Factors associated with the maintenance in food texture for dependent older people with dysphagia living in nursing home - A retrospective cohort study.

OBJECTIVES: Maintaining the texture of the food that nursing home residents eat is critical for maintaining quality of life and preventing malnutrition. The aim of the present study was to identify the conditions necessary for maintaining food texture for this population. MATERIALS AND METHODS: The study included 143 people for whom reevaluation 1-year post-baseline was possible from among 256 dependent older people who consumed solid food on admission to a nursing home (baseline). The age, sex, primary disease, activities of daily living, nutritional status, oral status, swallowing ability, primitive reflexes, and food texture of the participants were determined. The participants who ate pureed or jelly after 1 year were identified and evaluated to determine factors related to maintenance of a solid diet. RESULTS: A total of 21 participants (14.7%) changed to a pureed or jelly diet after 1 year. Multivariate analysis showed good activities of daily living (p < .05), good swallowing ability (p < .05), and maintained nutritional status (p < .05) to be correlated with solid food maintenance. CONCLUSIONS: Maintaining activities of daily living, feeding and swallowing ability, and nutritional status appear to be important factors for the maintenance of a solid diet.

Usefulness of Telemedicine for Disabled Children Receiving Feeding Therapy.

We performed a retrospective cohort study using medical records of 374 pediatric patients who visited a university dental clinic specializing in dysphagia rehabilitation in Japan between 2019 and 2020 to clarify the usefulness of telemedicine among disabled children receiving feeding therapy. The primary outcome was the feeding developmental stage confirmed at the final evaluation. Propensity score matching was performed between individuals in two treatment groups (in-person and telemedicine) before the final analysis using patients' age, sex, primary disease, gross motor function, and feeding developmental stage as covariates. A total of 36 patients were enrolled in each of the in-person and telemedicine groups. The initial evaluation for the propensity score matched population using the χ2 test showed no significant difference between the two groups in any parameter. The feeding developmental stage evaluated at the final evaluation using the Wilcoxon signed-rank test significantly improved compared with the stage at the initial evaluation in both groups (in-parson group, p = 0.007; telemedicine group, p = 0.013). The difference in level achieved at the final evaluation revealed that the most common level was "unchanged," followed by "improvement by one level" in both groups, indicating that there was no significant difference in the efficacy of feeding therapy between the two groups (p = 0.314). Our results show that telemedicine can achieve the same therapeutic outcomes as in-person therapy to improve feeding function in children with disabilities when receiving feeding therapy.

[Clinical Study to Determine the Dose Intensity of BEP Chemotherapy for Ovarian Malignant Germ Cell Tumors].

A standard regimen for ovarian malignant germ cell tumors is bleomycin, etoposide, cisplatin(BEP)chemotherapy. Adherence to a treatment schedule of every 21 days has been reported to be important. However, the incidence of febrile neutropenia( FN)and the optimaluse of granulocyte-colony stimulating factor(G-CSF)are unclear because of the low incidence of ovarian malignant germ cell tumors. We experienced 2 cases of ovarian malignant germ cell tumors that received BEP therapy after fertility-conserving surgery. In 1 case, we delayed drug administration in the first cycle because of FN. However, in order to maintain dose intensity(DI), we performed chemotherapy every 21 days by shortening the rest period. Myelosuppression may be severe in the first cycle of BEP therapy; however, it may be possible to adhere to the treatment schedule by using primary prophylactic administration of G-CSF.

Construction and applications of exon-trapping gene-targeting vectors with a novel strategy for negative selection.

BACKGROUND: Targeted gene modification by homologous recombination provides a powerful tool for studying gene function in cells and animals. In higher eukaryotes, non-homologous integration of targeting vectors occurs several orders of magnitude more frequently than does targeted integration, making the gene-targeting technology highly inefficient. For this reason, negative-selection strategies have been employed to reduce the number of drug-resistant clones associated with non-homologous vector integration, particularly when artificial nucleases to introduce a DNA break at the target site are unavailable or undesirable. As such, an exon-trap strategy using a promoterless drug-resistance marker gene provides an effective way to counterselect non-homologous integrants. However, constructing exon-trapping targeting vectors has been a time-consuming and complicated process. RESULTS: By virtue of highly efficient att-mediated recombination, we successfully developed a simple and rapid method to construct plasmid-based vectors that allow for exon-trapping gene targeting. These exon-trap vectors were useful in obtaining correctly targeted clones in mouse embryonic stem cells and human HT1080 cells. Most importantly, with the use of a conditionally cytotoxic gene, we further developed a novel strategy for negative selection, thereby enhancing the efficiency of counterselection for non-homologous integration of exon-trap vectors. CONCLUSIONS: Our methods will greatly facilitate exon-trapping gene-targeting technologies in mammalian cells, particularly when combined with the novel negative selection strategy.

Plasma mRNA concentrations of placenta-specific 1 (PLAC1) and pregnancy associated plasma protein A (PAPP-A) are higher in early-onset than late-onset pre-eclampsia.

AIM: Some mRNA concentrations are observed to increase in the maternal circulation in association with pre-eclampsia, including placenta-specific 1 (PLAC1) and pregnancy associated plasma protein A (PAPP-A), which were previously proposed as predictive markers for pre-eclampsia. Here, we investigated their concentrations in early-onset and late-onset pre-eclampsia maternal plasma to determine whether different mechanisms are involved in these two forms of the disorder. MATERIAL AND METHODS: Peripheral blood and placental samples were collected from patients with pre-eclampsia. RNA was extracted and levels of PLAC1 and PAPP-A mRNAs were determined using real-time quantitative PCR. RESULTS: PLAC1 and PAPP-A mRNA levels were significantly increased in plasma from pregnant women with pre-eclampsia compared with those from healthy pregnant women. The median concentration of PLAC1 was 5.5 times higher (P<0.01) and that of PAPP-A was 5.1 times higher (P<0.01) in early-onset than in late-onset pre-eclampsia. The expression of these mRNAs in the placenta showed no significant difference in early-onset pre-eclampsia, late-onset pre-eclampsia and healthy pregnant women. CONCLUSION: These findings suggest that the concentration of mRNAs in maternal plasma reflect leakage from damaged villus cells rather than expression levels in the placenta. Injury to chorionic villus cells might be more severe in early-onset pre-eclampsia than in late-onset pre-eclampsia.

Functional expression of purinergic P2X7 receptors in pregnant rat myometrium.

ATP has been reported to enhance the membrane conductance of myometrial cells and uterine contractility. Purinergic P2 receptor expression has been reported in the myometrium, using molecular biology, but the functional identity of the receptor subtype has not been determined. In this study, ATP-induced currents were recorded and characterized in single myometrial cells from pregnant rats using whole cell patch clamping. Extracellular ATP was applied in the range of 10 muM-1 mM and induced currents with an EC(50) of 74 muM, with no desensitization, time dependency, or voltage dependency. The currents induced carried multiple monovalent cations, with conductances ranked as K(+) > Cs(+) > Li(+) > Na(+). They were activated by P2X receptor agonists, with their effectiveness ranked as 2',3'-O-(4-benzoylbenzoyl)-ATP >> ATP > alphabeta-methylene-ATP > 2-methylthio ATP > or = UTP > or = GTP > ADP. These currents were blocked by the selective P2X7 receptor antagonist 3-[5-(2,3-dichlorophenyl)-1 H-tetrazol-1-yl]methyl pyridine (A-438079). We therefore concluded that ATP-induced currents in rat myometrial cells crossed cell membranes via P2X7 receptors. We further showed that the ATP-induced currents were blocked by extracellular Mg(2+) (IC(50) = 0.26 mM). Clinically, administering extracellular Mg(2+) is known to inhibit uterine contraction. It therefore seems likely that uterine contraction may be induced by raised extracellular ATP and suppressed via Mg(2+) inhibiting P2X7 receptors. Further research is needed into the P2X7 receptor as a therapeutic target in abnormal uterine contraction, as a possible treatment for premature labor.

Oral motor function and masticatory performance in the community-dwelling elderly.

This study was performed to ascertain the relationships between oral motor functions, such as those of the tongue and lips, and age in the community-dwelling elderly, as well as to investigate the effects of these factors on masticatory performance. The subjects were 268 healthy elderly Japanese living in Kyoto. They were divided into four age groups and further classified into the following two groups by the presence or absence of posterior occlusal support: Eichner A or B1-B3 (group A), and Eichner B4 or C (group B). They were wearing removable or fixed dentures if they had missing teeth. Oral function evaluation items included (1) masticatory performance and (2) oral motor skills. Significant differences were noted among the age groups in tongue pressure within group A (P < 0.01) and group B (P < 0.05), and in the number of repetitions of the syllables /ta/ and /ka/ in group B (/ta/: P < 0.05, /ka/; P < 0.01). The number of natural teeth (beta = 0.463, P < 0.001) in group A and tongue pressure (beta = 0.436, P < 0.001) in group B were the only predictors of masticatory performance when the data were analyzed by multiple regression analysis. The tongue may compensate for the missing teeth in masticatory performance of those elderly who have lost their natural teeth. The results of this study highlight the importance of tongue function in masticatory performance.