Concurrent deletion of BMP4 and OTX2 genes,two master genes in ophthalmogenesis

BMP4 and OTX2 are master genes in ophthalmogenesis. Mutations of BMP4 and OTX2 often lead to eye defects, including anophthalmia–microphthalmia. A significant degree of variable expressivity has been reported in heterozygous individuals with BMP4 or OTX2 mutation. Interestingly, both BMP4 and OTX2 reside on 14q22, being only 2.8 Mb apart. Previous studies reported that among three patients with 14q22 deletion involving BMP4 and OTX2, all had severe eye defects. The minimal degree of variable expressivity among these individuals who were doubly deleted for BMP4 and OTX2 could be attributed to the combinatorial relationship of the two genes observed in animal models. We herein report a patient with a concurrent deletion of BMP4 and OTX2 who exhibited bilateral microphthalmia, more specifically, anterior segment dysgenesis with microcornea. Evolutionarily conserved physical linkage of Bmp4 and Otx2 loci may suggest an advantage of the proximal alignment of the two genes. Another striking feature in the propositus was the progressive white matter loss observed by serial neuroimaging. A review of twelve previously reported patients with 14q22 microdeletion revealed decreased white matter volume in half of the patients. It remains to be elucidated whether the white matter lesion is age-dependent and progressive. In conclusion, anterior segment defects of the eyes, especially when accompanied by decreased white matter volume on neuroimaging, should raise the clinical suspicion of 14q22 microdeletion.     

Bonding performance and interfacial characteristics of short fiber‐reinforced resin composite in comparison with other composite restoratives

The purpose of this study was to investigate the shear bond strength (SBS) and surface free‐energy (SFE) of short fiber‐reinforced resin composite (SFRC), using different adhesive systems, in comparison with other composite restoratives. The resin composites used were everX Posterior (EP), Clearfil AP‐X (CA), and Filtek Supreme Ultra Universal Restorative (FS). The adhesive systems used were Scotchbond Multi‐Purpose (SM), Clearfil SE Bond (CS), and G‐Premio Bond (GB). Resin composite was bonded to dentin, and SBS was determined after 24 h of storage in distilled water and after 10,000 thermal cycles (TCs). The SFEs of the resin composites and the adhesives were determined by measuring the contact angles of three test liquids. The SFE values and SFE characteristics were not influenced by the type of resin composite, but were influenced by the type of adhesive system. The results of this study suggest that the bonding performance and interfacial characteristics of SFRC are the same as for other composite restoratives, but that these parameters are affected by the type of adhesive system. The bonding performance of SFRC was enhanced by thermal cycling in a manner similar to that for other composite restoratives.     

Posterior cerebral artery dissection on a serial magnetic resonance angiography

Posterior cerebral artery (PCA) dissection in children seldom is reported in the literature. This is the second report of acute PCA dissection with infarct occurring in a young child. A serial magnetic resonance angiography demonstrated a delayed and transient narrowing of the arterial caliber, which was consistent with a focal PCA dissection with delayed vascular recanalization. PCA dissection should be included in the causes of infarct in children and a thorough and serial neurovascular imaging should be considered if no cause of stroke is found.     

Shear fatigue strength of resin composite bonded to dentin at physiological frequency

The purpose of this study was to examine the shear fatigue strengths of a resin composite bonded to dentin. Three adhesive systems – a two‐step self‐etch adhesive (OptiBond XTR; Kerr) and two universal adhesives [Scotchbond Universal (3M ESPE) and G‐Premio Bond (GC)] – were used in self‐etch mode to bond a resin composite to dentin at a physiologic frequency of 2 Hz over 50,000, 100,000, and 1,000,000 cycles. A staircase method of fatigue testing was used. Twenty specimens were used for each test condition. There was no significant difference in shear fatigue strength across the cycling periods for the three individual adhesives. Differences in shear fatigue strength were found among the three adhesives within each cycling period. Regardless of the adhesive used in self‐etch mode for bonding a resin composite to dentin, shear fatigue strength was not influenced by the number of cycles used for testing.     

Treatment outcome of laparoscopic surgery after self-expandable metallic stent insertion for obstructive colorectal cancer

International Journal of Clinical Oncology - We assessed the technical and oncological safety of self-expandable metallic stent (SEMS) insertion followed by laparoscopic colorectal surgery as a...     

Effect of a functional monomer (MDP) on the enamel bond durability of single‐step self‐etch adhesives

The present study aimed to determine the effect of the functional monomer, 10‐methacryloxydecyl dihydrogen phosphate (MDP), on the enamel bond durability of single‐step self‐etch adhesives through integrating fatigue testing and long‐term water storage. An MDP‐containing self‐etch adhesive, Clearfil Bond SE ONE (SE), and an experimental adhesive, MDP‐free (MF), which comprised the same ingredients as SE apart from MDP, were used. Shear bond strength (SBS) and shear fatigue strength (SFS) were measured with or without phosphoric acid pre‐etching. The specimens were stored in distilled water for 24 h, 6 months, or 1 yr. Although similar SBS and SFS values were obtained for SE with pre‐etching and for MF after 24 h of storage in distilled water, SE with pre‐etching showed higher SBS and SFS values than MF after storage in water for 6 months or 1 yr. Regardless of the pre‐etching procedure, SE showed higher SBS and SFS values after 6 months of storage in distilled water than after 24 h or 1 yr. To conclude, MDP might play an important role in enhancing not only bond strength but also bond durability with respect to repeated subcritical loading after long‐term water storage.     

Comparison of valsartan and amlodipine on ambulatory blood pressure variability in hypertensive patients

We tested the hypothesis that calcium channel blockers (CCBs: amlodipine group, n = 38)) are superior to angiotensin receptor blockers (ARBs: valsartan group, n = 38) against ambulatory blood pressure variability (BPV) in untreated Japanese hypertensive patients. Both drugs significantly reduced ambulatory systolic and diastolic BP values. With regard to BPV, standard deviation (SD) in SBP did not change with the administration of either drug, but the ARB significantly increased SD in awake DBP (12 ± 4–14 ± 4 mmHg). The ARB also significantly increased the coefficients of variation (CVs)in awake and 24-h SBP/DBP (all P < 0.05), but amlodipine did not change the CV. CCB significantly reduced the maximum values of awake SBP (193 ± 24–182 ± 27 mmHg, P = 0.02), sleep SBP (156 ± 18–139 ± 14 mmHg, P < 0 .001), and awake and sleep DBP (P < 0.01 in both cases), but the ARB did not change the maximum BP values. In conclusion, a once-daily morning dose of CCB amlodipine was more effective at controlling ambulatory BPV than ARB valsartan, especially in reducing maximum BP levels.     

Low-Protein Diet for Diabetic Nephropathy

Diabetic nephropathy is the leading cause of progressive kidney disease, leading to end-stage renal disease and renal replacement therapy. Angiotensin-converting enzyme inhibitors and/or angiotensin receptor blockers have been considered effective at slowing the progression of kidney function deterioration. However, these drugs cannot sufficiently halt the progression of nephropathy to the extent that is required. A low-protein diet (LPD) is believed to be a nutritional intervention that may slow kidney disease progression. In fact, preclinical animal experiments have demonstrated excellent renoprotective effects of an LPD. However, in human clinical trials, analyses of the effects of protein restriction on diabetic nephropathy have not yet revealed consistently positive outcomes of this nutritional intervention. In this review, we analyze the potential renoprotective effects of an LPD on diabetic nephropathy and summarize the outcomes of clinical trials that have systematically investigated the efficacy of an LPD in diabetic nephropathy. In addition, we discuss some potential approaches associated with nutritional interventions to combat progressive kidney disease.