Explicit knowledge and intention to learn in sequence learning: an event-related potential study

The present study was performed to examine how intention to learn and explicit knowledge in sequence learning are reflected in event-related potentials. Participants responded to numerals presented in a repeating order, which were replaced infrequently by deviant numerals. The participants were given incidental or intentional learning instructions. Sequence parts for which they acquired explicit knowledge were identified for each participant by post-task memory tests. Reaction times indicated that sequence learning occurred under both types of instruction. The N2 enhancement for deviants was primarily associated with explicit sequence knowledge, and the P3 enhancement showed a weak association. These results suggested that N2 and P3 reflect different aspects of explicit learning.     

A 40-year-old gossypiboma (foreign body granuloma) mimicking a malignant femoral surface tumor

The patient was a 61-year-old man who developed gossypiboma of the left thigh and femur resulting in the imaging appearances of a malignant surface tumor. He had a past history of surgery on the left femur for open fracture 40 years previously. Radiographs and CT showed a soft tissue mass with osteolysis and periosteal thickening of the left femur. On MRI, the mass showed heterogeneous signal intensity with contrast enhancement at the periphery, suggesting a malignancy. ^99mTc-HMDP bone scintigraphy showed a faint ring-like uptake, but thallium -201 scintigraphy did not show any uptake in the tumor. An extensive intralesional excision was performed. Postoperative histopathological examination showed a fibrous foreign body with reactive changes. There were neither viable cells nor atypical giant cells around the foreign body. No malignant change was evident. Based on surgical and histopathological examinations, the tumor was finally diagnosed as gossypiboma related to a retained surgical sponge.The patient was treated by Dr. Kenshi Sakayama at Ehime University Hospital, Ehime, Japan     

Measurement of pulse wave "augmentation index (AI) "and its clinical application

Hypertension, hyperlipidemia, diabetes mellitus and obesity, all of these life-style related diseases advance arteriosclerosis and cause a cardiovascular event. It is said that the event can be greatly reduced by improvement of lifestyle or medication. The device is recently developed that enables us easily to measure AI i.e. augmentation index, and the studies applying the device have been clarifying the clinical usefulness of the index. The reflected wave from the peripheral artery is superimposed on the ejection wave generated by cardiac contraction, although the blood pressure waveform is observed as the synthesized one of those two. AI is defined as the proportion of the amplitude of the reflected wave to that of the ejection wave, and it does not only express a cardiac load, but also arterial stiffness. The vessel with arteriosclerosis generates a large reflected wave, and it reaches the left ventricle at high speed. Thereby the heart receives large mechanical stress which may cause cardiac hypertrophy, and as a result, the sustained stress may cause a serious accident. Thus, it is the management for both situations of the heart and the artery that matters, and AI can be regarded as a new marker of cardiovascular disease for suitable clinical management on both heart and artery.     

Indication for and surgical outcomes of the distraction method in various types of craniosynostosis

Background Various surgical techniques for the treatment of craniosynostosis using distraction devices have been described over the last few years and we have applied these procedures in seven patients with varying types of craniosynostosis. The aim of this report is to clarify the advantages and disadvantages of these surgical methods and to discuss current concepts for the surgical strategy in the treatment of craniosynostosis.Material and methods From January 2001 to March 2003, 25 patients with craniosynostosis were examined. Among them, 7 patients, 5 with Apert syndrome, 1 with Crouzon disease, and 1 with multiple-synostosis, underwent surgical treatment using the distraction method with internal distraction devices, according to our treatment strategy for craniosynostosis. All patients underwent preoperative and postoperative evaluations, which included the patients neurological state, developmental quotient (DQ), and three-dimensional CT (3D-CT).Results The timing of the procedures undertaken was between the ages of 1 year 5 months and 12 years 6 months (mean age 4 years 11 months). Five patients had received previous treatment and this procedure was used as a secondary operation. Postoperative distraction distances varied from 7 to 20.5 mm (mean distraction distance: 14 mm). Satisfactory cranial volume expansion and aesthetically pleasing morphological states were achieved in all cases. Regarding complications, one patient required re-operation because of dislocation of the device and skin erosion caused by infection around the penetrated wound. Finally, in a second patient a distortion of the device occurred, but no re-operation was needed.Conclusion The advantage of the distraction method is its applicability for Toddler or Elder Children Calvarial Reconstruction to correct cosmetic and functional problems. One disadvantage is the difficulty in using it for Infantile Calvarial Normalization because of thin calvarial bones and the necessity for re-operation to remove the device, which may result in it becoming a fixation procedure, essentially contraindicated for the fast-developing brain and calvarias. However, the efficacy of this procedure is that the many advantages outweigh the disadvantages as sufficient calvarial expansion and good results using the distraction method, especially in toddler and elder children age groups, can be achieved.     

Some evidence for the in vivo functional activation of suppressor T cells in asymptomatic patients with hemophilia A receiving Factor VIII concentrates

Of 14 asymptomatic hemophilia A patients receiving factor VIII concentrates, 11 severe hemophilia patients had an inverted T-helper/suppressor ratio but 3 moderate patients had a normal ratio. Most hemophilia patients showed poor lymphocyte proliferative responses to mitogens and diminished in vitro immunoglobulin-producing ability of lymphocytes. One important finding was that most patients were found to have increased numbers of Ia-like antigen-positive suppressor T cells, suggesting that circulation activated suppressor T cells. In addition, OKT8+ suppressor T cells from severe hemophilia patients showed strong suppressor activity on B-cell differentiation in a Nocardia delipidated cell mitogen-driven system, whereas those from normal age-matched controls showed no suppressor function. These results suggested that suppressor T cells in hemophilia patients treated with factors might be already activated in vivo by undetermined mechanisms, implying the presence of a peculiar immunoregulatory status in this disease.     

Cerebral vasculitis secondary to Wegener's granulomatosis: computed tomography and angiographic findings

The central nervous system is rarely involved by Wegener's granulomatosis. A case of Wegener's granulomatosis with involvement of the cerebral arteries was reported. Computed tomography showed extensive brain edema with angiographic demonstration of cerebral vasculitis.     

Physicochemical Properties of Solid Phospholipid Particles as a Drug Delivery Platform for Improving Oral Absorption of Poorly Soluble Drugs

Purpose

A novel drug delivery platform, mesoporous phospholipid particle (MPP), is introduced. Its physicochemical properties and ability as a carrier for enhancing oral absorption of poorly soluble drugs are discussed.

Methods

MPP was prepared through freeze-drying a cyclohexane/t-butyl alcohol solution of phosphatidylcholine. Its basic properties were revealed using scanning electron microscopy, x-ray diffraction, thermal analysis, hygroscopicity measurement, and so on. Fenofibrate was loaded to MPP as a poorly soluble model drug, and effect of MPP on the oral absorption behavior was observed.

Results

MPP is spherical in shape with a diameter typically in the range of 10–15 μm and a wide surface area that exceeds 10 m²/g. It has a bilayer structure that may accommodate hydrophobic drugs in the acyl chain region. When fenofibrate was loaded in MPP as a model drug, it existed partially in a crystalline state and improvement in the dissolution behavior was achieved in the presence of a surfactant, because of the formation of mixed micelles composed of phospholipids and surfactants in the dissolution media. MPP greatly improved the oral absorption of fenofibrate compared to that of the crystalline drug and its efficacy was almost equivalent to that of an amorphous drug dispersion.

Conclusion

MPP is a promising option for improving the oral absorption of poorly soluble drugs based on the novel mechanism of dissolution improvement.

     

The efficacy of herbal medicine (kampo) in reducing the adverse effects of IFN-beta in chronic hepatitis C

The purpose of this study was to determine if the adverse effects of interferon (IFN) in hepatitis C patients could be reduced by treatment with Japanese Oriental (Kampo) medicine. Twelve patients with chronic hepatitis C were treated with a combination of IFN-beta and either Mao-to or Dai-seiryu-to (groups A and B), and 16 patients were treated with IFN-beta alone (group C). Mao-to was administered to eight patients and Dai-seiryu-to was administered to four in groups A and B, respectively. Adverse effects were evaluated by clinical and laboratory examinations. The severity of symptoms was daily self-classified into four categories (1: none, 2: very slight, 3: moderate, and 4: serious), using a questionnaire consisting of 29 items. Scores of symptom such as discomfort and fever in group A, and discomfort, general malaise, paresthesia and arthralgia in group B were significantly lower than those in group C (p < 0.05). In all patients, HCV-RNA was negative at the end of the treatment, and serum alanine aminotransferase (ALT) levels had normalized transiently in all group A and B patients with genotype 1b by 2 weeks after cessation of IFN treatment. This study indicates that Kampo medicines are useful for reducing the adverse effects accompanying IFN treatment in patients with chronic hepatitis C without reducing the antiviral effects.