Assessment of effects of differences in trunk posture during Fowler's position on hemodynamics and cardiovascular regulation in older and younger subjects.

Background: Downward shifts in blood volume with changing position generally cause tachycardic responses. Age-related decreases in vagal nerve activity could contribute to orthostatic hypotension in older individuals. Fowler's position is a reclined position with the back between 30° and 60°, used to facilitate breathing, eating, and other routine daily activities in frail and elderly patients.

Choke point physiology in airway stenting: A case presentation and discussion.

Background: The point in the airway that allows the smallest maximal flow is known as the "choke point". The tube law describes the velocity of the expired air, which cannot exceed the wave-speed. Flow limitation during forced expiration is affected by the relationship between the transmural pressure (Ptm) and cross-sectional area (A) of the airway.

Usefulness of two interferon-γ release assays for rheumatic disease.

Background: The aim of this study was to evaluate the performance of two interferon-γ release assays (IGRA), QuantiFERON-TB Gold In-Tube (QFT-GIT) and T-SPOT.TB, for pediatric patients with rheumatic disease in Japan and to analyze the frequencies of indeterminate test results with these kits.

Methods: An IGRA was performed in 108 patients <20 years old in order to exclude tuberculosis infection at the time of first application of or change of biological agents and immunosuppressants in Yokohama City University Hospital.

Epileptogenesis and epileptic maturation in phosphorylation site-specific SNAP-25 mutant mice.

Snap25(S187A/S187A) mouse is a knock-in mouse with a single amino acid substitution at a protein kinase C-dependent phosphorylation site of the synaptosomal-associated protein of 25 kDa (SNAP-25), which is a target-soluble NSF attachment protein receptor (t-SNARE) protein essential for neurotransmitter release. Snap25(S187A/S187A) mice exhibit several distinct phenotypes, including reductions in dopamine and serotonin release in the brain, anxiety-like behavior, and cognitive dysfunctions. Homozygous mice show spontaneous epileptic convulsions, and about 15% of the mice die around three weeks after birth.

[Nonconvulsive status epilepticus; progress in clinical practice and research].

Mainly after 2000, we have reported novel manifestations of nonconvulsive status epilepticus (NCSE), such as reversible protracted coma, posthyperventilation apnea, and higher brain dysfunctions, including Klüver-Bucy syndrome. In this review, we discuss the progress in clinical practice and research of NCSE with best available evidence, especially the spectrum of electroencephalographic abnormalities in NCSE, clinical manifestations of malignant NCSE, relationship between sudden unexpected death in epilepsy (SUDEP) and NCSE, and a strategy for real-time neuromonitoring. In addition, we propose some new concepts, NCSE, such as the antiepileptic drug-responsive neurological deficit (ADND), critical NCSE, fosphenytoin challenge test, epilepsy-related organ dysfunction (Epi-ROD), and a Neurocritical Score (Integrated Scale) for the comprehensive and serial evaluation of neurocritical conditions.

Association between the location of diverticular disease and the irritable bowel syndrome: a multicenter study in Japan.

Objectives: No previous reports have shown an association between location of diverticular disease (DD) and the irritable bowel syndrome (IBS).

Methods: We included 1,009 consecutive patients undergoing total colonoscopy in seven centers in Japan from June 2013 to September 2013. IBS was diagnosed using Rome III criteria, and diverticulosis was diagnosed by colonoscopy with transparent soft-short-hood.

Effectiveness of tongue-tie division for speech disorder in children.

Background: The aim of this study was to determine the effectiveness of tongue-tie division (frenuloplasty/ frenulotomy) for speech articulation disorder in children with ankyloglossia (tongue-tie).

Methods: Articulation test was done in five children (3-8 years old) with speech problems who underwent tongue-tie division. The test consisted of 50 pictures of common Japanese words with 2-3 syllables.

Stress-induced phosphorylation of SNAP-25.

Synaptosomal-associated protein of 25 kDa (SNAP-25), a t-SNARE protein, plays a crucial role in neurotransmitter release by exocytosis. Protein kinase C phosphorylates SNAP-25 at Ser(187), however the physiological significance of this phosphorylation event in brain function remains unclear. In the present study, we found that SNAP-25 phosphorylation increased rapidly in the mouse brain following cold-water restraint stress.

[The present state and view of the cerebrospinal fluid hypovolemia research].

Spontaneous intracranial hypotension is a rare disease characterized by orthostatic headache, low cerebrospinal fluid pressure and diffuse dural enhancement in brain MRI. German neurologist Schaltenbrand reported that orthostatic headache by low cerebrospinal fluid pressure in 1938. This disease came to be known after development of radiological diagnosis in 1990'.

[Countermeasures against patient misidentification in laboratory study--chairmen's introductory remarks].

Since the launch of the "National Joint Action of Risk Management" back in May, 2008, as a participating organization, The Japanese Society of Laboratory Medicine has been running a Medical Safety Committee of our own. As part of our awareness education activities, our society has been holding symposia on medical safety at our annual meetings. In clinical practice, misidentification of patients is directly connected to serious medical mistakes.

Small proximal aortic diameter is associated with higher central pulse pressure and poor outcome in patients with congestive heart failure.

Background: A small proximal aortic diameter (AoD) is thought to be associated with a higher characteristic impedance of the proximal aorta. However, there has been no evidence of a relationship between directly evaluated AoD and directly measured central aortic pressure or the outcome of patients with cardiovascular diseases.

Methods And Results: (a) In 135 patients without heart failure (HF), who underwent coronary catheterization, we retrospectively examined the relationship between the AoD and the central aortic pressure or aortic elastance.

Trans-resectoscope stimulation predicts the need to block adductor response during bladder tumor resection.

Background: Obturator nerve block is performed on patients who undergo transurethral resection of inferolateral bladder tumors to prevent thigh adductor muscle contraction. However, other than the tumor site, we have no criteria to judge whether this block is necessary in all patients. Moreover, it is difficult to predict the efficacy of obturator nerve block before resection.

[Medical safety in infectious disease--chairmen's introductory remarks].

"The National Joint Action of Risk Management" was started in May 2008. The Japanese Society of Laboratory Medicine took this opportunity to set up a Medical Safety Committee as a participant in this Action. The Society holds symposia concerning medical safety to educate the Society members.

Alfacalcidol-supplemented raloxifene therapy has greater bone-sparing effect than raloxifene-alone therapy in postmenopausal Japanese women with osteoporosis or osteopenia.

Vitamin D insufficiency is prevalent in osteopenic and osteoporotic postmenopausal women. The persistent increase in circulating parathyroid hormone (PTH) caused by vitamin D insufficiency reduces bone density response to antiresorptive agents in these postmenopausal women. It is not well known whether administration of raloxifene might increase serum PTH secondary to the suppression of serum calcium in postmenopausal women with osteopenia or osteoporosis.

[Effectiveness of S-1 plus CPT-11 therapy for an elderly patient with recurrent colon cancer].

In May 2006, a 79-year-old man underwent left colectomy and D2 lymphadenectomy for descending colon cancer (fStage II , Cur A). No adjuvant chemotherapy was done. Eighteen months after surgery, the serum tumor marker level was increased (CA19-9 526 U/mL), and multiple liver metastases (H2) and peritoneal dissemination were detected using abdominal CT.

Assessment of adherence to treatment of postmenopausal osteoporosis with raloxifene and/or alfacalcidol in postmenopausal Japanese women.

Patients who are diagnosed with osteoporosis and beginning treatment often discontinue their osteoporosis medication relatively early after the start of treatment because of their poor recognition of fracture risk and the asymptomatic nature of osteoporosis. In this study we aimed to assess adherence to treatment with 1 microg alfacalcidol (D), 60 mg raloxifene (R) or a combination of both (D + R) for 1 year in postmenopausal Japanese women with osteoporosis or osteopenia. We defined persistence of D and R as continuing to take tablets for more than 7 of any 14 days immediately before the 1-year visit.

[A case of a primary gastrointestinal stromal tumor (GIST) found in the greater omentum of a 99-year-old woman].

We report the case of a primary gastrointestinal stromal tumor (GIST) found in the greater omentum of an extremely elderly woman. A 99-year-old woman with a history of heart failure and renal failure presented with dyspnea and disturbance of consciousness. A tumor located between the stomach and spleen had been detected by abdominal computed tomography three years previously.