Usefulness of the Measurement of Fractional Exhaled Nitric Oxide in Asthmatic Patients :Correlation with Pulmonary Function, Asthma Control and Health Status

Background and objective:This study was conducted to investigate whether or not FeNO correlates with lung function tests, the Asthma Control Test (ACT) for assessing asthma control or the Asthma Health Questionnaire (AHQ-33) for evaluating the health status in asthmatics. Methods :FeNO was compared with the results of spirometry,ACT and AHQ-33 in 57 non-smoking patients with asthma and 17 healthy individuals without pulmonary diseases who had never smoked. Sixteen of 57 asthmatics treated with inhaled corticosteroid (ICS)underwent step-down therapy if they showed good/total control or step-up therapy if they showed poor control, and were evaluated by spirometry, ACT and AHQ- 33 prior to and more than one month after starting step-down or step-up therapy. Results :FeNO in asthmatics was significantly higher than that in the control group.There were no significant correlations between FeNO and FEV1, ACT score or AHQ-33 scores. However, there were significant correlations between the changes in FeNO and changes in FEV1, ACT score or AHQ-33 scores following stepdown or step-up therapy. Conclusion :FeNO is a useful marker not only for the diagnosis of asthma but also for asthma control and determining the health status in an individual patient, although it is variable without any correlation with symptoms and lung function among asthmatics. Shinshu Med J 59 : 239 ―247, 2011Article信州医学雑誌 59(4): 239-247(2011)departmental bulletin pape

Collagen gene expression during chondrogenesis from chick periosteum-derived cells

AbstractChick periosteum-derived cells, which do not enter the chondrogenic cell lineage during normal bone development and growth, exhibit chondrogenic potential in high cell density culture conditions. In such cultures, collagen gene expression was temporally analyzed at the mRNA level by a reverse transcription PCR (RT-PCR) procedure, which showed that α1(II) and α1(IX) collagen mRNAs are coordinately increased, coincident with the onset of overt chondrogenesis, and subsequently decreased as chondrocytes exhibited hypertrophic characteristics. α1(X) collagen mRNA was detected well before the onset of chondrogenesis and markedly increased along with the hypertrophic change. For α2(I) collagen, both the bone/tendon form and the cartilage form of mRNA were detected throughout the culture period. This culture system provides an experimental vehicle capable of investigating the molecular events involved in the full range of chondrogenic differentiation starting from uncommitted periosteum-derived mesenchymal stem cells

Discrepancies between pathological examination and imaging analysis after primary systemic chemotherapy for breast cancer: report of two cases

Primary systemic chemotherapy (PSC) in breast cancer prolongs disease-free survival in patients who have obtained pathological complete remission (pCR). In combination with pathological examination, CT and MRI have been used to evaluate the efficacy of PSC, they generally coincide well with pathological evaluation. We here present two cases showing discrepancies between pathological examination and imaging analysis after PSC in breast cancer. We should keep such discrepancies in mind to determine the ideal treatment after PSC. An accurate method of evaluating cellular damage by PSC is needed

Duct lavage cytology for the detection of breast cancer: report of a case

Although many modalities have been established to diagnose breast cancers, it is sometimes difficult to reveal nonpalpable cases. Duct lavage cytology was originally established to reveal groups at high risk for breast cancers by detecting metaplastic ductal cells. We report here a case where duct lavage was useful for revealing a small cancer that had been undetected by repeated bloody nipple discharge and cytological examinations. Duct lavage cytology may be of use in cases where nipple discharge of unknown origin persists

Usefulness of Microcatheters Inserted Overnight for Additional Injection of Sclerosant after Initial Balloon-Occluded Retrograde Transvenous Obliteration of Gastric Varices

In patients with large gastric varices, dose limitation of the sclerosant can cause difficulties in achieving complete thrombosis of varices during a single balloon-occluded retrograde transvenous obliteration (BRTO) procedure. For patients with incomplete variceal thrombosis after the first BRTO, additional sclerosant must be injected in a second BRTO. We report a successful case of BRTO for large gastric varices in whom additional sclerosant was injected through a microcatheter that remained inserted overnight. To achieve complete variceal thrombosis in a patient with incomplete thrombosis of large gastric varices after a first BRTO, a retained microcatheter can be used to inject additional sclerosant in a second BRTO the next day

Localization of nonpalpable breast cancers using VATS marking system under ultrasonographic guidance

A preoperative tumor guiding system for nonpalpable breast cancer using a VATS guiding needle (Hakko Co., Ltd., Tokyo Japan) was reported. It was easy to introduce the guiding needle into breast cancers smaller than 1cm under ultrasonographic observation. Neither bleeding nor infection was experienced. Wound management was easy and painless. This guiding system is very useful for locating and managing nonpalpable breast cancers even in outpatient settings

COVID‐19治療後患者に対する廃用リハの重要性

This study examined the effects of rehabilitation on patients after coronavirus disease ２０１９ recovery. ４５ patients（male１８, female ２７, aged ４９‐９７, median：７９ years old）were evaluated for physical and cognitive functions using eight assessment items. We compared and analyzed these data at the time of admission with at the time of discharge, as well as outcome assessment using a performance index. Among the evaluated items, significant improvements were observed in FIM motor（p<０．００１）, cognitive（p<０．００１）, MMSE（p<０．００１）, right hand grip strength（p<０．０１）, left hand grip strength（p<０．００１）, skeletal muscle mass（p<０．０５）, and ６‐minute walk test（p<０．０５）. In addition, the performance index of the subjects was １００．６, which was much higher than the facility standard requirement. Furthermore, it was suggested that the establishment of exercise habits and lifestyle rhythms through rehabilitation may have contributed to the cessation of oxygen administration, insulin and psychotropic medication, it was clarified that the implementation of rehabilitation is effective

Far-East Asian Toxoplasma isolates share ancestry with North and South/Central American recombinant lineages

Ihara F., Kyan H., Takashima Y., et al. Far-East Asian Toxoplasma isolates share ancestry with North and South/Central American recombinant lineages. Nature Communications 15, 4278 (2024); https://doi.org/10.1038/s41467-024-47625-6.Toxoplasma gondii is a global protozoan pathogen. Clonal lineages predominate in Europe, North America, Africa, and China, whereas highly recombinant parasites are endemic in South/Central America. Far East Asian T. gondii isolates are not included in current global population genetic structure analyses at WGS resolution. Here we report a genome-wide population study that compared eight Japanese and two Chinese isolates against representative worldwide T. gondii genomes using POPSICLE, a novel population structure analyzing software. Also included were 7 genomes resurrected from non-viable isolates by target enrichment sequencing. Visualization of the genome structure by POPSICLE shows a mixture of Chinese haplogroup (HG) 13 haploblocks introgressed within the genomes of Japanese HG2 and North American HG12. Furthermore, two ancestral lineages were identified in the Japanese strains; one lineage shares a common ancestor with HG11 found in both Japanese strains and North American HG12. The other ancestral lineage, found in T. gondii isolates from a small island in Japan, is admixed with genetically diversified South/Central American strains. Taken together, this study suggests multiple ancestral links between Far East Asian and American T. gondii strains and provides insight into the transmission history of this cosmopolitan organism

The utility of superficial abdominal reflex in the initial diagnosis of scoliosis: a retrospective review of clinical characteristics of scoliosis with syringomyelia

<p>Abstract</p> <p>Background</p> <p>With increasing use of magnetic resonance imaging (MRI), underlying syringomyelia is increasingly found in patients with presumed idiopathic scoliosis. To determine the indications for MRI in the differential diagnosis of scoliosis, several clinical characteristics of syringomyelia have been reported. Neurological signs, particularly abnormal superficial abdominal reflex (SAR), are important in establishing the initial diagnosis of scoliosis. However, the prevalence of abnormal SAR in patients with scoliosis and the sensitivity of this sign in predicting syringomyelia are not well known. We aimed to determine the diagnostic utility of SAR and other characteristics of syringomyelia in patients with scoliosis.</p> <p>Methods</p> <p>We reviewed the medical records of 93 patients with scoliosis, 90 of whom underwent corrective surgery. All patients underwent MRI to determine the presence of syringomyelia. Mean age at surgery was 12.5 years. Abnormal SAR was defined as unilateral or bilateral absence or hyporeflexia of SAR. We calculated indices of diagnostic utility of abnormal SAR for non-idiopathic scoliosis and for syringomyelia. Abnormal SAR, left thoracic curve pattern, gender, and curve flexibility were compared between scoliosis with syringomyelia and idiopathic scoliosis. Logistic regression analysis was performed with the existence of syringomyelia as the dependent variable and curve flexibility as the independent variable.</p> <p>Results</p> <p>Abnormal SAR was observed in 20 patients (prevalence 22%). All 6 patients with myopathic scoliosis displayed bilateral absence of SAR. The sensitivity of abnormal SAR for non-idiopathic scoliosis was 38%, with 96% specificity, 90% PPV (positive predictive value), and 60% NPV (negative predictive value). Syringomyelia was identified in 9 of the 93 patients (9.7%); 8 of these had abnormal SAR. The sensitivity of abnormal SAR for syringomyelia in presumed idiopathic scoliosis was 89%, with 95% specificity, 80% PPV, and 98% NPV. Gender, abnormal neurological findings, and curve flexibility differed significantly between patients with syringomyelia and those with idiopathic scoliosis (P < 0.05). In the logistic regression model, the area under the receiver operating characteristic (ROC) curve was 0.79 and the cut-off value of curve flexibility for syringomyelia was 50% (P = 0.08).</p> <p>Conclusion</p> <p>Abnormal SAR was a useful indicator not only for syringomyelia, but also for myogenic scoliosis.</p