Different characteristics of 123I-IMP SPECT images of cerebral embolism and cerebral thrombosis

We performed 123I-IMP SPECT in patients with cerebral infarction within 48 hours after onset, to investigate its usefulness in differentiating cerebral embolism from thrombosis. Clearcut wedge-shaped defect was seen on the SPECT image in all six cases of clinically suspected cerebral embolism in our series, while this pattern was not observed among the five cases of cerebral thrombosis.     

Use of the internal mammary vessels as recipient vessels for an omental flap in head and neck reconstruction

The availability of reliable recipient vessels for free flap transfer in head and neck reconstruction may be limited in cases of prior neck dissection or radiation therapy. One solution is to use the internal mammary vessels as recipients for a free omental flap. Five patients were treated with free omental flap transfer using the internal mammary vessels as recipient vessels during head and neck reconstruction. Two patients presented with a pharyngocutaneous fistula, 1 had mandibular osteomyelitis, 1 had primary esophageal cancer, and 1 had bilateral cervical radiation ulcers. All patients had received radiation therapy previously (average dose, 75.4 Gy), and 4 had undergone neck dissection (3 bilateral and 1 ipsilateral). All patients were reconstructed using a free omental flap. Four patients had a second free flap combined with the free omental flap (3 free jejunal flaps and 1 free fibular osteocutaneous flap). The mean follow-up was 26.4 months. All free flaps took entirely, the only complication ileus requiring reoperation in 1 patient. The internal mammary vessels are reliable recipient vessels for a free omental flap in head and neck reconstruction. This procedure is a good option for patients in whom previous surgery or radiation therapy has compromised local recipient vessels.     

Biocompatibility and durability of Teflon-coated platinum–iridium wires implanted in the vitreous cavity

Teflon-coated platinum–iridium wires are placed in the vitreous as electrodes in artificial vision systems. The purpose of this study was to determine whether these wires have toxicity in the vitreous cavity, and to examine the durability of their coating when grasped by forceps. Rabbits were implanted with platinum–iridium wires that were 50 μm in diameter and coated with Teflon to a total diameter of 68 or 100 μm. To examine the biocompatibility, electroretinograms (ERGs) and fluorescein angiography (FA) were performed before and 1 week, 1, 3, and 6 months after the implantation of the electrode. After 6 months, the eyes were histologically examined with light microscopy. To check the durability, the surface of a coated wire was examined with scanning electron microscopy after grasping with different types of forceps. At all times after the implantation the amplitudes and implicit times of the ERGs recorded were not significantly different from those recorded before the implantation (P > 0.05). FA showed no notable change during the follow-up periods. Histological studies showed that the retinas were intact after 6 months of implantation. There was no damage to the Teflon-coated wire after grasping the wire with forceps with silicon-coated tips, while surface damage of the Teflon that did not extend to the platinum–iridium wire was found when grasped by vitreoretinal forceps. We conclude that Teflon-coated platinum–iridium wire is highly biocompatible in the vitreous for at least 6 months. Wires should be handled with vitreoretinal forceps with silicone-coated tips in order to avoid causing damage during wire manipulation.     

13C MRS reveals a small diurnal variation in the glycogen content of human thigh muscle

There is marked diurnal variation in the glycogen content of skeletal muscles of animals, but few studies have addressed such variations in human muscles. ¹³C MRS can be used to noninvasively measure the glycogen content of human skeletal muscle, but no study has explored the diurnal variations in this parameter. This study aimed to investigate whether a diurnal variation in glycogen content occurs in human muscles and, if so, to what extent it can be identified using ¹³C MRS. Six male volunteers were instructed to maintain their normal diet and not to perform strenuous exercise for at least 3 days before and during the experiment. Muscle glycogen and blood glucose concentrations were measured six times in 24 h under normal conditions in these subjects. The glycogen content in the thigh muscle was determined noninvasively by natural abundance ¹³C MRS using a clinical MR system at 3 T. Nutritional analysis revealed that the subjects' mean carbohydrate intake was 463 ± 137 g, being approximately 6.8 ± 2.4 g/kg body weight. The average sleeping time was 5.9 ± 1.0 h. The glycogen content in the thigh muscle at the starting point was 64.8 ± 20.6 mM. Although absolute and relative individual variations in muscle glycogen content were 7.0 ± 2.1 mM and 11.3 ± 4.6%, respectively, no significant difference in glycogen content was observed among the different time points. This study demonstrates that normal food intake (not fat and/or carbohydrate rich), sleep and other daily activities have a negligible influence on thigh muscle glycogen content, and that the diurnal variation of the glycogen content in human muscles is markedly smaller than that in animal muscles. Moreover, the present results also support the reproducibility and availability of ¹³C MRS for the evaluation of the glycogen content in human muscles. Copyright © 2015 John Wiley & Sons, Ltd.     

Churg-Strauss Syndrome with pleural involvement

A 51-year-old Japanese man with Churg-Strauss Syndrome (CSS) diagnosed by pleural biopsy is described. He was hospitalized because of high fever and bilateral knee, elbow and shoulder joint pain. Chest roentgenogram and chest computed tomography (CT) scan revealed bilateral massive pleural effusion. Pleural biopsy revealed eosinophilic infiltration and necrotizing granulomas. He was treated with oral prednisolone and his symptoms improved. This is the first report of CSS diagnosed by pleural biopsy.     

CD4 + and CD8 + T-lymphocyte number as predictive marker of relapse after rituximab treatment in childhood-onset refractory nephrotic syndrome

Clinical and Experimental Nephrology - Rituximab is a promising option for refractory idiopathic nephrotic syndrome. However, no simple predictive markers for relapse after rituximab have been...     

Humoral response to mRNA-based COVID-19 vaccine in patients with immune thrombocytopenia

Data for COVID-19 vaccine response in patients with immune thrombocytopenia (ITP) are very limited. In a study of 28 patients with ITP, anti-severe acute respiratory syndrome coronavirus 2 spike antibody titres were measured after vaccination. The seroconversion rate for ITP patients was 91.3%, comparable to that in healthy controls (HCs). However, the antibody titre in ITP patients was significantly lower than that in HCs and declined with ageing. Furthermore, the antibody titre in ITP patients who received a minimum prednisolone dose of at least 5 mg/day at any time-point at or after initial vaccination was lower than that in other patients.