Dextromethorphan attenuates and reverses analgesic tolerance to morphine.

Tolerance to the antinociceptive (analgesic) effect of morphine, a mu-opioid agonist, was developed in male CD-1 mice as assessed by a shift to the right of the analgesic (tail-flick) dose-response curves and an increase in the ED50 values. Administration of dextromethorphan at 30 mg/kg s.c.

The role of parkinsonism and antiparkinsonian therapy in the subsequent development of tardive dyskinesia.

Tardive dyskinesia (TD) is a side effect of prolonged neuroleptic treatment presenting as abnormal involuntary movements. This troublesome disorder occurs in only 15-30% of patients taking neuroleptics, suggesting that these individuals may be physiologically distinct so as to be predisposed. This study analyzed possible factors contributing to TD development.

Case management: a case study.

Prior to institution of case management Mr. G would have remained on the neuroscience acute care unit until nursing home placement could be arranged, a process which often took a year because of the severe shortage of Medicaid beds in South Carolina. Because case managers collaborated to identify and resolve the problem, the outcome for those such as Mr.

Photosynthesis, water relations, and growth of planted Pinus strobus L. on burned sites in the southern Appalachians.

We measured net photosynthesis, leaf conductance, xylem water potential, and growth of Pinus strobus L. seedlings two years after planting on two clear-cut and burned sites in the southern Appalachians. Multiple regression analysis was used to relate seedling net photosynthesis to vapor pressure deficit, seedling crown temperature, photosynthetically active radiation (PAR), needle N, xylem water potential, and soil water, and to relate seedling size and growth to physiological measurements (average net photosynthesis, leaf conductance, and cumulative xylem water potential), soil water, needle N, seedling temperature, and PAR.

Geographical mapping of diabetic patients from the deprived inner city shows less insulin therapy and more hyperglycaemia.

To determine whether or not economic and social deprivation were associated with different diabetic treatment and metabolic control, data of patients from deprived inner city wards and prosperous wards were compared. A database was obtained for 1528 patients attending our hospital Diabetes Care Centre. Demographic data and postcodes were used to construct geographical maps of disease and deprivation.

Neurologic pain syndromes in cancer patients.

Painful neurological syndromes in cancer patients require comprehensive clinical assessment for their accurate diagnosis. Early diagnosis of the painful neurological syndromes in cancer patients allows the clinician to target his therapy toward preventing escalating pain, disability, and further neurological morbidity. Active rehabilitation is critically important in the management of these patients with neurological pain syndromes.

Acute ethanol intoxication regulates f-met-leu-phe-induced chemotaxis and superoxide release by neutrophils and Kupffer cells through modulation of the formyl peptide receptor in the rat.

This study was performed to assess alcohol-induced alterations in superoxide release and chemotaxis by Kupffer cells and blood neutrophils. Male Sprague-Dawley rats received a bolus injection of alcohol (1.75 g/Kg) followed by an intravenous infusion (250-300 mg/Kg/hr).

Tendon jerks in Parkinson's disease.

Tendon reflexes were examined in 119 patients with idiopathic parkinsonism (IP) and 40 spouse controls to estimate the type and frequency of any alterations in the reflexes. Forty one of 119 patients and 2 of 40 controls had reflex ratings of 3+ at two or more sites (p < 0.001).

The NMDA receptor antagonists, LY274614 and MK-801, and the nitric oxide synthase inhibitor, NG-nitro-L-arginine, attenuate analgesic tolerance to the mu-opioid morphine but not to kappa opioids.

Once daily s.c. administration of 5 mg/kg morphine, a mu-opioid agonist, or U50488H (U50), a kappa 1-opioid agonist, for 5 days in male CD-1 mice results in a 2-3-fold shift to the right of the respective analgesic (tail flick) dose-response curves, indicating the development of tolerance.

HLA and ICAM-1 expression in alopecia areata in vivo and in vitro: the role of cytokines.

To investigate the hypothesis that aberrant HLA and adhesion molecule expression in alopecia areata (AA) are secondary to local release of interferon-gamma (IFN-gamma) or other cytokines, we have studied HLA ABC, -DQ, -DR and ICAM-1 expression by immunohistochemistry, and compared patterns of expression in lesional tissue sections with those observed in hair follicles maintained in short-term organ culture, both from normal individuals and non-lesional sites in AA patients. The organ cultures were supplemented with IFN-gamma, tumour necrosis factor-alpha (TNF-alpha), and granulocyte-macrophage colony stimulating factor (GM-CSF), in a range of doses. In lesional AA tissue sections, there was close spatial correlation of ICAM-1 with HLA-DR; prominent staining being noted in the pre-cortical matrix and dermal papilla (DP) of lesional anagen follicles.

Quantitation of NMDA receptor (NMDAR1) mRNA levels in the adult and developing rat CNS.

A rapid and sensitive solution hybridization assay was used to quantitate N-methyl-D-aspartate (NMDA) receptor mRNA levels in the central nervous system (CNS) of rat, mouse and human. A riboprobe labelled with 32P was prepared from a plasmid containing a 1413 base sequence from the cDNA for the functional rat NMDA receptor subunit, NMDAR1. Using a full length sense transcript as the calibration standard, the assay reliably measures 8 pg of NMDAR1 mRNA.

Changing ideas about family care for the elderly in Japan.

As rapid social changes occur around the world, accompanied by increasingly larger numbers of elderly in need of care, it is crucial to gain new knowledge of the relationship between changing social institutions and the impact of such changes on the context in which care is given to the elderly.In Japan, the family has tradiditnally been the context in which caregiving occurs. Although family care still remains central, 22 focus groups conducted in Tokyo in 1982 and 1990 with three different age groups (N=175) reflect the significant changes which are occurring in the traditional Japanese family system-despite important continuities-and the manner in which these changes are influencing the Japanese approach to care for the elderly.

Frequent psychiatric visitors to a Veterans Affairs medical center emergency care unit.

Objective: The study examined characteristics of patients who made repeat visits to the psychiatric emergency service of a Veterans Affairs medical center.

Methods: Computer records of patients who visited the emergency service were retrospectively examined for a one-year period after their index visit. Patients were divided into three groups according to the number of visits; nonrepeaters had only one visit, occasional repeaters had two or three visits, and frequent repeaters had four or more visits.

Isolation and characterization of fruit vacuolar invertase genes from two tomato species and temporal differences in mRNA levels during fruit ripening.

To determine the relationship between invertase gene expression and glucose and fructose accumulation in ripening tomato fruit, fruit vacuolar invertase cDNA and genomic clones from the cultivated species, Lycopersicon esculentum cv. UC82B, and a wild species, Lycopersicon pimpinellifolium, were isolated and characterized. The coding sequences of all cDNA clones examined are identical.

Hospital patient satisfaction: correlates, dimensionality, and determinants.

This paper investigates the correlates, dimensionality, and determinants of patient satisfaction in the hospital health care encounter. All of the individual hospital characteristics assessed were found to be significantly related to patient satisfaction. The findings suggest that patients evaluate hospital service quality along four distinct dimensions.

Service quality in the health care industry: how are hospitals evaluated by the general public?

This paper investigates the "expectations" aspect of service quality in the health care industry. Specifically, an examination is made of the importance of various hospital characteristics to consumers, the dimensionality of service quality, and the relative importance of these dimensions across demographic groups. The results suggest that the competency and the behavior of physicians are the most important characteristics in the minds of consumers.

Effects of gastrointestinal peptides on azoxymethane-treated colonic mucosa in vitro.

An organ-culture system has been used to investigate the effect of certain gastrointestinal peptides on the morphology and cell proliferation of explants of azoxymethane (AOM)-treated colonic mucosa. Our aim was to ascertain whether such factors play a direct part in the maintenance of hyperplastic changes in the large intestine. Explants of AOM-treated colonic mucosa from 15 animals were maintained in a serum-free medium in the presence of either gastrin-17 (250 pg/ml and 250 ng/ml), peptide YY (80 pmol/l and 160 pmol/l) epidermal growth factor (EGF) (10 ng/ml and 100 ng/ml) or the C-terminal fragment of glucagon-37 (30 pmol/l) for a period of up to 7 days.

Extensive replacement of spinal cord and brainstem by hemangioblastoma in a case of von Hippel-Lindau disease.

We report an extremely unusual case of von Hippel-Lindau disease, characterized by almost total replacement of the spinal cord and most of the medulla by capillary hemangioblastoma (CHB). A 34-year-old female presented 20 years earlier with signs of lower limb weakness. She developed progressive quadriplegia despite multiple surgical attempts to remove separate CHBs from the midthoracic and cervical spinal cord.