Preoperative evaluation of pleural adhesions with dynamic chest radiography: a retrospective study of 146 patients with lung cancer.

AIM: To assess the utility of dynamic chest radiography (DCR) during the preoperative evaluation of pleural adhesions. MATERIALS AND METHODS: Sequential chest radiographs of 146 patients with lung cancer were acquired during forced respiration using a DCR system. The presence of pleural adhesions and their grades were determined by retrospective surgery video assessment (absent: 121, present: 25). The maximum inspiration to expiration lung area ratio was used as an index for air intake volume. A ratio of ≥0.65 was regarded as insufficient respiration. Two radiologists assessed the images for pleural adhesions based on motion findings. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were compared for each adhesion grade and patient group (patients with sufficient/insufficient respiration). Pearson's chi-squared test compared the group. Statistical significance was set at p<0.05. RESULTS: DCR correctly identified 22/25 patients with pleural adhesions, with 20 false-positive results (sensitivity, 88%; specificity, 83.5%; PPV, 52.4%; NPV, 97.12%). Although the diagnostic performances for the various adhesion grades were similar, specificity in patients with sufficient respiration increased to 93.9% (31/33), identifying all cases except for those with loose adhesions. CONCLUSIONS: DCR images revealed restricted and/or distorted motions in lung structures and structural tension in patients with pleural adhesions. DCR could be a useful technique for routine preoperative evaluation of pleural adhesions. Further development of computerised methods can assist in the quantitative assessment of abnormal motion findings.

Restrictive pulmonary dysfunction is associated with vertebral fractures and bone loss in elderly postmenopausal women.

Association between lung function and bone metabolism remains controversial. We found that impaired lung function was associated with vertebral fractures and bone loss in Japanese postmenopausal women. While vertebral deformities would impair lung function, respiratory dysfunction might in turn increase fracture risk, suggesting a complex bidirectional interaction. INTRODUCTION: Association between bone metabolism and pulmonary function in the general population is controversial. The aim of this study was to investigate relationship between lung and bone parameters in elderly postmenopausal women. METHODS: One hundred and six postmenopausal women (75.6 ± 8.0 years old) who underwent spirometric tests were examined for prevalent vertebral fractures, bone mineral density (BMD), bone metabolic markers, and other metabolic indices such as urinary pentosidine. RESULTS: Multivariable logistic regression analyses revealed that forced vital capacity (FVC) (OR = 0.063, 95% CI: 0.011-0.352, p = 0.002) and urinary pentosidine (OR = 1.067, 95% CI: 1.020-1.117, p = 0.005) were associated with the presence of vertebral fractures after adjustment for height loss, age, and BMD at femoral neck. Moreover, vital capacity (VC) or FVC as well as body mass index and age was among independent determinants of BMD after adjustment for height loss and the number and grade of vertebral fractures in forced multiple linear regression analysis (VC: ß = 0.212, p = 0.021, FVC: ß = 0.217, p = 0.031). Urinary pentosidine was negatively correlated with pulmonary function parameters such as FVC and forced expiratory volume in 1 s (FEV1.0), although these correlations appeared dependent on age. CONCLUSIONS: Diminished FVC was associated with prevalent vertebral fractures and decreased BMD in Japanese postmenopausal women without apparent pulmonary diseases. Mechanism of such association between pulmonary function and bone status remains to be determined.

Independent association of bone mineral density and trabecular bone score to vertebral fracture in male subjects with chronic obstructive pulmonary disease.

Osteoporosis is a major comorbidity of chronic obstructive pulmonary disease (COPD), but the mechanism of bone fragility is unknown. We demonstrated that trabecular bone score, a parameter of bone quality, was associated with systemic inflammation and was a significant determinant of vertebral fracture independent of bone mineral density. INTRODUCTION: COPD is a major cause of secondary osteoporosis. However, the mechanism of bone fragility is unclear. We previously reported that vertebral fracture was highly prevalent in male COPD patients. To obtain clues to the mechanism of COPD-associated osteoporosis, we attempted to identify determinants of prevalent vertebral fracture in this study. METHODS: In this cross-sectional study, we recruited 61 COPD males and examined pulmonary function, vertebral fractures, bone mineral density (BMD), trabecular bone score (TBS), bone turnover markers, and inflammatory parameters. Determinants of the bone parameters were examined by multivariable analyses. RESULTS: The prevalence of any and grade 2 or 3 fractures was 75.4 and 19.7%, respectively. Osteoporosis and osteopenia defined by BMD were present in 37.7 and 39.3%, respectively. TBS was significantly lower in higher Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages compared to GOLD 1. Multivariable logistic regression analysis revealed that both TBS and BMD were independent determinants of grade 2 or 3 vertebral fractures (OR = 0.271, 95%CI 0.083-0.888, p = 0.031; OR = 0.242, 95%CI 0.075-0.775, p = 0.017) after adjustment for age. Correlates of TBS included age, BMD, high-sensitivity C-reactive protein (hsCRP), pulmonary function parameters, parathyroid hormone, and Tracp-5b. In multivariable regression analysis, hsCRP was the only independent determinant of TBS besides age and BMD. In contrast, independent determinants of BMD included body mass index and, to a lesser extent, 25-hydroxyvitamin D. CONCLUSION: Both BMD and TBS were independently associated with grade 2 or 3 vertebral fracture in COPD male subjects, involving distinct mechanisms. Systemic inflammation, as reflected by increased hsCRP levels, may be involved in deterioration of the trabecular microarchitecture in COPD-associated osteoporosis, whereas BMD decline is most strongly associated with weight loss.

Validation of host-specific Bacteroidales quantitative PCR assays and their application to microbial source tracking of drinking water sources in the Kathmandu Valley, Nepal.

AIMS: To validate host-specific Bacteroidales assays to identify faecal-source contamination of drinking water sources in the Kathmandu Valley, Nepal. METHODS AND RESULTS: A total of 54 composite faecal-source samples were collected from human sewage, ruminants, pigs, dogs, chickens and ducks, which were analysed by quantitative polymerase chain reaction using human-specific (BacHum, HF183 SYBR, gyrB and HF183 TaqMan), ruminant-specific (BacCow and BacR), pig-specific (Pig2Bac and PF163) and dog-specific assays (BacCan SYBR). The BacHum, BacR and Pig2Bac assays were judged the best performing human-specific, ruminant-specific and pig-specific assays respectively. The BacCan SYBR assay highly cross-reacted with other species, resulting in poor performance. Furthermore, these validated assays were applied to microbial source tracking (MST) of 74 drinking water samples. Out of these, 20, 12 and 4% samples were judged contaminated by human, ruminant and pig faeces respectively. Detection ratios of human and ruminant faecal markers were relatively higher in built-up and agricultural areas respectively. CONCLUSION: BacHum, BacR and Pig2Bac assays were found suitable for MST and both, human and animal faecal contaminations of drinking water sources were common in the valley. SIGNIFICANCE AND IMPACT OF THE STUDY: MST could be an effective tool for preparing the faecal pollution strategies as these are site specific.

Polyhydroxyalkanoate (PHA) accumulation potential and PHA-accumulating microbial communities in various activated sludge processes of municipal wastewater treatment plants.

AIMS: To clarify the polyhydroxyalkanoate (PHA) accumulation potential and the PHA-accumulating microbial community structure in activated sludge in municipal wastewater treatment plants (WWTPs) and to identify their influential factors. METHODS AND RESULTS: Nine activated sludge samples were collected from municipal WWTPs employing various biological treatment processes. In acetate-fed 24-h batch experiments under aerobic and nitrogen- and phosphorus-limited conditions, polyhydroxybutyrate (PHB) content of activated sludge increased from 0-1·3 wt% to 7·9-24 wt%, with PHB yields of 0·22-0·50 C-mol 3-hydroxybutyrate (C-mol acetate)(-1). Microbial community analyses found that activated sludge samples that accumulated >20 wt% of PHB after 24-h PHA accumulation experiments had >5·0 × 10(8) copies g(-1)-mixed liquor-suspended solid of phaC genes. CONCLUSIONS: Results indicated that (i) activated sludge in municipal WWTPs can accumulate up to approx. 20 wt% of PHA without enrichment processes, (ii) PHA accumulation potential of activated sludge varied depending on the operational conditions (treatment processes) of WWTPs, and (iii) phaC gene number can provide a simple indication of PHA accumulation potential. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first study to compare the PHA accumulation potential and PHA-accumulating microbial communities in activated sludge of various treatment processes. Our findings may be useful for enhancing the resource recovery potential of wastewater treatment systems.

A co-beneficial system using aquatic plants: bioethanol production from free-floating aquatic plants used for water purification.

A co-beneficial system using constructed wetlands (CWs) planted with aquatic plants is proposed for bioethanol production and nutrient removal from wastewater. The potential for bioethanol production from aquatic plant biomass was experimentally evaluated. Water hyacinth and water lettuce were selected because of their high growth rates and easy harvestability attributable to their free-floating vegetation form. The alkaline/oxidative pretreatment was selected for improving enzymatic hydrolysis of the aquatic plants. Ethanol was produced with yields of 0.14-0.17 g-ethanol/ g-biomass in a simultaneous saccharification and fermentation mode using a recombinant Escherichia coli strain or a typical yeast strain Saccharomyces cerevisiae. Subsequently, the combined benefits of the CWs planted with the aquatic plants for bioethanol production and nutrient removal were theoretically estimated. For treating domestic wastewater at 1,100 m(3)/d, it was inferred that the anoxic-oxic activated sludge process consumes energy at 3,200 MJ/d, whereas the conventional activated sludge process followed by the CW consumes only 1,800 MJ/d with ethanol production at 115 MJ/d.

Removal characteristics of retinoic acids and 4-oxo-retinoic acids in wastewater by activated sludge treatment.

Retinoic acid (RA) receptor (RAR) agonists are potential teratogens to various vertebrates. Their contamination has been detected in municipal wastewater in different countries. This study involved field investigations and laboratory batch treatment experiments to elucidate the removal characteristics by activated sludge treatment of RAs (all-trans RA and 13-cis RA) and 4-oxo-RAs (4-oxo-all-trans RA and 4-oxo-13-cis RA), which were identified as major RAR agonists in municipal wastewater. Results obtained in this study show that currently employed activated sludge treatments can remove RAs, 4-oxo-RAs and overall RAR agonist contamination effectively from municipal wastewater in general, although high RAR agonistic activity might sometimes remain in the effluent. Laboratory experiments revealed that RAs were removed rapidly from the aqueous phase by adsorption to the sludge, after which they were removed further by biological and/or chemical degradation. Aside from adsorption to the sludge, 4-oxo-RAs were also apparently removed by biological and chemical degradation. Biodegradation contributed greatly to the removal. Results of additional experiments indicated that novel non-identifiable RAR agonists can occur through the biodegradation of 4-oxo-RAs by activated sludge and that they can persist for a long period.

Cooperative cargo transportation by a swarm of molecular machines.

Cooperation is a strategy that has been adopted by groups of organisms to execute complex tasks more efficiently than single entities. Cooperation increases the robustness and flexibility of the working groups and permits sharing of the workload among individuals. However, the utilization of this strategy in artificial systems at the molecular level, which could enable substantial advances in microrobotics and nanotechnology, remains highly challenging. Here, we demonstrate molecular transportation through the cooperative action of a large number of artificial molecular machines, photoresponsive DNA-conjugated microtubules driven by kinesin motor proteins. Mechanical communication via conjugated photoresponsive DNA enables these microtubules to organize into groups upon photoirradiation. The groups of transporters load and transport cargo, and cargo unloading is achieved by dissociating the groups into single microtubules. The group formation permits the loading and transport of cargoes with larger sizes and in larger numbers over long distances compared with single transporters. We also demonstrate that cargo can be collected at user-determined locations defined by ultraviolet light exposure. This work demonstrates cooperative task performance by molecular machines, which will help to construct molecular robots with advanced functionalities in the future.

Comparative analysis of DNA-based microbial community composition and substrate utilisation patterns of activated sludge microorganisms from wastewater treatment plants operated under different conditions.

In this study, the microbial community structure and carbon source utilisation profile of activated sludge samples collected from full-scale municipal wastewater treatment plants (WWTPs) operated under different conditions were characterised and compared, respectively, using terminal-restriction fragment length polymorphism (T-RFLP) analysis and Biolog assay. Samples were collected from each biological treatment tank of six conventional activated sludge, two anaerobic-oxic, two anaerobic-anoxic-oxic, and one step-aeration processes in eight full-scale WWTPs in Osaka, Japan. Results of the T-RFLP analysis of eubacterial 16S rDNA showed that microbial communities of activated sludge differed greatly among samples, and that they were affected by process-based operational conditions. In contrast, the carbon source utilisation profiles of activated sludge samples were mutually similar, but appeared to be influenced slightly by aerated conditions at each reaction tank. Similar carbon source utilisation profiles among all samples suggest that the activated sludge community possesses functions that are necessary for wastewater treatment even if the phylogenetic composition is different. Different results from the T-RFLP analysis and Biolog assay suggest that the phylogenetic composition of microbial community might not necessarily reflect the wastewater treatment functions of the activated sludge.

Bcl-2 lies downstream of parathyroid hormone-related peptide in a signaling pathway that regulates chondrocyte maturation during skeletal development.

Parathyroid hormone-related peptide (PTHrP) appears to play a major role in skeletal development. Targeted disruption of the PTHrP gene in mice causes skeletal dysplasia with accelerated chondrocyte maturation (Amizuka, N., H. Warshawsky, J.E. Henderson, D. Goltzman, and A.C. Karaplis. 1994. J. Cell Biol. 126:1611-1623; Karaplis, A.C., A. Luz, J. Glowacki, R.T. Bronson, V.L.J. Tybulewicz, H.M. Kronenberg, and R.C. Mulligan. 1994. Genes Dev. 8: 277-289). A constitutively active mutant PTH/PTHrP receptor has been found in Jansen-type human metaphyseal chondrodysplasia, a disease characterized by delayed skeletal maturation (Schipani, E., K. Kruse, and H. Jüppner. 1995. Science (Wash. DC). 268:98-100). The molecular mechanisms by which PTHrP affects this developmental program remain, however, poorly understood. We report here that PTHrP increases the expression of Bcl-2, a protein that controls programmed cell death in several cell types, in growth plate chondrocytes both in vitro and in vivo, leading to delays in their maturation towards hypertrophy and apoptotic cell death. Consequently, overexpression of PTHrP under the control of the collagen II promoter in transgenic mice resulted in marked delays in skeletal development. As anticipated from these results, deletion of the gene encoding Bcl-2 leads to accelerated maturation of chondrocytes and shortening of long bones. Thus, Bcl-2 lies downstream of PTHrP in a pathway that controls chondrocyte maturation and skeletal development.

Development of DNA microarray for the evaluation of environmental functions.

DNA microarray mounted 85 functional gene sequences related to carbon, nitrogen and sulphur cycles, chemical degradation, metal metabolisms, and energy flows was developed to evaluate the function and status of the environment. Total of 24 river water samples from 6 sampling stations in 2 rivers in 4 seasons were analyzed using constructed DNA microarray. The numbers and constitution of the functional genes were much affected by the seasonal change. Some of the functional genes related to methane oxidation, nitrite reduction, nitrogen fixation, aromatic compounds degradation (catechol 2,3-dioxygenase), alkane degradation (group I and III) and iron reduction were detected in most of all the samples, suggesting that these could be the general functions of the river environment. Some other functional genes related to ammonium oxidation, aromatic compounds degradation (catechol 1,2-dioxygenase) and alkane degradation (group II) can be a certain indicator for the evaluation of the environmental condition.

Evaluation of biodegradation potential of organic compounds by river water microorganisms.

The aim of this study was to assess the availability of the biodegradation potential of aniline and phenol as the indicator for evaluating pollutant impact on a river environment. Biodegradation tests employing river water microorganisms were carried out by a modified TOC-Handai method using aniline and phenol as substrates. Complete degradation time and half-life were determined as indicators expressing the biodegradation potential of aniline and phenol, respectively. Investigations in Lake Biwa-Yodo River basin for more than two years showed that the biodegradation potential of both compounds varied seasonally. In addition, aniline biodegradation potential seemed to be influenced by the hydraulic retention time at each sampling station, while downstream stations with large input of wastewater from the surrounding cities were divided from upstream stations by phenol biodegradation potential. Comparison of the biodegradation potential in rivers at different pollution levels also showed that polluted and less polluted rivers were clearly divided by phenol biodegradation potential. These results indicated that phenol biodegradation potential can be applied as an indicator for evaluating the soundness of river environment from the view point of ecological function.

Evaluation of effectiveness of chemical and physical sewage treatment technologies for removal of retinoic acid receptor agonistic activity detected in sewage effluent.

Retinoic acid receptor (RAR) is a nuclear receptor involved in vertebrate morphogenesis, growth, cellular differentiation, and tissue homeostasis. Excess expression of the retinoid signaling can cause various developmental toxicities in animals and humans. We previously found that influents from sewage treatment plants (STPs) in Japan had a RAR agonistic activity and the activity cannot be removed completely by conventional biological treatments. In this study, we assessed the performance of chemical and physical sewage treatment technologies-ozonation, ultraviolet treatment, chlorination, coagulation using polyaluminium chloride (PAC) and ferric sulfate, and filtration with ultrafiltration (UF), nanofiltration (NF), and reverse osmosis (RO) membranes-in removal of RAR agonistic activity of STP effluent. All water treatment experiments were conducted in laboratory-scale reactors. The RAR agonistic activity of samples was measured using a yeast two-hybrid assay. Results showed that the effectiveness of tested technologies on the removal of RAR agonistic activity can be ranked as RO or NF > chlorination > ozonation > MF > UV > coagulation with ferric sulfate>>coagulation with PAC. Furthermore, the effectiveness of chlorination might rank lower because excess reaction might bring a side effect by producing some RAR agonistic by-product(s).

Age alone is not a risk factor for periprosthetic joint infection.

BACKGROUND: It is not known whether age alone or the increased comorbidities in older patients are responsible for the higher rate of periprosthetic joint infection (PJI) in older patients. AIM: To test the hypothesis that age alone is not a risk factor for PJI after total joint arthroplasty. METHODS: This retrospective study included the review of 23,966 patients undergoing primary total hip and knee arthroplasty between January 1st, 2010 and December 31st, 2016 at a single institution. Patients who developed PJI, as defined by International Consensus Meeting criteria, were identified. All enrolled patients were divided into three groups that included patients aged <65 years (N = 12,761), 65-74 years (N = 6850) and ≥75 years (N = 4355). Using multivariate analysis and propensity score matching analysis, the possible association between age and PJI was examined. FINDINGS: The incidence of PJI in the entire cohort was 0.72% (171 out of 23,966). Multivariate analysis adjusting for all variables, except age, demonstrated that, compared to the patients aged <65 years, there was no statistically significant difference in the rate of PJI for patients aged 65-74 years (odds ratio: 0.89; 95% confidence interval: 0.55-1.42; P = 0.62) or for patients aged ≥75 years (0.69; 0.36-1.32; P = 0.26). CONCLUSION: When adjusting for confounding variables, age alone is not a risk factor for PJI. Studies evaluating the influence of age on the incidence of PJI should take into account the other confounding variables that contribute to PJI.

Application of real-time polymerase chain reaction (PCR) coupled with ethidium monoazide treatment for selective quantification of viable bacteria in aquatic environment.

Ethidium monoazide (EMA) was used to quantify DNA selectively from viable cells with healthy membrane/cell wall system, but not from dead cells, of a target bacterium in the aquatic environment using real-time PCR. Spiking experiments to determine the EMA treatment conditions showed that EMA treatment with EMA at 10-25 microg/ml and subsequent halogen light exposure for 2 min was suitable for selective quantification of DNA from viable cells in an aquatic sample using real-time PCR coupled with EMA treatment (real-time EMA-PCR). Optimized real-time EMA-PCR was applied in combination with culture-based method and conventional real-time PCR without EMA treatment to elucidate the behavior of an Escherichia coli strain inoculated into a pond water microcosm. Quantification results obtained using real-time EMA-PCR were lower than those by conventional real-time PCR without EMA treatment and higher than those by culture-based method. The results suggest that quantification by real-time EMA-PCR seemed to represent the viable population, which would partly include viable but non-culturable state bacteria. Real-time EMA-PCR optimized here can be a useful tool for selective monitoring of the viable population of a target bacterium in the aquatic environment, and thereby contribute to assessment of potential microbial risks generated from waterborne pathogenic bacteria.

High expression of ABCG2 induced by EZH2 disruption has pivotal roles in MDS pathogenesis.

Both proto-oncogenic and tumor-suppressive functions have been reported for enhancer of zeste homolog 2 (EZH2). To investigate the effects of its inactivation, a mutant EZH2 lacking its catalytic domain was prepared (EZH2-dSET). In a mouse bone marrow transplant model, EZH2-dSET expression in bone marrow cells induced a myelodysplastic syndrome (MDS)-like disease in transplanted mice. Analysis of these mice identified Abcg2 as a direct target of EZH2. Intriguingly, Abcg2 expression alone induced the same disease in the transplanted mice, where stemness genes were enriched. Interestingly, ABCG2 expression is specifically high in MDS patients. The present results indicate that ABCG2 de-repression induced by EZH2 mutations have crucial roles in MDS pathogenesis.

Hochu-ekki-to inhibits rhinovirus infection in human tracheal epithelial cells.

BACKGROUND AND PURPOSE: A traditional Japanese herbal medicine, hochu-ekki-to, has been used for the symptomatic treatment of the common cold and to reduce the frequency of colds in patients with chronic obstructive pulmonary disease. However, the inhibitory effects of hochu-ekki-to on infection by rhinovirus (RV), the major cause of common colds, have not been studied. EXPERIMENTAL APPROACH: Human tracheal epithelial cells in culture were infected with a major group rhinovirus-RV14. Virus output and viral RNA were measured along with interleukin (IL)-1beta, IL-6, IL-8 and tumor necrosis factor (TNF)-alpha), mRNA for intercellular adhesion molecule (ICAM)-1 and acidic endosomes in cells. KEY RESULTS: RV14 infection increased virus titers, the content of cytokines in supernatants and RV14 RNA in the cells. Hochu-ekki-to decreased virus output, RV14 RNA in the cells, susceptibility to RV infection and supernatant cytokine concentrations after RV14 infection. Hochu-ekki-to reduced mRNA for ICAM-1, the receptor for RV14, the concentration of the soluble form of ICAM-1 and the number and fluorescence intensity of acidic endosomes in the cells, from which RV RNA enters into the cytoplasm, at RV14 infection. Glycyrrhizin, one of the chemical constituents of hochu-ekki-to, reduced supernatant virus titers dose-dependently. CONCLUSION AND IMPLICATIONS: Hochu-ekki-to inhibited RV14 infection by decreasing ICAM-1 and by blocking entry of viral RNA into the cytoplasm from the endosomes, in airway epithelial cells. Glycyrrhizin may be partly responsible for inhibition of RV infection by hochu-ekki-to. Hochu-ekki-to could modulate airway inflammation by reducing production of cytokines in RV infections.

Superconductivity in a chiral nanotube.

Chirality of materials are known to affect optical, magnetic and electric properties, causing a variety of nontrivial phenomena such as circular dichiroism for chiral molecules, magnetic Skyrmions in chiral magnets and nonreciprocal carrier transport in chiral conductors. On the other hand, effect of chirality on superconducting transport has not been known. Here we report the nonreciprocity of superconductivity-unambiguous evidence of superconductivity reflecting chiral structure in which the forward and backward supercurrent flows are not equivalent because of inversion symmetry breaking. Such superconductivity is realized via ionic gating in individual chiral nanotubes of tungsten disulfide. The nonreciprocal signal is significantly enhanced in the superconducting state, being associated with unprecedented quantum Little-Parks oscillations originating from the interference of supercurrent along the circumference of the nanotube. The present results indicate that the nonreciprocity is a viable approach toward the superconductors with chiral or noncentrosymmetric structures.