Rehabilitation Treatment of a Patient With Total Humeral Endoprosthetic Replacement.

Total humeral endoprosthetic replacement (THR) is a rare surgery for malignant humeral bone tumors. Studies focusing on its surgical methods and functional status are limited. Furthermore, rehabilitation treatment after THR has not been reported. Therefore, this case report aimed to investigate its postoperative rehabilitation treatment and reinstatement. A 69-year-old woman was diagnosed with chondrosarcoma of her left humerus. THR was performed the day following patient admission. The wide resection caused the loss of her left shoulder motor function. She had a left ulnar nerve disorder and carpal tunnel syndrome. Rehabilitation treatments such as joint range of motion training were initiated on postoperative day (POD) 1. We designed a shoulder abductor brace to maintain her left shoulder in an abducted and flexed position so she could use her left hand effectively. The manual muscle testing scores for elbow joint movements gradually improved. On POD47, she was transferred to a convalescent rehabilitation hospital to receive training in activities of daily living and barber work. The patient was discharged on POD107. The Disabilities of the Arm, Shoulder, and Hand score improved from 86.2 (POD7) to 17.2 (POD107). She continued outpatient rehabilitation and reinstated work on POD143. The use of a brace and seamless rehabilitation from the acute phase to convalescence and community-based rehabilitation enabled the patient with THR to return to work. This study suggests that precise assessment of the disorders and consecutive rehabilitation treatment with a brace should be considered after THR.

Improvement of Therapeutic Index by the Combination of Enhanced Peptide Cationicity and Proline Introduction.

Antimicrobial peptides (AMPs) are promising candidates for new therapeutics to combat the emergence of an increasing number of multidrug-resistant pathogens. However, a major obstacle to the systemic application of AMPs is their possible toxicity. In this study, we improved the therapeutic index of the typical AMP F5W-magainin 2 by simultaneously introducing positive charges (+9-+10) and Pro residues. The former and latter contributed to enhanced antimicrobial activity and reduced cytotoxicity, respectively. The results were sensitive to the positions of Pro substitution. The antimicrobial mechanism was considered to involve both membrane permeabilization and DNA binding. The latter was affected by the peptide charge but not the presence of Pro. The neutralization of lipopolysaccharides, another important role of AMPs, was not very sensitive to either the peptide charge or Pro introduction. This strategy using intrinsic amino acids is also promising from the viewpoints of the economic mass production of AMPs and safety of metabolized peptides.

Associations between diet and mental health using the 12-item General Health Questionnaire: cross-sectional and prospective analyses from the Japan Multi-Institutional Collaborative Cohort Study.

BACKGROUND: Mental health has become a major public health issue worldwide. Biological and epidemiological studies suggest diet has a role in the prevention or cure of mental disorders. However, further research is required to elucidate the relationship between diet and mental health. This study aimed to investigate associations between dietary intake of nutrients (macronutrients, vitamins, calcium, and fatty acids) and food groups (fish, meat and chicken, dairy products, and vegetables) and mental health among middle-aged Japanese in cross-sectional and prospective studies. METHODS: In total, 9298 men and women that participated in two areas of the Japan Multi-Institutional Collaborative Cohort Study were eligible for analysis at the baseline (cross-sectional) survey. Of these, 4701 participants were followed for about 5 years and included in the follow-up (prospective) analysis. The 12-item General Health Questionnaire (GHQ) was used to assess participants' general mental health status over the past several weeks. The average intake of 46 foods over the past year was assessed by a validated food frequency questionnaire. We also evaluated lifestyle and medical factors using a self-administered questionnaire. A cross-sectional logistic regression analysis was performed to estimate odds ratios for a GHQ score ≥ 4 (poor mental health) according to dietary intake of foods/nutrients at baseline. The prospective study used baseline dietary and lifestyle factors and GHQ scores at follow-up. RESULTS: The cross-sectional logistic regression analysis showed vegetables, protein, calcium, vitamin D, carotene and n-3 highly-polyunsaturated fatty acids were inversely associated with a GHQ score ≥ 4. On the other hand, mono-unsaturated fatty acids showed a positive association with higher GHQ score. The prospective logistic regression analysis found dairy products, calcium, vitamin B2, and saturated fatty acids were inversely correlated with a GHQ score ≥ 4. Calcium was associated with GHQ scores in both the cross-sectional and follow-up studies. In the follow-up study, the multivariable-adjusted odds ratio for a GHQ score ≥ 4 was 0.71 (95% confidence interval, 0.55-0.92) for the highest versus lowest quartiles of calorie-adjusted dietary calcium intake. CONCLUSION: Consuming particular nutrients and foods, especially calcium and dairy products, may lead to better mental health in Japanese adults.

Application of Three-Dimensionally Printed Probe and Reservoir to Critical Micelle Concentration Determination by Microvolume Surface Tension Measurement.

It is important to determine a critical micelle concentration (CMC) of a surfactant in a protein formulation for stabilizing the protein at maximum by preventing it from interfacial denaturation. There are several techniques for CMC determination. Among them, surface tensiometry is the most common approach because this has a long history and much data at many research fields. However, large amount of sample solution is usually required for the measurement (e.g., more than 1 mL is necessary when a standard reservoir like a glass petri dish is used). This is one of the hurdles for protein formulators because only a small amount of protein could be used at the early-stage development. In this research, we tried to minimize the required amount of sample solution for surface tension measurement by developing appropriate probe and reservoir using a three-dimensional printer (3D printer). The advantages and capabilities of 3D printer are (1) to control the shape and size of the printed material precisely, (2) to change the figure freely, and (3) to prepare the prototype quickly. After the experiments and thereby the refinement of probe as well as reservoir, we found that CMCs of polysorbate 20, polysorbate 80, and poloxamer 188 in water and protein formulations could be precisely detected using a probe 0.5 mm in diameter and small reservoir with a pocket of 7.5 mm in diameter/0.25 mm in depth which were made by a 3D printer. Furthermore, the required sample solution per each measurement could be reduced to 80 µL, which means more than 90% reduction against a standard reservoir.

Magainin 2 in action: distinct modes of membrane permeabilization in living bacterial and mammalian cells.

Interactions of cationic antimicrobial peptides with living bacterial and mammalian cells are little understood, although model membranes have been used extensively to elucidate how peptides permeabilize membranes. In this study, the interaction of F5W-magainin 2 (GIGKWLHSAKKFGKAFVGEIMNS), an equipotent analogue of magainin 2 isolated from the African clawed frog Xenopus laevis, with unfixed Bacillus megaterium and Chinese hamster ovary (CHO)-K1 cells was investigated, using confocal laser scanning microscopy. A small amount of tetramethylrhodamine-labeled F5W-magainin 2 was incorporated into the unlabeled peptide for imaging. The influx of fluorescent markers of various sizes into the cytosol revealed that magainin 2 permeabilized bacterial and mammalian membranes in significantly different ways. The peptide formed pores with a diameter of approximately 2.8 nm (< 6.6 nm) in B. megaterium, and translocated into the cytosol. In contrast, the peptide significantly perturbed the membrane of CHO-K1 cells, permitting the entry of a large molecule (diameter, >23 nm) into the cytosol, accompanied by membrane budding and lipid flip-flop, mainly accumulating in mitochondria and nuclei. Adenosine triphosphate and negatively charged glycosaminoglycans were little involved in the magainin-induced permeabilization of membranes in CHO-K1 cells. Furthermore, the susceptibility of CHO-K1 cells to magainin was found to be similar to that of erythrocytes. Thus, the distinct membrane-permeabilizing processes of magainin 2 in bacterial and mammalian cells were, to the best of our knowledge, visualized and characterized in detail for the first time.