Functional regulation of tactile sense by brain-derived neurotrophic factor in adult rats during acute inflammation

Nerve growth factor is present in skin in limiting amounts and is known to regulate the plasticity and the sensitivity of nociceptive neurons. Recently, knock-out mouse studies showed that neurotrophin-3 and brain-derived neurotrophic factor are required for the postnatal survival and functional maturation, respectively, of tactile sensory neurons. However, the roles of neurotrophin-3 and brain-derived neurotrophic factor in adult sensory neurons have not been clarified. Here, we report an unexpected and marked acute loss of tactile sense in the rat hind paw after adjuvant-induced inflammation. This loss was shown to be closely correlated with decreases in the expression of brain-derived neurotrophic factor, and to a lesser extent of neurotrophin-3 in the inflamed skin. Administration of brain-derived neurotrophic factor, but not neurotrophin-3, after inflammation accelerated the recovery of tactile sense.These results suggested a role of brain-derived neurotrophic factor in the physiological regulation of tactile sense in adulthood.     

The significance of the determination of AFP-isoform in the early diagnosis of hepatocellular carcinoma]

To evaluate the significance of the determination of the AFP-isoform in the early diagnosis of hepatocellular carcinoma (HCC), the AFP-isoform was determined in 48 patients with HCC and in 53 patients with liver cirrhosis, using the lectin electrophoresis of AFP by antibody-affinity blotting technique. 1. The HCC-type AFP-isoform was detected in 44 of the 48 patients with HCC, 2. In about 30% of the patients with HCC, the HCC-type AFP-isoform appeared 3-10 months before the graphic diagnosis of HCC, 3. In about 60% of the patients with liver cirrhosis found to have the HCC-type AFP-isoform, HCC developed within one year. Thus, the serial determination of the AFP-isoform in patients with liver cirrhosis was considered very useful for the early diagnosis of HCC.     

Association between HLA and Japanese patients with rheumatoid arthritis

Japanese patients with rheumatoid arthritis (RA) were observed to have a statistical association with HLA-DR4, MT3. Strong association between the clinical severity of RA and HLA was also observed. Male patients had a stronger association with HLA than female patients. Males are more resistant to RA than females. This suggested that the threshold of liability for RA is higher in males than in females. Japanese patients with RA with systemic vasculitis were negative for HLA-Bw44 and had antilymphocytotoxic autoantibody, indicating that RA with systemic vasculitis is different in etiology from RA without systemic vasculitis.     

High Frequency of Antibiotic-Associated Diarrhea due to Toxin A-Negative, Toxin B-Positive Clostridium difficile in a Hospital in Japan and Risk Factors for Infection

Patients hospitalized in a hospital with a high incidence of antibiotic-associated diarrhea due to toxin A-negative, toxin B-positive (A–/B+) Clostridium difficile were retrospectively investigated to determine the clinical manifestations and risk factors for infection. Of 77 Clostridium difficile isolates obtained from 77 patients during the 1-year investigation period, 30 were A–/B+ and 47 were toxin A-positive, toxin B-positive (A+/B+). By pulsed-field gel electrophoresis analysis, 23 of the 30 A–/B+ strains were outbreak-related, suggesting nosocomial spread of a single type of bacterium, which mainly affected patients in the wards of respiratory medicine, hematology and neurology. Using regression analysis, three factors were found to be associated with infection by A–/B+ isolates: (i) exposure to antineoplastic agents (P=0.01, odds ratio [OR]=5.1), (ii) the use of nasal feeding tubes (P=0.008, OR=5.2), and (iii) assignment to a certain internal medicine ward (P=0.05, OR=3.0). Between patients with Clostridium difficile-associated diarrhea caused by A–/B+ strains and those with A+/B+ strains, no statistically significant difference was found in body temperature, serum concentration of C-reactive protein, leukocyte count in whole blood, frequency of diarrhea, or type of underlying disease. These results indicate that A–/B+ strains of Clostridium difficile can cause intestinal infection in humans and they spread nosocomially in the same manner as A+/B+ strains.     

In vitro early changes in intercellular junctions by treatment with a chemical carcinogen

To examine early intercellular junction changes caused by treatmentwith 9, 10-dimethyl-l, 2-benzanthracene (DMBA), rat lingualepithelium was cultivated in isolation and observed by electrophysiological,freeze-fracture and whole-mount electron microscopy. Electrophysiologicalmeasurements showed a transient decrease in membrane potentialof -10.2 mV 6 h after the treatment. It returned to almost thesame level as that of the control group 1 day later. Six hoursafter treatment, input resistance decreased rapidly to 5.3 Mbut increased to 18.0 M 12 h after treatment. Transient reductionof input resistance and membrane potential occurred prior tothe decrease in the coupling ratio 6 h after treatment withDMBA. In freeze-fracture replicas, the number of gap junctionsdecreased by 45% of the control value 6 h after treatment withDMBA. At 12 h and thereafter, the number and area of gap junctionssubsequently decreased by 60–80% of the control value.Alterations in the number and area of desmosomes were similarto those of the gap junctions. The formation of epithelial cytoskeletons,partially devoid of the 2–4 and 5–8 nm filamentswas also observed. A decrease in the density of filament networksbeneath the plasma membranes was especially apparent. Treatmentwith a carcinogen brought about morphological cellular changesas early as 6 h after treatment, and such early changes mighttrigger metabolic cellular abnormalities. Affected cells appearto move away from normal cells in a process of repeated destructionand revision of intercellular junctions, and cytoskeletons.     

Habitual Dietary Intake Affects the Altered Pattern of Gut Microbiome by Acarbose in Patients with Type 2 Diabetes

The aim of this research was to reveal the characteristics of gut microbiome altered by acarbose intervention in Japanese patients with type 2 diabetes (T2D) and its possible association with habitual dietary intake. Eighteen patients with T2D were administered acarbose for four weeks. The abundances of two major phyla, namely Actinobacteria and Bacteroidetes, were reciprocally changed accompanied by the acarbose intervention. There were also significant changes in the abundances of ten genera, including the greater abundance of Bifidobacterium, Eubacterium, and Lactobacillus and the lower abundance of Bacteroides in the group after the intervention than that before the intervention. Hierarchical clustering of habitual dietary intake was performed based on the pattern of changes in the gut microbiota and were classified into distinct three clusters. Cluster I consisted of sucrose, cluster II mainly included fat intake, and cluster III mainly included carbohydrate intake. Moreover, the amount of change in Faecalibacterium was positively correlated with the intake of rice, but negatively correlated with the intake of bread. The intake of potato was negatively correlated with the amount of change in Akkermansia and Subdoligranulum. Acarbose altered the composition of gut microbiome in Japanese patients with T2D, which might be linked to the habitual dietary intake.     

In Vitro Validation of Tissue Doppler Left Ventricular Regional Wall Velocities by Using a Novel Balloon Phantom

Velocity data from tissue Doppler imaging (TDI)can provide valuable information on regional leftventricular wallmotion. Validation of TDImyocardialvelocity measurements has been carried out indirectlyfrom gray- scale M- mode images,and discrepancieshave been reported.Mc Dicken[1] and Miyatake etal[2 ]have reported the accuracy and validity of the TDIsystem using a rotating sponge model.However theoverall motion of the heart should be considered.Inthe present study,we described a new TDI…     

Comparison of Single and Dual Monitoring during Carotid Endarterectomy

We compared the rate of selective shunt and pattern of monitoring change between single and dual monitoring in patients undergoing carotid endarterectomy (CEA). A total of 121 patients underwent 128 consecutive CEA procedures. Excluding five procedures using internal shunts in a premeditated manner, we classified patients according to the monitoring: Group A (n = 72), patients with single somatosensory evoked potential (SSEP) monitoring; and Group B (n = 51), patients with dual SSEP and motor evoked potential (MEP). Among the 123 CEAs, an internal shunt was inserted in 12 procedures (9.8%) due to significant changes in monitoring (Group A 5.6%, Group B 15.7%, p = 0.07). The rate of shunt use was significantly higher in patients with the absence of contralateral proximal anterior cerebral artery (A1) on magnetic resonance angiography (MRA) than in patients with other types of MRA (p <0.001). Significant monitor changes were seen in 16 (12.5%) in both groups. In four of nine patients in Group B, SSEP and MEP changes were synchronized, and in the remaining five patients, a time lag was evident between SSEP and MEP changes. In conclusion, the rate of internal shunt use tended to be more frequent in patients with dual monitoring than in patients with single SSEP monitoring, but the difference was not significant. Contralateral A1 absence may predict the need for a shunt and care should be taken to monitor changes throughout the entire CEA procedure. Use of dual monitoring can capture ischemic changes due to the complementary relationship, and may reduce the rate of false-negative monitor changes during CEA.     

Potential predictors of the onset of focal intestinal perforation in extremely low birth weight infants based on an analysis of coagulation and fibrinolysis markers at birth: A case-control study based on ten years of experience at a single institution

Purpose: We aimed to investigate potential predictors of focal intestinal perforation (FIP) in extremely low birth weight infants (ELBWIs) among coagulation and fibrinolysis markers at birth.Methods: We reviewed the medical records of FIP patients and their coagulation and fibrinolysis markers at birth between 2010 and 2019, and matched patients according to gestational age. FIP was diagnosed based on macroscopic intestinal perforation with a punched-out lesion without necrosis. Patient characteristics and blood test results, including coagulation and fibrinolysis marker levels, were compared between the groups.Results: Two hundred forty ELBWIs were enrolled in this study (FIP, n = 18; controls, n = 222). In the FIP group, the gestational age at birth was significantly younger (p = 0.023) and the birth weight was significantly lower (p = 0.007) in comparison to the control group. Furthermore, the FIP group showed significantly lower levels of fibrinogen (p = 0.027) and factor XIII (F-XIII) (p = 0.007). The receiver operating characteristics curves for fibrinogen and F-XIII revealed that the 95% confidence intervals of fibrinogen and F-XIII were 0.530–0.783 (p = 0.027), and 0.574–0.822 (p = 0.007), respectively.Conclusions: This is the first report focusing on coagulation and fibrinolysis markers in FIP patients at birth. The fibrinogen and F-XIII values at birth are potential predictors of FIP in ELBWIs.Type of Study: Study of Diagnostic Test (Case Control Study)Level of Evidence: Level IV     

Preoperative adjuvant therapy for urinary bladder cancer--preoperative intra-arterial anticancer drugs infusion using artificial liver, and preoperative radiotherapy

One hundred patients with carcinoma of the urinary bladder were treated with preoperative intra-arterial anticancer drug infusion in combination with an active carbon-based artificial liver or preoperative radiotherapy (400 rad X 5 days, total 2000 rad) in order to alleviate systemic side effects after preoperative adjuvant therapy and to perform radical cystectomy as soon as possible. Five-year survival was 69.8% in the artificial liver combined preoperative intra-arterial anticancer drug infusion group, and that of the no-pretreatment group and the preoperative irradiated group was 48.6% and 45.8%, respectively. In particular, the CDDP treated group had a higher 5-year survival of 77.4% than did the without CDDP treated group. This was attributable mostly to improved prognosis of T2, whereas either of these preoperative adjuvant therapies failed to ameliorate the prognosis of T3 or T4 stage patients. Therefore, systemic preoperative anticancer chemotherapies such as M-VAC are necessary to destroy "micrometastases" and to improve the prognosis of highly advanced bladder cancer.