Biomedical subjects
Publications and source records attributed to H Wijsenbeek.
The association between musical hallucinations, depression and acquired hearing loss is described in two elderly patients. Following the presentation of this underdiagnosed clinical phenomenon we propose that musical hallucinations should be addressed as a final outcome of several factors including both mental and physical components. This conceptual framework enhances our understanding and treatment of such phenomena.
The involvement of the hypothalamic dopaminergic pathway in the treatment of anorexia nervosa (AN) was evaluated by monitoring the serum prolactin (PRL) levels in 10 adolescent anorectic females. 5 patients were treated by behavior therapy program and 5 were treated with pimozide, an antidopaminergic drug. The study was conducted for a period of 20 weeks. Elevation of PRL levels was used as an indicator of antidopaminergic activity. PRL was increased in the 5 patients receiving the antidopaminergic agent, while no elevation was observed in the patients undergoing behavior therapy. All 10 patients were treated successfully as expressed by their gradual gain in weight. It is concluded that antidopaminergic activity does not seem to be a prerequisite for clinical improvement.
Thirteen acute schizophrenic patients aged 14-18 years were treated with gradually increasing doses of diazepam to a maximum of 100-400 mg/day/p.o. with a total duration of treatment of 4 weeks. The clinical antipsychotic effect was evaluated by the Brief Psychiatric Rating Scale (BPRS), while the impact on the hypothalamic hypophyseal pathway was evaluated by monitoring the serum prolactin levels (SPL) determined by a highly sensitive homologous radioimmunoassay (RIA). High diazepam doses (100-400 mg/day) caused sedation but no clinical antipsychotic effect was observed. Diazepam treatment with doses up to 250 mg/day caused no significant rise in SPL, while the treatment with doses of higher than 250 mg/day resulted in a mild but still significant increase in SPL. The clinical and laboratory data suggest that diazepam has no direct antidopaminergic activity. The mild hyperprolactinemia achieved with the extremely high doses of diazepam (greater than 250 mg/day) is possibly due to activation of the GABA system which stimulates prolactin release directly or by inhibiting the dopaminergic neurons or alternatively to activation of the endorphinergic system.
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Fifty-nine uremic patients (38 males and 21 females) maintained on chronic hemodialysis (CHD) served as the subjects in a study of the relationship between sexual dysfunction and serum prolactin levels (SPL). Sexual desire and activity were evaluated by a self-report sexual function rating scale (SFRS). About half the population of this study reported sexual dysfunction. Males and females reporting disturbance of sexual function had significantly higher SPL than those with normal sexual function. Bromocriptine treatment in five hyperprolactinemic patients reduced SPL to normal range and improved the sexual function. Association between sexual dysfunction and hyperprolactinemia in uremic patients is suggested.
Serum prolactin levels and sexual function were evaluated in 28 men from 60 to 64 years of age and in 44 men from 65 to 70 years of age. All subjects were married, physically healthy, and had no psychopathology or marital problem. About a third of the men aged 60 to 70 years suffered from impotence. No obvious correlation between elevated levels of serum prolactin and impotence was obtained. Subjects aged 65 to 70 who had decreased libido exhibited a significant elevation of serum prolactin levels, while subjects of the same age group who had reserved (normal) libido appeared to have low serum prolactin levels. Nine of ten men aged 60 to 70 years with serum prolactin levels above 40 ng/ml reported decreased libido. Potent men of both age groups (60-70 years) with high prolactin levels showed a tendency to have a decrease in frequency of sexual intercourse. Thus, it seems that mild hyperprolactinemia in aging men may be associated with decreased sexual desire and frequency of sexual activity.
We show that there is a body image of an internal organ--the brain. Using questionnaires and drawings to compare three groups--healthy subjects, acutely ill and chronic patients (with a brain disease)--we demonstrate that there is constant body image, which is very little influenced by brain disease.
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The active uptake of serotonin (5-HT) blood platelets of 20 schizophrenic patients and their families was studied. The uptake was studied over a wide range of 5-HT concentrations (0.1-20 microM), and Km and Vmax of the uptake process were calculated. Of 20 patients, 18 exhibited a lower rate of uptake than the family average at 5-HT concentrations lower than the Km value. At a 5-HT concentration of 0.1 microM, the average 5-HT uptake of patients was 2.15 pmol/10(8) platelets/min, while that of families was 2.99 pmol/10(8) platelets/min (33% difference). At a high 5-HT concentration, only the drug-treated patients had lower Vmax than the family average, and this might be attributed to the effect of the drugs. Km of patients and families were very similar. In eight families, one or more of the family members showed 5-HT uptake patterns very similar to that of the patient. We termed these healthy family members "schizophrenic risks". Our findings indicate the involvement of some genetic factors in this disease.
Active uptake of serotonin (5-HT) by blood platelets with bipolar primary affective disorder-bipolar type has been compared to that of their family members and healthy controls, and Km and Vmax values were calculated for each subject. The uptake of patients' platelets, as reflected by Vmax, was found to be significantly higher than that of healthy controls (P less than 0.05) and non significantly higher than that of family members (P less than 0.05). The average value obtained (in pmol/10(8) platelets/5 min) were 253.4 (patients), 199.7 (families), and 171.5 (controls). The increased uptake by patients' platelets was not dependent on the state of disease. In two families, daughters of the patients exhibited the same uptake pattern as their ill mothers. The Km values for patients, family members, and controls were all about 1.06 x 10(-6) M. This study raises the possibility that the differences between patients and healthy individuals might be attributed to genetic factors. The meaning and interpretation of the findings are discussed.
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Cell-mediated immune response to human myelin basic protein was studied by the macrophage migration inhibition factor test in 17 autistic patients and a control group of 11 patients suffering from other mental diseases included in the differential diagnosis of the syndrome of autism. Of the 17 autistic patients, 13 demonstrated inhibition of macrophage migration, whereas none of the nonautistic patients showed such a response. The results indicate the existence of a cell-mediated immune response to brain tissue in the syndrome of autism.
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