OBJECTIVEThe aim of our study was to explore the relationship between a medium-scale earthquake and maternal depression and child-rearing in a depopulated community in the Noto Peninsula of Japan.

METHODSThree months after a major earthquake, self-rating questionnaires were distributed to women who were pregnant at the time of the earthquake or who became pregnant immediately thereafter, and who were receiving care at any of four major hospitals in the most devastated area. A total of 155 women who had given birth returned the completed questionnaire for analysis. Maternal postnatal depression among the participants was assessed using the Edinburgh Postnatal Depression Scale (EPDS).

RESULTSThe EPDS score was significantly associated with decreased "satisfaction with delivery" (beta = -0.28, p = 0.01), increased artificial "lactation" (beta = 0.31, p = 0.002), and increased "trouble with infant care" (beta = 0.47, p < 0.001) in multivariate analysis. It was also significantly associated with increased "anxiety about earthquakes" (beta = 0.30, p = 0.001), and "anxiety about earthquakes" was significantly associated with increased "fear of the earthquake" (beta = 0.20, p = 0.04).

CONCLUSIONSEarthquake-related factors such as "anxiety about earthquakes" and "fear of the earthquake" did not have a direct effect on child-rearing factors; however, they did have a significant relationship with increased EPDS. Based on these results, we conclude that screening strategies for maternal depression in peri- and postnatal women under emergency circumstances are necessary.

The case was a 77-year-old man. He had dizziness and dysphagia for 2 years, and underwent detailed screening at the internal medicine department for general malaise and bloody sputum. He was hospitalized for aspiration pneumonia due to dysphagia of unknown origin. This time, he visited a local doctor with palpitations and shortness of breath. Echocardiography indicated a left atrial tumor involving the mitral valve and arrhythmia. Emergency surgery was performed to remove the left atrial myxoma and close the patch at our hospital's cardiovascular surgery department. After the excision, swallowing function was restored, and the patient was diagnosed with postoperative Ortner's syndrome. We report a case where echocardiography was considered important as a detailed investigation of the cause of swallowing dysfunction and dizziness.

Methods: This study included 50 patients with CSM and 39 with C-OPLL who underwent multi-segment laminoplasty. Decreased CL was defined as the difference between preoperative and 2-year postoperative neutral C2–7 Cobb angles. Radiographic parameters included preoperative neutral C2–7 Cobb angles, C2–7 sagittal vertical axis (SVA), T1 slope (T1S), dynamic extension reserve (DER), and range of motion. The radiographic risk factors were investigated for decreased CL in CSM and C-OPLL. Additionally, the Japanese Orthopedic Association (JOA) score was assessed preoperatively and 2 years postoperatively. Results: C2–7 SVA (p =0.018) and DER (p =0.002) were significantly correlated with decreased CL in CSM, while C2–7 Cobb angle (p =0.012) and C2–7 SVA (p =0.028) were correlated with decreased CL in C-OPLL. Multiple linear regression analysis revealed that greater C2–7 SVA (B =0.22, p =0.026) and small DER (B =−0.53, p =0.002) were significantly associated with decreased CL in CSM. By contrast, greater C2–7 SVA (B =0.36, p =0.031) was significantly associated with decreased CL in C-OPLL. The JOA score significantly improved in both CSM and C-OPLL (p <0.001). Conclusions C2–7 SVA was associated with a postoperative decreased CL in both CSM and C-OPLL, but DER was only associated with decreased CL in CSM. Risk factors for decreased CL slightly differed depending on the etiology of the condition.

BACKGROUND/AIMS: Decreased trough levels of infliximab (TLI) and antibodies to infliximab (ATI) are associated with loss of response (LOR) in Crohn's disease. Two prospective studies were conducted to determine whether TLI or ATI better correlates with LOR (Study 1), and whether TLI could become a predictor of mucosal healing (MH) (Study 2). METHODS: Study 1 was conducted in 108 patients, including those with LOR and remission to compare ATI and TLI in discriminating the 2 conditions based on receiver operating characteristic (ROC) curve analyses. Study 2 involved 35 patients who were evaluated endoscopically. RESULTS: In Study 1, there were no differences between the 2 assays in ROC curve analyses; the TLI cutoff value for LOR was 2.6 µg/mL (sensitivity, 70.9%; specificity, 79.2%), and the ATI cutoff value was 4.9 µg/mL (sensitivity, 65.5%; specificity, 67.9%). The AUROC (area under the ROC curve) of TLI was greater than that of ATI. AUROC was useful for discriminating between the 2 conditions. In Study 2, the TLI was significantly higher in the colonic MH group than in the non-MH group (2.7 µg/mL vs. 0.5 µg/mL, P=0.032). CONCLUSIONS: TLI is better than ATI for clinically diagnosing LOR, and a correlation was observed between TLI and colonic MH.
Antibodies ; Cohort Studies* ; Colon ; Crohn Disease* ; Humans ; Infliximab* ; Prospective Studies* ; ROC Curve ; Sensitivity and Specificity

Background: To investigate the effect of high-voltage alternating current (AC) electric field exposure on muscle extensibility. Methods: The study design was a crossover comparison. Fifteen healthy men were randomly divided into two groups. The interventions were exposure and no exposure to a high-voltage AC electric field (18 kV, 30 min). Subjects then performed bilateral self-stretching of the trapezius, hamstrings, and rectus femoris. Skin temperature, blood flow rate, blood pressure, heart rate, muscle rigidity, and muscle extensibility were measured before and after the intervention, and muscle rigidity and muscle extensibility were measured again after stretching. Skin temperature was measured bilaterally on the palms, shoulder girdle, anterior thigh, and dorsum of foot. Blood flow rate was measured in the right radial artery and dorsal artery of the foot. Muscle rigidity was measured bilaterally in the trapezius, rectus femoris, and biceps femoris. Muscle extensibility indices were determined for the left and right angle of lateral neck flexion, heel-buttock distance, straight leg raise angle, and sit-and-reach distance. Skin temperature, blood flow rate, blood pressure, and heart rate were compared between before and after the intervention, and muscle rigidity and muscle extensibility were compared before and after the intervention and after stretching. Results: A significant improvement was found in muscle extensibility in the intervention group but not in the controls. Muscle extensibility improvements due to stretching were noted regardless of electric field exposure, but the degree and percentage of change in muscle extensibility was significantly higher after stretching following electric field exposure. Electric field exposure had no effect on muscle rigidity or circulatory dynamics. Conclusions: Exposure to the high-voltage AC electric field appeared to increase muscle extensibility and heighten the effect of stretching. However, as the mechanism for improved muscle extensibility due to high-voltage AC electric field exposure was not clear, further study is necessary.

Background/Aims: Image-enhanced endoscopy can detect superficial oro-hypopharyngeal squamous cell carcinoma; however, reliable endoscopy of the pharyngeal region is challenging. Endoscopy under general anesthesia during transoral surgery occasionally reveals multiple synchronous lesions that remained undetected on preoperative endoscopy. Therefore, we aimed to determine the lesion detection capability of endoscopy under general anesthesia for superficial oro-hypopharyngeal squamous cell carcinoma. Methods: This retrospective study included 63 patients who underwent transoral surgery for superficial oropharyngeal squamous cell carcinoma between April 2005 and December 2020. The primary endpoint was to compare the lesion detection capabilities of preoperative endoscopy and endoscopy under general anesthesia. Other endpoints included the comparison of clinicopathological findings between lesions detected using preoperative endoscopy and those newly detected using endoscopy under general anesthesia. Results: Fifty-eight patients (85 lesions) were analyzed. The mean number of lesions per patient detected was 1.17 for preoperative endoscopy and 1.47 for endoscopy under general anesthesia. Endoscopy under general anesthesia helped detect more lesions than preoperative endoscopy did (p<0.001). The lesions that were newly detected on endoscopy under general anesthesia were small and characterized by few changes in color and surface ruggedness. Conclusions Endoscopy under general anesthesia for superficial squamous cell carcinoma is helpful for detecting multiple synchronous lesions.