A 30-year-old woman who had no specific symptom was diagnosed with Turner syndrome at the age of 6 years. Subsequently, she was followed up at a hospital. However, she stopped going to the hospital when she was 18 years old. At 30 years of age, she underwent examinations involving echocardiography and enhanced chest CT at a hospital, which revealed severe aortic valve regurgitation and extreme dilatation of the aortic root. We performed the Bentall procedure through a median sternotomy following which she had an uncomplicated postoperative course. Aortic root enlargement increases the risk of aortic dissection in patients with Turner syndrome. However, no aortic events occurred before the surgery in this case. We considered the reason was related to the mosaic karyotype of this case.

BACKGROUND: Allergic contact dermatitis (ACD), which is accelerated by interferon (IFN)-γ and suppressed by interleukin (IL)-10 as regulators, is generally self-limited after removal of the contact allergen. Adipose tissue-derived multipotent mesenchymal stem cells (ASCs) potentially exert immunomodulatory effects. Considering that subcutaneous adipose tissue is located close to the site of ACD and includes mesenchymal stem cells (MSCs), the MSCs in adipose tissue could contribute to the self-limiting course of ACD. OBJECTIVE: The aims of the present study were to elucidate the effects of MSCs in adipose tissue on ACD and to examine any cytokine-mediated mechanisms involved. METHODS: Ear thickness in a C57BL/6 mouse model of ACD using contact hypersensitivity (CHS) elicited by 2,4,6-trinitro-1-chlorobenzene was evaluated as a marker of inflammation level. Five and nine mice were injected with ASCs and phosphate-buffered saline (PBS), respectively. After ASC or PBS injection, real-time reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay were performed. RESULTS: Histology showed that CHS was self-limited and ear thickness was suppressed by ASCs in a dose-dependent manner. IFN-γ expression in the elicited skin site and regional lymph nodes was significantly lower in ASC-treated mice than in control mice. IL-10 expression did not differ between treated and control mice. The suppressive effects of ASCs on CHS response did not differ between IL-10 knock-out C57BL/6 mice and wild-type mice. CONCLUSION: The present findings suggest that MSCs in adipose tissue may contribute to the self-limiting course of ACD through decreased expression of IFN-γ, but not through increased expression of IL-10.
Adipose Tissue* ; Animals ; Dermatitis, Allergic Contact* ; Dermatitis, Contact ; Ear ; Enzyme-Linked Immunosorbent Assay ; Inflammation ; Interferons ; Interleukin-10 ; Interleukins ; Lymph Nodes ; Mesenchymal Stromal Cells* ; Mice ; Picryl Chloride ; Skin ; Subcutaneous Fat

The sweet taste receptors present in the taste buds are heterodimers comprised of T1R2 and T1R3. This receptor is also expressed in pancreatic beta-cells. When the expression of receptor subunits is determined in beta-cells by quantitative reverse transcription polymerase chain reaction, the mRNA expression level of T1R2 is extremely low compared to that of T1R3. In fact, the expression of T1R2 is undetectable at the protein level. Furthermore, knockdown of T1R2 does not affect the effect of sweet molecules, whereas knockdown of T1R3 markedly attenuates the effect of sweet molecules. Consequently, a homodimer of T1R3 functions as a receptor sensing sweet molecules in beta-cells, which we designate as sweet taste-sensing receptors (STSRs). Various sweet molecules activate STSR in beta-cells and augment insulin secretion. With regard to intracellular signals, sweet molecules act on STSRs and increase cytoplasmic Ca2+ and/or cyclic AMP (cAMP). Specifically, when an STSR is stimulated by one of four different sweet molecules (sucralose, acesulfame potassium, sodium saccharin, or glycyrrhizin), distinct signaling pathways are activated. Patterns of changes in cytoplasmic Ca2+ and/or cAMP induced by these sweet molecules are all different from each other. Hence, sweet molecules activate STSRs by acting as biased agonists.
Bias (Epidemiology)* ; Calcium ; Cyclic AMP ; Cytoplasm ; Insulin ; Polymerase Chain Reaction ; Potassium ; Reverse Transcription ; RNA, Messenger ; Saccharin ; Sodium ; Taste Buds

Background: No consensus exists regarding which anthropometric measurements are related to bone mineral density (BMD), and this relationship may vary according to sex and age. A large Japanese cohort was analyzed to provide an understanding of the relationship between BMD and anthropometry while adjusting for known confounding factors. Methods: Our cohort included 10,827 participants who underwent multiple medical checkups including distal forearm BMD scans. Participants were stratified into four groups according to age (≥50 years or <50 years) and sex. The BMD values were adjusted for confounding factors, after which single and partial correlation analyses were performed. The prevalence of osteopenia was plotted for each weight index (weight or body mass index [BMI]) class. Results: Cross-sectional studies revealed that weight was more favorably correlated than BMI in the older group (R=0.278 and 0.212 in men and R=0.304 and 0.220 in women, respectively), whereas weight and BMI were weakly correlated in the younger age groups. The prevalence of osteopenia exhibited a negative linear relationship with weight among older women ≥50 years of age, and an accelerated increase was observed with decreasing weight in older men weighing <50 kg and younger women weighing <60 kg. When weight was replaced with BMI, the prevalence was low in most subgroups classified by weight. Conclusions Weight, rather than BMI, was the most important indicator of osteopenia but it might not be predictive of future bone loss.

Introduction: Prevention of the onset of cardio/cerebrovascular diseases, which represent circulatory system diseases, is now emphasized. It requires ensuring good arterial distensibility, which has been demonstrated to be reduced by life environments such as the lack of exercise or overnutrition but improved by aerobic exercise. Even if implementation of such exercises is possible, it increases the risks of the frail elderly with declined cardiopulmonary function and those with other diseases. This study aimed to focus on plantar flexion and dorsiflexion exercises of the ankles as a type of effective, low-load exercise that can induce dynamic stimulation associated with increased blood flow, using muscle pumping of the triceps surae and footbath, which could potentially increase overall blood flow via hyperthermic action. We then investigate the benefits of the combined effects of these two exercises on arterial distensibility. Methods: We selected 25 physically and mentally healthy adult men and women (17 men and eight women; mean ± SD age, 25.7 ± 3.3 years) as study subjects.   All the 25 subjects performed each of three exercises, namely footbath, ankle exercise, and ankle exercise in footbath, in a sitting position for 15 minutes. Ankle-brachial index (ABI), brachial-ankle pulse wave velocity (PWV), systolic blood pressure, diastolic blood pressure, and heart rate were measured using form PWV/ABI before and after the exercise for the evaluation of arterial distensibility. Results: No significant differences were observed in the PWVs, ABIs, systolic/diastolic blood pressures, and heart rates before and after exercise in the footbath and exercise groups. However, for the footbath exercise group, a significant reduction in PWV was observed from before to after exercise. Discussion: In this study, we focused our attention on the ankle exercise in footbath as a low-load exercise that could improve arterial distensibility. The results indicated a significant reduction in PWV, an index used to show the level of arterial distensibility, only for the footbath exercise group, which performed the combination of ankle exercise and footbath. We can infer that the improvement of arterial distensibility is attributed to the synergistic effect of the muscle pump and hyperthermic actions, which result in further increases and facilitation of cardiac output. Conclusions: This study demonstrated that the ankle exercise in footbath was beneficial for the improvement of arterial distensibility.

Purpose：The Southampton Hand Assessment Procedure (SHAP) is a test of upper extremity function composed of 12 movement tasks and 14 activities of daily living tasks, and is used as an assessment battery for upper extremity prostheses. The purpose of this study is to examine its validity in clinical practice.Methods：The study included 143 patients with hemiparesis. The validity of SHAP and an existing assessment battery were compared in this study. Factors influencing the validity of differences between dominant and non-dominant hands were examined.Results：Concomitant validity was shown between the SHAP Japanese version and an existing upper extremity function evaluation method. A strong correlation with the subjective evaluation scale was obtained in cases of dominant hand paralysis.Discussion：These results suggested that SHAP is able to accurately evaluate upper extremity hemiparesis, because the difficulty level in evaluation of upper extremity function is higher than that of the Action Research Arm Test, and a ceiling effect is unlikely. Therefore, SHAP is useful in clinical practice not only for assessment of an artificial hand but also for hemiparesis with stroke. Further study to clarify the characteristics of SHAP as well as verification of reliability and standard values is warranted.

Purpose：The Southampton Hand Assessment Procedure (SHAP) is a test of upper extremity function composed of 12 movement tasks and 14 activities of daily living tasks, and is used as an assessment battery for upper extremity prostheses. The purpose of this study is to examine its validity in clinical practice.Methods：The study included 143 patients with hemiparesis. The validity of SHAP and an existing assessment battery were compared in this study. Factors influencing the validity of differences between dominant and non-dominant hands were examined.Results：Concomitant validity was shown between the SHAP Japanese version and an existing upper extremity function evaluation method. A strong correlation with the subjective evaluation scale was obtained in cases of dominant hand paralysis.Discussion：These results suggested that SHAP is able to accurately evaluate upper extremity hemiparesis, because the difficulty level in evaluation of upper extremity function is higher than that of the Action Research Arm Test, and a ceiling effect is unlikely. Therefore, SHAP is useful in clinical practice not only for assessment of an artificial hand but also for hemiparesis with stroke. Further study to clarify the characteristics of SHAP as well as verification of reliability and standard values is warranted.

We provided inpatient rehabilitation treatment and return-to-school guidance to a junior high school student with medulloblastoma and pervasive developmental disorder (autism spectrum disorder). Here we describe the rehabilitation treatment for patients with physical and developmental disabilities. A 13-year-old boy who was diagnosed with pervasive developmental disorder at 4 years of age was able to perform activities of daily living independently and attend junior high school. However, he was admitted to our hospital with new-onset ataxia. Magnetic resonance imaging revealed a cerebellar tumor. After total tumor excision was performed, pathological analysis revealed medulloblastoma, which was treated initially with radiation therapy and then chemotherapy for 1 year. Rehabilitation was initiated 2 days post-surgery. We evaluated his communication abilities. He showed stereotypical behavior owing to the autism spectrum disorder；therefore, we performed low-intensity repetitive exercises. The functional independence measure score at discharge was 67/126 (motor 44/91, cognitive 23/35). We taught his teachers how to properly assist him, and he successfully returned to school post-discharge. Although this was a case in which the child had multiple disabilities, ataxia caused by the medulloblastoma aggravated his developmental disability. Thus, understanding the characteristics of communication and its strengths was vital in determining a treatment plan that enabled his return to school.

We provided inpatient rehabilitation treatment and return-to-school guidance to a junior high school student with medulloblastoma and pervasive developmental disorder (autism spectrum disorder). Here we describe the rehabilitation treatment for patients with physical and developmental disabilities. A 13-year-old boy who was diagnosed with pervasive developmental disorder at 4 years of age was able to perform activities of daily living independently and attend junior high school. However, he was admitted to our hospital with new-onset ataxia. Magnetic resonance imaging revealed a cerebellar tumor. After total tumor excision was performed, pathological analysis revealed medulloblastoma, which was treated initially with radiation therapy and then chemotherapy for 1 year. Rehabilitation was initiated 2 days post-surgery. We evaluated his communication abilities. He showed stereotypical behavior owing to the autism spectrum disorder；therefore, we performed low-intensity repetitive exercises. The functional independence measure score at discharge was 67/126 (motor 44/91, cognitive 23/35). We taught his teachers how to properly assist him, and he successfully returned to school post-discharge. Although this was a case in which the child had multiple disabilities, ataxia caused by the medulloblastoma aggravated his developmental disability. Thus, understanding the characteristics of communication and its strengths was vital in determining a treatment plan that enabled his return to school.

This study aimed to examine characteristics of physical functions, physical activity, and cognitive functions among community-dwelling older people who stopped driving automobiles. Participants were 589 community-dwelling older people (age: 65–89, 71.4 ± 5.1 years; 403 men, 186 women). The participants underwent nine physical assessments—hand grip strength, knee extension strength, timed up-and-go test, chair stand, one leg standing with open eyes, functional reach, vertical jump, preferred gait speed, maximal gait speed—and were evaluated for physical activity; and five cognitive assessments—the Mini-Mental State Examination (MMSE), Logical Memory I and II (WMS-R LM-I, LM-II) subtests of the Wechsler Memory Scale-Revised; and Trail Making Test A and B (TMT-A, TMT-B). They were divided into current driver (379 men, 169 women) and driving cessation (24 men, 17 women) groups. Among men, the driving cessation group had poorer vertical jump, TMT-A, and TMT-B results, while women had poorer hand grip strength, one leg standing with open eyes, WMS-R LM-II, and LM-II results, and longer inactivity time, compared with the current driver group and adjusted for covariates (P < 0.05 for all). The findings suggest driving cessation among community-dwelling older people is significantly associated with poorer physical functions, physical activity, and cognitive functions compared with those in current drivers.