Novel quantitative software for automatically excluding red bone marrow on whole‐body magnetic resonance imaging in patients with metastatic prostate cancer: A pilot study

OBJECTIVES

To establish a novel quantitative method that automatically excludes the red bone marrow and accurately quantifies the tumor volume on whole-body magnetic resonance imaging using updated imaging software. To also evaluate the association between the quantified tumor volume and the prognosis of patients with metastatic prostate cancer.

METHODS

This prospective analysis included patients diagnosed with metastatic hormone-sensitive or metastatic castration-resistant prostate cancer between 2017 and 2022. We developed an imaging software (Attractive BD_Score) that analyzed whole-body diffusion-weighted and in-phase and opposed-phase T1-weighted images to automatically exclude the red bone marrow. The quantified tumor volume was compared with that quantified by traditional whole-body diffusion-weighted imaging without red bone marrow exclusion. Prostate-specific antigen progression-free survival, time-to-pain progression, and overall survival were evaluated to assess the prognostic value of the quantified tumor volume.

RESULTS

The quantified tumor volume was significantly smaller than that quantified by the traditional method in metastatic hormone-sensitive (median: 81.0 ml vs. 149.4 ml) and metastatic castration-resistant (median: 29.4 ml vs. 63.5 ml) prostate cancer. A highly quantified tumor volume was associated with prostate-specific antigen progression-free survival (p = 0.030), time-to-pain progression (p = 0.003), and overall survival (p = 0.005) in patients with metastatic hormone-sensitive prostate cancer and with poor prostate-specific antigen progression-free survival (p = 0.001) and time-to-pain progression (p = 0.005) in patients with metastatic castration-resistant prostate cancer.

CONCLUSIONS

Our imaging method could accurately quantify the tumor volume in patients with metastatic prostate cancer. The quantified tumor volume can be clinically applied as a new prognostic biomarker for metastatic prostate cancer.

An investigation into the measurement properties of the King-Devick Eye Tracking system

Objectives

Eye tracking has been gaining increasing attention as a possible assessment and monitoring tool for concussion. The King-Devick test (K-DT) was expanded to include an infrared video-oculography-based eye tracker (K-D ET). Therefore, the aim was to provide evidence on the reliability of the K-D ET system under an exercise condition.

Methods

Participants (N = 61; 26 male, 35 female; age range 19-25) were allocated to an exercise or sedentary group. Both groups completed a baseline K-D ET measurement and then either two 10-min exercise or sedentary interventions with repeated K-D ET measurements between interventions.

Results

The test-retest reliability of the K-D ET ranged from good to excellent for the different variables measured. The mean ± SD of the differences for the total number of saccades was 1.04 ± 4.01 and there was an observable difference (p = 0.005) in the trial number. There were no observable differences for the intervention (p = 0.768), gender (p = 0.121) and trial (p = 0.777) for average saccade’s velocity. The mean ± SD of the difference of the total fixations before and after intervention across both trials was 1.04 ± 3.63 and there was an observable difference in the trial number (p = 0.025). The mean ± SD of the differences for the Inter-Saccadic Interval and the fixation polyarea before and after intervention across both trials were 1.86 ± 22.99 msec and 0.51 ± 59.11 mm2 and no observable differences for the intervention, gender and trial.

Conclusion

The results provide evidence on the reliability of the K-D ET, and the eye-tracking components and demonstrate the relationship between completion time and other variables of the K-D ET system. This is vital as the use of the K-DT may be increasing and the combination of the K-DT and eye tracking as one single package highlights the need to specifically measure the reliability of this combined unit.

Radiation Therapy for Advanced Mucinous Carcinoma of the Breast With a Malignant Wound: A Case Report

Patients with breast cancer who refuse standard treatment often suffer from malignant wounds due to the growth of local tumors. However, treatment strategies for patients with unresectable locally advanced breast cancer who refuse standard treatment remain unclear. Usually, such cases are treated with palliative irradiation and do not achieve local control by irradiation alone. This is the first case report discussing the role of high-dose local irradiation and the treatment course for a patient with a massive breast tumor (mucinous adenocarcinoma) who refused standard treatment. A 44-year-old female was diagnosed with mucinous carcinoma of the breast in the right breast (cT1N0M0, cStage I). She refused standard treatment for six years. She visited the emergency department because of acute bleeding from the right breast with malignant wounds. Macroscopically, the tumor in the right breast measured over 20 cm in diameter. The tumor was exudative, exhibited ulceration and slight bleeding, and emitted an odor. Imaging findings showed multiple lymph nodes and bone metastases, and the final diagnosis was stage IV breast cancer (cT4bN1M1). Although the surgeon recommended chemotherapy for breast cancer, the patient refused chemotherapy or other therapy due to concerns regarding treatment-related complications. Considering the symptoms of advanced breast cancer with malignant wounds, she finally agreed to receive radiation therapy (RT). We performed RT at 70 Gy in 35 fractions over seven weeks. The tumor-associated symptoms disappeared after RT. Three months after RT, the tumor had almost disappeared. We administered luteinizing hormone-releasing hormone agonists after RT. Two years after RT, she died due to multiple liver metastases and ascites; however, there was no disease progression in the right breast. High-dose RT for locally advanced mucinous carcinoma of the breast with malignant wounds is considered an effective therapeutic option.

Visceral fat accumulation and left atrial phasic function in the general population

Background

Obesity carries independent risk for incident atrial fibrillation (AF), although the impact of abdominal fat distribution on LA morphological and functional remodeling is not fully elucidated. Speckle-tracking echocardiography is a novel and sensitive tool that allows quantification and detection of subtle alterations in left atrial (LA) phasic function.

Purpose

This study aimed to investigate whether increased visceral adiposity is independently associated with impaired LA phasic function in a community-based cohort.

Methods

We included 527 participants without overt cardiac disease who underwent laboratory testing, abdominal computed tomographic examination and speckle-tracking echocardiography. Abdominal adiposity was quantitatively assessed as visceral fat area (VFA) and subcutaneous fat area (SFA) at the level of the umbilicus. Speckle-tracking echocardiography was performed to assess LA phasic function including reservoir, conduit and pump strain as well as left ventricular global longitudinal strain (LVGLS).

Results

Mean age was 57±10 years and 362 of the participants (69%) were men. LA reservoir and conduit strain were decreased according to the VFA quartiles (both p<0.05), whereas there was no significant difference in LA volume index and LA pump strain. When stratified by SFA, there was no significant differences in LA volume index and all LA phasic strain across the quartiles. In multivariable analysis, VFA as continuous variable was significantly associated with LA conduit strain, independent of traditional cardiovascular risk factors, pertinent laboratory parameters and LV morphology and function including LVGLS (standardized b=−0.146, p=0.011). Representative cases are shown in the Figure.

Conclusion

In a sample of the general population, VFA accumulation was independently associated with worse LA conduit strain, which may be involved in the pathophysiological mechanism of obesity-related AF.

Funding Acknowledgement

Type of funding source: Foundation. Main funding source(s): Yamauchi Susumu Scholarship for Cardiovascular Research

Association between insulin resistance and left ventricular diastolic dysfunction in non-diabetic general population

Background

Insulin resistance due to visceral fat accumulation plays a central role in the development of diabetic mellitus and subsequent cardiovascular disease. Abdominal obesity and diabetic mellitus are associated with the progression of left ventricular diastolic dysfunction which is the major structural abnormality in patients with heart failure. However, whether insulin resistance influences left ventricular diastolic dysfunction in non-diabetic subjects is unclear.

Purpose

In this study, we aimed to clarify the association between insulin resistance and left ventricular diastolic dysfunction in non-diabetic general population.

Methods

We examined 2,572 non-diabetic subjects with preserved left ventricular systolic function (ejection fraction ≥50%) and without a past history of diabetic mellitus, heart failure, coronary artery disease, atrial fibrillation, stroke, moderate to severe valvular disease, who underwent medical check-ups at the University of Tokyo Hospital from January 2009 to December 2018. Diabetes mellitus was defined as fasting glucose level ≥126 mg/dL or a subject's use of oral antidiabetic medications or insulin. We calculated the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) score [HOMA-IR = fasting glucose (mg/dL) × insulin (μU/mL) / 405], and defined insulin resistance as HOMA-IR ≥2.5. Left ventricular diastolic function was assessed by echocardiography, using tissue doppler analysis (E/E' ratio in septal and lateral). Visceral adiposity was assessed as visceral fat volume measured by computed tomography scanner.

Results

Mean age was 53.3±9.8 years, and 1,746 subjects (67.9%) were male. Overall, HOMA-IR was 1.1 on average, and HOMA-IR ≥2.5 was observed in 5.0% of study population. BMI and the prevalence of obesity were higher in subjects with HOMA-IR ≥2.5 than in those without. There was no significant difference in left ventricular ejection fraction between HOMA-IR ≥2.5 and ≤2.5. E/E' ratio in septal and lateral were higher in subjects with HOMA-IR ≥2.5 than in those without. Multivariable logistic regression analysis demonstrated that obesity and waist circumference, visceral fat volume were independently associated with HOMA-IR ≥2.5, however, age, hypertension, hypercholesterolemia were not. Further, multiple regression analysis including insulin resistance, age, male gender, obesity, hypertension, hypercholesterolemia, cigarette smoking and visceral fat volume, showed that insulin resistance was an independent determinant of increasing E/E' in both septal and lateral, whereas visceral fat volume was not (Figure 1).

Conclusion

The results of the present study suggest that insulin resistance due to visceral fat accumulation might be associated with the development of left ventricular diastolic dysfunction in non-diabetic general population without overt cardiovascular disease.

Figure 1

Funding Acknowledgement

Type of funding source: None

Relationship between Histological Grade and Histopathological Appearance in Canine Mammary Carcinomas

Canine mammary carcinomas are common tumours in female dogs and histopathological examination has an important role in identifying whether they are benign or malignant. The latest and most commonly used histological grading system was established by Peña et al. (2013) and is based on the extent of tubule formation, nuclear pleomorphism and number of mitoses. Before the establishment of this grading system, tumour size and classical histological indicators of malignancy such as lymphovascular invasion, infiltration into surrounding tissue, necrosis and presence of a micropapillary pattern were important predictors of biological behaviour. However, the system of Peña et al. does not consider tumour size or these histological features. Clarifying the association of these features and histological grade, especially in grade II and III carcinomas, is important. In this study, we confirmed that the system of Peña et al. is effective for predicting biological behaviour and that evaluation of histological features of malignancy reinforced histological grade, as determined by the system of Peña et al., especially in grade II carcinomas.

Rheology and Foaming of Long-Chain Branched Ethylene-Tetrafluoroethylene Copolymer and Its Blends

The long-chain branched ethylene-tetrafluoroethylene copolymer (B-ETFE) was synthesized by radical polymerization using ethylene, tetrafluoroethylene, termonomer, and a very small amount of divinyl monomer. We studied melt rheology under shear and elongational flow, and foamability for B-ETFE, comparing with conventional linear ETFE. Addition of a small amount of the divinyl monomer had a considerable impact on the melt rheology of ETFE and its blends. The observed non-linear elongational behavior and emergence of long relaxation time components can be explained by long-chain branching in the modified ETFE. B-ETFE and its blends showed excellent foaming processability: uniform and smaller cell sizes and much higher cell number densities than those of linear ETFE. To the best of our knowledge, this is the first report of the enhancement of the melt rheology of ETFE from the viewpoint of modification of its molecular architecture.

Cytomegalic Inclusion Disease caused by Cytomegalovirus Infection in the Salivary Glands of an African Hedgehog (Atelerix arbiventris)

Cytomegalic inclusion disease (CID) in the salivary gland of African hedgehogs (Atelerix arbiventris) has been reported before, and is suspected to reflect a cytomegalovirus infection. However, a recent ultrastructural study reported that African hedgehog CID reflected oncocytic metaplasia, mimicking a cytomegalovirus infection. We examined the submandibular and sublingual salivary glands of a 1-year-old male African hedgehog. Histologically, there were multiple foci composed of cytomegalic cells with intranuclear inclusion bodies. Ultrastructurally, viral particles (109-118 nm in diameter) were observed in the nuclei of the cytomegalic cells. There were numerous vesicles containing various numbers of enveloped viruses in the cytoplasm. We also attempted to detect viral DNA fragments by degenerate polymerase chain reaction and obtained amplicons of a predicted size. Phylogenetic analysis indicated that the virus is a betaherpesvirus, comparatively related to human and rodent cytomegaloviruses. The present study suggested that African hedgehog CIDs also include those caused by the cytomegalovirus.

Olympic torch flap: one-stop option for simultaneous brow, upper and lower lid reconstruction in post burn patients

Facial units reconstruction in a post burn patient poses tough challenges. Simultaneous brow and lid reconstruction is one of them. This article presents a 45-year-old epileptic male with burn of complete face. The task of reconstructing the brow, upper and lower lids was successfully accomplished using a modification of the Guyuron postauricular fasciocutaneous flap, after initial grafting and radial forearm flap reconstruction of forehead and other parts of the face. The article gives a single-stop solution for simultaneous reconstruction of brow and lids using a random pattern extension of the traditional postauricular flap, thus proving the excellent vascularity and hence durability of the flap in spite of a 180 degrees change in the orientation of the flap with respect to the axis.

The Relation between Hamstring Strain Injury and Physical Characteristics of Japanese Collegiate Sepak Takraw Players

The aim of this study was to investigate the injuries in Japanese collegiate sepak takraw players. We primarily focused on hamstring strain injury (HSI), and investigated the associated physical characteristics. The study included 77 Japanese collegiate sepak takraw players who were interviewed; data were collected regarding injuries sustained by them during the game within the past year. The hip range of motion (ROM) was measured. The total number of injuries was 48 in a year. The rate of HSI was the highest (31.3%) among all the injuries. All HSIs occurred in the dominant leg because of the sunback spike. Using the Mann-Whitney U test, significant differences in age and sport-related experience were observed between the injured group and uninjured group. Upon using logistic regression analysis, the presence of a HSI was found to be associated with the sport-related experience (adjusted odds ratio [OR], 0.30; 95% confidence interval [CI], 0.12-0.77) and the hip extension ROM (adjusted OR, 0.81; 95% CI, 0.66-0.99) after adjusting for sex, sport-related experience, and the hip ROM. HSI is the most common injury in Japanese collegiate sepak takraw players. Short sport-related experience and small hip extension ROM are related with the occurrence of HSI.

Atomic step-and-terrace surface of polyimide sheet for advanced polymer substrate engineering

Typical thermostable and flexible polyimide polymers exhibit many excellent properties such as strong mechanical and chemical resistance. However, in contrast to single-crystal substrates like silicon or sapphire, polymers mostly display disordered and rough surfaces, which may result in instability and degradation of the interfaces between thin films and polymer substrates. As a step toward the development of next-generation polymer substrates, we here report single-atom-layer imprinting onto the polyimide sheets, resulting in an ultrasmooth 0.3 nm high atomic step-and-terrace surface on the polyimides. The ultrasmooth polymer substrates are expected to be applied to the fabrication of nanostructures such as superlattices, nanowires, or quantum dots in nanoscale-controlled electronic devices. We fabricate smooth and atomically stepped indium tin oxide transparent conducting oxide thin films on the imprinted polyimide sheets for future use in organic-based optoelectronic devices processed with nanoscale precision. Furthermore, toward 2D polymer substrate nanoengineering, we demonstrate nanoscale letter writing on the atomic step-and-terrace polyimide surface via atomic force microscopy probe scratching.

'Transfer out' tuberculosis patients: treatment outcomes after cross-checking registers, 2012-2013, Lusaka, Zambia

SETTING

Lusaka, Zambia.

OBJECTIVE

To assess the actual treatment outcomes of 'transfer out' (TO) cases at a diagnostic centre in Lusaka, in the third and fourth quarters of 2012, and to see the impact of this cross-check in treatment success rates (TSR) in 2013 and early 2014.

DESIGN AND METHOD

In this retrospective cohort study, treatment outcomes for new bacteriologically positive tuberculosis (TB) cases referred from the diagnostic centre were reviewed and compared with those at the receiving treatment units.

RESULTS

Of 49 (58%) cases referred to three treatment units, the treatment outcomes of nine had to be updated at the diagnostic centre, which reduced the proportion of TO cases from 17.6% to 11.8% and increased the TSR to 70.6% from 64.7%.

CONCLUSION

The review and cross-checking of the TB registers at the diagnostic and treatment units led to a significant reduction in non-assessed cases, suggesting that the TB registers in the diagnostic and treatment units should be cross-checked regularly. There is also need for a complementary intervention to reduce the proportion of TOs associated with high loss to follow-up and non-evaluated TO rates.

Abundance and genetic damage of barn swallows from Fukushima

A number of studies have assessed or modeled the distribution of the radionuclides released by the accident at the Fukushima-Daiichi Nuclear Power Plant (FDNPP). Few studies however have investigated its consequences for the local biota. We tested whether exposure of barn swallow (Hirundo rustica) nestlings to low dose ionizing radiation increased genetic damage to their peripheral erythrocytes. We estimated external radiation exposure by using thermoluminescent dosimeters, and by measuring radioactivity of the nest material. We then assessed DNA damage by means of the neutral comet assay. In addition, we conducted standard point-count censuses of barn swallows across environmental radiation levels, and estimated their abundance and local age ratio. Radioactivity of nest samples was in the range 479-143,349 Bq kg(-1), while external exposure varied between 0.15 and 4.9 mGy. Exposure to radioactive contamination did not correlate with higher genetic damage in nestlings. However, at higher levels of radioactive contamination the number of barn swallows declined and the fraction of juveniles decreased, indicating lower survival and lower reproduction and/or fledging rate. Thus, genetic damage to nestlings does not explain the decline of barn swallows in contaminated areas, and a proximate mechanism for the demographic effects documented here remains to be clarified.

Positive association between serum thymic stromal lymphopoietin and anti-citrullinated peptide antibodies in patients with rheumatoid arthritis

Thymic stromal lymphopoietin (TSLP) has been suggested recently to play an important role in the pathophysiology of rheumatoid arthritis (RA). However, there is little information on serum TSLP concentrations in RA and its clinical significance. The present study investigated whether serum TSLP concentrations were affected in patients with RA. Using an enzyme-linked immunosorbent assay (ELISA), we measured TSLP concentrations in the serum obtained from 100 patients with RA, 60 patients with osteoarthritis (OA) and 34 healthy volunteers. We also investigated the correlation between serum TSLP concentrations and clinical parameters of disease activity in RA [disease activity score using 28 joint counts (DAS28)-C-reactive protein (CRP), DAS28-erythrocyte sedimentation rate (ESR), Clinical Disease Activity Index (CDAI]), patient's/-physician's Visual Analogue Scale (VAS), swollen joints count, tender joints count, CRP, ESR and matrix metalloproteinase-3 (MMP-3) concentrations]. In addition, we investigated the correlation between serum TSLP concentrations and anti-citrullinated peptide antibody (ACPA) and serum tumour necrosis factor (TNF)-α. Serum TSLP levels in patients with RA were significantly higher than those in patients with OA and in healthy volunteers. Interestingly, serum TSLP concentrations were correlated significantly with ACPA titres, but not with other clinical parameters. There was a significant increase in serum TSLP concentrations in patients with RA, which was correlated positively with serum ACPA titres. These findings suggest that in patients with RA, TSLP may play a role in ACPA production by B cells.

Enhanced thermal, mechanical and fire-retarding properties of polystyrene sulphonate-grafted-nanosilica/polypropylene composites

The addition of pSS-grafted-nanosilica to PP showed enhanced fire retardancy as assessed by mass loss, cone calorimetry and LOI measurements.

Flow Analyses in a Spiral Mandrel Die Assuming Wall Slip

It is often observed in industrial practice that the thickness uniformity of blown film obtained with a given die varies with the type of polymer. We have shown in previous works the importance of the wall slip of polymer melt in the film uniformity. Currently available models of polymer melt flow through spiral mandrel dies neglect the wall slip. The present work considers the slip in flow analyses and predicts the effects of rheological properties on the uniformity; the decreases in melt viscosity and wall slip and the increases in shear thinning and the stress dependence of wall slip reduce the uniformity. The predictions agree well with the experimental results obtained in our previous studies.

Effect of Pressure and Shear Stress on Crystallization Behaviors in Injection Molding

We studied in detail the effects of pressure and shear stress on the crystallization behaviors during injection molding process. Crystallization of isotactic-polypropylene (iPP) was simulated for various injection flow rates. The crystallization started during the filling stage under long filling condition. Moreover, the crystallization in some layers showed two -step growth behavior, while in other layers the crystallization does not progress during the packing -cooling stage. Since pressure becomes very high during molding process under long filling time condition, the change of pressure is the most important factor governing the crystallization.

Study on Viscoelastic Behavior and Extrusion Blow Molding Processability of PP/PE Blends

In this study, extrusion blow molding processability of polypropylene/polyethylene (PP/PE) blends was related to their viscoelastic behavior and morphology under shear flow. The propylene block-copolymer (PP-B) and blends comprising the PP-B and the linear low-density polyethylene (PE), weight fraction of the PE (ϕPE) was up to 20 wt.%, were mainly used for this study. Viscoelastic behavior under shear flow and swelling ratio of the extruded strands were measured by using a capillary type rheometer. Morphology of the strands was observed by TEM. In case of the PP-B, swelling ratio highly depended on shear rate. Coarse aggregated droplets were observed irrespective of shear rate under the measurement. The droplets were ethylene-propylene copolymers (EP) included in the PP-B aggregated at conversing section of the capillary. However, in case of the PP-B/PE blends, swelling ratio showed lower dependence on shear rate as the ϕPE was higher. When the shear rate was low, large droplets were observed and they were highly deformed in the flow direction. On the other hand, when shear rate was high, the droplets were smaller and showed no deformation in the flow direction because the droplets were broken up due to occurrence of high shear stress. Wall thickness of blow molded bottles produced from the PP-B/PE blends was not affected by the throughput rate. It was proportional to the die-core gap. On the other hand, wall thickness of bottles of the PP-B depended on the throughput rate and it was not proportional to the die-core gap. These results suggest that extrusion blow molding processability of polymer blends is good when the dependence of swelling ratio on shear rate is low.

Effect of Material Species on Flash Generation of PPS/GF Composites

Reduction of flash in injection molding is of great concern for manufacturers of electrical parts. In a previous report we have proposed a theoretical model for flash generation. The present study prepares five different poly(phenylene sulfide)/glass fiber composites using three different PPS; linear, branched and crosslinked PPS and measures the length of flash generated in the molding of the composites. Then, we have compared the flash data with a flash parameter defined in the model. This comparison has elucidated that flash length can be related with the flash parameter irrespective of PPS structure, as long as GF content is the same and the clearance of a gas vent is almost identical.

ROS evaluation for a series of CNTs and their derivatives using an ESR method with DMPO

Carbon nanotubes (CNTs) are important materials in advanced industries. It is a concern that pulmonary exposure to CNTs may induce carcinogenic responses. It has been recently reported that CNTs scavenge ROS though non-carbon fibers generate ROS. A comprehensive evaluation of ROS scavenging using various kinds of CNTs has not been demonstrated well. The present work specifically investigates ROS scavenging capabilities with a series of CNTs and their derivatives that were physically treated, and with the number of commercially available CNTs. CNT concentrations were controlled at 0.2 through 0.6 wt%. The ROS scavenging rate was measured by ESR with DMPO. Interestingly, the ROS scavenging rate was not only influenced by physical treatments, but was also dependent on individual manufacturing methods. Ratio of CNTs to DMPO/ hydrogen peroxide is a key parameter to obtain appropriate ROS quenching results for comparison of CNTs. The present results suggest that dangling bonds are not a sole factor for scavenging, and electron transfer on the CNT surface is not clearly determined to be the sole mechanism to explain ROS scavenging.

Paint/Polymer Interface Structure for ABS Injection Moldings

Structure of paint/polymer interface was investigated for the injection molded and compression molded ABS specimens. For the interface of the injection molded specimen, a peculiar “zigzag” structure formation of several tens μm in size was observed. In contrast, the interface structure was not observed for the compression molded specimen and injection molded specimen annealed above the glass transition temperature (Tg). These facts indicate that the interface structure is related to the residual stress and molecular orientation at the surface of the injection molding specimen, because both surface structures would be removed by annealing at temperatures above Tg. The interface structure was strongly dependent on the curing agent concentration. The depth of the structure decreased with increasing curing agent concentration because of decreasing in curing time. At painting temperature between 70°C and 130°C, the depth and pitch were constant. However, below 60°C and above 140°C, the depth and pitch were changed. These results strongly suggest that the interface structure is attributable to relaxation of the surface residual stress and molecular orientation by paint soaking.

Effect of Electric Current on Beads Formation in Electrospinning of Poly(Vinyl Alcohol)

We investigate effects of electric current on formations of beads in electrospinning by changing an electric conductivity of a poly(vinyl alcohol) (PVA) aqueous solution and spinning conditions, such as applied voltage, distance between a tip of needle and a collector, and relative humidity. From the results of experiments done by changing the conductivity of PVA aqueous solution and spinning conditions, we found that a beads formation is suppressed at a lower electric current. Furthermore, when the electrospinnings are performed at a certain constant electric current in various spinning conditions where the applied voltage and tip-collector distance are changed so as to give the same constant electric current, resultant PVA fibers have no beads and almost the same distribution of fiber diameter.

Development of Polymer Extrusion Extruder for Evaluating with a Small Amount of Polymeric Material

We developed the extrusion system to evaluate the extrusion behavior such as the shear viscosity, which is one of basic properties, and the processability of mono/multilayer film with a small amount of polymeric material. In order to measure the shear viscosity, the gear pump, the return path and the pressure sensors were introduced into the extruder with intermeshing co-rotating twin screws. The viscosity could be evaluated on-line from the volumetric flow rate of molten polymer and the pressure drop in the return path before film processing. The capacity of gear pump, the shape and size of return path were optimized to evaluate the viscosity of polymeric material, which generally undergoes shear rate of 10 ∼ 1000 s−1 in the film processing. The apparatus for mono and multilayer film processing consisted of two extruders including the multichannel feedblock and T-die with the manifold and land section. The compact feedblock was designed to receive two feedstreams, so that the product can have two layers. We investigated the on-line viscosity measurement methodology and the processability, which is the neck-in phenomenon for monolayer film and the interface stability for multilayer film, using typical polymer material of 30 grams at once. The viscosity evaluated with our system corresponded with the result of commercial rheometer. It was also confirmed that the processability of mono and multilayer film could be evaluated quantitatively with our system.

Radiological abnormalities and low back pain in gymnasts

Several studies have shown a higher prevalence of radiological abnormalities among gymnasts. However, the types of radiological abnormalities associated with low back pain (LBP) have not been clarified. The hypothesis was that significant relationships between radiological abnormalities and LBP may be revealed by discriminating between the types of MRI abnormalities while considering confounding factors. The subjects were 104 Japanese collegiate gymnasts (men, 70; women, 34). The presence of LBP was evaluated using the questionnaire developed by Osaka City University (OCU Test). Magnetic resonance imaging (MRI) abnormalities were evaluated using T1- and T2-weighted MRI. The prevalence of more than 1 MRI abnormality in gymnasts was 47.1% (49/104). The chi-square test showed that the incidence of lumbar disc degeneration (LDDG) and limbus vertebra was significantly greater in gymnasts with LBP than in gymnasts without LBP. By using logistic regression analysis to analyze the concomitant environmental variables, only LDDG (odds ratio, 2.70; 95% confidence interval, 1.10-6.66) was selected as a statistically significant variable accounting for LBP. In conclusion, LDDG is a predictor for LBP in Japanese collegiate gymnasts.

Insulinoma may mask the existence of Type 1 diabetes

BACKGROUND

Insulinoma is a tumour of insulin-producing cells of the pancreas and is known to be one of the causes of hypoglycaemia. Usually, appropriate removal of the insulinoma results in normalization of blood glucose levels. However, we found novel cases of insulinoma, in which hyperglycaemia developed soon after resection of the insulinoma.

CASE REPORT

We encountered two patients with repeated hypoglycaemia caused by insulinoma. Following removal of the insulinoma, unanticipated hyperglycaemia was observed in both patients. Thereafter, their blood tests revealed low levels of serum C-peptide and high titres of anti-glutamic acid decarboxylase antibody, indicating concomitant Type 1 diabetes. Indeed, histological examination of the resected specimen revealed that one patient showed insulitis in non-tumorous pancreatic tissue in which β-cells had already disappeared. Moreover, inflammatory cells infiltrated the insulinoma, as if it were insulitis of Type 1 diabetes, suggesting the existence of anti-islet autoimmunity.

CONCLUSION

These are first cases of insulinoma associated with underlying Type 1 diabetes. Physicians should be aware of the possibility that insulinoma may mask Type 1 diabetes, and measurement of anti-islet autoantibodies may be helpful to find underlying Type 1 diabetes, such as in these cases. It is pathologically interesting that the immune cell infiltration into insulinoma may be suggestive of anti-islet autoimmunity.

COL11A1 gene is associated with limbus vertebra in gymnasts

Several studies have shown higher frequencies of radiological abnormalities among gymnasts. Recently, the gene encoding the α1 chain of type XI collagen, (COL11A1) (rs 1676486), was associated with lumbar disc herniation in the Japanese population. We hypothesized that there was a significant relationship between abnormal magnetic resonance imaging (MRI) findings of the lumbar spine and the COL11A1 4603C/T gene polymorphism in collegiate gymnasts. Our study participants included 103 Japanese collegiate gymnasts (70 men and 33 women). Radiological abnormalities were evaluated using T1- and T2-weighted MRI. Genotyping for COL11A1 was performed for all the participants. By using logistic regression analysis, we observed significant associations between limbus vertebra and age (adjusted odds ratio=0.51, 95% confidence interval: 0.27-0.96), sporting experience (adjusted odds ratio=1.49, 95% confidence interval: 1.14-1.94), and a TT genotype (adjusted odds ratio=7.83, 95% confidence interval: 1.33-46.03). We conclude that a TT genotype of COL11A1 polymorphism may be a significant risk factor for limbus vertebra in Japanese collegiate gymnasts.

Analyses of laboratory data and establishment of reference values and intervals for healthy elderly people

OBJECTIVE

Protein-energy malnutrition is a common disorder in the elderly. Although serum albumin is commonly used as a nutritional marker, data is lacking on serum albumin levels in the elderly. The purpose of this study was to determine whether serum albumin levels decrease with advancing age and to establish reference value and interval of laboratory data for elderly people (75 years and over).

PARTICIPANTS

Blood samples from 13821 healthy people, 42064 outpatients, and 15959 inpatients were collected during 2008. Blood from 127 of our nutrition support team (NST) patients was also collected during August 2006 and May 2009, and analyzed.

MEASUREMENTS

Serum albumin, hemoglobin, total cholesterol levels and lymphocyte count were determined. We analyzed the change in each parameter in accordance with age, compared the data for elderly people with younger people, and established new reference values. Clinical outcomes were examined depending on the improved reference values.

RESULTS

Albumin was lower in older persons than in younger persons. The estimated reference value and interval were 42 (48-36) g/l in older persons and was much lower in NST patients. Hemoglobin was decreased while cholesterol and lymphocyte count were not changed in older persons: all were markedly decreased in NST patients. Terms of hospital stay were significantly longer and mortality rates were significantly higher in older persons, comparing from above to below using a new reference value of albumin (36 g/l).

CONCLUSIONS

The serum albumin level decreases with advancing age, but it was maintained to some extent in healthy older people. Serum albumin levels related to the clinical outcome. Hemoglobin and cholesterol levels and lymphocyte count were all lower in NST patients. These measurements may be valuable markers of nutritional status and can help in guiding the need for nutritional support.

[Maxillary and mandibular fractures. Treatment concepts in maxillofacial surgery]

Maxillary and mandibular fractures are a relatively frequent occurrence due to the exposed location of the jaws and are caused mainly by acts of violence, traffic and recreational accidents. Mandibular fractures can be treated conservatively with dental splints and intermaxillary fixation. Since Michelet, miniplate osteosynthesis via intraoral access has become the method of choice. Champy showed that the monocortical fixation of miniplates at the level of the linea obliqua results in stable osteosynthesis, despite postoperative micro-movements in the fracture gap, and postulated the principle of dynamic compression. Dislocated fractures of the mandibular collum are treated with stable osteosynthesis via an intra- or extraoral approach, while fractures of the mandibular joint are usually treated conservatively and early functional rehabilitation is favored. For mandibular fractures, the principle of load-bearing and load-sharing should be considered, i.e. in the case of sufficient bone and uncomplicated fractures, the bone can bear most of the force, such that miniplates are sufficient (load-sharing). If bones are weakened by atrophy or in the case of infected, comminuted or defect fractures osteosynthesis plates must bear the load alone (load-bearing).

Serum Amyloid a Low-Density Lipoprotein Levels and Smoking Status in Obese Japanese Patients

Serum amyloid A low-density lipoprotein (SAA-LDL) is formed by an oxidative interaction and is considered to be a new marker related to oxidative modification of LDL. As the effect of smoking on oxidized LDL is of concern, this study investigated the association between SAA-LDL and smoking status. A total of 578 Japanese obese outpatients (mean ± SD age 50.5 ± 14.3 years) were studied. Smoking status was examined via a self-reported questionnaire. Cardiometabolic variables, including high-sensitivity C-reactive protein (hsCRP), were analysed in addition to SAA-LDL. There was an increasing trend in SAA-LDL levels from non- to ex- to current smokers, and significantly higher SAA-LDL levels were observed in current smokers versus non-smokers (median SAA-LDL level 36 μg/ml versus 28 μg/ml, respectively). This significant difference was reduced after adjusting for multiple confounders, including lipid levels. Smoking may be associated with increased levels of SAA-LDL in an obese Japanese population, but further studies are needed.

Gas Source Silicon Molecular Beam Epitaxy

Gas source silicon molecular beam epitaxial (Si-MBE) growth is microscopically governed by a disociative adsorption of silicon hydrides, such as Si2H6 source gas molecules on Si surface. The dissociative adsorption generates SiH species on the surface. From this hydride phase, hydrogen desorbs thermaly. The temperature dependence of the growth rate indicated that the hydrogen desorption from the SiH is the rate limiting step. In HBO2 Knudsen cell doping, B adsorbates block the surface migration. Such a blocking effect can be avoided by B2H6 gas dopant, because of the similar incorpration mechanism of B2H6 to that of Si2H6. However, in PH3 gas doping, a crystal quality degradation was observed at a high doping range due to the preferentially high sticking coefficient of PH3 and the resulting surface dangling bond termination. The selective epitaxial growth of a B doped layer using Si2H6 and B2H6 was applied to a novel structured base fabrication for super self-aligned selectively grown base transistor (SSSBT). A successful achievement of the SSSBT fabrication indicates the high potentiality of gas source Si-MBE to the sub-micron size ultra-high speed bipolar large scale integrated (LSI) circuits.

Engulfment of spermatozoa by cumulus cells and the role of CD36

The function of cumulus cells after sperm penetration is not well understood. The present study examined the phagocytic action of cumulus cells on sperm after dispersion of cumulus-oocyte complexes. In a co-incubation system of cauda sperm and cumulus cells, the sperm heads were beginning to vanish after 2.5h and 77%±1.34 of sperm heads had disappeared at 30 h. Most of the sperm heads were engulfed by cumulus cells. Immunofluorescent studies showed that cumulus cells were expressing the CD36 molecule, and sperm were exposing phosphatidylserine (PS). Anti-CD36 antibody and annexin V inhibited the engulfment of sperm by cumulus cells by 26.0% and 40.5%, respectively. These results suggested that the cumulus cells recognized the PS molecules on sperm via CD36 and this molecular interaction possibly triggered the phagocytosis of sperm by cumulus cells. These results suggest that cumulus cells might play a role in inhibiting undesired immune reactions induced by sperm antigens.

Pharmacokinetics and disposition of CS-8958, a long-acting prodrug of the novel neuraminidase inhibitor laninamivir in rats

CS-8958, a prodrug of laninamivir (R-125489), is currently under development as an inhaled anti-influenza drug. In this study, the pharmacokinetics and disposition of CS-8958 were characterized in rats. After intratracheal administration of 14C-CS-8958, radioactivity was retained over long periods in the target tissues (trachea and lung) as its active metabolite R-125489 - 19.12% of the dose was retained in the lung at 24 h. After intratracheal administration of CS-8958, plasma R-125489 concentration was slowly eliminated, and its half-life (14.1 h) was considerably longer than that after intravenous administration of R-125489. The radioactivity of intratracheally administered 14C-CS-8958 was mainly excreted into the urine (67.5% of dose), and this excretion lasted over long periods. R-125489 accounted for most of the urinary radioactivity recovered after 24 h. These results demonstrated that CS-8958 administered intratracheally to rats was converted/hydrolysed to R-125489 in the target tissues, and that the R-125489 was slowly excreted into the urine via an absorption rate-limiting process. Such distinctive pharmacokinetics attributed to the slow release of R-125489 suggests the potential for a long-acting anti-influenza drug.

Effect of pressure on lattice distortion, transport and magnetic properties of Pr-substituted La(1.2)Sr(1.8)Mn(2)O(7) bilayered manganite

We have studied the effect of pressure on the anomalous lattice striction, both in the ab-plane and along the c-axis, of (La,Pr)(1.2)Sr(1.8)Mn(2)O(7) single crystals over the temperature region where the paramagnetic insulator to ferromagnetic metal transition takes place. We have examined the temperature dependence of the resistivity and the magnetization under applied pressure. The chemical pressure effect due to Pr-substitution at the La site suppresses the transition temperature of the parent crystal, while the application of external pressure on Pr-substituted crystals enhances the double exchange driven metallic state, resulting in a stable rise of T(c).

Prevalence of adult-onset multifactorial disease among offspring of atomic bomb survivors

The first study to examine whether parental radiation exposure leads to increased heritable risk of common adult-onset multifactorial diseases (i.e., hypertension, diabetes mellitus, hypercholesterolemia, ischemic heart disease, and stroke) was conducted among 11,951 participants in the clinical examination program out of a potential of 24,673 mail survey subjects who were offspring of survivors born from May 1946 through December 1984. Logistic regression analyses demonstrated no evidence of an association between the prevalence of multifactorial diseases in the offspring and parental radiation exposure, after adjusting for age, city, gender and various risk factors. The odds ratio (OR) for a paternal dose of 1 Gy was 0.91 [95% confidence interval (CI) 0.81-1.01, P = 0.08], and that for a maternal dose of 1 Gy was 0.98 (95% CI 0.86-1.10, P = 0.71). There was no apparent effect of parental age at exposure or of elapsed time between parental exposure and birth, but male offspring had a low odds ratio (OR = 0.76 at 1 Gy) for paternal exposure, but cautious interpretation is needed for this finding. The clinical assessment of nearly 12,000 offspring of A-bomb survivors who have reached a median age of about 50 years provided no evidence for an increased prevalence of adult-onset multifactorial diseases in relation to parental radiation exposure.