Low-dose maintenance steroid treatment could reduce the relapse rate in patients with type 1 autoimmune pancreatitis: a long-term Japanese multicenter analysis of 510 patients

Journal of Gastroenterology - The effect of maintenance steroid treatment (MST) in reducing the risk of relapse in patients with autoimmune pancreatitis (AIP) remains under debate. The aim of this...     

Astrocyte calcium signaling transforms cholinergic modulation to cortical plasticity in vivo

Global brain state dynamics regulate plasticity in local cortical circuits, but the underlying cellular and molecular mechanisms are unclear. Here, we demonstrate that astrocyte Ca(2+) signaling provides a critical bridge between cholinergic activation, associated with attention and vigilance states, and somatosensory plasticity in mouse barrel cortex in vivo. We investigated first whether a combined stimulation of mouse whiskers and the nucleus basalis of Meynert (NBM), the principal source of cholinergic innervation to the cortex, leads to enhanced whisker-evoked local field potential. This plasticity is dependent on muscarinic acetylcholine receptors (mAChR) and N-methyl-d-aspartic acid receptors (NMDARs). During the induction of this synaptic plasticity, we find that astrocytic [Ca(2+)](i) is pronouncedly elevated, which is blocked by mAChR antagonists. The elevation of astrocytic [Ca(2+)](i) is crucial in this type of synaptic plasticity, as the plasticity could not be induced in inositol-1,4,5-trisphosphate receptor type 2 knock-out (IP(3)R2-KO) mice, in which astrocytic [Ca(2+)](i) surges are diminished. Moreover, NBM stimulation led to a significant increase in the extracellular concentration of the NMDAR coagonist d-serine in wild-type mice when compared to IP(3)R2-KO mice. Finally, plasticity in IP(3)R2-KO mice could be rescued by externally supplying d-serine. Our data present coherent lines of in vivo evidence for astrocytic involvement in cortical plasticity. These findings suggest an unexpected role of astrocytes as a gate for cholinergic plasticity in the cortex.     

Delayed formation of a lower second premolar

Delayed odontogenesis of a lower second premolar is presented in a case treated without extraction and focuses on the 7-year follow-up of the delayed tooth bud. The follow-up was initiated when the crown formation was diagnosed and was finished when the tooth erupted completely into the orthodontically provided space, which enabled the orthodontic leveling and alignment of the delayed premolar. The long follow-up indicates that delayed tooth buds may develop completely and normally.     

An analysis of mental disorders of international students visiting the Mental Health Service at Tsukuba University Health Center

With the expected increase in the number of international students coming to Japan as part of the Ministry of Education, Culture, Sports, Science & Technology's "300,000 Foreign Student (Global 30) Plan", the demands on university mental health facilities will also increase. However, the rate of mental disorders of recent international students has not been fully evaluated. As part of an initiative to establish effective treatment measures for the mental health of international students, we investigated the present status and recent trends of these students who visited the Mental Health Service (MHS) in the Tsukuba University Health Center. The demographic characteristics, pathway, stress, and diagnosis of international students who visited the MHS from 2005 to 2010 were investigated retrospectively based on medical records. The subjects were 59 international students (15 male, 44 female; mean age: 28.4). The consultation rate of international students was significantly lower than that of Japanese students each year. Although the rate is almost stable in Japanese students (2.1-2.5%), it has increased significantly in international students, from 0.5% in 2005 to 1.4% in 2010. A larger percentage of the subjects were from Asia (66%), compared to the former Soviet Union (10%) and Europe (7%). A greater proportion of the subjects were graduate students (67%). The diagnoses were as follows: depression (34%), adjustment disorder (32%), insomnia (15%), and schizophrenia (9%). The percentage requiring emergency consultation was 24%, including the most severe cases that had to return to their home country. Sixty-nine percent of the subjects stayed in Japan for more than 1 year. Half of the subjects decided to visit the MHS themselves. The results of the present study show that the consultation rate of international students was lower than that of Japanese students in spite of the "culture shock" experienced by international students. This result is in agreement with previous reports. Among international students, however, there is a trend indicating an increase of visits to the MHS in recent years, approaching the rate for Japanese students. Preparations for emergency consultation are still important.