Conscious Hemiasomatognosia with No Somatosensory Disturbance Other Than a Unique Problem in Tactile Localization.

Conscious hemiasomatognosia is a disorder of the bodily self, involving subjective symptom where patients feel as if their whole body or part of one side has disappeared. Somatosensory disturbance is considered an essential component of conscious hemiasomatognosia. We herein report a 64-year-old man with conscious hemiasomatognosia of the right arm that developed after a left parietotemporal infarction, without any somatosensory disturbance except for a unique tactile localization problem. His response to the tactile localization test suggested impaired recognition of the positional relationship of his right arm relative to the entire body but normal recognition of positional relationships within the arm.

Enhancing the Motivation for Rural Career: The Collaboration between the Local Government and Medical School.

The shortage of medical workforce in rural areas is a global long-standing problem. Due to the severity of shortages in the medical workforce, Mie prefectural government has collaborated with a medical school and the municipal governments to increase the rural medical workforce. Since 2010, this collaboration has led to an annual lecture series on rural practice for medical students. We distributed questionnaires at the beginning and end of the lecture series to examine the effect of this program. The questionnaire consisted of two parts that included an understanding of rural practice and the motivation to work in rural areas. The lecture series significantly improved the responses to the following questions "Rural practice is interesting" (p < 0.001), "Rural practitioners can deliver adequate medical care" (p < 0.01), "Rural practitioners cannot go back to urban areas" (p < 0.001), "I want to be a rural practitioner" (p < 0.001), "Healthcare facilities in rural areas have been developed" (p < 0.001), "Rural practitioners can be a specialist" (p < 0.001), and "Rural residents can be served adequate healthcare service" (p < 0.01). The percentage of students who desired to work in rural areas increased significantly (11.1% vs. 23.9%, p = 0.04). A lecture series on rural practice enhanced the motivation of medical students and their interest in a rural career. While collaboration between the local government and medical school rarely occurs in planning medical education programs, this approach may offer a promising way to foster local health professionals.

Efficacy of eplerenone added to renin-angiotensin blockade in elderly hypertensive patients: the Jichi-Eplerenone Treatment (JET) study.

INTRODUCTION: We assessed the additional effects of eplerenone to angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) on 24-h blood pressure (BP) level, fibrinolytic activity, and cardiovascular protection in elderly (>60 years) hypertensive patients. MATERIALS AND METHODS: In total, 20 patients (mean age 74 years, 25% men), whose BP was uncontrolled despite the use of anti-hypertensive drugs including ACEIs or ARBs (average 2.4 drugs), received eplerenone once daily (mean 37.5 mg) for 24 weeks. RESULTS: Eplerenone treatment significantly reduced mean 24-h systolic/diastolic BP levels (143/80 mmHg to 132/74 mmHg, both p < 0.002). The reduction of 24-h systolic BP levels, especially night-time BP, was significantly associated with the reduction of atrial natriuretic peptide and brain natriuretic peptide levels (all p < 0.05). Furthermore, after eplerenone treatment, the mean plasminogen activator inhibitor-1 antigen level was significantly reduced (35 ng/ml to 25 ng/ml, p < 0.05), and the median level of plasma procollagen type III aminoterminal peptide and the urinary albumin excretion rate were also significantly reduced (0.8 U/ml to 0.6 U/ml, p < 0.003 and 53 mg/g·Cr to 23 mg/g·Cr, p < 0.05, respectively). During the intervention, eplerenone treatment was well tolerated with no reports of hyperkalaemia or hypotension. CONCLUSIONS: Addition of eplerenone to ACEIs or ARBs in elderly hypertensive patients offers significant benefits in terms of 24-h BP levels, fibrinolysis, and cardiovascular protection.

Amplification of IGH/CCND1 fusion gene in a primary plasma cell leukemia case.

The IGH/CCND1 fusion gene has been reported in many hematologic tumors such as mantle cell lymphoma, chronic lymphocytic leukemia, prolymphocytic leukemia, multiple myeloma, and plasma cell leukemia. We report a case of plasma cell leukemia showing five IGH/CCND1 fusion signals by interphase fluorescence in situ hybridization (FISH). Conventional cytogenetic analysis and multicolor spectral karyotyping showed a complex karyotype that did not include t(11;14). Metaphase FISH studies revealed three IGH/CCND1 fusion signals, two of which were amplified signals. These findings indicate that IGH/CCND1 fusion gene was amplified and interspersed in several chromosomes. The patient was treated with intensive chemotherapy. However, the clinical course was very aggressive. The amplification of the IGH/CCND1 fusion gene may contribute to the aggressive course of the disease. To our knowledge, this is the first case showing amplification of the IGH/CCND1 gene in plasma cell neoplasms.

Low-reflective wire-grid polarizers with absorptive interference overlayers.

Wire-grid (WG) polarizers with low reflectivity for visible light have been successfully developed. We theoretically consider the optical properties of simple sandwich structures of absorptive layer/transparent layer (gap layer)/high-reflective mirrors and found that it is possible to develop an antireflection (AR) coating owing to the interference along with the absorption in the absorptive layer. A wide variety of materials can be used for AR coatings by tuning the thicknesses of both the absorptive and the gap layers. This AR concept has been applied to reduce the reflectance of WG polarizers of Al. FeSi(2) as an absorptive layer has been deposited by the glancing angle deposition technique immediately on the top of Al wires covered with a thin SiO(2) layer as a gap layer. For the optimum combination of the thicknesses of FeSi(2) and SiO(2), the reflectance becomes lower than a few per cent, independent of the polarization, whereas the transmission polarization properties remain good. Because low-reflective (LR) WG polarizers are completely composed of inorganic materials, they are useful for applications requiring high-temperature durability such as liquid crystal projection displays.

Enantioselective acylation of secondary alcohols catalyzed by chiral N-heterocyclic carbenes.

[reaction: see text] The synthetic utility of chiral N-heterocyclic carbenes, which have been used mainly in transition metal-catalyzed reactions as a ligand, was demonstrated by the enantioselective acylation of secondary alcohols.

Bowl-Shaped Tris(2,6-diphenylbenzyl)tin Hydride: A Unique Reducing Agent for Radical and Ionic Chemistry.

Unique selectivity, hitherto not observable in ordinary radical and ionic reactions, is achieved with the bowl-shaped tris(2,6-diphenylbenzyl)tin hydride (TDTH; see structure), which has been successfully utilized as a new reducing agent.