Dysphoric and depressive symptoms in chronic schizophrenia

This study suggests that depressive symptoms are less common in severe, chronic, schizophrenic inpatients than would be predicted if these symptoms were manifestations of negative symptoms or drug-induced parkinsonism. The findings further suggest that depressive symptoms in such patients are independent phenomena which conform to a depressive syndrome. This depression does not represent a misidentification of the negative symptoms affective flattening and alogia, as measured by the SANS, or parkinsonism or akathisia. The study findings fail to support the view that long-term depot antipsychotic medication plays an important role in the genesis of depression and dysphoria in chronic schizophrenic patients. Depressive symptoms were found to occur as frequently, and dysphoria more frequently, in schizophrenic patients in the year after drug withdrawal compared with patients continuing on maintenance drug treatment for the same period.

The nature and prevalence of depression in chronic schizophrenic in-patients

Out of 194 chronic schizophrenic in-patients, depressed mood (item 23 of the PSE) was present in 25 (13%). When compared with 25 matched controls, the patients with depressed mood had significantly higher scores on the MADRS and the Beck Depression Inventory. Serious suicidal ideas and auditory hallucinations were significantly more common in the depressed group. However, there were no significant differences between the matched groups in terms of negative symptoms, Parkinsonism, tardive dyskinesia, anticholinergic medication, or current dose of antipsychotic drug, which suggests that the depression identified was not related to drug treatment, nor was it a direct manifestation or misinterpretation of negative symptoms. Over three-month follow-up, the MADRS and Beck scores covaried closely with the presence or absence of depressed mood. This depressive syndrome persisted over the three months in the majority of patients originally depressed.

Benign histiocytic fibroma of rib with CT correlation

Benign fibrous histiocytoma is a benign tumor with fibroblastic and histiocytic differentiation, most commonly found in soft tissues and less frequently in adult bones. It is identical histologically to non-ossifying fibromas of childhood but differs in its clinical and radiological features. We here report a 26-year-old woman with benign histiocytic fibroma in a rare location, a rib, with computed tomographic correlation. Such correlation has not been reported previously.

Use of magnitude estimation for estimating the parameters of dyspnea

Magnitude estimation, a psychophysic method, allows examination of variables associated with the respiratory sensation of loaded breaths. The subject's perceptual sensitivity can be quantified by magnitude-scaling exponents which describe the rate of growth of the dyspnea sensation associated with increases in the magnitude of the stimulus. Measurement of the perception of dyspnea by magnitude estimation can complement other measurements of variables that contribute to this complex sensation. Use of magnitude estimation techniques can enhance the study of similar clinical problems such as pain and fatigue.

Visualization of a pseudomeningocele on isotope cisternography

Pseudomeningocele, a hernial protrusion of the meninges, most commonly forms in wounds that have been incompletely closed at surgery. They are frequently seen with hydrocephalus, with or without increased intracranial pressure. The authors present a case of an incidental finding of a posterior fossa pseudomeningocele seen on cisternography that was performed because of postoperative hydrocephalus after removal of a cerebellar astrocytoma.

Structure and expression of c-fgr protooncogene mRNA in Epstein-Barr virus converted cell lines

The c-fgr protooncogene is a member of the c-src family of tyrosine kinases. Expression of c-fgr was studied in a series of Epstein-Barr virus (EBV) negative Burkitt's lymphoma cell lines and their EBV-converted derivatives. Two transcripts, of 2.9 kb and 3.5 kb, were present at dramatically elevated levels following EBV-conversion. The structure of the c-fgr transcripts was studied by the isolation and nucleotide sequence analysis of cDNA clones. This indicated that the c-fgr protein encoded by the mature mRNA would contain 529 amino acids and have a molecular weight of approximately 58,000. The N-terminus of the predicted c-fgr protein has low amino acid homology with the N-termini of other members of this family of proteins, suggesting a cell specific function for the N-terminal domain. Analysis of the c-fgr cDNA clones also revealed the presence of alternative functional polyadenylation signals, although the use of these does not account for the size difference between the two major c-fgr transcripts.

Postcholecystectomy bile leak. Serial hepatobiliary imaging and percutaneous drainage

In addition to diagnosing acute cholecystitis, hepatobiliary imaging offers a noninvasive, physiologic, highly sensitive, and apparently underutilized technique for the evaluation of biliary leaks. As this case report illustrates, radionuclide imaging can play an important role in the diagnosis and follow-up of postcholecystectomy biliary leaks, particularly those treated by percutaneous catheter drainage.

Psychiatric morbidity of a long stay hospital population with chronic schizophrenia and implications for future community care

In the United Kingdom there are plans to close most mental hospitals over the next 10 years. There is continuing uncertainty about the effectiveness of community psychiatric services that will be expected to cope with mental hospital inpatients after discharge, most of whom have schizophrenia. A survey was conducted to assess the severity of illness among such patients and implications for their future care. All 222 patients in non-psychogeriatric long stay wards of a mental hospital who met research diagnostic criteria for schizophrenia were interviewed by two psychiatrists with the comprehensive psychopathological rating scale to establish the prevalence of psychiatric symptomatology. A complete interview was not possible for 28 patients, mainly for reasons related to their schizophrenia. Despite energetic pharmacological and social treatments almost half of the 194 patients interviewed had enduring florid psychotic symptoms that presented as one or more delusions or auditory hallucinations, or both, and a sizable proportion showed behaviour that would set them apart in a community setting. The results illustrate a problem that is still imperfectly understood by policy makers and administrators in central and local government and in health authorities who are responsible for planning and implementing services for psychiatric care in the community.

Assessment of trace metal intake and status in a Gujerati pregnant Asian population and their influence on the outcome of pregnancy

Dietary assessments and biochemical indices including plasma zinc and copper were determined in pregnant vegetarian and non-vegetarian Gujerati women in India at 28 weeks gestation, and the results were contrasted with those of a comparable group of Gujerati pregnant women living in Harrow. Even though the dietary intake of energy, protein and zinc was significantly lower in the Indian vegetarian Gujerati group when compared to the equivalent group in Harrow, the birthweights of the babies delivered at term were similar. The intake of zinc in the diet of the Gujerati Indian vegetarian and non-vegetarian groups was only one quarter of the US recommended intake during pregnancy and was approximately one half in the Harrow Indian groups. Even so, the plasma concentrations of zinc were similar in all dietary groups in either India or Harrow. The albumin content in the plasma of both the Gujerati Indian vegetarian and non-vegetarian was significantly reduced when compared to the equivalent Harrow dietary groups. The plasma concentrations of both calcium and sodium were significantly correlated with the albumin concentration but not with the plasma content of zinc. Copper levels were elevated to the normal range in both dietary groups of the Gujerati and were similar to the concentrations found in the Harrow groups.

Peripheral pulmonary vascular and airway abnormalities in adolescents with rheumatic mitral stenosis

Lung biopsy specimens were taken from 15 adolescents (aged 11-21 years), at the time a mitral valvotomy was performed. In addition to quantitative light microscopic studies three specimens were also examined by scanning and transmission electron microscopy. In all cases, the pulmonary vascular abnormalities were most marked in the capillary bed and in the vessels immediately proximal and distal to it. The capillaries showed a marked increase in basement membrane material at the blood/gas barrier, and were embedded in dense connective tissue within the alveolar walls. Intra-acinar and, to a lesser extent, pre- and post-acinar vessels showed an increase in muscularity, severe circumferential intimal fibrosis, and abnormally thick and dense adventitial connective tissue. The peripheral airways were encased in dense connective tissue, which appeared to compress them. Bronchial smooth muscle was increased. Six months after the mitral valvotomy was performed, the mean pulmonary arterial pressure had fallen from 42 mm Hg to 23 mm Hg. Despite this satisfactory haemodynamic result, the long-term effects of small airway compression on the growing lung indicate the need for early relief of mitral valve obstruction, possibly made easier by the new technique of balloon angioplasty.

Sch 37137, a novel antifungal compound produced by a Micromonospora sp. Taxonomy, fermentation, isolation, structure and biological properties

A new antifungal compound, Sch 37137, was isolated from the cultured broth of a Micromonospora sp., SCC 1792. Sch 37137 is structurally related to A 19009, a dipeptide previously discovered from a Streptomyces sp. The compound was weakly active against species of Candida and dermatophytes (mean MICs greater than or equal to 128 micrograms/ml) in Sabouraud dextrose, yeast-nitrogen and modified Eagles minimum essential media; however activity against Candida sp. (mean MICs greater than or equal to 12 micrograms/ml) and dermatophytes (mean MICs greater than or equal to 0.8 microgram/ml) significantly improved in MA medium.

Sch 36605, a novel anti-inflammatory compound. Taxonomy, fermentation, isolation and biological properties

A novel anti-inflammatory compound, Sch 36605, belonging to the blasticidin family of nucleoside compounds was isolated from the fermentation filtrate of a Streptomyces sp. Sch 36605, as well as blasticidin S, demonstrated anti-inflammatory activity in the reverse passive Arthus reaction and the adjuvant arthritic rat at doses ranging between 1-10 mg/kg and 0.3-6.0 mg/kg, respectively. A minor component, Sch 366606, co-produced in the in the fermentation was isolated and identified as a known compound in the blasticidin family of compounds.

Study of cost by type of diagnosis in Switzerland

Lengths of stay, for a given diagnosis, are poorly correlated between Switzerland, the USA., and Australia; and between 5 hospitals within Switzerland. Three different sets of DRG cost weightings (U.S., French A, French B) are also poorly correlated. Hospital operating efficiencies, standardized by DRG, were estimated and compared. The three sets of cost weightings used all yielded very similar estimates of hospital operating efficiency. The use of current existing systems of cost weightings may, therefore, provide a rapid and cheap means of comparing hospital operating efficiency. In the long run, more precise and detailed cost data will enable national cost weightings to be obtained. Associated issues, such as costing methodologies and perspectives on utilization, are also discussed.

A new tetracycline antibiotic from a Dactylosporangium species. Fermentation, isolation and structure elucidation

An actinomycete identified as a Dactylosporangium sp. produces a new tetracycline, 4a-hydroxy-8-methoxychlortetracycline (Sch 34164). The addition of magnesium ions to complex fermentation media increased the antibiotic titers. Sch 34164 was isolated by solvent extraction and Sephadex G-25 column chromatography. The novel structure was proposed based on spectroscopic analysis. The shift of C-4a (35 to 77 ppm) and C-8 (140 to 163 ppm) in the 13C NMR as compared to chlortetracycline was indicative of the novel hydroxyl and methoxy substituents, respectively.

A novel tetracycline from Actinomadura brunnea. Fermentation, isolation and structure elucidation

A novel tetracycline antibiotic, Sch 33256, was isolated from a culture broth of a new species of Actinomadura. The antibiotic was isolated by solvent extraction, Sephadex G-25 column chromatography and crystallization. The structure was determined by comparison of the spectra with that of chlortetracycline. Spectroscopic analysis of the compound yielded 2'-N-methyl-8-methoxychlortetracycline as the proposed structure.

Multiple liver abscesses caused by Yersinia enterocolitica. A case report

Yersinia enterocolitica is an important cause of multiple liver abscesses in iron-overloaded or debilitated patients. The condition has a high mortality rate and causes diagnostic and therapeutic problems. The successful management of an iron-overloaded patient presenting with jaundice and chronic renal failure is described.

Fast protein liquid chromatography (FPLC) of leukaemic cell N-acetyl beta-D hexosaminidases

Leukaemic myeloid and lymphoid cell N-acetyl beta-D glucosaminidase (hexosaminidase) enzymes were fractionated by Fast Protein Liquid Chromatography (FPLC) using high-resolution ion exchange (Mono-S and Mono-Q), gel filtration (Superose-6) and chromatofocusing (Mono-P) columns. Although only one molecular weight species was detected in haemopoietic cells, with an apparent mass of 129 kD, "isoenzyme" variants defined by differences in molecular charge were considerably more diverse than previously thought. Separation of the major Hex forms (A and B) by chromatofocusing indicated that intermediate (I) components were present in most acute leukaemias irrespective of lineage supporting the concept that the I form is a non-specific marker of haemopoietic immaturity. Substrate and inhibitor studies further revealed that leukaemic cell hexosaminidases hydrolyse galactopyranosides at significantly lower rates than glucopyranosides and that the hydrolysis of N-acetyl beta-D glucosamine is inhibited by both glucosamine and galactosamine products.