Comprehensive Tool to Assess Oral Feeding Support for Functional Recovery in Post-acute Rehabilitation

Objective

To determine the influence of the Kuchi-kara Taberu (KT) index on rehabilitation outcomes during hospitalized convalescent rehabilitation.

Balloon tracheoplasty as initial treatment for neonates with symptomatic congenital tracheal stenosis

Neonates with congenital tracheal stenosis (CTS) sometimes develop respiratory distress and may be difficult to intubate. We used balloon tracheoplasty with a rigid bronchoscope for emergency airway management in neonates with symptomatic CTS. Herein, we describe the balloon tracheoplasty procedure and the early outcomes following its use as the initial treatment of neonatal symptomatic CTS. We performed a retrospective analysis of five neonates with CTS who were initially treated with balloon tracheoplasty at our institution from January 2010 to December 2013. Five patients with a mean birthweight of 2,117 g were treated during the study period. Of these, four developed respiratory distress after birth, and all patients had difficult intubations. In all five patients, definitive diagnosis of CTS was made by rigid bronchoscopy and 3-dimensional reconstruction scan. A total of nine balloon dilatations were performed in five patients. Following balloon tracheoplasty, two patients were extubated, one was extubated after resection and end-to-end anastomosis following initial balloon dilatation, and one remained hospitalized with tracheostomy for tracheomalacia. The remaining patient died from tracheal bleeding associated with congenital heart disease. Although our sample size was small, balloon tracheoplasty is a potentially effective initial treatment for selected cases with neonatal symptomatic CTS.     

Altered intracellular region of MUC1 and disrupted correlation of polarity‐related molecules in breast cancer subtypes

MUC1 glycoprotein is overexpressed and its intracellular localization altered during breast carcinoma tumorigenesis. The present study aimed to clarify the relationship of cytoplasmic localization of MUC1 with the breast cancer subtype and the correlation of 10 molecules associated with cell polarity in breast cancer subtypes. We immunostained 131 formalin-fixed and paraffin-embedded breast cancer specimens with an anti-MUC1 antibody (MUC1/CORE). For 48 of the 131 tumor specimens, laser-assisted microdissection and real-time quantitative RT-PCR were performed to analyze mRNA levels of MUC1 and 10 molecules, β-catenin, E-cadherin, claudin 3, claudin 4, claudin 7, RhoA, cdc42, Rac1, Par3 and Par6. Localization of MUC1 protein varied among breast cancer subtypes, that is, both the apical domain and cytoplasm in luminal A-like tumors (P < 0.01) and both the cytoplasm and cell membrane in luminal B-like (growth factor receptor 2 [HER2]+) tumors (P < 0.05), and no expression was found in triple negative tumors (P < 0.001). Estrogen receptor (ER)+ breast cancers showed higher MUC1 mRNA levels than ER− breast cancers (P < 0.01). The incidence of mutual correlations of expression levels between two of the 10 molecules (55 combinations) was 54.5% in normal breast tissue and 38.2% in luminal A-like specimens, 16.4% in luminal B-like (HER2+), 3.6% in HER2 and 18.2% in triple negative specimens. In conclusion, each breast cancer subtype has characteristic cytoplasmic localization patterns of MUC1 and different degrees of disrupted correlation of the expression levels between the 10 examined molecules in comparison with normal breast tissue.     

Clinical significance of serum hydroxyproline-containing peptides with special reference to hyproprotein

Serum hydroxyproline-containing peptides were separated into three fractions, i.e. large protein, polypeptide and smaller peptides, by gel filtration on Sephadex G-200. The large protein was presumed to be the C1q subunit of the first component of complement by an immunological analysis. The polypeptide had an electrophoretic mobility corresponding to beta-globulin and its molecular weight was estimated between 35000 and 45000 by gel filtration analysis. The polypeptide might well be defined as hyproprotein. The molecular weight of smaller peptides was estimated between 1400 and 3000. As compared with the control value, hyproprotein levels were significantly increased in rheumatoid arthritis, systemic lupus erythematosus and chronic liver disease. C1q levels were slightly lowered in rheumatoid arthritis and systemic lupus erythematosus, and were slightly increased in chronic liver disease but were not significant. In all patient groups smaller peptides levels remained in the normal range. These results suggest that serum hyproprotein levels are raised in some fibroproliferative disorders, probably reflecting collagen metabolism.     

Enhancement of antimicrobial activities of cefteram or clavulanic acid/amoxicillin against cefixime-resistant Neisseria gonorrhoeae in the presence of clarithromycin or azithromycin

We investigated the enhancement of the antimicrobial activities of β-lactams against cefixime (CFIX)-resistant Neisseria gonorrhoeae in the presence of macrolides. Ten strains of CFIX-resistant N. gonorrhoeae, isolated between 2000 and 2003 from male patients with urethritis at Jikei University Affiliated Hospital and its related clinics in the Tokyo metropolitan area, were tested. The fractional inhibitory concentrations of clavulanic acid/amoxicillin (CVA/AMPC), CFIX, or cefteram (CFTM), in the presence of clarithromycin (CAM) or azithromycin (AZM), against these strains were determined. Synergism, partial synergism, or additivity was recognized between CVA/AMPC or CFTM and macrolides against nine strains. Additivity and partial synergism between CFTM and macrolides against nine and ten strains, respectively, were also recognized. On the other hand, antagonism between CFIX and macrolides was recognized. These results indicate that combination antimicrobial chemotherapy, using CFTM or CVA/AMPC with macrolides, is a possible alternative treatment for CFIX-resistant N. gonorrhoeae infections.     

A case of ectopic salivary gland of the larynx

A 46-year-old man presented with sore throat. Laryngoscopic findings revealed a smooth yellow mass occupying the anterior portion of the false vocal fold on the left side. The authors performed biopsy under general anesthesia. The histopathological diagnosis was ectopic salivary gland. Because salivary glands are usually not found under the false vocal fold mucosa, ectopic salivary gland of the larynx was diagnosed.It is necessary to consider the possibility of ectopic salivary gland for mass lesions if swelling of the provisional vocal cord is found.     

A Case of In-Stent Neoatherosclerosis 10 Years after Carotid Artery Stent Implantation: Observation with Optical Coherence Tomography and Plaque Histological Findings

We report a patient''s case of slow progressive in-stent restenosis 10 years after bare-metal stent implantation to his carotid artery. We treated the patient with an additional stent placement under a distal filter protection device. Optical coherence tomographic assessment and plaque histology during the carotid artery stenting (CAS) revealed atheromatous change at in-stent neointima, which contained lipid-rich plaque and calcification deposits. These findings suggest that in-stent neoatherosclerosis may play an important role in the pathogenesis of very late stent restenosis after CAS.     

Recovery of menstruation after long-term chemotherapy and endocrine therapy in pre-menopausal patients with breast cancer

Background  

A luteinizing hormone-releasing hormone (LH-RH) agonist and tamoxifen (TAM) are used in hormonal therapy following pre- and post-operative chemotherapy in pre-menopausal advanced breast cancer patients who are positive for hormone receptors. However, it remains to be clarified how often patients recover menstruation after long-term LH-RH agonist plus TAM therapy. In this study, the incidence of menstruation recovery after therapy was examined.     

Inner ear cell therapy for hereditary deafness with multipotent stem cells

Congenital deafness affects about 1 in 1000 children and the half of them have genetic background such as connexin26 gene mutation. The strategy to rescue such hereditary deafness has not been developed yet. Inner ear cell therapy for hereditary deafness has been studied using some laboratory animals and multipotent stem cells, although the successful reports for the hearing recovery accompanied with supplementation of the normal functional cells followed by tissue repair and recovery of the cellular/molecular functions have been still few. To succeed in hearing recovery by inner ear cell therapy, appropriate cell type, surgical approach and the stem cell homing system to the niche are thought to be required.