Comparison of Saccharin Time in Nursing Home Residents With and Without Pneumonia: A Preliminary Study

ackground/Aim: Although mucociliary clearance is important for preventing pneumonia, its association with the onset of pneumonia is unclear. The aim of this study is to examine the association between saccharin test results as a potential measure of mucociliary clearance and history of pneumonia in nursing home residents. Patients and Methods: Ninety elderly nursing home residents (elderly group) were selected, 35 of whom had a history of pneumonia. Twenty-five healthy adults (adult group) were also investigated to provide baseline values for this study. We conducted the saccharin test to evaluate mucociliary clearance and compared the saccharin time (ST) between those with and without history of pneumonia. Results: Mean ST in the adult group was 12±6 min. The ST in the pneumonia group was significantly longer than that in the non-pneumonia group (32±23 min vs. 17±13 min) (p<0.05). Conclusion: Impaired mucociliary clearance is a factor in the development of pneumonia among nursing home residents

Curved-Tip Disposable Injector (OUReP Injector) to Insert Photoelectric Dye-Coupled Polyethylene Film (OUReP) as Retinal Prosthesis into Subretinal Space of Rabbit Eyes

The photoelectric dye-coupled thin polyethylene film functions as a novel type of retinal prosthesis in subretinal space of the eye. We previously reported a novel disposable injector to insert the thin film into subretinal space of the rabbit eye by vitreous surgery. The injection system composed of two separate parts, injector and loader. A circular film in 5 mm to 10 mm diameter was pulled into a transparent tube of the loader with a commercial 25-gauge forceps. The loader tube was joined with a sleeve to tube tip of the injector. The film in the loader was pushed with a plunger for the loader into the injector tube tip. The loader with the sleeve was removed from the injector tip, and the tube tip with the film was filled with solution. This study reported a small-bore curved-tip disposable injector with outer diameter of 1.6 mm. A curved-tip polypropylene tube was formed by the process of heating and cooling of the tube inserted with a curved guide wire. The plunger for the curved-tip tube was made of a polyphenylsulfone tip connected with a press-fitting inner polypropylene tube to a nylon rod. Bleb retinal detachment in 4 surgically aphakic eyes of rabbits were induced by infusing solution into subretinal space with a 38-gauge polyimide tip, and a retinal tear was made at the edge of retinal detachment with 25-gauge diathermy. The injector tip with the rolled film in 6 mm diameter was inserted from 2 mm wide scleral incision into vitreous and then into subretinal space. The rolled films were released into subretinal space with the tip end inserted into the retinal tear, and the released films were confirmed to stay under the retina with no additional aid. Dissection one month after surgeries confirmed successful implantation of 4 films into subretinal space of each rabbit eye. The curved-tip injector could release the rolled film into the subretinal space without additional effort, compared with the straight-tip injector, and would help surgeons implant photoelectric dye-coupled thin film retinal prosthesis easily at vitreous surgery

Case report: Remission of chronic low back pain and oral dysesthesia comorbid with attention deficit/hyperactivity disorder by treatment with atomoxetine and pramipexole

IntroductionOral dysesthesia is a disease characterized by pain and/or abnormal sensations in the oral region, without any organic abnormality. Its symptoms include pain, and it is considered to be a disorder associated with idiopathic oral-facial pain. It is also known that idiopathic oral-facial pain tends to coexist with chronic musculoskeletal pain, including low back pain, even before its onset. Such coexisting idiopathic pain conditions are also called chronic overlapping pain conditions (COPCs). In general, COPCs are often refractory to treatment. Recently, it has been reported that attention deficit hyperactivity disorder (ADHD) is associated with many COPCs, such as pain in the facial and lower back regions and so on. However, there are no reports of (1) ADHD as a comorbidity with oral dysesthesia (OD) or (2) of the therapeutic effects of ADHD medications or dopamine agonists on low back pain and OD or an (3) evaluation of cerebral blood flow over time after treatment with these medications for OD and low back pain.Case PresentationIn this study, we report the case of an 80-year-old man with OD and chronic low back pain that persisted for more than 25 years. His OD and chronic back pain were refractory to standard treatment, prevented him from continuing work, and tended to be exacerbated by conflicts in his relationship with his son. In recent years, ADHD has often been found to be comorbid with chronic pain, and ADHD medications have been reported to improve chronic pain as well. The patient was confirmed to have undiagnosed ADHD and was treated with the ADHD medication atomoxetine and dopamine agonist pramipexole, which dramatically improved his OD, chronic back pain, and cognitive function. Furthermore, along the course of treatment, there was improvement in cerebral blood flow in his prefrontal cortex, which was thought to reflect improved function in the region. Consequently, he was able to resume work and improve his family relationships.ConclusionTherefore, in the cases of ODs and COPCs, screening for ADHD and, if ADHD is diagnosed, ADHD medications or dopamine agonists may be considered

Anti-cytokine autoantibodies are ubiquitous in healthy individuals

AbstractAnti-cytokine autoantibodies in healthy individuals have been widely reported but the occurrence is variable and inconstant. We hypothesized that cytokine-binding in vivo may explain their variable and infrequent detection. Therefore, we focused on the detection of the cytokine-autoantibody complexes and found that anti-cytokine autoantibody to IL-2, IL-8, tumor necrosis factor-α, vascular endothelial growth factor and granulocyte-colony stimulating factor were present in all 15 individuals evaluated, while those to IL-3, osteopontin and macrophage-colony stimulating factor were not detected in anyone. Autoantibodies against IL-4, IL-6, IL-10, and interferon-gamma were variously detected. Thus, we discovered that anti-cytokine autoantibodies to multiple cytokines are ubiquitous in healthy individuals

Rearrangement of the breakpoint cluster region in Philadelphia chromosome positive acute leukemia.

The rearrangement of breakpoint cluster region (ber) was examined in leukemic cells obtained from 3 patients initially diagnosed as having Ph+ acute leukemia, 2 with acute lymphocytic leukemia (ALL) and one with acute mixed leukemia. DNA was digested with Bgl II and BamH I. The ber rearrangement was present in the case of acute mixed leukemia (Case 1), but was absent in the 2 cases of ALL (Cases 2 and 3). These results suggest that Case 1 represented a type of blast crisis of chronic myelocytic leukemia which was unusual in the sense of the occurrence of a myeloid-lymphoid conversion and lack of an apparent chronic phase. Cases 2 and 3 appeared to be de novo Ph+ ALL.</p

Case report: Treatment of persistent atypical odontalgia with attention deficit hyperactivity disorder and autism spectrum disorder with risperidone and atomoxetine

Chronic pain has recently been associated with developmental disorders [autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD)]. Regarding chronic pain in adulthood, fibromyalgia, migraine, and chronic low back pain have been associated with ADHD. The ICD-11 disease classification categorizes these pain diseases as chronic primary pain, suggesting high comorbidity with developmental disorders in chronic primary pain. Atypical odontalgia (AO) is a persistent tooth pain that occurs in the absence of any of the usual dental causes, most of which are triggered by dental treatment. Conditions characterized by tooth pain with no apparent cause are also classified as chronic primary pain. Approximately half the patients with AO are diagnosed with psychiatric disorders; the most common are depression (15.4%) and anxiety disorders (10.1%). However, there are no reports on neurodevelopmental disorders comorbid with AO. In the present study, we report a case of a 46-year-old man with numerous complaints (e.g., occlusal instability, difficulty eating, difficulty speaking), who took work leave due to worsening of his symptoms after periodontal scaling (“gingival recession” and “aggressive periodontal treatment”) and frequently expressed dissatisfaction and anger at the hospital, making the dental treatment difficult. After a referral to a psychiatrist specializing in chronic pain, AO and previously undiagnosed comorbidity of ASD and ADHD were confirmed. Atypical antipsychotic risperidone for ASD irritability and an ADHD medication, atomoxetine dramatically reduced anger, pain, anxiety, depression, and pain catastrophizing thoughts, leading to reduced obsession with his symptoms and less frequent complaints. After risperidone (1 mg/day) + atomoxetine (120 mg/day) were ultimately prescribed after adjustment, he was able to return to work 226 days after initiation of psychiatric treatment. Recent studies show that comorbidity of developmental disorders in patients with chronic pain is likely to be undetected. Clinicians should include screening for ASD and ADHD not only in cases of fibromyalgia, migraine, and chronic low back pain, but also in orofacial pain such as AO and other treatments for chronic primary pain. For patients diagnosed with ASD or ADHD, an effective drug therapy for ASD and ADHD should be considered

Genetic polymorphism of pleiotrophin is associated with pain experience in Japanese adults Case-control study

Genetic factors play a role in individual differences in pain experience. Here, we performed a genome-wide association study (GWAS) to identify novel loci regulating pain processing. We conducted a 2-stage GWAS and the candidate single-nucleotide polymorphisms (SNPs) association study on pain experience using an exploratory cohort of patients with cancer pain. The confirmatory cohort comprised of participants from the general population with and without habitual use of analgesic medication. In the exploratory cohort, we evaluated pain intensity using a numerical rating scale, recorded daily opioid dosages, and calculated pain reduction rate. In the confirmatory cohort, pain experience was defined as habitual nonsteroidal anti-inflammatory drug usage. Using linear regression models, we identified candidate SNP in the exploratory samples, and tested the association between phenotype and experienced pain in the confirmatory samples. We found 1 novel SNP (rs11764598)—located on the gene encoding for pleiotrophin on chromosome 7—that passed the genome-wide suggestive significance at 20% false discovery rate (FDR) correction in the exploratory samples of patients with cancer pain (P = 1.31 × 10-7, FDR = 0.101). We confirmed its significant association with daily analgesic usage in the confirmatory cohort (P = .028), although the minor allele affected pain experience in an opposite manner. We identified a novel genetic variant associated with pain experience. Further studies are required to validate the role of pleiotrophin in pain processing

北海道礼文華峠におけるブナ分布北限域孤立個体群の立地と植生

筆者らはブナの分布北限域における最前線孤立個体群を太平洋から水平距離で2.5km内陸に位置する豊浦町礼文華峠の岩峰上及びその周辺で発見した．これはブナの天然分布個体群の中でも太平洋側における最北限の個体群であると考えられた。付近のアメダスのデータによれば，年平均気温7.3 ℃，年降水量1,198 mm，最大積雪深85cmであった．現地の暖かさの指数WIは52.5℃・月と推定された．ブナの分布，植生と立地の状況を明らかにするために現地調査を行った結果，以下の知見を得た．（1）岩峰上に生育する胸高以上のブナは約1.7 haの範囲（標高196 ～ 275 m）に39本生育し，胸高直径階分布は緩やかなL字型を示し，10 cm以下の個体が最多であった．（2） 岩峰のブナは主にミズナラ，ホオノキ，シラカンバと混生し，競合する針葉樹は記録されなかった．（3） 植物群落の種構成は日本海側に成立するブナ林に類似していた．（4） 土壌pHはやや酸性で5.4 ～ 5.5であり，無機態窒素は全国のブナ林の値と大きな違いはなかった．以上の知見から，礼文華峠の岩峰上のブナ個体群は，その生育に適した気候条件に加え，本州の岩峰などでしばしば優占する針葉樹類が不在であるなどの条件が重なって成立したと考えられた