Repeated shunt dysfunction due to barium allergy

We encountered a case of repeated shunt dysfunction caused by barium allergy. The patient was a 60-year-old male who underwent ventricular peritoneal shunting for hydrocephalus following subarachnoid hemorrhage due to a ruptured aneurysm ; however, it malfunctioned many times. A patch test performed after the third reconstruction was positive for barium. To the best of our knowledge, this is the first case report of shunt malfunction due to barium allergy. The patch test is useful in cases of suspected allergy-related dysfunction. We recommend the introduction of barium into antigen testing using the patch test

Ability of Three Temperate Grasses to Compete with \u3cem\u3ePhalaris arundinacea\u3c/em\u3e L.

Weeds with rhizomes have become an ever-increasing problem in the grasslands of Hokkaido in northern Japan. Many meadows in the Tenpoku region, located in the northernmost part of Hokkaido, have been invaded by Phalaris arundinacea L., a grass with aggressive colonising ability known as the primary and most difficult to control weed in the Tenpoku region. However, dairy farmers in the grasslands of the Tenpoku region most commonly cultivate Phleum pratense L., in spite of its low competitive ability. The Tenpoku region frequently experiences years of low rainfall or drought, but P. pratense has low tolerance to drought (Okamoto et al., 2012; Okamoto and Furudate, 2010). Lolium perenne L. and Dactylis glomerata L. are also cultivated in the Tenpoku region, where they are used as rough forages; however, they are much less commonly cultivated than P. pratense. These species are thought to possess not only higher competitive ability than other grasses, but also higher drought tolerance than P. pratense, and thus may be more suitable for cultivation in some parts of the Tenpoku region. Therefore, we suggest that farmers choose a grass species suitable for their land. To further develop this concept, it is necessary to elucidate the differences among the abilities of these species to compete with invading P. arundinacea. Therefore, the objective of this study was to evaluate and compare the competitive ability of these temperate grass species (L. perenne, D. glomerata, and P. pratense) with those of P. arundinacea

A Pilot Study: The Beneficial Effects of Combined Statin-exercise Therapy on Cognitive Function in Patients with Coronary Artery Disease and Mild Cognitive Decline.

Objective Hypercholesterolemia, a risk factor in cognitive impairment, can be treated with statins. However, cognitive decline associated with "statins" (HMG-CoA reductase inhibitors) is a clinical concern. This pilot study investigated the effects of combining statins and regular exercise on cognitive function in coronary artery disease (CAD) patients with prior mild cognitive decline. Methods We recruited 43 consecutive CAD patients with mild cognitive decline. These patients were treated with a statin and weekly in-hospital aerobic exercise for 5 months. We measured serum lipids, exercise capacity, and cognitive function using the mini mental state examination (MMSE). Results Low-density lipoprotein cholesterol levels were significantly decreased, and maximum exercise capacity (workload) was significantly increased in patients with CAD and mild cognitive decline after treatment compared with before. Combined statin-exercise therapy significantly increased the median (range) MMSE score from 24 (22-25) to 25 (23-27) across the cohort (p<0.01). Changes in body mass index (BMI) were significantly and negatively correlated with changes in the MMSE. After treatment, MMSE scores in the subgroup of patients that showed a decrease in BMI were significantly improved, but not in the BMI-increased subgroup. Furthermore, the patients already on a statin at the beginning of the trial displayed a more significant improvement in MMSE score than statin-naïve patients, implying that exercise might be the beneficial aspect of this intervention as regards cognition. In a multivariate logistic regression analysis adjusted for age >65 years, sex, and presence of diabetes mellitus, a decrease in BMI during statin-exercise therapy was significantly correlated with an increase in the MMSE score (odds ratio: 4.57, 95% confidence interval: 1.05-20.0; p<0.05). Conclusion Statin-exercise therapy may help improve cognitive dysfunction in patients with CAD and pre-existing mild cognitive decline

マイクロコントローラを組み込んだ歯科インプラント動揺測定装置の開発

The aim of this study was to develop a portable device (IM checker) for measuring dental implant mobility using a microcontroller. A constant amplitude and frequency vibration was applied to a dental implant model and the acceleration signal was detected using measuring probe. Then the IM score was obtained using the criteria developed in this study. We made several implant models of different implant lengths, diameters and material of Rigolac® or Molteno®. There was a linear relationship between mechanical mobility at 400 Hz of the models and the IM scores (R(2) = 0.92). The IM checker could discriminate the mobility of dental implant models in twelve measurements with P < 0.01. There was no significant difference in the means of the IM score measured by four operators with P < 0.01. The results indicated that the IM checker had sufficient reliability and could be available in dental clinics.本研究の目的は歯科インプラントの動揺を簡易に測定できる装置の開発である｡本装置では測定プローブで一定振幅の周波数を歯科インプラントに与え､その加速度信号を検出する｡そして本研究で考察した評価基準に基づいてIM値を表示する｡さらにRigolac®やMolteno®を用い､インプラント体の長さおよび直径を変えたインプラントモデルを作製した｡400Hzにおけるモデルの機械モビリティとIM値との間には､よい相関が見られた(R(2)=0.92)｡IMチェッカーを用い､一人の測定者が行った12回の測定において､インプラントの動揺を判別することが可能であった(P<0.01)｡また4人の測定者による測定では,その平均値に対し測定者間の有意差は見られなかった(P<0.01)｡従ってIMチェッカーは十分な信頼性を有し､歯科臨床に有効であると考える

Relationship Between Brain Activity and Real-Road Driving Behavior: A Vector-Based Whole-Brain Functional Near-Infrared Spectroscopy Study

Automobile driving requires multiple brain functions. However, the brain regions related to driving behavior are unknown. Therefore, we measured activity of the frontal, parietal and occipital lobes during driving using functional near-infrared spectroscopy (fNIRS). Cortical activation patterns were examined in relation to driving behaviors, such as steering motion, accelerator pedal motion, and speed control. Six healthy adults participated in the experiment. Cerebral oxygen exchange (COE) was calculated based on the oxyhemoglobin and deoxyhemoglobin concentrations measured by fNIRS. The COE and driving behavior data were collected every 1 m and averaged for all subjects. Functional NIRS data for all 98 channels were extracted using principal component analysis. Similarity between extracted components and driving behaviors were confirmed by |cosine similarity|\u3e0.3. Among the factors with confirmed similarity, we identified brain regions with high principal component loading (|PCL|\u3e0.4). Among the 16 COE factors extracted, COE factor 1 and factor 5 exhibited similarity with steering motion (cosine similarity: factor 1, -0.538; factor 5, 0.551). The PCLs of COE factor 1 and factor 5 were high in the frontal lobe (Brodmann areas [BAs] 9, 8, and 4/3) (PCL\u3e0.8). COE factor 6 exhibited a similarity with accelerator pedal motion (cosine similarity: 0.369), and the PCL of COE factor 6 was highest in the parietal lobe (BA7) (PCL= -0.62). Speed control did not exhibit similarity with any COE factor. These findings will contribute to the selection of brain measurement areas when fNIRS is used for vehicle driving assessment

Frequent Loss of Genome Gap Region in 4p16.3 Subtelomere in Early-Onset Type 2 Diabetes Mellitus

A small portion of Type 2 diabetes mellitus (T2DM) is familial, but the majority occurs as sporadic disease. Although causative genes are found in some rare forms, the genetic basis for sporadic T2DM is largely unknown. We searched for a copy number abnormality in 100 early-onset Japanese T2DM patients (onset age <35 years) by whole-genome screening with a copy number variation BeadChip. Within the 1.3-Mb subtelomeric region on chromosome 4p16.3, we found copy number losses in early-onset T2DM (13 of 100 T2DM versus one of 100 controls). This region surrounds a genome gap, which is rich in multiple low copy repeats. Subsequent region-targeted high-density custom-made oligonucleotide microarray experiments verified the copy number losses and delineated structural changes in the 1.3-Mb region. The results suggested that copy number losses of the genes in the deleted region around the genome gap in 4p16.3 may play significant roles in the etiology of T2DM

Paediatric HIV and elimination of mother-to-child transmission of HIV in the ASEAN region: a call to action

Recent achievements in scaling up paediatric antiretroviral therapy (ART) have changed the life of children living with HIV, who now stay healthy and live longer lives. However, as it becomes more of a chronic infection, a range of new problems have begun to arise. These include the disclosure of HIV serostatus to children, adherence to ART, long-term toxicities of antiretroviral drugs and their sexual and reproductive health, which are posing significant challenges to the existing health systems caring for children with HIV with limited resources, experiences and capacities. While intensified efforts and actions to improve care and treatment for these children are needed, it is crucial to accelerate the prevention of mother-to-child transmission (PMTCT) of HIV, which is the main cause of paediatric HIV in the ASEAN region so as to eliminate the fundamental cause of the problem. This report argues that given over 70% of women have access to at least one antenatal care visit in the region and acceptance of HIV testing after receiving counselling on PMTCT could be as high as 90%, there is an opportunity to strengthen PMTCT services and eventually eliminate new paediatric HIV infections in the ASEAN countries

Utility of Distal Forearm DXA as a Screening Tool for Primary Osteoporotic Fragility Fractures of the Distal Radius A Case-Control Study

Background: Osteoporotic fragility fractures frequently occur at the distal part of the radius. This suggests that initial osteoporosis evaluation at this site may inform screening and treatment to prevent additional fractures. The purpose of this study was to investigate the utility of distal forearm dual x-ray absorptiometry (DXA) as a screening tool to assess the risk of fragility fractures at the distal part of the radius. Methods: This retrospective, case-control study included postmenopausal women who had sustained a distal radial fracture (fracture group, n = 110) and postmenopausal women with no history of fracture (control group, n = 95). DXA measurements at the spine, hip, and distal part of the forearm (ultra-distal, mid-distal, and one-third distal sections) were compared between the groups on the basis of bone mineral density (BMD), T-score, and the proportion of patients with a T-score of £–2.5 standard deviations (SD). We also investigated the regional differences on the basis of T-score among the skeletal sites. Furthermore, the reliability of distal forearm DXA measurements was validated by assessing the statistical correlation (r) with volumetric BMD by computed tomography (CT). Results: Compared with the control group, the fracture group showed significantly lower BMD and T-scores and higher proportions of patients with a T-score of £–2.5 SD at the ultra-distal, mid-distal, and one-third distal forearm; however, the spine and hip measurements did not differ significantly between the 2 groups. With respect to regional differences, in the fracture group, T-scores were significantly lower and the proportions of patients with a T-score of £–2.5 SD were significantly higher for the 3 distal forearm sites compared with the spine and hip. DXA measurements at all 3 of the distal forearm regions exhibited high correlation with volumetric BMD by CT (r = 0.83 to 0.92). Conclusions: Some postmenopausal women were found to exhibit bone loss preferentially at the distal part of the radius, which may render them vulnerable to fragility fractures. Forearm DXA for the assessment of local bone loss may demonstrate benefit in screening for those at risk for distal radial fractures and facilitate the early identification of patients who require intervention for osteoporosis. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.Miyamura S., Kuriyama K., Ebina K., et al. Utility of Distal Forearm DXA as a Screening Tool for Primary Osteoporotic Fragility Fractures of the Distal Radius A Case-Control Study. JBJS Open Access 5, E0036 (2020); https://doi.org/10.2106/JBJS.OA.19.00036

Five isoforms of the phosphatidylinositol 3-kinase regulatory subunit exhibit different associations with receptor tyrosine kinases and their tyrosine phosphorylations

AbstractThere are five isoforms of the regulatory subunit for the heterodimeric type of phosphatidylinositol 3-kinase. These five regulatory subunit isoforms were overexpressed using an adenovirus transfection system, and their own tyrosine phosphorylations and associations with various tyrosine kinase receptors were investigated. When overexpressed in CHO-PDGFR cells, the associations of these regulatory subunit isoforms with the platelet-derived growth factor receptor were similar. However, when overexpressed in CHO-IR cells, p55γ exhibited a significantly lower ability to bind with IRS-1 upon insulin stimulation, as compared with other regulatory subunit isoforms. Furthermore, p55α and p55γ were found to be tyrosine-phosphorylated. Finally, interestingly, when overexpressed in CHO-EGFR cells or A431 cells and stimulated with epidermal growth factor (EGF), phosphorylated EGF receptor was detected in p85α, p85β and p50α immunoprecipitates, but not in p55α and p55γ immunoprecipitates. In addition, EGF-induced tyrosine phosphorylation was observed in p85α, p85β, p55α and p55γ, but not in p50α, immunoprecipitates. Thus, each regulatory subunit exhibits specific responses regarding both the association with tyrosine-phosphorylated substrates and its own tyrosine phosphorylation. These results suggest that each isoform possesses specific roles in signal transduction, based on its individual tyrosine kinase receptor