Tasuku Suzuki

A dynamic and efficient MAP selection scheme for mobile IPv6 networks

While mobile communication systems provide certainly more flexibility to end-users, they present complex mobility management issues. To tackle mobility management issues, the concept of mobility anchor points (MAPs) was introduced and its use was proposed within the framework of the hierarchical mobile IPv6 (HMIPv6) protocol. However, due to traffic dynamics, the protocol performance remains critically affected by the selection of MAPs. This paper proposes a dynamic and efficient mobility management strategy for the selection of the most appropriate MAP with the lightest traffic load. The MAP selection is based on an estimation of MAP load transition using the exponential moving average (EMA) method. The proposed selection scheme is referred to as dynamic and efficient MAP selection (DEMAPS). The scheme performance is evaluated through simulations. Simulation results show that the DEMAPS scheme substantially reduces the number of packet drops, guarantees shorter service delays, makes better utilization of the network resources, avoids redundant transmissions, and maintains a fair and efficient distribution of the network load

Lower Back Pain as a Symptom of Migrainous Corpalgia

The symptoms and prevalence of migraine headaches are widely recognized; however, less is known about migraine-related spontaneous body pain, or migrainous corpalgia. Only a few reports have described it. The case of a 13-year-old boy with onset of migrainous corpalgia at the age of 12 years is presented. He suffered from pulsatile headaches and bilateral lower back pain, which would appear either with the headache or as an isolated symptom. Various medical examinations showed no abnormalities. He was diagnosed as having migraine without aura and successfully treated with valproic acid. It is unique for this patient to have lower back pain as a symptom of migrainous corpalgia. It would be important for physicians to understand the variety of pain symptoms in migraine patients, as shown here, for better and comprehensive understanding of migraine and its related condition.

Another case of lower back pain associated with migraine: the importance of specific questions.

Recently, the authors reported that lower back pain could be a symptom of migrainous corpalgia. Here, they report another pediatric patient who had lower back pain during a migraine, and based on their experience, they stress the importance of specifically asking questions to investigate this curious symptom. A 13-year-old boy visited an outpatient clinic complaining of headaches since the age of 12 years. These initially occurred twice monthly and had increased to 2 to 4 per week at the time of the visit. Headaches lasted 2 to 14 hours during each attack. Headaches were pulsatile or a heavy feeling, very intense, and lateralized to the left. He had occasional nausea, vomiting, and photophobia in conjunction with the headache as well as photopsias and scotoma. Detailed questioning also revealed that he had a painful feeling in his right arm and lower back pain during the attack, although he did not realize they were related to the headache. The neurological examination result between attacks was unremarkable. The blood examination findings were within normal limits, and computed tomography showed no obvious abnormality explaining his headaches. His profile was concordant with migraine with aura based on the criteria of the International Classification of Headache Disorder II. His headaches ameliorated dramatically with the administration of valproic acid. The experience provided confirmative evidence that lower back pain can be a symptom of migrainous corpalgia and highlighted the importance of specific questions by the physician to clarify the existence of hidden symptoms, such as lower back pain. The patient did not realize that his lower back pain was a part of his migraine before the doctors specifically asked about it. The authors speculate that the spatial distance between the head and lower back was related to his lack of awareness. In this context, it is extremely important for physicians to inquire about various symptoms to identify hidden symptoms, especially those whose connection to migraine is not recognized by the patient. Furthermore, such efforts can allow physicians to identify symptoms that are not known to be related on first consideration, as in this case. The authors believe that this recent short report gives physicians brand-new knowledge .

A case series of CAEBV of children and young adults treated with reduced‐intensity conditioning and allogeneic bone marrow transplantation: a single‐center study

Epstein–Barr virus (EBV)‐infected T or NK cells cause chronic active EBV infection (CAEBV). Allogeneic hematopoietic stem cell transplantation (HSCT) is curative treatment for CAEBV patients. However, chemotherapy prior to HSCT and optimal conditioning regimen for allogeneic HSCT are still controversial.

Tactile sensation and occlusal loading condition of mandibular premolars and molars.

The aim of the study was to investigate any correlation between tactile sensation and occlusal loading conditions of mandibular premolars and molars, by means of tactile detection threshold (TDT). TDTs of mandibular premolars and molars of twenty adults were determined by calibrated monofilaments. Occlusal force (OF) applied on each tooth at maximal-clenching was measured by a pressure-sensitive film. There was neither a correlation between the mean TDTs and the total OFs of individual participant nor in each tooth type. TDTs of the teeth on the preferred chewing side were significantly higher than those of the contralateral side. The results suggest that periodontal sensation is more related to frequency than to magnitude of loading.

Periodontal tactile sensation and occlusal loading condition of autotransplanted teeth: A retrospective pilot study

PURPOSE The objectives of this retrospective pilot study were: (1) to examine the occlusal properties (periodontal tactile sensation, occlusal force support ability, dynamic tooth mobility, occlusal force, contact area, preferred chewing side and main occluding area) of autotransplanted teeth with no clinical complications after transplantation (postoperative periods from 1 to 7 years). METHODS Three groups were formed from 20 subjects (23 teeth in each group): autotransplanted teeth (ATP group), teeth contralateral to the recipient site (control group A), and teeth contralateral to the donor site (control group B). RESULTS The tactile detection threshold of the ATP group was higher than both the control groups, and the individual occlusal force was significantly lower than control group A. The occlusal force ratio and the occlusal contact area ratio were significantly lower in the ATP group than in both control groups, while the mobility was similar in all groups. Eight out of 20 subjects chose the autotransplanted teeth side as the preferred chewing side. Especially when the recipient site was the first molar, the ATP of these subjects were included in the main occluding area. The pocket depth of the three groups was within the normal range. CONCLUSIONS These results demonstrate that teeth autotransplantation can achieve a mastication efficiency and periodontal condition similar to normal teeth; however, without proper healing, the periodontal sensation of autotransplanted teeth may be inferior to that of normal teeth (<250).

Dramatic response after functional hemispherectomy in a patient with epileptic encephalopathy carrying a de novo COL4A1 mutation

We describe the first case of a successful functional hemispherectomy in a patient with epileptic encephalopathy and a de novo collagen type IV alpha 1 (COL4A1) mutation. A 4-year-old girl was COL4A1 mutation-positive and suffered from drug-resistant epilepsy, hemiplegia, and developmental delay. Magnetic resonance imaging detected no porencephaly, and she had no cataract or renal abnormality. Following a presurgical evaluation for epilepsy, she underwent a functional hemispherectomy. She has been seizure free with no intracranial hemorrhage or other perioperative complications. Patients with a COL4A1 mutation have an increased risk for intracranial hemorrhage because of disrupted integrity in the vascular basement membrane due to the mutation. After weighing the risks and benefits to these patients, epilepsy surgery may not be absolutely contraindicated. Furthermore, pediatric neurologists should be aware of an undiagnosed COL4A1 mutation when a patient presents with an unexplained neurological phenotype, such as mild hemiparesis, even in the absence of porencephaly.

The study of mandibular position applied to oral appliance for treatment of obstructive sleep apnea syndrome

Oral appliances are generally designed to displace one’s mandible forward and downward, thus increasing the airway patency of the patient. Although it has been reported that the activity of the muscle genioglossus (GG) is increased by displacing the mandible protrusively, there is no study evaluating the relation between GG activity and the vertical displacement of mandible.