A Noise-Robust Data Assimilation Method for Crystal Structure Determination Using Powder Diffraction Intensity

Crystal structure prediction for a given chemical composition has long been a challenge in condensed-matter science. We have recently shown that experimental powder X-ray diffraction (XRD) data are helpful in a crystal structure search using simulated annealing, even when they are insufficient for structure determination by themselves (N. Tsujimoto et al., Phys. Rev. Materials 2, 053801 (2018)). In the method, the XRD data are assimilated into the simulation by adding a penalty function to the physical potential energy, where we used a crystallinity-type penalty function defined by the difference between experimental and simulated diffraction angles. To improve the success rate and noise robustness, we introduce a correlation-coefficient-type penalty function adaptable to XRD data with significant experimental noise. We apply the new penalty function to SiO2 coesite and ε-Zn(OH)2 to determine its effectiveness in the data assimilation method.

Anti-PD-1 antibody monotherapy versus anti-PD-1 plus anti-CTLA-4 combination therapy as first-line immunotherapy in unresectable or metastatic mucosal melanoma: a retrospective, multicenter study of 329 Japanese cases (JMAC study)

Background

Anti-programmed cell death protein 1 (PD-1) antibody monotherapy (PD1) has led to favorable responses in advanced non-acral cutaneous melanoma among Caucasian populations; however, recent studies suggest that this therapy has limited efficacy in mucosal melanoma (MCM). Thus, advanced MCM patients are candidates for PD1 plus anti-cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) combination therapy (PD1 + CTLA4). Data on the efficacy of immunotherapy in MCM, however, are limited. We aimed to compare the efficacies of PD1 and PD1 + CTLA4 in Japanese advanced MCM patients.

Patients and methods

We retrospectively assessed advanced MCM patients treated with PD1 or PD1 + CTLA4 at 24 Japanese institutions. Patient baseline characteristics, clinical responses (RECIST), progression-free survival (PFS), and overall survival (OS) were estimated using Kaplan–Meier analysis, and toxicity was assessed to estimate the efficacy and safety of PD1 and PD1 + CTLA4.

Results

Altogether, 329 patients with advanced MCM were included in this study. PD1 and PD1 + CTLA4 were used in 263 and 66 patients, respectively. Baseline characteristics were similar between both treatment groups, except for age (median age 71 versus 65 years; P < 0.001). No significant differences were observed between the PD1 and PD1 + CTLA4 groups with respect to objective response rate (26% versus 29%; P = 0.26) or PFS and OS (median PFS 5.9 months versus 6.8 months; P = 0.55, median OS 20.4 months versus 20.1 months; P = 0.55). Cox multivariate survival analysis revealed that PD1 + CTLA4 did not prolong PFS and OS (PFS: hazard ratio 0.83, 95% confidence interval 0.58-1.19, P = 0.30; OS: HR 0.89, 95% confidence interval 0.57-1.38, P = 0.59). The rate of ≥grade 3 immune-related adverse events was higher in the PD1 + CTLA4 group than in the PD1 group (53% versus 17%; P < 0.001).

Conclusions

First-line PD1 + CTLA4 demonstrated comparable clinical efficacy to PD1 in Japanese MCM patients, but with a higher rate of immune-related adverse events.

•

Anti-PD-1 plus anti-CTLA-4 antibody therapy (PD1 + CTLA4) is an option for patients with advanced mucosal melanoma (MCM).

•

Data on the efficacy of PD1 + CTLA4 compared with PD-1 monotherapy (PD1) for MCM, however, are limited.

•

We retrospectively analyzed data from 329 Japanese patients with advanced MCM treated with PD1 or PD1 + CTLA4.

•

No significant differences in objective response rate, progression-free survival, or overall survival were observed.

•

Immune-related adverse events resulting in treatment cessation were higher in the PD1 + CTLA4 group.

Emotion regulation processes and middle-aged Japanese women's health

OBJECTIVES

Emotion regulation processes, such as mindfulness, self-compassion, and acceptance, have been discussed as modifiable psychological factors related to middle-aged women's psychological distress and adjustment. Although these emotion regulation factors have been discussed separately, the question remains of which factors reflect the most variance in middle-aged women's health. Therefore, this study aimed to reveal the most relevant explanatory variable for middle-aged women's health: mindfulness, self-compassion, or acceptance.

METHOD

A total of 200 middle-aged women completed self-reported measures of depressive symptoms, menopausal symptoms, physical quality of life, mental quality of life, and well-being.

RESULTS

Correlation analysis showed that mindfulness, self-compassion, and acceptance were significantly associated with all variables of psychological distress and adjustment. Hierarchical multiple regression analysis revealed that acceptance significantly explained the most variance of depressive symptoms, menopausal symptoms, and mental quality of life. On the other hand, self-compassion significantly explained the greatest variance in well-being.

CONCLUSIONS

These findings suggest that, for middle-aged women, 'acceptance' is an important explanatory variable of psychological distress and 'self-compassion' is an important variable of psychological adjustment.

Anti-PD1 checkpoint inhibitor therapy in acral melanoma: a multicenter study of 193 Japanese patients

BACKGROUND

Acral melanoma (AM) is an epidemiologically and molecularly distinct entity that is underrepresented in clinical trials on immunotherapy in melanoma. We aimed to analyze the efficacy of anti-programmed cell death 1 (anti-PD-1) antibodies in advanced AM.

PATIENTS AND METHODS

We retrospectively evaluated unresectable stage III or stage IV AM patients treated with an anti-PD-1 antibody in any line at 21 Japanese institutions between 2014 and 2018. The clinicobiologic characteristics, objective response rate (ORR, RECIST), survival estimated using Kaplan-Meier analysis, and toxicity (Common Terminology Criteria for Adverse Events 4.0.) were analyzed to estimate the efficacy of the anti-PD-1 antibodies.

RESULTS

In total, 193 patients (nail apparatus, 70; palm and sole, 123) were included in the study. Anti-PD-1 antibody was used as first-line therapy in 143 patients (74.1%). Baseline lactate dehydrogenase (LDH) was within the normal concentration in 102 patients (52.8%). The ORR of all patients was 16.6% (complete response, 3.1%; partial response, 13.5%), and the median overall survival (OS) was 18.1 months. Normal LDH concentrations showed a significantly stronger association with better OS than abnormal concentrations (median OS 24.9 versus 10.7 months; P < 0.001). Although baseline characteristics were similar between the nail apparatus and the palm and sole groups, ORR was significantly lower in the nail apparatus group [6/70 patients (8.6%) versus 26/123 patients (21.1%); P = 0.026]. Moreover, the median OS in this group was significantly poorer (12.8 versus 22.3 months; P = 0.03).

CONCLUSIONS

Anti-PD-1 antibodies have limited efficacy in AM patients. Notably, patients with nail apparatus melanoma had poorer response and survival, making nail apparatus melanoma a strong candidate for further research on the efficacy of novel combination therapies with immune checkpoint inhibitors.

Pelvic organ cross-sensitization to enhance bladder and urethral pain behaviors in rats with experimental colitis

Neural cross-sensitization has been postulated as a mechanism underlying overlaps of chronic pelvic pain disorders such as bladder pain syndrome/interstitial cystitis (BPS/IC) and irritable bowel syndrome (IBS). Animals with experimental colitis have been used to study the underlying mechanisms for overlapped pelvic pain symptoms, and shown to exhibit bladder overactivity evidenced by frequent voiding; however, it has not directly been evaluated whether pain sensation derived from the lower urinary tract is enhanced in colitis models. Also, the cross-sensitization between the colon and urethra has not been studied previously. In the present study, we therefore investigated pain behaviors induced by nociceptive stimuli in the lower urinary tract and the involvement of C-fiber afferent pathways using rats with colitis induced by intracolonic application of 2,4,6-trinitrobenzenesulfonic acid (TNBS). In TNBS-induced colitis rats at 10 days, intravesical application of resiniferatoxin (RTx) induced a significantly greater number of episodes of both licking and freezing behaviors, which were reduced by capsaicin-sensitive C-fiber afferent desensitization. Histochemical studies using fluorescent dye tracers injected into the colon, bladder or urethra showed that dichotomized afferent neurons comprised 6.9-14.5% of L1, L6 and S1 dorsal root ganglion (DRG) neurons innervating the colon or the lower urinary tract. Transient receptor potential vanilloid 1 (TRPV1) mRNA expression was significantly increased in, the bladder, urethra and S1 DRG in colitis rats. An increase in myeloperoxidase (MPO) activity was found in the colon, but not in the bladder or urethra after intracolonic TNBS treatment. These results indicate that TNBS-induced colitis increased pain sensitivity in the bladder and urethra via activation of C-fiber afferent pathways due to colon-to-bladder and colon-to-urethral cross-sensitization, suggesting the contribution of pelvic organ cross-sensitization mechanisms to overlapped pain symptoms in BPS/IC and IBS.

Evaluation of genetic introgression from domesticated pigs into the Ryukyu wild boar population on Iriomote Island in Japan

We evaluated genetic introgression from domesticated pigs into the Ryukyu wild boar (RWB) population on Iriomote Island based on their genetic structure and diversity. We used a combination of mitochondrial DNA D-loop region (596 bp) polymorphisms and 23 microsatellite markers. RWBs (n = 130) were collected from 18 locations on Iriomote Island and compared with 66 reference samples of European and Asian domestic pigs. We identified six distinct haplotypes, involving 22 single nucleotide polymorphisms (including one insertion) in the RWB population. The phylogenetic tree had two branches: the RWB group and domestic lineage. Fourteen of 130 RWBs (10.8%) belonged to the European domestic lineage, including 11 RWBs from the Panari Islands, northwest of Iriomote Main Island (IMI). The heterozygosity values, total number of alleles, number of effective alleles and polymorphism information content of the RWB groups were lower than those of the European domestic groups. The RWB population on IMI had a lower heterozygous deficiency index (FIS = 0.059) than did the other populations, which indicates that this population was more inbred. There was a large genetic distance (FST = 0.560) between RWBs on IMI and the Meishan populations. Structure analysis using the 23 microsatellite markers revealed that 16 RWBs had an admixture pattern between RWB and domesticated pig breeds. These results suggest that gene flow may have occurred from domestic pigs to RWBs and demonstrate that there was low genetic variation in the IMI population.

Selective blockade of apoptosis by in vivo electroporation-mediated gene transfer combined with portal infusion of plasmid DNA attenuates liver cirrhosis

AIM

The purpose of the present study was to determine whether in vivo electroporation could achieve selective blockade of apoptosis in a rat liver cirrhosis model.

METHODS

A dimethylnitrosamine (DMN)-induced rat liver cirrhosis model was used. In vivo electroporation was performed after portal vein infusion of plasmid DNA. pFas-Fc plasmid DNA was used to block the apoptotic pathway. pUC/HGF and pCAGGS/EGFP were used as positive and negative controls, respectively. Liver collagen content was evaluated by hydroxyproline assay two weeks after gene transfer. Terminal deoxynucleotidyltransferase dUTP nick end-labeling was simultaneously performed in the liver to evaluate suppression of apoptosis. Survival analysis was performed using 10 rats that received the sFas gene, 10 that received the HGF gene, and 13 that received the GFP gene.

RESULTS

The apoptotic cell index in the DMN-injected liver was significantly lower in rats that received the sFas gene compared with the negative control. The collagen content of the DMN-injected liver was also lower in rats that received the sFas gene compared with the negative control. There was no significant difference in the apoptotic cell index and collagen content of rats that received the sFas and HGF genes. Ten weeks after the initiation of DMN treatment, the survival rates with the sFas, HGF, and GFP genes were 56%, 100%, and 0, respectively.

CONCLUSION

Selective blockade of apoptosis by in vivo electroporation-mediated gene transfer improved the apoptotic cell index, hydroxyproline content, and survival rate. Soluble Fas gene therapy using in vivo electroporation can be a safe and efficient therapy for liver cirrhosis in rats.

The effect of adaptive iterative dose reduction on image quality in 320-detector row CT coronary angiography

OBJECTIVE

To evaluate the effect of adaptive iterative dose reduction (AIDR) on image noise and image quality as compared with standard filtered back projection (FBP) in 320-detector row CT coronary angiography (CTCA).

METHODS

50 patients (14 females, mean age 68 ± 9 years) who underwent CTCA (100 kV or 120 kV, 400-580 mA) within a single heartbeat were enrolled. Studies were reconstructed with FBP and subsequently AIDR. Image noise, vessel contrast and contrast-to-noise ratio (CNR) in the coronary arteries were evaluated. Overall image quality for coronary arteries was assessed using a five-point scale (1, non-diagnostic; 5, excellent).

RESULTS

All the examinations were performed in a single heartbeat. Image noise in the aorta was significantly lower in data sets reconstructed with AIDR than in those reconstructed with FBP (21.4 ± 3.1 HU vs 36.9 ± 4.5 HU; p<0.001). No significant differences were observed between FBP and AIDR for the mean vessel contrast (HU) in the proximal coronary arteries. Consequently, CNRs in the proximal coronary arteries were higher in the AIDR group than in the FBP group (p<0.001). The mean image quality score was improved by AIDR (3.75 ± 0.38 vs 4.24 ± 0.38; p<0.001).

CONCLUSION

The use of AIDR reduces image noise and improves image quality in 320-detector row CTCA.

Reduction of the total injection volume of contrast material with a short injection duration in 64-detector row CT coronary angiography

The ability of short injection duration of contrast material to reduce the total injection volume in 64-detector row CT coronary angiography was investigated. 45 patients were divided into three groups: (i) those receiving 0.8 ml kg(-1) of contrast material (350 mgI ml(-1)) injected with a fixed duration of 14 s (Group A; n = 16); (ii) those receiving 0.8 ml kg(-1) of contrast material injected with a fixed duration of 10 s (Group B; n = 15); and (iii) those receiving 0.7 ml kg(-1) of contrast material injected with a fixed duration of 10 s (Group C; n = 14). All patients then received 20 ml of saline. Contrast densities of the ascending aorta and proximal and distal coronary arteries were assessed where vessel diameters were >2.0 mm. The mean enhancement value in the ascending aorta for Group B was significantly higher than that for Groups A and C (p<0.05), whereas there was no significant difference between Groups A and C. All enhancement values in the coronary arteries were higher than 250 Hounsfield units. The mean enhancement value for each coronary artery in Group B was significantly higher than that for Group A (p<0.05), whereas there was no significant difference between Groups A and C. In conclusion, a short injection duration allows a reduction in the total volume of contrast material from 0.8 ml kg(-1) to 0.7 ml kg(-1) while a steady contrast enhancement is maintained in the ascending aorta and coronary arteries.

[Serum HER-2 determination using a centauer HER-2/neu kit (CLIA method) in metastatic breast cancer]

Employing CLIA and EIA methods simultaneously, we determined serum HER-2/neu levels a total of 92 times in 51 patients with metastatic breast cancer(MBC)and 3 patients with non-recurrent breast cancer, and compared the levels measured by both methods with the level of IHC-staining for HER-2 and the clinical course. Among 20 patients with IHC HER-2/3+ MBC (including FISH+MBC), 14(70%)showed high levels by the CLIA method (>cut-off value of 15.2 ng/mL), whereas only 4(20%)revealed high levels by the EIA method(>cut-off value of 6.5 ng/mL). None of the patients with CR or non-recurrent breast cancer exhibited high levels by either method. Some IHC HER-2(-) patients also frequently showed high levels by the CLIA method. The EIA method not only revealed low-level sensitivity, but also was subject to interference(abnormally low levels)due to trastuzumab administration. The results obtained by the CLIA method were in agreement with the clinical course. In 93 MBC patients(except CR patients)whose serum HER-2 levels were determined by the CLIA method, the initial HER-2 levels were compared with the CEA and CA15-3 levels. Of the 32 IHC HER-2/3+ patients, 25, 13, and 12 were noted to have high serum levels of HER-2, CEA, and CA15-3, respectively. These results indicate that the serum HER-2 level as assessed by the CLIA method is the most sensitive marker of HER-2-positive MBC.

Depositional records of plutonium and (137)Cs released from Nagasaki atomic bomb in sediment of Nishiyama reservoir at Nagasaki

In a sediment core of Nishiyama reservoir at Nagasaki city, depth profiles of (240)Pu/(239)Pu isotopic ratio, (239+240)Pu and (137)Cs activities were determined. Sediments containing plutonium and (137)Cs, which were deposited immediately after a detonation of Nagasaki atomic bomb, were identified in the core. Observed below the sediments were macroscopic charcoals, providing evidence for initial deposit of the fallout of the Nagasaki atomic bomb. This is the first entire depositional records of plutonium and (137)Cs released from the Nagasaki atomic bomb together with those from atmospheric nuclear tests.

The inositol 1,4,5-trisphosphate receptor

Inositol 1,4,5-trisphosphate (InsP3) is a second messenger that releases Ca2+ from its intracellular stores. The InsP3 receptor has been purified and its cDNA has been cloned. We have found that the InsP3 receptor is identical to P400 protein, first identified as a protein enriched in cerebellar Purkinje cells. We have generated an L-fibroblast cell transfectant that produces cDNA-derived InsP3 receptors. The protein displays high affinity and specificity for InsP3. InsP3 induces greater Ca2+ release from membrane vesicles from transfected cells than from those from control L-fibroblasts. After incorporation of the purified InsP3 receptor into lipid bilayers InsP3-induced Ca2+ currents were demonstrated. These results suggest that the InsP3 receptor is involved in physiological Ca2+ release. Immunogold labelling using monoclonal antibodies against the receptor showed that it is highly concentrated on the smooth-surfaced endoplasmic reticulum and slightly on the outer nuclear membrane and rough endoplasmic reticulum; no labelling of Golgi apparatus, mitochondria and plasmalemma was seen. Cross-linking experiments showed that the receptor forms a homotetramer. The approximately 650 N-terminal amino acids are highly conserved between mouse and Drosophila, and this region contains the critical sequences for InsP3 binding. We have investigated the heterogeneity of the InsP3 receptor using the polymerase chain reaction and have found novel subtypes of the mouse InsP3 receptor that are expressed in a tissue-specific and developmentally specific manner.

Usefulness of saline pushing in reduction of contrast material dose in abdominal CT: evaluation of time–density curve for the aorta, portal vein and liver

The effects of saline pushing after contrast material injection were investigated as well as the possibility for this technique to reduce contrast material doses in liver CT examinations. 52 patients were divided randomly into three groups: 100 ml of contrast material (300 mg I ml(-1)) only (A; n = 19), 100 ml of contrast material pushed with 50 ml of saline solution (B; n = 17), and 85 ml of contrast material pushed with 50 ml of saline solution (C; n = 16). Single-level images were obtained at the level of the main portal vein after the initiation of contrast material injection. There were no significant differences in the mean peak enhancement values (PE) and the mean time to peak enhancement values (TPE) of the aorta between the three groups. The mean PE of the portal vein in group B increased 21 HU over that in group A (p<0.05), and there was no significant difference between groups A and C. The mean PE of the liver in group B increased 7 HU over that in group A (p<0.05), and there was no significant difference between groups A and C. The mean TPE of the portal vein was shorter by 4 s (p<0.05), and that of the liver was shorter by 5 s (p<0.05) in group C compared with those in group A. In conclusion, saline pushing increases the enhancement values of the portal vein and liver, and allows a contrast material dose reduction of 15 ml without decreasing hepatic and vascular enhancement at adequate scan timing.

Bronchoscopy-guided radiofrequency ablation as a potential novel therapeutic tool

The aim of the current study was to assess the safety of bronchoscopy-guided radiofrequency ablation (RFA) and compare the effectiveness between new internal cooled-RFA and standard noncooled-RFA. Normal lungs from sheep were used (n=6). Internal cooled-RFA and standard noncooled-RFA were set to assess the most suitable RFA conditions, such as power output, flow rate and ablation time. Internal cooled-RFA was then applied under the most optimal conditions of power output and flow rate for 15, 30, 60 and 120 s, and two water temperatures either room temperature (RT) water or cold water. Criteria for the most appropriate conditions were set over 15 s of ablation time and 50 degrees C of the tip's temperature. Internal cooled-RFA had no complications. Standard noncooled-RFA was complicated with bronchial bleeding after RFA. On the basis of the histological findings, average temperature and average output, the most appropriate conditions of the cooled-RFA were a power output of 30 W and flow rate of 30 or 40 mL.min(-1). The cooled-RFA using cold water caused a smaller, more discrete, lesion compared with that using RT water. Bronchoscopy-guided internal cooled-radiofrequency ablation was an effective, safe and feasible procedure that could become a potential therapeutic tool in managing lung pathology.

E3024, 3-but-2-ynyl-5-methyl-2-piperazin-1-yl-3,5-dihydro-4H-imidazo[4,5-d]pyridazin-4-one tosylate, is a novel, selective and competitive dipeptidyl peptidase-IV inhibitor

Dipeptidyl peptidase IV (DPP-IV) inhibitors are expected to become a useful new class of anti-diabetic agent. The aim of the present study is to characterize the in vitro and in vivo profile of E3024, 3-but-2-ynyl-5-methyl-2-piperazin-1-yl-3,5-dihydro-4H-imidazo[4,5-d]pyridazin-4-one tosylate, which is a novel imidazopyridazinone-derived DPP-IV inhibitor. E3024 inhibited recombinant human and mouse DPP-IV with IC50 values of approximately 100 nM. E3024 inhibited DPP-IV in human, mouse, rat and canine plasma with IC50 values of 140 to 400 nM. In contrast, E3024 did not inhibit DPP-8 or DPP-9 activity. Kinetic analysis indicated that E3024 is a competitive DPP-IV inhibitor. In Zucker fa/fa rats, E3024 (1 mg/kg) reduced glucose excursion after glucose load, with increases in plasma insulin and active glucagon-like peptide-1 levels. In fasted rats, this compound did not cause hypoglycemia. In a rat 4-week toxicological study, no notable changes were found at doses up to 750 mg/kg. The present preclinical studies indicate that E3024 is a novel selective DPP-IV inhibitor with anti-diabetic effects and a good safety profile.

Reaction mechanism and phospholipid structures of bovine heart cytochrome c oxidase

Bovine heart cytochrome c oxidase is a large multi-component membrane protein containing several phospholipids. X-ray structures of this enzyme at high resolution, determined recently, show a trigonal planar structure of CuB site in the O2 reduction site, which could contribute critically to the four-electron reduction of O2 bound at haem a3, and a hydrogen bond network, through which the proton pump is driven by haem a. The possible roles of phospholipids in the enzyme functions are discussed.

Virtual CT colectomy by three-dimensional imaging using multidetector-row CT for laparoscopic colorectal surgery

Laparoscopic colorectal surgery has been attracting attention for its capacity to improve the quality of life (QOL) of patients. However, there are disadvantages to this approach, namely, it is difficult to obtain an image of the entire view of the operative field, and organs and lesions cannot be manipulated directly by the surgeon during surgery. For this reason, it takes a relatively large amount of time to ligate vessel, which can vary between patients. Furthermore, vessels and organs can be damaged during lymph nodes dissection under laparoscopic guidance, leading to heavy bleeding that prevents the surgeon from having access to a good view of the operative field. Then, to assess preoperatively the vascular anatomy, we carried out multiphase, contrast-enhanced examinations using multidetector-row CT (MDCT) on patients with colorectal cancer, and prepared the fused image of 3D images of arteries, veins, the colorectum, organs, and tumor. We called the utilization of 3D imaging virtual CT colectomy, which contributed to rapid and safe manipulation of the origins of the arteries and the veins, as well as lymph nodes dissection, without incurring injury to the involved arteries and veins.

Effect of saline pushing after contrast material injection in abdominal multidetector computed tomography with the use of different iodine concentrations

PURPOSE

To investigate whether saline pushing after contrast material improves hepatic vascular and parenchymal enhancement, and to determine whether this technique permits decreased contrast material concentration.

MATERIAL AND METHODS

120 patients who underwent hepatic multidetector computed tomography were divided randomly into four groups (Groups A-D): receiving 100 ml of contrast material (300 mgI/ml) only (A) or with 50 ml of saline solution (B); or 100 ml of contrast material (350 mgI/ml) only (C) or with 50 ml of saline solution (D). Computed tomography (CT) values of the aorta in the arterial phase, the portal vein in the portal venous inflow phase, and the liver in the hepatic phase were measured. Visualization of the hepatic artery and the portal vein by 3D CT angiography was evaluated as well.

RESULTS

Although the enhancement values of the aorta were not improved significantly with saline pushing, they continued at a high level to the latter slices with saline pushing. The enhancement value of the portal vein increased significantly and CT portography was improved with saline pushing. The enhancement value of the liver was not improved significantly using saline pushing. In a comparison between groups B and C, the enhancement values of the aorta and portal vein and the visualization of CT arteriography and portography were not statistically different.

CONCLUSION

The saline pushing technique can contribute to a decrease in contrast material concentration for 3D CT arteriography and portography.

Preoperative measurement of the intrathrombotic pressure of a thrombosed popliteal artery aneurysm for decision of surgical indication

To evaluate the risk of rupture of a 77 mm thrombosed popliteal artery aneurysm (PAA) in an 82-year-old woman, the aneurysm was percutaneously punctured and the intrathrombotic pressure (ITP) was measured preoperatively. The percentage of the mean ITP to the mean brachial artery pressure was 80%. The aneurysm was judged to have the risk of rupture, and replacement with a prosthetic graft was performed. The percentages of the mean ITP to the mean radial artery pressure and to the mean femoral artery pressure measured intraoperatively were 83% and 71%, respectively, which approximated to the percentage measured preoperatively. PAA may have the risk of rupture even though thrombosed, and preoperative measurement of the ITP might be useful to decide surgical indication.

The effect of gamma-tocopherol administration on alpha-tocopherol levels and metabolism in humans

BACKGROUND

The bioavailability of gamma-tocopherol and metabolites of vitamin E after gamma-tocopherol administration is not well understood. We investigated the effect of gamma-tocopherol administration on the levels and metabolism of alpha- and gamma-tocopherol in healthy volunteers.

METHODS

We measured two metabolites of vitamin E (2,5,7,8-tetramethyl-2-(2'-carboxyethyl)-6-hydroxychroman (alpha-CEHC) and 2,7,8-trimethyl-2-(2'-carboxyethyl)-6-hydroxychroman (gamma-CEHC)) in plasma and urine by high-performance liquid chromatography with electrochemical detection (HPLC-ECD) during administration of gamma-tocopherol. Two groups of volunteers were enrolled. The gamma-tocopherol group received two gamma-tocopherol capsules (each containing 186.4 mg of gamma-tocopherol and 5 mg of alpha-tocopherol) for 28 days, while the control group received d-alpha-tocopherol at 5 mg/day, which was the same dose as that given to the gamma-tocopherol group. Blood and urine samples were obtained on days 0, 14, 28, 35, 42, and 56 after the initiation of gamma-tocopherol administration.

RESULTS

The plasma gamma-tocopherol concentration increased markedly during administration of gamma-tocopherol and the plasma gamma-CEHC concentration increased along with that of gamma-tocopherol. The plasma alpha-tocopherol concentration decreased significantly during gamma-tocopherol administration. The plasma concentration of alpha-CEHC decreased significantly and urinary excretion of alpha-CEHC tended to increase in the gamma-tocopherol group. Urinary sodium secretion was significantly increased at 1 week after the cessation of gamma-tocopherol administration, but there was no significant difference of urine volume between the two groups.

CONCLUSION

Metabolism of alpha-tocopherol is accelerated and the plasma alpha-tocopherol concentration is decreased during gamma-tocopherol administration.