A Comprehensive Study of Repetitive Transcranial Magnetic Stimulation in Parkinson's Disease

The clinical benefits of repetitive transcranial magnetic stimulation (rTMS) for Parkinson's disease (PD) remain controversial. We performed a comprehensive study to examine whether rTMS is a safe and effective treatment for PD. Twelve PD patients received rTMS once a week. The crossover study design consisted of 4-week sham rTMS followed by 4-week real rTMS. The Unified Parkinson's Disease Rating Scale (UPDRS), Modified Hoehn and Yahr Stage, Schwab and England ADL Scale, Actigraph, Mini-Mental State Examination, Hamilton Depression Scale, Wechsler Adult Intelligence Scale-revised, and cerebral blood flow (CBF) and cerebrospinal fluid (CSF) examinations were used to evaluate the rTMS effects. Under both drug-on and drug-off conditions, the real rTMS improved the UPDRS scores significantly, while the sham rTMS did not. There were no significant changes in the results of the neuropsychological tests, CBF and CSF. rTMS seems to be a safe and effective therapeutic option for PD patients, especially in a wearing-off state

Alu-mediated large deletion of the CDSN gene as a cause of peeling skin disease

Peeling skin disease (PSD) is an autosomal recessive skin disorder caused by mutations in CDSN and is characterized by superficial peeling of the upper epidermis. Corneodesmosin (CDSN) is a major component of corneodesmosomes that plays an important role in maintaining epidermis integrity. Herein, we report a patient with PSD caused by a novel homozygous large deletion in the 6p21.3 region encompassing the CDSN gene, which abrogates CDSN expression. Several genes including C6orf15, PSORS1C1, PSORS1C2, CCHCR1, and TCF19 were also deleted, however, the patient showed only clinical features typical of PSD. The deletion size was 59.1kb. Analysis of the sequence surrounding the breakpoint showed that both telomeric and centromeric breakpoints existed within Alu-S sequences that were oriented in opposite directions. These results suggest an Alu-mediated recombination event as the mechanism underlying the deletion in our patient. © 2013 John Wiley & Sons A/S.In Press / 発行後1年より最終

Along‐arc variation in the 3‐D thermal structure around the junction between the Japan and Kurile arcs

The thermal structure in subduction zones has a strong influence on seismogenesis and arc volcanism. Traditional 2‐D models have been used to provide reasonable agreement between models and observations, but in a number of cases clear 3‐D effects are present. One such case is in the Northern Japan subduction system. At the junction between Japan and Kurile arcs, surface heat flow and the occurrence of intermediate‐depth seismicity are different than in the Tohoku and Hokkaido regions. We investigate the effects of 3‐D slab geometry and a local deepening of slab‐mantle decoupling depth on the thermal structure in this region based on 3‐D finite element approach. We find that both effects produce the along‐arc variation of slab surface temperature, which could reach ∼100°C. The warmer region arises through 3‐D effects of thermal conduction and the colder region arises through localized slow incoming flow in the case where 3‐D slab geometry is taken into account. 3‐D flow arises where a local deepening of slab‐mantle decoupling depth is assumed, which leads to both warmer and colder regions. The effects on surface heat flow are small. While intermediate‐depth seismicity in the subducted crust is suggested to be controlled by temperature‐dependent phase transitions, the predicted changes in thermal structure are not sufficient to cause the observed deepening of seismicity. This suggests that the thermal structure of this subduction zone may be more strongly influenced by time‐dependent deformation of the overriding crust and slab. Key Points 3‐D effects on the thermal structure of the subduction zone are investigated The effects on slab surface temperature are moderate The effects on surface heat flow are insignificantPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108003/1/ggge20481.pd

Outcomes of definitive chemoradiotherapy for stage iva (T4b vs. n4) esophageal squamous cell carcinoma based on the japanese classification system: A retrospective single-center study

The differences in prognoses or progression patterns between T4b non-N4 and non-T4b N4 esophageal squamous cell carcinoma post chemoradiotherapy (CRT) is unclear. This study compared the outcomes of CRT for stage IVa esophageal squamous cell carcinoma according to T/N factors. We retrospectively identified 66 patients with stage IVa esophageal squamous cell carcinoma who underwent definitive CRT at our center between January 2009 and March 2013. The treatment outcomes, i.e., progression patterns, prognostic factors, and toxicities based on version 5.0 of the National Cancer Institute Common Terminology Criteria for Adverse Events, were studied. The patients (56 men and 10 women) had a median age of 67 (range: 37–87) years. The T/N classifications were T4b non-N4 (28/66), non-T4b N4 (24/66), and T4b N4 (14/66). Objective response was achieved in 57 patients (86.4%, (95% confidence interval, 74.6–94.1%)). There were no significant differences between the T/N groups in terms of overall survival, progression-free survival, and progression pattern. We found no significant differences in prognoses or progression patterns among patients with T4b non-N4, non-T4b N4, and T4b N4 esophageal squamous cell carcinoma. Thus, it seems impractical to modify CRT regimens based on T/N factors