Low serum potassium concentration is a predictor of chronic kidney disease

AIMS

The aim of this study was to examine whether low serum potassium concentration could be a predictor of chronic kidney disease (CKD) in a community-based cohort.

MATERIALS AND METHODS

We enrolled 1001 subjects, median period of 5.7 years, and evaluated the risk factors for CKD, defined as estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m(2), and assessed whether low serum potassium concentration could predict CKD.

RESULTS

Compared with the subjects without development of CKD, age, body mass index, fasting plasma glucose, uric acid (UA), creatinine and serum sodium concentration were higher, and serum potassium concentration was lower in subjects with development of CKD. Univariate Cox regression analyses demonstrated that age, body mass index, fasting plasma glucose, UA, creatinine, serum sodium concentration and serum potassium concentration were associated with progression of CKD. Multiple Cox regression analysis revealed that age, gender, creatinine and serum potassium concentration were independent predictors of CKD after adjustment for covariates. When serum potassium concentration was below 4.0 mmol/l at baseline, hazard ratio (95% confidence interval) of developing CKD was 2.65 (2.04-3.44; p < 0.0001).

CONCLUSIONS

Serum potassium concentration could be a clinically relevant risk factor for the progression of CKD, defined as eGFR < 60 ml/min/1.73 m(2) , in healthy subjects.

Oviposition stimulants in the coccoid cuticular waxes ofAphytis yanonensis De Bach & Rosen

Aphytis yanonensis De Bach & Rosen, a parasitic wasp of the arrowhead scale,Unaspis yanonensis (Kuwana), was introduced to Japan to controlU. yanonensis. A. yanonensis recognizes a host insect by antennal contact and deposits eggs on the insect body underneath the scale. Ovipositional behavior is induced by perceiving the cuticular wax of the host insect,U. yanonensis, and other coccoids. Chemical composition of the cuticular wax was analyzed and oviposition stimulants were isolated following a bioassay usingA. yanonensis.

Oxidative stress and antibody levels to periodontal bacteria in adults: the Nagasaki Islands study

OBJECTIVE

Periodontitis is a chronic inflammatory disease of the tissues supporting the teeth and is caused by subgingival plaque. Systemic increases in reactive oxygen species are involved in pathogenesis of periodontitis. This study addressed the relationship between levels of serum oxidative stress and antibodies against putative periodontopathic bacteria and their association with periodontal conditions, in a community-based study.

SUBJECTS AND METHODS

Serum samples were measured for reactive oxygen metabolite (ROM) levels and anti-oxidant capacity. The serum levels of immunoglobulin G (IgG) antibodies to Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Aggregatibacter actinomycetemcomitans (Aa), and Eikenella corrodens (Ec) were determined by ELISA.

RESULTS

The participants with greater clinical attachment loss had higher serum ROM levels and IgG antibody titers to Pg. Serum ROM levels were positively correlated with antibody titers to Pg, Pi, and Ec. When the participants with greater probing pocket depth and clinical attachment loss were used as the dependent variables, high ROM levels showed a statistically significant associations in multivariate logistic analyses; the adjusted odds ratios were 2.9 (95% confidence interval = 1.0-8.5) and 6.0 (95% confidence interval = 2.0-17.6), respectively.

CONCLUSIONS

It was concluded that an increased oxidative stress may be detrimental to periodontitis in Japanese community-dwelling adults.

Combined chemotherapy and radiation therapy for central nervous system germ cell tumors: preliminary results of a Phase II study of the Japanese Pediatric Brain Tumor Study Group

The authors conducted a multiinstitutional phase II study to establish a postsurgical combined chemotherapy and radiation therapy regimen for patients with primary germ cell tumors of the brain. After surgical debulking of the tumor and histological verification, patients were divided into three therapeutic groups: good prognosis, intermediate prognosis, and poor prognosis. Patients received two kinds of chemotherapy (three courses) prior to receiving radiation therapy: carboplatin-etoposide combination ([CARB-VP]: carboplatin 450 mg/m(2) on Day 1, etoposide 150 mg/m(2) on Days 1-3) or ifosphamide-cisplatin-etoposide combination ([ICE]: ifosphamide 900 mg/m(2), cisplatin 20 mg/m(2), and etoposide 60 mg/m(2) on Days 1-5). Patients in the good prognosis group (those with germinomas) were treated with CARB-VP followed by local radiation therapy (24 Gy). Patients in the intermediate prognosis group received CARB-VP followed by local radiation therapy (50 Gy); they received five additional chemotherapy treatments. Patients in the poor prognosis group received ICE followed by whole craniospinal radiation therapy; they also received five additional chemotherapy treatments. Eighty-two patients were evaluated. For the 56 patients with germinomas, a 93% rate of complete remission after treatment was achieved. The remission rate was 76% for 21 patients in the intermediate prognosis group, and no recurrence was detected during a median follow-up period of 2.6 years. In the group of five patients with poor prognosis, the disease in three patients progressed during chemotherapy or radiation therapy and they died within 6 months. There were no serious complications in the surviving patients. The authors found their treatment protocols to be currently effective for patients with germinomas and those with an intermediate prognosis.

The enhanced antitumor-activity of DNA topoisomerase ii-trapping drugs by natural human tumor-necrosis-factor against human glioma cell-lines in-vitro

We investigated the antitumor activity of human natural tumor necrosis factor (n-TNF) either alone or in combination with chemotherapeutic drugs on human glioma cell lines in vitro. Although the cytotoxic effect of n-TNF alone did not exceed 30%, n-TNF, in combination with topoisomerase II-trapping drugs, such as actinomycin D (ACD) and daunomycin (DAM), demonstrated a striking synergistic enhancement of the cytotoxicity, and reached a level of more than 80%, against all the tested cell lines. Thus this new combination therapy is considered to be a promising candidate in developing a new treatment approach to glioma patients.

Medulloblastoma in the first year of life: A report of five cases

Five infants with cerebellar medulloblastoma, who all presented within the first year of life, are presented. The initial characteristic presenting symptoms included vomiting and macrocrania, frequently followed by a delay in normal development. No patients showed any signs or symptoms of cerebellar dysfunction. One infant, who was initially diagnosed as having a congenital hydrocephalus, died 4 months after undergoing a cerebrospinal fluid shunt operation, while the remaining four patients all underwent direct surgery for their tumors and three also received an additional course of postoperative radiation therapy. Of these four patients, three died within 4 years after diagnosis, with a mean survival period of 2.7 years, whereas one is still alive after a follow-up period of more than 20 years. However, the patient does suffer from both physical and intellectual handicaps. The clinical and histological features of infantile medulloblastomas are reviewed while the therapeutic problems associated with these tumors are also discussed.

Andropausal symptoms in men with Type 2 diabetes

AIMS

Serum androgen concentration is reported to be low in patients with Type 2 diabetes. There have been no studies comparing andropausal symptoms such as sleep disturbance, depression, erectile dysfunction and lower urinary tract symptoms simultaneously between men with Type 2 diabetes and subjects without diabetes.

METHODS

We compared andropausal symptom scores such as the Pittsburgh Sleep Quality Index, the Self-Rating Depression Scale, the International Index of Erectile Function and the International Prostate Symptom Score in 296 men with Type 2 diabetes and in 267 subjects without diabetes. Furthermore, we evaluated relationships of andropausal symptom scores to various anthropometric factors and compared andropausal symptom scores according to diabetic complications in men with Type 2 diabetes.

RESULTS

Andropausal symptom scores such as the Pittsburgh Sleep Quality Index, the Self-Rating Depression Scale, the International Index of Erectile Function and the International Prostate Symptom Score were 4.2 ± 2.6 vs. 5.0 ± 3.3, P<0.01 by unpaired Student's t-test, 34.8 ± 8.2 vs. 38.4 ± 9.3, P<0.0001, 11.5 ± 6.4 vs. 9.9 ± 6.9, P<0.01 and 7.3 ± 6.7 vs. 9.0 ± 7.1, P<0.01 in subjects without diabetes and in patients with diabetes, respectively. The Pittsburgh Sleep Quality Index was higher in patients with neuropathy than without. The Self-Rating Depression Scale was higher in patients with advanced retinopathy. The International Index of Erectile Function was lower in patients with advanced retinopathy and nephropathy. The International Index of Erectile Function was lower and the International Prostate Symptom Score was higher in patients with cardiovascular disease than without.

CONCLUSIONS

Our data demonstrated that men with Type 2 diabetes have higher prevalence of andropausal symptoms, especially those with diabetic complications.

Different responses of benign and atypical meningiomas to gamma-knife radiosurgery: report of two cases with immunohistochemical analysis

Recent reports have shown that gamma-knife radiosurgery provides a safe and effective strategy for the management of brain tumors. To evaluate the role of stereotactic radiosurgery in the management of meningiomas, we investigated the histopathology of two patients. The patients, a 37-year-old man and a 54-year-old woman, presented with visual field disturbance or headache. Imaging studies demonstrated intracranial meningiomas--tentorial and sphenoid ridge, respectively. Each patient undewent subtotal surgical resection (more than 90% in both patients), followed by gamma-knife radiosurgery of the remnant tumor marginal doses of 15 Gy. Pathological examination of the original tumors revealed a meningothelial meningioma and an atypical meningioma, respectively. Enlargement of the remnant tumors 4 months after radiosurgery resulted in total surgical resection in both patients. Thirteen months later, the patient with the atypical meningioma underwent a third operation for early recurrence of the tumor. Histopathology was investigated, and MIB-1, p53, and bcl-2 labeling indexes (LI) were analyzed immunohistochemically. Histopathologically, the specimens showed necrosis and intratumoral vessel obliteration after radiosurgery in both cases. However, more remnant tumor cells survived in the atypical meningioma. Immunohistochemically, increased wild-type p53, decreased bcl-2 expression, and decreased MIB-1 LI were observed in the benign meningioma. In the atypical meningioma, on the contrary, MIB-1 LI was decreased and mutant-type p53 and bcl-2 expression were unchanged. The specimen from the third operation revealed an anaplastic meningioma, and MIB-1 LI was markedly increased. These findings suggest that the efficacy of radiosurgery may differ between benign and atypical meningiomas.

Microsurgical anatomy for lateral approaches to the foramen magnum with special reference to transcondylar fossa (supracondylar transjugular tubercle) approach

Microsurgical anatomy for lateral approaches to the foramen magnum, especially for transcondylar fossa (supracondylar transjugular tubercle) approach, was studied using cadavers. The transcondylar fossa approach is an approach in which extradural removal of the posterior portion of the jugular tubercle through the condylar fossa is added to the far lateral approach. Some differences between this approach and the transcondylar approach are demonstrated. The atlanto-occipital joint and the jugular tubercle are obstacles for the lateral approaches. The condylar fossa forming the external occipital surface of the jugular tubercle is located supero-posterior to the occipital condyle. The fossa is limited laterally by the sigmoid sulcus and the jugular foramen. The posterior condylar canal communicating anteriorly with the distal end of the sigmoid sulcus, the jugular foramen, or the hypoglossal canal opens at the bottom of the fossa. The condyle is situated inferior to the posterior condylar and hypoglossal canals, and the jugular tubercle is located superior to them. In the transcondylar fossa approach the posterior part of the jugular tubercle is extradurally removed, but the condyle and the atlanto-occipital joint are untouched. On the other band, in the transcondylar approach the medial parts of the condyle and the lateral mass of Cl are removed. The latter approach offers better visualization of the inferior part of the foramen magnum. The essential difference of the two approaches is in the direction of looking and the extent of resection of the atlanto-occipital joint. Both approaches offer excellent view of the ventral dural space in the lower clivus and the foramen magnum, but the level of exposure differs somewhat between them. In the lateral approaches to the foramen magnum, the condylar fossa, the posterior condylar canal, and the posterior condylar emissary vein all play an important role as intraoperative anatomical landmarks.

The architecture of the arcuate eminence-a microanatomical study and its application to the transpetrosal approach

This study was performed to determine if the arcuate eminence can be drilled down without opening the semicircular canal to obtain a flatter operative field during an anterior or posterior transpetrosal approach. The depth of the superior semicircular canal from the top of the arcuate eminence was measured in 43 dry temporal bones. We found that the arcuate eminence was situated approximately 20 mm from the petrosigmoid intersection, and the superior semicircular canal was located 2.0 mm deep from the top of the arcuate eminence (range, 0.2 mm to 4.2 mm). The arcuate eminence consists of either (1) the otic capsule and additional overlying bone, (2) the naked otic capsule of normal thickness, or (3) the thinned otic capsule. In cases strictly selected by preoperative computed tomography, it may be possible to drill down the arcuate eminence with meticulous manipulation. The relationship between opening the semicircular canal and hearing preservation is also discussed.

Low serum bilirubin concentration in haemodialysis patients with Type 2 diabetes

AIMS

Previous studies have implicated reduced serum bilirubin concentrations in the development of cardiovascular disease. The aim of this study was to examine whether bilirubin may explain the high incidence of vascular complications in haemodialysis patients with Type 2 diabetes.

METHODS

We compared serum bilirubin concentrations, as well as other known aetiological risk factors for cardiovascular disease, in 206 Type 2 diabetes patients on haemodialysis with those in 741 Type 2 diabetes patients not receiving haemodialysis, and evaluated the association between serum bilirubin concentration and cardiovascular disease incidence.

RESULTS

Incidences of cardiovascular disease and systolic blood pressure were higher; however, BMI and serum total cholesterol were lower in haemodialysis patients compared with those in patients without haemodialysis. Serum total (0.30 ± 0.10 vs. 0.74 ± 0.26 mg/dl, 0.005 ± 0.002 vs. 0.013 ± 0.004 mmol/l, P < 0.0001) and indirect (0.17 ± 0.08 vs. 0.70 ± 0.23 mg/dl, 0.003 ± 0.001 vs. 0.012 ± 0.004 mmol/l, P < 0.0001) bilirubin were lower in haemodialysis patients compared with those in patients without haemodialysis. Stepwise regression analysis demonstrated that age (β = 0.109, F = 5.959, P < 0.05), duration of diabetes (β = -0.112, F = 6.048, P < 0.05), sex (β = -0.123, F = 8.623, P < 0.05), cardiovascular disease events (β = -0.099, F = 5.131, P < 0.05) and presence of haemodialysis (β = -0.626, F = 201.727, P < 0.01) were independent factors for serum total bilirubin. Logistic regression demonstrated that age (OR 1.089, 95% CI 1.044-1.136; P < 0.0001), duration of diabetes (OR 1.029, 95% CI 1.001-1.059; P = 0.0423), body mass index (OR 1.115, 95% CI 1.001-1.242; P = 0.0487), habit of smoking (OR 2.445, 95% CI 1.046-5.716; P = 0.0391) and serum total bilirubin (OR 0.192, 95% CI 0.037-0.989; P = 0.0484) were independent factors for cardiovascular disease events.

CONCLUSIONS

Low serum bilirubin concentration could be one of the important factors for the high incidence of cardiovascular disease in Type 2 diabetes patients receiving haemodialysis.

Differential expression of CD44 variants among meningioma subtypes

Aims/background-CD44 is a widely distributed cell surface molecule which has numerous isoforms generated by alternative splicing. The diverse functions related to the CD44 variants (CD44v) have been reported in various physiological and pathological conditions. The pattern of expression of CD44v among meningioma subtypes was investigated to ascertain whether CD44 variants play a role in a variety of biological processes, such as epithelial differentiation and extracranial metastasis.Methods-Twenty three meningiomas were studied immunohistochemically using novel antibodies directed against CD44 isoforms. Six of the 23 samples were analysed by reverse transcription polymerase chain reaction (RT-PCR), followed by Southern blotting with CD44v specific probes.Results-In meningothelial, fibrous and anaplastic meningiomas, a standard form of CD44 was detected by RT-PCR and was homogeneously expressed in tumour cells when studied immunohistochemically. CD44v was not detected in these subtypes. In secretory meningiomas, however, CD44v isoforms were strongly expressed in the cell clusters that produce secretory granules and also accumulated in the granules. The population of tumour cells immunopositive for CD44v was similar to that which stained with antibodies directed against carcinoembryonic antigen, epithelial membrane antigen and ezrin. On RT-PCR with Southern blotting, only the secretory type showed high level expression of CD44v.Conclusions-CD44v in meningiomas is expressed in relation to tumour cell differentiation towards the epithelial type.

Proliferative activity and apoptosis of Langerhans histiocytes in eosinophilic granulomas as evaluated by MIB-1 and TUNEL methods

Aims-To identify the role played by apoptosis in tumour regression.Methods-The growth fraction and apoptotic cell loss of four cases of eosinophilic granuloma were investigated using monoclonal antibodies against Ki-67 proliferation marker (MIB-1) antigen and the TdT mediated dUTP-biotin 3'-OH nick end labelling (TUNEL) method. These data were then compared with the clinical growth rate.Results-Only the Langerhans histiocytic cells, which reacted positively with anti-S-100 protein antibody, were immunolabelled with antibodies to proliferating cell nuclear antigen and Ki-67 antigen (MIB-1). Many apoptotic figures of histiocytic cells were also detected in all cases by the TUNEL method. In a patient whose tumour clinically showed spontaneous regression, the TUNEL staining index gave a higher score than the MIB-1 staining index.Conclusions-The main cause of the spontaneous regression of the tumours was postulated to be programmed cell death (apoptosis).

Microbial community analysis at crude oil-contaminated soils targeting the 16S ribosomal RNA, xylM, C23O, and bcr genes

AIMS

The analyses targeting multiple functional genes were performed on the samples of crude oil-contaminated soil, to investigate community structures of organisms involved in monoaromatic hydrocarbon degradation.

METHODS AND RESULTS

Environmental samples were obtained from two sites that were contaminated with different components of crude oil. The analysis on 16S rRNA gene revealed that bacterial community structures were clearly different between the two sites. The cloning analyses were performed by using primers specific for the catabolic genes involved in the aerobic or anaerobic degradation of monoaromatic hydrocarbons, i.e. xylene monooxygenase (xylM), catechol 2,3-dioxygenase (C23O), and benzoyl-CoA reductase (bcr) genes. From the result of xylM gene, it was suggested that there are lineages specific to the respective sites, reflecting the differences of sampling sites. In the analysis of the C23O gene, the results obtained with two primer sets were distinct from each other. A comparison of these suggested that catabolic types of major bacteria carrying this gene were different between the two sites. As for the bcr gene, no amplicon was obtained from one sample. Phylogenetic analysis revealed that the sequences obtained from the other sample were distinct from the known sequences.

CONCLUSIONS

The differences between the two sites were demonstrated in the analyses of all tested genes. As for aerobic cleavage of the aromatic ring, it was also suggested that analysis using two primer sets provide more detailed information about microbial communities in the contaminated site.

SIGNIFICANCE AND IMPACT OF THE STUDY

The present study demonstrated that analysis targeting multiple functional genes as molecular markers is practical to examine microbial community in crude oil-contaminated environments.

Long-Term Effects of the Oral Adsorbent, AST-120, in Patients with Chronic Renal Failure

The oral adsorbent AST-120 has been widely used in Japan to delay the initiation of dialysis therapy in patients with chronic renal failure. This study evaluated the long-term effects of AST-120 in patients with chronic renal failure who had not previously undergone dialysis. One hundred out-patients were prospectively enrolled and prescribed 6 g/day oral AST-120 for ≥ 1 year. The clinical effectiveness of AST-120 was evaluated by comparing changes in the slope of the reciprocal serum creatinine-time plot (1/sCr slope) before and after AST-120 administration. The 1/sCr slope improved significantly after ≥ 1 year of AST-120 treatment and greatest improvement was observed in patients with the longest AST-120 administration period (> 30 months). The results suggest that long-term treatment with AST-120 may be beneficial for chronic renal failure patients in the pre-dialysis stage.

Specific-wavelength visible light irradiation inhibits bacterial growth of Porphyromonas gingivalis

BACKGROUND AND OBJECTIVE

The effects of laser irradiation on Porphyromonas gingivalis have been reported, but the results are still controversial regarding the efficiency because of the differences of the light sources and irradiation conditions. The aim of this study was to determine the wavelength and irradiation conditions under which the most effective inhibitory effect on P. gingivalis growth was seen without any photosensitizers.

MATERIAL AND METHODS

Using an Okazaki large spectrograph, monochromatic light spectra ranging from 400 to 700 nm were evaluated to determine which spectra effectively inhibited bacterial growth. Moreover, using a monochromatic 405-nm irradiating device, the effects of various irradiating conditions on P. gingivalis growth were examined.

RESULTS

Growth of bacteria irradiated at 400 nm and 410 nm was significantly suppressed compared with a nonirradiated control, whereas wavelengths of 430 nm and longer produced no significant inhibition. A constant energy density of 15 J/cm2 was found to be enough to show an inhibitory effect. Significant inhibition of bacterial growth was found after only 1 min at 50 mW/cm2 irradiation.

CONCLUSION

These results indicate that P. gingivalis growth is specifically suppressed by 405-nm light irradiation, suggesting that visible blue light irradiation is a promising means for eradicating periodontopathogenic bacteria from periodontal lesions.

Metabolic syndrome is not associated with markers of subclinical atherosclerosis, serum adiponectin and endogenous androgen concentrations in Japanese men with Type 2 diabetes

AIMS

Metabolic syndrome is characterized by its association with certain cardiovascular disease risk factors. The aim of this study was to investigate the relationships between metabolic syndrome and markers of subclinical atherosclerosis, serum adiponectin and endogenous androgen concentrations in Japanese men with Type 2 diabetes.

METHODS

Using the 2005 International Diabetes Federation (IDF) definition, we assessed the prevalence of the metabolic syndrome in 424 consecutive men with Type 2 diabetes aged 40-75 years in a cross-sectional study. We compared characteristics including ultrasonographic carotid atherosclerosis markers, pulse-wave velocity (PWV), and serum adiponectin, free testosterone, and dehydroepiandrosterone sulphate (DHEA-S) concentrations in diabetic patients with and without the metabolic syndrome.

RESULTS

The prevalence of the metabolic syndrome in Japanese men with Type 2 diabetes was 46.9%. Men with the metabolic syndrome had higher urinary albumin excretion rate than those without. Carotid intima-media thickness (0.97 +/- 0.26 vs. 0.91 +/- 0.18 mm), plaque score [3.3 (1.5-8.1) vs. 3.8 (1.3-6.2)], PWV (1818 +/- 331 vs. 1749 +/- 331 cm/s) and ankle-brachial index (1.10 +/- 0.14 vs. 1.08 +/- 0.16) did not differ significantly between patients with and without the metabolic syndrome. Similarly, serum adiponectin [3.70 (2.06-6.09) vs. 4.65 (3.09-7.02) microg/ml], free testosterone (36.4 +/- 10.7 vs. 34.7 +/- 11.1 pmol/l), and DHEA-S concentrations (3.29 +/- 1.83 vs. 3.17 +/- 1.63 micromol/l) did not differ significantly between groups,

CONCLUSIONS

The metabolic syndrome, as defined by the IDF, is not significantly associated with subclinical atherosclerosis markers, serum adiponectin, or endogenous androgen concentrations in Japanese men with Type 2 diabetes.

300 BLASTOCYST PRODUCTION BY IN VITRO MATURATION AND DEVELOPMENT OF PORCINE OOCYTES IN DEFINED MEDIA FOLLOWING INTRACYTOPLASMIC SPERM INJECTION

Most culture media for in vitro production (IVP) of porcine embryos contain serum or bovine serum albumin (BSA); especially in the case of in vitro maturation (IVM) porcine follicular fluid is added. The present study was carried out to establish porcine-defined IVP. In Experiment 1, we investigated the efficacy of additional 0.6 mM cystine, 100 �M cysteamine (Cys), or cystine + Cys to a defined TCM-199 maturation medium with regard to the developmental competence of in vitro-matured porcine oocytes following intracytoplasmic sperm injection (ICSI). The control medium was a modified TCM-199 containing 0.05% (w/v) polyvinyl alcohol (PVA). In Experiment 2, the effect of epidermal growth factor (EGF) addition to a modified porcine zygote medium (mPZM) for in vitro culture (IVC) medium was investigated on embryonic development following ICSI. As positive and negative controls, 0.3% BSA (mPZM-3) or 0.3% PVA (mPZM-4), respectively, was added to the basic medium. Five or 10 ng mL-1 of EGF was supplemented in the negative control medium (mPZM-4). All percentage data on cleavage and blastocyst development were subjected to arcsine transformation before statistical analysis using the STATVIEW program (Abacus Concepts, Berkeley, CA). The mean cell numbers per blastocyst (assessed by Giemsa staining method) were analyzed by one-way ANOVA, and the differences among the groups were also analyzed using Tukey-Kramer multiple comparison tests. In Experiment 1, there were no significant differences in the rates of cleavage (31.4 to 64.3%) and blastocyst formation (6.5 to 22.9%) among the treatment and control groups. The mean cell numbers per blastocyst ranged from 30 to 48 among the groups, without significant differences. In Experiment 2, the rates of cleavage (43.0 to 58.0%) and blastocyst formation (14.0 to 23.6%), and the mean cell numbers per blastocyst (30 to 37) were not significantly different among the groups. However, the addition of 5 ng mL-1 of EGF to the mPZM-4 resulted in a significantly (P d 0.05) higher blastocyst rate (48.6%) to cleaved embryos than the other two defined groups (mPZM-4 and mPZM-4 with 10 ng mL-1 EGF: 23.4% and 23.1%, respectively), but not significantly different with mPZN-3 (40.1%). The present results indicate that TCM-199 with added cysteamine (100 �M) can be used as a defined IVM medium for porcine oocytes, and further addition of cystine into the IVM medium is not necessary. The addition of 5 ng mL-1 of EGF to a defined IVC medium enhanced subsequent development after ICSI. These results show that porcine blastocysts can be produced by defined media throughout the steps of IVP (IVM, ICSI, and IVC). This study was partly supported by a grant-in-aid for Scientific Research (17580242) from the Japan Society for the Promotion of Science.

Surgical indications for arteriovenous malformations in patients over the age of 60 years: retrospective analysis of 33 patients

This retrospective study investigated the surgical indications in 33 patients aged > 60 years with brain arteriovenous malformation (AVM) taken from a group of 294 cases between 1981 and 2004. These 33 patients were further classified to two age groups: 60 - 64 years (A group) and > or = 65 years (B group). The overall haemorrhagic rate at initial presentation was 46.6% in the 294 patients. The rate was 48.5% in patients aged > 60 years, and 72.2 and 20% in the A and B groups, respectively. In three of four cases with extremely poor outcome with modified Rankin Scale 5 and 6, the cause of poor outcome was haemorrhage in those aged > 65 years. Because of the high haemorrhagic rate and poor outcome after haemorrhage, surgical treatment is indicated for patients aged > 60 years.

Salivary immunoglobulin A directed to oral microbial GroEL in patients with periodontitis and their potential protective role

The aim of this study was to identify salivary immunoglobulin A (IgA) directed to oral microbial GroEL in patients with periodontitis and to demonstrate their potential protective role through a reduction of inflammatory cytokine production induced by microbial GroEL. Using five different proteins belonging to the heat-shock protein 60 family, Western immunoblot analysis of salivary IgA from 63 subjects revealed immunoreactivities with Campylobacter rectus GroEL and Porphyromonas gingivalis GroEL in subjects with periodontitis (P < 0.05) compared to control subjects. Using the BIACORE 1000 to measure the salivary IgA titers directed towards C. rectus GroEL, high resonance unit (RU) values were observed in the saliva samples from patients with periodontitis (P < 0.01). Furthermore, the number of teeth with deep pocket depth (>or=5 mm) showed a high correlation coefficient with the RU value (r = 0.50, P < 0.01). C. rectus GroEL possessed the ability to stimulate the production of interleukin-6 by gingival fibroblasts. Interestingly, salivary IgA antibody directed to C. rectus GroEL caused a partial inhibition of interleukin-6 production. This study showed a relationship between high levels of salivary IgA directed to GroEL and periodontal disease severity. Although additional investigations are required, salivary IgA to GroEL may have a protective role by reducing the inflammatory response induced by GroEL derived from periodontopathogenic bacteria.

Daily profile of plasma %CoQ10 level, a biomarker of oxidative stress, in patients with diabetes manifesting postprandial hyperglycaemia

The purpose of this study was to investigate the effect of regular meals on the daily profile of blood oxidative stress markers in type 2 diabetic patients with postprandial hyperglycaemia. %CoQ10, calculated as the ratio of ubiquinone-10 (oxidised form of coenzyme Q10) to ubiquinol-10 (reduced form), was used as a sensitive marker of oxidative stress. Blood samples were collected from patients before and 2 h after breakfast, lunch and supper, and at 10 p.m. Patients were selected for the study if their blood glucose levels were <7 mmol/l before breakfast and > or =11.1 mmol/l on at least one occasion after breakfast. %CoQ10 levels after breakfast and throughout the day were significantly higher than those before breakfast (p=0.006-0.04). In contrast to the wave-like changes in plasma glucose levels, %CoQ10 levels increased after breakfast and remained at high levels throughout the day. These results indicated that diabetic patients with postprandial hyperglycaemia were exposed to meal-induced periods of oxidative stress during the day. Postprandial hyperglycaemia therefore has the potential to increase the risk of atherosclerotic cardiovascular disease through induction of oxidative stress.

Human mesenchymal stem cells successfully improve skin-substitute wound healing

BACKGROUND

Large or deteriorated skin defects are sometimes life threatening. There is increasing evidence that adult stem cells are useful for tissue regeneration. Human mesenchymal stem cells (hMSCs) are self-renewing and are potent in differentiating into multiple cells and tissues.

OBJECTIVES

To investigate the effects of hMSCs in cutaneous wound healing.

METHODS

Wound healing was studied in an hMSC-populated porcine skin substitute, using a nude rat model to minimize immune reactions. Full-thickness skin and soft tissue defects of 1.5 x 1.5 cm in size, including the panniculus carnosus, were excised and covered with hMSCs and basic fibroblast growth factor (bFGF)-soaked skin substitutes and an evaluation was made of wound size, histology and protein expression at 3, 7 and 42 days after injury.

RESULTS

The wound size was significantly smaller in the hMSC-treated groups (P < 0.01) and any dose of bFGF (1, 10, 100 microg) enhanced the healing (P < 0.01). The re-epithelialization markers integrin alpha3 and skin-derived antileucoproteinase were remarkably increased with the presence of bFGF in a dose-dependent manner, while the mesenchymal cell surface markers CD29 and CD44 were downregulated in a time-dependent manner. Human pancytokeratin, which does not cross-react with rat antigens, was observed by Western blotting at 38 kDa and 42 kDa from the hMSC-treated tissues on day 7. The expression levels were elevated by 10 microg bFGF (P < 0.01). The immunohistochemical expression of human pancytokeratin was only observed in the hMSC-treated groups.

CONCLUSIONS

These data suggest that hMSCs together with bFGF in a skin defect model accelerate cutaneous wound healing as the hMSCs transdifferentiate into the epithelium.

Association between alcohol consumption and serum dehydroepiandrosterone sulphate concentration in men with Type 2 diabetes: a link to decreased cardiovascular risk

AIMS

Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in patients with Type 2 diabetes. Both light-to-moderate alcohol consumption and higher serum concentrations of dehydroepiandrosterone (DHEA) are associated with reduced CVD mortality, raising the possibility of DHEA as a causal intermediate in CVD and alcohol consumption.

METHODS

Relationships between alcohol consumption and serum DHEA sulphate (DHEA-S) concentration, carotid atherosclerosis as evaluated by carotid ultrasonography and major cardiovascular risk factors were investigated in 404 consecutive men with Type 2 diabetes. Patients were divided into three groups according to mean ethanol consumption per week: non-drinkers, light-to-moderate drinkers (< 210 g per week) or heavy drinkers (> or = 210 g per week).

RESULTS

Plasma HDL-cholesterol was positively associated with the degree of alcohol consumption. Intima-media thickness (0.92 +/- 0.21 vs. 1.09 +/- 0.35 mm, P < 0.0001) and plaque score (3.0 +/- 3.3 vs. 5.2 +/- 4.9, P = 0.008) were lower in light-to-moderate drinkers than in non-drinkers. Serum DHEA-S concentrations were higher in light-to-moderate drinkers (1264.2 +/- 592.2 ng/ml, P < 0.0001) and heavy drinkers (1176.2 +/- 607.6 ng/ml, P = 0.0100) than in non-drinkers (956.8 +/- 538.6 ng/ml). In a subgroup aged 60-75-year-old patients (n = 277), serum DHEA-S concentrations were higher in light-to-moderate drinkers (1126.8 +/- 502.5 ng/ml, P = 0.0121) than in non-drinkers (937.9 +/- 505.1 ng/ml). Also, in a subgroup without CVD (n = 339), serum DHEA-S concentrations were higher in light-to-moderate drinkers (1328.5 +/- 593.7 ng/ml, P < 0.0001) than in non-drinkers (970.1 +/- 540.7 ng/ml).

CONCLUSIONS

Higher serum DHEA-S concentrations in light-to-moderate drinkers may represent part of the link between light-to-moderate alcohol consumption and lower CVD mortality.

Increased serum resistin levels in patients with type 2 diabetes are not linked with markers of insulin resistance and adiposity

The role of resistin in human biology remains uncertain. We measured serum resistin levels in Japanese patients with (n=111) and without (n=98) type 2 diabetes mellitus and investigated the significance of this hormone in the pathophysiology of diabetes. The levels of serum adiponectin and leptin were also measured. Resistin levels were increased significantly in patients with type 2 diabetes compared with non-diabetic subjects (24.7+/-2.6 vs. 15.0+/-1.2 ng/ml, p=0.0013). However, there was no correlation in either patient group between serum resistin levels and markers of insulin resistance, obesity or hyperlipidaemia. These results were in direct contrast to the data of leptin or adiponectin, both of which were closely related to these clinical markers of diabetes. Multivariate regression analysis on the combined data of the two groups demonstrated that the presence of diabetes and HDL cholesterol levels were significant predictors of serum resistin levels (diabetes: beta=0.159, p=0.035; HDL: beta=-0.172, p=0.039). No correlation was observed between C-reactive protein and resistin adjusted for BMI. Taken together, these findings demonstrate that serum resistin levels are increased in patients with type 2 diabetes, but this increase is not linked to markers of insulin resistance or adiposity. Further studies are necessary to elucidate the significance of serum resistin concentration in human pathophysiology.