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A triple antiemetic therapy combining aprepitant (APR) with conventional double antiemetic therapy, including 5-hydroxytryptamine 3 receptor antagonist (5-HT₃-RA) and dexamethasone (DEX), is recommended for preventing chemotherapy-induced nausea and vomiting induced by a carboplatin (CBDCA) regimen. However, consensus on the additive effects of APR for gynecological patients on a combined regimen of paclitaxel and CBDCA (TC regimen) has yet to be reached. This retrospective study investigated the antiemetic effects of palonosetron and DEX (PD therapy) and granisetron and DEX with APR (GDA therapy) in patients with gynecologic cancer and who underwent their first TC regimen cycle between April 2017 and March 2020 at the Gunma University Hospital Outpatient Chemotherapy Center. The results showed that the complete response rate of the 92 patients who underwent PD therapy (PD group) and the 46 patients who underwent GDA therapy (GDA group) were both 80.4% (p = 1.000), and the complete control rates of the PD and GDA groups were 78.3% and 80.4%, respectively (p = 0.828), resulting in no significant difference. Furthermore, we observed no significant difference between the PD and GDA groups in the incidence of grade ≥2 nausea, vomiting, and anorexia (nausea: 7.6% vs. 0%, p = 0.095; vomiting: 4.3% vs. 0%, p = 0.301; and anorexia: 9.8% vs. 2.2%, p = 0.164). Concerning adverse events, compared to the PD group, the GDA group showed significantly higher incidence of grade ≥2 malaise (7.6% vs. 19.6%, p = 0.039). Given the lack of difference in the antiemetic effects of PD and GDA therapies, antiemetic therapy should be selected carefully for individual patients by accounting for the incidence of adverse reactions and interactions with APR.

The tooth is mainly composed of dentin and enamel. Identification of dentin-producing odontoblasts and enamel-producing ameloblasts using reporter techniques is useful to study tooth development and regeneration with tissue engineering. Ameloblasts express Amelogenin, Ameloblastin, Enamelin, and Amelotin, whereas odontoblasts express Dentin sialophosphoprotein ( Dspp) and Dentin matrix protein1 ( Dmp1). Although there are several transgenic lines using promoter elements or bacterial artificial chromosomes (BACs) to label odontoblasts and ameloblasts, there is a possibility that the expression patterns vary from the endogenous genes. Here, we established 2 lines of mice where tdTomato was knocked into the second exon of X-chromosomal Amelogenin ( Amelx), and green fluorescent protein (GFP) was knocked into the second exon of Dspp. tdTomato and GFP were highly expressed on secretory ameloblasts and secretory and fully differentiated odontoblasts, respectively. In addition, DSPP and AMELX were not produced in the dentin matrix and enamel matrix of Dspp GFP/GFP and Amelx tdTomato male mice (as representative of AmelxtdTomato/Y hemizygous male mice), respectively. Moreover, micro–computed tomography analysis of Amelx tdTomato male mice revealed a notable reduction in enamel volume but increased dentin mineral density. Dspp GFP/GFP mice had reduced dentin mineral density. To identify odontoblasts and ameloblasts from developing tooth, we examined the expression of mesenchymal cell surface molecules CD90, CD166 and epithelial cell surface molecules CD49f, Epcam1 with fluorescence on odontoblasts and ameloblasts in these mice. We found that GFP+ odontoblasts and tdTomato+ ameloblasts in tooth germ from 0.5-d-old DsppGFP/+ mice and Amelx tdTomato male mice were enriched in CD45−/Ter119−/Epcam1−/CD90+/Integrin α4+cell fractions and CD45−/Ter119−/Epcam1+/CD49f+/CD147+ cell fractions, respectively. By using antibodies against mesenchymal and epithelial cell surface molecules and fluorescence, we can easily distinguish odontoblasts from ameloblasts and isolate each cell for further studies. These mice would serve as useful models for tooth development and regeneration as well as provide concurrent observation for the differentiation processes of odontoblasts and ameloblasts in vivo and in vitro.

To determine whether posterior implant removal prevents stress-shielding-induced vertebral osteopenia within the posterior fusion area in surgically treated patients with adolescent idiopathic scoliosis (AIS). Eighteen patients with major thoracic AIS (mean age, 43.3 years; range, 32–56 years; mean follow-up, 28.8 years, range, 20–39 years) who underwent posterior spinal fusion (PSF) alone between 1973 and 1994 were included. Participants were divided into implant removal (group R, n = 10, mean interval until implant removal, 50 months) and implant non-removal groups (group NR, n = 8). Bone mineral density was evaluated using the Hounsfield units (HU) of the computed tomography image of the full spine. The HU values of the UIV−1 (one level below the uppermost instrumented vertebra), apex, LIV+1 (one level above the lowermost instrumented vertebra), and LIV−1 (one level below the lowermost instrumented vertebra; as a standard value) were obtained. Stress-shielding-induced osteopenia was assessed as the UIV−1/LIV−1, apex/LIV−1, and LIV+1/LIV−1 HU ratios (× 100). Overall (median, 25th–75th percentile), the apex (144.7, 108.6–176.0) and LIV+1 (159.4, 129.7–172.3) demonstrated lower HU values than LIV−1 (180.3, 149.2–200.2) (both comparisons, p

Background and importance Recently, the number of foreign residents has significantly increased in Japan. At the consultation with physicians, the foreign language speaking patients (FLSP) often utilise medical interpreter services or ad hoc interpreters. However, few studies have reported how such patients receive information in community pharmacies affiliated with hospitals/clinics. Aim and objectives The objective of the study was to examine how and what pharmacists communicate with FLSP at pharmacies, in the Gunma prefecture, one of the most foreign residential prefectures in Japan. Material and methods A self-administered questionnaire survey was conducted among the pharmacy members of Gunma Pharmaceutical Association, in January and February 2018. The contents of the questionnaire were divided into two parts: (1) pharmacy system targeting the manager; and (2) pharmacists’ experience and skills. The answers were compared between the foreigner settlement area and the other area. Results Of the 773 pharmacies, 372 pharmacies responded. Approximately 90% of had ever treated FLSP with English and 25 other languages. For the pharmacists’ experiences, 65% of 844 pharmacist participants had some issues with language, regularly/often. Multilingual instruction tools were prepared in 18.5% of the pharmacies. Of the pharmacies without the tools, 54% did not know of the availability of these tools. As a means of communication, ‘accompanying acquaintance and family member interpreter’ was used significantly more often in the foreigner settlement area than in the other area. Most common medication instructions for FLSP were: how to use, how to follow and confirm the effects of the medicines, and how to confirm the side effects of the medicines. All were explained significantly better in the foreigner settlement area than in the other areas. Conclusion and relevance Regardless of where pharmacies are located, it is recommended to introduce multilingual instruction tools for FLSP. References and/or acknowledgements No conflict of interest.

Supplemental material, sj-pdf-1-jdr-10.1177_0022034520974576 for Simultaneous Fluorescent Identification of Odontoblasts and Ameloblasts by K. Isono, E. Takahashi, I. Miyoshi, M. Tsuneto, M. Hikosaka-Kuniishi, T. Yamane and H. Yamazaki in Journal of Dental Research

The mechanical properties of polyethylene (PE)/polypropylene (PP)/styrene-ethylene/butylene-styrene (SEBS)/mica composites were investigated as a model composition. Four types of mica with different particle sizes and different aspect ratios were used. These composites were extruded by a twin-screw extruder and subsequently injection molded, and their mechanical properties, including their tensile, bending, and impact properties were evaluated. The addition of mica to PE/PP/SEBS effectively improved its mechanical properties; the addition of SEBS as a compatibilizer likewise enhanced the mechanical properties compared with those of PE/PP composites without SEBS. The use of larger average particle size and higher aspect ratio mica, such as M-35, M-27, and P-33, effectively increased the tensile and bending properties of the PE/PP/SEBS/mica composites. The morphologies of the composites with an added mica as observed by scanning electron microscopy, showed good dispersion between the matrix polymer and the mica.

Immunosuppressive therapy is considered as one of the factors inducing to the onset of osteoporosis after organ transplantation. Chronic immunosuppressive therapy after transplantation is required for organ transplant patients, and it is important to prevent the occurrence of osteoporotic fractures to maintain the quality of life in patients. In this study, we examined the effects of cyclosporine and tacrolimus on bone metabolism in rats. Five-week-old male Wistar rats were treated orally with 15 mg/kg cyclosporine or 1.5 mg/kg tacrolimus daily for 4 weeks. Each of cyclosporine and tacrolimus significantly reduced the bone strength of the femoral mid-diaphysis and bone mineral density of the tibia and femur. Bone histomorphometry showed that the administration of both drugs resulted in a decrease in bone volume, number and thickness of trabeculae, and an increase in trabecular separation. Bone formation parameters such as osteoid volume, osteoblast surface, mineralizing surface, mineral apposition rate, and bone formation rate significantly increased in the cyclosporine-treated group. Bone resorption parameters such as eroded surface, osteoclast surface, and osteoclast number significantly increased in both the cyclosporine- and the tacrolimus- treated groups. These results showed that cyclosporine increases both bone formation and bone resorption, leading to a high-turnover bone loss, and that tacrolimus increases bone resorption without affecting bone formation, leading to bone loss.

The enthesis transmits a physiological load from soft to hard tissue via fibrocartilage. The histological alterations induced by this physiological loading remain unclear. This study was performed to examine the histomorphological alterations in the collagen fiber bundle alignment and depth of collagen interdigitation between the calcified fibrocartilage and the bone. We examined the Achilles enthesis of rats with sciatic denervation to explore the mechanical effects of structural changes in the enthesis. The parallelism of the collagen fiber bundles was significantly reduced 8 weeks after denervation. However, the depth of collagen interdigitation significantly increased at 2 and 4 weeks after denervation and then significantly decreased 8 weeks after denervation. In conclusion, a lack of muscle loading induced structural alterations in the distal calcified fibrocartilage. These findings suggest that while structural changes in the enthesis are necessary for the development of physiological loading, structural deformities are required in the long term. Anat Rec, 300:2166-2174, 2017. © 2017 Wiley Periodicals, Inc.

[Purpose] Chondrocytes in articular cartilage are aligned as columns from the joint surface. Notably, loss of chondrocyte and abnormalities of differentiation factors give rise to osteoarthritis (OA). However, the relationship between chondrocyte alignment and OA progression remains unclear. This study was performed to investigate temporal alterations in surgically-induced OA rats. [Subjects and Methods] Thirteen-week-old Wistar rats (n=30) underwent destabilized medial meniscus surgery in their right knee and sham surgery in their left knee. Specimens (n=5) were collected at 0, 1, 2, 4 and 8 weeks after surgery. Histological analysis with Osteoarthritis Research Society International (OARSI) scores, cell density ratios, cell alignments and correlation between OARSI scores and cell density/alignment was performed. [Results] OARSI scores were significantly higher at 1, 2, 4 and 8 weeks in the DMM group than in the control. Cell density ratios were decreased significantly in the DMM group at 2, 4 and 8 weeks compared with the control. Chondrocyte alignment was decreased significantly in the DMM group at 4 and 8 weeks. There were negative correlations between OA severity and cell density / cell alignment. [Conclusion] The results suggest a relationship between chondrocyte alignment and cartilage homeostasis, which plays an important role in OA progression.

An experiment was conducted to evaluate the effects of sweet green pepper (SGP) on the performance and egg quality of commercial laying hens. A total of 144 Hy Line W36 egg layers were randomly assigned to 4 treatments with 9 replicate groups of 4 hens each. Treatments consisted of the following diets: 1) basal diet (BD), 2) BD + 75 ppm SGP, 3) BD + 125 ppm SGP, 4) BD + 225 ppm SGP. The diets contained 2,730 kcal/kg metabolizable energy and 15.5% crude protein. Egg production and egg quality were monitored for 16 weeks. Feed intake, hen-day egg production, egg mass, and feed conversion per dozen were not significantly affected by the addition of SGP to the diets. The addition of 225 ppm of SGP decreased egg weight. Specific gravity, albumen height, Haugh unit, yolk weight, albumen weight, albumen percentage, and yolk yellowness (b*) were not significantly affected by the addition of SGP. The addition of SGP to the diets increased yolk percentage, yolk color using a Roche fan, and yolk redness (a*). Based on these data, SGP was shown to be a useful feed ingredient for laying hens; it can be included in diets without negative effects on performance and egg quality. However, owing to the depression of egg weight with the inclusion of SGP, it may be of interest to producers and industry to control egg size in old layers and possibly improve shell quality. The addition of SGP to the diets impacted yolk color and may be useful in specialty markets.

Long-term treatment with antiepileptic drugs (AED) is associated with an elevated risk of bone fracture due to decreased bone mineral density (BMD). Phenytoin has been shown to affect bone metabolism adversely, whereas newly developed AEDs have not been studied. This study evaluated the effects of topiramate and lamotrigine on bone metabolism in rats. Five-week-old male Sprague-Dawley rats were treated orally with phenytoin (20 mg/kg), topiramate (5 or 20 mg/kg), or lamotrigine (2 or 10 mg/kg) daily for 12 weeks. Phenytoin reduced bone strength, measured by maximum load to failure of the femoral mid-diaphysis, along with reduced femur total BMD. Serum tartrate-resistant acid phosphatase-5b levels significantly increased after phenytoin treatment, while serum osteocalcin levels decreased after topiramate 20 mg/kg treatment. Furthermore, osteoblast surface and bone mineralizing surface were significantly lowered by topiramate. Lamotrigine treatment did not affect bone strength, BMD, or bone turnover. We demonstrated that phenytoin treatment significantly increased bone resorption and lowered BMD and bone strength. Since lamotrigine did not affect bone metabolism, it can be concluded that lamotrigine is safety medicine for bone health. Topiramate was associated with decreased bone formation, which may affect bone strength and BMD with chronic use. Thus, patients taking topiramate should be monitored for changes in BMD to avoid risk of fracture.

We hypothesized that cancer cells actively migrate toward intratumor microvessels, guided by tissue gradients of metabolic substrates (such as O

The risk of schizophrenia is increased in offspring whose mothers experience malnutrition during pregnancy. Polyunsaturated fatty acids (PUFAs) are dietary components that are crucial for the structural and functional integrity of neural cells, and PUFA deficiency has been shown to be a risk factor for schizophrenia. Here, we show that gestational and early postnatal dietary deprivation of two PUFAs—arachidonic acid (AA) and docosahexaenoic acid (DHA)—elicited schizophrenia-like phenotypes in mouse offspring at adulthood. In the PUFA-deprived mouse group, we observed lower motivation and higher sensitivity to a hallucinogenic drug resembling the prodromal symptoms in schizophrenia. Furthermore, a working-memory task-evoked hyper-neuronal activity in the medial prefrontal cortex was also observed, along with the downregulation of genes in the prefrontal cortex involved in oligodendrocyte integrity and the gamma-aminobutyric acid (GABA)-ergic system. Regulation of these genes was mediated by the nuclear receptor genes Rxr and Ppar, whose promoters were hyper-methylated by the deprivation of dietary AA and DHA. In addition, the RXR agonist bexarotene upregulated oligodendrocyte- and GABA-related gene expression and suppressed the sensitivity of mice to the hallucinogenic drug. Notably, the expression of these nuclear receptor genes were also downregulated in hair-follicle cells from schizophrenia patients. These results suggest that PUFA deficiency during the early neurodevelopmental period in mice could model the prodromal state of schizophrenia through changes in the epigenetic regulation of nuclear receptor genes.

The All Together Better Health VI, the sixth international conference on interprofessional practice and education was held in Kobe, Japan on 6–9 October 2012. The Satellite Symposium in Uonuma was ...

To elucidate the initial mechanism of hematogenous metastasis of cancer cells, we hypothesized that cancer cells migrate toward regions with higher oxygen concentration such as intratumor micro vessels along the oxygen concentration gradient. To produce gradients of oxygen concentration in vitro, we devised the gap cover glass (GCG). After placing a GCG onto cultured MDA-MB-231 cells (a metastatic breast cancer cell line), the migration of individual cells under the GCG was tracked up to 12 h at 3 % oxygen in the micro incubator. We quantified the migration of individual cells using forward migration index (FMI). The cell migration perpendicular to the oxygen gradients was random in the direction whereas FMIs of the cell located at 300, 500, 700, and 1500 μm from the oxygen inlet were positive (p 0.05) indicating a unidirectional migration toward the oxygen inlet. Present results are consistent with our hypothesis that MDA-MB-231 cells migrate toward regions with higher oxygen concentration.

The periodic trend to cetacean mass stranding events in the Australian island state of Tasmania remains unexplained. This article introduces the hypothesis that domoic acid poisoning may be a causative agent in these events. The hypothesis arises from the previously evidenced role of aeolian dust as a vector of iron input to the Southern Ocean; the role of iron enrichment in Pseudo-nitzschia bloom proliferation and domoic acid production; and importantly, the characteristic toxicosis of domoic acid poisoning in mammalian subjects leading to spatial navigation deficits. As a pre-requisite for quantitative evaluation, the plausibility of this hypothesis was considered through correlation analyses between historical monthly stranding event numbers, mean monthly chlorophyll concentration and average monthly atmospheric dust loading. Correlation of these variables, which under the domoic acid stranding scenario would be linked, revealed strong agreement (r = 0.80-0.87). We therefore advocate implementation of strategic quantitative investigation of the role of domoic acid in Tasmanian cetacean mass stranding events.

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T18:40:14Z No. of bitstreams: 1 S1516-635X2008000200005.pdf: 139114 bytes, checksum: a1f535d9a5773468c3c037d9354a4f15 (MD5) Made available in DSpace on 2013-08-22T18:40:14Z (GMT). No. of bitstreams: 1 S1516-635X2008000200005.pdf: 139114 bytes, checksum: a1f535d9a5773468c3c037d9354a4f15 (MD5) Previous issue date: 2008-06-01 Made available in DSpace on 2013-09-30T19:25:30Z (GMT). No. of bitstreams: 2 S1516-635X2008000200005.pdf: 139114 bytes, checksum: a1f535d9a5773468c3c037d9354a4f15 (MD5) S1516-635X2008000200005.pdf.txt: 23837 bytes, checksum: d9690f784ebab10498987c62a0aa1323 (MD5) Previous issue date: 2008-06-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:19:23Z No. of bitstreams: 2 S1516-635X2008000200005.pdf: 139114 bytes, checksum: a1f535d9a5773468c3c037d9354a4f15 (MD5) S1516-635X2008000200005.pdf.txt: 23837 bytes, checksum: d9690f784ebab10498987c62a0aa1323 (MD5) Made available in DSpace on 2014-05-20T13:19:23Z (GMT). No. of bitstreams: 2 S1516-635X2008000200005.pdf: 139114 bytes, checksum: a1f535d9a5773468c3c037d9354a4f15 (MD5) S1516-635X2008000200005.pdf.txt: 23837 bytes, checksum: d9690f784ebab10498987c62a0aa1323 (MD5) Previous issue date: 2008-06-01 An experiment was carried out with male and females broilers of two different commercial breeds to evaluate bone mineral density of the right femur head. A number of 600 one-day-old broilers were raised in an experimental poultry house up to 42 days of age at the School of Veterinary Medicine and Animal Science of UNESP, Botucatu, Brazil. After slaughter, three males and three females in each breed in each of the established gross scores were selected. Their femora heads were submitted to gross examination, and subsequently the thighs were submitted to the Veterinary Hospital for radiographic analysis. Femora were also submitted to bone resistance, Seedor index, and dry matter content analyses. All these bone quality characteristics were different between males and females, independent of breed. Breeds presented similar behavior. It was possible to establish correlations between bone quality parameters, and confidence intervals for bone mineral density values, correlating them to femoral degeneration score, which allows characterizing femoral head lesions by radiographic optical densitometry. UNESP School of Veterinary Medicine and Animal Science Department of Animal Production UNESP School of Veterinary Medicine and Animal Science UNESP School of Veterinary Medicine and Animal Science Department of Animal Reproduction and Veterinary Radiology UNESP School of Agronomy Department of Rural Buildings UNESP School of Veterinary Medicine and Animal Science Department of Animal Production UNESP School of Veterinary Medicine and Animal Science UNESP School of Veterinary Medicine and Animal Science Department of Animal Reproduction and Veterinary Radiology UNESP School of Agronomy Department of Rural Buildings

Two embryonal CNS tumors, atypical teratoid/rabdoid tumor (AT/RT) and primitive neuroectodermal tumor (PNET), may be confused with each other and misdiagnosed. Here we report an infant with a congenital supratentorial tumor, which was detected by fetal MRI at 37 weeks gestation. On routine histological examination, the tumor was composed mainly of small undifferentiated cells, among which many rhabdoid cells and occasional sickle-shaped embracing cells were observed. No mesenchymal or epithelial areas were evident. Our impression was that the tumor was an atypical example of AT/RT. Immunohistochemically, almost all the tumor cells were strongly positive for vimentin. However, epithelial membrane antigen was notably negative, and most of the tumor cell nuclei were clearly positive for INI1. In addition, many tumor cells were positive for neurofilament protein. There were also occasional small areas containing many tumor cells positive for glial fibrillary acidic protein. Finally, a diagnosis of PNET, with a rhabdoid phenotype and expression of neuronal and glial markers, was made. In the present case, application of INI1 immunostaining was very helpful for distinguishing PNET from AT/RT.

長伐期林における陽樹冠管理のための定量的な基準を提示する目的で，吉野林業地の38～210年生の林分において，個体の陽樹冠量（陽樹冠直径，陽樹冠長，陽樹冠表面積）と年平均胸高直径成長量（ΔDBH）の関係を解析した。陽樹冠直径および陽樹冠表面積とΔDBHとの間には良好な回帰直線式が得られた。得られた式の信頼性および測定の簡便性等を検討した結果，特に陽樹冠直径（Dsc）が残存木選木の指標として有用であると結論できた。また，DscとΔDBHとの関係は林齢の増加にともなって変化しており，この結果は，単位陽樹冠量当たりの直径の成長効率が林齢に沿って変化することを示していた。したがって幅広い範囲の林齢や個体サイズを対象とする長伐期施業においては，林齢等の違いによるDscとΔDBHとの関係の変化を考慮することが重要であることが明らかとなった。さらに，DscとΔDBHの回帰直線式からΔDBHが0.25～0.54 cm/年（年輪幅が2 mm前後）となるDscの推定範囲を求めることができ，74～88％の精度でDscから年輪幅が2 mm前後であるか否かを判定できた。これらの結果から，これまで定性的に行われてきた残存木選木に対して，一定の精度を有する定量的な基準を林齢別に提示したといえる。

We report the efficacy of salvage therapy with a modified ProMACE-MOPP combined with radiation in patients with primary central nervous system lymphoma (PCNSL). Thirty-two immunocompetent patients were treated with a regimen of pirarubicin, cyclophosphamide, etoposide, vincristin, and methotrexate (MTX: 500 mg/m(2)) administered in 21-day cycles. Patients received 20 Gy of whole-brain radiotherapy after three cycles of chemotherapy. A single cycle of chemotherapy was repeated every four months for two years. Nine patients with CNS relapse were retreated with additional cycles of the ProMACE-MOPP hybrid regimen with a 90% objective response rate. Median complete response (CR) duration was 13.2 months and median survival time (MST) for the nine patients treated after initial relapse was 30 months. One of 17 patients (5.8%) who had less than 20 Gy of whole brain irradiation developed dementia. In contrast, six of seven (85.7%) patients who had more than 30 Gy of whole brain radiotherapy became demented. Maintaining a moderate dose of MTX, while adding chemotherapeutic agents and 20 Gy of whole brain radiation therapy, improved disease control and overall survival and lowered the incidence of delayed neurologic toxicity in patients with PCNSL. Additional treatment with a ProMACE-MOPP hybrid regimen is still effective for relapsed disease.

In Japan, over the past 60 years, the constant increase in life expectancy has resulted in one of the world’s highest longevities. As the number of elderly increases, it is difficult for any single professional to meet their diverse health and social care needs. During the past two decades, however, there has been a change in the view of health among Japanese — a ‘paradigm shift’ with particular attention being paid to improvement in the ‘quality of life’ (QoL). Healthcare professionals are required not only to increase the ‘mean life expectancy’, but also to help people, as QoL supporters, to extend their ‘healthy life expectancy’ and encourage independent living.