The question of whether or not to perform therapeutic hypothermia: A case of neonatal spinal cord injury

Neonatal spinal cord injury is an extremely rare perinatal complication that often occurs concurrently with hypoxic ischemic encephalopathy (HIE), further complicating diagnosis of spinal cord injury. Although therapeutic hypothermia for moderate to severe HIE is widely recommended in Japan, it is difficult to determine whether it satisfies the neurological findings-related entry criteria in some patients.We describe a female infant with neonatal spinal cord injury after forceps delivery, who underwent therapeutic hypothermia upon diagnosis of HIE. The Apgar scores were 5 at 1 min, 6 at 5 min, and not recorded at 10 min. Blood gas analysis of her umbilical artery was not performed. Since respiratory failure, hypotonia and the absence of primitive reflexes were found at 2 hours after birth, she was initially diagnosed with moderate HIE and underwent a therapeutic hypothermia. Magnetic resonance imaging after therapeutic hypothermia revealed the spinal cord was narrowed from the lower medulla oblongata to the upper cervical cord. Thus she was diagnosed with an upper spinal cord injury at that time.Some patients with neonatal spinal cord injuries satisfy the criteria for therapeutic hypothermia. When neonates with asphyxia present with prolonged respiratory failure and hypotonia, spinal cord injury should be considered in the differential diagnosis. Thus, an early MRI is vital for the diagnosis of spinal cord injury.

Faraday-cup-type lost fast ion detector on Heliotron J

A Faraday-cup type lost-fast ion probe (FLIP) has been designed and installed in Heliotron J for the purpose of the studies of interaction between fast ions and MHD instabilities. The FLIP can measure the co-going fast ions whose energy is in the range of 1.7-42.5 keV (proton) and pitch angle of 90^∘-140^∘, especially for fast ions having the injection energy of neutral beam injection (NBI). The FLIP successfully measured the re-entering passing ions and trapped lost-fast ions caused by fast-ion-driven energetic particle modes in NBI heated plasmas.

Development of beam emission spectroscopy for turbulence transport study in Heliotron J

This paper describes the development study of the beam emission spectroscopy (BES) for the turbulent transport study in Heliotron J. Modification of the sightlines (10 × 4 for edge and 10 × 2 for edge) enables us to obtain 2-dimensional BES imaging. The cooling effect on the reduction in the electrical noise of avalanche photodiode (APD) assembly has been investigated using a refrigerant cooling system. When the temperature of the APD element has set to be -20 °C, the electrical noise can be reduced more than 50%. The measurement error of the phase difference in the case of low signal level has been tested by two light-emitting diode lamps. The APD cooling has an effect to improve the measurement error at the low signal level of APD.

Logarithmic discretization and systematic derivation of shell models in two-dimensional turbulence

A detailed systematic derivation of a logarithmically discretized model for two-dimensional turbulence is given, starting from the basic fluid equations and proceeding with a particular form of discretization of the wave-number space. We show that it is possible to keep all or a subset of the interactions, either local or disparate scale, and recover various limiting forms of shell models used in plasma and geophysical turbulence studies. The method makes no use of the conservation laws even though it respects the underlying conservation properties of the fluid equations. It gives a family of models ranging from shell models with nonlocal interactions to anisotropic shell models depending on the way the shells are constructed. Numerical integration of the model shows that energy and enstrophy equipartition seem to dominate over the dual cascade, which is a common problem of two-dimensional shell models.

Injection barrel with a tapered structure for a low speed and small size cryogenic hydrogen pellet in medium-sized plasma fusion devices

An injection barrel was designed and fabricated for a small size 0.8 mm cryogenic pellet with a low speed of 200-300 m/s in medium-sized plasma fusion devices. Pellet injection with pneumatic acceleration was examined using a conventional in situ technique. A tapered structure was applied in the downstream side of the injection barrel to satisfy the requirement of pellet speed reduction by expansion of the propellant gas. Shadowgraph and light gate measurements show that the intact pellets have speeds of 260 ± 30 m/s and a typical size of 1.1-1.2 mm. The pellet ablation code based on a neutral gas shielding model shows that the penetration depth of the measured pellet parameters does not cross the plasma center, even in medium-sized plasma devices such as the Heliotron J helical device. The injection barrel with a tapered structure developed in this study is feasible for low speed pellet injection.

The prevalence of patellofemoral osteoarthritis: a systematic review and meta-analysis

OBJECTIVE

To determine the prevalence of radiographic patellofemoral osteoarthritis (OA) from population- and symptom-based cohorts and to evaluate if knee pain, physical function and quality of life (QOL) differ between people with isolated patellofemoral OA, isolated tibiofemoral OA and combined patellofemoral and tibiofemoral OA.

METHOD

Terms associated with "patellofemoral OA", "prevalence" and "clinical features" were used to search Medline, EMBASE, CINAHL, SCOPUS, AMED and Web of Science databases with no language restriction' from inception to August 2014. Two independent reviewers screened papers for eligibility. Studies were included if they reported prevalence of compartmental patterns of radiographic knee OA in population- or symptom-based cohorts. Studies were excluded if they evaluated a targeted sample (e.g., occupation-specific participants) or repeated already reported data from the same cohorts. Point prevalence estimates of patellofemoral OA were extracted from eligible studies, pooled and quantitatively analysed. A critical appraisal tool was used to evaluate methodological quality.

RESULTS

The search yielded 1891 records. The inclusion criteria were met by 32 studies. The crude prevalence of patellofemoral OA was 25% in the population-based cohorts (aged >20 years) and 39% in the symptom-based cohorts (aged >30 years). Eight studies reported knee pain, physical function and QOL in people with different compartmental disease; however no significant differences were found.

CONCLUSION

These findings confirm the substantial prevalence of patellofemoral OA, demonstrating the need to specifically consider the patellofemoral joint in knee OA research and clinical settings.

Validity and reliability of the Family Empowerment Scale for caregivers of adults with mental health issues

WHAT IS KNOWN ON THE SUBJECT?: Empowerment of family caregivers of adults with mental health issues has received increasing attention among mental health nurses in Japan and has been recognized as a new goal of family interventions. The Family Empowerment Scale (FES) was originally developed to measure the empowerment status of parents of children with emotional disorders. However, it was later applied to broader health issues. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: We developed a Japanese version of the FES for family caregivers of adults with mental health issues (FES-AMJ) and examined the validity and reliability among parents. Results showed that the FES-AMJ had acceptable concurrent validity and reliability; however, insufficient construct validity was found, especially for the subscale regarding the service system. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Further studies need to modify the scale. Clarification of ideal family empowerment status in the service system through discussion with mental health nurses and family caregivers may be important.

ABSTRACT

Introduction The Family Empowerment Scale (FES) was originally developed for parents of children with emotional disorders. In Japan, family empowerment is gaining increasing attention and may be one goal of nursing interventions. Aim To develop a Japanese version of the FES for family caregivers of adults with mental health issues and to study the validity and reliability of this scale among parents. Method We translated the FES into Japanese and administered this self-report questionnaire to 275 parents. Results The multitrait scaling analysis revealed acceptable convergent validity and insufficient discriminant validity among all subscales. In particular, all items of the Service system subscale had insufficient discriminant and/or convergent validity. Each subscale significantly correlated with the indicator of empowerment. The intraclass correlation coefficients of each subscale were .855-.917. Cronbach's alpha of each factor ranged from .867 to .895. Discussion The Service system subscale may not linearly reflect family empowerment, and instead may depend on unclear roles of family caregivers of adults, disorder severity or insufficient services. Implications for practice Further studies need to modify the scale. Clarification of ideal family empowerment status in the service system through discussion with mental health nurses and family caregivers may be important.

Autoimmune pancreatitis as the initial presentation of systemic lupus erythematosus

Pancreatitis is a relatively rare complication in systemic lupus erythematosus (SLE). Here we present a case of SLE associated with autoimmune pancreatitis. A 37-year old woman was admitted to our hospital because of fever, skin rash, proteinuria and abdominal pain. A diagnosis of SLE was made based on her clinical, laboratory and renal histological findings showing diffuse proliferative lupus nephritis. Elevated serum amylase, typical radiographic findings and selective increase in serum IgG4 all suggested that the patient also had autoimmune pancreatitis. Systemic administration of glucocorticoid successfully induced remission of pancreatitis and nephritis along with the reduction of IgG4. Autoimmune pancreatitis is a newly recognized type of pancreatitis, in which IgG4 immune response is thought to participate pathophysiologically. Although the disease has been observed to develop in patients having various connective tissue diseases, our report is the first to describe IgG4 related autoimmune pancreatitis in a patient with SLE.

Practices for Supporting and Confirming Decision-Making Involved in Kidney and Liver Donation by Related Living Donors in Japan: A Nationwide Survey

This nationwide survey investigated the actual practices for supporting and confirming the decision-making involved in related living-organ donations in Japan, focusing on organ type and program size differences. Answers to a questionnaire survey were collected from 89 of the 126 (71%) kidney and 30 of the 35 (86%) liver transplantation programs in Japan that were involved in living-donor transplantations in 2013. In 70% of the kidney and 90% of the liver transplantation programs, all donors underwent "third-party" interviews to confirm their voluntariness. The most common third parties were psychiatrists (90% and 83%, respectively). Many programs engaged in practices to support decision-making by donor candidates, including guaranteeing the right to withdraw consent to donate (70% and 100%, respectively) and prescribing a set "cooling-off period" (88% and 100%, respectively). Most donors were offered care by mental health specialists (86% and 93%, respectively). Third parties were designated by more of the larger kidney transplant programs compared with the smaller programs. In conclusion, the actual practices supporting and confirming the decision to donate a living organ varied depending on the organ concerned and the number of patients in the program.

Early results of multicenter phase II trial of perioperative oxaliplatin and capecitabine without radiotherapy for high-risk rectal cancer: CORONA I study

BACKGROUNDS

Perioperative introduction of developed chemotherapy into the treatment strategy for locally advanced rectal cancer (LARC) may be a promising option. However, the most prevalent treatment for high-risk LARC remains preoperative chemoradiotherapy (CRT) in Western countries.

PATIENTS AND METHODS

A phase II trial was undertaken to evaluate safety and efficacy of perioperative XELOX without radiotherapy (RT) for patients with high-risk LARC. Patients received 4 cycles of XELOX before and after surgery, respectively. Primary endpoint was disease-free survival.

RESULTS

We enrolled 41 patients between June 2012 and April 2014. The completion rate of the preoperative XELOX was 90.3%. Twenty-nine patients (70.7%) could start postoperative XELOX, 15 of these patients (51.7%) completed 4 cycles. Allergic reaction to oxaliplatin was experienced by 5 patients (17.2%) during postoperative XELOX. One patient received additional RT after preoperative XELOX. Consequently, the remaining 40 patients underwent primary resection. Major complications occurred in 6 of 40 patients (15.0%). Pathological complete response (pCR) rate was 12.2%, and good tumor regression was exhibited in 31.7%. N down-staging (cN+ to ypN0) and T down-staging were detected in 56.7% and 52.5%, respectively. Clinical T4 tumor was a predictor of poor pathological response (p < 0.001).

CONCLUSIONS

We could show the favorable pCR rate after preoperative XELOX alone. However, the T and N down-staging rate was likely to be insufficient. When tumor regression is essential for curative resection, the use of preoperative CRT is likely to be recommended. For patients with massive LN metastasis, the additional Bev to NAC might be a promising option.

Microstructure investigation, optical properties and magnetic phase transition of Tm3+ substituted nanocrystalline ZnO (Zn0.95Tm0.05O)

The onset of ferromagnetic ordering with high value of magnetization of Zn_0.95Tm_0.05O at, and below 30 K.

194 EFFECT OF CORPUS LUTEUM PRESENCE FOR THE DURATION OF FOLLICULAR GROWTH ON BOVINE OOCYTE DEVELOPMENTAL COMPETENCE

It has been reported that follicular wave control is effective to increase bovine oocyte (OC) quality of ovum pickup (Imai et al. 2008 Reprod. Fertil. Dev. 20, 182). However, the effect on the bovine OC developmental competence to the presence of corpus luteum (CL) for the duration of follicular growth (FG) is not known. This study was conducted to examine the developmental competence of OC after stimulation of FG with and without CL. Japanese Black cows (n = 4/session) were synchronised in oestrus (Day 0; D0) with prostaglandin F2α (PGF2α; 0.5 mg cloprostenol). On Day 9, cows were removed follicles (FL) ≥ 8 mm in diameter and CIDR were inserted. Cows in the PGF2α treatment group (PG) were administered PGF2α (0.75 mg cloprostenol) for regression of the CL; the PGF2α non-treatment group (non-PG) were not administered PGF2α for the presence of CL. The cows received 20 mg of FSH twice a day from the evening of Day 10 to the morning of Day 14 in decreasing doses. Oocytes were collected from FL ≥ 5 mm by OPU on Day 15. Collected OC were classified as follows: Grade 1, several layers of cumulus cells (CC) and homogeneous OC cytoplasm; Grade 2, 1 to 3 layers of CC; Grade 3, denuded OC; Grade 4, expanded CC or degenerated OC. The OC that were classified as Grade 1 to 3 were matured in vitro for 20–22 h and then inseminated with 3 × 106 sperm mL–1 for 6 h. Then presumptive zygotes were cultured in 5% newborn calf serum + CR1aa for 216 h in micro-well culture dishes (Dai, Nippon, Japan). Cows were assigned to groups of 4 with each pair placed into 1 of the treatments, and groups switched at ≥40 days of interval for crossover trials. To compare the quality of OC derived from CL ipsilateral FL and CL contralateral FL, the OC were subdivided in CL ipsilateral group (ipsi-CL) and CL contralateral group (contra-CL) in the non-PG. In addition, half of the data from PG were regarded as unilateral ovary (regression CL group; reg-CL). Statistical analysis was carried by Student’s t-test, Tukey’s test, Fisher’s exact probability test, and chi-squared test. Part of data was log-transformed. At OPU, all cows in the non-PG group had an observed CL, and the average diameter of the CL was 16 ± 0.1 mm in the long axis and short; all cows in the PG were observed to not have a CL. In PG and non-PG, there were no significant differences in the number of FL ≥ 5 mm, the rate of cleavage, or the rate of blastocyst (BL) formation (17 ± 2.0 v. 20.8 ± 2.6, 82.7 ± 5.6% v. 86.1 ± 3.9% and 53.4 ± 5.9% v. 62.1 ± 4.7%, respectively). The number of BL tended to increase in non-PG cows compared with PG cows (10.0 ± 1.2 v. 7.8 ± 0.9; P = 0.078). The number of BL rated as Code 1 or 2 (IETS code) was higher in non-PG cows than in PG cows (76 v. 46; P < 0.01). In ipsi-CL, contra-CL, and reg-CL, statistical differences were observed between the rate of Grade 1 to 2 OC and groups; the rate of Grade 1 to 2 OC was higher in ipsi-CL (93.8 v. 79.0 v. 86.7; P < 0.01). These results suggested that the presence of CL for the duration of FG did not affect the rate of cleavage and BL formation but may have improved efficiency of embryo production by increasing quality of OC and BL.

96 EFFICIENT PRODUCTION OF MONOZYGOTIC TWIN BOVINE EMBRYOS USING BLASTOMERE SEPARATION TECHNIQUE WITH COMMERCIAL WELL OF THE WELL CULTURE DISH

Monozygotic twin embryos can be produced using the technique of blastomere separation and well of the well (WOW) dish having handmade micro-wells by the needle depression (Tagawa et al. 2008). We have recently reported that developed commercial WOW dish enhances embryo competence in individual culture (Sugimura et al. 2010). The present study was conducted to evaluate the availability of commercial WOW dish for production of monozygotic twin embryos in bovine. Embryos were produced using oocytes from ovaries collected at an abattoir by IVM, IVF, and IVC. For each culture, TCM-199 supplemented with 5% calf serum (CS), Brackett-Oliphant solution supplemented with 10 mg mL–1 BSA, and CR1aa containing 5% CS were used. To evaluate the adaptability of dishes on culture of isolated blastomeres from different cell stage, 2- (n = 63), 4- (n = 94), 8- (n = 137), and 10- to 14- (n = 116) cell stages were obtained on 24–27 h, 30–36 h, 48–54 h, and 48–54 h from the beginning of fertilization, respectively. The zona pellucida was removed by exposure of 0.25% pronase, followed by gentle pipetting by inspiration and expiration in the IVC medium. Then, two halves separated from the original number of blastomeres were randomly allocated to the conical micro-wells of commercial dish (Dai Nippon Printing, Tokyo, Japan) or created micro-wells by pressing the bottom of the dish with an eyeleteer (control). The approximate diameter and depth of each 25 wells in a commercial dish was 287 and 168 μm, and each 20 wells in the control were 800 and 600 μm. The blastomeres were cultured in wells covered with a droplet of 2.5 μL well–1 IVC medium until Day 8 (IVF = Day 0). Expanded blastocysts (n = 28) derived from tetra-blastomeres of 8-cell stage were stained to determine the number of the inner cell mass (ICM) and trophectoderm (TE) in each group. Statistical significance of the blastocyst formation rates and the number of cells were analysed by the chi-square test and the Student’s t-test, respectively. In the 2-cell stage, blastocyst formation rate in commercial dish tended to be higher than that in the control (60.0% v. 46.1%). The rate of monozygotic blastocyst pairs in commercial dish was higher compared with the control (48.0% v. 26.3%, P < 0.05). In the 4-cell stage, rates of blastocyst formation (50.0% v. 33.0%, P < 0.05) and the pairs (39.5% v. 12.5%, P < 0.01) in the commercial dish, both were higher compared with the control. In the 8-cell stage, there were no differences between two groups in rates of blastocyst formation (53.1% v. 59.0%) and the pairs (41.8% v. 48.7%), similarly in the 10- to 14-cell stage (47.9% v. 56.8% and 36.2% v. 40.9%, respectively). The ICM, TE, and total cell numbers were not different between the commercial and the control dish (28.0 ± 3.2 v. 26.0 ± 3.8, 64.6 ± 4.3 v. 76.0 ± 7.9, and 92.6 ± 6.2 v. 102.0 ± 11.0, respectively). These results indicate that separated blastomeres could be developed to blastocysts efficiently and stably regardless of embryo cell stage with a commercial WOW culture dish.

Establishment of a specific cell death induction system in Bombyx mori by a transgene with the conserved apoptotic regulator, mouse Bcl-2-associated X protein (mouse Bax)

The induction of apoptosis in vivo is a useful tool for investigating the functions and importance of particular tissues. B-cell leukaemia/lymphoma 2-associated X protein (Bax) functions as a pro-apoptotic factor and induces apoptosis in several organisms. The Bax-mediated apoptotic system is widely conserved from Caenorhabditis elegans to humans. In order to establish a tissue-specific cell death system in the domestic silkworm, Bombyx mori, we constructed a transgenic silkworm that overexpressed mouse Bax (mBax) in particular tissues by the Gal4-upstream activation sequence system. We found that the expression of mBax induced specific cell death in the silk gland, fat body and sensory cells. Fragmentation of genomic DNA was observed in the fat body, which expressed mBax, thereby supporting apoptotic cell death in this tissue. Using this system, we also demonstrated that specific cell death in sensory cells attenuated the response to the sex pheromone bombykol. These results show that we successfully established a tissue-specific cell death system in vivo that enabled specific deficiencies in particular tissues. The inducible cell death system may provide useful means for industrial applications of the silkworm and possible utilization for other species.

Bilberry extract supplementation for preventing eye fatigue in video display terminal workers

OBJECTIVES

To examine the effect of a dietary supplement containing bilberry extract (BE) on eye fatigue induced by acute video display terminal (VDT) loads.

DESIGN AND SETTING

A prospective, randomized, double-blind, placebo-controlled study was performed from August 2012 to February 2013 in the Medical Corporation Jico-kai Yagi Hospital, and the Shinyokohama Shinoharaguchi Orthopedic Surgery and Dermatology Clinic, in Japan.

PARTICIPANTS

Two hundred eighty-one office workers aged 20-40 years that used VDTs were screened by critical flicker fusion (CFF) and near point accommodation (NPA).

INTERVENTION

The participants were randomized to either a BE (480 mg/day) or placebo (vehicle) group, and took allocated capsule, daily, for 8 weeks.

MEASUREMENTS

The CFF, NPA, contrast visual acuity, functional visual acuity, keratoconjunctival epithelial damage, and fluorescein tear film break-up time were examined, and 18 subjective symptoms of eye fatigue were evaluated by questionnaire. Adverse events were reported via medical interviews. Data were collected both before and after VDT load at baseline, and 4, and 8 weeks after daily supplementation with either BE or placebo.

RESULTS

Of 281 participants screened, 88 having relatively lower levels of CFF and NPA were enrolled in the study. Of these, 37 control and 43 BE group subjects completed the study. The VDT load-induced reduction in CFF was alleviated after 8 weeks of BE supplementation (95% confidence interval, 0.10-1.60; p=0.023), in contrast to placebo supplementation, while NPA variation was not. Of the subjective symptoms of eye fatigue, VDT load-induced ocular fatigue sensation, ocular pain, eye heaviness, uncomfortable sensation, and foreign body sensation were mitigated more in the BE group than in the control group, at week 8 (p<0.05). There were no severe adverse events in either group.

CONCLUSIONS

BE supplementation improved some of the objective and subjective parameters of eye fatigue induced by VDT loads.