Correlation of preference- and profile-based quality of life of Japanese oral cancer patients during the perioperative period measured using EQ-5D-5L and FACT-H&N.

The EuroQol 5-dimension 5-level (EQ-5D-5L) instrument is among the most used preference-based quality of life (QOL) measures for cost-utility analysis. Each dimension is evaluated on five levels. The aim of this study was to clarify whether the EQ-5D-5L, which consists of only five items, correlates with profile-based QOL measures in Japanese oral cancer patients during the perioperative period. One hundred participants with oral cancer undergoing radical therapy completed QOL assessments before treatment, at treatment completion, and 1 and 3 months after treatment using the EQ-5D-5L and Functional Assessment of Cancer Therapy - Head & Neck instrument (FACT-H&N, Japanese version). To clarify how the EQ-5D-5L reflects the FACT-H&N, multiple regression analyses were performed using FACT-H&N subscales. The ceiling effect of the EQ-5D-5L was investigated. The EQ-5D-5L moderately correlated with the FACT-H&N over the entire perioperative period (rs = 0.586, P < 0.01). In the multiple regression analysis, the EQ-5D-5L was strongly reflected in the physical wellbeing subscale of the FACT-H&N, excluding social wellbeing. The pre-treatment EQ-5D-5L score was decreased owing to the impacts of the dimensions of pain/discomfort and anxiety/depression. The EQ-5D-5L did not have a ceiling effect in oral cancer patients. The EQ-5D-5L appears to generally correlate with the FACT-H&N for oral cancer patients during the perioperative period.

Relation of Poor Nutritional Status to Mild Cognitive Impairment in Patients with Coronary Artery Disease.

OBJECTIVES: Nutritional status affects cerebral circulation and cognitive function. More attention needs to be paid to nutritional status in coronary artery disease (CAD) patients, yet the relation between nutritional status or dietary intake (DI) and cognitive function or mild cognitive impairment (MCI) in CAD patients remain unclear. Thus, we examined the following relations: 1) that between nutritional status and cognitive function, and MCI and 2) that between DI and cognitive function, and MCI. DESIGN, SETTING, AND PARTICIPANTS: We conducted a cross-sectional study of 208 patients with CAD but without dementia. MEASUREMENTS: MCI was estimated with the Japanese version of the Montreal Cognitive Assessment (MoCA-J). Nutritional status was assessed by the Geriatric Nutritional Risk Index (GNRI), and DI was assessed by total energy intake per day. We investigated the relation between nutritional status or DI and cognitive function by Pearson correlation analysis, and that between nutritional status or DI and MCI by multivariable logistic regression analysis. RESULTS: The GNRI and DI were positively associated with the MoCA-J score (r = 0.23, p < 0.001, and r = 0.24, p < 0.001, respectively), and both were independently associated with MCI in the multivariable logistic regression analysis (odds ratio, 0.96; p = 0.045, and odds ratio, 0.998; p = 0.020, respectively). CONCLUSIONS: Poor nutritional status and low DI were found to be significantly associated with cognitive function and MCI in CAD patients. Our findings regarding nutritional status and DI might be useful for clinicians to prevent or intervene in the early cognitive decline of inpatients with CAD.

Effects of postoperative dietary intake on functional recovery of patients undergoing cardiac surgery.

BACKGROUND AND AIM: Among elderly patients undergoing cardiac surgery, malnutrition is very common and related to muscle wasting known as sarcopenia. Cardiac surgery causes a further decline of nutritional status due to reduced dietary intake (DI); however, the impact of postoperative DI on functional recovery is unclear. METHODS AND RESULTS: We enrolled 250 consecutive patients undergoing cardiac surgery. Daily DI was measured between postoperative days 3 and 7. Patients were categorized as having sufficient or insufficient DI based on whether their DI met or was less than estimated total energy requirements. Functional capacity was measured using the 6-minute walking distance (6MWD) preoperatively and at discharge. Mean postoperative DI was 22.4 ± 3.0 kcal/kg/day, and postoperative DI was insufficient in 92 patients (36.8%). The prevalence of sarcopenia was not different by postoperative DI. Although there was no significant difference in preoperative 6MWD results (P = 0.65), the sufficient DI group had longer 6MWD at discharge than the insufficient DI group (P = 0.04). In multivariate regression analysis, preoperative poor nutritional status (ß = -0.29), duration of surgery (ß = -0.18), and postoperative DI (ß = 0.40) remained statistically significant predictors for improvement of 6MWD (P < 0.0001, adjusted R2 = 0.41). CONCLUSIONS: Postoperative DI was independently associated with functional recovery, but preoperative sarcopenia was not. Regardless of preoperative nutritional status or the presence of sarcopenia, aggressive nutritional intervention in the early stage after surgery helps support functional recovery.

Thermal Conductivity through the Quantum Critical Point in YbRh_{2}Si_{2} at Very Low Temperature.

The thermal conductivity of YbRh_{2}Si_{2} has been measured down to very low temperatures under field in the basal plane. An additional channel for heat transport appears below 30 mK, both in the antiferromagnetic and paramagnetic states, respectively, below and above the critical field suppressing the magnetic order. This excludes antiferromagnetic magnons as the origin of this additional contribution to thermal conductivity. Moreover, this low temperature contribution prevails a definite conclusion on the validity or violation of the Wiedemann-Franz law at the field-induced quantum critical point.

Verification of the Wiedemann-Franz law in YbRh2Si2 at a quantum critical point.

The thermal conductivity measurements are performed on the heavy-fermion compound YbRh(2)Si(2) down to 0.04 K and under magnetic fields through a quantum critical point (QCP) at B(c)=0.66 T∥c axis. In the limit as T→0, we find that the Wiedemann-Franz law is satisfied within experimental error at the QCP despite the destruction of the standard signature of Fermi liquid. Our results place strong constraints on models that attempt to describe the nature of the unconventional quantum criticality of YbRh(2)Si(2).

Thermoelectric response near a quantum critical point of ß-YbAlB4 and YbRh2Si2: a comparative study.

The thermoelectric coefficients have been measured down to a very low temperature for the Yb-based heavy-fermion compounds ß-YbAlB4 and YbRh2Si2, often considered as model systems for the local quantum criticality case. We observe a striking difference in the behavior of the Seebeck coefficient S in the vicinity of their respective quantum critical point (QCP). Approaching the critical field, S/T is enhanced in ß-YbAlB4, but drastically reduced in YbRh2Si2. The ratio of thermopower to specific heat remains constant for ß-YbAlB4, but it is significantly reduced near the QCP in YbRh2Si2. In both systems, on the other hand, the Nernst coefficient shows a diverging behavior near the QCP. The interplay between valence and magnetic quantum criticality and the additional possibility of a Lifshitz transition crossing the critical field under magnetic field are discussed as the origin of the different behaviors of these compounds.

Relation between maximum phonation time and exercise capacity in chronic heart failure patients.

BACKGROUND: Patients with chronic heart failure (CHF) commonly fatigue easily due to low peak oxygen uptake (peak VO(2)), an important index of exercise capacity. Maximum phonation time (MPT) is widely used to evaluate maximum vocal capabilities because it is non-invasive, quick, and inexpensive. AIM: The aim of this study was to determine the relation between MPT and exercise capacity, and MPT required to attain an exercise capacity of ≥5 metabolic equivalents (METs) in CHF outpatients. DESIGN: Cross-sectional study. SETTING: Outpatient cardiac rehabilitation unit. POPULATION: We enrolled 111 CHF outpatients (mean age 54.2±10.1 years). METHODS: Peak VO(2) was assessed during cardiopulmonary exercise testing (CPX) as the index of exercise capacity. After CPX, we divided the patients into two groups according to exercise capacity: ≥5 METs group (N.=68) and <5 METs group (N.=43). Measurements of MPT were taken in the seated position. All patients were asked to produce a sustained vowel /a:/ for as long as possible and were verbally encouraged during respiratory effort. RESULTS: After adjustment for patient clinical characteristics, MPT in the CHF patients was found to be significantly higher in the ≥5 METs group than in the <5 METs group (22.1±8.4 vs. 17.0±11.6 s, F=13.5, P<0.001). Receiver-operating characteristic curve analysis of exercise capacity of ≥5 METs extracted a cutoff value for MPT of 18.27 s, with a sensitivity of 0.76, 1-specificity of 0.33, and AUC value of 0.81 (95% CI: 0.70-0.87, P<0.001). CONCLUSION: There were differences in MPT in relation to an exercise capacity threshold of ≥5 METs in CHF outpatients. A MPT of 18.27 sec may be the best cutoff value to identify people with or without exercise capacity of ≥5 METs. CLINICAL REHABILITATION IMPACT: Measurement of MPT may be a useful method for estimating exercise capacity in CHF outpatients.

Twofold spontaneous symmetry breaking in the heavy-fermion superconductor UPt3.

The field-orientation dependent thermal conductivity of the heavy-fermion superconductor UPt3 was measured down to very low temperatures and under magnetic fields throughout the distinct superconducting phases: B and C phases. In the C phase, a striking twofold oscillation of the thermal conductivity within the basal plane is resolved reflecting the superconducting gap structure with a line of node along the a axis. Moreover, we find an abrupt vanishing of the oscillation across a transition to the B phase, as a clear indication of a change of gap symmetries. We also identify extra two line nodes below and above the equator in both B and C phases. From these results together with the symmetry consideration, the gap function of UPt3 is determined as a E(1u) representation characterized by a combination of two line nodes at the tropics and point nodes at the poles.

Enhanced quasiparticle heat conduction in the multigap superconductor Lu2Fe3Si5 .

Thermal transport measurements have been made on the Fe-based superconductor Lu2Fe3Si5 (T(c) ∼ 6 K) down to a very low temperature T(c)/120. The field and temperature dependences of the thermal conductivity confirm the multigap superconductivity with fully opened gaps on the whole Fermi surfaces. In comparison to MgB2, Lu2Fe3Si5 reveals a remarkably enhanced quasiparticle heat conduction in the mixed state. The results can be interpreted as a consequence of the unequal weight of the Fe 3d-electron character among the distinct bands.

Expression of ADAMTS4 in Ewing's sarcoma.

Ewing's sarcoma (EWS) is a malignant bone tumor that frequently occurs in teenagers. Genetic mutations which cause EWS have been investigated, and the most frequent one proved to be a fusion gene between EWS gene of chromosome 22 and the FLI1 gene of chromosome 11. However, a limited numbers of useful biological markers for diagnosis of EWS are available. In this study, we identified ADAMTS4 (a disintegrin and metalloproteinase with thrombospondin motifs) as a possible tumor marker for EWS using the retrovirus-mediated signal sequence trap method. ADAMTS4 is a secreted protein of 837 amino acids with a predicted molecular mass of 98-100 kDa. It is a member of metalloprotease family, is expressed mainly in cartilage and brain, and regulates the degradation of aggrecans. ADAMTS4 has been suggested to be involved in arthritic diseases and gliomas. Herein, we show that ADAMTS4 mRNA was expressed in all primary EWS samples and all EWS-derived cell lines examined, while its expression was detected only in small subpopulations of other solid tumors. Furthermore, ADAMTS4 expression was found to be regulated by EWS-FLI1 fusion gene-dependent manner. We also demonstrated that ADAMTS4 protein was highly expressed in tumor samples of the patients with EWS by using immunohistochemistry. These results suggest that ADAMTS4 is a novel tumor marker for EWS.

Thermoelectric response near a quantum critical point: the case of CeCoIn5.

We present a study of thermoelectric coefficients in CeCoIn5 down to 0.1 K and up to 16 T in order to probe the thermoelectric signatures of quantum criticality. In the vicinity of the field-induced quantum critical point, the Nernst coefficient nu exhibits a dramatic enhancement without saturation down to the lowest measured temperature. The dimensionless ratio of the Seebeck coefficient to the electronic specific heat shows a minimum at a temperature close to threshold of the quasiparticle formation. Close to Tc(H), in the vortex-liquid state, the Nernst coefficient behaves anomalously in puzzling contrast with other superconductors and standard vortex dynamics.

Premedication with cyclooxygenase-2 inhibitor meloxicam reduced postoperative pain in patients after oral surgery.

The efficacy of the selective cyclooxygenase-2 (COX-2) inhibitor meloxicam for treatment of postoperative oral surgical pain was assessed in a randomized controlled trial. Patients undergoing unilateral mandibular 3rd molar extraction surgery were allocated to 3 groups, A, B and C. After oral premedication of meloxicam 10 mg in group A, ampiroxicam 27 mg in group B and placebo in group C, surgery was completed within 30 min under local anaesthesia using 2% lidocaine. For postoperative pain relief the patients were allowed to take oral loxoprofen (60 mg per tablet). Postoperative pain was evaluated at the clinic on the 1st, 7th and 14th postoperative day (POD) using a visual analogue scale (VAS), as was the number of loxoprofen tablets consumed, and the results were compared among the 3 groups with statistical significance of P<0.05. VAS scores on 1 POD were significantly lower in group A than in group C. Loxoprofen consumption on the day of surgery and 1 POD was significantly lower in group A than in group C (P<0.01). Total analgesic consumption was significantly lower in groups A and B than in group C (P<0.02). The COX-2 inhibitor, meloxicam 10 mg used for premedication reduced postoperative pain compared with control in oral surgery.

Antiangiogenic activity of BAI1 in vivo: implications for gene therapy of human glioblastomas.

Glioblastomas are the most common primary brain tumors in adults. These tumors exhibit a high degree of vascularization, and malignant progression from astrocytoma to glioblastoma is often accompanied by increased angiogenesis and the upregulation of vascular endothelial growth factor and its receptors. In this study, we investigated the in vivo antiangiogenic and antitumor effects of brain-specific angiogenesis inhibitor 1 (BAI1) using human glioblastoma cell lines. Glioblastoma cells were transduced with an adenoviral vector encoding BAI1 (AdBAI1), and Northern and Western blot analyses, respectively, demonstrated BAI1 mRNA and protein expression in the transduced tumor cells. Using an in vivo neovascularization assay, we found that angiogenesis surrounding AdBAI1-transduced glioblastoma cells transplanted into transparent skinfold chambers of SCID mice was significantly impaired compared to control treated cells. Additionally, in vivo inoculation with AdBAI1 of established subcutaneous or intracerebral transplanted tumors significantly impaired tumor growth and promoted increased mouse survival. Morphologically, the tumors exhibited signs of impaired angiogenesis, such as extensive necrosis and reduced intratumoral vascular density. Taken together, these data strongly indicate that BAI1 may be an excellent gene therapy candidate for the treatment of brain tumors, especially human glioblastomas.

Multiband superconductivity in the heavy fermion compound PrOs4Sb12.

The thermal conductivity of the heavy fermion superconductor Pr(Os(4)Sb(12) was measured down to T(c)/40 throughout the vortex state. At lowest temperatures and for magnetic fields H approximately 0.07H(c2), already 40% of the normal state thermal conductivity is restored. This behavior (similar to that observed in MgB2) is a clear signature of multiband superconductivity in this compound.

Line nodes in the superconducting gap function of noncentrosymmetric CePt3Si.

The superconducting gap structure of recently discovered heavy fermion CePt(3)Si without spatial inversion symmetry was investigated by thermal transport measurements down to 40 mK. In zero field a residual T-linear term was clearly resolved as T --> 0, with a magnitude in good agreement with the value expected for a residual normal fluid with a nodal gap structure, together with a T2 dependence at high temperatures. With an applied magnetic field, the thermal conductivity grows rapidly, in dramatic contrast to fully gapped superconductors, and exhibits one-parameter scaling with T/sqrt[H]. These results place an important constraint on the order parameter symmetry; that is, CePt(3)Si is most likely to have line nodes.

Thermal transport in the hidden-order state of URu2Si2.

We present a study of thermal conductivity in the normal state of the heavy-fermion superconductor URu2Si2. Ordering at 18 K leads to a steep increase in thermal conductivity and (in contrast with all other cases of magnetic ordering in heavy-fermion compounds) to an enhancement of the Lorenz number. By linking this observation to several other previously reported features, we conclude that most of the carriers disappear in the ordered state and this leads to a drastic increase in both the phononic and electronic mean free path.

Flux-line lattice distortion in PrOs4Sb12.

We report that the flux-line lattice in the cubic superconductor Pr(Os4Sb12 is strongly distorted from an ideal hexagonal lattice at very low temperatures in a small applied field. We attribute this to the presence of gap nodes in the superconducting state on at least some Fermi-surface sheets.