Efficacy of interferon retreatment on interferon-resistant patients with chronic hepatitis C.

Chronic Hepatitis C can progress to end-stage liver cirrhosis or hepatocellular carcinoma. Interferon (IFN) therapy is effective in clearing the hepatitis C virus and in improving liver histology, however, few patients maintain a sustained response (SR) after IFN withdrawal. Immediate retreatment with IFN is therefore considered to be both effective and necessary, especially for patients who do not respond to the initial course of IFN therapy. All 145 patients included in the present study underwent liver biopsy, followed by a first treatment course with various IFNs (alpha2a, alpha2b, alpha, OIF or beta). If hepatitis C virus (HCV) RNA was positive after the first treatment, the patient was assigned to one of 3 groups, depending on whether his or her alanine transaminase (ALT)level was normalized (incomplete response, IR), partially responsive(PR), or non-responsive (NR). After an observational interval of 6 to 76 months, a second IFN treatment was initiated with a higher dose or the same dose of the same IFN for the IR group, and with a different IFN for the PR and NR groups. At 6 months after retreatment with IFN, the overall efficacy of the retreatment was 29.7.% In the case of the IR group, who received the same IFN, the overall efficacy was 45.2%. In patients identified as non-SR after the first treatment, who received a different type of IFN for retreatment, the overall efficacy was 18.6%. Anti-IFN antibody was not detected in most of the breakthrough cases. For some IR patients, retreatment with the same IFN was effective. Anti-IFN antibody was mostly negative, indicating that the same IFN can be used in both the first treatment and retreatment to obtain an SR. Switching to a different IFN was effective for some PR and NR patients, suggesting that changing IFN for such cases is a good therapeutic choice.</p

Mechanisms involved in an increment of multimodal excitability of medullary and upper cervical dorsal horn neurons following cutaneous capsaicin treatment

<p>Abstract</p> <p>Background</p> <p>In order to evaluate mechanisms that may underlie the sensitization of trigeminal spinal subnucleus caudalis (Vc; the medullary dorsal horn) and upper cervical spinal cord (C1-C2) nociceptive neurons to heat, cold and mechanical stimuli following topical capsaicin treatment of the facial skin, nocifensive behaviors as well as phosphorylation of extracellular regulated-kinase (pERK) in Vc and C1-C2 neurons were studied in rats.</p> <p>Results</p> <p>Compared to vehicle application, capsaicin application to the lateral facial skin produced 1 hour later a flare in the skin, and also induced significantly greater nocifensive behaviors to heat, cold or mechanical stimulus of the lateral facial skin. The intrathecal (i.t.) injection of the MEK inhibitor PD98059 markedly attenuated the nocifensive behaviors to these stimuli in capsaicin-treated rats. Moreover, the number of pERK-like immunoreactive (pERK-LI) cells in Vc and C1-C2 was significantly larger following the heat, cold and mechanical stimuli in capsaicin-treated rats compared with vehicle-treated rats. The number of pERK-LI cells gradually increased following progressive increases in the heat or mechanical stimulus intensity and following progressive decrease in the cold stimulus. The ERK phosphorylation in Vc and C1-C2 neurons was strongly inhibited after subcutaneous injection of the capsaicin antagonist capsazepine in capsaicin-treated rats.</p> <p>Conclusion</p> <p>The present findings revealed that capsaicin treatment of the lateral facial skin causes an enhancement of ERK phosphorylation in Vc and C1-C2 neurons as well as induces nocifensive behavior to heat, cold and mechanical simulation of the capsaicin-treated skin. The findings suggest that TRPV1 receptor mechanisms in rat facial skin influence nociceptive responses to noxious cutaneous thermal and mechanical stimuli by inducing neuroplastic changes in Vc and C1-C2 neurons that involve in the MAP kinase cascade.</p

Rapidly Destructive Arthrosis of Bilateral Humeral Heads Caused by Subchondral Insufficiency Fracture

The bilateral shoulder pain of an 81-year-old Japanese woman due to falls persisted despite celecoxib treatment, and plain X-rays later showed bilateral collapsed humeral heads. After ruling out osteoarthritis, infectious arthritis, crystal-induced arthritis, neuropathic arthropathy, and osteonecrosis, we diagnosed bilateral shoulder joint rapidly destructive arthrosis (RDA). Lumbar bone mineral density showed very low T-score (−4.1). Primary osteoporosis was observed. Histology of biopsied humeral head indicated the features of fracture healing process: callus formation and osteoclasts without empty lacunae. Her history thus included an insufficiency fracture due to severe osteoporosis. Bilateral humeral head replacement was performed; her shoulder joint function improved. This case is extremely rare in that RDA was caused by simultaneous bilateral shoulder joint collapse within a very short time, with minimal or low mechanical stress and severe osteoporosis

Sacral Stress Fracture Complicated by L5 Radiculopathy in a Patient with Rheumatoid Arthritis

A 60-year-old Japanese woman with severe osteoporosis presented with a history of right buttock pain and right lateral lower leg pain in an L5 distribution. She had been treated with methotrexate and methylprednisolone for rheumatoid arthritis (RA) and interstitial pneumonia. Computed tomography demonstrated a sacral stress fracture in the right sacral ala. The right L5 nerve root was compressed by the fracture site. This case is rare in that L5 radiculopathy was complicated by a sacral stress fracture. Clinicians should suspect sacral stress fractures when RA or osteoporosis is present in women who experiences lumbar pain and lumbar radiculopathy

Virological and serological characterization of asymptomatic blood donors positive for anti-hepatitis C virus antibody.

To study the virological and serological characteristics of asymptomatic hepatitis C virus (HCV) carriers, 165 blood donors positive for antibody against HCV proteins by the second generation assay, were analyzed for their clinical backgrounds, serological reactivity against antigens derived from HCV by recombinant immunoblot assay, and the amount and genotype of HCV by the polymerase chain reaction. Compared with blood donors having abnormal levels of alanine aminotransferase (ALT), sera from the donors with normal levels of ALT reacted less frequently against NS4 antigens (anti-5-1-1: 34.4% vs. 54.5%, P = 0.0609; anti-c100-3: 34.4% vs. 56.1%, P &#60; 0.05). Also the positivity for antibodies against these antigens were more frequent in sera from donors with genotype 1b HCV-RNA than other genotypes (anti-5-1-1: 61.0% vs. 23.5%, P &#60; 0.01; anti-c 100-3: 61.0% vs. 26.5%, P &#60; 0.01). The prevalence of each genotype in blood donors with normal ALT levels was different from that in patients with advanced liver disease (P &#60; 0.05), genotype 1b being less and genotype 2a being more frequent. The number of HCV-RNA copies/0.5 ml in donors with normal ALT was 10(7.9 +/- 1.0) (n = 27) and that in patients with chronic liver disease was 10(7.4 +/- 0.8) (n = 116), the difference being statistically significant (P &#60; 0.05). In conclusion, the results of this study suggest that asymptomatic blood donors carrying HCV have the serological and virological characteristics different from the patients with advanced liver disease.</p

Alteration of primary afferent activity following inferior alveolar nerve transection in rats

<p>Abstract</p> <p>Background</p> <p>In order to evaluate the neural mechanisms underlying the abnormal facial pain that may develop following regeneration of the injured inferior alveolar nerve (IAN), the properties of the IAN innervated in the mental region were analyzed.</p> <p>Results</p> <p>Fluorogold (FG) injection into the mental region 14 days after IAN transection showed massive labeling of trigeminal ganglion (TG). The escape threshold to mechanical stimulation of the mental skin was significantly lower (i.e. mechanical allodynia) at 11-14 days after IAN transection than before surgery. The background activity, mechanically evoked responses and afterdischarges of IAN Aδ-fibers were significantly higher in IAN-transected rats than naive. The small/medium diameter TG neurons showed an increase in both tetrodotoxin (TTX)-resistant (TTX-R) and -sensitive (TTX-S) sodium currents (<it>I</it>_Na) and decrease in total potassium current, transient current (<it>I</it>_A) and sustained current (<it>I</it>_K) in IAN-transected rats. The amplitude, overshoot amplitude and number of action potentials evoked by the depolarizing pulses after 1 μM TTX administration in TG neurons were significantly higher, whereas the threshold current to elicit spikes was smaller in IAN-transected rats than naive. Resting membrane potential was significantly smaller in IAN-transected rats than that of naive.</p> <p>Conclusions</p> <p>These data suggest that the increase in both TTX-S <it>I</it>_Naand TTX-R <it>I</it>_Naand the decrease in <it>I</it>_Aand <it>I</it>_kin small/medium TG neurons in IAN-transected rats are involved in the activation of spike generation, resulting in hyperexcitability of Aδ-IAN fibers innervating the mental region after IAN transection.</p

Detection of muscle fatigue by the surface electromyogram and its application

金沢大学理工研究域電子情報学系金沢大学理工研究域電子情報学系The muscle is moved by muscle fiber contraction receiving command from the brain. But, energy that moves muscle is not infinity. If muscle get into energy shortage, no matter how send command from the brain, muscle is not moved. Such a temporary muscular dysfunction is muscle fatigue. If muscle becomes excess fatigue condition, it may decrease work efficiency, or muscle strain. If we are able to measure muscle fatigue objectively, improve work efficiency, or avert muscle strain. Therefore, it is necessity to measure muscle fatigue. It is able to objectively measure with a surface electromyogram(EMG). The feature of muscle fatigue are increase in amplitude and make the transition from high frequency spectrum to low frequency spectrum. We evaluate muscle fatigue Mean Power Frequency (MPF). to evaluates frequency of surface EMG.We assume muscle recovery process is converse phenomenon from muscle fatigue, and it is able to evaluate elevated MPF. The purpose of the present study is to design of system that effective training, or improve work efficiency, or avert muscle strain uses feature of muscular fatigue and muscle recovery process. © 2010 IEEE

Skill evaluation method based on variability of antagonism power of EMG

金沢大学理工研究域電子情報学系We can more effectively take the physical skills of individual people into consideration from various points of view when we focus on evaluating their skills while exercising. We can focus on their maximum levels of speed and power, their smoothness through a series of exercises, their instantaneous force, repeatability, and their adjustability to agitation or obstacles such as circumjacent people or nature. A lot of exercise skills can relatively and easily be quantitatively evaluated by carefully analyzing the results and performance. However, it is difficult to evaluate the "repeatability" aspect, which is only one of exercise skill, when judging its degree from only viewing the given exercise. An example of a physical exercise process that can contribute stable results would need to be equivalent to a "skill" such as hitting a home run each time. We believe that the acquisition of a given skill is very useful in fields such as physical training. Therefore, we examined the repeatability aspect from this point of view. We also used an antagonism power index calculated using EMG to achieve such purposes. The index represents any adjustments made in the output power from the muscles. I thought that the adjust function of the output power of the muscles would be very useful when evaluating the exercise skills of a given individual. The antagonism power was calculated using the quasi-muscular tension and a skeletal muscle model consisting of one joint and two muscles. We also made a comparison between the unskilled state and a skilled state. As a result, the differences in exercise skill appeared to be antagonism power. Therefore, we thought that antagonism power was effective enough for creating a new exercise skill evaluation index that we define in this paper. Copyright 2011 ACM

Discussion on tips of exercise using EMG

金沢大学理工研究域電子情報学系All types of physical exercise have various information that individual ability, environment and so on. Exercises have different meanings but look much the same. This is called the Individual Characteristic Principle. From this principle, it is thought that the same precision motions have internal difference. However, we want to completely do away with difference between these exercises because we have aesthesia. For example, likes and dislikes and learning the ropes. Because of this we thought that the common motion structures exist and so researched the possible existence of the common motion structures in the same accuracy isometric work. © 2010 IEEE