High-flow priapism in children is a very rare condition, and there is no clear consensus on its management. High-flow priapism is associated with increased cavernosal blood flow and broadly divided ...into two groups based on the presence or absence of arteriocavernous fistula in the corpora cavernosa.
This study aimed to determine the appropriate management of high-flow priapism based on the existence of arteriocavernous fistula using penile color Doppler ultrasonography (CDU) findings in the pediatric population.
The cases of four boys aged between 6 and 11 years with high-flow priapism treated between 2009 and 2017 are reported. Two boys had prior perineal trauma, one boy had blunt penile glans trauma, and one had no obvious cause for the condition. All boys initially underwent penile CDU and were treated conservatively or via selective arterial embolization depending upon the presence or absence of an arteriocavernous fistula.
Penile CDU revealed an arteriocavernous fistula inside the corpus cavernosum penis in two of four boys and increased blood flow inside the corpus spongiosum in the remaining boys. The former two boys underwent selective arterial embolization and one boy underwent repeated embolization because of remaining arteriocavernous fistula feeding from the contralateral cavernosal artery, whereas the boys with no arteriocavernous fistula on CDU were managed conservatively. All boys were successfully treated within 1 month, and they had normal morning erection and no evidence of recurrent priapism at the follow-up.
Unlike low-flow priapism, high-flow priapism is not a medical emergency. Therefore, conservative therapy is an appropriate initial treatment, although selective arterial embolization can be effective for high-flow priapism with arteriocavernous fistula, with a success rate of 97% and no reported complications to date. Penile CDU is an imaging technique that can detect focal areas of turbulent flow with sensitivity close to 100%. This study has several limitations including a small number of cases, limited follow-up duration, and possibility of spontaneous arteriocavernous fistula closure in cases treated by arterial embolization.
Penile CDU could be a reliable tool to diagnose high-flow priapism and detect the presence or absence of arteriocavernous fistula. Although conservative therapy remains the first choice, selective arterial embolization may be an early treatment option when CDU reveals an arteriocavernous fistula.Table 1Clinical features of four boys with high-flow priapism.Table 1Patient No.Age (years)EtiologyExaminationCavernous blood gas analysisColor Doppler ultrasonographyTreatmentFollow-up period (months)Outcome111NoneSemi-rigid erectionN/AIncreased blood flow inside the corpus spongiosumConservative therapy12Spontaneous resolution after one month27Blunt glans traumaSemi-rigid erectionArterialIncreased blood flow inside the corpus spongiosumConservative therapy16Spontaneous resolution after four days310Straddle injury to perineumSemi-rigid erectionArterialArteriocavernous fistula in the left corpus cavernosumSelective arterial embolization42Re-embolization → Resolved47Horseriding trauma to scrotumSemi-rigid erectionN/AArteriocavernous fistula in the right corpus cavernosumSelective arterial embolization9ResolvedN/A, not available.
BACKGROUND/OBJECTIVES: Serum polyunsaturated fatty acid (PUFA) composition reflects dietary intake and is related to risks for cardiovascular diseases. We hypothesized that serum n-3 PUFA ...composition, especially including long-chain n-3 PUFA such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), is associated with inflammatory status, which is related to increased risk for cardiovascular diseases. SUBJECTS/METHODS: We investigated the relationship between serum PUFA composition and high-sensitivity C-reactive protein (hs-CRP) levels in a cross-sectional study among 1,102 healthy men and women aged 40–74 years who reside in Kobe City. Multiple linear regression models that predict hs-CRP level were prepared to confirm the contribution of serum total n-3 PUFA, long-chain n-3 PUFA, EPA and DHA compositions after adjusting for other PUFAs and atherosclerotic risk factors. RESULTS: The serum n-3 PUFA, particularly long-chain n-3 PUFA, compositions were inversely associated with the hs-CRP levels. The standardized regression coefficient was −0.089 (p < 0.01) for total n-3 PUFA, −0.091 (p < 0.01) for long-chain n-3 PUFA, −0.071 (p = 0.03) for EPA, and −0.068 (p = 0.04) for DHA. The n-6 PUFA compositions were also inversely associated with the hs-CRP levels (−0.169 p < 0.01 for total n-6 PUFA and −0.159 p < 0.01 for linoleic acid). CONCLUSIONS: The serum n-3 PUFA compositions were inversely related with the hs-CRP levels, similar associations were also observed in n-6 PUFA compositions. Our results suggest that dietary PUFA intake was inversely associated with attenuated inflammation in healthy Japanese population.
. Okamura T, Kadowaki T, Hayakawa T, Kita Y, Okayama A, Ueshima H (Shiga University of Medical Science, Shiga, Japan; Iwate Medical University, Morioka, Iwate, Japan). What cause of mortality can we ...predict by cholesterol screening in the Japanese general population? J Intern Med 2003; 253: 169–180.
Objective. In a population with a markedly lower coronary mortality such as in Japan, the benefit of cholesterol screening may be different from Western populations. We attempted to assess the importance of cholesterol screening in Japan.
Design. A 13.2‐year cohort study for cause‐specific mortality.
Setting. Three hundred randomly selected districts throughout Japan in which the National Survey on Circulatory Disorders 1980 was performed.
Subjects. A total of 9216 community dwelling persons aged 30 years and over, with standardized serum cholesterol measurement and without a past history of cardiovascular disease.
Results. There were 1206 deaths, which included 462 deaths due to cardiovascular disease with 79 coronary heart diseases. Hypercholesterolemia (>6.21 mmol L−1) showed a significant positive relation to coronary mortality (relative risk; 2.93, 95% confidence interval; 1.52–5.63) but not to stroke. Although hypocholesterolemia (<4.14 mmol L−1) was significantly associated with an increased risk of liver cancer, noncardiovascular, noncancer disease and all‐cause mortality, these associations, except for liver cancer, disappeared after excluding deaths in the first 5 years of the follow‐up. The multivariate adjusted attributable risk of hypercholesterolaemia for coronary disease was 0.98 per 1000 person‐years, which was threefold higher than that of hypocholesterolemia for liver cancer: 0.32 per 1000 person‐years. The attributable risk percentage of hypercholesterolaemia was 66% for coronary heart disease.
Conclusion. Similar to Western populations, it is recommended to provide screening for hypercholesterolaemia in Japan, especially for males, although its attributable risk for coronary disease might be small.
Coronary heart disease incidence and mortality remain very low in Japan despite major dietary changes and increases in risk factors that should have resulted in a substantial increase in coronary ...heart disease rates (Japanese paradox). Primary genetic effects are unlikely, given the substantial increase in coronary heart disease in Japanese migrating to the United States. For men aged 40–49 years, levels of total cholesterol and blood pressure have been similar in Japan and the United States throughout their lifetimes. The authors tested the hypothesis that levels of subclinical atherosclerosis, coronary artery calcification, and intima-media thickness of the carotid artery in men aged 40–49 years are similar in Japan and the United States. They conducted a population-based study of 493 randomly selected men: 250 in Kusatsu City, Shiga, Japan, and 243 White men in Allegheny County, Pennsylvania, in 2002–2005. Compared with the Whites, the Japanese had a less favorable profile regarding many risk factors. The prevalence ratio for the presence of a coronary calcium score of ≥10 for the Japanese compared with the Whites was 0.52 (95% confidence interval: 0.35, 0.76). Mean intima-media thickness was significantly lower in the Japanese (0.616 mm (standard error, 0.005) vs. 0.672 (standard error, 0.005) mm, p < 0.01). Both associations remained significant after adjusting for risk factors. The findings warrant further investigations.
The objective of this experiment was to evaluate the selection of a pig line with improved resistance to swine mycoplasmal pneumonia and meat production in Landrace pigs. The selection was conducted ...over 5 generations using estimated breeding values of daily gain (DG), backfat thickness (BF), and mycoplasmal pneumonia scores (MPS). In order to evaluate various lung lesions, we established two different rearing environments (regularly cleaned vs. not cleaned) for the pigs. The heritability estimates for DG, BF, and MPS were found to be 0.65, 0.60, and 0.07, respectively. To compensate for the low heritability of MPS we examined the genetic correlation of immunity traits with MPS to determine their usefulness in a selection index. Cortisol (COR) plasma levels at 105kg body weight had a high positive genetic correlation (0.65) with MPS, and therefore used as an immunity trait. The average breeding values in the fifth generation, as expressed in standard deviation units, were 1.32 for DG, −0.70 for MPS, and −0.04 for BF and COR. The selection traits showed good genetic progress in 5 generations demonstrating the possibility of selecting for both disease resistance and high meat production in animals.
BACKGROUND
Blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) are risk factors for coronary artery disease (CAD) and ischemic stroke. However, the hazards of their coexistence are ...not fully understood in Asian populations. We investigated whether the relationship between BP and cardiovascular disease (CVD) outcomes are modified by LDL-C level in a Japanese population.
METHODS
Individuals aged 30-79 years (n = 5,151) were classified into 6 groups according to LDL-C levels (<140 and ≥140mg/dL or lipid medication) and BP levels (optimal BP, prehypertension, and hypertension; reference: low LDL-C and optimal BP). Hazard ratios (HRs) were calculated after adjusting for age, high-density lipoprotein cholesterol, diabetes, smoking status, and alcohol consumption. The effect modification of LDL-C on BP-CVD association was assessed using likelihood ratio tests.
RESULTS
There were 264 CAD and 215 ischemic stroke events during 13 years of follow-up. With low LDL-C, the HRs of prehypertension and hypertension for CAD were 2.01 and 4.71, respectively. Similar trends of HRs were observed with high LDL-C (optimal BP = 2.09, prehypertension = 3.45, hypertension = 5.94). However, the HRs for ischemic stroke did not differ between normal and high LDL-C levels at the same BP level. The apparent effect modification of LDL-C was not observed in the BP-CVD association in either CAD (P = 0.48) or ischemic stroke (P = 0.39).
CONCLUSIONS
The HRs for CAD in prehypertensive and hypertensive groups were higher than those in the optimal BP group at the same LDL-C levels in a Japanese population; however, there was no statistical effect modification of LDL-C on the BP-CAD association.
The FUTURE trial (UMIN000029294) demonstrated the safety and efficacy of adding palbociclib after fulvestrant resistance in patients with hormone receptor-positive (HR+)/human epidermal growth factor ...receptor 2-negative (HER2−) advanced and metastatic breast cancer (ABC/MBC). In this planned sub-study, cancer panel sequencing of cell-free DNA (cfDNA) was utilized to explore prognostic and predictive biomarkers for further palbociclib treatment following fulvestrant resistance.
Herein, 149 cfDNA samples from 65 patients with fulvestrant-resistant disease were analysed at the time of palbociclib addition after fulvestrant resistance (baseline), on day 15 of cycle 1, and at the end of treatment using the assay for identifying diverse mutations in 34 cancer-related genes.
During the course of treatment, mutations in ESR1, PIK3CA, FOXA1, RUNX1, TBX3, and TP53 were the most common genomic alterations observed. Analysis of genomic mutations revealed that before fulvestrant introduction, baseline PIK3CA mutations were marginally lower in metastatic aromatase inhibitor (AI)-treated patients compared to adjuvant AI-treated patients (P = 0.063). Baseline PIK3CA mutations were associated with poorer progression-free survival hazard ratio: 1.62, P = 0.04. Comparative analysis between baseline and early-changing gene mutations identified poor prognostic factors including early-changing MAP3K1 mutations (hazard ratio: 4.66, P = 0.04), baseline AR mutations (hazard ratio: 3.53, P = 0.04), and baseline PIK3CA mutations (hazard ratio: 3.41, P = 0.02). Notably, the relationship between ESR1 mutations and mutations in PIK3CA, MAP3K1, and TP53 weakened as treatment progressed. Instead, PIK3CA mutations became correlated with TP53 and FOXA1 mutations.
Cancer panel testing for cfDNA identified prognostic and predictive biomarkers for palbociclib add-on therapy after acquiring fulvestrant resistance in patients with HR+/HER2− ABC/MBC.
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•Trial: palbociclib’s effect on cfDNA genetic changes in fulvestrant-resistant BC.•Baseline PIK3CA and AR mutations reduced progression-free survival.•Early-changing MAP3K1 mutations reduced progression-free survival.•As treatment advanced, correlation between ESR1, PIK3CA, and TP53 mutations weakened.•Instead, PIK3CA mutations became correlated with TP53 and FOXA1 mutations.
Summary
Respiratory disease is the most important health concern for the swine industry. Genetic improvement for disease resistance is challenging because of the difficulty in obtaining good ...phenotypes related with disease resistance; however, identification of genes or markers associated with disease resistance can help in the genetic improvement of pig health. The purpose of our study was to investigate whether quantitative trait loci (QTL) associated with disease resistance were segregated in a purebred population of Landrace pigs that had been selected for meat production traits and mycoplasmal pneumonia of swine (MPS) scores over five generations. We analysed 1395 pigs from the base to the fifth generation of this population. Two respiratory disease traits MPS scores and atrophic rhinitis (AR) scores and 11 immune‐capacity traits were measured in 630–1332 animals at 7 weeks of age and when the animal's body weight reached 105 kg. Each of the pigs, except sires in the base population, was genotyped using 109 microsatellite markers, and then, QTL analysis of the full‐sib family population with a multi‐generational pedigree structure was performed. Variance component analysis was used to detect QTL associated with MPS or AR scores, and the logarithm of odds (LOD) score and genotypic heritability of the QTL were estimated. Five significant (LOD > 2.51) and 18 suggestive (LOD > 1.35) QTL for respiratory disease traits and immune‐capacity traits were detected. The significant QTL for Log‐MPS score, located on S. scrofa chromosome 2, could explain 87% of the genetic variance of this score in this analysis. This is the first report of QTL associated with respiratory disease lesions.
The muon science facility (MUSE), along with the neutron, hadron, and neutrino facilities, is one of the experimental areas of the J-PARC project. The MUSE facility is located in the Materials and ...Life Science Facility (MLF), which is a building integrated to include both neutron and muon science programs. Since the autumn of 2008, users operation is effective and making use of the pulsed muon beam particularly at the D-Line. Unfortunately, MUSE suffered severe damages from the earthquake on March 11, 2011, the so-called "Higashi-Nippon Dai-Shinsai". We managed to have a stable operation of the superconducting solenoid magnet with use of the on-line refrigerator on December, 2012, although we had to overcome a lot of difficulties against components not working properly. But we had to stop again the whole operations on May 2013, because of the radioactive materials leakage accident at the Hadron Hall Experimental Facility. Finally we restarted the users' runs on February 2014.
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