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An account is given of a patient who had had chronic exposure to nitrobenzene and in whom the metabolites,p-nitrophenol andp-aminophenol, were present in the urine. A method of separative determination of these two substances in urine is described.A 47-year-old woman, after being exposed to nitrobenzene for 17 months, was admitted to hospital because of headache, nausea, cyanosis, and general weakness. Laboratory study revealed, in addition to methaemoglobinaemia, the presence of p-aminophenol as well as p-nitrophenol in the urine. Both compounds gradually disappeared from the urine during the two weeks after she was removed from the toxic agent. The fate of methaemoglobinaemia paralleled that of these two compounds. Case ReportA 47-year-old woman had been employed for 17 months in a small paint firm where she painted and polished lids of pans with a red paint containing nitrobenzene as solvent.At the end of March 1963 the workshop was remodelled, and ventilation became rather poor.On May 17, she complained of severe headache, nausea, vertigo, and numbness in the legs. Her appetite became very poor. Liver damage, hypotension, and cyanosis were recorded by a general practitioner. After five days of rest in bed she felt 'all right' and went back to work.There was a second attack of severe headache, nausea, and severe general weakness on August 16. This attack forced her to take to her bed and she was admitted to hospital the next day.On physical examination the patient was emaciated and in obvious distress; the body temperature was normal, the blood pressure was 120/72 mm. Hg, and the pulse 70, regular. The lips and oral mucosa were cyanotic and the sclerae were slightly icteric. The liver was palpable one and a half fingers' breadth below the right costal margin and was tender on pressure. The spleen was palpablk two fingers' breadth below the left costal margin and was also tender. There was hyperalgesia to pin-prick on the back of the hands and feet with slight cyanosis, but no thermal changes in the skin were detected. The patient felt 'stiff in the arm' when writing.After the administration of glucose, vitamin B1, vitamin B,, and iron preparations, the cyanosis and general weakness disappeared gradually and the numbness in the legs was relieved. Her appetite began to return and her body weight was restored to normal. The patient was discharged after 39 days in hospital with only residual hyperalgesia in the hands and feet.It should be noted that her friend, a woman of 53 years employed on the same work, was also sent to hospital with similar symptoms two weeks before the admission of the present patient. Laboratory InvestigationsUrine.-Urine samples were collected every 24 hours. To hydrolyse sulphates and glucuronides of phenols, 1 ml. of urine was mixed with 3 ml. of 1/3N H2SO4 in a 10 ml. ampoule, and the ampoule was sealed and heated in a boiling water bath for one hour as described in a previous report (Ikeda, 1964).Two millilitres (of aliquot) were transferred from the ampoule to a 20-ml. glass-stoppere...

Background A few case series on psychiatric adverse reactions to COVID-19 vaccines have been reported despite the absence of a history of psychiatric disorders. Herein, we report a case of a first episode of acute mania with psychotic features receival of the third mRNA-1273 vaccine. Case presentation A 37-year-old man developed talkativeness, grandiose delusions, emotional instability, sleeplessness, excitement, hyperactivity and suicidal behavior 4 days after receiving the third mRNA-1273 COVID-19 vaccine. On the 9thdays after vaccination, he was diagnosed with first-episode acute mania with psychotic features and admitted to the psychiatric institute for the first time. After olanzapine administration, the psychiatric symptoms improved within 4 weeks. Conclusions To our knowledge, this is the first report of a first episode of acute mania with psychiatric features associated with the mRNA-1273 vaccine booster. Psychiatrists should be aware of this possibility and be attentive to such a rare and severe adverse effect that could occur within 10 days of vaccination.

Background:In bipolar disorder (BD), reduced white matter (WM) integrity in the corpus callosum has been reported, but its detailed localization difference has not been clarified. In this study, we examined fiber integrity in 7 segments of the corpus callosum and their relationships with clinical symptoms in BD.Methods:Patients with BD (BD group, n = 17) and age-matched healthy controls (HC group, n = 24) were examined using diffusion tensor imaging tractography. The corpus callosum was divided into 7 segments (orbital frontal, anterior frontal, superior frontal, superior parietal, posterior parietal, temporal, and occipital) based on their cortical projection zones, and fractional anisotropy (FA) value of each segment was estimated. Differences in FA of each segment between the groups were examined using ANOVA with repeated measures. Correlations between FA of each segment and clinical symptoms (HAM-D, YMRS) were assessed using Spearman's rank correlation test in the BD group.Results:The BD group showed reduced FA in the orbital frontal, superior frontal, and posterior parietal-callosal segments compared to the HC group. In addition, the BD group showed a significant negative correlation between FA in the orbital frontal-callosal segment and HAM-D scores.Conclusions:Our results suggest that WM integrity in the anterior part of the corpus callosum is reduced in BD and that orbital frontal-callosal disintegrity may be related with severity of bipolar depression.