The aim of this study was to develop a new method for the determination of NO2 levels encountered in clinical settings as well as in environmental studies, using a bi−component atmospheric pressure ionization mass spectrometry(APIMS). Hydrogen (1%) diluted in pure argon was ionized by corona discharge in the first ionization component. Fifty ml of the analyte diluted in 250ml of composite air or carbon dioxide (CO2) was introduced into the second ionization component and analyzed. When composite air was used as the sample carrier gas, NO in the analyte was oxygenated and there was an increase in the NO2 content from that in the original analyte. However, when CO2 was used as the sample carrier gas, the level of NO2 in the analyte could be determined because CO2 did not change the NO2 content from that in the original analyte. A calibration curve with good linearity was obtained using the UG−410 APIMS system, with a regression equation of Y(%)=5.513*10-2 X(ppb) and a detection limit of 0.9ppb. Since APIMS detects NO2 directly within its system, the concentration of NO does not need to be measured. This system may be of great help in the accurate detection and determination of the concentration of low levels of NO2 during inhaled NO therapy
Carbon Dioxide ; ionization ; Spectrum Analysis, Mass ; Direct type of resin cement ; Adjudication

STUDY DESIGN: Retrospective, radiological study. PURPOSE: To determine the relationship between clinical symptoms and the extent of tumor occupation of the spinal canal by cauda equina schwannoma. OVERVIEW OF LITERATURE: Little is known about the relationship between the size of tumors of the cauda equina and the manifestation of clinical symptoms. We analyzed this relationship by estimating the percentage of tumor occupation (PTO) in the spinal canal in cauda equina schwannomas and by correlating this parameter with the presence and severity of clinical symptoms. METHODS: Twenty-two patients (9 men and 13 women; age, 19–79 years; mean age, 55.3 years) who were radiologically diagnosed with schwannomas of the cauda equina between April 2004 and July 2014 were retrospectively analyzed. PTO was measured in axial and sagittal magnetic resonance imaging slices in which the cross-sectional area of the tumor was the largest. Data regarding clinical symptoms and results of physical examinations were collected from patient medical records. PTO differences between symptom-positive and -negative groups were analyzed for each variable. RESULTS: In the 4 cases in which tumor presence was not related to clinical symptoms, PTO was 5%–10% (mean, 9%) in axial slices and 23%–31% (mean, 30%) in sagittal slices. In the 18 cases in which symptoms were associated with the tumor, PTO was 11%–86% (mean, 50%) in axial slices and 43%–88% (mean, 71%) in sagittal slices. PTO in axial slices was significantly higher in the presence of Déjèrine symptoms and/or muscle weakness, a positive straight leg raise test, and a positive Kemp sign. CONCLUSIONS: PTO >20% in axial slices and >40% in sagittal slices can be an indication of symptomatic cauda equina schwannoma.
Cauda Equina* ; Female ; Humans ; Leg ; Magnetic Resonance Imaging ; Male ; Medical Records ; Muscle Weakness ; Neurilemmoma* ; Occupations* ; Physical Examination ; Retrospective Studies ; Spinal Canal*

PURPOSE: Recently, the clinical application of the forced oscillation technique (FOT) has progressed with the spread of commercially available FOT devices, including the impulse oscillation system and MostGraph. We investigated the usefulness of color 3D imaging of respiratory impedance in asthma using MostGraph. METHODS: Whole-breath and within-breath respiratory system resistance (Rrs) and reactance (Xrs) were measured in 78 patients with asthma. Color 3D images were classified into three patterns: the chronic obstructive pulmonary disease (COPD)-like pattern (high values of Rrs and Xrs with a marked respiratory cycle and frequency dependence), the asthma pattern (moderately high Rrs over the entire frequency and a respiratory cycle with slight Xrs changes), and a normal-like pattern (low Rrs and Xrs with few within-breath changes). The classification was performed by three researchers, who were unaware of the clinical information, and the clinical characteristics were compared among the three groups. RESULTS: Color 3D imaging provided a COPD-like pattern in 25 patients, an asthma pattern in 39 patients, and a normal-like pattern in 14 patients. Patients with the COPD-like pattern were predominantly female with a higher body mass index, lower forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), and higher Rrs and Xrs values (whole-breath and within-breath variation). Those with the normal pattern had higher FEV1 and FVC, and a lower single-breath nitrogen washout slope. There were no differences in asthma control or exhaled nitric oxide levels among the three groups. CONCLUSIONS: These results suggest that color 3D imaging of respiratory impedance may show asthma phenotypes.
Asthma ; Body Mass Index ; Electric Impedance ; Female ; Forced Expiratory Volume ; Humans ; Nitric Oxide ; Nitrogen ; Phenotype ; Pulmonary Disease, Chronic Obstructive ; Respiratory System ; Vital Capacity

OBJECTIVES: Glucocorticoid (GC) treatment inhibits activation of runt-related transcription factor 2 (Runx2), which is essential for osteoblast differentiation from stem cells. As a result, GC treatment results in bone loss, GC-induced osteoporosis (GIO), elevated fracture risk, and delayed bone healing. Bisphosphonates such as alendronate (ALN) are recommended for treating or preventing GIO, and lowintensity pulsed ultrasound (LIPUS) facilitates fracture healing and maturation of regenerated bone. Combined therapy with ALN and LIPUS may stimulate cancellous bone healing in GIO rats. Here, we examined the effect of ALN and LIPUS on cancellous bone osteotomy repair in the proximal tibia of GIO rats. METHODS: Prednisolone (10 mg/kg body weight/day) was administered for 4 weeks to induce GIO in 6-month-old female Sprague-Dawley rats. Tibial osteotomy was then performed and daily subcutaneous injection of ALN (1-µg/kg body weight) was subsequently administered alone or in combination with LIPUS (20 min/day) for 2 or 4 weeks. RESULTS: ALN significantly increased bone mineral density (BMD) at 2 and 4 weeks, and ALN + LIPUS significantly increased BMD at 4 weeks. Bone union rates were significantly increased after 2 and 4 weeks ALN and ALN + LIPUS treatment. Lastly, ALN and ALN + LIPUS significantly increased the proportion of Runx2 positive cells at 4 weeks. CONCLUSIONS: ALN monotherapy and combined ALN and LUPUS treatment augmented BMD and stimulated cancellous bone repair with increased Runx2 expression at the osteotomy site in GIO rats. However, the combined treatment had no additional effect on cancellous bone healing compared to ALN monotherapy.
Alendronate* ; Animals ; Bone Density ; Bone Diseases, Metabolic* ; Diphosphonates ; Female ; Fracture Healing ; Humans ; Infant ; Injections, Subcutaneous ; Osteoblasts ; Osteoporosis ; Osteotomy* ; Prednisolone ; Rats* ; Rats, Sprague-Dawley ; Stem Cells ; Tibia* ; Transcription Factors ; Ultrasonic Waves*

OBJECTIVES: The purpose of this study is to evaluate the effects of teriparatide (TPTD) on bone mineral density (BMD), bone strength, and bone quality in Akita mouse models of diabetes mellitus. METHODS: Twelve-week-old female Akita mice and control mice (C57/BL/6NCrSlc) were divided into 4 groups: control mice treated with vehicle (n = 7) or TPTD (n = 6); and Akita mice treated with vehicle (n = 6) or TPTD (n = 7). TPTD or vehicle was administered subcutaneously 3 times a week for 8 weeks. Blood glucose, serum sclerostin, total tibial BMD, femoral shaft bone strength, and bone quality using Fourier-transform infrared spectroscopy imaging were evaluated. RESULTS: No significant differences in serum sclerostin levels were evident among these groups after 8 weeks of treatment. TPTD significantly increased BMD in control mice (+12.7%, P = 0.02) and Akita mice (+29.2%, P = 0.001) compared with vehicle. Maximum load and stiffness were significantly higher in Akita mice treated with TPTD than in Akita mice treated with vehicle (+56.6%, P = 0.03 and + 90.5%, P = 0.02, respectively). On Fourier-transform infrared spectroscopy imaging, the mineral/matrix ratio was significantly lower in Akita mice treated with vehicle than in control mice (−12.2%, P = 0.02), and TPTD treatment significantly increased the mineral/matrix ratio (P = 0.003). CONCLUSIONS TPTD thus improved BMD and bone strength in both control mice and Akita mice, with improvements in the mineral/matrix ratio among Akita mice.

We clarify the effect of combination of low-carbohydrate diet and resistance exercise training on physical characteristics and plasma concentrations of metabolites and hormones in humans. Intervention of low-carbohydrate diet and resistance exercise training were performed on 7 healthy men and 3 women (age 39.6 ± 7.0 year; BMI 25.1 ± 3.6 kg/m2) for 8 - 12 weeks. Physical characteristics and 106 test items including and blood concentrations of metabolites and hormones were measured before and after the intervention. The effects of intervention were analyzed by a paired t-test, in which multiple testing was corrected by the method of Storey (significant variation q <0.1). In both men and women, carbohydrate and energy intake per day were low, and protein intake per day was almost the same as the recommended dietary allowance. Because carbohydrate intake were limited (174 kcal), resulting in reduction of total energy (1186 kcal). After the intervention, body weight, BMI (Body Mass Index), fat mass, body fat, muscle mass and body water content significantly decreased, while muscle mass per body mass significantly increased. Glycine, 3-methyl histidine, inorganic phosphorous, urea nitrogen, urea nitrogen per creatinine, were significantly increased, while HbA1c, white blood cell count, β-aminoisobutyric acid, adrenalin, free T4, blood ammonia, γGTP, cholinesterase, and leptin were decreased.

Objective: Whether or not emergent decompression/fusion surgery for paralysis caused by metastatic spinal tumors of unknown origin improves patient neurological outcome and survival remains unclear. This study aimed to evaluate the clinical outcomes of emergent decompression/fusion surgery for paralysis caused by spinal tumors of unknown or not previously diagnosed origin.Patients and Methods: Data from the medical records of 11 patients with spinal tumors of unknown origin (study group) were compared with those of 15 patients with metastatic spinal tumors of known origin (control group). The outcome measures were postoperative performance status, motor function evaluated with the Frankel grade, and actual survival after surgery as compared with the estimated survival calculated using the Tokuhashi score. χ2 analyses were performed to evaluate differences between the groups.Results: The mean performance status was 3.6 preoperatively, which improved to 2.9 postoperatively (P<0.05), in the unknown origin group and 3.6 preoperatively, which improved to 2.7 postoperatively (P<0.05), in the control group. Seven patients (64%) in the unknown origin group showed improvement in paralysis by ≥1 Frankel grade. By contrast, only 4 patients (27%) in the control group showed improvement in paralysis. The unknown origin group tended to show better improvement (P=0.05). All the patients in the unknown origin group underwent adjuvant therapy after definitive diagnosis following surgery. The unknown origin group showed a slight tendency toward better survival than toward the estimated survival.Conclusion: Emergent decompression/fusion surgery for patients with paralysis caused by metastatic tumors of unknown origin is potentially useful for diagnosing tumor origin and improving neurological outcomes and performance status, and thus for extending survival.