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Extraction of As(III) from hydrochloric acid solution using various solvents on the basis of ion solvation has been reported, but a theoretical framework to describe the suitability of solvents for extraction has not been systematized. In this study, comprehensive extraction tests for As(III) using a variety of organic solvents were conducted to clarify the requirements for solvents to extract As(III). From the results of initial screening tests, various aromatics, ethers, and ketones were rated as candidates for the extraction of As(III) at high HCl concentrations, whereas aliphatic hydrocarbons were excluded. Many solvents showed high extraction capacity for As(III) to give organic fraction concentrations of 150 mM or higher. The logP value (P = partitioning coefficient between n-octanol and water) within a solvent class showed some correlation with extractability of As(III) but the correlation was invalid across solvent types. High correlation was shown between the Hansen solubility parameters of the solvents and As(III) extractability: Twenty of 22 solvents (90.9%) were appropriately classified as valid or invalid for the extraction of As(III) based on the Hansen sphere. 2-Nonanone was recommended as an ideal solvent for As(III) extraction because of its good balance between high extractability and its desirable physical properties for industrial operations. As(III) was quantitatively stripped from 2-nonanone into water with a concentration factor of 22.6. [ABSTRACT FROM AUTHOR]

This paper presents a double-mass dynamic vibration absorber (DVA) that rapidly reduces the motion of the object to be damped (main system) and converts it to the motion of the DVA. In this way, the DVA attenuates the vibration of the main system. A DVA is usually designed to improve the resonance amplitude and convergence time of the main system vibration, and the kinetic energy of the main system is dissipated as heat in the damping element of the DVA. We describe a novel configuration consisting of two DVAs connected by a spring and an inerter. This new structure enables a rapid response reduction of the main system and residual vibration in the DVA. By tuning the responses of both the main system and the DVA, two vibration modes can be realized: a damping mode and a residual vibration mode. The proposed device is optimized using a genetic algorithm and applied to a bridge to demonstrate its performance. [ABSTRACT FROM AUTHOR]

Context: With global population aging, the number of older patients with cancer is increasing. However, few data are available on palliative care for these patients.Objectives: To evaluate differences in symptom prevalence and the need for medical interventions among patients of different ages in a palliative care unit.Methods: In this retrospective analysis, a consecutive sample of 1032 terminally ill patients with cancer were categorized into the following age ranges: <70, 70-79, 80-89, and ≥90 years. We evaluated symptom prevalence, the need for palliative medicines, opioid dose on the day before death, and the need for palliative sedation. Trend tests were used to examine whether the prevalence of findings increased or decreased with age.Results: As age increased, significant decreasing trends were observed in the prevalence of pain, dyspnea, fatigue, constipation, nausea, drowsiness, difficulty sleeping, anxiety, and dysuria but not in appetite loss, edema, sputum production, or delirium. As age increased, significant decreasing trends were also observed in the need for opioids, benzodiazepines, antiemetics, and anticholinergics. The median opioid doses in the <70, 70-79, 80-89, and ≥90 years age groups were 118, 72, 48, and 48 mg oral morphine equivalents/day, respectively (P < 0.0001). The need for palliative sedation showed a significant decreasing trend as age increased (P < 0.0001).Conclusion: We found age to be inversely related to symptom prevalence and medical interventions among terminally ill patients with cancer, contributing to the understanding of the experience of older patients with cancer. [ABSTRACT FROM AUTHOR]

A new ternary sodium magnesium bismuthide, NaMgBi, has been synthesized from the constituent metals, and its crystal structure was determined by single-crystal X-ray diffraction. NaMgBi crystallizes in a tetragonal PbFCl-type structure corresponding to the space group P4/nmm, where Z = 2, a = 4.7123(4) and c = 7.8158(7) Å. The structure is composed of layers formed by edge-sharing Bi tetrahedra centered with Mg stacked in the c-axis direction, and these layers sandwich the Na atoms. First-principles computations based on density functional theory calculations have verified that the most stable atomic configuration is the one in which the Na and Mg atoms occupy the 2a and 2c sites, respectively. The electrical resistivity measured for a sintered polycrystalline sample of NaMgBi with a relative density of 70% was found to gradually decrease from 868 to 26.4 mΩ cm upon increasing the temperature from 297 to 506 K, and the Seebeck coefficient decreased from 273 to 180 μV K−1 upon increasing the temperature from 298 to 496 K. Electronic structure calculations have revealed that NaMgBi must be a semiconductor with a small band gap of ∼0.1 eV. [ABSTRACT FROM AUTHOR]

Objective In neuroendovascular treatment, there are many opportunities to guide multiple catheters into the intracranial blood vessels. We report the relationship between two microcatheters according to the guiding order with experimental in vitro studies. Materials and Methods We hypothesize that in a bent blood vessel such as a paraclinoid region of the internal carotid artery, the catheter that was first guided tended to pass through the inside, and the catheter that was guided later tended to pass through the outside. The in vitro verification was performed using a microcatheter and a balloon catheter in a silicone vascular aneurysmal model. Results As a result, it was found that the two catheters were arranged according to our hypothesis. This finding was also observed during the actual operation of balloon-assisted coil embolization. Conclusion The positional relationship between the two catheters according to the navigation order is very important, in particular during balloon-assisted coiling and stent-assisted coiling via a jailed microcatheter. [ABSTRACT FROM AUTHOR]

Crop models have suggested high sensitivity of soybean [Glycine max (L.) Merr.] to day length and the resultant extension of the growth period as a concept to overcome yield loss due to climate warming. However, experimental validation of this concept is incomplete. The E3 and E4 loci encode phytochrome A isoforms and enhance sensitivity to day length. Our previous study showed that the dominant E4 allele can mitigate yield loss due to warming. In this study, we similarly tested the hypothesis that the dominant E3 allele can reduce yield loss caused by warming. One of the leading Japanese cultivars Enrei (e3/E4) and near‐isogenic lines (NIL‐e3e4, NIL‐E3e4, and NIL‐E3E4) in the Enrei genetic background were grown at near ambient temperature or either 2.0°C or 4.7°C above ambient temperature in temperature‐gradient chambers (TGCs) in a cool region in Japan. The number of days from sowing to beginning of flowering (R1) decreased with increasing temperature, regardless of genotype. However, increasing temperature extended the period from R1 to beginning of pod filling (R3) and increased pod number per plant and seed yield per plant in all genotypes except NIL‐e3e4. Combined data from the TGC experiment and from field trials across three different latitudes showed that the decreased developmental rate during the R1–R3 period can be attributed to longer days, rather than by supra‐optimal temperatures. We conclude that E3, in addition to E4, could potentially increase seed yield in cool regions under future warming. [ABSTRACT FROM AUTHOR]

In southwestern Japan, soil water fluctuations from flooding to drought cause unstable soybean yields. Water table management (WTM) with sub-irrigation/drainage systems will overcome the soybean yield instability by inhibiting these fluctuations. Narrow row cultivation is expected to increase soybean yields. The effects of WTM and row width on soybean growth and yield in this region are not clear. We evaluated the effects of WTM with sub-irrigation/drainage systems and row widths (35 or 70 cm) on the growth and yield of one conventional (tall main stem) and two newly developed (short main stem) soybean cultivars. The WTM consisted of (1) fluctuation of the water table between the natural water table depth and that at 30 cm depth according to the growth stage and weather conditions, especially rainfall events (newly developed); (2) maintaining the water table at a 30 cm constant depth throughout the growth period (recommended in Japan); and (3) the natural water table with an underdrain (control). No significant interaction was observed between the WTM and cultivar or row width treatment, indicating that cultivars and row width treatments responded similarly to WTM. WTM 1 and 2 decreased the soybean yield by approx. 5% when the natural water table depth in control existed at 50–60 cm depths throughout the growing period, indicating that the natural water table depth in control was near optimum for soybean growth and yield. Before performing WTM, therefore, the natural water table depth should be measured and considered. The combination of newly developed cultivars with narrow rows had similar or greater yields than conventional cultivation (cultivar and row width), due mainly to an increase in pods m −2 and a decrease in yield loss without severe lodging. Thus, yield potential in southwestern Japan could be increased by narrow row cultivation, but cultivars with short main stem lengths should be cultivated. [ABSTRACT FROM AUTHOR]

Background: Corticosteroids are often used to treat fatigue and anorexia, but occasionally produce delirium. Information on the predictors of delirium in corticosteroid-treated cancer patients remains limited. Objective: To identify potential factors predicting the development of delirium in corticosteroid-treated cancer patients. Design: An exploratory, multicenter, prospective, observational study. Setting/Subjects: Inclusion criteria for this study were patients who had metastatic or locally advanced cancer and a fatigue or anorexia intensity score of 4 or more on a 0-10 Numerical Rating Scale. Measurement: Univariate and multivariable analyses were performed to identify the predictors of delirium diagnosed by the Confusion Assessment Method (CAM) within three days of initiation of corticosteroids. Results: Among 207 patients administered corticosteroids, 35 (17%; 95% confidence interval [CI] 12%-23%) developed at least one episode of delirium diagnosed by the CAM. Factors predictive of the development of delirium were as follows: Palliative Performance Scale ≤20, Eastern Cooperative Oncology Group Performance Status (ECOG PS) = 4, the Support Team Assessment Schedule (STAS) score of drowsiness >1, concurrent opioid use, parenteral hydration volume ≤500 mL, and the absence of lung metastasis. A multivariable analysis identified the independent factors predicting responses as ECOG PS = 4 (odds ratio [OR] 4.0; 95% CI 1.7-9.3), STAS score of drowsiness >1 (OR 3.4; 95% CI 1.4-8.2), and concurrent opioid use (OR 3.7; 95% CI 1.0-13). Conclusion: Delirium in corticosteroid-treated advanced cancer patients may be predicted by PS, drowsiness, and concurrent opioid use. Larger prospective studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]

Purpose: Although corticosteroids are widely used to relieve anorexia, information regarding the factors predicting responses to corticosteroids remains limited. The purpose of the study is to identify potential factors predicting responses to corticosteroids for anorexia in advanced cancer patients.Methods: Inclusion criteria for this multicenter prospective observational study were patients who had metastatic or locally advanced cancer and had an anorexia intensity score of 4 or more on a 0-10 Numerical Rating Scale (NRS). Univariate and multivariate analyses were conducted to identify the factors predicting ≥2-point reduction in NRS on day 3.Results: Among 180 patients who received corticosteroids, 99 (55 %; 95 % confidence interval [CI], 47-62 %) had a response with ≥2-point reduction. Factors that significantly predicted responses were Palliative Performance Scale (PPS) > 40 and absence of drowsiness. In addition, factors that tended to be associated with ≥2-point reduction in NRS included PS 0-3, absence of diabetes mellitus, absence of peripheral edema, presence of lung metastasis, absence of peritoneal metastasis, baseline anorexia NRS of >6, presence of pain, and presence of constipation. A multivariate analysis showed that the independent factors predicting responses were PPS of >40 (odds ratio = 2.7 [95 % CI = 1.4-5.2]), absence of drowsiness (2.6 [1.3-5.0]), and baseline NRS of >6 (2.4 [1.1-4.8]).Conclusions: Treatment responses to corticosteroids for anorexia may be predicted by PPS, drowsiness, and baseline symptom intensity. Larger prospective studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]

Context: Although corticosteroids are widely used to relieve cancer-related fatigue (CRF), information regarding the factors predicting responses to corticosteroids remains limited.Objectives: The aim of this study was to identify potential factors predicting responses to corticosteroids for CRF in advanced cancer patients.Methods: Inclusion criteria for this multicenter, prospective, observational study were patients who had metastatic or locally advanced cancer and had a fatigue intensity score of 4 or more on a 0-10 Numerical Rating Scale (NRS). Univariate and multivariate analyses were conducted to identify the factors predicting two-point reduction or more in NRS on day 3.Results: Among 179 patients who received corticosteroids, 86 (48%; 95% CI 41%-56%) had a response with two-point reduction or more. Factors that significantly predicted responses were performance status score of 3 or more, Palliative Performance Scale score more than 40, absence of ascites, absence of drowsiness, absence of depression, serum albumin level greater than 3 mg/dL, serum sodium level greater than 135 mEq/L, and baseline NRS score greater than 5. A multivariate analysis showed that the independent factors predicting responses were baseline NRS score greater than 5 (odds ratio [OR] 6.6, 95% CI 2.8-15.4), Palliative Performance Scale score more than 40 (OR 4.4, 95% CI 2.1-9.3), absence of drowsiness (OR 3.4, 95% CI 1.7-6.9), absence of ascites (OR 2.3, 95% CI 1.1-4.7), and absence of pleural effusion (OR 2.2, 95% CI 1.0-5.0).Conclusion: Treatment responses to corticosteroids for CRF may be predicted by baseline symptom intensity, performance status, drowsiness, and severity of fluid retention symptoms. Larger prospective studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has demanded a change in learning modalities, which led us to develop a remote personal training system for clinicians performing neuroendovascular procedures. A portable vascular model designed for practicing catheter navigation guidance, thrombus retrieval, and intracranial aneurysm coil embolisation was established. We created an environment that enabled interactive dialogue and communication across long distances using the Internet. The instructor conducted approximately 2 h of hands-on training with two to four trainees at a time. Despite the restrictions enforced by the Government of Japan due to the COVID-19 pandemic, 17 online hands-on training were successfully conducted throughout Japan over 1 year for a total of 48 trainees. The developed remote training programme, to avoid the aggregation of a large number of trainees at a developed time, proved to be at par with the conventional learning system. The training was well-received since the operation time was longer and the question and answer sessions were more fulfilling compared to the conventional format in which a group of trainees had got a brief opportunity to receive actual hands-on experience. [ABSTRACT FROM AUTHOR]

Hands-on training is a crucial part of education in neuroendovascular treatment to ensure safe and rapid acquisition of techniques. However, there is a significant gap between training and actual clinical practice. This study will introduce innovations for more practical thrombus retrieval training that was developed in this process. A Smart Vascular Model 3 in 1 was used. A pink pseudothrombus was inserted into the M1 (horizontal segment of the middle cerebral artery) section of the model. Then, a "red underlay" purchased at a stationery store was placed to cover the proximal part of M1 and beyond so that the pseudothrombus was not visible. The thrombus was retrieved during training by looking for the location of the thrombus based on the behavior and resistance of the tip of the guidewire and deployment of the stent retriever. The participants were required to have detailed observation skills and precise manipulation skills using a red film to prevent the direct visualization of the pseudothrombus. The implementation of this innovation to the previous hands-on training made the training more practical and effective. If the exact thrombus location can be determined by the behavior of the wire tip, the device's capabilities can be maximized, and rapid retrieval can be expected. It could also reduce complications, as unnecessary peripheral guidance of the device could be avoided. [ABSTRACT FROM AUTHOR]

Complete and secure occlusion of the entire aneurysmal neck remains a problem despite major advances in the treatment of intracranial aneurysms using endovascular coil embolization. Here, we present our initial clinical experience using a novel strategy for endovascular coil embolization involving a microcatheter tip, known as the "Γ (gamma) tip method," and compare the in vitro results of this technique with those of conventional straight microcatheters. The microcatheters were bent at a right angle starting 1–2 mm from the length of the tip using a catheter-shaping mandrel and a hot air gun. The tiny right-angled tip is the "Γ tip." In aneurysm models, we assessed the efficacy of shaping during coil deployment. The Γ-tipped microcatheters demonstrated better movement and oscillation during insertion of the coil into the aneurysm compared with the straight-tipped catheters. Moreover, the Γ-tipped microcatheter provided less coil protrusion into the parent artery and less microcatheter kickback compared with the straight tip. With the Γ-tipped microcatheter, even if the first coil loop migrated into the parent artery, its subsequent dynamic movement routed it back into the aneurysm. The Γ tip method enabled smooth movement of the microcatheter into the aneurysm, demonstrating the safety and security of coil insertion using the Γ tip compared with the conventional straight tip. [ABSTRACT FROM AUTHOR]

Objective We noticed that the X-ray absorption value of the tip of each microcatheter used for aneurysm treatment varied from product to product. We hypothesized that the differences were caused by variations in the metal's density braid, which could be related to the ability of the tip to retain its shape. Methods The X-ray absorption value of each microcatheter tip was measured. Next, heat forming was performed using a shaping mandrel at 6 mm and 90 degrees to determine whether there was a correlation between the X-ray absorption value and the forming angle. Next, the optimal mandrel angle for forming each microcatheter at 90 degrees was investigated. We also examined the shape retention after 20 times wire insertions into each microcatheter. Conclusion It was found that the higher the X-ray absorption value, the harder it was for the microcatheter to be formed. The mandrel angle required to form 90 degrees was determined by the X-ray absorption value. The higher the X-ray absorption value, the higher the shape retention of the tip shape. The heat formation and shape-retention conditions of the microcatheter tip were correlated with the X-ray absorption value of the metal braid. Even for unknown microcatheters, the optimum shaping conditions can be inferred from the X-ray absorption value. [ABSTRACT FROM AUTHOR]

Objectives: Various endovascular approaches have been reported for patients with intracranial aneurysms. However, the safety of navigating a microcatheter into the aneurysm remains debatable. In this study, we evaluated a novel method "dunk shot technique," in which a proximal balloon and a local balloon are used for navigation of a microcatheter into an aneurysm under challenging situations. Materials and Methods: We have reported two cases of unruptured internal carotid artery–superior hypothalamic artery aneurysm. An 8-F balloon-attached catheter was used as the guiding catheter. A local balloon catheter for neck remodeling and a microcatheter for coil insertion were navigated around the aneurysmal neck region. When it seemed difficult to navigate a microcatheter into an aneurysm, both the guiding balloon and a local balloon catheter were used for assistance. After inflation of the guiding balloon, the local balloon was inflated partially to negotiate the tip of the microcatheter. Results: The uncontrollable tip of the microcatheter could be intentionally moved by the local balloon. Conclusions: We evaluated the effectiveness of the balloon-assisted technique for the navigation of a microcatheter in cases with challenging anatomy. A little bit of direct effect to the tip of the microcatheter by a local balloon could produce effective outcomes under the proximal flow arrest. [ABSTRACT FROM AUTHOR]

Background and purpose In our previous study, we established the utility of 8-F balloon guide catheters for anterior circulation aneurysms. This study aims to assess the efficacy of the proximal flow control method using 8-F balloon guide catheters for coil deployment into the aneurysms as a novel adjunctive technique for aneurysmal coil embolisation along with local balloon neck remodeling, stent assist and double catheter techniques. Materials and methods We retrospectively analysed patients who underwent endovascular coiling of anterior circulation aneurysms between August 2013 and December 2017. Results Of 206 patients enrolled in this study, the balloon of the guiding catheter was inflated to assist coil deployment in 43 patients (20.9%). In addition, the proximal flow control method found utility in cases with small aneurysms and relatively narrow-necked internal carotid artery. We observed no intraprocedural complications in this study. Conclusion This technique enabled secure coil deployment without navigating another microcatheter or balloon catheter around the aneurysms. [ABSTRACT FROM AUTHOR]

Fear memory extinction has several characteristic behavioral features, such as spontaneous recovery, renewal, and reinstatement, suggesting that extinction training does not erase the original association between the conditioned stimulus (CS) and the unconditioned stimulus (US). However, it is unclear whether reactivation of the original physical record of memory (i.e., memory trace) is sufficient to produce conditioned fear response after extinction. Here, we performed pharmacogenetic neuronal activation using transgenic mice expressing hM3Dq DREADD (designer receptor exclusively activated by designer drug) under the control of the activity-dependent c-fos gene promoter. Neuronal ensembles activated during fear-conditioned learning were tagged with hM3Dq and subsequently reactivated after extinction training. The mice exhibited significant freezing, even when the fear memory was no longer triggered by external CS, indicating that the artificial reactivation of a specific neuronal ensemble was sufficient to evoke the extinguished fear response. This freezing was not observed in non-fear-conditioned mice expressing hM3dq in the same brain areas. These results directly demonstrated that at least part of the original fear memory trace remains after extinction, and such residual plasticity might reflect the persistent memory. [ABSTRACT FROM AUTHOR]

The combination of a flow reversal with two balloons and a filter protection device is one of the safest methods that can be used during carotid artery stenting (CAS). Although major adverse events did not occur under restrict protection, we experienced a case of in-filter thrombus during the procedure. A 68-year-old male presented with temporary right hemiparesis. The radiological examinations revealed 95% stenosis on the origin of the left internal carotid artery (ICA). The patient underwent left CAS of wherein a proximal common carotid artery balloon, an external carotid artery balloon, and a distal ICA filter, with continuous flow reversal to the femoral vein, were used. Although the reversal circulation was established, a massive newly developing thrombus was found in the proximal side of the filter. After an additional systemic heparinization, the thrombus disappeared. The procedure was performed without any complications. Physicians should be aware of the risk of developing intraprocedural thrombosis in a filter protection device. Because the filter protection device is designed for the antegrade flow, it may promote the development of thrombus against the retrograde flow. Thus, the filter protection device should be retrieved first under the flow reversal circumstance to avoid the distal migration of a clot around the filter device. [ABSTRACT FROM AUTHOR]

A method of guiding an intermediate catheter from a new alpha-type guiding catheter placed in the ascending aorta to the carotid artery is evaluated in neuroendovascular treatment in challenging anatomic directions of the guiding catheter, such as the bovine aortic arch and type III aortic arch. The existing 8-Fr guiding catheter was given a strong bending shape at the tip to make it an alpha type. The total length of the catheter was 85 cm. This guiding catheter was inserted into the ascending aorta to verify whether a 6-Fr intermediate or aspiration catheter could be coaxially guided into the right and left internal carotid arteries. A silicone vascular model was used for evaluation and in actual clinical cases. Creating an alpha shape of the catheter at the aortic arch was very easy. The inner catheter could be easily guided from the brachiocephalic artery to the right common carotid artery by pushing the alpha shape guiding catheter toward the aortic valve. The catheter was easily guided into the left common carotid artery when the α-guide was pulled a little bit backward. The 0.071-inch lumen aspiration catheter reached the bilateral middle cerebral arteries. The 8-Fr alpha shape guiding catheter quickly guides the inner catheter into the bovine and the type III aortic arch by looking up from the ascending aorta. [ABSTRACT FROM AUTHOR]

Neuroendovascular catheterization using fluoroscopy poses the problem to operators and staffs of cumulative radiation exposure. To solve this problem, we are developing a remote-controlled master-slave robot. Because a wire-like elongated treatment device is inserted into a blood vessel using a catheter, the robot requires a sensor to detect the insertion force of the wire. The proposed sensor is integrated into a robot installed in an X-ray fluoroscopy room that is remotely controlled from another room. The features of this sensor include measurement of the insertion force with sufficient accuracy, simple wire attachment, and an inexpensive disposable sensor head, rendering it very suitable for practical application. In this paper, we report on these features, as well as the results of a practical test of the sensor using a cerebrovascular model. [ABSTRACT FROM AUTHOR]

Variegatic acid is inhibitor of β-hexosaminidase release and TNF-α secretion from RBL-2H3 cells, the inhibitory mechanism involved inhibition of PKCβ. • Anti-inflammatory effect of variegatic acid was studied in RBL-2H3 cells. • Inhibitory effects were observable after the increase of intracellular Ca2+ ion. • It suppressed degranulation & inflammatory cytokine secretion via PKCβ1 inhibition. • Variegatic acid could be a possible candidate for new anti-allergic agent. Variegatic acid, isolated from Tylopilus ballouii dry fruiting bodies, is an inhibitor of β-hexosaminidase release and tumor necrosis factor (TNF)-α secretion from rat basophilic leukemia (RBL-2H3) cells, with IC 50 values of 10.4 μM and 16.8 μM, respectively. On the other hand, it inhibits PKCβ1 activity with an IC 50 value of 36.2 μM. [ABSTRACT FROM AUTHOR]

Purpose: Parenteral morphine is widely used for dyspnea of imminently dying cancer patients, but the outcomes to expect over time remain largely unknown. We examined outcomes after the administration of parenteral morphine infusion over 48 h in cancer patients with a poor performance status.Methods: This was a multicenter prospective observational study. Inclusion criteria were metastatic/locally advanced cancer, ECOG performance status = 3-4, a dyspnea intensity ≥ 2 on a Support Team Assessment Schedule, Japanese version (STAS-J), and receiving specialized palliative care. After initiating parenteral morphine infusion, we measured dyspnea STAS-J as well as Memorial Delirium Assessment Scale (MDAS), item 9, and Communication Capacity Scale (CCS), item 4, every 6 h over 48 h.Results: We enrolled 167 patients (median survival = 4 days). The mean age was 70 years, 80 patients (48%) had lung cancer, and 109 (65%) had lung metastases. The mean STAS-J scores decreased from 3.1 (95% confidence interval (CI) = 3.0-3.2) at the baseline to 2.1 (95%CI = 1.9-2.2) at 6 h, and remained 1.6-1.8 over 12-48 h. The proportion of patients with dyspnea relief (STAS-J ≤ 1) increased to 39% at 6 h, and ranged between 49 and 61% over 12-48 h. In contrast, up to 6.6 and 20% of patients showed hyperactive delirium (MDAS item 9 ≥ 2) and an inability to communicate (CCS item 4 = 3), respectively, over 48 h.Conclusions: Overall, terminal dyspnea was relatively well controlled with parenteral morphine, though a significant number of patients continued to suffer from dyspnea. Future efforts are needed to improve outcomes following standardized dyspnea treatment using patient-reported outcomes for imminently dying patients. [ABSTRACT FROM AUTHOR]

When endovascular clot retrievals are performed using a stent retriever and/or an aspiration catheter, identifying the accurate position of a clot is extremely important for a successful immediate recanalization. Herein, we report a new technique called microcatheter withdrawing angiography, which facilitates the identification of the precise position of a clot. The negative shadow appearance of the clot on angiography was referred to as the actual crab claw sign. When a 0.027-inch microcatheter penetrated the clot after inserting a 0.014-inch microwire, selective angiography was conducted using the microcatheter. Simultaneously, the microcatheter was slowly withdrawn with continuous contrast media injection, while the microwire was kept in the distal vessel. The precise position of the clot was found, which was referred to as the actual crab claw sign. Next, we conducted in vitro and in vivo analyses. The actual crab claw sign could be identified in the vascular model and in actual clinical settings. Therefore the sweet spot of the stent retriever could be set over the clot, and an accurate contact aspiration could be performed using an aspirator. Microcatheter withdrawing angiography can help identify the actual crab claw sign. This technique has a higher success rate and faster recanalization than conventional strategy, particularly in challenging cases of unsuccessful recanalization during the first attempt. [ABSTRACT FROM AUTHOR]

Mechanical thrombectomy has been widely used for the treatment of acute ischemic stroke. During this procedure, operators must navigate the microcatheter with a microguidewire (MGW) into vessels that cannot be visualized on fluoroscopy as rapidly as possible. In this study, we developed a modified pigtail-shaped MGW (MPMGW) for security and controllability. Moreover, the efficacy of the MPMGW for the treatment of acute ischemic stroke was assessed. The MPMGW was designed using 0.014 MGW. Because we created four MPMGWs during a clinical evaluation before the launch in the market, these wires were used in four consecutive patients with acute ischemic stroke in the single institution. The occluded arteries were the basilar artery (n = 1), middle cerebral arteries (M1 and M2, n = 2), and internal carotid artery (n = 1). All four procedures were conducted without any complications. The procedures included navigating the MGW and passing it through the clot. Complete recanalization was achieved in all cases. The average time between femoral artery puncture and recanalization was 15 min. The use of the preshaped MPMGW in acute thrombectomy was effective in terms of both security of procedure and reduction in recanalization time. [ABSTRACT FROM AUTHOR]

Background: Tumor fever and infection are common febrile etiologies among advanced cancer patients. To date, only few studies have been conducted to differentiate between tumor fever and infections. Objective: This study aimed to identify discriminating factors that provide rapid results and are feasible and minimally invasive for discriminating between tumor fever and infection in advanced cancer patients. Methods: This is a retrospective cohort study. Advanced cancer patients with clinically diagnosed tumor fever or infection, who received medical treatment from palliative care specialists in 10 nationwide Japanese hospitals, were consecutively identified during August 2012 and November 2014. The symptoms, physical findings, blood test results at baseline and during fever, imaging findings, and sociodemographic factors of these patients were retrospectively extracted. Results: Thirty-three patients with tumor fever and 72 patients with infection were identified. Their mean age was 68.8 years, 68 (64.8%) were men, and the median palliative performance status (PPS) was 50. Statistically significant factors predicting tumor fever by logistic regression analysis were as follows: deterioration of PPS (odds ratio, 0.078), shaking chills during fever (0.067), and change from baseline data of neutrophil/lymphocyte ratio of ≥5 (0.14). Conclusions: Shaking chills during fever, and changes from baseline of performance status and white blood cell differentiation can be useful to differentiate between tumor fever and infection among advanced cancer patients. Further confirmatory studies are needed. [ABSTRACT FROM AUTHOR]

Background: When inserting coils under stent deployment, a jailed microcatheter technique is typically applied as a first line approach. However, the trans cell approach might be required to achieve satisfactory complete occlusion. The trans cell approach occasionally ends in failure because the catheter cannot safely follow a proceeding guidewire into the aneurysm. Here, we report the new wireless trans cell approach (WTA), which allows feasible and safe catheter navigation through the stent strut into the aneurysm, without a proceeding guidewire. Methods: A straight tip microcatheter was used, and the tip was shaped as a very small bend of approximately 45°. The side aspect of the catheter tip exhibited a right angled edge, while the front aspect showed a round curve in the advancing direction. We compared the 45° microcatheter with a straight tip microcatheter using a silicon vascular model and then applied the WTA in a case of an unruptured basilar apex aneurysm. Results: Catheter navigation through the stent strut was smoother with the WTA than the conventional wire assisted approach. Our case of a basilar apex aneurysm was successfully treated with the dual catheter technique, which involved a jailed catheter and navigation using the WTA. After stent deployment from the right posterior cerebral artery to the basilar artery through the 45° microcatheter, the WTA was applied using the same catheter. No stress was detected during catheter navigation through the stent strut into the aneurysm. Conclusions: The WTA is associated with smoother catheter navigation compared with the conventional wire assisted approach in cases of a terminal type aneurysm. [ABSTRACT FROM AUTHOR]

Background: Gastrointestinal symptoms, including nausea, vomiting, bowel obstruction, ascites, constipation, and anorexia, are common and often refractory in advanced cancer patients. The palliation of gastrointestinal symptoms is important in improving the quality of life of cancer patients, as well as that of their families and caregivers. Currently published clinical guidelines for the management of gastrointestinal symptoms in cancer patients do not comprehensively cover the topics or are not based on a formal process for the development of clinical guidelines. Methods: The Japanese Society for Palliative Medicine (JSPM) developed comprehensive clinical guidelines for the management of gastrointestinal symptoms in cancer patients after a formal guideline development process. Results: This article summarizes the recommendations along with their rationale and a short summary of the development process of the JSPM gastrointestinal symptom management guidelines. We established 31 recommendations, all of which are based on the best available evidence and agreement of expert taskforce members. Discussion: Future clinical studies and continuous guideline updates are required to improve gastrointestinal symptom management in cancer patients. [ABSTRACT FROM AUTHOR]

Persistent primitive trigeminal artery (PPTA) is the most common type of fetal carotid-basilar persisting communication in adulthood; however, carotid-cavernous fistulas (CCFs) associated with PPTA are rare. An 84-year-old woman presented with traumatic CCF associated with PPTA manifesting as vascular bruit. Transarterial embolization was performed. Although a detachable coil was deployed at the fistula point, it was easy to migrate into the cavernous sinus because of the high-flow shunt. Therefore, a stent was deployed in the PPTA, and the inner lumen of the stent with a focus on the fistula point was occluded by using coils. Subsequently, the CCF completely disappeared. In-stent coil embolization was effective and reasonable for the high-flow CCF associated with the PPTA. This method reduced the number of coils required and operating time. However, careful preservation of perforators is needed. [ABSTRACT FROM AUTHOR]

Robotic technology is rapidly developing in the medical field, particularly contributing to support operative intervention using the da Vinci system during endoscopic surgery. Neuroendovascular intervention robot surgery is preferred when aiming to reduce radiation exposure among surgeons. We developed a prototype of a support robot with 2 independent slaves manipulating both the microcatheter and microguidewire connected with the remote master driver with 2 joysticks. This design simulates usual catheterization with both hands. The slave manipulator has a sufficient output force >1 N to reproduce the exact master intervention without slip and delay. This machine has a unique function that indicates the reaction force of the resistance on wire stuck using the sensor system. We investigated the master-slave response, reliability of the force gauge, and degree of slippage of the slave motion on the table and checked the controllability, safety, and reproducibility of microcatheterization and insertion maneuver into the experimental aneurysm in the in vivo silicone vessel model. We realized the well master-slave response with a stable driving speed of the microguidewire at approximately 1 mm/s and with linear correlation between the output voltage and driving force. Also, we confirmed the well safety function to avoid the overloading to the vascular wall with the slippage of the slave roller on loading >1 N pushing force. Successful microcatheterization and insertion into the aneurysm model was performed in the wet vascular model corresponding to the 3-dimensional handling without excessive stress to the vascular or aneurysmal wall. Neuroendovascular intervention requires delicate power adjustment with fine finger control. Our support robot for neuroendovascular interventions demonstrated the accurate reproducibility of the operator's maneuver and safe operation in the vascular model using the sensor system. This system will realize the neurointervention without human operators in the AngioSuite and may facilitate telesurgery with remote control in the near future. [ABSTRACT FROM AUTHOR]

A 75-year-old man presented with right-sided hemiplegia and was diagnosed with a left middle cerebral artery occlusion. He underwent endovascular thrombectomy, and a bulge was found. A modified pigtail-shaped microguidewire (MPMGW) proved useful for diagnosis because it allowed differentiation between the occluded artery and a saccular aneurysm as the etiology. When a clot was partially retrieved, a previously unidentified vessel dilatation appeared. The dilatation origin was unclear and could have resulted from either the occluded artery or an unruptured saccular aneurysm. We tried to navigate the MPMGW into the bulging area. The patient showed unusual body movement attributed to pain and the dilatation was diagnosed as an aneurysm. Subsequent 3-dimensional angiography revealed a recanalized artery and the aneurysm. With no subarachnoid hemorrhage or extravasation of the contrast medium. The hemiplegia dramatically improved. An MPMGW may be useful in acute thrombectomy where the target vessel cannot be visualized during the procedure. [ABSTRACT FROM AUTHOR]

Lumbar cerebrospinal fluid drainage has been widely performed in patients at the bedside; however, technical failure can occasionally occur as a result of blind maneuvering. Herein, we present the use of rotational fluoroscopic unit-guided lumbar drainage for patients with an unsuccessful initial attempt at bedside. In four of the 24 patients with aneurysmal subarachnoid hemorrhage, initial lumbar drainage could not be performed at bedside. Thus, a three-dimensional rotational technology guided by a high-quality fluoroscopic unit was used. After a cone-beam computed tomography scan was performed, an accurate puncture point and a target thecal sac were identified using the software. The fluoroscopic unit helped us to identify the puncture point and trajectory with a laser pointer on the patient. A needle was inserted along the tract until the cerebrospinal fluid was collected. The lumbar drainage tube was successfully inserted with a single puncture in all four patients. Rotational fluoroscopic technology helps to identify a suitable puncture point, trajectory and target site for lumbar spinal drainage. Our technique is considerably useful in an era wherein minimally invasive procedures are preferred. [ABSTRACT FROM AUTHOR]

Background Sinus pericranii (SP) is a rare abnormal connection between the intracranial and extracranial venous drainage pathways through the osseous channels. Herein we present the case of a patient with growing SP, which was successfully treated using endovascular transvenous embolization through external compression with a plastic cup for preventing glue migration into subcutaneous veins. Case Description A 9-month-old boy presented with a gradually growing mass on the midline cranial vertex after his birth, for which transvenous embolization was performed. A microcatheter was successfully navigated into the SP from the superior sagittal sinus. Because the subcutaneous drainages were confirmed to be multidirectional, we compressed the drainages through the skin using a plastic cup during the glue injection step for preventing glue migration. Subsequently, the SP was completely obliterated. The postoperative course was uneventful. Conclusions Manual compression using a plastic cup was useful not only for embolization but also for reducing the physician's exposure to radiation as compared with that in the finger compression method. When a direct puncture is required, a plastic cylinder can also be used. [ABSTRACT FROM AUTHOR]

Background Ehlers-Danlos syndrome (EDS) is a rare genetic connective tissue disorders, but the vascular type (type IV) typically poses the greatest risk to patients. We report a case of multiple cranial artery dissection, which was successfully treated with carotid artery stenting. Case Description A 50-year-old woman presented with recurrent severe headaches caused by bilateral vertebral artery dissections that were treated conservatively at our hospital. However, she developed right cervical pain and dizziness at 3 days after admission, and a magnetic resonance angiogram revealed dissection of the right internal carotid artery. Because the dissected portion of the artery had narrowed, a stent was placed. The pearl and string formations in the bilateral vertebral arteries then improved spontaneously. Subsequently, the patient was diagnosed with EDS type IV via a skin biopsy, and review of her family history revealed that multiple family members had suffered from subarachnoid hemorrhages. No neurologic deficits were observed, and the patient was discharged without further events at 30 days after admission. Conclusions It is extremely rare for multiple artery dissections to occur at the same time. EDS type IV should be considered as an important differential diagnosis in similar cases, even in adult patients without a known history of connective tissue disease or vascular complications. Highlights • We report a case of multiple cranial artery dissection associated with Ehlers-Danlos syndrome type IV. • Our case led us to consider whether there is an active period of dissecting arteries in patients with EDS type IV. • We hypothesize that patients might become stabilized after the acute, active period of a couple of weeks has passed. [ABSTRACT FROM AUTHOR]

Background Stent retrievers (SRs) can be used to perform mechanical thrombectomy for the treatment of acute major arterial occlusion. Recanalization is faster, and outcomes are better with treatment involving these devices than with internal treatment. Although several SRs are available, their clot-capturing abilities are unclear. Therefore in the present study, we numerically evaluated the clot-capturing abilities of SRs in an experimental vascular model. Methods A sham clot (urethane foam) was fixed with sutures at the middle of a vascular model (polyvinyl chloride tube). One end of the tube was connected to a measuring instrument. From the other end, an SR was inserted and deployed over the sham clot. The delivery wire of the stent was then withdrawn at a constant velocity using an automatic withdrawal machine. The maximum frictional force before the stent left the clot was measured. Five stents (Trevo ProVue [2 sizes], Revive, and Solitaire [2 sizes]) and three stent-deployment techniques (standard, push-and-fluff, and wire-push techniques) were evaluated. Results The clot-capturing ability (maximum withdrawing force [N: newton]) was greater for large-diameter stents than for small-diameter stents (mean 0.39 ± 0.11 vs. 0.56 ± 0.18). For Trevo and Revive, the clot-capturing ability was highest with the push and fluff technique (mean 0.43 ± 0.05). For Solitaire, the ability was the highest with the simple wire-push technique (mean 0.705 ± 0.16). Conclusions We successfully numerically evaluated the clot-capturing abilities of SRs. The clot-capturing ability differed among SRs and among stent-deployment techniques. [ABSTRACT FROM AUTHOR]

Background Pial arteriovenous fistulas (PAVFs) are rare vascular malformations, especially in neonates. The purpose of this report is to discuss the treatment strategy and its associated challenges. We present a case of prenatal intracranial PAVF treated by endovascular embolization in the neonatal period. Case Description The patient was born through Cesarean delivery and then treated twice using transarterial embolization with detachable platinum coils and n -butyl cyanoacrylate due to intractable heart failure. Even though angiography findings showed dramatical reduction in the shunt, the patient did not recover from heart failure and died at day 49 after birth. Conclusions Despite current developments in medical technology and therapies, the effective treatment of critical PAVFs still poses a challenge. Therefore, more indications and effective alternative treatments must be discussed. Highlights • We reported a case of prenatal intracranial PAVF treated by endovascular embolization in the neonatal period. • Although angiography showed dramatic reduction in the shunt, the patient died at day 49 after birth. • Despite developments in medical technology and therapies, neonatal PAVFs remain a challenging to treat. [ABSTRACT FROM AUTHOR]

Background Segmental arterial mediolysis is a rare disease characterized by idiopathic noninflammatory vasculopathy involving small to medium arteries. Here, we report a case of ruptured cerebral and abdominal aneurysms, which were successfully treated using emergency endovascular coil embolization. Case Description A 45-year-old male suffered subarachnoid hemorrhage caused by the rupture of the right vertebral artery dissecting aneurysm, which was treated using emergency endovascular coiling. Iatrogenic dissection of the left vertebral artery occurred during the procedure. A stent was placed, and antivasospasm therapy was initiated after operation. Eight days after admission, the patient experienced sudden hypovolemic shock because of an abdominal hemorrhage, which was diagnosed as the rupture of an aneurysm in the accessory middle colic artery and treated with urgent coil embolization. Conclusions It is extremely rare for a subarachnoid and an abdominal hemorrhage to occur simultaneously during hospitalization. Here, owing to the vulnerability of the unaffected vertebral artery during the initial procedure, segmental arterial mediolysis was diagnosed. [ABSTRACT FROM AUTHOR]

Olfactory signals, including the scent of urine, are thought to be processed by specific brain regions, such as the medial amygdala (Me), and regulate sexual behavior in a sex-dependent manner. We aimed to reveal the sex-specific neural circuit from the accessory olfactory bulb (AOB) to Me by using a transgenic mouse. We quantified the long-lasting green fluorescent protein (GFP) expression profile, which was controlled by the c-fos promotor in a sex-dependent manner by the scent of urine. Female urine predominantly activated neurons of the posterodorsal medial amygdala (MePD) in male mice and the posteroventral medial amygdala (MePV) in female mice. Male urine, in contrast, generated the opposite pattern of activation in the Me. Secondary, the selective artificial activation of these circuits was used to examine their specific behavioral function, by using a dual Cre-loxP viral infection. AAV-hSyn-FLEX-hM3Dq-EGFP–the designer receptor exclusively activated by a designer drug–was infused into the AOB after infection with trans-synaptic AAV(DJ)-CMV-mCherry-2A-Cre-TTC into either the MePD or the MePV. Double virus-transfected mice were injected with hM 3 Dq activator and their sexual behavior was monitored. However, selective activation of sex-dependent circuits, i.e., the AOB-MePD or AOB-MePV, did not significantly alter mounting or attack behavior in male mice. There were clear sex differences in the pheromone conveying circuits in the AOB-Me of mice. The sex-dependent functional activation of the Me, however, no effect on behavior. This suggests that a diverse number of nuclei and brain areas are likely to function in concert to successfully facilitate sexual and aggressive behaviors. [ABSTRACT FROM AUTHOR]

Purpose: Although corticosteroids can relieve dyspnea in advanced cancer patients, factors predicting the response remain unknown. We aimed to explore potential factors predicting the response to corticosteroids for dyspnea in advanced cancer patients.Methods: In this preliminary multicenter prospective observational study, we included patients who had metastatic or locally advanced cancer, were receiving specialized palliative care services, and had a dyspnea intensity of ≥3 on a 0-10 Numerical Rating Scale (NRS) (worst during the last 24 h). The primary endpoint was NRS of dyspnea on day 3 after the administration of corticosteroids. Univariate/multivariate analyses were conducted to identify factors predicting ≥1-point reduction in NRS.Results: Of 74 patients who received corticosteroids, 50 (68%) showed ≥1-point reduction in dyspnea NRS. Factors that significantly predicted the response were an age of 70 years or older (82 vs. 53%, p = 0.008), absence of liver metastases (77 vs. 46%, p = 0.001), Palliative Prognostic Index (PPI) ≤ 6 (90 vs. 61%, p = 0.041), presence of pleuritis carcinomatosa with a small collection of pleural effusions (84 vs. 55%, p = 0.011), presence of audible wheezes (94 vs. 60%, p = 0.014), and baseline dyspnea NRS ≥7 (76% vs. 52%, p = 0.041). In a multivariate analysis, factors predicting response included PPI <6 (odds ratio (OR), 36.2; p = 0.021), baseline dyspnea NRS (worst) ≥7 (OR, 6.6; p = 0.036), and absence of liver metastases (OR, 0.19; p = 0.029) or ascites/liver enlargement (OR, 0.13; p = 0.050).Conclusions: The patient characteristics, etiologies of dyspnea, and clinical manifestations may predict responses to corticosteroids for dyspnea. Larger prospective studies are promising to confirm our findings. [ABSTRACT FROM AUTHOR]

Dry-seeded rice cultivation is an effective low-cost cultivation method in Japan, but preventing water leakage from cultivated rice fields remains a challenge. Here we assessed the efficiency of using a vibratory roller in a dry-seeded rice field for preventing water leakage. The tests were conducted at two different soil-water contents ( WC : 32 and 39%) before roller compaction. We measured the acceleration response of the vibrating roller by using a micro-electro mechanical system (MEMS) accelerometer, and we determined the volume of water leakage from the field by using a rapid leakage capacity tester. We analyzed the changes in the soil structure by using a micro-focused X-ray CT scanner. We analyzed all of the resulting data to identify any correlation. We observed that water leakage from the field was sufficiently prevented when prior to roller compaction, soil moisture content was 39%. The shape of the soil pores that could efficiently prevent water leakage was flatter than that of the inefficiently compacted soil. In addition, the total porosity decreased, but the small-sized pore fraction increased. The vibration acceleration of the roller significantly increased with the decrease in the volume of water leakage. Thus, in addition to assessing the efficiency of vibratory rollers in reducing water leakage, our data suggest that it is to some extent possible to estimate the water leakage prevention effect from the acceleration response of a vibrating roller. [ABSTRACT FROM AUTHOR]

Background: Stent clot retrievers can be used to perform mechanical thrombectomies to treat cases of acute major arterial occlusion. This approach is associated with faster recanalization and better outcomes than internal treatments. The function of the stent retrievers is based on a technique known as confront clot scrambling method (CCSM), which usually involves the insertion of two stent retrievers (one from each side) and the simultaneous withdrawal of the retrievers with an equal force. It was determined that a stent used to remove the sham clot possessed a stronger ability for clot retrieval. However, this method involves inherent manipulation bias, and the results may vary due to operator-specific factors. Thus, this approach can be difficult to teach, especially to beginners. Materials and Methods: We evaluated the accuracy of using an equitable automatic withdrawal machine for the CCSM on a model of a sham clot in the middle of a polyvinyl chloride tube. Results: This tool is expected to facilitate thorough and repeated training that is needed to learn the fine maneuvers against invisible vessels associated with actual endovascular clot retrieval, particularly for beginners. [ABSTRACT FROM AUTHOR]

Background: When a shaping mandrel is inserted into the tip of a preshaped microcatheter, the existing curve becomes uncertain because the tip is straightened by the inner mandrel. Therefore, we developed a way to perform microcatheter shaping by means of an external cast, which we named "microcatheter shaping cast." Techniques: A shaping mandrel attached to a microcatheter was used and coiled 4–5 times around a metallic introducer, which was attached using a microguidewire. Then, a stent-like handmade cast was prepared. After the microcatheter tip was inserted into the cast, it was manually bent according to the aneurysmal shape and size. The tip and cast were heated with a hot air gun. We evaluated the relationship between degrees of bending and heating time to achieve appropriate right-angled shaping memory. Conclusions: The presented microcatheter shaping method should be more useful than conventional internal shaping, especially in cases that require an additional microcatheter shaping or reshaping during aneurysmal coil embolization. [ABSTRACT FROM AUTHOR]

Background: Interleukin-6 (IL-6), an inflammatory cytokine, plays important roles in cerebrospinal fluid (CSF) after subarachnoid hemorrhage (SAH). Chemokines are chemoattractant cytokines that regulate trafficking of monocytes/macrophages and lymphocytes to sites of inflammation. However, no studies have been reported regarding the temporal expression of these cytokines in CSF after SAH.Findings: The concentrations of IL-6, monocyte chemoattractant protein-1 (MCP-1), interferon-γ-inducible protein-10 (IP-10), and monokine induced by interferon-γ (MIG) in the CSF of ten patients with SAH were measured using ELISA kits over a period of 14 days. All aneurysms were located in the anterior circulation. CSF samples from patients with unruptured aneurysms were used as controls. The concentration of IL-6 significantly increased during the acute stage of the disease. The concentration of MCP-1 increased from days 1 to 5, peaking on day 3, and decreased thereafter. The concentrations of IP-10 and MIG progressively increased, peaked on day 5, and then gradually decreased. There were strong correlations between the maximum levels of IL-6 and MCP-1 and IP-10 and MIG on day 5. The maximum level of IL-6 was much higher in poor outcome patients than in good outcome patients.Conclusions: The present investigation demonstrated that increases in IL-6 levels may induce the expression of MCP-1 in CSF after SAH, followed by increases in the expression of IP-10 and MIG. Dynamic changes in the levels of these cytokines may induce inflammation and may be closely associated with the development of delayed ischemic neurological deficits after SAH. [ABSTRACT FROM AUTHOR]

Summary Exocrine gland-secreting peptide 1 (ESP1) released into male tear fluids is a male pheromone that stimulates sexually receptive behavior in female mice via the vomeronasal sensory system. ESP1 also induces c-Fos expression in male brain regions distinct from those in females. However, behavior in males following ESP1 exposure has not been examined. In the present study, we show that ESP1, in conjunction with unfamiliar male urine, enhances male aggression via the specific vomeronasal receptor V2Rp5. In addition, male mice that secrete ESP1 but lack V2Rp5 exhibit a lower level of aggressiveness than do mice that express V2Rp5. These results suggest that ESP1 not only acts as a male pheromone in both sexes but also serves as an auto-stimulatory factor that enhances male aggressiveness by self-exposure. Finally, re-activation of ESP1-induced c-Fos-positive neurons by using the designer receptor exclusively activated by designer drug (DREADD) approach resulted in enhancement of sexual and aggressive behaviors in female and male mice, respectively, indicating that sexually dimorphic activation in the brain is a neural basis for the sex-specific behavioral responses to ESP1. [ABSTRACT FROM AUTHOR]

Background: Recently, various examination and intervention techniques using cervical nerve ultrasonography have been developed. The specific shapes of the C7 transverse process and vertebral artery in front of the C7 transverse process have become landmarks.Purpose: To determine the prevalence of anomalies and anomalous vertebral artery entrances at the C7 transverse process.Material and Methods: The records of patients who underwent plain or contrast-enhanced neck or cervical spine computed tomography (CT) were reviewed. The examinations were scored for the anomalous presence of anterior tubercles or cervical ribs as well as vertebral artery entrances in the C7 transverse process. The prevalence of anomalies was compared based on patient sex and age.Results: Evaluating the examinations from 2067 patients (1046 men; 1021 women), 1% of patients exhibited an anomalous presence of anterior tubercles, and 0.3% of patients displayed cervical ribs at the C7 transverse process. The prevalence of anomalies process was significantly higher in men aged less than 40 years than in older men (P < 0.001), whereas the prevalence was not higher in women aged less than 40 years than in older women. The prevalence of vertebral artery entry into the C7 transverse foramen was 0.6%.Conclusion: Although an anomalous vertebral artery entry into the C7 transverse foramen was rare, the prevalence of an anomaly at the C7 transverse process was higher in men aged less than 40 years. Therefore, we recommend performing CT in younger men before cervical nerve ultrasonographic intervention to avoid misinterpretations at the cervical level. [ABSTRACT FROM AUTHOR]

Background The mitotic spindles are among the most successful targets of anti-cancer chemotherapy, and they still hold promise as targets for novel drugs. The anti-mitotic drugs in current clinical use, including taxanes, epothilones, vinca alkaloids, and halichondrins, are all microtubule-targeting agents. Although these drugs are effective for cancer chemotherapy, they have some critical problems; e.g. , neurotoxicity caused by damage to neuronal microtubules, as well as innate or acquired drug resistance. To overcome these problems, a great deal of effort has been expended on development of novel anti-mitotics. Methods We identified novel microtubule-targeting agents with carbazole and benzohydrazide structures: N ′-[(9-ethyl-9 H -carbazol-3-yl)methylene]-2-methylbenzohydrazide (code number HND-007) and its related compounds. We investigated their activities against cancer cells using various methods including cell growth assay, immunofluorescence analysis, cell cycle analysis, tubulin polymerization assay, and tumor inhibition assay in nude mice. Results HND-007 inhibits tubulin polymerization in vitro and blocks microtubule formation and centrosome separation in cancer cells. Consequently, it suppresses the growth of various cancer cell lines, with IC 50 values in the range 1.3–4.6 μM. In addition, HND-007 can inhibit the growth of taxane-resistant cancer cells that overexpress P-glycoprotein. Finally, HND-007 can inhibit HeLa cell tumor growth in nude mice. Conclusions and general significance Taken together, these findings suggest that HND-007 is a promising lead compound for development of novel anti-mitotic, anti-microtubule chemotherapeutic agents. [ABSTRACT FROM AUTHOR]

Nausea and vomiting are among the most common and distressing symptoms in patients with advanced cancer. Olanzapine, an antipsychotic agent, is known to have an affinity for multiple neurotransmitter receptors. Previous studies have reported olanzapine to be efficacious in the treatment of nausea and vomiting. Although it has been administered at a number of facilities, its applicability to treat nausea and vomiting in patients with advanced cancer is poorly understood. We investigated the use of olanzapine for nausea and vomiting in patients with advanced cancer at multiple centers. This retrospective study was carried out at seven palliative care units and three facilities with palliative care teams in Japan from 2013 to 2015. The dosage of olanzapine, treatment duration, and duration from initial use until death were collected from the medical records. One hundred and eight patients met our inclusion criteria. The average dose of olanzapine was 3.6 mg (2.5 mg, n = 61; 5 mg, n = 46; 10 mg, n = 1) and average treatment duration was 18.7 days. The average duration from initial use until death was 39.0 days. There were no differences in the duration of administration until death between olanzapine doses (2.5 and 5 mg). Our results suggest that olanzapine have been used in patients with poor prognoses for nausea and vomiting in patients with advanced cancer. Conducting a prospective trial would further yield promising results. [ABSTRACT FROM AUTHOR]