Differences in time-intensity sensory profiles of sweet taste intensity of glucose between older and young adults.

Background: To understand age-related changes in sweet taste perception in daily life, it is important to understand taste intensity at the suprathreshold level. Previous studies have attempted to characterize the temporal aspects of human taste perception in terms of time-intensity evaluations. The perception of dynamic taste intensity in older adults increases slowly for salty taste; however, there have been no previous studies on time-intensity sensory evaluation of sweet taste in older adults. We hypothesized that older adults perceive sweet taste intensity more slowly than young adults. Methods: Fifty young and 40 older adults participated in the study and glucose solutions of 0.6 M and 1.5 M were used as stimuli. The study comprised two experiments: (1) a cup tasting test (static taste perception in the mouth), and (2) a time-intensity sensory evaluation, in which the solutions were presented using a custom-made delivery system. The intra-oral device was made to fit each participant's dentition. Further, the level of gag reflex was taken into consideration for each participant in the design of the intra-oral device. A suction tube was placed across the posterior tongue near the throat to remove solution and saliva. The solution delivery system was controlled by an original computer program. Results: Older adults presented significantly different maximum intensity timing and slope for both concentrations compared with young adults (slope for 1.5 M, p < 0.01; others, p < 0.05). No significant differences were found between the older and young adults for reaction timing and maximum intensity. Conclusion: We conclude that older adults perceived sweetness more slowly than young adults, and ultimately perceived almost the same intensity as young adults. This is the first reported characterization of the time-intensity profile of sweet taste intensity of glucose in older adults. Using a standardized system enabled us to assess and compare feedback on taste intensities among different age groups in real-time. Based on this, we recommend older adults "savor" to perceive sweet tastes at the same level experienced by young adults.

Dentigerous cysts suspected the other odontogenic lesions on panoramic radiography and CT.

Dentigerous cysts are known as the second most common type of cyst in the jaws. The cyst is one of the lesions occurred frequently in the posterior body of the mandible and is often related to the unerupted third molar and forms around the crown of the unerupted tooth attaching at the cementoenamel junction. Such characteristic appearances are the diagnostic points differentiating from ameloblastoma or odontogenic keratocyst. However, it would be hard for us to diagnose it as a dentigerous cyst if the lesion does not show its typical appearance. We experienced two cases of dentigerous cysts which did not form around the crown of the unerupted tooth on radiologically. Both cysts were relatively large and resorbed adjacent teeth roots. Therefore, an ameloblastoma or an odontogenic keratocyst was suspected rather than a dentigerous cyst as the imaging diagnosis. The biopsy revealed that the lesion was a "dentigerous cyst" in one of the cases and "developmental cyst with inflammation" in another case. After the excision, the histopathological diagnosis was a dentigerous cyst with inflammation in both cases. This report shows the two cases of dentigerous cysts focusing on panoramic radiography and CT images. Also, we discuss the differential diagnosis by reconsidering those diagnostic points.

Reliability and validity of the Japanese version of the Chemotherapy-induced Alopecia Distress Scale.

BACKGROUND: The Chemotherapy-induced Alopecia Distress Scale (CADS) is a patient-reported outcome measure for assessing distress associated with Chemotherapy-induced alopecia (CIA). This study aimed to confirm the psychometric validity of the Japanese version of the CADS (CADS-J). METHODS: A total of 132 patients with breast cancer who developed CIA were asked to complete the CADS-J twice at 2 week intervals to confirm test-retest reliability. The body image domain of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ) breast cancer-specific module, the self-esteem scale from the Rosenberg Self-Esteem Scale, and the emotional domain of the EORTC QLQ Core 30 were used to confirm the convergent validity of the CADS-J. The overall quality of life and physical domains of the EORTC QLQ Core 30 were used to confirm the discriminant validity of the CADS-J. RESULTS: In total, 125 participants provided valid responses. The mean age was 52.2 years. The overall Cronbach's alpha for the CADS-J was 0.903. The intraclass correlation coefficients of the first and second responses were r = 0.874, r = 0.952, r = 0.911, and r = 0.959 for the physical domain, emotional domain, activity domain, and relationship domain, respectively. In terms of convergent validity, the total CADS-J score was moderately correlated with body image (r = - 0.63), self-esteem (r = - 0.48), and the emotional domain (r = - 0.61). Regarding discriminant validity, the total CADS-J score was weakly correlated with the overall quality of life (r = - 0.34) and physical domain (r = - 0.24). CONCLUSIONS: The CADS-J is psychometrically reliable and valid for evaluating the distress caused by CIA. It is expected to be used in daily practice and as an endpoint in various studies.

Subjective evaluations of self and others' driving behaviors: A comparative study involving data from drivers in Japan, China, and Vietnam.

INTRODUCTION: This study explored the influence of personal attributes on subjectively-reported aggressive driving behaviors, with an emphasis on the inter-influences between subjectively-reported aggressive driving behaviors between self and other individuals. To determine this, a survey was conducted comprising participants' socio-demographic data, information on their history with automotive accidents, and subjective scales to report on the driving behaviors between self and others. More specifically, a four-factor shortened version of the Manchester Driver Behavior Questionnaire was used to collect data on the aberrant driving behaviors of "self" and "others." METHOD: Participants were recruited from three countries, namely, Japan (1,250 responses), China (1,250), and Vietnam (1,000). This study only considered the "aggressive violations' factor," which was referred to as self-aggressive driving behaviors (SADB) and others' aggressive driving behaviors (OADB). After collecting the data, univariate and bivariate multiple regression models were employed to better understand the response patterns from both scales. RESULTS: This study found that accident experience had the strongest influence on the reporting of aggressive driving behaviors (followed by education level). However, variation in countries was also found between both the rate of engagement in aggressive driving behavior and its recognition. In this study, highly educated Japanese drivers tended to evaluate others as safe, whereas highly educated Chinese drivers tended to evaluate others as aggressive. This discrepancy can likely be attributed to cultural norms and values. Meanwhile, evaluations from Vietnamese drivers seemed to differ depending on whether they drove cars or bikes, with additional influences as a result of the driving frequency. Furthermore, this study found that it was most difficult to explain the driving behaviors on the "other" scale reported by Japanese drivers. PRACTICAL APPLICATIONS: These findings can aid policymakers and planners to develop road safety measures that reflect the behaviors of drivers in their respective countries.

Synthesis and Characterization of Hypervalent Pentacoordinate Carbon Compounds Bearing a 7-6-7-Ring Skeleton.

To stabilize SN 2 transition state-like penta-coordinate carbon species, triaryl-substituted cationic carbon compounds bearing a moderately flexible 7-6-7-ring skeleton with sulfur donors were synthesized and characterized. Electronic effects of para substituents (R=Cl, F, H, CH3 , SMe, OMe) of the two equatorial aryl groups bound to the cationic central carbon were investigated systematically along with a planar bidentate thioxanthene derivative. X-ray analysis on their solid-state structures showed that the parent (R=H), chloro-, fluoro- and methyl-derivatives were tetracoordinate carbon (sulfonium) structures, while the p-MeO and thioxanthenyl system were pentacoordinate carbocation structures. The Hammett substituent constants for the para substituents (σp + ) correlates well with the bonding in these compounds. The methylthio-derivative with intermediate Hammett substituent constants (p-MeS; σp + =-0.60) showed a tetracooridnate solid-state structure, though solution UV-Vis properties suggested the presence of a penta-coordinate structure. These findings amount to the first unambiguous solution evidence of the hypervalent apical 3c-4e interactions in pentacoordinate carbon compounds.

Do neurocognitive impairments explain the differences between brain tumor patients and their proxies when assessing the patient's IADL?

Background: Neurocognitive impairments are common among brain tumor patients, and may impact patients' awareness of performance in instrumental activities in daily life (IADL). We examined differences between patient- and proxy-reported assessments of the patient's IADL, and whether the level of (dis)agreement is associated with neurocognitive impairments. Methods: Brain tumor patients and their proxies completed the phase 3 version of the EORTC IADL-BN32 questionnaire measuring IADL, and patients completed six neurocognitive measures. Patient-proxy difference scores in IADL were compared between patients who were defined as neurocognitively impaired (≥2 neurocognitive measures ≥2.0 standard deviations below healthy controls) and non-neurocognitively impaired. With multinomial logistic regression analyses we examined if neurocognitive variables were independently associated with patient-proxy disagreement in IADL ratings. Results: Patients (n = 81) did not systematically (P < .01) rate IADL outcomes different than their proxies. Proxies did report more problems on 19/32 individual items and all five scales. This effect was more apparent in dyads with a neurocognitively impaired patient (n = 37), compared to dyads with non-neurocognitively impaired patients (n = 44). Multinomial logistic regression analyses showed that several neurocognitive variables (e.g., cognitive flexibility and verbal fluency) were independently associated with disagreement between patients and proxies on different scales. Conclusion: Neurocognitive deficits seem to play a role in the discrepancies between brain tumor patients and their proxies assessment of patient's level of IADL. Although replication of our results is needed, our findings suggests that caution is warranted in interpreting self-reported IADL by patients with neurocognitive impairment, and that such self-reports should be supplemented with proxy ratings.

Differences in dynamic perception of salty taste intensity between young and older adults.

In super-aged societies, high salt intake substantially increases the risk of stroke and cardiovascular disease. Perceived low salty taste often prompts the addition of table salt to food. However, it remains unclear how older adults perceive the nature and intensity of salty taste in the mouth and brain. We compared the perceptions of salty taste intensities of older adults with those of young adults. Participants were 74 healthy adults: 31 older (age, 60-81 years [65.0 ± 5.5 SD]) and 43 young (age, 21-39 years [25.0 ± 3.6 SD]). Our research project comprises three sequential experiments. This article reports on the first two, which were (1) static and (2) dynamic sensory evaluations of taste perceptions in the mouth. Participants assessed the taste of 0.3 M and 0.5 M sodium chloride solutions in two types of sensory evaluations: (1) a cup tasting test, in which they sipped the solution from cups, spat it out, and rated static salty taste intensity, and (2) a time-intensity sensory evaluation, in which the solutions were delivered to participants' tongues through a custom-made delivery system while they recorded dynamic taste intensities on a hand-held meter. Older adults perceived significantly lower taste intensities than young adults (p = 0.004 and p < 0.001 for 0.3 M and 0.5 M, respectively). Reaction timings for both solutions did not differ, but the slopes for both concentrations were significantly lower for older adults than for young adults (p < 0.001). Using a standardized system allowed us to evaluate and directly compare real-time feedback on taste intensities according to age. This study is the first to characterize the time-intensity profiles of salty taste intensity in older adults. Our findings show that older adults do not take longer to recognize a salty taste, but their perception of taste intensity slowly increases, and yet remains lower than that of young adults. This suggests that older adults should be aware of the tendency to add more salt to their food to compensate for their low perceptions of salty taste. We would like to suggest them to savor and chew sufficiently during eating to optimize the perceived salty taste. Furthermore, our results offer a reference for ordinary citizens' taste-intensity perceptions; our standardized system could be usefully integrated into clinical follow-up examinations and treatments.

Predictive factors for tooth loss in older adults vary according to occlusal support: A 6-year longitudinal survey from the SONIC study.

OBJECTIVES: The aim of this cohort study among community-dwelling older adults aged over 70 years was to investigate the influence of occlusal support on tooth loss, and to determine predictive factors for tooth loss for each occlusal support category using multilevel analyses. METHODS: Participants were 812 older adults who completed the baseline survey and the follow-up survey 6 years later. The Eichner index was used to evaluate occlusal support status. A generalized estimating equation (GEE) logistic regression analysis was used to examine the influence of occlusal support status on tooth loss while adjusting for various factors at individual and tooth levels. Similar analyses were separately performed in each Eichner class to determine predictive factors for tooth loss. RESULTS: The GEE showed that a decline in occlusal support increased the risk of tooth loss (Eichner A: reference category, Eichner B: odds ratio (OR) = 1.96, p < 0.001, Eichner C: OR = 3.04, p < 0.001). Stratified analysis showed that deeper periodontal pockets and abutment teeth for fixed partial dentures were significantly associated with tooth loss, regardless of occlusal support. In Eichner A, the presence of an opposing tooth was advantageous in protecting the tooth, and a missing adjacent tooth was not significantly associated with tooth loss. An opposing tooth was associated with the risk of tooth loss in Eichner B, and a missing adjacent tooth was significantly associated with tooth loss in Eichner B and C. CONCLUSIONS: A decline in occlusal support accelerated tooth loss. Predictive factors for tooth loss varied depending on occlusal support status. CLINICAL SIGNIFICANCE: Occlusal support is an important factor in preventing tooth loss. Dentition conditions such as missing adjacent teeth and the presence of opposing teeth increase the risk of tooth loss in participants with poor occlusal support. Dental personnel need to carefully examine dentition conditions to assess the risk of occlusal collapse.

Structure Dependence in Asymmetric Deprotonative Fluorination and Fluorocyclization Reactions of Allylamine Derivatives with Linked Binaphthyl Dicarboxylate Phase-Transfer Catalyst.

The asymmetric fluorofunctionalization of γ,γ-disubstituted allylamine derivatives (e.g., 3, 7, and 8) was investigated using our dianionic phase-transfer catalyst. Depending on the substituents on the alkene moiety, the reaction afforded chiral allylic fluorides and fluorinated dihydrooxazines in a highly enantioselective manner (up to 99% ee). The absolute stereochemistry of these products was found to be opposite to that in our previously reported fluorocyclization of γ-monosubstituted allylic amides (e.g., 13 and 14). To probe this interesting phenomenon, we investigated the influence of the substitution pattern of the alkene moiety on the reaction by means of NMR experiments and kinetic studies. The rate laws of the deprotonative fluorination and the fluorocyclization of γ,γ-disubstituted substrates were v = k[cat]0.6, while that of the fluorocyclization of γ-monosubstituted substrates was v = k[substrate][cat]0.4. An exponent of less than 1 suggests the involvement of an aggregated state of the catalyst ion pair in the catalytic cycle. Interestingly, a positive nonlinear effect was observed in the reactions of the γ,γ-disubstituted substrates, while a negative nonlinear effect was observed in the case of the γ-monosubstituted substrates. Thus, the reaction pathway depends on the presence or absence of an alkyl substituent at the γ position of the substrates, and on the basis of our mechanistic studies we propose that the active catalytic species for γ,γ-disubstituted substrates is a catalyst ion pair aggregate, whereas that for γ-monosubstituted substrates is the more active monomeric catalyst ion pair species, even though its concentration would be low.

Periodontal inflamed surface area is associated with hs-CRP in septuagenarian Japanese adults in cross-sectional findings from the SONIC study.

Periodontal disease is a chronic inflammatory condition that affects various peripheral organs. The periodontal inflamed surface area (PISA) quantifies periodontitis severity and the spread of inflammatory wounds. This study aimed to investigate the association between PISA and high-sensitivity C-reactive protein (hs-CRP), a systemic inflammation marker. This study included 250 community-dwelling septuagenarians (69-71 years). We collected information on their medical (e.g., diabetes and dyslipidemia) and dental examinations (e.g., measurement of the probing pocket depth). Generalized linear model analysis was used to explore the association between PISA and hs-CRP levels. There was a significant difference in hs-CRP levels between groups with PISA ≥ 500 and < 500 (p = 0.017). Moreover, the generalized linear model analysis revealed a significant association between PISA and hs-CRP levels (risk ratio = 1.77; p = 0.033) even after adjusting other factors. Further, we found a correlation between PISA and hs-CRP (Spearman's rank correlation coefficient, rs = 0.181; p = 0.023). Our findings suggest that PISA is an effective index for estimating the effect of periodontitis on the whole body, enabling medical-dental cooperation.

Neutrophil Extracellular Traps Promote the Development of Intracranial Aneurysm Rupture.

[Figure: see text].

Impact of occlusal force on decline in body mass index among older Japanese adults: Finding from the SONIC study.

OBJECTIVES: To determine any independent influence of occlusal force and of number of natural teeth on decline in body mass index (BMI) among older Japanese adults. DESIGN: Longitudinal study over a 3- to 6-year period. SETTING: Urban and rural area in Japan. PARTICIPANTS: Independently living Japanese adults aged 69-71 years and 79-81 years at baseline. This analysis excluded participants who were defined as underweight at baseline. MEASUREMENTS: Information was collected on age, gender, occlusal force, the number of teeth, BMI, socioeconomic factors, medical history, the number of daily prescription medications, cognitive function, depressive symptoms, hand grip strength, and physical function. Maximal occlusal force was measured with a pressure-sensitive sheet. Nutritional status was assessed using BMI, and participants with BMI <21.5 were defined as underweight. Then, they were divided into two groups: a "BMI declined" group who were defined as underweight at either 3- or 6-year follow-up survey, and a "BMI maintained" group who were not defined as underweight at both follow-up surveys. Logistic generalized estimating equation (GEE) models were used to assess the effect of occlusal force and the number of teeth at baseline on decline in BMI over 3 or 6 years, after adjusting for possible covariates associated with nutritional status. RESULTS: The final analysis included 704 participants. Eighty-six (12.2%) participants were classified into the BMI declined group. Logistic GEE models showed that the number of teeth was not significantly associated with decline in BMI. However, occlusal force was significantly associated with decline in BMI (odds ratio = 0.90, 95% confidence interval = 0.83-0.97) after adjusting for covariates. CONCLUSION: Participants with lower occlusal force were more likely to be in the BMI less than 21.5 kg/m2 . The findings suggest that to prevent decline in oral function is important to maintain nutritional status.

Development of an EORTC questionnaire measuring instrumental activities of daily living (IADL) in patients with brain tumours: phase I-III.

PURPOSE: Being able to function independently in society is an important aspect of quality of life. This ability goes beyond self-care, requires higher order cognitive functioning, and is typically measured with instrumental activities of daily living (IADL) questionnaires. Cognitive deficits are frequently observed in brain tumour patients, however, IADL is almost never assessed because no valid and reliable IADL measure is available for this patient group. Therefore, this measure is currently being developed. METHODS: This international multicentre study followed European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group module development guidelines. Three out of four phases are completed: phases (I) generation of items, (II) construction of the item list, and (III) pre-testing. This paper reports the item selection procedures and preliminary psychometric properties of the questionnaire. Brain tumour patients (gliomas and brain metastases), their informal caregivers, and health care professionals (HCPs) were included. RESULTS: Phase I (n = 44 patient-proxy dyads and 26 HCPs) generated 59 relevant and important activities. In phase II, the activities were converted into items. In phase III (n = 85 dyads), the 59 items were pre-tested. Item selection procedures resulted in 32 items. Exploratory factor analysis revealed a preliminary dimensional structure consisting of five scales with acceptable to excellent internal consistency (α = 0.73-0.94) and two single items. For three scales, patients with cognitive impairments had significantly more IADL problems than patients without impairments. CONCLUSION: A phase IV validation study is needed to confirm the psychometric properties of the EORTC IADL-BN32 questionnaire in a larger international sample.

Will implants with a fixed dental prosthesis in the molar region enhance the longevity of teeth adjacent to distal free-end edentulous spaces?

OBJECTIVES: Clinical evidence demonstrating the effectiveness of implants in preventing tooth loss is limited because of the many risk factors involved in tooth loss. This retrospective cohort study investigated whether an implant in the molar region of a distal free-end edentulous space affects the loss of the most distal tooth after 6 years, adjusting for other risk factors associated with tooth loss using propensity score matching analysis. MATERIAL AND METHODS: A total of 571 subjects and 1,085 teeth adjacent to a distal free-end edentulous space were evaluated. At baseline, the 1,085 teeth were divided into two groups according to the presence or absence of a molar implant with a fixed dental prosthesis in the distal free-end edentulous space. Propensity score matching analysis was used to reduce the effects of bias by matching teeth with and without implants according to similar background factors at baseline. The adjusted variables were age group, occlusal support status, Kennedy classification, tooth position, tooth type, restoration status, dental caries, periodontal pocket depth, and condition of the opposing tooth. RESULTS: A total of 56 teeth (28 associated with a molar implant; 28 with no implant) were enrolled according to propensity score matching. Fisher's exact test showed that a molar implant significantly protected the tooth adjacent to the distal free-end edentulous space (p = .01). CONCLUSIONS: Within the limitations of this retrospective cohort study, it was found that implants in free-end edentulous spaces may be beneficial in extending the longevity of adjacent teeth. Further research will be necessary to confirm this finding.

Influence of personality traits on aberrant driving behaviors: A comparison of Japanese, Chinese, and Vietnamese drivers.

INTRODUCTION: This study aims to explore the influence of Big Five personality traits in combination with various socio-demographic factors and experiences of accident involvement on aberrant driving behaviors. The study also compares the effects of the level of development (i.e., developed or developing) of three countries on the personality traits and driving behaviors. METHOD: The four-factor Driver Behavior Questionnaire was used to collect data on aberrant driving behaviors, while a short version of the 10-item Big Five Inventory was used to collect data on personality traits. Responses were collected from Japan (1,250 responses), China (1,250), and Vietnam (1,000). A latent variable model was applied after controlling data in each category (e.g., age). RESULTS: This study revealed that respondents who experienced accidents in the past and scored higher on Agreeableness were less likely to commit aggressive violations in Japan, China, and Vietnam. Further, Japanese and Vietnamese female drivers who scored high on Conscientiousness were found to be less likely to commit ordinary violations. Neuroticism was positively correlated with aggressive violations only in the case of Vietnamese drivers, irrespective of the history of accident involvement. CONCLUSIONS: Drivers with particular personality types that are linked with aberrant driving behavior may need to receive additional training on behavior management. Practical Applications: This study may help road traffic policymakers predict future driving behaviors of Vietnamese and Chinese drivers based on those of Chinese and Japanese drivers, respectively, and act accordingly.

Occlusal support predicts tooth loss in older Japanese people.

OBJECTIVES: Many older people lose their teeth. However, few studies have examined whether the number of remaining teeth or the amount of occlusal support is more important for tooth loss that occurs in older age after adjusting for systemic factors. The purpose of this study was to investigate comprehensively the factors related to tooth loss over a period of 6 years, including occlusal support in 70- and 80-year-old community-dwelling Japanese people. METHODS: This cohort study included 296 participants in the 70-year-old group and 232 in the 80-year-old group. The number of teeth of all participants was recorded at baseline and after 6 years, and the participants were divided into two groups according to the number of teeth lost (0 or 4 or more). Occlusal support was classified into three groups based on posterior occlusal support. Mean probing pocket depth, tooth brushing habits, frequency of dental check-ups, education level, economic status and systemic factors (carotid atherosclerosis, hypertension, diabetes mellitus, dyslipidemia, cognitive function and smoking habits) were evaluated. Multiple logistic regression analysis was performed to investigate the relationship of tooth loss with occlusal support and systemic factors. RESULTS: Logistic regression analysis revealed that mean probing pocket depth (odds ratio [OR] = 5.70, 95% confidence interval [CI] = 2.70-12.04, P < .01) and posterior occlusal support (reference = Eichner class A; Eichner B1-3, OR = 4.33, 95% CI = 1.54-12.17, P < .01; Eichner B4 or C, OR = 6.16, 95% CI = 1.17-32.44, P = .03) were associated significantly with the loss of four or more teeth. CONCLUSIONS: This study revealed that age itself is not a predictor of multiple tooth loss in community-dwelling older Japanese people. Deep mean probing pocket depth and a lack of posterior occlusal support were significantly associated with the loss of four or more teeth.

Determinants of Improvement of Mid-term Ejection Fraction in Patients with Acute Myocardial Infarction.

Persistent severe left ventricular (LV) systolic dysfunction after acute myocardial infarction (AMI) is associated with increased morbidity and mortality, whereas mid-term recovery of LV systolic function after AMI is associated with better long-term outcomes. The purpose of this study was to investigate the determinants of mid-term improvement of LV ejection fraction (EF) in AMI patients. We included 210 AMI patients who had modified Simpson EF both at the index admission and mid-term follow up. The difference of EF between the index admission and mid-term follow-up was calculated in all study patients. The EF improvement group was defined as mid-term ≥ 10% EF increase compared with the index admission EF. Of 210 AMI patients, 46 (21.9%) were allocated to the EF improvement group and 164 (78.1%) to the non-EF improvement group. Brain natriuretic peptide (BNP) at the timing of admission was significantly greater in the EF improvement group (735.8 ± 1077.6 pg/mL) than in the non-EF improvement group (239.0 ± 419.8 pg/mL) (P < 0.001). Multivariate logistic regression analysis revealed that log10 BNP at the timing of admission (OR 3.36, 95% CI 1.69-6.66, P < 0.001) and left main trunk-left anterior descending artery (LM-LAD) as the infarct-related artery (OR 3.34, 95% CI 1.59-7.02, P = 0.001) were significantly associated with EF improvement. In conclusion, elevated BNP at the timing of admission and LM-LAD as the infarct-related artery were significantly associated with mid-term LVEF recovery. Our results support aggressive acute treatment for those severe AMI, because the possibility of mid-term LVEF recovery is greater compared with other AMI.

Suppression of IgE-Independent Degranulation of Murine Connective Tissue-Type Mast Cells by Dexamethasone.

Steroidal anti-inflammatory drugs are widely used for the treatment of chronic cutaneous inflammation, such as atopic dermatitis, although it remains unknown how they modulate cutaneous mast cell functions. We investigated the effects of prolonged treatment with a synthetic glucocorticoid, dexamethasone, on murine connective tissue-type mast cells using in vitro and in vivo models. Our connective tissue-type bone marrow-derived cultured mast cell model was found to be sensitive to mast cell secretagogues, such as compound 48/80 and substance P, and higher expression levels of α subunit of a trimeric G protein, Gi1, and several Mas-related G protein-coupled receptor (Mrgpr) subtypes were observed in comparison with immature cultured mast cells. Secretagogue-induced degranulation and up-regulation of these genes was suppressed when cultured in the presence of dexamethasone. The profiles of granule constituents were drastically altered by dexamethasone. Topical application of dexamethasone down-modulated secretagogue-induced degranulation and the expression levels of several Mrgpr subtypes in cutaneous tissue. These results suggest that mast cell-mediated IgE-independent cutaneous inflammation could be suppressed by steroidal anti-inflammatory drugs through the down-regulation of G αi1 and several Mrgpr subtypes in mast cells.

A headache-free reversible cerebral vasoconstriction syndrome (RCVS) with symptomatic brain stem ischemia at late pregnancy as a rare manifestation of RCVS resolved with termination of pregnancy by semi-urgent cesarean section.

A 32-year-old pregnant woman in her 39th week of pregnancy presented at the emergency room complaining of sudden-onset dizziness with gaze disturbance and was admitted to our hospital. Her past medical history included hypertension, diabetes mellitus and infarction in the right medulla oblongata 18 months prior to this event. Magnetic resonance (MR) angiography showed multiple irregular stenosis of the intracranial arterial system. Although MR images revealed no fresh ischemic or hemorrhagic lesions, she was diagnosed with reversible cerebral vasoconstriction syndrome (RVCS) associated with pregnancy. Cesarean section immediately resolved the headache-free ischemic RCVS. The postpartum course of the patient was uneventful as well as that of her baby. Follow-up MR angiography showed improvement of intracranial vasoconstriction and follow-up MR imaging showed improvement of a left medial pontine ischemic lesion on diffusion-weighted image. This report describes a rare manifestation of pregnancy-related RCVS.

Asymmetric Fluorination of Cyclic Tetrasubstituted Alkenes with a Pendant Amide Groups under Dianionic Phase-Transfer Catalysis.

Asymmetric fluorination of cyclic tetrasubstituted alkenes with a pendant amide group was investigated under dianionic phase-transfer catalysis. Fluorination proceeded with high face selectivity, affording the corresponding allylic fluorides with a chiral tetrasubstituted carbon center with up to 97% enantiomeric excess (ee). It should be noted that deprotonative fluorination occurred mainly in preference to intramolecular nucleophilic attack of the amide group.