Association between equol producers and type 2 diabetes mellitus among Japanese older adults.

AIMS/INTRODUCTION: Equol, which is produced by enteric bacteria from soybean isoflavones, has a chemical structure similar to estrogen. Both in vivo and in vitro studies have shown the beneficial metabolic effects of equol. However, its effects on type 2 diabetes remain unclear. We investigated the association between the equol producers/non-producers and type 2 diabetes. MATERIALS AND METHODS: The participants included 147 patients with type diabetes mellitus aged 70-89 years, and 147 age- and sex-matched controls. To ascertain the equol producers or non-producers, we used the comparative logarithm between the urinary equol and daidzein concentrations (cut-off value -1.75). RESULTS: The urinary equol concentration was significantly lower in the diabetes group compared with the non-diabetes group (P = 0.01). A significant difference in the proportion of equol producers was observed among all participants (38.8% in the diabetes group and 53.1% in the non-diabetes group; P = 0.01). The proportion of equol producers among women was significantly lower in the diabetes group (31.4%) than in the non-diabetes group (52.8%; P < 0.01). Additionally, the frequency of dyslipidemia in female equol producers was significantly lower than that in female non-equol producers (P < 0.01). Among men, no such differences were observed. We found a significant positive correlation between the urinary equol and daidzein concentrations among equol producers (r = 0.55, P < 0.01). CONCLUSIONS: Our study findings showed that postmenopausal women had a low proportion of equol producers with diabetes and dyslipidemia.

Case report: Gross persistent rectal prolapse. A case treated without mesh using deep retrorectal dissection/suturing.

A previously well 15-year-old male presented with a history of gross rectal prolapse (GRP) involving full-thickness rectal prolapse of increasing severity and incidence over 6 months that occurred with every bowel motion, varying from 10 to 40 cm. He denied constipation and passed a soft motion once daily, adeptly reducing his prolapsed rectum after each motion. This case illustrates technical challenges and planning for surgical intervention for optimal treatment in keeping with an FDA alert issued April, 2019 banning surgical mesh for pelvic organ prolapse. Preoperative fluoroscopic defecography confirmed rectal prolapse beginning with eversion of the anal verge identified on inspection. For surgery, general anesthesia was induced, he was placed in a Trendelenburg position, and four ports were inserted. The peritoneum was incised and blunt dissection used to expose the levator ani complex (LAC) taking care to prevent lateral nerve injury and preserve regional vascularity. Seven polypropylene sutures were used to fix the seromuscular posterior wall of the rectum to the median raphe of the LAC, the presacral fascia, and the periosteum of the sacral promontory. Operative time was 170 min. Postoperative recovery and progress were unremarkable. Currently, 5 years postoperatively, defecation is regular without recurrence of prolapse. For prolapse involving protrusion of the upper rectum without eversion of the anal verge, rectal fixation to the sacral promontory without further dissection beyond the peritoneal reflection is adequate, but when extensive prolapse is associated with eversion of the anal verge, more extensive blunt dissection from the peritoneal reflection to the LAC with multiple rectopexy sutures is valid for reducing risks for recurrence and eliminating mesh-related complications.

Severe hand contracture treated by external fixation after proximal row carpectomy and awake tenolysis after general anesthesia: A case report.

Wide-awake local anesthesia has many advantages. We describe a new method to use wide-awake local anesthesia with more flexibility. A 32-year-old man with a severe right-hand contracture after an iatrogenic tourniquet accident during an anterolateral thigh flap for a partial hand amputation underwent contracture release using external fixation after proximal row carpectomy and subsequent tenolysis. We performed most of the tenolysis procedure under general anesthesia and the final stage with an intraoperative assessment of active finger movement and dissection under local anesthesia. He regained his grip strength 2.5 years post-injury. General anesthesia is useful to treat a surgical site with extensive hard scars, whereas local anesthesia is useful for adjusting tension in an awake patient. The indication for wide-awake surgery is yet to be established; our method of combining general and local anesthesia in the tenolysis procedure illustrates the possibilities in expanding this method.

Enantioselective GC-MS analysis of volatile components from rosemary (Rosmarinus officinalis L.) essential oils and hydrosols.

Essential oils and hydrosols were extracted from rosemary harvested in different seasons, and the chemical compositions of volatile components in the two fractions were analyzed by gas chromatography-mass spectrometry (GC-MS). Enantiomers of some volatile components were also analyzed by enantioselective GC-MS. Classification of aroma components based on chemical groups revealed that essential oils contained high levels of monoterpene hydrocarbons but hydrosols did not. Furthermore, the enantiomeric ratios within some volatile components were different from each other; for example, only the (S)-form was observed for limonene and the (R)-form was dominant for verbenone. These indicate the importance of determining the enantiomer composition of volatile components for investigating the physiological and psychological effects on humans. Overall, enantiomeric ratios were determined by volatile components, with no difference between essential oils and hydrosols or between seasons.

Effects of oral administration of heat-killed Enterococcus faecium strain NHRD IHARA in post-weaning piglets.

Probiotic bacteria such as lactic acid bacteria (LAB) have recently received attention as candidates for alternative anti-microbial feed additives. We previously isolated Enterococcus faecium strain NHRD IHARA (FERM BP-11090, NHRD IHARA strain) and reported its probiotic efficacy. However, we have not determined the effect of oral administration of heat-killed cells of this strain. Here, we performed two experiments to investigate the effect of oral administration of the heat-killed NHRD IHARA strain on post-weaning piglets. In Experiment 1, there was a significant improvement in growth performance (P = 0.04) and increase in serum immunoglobulin A (IgA) production (P = 0.03) in the group fed heat-killed cells. These results were similar to previous results we obtained with live cells. We also found changes in serum and fecal IgA production that were unrelated to the patterns of microbiotal change. In Experiment 2, we detected a significant improvement in villus growth in the jejunum (P = 0.0002). In conclusion, oral administration of the heat-killed NHRD IHARA strain in post-weaning piglets had the same efficacy as administration of the live strain. The heat-killed NHRD IHARA strain can be used as feed additives to improve pig growth and health on commercial farms.

A case of Pallister-Killian syndrome associated with West syndrome.

We report the case of a 19-month-old boy with Pallister-Killian syndrome associated with West syndrome. The child was born at term to a healthy mother after an uneventful pregnancy. He was born by cesarean section because of fetal macrosomia. He was observed to have nystagmus, craniofacial dysmorphism, and mental retardation. Intractable epileptic spasms developed 17 months after birth, and electroencephalography revealed a modified hypsarrhythmia. The seizures were uncontrollable with sodium valproate monotherapy. At the age of 19 months, the child was diagnosed with Pallister-Killian syndrome of mosaic tetrasomy 12p by fluorescence in situ hybridization. Combination treatment with high-dose pyridoxal phosphate and sodium valproate eliminated seizures and improved the electroencephalographic abnormalities. To our knowledge, this is the first reported case of Pallister-Killian syndrome associated with West syndrome.

Velocity-dependent EMG activity of masseter and sternocleidomastoideus muscles during a ballistic arm thrusting movement.

Two experiments were conducted to investigate the functional relationship between the general somatic motor function and the oral motor function. In Experiment 1, we analyzed the relationship between the amount of masseter muscle (MSS) activity and the velocity of a ballistic, 'karate-do' arm thrusting movement (ThrMov). ThrMov velocity was measured from video images taken with a high-speed CCD camera at a frequency of 500Hz. EMGs of MSS and sternocleidomastoideus (SCM) muscles as well as other related muscles were recorded simultaneously with video images in 6 varsity 'karate-do' athletes. Pearson's correlation coefficients were calculated between EMG amplitude and movement velocity. EMG activity of MSS as well as the other muscles increased as a function of ThrMov velocity in all participants, as evidenced by highly significant (p<.01) correlation coefficients, ranging from .64 to .87 (mean: .75). MSS EMG activity attained during ThrMovs performed at maximum velocity ranged between 14.6% and 113.8% of this muscle's MVC (45.7+/-39.3% MVC, mean+/-SD). SCM was also strongly active and closely associated with MSS. Besides changes in amount of EMG activity, it was further found that R-MSS EMG onset progressively shifted to the earlier phase of the ThrMov as ThrMov velocity increased. EMG onset time of R-MSS as well as R- and L-SCMs was negatively correlated with ThrMov velocity; when performed at maximum velocity MSS activation preceded the start of ThrMov by more than 100ms, whereas MSS was recruited last at approximately 150ms after the start of ThrMov when performed at moderate speed ( approximately 50% of maximum). In Experiment 2, the effects of head movement relative to the trunk on R-MSS and SCMs EMG activity were tested in both gazing and sidelong glancing conditions. A much smaller head rotation relative to the trunk was necessary during the ThrMov in the sidelong glancing condition compared to the gazing condition. R-MSS EMG activity was affected significantly by the difference between these conditions and decreased by 5.2% MVC in the sidelong glancing condition compared to the gazing condition. In association with the change in requirement for head movement between those conditions, EMG balance between the bilateral SCMs changed substantially. Finally, marked muscle activity during ThrMov was found in the MSS that was not directly involved in performing this movement, indicating a form of 'remote facilitation'.

A successful treatment with pyridoxal phosphate for West syndrome in hypophosphatasia.

We report a 2-month-old male with West syndrome associated with infantile hypophosphatasia. The male infant was born at term to a healthy mother after an uneventful pregnancy. He was born by cesarean section because of breech presentation. He was observed to have short extremities, and radiographs were consistent with achondroplasia. The serum alkaline phosphatase level was 2 IU/dL. Intractable tonic seizures developed 2 days after birth, and an electroencephalogram revealed a burst-suppression pattern for the first 2 months of life. The seizures were uncontrollable with conventional antiepileptic drugs. At the age of 2 months, he had a series of infantile spasms, and the electroencephalogram indicated hypsarrhythmia. Treatment with high-dose pyridoxal phosphate eliminated his seizures.

Acceleration of granulocyte colony-stimulating factor-induced neutrophilic nuclear lobulation by overexpression of Lyn tyrosine kinase.

Stimulation with granulocyte colony-stimulating factor (G-CSF) induces myeloid precursor cells to differentiate into neutrophils, and tyrosine phosphorylation of certain cellular proteins is crucial to this process. However, the signaling pathways for neutrophil differentiation are still obscure. As the Src-like tyrosine kinase, Lyn, has been reported to play a role in G-CSF-induced proliferation in avian lymphoid cells, we examined its involvement in G-CSF-induced signal transduction in mammalian cells. Expression plasmids for wild-type Lyn (Lyn) and kinase-negative Lyn (LynKN) were introduced into a murine granulocyte precursor cell line, GM-I62M, that can respond to G-CSF with neutrophil differentiation, and cell lines that overexpressed these molecules (GM-Lyn, GM-LynKN) were established. Upon G-CSF stimulation, both the GM-Lyn and GM-LynKN cells began to differentiate into neutrophils, showing early morphological changes within a few days, much more rapidly than did the parental cells, which started to exhibit nuclear lobulation about 10 days after the cells were transferred to G-CSF-containing medium. However, the time course of expression of the myeloperoxidase gene, another neutrophil differentiation marker, was not affected by the overexpression of Lyn or LynKN. Therefore, in normal cells, protein interactions with Lyn, but not its kinase activity, are important for the induction of G-CSF-induced neutrophilic nuclear lobulation in mammalian granulopoiesis.