Long-term results of nail fusion plasty of the duplicated thumb

SUMMARY

We report the long-term results of nail fusion plasty in eight duplicated thumbs. These eight cases were hypoplastic, with nails less than 80% the size of that on the normal side. We operated on these duplicated thumbs using a technique that we developed. We evaluated postoperative nail shape in our series using both our and Tada's scoring systems. The average follow-up period was 12 years. Excellent results were obtained in six cases, with natural-looking nails and even curvature. One case showed acceptable results. Only one case had uneven curvature and a gap in the nail. To reconstruct a natural-looking nail, it is important to correctly design and suture together two nails under no tension. To obtain one nail with even curvature, bones are left floating so that the nail can grow with a natural transverse curve without interference. This technique yielded promising results on long-term follow-up.

Primary retroperitoneal mucinous cystadenocarcinoma associated with pregnancy

Primary retroperitoneal mucinous cystadenocarcinoma (PRMC) is an extremely rare tumor. Only 30 cases have been reported previously in the English literature, and little information is available concerning its treatment and prognosis. The patient was a 28-year-old woman, presenting with a right mid-abdominal tumor at 26 weeks of gestation. At 31 weeks of gestation, she underwent an exploratory laparotomy and was diagnosed with a PRMC. No disseminated tumor was observed, and an excision of only the tumor was performed. She had an uneventful vaginal delivery at 38 weeks of gestation and remains free of disease at 13 months after the operation. This report describes a case of PRMC associated with pregnancy. The optimal management of these retroperitoneal masses during pregnancy is discussed. Based on limited experience and the current literature, a PRMC with an intact capsule and no dissemination appears to have a good prognosis and can be treated by tumor excision alone in patients who wish to preserve fertility

Treatment selection for cerebral arteriovenous malformations: radiosurgery or microsurgery

The clinical results and patient characteristics of 318 cases of cerebral arteriovenous malformations (AVMs) were analyzed: 138 patients were treated by surgery including 98 cases of total removal and 17 cases of subtotal removal; 37 patients were treated conservatively; 139 patients were treated by gamma-knife and 6 patients were treated by linac-knife radiosurgery using stereotactic multi-converging arcs systems. Clinical data analysis was performed using the same protocol in both of the surgery and the radiosurgery groups. Operative mortality for total removal was one out of 98 cases (1%). There was one death by hemorrhage, one case of symptomatic rebleeding and two cases of asymptomatic bleeding in patients treated by radiosurgery. Thus, mortality was 1 out of 145 (0.7%). Patients with total resection of AVMs had the best clinical results in comparison with subtotal resection or with conservative treatment. Morbidity was the lowest in the patients treated by radiosurgery. However, the total obliteration rate was lower than the surgical cure rate. The decision for treatment should be based on an estimation of mortality, morbidity and cure rate for each treatment.

Susceptibility-weighted imaging findings of cortical laminar necrosis in pediatric patients

BACKGROUND AND PURPOSE

MR susceptibility-weighted imaging (SWI) is a highly sensitive technique for detection of hemorrhage, but its utility in the evaluation of children with laminar necrosis is not yet known. We assessed whether cortical laminar necrosis in pediatric patients contains hemorrhage on SWI.

MATERIALS AND METHODS

"Cortical laminar necrosis" was defined as a hyperintense cortical lesion on T1-weighted imaging in the subacute or chronic phase of brain damage in some foci involving the cerebral cortex and white matter such as hypoxic-ischemic incidents and encephalopathy. Medical records, CT, and MR images were retrospectively analyzed. Fifteen patients (7 boys, 8 girls; age range, 0-13 years) were included. The areas of signal-intensity loss on SWI that were considered to be hemorrhage were correlated with the laminar necrosis. CT was assessed to correlate with the presence of calcification at the location of the signal-intensity loss on SWI. To assess appearance or signal-intensity changes of hemorrhage in the laminar necrosis, follow-up SWI was performed.

RESULTS

The causes of laminar necrosis included infarction in 4 patients, ischemic changes from Moyamoya disease in 2, meningoencephalitis in 2, hypoxic-ischemic encephalopathy in 2, shaken baby syndrome in 1, encephalopathy from severe infection in 1, status epilepticus in 1, citrullinemia in 1, and brain injury with posterior reversible encephalopathy syndrome in 1. T1-weighted imaging showed focal laminar necrosis in 8, multifocal laminar necrosis in 2, and diffuse laminar necrosis in 5. SWI findings correlated with laminar necrosis included the following: no hemorrhage in 13 patients (80.0%), dotted hemorrhage in 2 (13.3%), and laminar hemorrhage in 1 (6.7%). Follow-up SWI performed in 6 patients showed no additional hemorrhage.

CONCLUSION

Most areas of cortical laminar necrosis in pediatric patients showed no hemorrhage on SWI.

A femtosecond laser pacemaker for heart muscle cells

The intracellular effects of focused near-infrared femtosecond laser irradiation are shown to cause contraction in cultured neonatal rat cardiomyocytes. By periodic exposure to femtosecond laser pulse-trains, periodic contraction cycles in cardiomyocytes could be triggered, depleted, and synchronized with the laser periodicity. This was observed in isolated cells, and in small groups of cardiomyocytes with the laser acting as pacemaker for the entire group. A window for this effect was found to occur between 15 and 30 mW average power for an 80 fs, 82 MHz pulse train of 780 nm, using 8 ms exposures applied periodically at 1 to 2 Hz. At power levels below this power window, laser-induced cardiomyocyte contraction was not observed, while above this power window, cells typically responded by a high calcium elevation and contracted without subsequent relaxation. This laser-cell interaction allows the laser irradiation to act as a pacemaker, and can be used to trigger contraction in dormant cells as well as synchronize or destabilize contraction in spontaneously contracting cardiomyocytes. By increasing laser power above the window available for laser-cell synchronization, we also demonstrate the use of cardiomyocytes as optically-triggered actuators. To our knowledge, this is the first demonstration of remote optical control of cardiomyocytes without requiring exogenous photosensitive compounds.

Pharmacokinetics and metabolism of KW-4490, a selective phosphodiesterase 4 inhibitor: difference in excretion of KW-4490 and acylglucuronide metabolites between rats and cynomolgus monkeys

1. The pharmacokinetics and metabolism of KW-4490, a selective phosphodiesterase 4 inhibitor, were investigated in rats and monkeys. After oral administration, KW-4490 was rapidly absorbed, and then its plasma concentrations apparently declined with half-lives of approximately 5 h in rats and 3.5 h in cynomolgus monkeys; however, a number of secondary peaks were apparent in the profiles for both species. The plasma pharmacokinetics of KW-4490 were comparable between rats and monkeys. 2. After oral administration, KW-4490 was mainly eliminated by metabolism to acylglucuronides and renal excretion in the unchanged form. KW-4490 acylglucuronides were found in monkey but not rat urine. In rats, KW-4490 acylglucuronides were excreted only in bile. Although the pathway of excretion of acylglucuronides differed between rats and monkeys, cumulative excretion in the two animals was very similar, as expected from comparable hepatic clearance for glucuronidation in rat and monkey liver microsomes. 3. The glomerular filtration rate of unbound KW-4490 indicated that renal tubular secretion was significant in monkeys, whereas reabsorption was significant in rats. These species differences in urinary excretion of KW-4490 and its acylglucuronide metabolites are most likely due to substrate specificity of active transporters in rat and monkey kidney.

Biological functions of glucan-binding protein B of Streptococcus mutans

INTRODUCTION

Streptococcus mutans has been implicated as a major causative agent of dental caries in humans. Bacterial components associated with the adhesion phase of S. mutans include glucosyltransferases, protein antigen C and proteins that bind glucan. At least four glucan-binding proteins (Gbp) have been identified; GbpA, GbpB, GbpC and GbpD.

METHODS

In our previous study, the contributions of GbpA and GbpC to the virulence of S. mutans were investigated; however, the biological function of GbpB and its role in the virulence of S. mutans remain to be elucidated. Using a GbpB-deficient mutant strain (BD1), we demonstrated in the present study that GbpB has a role in the biology of S. mutans.

RESULTS

The growth rate of BD1 was lower than that of other strains, while it was also shown to be less susceptible to phagocytosis and to form longer chains than the parental strain MT8148. In addition, electron microscope observations of the cell surfaces of BD1 showed that the cell-wall layers were obscure.

CONCLUSION

These results suggest that GbpB may have an important role in cell-wall construction and be involved in cell separation and cell maintenance.

Management of chemical substances in a water environment communicating among stakeholders

With the implementation of Pollutant Discharge and Transfer Register (PRTR) in fiscal 2003, information on the quantity of chemical substances discharged annually from each business is released in Japan. Such information is expected to lead to heightened public concern about the presence of chemical substances in environment. This paper showed the effects of using PRTR data for managing chemical risk in a water environment communicating among stakeholders based on the results of the case study held in Japan. First, it was possible to identify the discharge sources using PRTR and related data for the chemicals such as Zn and NPs which were shown that they had relatively high risks based on the survey in a model area. Second, it was suggested that the chemical risk communication among the stakeholders including people using PRTR and related data would be a good way to encourage environmental activities of businesses, and to build a good relationship among stakeholders including people who have anxiety about chemical risk.

Intrahepatic splenosis with severe iron deposition presenting with atypical magnetic resonance images

An intrahepatic mass was incidentally found in a 41-year-old man with a history of a traffic accident injury which resulted in removal of a ruptured spleen. Hepatic splenosis was considered in the differential diagnosis but magnetic resonance imaging showed hypointensity on T2-weighted images, atypical for normal spleen. Histologically, the mass showed sinusoidal structures and lymphoid follicular aggregates. Immunohistochemical study showed that the phenotype of the vascular lining cells was CD8-positive, CD31-positive, and CD34 negative, the pattern diagnostic for ectopic spleen. In addition, severe iron deposition was histologically demonstrated, which was considered as the cause of the hypointense T2-weighted images.

Review of pathophysiology and clinical management of narcolepsy in dogs

Narcolepsy is a chronic sleep disorder that affects human beings and animals. Up to 17 breeds of dogs are affected sporadically, and familial forms occur in dobermanns, labrador retrievers and dachshunds. These dogs display characteristics strikingly similar to those of human narcolepsy, including cataplexy (a sudden loss of muscle tone in response to emotional stimulation) and a shorter sleep latency. It has recently been shown that the aetiology of both the familial form (receptor null mutation) and the sporadic form (loss of ligand production) of canine narcolepsy is associated with a deficit in hypocretin/orexin neurotransmission. Hypocretin deficiency can be detected by the measurement of hypocretin-1 in cerebrospinal fluid, and this could be used to diagnose hypocretin ligand deficient cases in clinical practice. Narcolepsy is neither progressive nor life-threatening, but the clinical signs persist throughout life, and lifelong treatment and care are required. This article reviews the recent progress in narcolepsy research in dogs, and describes the diagnosis and treatment of the disease.

Transforming growth factor-beta(2) polymorphisms are associated with childhood atopic asthma

BACKGROUND

Transforming growth factor (TGF)-beta plays an important role in the regulation of airway inflammation and remodelling in asthma. Recent studies suggest that TGF-beta(2) is a predominant isoform expressed in severe asthma and it is also associated with airway remodelling.

OBJECTIVE

To determine whether the polymorphisms in TGF-beta(2) are associated with childhood atopic bronchial asthma in a Japanese population.

METHODS

We identified a total of eight polymorphisms and characterized the linkage disequilibrium (LD) mapping of the gene. Three variants in the promoter and 3'UTR were genotyped, and we conducted an association study of TGF-beta(2) (childhood atopic asthma n=297, normal controls n=555). An association analysis of these variants and an expression and functional analysis were performed.

RESULTS

3'UTR 94862T >A was found to be significantly associated with the risk of childhood atopic asthma (P=0.00041). The -109-->ACAA ins promoter variant was also associated with the risk of childhood atopic asthma (P=0.0037). TGF-beta(2) expression was observed in both the normal and asthmatic bronchial epithelium, and both real-time PCR and an ELISA showed a significant basal and TGF-beta(1)-induced TGF-beta(2) expression in the bronchial epithelial cell line BEAS2B. Furthermore, the promoter variant -109-->ACAA ins increased the TGF-beta(2) promoter-reporter activity in BEAS2B cells.

CONCLUSIONS

Our data suggest that TGF-beta(2) may therefore be involved in the development of childhood atopic asthma by means of functional genetic polymorphism. The polymorphisms in TGF-beta(2) may become important information for asthma susceptibility in children.

Bacteriocin detection by liquid chromatography/mass spectrometry for rapid identification

AIMS

To establish a new system to detect and identify bacteriocins in the early stage of screening for novel bacteriocins.

METHODS AND RESULTS

Liquid chromatography/mass spectrometry (LC/MS) was employed for development of a new system for rapid detection and identification of bacteriocins. The system detected and identified bacteriocins such as nisin and lacticin 481 from 25 microl of culture supernatants of their producing strains by accurate mass determination coupled with simultaneous impurity removal within 40 min. Especially, the system clearly distinguished three nisin variants (A, Z, Q) in culture supernatants of their producing strains, although they have similar structures and molecular masses. Each one-step pretreatment by cell adsorption-desorption or acetone precipitation improved bacteriocin detection dramatically, especially for mundticin KS. This system could be applied for detection and molecular mass determination of novel bacteriocins by extracting bacteriocin-related ions.

CONCLUSIONS

The developed system could detect and identify some kinds of bacteriocin from culture supernatants or pretreated samples.

SIGNIFICANCE AND IMPACT OF THE STUDY

The developed system helps us to identify bacteriocins in the early stage of screening without any or with one-step pretreatment. This system is effective on not only detection of known bacteriocins but also identification of novel bacteriocins. Consequently, this system will accelerate discovery of novel bacteriocins.

Phrenic nerve conduction in the early stage of Guillain-Barre syndrome might predict the respiratory failure

OBJECTIVE

To investigate whether phrenic nerve conduction in the early phase of Guillain- Barre syndrome (GBS) predicts the need for respiratory assistance during the subsequent clinical course.

MATERIAL AND METHODS

We performed electrophysiological examinations of conventional peripheral nerve conduction and phrenic nerve conduction for GBS patients within 14 days from the onset. We excluded patients who had already been treated with immuno-related therapy and respiratory assistance.

RESULTS

Fifteen patients were enrolled. Three patients with the sum of phrenic nerve latency longer than 30 ms and the sum of bilateral diaphragmatic compound muscle action potential amplitude smaller than 0.3 mV required respiratory assistance after the conduction test.

CONCLUSION

Our findings showed that not only delayed distal latency but also decreased amplitude may predict the need for respiratory assistance during the subsequent disease course.

Hepatitis C virus directly associates with insulin resistance independent of the visceral fat area in nonobese and nondiabetic patients

Insulin resistance (IR) is known to be associated with the visceral adipose tissue area. Elucidation of the relationship between hepatitis C virus (HCV) and IR is of great clinical relevance, because IR promotes liver fibrosis. In this study, we tested the hypothesis that HCV infection by itself may promote IR. We prospectively evaluated 47 patients with chronic HCV infection who underwent liver biopsy. Patients with obesity, type 2 diabetes mellitus (DM), or a history of alcohol consumption were excluded. IR was estimated by calculation of the modified homeostasis model of insulin resistance (HOMA-IR) index. Abdominal fat distribution was determined by computed tomography. Fasting blood glucose levels were within normal range in all the patients. The results of univariate analysis revealed a significant correlation between the quantity of HCV-RNA and the HOMA-IR (r = 0.368, P = 0.0291). While a significant correlation between the visceral adipose tissue area and the HOMA-IR was also observed in the 97 control, nondiabetic, non-HCV-infected patients (r = 0.398, P < 0.0001), no such significant correlation between the visceral adipose tissue area and the HOMA-IR (r = 0.124, P = 0.496) was observed in the patients with HCV infection. Multiple regression analysis with adjustment for age, gender and visceral adipose tissue area revealed a significant correlation between the HCV-RNA and the HOMA-IR (P = 0.0446). HCV is directly associated with IR in a dose-dependent manner, independent of the visceral adipose tissue area. This is the first report to demonstrate the direct involvement of HCV and IR in patients with chronic HCV infection.

Intramuscular fat deposition in principal muscles from twenty-four to thirty months of age using identical twins of Japanese Black steers

The changes in i.m. fat deposition in the principal muscles [M. semitendinosus, M. semimembranosus, M. psoas major, M. latissimus dorsi, LM (7th to 8th and 10th to 11th thoracic vertebrae), and M. supraspinatus] from 24 to 30 mo of age were investigated using identical twins of Japanese Black steers. Four sets of identical twins of Japanese Black steers were used in this study. Animals were fattened from 10 to 24 or 30 mo of age for each pair of identical twins. Body weights of twin steers slaughtered at 24 and at 30 mo of age were similar at 10 mo of age and thereafter up to 24 mo of age. The changes in serum concentration of vitamin A, glucose, total cholesterol, albumin, and total protein were similar in each pair of twins during the first fattening stage (10 to 24 mo). Fat contents of LM (7th to 8th thoracic vertebrae) at 24 and 30 mo of age were 37.0 and 42.4%, respectively (P < 0.05). Moreover, in the principal muscles, except M. semimembranosus and M. supraspinatus, fat content at 30 mo of age was greater than at 24 mo of age (P < 0.05). The proportional increase in fat content from 24 to 30 mo of age was greatest in M. semitendinosus (+58.7%) and least in M. supraspinatus (+6.1%). These results demonstrate that i.m. fat continues to increase after 24 mo of age, and the rates of i.m. fat deposition and the ages when i.m. fat is deposited are different for every muscle.

Effects of CYP2A6 genotype and plasma level of 5-chloro-2,4-dihydroxipyridine (CDHP) on pharmacokinetics (PK) of tegafur (FT) and 5-fluorouracil (5-FU) in the patients treated by S-1

2504

Background: S-1, which is an oral anticancer agent comprised of FT, CDHP and potassium oxonate, is one of the most widely prescribed agents in the treatment of gastric and colorectal cancer in Japan. CYP2A6 is involved in the bioactivation of FT to 5-FU. Dihydropyrimidine dehydrogenase which is responsible for the detoxification of 5-FU is inhibited by CDHP to increase plasma exposure of 5- FU. The dose of S-1 is determined by body surface area (BSA) of the patients. We prospectively analyzed contribution of CYP2A6 genotype, plasma level of CDHP, and BSA on the PK of FT and 5-FU. Methods: Forty Japanese patients with metastatic/ recurrent cancers who received S-1 were enrolled. Genetic polymorphisms in CYP2A6 (*4, *7 and *9) related to deficient or reduced activity were analyzed. CYP2A6 genotypes were defined as wild (*1/*1), one-reduced allele (*1/*4, *1/*7 or *1/*9) and two-reduced alleles (*4/*4, *4/*7, *4/*9, *7/*7, *7/*9 or *9/*9). On the first day of the treatment, plasma concentration of FT, 5-FU and CDHP were measured. Multivariate linear regression analysis was used identifying association or correlation between oral clearance (CL/F) for FT or area under the time-concentration curve (AUC) for 5-FU and possible factors including CYP2A6 genotype, AUC for CDHP and patient’s characteristics including BSA. Results: CL/F for FT was significantly associated with CYP2A6 genotype (ANOVA, P=0.0000787, R2=50.1%), but not with other factors. CL/F for FT in patients with one- and two-reduced allele(s) were significantly lower than that in wild patients (P=0.0126 and 0.000128, respectively; Wilcoxon test). AUC for 5-FU was significantly correlated with AUC for CDHP (ANOVA, P=0.000534, R2=39%), but not with others. AUC for CDHP was correlated with creatinine clearance (Ccr) (ANOVA, P=0.00056, R2=27.2%). Conclusions: PK of FT and 5-FU are significantly affected by CYP2A6 genotype and exposure of CDHP, respectively. In addition, AUC for CDHP, which is correlated with Ccr, is the more critical factor to regulate AUC for 5-FU than BSA. Ccr-based dosing will be more rational than the conventional BSA-based dosing in the prescription of S-1.

No significant financial relationships to disclose.

Pharmacokinetic study of a combination chemo-endocrine treatment of paclitaxel and toremifene

13017

Background: The mechanism of paclitaxel (PXL) resistance has been investigated. P-glycoprotein (P-gp) on cell membrane could be an important target for improving efficacy of PXL. Toremifene (TOR) may moderate P-gp-related drug resistance in vitro. To determine safety and efficacy of PXL and TOR, we conducted a pharmacokinetic study for a combination chemo-endocrine treatment of PXL plus TOR for metastatic breast cancer. Methods: Patients with metastatic breast cancer, who were previously treated with a standard chemotherapy without PXL, were eligible. Patients received PXL 80 mg/m2(i.v.) weekly on days 1, 8, and 15 in a cycle. Concurrently, toremifene 120mg/body (p.o.) was given dairy from day 1–28 in a cycle. For pharmacokinetic study, single agent of PXL was initially administrated on day 1, 8, and 15. From day 18, TOR 120mg/body was given dairy. On day 22, PXL administration in second cycle was skipped. On day 32, blood samples were collected from the patients received PXL 80 mg/m2 + TOR 120 mg/day/body. Samples were analyzed by HPLC (Unisil Q 5CN). Response was evaluated by WHO criteria and adverse events were evaluated by NCI•CTC Ver.2. Results: Nineteen patients were enrolled. Out of 19, 15 patients had measurable disease, and 1 partial response, 8 stable disease, and 6 progressive disease were observed. The addition of TOR caused in no specific adverse events more than grade 3 and toxic profile in combination was similar that in PXL monotherapy. Pharmacokinetic profile of PXL was similar with/without TOR. In addition, Cmax of TOR was 1.85±0.71 mg/mL. Tmax was 2.9±1.8 hr were observed. AUC0–8 of TOR was not affected in the presence of PXL. AUC0- 8 of TOR-1, metabolite of TOR, also demonstrated the similar pharmacokinetic profile. Pharmacokinetic parameters of PXL did not reveal intra-patient variability in previously treated metastatic breast cancer patients. Conclusions: Pharmacokinetic profile in a combination of PXL and TOR was similar that in PXL monotherapy. The addition of TOR to PXL for previously treated metastatic breast cancer patients might be safety.

No significant financial relationships to disclose.

An Intrinsic Bond-Centered Electronic Glass with Unidirectional Domains in Underdoped Cuprates

Removing electrons from the CuO2 plane of cuprates alters the electronic correlations sufficiently to produce high-temperature superconductivity. Associated with these changes are spectral-weight transfers from the high-energy states of the insulator to low energies. In theory, these should be detectable as an imbalance between the tunneling rate for electron injection and extraction-a tunneling asymmetry. We introduce atomic-resolution tunneling-asymmetry imaging, finding virtually identical phenomena in two lightly hole-doped cuprates: Ca(1.88)Na(0.12)CuO(2)Cl2 and Bi2Sr2Dy(0.2)Ca(0.8)Cu2O(8+delta). Intense spatial variations in tunneling asymmetry occur primarily at the planar oxygen sites; their spatial arrangement forms a Cu-O-Cu bond-centered electronic pattern without long-range order but with 4a(0)-wide unidirectional electronic domains dispersed throughout (a(0): the Cu-O-Cu distance). The emerging picture is then of a partial hole localization within an intrinsic electronic glass evolving, at higher hole densities, into complete delocalization and highest-temperature superconductivity.

Gamow-Teller strength in the exotic odd-odd nuclei 138La and 180Ta and its relevance for neutrino nucleosynthesis

The Gamow-Teller strength distributions below the particle threshold in 138La and 180Ta, deduced from high-resolution measurements of the (3He,t) reaction at 0 degrees, allow us to evaluate the role of charged-current reactions for the production of these extremely rare nuclides in neutrino-nucleosynthesis models. The analysis suggests that essentially all 138La in the Universe can be made that way. Neutrino nucleosynthesis also contributes significantly to the abundance of 180Ta but the magnitude depends on the unknown branching ratio for population of the long-lived isomer.

Hematopoietic stem cells prevent hair cell death after transient cochlear ischemia through paracrine effects

Transplantation of hematopoietic stem cells (HSCs) is regarded to be a potential approach for promoting repair of damaged organs. Here, we investigated the influence of hematopoietic stem cells on progressive hair cell degeneration after transient cochlear ischemia in gerbils. Transient cochlear ischemia was produced by extracranial occlusion of the bilateral vertebral arteries just before their entry into the transverse foramen of the cervical vertebra. Intrascalar injection of HSCs prevented ischemia-induced hair cell degeneration and ameliorated hearing impairment. We also showed that the protein level of glial cell line-derived neurotrophic factor (GDNF) in the organ of Corti was upregulated after cochlear ischemia and that treatment with HSCs augmented this ischemia-induced upregulation of GDNF. A tracking study revealed that HSCs injected into the cochlea were retained in the perilymphatic space of the cochlea, although they neither transdifferentiated into cochlear cell types nor fused with the injured hair cells after ischemia, suggesting that HSCs had therapeutic potential possibly through paracrine effects. Thus, we propose HSCs as a potential new therapeutic strategy for hearing loss.

Association between ADAM33 polymorphisms and adult asthma in the Japanese population

BACKGROUND

ADAM33, a member of the ADAM (a disintegrin and metalloprotease) family, is a putative asthma susceptibility gene recently identified by positional cloning. It is important to know whether the association exists in ethnically diverse populations.

OBJECTIVE

To assess whether genetic functional variants of ADAM33 relate to the susceptibility or some phenotypes in adult patients with bronchial asthma in a Japanese population.

METHODS

We searched for single nucleotide polymorphisms (SNPs) in ADAM33 by PCR-directed sequencing and identified 48 SNPs. Fourteen SNPs were selected with regard to the LD pattern, and genotyped by Taq-Man and PCR-RFLP methods. We conducted an association study of ADAM33 with 504 adult asthmatic patients and 651 controls, and haplotype analyses of related variants were performed.

RESULTS

Significant associations with asthma were found for the SNPs T1 (Met764Thr), T2 (Pro774Ser), S2 and V-3 (with the lowest P-value for T1, P = 0.0015; OR 0.63). We analysed the haplotype using these four polymorphisms, and found a positive association with haplotype CCTG (P = 0.0024).

CONCLUSION

Our results replicate associations reported recently in other ethnic populations, and suggest that the ADAM33 gene is involved in the development of asthma through genetic polymorphisms.

Development of on-bed lower extremity exercise system for use with networked virtual space

A virtual space locomotion interface device using lower limb motion at supine position has been developed to allow the users to exercise and communicate each other at home. The velocity control performance, muscle activity and the energy consumption while using the developed device were evaluated. It was demonstrated that the developed device reflects the user's subjectivity adequately and the virtual space walking distance is to be set as three times of the actual distance to obtain the same exercise effect.

Development of automatic immediate fitting socket system for artificial leg socket modeling using fuzzy control

Automatic immediate fitting socket (AIFS) system was developed to shorten the long length of time for making an artificial leg, by applying powder technology. AIFS is constructed of an outer shell, a particle containing bag, which the rigidity can be controlled by the application of negative air pressure and three airbags between the outer shell and the particle bag to adjust the shape by controlling the compression. A fuzzy controller was applied for the real-time automatic control of the shape based on the subjective evaluation of the amputee. The surface contact pressure was evaluated during AIFS walking as well as the walking with the conventional socket. The peak pressure at the tibia end was 30 kPa in AIFS walking while 90 kPa with conventional socket. The pressure distribution among medial condyle, fibula head and tibia end was more uniform with AIFS. The shape modeling performance was evaluated by measuring the circumferences of four amputees' stumps. The modeling error was 6%. The shape modeling including test walking was completed in 10 minutes in all four amputees and practical shapes were obtained.

Influence of attention and predictive visual cue on motion perception and sickness in immersive virtual environment

Relieving motion sickness and enhancing self-motion perception are required for the public application of immersive visual display system. The effects of user attention and predictive visual cue have been experimentally evaluated in this study. A viewpoint moving visual stimulus was applied to eighteen healthy adults. The subjective evaluation presumably suggested that a predictive visual cue enhances self-motion perception and relieves motion sickness at a same time.

Comparison of glucan-binding proteins in cariogenicity of Streptococcus mutans

Streptococcus mutans has been implicated as a primary causative agent of dental caries in humans. Bacterial components associated with the adhesion phase of S. mutans include cell-associated and cell-free glucosyltransferases (GTFs), as well as protein antigen c and proteins that bind glucan. At least four types of S. mutans glucan-binding protein (Gbp) have been identified; GbpA, GbpB, GbpC and GbpD. In the present study, GbpA-, GbpB- and GbpC-deficient mutants (AD1, BD1 and CD1, respectively) were constructed, and their cariogenic properties were evaluated by comparing them to those of their parent strain MT8148. All of the Gbp mutants showed lower levels of dextran binding, while the sucrose-dependent adhesion levels of AD1 and CD1 were lower than in the parental strain. The expression of each GTF was detected in the Gbp mutants, however, they had lower levels of cell-free-GTF activity than the parental strain. On the other hand, in acid tolerance assays, BD1 was the most sensitive among all of the tested strains. These results suggest that GbpA and GbpC in S. mutans have strong relationships with cariogenicity, while GbpB may have another biological function.

Depression of sink activity precedes the inhibition of biomass production in tomato plants subjected to potassium deficiency stress

Tomato [Solanum lycopersicum (formerly Lycopersicon esculentum) L. cv. Momotarou] plants were grown hydroponically inside the greenhouse of Hiroshima University, Japan. The adverse effects of potassium (K) deficiency stress on the source-sink relationship during the early reproductive period was examined by withdrawing K from the rooting medium for a period of 21 d. Fruits and stem were the major sink organs for the carbon assimilates from the source. A simple non-destructive micro-morphometric technique was used to measure growth of these organs. The effect of K deficiency was studied on the apparent photosynthesis (source activity), leaf area, partitioning (13)C, sugar concentration, K content, and fruit and stem diameters of the plant. Compared with the control, K deficiency treatment severely decreased biomass of all organs. The treatment also depressed leaf photosynthesis and transport of (13)C assimilates, but the impact of stress on these activities became evident only after fruit and stem diameter expansions were down-regulated. These results suggested that K deficiency diminished sink activity in tomato plants prior to its effect on the source activity because of a direct effect on the water status of the former. The lack of demand in growth led to the accumulation of sugars in leaves and concomitant fall in photosynthetic activity. Since accumulation of K and sugars in the fruit was not affected, low K levels of the growing medium might not have affected the fruit quality. The micro-morphometric technique can be used as a reliable tool for monitoring K deficiency during fruiting of tomato. K deficiency directly hindered assimilate partitioning, and the symptoms were considered more detrimental compared with P deficiency.

Early clinical outcomes of 3D-conformal radiotherapy using accelerated hyperfractionation without intracavitary brachytherapy for cervical cancer

PURPOSE/OBJECTIVE

To evaluate the outcome of cervical cancer patients unable to undergo conventional intracavitary brachytherapy (ICBT) treated with 3D-conformal radiotherapy (3DCRT) alone using accelerated hyperfractionation (AHF).

METHODS AND MATERIALS

We reviewed the records of 7 patients who had received definitive radiotherapy with 3DCRT alone using AHF for cervical cancer between 2002 and 2005. FIGO stage was IB (1), IIB (2), IIIA (1), IIIB (2), and IVA (1). The reason we did not perform ICBT was due to patient refusal. In 1 patient with stage IB, a total dose of 65.4 Gy was delivered by local irradiation (LI) only. In 1 patient with stage IIIA, a total dose of 60 Gy was delivered by LI only. In 5 patients with Stage IIB-IV, a median total dose of 70.8 Gy was delivered by combination of whole pelvic irradiation (median dose of 45 Gy) with LI. Median overall treatment time was 42 days.

RESULTS

Median follow-up for survival patients was 17 months. Out of 7 patients, 6 patients had CR and 1 patient had PR. The response rate was 100%. The 2-year local control rate was 85.7%. Of these patients, 5 are alive without disease and 1 is alive with lung metastasis.

CONCLUSIONS

Our outcomes suggest that 3DCRT using AHF may be a promising as a definitive treatment for cervical cancer when ICBT is not able to be performed.

Blockade of Angiotensin II type-1 receptor reduces oxidative stress in adipose tissue and ameliorates adipocytokine dysregulation

Dysregulated production of adipocytokines may be involved in the development of atherosclerotic cardiovascular disease in metabolic syndrome and chronic kidney disease (CKD) associated with metabolic syndrome. The aim of this study was to determine the effects of treatment with angiotensin II (Ang II) type-1 receptor blocker (ARB) on the regulation of adipocytokines. Olmesartan, an ARB, significantly blunted the age- and body weight-associated falls in plasma adiponectin both in genetically and diet-induced obese mice, without affecting body weight, but had no effect on plasma adiponectin levels in lean mice. Olmesartan also ameliorated dysregulation of adipocytokines in obesity, such as tumor necrosis factor-alpha, plasminogen activator inhibitor-1, monocyte chemotactic protein-1, and serum amyloid A3. Olmesartan significantly reduced reactive oxygen species originating from accumulated fat and attenuated the expression of nicotinamide adenine dinucleotide phospho hydrogenase oxidase subunits in adipose tissue. In cultured adipocytes, olmesartan acted as an antioxidant and improved adipocytokine dysregulation. Our results indicate that blockade of Ang II receptor ameliorates adipocytokine dysregulation and that such action is mediated, at least in part, by targeting oxidative stress in obese adipose tissue. Ang II signaling and subsequent oxidative stress in adipose tissue may be potential targets for the prevention of atherosclerotic cardiovascular disease in metabolic syndrome and also in metabolic syndrome-based CKD.

Gamow-Teller strengths in the A = 14 multiplet: a challenge to the shell model

A new experimental approach to the famous problem of the anomalously slow Gamow-Teller (GT) transitions in the beta decay of the A=14 multiplet is presented. The GT strength distributions to excited states in 14C and 14O were studied in high-resolution (d,2He) and (3He,t) charge-exchange reactions on 14N. No-core shell-model calculations capable of reproducing the suppression of the beta decays predict a selective excitation of Jpi=2+ states. The experimental confirmation represents a validation of the assumptions about the underlying structure of the 14N ground state wave function. However, the fragmentation of the GT strength over three 2+ final states remains a fundamental issue not explained by the present no-core shell model using a 6homega model space, suggesting possibly the need to include cluster structure in these light nuclei in a consistent way.

Interplay of electron–lattice interactions and superconductivity in Bi2Sr2CaCu2O8+δ

Formation of electron pairs is essential to superconductivity. For conventional superconductors, tunnelling spectroscopy has established that pairing is mediated by bosonic modes (phonons); a peak in the second derivative of tunnel current d2I/dV2 corresponds to each phonon mode. For high-transition-temperature (high-T(c)) superconductivity, however, no boson mediating electron pairing has been identified. One explanation could be that electron pair formation and related electron-boson interactions are heterogeneous at the atomic scale and therefore challenging to characterize. However, with the latest advances in d2I/dV2 spectroscopy using scanning tunnelling microscopy, it has become possible to study bosonic modes directly at the atomic scale. Here we report d2I/dV2 imaging studies of the high-T(c) superconductor Bi2Sr2CaCu2O8+delta. We find intense disorder of electron-boson interaction energies at the nanometre scale, along with the expected modulations in d2I/dV2 (refs 9, 10). Changing the density of holes has minimal effects on both the average mode energies and the modulations, indicating that the bosonic modes are unrelated to electronic or magnetic structure. Instead, the modes appear to be local lattice vibrations, as substitution of 18O for 16O throughout the material reduces the average mode energy by approximately 6 per cent--the expected effect of this isotope substitution on lattice vibration frequencies. Significantly, the mode energies are always spatially anticorrelated with the superconducting pairing-gap energies, suggesting an interplay between these lattice vibration modes and the superconductivity.

Protective effect against 17beta-estradiol on neuronal apoptosis in hippocampus tissue following transient ischemia/recirculation in mongolian gerbils via down-regulation of tissue transglutaminase activity

We analyzed the protective effect of 17beta-estradiol (17beta-ED) injection against delayed neuronal death in the hippocampus tissue of the brain in Mongolian gerbils after transient ischemia/recirculation treatment, especially in relation with bcl-2 gene expression and enzymatic activity changes of caspase-3 and tissue transglutaminase (tTGase). Daily intraperitoneal injection of 17beta-ED to the animal after the ischemia stimulated the expression of an apoptosis suppressor gene, bcl-2, in the hippocampal tissue for a week. The gradually increasing apoptotic enzyme activity of caspase-3 and increased number of TUNEL positive fragmented neuronal nuclei caused by ischemic attack in the gerbil brain were clearly suppressed by 17beta-ED administration. The reduced activity and enzyme protein of tTGase, a neurodegenerative marker of apoptosis in the hippocampus after ischemia, were also restored to nearly normal levels by 17beta-ED injection. These results suggest that daily 17beta-ED administration to the gerbil after transient ischemic insult with progressing neuronal deteriorative changes in hippocampus tissue can effectively prevent apoptotic changes through a molecular cascade involving gene expression regulation.

Aberrant trafficking of a proteolipid protein in a mild Pelizaeus-Merzbacher disease

Pelizaeus-Merzbacher disease (PMD) is a rare X-linked leukodystrophy caused by proteolipid protein 1 (PLP1) gene mutations. Previous studies indicated that proteolipid proteins (PLPs) with disease-associated mutations are misfolded and trapped in the endoplasmic reticulum (ER) during transportation to the cell surface, which eventually leads to oligodendrocyte cell death in PMD. Here we report a PMD patient with a very mild phenotype carrying a novel mutation (485G-->T) in exon 4 of the PLP1 gene that causes a Trp(162)Leu substitution in the protein. We also investigated intracellular trafficking of this mutant PLP in COS-7 cells. Transiently transfected mutant PLP(W162L) fused to an enhanced green fluorescent protein (EGFP) or a short peptide tag was not carried to the plasma membrane. However, in contrast to previous studies, this mutant PLP was not retained in the ER, indicating an escape of the newly translated protein from the quality control machinery. We also found that the mutant PLP accumulated in the nuclear envelope (NE) in a time-dependent manner. This mutant PLP, with its distribution outside the ER and a very mild phenotype, supports the idea that accumulation of misfolded mutant protein in the ER causes the severe phenotype of PMD.

Preoperative factors influencing visual outcome following surgical excision of subfoveal choroidal

PURPOSE

To evaluate long-term visual acuity outcomes and the influences of various preoperative factors on visual outcome in patients undergoing surgical removal of choroidal neovascular neovascularization (CNV) caused by age-related macular degeneration (ARMD).

METHODS

The authors studied 146 eyes of 146 patients who were followed for at least 1 year after surgical excision of CNV associated with ARMD. Surgical indications included subfoveal active CNV localized mainly above the retinal pigment epithelium (RPE) and a standard Japanese decimal visual acuity of 0.3 or worse. CNV above the RPE was diagnosed by fluorescein angiography, indocyanine green angiography, and optical coherence tomography. CNVs were divided into completely classic CNV or mainly classic CNV. The relationships of the post-operative logarithm of the minimum angle of resolution (logMAR) visual acuity with preoperative logMAR visual acuity, the shortest distance from the center of the foveal avascular zone to the CNV margin, CNV size, and age were analyzed.

RESULTS

Final logMAR visual acuity was improved (defined as a logMAR visual acuity increase of 0.2 or more) in 78 eyes (54%), stable in 47 (32%), and worsened in 21 (14%). Stepwise regression identified CNV size as a significant factor influencing final logMAR visual acuity (R2 = 0.213, p<0.0001), while preoperative logMAR visual acuity, shortest distance from the center of the foveal avascular zone to the CNV margin, and age showed no significant correlation with final logMAR visual acuity. Surgical complications included retinal detachment in six eyes (4%), subretinal hematoma in four eyes (2%), macular hole in three (2%), and proliferative vitreoretinopathy in two (1%). CNV recurred postoperatively in 18 eyes (12%). In 92 eyes with completely classic CNV, visual acuity was improved in 57 (62%), stable in 27 (29%), and worsened in 8 (9%). In 54 eyes with mainly classic CNV, visual acuity was improved in 21(39%), stable in 20 (37%), and worsened in 13 (24%).

CONCLUSIONS

Surgical excision of CNV for ARMD was effective for completely classic CNV, and better postoperative visual acuity was achieved in cases of small CNV. Given the fact that photodynamic therapy (PDT) has only been used in Japan since 2004, future study should compare PDT and surgical excision in Japanese subjects for relative merits against surgical risk and postoperative complications, to define indications for PDT and surgical excision.

A pharmacogenetic study of irinotecan: Genetic polymorphisms in the coding region of UGT1A1 gene and SN-38 glucuronidation in the body

13078

Background: Pharmacogenetic testing of UGT1A1*28, a promoter variant of UGT1A1 gene, for estimating a risk of irinotecan toxicity has been introduced into clinical practice. Purpose: To elucidate clinical significance of UGT1A1*6 and UGT1A1*27, the variants in exon 1 that are found mostly in Asians. Methods: Pharmacogenetic relationships were explored between the genotyping results and ratio of area under the concentration-time curve (AUC) of SN-38 and its glucuronide (SN-38G) as a surrogate for a UGT1A1 activity (AUCSN-38/AUCSN-38G) in 36 Japanese patients who received various regimens of irinotecan chemotherapy at doses from 50 to 180 mg/m2. Results: No patients were homozygous for UGT1A1*28 and none had UGT1A1*27. One was heterozygous for UGT1A1*28. Two were homozygous and ten heterozygous for UGT1A1*6, all of whom were wild type with respect to UGT1A1*28. Two patients were simultaneously heterozygous for UGT1A1*28 and UGT1A1*6 that existed on the different chromosomes. The remaining 21 patients did not have any variants studied. The 2 patients who was simultaneously heterozygous for UGT1A1*28 and UGT1A1*6 and the 2 patients who were homozygous for UGT1A1*6 had significantly higher AUCSN-38/AUCSN-38G than the others (P = 0.004). Conclusions: Concurrence of the two UGT1A1 variants, UGT1A1*28 and UGT1A1*6 even in their heterozygous statuses, remarkably altered drug disposition of irinotecan and could enhance susceptibility to the drug. Patients who are homozygous for UGT1A1*6 should also be monitored cautiously. Genotyping of UGT1A1 polymorphisms in the coding region together with UGT1A1*28 is necessary for predicting irinotecan toxicity at least for Asian patient population.

[Table: see text]

[Table: see text]

Hydrolysis of functional monomers in a single-bottle self-etching primer--correlation of 13C NMR and TEM findings

Self-etching primers/adhesives that combine acidic methacrylate monomers with water in a single bottle are hydrolytically unstable and require refrigeration to extend their shelf-lives. This study tested the null hypothesis that one year of intermittent refrigeration of a 4-MET-containing simplified self-etching primer does not result in hydrolytic changes that are identifiable by transmission electron microscopy and (13)C NMR spectroscopy. Human dentin was bonded with UniFil Bond immediately after being unpacked, or after one year of intermittent refrigeration at 4 degrees C. Fresh and aged primers were analyzed by NMR for chemical changes. Ultrastructural observations indicated that there was an augmentation in etching capacity of the aged adhesive that was not accompanied by resin infiltration or effective polymerization. New NMR peaks detected from the aged ethanol-based primer confirmed that degradation occurred initially via esterification with ethanol, followed by hydrolysis of both ester groups in the 4-MET. Hydrolysis of functional methacrylate monomers occurs despite intermittent refrigeration.

Balloon or Stent-assisted Coil Embolization for Acutely Ruptured Wide-necked Aneurysms

SUMMARY

In this paper, we report five cases with acutely ruptured wide-necked aneurysms, which were treated with coil embolization using a balloon or stent-assisted technique. Balloon-assisted coil embolization using Equinox balloon, Commodore balloon, and Hyperform balloon were performed for four patients and stent-assisted coil embolization using BX velocity for one patient. We discuss problems of coil embolization for acutely ruptured wide-necked aneurysms with a balloon or stent-assisted technique.

Binding of glucan-binding protein C to GTFD-synthesized soluble glucan in sucrose-dependent adhesion of Streptococcus mutans

Streptococcus mutans produces glucan-binding proteins (Gbp proteins) which promote the adhesion of the organism to teeth. Three Gbp proteins, GbpA protein, GbpB protein, and GbpC protein have been identified; however, the mechanism of adhesion between glucans and bacterial cell surfaces is unknown. We used glucosyltransferase (GTF)- and/or Gbp-deficient mutants to examine the role of GbpC protein in the sucrose-dependent cellular adhesion of S. mutans to glass surfaces. The wild-type strain MT8148 and a GbpA-deficient mutant strain displayed increased sucrose-dependent adhesion following the addition of rGTFD. However, a GbpC-deficient mutant strain demonstrated no changes in the level of sucrose-dependent adhesion in spite of the addition of rGTFD. Further, the binding of rGbpC protein to the glucan synthesized by rGTFD was significantly higher than that to the glucan synthesized by either rGTFB or rGTFC. These results suggest that GbpC protein may play an important role in sucrose-dependent adhesion by binding to the soluble glucan synthesized by GTFD.

Characterization of salt tolerance in ectoine-transformed tobacco plants (Nicotiana tabaccum): photosynthesis, osmotic adjustment, and nitrogen partitioning

Ectoine (1,4,5,6-tetrahydro-2-methyl-4-pyrimidinecarboxylic acid) biosynthetic genes (ect. ABC) from Halomonas elongata were introduced to tobacco plants using an Agrobacterium-mediated gene delivery system. The genes for ectoine biosynthesis were integrated in a stable manner into the tobacco genome and the corresponding transcripts were expressed. The concentration of ectoine under salt-stress conditions was higher in the roots than in leaves. A close relationship was found between stomatal conductance and the amount of transported nitrogen, suggesting that water transport through the xylem in the stem and transpiration may be involved in nitrogen transport to leaves. The data indicate that the turgor values of the ectoine transgenic lines increased with increasing salt concentration. The data revealed two ways in which ectoine enhanced salinity tolerance of tobacco plants. First, ectoine improved the maintenance of root function so that water is taken up consistently and supplied to shoots under saline conditions. Second, ectoine enhanced the nitrogen supply to leaves by increasing transpiration and by protecting Rubisco proteins from deleterious effects of salt, thereby improving the rate of photosynthesis.

Slow Ca(2+) wave stimulation using low repetition rate femtosecond pulsed irradiation

We demonstrated stimulation of Ca(2+) in living cells by near-infrared laser pulses operated at sub-MHz repetition rates. HeLa cells were exposed to focused 780 nm femtosecond pulses, generated by a titanium-sapphire laser and adjusted by an electro-optical modulator. We found that the laser-induced Ca(2+) waves could be generated over three orders of magnitude in repetition rates, with required laser pulse energy varying by less than one order of magnitude. Ca(2+) wave speed and gradients were reduced with repetition rate, which allows the technique to be used to modulate the strength and speed of laser-induced effects. By lowering the repetition rate, we found that the laser-induced Ca(2+) release is partially mediated by reactive oxygen species (ROS). Inhibition of ROS was successful only at low repetition rates, with the implication that ROS scavengers may in general be depleted in experiments using high repetition rate laser irradiation.