Usefulness of Videofluoroscopic Swallow Study with Mixed Consistency Food for Patients with Stroke or Other Brain Injuries

This study evaluated the feasibility of mixed consistency foods test in patients with dysphagia which developed after stroke or other brain injuries. The findings of a videofluoroscopic swallow study (VFSS) were compared using single versus mixed consistency foods. Forty-nine patients with stroke or other brain injuries who had no significant abnormal findings in the single consistency food VFSS and started regular hospital diet were recruited for this study. Twenty-five (51%) of the 49 patients showed normal findings whereas 24 (49%) patients showed abnormal findings in the mixed consistency food VFSS. Abnormal findings included posterior spillage of liquid prematurely to pyriform sinus (n = 23), laryngeal penetration (n = 6), subglottic aspiration in the oral preparatory phase of swallowing (chewing), solid components (n = 2), and significant (more than 10%) residue in valleculae or pyriform sinus (n = 2). There was an increased risk of abnormal findings in mixed consistency food VFSS such as aspiration and penetration when a patient showed delayed pharyngeal delay time in single consistency food using liquids. In conclusion, VFSS protocols using mixed consistency foods would be useful before starting regular diet for patients after stroke or other brain injuries

Nearly 100% Horizontal Dipole Orientation and Upconversion Efficiency in Blue Thermally Activated Delayed Fluorescent Emitters

The relationship between anisotropic orientation and molecular structure of thermally activated delayed fluorescent (TADF)‐based organic light emitting devices (OLEDs) is studied using TADF emitters with carbazole, biscarbazole, and triscarbazole donor units. The bicarbazole and triscarbazole donors are more effective than the carbazole donor in driving the anisotropic orientation of the TADF molecules. A near‐perfect in‐plane orientation of the TADF dipole moment is demonstrated using the triscarbazole donor. In addition, the triscarbazole donor based OLED shows high photoluminescence quantum yield and an upconversion efficiency close to 100%. As a consequence, an external quantum efficiency >30% is obtained.A systematic study correlating donor structure with horizontal dipole orientation of blue triscarbazole thermally activated delayed fluorescent (TADF) emitters shows an exceptionally high horizontal dipole orientation of 95%. The dipole orientation and high photoluminescence quantum yield result in an external quantum efficiency >30% in organic light‐emitting diodes employing these TADF emitters.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145231/1/adom201701340.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145231/2/adom201701340_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145231/3/adom201701340-sup-0001-S1.pd

Assessment of the Efficacy of Reducing Peginterferon Alfa-2a and Ribavirin Dose on Virologic Response in Koreans with Chronic Hepatitis C

BACKGROUND/AIMS: The virologic response of Koreans to combination therapy for chronic hepatitis C is similar to westerns; however, dose modification occurs more frequently in Koreans. We evaluated the rates of peginterferon alpha-2a and ribavirin dose modifications and their effect on the virologic response in Koreans. METHODS: Patients with detectable HCV RNA and enrolled from multicenters were treated with peginterferon alpha-2a (180 microgram/week) and ribavirin (800 mg/day) for 24 weeks (genotype non-1, n=37) or peginterferon alpha-2a (180 microgram/week) and ribavirin (1,000-1,200 mg/day) for 48 weeks (genotype 1, n=55). RESULTS: Early virologic response (EVR) and sustained virologic response (SVR) were 77.2% (genotype 1, 75%; non-1, 81%) and 66.3% (genotype 1, 56%; non-1, 81%), respectively. The frequency of dose modification was 32.6% within the first 12 weeks and 52.2% during the entire treatment period. No difference was found in SVR regardless of dose modification. However, the SVR for patients using > or =80% of the peginterferon dose was significantly higher than for those using <80% (81.3 vs. 50.0%, p=0.007), despite varying ribavirin doses. No difference was found in SVR regardless of whether the ribavirin dose was <80% or not. These results did not change based on genotype. CONCLUSIONS: We suggest that using at least 80% of the peginterferon alpha-2a dose in Koreans not only maintains SVR but also reduces drug side effects during the entire treatment period. A lower dose of ribavirin may be as efficacious as a standard doseope

Differences in Bone Mineral Density between the Right and Left Hips in Postmenopausal Women

Bone mineral density (BMD) using dual energy radiography absorptiometry are commonly used for the diagnosis of osteoporosis. It is usually measured at the spine and also at one hip joint. Controversy still exists regarding the use of bilateral hip scanning. We analyzed the difference of BMD at bilateral hips in 384 postmenopausal women, retrospectively. The concordance and discordance rates of the lowest T-score and BMD between both hips were evaluated. The BMDs of the femoral neck and trochanter were significantly different between both hips (P < 0.05). There were also discrepancies between the lowest T-scores of both hips (P < 0.05). The discordance rates were about 30%. Due to significant differences in BMD between both hips at the femoral neck and trochanter and high discordance rate, bilateral hip measurements using DEXA are recommended to avoid underestimating osteoporosis

Non-Invasive Epigenetic Detection of Fetal Trisomy 21 in First Trimester Maternal Plasma

BACKGROUND: Down syndrome (DS) is the most common known aneuploidy, caused by an extra copy of all or part of chromosome 21. Fetal-specific epigenetic markers have been investigated for non-invasive prenatal detection of fetal DS. The phosphodiesterases gene, PDE9A, located on chromosome 21q22.3, is completely methylated in blood (M-PDE9A) and unmethylated in the placenta (U-PDE9A). Therefore, we estimated the accuracy of non-invasive fetal DS detection during the first trimester of pregnancy using this tissue-specific epigenetic characteristic of PDE9A. METHODOLOGY/PRINCIPAL FINDINGS: A nested, case-control study was conducted using maternal plasma samples collected from 108 pregnant women carrying 18 DS and 90 normal fetuses (each case was matched with 5 controls according to gestational weeks at blood sampling). All pregnancies were singletons at or before 12 weeks of gestation between October 2008 and May 2009. The maternal plasma levels of M-PDE9A and U-PDE9A were measured by quantitative methylation-specific polymerase chain reaction. M-PDE9A and U-PDE9A levels were obtained in all samples and did not differ between male and female fetuses. M-PDE9A levels did not differ between the DS cases and controls (1854.3 vs 2004.5 copies/mL; P = 0.928). U-PDE9A levels were significantly elevated in women with DS fetuses compared with controls (356.8 vs 194.7 copies/mL, P<0.001). The sensitivities of U-PDE9A level and the unmethylation index of PDE9A for non-invasive fetal DS detection were 77.8% and 83.3%, respectively, with a 5% false-positive rate. In the risk assessment for fetal DS, the adjusted odds ratios of U-PDE9A level and UI were 46.2 [95% confidence interval: 7.8-151.6] and 63.7 [95% confidence interval: 23.2-206.7], respectively. CONCLUSIONS: Our findings suggest that U-PDE9A level and the unmethylation index of PDE9A may be useful biomarkers for non-invasive fetal DS detection during the first trimester of pregnancy, regardless of fetal gender

Successful Treatment of Stereotactic Body Radiation Therapy Combined with Transarterial Chemolipiodolization for Hepatocellular Carcinoma with Biliary Obstruction

Conventional radiation therapy (RT) is a widely recognized treatment for hepatocellular carcinoma (HCC). However, conventional RT plays only a limited role in HCC treatment because of its low efficacy and the low tolerance of the liver for this modality. Stereotactic body radiation therapy (SBRT) was recently developed and represents the most advanced radiation therapy technique currently available. It can deliver a high dose in a short time to well-defined hepatic tumors, with rapid dose fall-off gradients. We believe that SBRT with transarterial chemolipiodolization (TACL) may prove promising as a combined treatment modality for HCC due to its precision and relative safety. Here we present a case of successful treatment of advanced HCC with obstructive jaundice using this combined modality

Lumbar Plexopathy Caused by Metastatic Tumor, Which Was Mistaken for Postoperative Femoral Neuropathy

Surgical excision was performed on a 30-years old woman with a painful mass on her left thigh. The pathologic findings on the mass indicated fibromatosis. After the operation, she complained of allodynia and spontaneous pain at the operation site and ipsilateral lower leg. We treated her based on postoperative femoral neuropathy, but symptom was aggravated. We found a large liposarcoma in her left iliopsoas muscle which compressed the lumbar plexus. In conclusion, the cause of pain was lumbar plexopathy related to a mass in the left iliopsoas muscle. Prompt diagnosis of acute neuropathic pain after an operation is important and management must be based on exact causes

Secondary Amyloidosis Associated with Multiple Sclerosis

Background Multiple sclerosis (MS) is a demyelinating disease of the central nervous system. Secondary amyloidosis can occur as a complication of chronic systemic inflammatory and infectious diseases. Until now there has been no report of secondary amyloidosis associated with MS. We report herein a case of renal biopsy-proven secondary amyloidosis in a patient with MS. Case Report A 41-year-old woman with MS was hospitalized due to aggravated quadriparesis and edema in both lower extremities. Laboratory findings showed nephrotic-range proteinuria and hypoalbuminemia. A percutaneous renal biopsy procedure was performed, the results of which revealed secondary amyloid-A-type amyloidosis associated with MS. Conclusions This is the first report of secondary amyloidosis associated with MS. J Clin Neurol 2009;5:146-14