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The optimal management method for pediatric pancreatic trauma is controversial. Moreover, the efficacy of stent placement via endoscopic retrograde pancreatography (ERP) remains poorly documented. The present, retrospective review of pediatric patients with pancreatic trauma was conducted from 2010 to 2020 at a single institution. Ten, male children with the median age of 9.5 years (range 4–14 years) with a grade I (n = 2), II (n = 4) or III (n = 4) pancreatic injury were identified. Of six of these patients in whom ERP was performed, four had a pancreatic duct injury (PDI). Pancreatic stent placement was performed in all the patients with ERP at a site proximal to the injury in four patients and across the injury in two patients. A pseudocyst or pancreatic fluid collection was detected in five patients, of these, two with a grade II injury were managed successfully with conservative therapy while three with PDI required surgery. In the four patients with PDI, only one in whom the stent was placed across the PDI was able to avoid surgery. Therapeutic ERP might be effective even if a patient has a PDI, therefore, early ERP should be considered as a treatment option.

Purpose: The slide tracheoplasty (STP) is the standard treatment for severe congenital tracheal stenosis (CTS). Understanding the features of the tracheal stenosis in each case and choosing an appropriate incision design are very important for successfully executing the procedure. The present study aimed to evaluate the advantages of three-dimensional (3D) printed models of the trachea for improving CTS. Methods: Three-D tracheal models were created using computed tomography (CT) data from ten patients undergoing STP for CTS. Simulated surgery was performed using the hollow models after reinforcing with them with a coating of gum spray. Clinical outcomes, including patient survival, postoperative surgical interventions, and time required for STP, were compared with the corresponding values in the last ten patients before the introduction of 3D model simulations. Results: All ten patients for whom simulated surgery using a 3D tracheal model were conducted achieved good airway patency after their STP. The surgeons reported feeling that the 3D model simulations were highly effective although there was no significant difference in the clinical outcomes of the groups with or without simulated STP. The models were useful not only for surgical planning but also for sharing important information among the multidisciplinary team and the patients’ family. Conclusion: Our experience using 3D tracheal models demonstrated several features enabling improvement in the surgical treatment of CTS.

The application of slide tracheoplasty (STP) in the treatment of congenital tracheal stenosis (CTS) has improved patient outcomes over the past few decades. We reviewed our experiences with the procedure, elucidated risk factors, and discussed important aspects of perioperative management to improve outcomes.Patients with CTS undergoing STP between July 1998 and December 2020 were enrolled. Patient characteristics, perioperative condition, management, operative details, and outcomes, including mortality and postoperative intervention, were collected from medical records.Eighty patients underwent STP. Sixty-five patients (81.3%) had an associated cardiovascular anomaly. Thirteen patients (16.3%) had unilateral lung agenesis or hypoplasia. Preoperative mechanical ventilation was necessary in 54 (67.5%) patients, and extracorporeal membrane oxygenation (ECMO) was required in eight patients (10.0%). An endotracheal tube was placed before the stenotic entrance to avoid granulation. During STP, the trachea was dissected as little as possible to maintain the blood supply. The one-year survival rate was 88.8% (nine patients died). One patient (1.3%) required postoperative balloon dilation, and none required stenting or granulation removal. Of the survivors, 62 (92.5%) achieved successful extubation without tracheostomy. Multivariable analysis revealed complex cardiovascular anomaly (P = 0.05) and preoperative ECMO (P = 0.019) to be adverse predictors of survival.Although STP can be performed successfully in CTS patients, surgeons and families should be aware of factors that may lead to a more difficult postoperative course or increase the mortality. Meticulous, perioperative positioning of the endotracheal tube and preserving the tracheal blood flow can minimize the need for postoperative intervention.

Previous studies have shown that diabetes and obesity increase the severity of periodontal disease—a well-known risk factor for tooth loss. However, the effect of obesity on tooth loss has not yet been fully characterized. Thus, we investigated the association between obesity and residual teeth (number and sites) using a large database of the Japanese population. We used the MinaCare database, composed of data from Japanese health insurance claims and health check-ups in 2015 to select 233,517 subjects from 706,150 based on the availability of BMI, HbA1c, teeth, and smoking information. Obesity was defined as BMI ≥25.0. The number of residual teeth at every age group was correlated with 4 BMI subsets (30.0). The unadjusted and adjusted odds ratios (ORs) for fewer than 24 residual teeth were estimated using logistic regression models. The number of residual teeth decreased with age (p for trend Disclosure M. Hayashi: Employee; Self; Sunstar Group. K. Morino: None. K. Harada: Employee; Self; Sunstar Group. M. Ishikawa: None. I. Miyazawa: None. A. Ishikado: Employee; Self; Sunstar Group. Employee; Spouse/Partner; Sunstar Group. H. Maegawa: Speaker’s Bureau; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo, Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Sanofi K.K., Takeda Pharmaceutical Company Limited.

Background: Diabetes mellitus (DM) is a well-known risk factor for periodontal disease, independent of age and smoking. However, the relationship between glycaemic control and tooth loss has not been well characterized. We aimed to determine whether the haemoglobin A1c (HbA1c) level is associated with the number of teeth remaining. Methods: This was a cross-sectional study of 233,567 individuals aged 20–74 years in a database comprising health insurance claim and health check-up data that was collected between April 1, 2015 and March 31, 2016. The participants were allocated to five groups according to their HbA1c, and the number of teeth was compared between age-groups. DM was defined by an HbA1c ≥6·5%. Findings: Fifty-two-point-seven percent were women and the mean (SD) age was 47·7 (9·6) years. Higher HbA1c was associated with fewer teeth if >30 years of age ( P for trend 30 years of age ( P

Scallop-shell powder, which is mainly composed of CaCO3, exhibits antimicrobial activity through heat treatment due to the generation of CaO. However, although heated scallop-shell powder (HSSP) is effective for disinfecting food, but it also generates CaCO3 scales on the surfaces of the processing equipment due to the reaction of CaO with CO2 in the air. In our previous study, we showed that the addition of sorbitol was able to suppress scale generation in the processing equipment; however, it requires HSSP to be dissolved in sorbitol for a while. Therefore, in this study, we prepared sorbitol-coated HSSP (SC-HSSP) in an attempt to ensure the elution of sorbitol before HSSP. The results revealed that sorbitol coating changed HSSP from a fine powder state (mean volume diameter [MVD] = 7.3 μm) to a granular state (MVD = 137.2 μm), resulted in improved flowability and handling quality, and also reduced the scale buildup and improved the hygroscopicity. The antimicrobial effectiveness of SC-HSSP was almost similar to that of HSSP and NaClO (200 ppm) in reducing total aerobic bacterial population and coliform population on cabbage, lettuce, and cucumber. Therefore, this functional improvement of HSSP along with its antimicrobial efficacy will be help its use as an effective disinfectant for the antimicrobial treatment of fresh produce.

A 6-year-old girl underwent ureterocystoneostomy (UCN) because of left flank pain due to delayed onset of ureteral stenosis one and a half years after endoscopic dextranomer/hyaluronic acid copolymer (Deflux) injection for the treatment of vesicoureteral reflux (VUR). Histopathological examination indicated chronic inflammation with abundant eosinophils characteristic of a reaction to Deflux. Several autoimmune diseases developed during the treatment for ureteral stenosis. First, 2 weeks prior to the onset of left flank pain, she was diagnosed as having systemic lupus erythematosus. Finally, she died of pulmonary hemorrhage due to thrombotic thrombocytopenic purpura 4 months after UCN. The fatal outcome in this case was suspected to be caused by autoimmune syndrome induced by adjuvants, which in this case was the hyaluronic acid polymer injected into the ureteric orifice for the treatment of VUR.

Recurrent tracheoesophageal fistula (TEF) is still difficult to diagnose and repair. In almost all cases, recurrence appears relatively soon after the primary surgery. We herein describe a case of recurrent TEF that appeared 10 years after the primary repair. At 2 years of age, the patient suffered from mental retardation due to encephalitis and developed a hiatus hernia with gastro-esophageal reflux. He underwent the repair of a hiatus hernia and fundoplication at 3 years of age. However, the hiatus hernia recurred 6 months after the operation. The patient suffered from recurrent pneumonia for 6 years after the appearance of the recurrent hiatus hernia. At 9 years of age, he was hospitalized frequently due to recurrent severe pneumonia. After admission at 9 years of age, an endoscopic study under general anesthesia was performed and revealed subglottic stenosis and a dilated esophagus with a recurrent hiatus hernia. Tracheotomy or laryngotracheal separation was first planned in order to improve his upper airway and facilitate the safer repair of the recurrent hiatus hernia. After laryngotracheal separation, the patient still suffered from severe pneumonia. In addition, a small volume of nutritional supplement was aspirated from the tracheostomy. Thus, recurrent TEF was suspected. Tests using dye under both esophagoscopy and bronchoscopy confirmed recurrent TEF. The fistula recurred in the cervical area because of the elevation of the esophagus due to the recurrent hiatus hernia. The fistula was surgically closed, with a sternothyroid muscle flap to prevent re-recurrence. At 4 months after this operation, the recurrent hiatus hernia was repaired. Thereafter, the patient’s respiratory symptoms showed a dramatic improvement. The patient is now doing well and free from further recurrences of TEF and hiatus hernia at 2 years after the final operation.

A derivative spectrophotometric method was validated for quantification of acyclovir in poly ( n-butylcyanoacrylate) (PBCA) nanoparticles. Specificity, linearity, precision, accuracy, recovery, detection (LOD) and quantification (LOQ) limits were established for method validation. First-derivative at 295.2 nm eliminated interferences from nanoparticle ingredients and presented linearity for acyclovir concentrations ranging from 1.25 to 40.0 µg/mL (r = 0.9999). Precision and accuracy data demonstrated good reproducibility. Recovery ranged from 99.3 to 101.2. LOD was 0.08 µg/mL and LOQ, 0.25 µg/mL. Thus, the proposed method proved to be easy, low cost, and accurate, and therefore, an useful alternative to quantify acyclovir in nanoparticles.

The oxidation of dietary polyphenols with a catechol structure leads to the formation of an o-quinone structure, which rapidly reacts with sulfhydryls such as glutathione and protein cysteine residues. This modification may be important for understanding the redox regulation of cell functions by polyphenols. In this study, to investigate the catechol modification of protein sulfhydryls, we used 3,4-dihydroxyphenyl acetic acid (DPA) as a model catechol compound and developed a new probe to directly detect protein modification by catechol type polyphenols using a biotinylated DPA (Bio-DPA). The oxidation-dependent electrophilic reactivity of DPA with peptide sulfhydryls was confirmed by both mass spectrometry and nuclear magnetic resonance spectroscopy. When RL34 cells were treated with Bio-DPA, the significant incorporation of Bio-DPA into a 40 kDa protein was observed by Western blot analysis. The band was identified by mass spectrometry as the cytoskeletal protein, beta-actin. This identification was confirmed by the pull-down assay with anti-beta-actin antibody. To examine the reactivity of the catechol type polyphenols, such as flavonoids, to endogenous beta-actin, RL34 cells were coexposed to Bio-DPA and the flavonoids quercetin, (-)-epicatechin, and (-)-epicatechin gallate. Upon exposure of the cells to Bio-DPA in the presence of the flavonoids, we observed a significant decrease in the DPA-modified beta-actin. These results indicate that beta-actin is one of the major targets of protein modification by catechol type polyphenols and that Bio-DPA is an useful probe for understanding the redox regulation by dietary polyphenols. Furthermore, Keap1, a scaffold protein to the actin cytoskeleton controlling cytoprotective enzyme genes, was also identified as another plausible target of the catechol type polyphenols by oxidative modification of the intracellular sulfhydryls. These results provide an alternative approach to understand that catechol type polyphenol is a potential modifier of redox-dependent cellular events through sulfhydryl modification.

Little has been understood about vitamin D status in relation to bone health in Asian women. The purpose of this study was to identify how the serum 25-hydroxyvitamin D (25[OH]D) concentration is associated with bone mass and bone metabolism. This cross-sectional, community-based epidemiologic study was conducted among 600 ambulatory postmenopausal women. The serum 25(OH)D concentration was measured with radioimmunoassay. Other blood biochemical measurements were intact parathyroid hormone and markers of bone turnover, including osteocalcin and type I collagen cross-linked N-telopeptides. Bone mineral density (BMD) of the lumbar spine and right femoral neck were measured with the dual-energy X-ray absorptiometry method using a QDR4500a. The mean serum 25(OH)D concentration was 55.6 nmol/L (SD 14.6). Serum 25(OH)D concentration was linearly associated with BMD of the femoral neck (R(2)=0.020, P=0.003), but not with BMD of the lumbar spine. Odds ratios (ORs) for low BMD (defined as t scoreor =-2.5 SD) were calculated for strata defined by 25(OH)D concentration. The prevalence of low BMD of the lumbar spine was significantly higher in the 40- to 50-nmol/L 25(OH)D group (adjusted OR=3.0, 95% CI: 1.3-7.0) compared to the reference group (or =70 nmol/L). Prevalence of low BMD for the femoral neck was significantly higher in the 30- to 40-nmol/L (adjusted OR=3.6, 95% CI: 1.1-12.1) and the 40- to 50-nmol/L (adjusted OR=7.6, 95% CI: 2.5-23.2) groups compared to the reference group (or =70 nmol/L). The mean serum concentration of intact PTH was significantly higher in subjects with serum 25(OH)D50 nmol/L compared to those with serum 25(OH)Dor =50 nmol/L. The present study suggests that higher serum 25(OH)D concentrations are associated with increased BMD of the femoral neck, and that a serum 25(OH)D concentration of at least 70 nmol/L is needed to obtain high BMD of the femoral neck, and that of at least 50 nmol/L is needed to achieve normal PTH levels and prevent low BMD in home-dwelling postmenopausal Japanese women.

The electron-transfer reactions from Fe(II)(CN)6 4− to the cupric ion in human- or bovine-copper, zinc-superoxide dismutase were followed at various pHs from pH 5.0 to 8.0 by the micro-stopped-flow method. From pH 5.0 to 8.0, Fe(II)(CN)6 4− first forms an adduct through the charge interaction with Arg 143 or 141 of the active cavity; electron-transfer then occurs from Fe(II)(CN)6 4− to the cupric ion of the enzyme in human- or bovine-copper, zinc-superoxide dismutase. The formation-constant values of the adducts in human- and bovine-copper, zinc-superoxide dismutase are almost constant between pH 7.0 and 8.0, but increase with decreasing pH at pH values lower than 7.0. In contrast, the electron-transfer rate constants from Fe(II)(CN)6 4− to the cupric ion of the enzyme after adduct-formation in human- and bovine-copper, zinc-superoxide dismutase are nearly constant from pH 5.0 to 8.0 and give almost the same values in bovine- or human-copper, zinc-superoxide dismutase. The pH dependencies of adduct-formation-constants in human- and bovine superoxide dismutase indicate that the protonation of some residue with pKa value less than 5.0 accelerates the formation of adducts formed through the charge interaction between Arg 143 (human) or Arg 141 (bovine) and Fe(II)(CN)6 4−. X-ray diffraction analysis data show that the arrangement of Arg 143 and Glu 133 around the copper ion in the active cavity of human-copper, zinc-superoxide dismutase is very similar to that of bovine copper, zinc-superoxide dismutase. The low pKa value of the residue involved in adduct-formation suggests that the protonation group should be the carboxylate. Protonation of the carboxylate group of Glu 133 (Glu 131) results in neutralization of the minus charge of the carboxylate group and a decrease in the electronic repulsion for Fe(II)(CN)6 4−, so that the formation-constant of the adduct should increase with decreases in pH at lower pH values.

The effects of neuromodulation with sacral magnetic stimulation (SMS) were examined in postoperative patients with bowel or bladder dysfunction. SMS was performed at the S3 level using a MagPro® instrument (Medtronic Inc., USA) while the patients were under light sedation. One treatment course consisted of stimulation delivered at 15 Hz for 5 s, 10 times over an interval of 1 min. Three patients with bladder or bowel dysfunction refractory to conservative treatment were examined. Case 1 is a 7-year-old male with a rectourethral fistula. This patient developed a hyperdynamic bladder after a laparoscopic pull-through operation at the age of 7 months. The administration of an anticholinergic agent slightly improved the condition. SMS was started at the age of 4 years with one trial each year. A marked expansion of bladder volume from 20 ml before trial to 120 ml after the third trial was obtained. Case 2 (a 4-year old female with a recto-vaginal fistula) and Case 3 (a 8-year-old female with an ano-vestibular fistula) showed severe constipation after radical surgery during infancy. Case 2 needed appendicostomy. After SMS, bowel movements could become controllable with enemas. No adverse effects were observed for any of the three cases. These results suggest that SMS might be a useful modality to improve postoperative bowel or bladder dysfunction.

A water-soluble polymer having galactose pendant groups was prepared by the synthesis and radical polymerization of p-vinylbenzyl galactoside. Copolymerization of the galactoside with p-vinylphenyl acetate and subsequent [125I]labeling by a chloramine-T method afforded a radio-labeled galactose-containing polymer, and the body distribution of the polymer in mice was examined along with that of galactosylated bovine serum albumin (BSA). Both [125I]labeled galactose-containing polymer and [14C]labeled galactosylated BSA highly accumulated in the liver (>90%) soon after intravenous administration. The excretion of the synthetic vinyl polymer from the liver was very slow, and 92% and 63% of the administered radioactivity still remained in the liver 2 and 24 h after the injection, respectively, while only 18% of the radioactivity was recovered 2 h after the injection of [14C]labeled galactosylated BSA.

ObjectiveLow Ca intake is common among Japanese women, but its effect on bone metabolism has not been fully elucidated. The aim of the present study was to determine the relationship between Ca intake and serum markers of bone turnover in postmenopausal Japanese women.DesignA cross-sectional study.SettingA community setting.SubjectsSubjects were 595 home-dwelling postmenopausal Japanese women. Ca intake was assessed by a validated FFQ. Serum type I collagen cross-linked N-telopeptides (NTX) and osteocalcin were measured as markers of bone turnover. The relationships between demographic characteristics, lifestyles, serum Ca, vitamin D and intact serum parathyroid hormone and bone turnover were also assessed.ResultsThe average age of the subjects was 64·5 (sd 5·8) years and the mean Ca intake was 527 (sd 160) mg/d. Ca intake was significantly associated with serum NTX (P = 0·0104), but not with serum osteocalcin. Mean serum NTX concentration in the lowest quartile of Ca intake (ConclusionsIncreased bone resorption may be one mechanism by which this Ca-depleted population normalizes bone metabolism and prevents osteoporosis.

Poly(phenylacetylene) bearing an achiral glycine residue exhibits an induced circular dichroism in the UV–vis region upon complexation with free amino acids in water due to a predominantly one-handed helix formation and the Cotton effect intensity is amplified in the presence of a Cu(II) ion.

The effect of brewer's yeast (BY) on the absorption of ferrous sulfate from the intestinal tract was investigated by using 59FeSO4 in an in vivo rat model.The absorption was significantly elevated by the simultaneous administration of BY. The elevation was also observed in glutathione and cysteamine (2-aminoetanethiol) with a strong anti-oxidative potency. BY showed almost the same anti-oxidative potency as that of glutathione or cysteamine. These data suggest that the anti-oxidative potency of BY may play a role in the mechanism of the elevation of ferrous sulfate absorption by BY.

Colonic volvulus is a rare surgical emergency condition in children. Only approximately 40 children with cecal volvulus have been reported in English literature in the past 50 years. Among these, a right colonic volvulus involving the long segment from the ileal end to the transverse colon, as in our case, is limited to a few reports. Neurodevelopmental delay and a history of chronic constipation have been reported as common associated disorders. This is the first report about a case of right colonic volvulus in an infant with trisomy 13 who required extensive colectomy during an emergency laparotomy.