PREDICT DIABETES INCIDENCE WITH HBA1C AND OTHER ITEMS

In diabetes screening with hemoglobin A1c in lieu of plasma glucose, the optimum cut-off point for predicting the incidence of diabetes mellitus in the four-year period was examined. In addition, considerations were given on items in the screening and questionnaire aside from hemoglobin A1c, which would be useful in predicting diabetes aside from hemoglobin A1c. The optimum cut-off point of hemoglobin A1c to predict diabetes, based on receiver operating characteristic curve, was 5.3 percent (sensitivity, 84.2%; specificity, 92.1%). Based on the logistic regression analysis, useful items (other than hemoglobin A1c) were alanine aminotransferase and γ-glutamyl transpeptidase. A combined application of hemoglobin A1c with alanine aminotransferase and γ-glutamyl transpeptidase for predicting the incidence of diabetes in the four-year period resulted in the sensitivity of 86.8% and the specificity of 96.3%. When the combined application was compared with the sole use of hemoglobin A1c at 5.3%, the combined use was superior to the latter in terms of both sensitivity and specificity, resulting in the reduction of false positives by more than 50%

Contribution of the Pulvinar and Lateral Geniculate Nucleus to the Control of Visually Guided Saccades in Blindsight Monkeys

After damage to the primary visual cortex (V1), conscious vision is impaired. However, some patients can respond to visual stimuli presented in their lesion-affected visual field using residual visual pathways bypassing V1. This phenomenon is called "blindsight." Many studies have tried to identify the brain regions responsible for blindsight, and the pulvinar and/or lateral geniculate nucleus (LGN) are suggested to play key roles as the thalamic relay of visual signals. However, there are critical problems regarding these preceding studies in that subjects with different sized lesions and periods of time after lesioning were investigated; furthermore, the ability of blindsight was assessed with different measures. In this study, we used double dissociation to clarify the roles of the pulvinar and LGN by pharmacological inactivation of each region and investigated the effects in a simple task with visually guided saccades (VGSs) using monkeys with a unilateral V1 lesion, by which nearly all of the contralesional visual field was affected. Inactivating either the ipsilesional pulvinar or LGN impaired VGS toward a visual stimulus in the affected field. In contrast, inactivation of the contralesional pulvinar had no clear effect, but inactivation of the contralesional LGN impaired VGS to the intact visual field. These results suggest that the pulvinar and LGN play key roles in performing the simple VGS task after V1 lesioning, and that the visuomotor functions of blindsight monkeys were supported by plastic changes in the visual pathway involving the pulvinar, which emerged after V1 lesioning.SIGNIFICANCE STATEMENT Many studies have been devoted to understanding the mechanism of mysterious symptom called "blindsight, " in which patients with damage to the primary visual cortex (V1) can respond to visual stimuli despite loss of visual awareness. However, there is still a debate on the thalamic relay of visual signals. In this study, to pin down the issue, we tried double dissociation in the same subjects (hemi-blindsight macaque monkeys) and clarified that the lateral geniculate nucleus (LGN) plays a major role in simple visually guided saccades in the intact state, while both pulvinar and LGN critically contribute after the V1 lesioning, suggesting that plasticity in the visual pathway involving the pulvinar underlies the blindsight

Interprofessional education in Japanese university nursing programs : Current status and evaluation of its impact

This study was aimed to identify the current status and the evaluation of the impact of interprofessional education (IPE) on nursing education in Japanese universities. Two hundred Japanese universities with nursing programs were the target of this study. Backward Binary Logistic Regression Analysis (Pin = 0.14, Pout = 0.15) was performed to determine the relationship between subjective evaluations of IPE and 24 indices such as the founding year of the university and the department of nursing, and the participation or nonparticipation of departments and each profession. One hundred ten valid responses (55.0%) were collected. Among those responses, 58 universities implemented IPE (52.7%) and 52 did not have an IPE program at their institute (47.3%). These results indicated that the significance of IPE program on nursing education tended to be highly evaluated when students of the Department of Nutrition and Dietetics, and Occupational Therapy participated in the program, whereas the significance of IPE tended to be considered low with the participation of students of the Department of Speech, Language and Hearing Sciences. Regarding the treatment or support of their clients (i.e., patients), when the IPE participating students shared the areas of responsibility of their intended professions, the impact of IPE was more likely to have the high evaluation score. On the contrary, the tendency of the Department of Speech, Language and Hearing Sciences (DSL&HS) indicated that the significance of IPE received low evaluations due to the low recognition by other professions for the contents of DSL&HS’s high expertise

Examining the Validity of Efforts of the Muscular Dystrophy Medical Network in Nagano : A Questionnaire Study

Article信州医学雑誌 66(3): 205-212(2018)journal articl

Continued growth of locally aggressive fibrous dysplasia of 22 years duration after reaching adulthood: a case report

Fibrous dysplasia generally stops growing when patients reach adulthood. Locally aggressive fibrous dysplasia is an extremely rare subtype of fibrous dysplasia that is characterized by progressive enlargement after bone maturation, cortical bone destruction and soft tissue invasion but without malignant transformation. At 50 years of age, a tumor was found in the rib of a patient. The tumor gradually enlarged over time and imaging findings suggested a malignant tumor. The case was further complicated by restrictive lung disorder. Biopsies from multiple sites showed no malignant findings, and marginal resection with partial curettage was performed. The final diagnosis was locally aggressive fibrous dysplasia, and the restrictive lung disorder improved postoperatively. The natural history of the disease is also unknown. This is the first report in the literature to describe a case in which a lesion exhibited long-term growth over a period of 22 years after reaching adulthood.ArticleJournal of surgical case reports 2020(2) : rjz406(2020)journal articl