Six recurrences of myocarditis in 3 years: A case report

A recent study revealed that recurrence of myocarditis occurs in a significant proportion of patients, but multiple recurrences of myocarditis have rarely been reported. The pathophysiology and best treatments for multiple recurrences of myocarditis remain unclear. A 60-year-old man presented to our emergency department with fever and chest pain. Physical examination, imaging, and laboratory findings were consistent with fulminant myocarditis. Paired titers confirmed adenovirus infection. The patient was treated with intra-aortic balloon pump and percutaneous cardiopulmonary support for 7 days and was discharged with near-normal electrocardiographic and echocardiographic findings on day 26. Over the subsequent 3 years, the patient experienced six episodes of recurrence of myocarditis with a progressive decrease in his ability to perform activities of daily living. At the time of his sixth recurrence, he died of ventricular fibrillation. Autopsy revealed mild enlargement of the left ventricle, extensive inflammatory cell infiltration, and mild interstitial fibrosis, suggesting left ventricle remodeling because of repetitive myocarditis. We have presented a case of multiple recurrences of myocarditis. This is the largest number of recurrences in a single patient reported to date. Further studies are needed to elucidate the underlying pathogenesis and best treatment of this condition. <Learning objective: Although few cases of multiple recurrent myocarditis have been reported, we recently experienced a case of multiple recurrences of myocarditis over a 3-year period. However, we did not definitively diagnose the etiology of myocarditis or perform etiologically based medical therapy, so we could not rescue our patient. In cases of multiple recurrent myocarditis, more aggressive and accurate investigation are required to elucidate the etiology and pathophysiology of this condition.>.

Increased collagenase activity in macrophages from bronchial lavage as a diagnostic marker of non-small cell lung cancer

BACKGROUND

The roles of matrix metalloproteinases (MMPs) in cancer metastasis have been studied. Macrophages are considered to release MMPs in the tissues of patients with lung cancer.

METHODS

Intracellular collagenase activity was measured in CD14+ CD45+ cells from bronchial lavage fluid to establish a new diagnostic tool for lung cancer. Between August 2000 and November 2001 bronchoscopy and bronchial lavage were performed in 45 patients with abnormal shadows on the chest radiograph; 21 had lung cancer and 24 had non-malignant disease.

RESULTS

Collagenase activity in patients with primary lung cancer (5.54 (0.65)) or non-small cell lung cancer (NSCLC) (5.62 (0.71)) was significantly higher than in those with non-malignant disease (3.63 (0.78), p=0.006 and p=0.008, respectively). Only three of 18 patients in the low activity group were diagnosed as having cancer compared with 18 of 27 in the high activity group (p=0.001). This significance was not seen in non-smokers but it was apparent in smokers/ex-smokers. Excluding non-smokers improved the specificity of collagenase activity in differentiating cancer and non-malignant disease from 62.5% to 80.0%. The sensitivity of the test was 85.7% in all patients and 88.2% in smokers/ex-smokers.

CONCLUSIONS

Measurement of intracellular collagenase activity in macrophages in bronchial lavage fluid is a useful diagnostic tool for distinguishing between cancer and non-malignant diseases, especially in smokers and ex-smokers.

[The effect of negative emotion on eyewitness functional field of view]

This study examined whether the functional field of view was shrunk by negative emotion. The functional field of view was determined in terms of the number detection task, in which a number presented for a brief exposure peripherally in one of the four video screen corners. Participants watched either negative emotional or neutral event on the screen. Emotion was evaluated by means of self-ratings of mood adjective checklist, and the results showed that tensional arousal increased in participants who watched the negative emotional event. After watching the video participants were asked to report whether they noticed the number. Participants who watched the emotional event were able to detect fewer numbers than participants who watched the neutral event. This result suggests that the functional field of view shrank because of negative emotion. Peripheral memory decrement reported in previous studies might be due to the shrinkage of the functional field of view.

[Effects of impression of faces on recognition of changes in face arrays: addition versus deletion]

A study was conducted examine whether the asymmetric confusability effect was generalized to an array of face photographs, and furthermore to investigate how the impression of faces affected the recognition of addition and deletion of the faces. In a preliminary investigation, 27 subjects rated the impression of 83 face photographs, and the photographs to be used in the present study were chosen on the basis of the impression scores. In the study, 40 subjects saw 14 photographs consisted of three or four faces and took a recognition test of unchanged photographs and changed photographs with a specific face added or deleted. The data showed that (a) the addition superiority was not found in the recognition of changes in face arrays; (b) the impression of faces differentially affected the recognition of addition and deletion changes in face arrays. These results suggest that the mechanism underlying the recognition of the deletion of a face may be different from that of addition.

Verification of impression of voice in relation to occupational categories

The present study examined how personality traits, physical characteristics, and occupational categories derived from listening to human voices are related to each other. Stimuli were 25 tape-recorded male vocal samples. In Study 1, 114 undergraduate and graduate students rated each of the 25 voices on 22 personality traits and 11 vocal characteristics. Participants were also given a list of 34 occupational categories from which they selected one suitable occupational category for each of the 25 voices. Of 34 occupations, 20 occupations selected most frequently were used in Study 2 wherein 90 junior college students rated the voices on the 20 occupational categories. Factor analyses produced three factors for personality characteristics, for vocal characteristics, and for occupational categories. Also, significant correlations among those factors (both positive and negative) indicated participants consistently attributed particular personality and vocal characteristics to specific voices and assigned those voices to particular occupational categories. Stereotypical perception of voices is discussed in terms of earwitness identification.

[Asymmetric confusability effects in recognition memory of line drawings]

Experiment 1 and 2 examined the effect of addition or deletion changes in a picture recognition test. Addition and deletion applied to original pictures were referred to deviation change, and addition to deleted pictures or deletion from added pictures was referred to restoration change. In Experiment 1 (n = 40), elaborative detailed information contained in line drawings of scenes was changed whereas one of major features in a single object was changed in Experiment 2 (n = 36). In the test phase, participants indicated whether each test picture was changed or not from the picture they had seen in the study phase. Deviation change had a greater effect on detection performance than restoration only in Experiment 2. Additions were easily detected than deletions only in deviation change in Experiment 2. In Experiment 3, 51 participants rated impression of added or deleted pictures used in Experiment 2. Impression of added pictures was significantly different from that of deleted in 3 factors. These results suggest that superiority of additions over deletions might be due to their different impression change.

Asymmetric effects on recognition of animate objects by children

The present study examined the effects of type of change in a picture (addition or deletion), and the effects of presentation time on children's recognition of animate objects (butterflies and cats). Five- or 6-yr.-old children viewed original pictures in a learning phase for 6 or 10 sec., and then they viewed in a test phase originals and altered pictures in which features were added to or deleted from original pictures. They were required to answer whether test stimuli had been seen before. Analysis showed that, although children discovered added features more frequently than deleted features in pictures of butterflies, they discovered deleted features more frequently than added features in pictures of cats (asymmetric recognition). Asymmetric recognition was not influenced by stimulus presentation time. Although asymmetric recognition was observed in children and adults for pictures of butterflies and cats, the feature for which alterations affected recognition was different. These results indicated that children process information about animate objects differently from that about inanimate objects and specifically by kind (domain-specific). The features to which children pay attention may change with development (age).

[Asymmetric confusability effect in recognition memory of cats pictures]

Performance superiority of the addition of features in the stimuli over the deletion on recognition (asymmetric confusability effect) has been shown in previous studies (Pezdek, Maki, Valencia-Laver, Whetstone, Stoeckert, & Dougherty, 1988; Ando & Hakoda, 1998). We investigated the same effect by using a familiar living thing (cat) as a stimulus. Ten subjects were given a recognition task using pictures of cats with feature changes (additions, deletions, or no change). Results showed that the picture with deletions were easier to recognize than those with additions, which was opposite to the previous studies. Then, we examined the possibility that performance superiority of the deletions over the additions was mediated by the factor of impression. Another group of 18 subjects was asked to rate the impression scales consisting of a "typicality-reality factor", a "stability-balance factor", and a "grotesque-disgust factor". Results showed that there was a significant difference in impression ratings for each factor between the additions and the deletions, and that impression ratings predicted recognition performance well. It was concluded that performance superiority of the deletions over the additions was mediated by the factor of impression.

Addition and deletion of objects on memory for composition of scenes

The present study examined the effect of addition and deletion of stimuli to the current environment on perceivers' performance of memory task. Further, the robustness of the asymmetric effects of addition and deletion was investigated. 48 objects in a room were grouped into four schematically consistent or inconsistent conditions. In the experiment, participants viewed a series of an original scene and a target scene with the placement of an object changed from the original scene before the recall and the recognition tasks. Participants were asked whether they noticed change from the original scene to the target scene. The recall tasks were performed both verbal and written. In the recognition task, each of the 24 objects (17 objects were actually present in the scene, but seven were not) was visually presented on the computer display along with confidence ratings. Analysis showed that participants were more likely to recall placement of objects classified as highly expected and highly salient according to an hypothesized schema of placement. There was also a significant effect of addition on recall performance when objects were classified as low in expectation but highly salient were added to the target scene. The effects of addition on schema-inconsistent information were discussed in terms of informativeness of the information.

[Asymmetric confusability effects in recognition memory of butterfly pictures]

The relation between recognition of butterfly pictures involving feature changes (additions, deletions, or no change) and discordance to expectation for those pictures was examined. The addition of deletion of features was applied to original butterfly photographs to generate changed pictures. Forty subjects were asked to rate the discordance of these pictures to expected butterflies. Other subjects were shown original pictures and then given a recognition test of original pictures and changed pictures with features added or deleted. The results showed that (a) additions or deletions increased discordance more markedly than no changes; (b) additions were easier to correctly rejected than deletions; and (c) recognition performance was not dependent on discordance. It was concluded that addition superiority over deletion was not mediated by the factor of discordance to expectation.

[Effect of weight of feature and frequency on recognition of butterfly patterns]

Three experiments are reported which deal with the nature of categorization of natural objects. Stimulus materials were schematic butterfly patterns. Systematic transformations were given to the original pattern to make stimulus instance. In Experiment 1, subjects were given a recognition memory task with recognition ratings. Recognition ratings were found to be related to family resemblance score (FRS: the sum of feature frequency in the category) rather than to transformation or subjective similarity to the original. In Experiment 2, subjects were given the recognition memory task while the FRS was kept constant. Weight of each feature affected recognition ratings differently, when FRS was kept constant. In Experiment 3, subjects were given the same task as in Experiment 2 while the FRS and the component frequency of each feature were kept constant. Again each feature affected recognition ratings differently. These findings suggest that both the frequency and weight of feature itself affect recognition ratings.

[Recognition and categorization of butterfly patterns]

Two experiments are reported which deal with the nature of categorization of visual patterns. Stimulus materials were schematic butterfly patterns. Systematic transformations of five physical features (fore wing, hind wing, size, body length and color) were applied to a prototype to generate a set of instances. In Experiment 1, subjects were asked to judge the visual similarity between each instance and the prototype. Similarity ratings were found to be related to an each instance's transformational distance from the prototype. In Experiment 2, subjects were exposed to a subset of instances of the pattern which varied in their transformational distance from the prototype, and then given a recognition test with confidence ratings. The recognition item consisted of the old and new instances including the prototype. Recognition ratings were found to be related to each instance's family resemblance score rather than its transformational distance and subjective similarity to the prototype. These results support Rosch and Mervis's family resemblance model of categorization.

[Schizophrenia and reverse-Stroop interference in the group version of the Stroop and reverse-Stroop test]

Previous studies showed that attentional task performance of schizophrenics was significantly inferior to that of normals. The classical Stroop Color-Word Interference Test is an example of such attentional tasks and performance on the "reverse" Stroop task is reported to discriminate schizophrenics from normals better than the regular Stroop task. These results suggest that schizophrenics are more susceptible to "reverse" Stroop interference in reading incongruent word-color combinations than normals. The group version of the Stroop and reverse-Stroop Color-Word Test, where the response is to choose a matching alternative, was used to test the hypothesis. The results virtually supported the hypothesis. In addition, interference was closely related to the patient's control of impulsiveness. It was suggested that schizophrenics have generation (or translation) deficits between different codes.

[On the relation between prototype abstraction and exemplar retention in the memory of melodies]

This study examined the relation between prototype abstraction and exemplar retention by using memory of melodies. Acquisition lists of melodies were constructed by applying a set of transformation rules to a fixed prototype melody (cf. Welker, 1982). Immediately after the presentation of acquisition list, recognition task was performed. The recognition rating for prototype was used as the indicator of the prototype abstraction. The discriminability of old melodies from new melodies (d') was used as the indicator of exemplar retention. In Exp. 1 with 30 undergraduates as subjects, the transformational distance of acquisition list was varied and it was demonstrated that as the transformational distance decreased, prototype abstraction was facilitated but exemplar retention was not changed. In Exp. 2 with 90 undergraduates as subjects, the number of presentation of each melody and the kinds of melodies in acquisition list were varied. Results demonstrated that as the number of presentation of each melody increased and also as the kinds of melodies decreased, the exemplar retention improved but prototype abstraction was not changed. It was argued that the systems underlying the prototype abstraction and exemplar retention were functionally independent of each other.

[Two kinds of interference in visual information processing (author's transl)]

An original stimulus (OS) containing three letters in a three by three matrix was briefly presented and followed, after various interstimulus intervals (ISIs), by an interpolated stimulus (IS) containing mask patterns. The exposure of IS impaired severely both position and identity recalls when ISIs were shorter than 20 ms. At longer ISIs, mere exposure of IS did not impair recall of OS, but, if the subjects were asked to make the recall, recognition, or reversal recall of IS before the recall of OS, these tasks caused the selective loss of position information of OS. The results suggested that visual backward masking originates in iconic storage, and visual retroactive interference originates in retrieval process from the visual short-term store.