PubMed · 7953300
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G Jossart, A Siperstein. 1994. Laparoscopic appendectomy.. https://pubmed.ncbi.nlm.nih.gov/7953300/
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There is increasing evidence that central noradrenaline (NA) transport mechanisms are implicated in the central nervous system complications of acute liver failure. In order to assess this possibility, binding sites for the high affinity NA transporter ligand [3H]-nisoxetine were measured by quantitative receptor autoradiography in the brains of rats with acute liver failure resulting from hepatic devascularization and in appropriate controls. In vivo microdialysis was used to measure extracellular brain concentrations of NA. Severe encephalopathy resulted in a significant loss of [3H]-nisoxetine sites in frontal cortex and a concomitant increase in extracellular brain concentrations of NA in rats with acute liver failure. A loss of transporter sites was also observed in thalamus of rats with acute liver failure. This loss of NA transporter sites could result from depletion of central NA stores due to a reserpine-like effect of ammonia which is known to accumulate to millimolar concentrations in brain in ischemic liver failure. Impaired NA transport and the consequent increase in synaptic concentrations and increased stimulation of neuronal and astrocytic noradrenergic receptors could be implicated in the pathogenesis of the encephalopathy and brain edema characteristic of acute liver failure.
The present study examined latent inhibition (LI) effects in 17 acute and 16 partially remitted schizophrenic patients, and in 20 healthy controls, by measuring manual response latencies and event-related potentials (ERPs) during an association learning task. ERPs were recorded to elucidate the role of attention in the LI effect. Subjects performed a go/no-go task with an auditory conditional stimulus predicting a visual go command. Half of the subjects in each diagnostic group were pre-exposed to the conditional stimulus which had been used as an irrelevant distractor in a preceding discrimination task. Independent of diagnostic group membership, pre-exposed subjects showed slower manual responses to go stimuli than non-pre-exposed subjects, reflecting a robust LI effect. The N100 wave after the conditional stimuli, however, showed a differential pattern: pre-exposure increased N100 amplitudes in acute schizophrenics, whereas pre-exposed control subjects showed a trend for decreased N100. The amplitude of the contingent negative variation (CNV) was unaffected by pre-exposure. The ERP results suggest that acute schizophrenics have a deficit in learned inattention to irrelevant stimuli. However, the intact LI effect in schizophrenics at the motor speed level shows that human LI is a complex phenomenon depending on the tasks and measures used.
OBJECTIVE: This study sought to evaluate levels of insight and change in insight in subjects with schizophrenia and other major psychiatric disorders. This study also evaluated the relationship of insight to acute psychopathology. METHOD: One-hundred and eighty-seven subjects consecutively admitted to an acute care psychiatric unit and who met DSM-III-R criteria were evaluated by the Insight and Treatment Attitudes Questionnaire and Brief Psychiatric Rating Scale on admission and discharge. Relationships of insight to diagnosis, involuntary commitment status and change in insight were evaluated with analysis of variance and post hoc Tukey's Standardized Range test. Relationships of change in insight and symptoms were evaluated with analysis of covariance (ANCOVA) and correlation. RESULTS: Insight deficits were more prevalent in schizophrenia, a mixed group of other psychosis and bipolar disorder as compared with major depressive and schizoaffective disorder. Committed patients had lower insight. Insight improved across diagnoses during hospital care in both voluntary and committed patients. Significant relationships between improved symptoms and improved insight were obtained in the bipolar, schizophrenia and major depressive groups. CONCLUSION: Insight deficits are prevalent in schizophrenia and bipolar disorder. Many patients show improved insight as their acute symptoms improve. Some aspects of insight are state related during exacerbation of illness in patients with schizophrenia and bipolar disorder.