Correlations of health-related quality of life questionnaire results in asthma and allergic rhinitis: effects of a leukotriene receptor antagonist.

Bronchial asthma and allergic rhinitis frequently coexist. This study investigated correlations of health-related quality of life (QOL) questionnaires for these diseases, assessing whether the selective leukotriene receptor antagonist (LTRA), pranlukast, had additional benefits to overall asthma control when there was concomitant allergic rhinitis. Patients with asthma-associated allergic rhinitis were randomly allocated to either LTRA(+) (n = 21, treated for 3 months with pranlukast), or LTRA(-) (n = 8, no pranlukast). At study start and at 3 months, pulmonary function was evaluated and QOL assessments were made using the Asthma Health Questionnaire-Japan (AHQ-Japan) and the Japan Rhino-conjunctivitis Quality of Life Questionnaire (JRQLQ). Total scores were significantly correlated both before and after therapy. After 3 months' therapy, pulmonary function and total AHQ-Japan and JRQLQ scores significantly improved in the LTRA(+) group, but not in the LTRA(-) group. A significant correlation between change at 3 months in the AHQ-Japan and JRQLQ scores from baseline values was seen in the LTRA(+) group. LTRA therapy improved allergic rhinitis symptoms, asthma symptoms and pulmonary function.

Amphetamine sensitization enhances regional c-fos expression produced by conditioned fear.

Chronically administered amphetamine can result in a paranoid psychosis that can be re-induced in former amphetamine abusers by psychological stressors. In an attempt to investigate the neurobiological correlates of this phenomenon, the present study examined the effects of prior D-amphetamine sensitization on regional c-fos expression induced by a psychological stressor. Rats received intermittent footshock in a distinctive environment for 30 min/day for three days. Three days after the last fear conditioning session, the animals received injections of saline or D-amphetamine (4 mg/kg, i.p.) once every second day for 16 days (eight injections in total). After a 14-day drug abstinent period, the animals were placed in the fear conditioning apparatus but without footshock. The amphetamine sensitization procedure significantly enhanced the effects of conditioned fear on c-fos expression in several brain regions. These included the cingulate cortex area 3, agranular insular cortex (layers 2 and 3), claustrum, piriform cortex, the shell region of the nucleus accumbens, medial striatum, ventral lateral septum, and CA3 and polymorphic layer of the hippocampal formation. These results indicate that D-amphetamine sensitization can have long-lasting effects on the neural circuitries activated by conditioned stressors.

Amphetamine sensitization augments amphetamine-induced Fos expression in the lateral habenula.

Repeated amphetamine (AMPH) administration results in behavioral sensitization. To investigate the neuroanatomical basis of this phenomenon, we examined the effects of AMPH sensitization on AMPH-induced Fos expression in 24 regions of the rat brain. Rats received repeated injections of AMPH (4 mg/kg, intraperitoneally, once every other day, eight times in total) or saline (same schedule as for AMPH). After a 14-day drug abstinence period, rats were challenged with 2 mg/kg AMPH intraperitoneally. As measured by Fos immunohistochemistry, the AMPH sensitization procedure enhanced subsequent AMPH-induced Fos expression in only one structure, the medial part of the lateral habenula. These results indicate that AMPH-induced behavioral sensitization is not accompanied by widespread increases in the ability of AMPH to increase regional Fos expression in the forebrain. The lateral habenula appears to be involved in the possible neural framework that is responsible for the expression of behavioral sensitization.

Ameliorating effects of rolipram on experimentally induced impairments of learning and memory in rodents.

The effects of rolipram, a cAMP-specific phosphodiesterase (phosphodiesterase 4) inhibitor, on experimentally-induced amnesia were examined using a 3-panel runway paradigm in rats and a passive avoidance task in mice. Scopolamine, cerebral ischemia induced by four-vessel occlusion and electric convulsive shock impaired working memory in the 3-panel runway task. Rolipram at 0.1 mg/kg reduced the increase in errors induced by scopolamine or cerebral ischemia. Rolipram at 0.32 mg/kg also reduced the increase in errors induced by electric convulsive shock. Dibutyryl cAMP also had similar effects in 3-panel runway experiments. In the passive avoidance task, rolipram reversed the impairments of the avoidance response induced by scopolamine, cycloheximide and electric convulsive shock at 10, 10 and 3 mg/kg, respectively. These results indicate that rolipram ameliorates impairments of learning and memory in rats and mice, and suggest that rolipram might ameliorate the impairments of learning and memory by elevating cAMP levels.

Gastric lesions produced by conditioned emotional stimuli in the form of affective communication and effects of benzodiazepines.

Formation of gastric lesions in response to conditioned emotional stimulus (CES) and effects of benzodiazepines were studied in mice. The CES was introduced in the form of affective communication through a communication box. The "senders" were exposed to electric foot shock and the "responders" were able to receive affective cues such as visual, auditory and olfactory from "senders". The "senders" and "responders" exhibited significantly greater gastric lesions than the controls. Diazepam at doses of 2 X 1 - 2 mg/kg (p.o.) and oxazolam at a dose of 2 X 2 mg/kg (p.o.), reduced the formation of gastric lesions of the "responders" induced non-physically by CES. The present results indicate that "responders" showed bodily changes under CES treatment, particularly in the development of gastric lesions, and that gastric lesions produced by CES were protected by diazepam and oxazolam.

Effects of antianxiety and antipsychotic drugs on DRL responding for brain stimulation.

Satiated rats could be trained to give stable rates of responding for rewarding stimulation of the lateral hypothalamus delivered on differential reinforcement of low rate (DRL) schedule requiring 2 to 8 sec interresponse intervals for reinforcement (DRL-2 to 8). The performance on a DRL-8 schedule was tested 30 min after the oral administration of benzodiazepines. Diazepam (5 and 10 mg/kg) and meprobamate (200 mg/kg) caused significant increases in response rates during the first 5 min of a session, but not thereafter. Bromazepam (1 and 5 mg/kg) also caused a significant increase in the rates during the first and second 5 min. On the other hand, chlorpromazine (20 mg/kg) caused no effect in the first 5 min but decrease in second and third 5 min. These results indicate that DRL schedules with a brain stimulation reward provided a useful tool for evaluation of antianxiety drugs. The advantage of the brain stimulation reward over food reward is that the possible effects of the drugs on hunger motivation need not be considered.

Methamphetamine mortality to emotional stimuli administered in the form of affective communication.

Methamphetamine induced mortality in physically stressed and non-physically stressed mice was investigated by employing a communication box in which shocked mice communicated their distress to unshocked mice in neighboring boxes. Intraperitoneal administration of methamphetamine 30 mg/kg caused greater mortality in both the shocked "sender" mice and the unshocked "responder" mice than in control when maintained at 27 +/- 1 degree C. Forty-eight hours after injection, the "sender", "responder" and control mice showed mortality of 80, 60 and 10%, respectively. This result indicates that the mortality of methamphetamine may be potentiated not only by physical stress but also by non-physical stress.

Effects of anxiolytic drugs on escape behavior induced by dorsal central gray stimulation in rats.

Each animal was chronically implanted with bipolar electrodes in dorsal central gray matter (DCG) and was trained to press a lever to decrease the DCG-stimulation current. Chlordiazepoxide (5-20 mg/kg, PO), diazepam (2-10 mg/kg, PO) and bromazepam (1-5 mg/kg, PO) produced dose-dependent increases in the DCG-stimulation threshold 1-4 h after administration without affecting motor performance. Meprobamate (200 mg/kg, PO) and pentobarbital (10 mg/kg, PO) also slightly increased the stimulation threshold. Their potency was in the order of bromazepam greater than diazepam greater than chlordiazepoxide greater than pentobarbital greater than meprobamate. The increase in the threshold induced by diazepam (10 mg/kg, PO) was inhibited by the GABA antagonists, bicuculline (1 mg/kg, IP) and picrotoxin (0.1 mg/kg, IP). These results suggest that decreased susceptibility to brain stimulation is involved in suppressing effects of anxiolytic drugs on the escape behavior, and also that the antiaversive action of benzodiazepines may be related to a GABAergic mechanism.

Can nutrition influence circadian rhythm and heart rate variability?

Recent studies indicate that there is an interaction between biorhythms, the biological clock and triggers, which may be important in the pathogenesis of altered heart rate variability (HRV) and blood pressure variability (BPV). Circadian rhythms are under the influence of, and physiological variables are mediated by the activation of the adrenals, sympathetic/parasympathetic, hypothalamic and pituitary activity. Emotional stress, physical exertion, sleep deprivation and large fatty meals are major triggers of myocardial ischemia, angina, infarction, sudden cardiac death (SCD) and stroke. These events have been reported to exhibit a circadian variation with increased frequency in the second quarter of the day, which has also been observed in our studies on Indians. Recent studies indicate that altered HRV and BPV are also important in the pathogenesis and progression of heart failure, atheroma and thrombosis. Mediation via beta-blockers, oestrogens, n-3 fatty acids, vitamin E and coenzyme Q10 and fasting appears to have a beneficial influence whereas progestins, nifedipine, stress and exercise may have an adverse effect on HRV and BPV. We have reported that plasma levels of vitamin E and C are lower in the second quarter of the day than at other times, indicating their role in the pathogenesis of variability and cardiac events. Prospective studies also indicate that HRV and BPV are important and independent risk factors for cardiovascular events. However, no study has yet been conducted in patients with abnormal HRV and BPV in a randomized, placebo-controlled intervention trial to find out whether improvement in variability can cause a significant reduction in cardiovascular events. There is a need to study the role of n-3 fatty acids, coenzyme Q10, the effect of regular physical training, medication and ACE inhibitors in patients with abnormal HRV and BPV to demonstrate that improving variability can modulate cardiovascular events.

Alternating light-darkness-influenced human electrocardiographic magnetoreception in association with geomagnetic pulsations.

Geomagnetic variations of partly interplanetary origin, with cyclic signatures in human affairs and pathology include the incidence of various diseases, regarding which this study of healthy subjects attempted to determine an underlying mechanism by worldwide archival and physiological monitoring, notably of heart rate variability (HRV). In the past half-century, the possible health and other hazards of natural, solar variability-driven temporal variations in the earth's magnetic field have become a controversial subject in view of the inconsistent results. Some well-documented claims of associations between geomagnetic storms and myocardial infarction or stroke have been rejected by a study based on more comprehensive data analyzed by rigorous methods - covering, however, only part of a solar cycle in only part of a hemisphere. It seems possible that inter-solar cycle and geographic variability, if not geographic differences, may account for discrepancies. Herein, we examine the start of a planetary study on any influence of geomagnetic disturbances that are most pronounced in the auroral oval, on human HRV. The magnetic field variations exhibit complex spectra and include the frequency band between 0.001-10 Hz, which is regarded as ultra-low frequency by physicists. Since the 'ultra-low-frequency' range, like other endpoints used in cardiology, refers to much higher frequencies than the about-yearly changes that are here shown to play a role in environmental-organismic interactions revealed by HRV, the current designations used in cardiology are all placed in quotation marks to indicate the need for possible revision. Whether or not this suggestion has an immediate response, we have pointed to a need for the development of instrumentation and software that renders the assessment of circadian, infradian and even infra-annual (truly low frequency) modulations routinely feasible. HRV was examined on the basis of nearly continuous 7-day records by ECG between December 10, 1998, and November 2, 2000, on 19 clinically healthy subjects, 21 to 54 years of age, in Alta, Norway. A geomagnetic record was obtained from the Auroral Observatory of the University of Tromsø. First, frequency-domain measures of HRV were compared for each person in 24-hour spans of high geomagnetic disturbance versus quiet conditions. Second, cross-spectra between geomagnetic activity and HRV measures were quantified via the squared coherence spectrum using 7-day time series. A 7.5% increase in the 24-hour average of heart rate, HR (P = 0.00020) and a decrease in HRV were documented on days of high geomagnetic disturbance. The decrease in HRV was validated statistically for the 'total frequency', 'TF' endpoint (18.6% decrease, P= 0.00009). The decrease in spectral power was found primarily in the 'circaminutan frequency', 'VLF' (21.9% decrease, P< 0.000001) in conjunction with the 'minutes-to-hours' component, ultra-low-frequency, 'ULF' (15.5% decrease, P= 0.00865) and circadecasecundan 'low frequency', 'LF' (14.2% decrease, P = 0.00187) regions of the spectrum. Power-law scaling of the power spectra did not show any statistically significant difference. It is noteworthy that most of the decrease in HRV, except for the circaminutan (VLF) component, was observed only in the season in which sunshine alternated with darkness (D/L), a finding suggesting a mechanism influenced by the alternation of light and darkness. The hypothesis of a light-dark-influenced magnetoreception was also supported by cross-spectral analysis. Group-averaged coherence at frequencies coincident with the geomagnetic Pc 6 pulsations (with periods ranging from 10 minutes to 5 hours) differed with a statistical significance (P < 0.000001) among the three natural lighting conditions, the association being weaker during UL or D/D than during D/L. By contrast, no statistically significant differences were found in terms of the circadian and circasemidian frequencies in relation to the alternation of sunshine with darkness or rather circannual rhythm stage. In conclusion, evidence is provided herein that an alteration of HRV is most apparent in the circaminutan ('VLF') region, which is clinically important, because a reduction in its power is a predictor of morbidity and mortality from cardiovascular disease. The circadecasecundan ('LF') component of HRV also decreased in association with geomagnetic disturbance, which may reflect an episodic alteration of arterial pressure related to changes in geomagnetic activity. Lastly, our study suggests the existence of a light-dark-influenced magnetoreception mechanism in humans involving mainly the Pc 6 band of the magnetic field.

Behavioral suppression using intracranial reward and punishment: effects of benzodiazepines.

Rats were chronically implanted with electrodes aimed at the lateral hypothalamus (LH) and the dorsal central gray (DCG) and trained to press a lever that delivered rewarding stimulation of the LH and punishing stimulation of the DCG. In this situation, both diazepam (5-20 mg/kg, PO) and bromazepam (2-10 mg/kg, PO) caused a marked dose-dependent increase of the lever pressing response in the punished period. In addition, the facilitation of lever pressing in unpunished period was also seen in diazepam (5 and 10 mg/kg). These results show that behavioral suppression on lever pressing maintained self-stimulation reward is inducible following DCG stimulation, and that benzodiazepines exhibit an anti-behavioral suppression effect in this situation.

Experimental study on the relationship between cardiac arrhythmias and sleep states by ambulatory ECG-EEC monitoring.

The relationship between cardiac arrhythmias and sleep states was investigated in rats using the ambulatory ECG-EEG monitoring system under the 14/10 light-dark illumination schedule. Records of 14 rats obtained over 94 days were analyzed. Bradyarrhythmias (SA block and AV block) and ventricular arrhythmias [ventricular premature contraction (VPC) and short run of VPCs (ventricular tachycardia, VT)] were observed. Average number of episodes of bradyarrhythmia per day was 7.5, and the ratio of SA block to AV block was 34.9% to 65.1%. Average VPC or VT occurrence per day was 0.9 or 0.1 times, respectively. Sleep states were divided into alertness, slow-wave sleep, and paradoxical sleep, and the relationship between sleep states and arrhythmias was investigated. Bradyarrhythmias appeared predominantly during paradoxical sleep, while ventricular arrhythmias appeared during alertness as well as paradoxical sleep. Bradyarrhythmic episodes decreased by right or left vagotomy 78% or 70%, respectively. Sinus bradyarrhythmias disappeared almost completely by the right vagotomy, while the occurrence of AV block decreased by the right or left vagotomy. Circadian rhythms in arrhythmias were also analyzed by the cosine-fitting technique, and significant circadian rhythms were demonstrated in both bradyarrhythmias and ventricular arrhythmias. Acrophases were 9:56 A.M. and 1:47 A.M., respectively. Occurrence of VT was rare, but the most frequent incidental time zone was immediately following transition from light effects (rest) to dark (activity). This knowledge of circadian rhythm effects in arrhythmias must be incorporated into improved treatment of arrhythmias.

Effects of HR-592, a new derivative of indole, on conditioned behavior.

Effects of HR-592, a new derivative of indole, on conditioned avoidance and intracranial self-stimulation behavior were investigated in rats using a shuttle box and a Skinner box, respectively. The oral administration of HR-592 at doses of 3-10 mg/kg caused a dose-dependent suppression of the conditioned avoidance response. Even the escape response was slightly suppressed in the group administered 10 mg/kg of HR-592. The self-stimulation behavior was suppressed dose-dependently from 1 to 8 h after the administration of 6-10 mg/kg of HR-592. These results indicate that the action of HR-592 on conditioned avoidance response and intracranial self-stimulation behavior is similar to the action of neuroleptics.

Effect of clotiazepam on gastric mucosal lesions produced by conditioned emotional stimuli in mice.

The anti-ulcer action of clotiazepam (a thienodiazepine derivative) was studied in mice subjected to non-physical and physical stimuli in a communication box. There were two groups of mice: the "sender" mice that received electric shocks on the feet and responded by squealing and jumping, and the "responder" mice that were affected by the senders' responses without receiving shocks on the feet. Gastric ulcers resulted in both groups. The effect of clotiazepam was compared with that of diazepam. The incidence of gastric ulcers was suppressed by clotiazepam at a dose of 3 mg/kg, per os, in "responder" and "sender" mice, and by diazepam at a dose of 1 mg/kg, per os, in "responder" mice. These results suggest that clotiazepam has a suppressive action against gastric ulcers produced by non-physical or physical stimuli, although its potency is slightly weaker than that of diazepam.

[Klinefelter syndrome accompanied by hypoplasia of the bilateral internal carotid arteries--a case report].

The patient was a 31-year-old male who was admitted to our hospital due to slowly progressive weakness of the right upper limb and both lower limbs. Physical examination showed a tall stature, gynecomastia, feminine pubic hair, small penis and small testis. His intellectual function on the Kohs-cubic test scored 85, on the WAIS scored performance 80, verbal 74 and full scale 78. He showed BE mixed type in YG personality test and neurotic in CMI. No abnormalities were observed except for severe weakness of the right upper limb, moderate weakness of the bilateral lower limbs and hypalgesia in the limbs. Clinical laboratory tests revealed low blood and urinary testosterone levels, and a high blood gonadotropin level. Cytogenetic studies showed a 47, XXY karyotype. On neuroradiological examinations, there were small bilateral carotid canals in CT scan and multiple long T2 lesions in MRI. Angiography showed hypoplasia of the bilateral internal carotid arteries and dilatation of the bilateral vertebral arteries. The results of activity measurements of affected limbs using actigraph indicated that a conversion type hysteria had resulted in weakness of the limbs. There is no report of Klinefelter syndrome accompanied by the hypoplasia of bilateral internal carotid arteries, and the condition is considered to be extremely rare.

Computer analysis of Holter electrocardiogram.

Computer analysis is indispensable for the interpretation of Holter ECG, because it includes a large quantity of data. Computer analysis of Holter ECG is similar to that of conventional ECG, however, in computer analysis of Holter ECG, there are some difficulties such as many noise, limited analyzing time and voluminous data. The main topics in computer analysis of Holter ECG will be arrhythmias, ST-T changes, heart rate variability, QT interval, late potential and construction of database. Although many papers have been published on the computer analysis of Holter ECG, some of the papers was reviewed briefly in the present paper. We have studied on computer analysis of VPCs, ST-T changes, heart rate variability, QT interval and Cheyne-Stokes respiration during 24-hour ambulatory ECG monitoring. Further, we have studied on ambulatory palmar sweating for the evaluation of mental stress during a day. In future, the development of "the integrated Holter system", which enables the evaluation of ventricular vulnerability and modulating factor such as psychoneural hypersensitivity may be important.

[Cardiovascular diseases].

Death from heart disease is sometimes observed at night. Life threatening arrhythmias or ischemic heart disease are suspected to be the cause of sudden death during night. Cheyne-Stokes respiration (CSR) is frequently observed in patients with chronic cardiac failure. CSR augments sympathetic nervous activity and reduces the quality of sleep. Sleep apnea or snoring is another stressful condition during sleep. During hyperventilatory phase of sleep apnea, the blood pressure, heart rate, end-systolic ventricular volume and vosomotor tone increases, and the periodic EEG arousal patterns are observed. Sleep apnea is suspected to be one of the risk factors of hypertension. The detection and early treatment of sleep apnea or Cheyne-Stokes respiration are required to reduce the mortality due to cardiac events during sleep.

[Heart rate variability].

Heart rate variability (HRV) has become a useful parameter for the quantification of autonomic nervous function. HRV has been quantified, either by time domain or frequency domain analysis. Time domain measures, such as CVRR and RR50, are easy to calculate but they only provide information related to parasympathetic activity. The spectral analyses, on the other hand, give us information concerning 3 oscillatory components. The high frequency band (the frequency between 0.15-0.5 Hz) is known as the respiratory sinus arrhythmia (RSA), and the middle frequency band (0.88-0.15 Hz) is attributed to baroreflex components. The low frequency band (0.01-0.08 Hz) may be of various origins, such as blood flow rhythm, periodic respiration (including Cheyne-Stokes respiration), renin-angiotensin, and thermal regulation. The efferent nerve to the high frequency band is totally operated by the parasympathetic system. The low frequency band is regulated by both sympathetic and parasympathetic nervous systems. We demonstrated that the diurnal variation of HRV may afford additional information, such as ultradian changes of autonomic activity, possibly due to REM/NREM cycles. It is believed that simultaneous monitoring of other physiological parameters such as EEG, EOG, respiration, and blood pressures, might give us information concerning the dynamic nature of autonomic nervous function.

[Analysis of EEG, respiration, and ECG by 24-hour polygraphic study in a case of aortitis syndrome associated with epilepsy].

The relationships between electroencephalographic changes and cardio-respiratory responses were analysed by using 24 hour ambulatory simultaneous monitoring of EEG, respiration, ECG in a patient with aortitis syndrome. Circadian changes of "absence" attacks, effects of anti-convulsive drugs on epileptic attacks, and respiratory arrest and abnormalities of the cardiorespiratory integration were clarified.