Biomedical subjects
Publications and source records attributed to J Kane.
Plasma dopamine-beta-hydroxylase (DBH) activity was determined in 8 chronic schizophrenic patients following neuroleptic treatment for 2 months. Enzyme activity was decreased by 13.7 +/- 3.4% (mean +/- SD). The difference from pre-drug levels was not statistically significant. The reduction in DBH activity stabilized after the 1st month of treatment and was unrelated to neuroleptic drug load.
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The efficacy of lithium carbonate plus imipramine hydrochloride vs lithium carbonate plus placebo in preventing relapse was assessed in a prospective, random-assignment double-blind study of 75 bipolar 1 patients. Outcome measures included type of relapse, time until relapse, and subsequent illness course. Infrequent depression relapse in either treatment group precluded any demonstration of an advantage of adding imipramine to a lithium carbonate regimen. There was little evidence that the combination of lithium carbonate and imipramine caused adverse reactions. However, interactions between type of most recent episode, treatment condition, sex, and type of relapse showed that women and mania-prone patients treated with imipramine had an increased risk of mania. Life table analysis showed that the overall probability of remaining well was the same for both treatment groups and that two thirds of all relapses occurred in the first six months.
To determine whether hospitalized mentally ill patients expose themselves to research with high risks more often than hospitalized nonpsychiatric patients, the authors asked patients from both groups if they would be willing to participate in a series of hypothetical research studies. The mentally ill patients did not agree to participate in studies of either high or low risk more frequently than nonpsychiatric patients. Both groups tended to agree to low-risk/high-benefit studies more often than high-risk/low-benefit studies. Although Brief Psychiatric Rating Scale scores clearly differentiated between psychiatric and nonpsychiatric patients, psychopathology did not correlate with willingness to participate in any of the studies.
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3-Hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase from rat liver microsomes has been purified to apparent homogeneity with recoveries of approximately 50%. The enzyme obtained from rats fed a diet supplemented with cholestyramine had specific activities of approximately 21,500 nmol of NADPH oxidized/min/mg of protein. After amino acid analysis a specific activity of 31,000 nmol of NADPH oxidized/min/mg of amino acyl mass was obtained. The s20,w for HMG-CoA reductase was 6.14 S and the Stokes radius was .39 nm. The molecular weight of the enzyme was 104,000 and the enzyme subunit after sodium dodecyl sulfate-polyacrylamide gel electrophoresis was 52,000. Antibodies prepared against the homogeneous enzyme specifically precipitated HMG-CoA reductase from crude and pure fractions of the enzyme. Incubation of rat hepatocytes for 3 h in the presence of lecithin dispersions, compactin, or rat serum resulted in significant increases in the specific activity of the microsomal bound reductase. Immunotitrations indicated that in all cases these increases were associated with an activated form of the reductase. However activation of the enzyme accounted for only a small percentage of the total increase in enzyme activity; the vast majority of the increase was apparently due to an increase in the number of enzyme molecules. In contrast, when hepatocytes were incubated with mevalonolactone the lower enzyme activity which resulted was primarily due to inactivation of the enzyme with little change in the number of enzyme molecules. Immunotitrations of microsomes obtained from rats killed at the nadir or peak of the diurnal rhythm of 3-hydroxy-3-methylglutaryl-CoA reductase indicated that the rhythm results both from enzyme activation and an increased number of reductase molecules.
Randomly selected psychiatric patients (271 total) were examined by raters blind to diagnosis and treatment history for the presence of abnormal movements. The prevalence of presumed tardive dyskinesia among neuroleptic-exposed patients was 4.6%. If minimal rating scale criteria were applied, 9% of those patients with no history of neuroleptic exposure might have been given 'presumptive' diagnoses of dyskinesia. Problems in establishing diagnostic criteria are discussed and a longitudinal approach toward validating diagnoses is recommended.
The ANB and "Wits" values of fifty patients were correlated to see how accurately one can predict the "Wits" value, given the ANB measurement. There is no correlation between these two values when the "Wits" measurement is negative. In our study, when the positive ANB measurement was less than 4 degrees, the "Wits" values could be either positive or negative. When the ANB angle was between 4 and 8 degrees, all "Wits" values were positive. When both the "Wits values were positive and the ANB values ranged between 1 and 8 degrees, we could predict the "Wits" measurement with a 38 percent accuracy. If the ANB range was narrowed to 4 to 8 degrees, all "Wits" values were positive and we could predict them 28 percent of the time. Both these figures are statistically significant but clinically irrelevant. Further studies are needed to determine the exact nature of these interrelationships.
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Trimipramine, a new tricyclic antidepressant, was compared to imipramine in 38 hospitalized depressives. Both groups improved, with no major differences seen between the drugs. Analysis of the power of the statistical analysis shows that it is very unlikely that a true difference was present and not detected. There were fewer adverse reactions to trimipramine.
Depression in children is currently an area of considerable controversy, as is the use of potent psychopharmacologic agents in children. Since EEG sleep techniques have proven to be useful in understanding the mechanisms of depression in adults and in predicting their response to antidepressants, a pilot study employing these techniques was undertaken in a population of hospitalized children. The EEG sleep of 12 children with significant depressive symptomatology was first examined after a two-week drug-free period and again approximately three weeks later when an optimum dose of imipramine had been maintained for at least 7 -- 10 days. Changes in sleep continuity, as reflected in increased wakefulness and a decreased sleep efficiency, as well as an increase in Stage 2 and a decrease in Stage 4 sleep, were observed throughout the entire sample. REM suppression was also noted, but tended to be most pronounced in those children who improved on imipramine.
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The authors conducted a 9-week blind controlled study of the effects of acupuncture on schizophrenic illness in three patients on an inpatient ward of a psychiatric hospital. This paitents were used as their own controls. The authors compared the effects of acupuncture, pseudo-acupuncture (random needling), and no treatment control periods. Two patients who had had florid schizophrenic symptoms responded positively to true acupuncture treatment and negatively to pseudo-acupuncture. The third patient, whose symptoms were primarily affective-depressive, showed no significant response to treatment. The authors explore the mechanisms thought to be involved in the etiology of schizophrenia, focusing on the cortical arousal hypothesis.
1 Forty-one patients with mild to moderate hypertension have been treated with labetalol for up to 5 years. 2 Mean BP before treatment was 180/107 mm Hg, after 2--3 yr treatment was 136/81 mmHg and after 5 yr was 136/74 mmHg. 3 One patient developed a licheniform rash and two patients have died of myocardial infarction. No other side-effects, not already observed in a previously reported double-blind trial, have emerged.
Thirty-six remitted schizophrenics who participated in an outpatient study of fluphenazine decanoate or oral fluphenazine vs placebo given for a year were examined for the effect of drug treatment upon social and vocational functioning. Only the period prior to any clinical relapse was evaluated. We found no difference between those on drug or placebo, and conclude that antipsychotic drugs, at least in the context of an aftercare clinic offering a rich spectrum of nonpharmacological services, and when combined with antiparkinson medication, do not interfere with social and vocational functioning.
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