Transoral removal of a hilo-parenchymal submandibular sialolith.

In sialolithiasis, the lithiasis is often large and located at the junction of the middle and posterior third of the duct, in the hilum region. In such cases, transoral approach for submandibular lithiases (TASL) is a useful treatment of choice in patients with large submandibular stones that can be palpated bimanually.

Forecasting maldistribution of human resources for healthcare and patients in Japan: a utilization-based approach.

BACKGROUND: Hokkaido's demographic trend of population decrease with aging population is remarkable even in Japan. Although healthcare policy decision-makers need to appropriately allocate resources while grasping regional demands, not much is available on whether medical demand would increase or not for future. In addition, little is known about what impact will current situation have on future demand-supply balance and equality by regions. This study aims to support decision-making in human resource planning for coping with changing population structure by forecasting future demand, and evaluation those regional maldistributions. METHOD: We set patients with acute myocardial infarction or cerebral stroke, and all medical care as study subjects and analyzed for 2015, 2025, and 2035 in Hokkaido and each Secondary Medical Care Area. We used a utilization-based approach to estimate the healthcare supply-demand balance in the future. Moreover, we evaluated the regional maldistribution of demand-supply balance by calculating Herfindahl-Hirschman Index, Gini Coefficients, the number of physicians/specialists per patient. Moreover, we conducted sensitivity analysis to evaluation impact on aspects of demand-supply balance by uncertainty of utilization for future. RESULTS: Our results displayed that concentration of patients will progress, while regional distribution will shrink in all subject. However, from comparison based on all medical care, Gini Coefficients of acute myocardial infarction and cerebral stroke has always been high. This suggest that the resource allocation of them has room for improvement. In addition, our analysis showed the change in this balance will differ in each region in the future. Moreover, demographic change will not consistent with the number of patient change from 2015 to 2035. CONCLUSION: These results suggest policy planners should use the number of patient by disease, by region as indicator of demand, instead of provider-to-population ratios being in use today. The result of our sensitivity analysis show two findings. First, the range of each indicator have possible for future. Second, increase of utilization, for instance lowing barrier in the use by development operation of patient transportation in AMI/CS, would improve maldistribution of opportunity for resident to get emergency medical services.

Therapeutic implication of mTORC2 in oral squamous cell carcinoma.

The aim of the present study was to clarify the association of mTORC2 expression with the cancer progression and the anti-tumor effects of Torin-1 alone and combined treatment with Cetuximab in OSCC cells. The expressions of Rictor and SGK1 were immunohistochemically evaluated and the relationships between the expressions of molecular markers and clinicopathological factors were determined. Moreover, OSCC cells were treated with Torin-1, Cetuximab or combined agents, and anti-tumor effects of OSCC cells were examined in vitro and in vivo. Rictor and SGK1 expressions were significantly associated with tumor stage and pattern of invasion in OSCC sections (P<0.05 and P<0.01, respectively). Treatment of OSCC cell lines with Torin-1 resulted in dose and time-dependent inhibition of proliferation with decrease of phosphorylation on downstream molecules. Combined treatment with Torin-1 and Cetuximab resulted in enhanced anti-tumor effects in vitro compared with either agent alone. Furthermore, treatment of mice bearing OSCC xenografts with Torin-1 and Cetuximab also demonstrated a remarked growth inhibition of tumor volumes. The results suggested that new regimens of systemic therapy combined with Cetuximab and Torin-1 may be useful for very advanced OSCC patients.

Efficacy and safety of sublingual immunotherapy for two seasons in patients with Japanese cedar pollinosis.

BACKGROUND: Japanese cedar (JC) pollinosis is the most common seasonal allergic rhinitis in Japan. Standardized JC pollen extract is available for subcutaneous immunotherapy, but this treatment is limited by potentially serious side effects. The aim of this double-blind, randomized comparative study was to evaluate the efficacy and safety of standardized JC pollen extract in a new oral formulation (CEDARTOLEN®, Torii Pharmaceutical Co., Ltd., Tokyo, Japan) for sublingual immunotherapy (SLIT) for JC pollinosis. METHODS: A total of 531 subjects with JC pollinosis were randomized into 2 groups at a ratio of 1:1 to receive daily sublingual administration of standardized JC pollen extract with a maintenance dose of 2,000 Japanese allergy units (JAU) or placebo for 2 consecutive pollen seasons. The efficacy was evaluated using the total nasal symptom and medication score (TNSMS) as the primary end point. Secondary end points included the total ocular symptom and medication score (TOSMS) and scores for individual symptoms and medication. RESULTS: The TNSMS was significantly lower (p < 0.0001) in the SLIT group than in the placebo group in the peak symptom period by 18 and 30% in the first and second seasons, respectively. All secondary end points were also significantly lower in the SLIT group in both seasons. No systemic anaphylaxis occurred. CONCLUSIONS: SLIT with daily administration of standardized JC pollen extract was effective for improving nasal and ocular symptoms of JC pollinosis and reducing the use of relief medication. The JC pollen extract was well tolerated with only local adverse events.

Structural modeling of RNase P RNA of the hyperthermophilic archaeon Pyrococcus horikoshii OT3.

Ribonuclease P (RNase P) is a ubiquitous trans-acting ribozyme that processes the 5' leader sequence of precursor tRNA (pre-tRNA). The RNase P RNA (PhopRNA) of the hyperthermophilic archaeon Pyrococcus horikoshii OT3 is central to the catalytic process and binds five proteins (PhoPop5, PhoRpp21, PhoRpp29, PhoRpp30, and PhoRpp38) which contribute to the enzymatic activity of the holoenzyme. Despite significant progress in determining the crystal structure of the proteins, the structure of PhopRNA remains elusive. Comparative analysis of the RNase P RNA sequences and existing crystallographic structural information of the bacterial RNase P RNAs were combined to generate a phylogenetically supported three-dimensional (3-D) model of the PhopRNA. The model structure shows an essentially flat disk with 16 tightly packed helices and a conserved face suitable for the binding of pre-tRNA. Moreover, the structure in solution was investigated by enzymatic probing and small-angle X-ray scattering (SAXS) analysis. The low resolution model derived from SAXS and the comparative 3-D model have similar overall shapes. The 3-D model provides a framework for a better understanding of structure-function relationships of this multifaceted primordial ribozyme.

Polymer-coated synthetic fibers designed for miniaturized sample preparation process.

Miniaturized sample preparation technique for complex sample matrices has been developed with a polymer-coated fibrous extraction medium. Several hundreds of fine fibrous materials were packed longitudinally into a fused-silica capillary followed by a polymeric coating on it to prepare the extraction capillary. The extraction capillary was installed in a liquid chromatograph as a sample loop of the injection valve. The on-line coupled sample preparation/separation system demonstrated a good validity for the analysis of phthalates in real river and wastewater samples. The lowest limits of quantification for several phthalates were less than 1 ng/ml. The effect of polymeric coating to the filaments on the extraction power was also investigated.

Miniaturized solid-phase extraction as a sample preparation technique for the determination of phthalates in water.

Miniaturized solid-phase extraction (SPE) has been developed and successfully employed for the determination of organic species in water samples by liquid chromatography (LC). The method is based on the concept of a microscale extraction technique using a fused-silica capillary column for gas chromatography (GC), so-called in-tube solid-phase microextraction (SPME). The extraction conditions, such as the extraction time and flow-rate for the extraction and desorption process, were investigated as well as the effect of the internal structure of the extraction capillary on the efficiency. By inserting a stainless steel wire into the extraction capillary to reduce the internal volume of the capillary with the same surface area of the coating, an improved extraction and pre-concentration effects were obtained. Further pre-concentration was accomplished by the extraction device with a novel fiber-in-tube configuration. The direct coupling of the extraction method with a LC system has made it possible to determine low levels of phthalates in water samples without high consumption of organic solvents. The system developed must have potential applications for the analysis of environmental and biological samples in aqueous sample matrices.

Miniaturized sample preparation and separation methods for environmental and drug analyses.

Miniaturized extraction and separation media have been successfully developed from precisely controlled technologies. In this article, recent developments in these high performance analytical methods, such as miniaturized sample preparation methods and the coupling of these techniques with microscale separation systems, have been reviewed, along with some applications to environmental and biological analysis. The advantage of the miniaturization is not only for the environmental compatibility but also for the developments of the high performance analytical systems. Down-sizing also makes it possible to investigate and introduce various compounds and materials as novel media (such as tailor-made materials and devices) in separation science. As a typical example of the novel miniaturized sample preparation system, the applications of fibrous materials for microcolumn liquid-phase separation methods are described.