Impact of combined assessment of coronary artery calcium score, carotid artery plaque score, and brachial-ankle pulse wave velocity for early coronary revascularization in patients with suspected coronary artery disease

Coronary artery calcium score (CACS) measured by multi-detector computed tomography, carotid plaque score (CPS) measured by carotid artery ultrasound, and brachial-ankle pulse wave velocity (baPWV) are noninvasive screening tools for coronary artery disease. The aim of this study was to determine whether the combination of CACS, CPS, and baPWV improves the prognostic value for future cardiac events. CACS, CPS, and baPWV were assessed in 77 patients (mean age, 65 years, 49 males) undergoing invasive coronary angiography. ECG-triggered MSCT was used to assess CACS. CPS was defined as the sum of all plaque heights in bilateral carotid arteries. The highest baPWV was used for analysis. Cardiac events were defined as cardiac death, nonfatal myocardial infarction, or coronary revascularization. Thirty-two cardiac events (41.6%) occurred during follow-up (23.6 ± 20.8 months), consisting of 28 PCIs and 4 CABGs. The best cutoff values of positive CACS, CPS, and baPWV for predicting cardiac events were ≥ 50, ≥ 5, and ≥1.6 m/second, respectively. For the combination of the 3 modalities, the positive test was defined as having at least 1 positive result by each method. The negative predictive value of all 3 modalities combined was better than that of CACS alone. The event-free rate was higher in patients with negative results for all 3 parameters compared with those that were positive (100% versus 44.8%, P < 0.0001). The prognostic value of using combined assessment of CACS, CPS, and baPWV is more effective for predicting cardiac events than CACS alone.     

Vitamin A deficiency after prolonged intake of an unbalanced diet in a Japanese hemodialysis patient

Background

In industrialized countries, vitamin A deficiency (VAD) is extremely rare, except association with bariatric surgeries and hepatobiliary disorders. It is unusual that VAD develops during hemodialysis due to reduced glomerular filtration of vitamin A-binding protein. We reported the case of a 58-year-old Japanese male hemodialysis patient diagnosed with VAD.

Case presentation

The patient undergoing hemodialysis for more than 15 years presented with progressive photophobia and night blindness and was ophthalmologically examined. He denied a history of cancer or hepatobiliary disease and reported that he loved eating prepackaged noodle bowls and foods, with prolonged low intake of fruits/vegetables. He had good visual acuity. Fundus images showed numerous white dots in the midperipheral retinae, but no degenerative changes. In baseline full-field electroretinography (ERG), b-wave responses were extremely reduced in rod ERG, a-wave amplitudes in standard-flash/strong-flash ERG were reduced to 20–25% of our controls, a- and b-wave amplitudes in cone ERG were reduced to 40–50% of the controls. Whole-exome sequencing identified no pathogenic variant for any inherited retinal disorder. He was diagnosed with VAD because of reduced serum vitamin A levels and treated with retinol palmitate. Two months after treatment commencement, the serum vitamin A level was within the normal range. Full-field ERG showed that the scotopic ERG responses markedly improved compared with baseline.

Conclusions

This is the first report of VAD associated with undernutrition in the Japanese hemodialysis population.

     

Transient electroretinographic abnormalities that mimic those of KCNV2 retinopathy: a case report

Documenta Ophthalmologica - The purpose of this report was to describe the case of a 68-year-old male patient with stage IV colon cancer who exhibited electroretinographic abnormalities that are...     

Detailed magnetic analysis and successful deep-neural-network-based conformational prediction for [VO(dmso)5][BPh4]2

Pentakis(dimethylsulfoxide-κO)oxidovanadium(iv) bis(tetraphenylborate), [VO(dmso)₅][BPh₄]₂ (dmso: dimethylsulfoxide), was synthesized, and its pseudo-C₄ VO₆ coordination geometry was revealed by a single-crystal X-ray method. A novel equation set was obtained for magnetic susceptibility and magnetization of the d¹ complexes, considering the axial distortion and the spin–orbit coupling for the ²D free-ion term. The equation set enabled magnetic simulation for significantly symmetry-lowered d¹ complexes to obtain the anisotropic g-values and also the excitation energies. In addition, conformational prediction was conducted, using the enumeration results on the basis of the group theory. The dominant conformers were predicted on the basis of the density functional theory (DFT) method, and especially, the conformer in the crystal was successfully predicted by a deep neural network method.

The conformer in the crystal was successfully predicted by a deep neural network method.     

Evaluation of the accuracy of femoral component orientation by the CT-based fluoro-matched navigation system

Purpose

Accurate orientation of acetabular and femoral components are important during THA. However, no study has assessed the use of the CT-based fluoro-matched navigation system during THA. Therefore, we have evaluated the accuracy of stem orientation by CT-based fluoro-matched navigation.

Methods

The accuracy of stem orientation by CT-based fluoro-matched navigation was assessed by postoperative CT data. Furthermore, we compared the postoperative stem orientation with the intraoperative registration errors.

Results

The average antetorsion error of the stem (navigation records − postoperative CT) was −0.5° ± 5.2°. The stem valgus error was 0.4° ± 2.7°. The accuracy of the navigation record for the orientation of the stem valgus was dependent on the intraoperative registration errors.

Conclusions

The clinical accuracy of CT-based fluoro-matched navigation is adequate for stem alignment orientation, and the intraoperative verification of registration errors is valuable for checking the accuracy of stem orientation by navigation.     

Spontaneous reduction of a floated ossification of the ligamentum flavum after posterior thoracic decompression (floating method); report of a case (abridged translation of a primary publication)

Background contextAlthough complete resection is the preferred surgical treatment for ossification of the ligamentum flavum (OLF), it sometimes results in the floating method because of adhesion to, or ossification of, the dura mater. It is difficult to anticipate the degree of floating, and if the floated ossification is large, decompression of the spinal cord may not be sufficient.PurposeTo describe a case of spontaneous reduction of a floated OLF after posterior decompression.Study designCase report and review of the literature.MethodsA 70-year-old woman with OLF of the thoracic spine presented with gait disturbance. A computed tomographic myelogram showed a large ossification and severe spinal canal stenosis at T10–T11. It also showed slight spinal cord compression by ossification at T9–T10.ResultsWe performed a laminectomy with floating ossification at T9–T11 and posterior fusion with a pedicle screw system at T10–T11. After the operation, the patient's neurologic improvement was excellent. Five weeks after the operation, a computed tomogram showed reduction of the floated ossification. Improvement progressed up to 3 months after the operation, bringing a sufficient decompression of the spinal cord, whereas it was insufficient immediately after the operation.ConclusionsOur present study is the first report that showed OLF was reduced after the floating method. Reduction of the floated ossification was observed 5 weeks after the operation.     

Self-reports of eating quickly are related to a decreased number of chews until first swallow, total number of chews, and total duration of chewing in young people

ObjectiveThe validity of a self-questionnaire about eating quickly remains unclear. If a significant relationship between subjective and objective methods to evaluate eating quickly can be confirmed, then the subjective method can be widely and reliably used in many fields. This study investigated relationships between subjective and objective methods to evaluate eating quickly and also numerically characterized the kinesis of eating quickly in young people.DesignOne hundred and thirteen students (44 males and 69 females; mean age 22.8 ± 2.0 years) were selected. All subjects completed written questionnaires, and number of chews until first swallow, total duration of chewing, number of chews, chewing rate and bite size were measured using test products (a Japanese cracker and rice ball).ResultsBoth male and female subjects who reported eating quickly showed a significantly lower number of chews until first swallow (Japanese cracker), a lower number of chews overall (rice ball), and a shorter total duration of chewing (rice ball) than other subjects. There was no difference in chewing rate between subjects who ate quickly or not.ConclusionsThese findings suggest that using test products, self-reports of eating quickly are related to a decreased number of chews until first swallow, total number of chews, and total duration of chewing, but not chewing rate, and that a self-reported questionnaire to evaluate eating rate is valid in young people.     

Combined effects of hydrogen sulfide and lipopolysaccharide on osteoclast differentiation in rats

Background: Lipopolysaccharide (LPS) stimulates osteoclast differentiation through toll‐like receptors (TLRs) 2 and 4, and hydrogen sulfide (H₂S) induces osteoclast differentiation. If H₂S activates TLRs, H₂S may enhance the effects of LPS on osteoclast differentiation. The purpose of the present study is to examine the combined effects of sodium hydrogen sulfide (NaHS, an H₂S donor drug) and LPS on osteoclast differentiation and TLR expression in rat periodontal tissue. Methods: Twenty‐eight male Wistar rats (8 weeks old) were divided into four groups (n = 7 per group): a control (no treatment) group and three experimental groups (NaHS group, LPS group, and a combination [NaHS + LPS] group). At 1 day after topical application of NaHS and/or Porphyromonas gingivalis LPS into the gingival sulcus of first molars, the number of tartrate‐resistant acid phosphate (TRAP)‐positive osteoclasts in the periodontal tissue was counted. Expression of TLR2 and TLR4 mRNAs and proteins in the gingival was also assessed. Results: The number of TRAP‐positive osteoclasts was significantly higher in the combination group than in any other group (P <0.01). The combination group had 11.0‐fold higher TLR4 mRNA levels than the control group. TLR4 protein levels were also higher in the combination group than in the NaHS or LPS group. However, the TLR2 mRNA and protein levels were not significantly different in the combination group and the LPS group. Conclusion: In rat periodontal tissue, NaHS and LPS had an additive effect on osteoclast differentiation through activation of the TLR4 pathway but not the TLR2 pathway.     

A case of naturally occurring visual field loss in a chimpanzee with an arachnoid cyst

Deficits in the occipital cortex have varying consequences among mammalian species. Such variations are indicative of evolutionary transitions in the striate cortical contribution to visually guided behavior. However, little is known about the role of the striate cortex in visually guided behavior in chimpanzees due to ethical concerns about invasive experiments and methodological limitations such as the inability to monitor gaze movements. We had the opportunity to study the behavioral consequences of a deficit in the occipital cortex in a chimpanzee with a naturally occurring arachnoid cyst in her right occipital lobe. We assessed the chimpanzee's ability to detect a small light probe (0.5 visual degree, Michelson contrast>0.9) presented at several locations in the visual field while monitoring gaze direction using an infra-red remote eye-tracker recently introduced to studies of great apes. The results showed the chimpanzee was unable to detect the probe in the lower left quadrant of the visual field, suggesting severe loss of contrast sensitivity in a part of hemivisual field that is retinotopically corresponded to the hemisphere of the cyst. A chimpanzee with a naturally occurring deficit in the right striate cortex and the availability of remote eye-tracking technology presented a unique opportunity to compare the role of the occipital lobe in visually guided behavior among various primate species.