Sinonasal Schwannoma with New Bone Formation Expressing Bone Morphogenic Protein

Schwannoma is a benign tumor that arises from the sheath of myelinated nerve fibers and may occur in any part of the body. Osteogenesis in schwannoma is extremely rare and, to date, new bone formation in sinonasal schwannoma has not yet been reported. Here, we describe the first reported case of sinonasal schwannoma with new bone formation. The tumor was successfully treated by endoscopic sinus surgery, and the patient showed no evidence of recurrence 24 months postoperatively. Immunohistochemically, the tumor expressed bone morphogenic protein 4, indicating a possible role of this protein in the new bone formation in schwannomas

Characteristics and behavior of dissolved organic matter in the Kumaki River, Noto Peninsula, Japan

Dissolved organic matter (DOM) in river water was studied to understand the transport behavior of DOM in a small watershed with forest and paddy fields. Field experiments were conducted under normal flow conditions in the Kumaki River, which is located in the central part of the Noto Peninsula in Japan, during the period 2009-2010. The concentrations and structural properties of fulvic acid-like components, which are the major components of DOM, were determined using three-dimensional excitation-emission matrix spectroscopy and high-performance size-exclusion chromatography. The relative fluorescence intensity for fulvic acid-like components at an excitation wavelength of 305-335 nm and an emission wavelength of 425-440 nm increased from the upper forest area to the lower paddy field area and increased seasonally in this river system in the following order: winter, autumn, spring, summer. Fulvic acid-like components with a higher molecular weight were observed in the summer samples. These results suggest that higher precipitation and agricultural activity in the summer season increase the amount of fulvic acid-like components with higher molecular weight that are transported from the watershed into the river. © 2014 The Japanese Society of Limnology

Different impressions of other agents obtained through social interaction uniquely modulate dorsal and ventral pathway activities in the social human brain

Internal (neuronal) representations in the brain are modified by our experiences, and this phenomenon is not unique to sensory and motor systems. Here, we show that different impressions obtained through social interaction with a variety of agents uniquely modulate activity of dorsal and ventral pathways of the brain network that mediates human social behavior. We scanned brain activity with functional magnetic resonance imaging (fMRI) in 16 healthy volunteers when they performed a simple matching-pennies game with a human, human-like android, mechanical robot, interactive robot, and a computer. Before playing this game in the scanner, participants experienced social interactions with each opponent separately and scored their initial impressions using two questionnaires. We found that the participants perceived opponents in two mental dimensions: one represented “mind-holderness” in which participants attributed anthropomorphic impressions to some of the opponents that had mental functions, while the other dimension represented “mind-readerness” in which participants characterized opponents as intelligent. Interestingly, this “mind-readerness” dimension correlated to participants frequently changing their game tactic to prevent opponents from envisioning their strategy, and this was corroborated by increased entropy during the game. We also found that the two factors separately modulated activity in distinct social brain regions. Specifically, mind-holderness modulated activity in the dorsal aspect of the temporoparietal junction (TPJ) and medial prefrontal and posterior paracingulate cortices, while mind-readerness modulated activity in the ventral aspect of TPJ and the temporal pole. These results clearly demonstrate that activity in social brain networks is modulated through pre-scanning experiences of social interaction with a variety of agents. Furthermore, our findings elucidated the existence of two distinct functional networks in the social human brain. Social interaction with anthropomorphic or intelligent-looking agents may distinctly shape the internal representation of our social brain, which may in turn determine how we behave for various agents that we encounter in our society

The involvement of the vasa vasorum in the development of vasculitis in animal model of Kawasaki disease

BACKGROUND: Kawasaki Disease (KD) involves a diffuse and systemic vasculitis of unknown etiology that mainly affects infants and children. Although a considerable number of analyses of the clinical, histopathological and molecular biological details underlying the mechanism responsible for the development of coronary arterial lesions, it is still poorly understood. The purpose of this study was to analyze the state of angiogenesis, vasculogenesis and the distribution of blood vessels using an animal model of KD like vasculitis. We investigated the involvement of the vasa vasorum from the adventitia in the vascular involvement and the development of the disease state by performing sequential histopathology, scanning electron microscopy (SEM) and micro computed tomography (CT) studies using a murine model of vasculitis induced by the Candida albicans water-soluble fraction (CAWS). METHODS: To prepare the animal model of KD like vasculitis, CAWS was intraperitoneally injected into C57BL/6N mice for five consecutive days as reported by Ohno et al. We observed the changes of the vasa vasorum at the aorta and the orifices of the coronary arteries by SEM and micro CT, and also compared the neovascularization at the media and adventitia of the aorta by an immunohistochemical analysis. RESULTS: As previously reported, obvious inflammation was detected two weeks after the injection of CAWS, and also intimal thickening was observed three weeks after the injection. We found that the vasa vasorum in the adventitia of the aorta was increased in the model mice. The vasa vasorum started increasing one week after the injection of CAWS, before any obvious vasculitis was microscopically detected. CONCLUSION: The present results indicate that the vasculitis in Kawasaki disease starts as a disorder of the vasa vasorum

地方都市の二次救急医療機関における救急外来受診者の実態

　地方都市の二次救急医療機関における救急外来の受診者の実態を明らかにし，患者教育を含めた保健福祉医療の連携の在り方を含めて考察することを目的とした．結果，受診者総数は2715名，平均年齢59.4歳であった．受診者の割合は，60 歳以上は1616名（59.5%），60 歳未満は1099名（40.5%）であった．全体受診者の主な疾患特性として「交通外傷を含む外傷」が最も多く，「てんかん・痙攣・意識障害」「骨折」「脳卒中」「悪性新生物」「心肺停止・自殺企図」「心筋梗塞・狭心症」が挙がった．また，60 歳以上の受診者が主な疾患別受診者の割合の中で多くの人数を占めていた．これらから，地方都市の二次救急医療施設における外来受診者の疾患特性やライフステージの特性を理解した上で，医療連携をスムーズにする管理体制を整える必要性が示唆された．また，外傷ケアプログラムの充実をはじめ，地域住民を含めたプレホスピタルケアを浸透させる教育体制を整えることや健康管理を充実させる必要があること等が示された．　This survey aimed to clarify the conditions of outpatients at the Secondary Medical Emergency in a local city. Also it aimed to evaluate what should be of the integration of the health welfare medical treatment including the patient education. The total of those who consulted a physician was 2,715 people, and average age 59.4 years old. In this number, 60 or more was 1,616 people (59.5%), and less than 60 was 1,099 person (40.5%). Their chief complaints were traffic injury and injury, epilepsy, convulsion, impaired consciousness, Fracture, stroke, malignant neoplasm, cardiac arrest, attempted suicide , and myocardial infarction and angina. From the above survey, patient’s chief complaints and disease-characteristic could be evaluated, Patient’s life stage suggests the system of care management in order to integrate the medical treatment cooperation. Moreover, at community area it was suggested that the traumatic caring program and pre-hospital care as patient education should be enhanced

学生による看護学部導入教育の評価

報告Report導入教育の一部として看護学部1年次生に対して2005年度に実施された、基礎セミナーIの全体授業(講演)について受講学生より得た評価を報告する。全体授業は4回行われ、看護や介護に限定せずに広範な分野から考える素材が提供された。難易度が適当か、\u27元気\u27や\u27意欲\u27(など前向きのパワー)を与えるか、「大学在学中に学修する、あるいは将来に医療(看護)・保健の専門職として活躍する」という観点から有意義であるかという事項について全回を共通して評価したところ、何れの回についても良好な回答の割合が多かったので、基礎セミナーIの全体授業に係る目標は高い水準で達成されたと評価できた。また、各回に特異な事項についても良好な評価であった。全回に共通する事項、各回に特異な事項の両者とも、看護師の仕事や障害に挫けない生き方に関わる内容のものがとくに好評であった

経皮静脈サンプリングで責任腫瘍を同定した腫瘍性骨軟化症の一例

We report a case of 57-year-old-female with progressive bone pain and proximal dominant muscle weakness. Laboratory test revealed hypophosphatemia with decreased TmP/GFR, high bone-type ALP and elevated levels of FGF23. Radiograph and CT examination revealed multiple fracture with decreased levels of bone mineral density. She also had 2 cm of subcutaneous elastic soft tumor which located on the base of left big toe. Moreover, somatostatin receptor scintigraphy revealed increase uptake in the tumor with high suspicion of the culprit tumor of tumor-induced osteomalacia （TIO）. To verify that the tumor generates FGF23, we performed percutaneous venous blood sampling. The FGF23 level in the left dorsal vein of foot was highest those in other veins. These results strongly suggested that the tumor produced FGF23 and was the culprit tumor for the disorder. The patient underwent resection of the tumor. One day after surgery, the serum FGF23 level in a peripheral vein decreased to less than the measurement sensitivity, while serum phosphate improved to normal range. Two months of following surgery, clinical and biochemical examinations confirmed the successful of operation. Although it is sometimes difficult to detect the culprit tumors in TIO cases, a combination of localization studies may improve diagnostic accuracy of the culprit tumors. Furthermore, percutaneous peripheral venous sampling would be clinically useful for cases who have the responsible tumor located on limbs, hands and feet

Genome-wide linkage and association mapping identify susceptibility alleles in ABCC4 for Kawasaki disease

BACKGROUND: Kawasaki disease (KD) is a self limited vasculitis in which host genetics plays a prominent role. To further the understanding of the role of host genetics in KD, a three-stage genetic study was conducted that began with a family linkage study and ultimately involved more than 3000 individuals to identify new genetic contributions to KD susceptibility. METHODS AND RESULTS: A 26-family linkage study followed by fine mapping was performed in a cohort of 1284 KD subjects and their family members (total 3248 individuals). Suggestive evidence of disease linkage (logarithm of odds (LOD) ≥3.0, p<1.00×10(-4)) was found for five genomic locations (Chr 3q, 4q, 10p, 13q, 21q). Two of these loci (Chr 4q and Chr 13q) overlapped with validated findings from a recent KD genome-wide association study. Fine mapping analysis revealed three single nucleotide polymorphisms (SNPs) in ATP-binding cassette, subfamily C, member 4 (ABCC4) underlying the Chr 13q linkage peak showing evidence of association to KD (lowest p=8.82×10(-5); combined OR 2.00, 95% CI 1.41 to 2.83). ABCC4 is a multifunctional cyclic nucleotide transporter that stimulates the migratory capacity of dendritic cells. It is also a mediator of prostaglandin efflux from human cells and is inhibited by non-steroidal anti-inflammatory medications such as aspirin. CONCLUSION: These genetic data suggest that ABCC4 could play a fundamental role in KD pathogenesis with effects on immune activation and vascular response to injury