Characteristics of headaches in Japanese elementary and junior high school students: A school-based questionnaire survey.

PURPOSE: Few studies have investigated pediatric headaches in Japan. Thus, we examined the lifetime prevalence and characteristics of headaches among elementary and junior high school students in Japan. METHODS: In this school-based study, children aged 6-15years completed a questionnaire based on the diagnostic criteria of the International Classification of Headache Disorders-3ß to assess headache characteristics and related disability. RESULTS: Of the 3285 respondents, 1623 (49.4%) experienced headaches. Migraine and tension-type headaches (TTH) were reported by 3.5% and 5.4% of elementary school students, respectively, and by 5.0% and 11.2% of junior high school students. Primary headaches increased with age. Compared with TTH sufferers, the dominant triggers in migraine sufferers were hunger (odds ratio=4.7), sunny weather (3.3), and katakori (neck and shoulder pain) (2.5). Compared with TTH, migraine caused higher headache-related frustration (P=0.010) as well as difficulty concentrating (P=0.017). Migraine-related disability was greater among junior high school students (feeling fed up or irritated, P=0.028; difficulty concentrating, P=0.016). TTH-related disability was also greater among junior high school students (feeling fed up or irritated, P=0.035). Approximately half of the students who complained of headache-related disability were not receiving medical treatment. CONCLUSION: This is the first detailed study of headaches in Japanese children to include elementary school students. Nearly 50% of the school children reported headaches and the disruption of daily activities caused by migraine was higher among junior high students than elementary school students.

[A case of chronic lower respiratory tract infection in which the traditional herbal medicine Hochuekkito was effective to prevent exacerbation].

A thin, 63-year-old man was receiving low-dose macrolide therapy for a diagnosis of chronic lower respiratory tract infection, but frequent exacerbations due to Streptococcus pneumoniae were observed. High-resolution computed tomography (CT) of the chest showed bronchiectasis and small centrilobular nodules in the right lower lobe. He had previously had several episodes of exacerbation of chronic lower respiratory tract infection, for which he had received antibiotic treatments (oral fluoroquinolones or intravenous cephems). However, he continued to experience recurrent exacerbations, and Pseudomonas aeruginosa was also isolated from his sputum. To improve his general condition, Hochuekkito, a herbal medicine, was initiated. His body weight and serum albumin level gradually increased, and after 6 months of administration, neither S. pneumoniae nor P. aeruginosa were isolated from his

Organic polyanionic high-spin molecular clusters: topological-symmetry controlled models for organic ferromagnetic metals.

Trianionic spin-quartet and tetraanionic spin-quintet molecular clusters derived from m-dibenzoylbenzene in solution were identified by CW-ESR/pulse-ESR based two-dimensional electron spin transient nutation spectroscopy, and their spin and clustering structures in the ground state were determined in terms of a D-tensor based phenomenological approach and DFT calculations. The molecular structures obtained semiempirically are supported by DFT-based quantum chemical calculations. The DFT calculations have been tested for a sodium ion bridged fluorenone-based cluster, [fluorenone(-)˙ {Na(+)(dme)(2)}](2), whose crystal structure was reported in the literature [H. Bock, H.-F. Herrmann, D. Fenske and H. Goesmann, Angew. Chem., Int. Ed. Engl., 1988, 27, 1067], reproducing the experimentally determined moelcular structure of the dimer cluster. It is suggested that both the quartet and quintet clusters in the 2-MTHF glass and solution form the cross-typed structures with the two m-dibenzoylbenzene moieties in cis-configuration. A dianionic spin-triplet m-dibenzoylbenzene derivative was detected for the first time and its charge and spin densities were studied by the quantum chemical calculations. The high-spin states of the open-shell entities under study were confirmed by X-band pulse-ESR based electron spin nutation spectroscopy in organic frozen glasses. The D values and other spin Hamiltonian parameters of all the polyanionic high-spin species were determined by the hybrid eigenfield spectral simulation for fine-structure ESR spectra. m-Dibenzoylbenzene provides pseudo-degenerate π-LUMOs arising from its topological symmetry of the π-electron network and its dianion in the triplet ground state is a prototypical model for topologically-controlled genuinely organic ferromagnetic metals.

[Case of a testicular germ cell tumor presenting with multiple metastasized pulmonary nodules and masses].

A 25-year-old man presented with a 2-month history of bloody sputum and unilateral gynecomastia. High-resolution computed tomography (HRCT) of his chest showed multiple nodules and masses. On physical examination, no enlargement of the testes was noted, but a tiny calcified lesion in his left testis was detected on a genital CT scan. He was referred to the urology department with a suspected testicular germ cell tumor. An echogram showed a micronodule in his left testis. A testicular mixed germ cell tumor was diagnosed on the basis of the histological features of the tumor removed by high orchiectomy, and systemic chemotherapy with bleomycin, etoposide, and cisplatin (BEP) was initiated. Testicular germ cell tumor should be considered in the differential diagnosis of multiple pulmonary nodules or masses in young men. Because high orchiectomy is indispensable for the treatment of testicular germ cell tumor, aggressive investigative studies of the testis are essential in patients with pulmonary, mediastinal, and retroperitoneal germ cell tumors.

Random-orientation high-spin electron spin resonance spectroscopy and comprehensive spectral analyses of the quintet dicarbene and dinitrene with meta-topological linkers: origins of peculiar line-broadening in fine-structure ESR spectra in organic rigid glasses.

In high-spin chemistry, random-orientation fine-structure (FS) electron spin resonance (ESR) spectroscopy entertains advantages as the most facile and convenient method to identify high-spin systems, as frequently reported in the literature. Random-orientation ESR spectroscopy applicable to organic high-spin entities can date back to the Wasserman and co-workers' attempt on the first spin-quintet dicarbene, m-phenylenebis(phenylmethlene) (m-PBPM), in the 2-MTHF glass in 1963 and 1967, following their successful work on randomly oriented triplet-state ESR spectroscopy. The FS ESR spectrum of m-PBPM in the 2-MTHF glass, however, has never fully been analyzed due to a peculiar line-broadening appearing at many canonical peaks. Organic high-spin spectra from most quintet dinitrenes also suffer from similar phenomena. Seemingly intrinsic line-diffusing or -broadening phenomena adversely affect the reliable determination of FS parameters for organic high-spin entities in rigid glasses. In high-spin chemistry, the line-broadening has been an obstacle that masks key FS transitions in many cases. Thus, both the origin of the broadening and the comprehensive spectral analysis have been a long-standing issue. In this report, we examine the origin of the line-broadening appearing in the FS ESR spectra, illustrated by a comprehensive spectral analysis for m-PBPM in the quintet ground state and the first-documented quintet-state dinitrene, m-phenylenebis(nitrene) (m-PBN) in the 2-MTHF glass. A complete analysis of the random-orientation FS spectra from m-PBPM diluted in the benzophenone crystal has shown that the g-anisotropy of m-PBPM is not prominent. Also the higher-order FS terms such as S(i)(2)S(j)(2) group-theoretically allowed for S = 2 are not necessary in spite of the argument for a hydrocarbon-based tetraradical (S = 2) in the ground state. Our new approach to the line-broadening analysis invokes both exact analytical solutions for the resonance fields of canonical peaks and the magnetic-parameters gradient method. The D- and E-values of m-PBPM acquired by the spectral simulation in this study give different molecular structures of the quintet dicarbene in the benzophenone crystal lattice (D = +0.0703(0) cm(-1), E = +0.0212(0) cm(-1)) and in the 2-MTHF glass (D = +0.0780(0) cm(-1), E = +0.0221(0) cm(-1)). Microscopic origins of the line-broadening observed for high-spin oligocarbenes or oligonitrenes generated by photolysis in organic glasses have been proposed.

Comparison of methimazole and propylthiouracil in patients with hyperthyroidism caused by Graves' disease.

CONTEXT: Although methimazole (MMI) and propylthiouracil (PTU) have long been used to treat hyperthyroidism caused by Graves' disease (GD), there is still no clear conclusion about the choice of drug or appropriate initial doses. OBJECTIVE: The aim of the study was to compare the MMI 30 mg/d treatment with the PTU 300 mg/d and MMI 15 mg/d treatment in terms of efficacy and adverse reactions. DESIGN, SETTING, AND PARTICIPANTS: Patients newly diagnosed with GD were randomly assigned to one of the three treatment regimens in a prospective study at four Japanese hospitals. MAIN OUTCOME MEASURES: Percentages of patients with normal serum free T(4) (FT4) or free T(3) (FT3) and frequency of adverse effects were measured at 4, 8, and 12 wk. RESULTS: MMI 30 mg/d normalized FT4 in more patients than PTU 300 mg/d and MMI 15 mg/d for the whole group (240 patients) at 12 wk (96.5 vs. 78.3%; P = 0.001; and 86.2%, P = 0.023, respectively). When patients were divided into two groups by initial FT4, in the group of the patients with severe hyperthyroidism (FT4, 7 ng/dl or more, 64 patients) MMI 30 mg/d normalized FT4 more effectively than PTU 300 mg/d at 8 and 12 wk and MMI 15 mg/d at 8 wk, respectively (P < 0.05). No remarkable difference between the treatments was observed in patients with initial FT4 less than 7 ng/dl. Adverse effects, especially mild hepatotoxicity, were higher with PTU and significantly lower with MMI 15 mg/d compared with MMI 30 mg/d. CONCLUSIONS: MMI 15 mg/d is suitable for mild and moderate GD, whereas MMI 30 mg/d is advisable for severe cases. PTU is not recommended for initial use.

Structures of palmitoyl-L and DL-lysine monolayers at the air-water interface--polarization modulation infrared reflection absorption spectroscopic study.

Polarization modulation infrared reflection absorption spectroscopy (PM-IRAS) was applied to measure the IR spectra of palmitoyl-DL-lysine (L-PL) and palmitoyl-DL-lysine (DL-PL) at the air-water interface. The spectra in the amide I and II regions were simulated by using the extinction coefficients of the amide I and II bands of L-PL and DL-PL determined by the analyses of the IR external reflection spectra of the Langmuir-Blodget (LB) films prepared on a Ge plate (Yasukawa et al. J. Mol. Struct. 2005, 735-736, 53), indicating the angle between the plane of the secondary amide group (the amide plane) and the surface normal in the L-PL monolayer to be about 20 degrees and the angle in the DL-PL monolayer to be about 37 degrees. Comparison of the tilt angles with the corresponding angles in the LB films (about 20 degrees for the LB film of L-PL; about 49 degrees for the LB film of DL-PL) indicated that, upon being transferred to the solid substrate from the air-water interface, the L-PL monolayer keeps the orientation of the amide plane virtually unchanged, while the DL-PL monolayer changes the orientation appreciably to a horizontal direction. The orientation change of the amide plane was interpreted as due to the accommodation of irregularly oriented palmitoyl groups into the LB films of DL-PL on the solid substrate.

[Laboratory examinations performed in rural practice].

Graduates from Jichi Medical School are obligated to work at rural clinics or hospitals, where most of them are the only medical doctor in the house. To understand how these graduates actually use laboratory examinations, what examinations they found most important in their practice, and when they were confident of their laboratory techniques, we designed a questionnaire to address these questions. Many respondents reported that their institutions had electrocardiographs, abdominal and/or cardiac ultrasonographs, urinalysis test paper, and portable blood glucose meters, and more than half of them reported having used these instruments without assistance in emergency situations. Moreover, a majority of the respondents said that they considered it important that a physician is able to use these instruments without the help of other staff members. Proficiency in many laboratory techniques was obtained and physicians were confident during their first postgraduate clinical practice. These responses clearly show the importance and usefulness of covering examination techniques and the principles of laboratory medicine in medical education and the first postgraduate clinical practice.

Nanoparticle formation of poorly water-soluble drugs from ternary ground mixtures with PVP and SDS.

Poorly water-soluble drugs N-5159, griseofulvin (GFV), glibenclamide (GBM) and nifedipine (NFP) were ground in a dry process with polyvinylpyrrolidone (PVP) and sodium dodecyl sulfate (SDS). Different crystallinity behavior of each drug during grinding was shown in the ternary Drug/PVP/SDS system. However, when each ternary Drug/PVP/SDS ground mixture was added to distilled water, crystalline nanoparticles which were 200 nm or less in size were formed and had excellent stability. Zeta potential measurement suggested that the nanoparticles had a structure where SDS was adsorbed onto the particles that were formed by the adsorption of PVP on the surface of drug crystals. Stable existence of crystalline nanoparticles was attributable to the inhibition of aggregation caused by the adsorption of PVP and SDS on the surface of drug crystals. Furthermore, the electrostatic repulsion due to the negative charge of SDS on a shell of nanoparticles could be assumed to contribute to the stable dispersion.

Improvement of physicochemical properties of N-4472. Part III. VC/N-4472 complex formation and self-association in aqueous solution.

To improve the aqueous solubility of a poorly water-soluble drug, N-[2-(3,5-di-tert-butyl-4-hydroxyphenethyl)-4,6-difluorophenyl]-N'-[4-(N-benzylpiperidyl)]urea (N-4472), organic acid/N-4472 evaporates were prepared by using succinic acid, L-tartaric acid, citric acid and L-ascorbic acid (VC). Among these evaporates, only the VC/N-4472 evaporate at a molar ratio of more than 2 (VC/N-4472) formed stable colloidal particles (with a mean particle size

Exceptionally Persistent Nitrogen-Centered Free Radicals. Syntheses, ESR Spectra, Isolation, and X-ray Crystallographic Structures of N-(Arylthio)-2-tert-butyl-4,6-diarylphenylaminyl and N-(Arylthio)-4-tert-butyl-2,6-diarylphenylaminyl Radicals(1).

The preparation, ESR spectra, isolation, and X-ray crystallographic structure of N-(arylthio)-2-tert-butyl-4,6-diarylphenylaminyls (1) and N-(arylthio)-4-tert-butyl-2,6-diarylphenylaminyls (2) are described. The aminyls are generated by PbO(2) oxidation of N-(arylthio)-2-tert-butyl-4,6-diarylanilines and N-(arylthio)-4-tert-butyl-2,6-diarylanilines. The kinetic ESR study shows that the aminyls are quite persistent, even in the presence of oxygen, and exist in the individual radical forms. Among the seventeen aminyls prepared, N-[(4-nitrophenyl)thio]-2-tert-butyl-4,6-diphenylphenylaminyl (1b), N-[(4-nitrophenyl)thio]-2-tert-butyl-4,6-bis(4-chlorophenyl)phenylaminyl (1f), N-[(4-nitrophenyl)thio]-4-tert-butyl-2,6-diphenylphenylaminyl (2b), N-[(4-nitrophenyl)thio]-4-tert-butyl-2,6-bis(4-chlorophenyl)phenylaminyl (2h), and N-[(3,5-dichlorophenyl)thio]-4-tert-butyl-2,6-bis(4-chlorophenyl)phenylaminyl (2j) are isolated as radical crystals. The crystallographic structures of 1b and 2b are determined by the X-ray crystallographic analyses. Aminyls 1 and 2 give similar ESR spectra consisting of 1:1:1 triplets with the a(N) values of 0.921-0.948 mT. Deuteration of the phenyl groups on the anilino benzene ring gives rise to a further splitting of the nitrogen 1:1:1 triplet by the anilino meta (0.126-0.138) and phenylthiyl ortho and para protons (0.077-0.096 mT). Upon recording at high gain, one of the partly deuterated aminyls gives satellite lines due to (33)S isotopes at natural abundance from which a(33)(S) is determined to be 0.51 mT. The ESR parameters for 1 and 2 are compared with those for structurally close N-(arylthio)-2,4,6-triarylphenylaminyl and N-(arylthio)-2,4,6-tri-tert-butylphenylaminyl.