Parkinson's disease (PD), one of the most common neurodegenerative disorders, is characterized by motor and non-motor symptoms. We evaluated the impairment in recognizing emotional facial expressions in PD patients using morphing techniques and investigated the related structures with brain perfusion on single photon emission CT (SPECT) using the threedimensional stereotactic surface projection (3D-SSP) technique. Finally, we demonstrated that PD patients displayed a prominent degree of hypoperfusion in the occipital lobe, while also demonstrating an impairment in recognizing the facial emotions for both anger and happiness. The ability to recognize the facial emotions for happiness has been shown to be closely associated with a decreased cerebral blood flow (CBF) in the right occipital lobe. In PD patients, an impairment in recognizing emotional facial expressions might be partially due to an occipital cortical dysfunction. As the present study is a preliminary one, further studies are thus needed to elucidate the mechanism of such impairments in recognizing emotional facial expressions in PD patients.

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Purpose: Aneurysms involving the proximal segment of the anterior cerebral artery (A1) are relatively rare. We report two cases we encountered and review the literature. Cases: Two female patients were referred to our hospital. The first, a 71-year-old woman, was found unconscious and semicomatose at home. Computed tomography (CT) revealed diffuse subarachnoid hemorrhage (SAH) with intraventricular and intracerebral hemorrhage. Cerebral angiography (CAG) showed a saccular aneurysm in the right A1 and unruptured right middle cerebral artery aneurysm. The second patient was a 76-year-old woman in whom an unruptured right A1 aneurysm was found incidentally. During a 3-year observation period, the aneurysm enlarged and changed its shape. Both patients underwent surgical clipping. The first patient showed moderate disability due to SAH insult while the second showed no neurological deficits. Conclusions: A1 aneurysms are rare intracranial aneurysms, but reportedly show strong correlations with vascular anomalies. When planning surgery, use of CAG and other radiological modalities are warranted to precisely assess the origin of the aneurysm neck and any accompanying anomalies. Anatomical speculations must be confirmed intraoperatively while paying attention to perforating arteries from the A1 segment.

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It is well known that the characteristics of nighttime sleep is strongly linked to cognitive abilities in daytime. However, studies investigating the influence of poor-sleep characteristics on pre-adolescent children's cognitive abilities are relatively few. The present study aimed at investigating the influence of night-time sleep characteristics on pre-adolescent children's cognitive abilities by utilizing objective indicators. To achieve this goal, we analyzed the relation between attentional control ability measured by standardized behavioral task and nighttime sleep characteristics quantified by actigraph measurement. The results revealed a significant correlation between ability of executive attention and total sleep time, i.e. total length of uninterrupted sleep. To be more specific, focal attention of children with long total sleep time was more easily distracted by goal-irrelevant information than that of children with short total sleep time, which indicates that sub-component of attentional control subserved by prefrontal cortex is particularly susceptive to sleep characteristics. The implication of this findings are discussed in the context of previous studies on the relation between children's nighttime sleep characteristics and their cognitive functions.

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A 26-year-old woman was admitted to our hospital with fever, dry cough and elevated serum CRP. Chest CT scans revealed mediastinal and bihilar lymphadenopathy, and sarcoidosis was clinically diagnosed based on additional findings. The walls of the aorta and other arteries were thickened and HLA typing was positive for HLA-B52, suggesting Takayasu's arteritis. Corticosteroid clearly improved the symptoms and the patient has remained free of recurrence since therapy was discontinued. We report the rare case of concurrent sarcoidosis and TA and review the literature.

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A 65-year-old male developed a subarachnoid hemorrhage(SAH) caused by a ruptured right internal carotid artery-posterior communicating artery aneurysm. Clipping of the aneurysm, removal of the hematoma, and external decompression were performed. Thereafter, he developed a bacterial meningitis after a spinal lumbar drainage that was done for the treatment of hydrocephalus. He was admitted to our hospital for rehabilitation 4 months after the onset of the SAH. He was still lethargic and delirious at the time of admission. He could not recognize spoken words, environmental sounds or music one month later, but was able to speak and understand the written words. He was diagnosed to have generalized auditory agnosia, based on almost normal pure tone audiometry, otoacoustic emission test, and ABR. Brain CT disclosed a right temporal and frontal lesions, but not in the left side. The eZIS and vbSEE analysis of the SPECT images disclosed a lesion in the left Heschl's transverse gyrus that could not be detected on CT. We emphasized that the detailed analysis of the SPECT images is useful to demonstrate the lesions that can not be detected by CT.

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A 54-year-old man had a history of subxiphoid pericardial window due to suspected tuberculous effusions. Seventeen years later, following chronic heart failure and implantation of a pacemaker, he again developed pericardial and pleural effusion, requiring repeated percutaneous pericardiocentesis, pleurocentesis and chest tube drainage. A 5×5-cm section of pericardium was successfully resected with video-assisted thoracic pericardial window. No recurrence of pericardial effusion has since been encountered during 36 months follow-up. An 85-year-old woman had a history of percutaneous pericardiocentesis and pleurocentesis due to chronic pericarditis. The effusion of unknown origin was refractory to medication and additional pericardiocentesis and percutaneous pericardial and chest tube drainage. A 4×4-cm section of pericardium was also successfully resected. No recurrence of pericardial effusion has been seen during 8 months follow-up. Video-assisted thoracoscopic pericardial window is an effective procedure for treating intractable pericardial effusion.

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