Background:We analyzed factors associated with worsened paresis in a large series of patients with brain lesions located within or near the primary motor area (M1) to establish protocols for safe, awake craniotomy of eloquent lesions.Methods:We studied patients with brain lesions involving M1, the premotor area (PMA) and the primary sensory area (S1), who underwent awake craniotomy (n = 102). In addition to evaluating paresis before, during, and one month after surgery, the following parameters were analyzed: Intraoperative complications; success or failure of awake surgery; tumor type (A or B), tumor location, tumor histology, tumor size, and completeness of resection.Results:Worsened paresis at one month of follow-up was significantly associated with failure of awake surgery, intraoperative complications and worsened paresis immediately after surgery, which in turn was significantly associated with intraoperative worsening of paresis. Intraoperative worsening of paresis was significantly related to preoperative paresis, type A tumor (motor tract running in close proximity to and compressed by the tumor), tumor location within or including M1 and partial removal (PR) of the tumor.Conclusions:Successful awake surgery and prevention of deterioration of paresis immediately after surgery without intraoperative complications may help prevent worsening of paresis at one month. Factors associated with intraoperative worsening of paresis were preoperative motor deficit, type A and tumor location in M1, possibly leading to PR of the tumor.

Transient epileptic amnesia (TEA) is characterised by recurrent brief episodes of amnesia and atypical amnesic symptoms, known as long-term anterograde amnesia and dense retrograde amnesia. It has been proposed that an antiepileptic drug (AED) can prevent not only epileptiform activity, but also accelerated forgetting. However, there have been no reports regarding the effects of such drugs on retrograde amnesia. We found that an AED prevented accelerated forgetting, but not dense retrograde amnesia, suggesting that accelerated forgetting in TEA was treatable, but retrograde amnesia was an irreversible process.

We report on the case of an extraordinary orangutan who spontaneously produced over a thousand drawings in 5 years. This female orangutan, Molly, started drawing when she was estimated to be 50 years old. Although it has been established that great apes spontaneously draw without training, she produced an enormous number of paintings in her old age, and the numbers of lines and colors in her drawings varied from day to day. As her drawings seemed to be affected by her surroundings, we attempted to analyze quantitatively relationships between her drawings and potentially influential factors during a specific period in which no ostensibly major events were observed. According to our results, her drawings were affected by the identity of her keeper, implying that her drawing behavior may have been affected by environmental factors. Thus, drawings may serve as windows to the internal states of non-human primates.

The MLR is an important and easy-to-assess prognostic factor that should be considered for staging lymph node metastasis in patients with gastric cancer.

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