Characteristics of Clinical and Imaging Findings of Epidermoid Cysts under the Skin of the Mental Region

Epidermoid cyst often arises in the fl oor of oral cavity; however, it is relatively rare to arise subcutaneously in the mental region. We reported characteristics of clinical and imaging fi ndings of epidermoid cysts under the skin of the mental region. The patient was a 53-year-old male. He complained of a subcutaneous mass without pain in the left mental region. A palpable soft and movable thumb-sized mass without pain was observed at the fi rst examination. Ultrasound examination revealed a well-demarcated mass with heterogenous hyper-echoic internal echo and posterior echo enhancement. On power Doppler sonography, a small amount of blood supply was found around the periphery of the mass. Plain CT scan revealeda globular soft-tissue mass with peripheral high and central low CT values area. The mass was removed under local anesthesia using intraoral approach. A histopathologic diagnosis was epidermoid cyst. Recurrence is not observed 2 years after surgery. There were only 3 reports of epidermoid cysts in the mental region, including our case in Japan, clinically characteristics of age ranging 20 to 66 years of age and the mean age of 46 years, with 2 males and 1 female. The size wasfrom 20 mm to 12 mm in diameter and from the tip of a thumb up to the tip of a small fi nger. Ultrasound images of the inside of epidermoid cysts that we experienced this time showed enhancement of relatively uniform hyperechoic image and posterior echo, which was characteristically slightly diff erent from fi ndings of epidermoid cysts generally reported

Membrane-anchored growth factor, HB-EGF, on the cell surface targeted to the inner nuclear membrane

Heparin-binding EGF-like growth factor (HB-EGF) is synthesized as a type I transmembrane protein (proHB-EGF) and expressed on the cell surface. The ectodomain shedding of proHB-EGF at the extracellular region on the plasma membrane yields a soluble EGF receptor ligand and a transmembrane-cytoplasmic fragment (HB-EGF-CTF). The cytoplasmic domain of proHB-EGF (HB-EGF-cyto) interacts with transcriptional repressors to reverse their repressive activities. However, how HB-EGF-cyto accesses transcriptional repressors is yet unknown. The present study demonstrates that, after exposure to shedding stimuli, both HB-EGF-CTF and unshed proHB-EGF translocate to the nuclear envelope. Immunoelectron microscopy and digitonin-permeabilized cells showed that HB-EGF-cyto signals are at the inner nuclear membrane. A short sequence element within the HB-EGF-cyto allows a transmembrane protein to localize to the nuclear envelope. The dominant-active form of Rab5 and Rab11 suppressed nuclear envelope targeting. Collectively, these data demonstrate that membrane-anchored HB-EGF is targeted to the inner nuclear membrane via a retrograde membrane trafficking pathway

Myosin motor Myo1c and its receptor NEMO/IKK-γ promote TNF-α–induced serine307 phosphorylation of IRS-1

Tumor necrosis factor-α (TNF-α) signaling through the IκB kinase (IKK) complex attenuates insulin action via the phosphorylation of insulin receptor substrate 1 (IRS-1) at Ser307. However, the precise molecular mechanism by which the IKK complex phosphorylates IRS-1 is unknown. In this study, we report nuclear factor κB essential modulator (NEMO)/IKK-γ subunit accumulation in membrane ruffles followed by an interaction with IRS-1. This intracellular trafficking of NEMO requires insulin, an intact actin cytoskeletal network, and the motor protein Myo1c. Increased Myo1c expression enhanced the NEMO–IRS-1 interaction, which is essential for TNF-α– induced phosphorylation of Ser307–IRS-1. In contrast, dominant inhibitory Myo1c cargo domain expression diminished this interaction and inhibited IRS-1 phosphorylation. NEMO expression also enhanced TNF-α–induced Ser307–IRS-1 phosphorylation and inhibited glucose uptake. In contrast, a deletion mutant of NEMO lacking the IKK-β–binding domain or silencing NEMO blocked the TNF-α signal. Thus, motor protein Myo1c and its receptor protein NEMO act cooperatively to form the IKK–IRS-1 complex and function in TNF-α–induced insulin resistance

Association between preoperative toe perfusion index and maternal core temperature decrease during cesarean delivery under spinal anesthesia: a prospective cohort study

Background: The main mechanism of body temperature decrease during cesarean delivery under spinal anesthesia is core-to-peripheral redistribution of body heat, attributable to vasodilation. Perfusion index (PI) obtained with a pulse oximeter helps to assess peripheral perfusion dynamics by detecting the change in peripheral vascular tone. This study aimed to examine whether preoperative toe PI could predict the decrease in core temperature induced by spinal anesthesia during cesarean delivery.Methods: Parturients undergoing scheduled cesarean delivery under combined spinal-epidural anesthesia from September 2019 to March 2020 were enrolled in this single-center prospective cohort study. All parturients received 0.5% hyperbaric bupivacaine (10 mg) with fentanyl (15 μg) intrathecally. A pulse oximeter probe was placed on the left second toe for continuous PI measurement. The 3 M™ Bair Hugger™ Temperature Monitoring System placed over the right temporal region was used to record core temperature over time. We evaluated the association between the maximum core temperature decrease, which is the primary outcome, and the preoperative toe PI at operating room (OR) admission using a segmented regression model (SRM) and a generalized additive model (GAM). The maximum core temperature decrease was defined as the difference between core temperature at OR admission and minimum intraoperative core temperature.Results: Forty-eight patients were evaluated. In the SRM, the slope for the association between the maximum core temperature decrease and the preoperative toe PI changed from 0.031 to 0.124 after PI = 2.4%. Likewise, with the GAM, there was a small core temperature decrease when preoperative toe PI was greater than 2.0 to 3.0%.Conclusions: Low preoperative toe PI was associated with maternal core temperature decrease during cesarean delivery under spinal anesthesia. Preoperative toe PI is a simple, non-invasive, and effective tool for the early prediction of perioperative core temperature decrease during cesarean delivery.Trial registration: UMIN Clinical Trials Registry (registry number: UMIN000037965)

Support team and its effects on house remodeling for aged and handicapped persons

地域で生活する高齢者･障害者にとって,住宅環境の整備は必須の要件である｡津山市では在宅生活を支援する立場にある保健婦やホームヘルパー,作業療法士等保健･福祉関係者と,建築関係者が共同で支援チームをつくり住宅改造に関わってきた｡本研究では,この支援チームが関わった事例と直接関わらないで当事者と業者のみで改造を実施した事例を比較し,支援チームが関わることの効果をみた｡調査方法は,各事例の家庭を訪問して面接聞き取り調査を行った｡調査内容は調査票を用いて改造箇所,生活空間,介護量,外出の状況について尋ねた｡改造前後の変化を比較して,支援チームの効果について以下のことが明らかになった｡ 1.支援チームの関与による浴室の改造は,入浴が可能となり生活空間が広がるなど改善が認められた｡ 2.離床を目的にした玄関･廊下･居室の改造は,外出などの日常生活行動を広げ,本人のQOLを高めることに役立つ｡以上より住宅の改造が,介護者の介護負担を必ずしも直接軽減するとは限らないが,高齢者･障害者の介護の質に変化を与えることが示唆された。The maintenance and improvement of housing environments are essential for aged and handicapped persons living in a local communities. The support team consists of public health nurses, home helpers, occupational therapists and architects took part in giving an advices for house remodeling in Tsuyama City. We compared the effectiveness of the participation of the team before and after remodeling of housing environment. An interview was conducted at each cases for places of remodeling, living spaces, quantity of care and ease of going. The results are as follows ; 1. The remodeling of bathrooms, participating support team improved the living spaces to be able to take bath. 2. The remodeling of entrances and corridors for leaving beds, improved the living space and the QOL of care recipients. The results suggest that the remodeling of houses dose not always lighten care burdens for caring, but changes the quality of care for aged and handicapped persons

Cutaneous T-cell-attracting chemokine as a novel biomarker for predicting prognosis of idiopathic pulmonary fibrosis: a prospective observational study

[Background] Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrotic lung disease that leads to respiratory failure and death. Although there is a greater understanding of the etiology of this disease, accurately predicting the disease course in individual patients is still not possible. This study aimed to evaluate serum cytokines/chemokines as potential biomarkers that can predict outcomes in IPF patients. [Methods] A multi-institutional prospective two-stage discovery and validation design using two independent cohorts was adopted. For the discovery analysis, serum samples from 100 IPF patients and 32 healthy controls were examined using an unbiased, multiplex immunoassay of 48 cytokines/chemokines. The serum cytokine/chemokine values were compared between IPF patients and controls; the association between multiplex measurements and survival time was evaluated in IPF patients. In the validation analysis, the cytokines/chemokines identified in the discovery analysis were examined in serum samples from another 81 IPF patients to verify the ability of these cytokines/chemokines to predict survival. Immunohistochemical assessment of IPF-derived lung samples was also performed to determine where this novel biomarker is expressed. [Results] In the discovery cohort, 18 cytokines/chemokines were significantly elevated in sera from IPF patients compared with those from controls. Interleukin-1 receptor alpha (IL-1Rα), interleukin-8 (IL-8), macrophage inflammatory protein 1 alpha (MIP-1α), and cutaneous T-cell-attracting chemokine (CTACK) were associated with survival: IL-1Rα, hazard ratio (HR) = 1.04 per 10 units, 95% confidence interval (95% CI) 1.01–1.07; IL-8, HR = 1.04, 95% CI 1.01–1.08; MIP-1α, HR = 1.19, 95% CI 1.00–1.36; and CTACK, HR = 1.12 per 100 units, 95% CI 1.02–1.21. A replication analysis was performed only for CTACK because others were previously reported to be potential biomarkers of interstitial lung diseases. In the validation cohort, CTACK was associated with survival: HR = 1.14 per 100 units, 95% CI 1.01–1.28. Immunohistochemistry revealed the expression of CTACK and CC chemokine receptor 10 (a ligand of CTACK) in airway and type II alveolar epithelial cells of IPF patients but not in those of controls. [Conclusions] CTACK is a novel prognostic biomarker of IPF

Elicitin-responsive lectin-like receptor kinase genes in BY-2 cells

The inhibition of elicitor-induced plant defense responses by the protein kinase inhibitors K252a and staurosporine indicates that defense responses require protein phosphorylation. We isolated a cDNA clone encoding Nicotiana tabacum lectin-like receptor protein kinase 1 ( NtlecRK1), an elicitor-responsive gene; in tobacco bright yellow ( BY-2) cells by a differential display method. NtlecRK forms a gene family with at least three members in tobacco. All three NtlecRK genes potentially encode the N-terminal legume lectin domain, transmembrane domain and C-terminal Ser/Thr-type protein kinase domain. Green fluorescent protein ( GFP) fusion showed that the NtlecRK1 protein was located on the plasma membrane. In addition, NtlecRK1 and 3 were responsive to INF1 elicitin and the bacterial elicitor harpin. These results indicate that NtlecRKs are membrane-located protein kinases that are induced during defense responses in BY-2 cells.</p

A case of intramuscular lipoma of the left buccal region

We report a case of intramuscular lipoma of the left buccal region, along with a review of the relevant literature. Magnetic resonance imaging showed a spindle–shaped mass extending from the canine region to the anterior portion of the masseter muscle in the buccal–alveolar portion of the left mandible. The inner part was visualized as homogeneous high–signal intensity on both T1– and T2–weighted images, and a partial linear region with the same signal intensity as muscle was also observed. The removed tumor measured 35×40×15mm in size, and histopathological findings showed an intramuscular lipoma composed of adipose, muscle and connective tissues. Intramuscular lipomas account for 1.7%–2% of all lipomas, and they very rarely occur in the oral and maxillofacial region. Twenty–three cases with intramuscular lipomas in the oral and maxillofacial region, including our case, have been reported in Japan. The postoperative healing process is generally good. We followed–up our patient after explaining to him the importance of careful, long–term follow–up. It has been only 2 months, to date, since surgery but the outcome appears to be good

A case of mandibular fracture including coronoid process fracture

The incidence of mandibular fractures is the highest among facial bone fractures. Addi-tionally, most of mandibular fractures occur in the mandibular angle and condylar process. On the other hand, the incidence of fracture of coronoid process is extremely low. We experienced a case of mandibular fractures involving mandibular body, condylar process as well as the coronoid process in a man aged 3₉–years–old who had received strong direct external force to the mandible. Mandibular fractures usually occur in the condylar process and mandibular angle because direct external force is more likely to transmit to these re-gions. Based on the classification of mandibular fractures, the incidence of mandibularfractures involving coronoid process increases with an increased number of fractures lines that means complicated fracture. At the viewpoint of anatomical portion, direct external force dose not transmit to coronoid process; however, it is possible that direct external force may transmit coronoid process in the case of complicated fracture. In this case report, we considered the potential mechanism of fracture of coronoid process by using a three–dimensional finite element model of a human mandible stress distribution analysis