Transcranial electric stimulation motor evoked potentials for cervical spine intraoperative monitoring complications: systematic review and illustrative case of cardiac arrest.

PURPOSE: We show a systematic review of known complications during intraoperative neuromonitoring (IONM) using transcranial electric stimulation motor evoked potentials (TES-MEP) on cervical spine surgery, which provides a summary of the main findings. A rare complication during this procedure, cardiac arrest by cardioinhibitory reflex, is also described. METHODS: Findings of 523 scientific papers published from 1995 onwards were reviewed in the following databases: CENTRAL, Cochrane Library, Embase, Google Scholar, Ovid, LILACS, PubMed, and Web of Science. This study evaluated only complications on cervical spine surgery undergoing TES-MEP IONM. RESULTS: The review of the literature yielded 13 studies on the complications of TES-MEP IONM, from which three were excluded. Five studies are case series; the rest are case reports. Overall, 169 complications on 167 patients were reported in a total of 38,915 patients, a global prevalence of 0.43%. The most common complication was tongue-bite in 129 cases, (76.3% of all complication events). Tongue-bite had a prevalence of 0.33% (CI 95%, 0.28-0.39%) in all patients on TES-MEP IONM. A relatively low prevalence of severe complications was found: cardiac-arrhythmia, bradycardia and seizure, the prevalence of this complications represents only one case in all the sample. Alongside, we report the occurrence of cardiac arrest attributable to TES-MEP IONM. CONCLUSIONS: This systematic review shows that TES-MEP is a safe procedure with a very low prevalence of complications. To our best knowledge, asystole is reported for the first time as a complication during TES-MEP IONM.

A Case of Stevens-Johnson Syndrome Complicated with Multimatrix System Mesalamine in Ulcerative Colitis.

A 41-year-old man was treated with prednisolone (PSL) and multimatrix (MMX) mesalamine for remission induction therapy of ulcerative colitis. PSL was tapered due to successful remission induction treatment. During the treatment course, ocular foreign body sensation, eyelid swelling, ocular conjunctiva hyperemia, facial redness and swelling, watery nasal discharge, stomatitis, anal pain, and reddish puffiness on the bilateral dorsum of the hands appeared, and he was diagnosed with Stevens-Johnson syndrome (SJS). SJS was improved by PSL treatment and intravenous immunoglobulin. MMX mesalamine was the causative agent by drug-induced lymphocyte stimulation test. This is the first reported case of SJS with MMX mesalamine.

Genetic landscape of Rett syndrome-like phenotypes revealed by whole exome sequencing.

BACKGROUND: Rett syndrome (RTT) is a characteristic neurological disease presenting with regressive loss of neurodevelopmental milestones. Typical RTT is generally caused by abnormality of methyl-CpG binding protein 2 (MECP2). Our objective to investigate the genetic landscape of MECP2-negative typical/atypical RTT and RTT-like phenotypes using whole exome sequencing (WES). METHODS: We performed WES on 77 MECP2-negative patients either with typical RTT (n=11), atypical RTT (n=22) or RTT-like phenotypes (n=44) incompatible with the RTT criteria. RESULTS: Pathogenic or likely pathogenic single-nucleotide variants in 28 known genes were found in 39 of 77 (50.6%) patients. WES-based CNV analysis revealed pathogenic deletions involving six known genes (including MECP2) in 8 of 77 (10.4%) patients. Overall, diagnostic yield was 47 of 77 (61.0 %). Furthermore, strong candidate variants were found in four novel genes: a de novo variant in each of ATPase H+ transporting V0 subunit A1 (ATP6V0A1), ubiquitin-specific peptidase 8 (USP8) and microtubule-associated serine/threonine kinase 3 (MAST3), as well as biallelic variants in nuclear receptor corepressor 2 (NCOR2). CONCLUSIONS: Our study provides a new landscape including additional genetic variants contributing to RTT-like phenotypes, highlighting the importance of comprehensive genetic analysis.

A Case of Lung Abscess Caused by Double Immunosuppressive Therapy to Treat Ulcerative Colitis.

A 25-year-old man was admitted to our institution for remission induction therapy to treat a 12-year condition of ulcerative colitis (UC). Previously, he was treated with drugs, such as mesalamine, immunomodulators, prednisolone (PSL), and anti-TNFα anti-body, but remission was not maintained. Therefore, we started remission induction therapy with 20 mg/day of tofacitinib (TOF) to inhibit the action of Janus kinase. On the 29th day after TOF administration, he developed a lung abscess with high fever. A chronic bulla was already present in his lung; therefore, the lung abscess was likely formed due to a combination of the bulla being present and the pharmacological effects of TOF. Our report is significant as it highlights the compounding association between TOF and PSL therapy and bulla presence with the rare adverse effect of developing an abscess.

Role and Function of LitR, an Adenosyl B12-Bound Light-Sensitive Regulator of Bacillus megaterium QM B1551, in Regulation of Carotenoid Production.

UNLABELLED: The LitR/CarH family of proteins is a light-sensitive MerR family of transcriptional regulators that contain an adenosyl B12 (coenzyme B12 or AdoB12)-binding domain at the C terminus. The genes encoding these proteins are found in phylogenetically diverse bacterial genera; however, the biochemical properties of these proteins from Gram-positive bacteria remain poorly understood. We performed genetic and biochemical analyses of a homolog of the LitR protein from Bacillus megaterium QM B1551, a Gram-positive endospore-forming soil bacterium. Carotenoid production was induced by illumination in this bacterium. In vivo analysis demonstrated that LitR plays a central role in light-inducible carotenoid production and serves as a negative regulator of the light-inducible transcription of crt and litR itself. Biochemical evidence showed that LitR in complex with AdoB12 binds to the promoter regions of litR and the crt operon in a light-sensitive manner. In vitro transcription experiments demonstrated that AdoB12-LitR inhibited the specific transcription of the crt promoter generated by a σ(A)-containing RNA polymerase holoenzyme under dark conditions. Collectively, these data indicate that the AdoB12-LitR complex serves as a photoreceptor with DNA-binding activity in B. megaterium QM B1551 and that its function as a transcriptional repressor is fundamental to the light-induced carotenoid production. IMPORTANCE: Members of the LitR/CarH family are AdoB12-based photosensors involved in light-inducible carotenoid production in nonphototrophic Gram-negative bacteria. Our study revealed that Bacillus LitR in complex with AdoB12 also serves as a transcriptional regulator with a photosensory function, which indicates that the LitR/CarH family is generally involved in the light-inducible carotenoid production of nonphototrophic bacteria.

Interdependent versus independent inconsistency: Cultural differences in how East Asian and Western people attribute hypocrisy.

Humans worldwide have long deplored hypocrisy, a concept that has been mentioned in texts dating back 100-1,000 years (e.g., the Analects of Confucius, the Tao Te Ching, the Bible, and the Qur'an). However, what influences the extent of hypocrisy attribution or counts as hypocrisy may differ as a function of culture. Previous studies have shown that Westerners attribute greater hypocrisy for within-person attitude-behavior inconsistency than East Asians. Building on this, we predict that East Asians' (vs. Westerners') hypocrisy attribution is more heavily influenced by social relationships. Consistent with past research, this can lead to greater leniency. However, as we show, this can also result in the novel finding we present that attributions of mild-to-moderate hypocrisy are made even when no explicit within-person attitude-behavior inconsistency is present. Across six experiments, we found that Koreans (vs. participants from the United States) attributed more hypocrisy to attitude-contradicting behavior when the person enacting the behavior was not the person who stated the attitude but was someone who shared social bonds with that person (i.e., cross-person, within-relationship attitude-behavior inconsistency; "relational hypocrisy"). Specifically, Koreans attributed more hypocrisy than Americans when a child's behavior contradicted their parent's views (Experiments 1a and 1b) or when attitude-contradicting behavior was enacted by the child of a close friend (Experiment 2). Experiments 3-5 replicated the findings from Experiments 1-2 using additional social contexts (e.g., a spousal relationship). Supplementary analyses showed that differences in hypocrisy attribution between Americans and Koreans were mediated by cultural differences in their perceptions of shared responsibility within relationships. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Symptomatic duodenal intramural hematoma caused by weight training: a report of two cases.

Symptoms of traumatic duodenal intramural hematoma, a rare disease caused by trauma, blood disease, or antithrombotic therapy, can include abdominal pain. Case 1 is that of a 35-year-old man at a gym who dropped a 100 kg barbell on his abdomen. It was diagnosed as a duodenal obstruction caused by a traumatic intestinal wall hematoma. In Case 2, a 16-year-old male adolescent performing deadlift training at a gym had subsequent abdominal pain. It was diagnosed as intestinal wall hematoma. Both patients improved with conservative treatment. Malignancy is sometimes suspected from imaging findings. Detailed patient history and imaging studies can avoid unnecessary surgery.

Comparison of early versus late addition of granulocyte and monocyte adsorption for incomplete remission induction in ulcerative colitis.

Background and aim: Ulcerative colitis (UC) is characterized by repeated relapse and remission. Because no fundamental therapeutic strategy has been established, the treatment goal is generally to maintain the remission phase for a long period after rapid remission induction. Granulocyte and monocyte adsorption (GMA) for UC is reportedly quite safe because it does not affect immunosuppression. Moreover, it is useful in combination with other remission induction therapy. The aim of this study was to evaluate the difference in efficacy by the timing of the addition of GMA with corticosteroids, calcineurin inhibitors, and anti-cytokine therapy for active UC. Methods: The study included 59 patients. Patients who started GMA of 5-11 days were in the early GMA combination group. Patients who started GMA 12 days or more were in the late GMA combination group. The primary endpoint was difference in the effect of additional GMA according to the timing of the intervention. The secondary endpoint was difference in the time to remission induction between the two groups. Results: Of the 32 early GMA group patients, 24 achieved remission induction. Of the 27 late group patients, 18 achieved remission induction. No significant difference in induction rates was found (P = 0.481). The early group had shorter mean time to remission induction (P < 0.001). Conclusions: In conclusion, results suggest that early addition of GMA might lead to earlier remission in patients who have had an inadequate response to remission induction therapy with corticosteroids, calcineurin inhibitors, and anti-cytokine therapy.

Bone-marrow-derived cells cultured in serum-free medium reduce liver fibrosis and improve liver function in carbon-tetrachloride-treated cirrhotic mice.

We have previously developed autologous bone marrow cell infusion (ABMi) therapy for liver cirrhosis patients. One problem associated with ABMi therapy is that general anesthesia is required to obtain 400 ml bone marrow fluid from liver cirrhosis patients. However, many patients with decompensated cirrhosis do not meet the criteria, because of decreased liver function or an increased bleeding tendency. To overcome these issues, our aim is to derive liver repair cells from small amounts of autologous bone marrow aspirates obtained under local anesthesia and to use these cells in liver cirrhosis patients. Here, we conducted, by using a mouse model, basic research aimed at achieving novel liver regeneration therapy. We cultured bone marrow cells aspirated from the femurs of C57 BL/6 Tg14 (act-EGFP) OsbY01 mice (green fluoresent protein [GFP]-transgenic mice). After 14 days of culture with serum-free medium (good manufacturing practice grade), the obtained spindle-shaped GFP-positive cells were injected (1×10(4) cells) via the caudal vein into mice with carbon tetrachloride (CCl4)-induced cirrhosis. Numerous cultured macrophages and some mesenchymal stem cells repopulated the cirrhotic liver. The results showed that serum albumin, liver fibrosis and liver function were significantly improved in the group treated with cultured bone marrow cells (P<0.01). Moreover, matrix metalloproteinase-9 expression was increased in the liver (P<0.01). Thus, infusion of bone-marrow-derived cultured cells improved liver function and liver fibrosis in mice with CCl4-induced cirrhosis.

Decreased L-tryptophan concentration in distinctive brain regions of mice treated repeatedly with phencyclidine.

It has been reported that repeated phencyclidine (PCP) treatment induces schizophrenia-like behavior in mice. L-Tryptophan (Trp) concentrations in brain tissues of control (n = 8) and PCP-treated mice (10 mg/kg/day, s.c., 14 days, n = 10) were determined using high-performance liquid chromatography (HPLC) with fluorescence detection. The HPLC method involved pre-column fluorescence derivatization with (R)-(-)-4-(N,N-dimethylaminosulfonyl)-7-(3-isothiocyanatopyrrolidin-1-yl)-2,1,3-benzoxadiazole (DBD-PyNCS). Eight different parts of the brain, namely, the frontal cortex, nucleus accumbens, striatum, hippocampus, amygdala, thalamus, hypothalamus, and cerebellum, of both groups were investigated. A significant decrease in the L-Trp concentration in the nucleus accumbens (p = 0.024) and hippocampus (p = 0.027) was observed in PCP-treated mice, suggesting that alteration of the L-Trp metabolism might occur in these brain parts.

Tailor-made RNAi knockdown against triplet repeat disease-causing alleles.

Nucleotide variations, including SNPs, in the coding regions of disease genes are important targets for RNAi treatment, which is a promising medical treatment for intractable diseases such as triplet repeat diseases. However, the identification of such nucleotide variations and the design of siRNAs conferring disease allele-specific RNAi are quite difficult. In this study we developed a pull-down method to rapidly identify coding SNP (cSNP) haplotypes of triple repeat, disease-causing alleles, and we demonstrated disease allele-specific RNAi that targeted cSNP sites in mutant Huntingtin alleles, each of which possessed a different cSNP haplotype. Therefore, the methods presented here allow for allele-specific RNAi knockdown against disease-causing alleles by using siRNAs specific to disease-linked cSNP haplotypes, and advanced progress toward tailor-made RNAi treatments for triplet repeat diseases.

Size reduction of gastric fundic gland polyposis by de-escalation of acid-suppressive therapy.

The patient, a 73-year-old woman, had been taking acid-suppressive therapy for refractory reflux esophagitis for 10 years. A potassium-competitive acid blocker was administered to strengthen acid-suppressive therapy for worsening symptoms of gastroesophageal reflux disease. Esophagogastroduodenoscopy showed an increase in the number and size of fundic gland polyposis (FGPs). When acid-suppressive therapy was changed from potassium-competitive acid blocker to proton pump inhibitor, the FGPs showed reduced size 1 year later. Furthermore, when acid-suppressive therapy was changed from proton pump inhibitor to histamine-2 receptor antagonist, FGPs were even smaller after 1 and 2 years. The patient, who had no flare-up of gastroesophageal reflux disease symptoms, continues to be treated medically with histamine-2 receptor antagonist. This case report describes changes in endoscopic findings of a patient with FGPs caused by acid-suppressive therapy for refractory gastroesophageal reflux disease.

Human Face Perception Using Electroencephalography and Magnetoencephalography.

The face has a large amount of information that is useful for humans in social communication. Recently, non-invasive methods have been used to investigate human brain activity related to perception and cognition processes. Electroencephalography (EEG) and magnetoencephalography (MEG) have excellent temporal resolution and reasonably good spatial resolution. Therefore, they are useful to investigate time sequences of human brain activity related to the face perception process. In this review, we introduce our previous EEG and MEG studies of human face perception that demonstrated the following characteristics of face perception processing: (1) Event-related components in the temporal area related to the activity in the inferior temporal (IT) area, corresponding to the fusiform face area (FFA), are evoked approximately 180 msec after the presentation of a face. The activity in the IT area plays an important role in the detection processing of a face, and the contours of a face affect the activity in the IT areas. (2) Event-related components in the temporal area related to the superior temporal sulcus (STS) activity are larger when eyes are averted than when directly looking into the eyes. (3) The direction of features of a face affects the face perception processing in the right hemisphere. On the other hand, the matching of the direction between the contours and features of a face affects the processing in the left hemisphere. (4) Random dots blinking (RDB), which uses temporal changes in patterns of many small dots to present stimuli without a change in luminance during the presentation of a face, is a useful visual stimulus method to investigate the brain activity related to face perception processing in the IT area using EEG and MEG.

Volition Speaks Louder Than Action: Offender Atonement, Forgivability, and Victim Valuation in the Minds of Perceivers.

On hearing of others' offenses, people frequently intervene to encourage offenders to correct their wrongs. However, externally imposed reconciliatory behaviors may not effectively convince outside observers that offenders value victims' welfare and deserve forgiveness. Four studies examined meta-judgments of victim valuation and offender forgivability when restitution was initiated voluntarily versus externally coerced. The same compensatory actions produced greater perceived valuation/forgivability when atonement was voluntary versus court-ordered (Experiment 1). Across multiple harm/measure types, voluntary (vs. imposed) atonement consistently yielded greater valuation/forgivability, but differences between imposed and no-atonement conditions were not captured using indirect valuation measures (Experiments 2-3). Experiment 3 also showed that voluntary (vs. imposed) atonement positively influenced perceivers' inferences about their own valuation. In Experiment 4, observers perceived greater valuation/forgivability when restitution was made voluntarily rather than imposed by an intervener or requested by the victim. These studies highlight that beyond their compensatory acts, offenders' volition to atone influences third-party evaluations.

Psychological predictors of vaccination intentions among U.S. undergraduates and online panel workers during the 2020 COVID-19 pandemic.

OBJECTIVE: Availability of safe and effective vaccines against COVID-19 is critical for controlling the pandemic, but herd immunity can only be achieved with high vaccination coverage. The present research examined psychological factors associated with intentions to receive COVID-19 vaccination and whether reluctance towards novel pandemic vaccines are similar to vaccine hesitancy captured by a hypothetical measure used in previous research. METHOD: Study 1 was administered to undergraduate students when COVID-19 was spreading exponentially (February-April 2020). Study 2 was conducted with online panel workers toward the end of the first U.S. wave (July 2020) as a pre-registered replication and extension of Study 1. In both studies, participants (total N = 1,022) rated their willingness to receive the COVID-19 vaccination and to vaccinate a hypothetical child for a fictitious disease, and then responded to various psychological measures. RESULTS: In both studies, vaccination intentions were positively associated with past flu vaccine uptake, self-reported vaccine knowledge, vaccine confidence, and sense of collective responsibility. Complacency (not perceiving disease as high-risk), anti-vaccine conspiracy beliefs, perceived vaccine danger, and mistrust in science/scientists were negative correlates of vaccination intentions. Constraints (psychological barriers), calculation (extensive information-searching), analytical thinking, perceived disease vulnerability, self-other overlap, and conservatism were weakly associated with vaccination intentions but not consistently across both studies or vaccine types. Additionally, similar factors were associated with both real and hypothetical vaccination intentions, suggesting that conclusions from pre-COVID vaccine hesitancy research mostly generalize to the current pandemic situation. CONCLUSION: Encouraging flu vaccine uptake, enhancing confidence in a novel vaccine, and fostering a sense of collective responsibility are particularly important as they uniquely predict COVID-19 vaccination intentions. By including both actual pandemic-related hesitancy measures and hypothetical hesitancy measures from past research in the same study, this work provides key context for the generalizability of earlier non-pandemic research.

Analysis of Endoscopic Evaluation Reliability for Ulcerative Colitis in Histological Remission.

The Mayo endoscopic subscore (MES) is a major endoscopic scoring system used to assign a status of mucosal inflammation and disease activity to patients with ulcerative colitis (UC). Using interobserver reliability (IOR), this study clarified the difficulties for endoscopic observers imposed by MES parameters used for the endoscopic evaluation of UC in histological remission. First, 42 endoscopists of four observer groups examined each MES parameter, which were evaluated from endoscopically obtained images of 100 cases as Grade 0 or 1 of the Nancy histological index of histopathological inflammation. Then, IOR was assessed using multiple κ statistics for each finding of MES. The results showed that IOR among all the observers was slight or fair for all the parameters, indicating a low IOR. The experts of the UC practice group had "moderate" or higher IOR for seven of the nine parameters, whereas "slight" or "fair" results were found for all parameters by the trainee group. The IOR for each MES parameter was calculated separately for the observer groups. All the groups showed "slight" or "fair" for "Erythema" and "Decreased vascular pattern". Large differences between the endoscopists were found in the IOR for the MES parameters in UC in histological remission. Even among UC practice experts, the IOR was low for "Erythema" and "Decreased vascular pattern".

Refractory Immune Checkpoint Inhibitor-Induced Colitis Improved by Tacrolimus: A Case Report.

Immune checkpoint inhibitors (ICIs) increase T-cell activity and antitumor immune response. However, they also have immune-related adverse effects that can affect the gastrointestinal (GI) tract. A 62-year-old male patient who had undergone right lung upper lobectomy for adenocarcinoma of the lung received chemotherapy with pemetrexed sodium hydrate, carboplatin, and pembrolizumab to prevent postoperative recurrence of liver metastasis. However, the patient experienced severe diarrhea four months after the start of chemotherapy. Although a corticosteroid and two biological preparations were administered to alleviate the diarrhea, no improvement was observed. Eventually, remission was achieved when tacrolimus was administered. Treatment with corticosteroids is recommended for patients with GI adverse effects of ICIs. Rapid introduction of infliximab is necessary for refractory patients. Nevertheless, for refractory cases such as that of our patient, for whom even this regimen is inefficacious, tacrolimus might be recommended to induce remission as with cases of ulcerative colitis.

A Case of Crohn's Disease with Cardiac Tamponade Caused by Tuberculous Pericarditis: Assessment of a Rare Phenomenon.

A 28-year-old woman was hospitalized for cardiac tamponade caused by tuberculous pericarditis. She was taking ustekinumab (UST) for Crohn's disease. UST is not considered to significantly increase the risk of developing serious infections, including tuberculosis. However, there is still a risk of Mycobacterium tuberculosis reactivation. Therefore, for patients on concurrent UST and antituberculosis medication, a close collaboration among specialists in infectious diseases, cardiology, and gastroenterology is necessary.

When do infants differentiate profile face from frontal face? A near-infrared spectroscopic study.

The objective of the present study was to determine whether a developmental difference occurs in brain activity when infants look at frontal and profile views using near-infrared spectroscopy (NIRS), which is an optical imaging technique used to measure changes in the concentrations of oxyhemoglobin (oxy-Hb), deoxyhemoglobin (deoxy-Hb), and total hemoglobin (total-Hb). For this objective, we compared NIRS results in two age groups, 5- and 8-month-old infants, while they were looking at frontal views, profile views, and objects. We found that the concentration of oxy-Hb and total-Hb in the 5-month-old group increased for only frontal views in the right temporal regions. In contrast, the concentration of oxy-Hb and total-Hb in the 8-month-old group increased for both frontal and profile views in the right temporal regions. Therefore, the present study indicated that the right hemisphere was dominant for the perception of profile views as well as frontal views. In addition, the most important and interesting finding was that the infants' brain activity of the face area would become view-invariant at the age of 8 months but not at 5 months. The developmental period for view-invariant face recognition has been discussed in previous psychological studies, but this is the first objective study to confirm that the period is between 5- and 8-months by measuring the blood flow in the brain using NIRS.

Effect of configural distortion on a face-related ERP evoked by random dots blinking.

Using random dots blinking (RDB), which reflects the activity of the higher visual area related to face perception, the following stimuli were presented. (1) Upright: a schematic face; (2) Inverted: the Upright stimulus inverted; and (3) Scrambled: the same contour and features as in Upright but with the spatial relation distorted. Clear negative components (N-ERP250) were identified at approximately 250 ms after stimulus onset. At the T5 and T6 electrodes, the peak latency was significantly longer for Inverted and Scrambled than for Upright. At the P4 electrode, the maximum amplitude was significantly larger for Scrambled than for Upright and Inverted. These results indicate that the delayed latency for Inverted and Scrambled reflects the involvement of the additional analytic processing caused by the configural distortion, and that the increase in amplitude for Scrambled indicates the existence of further processing caused by the distortion of the spatial relationship between the contour and features.