Psychological characteristics of eating disorders as evidenced by the combined administration of questionnaires and two projective methods: the Tree Drawing Test (Baum Test) and the Sentence Completion Test

The objective of this study is to examine psychological/psychopathological characteristics of eating disorders and their subtypes through a combined administration of questionnaires and projective tests. Three questionnaires (Eating Disorder Inventory - 2, Social Adaptation Scale, Southern California University Eating Disorder Inventory - Revised) and two projective tests (the Tree Drawing Test [TDT, Baum Test], and the Sentence Completion Test [SCT]) were administered to 126 female patients between the ages of 15 and 30 years, with eating disorders according to DSM-IV criteria at our outpatient clinic, and to 54 sex- and age-matched control subjects. The purging subtypes of eating disorders (anorexia nervosa - binge-eating/purging type [ANBP] and bulimia nervosa - purging type [BNP]) were clearly differentiated from the controls, both by the questionnaires and the projective tests. Compared with the controls, ANBP/BNP showed more problematic profiles across the three questionnaires, drew smaller and poorer trees in TDT to a more left location on the drawing paper, and gave fewer positive, and more negative responses in SCT. In contrast, few significant differences were found between anorexia nervosa- restricting type (ANR) and the controls, and between ANBP and BNP. As a trend, however, ANR was consistently located between the controls and ANBP/BNP across the whole questionnaires and projective tests.     

Is carbon dioxide as an insufflation agent for double contrast barium enema still worthwhile after a same-day flexible sigmoidoscopy?

PURPOSE: The aim of the study was to evaluate the efficacy of a double-contrast barium enema (DCBE) with CO(2) as a distending gas after a screening flexible sigmoidoscopy for reducing abdominal distension after an examination. PATIENTS AND METHODS: A total of 165 DCBEs for patients with positive faecal occult blood tests were randomly allocated to a CO(2) group (n = 83) and a control group (n = 82) using air. Abdominal radiograph were taken before the DCBE, immediately following it, and 30 minutes later to determine residual bowel gas. The degree of abdominal discomfort was recorded using a scoring system. RESULTS: The patients in the CO(2) group had significantly smaller amounts of residual gas 30 minutes after the DCBE than did the control group, both in the colon (P < 0.02) and in the small intestine (P < 0.001). There was significantly less abdominal distension after the DCBE in the CO(2) group compared to the control group (P < 0.001). The abdominal discomfort score at 30 minutes after CO(2) correlated with the residual gas in the small intestine (r = 0.390,P = 0.003) but not in the colon (r = 0.155, P = 0.15). The quality of the images and the number of polyps detected did not differ between two groups. CONCLUSIONS: We concluded that using CO(2) when administering a DCBE after a screening sigmoidoscopy was useful for relieving abdominal discomfort following the examination; furthermore, it did not impair the diagnostic ability of the DCBE.     

Two cases of postoperative erythroderma--clinical and pathological investigation]

Two cases of postoperative erythroderma, considered the Graft-Versus-Host disease like syndrome following blood transfusion during open heart surgery, were reported. In one, a 74-year-old female underwent the patch closure of ventricular septal perforation complicated with acute myocardial infarction, and in the other, a 67-year-old female underwent coronary artery bypass surgery. They had sudden fever, general eruption, liver dysfunction, leucopenia and thrombocytopenia, and died on the 15th and the 21st days after operation. In both, pathologically, eosinophilic necrosis was seen in agreement with basal cells and prickle cells on the epidermis. T-cells and monocytes widely infiltrated on the upper dermis, particularly around blood vessels. Furthermore, similar to on the skin, cellular infiltration and eosinophilic necrosis were seen on the esophageal mucosa. Various immunoglobulin-positive cells were seen on the dermis and the esophageal mucosa, but it is not clear that this is characteristic or not, because secondary infection possibly existed on them.     

Surgical results of high grade constriction of tricuspid annulus in DeVega technique for secondary tricuspid regurgitation

Sixty-six patients were operated on by our high degree constriction technique using DeVega tricuspid annuloplasty from 1985 to 1989. They were 20 men and 46 women, age distributed from 28 to 71 (mean 54.5). Preoperative tricuspid annular diameter ranged from 29 mm to 45 mm, average 36.3 mm. Those were constricted to 27 mm in 38 patients, and to 25 mm in 28 patients. Postoperative residual tricuspid regurgitation was observed in only 8.5% of total cases followed up 14 to 55 months. This results were comparable with other reports. We concluded that our tight constriction DeVega method is considered better to prevent postoperative tricuspid regurgitation than ordinary methods.     

Fenestrated blood vessels in craniopharyngioma

Summary The fine structure of two cases of craniopharyngioma was studied. Special attention was paid to the vasculature. The most striking finding is the presence of numerous fenestrae in the vascular endothelium. These structures are not present either in most parts of the normal brain or in skin, the organ which craniopharyngiomas most closely resemble. The origin of the fenestrae was discussed.     

Neurofibrillary changes,granulovacuolar bodies and argentophilic globules observed in tuberous sclerosis

Summary A lesion of tuberous sclerosis was observed in the parietal cortex of a 13-year old girl. Numerous giant neurons in the affected areas contained Alzheimer's neurofibrillary tangles, granulovacuolar degeneration and argentophilic globules. These findings in tuberous sclerosis, insofar as we know, are new in the literature.Aided by the Sandy Schneider Memorial Fund.     

Presence of Cu/Zn superoxide dismutase (SOD) immunoreactivity in neuronal hyaline inclusions in spinal cords from mice carrying a transgene for Gly93Ala mutant human Cu/Zn SOD

This investigation deals with the immunocytochemical localization of Cu/Zn superoxide dismutase (SOD) in the spinal cord neurons of transgenic mice that overexpress Gly93Ala mutant human Cu/Zn SOD and demonstrate clinicopathological features similar to human amyotrophic lateral sclerosis (ALS) with Cu/Zn SOD mutation. At low magnification of light microscopy, the gray and white matter of the spinal cord of Gly93Ala mice showed more intense Cu/Zn SOD immunoreactivity than that of control mice. At higher magnification, the cytoplasm of control mice neurons displayed a distinct staining for Cu/Zn SOD, whereas the surrounding neuropil was only weakly stained. In contrast, the intensity of Cu/ Zn SOD immunoreactivity in the cytoplasm of the majority of Gly93Ala mice neurons was similar to that in the neuropil. Almost all neuronal hyaline inclusions (NHIs) of Gly93Ala mice were positively immunostained by antibodies to Cu/Zn SOD, ubiquitin and phosphorylated neurofilament protein (NFP), the intensities of which were much higher in the NHIs than in the surrounding cytoplasm. In control mice, significant Cu/Zn SOD precipitation was not observed to be limited to any particular region of the neuronal cytoplasm. Intracytoplasmic vacuoles in the neuronal soma and processes of Gly93Ala mice were not stained by any of these antibodies. These results indicate that Cu/Zn SOD colocalizes with ubiquitin and phosphorylated NFP in NHIs of mice expressing mutant Cu/Zn SOD; similar findings have been shown for Lewy body-like inclusions of familial ALS patients with Cu/Zn SOD mutation. Moreover, our results point to the possibility that Cu/Zn SOD mutation may have a role in the abnormal Cu/Zn SOD accumulation in the NHIs, in association with motor neuron degeneration. Received:16 July 1997 / Revised, accepted: 25 September 1997     

A case of coronary spasm during general anesthesia successfully treated with nitroglycerin and verapamil

We had a patient without history of angina, who repetitively showed transient elevation of ST-segment during general anesthesia. Coronary spasm was suspected, but no triggering factors could be detected; the spasm being observed under deep and stable anesthesia and at this point no surgical stimulations were interposed. It was treated successfully with intravenous administrations of nitroglycerin and verapamil and no further elevations of ST-segment could be observed.     

PRIMARY SYSTEMIC AMYLOIDOSIS WITH SEVERE CARDIAC AMYLOIDOSIS

An autopsy case of primary systemic amyloidosis with severe cardiac amyloidosis in a 75-year-old Japanese man is reported. The initial signs were dyspnea and cough, followed by general fatigue and loss of appetite. Heart failure, pleural effusion, and liver cysts were found on physiological examination. Autopsy findings were primary sytemic amyloidosis with severe diffuse cardiac amyloidosis and cardiac hypertrophy (585 g). Focal necrosis by infarction was found in the liver and spleen. The cause of amyloidosis was unknown. ACTA PATHOL. JPN. 35: 905–914, 1985.     

Fine structure of a cerebellar neuroblastoma

Summary A cerebellar neoplasm of an 18-month-old boy was examined with both the light and electron microscopes. The diagnosis of neuroblastoma was made on the basis of the presence of numerous synaptic vesicles in the great majority of cell processes and the occasional complete synapses within the tumor tissue.