Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial

BACKGROUND

Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial.

METHODS

EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110.

FINDINGS

Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001).

INTERPRETATION

Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor.

FUNDING

Boehringer Ingelheim and Eli Lilly.

Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial

BACKGROUND

The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population.

METHODS

EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110.

FINDINGS

Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1).

INTERPRETATION

In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease.

FUNDING

Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.

StemPanTox: A fast and wide-target drug assessment system for tailor-made safety evaluations using personalized iPS cells

An alternative model that reliably predicts human-specific toxicity is necessary because the translatability of effects on animal models for human disease is limited to context. Previously, we developed a method that accurately predicts developmental toxicity based on the gene networks of undifferentiated human embryonic stem (ES) cells. Here, we advanced this method to predict adult toxicities of 24 chemicals in six categories (neurotoxins, cardiotoxins, hepatotoxins, two types of nephrotoxins, and non-genotoxic carcinogens) and achieved high predictability (AUC = 0.90-1.00) in all categories. Moreover, we screened for an induced pluripotent stem (iPS) cell line to predict the toxicities based on the gene networks of iPS cells using transfer learning of the gene networks of ES cells, and predicted toxicities in four categories (neurotoxins, hepatotoxins, glomerular nephrotoxins, and non-genotoxic carcinogens) with high performance (AUC = 0.82-0.99). This method holds promise for tailor-made safety evaluations using personalized iPS cells.

Inhibition of fibrotic changes in infrapatellar fat pad alleviates persistent pain and articular cartilage degeneration in monoiodoacetic acid-induced rat arthritis model

OBJECTIVE

We have reported that fibrotic changes in infrapatellar fat pad (IFP) after acute joint inflammation are closely associated with persistent pain in rats. In this study, to examine the effects of anti-fibrotic treatment on persistent pain, we used C-type natriuretic peptides (CNP) at the recovery phase after acute joint inflammation.

DESIGN

Thirty-two male Wistar rats were used in this study. Monoiodoacetic acid (MIA) was injected intra-articularly to induce IFP fibrosis and persistent pain. CNP was injected after acute inflammatory phase in the same knee joint. Time-course pain-avoidance behavior tests and histological analyses were performed to examine the effects of CNP.

RESULTS

Histological evaluations indicated that intra-articular injection of CNP inhibited fibrotic changes in IFP after acute inflammation. Incapacitance tests indicated that MIA injection into rat knee joint quickly decreased the percent weight on ipsilateral limb. In the vehicle group, the decrease was maintained up to day 28, suggesting that pain persistence occurred after acute inflammation (Day 0/Day 28, Est Dif -8.15, CI -10.78∼-5.53, Linear mixed-effect model). In contrast, the pain was alleviated in the CNP group after day 14 (Day0/Day 14, -0.51, -2.62-1.59). In addition, we observed significant improvement in the degree of articular cartilage degeneration at day 14 in the CNP group (OARSI score: vehicle 16.14 ± 4.37 vs CNP 6.87 ± 3.44, P < 0.01; Wilcoxon rank sum test).

CONCLUSION

Fibrotic changes in IFP may play important roles in both persistent pain and articular cartilage degeneration.

Swelling of Doubly Magic ^{48}Ca Core in Ca Isotopes beyond N=28

Interaction cross sections for ^{42-51}Ca on a carbon target at 280  MeV/nucleon have been measured for the first time. The neutron number dependence of derived root-mean-square matter radii shows a significant increase beyond the neutron magic number N=28. Furthermore, this enhancement of matter radii is much larger than that of the previously measured charge radii, indicating a novel growth in neutron skin thickness. A simple examination based on the Fermi-type distribution, and mean field calculations point out that this anomalous enhancement of the nuclear size beyond N=28 results from an enlargement of the core by a sudden increase in the surface diffuseness of the neutron density distribution, which implies the swelling of the bare ^{48}Ca core in Ca isotopes beyond N=28.

Secure quantum remote state preparation of squeezed microwave states

Quantum communication protocols based on nonclassical correlations can be more efficient than known classical methods and offer intrinsic security over direct state transfer. In particular, remote state preparation aims at the creation of a desired and known quantum state at a remote location using classical communication and quantum entanglement. We present an experimental realization of deterministic continuous-variable remote state preparation in the microwave regime over a distance of 35 cm. By employing propagating two-mode squeezed microwave states and feedforward, we achieve the remote preparation of squeezed states with up to 1.6 dB of squeezing below the vacuum level. Finally, security of remote state preparation is investigated by using the concept of the one-time pad and measuring the von Neumann entropies. We find nearly identical values for the entropy of the remotely prepared state and the respective conditional entropy given the classically communicated information and, thus, demonstrate close-to-perfect security.

Continuous-variable remote state preparation in the microwave domain would allow to leverage the superconducting technology for quantum networks applications. Here, the authors show how to deterministically prepare squeezed Gaussian states across 35 cm using previously shared entanglement.

Displacement of Propagating Squeezed Microwave States

Displacement of propagating quantum states of light is a fundamental operation for quantum communication. It enables fundamental studies on macroscopic quantum coherence and plays an important role in quantum teleportation protocols with continuous variables. In our experiments, we have successfully implemented this operation for propagating squeezed microwave states. We demonstrate that, even for strong displacement amplitudes, there is no degradation of the squeezing level in the reconstructed quantum states. Furthermore, we confirm that path entanglement generated by using displaced squeezed states remains constant over a wide range of the displacement power.

Microwave down-conversion with an impedance-matched Λ system in driven circuit QED

By driving a dispersively coupled qubit-resonator system, we realize an "impedance-matched" Λ system that has two identical radiative decay rates from the top level and interacts with a semi-infinite waveguide. It has been predicted that a photon input from the waveguide deterministically induces a Raman transition in the system and switches its electronic state. We confirm this through microwave response to a continuous probe field, observing near-perfect (99.7%) extinction of the reflection and highly efficient (74%) frequency down-conversion. These proof-of-principle results lead to deterministic quantum gates between material qubits and microwave photons and open the possibility for scalable quantum networks interconnected with waveguide photons.

Structural Study of Amorphous Co-Ferrite Film by Anomalous X-Ray Scattering

The structure of amorphous Co-ferrite film grown on a glass substrate was studied by anomalous X-ray scattering (AXS). Co atoms cannot be distinguished from Fe atoms with the usual X-ray diffraction technique. Therefore the AXS method at the Fe and Co K-absorption edges was adopted. In the previous AXS studies only the lower energy side of the absorption edges was adopted. In the previous AXS studies only the lower energy side of the absorption edge was used. In the present case, the lower energy side of the Co K-absorption edge corresponds to the higher energy side of the Fe K-absorption edge. Therefore, in order to overcome this inconvenience, the scattering was measured on both sides of the absorption edge, thus enabling the independent determination of the oxygen coordination numbers around Co and Fe in the ferrite film from the environmental RDFs estimated from the energy differential profiles by coupling with the linear least squares technique.

Observation of the three-state dressed states in circuit quantum electrodynamics

We have investigated the microwave response of a transmon qubit coupled directly to a transmission line. In a transmon qubit, owing to its weak anharmonicity, a single driving field may generate dressed states involving more than two bare states. We confirmed the formation of three-state dressed states by observing all of the six associated Rabi sidebands, which appear as either amplification or attenuation of the probe field. The experimental results are reproduced with good precision by a theoretical model incorporating the radiative coupling between the qubit and the microwave.

Path entanglement of continuous-variable quantum microwaves

Path entanglement constitutes an essential resource in quantum information and communication protocols. Here, we demonstrate frequency-degenerate entanglement between continuous-variable quantum microwaves propagating along two spatially separated paths. We combine a squeezed and a vacuum state using a microwave beam splitter. Via correlation measurements, we detect and quantify the path entanglement contained in the beam splitter output state. Our experiments open the avenue to quantum teleportation, quantum communication, or quantum radar with continuous variables at microwave frequencies.

Demonstration of half-metallicity in fermi-level-tuned Heusler alloy Co2FeAl0.5Si0.5 at room temperature

Fermi level tuning has been successfully demonstrated in Co-based full-Heusler alloy Co(2)FeAl(0.5)Si(0.5) (CFAS). The half-metallic band gap of CFAS was proved by the behavior of differential conductance of CFAS/(MgAl(2))O(x)/CoFe magnetic tunneling junctions with an unexplored crystalline (MgAl(2))O(x) barrier. CFAS exhibits the highest effective spin polarization (P_{eff}) at 300 K and the weakest temperature dependence of P_{eff} among all known half metals. Further study shows that P_{eff} of CFAS decays with increasing temperature (T) following T;{3/2} law perfectly, which indicates that the depolarization of CFAS is determined by spin wave excitation only.

Genetic correlations among carcass cross-sectional fat area ratios, production traits, intramuscular fat, and serum leptin concentration in Duroc pigs

Animals accumulate fat in tissues as subcutaneous, intermuscular, intramuscular, and abdominal fat. Genetic interrelationships of respective fat depositions, however, have not been examined in depth. This study estimated genetic parameters for subcutaneous, intermuscular, and abdominal fat areas of 545 Duroc purebred pigs slaughtered at 105 kg of BW. Measurements were obtained using an image analysis system for positions between the 5th and the 6th thoracic vertebra (56TV), at half body length (HBL), and at the last thoracic vertebra (LTV) of the carcass. Moreover, serum leptin, which is a hormone product that is synthesized and predominantly expressed by adipocytes, was measured to determine if serum concentrations of leptin are useful as physiological predictors of fat accumulation in pigs. The heritability estimate of all fat area percentage at the HBL (0.70 +/- 0.03) was significantly greater than at the 56TV (0.53 +/- 0.03) or the LTV (0.55 +/- 0.04). Furthermore, the heritability estimate of subcutaneous fat areas at the HBL (0.71 +/- 0.04) was greater than at the 56TV (0.56 +/- 0.04) or LTV (0.60 +/- 0.03). Moreover, high heritabilities were estimated for ultrasound backfat thickness (BF; 0.72 +/- 0.03) on the left side at the position of HBL, intramuscular fat content of the loin (0.51 +/- 0.03), the seam fat score (SFS; 0.49 +/- 0.04), and the serum leptin concentration (0.62 +/- 0.05). Increased genetic correlations of BF with the fat area percentage of subcutaneous fat and all fat at 56TV (0.90 +/- 0.03 and 0.91 +/- 0.03), at HBL (0.88 +/- 0.03 and 0.94 +/- 0.01), and at LTV (0.88 +/- 0.03 and 0.90 +/- 0.02) were estimated. The genetic correlations of serum leptin concentration with the percentage of subcutaneous fat area and all fat areas at each position were also high (0.72 to 0.82 and 0.83 to 0.84, respectively). These results suggest that BF and leptin are good indicators of selection for decreasing fat deposition. Increased genetic correlation of the SFS with intermuscular fat area at 56TV (0.74) suggests that SFS is an effective indicator for decreasing intermuscular fat. The genetic correlation between the leptin concentration and feed conversion ratio was high (0.75 +/- 0.04). Results of this study indicate that the combination of BF and serum leptin concentration is a valuable indicator that can be incorporated into selection programs to improve carcass quality and feed efficiency in pigs.

Single artificial-atom lasing

Solid-state superconducting circuits are versatile systems in which quantum states can be engineered and controlled. Recent progress in this area has opened up exciting possibilities for exploring fundamental physics as well as applications in quantum information technology; in a series of experiments it was shown that such circuits can be exploited to generate quantum optical phenomena, by designing superconducting elements as artificial atoms that are coupled coherently to the photon field of a resonator. Here we demonstrate a lasing effect with a single artificial atom--a Josephson-junction charge qubit--embedded in a superconducting resonator. We make use of one of the properties of solid-state artificial atoms, namely that they are strongly and controllably coupled to the resonator modes. The device is essentially different from existing lasers and masers; one and the same artificial atom excited by current injection produces many photons.

Functional changes induced by chronic UVA irradiation to cultured human dermal fibroblasts

Ultraviolet (UV) irradiation induces damage of the skin, and in particular, photoageing is known to be the result of chronic UV irradiation. Many investigations have attempted to clarify the mechanisms of photoageing induced by chronic UVA irradiation, but consensus has not been achieved yet by in vivo experiments, mostly due to differences among UV sources and animals used for experiments. In vitro experiments have shown that a single exposure to UVA irradiation causes overexpression of matrix metalloproteinases and denaturation of collagen, but the mechanisms of the photoageing effects of chronic UVA irradiation are still unclear. To examine the effects of chronic UVA irradiation, we used an in vitro fibroblast cellular ageing system as a model of photoageing. Chronic UVA irradiation of normal human fibroblasts induced shortening of the cellular life span and an increase of cellular diameter, in parallel with expression of senescence-associated beta-galactosidase. Extracellular degradation enzyme, matrix metalloproteinase 1 (MMP-1) was overexpressed after repeated UVA irradiation, but tissue inhibitor of metalloproteinase 1 (TIMP-1) expression was hardly changed by chronic UVA irradiation. We conclude that chronic UVA irradiation of normal human fibroblasts induces cellular functional changes, leading to accelerated cellular ageing and MMP-1 overexpression.

Global genomic changes induced by two-stage carcinogen exposure are precancerous alterations in non-transformed human liver epithelial THLE-3 cells

Global genomic changes, including DNA aneuploidy, may be necessary for carcinogenesis; however, such genomic changes in precancerous cells have not been studied extensively. To identify early global genotypic changes associated with precancerous lesions, a non-transformed human liver epithelial cell line, THLE-3, was treated with benzo[a]pyrene or N-methyl-N-nitro-N-nitrosoguanidine, then by 12-O-tetradecanoyl-phorbol-13-acetate, resulting in morphological transformation of cells. We examined genotypic changes of the transformed cells by laser scanning cytometry, fluorescence in situ hybridization, and comparative genomic hybridization. Transformed fusiform cells displayed tetraploidy, chromosomal instability, DNA copy number aberrations. Cells with these changes were still in the precancerous stage. However, it is suggested that these global genomic changes including tetraploidization provide cells with genetic alterations leading to cancer.

Quantum oscillation of the tunneling conductance in fully epitaxial double barrier magnetic tunnel junctions

We investigated spin-dependent tunneling conductance properties in fully epitaxial double MgO barrier magnetic tunnel junctions with layered nanoscale Fe islands as a middle layer. Clear oscillations of the tunneling conductance were observed as a function of the bias voltage. The oscillation, which depends on the middle layer thickness and the magnetization configuration, is interpreted by the modulation of tunneling conductance due to the spin-polarized quantum well states created in the middle Fe layer. This first observation of the quantum size effect in the fully epitaxial double barrier magnetic tunnel junction indicates great potential for the development of the spin-dependent resonant tunneling effect in coherent tunneling regime.

Macroscopic quantum tunneling in a d-wave high-TC Bi2Sr2CaCu2O8 + delta superconductor

While Josephson-junction-like structures intrinsic to the layered cuprate high temperature superconductors offer an attractive stage for exploiting possible applications to new quantum technologies, the low energy quasiparticle excitations characteristically present in these d-wave superconductors may easily destroy the coherence required. Here we demonstrate for the first time the feasibility of macroscopic quantum tunneling in the intrinsic Josephson junctions of a high temperature superconductor Bi(2)Sr(2)CaCu(2)O(8 + delta), and find it to be characterized by a high classic-to-quantum crossover temperature and a relatively weak quasiparticle dissipation.

Significant magnetoresistance enhancement due to a cotunneling process in a double tunnel junction with single discontinuous ferromagnetic layer insertion

We fabricate CoFe/AlOx/CoFe/AlOx/CoFe ferromagnetic double tunnel junctions and observe spin-dependent tunneling phenomena. A middle CoFe layer becomes discontinuous by forming CoFe particles two dimensionally, of which the average diameter is evaluated to be 2.0-4.5 nm from cross-sectional transmission electron microscopy images. Below 50 K, a Coulomb gap is observed in current-voltage curves, and both magnetoresistance ratios and resistances are found to increase significantly with decreasing temperature. This indicates that a cotunneling process is dominant within the gap, which agrees very well with theoretical prediction [Phys. Rev. Lett. 80, 1758 (1998)].

Protective effect of benidipine against sodium azide-induced cell death in cultured neonatal rat cardiac myocytes

We investigated the effect of benidipine, a calcium antagonist, against sodium azide (NaN(3))-induced cell death in cultured neonatal rat cardiac myocytes with increase of LDH release, depletion of cellular ATP contents, and collapse of mitochondrial membrane potential (DeltaPsi) as indicators. Cells were treated with 1 mmol/L NaN(3) for 18 h. Benidipine concentration-dependently inhibited NaN(3)-induced cell death. The protective effect of benidipine was compared with those of amlodipine, nifedipine, candesartan, and captopril. Calcium antagonists exhibited a protective effect and the IC(50) values of benidipine, amlodipine, and nifedipine were 0.65, 90, and 65 nmol/L, respectively. NaN(3)-induced cell death was inhibited completely with the calpain inhibitor. It was considered that the sustained elevation of [Ca(2+)](i) might be implicated in NaN(3)-induced cell death. Benidipine, moreover, concentration-dependently preserved cellular ATP contents and maintained DeltaPsi the extent of the control level. In conclusion, benidipine exhibited the protective effect at an approximately 100-fold lower concentration than those of amlodipine and nifedipine in the NaN(3)-induced cardiac cell death model. It was considered that both the inhibition of Ca(2+) influx and the preservation of cellular ATP contents might play an important role in the protective effect of benidipine.

Substantial reduction of critical current for magnetization switching in an exchange-biased spin valve

Great interest in current-induced magnetic excitation and switching in a magnetic nanopillar has been caused by the theoretical predictions of these phenomena. The concept of using a spin-polarized current to switch the magnetization orientation of a magnetic layer provides a possible way to realize future 'current-driven' devices: in such devices, direct switching of the magnetic memory bits would be produced by a local current application, instead of by a magnetic field generated by attached wires. Until now, all the reported work on current-induced magnetization switching has been concentrated on a simple ferromagnet/Cu/ferromagnet trilayer. Here we report the observation of current-induced magnetization switching in exchange-biased spin valves (ESPVs) at room temperature. The ESPVs clearly show current-induced magnetization switching behaviour under a sweeping direct current with a very high density. We show that insertion of a ruthenium layer between an ESPV nanopillar and the top electrode effectively decreases the critical current density from about 10(8) to 10(7) A cm(-2). In a well-designed 'antisymmetric' ESPV structure, this critical current density can be further reduced to 2 x 10(6) A cm(-2). We believe that the substantial reduction of critical current could make it possible for current-induced magnetization switching to be directly applied in spintronic devices, such as magnetic random-access memory.

Effective reduction of critical current for current-induced magnetization switching by a Ru layer insertion in an exchange-biased spin valve

Recently, it has been predicted that a spin-polarized electrical current perpendicular to plane directly flowing through a magnetic element can induce magnetization switching through spin-momentum transfer. In this Letter, the first observation of current-induced magnetization switching (CIMS) in exchange-biased spin valves (ESPVs) at room temperature is reported. The ESPVs show the CIMS behavior under a sweeping dc current with a very high critical current density. It is demonstrated that a thin ruthenium (Ru) layer inserted between a free layer and a top electrode effectively reduces the critical current densities for the CIMS. An "inverse" CIMS behavior is also observed when the thickness of the free layer increases.

Taxol resistance and its reversal by synthetic isoprenoids in human bladder cancer cell line

PURPOSE

We investigated the mechanism of action of reversal agents for taxol-resistance in bladder cancers.

MATERIALS AND METHODS

We isolated a taxol-resistant cell line (KK47/TX30) from a human KK47 bladder cancer cell line (KK47/WT). We characterized KK47/TX30 cells and screened reversal agents for taxol-resistance.

RESULTS

KK47/TX30 cells exhibited approximately 700-fold resistance to taxol and cross-resistance to Vinca alkaloids and topoisomerase II inhibitors. Western blot analysis demonstrated P-glycoprotein (P-gp) overexpression in taxol-resistant cells. Drug accumulation and efflux studies showed that the decreased taxol accumulation in the resistant cell line was due to enhanced taxol efflux. We synthesized 31 isoprenoids based on the structure of N-solanesyl-N,N'-bis(3,4-dimethoxybenzyl)ethylenediamine (SDB), which could completely reverse multidrug resistance (MDR) as shown previously. Among those examined, trans-N,N'-bis(3,4-dimethoxybenzyl)-N-solanesyl-1,2-diaminocyclohexane (N-5228) could completely reverse taxol-resistance in KK47/TX30 cells. Results of a structure-activity relationship study of isoprenoids suggested that the following structural features were important for overcoming taxol-resistance: (1) a basic structure of 8 to 10 isoprene units, (2) a cyclohexane ring or benzene ring within the framework, (3) two cationic sites in close proximity to each other, and (4) a benzyl group with 3,4-dimethoxy functionalities with moderate electron-donation.

CONCLUSIONS

Taxol-resistance was primarily mediated by P-gp overexpression in KK47/TX30 cells. One of the synthetic isoprenoids, N-5228 could completely reverse taxol-resistance in KK47/TX30 cells.

In vitro assembly of phytochrome B apoprotein with synthetic analogs of the phytochrome chromophore

Phytochrome B (PhyB), one of the major photosensory chromoproteins in plants, mediates a variety of light-responsive developmental processes in a photoreversible manner. To analyze the structural requirements of the chromophore for the spectral properties of PhyB, we have designed and chemically synthesized 20 analogs of the linear tetrapyrrole (bilin) chromophore and reconstituted them with PhyB apoprotein (PHYB). The A-ring acts mainly as the anchor for ligation to PHYB, because the modification of the side chains at the C2 and C3 positions did not significantly influence the formation or difference spectra of adducts. In contrast, the side chains of the B- and C-rings are crucial to position the chromophore properly in the chromophore pocket of PHYB and for photoreversible spectral changes. The side-chain structure of the D-ring is required for the photoreversible spectral change of the adducts. When methyl and ethyl groups at the C17 and C18 positions are replaced with an n-propyl, n-pentyl, or n-octyl group, respectively, the photoreversible spectral change of the adducts depends on the length of the side chains. From these studies, we conclude that each pyrrole ring of the linear tetrapyrrole chromophore plays a different role in chromophore assembly and the photochromic properties of PhyB.

Effects of increasing expenditure of energy during exercise on psychological well-being in older adults

The purpose of present study was to examine the effects on psychological well-being of energy expended as a result of the exercise intervention. 33 older adults (M age=68.6 yr., SD=4.7) participated in three supervised water-based exercise sessions per week for 12 wk. Based on the relative changes in daily energy expenditure as measured by questionnaire between pre- and posttraining, the subjects were split into three groups. This classified each subject as either having experienced a relatively low change (n=11), moderate change (n= 11), or high change (n= 11) in daily energy expenditure. Our data showed that the group with the greater increase in energy expenditure as a result of exercise, when compared pre- and posttraining, improved only on Depression-Dejection on the Profile of Mood States more than did the group with low change. Consequently, we concluded that the amount of energy expended was partially related to improvement in psychological well-being.

Developmental expression of vascular endothelial growth factor in the masseter muscle of rats

Developmental changes in vascular endothelial growth factor (VEGF) in rat masseter after birth were investigated. VEGF was extracted efficiently and reproducibly from muscle homogenate with low concentrations of non-ionic detergents, such as Triton X-100, Nonidet P-40, and Tween 20. The amount of VEGF measured by enzyme-linked immunosorbent assay (ELISA) increased markedly by approximately 9-fold, from day 8 to 35 after birth. The increase in VEGF was closely correlated with the development of the capillary network, as shown by the capillary to muscle fibre ratio (C/F ratio). Immunoblotting revealed that the predominant molecular species of VEGF concentrated with heparin-sepharose beads was VEGF(188). These results suggest that VEGF plays an important part in the development and maintenance of the capillary network in the rat masseter.

Comparison of water- and land-based exercise in the reduction of state anxiety among older adults

This study examined the effect of an acute exercise program of different exercise conditions on state anxiety among older adults. 73 healthy subjects were recruited and randomly assigned to either water exercise group (n = 36) or land exercise group (n = 37). State anxiety was assessed before exercise and following exercise. Subjects in the water exercise performed a 70-min. exercise program consisting of a 10-min. warm-up, a 20-min. brisk walking, a 20-min. rhythmic dancing, a 10-min. resistance training, and a 10-min. cool down exercise. The land exercise program contained a 10-min. warm up and a 30-min. combined endurance and resistance exercise, followed by a 10-min. cool down exercise. Analysis showed that both exercise groups scored significantly (p<.001) lower on anxiety after exercise, but there was no significant interaction for group by trial for scores on state anxiety. The data indicate that elderly persons who participate in these types of exercise report lower state anxiety.

Usefulness of quick intraoperative measurements of intact parathyroid hormone in the surgical management of hyperparathyroidism

We investigated the use of quick measurement of intraoperative intact parathyroid hormone (I-PTH) to predict the outcome of parathyroidectomy. We examined intraoperative monitoring of I-PTH in 34 consecutive primary hyperparathyroidism (pHPT) patients operated on between April and December 1999. The average patient age was 56 +/- 13 years, and all but one were women. Four had a history of thyroidectomy. Blood samples were drawn before excision of enlarged parathyroid gland(s) and at 2, 5, 10, and 15 minutes afterward. Plasma I-PTH was measured by a two-site immunochemiluminometric assay. Twenty-three patients were shown to have single gland disease, and ten had multiglandular disease. All patients, except one, underwent successful parathyroidectomies. The plasma I-PTH value 15 minutes after removal of enlarged gland(s) had dropped to 26 +/- 10% of pre-excision I-PTH value. In one patient with a previous history of thyroidectomy for thyroid papillary cancer, no gland enlargement was found in the area where the lesion had been suggested by both ultrasonography and 99mTc sestamibi scanning. In this case, intraoperative measurements of I-PTH in the bilateral internal jugular veins identified an ectopic parathyroid tumor, which was successfully removed. We conclude that quick measurement of intraoperative I-PTH is a valuable tool for decision-making, especially for reoperative parathyroid surgery, for patients with previous history of thyroidectomy, and for patients in whom unilateral neck exploration or a single-gland approach is scheduled based upon preoperative localization.

Effects of dietary consistency and water content on parotid amylase secretion and gastric starch digestion in rats

The aim was to estimate the significance of oral sensation and mastication in inducing amylase secretion from the parotid gland and subsequent starch digestion in the stomach. Rats were fed three diets of similar chemical composition but different physical presentations. Two were solid, either pellets or powder, and one was liquid. Oral sensory activity would be greatest with the pellets and least with the liquid. Only the pellets would require significant mastication. Three criteria were used to estimate amylase secretion, amylase activity in the stomach, the depletion of glandular amylase activity and plasma amylase concentrations. Gastric starch digestion was estimated by measuring the concentration of reducing-sugars in the stomach contents. Parotid amylase secretion and gastric starch digestion were similar whether rats were fed pelleted or powdered solid food but much lower in rats fed a liquid diet. These findings support the view that it is the contact of dry food with the oral mucosa rather than the jaw movements involved in mastication that stimulates parotid amylase secretion.

Relationship between parotid amylase secretion and osmolality in the gastric contents of rats fed a pelleted or liquid diet

The relationship between parotid amylase secretion and the osmolality in the gastric contents of rats fed a pelleted or liquid diet was investigated. In sham-operated rats fed a pelleted diet, amylase activity in the parotid glands decreased, amylase activity in the plasma increased, and there was strong amylase activity in the gastric contents. As a result, both reducing sugar concentration and osmolality in the gastric contents increased. In parotid duct-ligated rats, the feeding of a pelleted diet affected neither parotid nor plasma amylase activity and there was little amylase activity in the gastric contents; this resulted in decreased starch digestion. The amylase activity in the gastric contents of rats fed a liquid diet was lower than that of rats fed the pelleted diet. Both the reducing sugar concentration and osmolality in the gastric contents of rats fed the liquid diet were lower than those of rats fed the pelleted diet. However, both the reducing sugar concentration and osmolality in the gastric contents of rats fed the liquid diet were higher than those in the liquid diet itself. A small quantity of parotid amylase seems to effectively digest a large part of the starch in the stomaches of rats fed the liquid diet. These findings suggest that amylase secreted from parotid glands increases osmolality in the gastric contents via the production of reducing sugars from starch in rats when fed either pelleted or liquid diets.

Effects of bilobalide, a sesquiterpene in Ginkgo biloba leaves, on population spikes in rat hippocampal slices

The effects of bilobalide, a sesquiterpene isolated from the leaves of Ginkgo biloba L., were investigated in a rat hippocampal slice preparation. Bilobalide (10-500 microM) significantly increased the amplitude of population spikes evoked by electrical stimulation of Schaffer collateral/commissural fibers in a concentration-dependent manner. Paired-pulse inhibition at interpulse intervals of 10-50 ms was significantly reduced in the presence of bilobalide (50 microM). The inhibitory action of muscimol (1 microM) was attenuated by bilobalide (100 microM). These results suggest that bilobalide induces an enhancement of excitability of CA1 pyramidal neurons, which involves, at least in part, a reduction in GABAergic inhibition in rat hippocampus.

An attempt to distinguish between two reversal processing strategies for learning modeled motor skill

The first purpose was to examine the effects of reversal processing strategy of visual information on recognition and acquisition of a sequential gross movement task. The second purpose was to examine the relationship between a measure of reversal processing strategy and movements during eye fixation. 24 undergraduates were assigned into one of three conditions, a Reversal-emphasized condition in which subjects were instructed to recognize the movement correctly from a reversed angle, a Recognition-emphasized condition in which subjects were instructed to recognize the movement correctly, and a Recall-emphasized condition in which subjects were instructed to reproduce the movement correctly. Subjects observed stimuli with the model facing them. Following observation, the subjects' recognition of stimuli was tested with model facing towards (Facing Angle) and facing away (Rear Angle). Recall tests were carried out after the two recognition tests. Analysis indicated that accuracy and response time on recognition tests improved under each condition, but there were no other effects. The Reversal-emphasized condition showed significantly greater modeling effect than the other conditions. Movements during eye fixation were very similar among conditions.

Ultracytochemical analysis of E-PTA-positive synaptic junctions in postmortem-examined brains with neurologic disorders

The synaptic junctions from four postmortem-examined brains were studied ultracytochemically, using the ethanolic phosphotungustic acid (E-PTA) method. A noteworthy finding was the presence of variable-shaped vesicles that were not observed in the control E-PTA-treated preparations. This structural change in synaptic junctions is thought to represent a degenerative process. It is suggested that the neuronal transmission in brains with acquired neuropathologic abnormalities may be impaired because of the degenerative change in synaptic junctions.

Condensation of glycylglycine to oligoglycines with trimetaphosphate in aqueous solution. II: catalytic effect of magnesium ion

The previously reported condensation reaction of glycylglycine with trimetaphosphate (Yamanaka et al., 1988) was reinvestigated and shown to be catalyzed by magnesium ion. Aqueous solutions containing glycylglycine (0.5 M), trimetaphosphate (0.5 M) and magnesium chloride (0.5 M) were incubated at 38 degrees C at pH 4, 5, 6, 7 and 8. After incubation for ten days at pH 5, the maximum yields of tetraglycine and hexaglycine as condensation products were found to be about 12 and 1.4%, respectively. This result indicated the presence of a considerable catalytic effect of magnesium ion compared with the maximum yield of about 2% for tetraglycine and approximately 0% for hexaglycine in the absence of magnesium ion.

Trans-kingdom conjugation between Agrobacterium tumefaciens and Saccharomyces cerevisiae, a bacterium and a yeast

For conjugation between prokaryotic Agrobacterium tumefaciens and eukaryotic Saccharomyces cerevisiae, we constructed two novel conjugative plasmids. A. tumefaciens transmitted the plasmids to S. cerevisiae with the aid of tra genes on a helper plasmid. The transmitted plasmids retained their original structure and function in transconjugant yeasts. The presence of Ti plasmid barely affected the trans-kingdom conjugation.

Effect of Porphyromonas gingivalis ATCC 33277 vesicle on adherence of Streptococcus mutans OMZ 70 to the experimental pellicle

The vesicles of Porphyromonas gingivalis ATCC 33277 strongly aggregated Streptococcus cricetus, S. rattus, and S. mutans, but poorly aggregated S. sobrinus. The adherence of S. mutans OMZ 70 to hydroxyapatite (HA) coated with whole saliva was increased in parallel with the quantity of the vesicles. The significant increase of adherence of S. mutans OMZ 70 by the vesicles was also observed on the HA coated with parotid saliva, submandibular saliva, serum, and type I collagen. These findings suggest that the vesicles may act as a bridge between mutans streptococcus and the tooth surface.

[Biological monitoring of exposure to alkylating xenobiotics by determining them in complexes with plasma proteins, hemoglobin, mercapturic acids from urine of rats and industrial workers. I. Acrylonitrile]

A parent molecule of acrylonitrile (cyanoethylene, CE) may be isolated from its the model compound S-(2-cyanoethylene)-1-cysteine, as well as from its N-acetyl derivative and hemoglobin (Hb) and plasma proteins from the intoxicated animals and workers engaged in manufacturing synthetic rubber made from acrylonitrile. The developed procedure consists in the 1.5% H2O2 oxidation of a CE adduct for 30 min, followed by addition of a sample into the gas chromatographic injector at 250 degrees C, resulting in the release of CE from the adducts and in the current ingress of carrier gas into the capillary column in order to separate and determine with a FTD detector. There was a dose-response relationship between the formation of CE adducts with rat blood proteins, urinary mercapturic acids when the poison was given in a dose of 1-50 mg/kg. CE covalently bound to Hb was detected in the workers exposed to its monomer in working places.

[Biological monitoring of exposure to alkylating xenobiotics by determining them using a new analytical approach in complexes with hemoglobin, plasma proteins and mercapturic acids in urine. II. Acrylamide]

A new simple and prompt procedure for measuring acrylamide (propenamide, PA) in PA-derived mercapturic acid, such as N-acetyl-S-(2-propenamide)-L-cysteine (N-Ac-PAC), and in hemoglobin (Hb) and plasma protein adducts in the rats expose to PA was developed, by employing gas chromatography (GC). PA in mercapturic acids or proteins was liberated on high-temperature heating in an injector port during the working procedure of a GC capillary after preoxidation of sulfur atoms in PA-bound cysteine to a sulfoxide form with hydrogen peroxide and analyzed. This method resulted in 87% of PA in authentic N-Ac-PAC. The number of PA released from the protein adducts was proportional to the cumulative dose of PA given at a concentration of 1-75 mg/kg during 1-3 weeks. The alkylating level of Hb was approximately 65 times higher than that of plasma proteins and it was nearly 6.5% of its cumulative dose. The index of binding to Hb and the rate of its alkylation were 163 and 0.75.10(-3) liter/g-1/hour-1, respectively.

Specific effect of magnesium ion on 2',3'-cyclic AMP synthesis from adenosine and trimeta phosphate in aqueous solution

Phosphorylation of adenosine by trimetaphosphate was investigated using various catalysts in aqueous solution under mild conditions at pH approximately 7.0 and at 41 degrees C. The product was primarily 2',3'-cyclic AMP together with smaller amounts of ATP. Magnesium ion was found to have a remarkable catalytic effect of approximately one hundred times greater than the other chemicals tested. The mechanism for the specific effect of magnesium ion is discussed.

Effects of angle of model-demonstration on learning of motor skill

The purpose was to examine the effects of three different demonstrations by a model on acquisition and retention of a sequential gross movement task. The second purpose was to examine the relationship between reversal processing of visual information about skills and coding of skill information. Thirty undergraduates (15 men and 15 women) were assigned into one of three conditions, Objective condition which demonstrated the task with the model facing the subject. Looking-glass condition in which the skill was demonstrated with the model facing the subject who viewed the performance opposite the right and left directions in executing the task, and the Subjective condition in which the subject observed the model from the rear. Number of immediate recall tests required to accomplish the sequential movements completely and the sum of the performance points for reproduced movements at each delayed recall test (1 day, 7 days, and 5 mo. after the immediate recall test) were employed. Analysis indicated the Subjective condition produced a significantly greater modeling effect in immediate recall of the movements than the Looking-glass condition. Retention of the acquired skills was almost equal under the three conditions.