Pseudotumor of the craniovertebral junction associated with chronic subluxation: MR imaging studies

Masses at the craniovertebral junction generally have serious prognostic implications. However, the authors studied three patients who had chronic atlantoaxial subluxation from either degenerative disease or congenital dysplasia of the dens and who also had benign fibrous masses in this region, confirmed at surgery. The association of masses of the craniovertebral junction with chronic atlantoaxial subluxation raises the possibility that the underlying cause of the masses is chronic mechanical irritation. All patients were imaged with metrizamide myelography and adjunctive computed tomography (CT), then by magnetic resonance (MR) imaging. MR images were not only superior to myelograms and CT scans in delineating the exact extent of the lesions, they also indicated the benign, fibrous nature of the masses.     

Natural history of schizophrenia subtypes. II. Positive and negative symptoms and long-term course.

The natural history and long-term course of schizophrenia divided by pervasiveness of positive and negative symptoms was explored among 187 schizophrenic patients from the Chestnut Lodge follow-up study. Schizophrenia with many negative symptoms was associated with poor premorbid functioning, insidious onset, partial or no remissions during the first several years of illness, and in most cases a progressive course leading to permanent disability. Schizophrenia with few negative symptoms was associated with good premorbid functioning, acute onset, intermittent early course, and a better prognosis. Positive symptoms predicted future hospitalizations but were less powerful and specific as indicators of differential illness history, course, and long-term functional incapacity. As predictors of long-term outcome, negative symptoms were of greater value measured at index admission several years after illness onset than at first hospital admission. Multivariate analyses indicated that two negative symptoms (anhedonia and affective flattening) contribute significantly to outcome variance independent of their association with premorbid functioning or positive symptoms. Patients with the poorest long-term outcome tended to show an increase in negative symptoms during the early years of their illness. Progressive negative symptoms early in the course of schizophrenia may thus reflect or signal a process leading to long-term functional disability.     

人尿中脱氢睾酮代谢物的GC/MS分析

本文用GC/MS方法,对人尿中脱氢睾酮(boldenone)代谢物进行了研究。志愿者口服20 mg脱氢睾酮后,收集阳性尿。尿样经过包括XAD-2树脂柱吸附、酶水解、有机相萃取及三甲基硅烷衍生化反应的预处理后,用毛细管气相色谱与质谱检测器联用进行分析,鉴定了脱氢睾酮的几个主要代谢物和它们的代谢模式;总结了兴奋剂检测中具有意义的代谢物及其碎片离子;对收集的阳性尿中脱氢睾酮浓度进行测定;对预处理方法的回收率进行了研究。     

β-受体阻滞剂的分析研究

本文叙述了用高效毛细管气相色谱/氮磷检测器及气相色谱/质量选择检测器对13种β-受体阻滞剂的分析研究。样品用不同衍生化方法作了比较,初步结果表明:衍生化效果TFAA与MBTEA无很大差异;而MSTFA比上述两者效果均佳。本文的研究为β-受体阻滞剂的体液气相色谱研究提供了可行的方法。     

The positive-negative distinction in schizophrenia. Review of natural history validators.

A review of the interaction between the positive-negative symptom distinction in schizophrenia and multiple measures of illness natural history reveals some redundant and compelling patterns. Negative or deficit symptoms are often associated with inferior social/instrumental functioning premorbidly, more abnormal voluntary/involuntary movements at illness presentation, and poorer long-term outcome when present beyond the early phase of illness. Negative symptoms are semi-independent of positive symptoms. They are variable early in the illness but accrue in severity, stability, and prognostic weight with time. The nature of the processes that generate negative symptoms and their specificity to schizophrenia remain to be elucidated. Nevertheless, it is clear that negative symptoms are a common and valid component of schizophrenia and deserve recognition as such in our nosology.     

Similarity between mycobacterial and human epidermal antigens

Eight out of 17 mouse anti-Mycobacterium leprae monoclonal antibodies (MAb) were previously observed to react with human nerve and skin antigenic determinants in cryostat sections, using an indirect immunoperoxidase technique. These observations suggested that antigenic mimicry may be involved in the development of the clinical manifestations of leprosy. In the present study we have extended our earlier findings by investigating sera from leprosy patients and MAb using Western blot technique. It was observed that 30 sera and their corresponding F(ab')2 fragments from isolated IgG fractions of both tuberculoid and lepromatous patients reacted with 40-50 epidermal proteins of molecular weights (MW) ranging from 10 to 130 kDa. Sera from 14 controls, however, showed similar reactivity patterns. Absorption of nine patient and control sera with M. tuberculosis, M. marinum and M. kansasii resulted in the removal of several components of different MW in nine, four and three cases, respectively. No consistent differences between sera from leprosy patients and controls were observed. Four out of eight MAb against M. leprae which reacted with determinants in human epidermis and/or dermis in skin cryostat sections reacted with epidermal proteins of MW higher than 39 kDa in Western blot. Four MAb which showed reactivity in cryostat sections did not react in Western blot. Another four MAb did react with human epidermal proteins in Western blot but did not react in cryostat sections, indicating that the MAb were reacting with different epitopes in the two systems. Five MAb did not react with human epidermal proteins either in cryostat sections or in Western blot.(ABSTRACT TRUNCATED AT 250 WORDS)     

Predicting outcome in schizoaffective psychosis

Predictors of long-term outcome are identified for 68 patients with schizoaffective psychosis from the Chestnut Lodge Follow-up Study. Two dimensions regularly predicted better outcome: better developed premorbid instrumental skills and fewer typically schizophrenic symptoms.     

Neonatal ovarian cysts: sonographic-pathologic correlation

The authors reviewed the prenatal (11 infants) and postnatal (17 infants) sonograms and the clinical, surgical, and pathologic findings in 17 infants with an ovarian cyst to determine the sonographic features and natural history of neonatal ovarian cysts. An uncomplicated cyst (nontwisted, nonhemorrhagic) was completely anechoic and the cyst wall was imperceptible with sonography (five cases). A twisted or hemorrhagic cyst was cystic with a fluid-debris level, cystic with a retracting clot, septated with or without internal echoes, or solid (12 cases). These complicated cysts contained liquid and/or organized hematoma. Eleven of the 12 complicated cysts had a thin, highly echogenic wall. Cyst torsion commonly occurred in utero and could be diagnosed on prenatal sonograms by a typical sonographic appearance (eight cases). All of these infants were asymptomatic after birth. Four infants with hemorrhagic or twisted cysts were symptomatic. All cysts except one that resolved spontaneously were treated surgically, including three twisted cysts that showed no change in size over a 1-8-month interval. All of the cysts were of follicular origin.     

Hospital discharge status and long-term outcome for patients with schizophrenia, schizoaffective disorder, borderline personality disorder, and unipolar affective disorder

The prognosis of self-discharged inpatients has seldom been studied, especially by diagnosis, and is frequently assumed to be poor. This study evaluated the long-term (15-year average) outcome of inpatients discharged with medical advice (WMA), against medical advice (AMA), or by transfer for patients with schizophrenia (N = 113), schizoaffective disorder (N = 46), borderline personality disorder (N = 63), and unipolar affective disorder (N = 33) from a follow-up study. Results showed that outcome among discharge cohorts varied considerably depending on diagnostic category. Within each diagnostic cohort, outcome of transferred patients was poorest. The outcome of AMA-discharged patients was poorer than the outcome of patients discharged with medical advice only in the unipolar cohort, except that AMA discharge in schizoaffective patients correlated significantly with suicide.