A right orbitofrontal region and OCD symptoms: a case report.

OBJECTIVE: To discuss the relationship between obsessive-compulsive symptoms and a right orbitofrontal lesion. METHOD: Single case report. RESULTS: A 59-year-old man developed obsessive-compulsive disorder (OCD) symptoms after his head injury. Magnetic resonance imaging brain scans showed a small contusion in the right orbitofrontal region, and single-photon emission computed tomography revealed hypoperfusion in blood flow at the same region. CONCLUSION: The OCD symptoms that developed in the present case may be attributable primarily to hypofunction in the lesion localized to the right orbitofrontal area. Although caution is needed for interpretation of the observation because of our experience of only a single case, it suggests that the right orbitofrontal region may be important in forming OCD symptoms.

Poor maternal care and high maternal body mass index in pregnancy as a risk factor for schizophrenia in offspring.

OBJECTIVE: We investigated whether antenatal factors in mothers would increase the risk of schizophrenia in the offspring, and also examined any relationship between these factors and histories of obstetric complications (OCs). METHOD: Using the Mother and Child Health Handbooks of 52 patients with schizophrenia and 284 healthy subjects, we evaluated the risk-increasing effects of the frequency of antenatal care visits and mothers' body mass index (BMI) at both early and late pregnancy. RESULTS: In logistic regression analysis, there was a significant association between the number of antenatal care visits and the risk of the disorder; an increase in a unit of visits corresponds to a reduction of the risk by 12%. We also found a 24% increase in the risk with a one-unit increase of BMI at the early pregnancy, and a 19% increase at the late pregnancy. These antenatal factors were found to contribute, in part, to an excess of OCs in individuals with schizophrenia. CONCLUSION: Poor maternal care during pregnancy and comparatively high maternal BMI especially at early pregnancy may cause a predisposition to schizophrenia in the offspring.

[A case of hypertrophic spinal pachymeningitis].

A 79-year-old woman was admitted to our hospital complaining of gait disturbance. At the time of admission, she had incomplete monoparesis of the left lower extremity, with a sensory level of T6. MR images showed a thickened dura at the C6-T4 vertebral levels. The thickened dura showed low intensities on T1- and T2-weighted images, and was homogeneously enhanced by Gd-DTPA. Hypertrophic spinal pachymeningitis (HSP) was suspected, and laminectomy was performed from T2 to T3. The thickened dura was found and partially resected. Microscopically, the diagnosis was HSP. Steroid therapy was initiated after surgery. Postoperatively, the patient's physical status and radiographic images improved. The etiology of HSP is not clear in most cases. It is difficult to diagnose radiographically, although MR imaging can help differentiate it from other disorders. T1- and T2-weighted images of HSP show low intensities, and the T1-weighted image is homogeneously enhanced by Gd-DTPA. Treatment is early decompressive surgery with possible excision of the involved dura. Steroid therapy was effective in our case.

Proliferative activity of central neurocytoma: measurement of tumor volume doubling time, MIB-1 staining index and bromodeoxyuridine labeling index.

Central neurocytoma is considered to be a benign intracranial neoplasm, but little is known about the biological behavior of this type of tumor. Proliferative activity of central neurocytoma was measured in 10 cases using MIB-1 staining for Ki-67 antigen. The MIB-1 staining value varied from < 0.1% to 5.6%, to indicating that some of these tumors have proliferative potential similar to that of anaplastic astrocytoma or malignant meningioma. The bromodeoxyuridine labeling index (BUdR LI, BrdU LI) was measured in 2 cases and the results correlated well with those of the MIB-1 analysis. Tumor volume doubling time (Td) measured in one case was 358 days which is similar to that of malignant meningioma. In one case, the MIB-1 value taken before and after 58 Gy of radiation treatment decreased markedly from 5.6% to 0.2%. The other 9 cases were also treated by radiation therapy (50-60 Gy) and no tumor recurrence was observed during follow-up periods ranging from 23 to 160 months. Another two patients with partially removed and 3 with subtotally removed tumors showing relatively high MIB-1 values might also have benefited from radiation therapy.

A technique for prevention of donor site pain associated with harvesting iliac bone grafts.

Patients who have undergone anterior cervical spine fusion with an iliac bone graft frequently experience donor site pain after surgery. We found that an effective technique to avoid donor site pain is to round off the corners of the iliac crest with an air drill after harvesting the graft.

Afloqualone photosensitivity: immunogenicity of afloqualone-photomodified epidermal cells.

Afloqualone (AQ) is an oral muscle relaxant and evokes ultraviolet A (UVA)-induced photosensitivity dermatitis as a side effect. Histologic observations of the skin eruption suggest that AQ photosensitivity is mediated not only by phototoxic but also by photoallergic mechanisms. To address the immunological mechanisms of AQ photosensitivity, we examined the immunogenicity of AQ-photomodified epidermal cells in mice. Afloqualone was covalently coupled with bovine serum albumin by irradiation with UVA but not UVB. Because of this ability of AQ to photobind to protein, murine epidermal cells were easily modified with AQ by exposure to UVA. Subcutaneous inoculation of AQ-photomodified epidermal cells successfully induced an antigen-specific delayed-type hypersensitivity in mice. These findings suggest that AQ-photoderivatized epidermal cells are highly immunogenic and that photomodification of epidermal cells with AQ is an initial event to evoke AQ photosensitivity dermatitis.

Cutaneous T-cell lymphoma with massive co-infiltration of polyclonal B cells.

A 76-year-old man presented with a 3-month history of a cutaneous nodule on the right thigh. The tumour was composed of CD3+, large atypical cells, and CD20+, small normal-appearing cells. Flow cytometry showed that CD20+ cells outnumbered CD3+ cells. By Southern blot hybridization analyses, the malignant cells were shown to be of T-cell origin, because of the presence of rearranged bands for the beta chain of the T-cell receptor, but not for the immunoglobulin heavy chain. This case represents a T-cell lymphoma intermingled with a large number of non-neoplastic B cells.