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Summary: What is known and objective: Angiotensin converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) represent the cornerstones of hypertension and congestive heart failure treatment. Risk factors for hyperkalaemia associated with ACEI and ARB are chronic kidney disease and concomitant medications which increase serum potassium level. Body mass index (BMI) also affects pharmacokinetics of ACEI and ARB and potassium disposition. We evaluated the relationship between BMI and hyperkalaemia associated with ACEI and ARB treatments. Methods: Study design is a retrospective case‐control analysis. Patients who had been prescribed ACEI or ARB between June 2015 and June 2017 at Tokyo Women's Medical University, Medical Center East, were included. Patient clinical background was collected from medical records. Hyperkalaemia was defined as serum potassium above 5.5 meq/L. The concomitant use of ACEI and ARB, aldosterone antagonists, direct renin inhibitor, sulfamethoxazole‐trimethoprim and non‐steroidal anti‐inflammatory drugs (NSAIDs) was regarded as hyperkalaemia‐inducing medications. The relationship between BMI and hyperkalaemia associated with ACEI and ARB treatments was assessed using multivariable logistic regression analysis. Results and discussion: The study included 2987 patients aged 70.1 ± 12.9 years, 61.0% were men, and BMI was 23.8 ± 4.4 kg/m2. The incidence of hyperkalaemia was 7.8%. Multivariable logistic regression analysis revealed that age >65 years, low BMI, diabetes, history of treatment for hyperkalaemia, serum sodium <135 meq/L, eGFR <30 mL/min/1.73m2 and the concomitant use of hyperkalaemia‐inducing medications were independent risk factors for hyperkalaemia associated with ACEI and ARB. What is new and conclusion: This study demonstrated that BMI provides useful information for the identification of potential risk for hyperkalaemia associated with ACEI and ARB treatments. The incidence of hyperkalemia stratified by body mass index. x‐axis and y‐axis represent body mass index groups and incidence of hyperkalemia associated with ACEI and ARB, respectively. Body mass index is divided into three groups as follows: <18.5 kg/m2, 18.5‐24.9 kg/m2, ≥25 kg/m2. Number of patients stratified by BMI represent below the threshold of BMI. The values above bar graph represent percentage of hyperkalemia associated with ACEI and ARB. BMI, body mass index; N, number of patients. [ABSTRACT FROM AUTHOR]

Summary: What is known and objective: Anticholinergic drugs are associated with risks of falls, confusion and cognitive dysfunction. However, the effect of anticholinergic drug use on rehabilitation outcomes after a stroke is poorly documented. We therefore aimed to establish whether the anticholinergic load was associated with functional recovery among geriatric patients convalescing after stroke. Method: Consecutive geriatric stroke patients admitted and discharged from a convalescence rehabilitation ward between 2010 and 2016 were included in this retrospective cohort study. Anticholinergic load was assessed by the Anticholinergic Risk Scale (ARS), and functional recovery was assessed by the Functional Independence Measure (FIM). The primary outcome was cognitive FIM (FIM‐C) gain, but we also assessed the interaction of other putative factors identified from univariate analysis. Multivariate analyses were performed, adjusting for confounding factors. Results and discussion: We included 418 participants (171 males, 247 females) with a median age of 78 years (interquartile range, 72‐84 years). Multiple regression analysis revealed that ARS change, length of stay, and epilepsy were independently and negatively correlated with cognitive FIM gain. Multiple logistic regression analysis indicated that the "Comprehension" and "Memory" items of the cognitive FIM gain were independently and negatively associated with anticholinergic load. What is new and conclusion: A causal relationship cannot be established, but increased ARS scores during hospitalization may predict limited cognitive functional improvement in geriatric patients after stroke. Alternatively, cognitive impairment may lead to increased use of anticholinergic drugs. [ABSTRACT FROM AUTHOR]

Contents: Bovine granulosa cells (GC) vary in their morphological aspect during different stages of folliculogenesis. In this study, 10 morphologically normal bovine ovaries were collected to study the structural aspects of different stages of GC using intermediate filament protein antibodies including cytokeratin AE1/AE3 (AE1/AE3), vimentin, nectin‐4 and desmin. Hormonal immunolocalization was assessed using the immunomarkers anti‐Müllerian hormone (AMH) and inhibin alpha. In addition, tumour markers and proliferation markers using c‐erbB‐2 oncoprotein and proliferating cell nuclear antigen, respectively, were investigated. The immunolabelling of AE1/AE3 in GC was strongest in the early follicle stage and gradually decreased when reaching the Graafian follicle stage. Its immunolabelling increased again as the stage progressed from stage I to stage III. The immunolabelling of inhibin alpha was inversely proportional to that of AE1/AE3 in the developing ovarian follicles as their immunolabelling is opposite to each other during folliculogenesis. AMH was immunopositive in almost all GC stages in different intensities and percentages, except for some negative staining in the atretic IV follicles. The atretic IV follicle is a unique type of atretic follicle that shows Call‐Exner body formation, which was mainly found in older cows in this study. The distinct patterns of immunoreactivity for various types of immunomarkers in the different GC stages will play an important role in diagnostic assistance of various follicle conditions, including cystic ovaries and GC tumours. [ABSTRACT FROM AUTHOR]

Background Acoustic radiation force impulse ( ARFI) elastography is a non-invasive method for measuring liver stiffness. However, there are no reports evaluating the value of ARFI elastography for liver fibrosis in chronic hepatitis C patients with a sustained virological response ( SVR). Aim To investigate the diagnostic performance of ARFI elastography for the assessment of liver fibrosis in hepatitis C virus ( HCV) infected patients with an SVR. Methods In this prospective study, we enrolled 336 patients: 121 HCV patients with an SVR (44.6% women) and 215 patients with HCV (47.9% women). ARFI elastography measurements of all patients were performed on the same day of liver biopsy. Results The diagnostic accuracies, expressed as areas under the receiver operating characteristic curves for ARFI elastography, in HCV patients with an SVR and those in patients with HCV were 0.818 and 0.875 for the diagnosis of significant fibrosis (≥F2), 0.909 and 0.888 for the diagnosis of severe fibrosis (≥F3), and 0.981 and 0.890 for the diagnosis of liver cirrhosis (F4), respectively. The optimum cut-off values for ARFI elastography were 1.26 m/s for ≥F2, 1.31 m/s for ≥F3 and 1.49 m/s for F4 in HCV patients with an SVR. The liver stiffness values were lower in patients with SVR compared with those in patients with HCV at the same stage of fibrosis. The liver stiffness values were affected by the necroinflammatory activity and the time after SVR. Conclusion Acoustic radiation force impulse elastography is an acceptable method for predicting the severity of fibrosis in patients with hepatitis C virus and a sustained viral response. [ABSTRACT FROM AUTHOR]

Background The relationship among natural allergen exposure, induction of blocking antibody and the occurrence of atopic allergy-particularly in the presence of IgE production-is debatable. Objective To clarify the relationship between the dose of cutaneous exposure to dust mite allergen and susceptibility to the IgE-mediated allergic response in relation to IgG production. Methods NC/Nga mice were epicutaneously exposed to various doses of Dermatophagoides pteronyssinus allergen to induce atopic dermatitis-like skin lesions. We then evaluated the skin lesions, induction of mite-specific immune responses, and susceptibility to anaphylaxis. Results Dose-dependent exacerbation of atopic dermatitis-like skin lesions and increases in mite-specific IgG and IgE production were observed. However, mice exposed to relatively low doses of mite allergen showed hypersusceptibility to mite allergen-specific anaphylaxis. We also showed that adoptive transfer of total IgG from Dp-sensitized mice rescued mice from the hypersusceptibility seen in those exposed to low doses of mite allergen. Conclusions and Clinical Relevance High-dose cutaneous exposure to dust mites induced effective blocking IgG production, even if accompanied by IgE production. Our data might support the concept that an increase in IgG titre, not a decrease in IgE titre, is a marker of clinical improvement in allergen-specific immunotherapy. [ABSTRACT FROM AUTHOR]

Background The incidence of active tuberculosis ( TB) among liver transplant recipients varies depending on the endemic area and various reported TB risk factors. Although living-donor liver transplantation ( LDLT) is predominant in Japan, the TB incidence and risk factors among LDLT recipients are unknown. Methods Active TB episodes among 1222 LDLT recipient cases from 1990 to 2007 were retrospectively reviewed. A matched case-control study was performed to identify risk factors for active TB infection. Results Nine patients (0.74%, 5 males and 4 females, median age 48 years) developed active TB following LDLT. The incidence of TB in adults (over 18 years) and in the later cohort (2000-2007) was more than that of children and in the early cohort (1990-1999), respectively. Seven of 9 patients were diagnosed within 1 year after LDLT. No patient received isoniazid for latent TB infection treatment before transplantation. TB infection was controlled with anti-tuberculous drugs in all affected patients. However, 2 patients died of graft failure. Univariate analyses identified severe Child-Pugh score (≥ 11) ( P = 0.006; odds ratio [ OR], 10.0; 95% confidence interval [ CI], 1.9-51.5), requirement for plasma exchange or plasmapheresis ( P = 0.009; OR, 10.0; 95% CI, 1.9-53.4), and ABO-incompatible transplantation ( P = 0.0003; OR, 34.0; 95% CI, 4.7-248.3) as risk factors for onset of active TB infection. Conclusions Patients having an elevated Child-Pugh score, plasma exchange or plasmapheresis, and ABO-incompatible transplantation should be considered at greater risk for active TB infection, and treatment for latent TB infection before transplantation should be considered. [ABSTRACT FROM AUTHOR]

Aim The aim of the study was to determine the present state of diverting stoma construction in Japanese cancer centres and to investigate the relationship between symptomatic leakage and diverting stoma after low anterior resection for rectal cancer. Method Two hundred and twenty-two consecutive patients undergoing low anterior resection for rectal cancer located within 10 cm from the anal verge were investigated in a prospective, multicenter study. Results The overall leakage rate was 9.0% (20/222). Of 31 cases with an anastomosis within 2.0 cm from the anal verge, 22 (71%) had a diverting stoma. Of cases anastomosed within 5.0 cm, the absence of a diverting stoma and tumour size were significantly related to an increased rate of leakage [leakage in 13 (12.7%) of 102 cases without a diverting stoma; in three (3.8%) of 80 cases with a diverting stoma]. Among anastomoses within 2.0 cm from the anal verge, leakage occurred in four (44.4%) of nine cases without and in none (0%) of 22 cases with a diverting stoma. Conclusion We recommend a diverting stoma for an anastomosis within 5.0 cm of the anal verge and strongly recommend it for a very low anastomosis within 2.0 cm. [ABSTRACT FROM AUTHOR]

We created an algorithm for diagnosing subtypes of cerebral infarction (CI) during the acute stage by combining atrial fibrillation (AF) and D-dimer levels. One-hundred and eight patients hospitalized for acute CI were retrospectively analyzed. CI was classified into cardioembolic, atherothrombotic, lacunar infarction or others. Patients were classified in AF group if they had AF on admission or a prior history of AF. This group was diagnosed to suffer cardioembolic infarction. In non-AF group, cardioembolic infarction was diagnosed when D-dimer level exceeded the cutoff point determined using a receiver operating curve. Then, usefulness of the algorithm was validated prospectively in 259 consecutive patients with acute CI. For the retrospective group, cardioembolic infarction was found in 82% of the AF group. In non-AF group, cardioembolic infarction was found in only 2%, when D-dimer level was <1.6 μg/ml. However, 41% of non-AF group with atherothrombotic infarction had elevated D-dimer level (≥1.6 μg/ml). Results for the validation group were similar to those for the retrospective group (sensitivity, 89%; specificity, 66%; positive predictive value, 50%; and negative predictive value, 94%). D-dimer level in combination with AF can be useful for distinguishing CI subtypes during the acute stage. [ABSTRACT FROM AUTHOR]

Conidia from living conidiophores of barley powdery mildew ( Blumeria graminis f.sp. hordei) on host leaves were collected consecutively using an electrostatic spore collector. The collector consisted of an electrical conductor plate linked to an electrostatic voltage generator and insulator plates placed abreast on a timed conveyer. The conductor plate was negatively charged by the potential supplied from the voltage generator. The negatively charged conductor plate caused dielectric polarization of the insulator plate, and the surface charge on the insulator plate attracted mature conidia abstricted from conidiophores on colonies growing on leaves placed 2 cm from the insulator plate. The surface charge on the insulator plate was proportional to the voltage applied to the conductor plate. Under optimized conditions, abstricted conidia were attracted to the electrostatically activated insulator plates without any detriment to their survival. During a colony's life span of c. 460 h, conidia were released throughout the day and c. 12 × 104 conidia were collected during the lifetime of the colony. This is the first report on the direct quantification of progeny conidia produced by powdery mildew infecting host leaves. [ABSTRACT FROM AUTHOR]

Abstract: We evaluated the effects of sound noise or forced swim stress applied to pregnant mice or to neonatal mice on the anxiety-related behavior using the elevated plus-maze test performed during the age of 5 weeks. The forced swim stress applied at the late gestation period, days 10–18 of pregnancy, caused a significant reduction of the body weight gain of the dams. However, the anxiety-related behavior of the male and female offspring were not affected by the antenatal stress treatment. When the forced swim stress was applied to the neonatal mice during the late lactation period, 14–18 days after birth, the male mice showed an elevated level of anxiolytic behavior accompanying the reduction of the emotion-related motor activity. The anxiety-related behavior of the female mice was not affected by the stress treatment. Furthermore, we applied the sound noise or forced swim stress to the neonatal mice immediately after the weaning, 21–25 days after birth. The stress applied after the weaning period had no effect on the anxiety-related behavior. These results suggested that the stress applied during the lactation period, but not that during the antenatal period, nor after the weaning period, might have gender-dependently reduced the anxiety level of the male mouse. It was shown that the effects of perinatal stress on the anxiety-related behavior of the adolescent mouse varied according to the period of application and gender. The hypothesis that gender-dependent abnormalities in neurodevelopment might be caused by the excess stress applied to the breast-fed infant is of importance in elucidating the relationship between the psychoneurotic disorder in childhood and the environment stress of the breast-fed infant. [Copyright &y& Elsevier]

Successful prosthodontic treatments for a patient with removable partial dentures including maxillofacial prostheses hopefully brings about psychological wellbeing as well as improved health. The purpose of this study was to investigate the relationship between quality of life (QOL) and the various aspects of denture function. At first, a questionnaire with a visual analog scale with 16 question items concerning denture and/or eating problems, the present state of health, psychological and physical wellbeing, life satisfaction, and QOL was developed. To discuss the validity and reliability of the questionnaire, 48 outpatients who wore a denture were asked to fill it out. Next, to discuss the difference in QOL of the patient with various kinds of dentures and conditions, 103 outpatients were asked to complete the newly developed questionnaire. The questionnaire which contained four factor areas with eight questions for denture patients was developed by factor analysis with Varimax rotation. The reliability of the QOL scale was confirmed by reliability analysis (Cronbach's α=0·784). The QOL score of edentulous patients with a complete denture having some trouble chewing was significantly lower than that of other denture patients. It was suggested that the wearing of a denture significantly affected the QOL of elderly persons. [ABSTRACT FROM AUTHOR]

Aim: To determine the roles of myostatin and insulin-like growth factor-I (IGF-I) during postnatal growth, we examined IGF-I and myostatin mRNA expression in the skeletal muscles of hypophysectomized and underfed rats during postnatal growth. Methods: Five-week-old rats were divided into four groups: freely fed control, moderately underfed, severely underfed and hypophysectomized. Four weeks later, blood and muscle samples were gathered to determine serum IGF-I, myosin heavy chain (MHC) isoforms, IGF-I Ea, IGF-I Eb and myostatin mRNA. Results: The weights of soleus, plantaris and masseter muscles were decreased in underfed and hypophysectomized rats. Hypophysectomy resulted in significant increases of type I MHC at the expense of type IIx in plantaris muscle and of neonatal MHC at the expense of types IIx and IIb in masseter muscle. Serum IGF-I was decreased by underfeeding and hypophysectomy. Plantaris muscle IGF-I Ea mRNA in underfed and hypophysectomized rats was significantly lower than in normal controls. Plantaris muscle IGF-I Eb mRNA in underfed rats was significantly lower than in normal controls. Masseter muscle IGF-I Eb mRNA in severely underfed rats was significantly lower than in normal control and hypophysectomized rats. Soleus muscle myostatin mRNA in hypophysectomized rats was significantly higher than in normal and significantly underfed rats. No significant differences in plantaris and masseter muscle myostatin mRNA were observed between groups. Conclusion: Suppressed muscle growth caused by hypophysectomy and underfeeding may be attributed mainly to reduced circulating IGF-I and partially to reduced IGF-I mRNA, rather than to a change in myostatin. [ABSTRACT FROM AUTHOR]

In order to elucidate the relationship between the salivary secretion rate and masticatory efficiency, experimental hypo- and hyper-salivation were produced by the administration of atropine sulphate presenting an anticholinergic effect and pilocarpine hydrochloride having a muscarine effect orally in 10 healthy fully dentates. To confirm the pharmaceutical effect of these drugs, the unstimulated whole salivary secretion rate during 10 min, and masticatory efficiency using the sieve method were measured before and after medication. The unstimulated whole salivary secretion rate during 10 min decreased significantly by the administration of atropine sulphate ( P < 0·05), and increased significantly by pilocarpine hydrochloride ( P < 0·01). The masticatory efficiency after atropine sulphate medication was significantly lower than that before ( P < 0·01). The increase in salivary secretion by pilocarpine hydrochloride did not lead to a higher masticatory efficiency. The evidence supports the understanding that saliva plays an important role in masticatory function. [ABSTRACT FROM AUTHOR]

Abstract Blue discoloration of the iris was found in the left eye of a male laboratory Beagle dog, which had a normal tricolor coat and clinically showed no visual impairment. Ophthalmoscopically, the affected eye revealed red-colored tigroid fundus, in which no tapetum was present. The retinal vasculature and the optic disc showed no noticeable changes. Histopathologically, in the left eye melanocytes had extremely few melanin granules in the anterior segment, including the anterior border layer, in the stroma and sphincter muscle of the iris and in the stroma of the ciliary body and choroid. However, the posterior pigment epithelium of the iris, the pigment epithelium of the ciliary body and the retinal pigment epithelium showed normal pigmentation. The tapetal elements were completely absent. Number and distribution of the S-100 protein-positive melanocytes with or without melanin granules in the iris, ciliary body and choroid of the left eye were similar to those of the normal right eye. Ultrastructurally, melanocytes in the anterior segment of the affected iris possessed no or few melanosomes which were incompletely melanized. In the right eye, no abnormal features were observed. Based on these results, the present case was diagnosed as unilateral ocular subalbinism with tapetal aplasia in a Beagle dog. [ABSTRACT FROM AUTHOR]

In order to examine the relationship between occlusal support and head posture, the electromyographic (EMG) activities of the jaw closing muscles and the sternocleidomastoid muscle during voluntary maximal clenching (VMC) under several conditions of occlusal support in eight healthy dentates were recorded and analysed. The head posture was also recorded simultaneously by the electromagnetic, 6-degree-of-freedom tracking instrument (POLHMUS Co. 3 SPACE-WIN*). In the VMC with lateral imbalance of occlusal support, EMG activity of the jaw closing muscles and the sternocleidomastoid muscle on the occlusal support side was greater than those on the non-occlusal support side, and the neck was bent in the direction of the occlusal support side. Moreover, a positive correlation was found between the asymmetry of muscle activity (asymmetry index) of the sternocleidomastoid muscle and the angle of lateral bending of the neck. From these results, it can be said that lateral imbalance of the occlusal support could promote imbalance in sternocleidomastoid muscle activity, causing lateral bending of the neck. From this study, it is suggested that there is a close relationship between occlusal support and head posture. [ABSTRACT FROM AUTHOR]

Alkaline oesophagitis attributable to duodenal mechanisms may induce oesophageal carcinogenesis in a rat reflux model. To investigate the mechanism of the regurgitation after distal partial gastrectomy. The lower oesophageal sphincter pressure was reduced to 83% after surgery. The amplitude and duration of the peristaltic waves tended to be increased, and the velocity tended to be less after surgery (amplitude 120%, duration 114%, velocity 88%). Interrupted waves appeared more frequently after surgery. The manometric changes in gastrectomized patients are considered to be disadvantageous relative to regurgitation. After surgery, gastrin and pancreatic polypeptide were completely abolished postprandially, whereas cholecystokinin and neurotensin were significantly increased. The hormonal changes should have a suppressive effect on the lower oesophageal sphincter. Both the manometric and the hormonal changes may exacerbate reflux oesophagitis after distal partial gastrectomy. [ABSTRACT FROM AUTHOR]

An implantable glucose monitoring device based on a CMOS line sensor combined with a glucose‐responsive fluorescent hydrogel is developed. An implantable glucose monitoring device with sufficient sensitivity and response time is realised, which is an improvement over the authors' previous proof‐of‐concept device. A reduction of the sensor size made the device diameter injectable with a commercially available 16‐gauge syringe needle. The sensor's performance was confirmed through both in vitro and in vivo experiments. [ABSTRACT FROM AUTHOR]

In somaclonal tissues obtained from systemically TMV-infected tobacco plants, a relation between changes of TMV amounts and the callus growth was examined. The culture medium was suitable for maintaining a constant concentration of TMV as well as active callus growth. By using the shake-culture method, somaclonal tissues were separated into two classes on the basis of callus sizes. In large callus tissues, TMV amounts were constant during subculturing but the tissues did not either grow or release the newly divided cells after the last subculture. On the other hand, smaller callus tissues grew markedly and the TMV amounts were conspicuously lowered. After shake-subculture of smaller tissues, they were successfully regenerated to plantlets. None of the plantlets expressed any mosaic symptoms, while plantlets from the original somaclones showed severe mosaic symptoms of TMV in leaflets. Thus, the present report describes the successful production of virus-free plantlets from infected somaclonal callus cultures. [ABSTRACT FROM AUTHOR]