Transient Automatic Writing Behavior following a Left Inferior Capsular Genu Infarction

A 79-year-old, right-handed woman was admitted to the hospital with decreased spontaneity. Brain magnetic resonance imaging showed a left inferior capsular genu infarction. 99m TC-ECD single-photon emission computed tomography revealed a left-dominant diffuse hypoperfusionin the basal ganglia and frontal lobe. The patient showed abulia and increased writing activity without motor or sensory deficit. The writing was mainly perseverative, and words written along lines were legible and without spatial distortions. This augmented writing behavior disappeared on day 21. The writing characteristic was more similar to automatic writing behavior than hypergraphia. Dissociation between speech and writing behavior was present in our patient. We suggest that a disconnection within the frontal-subcortical circuit contributed to the development of motor perseveration in writing

Accounting for the economic relationship between Japan and the Asian Tigers

This paper applies the business cycle accounting method of Chari, Kehoe and McGrattan (2007) to a two-country, two-good model based on Backus, Kehoe and Kydland (1994) to investigate the economic relationship between Japan and the Asian Tigers from 1980Q1 to 2008Q2. We find that the main driver of long-run shifts and short-run fluctuations in output in each economy is domestic production efficiency. Furthermore, the recent increase in the cross-country business cycle correlation between the two can be attributed to an increase in the cross-country correlation of production efficiencies

Utility of Plain Chest Computed Tomography in Diagnosing Cardioembolic Stroke due to Paroxysmal Atrial Fibrillation

Background：Diagnosing cardioembolic stroke due to paroxysmal atrial fibrillation（PAF）is difficult, mainly due to low detection rate. We evaluated whether left atrial volume, which can be simply measured using non-contrast chest computed tomography（CT-LAV）, can contribute to the diagnosis of cardioembolic stroke due to PAF（PAF-CE）.Methods：Fifty-one consecutive patients with acute ischemic stroke within 24 h of onset were included in this study. Upon admission, we measured the left atrial diameter using transthoracic echocardiography（TTE-LAD）and CT-LAV. Patient background factors such as sex, age, and stroke risk factors were noted as well as brain natriuretic peptide（BNP）value and QTc interval were evaluated on admission. Utilities of BNP value, CT-ALV, and TTE-LAD in PAF-CE diagnosis were compared.Results：Patients were classified into three groups：cerebral thrombosis（CTB）group including large-artery atherosclerosis and small-vessel occlusion（n＝16）, cardioembolic stroke due to non-valvular atrial fibrillation（AF-CE）group（n＝20）, and cardioembolic stroke due to paroxysmal atrial fibrillation（PAF-CE）group（n＝15）. BNP value was highest in the AF-CE group（240.5 pg/mL）, followed by the PAF-CE（187.9 pg/mL）and CTB groups（35.0 pg/mL）（p＜0.001）. There was a significant difference in TTE-LAD among the groups（AF-CE group, 43.8 mm；PAF-CE group, 38.3 mm；CTB group, 34.1 mm）（p＜0.001）. CT-LAV was higher in the AF-CE group（142 mm3）than in the PAF-CE（95.8 mm3）and CTB groups（95.8 mm3）（p＜0.001）. In differentiating PAF-CE, the area under the receiver operating characteristic curve was 0.867, 0.742, and 0.845 for BNP value, TTE-LAD, and CT-LAV, respectively. A cut-off CT-LAV value of ≥ 69.6 mm3 had a high diagnostic rate（＞80％ of sensitivity, specificity, positive predictive value, negative predictive value, and accuracy）.Conclusion：CT-LAV can be useful in diagnosing PAF-CE. Further studies with larger sample size are required to confirm our findings and determine better cut-off value for CT-LAV

Dietary effect of pomegranate seed oil rich in 9cis, 11trans, 13cis conjugated linolenic acid on lipid metabolism in obese, hyperlipidemic OLETF Rats

Conjugated fatty acid, the general term of positional and geometric isomers of polyunsaturated fatty acids with conjugated double bonds, has attracted considerable attention because of its potentially beneficial biological effects. In the present study, dietary effect of pomegranate seed oil rich in punicic acid (9cis, 11trans, 13cis-conjugated linolenic acid; 9c, 11t, 13c-CLNA) on lipid metabolism was investigated in obese, hyperlipidemic Otsuka Long-Evans Tokushima Fatty (OLETF) rats. After 2 weeks feeding period, OLETF rats revealed obesity and hyperlipidemia compared with their progenitor LETO rats. Feeding of the diet supplemented with 9% safflower oil and 1% pomegranate seed oil (9c, 11t, 13c-CLNA diet) did not affect abdominal white adipose tissue weights and serum lipid levels compared with the diet supplemented with 10% safflower oil (control diet) in OLETF rats. However, the accumulated hepatic triacylglycerol was markedly decreased by 9c, 11t, 13c-CLNA diet in OLETF rats. Activities of hepatic enzymes related to fatty acid synthesis and fatty acid β-oxidation were not altered by 9c, 11t, 13c-CLNA diet. Levels of monounsaturated fatty acid (MUFA), major storage form of fatty acid, in serum triacylglycerol were markedly higher in obese, hyperlipidemic OLETF rats than in lean LETO rats. In addition, 9c, 11t, 13c-CLNA diet significantly decreased MUFA levels in OLETF rats. This is the first study showing that 9c, 11t, 13c-CLNA suppresses delta-9 desaturation in vivo, and we suggest that the alleviation of hepatic triacylglycerol accumulation by 9c, 11t, 13c-CLNA diet was, at least in part, attributable to the suppression of delta-9 desaturation in OLETF rats

Does Pramipexole Treatment Improve Headache in Patients with Concomitant Migraine and Restless Legs Syndrome?

Background: Recent studies have suggested a strong link between migraines and restless legs syndrome (RLS). It is possible that these disorders share a dopaminergic dysfunction in the hypothalamic A11 nucleus that contributes to this association. However, there have been no clinical studies to evaluate the effect of dopaminergic treatment on migraine symptoms in patients with concomitant migraines and RLS. Methods: We present an illustrative patient with concomitant RLS and migraine who showed improvement in her headache frequency and RLS symptoms following immediate‐release pramipexole (P‐IR) treatment and provide review results from the medical records of patients who experienced both migraines and RLS in our previous cross‐sectional study. Results: Ten patients (nine patients from the previously completed single‐center study) received P‐IR treatment were included in the study. RLS symptoms improved markedly in all of the subjects. Five out of the 10 patients (50%) reported improvement in migraine headaches. Of these five patients, four (80%) had reported morning headaches before P‐IR treatment. Discussion: Our results indicate that the identification of RLS in migraine patients is clinically significant and that dopaminergic treatment may improve both migraines, particularly morning headache (80% improvement in this study), and RLS symptoms. However, further clinical studies are warranted to verify our results