P7 The impact of coronary calcification on diagnostic performance of workstation CT derived fractional flow reserve - a multicentre experience

Background

On-site workstation based computed tomography derived fractional flow reserve (CT-FFR) is an emerging method to assess the vessel specific ischaemia in coronary artery disease (CAD). The impact of coronary calcification on its diagnostic performance is unknown.

Purpose

To evaluate the impact of coronary calcification on the diagnostic performance of reduced-order CT-FFR at detecting vessel specific ischaemia.

Methods

This is a retrospective pooled analysis of 141 patients with suspected CAD enrolled from 3 global centres who underwent CT-coronary angiography (CTA), onsite CT-FFR and invasive FFR.  Coronary calcification was assessed by Agatston score (AS). The diagnostic performance of CT-FFR (≤0.8) and CTA (≥50%) in evaluation of vessel specific ischaemia (FFR ≤ 0.8) was assessed across AS quartiles (Q1-4). A comparison of diagnostic performance of the low to mid AS (Q1 to Q3) versus high AS (Q4) was performed.

Results

Mean age and median AS was 65.8 ± 9.9 and 327.3 (interquartile range = 78.5 – 798.1). Diagnostic accuracy, sensitivity and specificity of CT-FFR for low-mid AS (0-798) and high AS (799-4019) were 77.4% vs 82.9%; 78.9% vs 94.7%; 68.8% vs 76.5% respectively with no statistical difference between the two groups.  The AUC for ischaemia of CT-FFR in low to mid AS was comparable with AUC in the high AS (0.76 [95% CI: 0.66-0.86] vs 0.84 [0.69-0.99]; P = 0.397).  The AUC for ischemia for CT-FFR in both low to mid AS and high AS was significantly higher than for CTA (0.76 [0.66-0.86] vs 0.57 [0.50-0.64]; P = 0.003 and 0.84 [0.69-0.99] vs 0.48 [0.38-0.57]; P < 0.001 respectively).

Conclusion

On-site workstation CT-FFR demonstrated consistently high diagnostic performance in patients with high AS. Its diagnostic performance was superior when compared with significant stenosis assessment on CTA across all spectrum of Agatston scores.

P6187Multicentre diagnostic performance of on-site workstation CT derived fractional flow reserve

Background

On-site workstation based computed tomography derived fractional flow reserve (CT-FFR) is an emerging method to assess vessel specific ischaemia in coronary artery disease (CAD). Global data on its diagnostic performance when compared with CT coronary angiography (CTA) is limited.

Purpose

To evaluate the on-site multicentre diagnostic performance of reduced-order CT-FFR at detecting vessel specific ischaemia.

Method

This is a retrospective pooled analysis of 141 patients (204 vessels) with suspected CAD enrolled from 3 global centres who underwent CTA, onsite CT-FFR and invasive FFR. On-site CT-FFR was performed using a reduced order model on a standard desktop computer with dedicated software. The per vessel diagnostic performance of CT-FFR (≤0.8) for vessel specific ischemia (FFR≤0.8) was compared with CTA (≥50% stenosis).

Results

Mean age was 65.8±9.9, 70.7% were male. FFR significant stenosis was present in 34.3% (70/204) of vessels. Pearson correlation of CT-FFR for invasive FFR was 0.52, P<0.001. Bland Altman analysis demonstrated a mean difference of 0.06±0.15 (95% limits of agreement −0.22 to 0.35). Per vessel diagnostic accuracy, sensitivity and specificity of CT-FFR and CTA were 79.9% vs 53.5%; 78.6% vs 85.7%; 80.6% vs 35.9% respectively. Diagnostic performance as assessed by area under the receiver operator curve (AUC) for CT FFR was superior to CTA (0.82 [95% CI 0.76–0.88] vs 0.61 [0.55–0.67]; P<0.001).

Conclusion

On-site workstation CT-FFR demonstrated high per vessel diagnostic performance and was superior when compared with CTA in assessment of vessel specific ischaemia as assessed by invasive FFR in a multicentre setting.

P6173Plaque characteristics on coronary CT angiography in case of discordance between fractional flow reserve (FFR) and instantaneous wave-free ratio (IFR)

Background

The usefulness of fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) evaluation has been confirmed in the determination of revascularization of coronary artery disease. When FFR≤0.8 and iFR≤0.89 were regarded as the criteria for positivity, the discordance was noted in approximately 20%, but this cause has not been well established.

Purpose

The purpose of this study was to investigate the patient background and features on coronary CT angiography (CCTA) showing the discordance between FFR≤0.8 and iFR≤0.89.

Methods

The subjects were consecutive 85 cases with 108 vessels in which stenosis of 30–90% was detected at one vessel of at least 2mm or more in the major epicardial vessels and FFR and iFR was performed within subsequent 90 days, among suspected cases of coronary arterial diseases which underwent CCTA. The factors showing the discordance between FFR and iFR (patient background, coronary artery calcification score, high risk plaque features on CCTA (positive remodeling, low attenuation plaque), plaque characteristics by a plaque analysis software using a new algorithm called labeling method (vessel volume, plaque volume, lumen volume, plaque length, maximum plaque burden, necrotic core area, fibrous area and calcium area) were evaluated using logistic regression analysis on per-patient and per-vessel basis.

Results

There were no significant both FFR and iFR positive definite factors on per-patient basis. The lumen volume/vessel volume (OR: 0.93, 95% CI: 0.88–0.98, P=0.0032) (OR: 0.90, 95% CI: 0.85–0.95, P<0.0001),minimum lumen area (MLA) (OR: 0.59, 95% CI: 0.41–0.85, P=0.0006) (OR: 0.64, 95% CI: 0.44–0.92, P=0.0047), the plaque volume/vessel volume (OR: 1.05, 95% CI: 1.01–1.10, P=0.0114) (OR: 1.09, 95% CI: 1.04–1.15, P=0.0002) and maximum plaque burden (OR: 1.08, 95% CI: 1.01–1.15, P=0.0095) (OR: 1.06, 95% CI: 1.00–1.13, P=0.0406) were significant both FFR and iFR positive definite factors on per-vessels basis. Discordance between FFR≤0.8 and iFR≤0.89 was observed in 23 vessels (21.3%) of 19 patients. In FFR positive and iFR negative group (15 vessels, 13.9%), positive remodeling (PR) (OR: 4.38, 95% CI: 1.13–17.00, P=0.0294) was only significant predictor. In FFR negative and iFR positive group, there was no significant predictors.

Conclusions

In both FFR and iFR, only lumen volume /vessel volume, MLA, plaque volume/vessel volume and plaque burden were significant positive definite factors. As for the discordance between FFR and iFR, PR is significant predictor in FFR positive and iFR negative group.

Successful live birth in a patient who underwent cranial radiotherapy and systemic chemotherapy by implantation of a cryopreserved blastocyst on day 7

Preservation of fertility has been recommended for cancer-bearing patients of reproductive age before undergoing cancer treatment. However, there are many considerations and it is difficult to preserve fertility for all patients undergoing therapy for malignancies. Female cancer survivors had lower pregnancy and live birth rates compared with others that underwent assisted reproductive technologies (ARTs). We should continue to consider the issue of infertility in patients who underwent therapies for malignancies. This is the first report of a successful live birth in a patient with a cranial tumor who underwent radiotherapy and chemotherapy after implantation of an autologous embryo. The patient was a 27-year-old Japanese woman. She was diagnosed with suprasellar germinoma at 13 years of age, and she developed panhypopituitarism after radiotherapy and chemotherapy. At 27 years of age, she began infertility treatment with in-vitro fertilization (IVF). The level of anti-Mallerian hormone (AMH) was 4.29 ng/ml. After ovarian stimulation by high purified human menopausal gonadotropin (HP-hMG), she obtained two blastocysts and became pregnant by implantation of a cryopre- served blastocyst. At 37 gestational weeks, she delivered a healthy female baby by cesarean section.

First Observation of the Doubly Cabibbo-Suppressed Decay of a Charmed Baryon: Λ_{c}^{+}→pK^{+}π^{-}

We report the first observation of the decay Λ_{c}^{+}→pK^{+}π^{-} using a 980  fb^{-1} data sample collected by the Belle detector at the KEKB asymmetric-energy e^{+}e^{-} collider. This is the first observation of a doubly Cabibbo-suppressed decay of a charmed baryon. We measure the branching ratio of this decay with respect to its Cabibbo-favored counterpart to be B(Λ_{c}^{+}→pK^{+}π^{-})/B(Λ_{c}^{+}→pK^{-}π^{+})=(2.35±0.27±0.21)×10^{-3}, where the uncertainties are statistical and systematic, respectively.

Observation of Z_{b}(10610) and Z_{b}(10650) Decaying to B Mesons

We report the analysis of the three-body e^{+}e^{-}→BB[over ¯]π^{±}, BB[over ¯]^{*}π^{±}, and B^{*}B[over ¯]^{*}π^{±} processes, including the first observations of the Z_{b}^{±}(10610)→[BB[over ¯]^{*}+c.c.]^{±} and Z_{b}^{±}(10650)→[B^{*}B[over ¯]^{*}]^{±} transitions that are found to dominate the corresponding final states. We measure Born cross sections for the three-body production of σ(e^{+}e^{-}→[BB[over ¯]^{*}+c.c.]^{±}π^{∓})=[17.4±1.6(stat)±1.9(syst)]  pb and σ(e^{+}e^{-}→[B^{*}B[over ¯]^{*}]^{±}π^{∓})=[8.75±1.15(stat)±1.04(syst)]  pb and set a 90% C.L. upper limit of σ(e^{+}e^{-}→[BB[over ¯]]^{±}π^{∓})<2.9  pb. The results are based on a 121.4  fb^{-1} data sample collected with the Belle detector at a center-of-mass energy near the ϒ(10860) peak.

Observation of the Decay B_{s}^{0}→K^{0}K[over ¯]^{0}

We measure the decay B_{s}^{0}→K^{0}K[over ¯]^{0} using data collected at the ϒ(5S) resonance with the Belle detector at the KEKB e^{+}e^{-} collider. The data sample used corresponds to an integrated luminosity of 121.4  fb^{-1}. We measure a branching fraction B(B_{s}^{0}→K^{0}K[over ¯]^{0})=[19.6_{-5.1}^{+5.8}(stat)±1.0(syst)±2.0(N_{B_{s}^{0}B[over ¯]_{s}^{0}})]×10^{-6} with a significance of 5.1 standard deviations. This measurement constitutes the first observation of this decay.

First Observation of the Hadronic Transition ϒ(4S)→ηh(b)(1P) and New Measurement of the h(b)(1P) and η(b)(1S) Parameters

Using a sample of 771.6×10(6) ϒϒ(4S) decays collected by the Belle experiment at the KEKB e(+)e(-) collider, we observe, for the first time, the transition ϒ(4S)→ηh(b)(1P) with the branching fraction B[ϒ(4S)→ηh(b)(1P)]=(2.18±0.11±0.18)×10(-3) and we measure the h(b)(1P) mass M(h(b)(1P))=(9899.3±0.4±1.0)  MeV/c(2), corresponding to the hyperfine (HF) splitting ΔM(HF)(1P)=(0.6±0.4±1.0)  MeV/c(2). Using the transition h(b)(1P)→γη(b)(1S), we measure the η(b)(1S) mass M(η(b)(1S))=(9400.7±1.7±1.6)  MeV/c(2), corresponding to ΔM(HF)(1S)=(59.6±1.7±1.6)  MeV/c(2), the η(b)(1S) width Γ(η(b)(1S))=(8(-5)(+6)±5)  MeV/c(2) and the branching fraction B[h(b)(1P)→γη(b)(1S)]=(56±8±4)%.

Search for the dark photon and the dark Higgs boson at belle

The dark photon A^{'} and the dark Higgs boson h^{'} are hypothetical constituents featured in a number of recently proposed dark sector models. Assuming prompt decays of both dark particles, we search for their production in the so-called Higgstrahlung channel e^{+}e^{-}→A^{'}h^{'}, with h^{'}→A^{'}A^{'}. We investigate ten exclusive final states with A^{'}→e^{+}e^{-}, μ^{+}μ^{-}, or π^{+}π^{-} in the mass ranges 0.1  GeV/c^{2} <m_{A^{'}}<3.5  GeV/c^{2} and 0.2  GeV/c^{2} <m_{h^{'}}<10.5  GeV/c^{2}. We also investigate three inclusive final states 2(e^{+}e^{-})X, 2(μ^{+}μ^{-})X, and (e^{+}e^{-})(μ^{+}μ^{-})X, where X denotes a dark photon candidate detected via missing mass, in the mass ranges 1.1  GeV/c^{2} <m_{A^{'}}<3.5  GeV/c^{2} and 2.2  GeV/c^{2} <m_{h^{'}}<10.5  GeV/c^{2}. Using the entire 977  fb^{-1} data set collected by Belle, we observe no significant signal. We obtain individual and combined 90% credibility level upper limits on the branching fraction times the Born cross section, B×σ_{Born}, on the Born cross section σ_{Born}, and on the dark photon coupling to the dark Higgs boson times the kinetic mixing between the standard model photon and the dark photon, α_{D}×ε^{2}. These limits improve upon and cover wider mass ranges than previous experiments. The limits from the final states 3(π^{+}π^{-}) and 2(e^{+}e^{-})X are the first placed by any experiment. For α_{D} equal to 1/137, m_{h^{'}}< 8  GeV/c^{2}, and m_{A^{'}}<1  GeV/c^{2}, we exclude values of the mixing parameter ε above ∼8×10^{-4}.

Measurement of the Direct CP Asymmetry in B¯→X(s+dγ) Decays with a Lepton Tag

We report the measurement of the direct CP asymmetry in the radiative B¯→X(s+dγ) decay using a data sample of (772 ± 11)×10(6) BB[over ¯] pairs collected at the ϒ(4S) resonance with the Belle detector at the KEKB asymmetric-energy e(+)e(-) collider. The CP asymmetry is measured as a function of the photon energy threshold. For Eγ*≥2.1  GeV, where Eγ* is the photon energy in the center-of-mass frame, we obtain A(CP)(B¯→X(s+dγ))=(2.2±3.9±0.9)%, consistent with the standard model prediction.

Observation of e+e- → π+π-π(0)(χbJ) and Search for X(b) → ωϒ(1S) at sqrt[s] = 10.867 GeV

The e(+)e(-) → π(+)π(-)π(0)χ(bJ) (J = 0,1,2) processes are studied using a 118 fb(-1) data sample acquired with the Belle detector at a center-of-mass energy of 10.867 GeV. Unambiguous π(+)π(-)π(0)χ(bJ) (J = 1,2), ωχ(b1) signals are observed, and indication for ωχ(b2) is seen, both for the first time, and the corresponding cross section measurements are presented. No significant π(+)π(-)π(0)χ(b0) or ωχ(b0) signals are observed, and 90% confidence level upper limits on the cross sections for these two processes are obtained. In the π(+)π(-)π(0) invariant mass spectrum, significant non-ω signals are also observed. We search for the X(3872)-like state (named X(b)) decaying into ωϒ(1S); no significant signal is observed with a mass between 10.55 and 10.65 GeV/c(2).

Effects of supplemental oxygen on urinary 8-hydroxy-2'-deoxyguanosine levels in extremely low birth weight infants

As the effects of supplementary oxygen on urinary excretion of 8-hydroxy-2'-deoxyguanosine (8-OHdG) are poorly understood, urinary 8-OHdG levels (ng/mg creatinine) were determined longitudinally on the postnatal day (PND) 1, 3, and 30 in 16 neonates with birth weight < 1000 g. No supplementary oxygen was required in 9 neonates during the first 24 h of life. Urinary 8-OHdG level on PND 1 was inversely correlated with birth weight in these 9 neonates (P = 0.0323) and was higher in four with birth weight < 750 g than five with birth weight > 750 g (41.0 ± 6.9 vs. 5.6 ± 2.7, respectively, P = 0.0200). Median urinary 8-OHdG on PND 1 of these 9 neonates was significantly lower than that of 7 neonates with oxygen (9.3 vs. 60.2, respectively), although there were no significant differences in clinical background, such as birth weight, between the two groups. Five of the 9 did not require supplemental oxygen at all during the first 30 days of life. Median urinary 8-OHdG levels were consistently significantly lower in the 5 neonates than in 11 neonates with oxygen transiently or persistently (9.3 vs. 54.6, 19.1 vs. 61.4, and 28.3 vs. 145 on PND 1, 3, and 30, respectively), although there were no differences in clinical background, such as birth weight, between the two groups. Urinary 8-OHdG on PND 30 was significantly positively correlated with supplemental oxygen dose on PND 30 (P < 0.0001), but not with birth weight in the 16 neonates. These results suggest that higher supplemental oxygen tension caused higher urinary 8-OHdG in this population.

Measurement of the branching fraction B(Λc+ → pK-π+)

We present the first model-independent measurement of the absolute branching fraction of the Λ(c)(+) → pK(-)π(+) decay using a data sample of 978 fb(-1) collected with the Belle detector at the KEKB asymmetric-energy e(+)e(-) collider. The number of Λ(c)(+) baryons is determined by reconstructing the recoiling D((*)-) pπ(+) system in events of the type e(+)e(-) → D((*)-) pπ(+)Λ(c)(+). The branching fraction is measured to be B(Λ(c)(+) → pK(-)π(+)) = (6.84 ± 0.24(-0.27)(+0.21))%, where the first and second uncertainties are statistical and systematic, respectively.

Measurement of the τ-lepton lifetime at Belle

The lifetime of the τ lepton is measured using the process e+ e- → τ+ τ- , where both τ leptons decay to 3πν(τ). The result for the mean lifetime, based on 711  fb(-1) of data collected with the Belle detector at the ϒ(4S) resonance and 60  MeV below, is τ=(290.17±0.53(stat)±0.33(syst))×10(-15)  s. The first measurement of the lifetime difference between τ+ and τ- is performed. The upper limit on the relative lifetime difference between positive and negative τ leptons is |Δτ|/τ<7.0×10(-3) at 90% C.L.

Applicability of ultrasound muscle thickness measurements for predicting fat-free mass in elderly population

OBJECTIVE

This study aimed to examine the applicability of ultrasound muscle thickness (MT) measurements for predicting whole body fat-free mass (FFM) in elderly individuals.

DESIGN AND SETTING

Cross-sectional study of 77 healthy elderly individuals.

METHODS

MTs at nine sites of the body and FFM were determined using B-mode ultrasound and dual-energy x-ray absorptiometry (DXA), respectively, in 44 women and 33 men aged 52 to 78 yrs. Stepwise multiple regression analysis produced two equations for predicting DXA-based FFM with sex (dummy: woman = 0 and man = 1) and either MTs at the anterior and posterior of thigh and lower leg (Eq1) or the product of MT and limb length (MT×LL) at thigh anterior and posterior, lower leg posterior, and upper arm anterior (Eq2) as independent variables.

RESULTS

The R2 and SEE for each of the two equations were 0.929 and 2.5 kg for Eq1 and 0.955 and 2.0 kg for Eq2. The estimated FFM from each of Eq1 (44.4 ± 8.9 kg) and Eq2 (44.4 ± 9.0 kg) did not significantly differ from that of the DXA-based FFM (44.4 ± 9.2 kg), without systematic error. However, the absolute value of the difference between the DXA-based and estimated FFM was significantly greater with Eq1 (2.0 ± 1.5 kg) than with Eq2 (1.5 ± 1.3 kg).

CONCLUSION

The current results indicate that ultrasound MT measurement is useful to predict FFM in the elderly, and its accuracy is improved by using the product of MT and limb length as an independent variable.

Search for bottomonium states in exclusive radiative Υ(2S) decays

We search for bottomonium states in Υ(2S) → (bb)γ decays with an integrated luminosity of 24.7  fb(-1) recorded at the Υ(2S) resonance with the Belle detector at KEK, containing (157.8±3.6)×10(6) Υ(2S) events. The (bb) system is reconstructed in 26 exclusive hadronic final states composed of charged pions, kaons, protons, and K(S)(0) mesons. We find no evidence for the state recently observed around 9975 MeV (X(bb)) in an analysis based on a data sample of 9.3×10(6) Υ(2S) events collected with the CLEO III detector. We set a 90% confidence level upper limit on the branching fraction B[Υ(2S) → X(bb)γ] × ∑(i)B[X(bb) → h(i)] < 4.9×10(-6), summed over the exclusive hadronic final states employed in our analysis. This result is an order of magnitude smaller than the measurement reported with CLEO data. We also set an upper limit for the ηb(1S) state of B[Υ(2S) → ηb(1S)γ] × ∑(i)B[ηb(1S) → h(i)] < 3.7×10(-6).

Precision measurement of charged pion and kaon differential cross sections in e+ e- annihilation at sqrt[s]=10.52 GeV

Measurements of inclusive differential cross sections for charged pion and kaon production in e+ e- annihilation have been carried out at a center-of-mass energy of sqrt[s]=10.52  GeV. The measurements were performed with the Belle detector at the KEKB e+ e- collider using a data sample containing 113×10(6) e+ e- → qq events, where q={u,d,s,c}. We present charge-integrated differential cross sections dσ(h±)/dz for h±={π±,K±} as a function of the relative hadron energy z=2E(h)/sqrt[s] from 0.2 to 0.98. The combined statistical and systematic uncertainties for π± (K±) are 4% (4%) at z∼0.6 and 15% (24%) at z∼0.9. The cross sections are the first measurements of the z dependence of pion and kaon production for z>0.7 as well as the first precision cross section measurements at a center-of-mass energy far below the Z0 resonance used by the experiments at LEP and SLC.

Evidence of a new narrow resonance decaying to χ(c1)γ in B→χ(c1)γK

We report measurements of B→χ(c1)γK and χ(c2)γK decays using 772×10(6) BB[over ¯] events collected at the Υ(4S) resonance with the Belle detector at the KEKB asymmetric-energy e(+)e(-) collider. Evidence of a new resonance in the χ(c1)γ final state is found with a statistical significance of 3.8σ. This state has a mass of 3823.1±1.8(stat)±0.7(syst) MeV/c(2), a value that is consistent with theoretical expectations for the previously unseen 1(3)D(2) cc[over ¯] meson. We find no other narrow resonance and set upper limits on the branching fractions of the X(3872)→χ(c1)γ and χ(c2)γ decays.

Search for an H-dibaryon with a mass near 2mΛ in Υ(1S) and Υ(2S) decays

We report the results of a high-statistics search for H dibaryon production in inclusive Υ(1S) and Υ(2S) decays. No indication of an H dibaryon with a mass near the M(H)=2m(Λ) threshold is seen in either the H→Λpπ(-) or ΛΛ decay channels and 90% confidence level branching-fraction upper limits are set that are between one and two orders of magnitude below the measured branching fractions for inclusive Υ(1S) and Υ(2S) decays to antideuterons. Since Υ(1S,2S) decays produce flavor-SU(3)-symmetric final states, these results put stringent constraints on H dibaryon properties. The results are based on analyses of 102 million Υ(1S) and 158 million Υ(2S) events collected with the Belle detector at the KEKB e(+)e(-) collider.

PP121. Expression of PlGF, sFlt, MTF-1, HO-1 and HIF-1 alpha mRNAs in preeclampsia placenta and effect of preeclampsia sera on their expression of choriocarcinoma cells

INTRODUCTION

Placenta growth factor (PlGF) is a growth factor originated from placenta. The sFlt-1 is soluble receptor for PlGF and suppresses PlGF function. It has been reported that in preeclampsia, serum level of PlGF decreased and sFlt-1 level increased and that preeclampsia placenta is in hypoxic condition. Metal-responsive transcription factor (MTF)-1, Hemoxigenase 1 (HO-1) and Hypoxia responsive factor -1 (HIF-1) may be induced in hypoxic condition.

OBJECTIVES

In order to investigate pathophysiology in preeclampsia, we studied the expression of PlGF, sFlt-1, MTF-1, HO-1 and HIF-1 alpha mRNAs in placenta taken from preeclampsia and the effect of preeclampsia sera on their expression of choriocarcinoma cells and analysed the effect of placental hypoxia and serum factor on the expression of PlGF and sFlt-1 mRNA.

METHODS

Placenta and serum samples were taken from preeclampsia and normal pregnancy with informed consent. The choriocarcinoma cells (JEG-3) were cultured in 24-well tissue culture plate. The cells were cultured with preeclampsia and normal pregnant sera. The RNAs were purified from these cells 24h after and placenta. The expressions of these mRNA were measured by using the real time PCR method (Applied Biosystems-7500).

RESULTS

The expression of PlGF mRNA decreased and that of sFlt-1mRNA increased in preeclampsia placenta. The expression of MTF-1 and HO-1 mRNA decreased. The correlation was found between the expression of PlGF and MTF-1 mRNA, PlGF and HO-1 mRNA and sFlt-1 and HO-1mRNA. Moreover, expression of sFlt-1mRNA increased and HO-1mRNA decreased in JEG-3 cells after incubation of preeclampsia sera.

CONCLUSION

The changes of PlGFmRNA in preeclampsia placenta may relate to the expression of MTF-1 and HO-1 mRNA. The changes of sFlt-1mRNA may relate to the expression of HO-1 mRNA and serum factor. Not only hypoxia but also serum factor may play a role of the levels of PlGF and sFlt-1 in preeclampsia placenta.

Study of mandibular growth in patients treated with Frankel s functional regulator (1b)

Objectives: The purpose of this study was to assess mandibular growth in patients with Class II division 1 malocclusions when treated with Fränkel´s functional regulator 1b. Study Design: The treatment group was made up of 43 patients that were divided into two groups: prepubescent (n:28), and pubescent (n:15). The control group included 40 patients who did not receive any kind of treatment and were likewise divided into a prepubescent group (n:19), and a pubescent group (n:21). A computerized cephalometric study was carried out and superimpositions were done in order to assess the antero-posterior, vertical and rotational movements of the mandible. A two-way ANOVA with interaction was done to compare the changes between the control group and the treatment group, while the Student t for independent samples was used to compare each age group. Results: The Gnathion and Gonion points showed significant differences in the whole sample (p<0.001) as well as in the prepubescent (p<0.001) and pubescent groups (p<0.05). Rotational changes of the mandible measured using the facial axis and mandibular plane showed no statistical differences between both groups (p>0.05). Conclusion: The results show that the FR produces vertical orthopedic growth in the mandible but not horizontal growth compared to non-treated Class II-type I malocclusion patients. No rotational changes were found in the mandible, but we did record mandibular growth along the inclination of the facial axis.

Key words:Fränkel appliance, orthodontics, functional appliances, mandibular growth.

Increases in discontinuous rib cartilage and fused carpal bone in rat fetuses exposed to the teratogens, busulfan, acetazolamide, vitamin A, and ketoconazole

Skeletal changes induced by treatment of pregnant rats with four potent teratogens, busulfan, acetazolamide, vitamin A palmitate, and ketoconazole, were evaluated using Alizarin Red S and Alcian Blue double-staining to investigate the relationship between drug-induced skeletal malformations and cartilaginous changes in the fetuses. Pregnant rats (N = 8/group) were treated once or twice between gestation days (GDs) 10 to 13 with busulfan at doses of 3, 10, or 30 mg/kg; acetazolamide at 200, 400, or 800 mg/kg; vitamin A palmitate at 100,000, 300,000, or 1,000,000 IU/kg; or ketoconazole at doses of 10, 30, or 100 mg/kg. Uterine evaluations and fetal external and skeletal examinations were conducted on GD 20. Marked skeletal abnormalities in ribs and hand/forelimb bones such as absent/ short/bent ribs, fused rib cartilage, absent/fused forepaw phalanx, and misshapen carpal bones were induced at the mid- and high-doses of busulfan and acetazolamide and at the high-dose of vitamin A palmitate and ketoconazole. Increased incidences of discontinuous rib cartilage (DRC) and fused carpal bone (FCB) were observed from the low- or mid-dose in the busulfan and acetazolamide groups, and incidences of FCB were increased from the mid-dose in the vitamin A palmitate and ketoconazole groups. Therefore, DRC and FCB were detected at lower doses than those at which ribs and hand/forelimb malformations were observed in the four potent teratogens.

Application of the Dental Hygiene Human Needs Conceptual Model and the Oral Health-Related Quality of Life Model to the dental hygiene curriculum in Japan

This paper reports the incorporation of the Dental Hygiene Human Needs Conceptual Model (DHHN) and the Oral Health-Related Quality of Life Model (OHRQL) into a dental hygiene curriculum in Japan. A simulated patient practice was offered to 67 dental hygiene students. In the practice activity, all students were introduced to the use of an OHRQL assessment tool. A DHHN assessment tool was utilized additionally only by the experimental student group. The statistical analysis of the post-practice survey showed that the OHRQL instrument was more helpful in assessment and problem identification than the DHHN instrument. By contrast, text-based analysis of dental hygiene diagnostic statements showed that the experimental group identified more domains of patients' human needs deficits than the control group. This suggested the possibility that the DHHN model helped them to see patients from broader perspectives. However, it was difficult for students to design care plans attending to the domains of the models. Also, in considerations to the cultural issues, the validity and equivalence of the Japanese versions of both models should be further investigated. Within the limitation of the present study, the results suggested that incorporation of the combination of the DHHN and OHRQL models can be useful in a dental hygiene curriculum, as each tool helps students expand the perspective from which they view client. Further improvements in learning strategies should facilitate the effective utilization of these models.

Terahertz surface-wave resonant sensor with a metal hole array

A surface-wave sensor based on the resonant transmission characteristics of metal hole arrays is demonstrated in the terahertz (THz) region. Since the frequency of the transmission peak of a metal hole array, which corresponds to the resonant frequency of the surface waves, is particularly sensitive to the refractive index in the vicinity of the metal surface, a very small change in the substances attached to the surface can be detected by monitoring the transmission spectrum. By attaching a layer of substance (thickness t < 5 microm) much thinner than the wavelength of the THz wave (lambda(THz) = 1 mm at 0.3 THz) to the surface of a metal hole array, we demonstrated that the existence of such a small amount of substance can be detected more easily than without the metal hole array. This demonstration of THz sensing with metal hole arrays indicates the possibility of realizing THz surface-wave sensors for biochemical molecules in the THz region.

CT findings in runner’s colitis

A spectrum of lower gastrointestinal tract symptoms occurs in marathon runners. Although most symptoms are transient, reversible ischemic colitis is a rare complication that typically responds to supportive therapy. Because computed tomographic features have not been previously described to our knowledge, we describe abdominal computed tomographic manifestations of reversible ischemic colitis in three marathon runners. On computed tomography, reversible ischemic colitis involves the cecum, with varying involvement of the proximal colon.

Diversification of exogenous genes in vivo in Neurospora

We have adapted the meiotic recombination hotspot cog of Neurospora crassa for shuffling exogenous DNA, providing a means of generating novel genes in situ from sequences introduced into chromosomes. Genes to be diversified are inserted between the his-3 locus and cog. Diversification crosses are heterozygous both for alleles of the exogenous DNA and for auxotrophic alleles of his-3. Progeny selected for ability to grow without histidine supplementation are enriched for exchange events within the exogenous DNA. Exchange events initiated by cog can propagate past DNA sequences mismatched for more than 370 bp and complete exchanges in patches of matched sequence as short as 24 bp, parameters that make the system suited for use in the directed evolution of genes for protein engineering. Here we demonstrate the system by shuffling human immunoglobulin kappa chain genes and also endoglucanase genes derived from different species of fungi.

Endothelial nitric oxide synthase gene (NOS3) variant and hypertension in pregnancy

Hypertension in pregnancy (HP), including preeclampsia, is known to be a multifactorial disease. Recently, a Glu298Asp variant of the endothelial nitric oxide synthase gene (NOS3) was identified as being associated with coronary spasm and myocardial infarction, whereas it has been reported that endothelial nitric oxide synthase plays a role in HP. We therefore performed an association study of the Glu298Asp variant with HP among 152 HP patients and 335 normal pregnant control individuals, in the context of other risk factors before pregnancy. The frequency of the variant GA+AA NOS3 genotypes was significantly higher in the patients (0.23) than in the controls (0.12) (P < 0.01). Multivariate analysis revealed that family history of hypertension, TT genotype of the angiotensinogen gene (AGT), GA+AA NOS3 genotype, and prepregnancy body mass index > or = 24 were independent potent risk factors, after adjustment for maternal age and parity. The odds ratios of the factors were 2.7, 2.3, 2.2, and 2.1, respectively. Our results suggested that the Asp298 of NOS3 is a potent, independent risk factor for HP.

Transverse colonic cancer presenting as an anterior abdominal wall abscess: report of a case

An 81-year-old man who had been aware of a right anterior abdominal mass for 1 week was admitted to our hospital on July 3, 1999, after the mass had perforated and was secreting mucinous purulent material. Computed tomography clearly showed an anterior abdominal wall abscess and a large intraabdominal tumor that contained a fistula-like structure. Barium enema revealed an apple-core sign at the transverse colon, with a fistula that connected the colon to the abscess cavity. Transverse colonic cancer complicated by an anterior abdominal wall abscess was diagnosed, and an extended right hemicolectomy was performed. We did not perform en bloc excision of the full thickness of the anterior abdominal wall, including the abscess, because the defect was determined to be too large to repair. Thus, when curative resection is not feasible, as in our patient, resection of the primary tumor with en bloc partial resection of the adherent parietal wall should be performed if possible, as this procedure has the potential to improve the postoperative quality of life of the patient.

Carrying and washing of grass roots by free-ranging Japanese macaques at Katsuyama

The acquisition and transmission of new feeding behaviours in Japanese macaques (Macaca fuscata) such as sweet potato washing [1, 2], wheat washing [2] and caramel eating [3, 4] have been well documented. These behaviours are all related to provisioned food. Here we report carrying and washing of grass roots by Japanese macaques in a free-ranging group. This would appear to be the first report of washing of dirt from natural food, such as grass roots, among macaques. Furthermore, some monkeys in the present study rubbed dirt from roots by rolling them along the surface of a flat rock at the edge of a river. This may be considered a tool-using behaviour.

A role of glutamate in drug-induced ototoxicity: in vivo microdialysis study combined with on-line enzyme fluorometric detection of glutamate in the guinea pig cochlea

The time course of the changes in perilymphatic glutamate was determined during the application of kanamycin and ethacrynic acid, which are known to damage the hair cells in the inner ear. For the continuous recording of glutamate, the microdialysis technique combined with an enzyme-linked fluorometric assay was used. In guinea pigs receiving a loading dose of 800 mg/kg of kanamycin subcutaneously followed 3 h later by an i.v. injection of 40 mg/kg of ethacrynic acid, a marked glutamate release was clearly found about 2 h after the injection of ethacrynic acid. Injection of kanamycin or ethacrynic acid alone did not produce any change in the perilymphatic glutamate. The morphological changes induced by the administration of both drugs indicated that the collapsing hair cells might release glutamate into the perilymphatic space. The present findings provide additional evidence that glutamate acts as an aggravating factor in aminoglycoside-induced ototoxicity.

Study of the presence of the spores of Clostridium botulinum in honey in Brazil

The isolation of Clostridium botulinum from honey samples is described. Botulism is characterized as an intoxication provoked by ingestion of contaminated foods with this toxin. Infant botulism happens by the ingestion of spores of C. botulinum together with food that in special conditions of the intestinal tract, such as those present in babies of less than 1 year old, will allow the germination and colonization of the intestine with production and absorption of botulinic toxin. The samples were subjected to dilution and to a thermal shock and cultivated in modified CMM (Difco). Cultures were subjected to Gram smears and toxicity tests in mice. The toxic cultures were purified in RFCA (Oxoid) plates and incubated in anaerobic jars. Positive samples were typed using the mouse assay neutralization test. From the 85 honey samples analyzed, six were positive for C. botulinum (7.06%), and identified as producers of type A, B, and D toxins.

Fruit set in Styrax obassia (Styracaceae): the effect of light availability, display size, and local floral density

Maternal reproductive success was examined in Styrax obassia (Styracaceae), a bumble-bee pollinated mass-flowering tree in a cool-temperate deciduous forest in northern Japan. The effects of flower number on the success of individual flowers at three levels (inflorescence, individual, and population) were considered. During 1995 and 1996, variations in size, light availability to branches, floral display size, and fruit set were monitored in 37 out of 211 individual S. obassia trees in a 4-ha forest plot. In addition, the locations of the 211 trees in this plot were mapped and the number of inflorescences in each tree was counted. A multiple regression analysis showed that flower number per inflorescence and inflorescence number per individual had negative effects on fruit set, and inflorescence number of aggregated clumps of flowering trees, tree size, and light resource had positive effects on fruit set although significant level were marginal. It is concluded that pollinator attraction may occur not at the individual tree level, but at the level of a clump of flowering trees. It is also suggested that geitonogamy increased with inflorescence number of tree and inflorescence size and that resource limitation was related to the light condition and variation of tree size.

Activation of human T lymphocytes by ganglioside-containing liposomes

We investigated the in vitro stimulatory effect of ganglioside (GM3, GD1a, GD1b, GT1b, or GQ1b)-containing liposomes on human immune cells. The effect of ganglioside-containing liposomes on the concentration of cytoplasmic free calcium ions ([Ca2+]i) in human immunocytes was examined using the confocal laser fluorescence microscopic method. The GD1a- and GT1b-containing liposomes significantly increased [Ca2+]i of human T lymphocytes compared with the GM3-, GD1b- and GQ1b-containing ones. The response of CD8+ and CD4+ cells was significantly higher than that of CD20+ cells. Our results show that the increase in [Ca2+]i may be caused by not the number of sialic acids contained in the gangliosides but the conformation of the sialic acid moiety to protrude exteriorly from the liposomal membrane surface, and that a sort of receptor recognizing the sialic acid moiety exists on human T lymphocytes (both CD8+ and CD4+ cells), which may be involved in the activation of the cells. The present results are almost the same as those obtained for the rat T lymphocyte system previously reported. This clearly confirms that a sort of ganglioside surely stimulates T lymphocytes directly, which is not species-specific but conserved in humans and rats among animal species.