Learned audio-visual cross-modal associations in observed piano playing activate the left planum temporale. An fMRI study

Lip reading is known to activate the planum temporale (PT), a brain region which may integrate visual and auditory information. To find out whether other types of learned audio-visual integration occur in the PT, we investigated "key-touch reading" using functional magnetic resonance imaging (fMRI). As well-trained pianists are able to identify pieces of music by watching the key-touching movements of the hands, we hypothesised that the visual information of observed sequential finger movements is transformed into the auditory modality during "key-touch reading" as is the case during lip reading. We therefore predicted activation of the PT during key-touch reading. Twenty-six healthy right-handed volunteers were recruited for fMRI. Of these, 7 subjects had never experienced piano training (na?ve group), 10 had a little experience of piano playing (less trained group), and the remaining 9 had been trained for more than 8 years (well trained group). During task periods, subjects were required to view the bimanual hand movements of a piano player making key presses. During control periods, subjects viewed the same hands sliding from side to side without tapping movements of the fingers. No sound was provided. Sequences of key presses during task periods consisted of pieces of familiar music, unfamiliar music, or random sequences. Well-trained subjects were able to identify the familiar music, whereas less-trained subjects were not. The left PT of the well-trained subjects was equally activated by observation of familiar music, unfamiliar music, and random sequences. The na?ve and less trained groups did not show activation of the left PT during any of the tasks. These results suggest that PT activation reflects a learned process. As the activation was elicited by viewing key pressing actions regardless of whether they constituted a piece of music, the PT may be involved in processes that occur prior to the identification of a piece of music, that is, mapping the complex sequence structure of hand movements onto the sequence of sounds.     

Laparoscopically assisted total gastrectomy with sentinel node biopsy for early gastric cancer: preliminary results

This study sought to describe a procedure involving laparoscopically assisted total gastrectomy (LATG) with sentinel node biopsy (SNB) and to evaluate the results of the first three patients. LATG for early gastric cancer was performed with sentinel node (SN) identification using a combined patent blue-violet dye and 99mtechnetium-labeled tin colloid technique. Laparoscopically resected SNs were processed for frozen section examination by routine hematoxylin and eosin (H&E) and immunohistochemical cytokeratin (IHC-CK) stains. LATG consists of a four-surgical port technique, removal of the specimen through a small 5-cm laparotomy, and stapled Roux-en-Y esophagojejunostomy. Five patients were candidates for LATG with SNB between March 2001 and June 2003; two had open surgery because of a tumor extending the serosal surface and peritoneal dissemination, whereas in the remaining three, SNs were successfully identified and evaluated with no evidence of sentinel node (micro) metastases intraoperatively. Based on the results of SNB, three patients underwent LATG with adequate lymphadenectomy. Mean operative time and blood loss were 375 min and 219 mL, respectively. No dissected lymph nodes had evidence of metastasis by H&E and IHC-CK on permanent sections. LATG with SNB followed by adequate lymphadenectomy is technically feasible, and with its acceptable operative time and blood loss, presents an excellent therapeutic option for early gastric cancer; while SNB and subsequent frozen section analysis by H&E and IHC-CK staining is a rapid and reliable diagnostic method for intraoperative detection of SN (micro) metastasis. This combination treatment is a promising alternative to laparoscopic gastrectomy with conventional lymphadenectomy.     

A pilot study of selected Japanese nurses' ideas on patient advocacy

This pilot study had two purposes: (1) to review recent Japanese nursing literature nursing advocacy; and (2) to obtain data from nurses on advocacy. For the second purpose, 24 nurses at a nursing college in Japan responded to a questionnaire. The concept of advocacy, taken from the West, has become an ethical ideal for Japanese nurses but one that they do not always understand, or, if they do, they find it difficult to fulfil. They cite nursing leadership support as necessary to enacting this role. Discussion on meaning of and the rationale for advocacy in a society where goodness or badness is relative to social situations and its impact may reveal two parallel but overlapping views of morality. Such a situation would not only influence notions of advocacy but also possibly render them more complex.     

A case of bilateral obturator hernias; feasibility of combination study of computed tomography and ultrasonography to make diagnostic and therapeutic strategies

Bilateral obturator hernias were diagnosed by computed tomography in a 77-year-old female. Ultrasonography was also performed and ultrasonographical difference was observed between right and left. This contributed the preoperative diagnosis of unilateral incarceration. Combination study with computed tomography and ultrasonography is thought to be feasible to make diagnostic and therapeutic strategies of obturator hernia.     

Virtual pancreatoscopy of pancreatic cancer

BACKGROUND/AIMS: Virtual endoscopy is a new method of diagnosis using computer processing of three-dimensional images data sets. However, there are few reports about the clinical application of virtual endoscopy for the pancreas. In this study, we evaluated the feasibility of surface-rendered magnetic resonance virtual endoscopy for pancreatic cancer. METHODOLOGY: Twenty-six cases of pancreatic cancer were studied. Fifteen patients had pancreatic head cancer, 7 had pancreatic body cancer, and 4 had pancreatic tail cancer. Twelve patients underwent surgical resection of the pancreas. Magnetic resonance imaging data were acquired with a 1.5-T clinical imager (Signal.5; GE Medical Systems, USA). We used a multislab single-shot fast spin-echo sequence. Section thickness was between 2 and 3 mm in the coronal plane. Three-dimensional reconstructed images and virtual endoscopic images were generated with Advantage Windows by GE. RESULTS: Virtual endoscopic images could be generated in 20 patients with pancreatic cancer (76.9%). In these cases, we were able to observe the inner surface of the pancreatic duct and the stricture from not only the pancreatic head but also the pancreatic tail. Clear virtual images could not be generated in 6 cases. We were able to divide the 20 cases in which images could be generated into groups according to the appearance of the stricture. The edge of the stricture appeared to be protruding in 4 cases (15.4%), and appeared to be polygonal in 13 cases (50.0%). In 3 cases, we recognized the existence of a stricture, but the detail of the stricture was unclear. CONCLUSIONS: Virtual endoscopy caused minimal discomfort compared to real endoscopic examination, and it can access cystic lesions and the pancreatic duct behind the stricture. It is concluded that virtual endoscopy for pancreatic cancer has potential clinical utility.     

Complete response in an elderly patient with advanced gastric cancer treated with TS-1

The patient was an 89-year-old woman whose complaints were anorexia and weight loss. As a result of various examinations, she was diagnosed with advanced gastric cancer, Borrmann 3. TS-1 was administered at 75 mg/day for two weeks followed by one-week discontinvation during hospitalization; This course was then repeated after discharge. Anorexia and weight loss improved after two weeks, and complete response (CR) was obtained after 10 months of treatment. No cancer cells were confirmed by endoscopic biopsy. During this period no severe toxicities occurred. This TS-1 administration schedule appears to be a feasible and effective therapy for elderly patients with advanced gastric cancer.     

High Toxoplasma antibody prevalence among inhabitants in Jakarta,Indonesia

We examined IgG antibody to Toxoplasma in sera from 1,693 inhabitants aged 20-85 years in Jakarta. The seroprevalence rate was 70%, without any significant differences between males (71%) and females (69%). Some epidemiological factors contributing to the high prevalences of antibody to Toxoplasma in inhabitants of urban areas in Indonesia were discussed.     

Different effects of phencyclidine and methamphetamine on firing activity of medial prefrontal cortex neurons in freely moving rats

Immunohistochemistry detected calcium-binding proteins (CaBPs) in corpuscular and Merkel nerve endings of the rat vibrissa. CaBP-immunoreactive (ir) corpuscular endings were divided into two types: ramified and unramified endings. Ramified endings were subdivided into reticular and Ruffini endings. Unramified endings were identical to longitudinal lanceolate endings which have been described previously. Reticular and unramified endings as well as Merkel endings co-expressed neurocalcin (NC)- and parvalbumin (PV)-immunoreactivity (ir). However, such endings were devoid of peptide 19 (PEP19)-ir. PV-ir Ruffini endings were immunoreactive for PEP19 but not NC. The retrograde tracing method revealed that 34, 21 and 18% of trigeminal neurons which project to the infraorbital nerve exhibited NC-, PEP19- and PV-ir, respectively. In addition, 73 and 36% of the PV-ir neurons showed NC- and PEP19-ir, respectively. The content and co-expression of CaBPs in vibrissal low-threshold mechanoreceptors may depend on their terminal morphology.