Affective modulation of the startle reflex in schizophrenic patients.

Startle-elicited blinks were measured during the presentation of affective slides in order to investigate emotional responsiveness in 24 male healthy subjects and 34 male schizophrenic patients. Although the two groups did not differ with regard to their subjective and autonomic responses to the slide stimuli, there was a significant difference between the groups in their responses to the startle probes. Patients rated low in affective expression showed a linear response pattern comparable to that of normal controls with largest amplitudes during unpleasant slides and smallest during pleasant slides. Patients without apparent deficit in affective expression showed a quadratic relationship with smaller blink amplitudes during both pleasant and unpleasant slides. Diminished affective expression rated on the basis of a clinical interview is not associated with a general attenuation of the blink reflex or of its modulation by exposure to emotional slides. Thus, we found no indication of an impairment in the perception of affective stimuli nor of reduced appreciation of pleasant stimuli (anhedonia) in these patients.

Slow cortical potentials (SCPS) in schizophrenic patients during performance of the Wisconsin card-sorting test (WCST).

Fifteen schizophrenic patients (diagnosed according to DSM-III-R) and 15 age- and education-matched controls were tested on a computerized version of the Wisconsin card-sorting test (WCST). Slow Cortical Potentials (SCPs) were recorded throughout the performance from frontal, central and parietal electrode sites. As expected, the patients were impaired on the WCST, achieving fewer categories overall and incurring significantly more "unique" errors, although they were not significantly more perseverative than the controls. The patients did not display a generalized impairment in SCPs, differences between the groups emerging only before presentation of the key-cards and after presentation of the feedback regarding the correctness of the response. Neither the choice-card at the beginning of the trial, nor the presentation of the key-cards resulted in attenuated Evoked Potentials (EPs) in the patients. The lack of any abnormality in EPs suggests that the reason for the poor performances of schizophrenic patients on the WCST lies elsewhere than in perceptual stimulus processing. Contrary to expectations no specific impairment in frontal SCPs was detected.

[Bowel cleansing prior to colonoscopy. A prospective, randomized, blind comparative study]. / Darmreinigung vor Koloskopie. Eine prospektive, randomisierte, blinde Vergleichsstudie.

A randomized, prospective, single blind study was performed in 90 hospital inpatients to compare the effect of three different bowel preparatory regimens prior to total colonoscopy. The extend of bowel cleansing, acceptance by the patients, side effects as well as body weight, blood pressure, pulse rate and various laboratory parameters served as major assessment criteria. Peroral colonic lavage was superior to a senna preparation and a combined laxative agent with regard to the extend of bowel cleansing (p less than 0.001). The study failed to detect significant differences in terms of acceptance by the patients between the three study groups. Minor deviations were found after the combination laxative (slight decrease of serum potassium levels by 0.32 mmol/l), after the senna preparation (minimal decrease of the heart rate), and after peroral lavage (slightly less weight reduction) as compared with the other study groups, respectively. We conclude that peroral lavage is significantly more effective with regard to the extend of bowel cleansing, when compared with two other bowel preparatory regimens, which use a senna preparation or a laxative combination, respectively. Likewise, this study failed to detect significant differences in terms of acceptance by the patients.

Prajmaliumbitartrate-associated liver damage. Report on seven further cases with follow-up for two to five years.

Seven further cases with n-propyl-ajmaliumbitartrate (NPAB)-associated liver damage observed between 1976 and 1980 in two collaborating institutions are reported. The cause/effect relationship could be classified as probable in three cases and as potential in the remaining four patients. No drug rechallenge was carried out. In the clinical management, definite exclusion of biliary tract obstruction had a clear priority over histologic documentation of the degree of the transient liver damage. Follow-up data after 2 years 8 months to 5 years 9 months by personal reinvestigation of three patients and by questionnaire to family physicians and patients in the remaining four cases gave no clinical or serologic indication of persisting or relapsing liver damage. Liver biopsies were not considered to be warranted in the follow-up of these asymptomatic patients with normal liver function tests.

[Antihistamines and reactivity]. / Antihistaminika und Reaktionsfähigkeit.

In two consecutive partial studies conducted under double-blind conditions the potential effects of the antihistamine 1-(4-fluorophenylmethyl)-N-[1-[2-(4-methoxypenyl)ethyl]-4-piperidinyl]- 1H-benzimidazole-2-amine (astemizole) on the ability to drive and the safe operation of machinery was tested in a total of 85 volunteers. The test was performed with psychometrical methods and included the activation level (= objective tiredness), the subjective feeling of tiredness as well as their impact on concentration and reactivity. It was shown, that after a single administration (first partial study) there was no difference in performance between astemizole and placebo, whereas under the influence of the reference substance ketotifen concentration and reactivity were significantly impaired. It should be mentioned that the volunteers of the reference group did not yet experience a subjective feeling of tiredness, while their performance had already fallen off. Also after seven days of treatment (second partial study) with astemizole or placebo the active group did not exhibit any decline in performance. The authors advise against the generalized reference to a "possibly impaired reactivity" in the case of antihistamines.

[Haemodialysis in the treatment of acute boric acid poisoning (author's transl)]. / Hämodialysebehandlung einer akuten Borsäurevergiftung

40 g boric acid was by error given instead of glucose solution to a 62-year-old man during an oral glucose test. During an 18-hour dialysis 8.32 g boric acid was eliminated, 8.6 g by forced diuresis and at least 9 g by gastric lavage. A large amount of the poison was also found in the vomitus. The most important signs of posioning were slight metabolic acidosis, total anuria for 14 hours and normochromic anaemia. There was no residual kidney damage or other effects of the poisoning.