Comparison of the diagnostic value of 3 T MRI after intratympanic injection of GBCA, electrocochleography, and the glycerol test in patients with Meniere's disease

Conclusion. 3 T MRI after intratympanic injection of gadolinium-based contrast agent (GBCA) is more useful for the diagnosis of endolymphatic hydrops compared with the glycerol test and electrocochleography (ECoG). Objective: To investigate the relationship between 3 T MRI after intratympanic injection of GBCA, the glycerol test, and ECoG in patients with Meniere's disease (MD). Methods: A total of 20 patients with MD were evaluated. Diluted gadodiamide (a gadolinium-based contrast agent) was administered to the bilateral tympanic cavity by injection through the tympanic membrane. After 24 h, the endolymphatic hydrops was evaluated by a 3.0 T MR scanner. To investigate cochlear hydrops, the glycerol test and ECoG were carried out in all patients. Results: A positive result was observed in 11 patients (55%) in the glycerol test and in 12 patients (60%) by ECoG. The incidence of positive findings when evaluating the same patients with both the glycerol test and ECoG increased to 75%. Nineteen of 20 (95%) patients showed positive results for 3 T MRI.ArticleACTA OTO-LARYNGOLOGICA. 132(2):141-145 (2012)journal articl

A Clinical Evaluation of American Brachytherapy Society Consensus Guideline for Bulky Vaginal Mass in Gynecological Cancer

Objectives American Brachytherapy Society (ABS)-recommended interstitial brachytherapy (IBT) should be considered for bulky vaginal tumor thicker than 5 mm. The aim of this study was to evaluate the ABS consensus guideline for patients with severe vaginal invasion based on our long-term follow-up results.Methods/MaterialsThe study included 7 patients with vaginal cancer and 14 patients with cervical cancer invading to the lower vagina. Based on prebrachytherapy magnetic resonance imaging findings, patients received intracavitary brachytherapy (ICT) for vaginal tumors 5 mm or less or IBT for vaginal tumors less than 5 mm. Nine patients received ICT and the remaining 12 patients received IBT. For dosimetric comparison, an experimental recalculation as the virtual IBT for patients actually treated by ICT, and vice versa, was performed.Results The 5-year local control rate for all tumors was 89.4%. No differences in local control between ICT- and IBT-treated groups were observed (P = 0.21). One patient experienced a grade 3 rectal complication. There were no significant differences in the CTV D90 and rectum D2cc between the 2 groups (P = 0.13 and 0.39, respectively). In the dosimetric study of ICT-treated patients, neither the actual ICT plans nor the experimental IBT plans exceeded the limited dose for organs at risk, which were recommended in the guideline published from the ABS. In the IBT-treated patients, D2cc for bladder and rectum of the experimental ICT plans was significantly higher than for the actual IBT plans (P < 0.001 and <0.001, respectively), and 11 experimental ICT plans (92%) exceeded the limited dose for bladder and/or rectum D2cc.Conclusions Tumor control and toxicity after selected brachytherapy according to vaginal tumor thickness were satisfactory; IBT instead of ICT is recommended for patients with vaginal tumor thickness greater than 5 mm to maintain bladder and/or rectum D2cc

Conduction-band electronic states of YbInCu4 studied by photoemission and soft x-ray absorption spectroscopies

We have studied conduction-band (CB) electronic states of a typical valence-transition compound YbInCu4 by means of temperature-dependent hard x-ray photoemission spectroscopy (HX-PES) of the Cu 2p3/2 and In 3d5/2 core states taken at hν=5.95 keV, soft x-ray absorption spectroscopy (XAS) of the Cu 2p3/2 core absorption region around hν∼935 eV, and soft x-ray photoemission spectroscopy (SX-PES) of the valence band at the Cu 2p3/2 absorption edge of hν=933.0 eV. With decreasing temperature below the valence transition at TV=42 K, we have found that (1) the Cu 2p3/2 and In 3d5/2 peaks in the HX-PES spectra exhibit the energy shift toward the lower binding-energy side by ∼40 and ∼30 meV, respectively, (2) an energy position of the Cu 2p3/2 main absorption peak in the XAS spectrum is shifted toward higher photon-energy side by ∼100 meV, with an appearance of a shoulder structure below the Cu 2p3/2 main absorption peak, and (3) an intensity of the Cu L3VV Auger spectrum is abruptly enhanced. These experimental results suggest that the Fermi level of the CB-derived density of states is shifted toward the lower binding-energy side. We have described the valence transition in YbInCu4 in terms of the charge transfer from the CB to Yb 4f states

Japan Prosthodontic Society position paper on “occlusal discomfort syndrome”

Purpose: Dentists may encounter patients who present with a sense of a malocclusion but in whom no objective findings can be detected. For the patient who insists that there is occlusal discomfort, in the absence of evidence some dentists elect to perform an occlusal adjustment that not only fails to alleviate symptoms, and may, in fact, exacerbate the discomfort. The patient–dentist relationship is then likely compromised because of a lack of trust. Study selection: In 2011, the Clinical Practice Guidelines Committee of the Japan Prosthodontic Society formulated guidelines for the management of occlusal discomfort. When formulating clinical practice guidelines, the committee bases their recommendations on information derived from scientific evidence. For ‘‘occlusal dysesthesia,’’ however, there are an insufficient number of high-quality papers related to the subject. Therefore, a consensus meeting was convened by the Japan Prosthodontic Society to examine evidence in the Japanese- and English-language literature and generate a multi-center survey to create an appropriate appellation for this condition. Results: As a result of the consensus meeting and survey findings, this condition may be justifiably termed ‘‘occlusal discomfort syndrome.’’ Conclusions: The Japan Prosthodontics Society believes that identification of an umbrella term for occlusal discomfort might serve as a useful guide to formulating clinical practice guidelines in the future. This position paper represents summary findings in the literature combined with the results of a multicenter survey focused on dental occlusal treatment and the condition of patients who present with occlusal discomfort syndrome

Japan\u27s sediment flux to the Pacific Ocean revisited

Quantifying volumes and rates of delivery of terrestrial sediment from island arcs to subduction zones is indispensable for refining estimates of the thickness of trench fills that may eventually control the location and timing of submarine landslides and tsunami-generating mega-earthquakes. Despite these motivating insights, knowledge about the rates of erosion and sediment export from the Japanese islands to their Pacific subduction zones remains patchy regardless of the increasing availability of highly resolved data on surface deformation, climate, geology, and topography. Traditionally, natural erosion rates across the island arc have been estimated from regression of topographic catchment metrics and reservoir sedimentation rates that were recorded over several years to decades. We review current research in this context, correct for a systematic bias in one of the most widely used predictions, and present new estimates of decadal to millennial-scale erosion rates of Japan\u27s terrestrial inner forearc. We draw on several independent and unprecedented inventories of mass wasting, reservoir sedimentation, and concentrations of cosmogenic 10Be in river sands. We find that natural 10Be-derived denudation rates of several mm yr− 1 in the Japanese Alps have been sustained over several centuries to millennia, and are, within error, roughly consistent with sediment yields inferred from artificial reservoir sedimentation. Local exceptions may likely result from release of sediment storage or regional landsliding episodes that trigger transient sediment pulses. Our synopsis further reveals that catchments draining Japan\u27s eastern seaboard differ distinctly in their tectonic, lithological, topographic, and climatic characteristics between the Tohoku, Japanese Alps, and Nankai inner forearc segments, which is underscored by a marked asymmetric pattern of erosion rates along the island arc. Erosion rates are highest (up to at least 3 mm yr− 1) in the Japanese Alps that mark the collision of two subduction zones, where high topographic relief, hillslope and bedrock-channel steepness foster rapid denudation by mass wasting. Comparable, if slightly lower, erosion rates characterise the Nankai inner forearc in southwest Japan, most likely due to higher typhoon-driven rainfall totals and variability rather than its high topographic relief. In contrast, our estimated erosion and flux rates are lowest in the Tohoku inner forearc catchments that feed sediment into the Japan Trench. We conclude that collisional mountain building of the Japanese Alps drives some of the highest erosion rates in the island arc despite similar uplift and precipitation controls in southwest Japan. We infer that, prior to extensive river damming, reservoir construction, and coastal works, the gross of Japan\u27s total sediment export to the Pacific Ocean entered the accretionary margin of the Nankai Trough as opposed to the comparatively sediment-starved Japan Trench. Compared to documented contemporary rates of sediment flux from mountainous catchments elsewhere in the Pacific, the rivers draining Japan\u27s inner forearc take an intermediate position despite high relief, steep slopes, very high seismicity, and frequent rainstorms. However, the average rates of millennial-scale denudation in the Japanese Alps particularly are amongst the highest reported worldwide. Local mismatches between these late Holocene and modern rates emphasise the anthropogenic fingerprint on sediment retention that may have significantly reduced the island arc\u27s mass flux to its subduction zones, as is the case elsewhere in east and southeast Asia

Serological and histopathological assessment of galactose-deficient immunoglobulin A1 deposition in kidney allografts: A multicenter prospective observational study.

BackgroundRecurrent immunoglobulin A (IgA) nephropathy is an important risk factor for kidney allograft loss. However, there is no classification system for IgA deposition in kidney allografts based on serological and histopathological evaluation of galactose-deficient IgA1 (Gd-IgA1). This study aimed to establish a classification system for IgA deposition in kidney allografts based on serological and histological evaluation of Gd-IgA1.MethodsThis multicenter prospective study included 106 adult kidney transplant recipients in whom an allograft biopsy was performed. Serum and urinary Gd-IgA1 levels were investigated in 46 transplant recipients who were IgA-positive and classified into four subgroups according to the presence or absence of mesangial Gd-IgA1 (KM55 antibody) deposits and C3.ResultsMinor histological changes without an acute lesion were observed in recipients with IgA deposition. Fourteen (30%) of the 46 IgA-positive recipients were KM55-positive and 18 (39%) were C3-positive. The C3 positivity rate was higher in the KM55-positive group. Serum and urinary Gd-IgA1 levels were significantly higher in KM55-positive/C3-positive recipients than in the other three groups with IgA deposition. Disappearance of IgA deposits was confirmed in 10 of 15 IgA-positive recipients in whom a further allograft biopsy was performed. The serum Gd-IgA1 level at the time of enrollment was significantly higher in recipients in whom IgA deposition continued than in those in whom it disappeared (p = 0.02).ConclusionsThe population with IgA deposition after kidney transplantation is serologically and pathologically heterogeneous. Serological and histological assessment of Gd-IgA1 is useful for identifying cases that should be carefully observed

(-)-Epigallocatechin-3-gallate Inhibits Differentiation and Matrix Metalloproteinases Expression in Osteoclasts

The osteoclast is a multinucleated giant cell differentiated from monocyte macrophages that has an important role in bone resorption. Several studies have reported a relationship between tea consumption and decreased risk of bone fracture. Matrix metalloproteinases (MMPs) play an important role in the degeneration of bone and cartilage matrix. Regulation of osteoclast activity is essential in the treatment of bone disease. Moreover, MMPs are associated with osteoclast formation and differentiation. We have reported previously that (-) -epigallocatechin-3-gallate (EGCG) inhibits MMP-2 and MMP-9 expression and activity. However, the effects of EGCG on osteoclasts and other MMPs are not clear. Therefore, in the present study we examined whether EGCG affects MMP expression, as well as osteoclast formation, differentiation and activity, in vitro. We used bone marrow cells from the femur and tibial bones of male ddY mice. Bone marrow cells were cultured in the presence of 1-100µM EGCG for 6 or 8 days. EGCG decreased the number of mature osteoclasts, as determined by tartrate-resistant acid phosphatase staining. Concentrations as low as 1µM EGCG clearly inhibited the differentiation of osteoclasts from bone marrow cells. EGCG also inhibited the number of osteoclasts with an actin-ring, as determined by rhodamine phalloidin staining, as well as osteoclast activity, as determined by the pit formation assay. Furthermore, EGCG concentration-dependently decreased MMP-9 and membrane type 1-MMP mRNA expression in mouse osteoclasts. However, EGCG had no changing on mRNA levels of tissue inhibitor of metalloprotease (TIMP)-1 and TIMP-3. Together, the results suggest that EGCG may be a suitable agent or lead compound for the development of treatments for bone resorption diseases associated with MMPs