Effect of Keishi-bukuryo-gan on asymptomatic cerebral infarction for short term

無症候性脳梗塞患者に対する桂枝茯苓丸の効果を検討した。142例(男性32例,女性110例,平均年齢68.9才)を対象とし,副作用のため内服を中止した3例を除く139例に対して,桂枝茯苓丸エキス1日量7.5gを12週間投与した。投与開始時と比較して,改訂長谷川式簡易知能評価スケール,Apathyスケール(やる気スケール),SDS(うつ状態スケール)は有意に改善した。また,頭重感,頭痛,めまいの自覚症状も桂枝茯苓丸の投与により改善し,拡張期血圧は投与前に比べ有意に低下した。これらの結果から,桂枝茯苓丸が無症候性脳梗塞に伴う認知機能の低下,精神症状や自覚症状の悪化に対して有効である可能性が示唆された。 The efficacy of Keishi-bukuryo-gan in patients suffering from asymptomatic cerebral infarction was studied. 142 patients, 32 males and 110 females, with a mean age of 68.9 years, were enrolled and analyzed, and 139 completed the study. They were given Keishi-bukuryo-gan extract (7.5g/day) three times a day for 12 weeks. In comparison to the beginning of the study, Keishi-bukuryo-gan showed improvement with statistical significance in the mean revised version of Hasegawa\u27s dementia scale, Apathy scale and Self-rating depression scale. The number of patients with subjective symptoms as headdullness, headache and dizziness decreased by the treatment with Keishi-bukuryo-gan, and diastolic blood pressure was decreased with statistical significance as compared to the beginning of the study. These results suggest that Keishi-bukuryo-gan is effective against dysfunction of acknowledgment, emotional disorder and subjective symptoms with asymptomatic cerebral infarction

Hepatitis C Treatment in Elderly Patients

The patients with chronic hepatitis C (CHC) are getting older and the demands for treatment to those patients are increasing due to the high risk of development of hepatocellular carcinoma. Elderly patients were previously defined as 60 years and over, however definition of the elderly patients shifted to be older year to year. Interferon (IFN) and ribavirin combination therapy was significantly improved efficacy of treatment, however ribavirin induces anemia, resulted in lower efficacy due to reduction of ribavirin for the elderly patients. And efficacy of over 60 years old was comparable to the patients under 60 years. In the CHC patients with genotype 1, the efficacy of elderly patient was significantly lower than that of younger patients, especially in female. Direct-acting antivirals (DAAs) therapy makes treatment efficacy improved to over 90% and side effect of treatment was dramatically reduced compared to IFN-based therapy. The efficacy of dual oral therapy by using asunaprevir (ASV) and daclatasvir (DCA) for elderly patients with hepatitis C virus (HCV) genotype 1b has not been fully clarified. In this article we would like to show the efficacy of elderly patients with CHC, especially patients infected with genotype 1b, from the era of IFN monotherapy to the era of new DAAs

Cnm of Streptococcus mutans is important for cell surface structure and membrane permeability

Streptococcus mutans, a Gram-positive facultative anaerobic bacterium, is a major pathogen of dental caries. The protein Cnm of S. mutans is involved in collagen binding, but its other biological functions are unknown. In this study, a Cnm-deficient isogenic mutant and a complementation strain were generated from a Cnm-positive S. mutans strain to help determine the properties of Cnm. Initially, comparison of the cell surface structure was performed by electron microscopy, which demonstrated that Cnm appears to be localized on the cell surface and associated with a protruding cell surface structure. Deep RNA sequencing of the strains revealed that the defect in Cnm caused upregulated expression of many genes related to ABC transporters and cell-surface proteins, while a few genes were downregulated. The amount of biofilm formed by the Cnm-defective strain increased compared with the parental and complemented strains, but the biofilm structure was thinner because of elevated expression of genes encoding glucan synthesis enzymes, leading to increased production of extracellular polysaccharides. Particular antibiotics, including bacitracin and chloramphenicol, had a lower minimum inhibitory concentration for the Cnm-defective strain than particular antibiotics, including bacitracin and chloramphenicol, compared with the parental and complemented strains. Our results suggest that S. mutans Cnm is located on the cell surface, gives rise to the observed protruding cell surface, and is associated with several biological properties related to membrane permeability