Probable Case of Neuroleptic Malignant Syndrome Following Administration of Antituberculotic Drugs in a Chlorpromazine-Treated Patient

Neuroleptic malignant syndrome (NMS), a potentially fatal adverse reaction to neuroleptics, is known to occur more often in the initial stage of antipsychotic treatment. We describe a patient with chronic schizophrenia who, in a few days after the addition of antituberculotic drugs to his antipsychotic regimen, developed probable NMS without pyrexia. We reasoned that rifampin, a strong hepatic enzyme inducer, decreased the plasma chlorpromazine concentration of the patient, with the result of cholinergic hyperactivity and finally, the symptoms of NMS. Therefore, physicians should be aware of drug interactions and the likelihood of NMS, and consider antipsychotic dose adjustment when prescribing drugs that may influence pharmacokinetic properties of antipsychotics in a patient with schizophrenia receiving long-term antipsychotic treatment

Dysfunction in Configural Face Processing in Patients With Schizophrenia

Background: Face recognition has important implications for patients with schizophrenia, who exhibit poor interpersonal and social skills. Previous reports have suggested that patients with schizophrenia have deficits in their ability to recognize faces, and because face recognition relies heavily on information about the configuration of faces, we hypothesized that patients with schizophrenia would have specific problems in processing configural information. Methods: We measured the performance of 20 patients with schizophrenia and 20 normal subjects in a face-discrimination task, using upright and inverted pairs of face photographs that differed in featural or configural information. Results: The patients with schizophrenia showed disproportionately poorer performance in discriminating configural compared with featural face sets. Conclusion: The result suggests that the face-recognition deficit in schizophrenic patients is due to specific impairments in configural processing of faces

Segmental duodenectomy with duodenojejunostomy of gastrointestinal stromal tumor involving the duodenum

Duodenal gastrointestinal stromal tumors (GISTs) are uncommon and a relatively small subset of GISTs whose optimal surgical procedure has not been well defined. Because submucosal spread and local lymph node involvement is infrequent in GISTs, wide margins with routine lymph node dissection may not be required. Various techniques of limited resection for duodenal GISTs have been described depending on the site and the size of the tumors. In this study, we report two cases of GIST involving the third and fourth portion of the duodenum successfully treated by segmental duodenectomy with end-to-end duodenojejunostomy. This technique should be considered as a treatment option for GIST located at the third and fourth portion of the duodenum

Altered Eye-Movement Patterns During Text Reading in Obsessive–Compulsive Disorder and Internet Gaming Disorder

Obsessive-compulsive disorder (OCD) and internet gaming disorder (IGD), which are similar in that both involve repetitive behaviors and related with cognitive dysfunctions, frequently begin in early adolescence, which is a critical period for learning. Although the deterioration in cognitive functioning caused by these conditions may have adverse effects on information processing, such as text reading, there has been no comprehensive research on the objective indicators of altered reading patterns in these patients. Therefore, we evaluated eye-movement patterns during text reading in patients with OCD or IGD. In total, 20 patients with OCD, 28 patients with IGD and 24 healthy controls (HCs) participated in the reading task using an eye tracker. We compared the fixation durations (FDs), saccade amplitudes and eye-movement regressions of the three groups during reading. We explored relationships between the parameters reflecting altered reading patterns and those reflecting the severity of clinical symptoms. The average FDs and forward saccade amplitudes did not differ significantly among the groups. There were more eye-movement regressions in patients with OCD than in patients with IGD and HCs. No correlation was found between altered eye-movement patterns during reading and the severity of clinical symptoms in any of the patient groups. The significantly increased number of regressions (NRs) in the OCD group during reading may reflect these patients’ difficulties with inferential information processing, whereas the reading pattern in the IGD group is relatively intact. These findings suggest that patients with OCD and patients with IGD have different eye-movement patterns during reading reflecting distinct cognitive impairments in the two patient groups

The Role of Glial Mitochondria in α-Synuclein Toxicity

The abnormal accumulation of alpha-synuclein (α-syn) aggregates in neurons and glial cells is widely known to be associated with many neurodegenerative diseases, including Parkinson’s disease (PD), Dementia with Lewy bodies (DLB), and Multiple system atrophy (MSA). Mitochondrial dysfunction in neurons and glia is known as a key feature of α-syn toxicity. Studies aimed at understanding α-syn-induced toxicity and its role in neurodegenerative diseases have primarily focused on neurons. However, a growing body of evidence demonstrates that glial cells such as microglia and astrocytes have been implicated in the initial pathogenesis and the progression of α-Synucleinopathy. Glial cells are important for supporting neuronal survival, synaptic functions, and local immunity. Furthermore, recent studies highlight the role of mitochondrial metabolism in the normal function of glial cells. In this work, we review the complex relationship between glial mitochondria and α-syn-mediated neurodegeneration, which may provide novel insights into the roles of glial cells in α-syn-associated neurodegenerative diseases. © Copyright © 2020 Jeon, Kwon, Jo, Lee, Kim and Kim.1

Gender Difference in the Prodromal Symptoms of First-episode Schizophrenia

To investigate the gender difference of early symptoms appearing before the onset of the psychotic symptoms in patients with first-episode schizophrenia, we reviewed the medical records of 63 patients (38 males, 25 females), who were hospitalized for first-episode schizophrenia. The frequency and duration of prodromal and psychotic symptoms, Clinical Global Impression scale scores, Global Assessment of Functioning (GAF) scale scores at admission, and other clinical characteristics were recorded for all patients. Overall, the most common prodromal symptoms were attenuated positive symptoms (89%), followed by mood symptoms (86%). Negative symptoms were the most common in male patients (97.4%), whereas attenuated positive symptoms were the most common in female patients (84%). Male patients demonstrated more frequent negative, cognitive, and obsessive-compulsive symptoms than female patients did and also showed a tendency of having negative symptoms for the longer period. Correlational analysis showed a significant negative correlation between the duration of negative symptoms and GAF scores at admission in male patients. Our findings suggest that different patterns of prodromal symptoms between male and female begin before the onset of the psychosis. Further prospective studies should be needed.This paper was supported by a grant (M103KV010012- 08K2201-01210) from Brain Research Center of the 21st Century Frontier Research Program funded by the Ministry of Science and Technology, Republic of Korea.Jeppesen P, 2008, PSYCHOL MED, V38, P1157, DOI 10.1017/S0033291708003449Cannon TD, 2008, ARCH GEN PSYCHIAT, V65, P28WILLHITE RK, 2008, SCHIZOPHR RES, V104, P237LAPPIN JM, 2007, BR J PSYCHIAT S, V51, pS123Goldstein JM, 2006, HORM BEHAV, V50, P612, DOI 10.1016/j.yhbeh.2006.06.029Rosen JL, 2006, SCHIZOPHR RES, V85, P124, DOI 10.1016/j.schres.2006.03.034Amminger GP, 2006, SCHIZOPHR RES, V84, P67, DOI 10.1016/j.schres.2006.02.018Barbui C, 2005, J CLIN PSYCHOPHARM, V25, P521, DOI 10.1097/01.jcp.0000185423.15891.02Perkins DO, 2005, AM J PSYCHIAT, V162, P1785Svirskis T, 2005, SCHIZOPHR RES, V75, P439, DOI 10.1016/j.schres.2004.11.002Norman RMG, 2005, J NERV MENT DIS, V193, P17, DOI 10.1097/01.nmd.0000149214.17924.d9Yung AR, 2004, SCHIZOPHR RES, V67, P131, DOI 10.1016/S0920-9964(03)00192-0Lieberman JA, 2003, AM J PSYCHIAT, V160, P1396McGlashan TH, 2003, SCHIZOPHR RES, V61, P7, DOI 10.1016/S0920-9964(02)00439-5Kinon BJ, 2003, PSYCHONEUROENDOCRINO, V28, P55, DOI 10.1016/S0306-4530(02)00127-0McGorry PD, 2002, ARCH GEN PSYCHIAT, V59, P921Gourzis P, 2002, SCHIZOPHRENIA BULL, V28, P415Norman RMG, 2001, PSYCHOL MED, V31, P381Bottlender R, 2000, SCHIZOPHR RES, V44, P145Cohen RZ, 2000, CAN J PSYCHIAT, V45, P544LEUNG A, 2000, ACTA PSYCHIAT SCAN S, V401, P3GOLDSTEIN JM, 2000, WOMEN SCHIZOPHRENIA, P111Hafner H, 1999, ACTA PSYCHIAT SCAND, V100, P105Pohjalainen T, 1998, MOL PSYCHIATR, V3, P256Behl C, 1997, MOL PHARMACOL, V51, P535Yung AR, 1996, AUST NZ J PSYCHIAT, V30, P587Larsen TK, 1996, SCHIZOPHRENIA BULL, V22, P241FOLNEGOVIC Z, 1994, SCHIZOPHR RES, V14, P83HAFNER H, 1993, BRIT J PSYCHIAT, V162, P80HAFNER H, 1992, SCHIZOPHR RES, V6, P209