Erratum: Attenuation of postprandial blood glucose in humans consuming isomaltodextrin: carbohydrate loading studies.

[This corrects the article DOI: 10.1080/16546628.2017.1325306.].

Extrapyramidal syndromes of chronic kidney disease and dialysis (diabetic uremic syndrome) with reversible parkinsonism and lentiform fork sign: A case report and literature review including metformin-induced encephalopathy.

Diabetic uremic syndrome has been rarely reported in patients on maintenance dialysis for diabetic nephropathy who present subacutely with neurological symptoms and bilateral basal ganglia lesions. There are also a few reports on metformin-induced encephalopathy, which is clinically similar to diabetic uremic syndrome. Because some patients with each of these diseases also have metabolic acidosis, it is speculated that these two diseases may have the same pathology. Recently, the term "extrapyramidal syndromes of chronic kidney disease and dialysis" (EPS-CKDD), with associated diagnostic criteria, has been proposed to describe these conditions, and metformin use is considered a risk factor for developing these syndromes. We report a case of a patient on maintenance hemodialysis for diabetic nephropathy who was taking metformin and developed subacute parkinsonism and bilateral basal ganglia lesions that rapidly improved after discontinuation of metformin with continued maintenance hemodialysis. We should ascertain whether patients with EPS-CKDD are taking metformin because it may be inappropriately prescribed for end-stage renal disease. If metformin has been prescribed, it should be discontinued immediately; its discontinuation may lead to rapid symptom recovery and improved prognosis.

Spatial distribution and benthic risk assessment of cyclic, linear, and modified methylsiloxanes in sediments from Tokyo Bay catchment basin, Japan: Si-based mass profiles in extractable organosilicon.

We investigated the spatial distribution, mass profiles, and benthic risk assessment of a wide range of methylsiloxanes (MSs), including 7 cyclic MSs (CMSs; D3-D9; the number refers to the number of SiO bonds), 13 linear MSs (LMSs; L3-L15), and 15 modified and other MSs (MMSs) in sediments from the Tokyo Bay catchment basin, Japan. We observed widespread distribution of MSs (ΣCMS, ΣLMS, and ΣMMS) in the sediment samples, with concentrations of 1.0-6180 ng/g dry weight (dw), 1.8-10,100 ng/g dw, and < 0.31-210 ng/g dw, respectively. Our study is the first to measure various MMSs modified with hydrogen, vinyl, or phenyl groups; however, only methyltris(trimethylsiloxy)silane and phenyltris(trimethylsiloxy)silane were detected with high occurrence frequency. Notably, no elevated concentrations of MSs were observed downstream of silicone manufacturers, whereas the sediment was characterized by a specific D4/D5 ratio. With the Si-based mass profiles in extractable organosilicon (EOSi), the measured CMSs, LMSs, and MMSs accounted for 5.4%, 7.8%, and 0.2%, respectively. Unidentified EOSi (unknown fraction) constituted a major proportion of the EOSi in the sediment, with a mean of 87%, suggesting that the organosilicon environmental emissions were more than the measured MSs. In risk assessment of the adverse effects of D4, D5, and D6 in sediment on benthic organisms, the respective distributions indicated no overlap between the 95th percentile field sediment concentration and the 5th percentile chronic sediment no-effect concentration in organic carbon-normalized concentration. Although the hazard quotient compared with the predicted no-effect concentration for D5 and D6 exceeded the threshold level (hazard quotient ≥1), the results of probabilistic risk assessment for the three CMSs were not high enough to indicate a threat to benthic organisms in the study area.

Dementia with Lewy Bodies with Pure Agraphia for Kanji (Japanese Morphograms).

A 70-year-old dextral woman was admitted to a hospital with agraphia for kanji (Japanese morphograms). She had a history of severe constipation, nightmares, and visual hallucinations. Neurological examinations revealed no obvious Parkinson's disease symptoms. She showed poor skills in writing the kanji for looking at picture objects, [e.g., writing the Japanese word "inu" (which means dog) when she saw a drawing of a dog] or dictated words. A reduced striatal uptake of [123I]-2ß-carbomethoxy-3ß-(4-iodophenyl)-N-(3-fluoropropyl) nortropane (FP-CIT) on single-photon-emission computed tomography and reduced meta-iodobenzylguanidine (MIBG) cardiac uptake on myocardial scintigraphy were detected. The accumulation of amyloid beta in the bilateral cerebral cortices was observed on amyloid-positron emission tomography. We herein report a case of Lewy body dementia with pure agraphia for kanji with underlying Alzheimer's disease pathology.

Inhibitory effect of isomaltodextrin on tyrosine metabolite production in rat gut microbiota.

We examined the effect of isomaltodextrin (IMD), a soluble dietary fiber, on production of putrefactive products by intestinal bacteria using a tyrosine load test to measure phenol production in IMD-treated rats. We observed a significant increase in phenol and p-cresol concentrations in rats administered with only tyrosine, but not for rats co-administered tyrosine and IMD. To elucidate the mechanism of this effect, we analyzed the intestinal microbiota in each group and found that although IMD had no direct effect on the proportion of bacteria known to produce phenols, it did alter the balance of intestinal microbiota. The results suggested that changes in the intestinal microbiota composition reduced the metabolic capacity for tyrosine and in turn suppressed production of phenol or p-cresol, putrefactive products in the intestine.

Anti-Inflammatory Activity of Isomaltodextrin in a C57BL/6NCrl Mouse Model with Lipopolysaccharide-Induced Low-Grade Chronic Inflammation.

：The purpose of this study was to identify the anti-inflammatory activity and mechanism of isomaltodextrin (IMD) in a C57BL/6NCrl mouse model with lipopolysaccharide (LPS)-induced systemic low-grade chronic inflammation and the effect on inflammation-induced potential risk of metabolic disorders. Pre-treatment of IMD decreased the production of pro-inflammatory mediators, TNF-α and MCP-1, and stimulated the production of the anti-inflammatory mediator, adiponectin by increasing the protein expression of peroxisome proliferator-activated receptor gamma (PPAR-γ) in the white adipose tissues. IMD administration reduced plasma concentrations of endotoxin, decreased macrophage infiltration into adipocytes, and increased expression of mucin 2, mucin 4, and the tight junction protein claudin 4. These results suggest that IMD administration exerted an anti-inflammatory effect on mice with LPS-induced inflammation, potentially by decreasing circulating endotoxin, suppressing pro-inflammatory mediators and macrophage infiltration, or by improving mucus or tight junction integrity. IMD exerted protein expression of insulin receptor subset-1 (IRS-1). IMD alleviated the disturbance of gut microflora in LPS-treated mice, as the number of B. bifidum, L. casei, and B. fragilis increased, and E. coli and C. difficile decreased, when compared to LPS-treated mice. The analysis of short chain fatty acids (SCFAs) further supported that the concentrations of acetic and butyric acids were positively correlated with IMD, as well as the number of beneficial bacteria. This study provides evidence that IMD possesses anti-inflammatory properties and exerts beneficial functions to prevent systemic low-grade chronic inflammation and reduces the risk of developing insulin resistance and associated metabolic diseases.

Prophylactic effects of isomaltodextrin in a Balb/c mouse model of egg allergy.

The aim of this study was to evaluate the potential effects of isomaltodextrin (IMD), a dietary saccharide polymer derived from enzymatically produced from starch, on the ability to alter immune response (IR) bias to hen egg ovalbumin (Ova) induced allergic inflammation in mice. Groups of Balb/c mice were pre-treated with various doses of IMD in drinking water (1.0, 2.5, and 5.0% w/v) for 6 weeks and subsequently sensitized to the Ova together with continuous administration of IMD. To evaluate changes in immune response bias, immunoglobulin isotype-associated antibody activity, concentrations of type 1 and 2 cytokines and the percentage of T-regulatory cells (T-regs) in blood were measured. Clinical signs of allergy were assessed after oral challenge with Ova. Treatment with IMD did not significantly alter the frequency of clinical signs, however there was a trend in the overall reduction of clinical signs. Effect on IR bias was observed in the treatment groups as reflected by reduction in a type 1-biased phenotype as evident by decrease in isotype-specific IgE, IgG and increase in IL-12 cytokine production and a high proportion of T-regs. This study revealed that IMD could be a useful prophylactic candidate for alteration of allergic IR bias in mice and an immune-stimulator for reducing egg induced allergic reactions.

Time series of hexabromocyclododecane transfers from flame-retarded curtains to attached dust.

While the production and new use of hexabromocyclododecane (HBCD) mostly ceased after being listed as a persistent organic pollutant under the Stockholm Convention in 2013, its emission from treated products in use to indoor environments still deserves attention. To examine the transfer of HBCD diastereomers to dust on the surface of flame-retarded curtains and to better characterize the potential of treated fabrics to be sources of HBCD in dust, we carried out a series of 196-day experiments using two types of curtains and attached dusts. Concurrently, the physicochemical properties (vapor pressure, water solubility, and octanol-water partition coefficient) of the HBCD diastereomers were measured. HBCD diastereomers migrated from curtains to dust with half-saturation times of about 20-50 days. By day 196, mean HBCD concentrations in dust had reached 13-290 µg/g, depending on the types of curtains and dusts. The composition of HBCD, dominated by γ-HBCD in the curtains, was dominated by α-HBCD in the post-experiment dusts, probably because of the higher vapor pressure of α-HBCD compared to γ-HBCD. The initial HBCD contents of the two curtains were comparable, but the concentrations and profiles of HBCD diastereomers in the post-experiment dusts differed markedly, probably because differences between the texture and/or surface finishing of the treated fabrics affected HBCD transfer to the attached dust.

A Case of Crossed Logopenic Primary Progressive Aphasia in a Dextral Patient with Underlying Frontotemporal Dementia.

A 61-year-old dextral woman was admitted to the hospital with difficulty finding words. Neurological examinations confirmed that her speech was affected by frequent pauses and occasional phonological paraphasia without cognitive deficits. We detected atrophy, hypoperfusion, and hypometabolism in the right perisylvian and parietal regions, expanding to the right anterior temporal lobes and right inferior frontal gyrus (opercular region) by magnetic resonance imaging, single-photon emission computed tomography, and fluorodexyglucose-positron emission tomography (PET), respectively. Amyloid-PET did not identify the accumulation of amyloid beta (Aß) in the bilateral cerebral cortices. We herein report a case of crossed aphasia with Aß-negative logopenic primary progressive aphasia that was likely the result of frontotemporal lobar degeneration.

Georeferenced multimedia environmental fate of volatile methylsiloxanes modeled in the populous Tokyo Bay catchment basin.

We investigated the multimedia fate of decamethylcyclopentasiloxane (D5) and dodecamethylcyclohexasiloxane (D6) in the densely populated catchment basin of Tokyo Bay, Japan, by using a georeferenced multimedia model. We estimated the daily per person consumption rate of these compounds in Japan according to literature. Emissions to the atmosphere accounted for almost all of the emissions of these compounds to the environment. The majority of these compounds was predicted to be distributed in the atmosphere (about 60%) and sediment (about 40%). The advective flows in and out of the atmosphere over the Tokyo Bay catchment basin dominated the flows of these compounds. The sewerage systems contributed considerably to the transport and fate of D5 and D6 in water. They transported these compounds from households to discharge outlets of sewage treatment plants (STPs), which in turn accounted for approximately one quarter of the emission of these compounds to rivers and to Tokyo Bay. The wastewater treatment plants also effectively removed these compounds from the wastewater. The overall persistence of D5 and D6 in the catchment basin was estimated to be 3.8-9.5 days. The horizontal distributions of these compounds were similar among environmental compartments; high concentrations were generally observed in populated areas. A sensitivity analysis demonstrated that the D5 discharge rate to Tokyo Bay excluding the direct discharge from STPs and the D5 mass in the river compartment were sensitive to changes of the organic-carbon-water partition coefficient. Comparison with the concentrations in rivers measured recently in the target area showed that the model captured overall trends of low to high concentrations in rivers. However, there was some variability and a bias toward underprediction. The model provided a better fit to measurements for D5 than for D6. One potential factor contributing to the bias toward underprediction was underestimation of the consumption rates.

Comparison of trophic magnification factors of PCBs and PBDEs in Tokyo Bay based on nitrogen isotope ratios in bulk nitrogen and amino acids.

Trophic positions (TPs) are key parameters for determining trophic magnification factors (TMFs) of environmental pollutants. We used compound-specific nitrogen isotope analysis of amino acids (CSIA-AA), with which we expected to obtain precise TPs, to estimate the TMFs of polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs) in the pelagic and benthic food webs of Tokyo Bay. The objective of the present study was to evaluate the difference between TMFs derived from TPs estimated by CSIA-AA (TPGlu/Phe) and TMFs derived from TPs estimated by bulk stable isotope analysis (TPbulk). TPGlu/Phe tended to be lower than TPbulk for many pelagic and benthic fishes. In the pelagic food web, the slopes for the relationships between PCB concentrations and TPGlu/Phe exceeded those between PCB concentrations and TPbulk for many congeners in samples from December 2014, and TMFGlu/Phe values (0.89-6.9) were higher than TMFbulk values (0.92-3.8). However, there were no statistically significant differences between the slopes of the relationships between PCB and PBDE concentrations and TPbulk or TPGlu/Phe for any of the congeners (analysis of covariance, P ≥ 0.08). In the benthic food web, PCB concentrations correlated with TPGlu/Phe for 9 PCB congeners in the samples collected during December 2014, although the concentrations of none of the PCB congeners correlated with TPbulk. A decrease of TMFGlu/Phe and TMFbulk values from December 2014 to May 2015 suggested that variation of PCB and PBDE concentrations in the organisms had more effect than TPs on the TMFs.

The morphology of amyloid fibrils and their impact on tissue damage in hereditary transthyretin amyloidosis: An ultrastructural study.

INTRODUCTION: We evaluated the morphology of amyloid fibrils in the peripheral nervous system using biopsy or autopsy specimens from hereditary transthyretin amyloidosis patients. The impact of amyloid fibril formation on neighboring tissues was also investigated. METHODS: Sural nerve biopsy specimens from 34 patients were examined using electron microscopy. Twenty-eight patients had Val30Met mutations, and the remaining 6 patients had non-Val30Met mutations (i.e., Glu54Lys, Pro24Ser, Thr49Ala, Val71Ala, Val94Gly, and Ala97Gly). The patients with the Val30Met mutation included a case from Brazil (supposedly of Portuguese origin), 6 early-onset cases from endemic foci in Japan, and 21 late-onset cases from non-endemic areas in Japan. RESULTS: Long amyloid fibers were abundant in the early-onset Val30Met cases from the Japanese endemic foci and Brazil, whereas the amyloid fibrils were generally short in the late-onset Val30Met and non-Val30Met cases. The amyloid fibrils seemed to mature from dotty structures among amorphous electron-dense extracellular materials and pull surrounding tissues during the maturation process. The distortion of Schwann cells close to amyloid fibril masses was conspicuous, particularly in cases with long amyloid fibrils. Atrophy was conspicuous in non-myelinating Schwann cells and bands of Büngner (i.e., Schwann cell subunits that previously contained myelinated axons), particularly those completely surrounded by amyloid fibrils. In contrast, the myelinated fibers tended to be only partially surrounded by amyloid fibrils and morphologically preserved due to their large size. Only a few demyelinated axons were found. CONCLUSION: Pre-fibrillar amyloid precursors appear to play a pivotal role during the initial phase of amyloid fibril formation. The mechanical distortion and subsequent atrophy of Schwann cells resulting from the elongation of amyloid fibrils may be related to small-fiber predominant loss, which is a classical characteristic of amyloid neuropathy. Although rather rare, the destruction of myelin (i.e., demyelination) resulting from amyloid deposition may relate to nerve conduction abnormalities mimicking chronic inflammatory demyelinating polyneuropathy.

Effects of isomaltodextrin in postprandial lipid kinetics: Rat study and human randomized crossover study.

Isomaltodextrin (IMD) is a novel dietary fiber-like polysaccharide: a type of α-glucan produced from starch using enzymes derived from microorganisms. The results of cohort studies show that dietary fiber can prevent cardiovascular disorders caused by lifestyle-related diseases such as metabolic syndrome. Inhibition of excess fat absorption by dietary fiber is known to be one of the mechanisms, and it is also known that the actions of dietary fiber vary depending on factors such as its structure or origin. Thus, we investigated the inhibitory actions of IMD on fat absorption, and analyzed its mechanism of action. In rats, the absorption of fat given by gavage was significantly lower at 1, 2, and 6 hours after IMD administration than after vehicle administration. In humans, IMD was associated with a lesser increase in blood triglycerides in subjects whose blood triglycerides were otherwise apt to rise. We also found by in vitro emulsion studies that IMD, which had no effect on digestive enzyme activity or emulsion formation, stabilized the micro size micelle by inducing enlarged micelle particle size and increased zeta potential. In conclusion, the mechanism of inhibition of fat absorption by IMD may be a delay in micelle particles accessing the intestinal epithelium through changes in the surface structure and the physical properties of the micelle particles.

Bioaccumulation Patterns of Perfluoroalkyl Acids in an Estuary of the Ariake Sea, Japan.

To evaluate the bioaccumulation potential of perfluoroalkyl acids (PFAAs) in an aquatic food web, we measured the concentrations of nine PFAAs in the water and aquatic organisms from an estuary of the Omuta River, Japan. Average log bioaccumulation factors for all PFAAs ranged from 2.0 to 2.8. There was no positive correlation observed between PFAA carbon chain length and there was no evidence of trophic magnification demonstrated among the sample types collected. These results differed from the findings of previous studies in enclosed bodies of water, perhaps because river mouth-estuarine ecotones are more variable spatially and temporally and include some fish that are highly migratory. Further investigations of bioaccumulation factors will be needed to elucidate the tendency of amphiphilic chemicals to bioaccumulate in these river mouth-estuarine ecotones.

Development and validation of a simulation method, PeCHREM, for evaluating spatio-temporal concentration changes of paddy herbicides in rivers.

In pesticide risk management in Japan, predicted environmental concentrations are estimated by a tiered approach, and the Ministry of the Environment also performs field surveys to confirm the maximum concentrations of pesticides with risk concerns. To contribute to more efficient and effective field surveys, we developed the Pesticide Chemicals High Resolution Estimation Method (PeCHREM) for estimating spatially and temporally variable emissions of various paddy herbicides from paddy fields to the environment. We used PeCHREM and the G-CIEMS multimedia environmental fate model to predict day-to-day environmental concentration changes of 25 herbicides throughout Japan. To validate the PeCHREM/G-CIEMS model, we also conducted a field survey, in which river waters were sampled at least once every two weeks at seven sites in six prefectures from April to July 2009. In 20 of 139 sampling site-herbicide combinations in which herbicides were detected in at least three samples, all observed concentrations differed from the corresponding prediction by less than one order of magnitude. We also compared peak concentrations and the dates on which the concentrations reached peak values (peak dates) between predictions and observations. The peak concentration differences between predictions and observations were less than one order of magnitude in 66% of the 166 sampling site-herbicide combinations in which herbicide was detected in river water. The observed and predicted peak dates differed by less than two weeks in 79% of these 166 combinations. These results confirm that the PeCHREM/G-CIEMS model can improve the efficiency and effectiveness of surveys by predicting the peak concentrations and peak dates of various herbicides.