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A detailed study on the excited-state-excitation migration taking place within the tetranuclear complex [{(tbbpy)(2)Ru(tmbi)}(2){Pd(allyl)}(2)](PF(6))(2) (tbbpy = 4,4'-di-tert-butyl-2,2'-bipyridine and tmbi = 5,6,5',6'-tetramethyl-2,2'-bibenzimidazolate) is presented. The charge transfer is initiated by the photoexcitation into the lowest metal-to-ligand charge-transfer (MLCT) band of one of the peripheral ruthenium(II) chromophores and terminates on the central structurally complex Pd(2) (II)(allyl)(2) subunit. Thus, the system under investigation can be thought of as a functional model for the photosynthesis reaction center in plants. The kinetic steps involved in the overall process are inferred from femtosecond time-resolved transient-grating kinetics recorded at spectral positions within the regions of ground-state bleach and transient absorption. The kinetics features a complex non-exponential time behavior and can be fitted to a bi-exponential rise (tau(1)> or =200 fs, tau(2) approximately 1.5 ps) and a mono- or bi-exponential decay, depending on the experimental situation. The data leads to the formulation of a model for the intramolecular excitation-hopping ascribing intersystem crossing and subsequent cooling as the two fastest observed processes. Following these initial steps, charge transfer from the ruthenium to the central complex Pd(2)(allyl)(2) moiety is observed with a characteristic time constant of 50 ps. A 220-ps component that is observed in the ground-state recovery only is attributed to excitation equilibration between the two identical Pd(allyl) chromophores.

The synthesis and photophysical properties of a series of substituted dipyridophenazine (dppz) ruthenium complexes of the type [(tbbpy)2Ru(dppz-R2)]2+ (where tbbpy = 4,4-tert-butyl-2,2-bipyridine and dppz = dipyrido[3,2-a:2',3'-c]phenazine and R represents substitution at the 11 and 12 position with: Br, phenyl, 4-tert-butyl-phenyl and para-biphenyl) are described. The ligands could be obtained in high yields using Suzuki-type coupling reactions, an approach which also has been successfully applied to the analogous dppz-Br2 ruthenium complex. All compounds are fully characterised by NMR, MS and UV-vis spectroscopy. The solid state structures of dppz-bi-para-biphenyl and the ruthenium complex [(tbbpy)2Ru(dppz-Br2)]2+ are also reported. The investigation of the free ligands reveals a pronounced effect of the arylic substitution on absorption and emission properties. These properties are mirrored in the corresponding complexes, which possess emission lifetimes of up to 900 ns. The resonance Raman investigation of the complex [(tbbpy)2Ru(dppz-Br2)]2+ supports the assumption that the excited state properties of the substituted complexes are related to the parent [(bpy)2Ru(dppz)]2+ compound, but that important differences may be expected based on the differences observed in the lowest energy absorption band.

Most functional imaging data are collected in single session experiments; little is known about the reproducibility or test-retest reliability of the activation patterns found in these experiments. In our study, 15 healthy volunteers performed four simple motor-paradigms ("Hand", "Foot", "Mouth" and "Tongue") for functional magnetic resonance imaging (fMRI) in 3 sessions on different days. Reproducibility of activations in four anatomical regions (pre- and postcentral gyri, paracentral lobule and the supplementary motor area) was measured in terms of voxels active in all sessions (common voxels) relative to voxels active in single sessions, giving reliability coefficients from 0 to 1. Two significance levels were used to identify active voxels. Reproducibility of activations was highest for foot and hand movements in the primary motorsensory areas; reliability coefficients were in the range of 0.62 to 0.78. Activations for mouth movements showed a very poor reproducibility. Application of the more stringent statistical threshold always led to a reduction of reproducible voxels. Reliability of fMRI data is not only a theoretical issue, but is of special practical importance in clinical settings such as integration of fMRI into neuronavigation for neurosurgical planning. Much care has to be taken if only single session data are available for interpretation.

A novel, and quite general, approach for the preparation of tris(heteroleptic) ruthenium(II) complexes is reported. Using this method, which is based on photosubstitution of carbonyl ligands in precursors such as [Ru(bpy)(CO)(2)Cl(2)] and [Ru(bpy)(Me(2)bpy)(CO)(2)](PF(6))(2), mononuclear and dinuclear Ru(II) tris(heteroleptic) polypyridyl complexes containing the bridging ligands 3,5-bis(pyridin-2-yl)-1,2,4-triazole (Hbpt) and 3,5-bis(pyrazin-2-yl)-1,2,4-triazole (Hbpzt) have been prepared. The complexes obtained were purified by column chromatography and characterized by HPLC, mass spectrometry, 1H NMR, absorption and emission spectroscopy and by electrochemical methods. The X-ray structures of the compounds [Ru(bpy)(Me(2)bpy)(bpt)](PF(6))x0.5C(4)H(10)O [1x0.5C(4)H(10)O], [Ru(bpy)(Me(2)bpy)(bpzt)](PF(6))xH(2)O (2xH(2)O) and [Ru(bpy)(Me(2)bpy)(CH(3)CN)(2)](PF(6))(2)xC(4)H(10)O (6xC(4)H(10)O) are reported. The synthesis and characterisation of the dinuclear analogues of 1 and 2, [{Ru(bpy)(Me(2)bpy)}(2)bpt](PF(6))(3)x2H(2)O (3) and [{Ru(bpy)(Me(2)bpy)}(2)bpzt](PF(6))(3) (4), are also described.

A series of [Ru(bipy)2L]+ and [Ru(phen)2L]+ complexes where L is 2-[5-(3,4-dimethoxyphenyl)-4H-1,2,4-triazol-3-yl]pyridine (HL1) and 4-(5-pyridin-2-yl-4H-1,2,4-triazol-3-yl)benzene-1,2-diol (HL2) are reported. The compounds obtained have been characterised using X-ray crystallography, NMR, UV/Vis and emission spectroscopies. Partial deuteriation is used to determine the nature of the emitting state and to simplify the NMR spectra. The acid-base properties of the compounds are also investigated. The electronic structures of [Ru(bipy)2L1]+ and Ru(bipy)2HL1]2+ are examined using ZINDO. Electro and spectroelectrochemical studies on [Ru(bipy)2(L2)]+ suggest that proton transfer between the catechol and triazole moieties on L2 takes place upon oxidation of the L2 ligand.

Semantically bounded disorders of verbal processing that result in selective dysnomias for items belonging to specific semantic categories have been well documented in lesion studies. Most commonly dissociations between the categories of living versus non-living things have been reported. Processing of living things such as animals seems to be impaired after bilateral lesions, whereas lesions resulting in impairment of processing of non-living things such as tools seem to be restricted to the left hemisphere. In this study, we tested the naming capabilities of epilepsy patients with subdural electrodes implanted for localization of the epileptogenic zone and preoperative mapping of cognitive functions. Tool and animal items were used, and the results show that during stimulation of the left hemisphere dysnomias for tool items were more pronounced than for animal items. This asymmetry is discussed within a model of more widely bilaterally distributed processing of living category members as compared to more restricted left-sided representation of non-living category members.

We have shown that 17beta-estradiol exerts profound protective effects against stroke-like ischemic injury in female rats. These effects are evident using physiological levels of estradiol replacement in ovariectomized rats and require hormone treatment prior to the time of injury. The protective actions of estradiol appear to be most prominent in the cerebral cortex, where cell death is not apparent until at least 4 h after the initiation of ischemic injury and where cell death is thought to be apoptotic in nature. Middle-aged rats remain equally responsive to the protective actions of estradiol. The maintenance of responsiveness of the cerebral cortex to the neuroprotective actions of estradiol was unexpected since responsiveness of the hypothalamus to estradiol decreases dramatically by the time animals are middle-aged. We believe that the protective actions of estradiol require the estrogen receptor-alpha, since estradiol does not protect in estrogen receptor-alpha knockout mice. We have also implemented a method of culturing cerebral cortical explants to assess the protective effects of estradiol in vitro. This model exhibits remarkable parallelisms with our in vivo model of brain injury. We have found that 17beta-estradiol decreases the extent of cell death and that this protective effect requires hormone pretreatment. Finally, 17alpha-estradiol, which does not interact effectively with the estrogen receptor, does not protect; and addition of ICI 182,780, an estrogen receptor antagonist, blocks the protective actions of estradiol. We have begun to explore the molecular and cellular mechanisms of estradiol-mediated protection. In summary, our findings demonstrate that estradiol exerts powerful protective effects both in vivo and in vitro and suggest that these actions are mediated by estrogen receptors.

An accumulating body of evidence clearly establishes that estradiol is a potent neuroprotective and neurotrophic factor in the adult: it influences memory and cognition, decreases the risk and delays the onset of neurological diseases such as Alzheimer's disease, and attenuates the extent of cell death that results from brain injuries such as cerebrovascular stroke and neurotrauma. Thus, estradiol appears to act at two levels: 1) it decreases the risk of disease or injury; and/or 2) it decreases the extent of injury incurred by suppressing the neurotoxic stimulus itself or increasing the resilience of the brain to a given injury. During the past century, the average life span of women has increased dramatically, whereas the time of the menopause has remained essentially constant. Thus, more women will live a larger fraction of their lives in a postmenopausal, hypoestrogenic state than ever before. Clearly, it is critical for us understand the circumstances under which estradiol exerts protective actions and the cellular and molecular mechanisms that underlie these novel, nonreproductive actions.

Estradiol protects against brain injury, neurodegeneration, and cognitive decline. Our previous work demonstrates that physiological levels of estradiol protect against stroke injury and that this protection may be mediated through receptor-dependent alterations of gene expression. In this report, we tested the hypothesis that estrogen receptors play a pivotal role in mediating neuroprotective actions of estradiol and dissected the potential biological roles of each estrogen receptor (ER) subtype, ER alpha and ER beta, in the injured brain. To investigate and delineate these mechanisms, we used ER alpha-knockout (ER alpha KO) and ER beta-knockout (ER beta KO) mice in an animal model of stroke. We performed our studies by using a controlled endocrine paradigm, because endogenous levels of estradiol differ dramatically among ER alpha KO, ER beta KO, and wild-type mice. We ovariectomized ER alpha KO, ER beta KO, and the respective wild-type mice and implanted them with capsules filled with oil (vehicle) or a dose of 17 beta-estradiol that produces physiological hormone levels in serum. One week later, mice underwent ischemia. Our results demonstrate that deletion of ER alpha completely abolishes the protective actions of estradiol in all regions of the brain; whereas the ability of estradiol to protect against brain injury is totally preserved in the absence of ER beta. Thus, our results clearly establish that the ER alpha subtype is a critical mechanistic link in mediating the protective effects of physiological levels of estradiol in brain injury. Our discovery that ER alpha mediates protection of the brain carries far-reaching implications for the selective targeting of ERs in the treatment and prevention of neural dysfunction associated with normal aging or brain injury.

Our appreciation that estrogens are important neurotrophic and neuroprotective factors has grown rapidly. Although a thorough understanding of the molecular and cellular mechanisms that underlie this effect requires further investigation, significant progress has been made due to the availability of animal models in which we can test potential candidates. It appears that estradiol can act via mechanisms that require classical intracellular receptors (estrogen receptor alpha or beta) that affect transcription, via mechanisms that include cross-talk between estrogen receptors and second messenger pathways, and/or via mechanisms that may involve membrane receptors or channels. This area of research demands attention since estradiol may be an important therapeutic agent in the maintenance of normal neural function during aging and after injury.

Neuroendocrine tumours- their rare occurrence and propensity for recurrences can undoubtedly pose as a diagnostic and therapeutic dilemma. A case report of one such case with recurrence and bony metastasis is presented.

Many clinical studies suggest that estrogen enhances memory and cognition and protects against neurodegenerative diseases and injury associated with stroke or stress. These results are strongly supported by experiments performed in animal models using both in vivo and in vitro methods. We present here data from our lab that establishes that physiological levels of estradiol exert profound protective actions against ischemic injury. Further we will present evidence that these effects may be mediated through estrogen receptors that may influence the bcl-2 family of genes.

Clinical studies demonstrate that estrogen replacement therapy in postmenopausal women may enhance cognitive function and reduce neurodegeneration associated with Alzheimer's disease and stroke. This study assesses whether physiologic levels of estradiol prevent brain injury in an in vivo model of permanent focal ischemia. Sprague-Dawley rats were ovariectomized; they then were implanted, immediately or at the onset of ischemia, with capsules that produced physiologically low or physiologically high 17beta-estradiol levels in serum (10 or 60 pg/mL, respectively). One week after ovariectomy, ischemia was induced. Estradiol pretreatment significantly reduced overall infarct volume compared with oil-pretreated controls (mean+/-SD: oil = 241+/-88; low = 139+/-91; high = 132+/-88 mm3); this protective effect was regionally specific to the cortex, since no protection was observed in the striatum. Baseline and ischemic regional CBF did not differ between oil and estradiol pretreated rats, as measured by laser Doppler flowmetry. Acute estradiol treatment did not protect against ischemic injury. Our finding that estradiol pretreatment reduces injury demonstrates that physiologic levels of estradiol can protect against neurodegeneration.

Recent studies from this laboratory established that dexamethasone (DEX) potentiates Ca2+ current via voltage-gated Ca2+ channels (VGCC), and as a consequence potentiates agonist-induced cytosolic Ca2+ transients in rat adrenal chromaffin cells. The present study examined whether DEX can also modulate VGCC activity and agonist-induced cytosolic Ca2+ transients in porcine adrenal medullary chromaffin (PAMC) cells, and if so whether this results in alterations in catecholamine secretion. Forty-eight-hr exposure to 1 microM DEX significantly increased peak Ca2+ current (delta + 138%; n = 6; P < 0.05) in PAMC cells. DEX treatment also significantly potentiated the increase in cytosolic Ca2+ in response to membrane depolarization with KCl (delta + 20%; n = 29; P < 0.05), but did not affect the amplitude of Ca2+ transients elicited by nicotine or acetylcholine. Despite the potentiation of intracellular Ca2+, DEX treatment had no effect on KCl-induced secretion of either norepinephrine or epinephrine. These data demonstrate that as in the rat chromaffin cell, DEX can also increase VGCC activity in PAMC cells. However, the subsequent potentiation of selected agonist-induced increases in intracellular Ca2+ does not appear to be sufficient to alter catecholamine secretion.

Objective: To investigate the single dose-response effects of grapefruit juice on terfenadine disposition and electrocardiographic measurements., Methods: Twelve healthy males received 250 ml water or regular- or double-strength grapefruit juice with 60 mg terfenadine in a randomized crossover trial. Plasma concentrations of the cardiotoxic agent terfenadine and the active antihistaminic metabolite terfenadine carboxylate were determined over 8 hours. The QTc interval was monitored., Results: Terfenadine concentrations were measurable (> 1 ng/ml) in 27 (20%; p < 0.001) and 39 (30%; p < 0.001) samples from individuals treated with regular- and double-strength grapefruit juice, respectively, compared to only four (3%) samples with water. Terfenadine plasma peak drug concentration (Cmax) was also higher. Terfenadine carboxylate area under the plasma drug concentration-time curve (AUC), Cmax, and time to reach Cmax (tmax) were increased by both strengths of juice. However, terfenadine carboxylate apparent elimination half-life (t1/2) was not altered. The magnitude of the interaction of terfenadine carboxylate AUC and Cmax ranged severalfold and correlated among individuals for regular-strength (r2 = 0.87; p < 0.0001) and double-strength (r2 = 0.78; p < 0.0001) grapefruit juice. No differences in the pharmacokinetics of terfenadine and terfenadine carboxylate were observed between the two strengths of grapefruit juice. QTc interval was not altered., Conclusions: A normal amount of regular-strength grapefruit juice produced maximum single-dose effects on terfenadine and carboxylic acid metabolite pharmacokinetics. The mechanism likely involved reduced presystemic drug elimination by inhibition of more than one metabolic pathway. The extent of the interaction was not sufficient to produce electrocardiographic changes. However, the pharmacokinetic effects were highly variable among individuals. This study further enhances the awareness of the potential for a serious interaction between grapefruit juice and terfenadine.

The present study examined whether the synthetic glucocorticoid dexamethasone (DEX) can modulate voltage-gated Ca2+ channel (VGCC) activity, and as a consequence agonist-induced increases in cytosolic Ca2+, in cultured rat adrenal medullary chromaffin (RAMC) cells. Exposure to 1 microM DEX for 48 h significantly increased peak VGCC current (delta +140%). DEX treatment also significantly potentiated the increases in cytosolic Ca2+ in response to submaximal stimulatory concentrations of KCl (delta +64%) and nicotine (delta +32%). The Ca2+ channel agonist BAY K-8644 increased both VGCC current (delta +109%) and potentiated the KCl-stimulated increase in cytosolic Ca2+ (delta +35%) to a comparable extent to that seen with DEX. These data suggest that DEX treatment increases VGCC activity, and that this increased Ca2+ influx leads to potentiation of agonist-induced increases in cytosolic Ca2+ in RAMC cells.

Lumbar disc herniation is rare in patients under the age of 20 years. In the department of orthopaedic surgery of the University Hospital of Frankfurt, 33 patients below the age of 20 with lumbar disc herniation were treated over a period of 10 years. Eighteen were managed conservatively and 15 surgically. The purpose of this study is to report on the long-term outcome of these patients and to compare the results of conservative and surgical treatment. We analysed information obtained from the medical records, and for the long-term follow-up we prepared a questionnaire. The questionnaire was composed of general questions about the patients' lifestyle and their ability to return to a normal life and activity after treatment, together with a request for them to score their pain level and remaining symptoms. We found that the longest duration of symptoms before diagnosis was 72 months, with a mean duration of 11.1 months. Low back pain and monoradicular sciatica were the main complaints, but findings of neurological deficits were rare. Lasegue's sign and tight hamstrings seemed to be strong diagnostic signs in this age group. On the day of discharge, 94% of patients reported excellent or good results. The outcomes after a mean follow-up period of 5.4 years were similar in both treatment groups. Almost all patients were able to attain a normal activity level and few reported restrictions on their daily life. Only 14% complained of permanent pain and 7% reported poor results regarding their activity capabilities. In conclusion, we believe that in all cases of lumbar disc herniation in the second decade of life, conservative treatment should be pursued as a mainstay of treatment. Only after a certain time, if conservative treatment is ineffective, should surgical treatment be considered.

Background: The Mulvihill-Smith syndrome consists of a large number of stigmata. A few of them are also seen in the LEOPARD syndrome. In both syndromes keratoconus has not yet been reported., Patient: We present a twenty-year-old male patient suffering from keratoconus in connection with a Mulvihill-Smith syndrome. A keratoplasty à chaud was done after perforation of the corneal ulcer., Conclusion: As a major complication corneal graft rejection is known after keratoplasty à chaud. However, in our patient immunological graft failure may be prevented by the T-cell defect.

The protein encoded by the envelope gene of Friend spleen focus-forming virus is responsible for the acute leukaemogenicity of this virus. In order to correlate glycosylation and intracellular processing of this protein with viral pathogenicity, envelope gene products of pathogenic and apathogenic glycosylation mutants were expressed in Rat-1 cells and metabolically labelled with [6-3H]glucosamine. Following immunoprecipitation, primary and secondary gene products (gp55, gp65) were separated by preparative polyacrylamide gel electrophoresis. Oligosaccharides were released from tryptic glycopeptides by treatment with endo-beta-N-acetylglucosaminidase H (gp55), peptide-N4-(N-acetyl-beta-glucosaminyl)asparagine amidase F (gp65) or by reductive beta-elimination. Resulting glycans were characterized by co-chromatography with authentic oligosaccharide standards using different HPLC systems and digestion with exoglycosidases. The results revealed that the primary envelope gene products of pathogenic glycosylation mutants were, in part, further processed in Rat-1 cells similar to wild-type glycoprotein, resulting in polypeptides carrying complex-type N-glycans as well as partially sialylated O-linked oligosaccharides. In contrast, corresponding glycoproteins encoded by apathogenic mutants were found to remain at the level of the primary translation product exclusively comprising high-mannose-type N-glycans. Hence, intracellular maturation of the envelope gene products in this model cell line seems to correlate with the in vivo pathogenicity of the glycosylation mutants studied.

In perimetry, threshold is defined as the stimulus intensity at which the frequency of perception is 50%. Around the threshold, there is a transition zone in which the frequency of perception turns from 0% to 100%. We examined the frequency-of-seeing-function in 21 persons with and without pathological damage at various locations in the visual field. We used the classic method of constant stimuli: 12 different stimulus intensities were presented 25-50 times each. The results were: (1) The frequency-of-seeing curve showed the typical S-shaped transition zone as is known from other psychophysical thresholds. The slope of the curve and thereby the size of the transition zone varied by a factor of 17. The 'threshold coefficient,' which is the difference between the intensities that provoke a 50% and a 84% frequency-of-seeing, ranged from 1.13 to 19.83 dB. (2) The threshold coefficient was strongly correlated with the threshold level itself (r2 = 0.596). (3) Other influencing factors such as pathological damage or peripheral location appeared to be covariant, because they influenced the threshold level. A substantial influence of these factors on the threshold coefficient could not be found. Different fluctuations of the threshold are therefore mainly an effect of the threshold level. This may serve as a anticipatory knowledge that allows the optimization of staircase measurement procedures and enables the improvement of the statistical analysis of visual fields.

Survival in the increasingly turbulent and uncertain health care environment should raise the application of business planning and corporate strategy to the highest levels of institutional consciousness. With hospital mergers and networking arrangements expected to account for over 60% of the hospital beds in the nation by 1990, and with government and business cost containment efforts squeezing hospital margins, the survivors are going to be those institutions able to develop and maintain a sustainable economic advantage over the competition in the programs and services that comprise the major portion of their business. The successful players will be those that allow the institution to identify and exploit new opportunities and concentrate management and financial resources in those segments of the market where competitive advantages are real and attainable.