Cationic liposome-mediated efficient induction of type I interferons by a low dose of poly I:poly C in mouse cell lines

Double-stranded polyriboinosinic acid:polyribocytidylic acid (poly I:poly C) is a powerful inducer of type I interferons (IFNs). However, the dose of poly I:poly C required for efficient IFN induction is so high as occasionally to be cytotoxic. In this work, we examined the IFN-inducibility of poly I:poly C complexed with several cationic reagents in mouse fibroblast L cells and found that Lipofectin and LipofectACE can induce the production of a substantial amount of type I IFNs (mostly beta-type) even at a two-order lower dose compared with poly I:poly C alone. Such effects of poly I:poly C were optimal at 0.1 microgram/ml for 2-10 microgram/ml of Lipofectin and LipofectACE. These conditions caused no significant cytotoxicity in the recipient cells. Furthermore, a short treatment (less than 10 min) with the complexes was sufficient for the maximum induction. This IFN induction method was applicable to other cell types and other species including human. Hence, our observations may pave the way for clinical application of the IFN inducer.

Targeted delivery of plasmid DNA to hepatocytes in vivo: optimization of the pharmacokinetics of plasmid DNA/galactosylated poly(L-lysine) complexes by controlling their physicochemical properties

In vivo receptor-mediated targeting of plasmid DNA to hepatocytes was achieved through optimizing the physicochemical and pharmacokinetic properties of a plasmid DNA/carrier complex. Galactosylated poly(L-lysine) (Gal-PLL) was synthesized using PLL with a molecular weight of 1,800, 13,000 or 29,000 without loss of the cationic charge. Plasmid DNA encoding chloramphenicol acetyltransferase was complexed with each Gal-PLL. A larger amount of PLL1800 is required for the complex formation than with PLL13000 and PLL29000, and increasing the number of galactose units on Gal-PLL resulted in reduced binding to plasmid DNA. The particle size and zeta-potential of the complexes varied depending on the mixing ratio and Gal-PLL used. Then, plasmid DNA/Gal-PLL complexes having diameters of 200 nm or less and a weak negative charge were prepared. After i.v. injection of [32P]plasmid DNA/Gal13-PLL13000 and [32P]plasmid DNA/Gal26-PLL29000, almost 80% of the radioactivity rapidly accumulated in the liver, preferentially in the parenchymal cells. The hepatic uptake clearances (CLliver) were much greater than any of the other tissue uptake clearances. Compared with these complexes, [32P]plasmid DNA/Gal5-PLL1800 and [32P]plasmid DNA/Gal5-PLL13000 had a smaller CLliver, suggesting that both the molecular weight of PLL and the degree of galactose modification determine the hepatic targeting of plasmid DNA. In vitro and in vivo gene expression studies revealed that plasmid DNA/Gal13-PLL13000 and plasmid DNA/Gal26-PLL29000 complexes are superior to plasmid DNA/Gal5-PLL1800 complex for introducing DNA into cells. These results demonstrated that an optimal design of a DNA/carrier complex based on physicochemical properties and a pharmacokinetic analysis of the distribution properties leads to successful in vivo gene delivery.

Subtalar arthrography in acute injuries of the calcaneofibular ligament

We treated 43 acute tears of the calcaneofibular ligament by operation in 43 patients after subtalar arthrography. There were 22 men and 21 women with a mean age of 22.3 years (14 to 61). Anteroposterior (AP), lateral and oblique views were obtained with the foot in 45° of internal rotation and the ankle in the neutral position. Any communication or leakage to the ankle, tendon sheaths, subcutaneous tissue and sinus tarsi was recorded. We examined an oblique view of the microrecess along the interosseous ligament and an AP view of the lateral recess just under the distal end of the fibula. We also studied a control group of 27 patients with isolated injuries of the anterior talofibular ligament without rupture of the calcaneofibular ligament.

The findings in the two groups were significantly different when examined for leakage to the ankle (p = 0.0002), to the peroneal tendon sheaths (p = 0.0347) and to the subcutaneous tissue (p = 0.0222), absence of the microrecess (p = 0.0055) and presence of the lateral recess (p = 0.0012).

Many ankle sprains which involve tearing of the calcaneofibular ligament are accompanied by injuries of the subtalar joint. Combined injuries of the anterior talofibular ligament and calcaneofibular ligament, and isolated injury of the anterior talofibular ligament should be differentiated.

Subtalar arthrography in acute injuries of the calcaneofibular ligament

We treated 43 acute tears of the calcaneofibular ligament by operation in 43 patients after subtalar arthrography. There were 22 men and 21 women with a mean age of 22.3 years (14 to 61). Anteroposterior (AP), lateral and oblique views were obtained with the foot in 45 degrees of internal rotation and the ankle in the neutral position. Any communication or leakage to the ankle, tendon sheaths, subcutaneous tissue and sinus tarsi was recorded. We examined an oblique view of the microrecess along the interosseous ligament and an AP view of the lateral recess just under the distal end of the fibula. We also studied a control group of 27 patients with isolated injuries of the anterior talofibular ligament without rupture of the calcaneofibular ligament. The findings in the two groups were significantly different when examined for leakage to the ankle (p=0.0002), to the peroneal tendon sheaths (p=0.0347) and to the subcutaneous tissue (p=0.0222), absence of the microrecess (p=0.0055) and presence of the lateral recess (p=0.0012). Many ankle sprains which involve tearing of the calcaneofibular ligament are accompanied by injuries of the subtalar joint. Combined injuries of the anterior talofibular ligament and calcaneofibular ligament, and isolated injury of the anterior talofibular ligament should be differentiated.

Biological effects and cellular uptake of c-myc antisense oligonucleotides and their cationic liposome complexes

The biological effects and cellular uptake of human c-myc antisense oligonucleotides and their liposome complexes were investigated in vitro using human promonocytic leukemia U937 cells. Antisense phosphorothioate oligonucleotides (S-Oligo) significantly inhibited the growth of U937 cells in a dose-dependent manner. However, no significant effect on cell proliferation was observed with unmodified phosphodiester (P-Oligo) and partially phosphorothioated (PS3-Oligo) oligonucleotides with an antisense sequence and S-Oligo with sense and G-quartet control sequences. In cellular uptake experiments, radiolabeled S-Oligo was taken up by U937 cells more than P-Oligo and PS3-Oligo. Similar results were obtained in mouse peritoneal macrophages used for comparison. Confocal microscopic studies demonstrated a significant distribution of FITC-labeled oligonucleotides on the cell surface and in the cytoplasm in a punctate pattern, but not in the nucleus. When complexed with cationic liposomes, cellular uptake of FITC-labeled P-Oligo or S-Oligo was significantly increased and the fluorescence was located mainly in the nucleus, indicating that the uptake and intracellular pharmacokinetics of both oligonucleotides can be modified by complexation. An inhibitory effect of the complexes was observed at a dose which is ineffective in the case of the oligonucleotides alone. However, this effect was also associated with cytotoxicity of the cationic liposomes, suggesting that optimization of this formulation will be necessary to achieve a more efficient delivery of the oligonucleotides to U937 cells.

Histopathological study of nonosseous tarsal coalition

Histopathological analysis was performed on 55 feet in 48 patients with nonosseous tarsal coalitions. Histological findings were similar to those observed at the tendinous attachment site of Osgood-Schlatter disease, accessory navicular, and bipartite patellae. No nerve elements were observed in the fibrocartilaginous tissue at the coalition. Nerve elements were present only in periosteum and articular capsule surrounding the coalition. Pain in the tarsal coalition is not mediated by nerve elements at the coalition site itself. It is assumed that the pain is caused by mechanical abnormality that results from incomplete coalition. Incomplete coalition produces microfractures and remodelings on the boundaries between bone and the coalition, which then lead to degenerative changes. This mechanical abnormality seems to induce pain via free nerve endings in the periosteum and in the articular capsule surrounding the coalition.

Control of plasma cholesterol-lowering action of probucol with various lipid carrier systems

In order to explore the relationship between the pharmacokinetic properties and pharmacological actions of lipophilic drugs injected with lipid carrier systems, probucol was selected as a model drug with high lipophilicity, and the effect of disposition control on cholesterol-lowering activities was evaluated. Both large emulsion, with mean diameter of 280 nm, and long-circulating type small emulsion containing egg sphingomyelin with mean diameter of 100 nm, showed stable incorporation of probucol. The former produced rapid accumulation of probucol in the liver, while the latter demonstrated prolonged systemic circulation and gradual hepatic uptake. On the other hand, injection of a micellar solution with HCO-60 (polyoxyethylene hydrogenated castor oil) showed a rapid decrease in plasma concentration and a high hepatic uptake of probucol, similar to injections with serum, suggesting the rapid release of the drug from the micelles. However, probucol in a micellar solution showed higher cholesterol-lowering action than that in emulsion formulations. These results suggested that the pharmacological action of probucol in the liver might be affected by the uptake mode and sequential disposition in the organ, depending on the drug retention properties of the lipid carrier particles.

Targeted delivery of plasmid DNA complexed with galactosylated poly(L-lysine)

Galactose was introduced to poly(L-lysine) (PLL) with an average molecular weight of 13,000 to develop a hepatocyte-specific carrier for gene drugs. The pharmacokinetic characteristics of a model plasmid, pCAT (plasmid DNA encoding chloramphenicol acetyltransferase reporter gene), complexed with galactosylated PLL (Gal-PLL) was studied in mice in relation to its physicochemical properties. pCAT/Gal-PLL complex at a ratio of 1:0.6 (w/w) has a zeta potential of -20 mV and a mean particle size of about 180 nm. After intravenous injection, [32P]pCAT/Gal-PLL was rapidly eliminated from the circulation and preferentially taken up by the liver's parenchymal cells. The hepatic uptake of [32P]pCAT/Gal-PLL was significantly inhibited by prior administration of Gal-bovine serum albumin, suggesting that the uptake was mediated by the asialoglycoprotein receptors on hepatocytes. In vitro transfection experiments using a hepatoma cell line expressing the asialoglycoprotein receptor revealed that pCAT/Gal-PLL gave a high CAT gene expression whereas pCAT complexed with unmodified PLL failed to transfect the cells.

Involvement of specific mechanism in plasmid DNA uptake by mouse peritoneal macrophages

The binding and uptake of plasmid DNA encoding luciferase reporter gene (pCMV-Luc) were studied in vitro using cultured mouse peritoneal macrophages. A significant and time-dependent cellular association of [32P]pCMV-Luc with resident macrophages was observed at 37 degrees C and this decreased at 4 degrees C. The binding at 4 degrees C was saturable and a Scatchard plot gave a maximum binding capacity of 0.81 microgram/mg-protein and a dissociation constant of 0.30 microgram/ml. The binding of [32P]-pCMV-Luc was inhibited by polyinosinic acid, dextran sulfate and salmon sperm DNA, but not by polycytidylic acid, dextran and EDTA. A confocal microscopic study demonstrated that fluorescein-labeled pCMV-Luc was internalized at 37 degrees C while only cell surface binding occurred at 4 degrees C. No significant luciferase gene expression was obtained after incubation with a high concentration (100 micrograms/ml) of pCMV-Luc. These data suggest that plasmid DNA is taken up by macrophages via a mechanism mediated by a receptor like the macrophage scavenger receptor.

Uptake and gene expression of naked plasmid DNA in cultured brain microvessel endothelial cells

Cellular uptake and gene expression of plasmid DNA and its cationic liposome complexes were studied using primary cultures of bovine brain microvessel endothelial cells (BMEC) developed as an in vitro model of the blood-brain barrier. An avid association of naked plasmid DNA with the BMEC monolayer was observed at 37 degreesC, which is comparable to that of the DNA/liposome complex. The cellular association significantly decreased at low temperature (4 degreesC). The binding at 4 degreesC was saturable and significantly inhibited by polyanions involving polyinosinic acid and dextran sulfate, typical ligands for the macrophage scavenger receptors, but not by polycytidylic acid or in the presence of EDTA. Unexpectedly, a significant gene expression in the BMEC was obtained by transfection with naked plasmid DNA although the expression level was lower than that obtained by plasmid DNA/cationic liposome complex. Taken together, cultured capillary endothelial cells derived from the brain are able to take up naked plasmid DNA via a scavenger receptor like-mediated mechanism for polyanions and gene expression in the cells takes place.

Pharmacokinetic characteristics and therapeutic effects of mitomycin C-dextran conjugates after intratumoural injection

The pharmacokinetics and therapeutic effects of macromolecular prodrugs of mitomycin C (MMC), MMC-dextran conjugates (MMC-D) were studied after intratumoural injection in rats bearing Walker 256 carcinosarcoma. As the first step, the intratumoural disposition characteristics of these drugs were delineated in perfusion experiments employing a tissue-isolated tumour preparation. While MMC immediately disappeared from the tumour preparation following direct intratumoural injection, cationic and anionic MMC-D were retained in the tumour longer, demonstrating that the intratumoural clearance of MMC can be greatly retarded by dextran conjugation. The effect was more pronounced in the case of the cationic conjugate. Venous outflow data in the perfusion experiments were analyzed based on a compartment model in which the tumour tissue was assumed to consist of two compartments, one well- and the other poorly-perfused. The pharmacokinetic analysis revealed that macromolecular conjugation reduced elimination of MMC from the poorly-perfused region rather than well-perfused region. Simulation of conjugated and free MMC levels in the tissue using the calculated parameters clearly showed that intratumoural injection of MMC-D, especially the cationic form, can maintain a certain level of active free MMC in the tissue for a much longer time period. The long retention of cationic MMC-D in tumour after intratumoural injection was also confirmed by an in vivo pharmacokinetic study and whole body autoradiography in rats bearing subcutaneous Walker 256 carcinosarcoma. In addition, superior antitumour activity of cationic MMC-D was observed against subcutaneous tumours after intratumoural injection. Together with the finding that MMC is selectively toxic to hypoxic tumour cells at low concentrations, these pharmacokinetic studies strongly support the therapeutic efficacy of the macromolecular prodrugs.

[Drug delivery systems in gene therapy]

The use of nonviral vectors is an attractive in vivo gene delivery strategy that is simpler and lacks some risks inherent in viral systems. Liposomes and receptor-mediated polycation systems are promising carriers for delivery and expression of plasmid DNA encoding genes into the target cells. Many barriers need to be overcome for successful in vivo DNA delivery using these carrier systems. Various factors such as the extent of DNA condensation, particle size of the DNA complex, route of administration, stability against nucleases, target sites, in vivo disposition, binding to cell surface receptor and internalization, intracellular trafficking affect the in vivo gene delivery and expression. This chapter will focus on the current status and perspectives of the plasmid DNA delivery systems for in vivo gene therapy.

Results of opening-wedge osteotomy for the treatment of a post-traumatic varus deformity of the ankle

We performed a one-stage opening-wedge valgus osteotomy in nine patients to correct a post-traumatic progressive varus deformity of the ankle. The osteotomy site was stabilized with two, three, or four Kirschner wires or with a plate and screws (in one patient). The site of the osteotomy united within two months after the operation in eight patients and at six months in one patient who was fifty-nine years old. The average duration of follow-up was seven years and four months (range, two years and four months to thirteen years and two months). Postoperatively, the range of motion of the ankle was decreased in six patients and remained unchanged in three. However, none of the patients reported any limitation in the activities of daily living, and the four adolescent patients were able to participate in sports activities. The result was graded as excellent for four ankles, good for two, and fair for three.

Cellular uptake properties of oligonucleotides in LLC-PK1 renal epithelial cells

The objective of this study was to clarify the renal uptake characteristics of oligonucleotides at a cellular level using LLC-PK1 renal epithelial cells derived from the proximal tubule. The association of [35S]-labeled 20-mer phosphodiester (PO) and phosphorothioate (PS) oligonucleotides with the monolayers of polarized LLC-PK1 cells cultured on polycarbonate filter was characterized after apical or basolateral application. The cellular association of PO and PS at both apical and basolateral membranes was time dependent and temperature dependent, and the apparent association amount of PS was larger than that of PO. The PO and PS association after apical application was saturable, with the apparent Km and Vmax values determined to be 5.4 microM and 0.14 nmol/mg protein for PO and 0.22 microM and 0.11 nmol/mg protein for PS, respectively. In contrast, almost linear kinetics were observed after basolateral application within a tested concentration range. The association was inhibited significantly by sodium azide and chloroquine, suggesting that an energy-dependent endocytotic process was involved. Internalization and subsequent transport to endosome and lysosome compartments of FITC-labeled oligonucleotides were shown by confocal laser scanning microscopy. The present study has demonstrated that both types of oligonucleotides are taken up by LLC-PK1 cells from both apical and basolateral surfaces probably via an endocytosis mechanism.

Pharmacokinetic analysis of hepatic uptake of galactosylated bovine serum albumin in a perfused rat liver

Hepatic uptake of 111In-labelled galactosylated bovine serum albumin (Gal-BSA) with different number of galactose residues per BSA were studied in rat liver perfusion experiments. During a single-pass constant infusion mode, [111In]Gal-BSAs (0.1-2.0 micrograms/ml) were continuously extracted by the liver and its extraction ratio at steady-state (Ess) was lowered as the inflow concentration increased. Hepatic clearance of [111In]Gal-BSAs increased significantly according to the increase in the number of galactose residues per BSA at an inflow concentration of 0.7 micrograms/ml. The outflow patterns of [111In]Gal-BSAs at various inflow concentrations were simultaneously fitted to a one-organ pharmacokinetic model, by which we can characterize their binding to the cell surface and internalization processes separately. The parameters obtained were varied significantly among [111In]Gal-BSAs depending on the number of galactose residues and indicate that not only the binding to the receptors but also the internalization after the binding are regulated by the number of galactose residues per BSA during hepatic uptake.

Tarsal tunnel syndrome caused by coalition associated with a ganglion

We examined seven patients with tarsal tunnel syndrome in one foot caused by talocalcaneal coalition and a ganglion. We excised the coalition and the ganglion in six of them. All the patients had pain, sensory disturbance in the sole, and a positive Tinel's sign. Older patients with a long history showed atrophy and weakness of the plantar muscles. Talocalcaneal coalition can be diagnosed on a plain lateral radiograph and an anteroposterior radiograph externally rotated 20 degrees, and confirmed by CT. MRI is also useful for diagnosis. The coalitions were medial, and the ganglion had developed from the incomplete part of the coalition; it was multilocular in some patients. After resection, there was early pain relief but sensory disturbances and Tinel's sign persisted. The postoperative results were excellent in one patient, good in four and fair in one.

Tarsal tunnel syndrome caused by coalition associated with a ganglion

We examined seven patients with tarsal tunnel syndrome in one foot caused by talocalcaneal coalition and a ganglion. We excised the coalition and the ganglion in six of them. All the patients had pain, sensory disturbance in the sole, and a positive Tinel’s sign. Older patients with a long history showed atrophy and weakness of the plantar muscles.

Talocalcaneal coalition can be diagnosed on a plain lateral radiograph and an anteroposterior radiograph externally rotated 20°, and confirmed by CT. MRI is also useful for diagnosis. The coalitions were medial, and the ganglion had developed from the incomplete part of the coalition; it was multilocular in some patients.

After resection, there was early pain relief but sensory disturbances and Tinel’s sign persisted. The postoperative results were excellent in one patient, good in four and fair in one.

Age-related changes of element contents in the human meniscus

The relative contents (RCs) of elements in the human menisci from 23 subjects in the age range between 65 and 93 yr were analyzed by inductively coupled plasma atomic emission spectrometry. The RCs of sulfur, calcium, and phosphorus in menisci increased progressively until the 80s, being the highest in the 80s, and thereafter decreased. The RCs of magnesium in menisci increased progressively until the 90s. Regarding the medial and lateral menisci, higher RCs of magnesium and iron, and a lower RC of phosphorus were found in lateral menisci in comparison with those in medial menisci. There were sexual differences in the RCs of calcium and phosphorus of medial and lateral menisci. The RCs of calcium and phosphorus were about 50% higher in women's menisci than in men's. Histological examinations showed that structureless mucoid masses were observed in the menisci, with very high RCs of calcium and phosphorus being detected.

Effect of particle size and charge on the disposition of lipid carriers after intratumoral injection into tissue-isolated tumors

PURPOSE

Pharmacokinetic properties of various lipid carriers (liposome and emulsions) after intratumoral injection were studied in perfusion experiments using tissue-isolated tumor preparations of Walker 256 carcinosarcoma.

METHODS

Four types of lipid carriers, large emulsion (254 nm), small emulsion (85 nm), neutral liposomes (120 nm) and cationic liposomes (125 nm) were prepared. We quantified their recovery from the tumor, leakage from the tumor surface and venous outflow after intratumoral injection into perfused tissue-isolated tumors, and analyzed venous appearance curves based on a pharmacokinetic model.

RESULTS

In contrast to the small emulsion and neutral liposomes, which immediately appeared in the venous outflow perfusate following intratumoral injection, the appearance of the cationic liposomes and the large emulsion was highly restricted, clearly demonstrating that intratumoral clearance of these formulations can be greatly retarded by the cationic charge and large particle size, respectively. The venous appearance rate-time profiles were fitted to equations derived from a two-compartment model by nonlinear regression analysis. When the calculated parameters were compared among these four formulations, the venous appearance rate did not exhibit such a large difference; however, the rate of transfer from the injected site to the compartment which involves clearance by venous outflow was all very different.

CONCLUSIONS

The results of this study indicate that the determining factor which alters the pharmacokinetic properties of these lipid carriers after intratumoral injection is not the rate of transfer from the interstitial space to the vascular side but the rate of intratumoral transfer from the injection site to the well-vascularized region.

Effects of Trp64Arg mutation in the beta 3-adrenergic receptor gene on weight loss, body fat distribution, glycemic control, and insulin resistance in obese type 2 diabetic patients

OBJECTIVE

To investigate the effects of Trp64Arg mutation in the beta 3-adrenergic receptor gene on weight loss, body fat distribution, glycemic control, and insulin resistance in obese type 2 diabetic patients.

RESEARCH DESIGN AND METHODS

We measured body weight, waist-to-hip ratio (WHR), adjusted resting metabolic rate, fasting blood glucose, fasting serum insulin levels, insulin resistance index (fasting glucose x fasting insulin/22.5), and HbA1c levels before and after 12 weeks of obesity treatment in 61 obese women with type 2 diabetes. The MvaI polymorphism of the beta 3-adrenergic receptor gene was determined by polymerase chain reaction-restriction fragment length polymorphism analysis.

RESULTS

Of obese type 2 diabetic patients, those with the mutation (n = 24) had a higher WHR (P < 0.001), a lower adjusted metabolic rate, and higher blood glucose levels, serum insulin levels, insulin resistance index (P < 0.001), and HbA1c levels (P = 0.016). Furthermore, patients with the mutation had smaller decreases in body weight, WHR, insulin resistance index, and HbA1c levels after the weight-loss program compared with patients without the mutation (n = 37), even though food intake, exercise, and serum thyroid hormone levels were similar in both groups.

CONCLUSIONS

These present findings show that the Trp64Arg allele of the beta 3-adrenergic receptor gene may predict difficulty in losing body weight, lowering WHR, and improving glycemic control and insulin resistance in obese patients with type 2 diabetes.

LENGTHENING OF SHORT GREAT TOES BY CALLUS DISTRACTION

We lengthened seven first metatarsals in four patients with short great toes by callus distraction using an external fixator. Good clinical and cosmetic results were obtained. Bone lengthening is effective in patients with short great toes not only for cosmesis, but also to relieve pain and callosities on the plantar aspect of the second and third metatarsal heads.

Excessive lengthening of the first metatarsal resulted in limitation of the range of movement of the metatarsophalangeal joint of the great toe. To prevent this the amount of lengthening should not exceed 40% of the preoperative length of the metatarsal.

Lengthening of short great toes by callus distraction

We lengthened seven first metatarsals in four patients with short great toes by callus distraction using an external fixator. Good clinical and cosmetic results were obtained. Bone lengthening is effective in patients with short great toes not only for cosmesis, but also to relieve pain and callosities on the plantar aspect of the second and third metatarsal heads. Excessive lengthening of the first metatarsal resulted in limitation of the range of movement of the metatarsophalangeal joint of the great toe. To prevent this the amount of lengthening should not exceed 40% of the preoperative length of the metatarsal.

Age-dependent changes of mineral contents in men and women's calcanei

To elucidate age-related change of mineral contents in human bones, the mineral content and density of human calcanei were determined by inductively coupled plasma atomic emission spectrometry and dual-energy X-ray absorptiometry. Calcanei were removed from 27 subjects (17 men and 10 women) who died in the age range from 40-98 yr old. Both the inductively coupled plasma emission spectrometry and dual-energy X-ray absorptiometry indicated that there were age-dependent decreases of the mineral contents and density in the men's calcaneus in the age range from 40-98 yr, but not in the women's calcaneus in the age range from 42-87 yr. It was also found that the calcanean masses of the men and women remained constant within the same age range until 98 yr.