Endoscopic thoracic sympathicotomy for Raynaud's phenomenon

AbstractPurpose: For many years, thoracic sympathectomy via open surgery was not used to treat Raynaud's phenomenon because of the invasiveness of this procedure and the poor long-term outcomes associated with it. However, with the introduction of endoscopic surgery, thoracic sympathectomy (or sympathicotomy) has been performed by some surgeons as a less invasive surgical option for patients with Raynaud's phenomenon. The less invasive procedure has the possibility of emphasizing merits of sympathectomy. The purpose of this study was to reevaluate the efficacy of sympathicotomy for Raynaud's phenomenon with endoscopic technique and its range of applicability. Methods: Between December 1992 and August 2001, endoscopic thoracic sympathicotomy (ETS) was performed in 28 patients with Raynaud's phenomenon (of a total of 502 patients with autonomic disorders who underwent ETS) at National Kanazawa Hospital. We considered indications for surgical treatment of Raynaud's phenomenon to include severe chronic symptoms or nonhealing digital ulceration refractory to intensive medical therapy. All patients were mailed a self-assessment questionnaire after surgery to determine the immediate and long-term results of the procedure. Data from both initial and long-term follow-up examinations were obtained. Results: Fifty-four ETS procedures were performed in 28 patients. No operative mortality was seen, and no occurrence of major complications necessitated open surgery. Initial resolution or improvement of symptoms was achieved in 26 of 28 patients (92.9%). However, later in the postoperative period, symptoms recurred in 23 of 28 patients (82.1%), although no recurrence of digital ulceration was seen throughout our observation. At the final follow-up examination (median follow-up period, 62.5 months), 25 patients (89.3%) reported overall improvement of the frequency and severity of their symptoms. Conclusion: Despite the high rate of recurrence, ETS clearly produced a high rate of initial relief. ETS did indeed promote healing of digital ulcers, and the procedure shows potential for reducing the severity of refractory symptoms. We consider ETS to be the method of choice for treatment of severe or refractory Raynaud's phenomenon, and especially for Raynaud's involving digital ulcer, because of its safety and efficacy. (J Vasc Surg 2002;36:57-61.

Dose-response relationship between sports activity and musculoskeletal pain in adolescents.

Physical activity has multiple health benefits but may also increase the risk of developing musculoskeletal pain (MSP). However, the relationship between physical activity and MSP has not been well characterized. This study examined the dose-response relationship between sports activity and MSP among adolescents. Two school-based serial surveys were conducted 1 year apart in adolescents aged 12 to 18 years in Unnan, Japan. Self-administered questionnaires were completed by 2403 students. Associations between time spent in organized sports activity and MSP were analyzed cross-sectionally (n = 2403) and longitudinally (n = 374, students free of pain and in seventh or 10th grade at baseline) with repeated-measures Poisson regression and restricted cubic splines, with adjustment for potential confounders. The prevalence of overall pain, defined as having pain recently at least several times a week in at least one part of the body, was 27.4%. In the cross-sectional analysis, sports activity was significantly associated with pain prevalence. Each additional 1 h/wk of sports activity was associated with a 3% higher probability of having pain (prevalence ratio = 1.03, 95% confidence interval = 1.02-1.04). Similar trends were found across causes (traumatic and nontraumatic pain) and anatomic locations (upper limbs, lower back, and lower limbs). In longitudinal analysis, the risk ratio for developing pain at 1-year follow-up per 1 h/wk increase in baseline sports activity was 1.03 (95% confidence interval = 1.02-1.05). Spline models indicated a linear association (P < 0.001) but not a nonlinear association (P ≥ 0.45). The more the adolescents played sports, the more likely they were to have and develop pain.This study was supported by a Grant-in-Aid from the Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japan. MK is supported by a JSPS Postdoctoral Fellowship for Research Abroad. FI is supported by the Medical Research Council Epidemiology Unit (MC_UU_12015/1; MC_UU_12015/5).This is the final version of the article. It first appeared from Wolters Kluwer via http://dx.doi.org/10.1097/j.pain.000000000000052

A New Serum Biomarker Set to Detect Mild Cognitive Impairment and Alzheimer’s Disease by Peptidome Technology

Background: Because dementia is an emerging problem in the world, biochemical markers of cerebrospinal fluid (CSF) and radio-isotopic analyses are helpful for diagnosing Alzheimer’s disease (AD). Although blood sample is more feasible and plausible than CSF or radiological biomarkers for screening potential AD, measurements of serum amyloid- β (Aβ), plasma tau, and serum antibodies for Aβ1 - 42 are not yet well established. Objective: We aimed to identify a new serum biomarker to detect mild cognitive impairment (MCI) and AD in comparison to cognitively healthy control by a new peptidome technology. Methods: With only 1.5μl of serum, we examined a new target plate “BLOTCHIP®” plus a matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF/MS) to discriminate control (n = 100), MCI (n = 60), and AD (n = 99). In some subjects, cognitive Mini-Mental State Examination (MMSE) were compared to positron emission tomography (PET) with Pittsburgh compound B (PiB) and the serum probability of dementia (SPD). The mother proteins of candidate serum peptides were examined in autopsied AD brains. Results: Apart from Aβ or tau, the present study discovered a new diagnostic 4-peptides-set biomarker for discriminating control, MCI, and AD with 87% of sensitivity and 65% of specificity between control and AD (***p  Conclusion: The present serum biomarker set provides a new, rapid, non-invasive, highly quantitative and low-cost clinical application for dementia screening, and also suggests an alternative pathomechanism of AD for neuroinflammation and neurovascular unit damage

Immunoassay using ion selective electrode and protein pendant liposomes

Immunoassay for an anti-human IgG antibody and a human IgG is presented. Thin-layer potentiometry, i.e., a combination of fluoride ion selective electrode and silver chloride coated silver-plate reference electrode was used to monitor fluoride release from the multilamellar liposome. Human IgG was attached to the surface of liposome membrane by the use of cross-linking reagent N-hydroxysuccinimidyl3-(2-pyridyldithio)propionate (SPDP). The antigen/antibody/complement reaction triggered the formation of "channel-like" holes across the liposome membrane which enabled entrapped fluoride anion flow through the hole. The fluoride ion release was specific for anti-human lgG and depended on the presence of complement. By the use of human IgG pendant liposomes, determination of about 10^-14 mol of anti-human IgG (rabbit) and 10^-14 mol human IgG was feasible

Capacitive level meter for liquid hydrogen

金沢大学理工研究域数物科学系A capacitive level meter working at low temperatures was made to use in magnetic refrigerator for hydrogen liquefaction. The liquid level was measured from the capacitance between parallel electrodes immersed in the liquid. The meter was tested for liquid nitrogen, hydrogen, and helium. The operation was successful using an AC capacitance bridge. The estimated sensitivity of the meter is better than 0.2 mm for liquid hydrogen. The meter also worked with pressurized hydrogen. © 2010

Improved bioavailability of hesperetin 7-O-glucoside inclusion complex with β-cyclodextrin in Sprague-Dawley rats and healthy humans

The flavonoid hesperidin and its aglycone are widely recognized for their functionality, wherein bioavailability is the key to ensuring their bio-efficacy for diverse health benefits. The aim of the present study was to evaluate the pharmacokinetics of a inclusion complex of hesperetin-7-O-glucoside with β-cyclodextrin (HEPT7G/βCD) in Sprague-Dawley (SD) rats, and in a randomized, double-blind, placebo-controlled, and crossover study in healthy human subjects. A significantly higher bioavailability (P < 0.01) of hesperetin metabolites derived from the HEPT7G/βCD inclusion complex compared with hesperetin-lecithin (Peretin-D) and α-monoglucosyl hesperidin formulations was observed in SD rats administered with identical doses by oral gavage feeding. Furthermore, in healthy human subjects, an acute single dose of the HEPT7G/βCD inclusion complex significantly enhanced the plasma hesperetin metabolites concentration (P < 0.001) and displayed an improved pharmacokinetic profile (P < 0.001) compared to an identical dose of hesperetin from hesperidin in maltodextrin (placebo: HES-Dex). The Tmax was nearly 10-fold faster (P = 0.016) after subjects consumed the HEPT7G/βCD inclusion complex compared with HES-Dex, and the MRT was significantly lowered (P = 0.011), respectively. Results also indicated the absence of any sequence (order effect) and period effect. No adverse effects were reported, and no clinically significant changes were noticed in blood biochemical markers. The oral intake of the HEPT7G/βCD inclusion complex in human subjects was well tolerated and safe. In summary, the bioavailability of hesperetin metabolites was regulated with HEPT7G/βCD inclusion complex consumption due to shifting the absorption site from the colonocyte to the enterocyte, and probably due to higher -2R enantiomer content. Such modulation of metabolites may be beneficial for regulating the biological functions of the dietary HEPT7G/βCD inclusion complex when used in foods, functional beverages, dietary supplements, and nutraceuticals

Structural Investigation of Hesperetin-7-O-Glucoside Inclusion Complex with &beta;-Cyclodextrin: A Spectroscopic Assessment

Flavonoids are biologically active natural products of great interest for their potential applications in functional foods and pharmaceuticals. A hesperetin-7-O-glucoside inclusion complex with &beta;-cyclodextrin (HEPT7G/&beta;CD; SunActive&reg; HCD) was formulated via the controlled enzymatic hydrolysis of hesperidin with naringinase enzyme. The conversion rate was nearly 98%, estimated using high-performance liquid chromatography analysis. The objective of this study was to investigate the stability, solubility, and spectroscopic features of the HEPT7G/&beta;CD inclusion complex using Fourier-transform infrared (FTIR), Raman, ultraviolet&ndash;visible absorption (UV&ndash;vis), 1H- and 13C- nuclear magnetic resonance (NMR), differential scanning calorimetry (DSC), liquid chromatography/mass spectroscopy (LC&ndash;MS), scanning electron microscopy (SEM), and powdered X-ray diffraction (PXRD) spectroscopic techniques including zeta potential, Job&rsquo;s plot, and phase solubility measurements. The effects of complexation on the profiles of supramolecular interactions in analytic features, especially the chemical shifts of &beta;-CD protons in the presence of the HEPT7G moiety, were evaluated. The stoichiometric ratio, stability, and solubility constants (binding affinity) describe the extent of complexation of a soluble complex in 1:1 stoichiometry that exhibits a greater affinity and fits better into the &beta;-CD inner cavity. The NMR spectroscopy results identified two different configurations of the HEPT7G moiety and revealed that the HEPT7G/&beta;CD inclusion complex has both &ndash;2S and &ndash;2R stereoisomers of hesperetin-7-O-glucoside possibly in the &ndash;2S/&ndash;2R epimeric ratio of 1/1.43 (i.e., &ndash;2S: 41.1% and &ndash;2R: 58.9%). The study indicated that encapsulation of the HEPT7G moiety in &beta;-CD is complete inclusion, wherein both ends of HEPT7G are included in the &beta;-CD inner hydrophobic cavity. The results showed that the water solubility and thermal stability of HEPT7G were apparently increased in the inclusion complex with &beta;-CD. This could potentially lead to increased bioavailability of HEPT7G and enhanced health benefits of this flavonoid