A case of glycogenic hepatopathy developed in a patient with new-onset fulminant type 1 diabetes: the role of image modalities in diagnosing hepatic glycogen deposition including gradient-dual-echo MRI

Glycogenic hepatopathy (GH) has been reported as a very rare and under recognized complication in long-standing poorly controlled type 1 diabetes (T1D) patients. GH is characterized by transient elevation of liver transaminase and hepatomegaly caused by reversible and excessive glycogen accumulation in hepatocytes. It has been reported that GH is indistinguishable from non-alcoholic fatty liver disease, which is more commonly seen in diabetic patients, even after a history is taken and a physical examination or imaging studies have been performed. GH can only be diagnosed by liver biopsy. We here demonstrate a 21-year-old male patient with new-onset fulminant T1D complicated with diabetic ketoacidosis who subsequently developed GH just after the initiation of insulin treatment. The marked liver dysfunction (serum levels of aspartate aminotransferase 769 IU/L and alanine aminotransferase 1348 IU/L) and hepatomegaly improved spontaneously via glycemic control without any specific treatments thereafter. Moreover, the insulin requirement dramatically decreased from 168 to 80 units per day as GH improved, suggesting a potential role of GH in insulin resistance. GH was diagnosed based on the histological findings of the liver in our case, but we were able to predict GH before the biopsy based on the findings in the gradient-dual-echo magnetic resonance imaging sequence combined with ultrasound and/or computed tomography examinations of the liver.     

In vitro susceptibilities of five Leptospira strains to 16 antimicrobial agents.

The in vitro activities of 16 antibiotics against five serovar strains of the genus Leptospira were determined. Five of the antibiotics (ampicillin, cefmetazole, moxalactam, ceftizoxime, and cefotaxime) exhibited a lower minimal inhibitory concentration than did penicillin G. In tests for minimal bactericidal concentration, ceftizoxime and cefotaxime were found to be more effective than penicillin G, streptomycin, tetracycline, ampicillin, and cefmetazole.     

Localization of individual area neuronal activity

A family of methods, collectively known as independent component analysis (ICA), has recently been added to the array of methods designed to decompose a multi-channel signal into components. ICA methods have been applied to raw magnetoencephalography (MEG) and electroencephalography (EEG) signals to remove artifacts, especially when sources such as power line or cardiac activity generate strong components that dominate the signal. More recently, successful ICA extraction of stimulus-evoked responses has been reported from single-trial raw MEG and EEG signals. The extraction of weak components has often been erratic, depending on which ICA method is employed and even on what parameters are used. In this work, we show that if the emphasis is placed on individual "independent components," as is usually the case with standard ICA applications, differences in the results obtained for different components are exaggerated. We propose instead the reconstruction of regional brain activations by combining tomographic estimates of individual independent components that have been selected by appropriate spatial and temporal criteria. Such localization of individual area neuronal activity (LIANA) allows reliable semi-automatic extraction of single-trial regional activations from raw MEG data. We demonstrate the new method with three different ICA algorithms applied to both computer-generated signals and real data. We show that LIANA provides almost identical results with each ICA method despite the fact that each method yields different individual components.     

Genetic relationship between Trichophyton mentagrophytes var. interdigitale and Arthroderma vanbreuseghemii

Thirty-nine Arthroderma vanbreuseghemii isolates identified by mating behavior were assayed to determine their ribosomal RNA gene internal transcribed spacer (ITS) region genotypes. Twenty-two isolates of mating type (+) and 4 of (-) showed the genotype of Trichophyton mentagrophytes var. interdigitale, 9 isolates of mating type (+) and 4 of (-) showed the genotype of A. vanbreuseghemii. Nine of 14 isolates with granular or asteroid colony morphology showed the genotype of T. mentagrophytes var. interdigitale. There was no relation between ITS genotype and morphology or mating type of the isolates. Isolates of T. mentagrophytes var. interdigitale genotype were shown to include non-sexually degenerate zoophilic strains with granular colony morphology as well as sexually and morphologically degenerate anthropophilic strains and may be just one genotype of a heterogeneous species, A. vanbreuseghemii.     

Transpulmonary Echocardiography to Guide Stent Implantation into Coarctation of the Aorta

Although stent implantation into aortic coarctation has been performed solely under fluoroscopy, we successfully applied intracardiac echocardiography (ICE) to guide this procedure in a 13‐year‐old patient. Placing an intracardiac echocardiographic catheter in the left pulmonary artery facing upward, we readily visualized the precise anatomy of coarctation, measured the pressure gradient, and monitored the stent inflation process. This report suggests a new application of ICE for intervention with structural and vascular diseases other than interatrial septum.     

Higher magnification microsurgical repair of donor artery dissection in superficial temporal artery to middle cerebral artery anastomosis--technical note

Donor artery dissection is a known cause of technical failure in microvascular anastomosis. A method for detection and direct repair of donor artery dissection before superficial temporal artery (STA) to middle cerebral artery (MCA) anastomosis is described using a high magnification operating microscope (maximum 50.4× magnification). Before STA-MCA anastomosis, the stump of the STA is stained using methylrosaniline chloride (pyoctaninum blue) and is observed under higher magnifications. Microsurgical suturing of the arterial dissection is performed before the anastomosis procedure under the high magnification microscope. This method was used in two patients with symptomatic hemodynamic cerebrovascular occlusive disease. Postoperative angiography revealed good patency and no complications occurred. This method may be useful for detection and direct repair of arterial dissection in small vessel walls before STA-MCA anastomosis.