Fisetin attenuates doxorubicin-induced cardiotoxicity by inhibiting the insulin-like growth factor II receptor apoptotic pathway through estrogen receptor-α/-β activation

Doxorubicin (DOX), an effective chemotherapeutic drug, has been used to treat various cancers; however, its cardiotoxic side effects restrict its therapeutic efficacy. Fisetin, a flavonoid phytoestrogen derived from a range of fruits and vegetables, has been reported to exert cardioprotective effects against DOX-induced cardiotoxicity; however, the underlying mechanisms remain unclear. This study investigated fisetin's cardioprotective role and mechanism against DOX-induced cardiotoxicity in H9c2 cardiomyoblasts and ovariectomized (OVX) rat models. MTT assay revealed that fisetin treatment noticeably rescued DOX-induced cell death in a dose-dependent manner. Moreover, western blotting and TUNEL-DAPI staining showed that fisetin significantly attenuated DOX-induced cardiotoxicity in vitro and in vivo by inhibiting the insulin-like growth factor II receptor (IGF-IIR) apoptotic pathway through estrogen receptor (ER)-α/-β activation. The echocardiography, biochemical assay, and H&E staining results demonstrated that fisetin reduced DOX-induced cardiotoxicity by alleviating cardiac dysfunction, myocardial injury, oxidative stress, and histopathological damage. These findings imply that fisetin has a significant therapeutic potential against DOX-induced cardiotoxicity.

A Wearable Assistant Device for the Hearing Impaired to Recognize Emergency Vehicle Sirens with Edge Computing

Wearable assistant devices play an important role in daily life for people with disabilities. Those who have hearing impairments may face dangers while walking or driving on the road. The major danger is their inability to hear warning sounds from cars or ambulances. Thus, the aim of this study is to develop a wearable assistant device with edge computing, allowing the hearing impaired to recognize the warning sounds from vehicles on the road. An EfficientNet-based, fuzzy rank-based ensemble model was proposed to classify seven audio sounds, and it was embedded in an Arduino Nano 33 BLE Sense development board. The audio files were obtained from the CREMA-D dataset and the Large-Scale Audio dataset of emergency vehicle sirens on the road, with a total number of 8756 files. The seven audio sounds included four vocalizations and three sirens. The audio signal was converted into a spectrogram by using the short-time Fourier transform for feature extraction. When one of the three sirens was detected, the wearable assistant device presented alarms by vibrating and displaying messages on the OLED panel. The performances of the EfficientNet-based, fuzzy rank-based ensemble model in offline computing achieved an accuracy of 97.1%, precision of 97.79%, sensitivity of 96.8%, and specificity of 97.04%. In edge computing, the results comprised an accuracy of 95.2%, precision of 93.2%, sensitivity of 95.3%, and specificity of 95.1%. Thus, the proposed wearable assistant device has the potential benefit of helping the hearing impaired to avoid traffic accidents.

Layout Dependence Stress Investigation in through Glass via Interposer Architecture Using a Submodeling Simulation Technique and a Factorial Design Approach

The multi-chiplet technique is expected to be a promising solution to achieve high-density system integration with low power consumption and high usage ratio. This technique can be integrated with a glass interposer to accomplish a competitive low fabrication cost compared with the silicon-based interposer architecture. In this study, process-oriented stress simulation is performed by the element activation and deactivation technique in finite element analysis architecture. The submodeling technique is also utilized to mostly conquer the scale mismatch and difficulty in mesh gridding design. It is also used to analyze the thermomechanical responses of glass interposers with chiplet arrangements and capped epoxy molding compounds (EMC) during curing. A three-factor, three-level full factorial design is applied using the analysis of variance method to explore the significance of various structural design parameters for stress generation. Analytic results reveal that the maximum first principal stresses of 130.75 and 17.18 MPa are introduced on the sidewall of Cu-filled via and the bottom of the glass interposer, respectively. Moreover, the EMC thickness and through glass via pitch are the dominant factors in the adopted vehicle. They significantly influence the stress magnitude during heating and cooling.

Reliability Assessment of Thermocompressed Epoxy Molding Compound through Glass via Interposer Architecture by the Submodeling Simulation Approach

In glass interposer architecture and its assembly process, the mechanical responses of interposer structure under thermocompression process-induced thermal loading and generated shrinkage of molding material are regarded as a major reliability issue. Thousands of metal-filled via are involved in glass interposers and are regarded as a potential risk that can lead to cracking and the failure of an entire vehicle. In this study, a finite element-based submodeling approach is demonstrated to overcome the complexity of modeling and the relevant convergence issue of interposer architecture. Convergence analysis results revealed that at least four via pitch-wide regions of a local simulation model were needed to obtain the stable results enabled by the submodeling simulation approach. The stress-generation mechanism during thermocompression, the coefficient of thermal expansion mismatch, and the curing process-induced shrinkage were separately investigated. The critical stress location was explored as the outer corner of the chip, and the maximum first principal stress during the thermocompression process generated on the chip and glass interposer were 34 and 120 MPa, respectively.

Auger Electron Spectroscopy Analysis of the Thermally Induced Degradation of MAPbI3 Perovskite Films

Organometal halide perovskites are highly promising materials for photovoltaic applications due to the rapid growth of power conversion efficiency in recent years. However, thermal stability is still a major hurdle for perovskite solar cells toward commercialization. Herein, we first explore the slow thermal response of the CH₃NH₃PbI₃ perovskite crystal investigated via Auger electron spectroscopy (AES). AES image mapping directly observes the evolution of morphology and elemental distribution over time. The AES small spot analysis demonstrates the precise initial degradation position of perovskite with both information regarding physical changes in crystals and chemical changes in elemental bonding at the nanometer scale. X-ray photoelectron spectroscopy (XPS) was used to confirm the surface chemical bonding and composition of the perovskite crystals. This work provides the first insights into the physical and chemical changes of perovskites investigated by AES upon long-term exposure to heat under ambient conditions.

Energy and nitrogenous waste from glutamate/glutamine catabolism facilitates acute osmotic adjustment in non-neuroectodermal branchial cells

Maintenance of homeostasis is one of the most important physiological responses for animals upon osmotic perturbations. Ionocytes of branchial epithelia are the major cell types responsible for active ion transport, which is mediated by energy-consuming ion pumps (e.g., Na⁺-K⁺-ATPase, NKA) and secondary active transporters. Consequently, in addition to osmolyte adjustments, sufficient and immediate energy replenishment is essenttableial for acclimation to osmotic changes. In this study, we propose that glutamate/glutamine catabolism and trans-epithelial transport of nitrogenous waste may aid euryhaline teleosts Japanese medaka (Oryzias latipes) during acclimation to osmotic changes. Glutamate family amino acid contents in gills were increased by hyperosmotic challenge along an acclimation period of 72 hours. This change in amino acids was accompanied by a stimulation of putative glutamate/glutamine transporters (Eaats, Sat) and synthesis enzymes (Gls, Glul) that participate in regulating glutamate/glutamine cycling in branchial epithelia during acclimation to hyperosmotic conditions. In situ hybridization of glutaminase and glutamine synthetase in combination with immunocytochemistry demonstrate a partial colocalization of olgls1a and olgls2 but not olglul with Na⁺/K⁺-ATPase-rich ionocytes. Also for the glutamate and glutamine transporters colocalization with ionocytes was found for oleaat1, oleaat3, and olslc38a4, but not oleaat2. Morpholino knock-down of Sat decreased Na⁺ flux from the larval epithelium, demonstrating the importance of glutamate/glutamine transport in osmotic regulation. In addition to its role as an energy substrate, glutamate deamination produces NH₄⁺, which may contribute to osmolyte production; genes encoding components of the urea production cycle, including carbamoyl phosphate synthetase (CPS) and ornithine transcarbamylase (OTC), were upregulated under hyperosmotic challenges. Based on these findings the present work demonstrates that the glutamate/glutamine cycle and subsequent transepithelial transport of nitrogenous waste in branchial epithelia represents an essential component for the maintenance of ionic homeostasis under a hyperosmotic challenge.

Comprehensive Stress Effect of Thin Coatings and Silicon-Carbon Lattice Mismatch on Nano-Scaled Transistors with Protruding Poly Gate

Enhancing the mobility in metal-oxide-semiconductor field-effect transistors (MOSFETs) with narrow channel widths is highly sensitive to the stress effects of Si channel when related advanced strain engineering is introduced and is compatible with semiconductor processes. In practice, layouts have significant effect on the device performance, especially for the protruding gate width on shallow trench isolation structures. The geometric parameter is investigated by systematically analysing an n-channel MOSFET composed of silicon-carbon (SiC) stressors embedded in the source and drain (S/D) regions and a tensile contact etch stop layer (CESL) using three-dimensional finite element simulation. Tensile CESL (1.1 GPa) and a SiC S/D stressor with a carbon mole fraction of 1.65% are loaded on the structure. The difference in the interactive percentages between the mechanical bending effect of the CESL from the top of the poly gate and the downward force of the CESL adjacent to the spacer sidewall of the gate occurs when the protruding gate width is increased. Results indicate that mobility was highly enhanced by approximately 72.5% at a width of approximately 0.2 μm. The mechanical bending effect becomes dominant when the gate width is more than 0.2 μm. Consequently, the mobility gain decays and consequently converges toward a constant.

Pheretima aspergillum extract attenuates high-KCl-induced mitochondrial injury and pro-fibrotic events in cardiomyoblast cells

Hyperkalemia is often associated with cardiac dysfunction. In this study an earthworm extract (dilong) was prepared from dried Pheretima aspergillum powder and its effect against high-KCl challenge was determined in H9c2 cardiomyoblast cells. H9c2 cells pre-treated with dilong (31.25, 62.5, 125, and 250 mg/mL) for 24 hours, where challenged with different doses of KCl treatment for 3 hours to determine the protective mechanisms of dilong against cardiac fibrosis. High-KCl administration induced mitochondrial injury and elevated the levels of pro-apoptotic proteins. The mediators of fibrosis such as ERK, uPA, SP1, and CTGF were also found to be upregulated in high-KCl condition. However, dilong treatment enhanced IGF1R/PI3k/Akt activation which is associated with cell survival. In addition, dilong also reversed high-KCl induced cardiac fibrosis related events in H9c2 cells and displayed a strong cardio-protective effect. Therefore, dilong is a potential agent to overcome cardiac events associated with high-KCl toxicity.

The Effects of a Supportive Care Program on the Posttraumatic Stress Symptoms of Patients With Oral Cancer After Surgery

This study aimed to estimate the effects of a supportive care program on the posttraumatic stress symptoms (PTSSs) of patients with oral cancer after surgery. Participants were divided into two groups. Outcome measurements included the Chinese version of the Davidson trauma scale to examine PTSSs at a clinical follow-up 1 week (T0), 1 month (T1), and 3 months (T2) after hospital discharge. The results indicated that the frequency and severity mean scores of PTSSs for the two groups at T0 were significantly higher than those at T1 and T2. Both the groups and times were significantly different; moreover, the supported group's PTSS score decreased more than that of the nonsupported group. These findings supported the effects of the supportive care program. Health care staff should be aware of the PTSS status of patients with oral cancer who undergo surgery and consider these issues in combination with patients' discharge care plans.

Alterations of Renal Epithelial Glucose and Uric Acid Transporters in Fructose Induced Metabolic Syndrome

BACKGROUND/AIMS

Hyperglycemia and hyperuricemia are two major disorders of Metabolic syndrome. Kidney plays a crucial role in maintaining the homeostasis of uric acid and glucose. The aim of the study was to examine the changes of renal glucose and uric acid transporters in animals with metabolic syndrome.

METHODS

Sprague-Dawley rats were fed with high fructose diet (60%) for 3 months (FR-3) and 5 months (FR-5). At the end study, serum and urine biochemical data were compared. Gene expression and protein abundance of renal GLUT1, GLUT2, GLUT9, SGLT1, SGLT2, UAT and URAT1 was investigated by using RT-PCR and immunohistochemical staining.

RESULTS

Metabolic syndrome was induced by high-fructose diet. Systolic blood pressure and proteinuria was significantly increased in FR-5 animals. In kidney tissue, gene expression of GLUT2 and SGLT2 increased significantly in a time dependent manner. GLUT9, SGLT1 and UAT were also significantly upregulated in FR-5. Immunohistochemical study showed a significant increase of SGLT1 in both FR-3 (413.5 ± 88.3% of control, p< 0.001) and FR-5 (677.6 ± 26.5% of control, p< 0.001). Also, SGLT2 protein was increased in both FR-3 (643.1 ± 41.3% of control, p< 0.001) and FR-5 (563.3 ± 21.7% of control, p< 0.001). Fructose rich food also induced increase of UAT by nearly 5-fold in both FR-3 and FR-5 (both p< 0.05) and more than 3-fold of GLUT-9 in FR-3 and FR-5 (both p< 0.05).

CONCLUSION

Long term high fructose diet induced metabolic syndrome with increased blood pressure and proteinuria in rats. Metabolic syndrome was associated with dual increase in renal glucose and uric acid transporters, including SGLT1, SGLT2, GLUT2, GLUT9 and UAT.

Cellular apoptosis and cardiac dysfunction in STZ-induced diabetic rats attenuated by anthocyanins via activation of IGFI-R/PI3K/Akt survival signaling

Anthocyanins are known cyto-protective agents against various stress conditions. In this study cardio-protective effect of anthocyanins from black rice against diabetic mellitus (DM) was evaluated using a streptozotocin (STZ)-induced DM rat model. Five-week-old male Wistar rats were administered with STZ (55 mg kg^-1 , IP) to induce DM; rats in the treatment group received 250 mg oral anthocyanin/kg/day during the 4-week treatment period. DM and the control rats received normal saline through oral gavage. The results reveal that STZ-induced DM elevates myocardial apoptosis and associated proapoptotic proteins but down-regulates the proteins of IGF1R mediated survival signaling mechanism. Furthermore, the functional parameters such as the ejection-fraction and fraction-shortening in the DM rat hearts declined considerably. However, the rats treated with anthocyanins significantly reduced apoptosis and the associated proapoptotic proteins and further increased the survival signals to restore the cardiac functions in DM rats. Anthocyanin supplementation enhances cardiomyocyte survival and restores cardiac function.

Application of oxaliplatin in combination with epirubicin in transcatheter arterial chemoembolization in the treatment of primary liver carcinoma

Many cases of liver carcinoma miss the opportunity of surgical treatment because of hidden onset and delayed diagnosis. In recent years, interventional treatment has gradually become a non-surgical method for treating liver carcinoma. To discuss the effects of oxaliplatin in combination with epirubicin in the treatment and its influence on prognosis, this study randomly selected 218 advanced primary liver carcinoma patients from Binzhou People’s Hospital, Binzhou, China and divided them into a control group (n=109) and an observation group (n=109). Patients in both groups were given interventional treatment. Patients in the control group were perfused with oxaliplatin, while patients in the observation group were perfused with oxaliplatin and epirubicin. The effectsat 6-month and 12-month survival rates were compared between the two groups. The results demonstrated that the overall effective rate and clinical benefit rate of the observation group were much higher than those of the control group (30.3% vs 11.9%; 79.8%; vs 44.3%) (P less than 0.05). The serum Alpha Fetal Protein (AFP) and Carcino Embryonie Antigen (CEA) levels of the observation group were much lower than those of the control group; the Karnofsky performance score of the observation group was much lower than that of the control group; the two differences had statistical significance (P less than 0.05). The 6-month survival rate of the observation group was 91.67%, higher than that of the control group (86.11%) (P>0.05). The 12-month survival rate of the observation group was 83.33%, much higher than that of the control group (61.11%) (P less than 0.05). The difference of the incidence of adverse reactions between the two groups had no statistical significance (P>0.05). Thus, it can be concluded that oxaliplatin in combination with epirubicin can improve survival quality, extend survival time, and decrease the serum AFP and CEA levels in the treatment of primary liver carcinoma, with definite effects but without aggravating toxic and side effects. Therefore, the therapy has important clinical value.

Biological mechanism of post-herpetic neuralgia: Evidence from multiple patho-psychophysiological measures

BACKGROUND

Post-herpetic neuralgia (PHN), which develops after the resolution of a herpes zoster eruption, is an exceptionally drug-resistant neuropathic pain. The unsatisfactory management of PHN partly results from the difficulty in dissecting out its contributing factors due to the complexity of PHN mechanism.

METHODS

Here, to elaborate our understanding of the PHN mechanism and to establish a basis for effective therapeutic strategies, we comprehensively investigated the contributions of multiple factors to PHN severity.

RESULTS

Based on the comparison of somatosensory detection thresholds (C, Aδ and Aβ fibre thresholds) between affected and unaffected sides, 16 PHN patients with significant sensory deficits and 13 PHN patients without significant sensory deficits were identified and assigned to different groups. The different extents of lesions in the nociceptive system between patients with and without sensory deficits were confirmed using laser-evoked brain responses. Moreover, patients with sensory deficits had more severe pain and psychological disorders, e.g. anxiety and depression. Importantly, chronic pain severity was significantly influenced by various psychophysiological factors (sleep disturbances, psychological disorders and hypothalamic-pituitary-adrenal axis dysfunction) for patients with sensory deficits.

CONCLUSIONS

Our findings demonstrated the contribution of multiple patho-psychophysiological factors to PHN severity, which could help establish a basis for the development of a rational, patient-centred therapeutic strategy.

SIGNIFICANCE

This study revealed the contribution of multiple patho-psychophysiological factors to PHN severity, which expanded our understanding of the underlying PHN mechanism, and helped develop a rational, patient-centred therapeutic strategy targeting towards the corresponding etiology and psychophysiological disorders for individual patient.

Effect of premature serum progesterone rise on embryo transfer outcomes and the role of blastocyst culture and transfer in assisted reproductive technology cycles with premature progesterone rise

OBJECTIVE

In 1991, researchers reported that a modest preovulatory increase in serum progesterone levels is associated with lower pregnancy rates and higher incidence of pregnancy loss in in vitro fertilization (IVF). We wonder whether embryo transfer (ET) in assisted reproductive technology (ART) cycles in patients with premature progesterone rise (PPR) have a negative impact on the clinical pregnancy rates (CPRs) and/or live birth rates (LBRs) in our series. Consequently, will blastocyst transfer reverse the negative impact?

MATERIALS AND METHODS

This noninterventional, retrospective, observational tertiary center study was conducted between January 2010 and December 2012. All fresh ET cycles with serum progesterone levels measured (n = 599) on the day of hCG administration were analyzed.

RESULTS

Sera lutenizing hormone (LH), E2, and progesterone (P) were measured and analyzed. The CPRs of cycles in patients with p ≤ 1.5 ng/mL (low) versus those with p > 1.5 ng/mL (high) were 37.04% versus 41.03% [odds ratio (OR) = 1.18, 95% confidence interval (CI): 0.728-1.920; p = 0.50). The LBRs of cycles in patients with low progesterone level versus those with PPR were 30.52% versus 34.62% (OR = 1.21, 95% CI: 0.729-1.992; p = 0.47). No statistically significant association was detected. We further analyzed the outcomes according to different stages of ET and found that blastocyst (D5) ET significantly increase the LBRs as compared with cleavage stage (D2/D3) ET in the PPR group (44.44% versus 21.43%; p = 0.043).

CONCLUSION

PPR did not significantly compromise the clinical outcomes in this series. However, shifting to blastocyst transfer probably could increase the live birth in cycles with PPR.

Anthocyanin Attenuates Doxorubicin-Induced Cardiomyotoxicity via Estrogen Receptor-α/β and Stabilizes HSF1 to Inhibit the IGF-IIR Apoptotic Pathway

Doxorubicin (Dox) is extensively used for chemotherapy in different types of cancer, but its use is limited to because of its cardiotoxicity. Our previous studies found that doxorubicin-induced insulin-like growth factor II receptor (IGF-IIR) accumulation causes cardiomyocytes apoptosis via down-regulation of HSF1 pathway. In these studies, we demonstrated a new mechanism through which anthocyanin protects cardiomyoblast cells against doxorubicin-induced injury. We found that anthocyanin decreased IGF-IIR expression via estrogen receptors and stabilized heat shock factor 1 (HSF1) to inhibit caspase 3 activation and apoptosis of cardiomyocytes. Therefore, the phytoestrogen from plants has been considered as another potential treatment for heart failure. It has been reported that the natural compound anthocyanin (ACN) has the ability to reduce the risk of cardiovascular disease (CVD). Here, we demonstrated that anthocyanin acts as a cardioprotective drug against doxorubicin-induced heart failure by attenuating cardiac apoptosis via estrogen receptors to stabilize HSF1 expression and down-regulated IGF-IIR-induced cardiomyocyte apoptosis.

What Do Stroke Patients Look for in Game-Based Rehabilitation: A Survey Study

Stroke is one of the most common causes of physical disability, and early, intensive, and repetitive rehabilitation exercises are crucial to the recovery of stroke survivors. Unfortunately, research shows that only one third of stroke patients actually perform recommended exercises at home, because of the repetitive and mundane nature of conventional rehabilitation exercises. Thus, to motivate stroke survivors to engage in monotonous rehabilitation is a significant issue in the therapy process. Game-based rehabilitation systems have the potential to encourage patients continuing rehabilitation exercises at home. However, these systems are still rarely adopted at patients' places. Discovering and eliminating the obstacles in promoting game-based rehabilitation at home is therefore essential. For this purpose, we conducted a study to collect and analyze the opinions and expectations of stroke patients and clinical therapists. The study is composed of 2 parts: Rehab-preference survey - interviews to both patients and therapists to understand the current practices, challenges, and expectations on game-based rehabilitation systems; and Rehab-compatibility survey - a gaming experiment with therapists to elaborate what commercial games are compatible with rehabilitation. The study is conducted with 30 outpatients with stroke and 19 occupational therapists from 2 rehabilitation centers in Taiwan. Our surveys show that game-based rehabilitation systems can turn the rehabilitation exercises more appealing and provide personalized motivation for various stroke patients. Patients prefer to perform rehabilitation exercises with more diverse and fun games, and need cost-effective rehabilitation systems, which are often built on commodity hardware. Our study also sheds light on incorporating the existing design-for-fun games into rehabilitation system. We envision the results are helpful in developing a platform which enables rehab-compatible (i.e., existing, appropriately selected) games to be operated on commodity hardware and brings cost-effective rehabilitation systems to more and more patients' home for long-term recovery.

Survey of depression by Beck Depression Inventory in uremic patients undergoing hemodialysis and hemodiafiltration

High prevalence of depression has been reported in patients with end stage kidney disease and depression is associated with increased morbidity and mortality. We aimed to investigate the prevalence of depression in patients receiving standard hemodialysis (SHD) and hemodiafiltration (HDF) and compare the associated factors between these treatment modalities. The Beck Depression Inventory (BDI) was used to survey for major depressive symptoms. Demographic and biochemical data were reviewed and collected. Point prevalence of depression in HDF patients was significantly lower than SHD patients (23.9% vs. 43.1%, P < 0.05). The BDI score was also higher in SHD than HDF group (13.2 ± 11.6 vs. 8.7 ± 11.2, P < 0.05). SHD patients with major depressive symptoms had significantly lower levels of hemoglobin, albumin, creatinine, sodium and hand grip strength but had higher prevalence of diabetes and high sensitivity C-reactive protein (hs-CRP) levels. In HDF patients, phosphorus level was significantly lower in patients with major depressive symptoms. Logistic regression analysis revealed that hs-CRP, serum sodium and hand grip strength were significantly associated with major depressive symptoms in patients treated with SHD; while serum phosphorus was identified in HDF groups. We concluded that prevalence of depression was high in dialysis patients. Patients receiving HDF had a lower mean BDI score and a nearly 50% lower prevalence rate of major depressive symptoms than that of SHD. Factors associated with depression were different between two modalities.

Development of the heat treatment system for the 40 T hybrid magnet superconducting outsert

The heat treatment of Nb(3)Sn coil with the glass fabric insulation is one of the key and critical processes for the outsert solenoids of the 40 T hybrid magnet, which could be wound with cable-in-conduit conductors using the insulation-wind-and-react technique. The manufacturing of the large vertical type vacuum/Ar atmosphere-protection heat treatment system has been completed and recently installed in the High Magnetic Filed Laboratory, Chinese Academy of Sciences. The heat treatment system composed mainly the furnace, the purging gas supply system, the control system, the gas impurities monitoring system, and so on. At present, the regulation and testing of the heat treatment system has been successfully finished, and all of technical parameters meet or exceed specifications.

TRPV1 mediates the uterine capsaicin-induced NMDA NR2B-dependent cross-organ reflex sensitization in anesthetized rats

Spinal cord-mediated cross-organ sensitization between the uterus and the lower urinary tract may underlie the high concurrence of obstetrical/gynecological inflammation and chronic pelvic pain syndrome characterized by urogenital pain. However, the neural pathway and the neurotransmitters involved are still unknown. We tested the hypothesis that the excitation of capsaicin-sensitive primary afferent fibers arising from the uterus through the stimulation of transient receptor potential vanilloid 1 (TRPV1) induces cross-organ sensitization on the pelvic-urethra reflex activity. Capsaicin (1–1,000 μM, 0.05 ml) was instilled into the uterus to induce cross-organ reflex sensitization. Activation of capsaicin-sensitive primary afferent fibers by capsaicin instillation into the uterine horn sensitized the pelvic-urethra reflex activity that was reversed by an intrauterine pretreatment with capsaizepine, a TRPV1-selective antagonist. Intrathecal injection of AP5, a glutamatergic N-methyl-d-aspartate (NMDA) antagonist, and Co-101244, an NMDA NR2B-selective antagonist, both abolished the cross-organ reflex sensitization caused by capsaicin instillation. These results demonstrated that TRPV1 plays a crucial role in contributing to the capsaicin-sensitive primary afferent fibers mediating the glutamatergic NMDA-dependent cross-organ sensitization between the uterus and the lower urinary tract when there is a tissue injury.

Acute anal stretch inhibits NMDA-dependent pelvic-urethra reflex potentiation via spinal GABAergic inhibition in anesthetized rats

The impact of acute anal stretch on the pelvic-urethra reflex potentiation was examined in urethane-anesthetized rats by recording the external urethra sphincter electromyogram activity evoked by the pelvic afferent stimulation. Test stimulation (1 stimulation/30 s) evoked a baseline reflex activity with a single action potential that was abolished by gallamine (5 mg/kg iv). On the other hand, the repetitive stimulation (1 stimulation/1 s) induced spinal reflex potentiation (SRP) that was attenuated by intrathecal 6-cyano-7-nitroquinoxaline-2,4-dione (a glutamatergic α-amino-3-hydroxy-5-methyl-4-isoxazoleproprionat receptor antagonist, 100 μM, 10 μl) and d-2-amino-5-phosphonovalerate [a glutamatergic N-methyl-d-aspartate (NMDA) antagonist, 100 μM, 10 μl]. Acute anal stretch using a mosquito clamp with a distance of 4 mm exhibited no effect, whereas distances of 8 mm attenuated and 12 mm abolished the repetitive stimulation-induced SRP. Intrathecal NMDA (100 μM, 10 μl) reversed the abolition on SRP caused by anal stretch. On the other hand, pretreated bicuculline [γ-aminobutyric acid (GABA) A receptor antagonist, 100 μM, 10 μl] but not hydroxysaclofen (GABAB receptor antagonist) counteracted the abolition on the repetitive stimulation-induced SRP caused by the anal stretch. All of the results suggested that anal stretch may be used as an adjunct to assist voiding dysfunction in patients with overactive urethra sphincter and that GABAergic neurotransmission is important in the neural mechanisms underlying external urethra sphincter activity inhibited by anal stretch.

Estrous cycle variation of TRPV1-mediated cross-organ sensitization between uterus and NMDA-dependent pelvic-urethra reflex activity

Cross-organ sensitization between the uterus and the lower urinary tract (LUT) underlies the high concurrence of pelvic pain syndrome and LUT dysfunctions, and yet the role of gonadal steroids is still unknown. We tested the hypothesis that cross-organ sensitization on pelvic-urethra reflex activity caused by uterine capsaicin instillation is estrous cycle dependent. When compared with the baseline reflex activity (1.00 +/- 0.00 spikes/stimulation), uterine capsaicin instillation significantly increased reflex activity (45.42 +/- 9.13 spikes/stimulation, P < 0.01, n = 7) that was corroborated by an increase in phosphorylated NMDA NR2B (P < 0.05, n = 4) but not NR2A subunit (P > 0.05, n = 4) expression. Both intrauterine pretreatment with capsazepine (5.02 +/- 2.11 spikes/stimulation, P < 0.01, n = 7) and an intrathecal injection of AP5 (3.21 +/- 0.83 spikes/stimulation, P < 0.01, n = 7) abolished the capsaicin-induced cross-organ sensitization and the increment in the phosphorylated NR2B level (P < 0.05, n = 4). The degrees of the cross-organ sensitization increased in a dose-dependent manner with the concentration of instilled capsaicin from 100 to 300 microM in both the proestrus and metestrus stages, whereas they weakened when the concentrations were higher than 1,000 microM. Moreover, the cross-organ sensitization caused by the uterine capsaicin instillation increased significantly in the rats during the proestrus stage when compared with the metestrus stage (P < 0.01, n = 7). These results suggest that estrogen levels might modulate the cross-organ sensitization between the uterus and the urethra and underlie the high concurrence of pelvic pain syndrome and LUT dysfunctions.

Spinal glutamatergic NMDA-dependent cyclic pelvic nerve-to-external urethra sphincter reflex potentiation in anesthetized rats

The purposes of this study were to investigate whether the pelvic nerve-to-external urethra sphincter (EUS) reflex potentiation can be induced under physiological conditions and to determine whether glutamatergic neurotransmission is involved in the reflex potentiation. Stimulation-evoked reflex activities, during rhythmic bladder contractions caused by a continuous saline infusion, in 21 anesthetized rats were recorded with/without the intrathecal administration of 10 μl of CNQX (a glutamatergic AMPA receptor antagonist; 100 μM) and APV( a glutamatergic NMDA receptor antagonist; 100 μM). Reflex activities became potentiated following the increment of intravesical pressure (IVP) during the storage phase (2.39 ± 0.28 spikes/mmHg, n = 21) and the ascending period of the voiding phase (1.46 ± 0.35 spikes/mmHg, n = 21) and decreased following the decrement of IVP during the descending period of the voiding phase (1.50 ± 0.33 spikes/mmHg, n = 21). Although it is characterized by a low IVP, a postvoiding reflex potentiation in stimulation-evoked activities was elicited at the critical period after a voiding contraction had just finished (23.95 ± 8.96 spikes/mmHg, n = 21). The slope of the regression line of evoked activities vs. the IVP during the storage phase was significantly ( P < 0.01) higher than that of the ascending and descending periods of the voiding phase, but there was no statistical difference between the ascending and the descending periods ( P > 0.05). In addition, the slope of the regression line of posttetanic reflex potentiation was significantly higher than that of the storage phase ( P < 0.01). All the slopes of the regression lines decreased after intrathecal CNQX administration (from 3.15 ± 0.44, 2.10 ± 0.57, 2.13 ± 0.53, and 21.30 ± 3.41 to 0.83 ± 0.31, 0.74 ± 0.12, 0.76 ± 0.12, and 4.31 ± 3.71 spikes/mmHg in storage, ascending and descending period of the voiding phase, and postvoiding potentiation, respectively; all P < 0.01, n = 10). The slopes of the regression lines became almost horizontal after intrathecal APV administration (from 3.15 ± 0.44, 2.10 ± 0.57, 2.13 ± 0.53, and 21.30 ± 3.41 to 0.16 ± 0.12, 0.21 ± 0.07, 0.18 ± 0.05, and 0.23 ± 0.76 spikes/mmHg in storage, ascending and descending period of voiding phase, and postvoiding potentiation, respectively; all P < 0.01, n = 10). Our results suggest that a potentiation in the pelvic nerve-to-EUS reflex can be induced under physiological conditions and the glutamatergic mechanism appears to be involved in this reflex potentiation.

Spinal glutamatergic NMDA-dependent pelvic nerve-to-external urethra sphincter reflex potentiation caused by a mechanical stimulation in anesthetized rats

The current study investigates whether the spinal pelvic nerve-to-external urethra sphincter (EUS) reflex potentiation can be induced by a mechanical stimulation and whether the glutamatergic mechanism is involved in yielding such a reflex potentiation. The external urethra sphincter electromyogram (EUSE) activity, evoked by a single or by repetitive pelvic nerve stimulation, in 30 anesthetized rats was recorded with/without bladder saline distension. Without saline distension (0 cmH2O), a single pulse nerve stimulation evoked a single action potential in the reflex activity, whereas repetitive pelvic stimulation and saline distension (6∼20 cmH2O) both elicited a long-lasting reflex potentiation (20.05 ± 3.21 and 75.01 ± 9.87 spikes/stimulation, respectively). The saline distension-induced pelvic nerve-to-EUS reflex potentiation was abolished by d-2-amino-5-phosphonovalerate [APV; a glutamatergic N -methyl-d-aspartic acid (NMDA) receptor antagonist; 100 μM, 10 μl, 1.72 ± 0.31 spikes/stimulation] and attenuated by 2,3-dihydroxy-6-nitro-7-sulfamoyl-benzo (F) quinoxaline [NBQX; a glutamatergic α-amino-3-hydroxy-5-methyl-4-isoxazoleproprionate (AMPA) receptor antagonist; 100 μM, 10 μl, 26.16 ± 7.27 spikes/stimulation], but was not affected by bicuculline (a GABAergic antagonist; 100 μM, 10 μl, 53.62 ± 15.54 spikes/stimulation). Intrathecal administration of glutamate (31.12 ± 8.25 spikes/stimulation, 100 μM, 10 μl) and NMDA (26.25 ± 4.12 spikes/stimulation, 100 μM, 10 μl) both induced a long-lasting pelvic nerve-to-EUS reflex potentiation without saline distension, which was similar to the findings observed from saline distension only. The duration of the contraction wave of the urethra was elongated by the saline distension-induced pelvic nerve-to-EUS reflex potentiation, whereas the peak pressure of the contraction wave was not affected. Our findings suggest that saline distension in the bladder elicits a pelvic nerve-to-EUS reflex potentiation and the glutamatergic mechanism contributes to the presence of such a reflex potentiation.

Impaired micturition reflex caused by acute selective dorsal or ventral root(s) rhizotomy in anesthetized rats

PURPOSE

To clarify the contributions of parasympathetic inputs and outputs to the micturition reflex.

MATERIALS AND METHODS

Intra-vesical pressure (IVP), external urethral sphincter electromyogram (EMG), pelvic afferent nerve activities (PANA), and pelvic efferent nerve activities (PENA) as well as the time-derived IVP (dIVP, an index of bladder contractility) were evaluated in intact and acute dorsal or ventral root(s) rhizotomized (DRX and VRX, respectively) rats.

RESULTS

In DRX rats, when compared with that in intact stage, the voiding frequency was decreased (75 +/- 15% of intact, P < 0.05, n = 8), while the threshold pressure to trigger voiding contractions was significantly increased (187 +/- 75% of intact, P < 0.05, n = 8). In addition, several insufficient contractions (5.3 +/- 3.5 contractions/voiding, P < 0.05, n = 8) occurred in ahead of each voiding contraction. On the other hand, in VRX rats, the peak and rebound IVP were significantly decreased (90 +/- 3.5% and 75 +/- 11.3% of intact, P < 0.01, n = 8), while the threshold pressure was not affected (102 +/- 11% of intact, P = NS, n = 8). The time-derived parameters were significantly decreased in VRX (peak dIVP, 78 +/- 10.2%, rebound dIVP, 75 +/- 15.6%, minimal dIVP, 68 +/- 14% of intact, P < 0.01, n = 8) but only peak dIVP was decreased (85 +/- 11% of intact, P < 0.01, n = 8) in DRX rats.

CONCLUSION

Acute selective DRX and VRX rat can be an animal model to investigate peripheral neural control in micturition functions.

Gel electrophoresis of polyphenol oxidase with instant identification by in situ blotting

Polyphenol oxidase (PPO) or tyrosinase is an important and ubiquitous enzyme responsible for browning in plants and melanization in animals. The molecular size of the plant PPO is varied among the species and its activity can be enhanced by a variety of anionic detergents. In the present study, we developed a simple method for the first-step identification of PPO in fruit and vegetable extracts. First, 3mm chromatographic paper was immersed in 0.5% (w/v) catechol solution as an immobilized PPO substrate. After running the extract with 10% sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE), one side of the glass plate was removed. The plate was immediately laid on top of the dried catechol-paper. A dark-brown band corresponding to PPO was visualized within 1 min and was further confirmed by a conventional Western blot using an antibody prepared against mushroom PPO. It also reveals that some vegetation (such as tomato, radish, and oriental melon) with low or no detectable activity in a conventional enzyme assay actually possessed marked levels of PPO activity when assessed by PAGE-blot. We propose that an inhibitor is associated with PPO in some plants; the inhibitor, however, is dissociated during the electrophoresis. Therefore, in addition to identify the molecular form of PPO, the present technique may explore the existence of PPO inhibitor(s) in plants. The detail of the method with respect to its relevance for searching a natural PPO inhibitor is described and discussed.

Effects of selective unilateral dorsal root(s) rhizotomy on micturition reflex in anesthetized rats

PURPOSE

To clarify the contributions of sensory inputs and glutamate transmissions to the spinal micturition reflex.

MATERIALS AND METHODS

Cystometrogram and external urethral sphincter electromyogram activities evaluated the L6 and/or S1 levels.

RESULTS

Changes in intravesicular pressure (IVP) in response to saline infusion (0.1 ml/min) were found after unilateral dorsal root rhizotomy at the L6 level, which showed significant increases in threshold pressure (rhizotomized vs. control: 14.25 +/- 0.82 vs. 8.40 +/- 0.69 cmH(2)O, P < 0.01, n = 28), post-voiding pressure (7.66 +/- 0.56 vs. 5.42 +/- 0.52 cmH(2)O, P < 0.01, n = 28), holding duration (135.06 +/- 23.6 vs. 77.73 +/- 13.56 sec, P < 0.05, n = 28), and inter-contraction interval (140.62 +/- 23.29 vs. 82.40 +/- 13.57 sec, P < 0.05, n = 28). Several (mean = 2.32 +/- 1.31 vs. 0.12 +/- 0.21, P < 0.01, n = 28, P < 0.01, n = 28) non-voiding contractions with gradual increase in IVP were found ahead of voiding contraction after rhizotomy. An additional dorsal root rhizotomy at the ipsilateral S1 level caused further increases in urodynamic parameters (threshold pressure, 18.18 +/- 1.67 cmH(2)O, P < 0.01; post-voiding pressure 8.07 +/- 0.96 cmH(2)O, P < 0.01; holding duration, 211.44 +/- 42.54 sec, P < 0.01; inter-contraction interval, 264.2 +/- 59.99 sec, P < 0.05; non-voiding contractions, 4.41 +/- 2.12, P < 0.01, n = 7). Intrathecal glutamate (100 microM, 10 microl) ameliorated all the pathological conditions induced by unilateral dorsal root rhizotomy at the L6 level in a dose dependent manner (ED(50) = 1.25 +/- 10(-5)). Intrathecal CNQX (6-cyano-7-nitroquinoxaline-2,3-dione; 100 microM, 10 microl) and APV (D-2-amino-5-phosphonovaleric acid; 100 microM, 10 microl) injections after rhizotomy at the L6 level induced disturbances similar to that caused by an additional rhizotomy at ipsilateral S1 level. Wherease, glutamate (100 microM, 10 microl) reversed the disturbances caused by CNQX but showed no effect on that by APV.

CONCLUSIONS

Acute partial sensory deprivation caused acute impaired micturition reflex in rat models. In addition, glutamatergic NMDA and AMPA receptors are important for mediating these impairments in micturition reflex.

Estrogen modulates the spinal N-methyl-D-aspartic acid-mediated pelvic nerve-to-urethra reflex plasticity in rats

The effects of gonadal steroids on glutamate-mediated pelvic nerve-to-urethra reflex (PUR) plasticity were investigated in rats, which received a sham operation (Sham), ovariectomy (OVX), or ovariectomy with daily supplemental estrogen (50 microg/kg, OVX + E2). The magnitude of the repetitive stimulation (RS, 1 Hz)-induced potentiation in PUR activity decreased significantly in the OVX group when compared with the Sham groups (18.09 +/- 3.91 and 7.40 +/- 1.03 spikes/stimulation in Sham and OVX group; respectively, P < 0.01, n = 21). Supplemental estrogen (OVX + E2, 12.60 +/- 1.49 spikes/stimulation) significantly reversed the decrease in RS-induced PUR potentiation caused by OVX (P < 0.01, n = 21). The magnitude of the RS-induced potentiation in PUR activity decreased significantly after intrathecal 2,3-dihydroxy-6-nitro-7-sulfamoyl-benzo (F) quinoxaline [(20 microm, 10 microl), from 18.09 +/- 3.91 to 10.40 +/- 0.81, from 7.40 +/- 1.03 to 3.20 +/- 0.94, and from 12.60 +/- 1.49 to 8.06 +/- 0.32 spikes/stimulation in Sham, OVX, and OVX + E2, respectively, P < 0.01, n = 18] and D-2-amino-5-phosphonoraleric acid [(100 microm, 10 microl), from 18.09 +/- 3.91 to 1.04 +/- 0.12, from 7.40 +/- 1.03 to 1.06 +/- 0.22, and from 12.60 +/- 1.49 to 0.98 +/- 0.25 spikes/stimulation in Sham, OVX, and OVX + E2, respectively, P < 0.01, n = 18]. In addition, potentiation in PUR activities was induced by intrathecal l-glutamate (0.1 mm, 10 microl, from 1.04 +/- 0.02 to 21.60 +/- 0.93, from 1.10 +/- 0.06 to 8.40 +/- 1.50, and from 1.03 +/- 0.03 to 18.04 +/- 0.84 spikes/stimulation in Sham, OVX, and OVX + E2, respectively, P < 0.01, n = 18) and N-methyl-D-aspartic acid (0.1 mm, 10 microl, from 1.04 +/- 0.02 to 14.80 +/- 0.97, from 1.10 +/- 0.06 to 4.60 +/- 0.48, and from 1.03 +/- 0.03 to 9.09 +/- 0.63 spikes/stimulation in Sham, OVX, and OVX + E2); N-methyl-D-aspartic acid-mediated PUR plasticity in female rats and may contribute to alterations in urinary dysfunction after menopause.

Dichloromethane activation. Direct methylenation of ketones and aldehydes with CH2Cl2 promoted by Mg/TiCl4/THF

[reaction: see text] This Mg-TiCl4-promoted CH2-transfer reaction of CH2Cl2 represents an extremely simple, practical, and efficient methylenation of a variety of ketones and aldehydes, especially in enolizable or sterically hindered ketones such as 2,2-dimethylcyclohexanone, camphor, and fenchone.

Two C-terminal amino acids, Ser(334) and Ser(335), are required for homologous desensitization and agonist-induced phosphorylation of opioid receptor-like 1 receptors

Various cellular signaling pathways induced by nociceptin activation of ORL1 (opioid receptor-like 1 receptor) develop homologous desensitization. Multiple lines of evidence suggest that agonist-induced phosphorylation of serine (Ser)/threonine (Thr) residues at intracellular carboxyl tail leads to homologous desensitization of G protein-coupled receptors. In the present study, we investigated the functional role played by C-terminal Ser/Thr residues in agonist-induced desensitization and phosphorylation of ORL1. In HEK 293 cells expressing wild-type ORL1 and ORL1(CDelta21), which lacks C-terminal 21 amino acids, nociceptin inhibition of adenylate cyclase activity exhibited homologous desensitization after 1 h pretreatment of nociceptin. In contrast, ORL1(CDelta34), which differs with ORL1(CDelta21) by lacking C-terminal Ser(334), Ser(335) and Ser(343) residues, failed to develop agonist-induced desensitization. Point mutant (S343A) ORL1 underwent homologous desensitization after nociceptin pretreatment. Substituting Ser(334) or Ser(335) with alanine greatly impaired nociceptin-induced ORL1 desensitization. In HEK 293 cells expressing double mutant (S334A/S335A) ORL1, nociceptin pretreatment failed to significantly affect the efficacy and potency by which nociceptin inhibits forskolin-stimulated cAMP formation. Mutation of Ser(334) and Ser(335) also greatly reduced nociceptin-induced ORL1 phosphorylation. These results suggest that two C-terminal serine residues, Ser(334) and Ser(335), are required for homologous desensitization and agonist-induced phosphorylation of ORL1.

Polyglutamine-expanded ataxin-7 activates mitochondrial apoptotic pathway of cerebellar neurons by upregulating Bax and downregulating Bcl-xL

Spinocerebellar ataxia type 7 (SCA7) is an autosomal dominant neurodegenerative disorder caused by polyglutamine-expanded ataxin-7. In the present investigation, we expressed disease-causing mutant ataxin-7-Q75 in the primary neuronal culture of cerebellum with the aid of recombinant adenoviruses. Subsequently, this in vitro cellular model of SCA7 was used to study the molecular mechanism by which mutant ataxin-7-Q75 induces neuronal death. TUNEL staining studies indicated that polyglutamine-expanded ataxin-7-Q75 caused apoptotic cell death of cultured cerebellar neurons. Mutant ataxin-7-Q75 induced the formation of active caspase-3 and caspase-9 without activating caspase-8. Polyglutamine-expanded ataxin-7-Q75 promoted the release of apoptogenic cytochrome-c and Smac from mitochondria, which was preceded by the downregulation of Bcl-x(L) protein and upregulation of Bax protein expression in cultured cerebellar neurons. Further real-time TaqMan RT-PCR assays showed that mutant ataxin-7-Q75 upregulated Bax mRNA level and downregulated Bcl-x(L) mRNA expression in the primary neuronal culture of cerebellum. The present study provides the evidence that polyglutamine-expanded ataxin-7-Q75 activates mitochondria-mediated apoptotic cascade and induces neuronal death by upregulating Bax expression and downregulating Bcl-x(L) expression of cerebellar neurons.

The clinical significance of gas-containing liver abscesses converting from total gas content to gas and fluid content: a case report

The first case of gas-containing liver abscesses converting from total gas content to gas and fluid content is reported, and the clinical significance of such a conversion is emphasised. A 58-year-old diabetic woman suffered from fever and chill due to totally gas-containing liver abscesses shown by computerised tomography (CT). The patient did not recover despite ultrasound-guided aspiration of the abscess. CT carried out 2 weeks later revealed that the initial totally gas-containing liver abscesses converted to ones with gas and fluid content. The patient recovered after CT-guided drainage of the abscesses.

Heterodimerization of opioid receptor-like 1 and mu-opioid receptors impairs the potency of micro receptor agonist

Nociceptin activation of ORL1 (opioid receptor-like 1 receptor) has been shown to antagonize mu receptor-mediated analgesia at the supraspinal level. ORL1 and mu-opioid receptor (muR) are co-expressed in several subpopulations of CNS neurons involved in regulating pain transmission. The amino acid sequence of ORL1 also shares a high degree of homology with that of mu receptor. Thus, it is hypothesized that ORL1 and muR interact to form the heterodimer and that ORL1/muR heterodimerization may be one molecular basis for ORL1-mediated antiopioid effects in the brain. To test this hypothesis, myc-tagged ORL1 and HA-tagged muR are co-expressed in human embryonic kidney (HEK) 293 cells. Co-immunoprecipitation experiments demonstrate that ORL1 dimerizes with muR and that intracellular C-terminal tails of ORL1 and muR are required for the formation of ORL1/muR heterodimer. Second messenger assays further indicate that formation of ORL1/muR heterodimer selectively induces cross-desensitization of muR and impairs the potency by which [D-Ala(2),N-methyl-Phe(4),Gly-ol(5)]enkephalin (DAMGO) inhibits adenylate cyclase and stimulates p42/p44 mitogen-activated protein kinase (MAPK) phosphorylation. These results provide the evidence that ORL1/muR heterodimerization and the resulting impairment of mu receptor-activated signaling pathways may contribute to ORL1-mediated antiopioid effects in the brain.

Functional analysis of connexin-26 mutants associated with hereditary recessive deafness

The physiological importance of connexin-26 (Cx26) gap junctions in regulating auditory function is indicated by the finding that autosomal recessive DFNB1 deafness is associated with mutations of the Cx26 gene. To investigate the pathogenic role of Cx26 mutation in recessive hearing loss, four putative DFNB1 Cx26 mutants (V84L, V95M, R127H, and R143W) were stably expressed in N2A cells, a communication-deficient cell line. In N2A cells expressing (R127H) Cx26 gap junctions, macroscopic junctional conductance and ability of transferring neurobiotin between transfected cells were greatly reduced. Despite the formation of defective junctional channels, immunoreactivity of (R127H) Cx26 was mainly localized in the cell membrane and prominent in the region of cell-cell contact. Mutant (V84L), (V95M), or (R143W) Cx26 protein formed gap junctions with a junctional conductance similar to that of wild-type Cx26 junctional channels. (V84L), (V95M), or (R143W) Cx26 gap junctions also permitted neurobiotin transfer between pairs of transfected N2A cells. The present study suggests that (R127H) mutation associated with hereditary sensorineural deafness results in the formation of defective Cx26 gap junctions, which may lead to the malfunction of cochlear gap junctions and hearing loss. Further studies are required to determine the exact mechanism by which mutant (V84L), (V95M), and (R143W) Cx26 proteins, which are capable of forming functional homotypic junctional channels in N2A cells, cause the cochlear dysfunction and sensorineural deafness.

Approaching healthy body mass index norms for children and adolescents from health-related physical fitness

Current body mass index (BMI) norms for children and adolescents are developed from a reference population that includes obese and slim subjects. The validity of these norms is influenced by the observed secular increase in body weight and BMI. We hypothesized that the performance of children in health-related physical fitness tests would be negatively related to increased BMIs, and therefore fitness tests might be used as criteria for developing a more appropriate set of BMI norms. We evaluated the existing data from a nation-wide fitness survey for students in Taiwan (444 652 boys and 433 555 girls) to examine the relationship between BMI and fitness tests. The fitness tests used included: an 800/1600-m run/walk; a standing long jump; bent-leg curl-ups; and a sit-and-reach test. The BMI percentiles developed from the subgroup whose test scores were better than the 'poor' quartile in all four tests were compared with those of the whole population and linked to the adult criteria for overweight and obesity. The BMIs were significantly related to the results of fitness testing. A total of 43% of students had scores better than the poorest quartile in all of their tests. The upper BMI percentile curves of this fitter subgroup were lower than those of the total population. The 85th and 95th BMI percentile values of the fitter 18-year-old-students (23.7 and 25.5 kg m(-2) for boys; 22.6 and 24.6 kg m(-2) for girls) linked well with the adult cut-off points of 23 and 25 kg m(-2), which have been recommended as the Asian criteria for adult overweight and obesity. Hence, the BMI norms for children and adolescents could be created from selected subgroups that have better physical fitness. We expect that the new norms based on this approach will be used not only to assess the current status of obesity or overweight, but also to encourage activity and exercise.

Identification of two C-terminal amino acids, Ser(355) and Thr(357), required for short-term homologous desensitization of mu-opioid receptors

Our recent study suggests that a cluster of Ser/Thr residues (T(354)S(355)S(356)T(357)) at the intracellular carboxyl tail of rat mu-opioid receptor (MOR1) is required for the development of short-term homologous desensitization. To investigate the functional role played by individual serine or threonine residue of this (TSST) cluster in the agonist-induced mu-opioid receptor desensitization, point mutant (T354A), (S355A), (S356A) and (T357A) mu-opioid receptors were prepared and stably expressed in human embryonic kidney 293 cells (HEK 293 cells). Similar to wild-type mu-opioid receptors, mutant (T354A) and (S356A) mu-opioid receptors stably expressed in HEK 293 cells developed homologous desensitization after 30 min pretreatment of DAMGO ([D-Ala(2),N-methyl-Phe(4),Gly-ol(5)]enkephalin), a specific mu-opioid receptor agonist. Substituting Ser(355)or Thr(357) with alanine resulted in a significant attenuation of agonist-induced mu-opioid receptor desensitization. In HEK 293 cells stably expressing double mutant (S355A/T357A) mu-opioid receptors, DAMGO pretreatment failed to significantly affect the efficacy and potency by which DAMGO inhibits forskolin-stimulated adenylyl cyclase activity. Consistent with the general belief that agonist-induced phosphorylation of guanine nucleotide binding protein (G protein)-coupled receptors is involved in homologous desensitization. Treating HEK 293 cells expressing wild-type mu-opioid receptors with 5 microM DAMGO for 30 min induced the receptor phosphorylation. Mutation of Ser(355) and Thr(357) also greatly impaired DAMGO-induced mu-opioid receptor phosphorylation. These results suggest that two C-terminal amino acids, Ser(355) and Thr(357), are required for short-term homologous desensitization and agonist-induced phosphorylation of mu-opioid receptors expressed in HEK 293 cells.

Antibodies to Epstein-Barr virus thymidine kinase: a characteristic marker for the serological detection of nasopharyngeal carcinoma

Patients suffering from nasopharyngeal carcinoma (NPC) generally exhibit elevated serum IgA antibody titres to Epstein-Barr virus (EBV) early antigen (EA) and virus capsid antigen (VCA). This property is frequently used as a diagnostic aid. Preliminary experiments suggested that an ELISA for IgA antibodies against the EBV-encoded thymidine kinase (TK) could form the basis of a more reliable diagnostic test. Here, we describe the construction of a recombinant baculovirus that expresses the EBV TK and present a full analysis of its use in serological surveys of NPC patients. Baculovirus-derived TK was used to develop a simple ELISA for serum IgA against this antigen. ELISA reactivity was strongly associated with NPC compared with an EBV-positive, normal control population. Comparison with the existing IgA-VCA and EA assays showed that the TK ELISA had higher sensitivity whilst the specificity was similar or higher. We conclude that the TK ELISA presents a strong predictor of NPC and, in its refined form, has improved pickup rates. In addition, results from patients with chronic nasopharyngitis (CNP) suggest that individuals with both symptoms of CNP and an elevated TK ELISA value may be at increased risk for the development of head-and-neck cancer.

Endoscopic staple-assisted esophagodiverticulostomy: an excellent treatment of choice for Zenker's diverticulum

OBJECTIVES

The objectives of the present study are to review the technique of endoscopic staple-assisted esophagodiverticulostomy (ESED) for the treatment of Zenker's diverticulum and to describe our experience and modifications with ESED and the advantages of ESED over previous treatments of Zenker's diverticulum.

STUDY DESIGN

Retrospective review of 74 cases of ESED performed for the treatment of Zenker's diverticulum.

METHODS

Patient's records were retrospectively reviewed and tabulated for age, sex, size of diverticulum, symptoms, duration of symptoms, operative time, length of postoperative hospital stay, oral intake, complications, and relief of symptoms.

RESULTS

The senior author (R.L.S) previously reported results in 36 cases of ESED performed in 34 patients with Zenker's diverticulum. We have performed an additional 38 cases of ESED in 37 patients between March 1997 and August 1999. The rate of success of ESED was similar between the two series The average perioperative time, time until oral intake, and length of postoperative hospital stay decreased in the second series. Overall, there were no mortalities and few complications with ESED. Compared with other forms of treatment of Zenker's diverticulum, such as Dohlman's procedure, diverticulectomy, and diverticulopexy, ESED has a similar rate of success, decreased perioperative time, decreased convalescence, and decreased mortality and complications.

CONCLUSIONS

Cost-effectiveness, safety, and efficacy of ESED offer new advantages over previously used treatments for Zenker's diverticulum. These results continue to support the use of ESED as the initial treatment of choice for patients with Zenker's diverticulum.

Benign metastasizing leiomyoma of the lung: a case report

Benign metastasizing leiomyoma (BML) refers to benign pulmonary neoplasm associated with a previous or coincident history of uterine leiomyomata. We report the case of a 56-year-old postmenopausal woman with a 4-year history of multiple benign leiomyomatous lesions in bilateral lungs and the uterus. The tumor cells from the lungs and uterus were focally immunoreactive for HMB-45 antibody and progesterone receptor. Immunoreactivity to HMB-45 is well known in smooth muscle cells of hamartomatous neoplasms, such as angiomyolipoma and lymphangioleiomyomatosis, but has not been reported in BML previously. These features suggest a multifocal hamartomatous histogenesis rather than metastasis in the present case.

Antioxidant and hepatoprotective effects of Acathopanax senticosus

Acathopanax senticosus (Rupr. et Maxim.) Harms. is a popular folk medicine used as a nutrient for hepatitis and cancer in Taiwan. In this study, the antioxidant activity of the crude extract and the hepatoprotective activities on CCl(4)- or acetaminophen-induced toxicity in the rat liver were evaluated. Our results suggest that A. senticosus exerts some antioxidant effects. On a CCl(4)- or acetaminophen-intoxicated -model, the levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were increased by CCl(4) or acetaminophen administration and reduced by treatment with the plant extract. Histological changes around the hepatic central vein were also recovered by treatments. However, treatments with larger doses of the crude extract of A. senticosus enhanced liver damage. This result suggests that even if A. senticosus had hepatoprotective activity in small doses, treatment with larger doses would possibly induce some cell toxicity.

Assessment of intragastric pH value changes after early nasogastric feeding

Studies have suggested that early feeding after injury decreases morbidity and mortality. Few reports, however, have focused on the change in pH inside the stomach after early tube feeding. The aim of the present study was the assessment of 1) the change in intragastric pH after surgery, and 2) the effect of early nasogastric tube feeding on intragastric pH value. From April 1997 to February 1998, 80 patients who underwent colon resection for colorectal cancer by a single surgeon entered the study and were randomized into four groups. Twenty patients (group I) were kept on NPO for 1 wk, and 20 patients per group (groups II, III, and IV) were fed through a nasogastric tube from the second to the seventh postoperative day with low-residual (Osmolite HN), high-fat (Pulmocare), and glutamine-containing (AlitraQ) enteral formulas. Feeding started at 500 kcal/500 cc/d. If the patient tolerated the formula well, feeding increased to 1500 kcal/1500 cc(-1)/d(-1) the following day. Intragastric pH was measured preoperatively and then twice daily until the sixth postoperative day. The pH value of intragastric juice increased significantly once feeding started (3. 67 +/- 1.33 on the third postoperative day; 4.28 +/- 1.26 on the six postoperative day). The pH value seemed only mildly affected by the patient's tolerance for tube feeding (poorly tolerated group, pH 3. 52 +/- 1.75 versus 3.75 +/- 1.21 in the well-tolerated group on the third postoperative day; poorly tolerated group, pH 3.67 +/- 1.02 versus 4.45 +/- 1.27 in the well-tolerated group on the sixth postoperative day). The pH value of intragastric juice was higher in group II than in groups III and IV (4.51 +/- 1.57, 3.90 +/- 1.20, 4. 42 +/- 0.89 respectively, on the sixth postoperative day). This series suggests that early nasogastric feeding can significantly elevate the intragastric pH value in patients after resection of colorectal cancer. Nasogastric feeding may decrease the incidence of stress ulceration by elevating the pH value of intragastric juice.

Antioxidant and hepatoprotective effects of Anoectochilus formosanus and Gynostemma pentaphyllum

Anoectochilus formosanus Hay. and Gynostemma pentaphyllum Makino are popular folk medicines that have been used for treating hepatitis, hypertension and cancer in Taiwan. Our previous studies showed that these crude drugs exert antiinflammatory activity and hepatoprotective activity against CC14-induced liver damage. In this study, the antioxidant effect of these crude drugs and their hepatoprotective activity on acetaminophen-induced liver injury in rat was evaluated. Our results suggest that A. formosanus and G. pentaphyllum do have antioxidant effects. On acetaminophen-intoxicated model, the increased levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) by acetaminophen administration were reduced by treatment with these two herbs. In histological observation, gross necrosis in the centribular area, sinusoidal congestion, infiltration of the lymphocytes and Kupffer cells around the hepatic central vein, and loss of cell boundaries and ballooning degeneration were reduced with herbal treatment. However, the effect of A. formosanus and G. pentaphyllum is biphasic. Methanol extract (100 and 300 mg/kg) and water extract (300 and 500 mg/kg) of A formosanus and water extract (100, 300 and 500 mg/kg) of G. pentaphyllum enhanced the recovery of liver injury while treatment with 500 mg/kg of A. formosanus methanol extract resulted in serious hepatic injury.

Genetic and biochemical studies with ataxia telangiectasia. A review

This article summarizes the genetics and clinical features of ataxia telangiectasia (AT) and then reviews recent cytogenetic, cellular, and biochemical studies which support the hypothesis that a defect in DNA repair is responsible for the various manifestations of the disease. The biochemical evidence further indicates that the defect specifically reduces the cellular capacity to remove bases and nucleotides damaged by ionizing radiation, without affecting the cells' ability to scavenge free radicals or to rejoin breaks in the sugar-phosphate backbone of DNA. Suggestions for additional research to more precisely identify the repair defect will also be presented.

LDL of Taiwanese vegetarians are less oxidizable than those of omnivores

The vegetarians in Taiwan consume diets high in polyunsaturated fatty acids. To investigate whether this dietary pattern results in high susceptibility of LDL to oxidation, 109 long-term (8 +/- 5 y) male and female vegans and lactovegetarians (ages 31-45 y) from Taipei and females from Hualien and matched omnivores were recruited to have 24-h-recall dietary assessments and blood lipid analysis. Body mass index and blood pressure were significantly lower in all vegetarian groups than in the matched omnivore groups (P < 0.05). Vegetarians consumed less energy except in the males and less protein, fat and cholesterol (P < 0.05). The mean polyunsaturated/saturated fatty acid (P/S) ratio of 2.4 in vegetarian diet was about two times that in omnivore diet (P < 0. 001). The concentrations of plasma total- and LDL-cholesterol (LDL-C) but not HDL-cholesterol (HDL-C) were significantly lower (P < 0.001) and resulting HDL-C/LDL-C ratio was 38, 46 and 30% higher (P < 0.01) in Taipei female, male and Hualien female vegetarians, respectively, than in the matched omnivores. Plasma triglyceride concentration was significantly lower only in the Hualien women vegetarians (31%, P < 0.001) than in the matched omnivores. The lag time of conjugated diene formation in LDL oxidized in vitro induced by copper was longer in Taipei female (62%, P < 0.001), male (29%, P < 0.05) and Hualien female (38%, P < 0.01), and the production of thiobarbituric acid reactive substances (TBARS) in LDL after 2-4 h of oxidation was 22-32% less (P < 0.005) in Taipei male and Hualien female vegetarians than the matched omnivores. Lag time of LDL oxidation was negatively related to LDL arachidonic (r = -0.55, P = 0.0003) and eicosapentaenoic (r = -0.47, P = 0.003) acid contents. LDL-TBARS production was negatively related to LDL linoleic acid content (r = -0.36, P = 0.023), but positively related to LDL arachidonic (r = 0.56, P = 0.0002) and eicosapentaenoic (r = 0.45, P = 0.004) acids. No significant differences were found in dietary vitamins C and E intakes and plasma LDL alpha-tocopherol concentrations between vegetarians and omnivores. Our results suggest that vegetarian diets decrease the susceptibility of LDL to oxidation despite their higher dietary P/S ratio.

Pneumoparotid: a case report and review of its pathogenesis, diagnosis, and management

Pneumoparotid is considered to be a rare entity, but the diagnosis might not be as uncommon as reported. We report a case in which computed tomography incidentally revealed air in the parotid ducts bilaterally. Treatment is aimed at the elimination of predisposing and causative factors, but because our patient denied any symptoms or precipitating factors and had a benign presentation, no immediate intervention was initiated.

Circadian variations in plasma and erythrocyte glutamate concentrations in adult men consuming a diet with and without added monosodium glutamate

This study evaluated the effect of monosodium glutamate (MSG) ingestion as a component of the diet on the 24-h variations in plasma and whole-blood glutamate (GLU) concentrations in healthy adult men. In the first arm of the study, subjects were given test meals without added MSG for 3 d. Protein and energy intakes of the subjects were 1.5 g and 40 kcal/(kg body weight.d), respectively. On d 3, blood samples were collected over the 24-h period. One week later, the same protocol was repeated, except that 100 mg/(kg body weight.d) MSG was added to the meals (15, 40 and 45 mg/kg body weight to breakfast, lunch and dinner, respectively). Both plasma and whole-blood samples were analyzed for free amino acids. Unlike large neutral amino acids, which experienced high peak plasma concentrations at 2100-2300 h, the circadian variations in plasma GLU concentrations were small, varying between 33 and 48 micromol/L on days in which no MSG was fed, and between 32 and 53 micromol/L on days in which MSG was added to the meals. In both trials, plasma GLU concentration increased (P < 0.01) after lunch and dinner, and decreased early in the morning (P < 0.05). Calculated erythrocyte GLU concentrations varied between 500 and 640 micromol/L, with or without MSG addition to the meals. The rather low plasma GLU concentrations over the 24-h period, despite high dietary intake of MSG, indicate that dietary MSG is metabolized very rapidly.

Circadian variations in plasma neutral and basic amino acid concentrations in young men on an ordinary Taiwanese diet

BACKGROUND AND PURPOSE

Plasma levels of circulating free amino acids reflect the net status of protein breakdown and synthesis, and may be linked to various disease states. We studied circadian variations in plasma concentrations of neutral and basic amino acids during a 24-hour period in healthy young men who consumed ordinary Taiwanese test meals.

METHODS

Ten subjects ingested the test diet (protein intake, 1.5 g.kg-1.d-1) which was offered in three meals and two light snacks during the day. Thirteen heparinized blood samples were collected from each subject to analyze plasma amino acid concentrations during the experimental period, at 1- to 3-hour intervals.

RESULTS

The plasma concentrations of all neutral amino acids, including the large neutral amino acids (leucine, isoleucine, valine, tryptophan, tyrosine, and phenylalanine) and methionine, as well as the small neutral amino acids (glycine, serine, threonine, and proline) and the basic amino acids (histidine, arginine, lysine), varied significantly as a function of the time of day (p < 0.001). Except for glycine and proline, all of the neutral amino acids exhibited a marked evening elevation after dinner, with the highest plasma concentration at 23:00. Proline showed peak concentrations at 09:00, while glycine and the basic amino acids exhibited peak concentrations at 21:00. Most of the plasma amino acids exhibited the lowest concentrations at 12:00.

CONCLUSION

Plasma neutral and basic amino acid concentrations exhibited significant circadian variations. The present study also provided the mean fasting plasma levels of amino acids in healthy young men consuming an ordinary Taiwanese diet.

Lymph node revealing solution and traditional 10% buffered formaldehyde for detecting lymph nodes in colorectal carcinoma

BACKGROUND

Cancer stage has been the most important factor in evaluating the prognosis and treatment of colorectal carcinoma, and the presence of lymph node metastasis in the resected specimen plays a key role in serial staging. We evaluated a newly proposed "lymph node revealing solution" (LNRS) that proponents claim is inexpensive, easy, rapid, and innocuous, and that could help to establish the stage of disease more accurately than buffered formaldehyde (formalin). Our study compared traditional 10% formalin and LNRS as second search solutions to determine whether LNRS is a more useful and practical solution than formalin.

METHODS

Thirty randomly selected colorectal carcinomas from low anterior resection (LAR) were studied. The specimens were handled routinely on the first day. Then, the entire fat of odd-numbered cases was immersed in three times its volume of LNRS, and the entire fat of even-numbered cases was immersed in 10 times its volume of formalin overnight. The chi-squared test was used to evaluate the results.

RESULTS

Of 145 cassettes in the second search by LNRS, seven had no lymph nodes. Of 107 cassettes in the second search by formalin, 18 had no lymph nodes. Totally, 792 lymph nodes were found with an average number of 26.4 per case and 1.53/cm (per centimeter of specimen) in all 30 cases. By the LNRS method, 138 lymph nodes were found in the 15 odd-numbered cases, and by the formalin method, 89 lymph nodes were found in the 15 even-numbered cases. We were able to adjust the stage upward in two cases by LNRS-fixation method. There were no changes in staging in the formalin-fixation method cases.

CONCLUSIONS

LNRS showed no statistically significant difference from formalin in the numbers of total lymph nodes, positive lymph nodes, or minute (less than 1 mm) lymph nodes found. Nonetheless, we do believe that LNRS is a potential replacement solution for formalin due to its fast fixation, ease of searching, high identification rate and time-saving procedure.

Clinicopathologic analysis of renal and extrarenal angiomyolipomas: report of 44 cases

BACKGROUND

Angiomyolipoma (AML) is a rare soft tissue tumor involving the kidneys, liver and other visceral organs. It is composed of smooth muscle cells, adipocytes and small- to medium-sized hyalinized vessels. The purpose of this study was to investigate the characteristic clinicopathologic manifestations of AML in different tissues.

METHODS

We collected 37 renal, four hepatic, one lymph node, one subcutaneous and one uterine cervical AML to analyze the clinical, histologic, histochemical and immunohistochemical variations of AML in different tissues.

RESULTS

Clinically, renal and hepatic AML were associated with tuberous sclerosis complex and predominate in women. There were several prominent pathologic differences between renal and extrarenal AML. First, none of the tumors were encapsulated except for the subcutaneous AML, which had a pseudocapsule. Secondly, the smooth muscle cells were usually epithelioid shaped in hepatic AML and occasionally in renal AML, but not in subcutaneous or uterine AML. Furthermore, hepatic AML characteristically showed extramedullary hematopoiesis and eosinophilic hyaline granules. Finally, only the tumor cells of renal, lymph node and hepatic AML had periodic acid-Schiff (PAS), PAS-D (after diastase digestion) positive granules and monoclonal mouse anti-human melanosome clone (HMB-45) immunoreactivity.

CONCLUSIONS

By combining the clinical, histologic, histochemical and immunohistochemical features, some discrepancies between the renal and extrarenal AML were observed, such as female predominance, association with tuberous sclerosis complex, morphology of the smooth muscle cells, presence of PAS, PAS-D positive granules and HMB-45 immunoreactivity in tumor cells. Extramedullary hematopoiesis and hyaline globules are unique to hepatic AMLs. These specific pathologic manifestations not only implicate the histogenesis of AML from different organs, but also assist in making a correct diagnosis.