65 research outputs found

    Frontal lobe epilepsy: Clinical characteristics, surgical outcomes and diagnostic modalities

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    SummaryObjectiveTo identify surgical prognostic factors and to characterize clinical features according to the location of the intracranial ictal onset zone of frontal lobe epilepsy (FLE) in order to assess the role of various diagnostic modalities, including concordances with presurgical evaluations.MethodsWe studied 71 FLE patients who underwent epilepsy surgery and whose outcomes were followed for more than 2 years. Diagnoses were established by standard presurgical evaluation.ResultsClinical manifestations could be categorized into six types: initial focal motor (9 patients), initial versive seizure (15), frontal lobe complex partial seizure (14), complex partial seizure mimicking temporal lobe epilepsy (18), initial tonic elevation of arms (11), and sudden secondary generalized tonic–clonic seizure (4). Thirty-seven patients became seizure-free after surgery. Five patients were deleted in the analysis because of incomplete resection of ictal onset zones. The positive predictive value of interictal EEG, ictal EEG, MRI, PET, and ictal SPECT, respectively were 62.5%, 56.4%, 73.9%, 63.2%, and 63.6%, and the negative predictive value were 46.0%, 44.4%, 53.5%, 44.7%, and 51.7%. No significant relationship was found between the diagnostic accuracy of these modalities and surgical outcome, with the exception of MRI (p=0.029). Significant concordance of two or more modalities was observed in patients who became seizure-free (p=0.011). We could not find any clinical characteristic related to surgical outcome besides seizure frequency. No definite relationship was found between the location of intracranial ictal onset zone and clinical semiology.ConclusionAlthough various diagnostic methods can be useful in the diagnosis of FLE, only MRI can predict surgical outcome. Concordance between presurgical evaluations indicates a better surgical outcome

    Novel Human Bocavirus in Children with Acute Respiratory Tract Infection

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    Human bocavirus (HBoV) and HBoV2, two human bocavirus species, were found in 18 and 10 of 235 nasopharyngeal aspirates, respectively, from children hospitalized with acute respiratory tract infection. Our results suggest that, like HBoV, HBoV2 is distributed worldwide and may be associated with respiratory and enteric diseases

    Cerebrospinal Fluid Biomarkers for the Diagnosis of Prodromal Alzheimer’s Disease in Amnestic Mild Cognitive Impairment

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    Background/Aims: Disease-modifying therapy for Alzheimer’s disease (AD) has led to a need for biomarkers to identify prodromal AD and very early stage of AD dementia. We aimed to identify the cutoff values of cerebrospinal fluid (CSF) biomarkers for detecting prodromal AD. Methods: We assessed 56 patients with amnestic mild cognitive impairment (aMCI) who underwent lumbar puncture. Additionally, 87 healthy elderly individuals and 34 patients with AD dementia served as controls. Positron emission tomography was performed using florbetaben as a probe. We analyzed the concentration of Aβ1–42, total tau protein (t-Tau), and tau protein phosphorylated at threonine 181 (p-Tau181) in CSF with INNOTEST enzyme-linked immunosorbent assay. Results: For the detection of prodromal AD in patients with aMCI, the cutoff values of CSF Aβ1–42, t-Tau, and p-Tau181 were 749.5 pg/mL, 225.6 pg/mL, and 43.5 pg/mL, respectively. To discriminate prodromal AD in patients with aMCI, the t-Tau/Aβ1–42 and ­p-Tau181/Aβ1–42 ratios defined cutoff values at 0.298 and 0.059, respectively. Conclusions: CSF biomarkers are very useful tools for the differential diagnosis of prodromal AD in aMCI patients. The concentration of CSF biomarkers is well correlated with the stages of the AD spectrum

    CT Analysis of the Anterior Mediastinum in Idiopathic Pulmonary Fibrosis and Nonspecific Interstitial Pneumonia

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    OBJECTIVE: We wanted to determine whether the amount and shape of the anterior mediastinal fat in the patients suffering with usual interstitial pneumonia (UIP) or nonspecific interstitial pneumonia (NSIP) was different from those of the normal control group. MATERIALS AND METHODS: We selected patients who suffered with UIP (n = 26) and NSIP (n = 26) who had undergone CT scans. Twenty-six controls were selected from individuals with normal CT findings and normal pulmonary function tests. All three groups (n = 78) were individually matched for age and gender. The amounts of anterior mediastinal fat, and the retrosternal anteroposterior (AP) and transverse dimensions of the anterior mediastinal fat were compared by one-way analysis of variance and Bonferroni's test. The shapes of the anterior mediastinum were compared using the Chi-square test. Exact logistic regression analysis and polychotomous logistic regression analysis were employed to assess whether the patients with NSIP or UIP had a tendency to show a convex shape of their anterior mediastinal fat. RESULTS: The amount of anterior mediastinal fat was not different among the three groups (p = 0.175). For the UIP patients, the retrosternal AP dimension of the anterior mediastinal fat was shorter (p = 0.037) and the transverse dimension of the anterior mediastinal fat was longer (p = 0.001) than those of the normal control group. For the NSIP patients, only the transverse dimension was significantly longer than those of the normal control group (p < 0.001). The convex shape of the anterior mediastinum was predictive of NSIP (OR = 19.7, CI 3.32-infinity, p < 0.001) and UIP (OR = 24.42, CI 4.06-infinity, p < 0.001). CONCLUSION: For UIP patients, the retrosternal AP and transverse dimensions are different from those of normal individuals, whereas the amounts of anterior mediastinal fat are similar. UIP and NSIP patients have a tendency to have a convex shape of their anterior mediastinal fat.This study is supported by KISTEP, the Ministry of Science and Technology, Korea

    Large Fragment Pre-S Deletion and High Viral Load Independently Predict Hepatitis B Relapse after Liver Transplantation

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    Hepatitis B virus (HBV) associated end-stage liver diseases are the leading causes of liver transplantation (LT) in Taiwan. Relapse of hepatitis B occurs after LT, raising the risk of graft failure and reducing patient survival. Although several oral antiviral agents have been approved for anti-HBV treatment, lamivudine (LAM) remained to be the most widely used preventive regimen in Taiwan. While several clinical predictors have been identified for hepatitis B relapse, the predictive roles of the histopathological characteristics in liver explants as well as the genotypic features of the viruses in pre-LT serum samples have not been assessed. Between September 2002 and August 2009, 150 consecutive hepatitis B surface antigen (HBsAg) positive patients undergoing LT were included for outcome analysis following assessment of the clinicopathological and virological factors prior to LT. Kaplan-Meier analyses discovered that pre-operative LAM treatment ≤3 months; membranous distribution and higher expression of tissue HBsAg in liver explants; preoperative viral load ≧106 copies/ml; and presence of large fragment (>100 base pairs) pre-S deletion (LFpreSDel) correlated significantly with hepatitis B relapse. Multivariate Cox regression analysis showed that the presence of LFpreSDel (P = 0.001) and viral load ≧106 copies/mL (P = 0.023) were independent predictors for hepatitis B relapse. In conclusion, besides high viral load, LFpreSDel mutation is an important independent predictor for hepatitis B relapse after LT. More aggressive preventive strategies should be applied for patients carrying these risk factors

    Recent history of sediment dynamics in Lake Toro and applicability of 210Pb dating in a highly disturbed catchment in northern Japan

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    Sediment dynamics for the last 300 years in Lake Toro and the applicability of 210Pb dating (CIC and CRS models) are here evaluated. The lake sedimentation and sediment yield were determined by 137Cs (1963) and two tephra layers (Ko-c2 in 1694 and Ta-a in 1739). The average sediment yields for initial development periods of catchments were 13.0-14.1 t km^[-2] yr^[-1] until 1963 and increased to 30.5 t km^[-2] yr^[-1] after 1963 because of the conversion of floodplain and upland forests to cultivated lands. In particular, the western zone of the lake near the conjunction with the Kushiro River had a high sedimentation rate, which is attributable to sediment inflow back from the Kushiro River during floods. The CIC model was not applicable because of fluctuations in the 210Pb profiles since 1963. The CRS model agrees with the 137Cs dating in all sites except for one site close to the Kushiro River inflow. 210Pb dating may contain considerable errors where the 210Pb concentration profile and flux is perturbed by floodwater from the Kushiro River, which contains low levels of 210Pb

    Radial Variation of Rays in two Commercial Softwoods Grown in Korea

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    Radial variation of the height and number of uniseriate and fusiform rays within the stems of two typical Korean softwoods, Pinus koraiensis and Larix kaempferi, was studied. The average height of uniseriate rays was about six cells in Pinus koraiensis and nine cells in Larix kaempferi. The height of fusiform rays, including radial resin canals, was on average 20 cells in both species. The height of fusiform rays was greater than that of uniseriate rays: about 3.2 times for Pinus koraiensis and about 2.3 for Larix kaempferi. The height of uniseriate and fusiform rays was lowest near the pith and increased with age to about ring 10 - 20 and then became constant toward the bark. The number of uniseriate rays in a 0.5 × 0.5 mm area was about 6.5 for Pinus koraiensis and 9.5 for Larix kaempferi. The number of uniseriate rays was at a maximum near the pith and decreased to about ring 10 - 20 and was nearly constant for subsequent rings. The ratio of fusiform to uniseriate rays was 1:45 in Pinus koraiensis and 1:53 in Larix kaempferi. Consequently, it was considered that the results obtained might provide useful information for evaluating juvenile and adult wood as well as identifying both species

    Precipitation patterns control the distribution and export of large wood at the catchment scale

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    Large wood (LW) plays an important role in river ecosystems, but LW-laden floods may cause serious damage to human lives and property. The relationship between precipitation patterns and variations in LW distribution and export at the watershed scale is poorly understood. To explore these linkages, we examined differences in LW distribution as a function of channel morphologies in six watersheds located in southern and northern Japan and analysed the impacts of different precipitation patterns on the fluvial export of LW from river catchments. In southern Japan, intense rainfalls caused by typhoons or localized torrential downpours initiate landslides and debris flows that introduce massive amounts of LW into channels. Gravel bars formed by frequent flood events are widely prevalent, and the LW temporarily stored on these bars is frequently moved and/or broken into smaller pieces by floods. In these systems fluvial export of LW is supply-limited, with smaller accumulations and shorter residence times than in northern Japan. Conversely, in northern Japan, where typhoons and torrential downpours rarely occur, LW is mostly recruited by bank erosion, tree mortality and windthrow into channels, rather than by landslides and debris flows. Recruited pieces accumulate in log jams on valley floors, particularly on floodplains supporting mature forests, resulting in larger accumulations and longer residence times. In these watersheds fluvial export of LW is transport-limited, and the pieces gradually decompose during long-term storage as log jams. Copyright (C) 2015 John Wiley & Sons, Ltd
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