Glycemic index of single and mixed meal foods among common Japanese foods with white rice as a reference food

OBJECTIVE

The objectives were to examine the feasibility of using white rice as a reference food in the study of glycemic index (GI) and to examine the GI values of both single and mixed meal foods among rice species, processed rice products, beans, and dairy products.

DESIGN

Subjects were served with 50 g carbohydrate content of white rice at least two times (maximum three times) and test food once after separate overnight fasts. Capillary blood glucose measurements were carried out before and during 120 min after each food load.

SETTING

The study was carried out in an outpatient setting.

SUBJECTS

A total of 58 (38 females and 20 males) nondiseased subjects, mean aged 37 y and mean BMI 22 kg/m(2) were included.

RESULT

The correlation between incremental area under curve of white rice and glucose was r=0.853 (n=10, P <0.0001) and white rice was considered suitable to be used as a reference food. Among mixed meal foods, the combination of carbohydrate foods with vinegar, dairy products, and bean products significantly decreased the GI value of white rice of 20-40%. The reduction of GI occurred whether the foods were taken together, before or after rice intake. GI of noodles such as udon, soba, and spaghetti showed low GI values.

CONCLUSION

White rice could be used as a reference food in determining GI values of foods. A total of 32 single and mixed meal Japanese common food products were examined for their GI values.

Effect of salt and heating on a mesoscopic structure composed of ovalbumin globules in aqueous solution

Mesoscopic structural changes of an ovalbumin solution by heating and adding NaCl have been investigated with a small-angle neutron scattering method. In the natural solution, a broad peak at q = 0.057 A(-1), which disappeared by adding NaCl, indicates the existence of an electrostatic long-range interaction between the ovalbumin globules. Along with the broad peak, a prominent intensity increase in a very small q region was observed on heating except for the initial and final stages, indicating the coexistence of a disordered structure of the denatured ovalbumin and a regular-interspacing structure of the natural ovalbumin globules. Though the macroscopic feature in the final stage, whether the solution forms a gel (10 wt %) or not (5 wt %), strongly depended on the concentration of the ovalbumin, the scattering profiles showed a common characteristic feature: the appearance of a new peak around q = 0.023 A(-1), which indicates the emergence of another regular structure.

Annular pancreas complicated by carcinoma of the bile duct: diagnosis by MR cholangiopancreatography and endoscopic ultrasonography

It has been reported that annular pancreas should be evaluated for coexisting malignant tumors. However, no cases have been reported in which magnetic resonance cholangiopancreatography and endoscopic ultrasonography clearly demonstrated an annular pancreas complicated by bile duct carcinoma. We present a case that emphasizes the importance of magnetic resonance cholangiopancreatography and endoscopic ultrasonography in directly confirming a diagnosis of annular pancreas complicated by bile duct carcinoma.

Congenital fibrosarcoma of the jejunum in a premature infant with meconium peritonitis

We report an unusual case of perforation of a congenital fibrosarcoma of the jejunum in utero and secondary meconium peritonitis. Prenatal ultrasound showed polyhydramnios and fetal ascites from 25 gestational weeks in the absence of other fetal congenital anomalies. A 2200 g baby girl was born at 34 weeks gestation, presenting with severe generalized edema and respiratory distress immediately after birth. Plain radiography revealed progressive abdominal distension and pneumoperitoneum. The baby subsequently underwent surgery at the age of one day. A perforation of the upper jejunum, which had resulted in meconium peritonitis, was discovered intraoperatively and the perforated section of the intestine was resected and anastomosed successfully. The postoperative course was uneventful. Pathological examination confirmed that the perforation was caused by rupture of a congenital fibrosarcoma originating from the jejunum. Rupture of a malignant tumor is an extremely rare cause of peritonitis in the fetus and neonate.

Dysregulation of the granulocyte-macrophage colony-stimulating factor receptor is one of the causes of defective expression of CD80 antigen in systemic lupus erythematosus

CD80 and CD86, expressed on the antigen-presenting cells (APCs) provide costimulatory signals for T lymphocytes. Recently, defective expression of CD80 has been reported in systemic lupus erythematosus (SLE) although its mechanism is unclear. Here, expression of the B7 antigens induced by interferon-gamma, interleukin-4 or granulocyte-macrophage stimulating-factor (GM-CSF) along the differentiation process of APCs was investigated. In contrast to CD86, expression of CD80 on the CD14+ cells induced by GM-CSF was reduced in SLE. GM-CSF receptor (GM-CSFR) was down-regulated by GM-CSF or phorbol 12-myristate 13-acetate in both of the normal controls and SLE patients, while this change was more remarkable in the latter. In the presence of 1-(5-isoquinolinsulfonyl)-2-methylpiperazine, an inhibitor of protein kinase C, the PMA-induced down-regulation of GM-CSFR was reversed in the normal controls but not in SLE. These data suggest that dysregulation of the GM-CSFR might be associated with the defective expression of CD80, leading to dysfunction of the APCs in SLE.

A novel synbiotic therapy dramatically improved the intestinal function of a pediatric patient with laryngotracheo-esophageal cleft (LTEC) in the intensive care unit

To demonstrate the beneficial effects of synbiotic therapy (combined use of probiotics and prebiotics) in critically ill patients, we designed a new protocol for such therapy. Three agents were used as synbiotics: Bifidobacterium breve, Lactobacillus casei, and galactooligosaccharides. More than 1 x 10(9) of probiotic bacteria were contained in each 1.0 g pack. We administered 3.0 g per day of each agent to the patient.A critically ill 9-month-old girl with laryngotracho-esophageal cleft (type IV) was treated by our new synbiotic therapy. Abundant amounts of synbiotic bacteria were detected in the feces which suggests that these administered bacteria affected intestinal function in situ. Bowel movements resumed soon after the commencement of synbiotic therapy and considerable amounts of short chain fatty acids were detected in the feces. Growth of the patient was satisfactory under this treatment. Our new synbiotic therapy had a beneficial effect to improve intestinal function. We recommend synbiotic therapy for critically ill patients in intensive care units as an important immunonutritional therapy.

Resting energy expenditure among Japanese

1. Resting energy expenditure (REE) provides appropriate basic data for the calculation of energy requirements. 2. The REE of 6498 subjects according to sex and age (1 year stratification), with a minimum of 10 subjects per group, was measured systematically using the easy portable calorimeter (Metavine; Vine, Tokyo, Japan). 3. The REE or the REE/kg according to age and sex was observed to obtain the amount of standard deviation (20-25%). 4. The REE/kg for male and female subjects was maintained at a steady level after the age of 15 years and was estimated to be around 29 kcal/kg.

Cavernous pancreatic ductal ectasia with smooth muscle proliferation causing recurrent acute pancreatitis

BACKGROUND

Pancreatic cystic lesions have various etiologies, including pseudocyst (inflammatory cyst), retention cyst, congenital cyst, and neoplastic cyst.

RESULTS

This report describes a previously unreported, unique pancreatic cyst-like lesion causing recurrent acute pancreatitis. A 23-yr-old man had an 8 x 5 x 3-cm pancreatic head mass which contained multiple 3-7-mm cysts communicating with the main pancreatic duct on imaging studies. Pancreatoduodenectomy with mass excision prevented further attacks of acute pancreatitis. Pathological examination showed multiple cystic dilatations of branch pancreatic ducts surrounded by proliferating smooth muscle tissue, probably associated with hamartomatous changes.

CONCLUSION

We consider the present lesion to represent cavernous pancreatic ductal ectasia with smooth muscle proliferation because of its striking cholangiopancreatographic similarity to Caroli disease.

In vivo effect of pancreatic phospholipase A2 on the arachidonic acid cascade

BACKGROUND

In acute pancreatitis, pancreatic phospholipase A2 increases in systemic circulation. Yet the pathophysiological significance is controversial, because previous in vitro studies have shown that the enzyme has little cytotoxicity or ability to activate the arachidonic acid cascade by itself in contrast to other isozymes.

AIM OF THE STUDY

The aims of this study are to examine the effect of pancreatic phospholipase A2 on the arachidonic acid cascade in vivo; to explain the discrepancy, if present, between in vitro and in vivo findings; and to reassess the pathophysiological significance of circulating pancreatic phospholipase A2.

METHODS

Pancreatic phospholipase A2 was infused intravenously in guinea pigs, and changes in the arachidonic acid cascade, plasma lipoprotein, and cardiopulmonary function were investigated.

RESULTS

Plasma concentrations of 6-keto-prostaglandin F1alpha, prostaglandin E2, and thromboxane B2 increased after intravenous (iv) infusion of pancreatic phospholipase A2. Some of the plasma phospholipids such as phosphatidylcholine and phosphatidylethanolamine decreased, and free dihomo-gamma-linolenic acid, arachidonic acid, and eicosapentaenoic acid were detected in plasma. These changes were accompanied with decreases in blood pressure, heart rate, and base excess.

CONCLUSION

Circulating pancreatic phospholipase A2 activates the arachidonic acid cascade, probably by supplying free eicosanoid precursors from plasma lipoprotein to eicosanoid-producing cells. It is supposed to be a cause of systemic complications in acute pancreatitis.

Viscoelastic properties and residual strain in a tensile creep test on bovine temporomandibular articular discs

This study was designed to evaluate the creep characteristics and residual strain of bovine temporomandibular joint (TMJ) discs in tension. Twenty discs were divided into three specimens each: central, lateral and medial regions. Tension of 1.0 MPa was applied and sustained for 20 min to the specimens from 10 right-side discs, and tension of 1.5 MPa to specimens from 10 left-side discs. After the period of tension for creep, the specimens were removed from the tension devices and restoration observed for 20 min. Time-dependent creep curves showed a marked change in strain during the initial 5s. The essential time delay in strain ceased after 2 min, and strain reached an almost steady level after 3 min. At a tensile stress of 1.5 MPa, a strain of 14.5% on average was produced after 20 min creep in the central specimens; peripheral specimens showed strains of 12.4% on average. There were significant differences in strain between the central and peripheral specimens. The residual strain after 20 min restoration was 0.93% on average and there were no significant regional differences. This creep feature could be well represented by a generalized linear viscoelastic model. It was concluded that the regional differences in viscoelasticity might be caused by the complicated articulating functions of the TMJ, and that the residual strain caused by sustained stress could be an important factor in disc deformation.

Possible contribution of CD44 variant 6 and nuclear beta-catenin expression to the formation of budding tumor cells in patients with T1 colorectal carcinoma

BACKGROUND

In an earlier study, the authors demonstrated that tumor budding was useful for predicting lymph node metastasis in patients with early invasive (T1) colorectal carcinoma. This study was undertaken to clarify the associations between tumor budding, E-cadherin-catenin complex, and CD44 variant 6 abnormalities.

METHODS

In 51 T1 colorectal carcinomas, tumor budding (the number of dedifferentiation units at the invasive margin) on hematoxylin and eosin-stained slides was counted under light microscopy. Immunostaining for E-cadherin, alpha-catenin, beta-catenin, and CD44 variant 6 was performed on formalin fixed, paraffin embedded sections. The associations between locoregional failure (lymph node metastasis or local recurrence) and tumor budding and clinicopathologic parameters and immunoreactivity were examined statistically.

RESULTS

In univariate analysis, tumor budding and nuclear beta-catenin expression were associated significantly with locoregional failure (P = 0.004, 0.01). Multivariate analysis showed that tumor budding alone was associated significantly with locoregional failure (P = 0.02), and the association between nuclear beta-catenin expression and locoregional failure was marginally significant (P = 0.07). Analysis of variance showed that lymphatic invasion alone was associated significantly with tumor budding (P = 0.02), and there was a significant interaction effect for tumor budding between CD44 variant 6 expression and nuclear beta-catenin expression (P = 0.01). There was a significant correlation between expression patterns of these two molecules and locoregional failure (P = 0.01).

CONCLUSIONS

The current results suggest that the up-regulation of CD44 variant 6 through nuclear beta-catenin activation may contribute to the formation of tumor budding, and immunostaining of these two adhesion molecules may be useful in identifying those at high-risk for locoregional failure among patients with T1 colorectal carcinoma.

Anomalous pancreaticobiliary junction demonstrated by extraductal ultrasonography using transduodenoscopic miniprobe

We present a case of an anomalous pancreaticobiliary junction (a long common channel) that was clearly demonstrated by extraductal ultrasonography with a transduodenoscopic miniprobe placed in the duodenal lumen. The present case suggests a potential indication for the ultrasound miniprobe, in extraductal ultrasonography, in the pancreatobiliary region. In this method, the position of a miniprobe can readily be adjusted under endoscopic guidance, unlike ordinary endoscopic ultrasonography.

[Clinical utility and safety of diagnostic thoracoscopy]

The increasing use of thoracoscopy performed under local anesthesia has made contributions to the diagnosis of pleural disease with effusion. During the past 7 years, we have performed 100 such thoracoscopy procedures using a flexible fiberoptic bronchoscope. On the basis of our clinical findings, we are able to discuss the utility and safety of this procedure. The causes of pleural effusion were carcinomatous pleurisy in 72 cases, tuberculosis pleurisy in 15 cases, infection without tuberculosis in 4 cases, malignant pleural mesothelioma in 8 cases and one case of asbestosis. The success rate of thoracoscopic pleural biopsies were 97% for carcinomatous pleurisy, 100% for malignant pleural mesothelioma and 86% for tuberculosis pleurisy. This procedure was performed with no serious effect on blood pressure, oxygen saturation, monitored ECG or BGA data, and with no serious complications. Therefore, we concluded that this method is very useful for the diagnosis of pleural effusions and has few complications.

A novel non-viral gene transfer system, polycation liposomes

To develop a novel non-viral gene transfer system, liposome was modified with cetylated polyethylenimine (PEI). This polycation liposome (PCL) showed remarkable transfection efficiency to COS-1 cells in vitro, in comparison with conventional cationic liposome preparations. Cytotoxicity against COS-1 cells and hemolytic activity of PCL or PCL-DNA complex were quite low in comparison with conventional cationic liposomes. Most conventional cationic liposomes require phosphatidylethanolamine or cholesterol as a component, though PCL did not. Egg yolk phosphatidylcholine- and dipalmitoylphosphatidylcholine-based PCL were as effective as dioleoylphosphatidylethanolamine-based PCL for gene transfer. Furthermore, the transfection efficacy of PCL was enhanced, instead of being diminished, in the presence of serum. Effective gene transfer was observed in all eight malignant and two normal line cells tested as well as in COS-1 cells. The effect of the molecular weight of PEI on PCL-mediated gene transfer was examined, and observed that PEIs with a molecular weight (Mr. Wt.) of 600 and 1800 Da were quite effective but PEI of 25,000 was far less effective. Effectiveness of gene transfer by using PCL was also observed in vivo: GFP and Luciferase genes were effectively expressed in mouse. We also discussed the mechanism of gene transfer by PCL. Taken together, PCL represents a new system useful for transfection and gene therapy.