Urinary Retention as an Initial Symptom of Acute Meningo-Encephalo-Radiculitis in Epstein-Barr Virus Infection

A 48-year-old man presented with urinary retention followed by disturbance of consciousness, areflexia, ophthalmoplegia, muscle weakness, and atrophy. Epstein-Barr virus DNA by PCR was positive in his cerebrospinal fluid. The cerebrospinal fluid revealed elevated myelin basic protein and an oligoclonal band. Magnetic resonance imaging showed high signal intensity in the pons, basal ganglia, and cerebral white matter on T2-weighted imaging and fluid-attenuated inversion recovery imaging. His consciousness, ophthalmoplegia, and muscle weakness almost full recovered. In this patient, the inflammation is thought to have begun as sacral radiculitis, and then extended to encephalitis, and brachial and lumbar radiculoneuritis

The Utility of the Combined Use of 123I-FP-CIT and 123I-MIBG Myocardial Scintigraphy in Differentiating Parkinson’s Disease from Other Parkinsonian Syndromes

【Background】123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy and 123I-FP-CIT dopamine transporter single photon emission computed tomography (DAT-SPECT) provide specific information that distinguish Parkinson’s disease (PD) from parkinsonian syndromes other than PD (non-PD), including atypical parkinsonian disorder (APD) and non-PD other than APD (nPD-nAPD). The purpose of this study was to determine whether combining DAT-SPECT and MIBG myocardial scintigraphy using multiparametric scoring system (MSS) could improve diagnostic test accuracy in discriminating PD from APD or discriminating PD from nPD-nAPD. 【Methods】A total of 52 patients, including 36 PD, eight APD and eight nPD-nAPD, underwent both MIBG myocardial scintigraphy and DAT-SPECT, were evaluated. The heart-to-mediastinum (H/M) ratios (early and delayed), washout-rate (WR), the average (Ave) and asymmetry index (AI) of specific binding ratio (SBR) were calculated. Cutoff values were determined, using ROC analysis, for discriminating PD from APD and for discriminating PD from nPD-nAPD, on five parameters. All cases were scored as either 1 (PD) or 0 (nPD-nAPD or APD) for each parameter according to its threshold in each discrimination. These individual scores were summed for each case, yielding a combined score to obtain a cutoff value for the MSS in each discrimination. 【Results】For discriminating PD from nPD-nAPD, the highest accuracy was 80% at a cutoff value of 19% for the WR and a cut off value of 2 improved diagnostic accuracy to 84% for MSS. For discriminating PD from APD, the highest accuracy was 86% at a cutoff value of 2.8 for the H/M ratio (late) and a cut off value of 2 showed diagnostic accuracy of 86% for MSS. 【Conclusion】A MSS has comparable or better accuracy compared to each parameter of MIBG myocardial scintigraphy and DAT-SPECT in distinguishing PD from nPD-nAPD or distinguishing PD from APD

The Cytoplasmic Domain of the Large Myelin-Associated Glycoprotein Isoform Is Needed for Proper CNS But Not Peripheral Nervous System Myelination

The myelin-associated glycoprotein (MAG) is a member of the immunoglobulin gene superfamily and is thought to play a critical role in the interaction of myelinating glial cells with the axon. Myelin from mutant mice incapable of expressing MAG displays various subtle abnormalities in the CNS and degenerates with age in the peripheral nervous system (PNS). Two distinct isoforms, large MAG (L-MAG) and small MAG (S-MAG), are produced through the alternative splicing of the primary MAG transcript. The cytoplasmic domain of L-MAG contains a unique phosphorylation site and has been shown to associate with the fyn tyrosine kinase. Moreover, L-MAG is expressed abundantly early in the myelination process, possibly indicating an important role in the initial stages of myelination. We have adapted the gene-targeting approach in embryonic stem cells to generate mutant mice that express a truncated form of the L-MAG isoform, eliminating the unique portion of its cytoplasmic domain, but that continue to express S-MAG. Similar to the total MAG knockouts, these animals do not express an overt clinical phenotype. CNS myelin of the L-MAG mutant mice displays most of the pathological abnormalities reported for the total MAG knockouts. In contrast to the null MAG mutants, however, PNS axons and myelin of older L-MAG mutant animals do not degenerate, indicating that S-MAG is sufficient to maintain PNS integrity. These observations demonstrate a differential role of the L-MAG isoform in CNS and PNS myelin

三次元デジタイズ技術を利用した教育研究環境の整備に関する研究2

　本研究は、美術系造形教育へ三次元デジタイズ技術を取り入れていくことを目的としている。複数種類の機器を導入して実験と教材開発を行い、各機器の特性、価格のバランスを含めて、実際の授業への導入実現性、継続性を分析していく。　5年計画の2年目にあたる本研究では、3Dスキャン4機種の運用実験に加えて、実際の授業でのシステムを利用した演習を行った。Photo Booth型システムでは、3Dメッシュとテクスチャの生成から、オートリギングとアニメーション設定を行った。また、一眼レフ型システムを構築して、複数種類の対象物を用いてスキャン実験を行った。　The goal of this project is to integrate 3D digitizing technologies into the curriculum of art educational institutions. We conduct experiments and develop teaching materials with several types of equipment. Based on the comparison between the characteristics of each equipment and its price, we analyze the feasibility and sustainability using the system in the classroom.　In the second year of the five-year plan, we conducted operational experiments of four 3D scanning systems and exercises using this system in the classroom. Using Photo Booth system, students generated 3D mesh and texture, and then set up auto-rigging and animation. In addition, we built a SLR (Single-lens reflex camera) system and conducted scanning experiments with multiple types of objects

Emergency Superficial Temporal Artery to Middle Cerebral Artery Bypass after Intravenous Recombinant Tissue Plasminogen Activator Administration for Acute Cerebral Ischemia in a Patient with Moyamoya Disease

There are few study data to help in the decision whether to perform aggressive surgical revascularization, such as emergency bypass, after intravenous recombinant tissue plasminogen activator (rt-PA) administration in patients with progressive symptoms due to acute cerebral ischemia. A 33-year-old healthy male with no known previous medical history developed right hemiparesis and motor aphasia. No acute lesion was observed on admission computed tomography. According to the treatment protocol, emergency intravenous rt-PA administration was indicated within 3 h. After rt-PA administration, symptoms progressed to complete right hemiplegia. Emergency magnetic resonance imaging (MRI) showed an acute ischemic lesion in the left basal ganglia. MR angiography showed severe stenosis of the bilateral terminal portion of the internal carotid artery and occlusion of the left middle cerebral artery (MCA). Obvious diffusion-perfusion mismatch was detected. We performed digital subtraction angiography and diagnosed this condition as acute cerebral ischemia induced by moyamoya disease. We decided to perform emergency superficial temporal artery (STA)-MCA bypass to prevent further damage. The operation began 7 h after the administration of rt-PA and successful bypass was achieved. Symptoms stabilized and improved postoperatively. The majority of the area with preoperative hypoperfusion was rescued. Four months after surgery, the patient resumed his previous employment and continues to do well after 1.5 years of follow-up. This is the first report of emergency STA-MCA bypass performed after intravenous rt-PA administration for acute cerebral ischemia in a patient with moyamoya disease. We conclude that emergency STA-MCA bypass is a viable option for patients with moyamoya disease even after administration of rt-PA