bluuebunny/crossref_metadata_2025 huggingface dataset:
Schizophrenia: A New Approach
Authors: Osmond Humphry , Smythies John
Published: August 2008

Mr. Gladstone, with that candour which a great Statesman can afford, once said, “Government is a rough business, and the results are most unsatisfactory.” Unfortunately no great psychiatrist has described the present state of our knowledge and treatment of schizophrenia in an equally robust phrase; but surely, “rough business and unsatisfactory results” would not be an unfair summing up ?

We have now known of this illness for nearly half a century, and yet our understanding of it is slight and our useful information scanty. This is not because we have been idle, but because our efforts have been poorly rewarded. Thousands of papers are written every decade; tens of thousands of observations are made; there is no lack of opportunity for studying patients when about one hospital bed in five in this country is occupied by a schizophrenic, yet we are still entirely ignorant of the cause of this disease. There are, it is true, numerous theories, but none is generally accepted. We have one form of treatment, deep insulin, which produces remission of symptoms in some cases and what seems to be a cure in others, but even the value of this treatment is hotly disputed. Because deep insulin is a purely empirical procedure the psychiatrist is always tempted to become preoccupied with details of technique so that he forgets, or at least becomes less aware of our fundamental ignorance.
A Comparative Study of the Causation of Mongolism, Peristatic Amentia, and Other Types of Mental Defect
Authors: Engler M.
Published: August 2008

Mental deficiency has been defined by Tredgold as a state of arrested or incomplete development of the mind. Numerous scientists have for long endeavoured to ascertain the cause or causes of this frequent abnormality. The protagonists of one school of thought made exaggerated claims that the great majority, if not all cases, were due to hereditary factors. Other investigators were able to demonstrate that certain special types of mental defectives owed their deficiency to agents acting after fertilization, and so came to the conclusion that genetic elements were only concomitant and not primary causative factors in many, if not in all types of defectives, and that research on these lines should eventually establish extrinsic causation in all these cases.

Thus one has gradually come to distinguish between two main groups of mentally abnormal individuals; those in whom endogenous or hereditary factors could be proved or at least suspected. (Tredgold speaks of primary aments, Strauss of endogenous types, and those in whom exogenous noxious influences could be demonstrated or suspected, and whom Tredgold termed secondary aments, Strauss calls exogenous types.) According to Tredgold and many other investigators, from between 70 to 80 per cent. of all defectives are to be found in the first group, while roughly 20 to 30 per cent. belong to the second. Penrose's figures in support of a hereditary causation are even higher.
“Psychiatry Ltd.”
Authors: Curran Desmond
Published: August 2008

I am satisfied one of the results, if not the objective, of medical education is for doctors to judge their success, or the state of progress of any branch of medicine, against a pathological rather than a sociological criterion. This is the inevitable effect of the amount of time and attention given to pathology in the medical curriculum, and is further reinforced by what is asked in examinations.

Traditionally, the problem for the doctor is to try to determine the pathological lesion, using this term at best in a wide sense, and to control this if he can; and the pathological criterion of disease he has in mind is an objective physical criterion, demonstrable in life or after death.

As we all know, no pathological lesion in this traditional sense is demonstrable in a large number of patients who go, or are brought, to see doctors. All physical examinations and investigations prove negative. Medicine is therefore faced with the dilemma in these cases of either (a) coming to the conclusion that there is nothing wrong, which is often clearly untenable, or (b) of expanding its scope almost indefinitely to cover every type of maladjustment.
The Lower Quadrant Leucotomy
Authors: Thorpe F. T. , Hardman James
Published: August 2008

In recent years efforts have been made to analyse the part played by the frontal lobes in the integration of personality. The pioneer work of Bianchi (1922) based on pathological lesions in human subjects, and on experimental bilateral ablations in monkeys, dogs and foxes, still appears to be as true to-day as when originally enunciated. Sherrington (1901) also described the changes following destruction of the frontal lobes. It was noted that such animals lost the power to learn and to enjoy themselves. They had no curiosity, but became restless, hyperactive and easily distracted. Brickner (1936) studied over many years a patient with bilateral frontal lobectomy who showed a diminished ability to synthesize abstract thoughts. Goldstein (1941) found that patients with frontal lobe damage lose their power for abstract thought and this is replaced by concrete behaviour, as shown by object grouping tests and their use of words. Similarly Penfield and Hebb (1940), in a case of extensive lobectomy for an infiltrating oligodendroglioma in an intelligent housewife, described a lack of ability for complex planning, such as is necessary for preparing a meal of several courses. Jefferson (1937) was unable to find any deficiency in cases of unilateral lobectomy. Rylander (1939), on the contrary, after lobectomy for tumours was able to detect changes similar to those found by Goldstein, and in cases with frontal lobe injury he found a lack of social sense. These patients were embarrassingly outspoken, and sometimes showed excessive activity or fatigue. Hebb (1945) concluded that studies on pathological lesions of the frontal lobes were not very helpful, owing to the lack of precision of the lesions due to the uncertain extent of the pathology.
A Preliminary Report on Fatigue and Pain Tolerance in Depressive and Psychoneurotic Patients
Authors: Hemphill R. E. , Hall K. R. L. , Crookes T. G.
Published: August 2008

Pain and fatigue, subjectively experienced, are two of the commonest complaints made by patients suffering from a variety of psychoneurotic and psychotic disorders. Neither phenomenon has so far been adequately studied with the available objective techniques, and the present paper embodies results of preliminary experimental investigations of fatigue and pain tolerance, together with a review of some of the clinical aspects of the problem.

In psychiatric disorders pain rarely produces overt signs which allow the observer to judge its severity, and the excruciating pain complained of by some patients appears to be accompanied by much less emotional reaction than, for example, the pain experienced by the normal individual after a burn, a crushed finger, or an abdominal catastrophe.
Experiments on the Prolongation of Induced Epileptiform Convulsions in the Cat
Authors: Ruf Hugo
Published: August 2008

THE present paper offers a brief summary of work which has been published in German journals dealing with the prolongation of induced convulsions. In the course of my experimental research the following phenomena were demonstrated:

(1)

Continuousconvulsionslastingup to oneand a half hours were produced by the administration of oxygen and adrenaline, preceded by the injection of phenyl-methyl-aminopropane.

(2)

Prolonged convulsions of 33 minutes were produced by the intravenous injection of 2 ml. of a io per cent. metrazol solution and continuous oxygen in suffiation.

(3)

Isolated continuous convulsive activity of the cerebellum was produced lasting 30 minutes after cessation of respiration and of all cortical electrical activity. This was achieved by continuous insuffiation of oxygen together with the injection of adrenaline and strychnine.

(4)

Activation of a prolonged convulsion up to 11 minutes, without further electric stimulation, was effected via the thalamus by the injection of adrenaline after administration of phenyl-methyl-aminopropane and continuous oxygen in sufflation.
Studies in Schizophrenia: II. Estimation of Serum-Cholesterol
Authors: Fleischhacker H. H. , Bullock F. N.
Published: August 2008

IN a previous paper (Bullock, Clancey and Fleischhacker, 1951) an attempt was made to separate schizophrenic reaction syndromes, due to diagnosable and often successfully treatable disease of known etiology, from idiopathic or cryptogenic schizophrenia. It was shown that the criteria of idiopathic schizophrenia are—

(1)

Positivey: (a) Mentally, the classical symptoms of inadequacy and inappropriateness : of thought (paralogia), of affect (parapathema), to which one may add of volition (paraboulema), usually accompanied by hallucinations, paranoid ideas, etc.

(b) Physically, a slightly pathological C.S.F., due essentially to an increase of the globulin fraction.

(2)

Negalively: the absence of generally acknowledged organic disease of the brain, or any physical disease which is known to produce such disorders of the central nervous system or the C.S.F., as mentioned under (i).
Some Clinical and Aetiological Aspects of Depersonalization with a Case Report of Identical Twins
Authors: Robin Ashley A. , Harrison E. J.
Published: August 2008

A search of the literature has not revealed a report of the depersonalization syndrome occurring in identical twins, although Palmer (1946) published a report of twins in which one patient was described as suffering from “all round loss of interest with some depression…. His thoughts … milled round in a ceaseless turmoil concerning his loss of contact with people and things. There was some complaint of unreality and loss of sexual desire…. His condition was one of distressed perplexity. The illness had come on gradually.” The second patient had “tried to get his twin brother to ‘pull himself together,’ when one Saturday he became intoxicated and for a wager attempted bestiality. He woke up next morning feeling unutterably guilty and depressed, and rapidly developed feelings of unreality. His compelling symptom was the fear that his mind was disintegrating.”

These cases appear essentially depressive and progressed to a woeful, hypochondriacal state six years later.
Narcolepsy: A Brief Critical Review and Study of Eight Cases
Authors: Pond D. A.
Published: August 2008

Most of the classical reviews of narcolepsy were written in the decade from 1925 (Kinnier Wilson, 1928; Redlich, 1931; Thiele and Bernhardt, 1933; Daniels, 1934, and others). The clinical picture was well established by these writers and does not need discussion. In addition to narcoleptic seizures, other symptoms are common, the most frequent being attacks of loss of tone and power, variously called cataplexy, “Lachschlag,” “Tonusverlust.” Night sleep is often disturbed by periods of wakefulness and bad dreams. During the phases of going to sleep or waking up, temporary paralysis of the muscles, without disturbance of consciousness, and hallucinatory episodes of all sense modalities sometimes occur. The generally accepted explanation of these various phenomena is that they represent a dissociation of the motor, sensory and central components of sleep. There are, however, three controversial points: firstly, the relationship of the patho-physiology of the seizures to epilepsy; secondly, the “somatic constitution “of the narcoleptic patient; and thirdly, the nosological status of narcolepsy.
Clinical and E.E.G. Aspects of Psychiatric Disorders Associated with Tetany
Authors: Bailey D. S. G. M. , Donovan J. F. , Galbraith A. J.
Published: August 2008

While the main syndrome of tetany arising from hypoparathyroidism is widely recognized, it is doubtful if a sufficiently comprehensive view has been taken of the extensive range of manifestations which may be presented. The underlying pathological mechanisms may also be complex, and the circumstances under which hypoparathyroidism may develop are not always self-evident. Lyle (1949) attempts to classify hypoparathyroidism on an aetiological basis, and distinguishes postoperative, intrinsic, extrinsic, and idiopathic types. In our paper we are mainly concerned with tetany following thyroidectomy, the incidence of which has been estimated by Bell and Bartels (1951) as 2·9 per cent., based on their observations of 2,000 consecutive operations. The case which we are going to describe is one in which a history of thyroidectomy did not immediately appear significant in relation to the presenting features. Admission to hospital followed the onset of a psychotic illness, which in itself did not indicate any underlying organic disturbance, despite an account of an occasional epileptic attack some time previously. The latter feature, however, led to routine E.E.G. investigations. These are of particular interest in this case, especially as some of the recordings had been made before the diagnosis of hypoparathyroidism was established, and before the significance of the fits in the clinical syndrome was appreciated.
The E.E.G.S of the Relatives of Schizophrenics
Authors: Chamberlain G. H. A. , Russell J. Gordon
Published: August 2008

It has been shown by a number of workers that in a large proportion of cases the E.E.G.s of schizophrenic patients are abnormal. This paper is an attempt to increase our knowledge of the hereditary background of schizophrenia by recording the E.E.G.s not only of those suffering from the disease but also those of their near relatives.
Gargoylism (Hurler's Disease)
Authors: MacGillivray Ronald C.
Published: August 2008

Hurler's disease is a condition characterized essentially by mental defect, chondro-osteodystrophy, hepatosplenomegaly and corneal opacities. The complex was first noted in 1900, by John Thomson of Edinburgh who, recognizing that he was dealing with a new disease, named it after his first patient “Johnny McL—'s Disease.” Subsequent descriptions were those of Hunter (1917) and Gertrud Hurler (1919).
Rorschach Validation. I: A Rationale
Authors: Keehn J. D.
Published: August 2008

The Rorschach ink-blot test is so well known amongst present-day psychologists that any attempt to describe its composition and the aims and ambitions of its protagonists would be presumptuous. However, the underlying assumptions involved in the use of the test are neither so widely understood nor so universally accepted. It is for this reason that there have been so many and so various attempts to establish the validity of the Rorschach.
A Preliminary Investigation into Abreaction Comparing Methedrine and Sodium Amytal with other Methods
Authors: Houston F.
Published: August 2008

In abreaction under any of the methods in use, a phase of cortical excitation is followed by a phase of temporary cortical inhibition with rupture of pre-existing patterns of conditioned reflexes and behaviour, a phase in which new modes of behaviour are easily adopted, the ultra-paradoxical phase (Pavlov, 1934). In this phase the patient is extremely suggestible, and this corresponds to psychological transference always found in post-abreactive states (Shorvon and Sargant, 1947).
The Presidential Address
Authors: Tennent Thomas
Published: August 2008

My first words must necessarily be an expression of sincere thanks to the Association for the great honour they have done me in electing me their President for the ensuing year. In the interval since this was proposed I have often reflected on the number of eminent men who have filled the Presidential chair with great distinction, only to become more conscious of my inadequacies to reach the standard they have set.
A Special Mental Hospital Unit for the Treatment of Psychosis and Neurosis in Juveniles
Authors: Sands Dalton E.
Published: August 2008

Since the treatment of juveniles as in-patients in a special unit is somewhat unusual in mental hospital practice, a brief introduction may not be out of place. These units might be considered as another development in a trend which has been progressing for the past 25 years. Until 1930 certification of all admissions to mental hospitals and a mainly custodial régime ensured the majority of patients being largely the end-results of psychiatric illness. Since 1930 the steadily increasing use of the voluntary system has brought many patients to hospital at a stage when their illness can be favourably influenced by modern therapeutic methods. An associated development was the increased provision of wards or units separate from the chronically disturbed cases, or even, as at this hospital, a complete villa system of detached and semi-detached wards for mainly voluntary adult patients.
Pictorial Art, Viewed from the Standpoint of Mental Organization As Revealed by the Excitatory Abreaction Techniques of Psychiatry
Authors: Colquhoun N. C. , Palmer Harold
Published: August 2008

The pictorial work of art bears witness, above all else, to the process of creation. Whatever it is that differentiates a work of art from mere skilled productivity—(and aesthetic theories rage about this issue)—it would appear that only in the case of the former is the spectator made conscious of that heightened scale of perception, at once purposive, integrated, and whole, which is the distinguishing feature of creative activity. And if we admit the principle of creativity in artistic expression, then we must seek in paintings something more than a reproduction of external appearance. The visible world indeed is the raw material of art, but it is moulded and fashioned by the artist according to his own purposes and, it is now suggested, by certain qualities of reminiscence. As a consequence of the relation which exists between his own emotional life and these qualities he creates in pictures a world of reality which has for him a compelling intensity—an irradiance in which he finds meaning and justification for his work. It is the embodiment of some new state of comprehension, bringing order, coherence and purpose to what otherwise would be formless and lacking in meaning. This world re-born, founded in experience, is invested with conviction and validity. The making of such an extra-sensory world is at the heart of creativity, for only so can the artist create the conditions for a communicable experience. A purely private world is mysterious and incommunicable, and does not provide the conditions in which schools of art can develop.
Celastrus Paniculata in Mental Deficiency: a Pilot Experiment
Authors: Morris J. V. , MacGillivray R. C. , Mathieson Constance M.
Published: August 2008

Celastrus paniculata (c. multiflora and c. mutans) is a large climbing shrub found in the hilly districts of India, Burma and Ceylon. The seeds, leaves and an oil extracted by distillation are used in Ayurvedic medicine and are believed to increase intelligence. The Sanskrit name Jyotishmati or “light-bringer” is an allusion to this reputed property. Other members of the family Celastraceae, notably Gymnosporia deflexa Sprague and Catha edulis Forsk, are favoured by the natives of Africa as mental stimulants (Watt and Breyer-Brandwijck, 1932).
Genetic Investigations in Twins
Authors: Slater Eliot
Published: August 2008

I am very grateful for the invitation of the Association to speak about the work I have been doing with twins, as it is an opportunity to thank the very many members who have helped in it. Without your kindness and co-operation the work would not have been possible. Medical Superintendents have put themselves out to make it possible for me to see patients and examine records; medical officers have discussed cases with me; I have been able to see the invaluable reports on family visits by social workers, and P.S.W's. have even made special inquiries on my behalf; hospital secretaries have made visiting books and other records available, and have rummaged through dusty files for ancient case-notes, and they have added to their labours routine inquiries about twinship which have considerably enlarged my series. This help has been given not only to me personally, but also to other workers collaborating with me. For all this and more, which I have no time to mention, I want to say thank you very much.
A Comparison of the Personality Changes After (1) Prefrontal Selective Surgery for the Relief of Intractable Pain and for the Treatment of Mental Cases; (2) Cingulectomy and Topectomy
Authors: Beau Jacques Le , Petrie Asenath
Published: August 2008

Extensive lesions of the frontal lobes are followed by pronounced personality changes. This has been shown beyond doubt by the effect of neuro-surgery performed for the removal of brain tumours or for the relief of mental illness. To identify such changes and the lesions responsible for them at least four conditions seem necessary: (a) Knowledge of the limits, variations and connections of the main pre-frontal areas.—In this field the researches of Professor Alfred Meyer and his associates, Mrs. Beck and T. McLardy, are of primary importance (1950).
An Experimental Inquiry into Some Aspects of the Motor Behaviour and Personality of Tiqueurs
Authors: Crown Sidney
Published: August 2008

Tics are involuntary, repetitive or stereotyped movements which apparently lack purpose and which, with adults, tend to be permanent or long-term abnormal aspects of the individual's motor behaviour. The question arises whether certain basic psycho-motor and personality traits characterize persons who develop tics. No previous experimental work on this problem has been reported. In the present research, therefore, a preliminary attempt was made to describe precisely, by the use of psychological tests, certain aspects of the motor behaviour and some of the personality characteristics of tic patients and to compare the results with a similar examination carried out on matched, but non-tic, control patients.
Phantasies of Birth and Prenatal Experiences Recovered from Patients Undergoing Hypnoanalysis
Authors: Kelsey Denys E. R.
Published: August 2008

In this paper, which is a preliminary communication, I want to present and discuss phantasies of the process of birth and of life before birth, which emerged from certain patients undergoing hypnoanalysis.
Some Pathological Processes Set in Train by Early Mother-Child Separation
Authors: Bowlby John
Published: August 2008

It is charactersitic of mental ill-health that the individual's capacity to make continuous co-operative relations with others is impaired. In the psychoses and psychopathic conditions this is unmistakable; in the neuroses it is sometimes less so, and there are even neurotic patients who seem to be especially kind and co-operative. But we know that they only achieve this behaviour at great cost of effort, anxiety and guilt and that, if they break down, they can be very hostile and withdrawn.
Myanesin in Psychiatry
Authors: Monro A. B. , Steadman H. H.
Published: August 2008

In the course of a systematic investigation of the pharmacological properties of a-substituted glycerol ethers it was found that some of these compounds produced muscular relaxation and paralysis. In small doses, administered sub-cutaneously, muscular relaxation and a sleep-like condition were produced in laboratory animals—in larger doses there was ataxia followed by paralysis. Of the various compounds studied, mephenesin was found to be the most potent and to possess the greatest margin of safety, and it is this product which is used, for oral administration, in Myanesin Elixir.
The Effects of Ethyl Alcohol on Maze Behaviour and Motor Co-Ordination of Rats. 2. the Assessment of Degrees of Intoxication
Authors: MacLeod Leslie D.
Published: August 2008

A previous communication (Carpenter and MacLeod, 1952) described the application of a maze, together with a simple test of limb co-ordination, to the study of alcoholic intoxication in rats, as modified by acetaldehyde. As part of a scheme of work here, it was desired to observe the effect of drugs and other substances upon the degree of intoxication produced in rats by ethyl alcohol. Such studies, pursued by the methods previously given, soon led to a formidable mass of recorded material, some features of which were not adequately dealt with by the scoring technique employed. It became necessary to adopt a scoring system which would give an overall indication of the various manifestations of alcoholic intoxication, to serve for the purpose of compact tabulation of results and the drawing of conclusions.
Subarachnoid Haemorrhage and Paranoid Psychosis
Authors: Cormier Bruno M.
Published: August 2008

Symptoms of mental disorder are common in cases with cerebral tumours and malformations. Progressive dementia, clouding of consciousness and personality changes make their appearance sooner or later. They have been understood as the result of interference with cerebral functions. However, there are patients in whom the relationship between cerebral lesions and mental disorder is obscure. They present conditions not usually associated with demonstrable structural changes, and the coexistence of mental and physical symptoms appears purely accidental, both running their course independently.
Experimental Studies of a Perceptual Anomaly. III. The Testing of an Explanatory Theory
Authors: Shapiro M. B.
Published: August 2008

This is the third of a series of articles reporting an investigation of the block design rotation effect. This effect is shown by some patients when they are doing the Kohs' Blocks Test, which is known in other forms as the Block Design Test. In this test the subject has to reproduce patterns with the aid of diversely coloured one-inch cubes. It was observed that some patients, while they reproduced these patterns correctly, left their blocks in an obviously rotated position, apparently with no idea that anything was amiss (see Illus
tration i). Such rotation can often be as great as 45°.
Rorschach Validation. III: An Examination of the Role of Colour as a Determinant in the Rorschach Test
Authors: Keehn J. D.
Published: August 2008

The importance and relevance of reaction to colour in the interpretation of Rorschach protocols has been so often and so vigorously stressed by proponents of the test that few psychologists can have remained unaffected by their views. It is the purpose of this paper to examine the validity of these views. Already the evidence pertinent to the hypothesis that certain reactions to the blots depend upon the indirect effect of colour, the so-called “colour-shock” signs, has been examined (Keehn, 14). Beyond repeating the general conclusion that such signs seem not to be dependent upon presence or absence of colour this topic will not be discussed, so restricting this paper solely to a consideration of the validity of the hypotheses concerning the direct reaction to colour on the cards. No better or succinct and documented statement of these hypotheses can be made than that of Hertz and Baker (10), who, after summarising numerous studies relating to the topic, conclude that— “There is general agreement that colour factors give a measure of the stability of the emotional life. They show the externally directed or expressed emotionality of an individual. FC represents emotional stability and adaptability, CF, emotional lability, excitability and lack of control, and C, lack of restraint and impulsiveness.”
Psychological Test Performance in Patients Over Sixty. II. Paraphrenia, Arteriosclerotic Psychosis and Acute Confusion
Authors: Hopkins Barbara , Roth Martin
Published: August 2008

The previous paper of this series (Roth and Hopkins, 1953) described test performance in senile and affective psychosis. The same tests have been administered to patients in three other diagnostic groups: paraphrenia, arteriosclerotic psychosis, and acute confusional states. These five clinical categories account for the majority of mental hospital admissions in patients over the age of 60.
Clinical Evaluation of the Effect of Mephenesin on Anxiety
Authors: Ewing John A. , Mendenhall John H.
Published: August 2008

The drug which is now known officially as Mephenesin (“Myanesin,” “Tolserol”) was introduced by Berger and Bradley (1946), who showed that it antagonizes strychnine convulsions, counteracts pre-narcotic excitement, and increases the duration of barbiturate anaesthesia. Small doses depress the reflex excitability of the spinal cord, and larger doses have an ascending depressant action on the central nervous system. When Berger (1947) found that doses with little effect on voluntary power restored deranged reciprocal innervation to normal, he suggested that mephenesin might be useful in spastic and hypertonic conditions.
Psychological Concomitants of Cortisone and Acth Therapy
Authors: Rees Linford
Published: August 2008

During recent years renewed interest has been taken in the possible importance of adrenocortical function in psychiatric disorders. Psychiatric syndromes and symptoms associated with pathological functioning of the adrenal cortex found in Cushing's and Addison's diseases have been recognized for many years. The classical work of Selye (1949) and his school has elucidated the importance of the adrenal gland in the individual's reaction and adaptation to stress. Qualitative and quantitative abnormalities in adrenocortical responsivity to stresses and stimuli in various psychiatric disorders have been reported in recent years (Freemanet al., 1944; Hoaglandet al., 1946; Pincus and Elmadjean, 1946; Pincuset al., 1949).
The Centenary of the Journal of Mental Science
Authors: Walk Alexander
Published: August 2008

The first number of the Journal of Mental Science appeared on 15 November, 1853. It will be noted that we are still in our 99th Volume—the discrepancy is accounted for by changes in the mode of issue during the first few years.
The Insane Root
Authors: Fleming G. W. T. H.
Published: August 2008

The first duty of your President is to say thank you and this I do with great sincerity. To be elected President of this historic association is indeed an honour, and I very much appreciate it.
An Investigation into the Supposed Differences Existing Between Mongols and Other Mentally Defective Subjects with Regard to Certain Psychological Traits
Authors: Blacketer-Simmonds D. A.
Published: August 2008

Mongolism was one of the earliest syndromes to be recognized as a specific type of mental deficiency and was first described as such by Langdon Down in 1866. The term “mongol” was applied to this type of defect by Langdon Down on account of the superficial facial resemblance he observed in its subjects to individuals of the Mongolian race.
Further Observations on the Effects of Lysergic Acid Diethylamide
Authors: Mayer-Gross W. , McAdam W. , Walker J. W.
Published: August 2008

In previous communications (1951, 1952) we have shown that lysergic acid diethylamide (LSD-25), a drug which has a remarkable psychological effect in minute oral doses, also has an effect on carbohydrate metabolism resulting in an increased concentration of hexosemonophosphate in the blood. This observation has been confirmed by Cornforth and Long (1952). What was less clear from the experiments in mentally healthy subjects was the relation in time and severity between the psychological symptoms and biochemical changes.
Salivary Cortisol Is Related to Atherosclerosis of Carotid Arteries
Authors: Dekker M. J. H. J. , Koper J. W. , van Aken M. O. , Pols H. A. P. , Hofman A. , de Jong F. H. , Kirschbaum C. , Witteman J. C. M. , Lamberts S. W. J. , Tiemeier H.
Published: August 2008

Background: Dysregulation of the hypothalamic-pituitary-adrenal axis has been suggested as an independent risk factor for ischemic heart disease. The aim of our study was to evaluate whether two markers of the hypothalamic-pituitary-adrenal axis activity, the level of salivary cortisol and the diurnal salivary cortisol pattern, are associated with atherosclerosis of the carotid arteries in an elderly population.

Methods and Results: A total of 1866 participants of the Rotterdam Study, a population-based cohort study in the elderly, provided four salivary cortisol samples throughout 1 d, and underwent ultrasonography to examine the presence of plaques in the common, internal, and bifurcation sites of both carotid arteries. Two summary measures of the separate cortisol values were computed: area under the curve (AUC), which is a measure of total cortisol exposure while awake; and the slope, which is a measure of diurnal cortisol decline.

Results: Total cortisol exposure while awake (AUC) was associated with higher plaque scores (β = 0.08 per sd of AUC, 95% confidence interval 0.00–0.16; P = 0.04) in a fully adjusted linear regression model. Persons with an AUC in the highest tertile had a higher number of plaques of carotid arteries compared with those in the lowest tertile (3.08 vs. 2.80, 95% confidence interval of difference 0.09–0.48; P = 0.005). There was no relation between diurnal cortisol decline and plaque score.

Conclusion: Our results support the hypothesis that increased total cortisol exposure is independently associated with atherosclerosis of the carotid arteries.
Pentanucleotide Repeat Polymorphism, Lipoprotein(a) Levels, and Risk of Ischemic Heart Disease
Authors: Kamstrup Pia R. , Tybjærg-Hansen Anne , Steffensen Rolf , Nordestgaard Børge G.
Published: August 2008

Context: Lipoprotein(a) is a cardiovascular risk factor. Levels of lipoprotein(a) are predominantly determined by apolipoprotein(a) gene variation, including a pentanucleotide repeat promoter polymorphism.

Objective: We tested the hypothesis that apolipoprotein(a) pentanucleotide repeat genotype predicts elevated lipoprotein(a) levels and risk of myocardial infarction (MI) and ischemic heart disease (IHD) in the general population.

Design: We used a cohort study of the Danish general population, The Copenhagen City Heart Study, including 10,276 individuals of which 860 and 1,781 developed MI and IHD, respectively, during up to 31 yr of follow-up, and a case-control study including 1,814 IHD patients and 5,076 controls. Follow-up was 100% complete.

Results: Allele frequencies were 0.0018, 0.0018, 0.6750, 0.1596, 0.1465, 0.0146, and 0.0004 for 6, 7, 8, 9, 10, 11, and 12 repeats, respectively. Mean lipoprotein(a) levels were 40, 36, and 27 mg/dl for individuals with 14–15, 16, and 17–22 repeats (sum of repeats on both alleles), respectively (trend, P < 0.001). Cumulative incidence of MI and IHD was increased for individuals with 14–15 vs. at least 16 repeats (log rank, P < 0.001 and P = 0.002). Multifactorially adjusted hazard ratios for 14–15 and 17–22 vs. 16 repeats were 3.1 (95% confidence interval, 1.6–5.8) and 1.0 (0.9–1.2) for MI and 2.2 (1.3–3.6) and 1.0 (0.9–1.1) for IHD. In the case-control study, multifactorially adjusted odds ratios for 14–15 and 17–22 vs. 16 repeats were 2.9 (1.1–7.8) and 0.9 (0.8–1.0) for MI and 2.5 (1.0–6.0) and 0.9 (0.8–1.0) for IHD.

Conclusions: Apolipoprotein(a) 14–15 pentanucleotide repeats predict elevated levels of lipoprotein(a) and a 3- and 2-fold increased risk of MI and IHD in the general population.
Role of N-linked oligosaccharides in the biosynthetic processing of the cystic fibrosis membrane conductance regulator
Authors: Chang Xiu-bao , Mengos April , Hou Yue-xian , Cui Liying , Jensen Timothy J. , Aleksandrov Andrei , Riordan John R. , Gentzsch Martina
Published: August 2008

The epithelial chloride channel CFTR is a glycoprotein that is modified by two N-linked oligosaccharides. The most common mutant CFTR protein in patients with cystic fibrosis, ΔF508, is misfolded and retained by ER quality control. As oligosaccharide moieties of glycoproteins are known to mediate interactions with ER lectin chaperones, we investigated the role of N-linked glycosylation in the processing of wild-type and ΔF508 CFTR. We found that N-glycosylation and ER lectin interactions are not major determinants of trafficking of wild-type and ΔF508 from the ER to the plasma membrane. Unglycosylated CFTR, generated by removal of glycosylation sites or treatment of cells with the N-glycosylation inhibitor tunicamycin, did not bind calnexin, but did traffic to the cell surface and exhibited chloride channel activity. Most importantly, unglycosylated ΔF508 CFTR still could not escape quality control in the early secretory pathway and remained associated with the ER. However, the absence of N-linked oligosaccharides did reduce the stability of wild-type CFTR, causing significantly more-rapid turnover in post-ER compartments. Surprisingly, the individual N-linked carbohydrates do not play equivalent roles and modulate the fate of the wild-type protein in different ways in its early biosynthetic pathway.
Mechanical forces facilitate actin polymerization at focal adhesions in a zyxin-dependent manner
Authors: Hirata Hiroaki , Tatsumi Hitoshi , Sokabe Masahiro
Published: August 2008

We examined the effects of mechanical forces on actin polymerization at focal adhesions (FAs). Actin polymerization at FAs was assessed by introducing fluorescence-labeled actin molecules into permeabilized fibroblasts cultured on fibronectin. When cell contractility was inhibited by the myosin-II inhibitor blebbistatin, actin polymerization at FAs was diminished, whereas α5β1 integrin remained accumulated at FAs. This suggests that actin polymerization at FAs depends on mechanical forces. To examine the action of mechanical forces more directly, the blebbistatin-treated cells were subjected to a sustained uniaxial stretch, which induced actin polymerization at FAs. These results demonstrate the novel role of mechanical forces in inducing actin polymerization at FAs. To reveal the molecular mechanism underlying the force-induced actin polymerization at FAs, we examined the distribution of zyxin, a postulated actin-regulatory protein. Actin-polymerizing activity was strong at zyxin-rich FAs. Accumulation of zyxin at FAs was diminished by blebbistatin, whereas uniaxial stretching of the cells induced zyxin accumulation. Displacing endogenous zyxin from FAs by expressing the FA-targeting region of zyxin decreased the force-induced actin polymerization at FAs. These results suggest that zyxin is involved in mechanical-force-dependent facilitation of actin polymerization at FAs.
On the shape of migrating cells — a `front-to-back' model
Authors: Bretscher Mark S.
Published: August 2008

The wide range of shapes that are seen in stationary animal cells is believed to be the result of an interplay between giant filamentous complexes – largely the microfilaments and microtubules – although how this is achieved is unknown. In a migrating cell these large elements are also important, but here I suggest an additional factor: the cell surface distribution of those molecules that attach the cell to the substratum. As an animal cell advances, the attachments it makes with the substratum necessarily move backwards with respect to the cell. A fresh supply of these attachments – usually integrin molecules – is required at the cell front so that new attachments can be made. This supply is believed to be provided by the endocytic cycle, which enables the collection of integrins and other molecules from elsewhere on the surface of the cell to be recirculated to the front end of the cell. The rate at which a particular integrin cycles will determine its distribution on the ventral surface of the cell and this, in turn, might help to determine the shape of the cell. I also propose that adhesion molecules that have a slow rate of cycling will produce a flattish phenotype, as seen in fibroblasts, whereas a more rapid cycling will lead to a more snail-like shape. In addition, this model suggests why membrane ruffling occurs and that large non-circulating surface molecules move towards the back of the cell where they might assist in detaching the back end of the cell.
Dynamic Pricing and Inventory Control of Substitute Products
Authors: Dong Lingxiu , Kouvelis Panos , Tian Zhongjun
Published: August 2008

We study dynamic pricing and inventory control of substitute products for a retailer who faces a long supply lead time and a short selling season. Within a multinomial logit model of consumer choice over substitutes, we develop a stochastic dynamic programming formulation and derive the optimal dynamic pricing policy. We prove that dynamic pricing converges to static pricing as inventory levels of all variates approach the number of remaining selling periods (assuming at most one customer arrival within each period). Our extensive numerical study of the effects of time and inventory depletion on the optimal pricing reveals two fundamental underlying driving forces of the complex price behavior: the level of inventory scarcity and the quality difference among products. We also compare the performance of three restricted pricing strategies: static, unified dynamic, and mixed dynamic pricing. We find that full-scale dynamic pricing is of great value in the presence of inventory scarcity, and initial inventory decisions are quite robust in the pricing scheme employed in the selling season. Based on the above insights, we propose a computationally efficient approach to the initial inventory decision, which delivers close-to-optimal inventory levels for all testing cases.
Benefits of Reevaluating Real-Time Order Fulfillment Decisions
Authors: Xu Ping Josephine , Allgor Russell , Graves Stephen C.
Published: August 2008

When a customer orders online, an online retailer assigns the order to one or more of its warehouses and/or drop-shippers to minimize procurement and transportation costs based on the available current information. However, this assignment is necessarily myopic because it cannot account for any subsequent customer orders or future inventory replenishment. We examine the benefits of periodically reevaluating these real-time assignments. We construct near-optimal heuristics for the reassignment for a large set of customer orders to minimize the total number of shipments. Finally, we present evidence of significant saving opportunities by testing the heuristics on order data from a major online retailer.
Antipsychotic Medication Utilization Trends Among Texas Veterans: 1997–2002
Authors: Yang Min , Barner Jamie C , Lawson Kenneth A , Rascati Karen L , Wilson James P , Crismon M Lynn , Worchel Jason , Mascarenas Cynthia A
Published: August 2008

Background

An antipsychotic utilization pattern has evolved substantially over the past 20 years or so due to the introduction of the second-generation antipsychotics (SGAs) and the increasing understanding of their adverse effect profile.

Objective

To understand antipsychotic utilization trends (including monotherapy, antipsychotic switching, and combination therapy) and to investigate factors associated with antipsychotic index medication selection (SGAs vs first-generation antipsychotics [FGAs]) among Texas veterans.

Methods

Data were taken from the Veterans Administration North Texas Health Care System (VANTHCS) and South Texas Veterans Health Care System (STVHCS) from January 1996 to December 2003. Adults with continuous enrollment (1 y before and after the Index date) who had newly initiated antipsychotic therapy were included. Prescriptions were followed for up to 12 months. Descriptive analyses examined utilization trends; logistic regression evaluated factors associated with antipsychotic index medication selection.

Results:

A total of 8096 patients were included in the study (VANTHCS n = 4477; STVHCS n = 3619), with the majority being male (93.6%) and white (62.6%) and nearly naif aged 55 years or older (44.1%). Between 1997 and 2002, antipsychotic prescriptions changed from primarily FGAs (1997:71.7%; 1999; 25.2%; 2002: 5.7%) to SGAs. Over the 6-year time frame, risperidone (31.0%) and olanzapine (30.7%) were most commonly prescribed. The overall combination therapy slightly increased over time (4.3%), switching to another antipsychotic remained stable (14.2%), and antipsychotic monotherapy remained dominant (81.5%). Hispanic and black patients were less likely than white patients to be initiated on SGAs. Patients who were older, had hypertension, and were in STVHCS were less likely to start on SGAs. Patients with dyslipidemia, bipolar disorder, and treatment in recent years were more likely to start on SGAs

Conclusions:

SGAs have replaced FGAs as first-line medications for patients with mental disorders. Race, age, physical comorbidities (ie, dyslipidemia, hypertension), and treatment initiation year were important factors in index medication selection.
Neuralgic Amyotrophy Associated with Antibiotic Therapy
Authors: Finstad Kody , Ramon Guajardo Jesus , Scoville Caryn
Published: August 2008

Objective

TO report a case of neuralgic amyotrophy associated with antibiotic therapy.

Case Summary:

A 22-year-old male with cystic fibrosis had been nonadherent to treatment for 4 years; when he returned to the clinic with symptoms, his forced expiratory volume in 1 second dropped from 84% predicted to 43% predicted. He was admitted to the hospital for treatment after failing to improve on oral ciprofloxacin and inhaled tobramycin. Treatment was initialed with intravenous tobramycin 560 mg daily and piperacillin/tazobactam 4.5 g infused every 6 hours. He continued inhaled tobramycin 300 mg twice daily, his home doses of pancreatic replacement enzymes and vitamins, albuterol 2.5 mg by high flow nebulizer (HFN) 4 times daily, and dornase alpha 2.5 by HFN daily. Sputum cultures were positive for methicillin-resistant Staphylococcus aureus, and intravenous vancomycin 1 g every 8 hours was added to the treatment regimen on hospital day 7. The patient developed bilateral shoulder pain followed by decreased function of his upper extremities 2 days later. He was treated with oral ibuprofen 600 mg every 6 h and oral cyclobenzaprine 5 mg daily, which improved his pain, but the shoulder stiffness remained throughout his hospital stay and persisted for 2 months following discharge. These symptoms resolved but recurred rapidly (within 24 h) and were more debilitating following a second exposure to the same antibiotics at the same doses 8 months later when the patient was readmitted for treatment of another cystic fibrosis-retated pulmonary exacerbation.

Discussion:

To our knowledge, this is the first case report illustrating neuralgic amyotrophy triggered by exposure to the antibiotics vancomycin, tobramycin, and piperacillin/tazobactam. After analysis of the case, ruling out other possibilities and using the Naranjo probability scale, we found that there is a highly probable likelihood that the symptoms presented by our patient were secondary to his drug therapy. Neuralgic amyotrophy is a rare condition of unknown etiology that has never before been associated with administration of these antibiotics, individually or in combination. Because of the specifics of the clinical history, we were unable to ascertain whether this complication was due to a single antibiotic or to the combination. It is quite possible that vancomycin was the only culprit, but impossible to ensure with the available evidence.

Conclusions:

Clinicians should be aware of this adverse reaction when facing similar complex neurologic symptoms in patients who are receiving the antibiotic treatment described here, especially vancomycin.