P1826Computational fluid dynamic analysis of acute aortic dissection

Background

Mechanism of acute aortic dissection still is not well understood. It is very difficult to predict where, when, and how acute aortic dissection occurs. This time we focused on blood flow velocity (FV), wall shear stress (WSS), and oscillatory shear index (OSI) which is three dimensional fluctuations of WSS inside ascending aorta. It is well recognized that a higher or lower WSS may cause intimal dysfunction, which could result in the progression of atherosclerosis. Furthermore, because of the non-slip boundary mechanical equilibrium of forces, WSS will separate the inner and outer layers of the aorta. This sheer force could stress the medial tissue and result in degeneration. OSI has been reported as important hemodynamic parameter that is highly associated with the progression of atherosclerosis by inducing radical oxygen production of the endothelial cells. Therefore, OSI may be more closely associated with the degeneration of the media in comparison with WSS. This time FV, WSS, and OSI was evaluated using computational fluid dynamics to identify the location of acute aortic dissection entry.

Method

Using computed tomography data of three patients (Case A, B, C) who had acute aortic dissection, each three pre-dissection aorta model was made. Computer simulation images of four dimensional pulsatile blood flow was made and pulsatile cardiac flow from one cardiac cycle was simulated. A three-dimensional movie was made to evaluate FV, WSS, and OSI. One normal size aorta was evaluated as a control.

Results

In control, blood flow inside ascending aorta was laminar, on the contrary, spiral flow was observed in three dissection cases. FV was slightly higher in dissection case (control: 0.56m/s, A: 0.77m/s, B: 1.05m/s, C: 0.35m/s). Maximum WSS in ascending aorta was 3.24Pa in control. In dissection cases, there was patchy high (A: 18.6Pa, B: 25.6Pa, C: 4.0Pa,) WSS lesion in ascending aorta. In case A and B, these patchy high lesions are close to the entry site. In all three dissection case, OSI was high around entry site.

Figure 1

Conclusion

According to our computer simulation, patchy high WSS and high OSI lesion is related with acute dissection entry site at the ascending aorta.

Acknowledgement/Funding

None

Development and validation of the comprehensive assessment scale for chemotherapy-induced peripheral neuropathy in survivors of cancer

Background

Appropriate assessment is essential for the management of chemotherapy-induced peripheral neuropathy (CIPN), an intractable symptom that cannot yet be palliated, which is high on the list of causes of distress for cancer patients. However, objective assessment by medical staff makes it easy to underestimate the symptoms and effects of CIPN in cancer survivors. As a result, divergence from subjective evaluation of cancer survivors is a significant problem. Therefore, there is an urgent need to develop a subjective scale with high accuracy and applicability that reflects the experiences of cancer patients. We developed a comprehensive assessment scale for CIPN in cancer survivors, named the Comprehensive Assessment Scale for Chemotherapy-Induced Peripheral Neuropathy in Survivors of Cancer (CAS-CIPN), and demonstrated its reliability and validity.

Methods

We developed a questionnaire based on qualitative studies of peripheral neuropathy in Japanese cancer patients and literature review. Twelve cancer experts confirmed the content validity of the questionnaire. A draft version comprising 40 items was finalized by a pilot test on 100 subjects. The participants in the present study were 327 Japanese cancer survivors. Construct validity was determined by factor analysis, and internal validity by confirmation factor analysis and Cronbach’s α.

Results

Factor analysis showed that the structure consisted of 15 items in four dimensions: “Threatened interference in daily life by negative feelings”, “Impaired hand fine motor skills”, “Confidence in choice of treatment/management,” and “Dysesthesia of the palms and soles.” The CAS-CIPN internal consistency reliability was 0.826, and the reliability coefficient calculated using the Spearman-Brown formula [q = 2r/(1 + r)] was 0.713, confirming high internal consistency and stability. Scores on this scale were strongly correlated with Gynecologic Oncology Group-Neurotoxicity scores (r = 0.714, p < 0.01), confirming its criterion-related validity.

Conclusions

The CAS-CIPN is an assessment tool with high reliability and validity for the comprehensive evaluation of CIPN in cancer survivors. The CAS-CIPN is simple to use, and can be used by medical professionals for appropriate situational assessment and intervention.

Phenotypic Reversion of Smooth Muscle Cells in Hybrid Vascular Prostheses

Our purpose was to evaluate whether or not and when phenotypic modulation of smooth muscle cells (SMCs) in hybrid vascular prostheses preincorporated with SMCs occurs upon implantation. Two types of hybrid vascular grafts incorporated with vascular cells derived from canine jugular veins were prepared: grafts containing a collagen gel layer covered with an endothelial monolayer at the luminal surface (Model I graft) and those containing an endothelial monolayer and SMC multilayer (Model II graft). They were bilaterally implanted into carotid arteries of the same dogs from which the cells had been harvested for 2 wk (n = 3) and 12 wk (n = 3). The time-dependent changes in populations of three SMC phenotypes (synthetic, intermediate, and contractile) in the neoarterial layers were quantified by morphometric evaluation using a transmission electron microscope in hybrid vascular grafts. Before implantation, all the SMCs were of the synthetic phenotype. In Model II grafts at 2 wk, synthetic and intermediate SMCs were dominant especially in the luminal layer. On the other hand, neoarterial layers at 12 wk were dominated by contractile SMCs, which were evenly distributed throughout the entire neoarterial tissues. A markedly delayed phenotypic reversion was noted for the Model I grafts at 12 wk. In the hybrid grafts, during about 3 mo of implantation, neoarterial SMCs transformed from the synthetic to the contractile phenotypes, which was promoted by SMC incorporation.

Regulation of L-alanine-initiated germination ofBacillus subtilis spores by alanine racemase

Germination ofBacillus subtilis spores was initiated by L-Ala and competitively inhibited by D-Ala, suggesting the presence of an alanine receptor. The spores showed alanine racemase activity in the spore coat. To investigate the role of alanine racemase (L → D) on germination, net racemase activity was determined using diphenylamine as a germination inhibitor and germination was measured using D-penicillamine as a racemase inhibitor. Apparent affinity of L-Ala to the germinant receptor was more than 1000 times higher than that to the racemase. Germination increased in the presence of D-penicillamine, when the concentration of L-Ala was low and that of spores was high. Racemase activity was optimal at 65°C at pH 9.0 and germination at 43°C at pH 7.2. Under unfavorable growth conditions such as high population of spores in limited nutrients, high temperature and high pH, spore alanine racemase converted the germinant actively to the inhibitor and this conversion may regulate germination for survival of the population.

Chitinase 3-like 1 promotes macrophage recruitment and angiogenesis in colorectal cancer

Chitinase 3-like 1 (CHI3L1), one of mammalian members of the chitinase family, is expressed in several types of human cancer, and elevated serum level of CHI3L1 is suggested to be a biomarker of poor prognosis in advanced cancer patients. However, the overall biological function of CHI3L1 in human cancers still remains unknown. Studies were performed to characterize the role of CHI3L1 in cancer pathophysiology utilizing human colorectal cancer samples and human cell lines. Plasma protein and tissue mRNA expression levels of CHI3L1 in colorectal cancer were strongly upregulated. Immunohistochemical analysis showed that CHI3L1 was expressed in cancer cells and CHI3L1 expression had a significant association with the number of infiltrated macrophages and microvessel density. By utilizing trans-well migration and tube formation assays, overexpression of CHI3L1 in SW480 cells (human colon cancer cells) enhanced the migration of THP-1 cells (human macrophage cells) and HUVECs (human endothelial cells), and the tube formation of HUVECs. The knockdown of CHI3L1 by RNA interference or the neutralization of CHI3L1 by anti-CHI3L1 antibody displayed strong suppression of CHI3L1-induced migration and tube formation. Cell proliferation assay showed that CHI3L1 overexpression significantly enhanced the proliferation of SW480 cells. ELISA analysis showed that CHI3L1 increased the secretion of inflammatory chemokines, IL-8 and MCP-1, from SW480 cells through mitogen-activated protein kinase (MAPK) signaling pathway. Both neutralization of IL-8 or MCP-1 and inhibition or knockdown of MAPK in SW480 cells significantly inhibited CHI3L1-induced migration and tube formation. In a xenograft mouse model, overexpression of CHI3L1 in HCT116 cells (human colon cancer cells) enhanced the tumor growth as well as macrophage infiltration and microvessel density. In conclusion, CHI3L1 expressed in colon cancer cells promotes cancer cell proliferation, macrophage recruitment and angiogenesis. Thus, the inhibition of CHI3L1 activity may be a novel therapeutic strategy for human colorectal cancer.

Involvement of interleukin-1 in lipopolysaccaride-induced microglial activation and learning and memory deficits

We have developed an animal model of learning and memory impairment associated with activation of microglia in the mouse brain. Injection of lipopolysaccharide into the CA1 region of the mouse hippocampus resulted in an increased production of inflammatory cytokines, such as interleukin-1β. Immunostaining for interleukin-1β revealed an increase in the signal at 6 hr after lipopolysaccharide injection. Immunopositive cells for interleukin-1β were colocalized with those immunopositive for CD11b. When subacute lipopolysaccharide treatment (20 μg/2 μl/injection, bilaterally for 5 consecutive days) was performed, long-term activation of microglia and learning and memory deficits as evaluated using a step-through passive avoidance test were observed in the wild-type mice. Gene expression of the N-methyl-D-aspartate receptor NR1 and NR2A subunits was also decreased by the lipopolysaccharide treatment. In contrast, activation of microglia and the associated behavioral deficits were not observed in mice lacking interleukin-1α and -1β following the subacute lipopolysaccharide treatment, together with little change in the gene expression of NR1 and NR2A subunits. However, the subacute lipopolysaccharide treatment produced almost similar changes in those parameters in the tumor necrosis factor-α knockout mice as in the wild-type animals. The injection of interleukin-1β neutralizing antibody with lipopolysaccharide for 5 consecutive days resulted in the improvement of lipopolysaccharide-induced learning and memory deficits. These findings suggest that the expression of interleukin-1 plays an important role in lipopolysaccharide-induced activation of microglia and the associated functional deficits in learning and memory.

Molecular analysis of digenic inheritance in Bartter syndrome with sensorineural deafness

BACKGROUND

Bartter syndrome (BS) is a genetic disorder accompanied by hypokalaemic metabolic alkalosis. BS with sensorineural deafness (SND, OMIM602522) is a newly identified phenotype caused by mutations in the BSND gene that encodes barttin, a beta-subunit for chloride channel ClC-Ka and ClC-Kb and classified as type IV BS. Type IV BS features the most severe phenotype entailing life-threatening neonatal volume depletion and chronic renal failure developing during infancy. A recent report described a case of BS with SND from a consanguineous family who showed homozygous mutations in the CLCNKA and CLCNKB genes. This case indicated the possibility of the occurrence of digenic inheritance in BS with SND resulting from double mutations in the CLCNKA and CLCNKB genes.

SUBJECT AND RESULTS

The current report concerns a 2-year-old girl from a non-consanguineous family with BS accompanied by SND. In our case, four loss-of-function mutations, consisting of mutations in both parental alleles in both CLCNKA and CLCNKB, were identified. The paternal allele had a nonsense mutation (Q260X) in CLCNKA and a splicing site mutation (IVS17+1 g>a) in CLCNKB. The maternal allele had a large deletion mutation (about 12 kbp) extending from CLCNKA to CLCNKB. Our case provides clear evidence that loss-of-function alleles in both alleles of both CLCNKA and CLCNKB results in a phenotype indistinguishable from that of mutations in BSND (type IV BS).

CONCLUSIONS

Recent advances in genetics have resulted in a better understanding of many human inherited diseases, but most of them are monogenic disorders and more complex inheritance patterns remain unresolved. Our case provides clear evidence of digenic inheritance outside the scope of Mendelian inheritance disorders.

Transcriptional expression of survivin and its splice variants in cervical carcinomas

The objective of this study was to evaluate transcriptional expression of survivin and the two splice variants (survivin-2B and survivin-ΔEx3) in cervical carcinomas. The gene expression levels of survivin and its splice variants in 11 human cervical carcinoma cell lines and 20 malignant and 12 normal cervical tissue samples were analyzed using quantitative reverse transcription–polymerase chain reaction analysis. Gene expression levels of survivin and survivin-ΔEx3 in cell lines were higher than those in normal cervical tissues (P= 0.0193 and 0.0489). Transcript levels of survivin and survivin-ΔEx3 in carcinoma tissues were also higher than those in normal controls (P= 0.0016 and 0.0011). Gene expression levels of survivin and survivin-ΔEx3 in adenocarcinomas were statistically higher than those in squamous cell carcinomas (P= 0.0260 and 0.0487). There was no significant difference in survivin-2B gene expression between malignant and normal cervical samples or different histologic types. The ratios of survivin-2B/survivin and survivin-ΔEx3/survivin in carcinoma tissues were higher than those in normal controls (P= 0.0288 and 0.0081). Interestingly, the ratio of survivin-2B/survivin was increased in the patients with higher stages and with pelvic lymph node metastasis (P= 0.0205 and 0.0437), respectively. We conclude that survivin and its splice variants might be involved in the pathogenesis and development of cervical carcinomas.

Activation of the c-myc p1 promoter in Burkitt's lymphoma by the hs3 immunoglobulin heavy-chain gene enhancer

The expression of c-myc is deregulated in Burkitt's lymphoma by the translocation t(8;14). Most of the increased c-myc expression is from the P1 promoter, which is normally a minor promoter. How the P1 promoter is activated by the immunoglobulin heavy chain gene enhancers is not understood. We identified a YY1 site in the immunoglobulin heavy-chain gene HS3 enhancer, which increased c-myc P1 promoter activity, and a MARE site, which decreased c-myc P1 activity. Small Maf proteins bound to the MARE site both in vitro and in vivo, recruited histone deacetylase 2, and resulted in deacetylation of histones H3 and H4 at the c-myc promoter region. In contrast, YY1 recruited CBP and increased histone acetylation at the c-myc promoter. Rb interacts with YY1 to prevent DNA binding in normal B cells, but no significant interaction with YY1 was detected in Burkitt's cells, and binding of YY1 to the HS3 enhancer was observed by chromatin immunoprecipitaton. Increased expression of MafK and/or decreased expression of YY1 by silencing RNA downregulated endogenous c-myc mRNA levels and increased the sensitivity of the cells to doxorubicin. Mutation of the major active sites (nuclear factor-kappa B and YY1) in the enhancers prevented c-myc activation.

Embolisation of proximal anastomotic pseudoaneurysm developing after surgical repair of abdominal aortic aneurysm with a bifurcated graft with n-butyl cyanoacrylate

We report a 60-year-old man who after undergoing surgical repair of an abdominal aortic aneurysm with a bifurcated graft subsequently developed a proximal anastomotic pseudoaneurysm, which was successfully treated by embolisation with n-butyl cyanoacrylate.

Fas gene promoter -670 polymorphism in gynecological cancer

Single-nucleotide polymorphism at -670 of Fas gene promoter (A/G) was examined in a total of 354 blood samples from normal healthy women and gynecological cancer patients. They consisted of 95 normal, 83 cervical, 108 endometrial, and 68 ovarian cancer cases. Eighty-three patients with cervical cancer had statistically higher frequency of GG genotype and G allele than 95 controls (P= 0.0353 and 0.0278, respectively). There was no significant difference in the genotype or allele prevalence between control subjects and endometrial or ovarian cancer patients. The Fas -670 GG genotype was associated with an increased risk for the development of cervical cancer (OR = 2.56, 95% CI = 1.08-6.10) compared with the AA genotype. The G allele also increased the risk of cervical cancer (OR = 1.60, 95% CI = 1.05-2.43) compared with the A allele. Germ-line polymorphism of Fas gene promoter -670 may be associated with the risk of cervical cancer in a Japanese population.

Fas gene promoter –670 polymorphism in gynecological cancer

Single-nucleotide polymorphism at −670 of Fas gene promoter (A/G) was examined in a total of 354 blood samples from normal healthy women and gynecological cancer patients. They consisted of 95 normal, 83 cervical, 108 endometrial, and 68 ovarian cancer cases. Eighty-three patients with cervical cancer had statistically higher frequency of GG genotype and G allele than 95 controls (P= 0.0353 and 0.0278, respectively). There was no significant difference in the genotype or allele prevalence between control subjects and endometrial or ovarian cancer patients. The Fas −670 GG genotype was associated with an increased risk for the development of cervical cancer (OR = 2.56, 95% CI = 1.08–6.10) compared with the AA genotype. The G allele also increased the risk of cervical cancer (OR = 1.60, 95% CI = 1.05–2.43) compared with the A allele. Germ-line polymorphism of Fas gene promoter −670 may be associated with the risk of cervical cancer in a Japanese population.

Stimulation of the nucleus basalis of Meynert increases diameter of the parenchymal blood vessels in the rat cerebral cortex

To verify the hypothesis that stimulation of the nucleus basalis of Meynert (NBM) induces vasodilation in the cerebral cortical parenchyma, we investigated whether the diameter of parenchymal blood vessels of rat parietal cortex is increased during stimulation of NBM using histological techniques. The parietal cortex was fixed by immersion fixation in situ during focal electrical stimulation of the NBM, which increased cortical blood flow. Cortical tissues were sectioned horizontally to the cortical surface, and the parenchymal blood vessels were morphometrically analyzed using electron microscopy. Mean inner diameter of the parenchymal blood vessels in NBM stimulated rats (5.51+/-0.33 microm) was significantly larger than that in non-stimulated control rats (4.93+/-0.23 microm). The result suggests that functional vasodilation in the cortical parenchyma during NBM stimulation correlates with histologically observed vasodilation in the cortical parenchyma.

Changes in serum 1,25-dihydroxyvitamin D3 and mRNAs for osteocalcin and alkaline phosphatase in femur unloaded by tail suspension in rats

To elucidate the mechanism involved in the development of disuse atrophy of bone by skeletal unloading, changes in osteocalcin and alkaline phosphatase mRNAs, markers for bone formation, were studied in the hind limb bones of tail-suspended rats. Tail suspension for 8 and 14 days resulted in a significant decrease in osteocalcin mRNA in the femur when compared with age-matched non-suspended controls. Serum 1,25-dihydroxyvitamin D3 decreased to 60% of the control level after 8 days of skeletal unloading but regained almost normal levels over the next 7 days. Since it is known that vitamin D3 up regulates and glucocorticoid down regulates transcription of the osteocalcin gene, the endocrine response evoked by tail suspension may have aggravated the disuse atrophy caused by skeletal unloading in this study.

Adrenocortical response to tail-suspension in young and old rats

We recently showed that increased glucocorticoid secretion aggravates disuse atrophy when induced by skeletal unloading. Disuse atrophy in the elderly is becoming a serious problem in many developed countries. In this study we attempted to examine how aging affects the glucocorticoid response to skeletal unloading. Three groups of rats (aged 5 weeks, 12 months and 18 months) were subjected to 7 days of hind limb unloading by tail-suspension. Urinary excretion of corticosterone over a 24-hr period were monitored every other day. Corticosterone excretion in the control group of 5-week-old rats was initially 87.4 +/- 12.8 ng/day and did not change throughout the experiment. Tail-suspension experiments yielded a significant increase (more than 3 fold) in excretion on days 1 and 3 of the suspension before returning to control levels. In the 12-month-old rats, a marked increase in the basal corticosterone level was observed in the control rats throughout the experiment, while the increase by tail-suspension was attenuated with a transient, significant increase on day 5. In 18-month-old rats, a further increase in the basal level was observed in the control group, although excretions tended to increase steadily from day 1 to day 3 and remained high until day 7. Urinary excretion of corticosterone among the 18-month-old suspension group was similar to those observed in the control group. These results indicate that the younger (5-week-old) rats adapted the stress load caused either by tail-suspension or manipulation alone faster than the older rats did (12 or 18 months old). The observation that basal corticosterone excretion increases with age suggests, alterations in the hypothalamic-pituitary-adrenal axis among the aged rats which might aggravates disuse atrophy induced by skeletal unloading.

Ascending aortic cannulation via left thoracotomy for distal aortic arch aneurysm operation

We have cannulated the ascending aorta for cardiopulmonary bypass via left thoracotomy in order to avoid conventional retrograde perfusion from the femoral arteries, which is associated with an increased risk of cerebral embolism. We use silk sutures to retract the anterior margin of the opened pericardium from the chest wall, which provides good exposure and easy control of the ascending aorta. Between July 1997 and November 2000, cannulation proved easy to do and reliable in 24 serial patients.

Gene expression of adhesion molecules and matrix metalloproteinases in endometriosis

Various types of cell adhesion molecules and matrix metalloproteinases (MMPs) seem to play an important role in the invasion process of endometriosis; however, limited investigation has focused on their gene expression in human peritoneal endometriotic lesions. A total of 63 endometriotic tissues were surgically obtained from 35 women with endometriosis, which included 43 pigmented and 20 non-pigmented lesions. Gene expression levels of E-cadherin, alpha- and beta-catenin, MMP-2, MMP-9 and membrane-type 1 (MT1)-MMP in these endometriotic lesions were compared with those in normal eutopic endometrium obtained from 12 women without endometriosis. MMP-2, MMP-9 and MT1-MMP mRNA expression in pigmented lesions was significantly higher than that in normal endometrium (p < 0.05), whereas E-cadherin, alpha- and beta-catenin mRNA expression was not suppressed in endometriotic lesions. There was a close correlation between MMP-2 or MT1-MMP and E-cadherin, alpha- or beta-catenin gene expression in 63 endometriotic tissues examined (p < 0.01). Immunohistochemical expression of E-cadherin, alpha- and beta-catenin in glandular epithelial cells was positive not only for all of seven cases with normal eutopic endometrium but also for 9 of 11 with ovarian endometriosis. MMP expression in ectopic endometrium was much greater than that in eutopic endometrium. These results suggest that endometriotic tissues expressing MMPs might be invasive and simultaneously possess cell-to-cell adhesion property in pelvic peritoneal foci.

Prognostic significance of immuno-proteosome subunit expression in patients with renal-cell carcinoma: a preliminary study

Our purpose was to elucidate the clinical roles of the "immuno-proteosome," which is involved in the accelerated pathway of the major histocompatibility complex (MHC) class I-restricted antigen presentation system, in renal cell carcinoma (RCC). The relative expression of six proteosome subunits (existing subunits X, Y, and Z and immunoproteosome subunits LMP7, LMP2, and MECL1) in 54 RCCs was investigated using RT-PCR analysis and was compared with clinicopathological measures, including patient outcome. Expression of the LMP7 and LMP2 genes was significantly low in high-grade tumors, and that of the LMP7 and MECL1 genes was significantly low in high-stage tumors. Low levels of LMP7, LMP2, and MECL1 expression were strongly associated with shortened survival (LMP7: P = 0.0002, LMP2: P < 0.0001, MECL1: P < 0.0047). The levels of subunits X, Y, and Z had no significant correlation with those measures. These findings suggest that RCCs with low level of immuno-proteosome subunit expression have a disorder in their antigen-presentation system. As a consequence, they may escape from immune surveillance and worsen patient outcome.

Effects of estrogen on tail suspension-induced disuse atrophy in ovariectomized rats: evaluation of the expression of interleukin-6 mRNA in the femur

It is known that estrogen deficiency results in osteoporosis in human and experimental animals. However, how this deficiency affects the development of disuse bone atrophy is not well understood. Recently, it has been reported that estrogen affects the production of cytokines such as interleukin 6 (IL-6) which acts as local bone-resorbing factor. We thus studied how estrogen deficiency caused by ovariectomy and estrogen supplements affects the expression of IL-6 mRNA in the femur of tail-suspended rats. Five-week old female Wistar rats were ovariectomized and divided into two groups. One group received an intramuscular injection of estradiol dipropionate once a week (OVX-E2 group), and the other received the vehicle alone (OVX group). After the third injection, the rats were subjected to tail suspension in metabolic cages for 1, 3, 5 and 7 days. The wet weight of femurs significantly decreased after day 3 of tail-suspension in the OVX group. However, no significant decrease was observed in the OVX-E2 group. The expression of IL-6 mRNA estimated by RT-PCR (reverse transcription coupled polymerase chain reaction) in the femur significantly increased on day 5 after tail suspension in the OVX group. In the OVX-E2 group, that level significantly decreased on day 1 after the commencement of tail suspension. During suspension the level tended to be lower than that in the OVX group, a significant difference being observed on days 5 and 7 of suspension. The present results suggest that estrogen administration to OVX rats prevents both IL-6 production in the femur and the development of disuse bone atrophy induced by tail suspension.

Regulation of glucose transporter 1 expression by gliclazide in rat L6 myoblasts

Sulphonylureas are known to enhance insulin secretion from the pancreas and its sensitivity of the extrapancreatic target organs. In this study, we clarified a direct extrapancreatic effect of the sulphonylureas and of gliclazide, on the glucose transport system in cultured rat L6 myoblasts, which predominantly expressed glucose transporter 1 (GLUT 1). Our results show that gliclazide stimulated 2-deoxy-[3H]-D-glucose (2DG) uptake, 24 h after treatment, in a dose-dependent manner, and it also increased GLUT 1 protein synthesis and mRNA expression; 2DG uptake and GLUT 1 protein synthesis induced by gliclazide were completely blocked by protein kinase A (PKA) inhibitors (H89 and rp-cAMP), and gliclazide increased the intracellular cAMP levels 3 to 24 hr after the treatment. These results show that in rat L6 myoblasts, gliclazide stimulates glucose transport activity by the induction of GLUT 1 gene expression through PKA.

Optimization technique for a Prompt Gamma-ray SPECT collimator system

Because background radiation in an irradiation room creates a problem with the PG-SPECT (Prompt Gamma-ray Single Photon Emission Computed Tomography) system, which evaluates the absorbed dose for the Boron Neutron Capture Therapy treatment, optimization of a collimator system was performed while taking the shielding of background gamma-rays into consideration. Assuming that a parallel-beam collimator is used, three parameters--the diameter of a hole, the length of the collimator, and the number of detectors (the number of holes of the collimator)--were selected for optimization. Because the combinations of these parameters are limitless, it is difficult to determine them simultaneously. Therefore, a statistically derived Optimization Criterion has been proposed to optimize these parameters. When the spatial resolution was 1 cm-FWHM (full width at half maximum), the optimal diameter of the collimator was 5.4 mm, the optimal length was 321 mm, and the optimal number of detectors was 31 x 31.

Psycho-physiological effects of the terrorist sarin attack on the Tokyo subway system

The investigation describes the follow-up of the victims of the 1995 Tokyo sarin attack who were followed by a team at the St. Luke's International Hospital. A symptom questionnaire ("St. Luke's Questionnaire") was developed and given 2, 3, and 5 years following the sarin attack. Somatic and psychological symptoms have continued for 5 years after the incident. New post-traumatic stress disorder diagnostic criteria, which include physical symptoms, were developed and applied for assessment of the outcomes. The St. Luke's cohort was also compared with other Japanese sarin attack cohorts. Interventions, including counseling, medical treatments, and support group activities, were associated with fewer symptoms among the victims.

Changes in mRNA levels of alkaline phosphatase and tartrate-resistant acid phosphatase in femur of ovariectomized rats: effects of estrogen and unloading

Our previous studies demonstrated that estrogen (E2) prevents the development of disuse atrophy of the femur in tail-suspended rats. To elucidate the mechanisms of this E2 action, we investigated the effects of E2 on the expression of alkaline phosphatase (ALP, a marker for bone formation) and tartrate-resistant acid phosphatase (TRAP, a marker for bone resorption) in the femur of ovariectomized and tail-suspended rats. One group of ovariectomized rats received estradiol dipropionate (OVX-E2), and the other the vehicle alone (OVX). Each group was subjected to tail-suspension. After 1, 3, 5 or 7 days of suspension, ALP and TRAP mRNA levels were determined by Northern blot analysis. The ALP mRNA level was not altered by suspension in the OVX group, but it gradually increased in the OVX-E2 group, the highest level being observed at day 5 of suspension. In contrast, TRAP mRNA significantly increased at days 5 and 7 in the OVX group, while it is decreased significantly from day 3 to 7 in the OVX-E2 group. These results indicate that E2 prevents disuse atrophy of the femur in an ovariectomized and tail-suspended rat model by stimulating bone formation and by inhibiting bone resorption.

Analysis of the gene expression of SPARC and its prognostic value for bladder cancer

PURPOSE

We analyzed the gene expression of the glycoprotein termed secreted protein, acidic and rich in cysteine (SPARC), also called osteonectin and BM40, in bladder cancer and its relationship with conventional clinical-histopathological manifestations, evaluated its prognostic value for patient outcome and determined the possible mechanism underlying the effect of SPARC on bladder cancer progression.

MATERIALS AND METHODS

Tissue samples from 63 patients with bladder cancer were used for analysis. Gene expression levels of SPARC and matrix metalloproteinase-2 were analyzed using reverse transcription-polymerase chain reaction. Correlations of the expression of SPARC with histopathological findings or patient outcome and with matrix metalloproteinase-2 were evaluated.

RESULTS

Significantly higher expression of SPARC was observed in grades 3 and 2 than in grade 1 tumors (p <0.001 and <0.05, respectively). Stage T2 or greater invasive tumors expressed a significantly higher level of SPARC than stages T1 or less superficial tumors (p <0.0001). Patients in whom the lesions showed high SPARC expression had a significantly worse prognosis than those with low SPARC expression disease (p <0.0001). Even in those with invasive bladder cancer high SPARC expression was associated with significantly worse survival than low expression (p <0.01). Moreover, gene expression of SPARC significantly correlated with matrix metalloproteinase-2 gene expression (p <0.0001), implying that regulation of matrix metalloproteinase-2 expression may be a possible mechanism underlying the effect of SPARC on bladder cancer progression.

CONCLUSIONS

A significant correlation was detected of the gene expression level of SPARC with histological grade, pathological stage and bladder cancer prognosis. SPARC may have an important role in bladder cancer progression and provide some additional information in patients with bladder cancer.

Arch-first reconstruction via median sternotomy. Short retrograde cerebral perfusion

In December 1998, we introduced arch-first reconstruction for total aortic arch replacement via conventional median sternotomy in order to shorten the duration of retrograde cerebral perfusion (RCP). We used a separate straight graft for an elephant trunk, which allowed an easy subsequent distal anastomosis. The average RCP duration in this series was 32.1+/-5.8 min (mean+/-SD, range, 24-40 min, n=12), which was significantly shorter (p<0.05) than that of the conventional procedure (45.6+/-12.4 min, range, 34-65 min, n=8), in which we first perform a distal anastomosis. No significant differences in cardiopulmonary bypass time (268+/-81 min vs 258+/-42 min) nor operation time (518+/-213 min vs 517+/-82 min) between the two groups were observed. There was no hospital death in either group. One patient in the second series (conventional method) suffered temporary neurological disturbance. For acceptable RCP duration, total aortic arch replacement is currently the standard procedure in our institution for Stanford A type aortic dissection.

Type A behavior, social support, and sex in Japanese college students

The relations among self-report scores for Type A behavior with social support and sex were examined in 239 female and 213 male Japanese college students. Scores on Type A behavior were inversely correlated with those for social support for both women and men separately. There were no significant differences in the magnitudes of these coefficients for women and men.

Temporal facilitation of the flexor reflex induced by C-fiber activity: comparison between adult and aged rats

We investigated the wind-up phenomenon of the flexor reflex in adult and aged rats. The sural nerve was stimulated at C-fiber strength and reflex activity was recorded from the semitendinosus muscle. The wind-up rate, the increment rate of the C-fiber response (i.e. activity from 100 to 600 ms after stimulation) by successive stimuli (five train pulses), was decreased exponentially with increasing stimulus intervals from 3 to 20 s. The time constant of the decay for the aged rats was 9.2+/-3.2 s (mean+/-SD), which was significantly longer than for the adult rats (6.4+/-2.9 s). The findings indicate that the effects of C-fiber activation on the spinal nociceptive pathways attenuate more slowly in aged rats as compared with adult rats.

Neurotic perfectionism, perceived stress, and self-esteem among Japanese men: a prospective study

The present study examined the relationship between self-report scores of neurotic perfectionism and of perceived stress and self-esteem 6 wk. later among 146 Japanese male college students. Hierarchical regression analysis indicated that scores for neurotic perfectionism accounted for statistically significant but functionally small variance (4% and 3%) in scores for perceived stress and self-esteem obtained at Time 2 (6 wk. later), after controlling for the scores for perceived stress and self-esteem at Time 1, respectively.

Neuronal pathways from group-I and -II muscle afferents innervating hindlimb muscles to motoneurons innervating trunk muscles in low-spinal cats

Synaptic inputs to motoneurons innervating the back and abdominal muscles in the lumbar part of the body from low-threshold hindlimb muscle afferents were studied in unanesthetized low-spinal cats. At a stimulus intensity of 1.2-1.5x threshold (T), which was sufficient to activate only group-I afferents, the incidence of post-synaptic potentials (PSPs) was higher when stimulating proximal muscle nerves than when stimulating distal muscle nerves (e.g., 52% versus 22% for motoneurons innervating m. iliocostalis lumborum: Ilio MNs; 38% versus 18% for motoneurons innervating m. obliquus externus: OEA MNs). At 2-5 T, at which group-II as well as group-I muscle afferents were presumably stimulated, the PSP incidence increased irrespective of nerves stimulated (e.g., 76% for Ilio MNs; 60% for OEA MNs). The minimal central latencies of EPSPs evoked at 1.2-1.5 T ranged 0.8-16.7 ms for Ilio motoneurons and 1.4 -14.2 ms for OEA motoneurons, indicating that the connection between back and abdominal motoneurons and low-threshold afferents from the hindlimb muscle include a monosynaptic one. The latencies of IPSPs were longer and ranged 1.9-18.8 ms for Ilio motoneurons and 2.4-15.8 ms for OEA motoneurons. Input patterns from various hindlimb muscles varied among individual motoneurons, even though they were within the same motoneuron pool. Such synaptic organization seems to differ from that for the leg motoneuron pool. The overall projection pattern of low-threshold afferents from leg muscles to lumbar back and abdominal motoneurons nevertheless suggests that group-I afferent inputs are related to lateral and vertical movements, and that group-II afferent inputs control the stiffness of the trunk.