Neuroleptic exposure following inpatient treatment of acute mania with lithium and neuroleptic.

The authors examined continued neuroleptic exposure following inpatient treatment of mania with neuroleptics and lithium through structured chart review of 40 consecutive patients. At discharge, patients were receiving a mean of 793 mg/day (SD = 695) chlorpromazine equivalents; 6 months later they were receiving a mean of 634 mg/day (SD = 684). This decrease was statistically significant, but the patients' ongoing neuroleptic exposure remained substantial.

Chronic neuroleptic exposure in bipolar outpatients.

BACKGROUND: Although the chronic use of neuroleptic medications is generally discouraged in patients with bipolar disorder, data on the actual extent of this practice are relatively scarce. METHOD: All bipolar patients receiving treatment at the Connecticut Mental Health Center on September 1, 1994, were identified through a computerized administrative database; the medical record was then examined. Patients were included in the study if (1) the last two recorded diagnoses in the chart were concordant for bipolar disorder and (2) the patient had not been hospitalized in the past year. RESULTS: Of 49 patients meeting review criteria, 33 (67%) met criteria for chronic neuroleptic exposure. The mean +/- SD continuous neuroleptic dosage for these 33 outpatients was 416 +/- 527 mg/day chlorpromazine (CPZ) equivalents. The dosage distribution was skewed, with 17 (52%) receiving < or = 200 mg/day CPZ [corrected] equivalents. CONCLUSION: Chronic neuroleptic administration occurred frequently in our sample of nonhospitalized bipolar outpatients.

In vitro and in vivo characterisation of anti-murine IL-13 antibodies recognising distinct functional epitopes.

Interleukin-13 (IL-13) sequentially binds to IL-13Ralpha1 and IL-4Ralpha forming a high affinity signalling complex. This receptor complex is expressed on multiple cell types in the airway and signals through signal transducer and activator of transcription factor-6 (STAT-6) to stimulate the production of chemokines, cytokines and mucus. Antibodies have been generated, using the UCB Selected Lymphocyte Antibody Method (UCB SLAM), that block either binding of murine IL-13 (mIL-13) to mIL-13Ralpha1 and mIL-13Ralpha2, or block recruitment of mIL-4Ralpha to the mIL-13/mIL-13Ralpha1 complex. Monoclonal antibody (mAb) A was shown to bind to mIL-13 with high affinity (K(D) 11 pM) and prevent binding of mIL-13 to mIL-13Ralpha1. MAb B, that also bound mIL-13 with high affinity (K(D) 8 pM), was shown to prevent recruitment of mIL-4Ralpha to the mIL-13/mIL-13Ralpha1 complex. In vitro, mAbs A and B similarly neutralised mIL-13-stimulated STAT-6 activation and TF-1 cell proliferation. In vivo, mAbs A and B demonstrated equipotent, dose-dependent inhibition of eotaxin generation in mice stimulated by intraperitoneal administration of recombinant mIL-13. In an allergic lung inflammation model in mice, mAbs A and B equipotently inhibited muc5ac mucin mRNA upregulation in lung tissue measured two days after intranasal allergen challenge. These data support the design of therapeutics for the treatment of allergic airway disease that inhibits assembly of the high affinity IL-13 receptor signalling complex, by blocking the binding of IL-13 to IL-13Ralpha1 and IL-13Ralpha2, or the subsequent recruitment of IL-4Ralpha.

Degradation of polychlorinated biphenyls by mixed microbial cultures.

Three different enriched mixed cultures capable of degrading polychlorinated biphenylas were isolated from two soil samples and a river sediment, respectively. The predominant organisms found in all three mixed cultures were Alcaligenes odorans, Alcaligenes dentrificans, and an unidentified bacterium. The polychlorinated biphenyl isomers that were more water soluble and had lower chlorination were not only degraded at a faster rate than those that were less water soluble and had higher chlorination, but were also more completely utilized by these mixed cultures. This resulted in the presence in the environment of polychlorinated biphenyl residues consisting mainly of higher-chlorinated isomers. A form of cometabolism of polychlorinated biphenyls was also found with these cultures in the presence of acetate as the cosubstrate.

Malignant fibrous histiocytoma metastatic to the colon presenting as a lower gastrointestinal bleed.

Primary and metastatic malignant fibrous histiocytoma of the alimentary tract is uncommon, even though it is the most frequently diagnosed malignant soft tissue tumor in adults. In this report, we describe a patient with a left gluteal malignant fibrous histiocytoma who had intermittent melena and hematochezia attributed to colon metastases, 1 yr after surgical removal of the gluteal sarcoma.

Growth hormone secretion in response to surgery. Effects of cholinergic blockade and octreotide.

Cholinergic blockade markedly reduces the growth hormone (GH) response to most stimuli, with the exception of insulin induced hypoglycaemia. We have administered the cholinergic antagonist, atropine, known to cross the blood brain barrier, to eight healthy female patients prior to elective surgery in order to investigate the role of cholinergic pathways in the GH response to surgery. Additionally, eight patients received the octapeptide analogue of somatostatin, octreotide, known to suppress GH secretion. A control group matched for age and weight received no injection. The GH response to surgery was assessed by peak values and areas under curves. Octreotide resulted in a significant inhibition of GH secretion compared with the control group (p < 0.01 for both parameters). In contrast, atropine did not significantly inhibit the GH response to surgery. In conclusion, octreotide completely suppressed GH secretion during surgery, whereas cholinergic blockade was ineffective. Thus surgery is similar to insulin induced hypoglycaemia poglycaemia in that the GH response is not decreased by cholinergic blockade.