Pictorial Essay Magnetic Resonance Imaging in Rheumatoid Arthritis and Related Disorders

In this pictorial essay we outline the role of MRI in the work-up of RA and related disorders, and discuss its strengths and limitations with the help of representative case presentations. MRI provides detailed information about the involvement of bones, joints and soft tissue, which may not be evident on radiography. Moreover, MRI often reveals changes consistent with the early inflammatory changes in the synovium and bone marrow. Contrast enhancement study, especially with fat-suppression technique, can be useful in providing objective and quantitative parameters to determine a disease activity and an effect of treatment

MR Imaging of Intra-articular / Juxta-articular Mass Lesions

A wide variety of pathologies can arise in intraarticular/ juxta-articular region. This can be a potential source of confusion in a clinical set-up. These entities are diverse in origin and can emanate from bone, synovium, soft tissue and other surrounding structures. The purpose of this essay is to present an overview of imaging features of these entities with emphasis on the usefulness and limitations of the magnetic resonance imaging (MRI) in the work-up. For the purpose of description the lesions are divided on the basis of their origin in separate groups

Research on Pupils' Progress of Mathematical Ability at Lower Secondary School Level (4) : Considering the "Number" of Test Points

Kassel-Exeter Projectによって開発された共通問題を用いて, 日本の中学生の数学的能力の発達・変容を調査し, その検討を通して, よりよい数学教育に向けての示唆を得ることが本研究の目的である。「数」調査問題をもとに1019名の公立中学校2, 3年生を対象とする調査を行ったところ, 日本の中学生の「数」得点は1年次からすでに高いレベルにあり, そのレベルを維持したままで, イギリス・ドイツなどと比して遜色のない程度の伸びを示していることがわかった。さらに, 問題ごとの正答率の変容に着目すると同時に, 被験者を3つの群に層化することによって, 正答率の変容の要因を分析した。その結果, 数学学習に対する「潜在力」の高い生徒および「潜在力」の低い生徒の「数」得点の変容に関する特徴が洗い出され, 個に応じた数学指導を考慮していく際の示唆が得られた。, The authors administered the "number" of test composed of 50 problems developed by Kassel-Exeter Project to students in Tokyo, Nara, Hiroshima, Fukuoka and Nagasaki prefectures a year earlier to identify the students' progress in mathematical ability at lower secondary school level. Analysis of the test shows that Japanese students' progress is almost comparable with the students from other countries like England and Germany, which can be attributed to the effective teaching of Mathematics.Aside from the overall analysis of the test scores, a longitudinal analysis of each problem was made. The analysis showed that Japanese pupils made remarkable progress in many problems but they showed corresponding regression on estimation of problems. Based on their points in a "potential" test, students were grouped as potentially high (PH), potentailly medium (PM) or potentially low (PL). PH students exhibited high points in comparatively difficult problem items while PL students' showed progress in comparatively easy problem items. The observed regression could be attributed to the same kind of problem items. Important implications for the improvement of the teaching of Mathematics were identified

Trigonal cavernous malformation with intraventricular hemorrhage : A case report and literature review

We reported a case of trigonal cavernous malformation (CM) with intraventricular hemorrhage. This 67-year-old woman experienced sudden onset of loss of consciousness and her Glasgow Coma Scale (GCS) was 5 points (E1V1M3) on admission. CT scan demonstrated intraventricular hemorrhage and acute hydrocephalus. Angiography did not demonstrate any vascular abnormality. Ventricular drainage was performed for acute hydrocephalus and the postoperative course was good. CT showed a hyperdense lesion in the left trigone, which was contrast-enhanced on T1-weighted MR. Removal of CM was performed via the left middle temporal sulcus. We conducted a Pub Med search for trigonal CM and found 17 cases. Herein we discuss the symptoms, CT and MR findings and treatment

Complete response to pembrolizumab in advanced hepatocellular carcinoma with microsatellite instability

Hepatocellular carcinoma (HCC) has limited systemic treatment options and a poor prognosis. The immune checkpoint inhibitor pembrolizumab was recently approved for the treatment of solid tumors with microsatellite instability (MSI). However, its clinical utility for the management of HCC remains to be clarified. Here, we present a case of unresectable HCC with MSI that showed an impressive response to pembrolizumab treatment. A 64-year-old man with chronic HCV infection was diagnosed with a large HCC. His severe liver dysfunction and poor performance status prevented any treatment option other than sorafenib. However, sorafenib failed after a few days due to the rapid progression of the tumor. Based on the finding of MSI in a biopsy specimen, immunotherapy using pembrolizumab was initiated. A dramatic improvement in his general condition and a reduction in tumor size were observed after the initiation of pembrolizumab treatment. Among a cohort of 50 consecutive patients with advanced HCC who were refractory to standard systemic therapy, MSI was found only in the present case. Immune checkpoint blockade therapy induced prominent anti-tumor effects in HCC with MSI. Screening for defects in DNA mismatch repair function may be warranted in HCC patients despite the low frequency of MSI

Global Norms, Local Activism, and Social Movement Outcomes: Global Human Rights and Resident Koreans in Japan

The authors integrate social movement outcomes research and the world society approach to build a theoretical model to examine the impact of global and local factors on movement outcomes. Challenging the current research on policy change, which rarely examines the effects of global norms and local activism in one analysis, they argue (1) that global regimes empower and embolden local social movements and increase pressure on target governments from below, and (2) that local activists appeal to international forums with help from international activists to pressure the governments from above. When the pressures from the top and the bottom converge, social movements are more likely to succeed. Furthermore, these pressures are stronger in countries integrated into global society and on issues with strong global norms. The empirical analysis of social movements by resident Koreans in Japan advocating for four types of human rights—civil, political, social/economic, and cultural—demonstrates that the movements produced more successes as Japan\u27s involvement in the international human rights regime expanded since the late 1970s, and that activism on issues with strong global norms achieved greater successes. The analysis also shows that lack of cohesive domestic activism can undercut the chances of social movements\u27 success even with strong global norms on the issue

The genetic architecture of the human cerebral cortex

The cerebral cortex underlies our complex cognitive capabilities, yet little is known about the specific genetic loci that influence human cortical structure. To identify genetic variants that affect cortical structure, we conducted a genome-wide association meta-analysis of brain magnetic resonance imaging data from 51,665 individuals. We analyzed the surface area and average thickness of the whole cortex and 34 regions with known functional specializations. We identified 199 significant loci and found significant enrichment for loci influencing total surface area within regulatory elements that are active during prenatal cortical development, supporting the radial unit hypothesis. Loci that affect regional surface area cluster near genes in Wnt signaling pathways, which influence progenitor expansion and areal identity. Variation in cortical structure is genetically correlated with cognitive function, Parkinson's disease, insomnia, depression, neuroticism, and attention deficit hyperactivity disorder