Sandglass-Typed Single Chameleon Luminophore for Water Mapping Measurements: Intramolecular Energy Migrations in the Hydrophilic Tb(III)/Sm(III) Cluster.

Novel hydrophilic and color-changeable single chameleon luminophores composed of Tb(III)/Sm(III) nona-nuclear clusters [TbxSm9-x(Sal-PEG-n)16(µ-OH)10]+(NO3)- (x = 1, 2, 3, and 9; Sal-PEG-n: salicylate polyethylene glycolmethylester, n = 2 and 4) are reported for water mapping measurements. Their characteristic sandglass structures and aggregates were analyzed using X-ray single crystal analysis and dynamic light scattering (DLS) measurements. The green- and yellow-luminescence of [Tb3Sm6(Sal-PEG-4)16(µ-OH)]+(NO3)- in water were observed at 20 and 50 °C, respectively. The ratio-metric luminescence analysis using green Tb(III) and orange Sm(III) emission bands is a promising candidate for exact temperature distribution measurements in fluid dynamics. The effective temperature-sensing property based on the competitive intramolecular energy transfer processes between Tb(III)-to-ligand and Tb(III)-to-Sm(III) in a non-a-nuclear cluster is explained using temperature-dependent kinetic analyses in the excited state.

Comparison of Serum Metabolomics Pathways and Patterns between Patients with Major Depressive Disorder with and without Type 2 Diabetes Mellitus: An Exploratory Study.

BACKGROUND: A close relationship exists between major depressive disorder (MDD) and diabetes mellitus. The metabolomic difference and similarity between patients with and without diabetes mellitus have not been well studied in the context of MDD. We aimed to examine these differences and common serum metabolomics patterns, pathways and biomarkers that can comprehensively reflect the pathogenetic difference and similarity between these MDD groups. METHODS: We performed a metabolomics analysis of serum samples of healthy controls (n = 6), patients with MDD and type 2 diabetes mellitus (n = 13), and patients with MDD without type 2 diabetes mellitus (n = 27). Metabolomics analysis was conducted using capillary electrophoresis Fourier transform mass spectrometry and a candidate compound was assigned to the 496 (290 cation, 206 anion) peaks. Moreover, we evaluated the sensitivity and specificity of the candidate biomarkers for distinguishing between MDD patients with or without type 2 diabetes mellitus. RESULTS: Principal component analysis revealed no clear distinction among the three groups, while naive partial least squares discriminant analysis yielded three relatively good and distinct populations based on the first principal component. Energy conversion by the tricarboxylic acid cycle represented the highest percentage among the top 30 positive factors of the first principal component, and glutamate metabolism and urea cycle represented the highest percentage among the top 30 negative factors of the first principal component. Synthesis and degradation of ketone bodies had high impact in MDD with type 2 diabetes mellitus group and taurine and hypotaurine metabolism had high impact in MDD without type 2 diabetes mellitus group for the pathway. CONCLUSIONS: Patterns of serum metabolites may be different among MDD with type 2 diabetes mellitus, MDD without type 2 diabetes mellitus, and healthy controls groups. Specifically, comorbid type 2 diabetes mellitus could affect metabolomics pathway and alter the distribution of serum metabolites in patients with MDD. These findings may shed light on the influence of the type 2 diabetes on the pathophysiology of MDD.

Elastic Polymer Coated Nanoparticles with Fast Clearance for 19 F†MR Imaging.

19 F magnetic resonance imaging (MRI) is a powerful molecular imaging technique that enables high-resolution imaging of deep tissues without background signal interference. However, the use of nanoparticles (NPs) as 19 F MRI probes has been limited by the immediate trapping and accumulation of stiff NPs, typically of around 100 nm in size, in the mononuclear phagocyte system, particularly in the liver. To address this issue, elastic nanomaterials have emerged as promising candidates for improving delivery efficacy in vivo. Nevertheless, the impact of elasticity on NP elimination has remained unclear due to the lack of suitable probes for real-time and long-term monitoring. In this study, we present the development of perfluorocarbon-encapsulated polymer NPs as a novel 19 F MRI contrast agent, with the aim of suppressing long-term accumulation. The polymer NPs have high elasticity and exhibit robust sensitivity in 19 F MRI imaging. Importantly, our 19 F MRI data demonstrate a gradual decline in the signal intensity of the polymer NPs after administration, which contrasts starkly with the behavior observed for stiff silica NPs. This innovative polymer-coated NP system represents a groundbreaking nanomaterial that successfully overcomes the challenges associated with long-term accumulation, while enabling tracking of biodistribution over extended periods.

Major depression with musical obsession treated with vortioxetine: a case report.

BACKGROUND: Musical obsession has been reported as the "stuck song syndrome" and can be accompanied by obsessive compulsive disorder (OCD). Musical obsession is the phenomenon where a particular set of known musical notes are perceived repeatedly. We present a case of major depression with musical obsession. In this case, vortioxetine improved both depressive symptoms and musical obsession. CASE PRESENTATION: A female, 34-year-old, high school teacher presented with a depressed mood, anergia, difficulty in concentration, poor motivation, restlessness, anxiety, insomnia, and loss of appetite. She was diagnosed with major depression by her family physician and prescribed escitalopram (20 mg/day). Her depressive state partially responded to escitalopram. When she had been depressed, she also experienced musical obsessions as repetitive commercial tunes or instrumental notes inside her head that were not under conscious voluntary control and lasting several hours, causing a high level of distress in her daily life. After switching from escitalopram to vortioxetine (20 mg/day), her depressive symptoms and musical obsession symptoms were ameliorated. CONCLUSIONS: This case report endorses the utility of vortioxetine for major depression with musical obsession, and further studies should be conducted to establish the optimal treatment.

Head elevation and lateral head rotation effect on facemask ventilation efficiency: Randomized crossover trials.

PURPOSE: We performed two prospective randomized crossover trials to evaluate the effect of head elevation or lateral head rotation to facemask ventilation volume. METHODS: In the first trial, facemask ventilation was performed with a 12-cm high pillow (HP) and 4-cm low pillow (LP) in 20 female patients who were scheduled to undergo general anesthesia. In the second trial, facemask ventilation was performed with and without lateral head rotation in another 20 female patients. Ventilation volume was measured in a pressure-controlled ventilation (PCV) manner at 10, 15, and 20 cmH2O inspiratory pressures. RESULTS: In the first trial evaluating head elevation effect, facemask ventilation volume was significantly higher with a HP than with a LP at 15 and 20 cmH2O inspiratory pressure (15 cmH2O: HP median540 [IQR480-605] mL, LP 460 [400-520] mL, P=0.006, 20 cmH2O: HP 705 [650-800] mL, LP 560 [520-677] mL, P<0.001). In the second trial, lateral head rotation did not significantly increase facemask ventilation volume at all inspiratory pressure. CONCLUSION: Head elevation increased facemask ventilation volume in normal airway patients, while lateral head rotation did not.

Blood Biomarkers Predict the Cognitive Effects of Aripiprazole in Patients with Acute Schizophrenia.

Aripiprazole has been reported to exert variable effects on cognitive function in patients with schizophrenia. Therefore, in the present study, we evaluated biological markers, clinical data, and psychiatric symptoms in order to identify factors that influence cognitive function in patients with schizophrenia undergoing aripiprazole treatment. We evaluated cognitive function in 51 patients with schizophrenia using Brief Assessment of Cognition in Schizophrenia (BACS), as well as background information, psychiatric symptoms, plasma catecholamine metabolites-homovanillic acid (HVA), 3-methoxy-4-hydroxyphenylglycol (MHPG)-, and serum brain-derived neurotrophic factor (BDNF). Multivariate analyses were performed in order to identify factors independently associated with cognitive function. Brain-derived neurotrophic factor levels, number of hospitalizations, and MHPG levels were associated with verbal memory and learning. Total hospitalization period and MHPG levels were associated with working memory. Age at first hospitalization and education were associated with motor speed. The number of hospital admissions, Positive and Negative Syndrome Scale negative subscale scores (PANSS-N), MHPG levels, BDNF levels, and Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS) scores were associated with verbal fluency. Homovanillic acid and MHPG levels, duration of illness, and PANSS-N scores were associated with attention and processing speed. Brain-derived neurotrophic factor and MHPG levels were associated with executive function. These results suggest that treatment of psychiatric symptoms and cognitive dysfunction may be improved in patients treated with aripiprazole by controlling for these contributing factors.

[Cesarean Section under General Anesthesia in a Pregnant Woman with Fibromyalgia].

We report a case of a 34-year-old pregnant woman with fibromyalgia (FM) who underwent cesarean sec- tion under general anesthesia. The patient was taking duloxetine and pregabalin for FM, as well as several anti-depressants due to severe depression. To avoid the exacerbation of FM by spinal anesthesia, we decided to perform cesarean section under general anesthesia. After a crash induction with propofol and rocuronium, tracheal intubation was performed using the Pentax- AWS Airwayscopeo. The procedure was completed uneventfully. Postoperatively, the patient received an ultrasound-guided transverse abdominal plane block and a continuous intravenous fentanyl infusion to relieve pain. No FM exacerbation was noted.

Comparative analysis of methods to determine DNA methylation levels of a tumor-related microRNA gene.

Quantifying levels of DNA methylation in tumors is a useful approach for the identification of potential tumor suppressors and to find biomarkers that can be used as prognostic or therapeutic indicators. In the current study, we compared three methods commonly used for quantifying DNA methylation-bisulfite pyrosequencing, quantitative methylation-specific PCR (Q-MSP), and MethyLight-by focusing on the CpG island of the gene encoding the microRNA-34b and microRNA-34c (miR-34b/c); aberrant regulation of this miR is associated with various human malignancies, including gastric cancer. Standard curve analysis using control DNA samples demonstrated the highest quantitative accuracy in Q-MSP analysis. We also carried out methylation analysis using gastric mucosa specimens obtained from gastric cancer patients. We found a high correlation between methylation levels determined by Q-MSP and those determined by MethyLight (R(2)=0.952), whereas the results of bisulfite pyrosequencing and the other two methods were less well correlated (R(2)=0.864 and R(2)=0.804 for Q-MSP and MethyLight, respectively). This may reflect possible PCR bias in the pyrosequencing technique, which we show can be corrected for by applying a cubic approximate equation to the original data. Thus, although results obtained by the different DNA methylation analysis techniques are largely comparable, an appropriate correction may be necessary for stringent comparison.

[Indirect method of measuring the scatter X-ray fraction using collimators in the diagnostic domain].

The lead disc method is conventionally applied to measure the scatter fraction directly in the energy range of diagnostic X-rays. There are numerous reports of use of this method, but it is difficult to make lead discs with sufficient fabrication accuracy. In this paper, we newly propose an indirect measurement method using collimators instead. In our method, we measure the following two experimental values: the sum of the intensities of the direct X-rays and scattered X-rays, and the intensity of direct X-rays using lead collimators. The ratio of these two values shows the fraction of the direct X-ray that is the complementary value of the scatter fraction. To verify this method experimentally, we carried out experiments using a computed radiography system at tube voltages of 40 kV to 100 kV, and phantom thicknesses of 10 mm to 100 mm. The results confirmed the validity of our method.

[Development of cloud chamber having thin-film entrance windows and proposal of practical training for beginners using X-ray equipment and unsealed radioactive material].

A cloud chamber is a detector that can visualize the tracks of charged particles. Hayashi, et al. suggested a visualization experiment in which X-rays generated by diagnostic X-ray equipment were directed into a cloud chamber; however, there was a problem in that the wall of the cloud chamber scattered the incoming X-rays. In this study, we developed a new cloud chamber with entrance windows. Because these windows are made of thin film, we were able to direct the X-rays through them without contamination by scattered X-rays from the cloud chamber wall. We have newly proposed an experiment in which beta-particles emitted from radioisotopes are directed into a cloud chamber. We place shielding material in the cloud chamber and visualize the various shielding effects seen with the material positioned in different ways. During the experiment, electrons scattered in the air were measured quantitatively using GM counters. We explained the physical phenomena in the cloud chamber using Monte Carlo simulation code EGS5. Because electrons follow a tortuous path in air, the shielding material must be placed appropriately to be able to effectively block their emissions. Visualization of the tracks of charged particles in this experiment proved effective for instructing not only trainee radiological technologists but also different types of healthcare professionals.

[Fabrication of improved multi-slit equipment to obtain the input-output characteristics of computed radiography systems: correction of the heel effect, and application to high tube-voltage experiments].

Multi-slit equipment is a new experimental apparatus that can measure the input-output characteristics of a CR (computed radiography) system with limited influence of the fading effect. Kimoto et al. recently proposed a new type of multi-slit apparatus in which the multi-slit setup, the insertion region of the phosphor plate, and plate shielding are integrated to create a single handy-type item (an all-in-one type multi-slit apparatus). However, some problems remained unsolved. The aims of this study were to devise a setup for application to high tube voltage conditions, and to improve the all-in-one type multi-slit equipment so as to correct the heel effect. We examined the capabilities of our improved multi-slit equipment using diagnostic X-ray apparatus and found that it can obtain input-output characteristics with 5% accuracy for tube voltages of 40-140 kV and SID (source to image receptor distances) of 50-200 cm.

Oromandibular Dystonia After Low-Dose Olanzapine Treatment in a Patient With Marchiafava-Bignami Disease With Demyelinating Lesions in the Corpus Callosum: A Case Report.

Marchiafava-Bignami disease is a rare disorder characterized by demyelination and necrosis of the central nervous system. Dystonia is a movement disorder characterized by sustained or intermittent muscle contractions. Herein, we present the case of a patient with Marchiafava-Bignami disease who developed acute oromandibular dystonia after receiving a very low dose of olanzapine. He was a 60-year-old Japanese man who was diagnosed with demyelinating lesions in the corpus callosum associated with Marchiafava-Bignami disease. At one point, he became agitated at night and was administered olanzapine 2.5 mg, resulting in the onset of oromandibular dystonia; however, the symptoms disappeared upon discontinuation of the drug. Primary dystonia is believed to arise solely from abnormal basal ganglia function in the absence of apparent morphological changes, according to the traditional view. However, recent studies suggest the involvement of lesions beyond the basal ganglia and organic factors, including ultrastructural changes. Rare side effects that develop following small doses of olanzapine indicate that demyelinating lesions of the corpus callosum may be partially responsible for oromandibular dystonia. This case report supports previous reports that the corpus callosum is involved in dystonia and provides insights into the pathophysiology underlying oromandibular dystonia.

Guideline for evaluating the effects of psychotropic drugs on motor vehicle driving performance in Japan: A tiered approach for the assessment of clinically meaningful driving impairment.

In December 2022, the Ministry of Health, Labour and Welfare (MHLW) of Japan issued and implemented the guideline for evaluating the effects of psychotropic drugs on motor vehicle driving performance. This guideline recommends the use of a tiered approach to assess clinically meaningful driving impairment. It is noted that adverse events cannot be solely explained by pharmacokinetics, as the onset and duration of these events vary. Among these adverse events, those affecting alertness, such as drowsiness caused by psychotropic drugs on driving performance, are more frequently observed during initial treatment stages and dose escalation. Hence, when evaluating the effects of psychotropic drugs on driving performance, it becomes crucial to assess the persistence of clinically meaningful impairment. Therefore, the MHLW guideline, developed by the authors, emphasizes the need to assess the temporal profile of adverse events affecting driving in all clinical trials. Additionally, the guideline states that when conducting driving studies, the timing of multiple dosing should consider not only the pharmacokinetics of the investigational drug but also its tolerance.

Molecular cloning and multifunctional characterization of host defense peptides from the bullfrog Harderian gland with special reference to catesbeianalectin.

The Harderian gland (HG) is an orbital gland found in many terrestrial vertebrates that possess a nictitating membrane. Using reverse-transcription polymerase chain reaction (RT-PCR), we cloned five cDNAs encoding antimicrobial peptide (AMP)-homologs, catesbeianalectin, ranacyclin-CBa, ranatuerin-1CBa, ranatuerin-2CBa, and ranatuerin-2CBb, from the bullfrog HG total RNA. Of these, catesbeianalectin has not been thoroughly studied in terms of its biological activities. We examined antimicrobial activities of the synthetic replicate of catesbeianalectin and its putative unprocessed precursor, catesbeianalectin-GK. Both peptides showed slight but significant growth inhibitory activity against the Gram-negative bacterium Escherichia coli. Subsequently, we tested catesbeianalectin and catesbeianalectin-GK for mast cell degranulation activity as a criterion of the release of N-acetyl-ß-D-glucosaminidase from the mouse-derived mastocytoma cell line P-815, followed by the standard MTT assay to assess cell survival and recovery after peptide treatment. We found that catesbeianalectin and catesbeianalectin-GK invariably exhibited mast cell degranulation activity without cytotoxic effects. Hemagglutination assay revealed the presence of lectin-like activity in both catesbeianalectin and catesbeianalectin-GK. Our findings strongly suggest that these multifunctional host defense peptides in the amphibian HG are involved in innate immunodefense of the eye of the host against pathogenic environmental microorganisms.

[Development of an experimental apparatus for energy calibration of a CdTe detector by means of diagnostic X-ray equipment].

Diagnostic X-ray equipment was used to develop an experimental apparatus for calibrating a CdTe detector. Powder-type samples were irradiated with collimated X-rays. On excitation of the atoms, characteristic X-rays were emitted. We prepared Nb2O5, SnO2, La2O3, Gd2O3, and WO3 metal oxide samples. Experiments using the diagnostic X-ray equipment were carried out to verify the practicality of our apparatus. First, we verified that the collimators involving the apparatus worked well. Second, the X-ray spectra were measured using the prepared samples. Finally, we analyzed the spectra, which indicated that the energy calibration curve had been obtained at an accuracy of ±0.06 keV. The developed apparatus could be used conveniently, suggesting it to be useful for the practical training of beginners and researchers.

[Development of all-in-one multi-slit equipment for measurements of the input-output characteristic of a phosphor plate].

An input-output characteristic curve is an essential piece of information for analyzing medical images taken using a phosphor plate. In the multi-slit method, an actuator moves shields that have numerous slits during X-ray irradiation. Numerous data can be measured by one-time irradiation, so the fading effect is negligibly small. This method was recently proposed by Takegami et al., but their equipment consisted of large multiple compositions. The aim of this study was to fabricate a new handy type equipment that combines multiple productions into one small production. In this paper, we propose an idea for downscaling the size of the equipment, and report that the same input-output characteristic is obtained using our newly proposed method.

[Basic research for development of pinhole camera using a Geiger Mueller counter].

To visualize the scattered X-ray distribution in the diagnosis domain, we examined whether a Geiger Mueller (GM) counter could be applied to a pinhole camera as an X-ray detector. The GM counter detects radiation at certain detection points. To obtain two-dimensional images using the GM counter, the detector needs to be moved two-dimensionally. We constructed an apparatus using industrial actuators to move the detector. To investigate the usability of the developed apparatus, the scattered X-rays from the phantom were measured using the GM counter. The images obtained were then compared with those measured using the phosphor plate. Our results demonstrated that the GM counter can detect low count-rate radiation, but further research will be needed to obtain clear two-dimensional images. In this paper, we propose that the GM counter can be used as a complementary detector to a phosphor plate.

Acute pancreatitis during valproic acid administration in a patient with vascular dementia, epileptic seizures, and psychiatric symptoms: a case report.

BACKGROUND: Valproic acid (VPA) is a relatively safe drug widely used for the treatment of epileptic seizures and mania in bipolar disorder, as well as the prevention of migraine headaches. Here, we present a case of VPA-induced pancreatitis in a patient with vascular dementia, epileptic seizures, and psychiatric symptoms. He had no distinctive abdominal symptoms. CASE PRESENTATION: A 66-year-old Japanese man was treated with VPA for agitation and violent behavior due to vascular dementia, epileptic seizures, and psychiatric symptoms. During admission, he experienced a sudden decrease in consciousness and blood pressure. Abdominal findings were unremarkable; however, blood tests showed an inflammatory response and elevated amylase levels. Contrast-enhanced abdominal computed tomography showed diffuse pancreatic enlargement and inflammation extending to the subrenal pole. VPA-induced acute pancreatitis was diagnosed, VPA was discontinued, and high-dose infusions were administered. Acute pancreatitis resolved after treatment initiation. CONCLUSIONS: Clinicians should be aware of this relatively rare side effect of VPA. Diagnosis may be challenging in elderly people and patients with dementia as they may present with non-specific symptoms. Clinicians should consider the risk of acute pancreatitis when using VPA in patients who cannot report spontaneous symptoms. Blood amylase and other parameters should be measured accordingly.

The new guideline for evaluating effects of psychotropic drugs on the performance to drive a motor vehicle in Japan: Comparison with US FDA guideline.

In December 2022, the new guideline for evaluating the effect of psychotropic drugs on the performance to drive a motor vehicle was issued by the Ministry of Health, Labour and Welfare (MHLW) and implemented in Japan. Of the safety information, information on the influence of medications on driving performance is particularly important because it can be relevant to the social functioning of patients. In principle, the package inserts of medications are designed based on evidence and provide precautions regarding the operation of heavy machinery such as automobiles in Japan, the United States, and Europe. The effects of medications on driving performance are generally evaluated in a tiered approach involving nonclinical and clinical studies. Because of the wide variety of functional domains involved in automobile driving, the selection of evaluation methods for a given medication depends on their characteristics, which is a complicated method. Therefore, to evaluate the effects of psychotropic drugs on driving performance efficiently and appropriately, we developed the MHLW guideline that specifically defines the evaluation methods used in pharmacological studies, the neuropsychological tests used in pharmacodynamic studies, and the situations in which driving studies are necessary. Regarding the planning of appropriate drug development strategies, we review the background of the MHLW guideline and its differences from the US Food and Drug Administration (FDA) guideline.