American Journal of Clinical Medicine Research

The subjects with Asperger’s Disorder (ASP) have difficulties in social interaction. The Prisoner’s Dilemma (PD) is a well-known model in game theory that illustrates the paradoxical disposition of interaction between two individuals. We investigated the cognitive characteristics of ASP by using a PD game. The subjects were 29 individuals with ASP and 28 healthy controls. In the PD game, each player has two cards: card 1 (cooperation) and card 2 (betrayal). The score each player obtains is decided depending on the combination of their selections according to a 2 x 2 payoff matrix. The P-score (“P” for punishment) is defined as the score that is given when they both select betrayal. Both the P-score at the end of the PD game and the total score were significantly higher in the ASP group although the rate of cooperative selection (the choice of Card 1) revealed no statistically significant difference between ASP and controls. ASP might be free of the dilemma that commonly arises among two persons because of social deficits in ASP subjects. The PD game might be a useful diagnostic support tool to understand the cognitive abilities in ASP.

American Journal of Clinical Medicine Research. 2013, 1(4), 75-76. DOI: 10.12691/ajcmr-1-4-7
Pub. Date: December 10, 2013

Full-Text PDF

13906 Views4333 Downloads32 Likes4 Citations

Using Economic Games to Investigate the Neural Substrates of Cognitive Processes

by Masao Nagatsuka, Hideo Shinagawa, Yoshiyaka Okano, Yuri Kitamura and Tatsuyoshi Saijo

Original Research

Our study has shown that changes can be induced in human decision-making and emotions by using the PD and PDAS games. This suggests that economic games may provide a way to study cognitive functions in detail by analyzing the structure of the economic games using game theory. In addition, the combined use of economic games and neuroimaging techniques such as fNIRS, fMRI, and MEG may capture and quantify neural the substrates of various cognitive processes in a clinical setting. They might be effective in extracting human emotional ups and downs in the process of the decision-making. Further studies of economic games for patients with mental illness or brain damage are needed to explore this approach further.

American Journal of Clinical Medicine Research. 2013, 1(4), 71-74. DOI: 10.12691/ajcmr-1-4-6
Pub. Date: December 10, 2013

Full-Text PDF

16182 Views5267 Downloads34 Likes

Plasma Cortisol Response to Asked Questions on Recent Events during Videogame Play in Individuals with Autism Spectrum Disorders

by Kunio Yui and Masako Ohnishi

Original Research

One of the core symptoms of autism spectrum disorders (ASD) is the need for consistency, repetition, rituals, and rigid patterns of play. The need for sameness may be extended to include videogame play and interaction with others.Unfamiliar social interactions and disruption of repetitive patterns of interests and behavior may easily exacerbate anxiety-related stress in individuals with ASD. Whereas, videogame can induce distraction of stress response. We examined the effects of videogame play on cortisol social under the situations of asked questions on daily events plasma.We conducted astructuredinterview consisting of the declarative memory recallon daily events during videogame.Before the start of the interviews, each participant played a videogame as the default context. Two serial contexts followed in which participants were exposed to different social stimuli. Twotypes of stimulators such as an unfamiliar female and an unfamiliar male asked the participants questions on unpleasant daily events, respectively. Immediately after these interviews, the participants were permitted to resume the video game play.A blood specimen for plasma cortisol determination were conducted twice: once at the time of 28 days before and again 5 minutes after the interviews.There were no significant differences in plasma cortisol levels between before and after the interview questions in the 10 children with ASD and the 7 normal healthy controls. Disruption of videogame play, asked questions conducted by the unfamiliar adults, and memory retrieval for the unpleasant daily life events may be able to increase plasma cortisol levels. However, plasma cortisol levels in the 10 children with ASD were not significantly increase plasma cortisol response. Considering that video playing has been found toinduce distraction or decrease and no stress response, video game play candistract cortisol response to stressors.

American Journal of Clinical Medicine Research. 2013, 1(4), 65-70. DOI: 10.12691/ajcmr-1-4-5
Pub. Date: December 10, 2013

Full-Text PDF

15119 Views6534 Downloads33 Likes

Prevalence of Antiphospholipid Antibodies in Sample of Iraqi Patients with Systemic Lupus Erythematosus: A Cross Sectional Study

by Ahmed S. Noori, Ali M. Jawad, Nizar A.Jassim and Faiq I. Gorial

Original Research

Objective: Antiphospholipid antibodies (APLAs) have high risk of vascularthrombosis with significant clinical comorbidities. Anticardiolipin antibodies (ACLAs)and Lupus anticoagulant (LA) are important APLAs. The aim of this study was to evaluate the prevalence of APLAs(ACLAs and LA) and their clinical significance among sample of Iraqi patients with systemic lupus erythematosus patients (SLE). Patients and methods: A single center cross sectional study conducted on 50 SLE patients diagnosed according to the 1997 revised American College of Rheumatology (ACR) criteria for SLE from February 2010 to April 2011. Patients' age at SLE diagnosis, disease duration, SLE disease activity index (SLEDAI), renal involvement, cerebral involvement, cardiac involvement, pregnancy events, and thrombotic events were analyzed. Serum samples were extracted and screened for IgG and IgM using an anticardiolipin (ACL) enzyme-linked immunosorbent assay, Lupus anticoagulant (LA), prothrombin time (PT), partial thromboplastic time (PTT), kaolin clotting time (KCT), and KCT index were assessed in all patients. Results: Of 50 SLE patients, the prevalence of positive anticardiolipin antibodies (ACLA) was 10(20%) and positive LA 5 (10%). Abnormal KCT12 (24.5%), Abnormal KCT index 5(10), Abnormal PTT2 (4.1%), and Abnormal PT 2(4%). Thrombotic events, pregnancy events, and cerebral involvement were associated with positive serology (P = 0.000, 0.225, 0.083 respectively). Renal and cardiac involvement were associated with negative serology (P = 0.019, 0.094 respectively). No new thrombotic events were found. Conclusions: Prevalence of positive ACLAs was 20% and positive LA 10%. Thrombotic events, pregnancy events, and cerebral involvement were associated with positive serology while renal and cardiac involvement with negative serology. We suggest screening SLE patients for the presence of APLAsand larger sample with longer follow up for their clinical manifestations.

American Journal of Clinical Medicine Research. 2013, 1(4), 61-64. DOI: 10.12691/ajcmr-1-4-4
Pub. Date: October 13, 2013

Full-Text PDF

18167 Views6513 Downloads33 Likes

Predictors of Early Virological Response of Viral Hepatitis C to Combination Therapy with Pegylated Interferon Plus Ribavirin

by Ahmed Faisal, Ashraf Anas Zytoon, Abdel-Naser Gad Allah and Alaa Dawood

Original Research

A combination therapy with pegylated interferon (PEG-IFN) plus ribavirin (RBV) has made it possible to achieve a sustained virological response (SVR) of 50% in refractory cases with genotype 1b and high levels of plasma HCVRNA. Several factors including virus mutation and host factors such as age, gender, fibrosis of the liver, lipid metabolism, innate immunity, and single nucleotide polymorphism (SNPs) are reported to be correlated to therapeutic effects. However, it is difficult to determine which factor is the most important predictor for an individual patient. Data mining analysis is useful for combining all these together to predict the therapeutic effects, It is important to analyze blood tests and to predict therapeutic effects prior to initiating treatment. Our aim is to determine the independent contribution of factors including age, gender, viral load, liver fibrosis, hepatitis activity index sore, and the homeostasis model assessment of insulin resistance (HOMA-IR) score in predicting response to therapy in chronic hepatitis C (CHC). Multivariate analysis of factors predicting rapid (RVR) and sustained (SVR) virological response in 280 consecutive, treatment-naive CHC patients treated with peginterferon alpha and ribavirin in a prospective multicentre study.

American Journal of Clinical Medicine Research. 2013, 1(4), 54-60. DOI: 10.12691/ajcmr-1-4-3
Pub. Date: September 22, 2013

Full-Text PDF

22479 Views7915 Downloads35 Likes7 Citations

An Unusual Complication of Ureteral Stone: Massive Gastric Dilatation and Duodenal Obstruction Due to Giant Hydronephrosis

by Mehmet Ali Karagoz, Mucahit Kabar, Arif Demirbas and Onur Telli

Case Report

A 42 year old man, was admitted to emergency service who suffered from nausea and vomitting for two days. In his physical examination the right side abdomen was severe distended, that had been lasting for a month. Distension was tender and cystic tough mass lesion was palbable. Plain abdominal radiography showed a 3cm radiopaque shadow in the pelvic area. Ct scan revealed massive gastric dilatation and duodenal obstruction due to giant hydronephrosis with the ureteric stone placing on the right lower ureter with a dimension of 3,5 to 3 cm. Nasogastrical decompression and right percutaneus nephrostomy catheter was performed, 5000 ml of gastric fluid and 5300 ml of nephrostomy catheter drainage was measured in the first six hours. 99m Tc-dimercaptosuccinic acid (DMSA) scan showed non-functioning right kidney and the patient finally underwent open simple nephroureterectomy. To the best of our knowledge the present patient represents one of the rarest complication of giant hydronephrosis cases reported to date.

American Journal of Clinical Medicine Research. 2013, 1(4), 51-53. DOI: 10.12691/ajcmr-1-4-2
Pub. Date: September 19, 2013

Full-Text PDF

16290 Views5137 Downloads32 Likes

A Case Report of Cerebellar Abscess Caused by Bacteroides fragilis

by Doğan M, Keskin F, Feyzioğlu B, Baykan M, Özdemir M, Kalkan E and Baysal B

Case Report

50 year old female patient who has headache, dizziness, and nausea-vomiting was admitted to neurosurgery clinic, and an image that was suggestive of an abscess was detected in the cerebellum by means of MRI (Magnetic resonance imaging). This cerebellar abscess was resected together with capsule by right paramedian suboccipital craniotomy, and ceftriaxone and metronidazole treatment was ordered empirically. In the microbiological examination by Gram stain, no micro-organisms were seen. Microorganism was detected on the anaerobic culture and was identified as B. fragilis. Metronidazole was susceptible according to the antibiotic susceptibility test results, so this treatment was continued. The patient was discharged by healing. In diagnosis and treatment of these kinds of patients, it should be considered that B. fragilis can be cause of abscess in the brain.

American Journal of Clinical Medicine Research. 2013, 1(4), 48-50. DOI: 10.12691/ajcmr-1-4-1
Pub. Date: July 11, 2013

Full-Text PDF

18894 Views6148 Downloads33 Likes