Gallbladder fossa nodularity in the liver as observed in alcoholic liver disease patients: Analysis based on hepatobiliary phase signal intensity on gadoxetate-enhanced MRI and extracellular volume fraction calculated from routine CT data.

The purpose of this study is to further verify the concept utilizing signal intensity on hepatobiliary phase (HBP) of gadoxetate-enhanced MRI and extracellular volume fraction (ECV) calculated from CT data. Between Jan 2013 and September 2018, consecutive ALD patients who had both quadruple phase CT and gadoxetate-enhanced MRI within six months were retrospectively recruited. Those who had any intervention or disease involvement around gallbladder fossa were excluded. All images were reviewed and ECV was measured by two experienced radiologists. GBFN grades, and their HBP signal intensity or ECV relative to the surrounding background liver (BGL) were analyzed. There were 48 patients who met the inclusion criteria. There were GBFN grade 0/1/2/3 in 11/15/18/4 patients, respectively. The signal intensity on HBP relative to BGL were iso/slightly high/high in 30/15/3 patients, respectively, and ECV ratio (ECV of GBFN divided by that of BGL) was 0.88 ± 0.18, indicating there are more functioning hepatocytes and less fibrosis in GBFN than in BGL. The GBFN grades were significantly correlated to relative signal intensity at HBP (Spearman's rank correlation, p < 0.01, rho value 0.53), and ECV ratio (p < 0.01, rho value -0.45). Our results suggest GBFN in ALD would represent liver tissues with preserved liver function with less fibrosis, as compared to BGL, which are considered to support our hypothesis as shown above.

Chloroquine regulates the lipopolysaccharide-induced inflammatory response in RAW264.7 cells.

INTRODUCTION AND OBJECTIVES: Macrophage-induced inflammation plays a key role in defense against injury and harmful pathogens. Autophagy and the inflammatory response are associated; however, the relationship between the autophagy pathway and lipopolysaccharide (LPS)- induced inflammatory responses remains unknown. We aimed to determine the effect of autophagy on the LPS-induced myeloid differentiation factor 88 (MyD88)/nuclear transcription factor kB (NF-kB) pathway-mediated inflammatory response in RAW264.7 cells. MATERIALS AND METHODS: To determine the effect of autophagy on the LPS-induced inflammatory response, using various in vitro assays, we determined the effect of autophagy inhibitors and inducers on the inflammatory response in RAW264.7 cells. RESULTS: Chloroquine (CQ), an autophagy inhibitor, suppressed pro-inflammatory cytokines, including interleukin (IL)-1ß, IL-6, and tumor necrosis factor α (TNFα) in LPS-stimulated RAW264.7 cells. CQ also affected inflammatory mediators such as myeloid differentiation factor 88 and NF-kB in LPS-stimulated RAW264.7 cells. CONCLUSION: This study demonstrated that CQ regulates the LPS-induced inflammatory response in RAW264.7 cells. We propose that targeting the regulation of pro-inflammatory cytokine levels and inflammatory mediators using CQ is a promising therapeutic approach for preventing inflammatory injury. CQ serves as a potential therapeutic target for treating various inflammatory diseases.

Impact of the quality and diversity of reference products on creative activities in online communities.

In creativity research, an important unresolved issue relates to identifying the kind of information an individual should be exposed to in order to be highly creative. We aimed to gain insights into this issue; we collected and statistically analyzed three datasets related to three large online communities (namely Cities: Skylines, SCP-wiki, and Archive of Our Own) engaged in mod development and novel writing to examine whether the quality and diversity of other people's products referred to have a positive effect on product generation. Our analysis revealed the following three findings: (1) the quality diversity of reference products generated by others has the most positive impact on the quality of generated products when it is neither high nor low, (2) the content diversity of reference products generated by others has a negative impact on the quality of generated products, and (3) the quality of reference products generated by others has a negative impact on the quality of generated products when it is extremely high. We conclude by discussing the implications of the findings for creativity research.

Reduced trunk muscle mass in patients with stroke is associated with reduced balance function recovery.

BACKGROUND & AIMS: Skeletal muscles are essential for postural retention and balance function. However, the relationship between trunk muscle mass (TMM) and balance function has not yet been clarified. This study aimed to examine the impact of TMM on the change in balance function in patients with stroke from admission to a rehabilitation hospital to discharge. METHODS: This retrospective observational study included patients aged ≥65 years with cerebral infarction admitted to our rehabilitation hospital from May 2018 to July 2022. The trunk muscle mass index (TMI) was calculated at admission and discharge using bioelectrical impedance analysis. Patients were divided into low and high TMI groups according to the median TMI at admission. The primary outcome was the change in the Berg Balance Scale (BBS) score (BBS score at discharge - BBS score at admission). RESULTS: A total of 315 patients (mean age, 78.9 ± 8.0 years; 172 men and 143 women) were included. The median TMI was 7.31 kg/m2 in men and 6.30 kg/m2 in women. Among male patients, the high TMI group had higher BBS scores at admission (31.2 ± 18.2 vs. 23.4 ± 17.7, P = 0.005) and discharge (43.0 ± 15.3 vs. 33.4 ± 19.0, P < 0.001) than those in the low TMI group. After adjusting for confounding factors, TMI at admission was independently associated with the change in BBS score (ß = 0.587, P = 0.002). CONCLUSIONS: Reduced TMM negatively influences balance function recovery in patients after stroke. A strategy aimed at increasing TMM could have beneficial effects on balance function.

Functional Analysis of Oligoadenylate Synthetase in the Emu (Dromaius novaehollandiae).

2'-5'-oligoadenylate synthetase (OAS) is one of the proteins that act as a defense mechanism against foreign RNA in cells. OAS has two functions: an antiviral effect against a wide range of virus species via the OAS/RNase L pathway with synthesized oligoadenylates and inhibition of viral replication specific to viruses of the genus Flavivirus, which is independent of enzymatic activity. Several birds have been reported to possess only one type of OAS family member, OASL, which has both enzymatic activity and inhibitory effects on flaviviral replication. However, the ostrich has two types of OASs, OAS1 and OASL, which show different functions-enzymatic and anti-flaviviral activities, respectively. In this study, emu OASs were cloned to investigate their sequence and function and elucidate the role of OASs in emus. The cloning results showed that emus had OAS1 and OASL, suggesting that emu OASs were more closely related to ostrich than to other birds. Functional investigations showed that emu OAS1 and OASL had enzymatic and anti-flaviviral activities, respectively, similar to those of the ostrich. Emus and ostriches are evolutionarily different from most birds and may be more closely related to mammalian OAS diversity.

Effectiveness of deep learning-based reconstruction for improvement of image quality and liver tumor detectability in the hepatobiliary phase of gadoxetic acid-enhanced magnetic resonance imaging.

PURPOSE: To evaluate the effectiveness of deep learning-based reconstruction (DLR) in improving image quality and tumor detectability of isovoxel high-resolution breath-hold fat-suppressed T1-weighted imaging (HR-BH-FS-T1WI) in the hepatobiliary phase (HBP) of Gadoxetic acid-enhanced magnetic resonance imaging (Gd-EOB-MRI). MATERIALS AND METHODS: This retrospective evaluated 42 patients with 98 liver tumors who underwent Gd-EOB-MRI between March 2023 and May 2023 using three techniques based on HBP imaging: isovoxel HR-BH-FS-T1WI reconstructed (1) with DLR (BH-DLR +) and (2) without DLR (BH-DLR -) and (3) HR-FS-T1WI scanned with a free-breathing technique using a navigator-echo-triggered technique and DLR (Navi-DLR +). The three techniques were qualitatively and quantitatively compared by the Friedman test and the Bonferroni post-hoc test. Tumor detectability was compared using the McNemar test. RESULTS: BH-DLR + (3.85, average score of two radiologists) showed significantly better qualitative scores for image noise than BH-DLR - (2.84) and Navi-DLR + (3.37) (p < 0.0167), and Navi-DLR + showed significantly better scores than BH-DLR - (p < 0.0167). BH-DLR + (3.77) and BH-DLR - (3.77) showed significantly better qualitative scores for respiratory motion artifact than Navi-DLR + (2.75) (p < 0.0167), but there was no significant difference in scores between BH-DLR + and BH-DLR - (p > 0.0167). BH-DLR + (0.32) and Navi-DLR + (0.33) showed significantly higher lesion-to-nonlesion CR than BH-DLR - (0.29) (p < 0.0167), but there was no significant difference in lesion-to-nonlesion CR between BH-DLR + and Navi-DLR + (p > 0.0167). BH-DLR + (89.8%) showed significantly better tumor detectability than BH-DLR - (76.0%) and Navi-DLR + (77.6%) (p < 0.05). CONCLUSION: The use of DLR for isovoxel HR-BH-FS-T1WI was effective in improving image quality and tumor detectability.

Low muscle mass in patients with stroke on admission reduces walking ability at discharge.

BACKGROUND & AIMS: Reduced skeletal muscle mass may negatively influence postural retention and walking function. This study aimed to examine the influence of the skeletal muscle mass index on walking function in patients with stroke. METHODS: This study included patients with cerebral infarction aged ≥65 years. The Asian Working Group for Sarcopenia's skeletal muscle mass index criteria were used to classify the participants into the low and high skeletal muscle mass index groups. The patient characteristics of the two groups were compared. The primary and secondary outcome measures were independent walking and walking speed, respectively. RESULTS: In total, 174 participants were included. There were no significant differences in the length of hospital stay, rehabilitation volume, or functional independence measure score at discharge between the males and females. Multivariate logistic regression analysis revealed that independent walking was independently associated with the skeletal muscle mass index on admission. The SMI, as an explanatory variable, was independently associated with the comfortable and fastest walking speeds. Faster walking was associated with higher skeletal muscle mass indexes on admission for both males and females. CONCLUSIONS: A low skeletal muscle mass index negatively influences walking function improvement in patients with stroke. A strategy aimed at increasing skeletal muscle mass can have beneficial effects on walking function in patients with stroke.

Visualizing the translational activation of a particular mRNA in zebrafish embryos using in situ hybridization and proximity ligation assay.

Fertilized eggs initiate translation of stored mRNAs in spatially and temporally controlled manners. Here, we present a protocol for visualizing spatial and temporal translation in zebrafish embryos by fluorescence in situ hybridization and proximity ligation assay. We describe steps for labeling newly synthesized proteins and mRNA, visualizing mRNA translation and mRNA, sample mounting, and observation. Coupling detection of mRNA molecules with their translation sites is useful for understanding the molecular and cellular mechanisms that drive embryo development. For complete details on the use and execution of this protocol, please refer to Sato et al.1 and Takada et al.2.

Impact of increased trunk muscle mass on trunk function and activities of daily living in older individuals with cerebral infarction.

BACKGROUND & AIMS: The association between trunk muscle mass or trunk function or trunk muscle strength and activities of daily living (ADLs) has been reported, but no studies have examined the impact of increased trunk muscle mass on trunk function or ADL. This study aimed to determine whether increased trunk muscle mass is associated with trunk function and ADL in older individuals with cerebral infarction during rehabilitation. METHODS: This retrospective observational study enrolled 158 patients with cerebral infarction aged ≥65 years who were admitted for post-stroke rehabilitation. The trunk muscle mass index (TMI) was calculated at admission and discharge using bioelectrical impedance analysis. Patients were divided into two groups: one with increased TMI (64 participants; 41 %) and the other without TMI increase (94 participants; 59 %). Multiple linear regression analysis was performed with functional assessment for control of trunk (FACT) or functional independence measure (FIM)-motor gain as the objective variable and increased TMI group as the explanatory variable. RESULTS: We analyzed a total of 158 patients (79.5 ± 7.8 years of age, 51.9 % men). TMI increase was independently associated with FACT gain (coefficient = 1.413, 95 % confidence interval = 0.34-2.49, P = 0.010), but not with FIM-motor gain. CONCLUSIONS: The results suggest that increased TMI is independently associated with recovery of trunk function. Further prospective studies are needed to elucidate the relationship between increased TMI and ADL.

Calculation of trunk muscle mass and trunk muscle quality indices for walking independence in asian patients with hip fractures.

BACKGROUND & AIMS: This study aimed to investigate the association between trunk muscle mass and muscle quality, as evaluated by bioelectrical impedance analysis (BIA), and the ability to walk independently in patients with hip fractures. Cutoff values for quantitative and qualitative indicators of the trunk muscles were also calculated. METHODS: This study included 181 patients with hip fractures who were admitted to a convalescent rehabilitation ward. Trunk muscle mass and phase angle of the participants were evaluated on admission. The phase angle in this study was defined as the trunk muscle quality index (TMQI). Patients were classified into the independent (functional independence measure [FIM]-walk score ≥6; n = 101) and non-independent (FIM-walk score ≤5; n = 80) walking groups according to the FIM mobility scores at discharge. RESULTS: The independent group had a higher FIM gain than the non-independent group (37.0 ± 13.6 vs. 27.1 ± 13.5, p < 0.001). Logistic regression analysis showed that the trunk muscle mass index (TMI) and TMQI were associated with the ability to walk independently. Furthermore, cutoff values of TMI and TMQI for male and female to estimate the ability to walk independently were 6.5 kg/m2 and 5.7 kg/m2, and 4.5° and 3.4°, respectively. CONCLUSION: TMI and TMQI are related to the ability to walk independently in patients with hip fractures. These results suggest the importance of improving trunk muscle mass and muscle quality during rehabilitation of patients with hip fractures.

Reduced Cross-Sectional Area of the Gluteus Medius Muscle is Associated With Decreased Activities of Daily Living in Older Adult Patients With Hip Fractures.

We investigated the association between the cross-sectional area (CSA) of the gluteus medius muscle (GMM) and activities of daily living in patients with hip fractures. This retrospective cohort study comprised 111 patients aged ≥65 years who underwent hip fracture rehabilitation. The CSA of the GMM was measured using computed tomography scans in the early stages of hospitalization. The group with decreased CSA of the GMM had a median GMI ≤17 cm2/m2 for male patients and ≤16 cm2/m2 for female patients. Patients in the group with decreased CSA of the GMM had lower functional independence measure gains than those in the control group. After adjusting for confounders, we found that decreased CSA of the GMM was significantly associated with lower functional independence measure gains (ß: -0.432, p < .001). In patients with hip fractures, decreased CSA of the GMM was associated with decreased activities of daily living.

Correlation between trunk function improvement and recovery of activities of daily living after stroke in older adult patients.

OBJECTIVES: To examine the impact of improved trunk function on activities of daily living in stroke patients using the Functional Independence Measure (FIM). METHODS: This retrospective observational study was conducted on patients aged ≥ 65 years who had cerebral infarction. Patients were divided into a group with improved trunk function and a group without trunk function improvement based on the difference between the calculated Functional Assessment for Control of Trunk (FACT) gain at discharge and admission. RESULTS: Of the 218 patients (mean age, 79.5 ± 7.9 years; 56.9% were men) included, 110 patients had improved FACT scores. Multiple linear regression analysis revealed that the group with improved FACT scores had higher FIM gain (coefficient = 7.562, 95% confidence interval = 3.870-11.253, P < 0.001). Multivariate logistic regression showed that the factors associated with FACT score improvement were the Mini Nutritional Assessment Short-Form score at admission, National Institutes of Health Stroke Scale score at admission, FACT score at admission, length of hospital stay, and period of rehabilitation. DISCUSSIONS: Improvement in trunk function suggests a positive correlation with the recovery of activities of daily living in patients with cerebral infarction. This relationship should be further validated through prospective observational studies.

Oxytocin receptor-expressing neurons in the medial preoptic area are essential for lactation, whereas those in the lateral septum are not critical for maternal behavior.

INTRODUCTION: In nurturing systems, the oxytocin (Oxt)-oxytocin receptor (Oxtr) system is important for parturition, and essential for lactation and parental behavior. Among the nerve nuclei that express Oxtr, the lateral septal nucleus (LS) and medial preoptic area (MPOA) are representative regions that control maternal behavior. METHODS: We investigated the role of Oxtr- and Oxtr-expressing neurons, located in the LS and MPOA, in regulating maternal behavior by regulating Oxtr expression in a region-specific manner using recombinant mice and adeno-associated viruses. We quantified the prolactin (Prl) concentrations in the pituitary gland and plasma when Oxtr expression in the MPOA was reduced. RESULTS: The endogenous Oxtr gene in the neurons of the LS did not seem to play an essential role in maternal behavior. Conversely, decreased Oxtr expression in the MPOA increased the frequency of pups being left outside the nest and reduced their survival rate. Deletion of Oxtr in MPOA neurons prevented elevation of Prl levels in plasma and pituitary at postpartum day 2. DISCUSSION/CONCLUSION: Oxtr-expressing neurons in the MPOA are involved in the postpartum production of Prl. We confirmed the essential functions of Oxtr-expressing neurons and the Oxtr gene itself in the MPOA for the sustainability of maternal behavior, which involved Oxtr-dependent induction of Prl.

Mature mRNA processing that deletes 3' end sequences directs translational activation and embryonic development.

Eggs accumulate thousands of translationally repressed mRNAs that are translated into proteins after fertilization to direct diverse developmental processes. However, molecular mechanisms underlying the translation of stored mRNAs after fertilization remain unclear. Here, we report a previously unknown RNA processing of 3' end sequences of mature mRNAs that activates the translation of stored mRNAs. Specifically, 9 to 72 nucleotides at the 3' ends of zebrafish pou5f3 and mouse Pou5f1 mRNAs were deleted in the early stages of development. Reporter assays illustrated the effective translation of the truncated forms of mRNAs. Moreover, promotion and inhibition of the shortening of 3' ends accelerated and attenuated Pou5f3 accumulation, respectively, resulting in defective development. Identification of proteins binding to unprocessed and/or processed mRNAs revealed that mRNA shortening acts as molecular switches. Comprehensive analysis revealed that >250 mRNAs underwent this processing. Therefore, our results provide a molecular principle that triggers the translational activation and directs development.

Relationship between Trunk Muscle Mass Index at Admission and Walking Independence in Patients with Hip Fracture.

Objectives: This study aimed to investigate the relationship between trunk muscle mass index (TMI), appendicular skeletal muscle mass index (ASMI), and walking independence in patients aged 65 years and older undergoing rehabilitation for hip fracture. Methods: This retrospective, observational study was conducted in a convalescent rehabilitation ward and included 314 patients (aged ≥65 years) with hip fracture. The patients were classified into the independence group [functional independence measure (FIM)-walk score ≥6] or the non-independence group (FIM-walk score ≤5) according to the mobility item score among the motor FIM items at the time of discharge. Age, sex, TMI, ASMI, and Mini Nutritional Assessment-Short Form (MNA-SF) data were also extracted. Between-group and multivariate analyses were performed to evaluate the factors associated with walking independence. Results: The independence group had higher TMI (males: 6.6±0.9 vs. 5.6±1.0 kg/m2, P <0.001; females: 6.1±0.8 vs. 5.7±1.0 kg/m2, P <0.001), ASMI (males: 6.7±1.1 vs. 5.9±1.3 kg/m2, P=0.004; females: 5.3±0.9 vs. 4.7±0.8 kg/m2, P <0.001), MMSE-J (21.5±4.9 vs. 16.4±4.5 points, P <0.001), and MNA-SF [median (interquartile range): 8 (6-9) vs. 7 (5-8) points, P <0.001] than the non-independence group. Multivariate analysis showed that TMI at admission was significantly associated with walking independence (odds ratio: 1.86, 95% confidence interval: 1.28-2.72, P <0.001). Conclusions: This study suggests that a higher TMI at admission was important for acquiring walking independence in patients with hip fracture and shows the importance of early evaluation of TMI during hospitalization of patients with hip fracture.

Preoperatively diagnosed intraductal oncocytic papillary neoplasm of the pancreas with prominent invasion: a case report.

Previously considered as one of the less-invasive subtypes of intraductal papillary mucinous neoplasm, intraductal oncocytic papillary neoplasm (IOPN) has recently been acknowledged as a new entity of pancreatic tumor. We herein present a case of preoperatively diagnosable IOPN invasion in the stomach and colon. A 78-year-old woman was referred to our hospital for evaluation of anorexia and gastroesophageal reflux. Upper gastrointestinal endoscopy revealed a gastric subepithelial lesion with ulcerated mucosa that required hemostasis. Computed tomography revealed a 96-mm-diameter solid tumor with a well-defined border and centrally positioned necrotic area, extending from the stomach to the transverse colon and pancreatic tail. Because it was suspected to be a pancreatic solid tumor with direct stomach invasion, endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) was performed, which led to a preoperative diagnosis of IOPN. Moreover, laparoscopic pancreatosplenectomy, proximal gastrectomy, and transverse colectomy were performed. Analysis of the surgical specimen revealed that the tumor was IOPN and had invaded the stomach and transverse colon. Lymph node metastasis was also confirmed. These findings indicate that IOPN can manifest as an invasive tumor, and EUS-FNB may be equally helpful for assessing the invaded area of a cystic lesion as it is for a solid lesion.

Adrenaline-resistant anaphylactic shock caused by contrast medium in a patient after risperidone overdose: a case report.

BACKGROUND: In Japan, the use of risperidone in combination with adrenaline is contraindicated, except in cases of anaphylaxis. Therefore, there is limited clinical evidence regarding the interaction of these two drugs. Here, we report the clinical course of a case of adrenaline-resistant anaphylactic shock induced by a contrast medium injection after a risperidone overdose. CASE PRESENTATION: A man in his 30s was transported to our hospital after attempting suicide by taking 10 mg of risperidone and jumping from a height of 10 m. To determine the location and severity of his injuries, he was injected with an iodinated contrast medium, after which he developed generalized erythema and hypotension and was diagnosed with anaphylactic shock. A 0.5 mg dose of adrenaline was administered with no improvement, followed by another 0.5 mg dose that did not change his blood pressure. After infusion of a sodium bicarbonate solution (8.4%), administration of fresh frozen plasma, and additional administration of adrenaline (0.6-1.2 µg/min), his blood pressure improved, and he recovered from the anaphylactic shock. CONCLUSIONS: This was a rare case of a risperidone overdose followed by adrenaline-resistant anaphylactic shock. The resistance is likely associated with the high blood concentration of risperidone. Our findings indicate that the potential for decreased adrenergic responsiveness should be considered in patients undergoing risperidone treatment in the event of anaphylactic shock.

Determination of a Low Skeletal Muscle Mass Index Using the Mass of the Gluteus Medius in Older Patients With Hip Fractures.

This study evaluated the relationship between the muscle mass of the gluteus medius (GM) and skeletal muscle mass index (SMI) measured in patients with hip fractures. In this study, 141 patients with hip fractures were divided into those with high or low SMI. The GM index (GMI) was calculated by dividing the GM by the square of the height in meters. The correlation between GMI and SMI was subsequently analyzed, and cutoff values for determining the loss of skeletal muscle mass were calculated using the receiver operating characteristic curve. GMI and SMI showed a positive correlation for both sexes (male: r = .890, female: r = .626, p < .001). The GMI cutoff values were 19.460 cm2/m2 for males and 17.850 cm2/m2 for females. Skeletal muscle mass evaluation of the GM could contribute to hip fracture recovery by improving mobility and facilitating the early diagnosis of loss of SMM.

Intraductal oncocytic papillary neoplasm of the pancreas: clinical and radiological features compared to those of intraductal papillary mucinous neoplasm.

PURPOSE: This study aimed to characterize the clinical and imaging findings of intraductal oncocytic papillary neoplasm of the pancreas (IOPN-P) compared to those of intraductal papillary mucinous adenoma/carcinoma (IPMA/IPMC). METHODS: This multi-institutional retrospective study reviewed the clinical, imaging, and pathological findings of 21 patients with pathologically proven IOPN-P. Twenty-one computed tomography (CT) and magnetic resonance imaging, and seven 18F-fluorodeoxyglucose (FDG)-positron emission tomography were performed before surgery. The following findings were evaluated: preoperative blood test results, lesion size and location, pancreatic duct diameter, contrast-enhancement effect, bile duct and peripancreatic invasion, maximum standardized uptake (SUVmax) value, and pathological stromal invasion. RESULTS: Serum carcinoembryonic antigen (CEA) and cancer antigen 19-9 (CA19-9) levels were significantly higher in the IPMN/IPMC group than in the IOPN-P group. Except in one patient, IOPN-P showed multifocal cystic lesions with solid components or a tumor in the main pancreatic duct (MPD) with dilatation. IOPN-P had a higher frequency of solid parts and a lower frequency of downstream MPD dilatation than IPMA. IPMC showed smaller overall cyst size, more radiological peripancreatic invasion, and worse recurrence-free and overall survival than IOPN-P. The average SUVmax value of IOPN-P was 7.5. Pathologically, 17 of the 21 IOPN-Ps had a malignant component, and six showed stromal invasion. CONCLUSION: IOPN-P shows cystic-solid lesions similar to IPMC but has lower serum CEA and CA19-9 levels, larger overall cyst size, lower frequency of peripancreatic invasion, and more favorable prognosis than IPMC. Moreover, the high FDG uptake by IOPN-Ps may be a characteristic finding of this study.

Unique image findings around "kissing" distal anterior cerebral artery aneurysms in addition to perianeurysmal edema: A case report.

Background: Some aneurysms cause edema formation in the surrounding brain parenchyma and are thought to reflect various phenomena occurring in the aneurysm. Some authors highlighted perianeurysmal edema (PAE) as a finding that indicates higher risk of rupture of the aneurysm. On the other hand, there are no reports of image changes in the surrounding brain parenchyma of aneurysm other than edema formation. Case Description: We describe a 63-year-old man with unique signal change in the surrounding brain parenchyma of "kissing" distal anterior cerebral artery aneurysms completely different from PAE. The large and partially thrombosed aneurysm presented well-defined signal change surrounding brain parenchyma in addition to PAE. Intraoperative findings revealed the signal change as a space of retaining serous fluid. Drain the fluid and clipping was made for the both anterior cerebral artery aneurysms. The postoperative course was uneventful and his headache was improved the day after the surgery. The perianeurysmal signal change was also disappeared immediately after the surgery except for the PAE. Conclusion: This case demonstrates a rare phenomenon of signal change around the aneurysm, and there is a possibility that the unique finding exists as an early manifestation of intracerebral hematoma associated with aneurysm rupture.