Free-operant performance on variable interval schedules with a linear feedback loop: no evidence for molar sensitivities in rats

Four experiments examined rats' sensitivity to molar and molecular factors on instrumental schedules of reinforcement. Rats were exposed to a variable interval schedule with a positive feedback loop (VI+), such that faster responding led to a shorter interreinforcement interval. In Experiments 1 and 2, rats responded faster on a variable response (VR) schedule than on either a VI schedule matched for reinforcement rate or a VI+ schedule matched for the feedback function. In Experiment 3, rats responded no differently on a VI schedule than they did on a VI+ schedule with equated rates of reinforcement. In Experiment 4, rats responded faster on a VI+ schedule with an interresponse time requirement yoked to that experienced on a VR schedule, than on a VI+ schedule with the same feedback function as the VR schedule. Taken together these results suggest that rats are more sensitive to the molecular than the molar properties of the schedules.

Serial position effects in recognition memory for odors

Five experiments examined recognition memory for sequentially presented odors. Participants were presented with a sequence of odors and then had to identify an odor from the list in a test probe containing 2 odors. All experiments demonstrated enhanced recognition of odors presented at the start and end of a series, compared with those presented in the middle of the series when a 3-s retention interval between list termination and test was used. In Experiments 2 and 3, when a 30-s or 60-s retention interval was used, participants performed at slightly lower levels, although the serial position function was similar to that obtained with the 3-s retention interval. These results were noted with a 5-item (Experiments 1 and 4), 7-item (Experiment 2), 6-item (Experiment 3), and 4-item (Experiment 5) list of odors. As the number of test trials increased, recognition performance decreased, indicating a strong role for olfactory fatigue or interference in these procedures. A verbal suppression task, used in Experiments 4 and 5, had little influence on serial-position-based performance.

Effect of cricoid pressure on insertion of and ventilation through the cuffed oropharyngeal airway

We have assessed the effect of cricoid pressure on insertion of and ventilation through the cuffed oropharyngeal airway (COPA) in 53 patients, in a double-blind, randomized study. Two anaesthetists assessed adequacy of ventilation in anaesthetized and paralysed patients at the same time but using different methods. The first assessed ventilation clinically, by observing synchronized chest expansion with gentle manual ventilation and the second noted measurements of tidal volume (VT) and peak inspiratory pressure (PIP). Five mask ventilated breaths ('baseline') were assessed as above. Patients were then allocated randomly to receive cricoid pressure (group A, n = 28) or no cricoid pressure (group B, n = 25). Five further mask ventilated breaths ('after manoeuvre') were again assessed. A COPA was then inserted and five further breaths ('after COPA') were assessed. A COPA was inserted at the first attempt in all patients except for one in group A who required two attempts. COPA placement was difficult in one patient in group B who had a small distance between the incisor teeth. Ventilation was clinically 'adequate' in all patients except for one in the cricoid pressure group. There were no significant differences in measured VT or PIP between 'baseline' and 'after manoeuvre' breaths. Significant differences in VT and PIP were found after COPA insertion in the group that received cricoid pressure, with a mean decrease in VT of 108 ml (P = 0.0049) and a mean increase in PIP of 5.2 cm H2O (P = 0.0111).

The impact of angiotensin-converting enzyme inhibitors on managed care: economic, clinical, and humanistic outcomes

This article examines evidence of the improved clinical, economic, and humanistic outcomes associated with the use of angiotensin-converting enzyme inhibitors (ACEIs) in clinical practice, in particular in the areas of hypertension, diabetic nephropathies, post-myocardial infarction, and congestive heart failure. Pharmacodynamic and pharmacokinetic differences may exist among this class, however, these may not be clinically relevant when the drugs are given in equivalent doses. Although additional studies are necessary before a class effect can be assumed for each of these outcomes, it is important for clinicians to consider all of these outcomes when using ACEIs.

Freedom from drug interference in new immunoassays for urinary catecholamines and metanephrines

BACKGROUND

Determination of urinary free catecholamine and total (i. e., free plus conjugated) metanephrine excretion is considered the most clinically sensitive biochemical test for pheochromocytoma. In this study, we evaluated new immunoassay methods for the measurement of these analytes for potential drug-based interference.

METHODS

Urine samples collected from patients on a variety of medications were grouped by specific drug type. The significance of any difference in the free catecholamine or total metanephrine concentrations in the different groups was assessed by one-way ANOVA. A group of patients receiving no medication was included as a control (no analytical interference). Additionally, analytical accuracy, detection limit, and precision were determined.

RESULTS

No significant differences were found in the concentrations of free catecholamines or total metanephrines in urine from patients taking the medications investigated and the control group: P = 0.649 (fE), 0.221 (fNE), 0.149 (tM), and 0.170 (tNM). For free catecholamines, intraassay CVs were 4.6-18%; interassay CVs were 10-25%. For total metanephrines, intraassay CVs were 9.6-27%; interassay CVs were 5. 8-22%. Detection limits were 0.009 and 0.027 micromol/L for fE and fNE and 0.119 and 0.346 micromol/L for tM and tNM, respectively.

CONCLUSIONS

None of the drugs examined in this study interfered in the measurement of free catecholamines or total metanephrines by these immunoassays. The technique is easier to use, requires less equipment, and is more accessible than HPLC. In combination, these assays are suitable as initial screening tests for pheochromocytoma.

A comparison of clinical response to electroconvulsive therapy in puerperal and non-puerperal psychoses

BACKGROUND

There is a widespread belief that puerperal psychosis is particularly responsive to electroconvulsive therapy (ECT), but research evidence for this is lacking.

METHOD

We have conducted a retrospective case-note study of clinical improvement following ECT in puerperal and non-puerperal psychosis. The main outcome measure was improvement in mental state at the end of a course of ECT, rated by a blind rater on a simple four-point scale. Additional indicators of responsiveness to ECT were improvement in mental state 4 weeks after stopping ECT, duration of in-patient stay following ECT and number of ECT received.

RESULTS

Women with puerperal psychosis showed greater clinical improvement than women with non-puerperal psychosis. The results were not explained by the greater preponderance of depressive illness in the puerperal group, as the same results were also found when the analysis was confined to women with a clinical diagnosis of depressive illness.

CONCLUSION

These findings are the first evidence of a particular sensitivity of ECT in puerperal psychosis. However, they are preliminary and a number of explanations are possible, including good responsiveness to treatment in general. A prospective study using standardised clinical ratings and definitions of key variables is now required.

CLINICAL IMPLICATIONS

Clinicians treating severe postpartum illness should continue to regard ECT as a treatment option.

LIMITATIONS OF THE STUDY

The study is limited by its reliance on retrospective examination of information recorded in case notes. Ratings of clinical improvement were not standardised.

No significant effects of sodium aurothiomalate on haem metabolism and mixed function oxygenase activity in patients with rheumatoid arthritis

OBJECTIVE

Animal studies suggest that gold compounds impair haem synthesis and increase haem degradation and, as a result, reduce activity of the hepatic haemoproteins cytochromes P-450. The aim of this study was to investigate whether intramuscular gold exerts similar effects in patients with rheumatoid arthritis (RA).

METHODS

Urinary porphyrin and precursor excretion, erythrocyte protoporphyrin, and antipyrine clearance, were measured in 6 patients with RA before and 10 weeks after commencement of intramuscular gold.

RESULTS

Parameters of haem metabolism were unaffected by gold. While antipyrine clearance was not statistically changed after gold treatment, in 3 of the patients there was an average decrease in antipyrine clearance of 23%.

CONCLUSION

Further studies examining RA patients at different time points are required to investigate further the possibility of reduced hepatic drug metabolising activity during prolonged treatment with gold.

Treatment of newly diagnosed AML, RAEB-t or RAEB with lisofylline or placebo in addition to chemotherapy

To determine whether the addition of lisofylline (LSF) to idarubicin (12 mg/m2 daily x 3) + ara-C (1.5 g/m2 daily x 4) affects the rates of infection, serious infection, CR or mortality during remission induction of newly diagnosed AML, RAEB-t or RAEB, we randomized 70 patients to 3 mg/kg lisofylline or placebo every 6 h i.v., to begin 6 h before the first dose of idarubicin and to continue until recovery of neutrophil and platelet counts or for 28 days, whichever came first. Eligibility required that patients be below age 71 years, have no history of abnormal counts, or chemotherapy for a prior malignancy, and have a creatinine <1.6 mg/dl and bilirubin <3.0 mg/dl. The study was double-blinded and infections were tabulated separately and independently at MD Anderson and by a three-member outside panel of experts. Logistic regression was used to assess the relative effects of treatment arm (LSF or placebo), age, performance status, treatment site (laminar air flow room or not), and cytogenetics on rates of infection and serious infection following the first course of chemotherapy, and on CR rate. There were 84% and 87% concordance between the expert panel and MD Anderson enumerations of infection and serious infections, respectively. Both analyses found no significant (P < 0.05) differences between the rates of infection, or serious infection, in the placebo and LSF groups. CR, 60-day, and overall mortality rates were similar in the two groups, as were time to neutrophil and blood count recovery and outcome once in CR. Logistic regression analyses supported the above conclusions. Severe nausea/vomiting and mucositis were more frequent in the LSF group. Our results suggest that larger studies of LSF in newly diagnosed AML, RAEB-t, or RAEB are not warranted.

Role of a stimulus filling an action-outcome delay in human judgments of causal effectiveness

Experiments examined the effect of a stimulus filling a response-outcome delay on human judgments of causal effectiveness. In Experiment 1, subjects rated the effectiveness of 2 concurrently available responses. One response led to the outcome with a 75% probability, the other never led to the outcome. Ratings were higher for the former compared to the latter key, and for immediate compared to delayed outcomes. A signal presented during the delay ameliorated this deficit. Experiments 2 and 3 examined conditioned reinforcement and perceptual catalysis accounts of this effect. In both experiments, 50% of responses on each of 2 keys led to an outcome. Ratings were high, relative to an unsignaled condition, when a stimulus filled the outcome delay, and when the same stimulus followed the response but did not precede the outcome. This result is not consistent with the operation of perceptual catalysis and was shown to be the result of secondary-reinforcement-like processes rather than outcome-confusion or generalization between responses (Experiments 3, 4).

Evidence for a type 1 diabetes susceptibility locus (IDDM10) on human chromosome 10p11-q11

A region of linkage to type 1 diabetes has been defined on human chromosome 10p11-q11 (IDDM10; P = 0.0007) using 236 UK and 76 US affected sibpairs and a 1 cM resolution microsatellite marker map. Analysis by the transmission disequilibrium test (TDT) in 1159 families with at least one diabetic child, from the UK, the US, Norway, Sardinia and Italy provided additional support for linkage at D10S193 (P = 0.006, Pc = 0.17). Notably, 5.1 cM distal to D10S193, marker D10S588 also provided positive TDT results (P = 0.009, Pc = 0.25) but the allele under analysis was also preferentially transmitted to nonaffected siblings (P = 0.0008, Pc = 0.02). This allele was positively associated in an independent UK case control study and, importantly, was neutrally transmitted in control CEPH families. These results suggest a type 1 diabetes susceptibility locus on chromosome 10p11-q11 (provisionally designated IDDM10) and demonstrate the necessity of analysis of non affected siblings in disease families, as well as analysis of control families.

Human immunodeficiency virus type 2 (HIV-2) seroprevalence and characterization of a distinct HIV-2 genetic subtype from the natural range of simian immunodeficiency virus-infected sooty mangabeys

The extent of zoonotic infections in rural Sierra Leone, where both feral and pet sooty mangabeys harbor divergent members of the human immunodeficiency virus type 2 (HIV-2)-sooty mangabey simian immunodeficiency virus (SIVsm) family, was tested in blood samples collected from 9,309 human subjects in 1993. Using HIV-1- and HIV-2-specific enzyme immunoassays and confirmatory Western blot analysis to test for antibodies to SIVsm-related lentiviruses, we found only nine subjects (0.096%) who tested positive for HIV: seven tested positive for HIV-1 and two tested positive for HIV-2. Compared with other rural West African communities, Sierra Leone displayed the lowest seroprevalence (0.021%) of HIV-2 infection yet reported, much lower than the previously reported seroprevalence in SIVsm-infected feral and household pet sooty mangabeys. Heteroduplex analysis demonstrated that two of the newly found HIV-1 strains belonged to subtype A, the most common HIV-1 subtype in Africa, but this is the first report of subtype A in Sierra Leone. The two HIV-2-infected individuals harbored two distinct HIV-2 strains, designated 93SL1 and 93SL2. Phylogenetic analysis indicated that HIV-2 93SL1 is a member of HIV-2 subtype A, the first strain of this HIV-2 subtype found in Sierra Leone. In contrast, HIV-2 93SL2 belongs to none of the five previously characterized HIV-2 subtypes (A to E) but is a new subtype, herein designated F, having the most divergent transmembrane sequences yet reported for HIV-2. The fact that both of the two most divergent HIV-2 subtypes known, E and F, are rare and found as single occurrences in persons from Sierra Leone may be related to the fact that this small region of West Africa also contains free-living and household pet sooty mangabeys with highly divergent variants of SIVsm. This finding provides support for the hypotheses that new HIV-2 subtypes result from independent cross-species transmission of SIVsm to the human population and that these single-occurrence transmission events had not spread widely into the population by 1993.

Visual Reinforcement Signals Interfere with the Effects of Reinforcer Magnitude Manipulations

Three experiments examined the effect of reinforcement magnitude on free-operant response rates. In Experiment 1, rats that received four food pellets responded faster than rats that received one pellet on a variable ratio 30 schedule. However, when the food hopper was illuminated during reinforcer delivery, there was no difference between the rates of response produced by the two magnitudes of reward. In Experiment 2, there was no difference in response rates emitted by rats receiving either one or four pellets of food as reward on a random interval (RI) 60-s schedule. In Experiment 3, rats responding on an RI 30-s schedule did so at a lower rate with four pellets as reinforcement than with one pellet. This effect was abolished by the illumination of the food hopper during reinforcement delivery. These results indicate that the influence of magnitude is obscured by manipulations which signal the delivery of reinforcement.

Signaled Delay of Reinforcement: Effects of Postconditioning Manipulation of Context Associative Strength on Instrumental Performance

Two experiments examined the influence of postconditioning treatments of contextual cues on instrumental responding acquired with a signaled delay of reinforcement schedule. In Experiment 1, mere exposure to the conditioning context after instrumental training resulted in an attenuated response rate during an extinction test. In the second experiment, responding was decreased by exposure to the contextual cues or sessions in which signaled noncontingent reinforcements occurred. The greatest response decrement, however, occurred following unsignaled noncontingent food presentations. The results are discussed with respect to the different roles of contextual cues on operant responding.

The von Restorff effect in rats (Rattus norvegicus)

Two experiments examined the functional equivalence of memory in the rat (Rattus norvegicus) with memory in humans for serially presented items. Memory was assayed with an 8-arm radial maze, in which rats were allowed access to 5 arms of the maze and were then removed. Following a retention interval of 16 min, the rats were replaced in the maze and allowed to retrieve pellets from the 3 unvisited arms. The errors in reentering previously visited arms were noted. Both primacy and recency effects were found as with humans. Presenting a stimulus change after entry to 1 of the maze arms improved recall for that arm relative to when no change occurred. This effect was found using both handling and tone cues, and irrespective of whether the change consisted of presentation or nonpresentation of the cue. These results suggest that rats are subject to a von Restorff-like effect similar to that in humans.

Genetic characterization of new West African simian immunodeficiency virus SIVsm: geographic clustering of household-derived SIV strains with human immunodeficiency virus type 2 subtypes and genetically diverse viruses from a single feral sooty mangabey troop

It has been proposed that human immunodeficiency virus type 2 (HIV-2) originated from simian immunodeficiency viruses (SIVs) that are natural infections of sooty mangabeys (Cercocebus torquatus atys). To test this hypothesis, SIVs from eight sooty mangabeys, including six new viruses from West Africa, were genetically characterized. gag and env sequences showed that while the viruses of all eight sooty mangabeys belonged to the SIVsm/HIV-2 family, each was widely divergent from SIVs found earlier in captive monkeys at American primate centers. In two SIVs from sooty mangabeys discovered about 100 miles (ca. 161 Km) from each other in rural West Africa, the amino acids of a conserved gag p17-p26 region differed by 19.3%, a divergence greater than that in four of five clades of HIV-2 and in SIVs found in other African monkey species. Analysis of gag region sequences showed that feral mangabeys in one small troop harbored four distinct SIVs. Three of the newly found viruses were genetically divergent, showing as much genetic distance from each other as from the entire SIVsm/HIV-2 family. Sequencing and heteroduplex analysis of one feral animal-derived SIV showed a mosaic genome containing an env gene that was homologous with other feral SIVsm env genes in the troop but having a gag gene from another, distinct SIV. Surprisingly a gag phylogenetic tree based on nucleotide sequences showed that the African relatives closest to all three household-derived SIVs were HIV-2 subtypes D and E from humans in the same West African areas. In one case, the SIV/HIV-2 cluster was from the same village. The findings support the hypothesis that each HIV-2 subtype in West Africans originated from widely divergent SIVsm strains, transmitted by independent cross-species events in the same geographic locations.

Rats' memory for serially presented novel flavours: evidence for non-spatial primacy effects

Four experiments examined the effects of serially presenting a number of novel flavours to rats on their subsequent consumption of those flavours. In Experiments 1-4, rats were orally infused with 0.5 ml of flavour over 30 sec for each of five flavours in the exposure phase of the experiment. In these studies, primacy and recency effects emerged, the size of the primacy effect being related to the length of the retention interval, which varied from zero to twenty-four hours. Thus, both primacy and recency effects can be generated using non-spatial stimuli with rats.

A double-blind, placebo-controlled, crossover trial of oral vitamin C in erythropoietic protoporphyria

There is evidence that reactive oxygen species and free radicals may be involved in the pathogenesis of photosensitivity in erythropoietic protoporphyria (EPP). Considering the well-known antioxidant properties of vitamin C, we investigated whether oral supplementation with this vitamin was photoprotective in patients with EPP. Twelve patients with EPP received either oral vitamin C 1 g daily or placebo, for 4 weeks, followed by a crossover period of another 4 weeks. Nine patients were already receiving beta carotene at entry and continued this at the same dose throughout the study. Patients compared their sunlight tolerance throughout each of the treatment periods with sunlight tolerance at entry on a 10 cm visual analogue scale; at the end of the study, they were asked to choose which treatment period they felt had been associated with least photosensitivity. Eight patients stated that they were able to tolerate sunshine better during the vitamin C period, 2 during the placebo period and 2 noticed no difference between the two periods. This distribution of preferences approached but did not reach statistical significance in favour of vitamin C. Visual analogue scores improved by a median of 1.2 cm in the vitamin C period. This change too approached but did not reach statistical significance. Although these results do not reach statistical significance, it appears possible that oral vitamin C may reduce photosensitivity in some patients with EPP. A larger study is necessary to confirm this impression.

Essential fatty acid status in patients on long-term home parenteral nutrition

BACKGROUND

Patients on total parenteral nutrition are known to be at risk of the development of essential fatty acid deficiency, presenting as a syndrome with scaly skin lesions and characterized by low plasma and erythrocyte linoleic acid concentrations. The essential fatty acid status of patients on long-term home parenteral nutrition who do have access to oral feeds has not been studied.

METHODS

With the use of an isocratic high-performance liquid chromatography method, fatty acids were measured in the erythrocytes and plasma of 25 nonfasting patients on long-term home parenteral nutrition and the findings compared with those of 46 hospital outpatients not on nutrition support and five laboratory staff.

RESULTS

Statistically significant differences in the two groups were limited to the erythrocytes. Linoleic acid was significantly lower (25.2 vs 40.7 mumol/10(6) red blood cells, p < .0001) and showed a significant correlation with triceps skinfold thickness (r = .52, p = .013). Palmitoleic and oleic acids were higher in patients than controls (10.8 vs 8.4 mumol/10(6) red blood cells, p = .009; 61.2 vs 51.7 mumol/10(6) red blood cells, p = .003).

CONCLUSIONS

Despite IV linoleic acid administration, patients on long-term home parenteral nutrition have low erythrocyte stores of this essential fatty acid. This appears to be related to their low body fat stores. We suggest that they may be using much of the infused linoleic acid as an energy source and therefore are at risk of subclinical essential fatty acid deficiency.

Prognostic value of residual normal metaphases in acute myelogenous leukemia patients presenting with abnormal karyotype

Two hundred and forty-four untreated acute myelogenous leukemia (AML) patients with unfavorable karyotypes and 109 others with favorable aneuploid karyotypes were used to evaluate the prognostic significance of having both normal and abnormal metaphases (AN) vs only abnormal metaphases (AA) at AML presentation. The AA and AN groups were similar with respect to known prognostic variables. Among patients with unfavorable karyotypes (-5, 5q-, -7, 7q-, and +8), the AN group had a significantly higher complete remission (CR) rate (46 vs 31%, P = 0.02), and a longer CR duration (P = 0.02) and survival (P = 0.026) than the AA group. The number of patients with other unfavorable karyotypes, such as t(11q23), were too small to evaluate properly. Among those with favorable karyotypes (inv(16) and t(8;21)), on the other hand, both the AN and AA group had similar CR rate, CR duration, and survival. Similarly, in patients with t(15;17), CR duration of the AN and AA groups were similar. These data suggest that, among patients with abnormal karyotypes, residual normal metaphases are associated with a higher CR rate, CR duration and survival, only in patients with unfavourable karyotypes, but not in those with favorable karyotypes.

Isolation and characterization of the first simian immunodeficiency virus from a feral sooty mangabey (Cercocebus atys) in West Africa

The lineage of HIV-2-like viruses was studied in feral sooty mangabeys (SMs) by serological and genetic methods. Four feral sooty mangabeys were positive for simian immunodeficiency virus (SIV) antibodies and a new isolate, SIVsmSL92a, was obtained. Genetic analysis of gag genes showed that SIVsmSL92a was highly diverse and a distinct sequence subtype within the SIV sm/HIV-2 family. The results showed that SIVsm is the most diverse group of SIVs found thus far in a single monkey species.

Enhanced latent inhibition following compound pre-exposure

The influence of non-reinforced exposure to compound stimuli on subsequent appetitive classical conditioning was examined in five experiments with rats as the subjects. Non-reinforced exposure to a visual stimulus retarded subsequent acquisition of conditioned responding relative to a non-pre-exposed condition (latent inhibition). If the target stimulus was pre-exposed in compound with a second (non-target) stimulus, then latent inhibition was abolished. Exposure to the non-target stimulus prior to compound exposure had varying effects on subsequent conditioning to the target: 40 exposures to the non-target stimulus resulted in latent inhibition to the target stimulus that was comparable in magnitude to that observed when the target stimulus was exposed in isolation; 120 exposures to the non-target stimulus enhanced latent inhibition to the target stimulus.

Hypertrichosis as the presenting feature of porphyria cutanea tarda

We report a case of porphyria cutanea tarda in which the only cutaneous abnormality and initial presenting complaint was hypertrichosis. The patient had a history of excessive alcohol consumption. Alcohol avoidance and treatment with low-dose hydroxychloroquine resulted in resolution of the hypertrichosis and normalization of biochemical abnormalities.

Fatty acids in erythrocytes measured by isocratic HPLC

We developed an isocratic reversed-phase HPLC method to measure arachidonic, palmitoleic, linoleic, eicosatrienoic, oleic, palmitic, and stearic acids from hydrolyzed erythrocytes. Washed erythrocytes were heated in methanol:HCl and the fatty acids extracted into hexane:amyl alcohol. After derivatization with 4-bromomethyl-7-methoxycoumarin, samples diluted in mobile phase (acetonitrile:water, 85:15 by vol) were injected onto a 250 x 4.6 mm C18 column, and the eluted fatty acids were detected fluorometrically. For all analytes, the mean within-batch CV was 8.2% (5.5-10.8%), the mean limit of detection was 7.0 mumol/L, a linear response was maintained up to 400 mumol/L, and results agreed well with those by gas chromatography. The addition of antioxidant (butylated hydroxytoluene) was essential for sample stability. We discuss hydrolysis and extraction times, derivatization temperature, critical steps in chromatography, and concentration units.

Fatty acids in erythrocytes measured by isocratic HPLC

We developed an isocratic reversed-phase HPLC method to measure arachidonic, palmitoleic, linoleic, eicosatrienoic, oleic, palmitic, and stearic acids from hydrolyzed erythrocytes. Washed erythrocytes were heated in methanol:HCl and the fatty acids extracted into hexane:amyl alcohol. After derivatization with 4-bromomethyl-7-methoxycoumarin, samples diluted in mobile phase (acetonitrile:water, 85:15 by vol) were injected onto a 250 x 4.6 mm C18 column, and the eluted fatty acids were detected fluorometrically. For all analytes, the mean within-batch CV was 8.2% (5.5-10.8%), the mean limit of detection was 7.0 mumol/L, a linear response was maintained up to 400 mumol/L, and results agreed well with those by gas chromatography. The addition of antioxidant (butylated hydroxytoluene) was essential for sample stability. We discuss hydrolysis and extraction times, derivatization temperature, critical steps in chromatography, and concentration units.

Factors affecting rehospitalisation rates of chronic schizophrenic patients living in the community

Eighty-eight [corrected] patients selected from a depot neuroleptic clinic in the hospital outpatients department were assessed clinically on various demographic and clinical variables with a view to determining the factors that may contribute to high rates of rehospitalisation amongst schizophrenics in remission. It was found that rehospitalisation rates during the preceding 5 years correlated with an early age of onset of illness, severity of positive and affective symptoms, current neuroleptic dose and total AIMS score, all reflecting the severity of underlying psychotic disorder and the neuroleptic treatment required to treat the psychosis. Poor compliance with neuroleptic prophylaxis was not found to be of importance in contributing to high relapse rates in this sample. It was concluded that patients who repeatedly relapse may do so because of the clinical characteristics of their illness.

Brief-stimulus presentations on multiform tandem schedules

Three experiments examined the influence of a brief stimulus (a light) on the behavior of food-deprived rats whose lever pressing on tandem schedules comprising components of different schedule types resulted in food presentation. In Experiment 1, either a tandem variable-ratio variable-interval or a tandem variable-interval variable-ratio schedule was used. The variable-interval requirement in the tandem variable-ratio variable-interval schedule was yoked to the time taken to complete the variable-ratio component in the tandem variable-interval variable-ratio schedule, and the length of the variable-interval component in the latter schedule was yoked to the variable-ratio component in the former schedule. If a brief stimulus occurred following completion of the first component, then behavior was differentiated in the two components; subjects responded more quickly in the variable-ratio than in the variable-interval component. If the stimulus was removed, then response rate was determined by the nature of the final component. Similar results were obtained in Experiments 2 and 3 with the use of a three-component tandem variable-ratio variable-interval variable-ratio schedule or tandem variable-interval variable-ratio variable-interval schedule. Thus, a brief stimulus that was not explicitly paired with reinforcement engendered behavior typical of the component schedule preceding its presentation.

Influence of the cost of responding on human causality judgments

In three experiments, the effect of costs associated with responding on judgments of the causal effectiveness of the response was examined. In Experiment 1, the temporal interval between outcomes was matched on a variable interval (VI) and a variable ratio (VR) schedule. When each response was made at some "cost," and outcomes represented some "gain" for the subject, the rating of causal effectiveness for responses was higher on the VR than on the VI schedule. This relationship was absent when the outcome was a triangle flash. In Experiment 2, the number of responses required per outcome on a VI and a VR schedule were matched, and responses on the VR schedule were rated as more causally effective. In Experiment 3, a VI-to-VR yoking procedure was used. With minimal response costs, judgments were similar on the VI and VR schedules, but with greater response costs, responses performed on the VR schedule were rated as more causally effective than those emitted on the VI schedule.

Plasma norepinephrine in sensory diabetic polyneuropathy

OBJECTIVE

To examine whether changes in circulating norepinephrine are associated with the sensory disturbances of diabetic polyneuropathy. Experimental studies have indicated that NE can excite sprouts from injured nerves, producing pain.

RESEARCH DESIGN AND METHODS

We measured supine and erect plasma NE in 13 normal, nondiabetic control subjects and three groups of diabetic patients: 20 without clinical neuropathy, 20 with chronic painful neuropathy, and 15 with painless neuropathy and foot ulceration. Neuropathy was characterized by symptom and deficit scores, sensory thresholds, electrophysiology, and cardiovascular autonomic function tests. Neuropathic pain was scored by the patients on a linear analogue scale.

RESULTS

In painless neuropathy, NE levels were greatly reduced (supine, 1.3 nM; erect, 2.2 nM) compared with control subjects (supine, 2.4 nM; erect, 4.0 nM; P < 0.001) and were combined with grossly abnormal autonomic reflexes. NE also was reduced in the diabetic group without neuropathy (supine, 1.7 nM; erect, 2.7 nM; P < 0.01 vs. control subjects). By contrast, in painful neuropathy NE levels (supine, 2.2 nM; erect, 3.6 nM) were similar to control subjects and significantly higher than in painless neuropathy (P < 0.01). Furthermore, NE correlated with the severity of neuropathic pain (r = 0.46, P = 0.02). To assess whether pain, acting as a stressor, could account for the observed differences in NE, we also measured the stress hormones epinephrine and cortisol. They did not differ among the diabetic groups.

CONCLUSIONS

Circulating NE is higher in painful than painless diabetic neuropathy. We suggest that painful neuropathy is associated with a relatively higher number of functioning sympathetic fibers that may contribute to pain.

An epizootic of Edwardsiella tarda in largemouth bass (Micropterus salmoides)

Edwardsiella tarda, an opportunistic bacterial pathogen, was isolated from dying largemouth bass (Micropterus salmoides) during an epizootic in a eutrophic lake system, Lochloosa Lake, Florida, USA. Approximately 1,500 adult fish died over a 6-wk period during the late summer and early fall of 1991. A mixed population of aerobic bacteria (E. tarda, Aeromonas hydrophila, and Pseudomonas sp.) was isolated from deep cutaneous ulcers and intestines of moribund bass. However, E. tarda in pure culture was the only bacterium isolated from several viscera of several fish; E. tarda may be the etiologic agent responsible for some episodes of seasonal mortality in largemouth bass.

Biochemical diagnosis of phaeochromocytoma: two instructive case reports

The biochemical features of two patients with phaeochromocytomas illustrate the inadvisability of depending on a single group of analytes for the diagnosis. The first case presented as a surgical emergency with retroperitoneal haemorrhage. Biochemical diagnosis was difficult since total 24 hour urinary free catecholamine excretion was within normal limits in two out of three samples, and only marginally raised in the third with an atypical preponderance of adrenaline. Plasma catecholamine concentrations were also normal. But urinary excretion of the catecholamine metabolites, metadrenaline and 4-hydroxy-3-methoxy mandelic acid (HMMA), was consistently raised. In contrast, the second patient presenting with headache and labile hypertension showed normal metabolite excretion in the face of grossly increased free noradrenaline excretion and raised plasma noradrenaline concentrations. It is therefore recommend that, as well as urinary free catecholamines, one group of their main metabolites, the 3-methoxy amines (normetadrenaline and metadrenaline) or HMMA, should routinely be measured whenever a phaeochromocytoma is suspected.

Lip fibromas associated with retrovirus-like particles in angel fish

Fibromas were observed on the lips of adult female and juvenile angel fish (Pterophyllum scalare) from 3 Florida farm populations. Tumor prevalence in each population was < 1%. Affected fish were clinically normal except for those with large tumors, which had weight loss caused by physical obstruction of food intake. Fibromas originated as elevated masses from the mucocutaneous junction near the midline of the upper and/or lower lips. Characteristic features included dense fibrous stroma covered by thickened, stratified squamous epithelium, numerous intraneoplastic teeth, and scattered foci of stromal inflammation. Electron microscopy revealed intracytoplasmic type-A retrovirus-like particles in stromal cells from all tumors. Attempts to transmit fibromas, using a cell-free tumor ultrafiltrate, were unsuccessful. The relationship of the intraneoplastic viral particles to the development of lip fibromas in angel fish is uncertain.

Differences Between Chronic Schizophrenic Patients in the Hospital and in the Community

Clinical differences between stable, chronic schizophrenic patients with long stays in the hospital and schizophrenic patients living in the community were investigated. Patients were matched for age, gender, and diagnosis. Hospitalized patients had more severe thought disorder and negative symptoms, and those in the community had a significantly higher incidence of depression and anxiety. The community-based patients were also receiving higher doses of neuroleptic drugs and had a higher incidence and severity of extra-pyramidal side effects. Results suggest that living in the community, despite its obvious benefits, may have its price in terms of the distressing effects of affective symptoms and neuroleptic side effects.

Effect of local context of responding on human judgment of causality

Two experiments examined the effect of various relationships between a response (pressing the space bar of a computer) and an outcome (a triangle flashing on a screen) on judgments of the causal effectiveness of the response. In Experiment 1, when responses were required to be temporarily isolated from each other prior to an outcome, ratings of the causal effectiveness of the responses were higher than in a condition in which the probability of an outcome following a response was the same but in which no temporal isolation was required. In Experiment 2, when a number of responses were required to be emitted temporally close to the outcome, ratings of the causal effectiveness of the responses were lower than in a condition in which the probability of an outcome following a response was the same but in which no temporal proximity was required. These results suggest that, in addition to the overall probability that an outcome will follow a response, the local context of responding at the time an outcome is presented is critical in influencing ratings of causal effectiveness.

Driving restrictions advised by midwestern cardiologists implanting cardioverter defibrillators: present practices, criteria utilized, and compatibility with existing state laws

Although some patients remain at risk of losing physical control or collapsing after implantation of a cardioverter defibrillator for sustained ventricular arrhythmias, little is known about restrictions advised by arrhythmia specialists to patients with implanted devices concerning physical activities such as driving. In this study, all of the 58 cardiologists implanting cardioverter defibrillators in three contiguous midwestern states were surveyed to determine present practices and the compatibility of these practices with existing state law. Of the 51 respondents (88%), 27 cardiologists (53%) advised only those implanted patients who had had arrhythmia-induced presyncope or physical collapse to cease driving. Twenty two of the remaining cardiologists (43%) advised all implanted patients to cease driving, whereas two cardiologists (4%) never advised any implanted patient to restrict driving. Permanent driving abstinence was advised by seven of the responding cardiologists (14%), while temporary driving abstinence for periods of 2-12 months (mean 6 +/- 3 months) was recommended by the remaining 42 respondents (82%) who advised against driving. The criteria utilized, driving restrictions advised, and durations advised for driving restrictions were not uniform in any of the 13 surveyed university and nonaffiliated cardiology practices with greater than or equal to 2 implanting cardiologists. Overall, 38 cardiologists (74%) advised against driving and recommended durations that equaled or exceed their state's minimum legal requirements, although only 27 of the 51 cardiologists (53%) based their practice upon knowledge of their state's driving laws. The results of this survey suggest that the majority of cardiologists who implant cardioverter defibrillators advise their patients against driving postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute intermittent porphyria treated by testosterone implant

The hereditary disorder acute intermittent porphyria is potentially fatal. Many more females present with active disease than males and some have attacks related to their menstrual cycle and pregnancy. We present a female patient who was diagnosed while pregnant at 19 years. She subsequently developed life-threatening attacks pre-menstrually at 24 years; these were associated with weight loss. Initial treatment was with high calorie feeding via a naso-gastric tube, followed by a gastrostomy. Subsequent gonadotrophin suppression with intranasal luteinizing hormone-releasing hormone analogue (buserelin) thrice daily met with limited success. We implanted 100 mg of testosterone subcutaneously in November 1989. The buserelin was discontinued in January 1990 and menses returned 3 months later. There have been no serious attacks since then. Repeat implantation was performed at 6 monthly intervals until her present pregnancy. Baseline biochemical parameters have remained high and unaltered despite treatment although the testosterone has clearly had a marked clinical benefit, without side effects.

Simple, optimized liquid-chromatographic method for measuring total hydroxyproline in urine evaluated

We have optimized a method for measuring total hydroxyproline (HYP) in urine by HPLC after release from urinary peptides by solid-phase hydrolysis on Dowex 50W x 8 ion-exchange resin. The HYP was derivatized with 4-chlor-7-nitrobenzo-2-oxa-1,3-diazole, and excess reagent was removed with the use of a 100-mg C18 Bond-Elut cartridge. The HYP derivative was separated isocratically at 30 degrees C on a 250 x 4.6 mm reversed-phase column containing 5-microns particles of Spherisorb S5 ODS-2, with S-carboxymethylcysteine as internal standard. Total assay time was 14 min. The standard curve for the method was linear from the detection limit for HYP, 3.6 mumol/L, to 10 mmol/L. The between-batch CV was less than 5.1% and the mean analytical recovery of HYP was 95% +/- 1.4%. Comparison with a commercially available colorimetric method showed good correlation: y = 1.158x + 19.76 mumol/L (Syx = 74, n = 120), but HPLC results were 15% higher, probably from incomplete hydrolysis with the colorimetric method. This method offers a considerable improvement in assay time, specificity, sensitivity, precision, and cost compared with the colorimetric method.

Simple, optimized liquid-chromatographic method for measuring total hydroxyproline in urine evaluated

We have optimized a method for measuring total hydroxyproline (HYP) in urine by HPLC after release from urinary peptides by solid-phase hydrolysis on Dowex 50W x 8 ion-exchange resin. The HYP was derivatized with 4-chlor-7-nitrobenzo-2-oxa-1,3-diazole, and excess reagent was removed with the use of a 100-mg C18 Bond-Elut cartridge. The HYP derivative was separated isocratically at 30 degrees C on a 250 x 4.6 mm reversed-phase column containing 5-microns particles of Spherisorb S5 ODS-2, with S-carboxymethylcysteine as internal standard. Total assay time was 14 min. The standard curve for the method was linear from the detection limit for HYP, 3.6 mumol/L, to 10 mmol/L. The between-batch CV was less than 5.1% and the mean analytical recovery of HYP was 95% +/- 1.4%. Comparison with a commercially available colorimetric method showed good correlation: y = 1.158x + 19.76 mumol/L (Syx = 74, n = 120), but HPLC results were 15% higher, probably from incomplete hydrolysis with the colorimetric method. This method offers a considerable improvement in assay time, specificity, sensitivity, precision, and cost compared with the colorimetric method.

Context extinction following conditioning with delayed reward enhances subsequent instrumental responding

In Experiment 1, delayed reward generated low response rates relative to immediate reward delivered with the same frequency. Lister rats exposed to delayed reward subsequently responded at a higher rate in extinction if they received nonreinforced exposure to the conditioning context after instrumental training and prior to test, compared with animals that received home cage exposure. In Experiment 2, a signaled delay of reinforcement resulted in higher rates than an unsignaled delay. Nonreinforced exposure to the conditioning context elevated response rate for subjects in the unsignaled condition relative to a home cage group, but had no effect on response rates for subjects that had received the signaled delay. In Experiment 3, following an unsignaled reinforcement delay, groups receiving either no event or signaled food in the context responded faster in extinction than groups receiving no context exposure or unsignaled food.

Marking effects in instrumental performance on DRH schedules

Three experiments investigated the effect of presenting a brief stimulus after a response sequence on the rate of lever-pressing by rats on differential reinforcement of high rate (DRH) schedules. In Experiment 1 enhanced responding was produced by a visual stimulus presented during a 500-msec delay of reinforcement compared to a condition in which no stimulus was presented. In Experiment 2 rats responded on a multiple DRH DRH schedule in which the DRH contingency was reinforced on a 50% schedule in each component. Equivalent levels of responding occurred in the components when reinforcement was signalled in one component and when the signal was presented following the non-reinforced schedules in the other components. A further group of rats received the stimulus presented after non-reinforced schedules in one component but not at all in the other component; responding was enhanced in the former component relative to the latter component. In Experiment 3 brief stimuli presented after the completion of DRH components on a second-order VR (DRH) schedule elevated response rates irrespective of whether the signal was presented paired or unpaired with reinforcement. The present data support the view that a brief signal may serve to mark a response sequence in memory and facilitate instrumental performance.