Cognitive empathy modulates the processing of pragmatic constraints during sentence comprehension

Previous studies have shown that brain regions for mentalizing, including temporoparietal junction (TPJ) and medial prefrontal cortex (mPFC), are activated in understanding the nonliteral meaning of sentences. A different set of brain regions, including left inferior frontal gyrus (IFG), is activated for dealing with pragmatic incongruence. Here we demonstrate that individuals’ cognitive empathic ability modulates the brain activity underlying the processing of pragmatic constraints during sentence comprehension. The lian … dou … construction in Chinese (similar to English even) normally describes an event of low expectedness; it also introduces a pragmatic scale against which the likelihood of an underspecified event can be inferred. By embedding neutral or highly likely events in the construction, we created underspecified and incongruent sentences and compared both with control sentences in which events of low expectedness were described. Imaging results showed that (i) left TPJ was activated for the underspecified sentences, and the activity in mPFC correlated with individuals’ fantasizing ability and (ii) anterior cingulate cortex (ACC) was activated for the incongruent sentences, and the activity in bilateral IFG correlated with individuals’ perspective taking ability. These findings suggest that brain activations in making pragmatic inference and in dealing with pragmatic failure are modulated by different components of cognitive empathy.     

Genes in the serotonin pathway are associated with bipolar affective disorder in a Han Chinese population

Serotonin plays an important role in mood regulation, but the involvement of serotonin pathway genes in the development of bipolar I disorder (BP-I), a mood disorder, is not clear. We selected 21 singlenucleotide polymorphisms (SNPs) within the HTR2A gene, 8 within the SLC6A4 gene and 23 within the TPH2 gene for genotyping using the GoldenGate genotyping assay. A total of 375 patients with BP-I and 475 normal controls were recruited. Two out of 21 SNPs (rs1475196 and rs9567747) in the HTR2A gene and 1/23 SNPs (rs17110566) in the TPH2 gene were significantly associated with BP-I, both genotype-wise and allele-wise. Furthermore, a specific haplotype in the HTR2A gene showed a significant association with BP-I. Our results indicate that the HTR2A and TPH2 genes in the serotonin pathway play important roles in susceptibility to BP-I.     

Comparative outcomes of the tubularized incised plate and transverse island flap onlay techniques for the repair of proximal hypospadias

Purpose

The optimal management of proximal hypospadias remains uncertain. In this study, the surgical outcomes of tubularized incised plate repair (TIP) and transverse island flap (TVIF) onlay urethroplasty in boys with hypospadias were compared.

Methods

A total of 176 patients with proximal hypospadias underwent TIP (n = 83) or TVIF onlay repairs (n = 93) by a single surgeon and were evaluated retrospectively. No patient received a testosterone injection prior to surgery. A retrospective review of their medical records collected data regarding age at surgery, chordee, dorsal plication, hypospadias site, penoscrotal transposition, bifid scrotum, congenital hernia, undescended testis and any postoperative complications, including fistula, recurrent curvature, dehiscence, diverticulum, meatal stenosis and urethral stricture. The pediatric penile perception score (PPPS) was completed by parents to evaluate their perception of cosmetic outcomes.

Results

There was no statistical difference in age or any of the anatomical and clinical features of hypospadias. The median follow-up duration was 22 months (range 12–48 months) and 25 months (14–51 months) for the TIP and TVIF onlay groups, respectively. The overall complication rate in the TVIF onlay group was 21.5 % (20/93), which was higher than 18.1 % (15/83) in the TIP group, but the difference was not statistically significant (P = 0.569). The most common complication was urethrocutaneous fistula, occurring in 9.6 % (8/83) of the TIP group and 10.8 % (10/93) of the TVIF onlay group. There were no significant differences in the rate of any complication and the overall PPPS between the two groups.

Conclusion

TIP and TVIF onlay are clinically equivalent for the repair of proximal hypospadias.     

The value of respective urodynamic parameters for evaluating the occurrence of complications linked to benign prostatic enlargement

Purpose

To assess the correlation between urodynamic parameters and urinary tract complications linked to benign prostatic enlargement (BPE), as well to assess the possible value of these parameters for predicting complications.

Methods

We retrospectively analyzed the relationship between the complications and correlative urodynamic data of 486 BPH patients. Multivariate stepwise logistic regression was used to identify major independent predictors and establish regression models. Receiver operating characteristic (ROC) curves were constructed to evaluate the models’ predictive values.

Results

All of the individual parameters examined significantly correlated with most of the complications linked to BPE, except bladder calculus. According to ROC analysis, all of the areas under ROC curves (AUC), comparison of the individual parameters and the combined effects from the logistical regression models reached statistical significance (p < 0.05), and combining the parameters revealed a higher AUC compared to the individual parameters; however, all of the AUCs were below 0.9.

Conclusions

Urodynamic parameters are significantly correlated with most of the complications linked to BPE, and these parameters have predictive value for the occurrence of these complications with limited values.     

A retrospective study of laparoscopic unilateral adrenalectomy for primary hyperaldosteronism caused by unilateral adrenal hyperplasia

Objective

To evaluated the long-term outcomes of laparoscopic unilateral adrenalectomy for primary aldosteronism (PA) caused by unilateral adrenal hyperplasia (UAH).

Methods

One hundred and sixty-four patients who underwent laparoscopic unilateral adrenalectomy for UAH from January 2004 to December 2011 were entered in this retrospective analysis. Patients demographics, perioperative parameters, and follow-up results were recorded and analyzed statistically.

Results

All 164 cases suffered hypertension with biochemical evidence of hyperaldosteronism prior to operation. Hypokalemia was observed in 52/164 (37.14 %) patients. UAH was proved by multi-slice computed tomography (MSCT). All operations were completed successfully without any conversions or complications. Postoperative pathology confirmed that 164 cases were cortical nodular hyperplasia, of which 4 cases coexist with medullary hyperplasia and 7 with micro-adenoma. At the median follow-up of 48 months, hypertension was cured in 88 (53.7 %) patients, improved in 71 (43.3 %) patients, and refractory in 5 (3.05 %) patients. Hypokalemia and hyperaldosteronism were cured in all patients except re-elevation of blood pressure and plasma aldosterone in two patients 1 month after adrenalectomy.

Conclusions

As an underestimated subtype of PA, UAH is accepted gradually. Laparoscopic unilateral adrenalectomy is nowadays the preferred approach to treat patients with PA caused by UAH. When adrenal venous sampling is not allowed, high-resolution MSCT is a reliable test for lateralization of aldosterone hypersecretion in carefully selected patients and 97 % had either cure or improvement in blood pressure control.     

Altered resting‐state network connectivity in congenital blind

The brain of congenital blind (CB) has experienced a series of structural and functional alterations, either undesirable outcomes such as atrophy of the visual pathway due to sight loss from birth, or compensatory plasticity to interact efficiently with the environment. However, little is known, so far, about alterations in the functional architecture of resting‐state networks (RSNs) in CB. This study aimed to investigate intra‐ and internetwork connectivity differences between CB and sighted controls (SC), using independent component analysis (ICA) on resting state functional MRI data. Compared with SC, CB showed significantly increased network connectivity within the salience network (SN) and the occipital cortex. Moreover, CB exhibited enhanced internetwork connectivity between the SN and the frontoparietal network (FPN) and between the FPN and the occipital cortex; however, they showed decreased internetwork connectivity between the occipital cortex and the sensorimotor network. These findings suggest that CB experience large scale reorganization at the level of the functional network. More importantly, the enhanced intra‐ and internetwork connectivity of the SN, FPN, and occipital cortex in CB may improve their abilities to identify salient stimuli, to initiate the executive function, and to top‐down control of attention, which are critical for the CB to guide appropriate behavior and to better adaption to the environment. Hum Brain Mapp 35:2573–2581, 2014. © 2013 Wiley Periodicals, Inc .     

Multi-label classification of retinal lesions in diabetic retinopathy for automatic analysis of fundus fluorescein angiography based on deep learning

Graefe's Archive for Clinical and Experimental Ophthalmology - To automatically detect and classify the lesions of diabetic retinopathy (DR) in fundus fluorescein angiography (FFA) images using...     

The diagnosis and management of temporal arteritis

Temporal arteritis (TA), or giant cell arteritis, is a systemic autoimmune vasculitis affecting patients over 50 years of age. It can cause rapid, irreversible bilateral vision loss in older adults and is therefore considered an ophthalmological emergency. Many of the symptoms and signs of TA can be vague, non-specific and gradual in onset, often leading to a delayed or inaccurate diagnosis. As such, it is important for a wide variety of primary optometrists and health practitioners to maintain a robust understanding of the clinical presentation, key investigations and time-sensitive management of this disease, as early initiation of treatment for TA can be vision- and life-saving.