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Problem: The effect of chronic endometritis (CE) on the subpopulation of CD4 + T cells, Th1, Th2, Th17, and regulatory T cells in the endometrium is unknown., Method of Study: Lymphocytes were isolated from the endometrium of CE patients (n = 12) and non-CE patients (n = 7). The CD4 + T-cell profile was analyzed by flow cytometry and immunofluorescence., Results: In the endometrium of CE patients, there were significantly more Th1 cells among CD4 + cells and fewer Th2 cells in comparison to non-CE patients. No marked difference was observed in Th17 cells or Foxp3 + Treg cells. Moreover, the proportion of Th1 cells increased and the proportion of Th2 cells decreased as the number of CD138 + cells increased. Furthermore, when the localization of CD138 + cells and CD4 + cells was examined, CD4 + cells were found to be clustered around CD138 + cells in CE patients., Conclusion: The CD4 + T-cell profile in the endometrium is altered in women with CE. This finding may help to clarify the pathophysiology and development of treatment methods for CE., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Appropriate goal-oriented treatment strategies are important for optimal treatment outcomes and may prevent under-treatment. As treatment goals vary by patient, a study to examine treatment goals is more meaningful when patients and their physicians are paired. There has not been any study that examines alignment between paired psoriasis patients and physicians in real-world clinical practice using skin clearance as a treatment goal indicator., Objectives: To evaluate treatment goal alignment between psoriasis patients and their paired physicians, and to quantitatively identify factors associated with goal misalignment., Methods: The study was a nationwide multicenter cross-sectional observational study. Subjects were physician-reported moderate-to-severe psoriasis patients with a history of systemic treatments, directly paired with their treating physicians. Subjects completed surveys independently. Treatment goals included seven categories, and patient-physician pairs were grouped as 'aligned' or 'misaligned' when the answers were the same or different, respectively., Results: A total of 425 pairs (mean response rate, 94.7%) of responses were collected from 54 sites (64.8% general practitioners or clinics; 35.2% university or large hospitals). Treatment goal misalignment was found in 67.9% of the patient-physician pairs. The misalignment was mainly 'patient predominant' (60.9%) indicating that patients had higher goals ('complete clearance') than physicians. In the multivariate logistic regression analyses, patients' treatment expectation for 'complete clearance' [odds ratio (OR): 1.927; 95% confidential interval (CI): 1.232-3.016] and physician rating of 'level of understanding on treatment options' being low (OR: 1.552, 95% CI; 1.082-2.227) were significant factors for treatment goal misalignment., Conclusions: The majority of treatment goal misalignment was found between paired psoriasis patients and their treating physicians in Japan. The most important contributing factors to misalignment were patients' treatment expectation for 'complete clearance' and physicians' rating of their patients' 'level of understanding on treatment options' being low., (© 2017 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.)

Perampanel [2-(2-oxo-1-phenyl-5-pyridin-2-yl-1,2-dihydropyridin-3-yl)benzonitrile; E2007] is a potent, selective, orally active non-competitive AMPA receptor antagonist developed for the treatment of epilepsy. Perampanel has a 2,3'-bipyridin-6'-one core structure, distinguishing it chemically from other AMPA receptor antagonist classes. Studies in various physiological systems indicate that perampanel selectively inhibits AMPA receptor-mediated synaptic excitation without affecting NMDA receptor responses. Blocking of AMPA receptors occurs at an allosteric site that is distinct from the glutamate recognition site. Radioligand-binding studies suggest that the blocking site coincides with that of the non-competitive antagonist GYKI 52466, believed to be on linker peptide segments of AMPA receptor subunits that transduce agonist binding into channel opening. As is typical for AMPA receptor antagonists, perampanel exhibits broad-spectrum antiseizure activity in diverse animal seizure models. Perampanel has high oral bioavailability, dose-proportional kinetics, and undergoes oxidative metabolism, primarily via CYP3A4, followed by glucuronidation. The terminal half-life (t½ ) in humans is 105 h; however, in the presence of a strong CYP3A4 inducer (such as carbamazepine), the t½ can be reduced. In sum, perampanel is a selective, centrally acting, negative allosteric modulator of AMPA receptors with good oral bioavailability and favorable pharmacokinetic properties., (© 2013 John Wiley & Sons A/S.)

1. To clarify the mechanism of the cardioprotective effect of nicorandil (2-nicotinamidoethyl-nitrate ester), the effects of nicorandil and nitric oxide (NO) donors on the release of ATP, ADP, AMP and adenosine from arterial segments and cultured endothelial cells of the porcine coronary artery were examined. 2. Nicorandil significantly increased the release of total adenyl purines from arterial segments and from cultured endothelial cells. 3. Cromakalim, an ATP-sensitive K+ channel opener, did not affect the release of total adenyl purines from coronary artery segments. 4. s-Nitroso-N-acetyl-D,L-penicillamine and isosorbide dinitrate, NO donors, significantly increased the release of total adenyl purines from coronary artery segments. 5. These results demonstrate that nicorandil stimulates ATP release from the coronary artery by acting not as an ATP-sensitive K+ channel opener, but as a nitrate, thus suggesting the cardioprotective properties of nicorandil.

We evaluated the apnea index (AI), the oxygen saturation above 95% (SA95), the lowest oxygen saturation (LSAT), and snoring before and after laser-assisted uvulopalatoplasty (LAUP) in 106 patients with obstructive sleep apnea syndrome (n=59) or snoring (n=47). Type 1 LAUP was performed in 42 patients and type 2 LAUP in 64 patients. A 50% or greater reduction in AI was observed in 15 patients (35.7%) who underwent type 1 LAUP and 37 patients (57.8%) who underwent type 2 LAUP. Snoring was diminished in 18 (51.4%) of 35 patients who underwent type 1 LAUP and 30 (55.6%) of 54 patients who underwent type 2 LAUP. SA95 and LSAT showed no difference. No serious complications such as significant bleeding, postoperative episodes of asphyxia, nasopharyngeal stenosis, or nasal regurgitation were observed. LAUP was an effective outpatient treatment.

We report a child with hereditary spherocytosis who developed human parvovirus B19 (HPV B19)-induced transient pancytopenia. Symptoms of acute-phase illness subsided promptly after infusion of gammaglobulin containing HPV B19 antibody. The HPV B19-containing serum on admission inhibited not only erythroid colony growth but also myeloid and megakaryocyte colony growths. The inhibitory effect was abrogated by convalescent-phase serum or gammaglobulin solution containing HPV B19 antibody. These findings suggest that HPV B19-induced inhibition of haematopoiesis may be pathogenetic for transient bone marrow failure of the patient. The passive immunization may be effective in shortening the duration of acute-phase illness of HPV B19 infection.

T cell-mediated inhibition of autologous erythroid colony formation was found in two patients with aplastic anaemia. Each patient was treated separately with ALG and methylprednisolone. Peripheral blood T cells were cryopreserved serially during the course of the disease. The inhibitory activity of T cells was assayed after remission using autologous bone marrow. The inhibitory activity of T cells was lost following the treatment and preceded haematopoietic recovery.

T cell-mediated inhibition of autologous late erythroid colony formation was found in two patients with PRCA. Each patient was treated separately with immunosuppressive agents, ALG, bolus methylprednisolone or cyclophosphamide. Cyclophosphamide was the most effective among these immunosuppressive therapies. Peripheral blood T cells, which were taken serially from the patients during the course of the disease, were cryopreserved until use. The inhibitory activity of T cells was assayed after remission using autologous bone marrow. It was found that the decrease of inhibitory activity was closely correlated with clinical improvement and that the effectiveness of the immunosuppressive therapy on inhibitory activities of T cells differed between therapies. These findings suggest that T cell-mediated inhibition of erythropoiesis may be pathogenetic for PRCA in some patients.

Two patients with aplastic anaemia were treated with immunosuppressive agents and peripheral blood T cells were cryopreserved serially. Inhibitory activity of T cells to autologous CFU-E, gamma-IFN production by T cells and T cell subpopulations were assayed after remission. Inhibitory activity to autologous CFU-E was not correlated with the numbers or ratios of T cell subpopulations. gamma-IFN production by T cells were within the normal range when inhibitory activity was found. In addition, gamma-IFN production increased after haematopoietic recovery. These findings suggest that gamma-IFN is not a soluble mediator of T cell-mediated haematopoietic inhibition in aplastic anaemia.