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Key relatives of 30 first or early admission psychotic patients (mainly with a diagnosis of schizophrenia) were interviewed (for a second time) 18 months after participating in an initial assessment of expressed emotion (EE). The patients were followed up throughout the interim period, during which time 17 experienced a psychotic relapse. Although there continued to be a negligible association between initial EE rating (established during the index admission) and relapse, a significant association between EE rating at 18 months and psychiatric status of the patient during the follow-up period emerged. Results are discussed in the context of recent interactional theories of the relationship between household EE and psychiatric morbidity.
We describe the existence of the savant syndrome in association with Gilles de la Tourette's Syndrome (GTS). The presentation of savant abilities is typical of that previously described. Similarities between autism, the disorder most characteristically associated with savants, and GTS in terms of obsessionality are noted. Previously reported psychological studies of autistic savants are briefly reviewed and, together with evidence from neuroimaging in GTS, obsessive compulsive disorder (OCD), and autism, used to support a model of the underpinnings of savant skills.
In reattribution, general practitioners (GPs) request psychosocial information directly and explain medically unexplained symptoms (MUS) using psychosocial information in the consultation. We explored whether reattribution training (RT) increased the communication of psychosocial information and decreased communication about somatic intervention between GPs and their MUS patients.
Method
A cluster randomized controlled trial (RCT) of RT versus usual treatment in GPs from 16 practices and 141 patients with MUS on audio-recorded and transcribed doctor–patient communication in an index consultation. In a secondary data analysis, the Liverpool Clinical Interaction Analysis Scheme (LCIAS) was applied by an experienced rater to each turn of speech in the transcript from the index consultation blind to treatment allocation.
Results
After RT, patients were more likely to disclose and discuss psychosocial problems, and propose psychosocial explanations for symptoms; around 25% of patients discussed psychosocial information extensively. In the RT group, GPs did not seek new psychosocial disclosure but they reduced advocacy for somatic intervention. After RT, GPs suggested, on average, two utterances of psychosocial explanation and six utterances of somatic intervention.
Conclusions
After RT, some patients discussed psychosocial issues extensively but GPs did not probe underlying psychosocial issues. They gave mixed psychosocial and somatic messages about MUS, which may have increased patients' concerns about their health. GPs should actively seek the disclosure of underlying psychosocial problems and give clear, unambiguous messages to MUS patients when they are willing to discuss psychosocial issues.
We describe a 31-year-old man with Down's syndrome who presented with severe chronic hypothyroidism and a massive pericardial effusion. Following partial aspiration of this effusion, he rapidly deteriorated and died. Findings at autopsy revealed him to have an atrioventricular septal defect with shunting at the atrial level. We postulate that, by releasing extrinsic pressure on his right heart by the aspiration, there was sudden shunting of blood from left-to-right, resulting in hypotension, shock, and subsequent death. We highlight the difficulties in management of such a case, and suggest alternative strategies.
The role of gene suppression technologies in pharmaceutical drug development
The completion of the human genome sequence (International Human Genome Sequencing Consortium, 2001; Venter et al., 2001) has ushered in a new era for the pharmaceutical industry. With access to a comprehensive list of candidate drug targets, together with a growing understanding of their association to signalling and metabolic pathways and human disease, there would seem to be endless opportunity for novel drug development. From a clinical perspective, this most basic of genetic insights should enhance the efficacy of existing drugs, while at the same time bring new drugs to market for many new therapeutic indications. From a corporate vantage, utilising the information embedded in the human genome for improved target validation should effectively reduce the attrition of candidate drug targets and therefore translate to a “competitive advantage.”
With thousands of candidate drug targets to select from, it is necessary to invest in strategic methods in order to navigate the complex maze of genetic information. Indeed, the identification and validation of targets that map to chemically tractable gene families (the ‘druggable’ genome, or ‘pharmome’) is now recognised as a fundamental challenge to the entire pharmaceutical industry (Figure 25.1). In an effort to achieve this goal, molecular technologies that suppress the expression of a candidate drug target (either in cis- or trans-) have become fixtures in most pharmaceutical R&D programmes, and there are many examples where this has been successful.
At the onset of metamorphosis in Drosophila melanogaster, the steroid hormone 20-OH ecdysone induces a small number of early and early-late puffs in the polytene chromosomes of the third-instar larval salivary gland whose activity is required for regulating the activity of a larger set of late puffs. Most of the corresponding early and early-late genes have been found to encode transcription factors that regulate a much larger set of late genes. In contrast, we describe here the identification of an ecdysone-regulated gene in the 62E early-late puff, denoted D-spinophilin, that encodes a protein similar to the mammalian protein spinophilin/neurabin II. The D-spinophilin protein is predicted to contain a highly conserved PP1-binding domain and adjacent PDZ domain, as well as a coiled-coil domain and SAM domain, and belongs to a family of related proteins from diverse organisms. Transcription of D-spinophilin is correlated with 62E puff activity during the early stages of metamorphosis and is ecdysone-dependent, making this the first member of this gene family shown to be regulated by a steroid hormone. Examination of the dynamic patterns of D-spinophilin expression during the early stages of metamorphosis are consistent with a role in central nervous system metamorphosis as well as a more general role in other tissues. As D-spinophilin appears to be the only member of this gene family in Drosophila, its study provides an excellent opportunity to elucidate the role of an important adaptor protein in a genetic model organism.
SiC MESFET's have shown an RF power density of 4.6 W/mm at 3.5 GHz and a power added efficiency of 60% with 3 W/mm at 800 MHz, demonstrating that SiC devices are capable of very high power densities and high efficiencies. Single devices with 48 mm of gate periphery were mounted in a hybrid circuit and achieved a maximum RF power of 80 watts CW at 3.1 GHz with 38% PAE.
We have examined a variety of structures for the {510} symmetric tilt boundary in Si, using first-principles calculations. These calculations show that the observed structure in Si is the lowest energy structure. This structure is more complicated than what is necessary to preserve four-fold coordination. We compare the results to classical and tight-binding models, in order to test these empirical approaches.
Serotonin aggregation is a measure of function of platelet 5-HT2 receptors. The test has been proposed as a valid peripheral model of central 5-HT2 receptor function. Receptors of this subtype are implicated in theories of the aetiology of depressive states.
This pilot study proposes a normal range for the test for both males and females. Untreated depressed subjects had results which grouped at the lower end of the range. The test proved reproducible with a correlation coefficient of r = 0.939 with an interval of at least six weeks between sampling. A small number of successfully treated patients were retested with no empirical difference in their results, which are included in the reproducibility studies.
Our provisional results indicate the reliability of serotonin aggregation scores for an individual. The difference in scores noted in depressed subjects is more likely to be a trait rather than a state marker.
This study investigated biological correlates of depression in patients with idiopathic Parkinson's disease (PD). We tested the hypothesis that in patients with PD and depression, there was regional dysfunction involving brain areas previously implicated in functional imaging studies of patients with primary depression.
Method
Using positron emission tomographic measurements of regional cerebral blood flow (rCBF), patterns of resting rCBF were measured in ten patiens with PD and major depression, and ten patients with PD alone. The results were compared with findings from ten patients with primary depression and ten normal controls, scanned using identical methods as part of an earlier study. Groups were matched for age, sex and symptom severity.
Results
Bilateral decreases in rCBF were observed in anteromedial regions of the medial frontal cortex and the cingulate cortex (Brodmann's areas (BA) 9 and 32) in the depressed PD group, compared with those with PD alone and compared with normal controls. This regional disturbance overlapped that observed in patients with primary depression.
Conclusions
The findings indicate that the medial prefrontal cortex is a common area of neural dysfunction in the manifestation of both primary depression and depression in PD.
Rapid tranquillisation – giving a psychotropic to control behavioural disturbances – is common in medical practice, yet few surveys describe its use in psychiatric populations. Over five months, 102 incidents, involving 60 patients, were retrospectively surveyed. Patients most often involved were young white men. The commonest diagnosis was affective disorder (manic phase) (39%) followed by schizophrenia (33%). Fifteen patients were involved in 57% of the incidents. The majority of incidents involved injury to people or damage to property. The most frequently used drugs were diazepam and haloperidol, alone or in combination. Droperidol, chlorpromazine, sodium amytal and paraldehyde were rarely used. Diazepam alone or in combination with haloperidol delivered intravenously was most rapidly effective and was associated with greatest staff satisfaction. Serious side-effects were rare.
Interferometric spectrometry techniques for measuring stellar oscillations have been developed at Imperial College, resulting in two separate interferometers, the Michelson and the Fabry-Perot based instruments. They have both been used on large telescopes; the Michelson instrument to search for oscillations in solar-type stars and the Fabry-Perot instrument to measure oscillations in δScuti-type stars. So far there has been only marginal evidence for solar-type oscillations, including our observations of εCyg with ~1ms−1 precision. In order to increase the significance of future observations we are currently improving both instruments and aim to achieve a ten-fold increase in precision, i.e. ~10cms−1, by using up to 100 separate spectral lines simultaneously. Such an improvement will allow us to continue the search for solar-type oscillations.
Monodisperse and spherical titania powders were prepared by the hydrolysis of titanium tetraethoxide in ethanol with hydroxy-propyl cellulose(HPC) present during particle precipitation. The mean particle size decreased as the concentration of tLPC increased. The critical concentration of HPC for the in situ stabilization of titania powder suspensions was determined by a photographic method, and found to be independent of the molecular weight of HPC within the molecular range of 60,000 to 300,000. The amount of HPC adsorbed on the particle surface, determined by a colorimetric method using a UV-visible spectrophotometer, decreased with the increasing molecular weight of HPC. Suspension stability was confirmed by theoretical calculations based on experimental results.
Between the Patras and New Delhi General Assemblies no meetings were directly sponsored by Commission 9 because the discipline was amply covered by the following:
- “Eighth Symposium on Photoelectronic Image Devices,” Imperial College (London) 5-7 September 1983 (B. L. Morgan, Ed., Academic Press, London, 1984).
- “Instrumentation in Astronomy V” 7-9 September 1983 (A. Boksenberg and D. Crawford, Eds., Proc. SPIE 415).
- IAU Symposium No. 109: “Astrometric Techniques,” 9-12 January 1984, Gainsville (Florida).
- “Astronomical Photography 1984,” Edinburgh, 4-6 April 1984 (E. Sim and K. Ishida, Eds., Number 14 of Occasional Reports of the Royal Observatory, Edinburgh).
- “IAU Colloquium No. 79: “Very Large Telescopes, Their Instrumentation and Programs,” Garching bei München, 9-12 April 1984 (M. H. Ulrich and K. Kjär, Eds.)
The volatile products from the thermal reaction (414°C) of silane in excess acetylene are hydrogen, ethylene, vinylsilane, ethynylsilane, vinylethynylsilane (possibly divinylsilane) and ethynyl-divinylsilane (1,2). We have reexamined this reaction using a 3 C2 H2/1 SiH4 reaction mixture and have obtained product yield curves for these products versus percent silane loss. We have also found that product curves are unaffected when propylene at pressures equal to that of acetylene is also present. Since only trace quantities of propylsilane are produced in the presence of propylene, we can rule out reactions involving silyl radicals. Thus the SiH4−C2H2 reaction involves silylene and silene intermediates. The products can be explained by a mechanism similar to one proposed by Barton and Burns (3).
It is clearly impossible to prepare a comprehensive review of three years’ work in the field of astronomical instrumentation within the space available in this volume. The selection of topics included and the space devoted to each is therefore largely subjective; some emphasis has been placed on material unlikely to be generally available elsewnere.