Healing through the martial way: Incorporating karate training into counselling and psychotherapy

This research paper describes lived experiences in dance therapeutic processes in the case of a woman called Asta. Rather than claiming results from therapeutic processes, the paper enlightens change processes through narratives about both Asta's bodily movement expressions and inner experiences. The paper focuses furthermore on illustrating the possibilities of using body language, movement and an energetic approach to therapy in Asta's case with the dance therapy form Dansergia. Asta moves through a shell of anxiety and into the dance of a gypsy, from an inner experienced black ring and hedgehog to a woman accepting difficult experiences in the past and new possibilities in the present. Asta's processes are analysed and interpreted in an energy-based theoretical framework, and are then reflected upon in terms of impact possibilities in a broader dance therapeutic and research oriented context.     

A novel p.Gly417Valfs*12 mutation in the MTTP gene causing abetalipoproteinemia: Presentation of the first patient in Mexico and analysis of the previously reported cases

BackgroundOur aims were to describe the first Mexican patient with abetalipoproteinemia and to perform a comparative analysis of biochemical, clinical, and genetic characteristics of 100 cases reported in the literature.MethodsWe performed biochemical and molecular screenings in a Mexican girl with extremely low lipid levels and in her family. Further, we integrated and evaluated the characteristics of the cases with abetalipoproteinemia described in the literature.ResultsOur patient is a six‐year‐old girl who presented vomiting, chronic diarrhea, failure to thrive, malabsorption, acanthocytosis, anemia, transaminases elevation, and extremely low lipid levels. MTTP gene sequencing revealed homozygosity for a novel mutation p.Gly417Valfs*12 (G deletion c.1250). With the analysis of the reported cases, 60 clinical features (14 classical and 46 non‐classical) were observed, being the most common acanthocytosis (57.5%), malabsorption (43.7%), and diarrhea (42.5%); 48.8% of the patients presented only classic clinical features, while the remaining 51.2% developed secondary effects due to a fat‐soluble vitamin deficiency. An odds ratio analysis disclosed that patients diagnosed after 10 years of age have an increased risk for presenting clinical complications (OR = 18.0; 95% CI 6.0‐54.1, p < 0.0001). A great diversity of mutations in MTTP has been observed (n = 76, being the most common p.G865X and p.N139_E140) and some of them with possible residual activity.ConclusionThe first Mexican patient with abetalipoproteinemia presents a novel MTTP mutation p.Gly417Valfs*12. Three factors that could modulate the phenotype in abetalipoproteinemia were identified: age at diagnosis, treatment, and the causal mutation.     

Alteration of serum thymus and activation‐regulated chemokine level during biologic therapy for psoriasis: Possibility as a marker reflecting favorable response to anti‐interleukin‐17A agents

Biologics show great efficacy in treating psoriasis, a chronic inflammatory skin disease. The high cost and side‐effects of biologics, dose‐reduction, elongation of administration interval and suspension are possible options. However, there has been no reliable biomarker we can use when we consider these moderations in therapy. This study was conducted to test the possibility of using serum thymus and activation‐regulated chemokine (TARC) level as an indicator for step down of biologic therapy. Serum TARC level was measured in 70 psoriatic patients at Asahikawa Medical University, and a correlation of TARC and severity of skin lesions was analyzed. Referring to serum TARC level, psoriatic patients can be divided into two groups. One is a population in which serum TARC level is positively correlated with severity of skin lesions, and the other is a population with low psoriatic severity and high TARC level. Serum TARC level was higher in the group that achieved PASI‐clear with biologics than in the group which did not achieve PASI‐clear. Among biologics, the group treated with secukinumab, an anti‐interleukin (IL)‐17A agent, showed significantly higher TARC level compared with the group treated with anti‐tumor necrosis factor agents. In certain populations achieving PASI‐clear, serum TARC level may be a potent marker reflecting better response to IL‐17A inhibitors, and in this case step down of treatment for psoriasis is possible.     

Binge alcohol-induced alterations in BDNF and GDNF expression in central extended amygdala and pyriform cortex on infant rats

Mothers who consume alcohol during pregnancy may cause a neurotoxic syndrome termed fetal alcohol spectrum disorder (FASD) in the offspring, which includes cognitive deficits and emotional/social disturbances. These alterations are thought to be caused, at least in part, by alcohol-induced imbalance in neurotrophic factor levels, which are critically involved in normal neurodevelopment. Our goal was to study whether brain-derived neurotrophic factor (BDNF) and glial-derived neurotrophic factor (GDNF) expression were affected by alcohol in central extended amygdala (CEXA) and pyriform cortex (Pyr), structures strongly involved in emotional/social behaviors. Further, we evaluated how these changes could be related to blood and brain alcohol concentrations. Postnatal day (PND) pups at 7, 15 and 20-days old were administered alcohol (2.5 g/kg s.c. at 0 and 2 h) or saline. Immunohistochemistry was used to detect the expression of BDNF and GDNF at 2, 12 and 24 h after drug administration. Also, gas chromatography was bused to measure blood alcohol levels (BALs) and brain alcohol levels (BrALs) at each hour, from 2 to 8 h after the second alcohol administration. Results showed: (1) alcohol-induced enhancement of BDNF positive cells on PND 7 and 20, a decrease on PND 15 in the CEXA, and no changes in the Pyr on PND 7 and 20, but a diminished on PND 15; (2) GDNF positive cells rise after alcohol administration for the three ages in the CEXA and Pyr except on PND 15, where there was a decline; and (3) pharmacokinetics analysis demonstrated age-related differences showing equal BALs on PND 7 and 20 but higher BALs on PND 15. In contrast, BrALs were higher on PND 7 than 15 and 20. Hence, BALs may not be predictive of BrALs in postnatal rats. Furthermore, we did not find a relationship between age in pharmacokinetic differences and neurotrophins response. In conclusion, the CEXA and Pyr are brain structures sensitive to alcohol-induced imbalance in neurotrophic factors expression; and BALs are not a mirror of BrALs.     

Establishing diagnostic reference levels for interventional procedures in Kenya

PurposeTo quantify ionizing radiation exposure to patients during interventional procedures and establish national diagnostic reference levels (NDRLs) for clinical radiation exposure management.MethodsThe cumulative reference point air kerma, kerma area product, fluoroscopy time and other operational parameters were monitored for 50 children and 261 adult patient procedures in five catheterization medical laboratories in Kenya. To estimate the risk associated with the exposure, effective doses were derived from the kerma area product using conversion factors from Monte Carlo models.ResultsAbout 3% of the measured cumulative reference point air kerma for the interventional procedures approached the threshold dose limit with the potential to cause deterministic effects such as skin injuries. In interventional cardiology, the results obtained for both children and adults indicated 33% were below the diagnostic reference levels (DRLs). In adult interventional radiology, 29% for cumulative reference point air kerma, and 43% for kerma area product and fluoroscopy time respectively were below the diagnostic reference levels. NDRLs were proposed for routine use in the procedures considered and for the non-existent DRLs situations in paediatric interventional cardiology.ConclusionThe measured patient doses were above the DRLs available in the literature indicating a need for radiation optimization through, continuous monitoring and recording of patient dose. To promote radiation safety, facilities performing interventional procedures need to establish a radiation monitoring notification threshold for possible deterministic effects, in addition to the use of the newly established national diagnostic reference levels, as a quality assurance measure.     

术前促性腺激素释放激素激动剂治疗对子宫内膜异位症患者血清学指标及内膜组织相关基因表达的影响

目的：分析术前促性腺激素释放激素激动剂(GnRH-a)治疗对子宫内膜异位症患者血清学指标及内膜组织相关基因表达的影响。方法选择于2012年12月~2014年12月在湖南省人民医院住院治疗的子宫内膜异位症患者82例作为研究对象,按照随机数字表法将其分为观察组和对照组,每组各41例。观察组患者接受术前GnRH-a联合腹腔镜治疗,对照组患者接受单纯腹腔镜治疗。比较两组患者的激素水平、疾病相关指标及复发相关指标、内膜组织基因表达等情况差异。结果观察组患者接受治疗后的雌二醇、卵泡刺激素、孕激素、黄体生成素水平明显低于对照组,差异均有统计学意义(P<0.05);观察组患者接受治疗后的CA125、CA199、基质金属蛋白酶抑制剂-1、血管内皮生长因子水平均显著低于对照组,差异均有统计学意义(P<0.05);观察组患者的内皮型一氧化氮合酶、CD34、LIvin表达水平显著低于对照组,差异均有统计学意义(P<0.05)。结论术前GnRH-a治疗有助于降低子宫内膜异位症患者的激素水平,有利于腹腔镜手术的病灶彻底切除,降低术后复发可能性。     

Development of Diagnostic Reference Levels Using a Real-Time Radiation Dose Monitoring System at a Cardiovascular Center in Korea

Digital cardiovascular angiography accounts for a major portion of the radiation dose among the examinations performed at cardiovascular centres. However, dose-related information is neither monitored nor recorded systemically. This report concerns the construction of a radiation dose monitoring system based on digital imaging and communications in medicine (DICOM) data and its use at the cardiovascular centre of the University Hospitals in Korea. The dose information was analysed according to DICOM standards for a series of procedures, and the formulation of diagnostic reference levels (DRLs) at our cardiovascular centre represents the first of its kind in Korea. We determined a dose area product (DAP) DRL for coronary angiography of 75.6 Gy cm² and a fluoroscopic time DRL of 318.0 s. The DAP DRL for percutaneous transluminal coronary intervention was 213.3 Gy cm², and the DRL for fluoroscopic time was 1207.5 s.