Guillain-Barré Syndrome and Posterior Reversible Encephalopathy Syndrome following Spinal Surgery

Guillain-Barré syndrome (GBS) typically occurs after gastroenteritis and respiratory tract infec-tion, but surgery has also been considered one of the triggers. Posterior reversible encepha-lopathy syndrome (PRES) is a rare complication of GBS. A normotensive female in her 70s pre-sented ascending paralysis and frontal-parieto-occipital subcortical lesions with intermittent hypertension after spinal surgery. Nerve conduction studies revealed demyelinating polyneu-ropathy. The patient’s brain lesions disappeared with amelioration of hypertension. She was diagnosed with the demyelinating form of GBS and PRES caused by intermittent hypertension. Intravenous immunoglobulin G (IVIG) improved her symptoms without exacerbation of the PRES. Surgery can be a trigger of GBS, and GBS can cause PRES by hypertension and present as central nervous lesions. It is important to treat hypertension before using IVIG when PRES is suspected as a complication of GBS, since the encephalopathy can be exacerbated by IVIG. There may be more undiagnosed cases of the coexistence of GBS and PRES after surgery be-cause surgery itself can also cause PRES. Proper control of blood pressure and confirmation of negative central nervous lesions are required to treat GBS patients with IVIG safely

Focal brain lactate accumulation in metformin-induced encephalopathy without systemic lactic acidosis: A case report suggesting mitochondrial vulnerability in lentiform fork sign

Metformin causes metabolic encephalopathy in some patients with end-stage chronic kidney disease, resulting in impaired consciousness and parkinsonism. This encephalopathy has a very characteristic magnetic resonance imaging feature in lentiform nuclei known as the “lentiform fork sign”. However, the mechanism is unknown. Here, we report a case of metformin-induced encephalopathy with a novel observation of lactate accumulation in the lentiform nuclei on magnetic resonance spectroscopy without systemic lactic acidosis. Since metformin is an inhibitor of mitochondrial complex-I, this focal brain lactate accumulation implies that a part of the pathogenesis of metformin-induced encephalopathy is the focal vulnerability of mitochondria to metformin in the lentiform nuclei. When metformin causes encephalopathy, not only testing for serum lactic acidosis and performing routine magnetic resonance imaging but also evaluation of brain lactate accumulation by magnetic resonance spectroscopy should be required to elucidate the etiology

Prolyl Isomerase Pin1 Directly Regulates Calcium/Calmodulin-Dependent Protein Kinase II Activity in Mouse Brains

Calcium/calmodulin-dependent protein kinase II (CaMKII) is abundant in the brain and functions as a mediator of calcium signaling. We found that the relative activity of CaMKII was significantly lower in the WT mouse brains than in the Pin1-/- mouse brains. Pin1 binds to phosphorylated CaMKII and weakens its activity. For this reason, the phosphorylation level of tau in the presence of Pin1 is lower than that in the absence of Pin1, and microtubule polymerization is not downregulated by CaMKII when Pin1 is present. These results suggest a novel mechanism of action of Pin1 to prevent neurodegeneration

Imaging of ulnar-sided wrist pain

Universidade Federal de São Paulo (UNIFESP) Departamento de Diagnóstico por ImagemUNIFESPUNIFESP, Depto. de Diagnóstico por ImagemUNIFESPSciEL

Effects of clozapine and N-desmethylclozapine on synaptic transmission at hippocampal inhibitory and excitatory synapses

Clozapine is the first atypical antipsychotic, and improves positive and negative symptoms of many patients with schizophrenia resistant to treatment with other antipsychotic agents. Clozapine induces minimal extrapyramidal side effects, but is more often associated with seizures. A large number of studies have been conducted to elucidate pharmacological profiles of clozapine and its major active metabolite, N-desmethylclozapine (NDMC). However, there are only a limited number of electrophysiological studies examining their effects on synaptic transmission. In this study, we examined effects of clozapine and NDMC on synaptic transmission by measuring inhibitory and excitatory postsynaptic currents in rat cultured hippocampal neurons. We found that clozapine and NDMC have qualitatively similar actions. They depressed the inhibitory transmission at 1-30 μM, and the excitatory transmission at 30 μM, the former being much more sensitive. The depression of IPSCs by 30 μM of these drugs was associated with an increase in the paired-pulse ratio. The GABA-induced currents were suppressed by these drugs, but less sensitive than IPSCs. The AMPA-induced currents were slightly potentiated by these drugs at 30 μM. At 30 μM, clozapine and NDMC slightly suppressed Ca2+ and Na+ channels. These results strongly suggest that clozapine and NMDC depress the inhibitory synaptic transmission mainly by antagonizing postsynaptic GABAA receptors, but at higher concentrations additionally by acting on presynaptic site, possibly in part through inhibition of presynaptic Ca2+ and Na+ channels. Preferential depression of inhibitory synaptic transmission by clozapine and NDMC might contribute to therapeutic actions and/or side-effects of clozapine. © 2011 Elsevier B.V. All rights reserved

Cooperative Effects in the Photoluminescence of (In,Ga)As/GaAs Quantum Dot Chain Structures

Multilayer In0.4Ga0.6As/GaAs quantum dot (QD) chain samples are investigated by means of cw and time-resolved photoluminescence (PL) spectroscopy in order to study the peculiarities of interdot coupling in such nanostructures. The temperature dependence of the PL has revealed details of the confinement. Non-thermal carrier distribution through in-chain, interdot wave function coupling is found. The peculiar dependences of the PL decay time on the excitation and detection energies are ascribed to the electronic interdot coupling and the long-range coupling through the radiation field. It is shown that the dependence of the PL decay time on the excitation wavelength is a result of the superradiance effect

Bulk-sensitive magnetic microscope utilizing x-ray magnetic circularly polarized emission

We report a bulk-sensitive x-ray magnetic microscope that exploits a new magneto-optical effect in x-ray emission, referred to as x-ray magnetic circularly polarized emission (XMCPE). An advantage of XMCPE is a large magnetic dichroic effect for 3???? transition-metal elements in the hard x-ray region, which enables the realization of a bulk-sensitive microscope suited to iron- and cobalt-rich ferromagnetic materials. We constructed a scanning microscope with 10 ????m lateral resolution. A key element is a Montel-type collimating mirror that widely collects the divergent x rays emitted from a sample and converts them into a well-collimated x-ray beam, which is required for circular polarization analysis. Owing to this mirror, the obtained XMCPE spectra of metallic iron exhibited strong intensity and a large magnetic dichroic effect. The performance of the microscope is also demonstrated by the acquisition of magnetization images of an electrical steel sheet with an insulating coating

Focal brain lactate accumulation in metformin-induced encephalopathy without systemic lactic acidosis: A case report suggesting mitochondrial vulnerability in lentiform fork sign

Metformin causes metabolic encephalopathy in some patients with end-stage chronic kidney disease, resulting in impaired consciousness and parkinsonism. This encephalopathy has a very characteristic magnetic resonance imaging feature in lentiform nuclei known as the “lentiform fork sign”. However, the mechanism is unknown. Here, we report a case of metformin-induced encephalopathy with a novel observation of lactate accumulation in the lentiform nuclei on magnetic resonance spectroscopy without systemic lactic acidosis. Since metformin is an inhibitor of mitochondrial complex-I, this focal brain lactate accumulation implies that a part of the pathogenesis of metformin-induced encephalopathy is the focal vulnerability of mitochondria to metformin in the lentiform nuclei. When metformin causes encephalopathy, not only testing for serum lactic acidosis and performing routine magnetic resonance imaging but also evaluation of brain lactate accumulation by magnetic resonance spectroscopy should be required to elucidate the etiology