Advanced wastewater treatment with ozonation and granular activated carbon filtration: Inactivation of antibiotic resistance targets in a long-term pilot study

The inactivation of antibiotic resistant bacteria (ARB) and genes (ARGs) in an advanced plant combining ozonation and granular activated carbon (GAC) filtration applied for effluent after conventional activated sludge treatment at a full-scale urban wastewater treatment plant was investigated for over 13 consecutive months. The nitrite compensated specific ozone dose ranged between 0.4 and 0.7 g O₃/g DOC with short-time sampling campaigns (0.2-0.9 g O₃/g DOC). Samples were analysed with culture-dependent methods for bacterial targets and with qPCR for genes. The log removal values were correlated with a decrease of the matrix UV absorption at 254 nm (ΔUV₂₅₄) and indicated a range of ΔUV₂₅₄ that corresponds to a sufficient membrane damage to affect DNA. For trimethoprim/sulfamethoxazole resistant E. coli, sul1, ermB and tetW, this phase was observed at ΔUV₂₅₄ of ~30 % (~0.5 g O₃/g DOC). For ampicillin resistant E. coli and bla_TEM-1, it was observed around 35-40 % (~0.7 g O₃/g DOC), which can be linked to mechanisms related to oxidative damages in bacteria resistant to bactericidal antibiotics. GAC treatment resulted in a further abatement for trimethoprim/sulfamethoxazole E. coli, sul1 and tetW, and in increase in absolute and relative abundance of ermB and bla_TEM-1.

Cytotoxicity of 4-hydroxy-N-(naphthalen-1-yl)-2-oxo-2H-chromene-3-carboxamide in multidrug-resistant cancer cells through activation of PERK/eIF2α/ATF4 pathway

After decades of research, multidrug resistance (MDR) remains a huge challenge in cancer treatment. In this study, the cytotoxic of 4-hydroxy-N-(naphthalen-1-yl)-2-oxo-2H-chromene-3-carboxamide (MCC1734) has been investigated towards multidrug-resistant cancer cell lines. MCC1734 exerted cytotoxicity on cell lines expressing different mechanisms of drug resistance (P-glycoprotein, BCRP, ABCB5, EGFR, p53 knockout) to a different extent. Interestingly, sensitive CCRF-CEM cells and multidrug-resistant P-gp-overexpressing CEM/ADR5000 cells represented similar sensitivity towards MCC1734, indicating MCC1734 can bypass P-gp-mediated resistance. Microarray-based mRNA expression revealed that MCC1734 affected cells by multiple pathways, including cell cycle regulation, mitochondrial dysfunction, apoptosis signaling, and EIF2 signaling. MCC1734 stimulated the generation of excessive reactive oxygen species and the collapse of mitochondria membrane potential in CCRF-CEM cells, companied by the arrest of the cell cycle in the G₂M phase and apoptosis induction as determined by flow cytometry. In addition, our immunoblotting analysis highlighted that MCC1734 triggered endoplasmic reticulum (ER) stress, evidenced by the activation of p-PERK, p-eIF2α, ATF4 and CHOP. The anti-cancer effects of MCC1734 were further observed in vivo using human xenograft tumors transplanted to zebrafish, providing further support for MCC1734 as a promising new candidate for cancer drug development.

A novel moniliformin derivative as pan-inhibitor of histone deacetylases triggering apoptosis of leukemia cells

New and potent agents that evade multidrug resistance (MDR) and inhibit epigenetic modifications are of great interest in cancer drug development. Here, we describe that a moniliformin derivative (IUPAC name: 3-(naphthalen-2-ylsulfanyl)-4-{[(2Z)-1,3,3-trimethyl-2,3-dihydro-1H-indol-2-ylidene]methyl}cyclobut-3-ene-1,2-dione; code: MCC1381) bypasses P-gp-mediated MDR. Using transcriptomics, we identified a large number of genes significantly regulated in response to MCC1381, which affected the cell cycle and disturbed cellular death and survival. The potential targets of MCC1381 might be histone deacetylases (HDACs) as predicted by SwissTargetPrediction. In silico studies confirmed that MCC1381 presented comparable affinity with HDAC1, 2, 3, 6, 8 and 11. Besides, the inhibition activity of HDACs was dose-dependently inhibited by MCC1381. Particularly, a strong binding affinity was observed between MCC1381 and HDAC6 by microscale thermophoresis analysis. MCC1381 decreased the expression of HDAC6, inversely correlated with the increase of acetylated HDAC6 substrates, acetylation p53 and α-tubulin. Furthermore, MCC1381 arrested the cell cycle at the G₂/M phase, induced the generation of reactive oxygen species and collapse of the mitochondrial membrane potential. MCC1381 exhibited in vivo anti-cancer activity in xenografted zebrafish. Collectively, MCC1381 extended cytotoxicity towards P-gp-resistant leukemia cancer cells and may act as a pan-HDACs inhibitor, indicating that MCC1381 is a novel candidate for cancer therapy.

Isopetasin and S-isopetasin as novel P-glycoprotein inhibitors against multidrug-resistant cancer cells

BACKGROUND

A major problem of cancer treatment is the development of multidrug resistance (MDR) to chemotherapy. MDR is caused by different mechanisms such as the expression of the ABC-transporters P-glycoprotein (P-gp, MDR1, ABCB1) and breast cancer resistance protein (BCRP, ABCG2). These transporters efflux xenobiotic toxins, including chemotherapeutics, and they were found to be overexpressed in different cancer types.

PURPOSE

Identification of novel molecules that overcome MDR by targeting ABC-transporters.

METHODS

Resazurin reduction assay was used for cytotoxicity test. AutoDock 4.2. was used for molecular docking. The function of P-gp and BCRP was tested using a doxorubicin uptake assay and an ATPase assay. ROS generation was detected using flow cytometry for the measurement of H₂DCFH-DA fluorescence. Annexin/PI staining was applied for the detection of apoptosis. Bioinformatic analyses were performed using LigandScout 3.12. software and DataWarrior software.

RESULTS

In our search for new molecules that selectively act against resistant phenotypes, we identified isopetasin and S-isopetasin, which are bioactive natural products from Petasites formosanus. They exerted collateral sensitivity towards leukemia cells with high P-gp expression in CEM/ADR5000 cells, compared to sensitive wild-type CCRF-CEM leukemia cells. Also, they revealed considerable activity towards breast cancer cells overexpressing breast cancer resistance protein, MDA-MB-231-BCRP clone 23. This motivated us to investigate whether the function of P-gp was inhibited. In-silico results showed the compounds bound with high affinity and interacted with key amino acid residues in P-gp . Then, we found that the two compounds increased doxorubicin accumulation in P-gp overexpressing CEM/ADR5000 by three-fold compared to cells without inhibitor. P-gp-mediated drug efflux was ATP-dependent. Isopetasin and S-isopetasin increased the ATPase activity of human P-gp in a comparable fashion as verapamil used as control P-gp inhibitor. As isopetasin and S-isopetasin exerted dual roles, first as cytotoxic compounds and then as P-gp inhibitors, we suggested that their P-gp inhibition is part of a larger complex of mechanisms to induce cell death in cancer patients. P-gp dysfunction induces mitochondrial stress to generate ATP. Upon continuing stress by P-gp inhibition, the mitochondria generate reactive oxygen species (ROS). Initially established for verapamil, this theory was validated in the present study for isopetasin and S-isopetasin, as treatment with the two candidates increased ROS levels in CEM/ADR5000 cells followed by apoptosis.

CONCLUSION

Our study highlights the importance of isopetasin and S-isopetasin as novel ROS-generating and apoptosis-inducing P-gp inhibitors.

Putative molecular determinants mediating sensitivity or resistance towards carnosic acid tumor cell responses

BACKGROUND

Carnosic acid (CA) is one of the main constituents in rosemary extract. It possesses valuable pharmacological properties, including anti-oxidant, anti-inflammatory, anti-microbial and anti-cancer activities. Numerous in vitro and in vivo studies investigated the anticancer profile of CA and emphasized its potentiality for cancer treatment. Nevertheless, the role of multidrug-resistance (MDR) related mechanisms for CA's anticancer effect is not yet known.

PURPOSE

We investigated the cytotoxicity of CA against known mechanisms of anticancer drug resistance (P-gp, ABCB5, BCRP, EGFR and p53) and determined novel putative molecular factors associated with cellular response towards CA.

STUDY DESIGN

Cytotoxicity assays, bioinformatic analysis, flow cytometry and western blotting were performed to identify the mode of action of CA towards cancer cells.

METHODS

The cytotoxicity to CA was assessed using the resazurin assays in cell lines expressing the mentioned resistance mechanisms. A pharmacogenomic characterization of the NCI 60 cell line panel was applied via COMPARE, hierarchical cluster and network analyses. Flow cytometry was used to detect cellular mode of death and ROS generation. Changes in proteins-related to apoptosis were determined by Western blotting.

RESULTS

Cell lines expressing ABC transporters (P-gp, BCRP or ABCB5), mutant EGFR or p53 were not cross-resistant to CA compared to their parental counterparts. By pharmacogenomic approaches, we identified genes that belong to different functional groups (e.g. signal transduction, regulation of cytoskeleton and developmental regulatory system). These genes were predicted as molecular determinants that mediate CA tumor cellular responses. The top affected biofunctions included cellular development, cellular proliferation and cellular death and survival. The effect of CA-mediated apoptosis in leukemia cells, which were recognized as the most sensitive tumor type, was confirmed via flow cytometry and western blot analysis.

CONCLUSION

CA may provide a novel treatment option to target refractory tumors and to effectively cooperate with established chemotherapy. Using pharmacogenomic approaches and network pharmacology, the relationship between cancer complexity and multi-target potentials of CA was analyzed and many putative molecular determinants were identified. They could serve as novel targets for CA and further studies are needed to translate the possible implications to clinical cancer treatment.

Identification and characterization of deschloro-chlorothricin obtained from a large natural product library targeting aurora A kinase in multiple myeloma

Multiple myeloma (MM) is a devastating disease with low survival rates worldwide. The mean lifetime of patients may be extendable with new drug alternatives. Aurora A kinase (AURKA) is crucial in oncogenesis, because its overexpression or amplification may incline the development of various types of cancer, including MM. Therefore, inhibitors of AURKA are innovative and promising targets. Natural compounds always represented a valuable resource for anticancer drug development. In the present study, based on virtual drug screening of more than 48,000 natural compounds, the antibiotic deschloro-chlorotricin (DCCT) has been identified to bind to AURKA with even higher binding affinity (free bindung energy: −12.25 kcal/mol) than the known AURKA inhibitor, alisertib (free binding energy: −11.25 kcal/mol). The in silico studies have been verified in vitro by using microscale thermophoresis. DCCT inhibited MM cell lines (KMS-11, L-363, RPMI-8226, MOLP-8, OPM-2, NCI-H929) with IC₅₀ values in a range from 0.01 to 0.12 μM. Furthermore, DCCT downregulated AURKA protein expression, induced G2/M cell cycle arrest and disturbed the cellular microtubule network as determined by Western blotting, flow cytometry, and fluorescence microscopy. Thus, DCCT may be a promising lead structure for further derivatization and the development of specific AURKA inhibitors in MM therapy.

Vitamin K3 chloro derivative (VKT-2) inhibits HDAC6, activates autophagy and apoptosis, and inhibits aggresome formation in hepatocellular carcinoma cells

Epigenetics plays a vital role in regulating gene expression and determining the specific phenotypes of eukaryotic cells. Histone deacetylases (HDACs) are important epigenetic regulatory proteins effecting multiple biological functions. Particularly, HDAC6 has become a promising anti-cancer drug target because of its regulation of cell mobility, protein trafficking, degradation of misfolded proteins, cell growth, apoptosis, and metastasis. In this study, we identified one out of six vitamin K₃ derivatives, VKT-2, as HDAC6 inhibitor using molecular docking and cell viability assays in HDAC6-overexpressing HuH-7 cancer cells. Microscale thermophoresis and HDAC6 enzymatic assays revealed that VKT-2 bound to HDAC6 and inhibited its function. We further identified its cytotoxic activity. VKT-2 hyperacetylated HDAC6 substrates and disturbed tubulin integrity leading to significant inhibition of tumor migration in both HuH-7 spheroids and U2OS-GFP-α-tubulin cells. Moreover, VKT-2 induced autophagic and apoptotic cell death in HuH-7, while aggresome formation was restrained after VKT-2 treatment. A HuH-7 cell-xenograft model in zebrafish larvae provided evidence that VKT-2 inhibited the tumor growth in vivo. To best of our knowledge, it is the first time to demonstrate that vitamin k₃ derivatives (VKT-2) inhibits HDAC6 in solid tumor cells. These unique findings suggested that VKT-2 is a promising anti-cancer agent targeting HDAC6.

Chemometric and Transcriptomic Profiling, Microtubule Disruption and Cell Death Induction by Secalonic Acid in Tumor Cells

Nature is an indispensable source of new drugs, providing unique bioactive lead structures for drug discovery. In the present study, secalonic acid F (SAF), a naturally occurring ergochrome pigment, was studied for its cytotoxicity against various leukemia and multiple myeloma cells by the resazurin assay. SAF exhibited cytotoxic activity on both leukemia and multiple myeloma cells. Generally, multiple myeloma cells were more sensitive to SAF than leukemia cells. NCI-H929 cells were the most affected cells among the tested panel of multiple myeloma cell lines and were taken for further studies to assess the mode of action of SAF on those cells. Cell cycle analysis revealed that SAF induced S and G2/M arrest in NCI-H929 cells. SAF-associated apoptosis and necrosis resulted in cytotoxicity. SAF further inclined the disassembly of the tubulin network, which may also account for its cytotoxicity. COMPARE and hierarchical cluster analyses of transcriptome-wide expression profiles of the NCI tumor cell line panel identified genes involved in numerous cellular processes (e.g., cell differentiation, cell migration, and other numerous signaling pathways) notably correlated with log₁₀IC₅₀ values for secalonic acid. In conclusion, the present study supports the therapeutic potential of SAF to treat multiple myeloma.

Inhibition of cell migration and induction of apoptosis by a novel class II histone deacetylase inhibitor, MCC2344

Epigenetic modifiers provide a new target for the development of anti-cancer drugs. The eraser histone deacetylase 6 (HDAC6) is a class IIb histone deacetylase that targets various non-histone proteins such as transcription factors, nuclear receptors, cytoskeletal proteins, DNA repair proteins, and molecular chaperones. Therefore, it became an attractive target for cancer treatment. In this study, virtual screening was applied to the MicroCombiChem database with 1162 drug-like compounds to identify new HDAC6 inhibitors. Five compounds were tested in silico and in vitro as HDAC6 inhibitors. Both analyses revealed 1-cyclohexene-1-carboxamide, 2-hydroxy-4,4-dimethyl-N-1-naphthalenyl-6-oxo- (MCC2344) as the best HDAC6 inhibitor among the five ligands. The binding affinity of MCC2344 to HDAC6 was further confirmed by microscale thermophoresis. Additionally, the anti-cancer activity of MCC2344 was tested in several tumor cell lines. Leukemia cells were the most sensitive cells towards MCC2344, particularly the P-glycoprotein-overexpressing multidrug-resistant cell line CEM/ADR5000 exhibited remarkable collateral sensitivity towards MCC2344. Transcriptome analysis using microarray hybridization was performed for investigating downstream mechanisms of action of MCC2344 in leukemia cells. MCC2344 affected microtubule dynamics and suppressed cell migration in the wound healing assay as well as in a spheroid model by hyper-acetylation of tubulin and HSP-90. MCC2344 induced cell death in CEM/ADR5000 cells by activation of PARP, caspase-3, and p21 in addition to the downregulation of p62. MCC2344 significantly inhibited tumor growth in vivo in zebrafish larvae without mortality until 20 pM. We propose MCC2344 as a novel HDAC6 inhibitor for cancer treatment.

Identification of inhibitors of the polo-box domain of polo-like kinase 1 from natural and semisynthetic compounds

PLK1 has an important role in the regulation of cell cycle and represents an important target for cancer treatment. This enzyme belongs to the Polo-like kinases family, which is characterized by a regulatory domain named Polo-box domain (PBD). Rather than regular kinase inhibitors, this domain provides high selectivity to PLK1. Here, we report on four novel PLK1 PBD inhibitors identified by cytotoxicity screening and fluorescence polarization assay of a chemical library of natural and semisynthetic compounds. These compounds revealed two- to three-fold higher selectivity to the PDB of PLK1 than to those of the related family members, PLK2 and PLK3. These four substances inhibited tumor cell growth of sensitive CCRF-CEM and multidrug-resistant CEM/ADR5000 leukemia cells. The tested compounds increased the apoptotic cell fraction, which indicates apoptosis as a major mechanism of cell death. Cell cycle analysis showed compound (5) arrested the cell cycle of CCRF-CEM cells in the G2/M phase, while the other three molecules ((compound (3), compound (4), and compound (6)) exerted pronounced cytotoxicity with an increase of cells in the sub-G1 population. Molecular docking was performed for the understanding of ligand-protein interaction, the tested candidates showed strong binding affinity to PLK1 PBD. In conclusion, we identified four new chemical scaffolds that may serve as lead compounds for the development of selective PLK1 inhibitors in the future.

MCC1019, a selective inhibitor of the Polo-box domain of Polo-like kinase 1 as novel, potent anticancer candidate

Polo-like kinase (PLK1) has been identified as a potential target for cancer treatment. Although a number of small molecules have been investigated as PLK1 inhibitors, many of which showed limited selectivity. PLK1 harbors a regulatory domain, the Polo box domain (PBD), which has a key regulatory function for kinase activity and substrate recognition. We report on 3-bromomethyl-benzofuran-2-carboxylic acid ethyl ester (designated: MCC1019) as selective PLK1 inhibitor targeting PLK1 PBD. Cytotoxicity and fluorescence polarization-based screening were applied to a library of 1162 drug-like compounds to identify potential inhibitors of PLK1 PBD. The activity of compound MC1019 against the PLK1 PBD was confirmed using fluorescence polarization and microscale thermophoresis. This compound exerted specificity towards PLK1 over PLK2 and PLK3. MCC1019 showed cytotoxic activity in a panel of different cancer cell lines. Mechanistic investigations in A549 lung adenocarcinoma cells revealed that MCC1019 induced cell growth inhibition through inactivation of AKT signaling pathway, it also induced prolonged mitotic arrest—a phenomenon known as mitotic catastrophe, which is followed by immediate cell death via apoptosis and necroptosis. MCC1019 significantly inhibited tumor growth in vivo in a murine lung cancer model without affecting body weight or vital organ size, and reduced the growth of metastatic lesions in the lung. We propose MCC1019 as promising anti-cancer drug candidate.

Novel 3,4-Dihydroisocoumarins Inhibit Human P-gp and BCRP in Multidrug Resistant Tumors and Demonstrate Substrate Inhibition of Yeast Pdr5

Multidrug resistance (MDR) in tumors and pathogens remains a major problem in the efficacious treatment of patients by reduction of therapy options and subsequent treatment failure. Various mechanisms are described to be involved in the development of MDR with overexpression of ATP-binding cassette (ABC) transporters reflecting the most extensively studied. These membrane transporters translocate a wide variety of substrates utilizing energy from ATP hydrolysis leading to decreased intracellular drug accumulation and impaired drug efficacy. One treatment strategy might be inhibition of transporter-mediated efflux by small molecules. Isocoumarins and 3,4-dihydroisocoumarins are a large group of natural products derived from various sources with great structural and functional variety, but have so far not been in the focus as potential MDR reversing agents. Thus, three natural products and nine novel 3,4-dihydroisocoumarins were designed and analyzed regarding cytotoxicity induction and inhibition of human ABC transporters P-glycoprotein (P-gp), multidrug resistance-associated protein 1 (MRP1) and breast cancer resistance protein (BCRP) in a variety of human cancer cell lines as well as the yeast ABC transporter Pdr5 in Saccharomyces cerevisiae. Dual inhibitors of P-gp and BCRP and inhibitors of Pdr5 were identified, and distinct structure-activity relationships for transporter inhibition were revealed. The strongest inhibitor of P-gp and BCRP, which inhibited the transporters up to 80 to 90% compared to the respective positive controls, demonstrated the ability to reverse chemotherapy resistance in resistant cancer cell lines up to 5.6-fold. In the case of Pdr5, inhibitors were identified that prevented substrate transport and/or ATPase activity with IC₅₀ values in the low micromolar range. However, cell toxicity was not observed. Molecular docking of the test compounds to P-gp revealed that differences in inhibition capacity were based on different binding affinities to the transporter. Thus, these small molecules provide novel lead structures for further optimization.

Epidemiology of gingivitis in schoolchildren in Bucharest, Romania: a cross-sectional study

BACKGROUND AND OBJECTIVE

Gingivitis is the most prevalent oral disease in children, being strongly associated to social gradients. Many studies have reported different results concerning the extent and intra-oral distribution of gingivitis in children. The aim of this study was to investigate the epidemiologic parameters and socio-related risk factors of gingivitis in the 10-17-year-old Bucharest schoolchildren population and to analyze its intra-oral distribution.

MATERIAL AND METHODS

Cross-sectional data were obtained from 1595 schoolchildren, social condition being assigned using a simple questionnaire. Classes of students were used as clusters in a single-stage cluster sampling method. An intra-oral exam was performed for all the children included in this study. Silness and Löe scores, prevalence and the extent of gingivitis were calculated.

RESULTS

The gingival scores showed a mild inflammation and the prevalence of gingivitis was 91%. Boys had a higher gingival (0.19 vs. 0.18; p < 0.05) and plaque scores (0.71 vs. 0.59; p < 0.01) than girls. Children who did not live in overcrowded households, whose parents had a better education and those who had direct access to school dental services displayed better gingival conditions (p < 0.05). Gingivitis was more severe on the upper teeth, with the maximum score being reached at the right upper lateral incisor (0.63 on distal surface).

CONCLUSIONS

Gingival condition in Bucharest schoolchildren population was associated to social gradients. School dental services are also another factor that seems to be related with gingivitis.

Docking-based virtual screening of covalently binding ligands: an orthogonal lead discovery approach

In pharmaceutical industry, lead discovery strategies and screening collections have been predominantly tailored to discover compounds that modulate target proteins through noncovalent interactions. Conversely, covalent linkage formation is an important mechanism for a quantity of successful drugs in the market, which are discovered in most cases by hindsight instead of systematical design. In this article, the implementation of a docking-based virtual screening workflow for the retrieval of covalent binders is presented considering human cathepsin K as a test case. By use of the docking conditions that led to the best enrichment of known actives, 44 candidate compounds with unknown activity on cathepsin K were finally selected for experimental evaluation. The most potent inhibitor, 4-(N-phenylanilino)-6-pyrrolidin-1-yl-1,3,5-triazine-2-carbonitrile (CP243522), showed a K(i) of 21 nM and was confirmed to have a covalent reversible mechanism of inhibition. The presented approach will have great potential in cases where covalent inhibition is the desired drug discovery strategy.

[Outpatient anesthesia for patients with obstructive sleep apnea: results of a national survey]

BACKGROUND

In Germany there is currently no national standard for the management of patients with obstructive sleep apnea syndrome (OSAS). The object of this survey was to obtain information on the treatment concept for patients with OSAS and to report on the current practice in Germany.

METHODS

Data collection was obtained through an online questionnaire. A total of 12,113 members of the supporting anesthesia societies from all over Germany were invited to participate via e-mail. Additionally an announcement was made in a professional journal.

RESULTS

A total of 1,671 questionnaires were analyzed. The average age of the respondents was 45 years, 64% were male and 36% were female. The average work experience was 16 years and 85% of the respondents were consultants. In total 85% of anesthesiologists were predominantly working in inpatient care and 12% were predominantly active in outpatient care. Of the respondents 63% preferred regional anesthesia, 20% preferred general anesthesia for patients with OSAS and 17% did not have a preference for a specific anesthesia procedure. Outpatient surgery for patients with OSAS was performed by 72% of the respondents using regional anesthesia and by 55% of the respondents using local anesthesia with sedation. Of the anesthesiologists 49% consented to outpatient surgery using general anesthesia and 14% to interventions involving the airways. Compared to anesthesiologists working predominantly in inpatient departments, those working predominantly in outpatient departments treated patients with OSAS more frequently on an outpatient basis, used general anesthesia significantly more often, discharged those patients significantly earlier and observed less complications.

CONCLUSIONS

This survey shows that outpatient surgery for patients with sleep apnea is common practice in Germany. It is also performed when patients have moderate or severe OSAS and for respiratory tract surgery. This means that the management is not conform to the guidelines of the American Society of Anesthesiologists (ASA).

Application of pressure mapping techniques to measure push and gripping forces with precision

Gripping and push forces, also named coupling forces, have induced effects on the transmission of the vibration in the upper limb. The assessment of the vibration exposure with powered tools thus requires that these man/machine coupling parameters are controlled and monitored. To date, no reliable metrological systems enable their precise measurements. This study first investigated how much precision could be expected from the pressure mapping technique for the determination of coupling forces by means of numerical integration. Then a specific procedure was worked out and validated to instrument hand-held tools and measure the coupling forces with regard to the appropriate current standards. The proposed method was applied as a case study on an ordinary breaker and an anti-vibration breaker.

[Smoking--a proven risk factor for periodontal disease?]

While bacterial dental plaque is widely considered as the etiological risk factor for the development of periodontal diseases, numerous publications from recent years pointed out the role of environmental factors like smoking as aggravating the severity of disease expression. The present paper reviews the updated literature linking epidemiologically between the presence of smoking habit and disease prevalence in the same population, as well as studies reporting on cell toxicity of nicotine and its by-products on gingival cells, negative effect on humoral and cell-mediated immune system, enhancement of bacterial plaque pathogeneity, and disruption of the wound healing processes. Finally, a negative effect is apparent on the supportive stage of the periodontal treatment, indicating lasting effect of smoking for years to come following the termination of active periodontal treatment.

[Periodontal disease--an additional risk factor for cardiovascular diseases?]

In 1989, a case-control study was published, linking between coronary heart disease and periodontal disease in the studied population. Since then, a number of additional studies, focused the attention to the possible role of dental infections in the pathogenesis of atherosclerosis. Some of these newer cohort studies, are prospective in nature, measuring incidence of the two diseases in large patient populations. The present article reviews these studies, and the proposed mechanisms which might explain the relationships between these two systemically distinct diseases.

The relationship between periodontal diseases and diabetes: an overview

Diabetes mellitus, caused by the malfunction of insulin-dependent glucose and lipid metabolism, presents with the classical triad of symptoms: polydypsia, polyuria, and polyphagia which are often accompanied by chronic fatigue and loss of weight. Complications of diabetes mellitus include retinopathy, nephropathy, neuropathy, and cardiovascular disease. Periodontal diseases are infections affecting the periodontium and resulting in the loss of tooth support. The association between diabetes mellitus and periodontitis has long been discussed with conflicting conclusions. Both of these diseases have a relatively high incidence in the general population (diabetes 1% to 6% and periodontitis 14%) as well as a number of common pathways in their pathogenesis (both diseases are polygenic disorders with some degree of immunoregulatory dysfunction). On the one hand, numerous reports indicate a higher incidence of periodontitis in diabetics compared to healthy controls, while other reports fail to show such a relationship. Clarification of this dilemma is occurring as the diagnostic criteria for periodontitis and diabetes mellitus improve, controlled studies with increased sample sizes are carried out, and the studies take into account major confounding variables that impact on the pathogenesis of both diseases. Current studies tend to support a higher incidence and severity of periodontitis in patients with diabetes mellitus. The overview looks at the bidirectional relationship between periodontitis and diabetes. An analysis of the National Health and Nutrition Examination Survey (NHANES) III data set confirms the previously reported significantly higher prevalence of periodontitis in diabetics than in non-diabetics (17.3% versus 9%). The analysis of the data also shows that the prevalence of diabetes in patients with periodontitis is double that seen in the non-periodontitis patients (12.5% versus 6.3%) and that this difference is also statistically significant. The pathogenesis of the 2 diseases is reviewed with an emphasis on common genetic and immune mechanisms. On the basis of the overview, 2 hypotheses for testing the relationship between periodontitis and diabetes are discussed. The first proposes a direct causal or modifying relationship in which the hyperglycemia and hyperlipidemia of diabetes result in metabolic alterations that may then exacerbate bacteria-induced inflammatory periodontitis. The second hypothesis proposes that a fortuitous combination of genes (gene sets) could result in a host who, under the influence of a variety of environmental stressors, could develop either periodontitis or diabetes or both.

Identifying and modelling prognostic factors with censored data

A major issue in the analysis of diseases is the identification and assessment of prognostic factors relevant to the development of the illness. Statistical analyses within the proportional hazards framework suffer from a lack of flexibility due to stringent model assumptions such as additivity and time-constancy of effects. In this paper we use tree-based models and varying coefficient models to allow for detectability of prognostic factors with possibly non-additive, non-linear and time-varying impact on disease development. Questions concerning model and smoothing parameter selection are addressed. An analysis of a data set of breast cancer patients demonstrates the ability of these methods to reveal additional insight into the disease influencing mechanisms.

Adherence of periodontopathic bacteria to bioabsorbable and non-absorbable barrier membranes in vitro

Guided tissue regeneration (GTR) techniques are increasingly used for the treatment of periodontal defects, or in conjunction with dental implant procedures. As adhesion of bacteria to barrier membranes used in these techniques may lead to failure, a prerequisite for treatment success is an infection-free healing process. The present study examined the adhesion of 3 periodontal pathogenic bacteria: Actinobacillus actinomycetemcomitans, Treponema denticola and Porphyromonas gingivalis, to 3 barrier membranes: Collagen, (Biomend) PTFE, (TefGen-FD) and e-PTFE, (Gore-Tex). The membranes were incubated with 3[H]-thymidine labeled bacteria, and the number of adherent bacteria was calculated using a scintillation counter. The effect of albumin coating on bacterial adherence to the membranes was also studied. Bacterial adherence to the membranes was further examined by scanning electron microscopy (SEM). The results show that the adherence of all bacterial strains to collagen membranes was significantly higher than to the other membranes tested. Precoating of the membranes with albumin did not change the bacterial adherence significantly. These findings are of importance in evaluating the ability of periodontal bacteria to colonize and infect different types of barrier membranes.

Modelling and exploring human sleep with event history analysis

In this paper we propose the use of statistical models of event history analysis for investigating human sleep. These models provide appropriate tools for statistical evaluation when sleep data are recorded continuously over time or on a fine time grid, and are classified into sleep stages such as REM and nonREM as defined by Rechtschaffen and Kales (1968). In contrast to conventional statistical procedures, event history analysis makes full use of the information contained in sleep data, and can therefore provide new insights into non-stationary properties of sleep. Probabilities of or intensities for transitions between sleep stages are the basic quantities for characterising sleep processes. The statistical methods of event history analysis aim at modelling and estimating these intensities as functions of time, taking into account individual sleep history and assessing the influence of factors of interest, such as hormonal secretion. In this study we suggest the use of non-parametric approaches to reveal unknown functional forms of transition intensities and to explore time-varying and non-stationary effects. We then apply these techniques in a study of 30 healthy male volunteers to assess the mean population intensity and the effects of plasma cortisol concentration on the transition between selected sleep stages as well as the influence of elapsed time in a current REM period on the intensity for a transition to nonREM. The most interesting findings are that (a) the intensity of the nonREM-to-REM transitions after sleep onset in young men shows a periodicity which is similar to that of nonREM/REM cycles; (b) 30-45 min after sleep onset, young men reveal a great propensity to pass from light sleep (stages 1 or 2) into slow-wave sleep (SWS) (stages 3 or 4); (c) high cortisol levels imposed additional impulses on the transition intensity of (i) wake to sleep around 2 h after sleep onset, (ii) nonREM to REM around 6 h later, (iii) stage 1 or stage 2 sleep to SWS around 2, 4 and 6 h later and (iv) SWS to stage 1 or stage 2 sleep about 2 h later. Moreover, high cortisol concentrations at the beginning of REM periods favoured the change to nonREM sleep, whereas later their influence on a nonREM change became weak and weaker. As sleep data are also available as event-oriented data in many studies in sleep research, event history analysis applied additionally to conventional statistical procedures, such as regression analysis or analysis of variance, could help to acquire more information and knowledge about the mechanisms behind the sleep process.

The fnr gene of Bacillus licheniformis and the cysteine ligands of the C-terminal FeS cluster

In the facultatively anaerobic bacterium Bacillus licheniformis a gene encoding a protein of the fumarate nitrate reductase family of transcriptional regulators (Fnr) was isolated. Unlike Fnr proteins from gram-negative bacteria, but like Fnr from Bacillus subtilis, the protein contained a C-terminal cluster of cysteine residues. Unlike in Fnr from B. subtilis, this cluster (Cys226-X2-Cys229-X4-Cys234) is composed of only three Cys residues, which are supposed to serve together with an internal residue (Cys71) as the ligands for an FeS center. Transfer of the B. licheniformis gene to an fnr mutant of B. subtilis complemented the ability for synthesis of nitrate reductase during anaerobic growth.

Adhesion of periodontal bacteria to titanium, and titanium alloy powders

In this study, the adhesion of radioactively labeled Actinomyces viscosus (A. viscosus), Actinobacillus actinomicetemcomitans (Aa) and Porphyromonas gingivalis (P. gingivalis) to titanium (Ti) and Ti-6-Al-4V alloy (Ti-alloy) coated with albumin or human saliva was investigated. All the tested bacteria displayed greater attachment to Ti-alloy than to Ti. P. gingivalis exhibited less adhesion to Ti and Ti-alloy than did the other bacterial strains. Adhesion of A. viscosus and Aa was greatly reduced when Ti or Ti-alloy were coated with albumin or saliva. P. gingivalis demonstrated a lesser reduction in adhesion to albumin or saliva-coated surfaces. The results show that oral bacteria have different adhesion affinities for Ti and Ti-alloy and that both albumin and human saliva reduce bacterial adhesion.

Resources for lesbian ethnographic research in the lavender archives

The problematics of undertaking lesbian ethnography and cultural history are related in part to the dearth of printed records lesbians kept or preserved for posterity. Technological, financial, and security considerations typically made it necessary for them to operate more informally and inconspicuously, hand-to-hand and by word-of-mouth. Lavender archives, nonetheless, are the repositories of lesbian cultural history. This paper preoccupies itself with the pragmatic issues of developing and maintaining accessible research venues from which to cultivate the study of multiracial and multiethnic lesbian lives. I provide a survey of available resources for doing lesbian scholarship, addressing some of the ethical issues involved with lesbian ethnographic research.

Mechanism of adsorption of human albumin to titanium in vitro

Our previous studies have shown that human albumin is one of the main salivary proteins that adsorb to titanium (Ti). The goal of the present study was to investigate the role of electrostatic interactions in the adsorption of human albumin to Ti-oxide (TiO2) in vitro. The binding profile of human albumin to Ti was analyzed according to an adsorption isotherm. Purified human serum albumin (HSA) was suspended with native, calcium-, magnesium-, or potassium-treated commercially pure Ti powders, at pH 3.0 and 7.0. The amount of unadsorbed protein in the supernatant fluid was measured. The maximum amount of adsorbed albumin was 0.13 mg/1.0 g Ti. The albumin-Ti association constant was 2.77 mL/mg. Pretreatment of Ti with calcium, or magnesium alone, or combined with increasing pH values (3.0-7.0) resulted in augmented adsorption of HSA to Ti. No increase in adsorption was observed following pretreatment of Ti with potassium. These results point to the involvement of electrostatic interactions in the adsorption of HSA to TiO2.

alpha-Amylase and salivary albumin adsorption onto titanium, enamel and dentin: an in vivo study

In vivo adsorption of salivary albumin and alpha-amylase onto titanium, enamel and dentin was analysed following their exposure to the oral cavity for 2h. Oral appliances in six adults served as a platform for carrying 4-mm discs of the three materials. Adherent proteins were eluted from the discs and the amounts of salivary albumin and alpha-amylase were measured by an enzyme-linked immunosorbent assay. While significant difference between the adsorption of albumin and alpha-amylase onto enamel as compared with dentin was observed, adsorption onto titanium was significantly lower. A sample of whole saliva was also collected from each participant. The mean total amounts of albumin and alpha-amylase in the participants' whole saliva were 0.03 and 0.54 mg ml-1, respectively. Titanium adsorbed significantly less (4.43%) of the total albumin than did enamel (14.30%) or dentin (18.80%). No significant difference was found in the relative amounts of alpha-amylase adsorbed by the three materials. This significantly selective adsorption of proteins may enable the attachment of specific bacteria and thus alter the composition of the dental plaque and its potential pathogenicity.

Clathrin-mediated endocytosis of high density lipoprotein3 in human intestinal Caco-2 cells. A post-embedding immunocytochemical study

The mechanism by which high density lipoprotein (HDL) removes excess cholesterol from intracellular sites has been the subject of much controversy. There is some evidence that HDL binds to specific cell surface receptors without internalization. Other evidence suggests that HDL is taken up by endocytosis, enters a pathway of endosomal trafficking and is resecreted from the cells (retroendocytsosis). In the present study, we investigated the distribution of apolipoprotein AI, the major protein constituent of HDL, in cultured intestinal Caco-2 cells employing post-embedding immunocytochemistry on LR White-embedded material. Cells grown under control conditions showed label for apolipoprotein AI in the endoplasmic reticulum. After incubation with native apolipoprotein E-free high density lipoprotein3 (HDL3) additional label for apolipoprotein AI was found in endosomes. These endosomes were observed near lipid droplets and in the basolateral cytoplasm. Further, it was demonstrated that label for apolipoprotein AI was colocalized with label for clathrin on the basolateral membrane. Our results support the concept that HDL3 is internalized and subsequently processed in an endosomal pathway in Caco-2 cells besides de novo synthesis of apolipoprotein AI.

Is there a dysplasia-carcinoma sequence in rat gastric remnant?

Epithelial dysplasia in the gastric remnant is generally considered to have a positive predictive value for malignancy. Whether dysplasia progresses to carcinoma or whether both just have a common origin, is still a matter of controversy. The aim of the present study in rats was to investigate the natural history of epithelial lesions in the gastric remnant. A gastric resection was carried out in 50 male Wistar rats. Postoperatively the animals received N-methyl-N'-nitro-N-nitrosoguanidine orally. Gastroscopy was carried out monthly and biopsies were taken for histologic evaluation. The rats were killed after 12 months or if gastric cancer was found on gastroscopy. Twenty-four rats died postoperatively and were excluded from the study. A total of 228 gastroscopies was performed in the remaining 26 animals; 24 animals developed dysplastic lesions during the follow-up period. The rate of development of gastric cancer within one month increased with the stage of dysplasia at the previous examination (3% for mild, 48% for moderate, 100% for severe dysplasia). There was a strong correlation between the time period following gastric resection and grade of dysplasia and between the grade of dysplasia and development of cancer. Our study demonstrates that gastric stump cancer in rats develops from dysplastic lesions. A dysplasia-carcinoma sequence can therefore be assumed.

Adsorption of salivary proteins onto prosthetic titanium components

In vivo adsorption of salivary proteins onto prosthetic titanium components was analyzed after exposure of titanium abutments to the oral environment for a period of 2 to 6 weeks. Gel electrophoresis and Western immunoblotting were used to separate and identify the proteins, which were mainly alpha-amylase and serum albumin. Selective adsorption of proteins enables attachment of specific oral bacteria and thus may alter the composition of the dental plaque formed on titanium surfaces.

Adsorption of human salivary proteins to titanium powder. I. Adsorption of human salivary albumin

Titanium (Ti) is among the most widely used implant materials in dentistry today. The success of Ti implants is associated with their interactions with the surrounding tissues and biological fluids. In the present study, the adsorption of salivary proteins to Ti and the effect of calcium (Ca) on this process were investigated. Untreated and Ca-treated Ti powders were suspended in human clarified whole saliva. After incubation, the supernatant fluid was collected for protein analysis. The powders were then washed and resuspended in EDTA to desorb proteins from Ti surfaces. Sodium dodecylsulphate polyacrylamide gel electrophoresis and Bradford protein assay were conducted to determine the concentration and type of proteins that adsorbed onto Ti surfaces. The presence of Ca ions enhanced the adsorption of salivary proteins to Ti. A 66 kDa protein, identified by immunoblotting as albumin, was found as the main adsorbed salivary protein. Adsorption of albumin to Ti pretreated with Ca was significantly greater than to native Ti. The Ca-dependent adsorption process was reversed by EDTA. The data suggest that salivary albumin is one of the main constituents of a salivary biofilm formed on Ti dental implants and its adsorption to Ti surfaces is Ca-dependent. The presence of albumin on Ti dental implants may affect plaque accumulation on the implants and the biocompatibility of Ti implants.

[Extended family, immediate family and caregiver contacts of 100-year-old patients in Hungary]

In the year 1987, 218 centenarians lived in Hungary. First the main demographic data were reported by the surveyors of the Central Statistics Office. The basis of the experience was gained on a limited population (123 subjects). The physicians' team was organized by the Gerontology Center of the Semmelweis University of Medicine. They carried out the detailed medical and environmental check-up. The medical and environmental experiences of the gerontologists were published (1). In our present paper we would like to show the different familial and other relationships of the oldest people. The 123 centenarians were scattered over the whole country, altogether in 67 larger or smaller settlements. More of them lived with a daughter (42%), with a son (14%), with a grandchild (7%), with other relatives (5%) and 3 persons lived together with their wives. We found that the subjects who lived with relatives had a better chance to live an active and meaningful life. The co-existence of several generations, the multilateral contacts of centenarians have a beneficial effect on the quality of life.

Health and living conditions of centenarians in Hungary

Demographic data of 218 centenarians in Hungary were collected, and 123 were examined by a medical team. This data showed that the centenarians are from families with a history of longevity. A larger proportion of the centenarians live in the capital, Budapest, than in the rural areas. The centenarians are mostly manual workers (rural) and nonmanual workers. Most of them live with their families. The centenarians are healthier than the general population, drug consumption is low, and they have good adaptative abilities. We compared the clinical laboratory findings of the centenarians with that of 60-80 year olds. Though age-related changes were present in the centenarians, these age-related biological changes did not hinder them from reaching very old age. Finally, we found a few differences in the immunological, clinical laboratory, and morphological profiles of this population. We anticipate more extensive elaboration on this data in future publications.

Elevated cerebellar glucose metabolism in microvascular white matter disease: normal aging and Alzheimer's disease

Young normal, elderly, and clinically diagnosed Alzheimer disease subjects who had undergone positron emission tomography (PET) and computed tomography (CT) examinations were studied to determine the effect of periventricular white matter lesions on cerebellar glucose metabolic rates. PET-determined cerebellar metabolic rates were elevated in subjects with periventricular white matter lesions. These results suggest the cautious use of cortical-to-cerebellar ratios in future PET or single-photon-emission CT (SPECT) studies.

Partners in life: unmarried couples in Hungary

"Non-marital cohabitation in Hungary is documented using data from the 1970 and 1980 censuses and the 1984 microcensus. Observed patterns contrast with those in several other countries, particularly those of western and northwestern Europe. Firstly, in Hungary unmarried couples or 'partners in life' are more common, and their proportion is increasing more rapidly, among the previously married than among the single. Secondly, both among the single and the previously married, mothers are more likely than childless women to be cohabiting. Thirdly, although proportions cohabiting are higher in urban than in rural areas, partners in life are concentrated among those with the lowest educational level." (SUMMARY IN FRE)

[Hungary's retirement life table, 1984]

"Multivariate tables [for Hungary] present mortality and retirement of [the economically] active male and female subpopulations as well as the mortality order of [the] retired population postulating the probabilities valid for 1984. The author points out large differences in mortality order by sexes at the age of retirement and among pensioners. The computation not only shows the present situation but also provides a basis for the reform of the pension system...." (SUMMARY IN ENG AND RUS)