Trigger digits in diabetes: their incidence and characteristics

The purpose of this study was to investigate the incidence and characteristics of trigger digits in patients with diabetes. A questionnaire about trigger digit was completed by 544 patients with diabetes. Ten percent of the patients had a history of trigger digits and 4% had multiple digit involvement. The risk was significantly higher in insulin-dependent patients. The average duration of diabetes was significantly longer in the multiple digit group. Independently, the medical records of 132 trigger digit patients who underwent surgery were reviewed. Twenty-seven patients had diabetes, and 62 patients had multiple digit involvement. Involvement of more than three digits was significantly related to co-existing diabetes. In patients with diabetes, the incidence of trigger digits was about four times higher than in the general population. Screening for diabetes may be warranted in patients with involvement of more than three digits.

A cubic-anvil high-pressure device for pulsed neutron powder diffraction

A compact cubic-anvil high-pressure device was developed for in situ neutron powder diffraction studies. In this device, a cubic shaped pressure medium is compressed by six anvils, and neutron beams pass through gaps between the anvils. The first high-pressure experiment using this device was conducted at J-PARC and clearly showed the neutron diffraction patterns of Pb. Combining the cubic-anvil high-pressure device with a pulsed neutron source will prove to be a useful tool for neutron diffraction experiments.

The fixed herbal drug composition "Saikokaryukotsuboreito" prevents bone loss with an association of serum IL-6 reductions in ovariectomized mice model

PURPOSE

Saikokaryukotsuboreito (SRB) is a traditional Japanese herbal medicine that has been used to treat hyperlipidemia. As some studies have shown that lipid-lowering drugs reduce osteoporosis, we investigated the effect of SRB on bone metabolism in the postmenopausal period using an ovariectomized (OVX) murine model.

MATERIAL AND METHODS

Fifteen aged 9 weeks female mice were divided into three groups (n=5 each). The OVX group and SRB group underwent bilateral ovariectomy, after which the OVX group was fed a normal diet and the SRB group fed a normal diet containing 2% SRB. The sham group underwent sham surgery and was then fed a normal diet. Eight weeks after surgery, all mice were sacrificed, and bone volume, bone histomorphometric parameters, and bone-associated phenotype were compared among the groups.

RESULTS

Compared with the OVX group, the SRB group showed suppression of bone volume loss at the tibia (SRB group: 12.7+/-0.7%, OVX group: 9.8+/-0.4%; p=0.005, ANOVA) and lumbar spine (SRB group: 15.1+/-0.9%, OVX group: 11.3+/-0.1%; p=0.031, ANOVA). A significant decrease in eroded surface was also observed in SRB-treated ovariectomized mice compared with the OVX group (p=0.022, ANOVA). We also found that serum levels of interleukin (IL)-6, a primary mediator of bone resorption, in the SRB group were significantly lower than in the OVX group (SRB: 52.5+/-6.8pg/ml; OVX: 138.0+/-23.1pg/ml; p=0.011, ANOVA). However, unexpectedly, SRB did not affect estradiol and total cholesterol in ovariectomized mice.

CONCLUSION

SRB can prevent loss of bone volume and suppress serum IL-6 levels in this postmenopausal model and is a promising candidate for treatment of postmenopausal osteoporosis.

Laser ion source: a direct plasma injection scheme for two-beam type interdigital-H radio frequency quadrupole linac

We developed a laser ion source using a direct plasma injection scheme (DPIS) as an injection system for a two-beam type radio frequency quadrupole (RFQ) linac with an interdigital-H (IH) type cavity. The laser ion source in the DPIS is directly connected to the RFQ cavity without the low energy beam transport system. We achieved a high current C(2+) beam above 60 mA per beam channel from the ion source. The beam will be injected to the two-beam type IH-RFQ linac, and the linac will generate a beam current of approximately 44 mA per beam channel.

Particle simulation for direct plasma injection in a radio frequency quadrupole matching section

We have been investigating direct plasma injection scheme (DPIS) for high-intensity heavy-ion beam acceleration. In the DPIS, laser-produced plasma is directly injected into a radio frequency quadrupole (RFQ) linac. To study the beam dynamics of the ion injection in the DPIS, we tracked particle motions in the RFQ matching section using three-dimensional particle-in-cell method. As a result of the numerical simulation, we found that the electrostatic field generated by the extraction electrode reduces the transmission efficiency. To avoid the radially defocusing force, the input beam into the RFQ has to be initially convergent. In the DPIS, further optimization of the plasma density is required for better matching.

Therapy for nifedipine-induced gingival overgrowth by Saireito in rats

Objective

A calcium antagonist, nifedipine, causes gingival overgrowth as a side effect. It has been confirmed that the Japanese traditional medicine, Saireito, inhibits the nifedipine-induced proliferation of gingival fibroblasts in vitro. We performed an in vivo experiment to determine whether Saireito has a therapeutic use in the treatment of nifedipine-induced gingival overgrowth.

Methods

The rats had significant gingival overgrowth induced by the administration of nifedipine. The space between the submandibular incisors and the width of buccal gingiva of maxillary left first molar were macroscopically measured. The buccal gingiva was microscopically examined.

Results

Eight weeks after Saireito was administrated together with nifedipine, Saireito decreased both the incisor space and the gingiva width which had been enlarged by nifedipine and furthermore, the area of connective tissue of nifedipine + Saireito group was significantly smaller than that of nifedipine alone.

Conclusion

In conclusion, Saireito may be clinically effective in therapy for calcium antagonist-induced gingival overgrowth.

Macrolide antibiotics like azithromycin increase lipopolysaccharide-induced IL-8 production by human gingival fibroblasts

Objective

Macrolide antibiotics are reported to modulate the production of cytokines in various type of cells. We examined the effect of macrolide antibiotics on inflammatory cytokines (IL-6 and IL-8) and chemical mediator (PGE₂) and also matrix metalloproteinases (MMPs) productions by human gingival fibroblasts (HGFs) treated with lipopolysaccharide (LPS).

Methods

The effect of macrolide antibiotics [erythromycin (EM), azithromycin (AZM) and josamycin (JOM)] on HGFs proliferation were examined by MTT assay. HGFs were treated with LPS from Porphyromonas gingivalis (PgLPS) and macrolide antibiotics, and IL-6, IL-8 and PGE₂ levels were evaluated by ELISA. MMPs were detected by gelatin zymography.

Results

AZM slightly but significantly decreased HGFs proliferation, while EM and JOM did not affected. AZM increased PgLPS-induced IL-8 production dose-dependently, while AZM did not alter IL-6 and PGE₂ productions. EM and JOM did not altered PgLPS-induced IL-6, IL-8 and PGE₂ productions. All macrolide antibiotics did not alter MMPs production. These results indicate that macrolide antibiotics have no direct anti-inflammatory effect. However, the use of the inhibitors of cell signaling pathway failed to reveal the mechanism that AZM enhanced PgLPS-induced IL-8 production.

Conclusion

These results suggest macrolide antibiotics have an indirect anti-inflammatory effect as a result of their antimicrobial properties. Because AZM increased LPS-induced IL-8 production by HGFs, the possibility is considered that neutrophils may be migrated to periodontal tissue and phagocytize the periodontopathic bacteria more efficiently.

Reduced perfusion in the anterior cingulate cortex of patients with pure autonomic failure: an 123I-IMP SPECT study

BACKGROUND

Pure autonomic failure (PAF) is a selective peripheral disorder in which Lewy bodies form within the autonomic ganglia. Patients with this disorder usually have no central lesions; however, chronic autonomic failure may secondarily affect the central nervous system. This study evaluated brain perfusion in patients with PAF by using N-isopropyl-p-(123)I iodoamphetamine ((123)I-IMP) single photon emission computed tomography (SPECT).

METHODS

Six patients with PAF (all men; mean (SD) age 68+/-5 years) who had experienced autonomic symptoms for more than 5 years and six age-matched healthy control subjects (all men; mean (SD) age 67+/-5 years) were included in this study. The regions of interest (ROI) on spacially normalized (123)I-IMP SPECT images were automatically computed for both groups.

RESULTS

Perfusion of the dorsal anterior cingulate cortex was decreased in the PAF group compared with the healthy control group (0.93 vs 1.01; p<0.001). In the other brain regions measured, there was no significant difference in regional perfusion between the two groups.

CONCLUSIONS

The dorsal anterior cingulate cortex is poorly perfused and may be functionally altered in patients with PAF. The reduced perfusion in such individuals may be a secondary change that results from chronic autonomic failure.

Sudomotor, skin vasomotor, and cardiovascular reflexes in 3 clinical forms of Lewy body disease

OBJECTIVE

To elucidate the differences among dementia with Lewy bodies (DLB), Parkinson disease with dementia (PDD), and Parkinson disease without dementia (PD), with respect to the involvement of the autonomic nervous system, we clinically investigated the cutaneous and cardiovascular autonomic functions in patients with Lewy body disease.

METHODS

We studied 36 patients with Lewy body disorders, including 12 patients with DLB (age, 75.4 +/- 5.9 years), 12 patients with PDD (71.0 +/- 6.8 years), and 12 patients with PD (70.9 +/- 4.2 years), and 12 healthy control subjects (69.9 +/- 5.3 years). Sympathetic sweat response (SSwR) and skin vasomotor reflex (SkVR) on the palm were recorded to estimate the cutaneous sympathetic function, and the head-up tilt test was performed and coefficient of variation of R-R intervals (CV(R-R)) was studied to estimate the cardiovascular function.

RESULTS

The patients with DLB, patients with PDD, and patients with PD showed severely reduced SSwR amplitudes, significantly lower than that in the controls. The mean SkVR amplitudes in the patients with DLB and patients with PDD were significantly lower than that in the controls, but not in the patients with PD. The mean decreases in the systolic blood pressure during the head-up tilt test in the patients with DLB and patients with PDD were less than that in the controls. The mean CV(R-R) value was significantly lower in the patients with DLB.

CONCLUSION

Sudomotor function on the palm may be severely affected in Lewy body disorders, while skin vasomotor function and the cardiovascular system may be more severely affected in dementia with Lewy bodies and Parkinson disease with dementia than in Parkinson disease.

Hyperthermia ameliorates 2,4,6-trinitrobenzene sulphonic acid-induced colitis in rats: The role of heat shock proteins

PURPOSE

Hyperthermia is known to protect against cellular injury through the expression of heat shock proteins. In this study, the therapeutic effects of hyperthermia on experimental colitis in the rat were evaluated.

MATERIALS AND METHODS

Male Wistar rats were given a single intracolonic injection of 2,4,6-trinitrobenzene sulphonic acid (TNBS). Hyperthermia was induced in anesthetized rats by placing them in a temperature-controlled water bath. We started the hyperthermic treatment on the day after the enema. The severity of colitis was evaluated pathologically, and the activities of tissue myeloperoxidase were measured 6 days after the induction of colitis. Furthermore, cytokines, and hyperthermia-induced heat shock proteins in colonic mucosa were detected by enzyme-linked immunosorbent assay and Western blotting. We also investigated the effects of geranylgeranylacetone and zinc protoporphyrin IX on the therapeutic effect of hyperthermia.

RESULTS

Hyperthermia significantly improved the macroscopic scores of colitis. The TNBS-induced increases in the activities of myeloperoxidase in the colonic tissue were blunted significantly in hyperthermia-treated animals. Furthermore, hyperthermia attenuated increases in cytokine-induced neutrophil chemoattractants-1 and tumor necrosis factor-alpha in the colon. Furthermore, hyperthermia induced the production of heat shock proteins in rat colonic mucosa, and the combination of geranylgeranylacetone with hyperthermia further induced the heat shock protein HSP70, which resulted in further improvement of TNBS-induced colitis. On the other hand, the combination of zinc protoporphyrin IX with hyperthermia attenuated the therapeutic effect of hyperthermia.

CONCLUSIONS

Hyperthermia ameliorates TNBS-induced colitis in rats through the expression of HSP70 and HO-1. It is postulated that hyperthermia may be useful for the treatment of inflammatory bowel diseases.

The effects of cigarette exposure on rat salivary proteins and salivary glands

OBJECTIVE

Passive smoking is the involuntary inhalation of cigarette smoke (CS) and has an adverse impact on oral health. We examined the effect of CS exposure on saliva and salivary glands (SGs).

METHODS

Cigarette smoke-exposed rats were intermittently housed in an animal chamber with whole-body exposure to CS until killed. Whole saliva was collected before CS exposure (0 day), and 15 and 30 days after the start of CS exposure. Saliva secretion was stimulated by administration of isoproterenol and pilocarpine after anesthesia. SGs were collected on 31 days.

RESULTS

The increase in body weight of the CS-exposed rats was less than that of the control rats. Salivary flow rates did not differ at 0, 15 or 30 days after the start of CS exposure. However, the amylase and peroxidase activities and total protein content in the saliva were significantly lower in 15-day CS-exposed rats than in 15-day control rats. Histological examination of the SGs of CS-exposed rats showed vacuolar degeneration, vasodilation and hyperemia.

CONCLUSION

These results suggest that CS exposure has adverse impacts on salivary composition and SGs, which could aggravate the oral environment.

Mapping of brain acetylcholinesterase alterations in Lewy body disease by PET

OBJECTIVE

To characterize brain cholinergic deficits in Parkinson disease (PD), PD with dementia (PDD), and dementia with Lewy bodies (DLB).

METHODS

Participants included 18 patients with PD, 21 patients with PDD/DLB, and 26 healthy controls. The PD group consisted of nine patients with early PD, each with a disease duration of less than 3 years, five of whom were de novo PD patients, and nine patients with advanced PD, each with a disease duration greater than or equal to 3 years. The PDD/DLB group consisted of 10 patients with PDD and 11 patients with DLB. All subjects underwent PET scans with N-[11C]-methyl-4-piperidyl acetate to measure brain acetylcholinesterase (AChE) activity. Brain AChE activity levels were estimated voxel-by-voxel in a three-compartment analysis using the arterial input function, and compared among our subject groups through both voxel-based analysis using the statistical parametric mapping software SPM5 and volume-of-interest analysis.

RESULTS

Among patients with PD, AChE activity was significantly decreased in the cerebral cortex and especially in the medial occipital cortex (% reduction compared with the normal mean = -12%) (false discovery rate-corrected p value <0.01). Patients with PDD/DLB, however, had even lower AChE activity in the cerebral cortex (% reduction = -27%) (p < 0.01). There was no significant difference between early PD and advanced PD groups or between DLB and PDD groups in the amount by which regional AChE activity in the brain was reduced.

CONCLUSIONS

Brain cholinergic dysfunction occurs in the cerebral cortex, especially in the medial occipital cortex. It begins in early Parkinson disease, and is more widespread and profound in both Parkinson disease with dementia and dementia with Lewy bodies.

Fbw7 promotes ubiquitin-dependent degradation of c-Myb: involvement of GSK3-mediated phosphorylation of Thr-572 in mouse c-Myb

Expression of oncoprotein c-Myb oscillates during hematopoiesis and hematological malignancies. Its quantity is not only regulated through transcriptional control but also through the ubiquitin-proteasome pathway, accompanied by phosphorylation, although the mechanisms are poorly understood. In this report, we tried to identify an E3 ubiquitin ligase, which targets c-Myb for ubiquitin-dependent degradation. We found that an F-box protein, Fbw7, interacted with c-Myb, which is mutated in numerous cancers. Fbw7 facilitated ubiquitylation and degradation of c-Myb in intact cells. Moreover, depletion of Fbw7 by RNA interference delayed turnover and increased the abundance of c-Myb in myeloid leukemia cells concomitantly, and suppressed the transcriptional level of gamma-globin, which receives transcriptional repression from c-Myb. In addition, we analysed sites required for both ubiquitylation and degradation of c-Myb. We found that Thr-572 is critical for Fbw7-mediated ubiquitylation in mouse c-Myb using site-directed mutagenesis. Fbw7 recognized the phosphorylation of Thr-572, which was mediated by glycogen synthase kinase 3 (GSK3). In consequence, the c-Myb protein was markedly stabilized by the substitution of Thr-572 to Ala. These observations suggest that SCF(Fbw7) ubiquitin ligase regulates phosphorylation-dependent degradation of c-Myb protein.

Investment in home-based maternal, newborn and child health records improves immunization coverage in Indonesia

Indonesia Demographic and Health Surveys show that the ownership of home-based immunization records among children aged 12-23 months increased from 30.8% in 1997 and 30.7% in 2002-3 to 37% in 2007. In 2002-3, 70.9% of children who owned records had received all vaccines by the time of the survey, whereas 42.9% of children who did not own records had been fully immunized. An Indonesian ministerial decree of 2004 stated that the Maternal and Child Health Handbook (MCH handbook) was to be the only home-based record of maternal, newborn and child health. The increased immunization coverage seen would be a reflection of MCH handbook implementation, through raising awareness of immunization among community and health personnel and children's parents or guardians and allowing more accurate measurement of immunization coverage.

An animal model of intrinsic dental erosion caused by gastro-oesophageal reflux disease

OBJECTIVES

To explore the association between dental erosion and gastro-oesophageal reflux disease (GORD), we used an animal model of GORD.

MATERIALS AND METHODS

We performed an operation to force gastro-duodenal contents reflux in male Wistar rats, and examined the teeth in the reflux rats at 15 or 30 weeks postoperatively. Dental erosion was evaluated based on a slightly modified index from a previous report. Estimation of pH was employed in the oesophageal and gastric contents.

RESULTS

Macroscopically, dental erosion was only detected in the reflux rats. Histopathologically, dentin exposure was detected in three of the seven cases after 30 weeks. Alveolar bone destruction and osteomyelitis were also noted in severe cases. The pH of the oesophageal and stomach contents was 6.93 +/- 0.15 and 3.7 +/- 0.39, respectively.

CONCLUSIONS

We confirmed the relationship between dental erosion and GORD. First step of dental erosion caused by GORD is the loss of surface enamel induced by regurgitation of an acidic liquid and acidic gas. Subsequently, further destruction of dental hard tissues and tooth supporting structure is accelerated by mixed juice with gastric and duodenal contents. The reflux animal model is a useful tool to examine the mechanism of dental erosion in GORD.

Intratumoural heterogeneity of intestinal expression reflects environmental induction and progression-related loss of induction in undifferentiated-type gastric carcinomas

AIMS

Gene expression in tumours is regulated by environmental as well as genetic/epigenetic factors. This study assessed the environmental factors in intestinal expression of gastric cancers.

METHODS AND RESULTS

We immunohistochemically examined intratumoural heterogeneity in the expression of Cdx2, MUC2, MUC5AC and MUC6 in 39 intramucosal and 49 extramucosally invasive undifferentiated-type gastric carcinomas (UGCs), consisting of signet ring cell carcinomas showing a layered structure (LS) in the mucosa and dedifferentiated tubular adenocarcinomas without LS and with minor tubular components (TC). The LS retains mucosal vertical polarity with superficial MUC5AC expression. Loss of this polarity was independent of intestinal expression and associated with extramucosal invasion. In LS(+) UGCs, intestinal expression was enhanced as the size of mucosal spread increased and was significantly reduced with deeper extramucosal invasion, whereas, in LS(-)/TC(+) UGCs, intestinal expression was frequent and predominant in the mucosa and was insignificantly reduced with deeper extramucosal invasion.

CONCLUSIONS

In LS(+) UGCs, intestinal expression showed dynamic alteration probably by environmental induction and progression-related loss of induction, whereas it was relatively stable in LS(-)/TC(+) UGCs. Thus, intestinal expression in UGCs is not useful as a marker of tumour progression because it is also affected by environmental factors and genetic lineage.

Putaminal hyperintensity on T1-weighted MR imaging in patients with the Parkinson variant of multiple system atrophy

BACKGROUND AND PURPOSE

A hyperintense putaminal rim, putaminal hypointensity, and putaminal atrophy on T2-weighted MR images are findings suggestive of parkinsonian-dominant multiple system atrophy (MSA-P). However, putaminal hyperintensity on T1-weighted images, which has not been discussed in previous reports, is also frequently observed in patients with MSA-P. Here, we investigated whether putaminal hyperintensity on T1-weighted images is helpful to diagnose MSA-P.

MATERIALS AND METHODS

Patients with MSA-P (n = 17), Parkinson disease (PD; n = 37) and progressive supranuclear palsy (PSP; n = 11), and healthy control subjects (n = 16) were enrolled in this study. Two examiners, who were blind to the diagnoses, independently rated the putaminal hyperintensity on T1-weighted images (T1H), hyperintense putaminal rim on T2-weighted images (T2H), putaminal hypointensity on T2-weighted images (T2 L), and putaminal atrophy by using a visual analog scale, and performed a receiver operating characteristic (ROC) analysis. The area under the curve (AUC; minimum, 0.5; maximum, 1.0) was automatically calculated as a positive parameter, indicating its usefulness to differentiate between diseases.

RESULTS

For differentiating patients with MSA-P from healthy control subjects, AUC values were 0.983 for T1H, 0.923 for T2H, 0.726 for T2 L, and 0.967 for putaminal atrophy. Between MSA-P and PD, the respective AUC values were 0.990, 0.921, 0.739, and 0.923; and between MSA-P and PSP, the respective AUC values were 0.984, 0.923, 0.727, and 0.967.

CONCLUSIONS

All putaminal findings except T2 L were useful for the diagnosis of MSA-P. T1H was superior to T2H to differentiate MSA-P from other diseases.

Secondary bronchiolitis obliterans organising pneumonia in a patient with carbamazepine-induced hypogammaglobulinaemia

Here we describe a case of a secondary bronchiolitis obliterans organizing pneumonia (BOOP), which was associated with repeated respiratory infections caused by carbamazepine (CBZ)- induced hypogammaglobulinaemia. A 49-year-old woman had been treated with CBZ (400 mg/day). Two and a half years later, she developed of dyspnea with productive cough and high-grade fever. Chest roentgenogram and computed tomography showed bilateral infiltrates in lower lung fields. Her laboratory findings revealed severe hypogammaglobulinaemia, suggesting that an immune system disorder caused pulmonary infection. Histological examination by trans-bronchial lung biopsy (TBLB) demonstrated that many foamed alveolar macrophages were obstructing the alveolar ducts and adjacent alveoli, suggesting BOOP. After cessation of CBZ, the hypogammaglobulinaemia and chest roentgenogram findings markedly improved. The present case suggests that CBZ may have some adverse effects on the immune system and cause frequent airway infections, and that secondary BOOP could be induced by repeated infections caused by CBZ-induced hypogammaglobulinaemia.

Needle-shaped deposits on retinal surface in a case of ocular amyloidosis

PURPOSE

To report a case in which optical coherence tomography (OCT) showed needle-shaped deposits on the retinal surface oriented toward the vitreous cavity and immunohistochemical findings suggested light chain-related amyloidosis.

METHODS

A 59-year-old man with no systemic complications had bilateral neovascular glaucoma and vitreous opacities in the right eye. Vitrectomy was conducted on the right eye and the excised vitreous was examined histopathologically.

RESULTS

Glass wool-like opacities were observed during vitrectomy. Postoperative fundus examination of the right eye showed retinal hemorrhage and white deposits around blood vessels and on retinal surface. Fluorescein angiography revealed hyperfluorescence of the optic disc, non-perfusion areas, and vascular focal staining. OCT depicted needle-shaped deposits perpendicular to the retinal surface oriented toward the vitreous. Histologic examination of deposits revealed positive reaction for Congo red stain, and immunohistochemical examination demonstrated positive reactivities for anti-lambda and anti-kappa light chains (precursors of amyloid protein), suggesting a diagnosis of light chain-related amyloidosis.

CONCLUSIONS

In this case, OCT showed needle-shaped deposits perpendicular to the retinal surface. Special staining with Congo red revealed the deposit to be amyloid deposition. Immunohistochemical staining suggested light chain-related amyloidosis. Vascular obstructive lesions and neovascular glaucoma secondary to retinal vascular damage in amyloidosis warrant particular attention.