A New Mass Spectrograph with Very Large Dispersion

A new type of mass spectrograph with large mass dispersion has been constructed. The distinguishing feature of this apparatus is that the mass dispersing action of a r-l magnetic field is utilized. The instrument has a r-1 magnetic field of 198.1° sector type (22 cm mean radius) as the dispersing field, a toroidal electric field of 118.7° sector type (30 cm mean radius) and a 30° uniform magnetic field (120 cm mean radius) as the focusing fields. The principle, the design and important parts of the apparatus are described. The dispersion on the photographic plate was estimated to be 14 cm for 1% mass difference and the maximum resolving power of about 500,000 was obtained.

Pim-2 kinase is an important target of treatment for tumor progression and bone loss in myeloma

Pim-2 kinase is overexpressed in multiple myeloma (MM) cells to enhance their growth and survival, and regarded as a novel therapeutic target in MM. However, the impact of Pim-2 inhibition on bone disease in MM remains unknown. We demonstrated here that Pim-2 expression was also upregulated in bone marrow stromal cells and MC3T3-E1 preosteoblastic cells in the presence of cytokines known as the inhibitors of osteoblastogenesis in MM, including interleukin-3 (IL-3), IL-7, tumor necrosis factor-α, transforming growth factor-β (TGF-β) and activin A, as well as MM cell conditioned media. The enforced expression of Pim-2 abrogated in vitro osteoblastogenesis by BMP-2, which suggested Pim-2 as a negative regulator for osteoblastogenesis. Treatment with Pim-2 short-interference RNA as well as the Pim inhibitor SMI-16a successfully restored osteoblastogenesis suppressed by all the above inhibitory factors and MM cells. The SMI-16a treatment potentiated BMP-2-mediated anabolic signaling while suppressing TGF-β signaling. Furthermore, treatment with the newly synthesized thiazolidine-2,4-dione congener, 12a-OH, as well as its prototypic SMI-16a effectively prevented bone destruction while suppressing MM tumor growth in MM animal models. Thus, Pim-2 may have a pivotal role in tumor progression and bone loss in MM, and Pim-2 inhibition may become an important therapeutic strategy to target the MM cell-bone marrow interaction.

3D simulation of platelet aggregation in cryosurgery

In cryosurgery for cancer treatment, cells are injured not only by freezing but also by vascular stasis. The vascular stasis caused by thrombosis necrotizes the surrounding non-targeted cells due to the lack of oxygen and nourishment. Inhibition of thrombus formation, which is the former phase of the vascular stasis, is required to prevent damaging normal cells around a tumorDForegoing studies simulated platelet aggregation based on distance between platelets. However, in cryosurgery, temperature dependency of blood-clotting factors' activity is required to be considered. The authors constructed a three-dimensional model consisting of vascular and extra- vascular tissues, and simulated heat transform and platelet aggregation. Heat transform was analyzed by boundary fitted coordinates method, and platelet aggregation was analyzed by particle method. The probability of bonding between platelets is derived from chemical reaction kinetics. The results showed larger size of simulated thrombus on higher temperature. The simulation with varied temperature around destructed area showed platelet aggregation depending on temperature.

Smart sensing of cardiovascular physiological information from soles without direct skin contact

This study proposes the development of a smart sensing measurement system using a mat-type sensor in order to obtain sole-electrocardiogram data from soles and toe-photoplethysmogram data from toes. In addition, the proposed measurement system can calculate pulse wave velocity from sole-ECG and toe-PPG. The subjective experiments revealed that the developed system can measure these parameters even when socks are being worn. Moreover, simultaneous measurements of systolic blood pressure and PWV determined by the developed system indicate a strong correlation was found between SBP and PWV. Therefore, this system can detect cardiovascular diseases or symptoms of common diseases and suggests the possibility to estimate the temporal changes in SBP without required compression using cuffs.

Automatic cropping method of chest radiographs based on adaptive binarization

General radiography systems are widely used for medical diagnoses. Since the size of image detectors of general radiography systems is standardized in several fixed sizes, relative size of target body parts differs according to patients. The spread of digitization of X-ray imaging forces radiological technologists to crop radiographs manually after measurement for suitable use on diagnoses. This cropping operation distracts attention of radiological technologists from measurement operations and from care to patients. The purpose of this study is to establish image processing method to achieve automatic cropping of X-ray images, which reduces the radiological technologists' burden in general radiography workflow. The proposed method utilizes adaptive binarization as pre-processing of radiographs. In this paper, we show the result of the proposed method applied for chest radiographs and the evaluation by radiological technologists.

Novel algorithm for real-time onset detection of surface electromyography in step-tracking wrist movements

We present a novel algorithm for real-time detection of the onset of surface electromyography signal in step-tracking wrist movements. The method identifies abrupt increase of the quasi-tension signal calculated from sEMG resulting from the step-by-step recruitment of activated motor units. We assessed the performance of our proposed algorithm using both simulated and real sEMG signals, and compared with two existing detection methods. Evaluation with simulated sEMG showed that the detection accuracy of our method is robust to different signal-to-noise ratios, and that it outperforms the existing methods in terms of bias when the noise is large (low SNR). Evaluation with real sEMG analysis also indicated better detection performance compared to existing methods.

A model to predict the frequency of integration of fitness-related QTLs from cultivated to wild soybean

With the proliferation of genetically modified (GM) products and the almost exponential growth of land use for GM crops, there is a growing need to develop quantitative approaches to estimating the risk of escape of transgenes into wild populations of crop relatives by natural hybridization. We assessed the risk of transgene escape by constructing a population genetic model based on information on fitness-related QTLs obtained from an F (2) population of wild soybean G. soja × cultivated soybean Glycine max. Simulation started with ten F (1) and 990 wild soybeans reproducing by selfing or outcrossing. Seed production was determined from the genetic effects of two QTLs for number of seeds (SN). Each seed survived winter according to the maternal genotype at three QTLs for winter survival (WS). We assumed that one neutral transgene was inserted at various sites and calculated its extinction rate. The presence of G. max alleles at SN and WS QTLs significantly decreased the probability of introgression of the neutral transgene at all insertion sites equally. The presence of G. max alleles at WS QTLs lowered the risk more than their presence at SN QTLs. Although most model studies have concentrated only on genotypic effects of transgenes, we show that the presence of fitness-related domestication genes has a large effect on the risk of transgene escape. Our model offers the advantage of considering the effects of both domestication genes and a transgene, and they can be widely applied to other wild × crop relative complexes.

Development of a spatially transparent electrotactile display and its performance in grip force control

An important function for a tactile navigation system of a handheld tool, such as a surgical scalpel, is the spatial transparency of the device. This paper proposed a new tactile display that can augment touch sensation at the finger pulps without the need for a stimulator between the tool and the finger pulps. We utilized transcutaneous electrical nerve stimulation at the middle phalanx of a finger to separate the stimulated and the perceived areas. In order to verify the effects of the spatial transparency, the performances of grip force control were examined. The results indicated that the proposed display was effective in helping the user to maintain the stable control of the grip force when using a handheld tool.

Electrical-thermal-structural coupling simulation for electrosurgery simulators

An electrosurgery is a fundamental operation that utilizes Joule heat generated by the passage of a radiofrequency current. Surgical simulators are demanded for training of the electrosurgical skill with fewer complications. However, foregoing simulators have never implemented a series of physics phenomena in electrosurgery. The aim of this study is to construct a surgical simulator with a unified physics-based modeling of whole processes of electrosurgery. In this paper, we developed an electrosurgical cutting simulation system with consideration of a series of physical phases: electrical, thermal, and structural phases. Especially, the structural change based on the vaporization and mechanical rupture is modeled. The experiments using porcine livers compared the simulated temperature change with the measured one in electrosurgical cutting, and the effectiveness of the proposed model was found. In addition, the rate-controlling step for real-time electrosurgery simulation was examined.

Prior estimation of motion using recursive perceptron with sEMG: a case of wrist angle

Muscle activity is followed by myoelectric potentials. Prior estimation of motion by surface electromyography can be utilized to assist the physically impaired people as well as surgeon. In this paper, we proposed a real-time method for the prior estimation of motion from surface electromyography, especially in the case of wrist angle. The method was based on the recursive processing of multi-layer perceptron, which is trained quickly. A single layer perceptron calculates quasi tensional force of muscles from surface electromyography. A three-layer perceptron calculates the wrist's change in angle. In order to estimate a variety of motions properly, the perceptron was designed to estimate motion in a short time period, e.g. 1ms. Recursive processing enables the method to estimate motion in the target time period, e.g. 50ms. The results of the experiments showed statistical significance for the precedence of estimated angle to the measured one.

88 COMPARISON BETWEEN STATIC AND DYNAMIC CULTURE RESULTS USING A NOVEL AIR ACTUATION SYSTEM

Mammalian embryos experience not only hormonal stimuli, but also mechanical stimuli (MS), such as shear stress (SS), compression and friction force, in the fallopian tube before nidation. Embryo development performed using previously described in vitro dynamic culture systems is significantly better than that performed using conventional static culture systems. Previously, we found that thawed human embryos showed developmental improvement in the blastocyst stage following a tilting embryo culture system (TECS) culture compared with static culture. However, a disadvantage of the system is the need to use electric devices inside the incubator under humidified conditions. To solve the problem, we developed a dynamic embryo culture system using air actuation and evaluated the applied MS and embryo culture results. We developed an air actuation system with microfluidic channels to apply MS by deforming a 0.1-mm-thick poly(dimethylsiloxane) (PDMS) membrane. The PDMS microfluidic device was placed in a humidified incubator and the mechanical actuator was placed outside the incubator. The embryos' motion in the microfluidic channel was recorded using an inverted microscope and a colour CCD camera with a frame rate of 30 frames s–1. Syringe velocity (VS) was controlled using a software model of the actuation system. The observed maximum velocity of the embryos (VE) and fluid velocity (VF) were calculated by tracking the images of the embryos and the particles in the medium, respectively. The experiments were repeated 3 times. Frozen 2-cell-stage embryos of imprinting control region (ICR) mouse were thawed. 10 to 13 embryos were applied into the microfluidic channel and cultured in ∼200 μL of potassium simplex optimized embryo culture medium covered with mineral oil for 3 days in a humidified environment of 5% CO2 in air at 37°C. The experiments were repeated 5 times. Chi-squared test and Student's t-test were used to determine differences in the blastocyst development rate and in the number of cells in the blastocysts between the groups, respectively. A P-value <0.05 was considered significant. Results: When syringe velocity (VS) was 0.5 mm over a period of seconds, the embryos rotated and did not slide. When VS and fluid velocity (VF) increased, the embryos slipped, did not come in contact with the floor. We conclude that different types and amounts of MS can be applied to the embryos by changing VS. We compared embryo development from the 2-cell stage to the blastocyst stage between static and dynamic cultures in the medium channel. Dynamic culture significantly improved the rate of development to the blastocyst stage (dynamic, 74% (n = 126); static, 62% (n = 118); P < 0.05). The average number of cells (mean ± standard error of the mean) in blastocysts obtained in dynamic and static cultures was 83 ± 3 (n = 54) and 76 ± 3 (n = 51) (P < 0.05), respectively. When the mouse embryos moved at VE of 0.2 mm s–1, there were significant differences in both blastocyst development rate and the average cell number of blastocysts between the 2 groups.

Actions of the Japanese Pancreas and Islet Transplantation Association regarding transplanted human islets isolated using Liberase HI

PURPOSE

The potential for introducing transmissible spongiform encephalopathy (TSE) into islet cells was indicated by recognizing that Liberase HI is isolated from Clostridium histolyticum grown in media containing brain-heart infusion broth. A national team within the Japanese Pancreas and Islet Transplantation Association implemented an islet transplantation program in Japan using Liberase HI. The program comprised 65 islet isolations from non-heart-beating donors and 34 transplants into 18 patients. Herein, we have summarized how the Association followed these recipients over the long term.

PROCEDURES

We established an ad hoc committee to follow recipients transplanted with islets isolated using Liberase HI after becoming informed of the associated dangers of using this enzyme. We also stopped islet transplantations using Liberase. The committee addressed the major concerns of the risk of the collagenase being contaminated with TSE and of the recipient follow-up. All recipients were examined by diffusion MRI and EEG and then scheduled for evaluation and follow-up by specialists in Creutzfeldt-Jakob disease (CJD). Bioassays of bovine spongiform encephalopathy prions in the enzyme proceeded using knock-in mice expressing bovine prion protein. These assays could detect contaminating prions at a dilution of 1 × 10(4). After inactivating its collagenase activity, Liberase HI was injected into the abdominal cavities of knock-in mice. Four months later, prion infectivity in Liberase HI was evaluated by immunohistochemical staining and Western blotting of spleen homogenates using anti-prion protein antibodies.

MAIN FINDINGS

Western blotting and immunohistochemical staining did not detect prions in Liberase HI. Diffusion MRI and EEG evaluations performed by CJD specialists confirmed that none of the transplanted recipients had CJD.

CONCLUSIONS

Three years of follow-up revealed that none of the Japanese recipients of islet transplants developed CJD. Prion bioassays showed that the Liberase HI used to isolate islets for transplantation was free of infectious TSE prions.

Phase II trial of preoperative chemotherapy for breast cancer: Japan Breast Cancer Research Network (JBCRN)-02 trial

BACKGROUND

Neoadjuvant chemotherapy (NAC) is one of the main strategies for patients with locally advanced breast cancer. In our previous study, biological markers such as estrogen receptor (ER), progesterone receptor (PgR), and HER2 were essential predictors of the effectiveness of NAC to help individualize treatment. This study examined the effect of NAC on the disease-free survival (DFS) of breast cancer patients. Furthermore, the study was expanded by adding Ki-67 as a biological marker, and examined the correlation between Ki-67 and the prognosis.

PATIENTS AND METHODS

Between September 2005 and September 2007, 43 patients with breast cancer received NAC and surgery. Four cycles of DC (doxorubicin: 60 mg/m(2) and cyclophosphamide: 500 mg/m(2)) were administered intravenously (i.v.) on day 1 every 21 days, followed by 12 cycles of paclitaxel i.v. (80 mg/m(2)) every 7 days, prior to surgery. The primary endpoint was the pathological complete response (pCR) rate and the secondary endpoint was DFS; the pCR rate was estimated for each groups stratified by the presence or absence of different factors (PcR, ER/PgR, and Ki-67).

RESULTS

The clinical response (cCR+cPR) rate was 81.0%, and the pCR rate was 25.6%. The pCR rate was 75, 50, 9 and 0% in HER2(+)/ER(-), HER2(+)/ER(+), HER2(-)/ER(-), and HER2(-)/ER(+) patients, respectively. The 4-year DFS rate was estimated at 78% for all patients. The HER2 status was an independent predictor of pathological complete response (pCR). The DFS rate of patients with lower Ki-67 values (<15%) was higher than that of patients with higher Ki-67 values (≥15%). The treatment-related adverse events were manageable: the majority were mild, but five patients experienced grade 3 (neutropenia and sensory neuropathy) adverse events.

CONCLUSION

DC followed by weekly paclitaxel is an active and manageable preoperative regimen for breast cancer patients. HER2 overexpression may be a good predictive marker of pCR, and the Ki-67 value after NAC may be a prognostic factor for DFS.

Haptic interface protocol for FEM-based deformable model and effects on fineness of force feedback and perceived hardness

The remote haptic collaboration system between operating and assistant surgeons causes both shift and step delays of force feedback, and then makes users feel coarse reaction forces and different hardness of the object. In this study, we propose a haptic interface protocol for finite-element-method based deformable objects, in order to achieve a high update rate of force calculation. The method exports the necessary information for calculation of reaction forces from the simulation loop to the haptic loop. The experimental results indicated that the proposed method improved the fineness of force feedback and subjective hardness significantly.

Efficacy of S-1 in patients with capecitabine-resistant breast cancer-Japan Breast Cancer Research Network (JBCRN) 04-1 trial

BACKGROUND

S-1 is an orally administered fluorinated pyrimidine with high activity in metastatic breast carcinoma (MBC) and in chemotherapy-pretreated metastatic breast carcinoma.

PATIENTS AND METHODS

Forty patients with MBC who did not respond to capecitabine-based chemo-therapy and then received S-1 were identified from our data base of records between 2006 and 2008. The clinico-pathological data and outcomes of these patients were then reviewed.

RESULTS

The overall response rate was 27.8%. The median survival was 19.2 months, and the median time to disease progression was 6.2 months. The most common treatment-related adverse events (all grades) were hand-foot syndrome (15%), nausea (15%), vomiting (7.5%), disorder of taste (7.5%), and diarrhea (5%). However, the majority were mild to moderate in intensity, and only one patient experienced grade 3 (according to the National Cancer Institute of Canada Common Toxicity criteria) adverse events. Myelosuppression and alopecia were rare, and there were no reported treatment-related deaths.

CONCLUSION

The results of the current study demonstrate that S-1 is an effective and well-tolerated treatment in patients with capecitabine-resistant MBC. In addition, it is a convenient, orally administered drug, which makes it an attractive agent for use in outpatient treatment.

A synthetic cell-penetrating peptide antagonizing TrkA function suppresses neuropathic pain in mice

Nerve growth factor (NGF) and its high-affinity receptor, TrkA, are one of the targets in the production of new drugs for the treatment of neuropathic pain. NGF contributes to both the initiation and maintenance of sensory abnormalities after peripheral nerve injury. This study examined the effects of IPTRK3, a new synthetic cell-penetrating peptide that antagonizes TrkA function, on neuropathic pain in mice. Partial sciatic nerve ligation (PSNL) was used to generate neuropathic pain, and we injected IPTRK3 (2 or 10 mg/kg) intraperitoneally on day 7 after PSNL. Effects of the peptide on hyperalgesia, allodynia, and expression of Fos in the spinal cord were examined. Single administration of the peptide on day 7 significantly suppressed both thermal hyperalgesia and mechanical allodynia. Gentle touch stimuli-evoked Fos expression in the lumbar spinal cord was also significantly reduced. Intraperitoneal injection of a cell-penetrating peptide antagonizing TrkA function appears effective for treatment of neuropathic pain in a mouse pain model.

The origin and fate of morphological intermediates between wild and cultivated soybeans in their natural habitats in Japan

The spread of transgenes into the genome of wild soybean is a concern when transgenic and wild soybeans are planted sympatrically. The objectives of this study were to investigate the origin and fate of morphological intermediates between wild and cultivated soybeans in their natural habitats in Japan. Twenty nuclear microsatellite and two chloroplast dCAPS markers were used to evaluate genetic variation of 468 wild, 17 intermediate, and 12 cultivated soybean samples collected from six sites between 2003 and 2006. Allelic differentiation of microsatellite markers between wild and cultivated soybeans was sufficient to detect their hybrids. Based on levels of observed heterozygosity, intermediate soybean plants were from two generations: either F(1) or an early segregating generation. Genetic admixture analysis and parentage assignment analysis revealed that the parents of all intermediate soybean plants could be assigned to a particular wild soybean plant and late-maturing cultivar. The chloroplast DNA haplotypes revealed that all intermediate soybean plants originated from gene flow from cultivated to wild soybeans at all sites. Based on monitoring at both the phenotypic and molecular levels, hybrids quickly disappeared from natural habitats, and secondary gene flow from these plants to wild soybean was not detected. Thus, while gene flow from transgenic soybean into wild soybean can occur, gene introgression appears to be rare in natural habitats in Japan. This is the first report on the detection of gene flow from cultivated to wild soybean at the molecular level.

Solution structure of LC5, the CCR5- derived peptide for HIV-1 inhibition

The synthetic peptide fragment (LC5: LRCRNEKKRHRAVRLIFTI) inhibits human immunodeficiency virus type 1 (HIV-1) infection of MT-4 cells. In this study, the solution structure of LC5 in SDS micelles was elucidated by using the standard (1)H two-dimensional NMR spectroscopic method along with circular dichroism and fluorescence quenching. The peptide adopts a helical structure in the C-terminal region (residues 13-16), whereas the N-terminal part remains unstructured. The importance of Phe17 in maintaining the structure of LC5 was demonstrated by replacing Phe17 with Ala, which resulted in the dramatic conformational change of LC5. The solution structure of LC5 elucidated in the present work provides a basis for further study of the mechanism of the inhibition of HIV-1 infection.

Insulin-mediated regulation of decidual protein induced by progesterone (DEPP) in adipose tissue and liver

We analyzed the profile of the genes expressed in human adipose tissue and identified the fat-derived molecules, adiponectin and aquaporin 7, which modulate glucose and lipid metabolism. The same Bodymap analysis revealed abundant expression of the decidual protein induced by progesterone (DEPP) in the white adipose tissue. Northern blot analysis confirmed that human DEPP mRNA was highly expressed in white adipose tissue. Mouse DEPP mRNA was detected in heart, lung, skeletal muscle, and white adipose tissue under feeding state. In contrast, under fasting state, mouse DEPP mRNA was enhanced in lung, skeletal muscle, and white adipose tissue and it appeared also in the liver and kidney, suggesting up regulation of DEPP by fasting. Because fasting-induced DEPP expression was observed in insulin-sensitive organs, we investigated the regulation of DEPP in white adipose tissue and liver. During adipogenesis of mouse 3T3-L1 cells, DEPP mRNA increased in a differentiation-dependent manner similar to adiponectin and aquaporin 7. Treatment of cultured 3T3-L1 mature adipocytes, rat H4IIE, and human HepG2 hepatoma cells with insulin significantly decreased DEPP mRNA levels in dose- and time-dependent manners. IN VIVO experiments showed significant decrease of hepatic and adipose DEPP mRNA levels in refed mice, compared to fasted animals, and also showed significant increase in DEPP mRNA in streptozotocin-induced insulin-deficient diabetic mice. These results indicate that DEPP is a novel insulin-regulatory molecule expressed abundantly in insulin-sensitive tissues including white adipose tissue and liver.

[Aortic valve replacement through right thoracotomy; report of a case]

A 78-year-old female was admitted to our hospital with a diagnosis of severe aortic valve regurgitation. She had had dyspnea on effort and syncope twice in 5 months. She had also suffered from right pneumonia 8 years before, and her respiratory function was severely constrictive. Chest X-ray showed her mediastinum significantly shifted toward the right side. Chest computed tomography (CT) revealed the main pulmonary artery, right atrium (RA) and right pulmonary veins also shifted toward the right. We planned right thoracotomy at 4th intercostals space to obtain a good surgical field. A cardiopulmonary bypass was established by RA appendage drainage and femoral artery perfusion. Aortic valve replacement(AVR) was performed successfully after aortic clamp. Though defibrillator pads were placed on her back and the anterior wall of the left chest during operation, no ventricular fibrillation occurred. AVR via right thoracotomy is considered to be a good option for such a mediastinum shifted case.

[Metastatic lung cancer origin from osteosarcoma of mandible invading tracheal lumen]

A 52-year-old woman underwent the surgical treatment for osteosarcoma of the left mandible in 2003 and was followed up afterward. She suffered from dry cough and bloody sputum, and was admitted to our hospital in April 2007. Computed tomography (CT) revealed several nodules in bilateral lung, and bronchofiberscopy showed the endobronchial tumor obstructing in the right main bronchus. The metastatic tumor progressed in the right main bronchus from the right S6 lung segment. The tumor rapidly progressed in the right bronchus in comparison with the CT findings in about 2 weeks, and the possibility of the tracheal obstruction was considered. She underwent the right middle and lower lobectomy, and the endobronchial tumor was pulled through the right main bronchus. The postoperative course was uneventful, the patient was discharged on 14th postoperative day, and the chemotherapy using cisplatin (CDDP) and adriamycin (ADR) is on-going.

Synthetic pentapeptides inhibiting autophosphorylation of insulin receptor in a non-ATP-competitive mechanism

In an attempt to develop non-ATP-competitive inhibitors of the autophosphorylation of IR, the effects of the synthetic peptides, Ac-DIY(1158)ET-NH(2) and Ac-DY(1162)Y(1163)RK-NH(2), on the phosphorylation of IR were studied in vitro. The peptides were derived from the amino-acid sequence in the activation loop of IR. They inhibited the autophosphorylation of IR to 20.5 and 40.7%, respectively, at 4000 microM. The Asp/Asn- and Glu/Gln-substituted peptides, Ac-NIYQT-NH(2) and Ac-NYYRK-NH(2), more potently inhibited the autophosphorylation than did the corresponding parent peptides. The inhibitory potencies of the substituted peptides were decreased with increasing concentrations of ATP, indicating that these peptides employ an ATP-competitive mechanism in inhibiting the autophosphorylation of IR. In contrast, those of the parent peptides were not affected. Mass spectrometry showed that the parent peptides were phosphorylated by IR, suggesting that they interact with the catalytic loop. Moreover, docking simulations predicted that the substituted peptides would interact with the ATP-binding region of IR, whereas their parent peptides would interact with the catalytic loop of IR. Thus, Ac-DIYET-NH(2) and Ac-DYYRK-NH(2) are expected to be non-ATP-competitive inhibitors. These peptides could contribute to the development of a drug employing a novel mechanism.

[Infective endocarditis with acute embolism to the lower extremity artery caused by a vegetation: report of a case]

Successful surgical treatment of a case of infective endocarditis with embolism to a lower extremity artery is reported. A 71-year-old man was referred to our hospital for the treatment of infective endocarditis. Echocardiography showed a vegetation on the non-coronary cusp of the aortic valve measuring 19 mm in diameter. We planned surgical treatment, including aortic valve replacement, however, embolism of a lower extremity artery by the vegetation occurred during the waiting period for the operation. We removed the offending vegetation from the popliteal artery and replaced the peccant aortic valve with a prosthetic valve in separate operations. The postoperative course was uneventful and the patient was transferred to another hospital on the 33rd day after the valve replacement surgery.

Phase II study of AC (doxorubicin and cyclophosphamide) followed by weekly paclitaxel as neoadjuvant chemotherapy in operable patients with primary breast cancer

e11587

Background: The objective of this multi center Phase II clinical study prove the benefit of neoadjuvant combination therapy using anthracycline based AC therapy (doxorubicin and cyclophosphamide), which is useful as a standard therapy, followed by weekly PTX(paclitaxel) in patients with early stage breast cancer. Methods: Forty-seven patients with operable breast cancer were enrolled to the study. Patients received four cycles of AC followed by weekly PTX. The primary endpoint was disease free survival (DFS) stratified by the absence of presence of Quasi-pCR (QpCR: absence of invasive tumor or only focal residual tumor cells). Secondary endpoints were predictors for QpCR, clinical response, breast conservation rate, and safety. The planned sample size was 25. Results: Of 43 assessable patients, 25.6% achieved QpCR. With 28.6 months median follow-up, DFS was estimated at 72% for all patients. 3 year DFS for patients with QpCR was 80% vs. 72% without QpCR. HER2 status and response to AC were independent predictors of QpCR. The overall clinical response was 79%; 58% of patients achieved breast conservation. Nausea was the most common adverse event, observed in 62.8% and 33.3% of patients during AC and PTX respectively. The second common adverse event was peripheral neuritis, observed in 9.3% and 57.1% of patients during AC and PTX respectively. Conclusions: Despite the small sample size, these data shows that AC followed PTX is a highly active neoadjuvant therapy for women with early stage breast cancer.

No significant financial relationships to disclose.

Cerebral infarction in a patient with congenital complete heart block

Stokes-Adams attacks are fairly common in children with congenital complete heart block, but the occurrence of cerebral infarction is quite unusual. We present the case of a 13-year-old boy with congenital heart block and an embolic stroke involving the cerebral artery. Echocardiography revealed no valvular regurgitation, hypokinetic segments, mural thrombus, or myxoma. Electrocardiographic monitoring demonstrated good response of ventricular rate to exercise and no episodes of atrial or ventricular dysrhythmia. It is assumed that embolism occurred due to bradycardia.

Relationship of the bovine growth hormone gene to carcass traits in Japanese black cattle

The bovine growth hormone gene (bGH) possesses three haplotypes, A, B and C, that differ by amino acid mutations at positions 127 and 172 in the fifth exon: (leucine 127, threonine 172), (valine 127, threonine 172) and (valine 127, methionine 172) respectively. The correlation between meat quality or carcass weight and these haplotypes was investigated in Japanese black cattle. Altogether, 940 bGH haplotypes were compared with respect to six carcass traits: carcass weight, longissimus muscle area, rib thickness, subcutaneous fat thickness, beef marbling score and beef colour. The frequency of the B haplotype was higher (0.421) than that of A (0.269) and C (0.311). High carcass weight and low beef marbling were associated with haplotype A (p < 0.05 and p < 0.01 respectively), whereas beef marbling was increased by haplotype C (p < 0.05). Estimated regression coefficient of the A haplotype substitution effect for carcass weight and beef marbling score were 5.55 (13.1% of the phenotypic SD) and -0.31 (17.0%) respectively. That of the C haplotype for beef marbling score was 0.20 (11.0%). The other traits showed no relationship to the haplotypes examined. The results of this investigation suggest that information pertaining to bGH polymorphisms in Japanese black cattle could be used to improve the selection of meat traits.

Pittosporumxanthins, cycloaddition products of carotenoids with alpha-tocopherol from seeds of Pittosporum tobira

A series of carotenoid-alpha-tocopherol cycloaddition products, named pittosporumxanthins B1 ( 3), B2 ( 4), C1 ( 5), C2 ( 6), A3 ( 7), and A4 ( 8), were isolated from the seeds of Pittosporum tobira. The structures were determined to be cycloaddition products of 9' Z-antheraxanthin at the 11' and 12' positions with alpha-tocopherol ( 3 and 4), 9' Z-neoaxanthin with alpha-tocopherol ( 5 and 6), and 9 Z-violaxanthin with alpha-tocopherol ( 7 and 8) on the basis of a detailed analyses of MS and NMR spectroscopic data. The configurations of the carotenoid end groups in the pittosporumxanthins were determined by a modified Mosher's method. Compounds 3, 5, and 7 were assigned (11' R,12' S) and 4, 6, and 8 (11' S,12' R) absolute configurations using CD measurements.

Inhibition of autophosphorylation of epidermal growth factor receptor by a small peptide not employing an ATP-competitive mechanism

Previously we found that short peptides surrounding major autophosphorylation sites of EGFR (VPEY(1068)INQ, DY(1148)QQD, and ENAEY(1173)LR) suppress phosphorylation of purified EGFR to 30-50% at 4000 microM. In an attempt to improve potencies of the peptides, we modified the sequences by substituting various amino acids for tyrosine or by substituting Gln and Asn for Glu and Asp, respectively. Among the modified peptides, Asp/Asn- and Glu/Gln-substitution in DYQQD (NYQQN) and ENAEYLR (QNAQYLR), respectively, improved inhibitory potencies. The inhibitory potency of NYQQN was not affected by the concentration of ATP, while that of QNAQYLR was affected. Docking simulations showed different mechanisms of inhibition for the peptides: inhibition by binding to the ATP-binding site (QNAQYLR) and inhibition by binding to a region surrounded by alphaC, the activation loop, and the catalytic loop and interfering with the catalytic reaction (NYQQN). The inhibitory potency of NYQQN for insulin receptor drastically decreased, whereas QNAQYLR inhibited autophosphorylation of insulin receptor as well as EGFR. In conclusion, NYQQN is not an ATP-competitive inhibitor and the binding site of this peptide appears to be novel as a tyrosine kinase inhibitor. NYQQN could be a promising seed for the development of anti-cancer drugs having specificity for EGFR.

[Right lung cancer with right aortic arch]

An abnormal shadow was detected on chest X-ray mass screening in an asymptomatic 63-year-old man. The further examinations revealed the shadow to be primary lung cancer (Rt. S6. adenocarcinoma, cT2N0M0, c-stage IB) with right aortic arch. We used 3 dimentional-computed tomography (3D-CT) to assess an anatomical feature of vessels in detail. The right lower lobectomy and the dissection of medi astinal lymph nodes was performed. We confirmed no abnormal anatomy of pulmonary artery and vein at surgery, and it was possible to perform right lower lobectomy with the common procedure. Since lymph node was found by intraopetrative pathological examination, since no metastasis from interlobar to subcarinal lymph node was found, we did not perform dissection of upper mediastinal dissection, which was equivalent to ND2a lymph nodes dissection of the left lung cancer in General Rule for Clinical and Pathological Record of Lung Cancer. The patient with right aortic arch is known to have variant anatomy of other intrathoracic vessels occasionally. 3D-CT was quite useful in assessing anatomical feature, and enabled us to perform safe operation.

Effect of synthetic cell-penetrating peptides on TrkA activity in PC12 cells

As TrkA, a high-affinity receptor of nerve growth factor (NGF), is a potential target for relieving uncontrolled inflammatory pain, an effective inhibitor of TrkA has been required for pain management. To identify a specific inhibitor of TrkA activity, we designed cell-penetrating peptides combined with amino-acid sequences in the activation loop of TrkA to antagonize tyrosine kinase activity. To select a peptide inhibiting TrkA activity, we examined the effect of cell-penetrating peptides on tyrosine kinase activity of recombinant TrkA in vitro and studied their effects on NGF-stimulated neurite outgrowth and protein phosphorylation in PC12 cells. Thereafter we investigated the effect of the selected peptide on NGF-stimulated TrkA activity and the expression of transient receptor potential channel 1 in PC12 cells. The selected peptide inhibited TrkA activity, but did not inhibit tyrosine kinase activities of other receptor-type tyrosine kinases in vitro. It also suppressed NGF-stimulated responses in PC12 cells. The selected synthetic cell-penetrating peptide antagonizing TrkA function would be a candidate for inflammatory pain therapy.

Haptic rate for surgical manipulations with fingers and instruments

In surgery, many kinds of manipulations are conducted using multiple fingers and instruments. The aim of this study is to investigate required haptic rate for multi-finger manipulation and instrumental manipulation. This paper investigated required haptic rate for multi-finger haptic interaction with haptic device and soft tissue deformation. Results of experiment clarified the fact that there is difference of threshold of haptic rate between the number of manipulating fingers.

Asynchronous teaching of psychomotor skills through VR annotations: evaluation in digital rectal examination

Many VR technology based training systems use expert's motion data as the training aid, but would not provide any short-cut to teaching medical skills that do not depend on exact motions. Earlier we presented Annotated Simulation Records (ASRs), which can be used to encapsulate experts' insight on psychomotor skills. Annotations made to behavioural parameters in training simulators enable asynchronous teaching instead of just motion training in a proactive way to the learner. We evaluated ASRs for asynchronous teaching of Digital Rectal Examination (DRE) with 3 urologists and 8 medical students. The ASRs were found more effective than motion-based training with verbal feedback.

Interaction of an amphipathic peptide with phosphatidycholine/phosphatidylethanolamine mixed membranes

The effect of 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine (DOPE) in mixed membranes with 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine (POPC) on interaction with a class A amphipathic peptide, Ac-DWLKAFYDKVAEKLKEAF-NH(2) (Ac-18A-NH(2)), was investigated. The fluorescence lifetime of 2-(9-anthroyloxy)stearic acid and (2)H NMR spectra were used to evaluate the penetration of water molecules into the membrane interface and the order of lipid acyl chains, respectively. The results demonstrated that DOPE in the mixed membranes decreased the fluorescence lifetime and increased the acyl-chain order, and that Ac-18A-NH(2) affected them more for membranes with higher DOPE fractions. The partition coefficient (K(p)) of the peptide to the mixed membranes was increased with the increase in the DOPE mole fractions. From the temperature dependence of the K(p) values, the binding of Ac-18A-NH(2) to POPC/DOPE mixed membranes was found to be entropy-driven. The formation of an alpha-helix at the membrane's surface is supposed to induce positive curvature strain, which decreases the headgroup hydration and acyl-chain order of lipids. Thus, the binding of Ac-18A-NH(2) to membranes is entropically more favorable at higher DOPE fractions since the peptide's insertion into the membrane can decrease the order parameter and unfavorable headgroup hydration, which explains the enhanced peptide binding.

Chemical design of a radiolabeled gelatinase inhibitor peptide for the imaging of gelatinase activity in tumors

Since elevated levels of gelatinases [matrix metalloproteinase (MMP)-2 and MMP-9] are associated with a poor prognosis in cancer patients, these enzymes are potential targets for tumor imaging. In the present study, a cyclic decapeptide, cCTTHWGFTLC (CTT), was selected as a mother compound because of its selective inhibitory activity toward gelatinases. For imaging gelatinase activity in tumors, we designed a CTT-based radiopharmaceutical taking into consideration that (1) the HWGF motif of the peptide is important for the activity, (2) hydrophilic radiolabeled peptides show low-level accumulation in the liver and (3) an increase in the negative charge of radiolabeled peptides is effective in reducing renal accumulation. Thus, a highly hydrophilic and negatively charged radiolabel, indiun-111-diethylenetriaminepentaacetic acid ((111)In-DTPA), was attached to an N-terminal residue distant from the HWGF motif ((111)In-DTPA-CTT). In MMP-2 inhibition assays, In-DTPA-CTT significantly inhibited the proteolytic activity in a concentration-dependent fashion. When injected into normal mice, (111)In-DTPA-CTT showed low levels of radioactivity in the liver and kidney. A comparison of the pharmacokinetic characteristics of (111)In-DTPA-CTT with those of other CTT derivatives having different physicochemical properties revealed that the increase in hydrophilicity and negative charge caused by the conjugation of (111)In-DTPA reduced levels of radioactivity in the liver and kidney. In tumor-bearing mice, a significant correlation was observed between the accumulation in the tumor as well as tumor-to-blood ratio of (111)In-DTPA-CTT and gelatinase activity. These findings support the validity of the chemical design of (111)In-DTPA-CTT for reducing accumulation in nontarget tissues and maintaining the inhibitory activity of the mother compound. Furthermore, (111)In-DTPA-CTT derivatives would be potential radiopharmaceuticals for the imaging of gelatinase activity in metastatic tumors in vivo.

[Beating heart surgery for the patient of severe mitral regurgitation with a episode of ventricular fibrillation; report of a case]

A 77-year-old female was admitted to our hospital with a diagnosis of severe mitral regurgitation. Cardiopulmonary revival was done by an emergent resuscitation for the ventricular fibrillation before admission. She had mild anoxic brain damage and brain magnetic resonance imaging (MRI) revealed severe brain atrophy. Chest X-ray showed severe cardiomegaly and congestion. Beating heart mitral valve replacement was planned for the prevention of reperfusion injury. A cardiopulmonary bypass was established by bicaval drainage and aortic return. The prolapse of anterior leaflet was recognized through transeptal approach after aortic clamp. We selected continuous infusion of antegrade cardioplegia for intraoperative coronary perfusion. Mitral valve replacement was done successfully. During intraoperation and postoperation, ventricular fibrillation did not occur. On-pump beating mitral valve replacement is a good procedure to prevent perioperative ventricular arrhythmia especially such the case with a decompressed myocardial function and with a preoperative episode of lethal ventricular arrhythmia necessary for cardiopulmonary resuscitation.