Towards a unified model of neutrino-nucleus reactions for neutrino oscillation experiments

A precise description of neutrino-nucleus reactions will play a key role in addressing fundamental questions such as the leptonic CP violation and the neutrino mass hierarchy through analyzing data from next-generation neutrino oscillation experiments. The neutrino energy relevant to the neutrino-nucleus reactions spans a broad range and, accordingly, the dominant reaction mechanism varies across the energy region from quasi-elastic scattering through nucleon resonance excitations to deep inelastic scattering. This corresponds to transitions of the effective degree of freedom for theoretical description from nucleons through meson-baryon to quarks. The main purpose of this review is to report our recent efforts towards a unified description of the neutrino-nucleus reactions over the wide energy range; recent overall progress in the field is also sketched. Starting with an overview of the current status of neutrino-nucleus scattering experiments, we formulate the cross section to be commonly used for the reactions over all the energy regions. A description of the neutrino-nucleon reactions follows and, in particular, a dynamical coupled-channels model for meson productions in and beyond the [Formula: see text](1232) region is discussed in detail. We then discuss the neutrino-nucleus reactions, putting emphasis on our theoretical approaches. We start the discussion with electroweak processes in few-nucleon systems studied with the correlated Gaussian method. Then we describe quasi-elastic scattering with nuclear spectral functions, and meson productions with a [Formula: see text]-hole model. Nuclear modifications of the parton distribution functions determined through a global analysis are also discussed. Finally, we discuss issues to be addressed for future developments.

Different views on treatment decisions by first-year interprofessional healthcare students

This study explored ethical treatment decisions of healthcare professional students beginning their education. As part of a first-semester modern medicine and bioethics course, 311 students watched and discussed, in interprofessional groups, a video titled Dax's Case: Who Should Decide? regarding the treatment of a life-threatening infectious disease against Dax's wish. The students then discussed and made their decision regarding treating or not. Their decisions, recorded on a worksheet, were classified as "will treat" or "won't treat." Professional groups' decision patterns were compared using the chi-square test. Overall, 151 (71%) opinions from students were classified as "will treat," and 61 (29%) as "won't treat." Nursing students were more likely to decide "won't treat" (in line with Dax's preference); however, the majority of other professions' students favoured treatment (against Dax's wish). Given the students' limited exposure to profession-specific education, our preliminary study supports the notion that healthcare profession students hold different values that align with their chosen profession at the start of their studies.

Potentially inappropriate medications in elderly Japanese patients: effects of pharmacists' assessment and intervention based on Screening Tool of Older Persons' Potentially Inappropriate Prescriptions criteria ver.2

WHAT IS KNOWN AND OBJECTIVES

The Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (stopp) criteria were updated in 2014 (stopp criteria ver.2), but few studies have evaluated the usefulness of stopp criteria in elderly patients. This prospective observational study evaluated the prevalence of potentially inappropriate medications (PIMs), and the efficacy of hospital pharmacists' assessment and intervention based on stopp criteria ver.2.

METHODS

The study was conducted at three medical units of Kobe University Hospital between April 2015 and March 2016. Pharmacists assessed and detected PIMs based on stopp criteria ver.2 and considered the patient's intention to change the prescription at the time of admission of each patient. If the pharmacists judged that benefits outweighed risks of prescription change and the patients consented to change the medications, they recommended the doctor to change the prescription. If there was a risk of exacerbation of disease by the change of medications and the pharmacists judged it to be difficult to adjust medications during hospitalization or the patients did not consent to change the medications, they did not recommend to change it. The pharmacists and the doctors discussed and finally decided whether to change the PIMs or not. The number of patients prescribed PIMs, the number and contents of PIMs, and the number of medications changed after pharmacists' intervention were calculated.

RESULTS

Totally, 822 new inpatients aged ≥65 years prescribed ≥1 daily medicine were included. Their median (interquartile range) age was 75·0 (71·0-80·0) years, and 54·9% were male. According to the criteria, 346 patients (42·1%) were prescribed ≥1 PIMs. Patients prescribed PIMs took significantly more medications than others: 10·0 (7·0-13·0) vs. 6·0 (4·0-9·0), P < 0·001. The total number of PIMs was 651%, 47·6% of which (n = 310) were recommended the doctors to change, and 292 of 651 PIMs (44·9%) were finally discontinued/changed after pharmacists' assessment and intervention. PIMs related to benzodiazepines, including Z-drugs, were most frequent, with a detailed classifications as follows (changed/total): (i) benzodiazepines for 4 or more weeks (75/205), (ii) drugs that predictably increase the risk of falls in older people (benzodiazepines) (30/67) and (iii) drugs that predictably increase the risk of falls in older people (hypnotic Z-drugs) (15/31).

CONCLUSION

Over 40% elderly patients were prescribed PIMs, and pharmacists' assessments and interventions based on stopp criteria ver.2 were useful in detecting and correcting prescription of PIMs.

Intact attentional orienting towards inverted faces revealed by both manual responses and eye-movement measurement in individuals with Williams syndrome

BACKGROUND

Individuals with Williams syndrome (WS) exhibit atypical attentional characteristics when viewing faces. Although atypical configural processing of faces has been reported in WS, the relative strengths of configural and local feature information to capture visual attention in WS remains unclear. We previously demonstrated that attentional capture by target-unrelated upright faces differs depending on what response is measured. Whereas eye movements reflected subtle atypical attentional properties at the late stage of visual search, manual responses could not capture the atypical attentional profiles towards target-unrelated upright faces in individuals with WS. Here we used the same experimental paradigm to assess whether sensitivity to configural facial information is necessary for capturing attention in WS.

METHODS

We measured both eye movements and manual responses from 17 individuals with WS and 34 typically developing children and adults while they were actively involved in a visual search task with an inverted face distractor. Task measures (reaction time and performance accuracy) and gaze behaviour (initial direction of attention and fixation duration) were analysed for each stimulus.

RESULTS

When the target and the inverted face were displayed in the same search array, reaction times and accuracies in individuals with WS showed similar tendencies as typical controls. Analysis of task and gaze measures revealed that attentional orienting towards inverted faces was not atypical.

CONCLUSION

Although individuals with WS exhibited atypical gaze behaviour towards upright faces in our previous study, this unusual behaviour disappears if the faces are upside down. These findings suggest that local feature information alone (e.g. eyes) does not contribute to the heightened attention to faces, but configural information appears necessary for drawing attention to faces in individuals with WS, at least in the current experimental paradigm.

Changes in Interface Pressure under Elastic and Short-Stretch Bandages during Posture Changes and Exercise

Objective:

To evaluate the pressure under short-stretch and elastic bandages.

Design:

Prospective study in 20 healthy volunteers, comparing the two different kinds of bandages.

Setting:

Department of Surgery, Aichi Prefectural College of Nursing, Nagoya, Japan.

Main outcome measures:

Pressure measurements were made beneath the bandages with different initial pressures of 10, 20, 30, 40, 50, 60, and 70 mmHg, during supine resting, standing, tip-toe exercise and walking.

Results:

Short-stretch bandages showed a significant increase in pressure during standing and exercise at lower initial pressures compared with elastic bandages. In analysing the pressure waveform during tip-toe exercise and walking, a significantly greater pressure difference between muscle contraction and relaxation was noted for short-stretch bandages compared with elastic bandages at any initial pressures.

Conclusions:

Short-stretch bandages produce a higher working pressure and a larger pressure difference during exercise. However, the effect depends on the initial pressures at the time of application. In clinical practice, prevention of a decrease in pressure with time and uniform application of bandages are important.

Clinical Significance of Corona Phlebectatica Associated with Varicose Veins

Objective:

To investigate the clinical significance of corona phlebectatica.

Design:

Clinical and plethysmographic evaluation of corona phlebectatica associated with primary varicose veins.

Setting:

Department of Surgery, Aichi Prefectural College of Nursing, Nagoya, Japan.

Main outcome measures:

In 411 limbs with greater saphenous incompetence, including 101 with skin changes and 310 without skin changes, clinical analysis and plethysmographic evaluation using the photoplethysmographic technique were carried out.

Results:

In 204 of 411 limbs, corona phlebectatica was observed, including 75 coloured red and 129 coloured blue. Blue coronas were observed significantly more often then red coronas in limbs with skin changes. The half refilling time in limbs with skin changes was significantly shorter than that in limbs without skin changes. In limbs without skin changes, limbs with blue coronas showed a significantly shortened half refilling time than those with red coronas.

Conclusions:

Blue coronas are a strong indicator of the presence of prolonged venous hypertension in varicose veins.

Interface Pressure under Elastic Stockings with Compression Pads during Posture Changes and Exercise

Objective:

To quantify the influence of posture and exercise on the interface pressure obtained under elastic stockings with compression pads.

Design:

Interface pressure measurement and plethysmographic evaluation of elastic stockings with and without compression pads.

Setting:

Department of Surgery, Aichi Prefectural College of Nursing, Nagoya, Japan.

Main outcome measures:

Pressure measurements in 24 volunteers were obtained beneath elastic stockings, elastic bandages and short-stretch bandages during supine resting, standing, tip-toe exercise and walking, and the effect of elastic stockings on the muscle pump of the leg was evaluated by strain-gauge plethysmography in 40 limbs with varicose veins.

Results:

Without compression pads, only short-stretch bandages showed a significant increase in pressure during standing and exercise. When pads were used, however, elastic stockings and bandages also showed a significant increase. With pads, significant improvement in the expelled volume during exercise was observed by strain-gauge plethysmography.

Conclusions:

Interface pressure under elastic materials during posture and exercise is similar to that under short-stretch bandages when compression pads are used, and pads effectively augment the muscle pump.

A comparison of physical methods for prophylaxis of deep vein thrombosis on augmentation of venous flow velocity and reduction of calf volume

Objective: This study was designed to determine the optimal physical methods for promoting venous return of the leg.

Methods: Ten healthy volunteers were investigated in the supine position on a couch, and their peak femoral venous velocity and calf muscle volume were determined using duplex ultrasound and strain gauge plethysmography,respectively,before and during deep respiration, limb elevation, calf squeezing and various types of leg exercises.

Results: Deep respiration showed the smallest effect on both percentage increase of peak flow velocity and expelled volume. Elevation of the leg showed the same effect on the expelled volume as calf muscle squeezing and ankle movement, while the former showed significantly less effect than the latter on the percentage increase of peak flow velocity. In both dorsal flexion of the ankle and squeezing at the calf, the stronger of each procedure caused more effective changes in haemodynamics. Ankle exercise was more effective in promoting venous return in the calf muscle than wiggling the toes, making circling movements with the feet or alternately flexing and spreading the toes.

Conclusions: Ankle exercise or calf muscle squeezing, performed maximally,may be the first recommendation for reducing venous stasis at the calf muscle and prophylaxis of deep vein thrombosis..

An automated rapid detection system using the quenching probe method for detecting interleukin 28B and inosine triphosphatase single nucleotide polymorphisms in chronic hepatitis C

Single nucleotide polymorphisms (SNPs) in the interleukin 28B gene (IL28B) are good pretreatment predictors of anti-hepatitis C virus (HCV) therapy with interferon. SNPs of the inosine triphosphatase (ITPA) gene are associated with reduced haemoglobin levels during treatment with ribavirin. The i-densy™ (Arkray, Inc.), which is based on the quenching probe (QP) method, automatically detects target genes in blood samples by fluorescence quenching within 100 min. Using a QP and primer set, a gene amplification response is generated that can quickly and easily detect a specific gene's arrangement by fluorometry. The present study was conducted to compare the utility of i-densy (QP method) with that of conventional direct sequencing (DS) for detecting SNPs in the IL28B and ITPA genes in chronic hepatitis C patients. Between June 2011 and January 2012, 73 consecutive patients underwent genotyping of IL28B, and 54 patients underwent genotyping of ITPA. All of the patients were seropositive for HCV-RNA. The IL28B and ITPA genotypes were tested for bi-allelic polymorphisms in rs8099917 (T/T, T/G and G/G; minor allele, G) and rs1127354 (C/C, C/A and A/A; minor allele, A), respectively. The results obtained with the QP method were identical to those obtained with the conventional DS method. The frequency of the IL28B genotypes TT, GT and GG were 74%, 24.7% and 1.4%, respectively, and those of the ITPA genotypes CC, AC and AA were 68.5%, 29.6% and 1.9%, respectively. These results indicate that the i-densy using the QP method can automatically, quickly and easily identify genotypes of IL28B and ITPA.

Effect of gaiters on muscle pump activity in healthy volunteers

OBJECTIVES

Exercise of the leg with external limb compression has been reported to be useful for preventing and reducing leg oedema. The aim of this study was to investigate the effects of leg gaiters on calf muscle pump activity.

METHODS

Continuous measurements of the interface pressure at the leg during exercise and determination of the femoral venous velocity at the groin during exercise were carried out in healthy volunteers with elastic stockings alone, leg gaiters alone and gaiters over the elastic stockings.

RESULTS

The greatest pressure difference between muscle contraction and relaxation during exercise was observed when gaiters were applied over the elastic stockings at the calf. Gaiters alone without elastic stockings led to a significantly greater pressure difference between muscle contraction and relaxation during exercise than elastic stockings alone (P < 0.01). A significantly higher value of the peak flow velocity of the femoral vein was observed with the combined use of gaiters and elastic stockings than the single use of elastic stockings.

CONCLUSIONS

Leg gaiters have a beneficial effect of augmenting venous femoral blood flow during calf muscle pump activity in volunteers with a normal valve function of leg veins.

Interface pressure is affected by slippage of bandages at thigh

AIM

Very little is known about how compression bandages lose interface pressure. We hypothesized that the loss of interface pressure is correlated with the slippage of the bandages, and studied the interface pressure and slippage of three bandages over 8 hours.

METHODS

Twenty-Seven legs from 27 healthy volunteers were bandaged with short stretch bandages (SS), cohesive short stretch bandages (CS), and long stretch bandages (LS). Pressure sensors were placed above the ankle (B1), below the knee (D), and mid thigh (F). Interface pressures in a sitting position were recorded at the beginning, and 4 and 8 hours later. In 17 legs, the pressure sensor sites were marked, and their heights were measured on standing upright.

RESULTS

SS and CS lost interface pressure quickly, but LS maintained pressure better than SS and CS at all sites. There was no pressure difference between SS and CS at the lower leg. However, CS maintained pressure better than SS at the mid thigh (44.6% vs. 54.4% pressure loss at 8 hours, respectively. P=0.037). There was a tendency toward less slippage with CS than SS at the mid thigh. In CS and LS, there was a linear correlation between the slippage of bandages and the interface pressure at the mid thigh (P <.01, in both).

CONCLUSION

The interface pressure may be affected by the slippage of bandages at the thigh, but not at the lower leg. Cohesive short stretch bandages may exert their beneficial impact at the thigh.

Development of separated elastic stockings

Objectives

To investigate the acceptability of newly developed separated elastic stockings, which are divided into two portions at the ankle.

Methods

The difficulty in putting on and taking off stockings was compared between the original or modified separated stockings with various techniques in order to reduce the shift of the stockings and current non-separated stockings in healthy volunteers and patients with lymphoedema by applying both stockings alternately. In the modified model, the shift during daily activities was measured in healthy volunteers and patients with lymphoedema.

Results

The two items, ‘easier compared with non-separated stockings’ and ‘much easier’, were chosen at rates of 75% and 81% for putting on and taking off stockings for the original separated stockings and 75% and 75% for the modified separated stockings, respectively. Complaints during daily activities with the modified type to the stockings decreased as compared with the original type. The shift of stockings after an average 11-hour application was 1.6 ± 3.0 SD mm (range: 0–10 mm).

Conclusions

Modified separated elastic stockings are easier to put on and take off compared with current non-separated stockings, and they can be used safely because of their low-level shift during daily activities.

Interface pressure and stiffness in different combinations of compression material

Objectives

To compare the interface pressure and stiffness between various combinations of compression material.

Methods

Using a stiffness-determining device, the interface pressure and stiffness were determined in several combinations of five elastic stockings and two elastic bandages.

Results

In the double stockings system, the interface pressure increased significantly and the highest stiffness was observed in double short-stretch stockings. When short-stretch bandages were applied over either short- or long-stretch stockings, a significant increase in stiffness was observed at any initial pressure compared with the single use of short-stretch stockings. In double bandage systems, when short-stretch bandages were applied over either short- or long-stretch bandages, the stiffness increased significantly. When long-stretch bandages were used over short-stretch bandages, the stiffness decreased significantly.

Conclusions

The stiffness is changeable according to the combinations of material, such as double stockings, double bandages and the wearing of bandages over stockings. The use of short-stretch bandages as the outside layer produces the highest stiffness at a high initial pressure.

Development of a device to determine the stiffness of elastic garments and bandages

Objective

To evaluate the reliability of a newly developed stiffness-determining device, composed of a leg mannequin and air-pack type analyser, for measuring the interface pressure.

Method

The correlation of stiffness values obtained employing the Hohenstein method and this new method was investigated using 17 different brands of medical elastic compression stocking.

Results

A significant correlation in stiffness values using the two methods was obtained ( P < 0.01). When this new method was applied to the bandages, the stiffness was significantly correlated with the initial pressure when assessing both short-stretch and long-stretch bandages. On the comparison of stiffness values between elastic stockings and bandages with the same initial pressure, the short-stretch bandages showed a predominantly higher value than long-stretch bandages and stockings ( P < 0.01).

Conclusion

The reliability of this new method, which can be easily applied to not only elastic stockings but also elastic bandages, was verified. In clinical practice, the compression pressure should be selected in consideration of the prospective stiffness.

Improvement of a three-dimensional measurement system for the evaluation of foot edema

BACKGROUND/AIMS

This study investigated the accuracy and usefulness of a newly improved three-dimensional measurement system for measuring the volume and circumference at the foot as well as at the calf and ankle.

METHODS

Regarding the newly improved device, halogen light was projected from four directions instead of the conventional two directions. The circumference and volume were measured in the morning and evening with and without elastic stockings in 23 healthy subjects.

RESULTS

The average circumference at the foot calculated using the 'average method', in which the circumference of the foot was measured in 10 places every 1 mm and the values were averaged, significantly increased in the evening compared with in the morning. When stockings were applied, the significant differences in the circumference or volume between the morning and evening disappeared at all sites of the leg.

CONCLUSION

The newly improved three-dimensional measurement system incorporating the halogen light from four directions, in which the foot circumference was calculated using an 'average method', was reliable and useful for evaluating edema at the foot as well as at the calf and ankle. The beneficial effect of elastic stockings on edema prevention was observed at all sites of the leg.

Molecular diagnosis of Myxobolus spirosulcatus associated with encephalomyelitis of cultured yellowtail, Seriola quinqueradiata Temminck & Schlegel

Mass mortality of cultured yellowtail, Seriola quinqueradiata, has recently been reported from fish farms in western Japan. Previous studies revealed that diseased fish were characterized by encephalomyelitis and presporogonic stages of a myxosporean-like parasite in the spinal cord. However, the parasite has remained unidentified because of the lack of mature stages being present. Thus, in the present study, analysis of the small subunit ribosomal DNA (18S rDNA) of the parasite as well as in situ hybridization (ISH) studies using histological sections of the infected tissue was conducted. The 18S rDNA of the myxosporean had higher sequence similarities with those of bile-duct-infecting myxosporeans rather than those infecting nervous tissues and was identified as Myxobolus spirosulcatus. The ISH using specific probes demonstrated that the DNA amplified was derived from the multinuclear organisms found in histological sections. A highly sensitive and specific PCR-based assay for M. spirosulcatus was developed, which revealed a high prevalence of infection in cultured yellowtail that exhibited the clinical signs of encephalomyelitis.

Comparison of stiffness and interface pressure during rest and exercise among various arm sleeves

OBJECTIVES

To compare the interface pressure during rest and exercise among various kinds of arm sleeves.

METHODS

The interface pressure underneath nine different arm sleeves was measured during 10 maximal opening and closing movements of fingers using a pressure transducer (Air Pack Type Analyser) in 16 healthy volunteers. Furthermore, in order to evaluate the characteristics of each arm sleeve, the extensibility, stiffness and thickness were determined in vitro by several apparatuses.

RESULTS

There was a significant correlation between stiffness and extensibility. The stiffness was significantly correlated with the pressure difference between muscle contraction and relaxation during exercise. The higher the value of stiffness, the greater the pressure amplitude during exercise.

CONCLUSION

Short-stretch arm sleeves characterized with a high level stiffness, including thick round- and flat-knitted arm sleeves, are more beneficial for the augmentation of muscle pumping than long-stretch arm sleeves, in the same way as short-stretch bandages or stockings applied to the leg.

Impaired gastric ulcer healing in diabetic mice: role of methylglyoxal

Methylglyoxal is a reactive dicarbonyl compound produced from cellular glycolytic intermediates that reacts non-enzymatically with proteins to form products such as argpyrimidine at arginine residue. The aim of the present study was to investigate the role of methylglyoxal in the delayed healing of gastric ulcer in diabetes, and to identify the methylglyoxal-modified proteins as a target molecule of this modification. Using male C57BL/6 mice, diabetes was induced by a single i.p. injection of streptozotocin and gastric ulcers were produced by the focal application of 40% of acetic acid to the serosal surface of the stomach. In order to evaluate the effect of OPB-9195, an inhibitor of methylglyoxal modification, on gastric ulcer healing, mice were given orally OPB-9195 (30 mg/kg) twice daily for 14 days, one week before and after the injection of streptozotocin. The area of gastric ulcer on day 7 was significantly increased in diabetic mice compared to non-diabetic mice, indicating delayed ulcer healing. This increase in ulcer area in diabetic mice was significantly reversed by the treatment with OPB-9195 without affecting blood glucose levels. Proteomics analysis showed the methylglyoxal-modification of peroxiredoxin 6 proteins in the diabetic gastric mucosa around gastric ulcer, and this modification was markedly inhibited by the treatment with OPB-9195. In conclusion, the present study suggests a link of increased methylglyoxal modification of proteins including peroxiredoxin 6 to the delayed gastric ulcer healing in diabetes, and also shows the therapeutic potential of the inhibitor of methylglyoxal modification for the treatment of diabetic gastric ulcers.

Association between gain-of-function mutations in PIK3CA and resistance to HER2-targeted agents in HER2-amplified breast cancer cell lines

BACKGROUND

The mechanism of resistance to human epidermal growth factor receptor 2 (HER2)-targeted agents has not been fully understood. We investigated the influence of PIK3CA mutations on sensitivity to HER2-targeted agents in naturally derived breast cancer cells.

MATERIALS AND METHODS

We examined the effects of Calbiochem (CL)-387,785, HER2 tyrosine kinase inhibitor, and trastuzumab on cell growth and HER2 signaling in eight breast cancer cell lines showing HER2 amplification and trastuzumab-conditioned BT474 (BT474-TR).

RESULTS

Four cell lines with PIK3CA mutations (E545K and H1047R) were more resistant to trastuzumab than the remaining four without mutations (mean percentage of control with 10 microg/ml trastuzumab: 58% versus 92%; P = 0.010). While PIK3CA-mutant cells were more resistant to CL-387,785 than PIK3CA-wild-type cells (mean percentage of control with 1 microM CL-387,785: 21% versus 77%; P = 0.001), CL-387,785 retained activity against BT474-TR. Growth inhibition by trastuzumab and CL-387,785 was more closely correlated with changes in phosphorylation of S6K (correlation coefficient, 0.811) than those of HER2, Akt, or ERK1/2. Growth of most HER2-amplified cells was inhibited by LY294002, regardless of PIK3CA genotype.

CONCLUSIONS

PIK3CA mutations are associated with resistance to HER2-targeted agents. PI3K inhibitors are potentially effective in overcoming trastuzumab resistance caused by PIK3CA mutations. S6K phosphorylation is a possibly useful pharmacodynamic marker in HER2-targeted therapy.

A comparison of interface pressure and stiffness between elastic stockings and bandages

Objectives

To compare the interface pressure during posture changes and exercise between elastic stockings and bandages.

Methods

Using a pressure transducer (air pack-type analyzer), the interface pressures associated with three different elastic stockings and three different elastic bandages were measured during supine resting, standing and exercise in 15 healthy volunteers.

Results

Short-stretch bandages showed a significantly higher static stiffness index value, which is defined as the pressure difference between lying and standing, than long-stretch bandages and short-stretch stockings ( P < 0.001). Furthermore, short-stretch bandages showed a significantly greater pressure difference between muscle contraction and relaxation in both tip-toe and knee-bending exercises than long-stretch bandages and short-stretch stockings ( P < 0.001).

Conclusion

Short-stretch bandages can be expected to have more pronounced benefits for augmenting muscle pump than long-stretch bandages and short-stretch stockings.

Relationship between Joint National Committee-VI classification of hypertension and ambulatory blood pressure in patients with hypertension diagnosed by casual blood pressure

BACKGROUND

White-coat hypertension has been diagnosed arbitrarily based on different criteria. In 1997, the Joint National Committee-VI (JNC-VI) reported a new classification of hypertension and strongly emphasized the importance of ambulatory blood pressure (ABP) monitoring. The report pronounced normal ABP values for the first time.

HYPOTHESIS

The study's aim was to clarify the relationship between casual blood pressure (BP) and ABP of patients with essential hypertension in each stage of JNC-VI classification, and the prevalence of white-coat hypertension diagnosed by using JNC-VI normal ABP criteria.

METHODS

Ambulatory blood pressure was monitored non-invasively in 232 patients with essential hypertension whose casual BP was > or = 140/90 mmHg. The patients were classified according to JNC-VI classification, and their casual BP was compared with ABP. The criterion of white-coat hypertension was defined as casual BP > or = 140/90 mmHg with normal ABP according to JNC-VI criteria (< 135/85 during daytime and < 120/75 during nighttime).

RESULTS

Mean ABP increased as the stage advanced, and the differences between casual BP and ABP also increased. There were considerable overlaps in the distribution of ABP among stages. The prevalence of white-coat hypertension was 13% overall: 30% of the patients with isolated systolic hypertension, 19% of those in stage 1, 10% in stage 2, and 4% in stage 3.

CONCLUSIONS

Classification of hypertension based on casual BP may not always correspond in severity to that based on ABP. Ambulatory blood pressure monitoring recommended by JNC-VI is very useful for the evaluation of hypertension to differentiate white-coat hypertension from true hypertension.

Enhanced iturin A production by Bacillus subtilis and its effect on suppression of the plant pathogen Rhizoctonia solani

Enhanced production of the antibiotic iturin A by Bacillus subtilis RB14-CS reached 4.4 g L(-1) in SM medium containing soybean meal and maltose, which was 16-fold and 2.2-fold higher than that in original and modified number 3S media, respectively. When various volumes of RB14-CS cultures grown in SM medium were applied to pot tests of tomato damping-off caused by Rhizoctonia solani, damping-off was dose-dependently suppressed by the cultures. Suppression by SM-grown cultures was significantly more effective than that by cultures grown in original or modified number 3S media. The iturin A concentrations in soil decreased to undetectable levels after 17 days of cultivation in pot tests, indicating that iturin A has a low persistence in soil.

Comparison of recurrence rate and hemodynamic effect among various technical approaches for ligations of great saphenous vein in treatment of varicose veins

BACKGROUND

The aim of this study was to compare the recurrence rate and hemodynamic effect retrospectively among various technical approaches for ligations of the great saphenous vein in the treatment of primary varicose veins.

PATIENTS AND METHODS

455 limbs with primary uncomplicated great saphenous varicose veins, which underwent ligations of the great saphenous vein followed by sclerotherapy, were classified into 5 groups according to different ligation techniques. The recurrence rate and hemodynamic effect, evaluated by the photoplethysmographic technique, were compared among the 5 groups at one year intervals up to 5 years.

RESULTS

The 3-ligation technique, in which the great saphenous vein was resected at the groin, thigh, and calf, showed a significantly lower recurrence rate at the 5-year follow-up. The recurrence rates were 27.7, 62.0, 58.5, and 91.9% in the 3-ligation group, 2-ligation group at the groin and thigh, 2-ligation group at the thigh and calf, and 1-ligation group at the thigh, respectively. A lower hemodynamic improvement was observed in the latter two groups. A significantly higher recurrence rate was shown even in the 3-ligation group, when all tributaries were not dissected at the sapheno-femoral junction (50.2 vs. 27.7%, p<0.01).

CONCLUSIONS

The 3-ligation technique followed by sclerotherapy, which includes the resection of the great saphenous vein for as long as possible, and dissection of all tributaries at the groin, thigh, and calf, is one of the important choices of minimum invasive treatments for varicose veins, although this technique is not a fully alternative procedure to the stripping operation.