Structural brain changes in patients with anorexia nervosa

Twenty-five patients with anorexia nervosa were compared with 17 normal healthy control subjects in terms of their cerebral computed tomographic (CT) scan appearances. The patients displayed significantly greater ventricular and sulcal enlargement when compared to control subjects. There were no relationships between the CT scan appearance and clinical indices of illness severity or weight loss in the patient group. In 14 patients who had repeat scans after attaining normal body weight, no significant change was observed in the ventricular appearance, but there was a significant lessening in the degree of sulcal widening.     

Response to drugs in schizophrenia: the influence of family history, obstetric complications and ventricular enlargement

A prospective study of antipsychotic drug treatment showed no difference in response between schizophrenic in-patients with or without a familial predisposition to the illness (N = 53). All patients received at least 600 mg chlorpromazine equivalents antipsychotic medication for 6 weeks. Ventricle brain ratios, ratings of cortical sulcal widening and a history of obstetric complications also failed to account for the variability, but early age of onset was associated with unsatisfactory response.     

CT scan studies of superficial cerebral regions: frequency and distribution of abnormalities in elderly psychiatric patients

The CT scans of 50 elderly psychiatric patients were evaluated for the presence of discrete cerebral abnormalities. The prefrontal, superior temporal and inferior parietal areas showed the most frequent occurrence of defects. Motor, sensory and tertiary visual cortical regions, on the other hand, did not commonly exhibit signs of atrophy or sulcal widening. Clinical diagnoses of depression and dementia occurred in patients whether or not specific gyral defects were present, and therefore did not predict their presence. Patients w with regional cerebral defects, however, were more likely to be older and to have sustained severe neurological insults. Patients with affective disorders who were treated with ECT showed no differences in the occurrence of superficial cerebral defects.     

CT scan studies of superficial cerebral regions: frequency and distribution of abnormalities in elderly psychiatric patients

The CT scans of 50 elderly psychiatric patients were evaluated for the presence of discrete cerebral abnormalities. The prefrontal, superior temporal and inferior parietal areas showed the most frequent occurrence of defects. Motor, sensory and tertiary visual cortical regions, on the other hand, did not commonly exhibit signs of atrophy or sulcal widening. Clinical diagnoses of depression and dementia occurred in patients whether or not specific gyral defects were present, and therefore did not predict their presence. Patients w with regional cerebral defects, however, were more likely to be older and to have sustained severe neurological insults. Patients with affective disorders who were treated with ECT showed no differences in the occurrence of superficial cerebral defects.     

The contributions of sex and drinking history to the CT brain scan changes in alcoholics

Consecutive series of male and female alcoholics, Alcoholic Anonymous (AA) members and controls were examined by interview and with a CT brain scan. Male controls were shown to have larger CT brain parameters than healthy females of the same age. Female alcoholics revealed equivalent CT scan abnormalities, apart from less sulcal widening, after a markedly shorter drinking history and at a lower estimated peak alcohol consumption than male alcoholics. The CT scan findings persisted after accounting for body weight and after matching for age and length of drinking history. The CT scan parameters of female AA members approached control values more completely and after briefer abstinence than did those of male AA members. Methodological problems and sex differences in selection and other processes are discussed. The findings are consistent with sex differences in the vulnerability of the brain to alcohol toxicity, and in its recovery with abstinence.     

Decreased cortical gray and cerebral white matter in male patients with familial bipolar I disorder

BACKGROUND: Previous MRI studies of bipolar disorder have failed to consistently demonstrate cortical gray or cerebral white matter tissue loss, as well as sulcal or ventricular enlargement. The inconsistencies are most likely due to the clinical and gender heterogeneity of the study populations as well as the different MRI acquisition and processing techniques. The objective of this study was to determine if there was a cortical gray matter and cerebral white matter deficit as well as sulcal and ventricular enlargement in a homogeneous sample of euthymic male patients with familial bipolar I disorder. METHODS: MRI tissue segmentation was utilized to obtain cortical gray matter, cerebral white matter, ventricular cerebrospinal fluid (CSF), and sulcal CSF volumes in 22 euthymic males with familial bipolar I disorder and 32 healthy male control subjects. RESULTS: Relative to the controls, the familial bipolar I patients demonstrated: (1) significant reductions of both cortical gray matter and cerebral white matter volumes; and (2) significant increases in both sulcal and ventricular CSF volumes. In the bipolar group, there was a significant negative correlation between cortical gray matter volume and sulcal CSF volume. LIMITATIONS: Small sample size, retrospective interviews, possible medication effects. CONCLUSIONS: These results provide evidence for significant cortical gray matter and cerebral white matter deficits and associated sulcal and ventricular enlargement in euthymic males with familial bipolar I disorder.     

Case-control study of GP attendance rates by suicide cases with or without a psychiatric history.

BACKGROUND: Targets for reduction in suicide deaths have been set against a background of an increasing number of people committing suicide. It is often assumed that a reduction can be effected by increasing the detection in primary care of patients at risk. This presupposes that there are indicators that enable suicide risk to be detected reliably. AIM: To compare the characteristics of those who commit suicide with an age- and sex-matched control group in terms of level of general practitioner attendance, diagnosis and pharmacological treatment of mental illness, and to compare those suicides with and without a psychiatric history in terms of general practitioner attendance and history of pharmacological treatment. METHOD: From a total of 48 deaths attributed to suicide and undetermined causes in the Forth Valley in 1993, general practice case notes were located for 41. Live controls were matched to index cases by age, sex and practice. Information on consultations, referrals to secondary care, medication and diagnoses in the previous 10 years was extracted from general practice and, for suicides, psychiatric case notes. RESULTS: Over the 10-year period, suicide patients attended their general practitioner at a higher level than control subjects. However, the number of suicide patients who attended their general practitioner in the month before their death did not differ in comparison with control subjects over a similar period. Suicide cases, in comparison with control subjects, were more likely to have received a psychiatric diagnosis from their general practitioner, been prescribed psychotropic medication and received referral to specialist mental health services. Those suicide patients with a psychiatric history had a significantly higher number of general practitioner consultations than those without a psychiatric history in four out of the five years preceding death. Those suicide patients without a psychiatric history did not differ significantly from control subjects on any of the variables assessed. CONCLUSION: For those people committing suicide who do not have a psychiatric history and whose consultation patterns do not differ from the norm, it is difficult to suggest how general practitioners might improve their detection of relevant suicidal risk factors. For those patients with a psychiatric history who commit suicide, until we have more detailed information regarding the specific content of general practitioner's consultations before death and how these differed from other consultations of the deceased, then it is premature to assume that general practitioners are failing to identify indicators of impending suicide.     

Obstetric complications and schizophrenia: a computed tomographic study

All patients aged 16-50 years who had been discharged from the Maudsley Hospital over a 4-year period with a diagnosis of schizophrenia were ascertained retrospectively. Case records were rated blindly for a history of obstetric complications (OCs). Sixty-one patients who satisfied the RDC for schizophrenia had undergone CT scanning. Those with a definite history of OCs presented at an earlier age. In this group widening of cortical sulci and fissures was more strongly correlated with VBR than in subjects without OCs. Moreover, large VBRs when accompanied by widened cortical sulci and fissures occurred more commonly in subjects with OCs than in those without. These results support the hypothesis that OCs, or a factor associated with them, lead to brain damage of aetiological significance in some cases of schizophrenia.     

Relationship between bronchial reactivity to inhaled acetylcholine, eosinophil infiltration and a widening of the intercellular space in patients with asthma

The hypothesis that epithelial damage is related to the development of bronchial hyperreactivity has been supported by many studies. Therefore, we further examined whether or not subjects with bronchial epithelium damage showed increased bronchial responsiveness. We took biopsy specimens of the airway mucosa from 20 asthmatic patients with various degrees of disease severity and bronchial hyperreactivity by using a bronchofiber scope. The morphology of the biopsy specimens was studied by electron microscopy. Bronchoscopy was carried out after local anesthesia. Specimens of bronchial mucosa were obtained from 20 asthmatic patients (14 males, 6 females) in remission. The electronmicroscopic studies showed widening of the intercellular space between the epithelial cells and openings of the tight junctions, as well as infiltrations of eosinophils and their granules beneath and between epithelial cells. The tight junction refers to the space between epithelial cells exposed to the airway surface, leading down to the intercellular space. The intercellular space refers to the space between epithelial cells, below the tight junction. Interestingly, eosinophils and their granules were found mainly in the widened intercellular space. The incidence of a widening of the intercellular space was higher in specimens showing eosinophil infiltration than in those not showing eosinophil infiltration. A significant correlation was found between the respiratory threshold to acetylcholine and the percentage of opened tight junctions (r = -0.47, p less than 0.05) and/or the widening of the space between epithelial cells (r = -0.65, p less than 0.01). These results suggest that widening of the intercellular space may be caused by infiltrations of eosinophils and that this widening increases bronchial reactivity.     

Morbidity risk for mood disorders in the families of borderline patients.

We analyzed the familial morbidity risk for mood disorders (MR) and the presence of a family history of alcoholism in a group of 58 patients with DSM-III borderline personality disorder (PD). The MR in the families of borderline subjects was not significantly different from that found in a control group of affective patients with other cluster II PD, or without PD. The MR in the families of borderline subjects who had never developed an affective episode was not significantly different from that found in the families of borderline PD with a history of mood disorders. Borderline subjects with mood disorders had higher rates of alcoholism in their families, mainly among parents. Our results support the hypothesis that borderline PD, even in absence of the codiagnosis of a mood disorder in the subject, may be a predictor of higher familial liability to mood disorders, although it may be more informative for the familial clustering of specific subgroups than for mood disorders as a whole.     

Metabolic changes in exercise-induced asthma

Five patients with a history of post-exercise bronchoconstriction and eleven control subjects were exposed to gradually increasing work loads on a bicyle ergometer. The asthmatic patients showed higher blood lactic acid levels at all work loads than the control subjects. In contrast to findings in the controls, the plasma free fatty acid in the asthmatics failed to ‘rebound’ following the cessation of exercise; and in two out of three patients plasma FFA did not rise after epinephrine injection. In addition, the asthmatic patients consumed less oxygen during the exercise than the controls. The results of this study suggest that patients with post-exercise asthma may have to rely more on carbohydrates as the main source of energy because of the reduced availability of FFA. Since the consumption of oxygen is also reduced, this may lead to a higher lactate production.     

Blood Cadmium Concentration of Residents Living near Abandoned Metal Mines in Korea

The purpose of this study was to investigate demographic and lifestyle variables and blood cadmium concentrations in residents living near abandoned metal mines in Korea. Blood cadmium concentrations were measured in 15,161 subjects living around abandoned metal mines (exposed group, n = 14,464) and compared with those living in designated control areas (control group, n = 697). A questionnaire was provided to all subjects to determine age, gender, mine working history, times of residence, smoking habits and dietary water type. The geometric mean (95% confidence intervals) of blood cadmium concentration (1.25 [1.24-1.27] µg/L) in the exposed group was significantly higher than in the control group (1.17 [1.13-1.22] µg/L). Mean residence time and mine working history in the exposed group were significantly higher than in the control group. Blood cadmium concentrations increased with increasing age, and residence time in both groups, and blood cadmium concentrations were higher in current-smokers than in non-smokers in both groups. This study shows the geometric mean of blood cadmium concentration in abandoned mining areas are higher than in non-mining areas in the general adult Korean population.

Graphical Abstract

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Elevated plasminogen activator inhibitor levels found in patients with malignant conditions

Impaired fibrinolysis often is found in patients with deep-vein thrombosis. Deep-vein thrombosis is seen in some patients with malignant conditions. In patients with malignant conditions, impaired fibrinolysis may be present and may contribute to the development of thrombotic complications. In this study, the extrinsic fibrinolytic system was evaluated in a group of patients with malignant conditions and compared to a positive control group of patients with history of thrombosis but with no malignant condition and also to a negative control group of normal subjects. The group of patients with malignant conditions had plasminogen activator inhibitor levels similar to those patients with a history of thrombosis. Both of these groups had higher plasminogen activator inhibitor levels than the normal control patients.     

Response selection in schizophrenia

Schizophrenia patients tend to have longer and more variable latencies of response than healthy control subjects. However, the distributions of data from the two groups overlap to a large extent. Therefore, we investigated (1) whether the process of response selection in schizophrenia patients is like that of slow control subjects or has different properties, and (2) whether the intra-individual variability of schizophrenia patients is intrinsically greater than that of control subjects or reflects their longer mean latency. To answer these questions we tested schizophrenia patients and healthy control subjects in a choice reaction time (RT) task with 2-choice and 4-choice conditions. We analyzed how mean RT in the 2-choice condition predicted mean RT in the 4-choice condition and found that the relation was significantly different between the two groups. In contrast, the intra-individual variability of RT was related to mean RT in the same way for schizophrenia patients and control subjects. These results indicate that the response selection process of schizophrenia patients was not simply a slower version of the same process engaged by control subjects, but it was a selection process with different dynamic properties. In contrast, schizophrenia patients did not have a greater intrinsic variability than control subjects. Furthermore, we found that the difference Δt between RT measured in the 4-choice condition and RT predicted for the control group in the same condition could be used to discriminate effectively patients and control subjects. However, there was no significant association between Δt and clinical variables. These results suggest that Δt could reflect a trait impairment of schizophrenia independent from symptom profile. Finally, we suggest that the impairment of the process of selection of the motor response in schizophrenia reflects the alteration of the time-dependent patterns of neural activity that result from anomalies in the connectivity of the brain areas engaged for the selection of the motor response.     

Relationship between diffusion tensor imaging and brain morphology in patients with myotonic dystrophy

Myotonic dystrophy type 1 (MyD) is a common inherited neuromuscular disorder. In addition to neuromuscular symptoms, many MyD patients show central nervous system neuropathology. This study evaluated whether MyD patients display diffusion tensor (DT) abnormalities associated with regional cortical atrophy and clinical features. Three-dimensional T1-weighted and DT magnetic resonance images of the brain were obtained in 11 MyD patients and 13 age- and sex-matched healthy subjects. Fractional anisotropy (FA) and mean diffusivity (MD) values were calculated in corpus callosum subregions with DT imaging (DTI) along with volumetric changes, and correlations with clinical features were examined. Differences between MyD patients and healthy subjects were analyzed statistically. Significantly lower FA and higher MD values were found in the genu, rostral body, anterior midbody, posterior midbody and splenium in MyD patients than in control subjects (p < 0.05, corrected; lower FA in the splenium was at a trend level). These corpus callosum subregions were the areas connected to cortical areas where significantly lower volumes were found in MyD patients. No significant decrease in volumes was noted in the parietal cortex, where connecting fibers pass through the isthmus in which DTI abnormalities were not detected in MyD patients. Significant negative correlations to volumes of frontal areas were noted, particularly bilateral motor areas, with cytosine thymine guanidine (CTG) triplet expansion. DTI results in corpus callosum may reflect morphological changes in the connecting cortical areas of MyD patients.     

2006-2010年清新县血吸虫病疫情分析

目的了解分析清新县2006-2010年血吸虫病疫情,为制定防控方案提供科学依据。方法根据《广东省血吸虫病巩固监测方案》,在原疫区对钉螺和传染源进行同步监测,对清新县2006-2010年的监测情况进行统计分析。结果 2006-2010年共查螺13hm2,未查获活钉螺。复查历史病人12人,未发现慢性或晚期病例。低年龄组（中、小学生）监测1122人,血清抗体阳性者10人,未查到血吸虫病人。检查流动人口2456人,抗体阳性者80人,查获血吸虫病慢性病人13例,其中虫卵阳性者2例。检查耕牛1900头,未发现血吸虫感染牛只。结论目前清新县血吸虫病防治成果巩固,今后要重点加强输入性传染源和钉螺的监测。     

Alteration of T cell function in healthy persons with a history of thymic x-irradiation.

The possible late effects of x-irradiation to the infantile thymus were investigated by studying immune functions in 12 healthy persons with a history of thymic x-irradiation and healthy control subjects. No differences were found in serum immunoglobulin values, humoral antibody levels, lymphocyte counts, and lymphocyte reactivity to phytochemagglutinin, vaccinia virus, purified protein derivative (PPD), and allogeneic cells. The irradiation group exhibited cellular hyperresponsiveness to streptoskinase-streptodornase (SK-SD). In contrast, mean skin and in vitro lymphocyte responses to Candida albicans were depressed in the patients with thymic irradiation. A dissociation of these two Candida responses was found in only 1 of 14 healthy control subjects but in 7 of 12 irradiated individuals. While thymic irradiation did not result in impaired immunologic defenses leading to clinical disease, it caused alterations in T cell responses similar to those reported in patients with chronic mucocutaneous candidiasis.     

Association of IFNG gene polymorphism with asthma in the Indian population

Epidemiologic studies in India show that the prevalence of asthma is increasing, but no genetic studies have been reported on the Indian population thus far. We selected the IFNG locus on 12q21 as a candidate gene for asthma on the basis of its role in pathophysiology and positive linkage demonstrated in other populations. The aim of this study was to investigate association of a CA-repeat marker in this gene with asthma and total serum IgE levels in the North Indian population. The repeat region was PCR-amplified from patients and control subjects and analyzed through use of GeneScan. The distributions of allele sizes were found to be significantly different between patients and control subjects (Kolmogorov-Smirnov test, P < 10(-6)). Alleles 10 and 11 were found to be overrepresented in individuals with asthma, whereas alleles 13 and 15 were less likely in asthmatic individuals. We found that the CA-repeat polymorphism in the IFNG gene was significantly associated with total serum IgE levels (ANOVA, P < 10(-4) for control subjects and P =.0036 for patients). Furthermore, a previously reported promoter polymorphism at the -333 base pair position was not detected in our population. This is the first report on the association of a candidate gene with asthma from the Indian subcontinent.     

Clinical and epidemiological implications of swine hepatitis E virus infection

In nonendemic areas, most patients with acute hepatitis E were infected through traveling to endemic areas. However, some patients did not have a history of foreign travel before infection. Furthermore, high seroprevalence rates of antibody to hepatitis E virus (anti-HEV) were found in the general adult population in some countries without any recorded outbreak of hepatitis E. The significance of anti-HEV assay in these subjects remains obscure. To study if swine might be a source of HEV infection, HEV was tested in sera of 235 pigs in Taiwan, and from 5 patients with acute HEV infection who either denied or did not provide any foreign travel history. Three (1.3%) pigs had detectable swine HEV RNA. The swine and human HEV strains from Taiwan formed a monophyletic group, distinct from three previously reported groups: the United States human and swine HEV strains, the Mexico strain, and the largest group composed of the Asian and the African strains. The identity of nucleotide sequences was 84-95% between swine and human HEV strains in Taiwan, and 72-79% between Taiwan strains and those from different areas. The predicted amino acid sequence of a Taiwan swine HEV strain within the peptide 3-2 used in commercial anti-HEV assay showed a high identity (91-94%) with those of other human and swine HEV strains. Swine may be a reservoir of HEV and subclinical swine HEV infection may occur. Cross-reactivity of current anti-HEV assay may account for the high prevalence rate of anti-HEV in the general population in nonendemic areas.