Patterns of lateral preference in psychotic patients.

Two tests of lateral preference (hand-clasping and arm-folding) were investigated in 50 adult right-handed healthy controls and in 42 right-handed psychotic patients. In the psychotics, hand-clasping and arm-folding with uppermost left positions were less evident than in the controls. In the psychotics with uppermost right positions in both tests (including handedness, i.e. unilateral right), good prognostic clinical features were most pronounced. These results, which were predominantly found in the males, are interpreted on the basis of possible relationships between hemispheric asymmetries and lateral preferences.

[Autoantibodies in lepromatous leprosy]. / Autoantikörper bei lepromatöser Lepra.

84 Turkish patients with lepromatous and borderline lepromatous leprosy were investigated with regard to the presence of antibodies to a variety of tissue constituents and immunoglobulins. Thirty Turkish-born volunteers and two groups of patients with systemic lupus erythematosus and primary biliary cirrhosis respectively served as controls. No increased incidence of autoantibodies to smooth muscle cells, nuclei, mitochondria, striated muscle, thyroid microsomes and thyroglobulin was detected. A high incidence of rheumatoid factor and circulating immune complexes was found.

[Anorexia nervosa--the triad of metric index, BMI age-specific percentile curve and goal weight]. / Anorexia nervosa--Die Trias von Metrik-Index, BMI-Altersperzentilenkurve und Zielgewicht.

Cross sectional and longitudinal data from the Berlin Anorexia Study on the inpatient treatment of n = 133 adolescent females with the principal axis I diagnosis of an eating disorder (n = 104 anorexia nervosa, n = 19 bulimia nervosa, n = 10 eating disorders not otherwise specified; according to ICD-10 and DSM-IV criteria) indicate a significant shift in the frequency distribution of somatometrically assessed types of body shape among patients as categorized by the Metric Index, towards the leptomorphic phenotype (p < 0.050, chi 2/Fisher's). Three explanatory models are discussed. Diagnostic and therapeutic implications, particularly of the determination of target weight in anorexia nervosa based on the individual's type of body shape, are emphasized, and an operational algorithm is proposed which uses the Metric Index and sex-specific BMI age percentiles adjusted for type of body shape.

[Eating disorders in adolescents in East and West Berlin in the 80's]. / Essstörungen bei Jugendlichen in Ost- und West-Berlin in den 8Oer Jahren.

Data collected in the 1980's, before the reunification of Germany, and comparing 39 patients in former East Berlin and 60 patients in former West Berlin are presented in this second report on the Berlin longitudinal study of eating disorders in adolescence. The clinical profiles of patients of former East Berlin were found to differ from those of their West Berlin counterparts in the following assessed measures: younger age at disease onset and at admission for inpatient treatment; greater number of siblings; fewer accounts of the clinical symptoms lanugo, bradycardia, hypothermia, constipation; lower rate of premorbid psychopathological features; lower number of psychopathological findings; less frequent sibling rivalry; lower rate of psychopathological attributes among the siblings; lower incidence of maternal mental and physical illness; higher parental educational status; fewer number of complaints, and better sense of well-being.

[How reliable is the diagnosis "anorexia nervosa"?]. / Wie sicher ist die Diagnose "Anorexia nervosa"?

A report is given on a 14-year-old girl and a 13-year-old boy from a group of 83 patients who met the diagnostic criteria (MAS; DSM-III-R) for anorexia nervosa. The behavior therapy interventions did not have the expected effects in either child. On repetition diagnostic evaluations showed that the girl had esophageal achalasia within the scope of Turpin's syndrome (megaesophagus, bronchus deformation) and the boy Burkitt's lymphoma (malignant non-Hodgkins' lymphoma). The differential diagnostic and classification problems associated with the diagnosis anorexia nervosa are pointed out.

Instability in functional motor laterality of children and adolescents with endogenous psychosis and predominantly motor disturbances.

A group of eight unmediated right-handed children and adolescents with endogenous psychosis and predominantly motor disturbances and two right-handed control groups (6 healthy subjects and 10 patients with different psychiatric diseases) were investigated with the help of a tapping-test series. The most important finding was related to differences in the stability of functional motor laterality between controls and psychotics. Stability of instability in functional motor laterality was identified by referring to the standard deviation (SD) of percentile right-left tapping differences calculated for each subject for the various parts of the tapping-test series. The high SDs in psychotics, in contrast to the low SDs in both control groups, point to increased variations or instabilities in the functional superiority of the preferred hand. Instability in functional motor laterality in this test is considered characteristic of this subgroup of patients, and may be due to a partial relapse to a lower hierarchical stage of handedness.

[Is periodic psychosis in adolescence a disease of its own? The differential diagnosis of psychomotor psychoses in childhood and adolescence]. / Ist die periodische Psychose der Adoleszenz ein eigenständiges Krankheitsbild? Ein Beitrag zur differenzierten Diagnostik psychomotorischer Psychosen im Kindes- und Jugendalter.

A historically orientated analysis of a disease that must be seen in connection with menstruation is made on the basis of literature on periodical psychoses in adolescence, which are described as nosologically separate disturbances. This relation turns out to be by no means obligatory, and this also applies to the homogeneity of the disease. Psychomotor disturbances of psychopathological importance are described by means of ideally typical cases of disease and presented with a differentiated diagnosis. Psychoses occurring during different periods in childhood and adolescence, do not show any sex-specific differences and no absolute dependence in accordance with the menstruation rhythm, but are mostly connected with a hereditary and also a perinatal strain in childhood. In their acute and long-term progress the psychomotoric disturbances allow a differentiated prognosis and therefore a therapeutic explanation. They can be classified in accordance with the Wernicke-Kleist-Leonhard classification schema as motility psychosis and periodic catatonia. With this in mind, the positive-negative dichotomy of schizophrenic disturbances in childhood and adolescence should be carefully reconsidered.

Are there specific disabilities of number processing in adolescent patients with Anorexia nervosa? Evidence from clinical and neuropsychological data when compared to morphometric measures from magnetic resonance imaging.

The cerebral effect of the loss of body weight in Anorexia nervosa (A.n.)--the so-called 'pseudoatrophy'-- is well known and confirmed by several neuroimaging studies. Another subject of intensive research has been whether A.n. leads to specific cognitive impairments, especially of intelligence. However, there are no previous studies on the relations between the cerebral changes, intelligence performance, and disorders of number processing in adolescent patients with A.n. We examined n = 18 inpatients with A.n. (means at admission: age 14.5 years, SD 1.59; BMI 14.9, SD 1.36), diagnosed according to ICD-10 criteria at three different timepoints: at admission to treatment (T1), with 50 % restoration of their normal weight (T2), and with normal weight (T3). At each timepoint, a cerebral MRI scan was obtained. Based on the MRI we determined the volume of the external and internal cerebrospinal fluid cavities, fissures of Sylvius, the surface of mesencephalon and pons, and surface and length of the Corpus callosum. At T1 and T3, a neuropsychological examination was conducted including tests of the general fluid ability and general cristallized ability of intelligence (CFT-20), as well as tests of vocabulary and number processing. The same instruments were given to a group of matched controls (means: age 15.8 years, SD 1.57; BMI 20.5, SD 2.3) at one timepoint. We could show a significant volume difference of the lateral ventricles and the fissure of Sylvius between patients at T, and controls, which abaded with the patient's weight restoration. But a significant surface deficit of the mesencephalon, and less pronounced in the pons, persisted to T3 in patients when compared to controls, suggesting a selectivity of the cerebral changes in A.n. The neuropsychological examinations revealed significant changes in test performance for both the general intelligence test and number processing. At T1 the number processing performance was significantly lower in patients when compared to controls. However, when the patients had restored their normal body weight, we found 2.02 % with a 'severe disorder of arithmetic skills' and 4.45 % with a 'functional disorder of arithmetic skills'. This combined prevalence of 6.47 % of patients with a subnormal arithmetic performance is analogous to that in the normal population.

Anorexia nervosa and sudden death in childhood: clinical data and results obtained from quantitative neurohistological investigations of cortical neurons.

A crude rate of mortality of 5.9% has been quoted for Anorexia nervosa (AN) in recent studies. There are different causes of death ranging from suicide to sudden death. Autopsy data are extremely rare about brain alterations in deceased AN patients. Reported in this study is a female patient, aged 13.5 years, who died of acute AN. Quantitative neurohistological investigation post mortem was performed on her brain. Results were compared with data obtained from a girl of the same age with no contributory neuropsychiatric findings. In the cortex of the anorexia case beside typical pyramidal neurons, a slim neuron type with one extremely long basal dendritic field was found to occur more frequently than normal. In the neurons of the AN case, the ramification pattern of single basal dendritic fields was found to be reduced and changes in the spine morphology, as well as reduction in spine density, were observed. However, a simultaneous lengthening of the terminal dendrites of higher order gave some evidence for repair mechanisms and neuronal plasticity. The AN-specific implications of these findings are discussed. The conclusion is that all AN deaths should be reported together with descriptions of causes and cerebral alterations.

The Eating Attitudes Test: comparative analysis of female and male students at the Public Ballet School of Berlin.

Differentiated examination of eating attitudes and behaviours of female and male German ballet school students with particular reference to their age and analysis of common points with and differences from female Anorexia nervosa (A.n.) patients. The Eating Attitudes Test (EAT-40) was used. Male and female adolescent students of a ballet school and a high school as well as anorectic patients participated in this study. EAT totals exhibited by female and male ballet school students were higher with significance than those recorded from high school students. EAT totals > 30 were reached by 21.6% of female ballet school students but by no male ballet school student at all. In the context of certain EAT items, a number of differences are described between female ballet school students, on the one hand, and female A.n. patients, on the other. No case was identifiable which would satisfy ICD-10 criteria for Anorexia nervosa. Attitudes and behaviours of adolescent female and male ballet dancers toward eating and their own body should be judged with due consideration of their specific living conditions.

In situ cannulation, microgrid follow-up and low-density plating provide first passage endothelial cell masscultures for in vitro lining.

A rapid and reliable harvest and culture technique was developed to provide a sufficient number of autologous endothelial cells for the confluent in vitro lining of cardiovascular prostheses. Enzymatic endothelial cell detachment was achieved by the in situ application of collagenase to short vessel segments. This harvest technique resulted in a complete lack of contaminating smooth muscle cells in all of 124 cultures from nonhuman primates and 13 cultures from human adults. The use of a microgrid technique enabled the daily in situ quantification of available endothelial cells. To assess ideal plating densities after passage the population doubling time was continuously related to the cell density. Surprisingly, a low plating density of 1.5 X 10(3) endothelial cells/cm2 achieved 43% shorter cell cycles than the usual plating density of 1.0 X 10(4) endothelial cells/cm2. Moreover, low density plating enabled mass cultures after one single cell passage, thereby reducing the cell damaging effect of trypsin. When the growth characteristics of endothelial cells from five anatomically different vessel sites were compared, the external jugular vein--which would be easily accessible and dispensable in each patient--proved to be an excellent source for endothelial cell cultures. By applying in situ administration of collagenase, low density plating and microgrid follow-up to adult human saphenous vein endothelial cells, 14,000,000 first passage endothelial cells--sufficient for the in vitro lining of long vascular prostheses--were obtained 26.2 days after harvest. (95% confidence interval:22.3 to 32.2 days).