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Objective: A survey was implemented for early assessment of pandemic-related practice processes and quality improvement (QI)., Background: In response to the public health measures in Hawaii to curtail the coronavirus 2019 pandemic, Hawaii Pacific Neuroscience (HPN) adapted their patient care to ensure continuity of neurological treatment., Methods: The telephone survey was conducted on patients seen at HPN during the period of April 22, 2020-May 18, 2020 to address four areas related to patients' outpatient experience: delivery of care, general well-being, experience with telemedicine, and disease-specific questions., Results: A total of 928 patients were contacted of which 429 (46.2%) patients responded and 367 (85.5%) agreed to participate. A total of 133 patients with migraine and 234 patients with other neurological conditions provided responses. Our migraine patients' survey responses suggest that their well-being was disproportionately negatively affected by the pandemic. Survey respondents with migraine were significantly more likely than their non-migraine peers to report worsening anxiety and sleep problems [62/132 (47.0%) vs. 78/234 (33.3%), χ 2  = 6.64, p = 0.010, and 64/132 (48.5%) vs. 73/234 (31.2%), χ 2  = 10.77, p = 0.001]; migraine patients also reported worsening of depression as a result of the pandemic more than patients with other diagnoses, though this was not statistically significant [44/132 (33.3%) vs. 57/234 (24.4%), χ 2  = 3.40, p = 0.065]. In regard to access to healthcare, significantly more migraine patients reported running out of medications than those with other diagnoses [20/133 (15.0%) vs. 18/234 (7.7%), χ 2  = 4.93, p = 0.026]. More avoided seeking medical help for new health problems because of the pandemic [30/133 (22.6%) vs. 30/234 (12.8%), χ 2  = 5.88, p = 0.015]. Migraine patients were also significantly impacted economically by the pandemic; 43/132 (32.4%) of migraine patients reported losing their jobs as the result of the pandemic versus 34/234 (14.5%) of their peers (χ 2  = 11.20, p < 0.001). An increase in headache severity or frequency was reported in 39/118 (33.1%) of respondents and 19/118 (16.1%) reported to using more abortive therapy than usual. Telemedicine was well received by almost all patients who took advantage of the option. Most of those patients found telemedicine to be easy to use and as valuable as an in-person visit. Migraine patients indicated with more frequency that without the telemedicine option, they would have missed their medical appointments [37/68 (54.4%) vs. 56/144 (38.6%), χ 2  = 4.31, p = 0.038]; a majority would prefer or consider telemedicine for future appointments over in-person visits., Conclusions: Insights gained from this QI survey to the practice's new pandemic-related processes include stressing lifestyle modification, optimizing treatment plans, and continuing the option of telemedicine., (© 2020 American Headache Society.)

Background: Esophageal injury following catheter ablation of atrial fibrillation (AF) is reported to occur in 35% of patients. Even with a low energy setting (20-25 W), lesions develop in 10% of patients. Body mass index (BMI) has been reported to be a predictor of esophageal injury, indicating that patients with a low BMI (<24.9 kg/m(2)) are at a higher risk. We hypothesized that catheter ablation with a lower energy setting of 20 W controlled by esophageal temperature monitoring (ETM) at 39 °C could prevent esophageal injury even in patients with a BMI <24.9 kg/m(2)., Methods: Twenty patients with AF were included (age, 63±8 years; BMI, 22.9±1.3 kg/m(2), left atrium diameter, 44±11 mm). If the esophageal temperature probe registered a temperature of >39 °C, radiofrequency (RF) application was stopped immediately. RF application could be performed in a "point by point" manner for a maximum of 20 s. Endoscopy was performed 1-5 days after ablation., Results: Esophageal mucosal injury was not observed in any patient in the study., Conclusions: Catheter ablation using ETM reduced the incidence of esophageal injuries, even in patients with a low BMI.

A large amount of secretory immunoglobulin A (S-IgA) is secreted in the alimentary tract of mammals. It has been reported that S-IgA coats a portion of commensal intestinal bacteria in human and mouse. However, S-IgA-coated bacteria have not been studied in pigs and calves. In this study, we evaluated the distribution of S-IgA-coated commensal intestinal bacteria in each portion of the gastrointestinal tracts of pigs and calves. Immunoglobulin G (IgG)-coated bacteria were also analyzed because a considerable amount of IgG is secreted in the gastrointestinal tracts of pigs, and in particular, calves. S-IgA- or IgG-coated bacteria were detected in all the segments of the gastrointestinal tracts of pigs and calves. The proportion of S-IgA-coated bacteria to total bacteria (i.e. S-IgA coating ratio) varied in the segments of the gastrointestinal tract in pigs, whereas those of calves were nearly the same throughout the gastrointestinal tract. The S-IgA and IgG coating ratios were higher in pigs than in calves for all segments of the gastrointestinal tract., (© 2012 The Authors. Animal Science Journal © 2012 Japanese Society of Animal Science.)

The C-terminal octapeptide of cholecystokinin (CCK8) includes some easily oxidizable amino acids. The oxidation of CCK8 by reactive oxygen species (ROS) such as hydrogen peroxide (H(2)O(2)) and hydroxyl radicals (OH(*)) was investigated using reversed-phase high performance liquid chromatography (RP-HPLC) and subsequent electrospray ionization mass spectrometry. The mechanism of oxidation of CCK8 in the H(2)O(2) system differed from that of CCK8 in the Fenton system, in which OH(*) are produced. In the H(2)O(2) system, (28)Met and (31)Met were oxidized to methionine sulfoxide, and no further oxidation or degradation/hydrolysis occurred. On the other hand, in the Fenton system, (28)Met and (31)Met residues were oxidized to methionine sulfone via the formation of methionine sulfoxide. In addition, the oxidized product was observed at the Trp residue but not at the Tyr residue, and small peptide fragments from CCK8 were observed in the Fenton system. From these results, it was concluded that (28)Met and (31)Met residues of CCK8 are susceptible to oxidation by ROS., ((c) 2009 John Wiley & Sons, Ltd.)

The recent discovery of the DMY gene (DM domain gene on Y chromosome and one of the DMRT1 family genes) as a key determinant of male development in the medaka (Oryzias latipes) has led to its designation as the prime candidate gene for sex-determination in this species. This study focused on the sites and pattern of expression of DMY and DMRT1 genes during gonadal differentiation of medaka to further determine their roles in testis development. DMY mRNA and protein are expressed specifically in the somatic cells surrounding primordial germ cells (PGCs) in the early gonadal primordium, before morphological sex differences are seen. However, somatic cells surrounding PGCs never express DMY during the early migratory period. Expression of DMY persists in Sertoli cell lineage cells, from PGC-supporting cells to Sertoli cells, indicating that only DMY-positive cells enclose PGCs during mitotic arrest after hatching. DMRT1 is expressed in spermatogonium-supporting cells after testicular differentiation (20-30 days after hatching), and its expression is much higher than that of DMY in mature testes. In XX sex-reversed testes, DMRT1 is expressed in the Sertoli cell lineage, similar to the expression of DMY in XY testes. These results suggest strongly that DMY regulates PGC proliferation and differentiation sex-specifically during early gonadal differentiation of XY individuals and that DMRT1 regulates spermatogonial differentiation., ((c) 2004 Wiley-Liss, Inc.)

The release of gamma-aminobutyric acid (GABA) and acetylcholine (ACh) from the strips of guinea-pig ileum was investigated in the presence of neurotensin. Neurotensin evoked the release of [3H]-GABA from the strips preloaded with [3H]-GABA, and the evoked release was Ca2+-dependent and tetrodotoxin-sensitive. Hexamethonium, scopolamine, [D-Pro2,D-Trp7,9] substance P and pretreatment with substance P did not alter the neurotensin-evoked release of [3H]-GABA. Pretreatment with neurotensin inhibited the release of [3H]-GABA evoked by neurotensin but not by high K+, thereby indicating that neurotensin induced a specific desensitization of its own receptor. These observations indicate that neurotensin may stimulate the GABAergic neurone through its own receptor. Neurotensin evoked the release of [3H]-ACh from strips preloaded with [3H]-choline and this release was Ca2+-dependent and tetrodotoxin-sensitive. The evoked release of [3H]-ACh was not affected by hexamethonium, scopolamine and [D-Pro2,D-Trp7,9] substance P. Bicuculline partly inhibited the neurotensin-evoked release of [3H]-ACh; thus neurotensin seems to induce a release of ACh partly through the release of endogenous GABA. All this evidence indicates that neurotensin induces release of GABA as well as ACh from the myenteric neurones of the guinea-pig ileum.