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PubMed1978

Physostigmine in mania.

Seven men and one woman with primary affective disorder, mania, were given a slow intravenous infusion of physostigmine salicylate. In six patients, mood and thought content changed from mania toward depression as evaluated by either a visual analog mood scale or the Pettersen scale. Two other patients, who were the only predominantly irritable manics in the study, demonstrated little change in their hostility, although one became somewhat depressed. These findings are consistent with earlier reports of suppression of manic symptoms after physostigmine infusion in some but not all patients with mania. The pharmacologic mechanism of physostigmine reversal of manic symptoms may be the direct result of increased cholinergic activity or a result of the effect of increased cholinergic activity on other brain neurotransmitters.

Affect↗
PubMed1979

Psychiatric disorders among professional women.

A group of 111 women physicians and 103 women PhDs, selected from the general community, were studied for the presence of psychiatric illness. Fifty-one percent of the MDs and 32% of the PhDs were diagnosed as having primary affective disorder (P less than .01). Other psychiatric disorders were found in less than 10% of each group. Depression among the psychiatrists was significantly more common (73%) than among the other physicians (46%). More than 50% of all the women reported prejudice in training or employment, and depressed subjects reported prejudice more often than well subjects. The presence of children and depression were shown to disrupt a woman's professional career. The finding of a high prevalence of affective disorder among women physicians is consistent with the reported excessive suicide risk for this group.

Adult↗
PubMed1980

Characterological depressions. Clinical and sleep EEG findings separating 'subaffective dysthymias' from 'character spectrum disorders'.

Early-onset characterological depressions are distinguished from late-onset chronic depressions that complicate the long-term course of unipolar and nonaffective illnesses. In turn, characterological depressions are divisible into at least two subtypes: (1) "Subaffective dysthymias" have even sex distribution, are often complicated by superimposed depressive episodes, rapid eye movement latency is shortened, and they tend to respond to tricyclics of lithium carbonate. In brief, they share many features of primary affective illness. (2) "Character spectrum disorders," by contrast, represent a heterogeneous mixture of personality disorders with inconstant depressive features, are more common in women, are often complicated by alcohol and drug abuse, and outcome tends to be unfavorable.

Adult↗
PubMed1981

Evaluation of the DSM-III criteria for melancholia.

The DSM-III criteria for melancholia are intended to define an endogenomorphic subcategory of major depressive episode for which somatic treatment is usually required. One hundred twenty-three inpatients having a major depressive episode were examined retrospectively to determine the ability of the melancholia criteria to identify patients observed to have an autonomous syndrome during the first week of hospitalization and to distinguish them from patients observed to be responsive to psychosocial intervention without drug treatment. The melancholia criteria correctly classified 77% of the sample. In comparison with the primary affective disorder criteria, the melancholia criteria appeared to be selective; fewer responsive patients were falsely identified. The predictive values of individual symptom criteria were examined. Of the current symptom criteria, two observed signs, lack of reactivity and psychomotor change, were most useful for making the autonomous-responsive distinction.

Depressive Disorder↗
PubMed1982

Adherence to treatment regimen in a lithium carbonate clinic.

Adherence to a prophylactic regimen for primary affective disorder was studied with the Standardized Compliance Questionnaire given to 48 outpatients to determine perceptions of their illness, treatment, mood state, and side effects. Clinicians rated the course of the illness for 12 months. Adherence was defined as lithium level between 0.5 and 1.5 mEq/L and attendance at 75% of clinic appointments for nine months. One patient was nonadherent with both indices, whereas 11 were nonadherent with neither medication regimen or appointment keeping, suggesting that each behavior should be scrutinized separately. Elevated mood was associated with overall nonadherence, marriage was associated with adherence to drug regimen, and perception of continuity of care was associated with appointment-keeping adherence. No association was found between nonadherence and diagnostic subcategory or between adherence and reported side effects. The relationship between nonadherence and poor outcome was significant.

Adult↗
PubMed1982

Random number generation, psychopathology and therapeutic change.

In two studies, 145 psychiatric inpatients were each asked to say 100 numbers in random order, using the numbers 1 through 10. Compared with normative data, patients with personality disorders and neuroses were not impaired on the random number generation (RNG) task and patients with chronic alcoholism and primary affective disorder, depression, were significantly imparied, but not as much as those with schizophrenia and organic brain syndrome. The relationship between RNG performance and psychiatric diagnosis may reflect severity of disturbed cognitive functioning. The Randomization Index was sensitive to changes in symptoms during hospitalization. The RNG task provides a brief objective measure of those components of attention, cognitive capacity, and short-term memory that are affected by severity of psychopathology.

Attention↗
PubMed1982

The sleep of patients with obsessive-compulsive disorder.

Fourteen patients with obsessive-compulsive disorder (OCD) were studied with all-night sleep EEG recordings. Nine of these patients reported abnormal sleep patterns before the polygraphic study. Analysis of the sleep records disclosed significantly decreased total sleep time with more awakenings, less stage 4 sleep, decreased rapid-eye-movement (REM) efficiency, and shortened REM latency compared with those of a group of age- and sex-matched normal subjects. These abnormalities generally resembled those of an age-matched group of depressed patients, although significant differences remained. These findings suggest that such sleep abnormalities as shortened REM latency may not be entirely specific for primary affective illness. They also point to a possible biological link between OCD and affective illness.

Adult↗
PubMed1985

Mortality in a follow-up of 500 psychiatric outpatients. I. Total mortality.

Total or all-cause mortality data were determined from a prospective study of 500 randomly selected psychiatric outpatients during a mean follow-up period of seven years. With the use of age-, sex-, and race-adjusted methods, a mortality nearly twice that expected from reference population rates was observed. Mortality was excessive among younger, but not older, patients; and among white men and women and black men, but not among black women. Certain psychiatric diagnoses (based on structured personal interviews performed at index and using explicit criteria) were associated with excess mortality: alcoholism, antisocial personality, drug addiction, homosexuality, organic brain syndrome, and schizophrenia. Excess mortality was not observed among patients with primary affective disorders, ie, disorders not antedated by nonaffective psychiatric illness.

Adolescent↗
PubMed1985

The outcome of antidepressant use in the medically ill.

To examine the feasibility of using antidepressant medication to treat major depressive syndromes in the hospitalized medically ill, we reviewed a series of psychiatric consultations meeting the following criteria: the consultant diagnosed a major depressive syndrome, treatment with an antidepressant was advised, the consultee initiated the antidepressant, and hospitalization had been prompted by a major medical illness. The final sample of 50 consultations, representing less than 5% of the case reviewed, was assessed by retrospective study of entries in the medical record. Judgments regarding response were thus a function of routine clinical observation and care. Drugs were not randomly assigned; rather, the choices represented ongoing clinical usage patterns. Two major points emerge from the data of the study. First, 32% of the trials were terminated due to side effects judged to be unacceptable by the physicians or consultants. Delirium accounted for half of such side effects; cardiotoxicity, however, was not evident. Second, only 40% of patients with medical illnesses, including malignant neoplasm, insulin-dependent diabetes, and epilepsy, responded to treatment. The trials of antidepressants in medical-surgical inpatients did not achieve the pattern of therapeutic responses routinely characterizing comparable interventions in psychiatric patients with primary affective disorder.

Adult↗
PubMed1986

Relationship between panic disorder and agoraphobia. A family study.

A family study of patients with agoraphobia (n = 40), panic disorder (n = 40), and nonanxious controls (n = 20) showed that the morbidity risk for panic disorder was increased among the relatives of agoraphobics (8.3%) and the relatives of patients with panic disorder (17.3%). The morbidity risk for agoraphobia was also increased among the relatives of agoraphobics (11.6%) but not the relatives of panic disorder patients (1.9%). Male relatives of agoraphobics were shown to be at higher risk for alcohol disorders (30.8%). No greater risk for primary affective disorders was found among the relatives of agoraphobic or panic disorder patients or among the relatives of probands with secondary depression compared with relatives of probands without secondary depression. Probands and relatives with agoraphobia reported an earlier onset of illness, more persistent and disabling symptoms, more frequent complications, and a less favorable outcome than probands and relatives with panic disorder. The findings suggest that agoraphobia is a more severe variant of panic disorder. They also lend support to the separation between anxiety disorders and affective disorders.

Adult↗
PubMed1987

Deafferentation-induced alterations in the rat dorsal horn: I. Comparison of peripheral nerve injury vs. rhizotomy effects on presynaptic, postsynaptic, and glial processes.

Light microscopical degeneration and ultrastructural alterations in the rat spinal dorsal horn were studied following either cutting of the sciatic nerve or rhizotomy at L4 and L5; survival time for both procedures was 3 weeks. Fink-Heimer silver methods showed minimal degeneration of afferent central processes after sciatic section, and limited ultrastructural changes were present. Both rhizotomy and nerve section resulted in degenerating terminals. Most were swollen and electron lucent, with loss of vesicles; some electron-dense terminals were present, particularly after rhizotomy. Both procedures also produced significant degeneration of postsynaptic dendrites and soma, evidenced by either increases in electron density, or loss of organelles and cavitation, or accumulation of osmiophilic floccular material. Glial processes frequently were expanded and extended to engulf single degenerating terminals and dendrites, or terminal-dendrite units; in other cases glial tongues separated terminals from their postsynaptic dendrite. Glial processes often wrapped around degenerating profiles or groups of profiles in several layers, sometimes forming complex labyrinths. These results confirm past descriptions of pre- and postsynaptic changes resulting from peripheral nerve section, but newly reveal that dendritic destruction and increased glial activity are also significant following rhizotomy. Documentation of these changes is relevant for studies of reorganization following nerve and spinal cord damage, as well as providing an ultrastructural basis for evaluation of effects of neurotoxins that affect primary afferents, as described in a companion paper.

Afferent Pathways↗
PubMed2004

Psychosocial correlates of late-onset psychosis: life experiences, cognitive schemas, and attitudes to ageing.

BACKGROUND: Psychosis with first onset after the age of 60, and arising in the absence of dementia or primary affective disorder, is thought to affect 2-4% of older people, and as many as half will not respond fully to medication. AIMS: This study represents a preliminary attempt to explore a number of possible psychosocial correlates of late-onset psychosis with potential relevance for a cognitive-behavioural formulation and for the development of psychosocial interventions for this group. METHODS: The nature and extent of adverse early life experiences, presence of maladaptive cognitive schemas, and morale in relation to ageing were compared for older people with a diagnosis of late-onset psychosis (LOP; n = 14) or late-onset depression (DEP; n = 13) and healthy older volunteers (HEV; n = 18) in a cross-sectional design. RESULTS: Both LOP and DEP groups reported significantly higher levels of adverse life experiences than the HEV group, with between-group differences in the types of experiences described. The LOP group scored significantly higher than the HEV group on four out of five schema domains, and significantly higher than the DEP group on two domains, other-directedness and over-vigilance/inhibition. The LOP group had significantly lower overall morale in relation to ageing than the HEV group, reflecting significantly higher levels of lonely-dissatisfaction. CONCLUSIONS: Life experiences, cognitive schemas and attitudes to ageing are important psychosocial correlates of LOP. These findings contribute to an understanding of the emotional world of individuals who develop psychosis in later life and may have implications for developing more effective intervention approaches.

Age of Onset↗
PubMed1975

Tumour inhibition mediated by BCG in immunosuppressed rats.

Two rat sarcomas (CC5 and P7) which grow progressively on transplantation into normal syngeneic hosts failed to develop when injected in admixture with the Glaxo strain of Bacillus Calmette-Guérin (BCG). Under comparable conditions, the local development of a third neoplasm (P8) was temporarily inhibited and the number of pulmonary metastases significantly reduced. Experiments were undertaken to determine the extent to which the anti-tumor action of BCG required an immunocompetent host. Rats were immunosuppressed by sub-lethal whole-body irradiation (450 R), with or without prior thymectomy and challenged with inocula of mixed BCG and tumour cells when their capacity to respond to bacterial, tumour and unrelated antigens was maximally depressed. In non-sensitized immunosuppressed rats, the ability of BCG to limit tumour outgrowth was abrogated only in the case of sarcoma CC5. For this neoplasm, immunogenic in syngeneic hosts by conventional criteria, there was a statistically significant difference in the number of tumours in immunosuppressed rats (51%) compared with non-sensitized immunocompetent controls (6%). Presensitization to either bacterial or tumour antigens, prior to thymectomy and/or irradiation, fully restored the tumour-inhibitory capacity of BCG. By contrast, sarcoma P7 was not significantly less susceptible to BCG-induced regression in non-sensitized immunosuppressed rats than in nonsensitized normal rats; and sarcoma P8 similarly failed to reveal any significant differences in susceptibility to BCG affecting primary or secondary tumour development. It is concluded that tumours may vary widely in their sensitivity to host reactions aroused by BCG. Certain neoplasms, exemplified by sarcoma CC5, require participation of an immune reaction of delayed hypersensitivity type for optimal destruction at BCG sites, while for others (e.g. sarcoma P7) an immunoreactive component of this type is not essential. By contrast, a third category of tumour (e.g. sarcoma P8) is relatively resistant to host reactions induced by the mycobacteria. An important component of BCG-mediated tumour inhibition is not dependent on an immunologically intact host.

Animals↗
PubMed1995

Over-expression of tissue inhibitor of matrix metalloproteinases (TIMP1 and TIMP2) suppresses extravasation of pulmonary metastasis of a rat bladder carcinoma.

The balance between matrix metalloproteinases and their inhibitors is a critical factor which affects tumor invasion and metastasis. We have established a rat bladder carcinoma cell line, LMC19, which is tumorigenic, invasive and metastatic to the retroperitoneal lymph nodes and to the lungs in nude mice. LMC19 cells secrete pro-gelatinases A and B as well as tissue inhibitors of matrix metalloproteinase (TIMP1 and TIMP2). We conducted the present study to determine whether or not over-expression of TIMP1 and TIMP2 can affect the metastatic potential of LMC19 cells. We transfected the cells with an expression vector containing TIMP1 or TIMP2 cDNA, isolated several clones over-expressing TIMP1 or TIMP2 and assessed their invasive and metastatic potential by inoculation at an orthotopic site (urinary bladder) in nude mice. Our results show that the transfectants over-expressing TIMP1 and TIMP2 marginally affect primary tumor growth, local invasion or metastasis to the retroperitoneal lymph nodes but significantly inhibit extravascular growth of pulmonary tumor emboli. Our results suggest that the net activity of matrix metalloproteinases of tumor cells may be a critical factor that controls extravasation at this distant metastatic site.

Animals↗
PubMed2006

Concentration-dependent effects of titanium and aluminium ions released from thermally oxidized Ti6Al4V alloy on human osteoblasts.

Thermal oxidation treatments of Ti6Al4V, at 500 and 700 degrees C, for 1 h result in the formation of an outer "ceramic" layer of rutile, which enhances osteoblast response. In the present study, we have measured in vitro Ti and Al ion release from Ti64 alloy in the as-received state and after thermal oxidation treatments at 500 or 700 degrees C, to culture medium under standard cell-culture conditions. Concentrations of both Ti and Al released from both thermal oxidation treatments were lower than from polished alloy. Al was released from the treated or untreated surfaces in substantially lower extent than Ti. Titanium and aluminium ions affected primary human osteoblast proliferation, metabolic activity, and differentiation in a dose-dependent manner. Treatments with individual Ti or Al metal ions in similar concentration ranges than released from the surfaces did not alter osteoblast response, which also remained unaffected after treatments with combinations of Ti plus Al applied in the proportional relations than detected in ion-release experiments. We then selected higher concentrations of Ti that impaired osteoblast proliferation and differentiation, while the proportional lower concentrations of Al did not alter osteoblast behavior. In spite of its inert character, it was found that Al significantly enhanced the deleterious effect of Ti on osteoblast differentiation. Therefore, thermal oxidation treatments of Ti6Al4V alloy may improve the biocompatibility of the alloy by reducing both Ti and Al release, and thus attenuating ion-mediated interference with osteoblast differentiation.

Aged↗
PubMed1994

A monoclonal antibody (A6) recognizing a unique epitope restricted to CD45RO and RB isoforms of the leukocyte common antigen family identifies functional T cell subsets.

The mAb A6 was produced by immunization of mice with human PHA-stimulated PBMC. Immunoprecipitation studies and staining of cell lines transfected with individual leukocyte common antigen (LCA) isoforms showed that A6 recognizes a unique epitope strongly expressed on the lower MW isoform (p180) of LCA, but also weakly expressed on the p190 isoform coded by exon B and the p205 coded by exons A and B. The epitope recognized by A6 was carbohydrate-dependent in that it was neuraminidase-sensitive, but trypsin-resistant. A6 strained most TCR-alpha beta+ cells with differential intensities, subdividing them into a bright and dim population, and strongly stained all TCR-gamma delta+ cells. A6 did not stain CD19+ B cells nor CD56+ NK cells. Anti-CD45 mAb such as UCHL1 recognizing CD45RO have been used to define memory T cells. Depletion of PBMC subsets with A6 or UCHL1 mAb dramatically decreased proliferative responses to the recall antigens anti-CD3 mAb and alloantigen and enhanced their responses to PHA. A6, unlike UCHL1, also depleted alloreactive T cells that affect primary and secondary MLC and CML. Thus, A6 was shown to recognize the lower MW isoforms of LCA which are expressed on functional T cell subsets including memory, activated, and alloreactive T cells.

Animals↗
PubMed1983

Types and phases of alcohol dependence illness.

The published data based on retrospective recall support the position that there is a characteristic developmental sequence of clinical signs and symptoms in alcohol dependence illness. These symptoms cluster in three sequential temporal phases: psychological dependence, physiological dependence, and neurological disorganization. Individuals may discontinue alcohol consumption during any phase and are not doomed to complete the sequence. Attempts to develop subtypes of alcohol-dependent individuals are generally based on inadequate samples from nonrepresentative treatment centers, many of whose patients are not alcohol dependent. The proposed essential-reactive, primary-affective, and life-style typologies have very weak support. Studies repeatedly confirm sociopathic, depressed, and anxious subgroups of alcohol dependent patients. However, such classifications have not been able to encompass more than one-half of the treatment populations studied. These concurrent symptom types are more prevalent in publicly operated treatment facilities and are predictive of recovery.

Affect↗
PubMed1992

Risk factors for development of panel reactive antibodies and their impact on kidney transplantation outcome.

The impact of potential risk factors for development of panel reactive antibodies (PRA) in 1078 cadaveric kidney graft recipients was investigated in a multivariate analysis. Multiple transplantation, transfusion of more than five blood units and more than two pregnancies were revealed as factors with a significant independent impact on the formation of high levels of PRA. Multiple transplantation and polytransfusion also affected primary non-function, initial function and long-term graft survival at 1, 3 and 5 years. Incidence of early rejection (within 30 days) was significantly increased with repeated transplantation and decreased with a full-house HLA match. However, these effects on transplantation outcome could only be observed when risk factors lead to the formation of antibodies. In patients with risk factors present, but without subsequent sensitization, the graft survival expectation was the same as in patients in whom risk factors were absent.

Antibodies↗