A comparison of serum leptin concentrations in obese and normal weight Japanese women with regular menstrual cycle

Leptin is a protein that is synthesized and secreted from adipose tissue. We examined the changes in serum leptin level during the menstrual cycle in 5 normal and 5 obese Japanese women, and compared the data with those of serum estradiol (E2) and progesterone (P4) concentrations. Serum leptin levels were highly correlated with body mass index (BMI) and percent body fat, being higher in the obese group than in the normal group. In the obese group, serum leptin level increased in the luteal phase in parallel with the rise in the serum E2 level. In the normal group, however, there was no significant change in serum level during the menstrual cycle. These results suggested that the serum leptin levels were influenced by the phase of menstrual cycle, probably through the action of E2, in different ways for obese and non-obese women.

Job stress, social support at work, and insomnia in Japanese shift workers

A cross-sectional study was conducted to clarify the contribution of psychological job stress to insomnia in shift workers. A self-administered questionnaire concerning job stress, sleep, depressive symptoms and lifestyle factors was submitted to a sample of 530 rotating shift workers of age 18-59 years (mean age 27) in an electric equipment manufacturing company. Perceived job stress, i.e., job demands, job control and social support at work, was assessed using the Japanese version of the Job Content Questionnaire. Insomnia was regarded as prevalent if the workers had at least one of the following symptoms in the last year; less than 30 minutes to fall asleep, difficulty in maintaining sleep, or early morning awakening almost everyday. Overall prevalence was 37.8%. Logistic regression analyses while adjusting relevant factors showed that lower social support at work was significantly associated with a greater risk of insomnia than the higher social support (adjusted OR 2.5). Higher job strain with lower social support at work increased the risk, compared to lower strain with higher support at work (crude OR 1.8; adjusted OR 1.5). Our findings suggest the low social support at work independently associated with insomnia in shift workers.

Predictive risk factors for delayed extubation in patients undergoing coronary artery bypass grafting

Prolonged mechanical ventilation increases hospitalization costs, airway and lung trauma, and stress. The objective of this study was to elucidate patient characteristics and operative variables that predict delayed extubation in patients undergoing coronary artery bypass grafting (CABG). The records of 167 patients who underwent CABG between 1994 and 1998 were examined retrospectively. The patients were divided into early and delayed extubation groups. Putative factors affecting the duration of intubation were included in a univariate analysis using the t-test and chi-squared test. A logistic regression model was then developed to determine the factors associated with delayed extubation. Forty-four percent of the patients needed prolonged mechanical ventilation (more than 24h). Univariate predictors of delayed extubation (P < 0.05) were emergency surgery, preoperative use of an intra-aortic balloon pump (IABP), the duration of anesthesia, surgery, cardiopulmonary bypass and aortic cross-clamping, the total volume of fentanyl. lowest rectal temperature, glucose level, perioperative transfusion, bleeding, perioperative heart failure, perioperative insertion of IABP, postoperative transfusion, cardiac index, inspired oxygen fraction (FiO2), arterial oxygen tension (PaO2), the PaO2/FiO2 ratio, and the volume of catecholamine. In the delayed extubation group, the intensive care unit stay was significantly longer (P < 0.001) and re-exploration was required more frequently (P = 0.004). Excellent prediction was provided by a model consisting of six variables: age, duration of surgery, perioperative heart failure, glucose level, postoperative transfusion, and the PaO2/FiO2 ratio. These results suggest that decreasing the cardiopulmonary bypass time, maintaining a low glucose level during cardiopulmonary bypass, and ensuring adequate perioperative hemostasis may help to avoid pulmonary dysfunction and delayed extubation. Moreover, the PaO2/FiO2 ratio may be a useful predictor of delayed extubation in patients undergoing CABG.

Multiple pulmonary emboli with pulmonary hypertension caused by effort thrombosis and effective balloon venoplasty of the subclavian vein

A 36-year-old woman with effort thrombosis of the subclavian vein associated with multiple pulmonary emboli was successfully treated with local thrombolysis of the subclavian vein using a pulse-spray catheter and systemic anticoagulation. Balloon venoplasty of the residual stenosis of subclavian vein was carried out and in follow-up venography 6 months later, there was no restenosis, and the patient has been asymptomatic for 12 months. Pulmonary embolism is not a rare complication of upper extremity deep vein thrombosis and should be managed as aggressively as lower extremity deep vein thrombosis.

Decreases of natural killer cells and T-lymphocyte subpopulations and increases of B lymphocytes following a 5-day occupational exposure to mixed organic solvents

The authors examined the effects of organic solvents on lymphocyte subpopulations in blood. Natural killer and T-lymphocyte subpopulations and B (CD19+) -lymphocytes were measured with flow cytometry in 16 male rotogravure printers on a Friday and on the following Monday. Numbers of all 3 subpopulations of natural killer cells (i.e., CD57+ CD16+, CD57- CD16+, and CD57+ CD16- cells), 2 subpopulations of T lymphocytes (CD4+ CD45RA+ and total CD8+ cells), and total lymphocytes on Friday were significantly fewer than those found on the following Monday. Conversely, the number of B lymphocytes on Friday was significantly larger than the number on Monday. The number of B lymphocytes was significantly correlated with blood toluene levels on Friday. The alteration in the number of CD57+ CD16+ NK cells from Friday to the following Monday was correlated inversely with the corresponding change in exposure level of toluene on Friday. The authors suggest that the effects of mixed organic solvents (primarily toluene) are recoverable decreases of natural killer cells and T lymphocytes and increases in B lymphocytes.

Congenitally corrected transposition of the great arteries in a 65-year-old woman

A 65-year-old Japanese woman was admitted to hospital because of exertional dyspnea. Transthoracic echocardiography showed diffuse hypokinesis of the left-sided ventricular wall, but was not clear enough to provide useful information because of the rotation of the cardiac apex and the presence of lung tissue. Systemic ventriculography showed that the left-sided ventricle with heavy trabeculations was morphologically similar to a normal right ventricle. Magnetic resonance imaging (MRI) clearly revealed corrected transposition of the great arteries. Because this patient had no severe associated cardiac anomalies, systemic ventricular dysfunction is thought to be the major cause of exertional dyspnea. MRI is a useful non-invasive method for the rapid evaluation of cardiac morphology.

G2/M-phase-specific transcription during the plant cell cycle is mediated by c-Myb-like transcription factors

Plant B-type cyclin genes are expressed specifically in late G2- and M-phases during the cell cycle. Their promoters contain a common cis-acting element, called the MSA (M-specific activator) element, that is necessary and sufficient for periodic promoter activation. This motif also is present in the tobacco kinesin-like protein gene NACK1, which is expressed with timing similar to that of B-type cyclin genes. In this study, we show that G2/M-phase-specific activation of the NACK1 promoter also is regulated by the MSA element, suggesting that a defined set of G2/M-phase-specific genes are coregulated by an MSA-mediated mechanism. In a search for MSA binding factors by yeast one-hybrid screening, we identified three different Myb-like proteins that interact specifically with the MSA sequence. Unlike the majority of plant Myb-like proteins, these Myb proteins, NtmybA1, NtmybA2, and NtmybB, have three imperfect repeats in the DNA binding domain, as in animal c-Myb proteins. During the cell cycle, the level of NtmybB mRNA did not change significantly, whereas the levels of NtmybA1 and A2 mRNAs fluctuated and peaked at M-phase, when B-type cyclin genes were maximally induced. In transient expression assays, NtmybA1 and A2 activated the MSA-containing promoters, whereas NtmybB repressed them. Furthermore, expression of NtmybB repressed the transcriptional activation mediated by NtmybA2. Our data show that a group of plant Myb proteins that are structurally similar to animal c-Myb proteins have unexpected roles in G2/M-phase by modulating the expression of B-type cyclin genes and may regulate a suite of coexpressed genes.

G2/M-phase-specific transcription during the plant cell cycle is mediated by c-Myb-like transcription factors

Plant B-type cyclin genes are expressed specifically in late G2- and M-phases during the cell cycle. Their promoters contain a common cis-acting element, called the MSA (M-specific activator) element, that is necessary and sufficient for periodic promoter activation. This motif also is present in the tobacco kinesin-like protein gene NACK1, which is expressed with timing similar to that of B-type cyclin genes. In this study, we show that G2/M-phase-specific activation of the NACK1 promoter also is regulated by the MSA element, suggesting that a defined set of G2/M-phase-specific genes are coregulated by an MSA-mediated mechanism. In a search for MSA binding factors by yeast one-hybrid screening, we identified three different Myb-like proteins that interact specifically with the MSA sequence. Unlike the majority of plant Myb-like proteins, these Myb proteins, NtmybA1, NtmybA2, and NtmybB, have three imperfect repeats in the DNA binding domain, as in animal c-Myb proteins. During the cell cycle, the level of NtmybB mRNA did not change significantly, whereas the levels of NtmybA1 and A2 mRNAs fluctuated and peaked at M-phase, when B-type cyclin genes were maximally induced. In transient expression assays, NtmybA1 and A2 activated the MSA-containing promoters, whereas NtmybB repressed them. Furthermore, expression of NtmybB repressed the transcriptional activation mediated by NtmybA2. Our data show that a group of plant Myb proteins that are structurally similar to animal c-Myb proteins have unexpected roles in G2/M-phase by modulating the expression of B-type cyclin genes and may regulate a suite of coexpressed genes.

Allylindation of cyclopropenes in organic and aqueous media: switching the regio- and stereoselectivity based on the chelation with a hydroxyl group and the crystal structure of the cyclopropylindium product

Hydroxy-bearing cyclopropenes react with allylindium reagents to undergo clean allylindation both in organic and aqueous media, in which the chelation of the hydroxyl group to indium plays the central role. The regio- and stereoselectivity have been regulated both by the location of the hydroxyl group in the molecules and the reaction solvents. In particular, the allylindation in water shows marked differences from that in organic solvents; the regio- and stereoselectivity have totally been reversed compared with those in organic solvents. Unusually stable cyclopropyl-indium compounds have been isolated from the reaction of 1-(omega-hydroxyalkyl)cyclopropenes and the structure has fully been established by X-ray crystallography.

Effect of high-rate algal ponds on viability of Cryptosporidium parvum oocysts

The physicochemical conditions of high-rate algal ponds were responsible for a more than 97% reduction in the infectivity of Cryptosporidium parvum oocysts in neonatal mice. The use of semipermeable bags of cellulose showed that pH, ammonia, and/or light seems to be a major factor for the inactivation of oocysts in wastewater, supporting the importance of alga-based systems for safer reuse of treated wastewater.

Assisted reproductive technologies in conjunction with conservatively treated endometrial adenocarcinoma. A case report

This case report illustrates the successful use of assisted reproductive technologies (ARTs) in a patient receiving conservative treatment for endometrial adenocarcinoma. A 31-year-old infertile woman, diagnosed as FIGO stage Ia endometrial adenocarcinoma (grade 1), received oral medroxyprogesterone acetate 400 mg/day for 12 weeks. Endometrial curettage was performed and the absence of endometrial carcinoma was confirmed. A single pregnancy was achieved with in vitro fertilization and embryo transfer. A healthy female infant was born via cesarean section at 42 weeks' gestation. The carcinoma has not recurred, and the patient now desires a second child. We conclude that ART combined with progesterone treatment might be a powerful option for the treatment of infertile patients with early stage, well-differentiated endometrial adenocarcinoma.

Bayesian value-of-information analysis. An application to a policy model of Alzheimer's disease

A framework is presented that distinguishes the conceptually separate decisions of which treatment strategy is optimal from the question of whether more information is required to inform this choice in the future. The authors argue that the choice of treatment strategy should be based on expected utility, and the only valid reason to characterize the uncertainty surrounding outcomes of interest is to establish the value of acquiring additional information. A Bayesian decision theoretic approach is demonstrated through a probabilistic analysis of a published policy model of Alzheimer's disease. The expected value of perfect information is estimated for the decision to adopt a new pharmaceutical for the population of patients with Alzheimer's disease in the United States. This provides an upper bound on the value of additional research. The value of information is also estimated for each of the model inputs. This analysis can focus future research by identifying those parameters where more precise estimates would be most valuable and indicating whether an experimental design would be required. We also discuss how this type of analysis can also be used to design experimental research efficiently (identifying optimal sample size and optimal sample allocation) based on the marginal cost and marginal benefit of sample information. Value-of-information analysis can provide a measure of the expected payoff from proposed research, which can be used to set priorities in research and development. It can also inform an efficient regulatory framework for new healthcare technologies: an analysis of the value of information would define when a claim for a new technology should be deemed substantiated and when evidence should be considered competent and reliable when it is not cost-effective to gather any more information.

Comparative analyses of the pigment-aggregating and -dispersing actions of MCH on fish chromatophores

In melanophores of the peppered catfish and the Nile tilapia, melanin-concentrating hormone (MCH) at low doses (<1 microM) induced pigment aggregation, and the aggregated state was maintained in the presence of MCH. However, at higher MCH concentrations (such as 1 and 10 microM), pigment aggregation was immediately followed by some re-dispersion, even in the continued presence of MCH, which led to an apparent decrease in aggregation. This pigment-dispersing activity at higher concentrations of MCH required extracellular Ca(2+) ions. By contrast, medaka melanophores responded to MCH only by pigment aggregation, even at the highest concentration employed (10 microM). Since it is known that medaka melanophores possess specific receptors for alpha-melanophore-stimulating hormone (alpha-MSH), the possibility that interaction between MSH receptors and MCH at high doses in the presence of Ca(2+) might cause pigment dispersion is ruled out. Cyclic MCH analogs, MCH (1-14) and MCH (5-17), failed to induce pigment dispersion, whereas they induced aggregation of melanin granules. These results suggest that another type of MCH receptor that mediates pigment dispersion is present in catfish and tilapia melanophores, and that intact MCH may be the only molecule that can bind to these receptors. Determinations of cAMP content in melanophores, which were isolated from the skin of three fish species and treated with 10 nM or 10 microM MCH, indicate that MCH receptors mediating aggregation may be coupled with Gi protein, whereas MCH receptors that mediate dispersion may be linked to Gs. The response of erythrophores, xanthophores and leucophores to MCH at various concentrations was also examined, and the results suggest that the distribution patterns of the two types of MCH receptors may differ among fish species and among types of chromatophore in the same fish.

Purification, cDNA cloning and characterization of the vascular apoptosis-inducing protein, HV1, from Trimeresurus flavoviridis

Hemorrhagic snake venom induces apoptosis in vascular endothelial cells (VEC). In previous reports, we described the purification and cDNA cloning from Crotalus atrox of a vascular apoptosis-inducing protein (VAP1) that specifically induces apoptosis in vascular endothelial cells. We report here the purification and cDNA cloning of another vascular apoptosis-inducing protein, HV1, from crude venom of Trimeresurus flavoviridis. The protein, namely HV1, was purified as an inducer of apoptosis in cultured vascular endothelial cells. HV1 was a homodimeric protein with a molecular mass of 110 kDa. HV1 cDNA encoded a protein with 612 amino-acid residues. The amino-acid sequence predicted from the cDNA was highly homologous to VAP1. The amino-acid sequence of HV1 indicated that HV1 belongs to the metalloprotease/disintegrin family, and that it is a multidomain polypeptide with a proprotein domain, a metalloprotease domain, a disintegrin-like domain and a cysteine-rich domain. In the disintegrin-like domain, the sequence DECD, replaces the RGD sequence that has frequently been found in such domains. This replacement also occurs in VAP1. Our results indicate HV1 as the first identified homolog of VAP1.

Oxidative stress and disturbed glutamate transport in hereditary nucleotide repair disorders

Xeroderma pigmentosum group A (XPA) and Cockayne syndrome (CS) are hereditary DNA repair disorders complicated by progressive neurodegeneration. Here we immunohistochemically examine the in situ expression of materials that are produced by oxidative stress and glutamate transporters (which can contribute to prevention of glutamate neurotoxicity) in the brains of 5 autopsied patients each of XPA, CS, and control groups. All oxidative products, including nitrotyrosine, advanced glycation end product, and 4-hydroxy-2-nonenal-modified protein (HNE) were deposited in large amounts in the globus pallidus of CS patients compared to XPA patients. They were frequently recognized in the pseudocalcified foci and free minerals in the neuropil, and more rarely in foamy spheroids. In addition, the deposition of HNE was observed also in hippocampal and cerebellar dentate neurons of both CS and XPA patients. The expression of glial glutamate transporters, EAAT1 and GLT-1, was affected in the globus pallidus in 5 CS patients and 3 XPA patients. They were also altered in the cerebellar cortex in most of the CS patients. These data suggest that oxidative stress and disturbed glutamate transport may be involved in pallidal and/or cerebellar degeneration in hereditary nucleotide repair disorders.

Enhanced phagocytic activity of neutrophils caused by administration of egg white derivatives (EWD) in cats injected with cyclophosphamide (CPA)

To examine in vivo effects of egg white derivatives (EWD), the numbers of peripheral blood cells and neutrophil phagocytosis were evaluated in cats injected intramuscularly with cyclophosphamide (CPA). There were no changes in the number of red blood cells (RBC) or packed cell volume (PCV) values regardless of oral administration of EWD or injection of CPA, but the numbers of platelets, white blood cells (WBC) and neutrophils in cats administered EWD significantly increased (p<0.05 to 0.01) when compared with those in control cats which received saline solution. In addition, the administration of EWD resulted in a significant enhancement in the phagocytic activity of neutrophils (p<0.01) when compared to control cats, suggesting that EWD has a stimulating effect on leukocyte progenitors. The numbers of platelets, WBC and neutrophils, and the phagocytic activity of neutrophils in cats injected with CPA alone were significantly lower (p<0.05 to 0.01) than those in control cats. However, co-administration of EWD to cats injected with CPA resulted in a significant increase in the numbers of platelets, WBC and neutrophils (p<0.05 to 0.01), and in the phagocytic response of neutrophils (p<0.01) when compared to cats injected with CPA alone. Therefore, these results suggest that co-administration of EWD may be effective in reducing some possible side effects in animals treated with immunosuppressive or antitumor agents.

Efficient production of menaquinone (vitamin K2) by a menadione-resistant mutant of Bacillus subtilis

Efficient production of menaquinone (MK) by Bacillus subtilis was achieved. An edible strain of B. subtilis, isolated from the traditional Japanese food natto, was mutated to improve MK productivity. A menadione-resistant mutant producing 30% more MK than its parent strain was obtained. Soybean extract and glycerol were the best nitrogen and carbon sources, respectively, among the sources tested. Addition of yeast extract also increased MK productivity. The maximum concentration of MK reached about 35.0 mg/l after 4 days of culture in a jar fermenter. The pH of the medium decreased to 5.5 after the start of cultivation, then spontaneously increased to 7.7-8.0. This pH change might be important in the production of MK because only small amounts of MK were obtained when pH was controlled at 5.7, 6.0, 7.0, 7.5 or 8.0.

Predictive risk factors for pulmonary oxygen transfer in patients undergoing coronary artery bypass grafting

The ratio of arterial oxygen tension to inspired oxygen fraction (PaO2/FiO2) is a useful indicator for weaning patients from mechanical ventilation and a reliable predictor of pulmonary dysfunction after cardiac surgery. The aim of this study was to elucidate the patient characteristics and variables that affect the PaO2/FiO2 ratio. Between 1994-1998, 167 patients who underwent coronary artery bypass grafting (CABG) were examined retrospectively. Spearman's correlation coefficients were calculated between the PaO2/FiO2 ratio and intubation period, and length of ICU stay. Patients were then divided into two groups with a PaO2/FiO2 ratio < 350 and PaO2/FiO2 ratio > or = 350. Univariate analysis of the putative risk factors was performed. A logistic regression model was developed to evaluate factors that would influence the PaO2/FiO2 ratio. A significant correlation was observed between the PaO2/FiO2 ratio and intubation period, and length of ICU stay. Univariate predictors of a PaO2/FiO2 ratio < 350 were low body weight, low preoperative PaO2 long operation time, high FiO2, low postoperative PaO2 history of smoking, hypertension and opening of pleura (p < 0.05). Excellent prediction was found with a model consisting of preoperative PaO2 and hypertension.

CONCLUSION

The results of this study suggest that patients with a low preoperative PaO2 or hypertension may need more careful peri- and postoperative management since these factors are closely associated with the PaO2/FiO2 ratio.

Neurodegenerative features in developmental brain disorders

The authors examined the occurrence of neurofibrillary tangles (NFT), senile plaques, spheroids in Goll's nucleus, grumose or foamy spheroid bodies (GFSB) in the basal ganglia, and hyaline inclusions in the brainstem nuclei in 62 patients under 40 years of age with non-progressive developmental brain disorders. Five cases had demonstrated NFT, which tended to be confined to the subcortical nuclei, whereas no senile plaques were identified in any case. Spheroids in Goll's nucleus were significantly increased in three cases of congenital brain anomalies and five cases of perinatal hypoxic ischemic encephalopathy. The GFSB-positive subjects were clinicopathologically divided into two subgroups consisting of four cases of congenital malformations, which were also associated with severe respiratory failure, and six cases of perinatal brain disorders in which the basal ganglia were severely affected. Eosinophilic intracytoplasmic inclusions, unlike the hyaline inclusions of the Lewy type, were found in the substantia nigra and/or locus ceruleus in two subjects. It is speculated that a variety of mechanisms, including accelerated aging and anoxic insults, may be involved in the increased occurrence of NFT and/or spheroids in non-progressive developmental disorders. A detailed investigation is useful to clarify the neuronal changes secondary to the brain damages early in development.

Arachidonic acid-induced Ca2+ sensitization of smooth muscle contraction through activation of Rho-kinase

Arachidonic acid activates isolated Rho-kinase and contracts permeabilized smooth muscle fibres. Various assays were carried out to examine the mechanism of this activation. Native Rho-kinase was activated 5-6 times by arachidonic acid but an N-terminal, constitutively-active fragment of Rho-kinase, expressed as a glutathione-S-transferase (GST) fusion protein and including the catalytic subunit (GST-Rho-kinase-CAT), was not. GST-Rho-kinase-CAT was inhibited by a C-terminal fragment of Rho-kinase and arachidonic acid removed this inhibition. These results suggest that the C-terminal part of Rho-kinase, containing the RhoA binding site and the pleckstrin homology domain, acts as an autoinhibitor. It is suggested further that activation by arachidonic acid is due to its binding to the autoinhibitory region and subsequent release from the catalytic site. Arachidonic acid, at concentrations greater than 30 microM, increases force in alpha-toxin-permeabilized femoral artery but not in Triton X-100-skinned fibres. The content of Rho-kinase in the latter was lower than in alpha-toxin-treated or intact fibres. The arachidonic acid-induced contraction was not observed at a pCa above 8.0 and was inhibited by Y-27632 and wortmannin, inhibitors of Rho-kinase and myosin light-chain kinase (MLCK), respectively. The activation of Rho-kinase and subsequent phosphorylation of the myosin phosphatase target subunit inhibits myosin phosphatase and increases myosin phosphorylation.