Explore the vast range of titles available.

Primary hyperparathyroidism (PHPT) is generally detected early, but this case involves a rare hypercalcemic crisis associated with a parathyroid adenoma. A 66-year-old man presented with extreme fatigue and loss of appetite. Serum calcium and parathyroid hormone (PTH) levels were elevated to 22.5 mg/dL and 3100 pg/mL, respectively. After the initial management of hypercalcemia, parathyroidectomy confirmed a benign adenoma. This case demonstrates a notable redistribution of bone minerals, with a significant decrease in cortical bone density but preservation, and even enhancement, of trabecular bone density. This redistribution highlights the complex dual action of PTH on bone metabolism, emphasizing the need for careful monitoring in severe PHPT cases.

Although immobility is a common cause of muscle atrophy, the mechanism underlying this causality is unclear. We here show that Krüppel-like factor 15 (KLF15) and IL-6 are upregulated in skeletal muscle of limb-immobilized mice and that mice with KLF15 deficiency in skeletal muscle or with systemic IL-6 deficiency are protected from immobility-induced muscle atrophy. A newly developed Ca2+ bioimaging revealed that the cytosolic Ca2+ concentration ([Ca2+]i) of skeletal muscle is reduced to below the basal level by immobilization, which is associated with the downregulation of Piezo1. Acute disruption of Piezo1 in skeletal muscle induced Klf15 and Il6 expression as well as muscle atrophy, which was prevented by antibodies against IL-6. A role for the Piezo1/KLF15/IL-6 axis in immobility-induced muscle atrophy was validated in human samples. Our results thus uncover a paradigm for Ca2+ signaling in that a decrease in [Ca2+]i from the basal level triggers a defined biological event.

Phosphatidylinositol 3-kinase (PI3K) plays an important role in protein metabolism and cell growth. We here show that mice (M-PDK1KO mice) with skeletal muscle–specific deficiency of 3′-phosphoinositide–dependent kinase 1 (PDK1), a key component of PI3K signaling pathway, manifest a reduced skeletal muscle mass under the static condition as well as impairment of mechanical load–induced muscle hypertrophy. Whereas mechanical load-induced changes in gene expression were not affected, the phosphorylation of ribosomal protein S6 kinase (S6K) and S6 induced by mechanical load was attenuated in skeletal muscle of M-PDK1KO mice, suggesting that PDK1 regulates muscle hypertrophy not through changes in gene expression but through stimulation of kinase cascades such as the S6K-S6 axis, which plays a key role in protein synthesis. Administration of the β 2 -adrenergic receptor (AR) agonist clenbuterol activated the S6K-S6 axis in skeletal muscle and induced muscle hypertrophy in mice. These effects of clenbuterol were attenuated in M-PDK1KO mice, and mechanical load–induced activation of the S6K-S6 axis and muscle hypertrophy were inhibited in mice with skeletal muscle–specific deficiency of β 2 -AR. Our results suggest that PDK1 regulates skeletal muscle mass under the static condition and that it contributes to mechanical load–induced muscle hypertrophy, at least in part by mediating signaling from β 2 -AR.

Carbon fibre (CF) is a lightweight next-generation material with numerous applications. CF production is predominantly based on the polyacrylonitrile (PAN) precursor because of the high tensile strength of PAN-based CFs (PAN-CFs). However, expensive and toxic organic solvents are required for PAN-CF production. Moreover, the corresponding thermal stabilisation process is highly energy-intensive, leading to high CO 2 emissions. Herein, aqueous polyacrylamide (aqPAM) fibre—prepared via polymerisation and dry spinning using water—is proposed as a water-soluble CF precursor that can be converted into high-performance CF at high carbon yields. The incorporation of small amounts of phosphoric acid into aqPAM considerably reduces the thermal stabilisation time and increases the carbon yield compared with that obtainable using PAN-CF. Moreover, the carbonised aqPAM-based CFs exhibit a high tensile strength and tensile modulus comparable with those of PAN-CFs. The developed process generates less CO 2 emissions than PAN-CF production. Carbon fibre is a lightweight next-generation material with various applications, but its production often requires expensive and toxic organic solvents, as well as highly energy-intensive heating processes. Here, the authors describe the polymerisation and spinning of carbon fibre using water, along with the implementation of a rapid heating process to reduce energy consumption.

and are two of the major pathogens responsible for pediatric rhinosinusitis. Rising antimicrobial resistance (AMR) and pneumococcal serotype replacement have complicated treatment decisions. This study aimed to investigate bacterial distribution and AMR patterns in nasal discharge samples from children at a Japanese otolaryngology clinic. We conducted a retrospective study at an otolaryngology clinic in Sendai, Japan, from February 2023 to March 2025. A total of 2009 nasal discharge specimens were analyzed. Bacterial identification and antimicrobial susceptibility testing were performed according to Clinical and Laboratory Standards Institute guidelines. and were phenotypically classified and stratified by age (0-2, 3-5, and 6-13 years). Age-group comparisons were performed using Fisher's exact test with Holm correction. Pathogens were detected in 1862 samples (92.7%). The most frequently isolated organisms were (30.9%), (23.0%), and (20.6%). Among the 697 isolates, 44.8% were ampicillin-resistant, and 31.3% of all isolates were β-lactamase-negative ampicillin-resistant (BLNAR) strains. Some BLNAR strains exhibited reduced susceptibility to amoxicillin-clavulanic acid (MIC = 8 μg/mL). Cefotaxime, cefditoren, and levofloxacin remained highly active. Among the 625 isolates, 66.6% were penicillin-susceptible, 31.0% were intermediate, and 2.4% were resistant; resistance to clarithromycin was observed in 84.3% of isolates. The prevalence of increased with age, with 25% of isolates in the 6-13-year group identified as methicillin-resistant. and remain key pathogens in pediatric rhinosinusitis and exhibit high AMR rates. Age-specific trends, including increased methicillin-resistant in older children, should guide empiric therapy. Ongoing AMR surveillance and culture-based management are essential.

Nasal adhesions, or synechiae, commonly occur following surgical procedures, resulting in nasal airway obstruction and patient discomfort. While various packing materials are available to prevent adhesion formation post-surgery, there is limited guidance on effectively dividing existing adhesions and determining the optimal packing materials to maintain separation afterward. We treated a 59-year-old man with severe adhesions in the anterior nasal cavity. After dividing the adhesions, we placed a combination of silicone sheets to cover the nasal septum, inferior turbinate, and inferior meatus. The airway remained open for one year following the procedure. Silicone is so far the best material to cover the raw surface of the nasal cavity. Being chemically inert, it does not easily interact with bodily tissues, resulting in minimal inflammatory responses. This low level of tissue reaction decreases the risk of significant inflammation or immune responses and helps to prevent tissue assimilation or excessive scarring around the material. Here, we present the treatment history and our novel technique utilizing silicone sheets.

This report introduces an endoscopic knot‐tying technique for a wide range of procedures, such as nasal mucosa suturing and dura mater reconstruction, without the need for specialized instruments. The technique utilizes basic tools like a needle holder, sutures, and bayonet‐shaped nasal forceps. The surgeon ties a surgeon's knot, guided by an endoscope, and pulls the suture with forceps to ensure proper tension. The method is effective in various surgeries, from septoplasty to skull base procedures, and has shown no adverse events in 137 patients. Its advantages include simplicity, no need for specialized tools, and ease of use in different facilities. The technique has the potential to advance endoscopic surgery, providing an efficient solution for diverse surgical applications.

Endotherms increase the rate of metabolism in metabolic organs as one strategy to cope with a decline in the temperature of the external environment. However, an additional major contributor to maintenance of body temperature in a cold environment is contraction-based thermogenesis in skeletal muscle. Here, we show that impairment of hind limb muscle contraction by cast immobilization induced a loss of function of skeletal muscle and activated brown adipose tissue (BAT) thermogenesis as a compensatory mechanism. BAT utilizes free branched-chain amino acids (BCAAs) derived from skeletal muscle as an energy substrate for thermogenesis, and interleukin-6 released by skeletal muscle stimulates BCAAs production in muscle for support of BAT thermogenesis. Additionally, this thermoregulatory system between BAT and skeletal muscle may also play an important role in response to cold temperatures or acute stress. Our findings suggest that BAT and skeletal muscle cooperate to maintain body temperature in endotherms.

Sutures play a crucial role in closing mucosal incisions during endoscopic nasal surgery. The duration until the spontaneous drop of polyglactin 910 (Vicryl) sutures in the nasal cavity remains uncertain. To investigate this, we examined the medical records of patients who underwent septoplasty, inferior turbinate reduction, or endoscopic modified medial maxillectomy with polyglactin 910 sutures. The sutures were counted and monitored during follow-up visits, and removal occurred only if patients reported discomfort. In our study of 124 patients, a total of 453 sutures were placed during surgery. Eighteen sutures had to be intentionally removed due to discomfort. Importantly, no surgical site infections were observed during the follow-up period. We found that sutures on the lateral nasal wall persisted longer than those on the nasal septum, with respective half-lives of 70 days and 64 days (p = 0.0071). In conclusion, using polyglactin 910 sutures in nasal surgery and allowing them to dissolve naturally in the submucosa is an effective approach. The sutures exhibit longer persistence on the lateral nasal wall compared to the nasal septum.