A case of acute radiation syndrome from the dermatological aspect

Accidental whole-body overexposure of radiation occurs very rarely. Radiation exposure causes DNA breaks in the cells and shows various clinical features, which are time dependent, dose dependent and tissue dependent. Neutron rays are more destructive than gamma rays but their actual effect on humans have been under-reported. We observed the time-dependent and the dose-dependent dermatological changes in a patient who was severely irradiated by neutron and gamma rays, with the aim of clarifying the clinicopathological features of severely irradiated skin. The detection of DNA breaks in keratinocytes was performed by the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labelling technique. The degenerative changes of the skin and the re-epithelialization varied in a time dependent and dose dependent manner. DNA breaks were significantly higher in irradiated keratinocytes. Neutron rays caused depth-dependent degeneration of the skin. Evaluation of DNA breaks in the skin cells might be a clue to estimate local dosimetry.

Bowel obstruction due to endometriosis in the rectovaginal septum

It is very rare that endometriotic lesions in the rectovaginal septum cause ileus. We report a case of bowel obstruction due to endometriotic lesions in the rectovaginal septum in a 22-year-old woman whose barium enema presented with apple-core-like findings. Diagnostic and treatment modalities were discussed. Preoperative and postoperative gonadotropin-releasing hormone analog and aromatase inhibitor therapy promote relief of clinical symptoms, a reduction of tumor volume and a better approach to radical surgery.

Comparison and evaluation of leakage flux on various types of dental magnetic attachment

A dental magnetic attachment is a device to retain dental prostheses such as overdentures by magnetic attraction. As compared with mechanical attachments, the dental magnetic attachment has superior characteristics such as easy insertion, good esthetics and less lateral pressure to its abutment tooth. As a result, it has come to be used widely. There are various types of dental magnetic attachments. There are a cup type and a sandwich type in Japan, and several types of dental magnetic attachments in other countries. They are used for a long term in the mouth, it is necessary to clarify those leakage magnetic fields. Therefore, in this paper, we evaluate the leakage magnetic fields leaking out of sandwich type and open magnetic circuit type of dental magnetic attachment.

[Mitral valve replacement for hypertrophic obstructive cardiomyopathy with repeated heart failure; report of a case]

A 62-year-old woman with hypertrophic obstructive cardiomyopathy suffered from repeated heart failure. Preoperative echocardiogrphy demonstrated pressure gradient (PG) of 64 mmHg in left ventricular cavity, mitral regurgitation II, and tricuspid regurgitation II with an ejection fraction of 74%. Cardiac catheterizaition revealed cardiac index of 1.50 l/min/m2. She was recommended mitral valve replacement (MVR) because she was hospitalized several times for heart failure. She underwent MVR, tricuspid annuloplasty, and modified maze operation. Postoperative PG fell till 15 mmHg in echocardiogrphy. Postoperative cardiac catheterization revealed cardiac index of 2.00 l/min/m2. MVR contributed to decrease of PG in intraventricular cavity and increase of cardiac output. Postoperative cardiac status was classified as New York Heart Association (NYHA) class I-II.

[Ventricular septal defect in adulthood found with heart failure; report of a case]

A 68-year-old woman was admitted because of face edema and dyspnea. Echograpy revealed ventricular septal defect (Kirklin IV). The pulmonary to systemic blood flow ratio was 3.73, and shunt ratio was 74%. Angiography showed mid-muscular defect with aditional defects. Left ventriculotomy was selected. The ventricular septal defect was 13 mm in diameter at mid-muscular portion and was closed with bovine pericardium. Postoperative course was uneventful. We think that the ventricular septal defect was recurrence after spontaneous closure of ventricular septal defect because the patient had no symptoms in childhood despite of large defect.

Evaluation of leakage flux out of a dental magnetic attachment

A dental magnetic attachment is a device to retain dental prostheses such as overdentures by magnetic attraction. As compared with mechanical attachments, the magnetic attachment has a superior retention properties due to less lateral pressure to its abutment tooth, and hence it has come to be widely used, particularly for retaining overdentures. Because the dental magnetic attachments are a device used in the mouth, the tissues in the mouth are exposed to the magnetic fields leaking out of the magnetic attachments for a long time. It may therefore be important to discuss biological effects of the leakage magnetic fields. It is required at first to evaluate the strength of the leakage magnetic fields.

Mitogenomic Evolution and Interrelationships of the Cypriniformes (Actinopterygii: Ostariophysi): The First Evidence Toward Resolution of Higher-Level Relationships of the World’s Largest Freshwater Fish Clade Based on 59 Whole Mitogenome Sequences

Fishes of the order Cypriniformes are almost completely restricted to freshwater bodies and number > 3400 species placed in 5 families, each with poorly defined subfamilies and/or tribes. The present study represents the first attempt toward resolution of the higher-level relationships of the world's largest freshwater-fish clade based on whole mitochondrial (mt) genome sequences from 53 cypriniforms (including 46 newly determined sequences) plus 6 outgroups. Unambiguously aligned, concatenated mt genome sequences (14,563 bp) were divided into 5 partitions (first, second, and third codon positions of the protein-coding genes, rRNA genes, and tRNA genes), and partitioned Bayesian analyses were conducted, with protein-coding genes being treated in 3 different manners (all positions included; third codon positions converted into purine [R] and pyrimidine [Y] [RY-coding]; third codon positions excluded). The resultant phylogenies strongly supported monophyly of the Cypriniformes as well as that of the families Cyprinidae, Catostomidae, and a clade comprising Balitoridae + Cobitidae, with the 2 latter loach families being reciprocally paraphyletic. Although all of the data sets yielded nearly identical tree topologies with regard to the shallower relationships, deeper relationships among the 4 major clades (the above 3 major clades plus Gyrinocheilidae, represented by a single species Gyrinocheilus aymonieri in this study), were incongruent depending on the data sets. Treatment of the rapidly saturated third codon-position transitions appeared to be a source of such incongruities, and we advocate that RY-coding, which takes only transversions into account, effectively removes this likely "noise" from the data set and avoids the apparent lack of signal by retaining all available positions in the data set.

Human oviductal epithelial cells express Toll-like receptor 3 and respond to double-stranded RNA: Fallopian tube-specific mucosal immunity against viral infection

BACKGROUND

The aim of this study was to evaluate the site-specific immunoregulatory mechanisms against viral infection in human Fallopian tubes.

METHODS

We therefore investigated the effects of double-stranded RNA (dsRNA) on the production of interleukin (IL)-6, IL-8 and granulocyte chemotactic protein-2 (GCP-2) by cultured oviductal epithelial cells (OECs) using enzyme-linked immunosorbent assays. Phosphorylation of inhibitor kappaB-alpha (IkappaB-alpha) protein after dsRNA stimulation and the expression of Toll-like receptor (TLR) 3 in these cells were also evaluated by western blot analysis.

RESULTS

Polyriboinosinic:polyribocytidylic acid (poly I:C), a synthetic dsRNA that antagonizes TLR3, stimulated the secretion of IL-6, IL-8 and GCP-2 by OECs. Poly I:C-induced production of these cytokines by OECs was inhibited by the pretreatment of these cells with anti-TLR3 antibody. The phosphorylation of IkappaB-alpha protein was detected in OECs after stimulation by poly I:C. The expression of TLR3 was also detected in OECs.

CONCLUSION

These results suggest that the epithelial cells of the human Fallopian tube have evolved a unique, site-specific mechanism for recognizing viral infection. TLR3-mediated production of proinflammatory cytokines and chemokines in OECs in response to viral dsRNA may be important for antiviral immunity in the human female reproductive tract.

Prevalence and characteristics of depression in a Japanese leprosarium from the viewpoints of social stigmas and ageing. A preliminary report

OBJECTIVE

To investigate the prevalence and characteristics of depressed patients living in a Japanese leprosarium who have been isolated by national law and are now becoming very elderly.

METHODS

We surveyed the prevalence of depressed patients living in the National Tamazenshouen Sanatorium, a major leprosarium in Japan. We also investigated the characteristics of patients who had suffered a depressive episode during the last 5 years (2000-2004). The characteristics of residents who committed suicide were also studied.

RESULTS

At the time of the investigation, 48 out of 385 (12.5%) patients were depressed or had experienced a depressive episode. Forty-one residents had committed suicide since the leprosarium was established in 1907. Somatic symptoms and depressive moods were the predominant symptoms and were not limited to symptoms unique to leprosy. The period of isolation was not statistically correlated with the GDS-SF or PGC morale scale scores.

CONCLUSION

The findings of this study emphasize the importance of consultation psychiatric for elderly leprosy residents and could be used as a reference for treatment in countries with ageing leprosy residents.

Antigen Chemically Coupled to the Surface of Liposomes Are Cross-Presented to CD8+ T Cells and Induce Potent Antitumor Immunity

We have previously demonstrated that liposomes with differential lipid components display differential adjuvant effects when Ags are chemically coupled to their surfaces. In the present study, Ag presentation of liposome-coupled OVA was investigated in vitro, and it was found that OVA coupled to liposomes made using unsaturated fatty acid was presented to both CD4+ and CD8+ T cells, whereas OVA coupled to liposomes made using saturated fatty acid was presented only to CD4+ T cells. Confocal laser scanning microscopic analysis demonstrated that a portion of the OVA coupled to liposomes made using unsaturated, but not saturated fatty acid, received processing beyond the MHC class II compartment, suggesting that the degradation of OVA might occur in the cytosol, and that the peptides generated in this manner would be presented to CD8+ T cells via MHC class I. The ability to induce cross-presentation of an Ag coupled to liposomes consisting of unsaturated fatty acid was further confirmed by in vivo induction of CTL and by the induction of tumor eradication in mice; E.G7 tumors in mice that received combined inoculation with OVA(257-264)-liposome conjugates, CpG, and anti-IL-10 mAbs were completely eradicated. In those mice, the frequency of CD8+ T cells reactive with OVA(257-264) peptides in the context of H-2K(b) was significantly increased. These results suggested that, by choosing lipid components for liposomes, surface-coupled liposomal Ags might be applicable for the development of tumor vaccines to present tumor Ags to APCs and induce antitumor responses.

β-Hydroxyisovalerylshikonin induces apoptosis and G0/G1 cell-cycle arrest of endometriotic stromal cells: a preliminary in vitro study

BACKGROUND

Most of the current medical treatments for endometriosis aim to down-regulate the estrogen activity. However, a high recurrence rate after medical treatments has been the most significant problem. Beta-hydroxyisovalerylshikonin (beta-HIVS) is an ATP non-competitive inhibitor of protein-tyrosine kinases and is considered an apoptosis-inducing agent. The aim of this study is to evaluate the effects of beta-HIVS on the proliferation, cell cycle and apoptosis of endometriotic stromal cells.

METHODS

We investigated the effects of beta-HIVS on cultured ovarian endometriotic cyst stromal cells (ECSC) by a modified methylthiazoletetrazolium (MTT) assay, a 5-bromo-2'-deoxyuridine (BrdU) incorporation assay and internucleosomal DNA fragmentation assays. The effect of beta-HIVS on the cell cycle of ECSC was determined by flow cytometry. The expression of apoptosis-related molecules was examined in ECSC using western blot analysis.

RESULTS

Beta-HIVS significantly inhibited the proliferation and DNA synthesis of ECSC and induced apoptosis and G0/G1 phase cell-cycle arrest of these cells. Down-regulation of the B-cell lymphoma/leukaemia-2 (Bcl-2) expression with the activation of caspase-3, caspase-8 and caspase-9 was observed in ECSC after beta-HIVS treatment.

CONCLUSIONS

These results suggest that beta-HIVS induces apoptosis of ECSC by suppressing anti-apoptotic proteins. Although our present findings are preliminary, beta-HIVS could potentially be a therapeutic agent for the treatment of endometriosis.

Detailed semiautomated MRI based morphometry of the neonatal brain: preliminary results

In the neonate, regional growth trajectories provide information about the coordinated development of cerebral substructures and help identify regional vulnerability by identifying times of faster growth. Segmentation of magnetic resonance images (MRI) has provided detailed information for the myelinated brain but few reports of regional neonatal brain growth exist. We report the method and preliminary results of detailed semiautomated segmentation of 12 normative neonatal brains (gestational age 31.1-42.6 weeks at time of MRI) using volumetric T1-weighted images. Accuracy was confirmed by expert review of every segmented image. In 5 brains, repeat segmentation resulted in intraclass correlation coefficients >0.9 (except for the right amygdala) and an average percent voxel overlap of 90.0%. Artifacts or image quality limited the number of regions segmented in 9/12 data sets and 1/12 was excluded from volumetric analysis due to ventriculomegaly. Brains were segmented into cerebral exterior (N = 8), cerebral lobes (N = 5), lateral ventricles (N = 8), cerebral cortex (N = 6), white matter (N = 6), corpus callosum (N = 7), deep central gray (N = 8), hippocampi (N = 8), amygdalae (N = 8), cerebellar hemispheres (N = 8), vermis (N = 8), midbrain (N = 8), pons (N = 8) and medulla (N = 8). Linear growth (P < 0.05) was identified in all regions except the cerebral white matter, medulla and ventricles. Striking differences in regional growth rates were noted. These preliminary results are consistent with the heterochronous nature of cerebral development and provide initial estimates of regional brain growth and therefore regional vulnerability in the perinatal time period.

Induction of Differential T-Cell Epitope by Plain- and Liposome-Coupled Antigen

The T-cell receptors of CD4(+) T lymphocytes recognize immunogenic peptide sequences bound within the groove of MHC class II molecules, and the peptides that bind to these molecules are known to share common structural motifs. For example, OVA(323-339), an I-A(d)-binding peptide, involves a motif of the I-A(d) peptide-binding groove. In the present study, OVA peptides of up to 26-mer were sequentially synthesized and screened, and two additional I-A(d) binding OVA peptides, OVA(20-43) and OVA(264-286), were found to stimulate CD4(+) T cells of OVA-immune BALB/c mice. OVA(20-43) involved structural motifs of the I-A(d) peptide-binding groove, while OVA(264-286) did not. The ability of these three I-A(d) binding OVA peptides to induce antigen-specific cytokine production was compared among CD4(+) T cells of mice immunized either with alum-adsorbed OVA (OVA-alum) or OVA chemically coupled to the surface of liposome (OVA-liposome). CD4(+) T cells of mice immunized with OVA-alum produced more cytokines when stimulated with OVA(264-286) than with OVA(323-339), while CD4(+) T cells of mice immunized with OVA-liposome conjugates produced more cytokines when stimulated with OVA(323-339) than with OVA(264-286). OVA(20-43) induced production of comparable levels of cytokines in mice immunized either with OVA-alum or OVA-liposome. Confocal laser scanning microscopic analysis demonstrated that chemically coupled OVA and liposomes were colocalized in APCs until OVA received processing. Three-dimensional structural analysis demonstrated that both OVA(264-286) and OVA(323-339) were present on the surface of OVA, but OVA(20-43) was not. These results suggested that the chemical coupling of OVA to liposome affected antigen processing in APCs and thus resulted in the induction of differential T-cell epitopes as compared with those induced by plain OVA.

[Treatment for perioperative arrhythmias with nifekalant hydrochloride]

Ventricular tachycardia (VT), ventricular fibrillation (VF), and atrial flutter (AFL) are potentially fatal or serious complications arising after cardiac surgery. Generally, we treat these complications with class I antiarrhythmic agents and/or direct counter shock (DC). However, sometimes these complications do not respond to antiarrhythmic agents and require frequent DC. Moreover, these class I agents induce heart failure due to their negative inotropic effect. Nifekalant hydrochloride (NIF) is a class III antiarrhythmic agent that prolongs the refractory period of the atrial and ventricular myocardium without any negative inotropic action. From July 2003 to September 2004, we treated 11 patients with NIF for perioperative arrhythmias (VT 5, VF 2, and AFL 4). NIF was administered by continuous intravenous infusion (0.3 to 0.4 mg/ kg/h) to prevent the recurrence of VT/VF and AFL. NIF prevented the recurrence of VT in 3 of the 5 cases. No recurrence was observed in 2 cases with VF. Furthermore, NIF prevented the recurrence of AFL in all the 4 patients. None of the patients exhibited changes in heart rate, cardiac output, and QTc interval. Additionally, no occurrence of Torsades de pointes was observed in any of the cases. In conclusion, NIF is an effective and safe antiarrhythmic agent for the treatment of perioperative arrhythmias under continuous monitoring of the QTc interval.

[Blunt right atrial rupture]

Atrial rupture without other major injury following blunt chest trauma is rare, but carries high mortality rate. Here we report 3 cases of blunt atrial rupture. All patients presented with hypotension and loss of consciousness. Echocardiography and computed tomography (CT) demonstrated pericardial effusion in all cases. All patients underwent surgery with a median sternotomy. Tear of the right atrium was seen in 2 patients, and no remarkable tear was seen in 1 patient. One of the 3 patients underwent surgery using cardiopulmonary bypass because he showed cardiogenic shock. Pericardiocentesis before the operation was not effective. All patients were discharged uneventfully. Echocardiography and CT were useful for diagnosis of cardiac rupture. In most reported cases, the cardiac tear has been repaired without using cardiopulmonary bypass. However, it is difficult to diagnose location of the tear, therefore, the repair became safer using cardiopulmonary bypass for the patients with cardiogenic shock. This article has described the mechanisms and generation of blunt chest trauma lesions.