Morphological changes in the meibomian glands of patients with phlyctenular keratitis: a multicenter cross-sectional study

Summary of 13 patients with phlyctenular keratitis. (XLSX 11 kb

Neural dynamics in human imitation revealed by ERP surface topography

To clarify the neural dynamics in human motor imitation, we examined event-related potentials (ERP) for a reaction time task that required responses to an actor's ¢nger motions with identical motions. Compared with a control task (reaction to an LED illumination), the ERP surface topography in the imitative reaction was di¡erentiated at around 120^200 ms post-cueing, showing an early sensitivity to the response hand over the pre-central region.This result suggested that activities around the motor areas were facilitated in the imitative reaction, which is consistent with recent neuroimaging studies. However, taken together with that there were no di¡erences in reaction times, the early ERP latency of conditional divergence indicated that neural activities related to imitation are visual responses and do not directly lead to motor acceleration. NeuroRepor

Student Himalayan Exercise Program: Summary of four years activity

第6回極域科学シンポジウム[OG] 地圏11月16日（月）　国立極地研究所１階交流アトリウ

Incidentally Found Primary Cerebral Malignant Melanoma Associated with Ota Nevus—Wide Dissemination after an Initial Phase of Slow Growth

Primary cerebral malignant melanoma accounts for 1% of all melanomas and for 0.7% of all primary tumours of the central nervous system (CNS). We report an incidentally found primary malignant melanoma in the right temporal lobe of a 76-year-old woman with an Ota nevus on her right eyelid and sclera. The lesion was initially characterised by slow growth, followed by tumoural bleeding and wide leptomeningeal dissemination. Magnetic resonance imaging (MRI) during brain checkup demonstrated an 8-mm mass in the right uncus with high intensity on T1-weighted images. The mass grew slowly over the next two years, but asymptomatic tumoural haemorrhage eventually developed. The patient underwent tumour removal via right frontotemporal craniotomy. Extensive subarachnoid dissemination from the right temporal tumour was found; the pathologic diagnosis was malignant melanoma. Despite adjuvant therapy comprising whole-brain radiation and nivolumab, the patient died of severe leptomeningeal dissemination at 4.5 months after the operation (33 months after the initial MRI study). Our literature review found 46 cases of primary CNS malignant melanoma, predominantly in middle-aged to elderly individuals. The most frequent symptom was headache, followed by visual disturbance, nausea/vomiting, and hemiparesis. Only one other case of primary cerebral malignant melanoma had been found incidentally; 11 previously reported patients manifested congenital nevi (Ota nevus, n = 5; other nevi, n = 6). Six patients suffered tumoural haemorrhage, 4 experienced leptomeningeal dissemination, and 5 developed extracranial metastases. The median survival time of the patients was 31 months

Symptomatic Developmental Venous Anomaly with an Increased β2-microglobulin Level in Cerebrospinal Fluid: A Case Report

Background: Gadolinium-enhanced magnetic resonance imaging (MRI) can be used to observe the progression of cerebral infarction, which sometimes mimics malignant brain tumors. While the β2-microglobulin (β2MG) level in blood plasma or cerebrospinal fluid (CSF) is useful for the diagnosis of malignant tumors or degenerative diseases, these results may create confusion regarding a definitive diagnosis, because it is not a specific marker. We present a rare case of symptomatic developmental venous anomaly (DVA), accompanied by transient, irregular, enhanced cerebral lesions and elevated β2MG in the CSF. Case Description: A 56-year-old woman developed dysarthria and underwent MRI, which revealed a right frontal hyperintense area around a previous lesion on diffusion-weighted imaging (DWI). She was treated based on the tentative diagnosis of an ischemic cerebrovascular event, and symptoms subsided in 3 days. MRI on day 7 revealed an enlargement of the hyperintense area on DWI. Post-gadolinium MRI showed multiple, enhanced patchy areas in the right frontal lobe and an abnormally large vein connected to dilated medullary venules, indicating DVA. Magnetic resonance angiography showed no stenosis or arterial occlusion. The β2MG level in the CSF was elevated at 2,061 μg/l, and a differential diagnosis from malignant tumor was required. However, MRI on day 23 revealed total disappearance of the enhanced lesions and a decrease in the high intensity area on DWI. Considering the clinical course, the DVA was symptomatic because of the perfusion disturbance. Conclusion: Careful evaluation is necessary when considering the associated pathologies and potential complications of DVA if detected near a gadolinium-enhanced lesion

Effect of Revascularization on Headache Associated with Moyamoya Disease in Pediatric Patients

Episodic headache is common in childhood moyamoya disease (MMD). The onset, mechanism, cause of headache and the effect of revascularization surgery on headache are not yet clear. We studied 10 cases of children (7 boys and 3 girls) younger than 18 years who underwent revascularization for MMD between 2009 and 2013. We evaluated frequency of headache and cerebral blood flow changes by single photon emission computed tomography brain imaging with [I123]-labeled iofetamine (IMP­SPECT) before and after surgery. Patients’ ages ranged from 0 to 15 years at onset and 2 to 17 years at the time of surgery, mean age being 6.7 and 8.0 years respectively. 9 of 10 patients presented with ischemic symptoms and 8 had headache. 5 patients underwent indirect bypass and 5 underwent combined direct and indirect bypass. Cerebral blood flow improvement was obtained in 14 of the 15 cerebral hemispheres revascularized mean follow-up duration was 32.9 months. All the patients had good outcomes with improvement of ischemic neurological deficits. Headache improved in 7 (87.5%) of 8 patients. Headache in pediatric moyamoya disease is associated with change in cerebral hemodynamics. Revascularization including combined direct bypass and indirect techniques may be required to reduce headache in patients with MMD

Solitary Cranial Langerhans Cell Histiocytosis : Two case reports

Langerhans cell histiocytosis (LCH) is a proliferation of Langerhans cells intermixed with inflammatory cells, in particular eosinophils, that may manifest as a unisystem (unifocal or multifocal) or multisystem disease. We describe the clinical and histologic spectrum of LCH of the orbit and skull in our two cases. Both cases had unifocal erosive skull lesions with a history of trauma. Typical histologic features included numerous histiocytes with varying degrees of giant cell formation and scattered eosinophilic granulocytes. The presence of Langerhans cells was confirmed by CD1a and S100 immunohistochemistry. LCH has an excellent prognosis when treated with surgical resection, steroids and radiotherapy or chemotherapy. One of our patients is disease free at 7 year follow-up and one patient had regression of lesion on follow-up

Magnetic Resonance Imaging Evidence of an Occipital- Straight Sinus Dural Arteriovenous Fistula Causing Severe Bilateral Thalamic Oedema: A Case Report

An 81-year-old woman, with a 3-month history of tinnitus and vertigo, presented with a deterioration of symptoms. Magnetic resonance imaging (MRI) of the brain, using fluid attenuated inversion recovery (FLAIR) and T2 weighted (T2WI) images, demonstrated hyperintensity and swelling of the bilateral thalami, medial parietal lobes, occipital lobes, and left cerebellar hemisphere. She was referred to us with the suggestion of a brain tumour that had spread into the bilateral thalami, or encephalitis. A review of the MR images, however, demonstrated dilatation of a vein on the surface of the cerebellar hemisphere on the T2WI image. Susceptibility weighted imaging (SWI) revealed small and multiple hypointense lesions, indicating microhaemorrhages, in the bilateral thalami and left cerebellar hemisphere. The time of flight source imaging demonstrated small hyperintense dots in the wall of the occipital and straight sinus. Finally, a digital subtraction angiogram (DSA) revealed a dural arteriovenous fistula (DAVF) in the occipito-straight sinus with reflux flow into the straight sinus (Borden Type II). A transvenous embolization and trans-arterial embolization were performed, in an emergency setting, for the occipital sinus and dural shunt, respectively, with the aim of preserving the antegrade flow of the straight sinus. The DSA following the endovascular treatment showed the disappearance of shunt flow and recovery of the antegrade flow in the straight sinus. Therefore, this case report highlights that meticulous analysis of MRI scans help diagnose DAVF, which results in quick and radical treatment

Increased tissue levels of omega-3 polyunsaturated fatty acids prevents pathological preterm birth

Omega-3 polyunsaturated fatty acids such as eicosapentaenoic acid (EPA) have anti-inflammatory effects. Preterm birth is an important problem in modern obstetrics and one of the main causes is an inflammation. We here showed that abundance of omega-3 fatty acids reduced the incidence of preterm birth induced by LPS with fat-1 mice, capable of converting omega-6 to omega-3 fatty acids. We also indicated that the gene expression of IL-6 and IL-1β in uteruses and the number of cervical infiltrating macrophages were reduced in fat-1 mice. The analyses of lipid metabolomics showed the high level of 18-hydroxyeicosapentaenoate in fat-1 mice, which was derived from EPA and was metabolized to anti-inflammatory product named resolvin E3 (RvE3). We finally showed that the administration of RvE3 to LPS-exposed pregnant wild type mice lowered the incidence of preterm birth. Our data suggest that RvE3 could be a potential new therapeutic for the prevention of preterm birth