Cerebrospinal fluid diagnostics in first-episode schizophrenia

We evaluated the clinical use and the safety of cerebrospinal fluid diagnostics in 155 patients with the suspected diagnosis of first-episode schizophrenia. Five patients (3.2%) revealed pathological findings that lead to diagnostic re-evaluation and changes in clinical management. No serious adverse events occurred, but we documented 16 (10.3%) cases of mild to moderate headache or local pain at the puncture site. Our results underline the value of lumbar puncture in the clinical workup of first-episode patients with suspected schizophrenia.     

The diagnostic threshold of generalized anxiety disorder in the community: a developmental perspective

Discussion surrounds the question as to whether criteria for generalized anxiety disorder (GAD) should change, particularly in youth. This study examines the effects of possible criteria changes on GAD prevalence and clinical correlates. DSM-IV GAD was assessed using the M-CIDI in a community sample of adolescents and young adults. Diagnostic thresholds were modified in two age spans (9-20 and 21-34 years) using a person-by-year data file (N = 38,534 cases). Relaxing the duration or excessiveness criteria led to the most pronounced changes in GAD prevalence, while relaxing frequency, uncontrollability, or associated-symptom criteria had smaller effects. A lower duration requirement increased rates more in older than younger age spans. Opposite effects occurred for changes in associated-symptoms or clinical-significance criteria. Broader GAD definitions identified cases in both age spans that appeared mostly milder than DSM-IV cases but that still differed from non-GAD cases in various clinical factors and validators. Developmental aspects require stronger consideration in future diagnostic systems.     

艾滋病颅内机遇性感染及肿瘤病变的CT诊断

目的:探讨HIV/AIDS相关性颅内感染及肿瘤病变的CT表现特点,提高颅内感染性及肿瘤病变的诊断水平。方法:回顾分析在博茨瓦纳玛丽娜公主医院临床及病理检验证实的26例AIDS患者的头颅CT表现。全部病例均有完整的CT资料。结果:①AIDS合并脑弓形虫感染6例,典型表现为颅内单发或多发结节影,边缘不规则,中央见坏死灶,增强扫描病灶明显强化,4例坏死灶不均匀轻度强化,周围见明显水肿带;②脑结核3例,表现为颅内多发散在低密度区及小结节灶,增强扫描2例病灶强化,1例表现为多发散在钙化点;③病毒性脑炎4例,两侧大脑多发片状低密度区,增强CT无明显强化,1例见沿脑回线样强化,轻度脑肿胀;④结核性脑膜炎2例,增强扫描见两侧大脑外侧裂池、桥脑环池明显异常强化;⑤脑脓肿7例,表现为颅内厚壁空洞形成,增强后壁明显强化,病灶周围水肿明显;⑥淋巴瘤4例,表现为颅内团块状影,平扫呈等或稍高密度,密度较均匀,增强后中度或明显强化,周围轻中度水肿。结论:CT检查是AIDS所致颅内机遇性感染最基本的影像学检查方法,能很好地显示病变的部位、形态以及病灶周围水肿情况。但在临床定性诊断时需要结合实验室检测和组织活检。     

Expression of CB<Subscript>1</Subscript> cannabinoid receptor in the anterior cingulate cortex in schizophrenia,bipolar disorder,and major depression

Summary The human endogenous cannabinoid system is an appealing target in the investigation of psychiatric disorders. In schizophrenia, endocannabinoids and their receptors are involved in the pathology of the disease. Previous studies reported an increased radioligand binding to cannabinoid receptors 1 (CB₁) in schizophrenia, both in the dorsolateral prefrontal cortex and in the anterior cingulate cortex (ACC). We analyzed the expression of the CB₁ receptors in the ACC at the protein level using immunohistochemistry. In a quantitative postmortem study, 60 patients suffering from schizophrenia, bipolar disorder, major depression and controls were included. Numerical densities of neurons and glial cells immunopositive for CB₁ receptors were evaluated. No evidence of an increased or decreased density of CB₁ receptor immunopositive cells in schizophrenia or bipolar disorder was found. In major depression, CB₁ receptor immunopositive glial cells in the grey matter were decreased. Furthermore, our data show that different medications have an impact on the expression of CB₁ receptors in the ACC.     

Is post-event processing specific for social anxiety?

In their model of social phobia, Clark and Wells [1995. A cognitive model of social phobia. In R. G. Heimberg, M. Liebowitz, D. A. Hope & F. Schneier (Eds.), Social phobia: Diagnosis, assessment, and treatment (pp. 69-93). New York, London: The Guilford Press] introduced a process called "post-event processing" (PEP), which is characterized by prolonged rumination about past social situations. The present study examined to what extent PEP is specific for (a) social anxiety or (b) social situations. In a cross-sectional study, 217 participants reported about a social and a phobic event followed by negative thinking. PEP as well as its potential predictors such as social anxiety, general anxiety, and depression were measured by questionnaires. Results showed that social events were followed more often and by more intense PEP. Further confirming specificity, the fear of negative evaluation as an aspect of social anxiety was significantly associated with PEP for social but not for phobic situations, and vice versa; general anxiety predicted PEP only after phobic but not after social situations. Furthermore, PEP was elevated particularly for interaction (as opposed to performance) situations, indicating that the ambiguity of the situation may be an important predictor for prolonged processing.     

Shifts in the myosin heavy chain isozymes in the mouse heart result in increased energy efficiency

Cardiac-specific transgenesis in the mouse is widely used to study the basic biology and chemistry of the heart and to model human cardiovascular disease. A fundamental difference between mouse and human hearts is the background motor protein: mouse hearts contain predominantly the alphaalpha-myosin heavy chain (MyHC) isozyme while human hearts contain predominantly the betabeta-MyHC isozyme. Although the intrinsic differences in mechanical and enzymatic properties of the alphaalpha- and betabeta-MyHC molecules are well known, the consequences of isozyme shifts on energetics of the intact beating heart remain unknown. Therefore, we compared the free energy of ATP hydrolysis (|DeltaG( approximately ATP)|) determined by (31)P-NMR spectroscopy in isolated perfused littermate mouse hearts containing the same amount of myosin comprised of either >95% alphaalpha-MyHC or approximately 83% betabeta-MyHC. |DeltaG( approximately ATP)| was approximately 2 kJ mol(-1) higher in the betabeta-MyHC hearts at all workloads. Furthermore, upon inotropic challenge, hearts containing predominantly betabeta-MyHC hearts increased developed pressure more than alphaalpha-MyHC hearts whereas heart rate increased more in alphaalpha-MyHC hearts. Thus, hearts containing predominantly the betabeta-MyHC isozyme are more energy efficient than alphaalpha-MyHC hearts. We suggest that these fundamental differences in the motor protein energy efficiency at the whole heart level should be considered when interpreting results using mouse-based cardiovascular modeling of normal and diseased human hearts.