The Beneficial Effect of Carboxylated Poly-L-Lysine on Cryosurvival of Vitrified Early Stage Embryos

BACKGROUND

In the vitrification of embryos, dimethyl sulfoxide (DMSO) is one of the most effective cryoprotectant agents (CPAs), but cytotoxic effects of DMSO on embryos are well known. Carboxylated poly-L-lysine (CPLL) has been identified as an effective cryoprotectant of cultured cell lines and mammalian oocytes.

OBJECTIVE

To evaluate the efficacy and safety of CPLL as a CPA for developmental stage embryos.

MATERIALS AND METHODS

Mouse 8-cell embryos and blastocysts were vitrified with ethylene glycol (EG), DMSO/EG, or CPLL/EG and the developmental potency assessed in vitro.

RESULTS

In 8-cell embryos, there were no differences between the levels of survival and developmental progress into the blastocyst stage in each solution. At the blastocyst stage, the proportion of dead cells was significantly higher in the EG compared with other solutions. In contrast, there were no differences between the DMSO/EG and CPLL/EG.

CONCLUSION

These results indicate that CPLL can be used as a replacement for DMSO in the vitrification of mouse embryos.

Quantitative assessment of provability of radiation-related cancers considering unavoidable existence of unadjusted risk factors

The attribution of stochastic effects to exposure to ionizing radiation has been qualitatively discussed by introducing two distinct concepts of provability and probability. This study aims to develop a method of quantitatively assessing the provability of radiation-related cancers. To this end, the 'minimum provable dose' (MPD) was developed and applied to actual cancer mortality in Japan. The background lifetime risk of cancer mortality was calculated for the esophagus, stomach, colon, liver, lungs, skin, breasts, ovaries, bladder, and bone marrow as well as the age-specific risk coefficients reproducing those given in the 2007 Recommendations of the International Commission on Radiological Protection (ICRP). Comparing the relative ratio of MPDs, which was defined herein as the 'provability index' (PI), we quantitatively ranked radiation-related cancers for different tissues and organs predicated on provability for ages of 10, 30, 50, and 0-85+  years at exposure. We discuss the radiological protection of male emergency workers focusing on cancers highly prioritized according to the ranking (i.e. colon, bone marrow, and bladder). The present study proposed the system to quantitatively evaluate the level of radiological protection taking into account the variations of the background cancer risk on the provability of radiation-related cancers.

A case report of a duodenal adenocarcinoma: a complication with Crohn's disease

The prevalence of Crohn's disease (CD) in Japan is increasing, and so is the incidence of colorectal and small bowel cancers associated with CD. However, few reports have described the malignant transformation of duodenal lesions; moreover, such a diagnosis is rarely possible preoperatively. We present a case of malignant degeneration in the duodenal mucosa associated with CD. A 54-year-old man had been receiving treatment for CD for more than 20 years. Seven years ago, he was diagnosed with duodenal stenosis related to CD. He was asymptomatic, and biopsy results from the proximal stricture showed inflammatory changes without malignant transformation. The lesion was then monitored during follow-up. In 2013, he underwent an endoscopy, which revealed an ulcerated, nodular mucosa, immediately proximal to a high-grade obstruction of the descending duodenum. A biopsy of the ulcer lesion confirmed a diagnosis of adenocarcinoma. The patient then underwent duodenopancreatectomy. Histopathological results from the resected duodenum confirmed a poorly differentiated adenocarcinoma that had invaded the subserosa. The patient recovered, and no recurrence has been observed. Although the duodenum can be accessed without difficulty during endoscopy, it is challenging to preoperatively diagnose malignant transformation. There are only four reported cases of duodenal cancer stemming from CD-associated stricture, and only one of them received a preoperative diagnosis of malignancy based on endoscopic biopsy results. Progressive duodenal narrowing and ulceration in patients with CD should indicate a need for careful endoscopic evaluation and biopsy in order to exclude malignant degeneration of Crohn's duodenitis. Early diagnosis of cases of CD-associated cancers is necessary. We report the features of a rare and illustrative case of duodenal adenocarcinoma in a patient with CD.

Teaching liaison psychiatry and clinical practice of psychosomatic medicine in the general hospital

One of the recent trends in the general hospital is the increase of psychiatric units and the number of psychiatrists working therein. Thus the psychiatrist has had greater opportunities to participate as a member of a clinical team in the care of patients of other units. Accordingly, daily cooperation with other specialties casts him into new roles which transcend those of the traditional psychiatric consultant. The role of liasion psychiatrist involves the complex relations of doctor--nurse--patient--family, interdepartmental relations, communications and so on. By improving these relationships he tries to bring about a more holistic approach in the general hospital.

I-ROAD could be efficient in predicting severity of community-acquired pneumonia or healthcare-associated pneumonia

INTRODUCTION

The ability to predict the prognosis of patients with pneumonia is critical, especially when making decisions regarding treatment regimens and sites of care. However, prognostic guidelines for healthcare-associated pneumonia (HCAP) have yet to be established. I-ROAD is the prognostic guideline of the Japanese Respiratory Society for hospital-acquired pneumonia (HAP). This study compared available prognostic guidelines to determine the usefulness of I-ROAD as a prognostic tool for patients with HCAP.

METHODS

We conducted a retrospective review of all patients with pneumonia admitted to Kameda Medical Center, Japan, from January 2006 to September 2009. Patients were categorised into two groups, namely those with community acquired pneumonia (CAP) and those with HCAP. We compared the baseline characteristics, laboratory findings, identified pathogens, antibiotic regimens, clinical outcomes, pneumonic severity and prognostic accuracy of each guideline between the two patient groups. The severity of each disease was assessed on admission using the A-DROP, CURB-65, PSI and I-ROAD guidelines.

RESULTS

Of the 302 patients evaluated, 228 (75.5%) were diagnosed with CAP and 74 (24.5%) with HCAP. Patients with HCAP were older and had a higher performance status than patients with CAP. The mortality rate in the CAP group tended to rise with increasing severity scores of prognostic guidelines. Although the severity scores of all prognostic guidelines could predict 30-day mortality in patients with CAP, I-ROAD exhibited a higher discriminatory power for patients with HCAP based on analysis of receiver-operating characteristic curves.

CONCLUSION

I-ROAD could be more accurate than other prognostic guidelines for evaluating the severity of HCAP.

Computational modeling of 137Cs contaminant transfer associated with sediment transport in Abukuma River

A numerical model capable of simulating the transfer of (137)Cs in rivers associated with transport of fine sediment is presented. The accident at Fukushima Dai-ichi Nuclear Power Plant (FDNPP) released radionuclides into the atmosphere, and after fallout several radionuclides in them, such as radiocesium ((134)Cs, (137)Cs) and radioiodine ((131)I) were adsorbed on surface soil particles around FDNPP and transported by surface water. To understand the transport and deposition of the radioactive contaminant along with surface soil particles and its flux to the ocean, we modeled the transport of the (137)Cs contaminant by computing the water flow and the associated washload and suspended load transport. We have developed a two-dimensional model to simulate the plane flow structure, sediment transport and associated (137)Cs contaminant transport in rivers by combining a shallow water flow model and an advection-diffusion equation for the transport of sediment. The proposed model has been applied to the lower reach of Abukuma River, which is the main river in the highly contaminated area around FDNPP. The numerical results indicate that most (137)Cs supplied from the upstream river reach with washload would directly reach to Pacific Ocean. In contrast, washload-oriented (137)Cs supplied from the upstream river basin has a limited role in the radioactive contamination in the river. The results also suggest that the proposed framework of computational model can be a potential tool for understanding the sediment-oriented (137)Cs behavior in rivers.

The effect of concentration of tackifying agent on adhesive and skin-protective properties of ceramide 2-containing hydrocolloid dressings

OBJECTIVE

In the treatment of pressure ulcers and leg ulcers it is necessary to achieve an effective balance between adhesive and skin-protective properties. We speculated that addition of a tackifying agent (TA) to ceramide 2-containing hydrocolloid dressings would increase their adhesiveness under dry conditions and reduce their adhesiveness under wet conditions because dry tack converts to wet tack after water absorption.

METHOD

We prepared ceramide 2-containing hydrocolloid dressings with varying amounts of TA. Basic characteristics of the test ceraminde dressings, such as initial tack force and peeling force, were evaluated using standard methods. Peeling force and stratum corneum (SC) removal on healthy human skin were also evaluated at 20 minutes, 7 hours, and 72 hours. In addition, the effect of 10 repeated applications on transepidermal water loss (TEWL) was investigated on the skin of hairless mice under dry and wet conditions. Statistical analyses were performed using one-way analysis of variance followed by Dunnett's multiple comparison test. A p-value of <0.05 was considered statistically significant.

RESULTS

On a stainless steel substrate, initial tack force and 180° peeling force increased as TA content increased. Twenty minutes after application on human skin, peeling force and SC removal increased with increasing TA content. When TA contents were over 10%, significant differences in peeling force and SC removal were obtained compared with ceramide 2-containing hydrocolloid dressings without TA (p<0.05). However, a TA content-dependent increase in peeling force was not evident 7 hours and 72 hours after application. Under dry conditions, TEWL increased with repeated application and peeling. Conversely, no significant increases in TEWL were evident under wet conditions after 10 repeated applications and peelings.

CONCLUSION

Our data demonstrate that the initial attachment of ceramide 2-containing hydrocolloid dressings to the skin increases with addition of TA. Skin damage can be avoided by conversion of the adhesive system to wet tack with water absorption.

DECLARATION OF INTEREST

Masushi Kohta and Tetsuji IwasakI are employees of ALCARE Co., Ltd., Japan. This project was supported by an unrestricted grant from ALCARE.

Administration of low-dose epoetin-alpha facilitates adherence to ribavirin in triple therapy with pegylated interferon-alpha-2b and telaprevir

AIM

Anemia frequently develops in patients given pegylated interferon, ribavirin (RBV), telaprevir (TVR) triple therapy and restricts treatment by forcing reduction or discontinuation of RBV administration. We investigated whether erythropoietin (EPO) could alleviate RBV-induced anemia to help maintain the RBV dose during the first 12 weeks, the triple therapy phase.

METHODS

Twenty-two patients with hepatitis C virus (HCV) genotype 1 were enrolled. Hemoglobin (Hb) concentration was measured every week. If Hb reduction from the baseline was 2 g/dL or more, 12 000 IU of epoetin-α was administrated. When further reduction (≥3 g/dL) was observed, 24 000 IU of epoetin-α was used. Inosine triphosphatase (ITPA) single nucleotide polymorphism (rs1127354) was genotyped for all patients.

RESULTS

Among the 22 patients enrolled in this study, three required RBV dose reduction due to anemia, two had to discontinue or reduce TVR and RBV due to creatinine elevation. The remaining 17 patients completed the treatment during the triple therapy phase without reduction of the RBV dose or adverse events attributable to EPO. Regardless of ITPA genotype, Hb decline was well controlled by EPO administration, whereas the total EPO dose tended to be higher in the CC genotype group. The average adherence to RBV during the triple therapy phase was 97.5%. SVR was achieved in 17 patients; two patients had viral breakthrough and three patients had relapse of HCV RNA.

CONCLUSION

EPO can be a favorable alternative to reduction of RBV to facilitate the adherence of patients on TVR-based triple therapy.

Regulation of E2F1-induced apoptosis by poly(ADP-ribosyl)ation

The transcription factor adenovirus E2 promoter-binding factor (E2F)-1 normally enhances cell-cycle progression, but it also induces apoptosis under certain conditions, including DNA damage and serum deprivation. Although DNA damage facilitates the phosphorylation and stabilization of E2F1 to trigger apoptosis, how serum starvation renders cells vulnerable to E2F1-induced apoptosis remains unclear. Because poly(ADP-ribose) polymerase 1 (PARP1), a nuclear enzyme essential for genomic stability and chromatin remodeling, interacts directly with E2F1, we investigated the effects of PARP1 on E2F1-mediated functions in the presence and absence of serum. PARP1 attenuation, which increased E2F1 transactivation, induced G2/M cell-cycle arrest under normal growth conditions, but enhanced E2F1-induced apoptosis in serum-starved cells. Interestingly, basal PARP1 activity was sufficient to modify E2F1 by poly(ADP-ribosyl)ation, which stabilized the interaction between E2F1 and the BIN1 tumor suppressor in the nucleus. Accordingly, BIN1 acted as an RB1-independent E2F1 corepressor. Because E2F1 directly activates the BIN1 gene promoter, BIN1 curbed E2F1 activity through a negative-feedback mechanism. Conversely, when the BIN1-E2F1 interaction was abolished by PARP1 suppression, E2F1 continuously increased BIN1 levels. This is functionally germane, as PARP1-depletion-associated G2/M arrest was reversed by the transfection of BIN1 siRNA. Moreover, PARP-inhibitor-associated anti-transformation activity was compromised by the coexpression of dominant-negative BIN1. Because serum starvation massively reduced the E2F1 poly(ADP-ribosyl)ation, we conclude that the release of BIN1 from hypo-poly(ADP-ribosyl)ated E2F1 is a mechanism by which serum starvation promotes E2F1-induced apoptosis.

Metabolomic investigation of pathogenesis of myxosporean emaciation disease of tiger puffer fish Takifugu rubripes

Serum biochemical analysis was undertaken to study the pathophysiological details of emaciation disease of the tiger puffer fish Takifugu rubripes (Temminck and Schlegel). Serum parameters were measured by biochemical analysis using automated dry chemistry and gas chromatography/mass spectrometry (GC/MS). Serum concentrations of albumin, amylase, calcium, creatinine, glucose and total protein were significantly lower in the emaciated fish when compared with those of normal fish. Regression analyses found close correlation between concentrations of total protein, albumin, amylase, glucose and progress of the disease. In contrast, serum alanine aminotransferase increased significantly in emaciated fish indicating liver function disorder. Further, GC/MS metabolic profiling of the puffer serum showed that the profile of the emaciated fish was distinct to that of non-infected control. The serum content of amino acids including glycine, 5-oxo-proline and proline, and ascorbic acid, fumaric acid and glycerol increased significantly in serum in moderately emaciated fish. The serum glucose, linolenic acid and tyrosine level decreased significantly in the late phase of the disease. Our results clearly show that prolonged intestinal damage caused by myxosporean infection impairs absorption of nutrients, resulting in extreme emaciation.