Flexural Properties and Polished Surface Characteristics of a Structural Colored Resin Composite

OBJECTIVE

The aim of this study was to determine the flexural properties and surface characteristics of a structural colored resin composite after different finishing and polishing methods, in comparison to those of conventional resin composites.

METHODS AND MATERIALS

A structural color resin composite, Omnichroma (OM, Tokuyama Corp, Chiyoda City, Tokyo, Japan), and two comparison resin composites, Filtek Supreme Ultra (FS, 3M, St Paul, MN, USA) and Tetric EvoCeram (TE, Ivoclar Vivadent, Schaan, Liechtenstein), were used. The flexural properties of the resin composites were determined in accordance with the ISO 4049 specifications. For surface properties, 70 polymerized specimens of each resin composite were prepared and divided into seven groups of 10. Surface roughness (Sa), gloss (GU), and surface free energy (SFE) were investigated after the following finishing and polishing methods. Three groups of specimens were finished with a superfine-grit diamond bur (SFD), and three with a tungsten carbide bur (TCB). After finishing, one of the two remaining groups was polished with a one-step silicone point (CMP), and the other with an aluminum oxide flexible disk (SSD). A group ground with SiC 320-grit was set as a baseline.

RESULTS

The average flexural strength ranged from 116.6 to 142.3 MPa in the following order with significant differences between each value: FS > TE > OM. The average E ranged from 6.8 to 13.2 GPa in the following order with significant differences between each value: FS > TE > OM. The average R ranged from 0.77 to 1.01 MJ/mm3 in the following order: OM > FS > TE. The Sa values of the OM groups polished with CMP and SSD were found to be significantly lower than those of the other resin composites, regardless of the finishing method. The GU values appeared to be dependent on the material and the finishing method used. The OM specimens polished with SSD showed significantly higher GU values than those polished with CMP. Most of the resin composites polished with SSD demonstrated significantly higher γS values compared to the other groups. Extremely strong negative correlations between Sa and GU in the combined data from the three resin composites and each resin composite and between Sa and γS in the OM specimens were observed; GU showed a strong positive correlation with γS in the same material.

CONCLUSION

These findings indicate that both flexural and surface properties are material dependent. Furthermore, the different finishing and polishing methods used in this study were observed to affect the Sa, GU, and SFE of the resin composites.

Evaluation of Color-matching Ability of a Structural Colored Resin Composite

PURPOSE

The present study evaluated the color-matching ability of a structural colored resin composite to compare it with resin composites employing pigments.

METHODS AND MATERIALS

A structural colored resin composite (Omnichroma [OMC]), a supranano-filled resin composite (Estelite ∑ Quick [ELQ]), and a nano-filled resin composite (Filtek Supreme Ultra [FSU]) were used. Each resin composite was packed into a Teflon mold and pressed down with a clear strip under a glass slide. The specimens were light irradiated through the slide with a light-emitting diode curing unit. The thickness of the specimens (n=6) was measured with a digital caliper before being transferred to distilled water and stored at 37°C for 24 hours. The measurements of the optical characteristics of the specimens on a black-and-white background were performed using a spectrophotometer. D65 (CIE D65) was used as a light source for the spectrophotometer. Measurements were repeated three times for each specimen under each color-measurement condition, and average values for three same-shade specimens were calculated. One-way analysis of variance and Tukey post hoc tests were used (α=0.05). To determine its ability to match the color of artificial teeth, each shade of resin composite was placed in a cavity before performing color measurements. Using a spectrophotometer (CMS-35F S/C) with a flexible sensor, L*, a*, and b* values were obtained.

RESULTS

The spectral reflectance curve of OMC showed that it reflected light wavelengths from 430-700 nm regardless of the background color and thickness of the specimens. The percentage of reflectance of ELQ decreased near wavelengths of 550-580 nm. Regarding the influence of background color on CIE L*, a*, b* values, the L* level showed significantly higher values for all tested materials with white backgrounds, and OMC was most affected by the difference in background color. However, a* values of ELQ and FSU were significantly higher with a black background than with a white background, and OMC showed a significantly higher value with a white background than with a black background. The b* values were higher with a white background than with a black background and were significantly higher for all three products, and these tendencies were much greater for ELQ and FSU.

CONCLUSIONS

The ability of OMC to match the color of artificial teeth showed acceptable color compatibility, regardless of the shade of the artificial teeth and the depth of the cavity. However, ELQ and FSU showed reduced color compatibility, especially for a cavity depth of 3.0 mm. Excellent color matching ability was confirmed for the structural colored resin composite OMC, resulting in reduced color differences and therefore improving the esthetic appearance of the restoration, simplifying shade matching, and compensating for any color mismatch.

Impact of a stent-less percutaneous coronary intervention strategy using directional coronary atherectomy and a drug coated balloon for left main and ostial lesions

Background

With the advent of drug eluting stents (DESs), the restenosis rate has markedly decreased. However, even with DESs, problems remain unsolved for bifurcated lesions including left main trunk (LMT) and right coronary artery (RCA) ostial lesions. In the era of directional coronary atherectomy (DCA) alone, an optimal DCA provides a significantly lower residual stenosis and lower angiographic restenosis than conventional balloon angioplasty, despite failing to reach a statistical significance for reducing late clinical events as compared to balloon angioplasty (Circulation 1998; 97:322–31.).

Purpose

This study aimed to examine the safety and effectiveness of stent-less percutaneous coronary intervention (PCI) using DCA and drug coated balloons (DCBs).

Methods

From November 2017 to June 2019, a stent-less PCI for LMT and ostial lesions was performed in 32 consecutive cases (male 24/female 8; mean age 70.9±9.8). A stent-less PCI was performed using SeQuent Please™ DCB after an ATHEROCUT™ DCA, and procedural success was obtained in all cases (6 cases with LMT, 18 with left anterior descending ostial, 6 with left circumflex ostial, and 2 with RCA ostial lesions).

Results

The percent plaque area (%PA) decreased from 70.0±7.7% at baseline to 51.6±8.1% after the DCA and to 46.1±9.0% after the DCBs. All patients completed a follow up coronary angiography after 6 months and no restenosis was observed. No major adverse cardiac events occurred in any cases including target lesion revascularizations. In 29 cases that the lumen was confirmed with IVUS at 6 months of follow-up, the lumen area (LA) had expanded significantly from 8.0±2.3 mm2 at baseline (post DCBs) to 8.9±2.7 mm2 at 6 months (P=0.023, Figure 1A). Local paclitaxel may induce late lumen enlargement (LLE) after a DCA/DCB. The group in which the LA increased during the chronic phase was defined as the Increased group and the group in which the LA decreased during the chronic phase was defined as the Decreased group. When comparing the LDL-Cho level pre DCA between the two groups, the LDL-Cho level in the Increased group was significantly low (74.0±25.8 mg/dl vs. 101.0±33.6 mg/dl, P=0.050, Figure 1B).

Conclusions

Stent-less PCI using DCA and DCBs for bifurcated lesions including LMT and RCA ostial lesions was effective, safe, and useful. Furthermore, a chronic LLE effect by DCBs is expected. In addition, intensive lipid-lowering therapy may also contribute to the chronic outcome after DCA/DCBs.

Funding Acknowledgement

Type of funding source: None

Total ankle arthroplasty incorporating a total talar prosthesis

Aims

Total ankle arthroplasty (TAA) has become the most reliable surgical solution for patients with end-stage arthritis of the ankle. Aseptic loosening of the talar component is the most common complication. A custom-made artificial talus can be used as the talar component in a combined TAA for patients with poor bone stock of the talus. The purpose of this study was to investigate the functional and clinical outcomes of combined TAA.

Patients and Methods

Ten patients (two men, eight women; ten ankles) treated using a combined TAA between 2009 and 2013 were matched for age, gender, and length of follow-up with 12 patients (one man, 11 women; 12 ankles) who underwent a standard TAA. All had end-stage arthritis of the ankle. The combined TAA features a tibial component of the TNK ankle (Kyocera, Kyoto, Japan) and an alumina ceramic artificial talus (Kyocera), designed using individualized CT data. The mean age at the time of surgery in the combined TAA and standard TAA groups was 71 years (61 to 82) and 75 years (62 to 82), respectively. The mean follow-up was 58 months (43 to 81) and 64 months (48 to 88), respectively. The outcome was assessed using the Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale, the Ankle Osteoarthritis Scale (AOS), and the Self-Administered Foot Evaluation Questionnaire (SAFE-Q).

Results

The mean preoperative JSSF score of the combined TAA and standard TAA groups was 44 (sd 11) and 49 (sd 10), respectively. The mean postoperative JSSF scores were 89 (sd 6.1) and 72 (sd 15), respectively. The mean postoperative JSSF score of the combined TAA group was significantly higher (p = 0.0034). The mean preoperative AOS scores for pain and function in the combined TAA and standard TAA groups were 5.8 (sd 3.3) and 5.5 (sd 3.1), and 8.6 (sd 1.3), and 7.1 (sd 2.9), respectively. The mean postoperative AOS scores of pain and function were 2.5 (sd 2.5) and 2.2 (sd 1.9), and 2.5 (sd 3.3) and 3.4 (sd 2.9), respectively. There were no significant differences between the two groups in terms of postoperative AOS scores. The mean postoperative SAFE-Q scores were: for pain, 76 (sd 23) and 70 (sd 23); for physical function, 66 (sd 25) and 55 (sd 27); for social function, 73 (sd 35) and 62 (sd 34); for shoe-related, 73 (sd 19) and 65 (sd 26); and for general health, 78 (sd 28) and 67 (sd 29), respectively. There were no significant differences between the two groups in terms of postoperative SAFE-Q scores.

Conclusion

Combined TAA resulted in better clinical results than standard TAA. Cite this article: Bone Joint J 2019;101-B:443–446.

Application of the Self- Assembling Peptide P11-4 for Prevention of Acidic Erosion

The aim of this study was to use ultrasonography to evaluate the effect of the self-assembling peptide P11-4 on acid erosion prevention. Curodont Repair (CR), which includes peptide P11-4, was used. Rectangular prisms of bovine enamel (4×1×1 mm) were immersed in pure orange juice for a period of 5 minutes six times per day for 28 days. These samples were divided into four groups of six specimens each and treated differently for an additional period of 28 days: 1) baseline group specimens were stored in artificial saliva; 2) CR group specimens were exposed to curodont without acid challenge; 3) NCRA (no curodont+acid challenge) specimens were treated with orange juice without curodont exposure; and 4) CRA (CR+acid challenge) specimens were treated with curodont before treatment with orange juice. The propagation time of longitudinal ultrasonic velocity (UV) was measured. Ultrastructural observation of each tested enamel surface was carried out using field-emission scanning electron microscopy (SEM). The UV data were analyzed using two-way analysis of variance with time and treatment as confounding factors. Post hoc pairwise tests among groups were performed using the Tukey honestly significant difference test. The average UV in intact bovine enamel for the baseline group ranged from 4,483 to 4,549 m/s and did not vary significantly within the test period. The average ultrasonic velocity (UV) in all samples decreased after the initial erosion. The UV in NCRA decreased further over time. Increased UVs were found for CR and CRA. For CR and CRA, there was no significant difference in UV at the end of the experiment from the initial value before erosion. In the results of SEM observation, the CR and CRA groups had similar morphologic features in that etching patterns were not clearly due to precipitation between the enamel rods. From the results of this in vitro study, it might be concluded that applying enamel matrix derivatives and self-assembling peptides on erosive lesions can improve remineralization.

Abstract P1-05-05: Hyperthermia regulates transporter expression via ROS production and enhances the cytotoxicity of doxorubicin

Introduction: Hyperthermia (HT) is a non-invasive cancer therapy. Treatment temperature between 41°C to 44°C has no cytotoxic damage in normal cells, however shows cytotoxicity in cancer cells because of the underdeveloped vascular system. HT often used with other cancer therapy such as radiation therapy and chemotherapy. However mechanism of synergistic effect using these therapies remains unclear. Compared to 37°C, 42°C is mild heat stress for cells, thus superoxide anion is released from tissue. Superoxide anion is produced by mitochondrial electron transport chain. Reactive oxygen species (ROS), produced by mild heat stress, can be released from mitochondria. We have previously reported that ATP-binding cassette sub-family G member 2 (ABCG2) expression was suppressed by increasing mitochondrial ROS, and induction of the cancer specific porphyrin accumulation. ABCG2 is a transporter of doxorubicin (DOX), therefore we hypothesized that synergistic effect of HT and chemotherapy would be induced by down-regulation of ABCG2 expression via intracellular ROS increase. In this study, we investigated if cytotoxic effect of breast cancer cell using DOX can be enhance by HT via intracellular ROS increase.

Materials and methods: The murine breast cancer cell line, 4T1E was incubated at 37°C or 42°C for 1h. Intracellular ROS generation after HT treatment was detected by electron spin resonance (ESR). Twenty four hours after HT treatment, cells were incubated in medium containing 0, 0.1 and 1 μM DOX for 24 h. Cell viability was measured using the Cell Counting Kit 8, a water-soluble tetrazolium-8 based colorimetric assay. ABCG2 expression in whole cells was analyzed by Western blotting.

Results and discussion: ESR signal peak with HT treatment became high as compared to without HT treatment, indicating intracellular ROS level was increased by HT treatment. Cell viability and ABCG2 expression were decreased by DOX exposure and by HT treatment. The enhancement of HT treatment effect by DOX is considered to be result of down-regulation of ABCG2 expression by ROS. When cells were exposed to DOX with 5-aminolevulinic acid (ALA), cell viability reduced further. Since it is known that porphyrin is introduced by ALA and is transported by ABCG2, we speculate that ALA worked as a competitive inhibitor of DOX excretion transporter to enhance cell death. ESR signal peak in ALA treatment cells was higher than that in non-ALA treatment cells. Significant increase in cellular damage by HT treatment was shown by adding ALA, but not without ALA. Moreover, cell death induced by HT and ALA treatment was suppressed by adding N-acetylcysteine (NAC), which is an antioxidant. These results suggest that cellular damage of HT treatment is due to ROS production induced by ALA.

Conclusion: HT treatment involved intracellular ROS production and down-regulated the expression of ABCG2 protein. HT treatment also enhanced the cell damage by DOX. Cell death by DOX was enhanced by combination with HT and ALA treatment, possibly via intracellular ROS generation, and was suppressed by additing antioxidant.

Citation Format: Terasaki A, Kurokawa H, Terasaki M, Ito H, Matsui H, Ichioka E, Tsushima Y, Manaka-Iguchi A, Bando H, Hara H. Hyperthermia regulates transporter expression via ROS production and enhances the cytotoxicity of doxorubicin [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-05-05.

Nickel Oxide Catalysts for Partial Oxidation of Methane to Synthesis Gas

<p class="Default">Nickel catalysts supported on different carriers (θ-Al₂O₃, γ-Al₂O₃, HZSM-5 with γ-Al₂O₃, HZSM-5, and NaX) have been investigated for the partial oxidation of methane. All the supported nickel catalysts showed a high activity for the formation of synthesis gas, and γ-Al₂O₃ was the most effective among all the tested carriers. The effect of the heat-treatment temperature of the 3 wt.% Ni/γ-Al₂O₃ catalyst on its catalytic activity was studied, and a considerable decrease in its activity was observed by the heat-treatment of the catalyst at 1000 °C compared with the catalysts prepared by the 300–800 °C – calcination. The XRD analysis suggested the formation of NiAl₂O₄ that is a non-reducible compound at the high calcination temperature. The addition of a modifier (Co, Ce, or La) to the 3 wt.% Ni/γ-Al₂O₃ catalyst increased the selectivity to H₂ and CO with the decreasing selectivity to CO₂, and the highest selectivity to H₂ was obtained by the 5 wt.% NiLa/γ-Al₂O₃. The developed 5 wt.% NiLa/γ-Al₂O₃ catalyst showed a high stability for 30 h for the partial oxidation of methane at 750 °C. The methane conversion reached 95%, selectivity to hydrogen 83% and 52% to carbon monoxide.</p>

Structural and Electrical Characterization of Undoped Poly-Si Oxides

We evaluated structural and electrical characteristics of undoped poly-Si oxide films. Poly-Si films made by solid phase crystallization at 600-900°C from undoped amorphous Si films were oxidized to form oxide layers of 140nm thickness. We observed protuberances on the surface of poly-Si layers after oxidation. Poly-Si oxide layers also generated protuberances above the protuberances of poly-Si films. The number of protuberances per unit area is larger in the case of high temperature crystallization. The measurement of current through the poly-Si oxide films shows that the conductivity of poly-Si oxide films depends on crystallization temperature of poly-Si films in the case of positive gate bias. When the gate is biased negatively, current through the poly-Si oxide films remained almost constant regardless of crystallization temperature. We find that poly-Si crystallized at lower temperatures offers poly-Si oxide films of lower leakage current in the case of electron injection from undoped poly-Si layers. The lower leakage current is due to highness of energy barrier for electron at undoped poly-Si/poly-Si oxide interface.

Continuous-wave and mode-locked lasers on the base of partially disordered crystalline Yb3+:{YGd2}[Sc2](Al2Ga)O12 ceramics

We present cw and mode-locked laser operations on the base of partially disordered crystalline Yb(3+):{YGd(2)}[Sc(2)](Al(2)Ga)O(12) ceramics. In continuous-wave laser operations, the average power of 2.9 W at the wavelength of 1051 nm and 2.8 W at the wavelength of 1031 nm with above 40% optical-to-optical efficiencies were achieved. In mode-locked laser operation, pulses as short as 69 fs with the average power of 820 mW was also obtained.

Influence of Power Density on Polymerization Behavior and Bond Strengths of Dual-cured Resin Direct Core Foundation Systems

The dentin bond strength and polymerization behavior of the dual-cured core foundation resins tested in this study were affected by the power densities of the curing unit. When using dual-cured core foundation systems, practitioners should consider power densities for getting optimal bond strength.

Effect of Prior Acid Etching on Bonding Durability of Single-Step Adhesives

The ability of acid etching to increase enamel bond strengths varies among single-step self-etch adhesive systems.

Ultrasonic Determination of the Effect of Casein Phosphopeptide-Amorphous Calcium Phosphate Paste on the Demineralization of Bovine Dentin

The purpose of this study was to investigate the demineralization of dentin by measuring changes in the velocity of the sonic longitudinal waves transmitted through this substrate. One group of samples was immersed in demineralization solution for 10 min twice a day and then stored in artificial saliva. Two additional groups of samples were treated with a solution of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste or a placebo paste without CPP-ACP before demineralization and a control group was stored in artificial saliva. The sonic velocity of the demineralized specimens was found to decrease significantly over time. No significant increase in sonic velocity was observed in specimens treated with CPP-ACP, suggesting that CPP-ACP acted to prevent demineralization.

Correlation between the incidence of central nodal necrosis in cervical lymph node metastasis and the extent of differentiation in oral squamous cell carcinoma

OBJECTIVES

To investigate the incidence of central nodal necrosis (CNN) in the cervical lymph nodes of patients with oral squamous cell carcinoma (SCC) and the factors that influence the formation of CNN.

METHODS

Lymph nodes shown as CNN on computed tomography (CT) films in 107 lymph nodes from 27 patients with oral SCC were selected. Lymph nodes with CNN on CT films were compared with the pathological findings of lymph nodes on specimens. We compared many kinds of factors influencing the formation of CNN, including the differentiated type, with the incidence of CNN.

RESULTS

Significant relationships were found between the incidence of CNN in metastatic lymph nodes and the presence of well-differentiated SCC and the presence of keratinization in tumour cells.

CONCLUSIONS

The results indicated that if a patient had SCC with low-grade differentiation, CNN in small lymph nodes would be difficult to detect on CT scan. Therefore, noting changes in lymph node density in the absence of CNN on CT scans is necessary in case the primary tumour is low-grade SCC.

The high prognostic value of the histologic grade at the deep invasive front of tongue squamous cell carcinoma

BACKGROUND

Although many histopathologic factors in squamous cell carcinoma of the tongue predict the prognosis, the major predictive factors have not been identified clearly. This study analyzed the prognostic value of the histologic grade at the deep invasive front of tongue squamous cell carcinoma.

METHODS

The clinicopathologic features of 124 consecutive patients seen between January 1985 and December 1999 with previously untreated squamous cell carcinoma of the tongue were reviewed. Their mean age was 58.5 years (range: 23-90) and the male-female ratio was 1.8: 1 (79 men and 45 women). There were 41, 40, 30, and 13 cases at stage I to stage IV, respectively. The clinicopathologic factors, especially the histologic grade at the deep invasive front (invasive front grade, IFG), were analyzed to determine factors predicting prognosis.

RESULTS

The 5-year disease-free survival rate of the patients treated with curative aim only was 66.7%. Clinicopathologic factors significantly associated with the prognosis were T classification, tumor size, stage classification, tumor depth, macroscopic appearance, cervical lymph node metastasis (nodal metastasis), microvascular invasion, and IFG. In a multivariate analysis, patients with tumor depth >/=4 mm, IFG >/=8 points, and nodal metastasis had a reduced disease-free survival and IFG >/=11 points had a predictive value for nodal metastasis (odds ratio: 7.34; P = 0.0019).

CONCLUSION

This study found that a high IFG malignancy score had a high prognostic value for squamous cell carcinoma of the tongue.

Optic nerve compression by normal carotid artery in patients with normal tension glaucoma

AIM

To determine whether compression of the optic nerve by the intracranial carotid artery (ICA) can be a causative factor of normal tension glaucoma (NTG).

METHODS

The medical records of 103 eyes of 54 Japanese patients with NTG and 104 eyes of 52 age matched control patients were reviewed. The neuroradiological findings of magnetic resonance images (MRI) were evaluated to determine the relation between the optic nerve and ICA. The clinical characteristics and general medical conditions, such as diabetes and systemic hypertension, were also compared between the two groups.

RESULTS

The prevalence of optic nerve compression by the ICA in patients with NTG was 49.5%, which was significantly higher than that in control group with 34.6% (p = 0.035). Bilateral compression of the optic nerve was detected in 22 patients with NTG (40.7%), and this was also significantly higher (p = 0.029) than that in the control group (11 patients, 21.2%). In the NTG group, eyes with cup/disc ratio (C/D ratio) > or =0.7 showed a higher percentage of compression (52.6%) compared with eyes with C/D ratio of <0.7 (12.5%; p = 0. 042). The presence of diabetes and hypertension did not affect the incidence of optic nerve compression by ICA significantly.

CONCLUSIONS

The significantly higher percentage of NTG patients who had optic nerve compression by the ICA suggests that compression of the optic nerve by ICA may be a possible causative factor or a risk factor for optic nerve damage in some patients with NTG.

Traumatic neuroma in the lower lip arising following laser/cryosurgery to treat a mucocele

A 15-year-old girl presented with a painless recurrent swelling on her right lower lip mucosa for about 10 months. She had a past history of treatment with laser surgery and cryosurgery. The clinical diagnosis was a 'recurrent mucocele'. Histopathological examination of the surgical specimen revealed a mucocele close to a neuroma with irregular nerve fascicles, leading to a diagnosis 'mucocele accompanied with a traumatic neuroma'. In the present report, the traumatic neuroma appears to have arisen following laser or cryosurgery.

Transfusion transmitted virus (TTV) in dental patients

Transfusion transmitted virus (TTV) is a new DNA virus found in patients with post-transfusion hepatitis. The prevalence of this virus among dental patients has not been reported, therefore, the prevalence of TTV infection in consecutive dental inpatients was evaluated. TTV DNA was assayed by the polymerase chain reaction (PCR) in 441 dental inpatients with oral cancer (n=192) or oral cysts (n=249). The serum HBs antigen and HCV antibody as well as aspartate transaminase (AST), alanine transaminase (ALT), and gamma glutamyl transpeptidase (gamma-GTP) concentrations were also measured. Of 441 subjects, 137 were infected with TTV (31.1%). This prevalence of TTV was much higher than that of HBV or HCV (HBV 1.2%; HCV 6.0%) in these dental patients. There was no gender or age difference in the prevalence of TTV infection. Of the 192 patients with oral cancer, 57 subjects had TTV in their sera, while 80 of 249 with oral cystic disease had TTV. The prevalence of TTV was similar between the two different disease groups. Neither the serum ALT nor serum AST concentrations were different between the subjects positive and negative for TTV DNA. In hospitalized dental patients, 31.1% were infected with TTV. The prevalence of TTV was much higher than that of HBV or HCV. There was no difference in the prevalence of TTV between subjects with cancer and cysts. Dentists should maintain high standards of infection control when treating any dental patient.

Solid-state microstructures, thermal properties, and crystallization of biodegradable poly(butylene succinate) (PBS) and its copolyesters

Studies of solid-state structures under different crystallization conditions, melting behavior, and crystal growth kinetics are reported for biodegradable aliphatic poly(butylene succinate) (PBS) and its random copolyesters of poly(butylene succinate-co-14 mol %ethylene succinate) [P(BS-co-14 mol %ES)] and poly(butylene succinate-co-15 mol %hexamethylene succinate) [P(BS-co-15 mol %HS)]. The crystal structures of two copolyesters determined by wide-angle X-ray diffraction (WAXD) are the same as that of the PBS homopolymer, suggesting that the second comonomers ES or HS units are excluded from the crystalline core and are in an amorphous state. The further investigations on the crystalline and amorphous phase structures and sizes by small-angle X-ray scattering (SAXS) method have provided quantitative evidence that the existence of second comonomers increases the amorphous thickness of copolyesters but that the influences of comonomers on the lamellar crystal structure and size of copolyesters are complicated. The origin of the complexity and its influences on the equilibrium melting temperature T(m)(0) of copolyester are discussed in the present paper. Gibbs-Thomson and Hoffman-Weeks equations were applied for the determination of T(m)(0) of PBS, P(BS-co-14 mol %ES), and P(BS-co-15 mol %HS)-three samples. Two equations gave different T(m)(0) values for each sample. On the basis of the Gibbs-Thomson equation, the P(BS-co-15 mol %HS) copolyester has the same T(m)(0) value as that of the PBS homopolymer, while the P(BS-co-14 mol %ES) copolyester has a lower one. This is due to the different influences of the second comonomers on the crystalline phase structure indicated by SAXS results, and the Gibbs-Thomson equation has been suggested to be more reliable. The crystal growth kinetics of the three samples was analyzed by using the secondary nucleation theory, and the influences of various parameters on the regime transition and nucleation constant were studied. Meanwhile some interrelations between regime transition temperature and melting behavior were found for the three samples.

Fibroma of the vulva

We describe a patient with fibroma of the vulva. The tumor had areas of marked hypointensity consistent with fibrosis on T1 and T2 weighted magnetic resonance (MR) images. The presence of abundant fibrous tissues on MR images enabled us to make a preoperative diagnosis of fibroma.

Relationship between thrombolytic therapy and perfusion defect detected by Gd-DTPA-enhanced fast magnetic resonance imaging in acute myocardial infarction

To study whether thrombolytic therapy affects Gd-DTPA-enhanced pattern and whether its pattern indicates myocardial viability, Gd-DTPA-enhanced magnetic resonance imaging (MRI) was performed in 43 patients with reperfused acute myocardial infarction 14.8+/-5.0 days after onset with breathhold scanning on a 1.5-T whole body system. The hypoenhanced area at 90 sec after contrast injection was defined as a perfusion defect (PD). Patients were divided into PD(+) and PD(-) groups. The PD was detected in 77.8% of patients treated with direct percutaneous transluminal coronary angioplasty (PTCA) and in 28.6% of patients treated by thrombolytic therapy with or without PTCA in the thrombolysis in myocardial infarction grade 3 group (p < 0.05). The myocardial wall was divided into seven segments based on the American Heart Association committee report. Wall motion of each segment was classified by one of six patterns (wall motion score [WMS]: dyskinesis, -1; akinesis, 0; severe hypokinesis, 1; hypokinesis, 2; slight hypokinesis, 3; normal, 4). By echocardiography, the average WMS and ejection fraction were similar between the PD(+) group and the PD(-) group on admission. Those parameters were significantly worse in the PD(+) group than in PD(-) group 1 month after onset. The change in WMS was significantly lower in the PD(+) group than in the PD(-) group. The number of patients and segments with more than two grades of improvement of WMS in the PD(+) group was significantly lower than that in the PD(-) group. Angiographically, left ventricular ejection fraction and WMS of the PD(+) group were significantly lower than those of the PD(-) group 3 months later. PDs were detected significantly less frequently in patients treated with thrombolytic therapy, suggesting that microvascular embolization related to formation of the no-reflow phenomenon.

Inhibition of erbB receptor (HER) tyrosine kinases as a strategy to abrogate antiestrogen resistance in human breast cancer

It has been proposed that binding of ligand to the estrogen receptor (ER) releases its association with transcriptional corepressors, allowing the ER to recruit coactivators, which possess histone acetylase activity, and induce transcription of gene promoters containing estrogen response elements. It has also been proposed that the antiestrogen tamoxifen recruits transcriptional corepressors to the AF-2 region of the hormone-binding domain of the ER, thus blocking ER-mediated transcription. The ER cross-talks with a number of mitogenic signaling pathways and second messengers, like the epidermal growth factor receptor, the insulin-like growth factor-I receptor, mitogen-activated protein (MAP) kinase, phosphatidylinositol-3 kinase/Akt, dopamine, and cyclic AMP. Some of these molecules may: (a) support ligand-independent ER transcription; (b) increase the association of ER with coactivators of transcription; and/or (c) reduce the antiestrogen-induced association of ER with corepressors. These events either alone or in combination may result in hormone independence and/or antiestrogen resistance. We have examined whether signaling by HER2/neu (erbB-2) receptor tyrosine kinase, which can induce antiestrogen resistance, can also disrupt the tamoxifen-induced interaction of ER with transcriptional corepressors. Notably, tamoxifen-induced association of ER with the transcriptional corepressors N-CoR or SMRT was reduced in HER2-overexpressing breast tumor cells but not in cells with low HER2 levels. Small molecule inhibitors of the HER2 kinase or MAP extracellular signal-regulated kinase 1/2 or dominant-negative MAP extracellular signal-regulated kinase 1/2 constructs restored the inhibitory effect of tamoxifen on both ER-mediated transcription and tumor cell proliferation. Treatment with both tamoxifen and the small molecule HER1/2 kinase inhibitor AG1478 reduced mitogen-activated protein kinase activity and markedly reduced growth of established MCF-7/HER2 xenografts in athymic nude mice. Similar results have been obtained with ZD1839 ("Iressa"), an epidermal growth factor receptor (HER1) tyrosine kinase inhibitor. Taken together, these data suggest that exogenous inhibitors of the HER-signaling network and other mitogenic pathways can abrogate or delay the emergence of antiestrogen resistance, thus providing an evaluable therapeutic strategy in human breast carcinoma.

Mechanism of the radiosensitization induced by vinorelbine in human non-small cell lung cancer cells

Vinorelbine (Navelbine, KW-2307), a semisynthetic vinca alkaloid, is a potent inhibitor of mitotic microtubule polymerization. The aims of this study were to demonstrate radiosensitization produced by vinorelbine in human non-small cell lung cancer (NSCLC) PC-9 cells and to elucidate the cellular mechanism of radiosensitization. A clonogenic assay demonstrated that PC-9 cells were sensitized to radiation by vinorelbine with a maximal sensitizer enhancement ratio at a 10% cell survival level of 1.35 after 24-h exposure to vinorelbine at 20 nM. After 24-h exposure to vinorelbine at 20 nM, the approximately 67% of the cells that had accumulated in the G2/M-phase were cultured in the absence of vinorelbine and then irradiated at a dose of 8 Gy. Flow cytometric analyses showed prolonged G2/M accumulation concomitant with continuous polyploidization, and induction of apoptosis was observed in the cells subjected to the combination of vinorelbine-pretreatment and radiation. Polyploidization and induction of apoptosis were confirmed by morphological examination and a DNA fragmentation assay, respectively. We concluded that vinorelbine at a minimally toxic concentration moderately sensitizes human NSCLC cells to radiation by causing accumulation of cells in the G2/M-phase of the cell cycle. Prolonged G2/M accumulation concomitant with continuous polyploidization and increased susceptibility to induction of apoptosis may be associated with the cellular mechanism of radiosensitization produced by vinorelbine.

Risk stratification using serum concentrations of cardiac troponin T in patients with end-stage renal disease on chronic maintenance dialysis

BACKGROUND

It has been recently suggested that cardiac troponin T (cTnT) may be more sensitive than troponin I (cTnI) for subclinical myocardial cell injury in patients on chronic dialysis.

METHODS

We prospectively compared the predictive value of cTnT with cTnI, atrial (ANP) and brain natriuretic peptide (BNP) in 100 consecutive outpatients on chronic dialysis without acute coronary syndromes over a period of 3 months, and assessed whether the combination of cTnT with clinical information including age, duration of dialysis, and medical histories was useful for risk stratification of these patients. During the 2-year follow-up period, 19 patients died, mostly due to cardiac causes (53%).

RESULTS

The area under the receiver operator characteristic (ROC) curve for the cTnT as predictor of both overall and cardiac death was significantly greater than the area under the cTnI curve (p < 0.0001 and p = 0.01), the BNP curve (p < 0.001 and p < 0.01) or the ANP curve (p < 0.0001 and p < 0.005). In a stepwise multivariate Cox regression analysis, only cTnT (p < 0.05 and p < 0.01) and a history of heart failure requiring hospitalization (p < 0.05 and p < 0.005) were independent predictors of both all cause and cardiac mortality. Using parameters of cTnT > or =0.1 microg/l and/or history of heart failure, the overall and cardiac mortality rate for the low risk group (n=66) were 4.5% and 1.5%, respectively, 40% and 16% for the intermediate risk group (n=25), and 67% and 56% for the high risk group (n=9).

CONCLUSION

cTnT concentrations offer a higher prognostic accuracy than cTnI, ANP and BNP in patients on chronic dialysis. The combination of elevated cTnT and a history of heart failure may be a highly effective means of risk stratification of these patients.

Mineral recovery system for a Closed Ecology Experiment Facility (CEEF)

A unique recovery system, which consists of electrodialysis (ED) and crystallization processes, is proposed for NaCl (salt) from waste water after oxidation of urine. NaCl recovery characteristics from the oxidized urine, which contains KCl and NO3- impurities, were experimentally evaluated. Concentrated NaCl/KCl mixed solution was obtained using the ED process from simulated oxidized urine and sweat. Large amounts of NO3- were contained in the concentrated solution. After the crystallization process, NaCl salt of 90% purity, containing less than 5% NO3-, could be recovered by crystallization from the solution at 90 degrees C because NaNO3 or KNO3 salt has high solubility in water at that temperature. The results show that the proposed mineral recovery system can recover NaCl from waste water in the CEEF.

Target-induced conformational adaptation of calmodulin revealed by the crystal structure of a complex with nematode Ca(2+)/calmodulin-dependent kinase kinase peptide

Calmodulin (CaM) is a ubiquitous calcium (Ca(2+)) sensor which binds and regulates protein serine/threonine kinases along with many other proteins in a Ca(2+)-dependent manner. For this multi-functionality, conformational plasticity is essential; however, the nature and magnitude of CaM's plasticity still remains largely undetermined. Here, we present the 1.8 A resolution crystal structure of Ca(2+)/CaM, complexed with the 27-residue synthetic peptide corresponding to the CaM-binding domain of the nematode Caenorhabditis elegans Ca(2+)/CaM-dependent kinase kinase (CaMKK). The peptide bound in this crystal structure is a homologue of the previously NMR-derived complex with rat CaMKK, but benefits from improved structural resolution. Careful comparison of the present structure to previous crystal structures of CaM complexed with unrelated peptides derived from myosin light chain kinase and CaM kinase II, allow a quantitative analysis of the differences in the relative orientation of the N and C-terminal domains of CaM, defined as a screw axis rotation angle ranging from 156 degrees to 196 degrees. The principal differences in CaM interaction with various peptides are associated with the N-terminal domain of CaM. Unlike the C-terminal domain, which remains unchanged internally, the N-terminal domain of CaM displays significant differences in the EF-hand helix orientation between this and other CaM structures. Three hydrogen bonds between CaM and the peptide (E87-R336, E87-T339 and K75-T339) along with two salt bridges (E11-R349 and E114-K334) are the most probable determinants for the binding direction of the CaMKK peptide to CaM.

Lack of association between QT dispersion and blood pressure response during dental surgery

1. It is well known that dental surgery induces increases in blood pressure. However, the factors influencing this increase are not yet fully understood. We have determined the relationship between QTc (= QT/RR(1/2), with RR being the R-R interval in seconds) dispersion, measured with a 12-lead surface electrocardiogram, and changes in blood pressure during tooth extraction. 2. Both QTc dispersion and the power spectrum of R-R variability were determined before the dental surgery was undertaken. The low-frequency (LF; 0.041-0.140 Hz), high- frequency (HF; 0.140-0.500 Hz) and total spectral powers (TF; 0.000-4.000 Hz) were calculated and the ratio of LF to HF and the percentage of HF relative to TF (%HF; HF/TF x 100) were used as indices of sympathovagal balance and parasympathetic activities, respectively. 3. In the present study, QTc dispersion failed to correlate with LF/HF and %HF. Systolic blood pressure and pulse rate increased significantly during tooth extraction; however, changes in these variables failed to correlate with QTc dispersion. 4. These results suggest that QTc dispersion is not associated with the power spectrum of R-R variability and that it does not affect the blood pressure response during tooth extraction.

Cardiovascular and sympathetic responses to dental surgery with local anesthesia

We investigated changes in blood pressure and blood variables, including plasma catecholamines, serum glucose and insulin concentrations, during dental surgery. The study included 11 normotensive patients (age, 22.5+/-0.7 years) who underwent tooth extraction at Kyushu Dental College Hospital. Three to 7 days prior to dental surgery, blood pressure, pulse rate, and heart rate variability were measured every 30 min over 24 h. The low frequency (LF: 0.05 to 0.15 Hz) and high frequency (HF: 0.15 to 0.40 Hz) powers were calculated, and the ratio of LF to HF (LF/HF) and HF were used as indexes of sympathetic and parasympathetic activities, respectively. Lidocaine, 2% with epinephrine (1:80,000), was used as the local anesthetic for all patients. Systolic blood pressures significantly increased during dental surgery (+10.8+/-3.5 mmHg); however, this increase failed to correlate not only with baseline systolic blood pressure but with 24-h averaged blood pressures, LF/HF or HF. On the other hand, plasma epinephrine and norepinephrine concentrations increased during dental surgery, and peak values of these variables were obtained after local anesthesia and during tooth extraction, respectively. Serum glucose level increased after local anesthesia (control vs. local anesthesia: 5.16+/-0.11 vs. 5.62+/-0.10 mmol/l; p<0.01); however, plasma insulin concentrations did not change significantly. These results suggest that 1) ambulatory measurements of blood pressure and heart rate variability over 24 h cannot predict the responses of blood pressure during dental surgery, and that 2) administration of local anesthetic and tooth extraction activate sympathoadrenal outflow, resulting in an increase in serum glucose level in normotensive subjects.

Direct screening of the IMP-1 metallo-beta-lactamase gene (blaIMP) from urine samples by polymerase chain reaction

BACKGROUND

As Gram-negative bacterial isolates producing plasmid-mediated IMP-1 metallo-beta-lactamase usually demonstrate resistance to various broad-spectrum beta-lactams, including cephamycins and carbapenems, transmission and proliferation of these microorganisms in clinical settings could become a clinical threat in the near future. According to previous studies by the same authors, IMP-1-producing strains are usually isolated from urine samples. Therefore, in this study, a polymerase chain reaction (PCR) was applied for direct screening of the IMP-1 metallo-beta-lactamase gene in urine samples.

METHOD

Urine samples were collected from 273 inpatients to whom various broad-spectrum beta-lactams, including carbapenems, had been administered in 57 hospitals in 1997. DNA templates for PCR analyses were prepared directly from 19 urine samples from which Serratia marcescens strains demonstrating high-level resistance (minimal inhibitory concentration > 128 microg/mL) to both ceftazidime and cefoperazone-sulbactam were later isolated.

RESULTS

The IMP-1 metallo-beta-lactamase gene (blaIMP)-specific 578 bp fragments were able to be amplified successfully in eight of the 19 samples. In the seven strains isolated from the eight samples, the presence of blaIMP was also detected by a DNA hybridization analysis. The lower limit of the PCR method was determined as 1 x 10(2) CFU of blaIMP-bearing bacterial cells per 1 mL of urine sample. No false positive result was found.

CONCLUSION

The PCR-aided direct screening of blaIMP is applicable to early recognition of IMP-1-producing bacteria in urine samples. This method would help to prevent nosocomial and interhospital transmission of this kind of hazardous bacteria, as well as the advancement of rigorous infection control.

Multiple myeloma: short T2 on MR imaging

We describe a rare case of multiple myeloma with marked hypointense areas on both T1- and T2-weighted images. Amyloid deposition and calcification were not found histologically. Hypointensity on T2-weighted images may be caused by distributed free radicals produced by significant macrophages.

Synthesis of variously oxidized abietane diterpenes and their antibacterial activities against MRSA and VRE

Variously oxidized 12 natural abietanes, 6,7-dehydroferruginol methyl ether (3), ferruginol (5), 11-hydroxy-12-oxo-7,9(11),13-abietatriene (7), royleanone (9), demethyl cryptojaponol (12), salvinolone (14), sugiol methyl ether (16), sugiol (17), 5,6-dehydrosugiol methyl ether (19), 5,6-dehydrosugiol (20), 6beta-hydroxyferruginol (23), and taxodione (25) were synthesized. Antimicrobial activities of synthesized phenolic diterpenes and their related compounds against MRSA and VRE were evaluated. Phenols (12-hydroxyabieta-8,11,13-trien-6-one 22 and 23), catechols (12 and 14) and taxodione 25 showed potent activity with 4-10 microg/mL of MIC against MRSA and 4-16 microg/mL of MIC against VRE. (-)-Ferruginol showed more potent activity than natural type (+)-ferruginol. Quinone methide 7 showed the most potent activity with 0.5-1 microg/mL of MIC against both MRSA and VRE.

Experimental study of fast and ultrafast T2-weighted imaging sequences using AMI-25 superparamagnetic iron oxide (SPIO)

The objective of this study was to evaluate fast and ultrafast T2-weighted images (T2WI), including echo planar imaging (EPI), using an AMI-25 agar phantom. Image quality for conventional spin echo (CSE) and turbo spin echo (TSE) was almost equivalent. In high-resolution TSE, image quality was highest due to the use of a 512 x 256 matrix. Half-Fourier single-shot turbo SE (HASTE) was associated with blurring of images, and turbo-gradient SE (TGSE) showed a deterioration of image quality. EPI also suffered from poor image quality because this method is very sensitive to magnetic field inhomogeneity. CSE showed good signal-to-noise ratio (S/N) and contrast ratio (CR), but also required the longest imaging times. Among the TSE sequences, TSE with a short echo train length (ETL) was superior in terms of S/N. The CR of EPI and fast low angle shot (FLASH) images were improved in proportion to the effective echo time (TE). At present, TSE is inferior to CSE in terms of S/N and CR. However, taking into consideration scanning time, TSE with a short ETL is thought to be suitable for routine examinations. Effective TE is an important factor in gradient echo (GRE) examinations.

Plasma concentration of brain natriuretic peptide as a biochemical marker for the evaluation of right ventricular overload and mortality in chronic respiratory disease

The purpose of this study was to evaluate whether the plasma brain natriuretic peptide (BNP) concentration is a useful marker of right ventricular (RV) overload and whether it has prognostic value as a predictor of death in patients with chronic respiratory disease (CRD). We measured the plasma BNP and atrial natriuretic peptide (ANP) concentrations in 31 consecutive patients with CRD who underwent right-heart catheterization to evaluate pulmonary hypertension. All patients were followed for >12 months. The plasma BNP concentration closely correlated with the mean pulmonary artery pressure and pulmonary vascular resistance (r=0.62, P<0.0005 and r=0. 85, P<0.0001), and showed a weak linear correlation with cardiac output (r=-0.36, P<0.05). During the follow-up period, 5 (16%) end-stage CRD deaths (4 RV heart failure and 1 respiratory infection) and 2 non-end-stage CRD deaths occurred. In a stepwise multivariate Cox proportional-hazards regression analysis including age, sex, BNP, ANP, hemodynamic variables and the ratio of PaO(2) to fraction of inspired oxygen, only BNP (P<0.05) was an independent predictor of end-stage CRD death. The upward and leftward shift in the receiver operating characteristic curve between patients with end-stage CRD death and those without was greater for BNP than for ANP. Our findings suggest that the plasma BNP concentration may be an inexpensive, simple and useful marker of RV overload and end-stage CRD death in CRD patients. These preliminary results need to be confirmed in a large series of CRD patients.

Inhibition of HER2/neu (erbB-2) and mitogen-activated protein kinases enhances tamoxifen action against HER2-overexpressing, tamoxifen-resistant breast cancer cells

HER2/neu (erbB-2) overexpression has been causally associated with tamoxifen resistance in human breast cancer cells. Forced expression of HER2 in MCF-7 breast cancer cells resulted in mitogen-activated protein kinase (MAPK) hyperactivity and tamoxifen resistance. Inhibition of HER2 and MAPKs with AG1478 and U0126, respectively, as well as dominant-negative MEK-1/2 constructs restored the inhibitory effect of tamoxifen on estrogen receptor (ER)-mediated transcription and cell proliferation. Both AG1478 and U0126 also restored the tamoxifen-mediated association of ER with nuclear receptor corepressor (N-CoR) in the antiestrogen-resistant MCF-7 cells. Treatment with a combination of tamoxifen and a HER2 kinase inhibitor reduced tumor MAPK activity and markedly prevented growth of HER2-overexpressing MCF-7 xenografts in athymic mice. Thus, blockade of HER2 and MAPK signaling may enhance tamoxifen action and abrogate antiestrogen resistance in human breast cancer.

A new SHV-derived extended-spectrum beta-lactamase (SHV-24) that hydrolyzes ceftazidime through a single-amino-acid substitution (D179G) in the -loop

A new SHV-derived extended-spectrum beta-lactamase (SHV-24) conferring high-level resistance to ceftazidime but not cefotaxime and cefazolin was identified in Japan. This enzyme was encoded by a transferable 150-kb plasmid from an Escherichia coli clinical isolate. The pI and K(m) for CAZ of this enzyme were 7.5 and 30 microM, respectively. SHV-24 was found to have a D179G substitution in the Omega-loop of the enzyme.

Suppression of cardiac sympathetic nervous system during dental surgery in hypertensive patients

We determined the changes in blood pressure, pulse rate, and heart rate variability during dental surgery in hypertensive patients. The study included 18 essential hypertensives and 18 age and sex matched normotensive controls who underwent tooth extraction at our hospital. Holter electrocardiographic monitoring was used to determine the power spectrum of R-R variability before and during dental surgery. The low frequency (LF: 0.041 to 0.140 Hz), high frequency (HF: 0.140 to 0.500 Hz), and total spectral powers (TF: 0.000 to 4.000 Hz) were calculated, and the ratio of LF to HF and the percentage of HF relative to TF (%HF: HF/TF x 100) were used as indexes of sympathetic and parasympathetic activities, respectively. The baseline blood pressure for hypertensive patients (149 +/- 4/85 +/- 2 mmHg) was significantly higher than that for normotensive patients (119 +/- 3/71 +/- 2 mmHg). The baseline pulse rates were similar between the two groups. Blood pressure increased during tooth extraction in both groups; however, changes in blood pressure did not differ between them. Administration of local anesthetic significantly decreased the %HF in normotensive patients (before vs. after anesthesia; 22.3 +/- 2.4 vs. 13.8 +/- 2.7%, p < 0.05). In contrast, the LF/HF significantly decreased during the local anesthesia and tooth extraction in hypertensive patients. These results suggest that pressor response induced by tooth extraction did not differ between normotensive and hypertensive patients, and that suppression of the cardiac sympathetic nervous system during dental surgery might attenuate the pressor response in patients with hypertension.

Ectopic p16(ink4) expression enhances CPT-11-induced apoptosis through increased delay in S-phase progression in human non-small-cell-lung-cancer cells

A tumor-suppressor gene, p16(INK4), which is deleted or mutated in tumors, regulates cell-cycle progression through a G(1)-S restriction point by inhibiting CDK4(CDK6)/cyclin-D-mediated phosphorylation of pRb. We have found that ectopic p16(INK4) expression increased cellular sensitivity of human non-small-cell-lung-cancer (NSCLC) A549 cells to a selective growth-inhibitory effect induced by the topoisomerase-I inhibitor 11, 7-ethyl-10-[4-(1-piperidino)-1-piperidino] carbonyloxy camptothecin (CPT-11) in vitro. In this study, we observed enhanced apoptosis characterized by DNA fragmentation in A549 cells transfected with p16(INK4) cDNA (A549/p16-1) and treated with CPT-11. This apoptosis was suppressed by the inhibitor of interleukin-1beta-converting enzyme (ICE/caspase-1) or ICE-like proteases, Z-Asp-CH2-DCB, as determined by DNA fragmentation and proteolytic cleavage of poly(ADP-ribose) polymerase, a natural substrate for CPP32/caspase-3. In A549/p16-1 cells, cytosolic peptidase activities that cleaved Z-DEVD-7-amino-4-trifluoromethylcoumarin increased during CPT-11-induced apoptosis and were suppressed by a highly specific caspase-3 and caspase-3-like inhibitor, Z-DEVD-fluoromethylketone. These findings indicate that p16(INK) is positively involved in the activation pathway of the caspase-3 induced by CPT-11. The increased delay in S-phase progression and subsequent induction of apoptosis were observed in CPT-11-treated A549/p16-1 cells on the basis of DNA histograms. Specific down-regulation of the cyclin-A protein level in A549/p16-1 cells was observed after CPT-11-treatment, whereas cyclin B, cdk2, and cdc2 protein levels were unaffected. These results suggest that ectopic p16(INK4) expression inappropriately decreases cyclin A and thereby terminates CPT-11-induced G(2)/M accumulation, which is followed by increased apoptosis in p16(INK4)-expressing A549 cells.

A monomeric histidine kinase derived from EnvZ, an Escherichia coli osmosensor

Histidine kinases function as dimers. The kinase domain of the osmosensing histidine kinase EnvZ of Escherichia coli consists of two domains: domain A (67 residues) responsible for histidine phosphotransfer and dimerization, and domain B (161 residues) responsible for the catalytic and ATP-binding function. The individual structures of these two domains have been recently solved by NMR spectroscopy. Here, we demonstrate that an enzymatically functional monomeric histidine kinase can be constructed by fusing in tandem two domains A and one domain B to produce a single polypeptide (A-A-B). We show that this protein, EnvZc[AAB], is soluble and exists as a stable monomer. The autophosphorylation and OmpR kinase activities of the monomeric EnvZc[AAB] are similar to that of the wild-type EnvZ, while OmpR-binding and phosphatase functions are reduced. V8 protease digestion and mutational analyses indicate that His-243 of only the amino proximal domain A is phosphorylated. Based on these results, molecular models are proposed for the structures of EnvZc[AAB] and the kinase domain of EnvZ. The present results demonstrate for the first time the construction of a functional, monomeric histidine kinase, further structural studies of which may provide important insights into the structure-function relationships of histidine kinases.

A preliminary survey of extended-spectrum beta-lactamases (ESBLs) in clinical isolates of Klebsiella pneumoniae and Escherichia coli in Japan

We conducted a survey of extended-spectrum beta-lactamases (ESBLs) among 16805 Escherichia coli and 9794 Klebsiella pneumoniae clinical isolates recovered from 196 separate medical institutions during the period January 1997 to January 1998. Using the criteria for minimal inhibitory concentrations (MICs) of oxyimino-cephalosporins of >/=8 microg ml(-1) and confirmation by double-disk test, we detected 15 E. coli and 34 K. pneumoniae isolates producing ESBLs. Genotypes of ESBLs determined by PCR with type-specific primers included one TEM-derived and 24 SHV-derived ESBLs, in addition to 24 Toho-1-type ESBLs, one of the major types of ESBLs reported in Japan. Nucleotide sequence analysis of SHV-specific PCR products revealed that SHV-12 was the dominant type of SHV-derived ESBL. In addition, we also identified TEM-26 and SHV-2. This is the first report characterizing TEM- and SHV-derived ESBLs in Japan.

[A SHV-derived extended-spectrum beta-lactamase (SHV-12) produced by an Escherichia coli recovered from wound abscess in post operative case with rectal carcinoma]

A 62-year-old woman admitted for rectal carcinoma suffered from a post-operative bacterial infection. Oxy-imino-beta-lactams including cefotiam (CTM) and cefozopran (CZOP) were prescribed for this case, but the patient developed a wound abscess followed by peritonitis. She recovered from the bacterial infection after drainage and recurrent washing of the abscess. An ephemeral aggravation of infectious signs was observed just after creation of an artificial anus, and CZOP was again administered, and no evident bacterial infection occurred. The patient recovered, then was followed as an outpatient to date. A CAZ-resistant (MIC, > 16 micrograms/ml) E. coli was recovered from pus of her wound abscess. Since the CAZ-resistance decreased (MIC, 64 micrograms/ml-->0.13 microgram/ml) by the presence of clavulanate (CVA) in this isolate, this strain was speculated to be an extended spectrum beta-lactamase (ESBL) producer at an early stage of infection. A similar strain was also isolated from the feces. Therefore, we immediately took measures to block the nosocomial spread of this microorganism, and we succeeded in preventing a nosocomial outbreak of this strain. It was later confirmed by PCR analysis and DNA sequencing analysis that this CAZ-resistant E. coli strain produces an ESBL (SHV-5-2a = SHV-12). This is the first report of a case of infection with SHV-derived ESBL producing E. coli strain in Japan. We are concerned that further dissemination of this kind of microorganism might occur in the near future also in Japan, as it has been widely observed in European countries and the US. We believe that it will be very important to distinguish the type of beta-lactamases for rigorous bacterial infection control with the prudent use of antibiotics. In other words, we in Japan must recall that various gram-negative bacterial species that produce TEM-, SHV-derived ESBLs, Toho-1, AmpC, or IMP-1 are already widespread. Thus, we should take this fact into consideration when we do antibiotic susceptibility tentings and interpretation of the results for promotion of accurate chemotherapy.

Synthesis of four stereoisomers of 1,4-thiazane-3-carboxylic acid 1-oxide via the asymmetric transformation (combined isomerization-preferential crystallization) of 1,4-thiazane-3-carboxylic acid

In order to synthesize four stereoisomers of 1,4-thiazane-3-carboxylic acid 1-oxide (TCA SO), (S)-1,4thiazane-3-carboxylic acid [(S)-TCA], which is one of the precursors, was prepared by the asymmetric transformation (combined isomerization-preferential crystallization) of (RS)-TCA. This asymmetric transformation was used (2R, 3R)-tartaric acid [(R)-TA] as a resolving agent and salicylaldehyde as the epimerization catalyst in propanoic acid at 110 degrees C to afford a salt of (S)-TCA with (R)-TA in 100% de with a yield of over 90%. Optically pure (S)-TCA was obtained by treating the salt with triethylamine in methanol in a yield of over 80%, based on (RS)-TCA as the starting material. In addition, asymmetric transformation of (R)-TCA gave (S)-TCA in a yield of 60-70%. (S)-TCA was oxidized by hydrogen peroxide in dilute hydrochloric acid to selectively crystallize (1S, 3S)-TCA.SO. (1R, 3S)-TCA SO of 70% de from the filtrate was allowed to form a salt with (R)-TA after a treatment with triethylamine to give (1R, 3S)-TCA SO as a single diastereoisomer. (1R, 3R)- and (1S, 3R)-TCA.SO were also prepared by starting from (R)-TCA that had been synthesized from L-cysteine.

Convenient test for screening metallo-beta-lactamase-producing gram-negative bacteria by using thiol compounds

A simple disk diffusion test was constructed for detection of IMP-1-type metallo-beta-lactamase-producing gram-negative bacteria. Two Kirby-Bauer disks containing ceftazidime (CAZ) and a filter disk containing a metallo-beta-lactamase inhibitor were used in this test. Several IMP-1 inhibitors such as thiol compounds including 2-mercaptopropionic acid, heavy metal salts, and EDTA were evaluated for this test. Two CAZ disks were placed on a Mueller-Hinton agar plate on which a bacterial suspension was spread according to the method recommended by the National Committee for Clinical Laboratory Standards. The distance between the disks was kept to about 4 to 5 cm, and a filter disk containing a metallo-beta-lactamase inhibitor was placed near one of the CAZ disks within a center-to-center distance of 1.0 to 2.5 cm. For IMP-1-producing strains, the growth-inhibitory zone between the two disks expanded, while no evident change in the shape of the growth-inhibitory zone was observed for CAZ-resistant strains producing serine beta-lactamases such as AmpC or SHV-12. As a result, 2 to 3 microliter of undiluted 2-mercaptopropionic acid or mercaptoacetic acid able to block IMP-1 activity gave the most reproducible and clearest results, and CAZ-resistant strains producing AmpC or extended-spectrum beta-lactamases were distinguishable from IMP-1 producers by this test. A similar observation was made with IMP-1-producing clinical isolates such as Serratia marcescens, Klebsiella pneumoniae, Escherichia coli, Enterobacter cloacae, Enterobacter aerogenes, Citrobacter freundii, Proteus vulgaris, Pseudomonas aeruginosa, Pseudomonas putida, Acinetobacter spp., and Alcaligenes xylosoxidans. The specificity and sensitivity of this test were comparable to those of PCR analysis using bla(IMP)-specific primers. Therefore, this convenient test would be valuable for daily use in clinical laboratories.

Crystal structure of hen apo-ovotransferrin. Both lobes adopt an open conformation upon loss of iron

The three-dimensional crystal structure of hen apo-ovotransferrin has been solved by molecular replacement and refined by simulated annealing and restrained least squares to a 3.0-A resolution. The final model, which comprises 5312 protein atoms (residues 1 to 686) and 28 carbohydrate atoms (from two monosaccharides attached to Asn(473)), gives an R-factor of 0.231 for the 11,989 observed reflections between 20.0- and 3.0-A resolution. In the structure, both empty iron binding clefts are in the open conformation, lending weight to the theory that Fe(3+) binding or release in transferrin proceeds via a mechanism that involves domain opening and closure. Upon opening, the domains rotate essentially as rigid bodies. The two domains of the N-lobe rotate away from one another by 53 degrees, whereas the C-lobe domains rotate away each another by 35 degrees. These rotations take place about an axis that passes through the two beta-strands, linking the domains. The domains of each lobe make different contacts with one another in the open and closed forms. These contacts form two interdomain interfaces on either side of the rotation axis, and domain opening or closing produces a see-saw motion between these two alternative close-packed interfaces. The interdomain disulfide bridge (Cys(478)-Cys(671)), found only in the C-lobe, may restrict domain opening but does not completely prevent it.

Vectorcardiographic evaluation of myocardial infarct size: comparisons with thallium myocardial scintigraphy

OBJECTIVE

To determine the usefulness of vectorcardiography (VCG) in assessing myocardial infarct size.

METHODS

The correlation of spatial and scalar parameters of VCG with the percent defect volume (%DV) of thallium myocardial single photon emission computed tomography (SPECT) was investigated in 63 patients with first-onset myocardial infarction (MI). VCG parameters included: (1) spatial parameters: magnitude, azimuth and elevation of the maximal vector, vectors at 20 ms and 30 ms, and (2) scalar parameters: amplitudes of 20 ms and 30 ms vectors at X, Y, and Z scalar leads abbreviated as X20, Y20, Z20, X30, Y30 and Z30, respectively.

RESULTS

For anteroseptal MI, the azimuth of 30 ms vector and Z20 showed a significant correlation with %DV (r = 0.572, P < 0.05 and r = 0.832, P < 0.001) while in anteroseptal MI with involvement of lateral wall, the azimuth of 30 ms vector and X30 were correlated with %DV significantly (r = 0.775, and r = 0.780, P < 0.01). For inferior and inferoposterior MI, the elevation of 30 ms vector and Y30 were correlated well with %DV (r = 0.871, P < 0.01, r = 0.928, P < 0.001 for inferior MI and r = 0.678, P < 0.01, r = 0.760, P < 0.001 for inferoposterior MI).

CONCLUSION

VCG parameters, especially scalar parameters, can be used to evaluate myocardial infarct size easily and non-invasively with remarkable accuracy.

Solution structure of the homodimeric core domain of Escherichia coli histidine kinase EnvZ

Escherichia coli osmosensor EnvZ is a protein histidine kinase that plays a central role in osmoregulation, a cellular adaptation process involving the His-Asp phosphorelay signal transduction system. Dimerization of the transmembrane protein is essential for its autophosphorylation and phosphorelay signal transduction functions. Here we present the NMR-derived structure of the homodimeric core domain (residues 223-289) of EnvZ that includes His 243, the site of autophosphorylation and phosphate transfer reactions. The structure comprises a four-helix bundle formed by two identical helix-turn-helix subunits, revealing the molecular assembly of two active sites within the dimeric kinase.

A learning algorithm for oscillatory cellular neural networks

We present a cellular type oscillatory neural network for temporal segregation of stationary input patterns. The model comprises an array of locally connected neural oscillators with connections limited to a 4-connected neighborhood. The architecture is reminiscent of the well-known cellular neural network that consists of local connection for feature extraction. By means of a novel learning rule and an initialization scheme, global synchronization can be accomplished without incurring any erroneous synchrony among uncorrelated objects. Each oscillator comprises two mutually coupled neurons, and neurons share a piecewise-linear activation function characteristic. The dynamics of traditional oscillatory models is simplified by using only one plastic synapse, and the overall complexity for hardware implementation is reduced. Based on the connectedness of image segments, it is shown that global synchronization and desynchronization can be achieved by means of locally connected synapses, and this opens up a tremendous application potential for the proposed architecture. Furthermore, by using special grouping synapses it is demonstrated that temporal segregation of overlapping gray-level and color segments can also be achieved. Finally, simulation results show that the learning rule proposed circumvents the problem of component mismatches, and hence facilitates a large-scale integration.