Transcranial magnetic stimulation in the acute treatment of major depressive disorder: clinical response in an open-label extension trial.

Background: This report describes the results of an open-label extension study of active trans-cranial magnetic stimulation (TMS) in medication-resistant patients with major depressive disorder who did not benefit from an initial course of therapy in a previously reported 6-week, randomized controlled study of active versus sham TMS.

Method: Patients with DSM-IV-defined major depressive disorder were actively enrolled in the study from February 2004 through September 2005 and treated with left prefrontal TMS administered 5 times per week at 10 pulses per second, at 120% of motor threshold, for a total of 3000 pulses/session. The primary outcome was the baseline to endpoint change score on the Montgomery-Asberg Depression Rating Scale (MADRS).

The efficacy of acute electroconvulsive therapy in atypical depression.

Objective: This study examined the characteristics and outcomes of patients with major depressive disorder (MDD), with or without atypical features, who were treated with acute bilateral electroconvulsive therapy (ECT).

Method: Analyses were conducted with 489 patients who met DSM-IV criteria for MDD. Subjects were identified as typical or atypical on the basis of the Structured Clinical Interview for DSM-IV obtained at baseline prior to ECT.

Transcranial magnetic stimulation in the treatment of major depressive disorder: a comprehensive summary of safety experience from acute exposure, extended exposure, and during reintroduction treatment.

Background: Transcranial magnetic stimulation (TMS) has demonstrated efficacy in the treatment of major depressive disorder; however, prior studies have provided only partial safety information. We examined the acute efficacy of TMS in a randomized sham-controlled trial, under open-label conditions, and its durability of benefit.

Method: Aggregate safety data were obtained from a comprehensive clinical development program examining the use of TMS in the treatment of major depressive disorder.

Insulin increases nuclear protein kinase Cdelta in L6 skeletal muscle cells.

Protein kinase C (PKC) isoforms are involved in the transduction of a number of signals important for the regulation of cell growth, differentiation, apoptosis, and other cellular functions. PKC proteins reside in the cytoplasm in an inactive state translocate to various membranes to become fully activated in the presence of specific cofactors. Recent evidence indicates that PKC isoforms have an important role in the nucleus.

Antidepressant medication treatment failure does not predict lower remission with ECT for major depressive disorder: a report from the consortium for research in electroconvulsive therapy.

Objective: To test whether antidepressant medication treatment failure predicts differential remission with electroconvulsive therapy (ECT) in nonpsychotic unipolar depression.

Method: Depressed patients diagnosed with the Structured Clinical Interview for DSM-IV receiving ECT were assessed for medication use with the Antidepressant Treatment History Form (ATHF) (N = 345). Response to ECT was assessed with the 24-item Hamilton Rating Scale for Depression.

Magnetic resonance imaging features of proximal metacarpal and metatarsal injuries in the horse.

Magnetic resonance (MR) imaging abnormalities in horses with lameness localized to the proximal metacarpal or metatarsal region have not been described. To accomplish that, the medical records of 45 horses evaluated with MR imaging that had lameness localized to either the proximal metacarpal or metatarsal region were reviewed. Abnormalities observed in the proximal suspensory ligament or the accessory ligament of the deep digital flexor tendon included abnormal high signal, enlargement, or alteration in shape.

Cytosolic protein tyrosine phosphatase-epsilon is a negative regulator of insulin signaling in skeletal muscle.

Whereas positive regulatory events triggered by insulin binding to insulin receptor (IR) have been well documented, the mechanism by which the activated IR is returned to the basal status is not completely understood. Recently studies focused on the involvement of protein tyrosine phosphatases (PTPs) and how they might influence IR signaling. In this study, we examined the possibility that cytosolic PTPepsilon (cytPTPepsilon) is involved in IR signaling.

Magnetic resonance imaging features of oblique and straight distal sesamoidean desmitis in 27 horses.

Injury to the oblique and straight distal sesamoidean ligaments is becoming recognized as a more common cause of lameness in horses than was previously thought. The purpose of this study was to review the magnetic resonance (MR) imaging findings of 27 horses affected with desmitis of the oblique and/or straight distal sesamoidean ligament and determine long-term prognosis for horses with this diagnosis. Imaging was performed with horses in right lateral recumbency in a high-field 1 T magnet.

Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial.

Background: We tested whether transcranial magnetic stimulation (TMS) over the left dorsolateral prefrontal cortex (DLPFC) is effective and safe in the acute treatment of major depression.

Methods: In a double-blind, multisite study, 301 medication-free patients with major depression who had not benefited from prior treatment were randomized to active (n = 155) or sham TMS (n = 146) conditions. Sessions were conducted five times per week with TMS at 10 pulses/sec, 120% of motor threshold, 3000 pulses/session, for 4-6 weeks.

Drying a tuberculosis vaccine without freezing.

With the increasing incidence of tuberculosis and drug resistant disease in developing countries due to HIV/AIDS, there is a need for vaccines that are more effective than the present bacillus Calmette-Guérin (BCG) vaccine. We demonstrate that BCG vaccine can be dried without traditional freezing and maintained with remarkable refrigerated and room-temperature stability for months through spray drying. Studies with a model Mycobacterium (Mycobacterium smegmatis) revealed that by removing salts and cryoprotectant (e.

Benefits of an electronic consultation-liaison note system: better notes faster.

Objective: The authors determined the efficiency of electronic documentation in consultation-liaison psychiatry.

Method: An electronic note system was customized for a psychiatric consultation note. Specific attention given to common diagnoses permitted rapid documentation.

Continuation electroconvulsive therapy vs pharmacotherapy for relapse prevention in major depression: a multisite study from the Consortium for Research in Electroconvulsive Therapy (CORE).

Background: Although electroconvulsive therapy (ECT) has been shown to be extremely effective for the acute treatment of major depression, it has never been systematically assessed as a strategy for relapse prevention.

Objective: To evaluate the comparative efficacy of continuation ECT (C-ECT) and the combination of lithium carbonate plus nortriptyline hydrochloride (C-Pharm) in the prevention of depressive relapse.

Design: Multisite, randomized, parallel design, 6-month trial performed from 1997 to 2004.

Involvement of PKCalpha in insulin-induced PKCdelta expression: Importance of SP-1 and NFkappaB transcription factors.

Protein kinase C delta (PKCdelta) is a key molecule in insulin signaling essential for insulin-induced glucose transport in skeletal muscle. Recent studies in our laboratory have shown that insulin rapidly stimulates PKCdelta activity and increases PKCdelta protein and RNA levels, and that the SP-1 transcription factor is involved in insulin-induced transcription of the PKCdelta gene. Activation of SP-1 involves serine phosphorylation and translocation to the nucleus.

Evolution and expansion of the Mycobacterium tuberculosis PE and PPE multigene families and their association with the duplication of the ESAT-6 (esx) gene cluster regions.

Background: The PE and PPE multigene families of Mycobacterium tuberculosis comprise about 10% of the coding potential of the genome. The function of the proteins encoded by these large gene families remains unknown, although they have been proposed to be involved in antigenic variation and disease pathogenesis. Interestingly, some members of the PE and PPE families are associated with the ESAT-6 (esx) gene cluster regions, which are regions of immunopathogenic importance, and encode a system dedicated to the secretion of members of the potent T-cell antigen ESAT-6 family.

Activation of the nuclear transcription factor SP-1 by insulin rapidly increases the expression of protein kinase C delta in skeletal muscle.

SP-1, a ubiquitous transcription factor involved in regulation of target genes participating in specific signaling pathways, is utilized by insulin for induction of gene transcription. Transcriptional activation generally occurs only after several (14-24) hours. A major element rapidly activated by insulin in skeletal muscle is PKCdelta, which plays a positive regulatory role in insulin signaling.

Protein kinase Cdelta participates in insulin-induced activation of PKB via PDK1.

PKCdelta has been shown to be activated by insulin and to interact with insulin receptor and IRS. PKB(Akt) plays an important role in glucose transport and glycogen synthesis. In this study, we investigated the possibility that PKCdelta may be involved in insulin-induced activation of PKB.

Use of magnetic resonance imaging to diagnose distal sesamoid bone injury in a horse.

Case Description: A 5-year-old Appaloosa mare was examined for severe left forelimb lameness of 4 months' duration.

Clinical Findings: Lameness was evident at the walk and trot and was exacerbated when the horse circled to the left. Signs of pain were elicited in response to hoof testers placed over the frog of the left front hoof, and a palmar digital nerve block eliminated the lameness.

Patterns of psychotropic medication use among patients with severe depression referred for electroconvulsive therapy: data from the Consortium for Research on Electroconvulsive Therapy.

Most studies of trends in antidepressant pharmacotherapy have focused on relatively mildly ill, nonpyschotic outpatients. In this report, we provide detailed information on psychotropic use among patients with unipolar depression participating in a large, multisite electroconculsive therapy (ECT) study. Adequacy of antidepressant medication trials was assessed with the Antidepressant Treatment History Form.

Specific protein kinase C isoforms as transducers and modulators of insulin signaling.

Recent studies implicate specific PKC isoforms in the insulin-signaling cascade. Insulin activates PKCs alpha, betaII, delta and zeta in several cell types. In addition, as will be documented in this review, certain members of the PKC family may also be activated and act upstream of PI3 and MAP kinases.

Detection of an epidermoid cyst in the foot of a horse by use of magnetic resonance imaging.

CASE DESCRIPTION-A 4-year-old Quarter Horse stallion was evaluated because of a 10-month history of moderate (grade 3/5) left forelimb lameness (detectable during trotting over a smooth, hard surface). CLINICAL FINDINGS-No abnormalities were detected in either forelimb via palpation or application of hoof testers; however, lameness was eliminated after administration of a palmar digital nerve block in the left forelimb. Whereas radiography and ultrasonography did not identify any left forelimb foot abnormalities, magnetic resonance (MR) imaging revealed a circumscribed soft tissue mass in the distal aspect of the digital flexor tendon sheath (DFTS) dorsal to the lateral aspect of the deep digital flexor tendon.

Protein kinase Calpha regulates insulin receptor signaling in skeletal muscle.

Certain PKC isoforms are stimulated by insulin and interact with IR as well as with IRS, but it is still not clear if specific PKC isoforms regulate IR signaling directly or through IRS-1. PKCalpha may regulate IRS activity in response to insulin. We investigated the possibility that PKCalpha may be important in insulin signaling.

Role of protein kinase Calpha in melatonin signal transduction.

Melatonin induces nuclear exclusion of the androgen receptor (AR) via activation of protein kinase C (PKC). The specific members of the PKC superfamily involved in AR nuclear exclusion were investigated in prostate cancer PC3 cells stably transfected with the wild-type androgen receptor (PC3-AR). PKCalpha was essentially cytoplasmic whereas PKCbeta and PKCepsilon were essentially membranal, suggesting their constitutive activity in the PC3-AR cells.

Slow-frequency rTMS reduces fibromyalgia pain.

Objective: Evidence suggests that fibromyalgia (FM) is a centrally mediated pain disorder. Antidepressants, including electroconvulsive therapy, provide some symptomatic relief in FM and other pain disorders. Repetitive transcranial magnetic stimulation (rTMS) is a new antidepressant treatment, which may also be useful in treating chronic pain.

Percutaneous release of A1 pulley.

We performed 100 percutaneous releases of the trigger digits in a cadaveric model using an 18-gauge needle. Successful percutaneous release was achieved for only 59 digits (59%). No neurovascular injury occurred.