Search

The aim of this study was to compare the neuropsychological functioning and symptoms of female and male high school athletes following a single concussion during the school year. The baseline test scores of the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) of 309 concussed athletes (169 females, 221 males) in varied sports were obtained. After a sport-related concussion, the athletes were re-administered the ImPACT, on the average, 7.25 days after the injury. MANCOVA compared the ImPACT baseline scores, post-concussion scores, and baseline-to-post-concussion changes of the female and male athletes, with p set at 0.01. The only significant sex comparison found females performing better on baseline visual motor speed (p < 0.001). Otherwise, no sex differences were found in baseline test scores, post-concussion scores, and baseline-to-post-concussion changes. The findings tentatively suggest that there are insignificant sex differences in the consequences of sport-related concussion after a week post-injury. Future studies on sex comparisons after a concussion are needed focusing on the acute and sub-acute phases of the recovery period.

Japan is one of the most earthquake-prone countries in the world, as well as experiencing other natural disasters arising from its geography, physiography and weather. The country has frequently experienced major disasters and it has been pointed out that it could be struck by large-scale earthquakes in the future, in areas such as the Nankai trough and Chishima trenches, and directly below Tokyo. Against this backdrop, the Japan Water Works Association (JWWA) has used its organizational strength to develop a mutual support system for recovery from disasters. In this paper the mutual support system's mechanism is described with an explanation of how JWWA developed it through its activities in recent disasters like the Great East Japan and Kumamoto earthquakes, in 2011 and 2016 respectively.

Introduction Cases of developing prostate cancer during hormone therapy for late-onset hypogonadism syndrome are rare. Objective We report a case of prostate cancer that developed and died during hormone therapy for late-onset hypogonadism syndrome. Case A 63-year-old man was diagnosed with depression around 2010. In 2011, he visited a private urologic clinic with complaints of depression and decreased libido, and was started on androgen replacement therapy (ART) with a diagnosis of late-onset hypogonadism (LOH) syndrome. His PSA was 0.87 ng/mL in 2012, but was 3.335 ng/mL at the time of his 2017 municipal checkup. He continued to receive hormone injections every 1-2 months, but his PSA was not retested. In August 2018, he had difficulty in urination and visited his local physician, who referred him to our hospital because of a markedly elevated PSA of 213.3 ng/mL. Prostate biopsy showed adenocarcinoma, Gleason score 5+4, and CT scan showed supraclavicular, mediastinal, and retroperitoneal lymph node metastases. He underwent maximal androgen blockade therapy with castration and bicalutamide. He died after PSA failure despite chemotherapy and other treatments. Conclusions There is no evidence that ART, which is the main treatment for LOH syndrome, directly causes prostate cancer. In this case, a rapid increase in PSA was observed during ART treatment, which may indicate that the treatment caused latent prostate cancer to become apparent, resulting in a rapid increase in PSA. However, in this case, the detection of prostate cancer might have been delayed because PSA levels, which were required during ART treatment, were not measured regularly. In addition, the psychiatric symptoms of LOH syndrome are similar to those of depression, and it is difficult to differentiate them. When there is a history of depression, as in this case, a more careful diagnosis and treatment strategy are required. Disclosure Work supported by industry: no.

Concussions have become a public health issue. This public health concern has drawn the attention of many states in which laws were created to address concussions safety, recognition of signs and symptoms, immediate removal, medical clearance, and return-to-play protocols. Most state legislation focused on student athletes participating in organized sports. However, the rise in concussion can be directly attributed to children, youth, and adolescents participating in nonsports-related events. Maximizing recovery from a concussion involves implementing education programs that focus on recognition of symptoms, treatment, and return-to-learn options. Treatment strategies used to address concussed youth include physical and cognitive rest and minimizing external stimuli that can increase symptoms. Because learning is a direct outcome for all youth, a return-to-learn protocol based on a collaborative school-based team approach is suggested.

Objective This study was designed to determine concussion incidence, risk, and relative risk among middle and high school athletes participating in various sports. Method Data were retrospectively obtained from 10,334 athletes of 12 different sports in Hawaii. In addition to determining the overall concussion incidence, comparisons of incidence, risk, and relative risk were made according to age, sex, concussion history, sport, and football position. Results The overall incidence of concussion among youth athletes was 1,250 (12.1%). The relative risk for a concussion was almost two times greater in 18-year olds than in 13-year-old athletes. In comparable sports, girls had a 1.5 times higher concussion risk than boys. Athletes with a prior concussion had 3-5 times greater risk to sustain a concussion than those with no history of a concussion. Among varied sports, wrestling and martial arts had the highest relative risk of a concussion, followed by cheerleading, football, and track and field. No differences in concussion risks were found among the football players in different positions. Conclusions Older youths, females, those with a history of concussion, and those participating in high contact sports were found to have higher risks of sustaining a concussion. The findings increase awareness of concussion patterns in young athletes and raise concerns regarding protective strategies and concussion management in youth sports.

Objective The aim of this research was to examine the role of native language in the performance of youth athletes on a computerized neuropsychological test battery, the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT). Method The study compared the baseline test scores of 5545 participants whose native language was English versus 195 whose native language was not English. The mean age of the participants was 15.06 years. Results A multivariate analysis of variance revealed no differences in the five ImPACT Composite scores of the two language groups. Conclusion Contrary to prior research, one cannot simply expect that non-native English speakers will do more poorly on ImPACT than native English speakers. Further research on the use of ImPACT with other non-native English-speaking youth athletes is recommended.

The aim of this study was to examine the effects of head impact frequency on the neuropsychological test results of football players who participate in different positions on the team. Based on the biomechanical measures of head impact frequency reported in high school football, a High Contact group (n = 480) consisting of offensive and defensive linemen was compared with a Low Contact group (n = 640) comprised of receivers and defensive backs. The results revealed that the High Contact group obtained poorer performances on the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) on three Composite scores (Verbal Memory, Visual Motor Speed, Impulse Control) and the Total Symptom score compared to the Low Contact group. The present study is the first, to date, to report differences in the neuropsychological test performances of athletes who participate in high and low contact football positions. The findings raise tentative concerns that youth football players exposed to repetitive head trauma, including subconcussive impacts, may be at risk for lowered neuropsychological functioning and increased symptoms.

OBJECTIVE The aim of this research was to develop preliminary norms for the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) administered to a large sample of adolescent athletes from diverse ethnic backgrounds. DESIGN A retrospective records review. SETTING Middle and high school athletic departments. PARTICIPANTS A total of 5741 male and female adolescent athletes in Hawaii, aged 13 to 18 years, in grades 9 to 12 were included in the study. INDEPENDENT VARIABLES Age, sex, ethnicity, and sport. MAIN OUTCOME MEASURES ImPACT Composite scores (Verbal Memory, Visual Memory, Visual Motor Speed, Reaction Time, and Impulse Control) and Total Symptom score from baseline testing. RESULTS The results indicated statistically significant differences between age and sex groups, as well as between ethnic and sport groups. CONCLUSIONS The findings support the continued use of stratified norms for age and sex for ethnically diverse adolescent athletes. Comparisons of ethnic and sport groups deserve further investigation. When baseline scores are not available for postconcussion comparison, present observations tentatively support the cautious use of standard ImPACT norms with ethnically diverse athletes.

The aim of this large-scale research was to determine the frequency of valid, invalid, and sandbagging results in ImPACT baseline testing of high school athletes. This retrospective study identified valid, invalid (identified by five embedded Invalidity Indicators), and sandbagging (identified by three "red flags") results in the ImPACT baseline test scores of 6,346 high school athletes. In addition, the ImPACT postconcussion scores of 266 athletes who sustained a concussion during the school year were evaluated to compare the baseline-to-postconcussion changes of valid versus a combined group of invalid and sandbagging scorers. There were 3,299 (51.99%) athletes who had valid baseline scores, 269 (4.24%) had invalid scores, and 3,009 (47.42%) had sandbagging scores. (There were 231 who obtained both invalidity and sandbagging scores.) The overall difference in baseline-to-postconcussion changes between the valid scorers and the combined group of invalid and sandbagging scorers was statistically significant. The high rate of athletes who had invalid and sandbagging scores raised concern that the underperformance of baseline testing occurs more commonly than is probably realized by those who utilize computerized neuropsychological testing with high school athletes. Accordingly, efforts are needed to improve test administration procedures so that maximal attention and effort can be maintained among the test takers. In the meantime, increased caution is called for in employing the baseline-to-postconcussion paradigm when return-to-play decisions are made.

The aim of this study was to examine the neuropsychological test results of non-concussed high school athletes playing at three different levels of contact sports. Based on the concussion risk data of 12 different sports, a High Contact group (n=2819; wrestling/martial arts, cheerleading, track and field, football), a Moderate Contact group (n=2323; softball, basketball, soccer), and a Low Contact group (n=1580; baseball, volleyball, water polo, tennis, cross-country) were formed and compared in terms of their scores on the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). The results revealed that the High Contact group obtained small but statistically poorer performances in ImPACT Visual Memory, Visual Motor Speed, Impulse Control, and Total Symptom scores compared to the Moderate and Low Contact groups. The High Contact group also had poorer Reaction Time scores compared to the Low Contact group. No differences between the Moderate and Low Contact groups were noted. The findings, along with prior similar results, tentatively raise concerns that participant in high contact sports, exposed to repetitive subconcussive head trauma, may be at greater risk for lowered neuropsychological functioning and increased symptoms, compared to other high school athletes. In view of the preliminary nature of this investigation, more research into the effects of frequent head impacts in high school sports is strongly recommended.

To assess the effects of two sports-related concussions on neuropsychological functioning and symptom reporting, the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) was administered to 483 high school athletes. Three groups of athletes were determined based on the number of previous concussions: no concussion (n = 409), 1 concussion (n = 58), and 2 concussions (n = 16). The results showed that the three groups did not differ in terms of their ImPACT composite scores (Verbal Memory, Visual Memory, Reaction Time, and Processing Speed) and the Total Symptom Score. As there are only a few studies that have reported the sequelae of 2 concussions in high school athletes, it is premature to declare that a repeated concussion does not have persistent neurocognitive effects on high school athletes.

Hydrogenated amorphous silicon ( a -Si) and microcrystalline silicon ( μc -Si) films were grown in atmospheric-pressure (AP) He/H 2 /SiH 4 plasma excited by a 150-MHz very high-frequency (VHF) power at a temperature of 220 °C. The variations in thickness and crystallinity of the deposited Si films along the gas flow direction were studied as functions of gas residence time in the plasma, VHF power density and H 2 flow rate. Furthermore, the electrical characteristics of bottom-gate thin film transistors (TFTs) were investigated to evaluate the film quality. The results revealed that the chemical reactions both in gas phase and on the growing film surface were significantly enhanced in AP-VHF plasma, promoting phase transition from amorphous to microcrystalline in a time of the order of 0.1 ms. The performance of the TFTs showed that a -Si layers formed in the upstream portion of the plasma zone had reasonably good electrical property (field-effect mobility of approximately 2 cm 2 /V s) despite very high deposition rates around 20 nm/s. While μc -Si layers deposited in the downstream portion were very defective, which might come from the insufficient passivation of grain boundaries with a -Si tissues due to a too long gas residence time in the plasma. The precise control of gas residence time by adjusting the length of plasma will be effective for the phase control of Si films with desired quality.

Four Minnesota Multiphasic Personality Inventory-2 (MMPI-2) validity scales, the F Scale, Symptom Validity Scale (FBS), Henry-Heilbronner Index (HHI), and Response Bias Scale (RBS), were evaluated in 60 personal injury litigants who sustained a traumatic brain injury (TBI). Based on a modified Slick, Sherman, and Iverson ( 1999 ) diagnostic criteria for malingered neurocognitive dysfunction and utilizing test-effort measures embedded in standard neuropsychological testing, a group of 23 patients with probable invalid neurocognitive dysfunction (PI) and a comparable group of 37 patients with noninvalid neurocognitive dysfunction were identified and compared with respect to their MMPI-2 validity scale scores. Logistic regression analyses, receiver-operating characteristic curve and area under the curve analyses, as well as sensitivity, specificity, positive predictive value, and negative predictive value analyses all revealed that RBS performed better than F, FBS, and HHI in classifying PIs. The present results add to a number of recent studies that suggest that RBS is a useful predictor of symptom validity failure and probable neuropsychological malingering among litigating TBI patients. The study also encourages further research employing embedded test-effort measures in classifying invalid neurocognitive dysfunction per the Slick et al. diagnostic criteria.

This replication study re-examined the neuropsychological effects of participation in high and low contact youth sports. Modeled after a recently published investigation, two contact sport groups of participants ages 12 to 18 were formed based on the rate of concussion in their respective sport, with the assumption that more head impacts and neuropsychological effects occur in high contact sports that have a greater number of reported concussions as compared with low contact sports. The preseason baseline ImPACT neuropsychological test scores and symptom scores of non-concussed youth athletes in a High Contact Sport (football, n = 139) and a Low Contact Sport (basketball, baseball, soccer, wrestling, volleyball, paddling, and cheerleading, n = 57) were compared. The results revealed significantly poorer ImPACT test performances in visual motor speed and reaction time among high contact sport athletes compared to low contact sport athletes. No differences were found between the two groups in Verbal Memory, Visual Memory, and Total Symptom. These findings were identical to a recent study in which nonconcussed youth athletes in a high contact sport, that is, football, exhibited poorer neuropsychological test performance than their peers in low contact sports, that is, basketball, baseball, soccer, wrestling, and judo. This research replication verified the results of the prior study, and raises concerns that youth athletes exposed to repetitive head trauma may be at risk for lowered neuropsychological functioning, even without a reported concussive event.

This exploratory study was designed to examine the neuropsychological effects of sports-related head trauma-specifically, repetitive subconcussive impacts or head blows that do not result in a diagnosable concussion. The researchers compared the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) neurocognitive test scores of 2 groups of nonconcussed youth athletes (n = 282), grouped according to the frequency of concussions in their respective sports, with the assumption that more subconcussive impacts occur in sports in which there are more reported concussions. The results indicated that high-contact-sport (football) athletes had significantly poorer performance in processing speed and reaction time compared with athletes in low-contact sports (wrestling, soccer, baseball, judo, and basketball). This study into the effects of repetitive subconcussive head trauma tentatively raises concern that participation in high-contact sports, even without evidence of a diagnosable concussion, could result in lowered neuropsychological functioning among high school athletes. Limitations of this exploratory research effort are discussed.

Twelve high schools in Japan (of which six are in Fukushima Prefecture), four in France, eight in Poland and two in Belarus cooperated in the measurement and comparison of individual external doses in 2014. In total 216 high-school students and teachers participated in the study. Each participant wore an electronic personal dosimeter 'D-shuttle' for two weeks, and kept a journal of his/her whereabouts and activities. The distributions of annual external doses estimated for each region overlap with each other, demonstrating that the personal external individual doses in locations where residence is currently allowed in Fukushima Prefecture and in Belarus are well within the range of estimated annual doses due to the terrestrial background radiation level of other regions/countries. © 2016 IOP Publishing Ltd.

Neoadjuvant chemotherapy (NAC) and chemoradiotherapy have been shown to extend postoperative survival, and preoperative therapy followed by esophagectomy has become the standard treatment worldwide for patients with esophageal squamous cell carcinoma (ESCC). The Japan Clinical Oncology Group 9907 study showed that NAC significantly extended survival in advanced ESCC, but the survival benefit for patients with clinical stage III disease remains to be elucidated. We compared the survival rates of NAC and upfront surgery in patients with clinical stage III ESCC. Consecutive patients histologically diagnosed as clinical stage III (excluding cT4) ESCC were eligible for this retrospective study. Between September 2002 and April 2007, upfront transthoracic esophagectomy was performed initially and, for patients with positive lymph node (LN) metastasis in a resected specimen, adjuvant chemotherapy using cisplatin and 5-fluororouracil every 3 weeks for two cycles was administered (Upfront surgery group). Since May 2007, a NAC regimen used as adjuvant chemotherapy followed by transthoracic esophagectomy has been administered as the standard treatment in our institution (NAC group). Patient characteristics, clinicopathological factors, treatment outcomes, post-treatment recurrence, and overall survival (OS) were compared between the NAC and upfront surgery groups. Fifty-one and 55 patients were included in the NAC and upfront surgery groups, respectively. The R0 resection rate was significantly lower in the NAC group than in the upfront surgery group (upfront surgery, 98%; NAC, 76%; P = 0.003). In the upfront surgery group, of 49 patients who underwent R0 resection and pathologically positive for LN metastasis, 22 (45%) received adjuvant chemotherapy. In the NAC group, 49 (96%) of 51 patients completed two cycles of NAC. In survival analysis, no significant difference in OS was observed between the NAC and upfront surgery groups (NAC: 5-year OS, 43.8%; upfront surgery: 5-year overall surgery, 57.5%; P = 0.167). Patients who underwent R0 resection showed significantly longer OS than did those who underwent R1, R2, or no resection (P = 0.001). In multivariate analysis using age, perioperative chemotherapy, depth of invasion, LN metastasis, surgical radicality, postoperative pneumonia, and anastomotic leakage as covariates, LN metastasis [cN2: hazard ratio (HR), 1.389; P = 0.309; cN3: HR, 16.019; P = 0.012] and surgical radicality (R1: HR, 3.949; P = 0.009; R2 or no resection: HR, 2.912; P = 0.022) were shown to be significant independent prognostic factors. In clinical stage III ESCC patients, no significant difference in OS was observed between NAC and upfront surgery. Although potential patient selection bias might be a factor in this retrospective analysis, the noncurative resection rate was higher after NAC than after upfront surgery. The survival benefit of more intensive NAC needs to be further evaluated.

The effects of forensic examiner role on validity scores have rarely been studied empirically. We used a repeated measures design to examine the association between examiner role (plaintiff- and defense-selected neuropsychologists) and scores on eight Minnesota Multiphasic Inventory-2 validity scores (MMPI-2-VRIN, -TRIN, -L, -K, -F, -Fb, -Fp, and -FBS) of the same 80 individuals. All 80 were involved in litigation following mostly minor neurological injuries. We found no significant within-group differences on any of the MMPI-2 validity scales. Concordance of pass/fail rates between examinations was above 80%, except for MMPI-2-Fb. For example, the Symptom Validity Scale (MMPI-2-FBS) showed equivalently high failure rates (70%) during both examinations. This study does not support the view that examiner role affects symptom validity scores in forensic settings.

Validity scales of the Minnesota Multiphasic Personality Inventory—2 (MMPI-2) are widely used for the detection of exaggerated psychological complaints, although little is known about the results of these scales with racial or ethnic minority individuals. Five validity scales derived from the MMPI-2, including the F Scale, the Back Infrequency Scale, the Symptom Validity Scale, the Infrequency-Psychopathology Scale, and the Dissimulation Scale-MMPI-2, were evaluated in 157 medical patients—109 Caucasian Americans and 48 Asian Americans. All patients were involved in personal injury litigation or seeking compensation for alleged psychological conditions. Analyses of variance (ANOVAs) conducted on the five validity scales revealed no significant group effects for race. The results were consistent with the limited available data on the MMPI-2 validity scales with minority group samples. Further research with other racial minorities, including relevant extra-test criteria for malingering, is encouraged.

This research evaluated the 2-year test-retest reliability of the Immediate Postconcussion Assessment and Cognitive Testing (ImPACT) neuropsychological battery, and clarified the need for biennial updated baseline testing of high school athletes. This study compared the baseline test scores of 212 non-concussed athletes that were obtained in Grade 9 and again 2 years later when they were in Grade 11. Regression-based methods indicated that 4 of the 5 ImPACT scores were stable over 2 years, as they fell within the 80% and 95% confidence intervals (CIs). The results suggested that updating baseline testing for high school athletes after 2 years is not necessary. Further research into the consistency of computerized neuropsychological tests over 2 years with high school athletes is recommended.

The effect of depression and anxiety upon neuropsychological test scores of candidates for coronary artery bypass graft (CABG) surgery was examined. Sixty patients were administered the Beck Depression Inventory II and the State-Trait Anxiety Inventory, along with a battery of neuropsychological tests. Regression analyses were conducted in which the neuropsychological test scores were predicted using age, education, depression, anxiety, and combined depression-anxiety scores. While age and education were significant predictors of several neuropsychological test measures, no significant regression analysis results were obtained for the depression, anxiety and combined depression-anxiety scores. Similarities and discrepancies between this research and previous studies are discussed. It appears that low levels of preoperative depression and anxiety states do not affect neuropsychological functioning among CABG candidates.

Much has been written about stalking, especially when well-known figures have become victims of obsessive stalkers. In fact, the most likely objects of stalking are not famous persons or celebrities but ordinary citizens who feel rejected and angry after the breakup of an intimate relationship. Occasionally physicians and other health care professionals also become victims of stalking, although little has been reported about patients stalking doctors. This paper reviews the topic of stalking of clinicians and presents a case study of a plastic surgeon who became the object of a love obsessional patient, with erotomanic delusions. Guidelines for the risk management of stalking are discussed.

Five MMPI-2 validity scales were evaluated with 120 personal injury litigation patients (LP) and 208 clinical patients (CP) along with 43 normal participants (NP). The validity measures included the Fake Bad Scale (FBS), Infrequency scale (F), Back Infrequency scale (Eb), Infrequency-Psychopathology scale (F[p]), and the Dissimulation scale-2 (DA2). Results showed that only the FBS significantly differentiated the LP and CP, whereas the LP and CP scored significantly higher than the NP on FBS, F, Fb, and Ds2. The content of the FBS, with several items from the Hypochondriasis (Hs) and Hysteria (Hy) Scales, appears to enhance the FBS' ability to detect the somatic overreporting often observed with personal injury claimants. The authors suggest that the FBS may be a useful index of symptom magnification when employed within a comprehensive assessment of malingering in personal injury plaintiffs.

Growth hormone (GH) is known to interact with adipose tissue and to induce lipolysis. Adipocytes produce leptin which regulates appetite and energy expenditure. In order to elucidate the role of GH in leptin production, we studied the effect of GH on leptin gene expression and body fat in fatty Zucker rats, a model of obesity with resistance to both leptin and insulin. Recombinant human GH administered subcutaneously at 0.5 mg/kg per day (low dose) as well as at 1.65 mg/kg per day (high dose) reduced leptin mRNA levels in epididymal fat tissue but not in subcutaneous fat tissue after 7 days. GH administration only at the high dose reduced percentage body fat. Insulin-like growth factor-I infusion (200 microg/kg per day) did not change percentage body fat or leptin mRNA levels in epididymal fat. These observations suggest that GH directly interacts with adipose tissue and reduces leptin gene expression in visceral fat tissue.

A large Faraday rotation is reported for Rh4+-substituted magnetic garnets in the near-infrared wavelength region. The Faraday rotation at 0.9 μm is about seven times larger than that in yttrium iron garnet by substituting Rh4+ ions of only 0.13 per formula unit at room temperature. From the electronic state calculations of a (Rh4+O62−)8− octahedral cluster performed by using an unrestricted self-consistent field–scattering wave–X α method, the origin of the Faraday rotation is attributable to the charge transfer transitions of an electron from O 2p to Rh 4d orbitals, or t1un(2p)→t2g*(4d) and t2un(2p)→t2g*(4d) transitions. Based on this assignment, the Faraday rotation spectrum is calculated by taking into account the spin–orbit interaction and the molecular field from iron magnetizations in the magnetic garnet.

The aim of this research was to evaluate the neurocognitive functioning and symptom reporting of high school athletes with the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) battery after sustaining a single sports-related concussion. The ImPACT battery was administered to 26 athletes at an average of 6.8 days after their head injury. ImPACT composite scores, including neurocognitive measures of Verbal Memory, Visual Memory, Processing Speed, and Reaction Time, as well as a Total Symptom Score, were also obtained from an equivalent group of 25 nonconcussed football players. The composite scores of the concussed athletes were lower but not statistically different than the nonconcussed athletes. The findings were consistent with previous ImPACT research that reported no differences between concussed and nonconcussed athletes 7 days after a concussion. The symptom scores of the concussed athletes, on the other hand, were significantly higher than those who had no concussion. The similarities and differences in ImPACT test performances of the present sample of concussed high school athletes as compared with previous studies of concussed high school athletes are discussed. This study raises awareness that with high school athletes, symptom complaints may persist, even after cognitive functioning has returned to preinjury levels.

The development concept, optical system, CCD layout and new type of digitized process circuits of a 4CCD HDTV color camera, developed as part of the HDTV W-VHS system are discussed. >

An effective, user-friendly neurocognitive test to diagnose minimal hepatic encephalopathy (MHE) is needed. Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) is a brief, validated, Web-based, neuropsychological test battery resulting in four composite scores [Verbal Memory (VrbM), Visual Memory, Visual Motor Speed (VMS), Reaction Time (RT)]. We compared ImPACT to traditional paper-and-pencil tests in patients at risk for MHE versus controls.Ninety cirrhotic patients with no history of overt hepatic encephalopathy were compared with 131 controls on standard psychometric tests (SPT) [Trail Making Test-A, Trail Making Test-B, Digit Symbol Test], 4 ImPACT composite scores, and the Sickness Impact Profile (SIP). MHE+ was defined by a score 2 SD below the normative mean on at least one of the SPT. ImPACT (ImP+) scores of patients were defined as 2 SD from the control mean.Cirrhotic patients scored more poorly than controls on 3/4 of ImPACT scores: VrbM (78.88 vs. 71.37, p0.001), VMS (26.47 vs. 22.68, p0.001) and RT (0.89 vs. 1.00, p0.01), as well as on all 3 SPT. Of the 90 cirrhotics, 16 (18%) were MHE+, who performed more poorly (p0.001) than patients without MHE on VrbM (58.13 vs. 74.19), VMS (16.77 vs. 23.95) and RT (1.24 vs. 0.95). Of the 90 cirrhotics, 25 (27.8%) were ImP+. MHE+ and ImP+ patients had increased SIP scores versus controls (p0.001).Compared to paper-and-pencil testing, ImPACT provides a brief, user-friendly, neuropsychological evaluation of MHE. ImPACT could become a new standard for MHE diagnosis.

A short form of the WPPSI, which consisted of the Block Design, Vocabulary, Arithmetic, and Comprehension subtests, was administered to 426 applicants to kindergarten at a private school. The following year a short form WPPSI-R, which consisted of the same subtests, was administered to 372 applicants to kindergarten at the same school. The FSIQs and subtest scores of the two short forms were nearly identical. The findings varied from the results of previous studies that found the complete WPPSI FSIQ to be 6 to 8 points higher than the WPPSI-R FSIQ. Limitations of the present study and of short form Wechsler IQs are discussed.

Five validity scales derived from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), the Infrequency Scale (F), Infrequency-Psychopathology Scale (F[p]), Symptom Validity Scale (FBS), Henry-Heilbronner Index (HHI), and Response Bias Scale (RBS) were evaluated in 118 litigation patients (LPs) and 163 clinical patients (CPs). Varied statistical methods, including hierarchical logistic regression analyses, Receiver Operating Characteristic (ROC) curve, Area Under the Curve (AUC) values, and sensitivity/specificity analyses, showed that RBS performed better than the other four scales in identifying LPs. The regression analyses found RBS to be the most significant predictor of LP and CP group membership (p

A 61-year-old man, who had medical history of hepatitis type C, surgery for malignant melanoma of the lower limb, endoscopic mucosal resection for esophageal cancer, was pointed out a pulmonary nodule in the right middle lobe by surveillance computed tomography after 5 years of surgery for melanoma. Pathology of esophageal cancer was squamous cell carcinoma limited in mucosa without lymphatic nor venous invasion. The nodule gradually enlarged and respiratory endoscopic examination could not establish pathological diagnosis. Thoracoscopy-assisted pulmonary biopsy revealed squamous cell carcinoma, and right middle lobectomy with mediastinal node dissection was performed. Histological examination showed moderately differentiated squamous cell carcinoma without lymph node involvement. The stage of lung cancer was T1N0M0, stage IA. Although 9 months have passed since surgery for lung cancer, recurrence of each malignancy has not been detected.

The Luria-Nebraska Neuropsychological Battery (LNNB) and the Minnesota Multiphasic Personality Inventory (MMPI) were administered to 184 head injury patients with varying degrees of headache activity. A multiple regression analysis, controlling for neurological status, compared the 11 LNNB scores of patients with Daily Headaches, Frequent Headaches, Infrequent Headaches, and No Headaches and found that the Arithmetic Scale was the only significant predictor, with the Daily Headache patients performing more poorly than the Infrequent Headache patients. A similar analysis of the 13 MMPI scores indicated that the K, Hs, and Pt Scales were significant predictors. However, post hoc Tukey tests revealed that K and Pt scores did not vary significantly among the four headache groups and only showed that Daily Headaches and Frequent Headaches patients had significantly higher Hs scores than the No headaches group. Subsequent comparisons of patients with and without headaches at the time of testing revealed no differences between the two groups on the LNNB and MMPI, after controlling for age, duration of symptoms, and neurological status. Overall, the results suggested that the relation between headache symptoms and neuropsychological functioning was insignificant.

We evaluated surgical results for the patients who underwent pulmonary resection combined with pericardial or left atrial resection due to locally advanced non-small cell lung cancer (NSCLC). Seven patients who underwent pericardial resection (T3 group) and 4 patients who underwent resection of the left atrium (T4 group) were included in this study, and clinical findings and prognosis were evaluated. Eight patients underwent pneumonectomy, and others underwent lobectomy or bilobectomy. Histology of the cancer was squamous cell carcinoma in all patinets. As for pathological node involvement, N0/N1 disease was 72.7% and N2 disease was 27.3%. Induction chemotherapy was performed in 75.0% of T4 group. Adjuvant chemotheraphy was performed in 71.4% of T3 group and 75.0% of T4 group. Five-year-survival was 57.1% in T3 group and 25.0% in T4 group. Five-year-survival was 62.5% in N0/N1 disease and 0% in N2 disease. Statistical significance in prognosis was seen in lymph node status (p = 0.0317). Extended resection of pericardium or left atrium for patients with N2 disease of NSCLC is not recommended. When invasion to pericardium or left atrium is diagnosed during surgery, extended resection should be indicated in patient without N2 metastasis.

A 46-years-old woman admitted for induction of continuous ambulatory peritoneal dialysis (CAPD). When peritoneal functional test was performed, dyspnea was occurred. Chest X-ray and chest computed tomography (CT) scan revealed massive right hydrothorax. Technetium-99m macroaggregated albumin scintigraphy showed communication between abdominal cavity and thoracic cavity. The thoracoscopic diaphragmal repair was performed. After CAPD was started, right hydrothorax occurred again. Re-repair of the diaphragm was performed in small thoracotomy and small hole was revealed. The hole was sutured and diaphragm was coverd by fibrin glue and polyglycolacid (PGA) felt all over. Since then, CAPD was continued successfully. Thoracoscopic surgery is less invasive and appropriate therapy for this case. It is important that the diaphragm will be covered all over by fibrin glue and PGA sheet because even pin-hole makes recurrence. For detect of the communicative portion, use of indigocarmin and examination of glucose concentration in the pleural effusion were effective.

Primary objective: To investigate possible sex differences in neuropsychological functioning among patients following mild traumatic brain injury (TBI).Methods and procedures: Retrospective records analysis of the neuropsychological test results of 102 participants with head injury, including 62 males and 40 females.Main outcome and results: A multivariate analysis of variance indicated that females and males performed similarly on neuropsychological tests, on average, ∼2 years after minor head trauma. A sex-by-age interaction effect was found on the Category and Trail Making A Tests, with a pattern similar to those obtained in a previous research.Conclusions: Although past research has found that females develop more TBI-related neuropsychological deficits than males in the immediate post-injury period, the present study found that, overall, sex differences in the performance of patients with mild TBI on a variety of neuropsychological tests were insignificant. More investigation into the sex-by-age inte...