Effectiveness of drinking plan and drinking diary in intervention program (HAPPY program) for heavy drinkers

We examined the effectiveness of a drinking plan (goal setting), and a drinking diary (self monitoring), in the intervention program (HAPPY program), for heavy drinkers in the workplace. 115 people participated, and 80 people were evaluated three months later and 31 people were evaluated one year later. We classified the drinking plans in the limitation of the quantity, non-drinking days, and the device of low risk drinking model. 75 people made the drinking diary for 12 weeks after brief intervention and studied three months later and 31 people were analyzed one year later. We evaluated on heavy drinking days of 28 days, and non-drinking days of 28 days and standard drinks of 7 days. The limitation of the quantity model is effective for low risk drinking. The non-drinking day model is easily achieved, but not effective for low risk drinking. The device of low risk drinking model improved drinking habits for a long-term. The drinking diary for 12 weeks after intervention improved drinking habits for a long-term. The drinking plan (goal setting), and drinking diary (self monitoring), in intervention program for heavy drinkers were effective for prevention of lifestyle-related disease and alcoholism.     

Diffuse axonal injury (DAI) in an autopsy case of head trauma with long survival]

The authors reported a clinico-pathological case survived 11 months after a traffic accident. A 41-year-old man had been hit by a motor car and was found in a state of semicoma. On admission, his consciousness level was III-100 to 200 (Japan Coma Scale). Pupils were isocoric; light reflex was present. Linear fracture of occipital bone was disclosed by Skull X-ray and subarachnoid hemorrhage was revealed on CT scan. This comatose state, lasting 24 hours, slowly improved and eventually he presented the so-called Korsakoff's syndrome until his death. He could not recognized his relatives, only uttered some meaningless words. He was unable to obey simple verbal orders. The patient was incontinent and right pyramidal sign was positive. On repeated CT scans, cerebral ventricles gradually increased in size; especially the enlargement of the fourth ventricle was remarkable. He expired of septic shock caused by bed sores. At autopsy brain weighed 1190 g. Old gloss contusional scars were observed on the bilateral frontal lobes including the orbital area and on the left temporal pole. Gliding contusions were revealed in the subcortical white matter beneath the left superior frontal convolution. Fibrillary gliosis was noted in this region, the deep white matter underlying the left temporal pole and the tissue surrounding the anterior horn of the left lateral ventricle. Nerve fibers were fragmented and lacerated at corpus callosum, anterior commissure and posterior limb of the left internal capsule. Bilateral pyramidal tracts showed mild myelin pallor at the brainstem. Loss of Purkinje cells were observed. This case would correspond to mile type of diffuse axonal injury proposed by Adams and Gennarelli. (ABSTRACT TRUNCATED AT 250 WORDS)     

Upgaze eyelid position allows differentiation between congenital and aponeurotic blepharoptosis according to the neurophysiology of eyelid retraction

To differentiate between congenital and aponeurotic blepharoptosis, we investigated whether upgaze with stretching of the mechanoreceptor of Mueller muscle increases involuntary reflex contraction of the levator slow-twitch muscle fibers.In 50 cases each of unilateral congenital blepharoptosis and of asymmetric aponeurotic blepharoptosis, the mean increases by upgaze in the upper eyelid margin to the line between the medial and lateral canthi as upper eyelid retraction distance (UERD) of the ptotic eyelid 0.4 mm and 2.9 mm, respectively. These were significantly smaller and significantly larger than those of the corresponding nonptotic eyelid, 2.0 mm and 2.3 mm, respectively.Worsening of ptosis on upgaze is common in congenital ptosis and is an abnormal differentiating sign, lacking the involuntary reflex contraction. Improvement of ptosis on upgaze is common in aponeurotic blepharoptosis and likely represents a normal physiological process, restoring the involuntary reflex contraction.     

Decreased plasma tryptophan associated with deep white matter lesions in elderly subjects

The aim was to identify potentially treatable riskfactors for cerebral white matter lesions often found on MRI in elderly persons. findings were assessed on 1.0 T MRI of 178 subjects living inthe community and aged 60 years or older. Participants underwent standardised evaluations including standard questionnaires, a physicaland neurological examination, cognitive function tests, electrocardiogram, a complete blood chemistry panel, and plasma aminoacid measurements. Brain MRI infarcts, deep white matter lesions(DWMLs), and periventricular hyperintensities were found in 26%, 43%,and 29% of the 178 participants, respectively. Subjects with DWMLswere significantly older and had a higher frequency of hypertension,higher systolic blood pressure, and more brain infarcts, but lowerplasma concentrations of tryptophan. In the multivariate model, greaterage and lower plasma tryptophan concentrations were independentlyassociated with DWMLs. Tryptophan concentrations were inversely relatedto DWML grading, whereas hypertension and brain infarction were morecommon in subjects with higher extents of DWMLs. The present studysuggests that greater age and lower plasma tryptophanconcentrations were important in producingDWMLs in elderly subjects.

     

Discrepancy in EBV-DNA load between peripheral blood and cerebrospinal fluid in a patient with isolated CNS post-transplant lymphoproliferative disorder

Post-transplant lymphoproliferative disorder (PTLD) is a fatal complication of allogeneic hematopoietic stem cell transplantation (HSCT) that is caused by reactivation of Epstein–Barr virus (EBV). A successful approach, monitoring EBV-DNA load in peripheral blood (PB) accompanied by preemptive rituximab therapy, has recently been reported. Here, we describe a 29-year-old woman who developed isolated central nervous system (CNS) PTLD. She received HSCT against acute myelogenous leukemia from a related human leukocyte antigen-haploidentical donor, following a conditioning regimen that included antithymocyte globulin. Tacrolimus and methylprednisolone were given as prophylaxis for graft-versus-host disease. On day +172, the patient’s consciousness deteriorated. Magnetic resonance imaging showed six ring-enhanced lesions in the cerebral hemispheres. These tumors were diagnosed, via a craniotomy and tumorectomy, as PTLD. EBV-DNA load was elevated in the cerebrospinal fluid (CSF) but not detected in PB. She was treated with whole-brain irradiation and rituximab, and achieved partial remission of the tumors. This case serves as a reminder that vigilance is required regarding the development of isolated CNS PTLD; it is worth examining EBV-DNA replication in CSF for diagnosis even when the EBV-DNA load is negative in PB.     

Non‐thermal cytocidal effect of infrared irradiation on cultured cancer cells using specialized device

As infrared penetrates the skin, thermal effects of infrared irradiation on cancer cells have been investigated in the field of hyperthermia. We evaluated non‐thermal effects of infrared irradiation using a specialized device (1100–18000 nm with filtering of wavelengths between 1400 and 1500 nm and contact cooling) on cancer cells. In in vitro study, five kinds of cultured cancer cell lines (MCF7 breast cancer, HeLa uterine cervical cancer, NUGC‐4 gastric cancer, B16F0 melanoma, and MDA‐MB435 melanoma) were irradiated using the infrared device, and then the cell proliferation activity was evaluated by 3‐(4,5‐dimethylthiazol‐2‐yl)‐5‐(3‐carboxymethoxyphenyl)‐2‐(4‐sulfophenyl)‐2H‐tetrazolium (MTS) assay. Proliferation of all the cancer cell lines was significantly suppressed by infrared irradiation. Total infrared output appeared to be correlated with cell survival. Increased temperature during infrared irradiation appeared not to play a role in cell survival. The maximum temperature elevation in the wells after each shot in the 20 and 40 J/cm² culture was 3.8°C and 6.9°C, respectively. In addition, we have shown that infrared irradiation significantly inhibited the tumor growth of MCF7 breast cancer transplanted in severe combined immunodeficiency mice and MDA‐MB435 melanoma transplanted in nude mice in vivo. Significant differences between control and irradiated groups were observed in tumor volume and frequencies of TUNEL‐positive and Ki‐67‐positive cells. These results indicate that infrared, independent of thermal energy, can induce cell killing of cancer cells. As this infrared irradiation schedule reduces discomfort and side effects, reaches the deep subcutaneous tissues, and facilitates repeated irradiations, it may have potential as an application for treating various forms of cancer. (Cancer Sci 2010)