Does using lower limit of normal values enhance the ability of a single bone mineral density measure to predict fractures?

Using a single bone mineral density (BMD) measure, we demonstrated that the lower limit of normal (LLN) method is more consistent in predicting osteoporosis fractures than the T-score in white menopausal women from the Study of Osteoporosis Fracture (SOF).

INTRODUCTION

In order to circumvent the inconsistencies and limitations with using the T-score when defining osteoporosis, we propose using 95% LLN values derived from centered polynomial models using the NHANES III BMD measures. The main aim of this study was to compare the two methods in prediction of fracture and agreement in osteoporosis classification using cohort data.

METHODS

We compared the fracture prediction ability of the two methods using a single BMD measurement in 4,948 white women aged 67-74 years in the SOF employing kappa statistics, sensitivity, and specificity.

RESULTS

The T-score provided inconsistent osteoporosis classification (46.6%) across the five hip regions of interest (ROIs) and this was significantly (p<0.0001) reduced when using the LLN method (36.5%). Kappa statistics of incident fracture during 12 years of follow-up related to the prevalence of osteoporosis at baseline was significantly improved using the LLN method compared to using T-score. Sensitivity and specificity for fracture based on a single BMD measurement of different hip ROIs were more consistent using the LLN method.

CONCLUSION

The LLN method provides a more consistent and efficient method for osteoporosis fracture prediction than the T-score in 67- to 74-year-old white women.

All-trans retinoic acid attenuates cardiac allograft vasculopathy in rats

OBJECTIVE

We sought to study the inhibitory effects of all-trans retinoic acid (ATRA) on cardiac allograft vasculopathy in rats.

METHODS

Inbred Wistar and Sprague-Dawley rats were used as donors and recipients, respectively. After abdominal heterotopic heart transplantation, animals were randomized to a cyclosporine (CsA) group versus a CsA+ATRA group: 10 mg/kg/d CsA versus the same CsA dose plus 10 mg/kg/d ATRA. Transplanted hearts were analyzed at 60 days. Cardiac allograft sections were treated with Van Giesson stain to examine vascular luminal occlusion, with immunohistochemistry for CD68 and proliferating cell nuclear antigen (PCNA), and with reverse-transcription polymerase chain reaction (RT-PCR) for platelet-derived growth factor A (PDGF-A) mRNA.

RESULTS

Luminal occlusion in the CsA+ATRA group was significantly less than that in the CsA group (40.10 +/- 8.20% vs 62.86 +/- 17.18%; P < .01). The CsA+ATRA group showed a marked reduction in PCNA- and CD68-positive cells: namely, 33.96 +/- 8.65% versus 60.17 +/- 17.74% (P < .01) and 17.63 +/- 4.24% versus 32.13 +/- 9.26 (P < .01), respectively. RT-PCR analysis showed that relative PDGF-A mRNA content in the CsA+ATRA group was significantly decreased compared with the CsA group (0.46 +/- 0.08 vs 0.94 +/- 0.11; P < .01).

CONCLUSION

ATRA may attenuate rat cardiac allograft vasculopathy by inhibiting macrophage infiltration and cell proliferation.

Protective effects of icariin on brain dysfunction induced by lipopolysaccharide in rats

In this study we examined the protective effects of icariin, a flavonol isolated from Herba epimedii, on learning and memory in a rat model with brain inflammation induced by lipopolysaccharide (LPS). Injecting LPS into the lateral ventricle caused rat brain dysfunction, as evidenced by deficits of spatial learning and memory in the Morris water maze. With administration of icariin (30, 60, 120mg/kg body wt./day) for 17 consecutive days, spatial learning and memory abilities were markedly altered. Escape latency and searching distance decreased, and the expressions of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and cyclooxygenase-2 (COX-2) of brain were significantly reduced as observed by real-time RT-PCR and immunohistochemistry. This study used ibuprofen (40mg/kg body wt./day) as positive control. In conclusion, this study suggested that icariin can improve spatial learning and memory abilities in rats with brain dysfunction induced by LPS, an effect which may be due to decreased expressions of TNF-α, IL-1β and COX-2 in the hippocampus.

Assessment of the Risk of Rupture of Intracranial Aneurysms using Three-Dimensional Cerebral Digital Subtraction Angiography

The aim of this study was to develop an improved binary logistic regression model for predicting the risk of intracranial aneurysm rupture. A cohort of patients ( n = 37) with aneurysms underwent three-dimensional digital subtraction angiography examination to measure several morphological parameters of the aneurysm. The aspect ratio (height/neck size) and the size ratio (length/mean diameter of parent vessel) were also calculated. All the morphological parameters combined with the aneurysm location and the patient's baseline data were used to derive a backward binary logistic regression model. In order to validate the model, it was applied to another independent cohort of 19 patients with aneurysms. The model had sensitivity, specificity and accuracy of 84.6%, 66.7% and 78.9%, respectively. This binary logistic regression model of aneurysm rupture risk identified the status of an aneurysm with high accuracy and could form the basis of more complex models in the future.

Depression, fracture risk, and bone loss: a meta-analysis of cohort studies

Whether depression can increase the risk of bone fractures is uncertain. This meta-analysis, which pooled results from 14 qualifying individual cohort studies, found that depression was associated with a significantly increased risk of fractures and bone loss.

INTRODUCTION

The effect of depression on the risk of bone fractures is controversial. We conducted a meta-analysis of prospective studies that examined the risk of osteoporotic fractures and bone loss associated with depression.

METHODS

We searched databases and reviewed citations in relevant articles to identify cohort studies that met prestated inclusion criteria; 14 studies were identified. Information on study design, participant characteristics, exposure and outcome measures, control for potential confounders, and risk estimates was abstracted independently by two investigators using a standardized protocol. Data were pooled by use of a random-effects model.

RESULTS

In studies that reported fracture outcomes as hazard ratios (HRs) (six studies [n = 108,157]), depression was associated with a 17% increase in fracture risk (HR = 1.17; 95% confidence interval [CI], 1.00-1.36; P = 0.05); in studies that reported risk ratios as fracture outcomes (four studies [n = 33,428]), depression was associated with a 52% increase in risk (risk ratio, 1.52; 95% CI, 1.26-1.85; P < 0.001). In studies that reported bone mineral density as an outcome (five studies [n = 8,931]), depression was associated with a reduced annualized bone loss rate of 0.25% (0.05-0.45%; P = 0.02) at the hip and 0.29% (-0.07-0.64%; P = 0.11) at the spine. The HR for the three studies (n = 14,777) that did not adjust for antidepressant treatment was 1.30 (95% CI, 1.11-1.52; P = 0.01), and the HR for the three studies (n = 93,380) that did adjust for antidepressant treatment was 1.05 (95% CI, 0.86-1.29; P = 0.6).

CONCLUSION

Evidence supports an association between depression and increased risk of fracture and bone loss that may be mediated by antidepressants.

Polymorphisms of PXK are associated with autoantibody production, but not disease risk, of systemic lupus erythematosus in Chinese mainland population

Systemic lupus erythematosus (SLE) is a complex immune disease. The genetic variation in the PXK gene was found to associate with SLE in Caucasian populations. However, the association of rs6445975 with SLE has not been extensively studied in a Chinese mainland population. A total of 288 SLE patients and 357 controls were recruited. Unlabeled probe-based high-resolution melting analysis (HRMA) was used in genotyping. HRMA with unlabeled probe successfully distinguished all genotypes. Neither genotype nor allele frequencies of SNP rs6445975 showed statistically significant differences between SLE patients and controls. The association of SNP rs6445975 with the diagnostic criteria of SLE was also examined. No obvious association was observed between rs6445975 and the incidence of clinical symptoms. However, the minor allele (G) of rs6445975 was found to significantly associate with increased abnormalities of anti-Smith (p = 0.004, odds ratio (OR) = 1.95, 95% confidence interval (CI) = 1.22-3.09), anti-Ro (p = 0.015, OR = 1.69, 95% CI = 1.10-2.58), anti-La (p = 0.008, OR = 1.86, 95% CI = 1.17-2.93) and C3C4 (p = 0.007, OR = 1.79, 95% CI = 1.17-2.74). Polymorphisms of rs6445975 in the PXK gene were associated with autoantibody production, but not disease risk, of systemic lupus erythematosus in a Chinese population.

The phenotypic and genotypic characterization of Enterobacter sakazakii strains from infant formula milk

Enterobacter sakazakii is an emerging foodborne pathogen associated with severe diseases in neonates. Infant formula milk (IFM) has been identified as one of the major contaminated sources and a transmission vehicle. To determine the phenotypic and genotypic characterization of this pathogen, 22 E. sakazakii strains isolated from IFM by an FDA-recommended method and PCR on the alpha-glucosidase gene were subtyped by random amplified polymorphic DNA (RAPD)-PCR, enterobacterial repetitive intergenic consensus (ERIC)-PCR, and antibiotic resistance patterns. At a similarity threshold of 80%, 16 ERIC-PCR fingerprint types were identified with a discriminatory power (D) of 0.933, and 18 RAPD-PCR types were identified with D of 0.973. Resistance to 9 antibiotics tested by disk diffusion assay revealed 6 antibiotic resistance patterns with D of 0.749. The comparison of characterization indicated that RAPD-PCR and ERIC-PCR have high discriminatory power showing genetic diversity of E. sakazakii isolates, and ERIC-PCR patterns showed a closer correlation than RAPD-PCR patterns to phenotypic characterization and the brands of IFM. Overall, the ERIC-PCR typing method could be used for tracing sources of E. sakazakii isolates in the food chain.

Urinary cadmium, osteopenia, and osteoporosis in the US population

SUMMARY

The association between cadmium and osteoporosis in a multiethnic population is unclear. We found that urinary cadmium is consistently associated with osteopenia and osteoporosis in the Third National Health and Nutrition Examination Survey, regardless of age, sex, race, and smoking status. Cadmium exposure may be an independent risk factor for osteoporosis.

INTRODUCTION

Our purpose was to test whether cadmium exposure is associated with a higher prevalence of osteopenia and osteoporosis in the general US population and selected subgroups.

METHODS

We used multinomial logistic regression to analyze data on 10,978 subjects (aged 30-90) from the Third National Health and Nutrition Examination Survey. We studied the association of urinary cadmium levels (adjusted for urinary creatinine) and the prevalence of osteopenia and osteoporosis as defined by the World Health Organization.

RESULTS

After adjustment for age, sex, ethnicity, body mass index, calcium intake, and physical inactivity, odds ratios (ORs) for osteopenia and osteoporosis increased dose dependently with two urinary cadmium levels (in micrograms of urinary cadmium per grams of urinary creatinine: level I, 1.00-1.99 mcg/g; level II, > or =2.00 mcg/g). Osteopenia results were as follows: level I OR, 1.49 (95% confidence interval [CI], 1.24-1.80); level II OR, 2.05 (95% CI, 1.52-2.78). Osteoporosis results were as follows: level I OR, 1.78 (95% CI, 1.26-2.52); level II OR, 3.80 (95% CI, 2.36-6.14). The association was consistent in all age, sex, race, and smoking status subgroups.

CONCLUSIONS

Cadmium exposure may be a potential risk factor for osteopenia and osteoporosis in the general US population.

High-resolution melting analysis of PCDH10 methylation levels in gastric, colorectal and pancreatic cancers

Protocadherins are celladhesion molecules with 6 or 7 cadherin motifs in their extracellular domain and various cyotoplasmic domains. PCDH10 was characterized a novel tumor suppressive gene in and was epigenetically silenced in multiple haematologic malignancies as well as some solid tumors such as gastric cancer, nasopharyngeal carcinoma and esophageal carcinoma. High-resolution melting (HRM) analysis has been used as a novel tool for analysis of promoter methylation. In our study, we used HRM analysis to detect the methylation levels of PCDH10 gene in 100 gastric cancers, 100 colorectal cancers, 70 pancreatic cancers and equal number of adjacent normal tissues. The frequency of PCDH10 methylation in all three types of cancers was significantly higher than that in normal tissues. Consistent with previous reports, expression levels of PCDH10 were inversely correlated with methylation levels. But we didn't find significant association between PCDH10 methylation status and TNM staging in all three types of cancers. In summary, application of HRM analysis to large amount of clinical samples proves to be a fast and high-throughput way to investigate the epigenetic status of PCDH10. And this is the first study to evaluate the prevalence of PCDH10 methylation based on large amount of tumor samples, showing that epigenetic regulation of PCDH10 was associated with carcinogenesis.

Distribution and fate of polybrominated diphenyl ethers in indoor environments of elementary schools

Polybrominated diphenyl ethers (PBDEs) are considered harmful to human health because of their toxicities and persistence in environments. In the current study, the distribution and fate of PBDEs in classrooms and computer rooms in 17 elementary schools in South Korea have been described. Eight congeners (brominated diphenyl ether-28, -47, -99, -100, -153, -154, -183, and -209) in air, floor dust, and product surface dust were measured. While Sigma(8)PBDEs in the air in classrooms showed considerable variations (0.659-1600 pg/m(3), arithmetic mean +/- s.d.: 377 +/- 441 pg/m(3)), those in computer rooms were somewhat similar (134-220 pg/m(3), arithmetic mean +/- s.d.: 169 +/- 40 pg/m(3)). Sigma(8)PBDEs in floor dust varied over a wide range, from 453 to 45,700 ng/g, for all rooms. Based on congener patterns, two groups were created--CL-1 that is dominated by high-brominated congeners and CL-2 primarily comprising low-brominated congeners--for both air and floor dust of classrooms. Surface dust had low concentrations, ranged from ND to 181, from ND to 128, and from ND to 256 pg/cm(2) for desk/chair sets, lockers, and playing tools, respectively. Pearson correlation coefficients were calculated individually for air, floor dust, and surface dust. The results indicate that both surface dust and floor dust may act as a secondary source of PBDEs in indoor environments after emission from facilities.

PRACTICAL IMPLICATIONS

Children have been estimated to have a higher potential exposure to PBDEs than adults. Since children spend most of their day time at school, PBDE distributions in school environments should be a matter of great concern.

Significance of mutation in the D-loop region in cervical cancer

AIM

To investigate the mutation in the D-loop region of mitochondrial DNA in cervical cancer and its influence on the changes of reactive oxygen species (ROS) and cell cycle.

METHODS

The D-loop region was amplified by PCR and sequenced. Reactive oxygen species and cell cycle were detected by flow cytometry in 40 specimens from cervical cancer and adjacent normal tissues. According to the sequence results, gastric cancer tissue was divided into mutation group and control group. Reactive oxygen species, apoptosis and proliferation in the two groups were compared.

RESULTS

Among the 40 cervical cancer specimens, 21 mutations were identified in 12 patients, the mutation rate being 30%. There were four microsatellite instabilities in the mutations. No mutation was found in the adjacent tissues. Reactive oxygen species, apoptosis and proliferation in the mutation group were all significantly higher than those in the control group.

CONCLUSION

Mutation in the D-loop region plays a role in the genesis and development of cervical cancer.