Susceptibility of congenitally athymic (nude) mice to sporotrichosis

Congenitally athymic (nu/nu) mice were found to be more susceptible to intravenous challenge with Sporothrix schenckii than their phenotypically normal (nu/+) littermates as measured by lethality and the number of viable yeast cells in the liver 7 days postinfection. Thymus reconstitution of nu/nu mice (nu/thy) conferred a significant degree of resistance to sporotrichosis. Immunization greatly enhanced the resistance of nu/thy and nu/+ mice, but unexpectedly increased the susceptibility of nu/nu mice. The susceptibility of nonimmunized nu/nu mice and the finding that thymus transplants augmented resistance to sporotrichosis suggest that T lymphocytes are critical to host defense.

A clinical note on food preference of individuals with Prader-Willi syndrome: the need for empirical research

The results have important heuristic value for several reasons. First, they indicate that contrary to popular belief, individuals with Prader-Willi syndrome do indicate a definite and, in fact, consistent food preference. Further, the degree of food preference seems to be related to the level of cognitive ability. Finally, these subjects consistently chose a lesser amount of preferred food over a greater amount of non-preferred food. This finding has many potential implications for contingent dietary management. These results which are contradictory to many reported observations, also indicate the importance of collecting objective data regarding the eating behaviour of this population.

Pituitary and testicular activity in chickens after embryonic testosterone treatment

This study was conducted to explain the lower circulating testosterone levels in chickens exposed to testosterone propionate (TP) on the 3rd day of incubation. Control and TP males were injected with either luteinizing hormone (LH) or gonadotropin-releasing hormone (GnRH). Testosterone (T), dihydrotestosterone (DHT), and LH were measured by radioimmunoassay. Levels of circulating T in 20-wk-old TP males were significantly lower than controls, but the response to GnRH was similar in both groups. LH levels were also similar. Testosterone responses to LH in 20-wk-old TP males were lower than controls, possibly due to their lower initial T concentrations. Pituitary extracts from TP and control birds showed similar abilities to induce testicular 32P uptake in day-old cockerels. The data demonstrate that the anterior pituitary gland and testes of TP birds are capable of responding to GnRH and LH, respectively. The TP males are defective in that they fail to produce testosterone, which may reflect a reduced concentration of LH receptors in their testes.

The determination of amoxapine in human fatal overdoses

Amoxapine, a recently introduced dibenzoxazepine, has been found effective in clinical studies for the treatment of various types of depression. Two amoxapine related deaths, a 53-year-old white male and a 21-year-old white female, have been investigated by this office. Both had been prescribed amoxapine for depression. Quantitation of amoxapine was by gas chromatography using a 3% OV-17 column with confirmation by ultraviolet spectrophotometry and thin layer chromatography. Blood amoxapine concentrations were found to be 18 mg/L in the first subject, and 6.7 mg/L in the second subject. These concentrations are many-fold higher than the therapeutic serum concentrations of up to 0.21 mg/L reported in a clinical study. These cases illustrate the potential lethality of amoxapine overdosage and the need for caution in prescribing amoxapine to patients with suicidal tendencies.

TRH receptor binding in retina and pituitary: major species variation

Retinas and anterior pituitary glands of nine readily available mammalian and one avian species have been examined for their TRH-sensitive binding of [3H]-[3-Me-His2]TRH. Among mammals, major species variations in TRH receptor binding have been detected in both tissues, amounting to about 100-fold in the retina and 20-fold in the pituitary. In the retina, TRH receptor binding was very high in the rat, quite high in sheep and guinea pig, intermediate in rabbit, pig, and mouse, and low but detectable in chicken, cat, calf and dog. In the pituitary gland, binding was very high in sheep, quite high in rabbit, rat, pig, calf and guinea pig, intermediate in chicken, and fairly low in mouse, cat, and dog. A number of possible interfering variables, including affinity differences, albino vs. non-albino strains, barbiturate anesthesia, time after death, sex and estrous cycle, age, and history of light exposure, were considered and/or tested directly, with generally negative results.

Species differences in the brain regional distribution of receptor binding for thyrotropin-releasing hormone

A survey of the regional distribution of binding of 1 nM [3H](3-Me-His2)thyrotropin-releasing hormone ([3H]MeTRH) to TRH receptors in the brains of eight mammalian species revealed major species differences in both the absolute and relative values of TRH receptor binding in different brain regions. Several brain regions exhibited binding equal to or exceeding that in the anterior pituitary gland of the same species, including the amygdala in the guinea pig and rat, the hypothalamus in the guinea pig, the nucleus accumbens in the rabbit, and all these and other regions in the cat and dog, for which pituitary binding was exceptionally low. Species could be divided into two groups according to which brain region appeared highest in binding: rabbits, sheep, and cattle had highest binding in the nucleus accumbens/septal area, whereas guinea pigs, rats, dogs, cats, and pigs had highest binding in the amygdala/temporal cortex area. The nucleus accumbens consistently exceeded the caudate-putamen in receptor binding. For most brain regions, rabbits, rodents, and sheep tended to be higher than carnivores, cattle, or pigs. Further regions that exhibited appreciable binding in most species included the olfactory bulb and tubercle, hippocampus, and various cortical and brain stem areas. In fact, essentially all brain regions appeared to have detectable levels of TRH receptors in at least some species, but no rat peripheral tissues have yet shown detectable receptor binding. The species differences appeared to reflect largely if not entirely differences in receptor density, although this was not tested in every species.

Treatment of murine cryptococcosis with liposome-associated amphotericin B

Liposomes were prepared to incorporate large amounts of amphotericin B. BALB/c mice were challenged with Cryptococcus neoformans and given liposome-associated amphotericin B (AMBL) or amphotericin B-deoxycholate (AMBD) intravenously. Mice that were treated with AMBL survived longer and had lower tissue counts of cryptococci than mice treated with AMBD or untreated control mice. The reduced acute toxicity of AMBL permitted much larger doses of amphotericin B to be given than were possible with AMBD. AMBL is a novel vehicle of administration that reduces toxicity and concentrates the drug in the appropriate target organs.

Amphotericin B in liposomes: a novel therapy for histoplasmosis

Incorporation of amphotericin B into liposomes significantly altered its toxicity, tissue distribution, and efficacy. Compared with intravenously administered amphotericin B-desoxycholate, liposome-amphotericin B showed a reduced acute toxicity and a maximal tolerable dose 9 times greater than amphotericin B-desoxycholate. Liposome-amphotericin B also produced higher tissue and lower serum concentrations than amphotericin B-desoxycholate, and was significantly more effective in prolonging survival of mice infected with Histoplasma capsulatum.

Properties of [3H](3-Me-His2)TRH binding to apparent TRH receptors in the sheep central nervous system

[3H](3-methyl-His2)thyrotropin releasing hormone ([3H]MeTRH) binds to sites in the sheep central nervous system (CNS) whose properties closely resemble both those of CNS binding sites for [3H]TRH and those of pituitary binding sites for [3H]MeTRH. Detailed studies for binding of [3H]MeTRH in the sheep nucleus accumbens and retina have yielded equilibrium dissociation constants of about 4 nM and densities of binding sites of about 3 and 2 pmol/g wet weight, respectively. The binding affinity of [3H]MeTRH was 8- to 10-fold higher than that of [3H]TRH, resulting in much lower non-specific binding with the new ligand. The association reaction had a rate constant of about 2-3 x 10(7) M-1 min-1, while the biphasic dissociation reaction had rate constants of 8-9 x 10(-2) min-1 for the fast phase and 1-2 x 10(-2) min-1 for the slow phase. The regional distribution of binding in the sheep CNS was similar to that observed previously with [3H]TRH. Highest binding outside the pituitary was in the nucleus accumbens area and retina, with another peak in the amygdala-temporal cortex area. Binding was widely distributed, so that no CNS region appeared totally devoid of binding. Nineteen TRH analogs, ranging in potency over 6 orders of magnitude, showed nearly identical abilities to complete for binding of [3H]MeTRH in the CNS areas and in the sheep anterior pituitary gland in side-by-side experiments. These findings argue strongly for identification of [3H]MeTRH binding sites in the CNS as TRH receptors.

Physical fitness and intraocular pressure

The ability of moderate to intense aerobic exercise to reduce intraocular pressure (IOP) has been reported. Previous studies have focused on a single postexercise recovery period not considering the long-term effect of improved physical fitness on IOP. A total of 32 adult subjects, all having IOP's of greater than 18 mmm Hg in each eye as determined by an American Optical Corporation Non-Contact Tonometer, were selected for the study. After a complete medical and visual evaluation, participants were randomly assigned to either an intervention group (N = 18) receiving a 6-month supervised exercise program to improve physical fitness or into a control group (N = 14). After 6 months, each group was reevaluated to observe changes in physical fitness and IOP. Pre- and poststudy measurements of maximum oxygen uptake (ml/kg/min) made with a Beckman O2 analyzer showed significant improvement in physical fitness in the intervention group (p less than 0.05). There was a significant decrease (p less than 0.05) in IOP, 2.0 mmm Hg in the right eye and 1.3 mm Hg in the left eye, in the intervention group; however, decreases in IOP were comparable and significant (p less than 0.05) in the control group. Results from multiple regression analysis for each individual group and for combined groups indicated that changes in IOP were not dependent upon changes in physical fitness.

Preparation of 3H-[3-M3-His2]TRH as an improved ligand for TRH receptors

[3H]-3-methyl-His2]thyrotropin releasing hormone ([3H]MeTRH) binds to sites in the sheep anterior pituitary gland which appear to be the same as those occupied by [3H]TRH and which can therefore be identified as TRH receptors. In competition experiments performed in parallel, both ligands gave the same number of binding sites, 15 pmol/g wet weight, and showed the same pharmacology for 19 TRH analogs ranging over more than 5 orders of magnitude in potency. The apparent dissociation constant of binding of [3H]MeTRH was about 3.5 nM compared to 29 nM for [3H]TRH. Kinetic experiments with [3H]MeTRH yielded a rate constant for association of 1.4 x 10(7) M-1 min-1 and rate constants for the biphasic dissociation of 5 x 10(-2) min-1 (fast phase) and 7 x 10(-3) min-1 (slow phase). Detailed methods are described for preparation of [3H]MeTRH by reduction of the dehydroproline precursor and its purification by ion exchange and antibody affinity chromatography. The major advantage of the new ligand is that its higher affinity of binding gives relatively less non-specific binding than is obtained with [3H]TRH, particularly in central nervous tissue.

Muscarinic receptors in the posterior pituitary gland

The characteristics of atropine-sensitive binding of l-[3H]-quinuclidinyl benzilate ([3H]-QNB) to membrane suspensions of sheep posterior pituitary indicate that the binding sites represent muscarinic cholinergic receptors. Scatchard plots of 6 saturation experiments showed a single class of binding sites, with an equilibrium dissociation constant of 16 +/- 2 pM and a density equivalent to 1.8 +/- 0.2 pmol/g wet weight of tissue. Kinetic analysis of 2 association and 3 dissociation curves yielded mean association and dissociation rate constants of 3.9 x 10(8) M-1 min-1 and 4.3 x 10(-3) min-1, respectively. The binding had a detailed pharmacology for 12 drugs consistent with muscarinic receptor identification. In rat neurointermediate lobes, superior cervical ganglionectomy had no demonstrable effect on [3H]-QNB binding. The location(s) and functional role(s) of neurohypophyseal muscarinic receptors remain to be elucidated.

Guanine nucleotides modulate TRH-receptor binding in sheep anterior pituitary

Binding of thyrotropin-releasing hormone (TRH, thyroliberin) to receptors in chilled membrane resuspensions from sheep anterior pituitary glands is reduced in affinity almost 2-fold by micromolar concentrations of guanosine 5'-triphosphate (GTP) and the hydrolysis-resistant analog guanyl-5'-yl imidodiphosphate (GppNHp) added to tissue during a 10-min preincubation at 37 degree C. Guanosine 5'-diphosphate (GDP) produced a similar effect at 1 mM, while GMP, ATP, ADP and AMP appeared relatively inactive. The number of TRH-binding sites was not affected by the nucleotide treatments. These results are consistent with reports of guanine nucleotide effects on other receptor types and with evidence suggesting an adenylate cyclase mechanism for some of TRH's effects in the anterior pituitary.

Differential performance of learning disabled and non-learning disabled children on the McCarthy scales, WISC-R, and WRAT

Individually administered the McCarthy Scales of Children's Abilities, WISC-R, and WRAT to 30 learning disabled and 30 non-learning disabled second-grade students. The McCarthy General Cognitive Index and the WISC-R Full Scale IQ scores were compared for both groups. In addition, correlations between the General Cognitive Index, WISC-R IQ, and mean WRAT achievement were reported. There was marginal support for previous studies that suggested that the McCarthy Scales are more consistent with the academic functioning of learning disable students. Implications and directions for future research were discussed.

Use of the AAMD classification system: a review of recent research

The present study was designed to analyze the use of the AAMD and other classification systems in recent research. Specifically, articles from the American Journal of Mental Deficiency and Mental Retardation between the years 1973 and 1979 (N = 566) were analyzed with regard to the type of classification system used. In addition, information on subject description, tests employed, test scores reported, and correctness of the classification was obtained. A surprisingly small percentage of authors used the AAMD classification system, and a relatively large percentage of investigators misclassified their subjects when test scores were reported. Implications of the data and recommendations were discussed.

Pituitary cell cultures contain muscarinic receptors

The presence of muscarinic receptors in 5-day dissociated cell cultures of rat anterior pituitary glands was detected by atropine-sensitive binding of 3H-quinuclidinyl benzilate (3H-QNB). Muscarinic receptor levels in cultures were compared to levels of receptors for dopamine and thyrotropin releasing hormone.

Muscarinic receptor binding in sheep anterior pituitary

The existence of typical muscarinic receptors in membranes of sheep anterior pituitary was detected by binding of [3H]quinuclidinyl benzilate ([3H]QNB), a potent and specific muscarinic antagonist. [3H]QNB binding sites in anterior pituitary had an equilibrium dissociation constant of about 20-40 pM, a rate constant for association at 37 degrees C of about 2 x 10(8) M-1 min-1, a rate constant for dissociation at 37 degrees C of about 4 x 10(-3) min-1, and the expected specificities for a variety of cholinergic and other drugs. The concentration of [3H]QNB binding sites in anterior pituitary, about 4-6 pmol/g tissue, was at least twice that in posterior pituitary, but less than a quarter that in the hypothalamus. Since there is no established cholinergic or other innervation of the anterior pituitary, the presence there of typical muscarinic receptors, if we assume that they are functional, suggests that acetylcholine reaches the tissue through the hypophyseal portal circulation, and that it may thus have a role in the regulation of pituitary function.

Binding sites for thyrotropin-releasing hormone in sheep nucleus accumbens resemble pituitary receptors

TRH binds to sites in the nucleus accumbens-septal area of sheep brain. These sites appear to represent receptors for at least some of its behavioral effects in other species and are very similar to sheep pituitary receptors. All measurements were performed on ice to prevent peptide degradation. High affinity [3H]TRH binding in brain regions was distinguished from interfering low affinity binding by use of [3-Me-His2]TRH, a more potent and specific analog, in blank tubes at a 1-microM concentration. The nucleus accumbens-septal area, particularly the nucleus accumbens itself, showed the highest binding of any of a variety of brain regions surveyed. Binding sites in both nucleus accumbens and anterior pituitary had an equilibrium dissociation constant of about 20-40 nM, a rate constant for association of about 1-3 x 10(6) M-1 min-1, and a rate constant for dissociation of about 0.07 min-1. Seventeen TRH analogs showed closely similar potencies in competing for binding in the two tissues. Six weak analogs appeared to be more potent in the nucleus accumbens than in the pituitary, but this was an artifact of their relatively greater potency in competing for low affinity binding sites which are absent in pituitary. The only major difference between the high affinity binding sites in the two tissues was in their concentration, which was about 2- to 3-fold higher in the pituitary.

Depression of leucine and isoproterenol induced insulin secretions in the spontaneously diabetic New Zealand white rabbit

Rabbits were studied from a closed colony of NZW rabbits which exhibits a 19% occurrance of spontaneous diabetes mellitus. Six overtly diabetic rabbits and eight rabbits with normal glucose disposal were tested with intravenous glucose challenge (500 mg/kg), L-leucine administration (125 mg/kg), and 30 minute infusions with isoproterenol (10 microgram/kg/min.). These agents were shown to be ineffective insulin secretogogues in the overtly diabetic group when compared to the highly significant IRI response observed in colony rabbits with normal glucose disposal. The data indicate that the defect in IRI secretion observed in the spontaneously diabetic NZW rabbits is not confined to stimulation by glucose, but represents an abnormal IRI release mechanism which appears to lack secretogogue specificity.

Systemic lupus erythematosus in pregnancy

Most literature on pregnancies in patients with systemic lupus erythematosus (SLE) is retrospective and selective. This report is a detailed, prospective analysis of 13 pregnancies in eight women with SLE. Pregnancy was best tolerated by mothers without significant nephropathy or cardiopathy who had been in clinical remission for more than three months prior to conception. Management was aided by serial evaluation of complement (C3 and C4) levels and careful supervision of immunosuppressive therapy when indicated. Although fetal status was closely monitored, premature deliveries and spontaneous abortions occurred frequently. No malformations or adverse sequelae were noted in surviving infants exposed to immunosuppressive agents during gestation.

Experimental sporotrichosis in Syrian hamsters

Syrian hamsters were infected with Sporothrix schenckii by subcutaneous footpad inoculation. Two types of infection could be uniformly induced: a self-limited, lymphatic infection resembling the classical disease in humans, and a generalized nonfatal infection. An infecting dose of approximately 5,300 yeast cells produced the localized subcutaneous-lymphatic disease which was limited to a single limb. In contrast, a 1,000-fold increase in the inoculum temporarily overwhelmed the animals' defense mechanisms, producing a systemic infection involving the liver and spleen. These models were used to demonstrate the development of increased resistance to subsequent infection following either infection or active immunization with ribosomal fractions or trypsinized cell wall antigens of S. schenckii incorporated in Freund complete adjuvant. Agglutination titers were detectable in all animals that were either infected or immunized. In one group of infected animals, the titers persisted for at least 1 year after three booster doses of Formalin-killed S. schenckii. The ability to produce an infection in hamsters which closely resembles the disease seen in humans makes the animal a good model with which to study experimental sporotrichosis.

Categorizing behavior in terms of severity: considerations for part two of Adaptive Behavior Scale

Forty-five respondents were asked to rate the items in the Violent and Destructive Behavior domain from Part Two of the AAMD Adaptive Behavior Scale on a 1 (not very severe) to 4 (extremely severe) scale. In addition, they were asked to assign the items to one of five categories based on the effects of the behavior on the environment. There was considerable agreement concerning both the severity and the appropriate category for each item. Suggestions for revision of Part Two, including the need for a weighting system and more precise definitions of the behavior items, were discussed.

Transperitoneal relocation of the ileal stoma without formal laparotomy

A method of transperitoneal ileal stoma relocation without formal laparotomy is described. Twenty of these procedures were performed during a ten year period. There was one postoperative failure. The barium stomal injection is a valuable aid in the peroperative diagnosis of possible underlying Crohn's disease. Transperitoneal relocation of an ileal stoma without formal laparotomy is a safe and useful method in selected patients.

Transmission of salmonid whirling disease by birds fed trout infected with Myxosoma cerebralis

Mallard ducks, Anas platyrhynchos and a black crested night heron, Nycticorax nycticorax were fed trout infected with Myxosoma cerebralis (HOFER) in 2 separate experiments. Feces from the birds were deposited in troughs containing M. cerebralis-free mud as well as in 1 trough without mud. Spore suspensions were also added directly to mud in 1 trough and to another without mud. Susceptible rainbow trout, Salmo gairdneri, developed whirling disease in all troughs containing mud contaminated with M. cerebralis but remained free of infection when exposed to M. cerebralis in troughs without mud. This demonstrates the possibility of bird transmission of the organism causing whirling disease to previously non-contaminated waters.

Purification of antibiotics from Physarum gyrosum by high pressure liquid chromatography

A family of five antibiotic substances was isolated from the slime mold Physarum gyrosum by high pressure liquid chromatography (HPLC). For this purpose, mold was cultured for two weeks in a liquid medium. Soluble products were harvested by rotary evaporation of medium and extraction with 1-butanol. Paper chromatography in ethyl acetate:pyridine:water (2:2:1 v/v) was used for preliminary fractionation. Active components were separated by HPLC with a reverse-phase column packed with Bondapack C18/Porasil B (Waters Associates) and were eluted with a linear gradient of methanol:water increasing from 70 to 100% methanol over 90 minutes. Purification was completed by rechromatographing individual fractions. Purity of the active components was verified by HPLC and thin layer chromatography. Activity assays against Bacillus cereus showed these materials to be bacteriostatic rather than bacteriocidal.

Scanning electron microscopy of human dental pellicle and initial plaque formation in vivo

Small, specially prepared gold alloy discs were recessed into the right and left posterior surfaces of duplicate maxillary dentures. At selected time intervals, a disc was removed from each side of the denture and prepared for examination with a scanning electron microscope (SEM). A thin, peeling film of pellicle was seen on the discs removed after two hours and projections designated "hemispherical globules" formed on the pellicle within the next seven hours.

Hepatic necrobacillosis. Report of a case resembling metastatic tumor

A 47-year-old man had multiple pyogenic liver abscesses from which the anaerobic bacteria Fusobacterium nucleatum and Peptostreptococcus were isolated. The clinical course, diagnostic evaluation, and appearance of the lesions at surgery suggested metastatic tumor. Histologically, the lesions consisted of necrotic liver tissue surrounded by zones of acute and chronic inflammation and fibrous connective tissue closely resembling the lesions of hepatic necrobacillosis attributable to F necrophorum. Treatment with high doses of penicillin was curative.

Overlay dentures. Philosophy and practice. II

The practical stages in the construction of mandibular overlay dentures, with and without precision attachment anchors, are described and illustrated in detail. The importance of post-insertion maintenance, continuing effective oral hygiene and patient care, as a prerequisite for a successful overlay denture experience, is emphasized.

Sensory interaction: vision is modulated by hearing

An irrelevant noise was turned on at various points during a visual reaction-time task. Latencies were reliably smaller than on quiet trials, provided the noise was turned on when a subject was looking at a relevant visual stimulus. This effect occurred regardless of whether the distribution of interstimulus intervals was constant or varied during a session, as well as independently of a subject's base rate of response and level of practice in the task. But it disappeared if reaction times in completely noisy sessions were compared to performances in quiet stimulated by a test form, but not with the particular ear stimulated by a noise. A model is suggested for these and related results in which the arousal elicited by a loud sound in the central nervous system either activates associative memories of form, inhibits early components of striate cortical unit response to the intensive properties of a visual stimulus, or both.

Sparganosis in the United States. Report of a case

A 20-year-old Philadelphia woman (recently moved from South Carolina) had sparganosis of her lower anterior abdominal wall. In the United States sparganosis occurs when man enters the life cycle of dog or cat tapeworms of the genus Spirometra. Most of the American cases have been reported from the southeastern United States, and the most probable source of infection is contaminated drinking water. Sporadic cases have also been seen in other parts of the country. If the pathologist is familiar with the morphology of spargana, the gross and histologic features are sufficient for identification of genus Spirometra.

Study of in vivo plaque formation

The technique of accumulating plaque on removable disks in a complete denture provides a convenient method for investigating plaque on artificial surfaces. Examination of the plaque specimen with a SEM indicated that the plaque consists of microorganisms and a nonstructured matrix. This technique provides results that are consistent for a given individual. However, a group of 12 different individuals had a wide range in the thickness and content of plaque accumulations during equal time intervals. Thin plaque accumulations consisted of a filmlike layer with an apparently small number of microorganisms. Thick layers of plaque consisted of relatively large numbers of microorganisms with some intercellular matrix. The thickness of the plaque layer is apparently determined primarily by the number of microorganisms present.

WAIS performance of neurologically impaired aged

The present study investigated the performance of patients with multi-infarct dementia, dementia due to Alzheimer's disease and vertebrobasilar insufficiency with dementia using the WAIS. Forty-two patients ranging in age from 45 to 85 yr. ( M, 66) were included. Significant differences in cognitive and intellectual performance were found between patients with dementia due to vertebrobasilar insufficiency and multiple-infarctions versus neuronal atrophy of the Alzheimer type. The group with Alzheimer's disease performed significantly and consistently lower on all measures. There were no significant differences between the two cerebrovascular disease groups, even though the multi-infarct dementia group performed consistently more poorly than the vertebrobasilar insufficiency group. A discriminant function analysis classified 74% of the patients correctly based on the individual WAIS scores. A step-wise regression analysis ranked Block Design and Similarities as the best discriminators.

Patterns of memory performance in the neurologically impaired aged

The specific behavioral manifestation associated with the different disorders producing the syndrome of dementia have remained poorly investigated. We examined the memory performance of three distinct groups of patients with dementia secondary to Alzheimer's disease (AD) multiple-infarctions (MID) and vertebrobasilar insufficiency (VBI) on the ten subtests of the Wechsler Memory Scale (WMS). Statistical methods of analysis were used to maximize the differences between the groups. Univariate statistical procedures revealed that the AD group performed significantly and consistently lower than the two cerebrovascular groups. There were no significant differences between the two cerebrovascular disease groups, even though the MID group tended to perform consistently more poorly than the VBI group. For heuristic and conceptual purposes as well as to determine which combination of the ten WMS variables produced the "best" statistical model differentiating the groups the data was analyzed by multivariate techniques. A discriminate function analysis obtained a 100% valid positive hit rate in discriminating among the three groups. One hundred percent diagnostic accuracy was also obtained in discriminating between MID and AD as well as AD and VBI. The two cerebrovascular groups tended to overlap in their probability distributions with an 81% hit rate. Different predicitive statistical models were identified to differentiate the various diagnostic groups. It was possible to discriminate the three diagnostic groups by different patterns of memory performance.

Analysis of intellectual and cognitive performance in patients with multi-infarct dementia, vertebrobasilar insufficiency with dementia, and Alzheimer's disease

A prominent feature in dementia is intellectual deterioration. Review of the clinical literature indicates a lack of suitably quantitated studies of specific intellectual defects in dementia. The present study investigated the performance of patients with multi-infarct dementia (MID), dementia due to Alzheimer's disease (AD), and vertebrobasilar insufficiency (VBI) with dementia using the Wechsler Adult Intelligence Scale (WAIS). Forty-two patients ranging in age from 45 to 85 years (x 66) were included. Significant differences in cognitive and intellectual performance were found between patients with dementia due to VBI and MID versus neuronal atrophy of the Alzheimer's type. The group with AD performed significantly and consistently lower on all measures. There were no significant differences between the two cerebrovascular disease groups, even though the MID group performed consistently more poorly than the VBI group. A discriminant function analysis classified 74% of the patients correctly based on the individual WAIS scores. The diagnosis was more easily made when tasks measuring visual motor coordination and abstract reasoning were included in the analysis.