Cuban Policosanol (Raydel®) Potently Protects the Liver, Ovary, and Testis with an Improvement in Dyslipidemia in Hyperlipidemic Zebrafish: A Comparative Study with Three Chinese Policosanols

Many policosanols from different sources, such as sugar cane and rice bran, have been marketed worldwide to improve blood lipid profiles. But so far, no comparative study has commenced elucidating the effect of different policosanols to improve the blood lipid profile and other beneficial effects. This study compared the efficacy of four different policosanols, including one sugar cane wax alcohol from Cuba (Raydel®) and three policosanols from China (Xi'an Natural sugar cane, Xi'an Realin sugar cane, and Shaanxi rice bran), to treat dyslipidemia in hyperlipidemic zebrafish. After 12 weeks of consumption of each policosanol (final 0.1% in diet, wt/wt) and a high-cholesterol diet (HCD, final 4%, wt/wt), the Raydel policosanol group and the Xi'an Natural policosanol group showed the highest survivability, of approximately 81%. In contrast, the Xi'an Realin policosanol and the Shaanxi policosanol groups showed 57% and 67% survivability, respectively. Among the five HCD groups, the Raydel policosanol group showed the lowest serum total cholesterol (TC, p < 0.001 versus HCD control) and triglyceride (p < 0.001 versus HCD control), with the highest percentage of high-density lipoproteins-cholesterol in TC. The Raydel policosanol group also showed the lowest serum aspartate aminotransferase and alanine aminotransferase levels, with the least infiltration of inflammatory cells and interleukin-6 production in hepatocytes with a marked reduction in reactive oxygen species (ROS) production and fatty liver changes. In the ovary, the Raydel policosanol group also showed the highest content of mature vitellogenic oocytes with the lowest production of reactive oxygen species and cellular apoptosis in ovarian cells. In the testes, the Raydel policosanol group also showed the healthiest morphology for spermatogenesis, with the lowest interstitial area and reactive oxygen species production in testicular cells. Conclusively, among the tested policosanols, Cuba (Raydel®) policosanol exhibited a comparatively better effect in maintaining zebrafish body weight, survivability, blood lipid profile, hepatic function biomarkers, fatty liver changes, ROS generation, inflammation, and restoration of the cell morphology in ovaries and testes affected by the HCD consumption.

Cuban Sugar Cane Wax Alcohol Exhibited Enhanced Antioxidant, Anti-Glycation and Anti-Inflammatory Activity in Reconstituted High-Density Lipoprotein (rHDL) with Improved Structural and Functional Correlations: Comparison of Various Policosanols

Policosanols from various sources, such as sugar cane, rice bran, and insects, have been marketed to prevent dyslipidemia, diabetes, and hypertension by increasing the blood high-density lipoproteins cholesterol (HDL-C) levels. On the other hand, there has been no study on how each policosanol influences the quality of HDL particles and their functionality. Reconstituted high-density lipoproteins (rHDLs) with apolipoprotein (apo) A-I and each policosanol were synthesized using the sodium cholate dialysis method to compare the policosanols in lipoprotein metabolism. Each rHDL was compared regarding the particle size and shape, antioxidant activity, and anti-inflammatory activity in vitro and in zebrafish embryos. This study compared four policosanols including one policosanol from Cuba (Raydel^® policosanol) and three policosanols from China (Xi'an Natural sugar cane, Xi'an Realin sugar cane, and Shaanxi rice bran). The synthesis of rHDLs with various policosanols (PCO) from Cuba or China using a molar ratio of 95:5:1:1 with palmitoyloleoyl phosphatidylcholine (POPC): free cholesterol (FC): apoA-I:PCO (wt:wt) showed that rHDL containing Cuban policosanol (rHDL-1) showed the largest particle size and the most distinct particle shape. The rHDL-1 showed a 23% larger particle diameter and increased apoA-I molecular weight with a 1.9 nm blue shift of the maximum wavelength fluorescence than rHDL alone (rHDL-0). Other rHDLs containing Chinese policosanols (rHDL-2, rHDL-3, and rHDL-4) showed similar particle sizes with an rHDL-0 and 1.1-1.3 nm blue shift of wavelength maximum fluorescence (WMF). Among all rHDLs, the rHDL-1 showed the strongest antioxidant ability to inhibit cupric ion-mediated LDL oxidation. The rHDL-1-treated LDL showed the most distinct band intensity and particle morphology compared with the other rHDLs. The rHDL-1 also exerted the highest anti-glycation activity to inhibit the fructose-mediated glycation of human HDL₂ with the protection of apoA-I from proteolytic degradation. At the same time, other rHDLs showed a loss of anti-glycation activity with severe degradation. A microinjection of each rHDL alone showed that rHDL-1 had the highest survivability of approximately 85 ± 3%, with the fastest developmental speed and morphology. In contrast, rHDL-3 showed the lowest survivability, around 71 ± 5%, with the slowest developmental speed. A microinjection of carboxymethyllysine (CML), a pro-inflammatory advanced glycated end product, into zebrafish embryos resulted in severe embryo death of approximately 30 ± 3% and developmental defects with the slowest developmental speed. On the other hand, the phosphate buffered saline (PBS)-injected embryo showed 83 ± 3% survivability. A co-injection of CML and each rHDL into adult zebrafish showed that rHDL-1 (Cuban policosanol) induced the highest survivability, around 85 ± 3%, while rHDL-0 showed 67 ± 7% survivability. In addition, rHDL-2, rHDL-3, and rHDL-4 showed 67 ± 5%, 62 ± 37, and 71 ± 6% survivability, respectively, with a slower developmental speed and morphology. In conclusion, Cuban policosanol showed the strongest ability to form rHDLs with the most distinct morphology and the largest size. The rHDL-containing Cuban policosanol (rHDL-1) showed the strongest antioxidant ability against LDL oxidation, anti-glycation activity to protect apoA-I from degradation, and the highest anti-inflammatory activity to protect embryo death under the presence of CML.

Drop-casted Platinum Nanocube Catalysts for Hydrogen Evolution Reaction with Ultrahigh Mass Activity

Platinum hydrogen evolution reaction (HER) electrocatalysts in the form of nanocubes (NCs) were synthesized at 50 °C by aqueous-based colloidal synthesis and were applied to electrochemical (EC) and photoelectrochemical (PEC) systems by a fast and simple drop-casting method. A remarkable Pt mass activity of 1.77 A mg^-1 at -100 mV was achieved in EC systems (fluorine-doped tin oxide/Pt NC cathode) with neutral electrolyte while maintaining low overpotential and Tafel slope. In the Cu(In,Ga)(S,Se)₂ (CIGS)-based PEC system, a carefully chosen amount of Pt NC loading to achieve a compromise between the catalytic activity (more Pt NCs) and better light transmittance (fewer Pt NCs) led to a maximum onset potential of 0.678 V against the reference hydrogen electrode. The photoelectrodes with Pt NCs also exhibited good long-term operational stability over 9.5 h with negligible degradation of the photocurrent. This study presents an effective strategy to greatly reduce the use of expensive Pt without compromising the catalytic performance because the drop-casting of Pt NC solutions to form electrocatalysts is expected to waste less raw material than vacuum deposition.

Prenylflavonoids isolated from Macaranga tanarius stimulate odontoblast differentiation of human dental pulp stem cells and tooth root formation via the mitogen-activated protein kinase and protein kinase B pathways

AIM

To identify odontogenesis-promoting compounds and examine the molecular mechanism underlying enhanced odontoblast differentiation and tooth formation.

METHODOLOGY

Five different nymphaeols, nymphaeol B (NB), isonymphaeol B (INB), nymphaeol A (NA), 3'-geranyl-naringenin (GN) and nymphaeol C (NC) were isolated from the fruit of Macaranga tanarius. The cytotoxic effect of nymphaeols on human DPSCs was observed using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The effect of nymphaeols on odontoblast differentiation was analysed with Alizarin Red S staining and odontoblast marker expression was assessed using real-time polymerase chain reaction and Western blot analysis. The molecular mechanism was investigated with Western blot analysis. In order to examine the effect of INB on dentine formation in the developing tooth germ, INB-soaked beads were placed under the tooth bud explants in the collagen gel; thereafter, the tooth bud explant-bead complexes were implanted into the sub-renal capsules for 3 weeks. Tooth root formation was analysed using micro-computed tomography and histological analysis. Data are presented as mean ± standard error (SEM) values of three independent experiments, and results are compared using a two-tailed Student's t-test. The data were considered to have statistical significance when the P-value was less than 0.05.

RESULTS

Three of the compounds, NB, INB, and GN, did not exert a cytotoxic effect on human DPSCs. However, INB was most effective in promoting the deposition of calcium minerals in vitro (P < 0.001) and induced the expression of odontogenic marker genes (P < 0.05). Moreover, this compound strongly induced the phosphorylation of mitogen-activated protein (MAP) kinases and protein kinase B (AKT) (P < 0.05). The inhibition of p38 MAP, c-Jun N-terminal kinase (JNK), and AKT substantially suppressed the INB-induced odontoblast differentiation (P < 0.001). In addition, isonymphaeol B significantly induced the formation of dentine and elongation of the tooth root in vivo (P < 0.05).

CONCLUSIONS

Prenylflavonoids, including INB, exerted stimulatory effects on odontoblast differentiation and tooth root and dentine formation via the MAP kinase and AKT signalling pathways. These results suggest that nymphaeols could stimulate the repair processes for dentine defects or injuries.

Gold Nanoparticle-Enhanced and Roll-to-Roll Nanoimprinted LSPR Platform for Detecting Interleukin-10

Localized surface plasmon resonance (LSPR) is a powerful platform for detecting biomolecules including proteins, nucleotides, and vesicles. Here, we report a colloidal gold (Au) nanoparticle-based assay that enhances the LSPR signal of nanoimprinted Au strips. The binding of the colloidal Au nanoparticle on the Au strip causes a red-shift of the LSPR extinction peak, enabling the detection of interleukin-10 (IL-10) cytokine. For LSPR sensor fabrication, we employed a roll-to-roll nanoimprinting process to create nanograting structures on polyethylene terephthalate (PET) film. By the angled deposition of Au on the PET film, we demonstrated a double-bent Au structure with a strong LSPR extinction peak at ~760 nm. Using the Au LSPR sensor, we developed an enzyme-linked immunosorbent assay (ELISA) protocol by forming a sandwich structure of IL-10 capture antibody/IL-10/IL-10 detection antibody. To enhance the LSPR signal, we introduced colloidal Au nanocube (AuNC) to be cross-linked with IL-10 detection antibody for immunogold assay. Using IL-10 as a model protein, we successfully achieved nanomolar sensitivity. We confirmed that the shift of the extinction peak was improved by 450% due to plasmon coupling between AuNC and Au strip. We expect that the AuNC-assisted LSPR sensor platform can be utilized as a diagnostic tool by providing convenient and fast detection of the LSPR signal.

Natural allelic variation of GVS1 confers diversity in the regulation of leaf senescence in Arabidopsis

Leaf senescence affects plant fitness. Plants that evolve in different environments are expected to acquire distinct regulations of leaf senescence. However, the adaptive and evolutionary roles of leaf senescence are largely unknown. We investigated leaf senescence in 259 natural accessions of Arabidopsis by quantitatively assaying dark-induced senescence responses using a high-throughput chlorophyll fluorescence imaging system. A meta-analysis of our data with phenotypic and climatic information demonstrated biological and environmental links with leaf senescence. We further performed genome-wide association mapping to identify the genetic loci underlying the diversity of leaf senescence responses. We uncovered a new locus, Genetic Variants in leaf Senescence (GVS1), with high similarity to reductase, where a single nonsynonymous nucleotide substitution at GVS1 mediates the diversity of the senescence trait. Loss-of-function mutations of GVS1 in Columbia-0 delayed leaf senescence and increased sensitivity to oxidative stress, suggesting that this GVS1 variant promotes optimal responses to developmental and environmental signals. Intriguingly, gvs1 loss-of-function mutants display allele- and accession-dependent phenotypes, revealing the functional diversity of GVS1 alleles not only in leaf senescence, but also oxidative stress. Our discovery of GVS1 as the genetic basis of natural variation in senescence programs reinforces its adaptive potential in modulating life histories across diverse environments.

Initial Experience With Hand-Assisted Laparoscopic Living Donor Nephrectomy: Training and Clinical Practice as a General Surgeon

BACKGROUND

To analyze our initial results of hand-assisted laparoscopic living donor nephrectomy, executed by a skilled gastrointestinal surgeon.

METHODS

A total of 22 consecutive patients underwent the hand-assisted laparoscopic living donor nephrectomy between December 2014 and January 2017. We retrospectively analyze the patient's perioperative clinical data, which were collected prospectively.

RESULTS

The right kidney was harvested in 12 patients. The mean operative time and intraoperative blood loss was 241.0 ± 43.4 minutes (range, 140-310 min) and 293.2 ± 203.1 mL (range, 50-700 mL), respectively. The mean warm ischemic time was 288.4 ± 103.4 seconds (range, 179-610 s). Postoperative complications included chyle leakage in 2 patients who were left kidney donors and oliguria in 1 patient who was a right kidney donor. All patients recovered with conservative care, and the mean hospital stay was 7.5 ± 1.7 days. The mean creatinine level was 0.7 ± 0.2 mg/dL before surgery, 1.1 ± 0.3 mg/dL at postoperative day (POD) 1, and 1.0 ± 0.2 mg/dL after discharge. The mean glomerular filtration rate was 97.9 ± 18.2 mL/min/1.73 m² before surgery, 60.7 ± 10.4 at POD 1, and 67.3 ± 11.1 after discharge. Operation time was not associated with patient body mass index and case number. No significant differences, other than postoperative complications, were found in the perioperative data for the side of kidney donation.

CONCLUSION

A skilled surgeon with experience in laparoscopic abdominal surgery (such as gastrectomy or colectomy) might safely perform hand-assisted donor nephrectomy. However, we could not identify a clear case number to complete the learning curve.

Characteristics of Adrenal Incidentalomas in a Large, Prospective Computed Tomography-Based Multicenter Study: The COAR Study in Korea

PURPOSE

Previous studies on adrenal incidentalomas (AIs) are limited by their retrospective design, small numbers of patients, Western populations, or use of an outdated imaging technique. We investigated the characteristics of AIs in Korean patients and compared them with those reported in the largest retrospective study in Italy to discover the effects of improved imaging techniques and ethnicity differences.

MATERIALS AND METHODS

This was a prospective, multicenter, cross-sectional observational study including 1005 Korean patients. Levels of plasma adrenocorticotrophic hormone, 24-h urinary free cortisol (UFC), serum cortisol after a 1 mg-dexamethasone suppression test, 24-h urinary fractionated metanephrine, and plasma aldosterone and plasma renin activity were measured. All AIs were characterized using computed tomography (CT).

RESULTS

Compared with the results of the Italian study, AIs in Korean patients were observed more frequently in men and predominantly on the left side. Korean patients with AIs were slightly younger, and fewer patients underwent surgery. Most AIs were nonfunctional in both studies, while fewer subclinical hypercortisolism and more primary aldosteronism (PA) cases were detected in Korean patients. In our study, high UFC levels showed very low sensitivity, compared to those in the Italian study. In pheochromocytoma or PA cases, there were no hormonal differences between the studies. AIs in Korean patients were smaller, such that a lower cutoff size for detecting adrenocortical carcinoma (ACC) could be warranted.

CONCLUSION

Recent advances in CT technology were leveraged to provide accurate characteristics of AIs and to detect smaller ACCs.

Cycloplegic Refraction in Hyperopic Children: Effectiveness of a 0.5% Tropicamide and 0.5% Phenylephrine Addition to 1% Cyclopentolate Regimen

Purpose

To evaluate the effectiveness of a cycloplegic regimen using 0.5% tropicamide and 0.5% phenylephrine (Tropherine, Hanmi Pharm), in addition to 1% cyclopentolate, in hyperopic children.

Methods

The medical records of hyperopic patients below the age of 14 years who had undergone cycloplegic retinoscopy were retrospectively reviewed. Cycloplegic refractions were performed using one of two cycloplegic regimens. Regimen 1 was a Tropherine-added regimen comprising the administration of one drop of 1% cyclopentolate followed by two to three drops of Tropherine added at 15-minute intervals. Regimen 2 was a cyclopentolate-only regimen comprising the administration of three to four drops of 1% cyclopentolate at 15-minute intervals. The mean difference between noncycloplegic and cycloplegic refraction was compared between the two regimens.

Results

A total of 308 eyes of 308 hyperopic children were included. The mean difference (±standard deviation) in the spherical equivalent (SE) between cycloplegic and noncycloplegic refraction was significantly larger in regimen 2 than in regimen 1, with values of +1.70 ± 1.03 diopters (D) and +1.25 ± 0.89 D, respectively (p=0.001). The SE change after cycloplegia was significantly different between the two regimens only in patients aged 5 years or younger (p=0.001), particularly in those with high hyperopia with an SE ≥5 D (p=0.005) or fully accommodative esotropia (p=0.009). There was no significant difference between the two regimens in patients older than 5 years, regardless of the presence of high hyperopia or fully accommodative esotropia.

Conclusions

The Tropherine-added regimen exerted a weaker cycloplegic effect than the cyclopentolate-only regimen, particularly in children under the age of 5 years with high hyperopia or fully accommodative esotropia. However, the difference in refraction between the two regimens was small. A Tropherine-added regimen can be effective in hyperopic children, with less associated discomfort than the instillation of cyclopentolate.

High-Throughput and Computational Study of Leaf Senescence through a Phenomic Approach

Leaf senescence is influenced by its life history, comprising a series of developmental and physiological experiences. Exploration of the biological principles underlying leaf lifespan and senescence requires a schema to trace leaf phenotypes, based on the interaction of genetic and environmental factors. We developed a new approach and concept that will facilitate systemic biological understanding of leaf lifespan and senescence, utilizing the phenome high-throughput investigator (PHI) with a single-leaf-basis phenotyping platform. Our pilot tests showed empirical evidence for the feasibility of PHI for quantitative measurement of leaf senescence responses and improved performance in order to dissect the progression of senescence triggered by different senescence-inducing factors as well as genetic mutations. Such an establishment enables new perspectives to be proposed, which will be challenged for enhancing our fundamental understanding on the complex process of leaf senescence. We further envision that integration of phenomic data with other multi-omics data obtained from transcriptomic, proteomic, and metabolic studies will enable us to address the underlying principles of senescence, passing through different layers of information from molecule to organism.

Influence of anatomic position and intraoperative exposure of the inferior alveolar nerve on neurosensory disturbance after sagittal split ramus osteotomy: a three-dimensional computed tomography study

OBJECTIVE

To evaluate the influence of the anatomic position and intraoperative exposure of the inferior alveolar nerve on neurosensory disturbance (NSD) in sagittal split ramus osteotomy.

STUDY DESIGN

The anatomic factors of the nerve were measured on preoperative three-dimensional computed tomography in 98 patients. The intraoperative nerve exposure was assessed. NSD was evaluated for 1 year after surgery. The correlations between NSD and the factors were analyzed.

RESULTS

The NSD decreased as the lateral marrow space from the nerve increased (P < .01). The complete nerve exposure increased NSD by 7.6 times (P = .01). The nerve exposure increased as the buccal plate thickness increased (P = .01) and decreased as the vertical marrow space from the nerve increased (P = .01).

CONCLUSIONS

The nerve exposure and the lateral marrow space from the nerve affected NSD. The buccal plate thickness and the vertical marrow space indirectly affected NSD through nerve exposure.

Web-Based Malignancy Risk Estimation for Thyroid Nodules Using Ultrasonography Characteristics: Development and Validation of a Predictive Model

BACKGROUND

To establish a practical and simplified method for analyzing thyroid nodules in a clinical setting, the development of a new practical prediction model was required. This study aimed to construct and validate a simple and reliable web-based predictive model using the ultrasonography characteristics of thyroid nodules to stratify the risk of malignancy.

METHODS

To analyze ultrasonography images, radiologists were asked to assess thyroid nodules according to the following criteria: internal content, echogenicity of the solid portion, shape, margin, and calcifications. Multivariate logistic regression was performed to predict whether nodules were diagnosed as malignant or benign. The developmental data set included 849 nodules (January-June 2003). The validation set included different data (n = 453, June 2008-February 2009).

RESULTS

Ultrasonography features, including solid content, taller-than-wide shape, spiculated margin, ill-defined margin, hypoechogenicity, marked hypoechogenicity, microcalicifications, and rim calcifications, were selected as predictors for malignant nodules in the development set. A 14-point risk scoring system was developed. Malignancy risk ranged from 3.8% to 97.4%, and the risk of malignancy was positively associated with increases in risk scores. The areas under the receiver operating characteristic curve of the development and validation sets were 0.903 and 0.897, respectively.

CONCLUSION

A simple and reliable web-based predictive model was designed using ultrasonography characteristics to stratify thyroid nodules according to the probability of malignancy.

Nosocomial empyema caused by a rare serotype, serotype 4c, of Listeria monocytogenes in a patient with rheumatoid arthritis and chronic kidney disease: A case report and review of the literature

The intracellular pathogen Listeria monocytogenes presents characteristically as meningoencephalitis and bacteremia. Herein, we report an extremely rare case of empyema caused by serotype 4c L. monocytogenes in an immunocompromised patient. This case supports the inclusion of L. monocytogenes infection in the differential diagnosis of empyema in an immunocompromised patient.

Comparative efficacy of radiofrequency and laser ablation for the treatment of benign thyroid nodules: systematic review including traditional pooling and bayesian network meta-analysis

PURPOSE

To compare the efficacy of radiofrequency ablation (RFA) and laser ablation (LA) for treatment of benign solid thyroid nodules, using a systematic review including traditional pooling and Bayesian network meta-analysis.

MATERIALS AND METHODS

A comprehensive literature search in PubMed-MEDLINE, EMBASE, and the Cochrane Library databases identified prospective studies evaluating the percentage mean change [absolute mean change (mL)] in nodule volume after RFA or LA. Studies from January 1, 2000, to November 1, 2013, were included. Review of 128 potential papers, including a full-text review of 33, identified 10 eligible papers covering a total of 184 patients for meta-analysis. The percentage mean change [absolute mean change] in nodule volume over a 6-month follow-up was compared between RFA and LA.

RESULTS

Based on the traditional frequentist approach, the pooled percentage mean changes (95% confidence interval) of RFA and LA were 76.1% (70.1-82.1) and 49.9% (41.4-58.5), respectively, and the pooled absolute mean changes (95% confidence interval) of RFA and LA were 8.9 mL (6.6-11.2) and 5.2 mL (4.3-6.1), respectively. Based on the Bayesian network meta-analysis, RFA achieved a larger pooled percentage mean change (95% credible interval) and absolute mean change (95% credible interval) compared to LA [77.8% (67.7-88.0) vs 49.5% (26.7-72.4), and 9.2 mL (5.8-11.9) vs 5.3 mL (2.1-8.5), respectively]. The RFA group has the highest probability of having the most efficacious treatment (98.7%). There were no major complications after either RFA or LA.

CONCLUSIONS

RFA appears to be superior to LA in reducing benign solid thyroid nodule volume, despite the smaller number of treatment sessions without major side effects.

SUMOylation of nonstructural 5A protein regulates hepatitis C virus replication

Viruses exploit cellular SUMOylation machinery to favour their own propagation. We show that NS5A is a target protein of small ubiquitin-like modifier (SUMO) and is SUMOylated at lysine residue 348. We demonstrated that SUMOylation increased protein stability of NS5A by inhibiting ubiquitylation, and SUMOylation was also required for protein interaction with NS5B. These data imply that SUMO modification may contribute to HCV replication. Indeed, silencing of UBC9 impaired HCV replication in Jc1-infected cells, and HCV replication level was also significantly reduced in SUMO-defective subgenomic replicon cells. Taken together, these data indicate that HCV replication is regulated by SUMO modification of NS5A protein. We provide evidence for the first time that HCV exploits host cellular SUMO modification system to favour its own replication.

Dual nanoparticle amplified surface plasmon resonance detection of thrombin at subattomolar concentrations

A novel dual nanoparticle amplification approach is introduced for the enhanced surface plasmon resonance (SPR) detection of a target protein at subattomolar concentrations. Thrombin was used as a model target protein as part of a sandwich assay involving an antithrombin (anti-Th) modified SPR chip surface and a thrombin specific DNA aptamer (Th-aptamer) whose sequence also includes a polyadenine (A30) tail. Dual nanoparticle (NP) enhancement was achieved with the controlled hybridization adsorption of first polythymine-NP conjugates (T20-NPs) followed by polyadenine-NPs (A30-NPs). Two different nanoparticle shapes (nanorod and quasi-spherical) were explored resulting in four different NP pair combinations being directly compared. It was found that both the order and NP shape were important in optimizing the assay performance. The use of real-time SPR measurements to detect target concentrations as low as 0.1 aM is a 10-fold improvement compared to single NP-enhanced SPR detection methods.

A Study Design to Evaluate Association between Smoking and Intracranial Atherosclerotic Stenosis

Purpose

Smoking is a well known risk factor for stroke. The cerebral arteries may be uniquely susceptible to the atherosclerotic effects of smoking, such that it has a different risk profile for stroke compared with other atherosclerosis risk factors. It remains uncertain whether smoking is associated specifically with intracranial (IC) or extracranial (EC) atherosclerotic cerebrovascular disease. The aim of this study design will be to evaluate the association between smoking and severe IC stenosis, adjusting for other atherosclerosis risk factors, particularly age distribution.

Study design

This is a retrospective cohort study design. Participants are patients (n=1714) with severe atherosclerotic stenosis undergoing cerebral catheter angiography because of stroke or transient ischaemic attack. All atherosclerotic steno-occlusive lesions are described in terms of location (anterior versus posterior circulation, IC versus EC, or intradural versus extradural). The atherosclerotic or stroke risk factors for analysis include age, gender, smoking history, number of lesions (single versus multiple), cardiac disease, diabetes mellitus, hypertension, family history, dyslipidemia, history of previous stroke, alcohol intake, metabolic syndrome and body mass index. Statistical analysis includes univariate analysis followed by multivariate logistic regression. The relationship between IC atherosclerotic stenosis and smoking will be assessed. Differences in risk factor distribution is analysed according to age at intervals of 10 years. Significant risk factors associated with IC atherosclerotic stenosis will also be assessed by multivariate logistic regression analysis.

Summary

This is an analytical study design that intends to measure the association between IC or EC atherosclerotic stenosis and smoking and other risk factors. We anticipate that it will have the power to detect any relationship between smoking and IC atherosclerotic lesions especially in younger patients.

Survival outcomes of different treatment methods for the ipsilateral breast of occult breast cancer patients with axillary lymph node metastasis: a single center experience

Purpose

This study compared the survival outcomes of different treatment methods for the ipsilateral breast of occult breast cancer (OBC) patients with axillary lymph node metastasis.

Methods

A retrospective study was conducted in which forty OBC patients with axillary lymph node metastasis were identified out of 15,029 patients who had been diagnosed with a primary breast cancer at between 1992 and 2010. The patients were categorized into three treatment groups based on ipsilateral breast management: breast-conserving surgery (BCS) (n=17), mastectomy (n=12), and nonsurgical intervention with or without radiation therapy (No surgery with or without radiation therapy [No Op±RT]) (n=11). All patients underwent axillary lymph node dissection. Cases were evaluated based on treatment and potential prognostic factors with respect to overall survival (OS) and disease-free survival (DFS).

Results

During the follow-up period (median follow-up of 71.5 months), the overall OS and DFS were 76.9% and 74.9%, respectively. The 5-year treatment-specific OS was 72.0% for the BCS group, 74.0% for the mastectomy group, and 87.5% for the No Op±RT group (log-rank p=0.49). The 5-year DFS was 70.6% for the BCS group, 66.7% for the mastectomy group, and 90.9% for the No Op±RT group (log-rank p=0.36). Recurrence rates for the BCS and No Op±RT groups were 5.9% and 18.2%, respectively. Histologic grade and lymph node status were inversely correlated with DFS (log-rank p=0.04 and p<0.01, respectively).

Conclusion

There was no difference in survival outcomes between the three treatment methods for the ipsilateral breast (mastectomy, BCS, and No Op±RT) of OBC patients with axillary lymph node metastasis. A large-scale multicenter study is needed to validate the results from this small retrospective study.

Ultrasensitive and ultrawide range detection of a cardiac biomarker on a surface plasmon resonance platform

One of the main challenges in the development of new analytical platforms for ultrasensitive bioaffinity detection is jointly achieving a wide dynamic range in target analyte concentration, especially for approaches that rely on multistep processes as a part of the signal amplification mechanism. In this paper, a new surface-based sandwich assay is introduced for the direct detection of B-type natriuretic peptide (BNP), an important biomarker for cardiac failure, at concentrations ranging from 1 aM to 500 nM. This was achieved using nanoparticle-enhanced surface plasmon resonance (SPR) where a DNA aptamer is immobilized on a chemically modified gold surface in conjunction with the specific adsorption of antiBNP coated gold nanocubes in the presence of the biomarker target. A concentration detection range greater than eleven orders of magnitude was achieved through dynamic control of only the secondary nanoparticle probe concentration. Furthermore, detection at low attomolar concentrations was also achieved in undiluted human serum.

Establishment of isolation and expansion protocols for human cardiac C-kit-positive progenitor cells for stem cell therapy

Although cardiac stem cells (CSCs) have emerged in regeneration research, the number of isolated CSCs is low, making a sufficient supply of functional elements an important consideration in cardiovascular research. In this study, we established an efficient method for CSC isolation. We directly compared cultures of single cells to human cardiac-derived c-kit-positive progenitor cells (hCPCs(c-kit+)). The two protocols employed enzymatically digested hCPCs(c-kit+) (ED-hCPCs) with tissue-expanded hCPC(c-kit+) (TE-hCPCs). Using fluorescence-activated cell sorting, we showed the concentration of c-kit in TE-hCPCs to be higher than in ED-hCPCs, although the total number of c-kit positive cells resulting from ED-hCPCs was similar to that resulting from TE-hCPCs. The cardiomyocyte-associated proteins, GATA4 and Nkx2-5, which were expressed during hCPCs expansion, did not differ between the isolation methods. Importantly, the expression of the CSC stem cell marker, c-kit, was more efficiently preserved using the ED-hCPCs versus the TE-hCPCs method. In a cell proliferation assay, the ED-hCPCs method produced a significantly greater number of cells. Finally, hCPCs derived using both protocols differentiated into endothelial, smooth muscle, and cardiomyocyte lineages. In conclusion, the single-cell culture protocol using an enzymatic digestion method may be more useful to isolate human cardiac-derived c-kit-positive elements compared with the tissue expansion method.

Suppression of PU.1-linked TLR4 expression by cilostazol with decrease of cytokine production in macrophages from patients with rheumatoid arthritis

BACKGROUND AND PURPOSE

The present study assessed the effects of cilostazol on LPS-stimulated TLR4 signal pathways in synovial macrophages from patients with rheumatoid arthritis (RA). These effects were confirmed in collagen-induced arthritis (CIA) in mice.

EXPERIMENTAL APPROACH

Expression of TLR4, PU.1, NF-κB p65 and IκBα on synovial fluid macrophages from RA patients was determined by Western blotting, and cytokines were measured by ELISA. Anti-arthritic effects were evaluated in CIA mice.

KEY RESULTS

Intracellular cAMP was concentration-dependently raised by cilostazol (1-100 μM). Cilostazol significantly suppressed LPS-stimulated increase of TLR4 expression by blocking PU.1 transcriptional activity in RA macrophages. In addition, cilostazol decreased LPS-induced myeloid differentiation factor 88 (MyD88) expression, but not that of TNF receptor-associated factor 6 (TRAF6). Cilostazol also suppressed IkBα degradation and NF-κB p65 nuclear translocation. Moreover, LPS-induced increase of cytokine production (TNF-α, IL-1β) was inhibited by cilostazol, an effect which was accompanied by suppression of IκBα degradation, and NF-κB p65 nuclear translocation. However, expression of anti-inflammatory IL-10 was elevated by cilostazol and forskolin/IBMX. In mice with CIA, post-treatment with cilostazol (30 mg kg⁻¹ day⁻¹) decreased expression of TLR4 in knee joints in association with decreased recruitment of macrophages. Consequently, synovial inflammation, proteoglycan depletion and bone erosion were significantly inhibited by cilostazol treatment.

CONCLUSIONS AND IMPLICATIONS

Cilostazol down-regulated LPS-stimulated PU.1-linked TLR4 expression and TLR4/MyD88/NF-κB signal pathways, and then suppressed inflammatory cytokine production in synovial macrophages from RA patients. Also cilostazol markedly inhibited the severity of CIA in mice.

Temperature evolution of itinerant ferromagnetism in SrRuO3 probed by optical spectroscopy

The temperature (T) dependence of the optical conductivity spectra σ(ω) of a single crystal SrRuO(3) thin film is studied over a T range from 5 to 450 K. We observed significant T dependence of the spectral weights of the charge transfer and interband d-d transitions across the ferromagnetic Curie temperature (T(c) ∼ 150 K). Such T dependence was attributed to the increase in the Ru spin moment, which is consistent with the results of density functional theory calculations. T scans of σ(Ω,T) at fixed frequencies Ω reveal a clear T(2) dependence below T(c), demonstrating that the Stoner mechanism is involved in the evolution of the electronic structure. In addition, σ(Ω,T) continues to evolve at temperatures above T(c), indicating that the local spin moment persists in the paramagnetic state. This suggests that SrRuO(3) is an intriguing oxide system with itinerant ferromagnetism.

Reliable polarization switching of BiFeO3

As a room temperature multi-ferroic with coexisting anti-ferromagnetic, ferroelectric and ferroelastic orders, BiFeO(3) has been extensively studied to realize magnetoelectric devices that enable manipulation of magnetic ordering by an electric field. Moreover, BiFeO(3) is a promising candidate for ferroelectric memory devices because it has the largest remanent polarization (P(r)>100 μC cm(-2)) of all ferroelectric materials. For these applications, controlling polarization switching by an electric field plays a crucial role. However, BiFeO(3) has a complex switching behaviour owing to the rhombohedral symmetry: ferroelastic (71°, 109°) and ferroelectric (180°) switching. Furthermore, the polarization is switched through a multi-step process: 180° switching occurs through three sequential 71° switching steps. By using monodomain BiFeO(3) thin-film heterostructures, we correlated such multi-step switching to the macroscopically observed reliability issues of potential devices such as retention and fatigue. We overcame the retention problem (i.e. elastic back-switching of the 71° switched area) using monodomain BiFeO(3) islands. Furthermore, we suppressed the fatigue problem of 180° switching, i.e. loss of switchable polarization with switching cycles, using a single 71° switching path. Our results provide a framework for exploring a route to reliably control multiple-order parameters coupled to ferroelastic order in other rhombohedral and lower-symmetry materials.

Switchable induced polarization in LaAlO3/SrTiO3 heterostructures

Demonstration of a tunable conductivity of the LaAlO(3)/SrTiO(3) interfaces drew significant attention to the development of oxide electronic structures where electronic confinement can be reduced to the nanometer range. While the mechanisms for the conductivity modulation are quite different and include metal-insulator phase transition and surface charge writing, generally it is implied that this effect is a result of electrical modification of the LaAlO(3) surface (either due to electrochemical dissociation of surface adsorbates or free charge deposition) leading to the change in the two-dimensional electron gas (2DEG) density at the LaAlO(3)/SrTiO(3) (LAO/STO) interface. In this paper, using piezoresponse force microscopy we demonstrate a switchable electromechanical response of the LAO overlayer, which we attribute to the motion of oxygen vacancies through the LAO layer thickness. These electrically induced reversible changes in bulk stoichiometry of the LAO layer are a signature of a possible additional mechanism for nanoscale oxide 2DEG control on LAO/STO interfaces.

Requirement for Pak3 in Rac1-induced organization of actin and myosin during Drosophila larval wound healing

Rho-family small GTPases regulate epithelial cell sheet migration by organizing actin and myosin during wound healing. Here, we report that Pak3, but not Pak1, is a downstream target protein for Rac1 in wound closure of the Drosophila larval epidermis. Pak3-deficient larvae failed to close a wound hole and this defect was not rescued by Pak1 expression, indicating differential functions of the two proteins. Pak3 localized to the wound margin, which selectively required Rac1. Pak3-deficient larvae showed severe defects in actin-myosin organization at the wound margin and in submarginal cells, which was reminiscent of the phenotypes of Rac1-deficient larvae. These results suggest that Pak3 specifically mediates Rac1 signaling in organizing actin and myosin during Drosophila epidermal wound healing.

Giant piezoelectricity on Si for hyperactive MEMS

Microelectromechanical systems (MEMS) incorporating active piezoelectric layers offer integrated actuation, sensing, and transduction. The broad implementation of such active MEMS has long been constrained by the inability to integrate materials with giant piezoelectric response, such as Pb(Mg(1/3)Nb(2/3))O(3)-PbTiO(3) (PMN-PT). We synthesized high-quality PMN-PT epitaxial thin films on vicinal (001) Si wafers with the use of an epitaxial (001) SrTiO(3) template layer with superior piezoelectric coefficients (e(31,f) = -27 ± 3 coulombs per square meter) and figures of merit for piezoelectric energy-harvesting systems. We have incorporated these heterostructures into microcantilevers that are actuated with extremely low drive voltage due to thin-film piezoelectric properties that rival bulk PMN-PT single crystals. These epitaxial heterostructures exhibit very large electromechanical coupling for ultrasound medical imaging, microfluidic control, mechanical sensing, and energy harvesting.

Coherent Brillouin spectroscopy in a strongly scattering liquid by picosecond ultrasonics

In a modification of a picosecond ultrasonic technique, a short acoustic pulse is launched into a liquid sample by a laser pulse absorbed in a semitransparent transducer film and is detected via coherent Brillouin scattering of a time-delayed probe pulse. With both excitation and probing performed from the transducer side, the arrangement is suitable for in vivo study of biological tissues. The signal is collected from a micrometer-thick layer next to the transducer and is not affected by the diffuse scattering of probe light deeper in the sample. The setup, utilizing a 33 nm thick single crystal SrRuO(3) transducer film, is tested on a full fat milk sample, with 11 GHz acoustic frequency recorded.

Concurrent reactivation of latent EBV with hepatitis A can affect clinical feature of childhood hepatitis

AIMS

Some children with acute hepatitis A virus (HAV) infection have concurrent Epstein-Barr virus (EBV) reactivation serologically. We studied the frequency of EBV reactivation during HAV infection and determined whether simultaneous occurrence of EBV reactivation and HAV infection affected the clinical features of HAV infection.

METHODS

The medical records of patients under 19 years of age diagnosed with acute hepatitis A between January 1996 and June 2009 were reviewed.

RESULTS

Among 72 patients with acute hepatitis A, 22 patients (30.6%) had EBV reactivation. A markedly prolonged duration of full recovery from hepatitis was observed in reactivated group. The peak levels of AST and ALT in reactivated group were higher than non-reactivated group (p = 0.012 and p < 0.001, respectively). Higher peak levels of AST and ALT in reactivated subgroups over 10 years old were observed compared to non-reactivated subgroup (p = 0.027 and p = 0.001, respectively). Duration of recovery showed significant differences between two subgroups.

CONCLUSIONS

Concurrent reactivation of latent EBV and HAV infections is common. EBV reactivation with HAV infection adversely affects the clinical feature of hepatitis. Therefore, we should keep in mind that the concurrence especially in older children may cause worse injury to the liver.

Ferroelectricity in strain-free SrTiO3 thin films

Biaxial strain is known to induce ferroelectricity in thin films of nominally nonferroelectric materials such as SrTiO3. By a direct comparison of the strained and strain-free SrTiO3 films using dielectric, ferroelectric, Raman, nonlinear optical and nanoscale piezoelectric property measurements, we conclude that all SrTiO3 films and bulk crystals are relaxor ferroelectrics, and the role of strain is to stabilize longer-range correlation of preexisting nanopolar regions, likely originating from minute amounts of unintentional Sr deficiency in nominally stoichiometric samples. These findings highlight the sensitive role of stoichiometry when exploring strain and epitaxy-induced electronic phenomena in oxide films, heterostructures, and interfaces.

Template engineering of Co-doped BaFe2As2 single-crystal thin films

Understanding new superconductors requires high-quality epitaxial thin films to explore intrinsic electromagnetic properties and evaluate device applications. So far, superconducting properties of ferropnictide thin films seem compromised by imperfect epitaxial growth and poor connectivity of the superconducting phase. Here we report new template engineering using single-crystal intermediate layers of (001) SrTiO(3) and BaTiO(3) grown on various perovskite substrates that enables genuine epitaxial films of Co-doped BaFe(2)As(2) with a high transition temperature (T(c,rho=0) of 21.5 K, where rho=resistivity), a small transition width (DeltaT(c)=1.3 K), a superior critical current density J(c) of 4.5 MA cm(-2) (4.2 K) and strong c-axis flux pinning. Implementing SrTiO(3) or BaTiO(3) templates to match the alkaline-earth layer in the Ba-122 with the alkaline-earth/oxygen layer in the templates opens new avenues for epitaxial growth of ferropnictides on multifunctional single-crystal substrates. Beyond superconductors, it provides a framework for growing heteroepitaxial intermetallic compounds on various substrates by matching interfacial layers between templates and thin-film overlayers.

Ferroelastic switching for nanoscale non-volatile magnetoelectric devices

Multiferroics, where (anti-) ferromagnetic, ferroelectric and ferroelastic order parameters coexist, enable manipulation of magnetic ordering by an electric field through switching of the electric polarization. It has been shown that realization of magnetoelectric coupling in a single-phase multiferroic such as BiFeO(3) requires ferroelastic (71 degrees, 109 degrees) rather than ferroelectric (180 degrees) domain switching. However, the control of such ferroelastic switching in a single-phase system has been a significant challenge as elastic interactions tend to destabilize small switched volumes, resulting in subsequent ferroelastic back-switching at zero electric field, and thus the disappearance of non-volatile information storage. Guided by our phase-field simulations, here we report an approach to stabilize ferroelastic switching by eliminating the stress-induced instability responsible for back-switching using isolated monodomain BiFeO(3) islands. This work demonstrates a critical step to control and use non-volatile magnetoelectric coupling at the nanoscale. Beyond magnetoelectric coupling, it provides a framework for exploring a route to control multiple order parameters coupled to ferroelastic order in other low-symmetry materials.

Inhibitory effects of orobol 7-O-D-glucoside from banaba (Lagerstroemia speciosa L.) on human rhinoviruses replication

AIMS

The anti-human rhinovirus (HRV) activity of orobol 7-O-d-glucoside (O7G) from Lagerstroemia speciosa L. (Lythraceae) was evaluated in Hela cells.

METHODS AND RESULTS

We tested anti-HRV activity of O7G using a cytopathic effect (CPE) reduction method, which exhibited broad-spectrum anti-HRVs activity with a 50% inhibitory concentration (IC(50)) ranging from 0.58 to 8.80 microg ml(-1). The 50% cytotoxicity concentration (CC(50)) of O7G is more than 100 microg ml(-1), and the derived therapeutic indices are more than 12. Ribavirin didn't possess antiviral activity against HRV15, HRV3 and HRV5, but exhibited weak antiviral activity against HRV2 and HRV3, and showed strong anti-HRV6 and -14 activities.

CONCLUSIONS

These results suggest that O7G is a novel drug class with broad spectrum antiviral activity against HRV species A (HRV1B, HRV2, HRV15 and HRV40) and species B (HRV3, HRV6 and HRV14), as well as pleconaril-resistant virus (HRV5).

SIGNIFICANCE AND IMPACT OF THE STUDY

Therefore, these findings provide important information for the utilization of Q7G promising broad spectrum for human rhinovirus treatment.

Antiviral activity of raoulic acid from Raoulia australis against Picornaviruses

RNA viruses are a major source of respiratory diseases worldwide. The lack of effective therapeutical treatment underlines the importance of research for new antiviral compounds. Raoulic acid is a principal ingredient of the plant Raoulia australis Hook. F. Antiviral assay using cytopathic effect (CPE) reduction method showed that raoulic acid possessed strong antiviral activity against human rhinovirus 2 (HRV2) with a 50% inhibition concentration (IC(50)) value of less than 0.1mug/ml, human rhinovirus 3 (HRV3) with a IC(50) value of 0.19 microg/ml, coxsackie B3 (CB3) virus with IC(50) values of 0.33 microg/ml, coxsackie B4 (CB4) virus with IC(50) values of 0.40 microg/ml, and enterovirus 71 (EV71) virus with IC(50) values of less than 0.1 microg/ml. However, the compound did not possess antiviral activity against influenza A (Flu A/PR, Flu A/WS, H1N1) and B viruses at four concentrations ranging from 0.1 to 100 microg/ml.

Consecutive esodeviation after exotropia surgery in patients older than 15 years: comparison with younger patients

Purpose

The purpose of this study was to investigate the clinical course of esodeviation after exotropia surgery in older patients (older than 15 years) and to compare it with that in younger patients (15 years or younger).

Methods

The medical records of all surgeries for exodeviation from December 2004 to February 2007 were reviewed and 82 patients were found with consecutive esodeviation. The patients were divided into two groups according to their age: Group A (patients older than 15 years) and Group B (patients age 15 or younger). The clinical course of esodeviation in Group A was compared to that in Group B by means of survival analysis.

Results

The median survival times of the esodeviation were 2.0±0.1 months in Group A and 1.0±0.1 months in Group B (p=0.40). The prevalence of consecutive esotropia at six months was 0% in Group A and 6.1% in Group B (p=0.32). The myopic refractive error, worse sensory condition, and a larger preoperative exodeviation in Group A did not affect the clinical course of the two groups differently.

Conclusions

The postoperative esodeviation of patients older than 15 years after exotropia surgery tended to persist longer during the early postoperative period than that of patients 15 years or younger, however, the difference did not persist at postoperative six months.

Strain-induced polarization rotation in epitaxial (001) BiFeO3 thin films

Direct measurement of the remanent polarization of high quality (001)-oriented epitaxial BiFeO3 thin films shows a strong strain dependence, even larger than conventional (001)-oriented PbTiO3 films. Thermodynamic analysis reveals that a strain-induced polarization rotation mechanism is responsible for the large change in the out-of-plane polarization of (001) BiFeO3 with biaxial strain while the spontaneous polarization itself remains almost constant.

Physicochemical and biological characteristics of DEAE-derivatized PS7 biopolymer of Beijerinckia indica

Physicochemical and biological characteristics of the exopolysaccharide, PS7, produced from Beijerinckia indica were investigated. The PS7 weight fractions of Glc and GlcUA were 0.45 and 0.25, respectively, and the molar ratio of Glc:Rha:GalUA was approximately 5:1:1.3. The PS7 was chemically derivatized with diethylaminoethyl chloride-HCl (DEAE-HCl), and the resulting modified PS7 contained both positive and negative charges. The elemental and IR analyses were conducted to confirm the successful incorporation of DEAE groups into PS7. Large increase in nitrogen fraction was observed from the derivatized PS7 by elemental analysis. The characteristic CH(3) and CH(2) peaks originated from DEAE group were detected in (1)H NMR spectrum of the derivatized PS7 as well. Solubility of native PS7 was improved almost twice from 40 to 75% after DEAE-derivatization, while water holding capacity (WHC) drastically decreased from 10,026 to 245%. Oil binding capacity (OBC) of PS7 also significantly dropped from 1528 to 331% after the derivatization. The [eta] values of native and derivatized PS7 were 27.6 and 0.31 dL/g at 25 degrees C, respectively, which means that the DEAE-derivatization significantly decreased the [eta] of PS7. The bile acid binding capacity of PS7 was indirectly determined by measuring the holding capability of cholic acid inside the dialysis membrane. When PS7 was DEAE-derivatized, there was substantial decrease in the cholic acid retardation index (CRI). Up to 8-9h of dialysis, the derivatized PS7 hold 8.6% less of cholic acid compared to native one.

Electrical control of antiferromagnetic domains in multiferroic BiFeO3 films at room temperature

Multiferroic materials, which offer the possibility of manipulating the magnetic state by an electric field or vice versa, are of great current interest. In this work, we demonstrate the first observation of electrical control of antiferromagnetic domain structure in a single-phase multiferroic material at room temperature. High-resolution images of both antiferromagnetic and ferroelectric domain structures of (001)-oriented multiferroic BiFeO3 films revealed a clear domain correlation, indicating a strong coupling between the two types of order. The ferroelectric structure was measured using piezo force microscopy, whereas X-ray photoemission electron microscopy as well as its temperature dependence was used to detect the antiferromagnetic configuration. Antiferromagnetic domain switching induced by ferroelectric polarization switching was observed, in agreement with theoretical predictions.

Patterns of eating and movement that best maintain reduction in overweight

Two studies of the influences of specific patterns of eating and exercising behaviour on body weight in English Midlands women were re-analysed using correlations as the measure of effect size. As predicted from computational modelling of hunger-sating mechanisms, avoiding energy-containing drinks and foods at the ends of and between meals was the behaviour most influencing year-long weight loss. However, although eating between meals is often called snacking, the term 'snack' appeared to be too ambiguous in this culture for its use in helping efforts to control weight. Avoidance of particular sorts of fat-rich foods was also associated with longer-term weight loss. Attempts at severe restriction of intake at mealtimes were associated with weight loss during a period of intensive dieting, but did not contribute to maintenance of that weight reduction. Using diet formulae to attain rapid weight loss was associated with significant weight gain over a year. These results support the suggestion that the first line of defence against weight gain is avoiding all sources of energy during drink breaks, with personally relevant advice on lower fat versions of particular foods also being important. Continued neglect of the behaviour-specific correlational approach to gaining evidence for less fattening habits does nothing to slow the rise in obesity.

Mutational analysis of forkhead transcriptional factor 2 (FOXL2) in Korean patients with blepharophimosis-ptosis-epicanthus inversus syndrome

We screened for mutations in the forkhead transcription factor gene, FOXL2, in Korean patients with sporadic or familial blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) by polymerase chain reaction-single-stranded conformation polymorphism (PCR-SSCP) and direct sequencing. Five of nine BPES families and three of seven sporadic cases were detected to have FOXL2 mutations. We identified four types of FOXL2 mutations, two of which are novel. A new 14 bp deletion (939-952del14) causing a frameshift from G235W and the extension of the predicted protein to 527 amino acids was detected in a BPES family patient. In addition, a novel 845C > A transversion, resulting in a nonsense mutation (S203X), was found in a sporadic case of BPES. The previously reported in-frame 30 bp duplication (909-938dup30) was the most common mutation and was found in eight patients of four BPES families and one sporadic case. A known 17 bp duplication (1080-1096dup17) was observed in a sporadic BPES case. We were unable to find a causal mutation in four BPES families and four sporadic cases. These results suggest that in a fraction of BPES patients, the genetic defect might be associated with a mutation in the non-coding region of the FOXL2 gene or in other genes.