Loperamide

In castor oil challenged rats, low doses of loperamide inhibit diarrhea and normalize intestinal propulsion. Unlike other opioids, loperamide is devoid of central opiate-like effects, including blockade of intestinal propulsion, up to the highest subtoxic oral dose. Nevertheless, the antidiarrheal action of loperamide can be considered to be -opiate receptor mediated, only a fewin vitro effects at rather high concentrations being not naloxone-reversible. There is little evidence that interactions with intestinal opiate receptors directly change epithelial cell function. When secretory stimuli increase mucosal tension, however, loperamide may reverse the elevated hydrostatic tissue pressure that opposes normal absorption. This antisecretory effect at the mucosal level is accompanied by motor effects when loperamide reaches the myenteric -opiate receptors. At therapeutic doses for the treatment of acute diarrhea, it is likely that the mucosal effect prevails.     

Combined Clozapine and Electroconvulsive Therapy

We reviewed consecutive patients (n = 12) at McLean Hospital from 1990 through 1991 treated with the combination of the atypical antipsychotic agent clozapine and electroconvulsive therapy (ECT). There were no adverse effects. Three patients had a marked clinical improvement, one a moderate response, four a minimal response, two minimal to no response, and two no response. Using daily doses of up to 550 mg clozapine, this combination appears to be safe, and may be useful in some patients with treatment-refractory psychosis.     

“No-effect-level” of melathion (0,0′-dimethyl dithiophosphate of diethyl mercaptosuccinate) inBubalus bubalis

Summary An oral dose of 0.5 mg/kg/day malathion continuously administered for one year has been investigated to produce no change in biochemical (RChE, PChE, aspartate-and alanine aminotransferases, blood glucose, serum urea and plasma total proteins) or haematological (Hb, PCV, tRBC and tWBC) parameters and, therefore, considered to be no-effect-level inBubalus bubalis. However, the administration of higher doses (1.0 and 1.5 mg/kg/day) produced significant (P<0.05) changes in all biochemical parameters studied. With these doses leucocytosis was evident among haematological parameters measured.     

Pseudohomosexual psychosis in basic military training

The emergence of homosexual anxieties in heterosexual males following a severe blow to masculine self-esteem has been termed pseudohomosexual by Ovesey and has been shown to reflect sexual dependency and power conflicts. This article extends the concept, described largely in neurotic patients, to psychotic reactions occurring in basic trainees following failure to adapt to military life. The military setting is viewed as a culturally specific stress for emergence of pseudohomosexual anxieties in predisposed individuals. Case studies illustrate the power and dependency conflicts, sexual symbolization, projective defenses, and restitutional violence which characterize these patients. The pseudohomosexual psychosis defends the patient against perceiving his inability to effect separation from mother, bear the object loss, and attain cultural manhood.The views presented represent those of the author and are not to be interpreted as representing the Department of Defense or the U.S. Air Force.     

Pentose shunt activity in developing chick retina and pigment epithelium: A switch in biochemical expression in cultured pigment epithelial cells

Pentose shunt activity in developing chick retina and pigment epithelium was studied by measuring the rate of ¹⁴CO₂ evolution from glucose selectively labelled in the C-1 and C-6 positions. In the retina, shunt activity declines from appreciable levels at stages 29–31 to minimal activity in the 2-week-old hatched chick. Overall retinal metabolism also declines up to stage 45, but dramatically increases again after hatching. Developing chick pigment epithelium has minimal shunt activity at all stages studied. In contrast, cultured chick pigment epithelium has appreciable shunt activity which is constant over a period of several weeks in culture. This appears to be a switch in biochemical differentiation which could form the basis at least in part for subsequent changes in cell types observed in cultured pigment epithelial cells byEguchi and Okada (1973).     

Pharmacokinetics and protein binding of cis-dichlorodiammine platinum (II) administered as a one hour or as a twenty hour infusion

Summary The pharmacokinetics of cis-dichlorodiamminoplatinum (II) (cisplatin) have been studied in seven patients, of whom four received the drug as a one hour infusion and three received it as a 20 h infusion. The patients receiving the drug over one hour exhibited biphasic clearance of total platinum with a rapid initial phase (8.7–22.5 min) and a prolonged second phase (30.5–106 h). Free (ultrafilterable) cisplatin was readily detectable in this group and was rapidly cleared (half-life about 22 min). The volume of distribution of the drug was 50.3–65.6 liters and it was 26.6–50% excreted in the urine in 48h. In the patients receiving the 20 h infusion, a more complex plasma elimination curve was seen, with the appearance of a secondary peak. Free drug was not detectable in these patients and they showed less urinary excretion (21.4–25.9% at 48 h) than the one hour group. Cisplatin was bound to several plasma proteins, including albumin, transferrin, and -globulin. The data indicate that cisplatin is retained in the body more extensively after a 20 h infusion than after a one hour infusion.     

Naphthaquinones of Diospyros batocana

Root bark of West African tree DIOSPYROS BATOCANA H IERN, Ebenaceae, was examined. On the basis of chromatographic and spectral analysis it was shown to contain the naphtaquinones 7-methyljuglone, 2-methylnaphthazarin, biramentaceone, rotundiquinone, mamegakinone, diospyrin, diosquinone, isodiospyrin and batocanone. This last compound proved to be the (-)-enantiomer of isodiospyrin-2', 3'-epoxide. The probable existence of beta-dihydrodiospyrin, of a batocanone isomer and of an isodiospyrin diepoxide in this material is mentioned. The partial synthesis of two isomeric isodiospyrin di-epoxides is described.     

“Dropping out” from an adolescent therapeutic group: a study of factors in the patients and their parents which may influence this process

A significant proportion of all patients offered group therapy "drop out" before any help can be given to them. This process of attrition is likely to be even higher in adolescent groups. This paper considers factors, observable in the initial assessments of adolescents and their families, which might be associated with this process. Two styles of "drop out" were noticed; one appearing to be less destructive than the other to the patient and to the group. A highly significant association was observed between an assessor's feeling that either the adolescent or one of their parental figures had a paranoid personality and a tendency to leave the group in a precipitate and destructive manner. It is suggested that the sort of therapy offered by the group described in this study may not be the treatment of choice for adolescents of this type, and that there are benefits to be gained from assessing the family of an adolescent before he is offered group therapy on his own.