Prism adaptation and perceptual skill learning deficits in early-stage Parkinson's disease.

BACKGROUND: Skill learning deficits in Parkinson's disease (PD) at an early stage are not well known, and findings in behavioral studies with mirror reading and prism adaptation tasks are mixed. Moreover, skill learning over several days in PD patients has not been studied. METHODS: A total of 12 nondemented early-stage PD patients and 12 age-matched normal control subjects participated in this study. The Wechsler Memory Scale-Revised (WMS-R) was applied to all subjects to assess declarative memory. The mirror reading task of horizontally presented kana letters and the reversed vision task using a prism were performed throughout 3 consecutive days. RESULTS: For the mirror reading skill, the early-stage PD patients showed significantly increased mirror reading time on days 2 and 3. For the prism adaptation, the PD patients performed significantly more slowly in reversed vision than the normal controls, specifically at blocks 1 and 2, over 3 days. The WMS-R subscores did not show a significant correlation with the reaction times in reversed vision or with the mirror reading times. CONCLUSIONS: Using two tasks with different modalities, the present study revealed visuomotor adaptation deficits and acquisition/retention deficits, especially in the later phase of perceptual skill learning, in early-stage PD patients.

[Study on adjuvant MTX-5-FU intraperitoneal chemotherapy for advanced gastric cancer].

The intraperitoneal administration of anti-cancer drug is a rationale route to adjuvant chemotherapy. We applied adjuvant MTX-5-FU intraperitoneal chemotherapy for 60 advanced gastric cancer cases which had undergone gastrectomy (Stage II 18, Stage III A 19, Stage IIIB 13, and Stage IV 10 cases). A 5-year survival rate of Stage II, III A, IIIB and IV was 66.2%, 60.7%, 46.5% and 18.8%, respectively. Five-year survival rates of both Stage III A and IIIB on this study were likely to be higher than the rates of Stage III A and IIIB of other institutions. The 24 out of 42 cases with the serosal surface exposure of cancer demonstrated a cancer recurrence. Seventy percent (17 cases) of the 24 recurred cases developed a peritoneal recurrence, which means that the intraperitoneal chemotherapy did not touch a pattern of the recurrence of the gastric cancer with the serosal surface exposure.

[Influence of intraperitoneal chemotherapy to a recurrence pattern of gastric cancer with serosal exposure].

We analyzed a recurrence pattern and prognosis of 42 gastric cancer cases with histological serosal exposure of cancer and without macroscopical residual cancer in the operation. These cases received adjuvant MTX-5-FU chemotherapy intraperitoneally. Twenty four patients showed a recurrence of gastric cancer. Twenty two patients died of recurrence, and two patients were still alive with recurrence. Seventeen patients (71%) developed peritoneal seeding, which means intraperitoneal chemotherapy made no influence to the pattern of recurrence of gastric cancer with serosal invasion. All of the recurred patients with Stage II and IIIA gastric cancer and about 60% of the recurred patients with Stage IIB and IV developed peritoneal metastasis. The prognosis of recurred 24 patients showed that 9 patients (38%) were kept alive for more than 3 years, and 5 patients (21%) were kept alive for more than 5 years. Intraperitoneal chemotherapy of MTX-5-FU did not touch the pattern of recurrence of gastric cancer with serosal invasion, but the analysis of the prognosis revealed a possibility of improvement of the prognosis.

Differential characteristics of the middle latency auditory evoked magnetic responses to interstimulus intervals.

OBJECTIVE: The human middle latency auditory evoked magnetic fields were recorded with different interstimulus intervals (ISI) to investigate the differential natures of P30m and the P50m, including whether the P50m source was spatially different or not from the P30m source. METHODS: Twenty right-handed healthy subjects participated in the experiment. Auditory magnetic responses were recorded in the 0.5 s ISI (ISI were between 0.4 and 0.6 s) and the 1.5 s ISI conditions (ISI were between 1 and 2 s). Tone bursts were presented to the right ears 880 times consecutively for each condition. The P30m and the P50m responses were investigated, and the dipole source localization was performed. RESULTS: The P50m latency was significantly prolonged, while the P30m latency did not vary in the shorter ISI. Both P50m and P30m amplitudes were significantly reduced in the shorter ISI. The P50m was located significantly more anteriorly than P30m. CONCLUSIONS: These results suggest the existence of differential characteristic and spatially different magnetic responses in the middle latency range. SIGNIFICANCE: This study has revealed one aspect of the different natures between P30m and P50m, and may provide a key for auditory perceptional processes in humans.

Significance of hepatic resection combined with inferior vena cava resection and its reconstruction with expanded polytetrafluoroethylene for treatment of liver tumors.

BACKGROUND: Resection of the IVC is required when a liver tumor invading the IVC is completely removed. The purpose of this study was to evaluate the clinical significance of hepatectomy combined with IVC resection and reconstruction with an ePTFE graft for treatment of invasive liver tumors and to discuss the validity of this surgery. STUDY DESIGN: Eleven selected patients with liver tumors underwent various types of hepatectomy with retrohepatic IVC resection, followed by IVC reconstruction. The postoperative courses, clinicopathologic features of the tumors, operative procedures, and outcomes of the patients were studied. RESULTS: Ten of 11 patients did not require an active ventriculovenous bypass using a biopump. Invasion to the IVC was histologically proved in 9 of the 11 patients. After reconstruction, all artificial vessel grafts maintained patency throughout the observation period. Four patients are still alive with cancer-free status ranging from approximately 11 years to 5 months. One-year, 3-year, and 5-year survival rates were 63.6%, 38.2%, and 25.5%, respectively, with a 50% survival of 29 months. CONCLUSIONS: IVC resection and its reconstruction with ePTFE for treatment of liver tumors was safely performed on 11 selected patients with a 50% survival of 29 months. Patency of the graft was maintained for the longterm without infectious complications. This surgical procedure is indicated in some select patients in whom IVC invasion is extensive.