Neuroanatomy of reduced distortion of body-centred spatial coding during body tilt in stroke patients.

Awareness of the direction of the body's (longitudinal) axis is fundamental for action and perception. The perceived body axis orientation is strongly biased during body tilt; however, the neural substrates underlying this phenomenon remain largely unknown. Here, we tackled this issue using a neuropsychological approach in patients with hemispheric stroke. Thirty-seven stroke patients and 20 age-matched healthy controls adjusted a visual line with the perceived body longitudinal axis when the body was upright or laterally tilted by 10 degrees. The bias of the perceived body axis caused by body tilt, termed tilt-dependent error (TDE), was compared between the groups. The TDE was significantly smaller (i.e., less affected performance by body tilt) in the stroke group (15.9 ± 15.9°) than in the control group (25.7 ± 17.1°). Lesion subtraction analysis and Bayesian lesion-symptom inference revealed that the abnormally reduced TDEs were associated with lesions in the right occipitotemporal cortex, such as the superior and middle temporal gyri. Our findings contribute to a better understanding of the neuroanatomy of body-centred spatial coding during whole-body tilt.

Treatment of thigh abscess caused by retroperitoneal perforation of cecal cancer: A case report.

Introduction and importance: Iliopsoas and iliacus abscesses are caused by hematogenous and lymphatic infections and the spread of inflammation in neighboring organs. A small number of cases have been reported in which inflammation spread not only within the iliopsoas muscle but also to the thigh. Here we report a case of retroperitoneal infiltration and perforation of cecal cancer that caused extensive abscess formation from the iliacus muscle to the thigh. Case presentation: An 80-year-old man who had undergone chemotherapy for cecal cancer had abdominal pain and right thigh pain without any particular attraction. CT images showed extensive abscess formation from the iliacus muscle to the subcutaneous part of the thigh due to retroperitoneal infiltration and perforation of cecal cancer. Ileocecal resection, colostomy, and retroperitoneal abscess drainage were performed for perforation of cecal cancer and pelvic abscess. Although the thigh was initially drained by a small incision, the infection did not heal. Extensive debridement and drainage were required for all of the contaminated areas, and after all the infection was completely cured. Clinical discussion: The optimal treatment for an abscess that has spread from the inguinal region to the thigh is unclear. In this case, active debridement and drainage of the infected area were effective and should have been done early. Conclusion: We believed that debridement and drainage should have been performed from the time of the first surgery not only by the small incision drainage but also for all of the contaminated areas when the infection had been widespread.

Nontuberculous mycobacterial infection of the knee after arthrocentesis for idiopathic hemarthrosis: A case report.

INTRODUCTION: Nontuberculous mycobacterial (NTM) infections of the musculoskeletal system are uncommon. Such infections are typically acquired by direct inoculation after penetrating trauma, surgical procedures, or needle injections. There are no reported cases of NTM infection after arthrocentesis for idiopathic hemarthrosis of the knee. Here we report a case of NTM infection in the knee that developed after arthrocentesis for idiopathic hemarthrosis of the knee. PRESENTATION OF CASE: The patient was an 85-year-old woman who experienced swelling of the left knee. An arthrocentesis was carried out, and hemarthrosis was found. The patient was referred to our hospital for repeated recurrence of hematoma of the knee. Significant swelling was observed in the suprapatellar sac. Magnetic resonance imaging examination revealed a mass at the suprapatellar sac. Laboratory data showed elevation of inflammatory markers. Debridement was performed under arthroscopy and samples were collected for culture. Although routine microbiological cultures were negative, the patient continued to experience knee swelling and laboratory data showed high C-reactive protein levels. Therefore, open debridement was carried out. At 4 weeks after the first surgical treatment, intraoperative cultures yielded Mycobacterium intracellulare. At this point, we diagnosed septic arthritis of the knee due to NTM infection. The patient showed an excellent prognosis with three-drug medical treatment for 1 year. CONCLUSION: Clinically, diagnosis of septic arthritis due to NTM infection is not easy. Because selection of examination depends on clinical suspicion, NTM infections should be considered for patients with elevation of inflammatory markers after episodes of surgical procedures, and/or needle injections.

[Pure agraphia with topographical disorientation caused by right hemisphere lesion].

A 69-year-old, right-handed, Japanese male patient presented with pure agraphia with topographical disorientation after hemorrhage in the right parietal lobe. Upon developing cerebral hemorrhage, he was referred to our hospital for close examination of agraphia. There was no paresis or clumsiness in his extremities. His speech was fluent and well-articulated. Neither aphasia nor reading impairments was found, although there was a clear writing impairment with effort and hesitation. His writing of both kanji and kana letters contained additional, absent or deformed strokes or parts. No hemianopia, prosopagnosia, constructional disturbances and dressing apraxia were found. He could recognize familiar buildings or landscapes, but often lost his way around well-known areas. MR images revealed subcortical lesions of precuneus, superior and inferior parietal lobules in the right hemisphere, around the posterior horn of the lateral ventricle. He revealed pure agraphia and topographical disorientation after the right brain haemorrhage, without dementia or personality change. These findings indicate that the right parietal lobe participates in the kinesthetic movements of writing. Some authers have been documented cases of aphasic agraphia or alexia with agraphia caused by right hemisphere damage in dextrals, but pure agraphia caused by the lesion in the right hemisphere is very rare.

Chiral separation of acidic drug components by open tubular electrochromatography using avidin immobilized capillaries.

Avidin was immobilized covalently onto the inner surface of fused silica capillaries as a stationary phase in an open tubular capillary electrochromatography (OT-CEC) for chiral separations. The modification was attained by a combination of glutaraldehyde with both an amino-silylated fused silica surface and avidin using a Schiff base formation reaction. This method couples the advantage of high efficiency and small consumption of a chiral selector with the possibility of UV detection without limitations of protein absorption. In addition, the prepared capillary was stable for 50 days with over 100 runs. To evaluate the electrochromatographic performance of the prepared capillaries, the chiral separation of abscisic acid and arylpropionic acids were investigated. Effects of the modification condition of protein, pH of running buffer, and an organic modifier on the enantioseparation were also investigated. In addition, the avidin immobilized capillary was employed for the selective chiral analysis with an electrospray ionization mass spectrometry (ESI-MS) detection scheme.

Symmetrical localization of extrachromosomally replicating viral genomes on sister chromatids.

In eukaryotes, many latent viruses replicate as extrachromosomal molecules, called episomes, and efficiently segregate to daughter cells by noncovalently attaching to mitotic chromosomes. To understand the mechanism governing the processes, we analyzed the detailed subcellular localization of Epstein-Barr virus (EBV) genomes and a viral protein EBNA1, a bridging molecule between viral genomes and cellular chromatin. In the cells that were infected with a recombinant EBV expressing epitope-tagged EBNA1, EBNA1 localized to intranuclear punctate dots, which coincided with the localization of EBV genomes as revealed by fluorescence in situ hybridization (FISH). A significant number of EBNA1 dots were found to localize symmetrically on sister chromatids of mitotic chromosomes. Such symmetrical localization of EBNA1 dots was observed in prematurely condensed G2 chromosomes as well, correlating with the presence of closely spaced double dots of EBNA1 in G2-phase-enriched cells. The EBNA1 double dots were occasionally interconnected by the FISH signals of EBV episomes, exhibiting a dumbbell-like appearance. Thus, we propose that the partitioning of EBNA1 molecules onto sister chromatids during cellular DNA replication underlies the non-stochastic segregation of extrachromosomally replicating viral genomes.

Electrophoretic analysis of proteins and enantiomers using capillaries modified by a successive multiple ionic-polymer layer (SMIL) coating technique.

The applicability of three-layer coatings consisting of three different polymers (A(+)-B(-)-C(+) coating) prepared by a successive multiple ionic-polymer layer (SMIL) coating technique to the immobilization of polypeptides and/or proteins onto the inner surface of the capillaries was investigated to provide a high-performance separation medium for proteins and enantiomers in capillary electrophoresis (CE). To obtain a stable protein-coated capillary, high molecular mass poly(ethyleneimine) (PEI) was employed as the first layer in the A(+)-B(-)-C(+) coating, and then a cationic protein was immobilized as the third layer. Comparisons of analytical performances between the A(+)-B(-)-C(+) coating and the conventional SMIL-coated (A(+)-B(-)-A(+) coating) capillary were conducted. The CE separation of cationic proteins was successfully achieved with the prepared capillaries. In addition, the polypeptide- and protein-coated capillaries were applied to the chiral separation of a binaphthyl compound. It should be noted that the chiral separation efficiency was strongly dependent on the second anionic polymer layer of the coating. Effects of the interaction between oppositely charged ionic polymer layers on the separation efficiency are discussed.

Sjögren's syndrome with bilateral spontaneous fracture of the femoral neck following aseptic necrosis of the femoral head.

Abstract A woman with Sjögren's syndrome concurrently suffered bilateral fractures of the femoral neck without any proximate cause, while she had aseptic necrosis of the femoral head resulting from the treatment for Sjögren's syndrome. According to previous reports, fractures of the femoral neck following aseptic necrosis of the femoral head are attributed to primary diseases such as systemic lupus erythematosus (SLE) or idiopathic thrombocytopenic purpura (ITP), and steroids are administered in most cases. Heterogeneous bone regeneration after necrosis causes irregularity in its mechanical strength depending on which regions of frailty are generated. Patients with aseptic necrosis of the femoral head whose bone density is considerably reduced need careful medical attention to avoid fractures of the femoral neck caused by weak forces.