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We describe a case of thoracic myelopathy in a patient with renal osteodystrophy. The patient had chronic renal failure for longer than 20 years and had skeletal changes indicative of renal osteodystrophy, before the onset of myelopathy. Association between spinal stenosis and this entity has been documented only once before in the lumbar region. This is therefore the first case of thoracic myelopathy due to severe stenosis in just one vertebra in a patient with renal osteodystrophy, which was documented by computed tomography as well as magnetic resonance imaging and proven by histopathology.

The authors investigated the pharmacological treatment of delusional depression by assigning patients on a random double-blind basis to amitriptyline alone, perphenazine alone, or a combination of the two. Fourteen (78%) of the 18 patients assigned to amitriptyline plus perphenazine were responders, compared with seven (41%) of 17 patients treated with amitriptyline alone and three (19%) of the 16 patients treated with perphenazine alone. The combination of amitriptyline and perphenazine was clearly superior (p less than .01).

In this study the sleep of borderline patients and patients with primary nondelusional depression showed sleep continuity disturbance and greater REM activity and density (particularly during the first REM period) than that of normal control subjects. First-night REM latencies were more variable in the borderline than in the depressed group, but by the second night both groups showed shorter REM latencies than the controls. The similarities in EEG sleep suggest a relationship between borderline disorder and the affective spectrum and cast doubt on the definition of the borderline disorder as a pure character type.