A short echo proton magnetic resonance spectroscopy study of the left mesial-temporal lobe in first-onset schizophrenic patients.

BACKGROUND: Past 1H magnetic resonance spectroscopy (MRS) studies of the temporal lobe in schizophrenic patients have shown decreased levels of N-acetylaspartate (NAA) suggesting reduced neuronal density in this region. However, the measured volumes have been large and included contributions from mostly white matter. METHODS: Short echo 1H MRS was used to measure levels of NAA and other metabolites (i.e., glutamate and glutamine) from a 6 cm3 volume in the left mesial-temporal lobe of 11 first-episode schizophrenic patients and 11 healthy control subjects of comparable age, gender, handedness, education, and parental education levels. Spectra were quantified without operator interaction using automated software developed in our laboratory. Metabolite levels were normalized to the internal water concentration of each volume studied. Images were also obtained to determine temporal lobe gray and white matter volumes. RESULTS: No significant differences were found between levels of NAA or other metabolites, or gray and white matter volumes, in first-episode schizophrenic patients and comparison subjects. CONCLUSIONS: Since the volume studied was small compared to previous studies and contained mostly gray matter, this result suggests consequential NAA decreases may be restricted to regions of white matter.     

Leïomyosarcome de la prostate: Neoplasie rare

The prostatic leïomyosarcoma is a very uncommon tumor of the adult. It is often diagnosed to an advanced stage, because of the clinical and radiological non specificity. Its prognosis is very dark.The objective of our study is to illustrate the important role of the imagering, represented by the CT and especially the MRI in the balance of extension and the post-therapeutic follow-up of this tumor.We report a 49 years old patient's observation, allowed for unrests mictionnels evolving since 6 months in a context of change of the general state. To the clinical exam, the prostate was increased of volume and nodular. A radiological balance made of US, CT and abdomino-pelvic MRI has been achieved. It showed an heterogeneous prostate, infiltrating the grease of neighborhood and the ureteral meats, with important bilateral urétéro-hydronephrosis of uphill. One also noted the presence of suspected hepatic nodules. A trans-perineal prostatic biopsy has been achieved, concluded to a prostatic leïomyosarcoma. Because of the bad general state and the importance of the local extension and from afar of the prostatic tumor, a trans-ureteral resection has been achieved, associated to a chemotherapy. The evolving have been marked by the patient's death after his second cure of chemotherapy.The CT and especially the MRI had a primordial role in the balance of local extension and from afar of the prostatic léïomyosarcoma and the only means to affirm the diagnosis is the histology completed by an immuno-histochimical study. Their therapeutic handling is not codified at the present time and their prognosis remained very dark.     

Molecular analysis of the litaf/simple and prx genes in patients with demyelinating charcot‐marie‐tooth (CMT) disease

Mutations in the GJB1/Cx32 gene (Xq13.1) cause the most common X‐linked form of CMT (CMTX1) and are the most frequent cause of CMT disease after the CMT1A duplication. The disorder is characterized by a moderate‐to‐severe neuropathy in affected males and mild‐to‐no symptoms in carrier females. We report here a CMT1A‐negative family in which 4 females and 2 males were affected, exhibiting different disease severity. Molecular analysis of the GJB1/Cx32 gene uncovered a nonsense mutation (Arg22stop) in exon 2. The mutation, which had been previously described by others and observed by us in numerous other families, occurred in heterozygous form in the 4 females. However, while one of the two male patients was severely affected and shown to be hemizygous, as expected, the other was mildly affected and found to carry the mutation in heterozygous form. Genotyping at the SRY (Yp11.3) and DMD (Xp21) loci suggested the occurrence of the XXY genotype associated with Klinefelter syndrome. Microsatellite analysis indicated that the nondysjunctional error was of paternal origin, as it is usually observed in about half the cases. The patient had no children. At clinical examination, he exhibited a very mild neurologic phenotype and showed signs of hypogonadism (mild gynecomastia and small testes) as well as moderate cognitive impairment. Electrophysiologic, cytogenetic and endocrinologic investigations are in progress in order to define the unusual phenotype in this patient.     

Intramuscular bipenicillin vs. intravenous penicillin in the treatment of erysipelas in adults: randomized controlled study

The objective of the study was to evaluate the efficacy of intramuscular penicillin: mixture of benzyl penicillin and procain penicillin (2 MU x 2 times daily) and intravenous benzyl penicillin (4 MU x 6 times daily) in the treatment of hospitalized adult patients with erysipelas. A prospective randomized unicentric trial was conducted. In total, 112 patients entered the study; 57 in the intramuscular group and 55 patients in the intravenous group completed the trial. The failure rate was 14% for intramuscular group and 20% for the intravenous group (P = 0.40). Local complications such as of the leg abscesses were observed in the two groups (intravenous 9.1%, intramuscular 7%; P = 0477). Of the patients treated with intravenous benzyl penicillin, 25.5% presented complications related to the route (venitis). Intramuscular penicillin should be considered an effective and well-tolerated treatment of erysipelas in adult patients.     

肥大性下橄榄核变性的MRI表现

目的 总结肥大性下橄榄核变性(hypertrophic olivary degeneration，HOD)的MRI特征.方法 搜集继发于脑干和小脑病变的HOD病例15例，原发病变位于脑干9例，其中血管畸形出血4例，高血压脑干出血2例，梗死2例，脑干挫伤1例；原发病变位于小脑6例，其中小脑半球出血4例，小脑第4脑室肿瘤术后1例，小脑转移瘤1例。15例均做了MR平扫，2例做了增强扫描。结果 HOD表现为延髓腹外侧局部体积稍增大(共6例)，T1WI表现为等或稍低信号(15例)，在T2WI为高信号(15例)。原发性病变导致中脑红核或桥脑被盖束受损者，发生同侧HOD(8例)；原发病变导致小脑齿状核受损者并引起对侧HOD(4例)，双侧中央被盖束受损(1例)或双侧小脑齿状核受累及者(2例)，发生双侧HOD。结论 MRI能非常清晰地显示下橄榄核的继发性变性病变，可以提高对该变性的认识，避免误诊的发生.