Urinary Immunoglobulin G Is a Novel Biomarker for Atherosclerotic Burden in Mild Acute Ischemic Stroke Patients.

AIMS: Urinary immunoglobulin G (IgG) may be a stronger marker of atherosclerosis than microalbuminuria are because urinary IgG reflects proteinuria level and size-selectivity loss. Microalbuminuria-not urinary IgG-is associated with mild acute ischemic stroke (MAIS). METHODS: Using the Jikei University School of Medicine Stroke Registry, we selected and screened patients with symptomatic acute ischemic stroke (onset-to-door time ≤ 24 h). The exclusion criteria were (1) on-admission NIHSS scores ＞10, (2) a modified Rankin Scale (mRS) score ≥ 2 prior to stroke onset, (3) incomplete data (no urinalysis ≤ 3 days after admission or no mRS score at 90 days from stroke onset), and (4) an active malignancy. Patients at 90 days post-discharge were divided into those with favorable mRS scores of 0-1 and those with unfavorable mRS scores of 2-6. Clinical backgrounds were compared for (1) patients with positive and negative urinary IgG results, and (2) patients with favorable and unfavorable outcomes. RESULTS: Of our study's 210 patients (164=male, median age=68, median eGFR=53.2 ml/min/1.73 m2), 30 (14%) presented with positive urinary IgG, which was associated with cardiovascular risk factors. Higher BNP, higher D-dimer, lower eGFR, and higher CAVI were associated with higher positive urinary IgG. The favorable group, comprising 155 (74%) patients, had higher negative urinary IgG than the unfavorable group (89% vs 76%, P=0.026). No statistical difference emerged regarding microalbuminuria (29% vs 29%, P=1.000). CONCLUSION: In MAIS, urinary IgG was associated with both the presence of atherosclerosis and an unfavorable outcome at 90 days after stroke onset.

Effects and safety of high-frequency rTMS in acute intracerebral hemorrhage patients: A pilot study.

OBJECTIVE: Although high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) in chronic intracerebral hemorrhage (ICH) is beneficial, it has been poorly investigated in rTMS for acute ICH. Our aim is to investigate the effects and safety of rTMS in acute spontaneous ICH. METHODS: We prospectively performed HF-rTMS on consecutive patients with ICH within 24 h from onset between April 2019 and August 2021. The inclusion criterion was (1) persistent paralysis, with an NIHSS scale of 1 or higher for at least 3 days after onset. The exclusion criteria were (1) cortical, subcortical, and cerebellar ICH, (2) disturbance of consciousness, and (3) over 80 years of age. For the purpose of comparison, we used a conventional rehabilitation group whose patients met the same criteria between April 2016 and March 2019. We evaluated incidence of epilepsy and exacerbation of the NIHSS score in the rTMS group. We also compared the two groups regarding clinical background and outcome. RESULTS: Enrolled in the study were a total of 44 patients. Of the patients, 22 (50%) were in the rTMS group. The median (IQR) time from onset to the start of rTMS was 9 (6-12) days. There were no cases of epilepsy or exacerbation of NIHSS after the start of rTMS. Favorable outcome (modified Rankin Scale score of between 0 and 2) at 3 months was frequently observed in the rTMS group (73% vs 27%, p = 0.006). HF-rTMS was independently associated with favorable outcome at 3 months (OR = 11.5, 95% CI = 2.194-60.447, p = 0.004). CONCLUSIONS: HF-rTMS may be safe and effective in acute ICH patients.

The occurrence of spontaneous functional and nonfunctional orofacial activities in subjects without pain under laboratory conditions: a descriptive study.

AIMS: To assess the occurrence and the modality of spontaneous orofacial behaviors of awake healthy subjects without pain who were unaware of bruxism during wakefulness. METHODS: Sixteen asymptomatic subjects read silently for 30 minutes while polygraphic recordings, including electromyographic (EMG) activity from masticatory and leg muscles, chest respiratory movements, and the movements and sounds of larynx, were made with simultaneous audio-video monitoring. Orofacial behaviors were scored based on the polygraphic and audio-video records. The activity and duration of masseter EMG bursts were calculated for the types of orofacial behaviors. RESULTS: The number of orofacial behaviors varied between subjects; swallowing was most frequently observed. Approximately half of the orofacial behaviors occurred closely with body movements. Of all masseter EMG bursts detected, 55% were associated with functional orofacial behaviors, while 45% were regarded as nonfunctional. More than 80% of these masseter bursts lasted for less than 2 seconds, with an activity less than 20% of maximal voluntary clenching. These values did not differ between the types of associated orofacial behaviors. CONCLUSION: Although the occurrence of spontaneous orofacial motor activity is variable, asymptomatic subjects can exhibit substantial masseter bursts during wakefulness that are not associated with functional orofacial behaviors. The use of physiological and audio-video records permits spontaneous orofacial behaviors to be specifically identified, thereby allowing nonfunctional masseter EMG activity to be differentiated from functional masseter EMG activity.

[Application of slightly acidic hypochlorous acid water to the dental field--setting expansion and compressive strength of dental gypsum mixed with slightly acidic hypochlorous acid water].

PURPOSE: This study investigated both the setting expansion and compressive strength of dental gypsum mixed with slightly acidic hypochlorous acid water for the prevention of hospital infection. METHODS: Slightly acidic hypochlorous acid water (PURESTER Mp-240B, Morinaga Milk Industry) was used to mix each of three types of gypsum (model plaster, dental stone and high strength dental stone), and both the setting expansion and compressive strength of these gypsum products were analyzed in comparison with those mixed with tap water. RESULTS: 1. With regard to the setting expansion, a significant difference was not observed between gypsum products mixed with the two types of water, except for both the model plaster and dental stone 30 minutes after the start of mixing. 2. Regarding the compressive strength, a significant difference was not observed between gypsum products mixed with the two types of water, except for the model plaster 90 minutes after the start of mixing. CONCLUSIONS: From the results of the study, it was revealed that both the setting expansion and compressive strength of gypsum products using the slightly acidic hypochlorous acid water showed almost the same characteristics as those using tap water.