Predictive factors for progressive motor deficits in penetrating artery infarctions in two different arterial territories

BackgroundProgressive motor deficits (PMD) are common in cerebral penetrating artery disease (PAD) during the acute stage and leads to severe disability. Reliable predictors and stroke mechanism for PMD in PAD have been yet to be elucidated. Moreover, difference of predictors between topographically classified PAD has not ever been systematically studied.MethodsThree hundred ninety two consecutive patients with acute PAD (< 20 mm) who showed lacunar motor syndrome and admitted within 24 h after onset were selected for this study. Patients were divided into 2 groups whose infarcts were topographically located within the territories of lenticulostriate arteries (LSA), and anterior pontine arteries (APA). Within each of the 2 groups, factors associated with PMD were analyzed.ResultsProgressive motor deficits were found in 55 patients (21.0%) in LSA group and 38 patients (29.0%) in APA group. In multivariate analysis, female sex and severity of motor deficit on admission (NIHSS 5 or more) were common independent predictors for PMD in both groups. The specific predictors were single infarcts without concomitant silent lacunar infarcts and preceding TIAs in LSA group and diabetes mellitus in APA group.ConclusionsPredictive factors for PMD were different in the 2 different territory groups. Diabetes mellitus was particularly associated with PMD in APA group.     

Relationship of parental bonding styles with gray matter volume of dorsolateral prefrontal cortex in young adults

Previous epidemiologic studies using the parental bonding instrument (PBI), a self-report scale to rate attitudes of parents during the first 16 years, have suggested that a lower parental care score or higher parental overprotection score could lead to an increased risk of several psychiatric disorders, including schizophrenia and mood disorder. However, neuroimaging studies of an association between PBI scores and brain developmental abnormalities are still limited. In this region-of-interest analysis study using a cross-sectional design, we examined 50 normal young adults, in terms of relationships of parental bonding styles during the first 16 years measured by PBI with regional gray matter (GM) volume in the dorsolateral prefrontal cortex (DLPFC). Our study showed that paternal care score positively correlated with the GM volume in the left DLPFC, and paternal and maternal overprotection score negatively correlated with the GM volume in the left DLPFC. In conclusion, our results suggest that in normal young adults, lower paternal care and higher parental overprotection scores correlated with the GM volume reduction in the DLPFC     

Combination treatment of db/db mice with exendin‐4 and gastrin preserves β‐cell mass by stimulating β‐cell growth and differentiation

Aim/Introduction: Preservation of β‐cell mass is crucial for maintaining long‐term glucose homeostasis. Therapies based on incretin and its mimetics are expected to achieve this goal through various biological functions, particularly the restoration of β‐cell mass. Here we tested the effects of gastrin and exendin‐4 in type 2 diabetic animals. Materials and Methods: The effects of exendin‐4 and gastrin on β‐cell function and mass were examined in 8‐week‐old db/db mice. INS‐1 beta cells and AR42J cells were used to determine the molecular mechanism underlying the effects of the two agents. Immunohistochemistry, western blotting and RT‐PCR assays were used to assess the biological effects of the two agents. Results: Two weeks of combination administration of exendin‐4 plus gastrin resulted in a significant improvement of glucose tolerance associated with a marked preservation of β‐cell mass in db/db mice. Immunohistochemical analysis showed that such treatment resulted in the appearance of numerous irregularly‐shaped small islets and single insulin‐positive cells. While gastrin had little biological effect on INS‐1 β‐cells consistent with low expression of its intrinsic receptor on these cells, it caused differentiation of AR42J cells into insulin‐producing cells. Co‐stimulation with exendin‐4 significantly enhanced gastrin‐induced endocrine differentiation of AR42J precursor cells. These findings were further supported by enhanced expression of key genes involved in β‐cell differentiation and maturation, such as neurogenin3 (Ngn3) and MafA. Conclusions: These results suggest that combination treatment of db/db mice with exendin‐4 and gastrin preserves β‐cell mass by stimulating β‐cell growth and differentiation. (J Diabetes Invest, doi: 10.1111/j.2040‐1124.00044.x, 2010)     

Reconsiderations of mitral stenosis: rheumatic mitral valve repair and the Wilkins score

Background  

Mitral valve repair is a feasible treatment option in patients with rheumatic mitral valve disease, but it is not always successful. Mitral valve replacement is generally the surgical treatment of choice in such patients. We aimed to examine whether the Wilkins score can predict the feasibility of surgical repair in such patients.     

Changes with time in skin temperature of the shoulders in healthy controls and a patient with shoulder-hand syndrome

Background

Abnormal skin temperature in the shoulder is caused by various diseases. A thermography is unable to capture temperature changes over time. In contrast, a Thermocron is an effective measuring device to monitor temperature changes over time.

Purposes

The purposes of this study employing a Thermocron were to measure shoulder skin temperature over time in healthy subjects and to detect shoulder skin temperature abnormalities in a patient with shoulder-hand syndrome.

Subjects and methods

Subjects comprised 10 healthy volunteers (20 shoulders; 4 men and 6 women, mean age 54 years). For measurements, a Thermocron was attached on both shoulders. Measurements were made from 21.00 to 07.00 the following morning at 15-minute intervals.

Results

Gradual difference in right and left shoulder skin temperature was observed with the timing of measurements but no significant difference was apparent, i.e. dominant side 34.9 ± 0.8°C, non-dominant side 34.9 ± 0.9°C (P = 0.28).

Presentation of a case with shoulder-hand syndrome

A 54-year-old woman with the diagnosis of rotator cuff tear underwent surgical treatment of rotator cuff repair, but the pain of the operated shoulder persisted due to phase 1 shoulder-hand syndrome. In postoperative week 3, skin temperature measurement using Thermocrons demonstrated a significant decrease in temperature on the operated side (affected side 34.3 ± 0.4°C, healthy side 35.2 ± 0.3°C; P < 0.05).

Conclusion

The changing of the skin temperature during night-time was successfully recorded both in the healthy subjects and a case with shoulder-hand syndrome using a Thermocron.