Correction to: Swallowing evaluation by the Kuchikara Taberu Balance Chart and videoendscopic examination reveals that respiratory conditions,chewing, and position are strongly related to dysphagia

This study focused on the Kuchikara Taberu Balance Chart (KTBC) as a tool for swallowing function evaluation. To clarify the relationship between videoendoscopic (VE) examination of swallowing function and the KTBC, we compared median KTBC scores with and without laryngeal penetration identified by VE. Sixty-five patients with a mean age of 84.3 ± 7.9 years were examined at the Towada City Hospital. The patients were classified into groups based on laryngeal penetration, including 28 patients with and 37 patients without penetration. We found no significant differences in patient backgrounds. The median KTBC score (interquartile range) was 36.5 (31–44.5) in the group with laryngeal penetration and 42 (35–48.5) in the group without penetration, but the scores were not significantly different (level of statistical significance at α = 0.0036 determined by the Bonferroni correction method) when compared with the Mann–Whitney U test (36.5 vs. 42, z = -2.33, p = 0.020). The median respiratory condition (3 vs. 4, z = − 3.23; p < 0.0036), oral preparatory and propulsive phases (3 vs. 4, z = − 2.96; p < 0.0036), and position and endurance (1 vs. 3, z = − 3.25; p < 0.0036) scores were significantly lower in the group with laryngeal penetration. This study revealed a correlation between laryngeal penetration confirmed by VE and KTBC scores. Consequently, respiratory condition, oral preparatory and propulsive phases, and position and endurance may be useful as tools for the assessment of swallowing. In particular, we recommend adding respiratory status to dysphagia screening.

     

Dietary nucleic acids promote a shift in Th1/Th2 balance toward Th1-dominant immunity

BACKGROUND: Dietary sources of nucleic acids and their relative components are known to affect host immune function; however, it has not yet been clarified whether such dietary nucleic acids influence the pathogenesis of allergic reaction. OBJECTIVE: The purpose of this study is to elucidate the effect of dietary nucleic acids on Th1/Th2 balance. METHODS: Both human flora-associated and specific pathogen-free BALB/c mice were maintained on either nucleic acid-free, or -supplemented diets. The effects of nucleic acids on both in vivo antibody levels and in vitro splenocyte cytokine production were compared using these mice. RESULTS: Supplementation of nucleic acids caused a reduction in the serum antibody levels of total IgM, IgG, IgG1, and IgE in the human flora-associated mice without affecting the composition of intestinal flora. In contrast, there was no significant difference of the serum IgG2a levels between nucleic acid-free and -supplemented mice. Such a phenomenon as that, the supplementation of dietary nucleic acids reduces the serum IgE or IgG1 levels, but not the IgG2a level, was also seen in the specific pathogen free mice. Moreover, when the mice were systematically challenged with ovalbumin, the supplementation of nucleic acids also suppressed the serum ovalbumin-specific IgE and IgG1 antibody levels as well as in vitro IL-4 and IL-10 secretion, while enhancing both the serum ovalbumin-specific IgG2a antibody levels and in vitro IFN gamma secretion. CONCLUSION: These results suggested that dietary nucleic acids may play an important role in promoting a shift in Th1/Th2 balance toward Th1-dominant immunity.     

Effects of exercise and standing on atrial parasystole: Prolongation and shortening of the parasystolic cycle length

In recently reported cases of ventricular parasystole, it was shown that after exercise the parasystolic cycle length is prolonged, in contrast to a shortening of the sinus cycle length, whereas during standing the parasystolic cycle length and the sinus cycle length both shortened. In this report, to explore whether the same features as occur in ventricular parasystole are seen in atrial parasystole, effects of exercise and standing on the parasystolic cycle length were investigated in two men with atrial parasystole. The atrial parasystolic cycle length was prolonged after exercise, whereas it shortened during standing, similar to what occurs in ventricular parasystole. This is the first report to show such changes of cycle length in atrial parasystole. These findings suggest that in atrial parasystole, as in ventricular parasystole, influences on the parasystolic cycle length do not always act in the same direction as those on sinus cycle length.     

Physicochemical and biomechanical examination of surfaces of retrieved polyethylene heads from total hip prostheses with rotating polyethylene head system

In order to assess whether hydrodynamic lubrication occurs in total hip prostheses with a rotating polyethylene (PE) head system (R-THP), several physicochemical, morphological, and biomechanical tests were carried out. R-THPs have been used in more than 1000 patients since 1970, and 12 PE heads, retrieved from 10 patients after an average of 24 · 5 years since total hip arthroplasty (THA), were employed for the tests. The weight-bearing area of the PE surface was light yellow in color and considerably oxidized, but no wear scars were observed. In the non-weight-bearing area, in contrast, discoloration and oxidation were hard to detect. The weight-bearing surface of the PE head became smoother with time after THA, and the friction coefficient did not differ significantly from that of an unused PE head. The radial clearance between head and socket decreased at a temperature of 17°C, which is equivalent to the difference between room temperature and the temperature of the human body. Scanning electron microscopy showed a fine undulating pattern, which suggested that hydrodynamic lubrication could occur in the rotating PE head system. Received: October 19, 2000 / Accepted: June 5, 2001     

Clinical features and characteristics of blood flow of uterine vascular abnormalities

Purpose  The purpose of this study was to assess the clinical features and characteristics of the blood flow in uterine vascular abnormalities using ultrasound and magnetic resonance imaging (MRI). Methods  A total of 17 women were diagnosed with uterine vascular abnormalities by ultrasound. The clinical characteristics of the patients and the distribution and waveform of the intrauterine vessels were examined using transvaginal gray-scale and Doppler ultrasonography, spin-echo MRI, and MR angiography. Results  The average age of the 17 subjects was 44.3 years, and 5 were postmenopausal women. The number of pregnancies and deliveries was 2.0 and 1.7, respectively. Of the 17 subjects, 7 had a moderate or severe grade of dysmenorrhea and 7 had a history of vascular disease. In all subjects, vaginal ultrasound demonstrated tubular or numerous tortuous anechoic areas in the uterine wall, and Doppler ultrasound showed that the tubular or numerous dilated tortuous vessels had an atypical wave flow, unlike that of an artery or a vein. The distribution of displayed flow varied, and the waveforms of the Doppler ultrasound displayed three patterns. The averages of the pulse Doppler flow indices showed low impedance in the abnormal uterine vessel and the uterine artery, especially in cases of true arteriovenous malformations. MR angiography demonstrated distinct, tortuous, and coiled vascular channels in the pelvis during and just after the arterial phase. Conclusion  Characterization of the clinical features of uterine vascular abnormalities is considered to be valuable for obstetricians and gynecologists.     

Measuring the effect of patient comfort rounds on practice environment and patient satisfaction: A pilot study

Hourly rounding in the acute hospital setting has been proposed as an intervention to increase patient satisfaction and safety, and improve the nursing practice environment, but the innovation has not been adequately tested. A quasi-experimental pretest post-test non-randomized parallel group trial design was used to test the effect of hourly patient comfort rounds on patient satisfaction and nursing perceptions of the practice environment, and to evaluate research processes and instruments for a proposed larger study. A Patient Satisfaction Survey instrument was developed and used in conjunction with the Practice Environment Scale of the Nursing Work Index. Results on patient satisfaction showed no significant changes. Significant changes were found for three of the five practice environment subscales. Consistent with the aim of a pilot study, this research has provided important information related to design, instruments and process that will inform a larger sufficiently powered study.     

Centroblastic and centroblastic/centrocytic lymphoma associated with a prominent epithelioid granulomatous response: a clinicopathologic study of 50 cases.

A minority of centroblastic and centroblastic/centrocytic cell lymphomas are accompanied by a prominent epithelioid cell response and were suggested to be a distinct variant of B-cell lymphoma of germinal center cell origin. To confirm the clinicopathologic significance of these mainly large B-cell lymphomas with an epithelioid cell response (LBCL-ER), we reviewed 50 patients with LBCL-ER and compared the results with those of 167 other diffuse large B-cell lymphomas (DLBCL) and 94 follicular lymphomas (FL) without epithelioid response. The patients with LBCL-ER showed a higher age distribution (median 71, P =.03), a female predominance (M:F = 18:32, P =.001) and less frequent involvement of extranodal sites >1 (P =.004) compared with those with DLBCL, and presented with a bulky mass of the affected lymph nodes in 54% of cases. They were also older (P =.0006) and more associated with the aggressive clinical factors such as serum LDH level and International Prognostic Index score than those with FL. Histologically, nine cases (18%) partially showed a follicular growth pattern, and the others (82%) were occupied by a diffuse growth pattern. The epithelioid cells were accumulated in large demarcated masses, partially imparting a lymphoepithelioid (Lennert) lymphoma-like appearance to some portions of the lesions in every case. Immunohistochemically, LBCR-ER was positive for CD20 in every case, CD10 in 43% of the cases, and BCL-2 in 56%. None of the tumor cells in the 40 cases tested expressed CD5 antigen. Immunostaining also often highlighted the remnants of the follicular dendritic cell network. The BCL-2 gene rearrangement was detected in only 19% of the cases examined. The survival curve of the cases of LBCL-ER was almost identical with that of DLBCL and was significantly inferior to that of FL. The centroblastic and centroblastic/centrocytic lymphoma with an epithelioid cell response may be regarded as the morphologic variant of DLBCL preferentially arising in the aged population and reflecting the disease progression of FL.     

Giant meningioma fed by the anterior choroidal artery: successful removal following embolization--case report.

A 53-year-old female was admitted with apathy, left sensory and motor disturbance, left homonymous hemianopsia, and dressing apraxia. Computed tomography and magnetic resonance imaging showed a huge mass markedly enhanced in and around the right trigone. Cerebral angiography revealed rich vascularity of the tumor mainly fed by the right anterior choroidal artery. The feeding vessel was embolized with microfibrillar collagen after superselective catheterization. Seven days later, the tumor was totally removed with low blood loss. The histological diagnosis was fibroblastic meningioma. She was discharged without neurological deficit, except for left homonymous hemianopsia.