Psychogenic psychoses. A retrospective study with special reference to clinical course and prognosis

The study comprises a retrospective evaluation of case records of 220 patients admitted for the first time with psychogenic psychosis with special reference to clinical course and prognosis within a period of 13--14 years. The reliability of the diagnosis at the time of the first admission is about 60% when the evaluation is based on positive criteria for psychosis. If the psychogenic psychoses are divided into subgroups, the reliability of the diagnosis of psychogenic affective psychoses is about 30%, whereas it is over 90% for psychogenic confusional psychoses and psychogenic paranoid psychoses. If subsequent cases of other functional psychoses (manic-depressive psychosis and schizophrenia) are subtracted, the diagnostic reliability is 50% (111 of 220 cases), which represents the number of retrospectively verified psychogenic psychoses. The frequency of recurrence of psychogenic psychosis was 18% (40), corresponding to 36% of psychogenic psychoses verified by retrospective evaluation (111 of 220 cases). The recurrences were mainly homologous, as heterologous recurrences developed only among the psychogenic affective psychoses (slightly less than half of the recurrences in question). Schizophrenia developed in only 10% (23), and subsequent episodes of manic-depressive psychosis occurred in 8% (18). The stability of psychogenic psychosis on recurrence of functional psychosis was 49% expressed in relation to all subsequent cases of functional psychosis. The over-all prognosis for the psychogenic/reactive psychosis is thus good as regards subsequent mental disease. Chronic functional psychosis (schizophrenia) developed in only 10% (and in less than 20% if the prognosis is assessed on the basis of the reliability of the diagnosis at the time of the first admission (about 60%)). However, in the group of psychogenic/reactive psychoses as a whole an overmortality of 100% was observed in the course of the 14 years, highest in the younger age groups.

Anti-depressive treatment in Parkinson's disease. A controlled trial of the effect of nortriptyline in patients with Parkinson's disease treated with L-DOPA

Nineteen patients with L-DOPA treated parkinsonism involving depressive symptoms, the therapeutic effect of nortriptyline was compared to placebo in a controlled trial. The depressive and neurological symptoms were evaluated by rating scales. Nortriptyline had a clinical significant effect with regard to the depressive symptoms, whereas the neurological parameters were unchanged. The authors suggest the depression in Parkinson's disease to be of both reactive and endogenous origins.

Lymph node identification in carcinoma of the colon and rectum. Value of tissue specimen radiography

A method for identifying lymph nodes in tissue specimens from patients with carcinoma of the colon and rectum by soft X-rays is described and assessed. The method seems superior to more time-consuming and possibly tissue-damaging procedures, and it affords a possibility of identifying lymph nodes down to a size 1--2 mm in formalin-fixed as well as in non-fixed tissue specimens.

Unsaturated and cobalamin saturated transcobalamin I and II in normal human plasma

Insolubilized antibody against human transcobalamin I has been used as a specific and precise tool for the separation of transcobalamin I (and III) from transcobalamin II. Range and mean (in parentheses) for the unsaturated binding capacity for twenty samples are 40-190 (90) pmol/l and 220-1170 (560) pmol/l for transcobalamin I (and III) and transcobalamin II, respectively. The similar figures for the cobalamin saturated transcobalamins are 200-549 (320) pmol/l and 75-475 (160 pmol/l. On analyses of the cobalamins attached to each of the transcobalamins, it is shown that methylcobalamin accounts for most of the cobalamins attached to transcobalamin I whereas transcobalamin II carries most of the 5'-deoxyadenosylcobalamin.

Lymph node identification. Specimen radiography of tissue predominated by fat

A method for identifying, by soft x-rays, lymph nodes in tissue specimens predominated by fat is presented. The method is quick and demonstrates lymph nodes as small as 1 to 2 mm in diameter.

Pulmonary function in obese patients scheduled for jejuno-ileostomy

Preoperative pulmonary parameters were evaluated in 37 extremely obese but otherwise healthy patients. They were on average 100.9% overweight. X-ray of the chest, electrocardiograms, and residual volume, vital capacity, total lung capacity, maximum breathing capacity, forced expired volume in 1 second, and related ratios were all within the normal range. The alveolar-arterial oxygen gradient and the arterial carbon dioxide tension were also within the normal range. The only abnormal finding was a substantially reduced arterial oxygen tension. It is suggested that the measurement of functional residual capacity, closing volume, and the slope of the alveolar plateau (phase III in the single breath nitrogen washout technique) might give more valuable information.

Evaluation of impedance cardiography druing anesthesia in extremely obese patients

In three anesthetized markedly obese patients, non-invasive stroke volumes (the transthoracic electrical impedance method) were compared to simultaneously obtained invasively measured stroke volumes (dye-dilution method). Close correlations were obtained (r = 0.90--0.98) between the two methods, although constant lower impedance stroke volumes were found in these patients when the values usually employed for the electrical resistivity of the blood (zeta) were used for calculation of the impedance stroke volume. No statistically significant difference (P greater than 0.10) between the two methods was found when a zeta of 175 ohm X cm was used for the calculations, or when the percentage changes in stroke volumes were analyzed. The impedance method is safe and reliable; it also permits non-invasive measurements of stroke volume during anesthesia in markedly obese patients.

Postoperative pulmonary function in obese patients after upper abdominal surgery

The pulmonary course after jejuno-ileal by-pass operation in six massively obese patients (mean weight 130.2 kg) was followed for the first 5 postoperative days by means of arterial blood gas analysis and measurements of forced vital capacity (FVC), forced expired volume in the first second (FEV1.0) and peak expiratory flow rate (PEFR). The patients were extubated in the operating room and were breathing spontaneously in the postoperative period. Pao2 and FVC reached their minimum values in the first 24 postoperative hours (respectively, 74% and 45% of their preoperative values), but were almost restored in 5 days. PEFR had at this time reached 77% of its preoperative value FEV1.0% (FEV1.0%in per cent of FVC) did not change from the pre- to the postoperative period, but remained about 70%.

High-dose treatment of rats with perphenazine enanthate

Previously we demonstrated an approximately 20% loss of nerve cells in the basal ganglia of rats following treatment with perphenazine enanthate 3.4 mg/kg s.c. every 2nd week during 12 months. If the treatment period was only 2 or 3 months no significant differences were found.