bluuebunny/crossref_metadata_2025 huggingface dataset:
Multiplane Transesophageal Echocardiographic Detection and Differential Diagnosis of Isolated Right Pulmonary Artery Agenesis
Authors: KISS ZOLTÁN , GALUSKA LÁZLÓ , TIMÅ SÁNDOR
Published: August 2007

We present a case report of isolated right pulmonary artery agenesis detected by multiplane trans‐esophageal echocardiography (TEE). A special emphasis is placed on its important role in the differential diagnosis and hemodynamic and functional evaluation of patients with unilateral pulmonary oligemia on chest radiograph. We also present a case report of pulmonary embolism with complete obstruction of the right pulmonary artery for better understanding and for comparison of TEE images in patients with pulmonary artery agenesis.
Peripheral Artery Pseudoaneurysm
Authors: MURPHY PATRICK B. , BAJWA TANVIR K. , KUBOTA JAMES , GAL RAMI
Published: August 2007

Pseudoaneurysm is a well‐recognized complication of invasive arterial procedures that is easily diagnosed with ultrasound. While most pseudoaneurysms will be resolved spontaneously within 3 months, some may lead to limb swelling, ischemia, thromboembolism, or nerve damage. To forestall such complications, we attempted to close the lesion using ultrasound to guide application of pressure in 13 patients with pseudoaneurysms following arterial catheterizations. Successful closure averaged 64 minutes (range 20–180) with successful results achieved in 11 (85%) of the 13 patients. No complications followed the application of either manual or device‐assisted pressure. We conclude that transcutaneous compression is a generally safe and successful treatment of uncomplicated pseudoaneurysm and should be used as the treatment of choice for this lesion.
Ultrasound Densitometric Analysis
Authors: FERNANDEZ ANTHONY P. , ARONSON SOLOMON , TOLEDANO ALICIA , WINKELMANN JACQUELINE , SALDIVAR JOSE , FEINSTEIN STEVEN B.
Published: August 2007

Videodensitometric analysis of myocardial contrast echocardiography is traditionally performed off line. Recently, an online contrast ultrasound analysis system, Acoustic Densitometry (Hewlett‐Packard), was introduced. We compared pixel intensities acquired with Acoustic Densitometry to pixel intensities derived from videodensitometry. A tissue phantom was imaged in phase I using three transducer frequencies (2.5, 3.5, and 5.0 MHz). In phase II, an in vitro flowing tube model with various concentrations of Albunex®was imaged at two flow rates, 0.6 and 1.2 m/sec, and at two transducer frequencies, 2.5 and 3.5 MHz. The relationship between pixel intensities yielded by the two systems for identical ultrasound signals was determined with linear regression. Intensities derived with Acoustic Densitometry strongly correlated with those derived from the offline videodensitometry system. The intensities were related by a predictive multiplicative factor based on display characteristics of the two systems. These results suggest that semiquantitative, online perfusion analysis with Acoustic Densitometry is as sensitive as analysis offline with videodensitometry.
Echocardiographic Findings in Rupture of Long False Tendons
Authors: RIFKIN ROBERT D. , HARPER KATHLEEN A. , TIGHE DENNIS A. , ELMANSOURY NASSER , D'AMOURS JANET
Published: August 2007

Long left ventricular false tendons, which connect distant sites on the ventricular endocardium, are common incidental echocardiographic findings. We describe two cases in which rupture of such long false tendons produced unusual, highly mobile, intracavitary echo densities that could be mistaken for other important pathologies, such as thrombus or vegetation. The differentiation of ruptured long false tendons and intact short apical false tendons from other entities they may mimic is described.
Cerebral Embolism as a Cause of Stroke and Transient Ischemic Attack
Authors: MEYER JOHN STIRLING , MURAMATSU KAZUHIRO , SHIRAI TOSHITAKA
Published: August 2007

The most frequent cause of stroke and transient ischemic attacks is cerebral embolism. Cardiogenic cerebral embolization is common among patients with any cause of atrial fibrillation (AF) but particularly in AF resulting from rheumatic and arteriosclerotic heart disease. Rare causes of cerebral embolism include fat entering the bloodstream after trauma, tumor cells arising from atrial myxomata, and gas embolism. Cerebral embolic infarctions and their sources of origin can now be confirmed during life by many invasive (I) and noninvasive (NI) procedures including computerized tomography (CT) scanning (NI), magnetic resonance imaging (MR) (NI), contrast angiography (I), digital subtraction angiography (I), magnetic resonance angiography (NI), carotid Doppler and transcranial Doppler (NI), and echocardiography (NI) without and with contrast. These tests visualize the following: embolic occlusions of small and large cerebral arteries, resultant cerebral infarctions in appropriate vascular territories, plaques within the aorta, subclavian, vertebral, and carotid arteries, and mural thrombi located within the heart and aortocephalic arteries. Transcranial Doppler monitoring of the middle cerebral artery detects both small (asymptomatic) and large (symptomatic) cerebral emboli, as well as transseptal cardiac shunting, which is a cause of paradoxical embolization. Holter monitoring detects episodic cardiac dysrhythmias not apparent during routine ECG. CT or MRI identify cerebral infarctions resulting from virtually all large cerebral emboli. Early recognition and identification of types of cerebral embolism are important because of the availability of effective prophylactic therapies.
Fundamental Concepts Regarding Sizing and Discrimination of Air Bubbles and Red Cell Aggregates Using Pulsed‐Doppler Ultrasound
Authors: MOEHRING MARK A.
Published: August 2007

The embolus to blood power ratio (EBR) model is briefly described, which predicts that emboli become more detectable as Doppler carrier frequency decreases and vessel diameter decreases. The EBR model indicates that the use of the backscattered power from the blood in the Doppler sample volume and the use of more than one carrier frequency will be useful in discriminating size and composition of an embolic signal. The EBR model is shown to provide both sizing and discrimination of red cell aggregates from air bubbles, using dual frequency interrogation of an embolus
Three‐Dimensional Echocardiographic Reconstruction of the Left Ventricle by a Transesophageal Tomographic Technique
Authors: PAI RAMDAS G. , JINTAPAKORN WORAVUT , TANIMOTO MASATO , CAO QI‐LING , PANDIAN NATESA , SHAH PRAVIN M.
Published: August 2007

Accurate determination of left ventricular (LV) volume has important therapeutic and prognostic implications in patients with cardiac disease. Volume estimations by two‐dimensional techniques are not very accurate due to geometric assumptions. Objectives: To validate LV volume determinations by a new transesophageal three‐dimensional echocardiographic technique. We performed three‐dimensional reconstruction of the LV using an echo‐computed tomographic (CT) technique based on serial pullback parallel slice imaging technique in both in vitro and in vivo settings. Fourteen latex‐balloons with various sizes (30–235 mL) and shapes (conical, pear shaped, round, elliptical, and aneurysms in various locations) filled with known volumes of water were imaged in a water bath. From the static three‐dimensional image, the LV long axis was defined and the LV was sectioned perpendicular to this axis into 2‐mm slices. The volume of each slice was calculated with the observer blinded to the actual volume as the product of the slice thickness and the manually traced perimeter of the slice and the LV volume as the sum of the volumes of the slices (Simpson's method). The calculated LV volume closely correlated with the actual volume (r = 0.99, P < 0.0001, calculated volume = 1.06x – 11.3, Δvolume =‐5.7 ± 10.0 cc). Using the same system, transesophageal echocardiographic (TEE) images of the LV were obtained in 15 patients gated to respiration and ECG. Satisfactory dynamic three‐dimensional reconstruction of the LV was possible in ten patients. The three‐dimensional LV volumes (systolic and diastolic) using Simpson's method correlated well with those obtained from biplane or multiplane TEE images using the area length method (r = 0.89, P < 0.0001, y = 12.7 + 0.84x, Δvolume = 1.3 ± 18.1 cc). The LV major‐axis diameters by the two methods showed very close correlations as well (r = 0.86, P < 0.0001, y = 19 + 0.74x, Δdiameter = 1.0 ± 7.2 mm). We conclude that three‐dimensional LV volume calculation by the echo‐CT technique is intrinsically sound, is independent of LV geometry, and with some limitations, is applicable in vivo.
Mitral Stenosis, Sinus Venosus Atrial Septal Defect, and Partial Anomalous Pulmonary Venous Return
Authors: SHIRANI JAMSHID , WOO DANNY , GOTSIS WILLIAM , MEISNER JAY S. , STROM JOEL A.
Published: August 2007

We describe a 42‐year‐old man with rheumatic mitral stenosis, sinus venosus atrial septal defect, and anomalous drainage of the right upper pulmonary vein to the superior vena cava. Transthoracic echocardiography (TTE) failed to identify the atrial septal defect and the partial anomalous pulmonary venous return. Transesophageal echocardiography (TEE), using a multiplane probe, was useful in delineating the abnormalities. To our knowledge, this is the first reported patient with rheumatic mitral stenosis and sinus venosus defect.
Decisions About Transfer From Nursing Home to Emergency Department
Authors: Jablonski Rita A. , Utz Sharon W. , Steeves Richard , Gray D. Patricia
Published: August 2007

Purpose: To describe how decisions occurred to transfer nursing home (NH) residents to emergency departments (EDs).

Design: Three nursing homes (NHs) in Virginia were selected based on geographic and ownership variability. The phenomenon of concern was the decision‐making process culminating in the transfer of NH residents to EDs. Sixteen transfers met the inclusion criteria and were analyzed. A minimum of two informants per transfer were interviewed, with a range of 2 to 4 interviews per transfer. All 42 respondents were asked to describe how the transfer decision was reached, to identify who participated in making the decision, and to describe any particular positive or negative aspects of reaching the transfer decision.

Method: Data were analyzed with hermeneutic phenomenological methods. Journal writing, audit trails, informal and formal member checks, and expert consultation were used to control bias.

Findings: The three main themes identified were Consensus, Conflict, and Cogency. Consensus, or agreement, occurred when all decision participants reported similar interpretations as to the severity and acuity of the presenting problem or had shared interpretations of the best interests of the elder. When decision participants held dissimilar interpretations, conflict occurred. Decision participants used cogency by persuading others, in order to reach consensus.

Conclusions: The findings cannot be generalized to long‐term care facilities across the US or to other countries, but they enhance understanding about some of the ways transfer decisions occur and the role of nurses in those transfers, especially when conflict arises.
Improving Participant Comprehension in the Informed Consent Process
Authors: Cohn Elizabeth , Larson Elaine
Published: August 2007

Purpose: To critically analyze studies published within the past decade about participants' comprehension of informed consent in clinical research and to identify promising intervention strategies.

Design:Integrative review of literature.

Methods: The Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed, and the Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials were searched. Inclusion criteria included studies (a) published between January 1, 1996 and January 1, 2007, (b) designed as descriptive or interventional studies of comprehension of informed consent for clinical research, (c) conducted in nonpsychiatric adult populations who were either patients or volunteer participants, (d) written in English, and (e) published in peer‐reviewed journals.

Findings: Of the 980 studies identified, 319 abstracts were screened, 154 studies were reviewed, and 23 met the inclusion criteria. Thirteen studies (57%) were descriptive, and 10 (43%) were interventional. Interventions tested included simplified written consent documents, multimedia approaches, and the use of a trained professional (consent educator) to assist in the consent process. Collectively, no single intervention strategy was consistently associated with improved comprehension. Studies also varied in regard to the definition of comprehension and the tools used to measure it.

Conclusions: Despite increasing regulatory scrutiny, deficiencies still exist in participant comprehension of the research in which they participate, as well as differences in how comprehension is measured and assessed. No single intervention was identified as consistently successful for improving participant comprehension, and results indicated that any successful consent process should at a minimum include various communication modes and is likely to require one‐to‐one interaction with someone knowledgeable about the study.
Close relation of arterial ICC‐like cells to the contractile phenotype of vascular smooth muscle cell
Authors: Pucovský Vladimír , Harhun Maksym I. , Povstyan Oleksandr V. , Gordienko Dmitri V. , Moss Ray F. , Bolton Thomas B.
Published: August 2007

This work aimed to establish the lineage of cells similar to the interstitial cells of Cajal (ICC), the arterial ICC‐like (AIL) cells, which have recently been described in resistance arteries, and to study their location in the artery wall. Segments of guinea‐pig mesenteric arteries and single AIL cells freshly isolated from them were used. Confocal imaging of immunostained cells or segments and electron microscopy of artery segments were used to test for the presence and cellular localization of selected markers, and to localize AIL cells in intact artery segments. AIL cells were negative for PGP9.5, a neural marker, and for von Willebrand factor (vWF), an endothelial cell marker. They were positive for smooth muscle α‐actin and smooth muscle myosin heavy chain (SM‐MHC), but expressed only a small amount of smoothelin, a marker of contractile smooth muscle cells (SMC), and of myosin light chain kinase (MLCK), a critical enzyme in the regulation of smooth muscle contraction. Cell isolation in the presence of latrunculin B, an actin polymerization inhibitor, did not cause the disappearance of AIL cells from cell suspension. The fluorescence of basal lamina protein collagen IV was comparable between the AIL cells and the vascular SMCs and the fluorescence of laminin was higher in AIL cells compared to vascular SMCs. Moreover, cells with thin processes were found in the tunica media of small resistance arteries using transmis‐sion electron microscopy. The results suggest that AIL cells are immature or phenotypically modulated vascular SMCs constitutively present in resistance arteries.
Caveolin and MAP kinase interaction in angiotensin II preconditioning of the myocardium
Authors: Das Manika , Das Samarjit , Das Dipak K
Published: August 2007

Angiotensin II (Ang II) has been found to exert preconditioning (PC)–like effect in mammalian hearts. The present investigation reported for the first time a unique mitogen activated protein (MAP) kinase signalling in Ang II PC of the heart involving lipid rafts, which generated a survival signal by differentially associating MAP kinases with caveolin. A group of rat hearts was treated with Ang II in the absence or presence of NADPH oxidase inhibitor, apocynin or a cell permeable reactive oxygen species (ROS) scavenger, N‐acetyl‐cysteine (NAC). Ang II pre‐treatment improved post‐ischaemic ventricular recovery, myocardial infraction and decreased the number of cardiomyocyte apoptosis indicating PC effect of Ang II. Both apocynin and NAC abolished the PC ability of Ang II. In Ang II treated heart, there was a decreased association of p38MAPKβ & extracellular‐signal regulated kinase (ERK) 1/ 2 (anti‐death signalling component) with caveolin while there was an increased association of p38MAPKα & Jun N‐terminal kinase (JNK) (death signalling component) indicating reduced amount of death signal components and increased amount of anti‐death signalling components being available to the Ang II treated heart to generate a survival signal, which was reversed with NAC or apocynin. The survival signal was also demonstrated by increased phosphorylation of serine/threonine‐protein kinase B (AKT) and enhanced induction of expression of Bcl‐2 during Ang II PC and its reversal with NAC & apocynin treated heart.
Transient down‐regulation of beta1 integrin subtypes on kidney carcinoma cells is induced by mechanical contact with endothelial cell membranes
Authors: Jones Jon , Berkhoff Stefan , Weich Eva , Engl Tobias , Wedel Steffen , Relja Borna , Jonas Dietger , A.Blaheta Roman
Published: August 2007

Adhesion molecules of the integrin beta1 family are thought to be involved in the malignant progression renal cell carcinoma (RCC). Still, it is not clear how they contribute to this process. Since the hematogenous phase of tumour dissemination is the rate‐limiting step in the metastatic process, we explored beta1 integrin alterations on several RCC cell lines (A498, Caki1, KTC26) before and after contacting vascular endothelium in a tumour‐endothelium (HUVEC) co‐culture assay. Notably, alpha2, alpha3 and alpha5 integrins became down‐regulated immediately after the tumour cells attached to HUVEC, followed by re‐expression shortly thereafter. Integrin down‐regulation on RCC cells was caused by direct contact with endothelial cells, since the isolated endothelial membrane fragments but not the cell culture supernatant contributed to the observed effects. Integrin loss was accompanied by a reduced focal adhesion kinase (FAK) expression, FAK activity and diminished binding of tumour cells to matrix proteins. Furthermore, intracellular signalling proteins RCC cells were altered in the presence of HUVEC membrane fragments, in particular 14‐3‐3 epsilon, ERK2, PKCdelta, PKCepsilon and RACK1, which are involved in regulating tumour cell motility. We, therefore, speculate that contact of RCC cells with the vascular endothelium converts integrin‐dependent adhesion to integrin‐independent cell movement. The process of dynamic integrin regulation may be an important part in tumour cell migration strategy, switching the cells from being adhesive to becoming motile and invasive.
Comparison of MY09/11 consensus PCR and type‐specific PCRs in the detection of oncogenic HPV types
Authors: Depuydt C. E. , Boulet G. A. V. , Horvath C. A. J. , Benoy I. H. , Vereecken A. J. , Bogers J. J.
Published: August 2007

The causal relationship between persistent infection with high‐risk HPV and cervical cancer has resulted in the development of HPV DNA detection systems. The widely used MY09/11 consensus PCR targets a 450bp conserved sequence in the HPV L1 gene, and can therefore amplify a broad spectrum of HPV types. However, limitations of these consensus primers are evident, particularly in regard to the variability in detection sensitivity among different HPV types. This study compared MY09/11 PCR with type‐specific PCRs in the detection of oncogenic HPV types. The study population comprised 15, 774 patients. Consensus PCR failed to detect 522 (10.9%) HPV infections indicated by type‐specific PCRs. A significant correlation between failure of consensus PCR and HPV type was found. HPV types 51, 68 and 45 were missed most frequently. The clinical relevance of the HPV infections missed by MY09/11 PCR was reflected in the fraction of cases with cytological abnormalities and in follow‐up, showing 104 (25.4%) CIN2+ cases. The MY09/11 false negativity could be the result of poor sensitivity, mismatch of MY09/11 primers or disruption of L1 target by HPV integration or DNA degradation. Furthermore, MY09/11 PCR lacked specificity for oncogenic HPVs. Diagnostic accuracy of the PCR systems, in terms of sensitivity (MY09/11 PCR: 87.9%; type‐specific PCRs: 98.3%) and specificity (MY09/11 PCR: 38.7%; type‐specific PCRs: 76.14%), and predictive values for histologically confirmed CIN2+, suggest that type‐specific PCRs could be used in a clinical setting as a reliable screening tool.
Studies on brain volume, Alzheimer‐related proteins and cytokines in mice with chronic overexpression of IL‐1 receptor antagonist
Authors: Oprica M. , Hjorth E. , Spulber S. , Popescu B. O. , Ankarcrona M. , Winblad B. , Schultzberg M.
Published: August 2007

Inflammation is associated with both acute and chronic neurological disorders, including stroke and Alzheimer's disease (AD). Cytokines such as interleukin (IL)‐1 have several activities in the brain both under physiological and pathophysiological conditions. The objective of this study was to evaluate consequences of the central blockade of IL‐1 transmission in a previously developed transgenic mouse strain with brain‐directed overexpression of human soluble IL‐1 receptor antagonist (Tg hsIL‐1ra). Effects on brain morphology and brain levels of the AD‐related proteins β‐amyloid precursor protein (APP) and presenilin 1(PS1), as well as the levels of IL‐1β, IL‐6 and tumour necrosis factor‐α (TNF‐α) were analysed in homozygotic and heterozygotic mice and wild type (WT) controls, of both genders and of young (30–40 days) and adult (13–14 months) age. A marked reduction in brain volume was observed in transgenic mice as determined by volumetry. Western blot analysis showed higher levels of APP, but lower levels of PS1, in adult animals than in young ones. In the cerebellum, heterozygotic (Tg hsIL‐1ra+/−) mice had lower levels of APP and PS1 than WT mice. With one exception, there were no genotypic differences in the levels of IL‐1β, IL‐6 and TNF‐α. The cytokine levels were generally higher in adult than in young mice. In conclusion, the chronic blockade of IL‐1 signalling in the brain was associated with an atrophic phenotype of the brain, and with modified levels of APP and PS1. Brain‐directed overexpression of hsIL‐1ra was not followed by major compensatory changes in the levels of pro‐inflammatory cytokines.
A CONTROLLED TRIAL OF COMBINED MEDICATIONS ON BEHAVIORAL AND EXTRAPYRAMIDAL EFFECTS
Authors: SIMPSON G. M. , B. M. , B. CH. , KRAKOV L. , D. M. , KUNZ‐BARTHOLINI ESTHER , D. M.
Published: August 2007

Under double‐blind conditions, increasing amounts of perphenazine, or a perphenazine‐amitriptyline combination, were given to chronic schizophrenic patients already receiving “optimal” therapeutic dosages of perphenazine. Slight behavioral improvement was obtained in both groups, but a significantly smaller amount of extrapyramidal side effects was noted in the group receiving the combination. A double‐blind crossover study was used, which eliminated any order effect. The implications of these findings for therapy are briefly discussed.
Indian vultures: victims of an infectious disease epidemic?
Authors: Cunningham A. A. , Prakash V. , Pain D. , Ghalsasi G. R. , Wells G. A. H. , Kolte G. N. , Nighot P. , Goudar M. S. , Kshirsagar S. , Rahmani A.
Published: August 2007

During the 1990s, populations of two species of griffon vulture, the Indian white‐backed Gyps bengalensis and the long‐billed Gyps indicus, declined by more than 90% throughout India. These declines are continuing and are due to abnormally high rates of both nesting failure and adult, juvenile and nestling mortality. Affected birds exhibit signs of illness (neck drooping syndrome) for approximately 30 days prior to death. Epidemiological observations are most consistent with an infectious cause of this morbidity and mortality. To investigate the cause of these declines, 28 vulture carcases, including adults and juveniles of both species, were examined in detail. Significant post‐mortem findings included visceral gout, enteritis, vasculitis and gliosis. Although we have not yet been able to identify the causative agent of the declines, the results of our pathological studies are most consistent with those for an infectious, probably viral, aetiology. We examine hypotheses for the cause of the declines and, based on our epidemiological and pathological findings, we show infectious disease to be the most tenable of these.
A PSYCHOLOGICAL AND PSYCHIATRIC INVESTIGATION OF THE ADJUSTMENT OF FEMALE SCOLIOSIS PATIENTS
Authors: Bengtsson G. , Fällström K. , Jansson B. , Nachemson A.
Published: August 2007

Twenty‐six women with an idiopathic scoliosis of a high degree (average curvature 105°) underwent a psychiatric investigation and a psychological evaluation made from both socio‐psychological and personality‐psychological aspects, the latter being covered by a projective test (Rorschach) and a gestalt‐psychological test (Bénder). A synthesis was made of the different evaluations characterising the patients' experience of disability according to a 4‐grade scale. This variable was then related to important somatic variables.

The patients' superficial psychosocial adjustment was obviously very good. Only one woman had an invalid pension and the psychiatric contact of the material only moderately exceeded the figure for other women with the same age‐distribution. However, the personality‐psychological examination gave results indicating that adjustment was not always so good. Two case histories illustrate the discrepancy between a good superficial adjustment and a high‐grade psychological handicap.

The patients' lives were marked to a high degree by their deformity. The group was characterised by hypersensitivity and insecurity, with a tendency to dysphoric mood; the level of energy was high. Not unexpectedly, the psychological adjustment deteriorated with an increasing degree of deformity. Poor vital capacity also impaired adjustment.
THE RATING OF CLINICAL ANXIETY
Authors: Lader M. H. , Marks I. M.
Published: August 2007

Many scales and inventories have been introduced for the rating of anxiety. They can be divided into those aimed at assessing “trait anxiety” (habitual anxiousness), and those designed to rate “state anxiety” (anxiety at that moment). The former are essentially personality inventories and include the Minnesota Multiphasic Personality Inventory (MMPI), the Taylor Manifest Anxiety Scale, the 16 Personality Factor Questionnaire of Cattell and the Eysenck Personality Inventory. Clinical rating scales are primarily mood assessment instruments and include simple linear scales, the Hamilton Anxiety Scale, the Lipman Scale, the Psychiatric Outpatient Mood Scales, the Cornell Medical Index and the Morbid Anxiety Inventory. These various scales together with many others are reviewed, their advantages and disadvantages listed and recommendations made for the rating of trait and state anxiety.

The importance of distinguishing between scales which establish diagnostic profiles and those which measure changes in the severity of symptoms is emphasized.
NON‐PSYCHOTIC DISORDERS IN THE FAMILIES OF PROCESS SCHIZOPHRENICS
Authors: Fowler R. C. , Tsuang M. T. , Cadoret R. J. , Monnelly E.
Published: August 2007

The present study was designed to test the hypothesis of “schizophrenic spectrum” disorders. The families of 60 process schizophrenics were systematically interviewed with structured interview forms, and evaluated for psychiatric illness according to strict diagnostic criteria The interviewed persons were then separated into two groups for comparative analysis according to a positive (FH+) or negative (FH‐) family history for schizophrenia. The frequencies of affective disorder and all non‐psychotic conditions did not differ to a convincingly significant degree between the two groups. Our data thus fail to support the “schizophrenic spectrum” hypothesis in which neurosis and sociopathy occur as a consequence of a genetic loading for schizophrenia.
PIMOZIDE IN THE TREATMENT OF MONOSYMPTOMATIC HYPOCHONDRIACAL PSYCHOSIS
Authors: Riding J. , Munro A.
Published: August 2007

An account is given of six cases treated with pimozide. Four of there cases fall into the diagnostic category of monosymptomatic hypochondriacal psychosis, a group with a traditionally poor prognosis. Three out of the four have responded favourably to pimozide, while the fourth showed a partial improvement. A fifth case also showed a marked degree of improvement despite a possibility of early cerebral arteriopathy. The one case which showed no improvement was suspected all along of having a personality disorder rather than a psychotic illnes, and this was subsequently confirmed.

It is suggested that pimozide: a) may be an effective treatment for monosymptomatic hypochondriacal psychoses whatever their aetiology; and b) may differentiate rapidly between cases of mono‐symptomatic hypochondriacal psychoses and dysmorphophobias due to neurotically determined factors.
MANIC‐DEPRESSIVE PSYCHOSIS AND SEASON OF BIRTH
Authors: Hare E. H.
Published: August 2007

National series of psychiatric inpatients studied in Scandinavian countries and in England and Wales have all shown that compared with live births in the general population, schizophrenic patients have a significant excess of births in the early months of the year. But there has been disagreement on whether a similar birth distribution holds for manic‐depression. The present paper presents new data on the seasonal distribution of births of patients born in England and Wales between 1921 and 1955. Compared with all live births, manic‐depression was associated with a significant excess of births in the first quarter, and a corresponding deficiency in the third quarter of the year. Neurotic depression showed no such association.

Possible reasons for the disagreement among national findings for manic‐depression include difference in the proportion of first ever admissions in the series, differences in age structure, and differences in diagnostic practice and classification. The importance of the age structure of a series is considered in relation to: a) the possible effect of age on the manifestation of a disorder associated with some seasonally related constitutional damage; b) the possibility of secular variation in the severity of a seasonally related noxious factor; and c) the effect of age incidence on distorting the expected seasonal distribution of births in any series of cases.
ATTEMPTED SUICIDE AND SUICIDE IN FUNCTIONAL PSYCHOSES
Authors: Noreik K.
Published: August 2007

A total of 2,243 first admissions to Gaustad Hospital between 1938 and 1961 diagnosed as functional psychotics were either followed up to the time of their death within 5 years, or observed over a period of 5 years, and then reexamined. Of these patients, 325 had attempted suicide prior to their admission.

The frequency of attempted suicide was equal in both sexes. Men appeared to use more dangerous methods, and to have more serious intentions.

The psychosis appears to have been of importance when considering whether, but not how the suicide should be attempted. The greatest risk of attempted suicide was to be found amongst patients with psychoses of a depressive nature.

Twenty‐eight of the 2,243 patients in this study committed suicide with in 5 years following their discharge, and a further 20 took their own lives prior to the reexamination.

A certain connection can be seen between attempted suicide and psychotic symptoms.
SUICIDE IN FIJI: A TWO‐YEAR SURVEY
Authors: Price J. , Karim I.
Published: August 2007

This article reviews certified suicide in Fiji during the 2‐year period from 1971–1972. The data show the much higher incidence of suicide in Fiji Indians than in other races, the incidence in Fiji Indian females being particularly high. The findings on a more detailed sample survey of 50% of the certified cases are presented. In the Fiji Indian population, a positive correlation between suicide and rural residence and a negative correlation between suicide and Moslem religion were found.

These findings are discussed in relation to the cultural and social characteristics of the population of Fiji.
THERAPEUTIC RESULTS IN BRIEF‐INTERVAL UNILATERAL ECT
Authors: Strömgren L. Sand
Published: August 2007

The study reported comprised 104 patients with endogenous depression who were given unilateral electroconvulsive therapy (ECT). The patients were divided into two equally large groups, one receiving two and the other four treatments per week. The latter group was selected openly, while the former had been collected by a double‐blind technique on a previous occasion. The severity of depression was assessed before the first treatment and on the days after the sixth and the last treatment, and at these times memory testing by WMS Forms I and II and EEG were also performed.

An analysis is presented of the therapeutic effect obtained, assessed by: (1) the number of treatments applied in the two groups; (2) the reduction in the depression score; and (3) the effect achieved per treatment. In the group with frequent electrostimulation one to two additional treatments were required, the difference being statistically significant. On the other hand, frequent stimulation tended to be more effective in terms of the reduction in the depression score. The effect per treatment was identical in the two groups. Four treatments per week did not result in a higher frequency of complications. A comparison of the five severest depressions in each of the two groups did not reveal any difference in the therapeutic effect of the two methods of treatment.

It is concluded that the technique with four treatments per week instead of two offers the advantage that the duration of the treatment period is reduced by 11–12 days. As the study also revealed that the discomforts, including memory impairment, are not increased by frequent stimulation, it is recommended that unilateral ECT is administered with a frequency of four treatments per week.
DEPRESSION: PREDISPOSING FACTORS
Authors: Nyström S. , Lindegård B.
Published: August 2007

Factors predisposing to a depressive state had been investigated in a prospective study on a stratified population, accounted for in the preceding article (Nyström & Lindegård (1975a)).

Of the 114 persons seeking psychiatric care during the period of observation, 37 had a depression as the main diagnosis. As compared to their 370 matched controls, these patients showed a significant overrepresentation of psychasthenic traits (subvalidity according to Sjöbring), a tendency to ruminate, shyness in company and lack of endurance, certain asthenic subclinical symptoms such as habitual fatigue and irritability, certain depressive subclinical phenomena, various expressions of anxiousness, all kinds of insomnia, and certain forms of medical care and examinations.

The findings can be used for mental hygienic purposes. It can be recommended that the environmental pressure within occupational as well as within private life, should be kept as low as possible, especially for persons with characteristics shown to indicate mental vulnerability.
A COMPARATIVE TRIAL OF FLUPHENAZINE DECANOATE AND FLUPENTHIXOL DECANOATE
Authors: Haslam M. T. , Bromham B. M. , Schiff A. A.
Published: August 2007

A double‐blind cross‐over study is reported which compares the antipsychotic properties and the side effects of depot flupenthixol with fluphenazine decanoate in chronic schizophrenic inpatients. Special emphasis was laid on examining changes in the target symptoms of apathy/anergia and depression in which flupenthixol has been claimed to be particularly effective.

No significant differences were found between treatments on schizophrenic symptoms, or as regards the extrapyramidal side effects produced by equipotent doses of the two drugs.

Reasons for the essentially negative results are discussed against a background review of earlier optimistic studies of flupenthixol.
PLASMA AND ERYTHROCYTE MAGNESIUM LEVELS IN PATIENTS WITH PRIMARY AFFECTIVE DISORDER DURING CHRONIC LITHIUM TREATMENT
Authors: Dunner D. L. , Meltzer H. L. , Schreiner H. C. , Feigelson J. L.
Published: August 2007

Plasma and erythrocyte magnesium concentrations were measured in 79 clinic outpatients who had histories of bipolar or unipolar primary affective disorder and who were being chronically treated with lithium carbonate (60 patients) or placebo (19 patients). Although slight differences in the mean concentration of magnesium in plasma and erythrocytes were noted with lithium treatment, diagnosis, and sex, the differences overall failed to achieve statistical significance. In contrast to prior reports demonstrating increases in plasma magnesium during acute lithium carbonate treatment of affectively ill patients, these data suggest that the pre‐lithium steady state is achieved during chronic lithium treatment.
THE CONCEPTS: DISTURBED STATE OF CONSCIOUSNESS AND PSYCHOSIS
Authors: Aggernæs A.
Published: August 2007

A theoretical analysis is made of the two concepts: “disturbed state of consciousness” (DSC) and “psychosis”, and these concepts are defined in ways which are consistent with actual clinical psychiatric work on the Continent.

Concerning DSC's two points are emphasized: Whether we, as psychiatrists, are conscious of it or not ‐ one of our premisses for classifying a state as a pathological DSC is an evaluation of the client's ability to change the state voluntarily. Furthermore, stating that a DSC was present in the time interval t1‐tn implies stating that all experiences were abnormal in some way during the interval ‐ when the word “experience” is taken in the broad sense, including William James' “fringe” and “embeddedness” in the stream of consciousness.

Reality testing may remain the cardinal point in the definition of “psychosis” ‐ if we make the distinction between theoretical, “fullblown”, syndromes and concrete syndromes with fewer symptoms clear to ourselves.
DEPOSITS IN THE LENS AND CORNEA OF THE EYE DURING LONG‐TERM CHLORPROMAZINE MEDICATION
Authors: Rasmussen K. , Kirk L. , Faurbye A.
Published: August 2007

Thirty patients on long‐term treatment with chlorpromazine in moderate doses showed deposits in the lens, and the majority of the patients also showed deposits in the cornea.

These deposits did not increase in the 13 patients who continued on chlorpromazine during an observation period of 31/2 years. Thus, when chlorpromazine is used in moderate doses, the deposits in the eyes seem to increase only up to a certain extent.

Twelve patients who were switched over to thioridazine showed no change in the deposition in the lens and cornea after the observation period, indicating that the deposits are irreversible.

After the observation period visual acuity had deteriorated somewhat in the material as a whole, presumably because of advancing age, not because of the deposits.

The risk of using chlorpromazine in moderate dosage is slight.
DETERMINATION OF MONOAMINE AND MONOAMINE METABOLITES IN THE HUMAN BRAIN: POST MORTEM STUDIES IN A GROUP OF SUICIDES AND IN A CONTROL GROUP
Authors: Beskow J. , Gottfries C. G. , Roos B. E. , Winblad B.
Published: August 2007

Different nuclei and regions of the brain from patients who had committed suicide and from controls were analysed for their content of monoamine and monoamine metabolites.

There was a post mortem breakdown of 5‐hydroxyindoleacetic acid (5‐HIAA) which could be correlated to the time elapsed between the occurrence of death and autopsy. Homovanillic acid (HVA) and the monoamines did not decrease post mortem during the time observed (6–148 hours). There was no significant correlation between age and chemical variables in this investigation.

There were no significant group differences between suicides and controls concerning dopamine, noradrenaline, 5‐hydroxytryptamine, and HVA, 5‐HIAA levels were significantly lower in the suicide group in six out of eight parts of the brain investigated. It was, however, also demonstrated that there was a longer time elapse between the occurrence of death and autopsy in the suicide group. The suicides came on average 48 hours later to autopsy than the controls. As there was a post mortem decrease of 5‐HIAA, this time variable had to be kept constant when group differences were analysed. When the influence of this time variable had to be kept constant when group differences were analysed. When the influence of this time variable was eliminated there were no longer any differences between suicides and controls.

According to this investigation, there seem to be no differences in levels of monoamines and their metabolites between suicides and controls.
LITHIUM MAINTENANCE TREATMENT OF MANIC‐MELANCHOLIC PATIENTS: ITS ROLE IN THE DAILY ROUTINE
Authors: Bech P. , Vendsborg P. B. , Rafaelsen O. J.
Published: August 2007

The purpose of this study was to evaluate the desired and undesired effects of relapse‐preventive lithium treatment given routinely to manic‐melancholic patients who had accepted the necessity of a strict tablet regime. The evaluation was based upon case record data and various rating scales, and 76 patients took part in the investigation. Our results showed that in 24 % of the patients treatment was discontinued. This was due to side effects in 16 % and to insufficient effect in 8% of the cases. The suicide risk was not eliminated, and 29 % of the patients were receiving additional antidepressive or antimanic treatment at the test day. On the other hand, 78 % of the patients rated the relapse‐preventive lithium effect as moderate to excellent. Indirect evidence was obtained in support o a stabilizing effect of lithium on the emotional control in bipolar patients. The most frquent complaints during lithium treatment were tremor and increased thirst.
TREATMENT OF VAGINISMUS BY I. V. DIAZEPAM (VALIUM®) ABREACTION INTERVIEWS
Authors: Mikhail A. R.
Published: August 2007

A new method of treatment of vaginismus by using intravenous diazepam abreaction interviews is reported. Four patients between the ages of 19 and 28 were interviewed. The duration of their main complaint varied from 6 months to 3 years. Three to six abreaction interviews were conducted; the maximum dosage of Valium® used was from 20–30 mg. All of these patients reported having successful intercourse after these interviews. Individual psychotherapy continued after the interviews on a weekly basis, and marital therapy on a monthly basis, for a period of 2 to 6 months. Three out of four women reported being orgasmic for the first time. It is the opinion of the author that this new method of treatment of vaginismus is greatly beneficial.
AMBULANT TREATMENT OF ALCOHOL WITHDRAWAL SYMPTOMS WITH CARBAMAZEPINE: A FORMAL MULTICENTRE DOUBLE‐BLIND COMPARISON WITH PLACEBO
Authors: Björkqvist S. ‐E. , Isohanni M. , Mäkelä R. , Malinen L.
Published: August 2007

One hundred male out‐patients were treated for alcohol withdrawal symptoms with either carbamazepine or placebo in a double‐blind, multicentre trial carried out at five Finnish A‐clinics (alcoholism treatment centres) in different parts of the country. In both the carbamazepine and the placebo groups two thirds of the patients completed the 7‐day treatment successfully, and the final treatment results were considered equally good in both groups. However, the withdrawal symptoms, especially the sleep disturbances, subsided faster in the carbamazepine group than in the placebo group. The change in the total symptom score from the first day of treatment to the second was significantly greater in the carbamazepine group than in the placebo group. The patients' ability to work improved significantly faster in the carbamazepine group.
A TEN ‐ YEAR FOLLOW ‐ UP OF CHILDREN OF SCHIZOPHRENIC MOTHERS CLINICAL ASSESSMENT
Authors: Schulsinger H.
Published: August 2007

A group of 207 subjects with severely schizophrenic mothers and a matched group of 104 subjects without known mental illness in the parents or grandparents have been followed since 1962 in a prospective study based on Mednick's learning theory of schizophrenia. The present paper describes an analysis of the clinical outcome based on a follow‐up examination in 1972–1974. The examination consisted of a 3 1/2‐hour clinical interview using three approaches (two with computer‐derived diagnoses and one traditional clinical interview). 173 high‐risk and 91 low‐risk subjects were fully clinically reassessed. At the time of the assessment they were between 18 and 30 years old. The diagnostic distribution showed marked differences between the two groups with regard to type and degree of psychopathology.

The results are discussed in relation to the methods used, and with regard to the case and non‐case status of the subjects.
EMOTIONAL DISORDERS IN SIX ISRAELI VILLAGES
Authors: Levav I. , Arnon A.
Published: August 2007

This is a report on a psychiatric epidemiological census conducted in six Israeli villages. The method of case identification relied on data extracted from medical cards and the use of two shortened versions of the CMI. The results showed a distribution affected by sex, age, ethnicity, education, and “status consumer”. A comparison with other Israeli studies is made.
Controlled trial of penfluridol and thiothixene in the maintenance treatment of chronic schizophrenic syndromes
Authors: Jacobsson L. , von Knorring L. , Mattsson B. , Perris C. , Rapp W. , Edenius B. , Kettner B. , Magnusson K. E. , Villemoes P.
Published: August 2007

In a controlled trial of penfluridol and thiothixene as maintenance drugs in patients with chronic schizophrenic syndromes, some improvement over previous neuroleptics was seen with both drugs. This improvement was mainly evident in variables concerned with participation in social activities as assessed with the S‐scale and by ward behaviour. The drug dosages necessary were very low and gave few and easily manageable side‐effects. There was no significant difference between penfluridol and thiothixene. Penfluridol has the clear practical advantage of being the only long‐acting drug for oral administration so far available.
Birthday blues: The association of birthday with self‐inflicted death in the elderly
Authors: Barraclough B. M. , Shepherd D. M.
Published: August 2007

An excess of deaths was observed in the 30 days before and after a birthday for a sample of self‐inflicted deaths aged 75 and over.
Differential fertility of adopted schizophrenics and their half‐siblings
Authors: Rimmer J. , Jacobsen B.
Published: August 2007

The paper presents data on the differential fertility of schizophrenics and controls, and the fertility of their siblings. This study used several methodological procedures in the study of schizophrenia reproduction, which strengthens the validity of the findings. Firstly, both male and female rates were examined. Secondly, the method of selection of a control avoided the biases introduced by using census data or other non‐matched controls. Third, a diagnostic criterion was used which minimizes the possibility of the inclusion of other psychiatric illnesses.

The results obtained support prior reports of the lowered reproductive rates of schizophrenics. Further, the siblings of schizophrenics were found not to have a reproductive advantage when contrasted to control siblings. The failure to find a reproductive advantage conflicts with a hypothesis of a balanced polymorphism as the mechanism maintaining an apparent constant rate of schizophrenia.
Urbanization and psychiatric disorders ‐ the Hong Kong scene
Authors: Lo W. H.
Published: August 2007

Indices were used to portray the rapidity and intensity of urbanization Hong Kong had undergone in the past 2–3 decades. Next the preliminary result of a psychiatric survey was quoted as an estimate of mental ill‐health in Hong Kong. Data were obtained from the Mental Health Service to show the increasing demand for psychiatric care for the past 25 years. Attempts were made to analyze the basic composition of the new patients attending a psychiatric centre during this period.

High density living associated with urbanization in Hong Kong was found to generate a high level of emotional strain, and psychiatric ill‐health was as prevalent as that in New York. Neuroses were on the increase and psychiatrists were being consulted on a wider variety of problems. Provision of mental health care in future should take the changes in the composition of psychiatric populations into consideration.