Differential effects of a new dibenzo-epine neuroleptic compared with haloperidol. Results of an open and crossover study

Fluperlapine (NB-106-689) was tested on 26 schizophrenic patients in an open and crossover study. In addition to its good antipsychotic effect, it also alleviated the apathic and depressive syndromes. Six patients who had shown only slight or no improvement after 4 weeks of haloperidol therapy responded positively to fluperlapine. The alleviation of the anergic syndrome was especially impressive. The therapeutic response of the depressive-apathic syndromes could represent an important extension of pharmacotherapy for schizophrenia. The virtual lack of extrapyramidal motor side effects with fluperlapine supports an intensification of the search for other nonclassic dibenzo-epine neuroleptics.     

Utilization of screening mammography: comparison of different physician specialties

Data obtained on 426 consecutive patients referred to a breast center by 122 physicians, including family practitioners, general surgeons, and other specialists, showed that the obstetricians-gynecologists referred the greatest average number of patients per physician, with more than 50% of these referrals for screening mammography. Internists referred fewer patients by nearly a factor of ten, with only one-third of these patients referred for screening mammography. Internists may be the weakest link in the utilization of screening mammography.     

Perioperative short-term preventive antibiotics in head-neck surgery

A prospective perioperative trial with cefotiam and metronidazol was carried out in 114 patients undergoing head and neck surgery. The patients were stratified in one group receiving a single-dose prophylaxis and a second group receiving a 24-hour prophylaxis. The postoperative complication rates were analysed depending on various risk factors and the size and duration of surgery. For operations of similar size the long term prophylaxis had no advantage over the one-dose prophylaxis. It is concluded that a one-dose prophylaxis appears sufficient in major head and neck cases.     

Radiographic differentiation between different etiologies of pulmonary edema

We compared the plain chest radiographs of critically ill patients who had different types of pulmonary edema and evaluated the radiographs according to a standardized score sheet of findings. We included 94 total cases of pulmonary edema: 49 with cardiogenic, 33 with permeability, and 12 with renal/overhydration pulmonary edema. Patients with cardiogenic edema had enlarged hearts, vascular engorgement, septal lines, and absence of air bronchograms significantly more often than patients with permeability pulmonary edema. Renal/overhydration patients had enlarged hearts significantly more often than patients with permeability edema. There were no other statistically significant differences. Heart size and presence or absence of septal lines could have been used to distinguish cardiogenic and permeability edema in 83% of cases.     

Concept of computed tomography (CT) of the temporo-mastoid bone : Normal CT anatomy and their variations

Computed tomography is being increasingly employed in the radiographic assessment of the temporal bone. Recent introduction of high-resolution computed tomography (CT) which is capable of resolving the delicate bony structures of the temporal bone and adjoining region of the base of the skull has made radiological visualisation much more easier. Thin section 2 (1) mm at an interval of 2 (1) mm in different planes like 0°, 30°, 70° clearly demonstrated the cochlear turns, oval and round windows, internal auditory canal, ossicles, vestibule, semi-circular canals, facial nerve canal and adjacent regions of the skull base. Thus the high-resolution CT virtually replaced the conventional radiography and polytomography in evaluation and treatment planning of patients with temporomastoid bone pathology.     

Increased serotonin2 and beta-adrenergic receptor binding in the frontal cortices of suicide victims

A statistically significant 28% increase in the mean (+/- SD) number of serotonin2 receptors (127.8 +/- 13.4 vs 99.6 +/- 11.1 fmol/mg of protein) and a 73% increase in beta-adrenergic receptor binding (14.5 +/- 1.5 vs 8.4 +/- 1.5 fmol/mg) was found in the frontal cortices of violent suicide victims compared with matched controls. No significant differences were found in the number of serotonin1 binding sites (109.5 +/- 13.4 vs 99.9 +/- 8.8 fmol/mg). We have previously reported a reduced density of presynaptic tritiated imipramine binding sites on serotonergic nerve terminals in the frontal cortices of suicide victims. These data support the hypothesis that suicide completed by violent methods is associated with reduced presynaptic serotonergic activity that has generated compensatory upregulation of the postsynaptic serotonin2 receptor sites. The increase observed in beta-adrenergic binding suggests that there may also be a concomitant reduction in presynaptic noradrenergic activity associated with suicide. If antidepressant pharmacotherapies specifically downregulate cortical beta-adrenergic and/or serotonin2 receptors in depressed subjects, as has been demonstrated in animal studies, and since these effects would be in the opposite direction of the receptor changes found in suicide victims, they may account for the therapeutic action of antidepressants on suicidal behavior and depressive disorders.     

TRANSFORMATIONAL, CONSERVATIVE AND TERMINAL OBJECTS: THE APPLICATION OF BOLLAS'S CONCEPTS TO PRACTICE

ABSTRACT This paper focuses on Christopher Bollas's contributions to the understanding of transformations in object usage. Bollas has delineated numerous kinds of object usage but has not described the possible transformations that could occur as a result of psychotherapy. The author examines conservative and terminal objects, on the one hand, and transformational objects, on the other hand, as signifiers for the kinds of transformation that are likely to occur in psychotherapy. Two vignettes informed by Bollas's ideas will illustrate how the therapist can facilitate the patient' s use of the therapeutic environment that'transforms' rather than'conserves' or'terminates' psychic evolution. The author describes how Bollas draws from diverse theoretical sources, particularly from Freud, Winnicott and Bion. The author also suggests that unrestricted use of different theoretical frameworks is consistent with Bollas's favoring free movement between different modes of interpretation. It is argued that this flexibility of moving between modalities is indeed the chief distinguishing characteristic of Bollas's therapeutic style.     

Use of the TLX ultracentrifuge for the isolation of different density lipoproteins and effects of freeze/thawing of human plasma before ultracentrifugation

Abstract Background: Isolation of different density lipoproteins by ultracentrifugation can require lengthy centrifugation times and freeze/thawing of plasma may influence recovery. Methods: We isolated a range of lipoproteins using a preparative ultracentrifuge and the TLX micro-ultracentrifuge and determined the effect of freeze/thawing of plasma beforehand. Results: In fresh plasma, there was no significant difference in results for small-dense low-density lipoprotein apolipoprotein B (LDL apoB) (density >1.044 g/mL) or cholesterol at density >1.006 g/mL. Freeze/thawing had no effect on closely correlated results for small-dense LDL apoB (r=0.85; p<0.0001) or high-density lipoprotein (r=0.93; p<0.0001). Conclusions: The TLX micro-ultracentrifuge is a reliable alternative to the preparative ultracentrifuge and freeze/thawing has only a small effect on small-dense LDL apoB or high-density lipoprotein cholesterol. Clin Chem Lab Med 2008;46:1285-8.