A TRANSPETROSAL APPROACH FOR EXTENSIVE EPIDERMOID CYST IN THE CEREBELLOPONTINE ANGLE IN A YOUNG ADULT

A 26-year-old male with a large epideroid cyst in the cerebellopontine angle (CPA) undergoing successful total removal via the transpetrosal approach is described. He was referred to our clinic with a history of left facial pain for five years and left hearing disturbance for three years. Computed tomography and magnetic resonance imaging revealed a low-density mass located at the left side of the brainstem, which extended from the ventral side of the medullae to the left parasellar region and medial temporal fossa without abnormal enhancement. Operation was performed via the transpetrosal approach under facial nerve electromyographic, somatosensory evoked potential and auditory brainstem response monitoring. Two-staged operation through the pre- and retrosigmoid route was performed and resulted in successful total removal. In such extensive epidermoid cysts as the present case, a wide operative field is required for total removal, so the transpetrosal approach is very useful

Prediction of trauma responses following myocardial infarction

For survivors of MI, the most common subsequent psychological complications include anxiety and depression. Recent interest has increased in examining the incidence of anxiety disorders, including Post-Traumatic Stress Disorder (PTSD), among post-MI patients. The purpose of this study was to prospectively evaluate trauma responses among a consecutive sample of post-MI patients. Forty-six post MI patients completed questionnaires and forty completed structured interviews during their initial hospitalization for MI. Six of these individuals reported acute stress disorder symptoms in response to their MI. These six patients scored significantly higher on most measures of PTSD. Thirty-two individuals completed a follow-up assessment of PTSD symptoms. Eight individuals (30%) reported symptoms sufficient for a diagnosis of PTSD; five of whom had subclinical symptoms during Phase One. Younger age, lower levels of perceived social support from family, and less use of avoidant coping style significantly predicted PTSD measures at follow-up. Physician ratings of distress, perceived distress during MI, anticipated disability as a result of MI, and prior exposure to more traumatic events significantly correlated with PTSD measures, but they did not add unique variance in the regression models. Objective measures of the severity of the MI (peak cardiac enzymes, ejection fraction, and length of stay) did not correlate with number or severity of PTSD responses. Finally, prior exposure to traumatic events significantly predicted overall psychological distress. These findings suggest that PTSD is a common reaction to MI and that efforts to assess this treatable anxiety disorder, using multidisciplinary teams including mental health professionals should be encouraged

Combination of Endoscopic Resection and Heat Ablation Is a Promising Endoscopic Therapy for Adenoma-Like Dysplastic Lesion in Chronic Ulcerative Colitis

In January 2007, a 74-year-old male was admitted to our hospital for treatment of an adenoma-like dysplastic lesion (ALM). He had a four-year history of ulcerative colitis. Endoscopic findings revealed that a protruded lesion with an approximate size of 3 cm at the splenic flexure was surrounded by pseudopolyps. Lifting of the tumor was poor despite injection of normal saline around it. Therefore, the combination of endoscopic resection and heat ablation therapy with argon plasma coagulation was performed. Histopathological examination of the resected specimen showed tubular adenoma with high-grade atypia. Endoscopic examination 15 months after this treatment revealed no occurrence of ALM. Whether or not there is a possibility of local recurrence after ablation therapy in addition to endoscopic resection performed in this case remains unclear. However, this endoscopic therapy is a promising option for ALM in chronic ulcerative colitis

Single sheet tester having open magnetic path for measurement of magnetostriction of electrical steel sheet

A single sheet tester having closed magnetic path (a closed type of SST) has a problem that measurement accuracy of magnetostriction is considerably affected by electromagnetic force between specimen and yoke. Therefore, an open type has been developed. In order to get uniform flux distribution in a sufficiently large region, a compensating magnetizing winding is installed, and a method of waveform control is investigated, in which applied voltages to main and compensating windings are adjusted individually. The effectiveness of the newly developed open type is demonstrated by measuring magnetostrictions of thin amorphous sheet as well as highly grain-oriented silicon steel sheet</p

Measuring System of Magnetostriction Under AC Excitation Using Optical Methods

A measuring system for magnetostriction of silicon steel sheet using optical methods and a single sheet tester has been developed to establish a standard test method for IEC and JIS. Various factors affecting measurement accuracy and reproducibility of the developed system are examined. Two optical instruments, such as a laser Doppler vibrometer and a heterodyne displacement meter, are compared. 3-D characteristics of magnetostriction under ac excitation in the rolling direction are measured up to 2.0 T </p

SUCCESSFUL PAIN RELIEF BY MOTOR CORTEX STIMULATION FOR EXTENSIVE THALAMIC PAIN : CASE REPORT

Thalamic pain is known as the most difficult pain syndrome to treat. This paper describes our case treated successfully by motor cortex stimulation for extensive thalamic pain. A 59-year-old man with left thalamic pain was readmitted two years after an episode of right thalamic hemorrhage. He complained of tearing pain in the left eye, burning pain in the left upper and lower extremities, and chest pain. After one week of test stimulation, permanent implantation using two electrode arrays to include the area of the lower extremity was done. Excellent pain relief has been sustained for 10 months

Ischemia Alters the Expression of Connexins in the Aged Human Brain

Although the function of astrocytic gap junctions under ischemia is still under debate, increased expression of connexin 43 (Cx43) has been observed in ischemic brain lesions, suggesting that astrocytic gap junctions could provide neuronal protection against ischemic insult. Moreover, different connexin subtypes may play different roles in pathological conditions. We used immunohistochemical analysis to investigate alterations in the expression of connexin subtypes in human stroke brains. Seven samples, sectioned after brain embolic stroke, were used for the analysis. Data, evaluated semiquantitatively by computer-assisted densitometry, was compared between the intact hemisphere and ischemic lesions. The results showed that the coexpression of Cx32 and Cx45 with neuronal markers was significantly increased in ischemic lesions. Cx43 expression was significantly increased in the colocalization with astrocytes and relatively increased in the colocalization with neuronal marker in ischemic lesions. Therefore, Cx32, Cx43, and Cx45 may respond differently to ischemic insult in terms of neuroprotection