Clinical and biomarker investigation of a patient with a novel presenilin-1 mutation (A431V) in the mild cognitive impairment stage of Alzheimer's disease.

We report an individual who developed Alzheimer's disease (AD) due to a novel presenilin-1 mutation (Alanine-->Valine at codon 431). When he first presented, the patient met criteria for mild cognitive impairment but progressed over 16 months to fulfill diagnostic criteria of AD. At his first presentation, he showed widespread metabolic deficits in the posterior cingulate, lateral parietal, posterior parietal, and medial temporal regions on positron emission tomography as well as elevated tau and phospho-tau levels in cerebrospinal fluid (CSF). We suggest that functional neuroimaging and CSF biomarkers can serve as useful predictors of development of AD. Accumulation of pathologic tau isoforms and neuron death occur even in the mildest clinical stages of AD.     

Diagnosis of gallstone composition in magnetic resonance imaging: in vitro analysis.

OBJECTIVE: To elucidate the cause of the signal intensity of gallstones on magnetic resonance (MR) images and to determine whether MR imaging would enable the prediction of the composition of gallstones. MATERIALS AND METHODS: 50 gallstones removed by cholecystectomy from 50 patients were used for in vitro study. All 50 gallstones were examined by MR imaging using a body phantom. After imaging, all gallstones were cut into two pieces, and the MR appearances were compared with their cross-sections. Chemical analysis was subsequently performed on 32 gallstones. RESULTS: On T2-weighted (T2W) images, 24 of 50 gallstones showed high signal intensities only in their center. These central high intensities seen on T2W images corresponded to the clefts filled with fluid within gallstones. In 45 of 50 gallstones there were high signal intensity areas in central and/or peripheral regions on T1-weighted (T1W) images. On T1W images, not only the clefts within gallstones but also other regions were seen as high intensity, and these regions had a brown to black color, coarse structure, and contained much copper. CONCLUSION: MR imaging can visualize the structures and compositions of gallstones in detail.     

A case of splenic inflammatory pseudotumor]

A 59-year-old man was admitted to our hospital because of continuous C-reactive protein elevation. Abdominal computed tomography scan revealed a low density mass on the surface of the spleen. Magnetic resonance imaging showed low intensity at peripheral area and slightly high intensity in the central area of the mass lesion on T1 and T2-weighted image. Splenectomy was performed since we could not rule out the possibility of malignant neoplasm only by diagnostic imaging. The pathological diagnosis of the tumor was inflammatory pseudotumor. Splenectomy is considered to be significant from the standpoints of both diagnosis and therapy in cases in which diagnostic imaging is difficult to interpret.     

An 11-year-old girl with reflex sympathetic dystrophy successfully treated by thoracoscopic sympathectomy

Abstract We report on an 11-year-old girl with reflex sympathetic dystrophy (RSD) complaining of severe pain in her right upper extremity. Oral administration of narcotics or non-steroid anti-inflammatory drugs gave no relief in pain. Thoracoscopic electrocauterization of the thoracic sympathetic ganglion at the level of T3 was performed 3 months after the start of symptoms, and brought complete resolution of pain.     

Chronic total occlusions in the superficial femoral artery: a novel strategy using a 1.5 mm J-tip hydrophilic guidewire with an over-the-wire balloon catheter under ultrasound guidance.

Chronic total occlusions in the superficial femoral artery (SFA) are the longest and straightest lesions in the whole body. This presents additional technical challenges and the inability to cross the occluded lesion is a common cause of procedural failure in these percutaneous interventions. The objective of this study was to investigate the usefulness of a strategy using a hydrophilic 1.5 mm J-tip 0.035' guidewire with an over-the-wire balloon catheter under ultrasound guidance for chronic total occlusions in the SFA. This strategy was performed in 32 consecutive patients (36 limbs). Average occlusion length was 17 +/- 10 cm (3-40 cm). The crossover approach was performed in 26 cases (72%); in the remaining 10 cases, the antegrade ipsilateral approach was selected. The technical success rate was 92% (32/36). A secondary popliteal artery approach was performed in the three failed limbs and was successful in two limbs, increasing the final technical success rate to 97%. This novel procedure may be considered the preferred strategy for intervening in chronic total occlusions in the SFA.     

Device that keeps a pierced ear hole intact while treating an infected earlobe

The authors describe a simple, inexpensive, Teflon shaft and silicone ring device that keeps a pierced hole in an infected earlobe intact while an infection is being treated.     

Increase in natural killer cell activity following living-related liver transplantation

Abstract We monitored the serial changes of natural killer cell (NK) activity in eight recipients of living-related liver transplantation. The HLA types of all eight patients were haplotypically identical with those of their donors. Tacrolimus and methylprednisolone were used for immunosuppression. The NK activity before transplantation was 24.1 ± 20.2 % which is surprisingly low when compared with the value for normal individuals (67.7 ± 13.2%, P < 0.01) or a liver dysfunction group (49.4 ± 21.9%, P < 0.05). Serial changes in NK activity revealed a minimum of 6.1 ± 3.6% 1 week after transplantation, gradually increasing to 49.2 ± 12.5 % at 2 months after transplantation. These results suggest that the diseased liver might play an important role in the suppression of NK activity.     

幽门螺杆菌根除可诱导H＋／K＋-ATP酶的高表达而不改变胃黏膜壁细胞数量

背景与目的：已知幽门螺杆菌（HP）感染时胃酸分泌下降，HP根除后上调，但这种机制却不明确。该研究拟探讨HP根除对人胃黏膜壁细胞数量及胃酸分泌功能分子表达的影响。方法：选取患有HP相关的慢性胃炎患111例，于成功根除HP之前及之后12周经内镜取组织活检，计算壁细胞数量；应用实时逆转录聚合酶链反应（RF—PCR）检测H＋／K＋-ATP酶、阴离子交换子2、毒蕈碱受体M3、内因子及白介素-1β的mRNA表达水平；应用血清胃蛋白酶原Ⅰ／Ⅱ比值来评价胃萎缩的程度。结果：HP根除前后壁细胞数量无显性差异。HP根除后胃黏膜H＋／K＋-ATP酶mRNA表达的中位数升高250倍，而白介素-1β则下降，即使在严重萎缩性胃炎中H＋／K＋-ATP酶也有明显升高。与此不同，HP根除后内因子、阴离子交换子2和毒蕈碱受体M3的mRNA表达水平仅分别升高1．4倍、2．3倍和2．5倍。