltransferase in Sf9 cells, and periodate-oxidized adenosine inhibited this methylation by 90%. Carboxyl methylation of beta(1) gamma(2), beta(2) gamma(3), and beta(2) gamma(7) enhanced pertussis toxin-catalyzed ADP-ribosylation of alpha(i2) and alpha(i3) by about 2-fold. On the other hand, methylation did not enhance membrane attachment of beta gamma subunits. These results suggest that methylation of isoprenylated gamma subunits is required for optimal G protein-mediated signal transduction, but not membrane attachment.

Photodynamic therapy of bladder carcinoma.

Photodynamic therapy for bladder cancer is an intriguing modality with theoretical potential for successful treatment of visible tumor and areas of carcinoma in situ and dysplasia throughout the bladder mucosa. There remain many unanswered determinations about photodynamic therapy, including the most effective photosensitizer, the dose of laser that should be used, and the optimum timing for laser therapy following the injection of photosensitizer. Nonetheless, clinical studies thus far have shown photodynamic therapy to have efficacy in eradicating superficial noninvasive tumors. Treatment of diffuse carcinoma in situ at present appears the most impressive. Prospective studies designed to examine photodynamic therapy in a standardized protocol in comparison with other conventional methods for treatment and prophylaxis of noninvasive bladder cancer are most needed and are currently in progress. In the future, development of alternate photosensitizers or methods of direct intravesical uptake of DHE, perhaps limiting cutaneous phototoxicity, are expected.

Coping behaviors among depressed and nondepressed medical inpatients.

Sixty medical inpatients completed a variety of psychological measures related to factors associated with depression. An analysis of self-reported depression and coping response indices revealed significant differences in coping strategies between depressed and nondepressed medical inpatients. Depressed patients more often reported avoidance strategies to cope with the stressors associated with hospitalization, while nondepressed patients were more likely to utilize active coping techniques. Since the coping and depression measures were assessed concurrently, the direction of influence cannot be determined. Still, these findings are consistent with the learned helplessness model of depression for medical inpatients and suggest specific psychological interventions for treating this population. Such treatment would attenuate the adverse effects of inpatient medical depression and thereby enhance the desired benefits of medical hospitalization. It is suggested that future research examine the effectiveness of coping in a prospective design to clarify the direction of the coping and depression relationship.

Nontraumatic intramural hematoma of the duodenum complicating warfarin therapy.

A 74-year-old man receiving chronic anticoagulant therapy presented with symptoms of acute small bowel obstruction. He was subsequently found to have an intramural hematoma of the duodenum. Early noninvasive diagnosis was possible using computed tomography. Conservative therapy proved successful in allowing resolution of obstructive symptoms. This case illustrates the effectiveness of a conservative approach to intramural hematoma of the duodenum, even in patients requiring anticoagulation.

Relationship between WAIS-R and wide range achievement test in a sample of mixed patients.

Correlations between the WAIS-R Verbal, Performance, and Full Scale IQs, WAIS-R subtest scaled scores, and Wide Range Achievement Test Reading, Spelling, and Arithmetic standard scores were computed for a sample of 60 patients at a V.A. medical center who were referred for routine psychological evaluation. The Full Scale IQ and Verbal IQ yielded large correlations with the three achievement area standard scores (rs of .60 to .76). However, Performance IQs correlated moderately with reading and spelling scores (rs of .41 and .42), but a larger correlation obtained with arithmetic scores (r = .66). The results support the concurrent validity of the WAIS-R.

On substituting the WAIS-R for the WAIS in neuropsychological assessment: a caution for clinicians.

The Wechsler Adult Intelligence Scale-Revised (WAIS-R) yields lower Full Scale IQs than the Wechsler Adult Intelligence Scale (WAIS). Thus, a prediction about a patient's neuropsychological functioning based on the WAIS-R will differ from that based on the WAIS. The present study compared predicted Halstead Category Test (HCT) error scores based on the WAIS-R with those based on the WAIS. Thirty-five patients with the neurological and/or psychiatric conditions completed the HCT and WAIS-R, while 35 diagnostically similar patients were given HCT and WAIS. Regression equations to estimate HCT error scores were developed with the use of appropriate Full Scale IQs as the predictors. Results indicated that predicted HCT error scores were higher with the WAIS Full Scale IQ than with the WAIS-R. When the WAIS-R is substituted for the WAIS in a neuropsychological battery, the established relationship between IQ and expected neuropsychological performance should not be utilized.

Sexual function and satisfaction in heterosexual couples when men are administered sildenafil citrate (Viagra) for erectile dysfunction: a multicentre, randomised, double-blind, placebo-controlled trial.

OBJECTIVE: To investigate the effect of improvement in erectile dysfunction (ED) on sexual function and satisfaction measures in heterosexual couples in which the woman reports that sexual intercourse is unsatisfactory at least half of the time. DESIGN: Multicentre, double-blind, placebo-controlled study. SETTING: Outpatient medical clinics. POPULATION: Hundred and eighty men with ED and their female partners in whom sexual intercourse was satisfactory about half the time or less (score of < or =3 on the Female Partner of ED Subject Questionnaire question 3 [FePEDS Q3]). METHODS: Men were randomised to flexible-dose sildenafil (25, 50, and 100 mg) or placebo as needed for 12 weeks. MAIN OUTCOME MEASURES: Primary: FePEDS Q3 ('Over the past four weeks, when you had sexual intercourse, how often was it satisfactory for you?') scored as 0 (no sexual activity) and 1 (almost never or never) to 5 (almost always or always). Secondary, partners: Sexual Function Questionnaire, Female Sexual Function Index (FSFI), and ED Inventory of Treatment Satisfaction (EDITS) partner version (EDITS-Partner). Secondary, men: International Index of Erectile Function (IIEF), General Efficacy Questions, event log data, Self-Esteem And Relationship questionnaire, and EDITS. Secondary, partners and men: Dyadic Adjustment Scale. RESULTS: The intention-to-treat population included 85 sildenafil recipients (mean age 59 +/- 12 years) and 91 placebo recipients (mean age 57 +/- 11 years). Most partners (aged 20-79 years; mean, 54 years) were postmenopausal. Sildenafil compared with placebo couples had greater improvement in the primary outcome (FePEDS Q3 [P < 0.0001]) and in sexual function, intercourse success rates, and secondary sexual satisfaction measures (FSFI satisfaction domain [P < 0.0001] and IIEF satisfaction domains [P < 0.001]) and had higher treatment satisfaction (EDITS and EDITS-Partner; P < 0.0001). Several predictors of improvement were identified, and improvement in one member of the couple correlated positively with improvement in the other member. CONCLUSIONS: The interdependence of sexual function and sexual satisfaction measures between members of couples consisting of men with ED and sexually healthy women reporting infrequent satisfactory sexual intercourse underscores the importance of including partners in ED treatment discussions.

Validity of the Verbal IQ as a short form of the Wechsler Adult Intelligence Scale-Revised.

Assessed the validity of the Verbal IQ as a short form of the WAIS-R. Ss were 104 psychiatric patients with means for age, education, and Full Scale IQ of 36.22 (SD = 9.04), 12.46 (SD = 1.98), and 93.94 (SD = 12.19), respectively. A correlation of .93 (p less than .001) between the Verbal and Full Scale IQs was found. The average Verbal IQ exceeded the average Full Scale IQ by a small (i.e., 1.65 IQ points) but statistically significant amount (p less than .001). Thirty-three (32%) Ss showed changes in their intelligence categories when the Verbal IQ was compared to the Full Scale IQ. However, when the Verbal IQ was banded by the standard error of measurement (SEM = +/- 3) and the precision range was compared to the Full Scale IQ, results indicated 88% agreement. If clinicians must rely on the Verbal IQ as an estimate of the Full Scale, reporting the score in conjunction with a precision range will increase its accuracy.

Psychoanalytic psychotherapy with brain-injured adult psychiatric patients.

Scant attention has been paid to psychotherapy with patients who have acquired neurological conditions. In this paper the authors describe the common psychological problems and repetitive themes that emerge in the therapeutic process with these patients, as well as the salient attitudes toward therapy and the therapist that these patients manifest. Case vignettes illustrate the theoretical and technical considerations.

Revising the Seriousness of Illness Rating Scale: modernization and re-standardization.

The burgeoning research in psychosomatic medicine requires quantitative measures reflecting important biological, psychological, and social variables. The Seriousness of Illness Rating Scale (SIRS), although twenty years old, is currently utilized in psychosomatic research as an index of illness seriousness. In light of medical advances during the past two decades, an expansion and re-standardization of the SIRS appeared warranted. Forty-six medical students, residents, and faculty rated the seriousness of 137 disease items. High inter-rater reliability was demonstrated by a concordance coefficient of 0.716 and overwhelming agreement on relative disease item rankings between the three medical groups. Thus, the Seriousness of Illness Rating Scale-Revised (SIRS-R) is an ordinal level scale which reliably measures current views on illness seriousness and can be easily employed in multivariate psychosomatic research.

Rey Auditory-Verbal Learning Test performance of patients with and without memory impairment.

Investigated performance on the Rey Auditory Verbal Learning Test (AVLT) of 92 psychiatric and neurological patients classified as memory-impaired (N = 45) or non-memory-impaired (N = 47). The groups were comparable on age and education. Relative to the non-memory-impaired Ss, performance of the memory-impaired patients was significantly lower on all AVLT scores, ps less than .01. The AVLT appears to hold promise as a quick screening measure for the clinical evaluation of patients with suspected verbal learning and memory impairments.

Experience with the Jonas penile prosthesis.

Between April 1981 and June 1983 the Jonas penile prosthesis was inserted in 57 patients. There were 10 early complications (17.5 per cent), with 8 operations for revision or removal (14 per cent). Late complications were rare and the over-all success rate was 96 per cent.

Homicide and attempted homicide by patients suffering from dementia: two case reports.

Two elderly patients suffering from a dementing illness are described. The patients manifested homicidal behaviour in association with dementia. Possible risk factors for such behaviour are explored. Implications arising from the cases are discussed.

Childhood sexual abuse in patients with paradoxical vocal cord dysfunction.

We present three prototypical cases of paradoxical vocal cord dysfunction. The symptoms of this functional disorder mimic those of bronchial asthma attacks. These patients typically have experienced extensive medical intervention including intubation and corticosteroid use. We identify a history of childhood sexual abuse as an important factor contributing to the development of this psychosomatic disorder. We discuss the severity of psychopathology in patients with paradoxical vocal cord dysfunction and how this physical symptom may have developed to express psychological difficulties.