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BMC Urology (1)
Neuropsychiatric Disease and Treatment (1)
Social Cognitive and Affective Neuroscience (1)
Hayashi, Takuji (3)
Fujimi, Satoshi (1)
Fujita, Kazutoshi (1)
Hosomi, Masahiro (1)
Imamura, Ryoichi (1)
Inoue, Yushi (1)
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Noma, Shun’ichi (1)
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Usui, Keiko (1)
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Wada, Daiki (1)
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Yamamoto, Yoshiyuki (1)
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Clinical characteristics and risk factors for septic shock in patients receiving emergency drainage for acute pyelonephritis with upper urinary tract calculi
Acute pyelonephritis (APN) is a common complication of ureteral obstruction caused by urolithiasis, and it can be lethal if it progresses to septic shock. We investigated the clinical characteristics of patients undergoing emergency drainage and assessed risk factors for septic shock.
A retrospective study was performed of 98 patients (101 events) requiring emergency drainage at our urology department for obstructive APN associated with upper urinary tract calculi from January 2003 to January 2011. Clinical characteristics were summarized, and risk factors for septic shock were assessed by logistic regression analysis.
Objective evidence of sepsis was found in 64 (63.4%) events, and 21 events (20.8%) were categorized as septic shock. Ninety-six patients recovered, but 2 patients died of septic shock. Multivariate analysis revealed that age and the presence of paralysis were independent risk factors for septic shock.
APN associated with upper urinary tract calculi is a severe disease that should be treated with caution, particularly when risk factors are present.
Involvement of medial temporal structures in reflexive attentional shift by gaze
Social Cognitive and Affective Neuroscience
Recent studies have revealed that eye gaze triggers reflexive shift of the observer's visuospatial attention to its direction even if it does not predict any events in the environment. To determine whether medial temporal structures are involved in this reflexive gaze processing, an experiment of the gaze-cuing paradigm was carried out in seven epileptic patients who had undergone unilateral temporal lobectomy and nine age- and IQ-matched epileptic controls who had not undergone any surgical treatments. Gaze cues were presented for 200 ms to the unilateral visual field, after which subjects were required to localize targets as quickly as possible. They were also instructed that gaze directions were not predictive of the location of the targets. When the gaze cues stimulated the intact hemisphere in lobectomized patients or either hemisphere in controls, reaction times for correct responses were significantly shorter when gaze directions were toward the targets than away from the targets. This cuing effect was not manifested following stimulation of the lesioned hemisphere in lobectomized patients. These findings suggest that the medial temporal structures, including the amygdala, play a crucial role in the reflexive shift of attention triggered by another person's gaze direction in humans.
medial temporal structures; gaze direction; reflexive attentional shift; cuing paradigm; anterior temporal lobectomy; unilateral visual field presentation
Effects of milnacipran on binge eating – a pilot study
Neuropsychiatric Disease and Treatment
Selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors are effective in the treatment of bulimia nervosa. There have been relatively few studies of the efficacy of specific serotonin and norepinephrine reuptake inhibitors in the treatment of eating disorders. Twenty-five outpatients with binge eating episodes, diagnosed as anorexia nervosa, binge-eating/purging type, bulimia nervosa/purging type, or bulimia nervosa/non-purging type, were treated with milnacipran and 20 patients completed the 8-week study. Symptom severity was evaluated using the Bulimic Investigatory Test, Edinburgh (BITE) self-rating scale before administration of milnacipran and after 1, 4, and 8 weeks treatment. The scores improved after 8 weeks, especially drive to, and regret for, binge eating. Milnacipran was more effective in patients without purging and in younger patients, while there was no difference in the efficacy of milnacipran among subtypes of eating disorders.
milnacipran; specific serotonin and norepinephrine reuptake inhibitors; binge eating; vomiting; eating disorder; pharmacotherapy
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