Subcutaneous Achilles tendon rupture in an eighty-year-old female with an absence of risk factors

Achilles tendon ruptures rarely occur in patients over 80 years of age. However, it is unclear what treatment, surgical or conservative, is suitable for such an Achilles tendon rupture in the elderly. In addition, the clinical results of an Achilles tendon rupture in the elderly are disappointing. We report here the case of a subcutaneous Achilles tendon rupture in an eighty-year-old, healthy female, who returned to her previous level of activity following surgical treatment. Additional case reports of other instances of successful treatment are needed to help establish the optimal treatment protocol for an Achilles tendon rupture in the elderly

Mice Transgenic for KitV620A: Recapitulation of Piebaldism but not Progressive Depigmentation Seen in Humans with this Mutation

Piebaldism is an autosomal dominant genetic pigmentary disorder, characterized by congenital white hair and patches located on the forehead, anterior trunk, and extremities. Most piebald patients have a mutation of the KIT gene, which encodes a tyrosine kinase receptor involved in pigment cell development. The white hair and patches of such patients are already completely formed at birth and do not usually expand thereafter. This stability of pigmented spots also applies to KitW and KitlSl mutant mice. However, two novel cases of piebaldism were reported in 2001, in which both mother and daughter having a novel Val620Ala mutation in their KIT gene showed progressive depigmentation. To prepare an animal model of this mutation, to explore undefined functions of KIT signaling for maintaining pigmented melanocytes in the skin or more specifically the integrity of the melanocyte stem cell system in the postnatal skin, we produced transgenic mice expressing Val620Ala Kit. These mice well mimicked the white spotting pattern of patients; however, no change in this pattern was observed after birth, even after increasing the transgene expression by various means. Here, we report the unexpectedly extremely stable maintenance of the melanocyte stem cell system under stringent conditions for KIT signaling

Primordial black hole formation from an axion-like curvaton model

We argue that the existence of the cold dark matter is explained by primordial black holes.We show that a significant number of primordial black holes can be formed in an axion-like curvaton model, in which the highly blue-tilted power spectrum of primordial curvature perturbations is achieved.It is found that the produced black holes with masses $\sim 10^{20} -10^{38} \mathrm{g}$ account for the present cold dark matter.We also argue the possibility of forming the primordial black holes with mass $\sim 10^5 M_{\odot}$ as seeds of the supermassive black holes.Comment: 18 pages, 9 figure

Flow of wormlike micellar solutions around microfluidic cylinders with high aspect ratio and low blockage ratio

We employ time-resolved flow velocimetry and birefringence imaging methods to study the flow of a well-characterized shear-banding wormlike micellar solution around a novel glass-fabricated microfluidic circular cylinder. In contrast with typical microfluidic cylinders, our geometry is characterized by a high aspect ratio alpha = H/W = 5 and a low blockage ratio beta = 2r/W = 0.1, where H and W are the channel height and width, and the cylinder radius r = 20 mum. The small cylinder radius allows access up to very high Weissenberg numbers 1.9 </= Wi = lambdaMU/r </= 3750 (where lambdaM is the Maxwell relaxation time) while inertial effects remain entirely negligible (Reynolds number, Re < 10-4). At low Wi values, the flow remains steady and symmetric and a birefringent region (indicating micellar alignment and tensile stress) develops downstream of the cylinder. Above a critical value Wic approximately 60 the flow transitions to a steady asymmetric state, characterized as a supercritical pitchfork bifurcation, in which the fluid takes a preferential path around one side of the cylinder. At a second critical value Wic2 approximately 130, the flow becomes time-dependent, with a characteristic frequency f0 approximately 1/lambdaM. This initial transition to time dependence has characteristics of a subcritical Hopf bifurcation. Power spectra of the measured fluctuations become complex as Wi is increased further, showing a gradual slowing down of the dynamics and emergence of harmonics. A final transition at very high Wic3 corresponds to the re-emergence of a single peak in the power spectrum but at much higher frequency. We discuss this in terms of possible flow-induced breakage of micelles into shorter species with a faster relaxation time

Reducing salt intake for prevention of cardiovascular diseases in high-risk patients by advanced health education intervention (RESIP-CVD study), Northern Thailand: study protocol for a cluster randomized trial

BACKGROUND: Decreasing salt consumption can prevent cardiovascular diseases (CVD). Practically, it is difficult to promote people’s awareness of daily salt intake and to change their eating habits in terms of reducing salt intake for better cardiovascular health. Health education programs visualizing daily dietary salt content and intake may promote lifestyle changes in patients at high risk of cardiovascular diseases. METHODS/DESIGN: This is a cluster randomized trial. A total of 800 high-CVD-risk patients attending diabetes and hypertension clinics at health centers in Muang District, Chiang Rai province, Thailand, will be studied with informed consent. A health center recruiting 100 participants is a cluster, the unit of randomization. Eight clusters will be randomized into intervention and control arms and followed up for 1 year. Within the intervention clusters the following will be undertaken: (1) salt content in the daily diet will be measured and shown to study participants; (2) 24-hour salt intake will be estimated in overnight-collected urine and the results shown to the participants; (3) a dietician will assist small group health education classes in cooking meals with less salt. The primary outcome is blood pressure change at the 1-year follow-up. Secondary outcomes at the 1-year follow-up are estimated 24-hoursalt intake, incidence of CVD events and CVD death. The intention-to-treat analysis will be followed. Blood pressure and estimated 24-hour salt intake will be compared between intervention and control groups at the cluster and individual level at the 1-year follow-up. Clinical CVD events and deaths will be analyzed by time-event analysis. Retinal blood vessel calibers of CVD-risk patients will be assessed cross-sectionally. Behavioral change to reduce salt intake and the influencing factors will be determined by structured equation model (SEM). Multilevel regression analyses will be applied. Finally, the cost effectiveness of the intervention will be analyzed. DISCUSSION: This study is unique as it will recruit the individuals most vulnerable to CVD morbidity and mortality by applying the general Framingham CVD risk scoring system. Dietary salt reduction will be applied as a prioritized, community level intervention for the prevention of CVD in a developing country. TRIAL REGISTRATION: ISRCTN3941627

Factors associated with access to HIV testing among international students in Japanese language schools in Tokyo.

Japan has been recognized for its excellent universal health coverage system. However, the migrant population faces many barriers in accessing health services in Japan. Japan hosts around 260,000 international students, mostly from developing countries. Among them, language school students tripled from 2011 to 2017, against the backdrop of labor shortage in Japan. Most of these students are also engaged as cheap laborers and are vulnerable populations with poor access to health services. Several socio-economic and behavioral factors may increase their vulnerability to HIV and prevent them from accessing HIV testing in Japan. We examined the factors associated with access to HIV testing among international students in language schools in Tokyo. We conducted a cross-sectional study among international students studying in Japanese language schools in Tokyo. We collected data from 769 Chinese, Vietnamese, and Nepalese students using a self-administered questionnaire. We measured their access to HIV testing through questions on their knowledge of where to receive HIV testing and utilization of HIV testing. Bivariate and multivariable logistic regression models were used to analyze the data. Nepalese students were less likely to know where to receive HIV testing in Japan than Chinese students (AOR = 0.12, 95% CI 0.01-0.96). Students who did not need Japanese language interpreters during visits to health facilities were more likely to know where to receive HIV testing (AOR = 1.93, 95% CI 1.14-3.25). Students who did not have knowledge of free and anonymous HIV testing in Japan were also less likely to know where to receive HIV testing in Japan (AOR = 0.18, 95% CI 0.08-0.42). Students who did not have knowledge of free and anonymous HIV testing (OR = 0.05, 95% CI 0.02-0.10) and who had not utilized HIV testing in their home country (OR = 0.12, 95% CI 0.06-0.27) were less likely to utilize HIV testing in Japan. Factors associated with access to HIV testing among Japanese language school students in Tokyo are nationality, need for Japanese language interpreters, perceived access to doctors/health workers, utilization of HIV testing in the home country, and knowledge of free and anonymous HIV testing. These findings may help to design interventions for improving access to HIV testing among international students in Japan

Purulent lymphadenitis due to Halomonas hamiltonii: a case report

Halomonas hamiltonii is a gram-negative rod bacterium isolated from highly saline environments. H. hamiltonii has rarely been reported as a human pathogen. Herein, we present the first case report of a purulent lymphadenitis caused by H. hamiltonii worldwide. The patient was a previously healthy girl aged 1 year who was referred to our hospital for left axillary lymphadenitis. Although oral amoxicillin was administered, lymphadenitis did not improve, and an abscess developed. After incision and drainage, the abscess was reduced. No recurrence of lymphadenitis was observed. The pus culture was negative. However, the 16S ribosomal DNA was amplified by the melting temperature mapping method. The amplified 16S ribosomal DNA sequence revealed 99.7% identity of H. hamiltonii. To the best of our knowledge, this is the first case of H. hamiltonii infection in a lymph node. This pathogen should be considered when diagnosing purulent lymphadenitis in healthy patients with lymphadenopathy of unknown origin