Dipole source localization of MEG by BP neural networks

Summary The purpose of this study was to examine the usefulness of BP neural networks for source localization of MEG. Since the performance of this method does not depend on the complexity of brain parameters and source models, a homogeneous brain model and a single current dipole source are assumed for convenience. Localization accuracy was examined in relation to the configuration and scale of the network. As a result, average error for position and moment estimations was within 2%, while the maximum error was about 5%. It was therefore concluded that the neural network method was useful for MEG source localization, though some improvements are still necessary.     

Assessment of blood flow in orbital arteries in ocular sarcoidosis

PURPOSE: Posterior uveitis in ocular sarcoidosis is characterized by obliterative arteriolitis, so-called "microangiopathy", in sarcoidosis that may affect blood flow in ocular arteries. This study was performed to evaluate blood flow velocity in orbital arteries in patients with ocular sarcoidosis. METHODS: This study is a case-control study. Thirty-two patients with posterior uveitis diagnosed on the basis of pathological or clinical findings as having ocular sarcoidosis functioned as cases and 24 healthy volunteers as controls. Pulse rate and blood flow velocities were measured in central retinal arteries, ophthalmic arteries, or short posterior ciliary arteries by the pulsed Doppler method. Laser flaremetry was also performed. Blood flow velocities were compared in patients with sarcoidosis and controls and the correlation coefficients between flare intensity values and flow velocities were evaluated using Student's t-test. RESULTS: Blood flow velocities in orbital arteries in eyes with sarcoidosis were significantly lower than those in normal eyes. The resistance index (RI) of peripheral vessels, which is calculated as (maximal velocity - minimal velocity)/maximal velocity, was significantly higher in patients with sarcoidosis. No association was found between flare intensity values and flow velocities. CONCLUSIONS: Patients with ocular sarcoidosis have impairment in ocular circulation. We speculate that changes in orbital blood flow resulted from inflammatory changes in fundus vasculature.     

The effects of intensive care environment on postoperative nightmare

Purpose

We retrospectively investigated the incidence of postoperative nightmares and evaluated the impact of postoperative intensive care on the incidence of during subsequent hospital stay. To reduce the effect of selection bias, we compared the incidence of nightmares in propensity-matched pairs with postoperative management in ICUs or in surgical wards.

Methods

This is a retrospective review of an institutional registry containing 21,606 anesthesia cases and was conducted with ethics board approval. Outcomes of surgical patients treated in ICUs and in postsurgical wards (ICU admission vs non ICU admission) were compared first for nightmares using the initial 12,508 patients. To avoid channeling bias, propensity score analysis was used to generate a set of matched cases (ICU admission) and controls (non ICU admission), yielding 642 matched patient pairs. The incidence rate of nightmares was compared as the primary outcome.

Results

Before adjusting patients’ characteristics, ICU environment exposure increased the incidence of nightmares compared with non-ICU environment during subsequent hospital stay [ICU vs non-ICU: 101/718 (12.3 %) vs 1147/10,542 (9.81 %)]. The odds ratio (95 % CIs) for ICU was 1.29 (1.03–1.61) for nightmares (p = 0.022). After propensity score matching, however, an equal rate of nightmares occurred in the ICU environment exposure compared to the non-ICU environment [ICU vs non-ICU: 81/561 (12.6 %) vs 73/569 (11.4 %)]. The odds ratio and 95 % CIs for ICU were 1.13 (0.80–1.58) for nightmares (p = 0.54).

Conclusions

The incidence of nightmares did not become more evident during subsequent hospital stay after ICU environment exposure.

     

Serial clinical and angiographic follow-up after phosphorylcholine-coated stent implantation

The efficacy of drug-eluting stents (DES) has been proven, but concerns about late complications after DES have been raised. Polymers that do not increase inflammatory or hypersensitivity reactions which may contribute to late complications are needed for new generation DES. To evaluate the safety and efficacy of phosphorylcholine-polymer coating, we investigated serial clinical and angiographic outcomes after phosphorylcholine-coated stent placement. Seventy-five consecutive patients treated with a BiodivYsio phosphorylcholine-coated stent for de novo lesions at our institute between October 2001 and August 2002 were enrolled. Six-month follow-up angiography was performed in 71 lesions (94.7%), and angiographic restenosis was found in 19 lesions (26.8%). Target lesion revascularization (TLR) was performed in 10 lesions (14.1%). Eighteen-month follow-up angiography was performed in 58 (95.1%) of the remaining 61 lesions (excluding TLR lesions), and angiographic restenosis was found in only 3 lesions. The cumulative MACE-free survival rate was 86.3%, 83.6%, and 78.6% at 6-month, 18-month, and 8-year follow-up, respectively. There were no episodes of stent thrombosis. Late loss decreased significantly from 0.74 ± 0.40 mm (6-months) to 0.51 ± 0.46 mm (18-months) (P < 0.0001). Phosphorylcholine-coated stent implantation was associated with acceptable clinical and angiographic results. Phosphorylcholine-coating may be an ideal polymer for new generation DESs.     

Metoclopramide does not prolong duration of action of landiolol attenuating the hemodynamic response to induction of anesthesia and tracheal intubation

Landiolol is a new ultra-short-acting beta 1-selective adrenoreceptor antagonist, which is metabolized rapidly by plasma cholinesterase (PCHE). Metoclopramide has been shown to inhibit PCHE in vitro. Therefore, metoclopramide might prolong beta blocking effects of landiolol and spoil its ultimate-short-acting property. Just before induction of anesthesia, gynecological patients were randomly assigned to receive 0.2 mg/0.1 ml/kg landiolol and 2 ml saline (Landiolol group; n = 20), 0.2 mg/0.1 ml/kg landiolol and 10 mg metoclopramide/2 ml solution (Landiolol-M group; n = 20), or 0.1 ml/kg saline and 2 ml saline (Control group; n = 20). Tracheal intubation was performed 3 min after induction of anesthesia. Heart rate and blood pressure were recorded. Landiolol with or without metoclopramide similarly inhibited increase in heart rate after induction of anesthesia and tracheal intubation. However, changes in blood pressure were not affected. Metoclopramide at induction of anesthesia did not prolong duration of action of landiolol attenuating the hemodynamic response to induction of anesthesia and tracheal intubation.     

Paraneoplastic aqueous flare intensity in patients with esophagogastric carcinoma

A study was conducted of anterior chamber aqueous flare intensity in patients with esophagogastric malignancies. The subjects included 79 patients with upper alimentary tract malignancies (69 scheduled for surgery for the underlining cancer and 10 with metastases), 47 patients with stable ocular sarcoidosis, and 46 age-matched healthy volunteers. A laser cell-flare meter was used to measure flare intensity in patients and healthy controls. The average flare intensity before surgery in patients with cancer was 10.7 ± 4.9 photon counts/millisecond (pc/ms), which was not statistically significantly different from that in patients with sarcoidosis (11.9 ± 8.3 pc/ms) but was significantly higher (p &lt; 0.0001) than that in healthy volunteers (4.3 ± 1.3 pc/ms). The average flare intensity after surgery in patients with carcinomas was 7.5 ± 2.5 pc/ms, which was significantly (p &lt; 0.0001) lower than the preoperative value. These results suggest that alterations in aqueous flare intensity might represent a paraneoplastic syndrome in patients with esophagogastric carcinoma. If so, measurements of flare intensity may be helpful in the differential diagnosis and evaluation of the disease course of digestive tract cancer.