Cases Of HM Research Articles

Endophthalmitis after cataract surgery

Aims/Purpose: Retrospective review in 164 patients with endophthalmitis after cataract surgery, and intended to figure out the factors which affect clinical features, bacteria identification and final visual acuity (VA).Methods: We followed the guideline of EVS for operative treatment. In the case of initial LP, vitrectomy was conducted. HM or better, either IOAI (intraocular antibiotics injection, 1.0 mg/0.1 mL of vancomycin and 2.25 mg/0.1 mL of ceftazidime) or vitrectomy was optionally conducted. After initial treatment, we conducted reintervention within 48 h where the decrease of vitreous opacity and hypopyon, and pain relief did not show up. We obtained A/C fluid and vitreous specimen for figure out the bacteria identification.Results: 25 patients had initial VA below LP, the cases of HM were 86 and 53 patients had better than FC. 81 patients were observed where it took 3 days until the symptoms of post‐operative endophthalmitis occurred. Where final VA improved by 0.5 or better, the case that vitrectomy was conducted with early treatment was not statistically much different from the case of sole IOAI. The influential factors in final VA was where it took more than 3 days for endophthalmitis to occur after cataract surgery, initial VA was HM or better, and the result of bacteria identification was Gram(+) and those 3 cases affected the positive outcomes.Conclusions: Good initial VA means the diagnosis of endophthalmitis was relatively prompt. It can be said that intraocular tissues were less damaged, the virulent would be infected by less bacteria and then those affect positive prognosis. In addition, endophthalmitis diagnosed 3 days later after surgery, prognosis was good. It seems that this is because damage of intraocular tissues occurs slowly as pathogenicity did not progress quickly with light clinical features where it is infected by weak bacteria. And it can be considered that the period until post‐operative endophthalmitis occurs affects prognosis.

Abstract 12777: The Lingering Snag in Era of Mechanical Pumps: A Case of Acute Pump Thrombosis Immediately After Heartmate 3 Implantation

Background: Pump thrombosis (PT) remains a dreaded complication of left ventricle assist device (LVAD) implantation. PT immediately after HeartMate 3 (HM3) implantation is rare but should be kelp in mind if early low flow alarms are noted. Case: A 57-year-old male with ischemic cardiomyopathy, Stage D heart failure (LVEF ~20%), INTERMACS category 3 on 5mcg/kg/min Dobutamine drip underwent advanced heart failure therapy evaluation and was deemed suitable candidate for LVAD implant. His ECHO showed LVIDD 6.04 cm and LV Diastolic Volume Index 122 mL. He underwent HM3 implantation via left anterior thoracotomy and upper-hemi sternotomy on 5/24/2022. Surgery was successful and the patient was taken off bypass. Pre-implant some LV trabeculations and debris were removed. However, less than 1 hour from being off bypass, the low flow alarms began which did not resolve after volume and blood pressure optimization. No RV failure was noted on TEE. Decision was made to re-open the sternum. Upon exploration, no compression of the outflow graft was noted, and inlet cannula was not mispositioned. Inspection of LVAD inlet and outlet cannula showed significant amount of white thrombus (Figure 1) and device was ultimately exchanged. Thrombus was confirmed on histopathological analysis. Post-operatively no low flow alarms were noted after pump exchange. Factor V Leiden screen and protein C activity were normal and Antithrombin 3 was falsely low (due to recent thrombus) on post-op day 1. Discussion: This is the second case of HM 3 device thrombosis within 1 hour of implant in the literature. Most of the earlier reported cases were on post-Op Day 3. The etiology of PT is unknown and further investigation is required to elucidate the same. This case will create awareness among physicians to keep PT in differentials when low flow alarms are encountered immediately post-op despite volume and BP optimization.

Successful Thrombolytic Therapy in a Suspected Case of HeartMate 3 LVAD Thrombosis

IntroductionAlthough less common with the HeartMate 3 (HM3), pump thrombosis remains a life-threatening complication of durable left ventricular assist devices (LVAD). We present what we believe is the first case of suspected pump thrombosis in a patient with a HM3 LVAD that was successfully managed with tissue plasminogen activator (tPA).Case ReportA 22-year-old man who underwent HM3 implantation for end stage heart failure due to left ventricular non-compaction presented after experiencing two low flow alarms. His physical examination was notable for tachycardia at 125 beats per minute and an elevated Doppler mean blood pressure of 92 mm Hg. LVAD interrogation revealed low flows without power spikes (Figure 1A). Within 24 hours, he developed persistent hypotension requiring vasopressor support and multiple low flow alarms. Serial laboratory results were notable for rising LDH, peaking at 4,741 U/L and acute liver injury with AST 2,712 U/L, ALT 798 U/L and INR 5.2. Transthoracic echocardiography and computed tomography (CT) angiography did not reveal any obvious thrombus. Given this constellation of findings, pump thrombosis was suspected. Following multidisciplinary discussion, unfractionated heparin bolus and infusion were started. After an unremarkable head CT, heparin was stopped and systemic tPA was given at a dose of 5 mg over one minute followed by 10 mg over 10 minutes due to ongoing liver dysfunction. Heparin was resumed after PTT returned to therapeutic range. Immediately post tPA infusion, his LVAD flows improved from 2.3 L/min to 4.1 L/min (Figure 1B). Vasopressor support was quickly weaned. LDH, creatinine, and liver enzymes improved over the following days. Warfarin was resumed on day 14 of admission. He was discharged on aspirin, clopidogrel and warfarin.SummaryThrombolytics may be a potential therapeutic option in select cases of HM 3 pump thrombosis. Further research is warranted to delineate LVAD parameters that facilitate early recognition of pump thrombosis and successful medical management. Although less common with the HeartMate 3 (HM3), pump thrombosis remains a life-threatening complication of durable left ventricular assist devices (LVAD). We present what we believe is the first case of suspected pump thrombosis in a patient with a HM3 LVAD that was successfully managed with tissue plasminogen activator (tPA). A 22-year-old man who underwent HM3 implantation for end stage heart failure due to left ventricular non-compaction presented after experiencing two low flow alarms. His physical examination was notable for tachycardia at 125 beats per minute and an elevated Doppler mean blood pressure of 92 mm Hg. LVAD interrogation revealed low flows without power spikes (Figure 1A). Within 24 hours, he developed persistent hypotension requiring vasopressor support and multiple low flow alarms. Serial laboratory results were notable for rising LDH, peaking at 4,741 U/L and acute liver injury with AST 2,712 U/L, ALT 798 U/L and INR 5.2. Transthoracic echocardiography and computed tomography (CT) angiography did not reveal any obvious thrombus. Given this constellation of findings, pump thrombosis was suspected. Following multidisciplinary discussion, unfractionated heparin bolus and infusion were started. After an unremarkable head CT, heparin was stopped and systemic tPA was given at a dose of 5 mg over one minute followed by 10 mg over 10 minutes due to ongoing liver dysfunction. Heparin was resumed after PTT returned to therapeutic range. Immediately post tPA infusion, his LVAD flows improved from 2.3 L/min to 4.1 L/min (Figure 1B). Vasopressor support was quickly weaned. LDH, creatinine, and liver enzymes improved over the following days. Warfarin was resumed on day 14 of admission. He was discharged on aspirin, clopidogrel and warfarin. Thrombolytics may be a potential therapeutic option in select cases of HM 3 pump thrombosis. Further research is warranted to delineate LVAD parameters that facilitate early recognition of pump thrombosis and successful medical management.

Memory and Memories: An Interdisciplinary Approach

Only humans seem to have the ability to project themselves into their past or future. This mental phenomenon, called autonoetic consciousness, proves the interrelation of memory, imagination, emotion, intelligence and consciousness as a way of creating self-images. The current paper constitutes an integrative study on memory from a theoretical perspective. The first part presents the most known neuroscientific viewpoints on the memory process, along with the pathological case of patient HM, who lost his memory following the removal of his hippocampus. The second part provides a humanistic perspective on recollection to demonstrate its compatibility with the neurological processes of storing information and forming memories. The final part conveys the phenomenon of recollection from the perspective of identity crisis in Kazuo Ishiguro’s novels, as a case study in memory literature. According to memory theories to date, identity cannot exist outside the process of recording and recalling past experiences. Despite the fallible nature of recollection, human beings return to their past in order to give a healthy meaning to their present.

Memory and Memories: An Interdisciplinary Approach

Only humans seem to have the ability to project themselves into their past or future. This mental phenomenon, called autonoetic consciousness, proves the interrelation of memory, imagination, emotion, intelligence and consciousness as a way of creating self-images. The current paper constitutes an integrative study on memory from a theoretical perspective. The first part presents the most known neuroscientific viewpoints on the memory process, along with the pathological case of patient HM, who lost his memory following the removal of his hippocampus. The second part provides a humanistic perspective on recollection to demonstrate its compatibility with the neurological processes of storing information and forming memories. The final part conveys the phenomenon of recollection from the perspective of identity crisis in Kazuo Ishiguro’s novels, as a case study in memory literature. According to memory theories to date, identity cannot exist outside the process of recording and recalling past experiences. Despite the fallible nature of recollection, human beings return to their past in order to give a healthy meaning to their present.

A case report of atypical hemiplegic migraine with nonheadache onset in a Chinese child

BackgroundHemiplegic migraine (HM) is an uncommon subtype of migraine with aura including motor weakness. The core symptoms of HM are headache and motor weakness. However, we report a rare case of atypical HM with nonheadache onset in a Chinese child who was misdiagnosed several times.Case presentationWe report a Chinese boy whose onset was sudden when he was 3 years old. He presented with a variety of phenotypes, including fever, vomiting, alternating hemiplegia, and drowsiness, but no headache in the initial stages. Magnetic resonance imaging (MRI) demonstrated unilateral cerebral oedema during the initial episode of hemiplegia. These symptoms recurred many times. As the disease progressed, the patient developed episodic headache. The patient was misdiagnosed several times with encephalitis, alternating hemiplegia of childhood (AHC) and mitochondrial encephalopathy. Whole-exome next-generation sequencing revealed a de novo heterozygous missense mutation in the ATP1A2 gene(p.Gly715Arg) classified as pathogenic and eventually led to a diagnosis of HM when he was 11 years old. Flunarizine was subsequently administered, and no recurrence was found during follow-up.ConclusionsHM in children may be atypical in the initial stage of the disease, which could manifest as fever, alternating hemiplegia and drowsiness but no headache at the onset. This could easily lead to misdiagnosis. With age, it may eventually manifest as typical HM. Therefore, attention should be given to differentiation in clinical practice.When similar clinical cases appear, gene detection is particularly important, which is conducive to early diagnosis and treatment.

Episodic Memories: How do the Hippocampus and the Entorhinal Ring Attractors Cooperate to Create Them?

The brain is capable of registering a constellation of events, encountered only once, as an episodic memory that can last for a lifetime. As evidenced by the clinical case of the patient HM, memories preserving their episodic nature still depend on the hippocampal formation, several years after being created, while semantic memories are thought to reside in neocortical areas. The neurobiological substrate of one-time learning and life-long storing in the brain, that must exist at the cellular and circuit level, is still undiscovered. The breakthrough is delayed by the fact that studies jointly investigating the rodent hippocampus and entorhinal cortex are mostly targeted at understanding the spatial aspect of learning. Here, we present the concept of an entorhinal cortical module, termed EPISODE module, that could explain how the representations of different elements constituting episodic memories can be linked together at the stage of encoding. The new model that we propose here reconciles the structural and functional observations made in the entorhinal cortex and explains how the downstream hippocampal processing organizes the representations into meaningful sequences.

Distribution and features of hematological malignancies in Eastern Morocco: a retrospective multicenter study over 5 years.

BackgroundHematological malignancies (HM) are a public health problem. The pattern and distribution of diagnosed hematological cancers vary depending on age, sex, geography, and ethnicity suggesting the involvement of genetic and environmental factors for the development of these diseases. To our knowledge, there is no published report on HM in the case of Eastern Morocco. In this report we present for the first time the overall pattern of HM for this region.MethodsRetrospective descriptive study of patients diagnosed with HM between January 2008 and December 2012 in three centres in Eastern Morocco providing cancer diagnosis, treatment or palliative care services. The FAB (French-American-British) classification system has been taken into account in the analysis of myeloid and lymphoid neoplasms.ResultsIn this study, a total of 660 cases of HM were registered between January 2008 and December 2012. Overall, 6075 cases of cancers all sites combined were registered during this study period, indicating that HM account for around 10.9 % (660/6075) of all cancers recorded. Among the 660 registered cases of HM, 53 % were males and 47 % were females, with a male to female ratio of 1.1. Thus, overall, men are slightly more affected with HM than women. By contrast, a female predominance was observed in the case of Hodgkin’s lymphoma (HL), myeloproliferative neoplasms (MPN), acute myeloid leukemia (AML) and the myelodysplastic syndrome (MDS). HM occur at a relatively young age, with an overall median age at diagnosis of 54 years. Non-Hodgkin’s lymphoma (NHL) was the most common HM accounting for 29.7 % of all HM, followed by HL, MPN, multiple myelomas (MM), chronic lymphocytic leukemia (CLL), AML, MDS, acute lymphoblastic leukemia (ALL), and Waldenström macroglobulinemia (WM). The majority of HM cases have been observed among patients aged 60 years and over (40.4 % of HM). Among this age group, NHL was the most common HM. In adolescents, HL was the most frequent HM.ConclusionsThis study provided for the first time the pattern and distribution of HM in Eastern Morocco. Our findings justify the need to establish a regional cancer registry as a first step in blood cancer control in Eastern Morocco.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2205-5) contains supplementary material, which is available to authorized users.

Knowledge of facts mediate “continuous improvement” in elite sport: a comment on Stanley and Krakauer (2013)

Traditional theories of motor skill learning (e.g., Fitts and Posner, 1967) and many contemporary perspectives in sport psychology (see Masters and Maxwell, 2008) and cognitive neuroscience (see Yarrow et al., 2010) argue that skilled action is guided by procedural or implicit knowledge. Researchers adopting this perspective believe that skilled performance proceeds rapidly, efficiently and without the need for conscious monitoring, or a reliance on propositional knowledge (what some might term declarative or explicit knowledge) to guide an activity. However, in a recent paper published in this journal, Stanley and Krakauer (2013) present a compelling argument which offers a stern challenge to the latter of these assumptions. Drawing on evidence from famous cases in neuroscience (e.g., the case of HM) and other research on the nature of skill, Stanley and Krakauer (2013) suggest that becoming proficient at any motor task, and maintaining and improving one's skill in that activity, is heavily influenced by the use of what they refer to as “knowledge of facts” (i.e., propositional knowledge). The aim of this brief commentary is to build on Stanley and Krakauer's work by pointing to empirical evidence (e.g., Collins et al., 1999), recent theory (e.g., Shusterman, 2009) and phenomenological descriptions (e.g., Cotterill et al., 2010) which suggest that “continuous improvement” at the elite level of sport is mediated by the “ongoing accrual and improving application of knowledge of facts about an activity” (Stanley and Krakauer, 2013, p. 2). More specifically, the current paper presents evidence which demonstrates how performers use knowledge of facts in two distinct sporting situations: (1) in the training context when the performer is seeking to improve “attenuated” movement patterns and (2) during the planning and strategizing that occurs in pre-performance routines during on-line competitive performance.

Do the Medial Temporal Lobes Resolve Perceptual Interference?

The role of the medial temporal lobes (MTLs) in memory was first clearly established with the case of patient HM, who suffered from an inability to form new memories following surgical removal of bilateral MTLs ([Scoville and Milner, 1957][1]). Subsequent work in humans and animals revealed that

Association of renal cell carcinoma and hematologic malignancy.

449 Background: An increased incidence of both RCC and HM occurring in the same patients has been reported. Also, a relationship between adenocarcinoma and HM has been previously suggested. Moreover, detailed family history in our patients with RCC suggested an increased incidence of HM in their family members. The purpose of this study is to characterize the HM in relatives of patients with RCC. Methods: Data from 700 patients with RCC seen by us from 2004 to the present were retrospectively evaluated through chart review. The patient, family history and pathology characteristics were collected to determine the frequency of HM in first and second-degree relatives of patients with RCC. Pedigrees were then constructed and subtypes of HM were characterized. Results: A family history of HM was observed in 74 relatives involving 59 families. Of these, 50/74 cases of HM were in first-degree relatives and 19/74 were in second-degree relatives. The most common HMs were lymphoma and leukemia: 24 non-Hodgkin’s lymphoma, 8 Hodgkin’s lymphoma, 8 lymphoma not further specified (NOS), 11 chronic lymphocytic leukemia, 1 chronic myeloid leukemia, 1 acute myeloid leukemia, 5 acute leukemia NOS and 4 leukemia NOS. Other HM observed were multiple myeloma in 2 patients, Waldenström’s macroglobulinemia, myelodysplastic syndrome, and myelofibrosis. Additionally, 2 relatives had blood cancers that were NOS. Of the 59 patients with RCC, 40 had clear cell histology, 4 papillary, 3 chromophobe, 1 sarcomatoid, 1 transitional and in 10, RCC histology was not recorded. Conclusions: HM is observed in patients with RCC with increased frequency compared with the SEER database. We now observed an increased frequency of HM in relatives of patients with RCC. The majority of HMs observed were B-cell malignancies, as we previously reported for HMs that occur in patients with breast cancer or RCC. The etiology of this association remains unclear, but suggests a common etiopathogenesis for RCC and B-cell tumors. Genetic mutations, hereditary immunological defects, and environmental factors may be involved. A larger study with statistical evaluation for confirmation is required. We plan to collect serum and tissue samples from patients and relatives for future molecular studies.

Towards a left MTL specialization for arbitrary-associative learning? A multiple-case study.

Since the famous case of HM provided unquestionable evidence for the involvement of medial temporal lobe (MTL) structures in memory, a dominant neuropsychological model raised up in the 1970’s. Brenda Milner proposed that “the most significant variable (to explain post-surgery memory outcome in temporal lobe epilepsy) is the verbal or non-verbal character of the material to be retained” [1]. This model predicts that verbal and non-verbal memories are homogenous and independent systems, respectively relying upon left and right temporal lobes. Yet, series of cases of amnesia following unilateral temporal lobectomy have been documented, drawing a more complex picture [2]. Moreover, cases of poorer verbalmemory outcome after right TL surgery had been reported [3], and other studies underlined deficits in spatial learning after left surgery. Taken together, those data strongly challenges the dominant material-specific view. In linewith those challenging data,other authors suggested that beyond material-specificity, task-specifi-

Hydatidiform mole resulting from sexual violence.

BackgroundHydatidiform mole (HM) is characterized by abnormal proliferation of human trophoblast with producers functioning tissues of human chorionic gonadotropin. It can evolve with ovarian cysts tecaluteínicos, hypertension of pregnancy or hyperthyroidism. The incidence of HM is variable and its etiology poorly known, associated with nutritional factors, environmental, age, parity, history of HM, oral contraceptives, smoking, consanguinity or defects in germ cells. There is no reference in literature on HM resulting from sexual violence, objective of this report.MethodDescription of two cases of HM among 1146 patients with pregnancy resulting from sexual violence treated at Hospital Pérola Byington, São Paulo, from July 1994 to August 2011.ResultsThe cases affected young, white, unmarried, low educated and low parity women. Sexual violence was perpetrated by known offenders unrelated to the victims, under death threat. Ultrasound and CT of the pelvis showed bulky uterus compatible with HM without myometrial invasion. One case was associated with theca lutein cysts. The two cases were diagnosed in the second trimester of pregnancy and evolved with hyperthyroidism. There was no hypertension, disease recurrence, metastasis or sexually transmitted infection.ConclusionThe incidence of HM was 1:573 pregnancies resulting from rape, within the range estimated for Latin American countries. Trophoblastic material can be preserved to identify the violence perpetrator, considering only the paternal HM chromosomes. History of sexual violence should be investigated in cases of HM in the first half of adolescence and women in a vulnerable condition.

Histiocytose multicentrique paranéoplasique

Multicentric histiocytosis (MH) is a rare form of histiocytosis of unknown aetiology and is associated with a malignant neoplasm in 25% of cases. Herein, we report the case of a female patient in whom HM enabled us to diagnose gastric carcinoma.A 74-year-old woman consulted for papules and nodules on the hands associated with destructive polyarthralgia of the interphalangeal joints and asthenia. Biopsy of a nodule revealed infiltration of the superficial dermis by numerous multinucleated giant cells containing eosinophilic cytoplasm; immunohistochemical analysis showed positive staining for CD68, confirming the diagnosis of MH. Additional screening tests for malignancy enabled us to diagnose gastric carcinoma. The cutaneous lesions disappeared several weeks after gastrectomy and no recurrence of HM or malignancy was seen in the ensuing 7 years.Fewer than 200 cases of HM have been reported. This non-Langerhans proliferative histiocytosis is a rare systemic disorder of unknown aetiology characterized clinically by papules and nodules associated with destructive polyarthralgia, and histologically by dermal proliferation of histiocytic multinucleated giant cells of skin, mucous membrane and synovial membrane. Routine screening for neoplasia should be performed following the discovery of HM as an association is seen in 25% of cases. However, the two diseases do not generally progress in parallel. In our case, the rapid disappearance of lesions within a few weeks of surgery suggests that HM was a true paraneoplastic syndrome.

Haematological Malignancies on the Island of Sardinia, 1974-1993: A Geographical Study

We studied the geographical distribution of all cases of HM that were diagnosed among residents of Sardinia during the 20-year period from 1974 to 1993. Cases, grouped into three categories (lymphoproliferative diseases, myeloproliferative diseases, and total haematological malignancies), were assigned to the 356 municipalities of the island according to the reported residence of each patient. In each municipality, the relative risk (RR) of diagnosis was calculated for the three disease groups, for females, for males, and for the total population. The RR of diagnosis of HM was significantly different from 1 (p<0.05) for a limited number of estimates (5.4%), with almost as many instances of elevated RR as of reduced RR.

Neuropharmacology of cognition and memory: A unifying theory of neuromodulator imbalance in psychiatry and amnesia

The case of HM, a man with intractable epilepsy who became amnesic following bilateral medial temporal lobe surgery nearly half a century ago has instigated ongoing research and theoretical speculation on the nature of memory and the role of the hippocampus. Neuropsychological testing showed that although HM had extensive anterograde memory loss he could still acquire motor and cognitive skills implicitly, but could not remember the context of this learning. This has lead to declarative and procedural descriptions of the memory process. Cholinergic and monoaminergic neurotransmitter systems have also been implicated in the memory process and anticholinergic drugs traditionally have been associated with impairment of declarative memory. The cholinergic hypothesis of Alzheimer's disease is a classic example of an application of these neuropharmacological findings. In schizophrenia, preattentive deficits have been amply demonstrated by unconscious priming studies. Memory processes are also impaired in these patients. Dopamine, glutamate and even cholinergic dysfunction has been implicated in the clinical picture of schizophrenia. The present paper will attempt to bring together both the anatomical and pharmacological data from these disparate fields of research under a cohesive theory of cognition and memory. A hypothesis is presented for an inverse relationship between monoaminergic and cholinergic systems in the modulation of implicit (unconscious) and explicit (conscious) cognitive processes. It is postulated that muscarinic cholinergic receptors and monoaminergic systems facilitate unconscious and conscious processes, respectively, and they disfacilitate conscious and unconscious processes, respectively (the purported inverse relationship). In fact, the muscarinic and monoaminergic modulations of a neural network are proposed to be finely balanced such that, if, the activity of one receptor system is modified then this by necessity has effects on the other system. It takes into account receptor subtypes and their effects mediated through excitatory and inhibitory G-protein complexes. For example, m1/D2 and D1/m4 paired receptor subtypes, colocalized on separate neurons would have opposing functional effects. A theory is then presented that the critical underlying pathophysiology of schizophrenia involves a hypofunctional muscarinic cholinergic system, which induces abnormal facilitation of monoaminergic subsystems such as dopamine (e.g., a decrease in m1R function would potentiate D2R function). This extends the idea of an inverted U function for optimal monoaminergic concentrations. Not only would this impair unconscious preattentive processes, but according to the hypothesis, explicit cognition as well including memory deficits and would underlie the mechanism of psychosis. Contrary to current thinking a different view is also presented for the role of the hippocampus in the memory process. It is postulated that long-term explicit memory traces in the neocortex are laid down by phasic coactivation of forebrain projecting monoaminergic systems above some basal firing rate, such as the rostral serotonergic raphe, which projects diffusely to the cortex and according to a modified Hebbian principle. This is the proposed principal function of the hippocampal theta rhythm. The phasic activation of the cholinergic basal forebrain is mediated by projections from a separate cortical structure, possibly the lateral prefrontal cortex. Phasic muscarinic receptor activation is proposed to strengthen implicit memory traces (at a synaptic level) in the neocortex. Thus, the latter are spared by medial temporal surgery explaining the dissociation of explicit from implicit memory.

99m TC HM‐PAO SPECT in Pediatric Migraine

99mTC HM-PAO SPECT brain imaging was performed during the headache-free period in 19 young migraineurs, affected by common migraine (CM, 10 cases), classic migraine (CLM, 6 cases) and hemiplegic migraine (HM, 3 cases). SPECT findings were negative in all 10 patients with CM, in 3 cases of CLM and in 2 cases of HM. Positive findings in the remaining 4 patients (3 cases of CLM and 1 of HM) showed a decreased tracer distribution in the temporo-occipital regions (2 cases) and parietal regions (2 cases): the two with decreased temporo-occipital perfusion reported prodromal symptoms exclusively contralateral to the areas of hypoperfusion. An impaired regional cerebral vascular autoregulation may exist even during headache-free intervals in patients suffering from classic and hemiplegic migraine.

On the IR variability of symbiotic stars - The case of V1016 Cygni, HM Sagittae, and V1329 Cygni

On the IR variability of symbiotic stars - The case of V1016 Cygni, HM Sagittae, and V1329 Cygni