Oxidative Stress and Cardiovascular Risk in Type 1 Diabetes Mellitus: Insights From the DCCT/EDIC Study

Background

Hyperglycemia leading to increased oxidative stress is implicated in the increased risk for the development of macrovascular and microvascular complications in patients with type 1 diabetes mellitus.

Methods and Results

A random subcohort of 349 participants was selected from the DCCT / EDIC (Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications) cohort. This included 320 controls and 29 cardiovascular disease cases that were augmented with 98 additional known cases to yield a case cohort of 447 participants (320 controls, 127 cases). Biosamples from DCCT baseline, year 1, and closeout of DCCT , and 1 to 2 years post‐ DCCT ( EDIC years 1 and 2) were measured for markers of oxidative stress, including plasma myeloperoxidase, paraoxonase activity, urinary F 2α isoprostanes, and its metabolite, 2,3 dinor‐8 iso prostaglandin F 2α . Following adjustment for glycated hemoblobin and weighting the observations inversely proportional to the sampling selection probabilities, higher paraoxonase activity, reflective of antioxidant activity, and 2,3 dinor‐8 iso prostaglandin F 2α , an oxidative marker, were significantly associated with lower risk of cardiovascular disease (−4.5% risk for 10% higher paraoxonase, P <0.003; −5.3% risk for 10% higher 2,3 dinor‐8 iso prostaglandin F 2α , P =0.0092). In contrast, the oxidative markers myeloperoxidase and F 2α isoprostanes were not significantly associated with cardiovascular disease after adjustment for glycated hemoblobin. There were no significant differences between DCCT intensive and conventional treatment groups in the change in all biomarkers across time segments.

Conclusions

Heightened antioxidant activity (rather than diminished oxidative stress markers) is associated with lower cardiovascular disease risk in type 1 diabetes mellitus, but these biomarkers did not change over time with intensification of glycemic control.

Clinical Trial Registration

URL : https://www.clinicaltrials.gov . Unique identifiers: NCT 00360815 and NCT 00360893.

Acute hemodynamic changes after rapid intravenous bolus dosing of dexmedetomidine in pediatric heart transplant patients undergoing routine cardiac catheterization

BACKGROUND

Dexmedetomidine is a highly selective α(2)-adrenoceptor agonist with sedative, anxiolytic, and analgesic properties that has minimal effects on respiratory drive. Its sedative and hypotensive effects are mediated via central α(2A) and imidazoline type 1 receptors while activation of peripheral α(2B)-adrenoceptors result in an increase in arterial blood pressure and systemic vascular resistance. In this randomized, prospective, clinical study, we attempted to quantify the short-term hemodynamic effects resulting from a rapid i.v. bolus administration of dexmedetomidine in pediatric cardiac transplant patients.

METHODS

Twelve patients, aged 10 years or younger, weighing ≤40 kg, presenting for routine surveillance of right and left heart cardiac catheterization after cardiac transplantation were enrolled. After an inhaled or i.v. induction, the tracheas were intubated and anesthesia was maintained with 1 minimum alveolar concentration of isoflurane in room air, fentanyl (1 μg/kg), and rocuronium (1 mg/kg). At the completion of the planned cardiac catheterization, 100% oxygen was administered. After recording a set of baseline values that included heart rate (HR), systolic blood pressure, diastolic blood pressure, central venous pressure, systolic pulmonary artery pressure, diastolic pulmonary artery pressure, pulmonary artery wedge pressure, and thermodilution-based cardiac output, a rapid i.v. dexmedetomidine bolus of either 0.25 or 0.5 μg/kg was administered over 5 seconds. The hemodynamic measurements were repeated at 1 minute and 5 minutes.

RESULTS

There were 6 patients in each group. Investigation suggested that systolic blood pressure, diastolic blood pressure, systolic pulmonary artery pressure, diastolic pulmonary artery pressure, pulmonary artery wedge pressure, and systemic vascular resistance all increased at 1 minute after rapid i.v. bolus for both doses and decreased significantly to near baseline for both doses by 5 minutes. The transient increase in pressures was more pronounced in the systemic system than in the pulmonary system. In the systemic system, there was a larger percent increase in the diastolic pressures than the systolic pressures. Cardiac output, central venous pressure, and pulmonary vascular resistance did not change significantly. HR decreased at 1 minute for both doses and was, within the 0.5 μg/kg group, the only hemodynamic variable still changed from baseline at the 5-minute time point.

CONCLUSION

Rapid i.v. bolus administration of dexmedetomidine in this small sample of children having undergone heart transplants was clinically well tolerated, although it resulted in a transient but significant increase in systemic and pulmonary pressure and a decrease in HR. In the systemic system, there is a larger percent increase in the diastolic pressures than the systolic pressures and, furthermore, these transient increases in pressures were more pronounced in the systemic system than in the pulmonary system.

Biological, technical, and social aspects of applying electrified fladry for livestock protection from wolves (Canis lupus)

Context. Wolf predation on livestock can cause economic hardship for livestock producers as well as reduce tolerance for wolves. Lethal control of wolves is often controversial; thus, development of effective non-lethal methods for reducing wolf–livestock conflict is important. Electrified fladry is a new tool that is similar to fladry (i.e. a barrier system that scares wolves), but electrified fladry also incorporates an electric shock designed to decrease the potential for wolves to habituate to the barriers. Aim. Evaluation of electrified fladry requires understanding of its effectiveness relative to fladry and the costs and benefits of applying it in the field. Methods. By using captive wolves, we compared the effectiveness of electrified fladry v. fladry for protecting a food resource during 2-week trials. We then performed a field trial with electrified fladry for managing wolves in Montana, USA. We measured livestock depredation and wolf activity on six treatment and six control pastures, calculated the cost of installation and maintenance, and surveyed all study participants about application of electrified fladry. Key results. We found electrified fladry 2–10 times more effective than fladry at protecting food in captivity and that hunger increased the likelihood of wolves testing fladry barriers. In field trials, we installed 14.0 km of EF systems in treatment pastures and detected wolves twice in control pastures but never in the treatment pastures. No livestock were killed by wolves in treatment or control pastures. A completed electrified fladry system cost $2303 for the first km and $2032 for each additional km, and required 31.8 person-hours per kilometre to install. We observed 18 failures (i.e. electrified system stopped working) during a total of 394 days of use. In total, 83% of ranchers who used fladry would continue to use it under certain conditions, indicating some psychological benefit to users. Conclusions and implications. The present study has demonstrated that electrified fladry offers superior protection compared with non-electrified fladry; however, further field tests are warranted to help determine whether benefits outweigh costs.

The lakes of Titan

The surface of Saturn's haze-shrouded moon Titan has long been proposed to have oceans or lakes, on the basis of the stability of liquid methane at the surface. Initial visible and radar imaging failed to find any evidence of an ocean, although abundant evidence was found that flowing liquids have existed on the surface. Here we provide definitive evidence for the presence of lakes on the surface of Titan, obtained during the Cassini Radar flyby of Titan on 22 July 2006 (T16). The radar imaging polewards of 70 degrees north shows more than 75 circular to irregular radar-dark patches, in a region where liquid methane and ethane are expected to be abundant and stable on the surface. The radar-dark patches are interpreted as lakes on the basis of their very low radar reflectivity and morphological similarities to lakes, including associated channels and location in topographic depressions. Some of the lakes do not completely fill the depressions in which they lie, and apparently dry depressions are present. We interpret this to indicate that lakes are present in a number of states, including partly dry and liquid-filled. These northern-hemisphere lakes constitute the strongest evidence yet that a condensable-liquid hydrological cycle is active in Titan's surface and atmosphere, in which the lakes are filled through rainfall and/or intersection with the subsurface 'liquid methane' table.

Titan Radar Mapper observations from Cassini's T3 fly-by

Cassini's Titan Radar Mapper imaged the surface of Saturn's moon Titan on its February 2005 fly-by (denoted T3), collecting high-resolution synthetic-aperture radar and larger-scale radiometry and scatterometry data. These data provide the first definitive identification of impact craters on the surface of Titan, networks of fluvial channels and surficial dark streaks that may be longitudinal dunes. Here we describe this great diversity of landforms. We conclude that much of the surface thus far imaged by radar of the haze-shrouded Titan is very young, with persistent geologic activity.

The Sand Seas of Titan: Cassini RADAR Observations of Longitudinal Dunes

The most recent Cassini RADAR images of Titan show widespread regions (up to 1500 kilometers by 200 kilometers) of near-parallel radar-dark linear features that appear to be seas of longitudinal dunes similar to those seen in the Namib desert on Earth. The Ku-band (2.17-centimeter wavelength) images show approximately 100-meter ridges consistent with duneforms and reveal flow interactions with underlying hills. The distribution and orientation of the dunes support a model of fluctuating surface winds of approximately 0.5 meter per second resulting from the combination of an eastward flow with a variable tidal wind. The existence of dunes also requires geological processes that create sand-sized (100- to 300-micrometer) particulates and a lack of persistent equatorial surface liquids to act as sand traps.

Cassini Radar Views the Surface of Titan

The Cassini Titan Radar Mapper imaged about 1% of Titan's surface at a resolution of approximately 0.5 kilometer, and larger areas of the globe in lower resolution modes. The images reveal a complex surface, with areas of low relief and a variety of geologic features suggestive of dome-like volcanic constructs, flows, and sinuous channels. The surface appears to be young, with few impact craters. Scattering and dielectric properties are consistent with porous ice or organics. Dark patches in the radar images show high brightness temperatures and high emissivity and are consistent with frozen hydrocarbons.

Effect of steroids and nitric oxide on pituitary hormone release in ovariectomized, peripubertal rats

The purpose of this study was to determine the effects of the duration of steroid depletion on the steroid-induced luteinizing hormone and prolactin surges in ovariectomized, peripubertal female rats. Additionally, the role of nitric oxide (NO) in mediating the surge responses was determined. Peripubertal, 6-week-old, female Sprague-Dawley rats were ovariectomized. One or three weeks later, animals were injected with 17β-estradiol (50 μg, sc) followed 48 h later by progesterone (2.5 mg, sc). Effects of NO were examined by administeringl-arginine (300 mg/kg, ip). The response of ovariectomized, adult females to steroid treatment was also determined.

One and three weeks after ovariectomy, steroid replacement produced an LH and prolactin surge in peripubertal animals. However, both the magnitude and duration of the LH surge was greater 3 weeks after ovariectomy. Whilel-arginine significantly enhanced the magnitude of the LH surge 1 week after ovariectomy, by 3 weeksl-arginine caused a decrease in the duration, but not the magnitude of the surge. In contrast,l-arginine did not affect either the magnitude or duration of the prolactin surge one week after ovariectomy, but diminished the magnitude after 3 weeks of steroid depletion. In adults, steroids induced significant increases in both LH and prolactin. These results demonstrate that sensitivity to NO stimulation of LH, but not prolactin secretion, is modulated by the duration of gonadal steroid hormone depletion. The differences in the responsiveness of LH and prolactin to steroid-induced stimulation in peripubertal animals demonstrate that these hormones are regulated by NO through different mechanisms.

Effects of cyclic steroid hormone replacement on prolactin and luteinizing hormone surges in female rats

The ability of steroid hormones to produce an LH or prolactin (PRL) surge was determined in rats ovariectomized at 6, 9 or 13 weeks of age and subjected to one, three or six cycles of estrogen and progesterone replacement. Sensitivity to steroid replacement was dependent on the age of the animal at the time of ovariectomy. Repeated cyclic steroid hormone replacement significantly increased the magnitude of the PRL response, but not the LH response, in animals ovariectomized at 6 weeks. The LH response was significantly altered by cyclic steroid replacement only in animals ovariectomized at 13 weeks. These results indicate that the mechanisms involved in the regulation of PRL secretion are influenced by steroid hormone replacement and that cyclic steroid hormone exposure increases the magnitude of the PRL secretory response.

Immunoneutralization of endogenous opioid peptides prevents the suckling-induced prolactin increase and the inhibition of tuberoinfundibular dopaminergic neurons

Previous studies have shown that the endogenous opioid peptides, acting at specific opiate receptor subtypes, are involved in the suckling-induced prolactin secretory response. The prolactin increase elicited by suckling is due, at least in part, to an inhibition of tuberoinfundibular dopaminergic (TIDA) neurons in the hypothalamus. We investigated the effects of immunoneutralization of dynorphin, leu-enkephalin and met-enkephalin on the suckling-induced prolactin increase and on the activity of the TIDA neurons in lactating female rats between days 7 and 12 postpartum. Rats were injected into the right lateral ventricle with antiserum specific for one of these three peptides. Control rats were administered equal amounts of immunoglobulin proteins. Suckling produced a profound and significant increase in prolactin levels, as well as a decrease in DOPA accumulation in the median eminence of lactating rats. Administration of immunoglobulin concentrations of up to 3.6 microg did not inhibit the prolactin secretory response to the suckling stimulus and did not prevent the suckling-induced inhibition of TIDA neurons. Antisera to all three endogenous opioid peptides abolished the suckling-induced prolactin increase and prevented the inhibition in DOPA accumulation in the median eminence. Thus, the endogenous opioid peptides, dynorphin, leu-enkephalin and met-enkephalin, are essential for the prolactin secretory response to suckling and inhibition of TIDA neuronal activity is at least one of the mechanisms of action utilized by these peptides.

Cervical pathology in West Virginia adolescents

Cytologic screening is an important diagnostic tool used to detect precancerous and cancerous lesions of the cervix. We studied the prevalence of cervical abnormalities, based on Pap smear results, in patients at the Outpatient Adolescent Clinic at West Virginia University. We found a high incidence of overall intraepithelial cell pathology (24%) in this group with 2.4% high grade and 9.9% low-grade lesions. These findings show that major cervical pathology is present in this age group. Furthermore, repeat smears at intervals of < one year were performed on 317 patients. Of these repeat smears, 7% changed from normal to abnormal in this period. Sexually active adolescent females should have Pap smears at least annually to detect abnormalities that may otherwise not be detected until they are more advanced and difficult to manage. Higher risk adolescents may need semiannual screening.

Multisite evaluation of a new diabetes self-test for glucose and glycated protein (fructosamine)

BACKGROUND

In diabetes management, the true average blood glucose is best obtained using glycated protein tests that give the average blood glucose over a previous time window of either weeks (fructosamine tests) or months (glycated hemoglobin tests). Until now, glycated protein tests have only been available as laboratory tests and have therefore been underutilized in diabetes management. Recently, a fructosamine self-test for use by diabetes patients at home was cleared for marketing by the U.S. Food and Drug Administration (FDA). We have studied the performance of this test in three geographically distinct diabetes clinics to confirm the performance and accuracy of both glucose and fructosamine testing with this device. This new self-testing system has the potential to improve glycemic control dramatically in patients with diabetes, including those patients with type 2 diabetes using oral drug therapy.

METHODS

Three geographically different sites (San Diego, CA, Tallahassee, FL, and Minneapolis, MN) were selected for the study. Sixty male and 56 female adult patients, with both type 1 (59) and type 2 (57) diabetes, were selected for participation in the study (total patients = 116). Fingerstick puncture capillary blood glucose was tested using the YSI Model 1500 and the Duet Glucose test. A fingerstick puncture capillary blood test was also tested with the Duet GlucoProtein (fructosamine) test strip in duplicate. For fructosamine comparison, a venipuncture blood sample of ethylene diaminetetraacetic acid (EDTA) plasma was collected and tested using the Roche Unimate laboratory test.

RESULTS

The glucose test gave excellent correlation to the reference laboratory method (r = 0.98) and the GlucoProtein test gave a correlation of 0.72 compared to the laboratory method. The bias of both tests compared to the laboratory tests was 10% or less at all concentrations. Error grid analysis of the glucose test showed that 97.5% of test results were in the accurate zone and 2.5% were in the clinically neutral or benign errors zone. Analysis of fructosamine test results using a two-by-two grid yielded sensitivity of 100%, specificity of 92% and accuracy of 94%.

CONCLUSIONS

The Duet Glucose Control System is accurate for both measuring glucose and GlucoProtein (fructosamine) using a fingerstick blood sample. This new testing system has the potential to provide useful information to both healthcare specialists in their office and also to patients at home to help them achieve better long-term glucose control and avoid the potential acute and chronic complications of diabetes.

Orphanin FQ stimulates prolactin and growth hormone release in male and female rats

Intracerebroventricular administration of Orphanin FQ (5.5, 55 or 550 pmol) caused a dose-related increase in prolactin secretion in both male and female rats and stimulated GH secretion in males. The magnitude of the prolactin secretory response was greater in females than in males. These effects of OFQ on prolactin and growth hormone release are the same as the stimulatory effects of the endogenous opioid peptides.

Species differences in hormones: yes, it does matter

Laboratory Animal Endocrinology. Hormonal Action, Control Mechanisms and Interactions with Drugs By David D. Woodman. Chichester, UK, Wiley, 1997, $189.95 (vii+567 pages), ISBN 0-471-97262-2.

Immunoneutralization of beta-endorphin blocks prolactin release during suckling without affecting tuberoinfundibular dopaminergic neural activity

The effect of immunoneutralization of beta-endorphin on the suckling-induced prolactin increase and on the activity of the tuberoinfundibular dopaminergic (TIDA) neurons was determined in lactating female rats between days 8 - 12 post-partum. Two antisera were used in the immunoneutralization studies. Both were specific for beta-endorphin, exhibiting little cross reactivity with met- or leu-enkephalin or dynorphin. Antisera to beta-endorphin completely abolished the suckling-induced prolactin increase indicating that this endogenous opioid peptide is involved in this response. Suckling significantly inhibited DOPA accumulation in the median eminence and antiserum to beta-endorphin did not prevent this inhibition. Additionally, 5-endorphin antiserum significantly reduced TIDA neural activity even in pup-deprived dams. These results indicate that beta-endorphin is involved in the prolactin secretory response to suckling but that inhibition of TIDA neuronal activity is not its mechanism of action. Other possible mechanisms are discussed.

Relationship Between Tolerance/Intolerance of Ambiguity and Perceived Environmental Uncertainty in Hospitals

1 Many variables may contribute to a nurse's perceptions when working in a changing health care environment, especially in the field of psychiatry. 2 While this study did not find a relationship between tolerance for ambiguity and perceived environmental uncertainty in hospitals, age and educational background appear to be variable, which may warrant further study as ultimately impacting nursing. 3 Research which explores those personality variables which underlie perception would assist nurse administrators in designing interventions, opening new lines of communication, and increasing sensitivity to individual nurse's need in these changing times.

Primary care management of common dermatologic disorders in women. Pharmacologic considerations

This article describes the clinical management of dermatologic disorders most commonly encountered in the primary care setting. The common presenting clinical signs and symptoms are reviewed, and the initial laboratory tests that may establish the diagnosis are recommended. Pharmacologic and nonpharmacologic treatments are reviewed. Diagnosis and management of disorders of the sebaceous and apocrine glands, disorders of the hair and pigmentation, fungal, viral, and bacterial infections, dermatitis, and infestations are discussed. A review of the care of skin burns and wounds is included as well as the diagnosis and management of urticaria.

Effects of age and gender on the AII-induced stimulation of prolactin release and inositol phosphate accumulation in rat anterior pituitary cells in vitro

The stimulatory effects of Angiotensin II (AII) on prolactin secretion and inositol phosphate accumulation were examined in dispersed anterior pituitary cells collected from young (3-4 month), mature (7-8 month) and old (18-20 month) male and female rats. Physiological doses of AII (0.01-10 nM) stimulated prolactin release from cells collected from mature female rats only. This effect was antagonized by pretreatment with Saralasin, an AII receptor antagonist. Significant accumulation of the inositol phosphates was observed in cells obtained from the mature, female donors and this increase preceded the prolactin response. Although there was a small increase in total inositol phosphate accumulation in cells obtained from the old female rats, this was transient and did not coincide with a similar increase in prolactin release. These results indicate that pituitary sensitivity to AII stimulation is related to the age and the gender of the donor animal. The physiological role of pituitary AII needs to be examined in sexually mature female animals.

Inhibition of tuberoinfundibular dopaminergic neural activity during suckling: involvement of mu and kappa opiate receptor subtypes

Previous studies have shown that mu (mu) and kappa (kappa) opioid antagonists inhibit suckling-induced prolactin release. Prolactin responses elicited by pup suckling or opioid administration are mediated, at least in part, by suppression of dopamine (DA) release from tuberoinfundibular dopaminergic (TIDA) neurons in the hypothalamus. We examined the effects of the mu opiate receptor antagonist, beta-funaltrexamine (beta-FNA), and the kappa opiate receptor antagonist, nor-binaltorphimine (nor-BNI) on the activity of TIDA neurons in lactating rats. TIDA neuronal activity was determined by measuring DOPA accumulation in the caudate putamen (CP) and median eminence (ME). The effects of opioid antagonist treatment were determined in pup-deprived (low circulating prolactin levels) or pup-suckled rats (high circulating prolactin levels). The accumulation of 5-hydroxytryptophan (5-HTP) in the medial preoptic area (MPOA), the anterior hypothalamus (AH) and the median eminence (ME) was quantified as an index of serotonergic activity in the same animals for comparative purposes. In vehicle treated rats, suckling caused a significant and selective decrease in DOPA accumulation in the ME. beta-FNA (5 micrograms, i.c.v.) pretreatment significantly increased DOPA accumulation in the ME of pup-deprived and pup-suckled rats. beta-FNA pretreatment also prevented the suckling-induced suppression of DOPA accumulation in the ME. In contrast to the actions of beta-FNA, pretreatment with nor-BNI (8 micrograms, i.c.v.) did not significantly affect the activity of the TIDA neurons in pup-deprived or pup-suckled rats. Suckling alone did not alter 5-HTP accumulation in any of the brain regions examined, and neither opioid antagonist had appreciable effects on 5-HTP accumulation. These results demonstrate that the EOP tonically inhibit the TIDA neurons in both pup-deprived and pup-suckled, post-partum female rats by acting through the mu, but not the kappa, opiate receptor subtype. Furthermore, the suckling-induced inhibition of TIDA neurons is also mediated through the EOP acting at mu, but not kappa opioid receptors.

Multiple opiate receptor subtypes are involved in the stimulation of growth hormone release by beta-endorphin in female rats

The growth hormone (GH) secretory response to beta-endorphin and the involvement of opiate receptor subtypes in this response were determined in diestrous female rats. The involvement of the mu (mu), delta (delta) and/or kappa (kappa) site was determined by administering specific antagonists for each of these sites prior to beta-endorphin. beta-Funaltrexamine (1 or 5 micrograms) was administered to block mu sites, ICI 154,129 (5 or 25 micrograms) blocked delta sites and nor-binaltorphimine (8 micrograms) blocked kappa sites. The ability of these antagonists to block GH secretion following intravenous morphine administration was also determined. The opiate antagonists and beta-endorphin were administered into the lateral ventricle. A dose-response study for beta-endorphin indicated that 0.5 micrograms beta-endorphin was the minimum stimulatory dose for GH release, producing an approximately 4-fold increase in circulating levels of GH; lower doses of beta-endorphin did not stimulate secretion. All three antagonists were capable of blocking the stimulatory effects of beta-endorphin. These results provide evidence that all three opiate receptor subtypes are involved in the stimulatory effect of beta-endorphin on GH release.

Opiate receptor subtype involvement in the stimulation of prolactin release by beta-endorphin in female rats

The prolactin secretory response to beta-endorphin and the involvement of opiate receptor subtypes in this response was determined in both diestrous and postpartum, lactating female rats. The involvement of the mu-, delta- and/or kappa-site was determined by administering specific antagonists for each of these sites prior to beta-endorphin. beta-Funaltrexamine (beta-FNA, 1 or 5 micrograms) was administered to block mu-sites, ICI 154,129 (5, 10 or 25 micrograms) blocked delta-sites and nor-binaltorphimine (norBNI, 8 micrograms) blocked kappa-sites. The ability of beta-FNA and ICI 154,129 to block prolactin secretion following morphine administration was also determined. A dose response study for beta-endorphin indicated that beta-endorphin, at doses as low as 25 ng, was a potent stimulus for prolactin release producing an increase in prolactin that mimicked the suckling-induced prolactin increase. In addition, all three antagonists were capable of antagonizing the stimulatory effect of beta-endorphin in both diestrous and postpartum female rats. These results indicate that beta-endorphin is a potent stimulus for prolactin secretion and that these three opiate receptor subtypes interact to produce its stimulatory effect on prolactin release.

Morphine induced analgesia is attenuated in post-partum lactating rats

The analgesic effects of morphine administration were determined in post-partum, lactating female rats, as well as in intact, cycling females during the diestrous stage of the estrous cycle. All doses of morphine (2.5, 5 and 10 mg/kg, iv) produced a significant analgesic response in both post-partum and diestrous females using the hot water tail immersion latency test. However, the analgesic response in the post-partum females was significantly less than during diestrus at all doses tested. In addition, pretreatment with the mu 1 specific antagonist, Naloxonazine, significantly blunted the analgesic response in diestrous females, but did not significantly affect analgesia in post-partum females. These results indicate that morphine is less effective in producing analgesia in post-partum females. The mu 1 opiate receptor site does not appear to be involved in the analgesia produced during the post-partum period.

The role of the mu(1) opioid receptor subtype in the regulation of prolactin and growth hormone secretion by Beta-endorphin in female rats: studies with naloxonazine

The μ opioid receptor subtype has been reported to mediate the prolactin secretory response to opioids. This receptor subtype has been implicated in the morphine-induced prolactin increase, as well as the prolactin response to μ-specific opioid peptides. Subtypes of the μ receptor have been proposed and the μ(1) , site has been postulated as the receptor subtype involved in the morphine-induced prolactin secretory response. However, the role of this receptor subtype in mediating the endocrine effects of the endogenous opioid peptides has not been characterized. In order to determine the physiological significance of this receptor subtype, animals were pretreated with saline, WIN 44,441-3 (a μ, δ and κ antagonist) or naloxonazine (a μ(1) antagonist) followed by a stimulatory dose of morphine or β-endorphin. A dose response study for β-endorphin was conducted to determine the minimal stimulatory dose of β-endorphin on the prolactin and growth hormone (GH) secretory response. The dose response study indicated that β-endorphin is a more potent stimulus for prolactin release than for GH. A dose as low as 25 ng increased prolactin levels as much as 100-fold in both lactating and diestrous female rats. In contrast, 2.5 μg β-endorphin was required in order to consistently and significantly increase circulating levels of GH by 2- to 3-fold. WIN 44,441-3 antagonized the stimulatory effects of β-endorphin on both prolactin and GH secretion. Naloxonazine pretreatment abolished the morphine-induced prolactin secretory response, without affecting the GH increase in diestrous females. Naloxonazine also antagonized the prolactin response to β-endorphin in both lactating and diestrous females. In addition, it attenuated the GH secretory response but did not totally abolish it. These data indicate that β-endorphin elicits an increase in prolactin release through an opioid specific receptor which appears to be the μ(1) opioid receptor subtype. They further suggest that β-endorphin may increase GH levels, at least partially, via its action at this μ(1) site.

Cadmium exposure inhibits the prolactin secretory response to thyrotrophin releasing hormone (TRH) in vitro

In vitro dose response (0.1-100 microM) and time course studies were performed on anterior pituitary cells isolated from female Sprague-Dawley rats in the diestrous stage of the estrous cycle. All doses of TRH produced a significant increase in prolactin release by 5 min which was sustained for 30 min. Pretreatment with 25 or 50 microM Cd for 2 or 4 h produced a significant decrease in prolactin secretion during Cd exposure and in the prolactin secretory response to 1 microM TRH. These results suggest that Cd pretreatment alters the subsequent ability of the lactotrophs to respond to the physiological secretagogue TRH. This alteration does not appear to be due to a rebound phenomenon since basal prolactin release was the same in Cd-pretreated and control cells once the metal was removed. These results suggest that Cd pretreatment produces a significant decrease in prolactin release from the anterior pituitary lactotrophs in response to subsequent TRH stimulation in vitro.

Effects of immobilization stress on tuberoinfundibular dopaminergic (TIDA) neuronal activity and prolactin levels in lactating and non-lactating female rats

The effects of immobilization stress on the prolactin secretory response and on the activity of the tuberoinfundibular dopaminergic (TIDA) neurons were determined in intact, virgin female rats on the morning of diestrus or proestrus and in post-partum, lactating female rats. The virgin females exhibited a significant increase in circulating levels of prolactin which was evident by 1 minute and persisted during the immobilization (5 minutes). In contrast, the prolactin secretory response in lactating females was significantly attenuated compared to non-lactating animals. The activity of the TIDA neurons was not altered by the 5 minutes of stress. Even after 30 minutes of immobilization, TIDA neuronal activity was not affected in either the lactating or cycling females. These data suggest that the cycling female rat is capable of a prolactin secretory response to the stressor without inhibition of TIDA neuronal activity. It seems likely that prolactin releasing factors mediate this response. In contrast, stress did not produce a similar prolactin increase during lactation. It seems likely that, during lactation, the pituitary is not sensitive to releasing factors unless the TIDA neurons are inhibited. There appear to be differences in the sensitivity of the pituitary depending on the physiological state of the model employed.

Brief Admission Program: An Alliance of Inpatient Care and Outpatient Case Management

1. Brief planned and crisis admissions to an inpatient psychiatric unit are presented as a component supportive of outpatient care and case management for chronically mentally ill patients. 2. Typical patients admitted to this inpatient short-term program are those experiencing a life stress or temporary crisis; chronically mentally ill patients who cycle and experience exacerbations of their illness; and those who need to make the transition from an acute inpatient unit to community living. 3. The Brief Admission Program treats the individual's response to and the consequences of a lifelong illness and enables the patient to return to his previous level of functioning and continue necessary outpatient treatment.

Time course of the insensitivity of prolactin release to morphine administration in the lactating female rat

The effect of morphine on circulating levels of prolactin and growth hormone (GH) in the lactating female model was determined at various time intervals following the termination of suckling. Morphine administration did not produce an increase in prolactin levels when dams remained suckling. Four days after suckling was terminated, 50% of the dams tested showed a morphine induced prolactin increase. The prolactin secretory response to morphine gradually returned in dams, so that after 8 days of non-suckling, all animals tested showed a morphine induced prolactin increase. Consistent with the lack of prolactin stimulation, the tuberoinfundibular dopaminergic (TIDA) neurons, were insensitive to the morphine induced inhibition of activity during lactation. In contrast, circulating levels of GH were increased in these dams following morphine administration. These results suggest that the lactating female rat is insensitive to the mu mediated stimulation of prolactin release while suckling. However, sensitivity begins to return following at least 4 days of non-suckling.

A primary genetic map of chromosome 13q

We have constructed a primary genetic map spanning most of human chromosome 13. A total of 14 polymorphic DNA sequences and one protein polymorphism provided, after construction of haplotypes, seven markers for the long arm of this chromosome. A panel of cell lines from 30 three-generation families with large sibship size served as the sample set. Pairwise cross analysis of the inheritance patterns of the marker loci established that six of the seven loci constituted a single linkage group; the seventh was localized by physical means. Significantly higher recombination rates were found in female than in male meioses in several intervals. The six closely linked loci were arranged, based on the two-point data, in three clusters, and a number of alternate gene orders were excluded by three-point linkage tests. The order and spacing of the individual loci were refined by linkage analyses that considered five loci jointly.

Prolactin release and tuberoinfundibular dopaminergic neuronal activity following single and double injections of morphine

It is well established that opiate agonists alter tuberoinfundibular dopaminergic activity and consequently prolactin release. The purpose of this study was to characterize the effects of morphine on prolactin secretion and tuberoinfundibular dopaminergic neuronal activity with respect to time after administration. Additionally, the effect of an initial morphine injection on the response produced by a second injection of morphine was determined. The rate of depletion of median eminence dopamine content following synthesis inhibition by alpha-methyl-p-tyrosine was used as an index of dopaminergic neuronal activity. Male rats given a single injection of morphine sulfate (15 mg/kg, s.c.) showed a significant increase in circulating prolactin levels and had a lower rate of median eminence dopamine turnover 1 h after injection. Four hours after injection, circulating prolactin levels were similar to those in vehicle treated rats, while dopamine turnover was significantly higher than controls. When two injections of morphine sulfate (15 mg/kg, s.c.) were given 4 h apart, the stimulation of prolactin release produced by the second injection was significantly attenuated. Although this second injection caused a significant decrease in dopamine turnover, the turnover rate following this injection was significantly greater than that following the initial injection. The combination of fluoxetine and 5-hydroxytryptophan (FLX/5-HTP) caused an initial increase in prolactin secretion with plasma values returning to basal levels by 4 h. When rats were pretreated with FLX/5-HTP instead of morphine, the prolactin response to an injection of morphine 4 h later was not attenuated. Similarly a FLX/5-HTP pretreatment had no influence on a second injection of FLX/5-HTP administered 4 h later.(ABSTRACT TRUNCATED AT 250 WORDS)

Construction of linkage maps with DNA markers for human chromosomes

DNA markers and sampling of three-generation families can be used to construct complete linkage maps of human chromosomes. This is important in mapping disease loci and in determining the genetic or environmental component of a disease.