Relationship between dementia degree and gait ability after surgery of proximal femoral fracture: Review from Clinical Pathway with Regional Alliance data of rural region in Japan.

BACKGROUND: Proximal femoral fracture (PFF) is one of the most serious injury-related problems in developed countries. Functional prognosis after operation for PFF is unsatisfactory, as a considerable number of patients cannot perform similar gait function before fracture. Postoperative gait function is a key in performing activities of daily living (ADL). It is well known that PFF patients with dementia result in worse prognosis compared to without dementia. It is believed that dementia affects gait function after operation. However, it is still unclear whether lost function recovers after dementia level improves. METHODS: Relationship between ADL and dementia of PFF patients after surgery was investigated using data of Clinical Pathway with Regional Alliance system. Functional Independence Measurement (FIM), revised version of Hasegawa's Dementia Scale (HDS-R), motivation for rehabilitation (MR), and gait status (GS) measured in acute and recovery institute (A-I and R-I) of 266 patients were analyzed with linear regression analysis. Degrees of patients' dementia were classified into three groups with HDS-R for ten points increment partition, and their average FIM and GS in R-I for groups were compared statistically with ANOVA. FIM gain and GS gain from A-I to R-I were compared statistically with chi-square test. RESULTS: FIM and HDS-R demonstrated significant regression with each of all other parameters (p < 0.01) for both A-I and R-I. The group with lowest HDS-R score demonstrated significant lower FIM gain and lower GS gain than groups with higher scores (p < 0.01). However, patients who demonstrated improvement in HDS-R at R-I demonstrated significant better GS gain (p < 0.05) even in the group with lowest HDS-R at A-I. CONCLUSIONS: These results show that there is a very close correlation between patients' gait function and dementia and that it is necessary to control a patient's status not only for physical condition but also for mental status after PFF operation.

Investigation of plasmonic gold-silica core-shell nanoparticle stability in dye-sensitized solar cell applications.

Plasmonic core-shell Au@SiO2 nanoparticles have previously been shown to enhance the performance of dye-sensitized solar cells (DSSCs). A thin silica coating can provide a better stability during thermal processing and chemical stability to survive the corrosive electrolyte used in DSSCs. However, the thickness and completeness of the silica shell has proven crucial for the performance of the plasmonic particles and is largely controlled by the linking chemistry between the gold core and silica shell. We have evaluated four different silica coating procedures of ∼15 nm gold nanoparticles for usage in DSSCs. The chemical stability of these core-shell nanoparticles was assessed by dispersing the particles in iodide/triiodide electrolyte solution and the thermal stability by heating the particles up to 500°C. In order to maintain stable gold cores a complete silica coating was required, which was best obtained by using a mercaptosilane as a linker. In situ TEM characterization indicated that the heating process only had minor effects on the core-shell particles. The final step was to evaluate how the stable Au@SiO2 nanoparticles were influencing a real DSSC device when mixed into the TiO2 photoanode. The plasmon-incorporated DSSCs showed a ∼10% increase in efficiency compared to devices without core-shell nanoparticles.

A donor-acceptor type organic dye connected with a quinoidal thiophene for dye-sensitized solar cells.

A donor-acceptor type organic dye connected with a quinoidal thiophene as a π-conjugated chain, cyano-[5'-(4''-(N,N-dimethylamino)benzylidene)-5H-thiophen-2'-ylidene]acetic acid, was synthesized and applied to dye-sensitized solar cells (DSSCs). The absorption band of this quinoidal thiophene dye appeared at longer wavelengths than those of dyes with similar π-conjugation length, indicating the effective π-conjugation through the quinoidal structure. Although the excited state of the quinoidal thiophene dye is deactivated within several picoseconds even in solution, the DSSCs using the quinoidal thiophene dye showed incident photon to current conversion efficiency (IPCE) values of more than 90%, demonstrating the fast and efficient electron injection from the excited dye to TiO(2). By optimizing the fabrication conditions, the DSSC using this dye afforded a photoelectric conversion efficiency of 5.2%, without enlarging the molecular size.

Giant bone island of femur with femoral head necrosis: a case report.

A bone island is a hamartomatous malformation in the bone, unusually having a huge expansion. We report a rare case of giant bone island of femur concurrent with ipsilateral femoral head necrosis. Although roentgenographic features indicated the possible diagnosis of bone island, there were unusual findings, such as a huge expansion of the lesion, increased uptake of radionuclide on bone scan, and presence of symptoms. Cementless hemiarthroplasty was performed for femoral head necrosis and the diagnosis was confirmed by histology. Prosthesis insertion was considerably complicated by the presence of giant bone island located at the cut surface of the femoral neck. Despite concerns over the stability of the cementless prosthesis surrounded by bone island, roentgenograms at 4 years after surgery showed no evidence of loosening and the patient's symptoms completely disappeared.

Structural analysis of human glutamine:fructose-6-phosphate amidotransferase, a key regulator in type 2 diabetes.

Glutamine:fructose-6-phosphate amidotransferase (GFAT) is a rate-limiting enzyme in the hexoamine biosynthetic pathway and plays an important role in type 2 diabetes. We now report the first structures of the isomerase domain of the human GFAT in the presence of cyclic glucose-6-phosphate and linear glucosamine-6-phosphate. The C-terminal tail including the active site displays a rigid conformation, similar to the corresponding Escherichia coli enzyme. The diversity of the CF helix near the active site suggests the helix is a major target for drug design. Our study provides insights into the development of therapeutic drugs for type 2 diabetes.

A novel mediator-polymer-modified anode for microbial fuel cells.

A high-performance anode system based on a combination of mediator-polymer-modified graphite felt and bacteria capable of reducing extracellular materials shows significant potential for practical use in microbial fuel cells (MFCs).

Screening for novel antituberculosis agents that are effective against multidrug resistant tuberculosis.

The challenges in preventing and controlling tuberculosis are further complicated by the deadly rise of multi-drug-resistant tuberculosis (MDR-TB). Recognizing the seriousness of the situation, we initiated a program to screen new agents that would satisfy these unmet needs and have a favorable safety profile. Mycobacteria are well known for their lipid-rich properties. In Mycobacterium tuberculosis, mycolic acid in particular has been established the wall component related to the pathogenesis in the host. There are approximately 250 identified genes related to biosynthesis of the lipid turnover that contain InhA, the main target of isoniazid. Thus, the logical approach for developing a chemotherapy agent against tubercle bacilli included screening compounds that could inhibit the biosyntheses of mycolic acid and that had a novel chemical structure to ensure improved efficacy against MDR-TB. Some of the screening systems established for those purposes and some of the candidates are outlined.

Synthesis and antituberculosis activity of a novel series of optically active 6-nitro-2,3-dihydroimidazo[2,1-b]oxazoles.

In an effort to develop potent new antituberculosis agents that would be effective against both drug-susceptible and drug-resistant strains of Mycobacterium tuberculosis, we prepared a novel series of optically active 6-nitro-2,3-dihydroimidazo[2,1-b]oxazoles substituted at the 2-position with various phenoxymethyl groups and a methyl group and investigated the in vitro and in vivo activity of these compounds. Several of these derivatives showed potent in vitro and in vivo activity, and compound 19 (OPC-67683) in particular displayed excellent in vitro activity against both drug-susceptible and drug-resistant strains of M. tuberculosis H37Rv (MIC = 0.006 microg/mL) and dose-dependent and significant in vivo efficacy at lower oral doses than rifampicin in mouse models infected with M. tuberculosis Kurono. The synthesis and structure-activity relationships of these new compounds are presented.

OPC-67683, a nitro-dihydro-imidazooxazole derivative with promising action against tuberculosis in vitro and in mice.

BACKGROUND: Tuberculosis (TB) is still a leading cause of death worldwide. Almost a third of the world's population is infected with TB bacilli, and each year approximately 8 million people develop active TB and 2 million die as a result. Today's TB treatment, which dates back to the 1970s, is long and burdensome, requiring at least 6 mo of multidrug chemotherapy. The situation is further compounded by the emergence of multidrug-resistant TB (MDR-TB) and by the infection's lethal synergy with HIV/AIDS. Global health and philanthropic organizations are now pleading for new drug interventions that can address these unmet needs in TB treatment. METHODS AND FINDINGS: Here we report OPC-67683, a nitro-dihydro-imidazooxazole derivative that was screened to help combat the unmet needs in TB treatment. The compound is a mycolic acid biosynthesis inhibitor found to be free of mutagenicity and to possess highly potent activity against TB, including MDR-TB, as shown by its exceptionally low minimum inhibitory concentration (MIC) range of 0.006-0.024 microg/ml in vitro and highly effective therapeutic activity at low doses in vivo. Additionally, the results of the post-antibiotic effect of OPC-67683 on intracellular Mycobacterium tuberculosis showed the agent to be highly and dose-dependently active also against intracellular M. tuberculosis H37Rv after a 4-h pulsed exposure, and this activity at a concentration of 0.1 microg/ml was similar to that of the first-line drug rifampicin (RFP) at a concentration of 3 microg/ml. The combination of OPC-67683 with RFP and pyrazinamide (PZA) exhibited a remarkably quicker eradication (by at least 2 mo) of viable TB bacilli in the lung in comparison with the standard regimen consisting of RFP, isoniazid (INH), ethambutol (EB), and PZA. Furthermore, OPC-67683 was not affected by nor did it affect the activity of liver microsome enzymes, suggesting the possibility for OPC-67683 to be used in combination with drugs, including anti-retrovirals, that induce or are metabolized by cytochrome P450 enzymes. CONCLUSIONS: We concluded that based on these properties OPC-67683 has the potential to be used as a TB drug to help combat the unmet needs in TB treatment.

Primary abscess of the omentum: report of a case.

We report a case of a primary abscess of the omentum without any obvious etiology. A 62-year-old man was referred to our clinic with lower abdominal pain, and computed tomography showed an intra-abdominal abscess in the left pelvic area. Laparotomy revealed that the abscess adhered to the urinary bladder and abdominal wall, but no perforation of the alimentary tract was identified and there was no foreign body in the abscess cavity. A culture of the abscess fluid grew Clostridium perfringens. The patient was discharged on the 16th hospital day after an uneventful postoperative course without any complications.

Discovery of novel neuronal voltage-dependent calcium channel blockers based on emopamil left hand as a bioactive template.

A series of novel neuronal voltage-dependent calcium channel (VDCC) blockers, with inhibitory activity at low micromolar and moderate solubility in water, was discovered by constructing and screening a focused library based on emopamil (1) left hand (ELH) as a bioactive template.

Holmium: YAG laser-induced liquid jet knife: possible novel method for dissection.

BACKGROUND AND OBJECTIVES: Making surgical incisions in vessel-rich organs without causing bleeding is difficult. Thus, it is necessary to develop new devices for this purpose, especially for surgery involving small vessels as in neurosurgery, where damage against even small cerebral vessels result in severe neurological deficits. STUDY DESIGN/MATERIALS AND METHODS: A laser-induced liquid jet was generated by irradiating pulsed Holmium Yttrium-Aluminum-Garnet (Ho: YAG) laser (beams of 350 microseconds pulse width) within a copper tube (internal diameter, 1 mm) with pure water (150 ml /hour). Ho: YAG laser beams were irradiated through an optical fiber (core diameter, 0.4 mm). The influence of the input of laser energy, structure of the nozzle, and the stand-off distance between the optical fiber tip and nozzle exit on the jet velocity was measured by a high-speed video camera to evaluate controllability of jet. The effect on artificial organs made of 10 and 30%(w/v) gelatin, each of which represent features of soft tissue and blood vessels. RESULTS: Jet velocity increased in proportion to gain in laser energy input, and maximum penetration depth into 10%(w/v) gelatin was 35 mm by single exposure at 350 mJ/pulse without impairing a vessel model. Shapes of nozzle also modified jet velocity with optimal nozzle/tube area ratio of 0.25. CONCLUSIONS: The laser-induced liquid jet has excellent potential as a new tool for removing soft tissue without damaging vital structures.