Effect of Antihypertensive Therapy on Blood Rheology in Patients with Essential Hypertension

Hypertension is an important risk factor for cardiovascular disease, and antihypertensive drugs can decrease the occurrence of such events in hypertensive patients. This study compared the rheological properties of blood in 22 untreated hypertensive patients, 42 patients taking antihypertensive drugs and 74 normotensive subjects. Using a microchannel method, the whole blood passage time was measured and blood movement was observed with a microscope connected to an image display unit. The blood passage time in untreated hypertensive patients was significantly higher than in treated hypertensive patients or normotensive subjects, but was similar in the latter two groups. Microscopic observations showed that platelet aggregation and leucocyte adhesion were increased in untreated hypertensive patients, resulting in poor flow, while blood samples from treated hypertensive patients and normotensive subjects passed smoothly through the microchannels. These rheological differences could contribute to the decrease in cardiovascular disease seen when hypertensive patients are treated effectively.

Clinical efficacy of thrombus aspiration on 5-year clinical outcomes in patients with ST-segment elevation acute myocardial infarction undergoing percutaneous coronary intervention

Background

Adjunctive thrombus aspiration (TA) during primary percutaneous coronary intervention (PCI) was reported to promote better coronary and myocardial reperfusion. However, long-term mortality benefit of TA remains controversial. The objective of this study is to investigate the clinical impact of TA on long-term clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary PCI.

Methods and Results

The CREDO-Kyoto AMI Registry is a large-scale cohort study of acute myocardial infarction patients undergoing coronary revascularization in 2005–2007 at 26 hospitals in Japan. Among 5429 patients enrolled in the registry, the current study population consisted of 3536 patients who arrived at the hospital within 12 hours after the symptom onset and underwent primary PCI. Clinical outcomes were compared between the 2 patient groups with or without TA. During primary PCI procedures, 2239 out of 3536 (63%) patients underwent TA (TA group). The cumulative 5-year incidence of all-cause death was significantly lower in the TA group than in the non-TA group (18.5% versus 23.9%, log-rank P<0.001). After adjusting for confounders, however, the risk for all-cause death in the TA group was not significantly lower than that in the non-TA group (hazard ratio: 0.90, 95% CI: 0.76 to 1.06, P=0.21). The adjusted risks for cardiac death, myocardial infarction, stroke, and target-lesion revascularization were also not significantly different between the 2 groups.

Conclusions

Adjunctive TA during primary PCI was not associated with better 5-year mortality in STEMI patients.

Dysregulation of BMI1 and microRNA-16 collaborate to enhance an anti-apoptotic potential in the side population of refractory mantle cell lymphoma

The proto-oncogene BMI1 and its product, Bmi1, is overexpressed in various types of tumors, particularly in aggressive tumors and tumors resistant to conventional chemotherapy. BMI1/Bmi1 is also crucially involved in cancer-initiating cell maintenance, and is recurrently upregulated in mantle cell lymphoma (MCL), especially aggressive variants. Recently, side population (SP) cells were shown to exhibit tumor-initiating characteristics in various types of tumors. In this study, we show that recurrent MCL cases significantly exhibit upregulation of BMI1/Bmi1. We further demonstrate that clonogenic MCL SP shows such tumor-initiating characteristics as high tumorigenicity and self-renewal capability, and that BMI1 was upregulated in the SP from recurrent MCL cases and MCL cell lines. On screening for upstream regulators of BMI1, we found that expression of microRNA-16 (miR-16) was downregulated in MCL SP cells by regulating Bmi1 in the SPs, leading to reductions in tumor size following lymphoma xenografts. Moreover, to investigate downstream targets of BMI1 in MCL, we performed cross-linking/chromatin immunoprecipitation assay against MCL cell lines and demonstrated that Bmi1 directly regulated pro-apoptotic genes such as BCL2L11/Bim and PMAIP1/Noxa, leading to enhance anti-apoptotic potential of MCL. Finally, we found that a proteasome inhibitor bortezomib, which has been recently used for relapsed MCL, effectively induced apoptosis among MCL cells while reducing expression of Bmi1 and increasing miR-16 in MCL SP. These results suggest that upregulation of BMI1 and downregulation of miR-16 in MCL SP has a key role in the disease's progression by reducing MCL cell apoptosis. Our results provide important new insight into the pathogenesis of MCL and strongly suggest that targeting BMI1/Bmi1 might be an effective approach to treating MCL, particularly refractory and recurrent cases.

Rapid improvement of osseous sarcoidosis after the treatment of pulmonary aspergillosis by itraconazole

Osseous sarcoidosis is relatively uncommon, and treatment with corticosteroids is not always effective. Moreover, patients with an advanced stage of pulmonary sarcoidosis are sometimes infected with aspergillus in the cavities of the pulmonary lesions, and long-term use of corticosteroids should be prohibited to prevent the development of fatal invasive pulmonary aspergillosis. Here, we described a unique case of osseous sarcoidosis with pulmonary aspergillosis, showing a rapid improvement of the osseous symptoms just after the administration of the antifungal agent, itraconazole. Itraconazole is likely to become a candidate among new therapeutic agents for osseous sarcoidosis.

Influence of thyroid hormones and transforming growth factor-β1 on cystatin C concentrations

Serum cystatin C concentrations are reported to increase in the hyperthyroid state. Serum concentrations of cystatin C and transforming growth factor-β1 (TGF-β1) were measured in patients with thyroid dysfunction, and the effects of 3,5,3'-tri-iodothyronine (T(3)) and TGF-β1 on cystatin C production in human hepatoblastoma (Hep G2) cells were studied. Serum concentrations of cystatin C and TGF-β1 were significantly higher in patients with Graves' disease compared with control subjects. Significantly positive correlations were observed between thyroid hormones and cystatin C, thyroid hormones and TGF-β1, and TGF-β1 and cystatin C in patients with thyroid dysfunction. Serum concentrations of cystatin C and TGF-β1 decreased after treatment for hyperthyroidism. Cystatin C mRNA levels and cystatin C secretion were increased by T(3) and TGF-β1 in cultured Hep G2 cells. These results suggest that serum cystatin C concentrations increase in patients with hyperthyroidism. The mechanisms for this may involve elevation of serum TGF-β1 levels and the stimulatory effects of T(3) and TGF-β1 on cystatin C production.

A simple, sensitive high-performance liquid chromatography -ultraviolet method for the quantification of concentration and steady-state pharmacokinetics of itraconazole and hydroxyitraconazole

Background

A steady-state trough plasma itraconazole concentration greater than 500 ng/mL is a therapeutic target for itraconazole. A simple, rapid and sensitive high-performance liquid chromatography-based method was developed for quantitation of itraconazole and hydroxyitraconazole in human plasma.

Methods

Itraconazole and hydroxyitraconazole were separated using a mobile phase of 0.5% KH2PO4 (pH 6.0)-acetonitrile (30:70, v/v) on a CAPCELLPAK C18 MGII column at a flow rate of 0.5 mL/min and ultraviolet absorbance at 260 nm.

Results

The analysis required 200 μL of plasma and involved a rapid, simple solid-phase extraction with an Oasis HLB cartridge, which resulted in recoveries of 87–92% for itraconazole and 91–94% for hydroxyitraconazole. The lower limit of quantification for itraconazole and hydroxyitraconazole was 5 ng/mL each. Intra- and interday coefficients of variation for itraconazole and hydroxyitraconazole were less than 11.3% and 12.2%, respectively, and accuracies were within 11.7% and 4.5% over the linear range, respectively. Although the steady-state plasma concentrations of itraconazole and hydroxyitraconazole ranged from 506 to 2482 ng/mL and from 766 to 2444 ng/mL, respectively, after a two-day loading dose of 400 mg/day intravenous itraconazole followed by the administration of 200 mg/day itraconazole oral solution, calibration curves of itraconazole and hydroxyitraconazole showed positive linearity in a concentration range of 5–2500 and 50–2500 ng/mL, respectively.

Conclusions

Our results indicate that this method is applicable for the monitoring of plasma levels of itraconazole and hydroxyitraconazole in a clinical setting. Furthermore, the regimen presented here might also be effective in preventing infection, but further studies with large sample sizes are necessary to investigate this avenue.

Impaired blood rheology and elevated remnant-like lipoprotein particle cholesterol in hypercholesterolaemic subjects

Blood rheology, fasting serum concentrations of remnant-like lipoprotein particle cholesterol (RLP-C) and concentrations of other lipids were compared in 23 hypercholesterolaemic and 69 normocholesterolaemic subjects, and the relationship between red blood cell (RBC) deformability and RLP-C concentrations were studied in a different set of six hypercholesterolaemic and six normocholesterolaemic subjects. Passage time of whole blood and concentrations of total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and RLP-C were significantly higher in hypercholesterolaemic than in normocholesterolaemic subjects. Passage time of whole blood correlated positively with TC, TG, LDL-C and RLP-C and negatively with high-density lipoprotein cholesterol. Furthermore, the passage time of 10% haematocrit-adjusted RBCs in phosphate-buffered saline, which reflects RBC deformability, correlated positively with the passage time of whole blood and RLP-C. Thus, hypercholesterolaemic subjects had impaired blood rheology and elevated RLP-C concentrations, which may be associated with the pathophysiology of atherosclerosis in hypercholesterolaemic subjects. Impaired RBC deformability may contribute to impaired blood rheology associated with elevated RLP-C in hypercholesterolaemic subjects.

Secondary bronchiolitis obliterans organising pneumonia in a patient with carbamazepine-induced hypogammaglobulinaemia

Here we describe a case of a secondary bronchiolitis obliterans organizing pneumonia (BOOP), which was associated with repeated respiratory infections caused by carbamazepine (CBZ)- induced hypogammaglobulinaemia. A 49-year-old woman had been treated with CBZ (400 mg/day). Two and a half years later, she developed of dyspnea with productive cough and high-grade fever. Chest roentgenogram and computed tomography showed bilateral infiltrates in lower lung fields. Her laboratory findings revealed severe hypogammaglobulinaemia, suggesting that an immune system disorder caused pulmonary infection. Histological examination by trans-bronchial lung biopsy (TBLB) demonstrated that many foamed alveolar macrophages were obstructing the alveolar ducts and adjacent alveoli, suggesting BOOP. After cessation of CBZ, the hypogammaglobulinaemia and chest roentgenogram findings markedly improved. The present case suggests that CBZ may have some adverse effects on the immune system and cause frequent airway infections, and that secondary BOOP could be induced by repeated infections caused by CBZ-induced hypogammaglobulinaemia.

Living donor liver transplantation for a child with recurrent pediatric adult-type hepatocellular carcinoma

INTRODUCTION

Pediatric hepatocellular carcinoma (HCC) is an uncommon disease with a poor prognosis. There are few reports about liver transplantation for pediatric adult-type HCC. We experienced a case of living donor liver transplantation (LDLT) for a child with recurrent pediatric adult-type HCC.

CASE REPORT

A 12-year-old boy was admitted to the Department of Pediatrics in our institution due to HCC in May 2005. He underwent hepatectomy after 3 courses of chemotherapy in July 2005. After the operation, he had 2 more courses of the same chemotherapy. His posttheraputic course was uneventful for 1 year. However, his alpha-fetoprotein level increased and a computed tomography (CT) scan showed recurrent tumor in his remnant liver in October 2006. He underwent another chemotherapy session immediately. However, CT revealed multiple liver tumors after chemotherapy in December 2006. His mother requested to be an LDLT donor, which was performed on January 23, 2007. The donor operation was a right hepatic lobectomy. The postoperative course of the donor was unremarkable and she has now returned to work. The recipient's posttransplantation course was uneventful and he was discharged at postoperative day 53 and is currently doing well.

CONCLUSION

Liver transplantation in conjunction with chemotherapy may have an increasing role in the management of pediatric HCC.

Gastric mucin is expressed in a subset of endocervical tunnel clusters: type A tunnel clusters of gastric phenotype

AIMS

Gastric mucin expression has been demonstrated in a group of endocervical glandular lesions. The aim of this study was to gain further insight into endocervical lesions with a gastric phenotype.

METHODS AND RESULTS

Various types of tunnel clusters (TC) were examined for gastric mucin by alcian blue/periodic acid-Schiff staining and immunohistochemistry for HIK1083. Five of 34 cases of TC expressed gastric mucin defined by PAS dominant neutral mucin and immunopositivity for pyloric gland mucin. Histologically, TC expressing gastric mucin showed lobular arrangements of small to medium-sized glands composed of mucin-rich columnar cells and were classified as Flumann's type A TC. Neither type B TC nor normal endocervical glands expressed PAS dominant neutral mucin and none of them was immunopositive for pyloric gland mucin. Five patients with type A TC of gastric phenotype ranged in age from 33 to 79 years (mean 58 years) and were multiparous. Type A TC of gastric phenotype, ranging from 2 to 4 mm in maximum diameter, were incidental findings in hysterectomy specimens.

CONCLUSION

Type A TC of gastric phenotype could be related to lobular endocervical glandular hyperplasia of gastric phenotype. The pathogenesis of gastric metaplasia in TC remains unclear.

Evidence for a long-range component in the pion emission source in Au+Au collisions at sqrt sNN=200 GeV

Emission source functions are extracted from correlation functions constructed from charged pions produced at midrapidity in Au+Au collisions at sqrt[s(NN)]=200 GeV. The source parameters extracted from these functions at low k(T) give first indications of a long tail for the pion emission source. The source extension cannot be explained solely by simple kinematic considerations. The possible role of a halo of secondary pions from resonance emissions is explored.

Impaired blood rheology in critically ill patients in an intensive care unit

Critically ill patients are at increased risk of thromboembolic complications. Japanese patients admitted to the intensive care unit of Gunma University Hospital were divided into critically ill (high score) and moderately ill (low score) groups according to mean Acute Physiology and Chronic Health Evaluation (APACHE) II score. White blood cell count, potassium, creatinine, immunoglobulin G and blood passage time, measured using the microchannel method, were significantly higher and the platelet aggregation score and platelet count were significantly lower in the high-score group than in the low-score group, but other haemorheological parameters did not differ significantly between the two groups. White blood cell count, potassium, creatinine, APACHE II score and levels of immunoglobulins G, A and M were positively correlated with blood passage time in all patients. Critically ill patients had impaired blood rheology, which could result from increased white blood cell count, potassium, creatinine and immunoglobulins and may be associated with the pathophysiology of the thromboembolic process.

Dense-medium modifications to jet-induced hadron pair distributions in Au+Au collisions at sqrt s NN=200 GeV

Azimuthal correlations of jet-induced high-p(T) charged hadron pairs are studied at midrapidity in Au+Au collisions at sqrt[s(NN)]=200 GeV. The distribution of jet-associated partner hadrons (1.0<p(T)<2.5 GeV/c) per trigger hadron (2.5<p(T)<4.0 GeV/c) is found to vary with collision centrality, in both shape and yield, indicating a significant effect of the nuclear collision medium on the jet fragmentation process.

Common suppression pattern of eta and pi0 mesons at high transverse momentum in Au + Au collisions at square root S(NN) = 200 GeV

Inclusive transverse momentum spectra of eta mesons have been measured within p(T) = 2-10 GeV/c at midrapidity by the PHENIX experiment in Au + Au collisions at square root S(NN) = 200 GeV. In central Au+Au the eta yields are significantly suppressed compared to peripheral Au + Au, d + Au, and p + p yields scaled by the corresponding number of nucleon-nucleon collisions. The magnitude, centrality, and p(T) dependence of the suppression is common, within errors, for eta and pi0. The ratio of eta to pi0 spectra at high p(T) amounts to 0.40 < R(eta/pi)0 < 0.48 for the three systems, in agreement with the world average measured in hadronic and nuclear reactions and, at large scaled momentum, in e+e- collisions.

Conjugated estrogen plus medroxyprogesterone does not impair blood rheological properties in hypertensive postmenopausal women

OBJECTIVES

Hypertension and estrogens are both prothrombotic. We used the microchannel method to investigate whether hormone replacement therapy (HRT) with conjugated equine estrogen (CEE) plus medroxyprogesterone acetate (MPA) affects blood flow through the microchannels in hypertensive postmenopausal women being treated with antihypertensive drugs and in normotensive postmenopausal women.

METHODS

Sixty-two consecutive postmenopausal women were randomly assigned to a hypertensive HRT group (n=16), hypertensive control group (n=15), normotensive HRT group (n=16) and normotensive control group (n=15). Each HRT group received CEE 0.625 mg plus MPA 2.5 mg daily orally for 12 months. Both hypertensive groups were being treated with antihypertensive drugs before the study. Microvascular blood flow was assessed on the basis of blood passage time, the time required for 100 microl of whole blood to pass through a cylinder, was determined before and 12 months after the start of HRT by the microchannel method (micro channel array flow analyzer).

RESULTS

CEE plus MPA therapy did not change blood passage time in any of the groups. Microscopic observation showed that the whole blood passed smoothly through the microchannels in every group.

CONCLUSIONS

CEE plus MPA therapy may not impair blood flow through the microchannels in hypertensive postmenopausal women receiving antihypertensive drugs or in normotensive postmenopausal women. However, administration of CEE plus MPA to postmenopausal women with hypertension warrants caution against the occurrence of thromboembolic events.

Single electrons from heavy-flavor decays in collisions at

The invariant differential cross section for inclusive electron production in p+p collisions at [FORMULA: SEE TEXT] has been measured by the PHENIX experiment at the BNL Relativistic Heavy Ion Collider over the transverse momentum range 0.4<or=pT<OR=5.0 GeV/c in the central rapidity region ([FORMULA: SEE TEXT]). The contribution to the inclusive electron spectrum from semileptonic decays of hadrons carrying heavy flavor, i.e., charm quarks or, at high , bottom quarks, is determined via three independent methods. The resulting electron spectrum from heavy-flavor decays is compared to recent leading and next-to-leading order perturbative QCD calculations. The total cross section of charm quark-antiquark pair production is determined to be [FORMULA: SEE TEXT].

Measurement of identified and inclusive photon second-harmonic parameter and implications for direct photon production in [FORMULA: SEE TEXT] Au+Au

The azimuthal distribution of identified pi0 and inclusive photons has been measured in [FORMULA: SEE TEXT] Au+Au collisions with the PHENIX experiment at the Relativistic Heavy-Ion Collider (RHIC). The second-harmonic parameter (nu2) was measured to describe the observed anisotropy of the azimuthal distribution. The measured inclusive photon is consistent with the value expected for the photons from hadron decay and is also consistent with the lack of direct photon signal over the measured pT range 1-6 GeV/c. An attempt is made to extract nu2 of direct photons.

Nuclear modification of electron spectra and implications for heavy quark energy loss in Au+Au collisions at [FORMULA: SEE TEXT]

The PHENIX experiment has measured midrapidity ([FORMULA: SEE TEXT]) transverse momentum spectra ([FORMULA: SEE TEXT]) of electrons as a function of centrality in Au+Au collisions at [FORMULA: SEE TEXT]. Contributions from photon conversions and from light hadron decays, mainly Dalitz decays of pi0 and eta mesons, were removed. The resulting nonphotonic electron spectra are primarily due to the semileptonic decays of hadrons carrying heavy quarks. Nuclear modification factors were determined by comparison to nonphotonic electrons in p+p collisions. A significant suppression of electrons at high pT is observed in central Au+Au collisions, indicating substantial energy loss of heavy quarks.

Measurement of transverse single-spin asymmetries for midrapidity production of neutral pions and charged hadrons in polarized p + p collisions at square root(s) = 200 GeV

Transverse single-spin asymmetries to probe the transverse-spin structure of the proton have been measured for neutral pions and nonidentified charged hadrons from polarized proton-proton collisions at midrapidity and square root(s) = 200 GeV. The data cover a transverse momentum (pT) range 1.0-5.0 GeV/c for neutral pions and 0.5-5.0 GeV/c for charged hadrons, at a Feynman-x value of approximately zero. The asymmetries seen in this previously unexplored kinematic region are consistent with zero within errors of a few percent. In addition, the inclusive charged hadron cross section at midrapidity from 0.5 < pT < 7.0 GeV/c is presented and compared to next-to-leading order perturbative QCD (pQCD) calculations. Successful description of the unpolarized cross section above approximately 2 GeV/c suggests that pQCD is applicable in the interpretation of the asymmetry results in the relevant kinematic range.

Saturation of azimuthal anisotropy in Au + Au collisions at (square root)s(NN) = 62-200 GeV

New measurements are presented for charged hadron azimuthal correlations at midrapidity in Au+Au collisions at (square root)s(NN) = 62.4 and 200 GeV. They are compared to earlier measurements obtained at (square root)s(NN) = 130 GeV and in Pb + Pb collisions at (square root)s(NN) = 17.2 GeV. Sizeable anisotropies are observed with centrality and transverse momentum (pT) dependence characteristic of elliptic flow (upsilon2). For a broad range of centralities, the observed magnitudes and trends of the differential anisotropy, upsilon2(pT), change very little over the collision energy range (square root)s(NN) = 62-200 GeV, indicating saturation of the excitation function for upsilon2 at these energies. Such a saturation may be indicative of the dominance of a very soft equation of state for (square root)s(NN) approximately 60-200 GeV.

Centrality dependence of direct photon production in (square root)S(NN) = 200 GeV Au + Au collisions

The first measurement of direct photons in Au + Au collisions at (square root)S(NN) = 200 GeV is presented. The direct photon signal is extracted as a function of the Au + Au collision centrality and compared to next-to-leading order perturbative quantum chromodynamics calculations. The direct photon yield is shown to scale with the number of nucleon-nucleon collisions for all centralities.

Primary immunosuppression regimen of rapid steroid withdrawal after living related liver transplantation: a single-center experience

AIM

Corticosteroids have been considered the mainstay of immunosuppressive therapy after liver transplantation. However, the side effects of long-term steroid use such as diabetes, infections, and bone disease, including growth retardation in children, are serious problems. Our immunosuppression regimen includes FK506 and steroid withdrawal by 30 days after transplantation. The aim of this study was to determine the outcomes of liver transplant, using this immunosuppressive regimen.

PATIENTS

Fifteen primary liver transplant recipients were performed between January 1994 and May 2003 and data were reviewed retrospectively. Eight pediatric and four adult recipients, who had survived more than 3 months after transplantation, were included in this sample. The immunosuppressive regimen consisted of FK 506 (Prograf), initially at doses of 0.03 mg/kg, with dose adjustments to achieve daily trough levels of approximately 10 to 12 ng/mL, and predonisone, initially at 4 mg/kg/d, with a taper and cessation by 30 days when the graft was stable.

RESULTS

All recipients were successfully withdrawn by 30 days. Acute rejection episodes occurred in three patients, no patient was diagnosed with chronic rejection. The acute rejection-free rate at 5 year was 74.1%. No recipient had diabetes, serious infections or bone disease.

CONCLUSION

Our primary immunosuppressive regimen of rapid steroid withdrawal is safe with regard to acute and chronic rejection with benefits upon steroid-related side effects.

Deuteron and antideuteron production in Au+Au collisions at square root of s(NN)=200 GeV

The production of deuterons and antideuterons in the transverse momentum range 1.1<p(T)<4.3 GeV/c at midrapidity in Au+Au collisions at square root of s(NN)=200 GeV has been studied by the PHENIX experiment at RHIC. A coalescence analysis, comparing the deuteron and antideuteron spectra with that of proton and antiproton, has been performed. The coalescence probability is equal for both deuterons and antideuterons and it increases as a function of p(T), which is consistent with an expanding collision zone. Comparing (anti)proton yields, p /p=0.73+/-0.01, with (anti)deuteron yields, d /d=0.47+/-0.03, we estimate that n /n=0.64+/-0.04. The nucleon phase space density is estimated from the coalescence measurement.

Centrality dependence of charm production from a measurement of single electrons in Au+Au collisions at sqrt[s(NN)]=200 GeV

The PHENIX experiment has measured midrapidity transverse momentum spectra (0.4<p(T)<4.0 GeV/c) of single electrons as a function of centrality in Au+Au collisions at sqrt[s(NN)]=200 GeV. Contributions from photon conversions and Dalitz decays of light neutral mesons are measured by introducing a thin (1.7% X0) converter into the PHENIX acceptance and are statistically removed. The subtracted nonphotonic electron spectra are primarily due to the semileptonic decays of hadrons containing heavy quarks, mainly charm at lower p(T). For all centralities, the charm production cross section is found to scale with the nuclear overlap function, T(AA). For minimum-bias collisions the charm cross section per binary collision is N(cc )/T(AA)=622+/-57(stat)+/-160(syst) microb.

Attenuation of canine warm ischemic small bowel injury by novel combination of nitric oxide donor, FK409, and cytokine suppressive anti-inflammatory agent FR167653

Organ ischemia-reperfusion injury is caused by two consecutive steps, microcirculatory disturbance and neutrophil-endothelial cell interactions, which are caused by inflammatory cytokines. We examined the hypothesis that combination therapy with a donor (FK409) of nitric oxide, one of the potent mediators with diverse roles as a vosodilator and a platelet inhibitor, together with the cytokine suppressor agent (FR167653) attenuates warm ischemic injury in canine small bowel. Small bowel ischemia was initiated by clamping the superior mesenteric artery and vein. Animals were divided into two groups: a control group (n = 5) subjected to 2-hour small bowel ischemia only, and a combination therapy group (FK/FR group, n = 5) that received FK409 (300 mcg/kg/h) plus FR167653 (1 mg/kg/h) intravenously before and after the ischemic event. We evaluated animal survival, small bowel tissue blood flow, and enzyme release from the small bowel. All controls died from severe acidosis within 2 days and all the FK/FR animals survived 7 days (P < .05). The FK/FR group recovered more than 70% of blood flow immediately after the revascularization, while the flow was less than 40% among the controls. Serum creatine phosphokinase values in the control group after reperfusion were significantly higher than those in the FK/FR group. In conclusion improvement of the microcirculation by FK409 and inhibition of cytokine release by FR167653 together attenuated warm ischemic small bowel injury.

Bose-Einstein correlations of charged pion pairs in Au + Au collisions at square root sNN = 200 GeV

Bose-Einstein correlations of identically charged pion pairs were measured by the PHENIX experiment at midrapidity in Au + Au collisions at square root s(NN)=200 GeV. The Bertsch-Pratt radius parameters were determined as a function of the transverse momentum of the pair and as a function of the centrality of the collision. Using the standard core-halo partial Coulomb fits, and a new parametrization which constrains the Coulomb fraction as determined from the unlike-sign pion correlation, the ratio R(out)/R(side) is within 0.8-1.1 for 0.25< <k(T)> <1.2 GeV/c. The centrality dependence of all radii is well described by a linear scaling in N(1/3)(part), and R(out)/R(side) for <k(T)> approximately 0.45 GeV/c is approximately constant at unity as a function of centrality.

In vitro evaluation of cross-circulation system using semipermeable membrane combined with whole liver perfusion

INTRODUCTION

Many types of isolated hepatocytes-based bioartificial liver have been developed. However, to maintain hepatocyte-specific functions for a long period is still a significant challenge. The possibilities of rejection or viral transmission still remain as untackled obstacles. We developed a cross-circulation system, using a semipermeable membrane combined with whole liver perfusion. Detoxifying functions of the extracorporeal porcine liver and molecular movements across the membrane were evaluated in vitro.

METHODS

The hollow-fiber module has a molecular cutoff of 100 kD. A spiked solution containing 500 mL low molecular dextran solution spiked with 12 mg ammonium chloride, 500 mg D-galactose, and 300 mg lidocaine, which mimicked a patient, was recirculated through the inner fiber space. The extracorporeal liver perfusion circuit consisted of an extra-fiber spaces. A reservoir containing 1000 mL healthy pig plasma, a membrane oxygenator, and a porcine whole liver. Both circuits circulated in the opposite direction for 6 hours.

RESULT

In 6 hours, 47.3% +/- 10.2% of ammonia, 89.5% +/- 1.7% of D-galactose, and 95.5% +/- 1.0% of lidocaine were eliminated from the circuits; 66.5 +/- 11.1 mg of urea were produced at the same time. Oxygen consumption was maintained between 0.248 and 0.259 mL/100 g liver/min for 6 hours. Movement of IgM was completely blocked by the 100-kD membrane, whereas albumin was freely transferred from the reservoir to the intrafiber space.

CONCLUSION

The perfusion experiments showed the possibility of using a whole liver with oxygenated plasma perfusion in a bioartificial liver system in vitro.

Measurement of nonrandom event-by-event fluctuations of average transverse momentum in square root of (sNN)=200 GeV Au+Au and p+p collisions

Event-by-event fluctuations of the average transverse momentum of produced particles near midrapidity have been measured by the PHENIX Collaboration in square root of (sNN)=200 GeV Au+Au, and p+p collisions at the Relativistic Heavy Ion Collider. The fluctuations are observed to be in excess of the expectation for statistically independent particle emission for all centralities. The excess fluctuations exhibit a dependence on both the centrality of the collision and on the pT range over which the average is calculated. Both the centrality and pT dependence can be well reproduced by a simulation of random particle production with the addition of contributions from hard-scattering processes.

J/psi production from proton-proton collisions at square root of s=200 GeV

J/psi production has been measured in proton-proton collisions at square root of s=200 GeV over a wide rapidity and transverse momentum range by the PHENIX experiment at the Relativistic Heavy Ion Collider. Distributions of the rapidity and transverse momentum, along with measurements of the mean transverse momentum and total production cross section are presented and compared to available theoretical calculations. The total J/psi cross section is 4.0+/-0.6(stat)+/-0.6(syst)+/-0.4(abs) mu b. The mean transverse momentum is 1.80+/-0.23(stat)+/-0.16(syst) GeV/c.

Midrapidity neutral-pion production in proton-proton collisions at square root s = 200 GeV

The invariant differential cross section for inclusive neutral-pion production in p+p collisions at sqrt[s]=200 GeV has been measured at midrapidity (|eta|<0.35) over the range 1<p(T) less, similar 14 GeV/c by the PHENIX experiment at the Relativistic Heavy Ion Collider. Predictions of next-to-leading order perturbative QCD calculations are consistent with these measurements. The precision of our result is sufficient to differentiate between prevailing gluon-to-pion fragmentation functions.

Elliptic flow of identified hadrons in Au+Au collisions at sqrt sNN =200 GeV

The anisotropy parameter (v(2)), the second harmonic of the azimuthal particle distribution, has been measured with the PHENIX detector in Au+Au collisions at sqrt[s(NN)]=200 GeV for identified and inclusive charged particle production at central rapidities (|eta|<0.35) with respect to the reaction plane defined at high rapidities (|eta|=3-4 ). We observe that the v(2) of mesons falls below that of (anti)baryons for p(T)>2 GeV/c, in marked contrast to the predictions of a hydrodynamical model. A quark-coalescence model is also investigated.

Scaling properties of proton and antiproton production in sqrt[s(NN)]=200 GeV Au+Au collisions

We report on the yield of protons and antiprotons, as a function of centrality and transverse momentum, in Au+Au collisions at sqrt[s(NN)]=200 GeV measured at midrapidity by the PHENIX experiment at the BNL Relativistic Heavy Ion Collider. In central collisions at intermediate transverse momenta (1.5<p(T)<4.5 GeV/c) a significant fraction of all produced particles are protons and antiprotons. They show a centrality-scaling behavior different from that of pions. The pmacr;/pi and p/pi ratios are enhanced compared to peripheral Au+Au, p+p, and e(+)e(-) collisions. This enhancement is limited to p(T)<5 GeV/c as deduced from the ratio of charged hadrons to pi(0) measured in the range 1.5<p(T)<9 GeV/c.

Somatic mutation of the Caspase-5 gene in human lung cancer

Using cDNA array-based gene expression profiling, we previously found reduced expression of the Caspase-5 gene in highly metastatic subpopulations of a lung cancer cell line. The Caspase-5 gene contained poly(A) repeats in its coding region, an area that has been reported to be mutated in both endometrial and gastrointestinal tumors displaying evidence of microsatellite instability. In order to determine the contribution of Caspase-5 gene inactivation to lung cancer development and progression, the mutational status of the Caspase-5 poly(A) tract in 30 primary lung cancers with distant metastasis and 30 lung cancer cell lines was determined by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) analysis and direct sequencing. Three somatic mutations of the Caspase-5 gene were found in two out of 30 lung cancer tissues, although no mutations were found in other genes that also contain small nucleotide repeats, such as hMSH3, hMSH6 and BAX. The results of the present study, combined with our prior cDNA array-based gene expression profiling data, suggest that Caspase-5 might be a suppressor gene of highly metastatic potential in lung cancer.

Suppressed pi(0) production at large transverse momentum in central Au+Au collisions at sqrt[s(NN)]=200 GeV

Transverse momentum spectra of neutral pions in the range 1<p(T)<10 GeV/c have been measured at midrapidity by the PHENIX experiment at BNL RHIC in Au+Au collisions at sqrt[s(NN)]=200 GeV. The pi(0) multiplicity in central reactions is significantly below the yields measured at the same sqrt[s(NN)] in peripheral Au+Au and p+p reactions scaled by the number of nucleon-nucleon collisions. For the most central bin, the suppression factor is approximately 2.5 at p(T)=2 GeV/c and increases to approximately 4-5 at p(T) approximately 4 GeV/c. At larger p(T), the suppression remains constant within errors. The deficit is already apparent in semiperipheral reactions and increases smoothly with centrality.

Placental site trophoblastic tumor: p53 gene analysis

BACKGROUND

Placental site trophoblastic tumor (PSTT) is the rarest type of trophoblastic neoplasm. Because of its rarity, the clinical behavior and pathogenesis of PSTT are still unclear.

CASE

A 20-year-old woman presented with secondary amenorrhea and irregular vaginal bleeding. Examination of the patient revealed elevated serum hCG and a uterine mass. The specimen obtained by curettage was diagnosed as possible PSTT. The patient was treated with two cycles of EMA/CO, but her uterine mass increased in size. Subsequently, she underwent total abdominal hysterectomy. Microscopic observation revealed a PSTT. To estimate the status of expression of p53 protein and to determine whether p53 gene mutation was present in this PSTT, we carried out immunohistochemical staining for p53 and PCR-SSCP analysis. Immunohistochemical staining for p53 revealed intense nuclear labeling, but no p53 gene mutation was detected in exons 5-8.

CONCLUSION

Analysis of the p53 gene may aid understanding of the pathogenesis of PSTT.

A death resulting from inadvertent intravenous infusion of enteral feed

A female patient suffering from the after-effects of an intracerebral hemorrhage, inadvertently received approximately 50 ml of enteral feed containing high molecular weight dextrin intravenously and died 6 h later despite intensive emergency resuscitation attempts. The total quantity of enteral feed received was calculated from the amounts of dextrin measured in the blood. This is the first report describing how the total quantity of enteral feed administered intravenously was determined using biochemical analysis.

Efficacy of double filtration plasmapheretic cross-circulation using a high permeability membrane between totally hepatectomized dogs and donor pigs

BACKGROUND

Major obstacles to develop a bioartificial liver are xenogeneic immune reactions and viral infection from donor pigs. To solve these problems, we studied the effect of xenogeneic double filtration plasmapheretic cross-circulation (DFPCC) using a high performance semipermeable membrane on totally hepatectomized dogs.

METHODS

Mongrel dogs, weighing 12-15 kg, underwent total hepatectomy in one stage (n=18). One hr after total hepatectomy, the femoral vein and the jugular vein were cannulated in both dogs and pigs by using the blood access catheter tubes that were connected to the DFPCC system. In the DFPCC circuit, filtrated dog plasma and pig plasma counterflowed in a hollow fiber cartilage at a rate of 25 ml/min for 6 hr and met through a semipermeable membrane with 100 kd nominal molecular weight cut-off (n=5). In control dogs, the circuit was not connected to the pig (n=13).

RESULTS

In vitro mass transfer study suggested that very little immunoglobulins crossed the semipermeable membrane. During and after 6 hr of DFPCC, anhepatic dogs had significantly lower blood ammonia and aromatic amino acid levels than did controls. DFPCC-treated dogs demonstrated decreased intracranial pressure and survived significantly longer than control dogs (20.75+/-3.80 hr vs. 14.75+/-1.30 hr, P<0.05). Histology showed no xenogeneic rejection in both dogs and pigs.

CONCLUSIONS

Our DFPCC systems with a high permeability membrane demonstrated detoxification-function and contributed to intracranial decompression and longer animal survivals without adverse immune reaction and the possibility of zoonosis.

Fourier-transform infrared spectroscopic study of Ca2+-binding to osteocalcin

Osteocalcin, the gamma-carboxyglutamic acid-containing protein, which is the most abundant noncollagenous protein of bone and dentin, is considered to play roles in bone formation and remodeling. It is unclear how the gamma-carboxyglutamic acid side-chains in osteocalcin coordinate to Ca2+, since the X-ray structure of osteocalcin is not available. Interactions between Ca2+ and the gamma-carboxyglutamic acid side-chains in osteocalcin were investigated by Fourier-transform infrared spectroscopy. In the region of the antisymmetric stretches, the loss of intensity at 1574 cm(-1) and gain of intensity at 1600 cm(-1) were observed due to Ca2+-binding to osteocalcin. The spectral changes indicate that the gamma-carboxyglutamic acid side-chains in osteocalcin coordinate to Ca- in the malonate chelation mode, where a Ca2+ interacts with two oxygen atoms, one from each of the two COO- groups of a single gamma-carboxyglutamic acid residue. Addition of Ca2+ does not cause any spectral change in the spectra of decarboxylated osteocalcin since the gamma-carboxyglutamic acid residues are converted to the glutamic acid residues by chemical modification.

Coordination structures of Ca2+ and Mg2+ in Akazara scallop troponin C in solution. FTIR spectroscopy of side-chain COO- groups

FTIR spectroscopy has been applied to study the coordination structures of Mg2+ and Ca2+ ions bound in Akazara scallop troponin C (TnC), which contains only a single Ca2+ binding site. The region of the COO- antisymmetric stretch provides information about the coordination modes of COO- groups to the metal ions: bidentate, unidentate, or pseudo-bridging. Two bands were observed at 1584 and 1567 cm-1 in the apo state, whereas additional bands were observed at 1543 and 1601 cm-1 in the Ca2+-bound and Mg2+-bound states, respectively. The intensity of the band at 1567 cm-1 in the Mg2+-bound state was identical to that in the apo state. Therefore, the side-chain COO- group of Glu142 at the 12th position in the Ca2+-binding site coordinates to Ca2+ in the bidentate mode but does not interact with Mg2+ directly. A slight upshift of COO- antisymmetric stretch due to Asp side-chains was also observed upon Mg2+ and Ca2+ binding. This indicates that the COO- groups of Asp131 and Asp133 interact with both Ca2+ and Mg2+ in the pseudo-bridging mode. Therefore, the present study directly demonstrated that the coordination structure of Mg2+ was different from that of Ca2+ in the Ca2+-binding site. In contrast to vertebrate TnC, most of the secondary structures remained unchanged among apo, Mg2+-bound and Ca2+-bound states of Akazara scallop TnC, as spectral changes upon either Ca2+ or Mg2+ binding were very small in the infrared amide-I' region as well as in the CD spectra. Fluorescence spectroscopy indicated that the spectral changes upon Ca2+ binding were larger than that upon Mg2+ binding. Moreover, gel-filtration experiments indicated that the molecular sizes of TnC had the order apo TnC > Mg2+-bound TnC > Ca2+-bound TnC. These results suggest that the tertiary structures are different in the Ca2+- and Mg2+-bound states. The present study may provide direct evidence that the side-chain COO- groups in the Ca2+-binding site are directly involved in the functional on/off mechanism of the activation of Akazara scallop TnC.

Positive correlation between circulating leptin levels and lipid lipoproteins in postmenopausal women administered hormone replacement therapy

Beneficial effects of hormone replacement therapy are reported on plasma concentrations of lipids and lipoproteins. Plasma leptin levels are reported to reflect lipid metabolism. We treated 40 healthy postmenopausal women with continuous combined HRT (0.625 mg conjugated equine estrogen and 2.5 mg medroxyprogesterone acetate orally) daily for 6 months and then investigated total cholesterol, triglyceride, high-density lipoprotein (HDL) cholesterol, and low-density lipoprotein (LDL) cholesterol, which are considered to be factors inducing cardiovascular disease (CVD). We measured the plasma levels of lipids and leptin, which are considered to be altered with HRT. Plasma leptin and lipid levels were measured at baseline and after 3 and 6 months of HRT. The plasma levels of leptin in PMW were not significantly reduced by HRT. Although the plasma levels of total cholesterol and LDL-cholesterol did not change by HRT, the administration of HRT significantly increased plasma levels of triglycerides and HDL-cholesterol in PMW. The correlation between leptin and total cholesterol or triglycerides was positive after HRT while these relations were not correlated at baseline. The correlation between lipid levels and leptin may explain the new role of leptin in plasma lipid levels in HRT.

Temperature dependence of near-IR excited Raman spectra of crystalline hen egg-white lysozyme

Near-IR excited Raman spectroscopy was applied to examine the structural change of hen egg-white lysozyme in tetragonal crystals at low temperatures. There was little difference found in the amide I and amide III regions between the spectra observed at 77 and 298 K, suggesting that the secondary structures of lysozyme were conserved in the temperature range from 77 to 298 K. Several bands arising from the protein side chains, particularly the methylene and phenylalanyl groups, showed significant changes in either intensity or bandwidth (or in both of them) on going from 77 to 298 K. Some of the spectral changes occurred gradually over the wide temperature range, and others occurred abruptly at around 200-240 K. The implications of these findings are discussed.

Two types of movement-related cortical potentials preceding wrist extension in humans

We compared the occurrence patterns of movement-related cortical potentials (MRCPs) preceding wrist extension in athletes (kendoists and gymnasts) and non-athletes. The MRCPs of the non-athletes started approximately 1.5 s before the EMG onset of wrist extension. In the athletes, the duration of the MRCPs was shorter and the amplitudes of early component (Bereitschaftspotential) were smaller than in the non-athletes. The MRCPs in the athletes started approximately 400 ms before the onset of wrist extension and increased rapidly. In topographical maps, MRCPs of the athletes were localized markedly on the contralateral motor area (C3) compared with the non-athletes. In the present study, the duration of MRCPs was classified into two types.