Saccadic reaction times in acute and remitted schizophrenics

Summary Schizophrenics are known to have various disturbances of the visuomotor system. Whereas smooth pursuit eye movement disorders have been repeatedly confirmed, there are relatively few reports regarding possible disturbances of the saccadic system. In this study, the saccadic reaction times of 47 schizophrenic inpatients were investigated upon admission and later in the remitted state; 28 age- and sex-matched normal volunteers were tested as controls. Psychopathology and outcome were evaluated according to the Brief Psychiatric Rating Scale and the Prognostic Scale. Light stimuli were presented at random direction, location (ranging from 0° to 20°) and duration (800, 1000, and 1200 ms). The eye movements were recorded by electro-oculography. Compared with the control group, schizophrenics revealed prolonged saccadic reaction times, which correlated with pronounced negative symptoms and an unfavourable course of the illness. The saccadic reaction times remained prolonged in schizophrenic patients. These findings suggest attentional deficits in schizophrenics.This article was presented in part at the Symposium on Eye Movements and Psychopathology, Berlin, 23–24 June 1988     

Delayed expression of NADPH-diaphorase in rat brain after administration of the cholinotoxin AF64A

Administration of cholinotoxin etylcholine aziridinium (AF64A) into the brain selectively induces nonrever-sible cholinergic deficit. Wistar rats were injected intracerebroventricularly bilaterally with AF64A at doses of 1–3 nmol/ventricle. 28 days later the number of neurons survived was counted in dorsolateral, intermediate and medial groups of cells of the medial septum. AF64A induced a decrease in neuronal density and expression of cholineacetyl transferase at all doses used as well as in all regions studied. Brain sections were also stained for NADPH-diaphorase representing neuronal NO-synthase. Effects of AF64A on NADPH-diaphorase expression depended on the region studied. The number of NADPH-diaphorase-positive cells increased in the medial cellular group where more cholineacetly transferase-positive cells survived. In contrast, decrease in NADPH-diaphorase expression in the dorsolateral group of cells coincided with low level of cholineacetyltransferase-po-sitive neurons. The data presented suggest that in the AF64A-dependent model of neurodegeneration NO may play a neuroprotective function.     

General and specific cognitive deficits in schizophrenia.

BACKGROUND: It is controversial whether the cognitive deficit in schizophrenia is better characterized as generalized or as reflecting relatively independent deficits in different cognitive domains. The issue has implications for assessment practice, intervention design, and the exploration of schizophrenia genetics. METHODS: We used a specialized structural equation modeling approach, single common factor analysis, to explore the relative importance of generalized versus independent cognitive deficits in schizophrenia. Eighteen subtest scores from the Wechsler Adult Intelligence Scale-III and the Wechsler Memory Scale-III were included in the analysis. We analyzed these data for 97 schizophrenia or schizoaffective disorder outpatients and 87 healthy control subjects. RESULTS: Approximately two thirds of the overall effect of a schizophrenia diagnosis on cognitive performance was mediated through a single common factor. The Wechsler subtest scores showed almost uniformly strong relationships with this factor. The independent associations of group status with the subtest scores were smaller in magnitude and only selectively significant. CONCLUSIONS: The relatively greater magnitude of illness effects mediated through the common factor in this analysis, compared with the specific, independent effects, suggests that a generalized cognitive deficit is a core feature of schizophrenia.     

Perioperative specific management of blood volume loss in craniosynostosis surgery

Accurate assessment and replacement of blood loss and fluid–electrolyte deficit during craniosynostosis repair is difficult owing to patient size and the diversity of surgical technique. Forty-three patients undergoing primary craniosynostosis repair over a 10-year period were studied retrospectively to determine blood loss and fluid deficit and to assess blood transfusion practices during both intraoperative and postoperative periods. Blood loss was calculated on the basis of estimated red cell mass (ERCM) and fluid-electrolyte imbalance was investigated with blood samplings. Blood transfusion was considered appropriate if the postoperative or posttransfusion ERCM was within 12% of the preoperative value. Estimated fluid requirement (EFR) was used in 4 ml kg^–1 h^–1 except for neonates. Intraoperatively, 80% of all patients were appropriately managed with respect to blood transfusion and EFR. Postoperatively only 20% of the patients receiving transfusions were transfused appropriately. In 23.3% of these patients (10/43) unexpected respiratory distress developed immediately after their recovery from the anesthesia. With the measurement of estimated blood volume and allowable blood loss, appropriate transfusion could be achieved for the successful treatment of the primary craniosynostosis. Received: 16 February 1998     

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目的通过对比合并与不合并注意缺陷多动障碍(ADHD)的阻塞性睡眠呼吸暂停低通气综合征(OSAHS)儿童的多导睡眠监测指标,试图从睡眠结构和睡眠主要参数的层次上来探讨ADHD的发病机制。方法选择2004-01—2006-10于广州市儿童医院就诊的OSAHS患儿36例作为OSAHS组,合并有OSAHS的ADHD患儿20例作为观察组,选取无OSAHS及ADHD的儿童30例作为对照组,三组之间在年龄、性别、体重指数等方面相比,差异无显著性。通过多导睡眠监测(PSG),并由神经康复科专科医生对其是否患有ADHD作出诊断。采用相应的统计学方法,对OSAHS组、观察组及对照组的睡眠结构进行比较,并对OSAHS组和观察组进行呼吸事件及血氧状况的比较。结果(1)与对照组相比,OSAHS组及观察组睡眠Ⅰ期增加,睡眠Ⅱ期、SWS及REM睡眠减少,差异有统计学意义(P<0.05),OSAHS组的REM%为8.66±3.94,观察组的REM%为5.65±5.41,REM%的改变有统计学意义(P<0.05)。(2)观察组儿童呼吸事件的次数与持续时间及血氧饱和度下降较OSAHS儿童严重,差异有统计学意义(P<0.05)。结论观察组儿童REM%及血氧饱和度的下降可能在ADHD的发病中起一定的作用。     

动脉瘤术后血管痉挛的综合治疗(附284例报告)

目的总结动脉瘤手术后血管痉挛及延迟性缺血性神经功能障碍(DIND)的防治经验。方法回顾性分析284例接受颅内动脉瘤夹闭术病人的临床资料,对颅多普勒超声(TCD)的结果与DIND的发生情况进行统计分析。结果137例病人手术后发生血管痉挛,79例发生DIND。TCD所示血流速度与DIND的发生有密切的相关关系。经治疗,62例DIND病人(78.5%)症状消失。病死率2.5%。结论血管痉挛是导致DIND的主要因素,个体化的综合治疗能明显提高疗效。     

Early parental adjustment to visible congenital disfigurement

Summary When a baby is born with a visible disfigurement, then parents need to adjust to the loss of the anticipated 'perfect' child and thus accept their baby. The impact of the birth on the parents is described in the context of a measure which identifies areas of potential difficulty. The two groups studied were parents of children with cleft palates and parents of children with congenital hand deficit. A wide range of adjustment was found. There was no significant difference between the two groups in terms of their overall adjustment, but there were individual differences in adjustment which did not relate to the severity or type of anomaly. The only significant variable found to relate to parental adjustment was perceived family support.