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Background:Substance use disorders (SUDs) impact everything about an individual's life-health, family, employment, education, housing, transportation, and finances. By the time individuals with SUDs begin treatment-especially in publicly funded programs-most have few financial resources. Many have resorted to property crimes, resulting in fines, fees, and restitution costs that compound their financial difficulties. Reestablishing financial functioning is key to recovering from the consequences of addiction. Yet access to cash may also trigger relapses-especially in early recovery. Objective: This paper reports initial results from studies exploring how clients in treatment for SUDs manage their financial responsibilities, assessing their financial capability both in terms of access to financial services and personal financial literacy. Method: Using data collected between June 2017 and October 2019 from almost 5,000 SUD clients as they entered treatment as well as a financial needs assessment study of 70 clients during treatment, we conducted Chi-square testing and logistic regressions to analyze the relationships between client characteristics and financial capability. Results: Our results indicated that over 50% of individuals in addiction treatment did not have access to accounts at insured financial institutions, and that clients' ages and education levels were significantly related to their financial capability. We also found that 78% of clients feel that money management skills are important to their recovery. Conclusions: Many SUD clients in recovery have limited financial capability, and they are interested in developing financial skills. Increasing client financial capability may be an underemphasized, yet important part of recovery capital.

Guillain-Barré syndrome (GBS) typically occurs after gastroenteritis and respiratory tract infection, but surgery has also been considered one of the triggers. Posterior reversible encephalopathy syndrome (PRES) is a rare complication of GBS. A normotensive female in her 70s presented ascending paralysis and frontal-parieto-occipital subcortical lesions with intermittent hypertension after spinal surgery. Nerve conduction studies revealed demyelinating polyneuropathy. The patient’s brain lesions disappeared with amelioration of hypertension. She was diagnosed with the demyelinating form of GBS and PRES caused by intermittent hypertension. Intravenous immunoglobulin G (IVIG) improved her symptoms without exacerbation of the PRES. Surgery can be a trigger of GBS, and GBS can cause PRES by hypertension and present as central nervous lesions. It is important to treat hypertension before using IVIG when PRES is suspected as a complication of GBS, since the encephalopathy can be exacerbated by IVIG. There may be more undiagnosed cases of the coexistence of GBS and PRES after surgery because surgery itself can also cause PRES. Proper control of blood pressure and confirmation of negative central nervous lesions are required to treat GBS patients with IVIG safely.

Change detection is one of the most basic techniques using terrestrial laser scanner and many applications have been studied. High-speed laser scanner has some potential for real-time detec...

Laparoscopic myomectomy may become a cause to increase intraoperative hemorrhage. The purpose of this investigation was to study the relationship between clinical features, MR imaging findings and intraoperative hemorrhage during laparoscopic myomectomy. This study included 126 patients clinically and pathologically diagnosed as uterine leiomyoma between 2010 and 2015. These findings were statistically compared between significant intraoperative hemorrhage group (greater than 300 ml) and nonsignificant intraoperative hemorrhage group (less than 300 ml). Correlation between the maximum diameter of resected leiomyomas and the maximum diameter leiomyomas on MR imaging were also evaluated. Significant hemorrhage group showed larger maximum diameter of resected leiomyoma (p = 0.01), larger maximum diameter of leiomyoma on MR imaging (p = 0.01) and have cellular leiomyomas on MR imaging more frequently (p = 0.03) than nonsignificant intraoperative hemorrhage group. The maximum diameter of resected leiomyomas significantly correlated with that of leiomyomas on MR imaging (Spearman’s rho = 0.797, p

BFE1224, prodrug of ravuconazole, is a novel, once-daily, oral, triazole antifungal drug, and currently in development for the treatment of onychomycosis. The clinical drug-drug interaction (DDI) potential of BFE1224 with cytochrome P450 (CYP) and transporter was assessed by using two types of cocktails in healthy subjects in separate clinical studies. The CYP and transporter cocktails consisted of caffeine/tolbutamide/omeprazole/dextromethorphan/midazolam used in study 1 and digoxin/rosuvastatin used in study 2. In addition, repaglinide was separately administered to the same subjects in study 2. There were no major effects on the pharmacokinetics of CYP and transporter substrates, except for an approximate threefold increase in midazolam exposure after oral administration of BFE1224. The clinical DDIs of BFE1224 were mild for CYP3A and minor for other major CYPs (CYP1A2/2C8/2C9/2C19/2D6) as well as those of P-glycoprotein (P-gp), breast cancer resistance protein (BCRP), organic anion transporting polypeptide (OATP) 1B1, and OATP1B3.

Two-dimensional (2D) layered transition-metal dichalcogenides (LTMDs) display various crystal phases with distinct symmetries, structures, and physical properties. Exploring and designing different structural phases in two dimensions could provide an avenue for switching material properties, aiming at practical applications for potential fields. Here we demonstrate a conceptually designed approach to narrow the band gap of MoSe2 and obtain a conductive red MoSe2 nanosheet. By introducing the high valence state of Mo species and constructing the Mo–O bonding on the surface of the MoSe2 nanosheets, the electronic properties can be modified and the conductivity is accordingly improved, an effect that significantly improves their lithium storage capacity and high-rate capability. We anticipate that the exploration of the conductive red MoSe2 with tunable band gap could help us unlock more potential crystal structures of LTMD-based and even other 2D materials for further applications.

Metformin causes metabolic encephalopathy in some patients with end-stage chronic kidney disease, resulting in impaired consciousness and parkinsonism. This encephalopathy has a very characteristic magnetic resonance imaging feature in lentiform nuclei known as the “lentiform fork sign”. However, the mechanism is unknown. Here, we report a case of metformin-induced encephalopathy with a novel observation of lactate accumulation in the lentiform nuclei on magnetic resonance spectroscopy without systemic lactic acidosis. Since metformin is an inhibitor of mitochondrial complex-I, this focal brain lactate accumulation implies that a part of the pathogenesis of metformin-induced encephalopathy is the focal vulnerability of mitochondria to metformin in the lentiform nuclei. When metformin causes encephalopathy, not only testing for serum lactic acidosis and performing routine magnetic resonance imaging but also evaluation of brain lactate accumulation by magnetic resonance spectroscopy should be required to elucidate the etiology., Graphical abstract Unlabelled Image, Highlights • Metformin-induced encephalopathy with lactate accumulation in lentiform fork sign was reported. • Lentiform nuclei might be more vulnerable to metformin than other organs. • This case suggested an etiology for the lentiform fork sign because metformin is a mitochondrial inhibitor.

An integral photography and deconvolution techniques have been applied to observe plasmas, i.e. continuous translucent luminous objects. We experimentally succeeded in distinguishing the three-dimensional distribution of them from a single-exposure image obtained from one direction.

Background Birth-related femur fractures are rare. They have been reported following difficult delivery and are commonly diagnosed immediately after birth or on the following day. However, some birth-related femur fractures are diagnosed several days after birth. Mechanisms underlying the development of delayed femur fracture are incompletely understood. Case We report the case of a girl diagnosed with a left spiral femur fracture with associated edema and hypoesthesia on postpartum day 9. A nondisplacement femur fracture was identified on plain radiography at birth after cesarean section; however, it was undiagnosed due to the lack of symptoms. She was treated with plaster cast fixation; the physical examination at age 1 was normal. Herein, the diagnosis of birth-related femur fracture according to plain radiography findings suggests that the symptoms related to birth trauma develop several days after birth. Conclusion Birth-related fracture should be considered in all neonatal femur fracture cases and in patients with no symptoms at birth. Neonates delivered in the breech presentation by cesarean section should be carefully monitored after birth. The findings of the present case further our understanding of the pathogenic mechanisms underlying delayed diagnosis of birth-related femur fracture.

Fingolimod, a functional antagonist of sphingosine-1 phosphate receptor, is a disease modifying drug of multiple sclerosis and its remarkable adverse effect is peripheral lymphopenia because the drug retains lymphocyte in the secondary lymphoid tissues. Therefore, in theory, when severe bleedings occurred, the fingolimod-treated patients could not compensate for the loss of lymphocytes induced by bleedings because of the retention in the secondary lymphoid tissues. In addition, because most of the fingolimod is reported to be distributed in the erythrocytes, and the erythrocytes are the main regulator of serum sphingosine-1 phosphate concentration, bleeding may also affect metabolism of fingolimod and prognosis of multiple sclerosis. However, no study had focused the relationship between fingolimod and bleedings in multiple sclerosis. We encountered the first case in which fingolimod-associated lymphopenia worsened synchronously with gynecological bleeding, and was improved by the bleeding prophylaxis, uterine myomectomy. This case had statistically significant positive correlation between the serum hemoglobin level and peripheral lymphocyte count (P = 0.0000000507). We then had three similar cases. In these 4 correlative patients out of the 14 fingolimod-treated patients in our institution, the importance of the bleeding in fingolimod-treated patients was indicated by line graphs, point diagrams, and statistically significant correlation coefficients. Bleeding should be focused on by all of physicians treating multiple sclerosis with fingolimod.

Background and aims Neuraxial anesthesia is preferred to general anesthesia for cesarean section (CS), especially in obese patients. However, it is often technically challenging in these patients, and the uncertainty of the time needed to induce anesthesia is a potential problem. Therefore, in this retrospective study, we examined the relationship between obesity and the time taken to receive subarachnoid injection of local anesthetics after entering the operating room. Methods We reviewed electronic medical records of patients who had undergone CS under neuraxial anesthesia in our hospital between the start of 2010 and the end of June 2018. A total of 795 (49.0%) patients underwent spinal anesthesia while 722 (44.5%) underwent combined spinal-epidural (CSE) anesthesia. The effects of obesity, expressed as body mass index (BMI), on the anesthesia procedure time (AP-time) of neuraxial anesthesia were analyzed in the spinal and CSE anesthesia groups separately. Results The AP-time was longer in obese patients than in non-obese ones in both the spinal and CSE anesthesia groups. This effect was also confirmed, with a weak significant linear correlation, between AP-time and BMI, but the variations within each BMI class were considerably higher (95% confidence interval, 20 min). Conclusions This retrospective study using medical records from a single hospital showed that obesity in pregnancy marginally prolongs the time needed to achieve neuraxial anesthesia. The effect was, however, less than the variation within the same BMI class.

BACKGROUND The Japan Otology Society (JOS) proposed the classification and staging system for middle ear cholesteatoma. However, there was little analysis of the pathology of cholesteatoma using this staging system. AIMS/OBJECTIVES To analyze the pathology of pars flaccida cholesteatoma using the staging system by JOS. MATERIAL AND METHODS A total of 183 cases of fresh pars flaccida cholesteatoma treated between January 2009 and December 2015 were included. We used the staging system recommended by JOS (2015). The association of the following variables in each stage of pars flaccida cholesteatoma was examined: age, gender, preoperative hearing level, staging, statuses of mastoid cell growth and stapes, tympanic sinus invasion. RESULTS Stage II disease showed the highest degree of progression, and peak incidence was observed in the third and fourth decades of life. Stage III significantly increased after the age of 40 years. The progression of the disease stage was significantly associated with deterioration of hearing level. Cholesteatoma invasion to tympanic sinus was recognized in 14.2% of cases. The state of the stapes is increasingly likely be to fracture as stage progresses. CONCLUSIONS The JOS Staging System appropriately reflects the disease state, and it was found to be clinically meaningful in this study.

Recently, some commercially available active-type radon–thoron monitors were developed, however, their performance has not been characterized. This article presents the characteristics of three commercially available active-type radon–thoron monitors (RAD7, Radon Mapper, and AlphaGUARD) at different sampling flow rates. The thoron concentration measured by the monitors was compared with the reference value measured by a grab sampling method. As a result, the ratio of the measured concentration to the reference increased with flow rate for the RAD7 and the Radon Mapper although that of the AlphaGUARD decreased. The difference may be attributed to the coefficients used in the calculation and the measurement time scheme. The results indicate the importance of the sampling flow rate in thoron measurement. Monitoring of flow rate at the measurement and periodic calibration at multiple sampling flow rates should be conducted for quality assurance and quality control of the measurand.

The purpose of this study was to investigate the patterns of bilateral agenesis of maxillary third molars and other tooth agenesis in Japanese orthodontic patients. A group of 262 subjects with bilateral agenesis of maxillary third molars (group A) was divided into three subgroups: group 1A consisting of 114 subjects without agenesis of mandibular third molars; group 2A, 31 subjects with unilateral agenesis of mandibular third molars; and group 3A, 117 subjects with agenesis of all third molars. As controls, 926 other subjects without third molar agenesis were selected (group C). Panoramic radiographs were mainly used to examine for tooth agenesis. The Chi square test and odds ratio were used to make statistical comparisons. The prevalence rates of agenesis of maxillary lateral incisors, mandibular incisors and maxillary and mandibular second premolars, and bilateral agenesis of maxillary lateral incisors and second premolars were significantly higher in any one of the third molar agenesis groups than in the control group. Characteristically, no significant increase in occurrence of bilateral agenesis of mandibular second premolars was demonstrated by the subjects with bilateral agenesis of maxillary third molars. Irrespective of whether unilateral or bilateral agenesis of mandibular third molars is present or not, the Japanese orthodontic patients with bilateral agenesis of maxillary third molars exhibited a significantly increased occurrence of unilateral or bilateral agenesis of maxillary lateral incisors, mandibular incisors and maxillary and mandibular second premolars, except for bilateral agenesis of mandibular incisors and second premolars.

Cell-free and concentrated ascites reinfusion therapy (CART) is expected to improve symptoms associated with refractory ascites of the decompensated liver cirrhosis patients. The aim of this study was to evaluate the safety and efficacy of the CART system performed on the decompensated liver cirrhosis patients. In this retrospective observational study, we evaluated 24 CART processes performed on 11 patients with decompensated liver cirrhosis. We evaluated the effectiveness and adverse events during CART procedures. The amounts of collected and concentrated ascites were 4491.7 ± 2222.8 mL (mean ± SD), respectively, and the concentration ratio was 22.4 ± 15.3 times, respectively. The amount of collected protein in ascites was 2.3 ± 0.5 g/dL, and concentration ratio of protein was 8.2 ± 9.4 times. Serum protein level was not significantly different between before and after CART sessions. Thus, CART allowed for the reduction of doses of albumin preparations (Alb) to be administered. CART has been reported to cause two adverse reactions: elevation of body temperature and decrease in blood pressure. In our study, decreased blood pressure was not observed even in patients with > 5 L of ascites drained. Although a transient elevation in body temperature was seen in only one patient, this febrile patient immediately returned to normal body temperature with the use of NSAIDs. In patients with refractory ascites of decompensated liver cirrhosis in whom complete cure cannot be expected, CART improves their QOL and, in terms of medical economy, allows for the reduction of doses of Alb. CART can be effectively applied as a palliative procedure for refractory ascites of decompensated liver cirrhosis patients.

We developed a new Mie-scattering ellipsometry system for the analysis of the generation and transport of dusts in large plasma devices, such as nuclear fusion experiment devices. The system is a rotating-compensator type and consists of polarizer and analyzer modules and a 2-D image sensor. A preliminary experiment was carried out using a small dust plasma cubic chamber. Spherical divinylbenzene polymer particles of $2.25~\pm ~0.05~\mu \text{m}$ in diameter with a dispersion degree of 0.1 $\mu \text{m}$ were injected and suspended in an argon plasma. Light intensity data for 1600 pixels on each image taken 30 times per second were summed as a function of compensator azimuth angle, and then, ellipsometric parameters $\Psi $ and $\Delta $ were determined through Fourier analysis and relational equations. By the comparison of the determined $\Psi $ and $\Delta $ values with the calculated ones based on the Mie theory, it can be stated that they agree fairly well with each other and the measurement method is reliable.

The initial result of 3-D reconstruction of dusty plasma obtained through the integral photography technique has been reported. Integral photography has been applied to observe fine particles floating in a horizontally parallel-plate radio-frequency plasma. By using a simple system with a lens array and a standard charge-coupled device camera, we can identify the 3-D position of dust particles from a single exposure image obtained from one viewing port.

We propose an optical encryption framework that can encrypt and decrypt large-sized images beyond the size of the encrypted image using our two methods: random phase-free method and scaled diffraction. In order to record the entire image information on the encrypted image, the large-sized images require the random phase to widely diffuse the object light over the encrypted image; however, the random phase gives rise to the speckle noise on the decrypted images, and it may be difficult to recognize the decrypted images. In order to reduce the speckle noise, we apply our random phase-free method to the framework. In addition, we employ scaled diffraction that calculates light propagation between planes with different sizes by changing the sampling rates.

The integral photography and deconvolution techniques have been applied to identify the three-dimensional (3D) positions of particles levitating in plasma. Artifacts in the light field, i.e. ghost particles, are removed by collating between results of integral photography and direct Richardson-Lucy deconvolution (RLD). Our reconstruction system is tested with known target particles and it is found that it works well in the range of our dust experiment. By applying the integral photography and RLD techniques to the obtained experimental image, we identified the 3D positions of dust particles floating in a radio-frequency plasma. Ghost particles are eliminated from the results by deconvolution and we succeeded in obtaining the 3D structure of a dusty plasma from a single-exposure image obtained from one view port.

Several studies have suggested that non-stenotic carotid plaque was a risk factor for embolic stroke of undetermined source in some patients. However, individual backgrounds of these patients is unclear. We encountered a 64-years-old female with cerebral emboli, from an apparently stable non-stenotic carotid plaque (only 1.42mm thick) at the distal left common carotid artery, caused by violent tic movement of thyroid cartilage under well controlled dyslipidemia. Even though the plaque appeared thin and stable, mechanical stimulation could cause multiple, unnaturally localized emboli by stimulation-induced atherogenesis and plaque rupture, resulting in a misdiagnose of embolic stroke of undetermined source with non-stenotic carotid plaque.

Natural period of architectural structure have been longer to be high-rise in recent years. Tuned Mass Damper (TMD) is applied for the structural response reduction in such a long period structure. In general since there are a lot of design cases using a guide rail for linear motion guide of the mass in TMD, the friction coefficient in assembled TMD becomes almost from 3/1000 to 5/1000. The friction coefficient leads an important problem in view point of performance design for long period structures because of that the friction force becomes a large compared with starting inertia force. In this study, new type TMD with air pressure floating technique has been examined to reduce a friction force for starting inertia force, and to set 0.01 m/s2 in starting acceleration as a performance target. This paper shows the evaluation results for fundamental performance from static loading test and shaking table test.

This is the peer reviewed version of the following article: Kamada, S., Hanazono, A., Sanpei, Y., Inoue, T., Suzuki, S., Sugawara, M. and Iijima, K. (2019), Alternative to steroid therapy for myasthenia gravis and myositis occurring as immune-related adverse events. Clin Exp Neuroimmunol, 10: 190-191,which has been published in final form at https://doi.org/10.1111/cen3.12526. This article may be used for non-commercial purposes in accordancewith Wiley Terms and Conditions for Use of Self-Archived Versions.

Background/Aims: We aimed to determine whether the concentration of serum C-reactive protein (CRP) is associated with cognitive function in an adult Japanese population. Methods: Participants of this cross-sectional study were from a subgroup of the Project in Sado for Total Health (PROST; n = 454; mean age, 70.5 years). The cognitive state was evaluated using the Mini-Mental State Examination (MMSE), and those with an MMSE score APOE allele. Results: Of the 454 participants, 94 (20.7%) were cognitively declined. Relative to the lowest (first) quartile of CRP concentration, adjusted ORs were 1.29 (95% CI 0.61-2.75) for the second, 1.78 (95% CI 0.82-3.86) for the third, and 3.05 (95% CI 1.45-6.42) for the highest (fourth) quartiles (p for trend = 0.018). When data were stratified by sex, the association between CRP concentration and cognitive decline was observed only in women. Conclusion: Our findings suggest an association between higher CRP concentration and lower cognitive function. Chronic inflammation may affect cognitive function in adults, in particular women.

The purpose of this study was to investigate the patterns of third molar agenesis and incidence of agenesis of other permanent teeth in a Japanese orthodontic patient group. A total of 417 Japanese subjects (134 males and 283 females) with agenesis of one or more third molars were divided into four groups according to the agenesis pattern, and 874 other Japanese subjects (302 males and 572 females) without third molar agenesis were assigned to a control group. Panoramic radiographs and medical and dental records were used to examine for tooth agenesis. The Chi-square test and odds ratio were used to make statistical comparisons. The prevalence of third molar agenesis worked out at 32.3 % with no statistically significant gender difference. A high prevalence rate of agenesis of third molars, unilateral or bilateral, could be considered characteristic of the Japanese orthodontic population. Significant increases in occurrence of oligodontia, and unilateral or bilateral agenesis of other teeth, including maxillary lateral incisors and maxillary and mandibular second premolars, were observed in all or almost all of the third molar agenesis groups, compared with the controls. A significantly increased prevalence rate of mandibular lateral incisor agenesis was observed in almost all of the third molar agenesis groups. The Japanese patients with third molar agenesis had a significantly increased occurrence of oligodontia, and unilateral or bilateral agenesis of maxillary and mandibular lateral incisors and second premolars, except for bilateral agenesis of mandibular lateral incisors.

Background Recent years have seen increased numbers of children with conditions that contribute strongly to atherosclerotic disease, such as passive smoking, obesity, and dyslipidemia. In the present study, we evaluated the utility of non-invasive urinary markers in preventing lifestyle-related diseases by comparing lipid metabolism-related parameters with oxidative stress markers in school children. Methods Subjects were 85 first-grade students. The variables examined included the smoking in subjects' household; exercise habits; height and weight; blood pressure; and plasma total cholesterol, high-density lipoprotein cholesterol, triglyceride, leptin, blood sugar, urinary cotinine, 8-hydroxy-2'-deoxyguanosine (8-OHdG), and 8-isoprostaglandin F2α (IsoP). Results Of the subjects, 10.6% were obese (% overweight ≥20%), 3.5% had a high-risk arteriosclerosis index (AI; 3 ≤ AI < 5), and 29.4% were passive smokers. No significant differences were seen between boys and girls for any of the measurement parameters. Both urinary 8-OHdG (6.8–24.5 ng/mg creatinine) and IsoP (0.9–7.4 ng/mg creatinine) were detected in all subjects, and a significant positive correlation was seen between the two markers. On multiple regression analysis using AI as an objective variable and all non-invasive markers as explanatory variables, urinary IsoP correlated most strongly with AI (P ≤ 0.01). Conclusions Risk factors for atherosclerosis in adults, such as obesity and hypercholesterolemia, are associated with oxidative stress and inflammation. The present findings of the strongest correlation between urinary IsoP and AI suggest that urinary IsoP may serve as a non-invasive and effective early marker in predicting risk in children of developing lifestyle-related diseases.

A 60-year-old man presented with progressive dementia and generalized convulsions. An initial MRI revealed a widespread high-intensity area with a mass effect in the right frontal and temporal lobes on T2-weighted images. Findings on digital subtraction angiography were normal. Serum and CSF tests showed high titers of antibodies to Treponema pallidum, which helped to distinguish neurosyphilis from glioma. He was initially treated with penicillin injection; however, it caused liver dysfunction and penicillin was switched to erythromycin. Even after antibiotic therapy for 2 months, his dementia did not improve. He underwent brain MRI four times during the treatment course, and they showed steady progression of brain atrophy in the right hemisphere. Taking these findings together, we diagnosed Lissauer form of general paresis. To the best of our knowledge, this is the first case of Lissauer form of paretic neurosyphilis, in which the progression of brain atrophy was clearly demonstrated on MRI.

Background and aims Colonoscopy can be painful and uncomfortable. Aromatherapy is often used for the relief of anxiety or discomfort. Recently, it has been reported that olfactory stimulation induces various physiological effects. We investigated the effects of aromatherapy on anxiety and abdominal discomfort during colonoscopy. Methods The investigation was carried out using a randomized controlled study. Aromatherapy was performed by vapor diffusion, and each patient was given one of the following treatments: no inhalation (control group), essential-oil-less vapor (vehicle group), lavender oil (lavender group), grapefruit oil (grapefruit group), or Osmanthus fragrans oil (Osmanthus fragrans group). Following total colonoscopy procedures, each patient estimated their anxiety and abdominal discomfort using the Numeric Rating Scale. Results Total colonoscopy was performed on 361 patients. No complications caused by colonoscopy or aromatherapy were experienced. In the Osmanthus fragrans group, anxiety was significantly attenuated. The abdominal discomfort of patients who reported strong anxiety during colonoscopy was significantly attenuated in the grapefruit group and the Osmanthus fragrans group. Conclusion Aromatherapies using Osmanthus fragrans oil and grapefruit oil are effective complementary treatments for anxious patients undergoing colonoscopy.

Objective: The purpose of this study was to assess the effects of long-term repeated topical application of fluoride before bonding and an adhesion promoter on the bond strength of orthodontic brackets. Materials and Methods: A total of 76 bovine incisors were collected and divided equally into four groups. In group 1, the brackets were bonded without topical fluoride application or adhesion promoter. In group 2, before bonding, the adhesion promoter was applied to nonfluoridated enamel. In group 3, the brackets were bonded without the application of the adhesion promoter to enamel, which had undergone long-term repeated topical fluoride treatments. Teeth in group 4 received the long-term repeated topical applications of fluoride, and the brackets were bonded using the adhesion promoter. All the brackets were bonded using BeautyOrtho Bond self-etching adhesive. The shear bond strength was measured and the bond failure modes were evaluated with the use of the adhesive remnant index (ARI) after debonding. Results: The mean shear bond strength was significantly lower in group 3 than in groups 1, 2, and 4, and there were no significant differences between the groups except for group 3. There were significant differences in the distribution of ARI scores between groups 2 and 3, and between groups 3 and 4. Conclusions: The adhesion promoter can recover the bond strength reduced by the long-term repeated topical applications of fluoride to the prefluoridation level and had a significantly great amount of adhesives left on either fluoridated or nonfluoridated enamel.

The aim of this study was to elucidate the characteristics, pathogenesis and treatment strategy of hypertrophic pachymeningitis that is associated with myeloperoxidase anti-neutrophil cytoplasmic antibody (ANCA). We retrospectively investigated clinical, radiological, immunological and pathological profiles of 36 patients with immune-mediated or idiopathic hypertrophic pachymeningitis, including 17 patients with myeloperoxidase-ANCA, four patients with proteinase 3-ANCA, six patients with other immune-mediated disorders, and nine patients with 'idiopathic' variety. Myeloperoxidase-ANCA-positive hypertrophic pachymeningitis was characterized by: (i) an elderly female predominance; (ii) 82% of patients diagnosed with granulomatosis with polyangiitis (previously known as Wegener's granulomatosis) according to Watts' algorithm; (iii) a high frequency of patients with lesions limited to the dura mater and upper airways, developing headaches, chronic sinusitis, otitis media or mastoiditis; (iv) a low frequency of patients with the 'classical or generalized form' of granulomatosis with polyangiitis involving the entire upper and lower airways and kidney, or progressing to generalized disease, in contrast to proteinase 3-ANCA-positive hypertrophic pachymeningitis; (v) less severe neurological damage according to the modified Rankin Scale and low disease activity according to the Birmingham Vasculitis Activity Score compared with proteinase 3-ANCA-positive hypertrophic pachymeningitis; (vi) increased levels of CXCL10, CXCL8 and interleukin 6 in cerebrospinal fluids, and increased numbers of T cells, neutrophils, eosinophils, plasma cells and monocytes/macrophages in autopsied or biopsied dura mater with pachymeningitis, suggesting TH1-predominant granulomatous lesions in hypertrophic pachymeningitis, as previously reported in pulmonary or renal lesions of granulomatosis with polyangiitis; and (vii) greater efficacy of combination therapy with prednisolone and cyclophosphamide compared with monotherapy with prednisolone. Proteinase 3-ANCA may be considered a marker for more severe neurological damage, higher disease activity and a higher frequency of the generalized form compared with myeloperoxidase-ANCA-positive hypertrophic pachymeningitis. However, categorization into 'granulomatosis with polyangiitis' according to Watts' algorithm and immunological or pathological features were common in both proteinase 3- and myeloperoxidase-ANCA-positive hypertrophic pachymeningitis. These data indicate that most patients with myeloperoxidase-ANCA-positive hypertrophic pachymeningitis should be categorized as having the central nervous system-limited form of ANCA-associated vasculitis, consistent with the concept of ophthalmic-, pulmonary- or renal-limited vasculitis.

Velopharyngeal closure plays an important role in preventing air pressure leakage during swallowing and phonation from oropharynx to nasopharynx. Levator veli palatini muscle activity is influenced by oral and nasal air pressure, volume of the swallow bolus and postural changes. However, it is unclear how velopharyngeal closing pressure is affected by reclining posture. The purpose of this study was to investigate the effects of reclining posture on velopharyngeal closing pressure during swallowing and phonation. Nine healthy male volunteers (age range, 27-34 years) participated in this study. Velopharyngeal closing pressure during a dry swallow, a 5-mL liquid swallow, a 5-mL honey-thick liquid swallow and phonations of /P∧/ and /K∧/ were evaluated in an upright posture and at reclining postures of 60° and 30°. A manometer catheter was inserted transnasally onto the soft palate, and each trial was repeated three times. A solid-state manometer catheter with an intra-luminal transducer was used to evaluate the amplitude and duration of each trial, and data were statistically analysed. Average amplitudes during dry and liquid swallows were significantly lower in reclining postures compared with the upright posture, but the amplitude was not significantly different during the thick liquid swallow. Average durations were not affected by postural changes. The amplitudes during phonations were lower in reclining postures, but the differences were not significant. Velopharyngeal closure is significantly affected by reclining posture. This suggests that velopharyngeal closing pressure may be adjusted according to afferent inputs, such as reclining posture and bolus viscosity.

Patients of gastrointestinal carcinoma with the refractory ascites are often chemotherapy-resistant cancer patients, and these patients are good indication of the cell-free and concentrated ascites reinfusion therapy (CART). CART is expected to improve symptoms associated with refractory ascites of patients with gastrointestinal carcinoma. The aim of this study is to evaluate the safety and efficacy of the CART system performed on the gastric cancer patients with massive refractory ascites. In this retrospective observational study, we evaluated 5 CART processes performed 3 patients with the gastric cancer. We evaluated the effectiveness and adverse events during CART procedures. The amounts of collected and concentrated ascites were 2410.0 ± 1762.6 ml (mean ± SD), and concentration ratio was 10.5 ± 4.3 times. The amount of collected protein in ascites was 3.4 ± 1.3 g/dl, and concentration ratio of protein was 4.2 ± 2.0 times. Serum protein level was no significant different between before and two weeks after CART. No patients received an albumin (25% albumin preparation Alb) transfusion within two weeks prior to the first CART. Thus, CART allowed for the reduction doses of Alb to be administered. CART has been reported to cause two adverse reactions as elevation of body temperature and decrease in blood pressure. In our study, decreased blood pressure was not observed in all patients, and body temperature significantly rose after CART, but there were no patients more than 37 degrees. In patients with refractory ascites of the gastric cancer patients in whom complete cure cannot be expected, CART improves their QOL and, in terms of medical economy, allows for the reduction doses of

This paper experimentally investigates the applicability of a micro-channel plate (MCP) followed by a phosphor screen to charged particles along with a calibration method for estimating the acceptable limit of input particle flux and appropriate operation parameters of a particular MCP. For the first time, plasmas consisting of only lithium ions are injected into the MCP. Despite large ion numbers (Ni) on the order of ≃10(7), no deterioration in the effective gain (αG) of the MCP owing to an excess amount of the extracted charge occurs in a certain range of the amplifier voltage (ΔUM) applied to the MCP. The measured αG nearly agrees with the expected value. However, once ΔUM exceeds a limit value, αG eventually begins to saturate. This is also verified in experiments using pure electron plasmas. An appropriate range of ΔUM is presented to avoid saturation and, finally, derive Ni directly from the secondary electron current outputted from the MCP only after the indispensable calibration.