A novel approach to sexing bovine blastocysts using male-specific gene expression.

When examining gene expression profiles for the purposes of assessing embryo quality, it is imperative that sex be considered, because many embryonic transcripts have sex-related expression patterns. The objective of this study was to systematically examine eight Y chromosome linked genes (DDX3Y, EIF1AY, HSFY, SRY, TSPY, USP9Y, ZFY, and ZRSR2Y) to characterize their expression in bovine blastocysts and to examine the usefulness of this expression for the purpose of RNA-based embryo sexing. In order to examine the expression of these genes, pools of blastocysts (groups of 10 and 20) as well as single embryos (N = 50) were analyzed with reverse transcriptase polymerase chain reaction (RT-PCR) and reverse transcriptase quantitative PCR (RT-qPCR). Of the 50 single embryos, 32 were concurrently sexed with DNA-based methods. Transcripts of DDX3Y, EIF1AY, TSPY, USP9Y, ZFY and ZRSR2Y were detected in the pooled and single blastocysts, but no transcripts were detected for HSFY or SRY. After performing DNA-based sexing experiments, we concluded that this expression was restricted to the male embryos. The consistency of the expression varied according to the gene as well as the specific primer set. Three genes were expressed in the full set of male embryos, DDX3Y, USP9Y, and ZRSR2Y and therefore represent good candidates for RNA-based sexing methods.

Unrecognized glucose intolerance is not associated with depression. Screening for Impaired Glucose Tolerance study 3 (SIGT 3).

AIMS: To understand the metabolic and temporal links in the relationship between diabetes and depression, we determined the association between depressive symptoms and unrecognized glucose intolerance. METHODS: In a cross-sectional study, 1047 subjects without known diabetes were screened for diabetes or pre-diabetes using the oral glucose tolerance test and for depressive symptoms using the Patient Health Questionnaire (PHQ). RESULTS: Mean age was 48 years, body mass index 30 kg/m(2); 63% were female, 54% black, 11% previously treated for depression and 10% currently treated; 5% had diabetes and 34% pre-diabetes. Median PHQ score was 2 (interquartile range 0-5). Depressive symptoms did not increase with worsening glucose tolerance, after adjusting for age, sex, ethnicity, body mass index, family history, exercise, education and depression treatment. CONCLUSIONS: There is no association between depressive symptoms and unrecognized glucose intolerance. However, it remains possible that diagnosed diabetes, with its attendant health concerns, management issues, and/or biological changes, may be a risk for subsequent development of depression. Thus, patients with newly diagnosed diabetes should be counselled appropriately and monitored for the development of depression.

Racial effects on neuropsychological functioning in schizophrenia.

OBJECTIVE: This study assessed the effects of race on neuropsychological functioning in patients with schizophrenia. METHOD: A total of 160 patients with schizophrenia completed an extensive neuropsychological test battery. Scores were standardized to a group of 99 psychiatrically and physically healthy subjects and categorized into seven functional domains: concentration, executive function, language, motor function, spatial memory, verbal memory, and visual processing. RESULTS: African Americans (N=25) had significantly lower mean scores on executive function, language, spatial memory, and visual processing than did Caucasians (N=135). Statistical control for patient and family education eliminated all significant effects. CONCLUSIONS: Educational differences in patients and families may account for some of the performance heterogeneity reported in patients with schizophrenia and should be routinely analyzed with other sociodemographic factors such as race and sex.

Race in the "decade of the brain".

Despite NIMH efforts to facilitate the study of women and minorities in federally funded schizophrenia research, there is a significant lack of information about race differences in brain morphology and neuropsychological function in schizophrenia. A review of three major psychiatric journals between 1994 and 1996 revealed that only 14 (2.8%) of 502 schizophrenia articles reported the results of race analyses. Only 84 (16.7%) even reported the racial composition of the study sample. The study of race differences in schizophrenia, although fraught with methodological complexity and social/political tension, is necessary to prevent inappropriate generalization of research results across racial groups.

Schizophrenia, substance use, and brain morphology.

The high rate of comorbid substance abuse in schizophrenia and the consistently poor outcome of this comorbidity are well established findings in the research literature. However, the reasons for the high rate of comorbidity are not adequately understood, and the question of why some patients with schizophrenia abuse substances and others do not remains unanswered. There is widespread agreement about the clinical heterogeneity of schizophrenia, and there is some evidence suggesting that the heterogeneous clinical presentation may reflect a parallel underlying heterogeneity of brain morphology. We were interested in examining the possibility that the high rate of substance abuse and the characteristically poor outcome may be associated with the underlying brain morphology. Our hypothesis was that study subjects with schizophrenia and substance abuse would have higher rates of gross brain abnormalities than subjects with only schizophrenia. In an attempt to explore this possibility, we looked at qualitative differences in magnetic resonance imaging scans for a large sample (n = 176) of schizophrenia patients. In the group of patients who abused both alcohol and drugs, we found the rate of gross brain abnormalities to be slightly less than half the rate found among the patients with no history of alcohol or substance abuse (8 vs. 19). Although these results are not statistically significant, they reflect a trend that is compatible with previous findings, suggesting that substance abuse history may be accompanied by less impairment in certain areas, which in turn may be reflected in a better premorbid adjustment. However, our findings are not compatible with previous findings that show substance abuse to be associated with more severe symptoms and a poorer outcome in schizophrenia.

Sex differences in verbal IQ-performance IQ discrepancies among patients with schizophrenia and normal volunteers.

Substantial verbal IQ (VIQ)-performance IQ (PIQ) discrepancies may reflect brain dysfunction. The authors examined 159 patients with schizophrenia (115 men and 44 women) or schizoaffective disorder (25 men and 19 women) and 79 normal participants (33 men and 46 women), calculated mean VIQ-PIQ discrepancy scores by sex and diagnosis, and identified persons with large VIQ-PIQ discrepancies (15-point difference in either direction). Schizophrenic/schizoaffective men had a larger mean VIQ-PIQ discrepancy than did other groups. The proportion of all patients with either VIQ > PIQ or PIQ > VIQ (17.8%) was not significantly different from that of normal participants (22.8%). However, significantly more men than women with schizophrenia exhibited a VIQ > PIQ pattern (20% vs. 3.2%). No unusual discrepancy patterns were noted among normal participants. Results were interpreted in light of theories of hemisphere dysfunction in schizophrenia.

Sex-onset effects on neuropsychological function in schizophrenia.

Heterogeneity of results continues to hamper schizophrenia research. The examination of sex differences in the effort to reduce this heterogeneity has had mixed results in neuropsychology. We have begun to examine the validity of both sex and onset age to define early-onset male and late-onset female prototypes of the disorder. Extensive neuropsychological assessment of 191 schizophrenia/schizoaffective patients was conducted. Analysis of performance scores revealed a significant pattern reflecting poorer performance and less lateralized function in early-onset men and late-onset women compared with late-onset men and early-onset women. The discussion addresses the etiological implications of these findings.

Sex differences in neuropsychological functioning among schizophrenic patients.

OBJECTIVE: The view of schizophrenic men as having poorer premorbid development, earlier age at onset, and worse outcome than schizophrenic women predicts greater neuropsychological impairment in the former than the latter. The authors examined in detail neuropsychological functioning in a large group of schizophrenic patients and a healthy comparison group. METHOD: Neuropsychological functioning in 132 male and 63 female patients with schizophrenia or schizoaffective disorder was extensively studied and compared with that of 99 (40 male, 59 female) healthy individuals. RESULTS: As expected, the schizophrenic patients as a group were pervasively and significantly more impaired than the comparison group. Within schizophrenia, in contrast to the prediction, women performed significantly more poorly than men in verbal memory, spatial memory, and visual processing. Female schizophrenic patients also had significantly poorer right than left hemisphere performance, whereas male schizophrenic patients had identical scores for right and left hemisphere impairment. CONCLUSIONS: The findings are consistent with the hypothesis that schizophrenia among women may be partially understood as a right hemisphere dysfunction. Sampling, diagnostic, and epidemiologic factors may have affected the results.

Home care for venous leg ulcers.

More than a quarter of the adult population in the United States is afflicted with lower extremity venous insufficiency, and 1 in 100 have had, or now have, stasis ulcers. Most of these patients will be treated on an outpatient basis, with many of them requiring home health care. The cost to treat venous ulcers alone has been estimated at $750 million to $1 billion a year. Understanding the pathogenesis and treatment of the problem is imperative as home health care nurses move into an era of cost containment and demographic shift toward an increasingly larger elderly population.

Differences in qualitative brain morphology findings in schizophrenia, major depression, bipolar disorder, and normal volunteers.

This study examined the frequency and type of qualitative brain morphologic anomaly as a function of sex and diagnosis. Magnetic resonance imaging brain scans were evaluated by an experienced neuroradiologist blind to diagnosis. The scans of 325 individuals (108 schizophrenic, 20 schizoaffective, 27 major depressive, 20 bipolar and 150 healthy volunteers) were categorized into one of five groups: normal, hyperintensity signals, volume loss, ventricular anomaly or "other" abnormality. Schizophrenic men had significantly more morphologic anomalies, especially of the lateral ventricles than healthy male volunteers. Schizophrenic women did not differ from healthy women. Schizoaffective patients of both sexes, male depressive and female bipolar patients were also characterized by higher rates of brain anomalies. Independent of diagnosis, women were more likely than men to have hyperintensity signals among individuals with positive scan findings. The overall rate of brain morphologic anomalies is significantly higher among male schizophrenic patients than healthy volunteers; this is not specific to male schizophrenics, however, suggesting a global sex effect. Type of anomaly may differ by sex and give us clues about sex differences in the pathophysiology of psychopathology.

Reperfusion injury.

Reperfusion injury occurs after flow is restored to an ischemic area in an effort to salvage limbs and prevent amputation. Skeletal muscle damage occurs during ischemia as well as during reperfusion. Literature review supports the theory that reperfusion of the ischemic area may cause a chain of events that results in irreversible necrosis. Neutrophils, calcium, and oxygen free radicals appear to play a significant role in the cellular injury during reperfusion. Free radical scavengers administered at the appropriate time may prevent injury. Nurses play a significant role in identifying signs of reperfusion injury.

Natural killer cell activity in schizophrenia and schizoaffective disorder: a pilot study.

Natural killer cell activity was prospectively studied in 15 patients with chronic schizophrenia and in seven patients with schizoaffective disorder, depressed type. These patients were compared to individually matched normal controls. No mean differences in natural killer cell activity between the patient groups and their controls were observed.

Limbic-hypothalamic-pituitary-adrenal axis activity and ventricular-to-brain ratio studies in affective illness and schizophrenia.

Some investigators have speculated that structural brain alterations observed in some psychiatric patients might be related to increased limbic-hypothalamic-pituitary-adrenal axis (LHPA) activity. To explore this hypothesis, we prospectively studied 166 research volunteers (19 patients with research diagnostic criteria (RDC) major depression, 9 patients with RDC bipolar depression, 45 patients with RDC schizophrenia, and 94 RDC normal controls), examining the relationship between magnetic resonance image-determined ventricular-to-brain ratio (VBR) and indices of LHPA axis function (cerebrospinal fluid (CSF) corticotropin-releasing factor (CRF), CSF adrenocorticotropic hormone (ACTH), and 24-hour urinary-free cortisol secretion). We observed no significant differences in mean VBR among the three patient groups and the normal control volunteers. Of the indices of LHPA activity, only CSF CRF concentrations distinguished the four subject groups, with CSF CRF being significantly elevated in the more severely depressed major depression patients. Indices of LHPA activity were not significantly correlated with VBR in any of the three patient groups or in the normal volunteers. These preliminary results suggest that VBR is not highly associated with alterations in LHPA activity, at least as determined cross-sectionally. Further longitudinal studies with reference to diagnostic subtypes, severity, symptom profiles, and more specific neuroanatomic regions may allow the elucidation of possible relationships between LHPA pathology and structural brain alterations.