Dexamethasone suppression test in psychiatric diagnosis and psychopathology for Chinese patients

The rate of abnormal dexamethasone suppression test (AbDST, post-dexamethasone cortisol greater than 5.0 micrograms/dl) was analyzed in different psychiatric samples, diagnostic categories and different time points of blood sampling. Differences in the AbDST rate in different samples were largely due to different composition of diagnostic categories and time points of samplings. By standard DST protocol (using 4 PM and 11 PM as sampling time points), melancholics had the highest AbDST rate (58.5%) among all diagnostic groups. DST was not a practical technique for differential diagnosis in psychiatric practice because of low prevalence of melancholia in the total patient population. However, it could be a promising variable for psychopathological study. The rate of AbDST was higher at the sampling time of 4 PM than any others. For one time point sampling, the 4 PM one was suggested. 8 AM and 4 PM sampling times were suggested as a practical 2-time-point sampling for DST. The rate of AbDST in different diagnostic groups had a positive relation with the severity of depressive psychopathology in a global sense. There was not any single item or any cluster of depressive symptomatology consistently related to AbDST among all diagnostic categories. Each diagnostic category had its own specific depressive symptoms in relation to AbDST, either positively or negatively. The severity of hypothalamic-pituitary-adrenal axis dysfunction, as shown in persistent AbDST and a high level of post-dexamethasone cortisol level, showed heterogeneous relation with depressive psychopathology. The relation was positive in schizophrenia and mania, was nill in melancholia, and probably reversed U relation in other psychotics and neurotics. Multiple psychopathological and pathophysiological mechanisms responsible for AbDST were suggested.     

Dexamethasone suppression test as a simple measure of stress?

Non-suppression of cortisol by dexamethasone has been described as a biological marker of a diagnostic subgroup of depressed patients. This paper presents the hypothesis that the degree of non-suppression is a variable that reflects the quantity of stress or distress experienced by the patient rather than relating to a specific diagnosis. Such a quantitative measure of stress would be valuable for research in general medicine as well as in psychiatry. Testing of this postulate should apply a more precise interpretation of endocrine principles than has been applied to the dexamethasone suppression test to date.     

Suppressor T cell recognition of major and minor histocompatibility alloantigens: selected suppression of MHC-directed responses by minor alloantigen Ts

The induction of suppression by i.v. administered alloantigens in the murine host was analyzed as a model of the possible effects of blood transfusion on transplant survival. The results indicated that suppressor T cells (Ts) specific for minor histocompatibility alloantigens could be readily induced by the i.v. presentation of minor alloantigen-disparate spleen cells. In contrast, similar priming with cells differing solely at the H-2 major histocompatibility complex stimulated only positive T cell immunity, with no evidence of suppression. The induction of H-2 directed Ts activity could be accomplished only by i.v. priming with major plus minor incompatible donor cells, suggesting that suppressor cell recognition of minor alloantigens may have facilitated the generation of Ts against H-2-encoded major transplantation antigens. A role for minor histocompatibility antigens in the regulation of H-2-specific immunity at the effector level was also indicated. Ts induced by i.v. pretreatment with minor antigen-disparate donor cells not only suppressed the delayed-type hypersensitivity (DTH) response to the relevant minor alloantigens, but also inhibited DTH against unrelated H-2 alloantigens introduced during subsequent intradermal immunization. Suppression of H-2-directed T cell reactivity was specific in that the presence of the Ts-inducing minor alloantigens was also required and occurred only when the minor and unrelated major alloantigens were presented within the same inoculum, if not on the same cell surface. The capacity of Lyt-2+Ts or Ts-derived suppressive factors specific for one set of cell surface molecules to modulate responses to an unrelated group of surface antigens does not appear to represent a general phenomenon, because similar suppression of immunity to unrelated tumor-specific transplantation antigens by minor-specific Ts was not observed. These results are discussed with respect to the possible mechanism of H-2-directed suppression and the role of the I region in Ts recognition of antigen.     

Dexamethasone suppression of sexual behavior in the ovariectomized mare

The influence of steroids of adrenal cortical origin on estrous behavior in the ovariectomized mare was evaluated by adrenal suppression via dexamethasone (DEX) administration in two experiments. In Experiment I, 12 mares (six DEX, six control) were tested for sexual behavior in harem groups (two DEX and two control mares plus one stallion per group) for 9 consecutive days. In Experiment II, estradiol (E₂) was given to a group of DEX-treated mares as an additional control. Twelve mares (four DEX, four DEX + E₂, and four control) were tested in harem groups (one DEX, one DEX + E₂, and one control mare plus one stallion per group) for 10 days. All DEX mares showed a clear suppression of sexual response compared to control or DEX + E₂ mares, indicating that the estrous behavior seen in ovariectomized mares may be due to steroids from the adrenal cortex. The control and DEX + E₂ mares were similar in all measures of proceptivity. Despite being more receptive, as indicated by fewer negative responses, the DEX + E₂ mares received fewer intromissions and ejaculations than did the control animals. The ability of estradiol to induce estrous behavior in the dexamethasone-suppressed mare notwithstanding, other adrenal steroids, e.g., androgens, may be involved in estrous behavior in the untreated, ovariectomized mare.     

Relationship among Dexamethasone Suppression Test, personality disorders and stressful life events in clinical subtypes of major depression: An exploratory study

: BACKGROUND: The present study aimed to investigate the relationship between dexamethasone suppression test, personality disorder, stressful life events and depression. MATERIAL: Fifty patients (15 males and 35 females) aged 41.0 +/- 11.4 years, suffering from Major Depression according to DSM-IV criteria entered the study. METHOD: Diagnosis was obtained with the aid of the SCAN v 2.0 and the IPDE. Psychometric assessment included the HDRS, HAS, the Newcastle Scale (version 1965 and 1971), the Diagnostic Melancholia Scale, the Personality Deviance Scale and the GAF scale. The 1 mg DST was used. STATISTICAL ANALYSIS: Included MANOVA, ANOVA with LSD post hoc test and chi-square test. RESULTS: Sixteen (32%) patients were non-suppressors. Eight patients without Personality Disorder (PD) (23.5%), and 5 of those with PD of cluster B (50%) were non-suppressors. Atypical patients were the subtype with the highest rate of non-suppression (42.85%). No difference between suppressors and non-suppressors was detected in any of the scales. DISCUSSION: The results of the current study suggest that pathological DST is not a core feature of major depression. They also suggest that there are more than one subtypes of depression, concerning the response to stress. It seems that the majority of depressed patients (50%) does not experience high levels of stress either in terms of self reported experience or neuroendocrine function. The rest of patients however, either experience high levels of stress, or manifest its somatic analogue (DST non-suppression) or have a very low threshold of stress tolerance, which makes them to behave in a hostile way.     

Chipping away at major depressive disorder

An intriguing recent study examines the role of miR-1202, a glutamate receptor regulating microRNA, in regulating major depressive disorder.     

Intrinsic nerves of the pectoralis major and minor in man

In the human intraorganic nerves of the thoracic muscles amyelin fibers make 62% and myelin ones--38%. In transversal sections ultrastructure of the myelin and amyelin fibers varying in their diameters has been studied. In the myelin and amyelin fibers the amount of various organells is not equal: in the amyelin fibers the arrangement density of microtubules is greater than that of neurofilaments, there is a reverse dependence between the amount of the microtubules and the neurofilaments on the one hand, and the fibrilar diameter, on the other hand. In the myelin fibers with the increasing diameter, the amount of the neurofilaments increases, while that of the microtubules decreases.     

Genome-wide DNA methylation scan in major depressive disorder

While genome-wide association studies are ongoing to identify sequence variation influencing susceptibility to major depressive disorder (MDD), epigenetic marks, such as DNA methylation, which can be influenced by environment, might also play a role. Here we present the first genome-wide DNA methylation (DNAm) scan in MDD. We compared 39 postmortem frontal cortex MDD samples to 26 controls. DNA was hybridized to our Comprehensive High-throughput Arrays for Relative Methylation (CHARM) platform, covering 3.5 million CpGs. CHARM identified 224 candidate regions with DNAm differences >10%. These regions are highly enriched for neuronal growth and development genes. Ten of 17 regions for which validation was attempted showed true DNAm differences; the greatest were in PRIMA1, with 12-15% increased DNAm in MDD (p = 0.0002-0.0003), and a concomitant decrease in gene expression. These results must be considered pilot data, however, as we could only test replication in a small number of additional brain samples (n = 16), which showed no significant difference in PRIMA1. Because PRIMA1 anchors acetylcholinesterase in neuronal membranes, decreased expression could result in decreased enzyme function and increased cholinergic transmission, consistent with a role in MDD. We observed decreased immunoreactivity for acetylcholinesterase in MDD brain with increased PRIMA1 DNAm, non-significant at p = 0.08.While we cannot draw firm conclusions about PRIMA1 DNAm in MDD, the involvement of neuronal development genes across the set showing differential methylation suggests a role for epigenetics in the illness. Further studies using limbic system brain regions might shed additional light on this role.     

Scheduling parallel machines with major and minor setup times

This article discusses the problem of scheduling a large set of parts on an FMS so as to minimize the total completion time. Here, the FMS consists of a set of parallel identical machines. Setup time is incurred whenever a machine switches from one type of part to another. The setup time may be large or small depending on whether or not the two part types belong to the same family. This article describes a fast heuristic for this scheduling problem and derives a lower bound on the optimal solution. In computational tests using random data and data from an IBM card test line, the heuristic archieves nearly optimal schedules.