The aim of this study was to examine the relationship between deep squatting or ROM of lower limbs, and physical function in typically developing children. 337 elementary school students were recruited for this study. The subjects were performed to squat with their heels down and then were divided into 2 groups: possible squatting and impossible squatting. ROM of lower limbs (hip flexion, knee flexion, and ankle dorsiflexion), circumference of leg, standing long jump, the five-repetition sit-to stand test (FTSST) and a standing test were analyzed. Unpaired t-test or Mann-Whitney U test was used for the two-group comparison. Logistic regression analysis was used to determine variables associated with squatting, and multiple regression analysis was used to determine variables associated with physical function. The rate of impossible squatting was 11.9%. The ROM of the lower limbs was significantly decreased in the impossible group. Multiple regression analysis showed that the ankle dorsiflexion ROM and BMI were correlated with squatting. In physical function, the FTSST and standing test were correlated with squatting. However, in the multiple regression analysis squatting did not significantly affect physical function. In this study, ROM of the ankle dorsiflexion and BMI affected the squatting. It was suggested that the squatting might be useful as a screening for ankle dorsiflexion ROM.

Background/Aims: A subgroup analysis was conducted in Japanese patients with moderate to severe ulcerative colitis (UC) enrolled in the phase 3 VISIBLE 1 study, which evaluated the safety and efficacy of a new vedolizumab subcutaneous (SC) formulation. Methods: Eligible patients received open-label infusions of vedolizumab 300 mg intravenous (IV) at weeks 0 and 2 in the induction phase. Patients with clinical response by complete Mayo score at week 6 entered the double-blind maintenance phase and were randomized to vedolizumab 108 mg SC every 2 weeks, placebo, or vedolizumab 300 mg IV every 8 weeks. The primary endpoint was clinical remission (complete Mayo score ≤ 2 points; no individual subscore > 1 point) at week 52. Results: Of 49 patients who entered the induction phase, 22 out of 49 patients (45%) had clinical response at week 6 and were randomized to vedolizumab 108 mg SC (n = 10), placebo (n = 10), or vedolizumab 300 mg IV (n = 2). At week 52, 4 out of 10 patients (40%) who received vedolizumab SC had clinical remission versus 2 out of 10 patients (20%) who received placebo (difference: 20% [95% confidence interval, –27.9 to 61.8]). Two patients (2/10, 20%) who received vedolizumab SC experienced an injection-site reaction versus none who received placebo. Conclusions Our results indicate that the efficacy of vedolizumab SC in a subgroup of Japanese patients with UC are similar with those in the overall VISIBLE 1 study population, and with those established with vedolizumab IV. The safety and tolerability of vedolizumab SC were generally similar to that established for vedolizumab IV. (ClinicalTrials.gov ID NCT02611830; EudraCT 2015-000480-14)

According to the World Health Organization (WHO), mortality by age, sex, and cause of death is the foun­dation of public health both globally and domestically. Comparable mortality statistics over time and investi­gations of mortality were used to develop the International Statistical Classification of Diseases and Related Health Problems (ICD). In the ICD, the WHO states that morbidity statistics are also an essential foundation of public health, but they are much less widely applied. The 10th revision of the ICD (ICD-10) is now in use, but further revisions must be made in the development of the 11th revision (ICD-11) to capture advances in health science and medical practice, to make better use of the digital revolution, and to evaluate traditional medicine (TM). Revision of ICD-10 began in 2007, and an ICD-11 version for preparing implementation was released on July 18, 2018. ICD-11 features a new TM chapter on Japanese traditional medicine, known as Kampo medicine, traditional Chinese medicine, and Korean medicine. ICD-11 will be approved at the next World Health Assembly in May 2019 and will come into effect. This means that the WHO does not currently recognize the effects of TM, but that we as well as the WHO will have hard time to prepare and study the effects of TM on morbidity statistics. It is very important to the study of Kampo medicine that we will be able to properly evaluate the terms and classifications contained in ICD-11.

Since the discovery of the first strain in 1961 in England, MRSA, the most notorious multidrug-resistant hospital pathogen, has spread all over the world. MRSA repeatedly turned down the challenges by number of chemotherapeutics, the fruits of modern organic chemistry. Now, we are in short of effective therapeutic agents against MRSA prevailing among immuno-compromised patients in the hospital. On top of this, we recently became aware of the rise of diverse clones of MRSA, some of which have increased pathogenic potential compared to the classical hospital-associated MRSA, and the others from veterinary sources. They increased rapidly in the community, and started menacing otherwise healthy individuals by causing unexpected acute infection. This review is intended to provide a whole picture of MRSA based on its genetic makeup as a versatile pathogen and our tenacious colonizer.
Adenosine ; Chemistry, Organic ; Chromatography, Micellar Electrokinetic Capillary ; Clone Cells ; Colon ; England ; Fruit ; Humans ; Methicillin ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Sprains and Strains ; Staphylococcus ; Staphylococcus aureus

A 58-year-old man with diabetic nephropathy had been on hemodialysis for 15 years. He had lost his left leg below the knee and whole right leg due to atherosclerotic necrosis. During the past 3 years, his cardiac function had also gradually deteriorated. For the past 2 years, echocardiography showed progressively worsening mitral valve regurgitation. Coronary angiography showed severe stenosis in the left main trunk and left descending artery. Ischemic cardiomyopathy with mitral regurgitation were diagnosed. He underwent coronary artery bypass grafting and mitral valve annuloplasty. Because of difficulty in weaning him from cardiopulmonary bypass, he required intra-aortic balloon-pump (IABP) support. An IABP was inserted through the ascending aorta via a tube graft. It was removed on the 4th postoperative day with a small skin incision, under local anesthesia. The postoperative course was uneventful. This IABP insertion technique was useful for a patient with severe arteriosclerotic disease.

The human CCR4-NOT deadenylase complex consists of at least nine enzymatic and non-enzymatic subunits. Accumulating evidence suggests that the non-enzymatic subunits are involved in the regulation of mRNA deadenylation, although their precise roles remain to be established. In this study, we addressed the function of the CNOT1 subunit by depleting its expression in HeLa cells. Flow cytometric analysis revealed that the sub G(1) fraction was increased in CNOT1-depleted cells. Virtually, the same level of the sub G1 fraction was seen when cells were treated with a mixture of siRNAs targeted against all enzymatic subunits, suggesting that CNOT1 depletion induces apoptosis by destroying the CCR4-NOT-associated deadenylase activity. Further analysis revealed that CNOT1 depletion leads to a reduction in the amount of other CCR4-NOT subunits. Importantly, the specific activity of the CNOT6L immunoprecipitates-associated deadenylase from CNOT1-depleted cells was less than that from control cells. The formation of P-bodies, where mRNA decay is reported to take place, was largely suppressed in CNOT1-depleted cells. Therefore, CNOT1 has an important role in exhibiting enzymatic activity of the CCR4-NOT complex, and thus is critical in control of mRNA deadenylation and mRNA decay. We further showed that CNOT1 depletion enhanced CHOP mRNA levels and activated caspase-4, which is associated with endoplasmic reticulum ER stress-induced apoptosis. Taken together, CNOT1 depletion structurally and functionally deteriorates the CCR4-NOTcomplex and induces stabilization of mRNAs, which results in the increment of translation causing ER stress-mediated apoptosis. We conclude that CNOT1 contributes to cell viability by securing the activity of the CCR4-NOT deadenylase.
Apoptosis ; Caspases, Initiator ; genetics ; metabolism ; Cell Survival ; Endoplasmic Reticulum ; enzymology ; Enzyme Activation ; Flow Cytometry ; HEK293 Cells ; HeLa Cells ; Humans ; Protein Subunits ; genetics ; metabolism ; RNA Stability ; RNA, Messenger ; analysis ; RNA, Small Interfering ; genetics ; metabolism ; Ribonucleases ; metabolism ; Stress, Physiological ; Transcription Factor CHOP ; genetics ; metabolism ; Transcription Factors ; genetics ; metabolism ; Transfection

A 72-year-old man was admitted to a local hospital with symptoms of unstable angina pectoris. He was given Clopidogrel for acute coronary syndrome. Coronary angiography showed left main trunk and three-vessel disease. He was then admitted to our hospital due to a sudden onset of unstable angina following shock during the PCI procedure. We performed emergency off-pump coronary artery bypass grafting (OPCAB). He received 10 mg/kg/h tranexamic acid during the operation. He also received 2,000 U ascorbic acid at the start of surgery and 2,000 U after undergoing anastomoses of the coronary artery. Postoperatively, only some minor bleeding was observed. Tranexamic acid and Ascorbic acid reduce bleeding, and transfusion requirements of packed red blood cells, platelets, and the total blood units in patients on Clopidogrel who undergo emergency OPCAB.

This paper reports the findings of off-pump coronary artery bypass grafting (OPCAB) for a 56-year-old man who had undergone a renal transplantation. Coronary angiography (CAG) revealed triple-vessel coronary disease. OPCAB was therefore performed. The patient was discharged 20 days after surgery without any subsequent rejection, infection or renal dysfunction. At two years after the operation the patient is doing well without any cardiac events. Cardiac disease, especially coronary artery disease is a common cause of death in renal transplant patients. Cardiac surgery in renal transplant patients is expected to increase. OPCAB for renal transplant patients with ischemic heart disease is therefore expected to reduce the incidence of myocardial infarction, thereby prolonging patient survival.

A 75-year-old man was admitted with symptoms of unstable angina pectoris. The patient was initially treated with ticlopidine and aspirin after first undergoing percutaneous coronary intervention (PCI) by means of a drug eluting stent (DES). Coronary angiography thereafter showed re-stenosis in left main trunk and two-vessel disease. As a result, emergency off-pump coronary artery bypass grafting (OPCAB) was therefore performed. However, major bleeding (3, 245ml) occurred after OPCAB. Therefore, a re-thoracotomy operation had to be performed to stop the bleeding. Based on the above findings it is important for surgeons to keep in mind that pre-operative ticlopidine administration can increase the risk of re-operation for hemostasis, while also potentially increasing and the requirements for blood and blood product transfusion both during and after OPCAB surgery.

The main objective of this study was to describe the long-term results of left internal thoracic artery grafting of the left anterior descending artery with a sternotomy or anterior minithoracotomy without using extracorporeal circulation. From March 1997 to February 2000, a median sternotomy was performed in 8 patients and a minithoracotomy in 22 patients. We compared and analyzed the findings of these groups. An emergency operation was performed in 75% of the patients in the median sternotomy group and in 27.3% of those in the minithoracotomy group (p=0.03). The operation time was 2.1h in the median sternotomy group and 3.9h in the minithoracotomy group (p<0.01). The early graft patency rate was 100% in the median sternotomy group and 90.4% in the minithoracotomy group (NS). The five-year actuarial survival rate was 100% in the median sternotomy group and 86.4% in the minithoracotomy group. The five-year cardiac event free rate was 100% in the median sternotomy group and 86.4% in the minithoracotomy group. In conclusion, the results for the median sternotomy group were comparatively better than for minithoracotomy group. Minithoracotomy and median sternotomy have differences in operation time, early graft patency and early outcome. The median sternotomy technique therefore remains an invaluable operative modality for the treatment of one-vessel disease.