Pathology of failure of the rotator cuff tendon

In failure of the rotator cuff tendon, interference with its function prevents the rotator cuff from fulfilling its physiologic role. Trauma in younger individuals, calcifying tendinitis, degenerative changes of cuff tendon, and partial- or full-thickness tears cause cuff failure intrinsically. Degenerative changes constitute the most frequent cause of cuff failures and correlate with tendon tearing. An acromial spur, long coracoid process, subacromial bursitis, and thickening of the corocoaromial ligament causes cuff failure extrinsically.

New anticancer antibiotics pelagiomicins, produced by a new marine bacterium Pelagiobacter variabilis

In the course of our screening for new anticancer compounds produced by marine bacteria, we found that a new genus marine bacterium Pelagiobacter variabilis produced new phenazine antibiotics, pelagiomicins A, B and C. Those compounds were labile in water and alcohols. The absolute structure of the main component, pelagiomicin A, and the structures of the minor ones were determined from the spectroscopic data and by synthesis. Pelagiomicin A exhibits activity against Gram-positive and -negative bacteria and antitumor activity in vitro and in vivo.

Highly sensitive ELISA for soluble Fas in serum: increased soluble Fas in the elderly

We have developed and characterized a highly sensitive ELISA for soluble Fas (sFas) in the serum. The linearity of calibrator range was 0.06-2.00 micrograms/L and the detection limit was 0.01 microgram/L. The average within- and between-run CVs were 3.9% and 3.8%, respectively. The recovery of added sFas to serum was 93-118%. The effects of possible interferences (tryglyceride, hemoglobin, bilirubin) were negligible. We determined serum sFas in 155 healthy subjects, ages 20-69. The mean value of sFas in men (2.50 +/- 0.63 micrograms/L, n = 78) was significantly higher than that in women (2.01 +/- 0.53 micrograms/L, n = 77) (P < 0.001). Furthermore, there was a significant correlation between serum sFas concentration and age (men, r = 0.397, P < 0.001; women, r = 0.569, P < 0.001). Although the concentrations of sFas tended to increase with aging, it remains to be clarified how Fas-mediated apoptosis relates to aging.

Stereoscopic synthesized brain-surface imaging with MR angiography for localization of a peripheral mycotic aneurysm: case report

A patient with subacute bacterial endocarditis and a peripheral mycotic aneurysm is presented. We used a combined multi-slice surface anatomy scanning (SAS) and contrast-enhanced MR angiography image to determine the exact location of the small lesion by applying a skin marker on the scalp and visualizing the relationship of the marker to the brain surface structures and to the lesion. This technique was useful for the removal of a small peripheral aneurysm using only a limited craniotomy.

Highly sensitive ELISA for soluble Fas in serum: increased soluble Fas in the elderly

We have developed and characterized a highly sensitive ELISA for soluble Fas (sFas) in the serum. The linearity of calibrator range was 0.06-2.00 micrograms/L and the detection limit was 0.01 microgram/L. The average within- and between-run CVs were 3.9% and 3.8%, respectively. The recovery of added sFas to serum was 93-118%. The effects of possible interferences (tryglyceride, hemoglobin, bilirubin) were negligible. We determined serum sFas in 155 healthy subjects, ages 20-69. The mean value of sFas in men (2.50 +/- 0.63 micrograms/L, n = 78) was significantly higher than that in women (2.01 +/- 0.53 micrograms/L, n = 77) (P &lt; 0.001). Furthermore, there was a significant correlation between serum sFas concentration and age (men, r = 0.397, P &lt; 0.001; women, r = 0.569, P &lt; 0.001). Although the concentrations of sFas tended to increase with aging, it remains to be clarified how Fas-mediated apoptosis relates to aging.

Regional bond strengths of resins to human root dentine

OBJECTIVES

The demand for restoration of root dentine defects such as cervical erosion and root caries has significantly increased recently, but there is limited information on the performance of the adhesive resins to radicular dentine. The purpose of this study was to measure the regional tensile bond strength (TBS) of composite bonded to human root and coronal dentine, and to observe the interface between resin and root dentine by SEM.

METHODS

Human extracted cuspid teeth were used to measure TBS with a new microtensile bond test. Enamel and cementum were removed from the labial tooth surfaces to form a long cavity preparation into dentine from the mid-crown to the apex of the root within the same tooth. All Bond 2 (all etch technique) or Imperva Bond (no etch) was bonded to dentine surfaces and covered with Protect Liner resin composite. The resin-bonded teeth were serially sliced into 16 sections at right angles to the long axis of the tooth, and the bonded surfaces were trimmed to give a bonded surface area of 1 mm2 for TBS testing.

RESULTS

All Bond 2 bond strengths to coronal and apical dentine showed high values (23.5 MPa) but the bond strength was significantly lower on cervical root dentine. Imperva Bond produced a relatively high tensile bond strength to all regional areas. SEM showed that the thickness of the resin-infiltrated layer formed by All Bond 2 in root dentine was less than coronal areas. Resin infiltration with Imperva Bond was always less than 0.5 micron. The results suggest that high TBS values can be obtained with minimal resin infiltration in root dentine.

Sequencing of a 65 kb region of the Bacillus subtilis genome containing the lic and cel loci, and creation of a 177 kb contig covering the gnt-sacXY region

Within the framework of an international project for the sequencing of the entire Bacillus subtilis genome, this paper communicates the sequencing of a chromosome region containing the lic and cel loci (65 kb), which creates a 177 kb contig covering the region from gnt to sacXY. This 65 kb region contains 64 ORFs (62 complete and two partial genes). The 14th, 15th and 17th genes correspond to licT, licS and katE, encoding the antiterminator for licS transcription, beta-glucanase (lichenase) and catalase 2, respectively. The 11th, 30th, 36th, 39th, 41st, 45th-48th, 51st and 58th genes are designated deaD, pepT, galE, aldY, msmX, cydABCD, sigY and katX because their products probably encode ATP-dependent RNA helicase, tripeptidase, UDP-glucose 4-epimerase, aldehyde dehydrogenase, multiple sugar-binding transport ATP-binding protein, the respective components of cytochrome d ubiquinol oxidase and ATP-binding cassette transporter, sigma-factor of RNA polymerase and catalase, respectively. The 60th-64th genes are celRABCD, which are probably involved in cellobiose utilization. Gene organization and gene features in the gnt-sacXY region are discussed.

Bond strength to crown and root dentin

PURPOSE

To investigate (1) the tensile bond strengths of four commercial dentin bonding systems to bovine crown and root dentin and (2) the structure of the hybrid layers for each system bonded to the two dentin substrates.

MATERIALS AND METHODS

Superficial surfaces were exposed in bovine crown and root dentin. The teeth were embedded in plaster and a 3 mm diameter bonding area was demarcated. The four bonding systems used were All-Bond 2, Super-Bond D-Liner Plus, Clearfil Liner Bond II, and ProBond. Bonding procedures followed the manufacturers' instructions with the exception of Super-Bond D-Liner Plus where the primer was left in situ for 60 seconds. Tensile bond strengths were tested after 24-hour storage in 37 degrees C deionized water. Specimens were also prepared for SEM observation of the hybrid layer, after treatment with 10% phosphoric acid, and 10% phosphoric acid and 5% sodium hypochlorite.

RESULTS

Statistically lower bond strengths to crown dentin when compared with root dentin were observed for All-Bond 2, whereas Liner Bond II showed the opposite (P < 0.01). Both ProBond and Super-Bond D-Liner Plus showed no statistical differences between crown and root dentin (P > 0.05). Hybrid layers could be observed for All-Bond 2, Liner Bond II and Super-Bond D-Liner Plus, with no apparent differences between the hybrid layers of crown and root dentin. In the case of ProBond, where the smear layer was not removed during the priming stage, it appeared that the primer had infiltrated and caused hybridization of the smear layer. The differences in bond strength were thought to be related to the different bonding mechanisms of each material, as well as possible variations in the crown and root dentin substrates.

Halymecins, new antimicroalgal substances produced by fungi isolated from marine algae

Novel antimicroalgal substances halymecins A (1), B (2) and C (3) were isolated from the fermentation broth of a Fusarium sp. and halymecins D (4) and E (5) from an Acremonium sp. The structures of these halymecins, Fig. 1, were determined based on extensive 2D NMR studies as well as mass spectral data. These chemical structures are conjugates of di- and trihydroxydecanoic acid. Halymecin A showed antimicroalgal activity against Skeletonema costatum.

Pseudoaneurysm of the cystic artery associated with upper gastrointestinal bleeding

Pseudoaneurysm of the cystic artery is a cause of hemobilia, and is extremely rare, with only eight cases having been reported in the world literature. We report a case of pseudoaneurysm of the cystic artery in a 72-year-old Japanese man. The patient experienced epigastric pain and melena, and was found to have jaundice and liver dysfunction. Repeated gastroendoscopy did not reveal the cause of the alimentary tract bleeding; however, color-Doppler ultrasonography detected an aneurysm of the cystic artery in the gallbladder. Selective hepatic arteriography demonstrated that the posterior branch of the cystic artery was markedly dilated and that an aneurysm had formed in the midst of the artery. We diagnosed hemobilia due to the pseudoaneurysm of the cystic artery, and associated gastrointestinal bleeding. Cholecystectomy was performed immediately. Pathologically, the gallbladder showed acute calculous cholecystitis. This case emphasizes the importance of including hemobilia in the differential diagnosis whenever gastrointestinal bleeding is associated with signs of biliary disorder; color-Doppler imaging is a favorable modality for the diagnosis of pseudoaneurysm of the cystic artery.

Surgical treatment of internal carotid siphon aneurysms

Surgical treatment of internal carotid artery aneurysms around the carotid siphon is discussed. The surgical approach to the aneurysms in this region, is as follows: 1. A fronto-temporal approach with the patient in a 45 degrees semi-sitting position to decrease venous pressure. 2. A Dolenc approach cutting a part of the dura mater of the superior orbital fissure to facilitate removal of the anterior clinoid process and unroofing of the optic canal. 3. Opening the medial triangle followed by transection of the optic canal dural sheath. Carotid siphon aneurysms can be divided into three groups anatomically; aneurysms of the ophthalmic segment (C2), those of the clinoid segment (C3), and those of the horizontal segment (C4). We present 29 cases of aneurysms arising from the C2 or C2/3 segment, 14 cases arising from the C3 or C3/4 segment, and 11 cases arising from the C4 segment. Anatomic localization of the aneurysms was established preoperatively by angiography and three-dimensional CT imaging. Small aneurysms of the ophthalmic segment projecting infero-medially can be clipped using a contralateral approach via the prechiasmatic root. Aneurysms of the ophthalmic segment projecting superiorly can be clipped following resection of the anterior clinoid process. The clinoid process should be resected intradurally with direct visualization of the aneurysms. Straight side-angled clips are suitable for these aneurysms. Carotid cave aneurysms, which include aneurysms of the ophthalmic segment oriented infero-medially and of the clinoid segment projecting postero-medially, can be clipped using curved fenestrated clips via Dolenc's extradural approach. For accurate clipping, opening of the medial triangle and full mobilization of the IC at the clinoid segment and optic nerve by unroofing the optic canal are required. Aneurysms of the horizontal portion are clipped after full exposure of the artery in the cavernous sinus only when the aneurysms are large and symptomatic. We used the fronto-temporal and Dolenc approaches and applied fenestrated clips to aneurysms oriented or postero-medially and straight or oblique clips to aneurysms projecting antero-laterally. Out of 40 aneurysms which underwent surgical clipping, 37 resulted in good post-operative recovery. There were three deaths secondary to complications of vasospasm and three cases with post-operative visual loss. The classification of these aneurysms and the surgical techniques we employed are discussed in detail.

Stimulative effect of epinephrine on glucose production and utilization rates in sheep using a stable isotope

The rates of the production and utilization of blood glucose were measured during intravenous epinephrine infusion (2.0 nmol kg-1 min-1 for 1 hr) in sheep. An isotope dilution method with an infusion of [U-13C]glucose and nonsteady-state equations were used for the determination of blood glucose kinetics. Heart rate and concentrations of blood glucose, plasma free fatty acids, and lactate increased (P < 0.01), whereas plasma insulin concentrations tended to decrease (P < 0.06) during epinephrine infusion. The blood glucose turnover rate was 1.9 +/- 0.1 mg kg-1 min-1 before epinephrine infusion. The rate of blood glucose production increased (P < 0.01) to 6.4 +/- 0.5 mg kg-1 min-1 at 20 min after the initiation of epinephrine infusion. The blood glucose utilization rate increased (P < 0.05) gradually and reached 4.1 +/- 1.2 mg kg-1 min-1 at 60 min after the initiation of epinephrine infusion. These results suggest that in sheep, epinephrine stimulates the rates of both the production and the utilization of blood glucose and that hyperglycemia induced by epinephrine infusion is mainly due to a rapid enhancement in the rate of the production of blood glucose.

Effects of new titanium cerebral aneurysm clips on MRI and CT images

We studied the effects of newly developed aneurysm clips made of a titanium alloy (manufactured by Aesculap, A.G.) on the quality of MR and CT images. Prior to clinical application in twenty patients, the effects of five types of conventional aneurysmal clips on MR images were examined utilizing a phantom. When compared with conventional aneurysm clips, the new titanium clips produce only limited artifacts and yielded improved images in patients who underwent aneurysm clipping post-operative.

Deep hypothermia cardiopulmonary bypass and direct surgery of two large aneurysms at the vertebro-basilar junction

This paper highlights two interesting cases of radial clipping of large aneurysms at the vertebro-basilar junction accompanied by a vascular anomaly, consisting of fenestration of the split basilar artery at its origin. Description of the inner and outer surface of the aneurysm were obtained pre-operatively, from analysis by 3D CT and 3D CT endoscopy of the form of the neck, parent vessels of the vertebral arteries on both sides, basilar artery and split basilar artery, as well as other details of branching. The neck exhibited a broad base in both cases. The height of the neck extended to the internal acoustic meatus, and it was possible to expose the circumference of the aneurysmal neck, peripheral basilar artery and both vertebral arteries proximally with an anterior, transpetrosal approach. Based on the size of the aneurysm and the site being the anterior surface of the brain stem, clipping (consisting of interruption of the occluded portion and reconstruction of the parent vessels) was performed. In the first case it was achieved protecting the brain by hypothermia and barbiturates under deep hypothermia with extracorporal circulation, and in the second case, a state of circulatory arrest was used. This paper documents the report of two cases along with other cases treated so far.

Identification of significant residues in the substrate binding site of Bacillus stearothermophilus farnesyl diphosphate synthase

Farnesyl diphosphate synthases have been shown to possess seven highly conserved regions (I-VII) in their amino acid sequences [Koyama et al. (1993) J. Biochem. (Tokyo) 113, 355-363]. Site-directed mutants of farnesyl diphosphate synthase from Bacillus stearothermophilus were made to evaluate the roles of the conserved aspartic acids in region VI and lysines in regions I, V, and VI. The aspartate at position 224 was changed to alanine or glutamate (mutants designated as D224A and D224E, respectively); aspartates at positions 225 and 228 were changed to isoleucine and alanine (D225I, D228A); lysine at position 238 was changed to either alanine or arginine (K238A, K238R). The lysines at positions 47 and 183 were changed to isoleucine and alanine (K471, K183A), respectively. Kinetic analyses of the wild-type and mutant enzymes indicated that the mutagenesis of Asp-224 and Asp-225 resulted in a decrease of Kcat values of approximately 10(4)- to 10(5)-fold compared to the wild type. On the other hand, D228A showed a Kcat value approximately one-tenth of that of the wild type, and the k(m) value for isopentenyl diphosphate increased approximately 10-fold. Both K471 and K183A showed k(m) values for isopentenyl diphosphate 20-fold larger and kcat values 70-fold smaller than the wild type. These results suggest that the two conserved lysines in regions I and V contribute to the binding of isopentenyl diphosphate and that the first and the second aspartates in region VI are involved in catalytic function. Aspartate-228 is also important for the binding of isopentenyl diphosphate rather than for catalytic reaction.

Advanced glycation end products and their recognition by macrophage and macrophage-derived cells

Modification of proteins by long-term incubation with glucose leads to the formation of advanced glycation end products (AGEs). AGE proteins are taken up by macrophages via the AGE receptor, which is similar to the macrophage scavenger receptor (MSR). In the present study, we compared the ligand specificity of the AGE receptor with that of MSR by three different experiments. The endocytic uptake of 125I-acetyl-LDL by RAW cells was effectively inhibited by unlabeled AGE-bovine serum albumin (BSA), whereas the inhibitory effect of acetyl-LDL on 125I-AGE-BSA was partial. Polyanions showing an effective inhibition for endocytic uptake of AGE-BSA were not always inhibitory for endocytic degradation of acetyl-LDL. These data, together with those obtained by three-dimensional fluorescence-activated cell sorter analysis, indicate that AGE proteins are recognized by more than two receptors, of which MSR is at least one. Finally, we examined whether MSR could mediate the endocytic uptake of AGE proteins by Chinese hamster ovary cells overexpressing bovine type II MSR (CHO-SRII cells). 125I-AGE-BSA underwent endocytic degradation by CHO-SRII cells, and this was effectively inhibited by unlabeled acetyl-LDL. These results clearly show that MSR mediates the endocytic uptake of AGE proteins, suggesting a new role of MSR in biological recognition of AGE in vivo.

Magnetic resonance arthrography in the assessment of anterior instability of the shoulder: comparison with double-contrast computed tomography arthrography

Forty-seven shoulders with traumatic anterior instability were studied by magnetic resonance arthrography (MRA) and computed tomography arthrography (CTA) to compare the diagnostic performance of these examinations in the evaluation of Bankart lesions. All shoulders were examined by arthroscopy to verify the lesions. Labral damage evaluated by MRA and by CTA correlated significantly with arthroscopic findings (MRA, r = 0.55, p < 0.0001; CTA, r = 0.45, p = 0.0050). MRA possessed higher sensitivity in detecting torn labra (MRA, sensitivity = 87%, specificity = 75%; CTA, sensitivity = 33%, specificity = 88%). In detecting displaced labra, sensitivity and specificity were 65% and 94% for MRA and 75% and 69% for CTA. The inferior glenohumeral ligament was depicted as a lax structure in 74% by MRA but in only 21% by CTA. We conclude that MRA is superior to CTA in detecting lesions associated with shoulder instability.

Nitric oxide releasing reagent, S-nitroso-N-acetylpenicillamine, enhances the expression of manganese superoxide dismutase mRNA in rat vascular smooth muscle cells

Cultured rat vascular smooth muscle cells (VSMCs) produce nitric oxide (NO) under stimulation by lipopolysaccharide (LPS) and interferon-gamma (IFN-gamma). NO synthase (NOS) and manganese superoxide dismutase (Mn-SOD) mRNA expressions are simultaneously induced by these stimulants in rat VSMCs. In VSMCs, S-nitroso-N-acetyl penicillamine (SNAP), one of the NO releasing reagents, induces Mn-SOD mRNA which may protect the VSMCs themselves. This suggests that NO itself may enhance the expression of Mn-SOD to protect the VSMC themselves against NO radicals in cultured rat VSMCs.

N (epsilon)-(carboxymethyl)lysine protein adduct is a major immunological epitope in proteins modified with advanced glycation end products of the Maillard reaction

Long-term incubation of proteins with glucose leads to the formation of advanced glycation end products (AGE). Recent immunological studies have suggested the potential role of AGE in atherosclerosis, aging, and diabetic complications. We previously prepared a monoclonal (6D12) as well as a polyclonal anti-AGE antibody and proposed the presence of a common AGE structure(s) that may act as a major immunochemical epitope [Horiuchi, S., Araki, N., & Morino, Y. (1991) J. Biol. Chem. 266, 7329-7332]. The purpose of the present study was to determine the major epitope. Amino acid analysis of AGE-proteins indicated that N(epsilon)-(carboxymethyl)lysine (CML) was a major modified lysine residue. Immunologic studies demonstrated the positive reaction of 6D12 not only to all CML-modified proteins tested, but also to BSA modified with several aldehydes known to generate a CML-protein adduct, and a linear correlation between the CML contents of CML-BSA and their immunoreactivity to 6D12 up to approximately 8 mol/mol of protein. Further experiments with CML analogs revealed that the epitope of 6D12 is a CML-protein adduct with an important carbonyl group. In contrast to 6D12, our polyclonal anti-AGE antibody showed a significant but much weaker immunoreactivity to CML-BSA, suggesting that the polyclonal antibody contains two populations, one reactive to CML (CML-PA) and the other unreactive to CML (Non-CML-PA). Non-CML-PA separated from CML-PA by CML-BSA affinity chromatography did not react with all CML-modified preparations, but retained its property to react commonly with AGE preparations obtained from proteins, lysine derivatives, and monoaminocarboxylic acids. Therefore, it is clear that a CML-protein adduct is a major immunological epitope in AGE structures, but there still exist other major epitope(s) expressed commonly in AGE-proteins.

Insulin responsiveness, action and sensitivity in growing lambs and mature rams

Insulin responsiveness, action and sensitivity, using the glucose clamp technique, were measured in ruminating growing lambs (5 and 9 mo old) and mature rams (3 yr old). In the hyperglycemic clamp experiment, blood glucose concentrations were designed to remain 50 mg dL−1 above basal concentrations for more than 1 h. Plasma insulin concentrations during glucose infusion were lower (P < 0.05) for 5 mo-old lambs than for 9 mo-old lambs and mature rams and were higher (P < 0.05) for 9 mo-old lambs than for 5 mo-old lambs and mature rams. In the hyperinsulinemic euglycemic clamp experiment, insulin was infused over five sequential 1-h periods at rates from 0.64 to 25 mU kg−1 min−1 with concomitant glucose infusion to maintain preinfusion blood glucose concentrations. Glucose infusion rates during insulin infusion were lower (P < 0.05) for 5 mo-old lambs than for 9 mo-old lambs and plasma insulin concentration at half-maximal glucose infusion rate was numerically lower for 5 mo-old lambs, whereas maximal glucose infusion rate did not differ among growth stages. It is likely that in ruminating sheep insulin responsiveness, action and sensitivity may change with growth stage. Key words: Development, insulin response, insulin sensitivity, sheep, glucose clamp technique

Case report: fibrolamellar hepatocellular carcinoma in a Japanese woman: a case report and review of Japanese cases

Fibrolamellar hepatocellular carcinoma (FLHCC) is an entity distinct from ordinary hepatocellular carcinoma and is very rare in Oriental countries. We present here a Japanese case of FLHCC in a 25 year old woman, and review Japanese cases of FLHCC. The patient had mild abdominal pain when the hepatic tumour was revealed by ultrasonography. Hepatitis B surface antigen (HBsAg) and anti-hepatitis C antibody were negative and serum alpha-fetoprotein (AFP) was within the normal limit. Ultrasound-guided fine needle biopsy was performed and the tumour was histologically diagnosed as FLHCC. A right lobectomy of the liver was then performed. Macroscopically, the tumour (10 x 10 x 8 cm) was circumscribed, rather hard and yellowish white. Microscopically, neoplastic hepatocytes were polygonal and large with eosinophilic cytoplasm, which contained pale bodies. A number of fibrous stroma were arranged in thin parallel bands. Consequently, the case was diagnosed as FLHCC. In Japan, approximately 18,000 people die of ordinary hepatocellular carcinoma annually, while only nine cases (including the present case; six males, three females) of FLHCC in Japanese subjects have been reported previously. The mean age of the Japanese cases of FLHCC is 20.9 years old. One case with positive HBsAg, liver cirrhosis and high level of AFP was observed of nine cases. The nature of FLHCC in Japanese subjects may not be significantly different from that in Caucasians, except for male predominance.

Regional strengths of bonding agents to cervical sclerotic root dentin

The regional bond strengths of three current-generation bonding systems (All Bond 2, Scotchbond Multi-Purpose, and Clearfil Liner Bond 2) were measured in natural wedge-shaped defects in the cervical area of extracted human teeth. A microtensile testing method was used to compare the strengths of resin bonds made to occlusal margins with those made to gingival margins. Controls consisted of normal teeth which had artificial wedge-shaped defects, of the same depth and dimension, created with a high-speed bur. The results indicated that there were no regional differences in bond strength, although bonds made to natural lesions were from 20 to 45% lower than those made to normal dentin in artificially created wedge-shaped defects, depending on the bonding agent. Scanning electron microscopy revealed that Clearfil Liner Bond 2 created the thinnest hybrid layers, which were difficult to measure in the natural lesions. The natural lesions contained sclerotic dentin, whereas the artificial lesions were composed of normal dentin. Although the bond strengths to sclerotic dentin were lower than those to normal dentin, the absolute values (ca. 16 to 17 MPa) were high relative to previous-generation bonding agents.