Propranolol in schizophrenia. Clinical, metabolic, and pharmacological findings.

Six schizophrenic patients received propranolol hydrochloride to evaluate pharmacological, endocrinological, and antipsychotic properties of the drug. They had previously been unsuccessfully treated with phenothiazines. After a drug-free period of two weeks, propranolol was administered in gradually increasing doses. After two to four weeks, a low dose of phenothiazines was added. The clinical effect was evaluated using the Comprehensive Psychopathological Rating Scale. Three of the six patients showed a definite improvement with propranolol therapy given as a sole treatment. Propranolol in plasma was positively correlated to dosage. The proportion of its major metabolite, 4-hydroxy-propranolol, decreased with increasing drug dose. Melatonin and prolactin levels in serum decreased noticeably with propranolol treatment. When phenothiazines were added, prolactin increased above drug-free levels. These results support the view that propranolol has an antipsychotic potential that needs further evaluation in clinical trials.

Management of pancreatic pseudocysts.

Between 1969 and 1987, 68 patients with pancreatic pseudocysts were treated. The median cyst size was 10 cm (range 2-25 cm). Nine patients were managed conservatively with resolution of the pseudocyst occurring in eight patients. These patients had significantly smaller (median 4 cm) cysts compared with those in both percutaneously and surgically treated patients (P less than 0.01). In 22 patients the pseudocysts (median 9 cm) were punctured percutaneously under ultrasound guidance and the cyst fluid was aspirated or drained through a catheter. Complete resolution occurred in 13 patients after 1-4 (mean 1.8) punctures per patient, regression occurred in six patients after 1-4 (mean 2.0) puncture procedures per patient and three were unchanged. No complications were noted, except that two patients treated percutaneously required additional surgery. Thirty-seven patients were managed surgically (median cyst size 11 cm) with external drainage (12 patients), cystgastrostomy (17 patients), cystduodenostomy (three patients) cystjejunostomy (three patients) and pancreatic resection (two patients). Resolution of the cyst was noted in 29 patients, regression in five and three were unchanged. Five patients required additional surgery. Twelve complications were seen in ten patients (27 per cent), most frequently after external drainage. One patient died after surgical treatment. Mean hospital stay was 13 days among patients treated conservatively and 30 days in both percutaneously and surgically treated patients. Aspiration or catheter drainage of pseudocyst fluid guided by ultrasonography seems a safe and effective treatment of pancreatic pseudocysts and should be considered as initial therapy. If surgery is required cystgastrostomy is preferred.

Microcalorimetric Measurements of the Heat Evolution and Its Sensitivity to Dinitrophenol during Different Stages of Synchronous Cultures of Scenedesmus.

The applicability of the LKB flow microcalorimeter in a microalgal system was tested. Respiration and its sensitivity to 2,4-dinitrophenol during different stages of a synchronous culture of Scenedesmus obtusiusculus were studied. In cells harvested during the first 8 hours of illumination, heat evolution was 10 to 15 microwatts per 10 million cells and then rose to a peak of about 80 microwatts per 10 million when the cells were harvested in the beginning of the dark period, just before the onset of the divisions. Calculated per milligram dry weight, the highest values were about 140 microwatts, also obtained early in the dark period, after which the values dropped. They were roughly 90 microwatts per milligram at the onset of light and a little below 70 microwatts per milligram after 8 hours of illumination. Thus, the synthesis of new cell material does not give rise to actively respiring mitochondria during the first half of the light period, after which the situation is reversed. Low concentrations of dinitrophenol increased heat evolution, and high concentrations were inhibitory. Cells from the early stages of development were more sensitive to dinitrophenol than older cells. Young cells gave a transient peak of heat evolution even when the steady state was inhibited. Coupled oxidative phosphorylation seems necessary for substrate mobilization and transport to the mitochondria of the young cells. Possibly, young cells use mainly fatty acids and old cells carbohydrates as their main substrate for respiration.