Factors related to dissociation between objective and subjective masticatory function in Japanese community-dwelling elderly adults.

Clinicians' evaluations of older adults sometimes reveal inconsistencies between objective and subjective dental status. This study investigated which factors contribute both to good objective masticatory function (OMF) and the poor subjective masticatory function (SMF) that often becomes a clinical issue. Study participants included 635 elderly community-dwelling Japanese adults who underwent a comprehensive geriatric health examination in 2012. SMF was assessed with a question from the Kihon Checklist on eating difficulties (poor or good). OMF was assessed by a colour-changing gum (poor or good). Also investigated were age, sex, depressive symptoms, instrumental activities of daily living (I-ADLs), number of people who joined the participant at dinner, grip strength, usual walking speed, number of remaining teeth, number of functional teeth and their occlusal force. The group with good OMF and good SMF, defined as group 1, and the group with good OMF but poor SMF, group 2, were compared. Logistic regression analyses confirmed that the number of remaining and functional teeth participants had was statistically unrelated to differences between OMF and SMF. Instead, differences were related to stronger depressive symptoms (OR = 1.67, CI = 1.14-2.44), less ability to conduct I-ADL activities (OR = 0.73, CI = 0.59-0.91), slower usual walking speeds (OR = 0.18, CI = 0.06-0.58) and less occlusal force (OR = 0.99, CI = 0.99-1.00). Depressive symptoms, I-ADLs, and physical function are shown to be significantly related to divergence between objective and subjective masticatory function in elderly Japanese. This suggests that dissociations between objective and subjective dental evaluations of elderly adults indicate need for assessment of their mental and physical function.

FUT2 non-secretor status is associated with Type 1 diabetes susceptibility in Japanese children.

AIM: To examine the contribution of the FUT2 gene and ABO blood type to the development of Type 1 diabetes in Japanese children. METHODS: We analysed FUT2 variants and ABO genotypes in a total of 531 Japanese children diagnosed with Type 1 diabetes and 448 control subjects. The possible association of FUT2 variants and ABO genotypes with the onset of Type 1 diabetes was statistically examined. RESULTS: The se2 genotype (c.385A>T) of the FUT2 gene was found to confer susceptibility to Type 1A diabetes in a recessive effects model [odds ratio for se2/se2, 1.68 (95% CI 1.20-2.35); corrected P value = 0.0075]. CONCLUSIONS: The FUT2 gene contributed to the development of Type 1 diabetes in the present cohort of Japanese children.

Variants associated with autoimmune Type 1 diabetes in Japanese children: implications for age-specific effects of cis-regulatory haplotypes at 17q12-q21.

AIMS: The aim of this study was to clarify the significance of previously reported susceptibility variants in the development of autoimmune Type 1 diabetes in non-white children. Tested variants included rs2290400, which has been linked to Type 1 diabetes only in one study on white people. Haplotypes at 17q12-q21 encompassing rs2290400 are known to determine the susceptibility of early-onset asthma by affecting the expression of flanking genes. METHODS: We genotyped 63 variants in 428 Japanese people with childhood-onset autoimmune Type 1 diabetes and 457 individuals without diabetes. Possible association between variants and age at diabetes onset was examined using age-specific quantitative trait locus analysis and ordered-subset regression analysis. RESULTS: Ten variants, including rs2290400 in GSDMB, were more frequent among the people with Type 1 diabetes than those without diabetes. Of these, rs689 in INS and rs231775 in CTLA4 yielded particularly high odds ratios of 5.58 (corrected P value 0.001; 95% CI 2.15-14.47) and 1.64 (corrected P value 5.3 × 10-5 ; 95% CI 1.34-2.01), respectively. Age-specific effects on diabetes susceptibility were suggested for rs2290400; heterozygosity of the risk alleles was associated with relatively early onset of diabetes, and the allele was linked to the phenotype exclusively in the subgroup of age at onset ≤ 5.0 years. CONCLUSIONS: The results indicate that rs2290400 in GSDMB and polymorphisms in INS and CTLA4 are associated with the risk of Type 1 diabetes in Japanese children. Importantly, cis-regulatory haplotypes at 17q12-q21 encompassing rs2290400 probably determine the risk of autoimmune Type 1 diabetes predominantly in early childhood.

Engineering a Spin-Orbital Magnetic Insulator by Tailoring Superlattices.

In 5d Ir oxides with an interplay of spin-orbit coupling and electron correlations, we have tailored a spin-orbital magnetic insulator out of a semimetal SrIrO(3) by tuning the structure through superlattices [(SrIrO(3))(m), SrTiO(3)] (m=1,2,3,4, and ∞). We observed the systematic decrease of the magnetic ordering temperature and the resistivity as a function of m. The transition from the semimetal to the insulator is found to be closely linked to the appearance of magnetism at m≃3. Long range magnetic ordering was realized even in the m=1 single layer superlattice, implying that the design and realization of novel electronic phases is feasible at the level of a single atomic layer in complex Ir oxides.

Effects of emulsifying components in the continuous phase of cream on the stability of fat globules and the physical properties of whipped cream.

The emulsifying components in cream are very important in controlling the physical characteristics of whipped cream. The effects of those components on the stability of fat globules and the physical characteristics of whipped cream were investigated. A low-molecular-weight emulsifier, and protein ingredients such as sodium caseinate and a casein partial hydrolysate (casein peptides), were used as emulsifying components in this investigation. The viscosity of deaerated whipped cream (called the serum viscosity) was measured to evaluate the degree of fat-globule aggregation. Furthermore, the shape-retention ability, which is the degree of reduction in the firmness of whipped cream between immediately after whipping and after 1d of refrigeration, was explored. The addition of the low-molecular-weight emulsifier in the continuous phase of dairy cream, which does not contain added low-molecular-weight emulsifiers, increased the stability of the fat globules and reduced the shape-retention ability of the whipped cream. The addition of protein ingredients (sodium caseinate and casein peptides) to the continuous phase of dairy cream had little effect. However, the addition of casein peptide in the continuous phase of dairy cream together with the low-molecular-weight emulsifier reduced the effect of the low-molecular-weight emulsifier on the stabilization of fat globules and the shape-retention ability of the whipped cream. The addition of casein peptide did not recover the serum viscosity; thus, other mechanisms might underlie this phenomenon.

Respiratory syncytial virus infection in children with severe motor and intellectual disabilities.

Children with severe motor intellectual disabilities (SMID) are at high risk of death from acute viral lower respiratory tract infections (LRTI). Although respiratory syncytial virus (RSV) is the most common cause of viral LRTI in children, there have been a few reports on the relationship between SMID and the severity of RSV-LRTI. The aim of the present study is to assess the influence of RSV-LRTI in children with SMID. A case-control study composed of children with SMID (n = 18) and previously healthy children (n = 43) less than 16 years old hospitalized for RSV-LRTI was performed during five consecutive RSV seasons. The clinical presentation and the laboratory data in the SMID group were compared with those in the non-SMID group. In the bivariate analysis, the median age of the SMID group was higher than that of the non-SMID group (p = 0.002). Children with SMID had an increased risk for ventilation support (p = 0.057). The count of neutrophils in the SMID group was significantly increased (p = 0.012), whereas the proportion of bacterial co-infection was lower than that in the non-SMID group (p = 0.005). Multivariate logistic analysis showed that SMID was associated with longer oxygen usage [>7 days: odds ratio (OR) 5.309, p = 0.033]. The present study revealed that children with SMID were prone to developing hypoxia by RSV-LRTI. The strategies for the treatment and prevention of RSV infection need to be improved in SMID children.

Histo-blood group gene polymorphisms as potential genetic modifiers of the development of coronary artery lesions in patients with Kawasaki disease.

Abnormal immunological responses to certain microbial agents may play a crucial role in the pathogenesis of Kawasaki disease (KD). The association studies between histo-blood group genes (Lewis and ABO blood types) and various types of infectious diseases or vasculopathy have been carried out based on the fact that glycosylated antigens could directly mediate microbial infections. We attempted to clarify the role of blood type antigens in the development of KD and coronary artery lesions in KD patients. The subjects included 164 KD patients enrolled from 1998 to 2003 (1st group), 232 patients from 2004 to 2009 (2nd group), and 223 healthy children and 118 patients with growth hormone deficiency as controls. The genotyping of the FUT2 and FUT3 genes, and ABO genotypes, was determined with the TaqMan SNP assay and allele-specific polymerase chain reaction. No significant differences were observed in the genotypes and allele frequencies of the FUT2 and FUT3 genes between the groups. The frequency of the BB blood genotype was significantly higher in KD patients with coronary artery lesions in the 1st and 2nd groups than in the controls (17% and 14% vs. 5%, P = 0.0020). This is the first report to investigate the roles of ABO and Lewis blood types in the development of KD, and in the formation of coronary artery lesions in KD patients. These data suggest that the ABO blood type may play a role in the development of coronary artery lesions in KD patients.

Advantages of intra-capsular micro-enucleation of schwannoma arising from extremities.

BACKGROUND: Schwannoma is the most common tumor of the peripheral nerves, with surgical enucleation being the established treatment modality. However, some schwannomas cannot be easily enucleated and this sometimes results in iatrogenic nerve injury even with atraumatic procedures. Here we present a retrospective review of the management of schwannoma in the extremities and compare clinical outcomes from the two techniques of extra-capsular and intra-capsular enucleation. METHODS: We reviewed 36 schwannomas from 35 patients who underwent surgical excision of schwannomas arising from the extremities. Twenty had undergone extra-capsular resection and 16 had undergone enucleation using the intra-capsular technique. The post-operative neurological deficits were graded as minor, major, and transient. The duration of symptoms, maximum tumor diameter and site of occurrence were compared between patients with the three grades of deficit. RESULTS: In total, 22 patients developed no sensory changes following enucleation of schwannoma or only temporary and minor changes that had fully resolved within 6 months. Ten patients developed new neurological deficits following surgery that took longer than 6 months to resolve. Four patients experienced new motor deficits or paresthesia following operation that had still not recovered at the final follow-up, all of whom underwent enucleation using the extra-capsular technique. Neurological deficit after enucleation was significantly lower using the intra-capsular compared with the extra-capsular technique. Patient age, duration of symptoms, maximum diameter of the tumor and site of occurrence did not influence the neurological deficit following enucleation of schwannoma. CONCLUSION: These results support intra-capsular micro-enucleation as a safe and reliable treatment for every type of schwannoma. To minimize the risk of nerve injury, en bloc resection should not be used because the main purpose of schwannoma surgery is the relief of symptoms, not tumor resection. Thorough pre-operative counseling of patients to inform them of the potential occurrence of neurological deficit is important.

Influence of whipping temperature on the whipping properties and rheological characteristics of whipped cream.

The effects of whipping temperature (5 to 15 degrees C) on the whipping (whipping time and overrun) and rheological properties of whipped cream were studied. Fat globule aggregation (aggregation ratio of fat globules and serum viscosity) and air bubble factors (overrun, diameter, and surface area) were measured to investigate the mechanism of whipping. Whipping time, overrun, and bubble diameters decreased with increasing temperature, with the exception of bubble size at 15 degrees C. The aggregation ratio of fat globules tended to increase with increasing temperature. Changes in hardness and bubble size during storage were relatively small at higher temperatures (12.5 and 15 degrees C). Changes in overrun during storage were relatively small in the middle temperature range (7.5 to 12.5 degrees C). From the results, the temperature range of 7.5 to 12.5 degrees C is recommended for making whipped creams with a good texture, and a specific temperature should be decided when taking into account the preferred overrun. The correlation between the whipped cream strain hardness and serum viscosity was high (R(2)=0.906) and persisted throughout the temperature range tested (5 to 15 degrees C). A similar result was obtained at a different whipping speed (140 rpm). The multiple regression analysis in the range of 5 to 12.5 degrees C indicated a high correlation (R(2)=0.946) in which a dependent variable was the storage modulus of whipped cream and independent variables were bubble surface area and serum viscosity. Therefore, fat aggregation and air bubble properties are important factors in the development of cream hardness. The results of this study suggest that whipping temperature influences fat globule aggregation and the properties of air bubbles in whipped cream, which alters its rheological properties.

Association study between B- and T-lymphocyte attenuator gene and type 1 diabetes mellitus or systemic lupus erythematosus in the Japanese population.

This study is to elucidate whether the B- and T-lymphocyte attenuator (BTLA) gene is a new susceptibility gene for the development of type 1 diabetes (T1D) and systemic lupus erythematosus (SLE). As a result, this study did not find any genetic contribution of the BTLA gene to the development of T1D and SLE in Japanese population.

Intrasacral schwannoma: clinical presentation, diagnosis and management.

Intrasacral schwannoma is a very rare lesion. We report here three cases of intrasacral schwannoma originating within the sacrum and discuss their clinical presentation, diagnosis and management. Complete excision would appear to be the treatment of choice, but conservative treatment is an option provided the tumour causes no serious symptoms.

Frailty Severity and Dietary Variety in Japanese Older Persons: A Cross-Sectional Study.

Providing older person individuals with an appropriate intervention at the time of frailty onset is important to prevent the progression of the condition and the need for long-term care. However, the proper timing of starting nutritional and dietary interventions for frail older person subjects has not been fully elucidated. Therefore, in this cross-sectional study, we aimed to clarify the association between frailty and dietary variety among older persons in Japan. We surveyed sex, age, body height, body weight, body mass index, serum albumin level, dietary variety, and nutritional intake indexes in 747 community-dwelling older person individuals who underwent a comprehensive health examination in October 2014. Frailty was determined using the Kihon Checklist (25 questions). Kihon Checklist is widely used to assess frailty in Japan, and their physical, cognitive and social function was evaluated. After excluding those who did not complete the Kihon Checklist and those who required long-term care, frailty status was analyzed in 665 older person individuals. The numbers and percentages of frail, pre-frail and robust older persons were found to be 77 (11.6%), 182 (27.4%) and 406 (61.0%) respectively. Significant differences among robust, pre-frail, and frail subjects were observed in terms of age, serum albumin level, alcohol consumption, smoking, and history of diabetes. Among the nutrition-related indexes, only the dietary variety showed a significant difference. The results of ordinal logistic regression analysis showed a significant association between frailty and sex, age, smoking status, diabetes, and dietary variety score. Dietary variety was significantly associated with the progression of frailty among older persons in the community.

Construct validity of the Enneking score for measuring function in patients with malignant or aggressive benign tumours of the upper limb.

We evaluated the construct validity of the Musculoskeletal Tumour Society rating scale (Enneking score) as a functional measure for patients with sarcoma involving the upper limb. We compared the Enneking score by examining the correlation between two patient-derived outcome measures, the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire and the Medical Outcomes Study Short Form-36 (SF-36) as indicators of functional status in 40 patients with malignant or aggressive benign bone and soft-tissue tumours of the upper limb who had undergone surgical treatment. The frequency distributions were similar among the three scoring systems. As for the validity, Spearman's rank correlation coefficient of the Enneking score to the DASH questionnaire was -0.79 and that of the Enneking to the SF-36 subscales ranged from 0.38 to 0.60. Despite being a measure from the surgeon's perspective, the Enneking score was shown to be a valid indicator of physical disability in patients with malignant or aggressive benign tumours of the upper limb and reflected their opinion.

Relationship between Sensory Perception and Frailty in a Community-Dwelling Elderly Population.

BACKGROUND: Aging anorexia, defined as loss of appetite and/or reduced food intake, has been postulated as a risk factor for frailty. Impairments of taste and smell perception in elderly people can lead to reduced enjoyment of food and contribute to the anorexia of aging. OBJECTIVE: To evaluate the relationship between frailty and taste and smell perception in elderly people living in urban areas. DESIGN: Data from the baseline evaluation of 768 residents aged ≥ 65 years who enrolled in a comprehensive geriatric health examination survey was analyzed. Fourteen out of 29-items of Appetite, Hunger, Sensory Perception questionnaire (AHSP), frailty, age, sex, BMI, chronic conditions and IADL were evaluated. AHSP was analyzed as the total score of 8 taste items (T) and 6 smell items (S). Frailty was diagnosed using a modified Fried's frailty criteria. RESULTS: The area under the receiver operator curves for detection of frailty demonstrated that T (0.715) had moderate accuracy, but S (0.657) had low accuracy. The cutoffs, sensitivity, specificity and Youden Index (YI) values for each perception were T: Cutoff 26.5 (YI: 0.350, sensitivity: 0.639, specificity: 0.711) and S: Cutoff 18.5 (YI: 0.246, sensitivity: 0.690, specificity: 0.556). Results from multiple logistic regression models, after adjusting for age, sex, IADL and chronic conditions showed that participants under the T cutoff were associated with exhaustion and those below the S cutoff were associated with slow walking speed. The adjusted logistic models for age, sex, IADL and chronic conditions showed significant association between T and frailty (OR 2.81, 95% CI 1.29-6.12), but not between S and frailty (OR 1.73, 95% CI 0.83-3.63). CONCLUSIONS: Taste and smell perception, particularly taste perception, were associated with a greater risk of frailty in community-dwelling elderly people. These results suggest that lower taste and smell perception may be an indicator of frailty in old age.

Persistent diffusion abnormalities in the brain stem of three children with mitochondrial diseases.

We report 2 children (patients 1 and 2) with Kearns-Sayre syndrome and 1 (patient 3) with Leigh syndrome, who underwent serial diffusion-weighted MR imaging (DWI) studies for 2.8 (patient 1), 4.2 (patient 2), and 1.0 years (patient 3). The DWI revealed the persistent hyperintense signals in the pontine and mesencephalic tegmenta. The apparent diffusion coefficient in the affected regions remained constantly low, suggesting that cytotoxic edema and spongiform degenerations may compose these brain stem lesions.

A new navigation system based on cephalograms and dental casts for oral and maxillofacial surgery.

Intraoperative navigation systems help surgeons to accurately carry out preoperative plans without injuring anatomically important structures. A system is evaluated that uses cephalograms instead of computed tomographic (CT) scans to create images. Three-dimensional (3D) dental casts provide registration between imaging data and the patient. Cephalograms are widely employed in orthognathic and oral and maxillofacial surgery and expose patients to lower doses of radiation than CT. The system uses a dental cast to register the operation field to a pair of frontal and lateral cephalograms. The cast is transformed to 3D data with a laser scanner and a programme that runs on a personal computer. 3D data describing the dental cast, cephalograms and the oral and maxillofacial region of the patient are integrated with specialized software. The optical tracking system for navigation uses charged-coupled-device (CCD) video cameras and light-emitting diodes (LEDs). Two CCD video cameras follow the 3D coordinates of LED assemblies attached to the head, lower jaw and a handpiece. Errors occurring when a dental cast was transformed to 3D data ranged from 0.08 to 0.21 mm. Mean errors were 0.71 mm (0.21-1.09 mm) for the right maxillary central incisor, 0.62 mm (0.04-1.69 mm) for the right maxillary 2nd molar and 1.02 mm (0.23-1.47 mm) for the left maxillary 2nd molar. This surgical navigation system is sufficiently accurate for use in oral and maxillofacial surgery.

A glial K(+) /Cl(-) cotransporter modifies temperature-evoked dynamics in Caenorhabditis elegans sensory neurons.

K(+) /Cl(-) cotransporters (KCCs) are known to be crucial in the control of neuronal electrochemical Cl(-) gradient. However, the role of these proteins in glial cells remains largely unexplored despite a number of studies showing expression of KCC proteins in glial cells of many species. Here, we show that the Caenorhabditis elegans K(+) /Cl(-) cotransporter KCC-3 is expressed in glial-like cells and regulates the thermosensory behavior through modifying temperature-evoked activity of a thermosensory neuron. Mutations in the kcc-3 gene were isolated from a genetic screen for mutants defective in thermotaxis. KCC-3 is expressed and functions in the amphid sheath glia that ensheathes the AFD neuron, a major thermosensory neuron known to be required for thermotaxis. A genetic analysis indicated that the regulation of the thermosensory behavior by KCC-3 is mediated through AFD, and we further show that KCC-3 in the amphid sheath glia regulates the dynamics of the AFD activity. Our results show a novel mechanism by which the glial KCC-3 protein non-cell autonomously modifies the stimulus-evoked activity of a sensory neuron and highlights the functional importance of glial KCC proteins in modulating the dynamics of a neural circuitry to control an animal behavior.

Serum BDNF levels before and after the development of mood disorders: a case-control study in a population cohort.

Serum levels of brain-derived neurotrophic factor (BDNF) are low in major depressive disorder (MDD), and were recently shown to decrease in chronic depression, but whether this is a trait or state marker of MDD remains unclear. We investigated whether serum BDNF levels decrease before or after the developments of MDD and other mood disorders through a case-control study nested in a cohort of 1276 women aged 75-84 years in 2008. Psychiatrists using the Structured Clinical Interview for DSM-IV identified incident cases of mood disorders at follow-up surveys in 2010 and 2012: 28 of MDDs, 39 of minor depressive disorders (minDDs) and 8 of minor depressive episodes with a history of major depressive episodes (minDEs with MDE history). A total of 106 representative non-depressed controls were also identified in the 2012 follow-up. We assayed BDNF levels in preserved sera of cases and controls at baseline and at follow-up. Serum BDNF levels at baseline in cases of MDD, minDD or minDE with MDE history were no lower than those in controls. The decrease in the serum BDNF level from baseline to follow-up was greater in cases of MDD or minDE with MDE history than in controls or cases of minDD. These results show that serum BDNF levels are not a trait marker of MDD in old women but appeared to be a state marker. The different changes in BDNF levels among diagnostic groups suggest that MDD has a pathophysiologic relation to minDE with MDE history, rather than to minDD.

Evolution of the archaeal rhodopsins: evolution rate changes by gene duplication and functional differentiation.

The amino acid sequences of 25 archaeal retinal proteins from 13 different strains of extreme halophiles were analyzed to establish their molecular phylogenetic relationship. On the basis of amino acid sequence similarity, these proteins apparently formed a distinct family designated as the archaeal rhodopsin family (ARF), which was not related to other known proteins, including G protein-coupled receptors. The archaeal rhodopsin family was further divided into four clusters with different functions; H+ pump (bacteriorhodopsin), Cl- pump (halorhodopsin), and two kinds of sensor (sensory rhodopsin and phoborhodopsin). These four rhodopsin clusters seemed to have occurred by gene duplication(s) before the generic speciation of halophilic archaea, based on phylogenetic analysis. Therefore, the degrees of differences in amino acid sequences within each cluster simply reflected the divergent evolution of halophilic archaea. By comparing the branch lengths after speciation points of the reconstituted tree, we calculated the relative evolution rates of the four archaeal rhodopsins bacteriorhodopsin:halorhodopsin:sensory rhodopsin: phoborhodopsin to be 5:4:3:10. From these values, the degrees of functional and structural restriction of each protein can be inferred. The branching topology of four clusters grouped bacteriorhodopsin and halorhodopsin versus sensory rhodopsin and phoborhodopsin by likelihood mapping. Using bacteriorhodopsin (and halorhodopsin) as an outgroup, the gene duplication point of sensory rhodopsin/phoborhodopsin was determined. By calculating the branch lengths between the gene duplication point and each halophilic archaea speciation point, we could speculate upon the relative evolution rate of pre-sensory rhodopsin and pre-phoborhodopsin. The evolution rate of pre-sensory rhodopsin was fivefold faster than that of pre-phoborhodopsin, which suggests that the original function of the ancestral sensor was similar to that of phoborhodopsin, and that sensory rhodopsin evolved from pre-sensory rhodopsin by the accumulation of mutations. The changes in evolution rate by gene duplication and functional differentiation were demonstrated in the archaeal rhodopsin family using the gene duplication date and halobacterial speciation date as common time stamps.