Association between the early repolarization pattern and nocturnal suicide attempts.

AIM: Numerous recent reports have highlighted the association between mental disorders and electrocardiographic findings. The early repolarization pattern (ERP) on electrocardiogram has been linked with a history of suicide attempts and attention deficit hyperactivity disorder, and associations with impulsivity have also been reported. It is known that suicidal intent is more common at night. Patients who have a mental disorder and ERP may have a higher likelihood of impulsivity, potentially increasing the risk of suicide at night. METHODS: The subjects were 43 patients with a history of suicide attempts who had undergone electrocardiographic examination at Jikei University School of Medicine Kashiwa Hospital and received intervention from our department. Due to the diurnal variation in electrocardiographic findings, only patients who underwent the examination during the daytime were included. Patients' clinical backgrounds were compared according to the presence or absence of ERP, and the association between nocturnal suicide attempts and ERP was examined using multivariate analysis. RESULTS: The frequency of nocturnal suicidal behavior was 76.2% in patients with ERP and 31.8% in those without ERP, but the difference was not significant after Bonferroni correction. In the multivariate analysis, there was a significant association of ERP with nocturnal suicide attempts (p = 0.018). CONCLUSION: The finding of an association between ERP and nocturnal suicide attempts indicates that ERP is a biological indicator that can predict nocturnal suicide attempts.

Examining Frontal Lobe Asymmetry and Its Potential Role in Aggressive Behaviors in Early Alzheimer's Disease.

Background: Neuropsychiatric symptoms (NPS) in patients with dementia lead to caregiver burdens and worsen the patient's prognosis. Although many neuroimaging studies have been conducted, the etiology of NPS remains complex. We hypothesize that brain structural asymmetry could play a role in the appearance of NPS. Objective: This study explores the relationship between NPS and brain asymmetry in patients with Alzheimer's disease (AD). Methods: Demographic and MRI data for 121 mild AD cases were extracted from a multicenter Japanese database. Brain asymmetry was assessed by comparing the volumes of gray matter in the left and right brain regions. NPS was evaluated using the Neuropsychiatric Inventory (NPI). Subsequently, a comprehensive assessment of the correlation between brain asymmetry and NPS was conducted. Results: Among each NPS, aggressive NPS showed a significant correlation with asymmetry in the frontal lobe, indicative of right-side atrophy (r = 0.235, p = 0.009). This correlation remained statistically significant even after adjustments for multiple comparisons (p < 0.01). Post-hoc analysis further confirmed this association (p < 0.05). In contrast, no significant correlations were found for other NPS subtypes, including affective and apathetic symptoms. Conclusions: The study suggests frontal lobe asymmetry, particularly relative atrophy in the right hemisphere, may be linked to aggressive behaviors in early AD. These findings shed light on the neurobiological underpinnings of NPS, contributing to the development of potential interventions.

Relationship between the early repolarization pattern and a history of suicide attempts among drug-free psychiatric patients.

AIM: Suicide attempts are an important severe psychiatric symptom and a clear outcome for mental disorders. Although the relationship between the early repolarization pattern in electrocardiogram and psychiatric disorders has recently been reported, these reports have not been able to exclude the influence of psychiatric drugs. This study aimed to investigate the relationship between the early repolarization pattern and a history of suicide attempts among patients not receiving psychiatric medication. METHODS: A total of 71 patients with a history of suicide attempts were investigated, 38 of whom were analyzed for this study. We compared the frequency of the early repolarization pattern between a suicide attempt group and a control group. Then, we investigated the association between the early repolarization pattern and the suicide attempt group by logistic regression analysis, including electrocardiographic findings associated with psychiatric disorders. RESULTS: The findings indicated that the frequency of the early repolarization pattern was significantly higher in the suicide attempt group (n = 20; 52.6%) than in the control group (n = 4; 10.5%) (P < 0.001), and the results of the logistic regression analysis indicated that the early repolarization pattern was associated with suicide attempts. CONCLUSIONS: These findings suggest that the early repolarization pattern is associated with a history of suicide attempts.

Detection of alpha radionuclides in air from patients during Ra-223 alpha radionuclide therapy.

Ra-223 has recently been introduced to alpha radionuclide therapy. According to the decay scheme of Ra-223, an inert gas, Rn-219 is released from patients during alpha radionuclide therapy and its daughter radionuclides may accumulate around the patient. However, the concentration of these radon daughters during alpha radionuclide therapy was not obvious. Here, we first detected the radon daughters of Rn-219 around patients during alpha radionuclide therapy. While the Ra-223-administered patients were in a room for ~1.5 hours, the radon daughter concentration increased to 4 to 5 times higher than without the patients. When the patients were in the room, the energy spectra of the alpha particles in the air showed the peak of the radon daughter of Rn-219, Bi-211 (6.6 MeV), which was different from that without the patients. We conclude that the daughter radionuclides of Rn-219 are accumulated around the patient, and the concentration was higher than that of the natural radon daughters. However, the increase in levels of alpha emitters, while detectable, is lower than the daily variations and thus is likely not a source of concern for radiation exposure.

Pin-photodiode array for the measurement of fan-beam energy and air kerma distributions of X-ray CT scanners.

PURPOSE: Patient dose estimation in X-ray computed tomography (CT) is generally performed by Monte Carlo simulation of photon interactions within anthropomorphic or cylindrical phantoms. An accurate Monte Carlo simulation requires an understanding of the effects of the bow-tie filter equipped in a CT scanner, i.e. the change of X-ray energy and air kerma along the fan-beam arc of the CT scanner. To measure the effective energy and air kerma distributions, we devised a pin-photodiode array utilizing eight channels of X-ray sensors arranged at regular intervals along the fan-beam arc of the CT scanner. METHODS: Each X-ray sensor consisted of two plate type of pin silicon photodiodes in tandem - front and rear photodiodes - and of a lead collimator, which only allowed X-rays to impinge vertically to the silicon surface of the photodiodes. The effective energy of the X-rays was calculated from the ratio of the output voltages of the photodiodes and the dose was calculated from the output voltage of the front photodiode using the energy and dose calibration curves respectively. RESULTS: The pin-photodiode array allowed the calculation of X-ray effective energies and relative doses, at eight points simultaneously along the fan-beam arc of a CT scanner during a single rotation of the scanner. CONCLUSIONS: The fan-beam energy and air kerma distributions of CT scanners can be effectively measured using this pin-photodiode array.

The mRNA expressions and immunohistochemistry of factors involved in angiogenesis and lymphangiogenesis in the early stage of rat skin incision wounds.

Wound healing evaluation is important in forensic pathology, in which angiogenesis plays an important role. We have already shown that vascular endothelial growth factor A (VEGF) is produced in the rat skin incision wounds by neutrophils, endothelial cells, and fibroblasts. In this study, we assessed the changes in the mRNA expressions of various factors possibly involved in angiogenesis including angiopoietin (ANGPT) 1 and 2, cadherin 5 (CDH5), granulocyte-macrophage colony stimulating factor (CSF2/GM-CSF), granulocyte colony stimulating factor (CSF3/G-CSF), chemokine (C-X-C motif) ligand 2 (CXCL2), chemokine (C-X-C motif) ligand12 (CXCL12/SDF1), endothelin 1 (ET1), fibroblast growth factor 1 (FGF 1), hepatocyte growth factor (HGF), hypoxia inducible factor 1 alpha (HIF1a), leptin, matrix metallopepitidase 9 (MMP9), serpine/plasminogen activator inhibitor1 (PAI1), platelet-derived growth factor-A (PDGF-A), transforming growth factor alpha and beta 1 (TGFa and b1), tenomodulin (TNMD), and troponin I type 2 (TNNI2) in the early stage of the rat skin incision wounds by real time RT-PCR. Factors reported to be involved in lymphangiogenesis such as fibroblast growth factor 2 (FGF 2), c-fos induced growth factor (FIGF/VEGF-D), forkhead box C2 (FOXC2), and prospero homeobox 1 (PROX1) were also studied. One and 3 days after the dorsal skin incisions, wounds on male Sprague-Dawley rats showed the statistically significant increases in the mRNA expressions for CXCL2, CSF3, MMP9, PAI1, and CSF2, whereas TGFa, TNNI2, FGF1, TNMD, leptin, and CXCL12 showed the statistically significant decreases. Interestingly, lymphgangiogenic factors FOXC2, PROX1, and FGF2 also showed the statistically significant decreases. In situ hybridization and immunohistochemistry showed the mRNA and protein positivity in endothelial cells, fibroblasts, and some leukocytes at the bottom of the wound tissue for PAI1, CSF3, and MMP9, 1 day after the skin incisions. Our novel findings show the possible involvement of several factors involved in angiogenesis and lymphangiogenesis in the early stage of wound healing process, which may be useful for forensic wound evaluations.

Neurovascular coupling in primary auditory cortex investigated with voltage-sensitive dye imaging and laser-Doppler flowmetry.

The spatiotemporal dynamics of the neurovascular response to brief acoustic stimuli were investigated in guinea pig primary auditory cortex. Neural activity and cortical tonotopic organization were measured with a voltage-sensitive dye (VSD) technique, whereas cerebral blood flow (CBF) response to neural stimulation was measured with laser-Doppler flowmetry (LDF). The acoustic stimulus was given as a wide band sound (click), which induced global activation or as one of two pure tones (1 kHz and 12 kHz), which induced distinct localizations in the auditory cortex. The VSD imaging showed that the sound-induced activation area varied dynamically, and that the spatial extent had peaks at 37+/-3 ms and 38+/-8 ms after the onset of stimulation during 1-kHz and 12-kHz tones, respectively. We observed that the average CBF response had a similar peak intensity irrespective of the type of stimuli: 16+/-9%, 18+/-11%, and 16+/-8% for click, 1-kHz, and 12-kHz tones, respectively. No significant differences in the CBF time course, time-to-onset (approximately 0.6 s), or time-to-peak (approximately 3.3 s) were found across the recording sites and stimulus types. These results showed that the CBF response measured with LDF produced a less specific spatial pattern relative to the neural map determined with VSD. The findings can be explained by the methodological limitations of LDF and/or neurovascular regulatory systems in the auditory cortex.

Wall shear stress and intrahepatic leukocytes of graft in living related donor liver transplantation.

BACKGROUND/AIMS: We investigated the influence of HTK solution against natural killer T cells and thymic T cells in liver graft before and after perfusion in adult living related donor liver transplantation. METHODOLOGY: Graft samples were obtained before liver resection, after perfusion, and one hour after liver transplantation. Flowcytometry analysis was conducted using several human natural killer markers; CD16, CD56, CD57, and CD161. RESULTS: Natural killer T cells existed prominently in the liver leukocytes compared with their presence in peripheral blood lymphocytes, and the difference was significant. CD56+ T and CD161+ T cells, in comparison with CD16+ T cells and CD57+ T cells, were especially numerous in the liver. The proportion of CD56+ T and CD161+ T cells increased in the graft immediately after perfusion with HTK solution. However, CD16+ T cells and CD57+ T cells decreased in the graft immediately after perfusion and reperfusion of portal blood flow. Thymus-derived cells also decreased significantly after perfusion. The proportion of CD56+ T cells among CD3+ cells showed a significant increase immediately after perfusion. All types of natural killer cells in the graft immediately increased after perfusion by HTK solution and reperfusion of portal blood flow. Compared with CD57+ NKT cells, CD56+ NKT cells showed a significant tendency to stay in the liver graft against the perfusion. CD57+ NKT cells tended to wash out from the liver into the systemic circulation. Moreover, thymus-derived T cells showed the strongest tendency to wash out from the liver graft. CONCLUSIONS: CD56+ NKT cells and natural killer cells are more involved in local immunity, whereas thymus-derived cells and CD57+ NKT cells are involved in regulation of systemic immunity. Alloimmunity between local and systemic systems may be affected by the dynamic changes in hepatic circulation associated with living related donor liver transplantation.

Stereoselective dialkylation of the proximal hydroxy groups of calix- and thiacalix[4]arenes.

Treatment of p-tert-butylcalix[4]arene (C1) and its sulfur-bridged analog T1 with 1,3-dichloro-1,1,3,3-tetraisopropyldisiloxane in the presence of imidazole gives proximally O,O'-disiloxane-1,3-diyl-bridged calixarenes C2 and T2 in excellent yields, respectively. Subsequent base-catalyzed etherification of the remaining hydroxy groups with alkyl halides gives syn- and anti-O'',O'''-dialkylated products, the stereoselectivity of which varies depending on the nature of the macrocycle, as well as the metal cation of the base employed. Thus, conventional calixarene C2 preferentially affords syn compounds of 1,2-alternate conformation (C3) with the aid of tert-BuOK and K(2)CO(3) and anti counterparts of partial-cone conformation (C4) with Cs(2)CO(3). On the other hand, thiacalixarene T2 affords syn compounds of 1,2-alternate conformation (T3) with any of the bases. The disiloxanediyl bridge of the resulting products can readily be removed by treatment with tetrabutylammonium fluoride. Thus, the net process provides an efficient method for the regio- and stereoselective synthesis of proximally dialkylated calix[4]arenes.

Nine short tandem repeat loci analysis in aged semen stains using the AmpFLSTR Profiler Kit and description of a new vWA variant allele.

Nine short tandem repeat (STR) loci, D3S1358, D5S818, vWA, TH01, D13S317, TPOX, FGA, D7S820 and CSF1PO, were investigated in semen stains of various ages using the AmpFLSTR Profiler Kit. The nine STR loci were typed from semen stains stored for up to 25 years with the application of 1-10 ng DNA. This system provides a useful tool in medicolegal individualization of aged semen stains. During this investigation we found a new variant allele 18.1 at the vWA locus.

Repeating intraportal donor-specific transfusion may induce tolerance following adult living-related donor liver transplantation.

BACKGROUND/AIMS: Oral or portal administration of allogeneic antigens downregulates the alloimmune response and prolongs graft survival following organ transplantation. However, the effect of donor-specific transfusion via the portal vein has been reported in rodent models, but has not been reported in human cases. We investigated whether donor-specific transfusion via the portal vein would bring up the clinical and immunological benefits in living-related donor liver transplantation. METHODOLOGY: Eighteen patients who underwent living-related donor liver transplantation from March 1999 to December 2001, were investigated. Seven patients were given the Tac + steroid regimen (IP(-) group: n = 7, mean age 54 +/- 9 yo). Eleven patients had postoperative repeated donor specific transfusion performed via a portal venous catheter inserted from vena colica media besides from the Tac + steroid (IP(+) group: n = 11, mean age 45 +/- 15 yo). The clinical effects of the reduction of immunosuppression and the rejection, and the immunological analysis were studied in the two groups. RESULTS: Total amount of methylprednisolone and prednisolone within one month in the IP(+) group was smaller than that in the IP(-) group with statistical significance. Amount of Tac within one month and Trough level of Tac was statistically smaller in the IP(+) group than that in the IP(-) group. Minimum dose of Tac in the IP(+) group was clearly smaller than that in the IP(-) group with statistical significance. The frequency of acute cellular rejection within one month and after one month or total frequency of acute cellular rejection in the IP(+) group tended to be less than that in the IP(-) group. Macrochimerism of donor type CD56+ T cells in a graft were confirmed in patients with donor-specific transfusion via the portal vein. Conversely recipient type CD56+ T cells increased in the graft liver in patients without donor-specific transfusion. IL-10 production of the donor-specific transfusion(+) group was higher than that of the donor-specific transfusion(-) group on day 1 after living-related donor liver transplantation. CONCLUSIONS: The repeated donor-specific transfusion via the portal vein has brought the rapid reduction of immunosuppressants. Donor type natural killer T cells especially CD56+ T cells, may induce tolerance by Veto mechanism and anti-idiotype network mechanism. These benefits might introduce more advantages in frequency of complications and cost of transplantation.