<Study 2> Saccadic eye movements and regional cerebral blood flow in schizophrenic patients.

This study examined tracking eye movements on predetermined stationary targets inpatients with schizophrenia spectrum dis order.The targets were 8 black points or 8 arabics\u27 numbered points placed on the circumference of a circle.Self-paced eye movements during clockwise tracking of these points by 23 patients and 23 normal controls were recorded using an infrared eye-mark recorder.Eye movements were an alyzed at two settings : first, when "fixation point" was defined as a point at which a gaze was held for at least 200 msec, and second, when held for at least 100 msec.The results indicated that at the 200 msec setting schizophrenic patients track with significantly fewer correct scores and more deviant scores than controls under black-point conditions.At the 100-msec setting, however, the correct scores of the patients were not significantly different from those of the controls, although the patients displayed more aberrant paths than the controls.The superfluous fixations in the patients improved significantly under numbered-point conditions, but patients still achieved lower correct scores than the controls. Four of the 23 patients exhibited centering (aberrant path directed toward the center point), suggesting immature control of eye movements under black-point conditions but not numbered-point conditions.These results suggest that some schizophrenic patients viewed the targets too quickly and that they have impaired directed attention, which can be improved by cues, and may have impaired preprogramming of eye movements, which is not improved by external cues.This study examined saccadic eye movements using simple stationary targets, in schizophrenic patients.The targets were 8 black points or 8 arabic-numbered points placed in randomized order on the circumference of a circle.Self-paced eye movements during clockwise tracking of these points, by 23 patients and 23 controls, were recorded using an infrared eye-mark recorder.Then the relationship between the saccades and clinical syndromes was investigated. Finally, the relationship between the performance of the saccades and resting regional cerebral blood flow (rCBF) was examined using single photon emission computed tomography with 99mTc-hexamethyl propyleneamine oxime (HMPAO).The results indicate that patients track with significantly fewer correct scores and more deviant scores than controls, in agreement with our previous study.There were two groups of patients : an ordinary group who obtained a full target hitting score at a 200 ms setting and a fast group who obtained the full score at 100 ms but not at 200 ms.Some patients displayed significantly more hypermetria than controls.Significant correlations were found between alienation syndrome (auditory hallucination and disturbance of the self) and correct scores, or delusion syndrome and deviant score.With respect to relative rCBF, fast group patients showed significantly decreased rCBF in the left limbic and inferior parietal areas as compared with ordinary group patients.These findings suggest that some schizophrenic patients view the stationary targets too fast and this may be related to dysfunction in the limbic-parietal association area in the left hemisphere.富山医科薬科大学・博士(医学)・乙第283号・松井三枝・1995/6/28富山医科薬科大

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

Anterior Pituitary Progenitor Cells Express Costimulatory Molecule 4Ig-B7-H31

Abstract Stem/Progenitor cells in the postnatal pituitary gland are embedded in a marginal cell layer around Rathke’s pouch. However, the nature and behavior of anterior pituitary progenitor cells remain unclear. We established bovine anterior pituitary progenitor cell line (BAPC)-1 from the anterior pituitary gland, which expressed stem/progenitor cell-related genes and several inflammatory cytokines. To characterize and localize these pituitary progenitor cells, we produced a mAb (12B mAb) against BAPC-1. The 12B mAb recognized the 4Ig-B7-H3 molecule, which is a costimulatory molecule and negative regulator in T cell activation. WC1+ γδ T cells in young bovine PBMC express the 4Ig-B7-H3 molecule, but few or no 4Ig-B7-H3-immunoreactive cells are expressed in PBMC in adult cattle. The 12B-immunoreactive cells in the bovine anterior pituitary gland were localized around Rathke’s pouch and expressed IL-18 and MHC class II. However, the number of 12B-immunoreactive cells was lower in adult than in young cattle. BAPC-1 expressed IL-18 and MHC class II, and demonstrated phagocytotic activity. BAPC-1 also had the ability to promote CD25 expression in PBMC after 5 days of coculture, and blocking 4Ig-B7-H3 × 12B mAb enhanced their expression of CD25. In addition, the 12B-immunoreactive cells were observed around the pars tuberalis closely bordering the median eminence and in the blood vessels of the primary portal plexus in the anterior pituitary gland. These results suggest that an established BAPC-1 may originate from these progenitor cells, and that the progenitor cells with 4Ig-B7-H3 may play a critical role in the immunoendocrine network.</jats:p

Association between objectively measured walking steps and sleep in community-dwelling older adults: A prospective cohort study.

Physical inactivity and sleep disturbances are major problems in an ageing society. There is increasing evidence that physical activity is associated with sleep quality. However, the association between daily walking steps and sleep remain unclear. This prospective study examined the relationship between objectively measured daily walking steps and sleep parameters in Japanese community-dwelling older adults. In total, 855 community-dwelling individuals aged 65 and above, with an uninterrupted follow-up from August 2015 to March 2016, were enrolled. The participants wore a wristband sensor for an average of 7.8 days every three months. Multiple linear regression analysis was performed to examine the relationship between daily walking steps and sleep parameters, including the total sleep time, sleep efficiency, time awake after sleep onset (WASO), awakening time count during the night, and naptime. The median (interquartile range, IQR) age of the participants was 73 (69-78) years, with 317 (37.1%) men and 538 (62.9%) women. The median (IQR) educational level was 12 (11-12) years, and the median (IQR) Mini-Mental State Examination score was 29 (27-30) points. The number of daily walking steps showed a positive correlation with sleep efficiency and an inverse correlation with WASO, awakening time count, and naptime, after adjusting for covariates and correcting for the false discovery rate (β = 0.098, 95% confidence interval [CI]: 0.034 to 0.162, p = 0.003; β = -0.107, 95% CI: -0.172 to -0.043, p = 0.001; β = -0.105, 95% CI: -0.17 to -0.04, p = 0.002; and β = -0.31, 95% CI: -0.371 to -0.249, p < 0.001, respectively). Our results can help promote walking as an intervention for preventing sleep disturbances in community-dwelling older adults

Relationship between White Matter Lesions and Progression of Cognitive Decline in Alzheimer's Disease

Background: This study examined the relationship between baseline white matter lesions (WMLs) and the progression of cognitive decline in patients with late-onset Alzheimer's disease (AD). Methods: Fifty-six patients with AD were included in the study (23 men, 33 women; mean age, 77.8 years). All subjects were treated with acetylcholinesterase inhibitors and followed up for approximately 1 year. The Mini-Mental State Examination (MMSE) score was assessed at least twice to evaluate the progressive cognitive impairment. All subjects underwent brain MRI at baseline and were divided into WMLs(-), mild WMLs(+), and moderate WMLs(+) groups based on WML severity. Changes in MMSE scores between baseline and follow-up were analyzed using the Wilcoxon signed-rank test. Results: MMSE scores at baseline did not differ significantly among the three groups (p = 0.1658), whereas MMSE scores at the follow-up evaluation were significantly lower in the moderate WMLs(+) group than in the WMLs(-) group (p = 0.0257). The mean MMSE scores remained above baseline values during the approximately 1-year follow-up in the WMLs(-) group, whereas they were decreased in the mild and moderate WMLs(+) groups. Moreover, the frequency of improvement in patients from the WMLs(-) group tended to be higher than that in patients from the WMLs(+) groups. Conclusion: Baseline WMLs may be associated with the heterogeneous progression of cognitive decline in patients with AD

The Organogermanium Compound THGP Suppresses Melanin Synthesis via Complex Formation with L-DOPA on Mushroom Tyrosinase and in B16 4A5 Melanoma Cells

The organogermanium compound 3-(trihydroxygermyl)propanoic acid (THGP) has various biological activities. We previously reported that THGP forms a complex with cis-diol structures. L-3,4-Dihydroxyphenylalanine (L-DOPA), a precursor of melanin, contains a cis-diol structure in its catechol skeleton, and excessive melanin production causes skin darkening and staining. Thus, the cosmetic field is investigating substances that suppress melanin production. In this study, we investigated whether THGP inhibits melanin synthesis via the formation of a complex with L-DOPA using mushroom tyrosinase and B16 4A5 melanoma cells. The ability of THGP to interact with L-DOPA was analyzed by 1H-NMR, and the influence of THGP and/or kojic acid on melanin synthesis was investigated. We also examined the effect of THGP on cytotoxicity, tyrosinase activity, and gene expression and found that THGP interacted with L-DOPA, a precursor of melanin with a cis-diol structure. The results also showed that THGP inhibited melanin synthesis, exerted a synergistic effect with kojic acid, and did not affect tyrosinase activity or gene expression. These results suggest that THGP is a useful substrate that functions as an inhibitor of melanogenesis and that its effect is enhanced by combination with kojic acid

“Recurrent multiple cerebral infarctions related to the progression of adenomyosis: a case report”

Abstract Background Benign gynecologic tumor, such as uterine adenomyosis, has been suggested to develop hypercoagulability. Although some cases of cerebral infarction associated with adenomyosis have been reported, the mechanism of hypercoagulation initiated by adenomyosis is still not clear, and the therapeutic strategy is uncertain. Case presentation A 44-year-old woman was presented to our department with headache, left hand weakness, and gait disturbance during her menstrual phase. She had a history of adenomyosis and infertility treatment for 18 years and heavy menstrual bleeding. Magnetic resonance imaging on admission showed multiple hyperintense lesions in cortical and subcortical areas in the cerebrum and cerebellum on diffusion-weighted imaging. Transesophageal echocardiography showed neither embolic sources nor existence of foramen ovale. Her laboratory data revealed anemia, a high D-dimer level, and elevated levels of a mucinous tumor marker. She had adenomyosis and no malignancy was detected. Anticoagulation therapy with intravenous heparin followed by rivaroxaban did not prevent recurrence of cerebral infarction. We discontinued rivaroxaban, and started warfarin therapy with pseudomenopause treatment, which prevented recurrence for 6 months. Five months after her last pseudomenopause treatment, multiple cerebral infarctions occurred. Total hysterectomy was performed, which prevented recurrence of the multiple cerebral infarctions for 2 years without anticoagulation therapy. Conclusions Our findings reveal for the first time that anticoagulation therapy, including novel oral anticoagulants, had no preventive effect against cerebral infarctions associated with adenomyosis in a middle-aged woman. Although pseudomenopause treatment temporarily prevented recurrence, resection of the adenomyosis might be the most effective therapy in these cases

Brain Perfusion in Corticobasal Syndrome with Progressive Aphasia

Background: Brain perfusion may differ between patients with corticobasal syndrome (CBS) with and without aphasia. Methods: Twenty-six (9 males and 17 females; mean age 76 ± 5.3 years) patients with CBS were enrolled in the study. Brain MRI and single-photon emission computed tomography were performed in all subjects. Language was evaluated using the Standard Language Test of Aphasia. The patients were divided into two subgroups according to the presence or absence of progressive aphasia. Differences in the regional cerebral blood flow (rCBF) between the two groups were detected based on voxel-by-voxel group analysis using Statistical Parametric Mapping 8. Results: All patients exhibited asymmetric motor symptoms and signs, including limb apraxia, bradykinesia, and akinetic rigidity. Of 26 patients, 9 had a clinically obvious language disturbance, characterized as nonfluent aphasia. Almost all CBS patients with aphasia exhibited cortical atrophy predominantly in the left frontal and temporal lobes with widening of the Sylvian fissure on MRI. The rCBF in the left middle frontal gyrus differed significantly between CBS patients with and without aphasia. Conclusion: CBS patients with aphasia exhibit motor symptoms predominantly on the right side and cortical atrophy mainly in the left perisylvian cortices. In particular, left frontal dysfunction might be related to nonfluent aphasia in CBS