Expression of vascular endothelial growth factor and angiogenesis in patellar tendon grafts in the early phase after anterior cruciate ligament reconstruction

The aim of this study was to clarify vascular endothelial growth factor (VEGF) expression and angiogenesis in the patellar tendon (PT) autograft in the early phase after anterior cruciate ligament (ACL) reconstruction using a rabbit model. The right knees of 30 Japanese white rabbits underwent ACL reconstruction using the medial third of the PT complex. We evaluated the grafted tendon at 1, 2, 3, 4, and 8 weeks after ACL reconstruction by immunohistology for proliferating cell nuclear antigen, VEGF, and CD31, which is a marker for vascular endothelial cells. At week 1 , few cells were observed at the midsubstance of the grafted tendon. A number of proliferating cells were observed at the surface area of the PT graft 2 weeks after graft transplantation, while no vessel formation was observed in the graft at the same time. VEGF was highly expressed 2-3 weeks postoperatively. Vessel formation in the PT graft increased with time from 3 to 8 weeks after ACL reconstruction. The rates of proliferating cells and VEGF-expressing cells decreased with time from 3 to 8 weeks. This study has suggested that VEGF is involved in the graft remodeling process particularly at the early phase after ACL reconstruction.

Improvement of Functional Properties of Whey Protein Isolate Through Glycation and Phosphorylation by Dry Heating

Whey protein isolate (WPI) was glycated with maltopentaose (MP) through the Maillard reaction, and the MP-conjugated WPI (MP-WPI) was then phosphorylated by dry heating in the presence of pyrophosphate. Glycation occurred efficiently, and the sugar content of WPI increased approximately 19.9% through the Maillard reaction. The phosphorylation of MP-WPI was enhanced with an increase in the dry-heating time from 1 to 5 d, and the phosphorus content of WPI increased approximately 1.05% by dry heating at pH 4.0 and 85 degrees C for 5 d in the presence of pyrophosphate. The electrophoretic mobility of WPI increased with an increase in the phosphorylation level. The stability of WPI against heat-induced insolubility at pH 7.0 was improved by conjugation with MP alone, and further improved by phosphorylation. Although the emulsifying activity of WPI was barely affected by glycation and phosphorylation, the emulsifying stability of phosphorylated MP-WPI (5 d), was 2.2 times higher than that of MP-WPI. Gelling properties such as hardness, resiliency, and water-holding capacity of heat-induced WPI gel were markedly improved, and the gel was rendered transparent by phosphorylation. The calcium phosphate-solubilizing ability of WPI was enhanced by phosphorylation. These results suggested that phosphorylation by dry heating in the presence of pyrophosphate after conjugation with MP is a useful method for improving the functional properties of WPI.

Dynamics of neural crest-derived cell migration in the embryonic mouse gut

Neural crest-derived cells that form the enteric nervous system undergo an extensive migration from the caudal hindbrain to colonize the entire gastrointestinal tract. Mice in which the expression of GFP is under the control of the Ret promoter were used to visualize neural crest-derived cell migration in the embryonic mouse gut in organ culture. Time-lapse imaging revealed that GFP(+) crest-derived cells formed chains that displayed complicated patterns of migration, with sudden and frequent changes in migratory speed and trajectories. Some of the leading cells and their processes formed a scaffold along which later cells migrated. To examine the effect of population size on migratory behavior, a small number of the most caudal GFP(+) cells were isolated from the remainder of the population. The isolated cells migrated slower than cells in large control populations, suggesting that migratory behavior is influenced by cell number and cell-cell contact. Previous studies have shown that neurons differentiate among the migrating cell population, but it is unclear whether they migrate. The phenotype of migrating cells was examined. Migrating cells expressed the neural crest cell marker, Sox10, but not neuronal markers, indicating that the majority of migratory cells observed did not have a neuronal phenotype.

Development of software for internal dose calculation from bioassay measurements

Recently developed biokinetic models of ICRP permit increasingly realistic descriptions of the behaviour of radionuclides in the human body. This, however, has made the interpretation of bioassay data extremely difficult. Thus computer programs for implementing these models are in need, but very few are available. The present work describes personal-computer-based software, MONDAL2 (monitoring to dose calculation ver. 2), that enables users to estimate intake activity and the resulting effective doses from bioassay measurements for both workers and members of the public. This software runs on Microsoft Windows 95, 98, Millennium edition, 2000 or XP. If the system is to be fully copied to a hard disk, hard disk space of 23 MB is required. This software is distributed by the National Institute of Radiological Sciences free of charge.

Runx2 expression and action in chondrocytes are regulated by retinoid signaling and parathyroid hormone-related peptide (PTHrP)

OBJECTIVE

Runx2 (also known as Cbfa1) is a transcription factor required for chondrocyte maturation and osteoblast differentiation. While there is information on the regulation of its expression during osteogenesis, much less is known about it during cartilage maturation. Here we asked whether Runx2 expression and function are affected by retinoic acid (RA) and parathyroid hormone-related peptide (PTHrP), which represent an important stimulator and inhibitor of chondrocyte maturation, respectively.

DESIGN

We first cloned and characterized Runx2 expressed by chick chondrocytes (cRunx2). We then constructed expression vectors of cRunx2 and a dominant-negative form (DN-cRunx2) and determined their effects on chondrocyte maturation in culture before and during retinoid and PTHrP treatment.

RESULTS

cRunx2 showed similar transactivation activity to that of its mammalian counterparts although it has a very short QA domain and lacks a small portion of the PST domain. cRunx2 over-expression stimulated chondrocyte maturation, as indicated by increases in alkaline phosphatase activity (APase), mineralization, and type X collagen and MMP-13 expression, and by maintenance of Indian hedgehog (Ihh) expression. RA treatment stimulated cRunx2 gene expression and boosted its pro-maturation effects. PTHrP treatment blocked Runx2 expression and its pro-maturation effects. Over-expression of DN-cRunx2 inhibited maturation and even prevented RA from exerting its pro-maturation role.

CONCLUSIONS

As previously indicated by mammalian studies, cRunx2 has chondrocyte pro-maturation activity. Its expression and roles are favorably modulated by retinoid signaling but are completely inhibited by PTHrP. A model integrating cRunx2 with PTHrP, Ihh and retinoid signaling and operating during skeletogenesis is proposed.

Database of calculated values of retention and excretion for members of the public following acute intake of radionuclides

Intakes of radionuclides can be estimated from measurements of radioactivity in the whole body or in specific organs or in excreta by comparing them with predicted retention or excretion data calculated using standard biokinetic models. For occupational exposure monitoring, data are presented by ICRP for 29 radionuclides in Publication 78 (1997) and by the authors for 42 radionuclides as electronic look-up tables in Microsoft Excel. In the present work, values of retention and excretion were computed for selected radionuclides inhaled or ingested by members of the public. Graphs were constructed from the computed results showing the predicted monitoring data as functions of time following acute intakes of radionuclides. A graphical database was assembled on the Web site http//www.nirs.go.jp/RPD/ to provide a tool for the interpretation of bioassay measurements.

The usefulness of prevention consolidation therapy of esophageal varices using an argon plasma coagulation technique

BACKGROUND AND STUDY AIM: esophageal variceal ligation (EVL) has been spread widely as a simple and effective method for treating esophageal varices. However, in view of the unacceptably high rate of recurrence associated with this technique, the availability of other supplemental consolidation therapies has been earnestly desired. Under these circumstances, attempts such as endoscopic injection sclerotherapy (EIS) have been made for this particular therapeutic purpose. In the current study, we tested the clinical usefulness and safety of the argon plasma coagulation technique (APC). PATIENTS AND METHODS: 11 patients with imminent signs of esophageal varix rupture in our hospital were subjects in the present study. Before APC was performed, these patients underwent EVL with consequent improvement of esophageal varices from F3 (largest sized varices) to disappear or F1 (straight). RESULTS: the patients were followed up for a mean post-treatment period of 637.4 (SD +/-56.5) days, and no obvious recurrence of varices in the so-called critical area was noted. In addition, no serious complications were observed. CONCLUSION: our current clinical study has demonstrated that APC may be an effective prevention consolidation therapy after EVL without serious complications.

Clinical study of vestibular-evoked myogenic potentials and auditory brainstem responses in patients with brainstem lesions

A total of 13 patients, who were diagnosed with localized brainstem lesions using MRI, were investigated. The diagnoses were multiple sclerosis in five patients, brainstem hemorrhage in three patients, pontomedullary infarction in one patient and Wallenberg's syndrome in four patients. In addition, 42 ears of 21 normal adult volunteers were also examined. In a patient with upper brainstem lesions mainly affecting the midbrain, the auditory brainstem response (ABR) was abnormal but the vestibular-evoked myogenic potential (VEMP) was normal. In four patients with middle brainstem lesions which mainly affected the pons, both ABR and VEMP were abnormal. In five patients with lower brainstem lesions which mainly affected the medulla, the ABR was normal but the VEMP was abnormal. In those patients with middle-to-lower brainstem lesions, a disappearance of VEMP reactions, delay of the positive-negative (PN) wave, increase in PN interpeak latency and decrease in PN amplitude on the affected side were confirmed. In conclusion, the VEMP test comprises a useful new diagnostic method for identifying lower brainstem lesions.

Participation of Cbfa1 in regulation of chondrocyte maturation

OBJECTIVE

Cbfa1 is a transcription factor, which is classified into the runt family. The mice lacking this gene display complete loss of bone formation, indicating that Cbfa1 is an essential factor for osteoblast differentiation. The Cbfa1-deficient mice also show an abnormality in cartilage development. Although cartilage anlagens are well formed in these mice, endochondral ossification is blocked, and most of chondrocytes fail to differentiate into their maturation form as characterized by the absence of type X collagen and low levels of alkaline phosphatase activity. It is suggested that Cbfa1 may participate in chondrocyte differentiation. In this study, we have investigated the role of Cbfa1 in chondrocytes during their cytodifferentiation in vitro.

DESIGN

To investigate the role of Cbfa1 in regulation of chondrocyte differentiation, we over-expressed Cbfa1 or its dominant negative form in cultured chick chondrocytes using a retrovirus (RCAS)system and examined changes in chondrocyte behaviour induced by the introduced genes.

RESULTS

Mature chondrocytes isolated form the cephalic portion of sterna seemed to express Cbfa1 more prominently than immature chondrocytes isolated from the one-third caudal portion of sterna. Over-expression of Cbfa1 in immature chondrocytes strongly stimulated alkaline phosphatase activity and matrix calcification. In contrast, expression of a dominant negative form of Cbfa1, which lacks the C-terminal PST domain, severely inhibited alkaline phosphatase activity and matrix calcification in mature chondrocytes.

CONCLUSION

Taken together with the observation that Cbfa1 transcripts dominantly localized in hypertrophic chondrocytes as well as in osteoblasts, it is suggested that Cbfa1 plays an important role in the progression of chondrocyte maturation.

Induction of micronuclei in a rat alveolar epithelial cell line by alpha particle irradiation

Dose-response relationships for the induction of micronuclei were characterised in the rat alveolar epithelial cell line (SV40T2) exposed to either alpha particles(241Am: 3.2 MeV, 128 keV.micron-1, 0.093 Gy.min-1 at the cell-Mylar interface) or X rays (200 kVp, 1 Gy.min-1). The frequency of micronucleus formation was 1.6-3.0% for unirradiated subjects but increased for irradiated ones in a dose-dependent manner. A linear relationship between the dose and the micronucleus formation was observed until 1 Gy for alpha particles and 4 Gy for X rays. The linear slope for alpha particles was 28.5% per Gy and the relative biological effectiveness (RBE) was 4.3, as calculated from the slopes. The slope for alpha particles was dependent on the energy of the alpha particles. These results indicate that the micronucleus assay is available for biodosimetry of alpha particle irradiation in the rat alveolar epithelial cells, although consideration should be given to the range of the linearity and the LET of alpha particles.

Decreased sensory cortical excitability after 1 Hz rTMS over the ipsilateral primary motor cortex

OBJECTIVES

To study changes in the excitability of the sensory cortex by repetitive transcranial magnetic stimulation (rTMS) in humans.

METHODS

Somatosensory evoked potentials (SEPs) and antidromic sensory nerve action potentials (SNAPs) were elicited by right median nerve stimulation at the wrist before and after low frequency (1 Hz) rTMS over the left motor cortex, lateral premotor cortex, sensory cortex, and also after sham stimulation. The intensity of rTMS was fixed at 1.1 times the active motor threshold at the hand area of motor cortex.

RESULTS

N20 peak (N20p)-P25 and P25-N33 amplitudes were suppressed after rTMS over the motor cortex, whereas the N20 onset (N20o)-N20p and SNAP amplitudes were not affected. They recovered to the baseline about 100 min after the rTMS. rTMS over the premotor cortex or sensory cortex or sham stimulation had no suppressive effect on SEPs.

CONCLUSIONS

The reduction of N20p-P25 and P25-N33 components without any changes of N20o-N20p amplitude suggests that the suppression occurs in the sensory cortex. rTMS (1 Hz) of the motor cortex induces a long-lasting suppression of the ipsilateral sensory cortex even at an intensity as low as 1.1 times the active motor threshold, probably via cortico-cortical pathways between motor and sensory cortex.

RET signaling is essential for migration, axonal growth and axon guidance of developing sympathetic neurons

Sympathetic axons use blood vessels as an intermediate path to reach their final target tissues. The initial contact between differentiating sympathetic neurons and blood vessels occurs following the primary sympathetic chain formation, where precursors of sympathetic neurons migrate and project axons along or toward blood vessels. We demonstrate that, in Ret-deficient mice, neuronal precursors throughout the entire sympathetic nervous system fail to migrate and project axons properly. These primary deficits lead to mis-routing of sympathetic nerve trunks and accelerated cell death of sympathetic neurons later in development. Artemin is expressed in blood vessels during periods of early sympathetic differentiation, and can promote and attract axonal growth of the sympathetic ganglion in vitro. This analysis identifies RET and artemin as central regulators of early sympathetic innervation.

Residue aspartate-147 from the third transmembrane region of Na(+)/H(+) antiporter NhaB of Vibrio alginolyticus plays a role in its activity

NhaB is a bacterial Na(+)/H(+) antiporter with unique topology. The pH dependence of NhaB from Vibrio alginolyticus differs from that of the Escherichia coli NhaB homolog. Replacement of Asp-147 with Glu made high H(+) concentrations a requirement for the NhaB activity. Replacement of Asp-147 with neutral amino acids inactivated NhaB.

[Effect of combination chemotherapy with nedaplatin and 5-FU for head and neck squamous cell carcinoma]

Nedaplatin (254-S), which is a cisplatin (CDDP) analog, is an effective agent for head and neck squamous cell carcinoma (HNSCC). 254-S is expected to play an important role in neo-adjuvant chemotherapy (NAC) for HNSCC in place of CDDP. We have been using combination chemotherapy including CDDP, 5-FU, MTX and LV. The response rate and CR rate of this 4-drug combined chemotherapy are 87% and 33%. Thirty-six patients with HNSCC were treated with 5-FU, 800 mg/m2/day for 5 days and 254-S, 100 mg/m2 on day 4. Chemotherapy was discontinued in one patient because of allergic shock. Three patients showed a CR and 10 patients showed a PR. The response rate and CR rate of 254-S plus 5-FU chemotherapy were 37.1% and 8.6%. These were inferior to those with the 4-drug combined chemotherapy. Fourteen percent of patients showed grade 3 leukocytopenia, and 17% showed more than grade 3 thrombocytopenia. The effect of combination chemotherapy of 254-S and 5-FU was inferior to that of the previous chemotherapy including CDDP, 5-FU, MTX and LV. Further study or another combination therapy including 254-S will be essential for improving efficacy against HNSCC.

Hypoxic ventilatory depression in a patient with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes

We describe a case of a 21-year-old man with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) who presented with hypoxic ventilatory depression. He had chronic hypoventilation, which was not explained by weakness of respiratory muscles. His hypercapnic ventilatory response was not impaired. In contrast, hypoxic ventilatory depression was observed in the isocapnic progressive hypoxic response test. After exposure to hypoxic conditions, his respiratory frequency decreased and tidal volume was unchanged. The hypoxic ventilatory depression was partially blocked by pretreatment with aminophylline. In conclusion, we need to be careful with patients with MELAS who are hypoxaemic because a vicious circle of hypoxia and hypoventilation can occur.

Effect of levofloxacin on theophylline clearance during theophylline and clarithromycin combination therapy

OBJECTIVE

To report a case of decreased theophylline clearance by the addition of levofloxacin in a patient receiving theophylline and clarithromycin.

CASE SUMMARY

A 59-year-old Japanese man who was receiving theophylline for emphysema experienced stimulation, insomnia, and tachycardia due to theophylline toxicity after clarithromycin and levofloxacin were added to the regimen. The combination of these agents resulted in a decrease in theophylline clearance to approximately 60% of the initial value obtained while the patient was receiving theophylline alone. The adverse effects disappeared after the dosage was reduced and the theophylline serum concentration decreased; however, there was no change in theophylline clearance. After discontinuation of levofloxacin, the theophylline serum concentration decreased, and theophylline clearance returned to the initial level even though clarithromycin was continued.

DISCUSSION

Levofloxacin is believed not to influence the clearance of theophylline, although some new fluoroquinolones have been reported to do so. This case indicates that levofloxacin and clarithromycin inhibited theophylline metabolic pathways catalyzed by both CYP1A2 and CYP3A4 and resulted in the decrease in theophylline clearance. The clearance of theophylline, therefore, is not influenced by clarithromycin alone.

CONCLUSIONS

Careful monitoring is required when levofloxacin is prescribed for patients who are taking clarithromycin with theophylline.

Mantle cell lymphoma of the rectum at an early stage: a case report

We report a very rare early-stage case of mantle cell lymphoma, which arose from the rectum. A 60-year-old man presented with a small elastically hard polypoid lesion in the rectum. The lesion was 1.2 x 1.2 cm in size. As a preoperatively barium enema and endoscopy suggested a benign tumor of the rectum, he underwent local excision of a rectal polypoid mass transanally under spinal anesthesia. However, histological examination revealed a malignant lymphoma, because the lesion was histologically characterized by solid growths of small to medium-sized round cells. Furthermore, immunohistochemical tests revealed B-cell marker positivity and CD5 positivity, but cyclin D1 negativity. Since it was reported that lymphomas with a mantle cell lymphoma morphology and CD5 expression, but without cyclin D1 overexpression, exist in about 10% of mantle cell lymphoma cases, we diagnosed his disease as mantle cell lymphoma. To our knowledge, this is the first reported case of an early-stage mantle cell lymphoma, originating from the rectum.

[Osteoblast differentiation and a transcriptional factor, Cbfa1]

Cbfa1 is a member of runt-domain gene family. Cbfa1-deficient mice lack of bone formation and introduction of Cbfa1 into non-osteoblastic cells induced the expression of osteoblast specific genes. Cbfa1-deficient calvarial cells were composed of immature mesenchymal cells and can differentiated into adipocytes and chondrocytes. Based on these findings, Cbfa1 has been identified as a master regulatory gene of the osteoblast differentiation and it has been suggested that Cbfa1 plays an essential role in determining the lineage of multipotential mesenchymal precursor cells.

A single motor unit recording technique for studying the differential activation of corticospinal volleys by transcranial magnetic stimulation

The purpose of this method is to establish a single motor unit recording technique to study the differential activation of corticospinal volleys by various types of transcranial magnetic stimulation (TMS). TMS is performed with various coil orientations over the hand or leg motor areas and surface EMG, and single motor unit recordings are made either from the studied hand or leg muscle. Transcranial electrical stimulation (TES) is also performed over the motor cortex as well as at the foramen magnum level to determine the latency of D waves. The intensity of stimulation is set just above the motor threshold for each type of stimulation. This method makes it possible to activate some I volleys (especially I1 and I3 waves) preferentially, if not selectively, from the hand and leg motor areas. The obtained results accord well with recent epidural recording studies, which lends support to the validity of this method.

Interhemispheric facilitation of the hand motor area in humans

1. We investigated interhemispheric interactions between the human hand motor areas using transcranial cortical magnetic and electrical stimulation. 2. A magnetic test stimulus was applied over the motor cortex contralateral to the recorded muscle (test motor cortex), and an electrical or magnetic conditioning stimulus was applied over the ipsilateral hemisphere (conditioning motor cortex). We investigated the effects of the conditioning stimulus on responses to the test stimulus. 3. Two effects were elicited at different interstimulus intervals (ISIs): early facilitation (ISI = 4-5 ms) and late inhibition (ISI > or = 11 ms). 4. The early facilitation was evoked by a magnetic or anodal electrical conditioning stimulus over the motor point in the conditioning hemisphere, which suggests that the conditioning stimulus for early facilitation directly activates corticospinal neurones. 5. The ISIs for early facilitation taken together with the time required for activation of corticospinal neurones by I3-waves in the test hemisphere are compatible with the interhemispheric conduction time through the corpus callosum. Early facilitation was observed in responses to I3-waves, but not in responses to D-waves nor to I1-waves. Based on these results, we conclude that early facilitation is mediated through the corpus callosum. 6. If the magnetic conditioning stimulus induced posteriorly directed currents, or if an anodal electrical conditioning stimulus was applied over a point 2 cm anterior to the motor point, then we observed late inhibition with no early facilitation. 7. Late inhibition was evoked in responses to both I1- and I3-waves, but was not evoked in responses to D-waves. The stronger the conditioning stimulus was, the greater was the amount of inhibition. These results are compatible with surround inhibition at the motor cortex.