Amplitude of the s-Wave of Multifocal Electroretinograms Can Indicate Local Retinal Sensitivity in Glaucomatous Eyes

Purpose To determine whether the amplitude of the s-wave on a multifocal electroretinogram (mfERG) is correlated with the degree of visual field depression in eyes with glaucoma.Methods Twenty patients (20 eyes) with glaucoma,ages 46 to 69 years, were studied. Twenty healthy volunteers (20 eyes) with normal intraocular pressure and with no eye diseases served as controls. The retinal sensitivities of the upper and lower visual fields of the glaucomatous eyes were determined with a Humphrey Field Analyzer. The severity of retinal sensitivity depression was rated as mild (Group A), intermediate (Group B), or severe (Group C). To record the s-wave, mfERGs were elicited by pseudorandom stimulation, with the stimulus alternating according to a binary m-sequence for base periods (bpds) of 13.3, 26.7, 53.3, 106.7, and 213.3ms. The mfERGwaves recorded from the upper and lower visual field were summed separately.Results In the control group, the s-wave in the summed mfERG was observed in all visual field halves at all bpds 53.3ms or longer. The s-wave amplitude at a bpd of 213.3ms was significantly larger than that at a bpd of 53.3ms (P < 0.05). The s-wave was also present in the glaucoma patients eyes, and the s-wave amplitude increased as the bpd increased. At bpds of 53.3, 106.7, and 213.3-ms, the mean s-wave amplitudes in Groups B and C were significantly smaller than those in the control group (P < 0.05, 0.01, and 0.05, respectively). At bpds of 53.3 and 106.7ms, the mean amplitude of the s-waves in Group C was significantly smaller than that in Group A (P < 0.05). At a bpd of 106.7ms, a significant correlation was observed between the retinal sensitivity and the s-wave amplitude (P < 0.05).Conclusions The significant correlation between the retinal sensitivity and the amplitude of the swave at a bpd of 106.7ms supports the suggestion that the s-wave originates from the retinal ganglion cells and their axons. The amplitude of the s-wave may serve as an objective indicator of the severity of retinal ganglion cell damage. Jpn J Ophthalmol 2004;48:215–221 © Japanese Ophthalmological Society 2004     

Delayed Vasovagal Reaction with Reflex Syncope Following COVID-19 Vaccination

Coronavirus disease 2019 (COVID-19) has become a pandemic, and vaccines remain the only effective tools available for ending it. However, their side effects, such as syncope, which mimics sudden cardiac death, are serious concerns. We herein report 6 cases of delayed vasovagal syncope and presyncope (VVR) caused by COVID-19 vaccination among 25,530 COVID-19 patients. The prevalence of delayed VVR due to COVID-19 vaccination was 0.026%. In addition, no delayed VVR was found among 17,386 patients who received the influenza vaccine. Delayed VVR is likely to be overlooked if medical staff are not aware of this symptom. This report provides significant information regarding effects of COVID-19 vaccination.     

A dose-finding study of glycosylated G-CSF (Lenograstim) combined with CHOP therapy for stem cell mobilization in patients with non-Hodgkin's lymphoma

BACKGROUND: Peripheral blood stem cell (PBSC) reinfusion has been widely used for hematopoietic reconstitution after high-dose chemotherapy. However, the optimal dose of granulocyte colony-stimulating factor (G-CSF) for PBSC mobilization in combination with chemotherapy for autograft remains unknown. METHODS: To find the optimal dose of glycosylated G-CSF (lenograstim) for PBSC mobilization in combination with chemotherapy for aggressive non-Hodgkin's lymphoma (NHL), we conducted a dose-finding study on 43 newly diagnosed patients who had unfavorable prognostic factors. They received four to six courses of cyclophosphamide, doxorubicin, vincristine and prednisolone combined with lenograstim every 2 weeks (biweekly CHOP therapy). PBSC apheresis was started after the third course of biweekly CHOP therapy. Lenograstim was given daily from day 3 until the day of the last apheresis. The optimum dose of lenograstim was assessed based on mobilization efficacy and safety profiles at a daily single dose of 2, 5 and 10 microg/kg for eight patients in each level. RESULTS: The collected number of CD34+ cells in the first apheresis products was higher in the 5 microg/kg group than in the 2 microg/kg group (median, 4.22 x 10(6) vs 2.49 x 10(6) CD34+ cells/kg, P = 0.051). The highest dose of 10 microg/kg (median, 2.99 x 10(6) CD34+ cells/kg) failed to show a dose dependence in PBSC mobilization. The efficacy and safety of the 5 microg/kg dose were further confirmed in an additional 19 patients. CONCLUSIONS: The present study suggests that the recommended dose of lenograstim for PBSC mobilization with CHOP therapy in untreated NHL is 5 microg/kg.     

Atrial Fibrillation-triggered Ventricular Fibrillation in a Patient with Early Repolarization Syndrome

A 54-year-old man with early repolarization syndrome (ERS) implanted with an implantable cardioverter-defibrillator (ICD) developed persistent atrial fibrillation (AF) three years after the implantation. Similarly, the remote monitoring system begun frequently detecting ventricular fibrillation (VF) and polymorphic ventricular tachycardia (PVT). Longer RR intervals were repeatedly observed just before the initiation of PVT/VF. Catheter ablation for AF successfully diminished both the PVT and VF events.     

Interaction between cytochrome P450 gene polymorphisms and serum organochlorine TEQ levels in the risk of endometriosis

Exposure to dioxins and polychlorinated biphenyls (PCBs) has been suggested as a possible etiologic factor for endometriosis, but the association remains highly controversial. To assess whether cytochrome P450 (CYP) gene polymorphisms modulate the effect of dioxins and/or PCBs in endometriosis risk, we conducted a case-control study among infertile Japanese women. A total of 138 eligible women aged 20-45 were diagnosed laparoscopically and classified into three subgroups: control (no endometriosis), early endometriosis (stages I-II) and advanced endometriosis (stages III-IV). Neither CYP1A1 Ile462Val and CYP1B1 Leu432Val polymorphisms (genotypes with versus genotypes without the minor allele) nor serum dioxin and PCB toxic equivalency (TEQ) levels (low versus high) were independently associated with either early or advanced endometriosis risk. However, genotypes with the CYP1A1 462Val allele showed a statistically significant reduced risk of advanced endometriosis in combination with high serum dioxin TEQ levels (adjusted odds ratio = 0.13, 95% confidence interval: 0.02-0.76) (P for interaction = 0.08). Although no association was found between serum PCB TEQ level and advanced endometriosis in any stratum of CYP1B1 Leu432Val polymorphism, a statistically significant interaction was found (P for interaction = 0.05). CYP1A1 and CYP1B1 polymorphisms may modify the relation between environmental exposure to organochlorine and advanced endometriosis risk.     

Structural dependence of apatite formation on titania gels in a simulated body fluid

The apatite-forming ability of titania gels with different structures has been investigated in a simulated body fluid with ion concentrations nearly equal to those of human blood plasma. Titania gels with an amorphous structure or with an anatase or rutile structure were prepared by the sol-gel process with a subsequent heat treatment at various temperatures. The titania gels with an amorphous structure did not induce apatite formation on their surfaces in the simulated body fluid, whereas gels with an anatase or rutile structure induced apatite formation on their surfaces. The deposition of apatite was more pronounced on the anatase gels than on the rutile gels. This indicates that a specific structure of titania is effective in inducing apatite formation in a body environment. Such a specific structure was assumed in this study to be the crystalline planar arrangement in the anatase structure, which facilitates epitaxy of the apatite crystal.     

Predictive value of the adipocyte-derived plasma protein adiponectin for restenosis after elective coronary stenting

The purpose of this study was to test the hypothesis that plasma levels of adiponectin can predict angiographic in-stent restenosis after coronary stenting. We prospectively examined adiponectin levels in 127 consecutive patients undergoing elective coronary stenting. Restenosis was defined as more than 50% stenosis at follow-up study by quantitative coronary angiography. There were no significant differences in the clinical characteristics or angiographical findings between the groups with restenosis and no restenosis. The levels of adiponectin did not differ between the restenosis group and the no restenosis group (5.7 +/- 2.8 vs 5.9 +/- 3.6 microg/mL, p = 0.72). The plasma levels of adiponectin were not related with the late loss index after coronary stenting (r = 0.01, p = 0.89). The levels of adiponectin were significantly lower in men than in women (5.5 +/- 3.2 vs 8.8 +/- 3.7 microg/ mL, p < 0.001), and negatively correlated with body mass index (r = -0.21, p = 0.01). We analyzed adiponectin levels in male, female, obese, non-obese, diabetes, and non-diabetes patients, however, there were no significant differences between the restenosis group and no restenosis group. This study has demonstrated that the measurement of adiponectin could not predict angiographic restenosis after elective coronary stenting, whereas the plasma levels of adiponectin were associated with some coronary risk factors in patients with coronary artery disease.     

Transplantation of telencephalic neural progenitors induced from embryonic stem cells into subacute phase of focal cerebral ischemia

Cerebral ischemia causes neuronal death and disruption of neural circuits in the central nervous system. Various neurological disorders caused by cerebral infarction can severely impair quality of life and are potentially fatal. Functional recovery in the chronic stage mainly depends on physical treatment and rehabilitation. We aim to establish cell therapy for cerebral ischemia using embryonic stem (ES) cells, which have self-renewing and pluripotent capacities. We previously reported that the transplanted monkey and mouse ES cell-derived neural progenitors, by stromal cell-derived inducing activity method, could survive and differentiate into various types of neurons and glial cells, and form the neuronal network in basal ganglia. In this report, we induced the differentiation of the neural progenitors from mouse ES cells using the serum-free suspension culture method and confirmed the expression of various basal ganglial neuronal markers and neurotransmitter-related markers both in vitro and in vivo, which was thought to be suitable for replacing damaged striatum after middle cerebral artery occlusion. This is the first report that used selectively induced telencephalic neural progenitors into ischemia model. Furthermore, we purified the progenitors expressing the neural progenitor marker Sox1 by fluorescence-activated cell sorting and Sox1-positive neural progenitors prevented tumor formation in ischemic brain for 2 months. We also analyzed survival and differentiation of transplanted cells and functional recovery from ischemic damage.