New digital technologies for the surveillance of infectious diseases at mass gathering events.

Outbreaks of infectious diseases at mass gatherings can strain the health system of the host region and pose a threat to local and global health. In addition to strengthening existing surveillance systems, most host nations also use novel technologies to assess disease risk and augment traditional surveillance approaches. We review novel approaches to disease surveillance using the Internet, mobile phone applications, and wireless sensor networks. These novel approaches to disease surveillance can result in prompt detection.

One Health in social networks and social media.

In the rapidly evolving world of social media, social networks, mobile applications and citizen science, online communities can develop organically and separately from larger or more established organisations. The One Health online community is experiencing expansion from both the bottom up and the top down. In this paper, the authors review social media's strengths and weaknesses, earlier work examining Internet resources for One Health, the current state of One Health in social media (e.g. Facebook, Twitter, YouTube) and online social networking sites (e.g. LinkedIn and ResearchGate), as well as social media in One Health-related citizen science projects. While One Health has a fairly strong presence on websites, its social media presence is more limited and has an uneven geographic distribution. In work following the Stone Mountain Meeting,the One Health Global Network Task Force Report recommended the creation of an online community of practice. Professional social networks as well as the strategic use of social media should be employed in this effort. Finally, One Health-related research projects using volunteers (citizen science) often use social media to enhance their recruitment. Including these researchers in a community of practitioners would take full advantage of their existing social media presence. In conclusion, the interactive nature of social media, combined with increasing global Internet access, provides the One Health community with opportunities to meaningfully expand their community and promote their message.

[Lymphocytic infundibulo-hypophysitis with diabetes insipidus as a new clinical entity: a case report and review of the literature].

In 1992, we reported a lymphocytic adenohypophysitis (LIH) (Neurol Med Chir). We considered this case unusual in that the case was that of a menopausal female and that it was accompanied with diabetes insipidus as classical lymphocytic adenohypohysitis (LAH). Subsequently, Ahmed reported two cases which presented a similar pathological manifestation, except for necrosis, as did our case and named them "necrotizing infundibulo-hypophysitis." Recently we encountered another similar case, which is reported hereunder. A female, 34 years of age, had suffered from headache, polyuria, and amenorrhea. CT scan showed a pituitary mass, and pituitary tumor was surgically removed transcranially at a local hospital. The pathological examination revealed the findings of chronic inflammation and necrosis. One month after the operation, however, she was an in-patient again under the suspicion of meningitis for fever and, when antibiotic therapy at the local hospital resulted in no improvement, she was referred to our hospital. Endocrinological studies showed low FSH, LH, ACTH and plasma cortisol level. Antibodies of serum to RNP, Sm, mitochondria, nucleus, AChR, and DNA were all negative. Because of an intrasellar mass with suprasellar extension on MRI, transsphenoidal operation was conducted four months after the initial operation. The pathological examination revealed the infiltration of lymphocytes, plasma cells, and foamy macrophages, and necrosis. After this operation, the headache was cured and the patient was discharged. Two months subsequent to the second operation, headache recurred and temporal upper quadrantic anopsia was noted. An enlarged tumor was found, but prednisolone worked to cure the pain and the visual field defect was found to have been remedied. The patient's diabetes insipidus is presently persisting, and she still relies on the use of desmopressin acetate and is still in need of cortisol replacement therapy. Including our cases, ten cases of lymphocytic hypophysitis, not related to pregnancy or delivery but with diabetes insipidus, have been reported. Several clinical and anatomical features distinguish these 10 cases from classical LAH. The classical LAH was predominantly related to pregnancy or delivery. However 6 of 10 cases were male in LIH. LAH related to pregnancy or delivery does not accompany diabetes insipidus, but all reported cases of LIH had a diabetes insipidus. Visual field and/or ocular movement disturbance are LAH's chief complaints (15 out of 25 cases) but visual field disturbance seldom occurs in LIH (1 out of 10 cases). Hypopituitarism is more serious in LAH, and 4 cases became fatal from an adrenal crisis. Anatomically, inflammatory change of LIH is located anterior and posterior to the pituitary gland and extends to the pituitary stalk and, at times, hypothalamus. On the other hand, LAH relates to pregnancy or delivery, the inflammatory change localizes to the adenohypophysis. Ahmed emphasized necrosis, while necrosis was not a prominent histological finding in LIH. Necrosis was noted only in 3 of 10 cases. To be stressed, rather, are the inflammatory changes seen on the neurohypophysis and the pituitary stalk, together with the characteristic diabetes insipidus. We believe, in view of the above, that what Ahmed named necrotizing infundibulo-hypophysitis should be named "LIH with diabetes insipidus." Whereas differential diagnosis is necessary between this said new disorder and the conventional LAH, we advocate that the latter, which is related to pregnancy or parturition but is free from neurohypophysitis be identified as "LAH related to pregnancy or delivery." With respect to treatment, steroid therapy is essential. If the symptoms do not improve, a transsphenoidal operation for diagnosis (LIH and LAH) and decompression (the case of LAH with visual or external ocular movement disturbance) is advisable. However, extensive surgery is not recommended, because per

[Management of hydrocephalus in the case with pineal region tumor].

When patients have a pineal region tumor, they frequently present with hydrocephalus. However, not all of patients with pineal region tumor continue to suffer from hydrocephalus after tumor therapy. We have retrospectively studied 24 patients, and found that 20 patients (83.3%) have hydrocephalus, and 5 patients (20.8% of all cases and 25.0% of hydrocephalic cases) still have a shunt. We confirmed how fast germinoma diminished under radiation therapy. Irradiation dosage ranged between 30 and 65.8 Gy. Using 10 Gy, germinoma volume decreased to 20.2% of pre-irradiation size. Furthermore, 6 patients who did not receive surgical management for hydrocephalus before radiotherapy did not require a shunt subsequently. Therefore, we concluded that most of pineal germinoma cases do not need surgical management for hydrocephalus, except in those cases where there is pineal apoplexy and aqueductal dissemination.

[Cranio-orbital zygomatic extradural approach for cavernous sinus or Meckel's cave tumors].

Direct surgery to cavernous sinus (CS) lesions has become one of the optimal treatments based on advancement in microsurgical anatomy and imaging modality, and the progress of microsurgical techniques. We have removed the CS or Meckel's cave tumors extradurally when they do not extend intradurally, using modified Al-Mefty's cranio-orbital zygomatic craniotomy. Three CS tumors; trigeminal neurofibroma, squamous cell carcinoma and chondrosarcoma, and a Meckel's cave meningioma were reported. Total removal was achieved in all but one (case 4). Postoperative complications were permanent ophthalmoplegia in one, transient ophthalmoplegia in one, subcutaneous CSF accumulation in two and trigeminal dysfunction in one. The extradural approach can be the first choice of methods for total removal of tumors when they are confined to the CS or Meckel's cave.

Astrocytoma linked to familial ataxia-telangiectasia.

A 7-year and 11 month-old girl with cerebellar astrocytoma linked to familial ataxia-telangiectasia (AT) is presented. She was born as the 7th girl of a woman with aortic arch syndrome. Two elder sisters of the patient have ataxia telangiectasia. She had immunodeficiency, and cerebellar ataxia, but had no oculocutaneous telangiectasia. The risk of cancer developing in AT patients is about 1,200 times greater than that in age-matched controls. With regard to central nervous system tumours, seven primary tumours have been reported, such as 3 cases of medulloblastoma and 4 cases of glioma. Members of AT families who were under the age of 45 had a risk of dying of a malignant neoplasm five times greater than in the general population. However, there were no reports of glioma in AT families. In this case, it is suggested that IgA deficiency linked to familial AT may have contributed to the development of astrocytoma.

[Crossed cerebellar diaschisis in putaminal hemorrhage--evaluation by the Xe-133 clearance method].

Metabolic depression in the contralateral cerebellar hemisphere caused by a supratentorial lesion is called crossed cerebellar diaschisis (CCD). In order to investigate diaschisis based on the location and extension of lesions, time course and prognosis, 31 patients with putaminal hemorrhage were examined by the Xe-133 clearance method (67 studies in all). They consisted of 20 males and 11 females, from 40 to 77 years old (mean: 57.1 +/- 8.9). Small hematomas (mean volume: 16.1 +/- 8.4 ml) in 18 patients were treated nonsurgically, whereas medium and large hematomas (mean volume: 57.5 +/- 29.9 ml) in 13 patients were treated by craniotomy for evacuation. rCBF was measured using a BI 1400 rCBF Analyzer (Valmet, Denmark), and CCD was considered positive when the percentage difference in cerebellar blood flow was 10.1% (mean + 2SD) greater than obtained in 21 normal controls. CCD was observed in 10 patients (55.6%) in the non-surgical group and in 9 patients (69.2%) in the surgical group. In the non-surgical group, CCD was positive in 5 of the 7 cases (71.4%) involving the posterior limb of the internal capsule and in 7 of the 11 cases (63.6%) involving the corona radiata. The surgical group was divided into three types based on the time course of CCD after surgery, i.e., type A: persistent CCD found two months later, type B: postoperative CCD had resolved two months later, and type C: no CCD observed after surgery. Mean hematoma volume was significantly greater in type A (79.0 +/- 19.8 ml) than in type B (44.6 +/- 8.5 ml) or type C (30.7 +/- 3.7 ml) (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Human recombinant interleukin-1 beta-mediated growth inhibition of cultured malignant glioma cells.

The effect of human recombinant interleukin-1 beta (hrIL-1 beta) on tumor growth was studied in eight glioma cell lines. hrIL-1 beta inhibited growth in all cell lines, but to varying extents. Two cell lines were suppressed by 0.5 ng/ml hrIL-1 beta, and three cell lines required 20 ng/ml. hrIL-1 beta also induced morphological changes and increased F-actin contents. hrIL-1 beta-treated cells demonstrated multipolar shapes and numerous processes with a greater number of cell-cell contacts 24 hours after treatment. Fluorescence microscopy revealed that these processes contained a large amount of polymerized F-actin. These results suggest that hrIL-1 beta-mediated growth inhibition may be related to the differentiation of glioma cells.

Lymphocytic adenohypophysitis with sudden onset of diabetes insipidus in menopausal female--case report.

A rare case of a postmenopausal (60-year-old) female with lymphocytic adenohypophysitis manifesting as a sudden onset of diabetes insipidus is reported. Magnetic resonance imaging with gadolinium-diethylene-triaminepentaacetic acid enhancement showed a spherical lesion, approximately 1 cm in diameter, in the sella turcica and a thickened, deviated pituitary stalk. The abnormal tissue was totally removed. Histological examination showed marked infiltration of lymphocytes and plasma cells. Postoperatively, the pituitary stalk became normal. Preoperative differentiation of lymphocytic adenohypophysitis from pituitary adenoma is extremely difficult, and biopsy is essential.

[A case of calcified intracranial tuberculoma presenting unique MRI findings].

A 41-year-old male patient was admitted in our Ryukyu University Hospital complaining of parosmia. He had a history of miliary tuberculosis 21 years ago. Neurologically he showed left anosmia and hyperreflexia of the right upper extremity. Plain skull X-P and CT scan revealed a calcified mass, 25mm in diameter, at the left frontal base. In MRI, the mass showed isointensity using the T1 weighted inversion recovery sequence and heterogenously low intensity using the T2 weighted spin echo sequence. Surgery was performed by bifrontal craniotomy. Then the tumor was removed totally including two coexisting small tumors. Histologically, they consisted of calcified caseous tissue and thick collagen capsule, suggesting old calcified tuberculomas. Postoperative course was uneventful and did not result in meningitis. Antituberculous therapy of streptomycin, isoniazid and rifampin was given for 2 weeks, started on the operative day. MRI findings were presented in detail and the guideline of antituberculous therapy to the tuberculoma was discussed.

Enterogenous cyst in the cervical spinal canal. Case report.

The case of an 11-year-old Japanese girl with an intradural and extramedullary enterogenous cyst is presented. A mass giving a low-intensity signal in comparison with the spinal cord was demonstrated on magnetic resonance imaging. Histologically, the diagnosis was confirmed on specimens stained with periodic acid-Schiff, alcian blue, mucicarmine, and immunohistochemical staining of carcinoembryonic antigen, and by electron microscopy.