Association of Cardiac Dose with Cardiac Events and Survival for Locally Advanced Non-Small Cell Lung Cancer (LA-NSCLC) Treated with Concurrent Chemoradiotherapy (cCRT) in the Era of Immune Checkpoint Inhibitor (ICI) Consolidation

PURPOSE/OBJECTIVE(S)

To assess the association of cardiac dose with post-cCRT cardiac events and survival among patients (pts) with LA-NSCLC after adoption of ICI consolidation, modern radiotherapy (RT) techniques, and data-driven cardiac constraints.

MATERIALS/METHODS

This single-institution, multi-site retrospective study included 335 pts with LA-NSCLC treated with definitive cCRT (60-70 Gy) from October 2017 to December 2021. Pts were evaluated for ICI consolidation. Cardiac dose constraints included heart volume receiving ≥50 Gy (V50) <25% and mean heart dose (MHD) <20 Gy. Heart, left anterior descending artery (LAD), and left ventricle were autocontoured, manually reviewed, and edited. 21 dosimetric parameters (mean dose, max dose, and min dose to the hottest x% volume [Dx%(Gy); x from 5-95 in 5% intervals]) for each were extracted, as well as LAD V15. Baseline cardiovascular disease (bCVD) was defined as heart failure (HF), coronary artery disease, peripheral vascular disease, or cerebrovascular disease. Primary endpoint was post-cCRT major adverse cardiac events (MACE), defined as acute coronary syndrome, HF hospitalization/urgent visit, coronary revascularization, or cardiac death. Secondary endpoints were grade ≥3 cardiac events (CTCAE v5.0), overall survival (OS), cancer specific mortality (CSM), and other cause mortality (OCM). Competing risk regression was used for MACE and grade ≥3 cardiac events, and Cox regression for OS, CSM, and OCM.

RESULTS

Median age was 68 years, 139 (41%) had bCVD, and 225 (67%) received consolidation ICI. Proton therapy was used in 117 (35%), intensity-modulated RT in 199 (59%), and 3D conformal RT in 19 (6%). Median MHD was 8.7 Gy (IQR 4.6-14.4) and median LAD V15 1.4% (IQR 0-22). Median follow-up was 39.5 months. 35 MACE events occurred; 1- and 2-year cumulative incidence (CI) were 4.2% and 9.5%. No cardiac dosimetric parameter associated with MACE after adjusting for bCVD and age (e.g., MHD sHR 0.98/Gy, 95% CI 0.93-1.03, p = 0.43) or within the following 3 subgroups: no bCVD, photon therapy, and ICI consolidation. 87 grade ≥3 cardiac events occurred; 1- and 2- year CI were 12.6% and 20.4%. Heart dose was not associated with grade ≥3 cardiac events after adjusting for bCVD, ECOG, and BMI (e.g., MHD sHR 1.00/Gy, 95% CI 0.97-1.03, p = 0.85) or within the 3 aforesaid subgroups. 183 OS events occurred, including 125 CSM and 58 OCM events. Multiple cardiac dosimetric parameters associated with worse OS on multivariable analysis (e.g., LAD V15 HR 1.01/%, 95% CI 1.00-1.02, p = 0.003), driven by associations with CSM (LAD V15 HR 1.02/%, p<0.001) but not OCM (LAD V15 HR 1.00/%, p = 0.73). Median OS was worse for LAD V15 ≥10% (22.2 vs 35.1 months, p = 0.004).

CONCLUSION

Among pts with LA-NSCLC treated with cCRT after adoption of ICI consolidation, modern RT techniques, and cardiac constraints, post-cCRT cardiac events were common but showed no association with cardiac dose. Cardiac dose associated with OS, driven by an association with CSM and not OCM, which may not reflect cardiac toxicity.

Facemask ventilation and vocal cord angle following neuromuscular blockade: a prospective observational study. Anaesthesia 2022;77:1010-1017. [PMID: 35727620 DOI: 10.1111/anae.15786]

Numerous studies support the idea that neuromuscular blockade facilitates facemask ventilation after induction of anaesthesia. Although improved airway patency or pulmonary compliance and a resolution of laryngospasm have been suggested as possible causes, the exact mechanism remains unclear. We aimed to assess whether neuromuscular blockade improves facemask ventilation and to clarify whether this phenomenon is associated with the vocal cord angle. This prospective observational study included patients aged between 20 and 65 years scheduled for elective surgery under general anaesthesia. After induction of anaesthesia, patients' lungs were ventilated with pressure-controlled ventilation using a facemask. During facemask ventilation, a flexible bronchoscope was inserted through a self-sealing diaphragm at the elbow connector attached to the facemask and breathing circuit and positioned to allow a continuous view of the vocal cords. The mean tidal volume and vocal cord angle were measured before and after administration of neuromuscular blocking drugs. Of 108 patients, 100 completed the study. Mean (SD) tidal volume ((11.0 (3.9) ml.kg^-1 vs. 13.6 (2.6) ml.kg^-1 ; p < 0.001) and mean (SD) vocal cord angle (17° (10°) vs. 26° (5°); p < 0.001) increased significantly after neuromuscular blockade. The proportional increase in mean tidal volume after neuromuscular blockade was positively correlated with vocal cord angle (Spearman's ρ = 0.803; p < 0.001). In conclusion, neuromuscular blockade facilitated facemask ventilation, and the improvement was correlated with further opening of the vocal cords.

1092 Attention-deficit/hyperactivity Disorder Symptoms And Sleep Characteristics Within A Seasonal Affective Disorder Spectrum

Introduction

Seasonal affective disorder (SAD) increases risk for attention-deficit/hyperactivity disorder (ADHD), although the mechanism linking SAD and ADHD is unknown. Prior research has identified insomnia and delayed sleep phase in both ADHD and SAD. We hypothesized that sleep duration and timing in SAD would be associated with the severity of ADHD symptoms.

Methods

Adults with SAD (n = 45) and subsyndromal SAD (S-SAD; n = 18) aged 19-66 years from Pittsburgh, PA., were assessed for ADHD symptoms, self-report sleep quality, depression severity, and daytime sleepiness in the Winter. Participants wore an Actiwatch for 4-14 days, from which we calculated sleep-onset latency, total sleep time, sleep midpoint, and sleep efficiency. We conducted a hierarchical multivariate linear regression to determine if sleep characteristics predict ADHD symptom severity in our sample while controlling for depressive symptoms. Age and gender were added in Step 1, seasonal depression severity in Step 2, actigraphy-based total sleep time, sleep onset latency, midpoint, and efficiency in Step 3, and self-reported sleep quality and daytime sleepiness in Step 4.

Results

Participants mostly scored in the “likely” or “highly likely” ADHD range (87.30%, n=55), higher than the national prevalence rate (4.4%). When controlling for age, gender, and depression severity, only shorter actigraphy-based total sleep time was associated with higher ADHD symptom severity (β=-0.30, p&lt;0.05). However, when self-reported sleep quality and daytime sleepiness were added as predictors, total sleep time was no longer a statistically-significant predictor of ADHD symptom severity and only daytime sleepiness predicted ADHD symptom severity (β=0.31, p&lt;0.05).

Conclusion

Our results suggest that individuals with SAD who experience daytime sleepiness and/or possibly shorter actigraphy-based sleep duration experience higher ADHD symptom severity. Treatments like Trans-C or CBT-I to improve daytime sleepiness and sleep duration may be indicated for SAD patients who present with comorbid ADHD symptoms.

Support

NIMH K.A.R. MH103303

Influence of green light illumination at night on biological characteristics of the oriental armyworm, Mythimna separata (Lepidoptera: Noctuidae)

The oriental armyworm, Mythimna separata is an important crop pest in eastern Asia. Nocturnal insects, including nocturnal moths, have phototactic behavior to an artificial light source. Phototactic behavior in insects is species-specific in response to different wavelengths of light sources. Our previous study showed that green (520 nm) light emitting diode (LED) light resulted in a significantly higher phototactic behavior in M. separata moths compared to the other wavelength LED lights. The goal of the present study is to investigate the influence of green light illumination on biological characteristics of different developmental stages in M. separata. Our results revealed that when different developmental stages of M. separata were exposed to the green light illumination in a dark period, several biological characteristics in all developmental stages except for egg stage were positively changed, but those of F1 generation M. separata which are next generation of the adults exposed to the green light did not significantly change compared with the control level. These findings suggest that green light illumination at night (or dark period) has a positive effect on the development and longevity of M. separata.

Parkinson's disease and the risk of osteoporotic vertebral compression fracture: a nationwide population-based study

Patients with Parkinson's disease (PD) were at higher risk of osteoporotic vertebral compression fractures (OVCF) compared to controls and had elevated mortality rates. Compared to conservative treatment, surgical treatment for OVCF in PD patients seemed to be associated with better outcomes.

INTRODUCTION

The purpose of this study was to evaluate the risk of OVCF in patients with PD.

METHODS

Data from patients over the age of 60 years who were diagnosed with PD were collected between 2004 and 2013 from the Korean National Health Insurance Database (n = 3370). The comparison group (non-PD) consisted of randomly selected patients (five per patient with PD; n = 16,850) matched to the PD group, who were newly diagnosed annually according to age and sex. Cox proportional hazard regressions were used to examine the relationships between osteoporosis, OVCF, surgery for OVCF, and PD. Household income and residential area of patients were also assessed. Overall survival rates were calculated after adjusting for confounding factors, such as hypertension, diabetes mellitus, and chronic kidney disease.

RESULTS

OVCF was developed in 12.5% of patients in the PD group and in 7.4% of patients in the control group. PD was associated with increased risk of osteoporosis (hazard ratio [HR], 1.32; 95% confidence interval [CI], 1.21-1.43; p < 0.001), OVCF (HR 1.66; 95% CI, 1.47-1.87; p < 0.001), and surgery for OVCF (HR 2.69; 95% CI, 1.78-4.08; p < 0.001). Household income was not significantly related with development of osteoporosis, incidence of OVCF, or surgery for OVCF. Residential area was statistically associated with osteoporosis, OVCF, and surgery for OVCF. The mortality rate of the PD group was about 1.7 times higher than that of the non-PD group after adjusting for potential confounders, and the mortality rate of the PD with OVCF group was higher than that of the non-PD group, but not significantly (p = 0.09). The survival rate of the PD group with surgery for OVCF showed a trend toward a more positive prognosis compared with that of the PD group with conservative treatment.

CONCLUSIONS

Patients with PD had significantly increased risk of osteoporosis and OVCF. Surgical treatment for OVCF in PD patients was associated with a better prognosis than conservative treatment.

Enamel Surface with Pit and Fissure Sealant Containing 45S5 Bioactive Glass

Enamel demineralization adjacent to pit and fissure sealants leads to the formation of marginal caries, which can necessitate the replacement of existing sealants. Dental materials with bioactive glass, which releases ions that inhibit dental caries, have been studied. The purpose of this study was to evaluate the enamel surface adjacent to sealants containing 45S5 bioactive glass (BAG) under simulated microleakage between the material and the tooth in a cariogenic environment. Sealants containing 45S5BAG filler were prepared as follows: 0% 45S5BAG + 50.0% glass (BAG0 group), 12.5% 45S5BAG + 37.5% glass (BAG12.5 group), 25.0% 45S5BAG + 25.0% glass (BAG25.0 group), 37.5% 45S5BAG + 12.5% glass (BAG37.5 group), and 50.0% 45S5BAG + 0% glass (BAG50.0 group). A cured sealant disk was placed over a flat bovine enamel disk, separated by a 60-µm gap, and immersed in lactic acid solution (pH 4.0) at 37 °C for 15, 30, and 45 d. After the storage period, each enamel disk was separated from the cured sealant disk, and the enamel surface was examined with optical 3-dimensional surface profilometer, microhardness tester, and scanning electron microscopy. The results showed a significant increase in roughness and a decrease in microhardness of the enamel surface as the proportion of 45S5BAG decreased (P< 0.05). In the scanning electron microscopy images, enamel surfaces with BAG50.0 showed a smooth surface, similar to those in the control group with distilled water, even after prolonged acid storage. Additionally, an etched pattern was observed on the surface of the demineralized enamel with a decreasing proportion of 45S5BAG. Increasing the 45S5BAG filler contents of the sealants had a significant impact in preventing the demineralization of the enamel surface within microgaps between the material and the tooth when exposed to a cariogenic environment. Therefore, despite some marginal leakage, these novel sealants may be effective preventive dental materials for inhibiting secondary caries at the margins.

Association between VEGF and eNOS gene polymorphisms and lumbar disc degeneration in a young Korean population

Disturbances in blood flow to intervertebral discs (IVD) play an important role in IVD degeneration. Vascular endothelial growth factor (VEGF) and endothelial nitric oxide synthase (eNOS) are extremely important angiogenic factors for vasodilation and neovascularization. We investigated the relationship between single nucleotide polymorphisms (SNPs) of the VEGF and eNOS genes and genetic susceptibility to lumbar IVD degeneration in a young adult Korean population. Two hundred and forty-one participants (aged 18 to 30 years), with or without low back pain, were selected for the study. Magnetic resonance imaging was made of the lumbar spine in all participants. The patient group (N = 102) had low back pain clinically and lumbar IVD degeneration radiographically. The control group (N = 139) included subjects with and without low back pain; all were negative radiographically for lumbar IVD degeneration. Using PCR-RFLP analysis, we analyzed VEGF (-2578C>A, -1154G>A, -634G>C, and 936C>T) and eNOS (-786T>C, 4a4b and 894G>T) SNPs. We made combined analyses of the genes and performed haplotype analyses. There were no significant differences in the genotype distribution of polymorphisms of VEGF and eNOS genes among patients and controls. However, the frequency of VEGF -2578CA +AA/-634CC combined genotypes was significantly higher in patients when compared with controls [odds ratio (OR) = 21.00; 95% confidence interval (CI) = 2.590- 170.240]. The frequencies of the -2578A/-1154A/-634C/936C (OR = 3.831; 95%CI = 1.068-13.742), -2578A/-1154A/-634C (OR = 3.356; 95%CI = 1.198-9.400), and -2578A/-634C/936C (OR = 10.820; 95%CI = 2.811-41.656) haplotypes were also significantly higher in patients than in controls. We conclude that the combined genotype VEGF -2578CA+AA/-634CC is a possible risk factor for IVD degeneration and the VEGF -2578A/-1154A/-634C/936C haplotype may increase the risk for development of IVD degeneration. Furthermore, the VEGF -634C allele appears to be associated with susceptibility to IVD degeneration.

Relationship between body-mass index and serum folate concentrations in pregnant women

The concentration of micronutrients impacts fetal development and pregnancy outcome and has been suggested to be negatively correlated with the body-mass index (BMI). We evaluated the relationship between BMI and the serum folate concentration in 802 and 660 Korean pregnant women in mid- and late pregnancy, respectively, who participated in a multicenter prospective study. There was a significant negative correlation between BMI value and the serum folate concentration at mid- and late pregnancy (P for trend 0.001 and 0.024, respectively). A general linear model confirmed this correlation at both time points after adjusting for gestational age and total folate intake. These findings are important as the serum folate concentration is a rate-limiting factor for placental folate transport to the fetus, and an inadequate folate supply may cause various malformations.

Simultaneous unilateral internal carotid artery and occlusive basilar artery dissections

We report a case of brain stem infarction. The case is interesting for simultaneous occurrence of basilar artery (BA) occlusion caused by BA dissection and left internal carotid artery (ICA) dissection after a minor cervical trauma. Stents were implanted at the ICA dissection, and BA occlusion was treated conservatively.

Progressive collapse of PMMA-augmented vertebra: a report of three cases

Vertebroplasty using polymethylmethacrylate (PMMA) for augmentation is accepted as a safe and effective treatment for vertebral compression fracture. However, various complications related to PMMA vertebroplasty have recently been reported. We experienced three cases with progressive collapse of PMMA-augmented vertebra. Collapse progressed after augmentation in cases where PMMA conglomerated without contiguous bone interdigitation. A high viscosity of the PMMA preparation and vertebral body cavitory lesion may play a role in progressive vertebral collapse. To avoid this complication, bone cement should be injected sufficiently and permeate to contiguous bone to create strong support and anchorage.

Surgical management of spinal cord haemangioblastoma

BACKGROUND

The surgical management of spinal cord haemangioblastomas is distinct from that of other benign spinal cord tumours and optimal surgical strategy is still being determined because of the rarity of the condition. The aim of this study is to investigate factors that affect the outcome of surgical management.

PATIENTS AND METHODS

We retrospectively analysed 24 operations for symptomatic spinal cord haemangioblastomas in 20 patients. Clinical features and surgical results were investigated by medical record review, telephone interviews, angiographic images, and magnetic resonance images (MRI). The mean follow-up period was 5.6 years (range 6 months to 13.6 years).

RESULTS

Patients with cystic components showed pre-operative motor weakness and sensory change more commonly than those without cystic components. Post-operative function scale had a positive correlation with pre-operative function (R(2) = 0.727; p < 0.001) and no correlation with the extent of the surgery. All subtotally removed tumours recurred, whereas totally removed tumours recurred in only 3 patients.

CONCLUSION

The cystic component of spinal cord haemangioblastomas is responsible for symptom generation and is helpful for dissecting tumours. Post-operative functional status is determined by pre-operative functional status. Total removal is feasible by using the correct surgical technique and is recommended to prevent recurrence.

Outcome of surgery for a symptomatic herniated thoracic disc in relation to preoperative characteristics of the disc

BACKGROUND

This report presents general information on herniated thoracic discs, their clinical manifestations as well as surgical treatment, and examines the differences in the surgical outcome based on disc characteristics.

METHODS

This study includes 33 thoracic discectomies in 29 patients with a ventrally situated herniated thoracic disc reaching to the thoracic cord. Using preoperative computed tomography scanning and magnetic resonance imaging, the direction of the disc was classified as either central or lateral, and disc consistency classified as either soft or hard. Clinical outcome was assessed according to the Japanese Orthopedic Association (JOA) Score for thoracic myelopathy. The score was obtained by analysing motor, sensory and bladder function. Recovery rate was assessed, comparing preoperative and postoperative status based on disc characteristics. The correlations between outcome, symptom duration and recovery rate were also investigated.

FINDINGS

Clinical outcome according to the JOA Score showed significant postoperative improvement, increasing from 7.0 +/- 3.1 points to 8.2 +/- 2.7 points postoperatively (p < 0.01). The mean recovery rate was 12.4 +/- 56.9%, and 16 patients (55.2%) showed improvement. In the soft disc group, there was improvement in all categories, but the hard disc group showed no improvement. The central disc group showed improvement in sensory function, but the lateral disc group showed little improvement. Regression analysis revealed a statistically significant correlation between the preoperative and postoperative score, symptom duration and recovery rate.

CONCLUSIONS

Clinical outcome after surgery of a herniated thoracic disc proved successful, especially when the disc was considered to have a soft consistency. In order to decide the optimal surgical strategy and prospective surgical outcome, disc characteristics, including consistency and direction of prolapse should be considered preoperatively.

Biological responses in osteoblast-like cell line according to thin layer hydroxyapatite coatings on anodized titanium

Several features of the implant surface, such as roughness, topography and composition play a relevant role in implant integration with bone. This study was conducted in order to determine the effects of various thin layer hydroxyapatite (HA) coatings on anodized Ti surfaces on the biological responses of a human osteoblast-like cell line (MG63). MG63 cells were cultured on 100 nm HA (100 nm HA coating on anodized surface), 500-700 nm HA (500-700 nm HA coating on anodized surface), 1 mum HA (1 mum HA coating on anodized surface) and anodize (non-HA coating on anodized surface) Ti. The morphology of these cells was assessed by scanning electron microscopy (SEM). The cDNAs prepared from the total RNAs of the MG63 were hybridized into a human cDNA microarray (1152 elements). The appearances of the surfaces observed by SEM were different on each of the four dental substrate types. MG63 cells cultured on 100 nm HA, 1 mum HA and anodize exhibited cell-matrix interactions. It was 500-700 nm HA surface showing cell-cell interaction. In the expression of genes involved in osseointegration, several genes, including bone morphogenetic protein 2, latent transforming growth factor beta binding protein 1, catenin (cadherin-associated protein), integrin, PDGFRB and GDF-1 growth differentiation factor 1 were up-regulated on the different surfaces. Several genes, including fibroblast growth factor receptor 3, fibroblast growth factor 12 and CD4 were down-regulated on the different surfaces. The attachment and expression of key osteogenic regulatory genes were enhanced by the surface morphology of the dental materials used.

Cervical arthroplasty in a patient with Klippel-Feil syndrome

This is the first published report of a patient with Klippel-Feil syndrome treated with cervical arthroplasty. A 36-year-old man presented with posterior neck pain and myelopathic symptoms. A radiograph demonstrated congenital fusion of the vertebral bodies at C2-3, C4-5 and C5-6. On MRI, the spinal cord was compressed by a protruding cervical disc and bony spurs at C6-7. After anterior discectomy and decompression of the spinal cord at the C6-7 level, the disc was replaced with the Bryan cervical disc system (Medtronic Sofamor Danek, Memphis, TN, USA) to restore normal motion. The absence of adjacent segment degeneration and the preservation of cervical motion were noted 2 years after surgery. Arthroplasty may be performed in selected patients with Klippel-Feil syndrome in order to restore motion and to prevent degeneration of the adjacent segment by reducing hypermobility.

Clinical and radiological results following cervical arthroplasty

BACKGROUND

This was a retrospective study of clinical and radiological results of cervical arthroplasty using the Bryan cervical disc prosthesis to evaluate the efficacy of arthroplasty in clinical applications.

METHODS

A total of 46 patients underwent arthroplasty of a single level using the Bryan disc prosthesis. Clinical outcome was assessed using the visual analogue scale (VAS) and the neck disability index (NDI). All patients were evaluated using preoperative and postoperative static cervical spine radiographs to compare cervical sagittal balance. Dynamic cervical spine radiographs were used to compare movement at the level of the procedure, movement at the adjacent level and movement of the whole cervical spine.

FINDINGS

With the exception of four patients with aggravated neck pain, the NDI and VAS scores decreased significantly in late follow-up evaluations. The range of movement of the whole cervical spine, the functional segmental unit, and the adjacent segments were preserved after arthroplasty. The sagittal alignment of the cervical spine showed kyphosis after surgery but restored lordosis at a later time. The postulated cause of kyphotic changes include "over-milling" at the dorsal endplate, inappropriate angle of disc insertion, structural absence of lordosis in the Bryan disc, removal of posterior longitudinal ligament, and pre-existing kyphosis.

CONCLUSIONS

Arthroplasty using the Bryan disc appears to be safe and provided a favorable preliminary clinical and radiological outcome. Postoperative kyphosis can be prevented by understanding the biomechanical properties of the Bryan disc. Future studies will need to address the association between postoperative kyphosis, clinical outcome and adjacent segment disease.

Effect of various implant coatings on biological responses in MG63 using cDNA microarray

During the process of bone formation, titanium (Ti) surface is an important factor in the modulation of osteoblastic function. This study was conducted in order to determine the effects of different Ti surfaces on the biological responses of a human osteoblast-like cell line (MG63). MG63 cells were cultured on smooth (S), sandblasted large-grit and acid etching (SLA), hydroxyapatite (HA), hydroxyfluoride (HF), titanium nitrate (TIN), and diamond-like carbon (DLC) Ti. The morphology of these cells were assessed by SEM. The cDNAs prepared from the total RNAs of the MG63 were hybridized into a human cDNA microarray (1152 elements). The appearances of the surfaces observed by SEM were different on each of the six dental substrate types. The SLA and HA surfaces were determined to be rougher than the others. MG63 cells cultured on SLA and HA exhibited cell-matrix interactions. In the expression of genes involved in osseointegration, several genes, including bone morphogenetic protein, cadherin, integrin, and insulin-like growth factors, were upregulated on the different surfaces. Several genes, including fibroblast growth factor receptor 4, Bcl 2-related protein, and collagen, were downregulated on the different surfaces. The attachment and expression of key osteogenic regulatory genes were enhanced by the surface roughness of the dental materials used.

Obesity in Korean pre-adolescent school children: comparison of various anthropometric measurements based on bioelectrical impedance analysis

OBJECTIVES

To examine the relationships between body mass index (BMI), percentage-weight-for-height (PWH) and percentage body fat (PBF), and to compare their validity based on PBF with the BMI criteria of International Obesity Task Force (IOTF) for childhood obesity in Korean pre-adolescent school children.

DESIGN

Statistical comparative analysis for anthropometric measures.

SUBJECTS

Korean pre-adolescent children (438 boys and 454 girls, aged 8-12 years, mean BMI 19.5+/-3.4 kg/m2).

MEASUREMENTS

Body mass index and PWH were calculated as body size indices from height and weight. Hand-to-foot bioelectrical impedance analysis (BIA) was performed to obtain PBF values, with obese children defined as PBF above 35%. Sensitivity and specificity were displayed with the gold standard of PBF, and receiver operating characteristic (ROC) curves were used to assess the performance of BMI and PWH in detecting obesity.

RESULTS

The prevalence of obesity varied by the criteria: 18.8% by Korean BMI standards for 95 percentile, 11% by the IOTF-BMI 30 kg/m2 and 29.4% by Korean PWH cutoffs. Body mass index and PWH were significantly correlated with PBF after adjusting for age, 0.910 (P<0.01) and 0.915 (P<0.01), respectively. The sensitivity and specificity of the PWH cutoffs were 0.909 and 0.882, respectively. The local BMI 95 percentiles had lower sensitivity (0.714) and specificity (0.790). The IOTF-BMI definition showed much lower sensitivity (0.457) and higher specificity (0.990). The BMI cutoffs corresponding with the highest accuracy were smaller than IOTF-BMI 30 kg/m2 for all age groups in both boys and girls.

CONCLUSION

The prevalence of obesity among Korean pre-adolescent children widely varied according to the diagnostic criteria applied. Universally recommended cutoffs for children by IOTF showed the lowest sensitivity among the criteria used, and may therefore underestimate obesity in this population.

Effect of human mesenchymal stem cell transplantation combined with growth factor infusion in the repair of injured spinal cord

Recently, bone marrow stromal cells have been shown to have the capacity to differentiate into neural cell under experimental cell culture conditions. Some investigators suppose that these cells, when placed into an environment of injury, express factors that promote repair or active compensatory mechanisms and endogeneous stem cells within the injured tissue. Rats were subjected to a weight driven implant spinal cord injury. After one week, the rats were treated with cultured human mesenchymal stem cells (MSCs) transplantation and basic fibroblast growth factor (bFGF) infusion into the CSF space. Functional outcome and histologic evaluation were performed. The data showed improved functional outcome in the group treated with MSCs transplantation and bFGF administration compared with the group of MSCs transplantation and control, which means bFGF might take an additional role to improve functional outcome. Glial differentiation of MSCs was noted but neuronal differentiation was doubtful. In this study, we did not demonstrate the mechanism of the neurotrophic factor affecting neural repair. However, this study is consistent with growing literature that MSCs and neurotrophic factor promote tissue repair and functional recovery after spinal cord injury and suggests that MSCs transplantation and bFGF warrants investigation as a therapeutic intervention after spinal cord injury.

Functional recovery after human umbilical cord blood cells transplantation with brain-derived neutrophic factor into the spinal cord injured rat

There have been many efforts to recover neuronal function from spinal cord injuries, but there are some limitations in the treatment of spinal cord injuries. The neural stem cell has been noted for its pluripotency to differentiate into various neural cell types. The human umbilical cord blood cells (HUCBs) are more pluripotent and genetically flexible than bone marrow neural stem cells. The HUCBs could be more frequently used for spinal cord injury treatment in the future. Moderate degree spinal cord injured rats were classified into 3 subgroups, group A: media was injected into the cord injury site, group B: HUCBs were transplanted into the cord injury site, and group C: HUCBs with BDNF (Brain-derived neutrophic factor) were transplanted into the cord injury site. We checked the BBB scores to evaluate the functional recovery in each group at 8 weeks after transplantation. We then, finally checked the neural cell differentiation with double immunofluorescence staining, and we also analyzed the axonal regeneration with retrograde labelling of brain stem neurons by using fluorogold. The HUCBs transplanted group improved, more than the control group at every week after transplantation, and also, the BDNF enabled an improvement of the BBB locomotion scores since the 1 week after its application (P<0.05). 8 weeks after transplantation, the HUCBs with BDNF transplanted group had more greatly improved BBB scores, than the other groups (P<0.001). The transplanted HUCBs were differentiated into various neural cells, which were confirmed by double immunofluorescence staining of BrdU and GFAP & MAP-2 staining. The HUCBs and BDNF each have individual positive effects on axonal regeneration. The HUCBs can differentiate into neural cells and induce motor function improvement in the cord injured rat models. Especially, the BDNF has effectiveness for neurological function improvement due to axonal regeneration in the early cord injury stage. Thus the HUCBs and BDNF have recovery effects of a moderate degree for cord injured rats.

An in vitro evaluation of miniplate fixation techniques for fractures of the atrophic edentulous mandible

This study was undertaken to evaluate the biomechanical stability of various miniplate fixation techniques in varying degrees of atrophy and to determine optimal fixation techniques for fractures of the atrophic edentulous mandible. A total of 78 bovine ribs were randomly divided into 13 groups of six each; one non-atrophic group and twelve atrophic groups. Each one of the 13 sets of six ribs was formed based on the vertical dimension (40, 20, 15 or 10 mm) and osteotomized. The segments so produced were then reduced and fixed using various miniplate fixation techniques. The stability of various miniplate fixations in ribs showing varying degrees of atrophy (10, 15 and 20 mm) was compared with that of one miniplate fixation in non-atrophic ribs (40 mm), used as a standard. Atrophic groups utilizing single miniplate were significantly less stable than the non-atrophic group, whereas atrophic groups fitted with double miniplates, such as two 4-hole or two 6-hole miniplates, were significantly more stable than the non-atrophic group. The two miniplate fixation technique is recommended for the provision of adequate fracture site stability when open reduction is indicated in cases of atrophic edentulous mandibular fractures.

Primary malignant fibrous histiocytoma extending into spinal canal through intervertebral foramina

A 60-year-old man was referred to us because of gradual-onset radiculopathy in his left leg for 2 months. Magnetic Resonance Imaging (MRI) of the lumbar spine demonstrated a relatively homogeneous huge mass in the left paravertebral area from L1 to L3 (Fig. 1A, B). Axial MRI scan (Fig. 1C) confirmed the extension of the tumour into the adjacent spinal canal through the neural foramina, forming an extradural mass, which resulted in the compression of both the dural sac and the nerve roots. The patient was operated on by a staged-resection. First, a left retroperitoneal approach was performed for the paraspinal mass. The tumour appeared brown to tan in color and was moderately firm. Nine days after his first operation, the patient underwent a resection of the intraspinal/extradural tumour by a posterior approach. After the left L1-2 hemilaminectomy was performed, the extradural tumour was easily identified, dissected, and completely removed. Microscopically, it was a highly cellular tumour composed of anaplastic cells assuming a gigantic size with bizarre nuclei, which were admixed with inflammatory cells (Fig. 1D). The tumour cells were immunohistochemically characterized by positive staining for vimentin confirming its mesenchymal origin, and CD68 consistent with histiocyte-like qualities (Fig. 1E, F). A diagnosis of inflammatory malignant fibrous histiocytoma (MFH) could be made. Postoperatively, the patient made an uneventful recovery and received radiotherapy as an adjuvant therapy.

The influence of lithium fluoride on in vitro biocompatibility and bioactivity of calcium aluminate-pMMA composite cement

The objective of this study is to assess the influence of lithium fluoride on in vitro biocompatibility and bioactivity of calcium aluminate (CA)-polymethylmethacrylate (PMMA) composite cement exhibiting quick setting time ( < 15 min), low exothermic temperature (< 47 degrees C), and high compressive strength (> 100 MPa). The biocompatibility was measured by examining cytotoxicity tests such as the agar diffusion test with L929 cell line and the hemolysis test with fresh rabbit blood. To estimate the bioactivity of CA-PMMA composite cement, we determined hydroxyapatite (HAp) formation on the surface of composite cement in the simulated body (SBF) solution by using thin-film XRD, XPS, SEM, EPMA and ICP-AES. The results of biocompatibility tests indicated that all experimental compositions of this study had no cytotoxicity and no hemolysis so that there was no cytotoxicity with regard to non-reacted monomers (MMA and TEGDMA) and lithium fluoride. The results of bioactivity tests revealed that CA-PMMA composite cement without lithium fluoride did not form HAp on its surface after 60 days of soaking in the SBF. On the other hand, LiAl2(OH)7 . 2H2O and HAp were formed on the surface of CA-PMMA composite cement including 1.0% by weight of lithium fluoride after 7 and 15 days of soaking in the SBF, respectively. The 5 microm of LiAl2(OH)7 . 2H2O and HAp mixed layers were formed on the surface of specimen after 60 days of soaking in the SBF.

Effects of the interaction between the C677T 5,10-methylenetetrahydrofolate reductase polymorphism and serum B vitamins on homocysteine levels in pregnant women

OBJECTIVE

The purpose of this study was to investigate the effect of the interaction between the C677T mutation in the 5,10-methylenetetrahydrofolate reductase (MTHFR) genotypes and serum levels of B vitamins on serum homocysteine levels in pregnant women.

DESIGN

A cross-sectional study.

SETTING

Ewha Womans University Hospital, Seoul, Korea.

SUBJECTS

A total of 177 normal pregnant women, 24.6+/-1.1 weeks of gestation, in a 6-month period during 2001-2002.

INTERVENTIONS

Serum vitamin B2, vitamin B6, and homocysteine analyses were conducted using high-performance liquid chromatography methods. Serum folate and vitamin B12 concentrations were determined using a radioimmunoassay kit. MTHFR gene mutation was investigated by the polymerase chain reaction of a genomic DNA fragment.

RESULTS

Serum homocysteine was higher in women with the T/T genotype than those with the C/T or C/C genotype of the MTHFR gene (P<0.05). Serum homocysteine was negatively correlated with serum folate in all MTHFR genotypes (P<0.001), and the correlation between the two serum levels was the strongest in the T/T genotype. Serum homocysteine was higher in the subjects with the T/T MTHFR genotype only when the serum folate was below the median level. Explanatory power of B vitamin status as predictors of serum homocysteine levels was more pronounced in the T/T genotypes (68.5%) compared with the C/T (37.9%) or C/C genotypes (20.6%).

CONCLUSIONS

Serum homocysteine levels in pregnant women varied significantly with MTHFR genotype and the serum B vitamin status. Higher serum folate, vitamin B2, and vitamin B12 concentrations may lessen the MTHFR genotypic effect on serum homocysteine levels.

Intermediate filament nestin expressions in human cord blood monocytes (HCMNCs)

OBJECTS

Nestin is an intermediate protein and a well-known specific neural stem cell antigen. Some bone marrow stem cells can generate not only blood cells but also neurons and glial cells under specific culture conditions. Furthermore, in vitro cultured bone marrow stem cells also express nestin antigen. However, it is unclear whether cord blood cells also differentiate into neural cells or not. In this study, we investigated the expression of nestin on human cord blood monocytes (HCMNCs) and we discuss the relevance of this finding upon future therapeutic applications of HCMNCs in neurological diseases.

METHODS

HCMNCs were prepared from normal placenta after full-term normal delivery. Immunocytochemical staining and reverse transcriptase polymerase chain reaction (RT-PCR) for nestin and CD133 antigen were performed to confirm nestin and CD133 antigen expression in the HCMNCs.

RESULTS

Some nestin expressing HCMNCs were found. Immunocytochemical staining showed that some of the blood stem cell marker CD133 expressing cells co-expressed nestin. RT-PCR demonstrated nestin and CD133 mRNA in HCMNCs, but not in adult blood monocytes. Approximately, 60 +/- 8% of CD133 expressing cells expressed nestin.

CONCLUSION

In the present study, we found that more than 60% of CD133 expressing HCMNCs also express nestin antigen in their cytoplasm, which supports the idea that cord blood stem cells can adopt a neuronal fate.

Development of a new photocurable composite resin with reduced curing shrinkage

OBJECTIVE

This study was conducted to evaluate the potential of a novel trifunctional methacrylate as a component of a photocurable composite resin with reduced curing shrinkage.

METHODS

Tris[4-(2'-hydroxy-3'-methacryloyloxypropoxy)phenyl]methane (TTEMA) was synthesized by reacting triphenylolmethane triglycidyl ether (TTE) with methacrylic acid in the presence of 4-(dimethylamino)pyridine. Photopolymerization reactivity and volumetric shrinkage of unfilled resins based on TTEMA were investigated by Fourier transform infrared spectroscopy and density measurements, respectively, and the results were compared with those for conventional dental monomers. A three-point bending test of the TTEMA-containing composite resin was carried out.

RESULTS

TTEMA was easily prepared in a good yield of 89%. Unfilled resins of TTEMA and bis-GMA, each containing 40% TEGDMA, showed similar photopolymerization reactivity. TTEMA exhibited a very low photopolymerization shrinkage of 2.09%, and 3:2 TTEMA-TEGDMA unfilled resin revealed 10% lower shrinkage than a conventional bis-GMA system containing the same amount of TEGDMA. The flexural strength of a light-activated composite resin formulated with TTEMA is comparable to that of a bis-GMA composite resin under the same conditions.

SIGNIFICANCE

TTEMA is promising for application as a photocurable dental monomer due to ease of synthesis, good polymerization reactivity, and relatively low curing shrinkage.

A study of the effects of chewing patterns on occlusal wear

The chewing cycle is a functional movement, closely related to occlusion, the neuromuscular system and the central nervous system. Although actual chewing paths are complicated and vary from individual to individual, there are two typical patterns. One is more vertical in nature and is similar to a chopping movement. The other is a more lateral type that is similar to a grinding movement. The purpose of this study was to evaluate the effects of chewing patterns on occlusal wear. Fifteen subjects exhibiting a chopping-chewing pattern and 15 subjects exhibiting a grinding-chewing pattern were selected using a jaw tracking device. The occlusal wear values, obtained by both ordinal and Woda's arbitrary scales, and frequencies of non-working facets were calculated for each group. The occlusal wear values in all teeth and in each segment, obtained by the use of the ordinal scale did not vary significantly between the chopping and the grinding type group. However, the occlusal wear values of the grinding type group in all teeth and in posterior teeth segments, obtained by the use of Woda's arbitrary scale, were significantly greater than those of the chopping type group. Frequencies of non-working facets in posterior teeth showed no significant differences between the groups.

Current Medication Choices in Juvenile Rheumatoid Arthritis II –Update of a Survey Performed in 1993

The documentation of treatments used for Juvenile Rheumatoid Arthritis (JRA) is important to allow for the evaluation of practice patterns for future outcome studies. A survey of nine pediatric rheumatologists was performed between September 1999 and February 2000. Each of the physicians prospectively recorded demographic and treatment information on consecutively sampled JRA patients (n=395). Pauciarticular onset JRA was present in 46%, polyarticular onset JRA in 35%, and systemic onset JRA in 19% of the children. Naproxen was the most frequently prescribed medication (55% of the patients), followed by methotrexate (MTX), which was used in 39% of the patients. Folic acid supplementation (1 mg/day) was provided to 69% of the patients treated with MTX. Etanercept was used in 11% of the children. Eleven percent of the patients received corticosteroids, and 13% of children on corticosteroids took calcium supplements. Uveitis was present in 8% and had a chronic course in 79% of those cases. Although systemic medications were used in 50% of the children with uveitis to control eye inflammation, severe damage to the eyes developed in 30% of them. Fourteen percent of the patients required gastroprotective medications. Compared with findings of a similar survey performed in 1993, there was no significant change in the frequency of use of naproxen, but nabumetone is now more often prescribed, and COX-2 inhibitors have been introduced in the therapy of JRA. Changes among second-line agents used for JRA have also occurred, although there was no change in the frequency of use of MTX or corticosteroids. JRA continues to be a treatment challenge for the practicing pediatric rheumatologist. Patients often show incomplete response to the currently available medications. Therefore, new therapeutic agents need to be evaluated for their use in JRA, and the treatment of JRA associated uveitis especially needs to be improved.

Glutamate-induced cobalt uptake reveals non-NMDA receptors in developing rat taste buds

Non-NMDA type glutamate receptors are present in rat taste buds. However, the function of those receptors is not yet known. Developmental changes in the glutamate receptors in taste cells may provide clues to their functional role. We used a cobalt staining technique to determine at which stage in development functional non-NMDA glutamate receptors first appeared. Cobalt-stained taste bud cells first appeared in 20-day-old rats. The number of cobalt-stained cells increased with age and reached a maximum at 45 days. The shape of stained cells looked similar at all age groups. Cobalt-labeled cells appeared to be correlated with synaptic, not taste, glutamate receptors.

Dimensional changes of dental impression materials by thermal changes

Dental impression materials for prosthodontic treatment must be easy to use, precisely replicate of oral tissue, be dimensionally stable, and be compatible with gypsum materials. The dimensional accuracy of all materials is affected by thermal changes; impression materials shrink during cooling from mouth temperature (37 degrees C) to room temperature (23 degrees C). Five kinds of light body addition-reaction silicone impression materials [Contrast (CT), Voco Co., Germany; Examix (EM), GC Co., Japan; Extrude (EX), Kerr Co., USA; Imprint II (IM), 3M Co., USA; Perfect (PF), Handae Chemical, Korea] were tested by making cylindrical specimens (6 mm diameter and 12 mm height). The thermal expansion of the impression materials was measured with a thermomechanical analyzer (TMA 2940, TA Instruments, USA) between 23-37 degrees C. Data were analyzed via the Mann-Whitney Usage Test. To simulate actual dental impressions, tooth and tray shapes were modeled to measure the linear shrinkage of impression materials at anterior and posterior locations. The thermal expansion of impression materials tested decreased as follows: CT >or= PF >or= EM >or= EX >or= IM (p < 0.05). The anterior region changed more than the posterior region for the same impression materials. The dimensional changes averaged more than 40 microm in the anterior region, but less than 40 microm in the posterior region for all materials. Thermal expansion coefficients of some impression materials were significantly different from each other (p < 0.05), and the anterior region had more dimensional change than the posterior region for the same impression materials.

Research on annihilation of cancer cells by glass-ceramics for cancer treatment with external magnetic field. I. Preparation and cytotoxicity

Ferrimagnetic glass-ceramics were prepared as a heating mediator for hyperthermia in cancer treatment. We prepared glasses in the system 40Fe2O3-30CaO-30SiO2 and precipitated ferrimagnetic crystallites through controlled two-step heat treatment. To improve the heating capability of ferrimagnetic crystallites, i.e., magnetite, generation of other crystalline phases should be prohibited. The addition of each 1% of P2O5 and B2O3 led to lowering the crystallization temperature of magnetite, which was useful to suppress the other crystalline formation. The maximum nucleating and crystal growth rates were 20.47 x 10(6)/mm2 x s at 690 degrees C and 8.125 nm/min(0.5) at 940 degrees C, respectively. After nucleation at 690 degrees C for 60 min prior to crystal growth at 940 degrees C for 2 h, samples exhibited the following properties: crystallite size of 90.5 nm, the maximum volumetric fraction of 31.1%, and saturation magnetization of 100 emu/cm2. The coercive forces were ranged between 382.0 and 388.2 Oe in all heat-treatment conditions. As a result of a preclinical evaluation of biocompatibility by agar diffusion test with L929 cells, both as-quenched and heat-treated glasses could be biocompatible.

Studies on the possible mechanisms of protective activity against alpha-amanitin poisoning by aucubin

Aucubin, an iridoid glucoside, was investigated to determine whether it has a stimulating effect on alpha-amanitin excretion in alpha-amanitin intoxicated rats, and whether there is binding activity to calf thymus DNA. High-performance liquid chromatography (HPLC) analysis of alpha-amanitin in rat urine allowed quantitative measurement of the alpha-amanitin concentration with a detection limit of 50 ng/ml. In this system, a group treated with both alpha-amanitin and aucubin showed that alpha-amanitin was excreted about 1.4 times faster than in the alpha-amanitin only treated group. Our previous results showed that the toxicity of alpha-amanitin is due to specific inhibition of RNA polymerase activity and the resultant blockage of the synthesis of certain RNA species in the nucleus. However, no significant activity change on RNA polymerase from Hep G2 cells was observed when aucubin was treated with alpha-amanitin at any concentration tested. Nevertheless, aucubigenin inhibited both DNA polymerase (IC50, 80.5 microg/ml) and RNA polymerase (IC50, 135.0 microg/ml) from the Hep G2 cells. The potential of both alpha-amanitin and aucubin to interact with DNA were examined by spectrophotometric analysis. Alpha-Amanitin showed no significant binding capacity to calf thymus DNA, but aucubin was found to interact with DNA, and the apparent binding constant (Kapp) and apparent number of binding sites per DNA phosphate (Bapp) were 0.45 x 10(4) M(-1) and 1.25, respectively.

The flexural properties of fiber-reinforced composite with light-polymerized polymer matrix

PURPOSE

The aim of this study was to measure the flexural strength and the elastic modulus of composite resin with and without reinforcing fibers and to evaluate the reinforcing effect of various fibers.

MATERIALS AND METHODS

A polyethylene fiber (Ribbond), a polyaramid fiber (Fibreflex), and three glass fibers (FibreKor, GlasSpan, Vectris) were used to reinforce composite resins. The flexural strength and elastic modulus of specimens in the three-point bending mode were measured using a universal testing machine at a cross-head speed of 1 mm/min after storage in water at 37 degrees C for 24 hours. All tests were carried out in a water bath at 37 degrees C. The data were analyzed using analysis of variance and the Sheffé test at P= 0.05. After testing, the fractured surface was evaluated using a scanning electron microscope at 50x, 500x, and 3,000x magnifications.

RESULTS

Yield flexural strengths of nonreinforced resins were 48 to 56 MPa, and those of reinforced resins were 56 to 134 MPa. Ultimate flexural strengths of nonreinforced specimens were 96 to 119 MPa, and those of reinforced ones were 203 to 386 MPa. Elastic modulus of nonreinforced resin was 6 to 9 GPa, and fiber reinforcing increased the value to 9 to 15 GPa, while it had no effect in Ribbond.

CONCLUSION

Most of the fibers used in this study increased both yield and ultimate flexural strengths of composite resins, with the exception of the yield strength of Vectris. GlasSpan, Fibreflex, and FibreKor were effective in reinforcing elastic modulus, while Ribbond had no effect on it. Unidirectional glass fibers and polyaramid fiber were effective in reinforcing both flexural strength and elastic modulus of composite resin.

Interaction specificity of Arabidopsis calcineurin B-like calcium sensors and their target kinases

Calcium is a critical component in a number of plant signal transduction pathways. A new family of calcium sensors called calcineurin B-like proteins (AtCBLs) have been recently identified from Arabidopsis. These calcium sensors have been shown to interact with a family of protein kinases (CIPKs). Here we report that each individual member of AtCBL family specifically interacts with a subset of CIPKs and present structural basis for the interaction and for the specificity underlying these interactions. Although the C-terminal region of CIPKs is responsible for interaction with AtCBLs, the N-terminal region of CIPKs is also involved in determining the specificity of such interaction. We have also shown that all three EF-hand motifs in AtCBL members are required for the interaction with CIPKs. Several AtCBL members failed to interact with any of the CIPKs presented in this study, suggesting that these AtCBL members either have other CIPKs as targets or they target distinct proteins other than CIPKs. These results may provide structural basis for the functional specificity of CBL family of calcium sensors and their targets.

A study on the mandibular movement of anterior openbite patients

The purpose of this study was to compare the mandibular movements of anterior openbite patients using those of normal bite (angle class I) patients, to ascertain which components of mandibular movement are different in the two groups, and to use this information for occlusal treatment. The Saphon Visi-trainer Model 3 and the Denar Pantronic were used to record mandibular movement and a Pantronic survey was performed using an arbitrary hinge axis, according to manufacturer's instructions. The subjects were 43 adults and included 28 subjects presenting with acceptable normal occlusion (angle class I) with no sign of TM dysfunction syndrome (TMD) and 15 subjects with anterior openbite with no anterior guidance. In the anterior openbite group, the average anterior and lateral condylar inclination, maximum opening and the distance between the intercuspal position with retruded contact position distance (anterior-posterior) were significantly lower than normal. The results suggest that in openbite patients the condyle inclination is flatter and the function of the TMJ is more restricted than in the mandibular movements of the normal group. It is hoped that these results will be useful for the correction of the anterior openbite condition.

Heterogeneous effects of IL-2 on collagen-induced arthritis

IL-2 is generally considered a pro-inflammatory cytokine that exacerbates Th1-mediated disease states, such as autoimmune arthritis. Consistent with this role for IL-2, recent studies from our laboratory demonstrate that IL-2 mRNA is markedly increased during the acute stage of collagen-induced arthritis (CIA), an animal model of rheumatoid arthritis. To further define the role of IL-2 in CIA, the levels of IL-2 protein and its receptor and the effects of IL-2 administration were analyzed during CIA. IL-2 protein and IL-2R were preferentially expressed at disease onset, compared with later stages of disease. Administration of recombinant human IL-2 (rhIL-2) at, or just before, disease onset exacerbated disease; surprisingly, rhIL-2 given before disease onset inhibited CIA, associated with reduced cellular and humoral responses to type II collagen. Determination of in vivo serum levels of Th1 and Th2 cytokines in response to rhIL-2 treatment demonstrated that IFN-gamma, but not IL-4, was markedly up-regulated in response to IL-2. In mice treated with anti-IFN-gamma Ab, both early and late IL-2 administration exacerbated CIA. Thus, IL-2 can have two opposite effects on autoimmune arthritis, a direct stimulatory effect and an indirect suppressive effect that is mediated by IFN-gamma.

Effect of iron state on crystallization and dissolution in Fe2O3-CaO-SiO2 glasses

The possibility of iron-containing glasses as thermoseeds for hyperthermia of bone tumor was reported previously. There is, however, no report about the effect of iron state on the crystallization of magnetite and the resultant properties. The iron states were determined by Mössbauer spectroscopy in Fe2O3-CaO-SiO2 system. It was found that the higher CaO content interrupts the crystallization of magnetite crystallites as well as the oxidation of iron, that is, the transformation from Fe3+ to Fe2+. A sample containing large amounts of Fe2+ showed the faster increment of temperature when the alternating magnetic field was applied. In order to use the thermoseed for a hyperthermia, we can say that the composition with low CaO content is most useful.

On the mechanism of protection of distal joints after local gene transfer in collagen-induced arthritis

Considerable interest has been generated by the observation that adenovirus-mediated gene delivery to a single arthritic joint results in suppression of arthritis in distal joints associated with the presence of small numbers of transduced cells in distal joints. It has been proposed that this is mediated by trafficking of transduced cells from the injected to distal joints. There are, however, alternative explanations that have not been explored, including the possibility that transgene protein or infectious virions circulate to distal sites. To investigate these possibilities, a replication-incompetent adenovirus encoding viral IL-10 (vIL-10) was administered to naive mice and to mice with collagen-induced arthritis by intraarticular, periarticular, or intravenous injection. In all cases, the ability to protect distal joints correlated with serum levels of vIL-10 protein. After intraarticular or intravenous injection, vIL-10 cDNA could be detected not only in distal joints, but also in the liver, which is the major target of circulating adenovirus, demonstrating that adenovirus circulating through the bloodstream is taken up by the joint tissue. Periarticular administration of adenovirus, which resulted in lower serum levels of vIL-10, protected only the injected paws and failed to induce trafficking immunoregulatory cells capable of suppressing distal disease. These observations suggest that circulating vIL-10 protein is the major mediator of distal protection. The presence of small numbers of transduced cells at distal sites can be accounted for by transduction of distal synovium after entry of adenovirus virions into the circulation.

Glutamate-induced cobalt uptake reveals non-NMDA receptors in rat taste cells

Taste receptor cells are chemical detectors in the oral cavity. Taste cells form synapses with primary afferent neurons that convey the gustatory information to the central nervous system. Taste cells may also synapse with other taste cells within the taste buds. Furthermore, taste cells may receive efferent connections. However, the neurotransmitters at these synapses have not been identified. Glutamate, a major excitatory neurotransmitter in other sensory organs, might act at synapses in taste buds. We used a cobalt staining technique to detect Ca(2+)-permeable glutamate receptors in taste buds and thus establish whether there might be glutamatergic synapses in gustatory end organs. When 500 microm slices of foliate and vallate papillae were briefly exposed to 1 mM glutamate in the presence of CoCl(2), a subset of spindle-shaped taste cells accumulated Co(2+). Cobalt uptake showed concentration-dependency in the range from 10 microm to 1 mM glutamate. Interestingly, higher glutamate concentrations depressed cobalt uptake. This concentration-response relation for cobalt uptake suggests that synaptic glutamate receptors, not receptors for glutamate taste, were activated. Sensory axons and adjacent non-sensory epithelium were not affected by these procedures. Glutamate-stimulated cobalt uptake in taste cells was antagonized by the non-NMDA receptor antagonist CNQX. Depolarization with 50 mM K(+) and application of NMDA (300 microM) did not increase the number of stained taste cells. This pharmacological characterization of the cobalt uptake suggests that non-NMDA receptors are present in taste cells. These receptors might be autoreceptors at afferent synapses, postsynaptic receptors of a putative efferent system, or postsynaptic receptors at synapses with other taste cells.

Effect of external stresses on calcium phosphate glass investigated by IR spectroscopy

The effect of external stress on calcium phosphate glasses was investigated because they experience high stress in practical uses such as mastication. In order to understand the structural change of calcium phosphate glasses caused by an applied stress, the IR reflection peak shift of the phosphate structural band of the calcium phosphate glass fiber due to a bending stress was measured. The peak shift represents the change of the P-O-P bond angle. The IR reflection peak of the phosphate structural bands near approximately 1300 and approximately 910 cm(-1) shifted to a higher wavenumber under tensile stress and to a lower wavenumber under compressive stress when calcium phosphate fiber with a uniform structure was employed. This indicates that the P-O-P bond angle increases under tensile stress and decreases under compressive stress. The extents of both peak shifts were larger with a lower [corrected] Ca/P ratio than with a higher [corrected] Ca/P ratio. Therefore, phosphate glass with a higher Ca/P ratio is expected to withstand loads under external stress.

Viral IL-10 and soluble TNF receptor act synergistically to inhibit collagen-induced arthritis following adenovirus-mediated gene transfer

Viral IL-10 (vIL-10) and soluble TNF receptor (sTNFR) are anti-inflammatory proteins that can suppress collagen-induced arthritis (CIA). These and related proteins have shown efficacy in the treatment of human rheumatoid arthritis; however, neither alone is able to completely suppress disease. Furthermore, they have short half-lives, necessitating frequent administration. To determine the ability of these proteins to act synergistically following gene transfer, arthritis was induced in DBA/1 male mice by immunization with type II collagen on days 0 and 21. Mice were injected i.v. either before disease onset (day 20) or after disease onset (day 28) with 1010 particles of adenovirus encoding vIL-10, a soluble TNF receptor-IgG1 fusion protein (sTNFR-Ig), a combination of both vectors, or a control vector lacking a transgene. Significant synergism was observed with the combination of vIL-10 and sTNFR-Ig, with a substantial reduction in both the incidence and severity of disease as well as inhibition of progression of established disease. sTNFR-Ig alone had no effect on CIA. vIL-10 alone inhibited disease when given before disease onset, but had minimal effect on established disease. Both proteins inhibited spleen cell proliferation and IFN-gamma secretion in response to stimulation with type II collagen, but only vIL-10 reduced the synovial mRNA levels of the proinflammatory cytokines IL-1beta, TNF-alpha, and IL-6. These findings demonstrate that vIL-10 and sTNFR-Ig act synergistically in suppressing CIA and suggest that gene transfer offers a potential therapeutic modality for the treatment of arthritis.

Tuberculous aneurysm of the abdominal aorta: endovascular repair using stent grafts in two cases

Tuberculous aneurysm of the aorta is exceedingly rare. To date, the standard therapy for mycotic aneurysm of the abdominal aorta has been surgery involving in-situ graft placement or extra-anatomic bypass surgery followed by effective anti-tuberculous medication. Only recently has the use of a stent graft in the treatment of tuberculous aortic aneurysm been described in the literature. We report two cases in which a tuberculous aneurysm of the abdominal aorta was successfully repaired using endovascular stent grafts. One case involved is a 42-year-old woman with a large suprarenal abdominal aortic aneurysm and a right psoas abscess, and the other, a 41-year-old man in whom an abdominal aortic aneurysm ruptured during surgical drainage of a psoas abscess.

Novel protein kinases associated with calcineurin B-like calcium sensors in Arabidopsis

Members of the Arabidopsis calcineurin B-like Ca(2)+ binding protein (AtCBL) family are differentially regulated by stress conditions. One AtCBL plays a role in salt stress; another is implicated in response to other stress signals, including drought, cold, and wounding. In this study, we identified a group of novel protein kinases specifically associated with AtCBL-type Ca(2)+ sensors. In addition to a typical protein kinase domain, they all contain a unique C-terminal region that is both required and sufficient for interaction with the AtCBL-type but not calmodulin-type Ca(2)+ binding proteins from plants. Interactions between the kinases and AtCBLs require micromolar concentrations of Ca(2)+, suggesting that increases in cellular Ca(2)+ concentrations may trigger the formation of AtCBL-kinase complexes in vivo. Unlike most serine/threonine kinases, the AtCBL-interacting kinase efficiently uses Mn(2)+ to Mg(2)+ as a cofactor and may function as a Mn(2)+ binding protein in the cell. These findings link a new type of Ca(2)+ sensors to a group of novel protein kinases, providing the molecular basis for a unique Ca(2)+ signaling machinery in plant cells.

Identification of cis-acting elements important for expression of the starch-branching enzyme I gene in maize endosperm

The genes encoding the starch-branching enzymes (SBE) SBEI, SBEIIa, and SBEIIb in maize (Zea mays) are differentially regulated in tissue specificity and during kernel development. To gain insight into the regulatory mechanisms controlling their expression, we analyzed the 5'-flanking sequences of Sbe1 using a transient gene expression system. Although the 2.2-kb 5'-flanking sequence between -2,190 and +27 relative to the transcription initiation site was sufficient to promote transcription, the addition of the transcribed region between +28 and +228 containing the first exon and intron resulted in high-level expression in suspension-cultured maize endosperm cells. A series of 5' deletion and linker-substitution mutants identified two critical positive cis elements, -314 to -295 and -284 to -255. An electrophoretic mobility-shift assay showed that nuclear proteins prepared from maize kernels interact with the 60-bp fragment containing these two elements. Expression of the Sbe1 gene is regulated by sugar concentration in suspension-cultured maize endosperm cells, and the region -314 to -145 is essential for this effect. Interestingly, the expression of mEmBP-1, a bZIP transcription activator, in suspension-cultured maize endosperm cells resulted in a 5-fold decrease in Sbe1 promoter activity, suggesting a possible regulatory role of the G-box present in the Sbe1 promoter from -227 to -220.

Evaluation of condylar neck fracture plating techniques

The purpose of this study was to compare the biomechanical stability of four different plating techniques used to fix condylar neck fractures and to decide which fixation systems are strong enough to withstand the functional load. Ten recently acquired formalin-fixed cadaver mandibles were used for this study. Each of the four sets of osteotomized condylar processes was fixed by one of four different fixation systems. The mandibles were then held in an angle vice so that the mandibles were oriented to simulate actual masticatory force loading on the temporomandibular joint and were loaded with an Instron loading machine. Data demonstrated that a two-miniplate system applied to the anterior and posterior regions of the condylar neck was more stable than single-plate repairs using either mini-dynamic compression plates or 2.4 mm plates. The two-miniplate-fixation technique is indicated in cases of condylar neck fracture to achieve early mobility of the jaw and stability of the fracture site.

Molecular cloning and characterization of the Amylose-Extender gene encoding starch branching enzyme IIB in maize

The amylose-extender (Ae) gene encoding starch-branching enzyme IIb (SBEIIb) in maize is predominantly expressed in endosperm and embryos during kernel development. A maize genomic DNA fragment (-2964 to +20,485) containing the Ae gene was isolated and sequenced. The maize Ae mRNA is derived from 22 exons distributed over 16,914 bp. Twenty-one introns, differing in length from 76 bp to 4020 bp, all have conserved junction sequences (GT..AG). Sequence analysis of the 5'- and 3'-flanking regions revealed a consensus TATA-box sequence located 28 bp upstream of the transcription initiation site as determined by primer extension analysis, and a putative polyadenylation signal observed 29 bp upstream of the polyadenylation site based on cDNA sequence. Genomic Southern blot analysis suggests that a single Ae gene is present in the maize genome. Promoter activity was confirmed by testing a transcriptional fusion of the Ae 5'-flanking region between -2964 and +100 to a luciferase reporter gene in a transient expression assay using maize endosperm suspension cultured cells. 5' deletion analysis revealed that the 111 bp region from -160 to -50 is essential for high-level promoter activity.