Colloidal Stability of Emulsifier-free Oil-in-Water Emulsions: Effect of Oil Properties.

This study aims to determine the factors affecting the colloidal stabilization of emulsifier-free (EF) oil-in-water (O/W) emulsions prepared by mixing oil and water with a high-powered bath-type ultrasonicator (HPBath-US; 28 kHz, 300 W) in the absence of emulsifiers such as surfactants. The interrelation between the colloidal stability, oil properties (oil density, interfacial tension between oil and water, solubility parameter of oil, and oil viscosity), and emulsion properties (diameter and zeta-potential of oil droplets) of such EF-O/W emulsions were examined for this purpose. The colloidal stability of EF-vegetable oil-in-water emulsions (EF-VEG/W) was significantly higher than that of EF-hydrocarbon oil-in-water emulsions (EF-HDC/W) and EF-fatty acid-in-water emulsions (EF-FA/W). This can be attributed to the larger density of vegetable oils (VEG) (approximately 0.9 g cm-3), the formation of smaller-sized oil droplets (diameter of approximately 0.2 µm) in the EF-VEG/W emulsions, and the lower solubility parameter of VEG (δ around 1). Furthermore, the formation of smaller-sized oil droplets in the EF-O/W emulsions correlated with the physical properties of the oil.

Colloidal Stability of Emulsifier-free Triolein-in-Water Emulsions: Effects of Temperature.

Herein, we report the colloidal stability of emulsifier-free (EF-) triolein-in-water (TO/W) emulsions prepared by mixing TO and water using a high-powered bath-type ultrasonicator (HPBath-US; 28 kHz, 300 W) in the absence of emulsifiers such as surfactants. In particular, the effect of the temperature (15-60℃) on the colloidal stability of EF-TO/W emulsions was examined because this is important for the practical application of EF-TO/W emulsions, for example, in foods, pharmaceuticals, and cosmetics. We found that the colloidal stability of the EF-TO/W emulsions decreased with increase in the temperature from 15 to 25°C, whereas it increased with increase in temperature from 25 to 40°C, and the high colloidal stability of the EF-TO/W emulsions was maintained above 40°C. The reduction in the colloidal stability of EF-TO/W emulsions between 15 and 25°C is likely a result of the TO droplets formed by thermal motion, as well as enhanced Ostwald ripening at higher temperatures. On the other hand, the increase in the colloidal stability of the EF-TO/W emulsions from 25 to 40°C and their high colloidal stability above 40℃ is attributed to the reduction in the interfacial tension between TO and water at higher temperatures. This decrease in the interfacial tension between TO and water with temperature increase is related to the transformation of short-range ordered domains (clusters) of TO molecules in the liquid state, which increases the colloidal stability of the EF-TO/W emulsions.

Strip Meniscometry Correlates With Ocular Surface Tests and Symptoms.

Purpose: The aim of this study was to investigate the association of dry eye disease (DED)-related signs and symptoms with two tear function tests. Methods: This was a clinic-based, cross-sectional study with recruitment of consecutive participants. Schirmer test (ST), tear strip meniscometry (SM), and fluorescein tear breakup time were measured and corneal staining score was examined in outpatients at three clinics. Seven subjective symptoms were assessed by interview, including dryness, irritation, pain, lacrimation, fatigue, blurring, and photophobia. Statistical analyses included regression analysis and comparison tests. Results: The mean age of the 210 participants was 61.2 ± 15.2 years (range, 12-91 years), with 135 women (64.3%) in the cohort. The mean ST value was 12.9 ± 9.3 (0-35) mm, and SM was 2.5 ± 1.6 (0-10) mm, with no difference between women and men. SM values were lower in the presence of irritation (P = 0.046) and photophobia (P = 0.011). Regression analysis revealed ST and SM values were strongly correlated (ß = 0.255, P < 0.001). SM was significantly correlated with breakup time (ß = 0.149, P = 0.032), whereas there was no correlation between ST and DED-related signs and symptoms. Conclusions: SM was correlated with DED-related symptoms and breakup time, whereas ST was not. A low SM value could be an alternative clinical parameter to determine tear film-oriented therapy. Translational Relevance: Tear strip meniscometry could be a useful tear function examination on a routine clinical basis since it is a 5-second noninvasive procedure and associated with subjective symptoms and the value of the conventional Schirmer test.

Mucin phenotypes and macroscopic shape of multiple hyperplastic polyps together with two carcinomas in the stomach.

The patient was a 57-year-old Japanese woman who had been identified as having anemia and hypoproteinemia by a local group medical check-up. Esophagogastroduodenoscopy revealed an elevated lesion of 35mm in diameter on the posterior wall of the gastric antrum, surrounded by multiple polyps. The elevated lesion was diagnosed as an adenocarcinoma on the basis of biopsy, and total gastrectomy was performed. Histological examination of entire resected stomach revealed two lesions of intramucosal carcinoma together with multiple hyperplastic polyps. To investigate the mucin phenotypes and carcinogenesis of these lesions, immunohistochemical analyses of MUC2, MUC5AC, MUC6, CD10, Ki-67 and p53 protein expressions were performed in 17 hyperplastic polyps and two cancerous lesions. Expression of the MUC6 positive glands beneath the surface foveolar epithelium of hyperplastic polyps caused a morphological change from sessile to pedunculated, suggesting that this was also involved with cancerous changes. The case reported herein seems to be extremely interesting in terms of elucidating the process whereby gastric cancer arises from hyperplastic polyps.

Longitudinal relationship between retinal nerve fiber layer thickness parameters assessed by scanning laser polarimetry (GDxVCC) and visual field in glaucoma.

PURPOSE: To investigate the longitudinal relationship between retinal nerve fiber layer (RNFL) thickness parameters assessed by scanning laser polarimetry with variable corneal compensation (GDxVCC) and visual field parameters obtained with the Humphrey field analyzer (HFA) in patients with glaucoma, and to assess the usefulness of GDxVCC in longitudinal follow-up. METHODS: A total of 242 eyes in 122 patients with glaucoma were periodically assessed using GDxVCC and HFA program SITA fast 30­2 for 3­5 years. Eyes with more than four times of reliable HFA and GDxVCC data were obtained from during the follow-up periods were included in the analysis. Changes in HFA parameters (mean deviation [MD], pattern standard deviation [PSD]) and those in GDxVCC parameters (superior average, inferior average, temporal-superior-nasal-inferior-temporal [TSNIT] average, TSNIT standard deviation [SD], nerve fiber indicator [NFI]) were determined by regression analysis. The relationship between HFA and GDxVCC parameters at the initial point and their annual changes were analyzed with canonical correlation analysis and Pearson's correlation coefficients. RESULTS: Twenty-four eyes (9.9%) of 19 patients that met inclusion criteria were statistically analyzed. Longitudinal progression was 0.039 ± 0.971 dB/year in MD, 0.156 ± 0.644 dB/year in PSD, −0.197 ± 0.970 µm/year in TSNIT average, −0.503 ± 1.341 µm/year in superior average, −0.282 ± 0.974 µm/year in inferior average, −0.284 ± 1.013/year in TSNIT SD and 1.269 ± 2.560/year in NFI. In canonical correlation analysis at the initial point, first canonical variates were not statistically significant between HFA and GDxVCC parameters. First canonical variates of annual changes significantly correlated between HFA and GDxVCC parameters (p < 0.01), with correlation coefficient of 0.85. In Pearson's correlation analysis of each parameter, there was a significant relationship between MD and NFI at the initial point (r = −0.46, p < 0.05). There was a statistically significant relationship between progressions in MD and NFI (r = −0.54, p < 0.01) and in PSD and NFI (r = 0.53, p < 0.01). CONCLUSIONS: Longitudinal progression in NFI obtained with GDxVCC was significantly correlated with that in HFA parameters, such as MD and PSD. GDxVCC is a useful tool for longitudinal follow-up assessment of glaucoma.

Protein disulfide isomerase-P5, down-regulated in the final stage of boar epididymal sperm maturation, catalyzes disulfide formation to inhibit protein function in oxidative refolding of reduced denatured lysozyme.

In mammalian spermiogenesis, sperm mature during epididymal transit to get fertility. The pig sharing many physiological similarities with humans is considered a promising animal model in medicine. We examined the expression profiles of proteins from boar epididymal caput, corpus, and cauda sperm by two-dimensional gel electrophoresis and peptide mass fingerprinting. Our results indicated that protein disulfide isomerase-P5 (PDI-P5) human homolog was down-regulated from the epididymal corpus to cauda sperm, in contrast to the constant expression of protein disulfide isomerase A3 (PDIA3) human homolog. To examine the functions of PDIA3 and PDI-P5, we cloned and sequenced cDNAs of pig PDIA3 and PDI-P5 protein precursors. Each recombinant pig mature PDIA3 and PDI-P5 expressed in Escherichia coli showed thiol-dependent disulfide reductase activities in insulin turbidity assay. Although PDIA3 showed chaperone activity to promote oxidative refolding of reduced denatured lysozyme, PDI-P5 exhibited anti-chaperone activity to inhibit oxidative refolding of lysozyme at an equimolar ratio. SDS-PAGE and Western blotting analysis suggested that disulfide cross-linked and non-productively folded lysozyme was responsible for the anti-chaperone activity of PDI-P5. These results provide a molecular basis and insights into the physiological roles of PDIA3 and PDI-P5 in sperm maturation and fertilization.

Comparison of the anti-hypertensive effects of the L/N-type calcium channel antagonist cilnidipine, and the L-type calcium channel antagonist amlodipine in hypertensive patients with cerebrovascular disease.

OBJECTIVES: It is known that the risk of cerebral stroke recurrence in post-stroke patients is comparatively higher than in normal subjects, and it is suggested that autonomic nervous system dysfunctions elevate this risk. We investigated the anti-hypertensive effects of cilnidipine, a Ca antagonist which suppresses sympathetic nerve activation, in hypertensives with chronic-stage cerebrovascular disease in a comparison with amlodipine. METHODS: Amlodipine 5-7.5 mg/day, or cilnidipine 5-10 mg/day was administered to 78 hypertensive subjects (greater than 140 mmHg systolic, or 90 mmHg diastolic) undergoing outpatient treatment. Amlodipine or cilnidipine was also administered similarly, to 30 subjects having hypertension associated with a cerebral infarct which occurred more than one month earlier due to cerebral thrombosis or embolism. After 3 months administration, the subjects' blood pressures and pulse rates were recorded with an ambulatory blood pressure monitor over 24 hours. RESULTS: No difference was recognized in patient age, gender, and systolic and diastolic blood pressure before treatment between the groups. In the cilnidipine groups, no difference in average 24-hour or waking systolic blood pressure values was seen between cerebrovascular disease (CVD) subjects and non-CVD subjects, although in the amlodipine groups, CVD subjects had significantly higher blood pressure values than non-CVD subjects. In the cilnidipine group, the coefficient of variation values of pulse rate were significantly higher in CVD subjects than in non-CVD subjects (p<0.05). CONCLUSION: In patients with recent stroke, a Ca antagonist with no sympathetic nerve suppression had weaker blood pressure-lowering effects. Significantly increased pulse rate variability, shown in the CVD subjects administered cilnidipine, suggests that cilnidipine enhanced the parasympathetic function in hypertensive patients with CVD.

A study of the relationship between Helicobacter pylori microbial susceptibility, 13C-urea breath test values.

BACKGROUND/AIMS: Diagnostic methods for Helicobacter pylori (H. pylori) infection can be divided into invasive endoscopic methods and non-invasive methods. A typical and widely used non-invasive method is the 13C urea breath test (UBT). In this study, the possibility of a correlation between pre-treatment UBT values with H. pylori antimicrobial resistance is investigated. METHODOLOGY: The subjects were 119 consecutive patients who attended this hospital for H. pylori testing. Average age was 47.5 +/- 13.2 years, with a male:female ratio of 2.05:1. The diagnosis was gastric ulcer in 43 subjects, duodenal ulcer in 27, gastroduodenal ulcer in 21 and chronic gastritis in 28. Subjects underwent UBT as well as upper gastrointestinal endoscopy (UGITE). The diagnosis of H. pylori infection was examined by the results of culture, histological examination and the rapid urease test (RUT). The mean inhibitory concentration (MIC) was determined for each antimicrobial agent in the bacterial isolates that could be cultured. RESULTS: In this study, the sensitivity and specificity were excellent at 97.0% and 100% with a cut-off point of 3.5 per thousand for UBT respectively. Clarithromycin resistance was more common in the group with high UBT values. No correlation at all was seen between UBT values and metronidazole, sparafloxacin, cefaclor and amoxicillin susceptibility. CONCLUSIONS: It is possible that UBT values also tend to be higher in cases of CAM resistance.

Efficacy of low-dose proton pump inhibitor (PPI) in the eradication of Helicobacter pylori following combination PPI/AC therapy in Japan.

BACKGROUND/AIMS: In Japan, eradication regimens consisting of a proton pump inhibitor (PPI) + amoxicillin (AMPC) + clarithromycin (CAM) (PPI/AC) for 1 week have been conducted. In the present study, we assessed the eradication rates following treatment with low doses of various PPIs. METHODOLOGY: 135 patients were divided randomly into one of three 7-day regimens: (i) omeprazole (OPZ) 20 mg/day + AMPC 1500 mg/day + CAM 600 mg/day (OAC); (ii) lansoprazole (LPZ) 30 mg + AMPC 1500 mg/day + CAM 600 mg/day (LAC); and (iii) rabeprazole (RPZ) 10mg/day + AMPC 1500 mg/ day + CAM 600 mg/day (RAC). The genetic polymorphism of CYP2C19 was also examined. RESULTS: The eradication rates according to the treatment regimen were as follows: 69.9% (31/45) for OAC, 62.2% (28/45) for LAC, and 71.1% (32/45) for RPZ. No significant differences were found among the regimens. Moreover, eradication rates, according to CYP2C19 phenotype (homozygous extensive metabolizer (EM), heterozygous EM, and poor metabolizer) were: 68.6% (35/51), 77.4% (41/53), and 82.4% (14/17), respectively. CONCLUSIONS: In PPI/AC therapy, the eradication rate for each low-dose PPI was 60-70%, which is low. Based on previous reports, it is considered that doses greater than 40 mg/day OPZ, 60 mg/day LPZ, and 20 mg/day RPZ are required.

Immunohistochemical analysis of p53 and MIB-1 in tissue specimens obtained from endoscopic ultrasonography-guided fine needle aspiration biopsy for the diagnosis of solid pancreatic masses.

Endoscopic ultrasonography-guided fine-needle aspiration biopsy (EUS-FNAB) has been shown to be a highly accurate technique for distinguishing benign from malignant pancreatic masses. In this study, we examined p53 immunohistochemical analysis in FNAB specimens obtained from solid pancreatic diseases, and prospectively evaluated clinical applications for the diagnosis of malignancy in combination routine histological examination. Tissue specimens obtained from 62 pancreatic masses (51 pancreatic cancers and 11 chronic pancreatitis) by EUS-FNAB were evaluated by routine histological examination and p53 immunostaining. The conventional EUS-FNA diagnostic test statistics for the pancreatic masses were as follows: 76% sensitivity, 91% specificity and 79% accuracy. p53 protein overexpression was observed in 67% patients with pancreatic cancer, but not in patients with chronic pancreatitis. If the diagnosis of malignancy was made using the combination of p53 protein overexpression and conventional histological examination, the diagnostic test statistics changed as follows: 90% sensitivity, 91% specificity and 92% accuracy. p53 immunostaining in combination with routine histological examination of EUS-FNAB may improve the diagnostic accuracy for pancreatic cancer.

[Diplopia in Wallenberg's syndrome].

The incidence and mechanism of diplopia were investigated in 31 patients with Wallenberg's syndrome resulting from acute dorsolateral medullary infarction. Diplopia was found in 10 of 31 patients (32%), with 5 patients reporting vertical diplopia alone and 5 reporting vertical and horizontal diplopia. Diplopia in Wallenberg's syndrome is considered to be caused by a lesion involving the otolith-ocular system. Vertical diplopia is simply explained by ocular skew deviation due to a lesion involving the vestibular nucleus; in which the affected eye becomes deviated inferiorly. In this situation, rotation of the eye due to ocular tilt reaction also occurs. Concomitant horizontal diplopia may require involvement of the medial longitudinal fasciculus (MLF), which produces skew deviation in mirror image; the unaffected eye becomes deviated inferiorly. When downward deviation of the eye affected by dysfunction of the vestibular nucleus and that due to MLF dysfunction affecting the other eye are comparable, only horizontal diplopia becomes apparent. MLF syndrome may be accompanied by paralytic pontine exotropia (PPE) or non-paralytic pontine exotropia (NPPE), both of which may also participate in the appearance of horizontal diplopia.

[Clinical features and neuropathological findings of familial amyotrophic lateral sclerosis with an H43R mutation in Cu/Zn superoxide dismutase].

We report the clinical and neuropathological features of a Japanese family with familial amyotrophic lateral sclerosis (FALS), whose members have an amino acid substitution of histidine by arginine in Cu/Zn superoxide dismutase. A 58-year-old woman developed muscle weakness in the legs, and died of respiratory insufficiency 7 months after the onset of her weakness. Her family history included 7 patients with FALS over 3 generations. Their pertinent neurological abnormalities consisted primarily of lower motor neuron signs, and their clinical progression was rapid. Autopsy of our patient showed the involvement of the lower and upper motor neuron systems with Lewy body-like hyaline inclusions, in addition to degeneration in the posterior columns, Clarke's nuclei and posterior spinocerebellar tracts. The inclusions reacted with both anti-SOD1 and anti-ubiquitin antibodies. This is the first report of the neuropathological findings of FALS with this mutation.

[A case of amyotrophic lateral sclerosis with SIADH and throbbing headache induced by selective serotonin reuptake inhibitor].

A 57-year-old man with amyotrophic lateral sclerosis (ALS) was admitted because of depressive state. Selective serotonin reuptake inhibitor (SSRI), an antidepressant, was started on the admission day. The throbbing headache in the right temporal region appeared on day 3, and an analgesic drug was not completely effective. Serum sodium value on admission was 131 mEq/l. After SSRI was started the hyponatremia rapidly progressed, and it became 112 mEq/l on day 4. SSRI was discontinued, and headache disappeared; serum sodium was improved to 129 mEq/l. It has been reported that syndrome of inappropriate secretion of antidiuretic hormone (SIADH) may be associated with ALS. We consider that subclinical SIADH was manifested by SSRI in this case. SSRI seems to be a cause of headache, since headache disappeared completely by discontinuation of SSRI.

Is abnormal focal steepening of the cornea related to persistent monocular diplopia?

PURPOSE: Some case reports have shown that abnormal focal steepening of the cornea appears to cause monocular diplopia by prismatic effect. The purpose of this study was to ascertain prospectively if the pattern of corneal distortion was related specifically to persistent monocular diplopia. METHODS: We selected 16 visually normal eyes (controls) and two groups of volunteers in which abnormal focal steepening of the cornea was expected to be found: 40 eyes of 20 volunteers who wore rigid gas-permeable contact lenses (RGP) for myopia and 10 eyes of seven patients with keratoconus. New charts that consisted of white dials on a black background were prepared for detection and measurement of secondary images. Any secondary image that could not be eliminated by any trial lens correction was defined as a persistent secondary image, using the charts. Corneal topography from all subjects was classified: round or oval, symmetric or asymmetric bowtie, abnormal focal steepening accompanied by contact lens-induced corneal warpage or keratoconus, or amorphous. We analyzed the relationship between the persistent secondary image and the corneal topographical patterns. RESULTS: A persistent secondary image was detected from seven eyes of RGP wearers and all keratoconus eyes. All corneal topographies of the seven RGP eyes with a persistent secondary image showed abnormal focal steepening related to contact lens-induced corneal warpage. The direction of the persistent secondary image was approximately consistent with the location of the focal steepening as seen on the corneal topography. CONCLUSION: Abnormal focal steepening of the cornea that appeared to produce a prismatic difference between two parts of the cornea was specifically related to persistent monocular diplopia.

Measurement of axial length of eyes with incomplete filling of silicone oil in the vitreous cavity using x ray computed tomography.

AIMS: To establish a reliable method for measuring the axial length of the eye with incomplete filling of silicone oil in the vitreous cavity in order to determine the IOL power before executing combined cataract surgery and silicone oil removal. METHODS: 12 eyes of 12 patients undergoing combined cataract extraction and silicone oil removal between October 1998 and June 2000 were entered prospectively into this study. All eyes were examined using an x ray computed tomography (CT) scanner. Each axial length of a silicone oil injected eye was measured on the best CT slice among eyeball cuts, which showed both the insertions of the medial and lateral rectus muscle, the thickest slice of the lens, and the optic nerve. The IOL power for the eyes was determined using the SRK/T formula based on the CT data. The deviation of postoperative refraction from the goal refraction was evaluated for each eye. RESULTS: The CT slices demonstrated that the vitreous cavity was not completely filled with the oil in all of the silicone oil injected eyes. The deviation of postoperative refraction from the goal refraction was less than 1 dioptre (D) error in six of 12 eyes (50%), and was less than 2 D error in nine eyes (75%). In the other three eyes having more than 2 D error, the axial length was 27 mm or more. CONCLUSION: The CT measurement of axial eye length for determining IOL might be a useful method for evaluating silicone oil injected eyes before combined cataract surgery and silicone oil removal.