Synaptic architecture of leg and wing premotor control networks in Drosophila

Animal movement is controlled by motor neurons (MNs), which project out of the central nervous system to activate muscles. MN activity is coordinated by complex premotor networks that allow individual muscles to contribute to many different behaviors. Here, we use connectomics to analyze the wiring logic of premotor circuits controlling the Drosophila leg and wing. We find that both premotor networks cluster into modules that link MNs innervating muscles with related functions. Within most leg motor modules, the synaptic weights of each premotor neuron are proportional to the size of their target MNs, establishing a circuit basis for hierarchical MN recruitment. In contrast, wing premotor networks lack proportional synaptic connectivity, which may allow wing steering muscles to be recruited with different relative timing. By comparing the architecture of distinct limb motor control systems within the same animal, we identify common principles of premotor network organization and specializations that reflect the unique biomechanical constraints and evolutionary origins of leg and wing motor control.

AB0157 EFFICACY AND SAFETY OF FILGOTINIB IN ACTIVE RHEUMATOID ARTHRITIS PATIENTS WITH INADEQUATE RESPONSE TO METHOTREXATE: COMPARATIVE STUDY WITH FILGOTINIB AND TOCILIZUMAB EXAMINED BY CLINICAL INDEX AS WELL AS MUSCULOSKELETAL ULTRASOUND ASSESSMENT (TRANSFORM STUDY): STUDY PROTOCOL

Background

The administration of Janus kinase (JAK) inhibitors as well as biological disease-modifying anti-rheumatic drugs has dramatically improved even the clinical outcomes in rheumatoid arthritis (RA) patients with inadequate response to methotrexate (MTX). The dysregulation of JAK- signal transducer and activator of transcription (STAT) pathways via overproduction of cytokines, such as interleukin-6 (IL-6) is involved in the pathogenesis of RA (1). Filgotinib, a preferential JAK1 inhibitor, is effective in suppressing disease activity and preventing the progression of joint destruction due to inhibition of the JAK-STAT pathway. IL-6 inhibitors such as tocilizumab also inhibit the JAK-STAT pathways due to inhibition of IL-6 signaling. Thus, it should be desirable to investigate whether the effectiveness of filgotinib monotherapy is non-inferior to those of tocilizumab monotherapy in RA patients with inadequate response to MTX. In addition, it is important to accurately evaluate disease activity at the joint level by using musculoskeletal ultrasound (MSUS) and clinical disease activity indices, including subjective parameters (2).

Objectives

This study’s principal objective is to evaluate the effects of filgotinib monotherapy is non-inferior to those of tocilizumab monotherapy in RA patients with inadequate response to MTX. In addition, we will evaluate changes in patients’ parameters, including clinical disease activity indices, MSUS scores, serum biomarkers, patient-reported outcome (PRO), and modified total Sharp score (mTSS) after the administration of filgotinib or tocilizumab. Herein, we describe the study protocol for this study.

Methods

This study is an interventional, multicenter, randomized, open-label, parallel-group and non-inferiority clinical trial with a 52-week follow-up. In total, 400 RA patients with at least moderate disease activity during treatment with MTX will be included. Patients will be randomized in a 1:1 ratio to administration of filgotinib 200mg/day monotherapy or subcutaneous tocilizumab 162mg/biweekly monotherapy switched from MTX (Figure 1). We will evaluate disease activity by measuring clinical disease activity indices and by using MSUS. The primary endpoint is the proportion of patients who achieve an American College of Rheumatology 50 response at week 12. Important secondary endpoints are the changes from the baseline of the MSUS scores, PRO, and mTSS. We will also comprehensively analyze the serum levels of multiple biomarkers such as cytokines and chemokines.

Figure 1.

Results

Although the study results cannot be shown because the research entry is in progress, they are expected to show the non-inferiority of filgotinib monotherapy to tocilizumab monotherapy in RA patients with inadequate response to MTX.

Conclusion

The strength of this study is its prospective evaluation of therapeutic efficacy using not only clinical disease activity indices but also MSUS, which accurately and objectively evaluate disease activity at the joint level among patients drawn from multiple centers with a standardized evaluation by MSUS. In addition, we will evaluate the effectiveness of both drugs by integrating multilateral assessments, i.e., clinical disease activity indices, MSUS findings, and serum biomarkers.

References

[1]Gadina M, Le MT, Schwartz DM, Silvennoinen O, Nakayamada S, Yamaoka K, et al. Janus kinases to jakinibs: from basic insights to clinical practice. Rheumatology (Oxford). 2019;58(Suppl 1):i4-i16.

[2]Colebatch AN, Edwards CJ, Ostergaard M, van der Heijde D, Balint PV, D’Agostino MA, et al. EULAR recommendations for the use of imaging of the joints in the clinical management of rheumatoid arthritis. Ann Rheum Dis. 2013;72(6):804-14.

Disclosure of Interests

Toshimasa Shimizu: None declared, Shin-ya Kawashiri: None declared, Shimpei Morimoto: None declared, Yurika Kawazoe: None declared, Shohei Kuroda: None declared, Rina Kawasaki: None declared, Yasuko Ito: None declared, Shuntaro Sato: None declared, Hiroshi Yamamoto: None declared, Atsushi Kawakami Grant/research support from: Gilead Sciences, Inc.

P–572 Purifying selection for aneuploidy cells in mosaicism embryo at post-implantation stage

Study question

Why low ratio mosaicism embryos develop to normal karyotype babies?

Summary answer

Our in vitro implantation assay clarified purifying selection for aneuploid cells in post implantation embryos.

What is known already

There are some reports about healthy live birth after transfer of mosaic embryos, which was reported for the first time from Italy in 2015. It is also reported that the abnormal cell is screened with the mouse in the embryo development, and only a normal cell contributes to the development. But it has not been examined in human.

Study design, size, duration

To clarify the change of aneuploid cells and mitochondrial activity in human embryo, we biopsied several parts from one blastocyst and examined karyotype. After in vitro implantation assay for biopsied embryos, we compared the karyotype of biopsy sample with that of cultured cell mass.

Participants/materials, setting, methods

Under the ethical review of Yokohama City University and informed consent with patients, we collected human surplus blastocysts those are donated after successful clinical treatment or discarded because of poor development grade. We biopsied multiple parts from one blastocyst and cultured the biopsied embryos, and extracted whole DNA from the biopsy samples and cultured embryos. Karyotyping by next generation sequencing were performed.

Main results and the role of chance

We analyzed 34 samples from 11 embryos, including 25 biopsy sample from 11 embryos and 9 cell mass from 7 cultured embryos. In the karyotype tracking results, even though biopsy sample analysis before the culture were uniformed aneuploid or chromosome mosaic, the developing embryo cell mass had normal karyotype. In one embryo as an example, among the three biopsied extra trophectoderm samples from that, two of them were mosaic, and one of them had uniformed chromosome 21 trisomy and chromosome 16 mosaic monosomy. But the embryo formed multiple cell mass in implantation assay. We examined karyotype of three cell mass, and the result from all were normal karyotype. We suggested that the chromosome aberration cells were screened in the human embryo development, and when the function was not carried out the embryo stopped the development.

Limitations, reasons for caution

Because of small number of samples available, we need more samples for a more accurate evaluation. Furthermore, we cannot evaluate the absolute mechanism that cells with chromosome aberration decreases.

Wider implications of the findings: Conventional PGT-A techniques are based on uniformed embryos developing hypothesized past time. As showed in some clinical reports, PGT-A can reduce of spontaneous abortion and chance of embryo transfer. Thinking about aneuploid cell purifying system in embryo development, effectiveness of PGT-A should be more questionable for infertility treatment.

Trial registration number

A200326004

P6154Association between n-3 and n-6 polyunsaturated fatty acids and plaque vulnerability by optical coherence tomography in acute myocardial infarction patients

Background

The values of n-3 and n-6 polyunsaturated fatty acids (PUFAs) like low eicosapentaenoic acid (EPA) /arachidonic acid (AA) ratio are known to be associated with cardiovascular events, however their relationship with coronary plaque vulnerability in acute myocardial infarction (AMI) is not revealed.

Purpose

We evaluated the relationship between n-3 and n-6 PUFAs and coronary plaque vulnerability assessed by optical coherence tomography (OCT) in AMI patients.

Methods

We investigated 79 AMI lesions (51 ST elevated myocardial infarction (STEMI) lesions and 28 non-STEMI lesions) that had undergone emergency percutaneous coronary intervention using OCT. Coronary plaque characteristics by OCT were compared with n-3 and n-6 PUFAs values which were measured on admission.

Results

Of all AMI lesions (n=79), 43 thin-cap fibroatheroma (TCFA) and 35 plaque rapture (PR) were detected by OCT. Lesions with TCFA had no significant relationship with n-3 and n-6 PUFAs values, whereas lesion with PR had significantly lower EPA values than those without (55.8±29.5 vs 74.3±37.1 μg/ml, p=0.018). Median low-density lipoprotein (LDL) cholesterol value was 117 (98–137) mg/dl and sub-analysis in patients who had lower LDL cholesterol values than median (n=39) revealed that EPA values were significantly lower in lesions with TCFA (56.3±30.9 vs 85.3±47.7 μg/ml, p=0.03). In STEMI patients, the values of EPA and EPA/AA ratio were significantly lower in lesions with TCFA (EPA: 55.5±22.8 vs 80.8±46.1 μg/ml, p=0.01; EPA/AA ratio: 0.34±0.16 vs 0.50±0.36, p=0.03). STEMI patients who had lower LDL cholesterol values <114 mg/dl of median (n=26), the values of EPA, EPA/AA ratio, and EPA+ docosahexaenoic acid (DHA) /AA ratio were significantly lower in lesions with TCFA (EPA: 51.4±20.7 vs 93.1±53.0 μg/ml, p=0.01; EPA/AA ratio: 0.37±0.16 vs 0.67±0.41, p=0.01; EPA+DHA/AA ratio: 1.13±0.41 vs 1.63±0.76, p=0.04). In STEMI patients with lower LDL cholesterol values, EPA/AA ratio positively correlated with fibrous cap thickness (Spearman, ρ=0.35, p=0.08). The cutoff value of EPA/AA ratio predicting the existence of TCFA was 0.52 (area under the curve 0.78, sensitivity 93.8%, specificity 70.0%, p=0.02).

Conclusion

This study demonstrated that n-3 and n-6 PUFAs values were associated with coronary plaque vulnerability by OCT in AMI patients, especially in STEMI. These results suggest that n-3 and n-6 PUFAs may be residual risk markers of severe acute cardiovascular events in patients with low LDL cholesterol values.

A case of under-dosing after raltegravir formulation change in an elderly patient treated for HIV

Our case was a 70-year-old male (height: 168 cm, weight: 74.3 kg) with polypharmacy (total 15 drugs including 10 tablets) who was treated for HIV infection. His dosing schedule of raltegravir was changed from BID (a 400 mg tablet, twice) to QD (2x600 mg tablet, once). After a month, we found that he miss-took raltegravir for 1x600 mg tablet at once. His HIV-1 RNA increased from undetectable levels to < 20 copies per mL. Pharmaceutical companies should therefore carefully consider swallowing difficulties in old patients, such as by reformulating medications so that only one dosing is required per day and decreasing the size of tablets to 7-8 mm in diameter or orally distinguish tablet.

A case of a rare variant of Klinefelter syndrome, 47,XY,i(X)(q10)

Klinefelter syndrome is a condition in which a male patient has one Y chromosome and one or more extra X chromosomes. It is the most common sex chromosome disorder. Klinefelter syndrome is distinguished by many clinical features, such as infertility, high gonadotropin and low testosterone levels, increased height, and sparse body and facial hair. We report the case of a 32-year-old man who visited our hospital complaining of male infertility. Semen analysis showed azoospermia, and chromosomal analysis revealed a 47,XY,i(X)(q10) karyotype, which is a rare variant of Klinefelter syndrome. No spermatozoon was found on microdissection testicular sperm extraction, and the testis biopsy histology showed only Sertoli cells and hyalinised seminiferous tubules. 47,XY, i(X)(q10) has an additional isochromosome made of the long arm of the X chromosome, which shares some features of classical Klinefelter syndrome in many aspects, but patients are usually shorter than average height and have normal intelligence. In addition, to the best of our knowledge, no successful sperm extractions from 47,XY, i(X)(q10) patients were reported in the literature. The reports of patients who have undergone microdissection testicular sperm extraction are very rare. Further reports and studies of this chromosomal abnormality are needed.

Digoxin Transport by Renal Proximal Tubule Cells is Enhanced by Adhesive Synthetic RGD Peptide

Introduction

The dialyzer apparatus has been widely used as an artificial kidney in medical treatment. However, side effects such as amyloidosis have occurred during long-term treatment. Therefore, we focused on developing a hybrid artificial kidney with a filtration and reabsorption apparatus, but it was found that cells spread extensively and it is difficult to maintain a uniform monolayer with a regular cell shape on a collagen-coated substrate. The purpose of this study was to improve cell adhesion, uniform stable monolayer formation and active transport function by immobilization of arginine-glycine-aspartic acid (RGD) on the culture substratum.

Materials and Methods

Polycarbonate semipermeable membranes were coated with collagen, fibronectin, laminin and synthetic polypeptide, including RGD (Pronectin F). Cell adhesion and digoxin transport were estimated using a renal proximal tubule cell line that overexpressed the P-glycoprotein gene.

Results and Discussion

Under initial and confluent conditions, immobilized cell density in Pronectin F-coated wells was higher than that under other conditions. Transepithelial electrical resistance and digoxin transport activity on Pronectin F-coated membranes were the highest of all conditions. This might have been caused by uniform cell morphology and high cell density.

High efficiency penetration of antibody-immobilized nanoneedle thorough plasma membrane for in situ detection of cytoskeletal proteins in living cells

Background

The field of structural dynamics of cytoskeletons in living cells is gathering wide interest, since better understanding of cytoskeleton intracellular organization will provide us with not only insights into basic cell biology but may also enable development of new strategies in regenerative medicine and cancer therapy, fields in which cytoskeleton-dependent dynamics play a pivotal role. The nanoneedle technology is a powerful tool allowing for intracellular investigations, as it can be directly inserted into live cells by penetrating through the plasma membrane causing minimal damage to cells, under the precise manipulation using atomic force microscope. Modifications of the nanoneedles using antibodies have allowed for accurate mechanical detection of various cytoskeletal components, including actin, microtubules and intermediate filaments. However, successful penetration of the nanoneedle through the plasma membrane has been shown to vary greatly between different cell types and conditions. In an effort to overcome this problem and improve the success rate of nanoneedle insertion into the live cells, we have focused here on the fluidity of the membrane lipid bilayer, which may hinder nanoneedle penetration into the cytosolic environment.

Results

We aimed to reduce apparent fluidity of the membrane by either increasing the approach velocity or reducing experimental temperatures. Although changes in approach velocity did not have much effect, lowering the temperature was found to greatly improve the detection of unbinding forces, suggesting that alteration in the plasma membrane fluidity led to increase in nanoneedle penetration.

Conclusions

Operation at a lower temperature of 4 °C greatly improved the success rate of nanoneedle insertion to live cells at an optimized approach velocity, while it did not affect the binding of antibodies immobilized on the nanoneedle to vimentins for mechanical detection. As these experimental parameters can be applied to various cell types, these results may improve the versatility of the nanoneedle technology to other cell lines and platforms.

Electronic supplementary material

The online version of this article (doi:10.1186/s12951-016-0226-5) contains supplementary material, which is available to authorized users.

Inactivation of the Odontogenic ameloblast-associated gene affects the integrity of the junctional epithelium and gingival healing

Odontogenic ameloblast-associated (ODAM) belongs to the secretory calcium-binding phosphoprotein (SCPP) gene cluster. It is expressed by the epithelial ameloblasts during the accrued mineralisation of enamel and by cells of the junctional epithelium (JE), a specialised portion of the gingiva that plays a critical role in periodontal health. In both cases, ODAM localises at the interface between the cells and the tooth surface. It is also present among the cells of the JE, and is distinctively highly expressed in many epithelial tumours. ODAM has been proposed to be a matricellular protein implicated in the adhesion of epithelial cells to tooth surfaces, and possibly in mediating cell status. To gain further understanding of the role of ODAM, we have created an Odam knockout (KO) mouse by deleting coding exons 2-6. Inactivation of the gene was verified by Southern blot, PCR, real-time qPCR and loss of immunostaining for the protein. Young Odam KO mice showed no readily apparent phenotype. No significant differences were observed in enamel volume and density, rod-interrod organisation, and its attrition. However, in older animals, the JE presented some detachment, an increase in inflammatory infiltrate, and apical down-growth. In addition, its regeneration was delayed following a gingivectomy challenge. Our results indicate that inactivation of Odam expression has no dramatic consequence on enamel but the phenotype in older animals replicates some JE changes seen during human periodontal disease. Altogether, our results suggest that ODAM plays a role in maintaining integrity of the JE.

An open-label, dose-escalation, safety, and pharmacokinetics phase I study of ombrabulin, a vascular disrupting agent, administered as a 30-min intravenous infusion every 3 weeks in Japanese patients with advanced solid tumors

PURPOSE

To determine ombrabulin's maximum tolerated dose and dose recommended for Japanese patients with advanced solid tumors and to assess its antitumor activity and overall safety and pharmacokinetic profiles.

METHODS

This was a multi-center, open-label, sequential-cohort, dose-escalation phase I study of ombrabulin, a vascular disrupting agent, administered once every 3 weeks. Patients were treated with 15.5, 25, 35, or 50 mg/m(2) ombrabulin over a 30-min intravenous infusion. The recommended dose was the highest dose at which <33 % of all evaluable patients experienced dose-limiting toxicities (DLTs) during the first treatment cycle or 50 mg/m(2) (recommended in Caucasian patients) if the previous definition was not met.

RESULTS

Fifteen patients were treated. No DLT occurred with 15.5, 25, or 35 mg/m(2) ombrabulin. In the 50 mg/m(2) group, one patient had Grade 3 lymphopenia, and another experienced Grade 2 hypertension and Grade 3 diarrhea judged as DLTs. The most frequent related adverse events in this group were diarrhea, nausea, and hypertension. Two patients had Grade 3 anemia, one at the 15.5 mg/m(2) and the other at the 50 mg/m(2). No AEs necessitating dose reduction or Grade 4 AEs were observed. Overall, five patients had stable disease. Pharmacokinetic parameters were comparable to those in non-Japanese patients.

CONCLUSIONS

Ombrabulin treatment once every 3 weeks was well tolerated in Japanese patients with advanced solid tumors. The dose recommended is 50 mg/m(2), as in Caucasian patients. The safety and pharmacokinetic profiles were comparable between Japanese and Caucasian patients (funded by Sanofi; ClinicalTrials.gov number, NCT00968916).

Experimental validation of a novel compact focusing scheme for future energy-frontier linear lepton colliders

A novel scheme for the focusing of high-energy leptons in future linear colliders was proposed in 2001 [P. Raimondi and A. Seryi, Phys. Rev. Lett. 86, 3779 (2001)]. This scheme has many advantageous properties over previously studied focusing schemes, including being significantly shorter for a given energy and having a significantly better energy bandwidth. Experimental results from the ATF2 accelerator at KEK are presented that validate the operating principle of such a scheme by demonstrating the demagnification of a 1.3 GeV electron beam down to below 65 nm in height using an energy-scaled version of the compact focusing optics designed for the ILC collider.

Antibacterial activity of adriamycin against bacillus Calmette-Guerin

Although intravesical instillation of bacillus Calmette-Guerin (BCG) or adriamycin (ADR) is an established and effective therapy for superficial bladder cancer, the current major problems are BCG-resistant and ADR-resistant bladder cancer and recurrence after the instillation therapy. Combination therapy with BCG and ADR might overcome the drug-resistance of bladder cancer. However, before combined used of BCG and ADR, it should be clarified whether ADR has bactericidal and bacteriostatic effects on BCG or not, since only alive BCG has a potential antitumor effect. In the current study, the in vitro antibacterial activity of ADR was assessed on BCG by the standard serial two-fold dilution method. When BCG was treated with ADR at 0.13-125 mu g/ml for two hours, ADR had no effect on the viability and the growth of BCG. However, ADR at 250-1,000 mu g/ml had a bactericidal effect on BCG. Epirubicin (EPI) at 0.13-15.6 mu g/ml did not affect the viability and the growth of BCG, however, EPI at 31.3-1,000 mu g/ml had a bactericidal activity. Pirarubicin (THP) at 125-1,000 mu g/ml also had a bactericidal activity. The minimal inhibitory concentrations of ADR, EPI and THP were 250, 250 and 125 mu g/ml, respectively. This study demonstrates that ADR at high concentrations had bactericidal and bacteriostatic effects on BCG. These findings suggest that combination treatment with BCG and low dose ADR could be used and overcome the resistance of bladder cancer to BCG and ADR. The possible clinical implications of the combined use of BCG and ADR are discussed.

Association study of serine racemase gene with methamphetamine psychosis

Experimental studies have demonstrated that not only dopaminergic signaling but also glutamatergic/NMDA receptor signaling play indispensable roles in the development of methamphetamine psychosis. Our recent genetic studies provided evidence that genetic variants of glutamate-related genes such as DTNBP1, GLYT1, and G72, which are involved in glutamate release and regulation of co-agonists for NMDA receptors, conferred susceptibility to methamphetamine psychosis. Serine racemase converts l-serine to d-serine, which is an endogenous co-agonist for NMDA receptors. Three single nucleotide polymorphisms (SNPs) in the promoter region of the serine racemase gene (SRR), rs224770, rs3760229, and rs408067, were proven to affect the transcription activity of SRR. Therefore, we examined these SNPs in 225 patients with methamphetamine psychosis and 291 age- and sex-matched controls. There was no significant association between methamphetamine psychosis and any SNP examined or between the disorder and haplotypes comprising the three SNPs. However, rs408067 was significantly associated with the prognosis for methamphetamine psychosis and multi-substance abuse status. The patients with C-positive genotypes (CC or CG) of rs408067 showed better prognosis of psychosis after therapy and less abuse of multiple substances than the patients with GG genotypes. Because the C allele of rs408067 reduces the expression of SRR, a lower d-serine level or reduced NMDA receptor activation may affect the prognosis of methamphetamine psychosis and multiple substance abuse. Our sample size is, however, not large enough to eliminate the possibility of a type I error, our findings must be confirmed by replicate studies with larger samples.

Enhanced osteoblast and osteoclast responses to a thin film sputtered hydroxyapatite coating

A sputtering technique followed by a low temperature hydrothermal treatment has been demonstrated to produce a dense-and-bioactive hydroxyapatite thin film coating. The purpose of the present study was to investigate osteoblast and osteoclast responses to the hydroxyapatite coated plates and titanium plates with similar roughness. Rat bone marrow stromal cells were cultured on these plates to induce osteoblasts. The cells showed a significantly enhanced proliferation on the hydroxyapatite surface, accompanied by increase of osteoblastic phenotypes. The co-cultured osteoclasts exhibited the significantly different cell number and morphology between the hydroxyapatite and the titanium surfaces. A series of osteoclast marker genes were more stimulated on the hydroxyapatite and thirty two percent of the hydroxyapatite surface area could be resorbed by osteoclasts. The thin film sputtered hydroxyapatite could provide a favorable surface for both osteoblast and osteoclast formation and their function, indicating its good osteoconductivity and biodegradability.

Effect of co-doping of donor and acceptor impurities in the ferromagnetic semiconductor Zn(1-x)Cr(x)Te studied by soft x-ray magnetic circular dichroism

We have performed x-ray absorption spectroscopy (XAS) and x-ray magnetic circular dichroism (XMCD) studies of the diluted ferromagnetic semiconductor Zn(1-x)Cr(x)Te doped with iodine (I) or nitrogen (N), corresponding to electron or hole doping, respectively. From the shape of the Cr 2p absorption peak in the XAS spectra, it was concluded that the Cr ions in the undoped, I-doped and lightly N-doped samples are divalent (Cr(2+)), while Cr(2+) and trivalent (Cr(3+)) coexist in the heavily N-doped sample. This result indicates that the doped nitrogen atoms act as acceptors but that doped holes are located on the Cr ions. In the magnetic field dependence of the XMCD signal at the Cr 2p absorption edge, ferromagnetic behaviors were observed in the undoped, I-doped, and lightly N-doped samples, while ferromagnetism was considerably suppressed in the heavily N-doped sample, which is consistent with the results of magnetization measurements.

Autologous bone marrow stromal cell transplantation for central nervous system disorders - recent progress and perspective for clinical application

There is increasing evidence that the transplanted BMSC significantly promote functional recovery after CNS damage in the animal models of various kinds of CNS disorders, including cerebral infarct, traumatic brain injury and spinal cord injury. However, there are several shortages of information when considering clinical application of BMSC transplantation for patients with CNS disorders. In this review, therefore, we discuss what we should clarify to establish cell transplantation therapy as the scientifically proven entity in clinical situation and describe our recent works for this purpose. The BMSC have the ability to alter their gene expression profile and phenotype in response to the surrounding circumstances and to protect the neurons by producing some neurotrophic factors. They also promote neurite extension and rebuild the neural circuits in the injured CNS. The BMSC can be expanded in vitro using the animal serum-free medium. Pharmacological modulation may accelerate the in vitro proliferation of the BMSC. Using in vivo optical imaging technique, the transplanted BMSC can non-invasively be tracked in the living animals for at least 8 weeks after transplantation. It is urgent issues to develop clinical imaging technique to track the transplanted cells in the CNS and evaluate the therapeutic significance of BMSC transplantation in order to establish it as a definite therapeutic strategy in clinical situation in the future.

Fcgamma receptors contribute to pyramidal cell death in the mouse hippocampus following local kainic acid injection

Recent studies have demonstrated the contribution of the gamma subunit of the Fc receptor of IgG (FcRgamma) to neuronal death following ischemic injury and Parkinson's disease. We examined the role of FcRgamma in hippocampal pyramidal cell death induced by kainic acid (KA). FcRgamma-deficient mice (FcRgamma-/-) and their FcRgamma+/+ littermates (wild type, B6) received an injection of KA into the dorsal hippocampus. Pyramidal cell death was quantified 24 and 72 h after the injection. The number of survived pyramidal cells was significantly larger in FcRgamma-/- mice than in B6 mice in both the CA1 and CA3. Immunohistochemical and immunofluorescent studies detected FcgammaRIIB protein in parvalbumin neurons, whereas FcgammaRIII and FcgammaRI proteins were detected in microglial cells. No activated microglial cells were detected 24 h after the KA injection in FcRgamma-/- mice, whereas many activated microglial cells were present in B6 mice. The production of nitrotyrosine as well as of the inducible nitric oxide synthase and cyclooxygenase-2 proteins, increased by 16 h after the KA injection in B6 mice. In addition, tissue plasminogen activator and metalloproteinase-2 proteins increased. By contrast, the magnitude of oxidative stress and the increase in protease expression were mild in FcRgamma-/- mice. Co-injection of a neutralizing antibody against FcgammaRll and FcgammaRlll with KA abolished pyramidal cell death and microglial activation. In addition, the neutralizing antibody reduced oxidative stress and expression of proteases. These observations suggested a role for FcgammaRllB in parvalbumin neurons as well as FcRgamma in microglia in pyramidal cell death.

Stress analysis in the mandibular condyle during prolonged clenching: a theoretical approach with the finite element method

Parafunctional habits, such as bruxism and prolonged clenching, have been associated with functional overloading in the temporomandibular joint (TMJ), which may result in internal derangement and osteoarthrosis of the TMJ. In this study, the distributions of stress on the mandibular condylar surface during prolonged clenching were examined with TMJ mathematical models. Finite element models were developed on the basis of magnetic resonance images from two subjects with or without anterior disc displacement of the TMJ. Masticatory muscle forces were used as a loading condition for stress analysis during a 10 min clenching. In the asymptomatic model, the stress values in the anterior area (0.100 MPa) and lateral area (0.074 MPa) were relatively high among the five areas at 10 min. In the middle and posterior areas, stress relaxation occurred during the first 2 min. In contrast, the stress value in the lateral area was markedly lower (0.020 MPa) than in other areas in the symptomatic model at 10 min. The largest stress (0.050 MPa) was located in the posterior area. All except the anterior area revealed an increase in stress during the first 2 min. The present result indicates that the displacement of the disc could affect the stress distribution on the condylar articular surface during prolonged clenching, especially in the posterior area, probably leading to the cartilage breakdown on the condylar articular surface.

Trabeculotomy combined with phacoemulsification and implantation of intraocular lens for primary open-angle glaucoma

Retrospective study examined the surgical effects of lowering intraocular pressure of trabeculotomy combined with phacoemulsification and implantation of an intraocular lens. Included in the retrospective study were 96 eyes of 64 patients with primary open-angle glaucoma. Preoperative mean IOP was 25.6 mmHg. At final examination, the IOP was well-controlled at 21 mmHg or lower without medications in 32 of 96 eyes. In another 62 eyes, the IOP was well-controlled with antiglaucoma medications. The postoperative IOPs were in the high teens after surgery. The life table analysis using Kaplan-Meier methods showed that the success probability after phacoemulsification and implantation of intraocular lens, combined with trabeculotomy (PIT)-I and PIT-II, were 93.9% and 82.6% at 4 years, respectively. Postoperative visual acuity improved by more than two lines in 79 of the 96 eyes. In no case was the visual acuity decreased by more than two lines. Deterioration of the visual field was found in 4 eyes. There were no complications such as shallow anterior chamber, choroidal detachment, malignant glaucoma, hypotonic maculopathy, and endophthalmitis. This triple procedure should be performed in the early stages of glaucoma. Trabeculotomy is thought to relieve the resistance to aqueous outflow by mechanical cleavage of the trabecular meshwork and the inner layer of Schlemm's canal. This technique leads to aqueous outflow the from the opening of the internal trabecular meshwork to the collector channel. For this reason trabeculotomy was developed by a number of surgeons. Recently, however, trabeculotomy has not been selected for those patients with advanced stages of primary open-angle glaucoma because of the disadvantages such as transient intraocular pressure (IOP) elevation several days after surgery and somewhat higher levels (18 mmHg) of postoperative intraocular pressure (Fig. 1). To avoid the IOP spike (transient IOP elevation) after trabeculotomy, we reported previously that the new technique of trabeculotomy combined with outer sclerectomy was a useful surgical option. The results of our previous study indicated that the postoprative intraocular pressure levels after combined trabeculotomy and outer sclerectomy were significantly lower than that of trabeculotomy alone. On the other hand, trabeculotomy with mitomycin C is currently the standard filtration procedure for glaucoma. This technique, however causes severe postoperative complication such as hypotonic maculopathy, bleb leakage and late bleb infection. The major advantages of trabeculotomy preclude these severe complications resulting from creating progressive filtration of aqueous humor from the anterior chamber to the subconjunctival space. The recent advance of small-incision phacoemulsification procedure prompted phacoemulsification and implantation of intraocular lens and trabeculotomy. The theoretical advantages of smaller scleral, conjunctival incision, reduced stimuli to wound healing, and inflammation, could improve long-term IOP control in patients with glaucoma. Therefore several reports have been published on the surgical outcomes of combined trabeculotomy and modern phacoemulsification. These reports suggested that the combined trabeculotomy and a small-incision with intraocular lens implantation is effective in controlling IOP in patients with glaucoma.

Advanced nonpenetrating trabeculectomy (advanced NPT) and combined surgery of advanced NPT and phacoemulsification and intraocular lens implantation

We have devised a new glaucoma surgery combining deep sclerectomy with nonpenetrating trabeculectomy (NPT); we call this surgery advanced NPT. We evaluated intraocular pressure (IOP) control, postoperative complication and visual acuity after combined advanced NPT and phacoemulsification and intraocular lens implantation (combined surgery), and advanced NPT alone. The mean preoperative IOP for the trabeculectomy only group was 22.4 +/- 6.3 mmHg(bleb+), 23.0 +/- 4.9 mmHg(bleb-), and that of the combined surgery group was 18.1 +/- 4.5 mmHg(bleb+), 18.5 +/- 2.6 mmHg(bleb-). Mean postoperative IOP for the two groups were 13.0 +/- 2.3 mmHg(bleb+), 15.0 +/- 1.5 mmHg(bleb-) and 12.9 +/- 2.7 mmHg(bleb+), 13.3 +/- 2.4 mmHg(bleb-), respectively. After 15 months, the success probability for postoperative IOP control were 63%(bleb+), 23%(bleb-) in the advanced NPT only group (<or=12 mmHg), and 60% in the advanced NPT only group, 70% in the combined surgery group (<or=14 mmHg) (Kaplan-Meier survival rate). In early complication, there were significantly fewer cases of shallow anterior chamber, hypertension, hypotension and anterior chamber inflamation in both groups than that of trabeculectomy. Nd:YAG goniopuncture was performed for purposes of better IOP control; preferred performance being within a month after surgery. Regarding visual acuity after either advanced NPT alone or combined surgery, an earlier recovery can be expected than with trabeculectomy. Advanced NPT and combined procedure is a reliable technique for glaucoma and cataract surgery.

Trabeculectomy combined with phacoemulsification and intraocular lens implantation

It has recently become popular to use mitomycin C (MMC) with trabeculectomy. MMC helps to maintain effective filtration and long-term intraocular pressure (IOP) control, while the use of laser suture lysis has improved the safety of this procedure. We evaluated the outcome of trabeculectomy alone and of trabeculectomy plus phacoemulsification (PEA) and intraocular lens (IOL) implantation, each supplemented with MMC. The mean preoperative IOP for the trabeculectomy alone group was 22.4 +/- 3.2 mmHg(bleb+), 25.3 +/- 2.6 mmHg(bleb-), and that of the combined surgery group was 22.4 +/- 2.8 mmHg(bleb+), 21.0 +/- 3.5 mmHg(bleb-). Mean postoperative IOP for the two groups were 13.3 +/- 2.7 mmHg(bleb+), 17.1 +/- 4.4 mmHg(bleb-) and 11.9 +/- 2.7 mmHg(bleb+), 16.4 +/- 3.4 mmHg(bleb-), respectively. After 4.5 years, the success probability for postoperative IOP control was 38%(bleb+), 3%(bleb-) in the trabeculectomy alone group and 53%(bleb+), 10%(bleb-) in the combined surgery group (<or=12 mmHg) and 65%(bleb+), 3%(bleb-) and 75%(bleb+), 10%(bleb-) (<or=14 mmHg)(Kaplan-Meier survival rate). With early complications, the frequency of shallow anterior chamber and choroidal detachment were significantly fewer in the combined surgery group. The combined surgery of PEA, IOL implantation and trabeculectomy is an effective procedure that offers visual rehabilitation, fewer early complications and good IOP control in patients with advanced, medically uncontrolled glaucoma and cataract.