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Background: Among eye movements in amyotrophic lateral sclerosis (ALS), we identified the characteristics of square-wave jerks (SWJs) seen during times without visual fixation (VF) and analyzed their relationships with clinical parameters., Materials and Methods: Clinical symptoms were evaluated and eye movements were tested using electronystagmography in 15 patients with ALS (10 men, 5 women; mean age, 66.9 ± 10.5 years). SWJs with and without VF were recorded, and their characteristics were identified. Relationships between each SWJ parameter and clinical symptoms were evaluated. Results were compared with eye movement data from 18 healthy individuals., Results: The frequency of SWJs without VF was significantly higher in the ALS group than in the healthy group (P < 0.001). When the condition was changed from VF to no-VF in the ALS group, the frequency of SWJs was significantly higher in healthy subjects (P = 0.004). A positive correlation was seen between frequency of SWJs and percentage predicted forced vital capacity (%FVC) (R = 0.546, P = 0.035)., Conclusion: The frequency of SWJs was higher with VF in healthy people, and was suppressed without VF. In contrast, the frequency of SWJs was not suppressed without VF in ALS patients. This suggests that SWJs without VF have some clinical significance in ALS patients. Moreover, a relationship was noted between the parameters of SWJs without VF in ALS patients and results of pulmonary function tests, suggesting that SWJs during times without VF may offer a clinical parameter of ALS., (© 2023. Fondazione Società Italiana di Neurologia.)

Background: Appropriate regimens of peripheral parenteral nutrition (PPN) have been proposed for the improvement of protein metabolism after surgery. When evaluating the efficacy of administered nutrients, it is vital to consider the severity of surgical stresses to avoid confounding effects of the trauma on the postoperative metabolism. This study was designed to evaluate protein-sparing regimens through PPN in patients who had undergone subtotal gastrectomy., Study Design: Patients hospitalized at our institutes for gastric cancer were randomly divided into the following five groups and received PPN for 7 days after surgery: 1. G group (n = 9), 200 g glucose (per day); 2. AG group (n = 10), 54 g amino acids + 150 g glucose; 3. AGG group (n = 9), AG + 110 g glucose; 4. AGF group (n = 10), AG + 40 g fat; and 5. AGL group (n = 7), 58 g amino acids + 60 g glycerol. Biochemical studies were done before and after surgery., Results: In comparison to G group patients, AG group patients showed less negative cumulative nitrogen balances. No significant differences in cumulative nitrogen balances were observed between AGG, AGF, and AGL groups. Restoration of the reduced serum rapid turnover protein occurred earlier in the AGL group than in either the AGG or the AGF groups. Hyperglycemia, glucosuria, and hyperinsulinemia were prominent in the AGG group, and less prominent in the AGL group. Marked ketosis together with an increase in serum-free fatty acid levels was found in the AGL group., Conclusions: These results suggest that in patients who have undergone major elective surgery, infusion of amino acid solutions is advantageous for improving protein metabolism after surgery, and nonprotein energy source and intake are not essential when combined with amino acid solutions for improving nitrogen balance after surgery.

We stained 77 resected stomachs with Alcianblue and studied the distribution and the morphological features of intestinal metaplasia by macroscopic and stereoscopic observation using a clinical point drying method. And we made complete serial sections of minute metaplastic foci to study the reason why intestinal metaplasia show different features in particular areas of the stomach. The results are: Intestinal metaplasia exists both in pyloric gland area and intermediate zone in 92.2% of all cases (71/77). In intermediate zone, almost all metaplastic foci consist of complete type of intestinal metaplasia and in contrast incomplete type of it is more prevalent in pyloric gland area. The ratio of the 2 histological types in each area is not different in cases which metaplastic foci are sparse and in cases which they are extensive. Metaplastic foci are usually elevated in pyloric gland area and depressed in intermediate zone. By serial sections, many goblet cell metaplasias are observed at the flat portions of the mucosa in pyloric gland area. In intermediate zone, all minute metaplastic foci are observed at the bottoms of the grooves of the mucosa.