The role of Kölliker-Fuse nucleus in breathing variability

The Kölliker-Fuse nucleus (KF), which is part of the parabrachial complex, participates in the generation of eupnea under resting conditions and the control of active abdominal expiration when increased ventilation is required. Moreover, dysfunctions in KF neuronal activity are believed to play a role in the emergence of respiratory abnormalities seen in Rett syndrome (RTT), a progressive neurodevelopmental disorder associated with an irregular breathing pattern and frequent apneas. Relatively little is known, however, about the intrinsic dynamics of neurons within the KF and how their synaptic connections affect breathing pattern control and contribute to breathing irregularities. In this study, we use a reduced computational model to consider several dynamical regimes of KF activity paired with different input sources to determine which combinations are compatible with known experimental observations. We further build on these findings to identify possible interactions between the KF and other components of the respiratory neural circuitry. Specifically, we present two models that both simulate eupneic as well as RTT-like breathing phenotypes. Using nullcline analysis, we identify the types of inhibitory inputs to the KF leading to RTT-like respiratory patterns and suggest possible KF local circuit organizations. When the identified properties are present, the two models also exhibit quantal acceleration of late-expiratory activity, a hallmark of active expiration featuring forced exhalation, with increasing inhibition to KF, as reported experimentally. Hence, these models instantiate plausible hypotheses about possible KF dynamics and forms of local network interactions, thus providing a general framework as well as specific predictions for future experimental testing.

Key points

The Kölliker-Fuse nucleus (KF), a part of the parabrachial complex, is involved in regulating normal breathing and controlling active abdominal expiration during increased ventilation. Dysfunction in KF neuronal activity is thought to contribute to respiratory abnormalities seen in Rett syndrome (RTT). This study utilizes computational modeling to explore different dynamical regimes of KF activity and their compatibility with experimental observations. By analyzing different model configurations, the study identifies inhibitory inputs to the KF that lead to RTT-like respiratory patterns and proposes potential KF local circuit organizations. Two models are presented that simulate both normal breathing and RTT-like breathing patterns. These models provide plausible hypotheses and specific predictions for future experimental investigations, offering a general framework for understanding KF dynamics and potential network interactions.

Associations of antenatal maternal psychological distress with infant birth and development outcomes: Results from a South African birth cohort

BACKGROUND

Antenatal maternal psychological distress is common in low and middle-income countries (LMIC), but there is a dearth of research on its effect on birth and developmental outcomes in these settings, particularly in Sub-Saharan Africa. This study set out to identify risk factors for antenatal maternal psychological distress and determine whether antenatal maternal psychological distress was associated with infant birth and developmental outcomes, using data from the Drakenstein Child Health Study (DCHS), a birth cohort study in South Africa.

METHODS

Pregnant women were enrolled in the DCHS from primary care antenatal clinics. Antenatal maternal psychological distress was measured using the Self-Reporting Questionnaire 20-item (SRQ-20). A range of psychosocial measures, including maternal childhood trauma, depression, and posttraumatic stress disorder (PTSD) were administered. Birth outcomes, including premature birth, weight-for-age z-score and head circumference-for-age z-score, were measured using revised Fenton growth charts. The Bayley III Scales of Infant and Toddler Development was administered at 6 months of age to assess infant development outcomes, including cognitive, language, and motor domains in a subset of n=231. Associations of maternal antenatal psychological distress with psychosocial measures, and with infant birth and developmental outcomes were examined using linear regression models.

RESULTS

961 women were included in this analysis, with 197 (21%) reporting scores indicating the presence of psychological distress. Antenatal psychological distress was associated with maternal childhood trauma, antenatal depression, and PTSD, and inversely associated with partner support. No association was observed between antenatal maternal psychological distress and preterm birth or early developmental outcomes, but antenatal maternal psychological distress was associated with a smaller head circumference at birth (coefficient=-0.30, 95% CI: -0.49; -0.10).

CONCLUSION

Antenatal maternal psychological distress is common in LMIC settings and was found to be associated with key psychosocial measures during pregnancy, as well as with adverse birth outcomes, in our study population. These associations highlight the potential value of screening for antenatal maternal psychological distress as well as of developing targeted interventions.

Installation and commissioning of the ion source systems for the new spallation neutron source 2.5 MeV injector

The U.S. Spallation Neutron Source (SNS) is a state-of-the-art neutron scattering facility delivering the world's most intense pulsed neutron beams to a wide array of instruments, which are used to conduct investigations in many fields of engineering, physics, chemistry, material science, and biology. Neutrons are produced by spallation of liquid Hg by the bombardment of short (∼1 µs), intense (∼35 A) pulses of protons delivered at 60 Hz by an accumulator ring which is fed by a high-intensity, 1 GeV, H^- LINAC (linear accelerator). This facility has operated nearly continuously since 2006 but has recently undergone a 4-month maintenance period, which featured a complete replacement of the 2.5 MeV injector feeding the LINAC. The new injector was developed at ORNL in an off-line beam test facility and consists of an ion source, low energy beam transport, and a Radio Frequency Quadrupole (RFQ). This report first describes the installed configuration of the new injector detailing the ion source system. The first beam current, RFQ transmission, emittance, and energy measurements from the injector installed on the SNS are reported. These data not only show a significant performance improvement for our existing facility but will also make accessible the higher beam current requirements for future SNS upgrade projects: the proton power upgrade and second target station.

Antenatal and early life tobacco smoke exposure in an African birth cohort study

BACKGROUND

Exposure to tobacco smoke in African infants has not been well studied, despite the high burden of childhood respiratory disease in these communities.

OBJECTIVE

To investigate the prevalence of antenatal and early life tobacco smoke exposure and associations with infant birth outcomes in an African birth cohort, the Drakenstein Child Health Study.

METHODS

Self-report questionnaires assessing maternal and household smoking were administered. Maternal and infant urine cotinine testing was conducted antenatally, at birth and at 6-10 weeks of life to measure tobacco smoke exposure. Multivariate regression models explored the associations between exposure to smoke and infant birth outcomes.

RESULTS

Of 789 pregnant women included, 250 (32%) were active smokers on cotinine testing. At birth and at 6-10 weeks of life, respectively 135/241 (56%) and 154/291 (53%) infants had urine cotinine levels indicating tobacco smoke exposure. Household smoking was prevalent and was associated with positive infant cotinine test results. Antenatal maternal smoking was associated with decreased infant birthweight-for-age Z-score (0.3, 95%CI 0.1-0.5).

CONCLUSION

Antenatal and early life tobacco smoke exposure is highly prevalent in this community, and may impact on birth outcomes and subsequent child health. Smoking cessation interventions are urgently needed to reduce tobacco smoke exposure in African communities.

Maternal and infant factors had a significant impact on birthweight and longitudinal growth in a South African birth cohort

Aim

This birth cohort study investigated longitudinal infant growth and associated factors in a multiethnic population living in a low‐resource district surrounding the town of Paarl in South Africa.

Methods

Between March 2012 and October 2014, all mothers attending their second trimester antenatal visit at Paarl Hospital were approached for enrolment. Mother–infant pairs were followed from birth until 12 months of age. Comprehensive socio‐demographic, nutritional and psychosocial data were collected at birth, two, six and 12 months. Infant anthropometry was analysed as z‐scores for weight and height. Linear regression was used to investigate predictors of birthweight, and linear mixed‐effects models were used to investigate predictors of infant growth.

Results

Longitudinal anthropometric data from 792 infants were included: 53% were Black African, 47% were mixed race, and 15% were born preterm. Stunting occurred in 13% of infants at 12 months. Maternal height, antenatal alcohol and tobacco use, ethnicity and socioeconomic status were significant predictors of birthweight. In the adjusted mixed‐effects model, birthweight was a significant predictor of growth during the first year of life.

Conclusion

Birthweight was an important predictor of growth trajectory during infancy. Birthweight and growth were influenced by several important modifiable factors.

Investigating the psychosocial determinants of child health in Africa: The Drakenstein Child Health Study

BACKGROUND

Early life psychobiological and psychosocial factors play a key role in influencing child health outcomes. Longitudinal studies may help elucidate the relevant risk and resilience profiles, and the underlying mechanisms that impact on child health, but there is a paucity of birth cohort data from low and middle-income countries (LMIC). We describe the rationale for and present baseline findings from the psychosocial component of the Drakenstein Child Health Study (DCHS).

METHODS

We review the psychosocial measures used in the DCHS, a multidisciplinary birth cohort study in a peri-urban area in South Africa, and provide initial data on psychological distress, depression, substance use, and exposure to traumatic stressors and intimate partner violence (IPV). These and other measures will be assessed longitudinally in mothers in order to investigate associations with child neurodevelopmental and health outcomes.

RESULTS

Baseline psychosocial data is presented for mothers (n=634) and fathers (n=75) who have completed antenatal assessments to date. The sample of pregnant mothers is characterized by multiple psychosocial risk factors, including a high prevalence of psychological distress and depression, high levels of substance use, and high exposure to traumatic stressors and IPV.

DISCUSSION

These data are consistent with prior South African studies which have documented a high prevalence of a multitude of risk factors during pregnancy. Further longitudinal assessment of mothers and children may clarify the underlying psychobiological and psychosocial mechanisms which impact on child health, and so inform clinical and public health interventions appropriate to the South African and other LMIC contexts.

Investigating the early-life determinants of illness in Africa: the Drakenstein Child Health Study

Respiratory disease is the predominant cause of illness in children globally. We describe a unique multidisciplinary South African birth cohort, the Drakenstein Child Health Study (DCHS), to investigate the incidence, risk factors, aetiology and long-term impact of early lower respiratory tract infection (LRTI) on child health. Pregnant women from a poor, peri-urban community with high exposure to infectious diseases and environmental risk factors are enrolled with 1000 mother–child pairs followed for at least 5 years. Biomedical, environmental, psychosocial and demographic risk factors are longitudinally measured. Environmental exposures are measured using monitors placed at home visits. Lung function is measured in children at 6 weeks, annually and during LRTI episodes. Microbiological investigations including microbiome and multiplex PCR measures are done longitudinally and at LRTI episodes. The DCHS is a unique African birth cohort study that uses sophisticated measures to comprehensively investigate the early-life determinants of child health in an impoverished area of the world.

Coagulation factor and hemostatic protein content of canine plasma after storage of whole blood at ambient temperature

Background

Standard practice in canine blood banking is to produce fresh frozen plasma (FFP) by separating and freezing plasma produced from blood within 8 hours of collection. Within canine blood donation programs, this can limit the number of units collected.

Hypothesis/Objectives

The aim was to compare the coagulation factor and hemostatic protein content (CF&HPC) of plasma produced from blood stored at ambient temperature for 8, 12, and 24 hours. Another aim was to compare the CF&HPC between Greyhound types and other breeds.

Animals

None.

Methods

In vitro study. A convenience sample of 58 units of canine blood from a blood donor pool was processed to prepare and freeze plasma 8, 12, or 24 hours following collection.

Results

Regardless of time of processing, the units contained therapeutic CF&HPC. Frozen plasma prepared after 24 hours had significantly higher factor VIII (P = .014) and factor X (P = .03) when compared with the frozen plasma prepared at 8 hours. Factor X (P < .01), fibrinogen (P < .01), and vWF (P = .04) were significantly lower in plasma collected from Greyhound types than in plasma collected from other breeds.

Conclusions and Clinical Importance

Storing whole blood for up to 24 hours is a suitable method for producing FFP. Lower values for some coagulation factors and hemostatic proteins in plasma produced from Greyhound types would not preclude these dogs as FFP donors.

Perceived adherence barriers among patients failing second-line antiretroviral therapy in Khayelitsha, South Africa

Background. The recent scale-up of antiretroviral therapy (ART) coverage in resource-limited settings has greatly improved access to treatment. However, increasing numbers of patients are failing first- and second-line ART.Objective. To examine factors affecting adherence to second-line ART from the perspective of clinic staff and patients, assessing both individual and structural perceived barriers.Methods. Research was conducted at a large primary care tuberculosis (TB)/HIV clinic in Khayelitsha, a peri-urban township in Cape Town, South Africa. Participants were drawn from a Médecins Sans Frontières-run programme to support patients failing second-line ART. A qualitative research approach was used, combining multiple methodologies including key informant interviews with staff (n=11), in-depth interviews with patients (n=10) and a Photovoice workshop (n=11). Responses and photographs were coded by content; data were transformed into variables and analysed accordingly.Results. Staff identified drinking, non-disclosure, not using condoms and pill fatigue as barriers to ART adherence, while patients identified side-effects, not using condoms and a lack of understanding concerning medication timing. With respect to service delivery, staff identified a need for continued counselling and educational support following ART initiation. Patients were concerned about missing medical records and poor staff attitudes in the clinic.Conclusion. These findings identify discrepancies between provider and patient perceptions of barriers to, and facilitators of adherence, as well as of service delivery solutions. This highlights the need for on-going counselling and education following ART initiation, improved quality of counselling, and improved methods to identify and address specific barriers concerning medication adherence.

[Disguised Tourette's syndrome. A contribution to the differential diagnosis on phobia and fear]

Patients with Tourette's syndrome often develop multiple psychopathological symptoms beyond the basic symptoms (motor and vocal tics). We describe a female patient who had been treated over years with cognitive-behavioural methods under the diagnosis of anxiety disorder without success. Her obsessive-compulsive and tic symptoms had been ignored because they had not been reported by the patient, who was accustomed to them. Our case underlines the necessity of specific exploration and taking of a case history, especially when symptoms are atypical and do not improve under treatment. This gives cause for some critical remarks on the principle of comorbidity.

Neurophysiologic tests during antidepressive treatment - an exploratory study

This is a non-randomized exploratory study showing the sensitivity of neurophysiological parameters for autonomic side-effects during the application of antidepressant drugs. Inpatients on tricyclic antidepressants (TCA: amitriptyline or doxepine), inpatients on serotonine-reuptake inhibitors (SSRI: fluvoxamine or paroxetin) and a control group of healthy volunteers underwent neurophysiological examination. The treatment group was investigated after at least 7 days of continuous treatment with the final dose. Adjustment of the autonomic nervous system was studied, first, by measuring latency and amplitude of the sympathetic skin response (SSR), elicited by electric stimuli and by deep inspiration, and second, by analysis of the heart rate variation (HRV) during rest and inspiration. Relevant affections of the peripheral parts of the reflex arc under discussion were excluded by taking the nerve conduction velocity (NCV) and F-wave referring to cervical segment C7. In total, 48 individuals were examined. The TCA group showed delayed latencies and smaller amplitudes of the SSR in comparison with the controls. In the SSRI group, these parameters did not differ significantly from those of the controls. Analysis of HRV put further emphasis on the impaired adjustment of the autonomic nervous system in the TCA group. To sum up, our test battery indicated a specific vegetative alteration due to TCA.

Repeated arson: data from criminal records

The criminal careers of all arsonists convicted in former West-Germany between 1983 and 1985 who were found not to be responsible due to diminished responsibility for psychiatric reasons and a random sample (every third) of all criminally liable arsonists during the same period of time were followed up until 1994 by means of their trial records. Reappearance before the court for arson did not differ between the groups. When subjects are grouped by the additional occurrence of crimes other than arson, however, arsonists with diminished responsibility are the most problematic group: In comparison with all other subgroups, the arsonists who were partly responsible who did not commit any crimes other than arson showed the highest number of fire-setting incidents. Among the arsonists who committed other crimes as well, arsonists with diminished responsibility had the highest number of additional offences.

The hysterical personality disorder: a phenomenological approach

The background of the present study is a general uncertainty as to what comprises the essence of hysterical (histrionic) personality disorder. Using phenomenological methodology, phenomena observable in the 'classic' hysterical personality are analysed, described, named, and classified according to the basic functions of human experience and behaviour. The resulting psychopathological picture of the hysterical personality facilitates a differential diagnosis that is often decidedly difficult. The phenomenon of dissociation of the mental processes is demonstrated for the various basic functions. A specific feature of the disorder is shown which generates a dissociation of contents of the personality along a conscious-preconscious-unconscious continuum. It is concluded that dissocation is, in the final analysis, the prerequisite for a compromised and partial acting out of prohibited non-integrated elements, e.g. aggression, as a coping strategy.

[Psychodynamics and therapy of trichotillomania]

After a short review of the literature, some aspects of the psychodynamics and therapy of trichotillomania with an adolescent patient are presented that up to now have not been described in great detail. Against the backdrop of previous fears of being abandoned, the patient feels threatened that while coping with the developmental tasks of sexuality and aggressiveness she will be dropped once again. This psychodynamically oriented therapy makes it possible for the patient to accept and verbalize the corresponding feelings in a relationship that gives a feeling of security. Therefore, the symptoms that previously served the purpose of regulating diffuse inner tensions and fears may be abandoned.

Recidivism and concomitant criminality in pathological firesetters

The purpose of this study was to explore dangerousness and fire setting recidivism of mentally disordered firesetters in comparison with mentally healthy arsonists. In Germany, all trials are registered centrally by the Federal Central Register. The records of this Register for the three year period from 1983 until 1985 were used in this follow-up study of arsonists to identify three samples of subjects: (1) All persons convicted of arson who have been found not guilty by reasons of insanity (n = 186), (2) all person convicted of arson who have been found guilty of diminished responsibility (n = 97), and (3) a random selection from all persons convicted of arson who have had no psychiatric examination in their trial (n = 187). The follow-up ended in 1994, providing a period of, on average, ten years. Mentally disordered arsonists differed from non-mentally disordered arsonists in the following ways: They were more likely, first, to have a history of arson before 1983, and secondly, to be convicted of arson again (11% relapse compared to 4%). Mentally disordered arsonists had fewer registrations of common offenses, such as theft as well as traffic violations and alcohol-related offenses. Based on the present sample, mentally disordered firesetters have a higher rate of recurrence of firesetting than non-mentally disordered firesetters and commit fewer common offenses other than firesetting.

Forecasting recidivism in delinquency by intelligence and related constructs

In a longitudinal survey of 122 healthy criminal offenders aged 18 to 37 years, the relationship between intelligence measured by the Wechsler Adult Intelligence Scale (WAIS), neuropsychological scales and delinquency was investigated. The Benton Test correlates well with the WAIS and moderately with offence data, but not with recidivism in delinquency. The 122 men had normal intelligence test scores (average IQ = 102), but bad school and working records. The 34 per cent and 60 per cent respectively of offenders, who relapsed within the time span of 1.5 and 3 years respectively, showed significantly worse results in the Verbal Scale and in the Block Design of the Wechsler Intelligence Scale. Poor performance in the Information and the Block Design sub-tests of the WAIS, a low level of formal education and the belief in external control by circumstances and powerful others are predictors of a high risk of recidivism.

[Primary and secondary negative symptoms: a useful differentiation? An empirical study]

The concept of schizophrenic negative symptomatology consisting of primary, treatment-resistant negative symptoms associated with cognitive dysfunction and treatable secondary composite negative symptoms was tested by comparing a group with non-chronic schizophrenia and a neurotic group with negative symptoms before and 8 weeks after the start of treatment. Contrary to our hypothesis, we found no association between schizophrenic negative symptoms and cognitive dysfunction as measured by CPT and K-V-T either at the first or at the second assessment point, but did find a strong relation between depressive and negative symptomatology at both assessment points in both groups. Thus, we conclude that a chronic course, rather than primary negative symptomatology, may be associated with cognitive dysfunction. The concept of primary negative symptoms based on cognitive dysfunction versus secondary negative composite symptoms encompassing motivation and reactive attitudes is not supported by these results.

[Psychotherapy in psychiatry--an assessment of current status. Report on the DGPPN Status Colloquium "Psychotherapy in Psychiatry" 22-24 February 1996 in Heidelberg]

The German psychiatrists have agreed to new training regulations which now include psychotherapy. On this occasion the German Psychiatric Association organized a symposium "psychotherapy within psychiatry". Psychotherapy researchers of all psychiatric departments in German speaking countries were invited. As a result, a cross-sectional picture of current psychotherapy research within psychiatry showed a great variety of methods and ways of thinking about research on psychotherapeutic process, outcome, and applications. Even non behavioural approaches showed a trend towards operationalized and quantifying, but also standardized qualitative research. All participants agreed on the necessity of better and in comparison with psychopharmacological research more fair financing of psychotherapy research.

The core of negative symptoms in schizophrenia: affect or cognitive deficiency?

The association of negative symptoms on one hand and cognitive failures and language and thought disturbances on the other hand was examined in 25 schizophrenics and 22 neurotics over a 2-month period of intensive therapy. Psychopathological negative symptoms were more pronounced in schizophrenics than in neurotics at the first assessment before intensive therapy. However, cognitive and language performance showed no difference between the groups in both cross-sectional comparisons before and after treatment. Thus, our hypothesis that cognitive deficiencies are the core of negative symptoms could not be confirmed. It is discussed that young schizophrenics at an early stage of the illness may imply more affective components in the psychopathology of their negative syndrome than chronic schizophrenics with more pronounced cognitive deficits.

[Stiff-man syndrome. Report of 4 cases]

Four patients are presented who exhibited progressive muscular rigidity in both legs, the thoracolumbar, paraspinal and the abdominal muscles. In only one patient, there was an initial involvement of the shoulder girdle muscles. Electromyography in all four patients at rest recorded continuous electric activity resembling an interference pattern. Following sudden exteroceptive stimuli the activity increased in amplitude and density this corresponded clinically to painful spasms. All patients had oligoclonal banding in CSF. In the serum and CSF of three patients IgG subtype autoantibodies were detected. These have been found to be directed against GABAergic nerve terminals in the rat and human cerebellum and, more specifically, to glutamic acid decarboxylase. All patients improved on clonazepam. Trials of intermittent high-dose methylprednisolone administration gave relief from rigidity in one patient and permitted reduction of clonazepam in another. Intravenous immunoglobulins however had no effect in one patient.

Pathological fire-setting 1951-1991: a review

The purpose of this article is to review the whole literature on pathological fire-setting and related fields since 1951 in order to present a state of the art picture of our contemporary knowledge about this phenomenon. Papers were initially selected by using a Medline search. From the articles obtained in this way the references had to be pursued, because many relevant papers and books in this research field of different scientific and practical disciplines are not listed in conventional literature services. Finally, only those contributions were selected which provided new information when published, by original research, theoretical interpretation or practical implications. The last forty years have brought a growing body of data and understanding--especially concerning pathological fire-setting by children--etiology, and therapy, which often proves successful. The situation remains unclear for arson by psychologically disturbed adults and we still have a poor understanding of arson without apparent motive. There is a conflict of opinion as to whether adult fire-setters are suitable for therapy and therapeutic efforts dealing with psychologically disturbed adults are rare. With increasing knowledge about child fire-setting and its successful treatment, etiological and therapeutic models for adult fire-setting behaviour may be developed. Research into the latter area should focus on both biographical and social conditions of development from childhood on as well as biological measures. Both will be reviewed here.

VIP receptors on canine submucosal synaptosomes

The present study characterized [125I]VIP binding to synaptosomes from the submucosa of canine small intestine. Studies of saturation, competition binding, and kinetic studies revealed high- and low-affinity binding sites. Studies with GTP-gamma-S and cholera toxin suggested that the receptor was coupled to a G-protein, possibly Gs. Competition with VIP analogs suggested that the N-terminal end of the molecule played the major role in determining affinity and that this receptor was for VIP, not PACAP. Cross-linking VIP to the receptor revealed a single peptide (M(r) congruent to 60,000). We suggest that VIP may act to modulate mediator release from enteric nerve endings.

[Psychology and psychopathology of firesetting behavior 1955 to 1991--a review]

After a historical introduction and some short remarks on criminal arson, this review of the literature since 1955 mainly focuses on pathological firesetting. It deals with all important aspects of the psychiatry of firesetting: arson by persons referred to psychiatric examination, by the mentally ill, and by psychiatric inpatients, the relationship between arson and sexuality, psychoanalytical contributions, arson by children and juveniles, therapy and prevention of firesetting behaviour. Female arsonists, recidivism, and suicide by burning are considered separately.

Untreated neuroborreliosis: Bannwarth's syndrome evolving into acute schizophrenia-like psychosis. A case report

In general, meningopolyradiculitis (Bannwarth's syndrome, stage 2 of neuroborreliosis) follows a predictable monophasic self-limiting course. In contrast, we report the case of a patient with an untreated meningopolyradiculitis which evolved into acute schizophrenia-like psychosis due to persistent infection with Borrelia burgdorferi. The psychosis resolved within 1 week of treatment with ceftriaxone. This case shows that the usually benign monophasic meningopolyradiculitis may progress to severe CNS complications, which may have implications on current pathophysiological beliefs.

Distribution of vasoactive intestinal polypeptide (VIP) binding in circular muscle and characterization of VIP binding in canine small intestinal mucosa

The present study examined the localization and characterization of [125I]vasoactive intestinal polypeptide (VIP) binding to synaptosomes and enterocyte membranes using preparations made from homogenized canine intestinal mucosa and compared it to [3H]saxitoxin binding and VIP-immunoreactive content (markers for synaptosomes). The highest [125I]VIP binding was located in the P2 fraction and was correlated with the locations of maximal [3H]saxitoxin binding and VIP-immunoreactive content. This correlation indicates that VIP receptors are present on synaptosomes of canine small intestinal mucosa. A fraction enriched in synaptosomes contained a high density of saturable VIP receptors (352 +/- 26.40 fmol/mg) having high affinity (Kd, 0.23 nM) for [125I]VIP. Studies of association and dissociation of [125I]VIP to this site revealed that binding was fully reversible and yielded a Kd value similar to that from equilibrium binding. Competition binding experiments suggested the presence of two binding sites, a high and a low affinity binding site. The order of competition potency was VIP greater than peptide histidine isoleucine greater than secretin greater than peptide histidine methionine greater than or equal to [D-Ala4]VIP greater than or equal to [Phe1]VIP greater than VIP10-28 greater than [4-Cl-D-Phe6-Leu17]VIP. All these competitors displaced all specifically bound VIP. VIP, peptide histidine isoleucine and secretin interacted differentially with each of the two binding sites. Peptide histidine methionine, [D-Ala4]VIP, [Phe1]VIP, VIP10-28 and [4-Cl-D-Phe6-Leu17]VIP interacted with a single low affinity at all binding sites. Other VIP binding sites were sought in circular muscle and submucosa.(ABSTRACT TRUNCATED AT 250 WORDS)

[Endogenous paranoid-hallucinatory syndrome caused by Borrelia encephalitis]

We describe a case with no neurological signs but marked psychiatric symptoms induced by borrelia burgdorferi, whose clinical picture was indistinguishable from an endogenous schizophrenia. The symptoms within one week under antibiotic treatment with ceftriaxon, but afterwards the patient showed a mild organic brain syndrome. The case demonstrated the aetiologic nonspecificity of paranoid symptoms and hallucinations and emphasizes that in psychotic patients without psychiatric history additional diagnostic measures should be performed.

Further notes on Munchausen's syndrome: a case report of a change from acute abdominal to neurological type

A rare case of Munchausen's syndrome beginning in early childhood is described. The diagnosis of Munchausen's syndrome was made at the age of 29 years, after the symptoms had changed from acute abdominal to neurological complaints, with feigned loss of consciousness, first ascribed to an encephalitis. Insight into the psychopathology of this patient is given by his biography, by assessment of a psychotherapist, who had treated him some years before, and by his observed profile in some psychological tests.

Canine myenteric, deep muscular, and submucosal plexus preparations of purified nerve varicosities: content and chromatographic forms of certain neuropeptides

Partially purified nerve varicosities prepared from canine small intestinal myenteric, deep muscular and submucosal plexuses were found to contain, by radioimmunoassay, gastrin-releasing polypeptide (GRP), substance P, Leu-enkephalin, Met-enkephalin, vasoactive intestinal polypeptide (VIP) and neurokinin A, but did not contain detectable amounts of neurokinin B. In all three plexus preparations, VIP was present in the highest concentration. In contrast to other species, GRP and the enkephalins were found to be present in relatively high concentrations in the submucosal plexus and GRP was present in low concentrations in the deep muscular plexus. Equal concentrations of substance P and neurokinin A were found in the myenteric and deep muscular plexus preparations but greater concentrations of substance P relative to neurokinin A were found in the submucosal plexus preparations. On reverse phase HPLC, a major peak of immunoreactivity occurred at the retention times of standard preparations for all six neuropeptides measured. Significant heterogeneity was found for GRP- and VIP-like immunoreactivity, especially in the submucosal plexus preparations. These partially purified canine small intestine nerve varicosity preparations may prove of value in studying release mechanisms for, and the posttranslational processing of, neuropeptides.

[Relationships following legal abortion--a longitudinal comparative study]

Although existence and functioning of a sexual relationship is of outstanding importance for the abortion decision as well as for the postabortive emotional adjustment, until now there are only some case studies focussing on the postabortive reaction of the sexual relationship. Results of a representative and controlled follow-up-study investigating the effects of legal abortion on the relationship with a partner are reported here. 117 women, a representative sample of all 263 women having a socially indicated legal abortion during the first 3 months of 1982 in Kiel, were interviewed some days before and 1 year after the abortion. The effects of abortion on the sexual relationship are described in comparison with a control group with similar preabortive characteristics of partnership using hormonal or intrauterine contraceptive devices. Rate and circumstances of separation, especially the role of abortion for the separation, as well as the quality of the remaining relationships have been analysed. We could find preabortive variables easily accessible for the counselor, predicting the development of the sexual relationship regarding quality and stability in the year after abortion.

Actions of galanin fragments on rat, guinea-pig, and canine intestinal motility

The 1-20 fragment of synthetic porcine galanin, prepared by tryptic digestion of the intact molecule, was equipotent to synthetic porcine galanin 1-29 in the smooth muscle actions of exciting the rat jejunal longitudinal muscle in vitro and inhibiting circular muscle contractions of the canine small intestine in vitro and in vivo, but was less potent in inhibiting nerve-stimulated contractions of the guinea-pig taenia coli. Fragment 21-29 was effective at high doses only in the canine ileum. Activity of galanin 1-11 was greatly reduced in the dog in vivo. These results may reflect species or cell type differences.

Characterization of content and chromatographic forms of neuropeptides in purified nerve varicosities prepared from guinea pig myenteric plexus

Partially purified nerve varicosities (PV) prepared from guinea pig ileal myenteric plexus were found to contain, by radioimmunoassay, gastrin-releasing polypeptide (GRP), substance P (SP), galanin, Leu-enkephalin (LE), Met-enkephalin (ME), and vasoactive intestinal polypeptide (VIP). SP was present in the highest concentration followed by, in descending order, ME, LE, VIP, GRP and galanin. On reverse-phase HPLC, SP-, LE- and ME-like immunoreactivity in the PV preparation eluted at retention times similar to their synthetic analogues, galanin-like immunoreactivity eluted at a retention time different from that of synthetic porcine galanin and VIP-like immunoreactivity eluted at the retention time of synthetic guinea pig VIP. GRP-like immunoreactivity, on reverse-phase HPLC, eluted at retention times close to that of synthetic porcine GRP-(1-27) and its major oxidized form. Evidence was obtained for the presence of an alpha-neurokinin-like immunoreactive entity and an unidentified SP-like immunoreactive entity in guinea pig myenteric plexus.

[Regional prospective study of psychiatric sequelae of legal abortion]

117 (45%) of the 263 women of German nationality who underwent socially indicated abortions in the postal-code area 2300 (Kiel) in the first quarter of 1982 were investigated before the abortion as well as one year later. As far as age, marital status and number of children were concerned, these women did not differ significantly from the other 55%. One year later information was collected on the women's emotional adjustment by means of a questionnaire concerning feelings of guilt and loss, personal reports of adjustment process and the investigator's judgement. According to the findings, 79% of the women had adjusted without any problems, 14% were still in a state of emotional imbalance, 7% were clearly impaired emotionally and in their everydays functioning. 21% of the women, who had adjustment problems, had already been more depressive before the abortion. One year later, they were also more depressive than the other women, more dissatisfied with their lives in general and with their sex lives. They were in greater doubt as to whether they had made the right decision, showed less inclination to consider a further abortion and reported stronger post-abortive feelings of guilt. Significantly connected with later emotional difficulties were low social class, a difficult financial situation, lack of intrapsychic differentiation between sex and reproduction, no partner or negative relation with partner and partner disagreements, particularly in the case where the male partner was more in favour of abortion than the woman. Statistically insignificant, although tendencially noticeable were social isolation, non-employment and pre-pregnancy psychical problems. Age, marital status, number of children, simultaneous abortion/sterilisation, previous abortions, a broken home in the patient's youth had no effect on the emotional adjustment after the abortion. The common factor of all variables predicting post-abortive emotional problems seems to be an external motivation for abortion together with a greater ambivalence towards the pregnancy.