Osteoconductive property of a mechanical mixture of octacalcium phosphate and amorphous calcium phosphate

The present study was designed to investigate the extent of osteoconductive property of a mechanical mixture of octacalcium phosphate (OCP) and amorphous calcium phosphate (ACP). OCP was mixed with ACP in granules that had a diameter of 300 and 500 μm, respectively, and at 25, 50, or 75 wt %. The physicochemical characteristics and the osteoconductive properties of the mixtures were compared with OCP alone or ACP alone through implantation into rat critical-sized calvaria defects for up to 12 weeks and simulated body fluid (SBF) immersion for 2 weeks. The mixtures of OCP and ACP, in particular the OCP 25 wt % and ACP 75 wt % (O25A75), had higher radiopacity compared to ACP and OCP alone. O25A75 induced greater enhancement of bone regeneration than ACP alone at 8 weeks and that than OCP alone at 12 weeks. X-ray diffraction and Fourier transform infrared (FTIR) analyses of the retrieved mixtures showed that ACP, OCP, and O25A75 tended to convert to hydroxyapatite (HA) after the implantation, while the structure of OCP remains without complete conversion after SBF immersion. Analyses by FTIR curve fitting of the solids and the degree of supersaturation of the SBF supported the observation that the existence of ACP enhances the kinetics of the conversion. Scanning electron microscopy found that the surface of O25A75 had distinct characteristics with OCP and ACP after SBF immersion. The results suggest that the extent of the osteoconduction of OCP could be controlled by the copresence of ACP most probably through the prevailing dissolution-precipitation of the surface of ACP crystals to form HA.

The Regenerated Bone Quality by Implantation of Octacalcium Phosphate Collagen Composites in a Canine Alveolar Cleft Model

Objective

Synthetic octacalcium phosphate and porcine atelocollagen composites significantly enhanced bone regeneration more than β-tricalcium phosphate collagen composite and hydroxyapatite collagen composite in a rat cranial defect model. However, the long-term stability and quality of octacalcium phosphate collagen (OCP/Col) composites–derived regenerated bone, when implanted in a canine alveolar cleft model, have yet to be elucidated. The present study investigated the longterm stability and quality of bone regenerated by OCP/Col.

Design

Disks of OCP/Col or collagen were implanted in a canine alveolar-cleft model (n = 6). Then, bone regeneration in the implanted areas was investigated macroscopically, radiographically, and histologically at 10 months after implantation. In addition, three-dimensional quantitative images of regenerated bone were analyzed by microcomputed tomography.

Results

Macroscopically, the OCP/Col treated alveolus was clearly augmented, and radio-opacity in the OCP/Col implanted area was comparable to that of the original alveolus bone. On histological analysis, the area was mostly filled with newly formed bone, and a few granules of implanted OCP/Col were enclosed in it. In the microcomputed tomography analysis, the regenerated bone volume in the OCP/Col group was larger than that in the collagen group. OCP/Col–derived bone consisted of outer cortical and inner cancellous structure with dense trabeculae and seemed like the original bone structure.

Conclusions

OCP/Co composites could be a useful bone regenerative material to substitute for autogenous bone because their implantation could elicit high bone regeneration and active structural reconstitution.

Modulation of neuronal activity with cue-invariant shape discrimination in the primate superior temporal sulcus

Shape perception can be achieved based on various cues such as luminance, color, texture, depth and motion. To investigate common neural mechanisms underlying shape perception cued by various visual attributes, we examined single-neuron activity in the monkey anterior superior temporal sulcus (STS) in response to shapes defined by luminance and motion cues during shape discrimination. We found cortical mapping with respect to selectivity for shapes as well as for direction of motion in the STS. About 90% of shape-selective neurons were located in the lower bank of STS (lSTS) assigned to the ventral pathway, while about 80% of direction-selective neurons existed in the upper bank of STS (uSTS) assigned to the dorsal pathway. The neurons showing selectivity for both shape and motion coexisted in lSTS as well as uSTS. This result indicates that integration or convergence of shape information and motion information can occur in both banks of STS. About 90% of STS neurons showing selectivity both for shapes defined by luminance cue and for shapes defined by motion cue were located in lSTS. They showed a highly similar shape preference between the different visual attributes, indicating cue-invariant shape selectivity. The cue-invariant shape-selectivity was modulated with target selection as well as with discrimination performance of monkeys. These results suggest that lSTS could be involved in cue-invariant shape discrimination, but not the uSTS.

Endpoints for clinical trials of sarcoidosis

Over the past few years an increasing number of prospective controlled sarcoidosis treatment trials have been completed. Unfortunately, these studies utilize different endpoints making comparisons between studies difficult. At the recent World Association of Sarcoidosis and other Granulomatous disease (WASOG) meeting, a session was dedicated to the evaluation of clinical endpoints for various disease manifestations. These included pulmonary, pulmonary hypertension, fatigue, cutaneous, and a classification of clinical disease phenotypes. Based on the available literature and our current understanding of the disease, recommendations for clinical evaluation were proposed for each disease category. For example, it was recommended that pulmonary studies should include changes in the forced vital capacity. Additionally, it was recommended that all trials should incorporate measurement of quality of life.

A CD40 single-nucleotide polymorphism affects the lymphocyte profiles in the bronchoalveolar lavage of Japanese patients with sarcoidosis

CD40 plays a critical role in adaptive immunity, and alveolar macrophages in patients with sarcoidosis express higher levels of CD40. This study investigated the association of rs1883832, a functional single-nucleotide polymorphism in the CD40 gene with susceptibility to sarcoidosis and phenotypes of sarcoidosis. Genotyping of rs1883832 in 175 Japanese patients with sarcoidosis and 150 age- and sex-matched controls revealed no significant difference between the genotypes of the patient and control groups (CC/CT/TT, 32.8/52.0/14.7% in the patients; 37.3/48.0/14.7% in the controls, P = 0.66; allele C, 59.1% in the patients, 61.3% in the controls, P = 0.57). T-cell and CD4+ cell counts in the bronchoalveolar lavage fluid were significantly higher in the TT genotype group than in the CC and CT genotype group.

Predictors of 5-year mortality in pulmonary Mycobacterium avium-intracellulare complex disease

SETTING

Kyoto, Japan.

OBJECTIVE

To determine predictors of 5-year mortality in pulmonary Mycobacterium avium-intracellulare complex (MAC) disease.

DESIGN

Retrospective study of 164 patients diagnosed with pulmonary MAC disease between 1999 and 2005 and followed for 5 years.

RESULTS

Overall 5-year mortality was 28.0%. Among 117 patients with microbiological outcomes, 54 were treated (treated MAC patients) and 24 were not treated and did not experience sputum culture conversion during follow-up (untreated chronic MAC patients); 39 patients were not treated and experienced sputum culture conversion. Five-year all-cause overall mortality among the 78 patients with definite MAC disease (including treated and untreated chronic MAC patients) was 25.6%. The mortality rate was 33.3% for untreated chronic MAC patients only vs. 22.2% for treated MAC patients (P = 0.30). After adjustment for clinical, microbiological and radiological confounders, independent factors for 5-year mortality were a high Charlson comorbidity index in cases with definite MAC disease (hazard ratio [HR] 1.76) and untreated chronic MAC (HR 3.08), and presence of cavitary lesions in cases with definite MAC disease (HR 1.82) and treated MAC patients (HR 3.91).

CONCLUSION

Patients with cavitary lesions require immediate treatment for sputum culture conversion and to improve their chances of survival.

Long-term changes in airway-wall thickness on computed tomography in asthmatic patients

BACKGROUND

Effects of long-term treatment with inhaled corticosteroids (ICSs) on airway-wall thickness in patients with asthma remain unknown.

OBJECTIVES

To determine whether airway-wall thickness consistently decreases after long-term ICS treatment, and to analyze factors contributing to long-term airway-wall changes in asthmatics.

METHODS

A retrospective analysis of long-term changes in airway-wall thickness using computed tomography was performed in 14 patients with asthma. Wall area corrected by body surface area (WA/BSA) was examined at baseline, 12 weeks after the commencement of ICSs (second measurement), and at least 2 years (mean +/- SEM. 4.2 +/- 0.5) after the second measurement (third measurement). Mean +/- SEM changes in WA/BSA from the second to the third measurements were analyzed.

RESULTS

The mean change in WA/BSA was not significant between the second and the third measurements (-0.27 +/- 0.59 mm2/m2/y). Overall, the changes were significantly associated with disease duration but not with other clinical indices. When the 14 patients were divided into 2 groups using a cutoff value of 0.32 mm2/m2/y for the mean change in WA/BSA, for the 5 patients whose WA/BSA exceeded this cutoff, daily ICS doses were not reduced and both forced expiratory volume in the first second (FEV1) and forced vital capacity decreased significantly. For the remaining 9 patients, daily ICS doses were reduced and long-term FEV1 values did not change.

CONCLUSIONS

Despite long-term treatment with ICSs, airway-wall thickness did not consistently decrease. One possible mechanism underlying poor response to long-term treatment may be long-standing asthma.

Bone regeneration by octacalcium phosphate collagen composites in a dog alveolar cleft model

Octacalcium phosphate (OCP) and porcine atelocollagen sponge composites (OCP/Col) markedly enhanced bone regeneration in a rat cranial defect model. To assess clinical application, the authors examined whether OCP/Col would enhance bone regeneration in an alveolar cleft model in an adult dog, which was assumed to reflect patients with alveolar cleft. Disks of OCP/Col or collagen were implanted into the defect and bone regeneration by OCP/Col or collagen was investigated 4 months after implantation. Macroscopically, the OCP/Col-treated alveolus was obviously augmented and occupied by radio-opacity, and the border between the original bone and the defect was indistinguishable. Histological analysis revealed it was filled and bridged with newly formed bone; a small quantity of the remaining implanted OCP was observed. X-ray diffraction patterns of the area of implanted OCP/Col indicated no difference from those of dog bone. In the collagen-treated alveolus, the hollowed alveolus was mainly filled with fibrous connective tissue, and a small amount of new bone was observed at the defect margin. These results suggest that bone was obviously repaired when OCP/Col was implanted into the alveolar cleft model in a dog, and OCP/Col would be a significant bone regenerative material to substitute for autogeneous bone.

CD24 gene exon 2 dimorphism does not affect disease susceptibility in Japanese sarcoidosis patients

BACKGROUND

CD24 proteins are expressed on several inflammatory cells, and play an important role for the T-cell activation.

OBJECTIVES

The aim of this study is to investigate the relationship of a CD24 gene polymorphism to disease susceptibility or clinical findings including bronchoalveolar lavage (BAL) cell profiles in Japanese sarcoidosis patients.

METHODS

A previously reported functional single nucleotide polymorphism (SNP) of CD24 gene exon 2 was examined in 186 Japanese sarcoidosis patients and 146 sex and age-matched healthy controls using restriction fragment length polymorphism method. The distribution of genotypes was compared between the two groups. The association between genotypes or alleles and clinical features or BAL cell profiles was also examined.

RESULTS

There were no significant differences in the distribution of genotypes or allele frequencies between sarcoidosis and controls. There were also no significant differences in clinical features or BAL cell profiles among patients with different genotypes of CD24.

CONCLUSIONS

There was no relationship between a CD24 exon 2 SNP and disease susceptibility or clinical findings in Japanese sarcoidosis patients.

Significance of plasma NT-proBNP levels as a biomarker in the assessment of cardiac involvement and pulmonary hypertension in patients with sarcoidosis

BACKGROUND

Cardiac involvement and pulmonary hypertension (PH) are life-threatening complications in sarcoidosis.

OBJECTIVE

This study aimed to investigate the utility of plasma NT-proBNP in the assessment of these conditions in sarcoidosis patients.

STUDY DESIGN AND METHODS

A prospective, observational study was performed on 150 consecutive Japanese sarcoidosis patients. Doppler echocardiography was performed in all subjects, and those who were successfully evaluated for PH status were included in the analysis. Cardiac sarcoidosis was diagnosed based on Japanese guidelines, and PH was defined as estimated systolic pulmonary artery pressure (sPAP) > or = 35 mmHg. The diagnostic accuracy of NT-proBNP according to the presence of cardiac sarcoidosis and PH was assessed based on receiver-operator characteristic (ROC) curves.

RESULTS

130 subjects were successfully evaluated for PH status. Of these, 29 met the diagnostic criteria of cardiac sarcoidosis, and 21 were diagnosed with PH. Plasma NT-proBNP levels were significantly higher in patients with cardiac sarcoidosis (p < 0.0001). Stepwise regression analysis showed that presence of cardiac sarcoidosis, decreased ejection fraction and increased sPAP were all independently associated with higher plasma NT-proBNP levels. Plasma NT-proBNP showed good accuracy in identifying patients with cardiac sarcoidosis (area under the ROC curve; AURC = 0.913). However, even when patients with cardiac sarcoidosis were excluded, plasma NT-proBNP levels could not be used reliably to identify patients with PH (AURC = 0.681).

CONCLUSION

In patients with sarcoidosis, plasma NT-proBNP levels are a useful biomarker to identify cardiac involvement, but not to identify PH.

Altered profiles of intestinal microbiota and organic acids may be the origin of symptoms in irritable bowel syndrome

BACKGROUND

The profile of intestinal organic acids in irritable bowel syndrome (IBS) and its correlation with gastrointestinal (GI) symptoms are not clear. We hypothesized in this study that altered GI microbiota contribute to IBS symptoms through increased levels of organic acids.

METHODS

Subjects were 26 IBS patients and 26 age- and sex-matched controls. Fecal samples were collected for microbiota analysis using quantitative real-time polymerase chain reaction and culture methods, and the determination of organic acid levels using high-performance liquid chromatography. Abdominal gas was quantified by image analyses of abdominal X-ray films. Subjects completed a questionnaire for GI symptoms, quality of life (QOL) and negative emotion.

KEY RESULTS

Irritable bowel syndrome patients showed significantly higher counts of Veillonella (P = 0.046) and Lactobacillus (P = 0.031) than controls. They also expressed significantly higher levels of acetic acid (P = 0.049), propionic acid (P = 0.025) and total organic acids (P = 0.014) than controls. The quantity of bowel gas was not significantly different between controls and IBS patients. Finally, IBS patients with high acetic acid or propionic acid levels presented with significantly worse GI symptoms, QOL and negative emotions than those with low acetic acid or propionic acid levels or controls.

CONCLUSIONS & INFERENCES

These results support the hypothesis that both fecal microbiota and organic acids are altered in IBS patients. A combination of Veillonella and Lactobacillus is known to produce acetic and propionic acid. High levels of acetic and propionic acid may associate with abdominal symptoms, impaired QOL and negative emotions in IBS.

Long-term complications and prognosis of chronic beryllium disease

BACKGROUND

Chronic beryllium disease (CBD) is a rare disease, and there are no previous reports that have followed CBD patients over several decades. Thus, the long-term complications and prognosis of this illness still remain unclear.

OBJECTIVE

The aim of this study was to investigate long-term complications and prognosis of CBD patients.

STUDY DESIGN AND METHODS

This was a retrospective study based on the medical records of all CBD patients diagnosed at Kyoto University Hospital between the period 1973 to the present day. Ultimately, ten patients whose diagnoses had been made during the period 1973 to 1977 were included. Long-term physiological and radiological change, complications and prognosis of these patients were investigated.

RESULTS

Three patients completely remitted, and one died of cor-pulmonale. Among the remaining six patients, four have been followed up for more than thirty years in our institute. The majority developed mixed patterns of lung function impairment, cavity lesions of the lung, pneumothorax, and respiratory infections.

CONCLUSIONS

Long-term prognosis of CBD was poor with several complications due to chronic parenchymal and airway lesions.

HLA-DQB1 0602 allele is associated with splenomegaly in Japanese sarcoidosis

OBJECTIVES

The association between HLA class II alleles and susceptibility to sarcoidosis is well documented. Further, the HLA-DRB1 15 and DQB1 0602 haplotype has been considered as a marker for both chronic and severe disease. Splenomegaly has been proposed as a marker for severity and activity in sarcoidosis, although its functional mechanism is unknown. In other diseases, HLA class II alleles can be markers for splenomegaly. We therefore set out to test the hypothesis that the primary DRB1 15-DQB1 0602 link in sarcoidosis would be to splenomegaly.

DESIGN AND SUBJECTS

We performed abdominal ultrasonography to evaluate the prevalence and extent of splenomegaly and genotyped for HLA-DRB1 and DQB1 using allele or allele group specific primers in polymerase-chain-reaction on 138 Japanese sarcoidosis patients as case comparison study. Furthermore, we explored their relationship with other clinically important indices, e.g. chest radiograph stage, serum angiotensin-converting enzyme (ACE) concentration and duration of disease.

RESULTS

Splenomegaly was detected in 37 (26.8%) sarcoidosis patients. DQB1 0602 showed associations with splenomegaly (P < 0.0001) and longer disease duration (P = 0.007). In addition, higher chest radiograph staging was associated with both DQB1 0602 (P = 0.02) and splenomegaly (P = 0.003). The presence of splenomegaly was associated with higher serum ACE concentration (P < 0.0001).

CONCLUSION

We conclude that in the Japanese population the primary association of HLA class II DQB1 0602 is with splenomegaly. This allele is also a marker for chronicity and lung disease severity. On the other hand, the presence of splenomegaly is a marker for severity and activity. Further studies are needed to explore the relationship between splenomegaly and sarcoidosis in other ethnic groups and its association with HLA-DQB1 0602.

Inclusive double-pomeron exchange at the fermilab tevatron p p collider

We report results from a study of events with a double-Pomeron exchange topology produced in p p collisions at sqrt[s]=1800 GeV. The events are characterized by a leading antiproton and a large rapidity gap on the outgoing proton side. We find that the differential production cross section agrees in shape with predictions based on Regge theory and factorization, and that the ratio of double-Pomeron exchange to single diffractive production rates is relatively unsuppressed as compared to the O(10) suppression factor previously measured in single diffractive production.