bluuebunny/crossref_metadata_2025 huggingface dataset:
Behaviour of macroglial cells, as identified by their intermediate filament complement, during optic nerve regeneration of Xenopus tadpole
Authors: Rungger‐Brändle Elisabeth , Alliod Chantal , Fouquet Bernadette , Messerli Marius M.
Published: December 2004

Assessment of glial cell behaviour during optic nerve (ON) regeneration in Xenopus tadpoles is hampered by the lack of classical cellular markers that distinguish different glial cells in mammals. We thus have characterized the intermediate filament (IF) complement of tadpole glial cells and used it to follow the fate of glial cell subsets during the first 10 days after ON crush. Glial cells synthesize a restricted number of cytokeratin (CK) species and vimentin. This pattern remains essentially unchanged during metamorphosis and regeneration. However, vimentin turnover is specifically enhanced after injury. The expression of CKs and vimentin has been followed immunocytochemically in situ and in isolated cells recovered from dissociated ON segments. In the normal nerve, 79% of ramified glial cells express both CK and vimentin, 1% CK and 4% vimentin only, whereas 16% express neither IF protein. We tentatively classified CK expressing cells as mature astrocytes and those without IF proteins as oligodendrocytes. In the regenerating ON, the relative number of oligodendrocytes is decreased, while the astrocytic subset becomes accordingly larger but is decreased by day 10 already in favour of cells expressing vimentin only. Astrocytes invade the lesion site soon after crush, arrange into a central core within the distal nerve segment and establish a peripheral scaffold that is readily crossed by axons. Unlike mammalian astrocytes that remain absent from the lesion site but form a scar at some distance to it, amphibian astrocytes appear to provide active guidance to axons growing through the lesion site. © 1995 Wiley‐Liss, Inc.
Regulation of GFAP expression in glial‐like cells of the rat pituitary intermediate lobe by lactation, salt‐loading, and adrenalectomy
Authors: Gary Keith A. , Chronwall Bibie M.
Published: December 2004

Glial‐like cells in rat pituitary intermediate lobe were localized and characterized by immunohistochemistry with antisera against glial fibrillary acidic protein (GFAP) and S‐100. Individual GFAP immunoreactive (IR) cells possessed several processes that often branched into secondary and tertiary processes, terminating with end‐feet. The GFAP‐immunopositive cell population was distributed in specific rostrocaudal and dorsoventral patterns. The distribution and numbers of cells differed between male and female rats. Examination of altered physiological states, e.g., adrenalectomy, lactation, and salt‐loading, revealed state‐specific changes in the appearance and distribution of GFAP‐IR cells. Adrenalectomy and lactation increased GFAP‐IR glial‐like cell numbers, whereas salt‐loading decreased their numbers and the typical pattern of distribution. By contrast, S‐100–expressing cells were evenly distributed in male and female rats, and its expression was not affected by the experimental conditions. Double‐label immunocytochemistry indicated that GFAP‐IR cells are a subpopulation of S‐100‐IR cells. These results suggest that cells normally expressing only S‐100 may be induced to express GFAP under altered physiologic conditions. Copy 1995 Wiley‐Liss, Inc.
Effect of transforming growth factor‐β1 and ‐β2 on Schwann cell proliferation on neurites
Authors: Guénard Véronique , Rosenbaum Thorsten , Gwynn Lisa A. , Doetschman Thomas , Ratner Nancy , Wood Patrick M.
Published: December 2004

Mechanisms regulating Schwann cell proliferation during development are unclear. Schwann cell division is known to be driven by an unidentified mitogen present on the surface of axons, but it is not known whether other molecules play a role in regulating this proliferation. Transforming growth factor‐beta (TGF‐β) which is found in the developing peripheral nervous system (PNS) and is mitogenic for neuron‐free Schwann cells in vitro could be involved. We have investigated the effects of TGF‐β 1, TGF‐β 2 and antibodies to TGF‐β and TGF‐β 2 on axon driven Schwann cell proliferation. Rat embryonic dorsal root ganglion neurons (DRG) neurons and Schwann cells from the sciatic nerve were isolated, purified and recombined in vitro. Confirming earlier reports by others, we observed that TGF‐β 1 and TGF‐β 2 added to the culture medium stimulated the proliferation of Schwann cells in the absence of neurons. However, when added to neuron‐Schwann cell co‐cultures, TGFβ caused a variable response ranging from no effect to moderate inhibition of Schwann cell proliferation in different experiments. A stimulation of Schwann cell proliferation by TGFβ was never observed in neuron‐Schwann cell co‐cultures. Antibodies to TGF‐β and TGF‐β 2 did not influence axon driven Schwann cell proliferation. To further determine the role of TGF‐β in Schwann cell proliferation and myelination, we studied Schwann cell proliferation in cultures from mice in which the TGF‐β 1 gene was delected by homologous recombination. Neuron‐Schwann cell cultures from wild‐type, heterozygous and homozygous mice were used. No differences were observed in either Schwann cell proliferation or myelination between cultures obtained from homozygous mutants and their heterozygous and wild‐type controls. These findings suggest that TGF‐β does not function as a part of the mitogenic mechanism presented by neurons to Schwann cells, but that the presence of active TGFβ in the cellular environment might regulate the degree of proliferation induced by neuronal contact. Copy 1995 Wiley‐Liss, Inc.
Acidic pH rapidly increases immunoreactivity of glial fibrillary acidic protein in cultured astrocytes
Authors: Oh Tae H. , Markelonis George J. , Von Visger Jon R. , Baik Bonsook , Shipley Michael T.
Published: December 2004

Neuroepithelial progenitor cells from forebrains of newborn rat pups develop into “mature” astrocytes in an epidermal growth factor‐containing medium free of serum (Von Visger et al: Exp Neurol 128:34, 1994). Eight‐week‐old “mature” astrocyte cultures on poly‐L‐lysine‐coated dishes were exposed to an acidic medium (pH 5.8–6.0) for 2–6 h. Immunoreactivity for glial fibrillary acidic protein (GFAP) dramatically and rapidly increased; this immediate increase was not affected by pretreatment with cycloheximide. In further experiments we found that the increase in GFAP was undiminished for 24–48 h after the acid‐treated astrocytes were returned to normal growth medium. The Ca2+ channel antagonists nifedipine and diltiazem attenuated the increase in GFAP immunoreactivity. These results suggest that extracellular acidosis may produce a rapid increase in GFAP immunoreactivity in astrocytes independent of de novo protein synthesis, possibly by increasing intracellular levels of free Ca2+ ions. Copy 1995 Wiley‐Liss, Inc.
The ependyma: A protective barrier between brain and cerebrospinal fluid
Authors: Del Bigio Marc R.
Published: December 2004

This review summarizes the current scientific literature concerning the ependymal lining of the cerebral ventricles of the brain with an emphasis on selective barrier function and protective roles for the common ependymal cell. Topics covered include the development, morphology, protein and enzyme expression including reactive changes, and pathology. Some cells lining the neural tube are committed at an early stage to becoming ependymal cells. They serve a secretory function and perhaps act as a cellular/axonal guidance system, particularly during fetal development. In the mature mammalian brain ependymal cells possess the structural and enzymatic characteristics necessary for scavenging and detoxifying a wide variety of substances in the CSF, thus forming a metabolic barrier at the brain‐CSF interface. © 1995 Wiley‐Liss, Inc.
Calcium waves in dissociated retinal glial (Müller) cells are evoked by release of calcium from intracellular stores
Authors: Keirstead Susan A. , Miller Robert F.
Published: December 2004

Calcium imaging techniques were used to study intracellular free calcium ion regulation in isolated Müller cells in response to changes in extracellular potassium concentration and to caffeine and ryanodine. Müller cells were dissociated from the adult tiger salamander (Ambystoma tigrinum) retina and studied using the calcium indicator Fura‐2 and video imaging microscopy techniques. Our results demonstrate that elevation of extracellular potassium in the presence of extracellular calcium evokes an increase in intracellular calcium ([Ca2+]i) throughout the length of the Müller cell. In contrast, in the absence of extracellular calcium, elevation of extracellular potassium can trigger a long latency, wave‐like increase in [Ca2+]i that begins in the apical region of the Müller cell and moves toward the endfoot. A similar calcium wave can be evoked in Müller cells when they are exposed to caffeine or ryanodine, agents that cause release of calcium from intracellular stores in many cell types. These data suggest that [Ca2+]i may be altered in Müller cells through an extracellular pathway as well as through a ryanodine‐sensitive intracellular release mechanism. The functional consequences of these changes in [Ca2+]i remain to be elucidated. © 1995 Wiley‐Liss, Inc.
Canine oligodendrocytes undergo morphological changes in response to basic fibroblast growth factor (bFGF) in vitro
Authors: Hoffman Kurt L. , Duncan Ian D.
Published: December 2004

The mature oligodendrocyte, though able to divide under certain circumstances, has been regarded as incapable of changing into a phenotypically plastic cell type. To further explore this question, we developed an in vitro system in which a virtually pure population of early postnatal canine oligodendrocytes were cultured in a serum free, defined medium. We tested the oligodendrocytes' morphological and mitotic responses to concentration of basic Fibroblast Growth Factor (bFGF) ranging from 5 ng to 100 ng/ml. We found that bFGF effected both the morphology and mitotic potential of these cells. In addition, oligodendrocytes exposed to bFGF respond to 10% fetal bovine serum (FBS) by undergoing morphological changes that are quite different than naive oligodendrocytes exposed to 10% FBS, suggesting that bFGF causes some fundamental change in plasticity. © 1995 Wiley‐Liss, Inc.
AMPA‐type glutamate receptors in glial precursor cells of the rat corpus callosum: Ionic and pharmacological properties
Authors: Berger Thomas
Published: December 2004

Glial cells in fiber tracts express various functional transmitter receptors, e.g., for glutamate. However, little is known about their biophysical and pharmacological profile. Using the in situ patch‐clamp technique, kainate‐ and AMPA‐induced conductance changes of glial precursor cells in the rat corpus callosum were investigated to study these aspects. Precursor cells were identified by their voltage‐gated currents and were easily discernable from astrocytes and oligodendrocytes. Kainate induced two overlying effects in these cells: the activation of a cationic current and the block of potassium conductances. Cesium in the pipette solution blocked potassium conductances nearly completely and the ionic profile of the kainate‐induced cationic current could be studied in detail. Full replacement of the sodium in the bath by calcium resulted only in a small kainate‐induced (calcium) inward current flow, but the kainate‐induced outward current carried by Cs+ was less affected reflecting a weak calcium permeability. The kainate response could be blocked by 6,7‐dinitroquinoxaline‐2,3‐dione (DNQX) and millimolar zinc concentrations. Co‐application of microinolar concentrations of zinc slightly enhanced the kainate‐induced current, while Evans Blue was without any significant effect. Cyclothiazide increased the kainate response by a factor of x6 while concanavalin A did not enlarge it. The AMPA‐induced current was amplified by a factor of X39 by cyclothiazide.

The present data suggested the expression of weakly calcium‐permeable AMPA receptors on glial precursor cells in the rat corpus callosum. Only a small fraction of the agonist‐induced current could be seen without the appropriate blockers of receptor desensitization. An additional expression of kainate‐preferring glutamate receptors could not be shown. © 1995 Wiley‐Liss, Inc.
Amoeboid microglia expressing GD3 ganglioside are concentrated in regions of oligodendrogenesis during development of the rat corpus callosum
Authors: Ellison J. A. , de Vellis J.
Published: December 2004

In a recent study we demonstrated expression of the platelet‐derived growth factor α receptor (PDGFRα) in cells of the early oligodendrocyte lineage that were identified as either GD3 ganglioside + oligodendrocyte progenitors or O4 sulfatide + preoligodendrocytes. We also identified a subpopulation of GD3 immunoreactive cells that did not express mRNA for the PDGF receptor. The distinct large amoeboid morphology of these cells was characteristic of cells in the macrophage lineage rather than in the oligodendrocyte lineage. To determine if the GD3‐positive but PDGFRα mRNA‐negative cells were in the macrophage lineage, we compared the spatial and temporal expression patterns of GD3 ganglioside and ED1, a macrophage‐specific antigen. Analysis prenatally indicated that at embryonic day 15, ED1+ and GD3 + cell populations resided in the subpial connective tissue. At embryonic day 21, these two populations were seen in a region extending from the lateral ventricle through the subventricular and intermediate zones. In this study we report that these large, round, GD3 immunoreactive cells have the same cell morphology and anatomical distribution as the ED1 immunoreactive cells. Both cell populations contained pyknotic nuclei within their cytoplasm. Furthermore, the GD3+/PDGFRα‐ cells appear to be involved in clearing cellular debris in regions of gliogenesis. These data suggest that this subpopulation of GD3 immunoreactive cells belongs to the microglia/macrophage lineage. © 1995 Wiley‐Liss, Inc.
Long‐term production of neurotrophic factors by astrocyte cultures from hemiparkinsonian rat brain
Authors: Langan Thomas J. , Plunkett Robert J. , Asada Hideo , Kelly Kindra , Kaseloo Paul
Published: December 2004

Transplantation of dopaminergic or neurotrophic tissues is an experimental treatment of Parkinson's Disease. However, in animal models sustained recovery may occur after surgical trauma to affected brain areas even in the absence of grafted tissue. Consequently, brain tissue reacting to local trauma in these experiments must be capable of substantial neurotrophic responses. To evaluate the potential of astrocytes in these neurotrophic responses, cultures were obtained from gelatin implants into striatal cavities that were created in hemiparkinsonian rats. The type 1 astrocyte phenotype as determined immunocytochemically was maximal at day 7 in vitro and paralleled the glial reaction in the adjacent brain parenchyma. Neurite‐promoting activity of the culture medium was determined in a chick dorsal root ganglion bioassay and also was established by 7 days. Nerve growth factor antibodies neutralized only around 40% of this activity. Neurotrophic activity was absent with assay of media from early or long‐term newborn rat astrocytes, and of medium conditioned by a monoyte/macrophage cell line. Passage after several months yielded astrocyte cultures that repeated a surge of neurite‐promoting activity. This long‐term potential to produce multiple neurotrophic factors indicates that autologous astrocytes in affected brain regions may serve either as targets for or agents of therapy of Parkinsonism. © 1995 Wiley‐Liss, Inc.
Biochemical subtypes of oligodendrocyte in the anterior medullary velum of the rat as revealed by the monoclonal antibody rip
Authors: Butt A. M. , Ibrahim M. , Ruge F. M. , Berry M.
Published: December 2004

Oligodendrocytes were studied in the anterior medullary velum (AMV) of the rat using the monoclonal antibody Rip, an oligodendrocyte marker of unknown function. Confocal microscopic imaging of double immunofluorescent labelling with antibodies to Rip and carbonic anhydrase II (CAII) revealed two biochemically and morphologically distinct populations of oligodendrocyte which were either Rip + CAII + or Rip + CAII−. Double immunofluorescent labelling with Rip and myelin basic protein (MBP) or glial fibrillary acidic protein (GFAP) provided direct evidence that Rip‐labelled cells were phenotypically oligodendrocytes and confirmed that Rip did not recognise astrocytes. Oligodendrocytes which were Rip+CAII+ supported numerous myelin sheaths for small diameter axons, whilst Rip+CAII− oligodendrocytes supported fewer myelin sheaths for large diameter axons. Morphologically, Rip+CAII+ oligodendrocytes corresponded to types I or II of classical nomenclature, whilst Rip+CAII− oligodendrocytes corresponded to types III and IV. The results demonstrated a biochemical difference between oligodendrocytes which myelinated small and large diameter fibres. © 1995 Wiley‐Liss, Inc.
GFAP mRNA fluctuates in synchrony with chronic relapsing EAE symptoms in SJL/J mice
Authors: Kothavale Avinash , Di Gregorio David , Paul Somera F. , Smith Marion E.
Published: December 2004

Activation of astrocytes and hypertrophy of their processes is a result of a number of pathological conditions in the central nervous system. Astrocytic gliosis is especially prominent in multiple sclerosis (MS), where astrocytic fibers form a dense matrix around demyelinated axons. Experimental allergic encephalomyelitis (EAE), a laboratory model for MS, is also accompanied by astrocytic hyperactivity. We have previously shown the formation of plaque‐like structures which stain heavily for glial fibrillary acidic protein (GFAP) in the brains and spinal cords of SJL/J mice after several episodes of chronic relapsing EAE (Smith and Eng: J Neurosci Res 18:203, 1987). To further investigate the mechanisms of this phenomenon, we have measured the levels of mRNA for GFAP throughout the course of three episodes and recoveries of EAE in the SJL/J mouse. Mice were immunized with spinal cord homogenate and subsequently developed EAE. After recovery they were again immunized at appropriate intervals, resulting in successive episodes of EAE, with partial or complete recovery between the paralytic stages. At appropriate times in the course of the different stages of EAE, spinal cords were dissected and RNA was prepared from each spinal cord. RNA Was analyzed by Northern blots to determine the levels of mRNA for GFAP and, as a control, for the 70 kDa neurofilament (NF‐L). With the onset of the first EAE episode GFAP mRNA in spinal cords from animals with mild symptoms increased to sixfold the control level (P < 0.02) and to 20‐fold in those with paralysis (P < 0.01). With recovery, the GFAP mRNA level decreased to twice the control. With each subsequent episodes, a chronic but stable neurological deficit was established, with GFAP mRNA at about eightfold the control levels (P < 0.01). Over the course of several episodes, the GFAP rose to about 2.8 times the control, while vimentin increased by a factor of 3.6. Thus multiple episodes of EAE resulted in upregulation of GFAP mRNA and accumulation of GFAP, which are associated with astrocyte activation and hypertrophy. Similar events may occur in the human demyelinative disease MS, where multiple episodes of inflammatory cell invasion occur, resulting in a neurological deficit. © 1995 Wiley‐Liss, Inc.
Differences in olfactory test performance between normal aged, Alzheimer and vascular type dementia individuals
Authors: Knupfer Lutz , Spiegel René
Published: December 2004

A comparison was made between 3 groups of elderly subjects — normal controls aged 69–79 years, patients with vascular dementia aged 64–84 years and patients with probable senile dementia of Alzheimer type (SDAT) aged 70–90 years — by means of several tests of olfactory functions. Significant group differences were found at all levels assessed — olfactory thresholds, smell recognition, smell identification, naming of smells — with the normal aged performing best and the SDAT group scoring lowest throughout. The differences were most pronounced with regard to smell recognition and smell identification where minimal or no overlap at all between controls and SDAT patients was found. Differences in age and severity of dementia did not fully account for the findings, suggesting that differential diagnosis of Alzheimer ‐ type dementia could be facilitated and improved by the use of olfactory tasks. Neurophysiological and ‐ pathological findings support a close association or even identity of brain structures involved in olfaction and affected in Alzheimer's disease.
Vitamin B12 absorption in psychogeriatric patients
Authors: Burns Alistair , Gillett Don S. , Jacoby Robin , Mibashan Reuben S.
Published: December 2004

The ability to absorb protein‐bound vitamin B12 was assessed in six elderly psychiatric patients who had low serum levels of the vitamin but normal Schilling tests. Three of the six had abnormal protein‐bound vitamin B12 absorption, suggesting that malabsorption may play a part in the genesis of subnormal serum levels although conventional testing may not show it. The therapeutic implications are discussed.
Dexamethasone suppression test in dementia
Authors: Abou‐Saleh M. T. , Spalding E. M. , Kellett J. M. , Coppen A.
Published: December 2004

The performance of the Dexamethasone Suppression Test (DST) was investigated in 60 demented patients including 14 patients admitted to a psychogeriatric assessment ward, 29 electively admitted patients and 17 long‐stay patients in comparison with 37 normal control subjects. It was shown that acutely admitted patients had the highest rate of DST non‐suppression (86%), whilst electively admitted patients had the lowest rate (55%) in comparison with normal controls (11%). In the electively admitted group abnormal DST results and Cortisol Suppression Index and DST non‐suppressors showed depressive signs more frequently than suppressors. There was no association between DST results and age, weight, cognitive, behavioural, cortical dysfunction and degree of cerebral atrophy as determined by CT scan results.
Haloperidol‐induced hypoglycaemia in diabetic patients with organic brain disease: Normalization by bromocriptine
Authors: Fäldt R. , Minthon L. , Dalfelt G.
Published: December 2004

Spontaneous hypoglycaemia was related to treatment with a commonly used neuroleptic drug (haloperidol) in two diabetic patients with organic brain disease. Hypoglycaemia disappeared when the drug was replaced by a dopamine agonist (bromocriptine). Impaired secretion of growth hormone (GH) was demonstrated in both of the patients during haloperidol medication, or a short time thereafter, and a normalized GH response was found when the patients were treated with bromocriptine. Cerebral ventricular dilatation and subnormal cerebral perfusion were demonstrated in both and a partially empty sella in one of the patients. Organic brain disease and possibly additional endocrine abnormalities might have contributed to hypoglycaemia in our patients. The significance of dopamine‐related neuroendocrine reactions and of GH in counteracting hypoglycaemic stimuli is discussed.
Tourettism as a presentation of dementia
Authors: Starling Andrew
Published: December 2004

An unusual case of tourettism starting in late life with no obvious organic cause is described. The patient later developed dementia.
Assessing social support and satisfaction in the elderly: Development of a brief assessment instrument, the index of social support
Authors: James Owen , Davies Ann D. M.
Published: December 2004

The construction and validation of a brief instrument for assessing social support in the elderly is described. The Index of Social Support (ISS) has nine items and provides separate measures of a person's perceived availability of support and his or her satisfaction with it. The two scales are shown to have high internal consistencies (coefficient alphas of 0.84 and 0.81) and the score totals discriminated significantly between non‐depressed elderly people and elderly people who had suffered a recent onset of depression. Principal components analysis showed that the perceived availability of support subscale provides a single factor accounting for 41% of the variance. Item analysis suggested that perceived availability of friends and good neighbours discriminated better between non‐depressed and depressed subjects than items based on feelings of family belongingness or having available someone with whom one could talk frankly.
Progressive supranuclear palsy: A cause of subcortical dementia
Authors: Rea Shelagh Mary , Patterson Diana G.
Published: December 2004

A case of progressive supranuclear palsy in a 69‐year‐old female is reported. Initially the patient presented to the pscyhiatric services with prominent paranoid delusions. Later, when dementia became more evident, neurological examination revealed typical features of progressive supranuclear palsy, including complete failure of upward gaze, facial bradykinesia, slow gait and bilateral cogwheel rigidity. During hospitalization, the patient's condition improved and she was discharged to an ordinary residential home for the elderly.

This unusual presentation of dementia demonstrates, once again, the importance of a full neurological examination in all cases of dementia.
Age, clinical features and prognosis in S.D.A.T.
Authors: Christie Alex. B. , Wood Eric R. M.
Published: December 2004

Two groups of patients suffering from Senile Dementia of the Alzheimer Type (S.D.A.T.) have been studied from first referral till death in hospital. The point of separation between the two groups was age — the younger group were aged 65–74 at the time of terminal admission and the older over 85.

The variables studied were history of illness prior to referral, assessment on the Crichton Royal Behavioural Rating Scale at the time of terminal admission, duration of illness and duration of hospital stay. The last two factors were measured both in absolute terms and as features relative to life expectancy.

The history proved unhelpful in identifying features capable of separating the two groups. Although in absolute terms the younger group survived longer, both from onset of illness and admission, in relative terms these patients fared considerably worse.

The possibility that S.D.A.T. in the very elderly runs a more benign course is discussed.
Benzodiazepine usage amongst the elderly: Findings of the liverpool community survey
Authors: Sullivan C. F. , Copeland J. R. M. , Dewey M. E. , Davidson I. A. , McWilliam C. , Saunders P. , Sharma V. K. , Voruganti L. N. P.
Published: December 2004

The use of benzodiazepines by a randomly selected community‐based sample of Liverpudlians aged 65 and over is reported. No significant change in usage between the two study periods 1982–83 and 1985–86 was found, in contrast to nationwide trends indicated by prescription audits. There was an excess of consumption by women, a high proportion of users who could be classified as long‐term users and an enduring popularity of long‐acting drugs.
Coprolalia vocal tics and depressive illness: A case report
Authors: Byrne E. Jane
Published: December 2004

Coprolalia arising for the first time in late life is an uncommon condition. This case report describes coprolalia in association with major depression in an elderly woman, whose symptoms were improved by a combination of tricyclic antidepressant and lithium.
Depressive symptoms and signs that differentiate major and atypical depression from dysthymic disorder in elderly finns
Authors: Kivelä Sirkka‐Liisa , Pahkala Kimmo , Eronen Ari
Published: December 2004

Symptoms and signs that in terms of severity differentiate major and atypical depression from dysthymic disorder were investigated in depressed Finns aged 60 years or over. The overall symptomatology of major depression was not significantly more severe than that of dysthymic disorder, although some symptoms, viz. sadness, paranoid symptoms, loss of interest in work and activities, loss of weight and depersonalization, were more severe in major depressive patients than in dysthymic patients. The overall symptomatology of atypical depression was less severe than that of dysthymic disorder. Sadness, psychic anxiety, loss of interest in work and activities, somatic anxiety, general somatic symptoms, strength of diurnal variation of symptoms, gastrointestinal symptoms and suicidal ideas were less severe in atypical depressive patients than in dysthymic patients but loss of insight was more severe in atypical depressive patients. Of objective signs, loss of weight was more common in major depressive patients than in dysthymic patients. Sad expression and crying were less common in atypical depressive patients than in dysthymic patients.
Who needs psychogeriatric continuing care?
Authors: Lam Dominic , Sewell Matthew , Bell Gary , Katona Cornelius
Published: December 2004

A survey of the degree of mental impairment, physical disability and behavioural problems was undertaken in residents in psychogeriatric continuing care beds at Friern Hospital (n=96) and Islington Local Authority old people's homes (OPHs) (n = 104). High levels of dependency were identified, particularly in those subjects with a clinical diagnosis of dementia, who constituted 80% of the hospital sample and 43% in OPHs. Precipitants of admission differed between the hospital and OPH groups (incontinence, aggression and wandering vs poor self‐care and living alone), both for the total sample and for those subjects with a clinical diagnosis of dementia. Subjects with dementia in the two settings, however, showed similarly high levels of dependency and behavioural problems. The implications of these findings for planned local reprovision of continuing psychogeriatric care and for the future development of local authority residential care are discussed.
Clinical assessment of psychiatric consultations in a medical long‐term care facility: Interrater reliability for DSM‐III diagnostic groups
Authors: Foster Jeffrey R. , Rubenstein Karen S. , Welkowitz Joan , Boksay Istvan , Seeland Irene
Published: December 2004

The reliability of the DSM‐III diagnostic system was assessed in a medical long‐term care facility population that was recently seen in psychiatric consultation. Six standard rating scales were used to determine interrater agreement for perceiving psychopathology prior to selecting diagnoses. The findings were that six major diagnostic groups could be accurately distinguished from one another: no disorder; organic mental disorders; affective disorders; paranoid disorders; schizophrenia and psychotic disorders not elsewhere classified; and a mixed group of other diagnoses that occurred in low frequency in this study population. The interrater reliability (kappa = 0.64–0.70) was comparable to that found in the general psychiatric population.
The elderly in long‐term care: 1 — prevalence of dementia and levels of dependency
Authors: Donnelly C. M. , Compton S. A. , Devaney N. , Kirk S. , McGuigan M.
Published: December 2004

One thousand and twenty‐three subjects in four different types of statutory accommodation were surveyed during a two‐week period using the Survey version of the Clifton Assessment Procedure for the Elderly. The types of accommodation were conventional residential accommodation (CRA), elderly mentally infirm homes (EMI), geriatric wards (GER), and psychogeriatric wards (PG), all within a specific geographic area. The survey was undertaken to determine prevaalence of dementia and levels of dependency in different types of unit and to ascertain if there were significant differences between them. There was a high level of both dementia and dependency in all four types of unit, but significant differences were demonstrated between different types of unit.
Delirium in the elderly: A review and a suggestion for a research programme
Authors: Macdonald Alastair J. D. , Simpson Avice , Jenkins Deborah
Published: December 2004

Delirium in the elderly attracts sporadic attention in the literature yet constitutes a major challenge to health services, complicating many illnesses and procedures in elderly patients, associated with high rates of mortality, cutting across disciplinary boundaries and posing theoretical difficulties for the organic/functional distinction that pervades medicine. In this review the importance of delirium in the elderly is emphasized, drawing attention to the suffering caused to the patient and the excess mortality. Problems of nomenclature (why use one word when three will do?) are discussed, the conclusion being that the oldest term is probably the best, provided that the concept of a ‘syndrome’ is preserved. Difficulties in research assessment are identified, and aetiology and the relationship of the delirium syndrome to dementia syndromes are discussed. Deficiencies in past approaches to management are identified and a definition of delirium is suggested. Finally, a proposal for a research programme is outlined.
Postoperative confusion in the elderly
Authors: Whitaker J. J.
Published: December 2004

With advancing age, postoperative confusion is an increasingly important problem. Its aetiology is complex and multifactorial and includes surgical factors, anaesthetic factors, preexisting medical, psychiatric or psychological problems and postoperative complications. It often prolongs hospital stay and although mental function recovers in the majority of cases, it may be followed by permanent mental impairment. Postoperative confusion may interfere with the management of the original surgical problem and it occurs in a setting where interest and expertise in its management are low. There is scope for improved recognition, treatment and prevention of postoperative confusion. More work needs to be done to evaluate the effect of surgery and anaesthesia on mental function, especially in the very elderly.
A trial of vitamin supplementation in senile dementia
Authors: Burns Alistair , Marsh Andrew , Bender David A.
Published: December 2004

The effect of supplements of vitamins B‐1, B‐2, niacin, B‐6 and C has been assessed in a randomized double‐blind trial in 15 hospitalized elderly patients suffering from senile dementia. Supplementation did not prevent an increase in either cognitive impairment or behavioural disturbance. However, it did result in weight gain over a six‐week period. Hospitalized demented patients generally suffer significant weight loss, which increases with the duration of hospitalization. Vitamin supplementation may therefore protect against physical deterioration and the development of cachexia.
Drug treatments for cognitive impairment due to ageing and disease: Current and future strategies
Authors: Dowson Jonathan H.
Published: December 2004

As the pathological changes in Alzheimer dementia include degeneration of cholinergic neurones, several strategies have been used to enhance the activity of remaining cholinergic neurones, including the administration of anticholinesterases. Other drugs which have been claimed to have a beneficial effect on cognitive impairment in the aged and in various diseases include dihydroergotoxine (the most widely used in clinical practice), bufluomedil, piracetam and centrophenoxine. These drugs, and the many other compounds which have been investigated, have a wide variety of actions. However, drugs which improve the function of neuronal populations affected by pathogenic mechanisms can only be palliative. Future strategies for drug treatments will be directed towards reducing the adverse effects of the ageing process (which may include an increased susceptibility to a range of diseases) and neutralizing the pathogenic mechanisms related to genetic factors, infections, toxins, trauma, anoxia and diet. One mechanism which may operate in ageing and in some pathological changes is the production of ‘free radicals’, which can cause cellular damage. Prophylactic administration of drugs with antioxidant activity can reduce adverse effects of this process in animal models, and such treatments may also protect the brain from the effects of anoxia and other pathogenic mechanisms. Other drugs with therapeutic potential include antagonists of the excitatory effects of glutamate and aspartate.
The prevalence of dementia in a general practice sample: Upward revision of reported rate after follow‐up and reassessment
Authors: Kay D. W. K. , Black S. E. , Blessed G. , Jachuck S. J. , Sahgal A.
Published: December 2004

A subsample (N=204) of a consecutive series of 378 general practice patients aged 70+, previously given the Mental Function Test (MFT) and reported to show a prevalence of dementia of 0.8% (Jachuck et al., 1986), was followed and survivors retested three years later. Dementia was categorized as definite, probable, possible or absent, based on AGECAT and on clinical diagnoses using ICD ‐10 criteria. The diagnoses were checked against patients' scores on the CAMCOG, MMSE, AMT, CAPE and Blessed Dementia Scale, and test‐retest differences on the MFT were noted. Patients who could not be interviewed were reassessed from their first MFT scores and the practice's research records. The MFT's performance and ability to predict death or dementia were examined. The prevalence of definite/probable dementia in the original sample is retrospectively reevaluated as about 11%. The rate in the general population aged 70+ is tentatively estimated after age adjustment to be approximately 9%, similar to that reported earlier (Kay et al., 1970). The age‐specific rates approximate to those derived from analysis of published data (Jorm et al., 1987). It is concluded that the original estimate was too low. The prevalence of dementia among the Newcastle elderly does not appear to have fallen.
Depression in geriatric patients with chronic medical illness
Authors: Sadavoy J. , Smith Isaac , Conn David K. , Richards Brian
Published: December 2004

All patients (N = 123) on the medical services of a chronic care hospital were approached to complete the Folstein Mini‐Mental State Exam and the Montogomery‐Asberg Depression Rating Scale. Of 63 patients completing the MADRS, 35% had scores in the depressed range. A comparison of MADRS scores for a depressed population of geriatric patients admitted to the psychiatric inpatient unit of the same institution showed that both depressed medical and depressed psychiatric patients were significantly different from the non‐depressed medical patients on all subtests of the MADRS except in the frequency of endorsement of ‘reported sadness’. There was no significant difference between the depressed medical patients and psychiatric inpatients. Two‐thirds of the depressed medical patients had a previously unrecognized diagnosis of depression, highlighting the need for a greater awareness of the degree of depression in institutionalized geriatric patients with chronic medical illness.
Reminiscing in depressed, ageing patients: Effect of ECT and antidepressants
Authors: Bachar Eytan , Dasberg Haim , Shapira Baruch , Lerer Bernard
Published: December 2004

Reminiscing, the mental activity of dwelling on the past, was quantified during a semistructured interview known for its reliability. Eighteen depressed, hospitalized patients (mean age 62 years; DSM‐III major depressive disorder) were compared to 12 normals with equivalent demographic characteristics. The depressed patients prior to treatment had significantly lower reminiscing scores. When the interviews were repeated after 3–4 weeks, the 10 patients treated with ECT were significantly improved clinically and their reminiscing score had increased to normal levels. The eight patients who received antidepressant medication were non‐responsive to treatment and reminiscing was further reduced during their second interview. The role of reminiscing and its therapeutic potential in ageing are discussed.
The mental health of elderly women in the community
Authors: Walton Valerie A. , Romans‐Clarkson Sarah E. , Mullen Paul E. , Herbison G. Peter
Published: December 2004

This community study of the mental health of women demonstrates twice as much psychiatric ill‐health among those over the age of 65 compared to younger women. The findings are best explained in terms of the loss of the work role for the elderly women rather than the loss of the domestic role. An apparently high frequency of phobia in the urban women is seen as an understandable reaction to their increased vulnerability and decreased mobility consequent on their chronic physical ill‐health.
Rapid autopsy brains for biochemical research: Experiences in establishing a programme
Authors: Procter Andrew , Doshi Bala , Bowen David , Murphy Elaine
Published: December 2004

Conventional techniques for postmortem acquisition of brains have several shortcomings for biochemical research. The authors describe the development of a technique for acquisition of brains by rapid autopsy and the practical details and problems of setting up the research programme. The techniques were established for the investigation of excitatory amino acid neurotransmitters.
Arteriosclerotic brain atrophy
Authors: Alzheimer Alois
Published: December 2004

Although Alzheimer is best known for the disease which bears his name and which was given its eponymous title by Kraepelin (1910), he established his reputation on his work on arteriosclerotic dementia, about which he wrote very extensively (1895, 1897, 1898, 1902, 1913). This early paper on the topic is concise and lacks the extensive, repetitive and extremely detailed neuropathological descriptions which are features of many others. Both in this paper and elsewhere, Alzheimer shows striking originality which is usually associated with modesty and generous attributions of primacy to those who may have described what he is writing about before him. This paper is naturally marked by the preoccupation with the separation of arteriosclerotic dementia from general paralysis of the insane since he was writing at a time when syphilis was probably the commonest cause of dementia. He shared the concerns and aims of Binswanger (1894), whose name is now associated with subcortical vascular disease. Both here and in his later publications, Alzheimer gave clear clinical guidelines which might allow his contemporaries to distinguish vascular dementia from general paralysis and senile dementia. The paper was presented at the yearly congress of the Society of German Alienists in Dresden in 1894 and published in the Allgemeine Zeitschift für Psychiatrie (1895). Alzheimer's style of writing is at times ponderous, opaque and repetitive. We have attempted to preserve as much as possible of the text's flavour while trying to make it comprehensible. We hope that it will draw some attention to Alzheimer's importance in the evolution of the concept of vascular dementia.
A follow‐up study of psychogeriatric day hospital patients with dementia
Authors: Woods Jonathan P. , Phanjoo Andre L.
Published: December 2004

One hundred and fifty‐five patients suffering from dementia who attended a psychogeriatric day hospital in 1985 were reviewed three years later. This review was performed to determine what proportion of discharges from the unit were unplanned or unforeseen and to look for any patterns in the care experienced by different groups of patients. The discharges were classified as planned or unplanned and by the living circumstances to which discharged. The outcome of patients surviving at follow‐up was also classified by living circumstances. Forty‐five per cent of discharges were unplanned. Significant differences were noted when comparing patients who had been living alone and those living with their spouses. The former, if institutionalized, were more likely to be admitted to a residential or nursing home whereas the latter were more likely to have been admitted to hospital. More of those living alone were alive at follow‐up. The findings of this study support the view that day hospital provision has little effect on the eventual need for long‐term care and that this need is related to the attitude and stamina of careers.
Acute psychiatric hospitalization for patients with irreversible dementia
Authors: Rabins Peter V. , Nicholson Marie C.
Published: December 2004

The charts of 121 patients who suffered from an irreversible dementing illness and were admitted to an acute psychiatric unit were retrospectively reviewed. Agitated behavior was the most common reason for admission but a variety of other behavioral and mood symptoms were also cited as leading to admission. Nursing care needs were greater for patients who were agitated, delirious or suffered from Alzheimer'disease. Agitated patients were more likely to be discharged to a nursing home.
The rationale of patient allocation for psychogeriatric assessment
Authors: Handy S. , Chithiramohan R. N. , Ballard C. G. , Bannister C. , Rusca R.
Published: December 2004

Our review of 100 patients using the Camdex and Crichton assessment schedules shows that the severity of illness and degree of dependency are similar in day hospital and impatient assessment groups. The main predictors of allocation for inpatient assessment and eventual placement in long‐stay geriatric wards were restlessness, irritability, the need for assistance with self‐care and physical illness. More planning and resourcess need to be mobilized in the assessment of dementia patients and the treatment of problem behaviours.
The effectiveness of validation therapy in dementia—a pilot study
Authors: Morton Ian , Bleathman Christine
Published: December 2004

The results of a pilot study investigating the effects of a weekly validation therapy group in demented subjects are presented. Five patients were studied and the effects of the intervention on their mood, behaviour and sociability were quantified using standardized instruments. There was some increase in levels of interaction. These results are discussed and the need for further research into the benefits of this therapy is highlighted.
Deaths in psychiatric care
Authors: Black Dawn , Jolley David
Published: December 2004

The significance of deaths among psychiatric inpatients has been reviewed in brief and a glimpse of the future suggested by a study of the characteristics of 100 patients dying in a general hospital psychiatric unit. Though suicide was a common cause of death among the few young patients dying, it did not occur among the elderly, who usually died of natural causes. Dementia and depression were more frequent diagnoses than schizophrenia and “other diagnoses” which still dominate mental hospital deaths and very long terminal admissions were unusual. Most patients had been admitted on more than one occasion and had received a great deal of extramural care and treatment—they represent a very disabled group. Multiple physical pathology was identified in many at the time of admission and new pathology arose during admission. Almost half of male deaths were sudden, but women often endured prolonged and distressed deaths and these require enlightened management.
Neuroleptic side‐effects—the “rabbit syndrome”
Authors: Almeida Joyce H.
Published: December 2004

Development of the “rabbit syndrome” as a side‐effect of long‐term neuroleptic treatment is described in a 75‐year‐old man residing in hospital. Awareness of this orofacial movement disturbance is particularly important, as unlike tardive dyskinesia it responds favourably to anticholinergic agents.
Aggression in psychiatric hospitalized geriatric patients
Authors: Meyer J. , Schalock R. , Genaidy H.
Published: December 2004

Data are presented that summarize the antecedents and consequences of aggressive episodes among geriatric (60°+) patients. The most common antecedents included being asked to do something, with verbal intervention being the principal preceding intervention. The aggressive behaviors were directed at staff slightly more often than towards another patient, with seclusion being the primary intervention used. Among diagnostic groups, geriatric patients diagnosed as schizophrenic or organically mentally disordered exhibited more aggression than similarly diagnosed non‐geriatric patients. Aggressive episodes were more frequently exhibited during the day shift (7 am—3 pm) and during winter, with significantly fewer during the fall. Environmentally based, less restrictive intervention strategies are also discussed.