Retrosplenial Amnesia Without Topographic Disorientation Caused by a Lesion in the Nondominant Hemisphere.

Retrosplenial Amnesia without Topographic Disorientation Caused by a Lesion in the Nondominant Hemisphere.

J Stroke Cerebrovasc Dis. 2013 Apr 20;
Maeshima S, Osawa A, Yamane F, Yoshihara T, Kanazawa R, Ishihara S

We report the case of a 68-year-old right-handed man who was admitted to our hospital because of sudden onset of headache. On admission, he presented with left homonymous hemianopsia, disorientation, and recent memory disturbance; however, he had normal remote memory and digit span. He was able to recall the room layout of his house and describe the route from the nearest station to his home on a map. However, at the hospital, he sometimes lost his way because of amnesia. Computed tomography (CT) and magnetic resonance imaging revealed a subcortical hematoma in the right occipital forceps and the parietal lobe, involving the cingulate isthmus. Single-photon emission CT imaging showed reduced perfusion not only in the retrosplenial region but also in the right thalamus. These findings suggested that the retrosplenial amnesia might have been caused by the interruption of hippocampal input into the anterior thalamus. HubMed – rehab


Efficacy of Multimodal Perioperative Analgesia Protocol With Periarticular Medication Injection in Total Knee Arthroplasty: A Randomized, Double-Blinded Study.

J Arthroplasty. 2013 Apr 19;
Kelley TC, Adams MJ, Mulliken BD, Dalury DF

Pain control is necessary for successful rehabilitation and outcome after total knee arthroplasty. Our goal was to compare the clinical efficacy of periarticular injections consisting of a long-acting local anesthetic (ropivacaine) and epinephrine with and without combinations of an ?2-adrenergic agonist (clonidine) and/or a nonsteroidal anti-inflammatory agent (ketorolac). In a double-blinded controlled study, we randomized 160 patients undergoing total knee arthroplasty to receive 1 of 4 intraoperative periarticular injections: Group A, ropivacaine, epinephrine, ketorolac, and clonidine; Group B, ropivacaine, epinephrine, and ketorolac; Group C, ropivacaine, epinephrine, and clonidine; Group D (control), ropivacaine and epinephrine. Compared with Group D, Group A and B patients had significantly lower postoperative visual analog pain scores and nurse pain assessment and Group C patients had a significantly greater reduction in physical therapist pain assessment. We found no differences in other parameters analyzed. HubMed – rehab


Aphasia rehabilitation: Does generalisation from anomia therapy occur and is it predictable? A case series study.

Cortex. 2013 Feb 4;
Best W, Greenwood A, Grassly J, Herbert R, Hickin J, Howard D

INTRODUCTION: The majority of adults with acquired aphasia have anomia which can respond to rehabilitation with cues. However, the literature and clinical consensus suggest change is usually limited to treated items. We investigated the effect of an experimentally controlled intervention using progressive cues in the rehabilitation of noun retrieval/production in 16 participants with chronic aphasia. METHOD: Participants were sub-divided relative to the group according to performance on semantic tasks (spoken/written word to picture matching) and phonological output processing (presence/absence of word length effect and proportion of phonological errors in picture naming) in order to investigate outcome in relation to language profile. Cueing therapy took place weekly for 8 weeks. RESULTS: Intervention resulted in significant improvement on naming treated items for 15/16 participants, with stable performance on control tasks. Change occurred at the point of intervention and not during pre-therapy assessments. We predicted particular patterns of generalisation which were upheld. Only participants classified as having relatively less of a semantic difficulty and more of a phonological output deficit demonstrated generalisation to untreated items. Outcome did not relate to traditional aphasia classification. CONCLUSION: A cueing hierarchy can improve word retrieval/production for adults with aphasia. In some cases generalisation to untreated items also occurs. The study demonstrates that the results of behavioural testing can be used to guide predictions of recovery with intervention. HubMed – rehab


Lost therapeutic potential of monocyte-derived DC through lost tissue homing; stable restoration of gut specificity with retinoic acid.

Clin Exp Immunol. 2013 Apr 16;
Bernardo D, Mann ER, Al-Hassi HO, English NR, Man R, Lee GH, Ronde E, Landy J, Peake ST, Hart AL, Knight SC

Human monocyte-derived DC (MoDC) are utilised for immunotherapy. However, in vitro immunological effects are often not mirrored in vivo. We studied tissue homing potential of MoDC. Circulating monocytes and DC expressed different tissue homing markers and during in vitro development of MoDC homing marker expression was lost resulting in a “homeless” phenotype. Retinoic acid (RA) induced gut-homing markers (?7 and CCR9) and a regulatory phenotype and function (decreased HLA-DR and increased ILT3 and FITC-Dextran uptake) in MoDC. RA-MoDC were less stimulatory and primed conditioned T-cells with a gut-homing profile (?7(+) CLA(-) ). Unlike normal intestinal microenvironment, that from inflamed colon of ulcerative colitis (UC) patients did not induce regulatory properties in MoDC. However, RA-MoDC maintained their regulatory gut-specific properties even in the presence of UC microenvironment. Therefore, MoDC may be ineffectual for immunotherapy because they lack tissue homing and tissue-imprinting specificity. However, MoDC rehabilitation with gut-homing potential by RA could be useful in promoting immunotherapy in pathologies like UC. HubMed – rehab