A. M. A. archives of neurology and psychiatry

The concept of the sedation threshold, recently introduced into the medical literature, has received considerable attention as a tool of value in psychiatric and psychosomatic research. It acquired its significance from the findings that it correlated with two important and fundamental determinants in the psychological and psychoanalytic theory: the degree of anxiety and the degree of impairment of ego functions. It also acquired another value as a relatively constant level for the individual and a relatively enduring biological characteristic of him, as indicated by a high testretest reliability in studies of the sedation thresholds for amobarbital (Amytal) sodium.10 A study has been undertaken to investigate the relationship between various manifestations that have been designated "anxiety" and the amount of central nervous system depressants—namely, amobarbital sodium and ethyl alcohol—required to produce the levels of the sedation thresholds. The assumption was that the psychological state of the organism determines, to a

ALI A. KAWI

A M A Archives of Neurology & Psychiatry

The Sedation Threshold

镇静阈值

<h3>Introduction</h3> Although a great deal has been written about porencephaly during the past 100 years, there is much that remains obscure. The clinical recognition of porencephaly is important because it occurs with sufficient frequency to require consideration in the differential diagnosis of focal cerebral lesions. The study of a group of patients is reported in order to clarify some of its clinical features. The patients considered to fulfill the criteria for this study were those with cystic defects of the cerebrum whose lesions were present at, or very shortly after, birth, excluding those with destructive lesions occurring later in life. <h3>Pathology</h3> The term porencephaly has undergone considerable change in its meaning since Heschl1first used it in 1859. The lesions included under the loose coverage of porencephaly vary widely. Heschl proposed the term porencephaly to designate specifically the types of circumscribed defects which "have this in common, that in

RICHARD W. NAEF

Clinical Features of Porencephaly

孔洞脑的临床特征

This report, a preliminary one, of a portion of a continuing research project on homosexuality as seen in the psychiatric section of a university student health service presents data in two areas where perusal of the literature on homosexuality reveals they are either lacking or minimal: (1) some characteristics of homosexuals in a college population and (2) treatment results. Most survey-type studies have dealt with prison and mental hospital inmate population; to our knowledge only one study has dealt specifically with a university student homosexual population, and another indirectly. Previously, little, if any, effort to assess the efficacy of therapy with a group of homosexuals as compared with that in a nonhomosexual psychiatric control group has been made. The Student Health Service at the University of California at Los Angeles provides outpatient psychiatric facilities to all students who are regularly enrolled. The records of the psychiatric division are separately kept,

MATHEW ROSS

Homosexuality in College

大学中的同性恋

Introduction Recent investigations in this laboratory of the ratio of cerebrospinal fluid calcium and magnesium in psychotic and nonpsychotic patients gave results which could be explained by the alteration of the permeability of the blood-brain barrier. 1,2 It was suggested that endocrine and other organ systems external to the central nervous system may have an effect on this permeability. Therefore it was decided to evaluate as many of these systems as possible in mental disease. Because of the widespread use of ataractic drugs in mental hospitals, it is difficult to obtain a patient group whose metabolic processes may not have been altered. However, patients undergoing insulin shock therapy are drug-free and receiving no therapy except insulin. In addition, they have the same diet and approximately the same amount of exercise and recreation as well as excellent surroundings and attention. Furthermore, it has been shown at this hospital that insulin therapy

WILLIAM H. HARRIS

A Combined Biochemical and Clinical Study of Mental Disease

精神疾病生化与临床综合研究

Recent investigations of convulsive therapy have emphasized EEG delta activity as the neurophysiologic basis for the induced behavioral change.1-5Little study, however, has been given to the biochemical effects of this therapy, except in the course of investigations of head injuries. In investigations of head trauma significance has been ascribed to changes in the acetylcholine-cholinesterase systems both for the behavioral and for the electroencephalographic effects. An increase in free acetylcholine6and an alteration of the ratio of cholinesterases7in the spinal fluid have been positively correlated with the degree of EEG abnormality and degree of neurologic deficit. The EEG patterns were "blocked," and some improvement in clinical status was reported following the administration of atropine.7,8In convulsive therapy, atropine and scopolamine were observed to block the appearance of delta activity,9although the systemic effects of the large doses of these agents were marked. Recent reports

MAX FINK

Effect of Anticholinergic Agent, Diethazine, on EEG and Behavior

抗胆碱能药物地乙酰嗪对脑电图和行为的影响

The proper management of intracranial arterial aneurysms has been the object of considerable controversy. In an effort to evaluate various methods of treatment, we have compared the results of these methods in 115 patients treated under similar conditions by the same surgeons. Before the evolution of modern neurosurgical techniques, intracranial aneurysms were curiosities, usually discovered at autopsy. In 1923 Symonds'1presentation of the criteria for the diagnosis of a ruptured intracranial aneurysm gave impetus to further study of this subject. Richardson and Hyland,2Walsh and King,3Dandy,4and numerous others have contributed much to the increasing frequency of diagnosis and successful treatment of aneurysms. Recently a more complete study by Hamby5has brought the entire subject into focus with a survey of the previous publications and an analysis of his own material. The mortality rate of ruptured intracranial aneurysms is known to be high, ranging

EBEN ALEXANDER

Intracranial Aneurysms

颅内动脉瘤

The presence of fibrillation in the muscles of the Bar Harbor strain of dystrophic mice has previously been reported from this laboratory.1We have observed that the electromyogram from dystrophic mice of this strain is strikingly similar to that recorded from muscles of patients suffering from dystrophia myotonica. The muscles of such patients and animals are hyperirritable, and the records obtained by the insertion of a concentric needle electrode reveal the presence of short motor volleys of high frequency against a background of electrical activity characteristic of denervated muscle. In order to demonstrate the presence of fibrillation, free of the superimposed activity from innervated structures, it was decided to study the electrical activity of muscles in dystrophic mice and patients in whom the motor nerves were blocked. The identification of characteristics common to both the dystrophy in this strain of mice and a particular form of dystrophy in man

A. R. McINTYRE

Muscle Dystrophy in Mice of the Bar Harbor Strain

巴港品系小鼠的肌肉萎缩症

Although the major complication of the 1957 pandemic of influenza was pneumonia, cases of neurological disorder were reported to accompany or to follow the initial respiratory infection. The brunt of the insult was borne at any level of the nervous system, giving rise to a varying combination of clinical symptoms and signs. One of these was the Guillain-Barré syndrome. Despite the occurrence of fatal cases and the opportunity for pathological study, this syndrome remains a clinical concept, although, since its first description in 1916,16the ambit of its diagnostic use has been greatly extended, particularly in the literature of Scandinavia, America, and the British Commonwealth. By the outbreak of World War II, Guillain14himself had accepted several varieties of the syndrome, and in his most recent communication15(1953) he allotted 3 of his series of 19 cases to a sixth variety, which had been described nearly 20

C. E. C. WELLS

Guillain-Barré Syndrome and Virus of Influenza A (Asian Strain)

吉兰-巴雷综合征与甲型流感病毒（亚洲株）

With the knowledge that anticoagulant drugs were effective in significantly reducing the incidence of cerebral embolic phenomena1,2and the evidence that in animals anticoagulants might increase the severity of experimental hemorrhagic infarcts,3-5the study of cerebral embolic phenomena in man has taken on new importance. This paper examines three aspects of cerebral embolism in man—the usual clinical course, the prognostic signs of significance, and the effects of anticoagulation upon the clinical outcome. <h3>I. The Natural History</h3> The present study is an effort to delineate the clinical features and course of cerebral embolic phenomena. In previous pathological studies6,7the natural history of those episodes ending in death has been considered, but this hardly gives a verisimilitude of the usual clinical course. The records of 185 patients with a diagnosis of cerebral embolism admitted to the New York Hospital over the past 18 years were critically assayed. In 82

CHARLES E. WELLS

Cerebral Embolism

脑栓塞

Since the introduction of phrenotropic drugs in psychiatry, the major syndromes influenced by them have been those associated with excitation, elation, agitation, and, sometimes, anxiety. There has been, as yet, no satisfactory means for chemical control of depressive states. Amphetamines, effective in mild depression, have a transitory unpredictable effect and are also habitforming. Iproniazid (Marsilid), one of the few promising antidepressants, may produce undesirable side-effects, and death, though rare, has followed its use.1While surveying different substances in this area, it was noted that Kuhn, in Switzerland,2had observed favorable results with an iminodibenzyl compound in 30 depressed patients. A preliminary trial with this substance3confirmed Kuhn's opinion. Concomitantly, Lehmann et al.4reached the same conclusions. The present study was undertaken to observe more fully the effects of this substance (imipramine), which appeared to be a potent antidepressant and also to investigate the changes in psychodynamic

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