Utility of VSRAD for diagnosing Alzheimer's disease in patients screened for dementia

Objective

To investigate the utility of the voxel-based specific regional analysis system for Alzheimer’s disease (VSRAD).

Methods

Clinical data from patients who underwent screening for dementia using VSRAD and the Japanese version of COGNISTAT, the Neurobehavioral Cognitive Status Examination, were retrospectively investigated to specify the domains of cognitive function that correlate with the statistical mean value of positive Z-scores in the target volume-of-interest (VOI). A receiver operating characteristic (ROC) curve was constructed to assess the mean value of positive Z-scores in discriminating patients with AD.

Results

A total of 72 patients were included (18 male and 54 female; 15 patients with AD). The mean value of positive Z-scores in the target VOI was significantly correlated with standardized COGNISTAT scores for Orientation and Memory in all patients (r = –0.35 and –0.38, respectively). ROC curve analysis revealed that a cut-off of 1.57 for mean value of positive Z-scores in the target VOI provided 69.4% accuracy in discriminating patients with AD, with a sensitivity of 0.80 and specificity of 0.67.

Conclusions

The results evinced the value of VSRAD in diagnosing AD. The degree of atrophy represented by the target VOI may reflect impairments in Orientation and Memory, which are early stage symptoms observed in AD.

Evaluation of biocompatibility of mineral trioxide aggregate with an improved rabbit ear chamber

In the present study, the biocompatibility of mineral trioxide aggregate (MTA) to the revascularization of the connective tissues was evaluated by using the improved rabbit ear chamber, in vivo. Twenty improved rabbit ear chamber was prepared from 12 male albino-rabbit by using a well through which a material could be introduced into the living vascular tissue. Ten chambers were provided for MTA, and the remaining 10 chambers were used for a calcium hydroxide-containing root canal sealer (Sealapex), as a comparator. A volume of about 1.5 mm(3) of the materials were inserted into the chamber and the interaction between the vascular tissue and materials was observed by using a biomicroscope immediately after application, at 1, 3, 5.5, 8, 24, 48, 72 h, and once a week up to 4 weeks. The results revealed that revascularization of connective tissue took place with complete recovery of microcirculation within 4 weeks in both MTA and Sealapex. However, the precipitate-barrier and brown zone around periphery of Sealapex was not observed in MTA treated samples. It can be concluded that MTA is biocompatible and does not produce any adverse site effect on microcirculation of the connective tissue.

Factors affecting peak bone density in Japanese women

Both genetic and environmental factors have been shown to contribute to the determination of bone density. To clarify the interaction between genetic and environmental factors affecting peak bone mass, we investigated the correlation between bone mineral density (BMD) and physical constitution, vitamin D receptor (VDR) genotype, age, age of menarche, history of menstrual dysfunction, and exercise in 157 healthy young Japanese women. History of exercise and menstrual dysfunction were significant independent predictors of BMD. The VDR genotype also affects peak bone density. Exercise has been shown to increase BMD in a similar way for each VDR genotype including those women who have the particular genotype associated with low bone density. This data indicate that there are complex gene-environmental interactions particularly in relation to menstrual history, exercise, and genetic factors during childhood/adolescence that may have implications for the development of adult BMD in women.

Nephropathy and hypertension as manifestations in a 13-y-old girl with primary antiphospholipid syndrome

Severe renal hypertension due to both unilateral renal arterial occlusion and renal thrombotic microangiopathy developed in a 13-y-old girl as a manifestation of primary antiphospholipid antibody syndrome. The combination of the intravenous high-dose urokinase therapy and oral anticoagulation therapy, comprising aspirin, warfarin and dipyridamole, was significantly effective in improving her renal function and preventing thrombotic events during an 18-month follow-up period.

Lingual cyst in infancy: importance of palpation for diagnosis

Two infants, 5 and 12 weeks of age, with lingual cysts were presented. Histological findings were compatible with a salivary retention cyst in one and a thyroglossal duct cyst in the other. Both infants were admitted to our hospital because of severe stridor that had developed from one to two weeks of age. Their lingual cysts were easily recognizable by simple palpation and were confirmed by non-invasive imaging techniques, such as ultrasound sonography, computed tomography and magnetic resonance imaging. Lingual cyst in infancy may be large enough to cause stridor and dyspnea, and occasionally result in sudden infant death, although once diagnosis is made a radical operation can be easily performed. Therefore, it is important that palpation in the oral cavity should be performed with all infants with persistent stridor as a part of a physical examination.

Human herpesvirus-6 (HHV-6)-associated hemophagocytic syndrome

Virus-associated hemophagocytic syndrome (VAHS) is characterized by histiocytic proliferation and phagocytosis triggered by virus infections. Viruses in the herpes group, especially the Epstein-Barr virus (EBV), are well known to cause VAHS; however, the relationship between this syndrome and human herpesvirus-6 (HHV-6) infection has rarely been reported. In this study, we describe a 23-month-old girl who exhibited typical manifestations of VAHS associated with HHV-6 infection. To the best of our knowledge, this case is the fifth reported case in the English literature.