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Background In our prior randomized trial on preventing influenza, asthma attacks as a secondary outcome occurred less often in the vitamin D group than in the placebo group. We aimed to clarify whether low-dose, short-term vitamin D supplementation, in addition to standard treatments, improves control of childhood asthma. Methods We conducted a randomized, double-blind, placebo-controlled trial comparing vitamin D3 supplements (800 IU/day) with placebo for 2 months in schoolchildren with asthma. The primary outcomes were frequency and severity of asthma judging from changes in asthma control levels defined by the Global Initiative for Asthma ( GINA) by collaborating doctors at 2 and 6 months. Results Japanese schoolchildren with asthma ( n = 89) were randomly assigned to receive vitamin D ( n = 54) or placebo ( n = 35). At 2 months, GINA asthma control was significantly more improved in the vitamin D group compared with the placebo group ( P = 0.015). Childhood asthma control test ( CACT) scores, a secondary outcome, were also significantly ( P = 0.004) improved in the vitamin D group compared with the placebo group at 2 months, and differences remained significant ( P = 0.012) at 6 months. The proportion of patients with a peak expiratory flow rate <80% predicted was significantly less in the vitamin D group (8/54: 15%) than in the placebo group (12/35: 34%) at 6 months ( P = 0.032). Conclusions Low-dose, short-term vitamin D supplementation in addition to standard treatment may improve levels of asthma control in schoolchildren. [ABSTRACT FROM AUTHOR]

Purpose: Lewy body disease (LBD) is comprised of a spectrum of diseases that includes Parkinson's disease (PD), PD dementia (PDD) and dementia with LBD (DLBD), an array of dementia, and motor symptoms. Low uptake of myocardial meta-iodobenzylguanidine (MIBG) validates diagnosis of LBD. Psychiatric symptoms sometimes precede atypical Parkinsonian syndromes in LBD. Of 34 patients with low MIBG uptake, late-onset depressive, anxiety, or psychotic symptoms were analyzed in term of clinical profiles. Method: Thirty-four patients were classed into three groups according to three main symptoms, 11 patients with visual hallucination (VH), 13 with depression-anxiety (DA), and 10 with psychosis with cognitive disturbance (PCD). Cutoff values of heart-to-mediastinum (HM) ratio of MIBG were set at 1.78 in early phase or 1.68 in late phase. Results: Group VH patients showed a trend toward higher age at onset and occipital lobe hypoperfusion. Group DA patients lacked central and core features of DLBD and five of them showed frontal lobe hypoperfusion. Group PCD patients had the highest frequencies of suggestive symptoms and UPDRS scores and showed temporal lobe hypoperfusion. HM ratio was not associated with clinical profiles of three groups. Cognitive function was more severely disturbed in atypical Parkinsonian syndrome cases at an initial visit. Conclusion: Group VH was considered to DLBD, and Group PCD was regarded as PDD or DLBD with early psychotic presentation. Group DA has a possibility of early depression or anxiety disorder of LBD although it lacked DLBD criteria. Atypical Parkinsonian syndromes are associated with cognitive disturbance irrespective of psychiatric profiles. [ABSTRACT FROM AUTHOR]

Sato N, Kamata T, Akiyama N, Kuwana M, Kanda T (Tokyo Metropolitan Bokutoh Hospital, Tokyo; Keio University School of Medicine, Tokyo; and Yamaguchi University School of Medicine, Ube; Japan). Acute inflammatory sensorimotor polyradiculoneuropathy associated with immune thrombocytopenic purpura (Case Report).J Intern Med2005;257:473–477.Although acute inflammatory polyneuropathy (AIP) and immune thrombocytopenic purpura (ITP) are both believed to be immune-mediated disorders, only a few cases have been reported in which these two diseases co-existed. We describe a case of a 67-year-old patient who developed quadriparesis, ophthalmoplegia and severe sensory impairment along with thrombocytopenia. Detailed examinations, including the measurement of anti-ganglioside antibodies and anti-glycoprotein-IIb-IIIa-IgG-producing B-cells, revealed that he developed AIP and ITP. By reviewing past similar reports, we noticed that AIP associated with ITP tends to manifest severe sensory impairment and is often preceded by upper respiratory tract infection, but not by gastrointestinal infection. [ABSTRACT FROM AUTHOR]

Although increased protein kinase C (PKC) activity has been invoked in the pathogenesis of diabetic retinopathy, nephropathy and macroangiopathy, the role of PKC in neuropathy remains unclear. We reported that total PKC activity in sciatic nerves of STZ-induced diabetic rats was not altered compared with that of normal rats, and that PKC-β inhibitor, LY-333531 (LY) ameliorated neural dysfunction and reduced endoneurial blood flow without affecting PKC activity, suggesting that this effect of LY would be mediated through its action on endoneurial microvasculature. In this study, effect of LY on diabetic neuropathy was investigated in Otsuka Long-Evans Tokushima fatty (OLETF) rats, an animal model of type 2 diabetes. Three-month-old male OLETF rats and Long-Evans Tokushima Otsuka (LETO) rats as normal control rats were divided into 5 groups as follows: 1) LETO control, 2) OLETF control, 3) LY (1 mg/kg/day)-treated OLETF, 4) sucrose-fed OLETF, and 5) sucrose-fed OLETF treated with LY. After 21-month treatment, motor nerve conduction velocity (MNCV) in tail nerves, sciatic nerve blood flow (SNBF) and protein expression of phosphorylated PKC in sciatic nerves were measured. 1) MNCV: OLETF rats demonstrated a significant delay in MNCV, which was enhanced by sucrose feeding, and these deficits were prevented by LY. 2) SNBF: reduced SNBF in OLETF and sucrose-fed OLETF rats was ameliorated by LY. 3) PKC: phosphorylated PKC expression was decreased in OLETF rats, which was more prominent in sucrose-fed OLETF rats. Treatment with LY increased phosphorylated PKC expression in both groups of OLETF rats. These observations suggest that diabetes with long duration and poor glycemic control decreases phosphorylated PKC in nerve tissues, which would contribute to the development of diabetic neuropathy, and that PKC-β inhibition would be beneficial for the prevention of this neuropathy. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: High negative pressure in the middle ear was thought to be closely related to the etiology of retraction-type cholesteatoma. Recently, it has been detected that mechanical forces are important factors in epithelial turnover and affect cytoskeletal remodeling. Continuous negative pressure in the middle ear may possibly accelerate the proliferation and differentiation of epithelial cells of the tympanic membrane., Study Design: Animal experimental study., Methods: Eleven adult male Sprague-Dawley rats were used, and continuous negative pressure was loaded by connecting a catheter from the rat's middle ear to the supply route of an implantable microinfusion pump, iPRECIO. At 7 days after implantation of the device, an otoendoscopic examination and micro-computed tomography (CT) analysis of the temporal bone were performed; the temporal bones were then collected for histological and immunohistochemical analysis. The degree of proliferation and differentiation of epithelial cells of the tympanic membrane was investigated immunohistochemically using the anti-cytokeratin-5 and anti-cytokeratin-10 antibodies., Results: Otoendoscopic examination revealed retraction of the pars flaccida in all of the ears under negative pressure. In the micro-CT analysis, soft tissue density area in the hypotympanum was observed in all ears under negative pressure. Histological analysis revealed thickened epithelium of the pars flaccida. In this region, the thickness of layers with cytokeratin-5-positive cells and cytokeratin-10-positive cells were increased., Conclusions: Continuous negative pressure in the middle ear can lead to thickening of the epithelium of the pars flaccida, and may accelerate the proliferation and differentiation of epithelial cells., (© 2014 The American Laryngological, Rhinological and Otological Society, Inc.)

Small heat-shock proteins (sHsps) bind and stabilize proteins denatured by heat or other stresses in order to prevent unfavourable protein aggregation. StHsp14.0 is an sHsp found in the acidothermophilic archaeon Sulfolobus tokodaii. A variant of StHsp14.0 was crystallized by the sitting-drop vapour-diffusion method. The crystals diffracted X-rays to 1.85 A resolution and belonged to space group P2(1)2(1)2, with unit-cell parameters a = 40.4, b = 61.1, c = 96.1 A. The V(M) value was estimated to be 2.1 A(3) Da(-1), assuming the presence of two molecules in the asymmetric unit. Heavy-atom derivative crystals were prepared successfully by the cocrystallization method and are isomorphic to native crystals.

Upshaw-Schulman syndrome (USS) is a congenital thrombotic thrombocytopenic purpura (TTP) due to mutations in the gene that encodes for ADAMTS13 (ADAMTS13), but its clinical signs may be mild or absent during childhood. We have identified 37 patients with USS (24 females, 13 males) belonging to 32 families. The nine women from six families who were diagnosed during their first pregnancy are the focus of this report. Six of the nine women had episodes of thrombocytopenia during childhood misdiagnosed as idiopathic thrombocytopenic purpura. Thrombocytopenia occurred during the second-third trimesters in each of their 15 pregnancies, with 16 babies (one twin pregnancy), often followed by TTP. Of 15 pregnancies, eight babies were stillborn or died soon after birth, and the remaining seven were all premature except one, who was born naturally following plasma infusions to the mother that had started at 8 weeks' gestation. All nine USS women had severely deficient ADAMTS13 activity. ADAMTS13 analyses demonstrated that eight women were compound heterozygotes of Y304C/G525D (2 siblings), R125VfsX6/Q1302X (2 siblings), R193W/R349C (2 siblings), I178T/Q929X, and R193W/A606P; one woman was homozygous for R193W. Only the R193W mutation has been previously reported. These observations emphasize the importance of measuring ADAMTS13 activity in the evaluation of thrombocytopenia during childhood and pregnancy.

In the title compound, [Pt(2)(C(5)H(10)NO)(2)(C(12)H(8)N(2))(2)](NO(3))(2)*-2H(2)O, the intradimer Pt-Pt distance is relatively short [2.8489 (17) A], which must be due to the strong intramolecular pi-pi-stacking interactions between the phenanthroline moieties. The dimers stack along the c axis, forming one-dimensional columns in which very intriguing d-d, pi-pi and d-pi interactions exist. Although the dimer-dimer Pt...Pt distances are very long [4.340 (2) and 4.231 (2) A], some short interdimer Pt...C contacts leading to strong interdimer associations are found [3.325 (19) and 3.402 (19) A].

Crystals of Cu(II)(NO(3))(2)(pm)(3) (1), and two crystalline forms of Cu(II)(NO(3))(2)(H(2)O)(2)(pm)(2), (2) and (3), showed ferromagnetic, antiferromagnetic and paramagnetic interactions at extremely low temperatures, respectively. Crystal structure analyses revealed that the complexes were catena-dinitrato[mu-pyrimidine-kappaN(1):kappaN(3)]-(pyrimidine-N(1))copper(II), [Cu(NO(3))(2)(pm)(2)](n), catena-diaquadinitrato[mu-pyrimidine-kappaN(1):kappaN(3)]copper(II), [Cu(NO(3))(2)(H(2)O)(2)(pm)](n), and diaquadinitratodipyrimidinecopper(II), Cu(NO(3))(2)(H(2)O)(2)(pm)(2) for (1), (2) and (3), respectively. In (1) the Cu atom is coordinated by the two nitrates and N atoms of the non-bridging pyrimidine and bridging pyrimidine to form a one-dimensional coordination polymer. The complex is a five-coordinated square pyramid and can be regarded as a pseudo-seven-coordinated complex, since other short non-bonding Cu.O contacts are observed. In the crystals of (2) the pyrimidine bridges the Cu atoms to form a one-dimensional coordination chain. On the other hand, complex (3) is not a coordination polymer. It is important to form a coordination polymer for the appearance of the magnetic interactions. Types of coordination of the bridging organic moieties should also play an important role in magnetic properties. Magnetic measurements of (1) and (2) show that they are good examples of uniform S = 1/2 ferro- and antiferromagnetic Heisenberg chains with exchange parameters 2J/kB = +1.8 and -36 K, respectively.

We reviewed a total of 1,432 patients diagnosed with cutaneous herpes zoster at Hyogo College of Medicine Hospital between 1989 and 1997 for epidemiologic assessment and outcome in patients with zoster paralysis referred for rehabilitation. Of the 1,432 herpes zoster patients (624 males and 808 females, mean age 54.3 years), 12 were referred to our department of rehabilitation medicine for muscle weakness: one had myelitis, and eleven others had lower motor neuron damage. Except for one 43-year-old man with myelodysplastic syndrome, all the lower motor neuron deficit patients were over 60 years of age. Involved myotomes were more widespread than involved dermatomes in eight patients. Electromyography in four patients demonstrated denervation of involved muscles. Five patients experienced complete or near complete recovery from their muscle weakness. The muscle weakness related to herpes zoster was occasionally diagnosed by electromyography as motor neuron damage. Manifestations of motor neuron complications were not noticed but might in fact be more common than was the clinical muscle weakness.