Myxedema coma accompanied by sick sinus syndrome and hypoventilation: A case report

Myxedema coma is an emergency presentation of hypothyroidism, and cardiopulmonary manifestations of the disease are related to a high mortality rate. We herein report a case of myxedema coma accompanied by sick sinus syndrome requiring temporary cardiac pacing and hypercapnic respiratory failure in an 87-year-old woman. This case is unique because both of the cardiac and pulmonary manifestations were reversible and successfully treated with thyroid hormone replacement. Our case indicates that early detection of the condition and administration of levothyroxine are essential to improve the life-threatening condition and avoid invasive treatment such as permanent pacemaker implantation or intubation

Limited Effect of General Trust in Judgment of Other\u27s Trustworthiness

信頼性判断と一般的信頼に関するこれまでの研究では，高信頼者が低信頼者よりも他者の信頼性を正確に見極めれるかどうかに関して，一貫した結果が得られていなかった.本研究では，信頼性判断に用いることができる情報量に着目し，ターゲットについての情報が加算的に追加される状況において，初期情報に基づく信頼性判断に及ぼす一般的信頼の効果とその持続性について検討した.また，後続情報に対する反応パタンと個人特性の関連について検討した.その結果，１）信頼性判断に及ぼす一般的信頼の効果は，情報が追加されるに従い速やかに消滅すること，２）自己利益のために他者を利用しようと考える傾向（道具的関係志向）の高い人ほど，ネガティブ情報が追加された際にターゲットの信頼性評価を急速に低下させないことが明らかとなった.In previous studies on general trust, empirical evidence of the relationship between general trust and judgment accuracy of other\u27s trustworthiness is not consistet. In this study, focusing on the amount of information that can be used to demermine the target\u27s trustworthiness, we examined the effect of general trust on evaluations of initial information and subsequent information. We also examined the relationship between individual psychological characteristics and the pattern of reaction to subsequent information. The results of the study suggeset that the effect of general trust on the evaluation of trust information disappears rapidly in accordance with information to be added. In addition, the results showed that those people who tend to think of trying to make use of others in order to promote their self-interest(with a high instrumental relationship-oriented score)do not lower their evalutation of the target\u27s trustworthiness rapidly in response to subsequent negative information

Co-existence of inhibitory and stimulatory factors modulating cell proliferation in rat liver cytoplasm.

Factors that inhibit and stimulate cell proliferation were found to coexist in rat liver supernatant. The inhibitory and stimulatory factors were separated by ethanol fractionation. Both factors were sensitive to heat- and trypsin-treatment. The activity of the inhibitor was diminished by partial hepatectomy. The inhibitor from normal livers inhibited DNA and RNA synthesis in the L-cell system, but the same fraction from regenerating livers caused little or no inhibition of nucleic acid synthesis. The stimulatory factor from regenerating livers had a stronger effect on cell proliferation than that of normal livers. Furthermore, the inhibitor from normal livers depressed DNA synthesis in vivo in regenerating livers

Enhancement or Suppression of ACE Inhibitory Activity by a Mixture of Tea and Foods for Specified Health Uses (FOSHU) That Are Marketed as “Support for Normal Blood Pressure”

The ACE inhibitory activities of mixtures of FOSHUs (Healthya, Goma-Mugicha, Lapis Support and Ameal) were examined in order to identify any antihypertensive interactions. Among combinations of Healthya with other samples that contain active peptides, only that with Ameal was found to have no inhibitory activity. Enhanced activity was observed in 2 other mixtures. The activity of a mixture of tea polyphenols and the whey component extracted from an Ameal solution was significantly decreased, thus demonstrating that whey protein lowered the ACE inhibitory activity of Healthya. Although oral administration of tea polyphenols alone significantly decreased SBP in SHR at 2 and 4 hr, combined administration with Ameal failed to decrease SBP at the same time points. In conclusion, the simultaneous intake of tea and FOSHUs that contain active peptides might affect daily self-antihypertensive management via enhancement or suppression of ACE inhibitory activity

The effectiveness of simulation-based education combined with peer-assisted learning on clinical performance of first-year medical residents: a case-control study

Background Simulation-based education and peer-assisted learning (PAL) are both known as useful educational methods. Previous research has reported that combining these two methods are effective for training medical residents in short-term evaluation. This study was aimed to evaluate the middle- to long-term effects of simulation-based education combined with PAL on the performance of medical residents during emergency department duties. Methods This study was designed as a case-control study and conducted over three years at Okayama University Hospital in Japan. Postgraduate-year-one medical residents were assigned to three groups: a simulation group that received simulation-based education, a lecture group that received traditional lecture-based education, and a control group that received no such prior trainings. Prior training in emergency department duties using PAL was performed as an educational intervention for the simulation and lecture groups during the clinical orientation period. The residents' medical knowledge was assessed by written examinations before and after the orientation. The performance of residents during their emergency department duties was assessed by self-evaluation questionnaires and objective-assessment checklists, following up with the residents for three months after the orientation period and collecting data on their 1st, 2nd, and 3rd emergency department duties. All the datasets collected were statistically analyzed and compared by their mean values among the three groups. Results A total of 75 residents were included in the comparative study: 27 in the simulation group, 24 in the lecture group, and 24 in the control group. The simulation and lecture groups obtained significantly higher written examination scores than the control group. From the self-evaluation questionnaires, the simulation group reported significantly higher satisfaction in their prior training than the lecture group. No significant differences were found in the emergency department performance of the residents among the three groups. However, when evaluating the improvement rate of performance over time, all three groups showed improvement in the subjective evaluation, and only the simulation and lecture groups showed improvement in the objective evaluation.ConclusionSimulation-based education combined with PAL is effective in improving the knowledge and satisfaction of medical residents, suggesting the possibility of improving work performance during their emergency department duties

Trapping DNA Replication Origins from the Human Genome

Synthesis of chromosomal DNA is initiated from multiple origins of replication in higher eukaryotes; however, little is known about these origins’ structures. We isolated the origin-derived nascent DNAs from a human repair-deficient cell line by blocking the replication forks near the origins using two different origin-trapping methods (i.e., UV- or chemical crosslinker-treatment and cell synchronization in early S phase using DNA replication inhibitors). Single-stranded DNAs (of 0.5–3 kb) that accumulated after such treatments were labeled with bromodeoxyuridine (BrdU). BrdU-labeled DNA was immunopurified after fractionation by alkaline sucrose density gradient centrifugation and cloned by complementary-strand synthesis and PCR amplification. Competitive PCR revealed an increased abundance of DNA derived from known replication origins (c-myc and lamin B2 genes) in the nascent DNA fractions from the UV-treated or crosslinked cells. Nucleotide sequences of 85 and 208 kb were obtained from the two libraries (I and II) prepared from the UV-treated log-phase cells and early S phase arrested cells, respectively. The libraries differed from each other in their G+C composition and replication-related motif contents, suggesting that differences existed between the origin fragments isolated by the two different origin-trapping methods. The replication activities for seven out of 12 putative origin loci from the early-S phase cells were shown by competitive PCR. We mapped 117 (library I) and 172 (library II) putative origin loci to the human genome; approximately 60% and 50% of these loci were assigned to the G-band and intragenic regions, respectively. Analyses of the flanking sequences of the mapped loci suggested that the putative origin loci tended to associate with genes (including conserved sites) and DNase I hypersensitive sites; however, poor correlations were found between such loci and the CpG islands, transcription start sites, and K27-acetylated histone H3 peaks

Culture and Egocentric Perceptions of Fairness in Conflict and Negotiation

In this article, the authors advanced a cultural view of judgment biases in conflict and negotiation. The authors predicted that disputants’ self-serving biases of fairness would be more prevalent in individualistic cultures, such as the United States, in which the self is served by focusing on one’s positive attributes to “stand out” and be better than others, yet would be attenuated in collectivistic cultures, such as Japan, where the self is served by focusing on one’s negative characteristics to “blend in” (S. J. Heine, D. R. Lehman, H. R. Markus, & S. Kitayama, 1999). Four studies that used different methodologies (free recall, scenarios, and a laboratory experiment) supported this notion. Implications for the science and practice of negotiation are discussed

Complication of Chronic Eosinophilic Pneumonia in an Elderly Patient with Sjögren Syndrome

An 81-year-old Japanese male with primary Sjögren syndrome (pSS) developed a low-grade fever and productive cough which were refractory to antibiotic therapy. Based on the high level of eosinophils observed in his bronchial alveolar lavage, he was diagnosed with chronic eosinophilic pneumonia (CEP) and successfully treated by oral prednisolone. Interstitial lung diseases associated with pSS (pSS-ILDs) usually present as nonspecific interstitial pneumonia or usual interstitial pneumonia; therefore, the present case is extremely unique in that the patientʼs condition was complicated with CEP. A diagnosis of advanced gallbladder cancer was made in the patientʼs clinical course, suggesting the advisability of a whole-body workup in cases of pSS, especially in elderly patients

Professional dietary coaching within a group chat using a smartphone application for weight loss: a randomized controlled trial

Purpose: To test the effectiveness of professional dietary coaching via group chat using a smartphone application (app) for weight loss.Methods: This study was a 12-week, assessor-blind, parallel-group, waitlist-controlled randomized trial that included a 4-week follow-up period (trial registration, UMIN000025340). Data were collected between October 2016 and May 2017 and were analyzed between July 2017 and January 2018. Participants were 112 overweight, obese, or abdominally obese Japanese adults, aged 20 to 64 years, with at least one cardiometabolic risk factor. Participants were randomized to the coaching group (n=75) or control group (n=37), with a ratio of 2:1. The coaching group received a commercial weight loss program characterizing dietary coaching by a certified nutrition professional via group chat delivered on a smartphone app. Participants posted photos of every meal into the group chat, and the certified professional gave immediate direct feedback and encouragement. The primary outcome was an 8-week weight change. Secondary outcomes included 8-week changes in cardiometabolic risk factors. The frequency of meal photo uploads was recorded as a measure of adherence.Results: Of the 112 randomized participants, 93 (83.0%) and 81 (72.3%) completed 8-week and 12-week visits, respectively. Intention-to-treat analysis demonstrated significantly larger 8-week weight loss in the coaching group (−1.4 kg; 95% confidence interval [CI]: −2.0, −0.8 kg) than that in the control group (−0.1 kg; 95% CI: −0.6, 0.4 kg). Significantly larger improvements in triglyceride and glycated hemoglobin A1c levels were also obtained in the coaching group. These benefits, except for the triglyceride level, were maintained until week 12. The frequent upload of meal photos was associated with a larger 8-week weight loss in a dose–response fashion (P-value for trend <0.001).Conclusion: This smartphone-delivered commercial weight loss program characterized as dietary coaching via group chat resulted in modest but significant weight loss. Facilitating participants’ active involvement in the program is necessary to achieve greater health benefits

Near-infrared and Mid-infrared Spectroscopy with the Infrared Camera (IRC) for AKARI

The Infrared Camera (IRC) is one of the two instruments on board the AKARI satellite. In addition to deep imaging from 1.8-26.5um for the pointed observation mode of the AKARI, it has a spectroscopic capability in its spectral range. By replacing the imaging filters by transmission-type dispersers on the filter wheels, it provides low-resolution (lambda/d_lambda ~ 20-120) spectroscopy with slits or in a wide imaging field-of-view (approximately 10'X10'). The IRC spectroscopic mode is unique in space infrared missions in that it has the capability to perform sensitive wide-field spectroscopic surveys in the near- and mid-infrared wavelength ranges. This paper describes specifications of the IRC spectrograph and its in-orbit performance.Comment: 13 pages, 7 figures, accepted for publication on PAS