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Idiopathic basal ganglia calcification (IBGC) is a neuropathological finding known to manifest motor disturbance, cognitive impairment and psychiatric symptoms. Pathophysiology of psychiatric symptoms, however, remains controversial. Previous biochemical study suggests that dopaminergic impairment is involved in IBGC. We therefore performed positron emission tomography (PET) to elucidate the pre- and postsynaptic dopaminergic function and glucose metabolism in two IBGC patients.
Methods:
Case 1 is a 44 years old woman presented with disorganized thought, echolalia, verbigeration and parkinsonism. She was administered bitemporal electro-convulsive therapy (ECT). Case 2 is a 35 years old woman with persecutory delusion. Computed tomography showed bilateral symmetric calcification of striatum, globus pallidus and dentate nucei. Other causes of intracranial calcification were excluded. PET scans were obtained using [11C]-labeled 2β-carbomethoxy-3β-(4-flurophenyl)-tropane, [11C]-labeled raclopride and [18F] fluorodeoxyglucose.
Results:
The decreased binding potential was severe in bilateral head of caudate nuclei and anterior putamen. In case 1, the decline was also found in posterior putamen. There were widespread decreases of glucose uptake in frontal, temporal and parietal cortices bilaterally in case 1. Significant hypometabolism was observed in the right frontal, temporal and parietal cortices. After the ECT session, the previous areas of significant hypometabolism in the right hemisphere had improved. In case 2, there was no significant change of glucose metabolism in cerebral cortex.
Conclusions:
The difference in affected region within basal ganglia might be associated with the diverse clinical pictures in IBGC. Particularly, in the psychiatric manifestation, dopaminergic dysfunction in caudate nucleus and anterior putamen could be participated.
Patients with psychiatric disorders, including schizophrenia and bipolar disorder, are reported to suffer from sleep disorders.
Objective
To investigate the effects of lurasidone on sleep architecture in rats using sleep electroencephalography.
Methods
Seven adult male rats were used in this study. A pair of electrode wires was implanted in the dura of each rat and electromyograms were recorded from their dorsal neck muscles. Drugs were administered at the start of the lights-on period, and electroencephalograms (EEG)were recorded for 6 hours in individual soundproof boxes. The course of sleep in rats has been classified into 3 stages: WAKE, non-REM (NREM) sleep and rapid eye movement (REM) sleep. Total NREM duration, REM duration, and latencies to the initial REM and NREM were calculated. In addition, the number and mean duration of bouts in every 2-hour period were calculated in each stage. EEG power in each of the following frequency bands during NREM sleep was quantified: delta (0.5-4 Hz), theta (4-8 Hz), alpha (8-12 Hz), beta (12-30 Hz) and gamma (30-80 Hz).
Results
Lurasidone shortened REM sleep duration and prolonged the mean duration of one bout in WAKE and NREM sleep. Quantitative frequency analyses during NREM sleep revealed that lurasidone increases slow waves and decreases fast waves. The serotonin 5-HT1A receptor partial agonist, tandospirone, and selective serotonin 5-HT7 receptor antagonist, SB-258741, also exhibited REM-inhibitory effects similar to those of lurasidone.
Conclusion
These results suggest that lurasidone ameliorates sleep disorders associated with psychosis through, at least partly, serotonin 5-HT1A and serotonin 5-HT7 receptors.
Clozapine-induced electroencephalography (EEG) abnormalities are common. It has been reported that clozapine-induced EEG abnormalities occur in a dose-dependent manner and correlate with the serum concentration of clozapine (C-CLZ). However, the oppositional results were also reported.
Objectives
The objective of this study was to investigate the relationship between serum level of clozapine and EEG abnormalities.
Methods
Twenty-eight patients were recruited in this study, but five patients were excluded because clozapine was discontinued before post-treatment EEG measurement or measurement of C-CLZ. Ultimately, 23 patients (6 males, 17 females) with an average age of 35 years were enrolled. The subjects were divided into EEG normal and abnormal group. C-CLZ and the serum concentration of metabolite of clozapine (N-CLZ) were measured. The correlation between C-CLZ and daily dose of CLZ (D-CLZ), N-CLZ and D-CLZ were evaluated in each group. C-CLZ per D-CLZ (C/D), N-CLZ per D-CLZ (N/D) and the ratio of C-CLZ to N-CLZ (C/N) were compared between the two groups.
Results
74 serum levels were measured. All patients had normal baseline EEGs, and 10 patients later showed EEG abnormalities. There were a significant correlation between C-CLZ and D-CLZ (EEG normal: rs 0.58, p<0.01, EEG abnormal: rs 0.56, p<0.01) and between N-CLZ and D-CLZ (EEG normal: rs 0.53, p<0.01, EEG abnormal: rs 0.57, p<0.01). There were no significant differences between the EEG normal and EEG abnormal groups in C/D, N/D, C/N.
Conclusion
There was no relationship between the serum concentration of clozapine and EEG abnormalities.
Clozapine is one of the most effective drugs for the treatment resistant schizophrenia (TRS). It was reported that modified electroconvulsive therapy (mECT) may be an effective clozapine augmentation strategy in TRS.
Objective
The objective of this study was to investigate the influence of clozapine to mECT in the TRS.
Methods
Forty-seven patients were recruited in this study, but eight patients were excluded because clozapine was discontinued by reason of side effects. Ultimately, 39 patients were enrolled.
Results
Seventeen patients received mECT before clozapine therapy. Two patients continued mECT after starting clozapine therapy. There was a significant difference between before–after clozapine therapy (χ2 test, P< 0.01). Intermittent mECT was performed for 3 patients before clozapine and for one patient after starting clozapine.
Discussion
This result suggests that clozapine therapy reduces mECT. In Japan, the first-line treatment for TRS is CLO. mECT is recommended for clozapine resistant schizophrenia patients. Prescription of CLO is limited in the part of medical facility because all physicians who prescribe clozapine must be registered with the clozaril patient monitoring service in Japan. It is considered that mECT is more readily selected than clozapine therapy. Therefore, the number of mECT is not reduced generally.
Conclusion
Clozapine therapy reduces the necessity of mECT.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Dementia with lewy bodies (DLB) is commonly considered the second most common form of dementia. The purpose of this study is to investigate the treatment effects of aripiprazole in patients with DLB.
Methods
Eleven patients who had meet the criteria for DLB participated in this study. The presence of psychotic symptoms was confirmed by scores of either the delusions or hallucinations items of the Neuropsychiatric Inventory (NPI) score. Patients who had 25 or more on the Mini-mental State Examination Scale (MMSE) at the entry or having brain damage were excluded. Aripiprazole was initiated at a low dose (3 or 6 mg/day) and titrated to higher doses at 2-weeks intervals or more rapidly based on investigator's judgment. Previous medications prior to aripiprazole administration were not changed through this trial. Patient's clinical status was assessed at baseline, then 2 weeks during the study by using NPI, Clinical Global Impression (CGI) and Brief Psychiatric Rating Scale (BPRS) to measure psychotic behavioral symptoms, and Simpson-Angus Scale (SAS) to measure parkinsonism symptoms. Clinical Dementia Rating (CDR) and MMSE were carried out at screening and end point to evaluate cognitive function.
Results
The mean scores of the SAS and CDR were significantly decreased at the study endpoint compared to baseline. The mean scores of the NPI and BPRS improved up until 4 weeks after having started aripiprazole. After 4 weeks, improvements slowed. The mean score of the CGI-S was decreased up until 8 weeks.
Conclusion
This study shows that aripiprazole may be effective for the treatment of psychotic symptoms in patients with DLB.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
We present ALMA detection of the [O iii] 88 μm line and 850 μm dust continuum emission in a Y-dropout Lyman break galaxy, MACS0416_Y1. The [O iii] detection confirms the object with a spectroscopic redshift to be z = 8.3118±0.0003. The 850 μm continuum intensity (0.14 mJy) implies a large dust mass on the order of 4×106M⊙. The ultraviolet-to-far infrared spectral energy distribution modeling, where the [O iii] emissivity model is incorporated, suggests the presence of a young (τage ≍ 4 Myr), star-forming (SFR ≍ 60M⊙yr−1), and moderately metal-polluted (Z ≍ 0.2Z⊙) stellar component with a stellar mass of 3 × 108M⊙. An analytic dust mass evolution model with a single episode of star formation does not reproduce the metallicity and dust mass in ≍ 4 Myr, suggesting an underlying evolved stellar component as the origin of the dust mass.
We use the LLAMA survey to study the density and outflow rate of ionized gas in a complete volume limited sample of local (<40 Mpc) luminous (43.0 < log LAGN(erg/s) < 44.5) AGN selected by very hard 14-195 keV X-rays. The detailed data available for this survey enable us to measure the density of the outflowing ionized gas in the central 300 pc of these AGN using three different and independent methods (the standard [SII] doublet ratio; a method comparing [OII] and [SII] ratios that include auroral and transauroral lines; and a recently proposed method based on the ionization parameter). For each method there is, as expected, a modest spread of densities among the AGN in the sample. But remarkably, the median densities for each method differ hugely, by an order of magnitude from below 400 cm-3 to almost 5000 cm-3. We discuss how the derived densities can be reconciled, and what the impact is on the implied outflow rate.
The onset of transient turbulence in minimal plane Couette flow has been identified theoretically as homoclinic tangency with respect to a simple edge state for the Navier–Stokes equation, i.e., the gentle periodic orbit (the lower branch of a saddle-node pair) found by Kawahara & Kida (J. Fluid Mech., vol. 449, 2001, pp. 291–300). The first tangency of a pair of distinct homoclinic orbits to this periodic edge state has been discovered at Reynolds number $Re\equiv Uh/\unicode[STIX]{x1D708}=Re_{T}\approx 240.88$ ($U$, $h$, and $\unicode[STIX]{x1D708}$ being half the difference of the two wall velocities, half the wall separation, and the kinematic viscosity of fluid, respectively). At $Re>Re_{T}$ a Smale horseshoe appears on the Poincaré section through transversal homoclinic points to generate a transient chaos that eventually relaminarises. In numerical experiments a sustaining chaos, which is a consequence of period-doubling cascade stemming from the upper branch of another saddle-node pair of periodic orbits, is observed in a narrow range of the Reynolds number, $Re\approx 240.40$–240.46. At the upper edge of this $Re$ range it is found that the chaotic set touches the lower branch of this pair, i.e., another edge state. The corresponding chaotic attractor is replaced by a chaotic saddle at $Re\approx 240.46$, and subsequently this saddle touches the gentle periodic edge state on the boundary of the laminar basin at the tangency Reynolds number $Re=Re_{T}$. After this crisis on the boundary of the laminar basin, for $Re>Re_{T}$, chaotic transients that eventually relaminarise can be observed.
Thermal transformations of kaolinite were studied by 29Si- and 27Al-MAS/NMR and ESR techniques. In metakaolin, Si is still dominantly in the Q3 state (three Si atoms bonded to an Si-O4 tetrahedron) and Al detectable by NMR is in both 4-coordination and 6-coordination. Coordination polyhedra around Al or Fe replacing Al are much distorted. Metakaolin crystallizes into γ-alumina and mullite exothermically at ∼980°C, this crystallization being preceded by a faint endothermic reaction. The latter is due to segregation of SiO2 and Al2O3, which results in an increase of Si in the Q4 state and an increase of 6-coordinated Al2O3.
Thallium leucite, TlAlSi2O6, has been synthesized at 450°C for 7 days, under ambient conditions, by the transformation of dehydrated analcime NaAlSi2O6 in the presence of excess TlCl. This substitution of Tl for Na leads to confirmation of a thallium-leucite pseudomorph after analcime. Their optical properties, X-ray powder diffraction patterns, electron microprobe analysis, infrared spectra, and X-ray photoelectron spectroscopy have characterized the synthetic Tl-leucites. The IR spectra show that the mid-IR modes T-O stretching and T-O-T bending vibrations for TlAlSi2O6 are more resemblant of those for analcime than for leucite, KAlSi2O6. This resemblance implies that Tl cation enters the W-site rather than the S-site in the analcime structure: Na (S) + H2O (W) ⇋ □ + K (leucite) ⇋ □ + Tl (Tl- leucite), where □ represents an S-site vacancy. The mechanism of this substitution is supported by the crystal chemical constraints: inasmuch as the S-site is smaller than the W-site, Tl+ cations being larger than Na+ plainly prefer the latter site to the former. One inference from the binding energy for Tl+ by XPS is that Tl+ occupies the extra-framework site in synthetic leucite pseudomorph, rather than the smaller tetrahedral site. The difference in Al/Si disordering between analcime and leucite and the nonstoichiometry due to the solid solution of the □Si3O6 component into the leucite structure may provide a fundamental insight into understanding why TlAlSi2O6 deviates from the trend defined by K-, Rb- and CsAlSi2O6 leucite series on the a-c parameter diagram, inasmuch as these three cations in the leucite structure occupy the W-sites. Finally, synthesis of TlAlSi2O6 leucite has an implication for the existence of other polymorphs due to different degrees of Al/Si disordering, except for high- and low-temperature leucites already known: natural leucites crystallized directly through igneous processes are different from those formed by substitution of K for Na in analcimes.
Pararsenolamprite, the third polymorph of native As, is found at the Mukuno mine, Oita Prefecture, Japan. It is orthorhombic, Pmn21 or P21nm, a = 3.633(2), b = 10.196(2), c= 10.314(2)Å, Z = 18. The seven strongest lines in the X-ray powder diffraction pattern are: 5.17 (100) (002), 4.60 (24) (012), 3.259 (58) (013), 2.840 (27) (032), 2.580 (22) (004), 2.299 (23) (024), and 1.794 (26) (105). Electron microprobe analysis gives As 91.89, Sb 7.25, S 0.48, total 99.62 wt.% (mean of 8), and lead to the empirical formula, As0.96Sb0.03S0.01. It is lead grey in colour and opaque with metallic lustre and black streak. It is sectile and brittle with perfect cleavage on [001]. The VHN25 is 66–91 kg/mm2, corresponding to 2–2.5 in Mohs' hardness scale. The measured and calculated densities are 5.88(5) g/cm3 and 6.01 g/cm3, respectively. In reflected plane-polarized light in air, it is white with a slightly greenish blue tint. Anisotoropy is strong, dark brown to dark greenish grey. Bireflectance is distinct; parallel to elongation it is creamy; perpendicular to elongation it is brown, grey and green. Internal reflections are absent. The reflectance spectra are tabulated in the text.
Pararsenolamprite occurs as euhedral crystals in close association with arsenic, stibnite and quartz in a Sb-As-Ag-Au-bearing quartz vein cutting altered Neogene andesite from the Mukuno mine. It forms radial or parallel aggregates of bladed cystals up to 0.8 mm in length.
The crystal structure of whewellite [Ca(C2O4)·H2O] and the dehydration mechanism of caoxite [Ca(C2O4)·3H2O] have been studied by means of differential thermal analysis, X-ray diffraction (powder and single-crystal) analysis and infrared analysis. The first and second analyses confirmed the direct transformation of caoxite into whewellite without an intermediate weddellite [Ca(C2O4)·2H2O] stage. Infrared spectra obtained from caoxite, weddellite and whewellite emphasize the similarity of the O–H-stretching band and O–C–O-stretching band in whewellite and caoxite and the unique bands of weddellite. The structure refinement at low temperature (123 K) reveals that all the hydrogen atoms of whewellite form hydrogen bonds and the two water molecules prop up the crystal structure by the hydrogen bonds that cause a strong anisotropy of the displacement parameter.
Comparing the structural features of whewellite with those of weddellite and caoxite suggests that caoxite and whewellite have a sheet structure consisting of Ca2+ ions and oxalate ions although weddellite does not. It is additionally confirmed that the sheets of caoxite are corrugated by hydrogen bonds but whewellite has flat sheets. The corrugated sheets of caoxite would be flattened by dehydration so the direct transformation of caoxite into whewellite would not occur via weddellite. Essential for this transformation is the dehydration of interlayered water molecules in caoxite leading to the building of the crystal structure of whewellite on its intralayered water molecules. The difference in conformation of water molecules between those two crystal structures may explain the more common occurrence of whewellite than of caoxite in nature.
Europium LIII-edge X-ray absorption near-edge structure (XANES) was employed to determine the Eu(II)/Eu(III) ratios in minerals. This ratio can be determined based on the peak-area ratio of white lines, the resonance peak, in normalized XANES spectra for Eu(II) and Eu(III) species. For precise determination of the Eu(II)/Eu(III) ratios, however, it was revealed that the transition probabilities for each individual Eu(II) and Eu(III) species in the system must be quantified, because we found that the peak area in normalized XANES spectra is different in each Eu(II) and Eu(III) species. Despite this ambiguity, the method was applied to Eu in natural hydrothermal apatites (Eu = 39 and 64 ppm) and fluocerite (Eu = 282 ppm). The relationship between the Eu(II)/Eu(III) ratio in these hydrothermal minerals, and the distribution coefficients of Eu(II) and Eu(III) were discussed, taking into account Eu anomalies in their REE patterns. It is considered that by combining the Eu(II)/Eu(III) ratios determined by XANES and the degree of Eu anomaly in REE patterns, we can provide new information on the distribution of Eu(II) and Eu(III) in various geochemical studies.
Several studies have reported association of altered levels of lipids and some trace elements with risk factors for cardiovascular disease development in adulthood. Accordingly, the present study aimed to determine the relationship among the serum levels of copper (Cu), zinc (Zn), lipids, lipoproteins and apolipoproteins in preterm infants through an assessment of atherogenic indices shortly after birth. Blood samples were collected within 20 min of birth from 45 preterm infants with gestational ages ranging from 32 to 35 weeks. Serum Cu, Zn, total cholesterol (TC), low-density lipoprotein cholesterol (LDLc), high-density lipoprotein cholesterol (HDLc), apolipoprotein-A1 (apoA1) and apolipoprotein-B (apoB) levels were measured, and the TC/HDLc, LDLc/HDLc and apoB/apoA1 ratios were calculated. Upon determining the correlation between the levels of Cu, Zn and these indices of lipid metabolism, triglyceride (TG) and Cu were found to correlate negatively with birth weight (BW) and the standard deviation (s.d.) score for body weight. Furthermore, Cu levels correlated positively with the TG level and TC/HDLc, LDLc/HDLc and apoB/apoA1 ratios and negatively with the HDLc level and HDLc/apoA1 ratios. However, a stepwise multiple regression analysis indicated that the s.d. score for BW and TG level were significant independent determinants of the Cu level. In contrast, Zn did not correlate with any of these indices. In conclusion, intrauterine growth restriction and the TG level at birth influence Cu levels in preterm infants, whereas atherogenic indices do not affect this parameter.
The Fukushima Daiichi and Daini Nuclear Power Plant workers experienced multiple stressors as both victims and onsite workers after the 2011 Great East Japan Earthquake and subsequent nuclear accidents. Previous studies found that disaster-related exposures, including discrimination/slurs, were associated with their mental health. Their long-term impact has yet to be investigated.
Method
A total of 968 plant workers (Daiichi, n = 571; Daini, n = 397) completed self-written questionnaires 2–3 months (time 1) and 14–15 months (time 2) after the disaster (response rate 55.0%). Sociodemographics, disaster-related experiences, and peritraumatic distress were assessed at time 1. At time 1 and time 2, general psychological distress (GPD) and post-traumatic stress response (PTSR) were measured, respectively, using the K6 scale and Impact of Event Scale Revised. We examined multivariate covariates of time 2 GPD and PTSR, adjusting for autocorrelations in the hierarchical multiple regression analyses.
Results
Higher GPD at time 2 was predicted by higher GPD at time 1 (β = 0.491, p < 0.001) and discrimination/slurs experiences at time 1 (β = 0.065, p = 0.025, adjusted R2 = 0.24). Higher PTSR at time 2 was predicted with higher PTSR at time 1 (β = 0.548, p < 0.001), higher age (β = 0.085, p = 0.005), and discrimination/slurs experiences at time 1 (β = 0.079, p = 0.003, adjusted R2 = 0.36).
Conclusions
Higher GPD at time 2 was predicted by higher GPD and discrimination/slurs experience at time 1. Higher PTSR at time 2 was predicted by higher PTSR, higher age, and discrimination/slurs experience at time 1.
Glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) are the incretin hormones secreted from the intestine in response to enteral feeding to stimulate insulin secretion. We investigated the relationship serum GIP and GLP-1 levels with gestational age, and insulin secretion in preterm infants. Serum GIP and GLP-1 levels were measured at birth and at 1, 2 and 4 weeks after birth in 30 infants, including 12 born before 30th week of gestation (early group) and 18 born after 30th week of gestation (late group). Blood glucose and serum insulin levels were measured, and the quantitative insulin sensitivity check index (QUICKI) was also calculated. The levels of GLP-1 at 2 and 4 weeks were significantly higher in the early group than those in the late group. The levels of GIP were not significantly different between two groups. At 4 weeks, serum insulin level was significantly higher and QUICKI was significantly lower in the early group. Furthermore, GLP-1 levels were significantly correlated with QUICKI and the serum insulin levels in all infants at 4 weeks. In preterm infants, enteral feeding to premature intestine may be associated with GLP-1 secretion. GLP-1 is also related to stimulated insulin secretion in early postnatal period.
To determine the characteristics of acute phase nystagmus in patients with cerebellar lesions, and to identify a useful indicator for differentiating central lesions from peripheral lesions.
Methods:
Acute phase nystagmus and the appearance of neurological symptoms were retrospectively investigated in 11 patients with cerebellar stroke.
Results:
At the initial visit, there were no patients with vertical nystagmus, direction-changing gaze evoked nystagmus or pure rotatory nystagmus. There were four cases with no nystagmus and seven cases with horizontal nystagmus at the initial visit. There were no neurological symptoms, except for vertigo and hearing loss, in any cases at the initial visit. The direction and type of nystagmus changed with time, and neurological symptoms other than vertigo appeared subsequently to admission.
Conclusion:
It is important to observe the changes in nystagmus and other neurological findings for the differential diagnosis of central lesions.
We previously reported an association between human parechovirus type 3 (HPeV3) and epidemic myalgia with myositis in adults during summers in which an HPeV3 outbreak occurred in children. However, this disease association has not yet been reported elsewhere. We have since continued our surveillance to accumulate data on this disease association and to confirm whether myalgia occurs in children as well as adults. Between June and August 2014, we collected 380 specimens from children with infectious diseases. We also collected clinical specimens from two adult and three paediatric patients suspected of myalgia. We then performed virus isolation and reverse-transcription–PCR using the collected specimens. We detected HPeV3 in 26 children with infectious diseases, which we regarded as indicating an outbreak. We also confirmed HPeV3 infection in all patients suspected of myalgia. In particular the symptoms in two boys, complaining of myalgia and fever, closely matched the criteria for adult myalgia. Based on our findings from 2008, 2011 and 2014, we again urge that clinical consideration be given to the relationship between myalgia and HPeV3 infections during HPeV3 outbreaks in children. Furthermore, our observations from 2014 suggest that epidemic myalgia and myositis occur not only in adults but also in children.