Communication of suicidal intent and suicide in unipolar depression. A forty year follow-up.

Two hundred and 25 unipolar depressives hospitalized during the 1930's were classified on the basis of documented communication of suicidal intent. A long term follow-up revealed 15 of the former patients had died by suicide. Communicated suicidal intent was documented in the index hospital record of all 15. The presence of communicated intent may distinguish a group of unipolar depressives at risk for suicide from those not at risk.     

Urethral polyp in asymptomatic male infant with prenatal hydronephrosis

Congenital posterior urethral polyps are rare, benign lesions of the posterior urethra. We report a 1-day-old newborn boy with a solitary fibroepithelial posterior urethral polyp who presented with a history of prenatal mild hydronephrosis, subsequently associated with bladder wall thickening on ultrasonography.     

Treatment of unipolar depression accompanied by delusions. ECT versus tricyclic antidepressant--antipsychotic combinations

A retrospective chart study conducted to compare the effectiveness of ECT to tricyclic antidepressant--antipsychotic combination therapy in the treatment of psychotic major depressive disorder. A favorable treatment response occurred in 86% of the ECT-treated patients and 42% of the antidepressant--antipsychotic-treated patients. Depressive symptoms showed improvement in all ECT-treated patients but only 50% of the tricyclic antidepressant--antipsychotic-treated patients. It was concluded that a significantly better treatment response can be expected in delusional depressed patients if treated with ECT rather than a tricyclic antidepressant--antipsychotic drug combination.     

Schizophrenia among first-degree relatives of paranoid and nonparanoid schizophrenics

In 1971, McCabe et al.¹ conducted a blind family study of a group consisting of 28 good-prognosis and 25 poor-prognosis schizophrenics. The results of that study showed that the families of poor-prognosis schizophrenics contained significantly more schizophrenia, neurosis, and overall illness, but significantly less affective disorder, than the families of good-prognosis schizophrenics. On the basis of their study, the data seemed to support the idea of at least two illnesses in schizophrenia: namely, that which could be called “good prognosis,” which tends toward affective disorder, and that which could be called “poor prognosis,” which tends toward process schizophrenia.Subsequently, Fowler et al.² reported a similar blind family study of a group consisting of 35 additional poor-prognosis schizophrenics and the 25 poor-prognosis schizophrenics from the McCabe study,¹ for a total of 60. Probands and their families were classified and then compared, according to paranoid (32) and nonparanoid (28) subgroups, to determine if there are still further distinct illnesses in schizophrenia on the basis of familial data. Family differences between the two groups were limited to a greater risk for the combination of schizophrenia, undiagnosed psychosis, and paranoid personality in the nonparanoid probands' families.This paper presents the results from the further analysis of data gathered for the 60 probands and their families. In addition to the overall frequency of schizophrenia in this group, frequency is calculated for the combined variables of sex, relationship to proband, and diagnostic subtype (of both the proband and of the ill family member).     

Genetic and environmental contributions to regional cortical surface area in humans: a magnetic resonance imaging twin study

Cortical surface area measures appear to be functionally relevant and distinct in etiology, development, and behavioral correlates compared with other size characteristics, such as cortical thickness. Little is known about genetic and environmental influences on individual differences in regional surface area in humans. Using a large sample of adult twins, we determined relative contributions of genes and environment on variations in regional cortical surface area as measured by magnetic resonance imaging before and after adjustment for genetic and environmental influences shared with total cortical surface area. We found high heritability for total surface area and, before adjustment, moderate heritability for regional surface areas. Compared with other lobes, heritability was higher for frontal lobe and lower for medial temporal lobe. After adjustment for total surface area, regionally specific genetic influences were substantially reduced, although still significant in most regions. Unlike other lobes, left frontal heritability remained high after adjustment. Thus, global and regionally specific genetic factors both influence cortical surface areas. These findings are broadly consistent with results from animal studies regarding the evolution and development of cortical patterning and may guide future research into specific environmental and genetic determinants of variation among humans in the surface area of particular regions.     

The effect of gelatin-chondroitin sulfate-hyaluronic acid skin substitute on wound healing in SCID mice

Tissue-engineered skin substitutes provided a feasibility to overcome the shortage of skin autograft by culturing keratinocytes and dermal fibroblasts in vitro. In this study, we applied bi-layer gelatin-chondrointin-6-sulfate-hyaluronic acid (gelatin-C6S-HA) biomatrices onto the severe combined immunodeficiency (SCID) mice to evaluate its effect on promoting wound healing. Human foreskin keratinocytes and dermal fibroblasts were cultured with reconstructed skin equivalent (rSE) for 7 days. The rSE was then grafted to the dorsum of SCID mice to evaluate its biocompatibility by histologic and immunohistochemistry analysis. The results showed that human epidermis were well-developed with the expression of differentiated markers and basement membrane-specific proteins at 4 weeks. After implantation, the percentages of skin graft take were satisfactory, while cell-seeded group was better than non-cell-seeded one. The basement membrane proteins including laminin, type IV collagen, type VII collagen, integrin alpha6, and integrin beta4 were all detected at the dermal-epidermal junction, which showed a continuous structure in the 4 weeks after grafting. This bi-layer gelatin-C6S-HA skin substitute not only has positive effect on promoting wound healing, but also has high rate of graft take. This rSE would have the potential to be applied on the extensively and deeply burned patients who suffer from severe skin defect in the near future.     

Selective dendritic degeneration of medium spiny neurons in dementia with Lewy bodies

Dementia with Lewy bodies (DLB) is the second most common form of dementia and shows more severely impaired performance on tests of executive functions compared to Alzheimer disease. Here the authors demonstrate selective spinodendritic degeneration of medium spiny neurons in regions of the caudate nucleus that subserve executive functions and propose that this may underlie, at least in part, the heightened executive dysfunction observed in patients with DLB.