Search

Fluoroquinolones (FQs) have been traditionally used for prophylaxis against bacterial infection. However, the rapid emergence of FQ-resistant Escherichia coli due to overuse and misuse have resulted in an increase in post-biopsy infections. We requested 723 patients undergoing transrectal or transrectal plus transperineal targeted prostate biopsy to provide preprocedure rectal swabs. The rectal swabs were plated onto deoxycholate hydrogen sulfate lactose agar culture and FQ resistance tests were conducted using the disc diffusion method following the guidelines of the Clinical and Laboratory Standards Institute. All patients undergoing biopsy were given a 1.0 g intravenous injection of cefmetazole (CMZ) 30 min before and 12 h after biopsy. Patients with FQ-resistant organisms received an additional 1.0 g intravenous injection of CMZ every 12 h for an additional 1.5 days, while those without FQ-resistant organisms received levofloxacin 500 mg for 4 days. We evaluated infectious symptoms during the 30 days after the biopsy. We also evaluated the incidence of acute prostatitis within 7 days after the biopsy and isolation rates of FQ-resistant strains. A total of 289 patients (40%) had FQ-resistant isolates on rectal swabs. The overall infectious complication rate was 0.69%. Two patients with FQ-resistant isolates and three patients without them experienced infectious episodes. One patient with FQ-resistant isolates and two patients without them suffered acute prostatitis. The difference in the rates of infectious complication and acute prostatitis rates between FQ-resistant and FQ-susceptible carriers were not significant (p = 1.0 and 1.0, respectively). Post-biopsy sepsis was identified in one patient (0.14%) who had FQ-resistant Escherichia coli. Targeted antimicrobial prophylaxis with cefmetazole based on presence of FQ-resistant isolates on rectal swabs may prevent post-prostate biopsy infectious complications, especially in geographic lesions with a high incidence of FQ-resistant strains in rectal flora.

As therapies for hereditary neuromuscular diseases are developed, the need for presymptomatic genetic testing and genetic counseling for early treatment is expected to increase. In Japan, there is no uniformly recommended protocol for presymptomatic genetic testing. In order to provide basic data for the establishment of a presymptomatic genetic testing system, we surveyed medical genetics departments in Japan about their current status (response rate: 67.4%). The questionnaire survey revealed that approximately 60% of facilities had established their own procedures for presymptomatic genetic testing, but the approaches used varied from facility to facility. The interview survey enabled us to identify the essential factors for the establishment of a presymptomatic genetic testing system for each case, each facility, and at the overall level. In the future, there is a need to develop a standardized protocol to help establish a presymptomatic genetic testing system.

Introduction Adenocarcinoma of the rete testis is a rare malignancy with a poor prognosis. We report a case of adenocarcinoma of the rete testis with a durable response to cisplatin-based chemotherapy. Case presentation A 48-year-old man with Down syndrome (trisomy 21) presented with a 1-month history of painless swelling of the left scrotum. The physical examination revealed a left testis with a hydrocele associated with a tumor and enlarged pelvic and para-aortic lymph nodes. He underwent a radical orchiectomy. The specimen was diagnosed as adenocarcinoma of the rete testis. The patient received 7 cycles of chemotherapy (1 cycle of BEP and 6 cycles of EP) postoperatively. The metastatic lymph nodes were reduced in size for at least 12 months. Our patient with adenocarcinoma of the rete testis obtained an acceptable response to cisplatin-based chemotherapy. Conclusion We treated a patient with an adenocarcinoma of the rete testis who had an acceptable response to platinum-based chemotherapy.

A woman in her seventies complained of chest pain during exertion and visited a local hospital. Computed tomographic scan showed right renal cell carcinoma with inferior vena cava (IVC) tumor thrombus extending above the diaphragm, and the patient was referred to our hospital. She was diagnosed with right renal cell carcinoma cT3cN0M0, with level IV IVC thrombus by Mayo classification. Axitinib and pembrolizumab were administered against intractable advanced renal cell carcinoma. The dose of axitinib was reduced due to grade 3 liver dysfunction. Right nephrectomy together with IVC thrombectomy was performed because the primary lesion had shrunk, and the level of IVC thrombus had become level III. The pathological results were clear cell carcinoma, pT3c, G3, Fuhrman grade3, INFA, v1, and ly0. Axitinib and pembrolizumab might be a presurgical option against an intractable renal cell carcinoma with an IVC thrombus.

Photodynamic diagnosis (PDD) using 5-aminolevulinic acid (5-ALA) is expected to be useful in preventing oversight of non-muscle-invasive bladder cancer (NMIBC) and in reducing the intravesical recurrence rate after transurethral resection of bladder tumor (TURBT). We report our initial experience with28 cases of PDD-assisted TURBT (122 samples) performed at our hospital from February 2018 to April 2019. The median age of the patients was 74.5 years, and 18 of the 28 were primary cases. Each patient underwent TURBT with oral administration of 5-ALA 20 mg/kg 3 hours before endoscopic examination. The sensitivity was 89.8% when both white light and blue light were used, which was superior to the sensitivity of 67.8% when using only white light (p＜0.01, McNemar's test). Among the first several cases, we experienced high false positivity, which suggested that some experience may be required to discriminate tumors from inflammatory lesions. In fact, the specificity and the positive likelihood ratio improved with experience. No grade 2 or higher adverse events were observed among our cases. The median follow-up period was 738 days, and 9 of 28 patients (32. 1%) had recurrence within the follow-up period. In conclusion, our initial experience with PDD-assisted TURBT demonstrated its excellent diagnostic sensitivity and safety, as previously reported.

A 21-year-old man with chief complaints of left hypochondriac and chest pain was shown to have multiple masses in the lung, a pleural effusion in the right cavum thoracis, a mediastinal mass, and lymphadenopathy detected by computed tomographic scan. He was diagnosed with an extragonadal germ cell tumor based on pathologic findings from lung biopsies and elevation of the serum total human chorionic gonadotropin. He underwent a reduced chemotherapy regimen consisting of bleomycin, cisplatin, and etoposide (reduced BEP) to lower the risk of acute respiratory distress syndrome (ARDS), a manifestation of choriocarcinoma syndrome, which occurs at induction chemotherapy with the full-dose BEP regimen. Choriocarcinoma syndrome did not develop during chemotherapy, and he has been disease-free since salvage chemotherapy and subsequent retroperitoneal lymph node dissection.

Objectives: The prevalence rate of migraines is 8.4%; it is mostly diagnosed in women at 20s to 40s, and is known to cause major physical and mental disruption to daily life. This study was conducted on women aged between their 20s and 40s, in order to investigate the possible differences in the features of the occlusal state between a migraine and a non-migraine (control) group.Methods: Age-matched female patients with migraine (n = 60) diagnosed by headache specialists and healthy controls (n = 57) were enrolled. Dental casts were used to evaluate some features.Results: The maxillary and mandibular dentition casts from the migraine group showed significantly characteristic findings in their Angle’s classification, overjet, and deviation in the anterior tooth midline, compared to the control group.Discussion: The results relating occlusal state to both tension-related headaches and migraines, which have different pathogeneses, suggest the possibility of dental intervention to improve the symptoms of prim...

In the 9th century, a new religion that combined Buddhism with mountain worship appeared in Japan, and many mountain temples inspired by this religion were built in Nara Prefecture. The unique site planning of these temples seems to have been devised to encourage faith in visitors. This study aims to identify the characteristics of site planning by analyzing the scenes along the visiting route of each temple, as they change from moment to moment. MOTATION, which was proposed by Lawrence Halprin, is a method for graphically representing the changing appearance of a landscape as a person moves through it. In this research, MOTATION was applied to three mountain temples: Muroji, Hasedera, and Kinpusenji. The visiting route of each temple was described by MOTATION based on videos and pictures. In addition, we graphed and analyzed the relationship between distance, height, and surrounding facilities along the visiting routes. We found that the relationship creates a characteristic scene transition by site-specific planning at each temple. This suggests that such scene transitions were intended to give a spatial impression to visitors.

Objective The nerve growth factor (NGF) family comprises of NGF, brain-derived neurotrophic factor (BDNF) and neurotrophins (NTs)-3 to -7, all of which are collectively referred to as NTs. However, the expression of NTs other than NGF in the salivary gland has not been described in detail. BDNF is a well-studied NT involved in the neurogenesis, differentiation, and maintenance of select peripheral and central populations of neuronal cells during development and adulthood. NTs, in concert with the hypothalamic–pituitary–adrenal (HPA) axis, play key roles in modulating brain plasticity and behavioral coping, especially during ontogenetically critical periods, when the developing brain is particularly sensitive to external stimuli. Early life events, such as psychophysical stress, affect BDNF levels, and induce dysregulation of the HPA axis, thereby affecting brain development and contributing to inter-individual differences in vulnerability to stress or psychiatric disorders. Immobilization stress modifies BDNF mRNA expression in some organs. Results We studied the effect of immobilization stress on BDNF and its receptor, tyrosine receptor kinase B (TrkB), in rat submandibular glands, and found increased BDNF expression in duct cells under immobilization stress. In addition, stress increases the amount of plasma BDNF derived from the submandibular gland, and the amount of TrkB receptor mRNA in the adrenal medulla. Conclusions Plasma BDNF might therefore activate TrkB receptors in the adrenal medulla during acute stress. The salivary glands are also likely to influence not only oral health, but also systemic organs. This review addresses the relationship between BDNF and stress in the saliva and salivary glands.

We have developed a polymer-stabilized blue-phase LCD in which the diffraction wavelength of blue-phase liquid crystal is in the ultraviolet region and which is driven at a low voltage of V100 = 27 V. Prototypes of 3.4-in polymer-stabilized blue-phase LCDs were made, which include a highly reliable crystalline oxide semiconductor. We succeeded in fabricating not a test cell but a display having a contrast ratio higher than 1000 : 1 for the first time in the world.

Objectives: Details on grinding patterns and types of contact during sleep bruxism in association with migraine headache have not yet been elucidated. This study compared the characteristics of sleep bruxism between patients with migraine and controls.Methods: The study included 80 female patients who had been diagnosed with migraine and 52 women with no history of migraine. Grinding patterns were measured using the BruxChecker® (Scheu Dental, Iserlohn, Germany).Results: There was a significant difference between the two groups in the distribution of grinding patterns at the laterotrusive side (p

We achieved low-voltage driving of a blue-phase liquid crystal display by employing liquid crystal with high dielectric anisotropy and a chiral material with high helical twisting power. A prototype of a 3.4-inch polymer-stabilized blue-phase display was made, which includes a highly reliable crystalline oxide semiconductor and operates favorably.

We realized a blue-phase liquid crystal display with low driving voltage and high contrast by using a liquid crystal material which is easily twisted and a protrusion electrode structure. Further, we made a prototype of a 3.4-inch panel by a novel manufacturing process suitable for a large-sized panel.

In recent years, research has progressed about the relevance of the Temporomandibular joint (TMJ) and headache, we also feels malocclusion are involved in the background. However, induction factors of migraine are many. In this study, we carried out splint therapy for migraine patients. We summarize the features of malocclusion and its effectiveness.

Temporomandibular joint (TMJ) is acting as the only diarthrodial joint in the crania. Therefore, disorders of muscles and TMJ are frequently caused by disharmony of occlusion. It generally showed patients malocclusion and temporomandibular disorders (TMD) treatment of a large number of patients resulted in significant improvement in the physiological state of the general condition and some indefinite complaints including the primary headache.