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Intermittent Akinetic Mutism after Bilateral Paramedian Thalamic Infarction Caused by Artery of Percheron Occlusion : A Case Report
Get PDFIntermittent clinical course of akinetic mutism is very unusual. We describe a 74-year-old man who started to demonstrate episodes of altered mental state with stopped moving and talking, poor response to commands, and muscle stiffness in both upper limbs approximately 1.5 months after cardioembolic bilateral paramedian thalamic infarction. Their frequency gradually increased and poststroke nonconvulsive status epilepticus was suspected, but prolonged video electroencephalography monitoring did not reveal any epileptiform abnormalities. The patient had no significant metabolic or infectious disorders. Thus, upon exclusion of other causes his condition was considered as intermittent akinetic mutism, which was indirectly confirmed by good response of symptoms to amantadine therapy and their recurrence upon termination of this treatment.journal articl
Cardiac arrest as an unusual complication in transforaminal full-endoscopic spine surgery under local anesthesia : a case report
Get PDFBackground : Transforaminal full-endoscopic surgery can be performed under local anesthesia, which is safer than general anesthesia, especially in the elderly. However, emergencies can still occur under local anesthesia. We describe a case of cardiac arrest at the start of full-endoscopic spine surgery under local anesthesia. Case presentation : The patient was an 80-year-old woman with right lower leg pain caused by two-level lumbar spinal canal stenosis. Two-stage full-endoscopic spine surgery under local anesthesia was planned. The first surgery was completed uneventfully. However, during the second surgery, cardiac arrest occurred because of Mobitz type II atrioventricular block. Percutaneous pacing was started immediately, followed by insertion of a temporary pacemaker via the femoral artery as a life-saving measure. Four days later, a permanent pacemaker was implanted. One month later, the second-stage decompression was completed without complications. Conclusion : Elderly patients require careful intraoperative monitoring for emergencies during surgery under local anesthesia as under general anesthesia.journal articl
Reversible Cerebral Vasoconstriction Syndrome without Headache
Get PDFA 49-year-old woman with a family history of Moyamoya disease presented with sudden onset of right hemiparesis without headache. Magnetic resonance imaging (MRI) of the head revealed a cerebral infarct in the left corona radiata, and magnetic resonance angiography (MRA) revealed severe stenosis of the bilateral internal carotid, middle, anterior, and posterior cerebral arteries. Antithrombotic therapy improved her symptoms. After 2 weeks, MRA revealed changes in cerebral arterial vasodilation, indicating reversible cerebral vasoconstriction syndrome (RCVS). Five months later, she presented with transient dysarthria without headache ; MRA revealed multiple cerebral artery stenosis, and 2 days later, it revealed changes in cerebral arterial vasodilation. RCVS presents with reversible multifocal narrowing of the cerebral arteries with thunderclap headache, commonly observed in middle-aged women. RCVS without headache is rare. RCVS should be a differential diagnosis in patients with multiple cerebral artery stenoses without headache, and serial MRI is important for its diagnosis.journal articl
Agricultural Biomass Waste Conversion into Biofuels and Biomaterial via Steam Explosion Pretreatment
Get PDFdoctoral thesi
Porphyromonas gingivalis infection alters microRNA composition in extracellular vesicles
Get PDFObjectives: Periodontitis, commonly associated with Porphyromonas gingivalis (Pg), involves intricate alterations of oral intercellular interactions, in which extracellular vesicles (EVs) play a pivotal role. The understanding of the miRNA profiles in the EVs derived from Pg-infected cells (Pg-EVs) remains incomplete despite acknowledging their importance in intercellular communication during periodontitis. Therefore, our objective was to identify and characterize the miRNAs enriched in Pg-EVs.
Methods: Microarray analysis was conducted to examine the miRNA profiles in the EVs derived from Pg-infected THP-1 cells. We compared the identified miRNAs with those upregulated in the EVs after stimulation with LPS. Additionally, we explored how inhibiting TLR signaling during Pg infection affects the transcription of specific miRNAs. We investigated the unique sequence motifs specific to the miRNAs concentrated in Pg-EVs.
Results: The levels of eleven miRNAs, including miR-155, were increased in Pg-EVs compared with those elevated after LPS stimulation. The Pg-induced miR-155 upregulation via TLR2 but not TLR4 signaling suggests the influence of TLR signaling on the miRNA composition of EVs. Furthermore, the miRNAs upregulated in Pg-EVs contained AGAGGG and GRGGSGC sequence motifs.
Conclusions: Our findings demonstrate that Pg-induced alterations in EV-containing miRNA composition occur in a TLR4-independent manner. Notably, the concentrated miRNAs in Pg-EVs harbor specific motifs with a high G+C content within their sequences. The upregulation of specific miRNAs in EVs under infectious conditions suggests the influence of both innate immune receptor signals and miRNA sequence characteristics.doctoral thesi
Acute Kidney Injury Caused by Rhabdomyolysis Is Ameliorated by Serum Albumin-Based Supersulfide Donors through Antioxidative Pathways
Get PDFOxidative stress is responsible for the onset and progression of various kinds of diseases including rhabdomyolysis-induced acute kidney injury (AKI). Antioxidants are, therefore, thought to aid in the recovery of illnesses linked to oxidative stress. Supersulfide species have been shown to have substantial antioxidative activity; however, due to their limited bioavailability, few supersulfide donors have had their actions evaluated in vivo. In this study, human serum albumin (HSA) and N-acetyl-L-cysteine polysulfides (NACSn), which have polysulfides in an oxidized form, were conjugated to create a supersulfide donor. HSA is chosen to be a carrier of NACSn because of its extended blood circulation and high level of biocompatibility. In contrast to a supersulfide donor containing reduced polysulfide in HSA, the NACSn-conjugated HSAs exhibited stronger antioxidant activity than HSA and free NACSn without being uptaken by the cells in vitro. The supersulfide donor reduced the levels of blood urea nitrogen and serum creatinine significantly in a mouse model of rhabdomyolysis-induced AKI. Supersulfide donors significantly reduced the expression of oxidative stress markers in the kidney. These results indicate that the developed supersulfide donor has the therapeutic effect on rhabdomyolysis-induced AKI.journal articl
The impact of COVID-19 on the number of people screened for countermeasure breast cancer in Tokushima City
Get PDFWe examined the impact of COVID-19 on countermeasure-based breast cancer screening in Tokushima City based on the number of breast cancer screening recipients at our hospital. The number of breast cancer screening recipients at our hospital was 576 in 2019 and slightly decreased to 550 in 2020, but no significant impact was observed. However, the number of examinees in 2021 clearly decreased to 416. In 2022, the number of infected patients increased about 10 times from the previous year, but the number of examinees did not change much from the previous year to 412. Although there were some problems in 2020, such as the cancellation of breast cancer screening, the impact was not that great, and in 2021. In 2022, the number of examinees remained unchanged from the previous year despite the increase in the number of infected persons. It is thought that the number of examinees did not decrease so much in 2022 due to the increase in the vaccination rate, progress in infection control measures, and the residentsʼ familiarity with COVID-19. The number of persons receiving examinations is expected to gradually recover in the future. The impact of COVID-19 on countermeasure-type breast cancer screening in Tokushima City was temporary and did not have a significant effect.journal articl
Clinical Significance of Phase Angle and Extracellular Water-to-Total Body Water Ratio Measured by Bioelectrical Impedance Analysis
Get PDFBioelectrical Impedance Analysis (BIA) is a simple and noninvasive method used to estimate body composition, Phase Angle (PhA), and Extracellular Water-to-Total Body Water Ratio (ECW/TBW). PhA serves as an indicator of cell mass, cellular integrity, and healthiness of the cell membranes. ECW/TBW is an indicator of cellular volume valance. Both metrics can be used to comprehensively assess the structural integrity of the body, including nutritional status and inflammation. Evidence suggests a close correlation of these parameters with prognosis and disease progression in non-cancer patients such as diabetes mellitus and in cancer patients, including those with hematological malignancies. BIA may be a valuable tool for assessing the current body status as well as for future predictions across different disease domains.journal articl
Earthquake Preparedness for Operating Room Staff : Lessons Learned From Experiences and the Literature
Get PDFEarthquakes pose hazards to healthcare workers and patients in operating rooms. Proactive planning based on insights gained from past experiences is crucial for enhancing safety. Through a comprehensive literature review, we summarize challenges and lessons learned from real earthquake events to inform the development of effective safety measures in operating rooms. Additionally, we discuss the anesthesiologist's role in crisis management.journal articl
