Emphysematous Cystitis in a Patient with Type 2 Diabetes Mellitus

A 62-year-old woman with a history of poorly controlled type 2 diabetes mellitus was admitted to our hospital with a 3-week history of mild fever, vomiting, and anorexia. Abdominal computed tomography (CT) showed bilateral hydronephrosis and gas accumulation in the urinary bladder wall and left ureter. Laboratory tests showed leukocytosis and elevated C-reactive protein level. Urine culture showed heavy growth of Escherichia coli. The final diagnosis was emphysematous cystitis. The patient was treated with systemic antibiotics and drainage using a urethral catheter. The clinical and radiographic findings resolved rapidly, and she was discharged from the hospital on day 28. Emphysematous cystitis is a relatively rare urinary tract infection associated with gas formation, and has the potential for a serious outcome if untreated. Early detection by imaging studies such as CT is important in providing prompt treatment and favorable clinical outcome

Professional Skills of Expert Teachers in Music Teaching: The Dynamic Nature of Effective Instruction

　本研究では，音楽科授業において，達人教師たちが子どもたちに効果的に説明しているさまざまな指導場面を切り出し，「即座に反応する応答力」と「音楽に関連する専門的知識」の２つの視点に則って，ワザの個別事例を分析した。その結果，（１）「即座に反応する応答力」は，指導の中で常に行われる学習者理解によって，教育内容を調整しどのような教授行為を行うかという判断を伴うもので，教師個人内の音楽に関する概念的知識と身体知に基づき間断なく行われる。また，（２）「音楽に関連する専門的知識」は，「音楽する」行為がもたらす身体知を教師と学習者が往還させながら教授・学習されるという特徴がある。したがって「達人教師達が効果的に説明する」というのは，教師と学習者の身体知を往還させながら，教授ストラテジーを巧みに選択し「即座に反応する応答力」を発揮していく創造性豊かな教授的行為である，と考えられた

Pure Choriocarcinoma of the Ovary in Silver-Russell Syndrome

Pure ovarian choriocarcinoma is an extremely rare malignancy that can be gestational or non-gestational in origin. Silver-Russell syndrome (SRS) is a rare congenital developmental disorder characterized by pre- and postnatal growth failure, relative macrocephaly, a triangular face, hemihypotrophy, and fifth-finger clinodactyly. We report a rare case of pure ovarian choriocarcinoma occurring in a 19-year-old woman with SRS. Following surgery, multiple chemotherapy courses were effective and she was free of disease at the 10-month follow-up

Effect of Surface Pre-Reacted Glass Ionomer Containing Dental Sealant on the Inhibition of Enamel Demineralization.

The effect of a surface pre-reacted glass ionomer (S-PRG)-containing sealant on the demineralization inhibition and remineralization of intact enamel adjacent to the sealant material was investigated. BeautiSealant (BTS, S-PRG sealant, Shofu), Teeth Mate F-12.0 (TMF, fluoride-releasing sealant, Kuraray Noritake Dental), and an experimental silica-filler sealant were investigated. After pH cycling for 10 days, the enamel surface adjacent to the sealant material was observed using confocal laser microscopy and scanning electron microscopy. The polymerized sealant disks were immersed in a demineralized solution (pH: 4.3) to measure pH change. The enamel specimens with polymerized sealant disks were additionally immersed in demineralized solution, followed by energy-dispersive X-ray spectroscopy. The demineralized area of BTS was significantly smaller than that of TMF and SS (p < 0.05). The surfaces adjacent to the sealant of TMF and SS were demineralized, while the surface of BTS was comparatively intact. An increase in pH values were observed in the BTS and TMF groups. Enamel surfaces presented an inhibition of demineralization for BTS and TMF, but not for SS. Fluoride uptake from the polymerized sealant was greater for BTS than for TMF. The S-PRG-containing sealant showed a buffering ability, demineralization inhibition, promotion of remineralization, and it can be advised for clinical applications

The changes of Auditory Evoked Potential (AEP) and EEG in the patients undergoing hemodialysis

AEP (Auditory Evoked Potential) and EEG were studied with 20 patients undergoing hemodialysis (dialyzed group, 41~65 y. o.), consisted of non-diabetic group (13 with chronic glomerulonephritis) and diabetic group (7 with diabetic nephropathy), comparing with those of 20 healthy subjects (normal group, 38~66 y. o.). EEGs containing AEPs evoked by click stimulation were recorded with 1024 msec of analysis time through the two derivations (3 CH : Cz→A1+2 and 6CH : Cz→T5). The group-mean AEPs were obtained with each group, and compared with each other, and then the differences of latencies and peak-to-peak amplitudes of the components were tested statistically between the groups. The EEGs were subjected to the quantitative frequency analysis. Correlation coefficients were tested statistically between the latencies, peak-to-peak amplitudes of AEP components and EEG power %, and between those and blood data. The following results were obtained. 1. The waveforms of group-mean AEP of normal group had hexaphasic contour, consisted of components P1~8 and N1~8, including the prominent negative peak N4 and positive peak P5, within 600 msec of latency. 2. The group-mean AEP of non-diabetic group had similar contour to that of normal group. Latencies of the components were significantly longer except for that of P5, and peak-to-peak amplitudes were mostly larger, than those of normal group. 3. The group-mean AEP of diabetic group had also similar contour to that of normal group, but the prominent negative peak was N3. Latencies of the components were significantly longer except for that of P5, and peak-to-peak amplitudes were smaller, than those of normal group. 4. The latencies of the diabetic group were significantly shorter, and the peak-to-peak amplitudes were also smaller, than those of non-diabetic group. 5. Quantitative frequency analysis of EEG resulted in significant decrease of α2 power% and increase of β1 power % in non-diabetic group, and significant decrease of β1 power % in diabetic group. 6. Positive correlation was found between δ power % of EEG and the latencies of long-latency components of AEP, and negative correlation between α1, α2, β2 power % and the latencies of middle-long-latency components. Between peak-to-peak amplitudes of AEP, negative correlation was found with δ power %, and positive correlation with β1 power %. 7. Between AEP-latencies, the positive correlation was found with Cr (creatinine) and K (potassium), negative correlation with P (phosphorus). Between AEP-amplitudes, positive correlation was found with BUN and P, and negative correlation with Cr and calcium. These results were considered to be attributed to the more prominent inhibition of GABA-inhibitory system in gray matter in non-diabetics, and to severe disturbances in both white and gray matter in diabetics, reflecting antagonistic influences from pathological condition between non-diabetics (uremia) and diabetic nephropathy