60Fe and 244Pu deposited on Earth constrain the r-process yields of recent nearby supernovae

Half of the chemical elements heavier than iron are produced by the rapid neutron capture process (r-process). The sites and yields of this process are disputed, with candidates including some types of supernovae (SNe) and mergers of neutron stars. We search for two isotopic signatures in a sample of Pacific Ocean crust-iron-60 (⁶⁰Fe) (half-life, 2.6 million years), which is predominantly produced in massive stars and ejected in supernova explosions, and plutonium-244 (²⁴⁴Pu) (half-life, 80.6 million years), which is produced solely in r-process events. We detect two distinct influxes of ⁶⁰Fe to Earth in the last 10 million years and accompanying lower quantities of ²⁴⁴Pu. The ²⁴⁴Pu/⁶⁰Fe influx ratios are similar for both events. The ²⁴⁴Pu influx is lower than expected if SNe dominate r-process nucleosynthesis, which implies some contribution from other sources.

Iodine-129 for determining the origin of salinity in groundwater in Pampanga, Philippines

Assessing groundwater vulnerability from salinity contamination is vital and relevant to meet the increasing demand for freshwater. Iodine-129 (¹²⁹I, half-life = 15.7 million years), a radioisotope of iodine, was used as an environmental tracer for the possible origin of salinization in groundwater (e.g., natural rock weathering, evaporated water, seawater, brine fossil water, contamination). In July 2017 (wet season), thirty-two (32) water samples were taken from production wells of different localities in Pampanga, a province in the Philippines that relies heavily on groundwater for freshwater sources. Hydrogeochemical (mainly Cl) and stable water isotopes (δ²H and δ¹⁸O) were able to identify seven samples potentially affected by seawater intrusion. The salinity origin of these samples was investigated using iodine-129 and iodine-127 isotopes by generating two graphs: ¹²⁹I vs. chloride and ¹²⁹I/¹²⁷I ratio vs. 1/¹²⁷I. ¹²⁹I vs. Cl graph was capable of showing a clear distinction between different salinity origins. Five out of the seven samples were being affected by evaporated water, one sample from possible wastewater, and one sample from brine fossil water. A conceptual model was produced to summarize the results. Compiled end-members (e.g., natural brine, seawater, modern rain) were plotted in the ¹²⁹I/¹²⁷I ratio vs. 1/¹²⁷I graph to show the interaction between two recharge sources. The results of this study will be helpful to the government, civil society, and other organizations for monitoring, policymaking, and management of the groundwater and the subsurface formations that will be crucial to continuously supply the freshwater needs of the present and future generation.

Functional analysis of a novel G87V TNFRSF1A mutation in patients with TNF receptor-associated periodic syndrome

Tumor necrosis factor (TNF) receptor-associated periodic syndrome (TRAPS) is an autoinflammatory disease that is caused by heterozygous mutations in the TNFRSF1A gene. Although more than 150 TNFRSF1A mutations have been reported to be associated with TRAPS phenotypes only a few, such as p.Thr79Met (T79M) and cysteine mutations, have been functionally analyzed. We identified two TRAPS patients in one family harboring a novel p.Gly87Val (G87V) mutation in addition to a p.Thr90Ile (T90I) mutation in TNFRSF1A. In this study, we examined the functional features of this novel G87V mutation. In-vitro analyses using mutant TNF receptor 1 (TNF-R1)-over-expressing cells demonstrated that this mutation alters the expression and function of TNF-R1 similar to that with the previously identified pathogenic T79M mutation. Specifically, cell surface expression of the mutant TNF-R1 in transfected cells was inhibited with both G87V and T79M mutations, whereas the T90I mutation did not affect this. Moreover, peripheral blood mononuclear cells (PBMCs) from TRAPS patients harboring the G87V and T90I mutations showed increased mitochondrial reactive oxygen species (ROS). Furthermore, the effect of various Toll-like receptor (TLR) ligands on inflammatory responses was explored, revealing that PBMCs from TRAPS patients are hyper-responsive to TLR-2 and TLR-4 ligands and that interleukin (IL)-8 and granulocyte-macrophage colony-stimulating factor (GM-CSF) are likely to be involved in the pathogenesis of TRAPS. These findings suggest that the newly identified G87V mutation is one of the causative mutations of TRAPS. Our findings based on unique TRAPS-associated mutations provide novel insight for clearer understanding of inflammatory responses, which would be basic findings of developing a new therapeutic and prophylactic approach to TRAPS.

Experience of Quatro-Therapy With Everolimus to Minimize Calcineurin Inhibitor for Kidney Transplant Recipients

BACKGROUND

This study was divided into three phases, on the occasion of the introduction of everolimus (EVR) in our hospital.

METHODS

In the first phase, a study group of six maintenance patients (three living related donors, three deceased donors) who had a history of malignant disease with less than 500 mg/day of proteinuria were enrolled; a high serum creatinine and upper limit of duration after kidney transplant operation was not considered. EVR was discontinued in four of the six patients because of side effects or worsening renal function. The second phase comprised a study group of 12 maintenance patients (12 living related donors) who were more than 5 years after kidney transplant operation with serum creatinine <3 ng/mL and proteinuria <500 mg/day. In two patients, EVR was discontinued because of a skin rash or general fatigue, but EVR was continued in 10 cases. Calcineurin inhibitor (CNI) dosage was reduced and renal function improved, and mean estimated glomerular filtration rate recovered from 42.3 mL/min to 44.8 mL/min, with no rejections occurring. In the third phase, a study group of eight de novo transplant patients who were 2 to 3 weeks after transplant operation were examined. In one case, EVR was discontinued because of proteinuria but was restarted with a stepwise increasing method after 4 months and was continued without any side effects.

RESULTS

Our study indicates that EVR was a useful drug for the maintenance of kidney transplant recipients for the optimal patients.

CONCLUSIONS

In de novo cases, EVR plus a high dose of mizoribine and low CNI protocol was a useful regimen without serious adverse effects.

Abstract P1-07-15: The outcomes for super elderly patients over 80 years old after breast cancer surgery

(Purpose)

Considering the dramatic increase in average life expectancy throughout the world, the management of super-elderly patients over 80 years old (SEP) with breast cancer has become a global issue. However, there have been few clinical trials for SEP until now. The reasons for this were a small population, unpredictable prognosis, a large number of non-cancer-related deaths and a lower function of multiple organs in SEP. Surgical treatment or post-operative treatment based on evidence of clinical trials for SEP has also not been unclear. We hypothesized that the outcome of SEP with breast cancer compared with other ages were similarly depended on the breast cancer subtypes.

The aim of this study was to clarify the breast cancer related survival (BRS) rate and overall survival (OS) rate at 5years for SEP according to breast cancer subtype.

(Methods)

We retrospectively analyzed 407 patients over 80 years old at initial operation between April, 1994 and April 2015 from 4 institutions of Chiba Youth Breast Oncology Research Group.

Overall, 366 patients with stage I to Stage IIIc were included.

41 patients with Stage 0 or IV were excluded in this study.

We compared the clinical characteristics, OS and BRS rates among the breast cancer subtype: such as ER positive HER2 negative (ER group), ER negative HER2 negative (TN group), ER negative HER2 positive (HER2 group) and ER positive HER2 positive (ER/HER2 group).

Univariate and multivariate analyses were performed to identify the factors of Tumor size, Lymph node, Ly, ER, HER2 and characteristics, associated with the OS and BRS.

(Results)

The median age of the 366 patients was 83 years (range 80-96 years).The median follow-up duration was 32 months (range, 2-120).

During the follow-up period, 25 (9.4%) patients in the ER group, 19 (27.5%) in TN group, 4 (22.2%) in HER2 group and 2 (20.0%) patients in ER-HER2 group died.

The 5 year OS and BRS rates were 89.2%, 97.1% in ER group, 64.6%, 81.2% in TN group, 61.5%,33.3% in HER2 group and 83.3%, 100% in ER-HER2 group, respectively.

Univariate and multivariate analyses revealed that ER was one prognostic factor to OS and BRS.

ER positive patients treatment with Aromatase inhibitor had significantly longer survival rates than treatment with Tamoxifen or no treatment (p=0.05).

There were no significant differences in OS or BRS of TN patients according to the use of chemotherapy (n=7) versus non treatment (n=61).

(Conclusions)

The prognosis and clinical course of super elderly patients with breast cancer depended on subtype.

Adjuvant therapy for ER group was one prognostic factor to OS and BRS.

Citation Format: Nakamura R, Matsuzaki H, Sakamoto M, Suda K, Hayama S, Sangai T. The outcomes for super elderly patients over 80 years old after breast cancer surgery. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-07-15.

Excitation-photon-energy selectivity of photoconversions in halogen-bridged Pd-chain compounds: Mott insulator to metal or charge-density-wave state

Ultrafast photoinduced transitions of a one-dimensional Mott insulator into two distinct electronic phases, metal and charge-density-wave (CDW) state, were achieved in a bromine-bridged Pd-chain compound [Pd(en)2Br](C5-Y)2H2O (en=ethylenediamine and C5-Y=dialkylsulfosuccinate), by selecting the photon energy of a femtosecond excitation pulse. For the resonant excitation of the Mott-gap transition, excitonic states are generated and converted to one-dimensional CDW domains. For the higher-energy excitation, free electron and hole carriers are produced, giving rise to a transition of the Mott insulator to a metal. Such selectivity in photoconversions by the choice of initial photoexcited states opens a new possibility for the developments of advanced optical switching and memory functions.

Secondary surgeries after digital replantations: a case series

We evaluated the injuries, survival rats, and secondary surgeries of patients who had undergone finger replantation or revascularization between October 2005 and July 2010. The 70 digits came from 43 patients (average age, 46 years; range, 19 to 78 years; 37 men). Overall replantation survival rate was 94%; 93% (27/29) for complete amputations and 95% (39/41) for near-amputations. In all, 39 digits from 21 patients required 48 secondary surgeries; skin grafts, tenolysis, joint fusion, bone graft, osteotomy, and web plasty. The more proximal or more severe the injuries, the higher the need of secondary surgeries. The most common surgery soon after replantation was skin coverage; the most common after two months was tendon surgery. Primary repair must be adequate to restore the function and appearance of amputated digits; however, the possible need for secondary surgeries must be kept in mind to avoid restricting the options for secondary procedures.

Diagnostic value of MRI for odontogenic tumours

OBJECTIVES

To evaluate the diagnostic value of MRI for odontogenic tumours.

MATERIALS AND METHODS

51 patients with odontogenic tumours were subjected to pre-operative MRI examinations. For tumours with liquid components, i.e. ameloblastomas and keratocystic odontogenic tumours (KCOTs), the signal intensity (SI) uniformity of their cystic components (UΣ) was calculated and then their UΣ values were compared. For tumours with solid components that had been examined using dynamic contrast-enhanced MRI (DCE-MRI), their CImax (maximum contrast index), Tmax (the time when CImax occurred), CIpeak (CImax × 0.90), Tpeak (the time when CIpeak occurred) and CI300 (i.e. the CI observed at 300 s after contrast medium injection) values were determined from CI curves. We then classified the odontogenic tumours according to their DCE-MRI parameters.

RESULTS

Significant differences between the UΣ values of the ameloblastomas and KCOT were observed on T1 weighted images, T2 weighted images and short TI inversion recovery images. Depending on their DCE-MRI parameters, we classified the odontogenic tumours into the following five types: Type A, CIpeak > 2.0 and Tpeak < 200 s; Type B, CIpeak < 2.0 and Tpeak < 200 s; Type C, CI300 > 2.0 and Tmax < 600 s; Type D, CI300 > 2.0 and Tmax > 600 s; Type E, CI300 < 2.0 and Tmax > 600 s.

CONCLUSION

Cystic component SI uniformity was found to be useful for differentiating between ameloblastomas and KCOT. However, the DCE-MRI parameters of odontogenic tumours, except for odontogenic fibromas and odontogenic myxomas, contributed little to their differential diagnosis.

Relaxation dynamics of photoexcited excitons in rubrene single crystals using femtosecond absorption spectroscopy

The relaxation dynamics of an exciton in rubrene was investigated by femtosecond absorption spectroscopy. Exciton relaxation to a self-trapped state occurs via the coherent oscillation with 78 cm(-1) due to a coupled mode of molecular deformations with phenyl-side-group motions and molecular displacements. From the temperature dependence of the decay time of excitons, the energy necessary for an exciton to escape from a self-trapped state is evaluated to be ~35 meV (~400 K). As a result, a self-trapped exciton is stable at low temperatures. At room temperature, excitons can escape from a self-trapped state and, subsequently, they are dissociated to charged species. The exciton dissociation mechanism is discussed on the basis of the results.

Preventing postoperative congestion in reverse pedicle digital island flaps when reconstructing composite tissue defects in the fingertip: a patient series

For reconstructing an injured fingertip, a reverse pedicle digital island flap can restore excellent function and appearance. However, postoperative flap congestion may lead to flap necrosis. We tested a method for dissecting the vascular pedicle to prevent congestion and to provide more reliable results. Between August 2002 and December 2010, we reconstructed 14 fingertips in 13 patients (average age, 43 years; range, 24 to 68 years; 9 men). Through a small zigzag incision, the digital artery and a 4-mm-wide subcutaneous venous network were elevated in retrograde fashion to facilitate venous drainage. All flaps healed completely without severe congestion or necrosis. Slight flexion contractures remained in the PIP (mean, 12°) and DIP (mean, 14°) joints. Our procedure is simpler and more reliable than other techniques, such as adding a narrow skin bridge to the pedicle or a venous anastomosis to prevent venous congestion, and it assures the survival of the flap.

A BLAUTH IIIB HYPOPLASTIC THUMB RECONSTRUCTED WITH A VASCULARISED METATARSO-PHALANGEAL JOINT TRANSFER: A CASE REPORT WITH 28 YEARS OF FOLLOW UP

We reconstructed the Blauth-IIIB hypoplastic right thumb of a 16-year-old girl with a vascularised metatarso-phalangeal (MTP) joint from her second toe combined with a dorsalis-pedis flap. Abduction was provided with an abductor policis long tendon advancement, and adduction, with an extensor indicis proprius tendon transfer. Opponoplasty was performed one year later using the flexor sublimis (IV) tendon. The transferred joint remained functional and non-osteoarthritic 28 years later. Radial and palmar abduction of the reconstructed thumb was 45° and 75° respectively. The index, middle, and ring fingers could oppose the thumb, however she grasped small objects between her index and middle fingertips. If a pollicisation using the index finger is not accepted, the reconstruction described here is one of the surgical options. However donor-foot morbidity is not negligible. Currently, we use a proximal-interphalangeal joint transfer with an opponoplasty using an abductor digiti minimi as a first choice, when planning a reconstruction of preserved hypoplasic thumb.

THE PURE CULTIVATION OF SPIROCHAETA ICTEROHAEMORRHAGIAE (INADA)

Pure cultures of the spirochætal causative agent of the disease known as Weil's disease, or febrile icterus, in Japan, have been obtained by us in a solid, a semisolid, and a fluid medium. The spirochæta thus isolated remains pathogenic for guinea pigs for many generations. Up to the present time we have succeeded through the courtesy of Professor Nagayo, Dr. Konuma, and Dr. Ishihara, in cultivating three different strains. The spirochæta is a facultative anaerobe. The solid and semisolid culture media possess one disadvantage, in that they are opaque on account of the addition of red blood corpuscles; but it is hoped that this drawback may soon be overcome by further studies. We shall report later the results of investigations regarding various questions in immunity as well as further details regarding the biological properties of the spirochæta.

A Blauth IIIB hypoplastic thumb reconstructed with a vascularised metatarso-phalangeal joint transfer: a case report with 28 years of follow up

We reconstructed the Blauth-IIIB hypoplastic right thumb of a 16-year-old girl with a vascularised metatarso-phalangeal (MTP) joint from her second toe combined with a dorsalis-pedis flap. Abduction was provided with an abductor policis long tendon advancement, and adduction, with an extensor indicis proprius tendon transfer. Opponoplasty was performed one year later using the flexor sublimis (IV) tendon. The transferred joint remained functional and non-osteoarthritic 28 years later. Radial and palmar abduction of the reconstructed thumb was 45 degrees and 75 degrees respectively. The index, middle, and ring fingers could oppose the thumb, however she grasped small objects between her index and middle fingertips. If a pollicisation using the index finger is not accepted, the reconstruction described here is one of the surgical options. However donor-foot morbidity is not negligible. Currently, we use a proximal-interphalangeal joint transfer with an opponoplasty using an abductor digiti minimi as a first choice, when planning a reconstruction of preserved hypoplasic thumb.

Predicting functional recovery and return to work after mutilating hand injuries: usefulness of Campbell's Hand Injury Severity Score

PURPOSE

We investigated the effect of severity and form of mutilating hand injuries on functional recovery and return to work, and the usefulness of an injury-severity score in predicting these outcomes.

METHODS

We reexamined patients in whom finger amputation or near amputation had been treated with replantation or revascularization at our institution at least 3 years earlier. We evaluated radiographs, sensory recovery, finger range of motion, skin temperature, and current overall hand function to calculate Tamai and Quick Disabilities of the Arm, Shoulder, and Hand scores, and recorded return-to-work status, duration of treatment, and time away from work. We determined injury level, number of involved fingers, type of injury, and Campbell's Hand Injury Severity score (HISS) from the medical record.

RESULTS

The average age of the 50 enrolled patients was 43 years (range, 18-69 years); average follow-up was 7.8 years (range, 3.1-15.3 years). More proximal injuries, more involved fingers, and more complicated injury predicted poorer functional recovery. HISS was highly correlated with Tamai's score (r = -0.77; p<.001) and moderately correlated with the Quick Disabilities of the Arm, Shoulder, and Hand score (r = 0.39; p = .009). HISS was only moderately correlated with length of treatment (r = 0.32; p<.05) and with time away from work (r = 0.34; p<.05). Mean HISS among the 3 return-to-work groups differed remarkably. When HISS was <50, 11 of 12 patients returned to their original jobs; when it was between 50 and 150, 17 of 23 patients were able to return; and when it was >150, only 4 of 15 were able to return to work.

CONCLUSIONS

Given the current surgical care of patients with mutilated hand injuries, HISS determined at the time of injury can adequately predict functional outcome and return to work status. Larger studies will be necessary to validate these findings.

Evaluation of panoramic radiographs taken at the initial visit at a department of paediatric dentistry

OBJECTIVES

To examine oral and maxillofacial lesions other than those related to the chief complaint in panoramic radiographs taken at the department of paediatric dentistry at our hospital.

METHODS

We retrospectively reviewed all 1092 patients who had visited the department of paediatric dentistry at our hospital and had a panoramic radiograph taken between August 1999 and October 2004. The following information was obtained from the patients' files and panoramic radiographs: gender, age, chief complaints and the presence or absence of lesions.

RESULTS

Lesions were observed in 140 of the 1092 panoramic radiographs (12.8%). Among the 140 patients discovered to have lesions in the panoramic radiographs, 66 (47.1%, or 6.05% of the entire group of 1092 patients) had different lesions from those underlying the chief complaint. These 66 patients ages ranged from 3 years to 14 years and the lesions involved 39 (59.1%) missing teeth, 20 (30.3%) mesiodentes, 4 supernumerary teeth, 1 odontoma, 1 radicular cyst and 1 impacted tooth. The missing teeth were observed in the central and lateral incisor, canine, and first and second premolar positions of both jaws, especially in the lower lateral incisor and upper central incisor positions.

CONCLUSIONS

We were able to detect incidental lesions at a rate of 6.05% (66 of 1092 patients) and at a relatively early age (mean 6.8 years) in the present study. Early treatment of these lesions could avoid maxillofacial deformity and other complications.

Serum levels of P-selectin in men with high-functioning autism

Immune dysfunction has been proposed as a mechanism for the pathophysiology of autistic-spectrum disorders. The selectin family of adhesion molecules plays a prominent role in immune/inflammatory responses. We determined the serum levels of three types of soluble-form selectin (sP, sL and sE) in 15 men with high-functioning autism and 22 age-matched healthy controls by enzyme-linked immunosorbent assay. Levels of sP-selectin and sL-selectin were significantly lower in patients than in controls. Furthermore, sP-selectin levels were negatively correlated with impaired social development during early childhood.

p53AIP1 expression can be a prognostic marker in non-small cell lung cancer

AIMS

p53AIP1 is a potential mediator of p53-dependent apoptosis that is mutated in many kinds of carcinoma. To investigate the role of this gene for non-small cell lung cancer, we compared the relationship between p53AIP1 gene expression and clinicopathological status of lung cancer.

MATERIALS AND METHODS

Seventy samples from non-small cell lung cancer patients were obtained between 1997 and 2003. For quantitative evaluation of RNA expression by polymerase chain reaction (PCR) we used the Taqman PCR methods. Exons 5-8 of the p53 gene were analysed using PCR-single-stranded conformation polymorphism and sequenced for mutation analysis.

RESULTS

p53AIP1 gene expression levels in the lymph node metastasis-positive group were significantly lower than in the negative group (positive 35.1+/-83.9; negative 64.2+/-113.4; P=0.0486). The overall survival of the p53AIP1 low expression group was significantly worse than that of the p53AIP1 high expression group (P=0.0206). In the multivariate Cox proportional hazard model, p53AIP1 (P=0.0489) was the independent predictor for overall survival. When we investigated mutation analyses of the p53 gene, we could find several point mutations in 15.7% of all samples. However, there was no relationship between p53AIP1 expression and p53 status.

CONCLUSIONS

These data suggest that the p53AIP1 gene is important for non-small cell lung cancer progression and may be a possible prognostic marker.

Effect of suture material and bone quality on the mechanical properties of zone I flexor tendon-bone reattachment with bone anchors

PURPOSE

To compare the initial biomechanical properties of zone I flexor tendon to bone repairs performed using pull-out and anchor techniques and to investigate the effect of bone quality and suture materials on the strength of anchor repairs.

METHODS

Using computed tomography, we measured bone mineral density and cortical thickness of the distal phalanx of 60 cadaver fingers (mean age, 77 years). Flexor digitorum profundus tendons were then transected at their insertion sites and repaired using a 4-strand grasping suture and either pull-out or anchor fixation. For pull-out repair (n = 20), the suture strands (Supramid 3-0; S. Jackson, Inc., Alexandria, VA) were passed through the distal phalanx and tied over a dorsal button. For anchor repair, 2 bone anchors were inserted into the distal phalanx, and tendons were grasped using either Supramid (n = 21), Ethibond (Ethicon, Inc., Somerville, NJ; n = 10), or FiberWire suture (Arthrex Inc., Naples, FL; n = 9) (all 3-0). Mechanical properties of the repaired tendon-bone constructs were determined in linear, load-to-failure loading and correlated with bone characteristics.

RESULTS

The FiberWire-anchor repair group had the best combination of mechanical properties, with ultimate force to failure no different from the pull-out repairs but with greater stiffness and reduced displacement. Pull-out suture repairs had significantly higher ultimate force-to-failure values than did Ethibond-anchor and Supramid-anchor repairs (p < .01). However, pull-out repairs had significantly reduced stiffness and greater displacement at 20 N force than did anchor repairs from all groups (p < .05). Both bone mineral density and cortical thickness correlated significantly with ultimate force (p < .01). Almost all anchors pulled out for bone mineral density below 420 mg/cm(3) or cortical thickness less than 0.31 mm, which occurred only for specimens aged greater than 75 years.

CONCLUSIONS

The mechanical properties of the double Mitek bone anchors were sensitive to both suture material and bone quality. FiberWire-anchor repairs provided the best combination of mechanical properties. Pull-out suture repairs had good strength but poor stiffness. Anchor fixation may be contraindicated in patients greater than 75 years because of poor bone quality.

Damaging fatigue loading stimulates increases in periosteal vascularity at sites of bone formation in the rat ulna

Bone formation in a variety of contexts depends on angiogenesis; however, there are few reports of the vascular response to osteogenic skeletal loading. We used the rat forelimb compression model to characterize vascular changes after fatigue loading. The right forelimbs of 72 adult rats were loaded cyclically in vivo to one of four displacement levels, to produce four discrete levels of ulnar damage. Rats were killed 3-14 days after loading, and their vasculature was perfused with silicone rubber. Transverse histological sections were cut along the ulnar diaphysis. We quantified vessel number, average vessel area, total vessel area, and bone area. On day 3, we observed a dramatic periosteal expansion near the ulnar midshaft, with significant increases in periosteal vascularity; total vessel area was increased 250-450% (P < 0.001). Vascularity remained elevated on days 7 and 14. Vessel number and average vessel area were not correlated (P = 0.09) and contributed independently to total vascular increases. Bone area was not increased on day 3 but on days 7 and 14 was increased significantly in all displacement groups (P < 0.01) due to periosteal woven bone formation. Vascular and bone changes depended on longitudinal location (P < 0.001), with peak increases 2 mm distal to the midshaft. Vascular and bone changes also depended on displacement level (P < 0.005), with greater increases at higher levels of fatigue displacement. We conclude that skeletal fatigue loading induces a rapid increase in periosteal vascularity, followed by an increase in bone area. The angiogenic-osteogenic response is spatially coordinated and scaled to the level of the mechanical stimulus.

Alendronate prevents bone loss and improves tendon-to-bone repair strength in a canine model

Previously we showed a loss of bone and a concomitant decrease in mechanical properties in the first 21 days after flexor tendon insertion site injury and repair in a canine model. The goal of this short-term study was to suppress bone loss after insertion site repair using alendronate in an attempt to prevent the reduction in biomechanical properties. Flexor tendons of the second and fifth digits of the right forelimbs of canines were injured and repaired. Dogs received a daily oral dose of alendronate (2 mg/kg). One digit in each dog also received a local dose of alendronate in the bone tunnel at the time of surgery. The repair was evaluated for bone mineral density (BMD) and biomechanical properties and compared to data from a previous study in which no alendronate was used. Alendronate was effective in protecting the distal phalanx from resorption during tendon-to-bone healing (BMD was 94 and 104% of control for systemic alendronate and for systemic plus local alendronate, respectively). Alendronate treatment prevented much of the decrease in ultimate load that occurs in the first 21 days. Without treatment, ultimate load was 42% of control. With systemic alendronate treatment and systemic plus local alendronate treatment, ultimate load was 78 and 69% of control, respectively. Failure mode was significantly different when comparing alendronate treatment to repair alone. A lower incidence of suture pull through was found in alendronate treated dogs, suggesting less tendon degeneration. Ultimate load can be improved in association with preventing the bone loss that normally occurs during the early period following tendon-to-bone repair. These initial short-term data demonstrate the potential for a clinical treatment that could enhance tendon-to-bone healing.

Osteopontin as biomarker in early invasion by squamous cell carcinoma in tongue

BACKGROUND

Osteopontin (OPN) expression in squamous cell carcinoma (SCC) of the tongue has not been clearly elucidated.

METHODS

We selected 46 cases of tongue SCC and investigated the expression of OPN by immunohistochemical staining. The immunopositive reaction and score for each case were semiquantitatively evaluated.

RESULTS

Scores were significantly higher in carcinoma nests than in neighboring normal epithelium or epithelial dysplasia. The OPN was expressed clearly in the cytoplasm of carcinoma cells. In cases of early invasive carcinoma, in particular, expression of OPN showed a remarkable increase at the invasion front compared with the non-invaded regions. However, there was no significant correlation between expression of OPN in the primary tumor nest and lymphatic metastasis, recurrence, or survival rate.

CONCLUSION

This suggests that OPN is a useful biomarker of early invasion by SCC in tongue.

Photoinduced metallic state mediated by spin-charge separation in a one-dimensional organic Mott insulator

Charge dynamics in a one-dimensional (1D) Mott insulator was investigated by fs pump-probe reflection spectroscopy on an organic charge-transfer compound, bis(ethylenedithio)tetrathiafulvalene-difluorotetracyanoquinodimethane (ET-F2TCNQ). The analyses of the transient reflectivity changes demonstrate that low-energy spectral weight induced by photocarrier doping is concentrated on a Drude component being independent of the doping density, and midgap state is never formed. Such phenomena can be explained by the concept of spin-charge separation characteristic of 1D correlated electron systems.

Onset of nephrocalcinosis depends on dietary phosphorus concentration in male rats fed a magnesium-deficient diet

Although a magnesium (Mg)-deficient diet is generally known to induce nephrocalcinosis, our previous study observed that despite the administration of a Mg-deficient diet, the kidney calcium (Ca) and phosphorus (P) concentrations were not increased in male rats. We speculated that this result was due to the P concentration of the experimental diet based on the AIN-93G formula used in the previous study. In the present study, male rats were fed modified AIN-93G diets containing the two different Mg concentrations [0.5 g per kg diet (normal-Mg) or Mg-free (Mg-deficient)] and three different P concentrations [3 (3-P), 5 (5-P) or 7 (7-P) g per kg diet]. By histological examination of the kidney, nephrocalcinosis was not observed in rats fed on the Mg-deficient diet containing 3-P While nephrocalcinosis appeared in rats fed on the Mg-deficient diet containing 5-P and 7-P The degree of nephrocalcinosis was severe in rats fed on the Mg-deficient diet containing 7-P compared with rats fed on the Mg-deficient diet containing 5-P These results demonstrated that the Mg-deficient diet based on AIN-93G formula dose not induce nephrocalcinosis and that the Mg-deficient diet based on AIN-93G formula with increased dietary P concentrations induces nephrocalcinosis in male rats. We suggest that the onset of nephrocalcinosis could depend on the dietary P concentration in male rats fed on a Mg-deficient diet.

Endoscopic Carpal Tunnel Release in the Elderly

The present study is aimed to clarify the postoperative outcome of endoscopic carpal tunnel release in elderly patients with carpal tunnel syndrome. Endoscopic carpal tunnel release was performed on 37 hands of 27 patients (2 men, 25 women) who were aged 70 years or older and clinically and electrophysiologically diagnosed with carpal tunnel syndrome. Mean age at the time of surgery was 74.5 years (range: 70-85 years). Mean postoperative follow-up was 35.5 months (range: 12-114 months). Pain was present preoperatively in 20 hands, but quickly resolved postoperatively in all cases. Numbness completely disappeared in 13 of 37 hands (35.1%), but some degree of numbness remained in the remaining cases. Preoperative severity of thenar muscle atrophy was none in 4 hands, mild in 7 hands, moderate in 12 hands and severe in 14 hands. Postoperative severity of thenar muscle atrophy at final follow-up was none in 13 hands, mild in 16 hands, moderate in 2 hands and severe in 6 hands, confirming that thenar muscle atrophy improves even in elderly patients. However, moderate or severe thenar muscle atrophy remained in 8 hands (21.6%). Endoscopic carpal tunnel release should be considered in the elderly, even though clinical symptoms may not improve substantially in advanced cases.

Phospho-regulation of human protein kinase Aurora-A: analysis using anti-phospho-Thr288 monoclonal antibodies

Mammalian Aurora-A is related to a serine/threonine protein kinase that was originally identified by its close homology with Saccharomyces cerevisiae Ipl1p and Drosophila melanogaster aurora that are key regulators in the orchestration of mitotic events. The protein level of Aurora-A, its peak kinase activity during mitosis, and its activation have been attributed to phosphorylation. Here we show that this enzyme is an arginine-directed kinase and define its substrate specificity. We also found that Thr288 within the activation loop is a critical residue for activating phosphorylation events in vitro and that it is spatiotemporally restricted to a brief window at mitosis on duplicated centrosomes and on spindle microtubules proximal to the poles in vivo. Immunodepletion assays indicated that an upstream kinase(s) of Aurora-A might exist in mammalian cells in addition to autophosphorylation. Furthermore, human activated Aurora-A forms complexes with the negative regulator protein serine/threonine phosphatase type 1 (PP1) that was negatively phosphorylated on Thr320. Interestingly, phospho-specific Aurora-A monoclonal antibodies restrain Aurora-A kinase activity in vitro, providing further therapeutic avenues to explore.

Early healing of flexor tendon insertion site injuries: Tunnel repair is mechanically and histologically inferior to surface repair in a canine model

Orthopedic injuries often require surgical reattachment of tendon to bone. Tendon ends can be sutured to bone by direct apposition to the bone surface or by placement within a bone tunnel. Our objective was to compare early healing of a traditional surface versus a novel tunnel method for repair of the flexor digitorum profundus (FDP) tendon insertion site in a canine model. A total of 70 tendon-bone specimens were analyzed 0, 5, 10 or 21 days after injury and repair, using tensile and range of motion mechanical testing, histology and densitometry. Ultimate force (a measure of repair strength) did not differ between surface and tunnel repairs at day 0. Both repair types had reduced strength at 10 and 21 days compared to 0 days, indicative of deterioration of suture grasping strength (tendon softening). At 21 days, tendons repaired in a bone tunnel had 38% lower ultimate force compared to surface repairs (p = 0.017). Histological findings were comparable between repair groups at 5 and 10 days but differed at 21 days, when we saw evidence of maturation of the tendon-bone interface in the surface repairs compared to an immature fibrous interface with no evidence of tendon-bone integration in the tunnel repairs. After accounting for bone removed by the tunnel, no difference in bone mineral density or trabecular bone volume existed between surface and tunnel repairs. If the results of our animal study extend to healing of the human FDP insertion, they indicate that FDP tendons should be reattached to the distal phalanx by suture to the cortical surface rather than suture in a bone tunnel.

Magnesium-deficient diet-induced reduction in protein utilization in rats is reversed by dietary magnesium supplementation

We investigated the effect of dietary magnesium (Mg) level on protein utilization in rats. Male Wistar rats were fed a control diet (control group) and a Mg-deficient diet (Mg-deficient group) for 28 days. After 28 days, the diet of half of the Mg-deficient group (recovery group) was changed from the Mg-deficient diet to the control diet for either 7 or 14 days. After 28 days, final body weight, weight gain and food efficiency were significantly decreased due to the Mg-deficient diet. Apparent Mg absorption, Mg retention and serum Mg levels were also significantly decreased due to the Mg-deficient diet. Furthermore, the Mg-deficient group showed a significant increase in urinary nitrogen (N) excretion and significant decreases in N retention and serum albumin level. At day 7 and 14 after changing the Mg-deficient diet to the control diet, apparent Mg absorption, Mg retention and serum Mg levels were significantly increased in the recovery group as compared with those in the Mg-deficient group. However, with regard to final body weight, weight gain and food efficiency, no significant differences were observed between the Mg-deficient group and the recovery group. At day 14 after changing the diet, urinary N excretion was significantly decreased and N retention was significantly increased in the recovery group as compared with the Mg-deficient group. At day 7 and 14 after changing the diet, the serum albumin level was also significantly increased in the recovery group as compared with that in the Mg-deficient group. These results suggest that: 1) the Mg-deficient diet depresses protein utilization; 2) the Mg-deficient diet-induced impairment of protein utilization is reversed by dietary Mg supplementation; and 3) the Mg-deficient diet-induced growth retardation is not completely reversed after 14 days of Mg supplementation.

Moderate magnesium-restricted diet affects bone formation and bone resorption in rats

This study investigated the effects of moderate magnesium (Mg)-restricted diet on bone formation and bone resorption in rats. Weanling Wistar strain rats were randomly divided into three dietary groups of 6 rats each and fed their respective diets; a control diet containing 0.05% Mg (C), a half Mg diet containing 0.025% Mg (1/2Mg), or a one-fifth Mg diet containing 0.01% Mg (1/5Mg), for 21 days. Serum osteocalcin level was significantly reduced with decreasing dietary Mg level. Urinary excretion of C-terminal telopeptide of type 1 collagen was significantly higher in the 1/5Mg group than in the C group. Serum insulin-like growth factor-1 (IGF-1) level was significantly lower in the 1/2Mg and 1/5Mg groups than in the C group. Serum soluble receptor activator of nuclear factor-kappaB ligand (sRANKL) level was significantly higher in the 1/2Mg and 1/5Mg groups than in the C group. These results showed that a moderate Mg-restricted diet induced a decrease in bone formation and an increase in bone resorption. Furthermore, these changes of bone formation and bone resorption might be caused by serum IGF-1 and sRANKL levels, respectively.

Ultrafast photoinduced melting of a spin-Peierls phase in an organic charge-transfer compound, K-tetracyanoquinodimethane

Ultrafast photoinduced phase transition in a spin-Peierls (SP) system of K-tetracyanoquinodimethane (K-TCNQ) was studied by femtosecond (fs) reflection spectroscopy. Photocarriers destabilize the SP phase, resulting in a decrease in molecular dimerization within 400 fs. Such a melting of the SP phase drives three kinds of coherent oscillations. By comparing the oscillations with the Raman bands activated by the dimerization, we show that the oscillation of 20 cm-1 is due to an LO phonon, and it plays an important role for the stabilization of the SP phase.

Effect of dietary magnesium supplementation on bone loss in rats fed a high phosphorus diet

The purpose of this study was to investigate the effect of dietary magnesium (Mg) supplementation on bone loss in rats fed a high phosphorus (P) diet. Weanling Wistar strain rats were randomly divided into four dietary groups of 6 rats each and fed their respective diets; a diet containing 0.3% P and 0.05% Mg (C), a diet containing 1.5% P and 0.05% Mg (HP), a diet containing 0.3% P and 0.15% Mg (HMg), or a diet containing 1.5% P and 0.15% Mg (HPMg), for 21 days. Compared to the C and HMg groups, serum parathyroid hormone (PTH) concentration was significantly higher in the HP and HPMg groups. Serum osteocalcin concentration and urinary excretion of C-terminal telopeptides of type I collagen (CTx), markers of bone turnover, were significantly higher in the HP and HPMg groups than in the C and HMg groups. Dietary Mg supplementation had no significant effects on serum PTH and osteocalcin concentrations, while urinary excretion of CTx was significantly lower in the HPMg group than in the HP group. These results suggested that dietary Mg supplementation suppressed bone resorption due to high P diet.

Effects of high calcium intake on bone metabolism in magnesium-deficient rats

We examined the effects of high calcium (Ca) intake on bone metabolism in magnesium (Mg)-deficient rats. Male Wistar rats were divided into three groups, with each group having a similar mean body weight, and fed a control diet (control group), a Mg-deficient diet (Mg-deficient group) or a Mg-deficient Ca-supplemented diet (Mg-deficient Ca-supplemented group) for 14 d. Femoral Ca content was significantly lower in the Mg-deficient Ca-supplemented group than in the control group and Mg-deficient group. Femoral Mg content was significantly lower in the Mg-deficient group and Mg-deficient Ca-supplemented group than in the control group. Furthermore, femoral Mg content was significantly lower in the Mg-deficient Ca-supplemented group than in the Mg-deficient group. Serum osteocalcin levels (a biochemical marker of bone formation) were significantly lower in the two Mg-deficient groups than in the control group. As a biochemical marker of bone resorption, urinary deoxypyridinoline excretion was significantly higher in the Mg-deficient Ca-supplemented group than in the control group and Mg-deficient group. The results in the present study suggest that high Ca intake had no preventive effect on alteration of bone metabolism in Mg-deficient rats.

Radiographic examination of mesiodens and their associated complications

OBJECTIVES

To examine mesiodens with regard to their status, their influence on adjacent teeth and their alteration during the follow-up period.

METHODS

From retrospective reviews of all patients who visited our institution from 1990-2001, we identified 200 patients (256 mesiodentes) who were shown to have mesiodentes on the basis of a periapical radiograph, a panoramic radiograph or an axial radiograph.

RESULTS

The number of supernumerary teeth was one in 146 cases (73%), two in 52 cases (26%) and three in 2 cases (1%). Of 256 mesiodentes, the direction of the crown of the mesiodens was inverted in 172 (67%), in a normal direction in 69 (27%) and in a horizontal direction with regard to the tooth axis in 15 (6%). Of the 147 mesiodentes for which axial radiography was performed, 131 (89%) were located at a palatal site against the dental arch, 16 (11%) overlapped the dental arch and none were at a labial site. Of our 200 cases, a delay of eruption of the permanent central incisor was seen in 12 (6%), malposition or rotation of the central incisor in 5 (2.5%) and dentigerous cyst formation arising from mesiodens in 22 (11%). Marked movement of the mesiodens was seen in 10 cases during the follow-up period of 5-7 years. Some complication arising from mesiodens was seen in 19.5% of all cases in our research.

CONCLUSION

Although mesiodentes are not caused by malocclusion, they may cause it. A long period of impaction of mesiodentes may bring about dentigerous cyst formation or movement of the mesiodentes.

Functional and Cosmetic Results of Fingertip Replantation

In fingertip amputations, conventional stump plasty provides an almost acceptable functional result. However, replanting fingertips can preserve the nail and minimize loss of function. We investigated the functional and cosmetic results of fingertip replantation at the terminal branch of the digital artery. Outcomes were nailbed width and distal-segment length; sensory recovery; and range of motion (ROM) of thumb-interphalangeal (IP) or finger-distal interphalangeal (DIP) joints, and total active motion (TAM) of the replanted finger. Of 15 fingertips replanted after only arterial anastomosis, 13 were successful, and 12 were studied. After a median of 1.3 years, mean nailbed widths and distal-segment lengths were 95.4% and 93.0%, respectively, of the contralateral finger. Average TAM and ROM of the thumb-IP or finger-DIP joints were 92.0% and 83.0% of normal, respectively. Semmes-Weinstein results were blue (3.22 to 3.61) in 4 fingers and purple (3.84 to 4.31) in 8; the mean result from the 2-point discrimination test was 5.9 mm (range, 3 to 11 mm). Thus, amputated fingertips should be aggressively replanted.

Long-term clinical and neurologic recovery in the hand after surgery for severe cubital tunnel syndrome

PURPOSE

Functional outcomes of cubital tunnel surgery may decline as the severity of preoperative ulnar neuropathy increases. When functional recovery will be adequate, or whether tendon transfers should be required, may be unclear. We investigated the extent of functional recovery, the duration of the recovery process, and the necessity of restoring intrinsic muscle function in patients with severe cubital tunnel syndrome after surgery.

METHODS

We retrospectively studied outcomes after cubital tunnel release in 15 patients with marked intrinsic muscle atrophy, claw-hand deformity, immeasurable (electrically silent) sensory and motor nerve conduction velocities, and Semmes-Weinstein test (SWT) results ranging from purple (3.84-4.31) to red (4.56-6.65). We evaluated subjective (numbness and activities of daily living [ADL] disturbances), objective (manual muscle testing [MMT] of index-finger abduction, and SWT), and neurophysiologic (nerve conduction velocity) outcomes. Overall functional outcome was evaluated by Akahori's criteria.

RESULTS

At a median follow-up evaluation of 4.5 years all outcomes had improved. Numbness was gone in 5 patients and greatly reduced in 9 patients; 6 patients reported slight difficulties in ADLs; and 9 patients had no difficulties. Motor nerve conduction velocity was measurable (mean, 35.3 m/s) in all 15 patients and sensory nerve conduction velocity was measurable (mean, 43.4 m/s) in 12. Recoveries in nerve conduction velocities persisted beyond 2 years. The SWT results were blue (3.22-3.61) in 6 patients, purple (3.84-4.31) in 8 patients, and red (4.56-6.65) in 1 patient. MMT of index finger abduction was grade 4 or 5 in 11 of 15 patients. Half the patients over 70 years old, however, were grade 3 or less. Akahori's criteria were excellent in 3 patients, good in 6 patients, and fair in 6 patients.

CONCLUSIONS

Patients with severe intrinsic muscle atrophy and absent motor and sensory nerve conduction velocities can expect satisfactory long-term functional results after surgery. Function continues to improve beyond 2 years. Restoring index finger abduction is not always necessary for ADLs, although recovery requires several years and is poorer in the elderly.