POS0257 COMPARISON OF SARS-CoV-2 VACCINE RESPONSE IN PATIENTS WITH INFLAMMATORY RHEUMATIC DISEASE; mRNA-1273 VACCINE INDUCES HIGHER HUMORAL IMMUNOGENICITY THAN BNT162b2

Background

The SARS-CoV-2 messenger RNA (mRNA) vaccines BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) have benefitted all countries amid the coronavirus disease 2019 (COVID-19) crisis. Whereas both of them have shown efficacy in preventing COVID-19 illness in healthy participants, there is paucity of data about immunogenicity and safety of mRNA COVID-19 vaccines in patients with autoimmune, inflammatory rheumatic disease. Recent observational studies evaluated mainly BNT162b2, suggesting that glucocorticoids, immunosuppressive agents impair SARS-CoV-2 vaccine responses. However, difference in immune reactions and safety between BNT162b2 and mRNA-1273 have not been clarified in patients with inflammatory rheumatic diseases.

Objectives

To assess humoral and T cell immune responses and safety profiles after two doses of different mRNA vaccine against SARS-CoV-2; BNT162b2 and mRNA-1273.

Methods

We enrolled consecutive, previously uninfected patients with inflammatory rheumatic diseases receiving mRNA vaccine including BNT162b2 and mRNA-1273. Healthy participants receiving BNT162b2 were also recruited as control. Blood samples were obtained 3weeks, 2 months, 3 months, 4 months, and 6 months after second dose of vaccines. We measured titres of neutralizing antibodies against SARS-CoV-2 and calculated seroconversion rates to evaluate humoral responses. We also assessed T-cell immunity responses by using interferon releasing assay against SARS-CoV-2 in a part of the patients. Answers to questionnaires about adverse reactions were obtained from participants.

Results

A total of 974 patients with inflammatory rheumatic diseases and healthy 630 control participants were enrolled. Among them, 796 patients received BNT162b2, 178 patients received mRNA-1273, and all control participants received BNT162b2. Seroconversion rates and neutralizing antibody titres 3 weeks after vaccination were significantly higher in patients with mRNA-1273 and healthy participants with BNT162b2 compared with patients with BNT162b2; seroconversion rates, 97.2% vs 99.5% vs 83.3%, p<0.001; titers of neutralizing antibodies, 29.4±33.9 IU/mL vs 23.9±14.2 IU/mL vs 10.8±16.5 IU/mL, p<0.001, respectively. On another front, T cell reaction against SARS-CoV-2 was similar in both patients with mRNA-1273 and BNT162b2; interferon gamma levels for antigen 1, 1.2±2.1 IU/mL vs 0.8±2.5 IU/mL, p=0.23; and for antigen 2, 1.4±1.9 IU/mL vs 1.0±2.1 IU/mL, p=0.11, respectively. Regarding adverse reaction of each mRNA vaccine, the frequency of systemic adverse reactions including fever and general fatigue are also significantly higher in patients with mRNA-1273 and healthy controls than patients with BNT162b2; fever, 48.0% vs 44.9% vs 10.2%, p<0.001; general fatigue, 70.4% vs 61.8% vs 31.2%, p<0.001, respectively). In longitudinal measurement, neutralizing antibody titres in patients with BNT162b2 were decreased more rapidly than those in healthy controls; 3.3±3.2 IU/mL in patients with BNT162b2 at 4 months and 3.2±4.7 IU/mL in healthy controls with BNT162b2 at 6 months. We identified age, glucocorticoid dose (prednisolone > 7.5mg), use of immunosuppressants including methotrexate, mycophenolate, cyclophosphamide, and tacrolimus are associated with rapid attenuation of humoral responses in patients with BNT162b2.

Conclusion

Our results demonstrated a significant higher humoral immunogenicity and frequency of systemic adverse reaction of the SARS-CoV-2 mRNA-1273 (Moderna) compared with the BNT162b2 (Pfizer-BioNTech) in inflammatory rheumatic disease patients. Glucocorticoid and immunosuppressive agents impaired induction and sustention of neutralizing antibody, and earlier third booster vaccination may be required within 4 months, especially for those receiving BNT162b2.

References

[1]Steensels D, Pierlet N, Penders J et al. JAMA. 2021;326(15):1533–1535.

[2]Friedman MA, Curtis JR and Winthrop KL. Ann Rheum Dis 2021;80:1255–1265.

Disclosure of Interests

None declared

Metallic ground states of undoped Ti2O3 films induced by elongated c-axis lattice constant

Ti₂O₃ exhibits unique metal–insulator transition (MIT) at ~ 450 K over a wide temperature range of ~ 150 K. The close relationship between MIT and crystal deformation has been proposed. However, as physical properties are governed by the thermodynamic equilibrium in bulk systems, conducting experimental studies under different lattice deformations remains challenging. Epitaxial thin films can offer high flexibility to accommodate adaptive crystal lattices and provide efficient platforms for investigating the MIT. In this study, we report the synthesis of corundum-type Ti₂O₃ films on various growth temperatures. We found that the metallic ground states appeared in the films grown at low temperatures. The electronic ground states were further investigated by the electronic-structure calculations. Results suggest that the electrical properties of Ti₂O₃ films were governed by the c/a ratio of the crystal structure, and the absence of the MIT was attributed to the lattice deformation characterized by an elongated c lattice constant.

Time course of improvement in novel nitric oxide-regulated hormones in response to exercise training in middle-aged and older adults

Introduction

Cardiovascular disease risk augments with advance of age. The mechanism of the increased cardiovascular disease risk by aging is related to attenuation of arterial function via endothelium-derived relaxing factor, such as nitric oxide (NO). Recently, apelin and adropin have identified as NO-upregulated hormones, whereas augmented secretion of asymmetric dimethylarginine (ADMA) have identified as NO-downregulated hormones. However, the effects of exercise training-induced changes in NO-regulated hormones on the reduction of arterial stiffness via NO productions remain unclear.

Purpose

This study aimed to determine the time-dependent changes in NO-regulated hormones related to exercise-training effects of arterial stiffness via NO productions in healthy middle-aged and older adults.

Methods

Thirty-two Japanese healthy middle-aged and older subjects (67±1 years) were randomly divided into two groups: exercise intervention and sedentary controls. Subjects in the training group completed 8-week of aerobic exercise training (60–70% peak oxygen uptake [VO2peak] for 45 min, 3 days/week). We evaluated plasma nitrite/nitrate (NOx), apelin, and ADMA levels, serum apelin level and carotid-femoral pulse wave velocity (cfPWV) as an index of arterial stiffness, measured every 2 weeks for 8-week in the training group.

Results

cfPWV was gradually declined from baseline to 8-week and significantly decreased from baseline at weeks 6 (P&lt;0.05) and 8 (P&lt;0.01). Plasma NOx level was gradually elevated during exercise intervention and significantly increased from baseline at weeks 6 (P&lt;0.05) and 8 (P&lt;0.01). Interestingly, plasma apelin and serum adropin levels were gradually elevated during exercise intervention and significantly increased from baseline at weeks 4, 6 and 8 (each P&lt;0.01). Additionally, plasma ADMA level was significantly decreased at 8-week intervention (P&lt;0.01). Furthermore, the exercise training-induced increase in plasma NOx level was significantly correlated with the changes in circulating apelin (r=0.505, P&lt;0.05), adropin (r=0.662, P&lt;0.01), or ADMA (r=−0.483, P&lt;0.05) levels before and after the 8-week. The exercise training-induced increase in plasma NOx level was significantly correlated with training-induced changes in circulating apelin (r=0.483, P&lt;0.05) or adropin (r=0.556, P&lt;0.05) before and after the 6-week.

Conclusions

These results suggest that the NO-upregulated hormones (apelin and adropin) were increased at the early stage of exercise training intervention and NO-downregulated hormone (ADMA) was decreased at the late stage of exercise training intervention, and these changes in NO-regulated hormones may be contributed to the reduction of arterial stiffness in the middle-aged and older adults.

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): This work was supported by a Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan.

Parametric attosecond pulse amplification far from the ionization threshold from high order harmonic generation in He. Opt Express 2020;28:24243-24252. [PMID: 32752406 DOI: 10.1364/oe.398595]

Parametric amplification of attosecond coherent pulses around 100 eV at the single-atom level is demonstrated for the first time by using the 3D time-dependent Schrödinger equation in high-harmonic generation processes from excited states of He⁺. We present the attosecond dynamics of the amplification process far from the ionization threshold and resolve the physics behind it. The amplification of a particular central photon energy requires the seed XUV pulses to be perfectly synchronized in time with the driving laser field for stimulated recombination to the He⁺ ground state and is only produced in a few specific laser cycles in agreement with the experimental measurements. Our simulations show that the amplified photon energy region can be controlled by varying the peak intensity of the laser field. Our results pave the way to the realization of compact attosecond pulse intense XUV lasers with broad applications.

62 Time course of improvement in secretory unbalance of asymmetric dimethylarginine and nitric oxide productions in response to exercise training in middle-aged and older adults

Funding Acknowledgements

Supported by Grants-in-Aid for Scientific Research (#17H02182, #16K13059, M. Iemitsu; #18J01024, S. Fujie)

Introduction

Aging is well known to elevate risks of cardiovascular diseases. As a mechanism of these increased risks with aging, a reduction of nitric oxide (NO) production via augmented secretion of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of NO synthesis is related. Habitual aerobic exercise has shown to improve secretory unbalance of endothelium-derived regulating factors with aging, such as increase in NO and decrease in ADMA, resulting in the reduction of arterial stiffness. However, the time course of improvement in secretory unbalance of NO and ADMA productions in response to exercise training in middle-aged and older adults remains unclear.

Purpose

This study aimed to determine the time course of changes in plasma nitrite/nitrate (NOx) and ADMA levels related to exercise-training effects of arterial stiffness in healthy middle-aged and older adults.

Methods

Thirty-two Japanese healthy middle-aged and older subjects (67 ± 1 years) were randomly divided into two groups: exercise intervention and sedentary controls. Subjects in the training group completed 8-week of aerobic exercise training (60-70% peak oxygen uptake [VO2peak] for 45 min, 3 days/week). We evaluated plasma NOx and ADMA concentrations and carotid-femoral pulse wave velocity (cfPWV) as an index of arterial stiffness, measured every 2 weeks for 8-week in the training group.

Results

cfPWV was gradually declined from baseline to 8-week and significantly decreased from baseline at weeks 6 (P &lt; 0.05) and 8 (P &lt; 0.01). Plasma NOx level was gradually elevated during exercise intervention and significantly increased from baseline at weeks 6 (P &lt; 0.05) and 8 (P &lt; 0.01). Interestingly, plasma ADMA level was significantly decreased at 8-week intervention (P &lt; 0.05). Furthermore, the exercise training-induced reduction in plasma ADMA level was negatively correlated with the change in plasma NOx level before and after the 8-week (r = -0.483, P &lt; 0.05). The exercise training-induced change in plasma ADMA concentration was positively correlated with training-induced change in cfPWV before and after the 8-week (r = 0.633, P &lt; 0.01). Additionally, there was a negative correlation between the changes in plasma NOx level and cfPWV before and after the 8-week (r = -0.642, P &lt; 0.05).

Conclusions

These results suggest that habitual aerobic exercise can normalize the secretory unbalance of NO and ADMA productions in 6 to 8 weeks, and these balance normalizations may be contributed to the reduction of arterial stiffness in the middle-aged and older adults.

P1534Short time and short term of high-intensity intermittent exercise training reduces arterial stiffness via upregulation of endothelial nitric oxide signalling

Introduction

Conventionally, as an exercise mode which leads to reduction of arterial stiffness, it is well used that moderate-intensity continuous exercise training (MICT). High-intensity interval training (HIIT), such as HIIT program with a total exercise time of 15–30 min is highly time-effective as an exercise mode for which reduces risks of cardiovascular disease. Recent study showed that even shorter HIIT leads to an effective reduction in arterial stiffness. Therefore, HIIT is an effectively exercise therapy which can use in patients with cardiovascular diseases. Although MICT induces vasodilation by acceleration of nitric oxide (NO) production via upregulating arterial endothelial NO synthase (eNOS)/protein kinase B (Akt) signalling pathway, an underlying mechanism of HIIT effects remains unclear.

Purpose

This study aimed to clarify the effects of short HIIT on arterial stiffness and arterial NO production in rats.

Methods

Forty 10-week-old male Sprague-Dawley rats were randomly divided into four groups; CON: 8-week sedentary control, MICT: treadmill running for 60 min at 30m/min, 5 days/wk for 8weeks, HIIT: fourteen 20 sec swimming sessions with a weight equivalent to 14–16% of each body weight and 10 sec pause was allowed between exercise sessions, 4 days/wk for 6 weeks from 12-week-old, and RT: ladder climbing, 8–10sets/day, 3 days/wk for 8 weeks groups (n=10 each group). After training session, we measured aortic pulse wave velocity (aortic PWV) as an index of arterial stiffness and plasma nitrite/nitrate (NOx) concentrations and phosphorylation of eNOS and Akt in the aorta.

Results

Aortic PWV was significantly reduced in both MICT and HIIT groups as compared to CON and RT groups (P<0.05), whereas there was no difference between RT and CON groups. Additionally, arterial phosphorylations of eNOS and Akt and plasma NOx levels were significantly elevated in both MICT and HIIT groups as compared to CON and RT groups (P<0.05), whereas there was no difference between RT and CON groups. Moreover, HIIT-induced reduction of aortic PWV and increase in eNOS and Akt phosphorylations and plasma NOx levels were equal to these MICT effects. Arterial eNOS phosphorylation was negatively correlated with aortic PWV in all groups (r=−0.38, P<0.05). Further study was conducted whether a single-bout high-intensity intermittent exercise accelerates NO production. After acute high-intensity intermittent exercise, plasma NOx levels were significantly elevated (P<0.05).

Conclusion

These results suggest that HIIT increases NO production via the upregulation of arterial Akt/eNOS signalling pathway, resulting in the reduction of arterial stiffness, despite a reduction in total exercise volume as compared with MICT.

Acknowledgement/Funding

JSPS KAKENHI (#17H02182 and #16K13059 for M. Iemitsu; #18H06423 for N. Hasegawa)

Health-related QOL of elderly patients with pulmonary M. avium complex disease in a university hospital

BACKGROUND

Little is known about the clinical characteristics and health-related quality of life (HQOL) of elderly patients with pulmonary Mycobacterium avium complex (pMAC) disease.

OBJECTIVES

To evaluate HQOL using the 36-Item Short-Form Health Survey and St George's Respiratory Questionnaire (SGRQ) and to investigate the predictors of HQOL changes among elderly patients with pMAC disease.

METHODS

This prospective cohort registry was conducted at Keio University Hospital, Tokyo, Japan, between May 2012 and July 2015 and included 84 patients with pMAC disease aged 75 years who had completed the HQOL questionnaire and 48 patients with pMAC disease who had been followed up and completed the HQOL questionnaire in cross-sectional and longitudinal analyses, respectively.

RESULTS

In cross-sectional analyses, elderly patients with pMAC disease had significantly lower role-physical, general health, vitality, social functioning, role-emotional and role/social component scores than the general Japanese elderly population. Analysis of covariance revealed that patients with cavitary lesions had significantly worse physical functioning and SGRQ scores (P < 0.05). Longitudinal analysis showed that under-treatment, short duration of disease and positive sputum smear at baseline were predictors of worse HQOL at 12 months.

CONCLUSIONS

Elderly patients with pMAC disease have reduced HQOL. Further large studies on HQOL are required to refine the use of this parameter in the treatment of these patients.

Nosocomial infection by human bocavirus and human rhinovirus among paediatric patients with respiratory risks

BACKGROUND

Nosocomial infections by respiratory viruses undetected by rapid tests are not often diagnosed. For paediatric patients with background diseases, nosocomial infection could be fatal.

AIM

To determine the relationship between developing symptoms by respiratory viruses undetectable by rapid tests and respiratory risks and to improve the management of infection control.

METHODS

Two episodes of nosocomial infection by human bocavirus (HBoV) and human rhinovirus (HRV) were retrospectively investigated in a tertiary hospital paediatric ward in Japan. Viruses were identified by polymerase chain reaction to determine infection control management. When viruses of the same species were detected from different patients, the virus homology was investigated. The relationship between respiratory risks and developing symptoms was statistically investigated.

FINDINGS

Three and four patients with respiratory risks in the HBoV and HRV outbreaks, respectively, developed respiratory symptoms. The nucleotide sequences of two patients in the HBoV outbreak and all four patients in the HRV outbreak were phylogenetically close. In both outbreaks, the patients with respiratory risks developed significantly more symptoms than those without any risk (P = 0.035 and 0.018, respectively). After the patients with respiratory infection were separated from those with respiratory risks, no additional nosocomial infection occurred.

CONCLUSION

Patients with respiratory risks easily develop respiratory symptoms and acquire severe symptoms of nosocomial infection by those viruses. In a paediatric ward, we should adopt not only standard precautions but also isolation management of the patients with respiratory symptoms, even if they have negative results in rapid tests.

First report of hepatobiliary Mycobacterium avium infection developing obstructive jaundice in a patient with neutralizing anti-interferon-gamma autoantibodies

This study describes a patient who experienced hepatobiliary Mycobacterium avium infection associated with neutralizing anti–interferon gamma (IFN-γ) autoantibodies during treatment for disseminated M. avium disease. Hepatobiliary M. avium infection should be considered in jaundiced patients with neutralizing anti–IFN-γ autoantibodies, including those receiving antimycobacterial therapy for disseminated M. avium disease.

Nosocomial BK Polyomavirus Infection Causing Hemorrhagic Cystitis Among Patients With Hematological Malignancies After Hematopoietic Stem Cell Transplantation

BK polyomavirus (BKPyV) is recognized as a pathogen that causes diseases such as hemorrhagic cystitis and nephritis after allogeneic hematopoietic stem cell transplantation (HSCT) or renal transplantation. BKPyV-associated disease is thought to occur through reactivation under immunosuppression. However, the possibility of its nosocomial transmission and the clinical significance of such transmission have not been elucidated. During a 6-month period, nine adult patients (median age: 47 years) who had hematological disorders and who were treated with HSCT (n = 7) or chemotherapy (n = 2) in a single hematology department developed hemorrhagic cystitis due to BKPyV infection. The polymerase chain reaction products of BKPyV DNA obtained from each patient were sequenced. Of the nine patients, six had subtype I, 2 had subtype IV, and 1 had subtype II or III. In the alignment of sequences, four and two of the six subtype I strains were completely homologous (100%). These results strongly suggest that BKPyV has the potential to cause nosocomial infection within a medical facility, especially among recipients of HSCT. Further studies are clearly warranted to elucidate the route(s) of BKPyV transmission in order to establish optimal infection control.

Effects of habitual aerobic exercise on the relationship between intramyocellular or extramyocellular lipid content and arterial stiffness

The accumulation of intramyocellular lipid (IMCL) and extramyocellular lipid (EMCL) is associated with arterial stiffness in middle-aged and older adults. Habitual aerobic exercise induces the improvement of arterial stiffness with reduction in fat accumulation. However, the relationship between aerobic exercise-induced changes in muscular lipids and arterial stiffness remains unclear. The purpose of this study was to investigate whether habitual aerobic exercise-induced changes in IMCL and EMCL content would lead to an improvement of arterial stiffness. First, in a cross-sectional study, we investigated whether cardiorespiratory fitness level affects the association between IMCL or EMCL content and arterial stiffness in 60 middle-aged and older subjects (61.0±1.3 years). Second, in an intervention study, we examined whether aerobic exercise training-induced changes in IMCL and EMCL content are associated with a reduction in arterial stiffness in 18 middle-aged and older subjects (67.0±1.7 years). In the cross-sectional study, IMCL content was negatively correlated with brachial-ankle pulse wave velocity (baPWV) (r=-0.47, P<0.05), whereas EMCL content was positively correlated with baPWV (r=0.48, P<0.05) in the low-fitness group, but was not correlated in the high-fitness group. Furthermore, 8-week aerobic exercise training in older adults increased IMCL content and reduced EMCL content. The training-induced change in baPWV was negatively correlated with training-induced changes in IMCL but was positively correlated with training-induced changes in EMCL. These findings suggest that aerobic exercise training-induced changes in IMCL and EMCL content may be related to a reduction in arterial stiffness in middle-aged and older adults.

Elevated pentraxin 3 level at the early stage of exercise training is associated with reduction of arterial stiffness in middle-aged and older adults

Regular exercise improves aging-induced deterioration of arterial stiffness, and is associated with elevated production of pentraxin 3 (PTX3) and anti-inflammatory as well as anti-atherosclerotic effects. However, the time-dependent effect of exercise training on arterial stiffness and PTX3 production remains unclear. The purpose of this study was to investigate the time course of the association between the effects of training on the circulating PTX3 level and arterial stiffness in middle-aged and older adults. Thirty-two healthy Japanese subjects (66.2±1.3 year) were randomly divided into two groups: training (exercise intervention) and sedentary controls. Subjects in the training group completed 8 weeks of aerobic exercise training (60-70% peak oxygen uptake (VO2peak) for 45 min, 3 days per week); during the training period, we evaluated plasma PTX3 concentration and carotid-femoral pulse wave velocity (cfPWV) every 2 wk. cfPWV gradually declined over the 8-week training period, and was significantly reduced after 6 and 8 week of exercise intervention (P<0.05). Plasma PTX3 level was significantly increased after 4 weeks of the intervention (P<0.05). In addition, the exercise training-induced reduction in cfPWV was negatively correlated with the percent change in plasma PTX3 level after 6 week (r=-0.54, P<0.05) and 8 weeks (r=-0.51, P<0.05) of the intervention, but not correlated at 4 weeks. Plasma PTX3 level was elevated at the early stage of the exercise training intervention, and was subsequently associated with training-induced alteration of arterial stiffness in middle-aged and older adults.

Nonlinear increase of X-ray intensities from thin foils irradiated with a 200 TW femtosecond laser

We report, for the first time, that the energy of femtosecond optical laser pulses, E, with relativistic intensities I > 10(21)  W/cm(2) is efficiently converted to X-ray radiation, which is emitted by "hot" electron component in collision-less processes and heats the solid density plasma periphery. As shown by direct high-resolution spectroscopic measurements X-ray radiation from plasma periphery exhibits unusual non-linear growth ~E(4-5) of its power. The non-linear power growth occurs far earlier than the known regime when the radiation reaction dominates particle motion (RDR). Nevertheless, the radiation is shown to dominate the kinetics of the plasma periphery, changing in this regime (now labeled RDKR) the physical picture of the laser plasma interaction. Although in the experiments reported here we demonstrated by observation of KK hollow ions that X-ray intensities in the keV range exceeds ~10(17)  W/cm(2), there is no theoretical limit of the radiation power. Therefore, such powerful X-ray sources can produce and probe exotic material states with high densities and multiple inner-shell electron excitations even for higher Z elements. Femtosecond laser-produced plasmas may thus provide unique ultra-bright X-ray sources, for future studies of matter in extreme conditions, material science studies, and radiography of biological systems.

Spin injection into a superconductor with strong spin-orbit coupling

We demonstrate spin injection into superconducting Nb by employing a spin absorption technique in lateral spin valve structures. Spin currents flowing in a nonmagnetic Cu channel are preferably absorbed into Nb due to its strong spin-orbit interaction, the amount of which dramatically changes below or above the superconducting critical temperature (TC). The charge imbalance effect observed in the Cu/Nb interface ensures that superconducting Nb absorbs pure spin currents even below TC. Our analyses based on the density of states calculated using the Usadel equation can well reproduce the experimental results, implying that the strong spin-orbit interaction of Nb is still effective for the spin absorption even below TC. Most importantly, our method allows us to determine the intrinsic spin relaxation time in the superconducting Nb, which reaches more than 4 times greater than that in the normal state.

Accuracy of an interferon-gamma release assay to detect active pulmonary and extra-pulmonary tuberculosis

OBJECTIVE

To examine the performance of an interferon-gamma (IFN-gamma) release assay (QuantiFERON-TB 2G assay [QFT-G]) to detect Mycobacterium tuberculosis infection in a Japanese general hospital, for the diagnosis of active pulmonary tuberculosis (PTB) and extra-pulmonary tuberculosis (EPTB).

DESIGN

We prospectively examined the performance of QFT-G in 194 patients suspected of active TB. Diagnosis was confirmed by 1) positive M. tuberculosis cultures, or 2) clinical manifestations or laboratory or pathological findings consistent with active TB and response to specific therapy.

RESULTS

Three patients with indeterminate QFT-G results were excluded. Among the remaining 191 patients, 77 had active TB. When the cut-off concentration of IFN-gamma was set at 0.35 IU/ml, as recommended by the manufacturer, the assay was positive in 69 patients and negative in 122. The sensitivity of the assay was 76.6% in all patients, 74.5% in the 47 patients with PTB and 80.0% in the 30 patients with EPTB. The overall specificity of the assay was 91.2%.

CONCLUSION

Although the specificity of the QFT-G to detect active TB was high and its sensitivity low, it was as accurate for the detection of active EPTB as for PTB when the 0.35 IU/ml INF-gamma cut-off concentration was used.

Enhancement of double auger decay probability in xenon clusters irradiated with a soft-x-ray laser pulse

The interaction of large Xe clusters with a soft x-ray laser pulse having a wavelength of 13.9 nm and an intensity of up to 2x10(10) W/cm2 was investigated using a time-of-flight ion mass spectrometer. The corresponding laser photon energy was sufficiently high to photoionize Xe 4d innershell electrons. It was found that Xe3+ ions (which result from double Auger decay of 4d vacancies) became the dominant final ionic product with increasing cluster size and x-ray intensity. This is in contrast to the results of synchrotron radiation experiments involving free Xe atoms, in which Xe2+ is the dominant resultant ion species. Possible mechanisms responsible for the enhancement of the double Auger transition probability in x-ray laser and cluster interaction are discussed.

Role of Toll-like receptor 4 in hyperoxia-induced lung inflammation in mice

OBJECTIVE

Prolonged exposure to hyperoxia causes lung inflammation, but the role of Toll-like receptor 4 (TLR4) in hyperoxia-induced signal transduction remains unclear.

MATERIAL OR SUBJECTS

We evaluated neutrophil accumulation, signal transduction and cytokine production during hyperoxia, comparing TLR4 mutant (C3H/HeJ) and wild type (C3H/HeN) mice.

METHODS

The mice were exposed to 80% oxygen in a hyperoxic chamber for 0 (control), 48, or 96 h. After the exposure, bronchoalveolar lavage (BAL) was performed for differential cell counting and cytokine measurement. In lung homogenate, activation of NF-kappaB and STAT1 was also examined.

RESULTS

In C3H/HeJ mice, hyperoxia-induced neutrophil accumulation in BAL fluid was significantly decreased compared with C3H/HeN. Hyperoxia for 96 h caused NF-kappaB translocation in C3H/HeN mice, which was significantly attenuated in C3H/HeJ mice (p < 0.05). In contrast, STAT1 activation occurred as early as after 48 h of oxygen exposure, which did not differ between the two strains. The levels of TNF-alpha, IL-6, and KC in BAL fluid were increased after oxygen exposure, which was suppressed by the lack of TLR4 signaling.

CONCLUSION

These results suggest that TLR4-dependent NF-kB activation may be an important process of the upregulation of proinflammatory mediators and subsequent neutrophil accumulation into the lung during hyperoxia.

Expression of clusterin, XIAP and survivin, and their changes by camptothecin (CPT) treatment in CPT-resistant PC-3 and CPT-sensitive LNCaP cells

AIM

Clusterin and IAPs (inhibitor of apoptosis proteins), such as survivin and XIAP, are known to be related to chemo-resistance in several cancer cells. In the current study, we investigated their expression levels in human prostate cancer cell lines, LNCaP and PC-3 which are sensitive and resistant to camptothecin (CPT), topoisomerase I inhibitor, respectively.

METHODS

LNCaP and PC-3 cells were cultured in the presence of CPT, cell death was evaluated using Hoechst 33342 and propidium iodide (PI) double staining. The expression of clusterin, XIAP and survivin on mRNA and protein levels was investigated by semi-quantitative RT-PCR and Western blotting, respectively.

RESULTS

Our data showed that 24 h treatment of LNCaP cells with 0.5 and 3.0 microM CPT resulted in higher number of apoptotic cells, than that in PC-3 cells. Western blot analysis revealed that the clusterin level in PC-3 cells was 5-fold higher than that in LNCaP cells. In contrast, XIAP expression level in PC-3 cells was lower than that in LNCaP cells, and survivin levels were similar in these two cell lines. Treatment with 0.5 and 3.0 microM CPT resulted in the reduced survivin and XIAP expression in both cell lines, while clusterin expression remained unchanged in LNCaP cells, but was increased in PC-3 cells.

CONCLUSION

The results suggest that clusterin may take a greater part in CPT-resistance than survivin and XIAP in PC-3 cells.

High prevalence rate of Helicobacter pylori resistance to clarithromycin during long-term multiple antibiotic therapy for chronic respiratory disease caused by non-tuberculous mycobacteria

BACKGROUND

Helicobacter pylori resistance to clarithromycin, probably due to the frequent use of this antibiotic for the treatment of other diseases, is the greatest obstacle against its eradication.

AIM

To clarify the prevalence of clarithromycin-resistant H. pylori in patients with non-tuberculous mycobacterial lung disease receiving multiple antibiotic treatment, including clarithromycin.

METHODS

We enrolled 88 patients with non-tuberculous mycobacterial lung disease; 29 underwent upper gastrointestinal endoscopy for the diagnosis of H. pylori infection prior to treatment, and 60 underwent it during treatment. The diagnosis of H. pylori infection was confirmed by histological examination, urease test and microaerobic bacterial culture. The minimum inhibitory concentration of clarithromycin was determined and the DNA was analysed for each of the isolated H. pylori strains.

RESULTS

Patients during the treatment had a high prevalence rate of clarithromycin-resistant H. pylori (100%). Analysis of DNA of the clarithromycin-resistant H. pylori isolates revealed point mutations at A2142G or A2143G. Moreover, a linear correlation was found between the total cumulative dose of clarithromycin and the minimum inhibitory concentration.

CONCLUSION

All patients with non-tuberculous mycobacterial lung disease being treated long-term with multiple antibiotics, including clarithromycin, harboured clarithromycin-resistant H. pylori in the stomach. Therefore, eradication of H. pylori before commencement of long-term therapy including clarithromycin should be recommended.

Covered expandable metallic stent placement for hemostasis of colonic bleeding caused by invasion of gallbladder carcinoma

A 72-year-old Japanese man was admitted to our hospital complaining of right upper-quadrant abdominal pain, blood in his stool, and symptoms of anemia. On physical examination a hard mass, about 6 cm in diameter, was palpable in the right upper quadrant of the abdomen. Computed tomography revealed a gallbladder carcinoma which had invaded the transverse colon, with liver metastasis. We diagnosed gallbladder carcinoma, stage IVB. Colonoscopy was performed for persistent blood in the stools. This revealed an elevated lesion which appeared to be an invasion of gallbladder carcinoma, with diffuse bleeding from the right-side of the transverse colon. It proved difficult to stop this bleeding by ordinary therapeutic endoscopy. In order to achieve hemostasis we therefore inserted a covered Ultraflex metallic stent to compress the tumor. After stent placement, blood was no longer seen in the patient's stools, he became able to eat soft food and was discharged. This treatment was uninvasive and effective. Covered stent placement appears to be a new and useful method in the management of bleeding from malignant gastrointestinal tumors.

Picosecond snapshot of the speckles from ferroelectric BaTiO3 by means of x-ray lasers

A picosecond x-ray laser speckle has been conducted to study the dynamics of a disordered surface domain structure (BaTiO3 with 90 degrees c/a domains) as a function of temperature for the first time. The transient surface structures induced by ferroelectric domains decrease as temperature increases towards the Curie temperature T(c) and completely disappear above T(c). The dramatic change of the spatial configuration of the c/a domains was observed to occur from a temperature 2 degrees C below T(c), near which the average correlated domain size at equilibrium decreases as (T(c)-T)(0.37+/-0.02).

Detection of mycobacteria in patients with pulmonary tuberculosis undergoing chemotherapy using MGIT and egg-based solid medium culture systems

SETTING

National Minami-Yokohama Hospital, Kanagawa, Japan.

OBJECTIVE

To compare the performance of a liquid medium system using the Mycobacteria Growth Indicator Tube (MGIT) with that of the conventional Japanese culture system using egg-based Ogawa medium, equivalent to Lowenstein-Jensen medium, in cases with pulmonary tuberculosis on chemotherapy.

DESIGN

A single-centre prospective case study of 61 hospitalised patients from 1 May to 31 July 1998 on a standard 6-month regimen of anti-tuberculosis chemotherapy including isoniazid, rifampin, streptomycin or ethambutol, and pyrazinamide. Sputum cultures using both culture systems were performed bi-weekly up to week 16 of treatment, and were further monitored by MGIT alone at the end of chemotherapy and every 6 months after the end of chemotherapy up to 2 years.

RESULTS

The detection time by MGIT gradually became longer with the progression of chemotherapy. The recovery rate at weeks 2, 4, 6, 8, and 10 by MGIT were significantly higher (P < 0.05) than on the Ogawa slants. Although one case was microbiologically diagnosed as a relapse, using the more sensitive MGIT system did not increase the relapse rate.

CONCLUSION

The gradual prolongation of detection time with the progression of treatment and an attainment of negativity of sputum culture at 4 months after chemotherapy could be a useful intermediate marker to monitor the efficacy of treatment for patients with pulmonary tuberculosis by the MGIT system. Further evaluation is necessary to establish the utility of MGIT in monitoring the treatment process.

Seasonal variations of 222Rn concentrations in the air of a tunnel located in Nagano city

The seasonal variation of 222Rn concentrations in the air of tunnels constructed during World War II at Nagano City has been investigated. The determination of 222Rn concentrations in tunnel air was performed using a solid-state nuclear track detector technique. The monthly radon concentrations changed smoothly, decreasing towards winter and increasing towards summer, and it was found that the concentrations strongly correlate with the temperature difference between the inside and the outside of the tunnel. In the innermost areas of the tunnel, the maximum concentration was observed in July, its value being about 6500 Bq m (-3). The concentrations of radon in the tunnel air decrease exponentially towards the openings of the tunnel, which indicates that the radon concentration in the tunnel is basically governed by diffusion and mixing of radon gas with air. These observations lead to the conclusion that the seasonal variation of the radon concentration in the tunnel air is mainly caused by a convection current due to a stack effect induced by the temperature difference between the tunnel air and the outside air.

Two c-type cytochromes, NirM and NirC, encoded in the nir gene cluster of Pseudomonas aeruginosa act as electron donors for nitrite reductase

Three c-type cytochromes, NirM, NirC, and NirN, are encoded in the nirSMCFDLGHJEN gene cluster for cytochrome cd(1)-type nitrite reductase (NIR) of Pseudomonas aeruginosa. nirS is the structural gene for NIR. NirM (cytochrome c(551)) is reported to be a physiological electron donor for nitrite reductase. The respective functions of NirC and NirN have remained unclear. In this study, we produced recombinant NirC and NirN in P. aeruginosa, and purified them from the periplasmic fraction. N-terminal amino acid sequences of the purified proteins showed that the N-terminal 31 and 18 residues of NirC and NirN precursors were cleaved, respectively, indicating that cleaved peptides act as signals for membrane translocation. In addition, the ability of NirC for electron donation to nitrite reductase was investigated. NirC, as well as NirM, was able to mediate the electron donation from the membrane electron pathway to NIR, suggesting that the structural gene for NIR is followed by the genes for two electron donors for NIR.

[Simultaneously detected double malignancies on a duplicated kidney associated with atrophied counterpart: a case report]

A case of simultaneous double malignant tumor in the same kidney, associating renal cell carcinoma with renal pelvic transitional cell carcinoma, in a 70 year-old-male was reported. On January 6, 2000 he presented with macroscopic hematuria. There were no remarkable findings on cystoscopic examination. Drip infusion pyelography and multidetector-row computed tomography demonstrated a tumor mass on the upper pole of the left kidney and atrophic right kidney. Systemic chemotherapy with CDDP, MTX and ADR was performed preoperatively. Then, hemi-left nephrectomy underwent with the diagnosis of renal pelvic tumor and renal tumor. The surgical specimen was pathologically diagnosed as transitional cell carcinoma of the renal pelvis and renal cell carcinoma of its upper pole. This is the 32nd case of simultaneous occurrence of renal cell carcinoma and transitional cell carcinoma in the same kidney in the Japanese literature.

Organization of inputs from cingulate motor areas to basal ganglia in macaque monkey

The cingulate motor areas reside within regions lining the cingulate sulcus and are divided into rostral and caudal parts. Recent studies suggest that the rostral and caudal cingulate motor areas participate in distinct aspects of motor function: the former plays a role in higher-order cognitive control of movements, whereas the latter is more directly involved in their execution. Here, we investigated the organization of cingulate motor areas inputs to the basal ganglia in the macaque monkey. Identified forelimb representations of the rostral and caudal cingulate motor areas were injected with different anterograde tracers and the distribution patterns of labelled terminals were analysed in the striatum and the subthalamic nucleus. Corticostriatal inputs from the rostral and caudal cingulate motor areas were located within the rostral striatum, with the highest density in the striatal cell bridges and the ventrolateral portions of the putamen, respectively. There was no substantial overlap between these input zones. Similarly, a certain segregation of input zones from the rostral and caudal cingulate motor areas occurred along the mediolateral axis of the subthalamic nucleus. It has also been revealed that corticostriatal and corticosubthalamic input zones from the rostral cingulate motor area considerably overlapped those from the presupplementary motor area, while the input zones from the caudal cingulate motor area displayed a large overlap with those from the primary motor cortex. The present results indicate that a parallel design underlies motor information processing in the cortico-basal ganglia loop derived from the rostral and caudal cingulate motor areas.

Relationship between lesion location and the outcome of pallidotomy for Parkinson's disease

The relationships between lesion location and clinical outcome following posteroventral pallidotomy for Parkinson's disease were studied. Forty-four patients were operated forty-six times and studied with neurological and psychological examinations before and after pallidotomy. Lesion location was confirmed using films with a coagulation electrode which were X-rayed during the operation. Changes of intelligence were observed in the patients with anteromedial lesions. Wearing-off phenomenon in four patients and dopa-induced dyskinesia in three patients were not improved following pallidotomy in twenty patients with severe wearing-off and dyskinesia. Lesions in the patients with no improvement of wearing off were located more lateral and those in the patients with sustained severe dyskinesia were located more dorsal in the internal part of the globus pallidus. It may be concluded that clinical outcome is related to lesion location.

Trehalose suppresses lipopolysaccharide-induced osteoclastogenesis bone marrow in mice

We have previously shown that trehalose suppresses bone loss in ovariectomized (OVX) mice by way of inhibiting osteoclast differentiation in bone marrow. Also, trehalose inhibits the secretion of interleukin-6 in bone marrow cell cultures, resulting in a decrease in osteoclast formation. In this study, we examined the effect of trehalose on osteoclastogenesis using another model of bone resorption, namely lipopolysaccharide (LPS)-stimulated osteoclast induction. Mice were given trehalose (1g/kg) by gastric intubation for 5 consecutive days, and 24 hours later, 14 mg/kg of LPS was injected intraperitoneally. Trehalose significantly suppressed LPS-induced tumor necrosis factor (TNF)-alpha production after 90 min and decreased the number of osteoclasts in the bone marrow 48 hours after LPS injection. These results indicate that trehalose suppresses excessive osteoclastogenesis not only in OVX mice but also in a LPS-induced bone resorption mouse model and further suggest that the latter finding may be mediated at least in part through a decrease in TNF-alpha production.