Will Preoperative Atrophy and Fatty Degeneration of the Shoulder Muscles Improve after Rotator Cuff Repair in Patients with Massive Rotator Cuff Tears?

Recently, retear rate after repair for massive cuff tear have been improved through devised suture techniques. However, reported retear rate is relevant to preoperative atrophy and fatty degeneration. The purpose of this study was to investigate whether preoperative atrophy and fatty degeneration of rotator cuff muscles improve by successful repair. Twenty-four patients with massive rotator cuff tear were evaluated on the recovery of atrophy and fatty degeneration of supraspinatus and infraspinatus muscle after surgery. Atrophy was classified by the occupation ratio and fatty degeneration by modified Goutallier's classification. Both were assessed on magnetic resonance imaging (MRI) before and after the operation. When the cuff was well repaired, improvement of the atrophy and fatty degeneration were observed in a half and a one-fourth of the cases, respectively. In retear cases, however, atrophy and fatty degeneration became worse. Improvement of atrophy and fatty degeneration of the rotator cuff muscles may be expected in the cases with successful achievement of rotator cuff repair for large and massive tear

Potent Inhibitory Effects of D-tagatose on the Acid Production and Water-insoluble Glucan Synthesis of Streptococcus mutans GS5 in the Presence of Sucrose

We examined and compared the inhibitory effects of D-tagatose on the growth, acid production, and water-insoluble glucan synthesis of GS5, a bacterial strain of Streptococcus mutans, with those of xylitol, D-psicose, L-psicose and L-tagatose. GS5 was cultured for 12h in a medium containing 10ｵ (w/v) of xylitol, D-psicose, L-psicose, D-tagatose or L-tagatose, and the inhibitory effect of GS5 growth was assessed. Each sugar showed different inhibitory effects on GS5. Both D-tagatose and xylitol significantly inhibited the acid production and water-insoluble glucan synthesis of GS5 in the presence of 1ｵ (w/v) sucrose. However, the inhibitory effect of acid production by D-tagatose was significantly stronger than that of xylitol in presence of sucrose

FOXO/TXNIP pathway is involved in the suppression of hepatocellular carcinoma growth by glutamate antagonist MK-801

BACKGROUND: Accumulating evidence has suggested the importance of glutamate signaling in cancer growth, yet the signaling pathway has not been fully elucidated. N-methyl-D-aspartic acid (NMDA) receptor activates intracellular signaling pathways such as the extracellular-signal-regulated kinase (ERK) and forkhead box, class O (FOXO). Suppression of lung carcinoma growth by NMDA receptor antagonists via the ERK pathway has been reported. However, series of evidences suggested the importance of FOXO pathways for the regulation of normal and cancer cell growth. In the liver, FOXO1 play important roles for the cell proliferation such as hepatic stellate cells as well as liver metabolism. Our aim was to investigate the involvement of the FOXO pathway and the target genes in the growth inhibitory effects of NMDA receptor antagonist MK-801 in human hepatocellular carcinoma. METHODS: Expression of NMDAR1 in cancer cell lines from different tissues was examined by Western blot. NMDA receptor subunits in HepG2, HuH-7, and HLF were examined by reverse transcriptase polymerase chain reaction (RT-PCR), and growth inhibition by MK-801 and NBQX was determined using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The effects of MK-801 on the cell cycle were examined by flow cytometry and Western blot analysis. Expression of thioredoxin-interacting protein (TXNIP) and p27 was determined by real-time PCR and Western blotting. Activation of the FOXO pathway and TXNIP induction were examined by Western blotting, fluorescence microscopy, Chromatin immunoprecipitation (ChIP) assay, and reporter gene assay. The effects of TXNIP on growth inhibition were examined using the gene silencing technique. RESULTS: NMDA receptor subunits were expressed in all cell lines examined, and MK-801, but not NBQX, inhibited cell growth of hepatocellular carcinomas. Cell cycle analysis showed that MK-801 induced G1 cell cycle arrest by down-regulating cyclin D1 and up-regulating p27. MK-801 dephosphorylated Thr24 in FOXO1 and induced its nuclear translocation, thus increasing transcription of TXNIP, a tumor suppressor gene. Knock-down of TXNIP ameliorated the growth inhibitory effects of MK-801. CONCLUSIONS: Our results indicate that functional NMDA receptors are expressed in hepatocellular carcinomas and that the FOXO pathway is involved in the growth inhibitory effects of MK-801. This mechanism could be common in hepatocellular carcinomas examined, but other mechanisms such as ERK pathway could exist in other cancer cells as reported in lung carcinoma cells. Altered expression levels of FOXO target genes including cyclin D1 and p27 may contribute to the inhibition of G1/S cell cycle transition. Induction of the tumor suppressor gene TXNIP plays an important role in the growth inhibition by MK-801. Our report provides new evidence that FOXO-TXNIP pathway play a role in the inhibition of the hepatocellular carcinoma growth by MK-801

The expression of Ca2+/calmodulin-dependent protein kinase I in rat retina is regulated by light stimulation

AbstractCa2+/calmodulin-dependent protein kinase I (CaM-kinase I) in rat retina was analyzed by immunohistochemical analysis, Western blot analysis and kinase activity assay. Western blot analysis revealed two immunoreactive bands similar to those detected in the brain. Developmental studies revealed that CaM-kinase I expression increased in accordance with postnatal development. Expression of CaM-kinase I in the retinas of rats raised in the complete darkness markedly decreased. CaM-kinase I activity assay supported these findings. Synapsin I was shown to be a possible intrinsic substrate of CaM-kinase I in rat retina. These results elucidated that CaM-kinase I is expressed in the retina and may play an important role in the retinal functions and that the expression of CaM-kinase I is regulated by light stimulation

D-Tagatose Effectively Reduces the Number of Streptococcus mutans and Oral Bacteria in Healthy Adult Subjects: A Chewing Gum Pilot Study and Randomized Clinical Trial

We examined the effect of D-Tagatose on the growth of oral bacteria including Streptococcus mutans (S. mutans). Saliva collected from 10 healthy volunteers was plated on BHI medium (to culture total oral bacteria) and MBS medium (to culture S. mutans, specifically). Agar plates of BHI or MBS containing xylitol or D-Tagatose were cultured under aerobic or anaerobic conditions. We then counted the number of colonies. In BHI plates containing D-Tagatose, a complete and significant reduction of bacteria occurred under both aerobic and anaerobic conditions. In MSB medium, significant reduction of S. mutans was also observed. We then performed a doubleblind parallel randomized trial with 19 healthy volunteers. They chewed gum containing xylitol, D-Tagatose, or both for 4 weeks, and their saliva was collected weekly and plated on BHI and MSB media. These plates were cultured under anaerobic conditions. Total bacteria and S. mutans were not effectively reduced in either the D-Tagatose or xylitol gum group. However, S. mutans was significantly reduced in volunteers chewing gum containing both D-Tagatose and xylitol. Thus, D-Tagatose inhibited the growth of S. mutans and many types of oral bacteria, indicating that D-Tagatose intake may help prevent dental caries, periodontitis, and many oral diseases

A Proposal for an Early Response to Delirium in Terminal Cancer Patients with the Aim of Preventing Extreme Grief

　余命２週間のがん末期の患者が，終末期のせん妄による看護師への暴力をきっかけに，「医療者に暴力をふるうような患者です．」と悪評され，不名誉を拭えないまま，両親に見守られる中，亡くなった．対応するスタッフが，終末期がん患者のせん妄に対し早期に対応できていればこのような事態を招かなかったと考えられる．今回の症例を通して，せん妄への早期対応を提案したく報告する．症例は30歳代男性で，４年前，中枢神経がんに対して化学療法が施行され奏効し寛解に到達した．しかし，社会復帰は困難な状況であったため，両親は共に仕事を辞め，付き添い本人を支えた．外来での経過観察中，１年前の３月に別のがんを発症した．後遺症による精神状態と PS不良を理由に化学療法は不可能と判断された．20XX 年２月になり，呼吸状態が悪化したため入院となった．入院後，状態悪化に伴うせん妄症状が出現し，せん妄のため看護師へ暴力行為を行ってしまった．暴力行為のため，転院せざるを得ない旨を両親に説明することとなったが，転院には間に合うことなく，転院の説明から１週間で永眠された．せん妄と，それに伴う暴力行為に対する早期予防・対策が立案できていないことが，この状況を招いた要因と考えられる．せん妄症状の発生に早い段階で気づき，暴力リスクを理解し対策していくことが，がん終末期患者とその家族の深い悲しみを回避する医療を行うために大切なことと考える．　A terminally ill patient with a life expectancy of two weeks was labeled as“a patient who is violent toward medical professionals.”The cause was his violent behavior toward the nurses, which was triggered by delirium that is prevalent in such end-of-life patients. Unable to overcome this unfortunate reputation, he passed away in the presence of his parents. It is thought that this would not have occurred if the support staff had taken some measures against delirium with the terminal cancer patient at an earlier stage. Through the example provided in this case, this paper proposes an early response to delirium. The patient, in this case, was an adult man in his 30s, who received chemotherapy for cancer of the central nervous system four years earlier and achieved remission. However, because of the difficulty he faced in returning to society, both of his parents quit their jobs to help support him. During an outpatient followup in March of the previous year, another cancer was detected. Due to his mental state caused by sequelae and his poor PS (performance status), chemotherapy was deemed impractical. In February 20XX, the patient was admitted to the hospital because of an aggravated respiratory condition. After his hospitalization, delirium symptoms associated with his aggravated condition developed. Because of his delirium, unfortunately, the nurses became victims of his violence. The patient\u27s parents were given the explanation that their son needed to be transferred to another hospital due to his violent behavior. However, before the transfer took place, just one week from the time the transfer was explained to the family, the patient passed away. It is believed the lack of early prevention and countermeasures against delirium and the associated violence had created this situation. It is thought that recognizing the appearance of delirium symptoms in their early stages, taking preventative measures with an understanding of the risk of violence, and providing medical care to end-stage cancer patients to prevent extreme grief for their families is important

Transcriptome profiling of the spermatheca identifies genes potentially involved in the long-term sperm storage of ant queens

Females of social Hymenoptera only mate at the beginning of their adult lives and produce offspring until their death. In most ant species, queens live for over a decade, indicating that ant queens can store large numbers of spermatozoa throughout their long lives. To reveal the prolonged sperm storage mechanisms, we identified enriched genes in the sperm-storage organ (spermatheca) relative to those in body samples in Crematogaster osakensis queens using the RNA-sequencing method. The genes encoding antioxidant enzymes, proteases, and extracellular matrix-related genes, and novel genes that have no similar sequences in the public databases were identified. We also performed differential expression analyses between the virgin and mated spermathecae or between the spermathecae at 1-week and 1-year after mating, to identify genes altered by the mating status or by the sperm storage period, respectively. Gene Ontology enrichment analyses suggested that antioxidant function is enhanced in the spermatheca at 1-week after mating compared with the virgin spermatheca and the spermatheca at 1-year after mating. In situ hybridization analyses of 128 selected contigs revealed that 12 contigs were particular to the spermatheca. These genes have never been reported in the reproductive organs of insect females, suggesting specialized roles in ant spermatheca

川崎医療短期大学における語彙力に関する調査

本稿は,川崎医療短期大学の在学生の語彙力に関する調査結果を報告することを目的とする.2007年度入学生の追跡調査結果では,中学生レベルの語彙力のまま卒業を迎える学生がいることが明らかになった.さらに,入学から1年後は語彙力が伸びるが,2年次以降は語彙力が伸びる学生と伸びない学生の差が顕著であることが明らかになった.今後の課題として,語彙力を継続的に高めていくための方策を検討することが挙げられる

In Vivo Analysis of Extracellular Proteins in Rat Brains with a Newly Developed Intracerebral Microdialysis Probe

Peptides and proteins in the extracellular space in the central nervous system were investigated in vivo using an intracerebral microdialysis probe. The molecular cut-off of the hollow fiber which was used for the probe was approximately 100 kDa. We examined recovery rates of several compounds in vitro. The recovery rates of proteins and peptides were between 7-28%, with the exceptions of substance P and insulin-like growth factor I. The recovery rates of monoamines and their metabolites were 22-40%. In in vivo studies, two major proteins with apparent molecular weights of 62 kDa and 12 kDa, and several minor proteins (28 kDa, 43 kDa, 52 kDa and 70 kDa) were detected by SDS-polyacrylamide gel electrophoresis in the dialysate from a probe implanted in the striatum of anesthetized rats. These results suggest that the newly developed, intracerebral microdialysis probe might be useful for investigating the dynamic changes of peptides and proteins in the central nervous system.</p

同種造血幹細胞移植患者への緩和ケアチーム介入の試み

　血液がんの治療の一つである同種造血幹細胞移植治療（以下，移植）は，患者にとって唯一の治癒を目指した治療であるが，想像以上の副作用に苦しむ可能性の高い治療でもある．成功率20～30% 程度と説明された不安，前処置の副作用，生着前・後の感染症状，GVHD 症状，退院に向けての社会的負担などの苦痛が測り知れなく出現する．主治医は患者の生命維持に精一杯であり，看護師は大量の点滴や身体ケアに精一杯であり，移植患者の苦痛への対応が困難な状況に陥りやすい．そこで，2018年10月から緩和ケアチームが移植患者全例に介入することとした．移植治療のインフォームドコンセント時に緩和ケアチームの専従看護師が立ち会い，主治医から移植治療中の苦痛に対して緩和ケアチームが介入していくことを説明し開始した．これまでに，４症例の移植患者に介入できており，主に心理的対応と栄養士の早期対応が実現できた．しかし，主治医との連携は，良好なものから連携不良とさまざまであり，今後も検討していく必要性があると考えられた．移植患者の苦痛への早期対応が，患者，家族そして主治医と看護師を含めた医療者との三位一体の緩和ケアが可能となり，成果が期待される．　Allogeneic hematopoietic stem-cell transplantation (hereinafter referred to as transplantation) is one of the treatments for blood cancer. Although it is the only treatment that may cure cancer, it is highly likely to cause excruciating side effects. Patients undergoing transplantation face difficulties beyond their imagination such as anxiety upon learning that the success rate is approximately 20-30%, side effects from preliminary treatment, infection symptoms before and after engraftment, GVHD symptoms, and social burden while preparing for discharge. Such patients’ doctors and nurses find it difficult to deal with their and distress. While the doctors are fully engaged in maintaining patients’ lives, nurses are similarly engaged in performing a large amount of drip infusions and maintaining their personal hygiene. Owing to this situation, in October 2018, a palliative care team began interventions for all patients who undergo transplantation. At the beginning of the intervention, a dedicated nurse from the palliative care team attends an informed consent session for transplantation treatment. The doctor explains to the patient that the palliative care team will perform an intervention for him or her in order to alleviate pain and distress during the transplantation treatment. To date, the team has performed interventions for four patients who underwent transplantation. The main achievements were psychological support and early-stage interventions by a dietitian. However, collaborating with the doctors of patients is not always successful. Thus, this practice requires further research in the future. Dealing with the pain and distress of a patient who undergoes transplantation at an early stage makes it possible for the patient, his or her family, and healthcare providers-including doctors and nurses-to collaborate with each other in palliative care. It is believed that such collaborative practices will lead to favorable outcomes