Efficacy of yoga, tai chi and qi gong on the main symptoms of chronic obstructive pulmonary disease: A systematic review.

INTRODUCTION: The aim of this systematic review was to summarize the effects of yoga, qi gong or tai chi in COPD patients. METHODS: Studies evaluating effects of the selected complementary therapies on lung function, dyspnea, quality of life or functional exercise capacity in COPD patients were identified and reviewed from three databases. RESULTS: Eighteen studies were included. Six studies evaluated the effects of yoga and the others focused on tai chi or qi gong separately or combined. The duration of the programs ranged from 6 weeks to 6 months and the frequency from 2 to 7 times a week. Each session reached 30 to 90 minutes. Benefits were observed on lung function and functional exercise capacity but benefit was clearly stated neither on quality of life nor on dyspnea. CONCLUSION: This systematic review highlights the potential of these therapies as complementary therapeutic approach in COPD patients.

Insulin sensitivity, adjusted beta-cell function and adiponectinaemia among lean drug-naive schizophrenic patients treated with atypical antipsychotic drugs: a nine-month prospective study.

Atypical antipsychotic drugs (AADs) induce weight gain and truncal adiposity, and even the metabolic syndrome (MetS), which may progress to IFG/IGT or DM. AAD effects in lean schizophrenic patients without MetS have not been documented, especially in terms of weight gain and changes in insulin sensitivity (S), beta-cell function (beta) and adiponectinaemia. We prospectively determined the effects of nine-month therapy with AADs on anthropometrics, metabolism and adiponectinaemia, including homoeostasis model assessment (HOMA) modelling of S, beta and betaxS (hyperbolic product, assessing individual beta adjusted for S). We analyzed 36 schizophrenic subjects (M/F: 24/12; Caucasian: n=23, North African: n=12, South Asian: n=1) aged 35+/- years (mean+/-one S.D.) free of MetS (NCEP-ATPIII), of whom 19 study completers were evaluated following AAD treatment. S, beta, betaxS and adiponectin were measured at zero, three and nine months. At nine months, BMI had risen from 22+/-2 to 25+/-2kg/m(2) (P<0.001) and waist circumference from 85+/-8 to 91+/-11cm (P<0.001), while adiponectin decreased from 10.4+/-5.1 to 7.4+/-3.8mug/mL (P<0.001). Blood pressure and lipids were unaffected. S decreased from 138+/-49 to 110+/-58% (P=0.006) and beta increased from 83+/-24 to 100+/-40% (P=0.034). As a result, betaxS decreased from 106+/-19 to 91+/-27% (P=0.015). Fasting glycaemia rose from 89+/-5 to 96+/-9mg/dL (P=0.007). On study completion, 21% had IFG. Long-term use of AADs in lean, drug-naive, schizophrenics initially free of MetS induced weight gain and truncal fat accumulation associated with decreases in adiponectin and hyperbolic product, explaining the increased fasting glycaemia and impaired fasting glucose seen in predisposed individuals.

The role of alexithymia factors in glucose control of persons with type 1 diabetes: a pilot study.

OBJECTIVE: To clarify the respective contribution of demographic characteristics, health conditions and three psychological variables (depression, anxiety, alexithymia) for glycaemic control measured by glycated hemoglobin (HbA1c). MATERIALS AND METHODS: Sixty-four persons diagnosed with type 1 diabetes completed psychological measures and demographic information at admission (T1) to the hospital and in a follow-up (+8 weeks) (T2). Additional information about their health conditions was also considered. RESULTS: At T1, the alexithymia factor "difficulties describing feelings" (DDF) predicted HbA1c over and above the predictive power of demographic information, health conditions, anxiety, and depression. Additionally, higher decrease in HbA1c from T1 to T2 was predicted by higher scores on the alexithymia factor DDF at admission over and above the other predictors. CONCLUSION: DDF is an important predictor of glucose control. Scoring higher on this factor is related to poorer glycaemic control at admission. Additionally, people with higher scores on this factor seem to benefit highly from the treatment administered at the hospital.

Gene profiling reveals decreased expression of uteroglobin and other anti-inflammatory genes in nasal fluid cells from patients with intermittent allergic rhinitis.

BACKGROUND: Intermittent allergic rhinitis (IAR) results from interactions between a large number of pro- and anti-inflammatory mediators. Little is known about anti-inflammatory mediators in IAR. DNA microarrays allow simultaneous analysis of the whole transcriptome in a sample. OBJECTIVE: To identify anti-inflammatory transcripts in nasal fluid cells from patients with IAR during season and from healthy controls. METHODS: Nasal lavage fluids were obtained from 15 patients with symptomatic birch/and or grass pollen-induced IAR and 28 healthy controls. RNA was extracted from the nasal fluid cells and pooled into one patient- and one control pool. These were analysed with DNA microarrays containing more than 44,927 genes and variants. RESULTS: Seventeen thousand three hundred and fifty three genes were expressed in the controls and 17 928 in the patients. One thousand five hundred and seventy nine of the genes had higher expression in patients than in controls, and 1570 had lower expression in patients. Out of 189 up-regulated inflammatory genes, 187 were pro-inflammatory and two were anti-inflammatory. These genes regulated key steps of inflammation, ranging from influx of leukocytes to immunoglobulin production. By comparison, out of 49 down-regulated inflammatory genes, 36 were pro-inflammatory and 13 were anti-inflammatory. The anti-inflammatory gene that decreased most in expression in the patients was uteroglobin (also known as Clara Cell protein 16, CC16). The nasal fluid concentrations of uteroglobin protein were significantly lower in patients than in controls, 5.43+/-1.53 and 12.93+/-2.53 ng/mL, respectively (P<0.05). CONCLUSION: IAR is associated with decreased expression of uteroglobin and other anti-inflammatory genes.

Adult liver transplantation at UCL: update 2002.

The authors present the results of a single centre study of 587 liver transplants performed in 522 adults during the period 1984-2002. Results have improved significantly over time due to better pre-, peri- and post-transplant care. One, five, ten and fifteen year actuarial survivals for the whole patient group are 81.2; 69.8; 58.9 and 51.2%. The high incidence of de novo tumors (12.3%), of cardiovascular diseases (7.5%) and of end-stage renal function (3.6%) should be further incentives to tailor the immunosuppression to the individual patient and to direct the attention of the transplant physician to the long-term quality of life of the liver recipient.

Self-inflicted repetitive optic nerve injury: a case report.

PURPOSE: To describe an obsessive-compulsive patient who developed blindness after self-inflicted repetitive optic nerve injury. METHODS: Case report. RESULTS: A myopic 46-year-old male became blind as a result of intermittent rubbing of his eyes, causing stretching of the optic nerves. Extensive ocular, neurologic and systemic work-ups were negative. Cerebral and orbital MR studies showed severe bilateral optic nerve atrophy. Psychiatric evaluation confirmed obsessive-compulsive personality. CONCLUSIONS: Self-inflicted optic nerve injury should be included in the differential diagnosis of progressive optic neuropathy in a young adult.

The effect of the vasoactive intestinal polypeptide agonist Ro 25-1553 on induced tone in isolated human airways and pulmonary artery.

Ro 25-1553 is a metabolically stable analogue of endogenous vasoactive intestinal polypeptide (VIP). This compound is a potent bronchodilator in vitro as well as in vivo. Moreover, Ro 25-1553 has been shown to be highly selective of the VPAC2 receptor. We assessed the effect of Ro 25-1553 on isolated human bronchi and pulmonary arteries in vitro. Macroscopically normal human airways and pulmonary arteries were obtained from patients undergoing surgery for lung cancer. The relaxing capability of Ro 25-1553 on bronchial and pulmonary artery tone was measured using standard techniques. Bronchial rings were pre-contracted with 0.1 mM histamine, and tone in pulmonary artery rings was induced with 10 microM PGF2alpha. Increasing concentrations of Ro 25-1553 within a range of 1 pM to 10 microM were added and isometric tension changes were recorded. Ro 25-1553 caused a concentration-dependent relaxation of airway and pulmonary artery preparations, with an EC50 of approximately 10 nM and a maximal relaxation of 70%-75% of the induced tone. The presence of VPAC2 receptors in the two tissues, though low in density, was confirmed by in situ hybridization, immunocytochemistry and ligand binding. These findings indicate that the VIP analogue Ro 25-1553 may be useful in the treatment of asthma and/or chronic obstructive pulmonary diseases.

Cerebellar abnormalities in mental illness. A study on Purkinje cell density in schizophrenic men.

The linear Purkinje cell density in the cerebellar vermis was investigated in a small cohort of adult onset schizophrenic men with well-documented hippocampal abnormalities. There were no differences in comparison with age-matched controls. This negative finding indicates that vermian abnormalities undoubtedly seen in some schizophrenic patients may constitute a subsyndrome, possibly related to autistic disorders in which cerebellar abnormalities are well corroborated.

Glucose utilisation in the lungs of septic rats.

Sequestration and degranulation of leucocytes in the pulmonary microcirculation is considered to be a key event in the development of acute respiratory distress syndrome in patients with sepsis. Glucose serves as the main source of energy in activated leucocytes. The aim of this study was to assess whether glucose utilisation in the lungs can be used as an indicator of pulmonary leucocyte accumulation in an experimental model of sepsis of intra-abdominal origin. Sepsis was induced in rats by abdominal implantation of a gelatine capsule containing bacteria and rat colonic contents. Empty gelatine capsules were implanted in control animals. Animals were studied 6 and 12 h after sepsis induction. Glucose utilisation was measured as the tissue uptake of fluorine-18-fluorodeoxyglucose ((18)FDG) 1 h after intravenous injection of the tracer. Micro-autoradiography was also performed after injection of tritiated deoxyglucose. We found increased uptake of (18)FDG in the lungs of septic animals. The uptake also increased with time after sepsis induction. (18)FDG uptake in circulating leucocytes was increased in septic animals compared with controls, and micro-autoradiography showed intense accumulation of deoxyglucose in leucocytes in the lungs of septic animals. We conclude that glucose utilisation is increased in the lungs of septic rats. Measurements of pulmonary glucose utilisation as an index of leucocyte metabolic activity may open new possibilities for studies of the pathophysiology of sepsis and for evaluation of therapeutic interventions.

Pyramidal neuron size in the hippocampus of schizophrenics correlates with total cell count and degree of cell disarray.

Hippocampal pyramidal neuron size was determined in all Cornu Ammonis subregions - CA1-CA4 - in five chronic schizophrenic men and compared with eight controls matched with respect to age and sex. Four out of five probands and the same eight controls had been examined in a previous study showing a significantly lower cell count and disorientation of pyramidal cells in the CA1- CA3 subregions of the schizophrenics. There was also a negative correlation between the total number of cells and the number of disoriented cells. In this study it was shown that the schizophrenic probands also had significantly smaller neurons in all subregions. There was a significant negative correlation between pyramidal neuron size and the number of disarrayed neurons in each subregion, and there was a significant positive correlation between neuron size and the total number of pyramidal cells in CA1 and CA2, but not in CA3 and CA4. The consistency of hippocampal anomalies in these schizophrenics is, thus, demonstrated by the statistical relations between the different parameters examined.

Uniform abnormalities in the hippocampus of five chronic schizophrenic men compared with age-matched controls.

In a post-mortem study five chronic schizophrenic men were matched with respect to age and sex to five control subjects without a known history of psychiatric illness, and were compared in pairs with regard to neurone number and pyramidal cell orientation in the left hippocampus. All five schizophrenics had significantly more disoriented pyramidal cells in the Cornu Ammonis subregions CA1-CA3 than their matched controls. They also had significantly fewer pyramidal cells in the observed areas of CA1 and CA3, but not in CA2 and CA4. There was no difference in the number of granular cells of the dentate gyrus. In pairwise comparisons the pattern was never reversed with respect to these two parameters, except in a single case where one schizophrenic proband had more cells in subregion CA2. In the absence of gliosis the findings were interpreted as sequelae of an early, presumably prenatal, injury.

Hippocampal pyramidal cell disarray correlates negatively to cell number: implications for the pathogenesis of schizophrenia.

Brains from patients with therapy-refractory schizophrenia were examined with respect to pyramidal cell disarray in the hippocampus, a finding reported in some studies, but not confirmed in others. A significantly higher number of disarrayed cells was seen in the brains of the schizophrenic patients in all subfields of the Cornu Ammonis (CA) investigated. Compared with controls the schizophrenic patients also had significantly fewer pyramidal cells in the observed areas of CA1-CA3, but not in CA4. There were no signs of gliosis. Finally, there was a significant negative correlation between the number of disarrayed cells and the total number of pyramidal cells in CA1-3 in the group of probands and controls taken together, a finding interpreted as lending support to the idea of a prenatal migratory disturbance in the pathogenesis of schizophrenic syndromes.

Neuropeptide Y in salivary glands of the rat: origin, release and secretory effects.

In the parotid gland, double immunostaining showed the perivascular and most of the periductal neuropeptide Y (NPY)-immunoreactive nerve fibres to contain dopamine beta-hydroxylase, while the majority of periacinar NPY-fibres contained vasoactive intestinal peptide. Sympathectomy caused a marked depletion of perivascular and periductal NPY-fibres, leaving periacinar NPY-fibres less affected. Following combined sympathectomy and parasympathectomy, only a few NPY-fibres persisted. The parasympathetic auriculotemporal nerve contributed most (75%) and the cervical sympathetic nerve least (15%) to the parotid gland content of NPY as judged by radioimmunoassay. The sensory neurotoxin capsaicin was without effect on the occurrence and gland content of NPY. Upon long-lasting electrical stimulation of the auriculo-temporal nerve at a high frequency, the gland content of NPY was reduced (by 55%), a depletion thought to indicate release of the peptide from parasympathetic nerve terminals. In vitro, tissues of parotid, submandibular and sublingual glands released concentration-dependently protein (and as to the parotid gland amylase also) in response to NPY; the protein response was largest from sublingual tissue (per unit weight). A concentration-dependent in vitro release of potassium from tissues of parotid and submandibular glands in response to NPY occurred and here, submandibular gland tissue was the most sensitive. Comparisons between the action of some secretagogues (at 10(-6) M) showed NPY to be less effective than vasoactive intestinal peptide and adrenaline, but as effective as bethanechol and substance P, in releasing protein (and amylase) in parotid and submandibular gland tissues; in sublingual gland tissue NPY was less effective than vasoactive intestinal peptide, in the range of adrenaline and more effective than bethanechol and substance P. As to potassium release (at agonist concentration of 10(-6) M) from tissues of parotid and submandibular glands NPY was less effective than substance P and vasoactive intestinal peptide. The fluid response to NPY upon i.v. administration was scanty from parotid and submandibular glands. NPY is likely to play a complementary role in mediating parasympathetic secretory responses in salivary glands of the rat. It seems preferentially involved in the control of protein secretion.

Changes in neuroendocrine elements in bronchial mucosa in chronic lung disease in adults.

BACKGROUND: It is not clear whether there is any association between metaplasia of the bronchial epithelium and changes in the distribution of neuroendocrine cells. This study examined, by immunohistological techniques, the distribution of neuroendocrine cells and juxtamucoscal nerve fibres in bronchial biopsies showing metaplastic changes. METHODS: Bronchial biopsies from 12 subjects with epithelial metaplasia associated with bronchiectasis and diffuse pulmonary fibrosis were examined by conventional light microscopy and immunohistological techniques for protein gene product 9.5 (PGP), chromogranin A and B (CAB), serotonin, vasoactive intestinal peptide (VIP), substance P (SP), calcitonin gene-related peptide (CGRP), calcitonin (CT), and gastrin releasing peptide (GRP). RESULTS: Regions of non-metaplastic epithelium contained numerous PGP and serotonin immunoreactive cells. Sub-populations of these cells displayed CAB, CGRP, CT, and GRP immunoreactivity. Metaplastic epithelium contained only a few weakly stained PGP, serotonin, CAB, GRP, CT and CGRP immunoreactive cells in six cases. Metaplastic epithelium was characterised by a high number of CAB-containing cells in six cases and in these biopsies prominent PGP-containing nerve bundles were seen in the subepithelial layer beneath the metaplastic epithelium. CONCLUSIONS: The distribution patterns of neuroendocrine cells and neuronal elements vary between areas of normal and metaplastic epithelium and within areas of metaplastic epithelium. Neuronal hyperplasia was associated with an increase in the number of CAB-containing cells within the metaplastic epithelium.

[The localization of protein gene product 9.5 in the lungs of children with bronchitis and bronchiectasis]. / Lokalizatsiia proteingenprodukta 9,5 v legkikh u detei s bronkhitom i bronkhoéktazami.

Human respiratory tract has a rich innervation with nerve fibers. Presence and distribution of nerve elements labeled with protein gene product 9.5 (PGP) were studied in the lungs of children with bronchitis and bronchiectasis. Smooth myocytes, blood vessels and mixed glands of the walls of bronchi principales were surrounded with single PGP-positive nerve fibers in perichondrium grows smaller with age. Nerve fibers also surround lymph nodules of the bronchi principales mucosa. Small or medium number of them in nerve plexuses and surround basically blood vessels. As neuropeptide function in respiratory tract vary, they may be of certain importance in pathogenesis of chronic lung diseases. Morphological base of this suggestion was given.

Distribution and origin of the peripheral innervation of rat cervical esophagus.

Several neurotransmitters, neuropeptide Y (NPY), vasoactive intestinal peptide (VIP), galanin, enkephalin, calcitonin-gene related peptide (GGRP), substance P, as well as nitric oxide synthase (NOS), and the noradrenergic marker tyrosine-hydroxylase (TH) were localized by immunocytochemistry in the cervical esophagus of rat. Nerve fibers containing the neuropeptides, NOS, and TH were distributed in the myenteric plexus, around muscle bundles and small blood vessels. Injection of the retrograde tracer True Blue (TB) into the cervical esophagus resulted in the appearance of labeled nerve cell bodies in the superior cervical, the stellate, the nodose, the sphenopalatine, the dorsal root ganglia at levels C2-C7, and in local ganglia close to the thyroid. Most of the TB-labeled nerve cell bodies in the superior cervical ganglia contained NPY. In the stellate ganglion, a few labeled nerve cell bodies contained VIP whereas an additional few cell bodies stored VIP. In local ganglia, the majority of labeled cell bodies contained VIP. In the nodose ganglion and cervical dorsal root ganglia, the majority of the labeled nerve cell bodies stored CGRP. The results indicate that the cervical esophagus has a dense innervation with multiple neurotransmitters emanating from several ganglia. As judged by the pattern of nerve fiber distribution, they may regulate esophageal peristalsis and blood flow, some of them possibly in a cooperative manner.

Basement membrane components of bronchial epithelium in humans suffering from chronic nonspecific lung diseases.

Collagen IV and laminin are important constituents of the basement membrane (BM). By use of immunocytochemistry we examined the occurrence and distribution of these two components in the BM beneath normal, mucoid and metaplastic epithelium of large bronchi in 22 adults suffering from chronic nonspecific lung diseases. Both collagen IV and laminin were expressed as a thin and continuous layer beneath the epithelium in most tissue specimens with normal epithelium. In a few specimens the layer showed interruptions with a patchy distribution of the immunoreactivity. Three patterns of distribution of BM components were found under the metaplastic epithelium. Total absence of immunoreactive collagen IV and laminin was the most common variant. Weak and scarce staining for both proteins in the BM characterized the second pattern. The third variant showed strong collagen IV immunoreactivity but lack of laminin. The BM beneath the mucoid epithelium was characterized by irregular distribution of collagen IV and laminin. We suggest that the occurrence and distributional pattern of the BM components are related to the type of overlying epithelium and connected with an altered synthesis of these components.

Developmental studies on vasoactive intestinal peptide, substance P and calcitonin gene-related peptide in salivary glands of postnatal rats.

The development of vasoactive intestinal peptide, substance P and calcitonin gene-related peptide in parotid, submandibular and sublingual glands of the male rat was followed by immunochemistry and immunocytochemistry. The total amounts of these peptides increased in surges during the first 8 weeks of the animal's life; one within 2-4 weeks and the other beginning 1-2 weeks later. Nerve fibres containing these peptides were present at birth showing a pattern of distribution similar to that in adults. During the first 4 weeks the nerve fibres increased in number.

Calcitonin, CGRP and helodermin in endocrine cells of the developing rat lung.

Calcitonin gene-related peptide (CGRP), calcitonin and immunoreactive helodermin occur in endocrine cells in the murine airways. In the lungs these cells form clusters, while they occur scattered in the larynx and trachea. In the present study of the developing rat CGRP-immunoreactive cells were more numerous at all stages than the calcitonin- and helodermin-containing ones. A subpopulation of the CGRP-containing cells contained either calcitonin or helodermin. Immunocytochemistry revealed a higher density of CGRP-containing endocrine cells in the lungs of fetal and newborn rats than in the lungs of older rats, while the density of calcitonin-containing cells was largely unchanged. The helodermin-containing cells were few at all developmental stages examined. The concentration and content of CGRP were highest in newborn rats; the levels decreased postnatally. The calcitonin concentration did not change during development while the content increased with age. The concentration and content of helodermin increased with age.