ORIGINAL ARTICLE: Detection of early amnestic mild cognitive impairment without significantly objective memory impairment: a case‐controlled study

Background: We encountered eight early amnestic mild cognitive impairment (aMCI) patients (early MCI group) who did not fulfill the diagnostic criteria for aMCI. We compared the scores of neuropsychological examinations as well as the cerebral metabolic rate for glucose consumption (CMRglc) decrease on ¹⁸F‐FDG PET examination between the early MCI group and 10 aMCI patients (MCI group) or six normal elderly subjects (normal group), to examine whether the current diagnostic criteria can detect early‐stage aMCI. Methods: The three groups underwent Mini‐Mental State Examination (MMSE), Wechsler Adult Intelligence Scale – Third Edition (WAIS‐III), Wechsler Memory Scale Revised (WMS‐R), magnetic resonance imaging and 18F‐fluorodeoxyglucose positron emission tomography (¹⁸F‐FDG PET) examinations. Results: The early MCI group did not show significant memory impairment of 1.0 SD or other cognitive dysfunctions on neuropsychological examinations, and did not fulfill the diagnostic criteria of aMCI. With one‐way anova and Tukey's HSD post‐hoc test, the early MCI group showed the highest scores for WAIS‐III, whereas the MCI group showed the lowest scores for WMS‐R, although there were no significant differences between the early MCI and normal groups. In order to show a discrepancy in scores between WAIS‐III and WMS‐R, we subtracted the scores of WMS‐R from WAIS‐III. Consequently, the normal group showed significantly smaller differences in scores than the other groups, although there were no significant differences between the early MCI and MCI groups. ¹⁸F‐FDG PET recognized a CMRglc decrease in the posterior cingulate gyrus and/or part of the parietotemporal area in both the MCI and early MCI groups, of which the extent and magnitude were weaker in the early MCI group. The normal group did not show a significant CMRglc. Conclusions: The early MCI group should be included in aMCI not only based on the discrepancy between intelligence and memory scores, but also based on the ¹⁸F‐FDG PET findings. The combination of these examinations would make it possible to diagnose early‐stage aMCI.     

A Small Polyp of Brunner's Gland Hyperplasia Causing Hemorrhage

Abstract: A rare case of a small Brunner's gland hyperplasia (BGH) of the duodenum which represented hemorrhage is presented. An 84-year-old male was admitted because of tarry stool and anemia. Endoscopic examination revealed a small, subpedunculated duodenal polyp with blood and clots on its surface, which was considered responsible for the tarry stool. The lesion was polypectomized without any complications. Since complications of BGH including bleeding and obstruction, are more likely to occur as the size of the lesion increases, small BGH lesions tend to be regarded as benign and are left alone in clinical settings. The present case showed the possibility that such a seemingly harmless small polyp may eventually lead to massive hemorrhage. (Dig Endosc 1999; 11: 52–54)     

Fyn and Lck tyrosine kinases regulate tyrosine phosphorylation of p105CasL, a member of the p130Cas docking protein family, in T-cell receptor-mediated signalling

We have previously shown that engagement of the T-cell receptor (TCR)/CD3 complex with anti-CD3 antibody induces tyrosine phosphorylation of p105CasL (CasL), a member of the p130Cas docking protein family. In the present work, we attempted to determine which protein tyrosine kinases (PTKs) regulate TCR-mediated phosphorylation of CasL. We show here that an association between CasL and two types of Src family PTKs, Fyn and Lck, is induced by anti-CD3 cross-linking of human H9 T cells. In contrast, ZAP-70, another PTK that also plays a critical role in the TCR signalling, failed to bind CasL, even after anti-CD3 stimulation. In vitro kinase assays revealed that Fyn and Lck, but not ZAP-70, were capable of phosphorylating CasL. Moreover, we found that CasL was constitutively hyperphosphorylated in vivo in splenocytes of MRL-MP-lpr/lpr mice, in which overproduction and excessive activation of Fyn and Lck have previously been shown to occur. Constitutive in vivo binding of CasL to both kinases was also demonstrated in lpr splenocytes. These results strongly suggest that CasL is a substrate for Fyn and Lck PTKs in TCR signal transduction.     

Growth and/or acid production of Candida albicans on soft lining materials in vitro

Effects of soft lining materials on the growth and/or acid production of Candida albicans were investigated using a simplified method monitoring the pH change in the growth medium. Reverse sigmoidal pH curves were observed with all samples and, as compared with acrylic, all soft lining materials inhibited fungal growth or acid production in the following way, i.e. delay of the beginning of a rapid and linear decline in pH, decreases in the rate of linear change in pH and increases in minimum pH.
Further examinations using a surface-modified glass tube revealed that the order of Candida growth agreed with the relative hydrophobicity and adherence capacity of substrates, suggesting that this adherence capacity affected the yeast growth on their surfaces.
Besides adherence capacities of substrates, the powder, liquid and plasticizer of some soft lining materials directly inhibited Candida growth. Thus, the results obtained here revealed that several factors within soft lining materials affected Candida growth and/or acid production.     

Gel Chromatographic Analysis of Cyclosporin and Its Metabolites in Human Blood Compartments

Gel chromatography combined with specific and non-specific cyclosporin radioimmunoassays was adopted for quantitative analysis of cyclosporin and metabolites in free and protein-bound forms in blood compartments of kidney transplant patients. The analytical method was proved to be useful for the purpose, although plasma protein-bound forms of neither cyclosporin nor metabolites could be quantitated in the system. The present study also provided, by gel chromatographic analysis, additional examples to prove that concentrations of cyclosporin metabolites in blood compartments may not be deduced or inferred simply from those of cyclosporin.     

Urodynamic effects and safety of modified intravesical oxybutynin chloride in patients with neurogenic detrusor overactivity: 3 years experience

BACKGROUND: Intravesical oxybutynin chloride with hydroxypropylcellulose (HPC) (modified intravesical oxybutynin) has been reported to be effective for treatment of overactive bladder. We reported the short-term effects of modified intravesical oxybutynin previously. In the present article, we detail the results of a 3-year follow-up study of patients from our previous analysis and report the efficacy and side-effects of modified intravesical oxybutynin. METHODS: Modified intravesical oxybutynin (5 mg/10 mL, twice a day) was applied for more than 3 years to six neurogenic overactive detrusor patients (three men and three women, average age 53.3 years) who were not satisfied with oral anticholinergic agents or the other therapy. A cystometogram (CMG) was performed before, 1 week after and 3 years after the start of modified intravesical oxybutynin treatment. We evaluated the patient's satisfaction of this treatment after 4 weeks and again after 3 years. We compared the patients' answers before and after the therapy (excellent, good, fair, unchanged and worse). We also monitored systemic and topical side-effects in these patients during this period. RESULTS: CMG studies showed that two of six patients no longer exhibited uninhibited contraction 1 week after the treatment and that the cystocapacity of patients before, 1 week after and 3 years after the initial modified intravesical oxybutynin was 129.7 +/- 19.4, 283.5 +/- 40.4 and 286.8 +/- 38.1 mL, respectively. For the evaluation of patients' satisfaction with this treatment, four patients considered the therapy excellent and one patient described it as good after both 4 weeks and after 3 years. Two patients dropped out of the study; one developed left ureteral cancer (2.25 years) and the other developed ileus (1.5 years). Dry mouth and acute cystitis were observed in both patients. CONCLUSION: Modified intravesical oxybutynin is an effective and relatively safe option of therapy for overactive bladder patients. However, this therapy requires careful observation for emergent side-effects.     

Mid-term report on the project "Disaster nursing in a ubiquitous society" in the academic years 2003 and 2004

Aim: This is the mid‐term report of the project titled “Disaster nursing in a ubiquitous society”, funded by the Japanese Government. The purpose of this project is to develop the self‐care abilities of communities and individuals to independently regenerate and recover from the consequences of disasters. Methods: The methods utilized in this project were questionnaires sent by post or placed on websites, and interviews. The participants in our research were people with special needs in the case of a disaster, nursing professionals, ordinary people, and other professionals. Results: During 2003 and 2004, there were activities that progressed according to the original plans, activities that progressed at a faster rate than foreseen in the original plans, and newly expanded research activities that were conducted. New academic knowledge gained from the project activities includes five factors for disaster preparedness, six common issues related to health, care, training, and others, six categories of necessary factors in nursing activities, the clarification of the support needs of care‐providers, and the clarification of specific groups with unique needs including children, pregnant and postpartum women, elderly people, people with chronic conditions, cancer patients, and care‐providers. Conclusions: The growing recognition of our center as a global base of disaster nursing is indicated by the fact that we receive numerous requests from Japan and abroad, that our suggestions influence some governmental policies, and that we take initiatives in promoting the concept of disaster nursing throughout the world. It is necessary to disseminate the results of this project, to develop further knowledge, to clarify future challenges related to disasters, and to contribute to the preparedness of people and communities.     

Effects of salivary or serum pellicles on the Candida albicans growth and biofilm formation on soft lining materials in vitro

summary The effects of salivary or serum pellicle on Candida albicans growth, biofilm formation and cavitation on the soft lining materials were examined. Both saliva and serum pellicles reduced the antifungal effects of soft liners. The fungal biofilm formation on these materials varied depending upon both the materials tested and protein-coats, and the pellicles which significantly enhanced the biofilm formation. Similarly, the pellicles enhanced the firm colonization and hyphal invasion of the yeasts on the specimens, although the cavitation appeared to be regulated by the plasticizer used. These results suggest that the interactions between proteinaceous pellicle, tissue conditioners and fungi are complex. They also suggest that denture pellicles facilitate fungal plaque formation onto soft lining materials through several mechanisms such as reduction of the antifungal effects of soft liners, facilitation of biofilm formation, firm colonization and hyphal invasion. In addition, the composition of the materials is also involved in the susceptibility to the fungi.