Pure topographical disorientation in novel environments without anterograde amnesia: a case study

ABSTRACT

Topographical disorientation (TD) in novel environments is considered to be a part of anterograde amnesia. A 56-year-old woman presented with pure TD only in novel environments following limbic encephalitis. She could not remember directions inside the hospital on weekly outpatient visits; however, her verbal and visual anterograde memories were normal. In the test of learning photographs of scenes, faces, and objects, only her scores for landscapes were worse than those in healthy controls. These findings suggested that her TD specific to landscapes and directions in novel environments was caused by category-specific memory impairment related to bilateral hippocampal and parahippocampal dysfunction.     

Visual acuity outcomes of anti-VEGF treatment for neovascular age-related macular degeneration in clinical trials

Japanese Journal of Ophthalmology - Anti-VEGF treatment for neovascular age-related macular degeneration (nAMD) has been evaluated in clinical trials. To select the best anti-VEGF drug and the best...     

Gender differences in maximum voluntary lip-closing force during lip pursing in healthy young adults

The objectives of this study were to quantitatively evaluate the gender differences in the lip-closing force (LCF) generated during pursing-like lip-closing movement using a multidirectional LCF measurement system in healthy young adults. In 40 healthy subjects (20 women, 20 men; median age = 26·5 years, range = 22-41 years), LCF was recorded in eight directions during the performance of a voluntary pursing-like lip-closing task in four measurement sessions. The correlations between the total sum of the forces generated in all eight directions [total LCF (TLCF)] and each directional LCF (DLCF) and those between opposing DLCF were statistically analysed. The TLCF obtained from the highly reproducible measurements acquired in the four different sessions was normally distributed in both genders. The TLCF in men was significantly greater than that in women. Among the eight pairs of opposing DLCF, seven pairs of opposing DLCF showed significant correlations in men, while five pairs were significantly correlated in women. In men, no significant difference was observed between opposing DLCF; however, three pairs of opposing DLCF were significantly different in women. The present results quantitatively indicate that there are gender differences in the magnitude and directional specificity of the LCF produced during pursing-like lip-closing movement in healthy young adults.     

Revised FIGO staging system for cancer of the ovary,fallopian tube,and peritoneum: important implications for radiologists

Ovarian cancer is the seventh most common cancer diagnosis among women worldwide. The International Federation of Gynecology and Obstetrics recently significantly revised staging criteria for cancer of the ovary. The latest revision was based on the concept that high-grade serous tubal intraepithelial carcinoma (STIC) may be the origin of some high-grade serous carcinomas of the ovary and peritoneum. Therefore, staging criteria for the ovary, fallopian tube, and peritoneum have been unified. Understanding this background and other important revised points are essential for radiologists concerned with imaging diagnosis in gynecologic oncology. Through this review, we introduce the STIC theory and show examples of diseases in accordance with the new staging criteria based on magnetic resonance imaging (MRI) and computed tomography (CT) results.     

Spleen Tyrosine Kinase Modulates Fibrous Airway Obliteration and Associated Lymphoid Neogenesis After Transplantation

Chronic lung allograft dysfunction, the major cause of death following lung transplantation, usually manifests as irreversible airflow obstruction associated with obliterative bronchiolitis (OB), a lesion characterized by chronic inflammation, lymphoid neogenesis, fibroproliferation and small airway obliteration. Spleen tyrosine kinase (Syk), a tyrosine kinase that regulates B cell function and innate immunity, has been implicated in the pathogenesis of chronic inflammation and tissue repair. This study evaluated the role of Syk in development of OB, using an intrapulmonary tracheal transplant model of OB with the conditional Syk‐knockout Syk^flox/flox//rosa26‐CreER^T2 mice and a Syk‐selective inhibitor, GSK2230413. BALB/c trachea allografts were transplanted into Syk‐knockout (Syk^del/del) mice or wild‐type C57BL/6 recipients treated with GSK2230413. At day 28, histological analysis revealed that in the Syk^del/del and GSK2230413‐treated C57BL/6 recipients, the graft lumen remained open compared with allografts transplanted into Syk‐expressing (Syk^flox/flox) and placebo control–treated C57BL/6 recipients. Immunofluorescence showed lymphoid neogenesis with distinct B and T cell zones in control mice. In contrast, lymphoid neogenesis was absent and few B or T cells were found in Syk^del/del and GSK2230413‐treated mice. These observations suggest that inhibition of Syk may be a potential therapeutic strategy for the management of OB following lung transplantation.     

An in vitro study of the effect of some dietary components on calculus formation: regulation of calcium phosphate precipitation

OBJECTIVE: We studied the effects of food components on the in vitro formation of calcium phosphate precipitates. MATERIALS AND METHODS: The effects of food components, such as starch, soybean flour, fish meal, rapeseed oil, and coconut oil, on calcium phosphate precipitation were studied using a pH drop method. RESULTS: Although the addition of starch had no effect on the rate of precipitation of amorphous calcium phosphate (ACP), it increased both the rate of transformation of ACP to hydroxyapatite (HAP) and the induction time (i.e. time for the initiation of transformation of ACP to HAP to occur); this was irrespective of the heat treatment of the starch. Amylopectin (insoluble constituent of starch) was effective in increasing the rate of HAP transformation, but amylose (soluble constituent of starch) was not. Oil specimen obtained from rapeseed (400 microl ml(-1)) increased the entire reaction of calcium phosphate precipitation, but that from coconut did not. Protein food, such as soybean flour and fish meal, decreased the rate of transformation of ACP to HAP and increased the induction time, while they had no effect on the rate of ACP precipitation. CONCLUSION: These results suggest that carbohydrate and oil (both are staple diets for the humans) enhance oral calcification (dental calculus formation or re-mineralization of tooth enamel), while side dishes of protein food would decrease it.     

An initial trial of quantitative evaluation of autoimmune pancreatitis using shear wave elastography and shear wave dispersion in transabdominal ultrasound

Background/ObjectivesWe aimed to examine therapeutic efficacy and prognosis prediction of autoimmune pancreatitis (AIP) using shear wave elastography (SWE) and shear wave dispersion (SWD) in transabdominal ultrasound (US).MethodsThe subjects were 23 patients with diffuse type 1 AIP who underwent SWE and SWD, and 34 controls with a normal pancreas. Elasticity and dispersion were defined as the pancreatic elastic modulus (PEM) and dispersion slope, respectively. PEM and dispersion slope were compared between AIP and control cases, and the short-term therapeutic effect and long-term prognosis were examined.ResultsPEM (30.9 vs. 6.6 kPa, P < 0.001) and dispersion slope (15.3 vs. 13.0 (m/sec)/kHz, P = 0.011) were significantly higher in AIP cases than in controls. Among the 17 AIP patients followed-up in two weeks after treatment, these parameters were 12.7 kPa and 10.5 (m/sec)/kHz with median decrease rate of 37.2% and 32.8%, respectively, which were significantly higher than the change in the size of pancreatic parenchyma (14.4%, P = 0.026). Fourteen of these subjects were followed up for >12 months, during which 2 had relapse; diabetes improved in 5 and worsened in 2; in 60% of cases, the pancreatic parenchyma was atrophied. The % change in PEM after two weeks was tended to be higher in non-atrophy cases.ConclusionSWE and SWD measurement in US may be useful for quantitative assessment of AIP and evaluation of short-term treatment efficacy.     

Barium peritonitis

A case of generalized peritonitis, secondary to a perforation of the rectosigmoid colon during barium-enema roentgenography, is presented. The patient required immediate surgical intervention with the prime importance of the treatment being removal of as much of the contaminating materials as possible. This was done successfully with irrigation and wiping, using urokinase solution. Peritoneal lavage with urokinase solution was also carried out in the early postoperative period. Fluid replacement with careful monitoring of fluid and electrolyte balance is essential before, during, and after the surgical procedure. Adequate antibiotic therapy and careful respiratory and nutritional support are also important.