Waterborne citalopram has anxiolytic effects and increases locomotor activity in the three-spine stickleback (Gasterosteus aculeatus).

Citalopram is an antidepressant drug, which acts by inhibiting the re-uptake of serotonin from the synaptic cleft into the pre-synaptic nerve ending. It is one of the most common drugs used in treatment of depression, it is highly lipophilic and frequently found in sewage treatment plant effluents and surface waters around the world. Citalopram and other selective serotonin re-uptake inhibitors have, at concentrations that occur in nature, been shown to have behavioural as well as physiological effects on fish and other animals. This study is the result of several different experiments, intended to analyse different aspects of behavioural effects of chronic citalopram exposure in fish. Our model species the three-spine stickleback is common in the entire northern hemisphere and is considered to be a good environmental sentinel species. Female three-spine sticklebacks were exposed to 0, 1.5 and 15µg/l nominal concentrations of citalopram for 21 days and subjected to the novel tank (NT) diving test. In the NT test, the fish exposed to 1.5µg/l, but not the 15µg/l fish made a significantly higher number of transitions to the upper half and stayed there for significantly longer time than the fish exposed to 0µg/l. The 15µg/l group, however, displayed a significantly lower number of freeze bouts and a shorter total freezing time. The test for locomotor activity included in the NT test showed that fish treated with 1.5 and 15µg/l displayed a significantly higher swimming activity than control fish both 5-7 and 15-17min after the start of the experiment. In the next experiment we compared fish exposed to 1.5µg/l and 0.15µg/l to pure water controls with regard to shoaling intensity and found no effect of treatment. In the final experiment the propensity of fish treated with 1.5µg/l to approach an unknown object and aggressive behaviour was investigated using the Novel Object test and a mirror test, respectively. The exposed fish ventured close to the unknown object significantly more often and stayed there for significantly longer time than unexposed fish. The aggression test yielded no statistically significant effects. It is concluded that citalopram changes the behaviour of the three-spine stickleback in a way that is likely to have ecological consequences and that it must not be considered an environmentally safe pharmaceutical.

Systemic differences in serum metabolome: a cross sectional comparison of women with localised and widespread pain and controls.

Chronic musculoskeletal pain exists either as localised to a single region or as widespread to multiple sites in several quadrants of the body. Prospective studies indicate that widespread pain could act as a far end of a continuum of musculoskeletal pain that started with chronic localised pain. The mechanism by which the transition from localised pain to widespread occurs is not clear, although many studies suggest it to be an altered metabolism. In this study, systemic metabolic differences between women with chronic localised neck-shoulder pain (NP), women with chronic widespread pain (CWP) and women who were healthy (CON) were assessed. Blood samples were analysed taking a metabolomics approach using gas chromatography mass spectrometry (GC-MS) and orthogonal partial least square discriminant analysis (OPLS-DA). The metabolomics analysis showed a clear systematic difference in the metabolic profiles between the subjects with NP and the CON but only a weak systematic difference between the subjects with CWP and the CON. This most likely reflects a difference in the portion of the metabolome influenced by the two pain conditions. In the NP group, the overall metabolic profile suggests that processes related to energy utilisation and lipid metabolism could be central aspects of mechanisms maintaining disorder.

Effects of polybrominated diphenyl ethers (PBDEs) and polychlorinated biphenyls (PCBs) on thyroid hormone and vitamin A levels in rats and mice.

The ability of the commercial polybrominated diphenyl ether (PBDE) preparation Bromkal 70-5 DE to alter thyroid hormone and vitamin A levels as well as microsomal enzyme activities was compared with that of the commercial polychlorinated biphenyl (PCB) preparation Aroclor 1254 in orally exposed female rats (Sprague-Dawley) and mice (C57BL/6 N). Additional mice were exposed to the PBDE congener 2,2',4,4'-tetrabromodiphenyl ether (DE-47), or to the PCB congener 2,3,3',4,4'-pentachlorobiphenyl (CB-105). For 14 days the animals were given approximately isomolar daily oral doses of Aroclor 1254, CB-105 (both 10 mg/kg body weight), Bromkal 70-5 DE or DE-47 (both at 18 mg/kg body weight). In addition, further groups of rats and mice received a higher dose of Bromkal 70-5 DE, 36 mg/kg body weight. Bromkal 70-5 DE and DE-47 decreased plasma free and total thyroxine (T4) levels in both rats and mice, although with lower potency than that of Aroclor 1254 and CB-105. By contrast, thyroid-stimulating hormone (TSH) levels were not significantly changed in any of the groups. Reduction of hepatic vitamin A levels was seen in rats after Aroclor 1254 and Bromkal 70-5 DE exposure. A similar tendency was seen also in mice, but the effects were significant only for concentration data and not the total amount. Induction ofmicrosomal phase I enzymes, measured as ethoxy, methoxy and pentoxy resorufin O-dealkylase (EROD, MROD, PROD) activities, was greatest after exposure to Aroclor 1254/CB-105 but were also significant in the Bromkal 70-5 DE/DE-47-treated groups. However, induction of uridine diphosphoglucuronosyl transferase (UDPGT) was small and for most groups insignificant. In conclusion, the PBDE compounds studied, although having a lower potency than the PCB compounds, decreased thyroxine and vitamin A levels and induced microsomal enzyme activities. Rats were more sensitive to the observed effects than mice. Microsomal phase I activity might be related, directly or indirectly, to the T4 and vitamin A effects, whereas several factors (such as weak enzyme induction and lack of correlation with altered T4 and vitamin A levels) argue against any UDPGT-related effects.

Beneficial Effects of Solid Matrix Chemo-priming in Okra.

Two field trials at Stillwater and Bixby, OK, evaluated the efficacy of solid matrix priming techniques, alone or in combination with fungicide seed treatment on seedling emergence and reduction of damping-off of okra in field soil naturally infested with Pythium ultimum. The following treatments were evaluated: thiram + carboxin (chemo-primed) (commercially applied), biological seed treatment (bio-primed) (Trichoderma harzianum isolate OK-110, 1 g suspended in 1% carboxymethylcellulose [CMC]), untreated seed (control), and a 1% CMC control. Chemo-primed seeds had a more uniform and faster emergence compared with untreated seeds at both field sites. Within 3 days, 92 and 78% of chemo-primed seeds had emerged at Stillwater and Bixby, respectively, compared with 84 and 71% emergence in the untreated control. Mean emergence of chemo-primed seeds was lower (P ≤ 0.05) than the untreated control. Chemo-primed seeds had greater vigor (P≤ 0.05) at both locations compared with either fungicide-treated or priming alone, at both locations. There were no differences (P ≤ 0.05) in yield among treatments at both locations. P. ultimum was consistently isolated from damped-off seedlings and surrounding soil at both locations. Isolates of P. ultimum were more pathogenic on okra in laboratory tests than isolates of Rhizoctonia spp., Fusarium spp., and other Pythium spp. also isolated from seed or soil.

Hair ignition by dye laser for port-wine stain: risk factors evaluated.

Flashlamp-pumped pulsed dye laser is the preferred treatment for port-wine stain. Vascular hemoglobin and epidermal melanin are competing sites for dye laser absorption and damage. The case presented illustrates the potential hazard of ignition induced by dye laser treatment on the face of a patient receiving inhalation anesthesia. A 6-year-old girl with almost black hair was treated for a port-wine stain covering most of the right half of her face. She was treated with dye laser under general anesthesia administered by mask. A laser pulse close to the upper part of the eyebrow induced a blaze and the eyebrow was instantly destroyed by the fire. Regrowth of the eyebrow was complete after a few months. Hair specimens of various colors were exposed experimentally to dye laser irradiation in room and oxygen-saturated atmospheres. Risk factors of ignition are high laser dosage, a high oxygen level, repeated pulses and dark colored hair.

Evaluation of epidural sensory block by thermal stimulation, laser stimulation, and recording of somatosensory evoked potentials.

BACKGROUND AND OBJECTIVES: The existence of differential sensory block during epidural analgesia has been confirmed by some authors and disputed by others. This study attempts to elucidate this issue by using quantitative methods for evaluation of sensory block. METHODS: A single epidural injection of 20 mL 0.5% bupivacaine with epinephrine was administered at the L1-T12 level in 11 male volunteers. Sensory block was evaluated by two qualitative (pinprick and light touch) and two quantitative methods (thermal stimulation with Thermotest [Somedic, Stockholm, Sweden] and argon laser stimulation). For measurement of motor block in the lower extremities and in the rectus abdominis muscle, quantitative methods were used. Sensory block was also assessed by somatosensory evoked potentials recorded during electrical and laser stimulation at the most cranial analgesic dermatome (loss of sharpness in pinprick perception) and the anesthetic dermatome L2 (loss of light touch perception). RESULTS: The zone of anesthesia was smaller than the zone of any other investigated variable. The cranial spread of analgesia and motor block was lower than that of laser-assessed block. Partial block of laser perception and thermal perception lasted longer than analgesia and motor block. No consistent segmental or temporal differences were found between the Thermotest and laser methods. During epidural block, prolongation of latencies and reduction in amplitudes of somatosensory evoked potentials produced at the most cranial analgesic dermatome did not differ significantly from those produced at the anesthetic dermatome. CONCLUSIONS: No differential block of small nerve fibers was found during epidural analgesia by Thermotest and argon laser stimulation. Recording of somatosensory evoked potentials did not demonstrate significant difference between responses from the sites with most superficial and with most intense sensory block.

Photodynamic therapy for recurrent nasopharyngeal cancer.

OBJECTIVE: A pilot study to determine if photodynamic therapy could be a safe and efficacious treatment for recurrent or persistent nasopharyngeal cancer. DESIGN: A consecutive sample intervention study with comparison with historic control subjects. SETTING: Tertiary referral hospital. PATIENTS: All patients with recurrent or persistent nasopharyngeal cancer following radiation therapy were considered for treatment. Patients with tumors with a depth of more than 10-mm invasion on computed tomographic scans were excluded, as were patients with recurrent metastasis to the neck. Five patients were thus acquired during a 3-year period. INTERVENTION: Four patients were injected intravenously with hematoporphyrin derivative (2.5 mg/kg) and one patient with porfimer sodium (2 mg/kg) (Photofrin, Quadra Logic Technologies, Vancouver, British Columbia) 48 hours before treatment. The drug was activated by a 630-nm laser light passed down a 1-mm core quartz fiber to a miniaturized convex mirror positioned in the nasopharynx via the contralateral nasal cavity. This procedure was carried out under topical anesthesia. MAIN OUTCOME MEASURE: Survival was determined after a minimum follow-up of 4 years. RESULTS: To date, three of five patients treated have no evidence of disease, with follow-up times of 51, 52, and 60 months, respectively. The patient with the longest survival time had been unsuccessfully treated with 136 Gy of ionizing radiation preceding photodynamic therapy. CONCLUSIONS: Long-term tumor control can be achieved by photodynamic therapy in cases where very high doses of ionizing radiation have failed. The entire treatment can be accomplished in 30 minutes under topical anesthesia. The technique carries no serious side effects.

Effects of verapamil and diltiazem on gastric emptying in normal subjects.

It has been suggested that calcium-channel blockers may delay gastric emptying by inhibiting gastric smooth muscle contraction. Most reports in man, however, reveal no significant delay in gastric emptying after using nifedipine; other calcium-channel blockers have not been studied in humans to date. We studied the effects of verapamil and diltiazem on solid-phase gastric emptying in 10 healthy volunteers. Each subject underwent a radionuclide gastric emptying determination (1) without preadministered medication, (2) after verapamil 80 mg orally every 6 hr for 10 doses, and (3) after diltiazem 60 mg by mouth given as one dose. Results revealed no significant difference in gastric emptying rates after pretreatment with verapamil or diltiazem when compared with no premedication (P greater than 0.37). We conclude that verapamil and diltiazem do not significantly delay gastric emptying in normal subjects. These data may be of clinical significance when prescribing calcium-channel blockers to patients with diseases associated with altered gastric emptying.

Renal excretion of endoscopic retrograde cholangiopancreatography injected contrast. A common phenomenon.

The renal excretion of contrast injected during endoscopic retrograde cholangiopancreatography (ERCP) has been described as an uncommon event. Patients with this phenomenon have been considered at increased risk of acute pancreatitis, but idiosyncratic reactions from this intravascular contrast have been discounted as nonexistent. Thirteen patients underwent noncontrast abdominal computed tomography (CT) before ERCP and noncontrast CT plus abdominal radiography immediately after ERCP. Renal excretion of ERCP-injected contrast was seen in two patients on abdominal films and in nine patients by CT. All patients had normal renal function and none developed clinical pancreatitis. Renal excretion of ERCP-injected contrast is much more common than previously suspected. Iodine allergy and possible reaction should be considered when performing this procedure.

Evaluation of motor blockade by isometric force measurement and electromyographic recording during epidural anaesthesia--a methodological study.

Methods for assessing motor blockade by means of isometric force measurements and surface electromyographic (EMG) recordings in the lower extremities and abdominal wall were evaluated in 30 volunteers. The coefficients of variation were 10% for force measurements and 14% and 20% for average rectified EMG (RIEMG) recordings over the quadriceps muscle and abdominal muscles, respectively, and 8% overall for TURNS (the number of changes in the sign of the direction of the EMG signal). Seven of the 30 volunteers received epidural anaesthesia with 20 ml of mepivacaine 2% with adrenaline. The mean maximal cephalad analgesic level was T9. At that abdominal segment, RIEMG showed a reduction of 50% and TURNS of 20%. Isometric force and RIEMG recorded simultaneously in the quadriceps muscles during epidural anaesthesia displayed a linear relationship with a correlation coefficient of 0.91. TURNS was insensitive to force variations above 60% of maximum voluntary contraction. During the regression phase, 90% of both the initial force and RIEMG value was noted 180 min after the epidural injection. It is concluded that recording of RIEMG is a good method for quantitative assessment of motor blockade during epidural anaesthesia.

Gallstones: a comparison of real-time ultrasonography and cholecystography with surgical correlation.

Real-time ultrasonography is more accurate and technically more efficient than gray scale ultrasonography in establishing the diagnosis of cholecystolithiasis. In prospective studies accuracy may be as high as 96%, and reflects the use of specific sonographic diagnostic criteria. Retrospective studies, however, reveal a lower accuracy rate of 90%, suggesting that practicing radiologists are not ready to accept these restricting criteria. On the other hand, oral cholecystography (OCG) is well tolerated and gives a reproducible, reliable result independent of technical expertise. It is 96% accurate in detecting the presence of gallstones and carries a sensitivity of .97. Both studies are prone to overinterpretation, which skews specificity and adversely affects diagnostic accuracy. In this retrospective review of 234 consecutive cases of cholecystectomy, real-time ultrasound was 90% accurate with a sensitivity of .96 in determining the presence of cholecystolithiasis. Oral cholecystography was 95% accurate with a sensitivity of .97.

CO2 production and breathing pattern during invasive and non-invasive respiratory monitoring.

A computerized non-invasive strain gauge system for respiratory monitoring is described and compared with pneumotachography. With the use of simultaneous capnography, changes in breathing pattern, end-tidal PCO2 and CO2 production were evaluated during non-invasive (NIM) and invasive breathing monitoring (IM) in 14 healthy subjects. An overall absolute difference between measured and calculated tidal volumes of 4.6 +/- 3.47% (r = 0.97) was found. When switching from NIM to IM, tidal volume increased by 19% and breathing frequency decreased by 11% with a 10% increase in minute ventilation. These changes were mainly accomplished by an increased respiratory drive with the timing component unaltered. During IM both end-tidal PCO2 and CO2 production increased significantly as compared with those during NIM.

A double-blind study of motor blockade in the lower limbs. Studies during spinal anaesthesia with hyperbaric and glucose-free 0.5% bupivacaine.

Sensory and motor blockade were studied double-blind during spinal anaesthesia in 20 urology patients who received 0.5% bupivacaine solution 4 ml with or without glucose. Using a new method for determining muscle strength, motor blockade during anaesthesia was recorded quantitatively for flexion of the hip, extension of the knee and plantar flexion of the big toe. Movements of the lower part of the thoracic cage were recorded at the same time. Complete motor blockade of longer duration was observed for all three movements following the administration of the glucose-free solution compared with the solution containing glucose. During the regression phase, the muscle strength returned significantly later (knee extension and hip flexion) when glucose-free bupivacaine solution was given. There was no significant difference between the two anaesthetic solutions regarding plantar flexion of the big toe during this phase. For hip flexion (L1-L3) there was no noteworthy difference between the levels of analgesia and the motor blockade, whereas for plantar flexion of the big toe (L5-S2) the level of analgesia was 2-3 segments higher than the level of motor blockade. Thoracic movements (maximal inspiration to normal expiration) did not appear to be notably influenced by the level of analgesia. Complete regression of motor blockade was not observed for any of the movements at grade O of a modified Bromage scale. Not until 1.5-2 h after the attainment of this grade was the muscle strength of all movements restored (90% of control value).

A new method for measuring motor block in the lower extremities.

A method for determining muscle strength in the lower extremities was developed and its clinical application evaluated in ten elderly, healthy subjects, and also subsequently in one of them during spinal anaesthesia. With the subject lying in the lithotomy position on a modified operating table, muscle strength measurements were made during flexion of the hip, extension of the knee and plantar flexion of the big toe. The electromechanical performance of the apparatus was stable, and the maximum measurement errors observed at loads of 245 and 49 N were 4 and 11% of the deflections, respectively. The subjects underwent repeated muscle strength measurements during a 4-h period without any difficulty. No signs of muscular fatigue were observed. The variation of the measured isometric muscle strength was small and the average coefficient of variation roughly 10%. In the patient receiving spinal anaesthesia, the degree of motor block was determined, and the results are presented graphically. This new method for evaluation of motor block in the lower extremities is a reliable quantitative method for bilateral, three-joint muscle strength measurements, which is also applicable during regional anaesthesia.

Bond strength of orthodontic direct-bonding cement-bracket systems as studied in vitro.

Tensile bond strength and failure location were evaluated in vitro for three types of direct bonding cements (unfilled, low filled, and highly filled) with three types of brackets (polycarbonate, stainless steel, and ceramic) using natural teeth and plastic as substrates. An unfilled acrylic cement gave the highest values of bond strength for both the plastic and ceramic brackets, whereas a highly-filled diacrylate cement gave the highest bond strength for the metal brackets. Bond failures occurred at the bracket-cement interface with the stainless steel brackets with each cement, whereas failure locations occurred at the bracket-cement interface, within the cement, and within the bracket for the plastic and ceramic brackets. There were no significant differences in bond strength nor failure location between tooth and plastic substrates.