Psychiatric Features of Children with Chronic Functional Constipation: Focusing on Individuals with Autism Spectrum Disorder

PURPOSE

The present study aimed to assess the psychiatric characteristics of children with chronic functional constipation using the Aberrant Behavior Checklist-Japanese version and the Pervasive Developmental Disorders/Autism Society Japan Rating Scale, and to examine the frequency of autism spectrum disorder in children with chronic functional constipation. We also investigated differences in treatment duration between children with and without autism spectrum disorder.

METHODS

Treatment outcomes were examined retrospectively for 55 participants (chronic functional constipation group: n = 30, mean age 3.4 years; control group: n = 25, mean age, 4.5 years). The association between chronic functional constipation and autism spectrum disorder was evaluated using multivariable logistic regression analysis.

RESULTS

The mean Aberrant Behavior Checklist score and frequency of individuals with autism spectrum disorder were significantly higher in the chronic functional constipation group. After adjusting for age and sex, chronic functional constipation was significantly associated with autism spectrum disorder. In the chronic functional constipation group, the frequency of onset was significantly higher in children with autism spectrum disorder under 1 year of age. When treated, the mean duration of constipation was significantly longer in children with autism spectrum disorder.

CONCLUSION

Pediatricians, pediatric surgeons, and child psychiatrists should work closely to ensure appropriate treatment of chronic functional constipation in children with autism spectrum disorder.

Prescribing Patterns in Child and Adolescent Outpatient Psychiatry: A Retrospective Cohort Study of Prescriptions in the First Year

OBJECTIVE

Recently, excessive and off-label prescribing of psychotropic drugs for children and adolescents have become a problem. Child and adolescent psychiatric patients receive treatment in many departments and department-specific psychotropic drug use has not been analyzed. We surveyed prescriptions for child and adolescent psychiatric outpatients during their first year of treatment.

METHODS

The participants were 302 patients, 15 years or younger, who made their first visit to the outpatient psychiatry department of Tokai University Hospital from September 1, 2015 to September 1, 2016. Prescription details and patient profiles were retrospectively investigated using medical records.

RESULTS

Medication was prescribed for 20.9% of patients (63/302) with the prescription rate increasing with age. Psychotropic drugs were prescribed for 15.6% of patients (48/302), with attention-deficit/hyperactivity disorder (ADHD) medications being most frequently prescribed (20 cases). Other than psychotropic drugs, iron pills (25 cases) and herbal medicines (21 cases) were prescribed frequently.

CONCLUSIONS

The pharmacotherapy and psychotropic prescription rates were low. This may be due to the use of non-pharmacological interventions and the lack of inpatient facilities. With the publication of guidelines for pharmacotherapy in child psychiatry in Japan, measuring the patterns of psychotropic drug prescription in children and adolescents is important, and would make treatment more transparent.

Predictive values of immune indicators on respiratory failure in the early phase of COVID-19 due to Delta and precedent variants

Background

Immune response indicators in the early phase of COVID-19, including interferon and neutralizing responses against SARS-CoV-2, which predict hypoxemia remains unclear.

Methods

This prospective observational study recruited patients hospitalized with COVID-19 (before emergence of omicron variant). As the immune indicators, we assessed the serum levels of IFN-I/III, IL-6, CXCL10 and VEGF, using an ELISA at within 5 days after the onset of symptoms, and serum neutralizing responses using a pseudovirus assay. We also assessed SARS-CoV-2 viral load by qPCR using nasal-swab specimens and serum, to assess the association of indicators and viral distribution.

Results

The study enrolled 117 patients with COVID-19, of which 28 patients developed hypoxemia. None received vaccine before admission. Serum IFN-I levels (IFN-α and IFN-β), IL-6, CXCL10, LDH and CRP were significantly higher in patients who developed hypoxemia. A significant association with nasopharyngeal viral load was observed only for IFN-I. The serum levels of IFN-α, IL-6, CXCL10 were significantly associated with the presence of RNAemia. Multivariable analysis showed higher odds ratio of IFN-α, with cut-off value of 107 pg/ml, in regard to hypoxemia (Odds ratio [OR]=17.5; 95% confidence interval [CI], 4.7-85; p<0.001), compared to those of IL-6, >17.9 pg/ml (OR=10.5; 95% CI, 2.9-46; p<0.001).

Conclusions

This study demonstrated that serum IFN-α levels in the early phase of SARS-CoV-2 infection strongly predict hypoxemic respiratory failure in a manner different from that of the other indicators including IL-6 or humoral immune response, and instead sensitively reflect innate immune response against SARS-CoV-2 invasion.

Impact of Gut Microbiota on Host Aggression: Potential Applications for Therapeutic Interventions Early in Development

Aggression in the animal kingdom is a necessary component of life; however, certain forms of aggression, especially in humans, are pathological behaviors that are detrimental to society. Animal models have been used to study a number of factors, including brain morphology, neuropeptides, alcohol consumption, and early life circumstances, to unravel the mechanisms underlying aggression. These animal models have shown validity as experimental models. Moreover, recent studies using mouse, dog, hamster, and drosophila models have indicated that aggression may be affected by the "microbiota-gut-brain axis." Disturbing the gut microbiota of pregnant animals increases aggression in their offspring. In addition, behavioral analyses using germ-free mice have shown that manipulating the intestinal microbiota during early development suppresses aggression. These studies suggest that treating the host gut microbiota during early development is critical. However, few clinical studies have investigated gut-microbiota-targeted treatments with aggression as a primary endpoint. This review aims to clarify the effects of gut microbiota on aggression and discusses the therapeutic potential of regulating human aggression by intervening in gut microbiota.

A Case of Nocturnal Enuresis Associated with Attention-deficit/hyperactivity Disorder Successfully Treated with Guanfacine Monotherapy

Nocturnal enuresis (NE) is a syndrome associated with abnormal nocturnal urine production, urination mechanism, and sleep arousal. NE is strongly associated with attention-deficit/hyperactivity disorder (ADHD), and it has been reported that NE occurs in approximately 30% of children with ADHD. There have been several reports on the efficacy of atomoxetine as treatment for NE with ADHD, while the efficacy of guanfacine is still limited. We report our experience of treating an 10-year-old girl with NE with ADHD with a single dose of guanfacine. The patient first visited our hospital because of difficulty concentrating, restlessness at home and school, and nocturnal incontinence. She was diagnosed with NE with ADHD based on a review of her personal history from her mother. Her NE symptoms improved with guanfacine monotherapy (1 mg/day. The patient weighed 28 kg).

Effective Tools to Predict Depression in Acute and Subacute Phase of Ischemic Stroke

OBJECTIVE

Despite the high frequency of depression in the first year following stroke, few studies have predicted risk of depression after the acute and subacute stroke periods. The aim of this study was to identify, in the acute and subacute periods, measures that would predict major depression during the first year after stroke.

METHODS

Study subjects were inpatients with ischemic stroke aged 20-85 years within 6 weeks of onset. Patients were evaluated at baseline and at 3, 6, 9, and 12 months. Patients were diagnosed with major depression using the Structured Clinical Interview for DSM-IV. The severity of depressive symptoms was measured with the Patient Health Questionnaire-9 (PHQ-9) and the Montgomery-Åsberg Depression Rating Scale (MADRS).

RESULTS

Of the 152 potential patients who met inclusion criteria, 49 had follow-up evaluations; one patient with major depression in the acute and subacute periods was excluded from the analysis. Among the remaining 48 patients, the number of those with major depression during the first year of stroke onset was five (10.4%). Patients who developed major depression had significantly more depressive symptoms in the acute and subacute stroke phase as assessed by both the PHQ-9 and MADRS. Patients with PHQ-9 scores ≥9 in the acute and subacute stroke phases were significantly more likely to develop major depression in a chronic phase of stroke.

CONCLUSIONS

The self-administered PHQ-9 can identify patients in the acute and subacute stroke periods who are at increased risk for developing major depression during the first year after stroke.

Iron supplementation for hypoferritinemia-related psychological symptoms in children and adolescents

BACKGROUND

Although some studies have described the association between serum ferritin levels and specific disorders in child and adolescent psychiatry, few have focused on mental health with low serum ferritin levels in children and adolescents. This study examined the effects of iron administration on psychological state of children and adolescents with reduced serum ferritin concentration.

METHODS

This prospective study evaluated 19 participants aged 6-15 years with serum ferritin levels <30 ng/mL who visited a mental health clinic and received oral iron administration for 12 weeks. The participants were assessed using the Clinical Global Impression Severity (CGI-S), Profile of Mood States 2nd Edition Youth-Short (POMS), Center for Epidemiologic Studies Depression Scale (CES-D), and Pittsburgh Sleep Quality Index (PSQI). In addition to serum ferritin, blood biochemical values such as hemoglobin (Hb) and mean corpuscular volume (MCV) were examined. School attendance was recorded.

RESULTS

The most prevalent physical symptoms were fatigability and insomnia. The CGI-S, PSQI, and CES-D scores decreased significantly following iron supplementation, whereas the scores of almost all POMS subscales improved significantly at week 12. No participant had hemoglobin levels <12 g/dL. Serum ferritin concentration increased significantly, whereas Hb and MCV remained unchanged. At baseline, 74% of the participants did not attend school regularly; this number improved to varying degrees by week 12.

DISCUSSION

Serum ferritin levels would be preferable to be measured in children and adolescents with insomnia and/or fatigability regardless of psychiatric diagnoses or gender. Iron supplementation can improve the hypoferritinemia-related psychological symptoms of children and adolescents, such as poor concentration, anxiety, depression, low energy and/or irritability.

Second-Generation Antipsychotic Drugs for Children and Adolescents

The effectiveness and safety of antipsychotics have not been fully established in children and adolescents. Many antipsychotics approved for use in adults are prescribed off-label to children and adolescents. We investigated the effectiveness and tolerability of antipsychotics for children and adolescents with schizophrenia and bipolar disorder. A literature review of the empirical evidence regarding the use of antipsychotics, particularly second-generation antipsychotics, in children and adolescents showed that these drugs were safe and effective for this population. Antipsychotics were similarly effective for treatment of schizophrenia and bipolar disorder in children and adolescents. When prescribing antipsychotics to this population, clinicians should consider adverse events and the discontinuation rate in treated patients. However, the current evidence shows a lack of consensus regarding the use of antipsychotics in children and adolescents.

Comparison of cerebral cortex activation induced by tactile stimulation between natural teeth and implants

Background

The purpose of this study was to assess the cortical-level sensory differences between natural teeth with a periodontal membrane and dental implants.

Material and Methods

We used functional near-infrared spectroscopy (fNIRS) to measure brain activity in the cerebral cortex of 12 patients who had both natural teeth and dental implants in the lower molar region. Painless vibratory tactile stimulation was performed on both the natural teeth and the dental implants.

Results

Activation was seen in the somatosensory cortex during stimulation of both natural teeth and dental implants. A comparison of cortical activation showed no significant differences between natural teeth and dental implants.

Conclusions

These results indicate the possible existence of sensory input to the cerebral cortex via dental implants as well as natural teeth, and thus suggest that may not only the periodontal membrane be involved in the signaling pathway. The data from this experiment may help us for understanding the neural mechanisms underlying natural teeth and dental implants.

Key words:fNIRS, natural teeth, implants, brain activity, somatosensory cortex.

Detection of norovirus in food samples collected during suspected food-handler-involved foodborne outbreaks in Tokyo

Although norovirus (NoV) is the major cause of gastroenteritis, with the largest number of NoV food poisoning cases in Japan, limited information is available regarding NoV detection in food. This study aimed to detect NoV in food samples during the 2015-2016 suspected foodborne outbreaks in Tokyo; 352 food samples from 64 NoV food poisoning outbreaks were collected. Bacterial culturing was performed for sample pretreatment and real-time reverse transcription polymerase chain reaction was conducted for NoV screening. The NoV detection rate was 1·7% (6/352). NoV-positive food samples included leftover boxed lunch, mackerel fillet (foodstuff), aburi salmon slice (partially seared salmon slice), raw tuna as a chirashizushi ingredient, raw amberjack as a sushi topping and ice for drinks. Since fresh fish as sushi toppings or ingredients and ice were consumed without heating, they may present a higher risk of viral infection. NoV-positive food samples were obtained from five outbreaks, wherein food handlers were NoV-positive in four. Each partial VP1 sequence from food samples matched completely with those in NoV-positive individuals and food handlers. Hence, food handlers play a potentially important role in food-based NoV transmission in all five outbreaks; therefore, hygiene education among them is essential to prevent NoV foodborne outbreaks. SIGNIFICANCE AND IMPACT OF THE STUDY: Significance and Impact of the Study: Norovirus (NoV) is a leading cause of foodborne outbreak in Japan. The most frequent route of transmission in NoV foodborne outbreaks is secondary contamination via infected food handlers. However, limited information is available regarding NoV contamination in food samples. This study reports the detection of NoV in food samples to elucidate the source and route of NoV infection leading to outbreaks for 2 years in Tokyo. Our data potentially contribute to education and the development of safe food-handling strategies among food handlers and employees in the food industry through elucidation of risk factors associated with NoV contamination.

Subjective Evaluation of Denture Adhesives: A Multicenter Randomized Controlled Trial

INTRODUCTION

Many reports show that denture adhesives improve the retention and stability of dentures. However, few randomized controlled trials have examined the effects of denture adhesives.

OBJECTIVE

This 10-center randomized controlled trial with parallel groups involving 200 edentulous patients wearing complete dentures aimed to evaluate the effects of short-term use of cream and powder denture adhesives.

METHODS

Patients were allocated into 2 cream- and powder-type adhesive groups and 1 control group. Intervention groups were treated with the 2 adhesives (1 each), and the control group received saline solution. Adhesive or control was applied to the denture-mucosal surface for 4 d, and data at baseline and after day 4 of intervention (i.e., 8 meals) were obtained. Patient satisfaction was evaluated with a 100-mm visual analog scale. Oral health-related quality of life was measured with the Japanese version of the Oral Health Impact Profile for Edentulous Patients. Perceived chewing ability was evaluated by a questionnaire regarding ease of chewing and swallowing food. Between-group comparisons were performed with Kruskal-Wallis tests with the Mann-Whitney U test adjusted by Bonferroni correction. Within-group comparisons of pre- and postintervention measurements were performed with the Wilcoxon signed-rank test. Intention-to-treat analysis was also performed.

RESULTS

Between-group comparisons showed no significant differences for general satisfaction or Oral Health Impact Profile for Edentulous Patients. However, significant differences in satisfaction with various denture functions with cream- and powder-type adhesives were seen in pre- and postintervention comparisons (P < 0.05). Significant differences were also observed for perceived chewing ability of hard foods (P < 0.05).

CONCLUSION

These results suggest that although denture adhesives do not invariably improve denture function, they do affect subjective evaluations and possibly chewing of hard foods. Therefore, the effects of denture adhesive use are insufficient to resolve any fundamental dissatisfaction with dentures ( ClinicalTrials.gov NCT01712802 ).

KNOWLEDGE TRANSFER STATEMENT

The results of this study suggest that denture adhesives should be applied under certain conditions; however, an appropriate diagnosis is important before application. These practice-based data provide information to establish evidence-based guidelines for applying denture adhesives.

Efficacy of Mirtazapine on Irritable Bowel Syndrome with Anxiety and Depression: A Case Study

Irritable bowel syndrome (IBS) is a disease in which gastrointestinal symptoms-primarily abdominal pain or discomfort and abnormal bowel movements persist chronically. For patients with IBS, mental illness, especially depression and/or anxiety, leads to a further lower quality of life. The purpose of this case study was to investigate the effects of mirtazapine (MIR) on mental health and IBS symptoms in a case of IBS accompanied by anxiety and a depressive state. This case report suggests that MIR is efficacious for the treatment of IBS with predominant diarrhea accompanied by depression and anxiety.

Suppression of Stress-induced nNOS Expression in the Rat Hypothalamus by Biting

Nitric oxide (•NO) modulates the activity of the endocrine system in the behavioral response to stress. The purpose of this study was to investigate the effect of restraining the body of an animal on expression of neuronal nitric oxide synthase (nNOS) in the paraventricular nucleus (PVN) of the hypothalamus, and the inhibitory effect of para-masticatory activity on restraint-induced nNOS expression. We observed an increase in nNOS mRNA expression and nNOS-positive neurons in the rat hypothalamus after 30 or 60 min of restraint. Biting on a wooden stick during bodily restraint decreased nNOS mRNA expression in the hypothalamus. In addition, the number of nNOS-positive neurons was significantly reduced in the PVN of the hypothalamus. These observations clearly suggest a possible anti-stress effect of the masticatory activity of biting, and this mechanism might be unconsciously in operation during exposure to psychological stressors.

Frequency and clinical features of patients who attempted suicide by Hara-Kiri in Japan

Hara-kiri is a unique Japanese custom, primarily stemming from the manners and customs that a samurai held. The aim of the present study was to investigate the clinical features of individuals who attempted suicide by hara-kiri. We enrolled 647 patients who had attempted suicide. Clinical features were compared between those who had employed hara-kiri and those who had used other methods. 25 of the 647 subjects had attempted suicide by hara-kiri. The ratio of men to women and the proportion of patients with mood disorders were significantly higher in the hara-kiri group than in the other methods group. The average length of stay in either the hospital or in the intensive care unit was also longer in the hara-kiri group than in the other methods group. Hara-kiri is an original Japanese method of attempting suicide, and suicide attempts by hara-kiri may be aimed at maintaining a reputation or taking responsibility.

Effect of dentist's clinical experience on treatment satisfaction of a complete denture

The relationship between the prosthodontic experience of dentists and satisfaction of complete denture wearers remains unknown. To investigate whether a prosthodontist's clinical experience affects treatment satisfaction of a complete denture wearer. From April 2004 to July 2006, we conducted a randomised controlled trial at two centres, including 74 edentulous patients; of these, 32 and 30 were randomly allocated to the ED or ID group, respectively. All the patients rated their satisfaction with dentures, including general satisfaction and satisfaction of chewing ability, speaking, cleaning, stability, retention, comfort and aesthetics. These satisfaction ratings were measured by a 100-mm visual analog scale (VAS). Perceived chewing ability to foods, divided into five grades, was measured using a questionnaire. The mastication index (MI) was calculated for each grade. General satisfaction and satisfaction of speaking, stability and retention were significantly higher in the ED than in the ID group (P = 0·049, 0·003, 0·019 and 0·041, respectively). No significant difference existed between the MI of the ED (71·3 ± 18·4) and ID group (64·1 ± 16·53). However, the perceived chewing ability of grade 5 food, whose texture was the hardest among all the grades, was significantly higher in the ED group than in the ID group. Within its limitations, this study showed that a clinician's prosthodontic experience affects a complete denture wearer's satisfaction ratings.

Towards control of the size and helicity of skyrmions in helimagnetic alloys by spin-orbit coupling

Chirality--that is, left- or right-handedness--is an important concept in a broad range of scientific areas. In condensed matter, chirality is found not only in molecular or crystal forms, but also in magnetic structures. A magnetic skyrmion is a topologically stable spin vortex structure, as observed in chiral-lattice helimagnets, and is one example of such a structure. The spin swirling direction (skyrmion helicity) should be closely related to the underlying lattice chirality via the relativistic spin-orbit coupling. Here, we report on the correlation between skyrmion helicity and crystal chirality in alloys of helimagnets Mn(1-x)Fe(x)Ge with varying compositions by Lorentz transmission electron microscopy and convergent-beam electron diffraction over a broad range of compositions (x = 0.3-1.0). The skyrmion lattice constant shows non-monotonous variation with composition x, with a divergent behaviour around x = 0.8, where the correlation between magnetic helicity and crystal chirality changes sign. This originates from continuous variation of the spin-orbit coupling strength and its sign reversal in the metallic alloys as a function of x. Controllable spin-orbit coupling may offer a promising way to tune skyrmion size and helicity.

[Childhood-onset schizophrenia]

Childhood-onset schizophrenia has been clinically studied and is believed to be on a continuum with adult-onset schizophrenia. However, childhood-onset schizophrenia is more difficult to diagnose than it is in adults, since children are in a developmental state. This article reviewed the literature regarding childhood-onset schizophrenia. This article discusses the clinical features, development until manifestation, possibility of early diagnosis, and treatment. Early intervention may improve the prognosis of psychotic disorders such as schizophrenia. However, early intervention of childhood-onset schizophrenia requires case histories with accurate descriptions of the development of the disease until its onset.

Structural phase transition and magnetic-field effect on the modulated structure in GdBaCo2O5+δ (δ < 0.5)

We investigated the crystal structures of an ordered perovskite-type cobaltate, GdBaCo2O(5+δ) (δ < 0.5), at elevated temperatures by transmission electron microscopy. Above the magnetic ordering temperature, we observed a first-order structural phase transition between the low-temperature tetragonal 3a(p) × 3a(p) and high-temperature orthorhombic 1a(p) × 2a(p) superstructure phases (where a(p) is the perovskite-unit cell). Upon the application of a magnetic field, an incommensurate phase emerges around the structural phase-transition temperature, which indicates a magnetic-field-induced structural phase transition via no magnetic ordering in the ordered perovskite-type cobaltate.

Frequency and clinical features of patients who attempted suicide by charcoal burning in Japan

BACKGROUND

To date, the clinical features between patients in Japan who have attempted suicide by charcoal burning and those who have attempted suicide by other methods in the context of a mental disorder diagnosis as assessed by structured interviews have not been reported.

METHODS

We enrolled 647 consecutive patients who attempted suicide and were hospitalized for inpatient treatment. Psychiatric diagnoses, frequency of suicide attempts, and clinical features were compared between charcoal burning and other suicide methods.

RESULTS

Twenty of the 647 patients (3.1%) had attempted suicide by charcoal burning. The ratio of men to women was significantly higher by this method compared with that of other methods. The proportion of patients with mood disorders was significantly higher in the charcoal burning group than that in the other methods group. The occurrence of a psychiatric history in patients in the charcoal burning group was significantly lower than that in the other methods group.

LIMITATIONS

The study sample was limited to a single hospital.

CONCLUSIONS

The results demonstrate the clinical characteristics of patients who attempted suicide by charcoal burning. Therefore, it is necessary to identify the clinical features of patients who have attempted suicide by charcoal burning in Japan.

Frequency and clinical features of suicide attempts in elderly patients in Japan

The objective of this study was to investigate the clinical features of suicide attempts in elderly patients (≥65 years) in Japan. We enrolled 546 patients who attempted suicide and were hospitalized for inpatient treatment. Characteristics were compared between the elderly and non-elderly patients. Compared with the non-elderly group, the incidence of mood disorders was significantly higher and the average length of stay in the intensive care unit and the duration of hospitalization were significantly longer in the elderly group. Elderly patients hospitalized for attempted suicide were more likely to have mood disorders than the non-elderly.

Clinical features of suicide attempts in adults with autism spectrum disorders

OBJECTIVE

The objective of this study was to investigate the frequency and clinical features of suicide attempts in adults with autism spectrum disorders (ASDs).

METHODS

We enrolled 587 consecutive patients aged 18 or over who attempted suicide and were hospitalized for inpatient treatment. Psychiatric diagnoses, suicide attempt frequency and clinical features were compared between ASD and non-ASD patients.

RESULTS

Forty-three (7.3%) of the 587 subjects who attempted suicide had ASDs. The incidence of patients with mood disorders was significantly lower (Fisher's Exact Test, P=.043) and that of those with an adjustment disorder was significantly higher (Fisher's Exact Test, P<.001) in the ASD group than in the non-ASD group. The average length of stay at both the hospital and intensive care unit in the ASD group was longer than that in the non-ASD group (z=-2.031, P=.042; z=-2.322, P=.020, respectively).

CONCLUSIONS

ASDs should always be a consideration when dealing with suicide attempts in adults at the emergency room.

Blonanserin in the treatment of delirium

The purpose of the present study was to provide preliminary data on the usefulness and safety of blonanserin for patients with delirium in the intensive care unit (ICU). The charts of 32 consecutive patients with delirium in the ICU were retrospectively reviewed. These patients were treated with blonanserin. A total of 96.6% had reduction in Memorial Delirium Assessment Scale score. The proportion of patients with side-effects was 24.1%. Blonanserin may be effective and safe in the treatment of delirium in the ICU.

Near room-temperature formation of a skyrmion crystal in thin-films of the helimagnet FeGe

The skyrmion, a vortex-like spin-swirling object, is anticipated to play a vital role in quantum magneto-transport processes such as the quantum Hall and topological Hall effects. The existence of the magnetic skyrmion crystal (SkX) state was recently verified experimentally for MnSi and Fe(0.5)Co(0.5)Si by means of small-angle neutron scattering and Lorentz transmission electron microscopy. However, to enable the application of such a SkX for spintronic function, materials problems such as a low crystallization temperature and low stability of SkX have to be overcome. Here we report the formation of SkX close to room temperature in thin-films of the helimagnet FeGe. In addition to the magnetic twin structure, we found a magnetic chirality inversion of the SkX across lattice twin boundaries. Furthermore, for thin crystal plates with thicknesses much smaller than the SkX lattice constant (as) the two-dimensional SkX is quite stable over a wide range of temperatures and magnetic fields, whereas for quasi-three-dimensional films with thicknesses over as the SkX is relatively unstable and observed only around the helical transition temperature. The room-temperature stable SkX state as promised by this study will pave a new path to designing quantum-effect devices based on the controllable skyrmion dynamics.

ESR detection of ROS generated by TiO2 coated with fluoridated apatite

Specific materials used in the manufacture of dentures may enhance the removal of micro-organisms. The ultraviolet A (UVA) irradiation of acrylic resin containing titanium dioxide (TiO(2)) generates reactive oxygen species (ROS) by photocatalysis that shows antibacterial effects. In this study, we tested the hypothesis that TiO(2) coated with fluoridated apatite (FAp-TiO(2)) can generate ROS via photo-catalysis by using electron spin resonance (ESR), and that acrylic resin containing FAp-TiO(2) can show antifungal properties by measuring the viability of Candida albicans. We demonstrated that hydroxyl radicals (HO(*)) were generated through excitation of TiO(2), TiO(2) coated with apatite (HAp-TiO(2)), and FAp-TiO(2). The HO(*) generation through excitation of FAp-TiO(2) was higher than that of TiO(2) and HAp-TiO(2). Regarding antifungal activity, cell viability on acrylic resin containing FAp-TiO(2) was lower than that of TiO(2) and HAp-TiO(2). FAp-TiO(2) showed superior photocatalytic effects, and these characteristics may lead to novel methods for the clinical application of denture-cleaning treatments.

Direct observation of the bandwidth-disorder induced variation of charge/orbital ordering structure in RE(0.5)(Ca(1-y)Sr(y))(1.5)MnO(4)

Changes in the charge/orbital ordering (CO/OO) structure with the bandwidth of the e(g) band and quenched disorder were investigated in doped manganites RE(0.5)(Ca(1-y)Sr(y))(1.5)MnO(4)(RE = Pr,Eu) with a single-layer perovskite structure. A systematic study of the modulation structure associated with the CO/OO phase demonstrated that the long-range commensurate structure changes to a short-range incommensurate structure with increasing Sr content through the enhancement of the bandwidth and quenched disorder in these systems. At the same time, the transition temperature of CO/OO (T(CO/OO)) decreases. Changes in structure and T(CO/OO) with different A-site combinations reveal that the CO/OO phase is strongly suppressed by the widening of the e(g) band and the stronger quenched disorder in these layered manganites.

Evaluation of a 3D digital photographic imaging system of the human face

The aim of this study was to investigate the accuracy of a 3D photographic imaging system for potential application in fabrication of maxillofacial prostheses. For validity estimates, computer digitized 3D photographic images of calibrated ruler attached to a model were analysed for linear and curvilinear distances in 1 mm increments (1-50 mm from the centre of the image). Distortion was evaluated from 1 mm distances measured 20, 40 and 60 mm from the centre of the field. To estimate reliability of measurements in vivo, two raters measured the right endocanthion-subnasale distance and the distance between right and left endocathion on images of 10 subjects, repeated three times (30 images total). From the digital file for one subject, a rapid prototyping (RP) machine produced a 3D model of the mid-face. Measures from the model were compared with those of the 3D computer image to estimate error in fabrication. Mean error values for calibrated distances ranged from 0.07 to 0.26 mm for linear distances, 0.08-0.34 mm for curvilinear distances, and 0.06-0.12 mm for distortion from the centre. Intra- and interexaminer correlation ranged from 0.92 to 1.00 and 0.94-1.00 respectively. Measures of the endocanthion and subnasale distances on the RP fabricated mid-face model were within 8% of the corresponding measures on 3D computer images. The accuracy of the photographic 3D imaging system tested was sufficient for clinical description of the mid-face structures and may be potentially useful for rapid prototyping of facial prostheses.

Relationship of bacterial strains to clinical syndromes of Campylobacter-associated neuropathies

BACKGROUND

Clinical and serologic studies suggest that Guillain-Barré syndrome (GBS) and atypical GBS with preserved muscle stretch reflexes (MSRs) form a continuous spectrum as well as do Fisher syndrome (FS), FS/GBS overlap, Bickerstaff brainstem encephalitis (BBE), BBE/GBS overlap, acute ophthalmoparesis (AO), ataxic GBS, and acute oropharyngeal palsy.

OBJECTIVE

To clarify the spectrum of neurologic disorders that occur subsequent to Campylobacter jejuni enteritis.

METHODS

We recruited patients with various neurologic conditions and from whom C jejuni was isolated. Bacterial features were investigated.

RESULTS

Diagnoses for the patients from whom C jejuni was isolated were GBS (n = 90), FS (n = 22), MSR-preserved GBS (n = 10), FS/GBS (n = 6), BBE (n = 1), BBE/GBS (n = 2), AO (n = 3), ataxic GBS (n = 1), and acute oropharyngeal palsy (n = 3). Isolates from MSR-preserved GBS were similar to those of GBS in serotype (HS:19), genotype (lipo-oligosaccharide [LOS] locus class A or B, cst-II genotype [Thr51]), and GM1 or GD1a epitope expression on LOS. FS/GBS overlap, BBE, BBE/GBS overlap, AO, ataxic GBS, and acute oropharyngeal palsy isolates were similar to those of FS in serotype (HS:2 or HS:4-complex), genotype (LOS locus class A or B, cst-II genotype [Asn51]), and GQ1b epitope expression on LOS.

CONCLUSIONS

The bacterial findings support the proposal that Guillain-Barré syndrome (GBS) and muscle stretch reflex-preserved GBS comprise a continuous spectrum as well as do Fisher syndrome (FS), FS/GBS overlap, Bickerstaff brainstem encephalitis (BBE), BBE/GBS overlap, acute ophthalmoparesis, ataxic GBS, and acute oropharyngeal palsy.

Observation of magnetic ripple and nanowidth domains in a layered ferromagnet

We investigated ferromagnetic domain structures on nanometer to micrometer scale for single crystals of a layered ferromagnet, La(2-2x)Sr(1+2x)Mn2O7 (0.32 < or = x < or = 0.40), as functions of x and temperature by means of Lorentz electron microscopy. We have succeeded in observing the evolution of magnetic ripple structure, dynamically, related to a spin reorientation transition where the magnetization direction switches between parallel and perpendicular to the layers. Our high-resolution magnetic domain imaging revealed that the ripple state is characterized by the evolution of magnetic nanowidth domains.

Genetic variation in hypoxia-inducible factor 1alpha and its possible association with high altitude adaptation in Sherpas

Hypoxic stress at high altitude requires adaptations in several physiological functions to ensure the optimal oxygenation of all cells. Several lines of evidence suggested that high-altitude native populations such as Sherpas have been genetically adapted to their stressful environment. We investigated the genetic variation in the hypoxia-inducible factor (HIF)-1alpha gene in Sherpas as compared with Japanese, native lowlanders, and found a novel dinucleotide repeat polymorphism in intron 13 of the HIF-1alpha gene. GT15 allele was more frequent in Japanese than in Sherpas with statistical significance, while GT14 allele was significantly more frequent in Sherpas as compared with Japanese. A possible genetic variation in the HIF-1alpha gene might function in adaptation to living at high altitude. Because the activity of HIF-1 is regulated by multiple steps including the transcriptional level, the effect of the polymorphism in intron 13 on the cellular hypoxic responses remains to be elucidated.

Effect of different proton pump inhibitors, differences in CYP2C19 genotype and antibiotic resistance on the eradication rate of Helicobacter pylori infection by a 1-week regimen of proton pump inhibitor, amoxicillin and clarithromycin

AIM

To investigate the effect of different proton pump inhibitors, S-mephenytoin 4'-hydroxylase (CYP2C19) genotype and antibiotic susceptibility on the eradication rate of Helicobacter pylori.

METHODS

One hundred and eighty-seven H. pylori-infected peptic ulcer patients were randomly treated with either rabeprazole (10 mg b.d.) or lansoprazole (30 mg b.d.) plus amoxicillin (750 mg b.d.) and clarithromycin (400 mg b.d.) for 1 week. The antibiotic susceptibility and CYP2C19 genotype (extensive or poor metabolizer) were investigated.

RESULTS

The eradication rates in the rabeprazole-amoxicillin-clarithromycin (RAC) and lansoprazole-amoxicillin-clarithromycin (LAC) groups were 75% and 69%, respectively, on an intention-to-treat basis, and 80% and 75%, respectively, on a per protocol basis. The eradication rate for clarithromycin-resistant strains was significantly lower than that for clarithromycin-sensitive strains (24% vs. 86%, P < 0.05). For clarithromycin-sensitive strains in the LAC group, there was a tendency for a lower eradication rate in extensive than poor metabolizers. The eradication rate in extensive metabolizers in the RAC group tended to be higher than that in extensive metabolizers in the LAC group (89% vs. 78%, P = 0.079726).

CONCLUSIONS

The success of the 1-week proton pump inhibitor-amoxicillin-clarithromycin regimen depends on the susceptibility of H. pylori to clarithromycin. Moreover, differences in CYP2C19 genotype influence the eradication rates of lansoprazole-based therapy, and the rabeprazole-based regimen has an advantage especially in extensive metabolizers.

Software techniques for EELS to realize about 0.3 eV energy resolution using 300 kV FEG-TEM

In this short communication we describe some software techniques for electron energy-loss spectrum measurement. We prepared DigitalMicrograph (Gatan) scripts for multiple spectrum acquisitions, quasi-simultaneous acquisition of low-loss and core-loss spectra, energy drift correction, and other operations. Narrow zero-loss spread of 0.27 eV is demonstrated using a 300 kV field-emission transmission electron microscope (TEM) (Hitachi, HF-3000) and a post-column energy filter (Gatan, GIF2002). The core-loss spectrum is acquired with an energy resolution of 0.36 eV with high reproducibility. The present software techniques effectively achieve the intrinsic energy resolution of electron sources. Sample scripts are provided in the Appendix.

Ferromagnetic domain structures and nanoclusters in Nd(1/2)Sr(1/2)MnO3

Magnetic domain structures of Nd(1/2)Sr(1/2)MnO3 were investigated by means of low-temperature Lorentz electron microscopy. On cooling, magnetic domain walls started to appear at 250 K, and they were oriented straight along the [100] and [110] directions. With a further decrease in temperature, the volume of each magnetic domain increased with discontinuous domain-wall jumps. A characteristic granular image was observed at around 140 K, near the charge-ordering transition temperature. We consider that this originated from ferromagnetic nanoclusters that appeared in the antiferromagnetic matrix.