Velocardiofacial manifestations and microdeletions in schizophrenic inpatients.

Velocardiofacial syndrome (VCFS) is associated with an increased frequency of schizophrenia and other types of psychiatric morbidity. In this study, we tried to identify a subgroup of schizophrenic patients with deletions in the VCFS region of the long arm of chromosome 22. For that purpose, we screened the records of two major general hospitals for patients with abnormalities characteristic of VCFS, such as cardiac anomalies and cleft palate, and cross-checked the data with the register of psychiatric hospitalizations in four psychiatric hospitals. Of the 24 patients that qualified, only seven patients could be studied. An additional eight schizophrenic inpatients were ascertained clinically, based on a working VCFS Clinical Scale. FISH studies and molecular analyses, using polymorphic markers from the VCFS region, documented hemizygosity of 22q11 in three out of 15 patients (20.0%). Increased awareness of psychiatrists to signs of VCFS among patients with psychiatric illnesses is encouraged, in order to direct molecular studies effectively. In order to cut down the cost of testing, we suggest screening suspected patients with a single marker, such as D22S941, and to study further only those who have a single electrophoretic band.

Chlorprothixene-induced hypouricemia: a biologic indicator of drug compliance.

Chlorprothixene is a neuroleptic as well as a potent uricosuric drug that consistently lowers the levels of plasma uric acid (PUA). The usefulness of this relative hypouricemia as an indicator of compliance with treatment was evaluated in 17 outpatients treated from 120 to 600 days. Plasma uric acid values were substantially reduced in all patients with all doses within the therapeutic range. Low levels of PUA remained stable as long as the patients were treated and returned to normal within 7 days after treatment was terminated. The authors discuss the advantages and the limitations of PUA as an indicator of chlorprothixene treatment compliance.

Conversion deafness.

Conversion deafness is very rarely encountered among adults. This report will illustrate two cases of this somatoform disorder following different traumatic experiences. It emphasizes the difficulties in establishing the diagnosis and reviews various aspects of treatment.

Clinical evaluation of fetal movements.

Fetal movement was examined in 200 pregnancies to establish normal patterns, influencing factors, possible clinical value and practical application. The mean number of movements per hour was 26 in hospitalized and 40 in ambulatory patients. These values remained fairly steady throughout pregnancy except for a significant decrease in the week preceding labor. Individual variations were large. The number of movements was uninfluenced by parity and fetal sex but was lower for small-for-gestational-age babies, in mothers suffering from both hypertension and diabetes and in mothers treated with diazepam. Fetal movement count may be used as a parameter of fetal well-being.

Control-related beliefs and sleep characteristics of posttraumatic stress disorder patients.

To examine correlations among chronic Posttraumatic Stress Disorder (PTSD), control-related beliefs, and sleep difficulties 7 PTSD casualities and 7 non-PTSD matched subjects were compared in their laboratory sleep patterns as well as in their beliefs about personal control over external and internal events in general and over sleep-related events in particular. Analyses indicated that PTSD casualties had poorer sleep and reported more doubts regarding their ability to control external and internal events than control subjects. Further, we found a significant association between perceived control and sleep difficulties. Results were discussed in terms of Horowitz's conception of intrapsychic processes related to PTSD.

Reassessing "Jacob's case": a serial killer re-examined after ten years.

The current study re-examines an exceptional case of a serial killer incarcerated since a decade ago. "Jacob" is the first serial killer apprehended in Israel. His known actions were committed during the eighties of the last century, and continued for eleven years. The victims were elderly individuals, including both his parents. Shortly after incarceration he became overtly schizophrenic and underwent five hospitalisations. The case is re-examined in view of changes, both in the perpetrator's diagnosis and criminal legislation. Was Jacob doomed to become a serial killer, or could his fate be avoided through early professional intervention? Were the killings presenting symptoms of a psychotic or pre-psychotic phase? Should he be eligible for a retrial? What would have been his position with the current law in view of the new 300A(a) clause ("Reduced Punishment") of the Israeli Criminal Code? Could he ever be released back to the community? These are some of the questions to be addressed.

[Biofeedback treatment of Raynaud's disease].

Raynaud's disease is characterized by intermittent peripheral vasoconstriction leading to pallor, cyanosis and reactive vasodilation of the arterioles of fingers and toes. These phenomena are accompanied by sensations of cold or warmth, pain and difficulty in manipulating the palms. Ulcerations of the fingertips can occur in severe cases. Since conservative medical treatment, consisting of preventive measures and changing various habits, results in alleviation in only half the patients, sympathectomy is often required. Psychological intervention, including biofeedback, also has a significant role. Biofeedback involving relaxation techniques, guided imagination, and in parallel, computer-assisted monitoring of sympathetic arousal, might lead to symptom reduction as a unique treatment or in conjunction with other treatment modalities.

[Determination of the intensity of antimicrobial immunity in diphtheria during an acute experiment]. / Opredelenie napriazhennosti antimikrobnogo immuniteta pri difterii v ostrom opyte.

The authors elaborated a method of determination of the antimicrobial immunity intensity in diphtheria in an acute experiment: guinea pigs were infected with a virulent culture of Corynebacterium diphtheriae grown on agar with iron in a concentration depressing the toxinogenesis. A temporary absence of the toxin formation permitted to evaluate the antibacterial immunity except the antitoxic one. Guinea pigs preimmunized with somatic Corynebacterium diphtheriae antigen or an immune antimicrobial serum constituted the experimental group. The antimicrobial protection level was assessed by the difference in the mortality rate of guinea pigs in the experimental and control groups.

[Various biological properties of enterobacteria, isolated from patients with diarrhea]. / Nekotorye biologicheskie svoistva énterobakterii, vydelennykh ot bol'nykh s diareiami.

381 enterobacterial strains isolated from patients with acute enteric diseases were studied. Of these, 279 strains, as well as 20 strains isolated from 50 healthy children, were studied for the presence of adhesins, hemolysins and catalase. The comparison of the hemagglutinating activity of enterobacteria isolated from sick and healthy children revealed no essential differences between them. 15.8% of enterobacterial strains isolated from sick children possessed hemolytic activity, while strains isolated from healthy children did not induce the hemolysis of erythrocytes. All enterobacterial strains isolated from patients with acute enteric diseases were multi-resistant to antibiotics. A multitude of different antibiograms was obtained, most of them occurring only once. In 1985 the number of multiresistant (i. e. resistant to 11 and more antibiotics) strains dropped from 61% to 26..9% in comparison with 1981.

[The persistence of Shigella sonnei in epithelial tissue in Serény's model]. / Persistentsiia Shigella sonnei v epitelial'noi tkani na modeli Shereni.

The duration of persistence of S. sonnei in the tissues of a guinea pig eye (Serény's model) has been studied. Bacteriological and histological investigations made with the use of fluorescent antibody techniques have revealed that S. sonnei can be preserved in macrophages (histiocytes) and intercellular space of the eye epithelium for a long time (up to 277 days). The injection of ACTH or Shigella vaccine into the animals may provoke the exacerbation of the infectious process and the release of the infective agent.

[Etiological structure of acute intestinal infections caused by opportunistic bacteria in young children]. / Etiologicheskaia struktura ostrykh kishechnykh infektsii, vyzvannykh uslovno-patogennymi bakteriiami u detei rannego vozrasta.

Altogether 587 children with diagnosed acute enteric infections were examined. In 26.4% of them pathogenic enterobacteria were detected, and in 59%, opportunistic enterobacteria. In 38.2% of children these bacteria were found to be the etiological factor of the disease. A reverse relationship between the contamination of feces with pathogenic enterobacteria and the age of children was established.

[Intestinal microflora in young children with rotavirus infection]. / Mikroflora kishechnika u detei rannego vozrasta s rotavirusnoi infektsiei.

A total of 270 children with rotavirus diarrhea were examined. The quantitative and qualitative composition of their intestinal microflora was studied. Most frequently microorganisms of the genus Enterobacter and most seldom, Serratia were isolated. A decrease in the amount of bifidobacteria, normal Escherichia coli and an increase in the amount of lactose-negative Escherichia were noted. In cases of pronounced dysbiosis in young children the clinical course of rotavirus infection is aggravated and the period of rotavirus excretion is prolonged.

[Protective somatic antigen of Corynebacterium diphtheriae]. / Zashchitnyi somaticheskii antigen Corynebacterium diphtheriae.

Deoxycholate C. diphtheriae extract was separated into fractions differing in the size of their molecules. Correlation between the molecular weight of each fraction, its specific protein content and its immunogenicity was observed. The high-molecular fraction (mol. wt. exceeding 300,000 daltons) was shown to be the protective somatic antigen of C. diphtheriae.

[A method for assessing the microfloral status of the human intestines by the quantity of adhesion-active bacteria and by the type of adhesins]. / Sposob otsenki sostoianiia mikroflory kishechnika cheloveka po kolichestvu adgezivno-aktivnykh bakterii i tipu adgezinov.

The method for the evaluation of the state of intestinal microflora in the diagnosis of enteric diseases by the determination of the number of actively adhesive bacteria and the type of adhesins in the primary culture of human microflora has been developed. This method permits the simultaneous analysis of all colonies grown in a given Petri dish by the sign of their adhesion, which eliminates the possibility of mistakes due to the occasional choice of colonies, as it may happen in the agglutination test. The time necessary for the study of adhesive properties is reduced, as the result is evaluated as early as on day 2 after the inoculation of the seed material. It is also of importance that the method is simple in realization, needs no special equipment, preparation and staining of the material. To determine the type of adhesins, a series of identical inoculations may be obtained by replication with the use of red blood cells of different animals. The proposed method may be used for the confirmation of the etiological role of enterobacteria as evidenced by the presence of high percentage of their actively adhesive colonies.