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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Early repolarization (ER) is an enigma. The purpose of this review is to reemphasize the overall electrocardiographic (ECG) pattern of this normal ST variant which continues to challenge the clinician because of its similarity to the current of injury potential to myocardium or an acute pericarditis. The data were provided from the studies identified through computerized searches of Medline, Toxline, Oxford, Agricola, and Bios Afterdark, Cumulative index, and a review of bibliographies of relevant articles on the related subjects. Early repolarization has elevated, upward, concave ST segments, located commonly in precordial leads, with reciprocal depression in a VR, tall, peaked and slightly asymmetrical T waves with notch, and slur on the R wave. The other accompanying features in the ECG are vertical axis, shorter and depressed P-R interval, abrupt transition, counterclockwise rotation, presence of U waves, and sinus bradycardia. Males dominate and patients are often younger than 50 years of age. The incidence of 1 to 2% is found equally common in all races. Degree and incidence of ST elevation decrease as age advances. Exercise or isoproterenol administration may normalize the ST segment. Early repolarization is a benign condition. If the ECG conforms to a classical pattern of ER on serial ECGs, it would exclude the unnecessary hazards of present day revascularization therapy for myocardial infarction such as primary angioplasty or thrombolytic therapy, or aggressive management of acute pericarditis, and so forth. This review concludes with a discussion of comparative ECG features of ER, pericarditis, and myocardial infarction, and provides an algorithm for diagnostic management of patients suffering from these conditions.
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PMID:Early repolarization. 1006 41

The possibility was investigated that human handedness is associated with an asymmetrical cortical and/or peripheral control of the cervical premotoneurones (PreMNs) that have been shown to mediate part of the descending command to motoneurones of forearm muscles. Heteronymous facilitation evoked in the ongoing voluntary extensor carpi radialis (ECR) electromyographic activity (EMG) by weak (0.8 times motor threshold) stimulation of the musculo-cutaneous (MC) nerve was assessed during tonic co-contraction of biceps and ECR. Suppression evoked by stimulation of a cutaneous nerve (superficial radial, SR) at 4 times perception threshold in both the voluntary EMG and in the motor evoked potential (MEP) elicited in ECR by transcranial magnetic stimulation (TMS) was investigated during isolated ECR contraction. Measurements were performed within time windows or at interstimulus intervals where peripheral and cortical inputs may interact at the level of PreMNs. Results obtained on both sides were compared in consistent right- and left-handers. MC-induced facilitation of the voluntary ECR EMG was significantly larger on the preferred side, whereas there was no asymmetry in the SR-evoked depression of the ongoing ECR EMG. In addition, the suppression of the ECR MEP by the same SR stimulation was more pronounced on the dominant side during unilateral, but not during bilateral, ECR contraction. It is argued that (1) asymmetry in MC-induced facilitation of the voluntary EMG reflects a greater efficiency of the peripheral heteronymous volley in facilitating PreMNs on the dominant side; (2) asymmetry in SR-induced suppression of the MEP during unilateral ECR contraction, which is not paralleled by a similar asymmetry of voluntary EMG suppression, reflects a higher excitability of cortical neurones controlling inhibitory spinal pathways to cervical PreMNs on the preferred side.
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PMID:Handedness-related asymmetry in transmission in a system of human cervical premotoneurones. 1022 23

Congenital depression of the fetal skull is a rare lesion (1 to 2.5 per 10,000 births) resulting in an asymmetrical skull. This depression is caused by exaggerated or prolonged pressure applied to the fetal head in utero or during delivery. Two types of congenital skull depression have been described: deformity without fracture and depression with fracture, the more common form. Congenital skull depression is important because it may be associated with underlying brain injury, especially when the depression is associated with fracture. The simple permanent cosmetic deformity may also constitute a complication. CT scan can now rule out intracranial complications and in this case, a conservative management is reasonable treatment option. The observation period should not exceed six months. After this period, orthopedic or surgical management may be indicated because spontaneous elevation of depression is uncommon after six months. The authors report two cases of congenital skull depression with deformity without fracture. The pathogenesis and treatment are discussed.
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PMID:[Congenital skull depression. Report of 2 cases]. 1042 35

The Sylvian fissure region gathers lateral frontotemporal cortices and subcortical structures that are frequently disturbed in patients with mood disorders. We have investigated possible CSF space changes in this brain region in severe melancholic depression. Fifty-seven patients and 37 control subjects received three-dimensional MRI. CSF volumes were obtained for cerebral CSF, lateral ventricles, and both Sylvian fissure regions. As a group, patients showed a significant CSF space enlargement that was prominent around the Sylvian fissure, particularly in the left hemisphere. Likewise, evident leftward asymmetry was more frequent in the patient group (patients 31.6%, controls 2.7%). The combination of CSF space enlargement and the pattern of Sylvian CSF asymmetry predicted the patient condition with 62.2% specificity and 82.5% sensitivity. We conclude that, in the context of a broad severity spectrum of imaging alterations in severe melancholic depression, asymmetrical CSF space enlargement may be evident in the Sylvian fissure region.
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PMID:CSF spaces of the Sylvian fissure region in severe melancholic depression. 1177 78

Spiny neurons in the neostriatum are highly vulnerable to cerebral ischemia. Recent studies have shown that the postischemic cell death in the right striatum was reduced after ipsilateral dopamine denervation whereas no protection was observed in the left striatum after dopamine denervation in the left side. In order to reveal the mechanisms of such asymmetrical protection, electrophysiological changes of dopamine-denervated striatal neurons were compared after ischemia between the left and right striatum using intracellular recording and staining techniques in vivo. No difference in cortically evoked initial excitatory postsynaptic potentials was found between the left and right striatum in intact animals after ipsilateral dopamine denervation. The initial excitatory postsynaptic potentials in the dopamine-denervated right striatum were suppressed after transient forebrain ischemia while no significant changes were found in the dopamine-denervated left striatum. Paired-pulse tests suggested that these changes involved presynaptic mechanisms. Although the incidence of a late depolarizing postsynaptic potential elicited by cortical stimulation increased after ischemia in both sides, the increase was greater in the left side. The analysis of current-voltage relationship of spiny neurons indicated that inward rectification in the left striatum transiently disappeared shortly after ischemia whereas that in the right side remained unchanged. The intrinsic excitability of spiny neurons in both sides were suppressed after ischemia, however, the suppression in the right side was stronger than in the left side. The above results demonstrate that after ipsilateral dopamine denervation, the depression of excitatory synaptic transmission and neuronal excitability in the right striatum is more severe than that in the left striatum following ischemia. The depression of excitatory synaptic transmission and neuronal excitability, therefore, might play an important role in neural protection after ischemic insult.
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PMID:Asymmetrical changes of excitatory synaptic transmission in dopamine-denervated striatum after transient forebrain ischemia. 1220 1

Given that the nature of hemispheric dysfunction is different in heterogeneous disorders, in the present investigation EEG power mapping was applied to establish neurophysiological profiles that might potentially discriminate patients with seasonal affective disorder (SAD) among other affective disorders. The baseline resting EEG activity was recorded from 31 depressed SAD patients and 30 controls. Power in the delta, theta-1, theta-2, alpha, beta-1 and beta-2 frequency bands was extracted by Fourier transformation. Patients were found to have a lower delta (in central, parietal, occipital, temporal, posterior-temporal areas), theta-1 (in central and parietal), theta-2 (in anterior-frontal, parietal, occipital) and alpha activity (in anterior-frontal, midfrontal, central, parietal and occipital areas) than controls. SAD subjects showed, compared to controls, an asymmetrical distribution of delta, theta-1, theta-2 and alpha activity in parietal and temporal regions due to an increase of EEG power over the right electrode sites, and beta activity in the lateral frontal region due to an increase of beta power over the right electrode site. It is assumed that differential hemispheric contributions of EEG spectra may discriminate between the varieties of depression or different depressive states.
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PMID:EEG mapping in seasonal affective disorder. 1220 18

Several flatfish species exhibit the unusual feature of bilateral asymmetry in prey capture kinematics. One species, Pleuronichthys verticalis, produces lateral flexion of the jaws during prey capture. This raises two questions: 1) How are asymmetrical movements generated, and 2) How could this unusual jaw mechanism have evolved? In this study, specimens were dissected to determine which cephalic structures might produce asymmetrical jaw movements, hypotheses were formulated about the specific function of these structures, physical models were built to test these hypotheses, and models were compared with prey capture kinematics to assess their accuracy. The results suggest that when the neurocranium rotates dorsally the premaxillae slide off the smooth, rounded surface of the vomer (which is angled toward the blind, or eyeless, side) and are "launched" anteriorly and laterally. The bilaterally asymmetrical trajectory of the upper jaw is determined by the orientation of the "launch pad," the vomer. During lower jaw depression, the mandibles rotate about their articulations with the quadrate bones of the suspensoria. The quadrato-mandibular joint is positioned farther anteriorly on the eye side than on the blind side, and this asymmetry deflects the lower jaw toward the blind side. Asymmetry in the articular surfaces of the lower jaw augments this effect. Thus, it appears that fish with intermediate forms of this asymmetrical movement could have evolved from symmetrical ancestors via a few key morphological changes. In addition, similar morphological modifications have been observed in other fish taxa that also produce jaw flexion during feeding, which suggests that there may be convergence in the basic mechanism of asymmetry.
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PMID:Modeling the jaw mechanism of Pleuronichthys verticalis: The morphological basis of asymmetrical jaw movements in a flatfish. 1261 70

The study aimed at determination of the structure of postpartum depressions in mothers and specification of the influence of some social and personality factors on their development. Nineteen mothers with borderline depression presented 3 types of depressive disorders: "maternity blues" syndrome, anxiety and agitated depression. All the women were exposed to special psychotherapeutic intervention. The differences were found between the study and control groups by social indices. The patients of the former one were featured by higher frequencies of first delivery and unregistered marriages, and their care-taking behavior bore formal character when mother fulfilled punctually all medical recommendations ignoring individual child's needs. Being evaluated according to A. Fogel et al, the types of mother-child interactions were determined as follows: reciprocal (symmetrical)--6 cases; unipolar (asymmetrical)--6 (maternal--3 and children--3); formal--6; disharmonic (uncoordinated)--1. The authors conclude that family aspect of psychotherapeutic effect is extremely important for the treatment of patients with postpartum borderline depressions.
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PMID:[Postpartum borderline depressive states in women]. 1462 84

The shapes of the head and ears of mammals are asymmetrical top-to-bottom and front-to-back. Reflections of sounds from these structures differ with the angle of incidence, producing cues for monaural sound localization in the spectra of the stimuli at the eardrum. Neurons in the dorsal cochlear nucleus (DCN) respond specifically to spectral cues and integrate them with somatosensory, vestibular and higher-level auditory information through parallel fiber inputs in a cerebellum-like circuit. Synapses between parallel fibers and their targets show long-term potentiation (LTP) and long-term depression (LTD), whereas those between auditory nerve fibers and their targets do not. This paper discusses the integration of acoustic and the proprioceptive information in terms of possible computational roles for the DCN.
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PMID:What's a cerebellar circuit doing in the auditory system? 1510 90

The ECG strain pattern of lateral ST depression and T-wave inversion is a marker for left ventricular hypertrophy (LVH) and adverse prognosis in population studies. However, whether ECG strain is an independent predictor of cardiovascular (CV) morbidity and mortality in the setting of aggressive antihypertensive therapy is unclear. ECGs were examined at study baseline in 8854 hypertensive patients with ECG LVH who were treated in a blinded manner with atenolol- or losartan-based regimens. Strain was defined by the presence of a downsloping convex ST segment with an inverted asymmetrical T wave opposite to the QRS axis in leads V5 and/or V6 and was present in 971 patients (11.0%). The Losartan Intervention For Endpoint reduction in hypertension (LIFE) study composite end point of CV death or nonfatal myocardial infarction or stroke occurred in 1035 patients (11.7%). In Cox analyses adjusting only for treatment effect, ECG strain was a significant predictor of CV death (hazard ratio [HR] 2.26, 95% confidence interval [CI] 1.78 to 2.86), fatal/nonfatal myocardial infarction (HR 2.16, 95% CI 1.67 to 2.80), fatal/nonfatal stroke (HR 1.76, 95% CI 1.39 to 2.21), and the composite CV end point (HR 1.99, 95% CI 1.70 to 2.33). After further adjusting for standard CV risk factors, baseline blood pressure, and severity of ECG LVH, ECG strain remained a significant predictor of CV mortality (HR 1.53, 95% CI 1.18 to 2.00), myocardial infarction (HR 1.55, 95% CI 1.16 to 2.06), and the composite CV end point (HR 1.33, 95% CI 1.11 to 1.59). Thus, ECG strain is a marker of increased CV risk in hypertensive patients in the setting of aggressive blood pressure lowering, independent of baseline severity of ECG LVH.
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PMID:Electrocardiographic strain pattern and prediction of cardiovascular morbidity and mortality in hypertensive patients. 1517 25


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