Large Variation of Dirac Semimetal State in Perovskite CaIrO_{3} with Pressure-Tuning of Electron Correlation.

The impact of electron correlation on the Dirac semimetal state is investigated for perovskite CaIrO_{3} in terms of the magnetotransport properties under varying pressures. The reduction of electron correlation with a pressure of 1 GPa enhances the Fermi velocity as much as 40%, but it reduces the mobility by an order of magnitude by detuning the Dirac node from the Fermi energy. Moreover, the giant magnetoresistance at the quantum limit due to the one-dimensional confinement of Dirac electrons is critically suppressed under pressure. These results indicate that the electron correlation is a crucial knob for controlling the transport of a correlated Dirac semimetal.

A magnetic heterostructure of topological insulators as a candidate for an axion insulator.

The axion insulator which may exhibit an exotic quantized magnetoelectric effect is one of the most interesting quantum phases predicted for the three-dimensional topological insulator (TI). The axion insulator state is expected to show up in magnetically doped TIs with magnetizations pointing inwards and outwards from the respective surfaces. Towards the realization of the axion insulator, we here engineered a TI heterostructure in which magnetic ions (Cr) are modulation-doped only in the vicinity of the top and bottom surfaces of the TI ((Bi,Sb)2Te3) film. A separation layer between the two magnetic layers weakens interlayer coupling between them, enabling the magnetization reversal of individual layers. We demonstrate the realization of the axion insulator by observing a zero Hall plateau (ZHP) (where both the Hall and longitudinal conductivity become zero) in the electric transport properties, excluding the other possible origins for the ZHP. The manifestation of the axion insulator can lead to a new stage of research on novel magnetoelectric responses in topological matter.

Etiology of acute ischaemic cerebrovascular disease associated with rheumatoid arthritis: changes with progression of anti-inflammatory therapy.

BACKGROUND AND PURPOSE: In patients with rheumatoid arthritis (RA), the serum C-reactive protein (CRP) level is associated with ischaemic cerebrovascular disease (iCVD). Acute iCVD patients with RA were investigated, assessing changes of clinical characteristics and CRP with progress in RA treatment. METHODS: Patients hospitalized for acute iCVD from August 2002 to February 2018 were divided into two groups at February 2010. Patients with RA were retrospectively identified. The incidence of RA, the occurrence of acute exacerbation of inflammation due to causes other than synovitis preceding iCVD (non-synovitis AEI) and serum CRP were compared. RESULTS: In the first and second periods, 23/1203 patients (1.9%) and 22/1094 patients (2.0%) respectively had acute iCVD with RA. Non-synovitis AEI was significantly less frequent in the second period (5%, n = 1) than in the first period (35%, n = 8) (P < 0.05). CRP was significantly lower at iCVD onset in the second period [median and interquartile range 2.72 (0.89-4.5) mg/dl vs. 0.34 (0.12-1.19) mg/dl, P < 0.01]. Excluding nine patients with non-synovitis AEI, CRP was still lower in the second period [1.21 (0.47-2.72) mg/dl vs. 0.33 (0.11-0.98) mg/dl, P < 0.01]. CRP levels before both iCVD and non-synovitis AEI tended to be lower in the second period [1.53 (0.3-2.78) mg/dl vs. 0.69 (0.06-1.28) mg/dl, P = 0.059]. Two patients using tocilizumab developed iCVD despite persistently low CRP levels. CONCLUSIONS: With progress in treatment, RA-related inflammation was better suppressed and CRP decreased, but the prevalence of RA amongst acute iCVD patients was unchanged. Strategies for tighter control of inflammation are needed, and a new biomarker may be required in patients using tocilizumab.

P450 oxidoreductase deficiency with maternal virilization during pregnancy.

PURPOSE: The authors report on a rare case of maternal virilization during pregnancy caused by autosomal recessive P450 oxidore- ductase (POR) deficiency. MATERIALS AND METHODS: A 24-year-old primigravida developed a deepening voice and hirsutism in the second trimester. Prenatal ultrasonography failed to detect any fetal abnormality and fetal growth was normal. POR deficiency was suspected, but the mother declined fetal genetic testing. A female neonate was delivered by cesarean section at 41 weeks' gestation. RESULTS: The neonate had skeletal abnormalities. Mutational analysis of the POR gene demonstrated homozygosity for c.1370 G>A and p.R457H in the patient and heterozygosity in her parents. POR deficiency was confirmed in the neonate. CONCLUSION: POR deficiency should be suspected in cases of maternal virilization. Maternal urinary estriol, fetal magnetic resonance imaging, and parental genetic testing should be performed. Parental consent for fetal genetic testing should be sought to ensure prompt diagnosis and early treatment.

Ethnic differences in GRHPR mutations in patients with primary hyperoxaluria type 2.

The objective of this study was to investigate ethnic differences in the glyoxylate reductase/hydroxypyruvate reductase (GRHPR) gene in patients with primary hyperoxaluria type 2 (PH2). GRHPR was genotyped in Japanese patients with PH2 and all GRHPR mutations described to date were reviewed in terms of geographic and ethnic association. We identified a novel mutation, a two-nucleotide deletion (c.248_249delTG) in exon 3 creating a premature 'stop' at codon 91. Also, we found that the c.864_865delTG mutation was associated with the rs35891798 single-nucleotide polymorphism. The allelic frequencies of the c.103delG, c.494G>A, c.403_404+2 delAAGT, and c.864_865delTG mutations in PH2 patients were 37.8%, 15.6%, 10.0%, and 10.0%, respectively. All patients with the c.103delG mutation were Caucasian. Patients with the c.494G>A mutation and 78% (7/9) of those with the c.403_404+2 delAAGT mutation were from the Indian subcontinent, whereas those with the c.864_865delTG mutation were Chinese or Japanese. Molecular analysis of GRHPR of four Japanese PH2 patients identified a novel mutation (c.248_249delTG in exon 3). Caucasians with PH2 should be screened for the c.103delG mutation; patients from the Indian subcontinent for c.494G>A; and patients of East Asian origin (particularly) for c.864_865delTG. The prevalence of the latter mutation in PH2 patients from East Asia was 75.0%.

Brain-derived neurotrophic factor/tropomyosin-related kinase B pathway in gastric cancer.

BACKGROUND: Brain-derived neutrophic factor (BDNF) is a member of the neutrophin family that is known to activate the high-affinity tropomyosin-related receptor kinase B (TrkB). This study aimed to clarify the clinical and biological significance of the BDNF/TrkB pathway in gastric cancer. METHODS: We analysed BDNF and TrkB expression in gastric cancer samples by real-time reverse transcription PCR and immunohistochemistry. To investigate the biological role of BDNF/TrkB axis, recombinant human BDNF (rhBDNF) and the Trk antagonist K252a were used for in vitro and in vivo analysis. RESULTS: The BDNF expression at the invasive front of primary tumours was significantly elevated compared with that in the tumour core and adjacent normal mucosa. Increased BDNF expression at the invasive front was significantly correlated with factors reflecting disease progression, and poor prognosis. Increased co-expression of the BDNF/TrkB axis was significantly correlated with poor prognosis. Gastric cancer cells expressed BDNF, and administration of rhBDNF promoted proliferation, migration, invasion, and inhibition of anoikis. These effects were generally inhibited by K252a. In an in vivo assay, BDNF(+)/TrkB(+) gastric cancer cells injected into nude mice established peritoneal dissemination, whereas K252a inhibited tumour growth. CONCLUSION: The BDNF/TrkB pathway might be deeply involved in gastric cancer disease progression.

A new disorder of praxis in neurodegenerative disease that may be part of Alzheimer's disease.

Apraxia is a well-known disorder of praxis and is caused mainly by damage to the left parietal lobe. We presented two cases of neurodegenerative disease with a distinct disorder of praxis, predominantly involving left parietal lobe. While both patients could understand what they should do, they were not able to initiate action and often stopped during execution of actions. They had no apraxia and no temporal and spatial errors on praxis. Magnetic resonance imaging of both patients showed atrophy of the left parieto-occipital and temporo-occipital lobes, and single photon emission computed tomography showed hypoperfusion in the same lobes. Moreover, one of our cases, using [11C] PIB PET, demonstrated increased uptake in the cerebral cortices, suggesting Alzheimer's disease. The symptoms described are different from other disorders of praxis and similar to bradyphrenia or freezing.

Predictive index for the onset of medication overuse headache in migraine patients.

Migraine patients are particularly prone to develop medication overuse headache (MOH). However, the risk factors for the transformation of migraine to MOH are still not clear. We investigated gene polymorphisms, personality traits, and characteristics of headache and lifestyle in 47 migraine patients (aged 36.4 ± 10.3) and 22 MOH patients (aged 39.6 ± 9.9) who progressed from migraine and made a scoring system for a predictive index (PI) of the onset of MOH in patients with migraine. By multivariate logistic stepwise regression analysis, type of migraine, regular and sufficient dietary intake, and methylenetetrahydrofolate reductase (MTHFR) C677T (rs1801133) and dopamine D2 receptor (DRD2) C939T (rs6275) polymorphisms were selected as significant factors that contribute independently to the development from migraine to MOH (P < 0.05). The regression coefficients (ß) of these four selected factors were approximated and scored. The PI score in MOH patients (7.32 ± 1.60) was significantly higher than that in migraine patients (4.62 ± 1.83, P < 0.001). The proposed scoring system should in the future be the object of larger studies to confirm its validity.

Ratings of perceived exertion in adults with chronically physical challenges.

AIM: The purposes of this study were to investigate: the relationship between ratings perceived exertion (RPE) and percentage of maximal oxygen uptake (%VO2max) during submaximal exercise; the influence of daily physical activities on RPE; and the influence of aerobic fitness on RPE. METHODS: The participants were thirty-eight adults with chronically physical challenges. Submaximal exercise testing was conducted to estimate VO2max. The participants themselves declared their perceived exertion just before the end of the exercise testing by indicating the Borg's 6-20 RPE scale. Measurement of continuous heart rates was employed for measurement of the intensity of daily physical activities. The relationship between %VO2max and RPE was analyzed. RESULTS: There was a significant correlation between %VO2max and RPE only in the active men who did daily aerobic physical activities with intensity of 30%HRR and more (N.=9, r=0.74, P=0.02). In the good fitness groups of both women and men, the actual %VO2max in 11 out of 12 participants was lower than the reference value of %VO2max of the RPE while the opposite trend was found in poor aerobic fitness group. CONCLUSION: Our results recommend that RPE should be used together with objective physiological variables such as HR for assessment of exercise intensity in people with chronically physical challenges, especially who are low in aerobic fitness or who are inactive.

Modified repeated intracyclic clomiphene citrate therapy after conventional clomiphene therapy.

PURPOSE OF INVESTIGATION: We compared modified repeated intracyclic clomiphene citrate therapy (RICCT) to gonadotropin therapy to determine whether this modified regimen was an effective alternative after conventional clomiphene therapy. METHODS: Patients with ovulation disorder received treatment with modified RICCT and gonadotropin, and ovulation, pregnancy, total drug cost, and adverse effects were compared. RESULTS: Among a total of 16 patients, 14 successfully ovulated after modified RICCT and 11 ovulated after gonadotropin therapy; two did not respond to either therapy. The total drug cost was US $36.3+/-17.9 for modified RICCT, which was significantly lower than the cost of gonadotropin therapy, US $213.9+/-100.4 (p=0.0001). CONCLUSIONS: Because modified RICCT does not require the discomfort of daily injection and has excellent ovulation-inducing effects, it is a useful treatment after conventional clomiphene therapy.

Interplay of spin-orbit coupling and Coulomb interaction in ZnO-based electron system.

Spin-orbit coupling (SOC) is pivotal for various fundamental spin-dependent phenomena in solids and their technological applications. In semiconductors, these phenomena have been so far studied in relatively weak electron-electron interaction regimes, where the single electron picture holds. However, SOC can profoundly compete against Coulomb interaction, which could lead to the emergence of unconventional electronic phases. Since SOC depends on the electric field in the crystal including contributions of itinerant electrons, electron-electron interactions can modify this coupling. Here we demonstrate the emergence of the SOC effect in a high-mobility two-dimensional electron system in a simple band structure MgZnO/ZnO semiconductor. This electron system also features strong electron-electron interaction effects. By changing the carrier density with Mg-content, we tune the SOC strength and achieve its interplay with electron-electron interaction. These systems pave a way to emergent spintronic phenomena in strong electron correlation regimes and to the formation of quasiparticles with the electron spin strongly coupled to the density.

Chemically assisted submucosal injection facilitates endoscopic submucosal dissection of gastric neoplasms.

BACKGROUND AND STUDY AIMS: A randomized in vivo animal study previously demonstrated that topical injection of mesna solution (sodium-2-mercaptoethanesulfonate) chemically softened submucosal connective tissues and facilitated mechanical dissection of the submucosal tissue plane. The present study evaluated the technical feasibility and safety of chemically assisted endoscopic submucosal dissection (CA-ESD) using mesna in 20 consecutive patients who underwent endoscopic excision of gastric neoplasm. MATERIALS AND METHODS: Following the margination of the lesion with a mucosal circumcision, 4 - 12 mL of 10 % mesna solution was injected into the submucosal layer. Mechanical submucosal dissection was then performed by bluntly cleaving the chemically treated submucosal layer with the tip of a cap-fitted gastroscope. The use of cautery was restricted to prophylactic hemostasis, dissection of the coagulated vessels and persistent submucosal tissues, and the final snare resection. Post-therapeutic ulceration repair and adverse events were followed up during a 1-week hospitalization and by repeat endoscopies at 1 day, 1 week, and 1 month after the procedure. RESULTS: Sixteen gastric cancers and four adenomas were treated in this study. The sampled tissue measured 38.25 +/- 14.53 mm, with an en bloc resection rate of 100 %. Mean operation time was 21.17 +/- 11.6 minutes. The time spent using cautery was limited to 26.1 % of the total submucosal dissection time. Ulcerations healed normally without complications. CONCLUSIONS: This preliminary study demonstrates that submucosal injection of mesna facilitates and expedites mechanical submucosal dissection. The major limitations in this study include the single-arm study design and a small patient population.

A strategy for delivering peptides into the central nervous system by sequential metabolism.

Most peptides do not enter the central nervous system because of their hydrophilic character and the presence of peptidolytic enzymes in the lipoidal blood-brain barrier. To achieve brain delivery of a peptide conjugate, an opioid peptide (enkephalin) was placed in a molecular environment that disguises its peptide nature and provides biolabile, lipophilic functions to penetrate the blood-brain barrier by passive transport. The strategy also incorporates a 1,4-dihydrotrigonellinate targetor that undergoes an enzymatically mediated oxidation to a hydrophilic, membrane-impermeable trigonellinate salt. The polar targetorpeptide conjugate that is trapped behind the lipoidal blood-brain barrier is deposited in the central nervous system. Analgesia was observed with "packaged" enkephalin but not with the unmodified peptide or lipophilic peptide precursors.

Interaction of IL-2R beta and gamma c chains with Jak1 and Jak3: implications for XSCID and XCID.

Interleukin-2 (IL-2) signaling requires the dimerization of the IL-2 receptor beta.(IL-2R beta) and common gamma (gamma c) chains. Mutations of gamma c can result in X-linked severe combined immunodeficiency (XSCID). IL-2, IL-4, IL-7 (whose receptors are known to contain gamma c), and IL-9 (whose receptor is shown here to contain gamma c) induced the tyrosine phosphorylation and activation of the Janus family tyrosine kinases Jak1 and Jak3. Jak1 and Jak3 associated with IL-2R beta and gamma c, respectively; IL-2 induced Jak3-IL-2R beta and increased Jak3-gamma c associations. Truncations of gamma c, and a gamma c, point mutation causing moderate X-linked combined immunodeficiency (XCID), decreased gamma c-Jak3 association. Thus, gamma c mutations in at least some XSCID and XCID patients prevent normal Jak3 activation, suggesting that mutations of Jak3 may result in an XSCID-like phenotype.

Investigating the relationship among self-reported oral health status, oral health-related behaviors, and self-consciousness in Romanian dental patients.

BACKGROUND: The purpose of this study was to investigate whether self-consciousness, self-reported oral health status, and oral health-related behaviors were associated in a Romanian population. METHODS: A cross-sectional study design was used. Data were collected between January and March 2008. The sample consisted of 180 Romanian adults (mean age: 35.8 years; 72.6% women; 57% married) who were a random population drawn consecutively from the registry file of a private dental practice in the Iasi area. The questionnaire included information about demographic, psychologic, self-reported oral health, and oral health-related behavior items. The self-consciousness (SC) scale with three subscales (public SC, private SC, and social anxiety) was applied. RESULTS: Significant differences were found on the public SC scale in relation to denture/removable false teeth and on the total SC scale in relation to periodontal problems. When oral health behaviors were analyzed, private SC was associated with oral health behaviors (flossing, use of mouthrinse, and dental visit frequency). There was no association between toothbrushing frequency and the self-consciousness subscales. CONCLUSION: The moderating effects of self-consciousness should be considered when evaluating risk-reduction interventions and tailoring intervention efforts to oral health promotion.

Repeated intracyclic clomiphene citrate therapy can be more effective than hMG therapy in inducing ovulation: case report.

PURPOSE OF INVESTIGATION: When clomiphene citrate is ineffective in the treatment of anovulation, hMG administration is typically selected. However, high-dose hMG therapy is associated with a variety of adverse events. We describe the use of a modified clomiphene citrate regimen that was successful in increasing the effectiveness of ovulation induction. CASE REPORT: A patient who did not initially respond to clomiphene citrate therapy required a total dose of 2400 IU hMG to prodeuce mature follicles. However, because of the physical and emotional burdens on the patient, and the possibility of multiple pregnancy and ovarian hyperstimulation syndrome, re-treatment with clomiphene citrate was then selected. Two courses of clomiphene citrate administered at a fixed interval during the same cycle safely induced ovulation. After initial induction of ovulation, her ovulatory failure improved and natural ovulation occurred. CONCLUSIONS: Repeated intracycle clomiphene cirate therapy may be more effective than hMG therapy in inducing ovulation in some patients.

Strong-correlation induced high-mobility electrons in Dirac semimetal of perovskite oxide.

Electrons in conventional metals become less mobile under the influence of electron correlation. Contrary to this empirical knowledge, we report here that electrons with the highest mobility ever found in known bulk oxide semiconductors emerge in the strong-correlation regime of the Dirac semimetal of perovskite CaIrO3. The transport measurements reveal that the high mobility exceeding 60,000 cm2V-1s-1 originates from the proximity of the Fermi energy to the Dirac node (ΔE < 10 meV). The calculation based on the density functional theory and the dynamical mean field theory reveals that the energy difference becomes smaller as the system approaches the Mott transition, highlighting a crucial role of correlation effects cooperating with the spin-orbit coupling. The correlation-induced self-tuning of Dirac node enables the quantum limit at a modest magnetic field with a giant magnetoresistance, thus providing an ideal platform to study the novel phenomena of correlated Dirac electron.

Frequency of rate of body temperature chart at mid cycle in pregnant women and the subsequent effect on pregnancy.

PURPOSE OF INVESTIGATION: To determine if changes in basal body temperature (BBT) during the ovuratory phase are related to subsequent effects on pregnancy. METHODS: BBT records from 216 pregnant women in a spontaneous cycle or a clomiphene citrate cycle during a recent 6-year period were studied. The last day of low phase (LDLP) and the number of days until high phase (NDHP) were determined for all subjects. RESULTS: In the spontaneous cycle group, medium-cycle cases were most frequent and long-cycle cases were most frequent in the clomiphene cycle group. The NDHP ranged between one and three days in 82.8% of the subjects in the spontaneous cycle group and in 86.1% of the subjects in the clomiphene cycle group. CONCLUSIONS: Our findings demonstrate the importance of properly evaluating an NDPH of two or even three days in a BBT-based assessment of ovarian function in the ovulatory phase.

[The management of post operative chylothorax].

Post operative chylothorax occurs in less than a few percentages of pulmonary resection and lymph node dissection for lung cancer and is a serious complication. The management of post operative chylothorax is both conservative and surgical treatment and generally the former is used. In our hospital during 1992-2005, almost patients responded to conservative treatment. Surgical interventions with video-assisted thoracoscopic surgery (VATS) is considered that it is low invasive method and can prevent the demerits of conservative therapy such as infection of long-term drain detention and lymphocyte loss, malnutrition and so on. Early detection of surgical interventions might be one of strategies in the management of post operative chylothorax for the patients with much quantity of drainage. We consider that administration of somatostatin and lymphangiography are effective treatments and are recommended as the previous step of surgical interventions.

Seven Japanese Herbals Prolonged Cardiac Allograft Survival.

Japanese herbal medicines have long been used as alternative therapy because of their immunomodulatory effects. In recent years, use herbal medicines is rapidly increasing worldwide. In this study, we investigated the effect of 17 components of traditional Japanese herbal medicines on alloimmune responses in a murine model of cardiac allograft transplantation. Fully vascularized heterotopic hearts from C57BL/6 donors were transplanted into CBA mice by using microsurgical techniques. Artemisiae capillaris herba (Inchinko) was given to CBA recipients at a dosage of 1 g/kg/day from the day of transplantation until 7 days afterward. The other 16 components were given at a dosage of 2 g/kg/day for the same time period. Naïve CBA mice rejected C57BL/6 cardiac grafts acutely (median survival time [MST] of 7 days). CBA transplant recipients given 2 g/kg/day of Glycyrrhizae radix (Kanzou), Poria sclerotium (Bukuryo), Pinellia tuber (Hange), Cnidii rhizome (Senkyu), Paeoniae radix (Shakuyaku), and Scutellariae radix (Ogon) had prolonged C57BL/6 allograft survival significantly (MSTs were 18, 18, 17, 14, 12, and 12 days, respectively). Moreover, CBA transplant recipients given 1g/kg/day of Artemisiae capillaris herba had prolonged C57BL/6 allograft survival (MST >100 days); however, none of other 10 components prolonged allograft survival. In conclusion, administration of 7 components of traditional Japanese herbal medicines might induce prolongation of fully major histocompatibility complex-mismatched cardiac allografts.