Twenty-four-hour ambulatory oxygen desaturation and electrocardiographic recording in obstructive sleep apnea syndrome

BACKGROUND

Although nocturnal pulseoximetry is routinely performed in obstructive sleep apnea syndrome (OSAS), pulseoximetry over a 24-h period has not been studied.

HYPOTHESIS

The purpose of the study was to determine whether simultaneous 24-h oxygen desaturation and electrocardiographic (ECG) recording might be used to screen for daytime sleep sequelae in patients with OSAS.

METHODS

Simultaneous recording of arterial oxygen saturation (SpO2) and ECG was conducted over a 24-h period in 18 male patients with OSAS (mean age 51.3 years) who were diagnosed by standard polysomnography (PSG), and in 15 age-matched healthy subjects (mean age 52.7 years) as controls to evaluate circadian variation of these parameters. The measures of heart rate variability (HRV) were calculated from 24-h ambulatory ECGs. Seventeen patients with OSAS showed excessive daytime sleepiness (EDS). We calculated the duration in which SpO2 decreased to < 90% (duration of SpO2 < 90%). The number of apnea/hypopneas per hour (AHI) during sleep was investigated with Apnomonitors (Chest MI, Co., Tokyo) on the same day as the SpO2 recordings.

RESULTS

Controls showed no episodes of oxygen desaturation. In patients with OSAS, driving (33.3% of patients with OSAS) was the most common activity in which SpO2 decreased to < 90%, followed by daytime napping (27.8%) and resting after meals (22.2%). The duration of SpO2 < 90% over a 24-h period correlated significantly with the duration levels recorded during sleep (r = 0.99, p < 0.05) and in the afternoon (r = 0.62, p < 0.05), and with the AHI (r = 0.55, p < 0.05), but not with the duration of SpO2 < 90% in the morning. The number of ventricular premature beats correlated significantly with the duration of SpO2 < 90% for a 24-h period, but not with measures of HRV. Ventricular tachycardia was found in two (11.1%) and ST-T depression in three patients (16.6%) with underlying cardiac diseases.

CONCLUSION

Our results suggest that daytime sleep attacks accompanied by oxygen desaturation in patients with moderate to severe OSAS may contribute to the occurrence of traffic or cardiovascular accidents. We conclude that 24-h ambulatory recordings of SpO2 and ECG are useful for screening for daytime sleep sequelae associated with the potential risk of this pathology in OSAS during social activities.

Hemispheric asymmetry of the arcuate fasciculus: a preliminary diffusion tensor tractography study in patients with unilateral language dominance defined by Wada test

OBJECTIVE

Lateralization of language function is a prominent feature of human brain function, and its underlying structural asymmetry has been recently reported in normal right-handed subjects. By means of diffusion tensor tractography (DTT), we investigated the asymmetry of the language network, namely, the arcuate fasciculus in patients in whom the unilateral language dominance was defined by Wada test.

METHODS

DTT was performed in 24 patients with a focal lesion or an epileptic focus outside the C-shaped segment of the arcuate fasciculus. The arcuate fasciculus was reconstructed by placing two regions-of-interest in the deep white matter lateral to the corona radiata. The pathway was then divided into one terminating in the temporal lobe (FT tract) and the other in the parietal lobe (FP tract). The relative number and volume of the FT and FP tracts in each hemisphere were submitted to repeated measure ANOVA separately, with the hemisphere as a within-subject factor and with the side of pathology as a between subject factor.

RESULTS

The FT tract showed a significantly larger number and volume in the language dominant hemisphere than in the non-dominant hemisphere, while, for the FP tract, no significant hemispheric difference was observed in the relative number or volume. There was a tendency that the FT tract was less lateralized when the pathology was located in the dominant hemisphere than in the non-dominant hemisphere.

CONCLUSION

Dominance of the FT tract in the language dominant hemisphere was demonstrated for the first time in a patient population and implicated a clinical utility of DTT for non-invasive evaluation of language lateralization. Our preliminary study might indicate reorganization of the language network in conjunction with pathology.

An aspergillotic aneurysm of the internal carotid artery following allogeneic bone marrow transplantation: successful management with catheter coil embolization and long-term antifungal agents

We report a case of a mycotic aneurysm of the internal carotid artery and cerebral hemorrhagic infarction resulting from Aspergillus middle ear infection in a patient with severe aplastic anemia who received unrelated bone marrow transplantation. Although a mycotic aneurysm is a rare complication, and most often fatal, the patient was successfully treated with catheter coil embolization of the internal carotid artery and long-term systemic antifungal therapy. This case emphasizes the need for the rapid diagnosis of potential fungal involvement of the vascular system and suggests the necessity for aggressive treatment, such as with the modality illustrated in this case.

Caveolin-3 regulates myostatin signaling. Mini-review

Caveolins, components of the uncoated invaginations of plasma membrane, regulate signal transduction and vesicular trafflicking. Loss of caveolin-3, resulting from dominant negative mutations of caveolin-3 causes autosomal dominant limb-girdle muscular dystrophy (LGMD) 1C and autosomal dominant rippling muscle disease (AD-RMD). Myostatin, a member of the muscle-specific transforming growth factor (TGF)-beta superfamily, negatively regulates skeletal muscle volume. Herein we review caveolin-3 suppressing of activation of type I myostatin receptor, thereby inhibiting subsequent intracellular signaling. In addition, a mouse model of LGMD1C has shown atrophic myopathy with enhanced myostatin signaling. Myostatin inhibition ameliorates muscular phenotype in the model mouse, accompanied by normalized myostatin signaling. Enhanced myostatin signaling by caveolin-3 mutation in human may contribute to the pathogenesis of LGMD1C. Therefore, myostatin inhibition therapy may be a promising treatment for patients with LGMD1C. More recent studies concerning regulation of TGF-beta superfamily signaling by caveolins have provided new insights into the pathogenesis of several human diseases.

Salvage of an Arm by Means of a Free Cutaneous Flap Based on the Posterior Tibial Artery

A case involving medial calf, free cutaneous flap based on the posterior tibial artery for one-stage reconstruction of soft tissue and main vessel damage is presented. Flap anatomy is outlined, and operative techniques for transfer are detailed, in a case of deep contact burn of an arm.

Umbilical cord milking reduces the need for red cell transfusions and improves neonatal adaptation in infants born at less than 29 weeks' gestation: a randomised controlled trial

OBJECTIVE

To investigate the effects of umbilical cord milking on the need for red blood cell (RBC) transfusion and morbidity in very preterm infants.

PATIENTS AND METHODS

40 singleton infants born between 24 and 28 weeks' gestation were randomly assigned to receive umbilical cord clamped either immediately (control group, n = 20) or after umbilical cord milking (milked group, n = 20). Primary outcome measures were the probability of not needing transfusion, determined by Kaplan-Meier analysis, and the total number of RBC transfusions. Secondary outcome variables were haemoglobin value and blood pressure at admission.

RESULTS

There were no significant differences in gestational age and birth weight between the two groups. The milked group was more likely not to have needed red cell transfusion (p = 0.02) and had a decreased number (mean (SD)) of RBC transfusions (milked group 1.7 (3.0) vs controls 4.0 (4.2); p = 0.02). The initial mean (SD) haemoglobin value was higher in the milked group (165 (14) g/l) than in the controls (141 (16) g/l); p<0.01). Mean (SD) blood pressure at admission was significantly higher in the milked group (34 (9) mm Hg) than in the controls 28 (8) mm Hg; p = 0.03). There was no significant difference in mortality between the groups. The milked group had a shorter duration of ventilation or supplemental oxygen than the control group.

CONCLUSION

Milking the umbilical cord is a safe procedure, reducing the need for RBC transfusions, and the need for circulatory and respiratory support in very preterm infants.

Pituitary adenylate cyclase-activating polypeptide is associated with schizophrenia

Pituitary adenylate cyclase-activating polypeptide (PACAP, ADCYAP1: adenylate cyclase-activating polypeptide 1), a neuropeptide with neurotransmission modulating activity, is a promising schizophrenia candidate gene. Here, we provide evidence that genetic variants of the genes encoding PACAP and its receptor, PAC1, are associated with schizophrenia. We studied the effects of the associated polymorphism in the PACAP gene on neurobiological traits related to risk for schizophrenia. This allele of the PACAP gene, which is overrepresented in schizophrenia patients, was associated with reduced hippocampal volume and poorer memory performance. Abnormal behaviors in PACAP knockout mice, including elevated locomotor activity and deficits in prepulse inhibition of the startle response, were reversed by treatment with an atypical antipsychotic, risperidone. These convergent data suggest that alterations in PACAP signaling might contribute to the pathogenesis of schizophrenia.

Microbial flora alterations in jejunum and colon after chemical bowel preparation before Kasai hepatoportojejunostomy

AIM

There is little reported evidence on the effect of preoperative chemical bowel preparation by the administration of oral antibiotics in patients with biliary atresia (BA). This study was designed to examine and compare the alterations of microbial flora in feces cultures before and after the administration of oral antibiotics, and to examine fluid cultures from the tip of the jejunal limb at bile duct reconstruction by Kasai hepatoportoenterostomy (HPJ), and to evaluate the effects of preoperative oral antibiotics on postoperative cholangitis.

MATERIAL AND METHODS

Between January 2003 and July 2005, 6 infants with BA underwent surgical correction, and were treated preoperatively with polymyxin B (80 000 U/kg/day in 3 divided doses for 2 days) and metronidazole (10 mg/kg/day in 2 divided doses for 2 days). Quantitative feces cultures, both before administration of oral antibiotics and at Kasai HPJ, were obtained in patients with BA. Furthermore, fluid cultures from the tip of the jejunal limb at bile duct reconstruction by Kasai HPJ were obtained to examine alterations of bacteria and fungi.

RESULTS

Bacterial colonization of the tip of the jejunal limb did not occur at the Kasai HPJ. The most commonly encountered organisms were ENTEROCOCCUS and intestinal bacterial flora. Fungus was not detected in the feces before or after the administration of oral antibiotics. CANDIDA was detected in the tip of the jejunal limb after Kasai HPJ in only one patient.

CONCLUSIONS

The authors propose that colonic-type flora are generally found in the feces before and after the administration of oral antibiotics, and no bacteria are detected in the bilioenteric conduits.

Cystic thymoma in a child: a rare case and review of the literature

Thymomas are rare mediastinal tumors in pediatrics and cystic thymoma, is characterized by a predominantly cystic formation, is extremely rare. This report describes a 13-year-old girl with cystic thymoma, who was treated by video-assisted thoracoscopic surgery. The microscopic findings were characteristic of cystic thymoma. The literature on cystic thymoma is reviewed here and the clinical characteristics of cystic thymoma are discussed.

Effects of blood and virus-infected blood on protein expression in the midgut of the dengue vector Aedes albopictus

Although the mosquito midgut is the primary site of bloodmeal storage and the first line of defence against pathogenic infection, little is known about its proteic composition at a time when an increasing number of proteins are reported to impair viral infection. Aedes albopictus Skuse (Diptera: Culicidae) is an important vector of the dengue virus. We compared 2-dimensional protein profiles of the adult midgut in this species, taking into account bloodmeal status. The comparison of profiles from sugar-fed and blood-fed females showed that a considerable number of proteins were present in both midguts. In addition, one set of proteins was present only after sugar intake and another set only after blood intake. The comparison of profiles of blood-fed midguts and dengue virus-2 infected blood-fed midguts revealed that at least six proteins were present only in the infected midguts. These results are discussed in the context of the identification of midgut proteins involved in the dengue virus infection process.

Rapamycin inhibits the growth of cholangiocarcinoma cells in vitro

15153

Background: In the present study, anti-neoplastic effect of rapamycin against cholangiocarcinoma was studied in vitro. Methods: Expression of mTOR in 4 cholangiocarcinoma cell lines, TFK1, HuCCT1, NOZW, and OZ was evaluated by real-time PCR. Then, the four cholangiocarcinoma cell lines were cultured with rapamycin (0, 25, 50, 100, 200 nM), gemcitabine (0, 0.5, 1, 2 μM), or both, and anti-proliferative effect was evaluated by MTT assay. Results: All the four cholangiocarcinoma cell lines expressed endogenous mTOR- mRNA. Level of expression was the highest in HuCCT1 (65.8), and the lowest in TFK1 (17.6). Then, rapamycin significantly inhibited the growth of all the four cholangiocarcinoma cell lines, in dose-dependent manner. Gemcitabine inhibited the growth of NOZW (48.4%) and HuCCT1 (48.9%), but less efficiently in TFK1 (5.9%) and OZ (27.4%). Furthermore, synergistic anti-proliferative effect of rapamycin and gemcitabine was observed in TFK1 (39.1%), NOZW (38.9%), and OZ (47.1%), not in HuCCT1 (18.9%). Conclusion: Rapamycin effectively inhibited the growth of the cholangiocarcinoma cell lines, and synergistic effect with gemcitabine was observed in three of the four cell lines.

No significant financial relationships to disclose.

Effect of new anti-neoplastic agent, MK615, from Japanese apricot, ume, on growth of breast cancer cells in vitro

11105

Background: MK615 is an extract mixture from Japanese apricot, UME. In this study, the anti-neoplastic effects of MK615 against breast cancer cells were investigated. Methods: Two breast cancer cell lines, MDA-MB-468 (MDA) and MCF7, were cultured with (600, 300, 150 μg/ml) or without MK615. After 72 hours of incubation, growth inhibition was evaluated by MTT assay, and the mechanism of the anti-neoplastic effect of MK615 was evaluated by cell cycle- and apoptosis assay. Results: MK615 inhibited the growth of MDA and MCF7 in a dose-dependent manner. The percentage growth inhibition of MDA at dosages of 600, 300, and 150 μg/ml was 59.2%, 52.4%, and 23.3%, respectively, and that for MCF7 was 83.5%, 52.7%, and 16.6%, respectively. Cell cycle analysis showed that MK615 increased the proportion of cells in G2-M phase in both MDA (7.8% to 11.7%) and MCF7 (8.1% to 18.7%), and finally both cell lines became apoptotic. The proportion of apoptotic cells increased with incubation time. Conclusions: MK615 effectively inhibits the growth of breast cancer cells in vitro, possibly by cell cycle modification and apoptosis induction.

No significant financial relationships to disclose.

Diffusion tensor fiber tractography for arteriovenous malformations: quantitative analyses to evaluate the corticospinal tract and optic radiation

BACKGROUND AND PURPOSE

We hypothesized that diffusion tensor fiber tractography would be affected by intracranial arteriovenous malformation (AVM). The purpose of the present study was to evaluate the influence of intracranial AVM on corticospinal tract and optic radiation tractography.

MATERIALS AND METHODS

The subject group comprised 34 patients with untreated intracranial AVM. Hemorrhage was present in 13 patients and absent in 21 patients. Perinidal fractional anisotropy (FA) and number of voxels along the reconstructed corticospinal and optic radiation tracts were measured, and left-to-right asymmetry indices (AIs) for those values were quantified. Patients were assigned to 1 of 3 groups: tracts distant from nidus, tracts close to nidus without neurologic symptoms, and tracts close to nidus associated with neurologic symptoms. One-way analysis of variance was used to compare differences in AI between groups. Hemorrhagic and nonhemorrhagic groups were assessed separately.

RESULTS

In patients without hemorrhage, AI of optic radiation volume (P<.0001), AI of perinidal FA along corticospinal tract (P=.006), and optic radiation (P=.01) differed significantly between groups. In patients associated with hemorrhage, AI of corticospinal tract volume (P=.01), AI of perinidal FA along corticospinal tract (P=.04), and optic radiation (P=.004) differed significantly between groups.

CONCLUSIONS

Corticospinal tract and optic radiation tractography were visualized in patients with AVM. In patients with both hemorrhagic and nonhemorrhagic AVM, the 2 fiber tracts close to the nidus were less visualized in the affected hemisphere than those distant from the nidus. Tracts were less visualized in patients with neurologic symptoms than in asymptomatic patients.

Detection of the virulent Marek's disease virus genome from feather tips of wild geese in Japan and the Far East region of Russia

Marek's disease (MD) virus (MDV) is known to cause malignant lymphomas in chickens. In 2001, we first reported an MD case in a white-fronted goose (Anser albifrons) in Japan. Therefore, the prevalence of MDV in the wild geese was surveyed by nested PCR using feather-tip samples in Japan and the Far East region of Russia, breeding habitats of geese migrating to Japan. MDV was detected in about 30% of analyzed white-fronted geese. Furthermore, by nucleotide sequence analysis, we confirmed that this MDV shows high homology to very virulent MDV, suggesting that highly virulent MDV is widespread in white-fronted geese migrating between Japan and Far East region of Russia.

Comparison between prenatally diagnosed choledochal cyst and type-1 cystic biliary atresia by CD56-immunostaining using liver biopsy specimens

Because it is difficult to distinguish preoperatively between a prenatally diagnosed choledochal cyst (CC) and type-1 cystic biliary atresia (BA) by ultrasound scanning or magnetic resonance imaging, some mode of discriminating between the 2 entities is required. The aim of this study was to investigate the immunohistological differences between prenatally diagnosed CC and type-1 cystic BA, using liver biopsy specimens immunostained for CD56. Five children with prenatally diagnosed CC and two children with prenatally diagnosed type-1 cystic BA were identified by fetal ultrasonography between 1985 and 2004. The control group included two children who were operated on at an earlier period due to postnatally diagnosed BA. Liver wedge biopsy in the right lobe was performed at the time of the radical operation. Histological findings of the CD56-stained liver biopsy specimens were classified into 4 categories each, with particular focus on staining distribution and intensity. The staining distribution was classified according to the scale 0 = no staining; 1 = some staining of bile ducts/ductules but staining in less than one-third of portal tracts; 2 = staining in one-third to less than two-thirds of portal tracts; and 3 = staining in more than two-thirds of portal tracts. Staining intensity was scored as follows: 0 = no staining, 1 = weak staining, 2 = moderate staining, and 3 = strong staining. The staining intensity and distribution in the CC group was zero in all 5 cases. The type-1 cystic BA group consisted of patients with scale 1 or 3 staining distribution and score 1 or 2 staining intensity. In the control group, staining distribution was 1 or 3, and staining intensity was 1 or 3. These results indicate that CD56-positive biliary duct cells are present in prenatally diagnosed type-1 cystic BA. The authors suggest that exploratory laparotomy might be avoided and, instead, immunohistological examination using liver biopsy specimens may be a reliable test for the differential diagnosis of CC and type-1 cystic BA in prenatally diagnosed neonates.

Comparative immunobiology of thymic DC mRNA in autoimmune-prone mice

New Zealand Black (NZB) mice have multiple defects in both innate and acquired immunity. A fundamental defect, described more than 25 years ago, is premature thymic involution. Subsequent studies have disclosed multiple defects in thymic epithelial cells, and it has been proposed that thymic dendritic cells (DCs) play an important role not only in thymic involution but also in the appearance of immunopathology. However, the number of available thymic DCs makes this population extremely difficult to study. We have taken advantage of our ability to isolate pure populations of thymic DCs and have examined several key mRNA levels of enzymes involved in signal transduction. Our data on NZB mice was compared to that of NZB x NZW F1 (B/WF1), BXSB-Yaa, MRL/lpr, NOD and control mice. Importantly, we demonstrate herein that a common feature in autoimmune-prone mice is an increase of thymic DC c-met mRNA. Indeed, the increase in c-met mRNA levels appeared specific to the thymus and was not noted in the spleen. Additionally, we demonstrate that E-cadherin, a downstream molecule of c-met, is also reduced. Finally, we note that the levels of HGF mRNA are normal in the autoimmune strains examined herein, confirming that the abnormality of c-met mRNA is not due to primary defects in thymic stromal cells. We submit that these results highlight the possibility of a selective defect in thymic DCs which will be a pivotal step in loss of tolerance, and suggest that future studies focus on adoptive cell transfer involving this population.

Recovery of zinc and lead from fly ash from ash-melting and gasification-melting processes of MSW--comparison and applicability of chemical leaching methods

Fly ash generated from MSW ash-melting and gasification-melting plants, known as Melting Furnace Fly Ash (MFA), contains considerable amounts of heavy metals such as Pb and Zn. These metals can be recovered using a smelting furnace after "pre-treatment" for removal of unnecessary elements such as Cl, Sn and Si. Chemical methods have been studied for pretreatment in the past. However, they have been discussed only with regard to treatment cost and the concentration of Pb and Zn recovered, but neither applicability to various types of MFA nor the environmental impact have been considered. In this study, acid, alkaline and ammonia/chloride leaching methods were compared from the standpoints of: (1) applicability to MFA, (2) concentration of Pb and Zn recovered, (3) treatment cost, and (4) environmental impact. Twenty-three samples of MFAs were collected and classified into 4 types based on element contents. A Pb and Zn recovery experiment was conducted for the representative MFA of those types. The results showed: (1) MFA from gasification-melting plants cannot be treated by chemical methods; (2) the other MFA can be treated to an acceptable quality by existing smelting furnaces; (3) only MFA from electric resistance ash-melting plants can be treated easily by the water washing method; and (4) alkaline and ammonia/chloride leaching methods were more effective than acid leaching.

Diffusion tensor fiber tractography of the optic radiation: analysis with 6-, 12-, 40-, and 81-directional motion-probing gradients, a preliminary study

BACKGROUND AND PURPOSE

Knowing the exact location of the optic radiation preoperatively is important for surgery of the temporal lobe. We hypothesized that a greater number of motion-probing gradients (MPGs) would provide better results of diffusion tensor (DT) fiber tractography of the optic radiation. To test this hypothesis, this study evaluated differences in DT fiber tractography of the optic radiation under different MPG settings.

METHODS

DT images were obtained in 12 healthy volunteers (7 men, 5 women) with a mean age of 32 years (range, 22-45 years) by using a 3T MR imaging scanner with single-shot echo-planar imaging with parallel acquisition (reduction factor = 2). MPG was applied in 6, 12, 40, and 81 independent directions. The first region of interest (ROI) was placed in the occipital lobe, and the second ROI was placed in the lateral geniculate body. Fibers penetrating both ROIs were considered as the optic radiation. Anteroposterior distance between the tip of the Meyer loop and the lateral geniculate body on an axial section was defined as a loop index. Numbers of fibers and loop indices in both cerebral hemispheres were evaluated statistically.

RESULTS

The optic radiation was well visualized in full length by DT fiber tractography in 20 of 24 hemispheres (83%). No significant differences were noted in number of fibers and loop indices among different MPG settings.

CONCLUSION

DT fiber tractography can frequently depict almost the entire optic radiation. MPG number does not exert any significant effect on visualization of the optic radiation, and 6-directional MPG is thus sufficient for this purpose.

[Bidirectional Glenn shunt without cardiopulmonary bypass]

From April 2002 to March 2005, 18 patients having undergone bidirectional Glenn shunt (BDG) without cardiopulmonary bypass (CPB) [off-pump BDG] were retrospectively reviewed. During BDG anastomosis, a temporary bypass was established between superior vena cava (15) or innominate vein (3) and main pulmonary artery (16) or right atrium (2). Hemodynamics and oxygenation were maintained well throughout the temporary bypass time. There was no emergent use of CPB. Mean transpulmonary pressure gradient immediately after and 24 hours after the BDG were 6.7 and 5.6 mmHg, respectively. Echocardiography showed mild flow turbulence at the anastomosis in 1 case. This simple and inexpensive technique provided good surgical view with stable hemodynamics enabling satisfactory BDG in selected cases. Furthermore, it could avoid adverse effects of CPB such as lung injury and possible blood transfusion. This experience would encourage off-pump BDG combined with more challenging procedures.

Blockade of Angiotensin II type-1 receptor reduces oxidative stress in adipose tissue and ameliorates adipocytokine dysregulation

Dysregulated production of adipocytokines may be involved in the development of atherosclerotic cardiovascular disease in metabolic syndrome and chronic kidney disease (CKD) associated with metabolic syndrome. The aim of this study was to determine the effects of treatment with angiotensin II (Ang II) type-1 receptor blocker (ARB) on the regulation of adipocytokines. Olmesartan, an ARB, significantly blunted the age- and body weight-associated falls in plasma adiponectin both in genetically and diet-induced obese mice, without affecting body weight, but had no effect on plasma adiponectin levels in lean mice. Olmesartan also ameliorated dysregulation of adipocytokines in obesity, such as tumor necrosis factor-alpha, plasminogen activator inhibitor-1, monocyte chemotactic protein-1, and serum amyloid A3. Olmesartan significantly reduced reactive oxygen species originating from accumulated fat and attenuated the expression of nicotinamide adenine dinucleotide phospho hydrogenase oxidase subunits in adipose tissue. In cultured adipocytes, olmesartan acted as an antioxidant and improved adipocytokine dysregulation. Our results indicate that blockade of Ang II receptor ameliorates adipocytokine dysregulation and that such action is mediated, at least in part, by targeting oxidative stress in obese adipose tissue. Ang II signaling and subsequent oxidative stress in adipose tissue may be potential targets for the prevention of atherosclerotic cardiovascular disease in metabolic syndrome and also in metabolic syndrome-based CKD.

Synthesis and electronic properties of ferrocene-filled double-walled carbon nanotubes

Double-walled carbon nanotubes (DWNTs) are filled with ferrocene molecules by a vapour diffusion method for the first time. The as-synthesized ferrocene-filled DWNTs are characterized by transmission electron microscopy (TEM), energy-dispersive x-ray spectrometry (EDX) and Raman spectroscopy. Electronic properties of double-walled carbon nanotubes (DWNTs) filled with ferrocene molecules are studied by fabricating them as the channels of field-effect transistor (FET) devices. Our results reveal that electronic properties of ferrocene-filled DWNTs are greatly modified due to the charge transfer between ferrocene molecules and DWNTs. In addition, after ferrocene molecules are decomposed inside DWNTs, electronic properties of DWNTs exhibit a further change due to Fe encapsulation, and unipolar n-type semiconducting DWNTs are consequently obtained.

Energetic proton acceleration and bunch generation by ultraintense laser pulses on the surface of thin plasma targets

Energetic proton acceleration from concave targets, the front of which were irradiated with 40 fs laser pulses with an intensity of 10(20)W/cm(2), has been studied as a function of the depth of the concave shape. Three kinds of targets, a triangular concave target, a circular concave target and a parabolic concave target are considered. When the depth of the concave shape was varied, the peak proton energy showed a maximum. The underlying mechanism for the existence of a maximum peak proton energy is presented by tracing the proton trajectory. It is concluded that a parabolic concave target is the best, among the targets considered, for accelerating a proton beam, since a proton beam from a parabolic concave target goes through the strongest electric field.

Management and algorithm for focal nodular hyperplasia of the liver in children

PURPOSE

The aim of this study was to determine an appropriate management plan for childhood and adolescent FNH, in particular to establish an algorithm for preoperative diagnosis and treatment.

PATIENTS AND METHODS

Between 1985 and 2003, 4 children with FNH were diagnosed. Of these 4 patients, 3 (Group A) underwent tumor resection, and 1 (Group B) was treated by conservative management. Clinical data, pathological findings and follow-up were evaluated retrospectively.

RESULTS

The 3 patients in Group A were symptomatic, while the 1 patient in Group B was asymptomatic. In 3 of 4 patients, a homogeneous tumor with a central stellate area was noted on abdominal ultrasonography, CT scan and MR imaging. In case 2, SPIO-enhanced MR imaging was useful for differentiating FNH from hepatocellular carcinoma. Though percutaneous needle biopsy was performed in case 3, a pathologically definitive diagnosis was impossible. An open biopsy was performed in case 4 and FNH was diagnosed. In case 4 treated by conservative management, the tumor size did not change during the 7 years after the diagnosis of FNH.

CONCLUSION

FNH is usually treated conservatively because of the good evolutionary outcome of the lesion. Surgery is indicated in cases of complications, compressed adjacent organs, lesion progression, or for symptomatic patients. We advocate the use of less invasive SPIO-enhanced MR imaging instead of open biopsy when the diagnosis of focal liver lesions is not clear after contrast-enhanced CT scan and non-enhanced MR imaging.

LDL particle size, fat distribution and insulin resistance in obese children

BACKGROUND

The importance of small dense low-density lipoprotein (sdLDL) cholesterol in coronary heart disease has been demonstrated in many studies. Body fat accumulation, especially abdominal adiposity, is one of the important factors modifying the expression of sdLDL in adults.

OBJECTIVE

To determine the prevalence of sdLDL in obese children, and to investigate its relationship with anthropometric and metabolic variables.

SUBJECTS

A total of 30 obese children (22 males, 8 females) aged 12.6+/-0.6 years (mean+/-s.e.), who presented to our outpatient clinic with obesity.

METHODS

LDL peak particle diameter was determined using gel electrophoresis. LDL subclasses were classified into sdLDL (pattern B; diameter<25.5 nm) and non-sdLDL (pattern A; diameter>or=25.5 nm). Anthropometric and metabolic variables were also determined to identify factors modifying LDL particle size.

RESULTS

sdLDL was detected in 11 children (40.0%). In children with sdLDL, waist/height ratio was significantly higher (P=0.0466), and they had significantly higher triglyceride (TG) (P=0.0035) and lower high-density lipoprotein cholesterol (HDLC) levels (P=0.036). Peak LDL diameter as a continuous variable was significantly correlated with HDLC and TG levels. In multiple regression analysis, body mass index and waist/height ratio were significant determinants of the peak LDL diameter variability.

CONCLUSIONS

We found a high prevalence of sdLDL in obese children, and a relationship of peak LDL diameter with abdominal fat accumulation, HDLC and TG levels. The presence of sdLDL might be an important risk factor for the metabolic syndrome.

A complex polymorphic region in the brain-derived neurotrophic factor (BDNF) gene confers susceptibility to bipolar disorder and affects transcriptional activity

Previous studies have suggested that genetic variations in the brain-derived neurotrophic factor (BDNF) gene may be associated with several neuropsychiatric diseases including bipolar disorder. The present study examined a microsatellite polymorphism located approximately 1.0 kb upstream of the translation initiation site of the BDNF gene for novel sequence variations, association with bipolar disorder, and effects on transcriptional activity. Detailed sequencing analysis revealed that this polymorphism is not a simple dinucleotide repeat, but it is highly polymorphic with a complex structure containing three types of dinucleotide repeats, insertion/deletion, and nucleotide substitutions that gives rise to a total of 23 novel allelic variants. We obtained evidence supporting the association between this polymorphic region (designated as BDNF-linked complex polymorphic region (BDNF-LCPR)) and bipolar disorder. One of the major alleles ('A1' allele) was significantly more common in patients than in controls (odds ratio 2.8, 95% confidential interval 1.5-5.3, P=0.001). Furthermore, a luciferase reporter gene assay in rat primary cultured neurons suggests that this risk allele (A1) has a lower-transcription activity, compared to the other alleles. Our results suggest that the BDNF-LCPR is a functional variation that confers susceptibility to bipolar disorder and affects transcriptional activity of the BDNF gene.

The rubble-pile asteroid Itokawa as observed by Hayabusa

During the interval from September through early December 2005, the Hayabusa spacecraft was in close proximity to near-Earth asteroid 25143 Itokawa, and a variety of data were taken on its shape, mass, and surface topography as well as its mineralogic and elemental abundances. The asteroid's orthogonal axes are 535, 294, and 209 meters, the mass is 3.51 x 10(10) kilograms, and the estimated bulk density is 1.9 +/- 0.13 grams per cubic centimeter. The correspondence between the smooth areas on the surface (Muses Sea and Sagamihara) and the gravitationally low regions suggests mass movement and an effective resurfacing process by impact jolting. Itokawa is considered to be a rubble-pile body because of its low bulk density, high porosity, boulder-rich appearance, and shape. The existence of very large boulders and pillars suggests an early collisional breakup of a preexisting parent asteroid followed by a re-agglomeration into a rubble-pile object.

Touchdown of the Hayabusa Spacecraft at the Muses Sea on Itokawa

After global observations of asteroid 25143 Itokawa by the Hayabusa spacecraft, we selected the smooth terrain of the Muses Sea for two touchdowns carried out on 19 and 25 November 2005 UTC for the first asteroid sample collection with an impact sampling mechanism. Here, we report initial findings about geological features, surface condition, regolith grain size, compositional variation, and constraints on the physical properties of this site by using both scientific and housekeeping data during the descent sequence of the first touchdown. Close-up images revealed the first touchdown site as a regolith field densely filled with size-sorted, millimeter- to centimeter-sized grains.

FKBP133: a novel mouse FK506-binding protein homolog alters growth cone morphology

FK506-binding proteins are the peptidyl prolyl cis-trans isomerases that are involved in various intracellular events. We characterized a novel mouse FK506-binding protein homolog, FKBP133/KIAA0674, in the developing nervous system. FKBP133 contains a domain similar to Wiskott-Aldrich syndrome protein homology region 1 (WH1) and a domain homologous to FK506-binding protein motif. FKBP133 was predominantly expressed in cerebral cortex, hippocampus, and peripheral ganglia at embryonic day 18.5. FKBP133 protein was distributed in the axonal shafts and was partially co-localized with F-actin in the growth cones of dorsal root ganglion neurons (DRG). The number of filopodia was increased in the DRG neurons overexpressing FKBP133. In contrast, the overexpression of a mutant deleted the WH1 domain reduced the growth cone size and the number of filopodia. Furthermore, the neurons overexpressing FKBP133 became significantly resistant to Semaphorin-3A induced collapse response. These results suggest that FKBP133 modulates growth cone behavior with the WH1 domain.

Possible association between nonsynonymous polymorphisms of the anaplastic lymphoma kinase (ALK) gene and schizophrenia in a Japanese population

We examined, for the first time, the possible association between schizophrenia and the anaplastic lymphoma kinase (ALK) gene which plays an important role in neurodevelopment. When two nonsynonymous polymorphisms (Arg1491Lys and Glu1529Asp) were examined, there were significant differences in genotype and allele distributions between patients and controls. Individuals homozygous for the minor allele (1491Lys-1529Asp) were more common in patients than in controls (p = 0.0064, odds ratio 2.4, 95% CI 1.3-4.6). These results suggest that genetic variations of the ALK gene might confer susceptibility to schizophrenia.

Effective esophageal balloon dilation for esophageal stenosis in recessive dystrophic epidermolysis bullosa

Recessive dystrophic epidermolysis bullosa (RDEB) is an inherited disorder of squamous epithelium that results in dystrophic scarring of the skin after minor trauma. RDEB is classified into two subtypes: Hallopeau-Siemens (HS) and non-Hallopeau-Siemens (nHS). Although severe scarring of the skin is the most common and obvious complication of the disease, esophageal scarring with formation of long strictures may also develop. Treatment options for esophageal stenosis in patients with RDEB include steroids, hyperalimentation, esophageal dilation and replacement. This report describes a child who was dilated immediately after diagnosis of severe esophageal stenosis subsequent to nHS-RDEB and managed successfully. Endoscopic esophageal balloon dilation under fluoroscopic control was very useful for detecting the region of stenosis and bougienage. The literature on such injuries is reviewed here, and the problems associated with the treatment of children with esophageal stenosis associated with RDEB are discussed.

Histological differentiation between prenatally diagnosed choledochal cyst and type I cystic biliary atresia using liver biopsy specimens

Because it is difficult to distinguish preoperatively between prenatally diagnosed choledochal cyst (CC) and type I cystic biliary atresia (BA) by ultrasound scanning or magnetic resonance imaging (MRI), some modality of discrimination for the 2 entities is required. The aim of this study was to investigate the histological differences between prenatally diagnosed CC and type I cystic BA using liver biopsy specimens. Four children with prenatally diagnosed CC and two children with prenatally diagnosed type I cystic BA were identified by fetal ultrasonography between 1985 and 2003. The control group included two children who were operated on at an earlier period due to postnatally diagnosed BA. Liver wedge biopsy in the right lobe was performed at the time of the radical operation. Histological findings of the H & E-stained liver biopsy specimens were classified into 4 grades (Grade 0, no abnormality; Grade 1, ductular proliferation without bridging fibrosis; Grade 2, ductular proliferation with bridging fibrosis; and Grade 3, liver cirrhosis). The CC group consisted of one case of Grade 0 and three cases of Grade 1. The type I cystic BA group consisted of one case each of Grade 2 and Grade 3. In the control group, both cases were Grade 2. The authors suggest that exploratory laparotomy might be avoided and, instead, histologic examination using liver biopsy specimens can be a reliable test for the differential diagnosis of CC and type I cystic BA in prenatally diagnosed neonates.