Kidney donor age of 50 years or above is a risk factor for calcineurin inhibitor-induced nephrotoxicity

INTRODUCTION

Calcineurin inhibitor (CNI)-induced nephrotoxicity (CNI-T) is a post-transplantation complication that leads to graft dysfunction. Older-donor kidney grafts may be susceptible to chronic CNI exposure because of long-term arteriolar damage. The primary aim of this study was to examine the CNI-T incidence and time-course changes in the graft function according to donor age.

METHODS

We included 334 kidney transplant recipients. CNI-T was defined by Banff arteriolar hyaline thickening scores of ≥2 based on allograft protocol biopsy. Depending on donor age, participants were divided into the D > 70 (≥70 years), D60 (60-69 years), D50 (50-59 years), and D < 49: (≤49 years) groups. We investigated the extent to which CNI-T affected the transplanted kidney function. Patients who did not develop CNI-T during the study period were included in the non-CNI-T group; the remaining were grouped into the CNI-T group.

RESULTS

The CNI-T incidence was higher in donors aged >50 years. Compared to D < 49, the CNI-T risk was 1.86 times higher in D50 and 2.9 times higher in D > 70. Furthermore, the CNI-T group exhibited a significantly lower graft function 10 years after transplantation.

CONCLUSION

CNI-T incidence increases in donors aged ≥50 years and affects renal function after 10 years.

Retinoic Acid Deficiency Underlies the Etiology of Midfacial Defects

Embryonic craniofacial development depends on the coordinated outgrowth and fusion of multiple facial primordia, which are populated with cranial neural crest cells and covered by the facial ectoderm. Any disturbance in these developmental events, their progenitor tissues, or signaling pathways can result in craniofacial deformities such as orofacial clefts, which are among the most common birth defects in humans. In the present study, we show that Rdh10 loss of function leads to a substantial reduction in retinoic acid (RA) signaling in the developing frontonasal process during early embryogenesis, which results in a variety of craniofacial anomalies, including midfacial cleft and ectopic chondrogenic nodules. Elevated apoptosis and perturbed cell proliferation in postmigratory cranial neural crest cells and a substantial reduction in Alx1 and Alx3 transcription in the developing frontonasal process were associated with midfacial cleft in Rdh10-deficient mice. More important, expanded Shh signaling in the ventral forebrain, as well as partial abrogation of midfacial defects in Rdh10 mutants via inhibition of Hh signaling, indicates that misregulation of Shh signaling underlies the pathogenesis of reduced RA signaling-associated midfacial defects. Taken together, these data illustrate the precise spatiotemporal function of Rdh10 and RA signaling during early embryogenesis and their importance in orchestrating molecular and cellular events essential for normal midfacial development.

UHPLC/MS and NMR-Based Metabolomic Analysis of Dried Water Extract of Citrus-Type Crude Drugs

Citrus-type crude drugs (CCDs) are commonly used to formulate decoctions in Kampo formula (traditional Japanese medicine). Our previous study reported metabolomic analyses for differentiation of the methanol extracts of Citrus-type crude drugs (CCDs) using ultra-HPLC (UHPLC)/MS, and ¹³C- and ¹H-NMR. The present study expanded the scope of its application by analyzing four CCD water extracts (Kijitsu, Tohi, Chimpi, and Kippi); these CCDs are usually used as decoction ingredients in the Kampo formula. A principal component analysis score plot of processed UPLC/MS and NMR analysis data indicated that the CCD water extracts could be classified into three groups. The loading plots showed that naringin and neohesperidin were the distinguishing components. Three primary metabolites, α-glucose, β-glucose, and sucrose were identified as distinguishing compounds by NMR spectroscopy. During the preparation of CCD dry extracts, some compounds volatilized or decomposed. Consequently, fewer compounds were detected than in our previous studies using methanol extract. However, these results suggested that the combined NMR- and LC/MS-based metabolomics can discriminate crude drugs in dried water extracts of CCDs.

Esterified carotenoids are synthesized in petals of carnation (Dianthus caryophyllus) and accumulate in differentiated chromoplasts

Although yellow and orange petal colors are derived from carotenoids in many plant species, this has not yet been demonstrated for the order Caryophyllales, which includes carnations. Here, we identified a carnation cultivar with pale yellow flowers that accumulated carotenoids in petals. Additionally, some xanthophyll compounds were esterified, as is the case for yellow flowers in other plant species. Ultrastructural analysis showed that chromoplasts with numerous plastoglobules, in which flower-specific carotenoids accumulate, were present in the pale yellow petals. RNA-seq and RT-qPCR analyses indicated that the expression levels of genes for carotenoid biosynthesis and esterification in pale yellow and pink petals (that accumulate small amounts of carotenoids) were similar or lower than in green petals (that accumulate substantial amounts of carotenoids) and white petals (that accumulate extremely low levels of carotenoids). Pale yellow and pink petals had a considerably lower level of expression of genes for carotenoid degradation than white petals, suggesting that reduced degradation activity caused accumulation of carotenoids. Our results indicate that some carnation cultivars can synthesize and accumulate esterified carotenoids. By manipulating the rate of biosynthesis and esterification of carotenoids in these cultivars, it should be feasible to produce novel carnation cultivars with vivid yellow flowers.

Structural Analysis of Polygalaxanthones, C-Glucosyl Xanthones of Polygala tenuifolia Roots

Polygalaxanthone III, a xanthone glycoside that is a major constituent of "Polygala Root" (Polygala tenuifolia roots, Onji in the Japanese Pharmacopoeia), has been used as a standard in the quality control of crude drugs. However, we previously noted differences in the chromatographic properties of one of three samples of polygalaxanthone III. Therefore, standardization of the standard itself is extremely important. The structures of three standard samples commercially available as polygalaxanthone III were characterized by LC/MS and NMR. LC/MS analysis revealed that two molecular types exist. Both types are chromatographically separable but have an identical mass number with distinguishable MS/MS spectra. One dimensional (1D)-NMR analyses demonstrated that both had the same xanthone moiety and heteronuclear multiple bond correlation (HMBC) analyses revealed that they are structural isomers at the connecting position of glucose to apiose 1-position. Consequently, the isomers were identified as polygalaxanthone III and its regioisomer, polygalaxanthone XI. Based on the findings, we recommend using the LC-MS/MS detection method, which discriminates polygalaxanthone III and XI, to confirm the quality of the standard.

High-Resolution Liquid Chromatography-Mass Spectrometry-Based Metabolomic Discrimination of Citrus-Type Crude Drugs and Comparison with Nuclear Magnetic Resonance Spectroscopy-Based Metabolomics

Five Citrus-type crude drugs (40 samples) were classified using liquid chromatography-mass spectrometry (LC-MS)-based metabolomics. The following six flavonoid derivatives were identified as contributors from the loading plots of multivariate analysis: naringin (1), neohesperidin (2), neoeriocitrin (3), narirutin (9), hesperidin (10), and 3,5,6,7,8,3',4'-heptamethoxyflavone (12). Three coumarin derivatives, namely, meranzin (6), meranzin hydrate (7), and meranzin glucoside (8), were also identified as contributors. Furthermore, compared with our previous studies on proton (¹H) and ¹³C NMR spectroscopy-based metabolomics, the present study revealed that the Citrus-type crude drugs were distinguished with the same pattern; however, the contributors differed between the ¹H and ¹³C NMR spectroscopy-based metabolomics. The high dynamic range of NMR spectroscopy provided broad coverage of the metabolomes including the primary and secondary metabolites. However, LC-MS appeared to be superior in detecting secondary metabolites with high sensitivity, some of which occurred in quantities that were undetectable using NMR spectroscopy.

1H NMR-based metabolomic analysis coupled with reversed-phase solid-phase extraction for sample preparation of Saposhnikovia roots and related crude drugs

¹H NMR-based metabolomics has been applied in research on food, herbal medicine, and natural products. Although excellent results were reported, samples were directly extracted with a deuterated solvent (e.g., methanol-d₄ or D₂O) in most reports. As primary metabolites account for most of the results, data for secondary metabolites are partially reflected. Consequently, secondary metabolites tend to be excluded from factor loading analysis, serving as a significant unfavorable feature of ¹H NMR-based metabolomics when investigating biologically active or functional components in natural products and health foods. Reversed-phase solid-phase extraction column (RP-SPEC) was applied for sample preparation in ¹H NMR-based metabolomics to overcome this feature. The methanol extract from Saposhnikoviae radix (SR), an important crude drug, was fractionated with RP-SPEC into 5% methanol-eluting fractions, and the remaining fraction was collected. Each fraction was subjected to ¹H NMR-based metabolomics and compared to results from conventional ¹H NMR-based metabolomics. Based on principal component analysis (PCA) and partial least squares projections to latent structures discriminant analysis (PLS-DA), the 5% methanol fraction and conventional method reflected the amount of saccharides such as sucrose on the PC1/PLS1 axes, and wild and cultivated samples were discriminated along those axes. The remaining fraction clearly distinguished SR from Peucedanum ledebourielloides root. The compounds responsible for this discrimination were deemed falcarindiol derivatives and other unidentified secondary metabolites from the s-plot on PLS-DA. The secondary metabolites from original plants were, therefore, presumed to be concentrated in the remaining fraction by RP-SPEC treatment and strongly reflected the species differences. The developed series is considered effective to perform quality evaluation of crude drugs and natural products.

Higher blood glucose and larger fluctuations detected postoperatively using continuous glucose monitoring: a preliminary study following total knee or hip arthroplasty

BACKGROUND

The control of diabetes mellitus (DM) should help reduce the incidence of periprosthetic joint infection (PJI). Self-monitoring of blood glucose (SMBG) concentration is usually undertaken at fixed time-points. Therefore, the extent of postoperative blood glucose fluctuation might be underestimated. To provide a more comprehensive assessment, continuous glucose monitoring (CGM) is beginning to be used. However, no previous studies have evaluated blood glucose concentrations using CGM following orthopedic surgery. Therefore, the differences between the maximum blood glucose concentrations measured using SMBG and CGM, and the mean amplitude of the glycemic fluctuation in patients with frank diabetes mellitus (DM) or pre-diabetes were evaluated. Blood glucose was measured in 20 patients who had undergone total hip or total knee arthroplasty (12 patients with DM and eight with pre-diabetes). Patients were fitted with a CGM device in the operating room, which was worn for 6 days postoperatively, and used to evaluate blood glucose concentration continuously. SMBG was performed simultaneously for the same period.

RESULTS

The mean difference between the maximum blood glucose concentrations measured using SMBG and CGM was 25.0 ± 20.3 mg/dl (range, - 17 to 81 mg/dl), with the concentrations measured using CGM tending to be higher than those measured using SMBG (P = 0.04). Blood glucose concentrations measured using CGM tended to be higher than those measured using SMBG until postoperative day 2, and to decrease gradually after postoperative day 4. There were no significant differences in the standard deviation of the blood glucose concentrations between the two groups.

CONCLUSIONS

Blood glucose concentrations > 200 mg/dl and larger fluctuations were more frequently recorded using CGM than SMBG, especially until postoperative day 2. Thus, CGM is more useful for the identification of high blood glucose concentrations and larger fluctuations. However, this information was not provided in real time.

13C-NMR-based metabolic fingerprinting of Citrus-type crude drugs

Five Citrus-type crude drugs (40 samples) were classified using ¹³C-NMR spectra-based metabolomics. The following eight metabolites were identified from the loading plots of multivariate analysis of the ¹³C-NMR spectra; naringin, neohesperidin, narirutin, synephrine, sucrose, α-glucose, β-glucose, and limonene. ¹³C-NMR spectra-based metabolic fingerprinting is a promising strategy for classifying crude drugs.

Effects of a combined exercise plus diet program on cardiorespiratory fitness of breast cancer patients

Background

Decreases in cardiorespiratory fitness among breast cancer patients have often been reported in previous studies, affecting patients’ health and survival. Peak oxygen uptake (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\dot{V}\text{O}}}_{{{\text{2peak}}}}$$\end{document}V˙O2peak) is the gold standard for assessing cardiorespiratory fitness and is inversely correlated with cardiovascular disease among women with breast cancer. Some previous studies have reported that aerobic exercise and proper diet positively influence \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\dot{V}\text{O}}}_{{{\text{2peak}}}}$$\end{document}V˙O2peak. However, almost all studies have been conducted in the Western countries, and few studies are investigating on Asian women who have lower BMI compared with Western ones.

Purpose

Investigating the effects of a combined exercise and diet program among Japanese cancer patients undergoing therapy on \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\dot{V}\text{O}}}_{{{\text{2peak}}}}$$\end{document}V˙O2peak.

Methods

Thirty-two Japanese women with breast cancer undergoing endocrine therapy (age; 50 ± 6 years, body weight; 59 ± 10 kg) were voluntarily assigned to either intervention group (n = 21) or control group (n = 11). The intervention group completed a 12-week combined exercise plus diet program, consisting of weekly aerobic exercise and maintaining a nutritionally well-balanced 1200 kcal/day diet. The control group was instructed to continue with their usual activities. Anthropometric indices and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\dot{V}\text{O}}}_{{{\text{2peak}}}}$$\end{document}V˙O2peak were measured at baseline and after the 12-week program.

Results

All 21 women completed the 12-week program. The \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\dot{V}\text{O}}}_{{{\text{2peak}}}}$$\end{document}V˙O2peak significantly increased from 26.7 to 30.4 mL/kg/min (1.57–1.62 L/min) in the intervention group, while it remained unchanged (26.9–26.9 mL/kg/min) in the control group. Mean reduction of body mass index was − 2.1 in the intervention group (P < .001) and + 0.1 in the control group.

Conclusions

Our combined exercise plus diet program may contribute to improvement in cardiorespiratory fitness and body weight compared with control group.

Preliminary Quality Evaluation and Characterization of Phenolic Constituents in Cynanchi Wilfordii Radix

A new phenolic compound, 2-O-β-laminaribiosyl-4-hydroxyacetophenone (1), was isolated from Cynanchi Wilfordii Radix (CWR, the root of Cynanchum wilfordii Hemsley), along with 10 known aromatic compounds, including cynandione A (2), bungeisides-C (7) and –D (8), p-hydroxyacetophenone (9), 2′,5′-dihydroxyacetophenone (10), and 2′,4′-dihydroxyacetophenone (11). The structure of the new compound (1) was elucidated using spectroscopic methods and chemical methods. The structure of cynandione A (2), including a linkage mode of the biphenyl parts that remained uncertain, was unambiguously confirmed using the 2D ¹³C–¹³C incredible natural abundance double quantum transfer experiment (INADEQUATE) spectrum. Additionally, health issues related to the use of Cynanchi Auriculati Radix (CAR, the root of Cynanchum auriculatum Royle ex Wight) instead of CWR have emerged. Therefore, constituents present in methanolic extracts of commercially available CWRs and CARs were examined using UV-sensitive high-performance liquid chromatography (HPLC), resulting in common detection of three major peaks ascribed to cynandione A (2), p-hydroxyacetophenone (9), and 2′,4′-dihydroxyacetophenone (11). Thus, to distinguish between these ingredients, a thin-layer chromatography (TLC) method, combined with only UV irradiation detection, focusing on wilfosides C1N (12) and K1N (13) as marker compounds characteristic of CAR, was performed. Furthermore, we propose this method as a simple and convenient strategy for the preliminary distinction of CWR and CAR to ensure the quality and safety of their crude drugs.

Abstract P6-11-04: Effects of a combined exercise plus diet intervention on cardiorespiratory fitness among Japanese women with breast cancer: A feasibility study

Background

Remarkable deterioration of physical fitness is a well-established adverse event associated with endocrine therapy among breast cancer patients. Especially, impairment in cardiorespiratory fitness has been often reported in previous studies, affecting patients' health and survival. Peak oxygen uptake (VO2peak) is the gold standard for assessing cardiorespiratory fitness and is inversely correlated with cardiovascular disease among women with breast cancer as well as ordinal people. A number of previous studies have reported that aerobic exercise improves the risk of cardiovascular disease. Moreover, a proper diet program positively influences VO2peak. However, almost all studies have been conducted in the Western community and there are few studies forcing on Asian women who have lower BMI compared with Western ones. Therefore, we investigated the feasibility of a combined exercise and diet program among Japanese cancer patients undergoing endocrine therapy and the effect on VO2peak.

Methods

Thirty-Two Japanese women with breast cancer undergoing endocrine therapy (age; 50±6 years, body weight; 126±22 lbs) were voluntarily assigned to either intervention group (n = 21) or control group (n = 11). The intervention group completed a 12-week combined exercise plus diet program, consisting of weekly aerobic training and maintaining a nutritionally well-balanced 1,200 kcal/d diet. The control group were instructed to continue with their usual activities. Anthropometric indices, VO2peak and QoL were measured at baseline and after the 12-week program. VO2peak was assessed using an Okura protocol (Okura. 1999).

Results

All of the 21 women completed the 12-week program. The VO2peak increased from 26.7 to 30.4 mL/kg/min (1.57 to 1.62 L/min) in the intervention group, while it remained unchanged (26.6 to 26.7 mL/kg/min) in the control group. Significant improvements were observed in VO2peak, and QoL in the intervention group (P &lt;. 001), while they remained essentially unchanged among the control group. Mean weight loss was 8.7% of the initial weight in the intervention group (P &lt;. 001) and 0.1% in the control group. No adverse events were reported in the intervention group.

Conclusions

Our combined exercise plus diet program may contribute to improvement in cardiorespiratory fitness, QoL, and body weight compared with control group. Importantly, cardiorespiratory fitness has been improved by as much as 15 % after three months. Further studies are needed to consider that what kind of aerobic exercise is best to improve cardiorespiratory fitness among Asian breast cancer patients.

Citation Format: Okumatsu K, Tsujimoto T, Seki A, Kotake R, Yamauchi T, Yamauchi H, Tanaka K. Effects of a combined exercise plus diet intervention on cardiorespiratory fitness among Japanese women with breast cancer: A feasibility study [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-11-04.

Chronic Expanding Hematoma After Metal-on-Metal Total Hip Arthroplasty

A 76-year-old woman who underwent bilateral metal-on-metal total hip arthroplasty fell 3 years after this procedure and subsequently incurred continuous pain in her buttock. Plain radiographs showed no fracture and no loosening of the hip prosthesis. Magnetic resonance imaging revealed an abnormal, large, thick-walled mass with heterogeneous signal intensity at the right buttock. The prerevision diagnosis was adverse reaction to metal debris. The mass was surgically resected, and the metal femoral head was replaced by a dual-mobility prosthesis. The intraoperative and histological analyses indicated an expanding hematoma. Cobalt ion concentrations of whole blood and effusion around the hematoma-1.9 µg/L and 1.3 µg/L, respectively-were not indicative of adverse reaction to metal debris. Transcatheter arterial embolization was performed 2 days postoperatively. The hematoma was reduced and was not present after 9 months. The diagnosis of a periprosthetic soft tissue mass after metal-on-metal total hip arthroplasty should be carefully reached with magnetic resonance imaging and assessment of blood metal ion concentrations. Expanding hematoma should be considered a potential diagnosis if metal ion concentrations are not increasing and magnetic resonance imaging shows a periprosthetic mass with a heterogeneous lesion. Embolization is useful for the management of an expanding hematoma. [Orthopedics. 2017; 40(6):e1103-e1106.].

Chemical Analysis of Counterfeit Hepatitis C Drug Found in Japan

In January 2017, counterfeits of the hepatitis C drug 'HARVONI^® Combination Tablets' (HARVONI^®) were found at a pharmacy chain through unlicensed suppliers in Japan. A total of five lots of counterfeit HARVONI^® (samples 1-5) bottles were found, and the ingredients of the bottles were all in tablet form. Among them, two differently shaped tablets were present in two of the bottles (categorized as samples 2A, 2B, 4A, and 4B). We analyzed the total of seven samples by high-resolution LC-MS, GC-MS and NMR. In samples 2A, 3 and 4B, sofosbuvir, the active component of another hepatitis C drug, SOVALDI^® Tablets 400 mg (SOVALDI^®), was detected. In sample 4A, sofosbuvir and ledipasvir, the active components of HARVONI^®, were found. A direct comparison of the four samples and genuine products showed that three samples (2A, 3, 4B) are apparently SOVALDI^® and that sample 2A is HARVONI^®. In samples 1 and 5, several vitamins but none of the active compounds usually found in HARVONI^® (i.e., sofosbuvir and ledipasvir) were detected. Our additional investigation indicates that these two samples are likely to be a commercial vitamin supplement distributed in Japan. Sample 2B, looked entirely different from HARVONI^® and contained several herbal constitutents (such as ephedrine and glycyrrhizin) that are used in Japanese Kampo formulations. A further analysis indicated that sample 2B is likely to be a Kampo extract tablet of Shoseiryuto which is distributed in Japan. Considering this case, it is important to be vigilant to prevent a recurrence of distribution of counterfeit drugs.

Radiologic and Clinical Features of Misdiagnosed Idiopathic Osteonecrosis of the Femoral Head

Idiopathic osteonecrosis of the femoral head (ONFH) can be correctly diagnosed in accordance with the established criteria. However, some general orthopedic physicians have misdiagnosed patients as having ONFH. The goal of this study was to clarify the radiologic and clinical features of misdiagnosed patients. This study included 50 patients who were referred to the authors' hospital by general physicians with a diagnosis of ONFH. The correct diagnosis was made based on the Japanese Investigation Committee diagnostic criteria for ONFH. Demographic data were compared between patients with and without ONFH. Of the 50 patients, 24 were diagnosed with other diseases: 10 with osteoarthritis, 7 with transient osteoporosis of the femoral head, 4 with rapidly destructive coxopathy, and 3 with subchondral insufficiency fracture. Seventeen patients who did not have ONFH had magnetic resonance imaging findings that showed a bone marrow edema pattern at the femoral head. The mean age of 62.9 years among patients without ONFH was significantly higher than that of 45.2 years among patients with ONFH. There were 18 female patients in the non-ONFH group and 5 female patients in the ONFH group. Bilateral disease was found in 1 patient in the non-ONFH group and 17 patients in the ONFH group. No patients in the non-ONFH group had a history of systemic steroid administration compared with 11 patients in the ONFH group. Clinical features associated with the non-ONFH group were female sex, older age, unilateral disease, and no history of systemic steroid administration. For patients with these features, the diagnosis of ONFH should be made carefully. [Orthopedics. 2017; 40(1):e117-e123.].

Fabrication of Porous Poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) Monoliths via Thermally Induced Phase Separation

This study deals with the fabrication of biodegradable porous materials from bacterial polyester, poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (P3HB3HH_x), via thermally induced phase separation. P3HB3HH_x monoliths with topological porous structure were prepared by dissolution of P3HB3HH_x in dimethyl sulfoxide (DMSO) at 85 °C and subsequent quenching. The microstructure of the resulting P3HB3HH_x monoliths was changed by the P3HB3HH_x concentration of the polymer solution. Differential scanning calorimetry and polarized optical microscope analysis revealed that the P3HB3HH_x monoliths crystallized during phase separation and the subsequent aging. The mechanical properties, such as compression modulus and stress, of the monoliths depended on the 3-hydroxyhexanoate content of P3HB3HH_x. Furthermore, the P3HB3HH_x monolith absorbed linseed oil in preference to water in a plant oil⁻water mixture. In combination with the biodegradable character of P3HB3HH_x, the present study is expected to contribute to the development of bio-based materials.

Reactive oxygen species derived from xanthine oxidase interrupt dimerization of breast cancer resistance protein, resulting in suppression of uric acid excretion to the intestinal lumen

The prevalence of hyperuricemia/gout increases with aging. However, the effect of aging on function for excretion of uric acid to out of the body has not been clarified. We found that ileal uric acid clearance in middle-aged rats (11-12 months) was decreased compared with that in young rats (2 months). In middle-aged rats, xanthine oxidase (XO) activity in the ileum was significantly higher than that in young rats. Inosine-induced reactive oxygen species (ROS), which are derived from XO, also decreased ileal uric acid clearance. ROS derived from XO decreased the active homodimer level of breast cancer resistance protein (BCRP), which is a uric acid efflux transporter, in the ileum. Pre-administration of allopurinol recovered the BCRP homodimer level, resulting in the recovering ileal uric acid clearance. Moreover, we investigated the effects of ROS derived from XO on BCRP homodimer level directly in Caco-2 cells using hypoxanthine. Treatment with hypoxanthine decreased BCRP homodimer level. Treatment with hypoxanthine induced mitochondrial dysfunction, suggesting that the decreasing BCRP homodimer level might be caused by mitochondrial dysfunction. In conclusion, ROS derived from XO decrease BCRP homodimer level, resulting in suppression of function for uric acid excretion to the ileal lumen. ROS derived from XO may cause the suppression of function of the ileum for the excretion of uric acid with aging. The results of our study provide a new insight into the causes of increasing hyperuricemia/gout prevalence with aging.

Intestinal P-glycoprotein Expression is Multimodally Regulated by Intestinal Ischemia-Reperfusion

Purpose. Reactive oxygen species (ROS) have multiple physiological effects that are amount-dependent. ROS are one of the causes of intestinal ischemia-reperfusion (I/R) injury. In this study, we investigated whether the amount of ROS and the degree of intestinal I/R injury affect the expression level of P-glycoprotein (P-gp). Methods. We used hydrogen peroxide (H2O2) as ROS in in vitro experiments. Intestinal I/R model rats, which were subjected 15-min ischemia (I/R-15), were used in in vivo experiments. Results. P-gp expression in Caco-2 cells was increased in response to 1 µM of H2O2 but decreased upon exposure to 10 mM of H2O2. We previously reported that P-gp expression is decreased after intestinal I/R with 30-min ischemia (I/R-30), which time a large amount of ROS is generated. I/R-15 induced slightly less mucosal and oxidative injury than did I/R-30. P-gp expression in the jejunum was increased at 1 h after I/R-15, and ileal paracellular permeability was increased. The blood concentration of tacrolimus, a P-gp substrate, was lower during 0-20 min but was higher during 40-90 min post-administration compared with that in the sham-operated rats. P-gp expression in the ileum was decreased at 6 h after I/R-15, due to abnormal localization of P-gp, resulting in a high blood tacrolimus concentration in rats reperfused for 6 h. Conclusions. ROS multimodally regulate P-gp expression depending on its amount. This is important for understanding the pattern of P-gp expression after intestinal I/R. This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.

Syntheses of Naturally Occurring Terphenyls and Related Compounds

Naturally occurring terphenyls and related compounds such as terferol and its corresponding quinone and phlebiarubrone were synthesized from 2,5-diphenyl-1,4-benzoquinone. According to the proposed biosynthetic pathway, chemical conversion of phlebiarubrone to ustalic acid, a toxic compound isolated from the poisonous mushroom, Tricholoma ustale, was examined to find a low-yield conversion to the ustalic acid dimethyl ester.

Comparison of the T2 relaxation time of the temporomandibular joint articular disk between patients with temporomandibular disorders and asymptomatic volunteers

BACKGROUND AND PURPOSE

T2 relaxation time is a quantitative MR imaging parameter used to detect degenerated cartilage in the knee and lumbar intervertebral disks. We measured the T2 relaxation time of the articular disk of the temporomandibular joint in patients with temporomandibular disorders and asymptomatic volunteers to demonstrate an association between T2 relaxation time and temporomandibular disorder MR imaging findings.

MATERIALS AND METHODS

One hundred forty-four patients with temporomandibular disorders and 17 volunteers were enrolled in this study. An 8-echo spin-echo sequence for measuring the T2 relaxation times was performed in the closed mouth position, and the T2 relaxation time of the entire articular disk was measured. Patients were classified according to the articular disk location and function, articular disk configuration, presence of joint effusion, osteoarthritis, and bone marrow abnormalities.

RESULTS

The T2 relaxation time of the entire articular disk was 29.3 ± 3.8 ms in the volunteer group and 30.7 ± 5.1 ms in the patient group (P = .177). When subgroups were analyzed, however, the T2 relaxation times of the entire articular disk in the anterior disk displacement without reduction group, the marked or extensive joint effusion group, the osteoarthritis-positive group, and the bone marrow abnormality-positive group were significantly longer than those in the volunteer group (P < .05).

CONCLUSIONS

The T2 relaxation times of the articular disk of the temporomandibular joint in patients with progressive temporomandibular disorders were longer than those of healthy volunteers.

Effect of oxidative stress on expression and function of human and rat organic anion transporting polypeptides in the liver

Reactive oxygen species (ROS) have physiological function and involve alteration of physical state. However, it is not clear effect of oxidative stress on pharmacokinetics. Organic anion transporting polypeptides (human: OATPs, rodent: Oatps) are important for uptake of endogenous and exogenous compounds into hepatocytes. Thus, alteration of OATPs/Oatps expression level may affect pharmacokinetics of various drugs. In this study, we investigated the alteration of OATPs/Oatps expression levels and function by oxidative stress, and the effect of alteration of those on pharmacokinetics of a typical OATPs/Oatps substrate pravastatin. OATPs/Oatps expression levels and function were altered by H2O2-induced oxidative stress in in vitro experiments. The alteration of Oatps expression by oxidative stress also occurred in in vivo experiments. Oatp1a1, Oatp1a4 and Oatp1b2 expression in the liver were decreased in rats fed powdery diet containing 2% inosine, which induces oxidative stress through activation of xanthine oxidase, for 1 day. The decrease in Oatps expression levels by oxidative stress caused the suppression of pravastatin uptake to the liver, and resulted in high plasma concentration of pravastatin and low biliary excretion. In conclusion, oxidative stress induces alteration of OATPs/Oatps expression and function in hepatocytes, resulting in alteration of pharmacokinetics of their substrates.

Intestinal Ischemia-Reperfusion Suppresses Biliary Excretion of Hepatic Organic Anion Transporting Polypeptides Substrate

Purpose. Intestinal ischemia-reperfusion (I/R) causes gut dysfunction and promotes multi-organ failure. The liver and kidney can be affected by multi-organ failure after intestinal I/R. Organic anion transporting polypeptides (OATPs) and organic anion transporters (OATs) are recognized in a broad spectrum from endogenous compounds to xenobiotics, including clinically important drugs. Therefore, it is important for understanding the pharmacokinetics to obtain evidence of alterations in OATPs and OATs expression and transport activities. In the present study, we investigated the expression of rat Oatps and Oats after intestinal I/R. Methods. We used intestinal ischemia-reperfusion (I/R) model rats. Real-time PCR and Western blotting were used to assess mRNA and protein expression levels. Plasma concentration and biliary excretion of sulfobromophthalein (BSP), which is used as a model compound of organic anion drugs, were measured after intravenous administration in intestinal I/R rats. Results. Although Oat1 and Oat3 mRNA levels were not altered in the kidney, Oatp1a1, Oatp1b2 and Oatp2b1 mRNA levels in the liver were significantly decreased at 1-6 h after intestinal I/R. Moreover, Oatp1a1 and Oatp2b1 protein expression levels were decreased at 1 h after intestinal I/R. Plasma concentration of BSP, which is a typical substrate of Oatps, in intestinal I/R rats reperfused 1 h was increased than that in sham-operated rats. Moreover, the area under the concentration-time curve (AUC0-90) in intestinal I/R rats reperfused 1 h was significantly increased than that in sham-operated rats. The total clearance (CLtot) and the biliary clearance (CLbile) in intestinal I/R rats reperfused 1 h were significantly decreased than those in sham-operated rats. Conclusions. Oatp1a1 and Oatp2b1 expression levels are decreased by intestinal I/R. The decreases in these transporters cause alteration of pharmacokinetics of organic anion compound. The newly found influence of intestinal I/R on the expression and function of Oatps may be a key to perform appropriate drug therapy.This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page

The decrease in farnesoid X receptor, pregnane X receptor and constitutive androstane receptor in the liver after intestinal ischemia-reperfusion

PURPOSE

Intestinal ischemia-reperfusion (I/R) damages remote organs, including the liver, and promotes multi-organ failure (MOF). However, the molecular mechanisms underlying acute liver injury after intestinal I/R have not been completely elucidated. Farnesoid X receptor (FXR), pregnane X receptor (PXR) and constitutive androstane receptor (CAR) regulate metabolizing enzymes and transporters, and coordinately prevent hepatotoxicity reflecting an inability of appropriate excretion of endogenous toxic compounds. In this study, we assessed FXR, PXR and CAR expression levels and their localization levels in nuclei in the liver after intestinal I/R. We also investigated the effect of IL-6 on FXR, PXR and CAR expression levels and their localization levels in nuclei in in vitro experiments.

METHODS

We used intestinal I/R model rats. Moreover, HepG2 cells were used in in vitro study. Real-time PCR and Western blotting were used to assess mRNA and protein expression levels. Nuclear receptor localization in nuclei was analyzed by Western blotting using nuclear extracts.

RESULTS

FXR and PXR expression levels began to be decreased at 3 h, and FXR, PXR and CAR expression levels were decreased at 6 h after intestinal I/R. The localization levels of FXR, PXR and CAR in nuclei began to be decreased at 3 h, and all of them were decreased at 6 h after intestinal I/R. In HepG2 cells, FXR, PXR and CAR expression levels were decreased by 0.5-1 ng/mL, 0.5-100 ng/mL and 100 ng/mL IL-6 treatment for 24 h, respectively. FXR, PXR and CAR localization levels in nuclei were suppressed by 0.5-10 ng/mL, 10-100 ng/mL and 10-100 ng/mL IL-6 treatment for 24 h, respectively.

CONCLUSIONS

FXR, PXR and CAR expression levels are decreased in the liver after intestinal I/R. IL-6 is one of main causes the decreases in expressions of these receptors.

Intestinal ischemia-reperfusion increases efflux for uric acid via paracellular route in the intestine, but decreases that via transcellular route mediated by BCRP

PURPOSE

Uric acid is thought to be one of the most important antioxidants in human biological fluids. Intestinal ischemia-reperfusion (I/R) is an important factor associated with high rates of morbidity and mortality. Reactive oxygen species (ROS) are responsible for intestinal I/R injury. The aim of this study was to clarify the efflux for uric acid from the intestine after intestinal I/R.

METHODS

We used intestinal ischemia-reperfusion (I/R) model rats. Serosal to mucosal flux for [¹⁴C]-uric acid was assessed by using Ussing-type diffusion chambers. BCRP/Bcrp expression was assessed by Western blot analysis. Caco-2 cells were used for a model of the intestinal epithelium, and rotenone was used as a mitochondrial dysfunction inducer.

RESULTS

Serosal to mucosal flux for uric acid was increased after intestinal I/R, and that for mannitol was also increased. Ko143, which is a BCRP inhibitor, did not affect the uric acid transport. The decreasing uric acid transport mediated by Bcrp was caused by decrease in the level of Bcrp homodimer, bridged by an S-S bond. The suppression of Bcrp S-S bond formation was associated with mitochondrial dysfunction. Moreover, BCRP S-S bond formation activity was decreased by rotenone in Caco-2 cells.

CONCLUSIONS

Serosal to mucosal flux for uric acid is significantly increased via the paracelluler route, but that via the transcellular route mediated by Bcrp is decreased after intestinal I/R. The decreasing uric acid flux mediated by Bcrp is caused by suppression of Bcrp S-S bond formation. This suppression of Bcrp S-S bond formation may be related to mitochondrial dysfunction.

Medial condyle fracture of the distal humerus in an adolescent with pre-existing fishtail deformity. A case report

Medial condyle fractures of the humerus are rare in any age group. We report a unique case of a humeral medial condyle fracture in a 15-year-old boy with posttraumatic fishtail deformity. The fracture line extended up from the top of the sharp trochlear wedge to the incomplete medial supracondylar cortical aperture. The appearance of the upward displacement and computed tomography imaging with three-dimensional reconstruction at the two different elbow positions suggested that an edge of the semilunar notch of the olecranon acted as a wedge to break and split the trochlea directly. This is the first visualized case of a wedge type injury and may provide evidence that humeral medial condyle fractures can be produced by the wedge force besides the valgus avulsion one.

Structures and Properties of TiAl-Base Alloys Containing Mn

Structures and mechanical properties of TiAl-base alloys have been studied, in which Zr, Nb, V or Mn is added as the third element and the Al content is changed. Behavior of the third element in the TiAl-base alloys and effects of various factors on ductility have been discussed. It has been concluded that the Ti-48.4 at% Al-1.0 at% Mn alloy is the optimum composition for obtaining good room temperature ductility.

Synthesis of an amphiphilic poly(gamma-glutamic acid)-cholesterol conjugate and its application as an artificial chaperone

A poly(gamma-glutamic acid) (gammaPGA)-cholesterol conjugate was synthesized and the properties of an aqueous solution were evaluated. The conjugate showed amphiphilic nature derived from the hydrophilic gammaPGA backbone and the hydrophobic cholesterol side chain. The conjugate spontaneously formed nanoparticles in the aqueous solution of the low concentration, and the high concentration resulted in the formation of the physical gel. By utilizing the self-aggregating properties of the conjugate in water, an artificial chaperone was developed. The complex of protein with the nanoparticles of the conjugate was formed and the protein was released upon the dissociation of the nanoparticles by the addition of beta-cyclodextrin. For denatured carbonic anhydrase, the activity was recovered in the artificial chaperone of the nanoparticle conjugate.

The recognition motif of the glycoprotein-folding sensor enzyme UDP-Glc:glycoprotein glucosyltransferase

The folding of glycoproteins is primarily mediated by a quality control system in the ER, in which UDP-Glc:glycoprotein glucosyltransferase (UGGT) serves as a "folding sensor". In this system, client glycoproteins are delivered to UGGT after the trimming of their innermost glucose residue by glucosidase II, which releases them from the lectin chaperones calnexin (CNX) and calreticulin (CRT). UGGT is inactive against folded proteins, allowing them to proceed to the Golgi apparatus for further processing to complex- or hybrid-type glycoforms. On the other hand, this enzyme efficiently glucosylates incompletely folded glycoproteins to monoglucosylated structures, providing them with an opportunity to interact with CNX/CRT. In order to clarify the mode of this enzyme's substrate recognition, we conducted a structure-activity relationship study using a series of synthetic probes. The inhibitory activities of various glycans suggest that UGGT has a strong affinity for the core pentasaccharide (Man3GlcNAc2) of high-mannose-type glycans. Our comparison of the reactivity of acceptors that have been modified by various aglycons supports the hypothesis that UGGT recognizes the hydrophobic region of client glycoproteins. Moreover, we discovered fluorescently labeled substrates that will be valuable for highly sensitive detection of UGGT activity.

Effects of structural anisotropy of cancellous bone on speed of ultrasonic fast waves in the bovine femur

Ultrasonic waves in cancellous bone change dramatically depending on its structural complexity. One good example is the separation of an ultrasonic longitudinal wave into fast and slow waves during propagation. In this study, we examined fast wave propagation in cancellous bone obtained from the head of the bovine femur, taking the bone structure into consideration. We investigated the wave propagation perpendicular to the bone axis and found the two-wave phenomenon. By rotating the cylindrical cancellous bone specimen, changes in the fast wave speed due to the rotation angle then were observed. In addition to the ultrasonic evaluation, the structural anisotropy of each specimen was measured by X-ray micro-computed tomography (CT). From the CT images, we obtained the mean intercept length (MIL), degree of anisotropy (DA), and angle of insonification relative to the trabecular orientation. The ultrasonic and CT results showed that the fast wave speed was dependent on the structural anisotropy, especially on the trabecular orientation and length. The fast wave speeds always were higher for propagation parallel to the trabecular orientation. In addition, there was a strong correlation between the DA and the ratio between maximum and minimum speeds (V(max)/V(min)) (R(2) = 0.63).

One-Pot Transformation of Trichloroacetamide into Readily Deprotectable Carbamates

[Structure: see text] A trichloroacetamide group was converted to an isocyanate, which was in situ captured by a variety of alcohols in the presence of CuCl and n-BuN4Cl to afford the corresponding carbamates. The scope and limitation of this transformation are also described.

The transport mechanisms of 222Rn in soil at Tateishi as an anomaly spot in Japan

The (222)Rn concentration profiles in soil have been measured at an anomaly spot in Tateishi, Japan. In winter, the concentrations were low and showed a negative gradient with depth, but in other seasons, the concentration had both positive and negative gradients with depth, and dramatically changed by time. On the assumption that there was ventilation in deep layers and with driving forces of wind and temperatures, these phenomena were successfully explained. This finding would contribute to a numerical model for (222)Rn transport in soil.