Frequency of office blood pressure measurements and the seasonal variability of blood pressure: results of the Hungarian Hypertension Registry

PURPOSE

Hypertension is a major public health problem, thus, its timely and appropriate diagnosis and management are crucial for reducing cardiovascular morbidity and mortality. The aim of the new Hungarian Hypertension Registry is to evaluate the blood pressure measurement practices of general practitioners (GPs), internists and cardiologists in outpatient clinics, as well as to assess the seasonal variability of blood pressure.

MATERIALS AND METHODS

Omron M3 IT devices were used during four-month periods between October 2018 and April 2023 in GP practices and in hypertension clinics. The blood pressure data were then transmitted online from the monitors' cuffs to a central database using the Medistance system of Omron.

RESULTS

Family physicians (n = 2491), and internists/cardiologists (n = 477) participated in the study. A total of 4804 821 blood pressure measurements were taken during 10 four-month evaluation periods. In the ten periods, the daily average number of measurements was between 3.0 and 5.6. Following ESH diagnostic criteria, the proportion of subjects in optimal, normal and high-normal blood pressure categories were 14, 13.4 and 16.7%, respectively. Altogether 56% of the measurements belonged to stage 1, stage 2 or stage 3 hypertension categories (31.6, 17.1 and 7.4%, respectively). On average, a difference of 5/2 mmHg was observed between winter and summer data in systolic and diastolic blood pressures, respectively. The average systolic blood pressure values were higher in GP practices with more than 2000 patients than in the ones with less than 1500 patients (141.86 mmHg versus 140.02 mmHg, p < 0.05).

CONCLUSION

In conclusion, the low daily average number of blood pressure measurements indicates a limited blood pressure screening awareness/capacity in the case of Hungarian family physicians. In GP practices with more patients, blood pressure is usually less well-controlled. These results suggest that the further promotion of home blood pressure monitoring is necessary.

Higher level of physical activity reduces mental and neurological symptoms during and two years after COVID-19 infection in young women

Previous studies found that regular physical activity (PA) can lower the risk of SARS-CoV-2 (COVID-19) infection and post-COVID-19 condition (PCC), yet its specific effects in young women have not yet been investigated. Thus, we aimed to examine whether regular physical activity reduces the number of symptoms during and after COVID-19 infection among young women aged between 18 and 34 (N = 802), in which the confounding effect of other morbidities could be excluded. The average time since infection was 23.5 months. Participants were classified into low, moderate, and high PA categories based on the reported minutes per week of moderate and vigorous PA. Using the Post-COVID-19 Case Report Form, 50 different symptoms were assessed. Although regular PA did not decrease the prevalence of COVID-19 infection and PCC but significantly reduced the number of mental and neurological symptoms both in acute COVID-19 and PCC. Importantly, the high level of PA had a greater impact on health improvements. In addition, the rate of reinfection decreased with an increased level of PA. In conclusion, a higher level of regular PA can reduce the risk of reinfection and the number of mental and neurological symptoms in PCC underlying the importance of regular PA, even in this and likely other viral disease conditions.

Peer education program to improve fluid consumption in primary schools-lessons learned from an innovative pilot study

Background

Although it is widely recognized that more attention needs to be paid to children's fluid intake, there is little information on how to improve it. Peer education has been suggested as an effective approach to changing health behaviors among school children. As a new approach, our study piloted a peer education program to improve children's fluid intake in primary schools.

Methods

University students were prepared for their role as peer educators in an elective university course, including the concept of peer education and different pedagogical methods. The peer educators evaluated the training process by completing a questionnaire. The intervention took place during a School Health Day led by the peer educators. An anonymous survey with a questionnaire on knowledge of fluid intake was administered two weeks before, at the end of, and 15 weeks after the intervention. Changes in hydration knowledge were tested using repeated measures ANOVA.

Results

The pilot program showed increased knowledge about fluid consumption (p < 0.001) in lower and upper primary school children (N = 326) at the end of the School Health Day compared to pre-intervention measures. A positive change was observed after 15 weeks only in upper primary students. Feedback from peer educators was useful for fine-tuning the program.

Conclusions

This innovative program induced positive changes in knowledge about fluid intake in primary school children. The persistence of the changes differed between lower and upper primary school children. Based on the results, the intervention should be replicated to adapt the program to the needs of lower primary school children. Because the training of peer educators and the peer education program appeared to be successful, this program is worthy of international replication. This approach may also be suggested for other behavior change issues.

Organizational development and management factors involved in the prevention and effective therapy of pressure ulcers: The results of the national survey conducted among Hungarian public hospitals

The prevention of pressure ulcer (PU) or pressure injury (PI) wounds is of public health importance in developed countries, including Hungary. The study aimed to assess the PU/PI prevention and care practices of Hungarian public hospitals and identify organizational and management factors. In 2022, a national, questionnaire-based survey of inpatient institutions relevant to PU/PI care was conducted, providing a picture of the practices of 86 hospitals for the year 2019. The questionnaire was processed using descriptive statistics and regression analysis. The survey results show that good practices in Hungary are isolated, the reporting system is inhomogeneous, and documentation is not uniform across our institutional system. Of the 86 institutions, 71.0% operate a PU prevention team, 64.0% use prophylactic dressings, and 88.3% use an anti-decubitus mattress, with an average ratio of 26.1% to the number of beds. Less than half of the institutions reported the incidence of hospital acquired pressure injuries (HAPIs). In this sample, we found no significant association between hospital type and hospital size with the incidence of full-thickness HAPIs (stage III and IV wounds). Developing a comprehensive PU/PI reporting system and updating the national PU/PI prevention and care guidelines are essential in Hungary.

[Energy and nutrient intakes and their relationship to body composition in patients with celiac disease]

Bevezetés: Coeliakia esetén a szigorú gluténmentes diéta mellett nagy jelentőséggel bír az optimális testösszetétel és a kiegyensúlyozott makro- és mikrotápanyag-tartalmú étrend. Célkitűzés: Célunk volt felmérni az energia- és tápanyagbevitelt, a testösszetételt és ezek kapcsolatát felnőtt, coeliakiás betegeknél. Módszer: Kutatásunk során 47, szövettannal is igazolt coeliakiás beteg (életkor: 36 ± 11,94 év) energia- és tápanyagbevitelét vizsgáltuk 7 napos táplálkozási-tüneti napló segítségével, a testösszetételt bioimpedancia-analízissel (InBody 770) mértük. A táplálkozási naplókat a NutriComp Sport 5.10 szoftver segítségével értékeltük ki. Eredmények: A betegek étrendjének fehérje-, élelmirost-, kalcium- és telítettzsírsav-tartalma szignifikánsan eltér a referenciaértékektől (p<0,05). A régebben diagnosztizált és az új nőbetegek csoportja között szignifikáns eltérés mutatkozik a vázizomtömeg-index tekintetében (új: 7,2 ± 1,2 kg/m2 vs. régi: 8,4 ± 0,8 kg/m2, p = 0,002). A Spearman-féle rangkorreláció eredménye szerint a testtömegindex és a hozzáadott cukor energiaszázalékos értéke statisztikailag szignifikáns, pozitív gyenge korrelációt mutat (ρ(44) = 0,318, p = 0,031). A férfiak testzsírtömege és az étrend hozzáadott cukortartalma statisztikailag szignifikáns, pozitív közepes kapcsolatot mutat (ρ(8) = 0,661, p = 0,038). A nők esetében a testzsírtömeg és a rostbevitel negatív gyenge korrelációt (ρ(33) = –0,344, p = 0,043) jelez. Következtetés: Eredményeink megerősítik, hogy a coeliakiás betegek tápláltsági állapotát és tápanyagbevitelét a diagnózis felállítását követően gondosan nyomon kell követni, különösen azoknál, akiknek a testösszetétele a megjelenéskor nem megfelelő, és/vagy akiknél táplálkozási rizikó áll fenn. Orv Hetil. 2023; 164(51): 2024–2032.

Screening attendance disparities among Hungarian-speaking Roma and non-Roma women in central and eastern European countries

The Roma populations in Central and Eastern Europe are two to three times more likely to have unmet health needs compared to non-Roma residents. The aim of the present study was to investigate the disparity in screening attendance between Hungarian-speaking Roma (R) and non-Roma (nR) women in Hungary (HU-R:322; nR:294), Romania (RO-R:258; nR:183), and Slovakia (SK-R:146; nR:163), while also identifying the factors that influence attendance at any kind of screening tests in both populations. In order to examine these factors, a multiple binary logistic regression was conducted. The findings revealed significant associations between attendance at any kind of screening tests and certain factors among different groups. Among Hungarian Roma women, it was found that having a chronic disease and smoking were linked to attendance at any kind of screening tests (p = 0.009). Specifically, having a chronic disease increased the odds of attendance (OR = 1.71 [1.01, 2.90]), while smoking decreased the odds (OR = 0.57[0.365, 0.91]). In Romania, the study found that not having health insurance decreased the odds of attendance among Roma women (OR = 0.50 [0.27, 0.91]), whereas having a chronic disease increased the odds (OR = 2.87 [1.44, 5.72]) (p = 0.006). Among non-Roma women in Romania, physical inactivity was associated with a decreased likelihood of attendance at any kind of screening tests (OR = 0.48 [0.25, 0.95]). Among Slovakian Roma women, not having health insurance (OR = 0.09[0.02, 0.36]) and smoking (OR = 0.25[0.11, 0.61]) were found to decrease the odds of attendance (p < 0.001). On the other hand, non-Roma women in Slovakia with chronic diseases were more likely to attend at any kind of screening tests (OR = 2.52[1.12, 5.66]). Our research emphasizes the impact of lacking health insurance on screening attendance, particularly among the Roma population. It also highlights the significance of health-related behaviours such as smoking and physical inactivity in relation to missed screening tests, which in turn contribute to the development of non-communicable diseases. Therefore, promoting targeted screening programs for the Roma community is crucial to ensure their access to screening tests, especially in cases of chronic illnesses.

Thyroid disturbances after COVID-19 and the effect of vaccination in children: a prospective tri-center registry analysis

Rapidly evolving clinical data suggest that the novel coronavirus (SARS-CoV-2) and vaccination against COVID-19 might be associated with thyroid disturbances. However, studies remain limited among the pediatric population. Our aim was to assess the prevalence and permanence of thyroid autoimmunity (TA) and dysfunction in children after an acute infection and its potential association with vaccination. A prospective, multicenter registry analysis was performed among 458 children (mean age: 12.4 ± 3,8 years, 45.4% male) with preceding COVID-19. Patient inclusion lasted from 24th March, 2021 to 23rd March, 2022 at three pediatric outpatient facilities at Semmelweis University, Budapest. Primary outcomes were the rate of thyroid disturbances assessed by laboratory parameters (thyroid function tests, antithyroglobulin [ATG] and anti-thyroid peroxidase [ATPO] antibodies) and thyroid ultrasound. TA rate among vaccinated and unvaccinated children was determined. Children with newly diagnosed thyroid alterations were followed up for 12.7 ± 4.3 months. Six children had previous thyroid disease. Out of 452 children, 30 cases (6.6%) of newly diagnosed TA (six of them had abnormal thyroid-stimulating hormone [TSH] levels) and eight cases (1.8%) of isolated TSH elevation were observed. Ultrasound-proven autoimmune thyroiditis (AIT) was 4.0%. No association was found between COVID-19 vaccination and thyroid autoimmunity (χ2(1,N = 452) = 0.138, p = 0.815). Among children with TA, 73.3% had long-lasting alterations.  Conclusion: Vaccination had no effect on the prevalence of TA. Until further controlled studies state otherwise, children with preceding COVID-19 might benefit from thyroid screening. What is Known: • Numerous case reports implicate that coronavirus disease-2019 (COVID-19) and vaccination against SARS-CoV-2 can be responsible for thyroid disturbances. • Thyroid alterations discovered during acute COVID-19 tend to cease by time and only incidental thyroid autoimmunity (TA) is diagnosed after COVID-19. In adults, no increase in vaccine-related hyper- or hypothyroidism was found. What is New: • TA rate after COVID-19 vaccination among children was not increased. TA had no role in long COVID syndrome. • We discovered a considerable rate of TA (6.6%) and ultrasound-proven autoimmune thyroiditis (AIT) (4.0%) after SARS-CoV-2 infection, and the majority of these alterations remained positive after 6 months.

A large sample cross-sectional study on mental health challenges among adolescents and young adults during the COVID-19 pandemic at-risk group for loneliness and hopelessness during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has posed unprecedented challenges for societies. Emerging data have indicated that the younger population are the most vulnerable group to the development of mental health problems during this pandemic. The present study aimed to examine the effects of the changes in health behaviors on mental health problems to identify an at-risk group among adolescents and young adults.

METHODS

In the present cross-sectional study, secondary school students (N = 2556) ages 15-21 years participated in Hungary. A self-report questionnaire was developed to measure the changes in health behaviors. Mental health problems were measured by the Beck Hopelessness Scale and the 20-item UCLA Loneliness Scale.

RESULTS

A significant proportion of the students showed moderate/severe hopelessness or high loneliness which were more pronounced among adolescent females. An at-risk group was identified among adolescents and young adults. Students who have a lower number of friends, spend less time in front of a screen, and feel lonely often/very often are more likely to have moderate/severe hopelessness with high loneliness.

LIMITATIONS

All data were collected online, and students completed the questionnaires voluntarily. Cross-sectional, non-preregistered study.

CONCLUSIONS

Loneliness and hopelessness were prevalent in the young population during the COVID-19 pandemic. The at-risk group of adolescents characterized by moderate/severe hopelessness with high loneliness highlights the need for follow-up mental health to avoid future poor mental and physical health. It is also recommended to develop effective interventions targeted to gender and age, with the promotion of resiliencies and buffers against vulnerabilities of negative life events.

The Effects of a Cyberbullying Intervention Programme Among Primary School Students

Background

With the increase of cyberbullying, several intervention programmes have been created that aim at reducing cyber-victimisation and perpetration.

Objective

Our study presents the effects of the STAnD anti-cyberbullying programme with peer-education both on the short and the long run among lower and upper primary school students, with a focus on the participants' cyberbullying roles.

Method

The sample comprised of 536 students who participated in the intervention programme, involving 36% lower and 64% upper primary school students. Participants were measured by a self-reported questionnaire before and right after the programme, then six months later.

Results

The main effect of the STAnD programme was a positive change in the participants' willingness to engage in help-seeking and their active-defending reaction, although this effect decreased after six months. The changes were larger among lower primary school students compared to upper primary school participants.

Conclusion

Our results imply that long-lasting and intensive health promotion programmes are necessary to reach a long-term intervention effect. Anti-cyberbullying programmes should take into consideration participants' involvement and roles in cyberbullying. As our study was a non-randomised uncontrolled study design, thus interpretation of the effectiveness of the programme is limited.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10566-022-09714-9.

A fizikai aktivitás és a szubjektív egészségi állapot értékelése magyar középiskolások körében a COVID–19-pandémia okán elrendelt távoktatási időszakban

Összefoglaló. Bevezetés: A SARS-CoV-2-világjárvány idején a középiskolai oktatás távoktatás formájában zajlott világszerte, így Magyarországon is. A csökkent fizikai aktivitás és az inaktív viselkedésmódok növekedése az elhízás, a cukorbetegség és a szív- és érrendszeri betegségek fokozott kockázatához vezet. Célkitűzés: Vizsgálatunk a fizikai aktivitás (aerob testmozgás, izomerősítés, csapatsportok) és az egészségi állapot szubjektív megítélésének változásaira irányult serdülőknél és fiatal felnőtteknél a világjárvány alatt. Módszer: Középiskolás diákokat kérdeztünk meg 37 magyarországi város 66 állami iskolájában (n = 2508). A fizikai aktivitásra és az egészségi állapot szubjektív megítélésére vonatkozó kérdőíves tételeket a WHO Health Behaviour of School-aged Children Survey és a Centers for Disease Control and Prevention Youth Risk Behavior Survey felméréséből vettük át. 2 × 2 × 4 faktoriális ANCOVA-t használtunk a nem és/vagy az életkor, illetve a régiók hatásának tesztelése céljából a fizikai aktivitás és az egészségi állapot szubjektív megítélésének változásaira, a távoktatási időszak előtt és alatt. Eredmények: A középiskolás diákok többsége kevesebb fizikai aktivitást jelzett, a fizikai aktivitás gyakoriságának csökkenése volt jellemző a távoktatás időszakában. Átlagosan heti 2–3 nappal kevesebbszer végeztek fizikai aktivitást régiótól függetlenül. Közel egynegyedük az egészségi állapotát rosszabbnak minősítette a távoktatás alatt, mint előtte. Az egészségi állapot szubjektív csökkenéséről nagyobb arányban számoltak be azok, akik a fizikai aktivitásukban is csökkenést jeleztek. Következtetés: A távoktatás időszakában tapasztalható csökkenés a fizikai aktivitás gyakoriságában együtt jár az egészségi állapot szubjektív megítélésének csökkenésével, különösen a lányok, a vidéken élők és a serdülő korú személyek körében. Orv Hetil. 2022; 163(17): 655–662.

Summary. Introduction: High school education took place in the form of distance learning during SARS-CoV-2 pandemic worldwide, including Hungary. Decreased physical activity and an increase in inactive behaviours may lead to an increased risk of obesity, diabetes, and cardiovascular disease. Objective: Our study focused on changes in physical activity (aerobic exercise, muscle strengthening, team sports) and subjective perceptions of health status in adolescents and young adults during the pandemic. Method: High school students in 66 public schools in 37 cities in Hungary (n = 2508) were surveyed. Questionnaire items on physical activity and subjective perceptions of health were adapted from the WHO Health Behaviour of School-aged Children Survey and the Centers for Disease Control and Prevention Youth Risk Behavior Survey. 2 × 2 × 4 factorial ANCOVA was used to test the effect of gender and/or age and region on changes in subjective perceptions of physical activity and health before and during distance education. Results: The majority of the high school students reported a decrease in physical activity frequency during the distance learning period, with an average of 2–3 fewer days of physical activity per week regardless of region. Nearly a quarter of them rated their health as worse during distance learning than before. A higher proportion of those who reported a subjective decline in health also reported a decline in physical activity. Conclusion: A decline in physical activity during the period of distance learning is associated with a decline in subjective perceptions of health, especially among rural adolescent girls. Orv Hetil. 2022; 163(17): 655–662.

Differentiating sepsis from similar groups of symptoms at triage level in emergency care

OBJECTIVES

Conditions that have similar initial presentations as sepsis may make early recognition of sepsis in an emergency room (ER) difficult. We investigated whether selected physiologic and metabolic parameters can be reliably used in the emergency department to differentiate sepsis from other disease states that mimic it, such as dehydration and stroke.

METHODS

Loess regression on retrospective follow-up chart data of patients with sepsis-like symptoms (N = 664) aged 18+ in a large ER in Hungary was used to visualize/identify cutoff points for sepsis risk. A multivariate logistic regression model based on standard triage data was constructed with its corresponding receiver operating characteristic (ROC) curve and compared with another model constructed based on current sepsis guidelines.

RESULTS

Age, bicarbonate, HR, lactate, pH, and body temperature had U, V, W, or reverse U-shaped associations with identifiable inflexion points, but the cutoff values we identified were slightly different from guideline cutoff values. In contrast to the guidelines, no inflexion points could be observed for the association of sepsis with SBP, DPB, MAP, and RR and therefore were treated as continuous variables. Compared to the guidelines-based model, the triage data-driven final model contained additional variables (age, pH, bicarbonate) and did not include lactate. The data-driven model identified about 85% of sepsis cases correctly, while the guidelines-based model identified only about 70% of sepsis cases correctly.

CONCLUSION

Our findings contribute to the growing body of evidence for the necessity of finding improved tools to identify sepsis at early time points, such as in the ER.

A De Quervain-féle tendinopathia kezelése konzervatív módszerekkel

Bevezetés: A De Quervain-féle tendinopathia a csukló-kéz régióját érintő betegség. A hüvelykujj mozgatása fájdalmassá válik, a kéz funkciója jelentősen romlik. A betegség a legújabb kutatások szerint inkább degeneratív, semmint gyulladásos eredetű. Első lépésként a kéz sínezése, nemszteroid gyulladáscsökkentő szerek és különböző fizikoterápiás kezelések alkalmazása javasolt. Hatástalanságuk esetén további lehetőség az ínhüvelybe fecskendezett szteroidinjekció és a műtéti úton végzett ínhüvelybemetszés. Célkitűzés: Kutatásunkban megvizsgáltuk, hogy az excentrikus tréninggel kibővített konzervatív kezelés megfelelő alternatíváját nyújthatja-e a jelenleg elfogadott kezelési lehetőségeknek. Módszer: Az excentrikus tréning 8 hétig tartott, melyet indokolt esetben 12 hetesre bővítettünk. A betegek (n = 9) a betanítást követően naponta többször végezték a tréninget, amit a heti találkozók alkalmával kontrolláltunk. Az 1., a 8., valamint a 12. heti találkozó során az inspekciót követően mértük az ízületi mozgástartományt, az izomerőt, a fájdalmas régiók számát, illetve elvégeztük a ’Numeric Pain Rating Scale’, a ’Quick Disabilities of the Arm, Shoulder and Hand’, valamint a ’Patient-Rated Wrist Evaluation’ kérdőívek felvételét. A méréseket páros mintás t-teszttel és ismételt méréses varianciaanalízissel elemeztük. Az elemzéseket IBM SPSS Statistics 25.0 és Microsoft Office Excel Professional Plus 2016 programmal végeztük; p<0,05 esetén tekintettük statisztikailag szignifikánsnak eredményeinket. Eredmények: Szignifikáns javulást mértünk a fájdalom intenzitása (’Numeric Pain Rating Scale’ p = 0,005, n = 9) és a kéz, valamint a csukló funkciója terén (’Quick Disabilities of the Arm, Shoulder and Hand Outcome Measure’ kérdőív 1. rész p<0,001, 2. rész p<0,001, ’Patient-Rated Wrist Evaluation’ kérdőív p<0,001; n = 9). Következtetés: Eredményeink alapján megfelelő betegbeválasztás mellett az excentrikus tréninggel kibővített konzervatív kezelés valós alternatívája lehet a jelenleg alkalmazott kezeléseknek. Orv Hetil. 2020; 161(11): 419–424.

Health related behaviours of secondary students living in dormitory in Hungary

Background

Previous studies have shown that unhealthy eating habits and lack of exercise are still widespread among high school students. Hungary and many other countries have attempted to introduce campaigns and health education programs among adolescents to promote healthier lifestyle, but the effectiveness of these programs is unclear. Our aim was to investigate the consistency between knowledge and behavior in adolescents.

Methods

A self-administered questionnaire survey was conducted in 9 secondary schools’ student dormitories, involving 163 students. Descriptive statistics were estimated and chi2- test was used to compare the prevalence between groups.

Results

Of the participants 69.3% reported their health status good, girls and those students who studied in vocational school frequently considered their own health bad (p = 0.002). Almost all of them highlighted the importance of regular physical activity, but 27.7% had low physical activity. Daily consumption of fruit and vegetables seems to be characteristic just half of the students, the structure of their daily snacks consists more in sugar-sweetened snacks (21.7%) and energy dense beverages (22.8%). Students with higher level of health-consciousness rated better their own health status and took exercise more frequently, but the higher level of health-consciousness had not positive effect on the healthy food consumption (p = 0.143).

Conclusions

Our findings suggest lack of exercise and unhealthy eating habits were still widespread among high school students. The results of the study showed that adolescents have sufficient knowledge about healthy lifestyle, however, it has little impact on their health-related behaviour.

Key messages

The most important characteristic of an effective health promotion programme is its ability to change behaviour. Health promotion programmes should continue in schools, especially focus on behaviour changing interventions to effectively influence the health of the students.

[The role of regular physical activity in the prevention and intervention of symptoms of anxiety and anxiety disorders]

Anxiety disorders are the most common mental illness, but are not uniform, many clinical diagnoses include the symptoms of anxiety. That is the reason why there are relatively small numbers of population surveys and randomized-controlled trials which have examined the relationship between exercise and the various anxiety symptoms/ disorders. In our review we summarize meta-analytic studies, epidemiological surveys and randomized controlled studies which examine the role of regular physical activity in the prevention and treatment of subclinical anxiety/anxiety symptoms and anxiety disorders. The meta-analytic studies and randomized-controlled trials examining the relationship between subclinical anxiety disorders and anxiety symptoms demonstrated small to moderate effect of exercise in the decrease of anxiety symptoms, especially for moderate-intensity exercise. This relationship was confirmed for both acute and chronic exercise, for state and trait anxiety in different sex, age and state of health groups. In the case of the anxiety disorders based on reviewed studies, we can conclude that there is a potential association between decreased symptoms of anxiety and exercise. The regular, moderate-intensity exercise can reduce and alleviate the symptoms of anxiety - at least in panic, agoraphobia and generalized anxiety disorders. The reviewed studies have been highlighted the fact, that exercise can be effective in psychiatric practice as an alternative or adjuvant therapy. Physically healthy people with anxiety symptoms, or patients with anxiety disorders can perform exercise, there are no contraindications. Although based on previous studies, we cannot assume that the relationship is causal, but we cannot ignore the evidences that are already available.

Diagnosis of primary insomnia by actigraphy--improved results by data selection

STUDY OBJECTIVES

In spite of the useful information provided by actigraphy in sleep medicine it is still not an independent tool either in the clinical diagnosis or in the follow-up. In the frame of a retrospective study, a simple new method of data reduction was applied with the aim of improving the clinical impact of actigraphy for the diagnosis of primary insomnia.

METHODS

Actigraphic records with a duration of 1 week produced on 47 subjects who met the inclusion-exclusion criteria. The daily activities during the investigational period were registered by means a self-completed questionnaire. Three parameters (sleep latency, sleep fragmentation and sleep efficiency) and only their three 'worse - as regards insomnia' daily values were analyzed statistically. The study participants comprised 13 healthy controls, 17 healthy 'bad sleepers' and 17 subjects with primary insomnia.

RESULTS

The post-hoc tests did not reveal statistically significant difference in the three parameters between the healthy and 'bad sleeper' groups, but these two groups differed statistically from the primary insomnia group.

CONCLUSION

The actigraphic analysis of sleep latency, sleep fragmentation and sleep efficacy allows a significant differentiation between subjects with primary insomnia and healthy controls, but not between healthy controls and healthy 'bad sleepers'. Statistical algorithms indicated 'models' for clinically good and bad sleepers. Further studies on large populations are necessary before this method can be introduced in the routine medical care of individuals with primary insomnia.

[Regular physical activity and mental health. The role of exercise in the prevention of, and intervention in depressive disorders]

In our review we examine the relationship between physical activity and mental health; especially we determine the effectiveness of exercise in the prevention and treatment of depression. Over the past two decades the literature in the area of physical activity and mental health has been growing. However it seems that the findings and evidences not being utilized by mental health agencies and health practitioners. Depression is the most common disorder in the world, generally has a higher prevalence among women. In our study we overview and demonstrate that the exercise is a powerful intervention for prevention and treatment not only in non-clinical but also in clinical levels of depression. In sub-clinical levels of depression the meta-analytic findings and population surveys suggest that the exercise is associated with a significant moderate reduction of depression in different groups by gender and age; as well as a physically active lifestyle associates with lower levels of depression. In clinical levels of depression the physical activity is an effective tool in the prevention, studies support an association between higher levels of physical activity and lower levels of depression. In the treatment of clinical depression the randomized-controlled trials suggest the clear positive effects of exercise. This effect is similar to psychotherapeutic interventions and it was appeared under relatively short time (4-8 weeks). The exercise is one of the most important preventive health-related behaviors. Our review suggests a protective effect from activity on the development of clinical levels of depression and depressive symptoms. In addition the randomized controlled trials support a causal connection between exercise and reduction of depression. In sum the reviewed studies clearly support the antidepressant effect of exercise.

Effects of Stigmatization on Gay Men Living with HIV/AIDS in a Central-Eastern European Context: A Qualitative Analysis from Hungary

This qualitative study highlights the social dynamics affecting people living with HIV (PLH) in Hungary and in the Central-Eastern European region. The study focused on the special needs and concerns of men living with HIV/AIDS as well as changes in their social relationships and institutional support provision, coping strategies and patterns of social functioning, especially in the context of social stigmatization. Consistent with international qualitative research findings in the field of HIV/AIDS prevention, the present study contributes to a fuller understanding of relationship between sexual behavior, HIV/AIDS related risks and risk perceptions as well as homosexuality-and HIV/AIDS stigma-related social exclusion in a previously under-researched socio-cultural setting. The findings of our study point to several barriers to effective HIV prevention, which should be overcome to improve the present situation by lessening the adverse effects of HIV/AIDS-and homosexuality-related stigma within the gay community, the general population and especially among service providers. One of the main barriers is the lack of public health programs specifically targeting MSM in Hungary, where the predominant mode of HIV transmission remains sex between men.

Making soil containing numerous eggs of WCR for greenhouse and laboratory experiments

In the course of our work we often faced to the problem that WCR lays its eggs unevenly (Berger, 2008) so it is impossible to find soils under field circumstances which contains eggs in homogenous distribution and in large numbers. Owing to the inhomogeneous distribution and low number of eggs it is quite difficult to study the effectiveness of soil disinfectant and seed-dressing insecticides on larvae of WCR in pot experiments. Therefore, the aim of our studies was to gain soil samples with known quantity and distribution of eggs. According to our prevailing idea, numerous adults are placed into a relatively small place under ideal environmental conditions and a small quantity of soil is provided for them to lay eggs.

Postnatal expression of Doublecortin (Dcx) in the developing cerebellar cortex of mouse

We have investigated the expression of Doublecortin (Dcx) protein in the developing cerebellum of mouse from postnatal 2nd day to postnatal 22nd day and in young adults by immunohistochemistry. Strong expression of Dcx was present in the inner zone of the external granule cell layer, and remained strong while postmitotic granule cell precursors were present in this transitory layer. Descending granule cell precursors exhibited Dcx immunostaining not only while migrating but for a short time also after their settlement. Dcx-immunostained cells appeared in deep cerebellocortical territories and in the cerebellar white matter during the first postnatal week. These bipolar cells were arranged in the sagittal plane and built up transitory migratory streams during the second postnatal week and their number gradually decreased during the third postnatal week. Upward migration of bipolar cells was observed while leaving the migratory streams, penetrating the internal granule cell layer and the molecular layer. These cells were considered as precursors of late migrating molecular layer interneurons. However, a proportion of Dcx-immunostained cells underwent a bipolar-to-multipolar dendritic remodellation and - on the basis of strong morphological similarities - was taken for "multipotent progenitor cells", described recently in the neocortex of adult rat.

Calretinin‐immunoreactive unipolar brush cells in the developing human cerebellum

We have studied the temporal and spatial characteristics of the development of unipolar brush cells (UBCs) in the human cerebellar vermis. Consistently with previous studies in rodents and cat, we have found that unipolar brush cells appear at a relatively late phase of cerebellar development and their development continues up to and beyond the first postnatal year. A series of 23 normal human brains, including 5 adult and 18 fetal or infant brains (between the 24th gestational week and the 11th postnatal month) were used. In order to visualize unipolar brush cells, calretinin-immunocytochemistry was performed on formaldehyde-fixed, paraffin-embedded blocks of the cerebellar vermis. Our results show that calretinin-immunoreactive unipolar brush cells are not yet present in the cerebellar vermis at the 28th gestational week. At birth, they are present in a relatively small number, mostly in the vestibular lobules. At the 3rd, 5th, 8.5th and 11th postnatal months the number of calretinin-immunoreactive unipolar brush cells gradually increase, first appearing in the vestibular lobules, followed by the invasion of the later developing vermal lobules, spreading in a rostro-caudal and proximo-distal direction. Although at the 11th postnatal month unipolar brush cells exhibited adult-like morphological and distributional features, their number appeared to be lower than in the adult cerebellum. The late maturation of unipolar brush cells implies that the cytoarchitectonical development of the human cerebellum is not completed by the end of the first postnatal year.

Delayed postnatal settlement of cerebellar Purkinje cells in vermal lobules VI and VII of the mouse

The postnatal development of the ganglionic (Purkinje) layer was studied in the mouse cerebellum from P0 to young adulthood with special emphasis to vermal lobules VI-VII (oculomotor vermis) in the mouse. In order to visualize Purkinje cells (PCs), toluidine blue staining of resin-embedded semithin sections and calbindin immunohistochemistry were utilized. The number of PCs in the whole cerebellum was 199,080+/-2966 at postnatal day eight (P8), 222,000+/-2979 at P20 and nearly the same, 225,800+/-7549 in young adults; i.e., there was an approximately 13.4% increase of PCs between P8 and adults. The number of PC somata aligned into a rostrocaudal stripe along the developing ganglionic layer increased by about 24% in vermal cerebellar lobule III but much more markedly (i.e., by 49%) in VI+VII between P6 and young adulthood. Between P6 and P16, the increase of the number of PCs in the ganglionic layer of lobules VI and VII resulted in the (delayed) completion of PC layer, caused by the (late) alignment of rostrocaudally dispersed PCs, although late postnatal migration of a smaller population of these cells cannot be excluded either. It is concluded that the oculomotor vermis belongs to the latest developing cerebellar cortical structures, which could be the reason for its frequent involvement in developmentally related disturbances and disorders.

Quick scouting of eggs of western corn rootworm (Diabrotica virgifera virgifera LeConte, 1868) from soil

Main method to control the American Corn Rootworm is crop rotation (Camprag et. al., 1994) but we don't know how to determine the possible number of larvae under fall so we cannot use autumn cereals to change the row of cultivated plants. The pest spends almost 10 months in soil in egg and larval state (Chiang, 1973). There are two methods for scouting Diabrotica eggs and larval instars from soil over the winter. One of the two most important methods is holding soil samples on fixed temperature (Fromm et al., 1999). This method takes more than one and a half month but its result is highly reliable. The conventional egg-washing technique takes fewer days to count the number of Diabrotica eggs in soil but it has lower effectiveness than the other one because the eggs in a sample cannot be counted correctly. Our results show that the effectiveness of egg washing with high concentrated salty water (NaCl) is high and the method is quick enough to help planning the crop rotation even under the autumn period (Takács et al., 2004).

Quantitative analysis of the postnatal development of Purkinje neurons in the cerebellum of the cat

We have studied the postnatal quantitative changes of cortical Purkinje neurons in the cerebellum of the cat at the following postnatal groups of age: P0, P42, P72 and adults. An unbiased counting method, the optical fractionator was used for the estimation of Purkinje cell numbers. A significant increase of Purkinje cell number was found between P0 (1.097 x 10(6)) and P42/P72 (1.805 x 10(6) and 1.895 x 10(6)) declining to 1.429 x 10(6) in the adult, still 30% higher than in the newborn. It was also observed that during the first few postnatal weeks large "gaps" were present in the Purkinje monolayer as revealed by Nissl staining and metabotropic glutamate receptor 1alpha immunocytochemistry. These Purkinje cell gaps were observed most frequently in well-definable areas, especially in the intermediate zone of the neocerebellum. Simultaneously with the numerical increase of Purkinje neurons between the P0 and P72 age groups, these gaps disappeared after the third postnatal week resulting in the completion of the Purkinje monolayer in the whole cerebellum.

Effective control method of larvae of Diabrotica virgifera virgifera Leconte

Larvae of WCR are feeding on the roots of corn while plants fall down. The egg hatching is continuous and soil insecticides are not effective to kill larvae. Unfortunately the recent control methods while we incorporate disinfectors Into the soil under seeding are not able to give enough effect on larvae of WCR under the whole period of larval development. We use to saw corn in the middle of April but eggs hatching start in the middle of May. The effectiveness of insecticides takes about one month so they are not able to protect plants from larvae are feeding on roots (Luckman et al., 1974 and Luckmann et al., 1975). They cause yield losses or in case of plant fall we can not harvest the corn. We have tested a material in greenhouse screening and field trips that is able to absorb insecticides and bind them into its body. This material is able to emit the agents continuously under the vegetation and we can protect our plants against the damages of WCR larvae. Our results shows that the material is able to elongate the effectiveness of the pesticides over 60 days and able to push the number of larvae under the economical threshold.

The ecological study of cotton bollworm (Helicoverpa rmigera Hubner 1808) in Hungary

The cotton bollworm (Helicoverpa armigera Hbn.) is a poliphagous pest. Caterpillars feed on flowers, crops and seeds. In 2001 the meaningful catching-period was in August (Szeoke, 2001). In 2003 we detected the swarming already in June. We observed many caterpillars on its nutritive crops. It caused significant economic damage in this year. 1ST EXAMINATION: We collected larvae and reared pupae out of it in a pot. We took it into the soil. The swarming of the moths from the pots was in June. The mortality was high, more than 90%. 2ND EXAMINATION: We made cold tests with pupae. We examined 5 x 10 pupae in three treatments. In the first treatment we reduced the temperature to -2 degrees C for 4 weeks. 92% of the pupae survived this cold. In the second treatment we reduced the temperature to -2 degrees C for 3 weeks and to -7 degrees C for 1 week. 86% of the pupae survived this procedure. In the third treatment we reduced the temperature to -2 degreesbC for 3 weeks and -15 degrees C for 1 week. 100% of the pupae were perished. 3RD EXAMINATION: In the first treatment we raised caterpillars on 13 hours lighting and 24 degrees C. The swarming was from 20th April to 4th May 2004. In the second treatment we reared the worms on 20 hours lighting and 18 degrees C. The main swarming was on 3rd January 2004. So we could say that the cotton bollworm has diapause. The more effective factor of the diapause is the length of the lighting.

Number of GABA immunonegative and GABA immunopositive neurons in human epileptic temporal cortex

The number of neurons, both GABA immunopositive and immunonegative, was determined in temporal epileptic foci of 7 patients after temporal lobectomy, and compared to neuronal numbers in temporal cortex of two controls taken from tumor operated patients. The thickness of the cortex of the epileptic cortex diminished by about 10%, while the number of nerve cells decreased to 67% of that of the control value: it was 19.000/mm(3) vs. 28.000/mm(3) found in the control. This decline was due to cell degeneration, which, however, was more severe for non-GABAergic nerve cells. Accordingly, the proportion of the GABA-positive neurons in the otherwise diminished neuronal population increased to 36.4% from the 32% control value. The number of GABAergic terminals, however, decreased even further, explaining the resulting disinhibition during epileptic seizures.

Morphological study of organotypic cerebellar cultures

Organotypic cerebellar cultures from 8-days-old (P8) mouse pups were studied following 11 days of in vitro (I IDIV) culturing. The cerebellar cytoarchitectonic structure was maintained in most parasagittal cerebellar cortical slice cultures (also containing the deep cerebellar nuclei). The two main extrinsic excitatory inputs (the climbing and the mossy fibers) seem to be replaced by other axonal types: in the molecular layer mostly by parallel fibers (for climbing fibers) and in the granular layer by intrinsic mossy fiber collaterals of local excitatory interneurons, the unipolar brush cells. However, in a few organotypic cultures, which (although preserving the trilaminar cerebellar cortical structure) were "granuloprival" but also contained some of the deep cerebellar nuclei, the participation of extracortical axons from the deep cerebellar nuclei in the replacement of the missing afferents is suggested.

3,8-diazabicyclo--[3.2.1]-octane derivatives as analogues of ambasilide, a Class III antiarrhythmic agent

Ambasilide, a representative of Class III antiarrhythmics, was reported to prolong the cardiac action potential duration in the dog, with little or no effect on Ca and Na currents. We synthesised a series of ambasilide analogues, having the 3,8-diazabicyclo-[3.2.1]-octane moiety instead of the 3,7-diazabicyclo-[3.3.1]-nonane present in ambasilide. The compounds were tested both in vitro extracellular electrophysiological assays and by the conventional microelectrode technique. Most of them lengthened the effective refractory period (ERP) with no change or slight increase on the impulse conduction time (ICT). Similarly some of the tested compounds lengthened the action potential duration (APD), a typical Class III feature, without exerting any significant effect on the maximal rate of depolarization, therefore apparently lacking Class I antiarrhythmic activity.

[Effectiveness of Lisinopril in the treatment of heart failure]

A prospective study was performed in patients (30 M, 16 F, mean age of 56.0 +/- 9.2 [42-73] years) with congestive heart failure to assess the efficacy of lisinopril during a 16 weeks treatment period. Changes in clinical signs, functional capacity, blood pressure, heart rate, echocardiographic parameters, exercise duration, laboratory data and quality of life were measured. After a 2-week run-in period starting daily dose of study drug was 5 mg, and an increase of medication was considered at 4 weeks. At the end of the study mean daily dose of lisinopril was 15.1 +/- 6.2 mg. Improvement of NYHA status by 2 grades was observed in 4 cases (9%), by 1 grade in 24 cases (51%), there was no change in 17 cases (38%), and worsening was observed in 1 case (2%). During the study both systolic (p = 0.001) and diastolic blood pressure (p = 0.0006) decreased significantly, the changes in pulse rate were not significant. Left ventricular end systolic (p = 0.001) and end diastolic (p = 0.003) dimensions decreased, ejection fraction rose by 4.4% (p = 0.0002). One patient was removed from the study because of drug-induced cough. Comparison of all the laboratory data for pre and post-study periods did not reveal any significant difference. Patients treated with lisinopril improved significantly for clinical, haemodynamic, echocardiographic and quality of life parameters, with few adverse experiences, good tolerability and once-daily dose.

Different neurorescue profiles of selegiline and p-fluoro-selegiline in gerbils

The neuroprotective/neuronal rescue effects of selegiline are not exactly understood, and show great variability in clinical trials. In this study, the dose-dependence of neuronal rescue potency of selegiline and its analogue para-fluoro-selegiline (PFS) was investigated in gerbils. The compounds were tested in a transient global cerebral ischemia model. Selegiline expressed a bell-shaped, dose-response curve with high intrinsic activity (with greatest effect at 0.001 mg/kg), as opposed to PFS which shows a saturation profile. These findings indicate possible therapeutic differences between PFS and selegiline in the treatment of neurodegenerative disorders. Inhibition of progression of the disease (neuroprotective effect) and improvements of symptoms (MAO-B inhibition) may occur at the same dose level using PFS, while these doses are separated in case of selegiline.

Postnatal development of unipolar brush cells in the cerebellar cortex of cat

The postnatal developmental distribution pattern of metabotropic glutamate receptor (mGluR1a) immunoreactive unipolar brush cells (UBCs) was studied in the cerebellar cortex of kittens. On the day of birth (P0) UBCs are already present in the white matter in lobule X of the vermis, but only a few of these cell seemed to migrate to the deeper region of the internal granular layer. By the end of the first week (P8) UBCs were seen to invade the white matter + internal granular layer of lobules IX, VIII, I, and II of the vermis, and they spread further in the transitory area medio-laterally from the vermis toward the cerebellar hemispheres. By P15, UBCs appeared in lobules III and VII of the vermis, as well as in corresponding lobules of the neocerebellum, with especially high numbers in lobule VII. By P22, UBCs migrated further after their medio-lateral course in the neocerebellum, and began to invade lobules V and VI. At P62 the amount of UBCs in midsagittal planes of early developing vermal lobules (I, II, VII-X) resembled the P132 or adult pattern. The medio-lateral migration and incorporation of UBCs into the late-developing cerebellar lobules V and VI was completed only by P132, when the spatial distribution of UBCs in both the vermal and neocerebellar lobules was comparable to that seen in the 1 year old young adult cat. Although by P132 the postnatal migration of the vast majority of UBCs seemed to be completed, in the cerebellum of adult cats a few migrating UBCs could still be observed in the white matter of the cerebellar lobules, and beneath the ependyma of the fourth ventricle. It is concluded that during ontogenesis the migration course of UBCs follows essentially the developmental sequence of cerebellar lobules, although the incorporation of UBCs into the internal granular layer continues until 4 months postnatally, i.e., much beyond the apparent completion (about two months postnatally) of cytoarchitectonic built up of the cerebellar cortex of kittens.

The role of the delayed rectifier component IKs in dog ventricular muscle and Purkinje fibre repolarization

1. The relative contributions of the rapid and slow components of the delayed rectifier potassium current (IKr and IKs, respectively) to dog cardiac action potential configuration were compared in ventricular myocytes and in multicellular right ventricular papillary muscle and Purkinje fibre preparations. Whole-cell patch-clamp techniques, conventional microelectrode and in vivo ECG measurements were made at 37C. 2. Action potential duration (APD) was minimally increased (less than 7%) by chromanol 293B (10 microM) and L-735,821 (100 nM), selective blockers of IKs, over a range of pacing cycle lengths (300-5000 ms) in both dog right ventricular papillary muscles and Purkinje fibre strands. D-Sotalol (30 microM) and E-4031 (1 microM), selective blockers of IKr, in the same preparations markedly (20-80%) lengthened APD in a reverse frequency-dependent manner. 3. In vivo ECG recordings in intact anaesthetized dogs indicated no significant chromanol 293B (1 mg kg-1 i.v.) effect on the QTc interval (332.9 +/- 16.1 ms before versus 330.5 +/- 11.2 ms, n = 6, after chromanol 293B), while D-sotalol (1 mg kg-1 i.v.) significantly increased the QTc interval (323.9 +/- 7.3 ms before versus 346.5 +/- 6.4 ms, n = 5, after D-sotalol, P < 0.05). 4. The current density estimated during the normal ventricular muscle action potential (i.e. after a 200 ms square pulse to +30 mV or during a 250 ms long 'action potential-like' test pulse) indicates that substantially more current is conducted through IKr channels than through IKs channels. However, if the duration of the square test pulse or the 'action potential-like' test pulse was lengthened to 500 ms the relative contribution of IKs significantly increased. 5. When APD was pharmacologically prolonged in papillary muscle (1 microM E-4031 and 1 microg ml-1 veratrine), 100 nM L-735,821 and 10 microM chromanol 293B lengthened repolarization substantially by 14.4 +/- 3.4 and 18. 0 +/- 3.4% (n = 8), respectively. 6. We conclude that in this study IKs plays little role in normal dog ventricular muscle and Purkinje fibre action potential repolarization and that IKr is the major source of outward current responsible for initiation of final action potential repolarization. Thus, when APD is abnormally increased, the role of IKs in final repolarization increases to provide an important safety mechanism that reduces arrhythmia risk.

An in vitro electrophysiological and Co2+-uptake study on the effect of infraorbital nerve transection on the cortical and thalamic neuronal activity

Changes of neuronal membrane characteristics in somatosensory barrel cortex and barreloid thalamus were investigated in rats following unilateral transection of the infraorbital nerve. Kainate induced Co2+-uptake method and image analysis were used to assess the Ca2+ permeability of non-NMDA (N-methyl-D-aspartate) glutamate receptors. Changes in some biophysical parameters of the affected cortical neurons were also investigated by intracellular recording in slice experiments. The altered neuronal activity was measured on days 1, 5 and 14 after surgery. Kainate induced Co2+ uptake increased markedly reflecting enhanced Ca2+ permeability of alpha-amino-3-hydroxy-5-methyl-isoxazole-4-propionate/kainate (AMPA/KAIN)-type receptors. Changes were more pronounced in the cortex than in the thalamus and peaked on the first day following nerve transection. After that, parameters gradually returned to the normal level. However, a small enhancement was still detectable in the cortex at the end of the 2-week-long observation period. In parallel with the increased Co2+-uptake, moderate membrane potential changes, stronger spiking activity and enhanced excitability were characteristic for cortical neurons. The observed alterations in neuronal characteristics underlie the reorganization and regeneration processes following injuries or surgeries. We can conclude that immediate change of the receptive field in the barrel cortex following unilateral nerve transection is based on changes in biophysical parameters of the neurons. Altered peripheral activation evokes changes in the neuronal activity, thus providing opportunity for a quick synaptic rearrangement. AMPA/KAIN-type glutamate receptors have a decisive role in the regulation of these processes. This kind of synaptic plasticity is more significant in the cortex than in the thalamus.

Metabotrop glutamate receptor type 1a expressing unipolar brush cells in the cerebellar cortex of different species: a comparative quantitative study

Morphology, distribution and number of unipolar brush cells (UBCs) was studied in the cerebellar vermal lobules I-X of the chicken, rat, guinea pig, cat, and monkey using monoclonal mGluR1a antibody as a marker to visualise these recently described nerve cells (Mugnaini and Floris [1994] J. Comp. Neurol. 339:174-180; Mugnaini et al. [1994] Synapse 16:284-311). The morphological appearance of mGluR1a immunopositive UBCs is similar in all species investigated: they are small cells, having a single, relatively short and thick dendrite, terminating in brush-like dendrioles. Although this, probably excitatory, cell type can be found all over the cerebellar cortex, highest density of UBCs can be seen in the vermal cortex. The present study, therefore, was focused on the quantitative morphology and distribution of UBCs in the 10 lobules of the vermis. Calculating the number of UBCs/l Purkinje cell (PC), we have found differences in this value (average in vermal lobules I-X) from 1.04 in rat, 1.10 in chicken, 1.16 in guinea pig, 2.27 in monkey, and up to 2.44 in cat. The highest density of UBCs was observed in lobules I, IX, and X, whereas the lowest number of UBCs/l PC was found in lobules IV-VI (in the mammals) and in lobules VII-VIII (in the chicken). In mammals, particularly the monkey and cat, an increased presence of UBCs was observed in vermal sub-lobules VIc-VIIb,c, a region defined as the oculomotor vermis because of its role in the control of saccadic eye movement. There is also a basic difference between chicken and mammals in the distribution of UBCs within the lobules: in mammals, the lowest density of these nerve cells was found in the peripheral portion of the lobules, near to the pia, while in the chicken, in contrast, the density of UBCs was the highest subpially with fewer UBCs located in the deepest curvature of the lobules. Finally, the functional significance of the differences in the density and in the distribution pattern of UBCs in the cerebellar vermis between the phylogenetically different species investigated is briefly discussed.

A specifically radiolabeled somatostatin analog with strong antitumor activity induces apoptosis and accumulates in the cytosol and the nucleus of HT29 human colon carcinoma cells

The new heptapeptide somatostatin analog TT-232 decreases proliferation of HT-29 human colon carcinoma cells in vitro by reducing mitotic and increasing apoptotic activity. We have synthesized and characterized a specifically tritium labeled 3H-Tyr3-TT-232 (30 Ci/mmol) to investigate the effect and the fate of this antitumor peptide on human colon tumor cells. 3H-labeled TT-232 could be detected on the cell surface, on cytoplasmic membranes and also in the nucleus of HT-29 cells, 1-6 h after the administration of 0.5 and 50 microg/mL [3H]TT-232. Binding and internalization of TT-232 to human colon tumor cells at a relatively high dose provide further evidence for the existence of low-affinity somatostatin receptors in such cells, which might mediate the apoptosis-inducing effect. Our data suggest the possible use of TT-232 in the treatment of human colon tumors.

Effect of benazepril on endothelial function in previously untreated hypertensive patients. The Working Group of Cardiology of the Academic Committee of Veszprém, Hungary

The aim of this study was to determine whether angiotensin-converting enzyme inhibitor administration improves the endothelial function of patients with previously untreated essential hypertension. Using high-resolution ultrasonography, we measured the arteria brachialis diameter at rest, during reactive hyperemia (endothelium-dependent flow-mediated dilatation [FMD]), and after sublingual nitroglycerin (endothelium-independent dilatator). Twenty-one previously untreated hypertensive patients participated in the study (13 men, 8 women; mean age, 39.1 +/- 15 years). In the 21 patients, the basal FMD was 5.02% +/- 4.1%. Two hours after the first 10-mg benazepril dose, the FMD was 6.67% +/- 3.9%, and after 1 month of daily 10-mg benazepril administration, the FMD was 5.59% +/- 2.9%. These changes were not significant compared with the baseline value. Nine patients had relatively normal FMD (>5%), whereas the other 12 patients had abnormal FMD (<5%) at baseline. In the latter group, the first 10 mg benazepril produced significant improvement in FMD, from 2.4% +/- 2.5% to 5.08% +/- 2.4% (P < 0.05), but 10 mg benazepril daily for 1 month resulted in no further improvement (4.78% +/- 2.7%) compared with the acute effect. No difference was found between groups with regard to age, gender, blood pressure, blood lipids, and basal arteria brachialis diameter. The previously untreated patients with essential hypertension have endothelial dysfunction, but individual differences were found. The angiotensin-converting enzyme inhibitor treatment improves endothelial function only in those patients who had endothelial dysfunction before the treatment.

Distribution of metabotropic glutamate receptor type 1a in Purkinje cell dendritic spines is independent of the presence of presynaptic parallel fibers

The metabotropic glutamate receptor type 1a (mGluR1a) is expressed at a high level in the molecular layer of the cerebellar cortex, where it is localized mostly in dendritic spines of Purkinje cells, innervated by parallel fibers. Treatment with methylazoxymethanol (MAM) of mouse pups at postnatal days (PND) 0 + 1 or 5 + 6 results in the partial loss of granule cells, the extent of which depends on the age of the animal at the time of injection. As a consequence of hypogranularity, the number of parallel fibers is decreased to such an amount that many of the postsynaptic Purkinje cell dendritic spines are devoid of axonal input, and only a limited number of spines participate in the formation of parallel fiber synapses, or, infrequently, in heterologous or heterotopic synapses with other presynaptic partners. At PND 30, 50% of the spines in the cerebella of mice treated with MAM at PND 0 + 1 was not contacted by any presynaptic element, compared to 5% in controls or 15% in the cerebella of mice treated with MAM at PND 5 + 6. The localization of mGluR1a was visualized by immunocytochemistry on ultrathin sections: approximately 80% of all Purkinje cell dendritic spines were immunopositive in controls and in both groups of MAM-treated mice, indicating that mGluR1a was present in Purkinje dendritic spines even when the corresponding synaptic input was absent. This observation indicates that the expression and subcellular distribution of mGluR1a are inherent, genetically determined properties of Purkinje cells.

Morphogenetic plasticity of neuronal elements in cerebellar glomeruli during deafferentation-induced synaptic reorganization

Reorganization of the cerebellar glomerulus, the main synaptic complex within the granule cell layer, was investigated using quantitative morphological techniques. All afferents to the cerebellar cortex, including mossy-fibers, were surgically destroyed by undercutting the cerebellar vermis. Fifteen days after the operation, which resulted in the removal of the main excitatory afferent to the glomerulus, a significant reorganization of the whole synaptic complex was observed, whereas the structural integrity of the glomerulus was remarkably well preserved. This was indicated by the observation that the number of granule cell dendrites (approximately 50 per glomerulus), as well as the number of dendritic digits (approximately 210 per glomerulus) bearing most of the approximately 230 synaptic junctions per glomerulus, did not change significantly after mossy-fiber degeneration. The total number of synapses in the reorganized glomerulus did not change either, despite the disappearance of two-thirds of (excitatory) synaptic junctions caused by mossy-fiber degeneration. In the reorganized glomeruli, however, the inhibitory, GABA-containing Golgi axonal varicosities became the dominant synaptic type-about four-fifths (approximately 200) of all synapses within the glomerulus-whereas the dendritic synapses between the granule cells represented only one-fifth of all synaptic junctions. The quantitative data of the reorganized cerebellar glomerulus demonstrate both a remarkable constancy and a plasticity of the excitatory granule cells and inhibitory Golgi neurons building up this synaptic complex. Constancy (the preservation of certain specific structural features) is represented by an eventually unchanged number of dendrites and synaptic junctions within the deafferented glomerulus. Such constancy was made possible, however, by the morphogenetic plasticity of both nerve-cell types to produce new, dendro-dendritic and axo-dendritic synapses to compensate for the loss of mossy-fiber synapses.

[N2O-induced acute funicular myelosis in latent vitamin B 12 deficiency]

The neurotoxicity of nitrous oxide ("laughing gas") had already been observed in 1956 when using N2O in the long-term sedation of tetanus patients. In 1967 Parbrook described leukopenic effects during long-term exposure to N2O. It was only in 1978 that further studies were conducted on myeloneuropathies and myelodepression under the influence of N2O. The basic cause is vitamin B12 deficiency and the irreversible oxidation of coenzyme B12 by N2O. Between 1986 and 1995 eight cases of acute funicular myelosis associated with latent vitamin B12 deficiency subsequent to nitrous oxide anaesthesia were reported. In our hospital, two further patients now have this disease. Two observations must be emphasised when assessing the 10 patients mentioned above: 1. There was no long-term exposure to N2O (> 6 hrs); the periods of anaesthesia were between 1.5 and 3.5 hrs. 2. Vitamin B12 deficiency was not known preoperatively, and there was no marked pernicious anaemia, so that the only pointers to the risk patients were supplied by the mean corpuscular haemoglobin (MCH) and the mean corpuscular volume (MCV) of the blood picture.

[Diagnosis of chronic massive pulmonary thromboembolism in elderly patients]

Chronic massive thromboembolism of the pulmonary artery is an occlusion of the major branches of the pulmonary artery which develops as a result of repeated embolisms, as a result of non-dissolution and organizing of a thrombus or retrograde growth of a thrombus. The authors observed four elderly patients with chronic massive pulmonary embolization. In their clinical picture dominated progressing dyspnoea and signs of right heart failure. In the diagnosis perfusion scan of the lungs and pulmoangiographic examination plays an important part as they revealed even unilateral absence of pulmonary circulation. This examination was stimulated by weaker respiration at the site of the lacking perfusion in a portion of the lungs.

Immunocytochemical localization of mGluR1a metabotropic glutamate receptor in inhibitory interneurons of the cerebellar cortex

Immunocytochemical investigation of metabotrop glutamate receptor la in the cerebellar cortex of rat revealed a presence of this receptor in all cortical inhibitory nerve cells (Purkinje, basket, stellate, Lugaro and Golgi). In addition to the previously described localization of this receptor in Purkinje dendritic spines supplied by parallel and climbing fibres and considered to be responsible for cerebellar long-term depression, we have observed metabotropic glutamate receptor la immunopositivity also in the synapses between parallel fibres and dendrites of basket, stellate and Golgi neurons. The postsynaptic receptor was also present occasionally in inhibitory synapses between stellate cell axons and Purkinje cells as well as between Purkinje axon collaterals and Lugaro cell dendrites. The possibility, that mGluR1a receptors in basket, Golgi and stellate cells might directly or indirectly contribute to cerebellar LTD, is discussed.

Postsynaptic and extrasynaptic localization of kappa-opioid receptor in selected brain areas of young rat and chick using an anti-receptor monoclonal antibody

kappa-opioid receptors were visualized by light and electron microscopical immunohistochemistry in young rat and chick brains, using a monoclonal antibody KA8 (IgG1, kappa) raised against a kappa-opioid receptor preparation from frog brain, which recognizes selectively the kappa-type receptor with preference for the kappa-2 subtype. The most pronounced kappa-opioid receptor-like immunoreactivity was observed in the hypothalamic nuclei of the rat brain and in the chick optic tectum, in regions where the functional significance of kappa-opioid receptors is well documented. Both neurons and glia were stained, the former on both somata and dendrites. At the ultrastructural level, the receptor-like immunoreactivity was similar in both species. Immunoprecipitate decorated the inner surface of the plasma membrane of glial cells, neuronal somata and dendrites, in a discontinuous arrangement. In the cytoplasm, labelling was associated with ribosomes, polyribosomes and rough endoplasmic reticulum membranes but not with Golgi cisternae. In the neuropil, the immunoprecipitate was observed along the dendritic microtubules and was also associated with postsynaptic sites. Nuclei and axons were devoid of label and immunoreactivity was never visible presynaptically. Our findings indicate that the antibody used in the present study marks various forms of the kappa-opioid receptor protein including those synthesised in ribosomes, transported along dendritic microtubules and incorporated into postsynaptic and non-synaptic membranes. The antibody also recognizes glial opioid receptors. The observed subcellular distribution appears to be conserved in phylogenetically distant species.

Similar fine structural localization of immunoreactive glutamate in the frog pineal complex and retina

The distribution of immunoreactive glutamate was compared in the pineal complex (pineal and frontal organs) and retina of frogs (Rana esculenta, R. arvalis, R. ridibunda, R. catesbeiana, Bufo viridis, Bombinator igneus) by postembedding immuno-electron microscopy. Similar to retinal photoreceptors (rods and cones), bipolars and ganglion cells, the rod- and cone-like photoreceptors and the neurons of the pineal and frontal organs exhibited glutamate immunoreactivity. Synaptic terminals of photoreceptor cells on secondary neurons of the pineal complex and retina were strongly immunoreactive. The pineal tract and the fibers of the frontal nerve also displayed glutamate immunoreactivity. There was no essential difference in the immunoreactivity of the retinal and pineal elements among the species studied. The similar histology of the pineal complex and retina of the frog and the high correlation of their binding sites of antiglutamate immunosera allow us to assume that glutamate performs a similar role in the pineal complex as is already known for the retina. The high immunoreactivity of the presynaptic region of pinealocytic processes and axons of secondary neurons suggests the role of a neurotransmitter for this excitatory amino acid in the efferent pathways of the pineal complex.

Developmental dynamics of Purkinje cells and dendritic spines in rat cerebellar cortex

Quantitative morphological changes of the developing Purkinje cells were studied from 6 to 90 postnatal (PN) days in the IVth lobule of vermis in the cerebellum of rats. The soma size (mean diameter) of Purkinje cells increased rapidly between 6 PN (on average 10 microns) and 18 PN (about 17 microns) days; it did not change between 18 and 25 PN days, but increased moderately again between 25 and 48 PN days (22-23 microns) and stabilized on the same value. In contrast, the number of Purkinje cells/100 microns (the "linear density") decreased rapidly from 6 to 18 PN days. The molecular layer area belonging to 1 Purkinje cell increased rapidly from 6 to 25 PN days (from about 370 to 6,200 microns 2) and less rapidly between PN days 30 to 48 (up to 9,300 microns 2), followed by a moderate decrease at PN day 90 (about 6,600 microns 2). The volume belonging to 1 Purkinje cell dendritic arbor was about 5,500 microns 3 at PN day 6, 93,000 microns 3 at PN day 25, and 100,000 microns 3 at PN day 90. The numerical density of dendritic spines in the molecular layer showed a biphasic curve: a rapid increase from PN days 6 to 21 followed by a significant but short decrease at PN day 25, moderate rise from PN days 25 to 48, and a subsequent decline between PN days 48 and 90. The number of spines belonging to 1 Purkinje cell showed two developmental "peaks": the first peak at 21 PN days was moderate (5.6 x 10(4) spines/Purkinje cell) while the second maximum at 48 PN days was more significant (1.2 x 10(5) spines/Purkinje cell), which then declined to 6.3 x 10(4) spines/Purkinje cell at PN day 90. It is suggested that the temporary overproduction and the following decline in the number of Purkinje dendritic spines during the development of the cerebellar cortex may be the morphological indicator of the dynamics of synaptogenetic and of synaptic stabilization processes.

[C-peptide levels in secondary sulfonylurea resistant diabetics]

In the presence of clinical features of secondary drug failure--even after reeducation on diet and intensive control of patients--is difficult to make a decision to switch on insulin. Therefore the serum C-peptide concentrations were assessed in order to get supporting data. From 35 patients with suspected secondary drug failure the therapy of 11 patients was continued with insulin, 24 patients remained on glibenclamide therapy. The decision based on clinical criteria. All of the patients were studied in i.v. glucagon test and with a test meal to evaluate their basal and stimulated serum C-peptide concentrations. There were only three patients with subnormal basal C-peptide (< or = 0.30 nmol/l), on the other hand nine patients had lower post-glucagon serum C-peptide level than 0.60 nmol/l. The basal and stimulated C-peptide concentrations from i.v. glucagon test and test-meal indicated the need of insulin therapy with a sensitivity of 81.8 percent and with specificity of 70.8 percent. The further glibenclamide treatment on the basis of C-peptide concentrations in 89.5 percent of cases could be accurately established. The statistical analysis showed that the glucagon-stimulated C-peptide concentration was the most characteristic feature to discriminate the patients in order to make a decision on the further diabetes therapy.

Age-related loss of GABA-positive and GABA-negative neurons in neocortical transplants

The numerical density of GABA immunopositive and GABA immunonegative neurons was quantitatively determined in 0, 12, 30 and 90 day-old neocortical transplants, derived from E17 rat embryos and transplanted into adult hosts. It was found that the original, very high neuronal density in the fetal transplant declined steadily after transplantation to the somatosensory cortex of adult rat. The decline in numerical density of GABA-positive neurons, however, was disproportionately larger than that of GABA-negative nerve cells: At 90 days the proportion of GABA-positive cells was 2.3% (in contrast to the 11.8% in the adult host cortex). The density of GABA-negative neurons, on the other hand, remained slightly higher than comparable values in the control cortex. The decline in density of GABA-positive neurons was continuous until the 90th post-transplantation day, while final, close to normal density values of GABA-negative nerve cells were already reached in 30 day-old grafts, with no significant change afterwards.