Association Between Metacognition and Mood Symptoms Poststroke.

INTRODUCTION: The link between metacognition and mood has been well established, particularly in other conditions with psychological comorbidity, however, there is no evidence regarding this association in the area of stroke. AIM: The aim of this study was to examine the association between metacognition, based on the Self-Regulatory Executive Function model, and mood symptoms in the acute phase after stroke. METHODS: One hundred thirty patients were recruited to a prospective stroke study in Bahrain, and n = 64 were assessed for mood and cognition. A neuropsychological battery of cognitive assessments included the following measures: the Mini-Mental State Examination, the Trail Making Test (A+B), and the Metacognition Questionnaire 30 (MCQ-30) for metacognition. The Hospital Anxiety and Depression Scale assessed mood symptoms, and stroke severity was measured using the National Institute of Health Stroke Severity Scale. RESULTS: Total MCQ-30 scores were significantly associated with both anxiety (r = .47, P = .001) and depression (r = .54, P <. 0001). The MCQ-30 subscales' cognitive confidence, cognitive self-consciousness, and uncontrollability/danger were the specific factors to be associated with mood symptoms (P < .01). Global cognition (r =.32, P < .01), but not executive function, was significantly associated with depression only. Metacognition remained a statistically significant correlate with depression (ß = .42, P < .0001) and anxiety (ß = .51, P < .0001) after adjusting for education and global cognition. DISCUSSION: Metacognition is a better determinant of mood symptoms after stroke, especially in regions where illiteracy levels are high in older populations, in comparison to executive function and global cognition.

Observation of superior and inferior limit of lobes of the thyroid gland: a postmortem study.

The size of thyroid gland varies considerably with age, sex, physiologic state, race and geographical location. Diseases of thyroid may need surgical intervention. This study is to carry out the macroscopic architecture of thyroid gland of different age and sex groups in Bangladeshi people to establish a normal standard. This is a descriptive cross-sectional study with an analytic component and was carried out on 54 autopsied human thyroid glands aged 5 to 65 years were collected from unclaimed dead bodies autopsied in morgue of Sylhet MAG Osmani Medical College, Sylhet. It was done in department of Anatomy, from 1st July 2006 to 30th June 2007. The collected specimens were divided into age Group A (10 years and below), Group B (11 to 20 years), Group C (21 to 30 years), Group D (31 to 40 years), Group E (41 to 50 years) and Group F (51 years and above). All specimens were examined morphologically by fine dissection method. It was observed that in most cases superior limit did not reach the midpoint of thyroid cartilage on either side. Inferior limit reached up to 6th tracheal ring on right side and 5th tracheal ring on left side in most cases.

The Osteogenetic Potential of Chitosan Coated Implant: An In Vitro Study.

Objective: Chitosan is a promising polymer that has been used for coating dental implants. However, research concerning coatings with implant surfaces other than commercially pure titanium is limited. Therefore, this study aims to clarify the chitosan material's effect with two degrees of deacetylation (DDA) as coatings for laser surface microtopographic implants. Methods: Sixty-three Laser-Lok (LL) implant discs were divided into three groups (21 in each group), and two groups were coated with either 80 or 95 DDA chitosan. The groups were categorized as LL 95, LL 80, or LL control. Then, hMSC-TERT 20 cells were used to evaluate the cell morphology, viability, and osteogenic capacity of the chitosan material 7 and 14 days after culture. Two-way ANOVA followed by one-way analysis of variance (ANOVA) and Tukey's post hoc test were used. Results: All samples were biocompatible and allowed cell attachment. However, cell spreading and attachment were noticeably increased in the LL 95 group. There was a significant increase in the expression of osteogenic markers in chitosan-coated samples compared to the control group. The 95 DDA-coated group exhibited higher ALP, Runx2, osteocalcin, and osteonectin expression compared to the 80 DDA and control groups on days 7 and 14. Conclusion: A high DDA of chitosan promotes biomineralization and osteoblast formation. Therefore, this combination of laser surface and chitosan can enhance future dental implant healing processes and osseointegration.

Associations between ApoE gene and psychological consequences post stroke in a Bahraini cohort.

BACKGROUND: The contribution of genetic factors such as the presence of ApoE allele e4 and its association with psychological consequences post stroke remains unknown within Middle-Eastern regions. This study examined the association of ApoE genotype with cognitive impairment and mood in stroke patients and compare with healthy older adults in Bahrain. METHOD: A prospective sample of n = 62 stroke patients (case group) and n = 53 healthy ageing individuals (control group) were eligible to participate in the study. A neuropsychological battery of cognitive assessments were conducted on all participants, and then stratified by cognitive function: no cognitive impairment, mild cognitive impairment and moderate to severe cognitive impairment. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). RESULTS: Most frequent ApoE genotype was e2/e3 in case (44%) and control groups (63%). ApoE allele e3 had the highest frequency for both groups with all stroke patients presenting with this allele and 86% for the control group (χ2 = 12.14, p < .0001). Stroke patients' non-carriers for ApoE allele e4 performed better on all cognitive measures but differences were not statistically significant (ns). Carriers of ApoE allele e2 in both groups had less mood symptoms compared to non-carriers. DISCUSSION: ApoE genotype e3/e4 and e4/e4 was low in this Bahraini cohort explaining why there may been no significant associations found for this genotype variant with cognitive impairment. Further investigation of cognitive impairment and mood dysregulation with the different variants of the ApoE gene in general ageing and stroke populations is required from different ethno-cultural groups and geographical regions globally.

MRI findings in neuro-Behçet's disease.

We report MRI findings in 6 patients with Behçet's disease and CNS involvement. There were 3 different stages of imaging appearance: (1) During the acute illness, there were scattered areas of high signal intensity on T2-weighted images with predilection to the central structures of the cerebrum, the cerebral peduncles, and basis pontis. (2) During the recovery phase, most of these findings improved, but some white matter high signal areas persisted in the upper brainstem and peripheral subcortical white matter. Occasionally, findings were suggestive of microhematoma. (3) During the chronic phase, atrophy of posterior fossa structures became evident with decreased signal intensity suggestive of hemosiderin deposits.

Abnormal brain scans: Contribution of blood radioactivity to image.

Images obtained with 99m-Tc-labeled red blood cells were compared with 99m-Tc-pertechnetate scans in 26 patients with primary and secondary brain tumors, intracerebral infcts, and hemorrhage. The results indicated that the contribution of blood pool radioactivity to a positive brain scan was minor.

Post-angiographic blindness in a patient with sickle cell disease.

This article described a 19-year-old woman with homozygous sickle disease in whom multiple cerebral infarcts developed after a technically uncomplicated cardiac angiogram. The article highlighted the risks of hyperosmolar solutions in patients with sickle cell disease and emphasized that only low osmolar contrast media, nonionic or ionic, should be used.

Observer variation in interpreting radiographs of the pituitary fossa.

Observer variation in interpreting sellar radiographs in patients suspected or known to have a pituitary tumor has been examined. Two radiologists experienced in interpreting sellar radiographs examined independently, without clinical details, plain films and tomograms of the sella of 101 patients. In most, only minor changes were anticipated. Of the 93 female patients, 67 were under investigation for amenorrhea. Radiographs were examined four times, each radiologist examining each set twice. Appearances were classified as normal, doubtful or abnormal on each occasion. Overall intraobserver agreement was 76%--85%. Neither radiologist changes his opinion by more than one category, e.g. from normal to doubtful. Overall interobserver agreement was 63%--75%. Disagreement between observers concerning 11 (11%) of the patients resulted from differences of opinion about whether minor changes in sellar outline represented an abnormality or merely a normal variation. Kappa analysis suggested that much of the agreement may be ascribed to chance. Agreement rates resemble those for other clinical and radiological investigations.

Syringomyelia in association with posterior fossa cysts.

This paper presents three patients with a triad of syringomyelia, midline posterior fossa cysts, and hydrocephalus. In the first patient, the clinical presentation was related to spinal cord cavitation, and the cranial anomalies were unexpected. In cases 2 and 3, the brain anomalies dominated the clinical picture, and syringomyelia was unexpected. These cases show that an examination of the whole neuraxis is as important in patients with midline posterior fossa cysts as it is in patients with developmental syringomyelia or Chiari I malformation.

Neurologic involvement in Behçet disease: imaging findings in 16 patients.

Behçet disease is a rare multisystem immune-related vasculitis that is prevalent in Japan, the Middle East, and many Mediterranean countries. In our study population of 36 patients with Behçet disease, 16 (44%) had CNS involvement. CT was noncontributory, except in a single patient with dural sinus thrombosis. MR imaging in nine patients showed foci of high signal intensity on T2-weighted images within the brainstem, the basal ganglia, and the cerebral hemispheres in that order of frequency. Unlike the plaques associated with multiple sclerosis, Behçet lesions show no predilection for the periventricular regions.

Myelographic study of the spinal cord ascent during fetal development.

To assess the length of the spinal cord relative to the vertebral column during fetal development, we performed translumbar myelograms on 340 spontaneously aborted fetuses. Of these, 146 were selected for study. There were 76 males and 70 females, with fetal age ranging from 7 to 33 weeks. Significant variation in the level of spinal cord termination was found in fetuses between 12 and 25 weeks gestational age. In fetuses between 25 and 33 weeks gestational age, the cord ended at or above the third lumbar vertebra.

Congenital muscular dystrophy with abnormal radiographic myelin pattern.

We report 11 children with a homogeneous clinical syndrome affecting both sexes, characterized by weakness at birth, slowly improving course, weakness of all muscle groups, arreflexia, elevated blood creatine kinase, normal nerve conduction velocity, dystrophic changes on muscle biopsy, and diffuse periventricular cortical white-matter abnormalities with sparing of corpus callosum, internal capsule, and brain stem. We compare them to 48 other previously reported similar cases and designate them as altered myelin radiographic pattern congenital muscular dystrophy (CMD), which is the same as occidental CMD. We compare them to the other presently accepted phenotypes: progressive Fukuyama CMD, Walker-Warburg or cerebral-ocular CMD, and Santavuori or muscle-eye-brain CMD. We suggest that the different phenotypes are alleles of the same gene, which regulates or expresses a structural protein required for muscle integrity, myelination, and formation of the cortex. Such phenotypic diversity has been established for mutations of Xp21 in X-linked muscular dystrophies.

Computer tomography in disseminated sclerosis.

A case is reported where the appearance of acute, diffuse, disseminated sclerosis on computer tomography (Ct scan) is described and the literature is reviewed. This disease may give rise to multiple, small areas of diminished X-ray absorption which may decrease in size during the course of the disease. The histological features of one of the lesions was correlated with the radiological findings. It is suggested that, perhaps, only during the active stage of demyelination can the lesions be detected on the Ct scan.

Craniopharyngioma: based on 160 cases.

This paper is the outcome of an extensive retrospective study of the clinical and radiological manifestations of a large number of craniopharyngiomas from five leading neuroscience centres in the U.K. The literature about this tumour has been reviewed with particular reference to its origin and radiological manifestations.

Pituitary and parapituitary tumours on computed tomography. A review article based on 230 cases.

This paper is based on a retrospective study of 230 tumours in the sellar area. All, except a few, were examined with the EMI 160 x 160 matrix and verified histologically. The main features of each pathological entity are described and most of the previous literature is reviewed. The degree of resolution of the scanner used precludes its reliability for detecting tumours less than one centimetre in diameter. Out of 30 microadenomas, only two were detectable on CT. This reflects an incidence of false negative results in 93% of microadenomas or 22% of all adenomas in the series. CT was also negative in 6% of craniopharyngiomas and 30% of chordomas. These findings emphasize the need for further neuroradiological tests in patients with clinically evident disease in the pituitary area. Many CT appearances are shared by more than one pathological entity; few are specific. However, if the CT findings are viewed in the light of the clinical presentation, a pathological diagnosis is possible in a large proportion of cases. Angiography is valuable; not only to exclude lesions of vascular origin, or show neovascularity, but also to demonstrate the relationship of the internal carotid arteries to the sphenoidal sinus prior to transsphenoidal surgery.

Anatomico-radiological study of the borderline sella.

Multidirectional thin section tomography was performed on 62 excised sphenoidal bones. The pituitary gland was then sectioned and examined microscopically for evidence of microadenoma, cellular hyperplasia or cysts. There is absolutely no meaningful correlation between the radiological and the histological findings. Minor sellar changes in the form of slight irregularity of the lamina dura, asymmetry of the sellar floor or thinning of the dorsum sellae may be found in the absence of any histopathological abnormality.