Brain morphology in first-episode schizophrenic-like psychotic patients: a quantitative magnetic resonance imaging study.

Brain morphology was examined using magnetic resonance imaging in 30 first-episode patients with a schizophreniclike psychosis, 15 chronic schizophrenics, and 20 neurological controls. Statistical analyses of computer-generated measurements of regions of interest were controlled for gender, age, social class, and total brain volume. Lateral ventricular size was increased in both first-episode and chronic schizophrenic patients, with greater significance on the left than on the right side. Only the chronic patients, however, had reduced temporal lobe size, which also was greater on the left side. No major correlations of regional brain morphological measurements with cognitive functioning were found, although some measurements of verbal memory were correlated with parahippocampal size. This is a report of a preliminary study that suggests that some morphological brain changes may be present at the time of first treatment for a psychotic illness, whereas others may occur later in the course of illness. Future prospective studies may determine the clinical significance of these changes and whether they progress with the development of illness chronicity.

A family with Alport syndrome and psychosis.

A family is described with a history of both hereditary nephritis (Alport syndrome) and chronic psychosis in multiple family members. Although the disorders do not segregate together in all cases, the finding of this family may provide a clue for the location of a psychosis gene. Alport syndrome has been mapped to the long arm of the X chromosome. Some studies also support a genomic locus on the X chromosome in at least some cases of manic-depressive disorder and schizophrenia.

Airway responsiveness in isolated perfused rat lungs: effect of thoracic irradiation.

We developed techniques for assessing airway reactivity in isolated perfused rat lungs by measuring the lung mechanics changes produced by injection of ACh into the pulmonary circulation. Lung resistance (RL) and dynamic compliance (Cdyn) changed in a dose-response fashion after ACh. We used the preparation to examine the effect of thoracic irradiation on airway responsiveness and pulmonary inflammation. Groups of rats were studied after sham irradiation or 24 h or 72 h after a single dose of 1500 rads. Thoracic irradiation did not alter baseline lung mechanics, but did increase the responsiveness of rat lungs to ACh 72 h after radiation. Radiation was not associated with an increase in neutrophils in lung lavage, airways or peripheral lung tissue. We conclude that thoracic irradiation alters airways reactivity without causing overt pulmonary inflammation, and that isolated perfused lungs can be useful for measurement of airway reactivity.

Transbronchoscopic needle aspiration in the diagnosis and staging of lung cancer.

We examined the safety and yield of transbronchial needle aspiration (TBNA) in 28 patients who were subsequently proven to have lung cancer. TBNA in 48 sites produced no complications. TBNA was positive for carcinoma in the two patients whose tracheal carinae appeared abnormal on computerized tomography. When the carinae were normal, only one of 13 aspirations was positive for cancer. None of eight paratracheal aspirations was positive. Aspiration of visibly abnormal bronchial bifurcations revealed carcinoma in four of 15 cases. We conclude that TBNA is a safe procedure for the diagnosis and staging of lung cancer, and that the likelihood of positive results is increased by the presence of radiologic and endoscopic abnormalities.