Two-handed facemask technique effectively causes hyperventilation in electroconvulsive therapy: an observational study

BACKGROUND

Electroconvulsive therapy (ECT) remains the mainstay treatment option for patients with psychiatric diseases, such as severe depression. Although various anesthetic techniques provide adequate therapeutic seizures, hyperventilation is a useful adjunct to augment seizure duration and improve seizure quality. We investigated how to efficiently use a facemask to accomplish protocolized hyperventilation and evaluate its effect on ECT seizure.

METHODS

We studied 60 patients aged ≥18 years who underwent ECT. The patients were divided into two groups according to the technique of facemask ventilation used: the one-handed (n = 30) and two-handed (n = 30) groups. Following anesthesia induction under preoxygenation conditions, hyperventilation induced hypocapnia in the one-handed facemask group with manual bag ventilation was compared to that in the two-handed facemask group with assisted pressure-controlled ventilation. Ictal and peri-ictal electroencephalogram parameters and cardiovascular responses were monitored and compared between the one-handed and two-handed groups.

RESULTS

The two-handed technique demonstrated better electroencephalogram regularity and minimized cardiovascular stress compared to the one-handed technique. These conclusions come from the fact that the one-handed technique induced a substantial volume of leaks around the facemask (201.7 ± 98.6 mL/breath), whereas minimal leaks (25.8 ± 44.6 mL/breath) with stabler and higher ventilation rate led to greater inhaled minute ventilation in the two-handed group (the one-handed group, 9.52 ± 3.94 L/min; the two-handed group, 11.95 ± 2.29 L/min; p <  0.005). At the end of ECT treatment, all parameters of blood pressure and heart rate increased significantly in both groups equally, with lower SpO₂ and more ST-segment depression on the electrocardiogram in the one-handed group. Comparing baseline values before anesthesia, ECT treatment significantly depressed ST-segment in both groups, while the degree of depression in ST-segment increased significantly in the one-handed group compared to that in the two-handed group.

CONCLUSIONS

End-tidal carbon dioxide monitoring for hyperventilation can reliably ensure hypocapnia only in the two-handed group. In ECT, the two-handed technique assisted by pressure-controlled ventilation is an effective and practical method for hyperventilation to induce adequate therapeutic seizures. While, the two-handed group with sufficient preoxygenation did not cause more cardiovascular stress than the one-handed group.

TRIAL REGISTRATION

UMIN Clinical Trials Registry 000046544, Date of registration 05/01/2022.

Prospects for observing and localizing gravitational-wave transients with Advanced LIGO, Advanced Virgo and KAGRA

We present possible observing scenarios for the Advanced LIGO, Advanced Virgo and KAGRA gravitational-wave detectors over the next decade, with the intention of providing information to the astronomy community to facilitate planning for multi-messenger astronomy with gravitational waves. We estimate the sensitivity of the network to transient gravitational-wave signals, and study the capability of the network to determine the sky location of the source. We report our findings for gravitational-wave transients, with particular focus on gravitational-wave signals from the inspiral of binary neutron star systems, which are the most promising targets for multi-messenger astronomy. The ability to localize the sources of the detected signals depends on the geographical distribution of the detectors and their relative sensitivity, and [Formula: see text] credible regions can be as large as thousands of square degrees when only two sensitive detectors are operational. Determining the sky position of a significant fraction of detected signals to areas of 5-[Formula: see text] requires at least three detectors of sensitivity within a factor of [Formula: see text] of each other and with a broad frequency bandwidth. When all detectors, including KAGRA and the third LIGO detector in India, reach design sensitivity, a significant fraction of gravitational-wave signals will be localized to a few square degrees by gravitational-wave observations alone.

[Fibrin-related Markers in Acute Phase of Pulmonary Embolism and Deep Venous Thrombosis]

BACKGROUND

The fibrin-related markers are considered to be useful in diagnosing pulmonary embolism (PE) and deep vein thrombus (DVT). We measured D-dimer (DD) and soluble fibrin monomer complex (SFMC) in these cases, in order to examine the usefulness of these markers.

METHODS

PE patients (P group: 14 cases) and DVT patients (D group : 16 cases) treated in our hospital, were examined. We measured the value of DD and SFMC on the first visit day and the second day. In PE cases, comparative examination of the markers were carried out between dead and survived cases.

RESULTS

The value of both markers in P group ware significantly higher compared with D group, on the second day. There was a significant correlation between SFMC and DD in P group, but in D group, significant correlation was not observed.

CONCLUSIONS

It seems that measuring DD and SFMC is useful to evaluate the pathology of PE and DVT.

[The Efficacy of Soluble Fibrin Monomer Complex (SFMC) for Diagnosis of Aortic Dissection (AD)]

BACKGROUND

Some biomarkers are helpful for AD diagnosis. Although many studies on efficacy of D-dimer have been reported, there are few reports about SFMC. Therefore we conducted a retrospective comparative study of efficacy of SFMC and D-dimer for diagnosis of AD.

METHODS

Nineteen patients diagnosed as AD in the emergency visit were examined. Patients with cardiopulmonary arrest on arrival were excluded. These patients were classified into three patterns as follows, Stanford A or B, terms of arriving at hospital, and closing type or patent type. The value of D-dimer and SFMC were measured at the time of the first medical examination, and comparative study of both biomarkers was carried out in each groups.

RESULTS

Background of patients were not significantly different in three studies. SFMC and D-dimer showed no significant difference between Stanford A and B. Short-terms SFMC is significantly higher than long-terms. But D-dimer showed no significant difference in each comparison. Patent type of SFMC showed higher than closing type. But D-dimer showed no significant difference between patent type and closing type.

CONCLUSIONS

SFMC showed earlier response to AD than D-dimer. Measuring SFMC coupled with D-dimer is helpful for AD diagnosis.

Coulomb Blockade in a Two-Dimensional Conductive Polymer Monolayer

Electronic transport was investigated in poly(3-hexylthiophene-2,5-diyl) monolayers. At low temperatures, nonlinear behavior was observed in the current-voltage characteristics, and a nonzero threshold voltage appeared that increased with decreasing temperature. The current-voltage characteristics could be best fitted using a power law. These results suggest that the nonlinear conductivity can be explained using a Coulomb blockade (CB) mechanism. A model is proposed in which an isotropic extended charge state exists, as predicted by quantum calculations, and percolative charge transport occurs within an array of small conductive islands. Using quantitatively evaluated capacitance values for the islands, this model was found to be capable of explaining the observed experimental data. It is, therefore, suggested that percolative charge transport based on the CB effect is a significant factor giving rise to nonlinear conductivity in organic materials.

X-ray STM: Nanoscale elemental analysis & Observation of atomic track

Scanning tunneling microscopy (STM) combined with brilliant X-rays from synchrotron radiation (SR) can provide various possibilities of original and important applications, such as the elemental analysis on solid surfaces at an atomic scale. The principle of the elemental analysis is based on the inner-shell excitation of an element-specific energy level "under STM observation". A key to obtain an atomic locality is to extract the element-specific modulation of the local tunneling current (not emission that can damage the spatial resolution), which is derived from the inner-shell excitation [1]. On this purpose, we developed a special SR-STM system and smart tip. To surmount a tiny core-excitation efficiency by hard X-rays, we focused two-dimensionally an incident beam having the highest photon density at the SPring-8.After successes in the elemental analyses by SR-STM [1,2] on a semiconductor hetero-interface (Ge on Si) and metal-semiconductor interface (Cu on Ge), we succeeded in obtaining the elemental contrast between Co nano-islands and Au substrate. The results on the metallic substrate suggest the generality of the method and give some important implications on the principle of contrast. For all cases of three samples, the spatial resolution of the analysis was estimated to be ∼1 nm or less, and it is worth noting that the measured surface domains had a deposition thickness of less than one atomic layer (Fig. 1, left and center).jmicro;63/suppl_1/i14-a/DFU045F1F1DFU045F1Fig. 1.(left) Topographic image and (center) beam-induced tip current image of Ge(111)-Cu (-2V, 0.2 nA). (right) X-ray- induced atomic motion tracks on Ge(111) that were newly imaged by the Xray-STM. On the other hand, we found that the "X-ray induced atomic motion" can be observed directly with atomic scale using the SR-STM system effectively under the incident photon density of ∼2 x10(15) photon/sec/mm(2) [3]. SR-STM visualized successfully the track of the atomic motion (Fig. 1, right), which enabled the further analysis on the mechanism of the atomic motion. It is worth comparing our results with past conventional thermal STM observations on the same surface [4], where the atomic motion was found to occur in the 2-dimensional domain. However, our results show the atomic track having a local chain distribution [3].The above mentioned results will allow us to investigate the chemical analysis and control of the local reaction with the spatial resolution of STM, giving hope of wide applications.

[Use of i-gel supraglottic airway for emergency airway management by novice personnel in comparison with laryngeal mask airway and tracheal intubation in manikin models]

BACKGROUND

Tracheal intubation (TI) is a difficult skill to acquire and its proficiency deteriorates over time if not regularly practiced. However, inexperienced personnel may be required to perform airway management in emergency situations. We compared a novel supraglottic device, i-gel, with laryngeal mask airway classic (cLMA) and TI devices in regard to total success count, time required for placement, and difficulties encountered by novice personnel using a manikin model.

METHODS

Following a brief training, 24 residents were asked to insert each of i-gel, cLMA, and TI in a randomize fasion using a manikin. Success counts for placement and time required to chest rise were recorded. After completing the tests, the participants scored the difficulty of each device using a visual ana-log scale (0-100 mm, very easy to very difficult).

RESULTS

The total success count with i-gel (46 times) was significantly higher than those of both cLMA (32 times) and TI (38 times), and the time to chest rise with i-gel (14 +/- 6 seconds) was significantly shorter than with cLMA (38 +/- 26 seconds). The difficulty score for i-gel (12 [0-51] mm) was significantly lower than those for both cLMA (51 [0-94] mm) and TI (25 [0-73] mm).

CONCLUSIONS

An i-gel may be useful for emergency airway management by inexperienced personnel. Further studies in a clinical setting are necessary to confirm these findings.

Proximal bowel necrosis after high ligation of the inferior mesenteric artery in colorectal surgery

BACKGROUND AND AIMS

High ligation of the inferior mesenteric artery may jeopardize blood supply to the proximal bowel. We undertook this study to review the clinical features and outcomes of patients who developed proximal bowel necrosis after high ligation of the inferior mesenteric artery, and to assess the incidence and the risk factors for this complication.

MATERIALS AND METHODS

A retrospective analysis of patients undergoing high or low ligation for sigmoid colon and rectal cancer with a primary anastomosis between April 2004 and March 2009 was performed. Patient and tumor characteristics and the incidence of bowel necrosis were reviewed.

RESULTS

Four hundred and nine patients were included to the analysis. Six out of 302 patients (2.0%) with high ligation developed proximal bowel necrosis, while the remaining 107 patients with low ligation did not suffer from this complication. All patients who developed proximal bowel necrosis underwent secondary surgery with resection of necrotic bowel. The pathological examination of the resected specimen revealed mucosal to transmural ischemic necrosis without the evidence of vascular thrombosis or embolic occlusion. Univariate analysis revealed that advanced age, cerebrovascular disease, and hypertension were significantly associated with proximal bowel necrosis. Multivariate analysis demonstrated that cerebrovascular disease was an independent predictor of this complication. Of these six patients, two died from associated complications.

CONCLUSIONS

Proximal bowel necrosis after high ligation is potentially fatal, and this report provides a warning in clinical settings where high ligation is indicated. Further studies are warranted to evaluate its distinct relationship with high ligation and to clarify whether low ligation would be a safeguard.

Characteristics of family caregivers with sleep dissatisfaction in Japan: identification using CHAID dendrograms

The rapid increase in the population of the elderly has raised several social issues. The current study focused on sleep dissatisfaction in family caregivers to identify family caregivers with a heavy care burden. This study aimed to detect the characteristics of caregivers who are most likely to have sleep dissatisfaction. A chi-squared automatic interaction detection technique was used to analyze data collected from 92 research care managers who collected demographic and sleep dissatisfaction information from 280 caregivers and their care recipients. Caregivers whose care recipients were unstable and bedridden were most likely to have sleep dissatisfaction. When care recipients were not stable or non-bedridden, had severe dementia symptoms, and were physically independent, their caregivers were the second most likely to have sleep dissatisfaction. When care recipients were not stable or non-bedridden, had moderate dementia symptoms, and did not need help in transferring, their caregivers had the lowest risk of sleep dissatisfaction. Although many recent studies have found a high prevalence of insomnia among the elderly, describing the characteristics of caregivers who are most likely to have sleep dissatisfaction is a significant challenge. When care recipients are physically independent, the severity of the recipient's dementia symptoms relates to the caregiver's dissatisfaction with his/her sleep. In physically dependent care recipients, the severity of the recipient's dementia did not contribute to the caregiver's dissatisfaction with his/her sleep.

Electrical conduction of organic ultrathin films evaluated by an independently driven double-tip scanning tunneling microscope

The electrical transport properties of organic thin films within the micrometer scale have been evaluated by a laboratory-built independently driven double-tip scanning tunneling microscope, operating under ambient conditions. The two tips were used as point contact electrodes, and current in the range from 0.1 pA to 100 nA flowing between the two tips through the material can be detected. We demonstrated two-dimensional contour mapping of the electrical resistance on a poly(3-octylthiophene) thin films as shown below. The obtained contour map clearly provided an image of two-dimensional electrical conductance between two point electrodes on the poly(3-octylthiophene) thin film. The conductivity of the thin film was estimated to be (1-8) × 10(-6) S cm(-1). Future prospects and the desired development of multiprobe STMs are also discussed.

[Adverse events during transcranial muscle evoked potential monitoring]

BACKGROUND

Transcranial muscle evoked potential (TC-MsEP) monitoring is available to assess spinal cord motor tract function for preventing paralysis in spine surgery. Recently, the quality of monitoring has improved. However, adverse events such as torn tracheal tube, bitten tongue, and mandibular fracture are reported.

METHODS

We reviewed retrospectively adverse events with TC-MsEP monitoring by Multipulse D-185 (Digitimer Ltd., the U.K.) during spine surgery in our hospital. In addition, we compared the number of cases with transformed tracheal tubes in cases using Multipulse D-185 and in cases using the other stimulation device.

RESULTS

Since June 2007, Multipulse D-185 is applied as a stimulating device of TC-MsEP, and we experienced two adverse events of lasceration of tongue and teeth dislocation. There was a significant difference (P=0.02) in the number of transformed tracheal tube between Multipulse D-185 (11 of 20) and the other stimulation device (2 of 19).

CONCLUSIONS

It seems that two adverse events were due to excessive masseter muscles contraction with TC-MsEP monitoring. Prevention for bite injury and ventilation strategy for tube occlusion or stenosis using Multipulse D-185 for TC-MsEP are necessary.

[Anesthetic management of a patient with erythropoietic protoporphyria for laparoscopic appendectomy]

Porphyria is a hereditary disorder due to reduction in enzyme activity of heme synthesis system, resulting in accumulation of heme precursors. Erythropoietic protoporphyria (EPP) is a type of porphyria. There are varieties of clinical expressions of EPP such as hepatic damage and photosensitivity, caused by the accumulation of protoporphyrin in the liver and the skin. Therefore it is important to prevent development of these clinical expressions. A 36-year-old woman with EPP was scheduled for a laparoscopic appendectomy. Anesthesia was induced with remifentanil, sevoflurane and rocuronium, and maintained with remifentanil, fentanyl and sevoflurane. She had performed normal daily activities without taking countermeasures against photosensitivity, so we did not change the light in the operating room, and allowed using endoscopy. The surgery was performed without any complications. No skin symptom was observed perioperatively. The level of aminotransferase was elevated temporally after the operation, while the level of protoporphyrin was unchanged. Therefore, we considered there was no manifestation of EPP perioperatively. In general, patients with EPP do not develop acute attacks induced by drugs like barbiturates. Since there was a case report of severe liver dysfunction of EPP, we did not use any contraindicated drugs in patients with acute intermittent porphyria in this patient. Considering a possibility of motor nerve damage in severe EPP, we carried out anesthetic management without epidural anesthesia.

Formation and electrical transport properties of pentacene nanorod crystal

The monophasic formation of an uncharted pentacene crystal, the pentacene nanorod, has been investigated. The restricted formation of the pentacene nanorod on a bare mica surface reveals a peculiar surface catalytic crystal growth mode of the pentacene. We demonstrated the charge transport measurements through a single pentacene nanorod and analyzed the data using a periodic hopping conduction model. The results revealed that the pentacene nanorod has a periodic conductive node within their one-dimensional crystal.

Acquired radioresistance of human tumor cells by DNA-PK/AKT/GSK3beta-mediated cyclin D1 overexpression

Recurrence is frequently associated with the acquisition of radioresistance by tumors and resulting failures in radiotherapy. We report, in this study, that long-term fractionated radiation (FR) exposures conferred radioresistance to the human tumor cells, HepG2 and HeLa with cyclin D1 overexpression. A positive feedback loop was responsible for the cyclin D1 overexpression in which constitutively active AKT was involved. AKT is known to inactivate glycogen synthase kinase-3beta (GSK3beta), which is essential for the proteasomal degradation of cyclin D1. The resulting cyclin D1 overexpression led to the forced progression of S-phase with the induction of DNA double strand breaks. Cyclin D1-dependent DNA damage activated DNA-dependent protein kinase (DNA-PK), which in turn activated AKT and inactivated GSK3beta, thus completing a positive feedback loop of cyclin D1 overproduction. Cyclin D1 overexpression led to the activation of DNA damage response (DDR) consisted of ataxia telangiectasia mutated (ATM)- and Chk1-dependent DNA damage checkpoint and homologous recombination repair (HRR). Long-term FR cells repaired radiation-induced DNA damage faster than non-FR cells. Thus, acquired radioresistance of long-term FR cells was the result of alterations in DDR mediated by cyclin D1 overexpression. Inhibition of the AKT/GSK3beta/cyclin D1/Cdk4 pathway by the AKT inhibitor, Cdk4 inhibitor or cyclin D1 targeting small interfering RNA (siRNA) suppressed the radioresistance. Present observations give a mechanistic insight for acquired radioresistance of tumor cells by cyclin D1 overexpression, and provide novel therapeutic targets for recurrent radioresistant tumors.

Depression among caregivers of the frail elderly in Japan before and after the introduction of the Public Long-Term Care Insurance System

Cross sectional studies were conducted in five towns in Japan before and after the introduction of the Long-term Care Insurance System (LTCIS), in order to evaluate the factors relating to depression among family caregivers for the frail elderly. Depressive caregivers were more likely to consult with their doctors, to be in poor health, to care for demented elderly with behavioral disturbances than the non-depressive caregivers both before and after the LTCIS. Before LTCIS, depressive caregivers were more likely to attend to the elderly for more than 16 hours per day than their counterparts. After the LTCIS, depressive caregivers were more likely to be a spouse, to care for a frail elderly male, and less likely to be able to go out without accompanying the elderly than their counterparts. Even after the introduction of LTCIS, half of the caregivers were depressive. It is suggested that a government agency should be created to support not only the frail elderly but also their caregivers.

Measurements of short-lived cosmic-ray-produced radionuclides in rainwater

Cosmic-ray-produced (CP) nuclides with half-lives shorter than 21h were measured in rainwater by ultra-low-background gamma spectrometry at Ogoya Underground Laboratory. As levels of CP nuclides are extremely low and their half-lives are very short, quick sampling methods for a large volume of rainwater and rapid chemical separations by ion exchange method were developed. The nuclides measured were short-lived (24)Na, (28)Mg, (38)S, (38)Cl, (39)Cl, as well as nuclides with longer half-lives (7)Be and (22)Na. The number of atoms of CP nuclides in rainwater were evaluated to range from 30 to 1500L(-1) for (24)Na (n=16, mean; 520 [6.7mBqL(-1)]), 80 to 600L(-1) for (28)Mg (n=13, mean; 260 [2.4mBqL(-1)]), 400 to 1900L(-1) for (39)Cl (n=6, mean; 1200 [250mBqL(-1)]), 1x10(6) to 4x10(7)L(-1) for (7)Be (n=16, mean; 7x10(6) [1.05BqL(-1)]) and 2x10(3) to 1x10(5)L(-1) for (22)Na (n=9, mean; 2x10(4) [0.2mBqL(-1)]).

Association of laboratory data and death within one month in cats with chronic renal failure

OBJECTIVES

To retrospectively compare the data taken at the first visit of 34 cats with chronic renal failure surviving more than one month (surviving group) and 16 cats dying within one month (non-surviving group).

METHODS

Records were collected on cats with chronic renal failure presented to a private veterinary practice in Nagoya, Japan, from March 1996 to March 2005. All cats with chronic renal failure diagnosed on the basis of case histories, clinical signs (such as, lethargy, anorexia, loss of bodyweight and vomiting) and a high plasma creatinine (>180 micromol/l) were included in the study.

RESULTS

Plasma creatinine, urea nitrogen, inorganic phosphate, packed cell volume and urine protein/creatinine ratio were significantly different between cats of the surviving and non-surviving groups. In the surviving group, survival statuses were recorded, and laboratory data was obtained within one month before death in 13 cats. In the 13 cats, plasma creatinine, packed cell volume and urine protein/creatinine ratio showed significant differences between the data taken within one month before death and that taken at first visit, and only urine protein/creatinine ratio exhibited a consistent alteration (increase) in relation to first visit data.

CLINICAL SIGNIFICANCE

These results indicated that plasma creatinine, urea nitrogen, inorganic phosphate, packed cell volume and urine protein/creatinine ratio were associated with death within one month and urine protein/creatinine ratio was most likely to be associated with mortality in cats with chronic renal failure.

Cytochemical Localization of Glycoconjugates in the Secretory Epithelial Cells Lining the Prostate Gland of the Miniature Pig

The aim of the study was to emphasize several specific functional aspects of the mammalian prostate gland. In this connection, the subcellular localization and characterization of glycoconjugates in the secretory epithelial cells were examined that line the prostate gland of the miniature pig, using cytochemistry, including lectin-gold methods. The results verified a diversified pattern of glycoconjugates in the structures of the secretory cells. The secretory granules and the free surface coat of the plasma membrane contained several sugar moieties such as alpha-D-Man, alpha-D-Glc, alpha-L-Fuc, beta-D-Gal, GalNAc, GlcNAc and NeuAc (sialic acid), whereas the Golgi apparatus exhibited GlcNAc and sialic acid residues. In addition, the cisterns of the endoplasmic reticulum showed alpha-D-Man and alpha-D-Glc moieties. It seems likely that the secretory glycoconjugates demonstrated contribute to favourable conditions for fertilization.

Morphological, histochemical and immunohistochemical characterization of secretory production of the ciliary glands in the porcine eyelid

In addition to performing general histology and cytology of the ciliary glands of the miniature pig, we studied the localization of glycoconjugates and beta-defensins in these glands with the use of carbohydrate histochemical and immunohistochemical methods. The secretory cells of the glands were equipped with non-homogeneous secretory granules, a well-developed Golgi apparatus and rough endoplasmic reticulum. The secretory epithelium and luminal secretion of the glands contained large amounts of neutral and acidic glycoconjugates with various saccharide residues (alpha-L-Fuc, beta-D-Gal, alpha-D-GalNAc and sialic acid). The sebaceous glands and tarsal glands also exhibited positive reactions to most of the histochemical methods. Additionally, the antimicrobial peptide group of beta-defensins was demonstrated to be products of the ciliary glands, as well as the sebaceous glands and tarsal glands. The results obtained are discussed with regard to the specific function of the ciliary glandular secretions. These secretory products may be related to the moistening and general protection of the skin surface of the eyelid and ocular surface.

Neuroradiologic and clinicopathologic features of oculoleptomeningeal type amyloidosis

OBJECTIVE

To clarify the pathogenesis of leptomeningeal amyloidosis in familial amyloidotic polyneuropathy amyloidogenic transthyretin Y114C (FAP ATTR Y114C).

METHODS

The authors analyzed eight FAP ATTR Y114C patients. Six patients showed CNS symptoms associated with leptomeningeal amyloidosis. To examine the function of the blood-CSF barrier and blood-brain barrier (BBB), the authors performed CSF and MRI studies. The authors also performed a histopathologic study of autopsy specimens to examine the distribution of amyloid deposition in the CNS.

RESULTS

CSF study showed high total protein concentrations and increased albumin CSF/serum concentration quotients (Qalb; an indication of blood-CSF barrier function). MRI with gadolinium (Gd) revealed enhancement from brainstem to spinal cord. Serial brain MRI studies with FLAIR images after Gd administration showed Gd leakage into the subarachnoid space (two patients). These findings suggested the blood-CSF barrier and BBB dysfunctions. Constructive interference in steady state (CISS) three-dimensional Fourier transformation (CISS-3DFT) sequence analysis demonstrated amyloid-induced funiculus structures joining the spinal cord and dura mater (one patient). Histopathologic study revealed intense amyloid deposition in leptomeninges, vessel walls, and parenchyma in spinal cord and the brain. These distributions of amyloid deposition are unique compared to other TTR related leptomeningeal amyloidosis.

CONCLUSIONS

Patients with familial amyloidotic polyneuropathy amyloidogenic transthyretin Y114C had CNS disorders related to amyloid deposition in leptomeninges, vessel walls, and parenchyma in spinal cord and the brain. The pathogenesis of CNS disorders may reflect disruption of the blood-CSF barrier and blood-brain barrier by amyloid deposition.

Electronic structure of a polydiacetylene nanowire fabricated on highly ordered pyrolytic graphite

A molecular wire candidate, the polydiacetylene chain, fabricated in a substantial support layer of monomers self-assembled on a highly ordered pyrolytic graphite surface, was studied using scanning tunneling microscopy and spectroscopy. The density of states of individual polymers and constituent monomers were observed on the same surface, and then compared with the calculated results. The spectrum delineating the density of states of the polydiacetylene wire clearly reveals the theoretically predicted pi-band and band edge singularities of the one-dimensional polymer.

Correlation between facial morphology, mouth opening ability, and condylar movement during opening-closing jaw movements in female adults with normal occlusion

The aim of this study was to investigate the relationship between parameters of facial morphology, maximal voluntary mouth opening ability, and condylar movements in 21 adult females, aged between 20 and 24 years. The subjects had a normal occlusion without sign or symptoms of temporomandibular joint (TMJ) dysfunction. Mandibular movements were recorded using an opto-electric jaw movement recording system with six degrees of freedom under a series of maximal mouth opening-closing movements. Maximal jaw opening and coincident condylar movement were measured three-dimensionally. The mean values of the incisor and condylar path were 41.1 +/- 3.5 mm (range 35.6-50.9 mm) and 12.8 +/- 2.8 mm (range 8.1-19.2 mm), respectively. Although the positive correlation between maximal jaw opening and facial morphology was significant, none of the variables significantly differed between the value of the condylar path and facial morphology. The length of the path of maximum incisor movement and the condylar path during mandibular movement also did not correlate. Stepwise multiple regression analysis indicated a positive association between the maximal length of the incisor path and the cephalometric value of mandibular ramus inclination (R2 value was 0.369). The results of this study suggest that facial morphology size has a limited effect on maximal voluntary mandibular opening and condylar movements in normal adult female subjects.

(4E)-dehydrocitrals [(2E,4E)- and (2Z,4E )-3,7-dimethyl-2,4,6-octatrienals] from acarid mite Histiogaster sp. A096 (Acari: Acaridae)

A mixture of two monoterpenes was obtained as the opisthonotal gland secretion from unidentified Histiogaster sp. A096 (Acari: Acaridae), and their structures were elucidated to be (4E)-dehydrocitrals [(2E,4E)- and (2Z,4E)-3,7-dimethyl-2,4,6-octatrienals] by GC/MS, GC/FT-IR, UV and 1H-NMR spectra. Both isomers of (4E)-dehydrocitral prepared by syntheses in 4 steps from 3-methyl-2-butenal with 34.2% yields (based on the ylide) were separated by column chromatography into the (2E,4E)- and (2Z,4E)-3,7-dimethyl-2,4,6-octatrienal. Mass spectra together with GC retention times of the purified natural (4E)-dehydrocitrals were identical with those of synthetic (2E,4E)-3,7-dimethyl-2,4,6-octatrienal and (2Z,4E)-3,7-dimethyl-2,4,6-octatrienal. The geometry at the 2-C position of both synthetic (4E)-dehydrocitrals was confirmed by NOESY analyses. This is the first identification of (4E)-dehydrocitrals from the animal kingdom.

Structural elucidation and synthesis of 3-hydroxybenzene-1,2-dicarbaldehyde from astigmatid mites

The structure of a novel aromatic compound contained in the unidentified Rhizoglyhus mite (Acaridae: Astigmata) was elucidated, without its isolation, to be 3-hydroxybenzene-1,2-dicarbaldehyde (tentatively named gamma-acaridial) by a combination of GC/MS and GC/FT-IR together with knowledge of related mite compounds. The structure was confirmed by a 5-step synthesis, starting from methyl 3-hydroxybenzoate, in a 15% overall yield. The compound is widely distributed not only among Astigmata but also among Oribatida, although its biological function is obscure at present.

Effects of genotype matching of feline major histocompatibility complex (FLA) class II DRB on skin-allograft transplantation in cats

In order to confirm the effects of matching of expressed feline major histocompatibility complex (FLA) class II DRB genotype on transplantation immunity in cats, skin-allogeneic transplantation was carried out between cats, in which DRB genes expressed were genotyped by the RT-PCR-RFLP method using group-specific primers. Duration until grafts were rejected was 14.63 +/- 1.69 days (mean +/- standard deviation) in the pairs that had the same type of subgroups, 7.25 +/- 0.71 days in the pairs that had one different type of subgroup and 6.88 +/- 0.35 days in the pairs that had two different types of subgroups. The duration of graft survival in the pairs with the same type of subgroups was significantly longer (P<0.01) than those in the pairs with different types. Although FLA components involved in transplantation immunity should not only be DRB genes, it was suggested that the expressed FLA-DRB genotype might associate with feline transplantation immunity, and that typing and matching of expressed FLA-DRB genes might be one of the important factors in the control of feline transplantation immunity.

Burden among caregivers of frail elderly in Japan

The present study was conducted in order to investigate the factors related to the feelings of psychological stress, called heavy burden, in caregivers who took care of frail elderly in the eastern part of Fukuoka Prefecture, Kyushu, Japan. Fifty-eight caregivers answered a self-administered questionnaire, involving the Japanese version of the Zarit Caregiver Burden Interview (ZBI) and thus described their own caregiving situation. Compared to caregivers with a light burden, heavily burdened caregivers were less likely to have time to go out without patients, but were more likely to consult physicians. Heavily burdened caregivers spent a longer time on looking after the elderly as well as on physical caregiving, and also used more social services than lightly burdened caregivers. However, the physical disabilities of the patients did not differ between the two groups. Even after controlling for confounding factors, the time spent on looking after frail elderly was found to be a significant factor related to the caregivers' heavy burden (10-24 hrs vs. 0-9 hrs; odds ratio: 5.35, 95% confidence interval: 1.17-25.58). These findings suggest that looking after frail elderly for a long time seems to be an important factor related to caregivers' developing psychological feelings of heavy burden.

Enantiomer separation by capillary electrophoresis utilizing noncyclic mono-, oligo- and polysaccharides as chiral selectors

Various noncyclic mono-, oligo- and polysaccharides have been successfully used for enantiomer separation in the analytical sciences such as HPLC and capillary electrophoresis (CE). This review presents enantiomer separation by CE utilizing mainly polysaccharides as chiral additives. The operation conditions that affect the enantioselectivity are briefly discussed.

The medaka rs-3 locus required for scale development encodes ectodysplasin-A receptor

The bodies of most teleost fish species are covered with specialized subepithelial structures known as scales. The scale is an epithelial appendage that differentiates from the dermal mesenchyme. Mammals, on the other hand, have no scales, but instead their bodies are covered with hair. Although their appearances are quite different, scales and hair can be considered structurally similar in that both of them are epithelial appendages distributed over the body surface in an orderly pattern. This analogy suggests that they may have the same evolutionary origin. But, to date, no molecular evidence has been presented that links scales and hair. A mutation at the rs-3 locus of medaka (Oryzias latipes) leads to almost complete loss of scales. We demonstrated that the rs-3 locus encodes ectodysplasin-A receptor (EDAR), which is required for the initiation of hair development in mammals. We identified a novel transposon inserted in the first intron of EDAR, which causes aberrant splicing. This work shows that EDAR is required for scale development in fish and suggests that it is an evolutionarily conserved molecule that is required for the development of epithelial appendages in vertebrates.

Aggregation pheromone activity of the female sex pheromone, beta-acaridial, in Caloglyphus polyphyllae (Acari: Acaridae)

Caloglyphus (= Sancasania) polyphyllae discharges from a pair of opisthonotal glands a characteristic set of volatiles, i.e. three monoterpenes and seven hydrocarbons. Among them, beta-acaridial, which is known as the female sex pheromone of the species and has antifungal activity, was newly identified as the aggregation pheromone for unfeeding and unmating mites. Feeding mites, however, exhibited sexually aroused behavior instead of the tendency to cluster when exposed to beta-acaridial. This is the first example of the compound demonstrating two pheromone functions depending upon the circumstances faced by the mites.