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Background: Evidence-based medicine education has not focused on how clinicians involve patients in decision-making. Although shared decision-making (SDM) has been investigated to address this issue, there are insufficient data on SDM in physiotherapy. This study aimed to clarify the issues concerning patient involvement in Japan, and to examine whether SDM is related to perceptions of patient involvement in decision-making. Methods: The study participants were recruited from among acute and sub-acute inpatients and community residents receiving physiotherapy outpatient care, day care, and/or home rehabilitation. The Control Preference Scale (CPS) was used to measure the patients' involvement in decision-making. The nine-item Shared Decision-Making Questionnaire (SDM-Q-9) was used to measure SDM. In analysis I, we calculated the weighted kappa coefficient to examine the congruence in the CPS between the patients' actual and preferred roles. In analysis II, we conducted a logistic regression analysis using two models to examine the factors of patient involvement. Results: Analysis I included 277 patients. The patients' actual roles were as follows: most active (4.0%), active (10.8%), collaborative (24.6%), passive (35.0%), and most passive (25.6%). Their preferred roles were: most active (3.3%), active (18.4%), collaborative (39.4%), passive (24.5%), and most passive (14.4%). The congruence between actual and preferred roles by the kappa coefficient was 0.38. Analysis II included 218 patients. The factors for patient involvement were the clinical environment, the patient's preferred role, and the SDM-Q-9 score. Conclusions: The patients in Japan indicated a low level of decision-making involvement in physiotherapy. The patients wanted more active involvement than that required in the actual decision-making methods. The physiotherapist's practice of SDM was revealed as one of the factors related to perceptions of patient involvement in decision-making. Our results demonstrated the importance of using SDM for patient involvement in physiotherapy. [ABSTRACT FROM AUTHOR]

For unknow reasons, the melanocyte stem cell (McSC) system fails earlier than other adult stem cell populations1, which leads to hair greying in most humans and mice2,3. Current dogma states that McSCs are reserved in an undifferentiated state in the hair follicle niche, physically segregated from differentiated progeny that migrate away following cues of regenerative stimuli4–8. Here we show that most McSCs toggle between transit-amplifying and stem cell states for both self-renewal and generation of mature progeny, a mechanism fundamentally distinct from those of other self-renewing systems. Live imaging and single-cell RNA sequencing revealed that McSCs are mobile, translocating between hair follicle stem cell and transit-amplifying compartments where they reversibly enter distinct differentiation states governed by local microenvironmental cues (for example, WNT). Long-term lineage tracing demonstrated that the McSC system is maintained by reverted McSCs rather than by reserved stem cells inherently exempt from reversible changes. During ageing, there is accumulation of stranded McSCs that do not contribute to the regeneration of melanocyte progeny. These results identify a new model whereby dedifferentiation is integral to homeostatic stem cell maintenance and suggest that modulating McSC mobility may represent a new approach for the prevention of hair greying.Local microenvironmental cues modulate melanocyte stem cells, which control hair pigmentation, to enter different differentiation states, shifting between hair follicle stem cell and transit-amplifying compartments, a process that is different to other self-renewing systems. [ABSTRACT FROM AUTHOR]

Melanogenesis is a major part of the environmental responses and tissue development of the integumentary system. The balance between reduction and oxidation (redox) governs pigmentary responses, for which coordination among epidermal resident cells is indispensable. Here, we review the current understanding of melanocyte biology with a particular focus on the "master regulator" of oxidative stress responses (i.e., the Kelch-like erythroid cell-derived protein with cap'n'collar homology-associated protein 1-nuclear factor erythroid-2-related factor 2 system) and the autoimmune pigment disorder vitiligo. Our investigation revealed that the former is essential in pigmentogenesis, whereas the latter results from unbalanced redox homeostasis and/or defective intercellular communication in the interfollicular epidermis (IFE). Finally, we propose a model in which keratinocytes provide a "niche" for differentiated melanocytes and may "imprint" IFE pigmentation. [ABSTRACT FROM AUTHOR]

Exercise motivation (EM) is related to individual capabilities and social support. However, in support facilities for people with disabilities, it is susceptible to a lack of social support. In this study, we classified EM into Autonomous Motivation (AM) and controlled motivation (CM) and then examined the influence of social support. Thirty-three residents from a support facility for people with disabilities in Japan participated in this study. We conducted a hierarchical multiple regression analysis in which age, gender and time since admission were entered in Step 1, mobility and self-efficacy as individual capabilities in Step 2, and family support, facility support and peer support as social support in Step 3. A significant increase in variance from Step 2 to Step 3 was found for both AM (ΔR2 = 0.504, ΔF = 12.18, p <.001) and CM (ΔR2 = 0.269, ΔF = 3.491, p =.031). The results also showed that AM was higher among those with high family and facility support, and CM was higher among those with low family and high peer support. Social support was a more significant predictor of EM among participants than individual capabilities. Among residents of support facilities for people with disabilities, assessing not only individual capabilities but also social support status can lead to better understandings of exercise motivation (EM). To enhance facility residents' autonomous motivation (AM), it is necessary to intervene after evaluating family and facility support. When family support is not readily available among facility residents, efforts should be made to encourage residents to interact with each other to increase peer support. [ABSTRACT FROM AUTHOR]

The Kelch-like erythroid cell-derived protein with cap'n'collar homology-associated protein 1 (KEAP1)-nuclear factor erythroid-2-related factor 2 (NRF2) system, a thiol-based sensor-effector apparatus, exerts antioxidative and anti-inflammatory effects and maintains skin homeostasis. Thus, NRF2 activation appears to be a promising treatment option for various skin diseases. However, NRF2-mediated defense responses may deteriorate skin inflammation in a context-dependent manner. Atopic dermatitis (AD) and psoriasis are two common chronic inflammatory skin diseases caused by a defective skin barrier, dysregulated immune responses, genetic predispositions, and environmental factors. This review focuses on the role of the KEAP1-NRF2 system in the pathophysiology of AD and psoriasis and the therapeutic approaches that utilize this system. [ABSTRACT FROM AUTHOR]

We report a case of ruptured abdominal aortic aneurysm complicated with occlusion of bilateral common iliac arteries. A 68-year-old man complained of sudden onset of lower abdominal and back pain. A contrast-enhanced computed tomography showed ruptured abdominal aortic aneurysm of about 80 mm in diameter and a giant retroperitoneal hematoma, as well as occlusion of both common iliac arteries. We performed Y-grafting, concomitant with thrombectomy of both iliac arteries from inside the aneurysm. Postoperative course was uneventful without ischemic findings of the legs and the patient was discharged on the 17th postoperative day. [ABSTRACT FROM AUTHOR]

Keratinization provides tolerance to desiccation and mechanical durability. Loricrin, which is an epidermal thiol-rich protein, efficiently stabilizes terminally differentiated keratinocytes and maintains redox homeostasis. The discovery of the largely asymptomatic loricrin knockout (LKO) phenotype decades ago was rather unpredicted. Nevertheless, when including redox-driven, NF-E2-related factor 2-mediated backup responses, LKO mice provide opportunities for the observation of altered or "quasi-normal" homeostasis. Specifically, given that the tissue structure, as well as the local metabolism, transmits immunological signals, we sought to dissect the consequence of truncated epidermal differentiation program from immunological perspectives. Through a review of the aggregated evidence, we have attempted to generate an integrated view of the regulation of the peripheral immune system, which possibly occurs within the squamous epithelial tissue with truncated differentiation. This synthesis might not only provide insights into keratinization but also lead to the identification of factors intrinsic to the epidermis that imprint the immune effector function. [ABSTRACT FROM AUTHOR]

The article presents KEAP1 and epidermal differentiation. Topics discussed include the stratum corneum (SC) covers the body of terrestrial animals and protects against the entry of pathogens, allergens, and irritants while preventing dehydration; and Epidermal layers exhibit a characteristic gradient of free sulfhydryl groups (–SH groups) allowing for adaptation to such xenobiotic insults.

Introduction: The stratum corneum protects against the entry of pathogens, allergens, and irritants while preventing dehydration. The Kelch-like erythroid cell-derived protein with cap-n-collar homology-associated protein 1 (KEAP1)/NF-E2-related factor 2 (NRF2) system maintains skin barrier homeostasis. Aggregated evidence suggests that NRF2-mediated antioxidative response is hardwired into the stratified squamous epithelia. Honey and chamomile have long been regarded as natural antioxidants. Nonetheless, it is still unclear whether they activate the KEAP1/NRF2 system in the epidermis and could promote epidermal barrier recovery. Methods: To address the abovementioned issue, we explored the antioxidative property of honey/chamomile extract by using non-cell-based KEAP1-inhibition assay and cultured human epidermal keratinocytes. Results: Herein we report that the extract inhibited KEAP1-NRF2 interaction and induced keratinocyte production of antioxidant small proline-rich protein. Conclusion: Our results may offer an opportunity to develop cosmetic products that boost NRF2-mediated antioxidative/antiaging, epidermis-intrinsic bio-responses. [ABSTRACT FROM AUTHOR]

Immune microenvironment controls the outcome of PD-1 blockade in cutaneous immune response The introduction of immune checkpoint inhibitors (ICI) targeting the programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) pathway or cytotoxic T-lymphocyte antigen 4 (CTLA-4) has brought about a revolution in anticancer therapy by embodying the concept that the host's exhausted pre-existing antitumor immunity can be reactivated. In line with the fact that the PD-1/PD-L1 pathway promotes T-cell exhaustion at the periphery and thereby prevents pathological consequences in various mouse models of infection or autoimmune diseases,[2] we have shown the exaggerated allergic response in the skin. [Extracted from the article]

A case study of a 57-year-old Japanese woman with no previous medical history was inoculated with a second dose of the mRNA-1273 Moderna COVID-19 vaccine, and the potential role of COVID-19 vaccines in triggering autoimmune diseases by emphasizing the importance of timely diagnosis and treatment.

Morphea profunda refers to inflammatory and sclerotic lesions that start primarily from the deep dermis, subcutaneous fat and fascia. Its pediatric case published work is limited. Here, we report the case of an 8‐year‐old girl with a 5‐year history of multiple subcutaneous nodules on her extremities and a right wrist joint contracture who had been previously diagnosed with juvenile idiopathic arthritis and treated with salazosulfapyridine, low‐dose prednisolone (PSL) and methotrexate. We performed biopsies of two subcutaneous nodules, which revealed the typical morphology of morphea profunda. She was administrated a tapered course of oral PSL then cyclosporin A (CyA) for 20 weeks which completely resolved her joint contracture and subcutaneous nodules. We reviewed 11 previously reported cases of morphea profunda and found that some include circumscribed/linear morphea that develop into subcutaneous tissues, indicating that "classical" morphea profunda arising within the deep tissues has rarely been reported. Our report is the first to demonstrate the efficacy of CyA for treatment of morphea profunda, and the possibility of CyA as a treatment option to reduce oral steroid doses in juvenile cases. [ABSTRACT FROM AUTHOR]

A 54-year old man suffering from back pain was diagnosed with Stanford type A aortic dissection in our emergency unit. During the preparation of the operating room, he developed coronary ischemia with chest pain and depressed blood pressure accompanied with abnormal electro- and echocardiography findings. He was transported to the catheter laboratory where stent placement into the left main coronary artery was successfully performed. Thereafter, he underwent total arch replacement, during which the stent was removed intentionally without performing coronary artery bypass graft. His postoperative course was uneventful and he is doing well without any ischemic event for 2 years after the surgery. [ABSTRACT FROM AUTHOR]

We demonstrate the generation of ultrabroad bandwidth attosecond continua extending to sub-50-as duration in the extreme ultraviolet (EUV) region based on a 1.6-cycle Ti:sapphire laser pulse. The combination of the amplitude gating scheme with a sub-two-cycle driver pulse and the double optical gating scheme achieves the continuum generation with a bandwidth of 70 eV at the full width at half maximum near the peak photon energy of 140 eV, which supports a Fourier-transform-limited pulse duration as short as 32 as. The carrier-envelope-phase (CEP) dependence of the attosecond continua shows a single-peak structure originating from the half-cycle cut-off at appropriate CEP values, which strongly indicates the generation of a single burst of an isolated attosecond pulse. Our approach suggests a possibility for isolated sub-50-as pulse generation in the EUV region by compensating for the intrinsic attosecond chirp with a Zr filter. [ABSTRACT FROM AUTHOR]

In the operation of a centrifugal compressor of turbocharger, instability phenomena such as rotating stall and surge are induced at a lower flow rate close to the maximum pressure ratio. In this study, the compressed air at the exit of centrifugal compressor was re-circulated and injected to the impeller inlet by using two injection nozzles in order to suppress the surge phenomenon. The most effective circumferential position was examined to reduce the flow rate at the surge inception. Moreover, the influences of the injection on the fluctuating property of the flow field before and after the surge inception were investigated by examining the frequency of static pressure fluctuation on the wall surface and visualizing the compressor wall surface by oil-film visualization technique. [ABSTRACT FROM AUTHOR]

Objective: To investigate the short-term effects of the life goal concept on subjective well-being and treatment engagement, and to determine the sample size required for a larger trial. Design: A quasi-randomized controlled trial that was not blinded. Setting: A subacute rehabilitation ward. Subjects: A total of 66 patients were randomized to a goal-setting intervention group with the life goal concept (Life Goal), a standard rehabilitation group with no goal-setting intervention (Control 1), or a goal-setting intervention group without the life goal concept (Control 2). Interventions: The goal-setting intervention in the Life Goal and Control 2 was Goal Attainment Scaling. The Life Goal patients were assessed in terms of their life goals, and the hierarchy of goals was explained. The intervention duration was four weeks. Main measures: Patients were assessed pre- and post-intervention. The outcome measures were the Hospital Anxiety and Depression Scale, 12-item General Health Questionnaire, Pittsburgh Rehabilitation Participation Scale, and Functional Independence Measure. Results: Of the 296 potential participants, 66 were enrolled; Life Goal (n = 22), Control 1 (n = 22) and Control 2 (n = 22). Anxiety was significantly lower in the Life Goal (4.1 ±3.0) than in Control 1 (6.7 ±3.4), but treatment engagement was significantly higher in the Life Goal (5.3 ±0.4) compared with both the Control 1 (4.8 ±0.6) and Control 2 (4.9 ±0.5). Conclusions: The life goal concept had a short-term effect on treatment engagement. A sample of 31 patients per group would be required for a fully powered clinical trial. [ABSTRACT FROM AUTHOR]

Microfluidic frameworks known as micro-total-analysis-systems or lab-on-a-chip have become versatile tools in cell biology research, since functional biochips are able to streamline dynamic observations of various cells. Glass or polymers are generally used as the substrate due to their high transparency, chemical stability and cost-effectiveness. However, these materials are not well suited for the microscopic observation of cell migration at the fluid boundary due to the refractive index mismatch between the medium and the biochip material. For this reason, we have developed a new method of fabricating three-dimensional (3D) microfluidic chips made of the low refractive index fluoric polymer CYTOP. This novel fabrication procedure involves the use of a femtosecond laser for direct writing, followed by wet etching with a dilute fluorinated solvent and annealing, to create high-quality 3D microfluidic chips inside a polymer substrate. A microfluidic chip made in this manner enabled us to more clearly observe the flagellum motion of a Dinoflagellate moving in circles near the fluid surface compared to the observations possible using conventional microfluidic chips. We believe that CYTOP microfluidic chips made using this new method may allow more detailed analysis of various cell migrations near solid boundaries. [ABSTRACT FROM AUTHOR]

The article presents Altered nucleocytoplasmic staining patterns of p62/SQSTM1 in cutaneous squamous cell carcinoma precursors. Topics discussed include the autophagy cargo receptor, p62/sequestosome, shuttles between the cytoplasmic and nuclear components of the cell and promotes autophagic degradation of ubiquitinated proteins; and the prognostic value of decreased nuclear p62 expression levels in oSCC was stressed, suggesting that SCC malignant progression.

The article presents a case study of a 47-year-old female patient that presented systemic lupus erythematosus (SLE)-associated skin nodules on her fingers. Topics discussed include the medical history and symptoms reported by the patient, results of the physical examination and blood tests performed, and the prevalence of tophi in SLE patients.

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Objective: In some of drug developments, the amount of bulk drug powder to use in early stages is limited and it is not easy to supply a sufficient drug amount for conventional preparation methods. Therefore, an ultra-small-scale high-shear granulator (less than 5 g) (USG) was developed and applied to small-scale granulation as a pre-formulation. Method: The sample powder consisted of 66.5% lactose, 28.5% microcrystalline cellulose and 5.0% hydroxypropylcellulose. The granules were obtained to agitate 5 g of the sample powder with 1.0 mL of water at 300 rpm for 5 min after pre-powder mixing for 3 min by the USG and the manual hand (HM) methods. Results: The granules were evaluated by the 10% and 90% accumulated particle size and the recoveries of the granules and the powder solid. Median particle size for the USG and the HM methods was 159.2 ± 2.3 and 270.9 ± 14.9 µm, respectively. The USG method had a narrower particle size distribution than those by the HM method. The recovery of the granules by USG was significantly larger than that by the HM method. Conclusion: Characteristics of all of the granules indicated that the USG method could produce higher quality granules within a shorter time than the HM methods. [ABSTRACT FROM AUTHOR]

In order to probe dynamical properties of mesoscopic soft matter systems such as polymers, structured liquid, etc., a new atomic force microscopy apparatus with a wide-band magnetic cantilever excitation system was developed. Constant-current driving of an electromagnet up to 1 MHz was implemented with a closed-loop driver circuit. Transfer function of a commercial cantilever attached with a magnetic particle was measured in a frequency range of 1–1000 kHz in distilled water. Effects of the laser spot position, distribution of the force exerted on the cantilever, and difference in the detection scheme on the obtained transfer function are discussed in comparison with theoretical predictions by other research groups. A preliminary result of viscoelasticity spectrum measurement of a single dextran chain is shown and is compared with a recent theoretical calculation. [ABSTRACT FROM AUTHOR]

From the viewpoint of mitigating global warming by SF6 gas, this paper discusses breakdown (BD) characteristics of different electronegative gas mixtures with N2O gas as SF6 gas substitutes for quasi-uniform electric field under lightning impulse voltage applications. Experimental results revealed the positive synergism in breakdown strength of binary N2O/CO2 and ternary N2O/CO2/O2 gas mixtures, respectively. Furthermore, N2 gas as a retardant gas was also mixed with the electronegative gas mixtures in order to reduce the electron energy into the effective levels of electron attachment ability by the electronegative gas mixtures. As the result, ternary N2O/CO2/N2 and quaternary N2O/CO2/O2/N2 gas mixtures could exhibit the significant synergistic effect in breakdown strength. The optimum mixture rate of quaternary N2O/CO2/O2/N2 gas mixtures was consistent with that estimated by assuming the independent contribution of component gases to the improvement of impulse BD characteristics. [ABSTRACT FROM AUTHOR]

Objective Antegrade selective cerebral perfusion (ASCP) and retrograde cerebral perfusion (RCP) have proven to be reliable methods of brain protection during aortic surgery. These techniques are usually accompanied by systemic circulatory arrest with moderate hypothermia (24–28°C) or deep hypothermia (18–24°C). However, hypothermia can lead to various problems. The present study therefore reports results for thoracic aorta replacement using ASCP with mild hypothermic systemic arrest (28–32°C). Design Between 1995 and 2003, 68 consecutive patients underwent repair of the ascending aorta and/or aortic arch. Mild hypothermic ASCP was utilized in 31 cases, moderate hypothermic ASCP in 20, and deep hypothermic RCP in 17. Various parameters were compared between the mild hypothermic ASCP, moderate hypothermic ASCP, and RCP. Results Hospital mortality was 10.3%, with no significant differences observed between any groups. Permanent neurological dysfunction was 8.8%, and no significant differences were observed between any groups. Mild hypothermic ASCP displayed significantly decreased transfusion volume, intubation time, and ICU stay. Conclusions Use of ASCP with mild hypothermic systemic circulatory arrest during aortic surgery resulted in acceptable hospital mortality and neurological outcomes. ASCP with mild hypothermic arrest allows decreased transfusion volume and reduced duration of intubation and ICU stay. [ABSTRACT FROM AUTHOR]

Seven different restriction fragment length polymorphisms (RFLPs) at the N-acetylgalactosamine-6-sulfate sulfatase (GALNS) locus were analyzed using Southern blotting and polymerase chain reaction based techniques to search for the frequency of each RFLP produced by StyI, SphI, HaeIII, StuI, HapII, XhoI, and BamHI restriction endonucleases, respectively, in 36 mutant alleles, including two sibling cases and 100 normal alleles. Calculation of heterozygosity indexes showed that these RFLPs were polymorphic, ranging from 0.31 to 0.69 in mucopolysaccharidosis IVA (MPS IVA) patients compared with 0.21 to 0.65 in normal individuals. There was some significant difference in several RFLPs and in the combination with four kinds of RFLPs ( SphI, StuI, HapII, XhoI polymorphisms). The normal alleles were composed of 13 different RFLPs haplotypes; the most common among the Japanese population carrying normal alleles was haplotype 8 (bDEF1) (31.3%), the others being dispersed. The same haplotype 8 was the most frequent in the mutant alleles (44.4%), with seven further haplotypes. These findings revealed the striking variety of polymorphic haplotypes in the MPS IVA gene. By using these five kinds of RFLPs, we examined the theoretical informativity of haplotype analysis in heterozygote detection in nine unrelated MPS IVA families and ten unrelated normal families. All the members of the MPS IVA families studied were diagnosed as a patient, carrier, or noncarrier. We propose that prenatal diagnosis or family analysis in cases in which mutations have not been characterized is now feasible. [ABSTRACT FROM AUTHOR]

A postoperative pseudoaneurysm is a rare complication that is difficult to diagnose. Computed tomography (CT) revealed a pseudoaneurysm in the ascending aorta of a 68-year-old female 8 days after mitral valve replacement and tricuspid annuloplasty. The defect was simply repaired during emergency surgery without cardiopulmonary bypass (CPB). The early detection of a postoperative pseudoaneurysm is important to avoid a second operation complicated by adhesions. Enhanced CT was useful for early detection in this patient. Pseudoaneurysm of the ascending aorta at the cannulation site can occur soon after surgery, and early recognition might allow simpler surgery without CPB. [ABSTRACT FROM AUTHOR]

We treated a 77-year-old woman diagnosed with severe aortic stenosis, who had undergone catheter ablation for paroxysmal supraventricular tachycardia at the age of 62. Although the patient remained in sinus rhythm, she had been receiving Coumadin with a target INR level of 2.0 since that time. Preoperative coronary angiography revealed a coronary-left atrium (LA) fistula, while computed tomography and echocardiography findings did not detect thrombus formation. Intra-operative transesophageal echocardiography revealed a 2-cm solid mass, which unexpectedly appeared during deairing manipulation. Prompt cross-clamping and removal of an LA thrombus with closure of the LA appendage contributed to an uneventful postoperative course. The LA should be explored if a coronary-LA fistula is noted, even in non-mitral cases, especially those with a history of catheter ablation. [ABSTRACT FROM AUTHOR]

Keratinization is a tissue adaptation, but aberrant keratinization is associated with skin disorders such as ichthyoses, atopic dermatitis, psoriasis, and acne. The disease phenotype stems from the interaction between genes and the environment; therefore, an understanding of the adaptation machinery may lead to a new appreciation of pathomechanisms. The KEAP1/NRF2 signaling pathway mediates the environmental responses of squamous epithelial tissue. The unpredicted outcome of the Keap1-null mutation in mice allowed us to revisit the basic principle of the biological process of keratinization: sulfur metabolism establishes unparalleled cytoprotection in the body wall of terrestrial mammals. We summarize the recent understanding of the KEAP1/NRF2 signaling pathway, which is a thiol-based sensor-effector apparatus, with particular focuses on epidermal differentiation in the context of the gene-environment interaction, the structure/function principles involved in KEAP1/NRF2 signaling, lessons from mouse models, and their pathological implications. This synthesis may provide insights into keratinization, which provides physical insulation and constitutes an essential innate integumentary defense system. [ABSTRACT FROM AUTHOR]

Objective: Previous studies suggest that endothelin-1 (ET-1) plays a role in myocardial ischemia/reperfusion injury. Although administration of an endothelin receptor antagonist to the recipient has been shown to improve myocardial function after ischemia/reperfusion in a rat heart transplantation model, the effect of administering an endothelin receptor antagonist to the donor has not yet been examined. This study was designed to investigate the effects of pretreating donors with an ET[sub A]/ET[sub B] endothelin receptor antagonist (TAK-044) on myocardial function after cold preservation of a rat heart. Design: Male rats were pretreated with normal saline (control group, n = 8), TAK-044 (TAK group, n = 8, 1 mg/kg). Following cardiac arrest using cardioplegia, we washed out the coronary vascular beds with cold University of Wisconsin solution followed by 6-h preservation. After preservation, the hearts were mounted on a Langendorff apparatus to estimate aortic flow (AF), coronary flow (CF), cardiac output (CO), systolic pressure (SP), heart rate (HR), and rate-pressure product (RPP: HR × SP). The concentration of lactate dehydrogenase (LDH) and creatine phosphokinase (CPK) within the coronary perfusate during reperfusion was measured. Results: AF, SP, and CO were significantly greater in the TAK group than in the control group (p = 0.0045, 0.004, and 0.0295, respectively). Conclusion: Pretreatment of donors with a nonselective endothelin receptor antagonist (TAK-044) improved cardiac functional recovery following preservation and may be beneficial for prolonged myocardial preservation. [ABSTRACT FROM AUTHOR]

We numerically construct stationary and spherically symmetric nontopological soliton solutions in a system composed of a complex scalar field, a U(1) gauge field and a complex Higgs scalar field that causes spontaneous symmetry breaking. It is shown that the charge of the soliton is screened by counter charge everywhere. [ABSTRACT FROM AUTHOR]

Cardiovascular surgery in patients with a retrosternal gastric tube (RGT) remains rare despite improvements in the prognosis of oesophageal cancer. A 75-year old woman with a history of total thoracic oesophagectomy with RGT reconstruction required emergency aortic arch replacement for an acute Stanford type A aortic dissection. We opted for a median sternotomy approach involving complete dissection of the RGT from surrounding tissues and retraction for surgical access to the dissection. Enhanced computed tomography was useful for the diagnosis and planning of the emergency surgery. [ABSTRACT FROM PUBLISHER]

Background: Malignant bowel obstruction affect a patient's quality of life, but, management of MBO is controversial. Case presentation: A 51-year-old woman who had been diagnosed as uterine cervix cancer 2 years ago and had undergone surgery, chemotherapy and radiotherapy, was admitted to our hospital. She was diagnosed as having a recurrence of peritoneal metastasis and bowel obstruction. For her nasal pain, we considered insertion of a postpyloric decompression tube through the gastrostomy instead of via the nasal cavity. After insertion of a percutaneous gastrostomy tube was performed endoscopically, we introduced a postpyloric decompression tube through her gastrostomy. She could be discharged home, and 91 days later, she died in her home under hospice care, as she had wished. Conclusions: Insertion of a postpyloric decompression tube through a gastrostomy might be useful in the management of advanced cancer patients with bowel obstruction [ABSTRACT FROM AUTHOR]