Season of birth and electrodermal unresponsiveness in male schizophrenics.

The present study was designed to examine differences in the electrodermal activity of schizophrenics born in the season of excessive risk (January-April), and those born in the season of nonexcessive risk (May-December). Thirty-two male schizophrenics were presented with a series of orienting tones (1000 Hz, 80dB, 2 sec duration) while electrodermal activity was monitored. They were subdivided according to season of birth and compared in three electrodermal variables, and also in some background and clinical parameters. We found that schizophrenics born in the season of excessive risk were characterized by significantly lower electrodermal activity and more negative symptoms than those born in the season of nonexcessive risk.

Electrodermal nonresponding, premorbid adjustment, and symptomatology as predictors of long-term social functioning in schizophrenics.

The hypothesis that electrodermal nonresponsiveness to orienting stimuli delineates a core group of "Kraepelinian" type schizophrenics was tested by following up social functioning outcome over a 2-year period in 37 schizophrenics. Good social functioning outcome required both some self-supporting ability in the job market and a minimal social life. The prior assessments included monitoring of electrodermal responses to a series of moderately intense tones, ratings of reported and observed symptoms during an interview, and ratings of premorbid adjustment on the basis of an interview with a close relative. Electrodermal nonresponding, poor premorbid adjustment, and negative symptomatology predicted poor social functioning during the second follow-up year, but the relationship to nonresponding pertained exclusively to a group of 15 first-episode patients. Discriminant analysis showed that electrodermal nonresponding and symptoms were the only independent predictors of outcome.

One versus five sessions of exposure in the treatment of flying phobia.

Twenty-eight patients with flying phobia, fulfilling the DSM-IV criteria for specific phobia, were assessed with behavioral, and self-report measures. They were randomly assigned to two treatment conditions: (1) 1-session, or (2) 5-sessions of exposure and cognitive restructuring. The first condition consisted of a single 3 hr session of massed treatment, and the second condition of 6 hr of gradual treatment. Treatment was done individually by very experienced therapists. The results showed that the two treatment conditions did equally well and there were no differences between them. At post-treatment 93% of the 1-session group and 79% of the 5-session group managed to take an unaccompanied return fight. At the 1-yr follow-up assessment the effects were maintained on all measures except the behavioral test; in both groups 64% of the patients took the flight. The most plausible reason for this deterioration is that during the follow-up year the subjects who relapsed didn't have the opportunity to fly as a job requirement with the employer paying the expenses. The implications of these results are discussed.

One vs five sessions of exposure and five sessions of cognitive therapy in the treatment of claustrophobia.

Forty-six patients fulfilling the DSM-IV criteria for claustrophobia were assessed with behavioral, physiological, and self-report measures. They were randomly assigned to four conditions: (1) one-session (E1); or (2) five-sessions of exposure (E5); (3) five-sessions of cognitive therapy (C5); and (4) Wait-list for 5 weeks. The first condition consisted of a single 3 h session of massed exposure, and condition 2 and 3 of 5 h of gradual treatment, which was done individually by very experienced therapists. The results showed that treatment was significantly better than the wait-list condition, and the three treatments did equally well with no differences between them. At post-treatment 79% of treatment patients vs 18% of the wait-list controls had improved to a clinically significant extent. When the three treatments were compared 80% in the E1-group, 81% in the E5-group, and 79% in the C5-group were clinically improved. At the 1 year follow-up the corresponding figures were 100%, 81%, and 93%, respectively. The implications of these results are discussed.

Electrodermal non-responding in schizophrenia: relationships to attentional, clinical, biochemical, computed tomographical and genetic factors.

The purpose of the present study was to examine whether a psychophysiologically delineated subgroup of electrodermally non-responding subjects show deviations in other data domains. Specifically, we examined clinical ratings of psychopathology, cognitive measures of distractibility in short-term memory, family history of schizophrenia, as well as biochemical indices of monoamine and endorphin activity, and measures derived from computed tomography. The non-responders had significantly lower skin conductance level, less spontaneous fluctuations, and a smaller ratio of elicited to spontaneous responses. The non-responders had a significantly higher incidence of schizophrenic relatives than the responders, and tended to show more psychotic symptoms. The two groups did not differ in cognitive distractibility, or in biochemical and computed tomographical measures.

Role of modifying alleles in the heritable colorectal cancer syndromes with polyps.

It is proposed, based on in vitro studies on hereditary colorectal cancer syndromes (adenomatosis of the colon and rectum, ACR), that the presence/absence of specific abnormal culture phenotypes within and between such ACR kindreds will demonstrate the interaction of a modifying allele with its proposed major polyposis gene, influencing expression of this major gene, at least in vitro. Such in vitro evidence would suggest that the variability of clinical phenotype was due, at least in part, to such gene-gene interaction and this should be considered as well as the influence of enviornmental agents on the development of both pre-malignant lesions and clinical cancer in such cancer-prone families.

Occult radiopaque jaw lesions in familial adenomatous polyposis.

Osteomatous jaw lesions have been reported to occur in connection with familial adenomatous polyposis (FAP) of the intestines. The disease is fatal if not treated. The aim of this investigation was to study the occurrence of bone jaw lesions in Swedish families, where some family members have developed FAP, in order to evaluate if these bone changes may be regarded as clinical markers of the disease. 132 individuals from ten families with FAP and a matched control group of 250 individuals were examined. Osteomatous lesions were diagnosed in 24 per cent in the FAP families and in 2 per cent in the controls. Individuals with verified FAP showed an increased occurrens of jaw lesions. Also in family members without verified FAP, first-degree relatives and other relatives, showed a significant higher incidence of osteomatous jaw lesions compared to the controls. Our results suggest that osteomatous jaw lesions in families with FAP are of predictive significance.

Surgical treatment of hereditary adenomatosis of the colon and rectum in Sweden during the last 20 years. Part I. Introduction. Surgical procedures used. Pre-and postoperative measures. Arrangement of follow-up. Propositi group, primary and late results.

An investigation of the prevalence of hereditary adenomatosis of the colon and rectum (ACR) in Sweden was started in 1959. Up to the end of 1972, 97 families were traced and 80 of them were more fully investigated. In 56 of the latter families there were at least 2 affected members; in the other 24, only one. In all, 340 affected individuals were found, 150 of whom were operated upon with the aim of cure. Of the operated patients 82 had presented with symptoms, the propositi group, while 68 affected individuals were detected during the family investigations and underwent prophylactic operations, the call-up group. A comparison was made between the two groups of the primary and long-term results after operation. Major surgery with total proctocolectomy and ileostomy (PCI) or colectomy with ileorectal anastomosis (IRA) was performed in 135 cases, 67 propositi and 68 call-up patients; minor surgery with segmental resection (SR) in 15 propositi. The propositi group is presented in detail in this paper, the call-up group in a following paper. In the propositi group there were 3 surgical deaths (3.7%). At the time of operation 48 patients (58.5%), had already developed cancer. Up to the end of the period of observation 16 of them died from metastases, 2 of other malignancies, and 3 of nonmalignant disease.

Surgical treatment of hereditary adenomatosis of the colon and rectum in Sweden during the last 20 years. Part II. Patients with prophylactic operations, primary and late results. Discussion and summary.

During the investigation, started in 1959, of Swedish families with hereditary adenomatosis of the colon and rectum (ACR), 68 affected, but symptom-free, individuals were detected and referred for surgical treatment. In all of them major surgery was performed, total proctocolectomy and ileostomy (PCI) in 10 cases, colectomy with ileorectal anastomosis (IRA) in 58. The surgical mortality was 4.4%. Six patients had cancer at the time of operation, and another 2 patients were operated on for colonic cancer many years prior to the diagnosis of ACR. One of those 8 patients died from metastases. Primary malignant kidney tumour was responsible for the only additional late death in this group. In a preceding paper the primary and long-term results after surgery in a group of patients who presented with symptoms, the propositi group, were reported in detail. In this group cancer was found in 48 patients, 16 of whom died from metastases. The most suitable time for operation, and the choice of operative method are discussed. The need for future supervision of affected families is stressed, and the arrangement of follow-up is outlined.

Carcinoembryonic antigen in hereditary adenomatosis of the colon and rectum.

Hereditary adenomatosis of the colon and rectum (ACR) invariably leads to malignant transformation unless the patients undergo prophylactic operations. The serum level of carcinoembryonic antigen (CEA) was determined in 130 individuals belonging to different ACR-families. Fifty-six of them were operated upon with colectomy, 27 affected individuals were still not operated on, and 47 were unaffected first degree relatives. Around 20 percent of the patients in each of these groups had moderately raised CEA serum levels compared to unrelated healthy subjects. Since the serum values were low or only moderately raised and occurred in all groups, the determination of serum levels cannot be generally used to indicate malignant transformation of adenomas. However, assays of the tissue CEA content in six histologically verified adenomas showed values similar to those of overt colonic carcinomas. This opens up stimulating possibilities of investigating the CEA activity in serum and tissues of chosen individuals with ACR.

In vitro evidence of genetic heterogeneity within the heritable colon cancer syndromes with polyposis coli.

Assays of in vitro biological properties associated with cellular transformation revealed differences in cultured skin cells within the heritable colon cancer syndromes with polyposis coli. Such evidence suggested that genetic heterogeneity, long assumed from in vivo differences in extracolonic lesions in these syndromes, could be detected in vitro. None of the properties studied nor any grouping of them made identification of a specific genotype possible.

In vitro studies on adenomatosis of the colon and rectum.

Cell culture studies on adenomatosis of the colon and rectum (ACR) suggested that the clinical phenotype, colonic adenomas which become malignant recognised as a single clinical entity, may not be entirely the result of a single dominant mutation. Of the dermal cultures containing both epithelioid and fibroblastic cells established from six affected subjects from six unrelated ACR families, four showed increased tetraploidy and two did not. Of similar cultures established from four affected subjects form families with ACR associated with sebaceous cysts in consecutive generations, three did and one did not have increased tetraploidy. Irrespective of the in vivo relationship of increased tetraploidy to colonic cancer, the cultures from seven ACR patients had populations of tetraploid cells, at least in vitro, with chromosome instability. Such a difference in expression of the ACR genotype in vitro suggested genetic heterogeneity within this clinically defined group.

Porous ceramics as a bone substitute in the medial condyle of the tibia. An experimental study in sheep. Long-term observations.

A recent 3-month implantation study indicated that a new porous ceramic material might be suitable as a bone substitute in regions exposed mainly to compressive forces. The porous ceramics were implanted into the medial condyle of the tibia of sheep. In the present study the implants were left for 10 months in three animals, and 12 months in two. In the two animals with 12 months' observation, the plate which had been used to stabilize the implant was removed at 10 months. The implants and the adjacent bone tissue were studied macroscopically, radiographically and by microradiography and transmitted light microscopy. All the implants were bound to the adjacent bone by ingrowth of bony tissue. The depth of the bony invasion was slightly greater than that observed at 3 months, being maximally 3-4 mm. Some signs of ossification were still seen within the pores. The bony bridges between the implants and the surrounding bone were particularly well developed in regions of maximal stress. This was interpreted as a sign of active adaption of the bone formation to the actual stress to which the shearing surfaces were exposed. It is concluded that the properties of the porous ceramic implants justify a clinical trial in man.

Intraepithelial bodies in colorectal adenomas: Leuchtenberger bodies revisited.

The presence of intraepithelial inclusion bodies (Leuchtenberger bodies) was recorded in rectal or colonic specimens from 130 patients. Large to moderate number of intraepithelial bodies were recorded in 81.8 percent of 55 colorectal adenomas from patients with familial adenomatous polyposis (FAP). Conversely, none of the 55 non-FAP adenomas or of the 20 specimens with ulcerative colitis (10 with dysplasia) had similar amounts of intraepithelial granules. Feulgen studies demonstrated that the granules contain DNA and are probably nuclear fragments of destroyed lymphocytes. Although the pathogenesis of this phenomenon remains obscure, it appears that the presence of large to moderate number of intraepithelial bodies in colorectal adenomas should strongly raise the suspicion of FAP.

Demonstration of altered cellular DNA content distribution in long-term colon epithelial cell lines with colon cancer genotypes.

During prolonged culture (7-40 passages assayed) DNA distribution was constant in IVT-negative lines with FPC genotype and in IVT-negative lines without any known colon cancer genotype, whereas the DNA histograms of the IVT-positive lines with HNPCC genotype showed a marked change. The DNA index (DI) of greater than 1 increased sixfold in the HNPCC-A (affected) line and threefold in the HNPCC-AR (at-risk) line due to an equal increase in DI of 2 and DI of greater than 2. It is proposed that there is a possible association between the HNPCC genotype, the presence of IVT, and the marked increase in both DI of 2 and DI of greater than 2 in DNA histograms, since neither the lines with normal nor those with FPC genotypes showed these changes. The biological significance of IVT might be due to its influence on the constancy of the distribution of cellular DNA content, leading to aneuploidy, which has been known to precede in vitro tumorigenic phenotypes.

Duodenal adenomatosis in familial adenomatous polyposis. DAF Project Group.

In order to evaluate the prevalence of duodenal adenomas in familial adenomatous polyposis (FAP) and the risk of carcinoma development, a multicenter study was initiated in Denmark, Finland, Holland, Norway and Sweden, which have national polyposis registers with an almost complete registration. Patients aged 20 years or more are being examined with biennial gastroduodenoscopy during 1990-2000. Multiple duodenal biopsies are examined by one pathologist from each country, and the endoscopic and histological criteria of Spigelman have been adopted. At the end of August 1992, 312 patients with a median age of 37 years (range 20-86) had completed their first endoscopy. The duodenum was examined in 310 patients, of whom 199 (64%) had duodenal adenomas. Twenty-two patients (11% of all patients with duodenal adenomas) had no endoscopically visible polyps. One patient had an asymptomatic adenocarcinoma. The Spigelman stage worsened significantly (P < 0.05) with time from the diagnosis of FAP, which may suggest an increasing risk of carcinoma by time.

Poly ICLC induces anti-IC antibodies in mice and rabbits.

Poly ICLC is an interferon (IFN) inducer and antiviral, antitumor, radioprotective, and immunoregulatory agent. We show that administration of poly ICLC to mice and rabbits also results in the presence of anti-IC antibodies in their serum.