ABSTRACT
We demonstrate the performance of an efficient insertable pulse cleaning module (IPCM) that uses a saturable absorber (SA) pair with a compensating multi-pass amplifier. IPCM consists of a first SA, a grating compressor, a second SA, a stretcher and a compensating Ti:sapphire amplifier. It is implemented with a conventional chirped pulse amplification (CPA) Ti:sapphire laser system, resulting in a double CPA system architecture, and suppresses the amplified spontaneous emission (ASE) level of the pulse pedestal by about three orders of magnitude while preserving the output pulse energy and repetition-rate of the overall laser system. The duration of recompressed cleaned pulses is comparable to that obtained without the cleaning module. The effectiveness of the cleaning module is confirmed in laser-driven proton acceleration experiments. At the 10(9) W/cm2 pedestal level, the surface structure and electrical resistivity of an insulator target (100 nm silicon nitride) are preserved prior to the arrival of the intense ultrashort pulse.
ABSTRACT
Kα line emissions from Mo and Ag plates were experimentally studied using clean, ultrahigh-intensity femtosecond laser pulses. The absolute yields of Kα x-rays at 17 keV from Mo and 22 keV from Ag were measured as a function of the laser pulse contrast ratio and irradiation intensity. Significantly enhanced Kα yields were obtained for both Mo and Ag by employing high contrast ratios and irradiances. Conversion efficiencies of 4.28×10â»5/sr for Mo and 4.84×10â»5/sr for Ag, the highest values obtained to date, were demonstrated with contrast ratios in the range 10⻹° to 10⻹¹.
Subject(s)
Lasers , X-Rays , Equipment Design , Equipment Failure Analysis , Radiation DosageABSTRACT
Optical parametric chirped-pulse amplification (OPCPA) operation with low gain by seeding with high-energy, clean pulses is shown to significantly improve the contrast to better than 10(-10) to 10(-11) in a high-intensity Ti:sapphire laser system that is based on chirped-pulse amplification. In addition to the high-contrast broadband, high-energy output from the final amplifier is achieved with a flat-topped spatial profile of filling factor near 77%. This is the result of pump beam spatial profile homogenization with diffractive optical elements. Final pulse energies exceed 30 J, indicating capability for reaching peak powers in excess of 500 TW.
Subject(s)
Aluminum Oxide , Lasers , Titanium , Time FactorsABSTRACT
The characteristics of synchronous and subsequent lesions of serrated adenomas (SAs) of the colorectum are still unclear. This study aimed to clarify the characteristics of synchronous and subsequent lesions of SAs compared with tubular adenomas (TAs) of the colorectum. Patients were divided into 2 groups: SA (127 patients) and TA (158 patients). The mean follow-up durations in the SA and TA groups were 39.7 and 42.7 months, respectively. The number and clinical features of the synchronous and subsequent lesions of both groups were examined. In the SA group, 19 (15%) patients had synchronous lesions and 3 (2%) patients had subsequent lesions. In the TA group, 68 (43%) patients had synchronous lesions and 14 (9%) patients had subsequent lesions. The frequencies of patients with synchronous and subsequent lesions in the SA group were significantly lower than those in the TA group (p < 0.0001 and p = 0.02, respectively). The most frequent synchronous lesion was SA (67%) in the SA group and TA (95%) in the TA group. The most subsequent lesion was SA (62%) in the SA group and TA (100%) in the TA group. The histology of the index polyp and synchronous and subsequent lesions tended to be identical. No invasive colorectal carcinomas were observed in either group. Our data suggest that the colonic tumorigenesis potential of patients with SA may differ from that of patients with TA.
Subject(s)
Adenoma/pathology , Colon/pathology , Colorectal Neoplasms/pathology , Rectum/pathology , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Polyps/pathology , Retrospective StudiesABSTRACT
BACKGROUND: The presence of white matter lesions (WML) is an important prognostic factor for the development of stroke. The elevated visceral fat accumulation (VFA) has been reported to be closely related to the development of atherosclerosis. This preliminary study was therefore designed to test the hypothesis that the presence of WML correlates with VFA and insulin resistance in type 2 diabetic patients not receiving insulin treatment. MATERIAL AND METHODS: Based on brain magnetic resonance imaging (MRI), 95 type 2 diabetic patients were divided into two groups: WML-positive group (aged 59 +/- 7 years, mean +/- SD n = 37) and WML-negative group (aged 58 +/- 5, years, n = 58). The level of blood glucose was assessed by fasting plasma glucose (FPG), fasting immunoreactive insulin, homeostasis model assessment (HOMA) index, and haemoglobin A1c. The fat distribution was evaluated by measuring the visceral fat accumulation by abdominal computerized tomography at the umbilical level. RESULTS: The body mass index was higher in the WML-positive group than in the WML-negative group (P < 0.005). Plasma levels of triglycerides were higher while high-density lipoprotein cholesterol was lower in the WML-positive group than in the WML-negative group (P < 0.05 and P < 0.01, respectively). FPG (P < 0.01), insulin concentrations (P < 0.0001), HOMA index (P < 0.0001) and VFA (<0.0001) levels were higher in the WML-positive group than in the WML-negative group. Multivariate logistic analysis revealed that WML was independently predicted by the high VFA and insulin resistance (P < 0.001, P < 0.0001, respectively). CONCLUSIONS: The results of this preliminary study indicate that the presence of WML was associated with the high VFA and insulin resistance in Japanese patients with type 2 diabetes mellitus. Further larger cohort studies are warranted to confirm these findings.
Subject(s)
Diabetes Mellitus, Type 2/complications , Insulin Resistance/physiology , Intra-Abdominal Fat/pathology , Stroke/etiology , Aged , Arteriosclerosis/etiology , Arteriosclerosis/physiopathology , Asian People , Brain/pathology , Diabetes Mellitus, Type 2/physiopathology , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Risk Factors , Stroke/physiopathologyABSTRACT
A high stability electron bunch is generated by laser wakefield acceleration with the help of a colliding laser pulse. The wakefield is generated by a laser pulse; the second laser pulse collides with the first pulse at 180 degrees and at 135 degrees realizing optical injection of an electron bunch. The electron bunch has high stability and high reproducibility compared with single pulse electron generation. In the case of 180 degrees collision, special measures have been taken to prevent damage. In the case of 135 degrees collision, since the second pulse is countercrossing, it cannot damage the laser system.
ABSTRACT
The presence of white matter lesions (WML) is an important prognostic factor for the development of stroke. Plasma total homocysteine (tHcy), which increases with diabetes, has been flagged as a novel predictor for cerebrovascular events. We tested the hypothesis that the presence of WML correlates with tHcy and insulin resistance in type 2 diabetic patients not receiving insulin treatment. Based on brain magnetic resonance imaging findings, 81 type 2 diabetic patients were divided into two groups, with-WML group (57 +/- 8 years, mean +/- standard deviation, n = 31) and without-WML group (57 +/- 6 years, n = 50). The blood glucose level was assessed by fasting plasma glucose (FPG), fasting immunoreactive insulin, Homeostasis Model Assessment (HOMA) Index and hemoglobin A1c. The body mass index was higher in the with-WML group than in the without-WML group (P < 0.05). Plasma levels of triglyceride were higher whilst high-density lipoprotein cholesterol was lower in the with-WML group than in the without-WML group (P < 0.05 and P < 0.0001 respectively). FPG (P < 0.005), insulin concentrations (P < 0.0001), HOMA Index (P < 0.0001) and tHcy (<0.0001) levels were higher in the with-WML group than in the without-WML group. Multivariate logistic analysis revealed that WML was independently predicted by the high tHcy and insulin resistance. Our findings indicate that the presence of WML was associated with the high tHcy and insulin resistance in these Japanese patients with type 2 diabetes mellitus.
Subject(s)
Brain Diseases/etiology , Brain Diseases/pathology , Diabetes Mellitus, Type 2/complications , Hyperhomocysteinemia/complications , Neuroglia/pathology , Blood Glucose/metabolism , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/pathology , Female , Homocysteine/blood , Humans , Insulin Resistance/physiology , Japan/epidemiology , Logistic Models , Male , Middle Aged , Risk FactorsABSTRACT
We present a compact optical system using a commercially available DVD pickup head for microarray scanning. Our instrument successfully provides a low-cost, compact, and simple microarray scanning optical system in comparison to conventional ones due to the use of small-sized optical components and the implementation of a simple autofocusing system using an embedded voice coil motor. The performance of this system was validated by using a microarray slide with spots of fluorescent dyes. It was confirmed that our optical head performed satisfactorily and was suitable for practical use in microarray scanners. This result provides evidence of the superiority of our microarray scanning optical system over conventional ones because of its space-saving properties and cost effectiveness.
Subject(s)
Fluorescent Dyes , Lasers , Oligonucleotide Array Sequence Analysis/instrumentation , Oligonucleotide Array Sequence Analysis/methods , Reproducibility of ResultsABSTRACT
The RFC5 gene encodes a small subunit of replication factor C (RFC) complex in Saccharomyces cerevisiae. We have previously shown that a temperature-sensitive (ts) rfc5-1 mutation is impaired in the S-phase checkpoint. In this report, we show that the rfc5-1 mutation is sensitive to DNA-damaging agents. RFC5 is necessary for slowing the S-phase progression in response to DNA damage. The phosphorylation of the essential central transducer, Rad53 protein kinase, is reduced in response to DNA damage in rfc5-1 mutants during the S phase. Furthermore, the inducibility of RNR3 transcription in response to DNA damage is dependent on RFC5. It has been shown that phosphorylation of Rad53 is controlled by Mec1 and Tel1, members of the subfamily of ataxia-telangiectasia mutated (ATM) kinases. We also demonstrate that overexpression of TEL1 suppresses the ts growth defect and DNA damage sensitivity of rfc5-1 mutants and restores phosphorylation of Rad53 and RNR3 induction in response to DNA damage in rfc5-1. Our results, together with the observation that overexpression of RAD53 suppresses the defects of the rfc5-1 mutation, suggest that Rfc5 is part of a mechanism transducing the DNA damage signal to the activation of the central transducer Rad53.
Subject(s)
Cell Cycle Proteins , DNA-Binding Proteins/physiology , Fungal Proteins/physiology , Homeodomain Proteins , Protein Kinases/metabolism , Protein Serine-Threonine Kinases , Proto-Oncogene Proteins c-bcl-2 , Repressor Proteins , S Phase/physiology , Saccharomyces cerevisiae Proteins , Saccharomyces cerevisiae/genetics , Signal Transduction/physiology , Checkpoint Kinase 2 , DNA Damage/physiology , DNA Replication , DNA-Binding Proteins/genetics , Fungal Proteins/genetics , G2 Phase/physiology , Gene Expression Regulation, Fungal/physiology , Genes, Fungal/physiology , Hydroxyurea/pharmacology , Methyl Methanesulfonate/pharmacology , Minor Histocompatibility Antigens , Mutagens/pharmacology , Mutation , Phosphorylation , Phosphotransferases (Alcohol Group Acceptor)/genetics , Phosphotransferases (Alcohol Group Acceptor)/physiology , Radiation Tolerance , Replication Protein C , Saccharomyces cerevisiae/growth & development , Saccharomyces cerevisiae/radiation effects , Temperature , Transcriptional Activation/physiology , Ultraviolet RaysABSTRACT
The RFC5 gene encodes a small subunit of replication factor C (RFC) complex in Saccharomyces cerevisiae and has been shown to be required for the checkpoints which respond to replication block and DNA damage. Here we describe the isolation of RAD24, known to play a role in the DNA damage checkpoint, as a dosage-dependent suppressor of rfc5-1. RAD24 overexpression suppresses the sensitivity of rfc5-1 cells to DNA-damaging agents and the defect in DNA damage-induced Rad53 phosphorylation. Rad24, like Rfc5, is required for the regulation of Rad53 phosphorylation in response to DNA damage. The Rad24 protein, which is structurally related to the RFC subunits, interacts physically with RFC subunits Rfc2 and Rfc5 and cosediments with Rfc5. Although the rad24Delta mutation alone does not cause a defect in the replication block checkpoint, it does enhance the defect in rfc5-1 mutants. Furthermore, overexpression of RAD24 suppresses the rfc5-1 defect in the replication block checkpoint. Taken together, our results demonstrate a physical and functional interaction between Rad24 and Rfc5 in the checkpoint pathways.
Subject(s)
Cell Cycle Proteins/metabolism , DNA Damage , DNA-Binding Proteins/metabolism , Homeodomain Proteins , Protein Serine-Threonine Kinases , Proto-Oncogene Proteins c-bcl-2 , Repressor Proteins , Saccharomyces cerevisiae Proteins , Saccharomyces cerevisiae/metabolism , Cell Cycle Proteins/chemistry , Cell Cycle Proteins/genetics , Checkpoint Kinase 2 , DNA-Binding Proteins/chemistry , DNA-Binding Proteins/genetics , Fungal Proteins/chemistry , Fungal Proteins/metabolism , Genes, Fungal , Genotype , Intracellular Signaling Peptides and Proteins , Kinetics , Methyl Methanesulfonate , Minor Histocompatibility Antigens , Mutagenesis , Mutagens , Phosphorylation , Protein Kinases/metabolism , Replication Protein C , Saccharomyces cerevisiae/genetics , Spindle Apparatus/genetics , Ultraviolet RaysABSTRACT
RAD24 and RFC5 are required for DNA damage checkpoint control in the budding yeast Saccharomyces cerevisiae. Rad24 is structurally related to replication factor C (RFC) subunits and associates with RFC subunits Rfc2, Rfc3, Rfc4, and Rfc5. rad24Delta mutants are defective in all the G(1)-, S-, and G(2)/M-phase DNA damage checkpoints, whereas the rfc5-1 mutant is impaired only in the S-phase DNA damage checkpoint. Both the RFC subunits and Rad24 contain a consensus sequence for nucleoside triphosphate (NTP) binding. To determine whether the NTP-binding motif is important for Rad24 function, we mutated the conserved lysine(115) residue in this motif. The rad24-K115E mutation, which changes lysine to glutamate, confers a complete loss-of-function phenotype, while the rad24-K115R mutation, which changes lysine to arginine, shows no apparent phenotype. Although neither rfc5-1 nor rad24-K115R single mutants are defective in the G(1)- and G(2)/M-phase DNA damage checkpoints, rfc5-1 rad24-K115R double mutants become defective in these checkpoints. Coimmunoprecipitation experiments revealed that Rad24(K115R) fails to interact with the RFC proteins in rfc5-1 mutants. Together, these results indicate that RFC5, like RAD24, functions in all the G(1)-, S- and G(2)/M-phase DNA damage checkpoints and suggest that the interaction of Rad24 with the RFC proteins is essential for DNA damage checkpoint control.
Subject(s)
Cell Cycle Proteins/genetics , Cell Cycle/genetics , DNA Replication/genetics , DNA-Binding Proteins/genetics , Gene Expression Regulation, Fungal , Homeodomain Proteins , Proto-Oncogene Proteins c-bcl-2 , Repressor Proteins , Saccharomyces cerevisiae Proteins , Saccharomyces cerevisiae/genetics , Intracellular Signaling Peptides and Proteins , Minor Histocompatibility Antigens , Mutation , Replication Protein C , Saccharomyces cerevisiae/cytologyABSTRACT
To maintain a stable thermophilic (55 degrees C) anaerobic digestion treating toilet paper-containing garbage, it is necessary to operate the digester at long hydraulic retention time (HRT) and low organic loading rate (OLR). Critical conditions of the digestion were investigated by operating the digester at HRT 23 days and OLR 3.4 gCOD(Cr)/L/d (R1) or HRT 14 days and OLR 5.6 gCOD/Cr)/L/d (R2) separately. Characteristics of methanogenesis of the two digesters were examined by measuring gas generation volume and volatile fatty acids (VFA) concentration, and the populations of four anaerobic acidogens and three methanogens were analyzed using quantitative PCR method. In digester R1, methanogenic activity was unstable but it could be recovered by stopping feeding as though VFA accumulation occurred. The population of acidogens and two methanogens were maintained at 10(11) - 10(13) copies/L, however, the population of Methanoculleus could not be recovered after methanogenesis recovering. In digester R2, the period of methanogenesis was significantly shorter than that in digester R1. Both the acidogens and the methanogens could not be maintained at a stable concentration. It is suggested that the critical HRT to sustain the population of acidogens in this process should be longer than 14 days and for all kinds of methanogens, HRT should be longer than 23 days.
Subject(s)
Bacteria, Anaerobic/metabolism , Bioreactors , Methane/metabolism , Paper , Refuse Disposal/methods , Sewage/microbiology , Acids/metabolism , Biodegradation, Environmental , Polymerase Chain Reaction , Population Dynamics , Sewage/chemistry , Time Factors , Toilet FacilitiesABSTRACT
We present a case of successful management for severe respiratory failure during thoracic aortic aneurysm repair by applying extracorporeal membrane oxygenation (ECMO). The patient was a 71-year-old man who was diagnosed as thoracic aortic aneurysm and coronary artery stenosis. Severe respiratory failure occurred during operation because of pulmonary hemorrhage, and it was difficult to wean from cardiopulmonary bypass. ECMO was provided for improvement of oxygenation and CO2 removal. Pulmonary hemorrhage was controlled by strict management of coagulation system, and ECMO was discontinued after improvement of oxygenation on the 4th postoperative day. It is considered that early application of ECMO was effective in this case.
Subject(s)
Aortic Aneurysm, Thoracic/surgery , Blood Vessel Prosthesis Implantation , Coronary Stenosis/complications , Extracorporeal Membrane Oxygenation , Intraoperative Complications/therapy , Respiratory Insufficiency/therapy , Aged , Aortic Aneurysm, Thoracic/complications , Cardiac Surgical Procedures/methods , Cardiopulmonary Bypass , Extracorporeal Membrane Oxygenation/standards , Hemorrhage/therapy , Humans , Lung Diseases/therapy , Male , Respiratory Insufficiency/etiologyABSTRACT
OBJECTIVE: Everyday experience suggests that highly emotional events are often the most memorable. Experimental work in animals and humans has demonstrated that the amygdaloid complex plays a crucial role in emotional memory, i.e., memory of events arousing strong emotions. The aim of this study was to elucidate the relationship between medial temporal damage and impaired memory of real-life emotional events in patients with Alzheimer's disease. METHOD: In 36 patients with probable Alzheimer's disease who experienced the 1995 earthquake in Kobe, Japan, memories of events surrounding the earthquake were examined as an index of emotional memory with the use of a semistructured interview, and amygdalar and hippocampal volumes were quantified by magnetic resonance imaging. The effects of the atrophy of these structures on recall performance were determined by multiple regression analysis. RESULTS: Irrespective of generalized brain atrophy and cognitive impairments, emotional memory was correlated more with normalized amygdalar volume (right and left averaged) than with normalized hippocampal volume. General knowledge of the earthquake was correlated with neither amygdalar nor hippocampal volume. CONCLUSIONS: The results indicate that impairment of emotional event memory in patients with Alzheimer's disease is related to intensity of amygdalar damage and provide evidence of the amygdala's involvement in emotional memory in humans.
Subject(s)
Alzheimer Disease/pathology , Amygdala/pathology , Emotions , Memory , Aged , Alzheimer Disease/diagnosis , Alzheimer Disease/psychology , Amygdala/physiology , Atrophy , Cell Count , Cognition Disorders/diagnosis , Cognition Disorders/psychology , Disasters , Emotions/physiology , Female , Hippocampus/pathology , Hippocampus/physiology , Humans , Japan , Life Change Events , Magnetic Resonance Imaging , Male , Memory/physiology , Middle Aged , Neuropsychological Tests , Psychiatric Status Rating Scales , Regression AnalysisABSTRACT
OBJECTIVE: Both the magnitude of brain atrophy and premorbid brain size determine the volume of the brain affected by Alzheimer's disease. To examine the possibility that premorbid brain volume is a determinant of cognitive reserve in patients with Alzheimer's disease, the relation between diffuse brain atrophy and cognitive decline and the impact of premorbid brain size on cognitive decline were studied in patients with Alzheimer's disease. METHOD: By measuring whole brain volume and intracranial volume in 60 patients with probable Alzheimer's disease, mild to moderate in severity, with the use of high-resolution magnetic resonance imaging and image processing, the authors studied the impact of premorbid brain volume and magnitude of diffuse brain atrophy on cognitive functions. On the basis of the normative brain-calvarium relationship derived from data an 28 healthy adults and the total intracranial volume measure of each patient, the magnitude of brain atrophy and premorbid brain volume were estimated. RESULTS: After control for the effects of age, sex, and education as confounding factors, it was found that the Alzheimer's disease patients' intelligence was correlated both positively with premorbid brain volume and negatively with magnitude of brain atrophy, while impairments in language and memory were correlated with magnitude of brain atrophy but not with premorbid brain volume. CONCLUSIONS: These findings partially support the hypothesis that premorbid brain volume is a determinant of reserves against intellectual decline in Alzheimer's disease.
Subject(s)
Alzheimer Disease/diagnosis , Brain/anatomy & histology , Cognition Disorders/diagnosis , Adult , Age Factors , Aged , Alzheimer Disease/pathology , Alzheimer Disease/psychology , Atrophy , Brain/pathology , Cognition Disorders/pathology , Cognition Disorders/psychology , Confounding Factors, Epidemiologic , Cross-Sectional Studies , Educational Status , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Neuropsychological Tests , Sex Factors , Wechsler ScalesABSTRACT
Hepatocyte growth factor activator inhibitor type 2 (HAI-2) was identified as a potent inhibitor of hepatocyte growth factor activator (HGF activator). The primary translation product of HAI-2 contains two Kunitz domains. To characterize their function, we introduced a point mutation into the reactive site of each Kunitz domain, and assayed the mutants for their HGF activator inhibitory activity. A point mutation in the COOH-terminal Kunitz domain did not affect the activity of HAI-2, whereas a point mutation in the NH2-terminal Kunitz domain markedly reduced the activity. These results suggest that the NH2-terminal Kunitz domain is mainly responsible for the HGF activator inhibitory activity of HAI-2.
Subject(s)
Membrane Glycoproteins/metabolism , Recombinant Proteins/genetics , Serine Endopeptidases/metabolism , Trypsin Inhibitor, Kunitz Soybean/metabolism , Amino Acid Sequence , Animals , Binding Sites , CHO Cells , Cricetinae , DNA, Complementary , Membrane Glycoproteins/genetics , Molecular Sequence Data , Mutation , Recombinant Proteins/metabolism , TransfectionABSTRACT
Hepatocyte growth factor (HGF) promotes proliferation of cultured hepatocytes by its interaction with cell surface receptors. In this paper, we examined the metabolic fate of HGF using hepatocytes. Kinetic analysis using [125I]HGF showed that 40% of surface-bound HGF was rapidly internalized in hepatocytes within 30 min at 37 degrees C. Under these conditions, the amount of HGF-bound c-Met, the high-affinity receptor, decreased from the cell surface. Furthermore, the internalized HGF was degraded and released from the cells. These results indicate that cell surface-bound HGF is internalized and degraded by the receptors, including c-Met, on hepatocytes.
Subject(s)
Down-Regulation , Hepatocyte Growth Factor/metabolism , Liver/metabolism , Proto-Oncogene Proteins/metabolism , Receptors, Cell Surface/metabolism , Animals , Cell Membrane/metabolism , Cells, Cultured , Immunosorbent Techniques , Kinetics , Male , Molecular Weight , Proto-Oncogene Proteins c-met , Rats , Rats, WistarABSTRACT
BACKGROUND: Surgical exclusion of portions of the gastrointestinal tract is a predisposing risk factor for the development of Wernicke-Korsakoff syndrome. When this disease occurs, it is usually within weeks after the gastrointestinal surgery. However, it is not well known that Wernicke-Korsakoff syndrome may occur after a long latent interval following gastrectomy. SETTING: A research-oriented hospital. PATIENTS: Three patients without a history of alcoholism or dietary deprivation developed Wernicke-Korsakoff syndrome 2 to 20 years after undergoing gastrectomy. In these patients, minor changes in dietary habit led to the development of Wernicke-Korsakoff syndrome. CONCLUSIONS: In addition to a long-standing latent deficiency in thiamin levels due to defective absorption following gastrectomy or gastrojejunostomy, other minor factors that may influence the intake of thiamin and the need for thiamin in subjects who have undergone gastrectomy may cause a state of thiamin deficiency resulting in Wernicke-Korsakoff syndrome. Results from our study indicate that the following measures are mandatory: educating patients about proper dietary habits, carefully monitoring their thiamin intake, recognizing Wernicke-Korsakoff syndrome early, and treating it immediately with appropriate measures.
Subject(s)
Gastrectomy/adverse effects , Wernicke Encephalopathy/etiology , Aged , Humans , Male , Middle AgedABSTRACT
BACKGROUND: In dementia with Lewy bodies (DLB), vision-related cognitive and behavioral symptoms are common, and involvement of the occipital visual cortices has been demonstrated in functional neuroimaging studies. OBJECTIVES: To delineate visuoperceptual disturbance in patients with DLB in comparison with that in patients with Alzheimer disease and to explore the relationship between visuoperceptual disturbance and the vision-related cognitive and behavioral symptoms. DESIGN: Case-control study. SETTING: Research-oriented hospital. PATIENTS: Twenty-four patients with probable DLB (based on criteria of the Consortium on DLB International Workshop) and 48 patients with probable Alzheimer disease (based on criteria of the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association) who were matched to those with DLB 2:1 by age, sex, education, and Mini-Mental State Examination score. MAIN OUTCOME MEASURES: Four test items to examine visuoperceptual functions, including the object size discrimination, form discrimination, overlapping figure identification, and visual counting tasks. RESULTS: Compared with patients with probable Alzheimer disease, patients with probable DLB scored significantly lower on all the visuoperceptive tasks (P<.04 to P<.001). In the DLB group, patients with visual hallucinations (n = 18) scored significantly lower on the overlapping figure identification (P = .01) than those without them (n = 6), and patients with television misidentifications (n = 5) scored significantly lower on the size discrimination (P<.001), form discrimination (P = .01), and visual counting (P = .007) than those without them (n = 19). CONCLUSIONS: Visual perception is defective in probable DLB. The defective visual perception plays a role in development of visual hallucinations, delusional misidentifications, visual agnosias, and visuoconstructive disability charcteristic of DLB.
Subject(s)
Lewy Body Disease/physiopathology , Visual Perception , Aged , Agnosia/diagnosis , Alzheimer Disease/diagnosis , Alzheimer Disease/physiopathology , Case-Control Studies , Diagnosis, Differential , Educational Status , Female , Hallucinations/diagnosis , Humans , Lewy Body Disease/diagnosis , Male , Neuropsychological Tests , Pattern Recognition, Visual/physiology , Predictive Value of Tests , Visual Cortex/physiopathology , Visual Perception/physiologyABSTRACT
BACKGROUND: Dementia with Lewy bodies (DLB) is emerging as a common cause of degenerative dementia. Some preliminary evidence exists that the pattern of cognitive impairment in DLB is different from that in Alzheimer disease (AD). OBJECTIVE: To delineate features of cognitive impairment of DLB on standardized neuropsychological tests. METHODS: We performed neuropsychological assessments of 26 patients with probable DLB (based on criteria of the consortium on DLB international workshop) and of 52 patients with probable AD (based on criteria of the National Institute of Neurological and Communicative Disorders and Stroke [now the National Institute of Neurological Disorders and Stroke])-Alzheimer's Disease and Related Disorders Association) who were matched to the patients with DLB 2:1 by age, sex, education, and Mini-Mental State Examination score. RESULTS: Compared with the group with probable AD, the group with probable DLB scored significantly lower on the picture arrangement, block design, object assembly, and digit symbol substitution subtests of the Wechsler Adult Intelligence Scale-Revised and on the Raven Colored Progressive Matrices test and significantly higher on the Mini-Mental State Examination locational orientation subtest and the Alzheimer's Disease Assessment Scale word recall subtest. A discriminant analysis revealed that the word recall score on the Alzheimer's Disease Assessment Scale and the block design score on the Wechsler Adult Intelligence Scale-Revised were the best discriminant factors. CONCLUSIONS: The disproportionately severe visuoperceptual, visuoconstructive, and visuospatial dysfunction and the disproportionately mild memory impairment in DLB compared with AD, which likely reflect the distribution of the pathologic changes in DLB, can help to differentiate DLB from AD.