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1.
Epidemiol Infect ; 137(9): 1242-8, 2009 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-19272210

RESUMEN

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) with the type IV staphylococcal chromosomal cassette mec (SCCmec) is rarely reported as being acquired in hospital. We report a hospital outbreak, in Grampian, Scotland, of eight cases of skin and soft-tissue infections due to such a strain. All patients had been in the labour, delivery and maternity units of a small community hospital during a 7-month period. Typing by pulsed-field gel electrophoresis showed the isolates to be a single strain closely related to the USA800 lineage (paediatric clone) and additional typing confirmed it as ST5-MRSA-IV. Genes for exfoliative toxin A (ETA) and enterotoxin D were detected by PCR in all the isolates although none carried the Panton-Valentine leukocidin gene. Region-wide surveillance of over 6000 MRSA isolates collected from 1998 to 2004 showed that 95 (1.6%) were closely related to the outbreak strain although only 60 carried the ETA gene. The strain has not been seen elsewhere in Scotland.


Asunto(s)
Infección Hospitalaria/epidemiología , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Infecciones Cutáneas Estafilocócicas/epidemiología , Adulto , Proteínas Bacterianas/genética , Infecciones Comunitarias Adquiridas/epidemiología , Brotes de Enfermedades , Electroforesis en Gel de Campo Pulsado , Exfoliatinas/genética , Femenino , Humanos , Recién Nacido , Staphylococcus aureus Resistente a Meticilina/genética , Proteínas de Unión a las Penicilinas , Escocia/epidemiología
2.
Neuroscience ; 147(2): 286-93, 2007 Jun 29.
Artículo en Inglés | MEDLINE | ID: mdl-17543463

RESUMEN

Development of cerebral edema (intracellular and/or extracellular water accumulation) following traumatic brain injury contributes to mortality and morbidity that accompanies brain injury. Chronic intermittent vagus nerve stimulation (VNS) initiated at either 2 h or 24 h (VNS: 30 s train of 0.5 mA, 20 Hz, biphasic pulses every 30 min) following traumatic brain injury enhances recovery of motor and cognitive function in rats in the weeks following brain injury; however, the mechanisms of facilitated recovery are unknown. The present study examines the effects of VNS on development of acute cerebral edema following unilateral fluid percussion brain injury (FPI) in rats, concomitant with assessment of their behavioral recovery. Two hours following FPI, VNS was initiated. Behavioral testing, using both beam walk and locomotor placing tasks, was conducted at 1 and 2 days following FPI. Edema was measured 48 h post-FPI by the customary method of region-specific brain weights before and after complete dehydration. Results of this study replicated that VNS initiated at 2 h after FPI: 1) effectively facilitated the recovery of vestibulomotor function at 2 days after FPI assessed by beam walk performance (P<0.01); and 2) tended to improve locomotor placing performance at the same time point (P=0.18). Most interestingly, results of this study showed that development of edema within the cerebral cortex ipsilateral to FPI was significantly attenuated at 48 h in FPI rats receiving VNS compared with non-VNS FPI rats (P<0.04). Finally, a correlation analysis between beam walk performance and cerebral edema following FPI revealed a significant inverse correlation between behavior performance and cerebral edema. Together, these results suggest that VNS facilitation of motor recovery following experimental brain injury in rats is associated with VNS-mediated attenuation of cerebral edema.


Asunto(s)
Edema Encefálico/terapia , Lesiones Encefálicas/terapia , Corteza Cerebral/patología , Terapia por Estimulación Eléctrica , Nervio Vago/fisiología , Animales , Conducta Animal/fisiología , Edema Encefálico/etiología , Edema Encefálico/patología , Lesiones Encefálicas/complicaciones , Lesiones Encefálicas/patología , Locomoción/fisiología , Masculino , Norepinefrina/metabolismo , Equilibrio Postural/fisiología , Desempeño Psicomotor/fisiología , Ratas , Ratas Long-Evans
3.
Neuroscience ; 123(1): 279-92, 2004.
Artículo en Inglés | MEDLINE | ID: mdl-14667462

RESUMEN

To help discern sites of focal activation during seizures of different phenotype, the numbers of Fos immunoreactive (FI) neurons in specific brain regions were analyzed following "brainstem-evoked," "forebrain-evoked" and forebrain/brainstem combination seizures induced by a variety of methods. First, pentylenetetrazol (PTZ, 50 mg/kg) induced forebrain-type seizures in some rats, or forebrain seizures that progressed to tonic/clonic brainstem-type seizures in other rats. Second, minimal electroshock induced forebrain seizures whereas maximal electroshock (MES) induced tonic brainstem-type seizures in rats. Third, forebrain seizures were induced in genetically epilepsy-prone rats (GEPRs) by microinfusion of bicuculline into the area tempestas (AT), while brainstem seizures in GEPRs were induced by audiogenic stimulation. A final set was included in which AT bicuculline-induced forebrain seizures in GEPRs were transiently interrupted by audiogenic seizures (AGS) in the same animals. These animals exhibited a sequence combination of forebrain clonic seizure, brainstem tonic seizure and back to forebrain clonic seizures. Irrespective of the methods of induction, clonic forebrain- and tonic/clonic brainstem-type seizures were associated with considerable Fos immunoreactivity in several forebrain structures. Tonic/clonic brainstem seizures, irrespective of the methods of induction, were also associated with FI in consistent brainstem regions. Thus, based on Fos numerical densities (FND, numbers of Fos-stained profiles), forebrain structures appear to be highly activated during both forebrain and brainstem seizures; however, facial and forelimb clonus characteristic of forebrain seizures are not observable during a brainstem seizure. This observation suggests that forebrain-seizure behaviors may be behaviorally masked during the more severe tonic brainstem seizures induced either by MES, PTZ or AGS in GEPRs. This suggestion was corroborated using the sequential seizure paradigm. Similar to findings using MES and PTZ, forebrain regions activated by AT bicuculline were similar to those activated by AGS in the GEPR. However, in the combination seizure group, those areas that showed increased FND in the forebrain showed even greater FND in the combination trial. Likewise, those areas of the brainstem showing FI in the AGS model, showed an even greater effect in the combination paradigm. Finally, the medial amygdala, ventral hypothalamus and cortices of the inferior colliculi showed markedly increased FND that appeared dependent upon activation of both forebrain and brainstem seizure activity in the same animal. These findings suggest these latter areas may be transitional areas between forebrain and brainstem seizure interactions. Collectively, these data illustrate a generally consistent pattern of forebrain Fos staining associated with forebrain-type seizures and a consistent pattern of brainstem Fos staining associated with brainstem-type seizures. Additionally, these data are consistent with a notion that separate seizure circuitries in the forebrain and brainstem mutually interact to facilitate one another, possibly through involvement of specific "transition mediating" nuclei.


Asunto(s)
Tronco Encefálico/metabolismo , Epilepsia Refleja/metabolismo , Prosencéfalo/metabolismo , Proteínas Proto-Oncogénicas c-fos/metabolismo , Convulsiones/metabolismo , Animales , Electrochoque/métodos , Epilepsia Refleja/inducido químicamente , Inmunohistoquímica , Pentilenotetrazol , Ratas , Ratas Sprague-Dawley , Convulsiones/inducido químicamente
6.
Med Health R I ; 84(10): 327-8, 2001 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-11693050

Asunto(s)
Antiinflamatorios no Esteroideos/uso terapéutico , Inhibidores de la Ciclooxigenasa/uso terapéutico , Dolor Postoperatorio/prevención & control , Antiinflamatorios no Esteroideos/administración & dosificación , Antiinflamatorios no Esteroideos/efectos adversos , Butanonas/administración & dosificación , Butanonas/efectos adversos , Butanonas/uso terapéutico , Celecoxib , Inhibidores de la Ciclooxigenasa/administración & dosificación , Inhibidores de la Ciclooxigenasa/efectos adversos , Diclofenaco/administración & dosificación , Diclofenaco/efectos adversos , Diclofenaco/uso terapéutico , Etodolaco/administración & dosificación , Etodolaco/efectos adversos , Etodolaco/uso terapéutico , Humanos , Ibuprofeno/administración & dosificación , Ibuprofeno/efectos adversos , Ibuprofeno/uso terapéutico , Indometacina/administración & dosificación , Indometacina/efectos adversos , Indometacina/uso terapéutico , Ketorolaco/administración & dosificación , Ketorolaco/efectos adversos , Ketorolaco/uso terapéutico , Lactonas/administración & dosificación , Lactonas/efectos adversos , Lactonas/uso terapéutico , Nabumetona , Naproxeno/administración & dosificación , Naproxeno/efectos adversos , Naproxeno/uso terapéutico , Dolor Postoperatorio/tratamiento farmacológico , Piroxicam/administración & dosificación , Piroxicam/efectos adversos , Piroxicam/uso terapéutico , Pirazoles , Sulfonamidas/administración & dosificación , Sulfonamidas/efectos adversos , Sulfonamidas/uso terapéutico , Sulfonas , Factores de Tiempo
7.
Anesth Analg ; 91(4): 921-4, 2000 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-11004049

RESUMEN

UNLABELLED: A potential area for departmental savings is to minimize inefficient use of pharmaceuticals. We recorded drug waste data for multiple drugs for a fiscal year and surveyed providers' knowledge of departmental drug waste. Six large-cost or large-volume use drugs were chosen for study: thiopental, succinylcholine, rocuronium, atracurium, midazolam, and propofol. Amounts administered to patients were collected for one year by using a computerized anesthesia record keeper. Total drug distributed was the number of vials restocked by pharmacy for the year. An efficiency index, the percent administered to patients, was calculated for each drug. Drug administration to 25,481 patients was analyzed. Drug use efficiency indices were: atracurium 29%; thiopental, 31%; succinylcholine, 33%; propofol, 49%; midazolam, 53%; rocuronium, 61%. The total cost of unadministered study drugs was $165,667, 26% of the expenditure for all drugs. Most dollars wasted were for propofol, $80,863, and thiopental, $32,839. The reason most cited for drug waste was the disposal of full, or partially full, syringes. Drug wastage represents a significant portion of the entire anesthesia drug budget. Waste reduction strategies should allow a portion of the "avoidable" waste to be reduced. IMPLICATIONS: Unadministered drug amounts were measured for six study drugs over one fiscal year and found to be significant; the cost of unadministered drugs totaled $165,667. The reason most cited for waste was disposal of full, or partially full, syringes.


Asunto(s)
Anestésicos/economía , Costos de los Medicamentos , Costos de la Atención en Salud , Androstanoles/administración & dosificación , Androstanoles/economía , Servicio de Anestesia en Hospital/economía , Servicio de Anestesia en Hospital/organización & administración , Anestésicos/administración & dosificación , Anestésicos Intravenosos/administración & dosificación , Anestésicos Intravenosos/economía , Atracurio/administración & dosificación , Atracurio/economía , Presupuestos , Utilización de Medicamentos/economía , Eficiencia , Registros de Hospitales , Humanos , Hipnóticos y Sedantes/administración & dosificación , Hipnóticos y Sedantes/economía , Sistemas de Registros Médicos Computarizados , Residuos Sanitarios/economía , Midazolam/administración & dosificación , Midazolam/economía , Fármacos Neuromusculares Despolarizantes/administración & dosificación , Fármacos Neuromusculares Despolarizantes/economía , Fármacos Neuromusculares no Despolarizantes/administración & dosificación , Fármacos Neuromusculares no Despolarizantes/economía , Servicio de Farmacia en Hospital , Propofol/administración & dosificación , Propofol/economía , Rocuronio , Succinilcolina/administración & dosificación , Succinilcolina/economía , Jeringas/economía , Tiopental/administración & dosificación , Tiopental/economía
8.
Brain Res Bull ; 52(5): 379-89, 2000 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-10922517

RESUMEN

Juvenile genetically epilepsy-prone rats (GEPR)-3s display one of three types of seizures in response to sound: a typical class 3 seizure consisting of an explosive running/bouncing episode followed by a clonic seizure (audiogenic response score, ARS-3); an ARS-3 seizure followed by a forebrain seizure that includes facial and forelimb (F&F) clonus with rearing (ARS-3f); or, a running/bouncing episode followed by a severe tonic seizure with complete hindlimb extension (ARS-9) not accompanied with subsequent F&F clonus. The adult seizure phenotype, manifest in all GEPR-3s by age 45 days of age, consists of an ARS-3 not followed by F&F clonus or tonic extension. The present studies sought to determine the neuronal networks activated during these various developmental convulsive patterns by examining anatomical patterns of [(14)C]2-deoxyglucose (2-DG) uptake or immediate-early-gene (Fos) expression subsequent to seizures. Many, but not all, brain areas of control rats showed age-related increases in Fos expression in response to the acoustic stimulation. An age effect was not observed in 2-DG uptake. In GEPRs, the profiles of Fos expression and 2-DG uptake following seizures were often parallel; however, there were notable exceptions. For example, increased 2-DG uptake in the cochlear nuclei, central region of the inferior colliculi, and the substantia nigra were not accompanied by increased Fos expression in these areas regardless of the seizure phenotypes. Reciprocally, other regions, particularly in the amygdala, ventromedial hypothalamus and parabrachial areas, displayed intense seizure related Fos labeling without detectable increases in 2-DG uptake. Fos and 2-DG uptake patterns in response to acoustic stimulation varied according to brain region, seizure phenotype and severity. In general, the degree of 2-DG uptake correlated with seizure severity. For example, the ARS-9 seizures, being the most intense, resulted in significant increases in 2-DG uptake in almost all brain regions examined. 2-DG uptake following the ARS-3f and ARS-3 seizures, although increased, did not reach statistical significance in most brain areas. In contrast to the 2-DG findings, a seizure-severity dependent effect was not seen with Fos. Rather, the induction of Fos associated with acoustic stimulation and seizure was more associated with age and seizure-phenotype. Thus, the developmental profiles of Fos expression and 2-DG uptake in response to seizures are distinctly different and concurrent examination of both markers is useful in the identification of brain circuitry involved in seizure development.


Asunto(s)
Envejecimiento/metabolismo , Desoxiglucosa/farmacocinética , Epilepsia/metabolismo , Proteínas Proto-Oncogénicas c-fos/biosíntesis , Convulsiones/metabolismo , Estimulación Acústica , Animales , Conducta Animal , Tronco Encefálico/metabolismo , Radioisótopos de Carbono , Modelos Animales de Enfermedad , Epilepsia/genética , Predisposición Genética a la Enfermedad , Inmunohistoquímica , Sistema Límbico/metabolismo , Fenotipo , Prosencéfalo/metabolismo , Ratas , Ratas Endogámicas , Convulsiones/genética
9.
Nat Neurosci ; 2(1): 94-8, 1999 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-10195186

RESUMEN

Neuromodulators associated with arousal modulate learning and memory, but most of these substances do not freely enter the brain from the periphery. In rodents, these neuromodulators act in part by initiating neural messages that travel via the vagus nerve to the brain, and electrical stimulation of the vagus enhances memory. We now extend that finding to human verbal learning. We examined word-recognition memory in patients enrolled in a clinical study evaluating the capacity of vagus nerve stimulation to control epilepsy. Stimulation administered after learning significantly enhanced retention. These findings confirm in humans the hypothesis that vagus nerve activation modulates memory formation similarly to arousal.


Asunto(s)
Memoria/fisiología , Nervio Vago/fisiopatología , Método Doble Ciego , Terapia por Estimulación Eléctrica , Epilepsia/psicología , Epilepsia/terapia , Humanos , Lenguaje
10.
Exp Neurol ; 156(1): 84-91, 1999 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-10192779

RESUMEN

The epileptic condition of the genetically epilepsy-prone rat (GEPR) appears to be caused partially by deficiencies in the locus coeruleus (LC) innervation of the superior colliculus (SC). Previous studies provide quantitative documentation of noradrenergic morphological deficits in the moderately epileptic GEPR-3. The present findings extend these studies by applying cell culture methodology to assessments of the severely epileptic GEPR-9. Our data show that total neurite length, the number of neurite branch points per cell, the cross-sectional area of cell bodies, and the cell perimeter are deficient in noradrenergic neurons in LC + SC cocultures derived exclusively from GEPR-9s compared to analogous cocultures obtained solely from nonepileptic control rats. Partial restoration of LC neuron morphology toward normal occurs when the GEPR-9 SC component of the coculture is replaced with nonepileptic control SC. Finally, when the GEPR-9 SC is cocultured with the control LC, a partial morphological deficit occurs in the otherwise normal noradrenergic neurons. However, the magnitude of this deficit is less than that observed in noradrenergic neurons of the GEPR-9 LC cocultured with the control SC. These data support the hypothesis that the developmental deficiencies of noradrenergic neurons of the GEPR-9 are derived from two sources, the LC and its target tissue, in this case, the SC. Also, intrinsic abnormalities of the LC appear to make a more pronounced contribution to the noradrenergic deficits than do those which reside in the SC.


Asunto(s)
Epilepsia/patología , Locus Coeruleus/patología , Neuronas/patología , Norepinefrina/metabolismo , Colículos Superiores/patología , Animales , Técnicas de Cocultivo , Técnicas de Cultivo , Epilepsia/genética , Femenino , Inmunohistoquímica , Locus Coeruleus/anomalías , Locus Coeruleus/ultraestructura , Neuritas/ultraestructura , Neuronas/metabolismo , Neuronas/ultraestructura , Embarazo , Ratas , Ratas Sprague-Dawley , Colículos Superiores/anomalías , Colículos Superiores/ultraestructura
11.
Exp Neurol ; 155(2): 295-301, 1999 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-10072305

RESUMEN

Previous studies have demonstrated that generalized tonic-clonic seizures (GTCS) consisting of running/bouncing clonic and tonic extension can still be elicited in rats after brain transections which separate forebrain from brain stem, showing that forebrain circuitry is not required for GTCS. Inasmuch as sound-induced generalized tonic-clonic seizures in rodents are characterized by running-bouncing clonic and tonic convulsions, we have hypothesized that these are brain stem seizures that can occur independently of the forebrain. To test this hypothesis, we examined the response of two strains of genetically epilepsy-prone rats (GEPR-3s and GEPR-9s) to seizure-evoking auditory stimuli 3 h after a precollicular transection or sham surgery performed under ether anesthesia. In addition, the effect of a precollicular transection on audiogenic seizures was evaluated in normal rats made susceptible to such seizures by infusing NMDA into the inferior colliculus. Following the transection 58% of GEPR-9s displayed a sound-induced tonic-clonic convulsion and the remaining 42% exhibited a sound-induced seizure when subjected to stimulation 5 min after a subconvulsant dose of pentylenetetrazol (PTZ). While sham surgery and the precollicular transection both reduced sound-induced seizure severity in GEPR-3s, the full seizure response could be elicited by sound stimulation following a subconvulsant dose of PTZ. Moreover, the audiogenic seizures in normal rats rendered susceptible by NMDA were unaltered by the precollicular transection. These findings show that the anatomical circuitry required for generalized tonic-clonic seizures evoked by sound stimulation in rodents resides within the brain stem.


Asunto(s)
Epilepsia Tónico-Clónica/fisiopatología , Convulsiones/fisiopatología , Colículos Superiores/fisiología , Estimulación Acústica , Animales , Epilepsia Tónico-Clónica/genética , Agonistas de Aminoácidos Excitadores/administración & dosificación , Agonistas de Aminoácidos Excitadores/toxicidad , Femenino , Masculino , Microinyecciones , N-Metilaspartato/administración & dosificación , N-Metilaspartato/toxicidad , Ratas , Ratas Sprague-Dawley , Convulsiones/genética
12.
Brain Res Bull ; 47(2): 155-61, 1998 Sep 15.
Artículo en Inglés | MEDLINE | ID: mdl-9820733

RESUMEN

Generalized tonic-clonic seizures of brain stem origin in rats are associated with acute induction of neuronal Fos in several discrete regions of the brain. One particular site in the dorsal pons shows remarkable Fos induction following generalized tonic seizures induced by maximal electroshock in normal rats or by audiogenic stimulation in genetically epilepsy-prone rats (GEPRs). Although this area shows the most intense Fos induction of any brain area following generalized tonic seizures, its identity has been uncertain. Based on its general location, we hypothesized that this nucleus was either 1) a component of the pedunculopontine tegmentum nucleus-pars compacta (PPTn-pc) or 2) the superior lateral subnucleus of lateral parabrachial area (LPBsl). The present study used Fos-protein immunocytochemistry in combination with the reduced form of nicotinamide-adenine dinucleotide phosphate (NADPH)-diaphorase histochemistry, cholecystokinin (CCK) immunocytochemistry, and neuronal tract-tracing to determine the identity of this cluster of Fos-immunoreactive neurons in the dorsal pons. Following maximal electroshock seizure (MES), Fos labeling was compared to NADPH diaphorase staining (a marker for cholinergic neurons of the PPTn-pc); retrograde transport of wheat germ agglutinin-horseradish peroxidase (WGA-HRP) injected into the ventromedial nucleus of the hypothalamus (VMH; to identify the LPBsl) or CCK immunoreactivity (also a marker for LPBsl neurons). Results showed this cluster of Fos immunoreactive (FI) neurons to be closely associated, but not overlapping, with the lateral and most caudal aspect of the PPTn-pc. Alternatively, WGA-HRP retrograde-labeled neurons corresponded precisely with the seizure-induced FI neurons. Additionally, the location of CCK immunoreactive neurons directly overlapped with the FI neurons, although they were not nearly as prevalent. These results demonstrate that the seizure-induced FI neurons in this area are neurons of the LPBsl and not cholinergic neurons of the PPTn-pc. This is the first report of seizure-induced Fos expression specifically localized to the superior lateral subnucleus of the lateral parabrachial area.


Asunto(s)
Puente/metabolismo , Proteínas Proto-Oncogénicas c-fos/metabolismo , Convulsiones/metabolismo , Animales , Colecistoquinina/metabolismo , Electrochoque , Femenino , Histocitoquímica , Inmunohistoquímica , Sondas Moleculares , NADPH Deshidrogenasa/metabolismo , Neuronas/metabolismo , Puente/patología , Ratas , Ratas Sprague-Dawley , Convulsiones/patología , Aglutinina del Germen de Trigo-Peroxidasa de Rábano Silvestre Conjugada
13.
Neurobiol Learn Mem ; 70(3): 364-73, 1998 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-9774527

RESUMEN

Peripherally administered or released substances that modulate memory storage, but do not freely enter the brain, may produce their effects on memory by activating peripheral receptors that send messages centrally through the vagus nerve. Indeed, vagus nerve stimulation enhances memory performance, although it is unclear whether this effect is due to the activation of vagal afferents or efferents. To eliminate the possible influence of descending fibers on memory storage processes, rats were implanted with cuff electrode/catheter systems along the left cervical vagus. Forty-eight hours following surgery, each animal received a 3. 0-microliter infusion (1.0 microliter/min) of either lidocaine hydrochloride (75.0 mM) or isotonic saline below the point of stimulation. Animals were then trained 10 min later on an inhibitory-avoidance task with a 0.75-mA, 1.0-s foot shock. Sham stimulation or vagus nerve stimulation (0.5-ms biphasic pulses; 20.0 Hz; 30 s; 0.2, 0.4, or 0.8 mA) was administered immediately after training. Memory, tested 24 h later, was enhanced by stimulation whether descending vagus nerve fibers were inactivated or not. Both lidocaine- and saline-infused groups showed an intensity-dependent, inverted-U-shaped pattern of retention performance, with the greatest effect observed for 0.4 mA (U = 9, p < .05, and U = 7, p < .01, respectively). Additionally, animals that received lidocaine infusions, but no vagus nerve stimulation, showed impaired memory compared to the performance of saline-infused control animals (U = 11, p < .05). Together, these findings suggest that vagal afferents carry messages about peripheral states that lead to the modulation of memory storage and that the memory-enhancing effect produced by vagus nerve stimulation is not mediated via the activation of vagal efferents.


Asunto(s)
Memoria/fisiología , Neuronas Aferentes/fisiología , Neuronas Eferentes/fisiología , Nervio Vago/fisiología , Animales , Estimulación Eléctrica/métodos , Aprendizaje/fisiología , Masculino , Ratas
14.
Epilepsia ; 39(7): 709-14, 1998 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-9670898

RESUMEN

PURPOSE: Although vagus nerve stimulation (VNS) is now marketed throughout most of the world as a treatment for drug-resistant epilepsy, the therapeutic mechanism of action of VNS-induced seizure suppression has not yet been established. Elucidation of this mechanism is an important first step in the development of strategies to improve VNS efficacy. Because the locus coeruleus (LC) has been implicated in the antinociceptive effects of VNS, we chemically lesioned the LC in the present study to determine if it is a critical structure involved in the anticonvulsant mechanisms of VNS. METHODS: Rats were chronically depleted of norepinephrine (NE) by a bilateral infusion of 6-hydroxydopamine (6-OHDA) into the LC. Two weeks later, they were tested with maximal electroshock (MES) to assess VNS-induced seizure suppression. In another experiment, the LC was acutely inactivated with lidocaine, and seizure suppression was tested in a similar fashion. RESULTS: VNS significantly reduced seizure severities of control rats. However, in animals with chronic or acute LC lesions, VNS-induced seizure suppression was attenuated. CONCLUSIONS: Our data indicate that the LC is involved in the circuitry necessary for the anticonvulsant effects of VNS. Seizure suppression by VNS may therefore depend on the release of NE, a neuromodulator that has anticonvulsant effects. These data suggest that noradrenergic agonists might enhance VNS-induced seizure suppression.


Asunto(s)
Terapia por Estimulación Eléctrica , Locus Coeruleus/fisiología , Convulsiones/prevención & control , Nervio Vago/fisiología , Animales , Terapia por Estimulación Eléctrica/normas , Electrochoque , Femenino , Hidroxidopaminas/farmacología , Lidocaína/farmacología , Locus Coeruleus/efectos de los fármacos , Norepinefrina/agonistas , Norepinefrina/metabolismo , Norepinefrina/fisiología , Ratas , Ratas Sprague-Dawley , Convulsiones/etiología , Convulsiones/terapia , Índice de Severidad de la Enfermedad
15.
Epilepsy Res ; 29(2): 135-46, 1998 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-9477146

RESUMEN

A primary determinant of seizure susceptibility and severity in genetically epilepsy-prone rats (GEPRs), is a generalized deficiency in the central noradrenergic system of these animals. In particular, this deficiency includes reduced numbers of norepinephrine (NE) synaptic terminals in several brain areas and distinctly fewer NE axons within the auditory tectum. Two strains of GEPRs have been developed: GEPR-3s that have moderately severe clonic seizures and GEPR-9s that have severe tonic seizures culminating in complete hindlimb extension. Seizures in animals of each substrain are preceded by a brief episode of wild running. The developmental profile of NE axonal growth in GEPRs compared to control rats is not known, but may be causally related to NE deficiencies in this seizure model. The present study compared developmental neurite extension of fetal NE neurons in vitro between GEPR-3s and Sprague-Dawley control rats, the strain from which GEPR-3s were originally derived. Neurite arborization of individual NE neurons was assessed by quantitative morphometry following immunocytochemical identification of tyrosine hydroxylase (TH). Preliminary studies using explant and dispersed-cell cultures of control-rat tissues showed that optimal culture parameters to support neuritogenesis of LC neurons included the use of dispersed-cell cultures, Pronectin-F substrate, day-14 gestation donor-tissue, no use of cytosine-arabinofuranoside (ARA-c, a glial mitotic inhibitor) and the presence of co-cultured tectal tissue. Compared to fetal control-rat NE neurons co-cultured with fetal control-rat tectum, NE neurons derived from fetal GEPR-3 LC in co-culture with GEPR-3 tectum exhibited only 30% of the neurite extension of control-rat LC neurons and GEPR-3 LC neurons had a similarly deficient amount of branching. This study suggests, but does not prove, that deficiency in tectal NE in GEPR-3s involves a developmental deficiency in neurite extension from GEPR-3 LC neurons. Hypothetically, this deficiency may also contribute to the well described NE deficiency in other regions of the adult GEPR brain.


Asunto(s)
Epilepsia/fisiopatología , Neuritas/fisiología , Neuronas/fisiología , Norepinefrina/fisiología , Ratas Mutantes/genética , Animales , Encéfalo/anatomía & histología , Encéfalo/citología , Encéfalo/enzimología , Recuento de Células , Supervivencia Celular/fisiología , Técnicas de Cocultivo , Técnicas de Cultivo , Desarrollo Embrionario y Fetal/fisiología , Epilepsia/genética , Femenino , Feto , Inmunohistoquímica , Locus Coeruleus/química , Locus Coeruleus/citología , Locus Coeruleus/fisiología , Masculino , Neuronas/química , Ratas , Ratas Sprague-Dawley , Tirosina 3-Monooxigenasa/análisis
16.
Neurosci Lett ; 233(1): 21-4, 1997 Sep 12.
Artículo en Inglés | MEDLINE | ID: mdl-9324230

RESUMEN

Seizures in genetically epilepsy-prone rats (GEPRs) may result from hypoactivity of locus coeruleus (LC) neurons during seizures. This study examined Fos-like-immunoreactivity (FLI) in the LC following audiogenic seizures in two strains of GEPRs (GEPR-9s and -3s), and following pentylenetetrazol (PTZ) or maximal electroshock seizures (MES) in normal rats. After tonic seizure, GEPR-9s showed an identical LC-FLI response to that of normal rats following tonic seizures induced by either PTZ or MES. GEPR-3s, having clonic seizures, had less FLI in the LC. Therefore, stimulus-transcription coupling in the GEPR LC is apparently normo-typic in its FLI response to seizure and thus is not likely the root cause of NE abnormalities in this seizure model.


Asunto(s)
Modelos Animales de Enfermedad , Epilepsia/metabolismo , Locus Coeruleus/metabolismo , Proteínas Proto-Oncogénicas c-fos/metabolismo , Animales , Electrochoque , Epilepsia/genética , Femenino , Pentilenotetrazol/farmacología , Ratas , Ratas Sprague-Dawley
17.
Exp Neurol ; 146(2): 341-53, 1997 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-9270043

RESUMEN

The mechanisms and brain circuitry that render genetically epilepsy-prone rats (GEPRs) susceptible to acoustically induced seizures are not completely known. The present study explores the neuroanatomy of acoustically induced seizures by immunohistochemical analysis of the proto-oncoprotein fos after intense acoustic stimulation (AS) with and without seizures. Acoustic stimulation induced tonic convulsions in GEPR-9s, but not in control rats. Locations of brain nuclei showing fos-like immunoreactive (FLI) neurons following AS with and without seizures were mapped. Semiquantitative methods were used to compare FLI neuron numerical densities in AS control rats and GEPRs. Many brain areas exhibited profound FLI in AS control rats and GEPRs. Unexpectedly, the cochlear nuclei and the central nucleus of the inferior colliculi (ICc), both of which are requisite for AGS initiation, exhibited a diminished fos expression in animals having seizures compared to AS controls. In contrast, GEPRs displayed a significant increase in FLI neurons within the dorsal cortex of the IC (ICd) compared to AS controls. This finding may suggest a seizure-related amplification of the auditory signal between the ICc and the ICd. Other nuclei, known to be involved in auditory transmission (i.e., superior olivary complex; trapezoid nucleus; dorsal nucleus of the lateral lemniscus, DNLL), did not show differential FLI densities between seizure and AS control animals. In contrast, seizure-induced FLI was observed in many nonauditory brain nuclei. Of particular interest was the identification of an intensely labeled nucleus in the GEPR. This nucleus resides in the most posterior and dorsal-lateral part of the pedunculopontine tegmental nucleus-pars compacta (PPTn-pc) immediately adjacent to the DNLL and extends posteriorly into the superior lateral subnucleus of the lateral parabrachial area (SLPBn). Therefore, we have tentatively termed this nucleus the PPSLPBn. The PPSLPBn lies in a region previously described as a mesencephalic locomotor region and a suspected functional involvement of this nucleus in display of seizure activity is under investigation. Other brain stem nuclei showing differential fos expression between GEPRs and AS control rats are also described.


Asunto(s)
Encéfalo/fisiopatología , Epilepsia/genética , Expresión Génica , Genes fos , Estimulación Acústica , Animales , Femenino , Predisposición Genética a la Enfermedad , Inmunoquímica , Ratas , Ratas Mutantes , Ratas Sprague-Dawley
18.
Eur J Pharmacol ; 336(1): 1-6, 1997 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-9384247

RESUMEN

Serotonin reuptake inhibitors, such as fluoxetine, have been shown to exert anticonvulsant effects in several animal models of epilepsy. In view of recent studies showing that 5-HT1A receptor antagonists (somatodendritic autoreceptor antagonists) enhance the increase in extracellular 5-hydroxytryptamine (5-HT, serotonin) produced by serotonin reuptake inhibitors, it was of interest to determine if these antagonists also enhance the anticonvulsant effect of fluoxetine in Genetically Epilepsy-Prone Rats (GEPRs). The 5-HT1A receptor antagonists (-)-pindolol and LY 206130 (1-[1-H-indol-4-yloxy]-3-[cyclohexylamino]-2-propanol maleate) were examined in the present study and both enhanced the anticonvulsant action of fluoxetine in severe seizure GEPRs (GEPR-9s). The latter effect of LY 206130 was found to be dose- and 5-HT-dependent. These findings provide further evidence that the increase in extracellular serotonin observed after administering fluoxetine in combination with a 5-HT1A receptor antagonist is physiologically important and that the anticonvulsant effect of fluoxetine in the GEPR is mediated through an increase in extracellular 5-HT.


Asunto(s)
Anticonvulsivantes/uso terapéutico , Fluoxetina/uso terapéutico , Receptores de Serotonina/efectos de los fármacos , Convulsiones/tratamiento farmacológico , Antagonistas de la Serotonina/uso terapéutico , Estimulación Acústica , Animales , Encéfalo/efectos de los fármacos , Encéfalo/metabolismo , Ciclohexilaminas/uso terapéutico , Interacciones Farmacológicas , Femenino , Fenclonina/farmacología , Norepinefrina/metabolismo , Pindolol/uso terapéutico , Ratas , Receptores de Serotonina 5-HT1 , Serotonina/metabolismo
19.
Epilepsia ; 37(4): 311-21, 1996 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-8603634

RESUMEN

We characterized the nature of the deficit in brain serotonin (5-HT) exhibited by genetically epilepsy-prone rats (GEPR-9s) by regionally assessing three markers for 5-HT terminals/neurons (5-HT content, 5-HT uptake into the P2-synaptosomal fraction, and tryptophan hydroxylase activity) in GEPR-9s and nonepileptic control rats. As compared with controls, GEPR-9s had reduced brain 5-HT concentration, synaptosomal 5-HT uptake, and tryptophan hydroxylase activity (measured in vivo and in vitro) in most regions of the forebrain and in selected regions of brainstem. Analysis of kinetic constants for synaptosomal [(3)H]5-HT uptake and in vitro tryptophan hydroxylase activity showed that the decrements in these parameters exhibited by GEPR-9s resulted from reductions in V(max) rather than changes in K(m). In general, the reduction in each of the presynaptic markers for 5-HT terminals/neurons was similar in both magnitude and in their regional distribution in the GEPR-9 brain. An exception to this was noted in the midbrain tegmentum of GEPR-9s, which displayed a significant reduction in tryptophan hydroxylase activity without showing alterations in 5-HT concentration or in high-affinity 5-HT uptake. The present findings support the hypothesis that there is a widespread reduction in the number of serotonergic/neurons in GEPR-9 brain.


Asunto(s)
Encéfalo/metabolismo , Epilepsia/genética , Terminales Presinápticos/metabolismo , Serotonina/análisis , Triptófano Hidroxilasa/metabolismo , Estimulación Acústica , Animales , Biomarcadores , Encéfalo/enzimología , Modelos Animales de Enfermedad , Epilepsia/metabolismo , Técnicas In Vitro , Masculino , Ratas , Convulsiones/metabolismo , Sinaptosomas/metabolismo , Distribución Tisular
20.
Life Sci ; 59(21): 1763-71, 1996.
Artículo en Inglés | MEDLINE | ID: mdl-8937503

RESUMEN

To further assess the role of 5-HT in the modulation of audiogenic seizures (AGS) in the Genetically Epilepsy-Prone Rat (GEPR), changes in AGS severity after widespread chronic depletion of brain 5-HT by intracerebroventricular administration of 5,7-dihydroxytryptamine (5,7-DHT) were examined in moderate seizure GEPRs (GEPR-3s). Following treatment with 5,7-DHT (150 micrograms/30 microliters), a significant increase in seizure severity was observed at 2, 3 and 4 weeks as compared to vehicle-injected controls. The increase in seizure severity was evidenced by a significant increase in the incidence of tonic convulsions in 5,7-DHT treated animals (53% in treated animals compared to 0% in vehicle treated controls) over the testing period. Interestingly, the latency to wild running was increased in 5,7-DHT treated GEPRs, suggesting that depletion of brain 5-HT may slow initiation of AGS. Neurochemical analysis revealed marked depletion of 5-HT in the cortex (-96%), hippocampus (-94%), thalamus (-80%), hypothalamus (-62%), midbrain (-51%) and pons-medulla (-52%) in animals that received 5,7-DHT. However, no significant reductions in brain norepinephrine content were observed in any of the regions assayed due to the pretreatment of all animals with protriptyline. The present findings lend further support for an inhibitory action of brain 5-HT on audiogenic seizures in GEPRs.


Asunto(s)
5,7-Dihidroxitriptamina/farmacología , Estimulación Acústica , Encéfalo/metabolismo , Convulsiones/metabolismo , Serotoninérgicos/farmacología , Serotonina/metabolismo , 5,7-Dihidroxitriptamina/administración & dosificación , Animales , Susceptibilidad a Enfermedades , Epilepsia , Inyecciones Intraventriculares , Masculino , Norepinefrina/metabolismo , Ratas , Serotoninérgicos/administración & dosificación
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