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PubMed1980

[Clinico-electrophysiologic and pathomorphologic characteristics of congenital paralysis of the arms].

Results of clinical, electrophysiological and roentgenological examinations of 36 children with natal paralyses of the arms are analyzed. In two cases a postmortem verification was carried out. The data obtained suggest that natal damages to the humeral plexus structures and the spinal cord radicles underlie these paralyses. Only in individual cases characterized with a grave damage to the cervical division of the vertebral column spinal cord traumas may be responsible. The low-frequency activity of the affected muscles on an EMG is not yet a proof of a gross primary affection of the spinal cord, and cannot serve as a criterion for localizing the damage to the peripheral motor neuron. The bioelectrical activity changes should be interpreted with consideration of the complex of clinical symptoms.

Birth Injuries↗
PubMed1993

HIV-1 Tat alters normal organization of neurons and astrocytes in primary rodent brain cell cultures: RGD sequence dependence.

The HIV-1 trans-activator protein Tat has been implicated as a mediator of neuronal dysfunction in several model systems. To explore the possibility that Tat can affect primary brain cells, we examined the effect of recombinant Tat protein on rat cortical brain cell cultures. Tat induced marked aggregation of neurons and astrocytes in developing cultures and caused the neuritic processes to coalesce into fascicles. Cell death was not seen and brain macrophages were not affected. These effects mapped to a different region from the trans-activation domain of Tat, as mutating the RGD (arginine-glycine-aspartic acid) sequence within the second exon abrogated aggregation and fascicle formation without affecting trans-activation capacity. Such effects on primary neurons and astrocytes may reflect specific interactions of Tat with uninfected cells within the CNS in vivo.

Amino Acid Sequence↗
PubMed1977

Linkage between an X-chromosome marker (deutan color blindness) and bipolar affective illness. Occurrence in the family of a lithium carbonate-responsive schizo-affective proband.

Studies with X-chromosome markers in mental illness have been limited to the diagnostic concept of primary affective disorders. The present study is the first to our knowledge to demonstrate statistically measurable linkage between color blindness and manic-depressive illness in a family identified by a schizo-affective proband. Linkage data and lithium carbonate response in the proband suggest that the schizophreniform-affective spectrum in members of the pedigree may reflect a genetically distinct disorder. The use of a genetic marker as a heuristic diagnostic criterion in a subgroup of heredofamilial psychoses with unclear diagnostic boundaries is proposed.

Adult↗
PubMed1982

Genealogic study of patients with admission diagnosis of functional psychosis.

The results are reported of a genealogic study of 313 patients (171 males and 142 females) consecutively admitted to the psychiatric department of the Medical School of Charles University in Prague, Czechoslovakia. Patients suffering from psychosis were selected and divided into five groups: "schizophrenia", "bipolar psychosis", "unipolar depressive psychosis", "schizoaffective psychosis" and "unspecified disorder" (the diagnosis of psychosis suspected but not yet certain at the time of investigation). A total of 1086 first degree relatives (parents and siblings) were ascertained and one or more first degree relatives of each proband were interviewed. The total morbidity risk of psychiatric disorder for parents and siblings was 12.6% for schizophrenic probands, 17.8% for bipolar probands, 10.7% for unipolar probands, 12.0% for schizoaffective probands and 12.6% for probands with unspecified psychosis. A striking increase of the frequency of affective disorders was found among secondary cases of schizoaffective probands. Heterogeneity between schizophrenia and primary affective disorders was tested and demonstrated. The pros and cons of the study design was discussed.

Adolescent↗
PubMedDate not supplied

Personal and family history of affective illness in patients with multiple sclerosis.

There is a high prevalence of affective illness, both depression and bipolar disorder, in patients with multiple sclerosis. In this study, the family history method was used to assess the prevalence of affective illness in first-degree relatives of patients with multiple sclerosis. There was not an excess of affective illness in the relatives suggesting that affective disorder associated with multiple sclerosis does not have a familial pattern similar to primary affective disorder. Clinical and theoretical implications of these findings are discussed.

Adult↗
PubMed1983

Detection of marijuana use in psychiatric patients by determination of urinary delta-9-tetrahydrocannabinol-11-oic acid.

Seventy-six male inpatients with diagnoses of schizophrenia, primary affective disorder, post-traumatic stress disorder, borderline personality disorder, other personality disorder, and primary substance abuse disorder were screened for the use of marijuana by determination of urinary delta-9-tetrahydrocannabinol-11-oic acid. Screening was performed to detect marijuana use in asymptomatic patients returning to the ward after passes, and also to elucidate changes in mental state in newly admitted patients and patients who had decompensated during hospitalization. Ward personnel found the screening procedure quite useful and incorporated it into psychotherapeutic and chemotherapeutic interventions. Although susceptible and resistant individuals were found in all diagnostic categories studied, no consistent features were found to distinguish those individuals who exhibited behavioral change in association with marijuana smoking, from those who did not.

Adult↗
PubMed1996

[Hereditary retinal diseases].

Hereditary retinal dystrophies can be subdivised into central (macular) and peripheral degenerations. Stargardt disease, Best disease, cone dystrophy and retinoschisis, affecting children or young adults, are the 4 commonest macular dystrophies. Retinitis pigmentosa, with primary affects photoreceptors, presents a wide clinical, genetic and molecular heterogeneity. It is certainly the most representative cause of peripheral degeneration. Recent advances in molecular biology allow a more complete clinical definition of these inheritable retinal diseases.

Adolescent↗
PubMed1994

Evaluation of the effects of albendazole and metronidazole on the ultrastructure of Giardia duodenalis, Trichomonas vaginalis and Spironucleus muris using transmission electron microscopy.

The three closely related parasitic protozoa, Giardia duodenalis, Trichomonas vaginalis and Spironucleus muris, all have very different sensitivities to albendazole and metronidazole. Ultrastructural studies reveal that the cytoskeletal elements of the ventral disk in G. duodenalis are affected by albendazole, whereas the other two parasites, neither of which possess this structure, are not affected by albendazole to the same extent. This suggests that albendazole may be having its primary affect on G. duodenalis by binding to cytoskeletal proteins and ultimately causing death of the parasite. Death may be occurring as the parasite loses its ability to adhere to the intestinal villi and obtain nutrients. Metronidazole showed a different pattern of activity against the three parasites. The evidence obtained from these ultrastructural studies supports the current theory that metronidazole adversely affects protozoa by disrupting inner cell membranes.

Albendazole↗
PubMed1984

Outcomes on lithium treatment as a tool for genetic studies in affective disorders.

From a genetic point of view, the application of mathematical models to affective disorders has not yet been useful, since they do not indicate a specific mode of transmission. To use these models correctly, we need to identify homogeneous genetic subgroups among those sharing the common phenotypic feature of affective illness. Our useful criterion for this is outcome on long-term lithium therapy, since experimental data suggest the existence of a close relationship between the genetic mechanisms that underly the affective disorders and those that underly outcome on lithium. We have studied 145 subjects with primary affective disorders, 92 of whom did not relapse during lithium treatment and 53 of whom did, together with 864 of their first-degree relatives. The data for both groups fit both single major locus and multifactorial polygenic models for genetic analysis, including a sex effect and therefore neither mode of transmission can be excluded.

Age Factors↗
PubMed1993

[Olfactory hallucinations in depression].

Olfactory hallucinations are rarely mentioned as a symptom of depressive disorder. This paper presents a review of the literature including a conceptual clarification and epidemiological aspects with an emphasis on the significance of olfactory hallucinations for psychopathology, in particular with respect to sensory perception and body self-awareness. The close relation to the olfactory reference syndrome is pointed at. Olfactory hallucinations are considered important for the biological interpretation of affective disorders. In this regard disturbed olfactory perception can be understood as an example of disturbed brain function in the state of depression. Olfactory symptoms are shown to be elements connecting primary affective disorders with other neuropsychiatric diseases as well as with neuroanatomical and neurophysiological models. A primary role is accordingly attributed to the temporal lobe epilepsies in which olfactory hallucinations as well as affective disturbances occur. The need for further investigation in this field is pointed out.

Brain↗
PubMed1980

Sleep disturbances in a series of elderly patients: polysomnographic findings.

A group of 27 elderly patients with complaints of either chronic insomnia or excessive daytime sleepiness were studied in the Sleep Evaluation Center of Western Psychiatric Institute and Clinic during the period January 1977-June 1979. On the basis of anamnestic data from patients and bedroom partners, together with polysomnographic findings, sleep disturbances were classified according to the nosology of the Association of Sleep Disorders Centers. Of the 27 patients, 19 had disorders of initiating or maintaining sleep (DIMS), 7 had disorders of excessive somnolence (DOES), and 1 had parasomnia (episodic nocturnal wandering). Of the 19 DIMS patients, two-thirds had either a primary affective disorder (depression) or a persistent psychophysiologic disturbance. Of the 7 DOES patients, 6 had a primary sleep disorder such as a sleep apnea syndrome or narcolepsy-cataplexy. Additional electroencephalographic sleep data are presented on elderly patients with primary nonpsychotic depression. The latency of rapid eye movements (REM) in the depressed patients was shorter (p less than 0.05) than in patients with a persistent psychophysiologic disturbance. The percentage of REM sleep was significantly elevated (p less than 0.05) in the depressed group, and intermittent wakefulness was decreased (p less than 0.01). The causes of sleep disturbance in the elderly are both heterogeneous and complex. The need for accurate differential diagnosis and a multiaxial approach is stressed.

Aged↗
PubMed1993

Psychiatric risk factors for adolescent suicide: a case-control study.

OBJECTIVE: The objective of this study was to determine the psychiatric risk factors for adolescent suicide. METHOD: Sixty-seven adolescent suicide victims were compared with 67 demographically matched community controls. Psychiatric disorder was assessed in suicide victims using a psychological autopsy protocol and in controls using similar semistructured psychiatric interviews. Risk factors were quantified by use of the odds ratio (OR), that is, the relative frequency of the occurrence of a given condition in the suicides compared with the controls. RESULTS: The most significant psychiatric risk factors associated with adolescent suicide were major depression (OR = 27.0), bipolar mixed state (OR = 9.0), substance abuse (OR = 8.5), and conduct disorder (OR = 6.0). Substance abuse was a more significant risk factor when comorbid with affective illness than when alone (OR = 17.0 versus 3.3). The majority of depressed suicide victims had a primary affective disorder (82%). A significant minority (31%) of depressed suicide victims had been depressed less than 3 months. Previous suicide attempts, suicidal ideation, and homicidal ideation also were associated with adolescent suicide. CONCLUSIONS: The development of effective treatments for youth who fit the above-noted risk profiles should be given high priority.

Adolescent↗
PubMed1984

The link between alcoholism and affective disorders.

The authors reviewed the family histories of 156 patients in an affective disorders program and identified two groups of affective disorders. Group 1 consisted of bipolar illness and major depression, with high familial incidence of affective disorder and low familial incidence of alcoholism. Group 2 consisted of dysthymic disorders and secondary depression, with low familial incidence of affective disorders and high familial incidence of alcoholism. These findings do not support the common assumption that primary affective disorders and alcoholism are closely linked. The authors discuss the implications for diagnosis of depression associated with alcoholism.

Alcoholism↗
PubMed1994

Primary care in transition.

It is generally agreed that too few physicians have chosen careers in primary care. The advent of managed care as a popular method of health care provision is now affecting primary care physicians in ways that may further discourage enthusiasm for the practice of primary care and have an unintended negative effect on the primary care physician supply. In addition, the early implementation of the resource-based relative value scale by Medicare and some insurance carriers has been less beneficial to primary care physicians than expected and may even have been harmful to general internists. Efforts to improve the position of primary care physicians in relation to payers and among peers are hindered by the fact that, as a group, primary care physicians are less affluent, less influential, and greatly outnumbered by their more specialized colleagues. Consequently, some of the support currently directed toward primary care may be more apparent than real. My proposals, which aim both to protect and to enhance primary care practice, are the creation of separate primary care fee schedules and separate primary care budgets within health plans, changes in consumer protection rules that intrude on primary care practice, and the development of statewide primary care associations for mutual support and greater bargaining power. Some aspects of contracting and gatekeeping require further study.

Career Choice↗
PubMed1986

Effects of carbamazepine on serum electrolytes in affectively ill patients.

The effects on serum electrolytes of carbamazepine, an acute and prophylactic treatment for manic-depressive illness, were assessed in subjects with primary affective disorder. Carbamazepine caused statistically significant, but clinically insubstantial, reductions in serum sodium and calcium, but not in the other electrolytes measured. Decreases in serum sodium and calcium were not related to carbamazepine dose, blood levels, or the degree of clinical improvement. The theoretical implications of these findings are discussed.

Adult↗
PubMed1996

Cu(II)-inhibitory effect on photosystem II from higher plants. A picosecond time-resolved fluorescence study.

The influence of Cu(II) inhibition on the primary reactions of photosystem II (PSII) electron transport was studied by picosecond time-resolved fluorescence on isolated PSII membranes. The fluorescence decay from Cu(II)-inhibited PSII centers showed a dominant amplitude of a fast phase (100-300 ps) similar to PSII centers in the uninhibited "open state" and minor contributions of components around 600 ps and 2.6 ns. These data indicate efficient primary charge separation in PSII membranes incubated with Cu(II). The quantum yield of primary reactions in the inhibited PSII centers was similar to that of "open" PSII centers. Kinetic analysis of the decay curves in the framework of the exciton/radical pair equilibrium model showed no significant changes in the rate constants associated with the charge separation/recombination equilibrium. However, in closed centers (QA reduced), a decrease in the rate constant K23, associated with the back-reaction of a relaxed radical pair, by a factor of 4 was calculated. The free energy losses upon primary charge separation (delta G1) and during subsequent radical pair relaxation (delta G2) were also determined in Cu(II)-inhibited centers and were compared with uninhibited centers. No changes in the delta G1 values and a significant decrease in the delta G2 values were found as compared with those of control PSII centers in the "closed" state. These data indicate that Cu(II) does not affect primary radical pair formation, but strongly affects the formation of a relaxed radical pair, by neutralizing the negative charge on QA- and eliminating the repulsive interaction between Pheo- and QA- and/or by modifying the general dielectric properties of the protein region, surrounding these cofactors. Moreover, a close attractive interaction between Pheo-, QA-, and Cu2+ can be proposed. Our results are in good agreement with very recent EPR results indicating an additional effect of Cu2+ on the acceptor side [Jegerschöld et al. (1995) Biochemistry 34, 12747-12758].

Cell Membrane↗
PubMed1989

Modulation of basal and corticotropin-releasing factor-stimulated proopiomelanocortin gene expression by vasopressin in rat anterior pituitary.

In several anterior pituitary hormone systems, factors that stimulate hormone release also stimulate hormone biosynthesis. In the corticotropes of the anterior pituitary, CRF stimulates ACTH release as well as cAMP accumulation and transcription of the POMC gene. Arginine vasopressin (AVP) is a well documented coregulator of ACTH release and potentiates CRF-stimulated cAMP accumulation. The present studies were undertaken to determine if AVP also potentiates the early effects of CRF on POMC gene expression in rat anterior pituitary primary cultures. We have measured the levels of the POMC primary transcript, processing intermediate, and mature mRNA in nuclear RNA samples and POMC mRNA in cytoplasmic RNA samples as well as ACTH release after treatment with CRF and/or AVP. After a 30-min treatment with 0.5 nM CRF, POMC primary transcript levels were increased by 200-400%. Thirty-minute or 1-h treatments with AVP alone (10 or 100 nM) did not affect primary transcript levels, but increased the amount of the processing intermediate, while a 2-h incubation with 100 nM AVP significantly decreased POMC primary transcript levels. The effects of CRF on the POMC primary transcript and nuclear processing intermediate were not potentiated by cotreatment with AVP, although a potentiation of CRF-stimulated ACTH release was observed. POMC nuclear and cytoplasmic mRNA levels were not affected by these 2-h or less treatments, while an 18-h incubation with 0.5 nM CRF alone or in combination with 100 nM AVP increased POMC cytoplasmic mRNA levels to about 140% of vehicle-treated control values. When a 1-h AVP treatment (100 nM) preceded presentation of CRF, we observed an attenuation of the stimulation of POMC primary transcript and processing intermediate levels by the 1-h CRF treatment. The effects of CRF on POMC primary transcript and processing intermediate levels in these experiments are consistent with a CRF-induced increase in POMC gene transcription. Our findings that AVP decreased primary transcript levels and attenuated the effects of CRF on this end point suggest that: 1) AVP clearly does not act in a synergistic manner with CRF to stimulate POMC gene expression; and 2) AVP possibly affects RNA stability and/or processing.

Adrenocorticotropic Hormone↗
PubMed1995

Suicide attempts, age and duration of illness in recurrent affective disorders.

One of the strongest predictors of suicide is a suicide attempt in the history of the patient. The question, however, is to what extent age and duration of the illness affects the risk of a suicide attempt. In this study, we examined the course of 310 patients with primary affective disorders before lithium prophylaxis and compared the clinical data of those with and without suicide attempts in their history. In a subgroup of 98 patients with suicide attempts, measures for both suicide attempts and inpatient episodes were investigated. Comparing patients with suicide attempts and those without, we found no difference between duration of illness and number of previous episodes between the two groups. However, those with a suicide attempt in their history had an earlier onset of the illness. In the group of 98 suicide attempters, we found no significant correlation between age and rates for both episodes and suicide attempts, which indicates that these rates were not declining as the illness progressed and the patient aged. Dividing the sample into three different age groups, episode rates and rates of attempted suicide were found to be positively correlated in all age groups, again indicating that as long as episodes occur, the suicide risk does not decline. The results are not in favor of findings which suggest that the risk of attempting suicide might manifest itself primarily in the early course of the illness or that suicide attempts in the early course of illness provide a 'cathartic effect' which leads to a lower risk in the later course of the illness. Rather, the findings support the view that the risk of suicide attempts in recurrent affective disorders is unchanged in all age groups and throughout all stages of untreated illness.

Adult↗