Non-bacterial cystitis with increased expression of programmed death-ligand 1 in the urothelium: An unusual immune-related adverse event during treatment with pembrolizumab for lung adenocarcinoma.

INTRODUCTION: Immune checkpoint inhibitors are now a standard therapeutic option for lung adenocarcinoma. However, Immune checkpoint inhibitors often induce various immune-related adverse events. CASE PRESENTATION: The patient was a 78-year-old woman with lung adenocarcinoma who had a partial response to pembrolizumab. During treatment, she complained of pollakiuria and nocturia with painful micturition. Histological analysis revealed infiltration of CD8-positive and/or TIA-1 cytotoxic granule-associated RNA binding protein-positive lymphocytes and programmed death-ligand 1 expression in the urothelium. A diagnosis of immune-related adverse event cystitis was made based on these clinical and pathological findings. The patient's subjective symptoms and findings on cystoscopy improved dramatically after treatment with prednisolone. CONCLUSION: Immune checkpoint inhibitors-induced cystitis is extremely rare. This report is the first to include an immunohistochemical analysis of the urothelial epithelium in immune-related adverse event cystitis and describes an instructive case.

Gait asymmetry assessment for older adults by measuring circular gait speed.

AIM: The aim of the present study was to evaluate the effectiveness of the circular gait test as a method for detecting side-to-side straight-line gait asymmetry in older adults. METHODS: A total of 25 healthy older adults and 20 healthy young adults participated in this study. Walking speeds, right- and left-leg step lengths, and stance durations were measured during straight-line walking using a triaxial accelerometer (G-walk from Bertec Japan). Step length and stance duration laterality were calculated using the side-to-side difference (|Left - Right|) and asymmetry index (|Left - Right| / mean right and left values × 100). For circular gait, the time required to walk twice around a 1-m diameter circle for right and left rotations was measured, and the laterality was calculated using the same formula as that described for the straight-line gait. RESULTS: The results showed no differences in straight-line step length or stance duration laterality between groups. However, circular gait asymmetry was significantly higher for older participants. A significant correlation was confirmed between circular gait time and straight-line step length for older adults (r = 0.404). CONCLUSIONS: The present study suggested that the circular gait test had better potential to detect age-related changes in gait laterality than straight-line gait step length or stance duration, and it might work as a simple assessment method for detecting laterality in straight-line walking. Geriatr Gerontol Int 2019; 19: 736-739.

Association of Activities of Daily Living With Load During Step Ascent Motion in Nursing Home-Residing Elderly Individuals: An Observational Study.

OBJECTIVE: This study aimed to examine the association of independence in activities of daily living with the loads during step ascent motion and other motor functions in 32 nursing home-residing elderly individuals. DESIGN: Independence in activities of daily living was assessed by using the Functional Independence Measure. The loads at the upper (i.e., pulling up) and lower (i.e., pushing up) levels during the step ascent task was measured on a step ascent platform. Hip extensor, knee extensor, plantar flexor muscle, and quadriceps setting strengths; lower extremity agility using the stepping test; and hip and knee joint pain severities were measured. One-legged stance and functional reach distance for balance and maximal walking speed, timed up-and-go time, five-chair-stand time, and step ascent time were also measured to assess mobility. RESULTS: Stepwise regression analysis revealed that the load at pushing up during step ascent motion and timed up-and-go time were significant and independent determinants of Functional Independence Measure score. Functional Independence Measure score decreased with decreased load at pushing up and increased timed up-and-go time. CONCLUSIONS: The study results suggest that depending on task specificity, both one step up task's push-up peak load during step ascent motion and timed up-and-go can partially explain activities of daily living's Functional Independence Measure score in nursing home-residing elderly individuals. Lower extremity muscle strength, agility, pain, or balance measures did not add to the prediction.

Effect of lumbo-peritoneal shunt surgery on neuropsychiatric symptoms in patients with idiopathic normal pressure hydrocephalus.

INTRODUCTION: Patients with idiopathic normal pressure hydrocephalus (iNPH) have neuropsychiatric symptoms that could affect patients' quality of life and caregiver burden. In this study, we assessed the effect of lumbo-peritoneal (L-P) shunt surgery on neuropsychiatric symptoms and the association between neuropsychiatric symptoms and caregiver burden after L-P shunt surgery. METHODS: We recruited 22 iNPH patients who had L-P shunt surgery and who were followed up for 3 months after surgery. Neuropsychiatric symptoms and caregiver burden were evaluated with the Neuropsychiatric Inventory (NPI) and Zarit Burden Interview (ZBI), respectively, before and 3 months after surgery. We evaluated the changes of NPI and ZBI and the association between the changes in these 2 scores and the triad symptoms. RESULTS: NPI total, apathy, and depression scores significantly decreased after surgery. The improvement in NPI total, apathy, disinhibition, and irritability scores after surgery were significantly and positively associated with improvement in ZBI score after surgery. Improvement in NPI apathy score was significantly associated with improvement in Frontal Assessment Battery score after surgery. CONCLUSION: L-P shunt surgery was effective in reducing not only the triad symptoms but also the neuropsychiatric symptoms, and the improved neuropsychiatric symptoms might decrease caregiver burden for iNPH patients.

Defibrillation lead placement using a transthoracic transatrial approach in a case without transvenous access due to lack of the right superior vena cava.

A 65-year-old woman with a history of syncope was diagnosed with hypertrophic cardiomyopathy. She had previously undergone mastectomy of the left breast owing to breast cancer. Holter electrocardiogram (ECG) and monitor ECG revealed sick sinus syndrome (Type II) and non-sustained ventricular tachycardia. Sustained ventricular tachycardia and ventricular fibrillation were induced in an electrophysiological study. Although the patient was eligible for treatment with a dual chamber implantable cardioverter defibrillator (ICD), venography revealed lack of the right superior vena cava (R-SVC). Lead placement from the left subclavian vein would have increased the risk of lymphedema owing to the patient׳s mastectomy history. Consequently, the defibrillation lead was placed in the right ventricle by direct puncture of the right auricle through the tricuspid valve. The atrial lead was sutured to the atrial wall, and the postoperative course was unremarkable. Defibrillation lead placement using a transthoracic transatrial approach can be an alternative method in cases where a transvenous approach for lead placement is not feasible.

Preparation of Mg-Al layered double hydroxide intercalated with Coomassie Brilliant Blue R anion and its uptake of aromatic compounds from aqueous solutions.

The objective of this study is to evaluate the capacity of Mg-Al layered double hydroxide (Mg-Al LDH) intercalated with organic dye to adsorb aromatic compounds in aqueous solutions. Mg-Al LDH intercalated with Coomassie Brilliant Blue R anion (BB(-)) was prepared by coprecipitation. The BB(-)-intercalated Mg-Al LDH was able to adsorb aromatic compounds from an aqueous solution, despite the electron density in the benzene ring of the aromatics. This uptake is caused by π-π stacking interactions, either between the electron-rich benzene rings of intercalated BB(-) and the benzene rings of aromatics with a low electron density or between the electron-poor benzene rings of intercalated BB(-) and the benzene rings of the aromatics with a high electron density.

Boron δ-doped (111) diamond solution gate field effect transistors.

A solution gate field effect transistor (SGFET) using an oxidised boron δ-doped channel on (111) diamond is presented for the first time. Employing an optimised plasma chemical vapour deposition (PECVD) recipe to deposit δ-layers, SGFETs show improved current-voltage (I-V) characteristics in comparison to previous similar devices fabricated on (100) and polycrystalline diamond, where the device is shown to operate in the enhancement mode of operation, achieving channel pinch-off and drain-source current saturation within the electrochemical window of diamond. A maximum gain and transconductance of 3 and 200µS/mm are extracted, showing comparable figures of merit to hydrogen-based SGFET. The oxidised device shows a site-binding model pH sensitivity of 36 mV/pH, displaying fast temporal responses. Considering the biocompatibility of diamond towards cells, the device's highly mutable transistor characteristics, pH sensitivity and stability against anodic oxidation common to hydrogen terminated diamond SGFET, oxidised boron δ-doped diamond SGFETs show promise for the recording of action potentials from electrogenic cells.