Probable Respiratory Sarcopenia Decreases Activities of Daily Living in Older Patients Hospitalized with Respiratory Diseases: A Cross-sectional Study

Objectives

Respiratory sarcopenia is characterized by low respiratory muscle mass and respiratory muscle strength, but its impact on activities of daily living (ADL) remains unknown. We aimed to investigate the association between respiratory sarcopenia and decreased ADL.

Methods

This retrospective cross-sectional study included older inpatients (≥65 years old) with respiratory diseases who underwent rehabilitation. Because the evaluation of respiratory muscle mass is challenging, probable respiratory sarcopenia was defined according to low appendicular skeletal muscle index (<7 kg/m2 for men, <5.7 kg/m2 for women) and peak expiratory flow rate (<4.4 L/s for men, <3.21 L/s for women). ADL was assessed on the first day of rehabilitation using the baseline Barthel Index (BI).

Results

Of 111 inpatients (median age 75 years; 57 women), 13 (11.7%) had probable respiratory sarcopenia. Forty-five patients (40.5%) had sarcopenia and 12 of these had probable respiratory sarcopenia. Pulmonary functions (Forced Vital Capacity and expiratory volume in 1 s) were significantly lower in patients with probable respiratory sarcopenia than those without. Spearman's rank coefficient analysis showed probable respiratory sarcopenia did not significantly correlate with age, phase angle, Charlson Comorbidity Index (CCI), or hemoglobin (Hb). Multivariate linear regression analysis with baseline BI revealed probable respiratory sarcopenia (β -0.279 and P=0.004) was the significant factor after adjusting for age, sex, body mass index, chronic obstructive pulmonary disease, CCI, and Hb.

Conclusions

Probable respiratory sarcopenia was independently associated with decreased ADL in patients aged 65 years and older who were hospitalized with respiratory diseases.

Survey of patients with stroke in the Kitakyushu Area, Japan: a 12-year retrospective analysis of the critical pathway

OBJECTIVES

We aimed to clarify the incidence, clinical profile, outcome, and activities of daily living of patients with stroke using the Kitakyushu clinical pathway database and to investigate the characteristics of patients with stroke in the Kitakyushu medical area in Japan.

MATERIALS AND METHODS

The clinical data of patients with stroke registered in the Kitakyushu database between April 1, 2009 and December 31, 2021 were retrospectively examined. The National Institutes of Health Stroke Scale was used to classify stroke severity. A descriptive analysis of basic variables, including age, stroke type, length of hospital stay, and activities of daily living, according to stroke severity was conducted.

RESULTS

There were 7,487 acute care hospital patients and 5,441 rehabilitation hospital patients. Compared with patients in similar cities in Japan, patients in the Kitakyushu area tended to be older at the time of stroke onset with a higher proportion of cases of hemorrhagic stroke. Length of hospital stay in both acute and rehabilitation hospitals increased with stroke severity. The Functional Independence Measure gain was highest in patients with moderate disability.

CONCLUSIONS

Compared with patients in similar cities in Japan, in the Kitakyushu area, patients with stroke were older and the proportion of patients with hemorrhagic stroke was higher. Stroke rehabilitation therapy is effective for patients with moderately severe stroke.

Impact of Presarcopenic Dysphagia on 1-Year Mortality After Videofluoroscopic Swallowing Study in Patients with Cancer

Sarcopenic dysphagia is the term for swallowing difficulty associated with loss of mass, strength, and physical performance, which leads to increased pharyngeal residues. Unlike sarcopenia, presarcopenia is characterized by low muscle mass without decreased muscle strength or physical performance and can develop into dysphagia due to low skeletal muscle mass. This retrospective study investigated the impact of presarcopenic dysphagia (PSD) on 1-year mortality in patients with cancer and dysphagia who underwent a videofluoroscopic swallowing study (VFSS). An operational definition of PSD based on presarcopenia and pharyngeal residues was adopted. The psoas muscle mass index (cm2/height [m2]), calculated by the psoas muscle area at the third lumber vertebra via abdominal computed tomography (CT) and related to height, was used to assess presarcopenia with cutoff values of 4.62 for men and 2.66 for women. Pharyngeal residues were assessed using a VFSS to evaluate dysphagia. Patients' medical charts were analyzed to investigate 1-year mortality after a VFSS. Out of 111 consecutive patients with cancer, 53 (47.7%) were defined as having PSD. In a forward-stepwise Cox proportional regression analysis, PSD (HR 2.599; 95% CI 1.158-5.834; p = 0.021) was significantly associated with 1-year mortality after a VFSS, even after adjusting for the factors of operation, Functional Oral Intake Scale (FOIS) scores at discharge, and modified Barthel Index (BI) scores at discharge. PSD, defined as CT-based presarcopenia and pharyngeal residues observed during a VFSS, is associated with increased 1-year mortality in patients with cancer and dysphagia.

Negative impact of computed tomography-based low skeletal muscle mass on swallowing recovery in patients with post-stroke dysphagia

OBJECTIVES

Dysphagia due to stroke has a high prevalence, and evaluating the swallowing function of dysphagia and promoting oral intake is essential in patients with stroke. The psoas muscle mass index（cm2/height2（m2））, calculated by the psoas muscle area at the L3 level via abdominal computed tomography （CT）, can predict the development of dysphagia. However, knowledge about the impact of CT-based skeletal muscle mass on swallowing recovery, remains unknown. Therefore, we investigated whether CT-based low skeletal muscle mass impacted swallowing recovery.

METHODS

A retrospective cohort study was conducted on patients with post-stroke dysphagia who underwent acute treatments along with a videofluoroscopic swallowing study（VFSS）. Swallowing recovery was identified as the improvement of the Functional Oral Intake Scale （FOIS） from the time of VFSS to discharge（observational period: ObPd）. The psoas muscle mass index's cut-off values for low skeletal muscle mass were 3.74 cm2/m2 and 2.29 cm2/m2 for men and women respectively.

RESULTS

There were 53 subjects （36 male, median age 73.9）. The median during the ObPd was 26 days, and the median days from onset to admission and admission to VFSS were 0 and 18, respectively. Sixteen patients had low skeletal muscle mass. The median improvement of FOIS during the ObPd was 2, and the median length of hospital stay was 51 days. In the stepwise multiple linear regression analysis for the improvement of FOIS during the ObPd, low skeletal muscle mass （β - 0.245; 95% confidence interval - 2.248 to - 0.127; p = 0.029） was a significant factor, even adjusted for serum albumin at admission, disturbance of consciousness at VFSS, FOIS at VFSS, and aspiration during VFSS.

CONCLUSION

CT-based low skeletal muscle mass negatively impacted swallowing recovery during the ObPd in patients with post-stroke dysphagia.

Applicability of non-destructive equipment for radioactivity measurement to screening radio-cesium in foods

This study aimed to evaluate the applicability of non-destructive radioactivity measurement equipments for screening radio-cesium in whole foods without sample preparation procedures. Wild mushrooms and bamboo shoots were collected and studied using five different non-destructive radioactivity devices, and activity concentration was determined by conventional gamma-ray spectrometry using a Ge-detector. Linear regression analyses of activity concentrations were conducted and prediction intervals determined as uncertainties. Overall, non-destructive radioactivity measurement devices found to be suitable for screening radioactive cesium contamination in foods with an effective screening level.

Estimation of dietary intake of 90Sr in Japan after the Fukushima Daiichi Nuclear Power Plant accident: market basket study, 2013-2018

Radionuclide contamination in foods has been a public concern in Japan after the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. To estimate time and regional trends of daily intake and annual committed effective dose of strontium-90 (⁹⁰Sr) after the accident, we analysed Market basket samples using a low background 2π gas-flow counter. Samples were collected from six regions, once a year from 2013 to 2018. There appeared to be little variation in estimated daily intake and annual committed effective dose of ⁹⁰Sr across the time periods and regions. The estimated maximum annual committed effective dose of ⁹⁰Sr was 0.00076 mSv/year, a value sufficiently lower than the intervention exemption level, 1 mSv/year, in foods in Japan. There was no noticeable difference between the range of estimated daily intake of ⁹⁰Sr in this study compared with daily intake measured before the FDNPP accident. These results suggested that no obvious increase in dietary intake of ⁹⁰Sr was observed after the FDNPP accident, and that the effects on commercial foods from ⁹⁰Sr due to the FDNPP accident were negligible.

Comprehensive analysis of a decade of cumulative radiocesium testing data for foodstuffs throughout Japan after the 2011 Fukushima Daiichi Nuclear Power Plant accident

The unexpected accident at the Fukushima Daiichi Nuclear Power Station in Japan, which occurred on March 11th, 2011, after the Great East Japan Earthquake and tsunami struck the north-eastern coast of Japan, released radionuclides into the environment. Today, because of the amounts of radionuclides released and their relatively long half-life, the levels of radiocesium contaminating foodstuffs remain a significant food safety concern. Foodstuffs in Japan have been sampled and monitored for ^134,137Cs since the accident. More than 2.5 million samples of foodstuffs have been examined with the results reported monthly during each Japanese fiscal year (FY, from April 1^st to March 31^st) from 2012 to 2021. A total of 5,695 samples of foodstuffs within the “general foodstuffs” category collected during this whole period and 13 foodstuffs within the “drinking water including soft drinks containing tea as a raw material” category sampled in FY 2012 were found to exceed the Japanese maximum permitted level (JML) set at 100 and 10 Bq/kg, respectively. No samples from the “milk and infant foodstuffs” category exceeded the JML (50 Bq/kg). The annual proportions of foodstuffs exceeding the JML in the “general foodstuffs” category varied between 0.37% and 2.57%, and were highest in FY 2012. The ^134,137Cs concentration for more than 99% of the foodstuffs monitored and reported has been low and not exceeding the JML in recent years, except for those foodstuffs that are difficult to cultivate, feed or manage, such as wild mushrooms, plants, animals and fish. The monitoring data for foodstuffs show the current status of food safety risks from ^134,137Cs contamination, particularly for cultured and aquaculture foodstuffs on the market in Japan.

A new method to quantify innervation of the ulnar intrinsic hand muscles by the anterior interosseous nerve in Martin-Gruber anastomosis and nerve transfer surgery

INTRODUCTION/AIMS

It is important to quantify the amount of crossover innervation from the anterior interosseous nerve (AIN) through Martin-Gruber anastomosis (MGA) particularly in patients with high ulnar nerve injury who undergo nerve transfer surgery. The objective of this study is to describe a novel electrophysiological method for quantifying innervation from the AIN that can be done using conventional nerve conduction study setup and commonly available software for analysis.

METHODS

Seven subjects with MGA and nine patients who had undergone AIN to ulnar nerve transfer underwent conventional motor nerve conduction studies. Recording was done over the hypothenar and first dorsal interosseous muscles while stimulating the median and ulnar nerves at the wrist and elbow. Datapoint-by-datapoint subtraction of the compound muscle action potentials evoked at the elbow and wrist was performed after they had been onset-aligned. The results were compared to the collision technique and innervation ratio method.

RESULT

Results from the digital subtraction method were highly correlated with the collision technique (r = 0.96, p < 0.05). In contrast, its correlation with the innervation ratio method is substantially lower.

DISCUSSION

In comparison to previously described techniques, the digital subtraction method has a number of practical advantages. It uses conventional nerve conduction study setup, and the added step of digital alignment and subtraction can be done through commonly available software. With the increasing use of nerve transfer surgery in severe high ulnar nerve injury, this could be a useful method to identify the presence of MGA prior to surgery and for evaluating nerve recovery following surgery.

Molecular and Clinical Elucidation of the Mechanism of Action of Steroids in Idiopathic Carpal Tunnel Syndrome

BACKGROUND

Carpal tunnel steroid injection is a nonoperative intervention for the treatment for idiopathic carpal tunnel syndrome (CTS). The antifibrotic, anti-inflammatory, and antiedematous properties of steroids account for their therapeutic effects in the context of CTS; however, their relative contribution has not been clarified.

METHODS

Fibroblasts from subsynovial connective tissues (SSCT) were intraoperatively collected from patients with idiopathic CTS and were incubated with or without the steroid triamcinolone acetonide (TA) for 1, 3, and 7 days; the expression of fibrosis-related genes and inflammatory cytokines was evaluated using quantitative reverse transcription-polymerase chain reaction. A clinical prospective study was conducted with patients who received carpal tunnel TA injections. We performed clinical and electrophysiological evaluations before and 1, 3, and 5 months after TA injection; and we compared the median nerve, flexor tendon, and SSCT areas and the median nerve flattening ratio before and 1 month after TA injection using 3-T magnetic resonance imaging (MRI).

RESULTS

TA induced downregulation of the fibrosis-related genes Col1A1 (collagen type I alpha 1 chain), Col1A2, and Col3A1 but not the inflammation-related genes. The nerve flattening ratio did not change after TA injection according to the MRI-based observation of the median nerve, flexor tendon, and SSCT areas.

CONCLUSIONS

The therapeutic effects of injected TA are apparently mediated by its antifibrotic rather than its anti-inflammatory and antiedematous properties. TA probably alters the properties but not the morphology of SSCT.

LEVEL OF EVIDENCE

Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Statins repress needle-like carbon nanotube- or cholesterol crystal-stimulated IL-1β production by inhibiting the uptake of crystals by macrophages

Statins are 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors that lower atherogenic LDL-cholesterol levels. Statins exert clinically relevant anti-inflammatory effects; however, the underlying molecular mechanism remains unclear. Studies have shown that endogenous and exogenous pathogenic crystals, such as cholesterol and monosodium urate (MSU), and needle-like nanomaterials, such as multi-wall carbon nanotubes (MWCNT), induce the production of IL-1β and play a critical role in the development of crystal-associated sterile inflammatory pathologies. In this study, we evaluated the effect of statins on crystal-induced IL-1β production in macrophages. We found that various statins, including pitavastatin, atorvastatin, fluvastatin, and lovastatin, but not squalene synthase inhibitor, repressed IL-1β release upon MWCNT stimulation. In addition, IL-1β production induced by cholesterol crystals and MSU crystals, but not by ATP or nigericin, was diminished. MWCNT-stimulated IL-1β release was dependent on the expression of NLRP3, but not AIM2, NLRC4, or MEFV. Statin-induced repression was accompanied by reduced levels of mature caspase-1 and decreased uptake of MWCNT into cells. Supplementation of mevalonate, geranylgeranyl pyrophosphate, or farnesyl pyrophosphate prevented the reduction in IL-1β release, suggesting a crucial role of protein prenylation, but not cholesterol synthesis. The statin-induced repression of MWCNT-elicited IL-1β release was observed in THP-1-derived and mouse peritoneal macrophages, but not in bone marrow-derived macrophages where statins act in synergy with lipopolysaccharide to enhance the expression of IL-1β precursor protein. In summary, we describe a novel anti-inflammatory mechanism through which statins repress mature IL-1β release induced by pathogenic crystals and nanoneedles by inhibiting the internalization of crystals by macrophages.

PERFORMANCE EVALUATION OF THE EQUIPMENT FOR MEASURING RADIOACTIVITY IN WHOLE FOODSTUFFS WITHOUT DESTRUCTIVE SAMPLE PREPARATION DEVELOPED AFTER THE FUKUSHIMA NPP ACCIDENT

Recently, several types of instruments for measuring radioactivity in whole foodstuff were developed by manufacturers, in which any sample preparation technique such as machining was avoided, and such types of instruments are employed by agricultural producers or municipality radioactivity testing stations in Fukushima. In this study, radioactivity in various kinds of 91 samples collected by residents were measured by use of instruments for radioactivity measurement in whole samples, and the activity in each sample was also measured by use of the conventional gamma-ray spectrometry technique using calibrated Ge detectors after the sample machining procedure. The results obtained by instruments for measurement in whole samples were roughly proportional to the result obtained by a conventional technique, although large differences or unexpected variations were found in some specimens.

[Development of a Rapid Determination Method for Strontium-90 in Foods Using a Strontium Extraction Column for Use during Emergency Events]

To ensure food safety during emergency events such as nuclear disasters, we developed a practical rapid determination method for strontium-90 (Sr-90) in foods. Purification of Sr from foods was simplified using a commercial Sr-extraction column. We also reduced the waiting time to achieve radiative equilibrium between Sr-90 and Y-90. Finally, we developed a rapid determination method for Sr-90 that can be completed in about a week. Using the new method, stable Sr recoveries exceeded 85%. The trueness of the method ranged from 109 to 115% and the detection limit of Sr-90 was estimated to be 0.07 Bq/kg fresh weight according to a performance evaluation using standard materials. Sr-90 radioactivity concentrations in food samples determined by the new method were highly correlated and nearly equal to concentrations determined by the conventional method. The present study suggests that the new method offers highly sensitive and rapid detection of Sr-90 which are necessary attributes for food tests during emergency events.

A modified multiple point stimulation method for motor unit number estimation of the hypothenar muscles

INTRODUCTION

The goal of this study is to test the hypothesis that single motor unit action potentials (SMUPs) originating from other ulnar nerve-innervated intrinsic hand muscles can inflate the motor unit number estimation (MUNE) of the hypothenar muscles.

METHODS

Using the multiple point stimulation method, SMUPs recorded over the hypothenar muscles from distant origins were characterized through multichannel recordings. The MUNE calculated using only the hypothenar SMUPs was compared with estimations based on the whole ensemble.

RESULTS

Of the 41 studies performed, distant SMUPs represented 17 ± 9.5% (mean ± SD) of the overall sample. MUNE calculated using only hypothenar SMUPs was 423 ± 204, compared with 537 ± 290 if all SMUPs were included (P < 0.05). The extent of increase in MUNE was highly correlated with the proportion of distant SMUPs found (r = 0.89, P < 0.05).

DISCUSSION

Erroneous inclusion of SMUPs from distant muscles can significantly distort the MUNE results. Muscle Nerve 59:337-341, 2019.

[Concentration of Radioactive Cesium in Domestic Foods Collected from the Japanese Market in Fiscal Years 2014-2016]

Between fiscal years 2014 and 2016, we surveyed the concentration of radioactive cesium in commercial foods produced in areas where there is a risk of radiation contamination due to the Fukushima Daiichi nuclear disaster. The number of samples with a concentration of radioactive cesium that exceeded the regulatory limit （100 Bq/kg for general foods） was 9 out of 1,516 （0.6％） in fiscal 2014, 12 out of 900 （1.3％） in fiscal 2015, and 10 out of 654 （1.5％） in fiscal 2016. Even though some samples were expected to be contaminated with radioactive cesium, because wild mushrooms and edible wild plants were intentionally included in this survey, the percentage of samples that exceeded the regulatory limit was only around 1％. The surveillance results confirmed that the pre-shipment food monitoring conducted by local governments was properly and efficiently performed, although continuous monitoring of the concentration of radioactive cesium in cultivated and wild mushrooms, edible wild plants, and wild animal meats is still required.

Determination of polychlorinated biphenyls in marine fish obtained from tsunami-stricken areas of Japan

We determined the polychlorinated biphenyl (PCB) congeners in 101 marine fish obtained from tsunami-stricken areas following the Great East Japan Earthquake in 2011. In particular, to determine the degree of PCB contamination in the fish, we investigated the concentration of total PCB (∑PCB) and the proportions of 209 individual PCB congeners by high-resolution gas chromatography/high-resolution mass spectrometry. The ∑PCB concentration was 1.7–33 ng/g in fat greenling (n = 29), 0.44–25 ng/g in flounder (n = 36), and 1.6–86 ng/g in mackerel (n = 36), all values being much lower than the provisional regulatory limit in Japan. In the congener analysis, tetra-, penta-, hexa-, and hepta-chlorinated PCB congeners dominated in all samples (comprising over 86% of the ∑PCB). The proportions of the chlorinated PCB congeners were similar to the contamination patterns derived from Kanechlor in the environment, implying that the marine fish were not contaminated with fresh PCBs.

An Analytical Method to Measure Free-Water Tritium in Foods using Azeotropic Distillation

A series of accidents at the Fukushima Dai-ichi Nuclear Power Plant has raised concerns about the discharge of contaminated water containing tritium ((3)H) from the nuclear power plant into the environment and into foods. In this study, we explored convenient analytical methods to measure free-water (3)H in foods using a liquid scintillation counting and azeotropic distillation method. The detection limit was 10 Bq/L, corresponding to about 0.01% of 1 mSv/year. The (3)H recoveries were 85-90% in fruits, vegetables, meats and fishes, 75-85% in rice and cereal crops, and less than 50% in sweets containing little water. We found that, in the case of sweets, adding water to the sample before the azeotropic distillation increased the recovery and precision. Then, the recoveries reached more than 75% and RSD was less than 10% in all food categories (13 kinds). Considering its sensitivity, precision and simplicity, this method is practical and useful for (3)H analysis in various foods, and should be suitable for the safety assessment of foods. In addition, we examined the level of (3)H in foods on the Japanese market. No (3)H radioactivity was detected in any of 42 analyzed foods.

[Surveillance of radioactive cesium in domestic foods on the Japanese market (Fiscal Years 2012 and 2013)]

We surveyed the concentration of radioactive cesium in foods purchased at markets in areas where possible contamination has been a concern after the Fukushima accident. In fiscal years 2012 and 2013, we surveyed 1,735 and 1,674 foods, respectively, using a NaI (Tl) scintillation spectrometer for the screening test and a γ-ray spectrometer with a germanium semiconductor detector for the final test. Only 3 and 4 samples (0.2% of our total samples) exceeded the regulatory limit (100 Bq/kg) for radioactive cesium in fiscal years 2012 and 2013, respectively. Our surveillance indicates that the pre-shipment monitoring of foods by local governments has been working effectively.

Development of wrist rehabilitation robot and interface system

The authors have developed a practical wrist rehabilitation robot for hemiplegic patients. It consists of a mechanical rotation unit, sensor, grip, and computer system. A myoelectric sensor is used to monitor the extensor carpi radialis longus/brevis muscle and flexor carpi radialis muscle activity during training. The training robot can provoke training through myoelectric sensors, a biological signal detector and processor in advance, so that patients can undergo effective training of extention and flexion in an excited condition. In addition, both-wrist system has been developed for mirror effect training, which is the most effective function of the system, so that autonomous training using both wrists is possible. Furthermore, a user-friendly screen interface with easily recognizable touch panels has been developed to give effective training for patients. The developed robot is small size and easy to carry. The developed aspiring interface system is effective to motivate the training of patients. The effectiveness of the robot system has been verified in hospital trails.

Repeater F-waves are signs of motor unit pathology in polio survivors

INTRODUCTION

The purpose of this study was to determine whether F-waves reveal electrophysiological features of anterior horn cells in polio survivors.

METHODS

Forty-three polio survivors and 20 healthy controls underwent motor nerve conduction studies of the median and tibial nerves bilaterally, including sampling of F-waves elicited by 100 stimuli and the determination of motor unit number estimation (MUNE).

RESULTS

A significant increase in abnormally stereotyped ("repeater") F-waves and a reduction of F-wave persistence were observed in both nerves in the polio group as compared with the control group. Repeater F-waves had a negative correlation with MUNE.

CONCLUSIONS

These trends in F-wave persistence and repeater F-waves after motor unit loss are characteristic findings in polio survivors. Repeater F-waves are a sign of motor unit pathology.

[Estimation of dietary intake of radioactive materials by total diet methods]

Radioactive contamination in foods is a matter of great concern after the Tokyo Electric Power Company's Fukushima Daiichi nuclear power plant disaster caused by the Great East Japan Earthquake. In order to estimate human intake and annual committed effective dose of radioactive materials, market basket and duplicate diet samples from various areas in Japan were analyzed for cesium-134 ((134)Cs), -137 ((137)Cs), and natural radionuclide potassium-40 ((40)K) by γ-ray spectroscopy. Dietary intake of radioactive cesium around Fukushima area was somewhat higher than in other areas. However, maximum committed effective doses obtained by the market basket and duplicate diet samples were 0.0094 and 0.027 mSv/year, respectively, which are much lower than the maximum permissible dose (1 mSv/year) in foods in Japan.

Lung adenocarcinoma metastasis to the male breast: a case report

We report the case of a 60-year-old male patient who was diagnosed with metastasis from primary lung cancer to the breast. The patient presented with a mass in the right breast. Mammography, ultrasound, and magnetic-resonance imaging each suggested primary breast cancer. A core-needle biopsy of the right breast mass indicated poorly differentiated adenocarcinoma. A basic chest X-ray showed a shadow in the left upper lung. Thoraco-abdominal computed tomography revealed a mass with a diameter of 90 mm in the left superior region, the shape of which was indicative of primary lung cancer. A lung biopsy confirmed poorly differentiated adenocarcinoma. We diagnosed primary lung cancer with metastases to the bone, brain and right breast (cT2N3M1, stage IV) by imaging and histopathology. He was administered carboplatin (area under the curve 6 mg / ml) and paclitaxel (200 mg / m(2)) tri-weekly, and underwent gamma-knife treatment for the brain metastasis. The treatments reduced the primary tumor and the metastases. However, after completion of the fifth treatment cycle, he developed disseminated intravascular coagulation from septic shock, and died on the eleventh day after completing the fifth cycle of treatment. Although metastasis to the mammary gland is uncommon, especially among males, metastasis to the mammary gland should be considered when a mammary mass does not exhibit the typical characteristics of breast cancer. A correct diagnosis of metastasis to the mammary gland from lung cancer makes it possible to select the most appropriate treatment method.

[Reduction of radioactive cesium content in pond smelt by cooking]

In Japan, seafood may be eaten raw or after having been cooked in diverse ways. Therefore, it is important to understand the effect of cooking on the extent of contamination with radioactive materials in order to avoid internal exposure to radioactive materials via seafood. In this study, we investigated the changes in radioactive cesium content in pond smelt cooked in four different ways: grilled, stewed (kanroni), fried and soaked (nanbanzuke). The radioactive cesium content in grilled, kanroni and fried pond smelt was almost unchanged compared with the uncooked state. In contrast, radioactive cesium content in nanbanzuke pond smelt was decreased by about 30%. Our result suggests that soaking cooked pond smelt in seasoning is an effective method of reducing the burden radioactive cesium.

[Reduction of radioactive cesium content in beef by soaking in seasoning]

It is important to obtain information about ways of removing radioactive cesium from foods in order to reduce internal radiation exposure from food and to ensure the safety and security of food. In this study, we investigated the change of radioactive cesium content in beef due to soaking in seasoning. Our results revealed that soaking beef in liquid seasoning (salt concentration: 8-10%) for 24 h or in miso seasoning (salt concentration: about 9%) for 7 days decreased the radioactive cesium content by about 20% and 55%, respectively, compared with that present in beef before soaking. Furthermore, soaking beef in 10% salt solution for 7 days while changing the salt solution every day or every three days decreased the radioactive cesium content by about 75%, compared with that present in beef before soaking. Because the seasoning is usually discarded after soaking, the procedure of soaking beef in seasoning is a useful method of reducing the burden of radioactive cesium.

Differential analysis of protein expression in RNA-binding-protein transgenic and parental rice seeds cultivated under salt stress

Transgenic plants tolerant to various environmental stresses are being developed to ensure a consistent food supply. We used a transgenic rice cultivar with high saline tolerance by introducing an RNA-binding protein (RBP) from the ice plant (Mesembryanthemum crystallinum); differences in salt-soluble protein expression between nontransgenic (NT) and RBP rice seeds were analyzed by 2D difference gel electrophoresis (2D-DIGE), a gel-based proteomic method. To identify RBP-related changes in protein expression under salt stress, NT and RBP rice were cultured with or without 200 mM sodium chloride. Only two protein spots differed between NT and RBP rice seeds cultured under normal conditions, one of which was identified as a putative abscisic acid-induced protein. In NT rice seeds, 91 spots significantly differed between normal and salt-stress conditions. Two allergenic proteins of NT rice seeds, RAG1 and RAG2, were induced by high salt. In contrast, RBP rice seeds yielded seven spots and no allergen spots with significant differences in protein expression between normal and salt-stress conditions. Therefore, expression of fewer proteins was altered in RBP rice seeds by high salt than those in NT rice seeds.

Research and development of compact wrist rehabilitation robot system

Compact rehabilitation robot system which can support movement of the wrist of patients has been developed. The robot system can detect and analyze the patient's intention to move the wrist by such a biological signal as muscle potential, then, assist the wrist exercise of patients. Also, both-wrist rehabilitation robot system by mirror effect has been successfully developed for practical use in the hospital and at home.

[Estimation of the committed effective dose of radioactive cesium and potassium by the market basket method]

The Tokyo Electric Power Company's Fukushima Daiichi nuclear power plant disaster after the Great East Japan Earthquake has caused radioactive contamination in food. Using the market basket method, total diet samples in Tokyo, Miyagi prefecture and Fukushima prefecture were analyzed for cesium-134 and -137 (radioactive cesium) and naturally occurring potassium-40 (radioactive potassium) in order to estimate the committed effective doses of these radioactive materials from food. Doses were calculated on the assumption that "not detected" corresponded to zero or to half the limit of detection (values in brackets). The estimated doses of radioactive cesium in Tokyo, Miyagi and Fukushima were 0.0021 (0.0024), 0.017 (0.018) and 0.019 (0.019) mSv/year, respectively. Although the doses in Miyagi and Fukushima were more than 8 times the dose in Tokyo, they were significantly lower than the maximum permissible dose (1 mSv/year) determined by the Ministry of Health, Labour and Welfare, Japan. The estimated doses of naturally occurring radioactive potassium in these areas were in the range of 0.17-0.20 (0.18-0.20) mSv/year, and there were no significant differences between the areas.

Comparison of Baselines in Extraction of F-Responses

The objective of this study is to eliminate slow responses that displace baselines positively. This is a key component of an automated technique for determining parameters of F-waves in an evoked potential obtained by limb stimulation. We investigate five methods and compare them to F-wave repeater data through visual observation by experts.

[Surveillance of radioactive cesium in foods]

We surveyed foods on the market from areas that had been exposed to radioactive materials contamination following the Fukushima accident. We used a NaI (Tl) scintillation spectrometer for the screening tests and a germanium semiconductor detector for the final tests. Test results from 1,427 samples showed that 6 samples (0.4%) exceeded the regulatory limit of 500 Bq/kg. Considering the detection rate of radioactive cesium in each food category, we suggest that it is necessary to continue monitoring fruits such as chestnuts and ginkgo nuts, mushrooms (especially raw wood-shiitake), mountain vegetables, and sea fish.

[Comprehensive analyses of hydrolyzed wheat protein using shotgun proteomics]

Hydrolyzed wheat protein (HWP; hydrolyzed gluten) is used in various types of products worldwide. Several cases of wheat-dependent, exercise-induced anaphylaxis following exposure to HWP (Glupearl 19S) in cosmetics have been reported. Glupearl 19S was produced from the gluten after partial hydrolysis with hydrogen chloride, and its allergenicity is larger than that of gluten (Adachi R., Allergy 2012;67:1392-9.). It is considered that provocation of allergic manifestations is caused by deamidated gluten in food and/or non-food products. Moreover, an increasing number of studies have shown that HWP can induce IgE-mediated hypersensitivity by skin contact and/or food ingestion. However, the essential molecular properties and profiles of HWP are still unknown. In this study, bioinformatic and multivariate analyses using shotgun proteomics have revealed that 27 proteins significantly decreased in Glupearl 19S compared with intact gluten as shown by the ratio of ion signal intensity of tryptic peptides. In contrast, a single protein significantly increased in HWP compared with intact gluten as shown by the ratio of ion signal intensity of tryptic peptides. Furthermore, we have identified six Glupearl 19S-specific peptides using shotgun proteomics, database searches on Mascot Sequence Query, and de novo sequencing. The six peptides were identified as the specific markers of Glupearl 19S.

[Effects of transplacental and trans-breast milk exposure to the organophosphate compound chlorpyrifos on the developing immune system of mice]

Navarro et al (2001) have reported that neonatal exposure of rat to the organophosphate compound chlorpyrifos (CPF) resulted in long-term deficits in T lymphocyte mitogenic response, although the mechanism has been unclear. In this study, pregnant BALB/c mice were exposed to 0, 2.8, 14, 70 ppm CPF via diet from gestational day 10 to postnatal day (PND) 21, and subpopulational changes in T lymphocytes of offspring were analyzed at PND21. The irreversibility of the effects was also investigated at PND77 after ceasing exposure by weaning at PND21. Serum cholinesterase activity was significantly reduced after exposure to CPF at PND21. An increase in the proportion of CD4 positive splenocytes was observed after exposure to CPF, which remained until PND77. We found that regulatory T cells were the only one CD4 positive subset which increased in the spleen of CPF-exposed mice at PND77.

[Study of radiation dose rate in air at Setagaya in Tokyo]

The great earthquake occurred at East Japan on March 11, 2011 and the following tsunami induced the accident which environmentally leaked radioactive materials from the nuclear power plant of the Fukushima Daiichi. We measured radiation dose rate in air by the NaI (Tl) scintillation and GM survey meters from March 15 to May 30 at Setagaya in Tokyo. Three measured points were at the 1m height from the ground on asphalt surfaced road, at the 5cm height from ground with weeds, and at the room of a reinforced concrete building. As a result, a transient increase was observed on March 15, a sustained rise was observed on both days of March 21 and 22. The latter was thought to be due to the radioactive rainfall. These measured values were compared with the radiation dose rate in air of the cities in Kanto area, and it was confirmed that the measured values at Setagaya are not so different from that of those cities.

[Effects of perinatal exposure to the brominated flame-retardant hexabromocyclododecane (HBCD) on the developing immune system in rats]

To evaluate the developmental immunotoxicity of brominated flame retardant, hexabromocyclododecane (HBCD) , maternal Sprague-Dawley rats were given HBCD at dietary concentrations of 0, 100, 1000, 10000 ppm from gestational day 10 to postnatal day 21 (postnatal week 3, PNW3). At PNW3 and PNW11, lymphocytes in the spleen, thymus, and peripheral blood of male pups were subjected to flow cytometric analyses for expression of surface markers (CD3, CD4, CD8a, CD25, CD45RA, CD71, and CD161 (NKRP1A)). The spleen and thymus weights, and number of white blood cells of two organs did not change between HBCD-exposed and control groups at PNW3 and PNW11. A significant decrease in thyroid hormone T3 and increase in serum albumin concentration were observed at PNW3 and lasted until PNW11. By flow cytometric analysis, the dramatic change was not observed in the population of the splenic and thymic T/B lymphocyte between the HBCD treated groups and control group. In the peripheral blood of BNW3 rats, the population of activated T cells was decreased and that of inactivated B cells was increased. And the population of NK cells in the spleen was decreased. All of these changes were mild in degree, and returned to the normal levels by PNW11. Production of anti-KLH IgG antibody after KLH immunization was reduced by the 10000 ppm HBCD treatment. These results suggest that developmental exposure to the highest dose of HBCD had a weak immunomodulatory effect at PNW3, and most of the immunomodulatory effect had recovered to normal levels by PNW11.

[Characterization of anti-mouse prion peptide single chain Fv antibody by phage display]

Antibodies can distinguish not only differences in amino acid sequences (primary structure), but also differences in three-dimensional structure and thus may be useful for detecting the conversion of prion proteins, especially in vivo. For diagnosis, we prepared chicken single chain variable fragment (scFv) antibodies that specifically recognized a prion protein using a phage display approach. As antigen, mouse prion protein (MoPrP) 138-153 containing YYR residues was conjugated with KLH. Total RNA was extracted from the splenocytes of an immunized chicken, and the cDNA of scFv was ligated in a phagemid vector. The phage display scFv library was panned against the peptide antigen four times. Twenty-three scFv phage clones that tested positive using ELISA with the peptide antigen were then reacted with recombinant mouse prion protein (23-231), mouse brain homogenate, mouse neuroblastoma Neuro-2a, recombinant human V129 and M129 prion proteins, and human glyoma T98G using ELISA, immunoblotting analysis, and immunocytochemistry. The results suggested that the scFv phage clones were useful for detecting mouse and human prion proteins.

Glycosylation analysis of IgLON family proteins in rat brain by liquid chromatography and multiple-stage mass spectrometry

IgLON family proteins, including limbic-associated membrane protein (LAMP), opioid-binding cell adhesion molecule (OBCAM), neurotrimin, and Kilon, are immunoglobulin (Ig) superfamily cell adhesion molecules. These molecules are composed of three Ig domains and a glycosylphosphatidylinositol (GPI) anchor and contain six or seven potential N-glycosylation sites. Although their glycosylations are supposed to be associated with the development of the central nervous system like other Ig superfamily proteins, they are still unknown because of difficulty in isolating individual proteins with a high degree of homology in performing carbohydrate analysis. In this study, we conducted simultaneous site-specific glycosylation analysis of rat brain IgLON proteins by liquid chromatography and multiple-stage mass spectrometry (LC-MS ( n )). The rat brain GPI-linked proteins were enriched and separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The four proteins were extracted from the gel, and subjected to LC-MS ( n ) after proteinase digestions. A set of glycopeptide MS data, including the mass spectrum, the mass spectrum in the selected ion monitoring mode, and the product ion spectra, was selected from all data based on carbohydrate-related ions in the MS/MS spectrum. The peptide portion and the carbohydrate structure were identified on the basis of peptide-related ion and carbohydrate-related ions, and the accurate mass. The site-specific glycosylations of four proteins were elucidated as follows. N-Glycans near the N-terminal were disialic acid-conjugated complex- and hybrid-type oligosaccharides. The first Ig domains were occupied by Man-5-9. Diverse oligosaccharides, including Lewis a/x-modified glycans, a brain-specific glycan known as BA-2, and Man-5, were found to be attached to the third Ig domain. Three common structures of glycans were found in the GPI moiety of LAMP, OBCAM, and neurotrimin.

Effects of developmental hypothyroidism induced by maternal administration of methimazole or propylthiouracil on the immune system of rats

Methimazole (MMI) and propylthiouracil (PTU) are popularly used antithyroid drugs (ATDs) for the treatment of Graves' hyperthyroidism. The aim of the present study was to determine the effects of ATDs on the developing immune system of the rats. Maternal Sprague-Dawley rats were given drinking water containing 200 ppm of MMI, 12 ppm of PTU (high-dose PTU), or 3 ppm of PTU (low-dose PTU) between gestational day (GD) 10 and postnatal week (PNW) 3. Exposure to the ATDs was ceased upon weaning at PNW3, and the male offspring were sampled at PNWs 3 or 11. The serum thyroid-related hormone levels and the hematological components in the offspring were then determined. The expressions of surface markers in the spleen, thymus and peripheral blood were determined using flowcytometry. The weights of the body, spleen and thymus and the splenic and thymic cell numbers were decreased in the MMI-treated and the high-dose PTU-treated animals at PNWs 3 and 11. The serum levels of thyroid-related hormones were depressed in the MMI and high-dose PTU groups. FACS analysis revealed that the ATDs caused proportional changes in the lymphoid cell subpopulations. The proportion of B cells among the total lymphocytes was significantly decreased at PNW3, whereas that of T cells, especially of inactive T cells, was dramatically increased. Moreover, the proportion of CD4(+)CD25(+) regulatory T cells was significantly increased in the spleen and peripheral blood at PNW3. Most of the above-described changes had recovered to normal levels at PNW11. These results suggest that ATDs might have temporal immunomodulatory effects on the developing immune system.

Postnatal expression profile of OBCAM implies its involvement in visual cortex development and plasticity

This study examined the expression of a neuron-specific cell adhesion molecule, OBCAM (opioid-binding cell adhesion molecule), at both the mRNA and protein levels in the cat primary visual cortex at various postnatal ages, using cDNA array analysis and immunocytochemistry. Results obtained using both methods showed that the expression level of OBCAM was high in young and low in older and adult visual cortex. OBCAM-immunoreactivities were associated predominantly with perikarya and dendrites of pyramidal neurons, and OBCAM-immunopositive neurons were present in all cortical layers. Immunostaining of OBCAM in adult visual cortex showed a reduced number of immunopositive neurons and neurites and relatively lower staining intensities as compared with younger animals. In addition, the number of OBCAM-immunopositive neurons was significantly higher in the visual cortex of 4-month-old animals dark-reared from birth than those in age-matched normally reared animals. These results suggest that OBCAM may play an important role in visual cortex development and plasticity.

Genetic Variations and Haplotypes of UGT1A4 in a Japanese Population

Nineteen genetic variations, including 11 novel ones, were found in exon 1 and its flanking region of the UDP-glucuronosyltransferase (UGT) 1A4 gene from 256 Japanese subjects, consisting of 60 healthy volunteers, 88 cancer patients and 108 arrhythmic patients. These variations include -217T>G and -36G>A in the 5'-flanking region, 30G>A (P10P), 127delA (43fsX22; frame-shift from codon 43 resulting in the termination at the 22nd codon, codon 65), 175delG (59fsX6), 271C>T (R91C), 325A>G (R109G), and 357T>C (N119N) in exon 1, and IVS1+1G>T, IVS1+98A>G and IVS1+101G>T in the following intron. Among them, 127delA and 175delG can confer early termination of translation, resulting in an immature protein that probably lacks enzymatic activity. Variation IVS1+1G>T is located at a splice donor site and thus may lead to aberrant splicing. Since we did not find any significant differences in the frequencies of all the variations among the three subject groups, the data were analyzed as one group. The allele frequencies of the novel variations were 0.006 for IVS1+101G>T, 0.004 for 30G>A (P10P) and 357T>C (N119N), and 0.002 for the 8 other variations. In addition, the two known nonsynonymous single nucleotide polymorphisms (SNPs), 31C>T (R11W) and 142T>G (L48V), were found at 0.012 and 0.129 frequencies, respectively. The SNP 70C>A (P24T), mostly linked with 142T>G (L48V) in German Caucasians, was not detected in this study. Sixteen haplotypes were identified or inferred, and some haplotypes were confirmed by cloning and sequencing. It was shown that most of 142T>G (L48V) was linked with -219C>T, -163G>A, 448T>C (L150L), 804G>A (P268P), and IVS1+43C>T, comprising haplotype *3a; haplotype *4a harbors 31C>T (R11W); 127delA (43fsX22) and 142T>G (L48V) were linked (haplotype *5a); 175delG (59fsX6) was linked with 325A>G (R109G) (*6a haplotype); and -219C>T, -163G>A, 142T>G (L48V), 271C>T (R91C), 448T>C (L150L), 804G>A (P268P), and IVS1+43C>T comprised haplotype *7a. Our results provide fundamental and useful information for genotyping UGT1A4 in the Japanese and probably Asian populations.

Effect of two nitrogenous diphenyl ether pesticides on mast cell activation

We examined the effect of two nitrogenous diphenyl ether pesticides, nitrofen (NIP) and chlornitrofen (CNP), on mast cell activation. RBL-2H3 (rat basophilic leukemia) cells were exposed to NIP or CNP for 30 min to investigate their effect on degranulation, and for 3 h to investigate their effect on cytokine production and gene expression. NIP and CNP increased IgE receptor-mediated beta-hexosaminidase release, MCP-1 release, and TNF-alpha release in a dose-dependent manner. The increasing effect of CNP on their release was greater than that of NIP. In the gene expression experiment, 30 microg/ml CNP significantly upregulated Egr-1, MCP-1 and GADD45a gene expression. These results suggest that at higher concentrations (more than 30 microg/ml) the nitrogenous diphenyl ether pesticides had both a degranulation-enhancing effect and proinflammatory cytokine-production enhancing effect through the expression of some transcription factors in RBL-2H3 cells.

[Study on a method for delivering scFv recombinant antibody into cultured cells]

We try to develop a method for delivering antibody from blood circulation through blood brain barrier to brain. In order to achieve this goal, antibody has to cross cellular membrane of brain capillary endothelial cells twice. As a first step of our study, we examined the ability for scFv antibody to cross cellular membrane of RBL-2H3 cells once and be delivered into the inside of the cultured cells with the help of TAT peptide. TAT peptide was originally found in Tat protein from the HIV-1 virus and known as one of protein transduction domains. First, oligonucleotide encoding TAT peptide was linked to 5' terminal of gene fragment of scFv antibody by PCR technology. TAT-linked scFv gene fragment was subcloned into pET-23b vector and successfully expressed in E. coli as inclusion body. After solubilization and purification, TAT-linked scFv recombinant protein was added to the culture of RBL-2H3 cells. TAT-linked scFv delivered into RBL-2H3 cells was detected by means of immunocytochemistry using fluorescence microscopy. TAT-linked scFv crossed cellular membrane more efficiently than scFv without TAT peptide.