The Influence of Speech-Language-Hearing Therapy Duration on the Degree of Improvement in Poststroke Language Impairment.

Background. The relevance of speech-language-hearing therapy (ST) duration to language impairment remains unclear. Objective. To determine the effect of ST duration on improvement in language impairment as a stroke sequela and to compare the findings with those for occupational therapy (OT) and physical therapy (PT). Methods. Data regarding patients with stroke sequelae who were registered in the Japanese Association of Rehabilitation Medicine database were analyzed. Propensity scores for ST, OT, and PT duration were calculated using logistic regression, followed by inverse probability weighting in generalized estimating equations to examine the odds ratio for improvement in the Functional Independence Measures scores for comprehension, expression, and memory. Analyses stratified by age and dementia severity were also conducted. Results. Compared with short-duration ST, long-duration ST was significantly associated with improved scores for comprehension and expression in the overall study population and in some groups, with higher benefit especially for younger participants (<64 years) and those with more severe dementia. A significant but less pronounced effect was also observed for OT and PT. Conclusion. Long-duration ST is more effective than long-duration OT or PT for improving language impairment occurring as stroke sequela. However, these effects are limited by age and severity of dementia.

[Eye Disorders Associated with S-1 Chemotherapy in Gastric Cancer Patients].

Eye disorders are one of the characteristic adverse events associated with S-1 chemotherapy. In this retrospective study, we investigated the frequency and outcome of eye disorders associated with S-1 chemotherapy in gastric cancer patients. This retrospective study included 75 advanced gastric cancer patients who received S-1 monotherapy between January 2014 and December 2015. We retrospectively evaluated the frequency, Grade, and treatment of eye disorders. Eye disorders were observed in 16 patients(21%). The median time of onset was 3(range, 1-8)months. Grade 2 watering eyes, eye discharge, and conjunctivitis were reported in 14, 8, and 4 patients, respectively. Artificial tears, fluorometholone eye-drops, and both of these treatments were used in 7, 1, and 8 patients, respectively. Ophthalmologic examination was performed for 3 patients. No delay or reduction of S-1 therapy was required for the eye disorders. Eye disorders associated with S-1 therapy in gastric cancer patients did not affect treatment if managed properly using eye drops.

Magnetic edge-states in nanographene, HNO3-doped nanographene and its residue compounds of nanographene-based nanoporous carbon.

We investigated the magnetic and electronic properties of nanographene and its charge transfer effect, using near edge X-ray absorption fine structure (NEXAFS), magnetic susceptibility and ESR measurements, and elemental analysis, with the employment of nanoporous carbon, which consists of a three dimensional disordered network of loosely stacked nanographene sheets, in relation to the host-guest interaction with HNO3 as the electron-accepting guest. The adsorption of electron acceptor HNO3 decreases the intensity of the edge state peak in NEXAFS as a result of the charge-transfer-induced Fermi energy downshift, in agreement with the decrease in the edge-state spin concentration, and it also induces the structural expansion, which makes the inter-nanographene sheet distance elongated, resulting in weakening of the inter-nanographene-sheet antiferromagnetic interaction as evidenced by the decrease in the Weiss temperature. In addition, the decomposition of HNO3, which takes place with the electron-rich edge state as an oxidation catalyst, results in the creation of oxygen/nitrogen-containing functional groups bonded to the periphery of the nanographene sheets. Heat-treatment of the HNO3-ACFs under evacuation desorbs the HNO3 molecules completely, though a part of the oxygen/nitrogen-containing species remains strongly bonded to the edge even at a high temperature of ∼800 °C, according to NEXAFS and elemental analysis results. These remaining species participate in the charge transfer, modifying the electronic structure as observed with the decrease in the orbital susceptibility and the strengthening of the inter-nanographene-sheet antiferromagnetic interaction.

Four cases of Acanthamoeba keratitis treated with phototherapeutic keratectomy.

PURPOSE: To report 4 cases of Acanthamoeba keratitis treated with excimer laser phototherapeutic keratectomy (PTK) and to discuss the clinical efficacy of this procedure. METHODS: Four cases with early stage Acanthamoeba keratitis resistant to medical amoebic therapy for at least 1 week and with an enlarged abscess underwent PTK. RESULTS: After PTK, the infected corneal lesions were removed and the clinical symptoms rapidly resolved in all cases. Another 40-µm ablation was required as a result of the 1-week delay in performing PTK. There was no recurrence during the postoperative period. CONCLUSION: When lesions are limited to about one third of the superficial corneal stromal layer, PTK could be the most beneficial option for treating Acanthamoeba keratitis, resistant to medical amoebic therapy using chlorhexidine or polyhexamethylene biguanide, because of direct removal of resistant amoebic cysts and better visual recovery without irregular astigmatism.

Effect of NIDEK optimized aspheric transition zone ablation profile on higher order aberrations during LASIK for myopia.

PURPOSE: To investigate the effect of the Optimized Aspheric Transition zone profile (OATz) that was devised to minimize the "red ring" in corneal topography on ocular higher order aberrations following LASIK for myopia. METHODS: Laser in situ keratomileusis with OATz using the Nidek Advanced Vision Excimer Laser Platform (NAVEX) was performed on 22 eyes with a 4.5-mm optical zone and 8.0-mm transition zone (OATz group). Conventional LASIK was performed on 11 eyes with a 6.0-mm optical zone and 7.0-mm transition zone as a control (conventional group). The higher order aberrations for the central 6-mm diameter were measured at 1 month postoperatively using a Hartmann-Shack wavefront sensor. In addition to the spherical aberration, the magnitude and orientation of trefoil, coma, tetrafoil, and secondary astigmatism were compared between two groups using Zernike vector analysis. RESULTS: The mean magnitude (root-mean-square) of the total higher order aberrations in the conventional group (0.70 +/- 0.28 microm) was significantly higher than that in the OATz group (0.51 +/- 0.15 microm, P < .05, unpaired t test). For spherical aberration, the OATz group had significantly lower values (0.22 +/- 0.17 microm) than the conventional group (0.38 +/- 0.23 pm, P < .05). The magnitude of coma in the conventional group was also higher than that in the OATz group (P < .05), and the mean axis of coma was 8.6 degrees in the conventional group and 64.3 degrees in the OATz group. No statistically significant differences were noted in the magnitude and axes of trefoil, tetrafoil, or secondary astigmatism between the two groups. CONCLUSIONS: The OATz profile may decrease the surgically induced increase of higher order aberrations, especially spherical aberration, following LASIK. However, a study with equivalent treatment groups and larger sample sizes is required for a definitive conclusion.

Usefulness of urinary NMP22 to detect tumor recurrence of superficial bladder cancer after transurethral resection.

BACKGROUND: In a prospective study we compared the usefulness of urinary nuclear matrix protein 22 (NMP22) with that of urine cytology and other urinary markers in the monitoring of superficial bladder cancer after transurethral resection (TURBT). METHODS: The subjects were 156 patients, comprising 99 patients with superficial bladder cancer in whom TURBT was planned (untreated group) and 57 patients without tumors in the bladder who had been followed up after TURBT (follow-up group). RESULTS: Among the 156 patients, who were monitored for 11-26 months (median, 21 months), recurrence was observed in 51 patients (33.0%). At the time of recurrence, the sensitivities of NMP22, basic fetoprotein (BFP), and bladder tumor antigen (BTA) tests, and urine cytology were 18.6%, 23.3%, 9.3%, and 7.0%, respectively. The factors affecting the sensitivity of NMP22 were tumor size and urinary WBC. The size of recurrent tumors was significantly smaller (P<0.05) than that of the initial tumors. Based on receiver operating characteristic (ROC) curves calculated from the data of patients with recurrence, the ideal cutoff values at recurrence were recommended to be 5.0 U/ml for NMP22 and 6.0 ng/ml for BFP. Using these cutoff values, the sensitivities of NMP22 and BFP were 48.8% and 44.2%, respectively. CONCLUSIONS: Because the size of recurrent bladder tumors is usually smaller than that of the initial tumors, the cutoff values of urinary markers should be reduced to detect these tumors. We recommend 5.0 U/ml as a cutoff value of NMP22 for detection of recurrence of bladder tumor.

The limited efficacy of methotrexate, actinomycin D and cisplatin (MAP) for patients with advanced testicular cancer.

BACKGROUND: Combination chemotherapy of methotrexate, actinomycin D and cisplatin (MAP) is reported to be effective against gestational choriocarcinoma. METHODS: Eight patients with metastatic testicular cancer who had elevated beta-hCG were treated with MAP. They included three refractory cases and two relapsed cases. An additional three patients received MAP as part of the induction therapy. The MAP therapy consisted of methotrexate (10 mg/m2) on days 1-5, actinomycin D (0.01 mg/kg) on days 1-5 and cisplatin (70 mg/m2) on day 1. RESULTS: In all three refractory patients, MAP failed to achieve tumor marker normalization. However, the elevated tumor markers normalized after MAP in the two cases of relapse. Of these two, one patient relapsed again 7 months after MAP and was subsequently salvaged with high-dose chemotherapy. The other patient relapsed and died of the disease 30 months after receiving MAP. Of the three patients who received MAP as part of the induction chemotherapy, one with pure choriocarcinoma achieved tumor marker normalization after MAP and is still alive without disease progression. In the other two patients, MAP failed to achieve marker normalization and the patients received high-dose chemotherapy. The toxicities were mainly bone marrow suppression and mucositis, which were almost acceptable. CONCLUSIONS: The results demonstrated the limited efficacy of MAP as salvage therapy. In addition, the efficacy of MAP as part of induction chemotherapy was negligible. However, there might be some role for MAP as a salvage therapy for patients with pure choriocarcinoma.

Sclerotic scattering illumination during phototherapeutic keratectomy for better visualization of corneal opacities.

PURPOSE: To report on a simple method to obtain a better view of corneal opacities during excimer laser phototherapeutic keratectomy (PTK). DESIGN: An interventional case report. METHODS: Phototherapeutic keratectomy was performed under sclerotic scattering illumination with a vitrectomy-endoilluminator at the limbus. RESULTS: During conventional PTK with diffuse illumination, the intraoperative observations of corneal opacities are not as good as that with a slit lamp. Conversely, subtle corneal opacities can be easily seen with sclerotic scattering illumination even under a surgical microscope. CONCLUSIONS: The use of sclerotic scattering illumination during PTK is valuable, because it provides a better view of opacified tissues and avoids excessive ablation.

Immunological protection induced by bacillus Calmette-Guérin treatment in a murine bladder tumor model.

BACKGROUND: It has been previously reported that MBT-2 tumor growth is completely inhibited when mice are inoculated with bacillus Calmette-Guérin (BCG). In this study it was examined whether or not vaccination with a mixture of BCG and MBT-2 cells also induces immunological protection against murine bladder tumors. METHODS: Seven hundred thousand MBT-2 cells and 1 mg of BCG (Tokyo 172 strain) per mouse were injected subcutaneously into female C3H/HeN mice. Four and eight weeks after vaccination with this mixture, animals were reinoculated with MBT-2 cells alone or MBT-2 cells cocultured with BCG. RESULTS: Animals vaccinated with a mixture of BCG and MBT-2 cells showed MBT-2 tumor growth but completely rejected the MBT-2 cells cocultured with BCG. MBT-2 cells cocultured with BCG developed into tumors when they were inoculated into the control animals. Splenocytes prepared from vaccinated animals showed specific cytocidal activity against MBT-2 cells precultured with BCG. CONCLUSIONS: The results suggest that a mixture of BCG and MBT-2 cells induces antitumor immunological protection against BCG- or MBT-2-associated antigens presented on MBT-2 cells precultured with BCG.