A Phase 0 Study Assessing the Intracranial Activity of a Metabolic Radiosensitizer in Patients with Glioblastoma

PURPOSE/OBJECTIVE(S)

Efforts to overcome treatment resistance in glioblastoma (GBM) have been unsuccessful due to tumor heterogeneity and poor intracranial drug penetration. Targeting altered metabolism is a promising approach to improve GBM therapy despite this heterogeneity. Mycophenolate mofetil (MMF) is an inhibitor of purine synthesis that sensitizes GBM to radiation and temozolomide (TMZ) in vitro and in vivo, but its ability to cross the blood brain barrier and inhibit GBM metabolism in patients is unknown. NCT04477200 is a phase 0/1 dose escalation study of MMF combined with radiation and temozolomide in GBM. Here we report the phase 0 results of this study assessing the intracranial activity of MMF.

MATERIALS/METHODS

Purine (GTP and IMP) and mycophenolic acid (MPA, the active metabolite of MMF) concentrations were determined using mass spectrometry in flash-frozen tumor (enhancing and non-enhancing) and normal cortex obtained from 8 patients with recurrent GBM who received MMF (500, 1000, 1500 and 2000 mg BID, N = 2 patients each dose level) for 1 week prior to re-resection and 5 control patients who did not receive MMF prior to re-resection. Plasma MPA concentration was similarly quantified to calculate the enhancing tumor, non-enhancing tumor and normal cortex to plasma MPA ratios.

RESULTS

Patients who received MMF had a mean MPA concentration of 2.2 ± 0.7 µM in the enhancing tumor samples, 1.2 ± 0.5 µM in the non-enhancing tumor samples and 1.3 ± 0.5 µM in normal cortex. MPA concentration was negligible in control patients. This corresponded to tissue/plasma MPA ratios of 0.31, 0.17 and 0.10 for enhancing tumor, non-enhancing tumor and normal cortex, respectively. The GTP/IMP ratio was decreased by 75% in enhancing tumor in MMF-treated patients compared to untreated controls (p = 0.009), indicating effective target engagement and inhibition of purine synthesis. The GTP/IMP ratio was also decreased in cortex and non-enhancing tumor, though a paucity of control samples prevented statistical analysis.

CONCLUSION

Twice daily MMF treatment yields intracranial drug concentrations above 1 µM and lowers the GTP/IMP ratio in GBMs, consistent with target engagement. As we have previously observed radiosensitization in vitro with MPA concentrations of 1 µM, these data suggest that MMF may achieve adequate CNS penetration for therapeutic benefit. The Phase 1 component of this study to determine the dose limiting toxicity and maximally tolerated dose of MMF when combined with reirradiation in recurrent GBM and radiation and TMZ in newly diagnosed GBM is ongoing.

Optimal patient selection for anticoagulant therapy in sepsis: an evidence-based proposal from Japan

Selecting an appropriate target population is essential to maximize survival benefits of anticoagulant therapy against sepsis. Our meta-analysis of three populations with sepsis and nationwide observational study in Japan showed that anticoagulants improved mortality only in sepsis-induced disseminated intravascular coagulation (DIC) but not in non-DIC. This divergent effect was physiologically explained by host-protective immune responses of local thrombosis, which are mandatory in the early stage of sepsis. Meanwhile, the lack of definitive evidence for survival benefit provided by several trials of sepsis-induced DIC indicated that this condition was probably not the best target of anticoagulants. Our multicenter cohort study including only patients with sepsis-induced DIC showed a survival benefit from recombinant thrombomodulin only in patients with high disease severity. Thus, we believe that the population with sepsis and DIC and high disease severity is the optimal target for anticoagulant therapy. Anticoagulant therapy without appropriate target selection should be avoided because of the increased risk of bleeding with no survival benefit.

Dynamic Stretching does not Change the Stiffness of the Muscle-Tendon Unit

The purpose of this study was to identify changes in ankle range of motion and passive mechanical properties of the muscle-tendon unit after dynamic stretching. 12 healthy subjects participated in this study. Displacement of the muscle-tendon junction was measured using ultrasonography while the ankle was passively dorsiflexed at 1°/sec to its maximal dorsiflexion angle. Passive torque was also measured using an isokinetic dynamometer. Measurements were conducted pre-intervention, immediately after the intervention and 5, 10, 15 and 30 min post-intervention. The dynamic stretching consisted of four 30-s periods of ankle dorsiflexion and plantarflexion. Ankle range of motion was significantly increased immediately (from 18.3±1.8° to 21.4±1.7°) and 10 min (20.9±1.9°) after dynamic stretching, but this change disappeared within 15 min. However, stiffness of the muscle-tendon unit and displacement of the muscle-tendon junction at the submaximal dorsiflexion angle did not differ between the experimental conditions. These results demonstrate that dynamic stretching by contracting an antagonist muscle group increases ankle range of motion temporarily without changing the passive mechanical properties of the muscle-tendon unit. The increased range of motion of the ankle after dynamic stretching might be caused by enhanced stretch tolerance.

Efficacy and safety of anticoagulant therapy in three specific populations with sepsis: a meta-analysis of randomized controlled trials

ESSENTIALS: Most anticoagulant therapy has failed to demonstrate a survival benefit in the overall sepsis population. We conducted separate meta-analyses of anticoagulant therapy in three different populations. Survival benefit was observed only in the septic disseminated intravascular coagulation (DIC) population. Further randomized controlled trials should focus on specific populations with septic DIC.

SUMMARY

BACKGROUND

Although many preclinical trials have indicated the effectiveness and safety of anticoagulant therapy as an adjuvant therapy against sepsis, there is little evidence to support its effectiveness to reduce mortality in the overall population with sepsis in clinical situations. However, several studies suggested that specific anticoagulant therapy may potentially reduce mortality in patients with sepsis-induced disseminated intravascular coagulation (DIC).

OBJECTIVE

We investigated whether the survival benefit of anticoagulant therapy might pertain to the coagulopathic population with sepsis.

METHODS

We conducted separate meta-analyses of randomized controlled trials for anticoagulant therapy in three different populations: (i) overall population with sepsis, (ii) population with sepsis-induced coagulopathy, and (iii) population with sepsis-induced DIC. We searched MEDLINE, Scopus, and the Cochrane Central Register of Controlled Trials comparing anticoagulant therapy with placebo or no intervention in sepsis patients. We measured all-cause mortality as the primary outcome and bleeding complications as the secondary outcome.

RESULTS

We analyzed 24 trials enrolling 14 767 patients. There were no significant reductions in mortality in the overall sepsis population and the population with sepsis-induced coagulopathy. Otherwise, we observed significant reductions in mortality (risk ratio 0.72, 95% confidence interval 0.62-0.85) in the population with sepsis-induced DIC. As adverse events, bleeding complications tended to increase similarly with anticoagulant therapy in all three populations.

CONCLUSION

Although associated with an increased risk of bleeding, anticoagulant therapy resulted in no survival benefits in the overall sepsis population and even the population with sepsis-induced coagulopathy; beneficial effects on mortality were observed only in the population with sepsis-induced DIC.

Exercise characteristics influence femoral cross-sectional geometry: a magnetic resonance imaging study in elite female athletes

The associations between mid-femoral cross-sectional geometry and exercise characteristics were investigated in female athletes. The effects on bone geometry for weight-bearing sports with low-to-high-impact were greater than those for non-impact weight-bearing sports, whereas low-impact or high-strain-magnitude/low-strain-rate sports had less of an effect on bone geometry compared with higher-impact sports.

INTRODUCTION

Many previous studies have investigated tibial geometry in athletes; however, few studies have examined the associations between femoral cross-sectional geometry and exercise characteristics. The aim of this study was to investigate these relationships using magnetic resonance imaging (MRI) at the femoral mid-shaft.

METHODS

One hundred and fifty-three female elite athletes, aged 18-34 years, were classified into five groups based on the characteristics of their sports. Sports were considered non-impact (n = 27), low- or moderate-impact (n = 39), odd-impact (n = 38), high-strain-magnitude/low-strain-rate (n = 10), or high-impact (n = 39). Bone geometrical parameters, including cortical area, periosteal perimeter, and moment of inertia (bone strength index), were determined using MRI images.

RESULTS

Higher-impact groups displayed bone expansion, with significantly greater periosteal perimeters, cortical areas (~37.3%), and minimum moments of inertia (I(min,) ~92.3%) at the mid-femur than non- and low-impact groups. After adjusting for age, height, and weight, the cortical area and I(min) of the low-impact and high-strain-magnitude/low-strain-rate groups were also significantly greater than those of the non-impact group.

CONCLUSIONS

Higher-impact sports with high strain rates stimulated periosteal bone formation and improved bone geometry and strength indices at the femoral mid-shaft. Although our results indicate that weight-bearing sports are beneficial even if they are low impact, the effects of lower-impact or high-strain-magnitude/low-strain-rate sports on bone geometry were less pronounced than the effects of higher-impact sports at the femoral mid-shaft.

Spatiotemporal expression patterns of doublesex and mab-3 related transcription factor 1 in the chicken developing gonads and Mullerian ducts

Sex of birds is genetically determined by the inheritance of sex chromosomes (ZZ for male and ZW for female), and the Z-linked gene named doublesex and mab-3 related transcription factor 1 (DMRT1) is a candidate sex-determining gene in avian species. However, the mechanisms underlying sex determination in birds are not yet understood, and the expression patterns of the DMRT1 protein in urogenital tissues have not been identified. In the current study, we used immunohistochemistry to investigate the detailed expression patterns of the DMRT1 protein in the urogenital systems (including Müllerian ducts) in male and female chicken embryos throughout embryonic development. Gonadal somatic cells in the male indifferent gonads showed stronger expressions of DMRT1 compared with those in the female indifferent gonads well before the presumptive period of the sex determination, and Sertoli cells forming testicular cords expressed DMRT1 in the testes after sex determination. Germ cells expressed DMRT1 equally in males and females after sex determination. The expression was continuous in males, but in females it gradually disappeared from the germ cells in the central part of the cortex of the left ovary toward both edges. The DMRT1 was also detected in the tubal ridge, which is a precursor of the Müllerian duct, and at the mesenchyme and outermost coelomic epithelium of the Müllerian duct in both sexes. Strong expression was observed in the males, but it was restricted to coelomic epithelium after the regression of the duct started. Thus, we observed the detailed spatiotemporal expression patterns of DMRT1 in the developing chicken urogenital systems throughout embryonic development, suggesting its various roles in the development of urogenital tissues in the chicken embryo.

Decrements in stiffness are restored within 10 min

The purpose of this study was to clarify the temporal course of stiffness in the muscle-tendon unit after stretching. In 11 male participants, displacement of the myotendinous junction on the gastrocnemius medialis muscle was measured ultrasonographically during the passive-dorsiflexion test, with the ankle was passively dorsiflexed at 1 °/s to the end of the range of motion. Passive torque, representing resistance to stretch, was also measured using an isokinetic dynamometer. On 4 different days, passive-dorsiflexion tests were performed before and immediately, 5, 10 or 15 min after stretching, which comprised dorsiflexion to end range of motion and holding that position for 1 min, 5 times. As a result, end range of motion and passive torque at end range of motion were significantly increased after stretching (P<0.05) as compared with each previous value. Although stiffness of the muscle-tendon unit was significantly decreased immediately and 5 min after stretching (P<0.05), this change recovered within 10 min. These results suggest that static stretching for 5 min results in significantly increased range of motion over 30 min, but significant decreases in stiffness of the muscle-tendon unit returned to baseline levels within 5-10 min.

Viscoelasticity of the muscle-tendon unit is returned more rapidly than range of motion after stretching

The purpose of this study was to clarify the time course of the viscoelasticity of gastrocnemius medialis muscle and tendon after stretching. In 11 male participants, displacement of the myotendinous junction on the gastrocnemius medialis muscle was measured ultrasonographically during the passive dorsiflexion test, in which the ankle was passively dorsiflexed at a speed of 1°/s to the end of the range of motion (ROM). Passive torque, representing resistance to stretch, was also measured using an isokinetic dynamometer. On five different days, passive dorsiflexion tests were performed before and 0, 15, 30, 60 or 90 min after stretching, which consisted of dorsiflexion to end ROM and holding that position for 1 min, five times. As a result, end ROM was significantly increased at 0, 15 and 30 min (P<0.05 each) after stretching as compared with each previous value. Passive torque at end ROM was also significantly increased after stretching. Although the stiffness of the muscle-tendon unit was significantly decreased immediately after stretching (P<0.05), this shift recovered within 15 min. These results showed that the retention time of the effect of stretching on viscoelasticity of the muscle-tendon unit was shorter than the retention time of the effect of stretching on end ROM.

Minimum level of jumping exercise required to maintain exercise-induced bone gains in female rats

SUMMARY

This study determines the minimum level of exercise required to maintain 8 weeks of jumping exercise-induced bone gains in rats. It was found that the minimum level of exercise required for maintaining the different exercise-induced bone gains varied between 11% and 18% of the initial exercise intensity.

INTRODUCTION

This study ascertains the minimum level of follow-up exercise required to maintain bone gains induced by an 8-week jumping exercise in rats.

METHODS

Twelve groups of 12-week old rats (n = 10 rats per group) were given either no exercise for 8 (8S) or 32 weeks (32S), or received 8 weeks of standard training program (8STP) that consisted of 200 jumps per week, given at 40 jumps per day for 5 days per week, followed by 24 weeks of exercise at loads of either 40 or 20 or 10 jumps per day, for either 5, or 3, or 1 day/week. Bone mass, strength, and morphometric properties were measured in the right tibia. Data were analyzed using one-way analyses of variance.

RESULTS

Bone mass, strength, mid-shaft periosteal perimeter and cortical area were significantly (p < 0.05) higher in the rats given 8STP than that in the 8S group. The minimal level of exercise required to maintain the bone gains was 31, 36, 25, and 21 jumps per week for mass, strength, periosteal perimeter and cortical area, respectively.

CONCLUSIONS

Eight weeks of jumping exercise-induced bone gains could be maintained for a period of 24 weeks with follow-up exercise consisting of 11% to 18% of the initial exercise load.

Adolescent exercise associated with long-term superior measures of bone geometry: a cross-sectional DXA and MRI study

OBJECTIVE

To investigate whether childhood sports participation, particularly weight-bearing sports, has any effect on bone mineral content (BMC), areal bone mineral density (aBMD) and bone geometric characteristics in middle-aged postmenopausal women. Design/

SETTING

In this cross-sectional comparison of two groups, 46 middle-aged women (mean age, 60.2 (SD 5.6) years; range, 52-73 years) were grouped according to sport participation during growth: weight-bearing sports, including high-impact weight-bearing activities; and low-impact non-weight-bearing sports or no participation.

MAIN OUTCOME MEASURES

Dual energy X-ray absorptiometry (DXA)-measured BMC, aBMD in the lumbar spine and femur. Magnetic resonance imaging (MRI) determined bone geometric characteristics in the femur, such as femoral mid-diaphyseal cross-sectional area, periosteal and endosteal perimeters and maximum and minimum second moment of area.

RESULTS

Postmenopausal middle-aged women with participation in weight-bearing sports during junior high to high school (12-18 years old) displayed significantly greater BMC in both lumbar spine and femoral neck regions, and also significantly greater femoral mid-diaphyseal bone cross-sectional area, periosteal perimeter and maximum and minimum second moment of area than the non-weight-bearing sports group.

CONCLUSIONS

Adolescent weight-bearing exercise exerts preservational effects on femoral mid-diaphyseal size and shape, while DXA-measured BMC effectively identified the same tendency. Weight-bearing exercise in youth affects bone, and these effects may be preserved as BMC, geometric and structural advantages even after 40 years.

Full suspension mountain bike improves off-road cycling performance

AIM

The purpose of the present study was to determine the effects of suspension systems on the cycling performance of cyclists during off-road bicycling.

METHODS

Eight elite male cyclists (67.8+/-5.8 ml/min/kg of (.-)VO(2max)) performed 30-minute riding tests on bicycles with 2 different suspension setups: front suspension (FS) and front and rear suspension (FRS). Heart rate, blood lactate concentration, pedaling power, cadence, cycling velocity, and completed distance during the trial were measured creatin kinase (CK), lactic dehydrogenase (LDH) and glutamic-oxaloacetic transaminase (GOT) were measured before and after the trials.

RESULTS

The average cadence during the trial was significantly higher (p<0.05) with the FRS (73.6+/-6.1 rpm) than the FS (70.2+/-6.2 rpm). Subjects rode significantly faster (p<0.05) on FRS (24.1+/-2.6 km/h) than FS bikes (22.9+/-2.4 km/h), although no significant difference was observed in pedaling power (240.7+/-26.6 W vs 242.2+/-28.8 W, FS vs FRS, respectively). Serum creatin kinase increased significantly (p<0.05) at 24 h after the trial when cyclists exercised with the FS bike.

CONCLUSIONS

We conclude that the FRS improved cycling performance over rough terrain. FRS might therefore be more suitable for cross-country mountain bike races.

Maintenance of bone mass and mechanical properties after short-term cessation of high impact exercise in rats

Abstract. The effects of cessation of high-impact exercise on bone mass in female Wistar rats was assessed. Fifty 10-week old rats were randomly divided into five groups (n = 10): 4 weeks jump-exercise (4JEX), 4 weeks sedentary control (4S), 8 weeks jump-exercise (8JEX), 4 weeks jump-exercise followed by 4 weeks sedentary (4JEX4S) and 8 weeks sedentary control (8S). The rats were jumped trained 40 times/session, 5 days/week. After 4 weeks or 8 weeks the mass and breaking force in tibia and cross-sectional areas of the tibia were measured. The tibia in the 4JEX and 8JEX groups had significantly greater fat-free dry weight and maximum loads at the fracture tests than those in the 4S and 8S groups. The tibia of 4JEX and 8JEX also had significantly larger cortical area without a significant change in the medullary area at the cross-sectional analysis. Bone mass acquired in 4JEX4S group was retained after cessation of exercise. The results indicate that high-impact jump-exercise, which is osteotropic, leads to an increased cortical bone with enhanced periosteal bone formation, which is also, however, maintained after cessation of exercise. It is therefore suggested that high-impact jump-exercise may provide greater safety margin against disuse-related or/and age-related bone loss and skeletal fragility later in life.

Effect of high-impact and low-repetition training on bones in ovariectomized rats

This study was designed to investigate the effect of high-impact and low-repetition jump training on bones in ovariectomized (OVX) rats. Forty female Wistar rats were sham-operated (sham) or OVX at the age of 11 weeks. The rats were divided randomly into the following four groups: sham-sedentary (SS; n = 10), sham-exercised (SE; n = 10), OVX-sedentary (OS; n = 10), and OVX-exercised (OE; n = 10). The rats started the jump training at the age of 12 weeks. The jump-training protocol was 10 times/day, 5 days/week and the jumping-height was 40 cm. After 8 weeks of training, the mass and breaking force in the tibia and ulna, cross-sectional areas of diaphysis in the tibia, and serum bone turnover markers were measured. The jump training significantly increased the fat-free dry weight, ash weight, and ultimate breaking force in the tibia. The rate of increase in these parameters was similar in both the sham and the OVX groups. On the other hand, in the ulna, there were no significant changes in the ultimate breaking force. The jump training significantly increased the periosteal perimeter and cortical area, although the increase in these parameters in OE compared with OS was lower than that in SE compared with SS. The jump training significantly increased serum osteocalcin in the OVX groups, as well as in the sham groups. These results suggest that high-impact and low-repetition training had beneficial effects on bone formation and bone biomechanical properties in OVX rats, as well as in sham rats.

A basic class I chitinase expression in winged bean is up-regulated by osmotic stress

We isolated a cDNA for basic class I chitinase (ChitiWb1). ChitiWb1 cDNA encodes a protein that consists of 315 amino acid residues and has a signal peptide. Northern blot analysis indicated that the class I chitinase mRNA in leaves and cultured cells of winged bean was increased by treatments with NaCl, KCl, CaCl2, mannitol or saccharose, but not with abscisic acid. Thus, class I chitinase expression was shown to be up-regulated by osmotic stress.

Exercise and mechanical loading increase periosteal bone formation and whole bone strength in C57BL/6J mice but not in C3H/Hej mice

To identify the genes, and the mechanisms that account for the 53% higher peak bone density in C3H/HeJ (C3H) mice compared with C57BL/6J (B6) mice, we are performing quantitative trait locus and phenotypic analyses. The phenotypic studies revealed differences in bone formation and resorption, and showed that hindlimb immobilization (by sciatic neurectomy) caused a greater increase in endosteal resorption in the tibiae of B6 compared with C3H mice. The current studies were intended to examine the hypothesis that the bones of C3H mice are less sensitive to mechanical loading than the bones of B6 mice. To increase mechanical loading, 9-week-old female B6 and C3H mice (n = 10-13 mice/group) were subjected to a jumping exercise (20 jumps/day, 5 days/week, to heights of 20-30 cm) for a total of 4 weeks. Control mice did not jump. Osteocalcin, alkaline phosphatase (ALP) activity, and IGF-I were measured in serum. The left tibiae were used for histomorphometry (ground cross-sections prepared at the tibiofibular junction) and the right tibiae and femora were used for determinations of bone breaking strength (3-point bending). The results of these studies revealed (1) significant effects of both mouse strain (B6 and C3H) and the jumping exercise on tibial strength; (2) an exercise-dependent increase in serum IGF-I in C3H, but not B6 mice; and (3) no effects on serum ALP or osteocalcin. The histomorphometric analyses showed no effect of exercise on C3H tibiae, but significant exercise-dependent increases in total bone area, periosteal perimeter, periosteal mineral apposition rate (MAR), and periosteal bone formation (P < 0.02 for each) in B6 tibiae. There were no effects of exercise on periosteal resorption or any endosteal measurement in either C3H or B6 mice. Since the jumping exercise was designed to cause a two-three fold increase in muscular-skeletal loading at the tibio-fibular junction, and the calculated stress (g/mm2) at this sampling site was only 16% greater for B6 compared with C3H mice, we had anticipated that both strains of mice would show exercise-dependent increases in periosteal bone formation, with a greater response in the B6 mice. The lack of a response in the C3H tibiae demonstrates that the bones of C3H mice are less sensitive to mechanical loading (and unloading) than the bones of B6 mice.

[Primary Sjögren's syndrome presenting as unconsciousness associated with IgA-lambda M-protein]

We describe the case of a 43-year-old woman who presented with primary Sjögren's syndrome (SS) which manifestated as unconsciousness due to M protein. A diagnosis of SS was made based on a ten-year history of dryness, a Shirmer test, and the histological findings of labial biopsy. A rouleaux formation was observed and serum protein electrophoresis revealed a monoclonal spike of 4.0 gm/dl in the gamma-region, which was characterized as IgA-lambda. Biopsy of the minor salivary glands showed marked polyclonal lymphoproliferation with lymphoid follicles, including both T cells and B cells as revealed by immunohistological staining. Therefore, the patient had a lymphoproliferative lesion of the minor salivary glands, which is also known as pseudolymphoma. We conclude that fainting associated with marked M protein may be manifestation of SS. Such cases should be followed carefully since the subsequent neoplastic transformation of pseudolymphomas have been previously reported.

Five jumps per day increase bone mass and breaking force in rats

The effects of jump training on bone morphological and mechanical properties were investigated in immature bones of female Fischer 344 rats. Five-week-old rats were divided into control or five jump-trained groups comprised of 5-, 10-, 20-, 40-, and 100-jump groups, representing the number of jumps per day. The rats were jump-trained 5 days/week for 8 weeks, and the height of jump was increased to 40 cm progressively. The femur and tibia in the 5-jump group had significantly greater fat-free dry weights per body weight and maximum loads at the fracture tests than those in the control group. The tibia in the 5-jump group also had significantly larger cortical area at the cross-sectional analysis. Although a slight tendency toward increase according to the number of jumps per day was observed, there were few differences in bone morphological and mechanical parameters among the 10-, 20-, and 40-jump groups. The present results indicate that a large number of strains per day is not necessary for bone hypertrophy to develop in rats.

Expression of endothelial nitric oxide synthase in human eccrine clear cells

Nitric oxide is generated from L-arginine by nitric oxide synthase (NOS), which has at least three isoforms; endothelial-type NOS (eNOS) and brain-type NOS (bNOS) are constitutive enzymes, and inducible-type NOS (iNOS) is expressed after stimulation. Studies by the avidin-biotin immunocomplex method, revealed eNOS immunoreactivity exclusively in the human eccrine clear cells. No eNOS immunoreactivity was observed in the eccrine dark cells or myoepithelial cells. No staining of iNOS or bNOS was observed in the eccrine gland. These findings indicate that NO plays a physiological part in the production and/or excretion of sweat in the human skin eccrine gland.

Immunohistochemical localization of nitric oxide synthase in normal human skin: expression of endothelial-type and inducible-type nitric oxide synthase in keratinocytes

Nitric oxide (NO) is a critical mediator of various biological functions. NO is generated from L-arginine by nitric oxide synthase (NOS), which has three isoforms; endothelial-type NOS (eNOS) and brain-type NOS (bNOS) are constitutive enzymes, and inducible-type NOS (iNOS) is expressed after stimulation. We investigated the expression of NOS in normal human skin by an immunohistochemical technique and western blotting analysis. In human skin, epidermal keratinocytes and the outer root sheath were labeled with not only eNOS antibody but also with iNOS antibody. Both eNOS and iNOS protein in epidermal keratinocytes were confirmed by western blotting. eNOS immunoreactivity was observed in endothelial cells, fibroblasts, the arrector pili muscle, apocrine secretory gland, eccrine coiled duct, and eccrine secretory gland. bNOS immunoreactivity was observed in mast cells. No staining with anti-bNOS antibody was observed in any other cell type. Our present findings suggest that epidermal keratinocytes in normal human skin contain both eNOS and iNOS.

Effects of jump training on bone hypertrophy in young and old rats

The effects of jump training on bone hypertrophy were investigated in 3, 6, 12, 20 and 27 month-old female Fischer 344 rats. The rats of all age groups were divided into jump training (height: 40 cm, 100 times/day, 5 days/wk for 8 wk), run training (speed: 30 ml/min, 1 h/day, 5 days/wk for 8 wk) or sedentary group. Fat-free dry weights (FFW) of the femur and the tibia were significantly greater in the jump-trained rats than in the run-trained rats, and were significantly greater in the run-trained rats than in the sedentary rats. Jump training significantly increased FFW of the femur and the tibia not only in young rats but also in old rats, while run training did not increase FFW significantly in old rats. In young rats, both jump training and run training significantly increased the length of the femur and the tibia and the diameter of the femur. The diameter of the tibia was greater in the jump-trained rats than in the sedentary and the run-trained rats in all age groups. The results of the present study indicate that jump training was a more effective training mode than run training for bone hypertrophy and that the effects were not limited by age.

[Studies on serum protein fractions of patients with uterine cervical cancer undergoing radiotherapy: relationship between changes in serum protein fractions and prognosis]

The levels of 23 protein components of the sera of 84 patients with uterine cervical cancer undergoing radiotherapy were determined by a single radial immunodiffusion method, before radiation therapy, after whole pelvic irradiation, and after intracavitary irradiation using a remote after roading system (RALS). We examined the correlations between changes in serum protein fractions and the prognosis of the patients. The patients with uterine cervical cancer were treated with combined external irradiation of 60Co gamma-rays or 10 MV X-rays, and RALS therapy. The levels of the same protein components were also measured in 21 normal adult women as a control. All patients were observed between 4 years and 8 years after radiation therapy. In the pretreatment sera obtained from patients with uterine cervical cancer, the concentrations of prealbumin (Prealb), alpha 2HS glycoprotein (alpha 2 HS), alpha 2-plasmin inhibitor (alpha 2PI), transferrin (Tf), plasminogen (Pmg), albumin (Alb), IgM and hemopexin (Hx) were significantly lower than those normal controls. However the serum concentrations of: alpha 1-antichymotrypsin (alpha 1 X), haptoglobin (Hp), C9, fibrinogen (Fib), ceruloplasmin (Cp), alpha 1-acid glycoprotein (alpha 1AG), alpha 1-antitrypsin (alpha 1AT) and C4 were elevated. At the completion of whole pelvic irradiation and RALS therapy, the Hp, C4, and Fib levels were significantly lower than those before radiation therapy, whereas Prealb, alpha 2HS and alpha 2PI were elevated. In patients who had lived between 4 years and 8 years after radiation therapy, the Cp, alpha 1 AG, Hp and C9 levels measured before radiation therapy were reduced significantly, while Tf was elevated compared with patients who died within 4 years. In those who had lived more than 4 years, the alpha 1 AT, Hp, alpha 1X, Cp and C9 levels measured after whole pelvic irradiation were reduced significantly; while the C4 level was elevated. In cases of uterine cervical cancer followed for a period of 4 to 8 years after radiation therapy, multiple regression analysis was used to determine whether increased concentrations of serum protein fractions were associated with good prognosis for the original disease. Tf, Pmg, and alpha 1AT before radiation therapy were positively correlated with survival, whereas AT III, Cp, C1Inh, IgA, alpha 1 AG and C9 showed negative correlations. After whole pelvic irradiation,Pmg, C4 Prealb, Alb,alpha 2M and Hp were found to be positively associated with survival, whereas Tf, alpha 2PI, AT III, alpha 1 AT,C1Inh, C9 and IgA were negative factors.

CT and MRI manifestations of intraabdominal panniculitis

We report a case of intraabdominal panniculitis. Computed tomography (CT) showed diffuse increased attenuation in the omentum, mesentery, and retroperitoneal region. As the disease progressed, the entire mesentery and retroperitoneal regions were involved. On magnetic resonance imaging (MRI), the lesion demonstrated an intermediate signal intensity on T1-weighted images and a slightly high signal intensity on T2-weighted images. Though the radiologic findings are not specific, this condition should be considered in the appropriate clinical context.

Immunocytochemical localization of copper-zinc superoxide dismutase in mouse olfactory mucosa

Copper-zinc superoxide dismutase (Cu-Zn SOD) has been localized in mouse nasal mucosa. Immunocytochemical staining using polyclonal antibody against Cu-Zn SOD revealed endogenous Cu-Zn SOD in sustentacular cells in the olfactory area, and in ciliated epithelial cells in the respiratory area of the olfactory mucosa. Since these cells are located in the superficial portion of the olfactory mucosa, Cu-Zn SOD may serve as an intracellular antioxidant.

Effects of voluntary exercise on bone growth and calcium metabolism in spontaneously hypertensive rats

The effects of voluntary exercise on bone length and calcium metabolism were investigated in spontaneously hypertensive rats (SHR) and Wistar rats. They were classified into voluntary exercise or sedentary group. Systolic blood pressure (SBP), bone length, urinary calcium excretion, plasma calcium and parathyroid hormone levels (PTH) were measured for analysis. SBP of the trained SHR (T-SHR) was significantly lower than that of the nontrained SHR (NT-SHR) at 10 and 11 weeks of age, but the trained Wistar rats (T-WR) and the nontrained Wistar rats (NT-WR) had similar SBP throughout the experimental period. The T-SHR had significantly longer bones in the extremities and the trunk than the NT-SHR, whereas the T-WR had similar or shorter bones than the NT-WR. The PTH level at 12 weeks of age was significantly lower in the T-SHR than in the NT-SHR. The urinary calcium excretion of the T-SHR was greater than that of the NT-SHR, but the food intake (calcium intake) of the T-SHR was also greater. The urinary calcium excretion and food intake of the T-WR and NT-WR were similar. No noticeable differences were observed in the plasma calcium level between the T-SHR and NT-SHR, the T-WR and NT-WR. From these results it is suggested that the abnormal calcium metabolism in the SHR is improved in some degree by voluntary exercise.

Finite element model of facial soft tissue. Deformation following surgical correction

The finite element method is used to predict facial deformation following orthognathic surgery for mandibular prognathism. The deformation is calculated using a model that assumes severe skeletal class III malocclusion. The possibilities and limitations of this method for clinical application are described.

The inheritance of β-amylase null in storage roots of sweet potato,Ipomoea batatas (L.) Lam

Several sweet potato genotypes were found to lack completely or to have only traces ofβ-amylase in their storage roots. Such genotypes do not increase in sweetness during cooking because, without a sufficient amount ofβ-amylase, the normal hydrolysis of starch to maltose does not occur in the cooking process. In order to study the inheritance of this biochemical variant in the genotype, 41 families were generated. The following conclusions were drawn from analyzing these families. (1) This trait is controlled by one recessive allele (designatedβ-amy) (2) It is inherited in a hexasomic or tetradisomic manner, but not disomically or tetrasomically. This conclusion supports previous cytological data that sweet potato is an autohexaploid or has two identical genomes plus one genome which is somewhat different. (3) Theβ-amy allele appears to exist at a high frequency in cultivated germplasm. (4) Breeding sweet potato for lowβ-amylase activity is relatively easy. New types of sweet potato without normalβ-amylase activity have great potential for processing and as a staple food.

[A case of the benign adrenal adenoma with remarkably high concentrations of deoxycorticosterone and 11-deoxycortisol]

The case was a 33-year-old woman with hypertension and hypokalemia, who presented depression of renin activity and the abnormal elevation of plasma deoxycorticosterone (DOC) and 11-deoxycortisol on laboratory tests. After admission, abdominal CT scan, 131I-adosterol scintigram and adrenal venogram revealed a tumor in the left adrenal, which histologically seemed to be benign. When the tumor was resected, blood pressure and all the biochemical data returned to normal range. DOC and 11-deoxycortisol levels in the tumor were abnormally elevated as compared with those in the normal adrenal tissue. These findings suggested that the abnormal elevation of hormone levels resulted from depression of 11 beta-hydroxylase. Though numerous adrenal tumors have been documented, we rarely encounter an apparently benign adrenal tumor that produces 2 kinds of hormones. This seemed to be the first case of benign adrenal tumor in which both DOC and 11-deoxycortisol were elevated.

Effect of albumin coating on the in vitro blood compatibility of Dacron arterial prostheses

A recirculating in vitro perfusion system was used to assess the effect of albumin precoating on the thrombogenicity of Dacron vascular grafts. A complete analysis of platelet activation was carried out, involving platelet count, release, adhesion and aggregation. Fibrin formation was assessed by measuring fibrinogen levels and fibrinopeptide A production; leucocyte interaction was analysed by measuring total leucocyte count as well as an analysis of cell adhesion to the surface by scanning electron microscopy. The platelet count decreased progressively with perfusion time for Dacron until by 30 min, it had declined to 69% +/- 2% of baseline. The platelet count did not, however, change significantly from baseline when albumin-coated Dacron was tested. Release of platelet factor 4 and beta-thromboglobulin at 180 min for Dacron was 37.8 +/- 29.8 times and 66.9 +/- 18.2 times baseline, respectively, while albumin coating caused significantly less (P less than 0.03) platelet release. Albumin coating diminished coagulation activation and fibrinopeptide A formation. The total leucocyte concentration decreased significantly for Dacron by 180 min, while that for albumin-coated Dacron did not change significantly from baseline levels. Albumin coating produced a film-like covering over the Dacron. For Dacron, there were numerous leucocytes and platelets adherent to the surface, whilst cellular deposition was minimal upon the albumin-coated surface. Thus, albumin coating improved the short-term blood compatibility of Dacron by all of the methods employed in this study.

Human platelet interactions with surfaces of type I collagen, chondroitin-4-sulphate, and chondroitin-6-sulphate in vitro

In vitro human platelet interactions with surfaces of type I collagen, chondroitin-6-sulphate (CH-6-S), chondroitin-4-sulphate (CH-4-S), a CH-6-S/collagen layer, and a collagen-CH-6-S complex were investigated. Polystyrene and silanized glass served as controls. Platelet counts, platelet factor 4 released, and platelet aggregating ability for the different surfaces were compared with controls. Platelet count and platelet factor 4 release data showed that there were no differences between surfaces of CH-6-S, CH-4-S and the controls. However, significant differences in platelet counts and platelet factor 4 released were found when collagen, the CH-6-S/collagen layer, and the collagen-CH-6-S complex were compared with controls. The pure type I collagen surface had the greatest influence on platelet activation. The collagen-CH-6-S complex had a greater effect that the CH-6-S/collagen layer on platelet activation. It appears that chondroitin-6-sulphate can modify the platelet activity of type I collagen.

Correlation between low gastric pH and the formation of gizzard erosions in chicks

1. The inner lining of the gizzard was degraded by in vitro pepsin treatment at pH values lower than 2. 2. A significant linear regression was observed between the pH values on the surface of the inner lining and those on the gizzard mucous layer just under the lining. 3. The control chicks had a specific distribution pattern of pH values on the lining of the gizzard. By feeding a gizzard erosion inducer, pH values were lowered and the distribution pattern disappeared. In the latter case, however, a gastric erosion was observed consistently at the area which showed the lowest pH value in the control chicks. 4. From the results, possible mechanisms of the formation of gizzard erosions are discussed.

Effects of histamine antagonists, an anticholinergic agent and antacid on gizzard erosions in broiler chicks

The effects of histamine antagonists, an anticholinergic agent and antacid on gizzard erosion (GE) induced by heated casein-histidine mixture (h-CH), histamine or starvation were examined. Diphenhydramine, an H1-antagonist, had no effect on the GE formation caused by h-CH, but reduced the severity of the lesions induced by histamine and starvation. Cimetidine, an H2-antagonist, blocked completely the formation of the lesions induced by h-CH or histamine but did not prevent starvation-induced GE. Gastric antacid decreased the severity of GE caused by h-CH and histamine. The formation of GE by starvation was blocked by the administration of propantheline bromide or inert solids. The results suggest that the stimulated gastric secretion caused by the H2-activity of h-CH or histamine is largely responsible for the formation of GE. In starvation-induced GE, however, alteration of gastric secretion had no effect on the formation of the lesion as it was caused by the emptiness of the gizzard.

Efficacy of an antibiotic coated indwelling catheter: a preliminary report

This study was conducted to examine if an aminoglycoside (dibekacin sulfate, DKB) incorporated into a coating layer on outer and inner surface of indwelling catheters would be released into urine both in vitro and in clinical cases on a sustained basis and if the released DKB would have any efficacy on delaying lower urinary tract infections. Released amounts of DKB from the catheter silicone rubber (SR) catheter were periodically measured both in vitro and in clinical applications. During the clinical applications, the catheters were indwelled in 14 patients. Organism counts in the patients' urine were determined and organisms were isolated from bacteriuria (defined as greater than or equal to 10(4) CFU/mL) and MICs to DKB were measured. Observations on several combined symptoms frequently associated with indwelling catheterization were performed. Results showed that sustained release of DKB continued for more than 25 days and 13 days in vitro and in clinical cases, respectively. Clinical studies suggested that 8 days of sterile urine after catheterization might be expected in patients without systemic administration of antibiotics and more than 2 weeks if combined with it. No particular problems in its use and associated symptoms were recognized.