To identify genes responsible for the susceptibility for schizophrenia, and to test the hypothesis that schizophrenia is etiologically heterogeneous, we have studied 39 multiplex families from a systematic sample of schizophrenic patients. Using a complex autosomal dominant model, which considers only those with a diagnosis of schizophrenia or schizoaffective disorder as affected, a random search of the genome for detection of linkage was undertaken. Pairwise linkage analyses suggest a potential linkage (LRH = 34.7 or maximum lod score = 1.54) for one region (22q12-q13.1). Reanalyses, varying parameters in the dominant model, maximized the LRH at 660.7 (maximum lod score 2.82). This finding is of sufficient interest to warrant further investigation through collaborative studies.
SUMMARY In an effort to discern whether cerebral vascular injuries provoke specific emotional disturbances, 20 consecutively admitted stroke patients were compared with 10 orthopaedic patients. Both groups were examined for functional disabilities (Activities of Daily Living) and for psychiatric symptoms. Reliable and valid instruments, the Hamilton Rating Scale, the Visual Analogue Mood Scale, the Present State Exam, and the Mini-Mental State Exam were employed to display the psychopathology. More of stroke patients than orthopaedic patients were depressed (45% versus 10%) even though the level of functional disability in both groups was the same. Patients with right hemisphere stroke seemed particularly vulnerable and displayed a syndrome of irritability, loss of interest, and difficulty in concentration, in addition to depression of mood (70% of right hemisphere stroke patients versus 0% left hemisphere stroke patients and 0% orthopaedic patients). We conclude that mood disorder is a more specific complication of stroke than simply a response to the motor disability. We suggest that a controlled trial of antidepressant medication is indicated for patients with this complication.Persistent and refractory depression of mood has often been reported to follow stroke (Bleuler, 1924;Post, 1961;Adams, 1963;Bell, 1966). This symptom is commonly explained as an expected psychological reaction of the patient to his disability or restrictions in activity. We began to doubt the adequacy of this explanation when we admitted to the Psychiatry Service for the elderly at the Westchester Division of the New York Hospital, a 72 year old physician who, after a stroke manifest by a left hemiparesis, had developed incapacitation, symptoms of irritability and depression persisting for two years. After treatment with antidepressant medication these distressing symptoms were relieved and his interest and enjoyment of life returned. From this experience we were prompted to study the emotional symptoms of a group of patients with stroke, comparing them with the emotional symptoms of patients with non-neurological but disabling conditions. Our purpose was to discover any specific emotional changes after stroke. Such a
Gastric emptying in four unanesthetized male Macaca mulatta was studied with the serial test meal method of Hunt and Spurrell. Liquid meals were infused into the stomach through a chronic indwelling Silastic cannula. Saline meals empty rapidly and exponentially. Doubling the volume of saline from 150 to 300 ml increased the emptying rate so that the half-life remained unchanged (15 min). The 150-ml glucose meals (0.05, 0.125, and 0.25 g/ml) emptied more slowly than saline, progressively more slowly with increasing concentrations (0.05--1.8, 0.125--0.78, and 0.25--0.37 ml/min) and linearly through most of their course. Doubling the volume of 0.125 g/ml-glucose meal did not change the rate of emptying. Converting grams of glucose to their caloric content, the emptying rate in kcal/min becomes constant (approx 0.4 kcal/min) in this range of concentrations. Isocaloric casein hydrolysate and medium-chain triglyceride oil meals at 0.5 kcal/ml empty at the same rate as glucose. The precision of this regulation is sufficient to give it a role in preabsorptive satiety and the control of caloric intake.
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