Gigantic aneurysm in the thoraco-abdominal aorta of an infant

We report the case of a boy with a gigantic aneurysm in the thoraco-abdominal region which was detected by a chest X-ray taken prior to surgical correction of ptosis of the eyelids at 11 months of age. At 18 months, he successfully underwent aneurysm exclusion and bypass grafting. A biopsy from the thoracic aorta revealed medial degeneration with conspicuous smooth muscle cell involvement. Laboratory examination showed altered elastase activity in the granulocytes and whole blood. The present case may represent a unique form of aneurysm in infancy.     

Recurrent paroxysmal episodes characterized by perceptual alteration in three schizophrenic patients on neuroleptic medication

Abstract A suddenly occurring episode characterized by perceptual alteration (SEPA), mainly of visual and/or auditory modalities, which repeatedly occurred in three schizophrenic patients on long-term neuroleptic medication, is described. Perceptual alteration showed some distinct features that were different from acute symptoms of schizophrenia, and was accompanied by mood changes such as severe anxiety and agitation and, in one of the patients, also by extrapyramidal symptoms. Perceptual alteration, as well as mood changes and extrapyramidal symptoms, responded well to an anticholinergic drug, biperiden. Recent studies have shown that SEPA occurred not only in schizophrenic patients but also in patients on long-term neuroleptic medication for treating other mental disorders. These findings suggest that SEPA is associated with dopaminergic hypoactivity in the brain, which is induced by long-term neuroleptic medication.     

Xanthogranulomatous pyelonephritis with a renocolic fistula caused by a parapelvic cyst

Fistula formation between the upper urinary tract and bowel is an uncommon complication in urogenital diseases. We present a rare case of focal xanthogranulomatous pyelonephritis with a renocolic fistula. This is the first case where a parapelvic cyst obstructs the caliceal outflow and leads to the formation of a renocolic fistula in renal inflammatory disease. It is difficult to make a preoperative diagnosis of focal xanthogranulomatous pyelonephritis with widespread involvement that is caused by non-calculous urinary tract obstruction.     

Neural substrates of emotionally valenced episodic memory: A PET study using film stimuli

Abstract  To reveal the pathogenetic mechanism of post-traumatic stress disorder (PTSD), we modeled the 're-experience' symptom of PTSD in healthy subjects, and investigated its neural substrates using PET activation experiments on an emotionally (fear) valenced episodic memory task and several contrast tasks. Ten right-handed healthy male volunteers underwent H₂¹⁵O-PET. Each subject was required to watch a horror film the previous day. During the PET scan, the subject was shown part of the film for 60 s immediately before the terrifying climax scene and told to recall the following scene. The subject did not watch the scene directly, but re-experienced fear induced by the trigger. The rCBF in this task compared with that in control tasks was analyzed with SPM99. The subjective emotional state of the subject in each task was evaluated using an analog scale. The main cerebral areas where rCBF significantly correlated with the task of emotionally valenced episodic memory, compared with the novel emotional task, were the left retrosplenial cortex (Brodmann's area: BA 31), the left visual association cortex (BA 19) and the right prefrontal cortex (BA 10). Although the retrosplenial cortex or the posterior cingulate gyrus has been regarded as engaged in processing either only emotion or only episodic memory, this area is considered to be involved in processing 'emotionally valenced episodic memory'.     

Erythrocyte deformability in schizophrenic patients

Erythrocyte deformability as a clinical indicator of microcirculatory disturbance was determined in the erythrocyte of 25 schizophrenic patients and of 18 normal controls. Schizophrenic patients had significantly lower erythrocyte deformability than did the normal controls (P < 0.001). This result suggests that microcirculation in schizophrenic patients is disturbed, and that this disturbance might be involved in the pathophysiological genesis of schizophrenia.