bluuebunny/crossref_metadata_2025 huggingface dataset:
Zonal Location of Compensatory Hepatocyte Proliferation Following Chemically Induced Hepatotoxicity in Rats and Humans
Authors: Lee Valentia M. , Cameron Ross G. , Archer Michael C.
Published: July 2017

Hepatocyte proliferation stimulated by partial hepatectomy occurs first in periportal cells, with midlobular and then perivenous cell division occurring later. We have previously shown that this pattern of compensatory cell proliferation also occurs following the hepatotoxicity of A/-nitrosodimethylamine. We examined the generality of this pattern in livers of rats given a minimally toxic dose of an hepatotoxin and in liver biopsy samples from patients who had taken overdoses of acetaminophen. Proliferating hepatocytes were detected immunohistochemically (5'-bromodeoxyuridine or Ki-67 antigens). The perivenous necrogens JV-nitrosodiethylamine, carbon tetrachloride (CC14), bromobenzene, and acetaminophen all induced periportal hepatocyte proliferation. With COL4, bromoben-zene, and acetaminophen, the initial appearance of proliferating periportal hepatocytes was followed 12-24 hr later by division in the midlobular region, with a few cells dividing adjacent to the perivenous region of necrosis. The periportal necrogen allyl alcohol also induced periportal cell division. In the human studies, perivenous necrosis was accompanied by periportal and midlobular hepatocyte proliferation. These results suggest that regardless of its lobular location chemically induced hepatotoxicity stimulates cell proliferation that begins in the periportal zone and then moves in an orchestrated response into the midlobular and perivenous zones.
A Poorly Differentiated Germ Cell Tumor (Seminoma) in a Long Evans Rat
Authors: Kerlin Roy L. , Roesler A. Ross , Jakowski Amy B. , Boucher Germaine G. , Krull David L. , Appel William H.
Published: July 2017

A large neoplasm that replaced 1 testis of a Long Evans Rat was noted at the final necropsy of a dietary 2-yr study. By light microscopy, the morphological features were consistent with a poorly differentiated seminoma. Ultrastructurally, the cells were polygonal, had a round nucleus, had straight cellular boundaries, and bore no resemblance to Sertoli cells. Although there was little evidence of spermatocytic differentiation, the presence of proacrosomal granules and vesicles, prominent Golgi apparatus, tight intercellular junctions, and a few centriolar pairs without axoneme development, in conjunction with the absence of lipid droplets or abundant smooth endoplasmic reticulum, supported the diagnosis of seminoma rather than Leydig cell tumor. The cells were S-100-and vimentin-positive, although cytokeratin- and a-fetoprotein-negative. Seminomas are extremely rare neoplasms in rats; this is the first report in this strain and the first extensive analysis of a rat seminoma without spermatocytic differentiation.
A histomorphometric study of the effect of chronic vitamin a deficiency on the circumvallate papilla of the rat
Authors: Chole Richard A. , Charpied George L.
Published: July 2017

Although a deterioration of taste sensitivity is known to occur during severe vitamin A depletion, the structural changes in the taste buds themselves have not been described. Circumvallate papillae from rats deprived of vitamin A were examined histomorphometrically at intervals, and changes in the gustatory apparatus were quantitated. The cross‐sectional area of the circumvallate trenches increases 30‐fold because of keratin accumulation when vitamin A deficiency is extreme. After 190 days on a vitamin A–free diet, 38% of rats had no detectable taste buds and the remaining taste buds appeared atrophied. The involution of the taste buds may be the result of keratin buildup in the adjacent trench or a direct consequence of vitamin A deficiency. The atrophy of the gustatory apparatus during vitamin A deficiency and the consequent presumed loss of taste sensation may contribute to a diminished interest in food and the subsequent protein‐calorie malnutrition seen in vitamin A–deficient populations.
Antibodies to human squamous cell carcinoma
Authors: Carey T. E. , Kimmel K. A. , Schwartz D. R. , Richter D. E. , Baker S. R. , Krause C. J.
Published: July 2017

We are studying membrane antigens of human squamous cell cancer with the use of naturally occurring autologous antibodies from patients’ sera, along with a set of other serologic reagents and monoclonal antibodies raised against cultured squamous cell lines. Twenty‐eight squamous cell carcinoma cell lines have been established in our laboratory from tissues obtained from 23 patients. Antibody reactivity has been found against the autologous tumor cell line in 13 of 23 patients. One of these is of sufficient titer for detailed analysis. Four cell lines are available from this patient. UM‐SCC‐17A is derived from the primary laryngeal carcinoma, and UM‐SCC‐17B is derived from a lymph node metastasis removed during the same surgical procedure. Fibroblasts have been cultured from normal mucosa, and a B‐lymphoblastoid line has been developed by Epstein‐Barr virus transformation of the patient's peripheral blood lymphocytes. Antibody from this patient reacts with the UM‐SCC‐17A and ‐17B tumor cell lines but does not react with the normal fibroblasts (UM‐NF‐17).
A safe, nonflammable, all‐metal, cuffless endotracheal Venturi ventilation system for use in laser surgery
Authors: Woo Peak , Vaughan Charles W.
Published: July 2017

In this preliminary study with seven dogs, ventilation with a Sanders bronchoscope attachment coupled to the Norton metal endotracheal tube and use of a jet O2 injector system proved adequate for sustained oxygenation and acid‐base balance. This system is shown to be superior to the conventional anesthesia volume ventilator when used with the cuffless metal endotracheal tube. The ventilatory capability can be easily adjusted upward and downward by changing the driving pressures of the reducing valve. Peak intratracheal and transtracheal pressure measurements show the pressures encountered to be similar to those of conventional volume ventilation techniques. The use of the all‐metal endotracheal tube in endolaryngeal laser surgery is discussed. The advantages of such a system lie in the elimination of a flammable endotracheal tube during laser endolaryngeal surgery while preserving adequate and stable ventilation.
Influence of argon laser stapedotomy on inner ear function and temperature
Authors: Vollrath Michael , Schreiner Christoph
Published: July 2017

The influence of argon laser stapedotomy on inner ear function was investigated in guinea pigs. The cochlear microphonics (CM) and the compound action potential (CAP) served as parameters for the functional status of the cochlear. Transitory depression of both potentials was found during and after laser stapedotomy. The time course of CM and CAP depression and recovery is compared to endocochlear temperature changes. Possible implications for clinical use are discussed.
Principles in embryonic development and differentiation of vestibular hair cells
Authors: Anniko Matti , Nordemar Hans , Sobin Aron
Published: July 2017

The early development and maturation of vestibular hair cells in the CBA/CBA mouse were analyzed at the ultrastructural level with conventional transmission electron microscopy and freeze fracturing. Cells differentiating into future hair cells pass their terminal mitosis close to the otocyst lumen. The earliest morphologic sign of differentiation into future hair cells was the arrangement of microvilli in a regular fashion. Hair cell cytodifferentiation occurred with a gradient from the hair cell surface to the base. In parallel with the maturation of sensory hairs a structural intracellular rebuilding occurred: the number of polyribosomes and amount of rough endoplasmic reticulum decreased, the nucleus moved basally, and mitochondria accumulated in the supranuclear region. Both tight junctions and gap junctions occurred initially on developing hair cells. From the sixteenth gestational day on, gap junctions disappeared, indicating an uncoupling phenomenon. Afferent nerve terminals developed before efferent nerve endings. Maturation of innervation occurred, for the most part, postnatally, and after that hair cells reached mature morphology.
Description and clinical importance of the lymphatics of the vocal fold
Authors: Werner Jochen A. , Schünke Michael , Rudert Heinrich , Tillmann Bernard
Published: July 2017

Findings of the presence of lymphatics in the subepithelial connective tissue layer of the true vocal cord range from the statement that lymphatics are absent to the observation that a dense lymphatic network exists. This is undoubtedly a result of the different methods of examination. The entire extent of a lymphatic system can be shown by either an enzyme histochemical demonstration of the 5'‐nucleotidase activity in the lymphatics, or electron microscopy, which is more elaborate. These two methods are used to describe a subepithelial lymphatic network of varying density in 80 human vocal folds, which—contrary a frequent assumption—is not interrupted in the area of the free margin of the true vocal cord. Under the squamous epithelium, the density of the lymphatic system, which is very high in the arytenoid region, decreases continuously toward the anterior portion of the true vocal cord. It is exactly in the region in which the lymphatic system is the sparsest that almost all cancers of the true vocal cord develop. This finding is highly significant, in view of the low incidence of lymphogenous metastasis formation in T1‐glottic cancers.
NMR spectroscopy evaluation of plasma “oncolipids” in head and neck cancer
Authors: Scher Richard L. , Ropka Mary E. , Neal Danny A. , Berr Stuart , Trouard Ted , Deutsch Brian , Cantrell Robert W. , Levine Paul A.
Published: July 2017

The use of water‐suppressed proton nuclear magnetic resonance spectroscopy of plasma as a serologic test for the detection of malignancy was first described in 1986. That report prompted the present study, which was undertaken to evaluate the efficacy of this test in differentiating patients who have head and neck malignancy from normal controls. Forty‐six patients who had a biopsy‐proven malignancy of the head and neck and 32 healthy individuals provided plasma for which the nuclear magnetic resonance spectrum was plotted, blind to patient diagnosis or group. The average line‐width of methyl and methylene resonance was calculated. Significant differences (p 0.05) were found between the group with disease and the group with no disease for the methyl line‐widths, using analysis of variance. In spite of this statistical difference, plotting of the values for the methyl, methylene, and average line‐widths clearly demonstrated that these three oncolipid measures have no clinical use because of the tremendous overlap between the disease and nondisease groups. The findings of this study do not support the use of water‐suppressed proton nuclear magnetic resonance spectroscopy as a clinically useful test for the diagnosis of head and neck malignancy.
Thyroid cancer: A computer‐assisted review of 5287 cases
Authors: Jensen Michael H. , Davis R. Kim , Derrick Larry
Published: July 2017

Retrospective computer analysis of all reportable cases of thyroid cancer for the Rocky Mountain Cancer Data Systems between 1973 and 1983 was undertaken. Follow‐up data were available for periods of 5 to 10 years. All major histologic findings are reviewed with regard to distribution, prognostic factors, mortality rates, and some treatment modalities. Interesting observations determined by this study include: (1) the significantly greater mortality rates seen in patients with thyroid cancer after 50 years; (2) the lack of increased mortality rates in young patients with differentiated cancer; (3) the poorer prognosis of male patients of equivalent age to female patients in all histologic types of cancer in the first 5 years; (4) the lack of sexual difference in influencing mortality rates after the first 5 years in differentiated cancers and lack of sex as a prognostic indicator in undifferentiated cancers; (5) the excellent prognosis of patients with localized differentiated and medullary cancers and a better‐than‐expected prognosis in the undifferentiated group; (6) the clear need for combined therapy (surgery and irradiation) in regional medullary cancer; (7) the observation that localized thyroid lymphoma had a higher mortality rate than had regional thyroid lymphoma; and (8) a significantly higher mortality rate in patients pider than 79 years with differentiated cancer.
The effect of a leukotriene antagonist on the early response to antigen
Authors: Flowers Whan K. , Proud David , Kagey‐Sobotka Anne , Lichtenstein Lawrence M. , Naclerio Robert M.
Published: July 2017

The sulfidopeptide leukotrienes (LT) C4, D4, and E4 increase in nasal secretions during the nasal response to antigen challenge, and nasal challenge with LTD4 induces nasal congestion. To further assess the role of leukotrienes, we administered an oral LTD4 antagonist, L‐649,923, to 12 patients who had nasal allergy to grass and ragweed pollen, in a double‐blind, placebo‐controlled, crossover study. Patients were challenged intranasally with increasing doses of pollen on each of 2 days, and the recovered nasal lavage fluids were assayed for histamine, TAME‐esterase activity, and immunoreactive LTC4/D4/E4. The patients graded runny nose, congestion, and throat irritation, and sneezes were counted. Significant (p < 0.01) increases in all parameters were found when comparing antigen challenge with diluent challenge, but no differences were seen among the treatment groups. Thus, oral L‐649,923 was not effective in blocking the symptoms of the early nasal allergic response.
Photodynamic therapy for treatment of head and neck cancer
Authors: Schweitzer Vanessa Gayl
Published: July 2017

Since 1975, photodynamic therapy has reportedly been effective in a variety of head and neck malignancies that failed traditional (conventional) therapy, including surgery, cryotherapy, chemotherapy, hyperthermia, and radiation therapy. Photodynamic therapy consists of the intravenous administration of (di)hematoporphyrin ether, a chemosensitizing drug selectively retained by neoplastic and reticuloendothelial tissues which, when exposed to a 630‐nm argon laser, catalyzes a photochemical reaction to release free oxygen radicals, “the cytotoxic” agents responsible for cell death and tumor necrosis. Preliminary investigations have assessed the efficacy of photodynamic therapy in treatment of: (1) superficial “condemned mucosa” or “field cancerization” of the oral cavity and (2) stage III and IV head and neck carcinomas that had unsuccessful conventional therapy. Complete and/or partial remissions were obtained in 11 of 12 patients (16 treatments) with a variety of carcinomas of the nasopharynx, palate and uvula, retromolar trigone, temporal bone, cervical esophagus, and AIDS‐related Kaposi's sarcoma of the oral cavity.
The Evolution of Lithium Therapy
Authors: Johnson F. Neil
Published: July 2017

The evolution of lithium therapy for the treatment of mania and depression, from its discovery to the present day, is described. Early problems with toxicity have been overcome and lithium is now established as a safe medication, provided serum levels are monitored. The mechanism of action of lithium is not yet known, but biochemical models are beginning to be put forward. Lower doses of lithium than were previously used are now recommended. Treatment with intermittent doses of lithium (every second day) seems to reduce side effects, while maintaining clinical efficacy. Lithium has recently been used in combination with other medications. Augmentation of unsuccessful antidepressant treatment with lithium may produce an antidepressant effect within a short time. Withdrawal from lithium therapy usually results in a relapse. Lithium treatment is also used outside psychiatry. Other potential clinical applications for lithium therapy are discussed.
Practical Aspects of Long-Term Treatment with Lithium
Authors: Glen Iain
Published: July 2017

There is no increase in the overall mortality of patients undergoing long-term lithium treatment compared with those receiving short-term treatment. Lithium causes a reduction in the incidence of suicide in patients suffering from manic depressive illness. Long-term treatment with lithium is more effective than treatment with imipramine or amitriptyline. Drug interactions may cause problems during long-term therapy with lithium. A reduction in plasma levels of lithium should be considered in stable patients on long-term prophylaxis. Discontinuation of therapy often results in a relapse. The toxicity of lithium is related to its effects on calcium transport.
Effects of lofepramine and dothiepin on memory and psychomotor function in healthy volunteerso
Authors: Allen David , Curran H. Valerie , Lader Malcolm
Published: July 2017

The effects of single doses of lofepramine (70 mg), dothiepin (50 mg) and placebo on memory and psychomotor function were compared in a cross-over study with 12 healthy volunteers. Dothiepin produced a differential pattern of effects across the range of memory assessments used, impairing episodic memory and slowing learning in a procedural task but not affecting working, semantic or implicit memory. Dothiepin also impaired performance on two attentional tasks, slowed down reaction times and increased subjective sedation. Lofepramine was similar to placebo on nearly all objective measures, but produced effects similar to dothiepin on critical flicker fusion threshold, salivary flow and most EEG wavebands. It is concluded that, unlike lofepramine, acute dosage with dothiepin is associated with sedative effects and impairments of concentration and memory.
Ondansetron, gender and antipredator defensive behaviour
Authors: Shepherd Jon K. , Rodgers R. John , Blanchard Robert J. , Magee Linda K. , Blanchard D. Caroline
Published: July 2017

The 5-HT3 receptor antagonist ondansetron has provided a somewhat equivocal profile in a number of animal models of anxiety. The present study assessed the effects of this compound in two ethological test batteries. The Fear/Defense Test Battery (F/DTB) and the Anxiety/Defense Test Battery (A/DTB) have been developed to investigate antipredator defensive reactions in rats. The F/DTB measures behavioural reactions of wild-trapped rats to human threat, while the A/DTB assesses behavioural responding in laboratory rats as a consequence of exposure to a domestic cat, and to cat odour per se. Ondansetron (0.001–0.10 mg/kg) failed to provide any reliable and consistent profile of anxiety/fear reduction in either test battery. In addition to the elucidation of drug effects, previous studies have provided clear evidence of gender differences with female rats showing higher levels of defensiveness than males in the A/DTB. Until now, no such differences have been observed with wild-trapped rats in the F/DTB. Thus, the present study indicated a clear gender difference with females exhibiting greater defensiveness. This finding is discussed with reference to the general decrease in defensiveness of the first generation animals compared with their wild-trapped parents.
Serotonin, sertraline and depression
Authors: Montgomery Stuart
Published: July 2017

Sertraline is a highly selective serotonin re-uptake inhibitor (SSRI) whose efficacy in depression has been established in a number of large placebo-controlled studies in patients with moderate to severe major depressive episodes (DSM-III). This antidepressant efficacy appears to be significantly more effective than placebo and imipramine and at least of the same order as that of the reference tricyclic antidepressants (TCAs) amitriptyline, clomipramine and dothiepin. More recently, two double-blind parallel group studies have demonstrated comparable efficacy to another SSRI, fluoxetine. Sertraline has demonstrated efficacy in the long-term maintenance and prophylaxis of depression and is one of the few SSRIs currently indicated for the prevention of relapse and recurrence of depression. Fixed dose studies have confirmed the efficacy and optimal tolerability of the minimum 50 mg dose. The efficacy of sertraline, demonstrated across a broad spectrum of depression, and its consistently improved tolerability and safety profile over the TCAs, confirm its potential as a first-line treatment for acute and recurrent episodes of depression.
The long-term management of depression
Authors: Lane Roger
Published: July 2017

The long-term outlook for patients with unipolar depression is often poor. As few as one-fifth will remain well and a similar number will suffer chronic depression. It is now standard practice to extend acute treatment into a 4–6 month period of continuation therapy, and the value of prophylactic treatment over longer periods is becoming more widely recognised. Care must, however, be exercised in choosing suitable long-term treatment. Relatively little work on the prophylactic efficacy of the tricyclic antidepressants has been carried out, although imipramine has been shown to be effective. The selective serotonin re-uptake inhibitors (SSRIs) have been studied extensively and may be the most suitable long-term treatment for depression. Sertraline is effective in preventing both relapse and recurrence of depression and was the first agent specifically indicated for the long-term treatment of depression in the UK. In addition to clinical efficacy, many other factors favour SSRIs in the long-term management of depression. The tolerability of a drug is of major importance in long-term therapy since it affects compliance. Other important considerations include toxicity, safety in overdose, drug interaction potential, psychomotor effects and accident liability.
Treatment approaches to therapy-resistant depression
Authors: Dinan Ted
Published: July 2017

Resistance to antidepressant treatment is a controversial field and therapy resistance has received a wide range of definitions. The field has suffered from a lack of consensus on how to classify treatment resistance and from the related failure to standardise clinical criteria in trials of new therapeutic approaches. A significant proportion of tricyclic antidepressant (TCA)-resistant depression results from the failure to sustain an adequate course of therapy. This can be due to either inadequate prescribing or the poor tolerability of TCAs. The majority of cases of treatment resistance, however, involve antidepressant therapy at a dose and duration that would normally be expected to be effective. In these cases, therapy may fail for many reasons. Refractory depression may occur in patients with medical conditions such as subclinical hypothyroidism, stroke and closed head injuries. Patients with alcoholism may prove refractory to treatment, as may those receiving certain medications, notably calcium channel blockers. Certain subtypes of depression, such as rapid-cycling disorder and delusional depression, also appear to be more refractory to treatment. A variety of therapeutic approaches have been applied to treatment-resistant depression but, for most of these, placebo-controlled clinical trials with substantial numbers of patients have not been conducted. Selective serotonin re-uptake inhibitors (SSRIs) may have a role to play in TCA-resistant patients as a result of their superior tolerability; monoamine oxidase inhibitors (MAOIs) also have a significant therapeutic role. ECT has an important role to play in patients who failed to respond to successive drug therapies. Of the various add-on therapies, thyroid augmentation (triiodothyronine) of antidepressant treatment has shown promise, and definite benefits have been established for lithium augmentation. Evidence has emerged to show that lithium is not only effective as an adjunct to TCA therapy, but also to the better tolerated SSRIs. However, further trials will be necessary to determine the optimal dosage and treatment duration for lithium augmentation.
Das histomorphologische Verhalten des Knochensystems des Jungrindes nach quantitativer Mangelernährung
Authors: Herrmann H. J.
Published: July 2017

As a contribution to the knowledge of metabolic skeletal disorders of cattle and to the comparative pathology of osteopathies due to quantitative undernutrition, the bone lesions observed in 7 markedly cachectic calves are described and discussed. The animals varied from 31/2 to 6 months of age. The most important findings included osteoblastic osteoporosis caused by pronounced inhibition of proliferation and maturation of the chondrocytes and osteoblasts as well as osteoclastic osteoporosis in one case resulting from significantly increased resorption. The bone marrow showed contained transudate, gelatinous replacement of the fat, and, replacing the hemopoietic cells, a ground substance containing fibrin and condensed plasma albumin and consisting primarily of acid mucopolysaccharides. The pathogenesis of the findings is discussed, and it is debated to what extent these changes are specific for quantitative undernutrition and how far quantitative malnutrition can be considered responsible for generalized osteodystrophia fibrosa. The findings in the calves are compared with literature reports on corresponding osteopathies in other animal species and in man. The more severe effect of undernutrition on the skeleton of growing domestic animals as compared to man is attributed to the more rapid growth of the former.
Vergleichende Untersuchungen über das Amyloid und Paramyloid verschiedener Tierarten
Authors: Trautwein G.
Published: July 2017

The histochemical attributes of amyloid and paramyloid deposits were investigated and compared, using material from cattle, dogs, mink and horses. Histochemically, there is considerable similarity between amyloid and paramyloid. Both are built from a neuraminic acid and carbohydrate-containing protein (glycoprotein), but their neuraminic acid and carbohydrate contents vary considerably in the individual varieties of amyloid. The fibrin-positive substances demonstrable in paramyloid are an indication that blood proteins are incorporated in this variety of amyloid in larger amounts than in ordinary amyloid.
Adenomatous Intestinal Hyperplasia (Proliferative Ileitis) of Swine
Authors: Dodd D. C.
Published: July 2017

A nodular proliferation of the ileal mucosa of a young pig which had suffered an attack of acute enteritis is described and illustrated. The condition is apparently the same as that reported some 37 years ago as ‘intestinal adenoma', but the author prefers the designation of ‘adenomatous intestinal hyperplasia'. The conditions of regional or terminal ileitis of the pig, regional ileitis of man, and muscular hypertrophy of the porcine ileum are reviewed and discussed with particular reference to adenomatous hyperplasia and to one another. A comparison is also made with ‘enzootic intestinal adenocarcinoma’ of hamsters, a disease which has many features similar to this porcine disease.
Multiple Neoplasia in a Rhesus Monkey Macaca mulatta
Authors: Chapman W. L. , Allen J. R.
Published: July 2017

The clinical course, radiographic description, hematologic changes, histopathologic evaluations, and electron microscopic findings are presented on an osteogenic sarcoma involving the frontal bone of an adult female Macaca mulatta, with metastases to the lungs and adrenal. In addition, this monkey also had a subcutaneous lipoma of the leg, a hemangioma of the liver, and a renal adenocarcinoma.
The Lung in Zwoegerziekte
Authors: Ressang A. A. , de Boer G. F. , de Wijn G. C.
Published: July 2017

The lungs in zwoegerziekte, a chronic pulmonary disease, are greatly increased in weight, do not collapse, and are either pale and dry or mottled with grey consolidation. The initial stage is characterized by peribronchial, perivascular, and solitary lymphoid hyperplasia and cellular infiltration of alveolar septa with consequent thickening. Fibrosis or myofibrosis, thickening of arterial walls, epithelial proliferation of air passages, and alveolar fetalization characterized the end stage.

Pathologically zwoegerziekte, maedi, and progressive pneumonia have predominantly a mesenchymal reaction and belong to a single entity, chronic interstitial pneumonia of sheep. Zwoegerziekte bears close pathologic similarity to ‘la bouhite’ and ‘Graaff-Reinet disease’ but differs from pulmonary adenomatosis. Whether atypical pneumonia, also a type of interstitial pneumonia but different from maedi, occur in The Netherlands and may complicate some cases of zwoegerziekte is not known.
Nocturnal headache: systemic arterial pressure and heart rate during sleep
Authors: Cirignotta Fabio , Coccagna Giorgio , Sacquegna Tommaso , Sforza Emiliana , Lamontanara Giuseppe , Zucconi Marco , Cortelli Pietro , Lugaresi Elio
Published: July 2017

In order to evaluate autonomic nervous system changes occurring before nocturnal headache attacks, we studied three subjects (one male, two females) suffering from chronic migraine. All three patients underwent a nocturnal polygraphic recording including continuous monitoring of systemic arterial pressure and heart rate. Two subjects showed increases and irregularities of arterial pressure before awakening with headache. These changes began during N–REM sleep and lasted during REM sleep preceding the awakening with headache. Heart rate did not change before the attacks. These findings do not support the hypothesis that autonomic instability during REM sleep represents the precipitating factor of the attacks.

On a étudié avec des méthodes polygrafiques trois sujets (1 homme et deux femmes) souffrant d'hémicranie chronique avec des crises nocturnes. Chez deux malades les crises étaient précédées d'augmentation et d'irrégularité de la tension artérielle. Ces modifications commençaient pendant le sommeil N-REM et contineaient pendant le sommeil REM qui précédait le réveil avec hémicranie. La fréquence cardiaque n'a pas subi de modification avant les crises. Les résultats obtenus ne confirment l'hypothèse selon laquelle le facteur causant les crises est l'instabilité anticronique à la fase REM.

Sono stati studiati con metodiche poligrafiche 3 soggetti (1 maschio e 2 femmine) affetti da emicrania cronica con attacchi notturni. In 2 di essi gli attacchi erano preceduti da incrementi ed irregolarità della pressione arteriosa. Tali modificazioni iniziavano durante il sonno N-REM e perduravano nel corso del sonno REM che precedeva il risveglio con cefalea. La frequenza cardiaca non si modificava prima dell'attacco. I risultati ottenuti non confermano l'ipotesi che il fattore precipitante gli attacchi emicranici sia l'instabilità anticronica della fase REM.
Neuroendocrinological signs of central neurotransmission disorders
Authors: Polleri Alessandro , Nappi Giuseppe , Murialdo Giovanni , Sances Grazia , Masturzo Paola , Savoldi Faustino
Published: July 2017

Modulation mechanisms of nociception have several neurotransmission interactions that are impaired in the disorder of painful perceptions. Neurotransmission changes may show up in several ways on the clinical level. They also have endocrinological correlations, since the neurotransmission systems implicated in the nociception disorders share transmitters with the regulation system operating at the pituitary level. In this sense, nocipathies exhibit analogies and may be compared to disorders of motricity and behaviour that also show endocrine changes that may be likewise explained. Though specifically different in each instance, the neurotransmission alteration that is a common denominator of these disorders allows comparisons, especially in those situations, such as the nocipathic and behavioural ones, where correlations are relevant on clinical and interpretative grounds.

Les mécanismes de modulation de la nociception ont des interactions multiples de la neurotransmission qui sont compromises dans les nocipathies. Ces altérations de la neurotransmission peuvent avoir différents aspects cliniques. Elles ont aussi des corrélations endocriniennes, du moment que le système de neurotransmission en question a des neurotransmetteurs en commune avec le système regulatoire de l'hypophyse. Donc, les nocipathies montrent des analogies avec les maladies de la motricité et du comportement, qui présentent de même des troubles endocrins sujets à une interprétation similaire. L'alteration de la néurotransmission, quoique spécifiquement différente chez chaque condition clinique, est un commune dénomiteur à ces disordres et permet de confronter entre eux situations où des corrélations peuvent avoir importance sur le niveau clinique et interprétatif.

I meccanismi di modulazione della nocicezione hanno multiple interazioni neurotrasmettitoriali che sono compromesse nelle nocipatie. Le alterazioni neurotrasmettitoriali possono manifestarsi in modo diverso sul piano clinico. Esse hanno anche correlazioni endocrine, poichè il sistema neurotrasmettitoriale in questione è condiviso nei suoi elementi dal sistema regolatorio dell’ ipofisi. Così, le nocipatie mostrano analogie e possono essere paragonate con malattie della motricità e del comportamento, che danno anch'esse luogo a turbe endocrine di analoga interpretazione. L'alterazione neurotrasmettitoriale, benché specificamente diversa in ciascun quadro clinico, è un denominatore comune di questi disordini, consente paragoni specialmente in quelle situazioni, come nocipatie e disturbi del comportamento, in cui le correlazioni possono aver rilievo sul piano clinico ed interpretativo.
Substance P and endogenous opioids: how and where they could play a role in cluster headache
Authors: Sicuteri Federigo , Rainò Liborio , Geppetti Pierangelo
Published: July 2017

Substance P appears to be involved in the transmission of pain signals from the periphery to the spinal cord and brain stem. Substance P containing neurons are responsible for the neurogenic vasodilation identical to that obtained by substance P release evoked by antidromic stimulation of these fibres. Both endogenous opioids and somatostatin inhibit the release of substance P from central and peripheral endings. Present pharmacological investigations conclude that morphine and somatostatin are as effective as ergotamine in reducing the pain of CH. All three drugs are significantly more active than placebo. Somatostatin and opiates could act by inhibiting the release of substance P.

La Substance P (SP) représente le probable transmitteur des sensations douloureuses de la périphérie à la moelle épinière et au tronc encéphalique. Les neurones contenants la SP semblent être aussi responsables de la vasodilatation neurogenique identique à celle qui peut être obtenue par le “release” de SP, induit par la stimolation antidromique de ces fibres. Soit ces opiaces endogènes que la somatostatine (SR1F) inhibent le “release” de SP par les terminaisons nerveuses céntrales et périphériques. Notre étude clinique parvient à la conclusion que la morphine et le SRIF ont une efficacité semblabe à celle de l'ergotamine en rediure la douleur pendant l'attaque de céphalée “en chapelet”, et que tous les troi medicaments sont significativement actifs plus que le placebo. Le SRIF et les opiacés pourraient agir en inhibant le “release” de SP par les terminaissons neuronales céntrales et périphériques.

La sostanza P viene indicata come il probabile trasmettitore delle sensazioni dolorifiche dalla periferia al midollo spinale ed al tronco encefalico. I neuroni contenenti SP sembrano inoltre essere responsabili della vasodilatazione neurogenica identica a quella ottenibile dal “release” di SP indotto dalla stimoalzione antidromica di queste fibre. Sia gli oppiacei endogeni che la Somatostatina inibiscono il “release” di sostanza P dai terminali nervosi centrali e periferici. Dalla presente ricerca emerge che la morfina ed il SRIF hanno una efficacia simile a quella dell'ergotamina nel ridurre il dolore nell'attacco di CH, e che tutti e tre i farmaci sono significativamente più attivi rispetto al placebo. SRIF ed oppiacei potrebbero agire inibendo il release di SP dalle terminazioni nervose sia a livello centrale che periferico.
Histamine skin test in cluster headache: effects of dihydroergotamine with timed release
Authors: Giacovazzo Mario , Romiti Alfredo , Martelletti Paolo , Gallo Maria Francesca , Megale Gaetano
Published: July 2017

The histamine skin test, as modified by Giacovazzo, was carried out on 20 patients with cluster headache and on 20 control subjects, 10 of whom suffered from migraine and 10 who were healthy volunteers not presenting any form of headache. The test was carried out before and after 30 days treatment with timed-release dihydroergotamine methanesulphonate in a dose of 10 mg/day. Data recorded on a “headache time chart” before and after treatment were evaluated by statistical analysis. Block variance analysis was used to evaluate results of three parameters (latency time, hyperemia diameter, extinction time) emerging from the histamine skin test before and after treatment. A statistical comparison was also made of data obtained in basal conditions in the three groups of subjects, in order to confirm the usefulness of this simple test in the diagnosis of cluster headache.

Les auteurs ont effectué le test cutané à l'histamine, d'après la méthode Giacovazzo, sur 20 personnes souffrant de céphalée de Horton, et sur 20 autres, parmi lesquelles 10 souffrant de migraines et les autres, volontaires, n'étant affectés d'aucun type de céphalée. Le test a été réalisé avant et après un traitement à base de 10 milligrammes par jour d'une préparation de dihydroergotamine métasulfonée se libérant d'une façon programmée, et ce durant 30 jours consécutifs. Les résultats enregistrés sur la “fiche des relevés horaires de la céphalée” ont été analysés statistiquement avant et après le traitement thérapeutique. C'est ensuite qu'ont été analysés, grâce à la méthode de variance à blocs (phases pré et post thérapie), les trois paramètres déduits du test cutané à l'histamine (temps de latence, diamètre d'hyperhémie, temps d'extinction). Et, il a finalement été possible, à l'appui de la validité diagnostique de ce simple test, de confronter statistiquement les résultats des trois paramètres de base relatifs aux différents groupes de patients.

E’ stato eseguito il test cutaneo all'istamina, secondo Giacovazzo, in 20 pazienti di cefalea a grappolo e in 20 soggetti di controllo, dei quali 10 affetti da emicrania e 10 volontari sani. Il test è stato eseguito prima e dopo trattamento con 10 mg al dì, per trenta giorni, di un preparato di diidroergotamina metansulfonato a liberazione programmata. Sono stati analizzati statisticamente i dati dedotti dalla “carta oraria della cefalea”, prima e dopo trattamento terapeutico. Il metodo della varianza per blocchi è stato usato per confrontare (fasi pre e post terapia) i tre parametri dedotti dal test cutaneo all'istamina (tempo di latenza, diametro di iperemia, tempo di estinzione). Un ulteriore confronto statistico è stato infine ese-guito tra i dati desunti dai tre parametri in condizioni di base, nei vari gruppi di pazienti, a conforto della validità diagnostica di questo semplice test.
DHE retard for prophylactic therapy of migraine: efficacy and tolerability
Authors: Centonze Vincenzo , Attolini Ettore , Santoiemma Luigi , Brucoli Caterina , Macinagrossa Giuseppe , Campanozzi Fausto , Albano Ottavio
Published: July 2017

The authors evaluated the efficacy of a DHE methanesulphonate for migraine attacks and its tolerability on liver, gallbladder and cardiovascular system functions. Twenty-eight patients affected by migraine were studied. They were withdrawn from preventive therapy for at least one month and treated for three months. The drug showed a good efficacy with a statistical significant reduction of severity and duration of attacks. No variation of the biochemical and morphological parameters of liver, gallbladder and cardiovascular function were found throughout the treatment.

Les Auteurs ont évalué l'efficacité contre les crises migraineuses et la tolérance, sur la base de données hépato-biliaires et cardio-vasculaires, de la DHE à liberation programmée. 28 patients migraineux ont été traités pendant 3 mois par la DHE à liberation programmée, à la dose de 10 mg par jour. Les résultats ont montré une excellente tolérance et une très bonne efficacité de la DHE à liberation programmée, en particulière contre l'intensité et la durée des crises migraineuses.

Gli AA. hanno valutato l'efficacia nel controllo delle crisi emicraniche e la tollerabilità nei confronti dell'apparato epato-biliare e cardio-vascolare, di una DHE metansulfonato a cessione programmata, in grado cioé di garantire la liberazione graduale nell'arco delle 24 ore del principio attivo. Sono stati studiati 28 soggetti affetti da emicrania, esenti da almeno un mese da terapie preventive e trattati per 3 mesi con DHE retard. Il farmaco ha dimostrato una buona efficacia con significativa riduzione della intensità e della durata delle crisi. Nessuna alterazione è stata riscontrata, inoltre, a carico dei parametri valutati.
Planned release dihydroergotamine in common migraine and “tension-vascular headache”: multicentre clinical trial
Authors: Fontanari D. , Perulli L. , Conte F. , Tambato E. , Toso V. , Zanetti R.
Published: July 2017

The antimigraine efficacy of dihydroergotamine methanesulphonate in the pharmaceutical form of planned release capsules has been evaluated. Forty-nine subjects were treated, 39 suffering from common migraine 10 from tensive vascular headache, for a period of 90 days, with an oral dose of 15 mg twice daily. The product was found to be efficacious in 71% of the common migraine cases, while unsatisfactory or nil results were obtained in the remaining 29%. In the tensive-vascular headache cases, efficacy was 40% compared to 60% unsatisfactory or nil results. Tolerance was good in 43 cases, while transient digestive disorders (nausea and vomiting) occurred in 6; in 2 cases the treatment had to be withdrawn for allergic erythema. The results demonstrate that the drug is indicated in cases of common migraine, while it does not appear to significantly influence the course of attacks of tensive-vascular headache.

On a etudié l'activité thérapeutique de la dihydroergotamine à action prolongée chez 49 malades porteurs de migraine commune (39 cas) et de céphalée tensive-vasculaire (10 cas), pendant 90 jours, à la dose de 5 mg deux fois par jour per os. Dans les cas de migraine commune le produit a été efficace dans 71% des cas, alors que dans 29% on a obtenu des résultats insuffisants ou des échecs. Dans les cas de cephalée tensive-vasculaire l'efficacité a été du 40%, contre un 60% de resultats insuffisants ou des échecs. La tolérance c'est averée bonne dans 43 cas, dans 6 cas ont été appreciés des troubles digestives (nausée et vomissement) transitoires et seulement dans 2 cas on a du interrompre le traitement pour intolérance (érythème allergique). Les résultats montrent que le produit constitue une bonne indication dans les cas de migraine commune, alors qu'il ne semble pas être en mesure de modifier significativement le cours des crises de cephalée tensive-vasculaire.

Si è valutata l'efficacia antiemicranica della diidroergotamina metansulfonato nella forma farmaceutica in capsule a cessione programmata. Sono stati trattati 49 soggetti, di cui 39 affeti da emicrania comune e 10 da cefalea tensivo-vascolare, per un periodo di 90 giorni, alla dose di 15 mg due volte al giorno per os. Nei casi di emicrania comune il prodotto si è dimostrato efficace nel 71%, mentre nel 29% si sono avuti risultati insufficienti o nulli. Nei casi di cefalea tensivo-vascolare l'efficacia è stata del 40%, contro un 60% di risultati insufficienti o nulli. La tolleranza è stata buona in 43 casi, in 6 casi si sono avuti disturbi digestivi transitori (nausea e vomito) e solo in 2 casi il trattamento è stato interroto per eritema allergico. I risultati mostrano che il farmaco trova indicazione nei casi di emicrania comune, mentre non sembra influenzare significativamente l'andamento delle crisi di cefalea tensivo-vascolare.
Post-traumatic headache: neuropsychological and clinical aspects
Authors: Fioravanti M. , Ramelli L. , Napoleoni A. , Lazzari R. , Ruggieri S. , Cerbo R. , Formisano R. , Grillo G. , Feliciani M. , Agnoli A. , Spissu A. , De Luca P. , Merli S.
Published: July 2017

Seventy patients suffering from post-traumatic headache were studied. Pain characteristics, personality and intellectual functions were assessed to be related to cranial trauma. No evident signs of brain damage were present, but an impairment related to pain in personal adjustment and well-being reducing work and study capabilities was identified. A psychopathological condition described as anxiety with somatizations and conversion mechanisms was found and when compared with the psychopathological characteristics from a group of common headache patients no differences were obtained between the two groups. DSM III diagnostic possibilities for post-traumatic headache patients were discussed.

On a retenu un groupe de 70 patients souffrant de céphalées traumatiques. Les caractéristiques de la douleur, la personnalité, les fonctions intellectives, étaient liées à un événement traumatique. Aucune trouble cérébral se présentait chez les patients, mais il était évident une aggravation accompagnée d'une douleur dans la capacité d'adaptation des sujets et une réduction dans les performances intellectives et du travail. On a relévé une condition psycopatologique comme les réactions chroniques d'anxiété accompagnées de somatisation, conversion en personalité que, comparée avec les caractéristiques psycopatologiques d'un groupe de patients souffrant de céphalée primaire, n'a trouvé aucune différence significatives entre les 2 groupes. Les possibilités diagnostiques du DSM III pour les patients souffrant de céphalée post-traumatiques seront par la suite discutées.

Sono stati indagati 70 pazienti sofferenti di cefalea post-traumatica. Le caratteristiche del dolore, la personalità, le funzioni intellettive erano indubbiamente correlate all'evento traumatico. Non erano presenti segni evidenti di danno cerebrale, ma era evidente un peggioramento correlato al sintomo dolore nella capacità di adattamento dei soggetti ed una riduzione nelle performance lavorative ed intelletive. Si è rilevata una condizione psicopatologica descritta come ansia corredata da episodi di somatizzazione e da meccanismi di conversione che, quando confrontata con le caratteristiche psicopatologiche di un gruppo di pazienti affetti da cefalea primaria, non ha evidenziato differenze significative fra i 2 gruppi. Le possibilità diagnostiche del DSM III per pazienti affetti da cefalea post-traumatica vengono qui discusse.
Combination Headache: Practical Experience with a Combination of a β-Blocker and an Antidepressive
Authors: Pfaffenrath V , Kellhammer U , Pöllmann W
Published: July 2017

In the prophylaxis of migraine β-blockers are commonly used. In the therapy of tension headache (TH) the use of tricyclic antidepressives is widespread. Therefore, from a rational point of view, one should combine an antidepressive and a β-blocker in the treatment of combination headache (CH), in which patients have both migraine and TH. In an open uncontrolled study, 61 patients with CH received a combination of an antidepressive (amitriptyline or amitriptyline- N-oxide and a β-blocker (propranolol or metoprolol) for at least 3 months. The 61 patients kept a diary in which they recorded frequency and duration of migraine attacks and tension headaches. The median migraine attack frequency decreased in the 3 months from four to two and the mean attack duration per month from 2 to 0.7 days. TH frequency was reduced from a median of 21 days to 6 days; TH duration fell from a median of 21 days to 2.7 days. At first sight, this treatment appears to be highly effective, at least when judged by the results at the group level. Nevertheless, in an open uncontrolled study like this, one must be aware of many problems, which are discussed in detail.