Effect of generous funding for AIDS research on general biomedical research.
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Acquired Immunodeficiency Syndrome↗
Biomedical subjects
J A Coffman
Publications and source records attributed to J A Coffman.
Antipsychotic withdrawal phenomena in the medical-surgical setting.
The literature describing nondyskinetic antipsychotic withdrawal symptoms is reviewed. The withdrawal of antipsychotic agents can result in nausea, emesis, anorexia, diarrhea, rhinorrhea, diaphoresis, myalgias, paresthesias, anxiety, agitation, restlessness, and insomnia. Psychotic relapse is often presaged by increased anxiety, agitation, restlessness, and insomnia. However, the temporal relationship of these prodromal symptoms to reduction in the dosage or discontinuation of neuroleptics distinguishes them from the effects of abrupt withdrawal.
Antidepressive Agents↗
Hypertension and depression: question of a causal relationship persists.
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Bipolar Disorder↗
Cholinergic mechanisms in delirium.
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Amoxapine↗
Seasonal depression.
Seasonal affective disorders are mood disturbances that occur with a change in season. The most common form is winter depression, marked by sadness, anxiety, decreased physical activity, increased appetite, carbohydrate craving, weight gain, hypersomnia, decreased libido, worsening of premenstrual symptoms, impaired work performance and interpersonal conflict. This syndrome often responds to daily exposure to bright artificial light.
Antidepressive Agents↗
Microtubule assembly kinetics. Changes with solution conditions.
The assembly kinetics of microtubule protein are altered by ionic strength, temperature and Mg2+, but not by pH. High ionic strength (I0.2), low temperature (T less than 30 degrees C) and elevated Mg2+ (greater than or equal to 1.2 mM) induce a transition from biphasic to monophasic kinetics. Comparison of the activation energy obtained for the fast biphasic step at low ionic strength (I0.069) shows excellent agreement with the values obtained at high ionic strength, low temperature and elevated Mg2+. From this observation it can be implied that the tubulin-containing reactant of the fast biphasic event is also the species that elongates microtubules during monophasic assembly. Second-order rate constants for biphasic assembly are 3.82(+/- 0.72) x 10(7) M-1.s-1 and 5.19(+/- 1.25) x 10(6) M-1.s-1, and for monophasic assembly the rate constant is 2.12(+/- 0.56) x 10(7) M-1.s-1. The microtubule number concentration is constant during elongation of microtubules for biphasic and monophasic assembly.
Animals↗
Right vs. left hemispheric blood-brain barrier permeability in schizophrenia: a dynamic computed tomographic study.
Dynamic computerized tomographic brain scanning was used to make determinations of mean cerebral tissue nonenhanced density and contrast-enhanced density in 10 bilateral brain regions in 10 psychotic subjects. Asymmetry of both nonenhanced and contrast-enhanced density was observed; left regional nonenhanced values were higher than right, whereas contrast-enhanced density values were higher on the right than on the left. No significant differences were observed in arterial mean transit time (AMTT) between right and left middle cerebral artery branches or in capillary or tissue mean transit time (CMTT) in the middle temporal cortex. However, corrected CMTT (CCMTT), i.e., CMTT minus AMTT, may have been prolonged in five subjects either on the left or right, or in both homologous regions. Only 2 of 10 subjects exhibited anterior-posterior (AP) gradients that resembled to some extent the hyperfrontal pattern reported in normal subjects by other investigators with different techniques.
Adult↗
Differences between schizophrenics and controls in CT-measured radiodensity of samples from the anterior corpus callosum.
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Corpus Callosum↗
Clinical effectiveness of oral and parenteral rapid neuroleptization.
A random assignment, double-blind, placebo-controlled evaluation was used to compare the effectiveness of rapid parenteral injections of fluphenazine hydrochloride with that of oral doses of the same drug in 16 patients with acute psychotic illnesses. Doses of fluphenazine hydrochloride were much higher in the parenteral neuroleptization group than in the oral administration group during the acute phase, although oral doses were equivalent during the continuation phase. The rate of improvement was not different for the two groups, but the rate of extrapyramidal side effects was higher in the parenteral neuroleptization group. The results suggest that rapid parenteral neuroleptization for the acute treatment of psychosis offers more risks than benefits.
Acute Disease↗
Structural abnormalities in the frontal system in schizophrenia. A magnetic resonance imaging study.
Thirty-eight schizophrenics and 49 normal controls underwent magnetic resonance imaging. Midline sagittal cuts indicated that the schizophrenics had significantly smaller frontal lobes, as well as smaller cerebrums and craniums. The findings are consistent with some type of early developmental abnormality that might retard brain growth and therefore skull growth. These findings are confirmed on a smaller sample of patients on whom we have coronal cuts. Decreased cerebral and cranial size are associated with prominent negative symptoms, although decreased frontal size is not. Decreased cranial and cerebral size was also associated with impairment on some cognitive tests. These findings are consistent with the hypothesis that some schizophrenics may have a type of early developmental abnormality associated with prominent negative symptoms and cognitive impairment. Further, the results suggest that schizophrenics may have a type of structural frontal system impairment. Thus, they provide anatomic evidence for the "hypofrontality hypothesis."
Adult↗
A controlled magnetic resonance imaging study of corpus callosum thickness in schizophrenia.
Two previous postmortem studies reported an increased thickness of the corpus callosum in schizophrenic patients compared to psychiatric controls. We report an in vivo study of the corpus callosum in schizophrenic patients (n = 38) and healthy controls (n = 41) using magnetic resonance (MR) brain imaging. A significant increase in mean callosal thickness was found in the middle and anterior, but not the posterior, parts of the callosal body. However, when the patients and controls were compared by gender and handedness, schizophrenic men were found not to differ from control men in callosal thickness, regardless of handedness, whereas schizophrenic women were found to have a highly significant increase in callosal middle and anterior thickness compared to control women. The data suggest that increased callosal thickness in schizophrenia is gender related, a factor that is not considered by postmortem studies. The implications of increased callosal dimensions in female schizophrenics are discussed.
Adult↗
Opiate antagonism fails to reverse post-ECT cognitive deficits.
The opiate antagonist naloxone has been reported to improve memory in animals and to produce partial improvement in Alzheimer's dementia. The usefulness of naloxone for reversing ECT-induced cognitive impairment was tested by comparing the effects of naloxone and placebo on several tests of cognitive performance in 10 patients who underwent bilateral ECT. No significant differences were found between naloxone and placebo. The results suggest that at the doses used, naloxone is not effective in reversing ECT-induced memory deficits.
Adult↗
Echocardiographic assessment of schizophrenics and manics: a reexamination of early necropsy findings.
Postmortem evaluation of schizophrenic patients earlier this century demonstrated relatively consistent findings of hypoplasia of the heart and great vessels. No recent attempts have been made, to our knowledge, to replicate these results. In vivo assessment of the left heart and aorta by M-mode echocardiographic examination seemed likely to provide an opportunity to investigate the relationship of major psychiatric illness to heart size and aortic diameter. Twenty-two chronic schizophrenics (mean age 31.5 years), 17 manics (mean age 30.9 years), and 14 normal volunteers (mean age 29.1 years) consented to echocardiographic examination. Patients were diagnosed by DSM-III criteria. Individuals with any history of cardiovascular disease or alcohol abuse were excluded. No statistically significant differences emerged among the groups in measures of left atrial, aortic root, or end-diastolic left ventricular diameters. Our results did not support previously reported autopsy findings. Implications of the relationship of chronic institutionalization and chronic neuroleptic treatment to heart and great vessel dimensions are discussed.
Adult↗
Relationships between brain density, cortical atrophy and ventriculomegaly in schizophrenia and mania.
A number of parameters assessed by computed tomography have been shown to differentiate between populations of psychiatric patients and normal controls. Changes in these parameters have been felt to result from atrophic processes. We hypothesized that changes in one parameter ought to result in related changes in another if they result from the same process. We tested this hypothesis by comparing CT scan results of density measurement with area and linear measurements of ventricular size and radiological assessments of cortical and cerebellar atrophy. Our results indicate that few statistically significant relationships appear to be present, the only such relationship being found between increased third ventricular size and cerebellar atrophy. We conclude that regional changes in brain density are not necessarily correlated with local changes in CSF volume, which suggests the involvement of disparate processes in their causation.
Adult↗
Plasma GABA levels in chronic alcoholics.
Ethanol intoxication has been noted to cause marked changes in brain and CSF levels of gamma-aminobutyric acid (GABA). Using plasma GABA levels to assess brain GABA activity, the authors found that 85 chronic alcoholics had significantly lower levels than control subjects.
Adult↗
Pseudoseizures.
Pseudoseizures have been historically, and continue to be, a challenging diagnostic and therapeutic problem. This paper reviews the literature relevant to these difficulties. The interplay of psychiatry and neurology in this disorder is discussed, with special attention to diagnostic issues. In addition, several matters relating to associated psychopathology and treatment are raised.
Diagnosis, Differential↗
Effects of naloxone on cognitive deficits following electroconvulsive therapy.
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Adult↗