Alexithymia and regional gray matter alterations in schizophrenia

Alexithymia is characterized by deficits in emotional self-awareness. Although alexithymia refers to a deficit in recognizing one's own emotions, some studies have focused on the relation between alexithymia and impaired social cognition. An association between alexithymia and schizophrenia has been previously reported, but the brain structures involved remain unclear. The present study investigated associations between alexithymia and specific brain structures to determine whether these regions overlapped with key structures underlying social cognition. Twenty-one patients with schizophrenia and 24 age-, gender- and education level-matched healthy controls underwent structural magnetic resonance imaging. Alexithymia was assessed using the 20-item Toronto Alexithymia Scale (TAS-20). We applied voxel-based morphometry to investigate the correlation between TAS-20 scores and regional brain alterations. TAS-20 scores were significantly higher in patients than controls. Bilateral ventral striatum and left ventral premotor cortex volumes were negatively correlated with TAS-20 total scores in controls, while left supramarginal gyrus (SMG) volume was negatively correlated with TAS-20 total scores in patients. These results suggest that schizophrenia is associated with alexithymia, and that gray matter alterations of the left SMG constitute a key pathology underlying alexithymia in schizophrenia. This association may be related to deficits in self-other distinction, self-disturbance, and language processing in schizophrenia.     

Clinical evaluation of the Gyro Pump C1E3 as a cardiopulmonary bypass pump

The Gyro Pump C1E3 is a new centrifugal pump with numerous features, including a ceramic pivot bearing system, secondary vanes, and an eccentric inlet port. To evaluate its biocompatibility, antithrombogenicity, and produced hemolysis, we used the Gyro Pump during cardiopulmonary bypass (CPB) for coronary artery bypass grafting (CABG) cases to compare it with the BioMedicus pump. From September 1998 to February 1999, 30 consecutive patients underwent CABG under conventional CPB. Fifteen patients were supported by the Gyro Pump C1E3 (Group G), and the remaining 15 patients, by a BioMedicus BP-80 pump (Group B). In both groups, flow rate was equivalent. Blood samples were taken as follows: preoperative, 60 minutes after the end of the procedure, and at postoperative days (POD) 0, 1, and 2. We evaluated the plasma free hemoglobin (free Hb) as an indication of hemolysis; beta-thromboglobulin (beta-TG) and platelet factor four (PF-4) as an indication of platelet deterioration; C3, C4, CH50 for complement activation; coagulation parameters, fibrinolytic factor, thrombomodulin, nitric oxide (NO), and endothelin as an indication of endothelial deterioration. This was the first clinical sized Gyro Pump CIE3. De-airing from the pump was easily accomplished via the eccentric oblique inlet port. The system, including its console, was easily and simply controlled. Perioperative laboratory data were not markedly changed in either group with demonstrated equivalence for biocompatibility and hemolysis. After pumping, no thrombus formation or pivot wear were observed inside the pump. This atraumatic, small centrifugal pump appears well suited not only for CPB but also for circulatory support.     

How the lack of visuomotor feedback affects even the early stages of goal-directed pointing movements

Pointing movements made with a hidden cursor from the center of gaze to a stationary, visible target overshot the actual target location. The systematic error decreased when the final cursor location from the previous trial was shown, which likely led to the creation of an internal sensorimotor model of movement. However, the putative model had a short memory, and could not substitute for on-line visuomotor feedback on subsequent trials. Contrary to common belief, the effect of a lack of visuomotor feedback was seen even in the early acceleration stage of the movement trajectory. Unchecked in the absence of visual monitoring, the acceleration stage of the movement lasted longer, as was evidenced by the significantly larger value of the peak cursor speed. Moreover, the speed peaked much later in the course of the movement. Speed declined more rapidly thereafter. Consequently, the delayed deceleration stage lasted far less than the acceleration stage. In the absence of visual feedback, the shift rightward in time of the peak speed position (PSP) in relation to total movement duration and other changes in the trajectory imply that visual feedback must play a significant role in determining when acceleration ceases (d V/d t=0), and argue against the traditional notion that visuomotor feedback is unavailable until the later stages of movement. Moreover, our data suggest that non-visual modalities, e.g., proprioception, may be too slow to make up for the absence of vision.     

Nephrotic syndrome complicated by renal and cerebral infarctions in a 14‐year‐old girl

Venous thrombosis is a well‐known complication of nephrotic syndrome (NS), while arterial thrombosis is rare. We know of no reports of children with this complication. Here we report a case of 14‐year‐old girl with NS, who complicated with renal and cerebral infarctions resulting from arterial thrombosis. Urinary examination showed heavy proteinuria. She had intravascular dehydration. Serum albumin was 0.9 g/dL. Contrast‐enhanced computed tomography (CT) showed a low‐attenuation area in the right kidney. Decreased blood flow in the right middle cerebral artery was observed on MRA and also on multi‐detector‐row head CT. Urokinase and heparin were given. Cerebral infarction was treated neuroprotectively by i.v. infusion of edaravone. Comprehensive assessment of intravascular dehydration and the coagulation–fibrinolysis system is needed to guide decisions concerning prophylactic anticoagulation therapy. Better understanding of NS and its risks, as well as the necessity of drug therapy, may help teenagers to accept and cooperate with treatment.     

Dorfin localizes to the ubiquitylated inclusions in Parkinson's disease,dementia with Lewy bodies,multiple system atrophy,and amyotrophic lateral sclerosis

In many neurodegenerative diseases, the cytopathological hallmark is the presence of ubiquitylated inclusions consisting of insoluble protein aggregates. Lewy bodies in Parkinson's disease and dementia with Lewy bodies disease, glial cell inclusions in multiple system atrophy, and hyaline inclusions in amyotrophic lateral sclerosis (ALS) are representative of these inclusions. The elucidation of the components of these inclusions and the mechanisms underlying inclusion formation is important in uncovering the pathogenesis of these disorders. We hypothesized that Dorfin, a perinuclearly located E3 ubiquitin ligase, participates in the formation of ubiquitylated inclusions in a wide range of neurodegenerative diseases. Here, we report that affinity-purified anti-Dorfin antibody labeled ubiquitylated inclusions of Parkinson's disease, dementia with Lewy bodies disease, multiple system atrophy, and sporadic and familial ALS. A double-immunofluorescence study revealed that Dorfin shows a distribution pattern parallel to that of ubiquitin. Furthermore, by a filter trap assay, we detected that Dorfin is present in the ubiquitylated high-molecular weight structures derived from these diseases. These results suggest that Dorfin plays a crucial role in the formation of ubiquitylated inclusions of alpha-synucleinopathy and ALS. However, because we failed to show the direct binding of alpha-synuclein with Dorfin, future investigations into the binding partner(s) of Dorfin will be needed to deepen our understanding of the pathophysiology of alpha-synucleinopathy and ALS.     

Geometrical differences in target volumes between slow CT and 4D CT imaging in stereotactic body radiotherapy for lung tumors in the upper and middle lobe

Since stereotactic body radiotherapy (SBRT) was started for patients with lung tumor in 1998 in our institution, x-ray fluoroscopic examination and slow computed tomography (CT) scan with a rotation time of 4 s have been routinely applied to determine target volumes. When lung tumor motion observed with x-ray fluoroscopy is larger than 8 mm, diaphragm control (DC) is used to reduce tumor motion during respiration. After the installation of a four-dimensional (4D) CT scanner in 2006, 4D CT images have been supplementarily acquired to determine target volumes. It was found that target volumes based on slow CT images were substantially different from those on 4D CT images, even for patients with lung tumor motion no larger than 8 mm. Although slow CT scan might be expected to fare well for lung tumors with motion range of 8 mm or less, the potential limitations of slow CT scan are unknown. The purpose of this study was to evaluate the geometrical differences in target volumes between slow CT and 4D CT imaging for lung tumors with motion range no larger than 8 mm in the upper and middle lobe. Of the patients who underwent SBR between October 2006 and April 2008, 32 patients who had lung tumor with motion range no larger than 8 mm and did not need to use DC were enrolled in this study. Slow CT and 4D CT images were acquired under free breathing for each patient. Target volumes were manually delineated on slow CT images (TV(slow CT)). Gross tumor volumes were also delineated on each of the 4D CT volumes and their union (TV(4D CT)) was constructed. Volumetric and statistical analyses were performed for each patient. The mean +/- standard deviation (S.D.) of TV(slow CT)/TV(4D CT) was 0.75 +/- 0.17 (range, 0.38-1.10). The difference between sizes of TV(slow CT) and TV(4D CT) was not statistically significant (P = 0.096). A mean of 8% volume of TV(slow CT) was not encompassed in TV(4D CT) (mean +/- S.D. = 0.92 +/- 0.07). The patients were separated into two groups to test whether the quality of target delineation on slow CT scans depends on respiratory periods below or above the CT rotation time of 4 s. No significant difference was observed between these groups (P = 0.229). Even lung tumors with motion range no larger than 8 mm might not be accurately depicted on slow CT images. When only a single slow CT scan was used for lung tumors with motion range of 8 mm or less, 95% confidence values for additional margins for TV(slow CT) to encompass TV(4D CT) were 4.0, 5.4, 4.9, 5.1, 1.8, and 1.7 mm for lateral, medial, ventral, dorsal, cranial, and caudal directions, respectively.     

Neuropsin is essential for early processes of memory acquisition and Schaffer collateral long-term potentiation in adult mouse hippocampus in vivo

Long-term potentiation (LTP) is thought to be particularly important in the acquisition of hippocampus-associated memory, in part because it develops quickly and persists for indefinite periods. Extracellular proteolysis has been hypothesized to contribute to LTP by modifying adhesive relations of synapses and thus the morphology of excitatory synapses. Here we report that neuropsin (NP), an extracellular serine protease, is critically involved in the formation of both the potentiation effect and hippocampus-dependent forms of memory. NP-knockout mice were significantly impaired in the Morris water maze and Y-mazes and failed to exhibit early phase LTP induced by a single tetanus. Potentiation was also impaired or completely blocked by in vivo application of a specific inhibitor or a neutralizing monoclonal antibody for NP. Intriguingly, recombinant (r-) NP alone, without tetanic stimulation, elicited either long-lasting potentiation or depression, depending on the applied dose. The r-NP-elicited potentiation was occluded by prior induction of LTP, while theta-burst-elicited LTP was occluded by application of r-NP alone, suggesting that the two forms of plasticity have a common signalling pathway. r-NP-elicited potentiation and depression increased phosphorylation at different sites on the GluR1 subunit of the AMPA receptor that had previously been associated with LTP or long-term depression. Thus, we conclude that NP is necessary for establishment of LTP and has a significant role in memory acquisition.