[Rational diagnosis of the bile ducts]

Since the introduction of MR cholangiography (MRC) diagnostic imaging of the biliary tract has been significantly improved. While percutaneous ultrasonography is still the primary examination, computed tomography (CT), conventional magnetic resonance imaging (MRI), as well as the direct imaging modalities of the biliary tract--i.v. cholangiography, endoscopic-retrograde-cholangiography (ERC), and percutaneous-transhepatic-cholangiography (PTC) are in use. This article discusses the clinical value of the different diagnostic techniques for the various biliary pathologies with special attention to recent developments in MRC techniques. An algorithm is presented offering a rational approach to biliary disorders. With further technical improvement shifts from ERC(P) to MRC(P) for biliary imaging could be envisioned, ERCP further concentrating on its role as a minimal invasive treatment option.

Neuropsychological impairment in first-episode and chronic schizophrenic patients

Patients with first-episode (FE) schizophrenia (n = 40), with chronic schizophrenia (n = 40) and healthy controls (n = 40) matched for age, gender, education and parental socioeconomic status were administered a battery of standardized neuropsychological (NP) tests. Both patient groups showed generalized impairment relative to controls and the most pronounced deficits in visual-motor processing and attention (VSM). Compared with FE patients, chronic schizophrenics performed worse in VSM and abstraction/flexibility. Our findings suggest that NP deficits are fundamental manifestations of the illness, and that mainly frontally based dysfunctions are more prominent in chronic, kraepelinian patients.

Dose-dependent reductions by naloxone of analgesia induced by cold-water stress

Animals exposed to cold-water swims, rotation, or inexcapable shocks, display analgesia comparable to that of 10 mg/kg of morphine. The present study investigated whether a narcotic antagonist would eliminate analgesia induced by cold-water swims. In one group of 12 rats, naloxone at 0, 1, 5, 10 and 20 mg/kg was administered at weekly intervals immediately preceding forced cold-water swims (2 degrees C for 3.5 min) and alterations in flinch-jump thresholds were determined 30 min thereafter. In a second group of six rats, the effects of the same dose range of naloxone were determined upon normal flinch-jump thresholds. Naloxone dose-dependently attenuated the cold-water swim-induced analgesia up to a maximal reduction of 50% at 20 mg/kg. In contrast, all doses of naloxone had no effects upon normal flinch-jump thresholds. Since low doses of naloxone completely abolish morphine-induced analgesia, the present data suggest that the analgesia induced by stress is not identical to that of opiates.