[A case of suspected vertebral artery stump syndrome assessed by CT angiography].

A 55-year-old man developed ischemic stroke in the bilateral cerebellar hemispheres and bilateral occipital lobes. He was admitted to our hospital 17 months later with recurrent ischemic stroke in the posterior circulation. The left vertebral artery (VA) was occluded on brain magnetic resonance angiography but was visualized with a delay on continuous three-phase CT angiography (CTA). Conventional angiography confirmed a to-and-fro blood flow pattern at the distal end of the left VA, therefore the patient was diagnosed with VA stump syndrome (VASS). VASS is a recurrent posterior circulation ischemic stroke caused by thrombi in an occluded unilateral VA. VASS should be suspected in patients with unilateral VA occlusion and repeated posterior-circulation ischemic stroke. The diagnostic criteria for VASS include confirmation of VA occlusion and the presence of an antegrade flow component at the distal end. In this case, the presence of collateral circulation in the VA was suspected based on CTA findings, leading to the diagnosis of VASS. It was thus suggested that devising the imaging method of CTA may help diagnose VASS.

Noniatrogenic Meningitis Caused by Streptococcus salivarius Associated with Early Esophageal Cancer and Early Gastric Cancer.

Streptococcus salivarius is part of the normal oral cavity and gastrointestinal tract microflora and an unusual cause of acute bacterial meningitis. We herein report an 81-year-old man with S. salivarius meningitis, which led to a diagnosis of early esophageal cancer and early gastric cancer. S. salivarius infection may occur through the gastrointestinal mucosa when it is disrupted in association with early gastrointestinal cancer. To our knowledge, this is the first report describing S. salivarius meningitis associated with multiple early gastrointestinal cancers in the absence of other sources of infection.

Non-contact heart rate variability monitoring using Doppler radars located beneath bed mattress: a case report.

BACKGROUND: Heart rate variability (HRV) has been investigated previously in autonomic nervous system-related clinical settings. In these settings, HRV is determined by the time-series heartbeat peak-to-peak intervals using electrocardiography (ECG). To reduce patient discomfort, we designed a Doppler radar-based autonomic nervous activity monitoring system (ANMS) that allows cardiopulmonary monitoring without using ECG electrodes or spirometry monitoring. CASE SUMMARY: Using our non-contact ANMS, we observed a bedridden 80-year-old female patient with terminal phase sepsis developed the daytime Cheyne-Stokes respiration (CSR) associated with the attenuation of the low frequency (LF) and high frequency (HF) of HRV components 20 days prior to her death. The patient developed a marked linear decrease in the LF and the HF of HRV components for over 3 days in a row. Furthermore, after the decrease both the LF and the HF showed low and linear values. Around the intersection of the two lines, the decreasing LF and HF lines and the constant LF and HF lines, the ANMS automatically detected the daytime CSR pathogenesis. The attenuation rate of HF (1340 ms2/day) was higher than that of LF (956 ms2/day). Heart rate increased by ∼10 b.p.m. during these 3 days. DISCUSSION: We detected CSR-associated LF and HF attenuation in a patient with terminal phase sepsis using our ANMS. The proposed system without lead appears promising for future applications in clinical settings, such as remote cardiac monitoring of patients with heart failure at home or in long-term acute care facilities.

Multiple bistability and tristability with dual spin-state conversions in [Fe(dpp)2][Ni(mnt)2]2 x MeNO2.

The multicomponent system of [Fe(dpp)(2)][Ni(mnt)(2)](2).MeNO(2) (1; dpp = 2,6-bis(pyrazol-1-yl)pyridine and mnt = maleonitriledithiolate) was prepared by the reaction of [Fe(dpp)(2)](BF(4))(2) with (Bu(4)N)[Ni(mnt)(2)] in MeNO(2). Variable-temperature X-ray structural analyses, magnetic susceptibility, and heat capacity measurements confirmed that 1 undergoes multiple spin-state conversions in both the cationic and anionic components. The asymmetric unit in the crystal contains one [Fe(dpp)(2)](2+) cation, two [Ni(mnt)(2)](-) anions ([Ni1](-) and [Ni2](-)), and one solvent molecule. Magnetic susceptibility measurements revealed that a paramagnetic state in the high-temperature region (HT phase) was abruptly converted to a diamagnetic low-temperature (LT) phase below 180 K as the temperature was lowered from 270 K. As the temperature was raised from 125 to 270 K, successive phase transitions occurred to the HT phase via intermediate phases (IM1, IM2, and IM3) at 175.5, 186.5, 194.0, and 244.0 K, respectively. In the HT phase [Fe(dpp)(2)](2+) is in the high-spin state, and each [Ni1](-) and [Ni2](-) moiety is arranged in monomeric form with an S = (1)/(2) spin ground state. In the LT phase [Fe(dpp)(2)](2+) is in the low-spin state and the nickel moieties are dimerized and diamagnetic. In the IM1 and IM2 phases the iron(II) sites are partially in the HS state and both [Ni](-) moieties are dimeric, as suggested by (57)Fe Mossbauer measurements. In the IM3 phase, [Fe(dpp)(2)](2+) is in the HS state and the anions exist in both their monomeric ([Ni1](-)) and dimeric ([Ni2](-)) forms. Rapid thermal quenching from 300 to 5 K yielded a metastable HS phase, which relaxed to the LT phase via the IM1 phase as the temperature was raised to 150 K. A partial light induced spin transition on the iron site was observed at 5 K.