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Adenomyosis is characterized by the presence of ectopic endometrial tissue within the myometrium. Treatment options ranges from use of non-steroidal anti-inflammatory drugs and hormonal suppression for symptomatic relief, to endometrial ablation or even hysterectomy. In this paper we report the case of successful ultrasound-guided aspiration of focal adenomyosis with intracavitary alcohol instillation in a young patient with symptomatic juvenile cystic adenomyoma. This is the second report of the treatment of sclerotherapy by alcohol instillation, which may be considered as an alternative modality in treating the cases of symptomatic adenomyoma.

Our presently somewhat limited knowledge of the modulation of the content, release and turnover of endorphins in brain and pituitary by acute and chronic drug treatment is reviewed and discussed particularly in relation to the problem of addiction. In vitro studies in striatal slices and isolated anterior and intermediate/posterior lobes of the pituitary point to the existence of specific interactions between endorphins and neurotransmitters. In vivo studies have revealed acute GABA-mediated effects of benzodiazepines upon striatal levels of met-enkephalin activity. Morphine exerts no acute effects upon endorphin levels, but decreases the levels of particular endorphins in specific areas of brain and pituitary after long-term treatment; somewhat similar effects are observed after prolonged intake of ethanol, whereas chronic haloperidol treatment results in an increase in levels of endorphins in brain and pituitary. Incorporation studies employing the intermediate/posterior lobe of the pituitary have revealed that the changes in beta-endorphin levels produced by prolonged treatment with morphine or haloperidol reflect a respective depressed or enhanced synthesis of the beta-endorphin precursor pro-opiocortin, whilst the enzymatic processing of this precursor remains unmodified. Studies in cell-free preparations demonstrated that m-RNA extracted from the intermediate/posterior lobes of chronically morphinized rats possesses a decreased "activity".

A measurement protocol providing a correct adjustment of the irradiation frequencies for well separated fat and water images of the lumbar spine is presented. To determine accurately the Larmor frequencies of water and fat protons within the vertebral bodies, a volume selective spectrum of a volume element (13 mm)3 located in a lumbar vertebral body was acquired with the 90 degrees-180 degrees-180 degrees double spin-echo method. These Larmor frequencies are used to adjust the frequency-selective pulse of the SENEX chemical-shift imaging sequence. This procedure provides well separated fat and water images for a large field of view even in the inhomogeneous region of the vertebral column. Their clinical importance is demonstrated by localized Larmor frequency-guided (LLFG) SENEX 1H images of the lumbar spine in healthy persons of different age and in a patient with acute myeloid leukemia.

Abstract Treatment of rats with ethanol for 3 weeks resulted in a significant increase in δ-opiate receptor binding whereas no change in μ-opiate receptor binding was observed. Scatchard analysis showed an increase in δ-receptor affinity without a change in the receptor density. Acute treatment with ethanol did not alter receptor characteristics. The data provide evidence that δ- and μ-opiate receptor sites can be differentially modulated in vivo.

Bei 200 Patienten mit den typischen Zeichen eines organischen Psychosyndroms wurden Hirndurchblutung, cerebraler Verbrauch von Sauerstoff und Glucose sowie der zur Oxydation gelangende Glucoseanteil bestimmt. In 170 Fallen (85%) war eine dieser Grosen fuhrend herabgesetzt, bei 28 Fallen (14%) lagen gesteigerte Werte vor, bei zwei Patienten (1%) waren die Befunde normal. Lediglich in 35 Fallen (17,5%) war eine Minderung der Hirndurchblutung der fuhrende Befund. Bei 68% der von uns untersuchten Patienten waren Storungen des Hirnstoffwechsels mit einem zum Teil erheblichen cerebralen Energiedefizit vorherrschend. Das bedeutet, das beim organischen Psychosyndrom viermal haufiger cerebrale Stoffwechselstorungen im Vordergrund stehen als cerebrale Durchblutungsstorungen. Damit werden auch die aus dem psychopathologischen Bild, dem EEG oder dem Pneumencephalogramm gestellten Diagnosen „cerebrale Durchblutungsstorungen“, „cerebrovasculare Insuffizienz“, „Cerebralsklerose“ oder „Hirnarteriosklerose“ in ihrem Aussagewert zweifelhaft.

To compare magnetic resonance (MR) imaging and multidetector computed tomography (MDCT) for the assessment of myocardial infarction (MI) after alcohol septal ablation (ASA).Ten patients (mean age, 60 years ± 16) were examined with both MDCT and 1.5-T MR imaging performed 10 minutes after injection, within 3 days after ASA. Half of them had a temporary pacemaker (PM) during MDCT examination. Global image quality (IQ) and localization of MI were noticed on both MDCT and MR images. Volumes of MI, contrast-to-noise ratios (CNR) and signal-to-noise ratios (SNR) were also calculated. ASA effectiveness was evaluated by echocardiography immediately and 3 months after procedure.Global IQ was considered adequate for both procedures. In 8 patients, MI reached the basal part of the septum on both MDCT and MR images. The 2 remaining patients exhibited sparing of the basal septum on MDCT and MR images. Volumes of MI were within the same range with the 2 techniques (MDCT: 22.1 ± 8.8 mL; MR imaging: 23.8 ± 9.4 mL) and correlated well each other (R(2)=0.85, p<0.002). The 2 patients with sparing of the basal interventricular septum had persistent gradient on echocardiography 3 months after ASA, suggesting failure of the procedure. The volumes of MI didn't correlate with the reduction of pressure gradient on echocardiography 3 months after ASA (R(2)=0.02, p<0.05).Evaluation of post ASA MI is feasible with MDCT by comparison with MR imaging. MDCT might serve as an alternative imaging method in case of PM implantation.

5-Hydroxytryptamine (5-HT, serotonin) type 3 (5-HT(3)) receptors belong to the alcohol-sensitive superfamily of Cys-loop ligand-gated ion channels, and they are thought to play an important role in alcoholism. Alcohols with small molecular volumes increase the amplitude of currents evoked by low 5-HT concentrations and shift the 5-HT concentration-response curve for 5-HT(3) receptor activation leftward, indicative of increased receptor sensitivity to agonist. This action is significantly smaller when currents are mediated by heteromeric 5-HT(3AB) receptors compared with homomeric 5-HT(3A) receptors. In this study, we used the highly inefficacious 5-HT(3) receptor agonist dopamine to determine whether this difference between 5-HT(3A) and 5-HT(3AB) receptors reflects differential alcohol modulation of agonist binding affinity or channel gating efficacy. Human recombinant 5-HT(3A) and 5-HT(3AB) receptors were expressed in Xenopus oocytes, and currents were measured in the absence and presence of alcohols using the two-electrode voltage-clamp technique. Modulation by alcohols of peak currents elicited by maximally activating concentrations of dopamine was alcohol concentration-dependent. Potentiation by smaller alcohols was consistently significantly greater in 5-HT(3A) than in 5-HT(3AB) receptors, whereas inhibition by larger alcohols was not. A representative small (butanol) and large (octanol) alcohol failed to alter the EC(50) value for channel activation by dopamine. We conclude that the presence of the 5-HT(3B) subunit in 5-HT(3AB) receptors significantly reduces the enhancement of gating efficacy by small alcohols without altering the inhibitory actions of large alcohols.

Because of a controversial view on the role of smoking in the recovery process of alcoholism, outcome data obtained for alcoholics who had been included in a long-term clinical trial with a putative anticraving drug were analyzed. To avoid unknown interactions between the drug under study and smoking behavior, only placebo-treated patients were evaluated in this investigation. After 12 months of rehabilitation, there was no significant difference regarding abstinence rate between 48 smoking alcoholics (who reported that they smoked 32 cigarettes on average per day) and 15 nonsmoking alcoholics (33% vs. 20%). However, smokers tended to be abstinent longer than nonsmokers (173 vs. 114 days; P= .092). This possible advantage might be related to nicotinic effects on central dopamine systems in smokers, as indicated by higher growth hormone secretion after apomorphine stimulation obtained in smokers, compared with findings for nonsmokers (area under the curve during chronic intoxication: 2253 vs. 1247 microg/min/l; P= .019). Multivariate regression analysis revealed a decreasing effect of ethanol blood level (P= .006) and the number of fullfilled International Classification of Diseases, 10th edition (ICD-10) criteria of the alcohol dependence syndrome (P= .012) on stimulated growth hormone secretion. In contrast, the reported number of smoked cigarettes per day had an increasing effect (P= .034), accounting for 6% of the variance of growth hormone secretion. However, differences in outcome could also be explained by other clinical features as smokers, compared with nonsmokers, were more frequently males (78.3% vs. 60.7%) and younger when studied at index episode (mean age 44.45 vs. 48.21 years; P= .054), reported higher ethanol consumption in the month before hospital admission (262 g vs. 192 g; P= .044), and met more criteria for the ICD-10 alcohol dependence syndrome (6.6 vs. 6.0; P= .047). Therefore, it cannot be stringently inferred from our data that a possible advantage of smoking for alcoholism recovery is causally related to the effects of nicotine on cerebral systems or human behavior, as our findings had not been based on a randomized design.