Alzheimer's disease (AD) research from 1984 disclosed that there is 10-20 years of time for transition from normal brain to Alzheimer's disease brain. Therefore, AD is a disease with long “Mibyo” phase. Since treatment effect in AD could be partial and limited, we need to consider prevention or “Youjou” not to develop AD more seriously. Amyloid imaging with PET can be promising in the visualization of amyloid burden or Mibyo state. Several medicinal herbs have a potent anti-amyloid aggregation effect as a new class of disease-modifying drug. Yi-Gan-San which has been originally described in Ming dynasty in China is efficacious in improving behavioral and psychological symptoms of dementia without developing falls or extra-pyramidal adverse effects. Multi-potent traditional medicine doctor with not only practicing traditional medicine alone, but they can also get insights on Western medicine and collecting information from abroad is warranted.
Admitting diagnosis ; Alzheimer's Disease ; Medicine ; Medicine, Kampo ; Fighting

Objective To evaluate the correlation between changes in regional cerebral glucose metabolism and reduced body mass index (BMI) in patients with mild to moderate Alzheimer's disease(AD). Methods Regional cerebral glucose metabolism in many regions of interest of 27 AD patients were measured by positron emission tomography (PET) through 18 F fluro deoxyglucose (FDG) and their correlation with low BMI was analysed. Results The analysis using simple and multiple regression correlation showed that the metabolic ratio had a positive correlation with low BMI only in anterior cingulate cortex. Conclusions Anterior cingulate cortex may preferably involve in the regulation of food intake and body weight.

Weproduced a transgenic rodent malaria parasite (Plasmodium berghei) that contained the luciferase gene under apromoter region of elongation factor-1α. These transgenic (TG) parasites expressed luciferase inall stages of their life cycle, as previously reported. However, we were the firstto succeed in observing sporozoites as a mass in mouse skin following theirdeposition by the probing of infective mosquitoes. Our transgenic parasites mayhave emitted stronger bioluminescence than previous TG parasites. The estimatednumbers of injected sporozoites by mosquitoes were between 34 and 775 (median 80). Since luciferase activity diminished immediately after the death of theparasites, luciferase activity could be an indicator of the existence of liveparasites. Our results indicated that sporozoites survived at the probed sitefor more than 42 hours. We also detected sporozoites in the liver within 15 minof the intravenous injection. Apart from the liver, bioluminescence was notobserved in the lung, kidney, or spleen. We reconfirmed that the liver was thefirst organ for malaria parasites to enter and increase in number.

We produced a transgenic rodent malaria parasite (Plasmodium berghei) that contained the luciferase gene under a promoter region of elongation factor-1α. These transgenic (TG) parasites expressed luciferase in all stages of their life cycle, as previously reported. However, we were the first to succeed in observing sporozoites as a mass in mouse skin following their deposition by the probing of infective mosquitoes. Our transgenic parasites may have emitted stronger bioluminescence than previous TG parasites. The estimated number of injected sporozoites by mosquitoes was between 34 and 775 (median 80). Since luciferase activity diminished immediately after the death of the parasites, luciferase activity could be an indicator of the existence of live parasites. Our results indicated that sporozoites survived at the probed site for more than 42 hours. We also detected sporozoites in the liver within 15 min of the intravenous injection. Bioluminescence was not observed in the lung, kidney or spleen. We confirmed the observation that the liver was the first organ in which malaria parasites entered and increased in number.

We assessed the effectiveness of practical instruction in parasitology for undergraduates at Jichi Medical School by examining grades on a practical examination. Two hundred six second-year medical students in 1997 and 1998 (103 students in each year) were enrolled in this study. The students took written and practical examinations at the end of the program. We found that grades on the practical examination were correlated with grades on the written examination (r=0.5664; p<0.001). The discrimination index ranged from 0.23 to 0.78. The percentage of correctly identified species was significantly higher when students studied live specimens than when they used other methods (p<0.0001 in both 1997 and 1998). The highest rates of correct identification (more than 90%) were for Anisakis species larvae and Enterobius vermicularis eggs in 1997 and for Anisakis species larvae, E. vermicularis eggs, and Anopheles mosquitoes in 1998. Results of neither written nor practical examinations differed significantly between students who chose biology at the entrance examination and those who did not. Our results suggest that undergraduates would gain a better understanding of parasitology by studying live specimens.

No abstract available.
Rupture ; Transcatheter Aortic Valve Replacement

Background: Arbekacin (ABK) is an aminoglycoside that exhibits anti-methicillin-resistant Staphylococcus aureus (MRSA) and anti-Pseudomonas aeruginosa activities. Therefore, for patients with febrile neutropenia (FN) and concurrent pneumonia suspected to be caused by MRSA, ABK may be sufficiently effective even as a single agent. Materials and Methods: Patients with hematologic malignancies treated with ABK who met the following criteria were included: 1) fever during neutropenia or functional neutropenia, 2) FN complicated by pneumonia, and 3) possible infection by antimicrobial-resistant Grampositive cocci. Results: This study encompassed 22 episodes involving 19 patients, of which, 15 (68.2%) were successfully treated with ABK. Of the nine episodes showing inadequate response to other anti-MRSA drugs, eight were successfully treated with ABK. Grade 2 or worse adverse events included acute kidney injury (13.6%) and increased transaminase levels (9.1%). Conclusion The present study demonstrated that ABK is effective and safe in patients with FN and concurrent pneumonia caused by antimicrobial-resistant Gram-positive cocci. ABK may also be effective in patients who are unresponsive to other anti-MRSA drugs. Therefore, ABK may be beneficial in the treatment of pneumonia caused by antimicrobial-resistant Gram-positive cocci in patients with FN.

Objective: BRCA1 and BRCA2 mutation carriers are recommended to undergo risk-reducing salpingo-oophorectomy (RRSO) by age 40 and 45, respectively. However, the carriers have a different way of thinking about their life plan. We aimed to investigate the distribution of age at diagnosis of ovarian cancer (OC) patients to examine the optimal timing of RRSO in the carriers. Methods: We examined a correlation between age at diagnosis of OC and common mutation types in 3,517 probands that received BRCA genetic testing. Among them, germline BRCA1 mutation (gBRCA1m), germline BRCA2 mutation (gBRCA2 m) and germline BRCA wild-type (gBRCAwt) were found in 185, 42 and 241 OC patients, respectively. Results: The average age at diagnosis of OC in gBRCA1m and gBRCA2 m was 51.3 and 58.3 years, respectively, and the difference from gBRCAwt (53.8 years) was significant. The gBRCA2 m carriers did not develop OC under the age of 40. The average age was 50.1 years for L63X and 52.8 years for Q934X in BRCA1, and 55.1 years for R2318X and 61.1 years for STOP1861 in BRCA2 . The age at diagnosis in L63X or R2318X carriers was relatively younger than other BRCA1 or BRCA2 carriers, however their differences were not significant. With L63X and R2318X carriers, 89.4% (42/47) and 100% (7/7) of women were able to prevent the development of OC, respectively, when RRSO was performed at age 40. Conclusion There appears to be no difference in the age at diagnosis of OC depending on the type of BRCA common mutation. Further analysis would be needed.

PURPOSE: This study compared the analgesic effects of local infiltration analgesia (LIA) and femoral nerve block (FNB) after total knee arthroplasty (TKA) and assessed factors associated with analgesia obtained by these two methods. MATERIALS AND METHODS: Study subjects included 66 patients (72 knees) who underwent TKA for osteoarthritis of the knee. Pain visual analogue scale (VAS), the amount of analgesics used, number of days to achieve 90° of flexion of the knee joint, date of initiating parallel-bar walking, range of motion of the knee joint at discharge, and adverse events were investigated. RESULTS: The VAS scores did not differ significantly between two groups, whereas the amount of analgesics used was significantly lower in the LIA group. Preoperative flexion contracture was significantly more severe in the LIA group with high VAS compared with low VAS. No serious adverse event occurred in the LIA or FNB group. CONCLUSIONS: The lower analgesic usage in the LIA group than the FNB group indicates that the analgesic effect of LIA was greater than that of singleshot FNB after TKA. There were no serious complications in either group. The postoperative analgesic effect of LIA was smaller in patients with severe than less severe preoperative flexion contracture.
Analgesia ; Analgesics ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Contracture ; Femoral Nerve ; Humans ; Knee ; Knee Joint ; Osteoarthritis ; Range of Motion, Articular ; Walking