The association between infection burden in Iranian patients with acute myocardial infarction and unstable angina.

AIM: to evaluate the association of ischemic heart disease (IHD) with the number of pathogens (infection burden) among individuals with infection. METHODS: a total of 120 patients with IHD as the acute myocardial infarction (AMI; n=60) or unstable angina (UA; n=60) group and 60 healthy subjects with sex- and age-matched as control group were enrolled in this study. Serum samples of all participants were tested for the presence of antibodies to Helicobacter pylori (H. pylori), cytomegalovirus (CMV), type-1 herpes simplex virus (HSV-1) and type- 2 HSV (HSV-2) by using ELISA. RESULTS: Regarding the association of the infection burden with IHD, the prevalence ratios and 95% confidence intervals (CI) were 3.18 (CI: 1.50-6.72; P<0.001) for 3 seropositivities and 3.83 (CI: 0.84-17.43; P<0.05) for 4 seropositivities. The rate of subjects with high infection burden (3 seropositivities) was significantly higher in IHD group as compared to control group (53.4% vs 21.6%; P<0.01). Moreover, the mean number of seropositivities was also significantly higher in patients with IHD in comparison to control group (2.47 vs 1.68; P<0.01). The seroprevalence of anti-H. pylori antibodies in AMI and UA groups was significantly higher compared to control group (P<0.0001). The seroprevalence of anti-CMV antibodies in AMI and UA group was also significantly higher than those observed in control group (P<0.01). Moreover, the seroprevalence of anti-HSV-1 antibodies was significantly higher in AMI and UA groups in comparison to control group (P<0.001). The seroprevalence of anti-HSV-2 antibodies was similarly expressed in patients and healthy control group. CONCLUSION: the infection burden was significantly higher in patients with IHD, which represent that the parameter should also be considered as an independent risk factor for development of IHD. The seroprevalence of H. pylori, CMV and HSV-1 were also higher in patients with IHD.

Serum concentrations of Helicobacter pylori IgG and the virulence factor CagA in patients with ischaemic heart disease.

To compare the serum concentrations of IgG to Helicobacter pylori and its virulence factor CagA in patients with ischaemic heart disease (IHD), we recruited 120 patients with IHD [acute myocardial infarction (AMI) (n = 60); unstable angina (UA) (n = 60)] and 60 sex- and age-matched healthy controls in this study. The seroprevalence of anti-H. pylori IgG was 86.7% in AMI, 91.7% in UA patients and 58.3% in the control group with mean titres of 33.2 U/ml [standard error (SE) 4.76], 57.96 U/ml (SE 7.54) and 25.72 U/ml (SE 4.01) respectively. The seroprevalence of anti-H. pylori in the patient groups was significantly higher than the control group. The mean levels of anti-H. pylori in the AMI and UA groups were also significantly higher than in the control group. The seroprevalence and mean titre of anti-CagA IgG did not differ significantly between patient and control groups.

Serum concentrations of Helicobacter pylori IgG and the virulence factor CagA in patients with ischaemic heart disease

To compare the serum concentrations of IgG to Helicobacter pylori and its virulence factor CagA in patients with ischaemic heart disease [IHD], we recruited 120 patients with IHD [acute myocardial infarction [AMI] [n = 60]; unstable angina [UA] [n = 60]] and 60 sex- and age-matched healthy controls in this study. The seroprevalence of anti-H. pylori IgG was 86.7% in AMI, 91.7% in UA patients and 58.3% in the control group with mean titres of 33.2 U/ml [standard error [SE] 4.76], 57.96 U/ml [SE 7.54] and 25.72 U/ml [SE 4.01] respectively. The seroprevalence of anti-H. pylori in the patient groups was significantly higher than the control group. The mean levels of anti-H. pylori in the AMI and UA groups were also significantly higher than in the control group. The seroprevalence and mean titre of anti-CagA IgG did not differ significantly between patient and control groups

Exploring the phase space of the quantum delta-kicked accelerator.

We experimentally explore the underlying pseudoclassical phase space structure of the quantum delta-kicked accelerator. This was achieved by exposing a Bose-Einstein condensate to the spatially corrugated potential created by pulses of an off-resonant standing light wave. For the first time quantum accelerator modes were realized in such a system. By utilizing the narrow momentum distribution of the condensate we were able to observe the discrete momentum state structure of a quantum accelerator mode and also to directly measure the size of the structures in the phase space.

Cytokines and etiopathogenesis of pervasive developmental disorders.

Autistic disorder, also known as early infantile autism, is a developmental disorder of unknown etiology. However, there is some evidence to suggest that abnormalities of the immune system mediate the pathophysiology of autistic disorder. Cytokines, which play a pivotal role in initiating and maintaining immune responses, have been implicated in the etiopathogenesis of major neuropsychiatric disorders including autism. Cytokines are synthesized in the periphery, as well as in the central nervous system, and exert their effects by binding to their receptors in the nervous tissues. It is suggested that, in genetically predisposed individuals, overproduction or decreased synthesis of certain cytokines may result in neurodevelopmental arrest and/or neurotoxicity.

Successful ECT in a patient with hydrocephalus, shunt, hypopituitarism, and paraplegia.

A 25-year-old patient with paraplegia, hypopituitarism, hydrocephalus, and a ventriculoperitoneal shunt was successfully treated with a course of bilateral electroconvulsive therapy (ECT) for major depression. Brain imaging studies and neurology/ endocrinology consultations were obtained prior to the use of ECT. Throughout the course of ECT, his replacement hormonal therapy continued. Prior to each ECT, additional parenteral hydrocortisone was also administered. Consistent with the previously published reports, the patient did not experience any neurological deterioration. A brief review of the literature on the use of ECT in patients with panhypopituitarism, spinal cord injury, and hydrocephalus is presented.

Mood disorders associated with interferon treatment: theoretical and practical considerations.

OBJECTIVE: To review the theoretical and clinical aspects of mood disorders associated with interferon treatment and discuss their management. DATA SOURCES: Pertinent and selected laboratory/clinical studies, review articles, letters, abstracts, and book chapters on behavioral and mood-related adverse effects of interferons published in English-language journals in the past two decades were identified by MEDLINE (June 1980-June 2000) and manual searches. DATA SELECTION AND DATA EXTRACTION: All of the publications identified were reviewed, and the relevant data were included. Studies not using criteria for psychiatric diagnosis or instruments for psychiatnc monitoring were excluded. DATA SYNTHESIS: Clinical observations and limited research data suggest that interferon treatment may be associated with mood disorders. Mood-related symptoms induced by interferons emerge in a few days or weeks and tend to be dose dependent. Their severity may necessitate discontinuation of interferon therapy and/or the use of antidepressant or antimanic agents. The mechanisms responsible for inducing or exacerbating mood disorders in interferon-treated patients have not been elucidated. There is limited evidence implicating alterations in the serotonin system. CONCLUSIONS: While interferon therapy may trigger or induce mood-related symptoms, preexisting or stable concurrent mood disorders in remission do not necessarily constitute a contraindication to treatment with interferons. Mood disorders associated with interferon treatment can present clinical challenges. However, they may promote our understanding of mood disorders in the context of the current biologic theories of depression and mania.

Ultrastructural immunolocalization of basic fibroblast growth factor in mast cell secretory granules. Morphological evidence for bfgf release through degranulation.

We previously reported that mast cells (MCs) serve as a source of basic fibroblast growth factor (bFGF), a potent angiogenic and mitogenic polypeptide, suggesting that bFGF may mediate MC-related neovascularization and fibroproliferation. Unlike many other growth factors, bFGF lacks a classic peptide sequence for its secretion, and the mechanism(s) for its release remains controversial. Because MCs release a wide spectrum of bioactive products via degranulation, we hypothesized that MC degranulation may be a mechanism of bFGF release and used ultrastructural immunohistochemistry to test the hypothesis. We reasoned that if bFGF is released through degranulation, it should be localized to MC secretory granules. Human tissues with chronic inflammation and rat/mouse tissues with anaphylaxis were studied. In all tissue samples examined, positive staining (or immunogold particle localization) for bFGF in MCs was predominantly in the cytoplasmic granules. Moderate bFGF immunoreactivity was also found in the nucleus, whereas the cytosol and other subcellular organelles exhibited minimal immunogold particle localization. In contrast, no immunogold particle localization for bFGF was observed in lymphocytes or plasma cells. In rat/mouse lingual tissue undergoing anaphylaxis, immunogold particle localization for bFGF was found not only in swollen cytoplasmic granules but also in the extruded granules of MCs. Three different anti-bFGF antibodies gave similar immunogold particle localization patterns, whereas all controls were negative. These results provide morphological evidence suggesting that, despite the lack of a classic secretory peptide in its structure, bFGF is localized to the secretory granules in MCs and may be released through degranulation.

Cytokines in dementia of the Alzheimer's type (DAT): relevance to research and treatment.

There is indirect evidence suggesting that some cytokines may be involved in the pathophysiology of dementia of the Alzheimer type (DAT). Measurement of proinflammatory cytokines in the biologic fluids and brain tissues of DAT patients have provided some support for such a role. However, these studies are limited in scope and have included a relatively small number of patients. Future studies are needed to elucidate the role of cytokines in the pathogenesis and treatment of DAT.

Synthesis of basic fibroblast growth factor by murine mast cells. Regulation by transforming growth factor beta, tumor necrosis factor alpha, and stem cell factor.

BACKGROUND: Mast cells (MC) are involved in a wide spectrum of disorders characterized by neovascularization and fibroproliferation. We and others recently reported that human MC are a source of basic fibroblast growth factor (b FGF-2), a potent angiogenic and mitogenic polypeptide, in several disease conditions, such as chronic inflammation, hemangioma, and benign cutaneous mastocytosis. These findings suggest that FGF-2 may be an important mediator of cell proliferation and angiogenesis associated with MC. Since MC are heterogeneous across species, it is unknown whether FGF-2 expression is a feature common to all MC, or whether FGF-2 expression by MC can be regulated. We therefore examined FGF-2 expression by MC in mouse tissue and MC lines. METHODS: Immunostaining, RT-PCR, ELISA, immunoblot and Northern blot analyses were employed to study four murine MC lines for FGF-2 expression and its regulation by transforming growth factor-beta (TGF-beta), stem cell factor (SCF), and tumor necrosis factor-alpha (TNF-alpha). RESULTS: Mouse tissue MC and three of four murine MC lines (CFTL-12, CFTL-15, ABFTL-3) express FGF-2 as judged by immunostaining, ELISA, Western blot and Northern blot analyses, and reverse transcription-polymerase chain reaction. While TNF-alpha appeared to downregulate FGF-2 mRNA levels, treatment with SCF or TGF-beta resulted in an increase in the expression of FGF-2 at mRNA level which can be attenuated by TNF-alpha. However, the concurrent increase in FGF-2 protein was negligible, possibly due to immaturity of these cell lines. CONCLUSION: Expression of FGF-2 may be a ubiquitous feature of MC in other species in addition to humans, and can be selectively regulated by SCF, TGF-beta and TNF-alpha.

Role of cytokines in psychopathology: therapeutic implications.

Cytokines can influence physiological functions such as sleep and food intake; they also interact with a number of neurotransmitters and second messengers in the brain. Cytokines are involved in a number of infectious, inflammatory, neoplastic, metabolic and degenerative illnesses. They also have been implicated in some psychiatric disorders, including 1) depressive and anxiety disorders; 2) schizophrenic disorders (chronic and acute); 3) autistic disorder; 4) eating disorders; and 5) obsessive-compulsive disorder. Alterations in cytokine peptide/receptor production or function in major psychiatric disorders are of special interest to researchers in the field. Exogenous administration of cytokines may be of therapeutic value in disorders in which the cytokine system may be disturbed. In some brain disorders of defined neuropathology, some cytokines have been found clinically useful. Such a development has yet to occur in the treatment of psychiatric disorders; however, some limited and very preliminary observations suggest that manipulation of the cytokine network may be of potential value in the treatment of some psychiatric disorders. Considering the human and economic costs of major psychiatric disorders, alteration of the cytokine network as a potential therapeutic tool is worthy of consideration and investigation.

Neuropsychiatric aspects of cytokines research: an overview.

Cytokines are a group of proteins primarily synthesized by various immune cells. They have multiple functions within the immune system and have been implicated in a number of disease states. There is growing evidence that some cytokines are also synthesized in the central nervous system. Taking into consideration that some cytokines are also capable of inducing behavioral effects, it has been suggested that cytokines may play a role in some psychiatric and neurologic disorders.

Use of ECT in a patient with a Harrington rod implant.

A 50-year-old depressed patient with prior Harrington rod implantation and spinal disease was treated with 6 electroconvulsive therapy (ECT) treatments, despite conflicting orthopedic recommendations. Complete muscle relaxation was achieved with succinylcholine 2.1-2.2 mg/kg without complication during or after ECT. Concerns and recommendations regarding the use of ECT in patients with Harrington rods are discussed.