Multifocal motor neuropathy and visual pathway impairment: A case report.

BACKGROUND: Multifocal motor neuropathy (MMN) occasionally presents with cranial nerve involvement. However, no MMN cases with visual pathway impairment demonstrated by visual evoked potential (VEP) have been reported. CASE REPORT: A 36-year-old man was admitted to our hospital with progressive muscular weakness. On admission, neurological findings revealed bilateral muscle weakness and atrophy of the distal upper limbs. The blood tests were positive for GM-1 ganglioside antibodies. Nerve conduction studies revealed bilateral conduction block in the median nerve. He was diagnosed with MMN. Intravenous immunoglobulin treatment improved muscle weakness and blurred vision, which was not a complaint when he was first seen. Moreover, VEP showed a post-treatment shortening of P100 latency. These treatment effects were consistently observed for 3.5 years. SIGNIFICANCE: Our findings suggested that MMN could affect the visual pathway through autoimmune mechanisms.

The new procedure for manual CPAP titration†:†the afternoon CPAP titration (aPT).

Study Objectives : Although the full-night continuous positive airway pressure (CPAP) titration (fnPT) has been recognized as the gold standard for determining an optimal therapeutic pressure for obstructive sleep apnea (OSA) treatment, it is labor-intensive, time-consuming because it requires overnight polysomnography attended by well-experienced sleep technologists. The aim of this study is to develop a practical and feasible alternative titration method. Methods : We assessed demographic data and diagnostic polysomnographic parameters, time spent in CPAP titration, CPAP efficacy and long-term adherence of the two groups of our OSA patients who had received CPAP titration either by fnPT (n = 46) or by afternoon CPAP titration (aPT, n = 22). Main results : Mean total recording time of aPT was significantly shorter than that by fnPT (p < 0.0001). There was no significant difference in mean residual apnea hypopnea index (AHI) on treatment, percent days with device usage, cumulative device usage hours during the 360 days, average device usage hours per day (360 days, days used), and percent of days with device usage ≥ 4 hours during the 360 days after starting CPAP treatment between the two groups. Conclusions : Our study demonstrated that aPT was feasible procedure as an alternative to fnPT. J. Med. Invest. 68 : 170-174, February, 2021.

Improvement of Thermotolerance of Zymomonas mobilis by Genes for Reactive Oxygen Species-Scavenging Enzymes and Heat Shock Proteins.

Thermotolerant genes, which are essential for survival at a high temperature, have been identified in three mesophilic microbes, including Zymomonas mobilis. Contrary to expectation, they include only a few genes for reactive oxygen species (ROS)-scavenging enzymes and heat shock proteins, which are assumed to play key roles at a critical high temperature (CHT) as an upper limit of survival. We thus examined the effects of increased expression of these genes on the cell growth of Z. mobilis strains at its CHT. When overexpressed, most of the genes increased the CHT by about one degree, and some of them enhanced tolerance against acetic acid. These findings suggest that ROS-damaged molecules or unfolded proteins that prevent cell growth are accumulated in cells at the CHT.

Spheronization mechanism of pharmaceutical material crystals processed by extremely high shearing force using a mechanical powder processor.

We aimed to elucidate the mechanism of the spheronization of pharmaceutical material crystals through extremely high shearing force using a mechanical powder processor, which produces spherical crystals without a solvent. The spheronization of theophylline, acetaminophen, clarithromycin, ascorbic acid and lactose was investigated, and the relationship between the spheronization mechanism and material characteristics was also examined. Theophylline and ascorbic acid crystals were partially destroyed during mechanical processing, yielding large particles and dust, and the large fragments were then layered with powder to produce spheres with a core-shell structure. Acetaminophen crystals were completely fragmented under stress, yielding fine particles to which powder then agglomerated to produce spheres with a mosaic structure. Clarithromycin and lactose crystals were not spheronized. Our results showed that the fracture strength of intact material may be closely related to the size of intermediate fragments, determining spheronization mechanism. Furthermore, the results for powder cohesiveness suggest that the materials with moderate-to-high cohesiveness (theophylline, acetaminophen and ascorbic acid) are finally spheronized regardless of the degree of the strength, whereas those with low cohesiveness (clarithromycin and lactose) are not spheronized due to poor granulation. Hence, the cohesiveness of a material has a significant effect on the success of mechanical spheronization processes.