Search

Megumi Sumizono,1,2 Yushin Yoshizato,1 Ryohei Yamamoto,1 Takaki Imai,1 Akira Tani,2 Kazuki Nakanishi,2 Tomomi Nakakogawa,2 Teruki Matsuoka,2 Ryoma Matsuzaki,2 Takashi Tanaka,3 Harutoshi Sakakima2 1Department of Rehabilitation, Kyushu University of Nursing and Social Welfare, Kumamoto, Japan; 2Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan; 3Department of Rehabilitation, Kumamoto Health Science University, Kumamoto, JapanCorrespondence: Megumi Sumizono, Department of Rehabilitation, Kyushu University of Nursing and Social Welfare, 888 Tominoo, Tamana, Kumamoto, 865-0062, Japan, Tel/Fax +81 968-75-1931, Email sumizono@kyushu-ns.ac.jpPurpose: Pain disrupts the daily and social lives of patients with neuropathic pain. Effective treatment of neuropathic pain is difficult. Pharmacological treatments for neuropathic pain are limited, and 40– 60% of patients do not achieve even partial relief of their pain. This study created a chronic constriction injury (CCI) model in rats to examine the effects of regular exercise on neuropathic pain relief, elucidate the mechanism, and determine the effects of neuropathic pain in the hippocampus.Methods: CCI model rats were randomly divided into exercise (Ex) and no exercise (No-Ex) groups. Normal rats (Normal group) were used as controls. The Ex group exercised on a treadmill at 20 m/min for 30 min, 5 days per week for 5 weeks post-CCI. The 50% pain response threshold was assessed by mechanical stimulation. Using immunohistochemistry, we examined activation of glial cells (microglia and astrocytes) by CCR2 and TRAF6 expression in the spinal cord dorsal horn and DCX and PROX1 expression in the hippocampal dentate gyrus.Results: The 50% pain response threshold was significantly lower in the Ex than in the No-Ex group at 5 weeks post-CCI, indicating pain relief. In the spinal cord dorsal horn, IBA1, CCR2, and TRAF6 expression was markedly lower in the Ex group than in the No-Ex group at 3 weeks post-CCI. IBA1, GFAP, CCR2, and TRAF6 expression was markedly lower in the Ex group than in the No-Ex group at 5 weeks post-CCI. In the hippocampus, DCX, but not PROX1, expression was significantly higher in the Ex group than in the No-Ex group at 3 weeks post-CCI. At 5 weeks post-CCI, both DCX and PROX1 expression was markedly increased in the Ex group compared to the No-Ex group.Conclusion: Our findings suggest that regular exercise can improve the neuropathic pain-induced neurogenic dysfunction in the hippocampal dentate gyrus.Keywords: CCR2, hippocampal dentate gyrus, microglia, neurogenesis, spinal dorsal horn, TRAF6

Tomonori Kurimoto, Yoshiaki Cho, Takashi Matsuoka Department of Pediatrics, Okinawa Prefectural Nanbu Medical Center and Children’s Medical Center, Okinawa, 901-1193, JapanCorrespondence: Tomonori Kurimoto, Okinawa Prefectural Nanbu Medical Center and Children’s Medical Center, 118-1, Shinkawa, Haebaru-cho, Shimajiri-gun, Okinawa, 901-1193, Japan, Tel +81-98-888-0123, Fax +81-98-888-6400, Email maron.n.tomo.o@gmail.comAbstract: Corynebacterium striatum, a common component of the skin and mucosal microbiota of both immunocompetent and immunocompromised individuals, has become an emerging pathogen, colonizing indwelling medical devices and causing infections at multiple sites. A 3-year-old boy with an Ommaya reservoir in the right ventricle and a medical history of grade 3 intraventricular hemorrhage, Hirschsprung disease, catheter-related methicillin-resistant Staphylococcus aureus bacteremia, and congenital central hypoventilation syndrome was hospitalized for Ommaya reservoir infection with C. striatum. He was treated with ampicillin, to which the initial isolate was susceptible. C. striatum may have acquired multiple-drug resistance during the antibiotic treatment due to biofilm production. The Ommaya reservoir was replaced by external ventricular drainage. Cultures of the removed Ommaya reservoir, and cerebrospinal fluid samples grew C. striatum, which was susceptible to meropenem and vancomycin and resistant to other antibiotics. The antibiotic was switched to vancomycin to treat this new multidrug-resistant strain. After 8 days of vancomycin treatment, the cerebrospinal fluid culture obtained by a lumbar puncture was negative for C. striatum. In cases of device-associated infections caused by biofilm-producing bacteria, it is desirable to remove the device as soon as possible.Keywords: coryneform bacterium, biofilm, antibiotic resistant, vancomycin

Yasumasa Otori, Takanori Matsuoka, Miho Kumoi, Eri Tachibana, Chieko Tsujino, Satoshi Matsuda Department of Ophthalmology, National Hospital Organization, Osaka National Hospital, Osaka, JapanCorrespondence: Yasumasa Otori Email otori.yasumasa.fe@mail.hosp.go.jpPurpose: To compare the outcomes of ab interno suture trabeculotomy (AbI-TLO) and ab externo metal trabeculotomy (AbE-TLO) in adult patients with glaucoma aged over 40 years.Patients and Methods: A retrospective chart review was conducted, including adult patients with glaucoma who underwent AbI-TLO or AbE-TLO between January 2015 and June 2019. A single surgeon (YO) performed all the operations. Eighty-one patients (81 eyes) were included in this study. Surgical success was defined as a postoperative intraocular pressure (IOP) of ≤ 18 mmHg and an IOP reduction of ≥ 20% from the preoperative IOP, without requiring additional glaucoma surgery. Success rates were assessed using Kaplan–Meier survival curves and log-rank (Mantel–Cox) tests, while risk factors were analyzed using the Cox proportional hazards model.Results: Forty-nine patients who underwent AbI-TLO and 32 patients who underwent AbE-TLO were studied; the preoperative IOPs were 27.9 ± 7.3 (mean ± standard deviation) mmHg and 25.6 ± 8.1 mmHg in the AbI-TLO and AbE-TLO groups, respectively (p=0.217). The 12-month postoperative IOPs were 15.8 ± 4.0 mmHg and 16.3 ± 4.2 mmHg in the AbI-TLO and AbE-TLO groups, respectively (p=0.724). The surgical success rates at 12 months were 77.6% and 62.5% in the AbI-TLO and AbE-TLO groups, respectively (p=0.144). Postoperative hyphema with level formation and ocular hypertension over 30 mmHg were observed in 22.4% and 26.5% of patients in the AbI-TLO group and 18.8% and 12.5% of those in the AbE-TLO group, respectively. Stepwise multivariate Cox regression analysis showed that a longer axial length was a risk factor for surgical failure (hazard ratio: 2.030; p=0.042).Conclusion: AbI-TLO and AbE-TLO had similar surgical outcomes and postoperative complications. A longer axial length was associated with an insufficient IOP reduction.Keywords: axial length, gonio-assisted transluminal trabeculotomy, intraocular pressure, MIGS, outcomes, trabeculotomy

Hiroshi Fujimoto,1 Teruyuki Matsuoka,1 Yuka Kato,1 Keisuke Shibata,1 Kaeko Nakamura,1 Kei Yamada,2 Jin Narumoto1 1Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; 2Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan Background and objective: Patients with Alzheimer’s disease (AD) are frequently unaware of their cognitive symptoms and medical diagnosis. The term “anosognosia” is used to indicate a general lack of awareness of one’s disease or disorder. The neural substrate underlying anosognosia in AD is unclear. Since anosognosia for memory disturbance might be an initial sign of AD, it is important to determine the neural correlates. This study was designed to investigate the characteristics and neural correlates of anosognosia for memory disturbance in patients with mild AD.Methods: The subjects were 49 patients with mild AD who participated in a retrospective cross-sectional study. None of the patients had been treated with cholinesterase inhibitors, memantine, or psychotropic drugs. All patients underwent magnetic resonance imaging (MRI). Anosognosia for memory disturbance was assessed based on the discrepancy between questionnaire scores of patients and their caregivers. Structural MRI data were analyzed to explore the association between anosognosia and brain atrophy, using a voxel-based approach. Statistical parametric mapping software was used to explore neural correlations. In image analysis, multiple regression analysis was performed to examine the relationship between anosognosia score and regional gray matter volume. Age, years of education, and total intracranial volume were entered as covariates.Results: The anosognosia score for memory disturbance was significantly negatively correlated with gray matter volume in the left superior frontal gyrus.Conclusion: The left superior frontal gyrus was involved in anosognosia for memory disturbance, while the medial temporal lobe, which is usually damaged in mild AD, was not associated with anosognosia. The left superior frontal gyrus might be an important region for anosognosia in mild AD. Keywords: anosognosia, Alzheimer’s disease, MRI, superior frontal gyrus

Yuka Kato,1 Jin Narumoto,1 Teruyuki Matsuoka,1 Aiko Okamura,1 Hiroyuki Koumi,2 Yusuke Kishikawa,3 Shigenori Terashima,4 Kenji Fukui1 1Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; 2Department of Clinical Psychology, Faculty of Social Welfare, Hanazono University, Kyoto, Japan; 3Misatopia Ogura Hospital, Nagano, Japan; 4Graduate School of Psychology, Kansai University, Osaka, Japan Objective: Because of the growing need for quick cognitive screening tests to distinguish Alzheimer’s disease (AD) from mild cognitive impairment (MCI), we compare the diagnostic performance of a combination of the Mini-Mental State Examination (MMSE) and a Clock Drawing Test (CDT) to the Japanese version of the Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-J cog) in differentiating between patients with AD, patients with MCI, and healthy controls (HC). Methods: Data from 146 subjects with AD and 60 subjects with MCI, as well as 49 HC, was retrospectively analyzed. We used logistic regression analysis with diagnosis as dependent variables and scores of the MMSE, the CDT-command, and the CDT-copy as independent variables, and receiver operating characteristic analysis to distinguish patients with AD from patients with MCI or HC. Results: When patients with AD were compared to HC, the independent predictors of AD were scores on the MMSE and the CDT-command. This combination was more sensitive than the MMSE alone and has nearly the same sensitivity and specificity as the ADAS-J cog. When patients with AD were compared to patients with MCI, the independent predictors were the MMSE and the CDT-copy. This combination was more sensitive and specific than the MMSE alone and was almost as sensitive and specific as the ADAS-J cog. Conclusion: The combination of the MMSE and the CDT could be a powerful screening tool for differentiating between patients with AD, patients with MCI, and HC. Its sensitivity and specificity are comparable to ADAS-J cog, which takes more time. Keywords: diagnostic techniques, Alzheimer’s disease, mild cognitive impairment, Clock Drawing Test, Mini-Mental State Examination

Shogo Taniguchi,1 Jin Narumoto,1 Keisuke Shibata,1 Nobutaka Ayani,1 Teruyuki Matsuoka,1 Aiko Okamura,1 Kaeko Nakamura,1 Hiroshi Shimizu,2 Kenji Fukui11Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; 2Umibeno-mori Hospital, Kochi, JapanBackground: Japan has become the world's most aged country. The percentage of elderly people in Japan is estimated to reach 25.2% in 2013, and the number of patients with dementia is estimated to reach 2.5 million in 2015. In addition to its deterioration of physical function and activities of daily living (ADL), behavioral and psychological symptoms of dementia (BPSD) often become major clinical problems, greatly annoying patients and their caregivers. In Japan, we utilize wards for elderly patients with dementia (WEDs) for BPSD treatment. However, there are few studies investigating the effectiveness of treatment in a WED. In such treatment, physical complications are a challenge physicians must overcome while treating BPSD and safely returning patients home or to the institutions in which they live. Therefore, we investigated the effectiveness of treatment in a WED, focusing on physical complications.Methods: The subjects were 88 patients who were admitted to and discharged from a WED. Severity of dementia, basic ADL, and BPSD were investigated using the Clinical Dementia Rating, Physical Self-Maintenance Scale (PSMS), and Neuropsychiatric Inventory. Differences in characteristics between patients discharged from the WED because of physical complications and all other patients were also examined.Results: We found significant improvements in the PSMS score and decreases in delusions and sleep disturbances in all patients. Patients discharged from the WED because of physical complications had significantly greater severity of dementia at discharge compared to all other patients.Conclusion: Treatment in a WED seems to be effective for BPSD and ADL, but care should be taken regarding physical complications, especially in patients with advanced dementia.Keywords: aged country, behavioral and psychological symptoms of dementia, physical complications, activities of daily living

The phase transition temperature in a (K, Na)NbO3 (KNN) phase of a KNN-based composite lead-free piezoelectric ceramic with a KTiNbO5 system ((K1-xNax)0.86Ca0.04Li0.02Nb0.85O3-δ-K0.85 Ti0.85Nb1.15O5-BaZrO3-Co3O4-Fe2O3-ZnO) is lower than that in an undoped KNN ceramic by approximately 200 °C. We have studied the structural changes around the phase transition by using synchrotron powder X-ray diffraction and transmission electron microscopy. The crystal system of the main KNN phase is assigned to tetragonal as a stable structure at room temperature and does not change to orthorhombic on lowering the temperature all at once. The crystal structure changes from tetragonal to orthorhombic through the successive transition state. The curve of the phase transition temperature from x = 0.33 to 0.75 has a V shape and reaches its lowest value of approximately 0 °C in the vicinity of x = 0.56. From selected-area electron diffraction patterns of the KNN phase, weak superlattice spots owing to the tilt-ordered NbO6 octahedra are observed for x ≥ 0.56. This tilt-ordered NbO6 octahedral phase is formed at the nanometer-scale (nanodomains) in the tetragonal and orthorhombic KNN matrices, regardless of the phase transition. The minimum x to generate the nanodomains is substantially equal to the Na fraction at which the starting temperature of the successive phase transition shifts to the lowest. [ABSTRACT FROM AUTHOR]

Author(s): R. Kodama (corresponding author) [1]; Y. Sentoku [2]; Z. L. Chen [1]; G. R. Kumar [1, 8]; S. P. Hatchett [3]; Y. Toyama [1]; T. E. Cowan [2]; R. [...]

We present an indirect method of estimating the strength of a shock wave, allowing on line monitoring of its reproducibility in each laser shot. This method is based on a shot-to-shot measurement of the X-ray emission from the ablated plasma by a high resolution, spatially resolved focusing spectrometer. An optical pump laser with energy of 1.0 J and pulse duration of ∼660 ps was used to irradiate solid targets or foils with various thicknesses containing Oxygen, Aluminum, Iron, and Tantalum. The high sensitivity and resolving power of the X-ray spectrometer allowed spectra to be obtained on each laser shot and to control fluctuations of the spectral intensity emitted by different plasmas with an accuracy of ∼2%, implying an accuracy in the derived electron plasma temperature of 5%-10% in pump-probe high energy density science experiments. At nano- and sub-nanosecond duration of laser pulse with relatively low laser intensities and ratio Z/A∼0.5, the electron temperature follows Te∼Ilas2/3. Thus, measurements of the electron plasma temperature allow indirect estimation of the laser flux on the target and control its shot-to-shot fluctuation. Knowing the laser flux intensity and its fluctuation gives us the possibility of monitoring shot-to-shot reproducibility of shock wave strength generation with high accuracy. [ABSTRACT FROM AUTHOR]