Motor neuron disease and dementia reported among 13 members of a single family.

All 49 members of four generations of a family were identified. In the first three generations eight members were afflicted with dementia, whereas in the fourth generation only one was demented but three of four were afflicted with motor neuron disease and they also had slight cognitive deficiencies. The pattern of heredity is compatible with dominant autosomal inheritance. Neuropsychological testing revealed affection mostly of the frontal lobes. A pedigree and six case reports are presented.

On the clinical deformation of maxillary complete dentures. Influence of denture-base design and shape of denture-bearing tissue.

This paper aimed to study the influence of denture base design and the shape of the denture-supporting area on the functional deformation of maxillary complete dentures. Six strain-gauged duplicate maxillary dentures were made for the study of two test subjects with different shapes of the palatal vault. Each subject was supplied with two polymethyl methacrylate dentures, one with a 1-mm-thick palatal base and the other 2 mm thick. A third denture was constructed with a cobalt-chromium base. The functional loading tests included maximum biting and the chewing of the food test samples. An analysis based on chewing time and total number of chewing cycles per test piece was also made. The results showed that surface straining is highly complex at the anterior part of the maxillary dentures constructed from polymethyl methacrylate and that increasing the denture thickness per se might not be accompanied by a reduction of strain. The results also suggest that high thrust to the supporting tissue is produced with high palatal vault dentures made in polymethyl methacrylate. The study proposes that cobalt-chromium bases may be used in maxillary dentures to reduce functional deformation and thrust to the supporting tissues at the anterior part of the maxilla.

Symptoms of classic migraine attacks: modifications brought about by metoprolol.

There is little information available concerning whether, and to what extent, migraine-prophylactic agents interfere with the symptoms of migraine attacks. The present study is a placebo-controlled, double-blind study concerning metoprolol in classic migraine. The data refer to the symptoms of single migraine attacks. During metoprolol treatment more attacks were characterized as mild (p = 0.002), and mean global rating (an integrated estimate of headache intensity and of other discomfort) was lower (4.2 versus 5.2, p = 0.003). The mean headache intensity per attack (1.97 versus 2.15) and the mean duration (5.5 versus 6.8 h) were not significantly different. Consumption of analgesics per attack was lower during metoprolol treatment (0.6 versus 1.1; p = 0.02). Attacks with associated symptoms accompanying the headache were fewer during metoprolol treatment (p = 0.014). Total visual and non-visual aura symptoms occurred with similar frequency, but scintillations and paraesthesia were more frequent during metoprolol treatment, whereas speech disturbances were less frequent. In spite of lower consumption of analgesics, the symptoms appeared milder during metoprolol than during placebo. The pattern of changes indicates that metoprolol exerts its action via the sympathetic nervous system; peripheral vasoconstriction is hardly the underlying mechanism of action.

On functional strain in fixed mandibular reconstructions. II. An in vivo study.

Six linear strain gauges and one rosette strain gauge were used on one partially dentate subject to study various types of functional deformation in a six-unit conventionally designed fixed mandibular bridge and a five-unit cantilever fixed mandibular bridge. The results of this study show that the clinical straining pattern was complex and different from those recorded in laboratory model studies of the same case. It was therefore concluded that functional deformations of fixed dental appliances can be studied accurately only in clinical experiments. Fundamentally different straining patterns were observed between the conventionally designed bridge and the cantilever one. The clinical significance of these results are discussed in relation to prosthetic treatment with various types of fixed-bridge constructions.

Metoprolol and propranolol in migraine prophylaxis: a double-blind multicentre study.

In a double-blind, cross-over multicentre trial, the prophylactic antimigraine effect of the beta 1-selective beta-blocker metoprolol was evaluated and compared with that of the non-selective beta-blocker propranolol. Metoprolol was used in a dosage of 50 mg b.i.d. and propranolol in 40 mg b.i.d. 56 patients with classical or common migraine were included in the double-blind part of the investigation. 3 patients withdrew, but none because of side-effects. The data suggest that metoprolol is clinically equivalent in effectiveness to propranolol in migraine prophylaxis regarding parameters such as attack frequency, improvement in sum of severity score and subjective evaluation. Both drugs were generally well tolerated and the number of reported side-effects was similar to those reported during the run-in period (placebo).

On functional strain in fixed mandibular reconstructions. I. An in vitro study.

Six linear strain gauges and one rosette strain gauge were used on three different types of models prepared from one partially dentate subject, to study loading deformation in a six-unit fixed mandibular bridge. The bridge was mounted on each of the models on an adjustable articulator and loaded in a universal testing machine at loading levels ranging from 0 to 491 N. The results showed considerable differences between the three types of model, with regard to both the magnitude of the recorded strains for the individual gauges and the calculated direction of the principal strains under the rosette gauges. The findings indicate that the mechanical properties and the design of the supporting structures have a major influence on the functional deformation of fixed dental appliances.

Treatment of chronic obsessive compulsive states with stereotactic anterior capsulotomy or cingulotomy.

A neuropsychological model on how to evaluate patients subjected to stereotactic psychosurgery is presented. Four patients with chronic obsessive compulsive neurosis were randomly assigned to either stereotactic anterior capsulotomy or cingulotomy, and assessed pre-, peri-, and postoperatively according to this model. The best immediate and long-term follow-up results in reducing obsessional symptoms were obtained in the two capsulotomized patients. Psychosurgery should only be performed by a multidisciplinary team of specialists, with objective evaluation, adequate information on patients, and reliable test instruments.

Genetic identification of a subgroup of depressed patients.

HLA antigens, blood groups and red cell enzyme polymorphisms were studied in patients with different types of affective disorders and in patients suffering from cycloid psychoses. Several statistically significant results were found. In particular, a subgroup of depressed patients characterized by a very extreme distribution of haptoglobin groups was identified. The implications of this last finding for the definition of a particular subgroup of depressed patients is discussed.

HL-A antigens and the response to prophylactic lithium.

82 consecutive patients checked at the out-patient clinic of the Psychiatric Department of the Umeå University were typed for HL-A antigens. The patients belonged to the diagnostic subgroups: bipolar (manic-depressive) psychosis (n = 33), unipolar recurrent depressive psychosis (n = 29) and cycloid psychosis (n = 20) and all had been on lithium treatment for at least 6 months. By comparing the group of those who did not relapse on lithium therapy (n = 48) with the group of those who did relapse (n = 34) there was a significantly higher frequency of the HL-A A3 antigens among those who did relapse, and none of those who did not relapse were found to have the HL-A B18 antigens. The results suggest a possible interference between HL-A antigens and response to lithium treatment. However, a large number of antigens were tested and a small number of patients.

Psychogenic needs in depression.

Thirty-eight depressed in- and outpatients at the Department of Psychiatry, Umeå University, were asked to complete a CMPS form concerning their psychogenic needs. The depression depth of these patients was then rated by a doctor who utilized selected items from the CPRS scale. The 38 patients were matched according to age and sex with 38 former depressed patients who had been investigated after recovery from a depressive syndrome to establish whether there is any correlation between psychogenic needs and severity of a depressive disorder and to determine whether these psychogenic needs depend on depression or are a more stable part of an individual's personality.

"Psychogenic needs" in patients with affective disorders.

To investigate the occurrence of different psychogenic needs or groups of needs, 118 consecutive out-patients with previous depressive disorders were asked to complete the Cesarec and Marke Personality Inventory; 103 completed it. Strict diagnostic criteria were used in subgrouping the series which thus consisted of unipolar depressive psychosis (UP), 26 patients; bipolar depressive psychosis (BP), 16; unclassified depression (NUD), 8; and reactio neurotico-depressive (RND), 15. BP distinguished themselves from the other groups by a tendency to have a reduced need of approval, dependency, guilt feelings and ego conflicts and a stronger wish to dominate and lead. These results are in line with earlier findings. The NUD group was small but tended to have extreme scores, i.e. a particularly weak need to dominate and to be in the centre but also to be cared for.

No association of red cell adenylate kinase phenotypes with affective disorders.

Red cell adenylate kinase (AK) phenotypes were studies in 195 patients with affective disorders (41 with the bipolar and 81 with the unipolar form of the disease) and 418 controls. No significant differences were found between patients and controls and between patients with different types of affective disorders. Thus the previous observation by Rundle et al. (1977) showing an increased frequency of the AK2 allele in the unipolar group was not confirmed.

Genetic markers in cycloid psychosis.

Frequencies of HLA antigens, blood groups, serum groups and red cell enzyme types in patients with cycloid psychosis were compared with those in patients with bipolar psychosis and in normal controls. Patients with cycloid psychosis showed (1) an increased frequency of the Rh-negative type compared to controls, (2) an increased frequency of the K(+) phenotype compared to both bipolar patients and controls, and (3) an increased frequency of the serum group Gc2--1.