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1.
Article in English | MEDLINE | ID: mdl-31469027

ABSTRACT

Phytic acid, a constituent of various plants, has been related to health benefits. Phytic acid has been shown to inhibit purine nucleotide metabolism in vitro and suppress elevation of plasma uric acid levels after purine administration in animal models. This study investigated the effect of phytic acid on postprandial serum uric acid (SUA) in humans. This randomized, double-blind, crossover design study included 48 healthy subjects with normal fasting SUA. Subjects consumed a control drink and a phytic acid drink with purine-rich food, and serum and urine uric acid levels were measured for 360 min after purine loading. Phytic acid lowered the incremental area under the curve (0-360 min) and incremental maximum concentration of SUA after purine loading (p < 0.05); tended to lower cumulative urinary uric acid excretion (0-360 min) after purine loading (p < 0.10); and suppressed postprandial SUA in this clinical study. Altogether, our findings suggest that phytic acid may play a beneficial role in controlling postprandial SUA.


Subject(s)
Phytic Acid/blood , Uric Acid/blood , Adult , Cross-Over Studies , Double-Blind Method , Female , Healthy Volunteers , Humans , Male , Middle Aged , Phytic Acid/administration & dosage , Purines/administration & dosage , Purines/blood , Young Adult
2.
Soft Matter ; 15(4): 602-614, 2019 Jan 28.
Article in English | MEDLINE | ID: mdl-30629082

ABSTRACT

We theoretically study the shapes of lipid vesicles confined to a spherical cavity, elaborating a framework based on the so-called limiting shapes constructed from geometrically simple structural elements such as double-membrane walls and edges. Partly inspired by numerical results, the proposed non-compartmentalized and compartmentalized limiting shapes are arranged in the bilayer-couple phase diagram which is then compared to its free-vesicle counterpart. We also compute the area-difference-elasticity phase diagram of the limiting shapes and we use it to interpret shape transitions experimentally observed in vesicles confined within another vesicle. The limiting-shape framework may be generalized to theoretically investigate the structure of certain cell organelles such as the mitochondrion.


Subject(s)
Lipid Bilayers/chemistry , Mechanical Phenomena , Elasticity , Models, Molecular
3.
Transplant Proc ; 50(10): 3460-3466, 2018 Dec.
Article in English | MEDLINE | ID: mdl-30577221

ABSTRACT

BACKGROUND: De novo complement-binding donor-specific anti-human leukocyte antigen antibodies (DSAs) are reportedly associated with an increased risk of kidney graft failure, but there is little information on preformed complement-binding DSAs. This study investigated the correlation between preformed C1q-binding DSAs and medium-term outcomes in kidney transplantation (KT). METHODS: We retrospectively studied 44 pretransplant DSA-positive patients, including 36 patients who underwent KT between April 2010 and October 2016. There were 17 patients with C1q-binding DSAs and 27 patients without C1q-binding DSAs. Clinical variables were examined in the 2 groups. RESULTS: Patients with C1q-binding DSAs had significantly higher blood transfusion history (53.0% vs 18.6%; P = .0174), complement-dependent cytotoxicity crossmatch (CDC-XM)-positivity (29.4% vs 0%; P = .0012), and DSA median fluorescence intensity (MFI) (10,974 vs 2764; P = .0009). Among patients who were not excluded for CDC-XM-positivity and underwent KT, there was no significant difference in cumulative biopsy-proven acute rejection rate (32.5% vs 33.5%; P = .8354), cumulative graft survival, and 3-month and 12-month protocol biopsy results between patients with and without C1q-binding DSAs. Although patients with C1q-binding DSAs showed a higher incidence of delayed graft function (54.6% vs 20.0%; P = .0419), multivariate logistic regression showed that DSA MFI (P = .0124), but not C1q-binding DSAs (P = .2377), was an independent risk factor for delayed graft function. CONCLUSIONS: In patients with CDC-XM-negativity, preformed C1q-binding DSAs were not associated with incidence of antibody-mediated rejection and medium-term graft survival after KT. C1q-binding DSAs were highly correlated with DSA MFI and CDC-XM-positivity.


Subject(s)
Complement C1q/immunology , Graft Rejection/immunology , HLA Antigens/immunology , Isoantibodies/blood , Kidney Transplantation/adverse effects , Adult , Delayed Graft Function/immunology , Female , Graft Rejection/blood , Graft Rejection/epidemiology , Graft Survival/immunology , Humans , Incidence , Isoantibodies/immunology , Male , Middle Aged , Retrospective Studies , Risk Factors , Tissue Donors
4.
Transplant Proc ; 50(5): 1482-1488, 2018 Jun.
Article in English | MEDLINE | ID: mdl-29880375

ABSTRACT

BACKGROUND: Several studies have suggested that decreased muscle volume is associated with attenuation of immune function. The recipient's immune system is responsible for rejection of transplanted organs, which is a major cause of graft loss after transplantation. We aimed to determine whether muscle volume is correlated with graft survival after pancreas transplantation (PT). METHODS: Forty-three patients underwent PT for type 1 diabetes mellitus at our institution from August 2001 to May 2016. The quantity of skeletal muscle was evaluated using the psoas muscle mass index (PMI). The correlation between PMI and outcome after PT was assessed. RESULTS: A total of 32 and 11 recipients underwent simultaneous pancreas-kidney transplantation (SPK) and PT alone/pancreas after kidney transplantation, respectively. Patients with a surviving graft showed a significantly lower PMI than those with graft loss (P = .0451). We divided the recipients into two groups according to the PMI cutoff values, which were established using receiver operating characteristic curves. The cumulative graft survival rate was significantly higher in patients with a low PMI (P = .0206). A multivariate Cox regression analysis revealed that a low PMI (P = .0075) is an independent predictive factor for better graft survival. A low PMI was not a significant predictive factor for acute rejection, but was an independent predictive factor for graft survival after the first acute rejection (P = .0025). CONCLUSIONS: Our data suggest that muscle volume could be a predictor of graft survival after PT.


Subject(s)
Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/surgery , Graft Survival/physiology , Pancreas Transplantation , Sarcopenia/complications , Adult , Area Under Curve , Cohort Studies , Female , Graft Rejection , Humans , Kidney Transplantation , Male , Middle Aged , Multivariate Analysis , Psoas Muscles/pathology , ROC Curve , Retrospective Studies , Sensitivity and Specificity
5.
Osteoarthritis Cartilage ; 26(5): 666-670, 2018 05.
Article in English | MEDLINE | ID: mdl-29428318

ABSTRACT

OBJECTIVE: An increase in coronal laxity is recognized as a risk factor for progression of knee osteoarthritis (OA). The purpose of this study was to evaluate coronal laxity, which was defined as the angular motion from the neutral, unloaded (baseline) position to the loaded position, in patients with advanced medial knee OA. METHOD: Preoperative coronal laxity was assessed using radiographs in patients with medial knee OA undergoing total knee arthroplasty by applying a force of 150 N with an arthrometer. A consecutive series of 211 knees with OA and 40 normal control knees were examined. A knee with OA was defined as clinically "balanced" when the difference between medial and lateral laxity was 3° or less. Values are expressed as median [25th, 75th percentile]. RESULTS: The laxity was 4° [3, 5] from the baseline on the medial side and 3° [2, 4] on the lateral side. The distribution of medial and lateral laxity indicated that 90% (189/211) of patients fell within 3°. The equivalence test showed that the medial and lateral laxity was similar, with an equivalence margin of 3° (P < 0.001). In the control knees, the laxity was 3° [2, 4] from the baseline on the medial side and 2° [2, 4] on the lateral side. The differences between the knees with advanced OA and the controls were significant (P = 0.005, medial; P = 0.006, lateral). CONCLUSION: This study showed that a clinically balanced knee was maintained even in patients with advanced medial knee OA.


Subject(s)
Joint Instability/complications , Knee Joint/physiopathology , Osteoarthritis, Knee/etiology , Radiography/methods , Range of Motion, Articular/physiology , Adult , Aged , Aged, 80 and over , Arthroplasty, Replacement, Knee , Disease Progression , Female , Follow-Up Studies , Humans , Joint Instability/diagnosis , Knee Joint/diagnostic imaging , Knee Joint/surgery , Male , Middle Aged , Osteoarthritis, Knee/diagnosis , Osteoarthritis, Knee/surgery , Preoperative Period , Risk Factors
6.
Transplant Proc ; 49(5): 1133-1137, 2017 Jun.
Article in English | MEDLINE | ID: mdl-28583543

ABSTRACT

BACKGROUND: Living pancreas transplantation plays an important role in the treatment of patients with severe type 1 diabetes. However, pancreatectomy is very invasive for the donor, and less-invasive surgical procedures are needed. Although some reports have described hand-assisted laparoscopic surgery for distal pancreatectomy in living-donor operations, less-invasive laparoscopy-assisted (LA) procedures are expected to increase the donor pool. We herein report the outcomes of four cases of LA spleen-preserving distal pancreatectomy (Warshaw technique [WT]) in living pancreas donors. PATIENTS AND METHODS: Four living pancreas donors underwent LA-WT at our institution from September 2010 to January 2013. All donors fulfilled the donor criteria established by the Japan Society for Pancreas and Islet Transplantation. RESULTS: The median donor age was 54 years. Two donors underwent left nephrectomy in addition to LA-WT for simultaneous pancreas-kidney transplantation. The median donor operation time for pancreatectomy was 340.5 minutes. The median pancreas warm ischemic time was 3 minutes. The median donor blood loss was 246 g. All recipients immediately achieved insulin independence. One donor required reoperation because of obstructive ileus resulting from a port-site hernia. Another donor developed a pancreatic fistula (International Study Group of Pancreatic Fistula grade B), which was controlled with conservative management. After a maximum follow-up of 73 months, no clinically relevant adverse events had occurred. These results were comparable with those of previous studies concerning living-donor pancreas transplantation. CONCLUSION: The LA-WT is a safe and acceptable operation for living-donor pancreas transplantation.


Subject(s)
Laparoscopy/methods , Living Donors , Pancreas Transplantation/methods , Pancreatectomy/methods , Tissue and Organ Harvesting/methods , Adult , Female , Humans , Male , Middle Aged , Pancreas/surgery
7.
J Wound Care ; 25(4): 177-80, 182, 2016 Apr.
Article in English | MEDLINE | ID: mdl-27064366

ABSTRACT

OBJECTIVE: To verify the reliability and validity of FLIR ONE, a device connected to a smartphone, for the assessment of inflammation based on relative temperature increase compared with the thermography routinely used in pressure ulcer (PU) and diabetic foot assessment. METHOD: Participants in this pilot cross-sectional observational study were recruited from the patients in the PU team rounds and the diabetic foot outpatient clinic at the university hospital in January 2015. Cohen's kappa coefficient with its 95% confidence intervals was used to evaluate the criterion-related validity and inter- and intra-rater reliability for the thermal imaging assessment. For assessing criterion-related validity, a hand-held high-end infrared thermography device was used to provide reference data. Comparison of thermal images between the smartphone-connected device and the hand-held device was performed with both a 'predetermined range' and an 'automatically-set range.' For assessing inter-rater reliability, two assessors evaluated the thermal images taken by the mobile thermography. For assessing intra-rater reliability, one assessor evaluated the thermal images twice. The thermal images were shown to the assessors at random. RESULTS: Among 16 thermal images obtained from eight patients, kappa coefficients for each value were as follows: for the predetermined range and automatically-set range, respectively, the criterion-related validity was 1.00 (95% confidence interval 1.00-1.00) and 1.00 (95% confidence interval 1.00-1.00); the inter-rater reliability was 1.00 (95% confidence interval 1.00-1.00) and 1.00 (95% confidence interval 1.00-1.00); and the intra-rater reliability was 1.00 (95% confidence interval 1.00-1.00) and 1.00 (95% confidence interval 1.00-1.00). CONCLUSION: This pilot study suggests that FLIR ONE can work as an alternative device for assessing subclinical inflammation in PUs and the diabetic foot in clinical settings. Our results may facilitate clinicians in accepting the routine use of thermal imaging assessment at the patients' bedside.


Subject(s)
Diabetic Foot/diagnosis , Pressure Ulcer/diagnosis , Smartphone , Thermography/instrumentation , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Humans , Inflammation , Male , Middle Aged , Pilot Projects , Reproducibility of Results , Sacrococcygeal Region , Thermography/methods
8.
J Hand Surg Eur Vol ; 41(2): 220-5, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26546605

ABSTRACT

UNLABELLED: We investigated the demographic characteristics of patients who were diagnosed with intersection syndrome and also investigated the dominance of the affected hand, duration of symptoms and any precipitating factor for pain of the wrist. These features were compared with patients who had de Quervain's disease. Ultrasonography was used to confirm the clinical diagnosis. Intersection syndrome occurred more frequently in men and in the dominant hand than de Quervain's disease when all the patients were compared and when peripartum women were excluded. It occurred at a younger age than de Quervain's disease only when the comparison excluded peripartum women. Patients with intersection syndrome presented with a much shorter duration of symptoms. These results were consistent with previous reports about occupational factors in intersection syndrome, and might be helpful in the understanding of epidemiological difference between the two conditions. LEVEL OF EVIDENCE: Level 3.


Subject(s)
Tenosynovitis/diagnostic imaging , Adult , De Quervain Disease/diagnostic imaging , Diagnosis, Differential , Female , Hand , Humans , Male , Middle Aged , Pain Measurement , Syndrome , Ultrasonography
9.
Transl Psychiatry ; 5: e596, 2015 Jul 07.
Article in English | MEDLINE | ID: mdl-26151924

ABSTRACT

Our open-label pilot study showed that supplementation with docosahexaenoic acid (DHA) increased serum brain-derived neurotrophic factor (BDNF) levels and that there might be an association between changes in serum BDNF levels and reduced psychological distress. Animal research has indicated that a DHA-enriched diet increases BDNF in the brain. In this randomized double-blind controlled trial of severely injured patients vulnerable to posttraumatic stress disorder (PTSD) and depression, we examined whether DHA increases serum BDNF levels and whether changes in BDNF levels are associated with subsequent symptoms of PTSD and depression. Patients received 1470 mg per day of DHA plus 147 mg per day of eicosapentaenoic acid (EPA; n = 53) or placebo (n = 57) for 12 weeks. Serum levels of mature BDNF and precursor pro-BDNF at baseline and 12-week follow-up were measured using enzyme-linked immunosorbent assay kits. At 12 weeks, we used the Clinician-Administered PTSD Scale to assess PTSD symptoms and depressive symptoms by the Montgomery-Åsberg Depression Rating Scale. We found a significant increase in serum BDNF levels during the trial in the DHA and placebo groups with no interaction between time and group. Changes in BDNF levels were not associated with PTSD severity but negatively associated with depression severity (Spearman's ρ = -0.257, P = 0.012). Changes in pro-BDNF were also negatively associated with depression severity (Spearman's ρ = -0.253, P = 0.013). We found no specific effects of DHA on increased serum levels of BDNF and pro-BDNF; however, evidence in this study suggests that increased BDNF and pro-BDNF have a protective effect by minimizing depression severity.


Subject(s)
Brain-Derived Neurotrophic Factor/blood , Docosahexaenoic Acids/therapeutic use , Protein Precursors/blood , Stress Disorders, Post-Traumatic/prevention & control , Adolescent , Adult , Aged , Aged, 80 and over , Biomarkers/blood , Depression/blood , Depression/prevention & control , Double-Blind Method , Eicosapentaenoic Acid/therapeutic use , Enzyme-Linked Immunosorbent Assay , Female , Humans , Male , Middle Aged , Psychiatric Status Rating Scales , Stress Disorders, Post-Traumatic/blood , Wounds and Injuries/psychology , Young Adult
10.
Transplant Proc ; 47(3): 733-7, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25891721

ABSTRACT

BACKGROUND: Simultaneous pancreas-kidney transplantation (SPK) is a definitive treatment for type 1 diabetics with end-stage renal disease (ESRD). Because of the shortage of deceased donors in Japan, the mortality rate during the waiting period is high. We evaluated mortality risk in patients with type 1 diabetes waiting for SPK, and the benefit of living-donor kidney transplantation (LDK) preceding pancreas transplantation, which may reduce mortality in patients awaiting SPK. METHODS: This retrospective study included 71 patients with type 1 diabetes. Twenty-six patients underwent SPK, 15 underwent LDK, and 30 were waiting for SPK. Their cumulative patient and graft survival rates were retrospectively evaluated. Risk factors contributing to mortality in patients with type 1 diabetes awaiting SPK were evaluated with the use of a Cox proportional hazards model. RESULTS: The 5-year cumulative patient survival rates in the SPK and LDK groups were 100% and 93.3%, respectively (P = .19), and 5-year kidney graft survival rates were 95.7% and 100% (P = .46), respectively. The cumulative survival rate in patients awaiting SPK was 77.7% at 5 years after registration. Duration of dialysis was the only factor significantly associated with patient and graft survivals according to both univariate and multivariate analyses. CONCLUSIONS: Patient and graft survival rates were similar in the SPK and LDK groups, but the survival rate of patients awaiting SPK decreased over time. Duration of dialysis was an independent risk factor for patient and graft survival. LDK preceding pancreas transplantation may be an effective therapeutic option for patients with type 1 diabetes and ESRD.


Subject(s)
Diabetes Mellitus, Type 1/surgery , Kidney Failure, Chronic/surgery , Kidney Transplantation/methods , Living Donors , Pancreas Transplantation/methods , Adult , Aged , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/mortality , Female , Graft Survival , Humans , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/mortality , Kidney Transplantation/mortality , Male , Middle Aged , Multivariate Analysis , Pancreas Transplantation/mortality , Proportional Hazards Models , Retrospective Studies , Risk Factors , Survival Rate , Treatment Outcome
11.
Transplant Proc ; 47(3): 608-11, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25817610

ABSTRACT

BACKGROUND: Renal transplantation has been established as a treatment for end-stage renal disease (ESRD) due to diabetic nephropathy. However, few studies have focused on the outcome after renal transplantation in patients with ESRD and type 2 diabetic nephropathy. To investigate the effect of renal transplantation on ESRD with type 2 diabetic nephropathy, we retrospectively analyzed patients who received renal transplantation at our facility. This study aimed to compare the outcome of renal transplantation for type 2 diabetic nephropathy with that for nondiabetic nephropathy. METHODS: We studied 290 adult patients, including 65 with type 2 diabetic nephropathy (DM group) and 225 with nondiabetic nephropathy (NDM group), who underwent living-donor renal transplantation at our facility from February 2008 to March 2013. We compared the 2 groups retrospectively. RESULTS: In the DM and NDM groups, the 5-year patient survival rates were 96.6% and 98.7%, and the 5-year graft survival rates were 96.8% and 98.0%, respectively, with no significant differences between the groups. There were no significant differences in the rates of surgical complications, rejection, and infection. The cumulative incidence of postoperative cardiovascular events was higher in the DM group than in the NDM group (8.5% vs 0.49% at 5 years; P = .002). CONCLUSIONS: Patient and graft survival rates after renal transplantation for type 2 diabetic nephropathy are not inferior to those for recipients without diabetic nephropathy. Considering the poor prognosis of patients with diabetic nephropathy on dialysis, renal transplantation can provide significant benefits for these patients.


Subject(s)
Diabetes Mellitus, Type 2/complications , Diabetic Nephropathies/surgery , Kidney Failure, Chronic/surgery , Kidney Transplantation/mortality , Adult , Aged , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Female , Graft Survival , Humans , Incidence , Kidney Transplantation/adverse effects , Living Donors , Male , Middle Aged , Renal Dialysis/adverse effects , Retrospective Studies , Survival Rate
12.
Cell Death Differ ; 22(1): 145-55, 2015 Jan.
Article in English | MEDLINE | ID: mdl-25190146

ABSTRACT

Although induced pluripotent stem (iPS) cells have significant implications for overcoming most of the ethical issues associated with embryonic stem (ES) cells, there are still several unresolved issues related to the use of iPS cells for clinical applications, such as teratoma formation. In this study, we were able to generate tissue-specific stem (induced tissue-specific stem; iTS) cells from the pancreas (iTS-P) or liver (iTS-L) by transient overexpression of reprogramming factors, combined with tissue-specific selection. The generation of iTS cells was easier than that of iPS cells. The iTS-P/iTS-L cells express genetic markers of endoderm and pancreatic/hepatic progenitors and were able to differentiate into insulin-producing cells/hepatocytes more efficiently than ES cells. Subcutaneous transplantation of both types of iTS cells into immunodeficient mice resulted in no teratoma formation. The technology used for the transient overexpression of reprogramming factors and tissue-specific selection may be useful for the generation of other tissue-specific stem cells, and the generation of iTS cells could have important implications for the clinical application of stem cells.


Subject(s)
Cellular Reprogramming , Induced Pluripotent Stem Cells/metabolism , Transcription Factors/metabolism , Animals , Antigens, Differentiation/biosynthesis , Antigens, Differentiation/genetics , Induced Pluripotent Stem Cells/cytology , Mice , Mice, SCID , Organ Specificity/genetics , Transcription Factors/genetics
13.
Calcif Tissue Int ; 96(4): 347-58, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25511229

ABSTRACT

Clinical and experimental studies have reported that phosphate overload plays a central role in the pathogenesis of vascular calcification in chronic kidney disease. However, it remains undetermined whether phosphate induces cellular senescence during vascular calcification. We established a modified uremic rat model induced by a diet containing 0.3% adenine that showed more slowly progressive kidney failure, more robust vascular calcification, and longer survival than the conventional model (0.75% adenine). To determine the effect of phosphate on senescence of vascular smooth muscle cells (VSMCs) and the protective effect of phosphate binders, rats were divided into four groups: (1) normal control rats; (2) rats fed with the modified adenine-based diet (CKD); (3) CKD rats treated with 6% lanthanum carbonate (CKD-LaC); and (4) CKD rats treated with 6% calcium carbonate (CKD-CaC). After 8 weeks, CKD rats showed circumferential arterial medial calcification, which was inhibited in CKD-LaC and CKD-CaC rats. CKD rats showed increased protein expression of senescence-associated ß-galactosidase, bone-related proteins, p16 and p21, and increased oxidative stress levels in the calcified area, which were inhibited by both phosphate binders. However, serum levels of oxidative stress and inflammatory markers, serum fibroblast growth factor 23, and aortic calcium content in CKD-CaC rats were higher than those in CKD-LaC rats. In conclusion, phosphate induces cellular senescence of VSMCs in the modified uremic rat model, and phosphate binders can prevent both cellular senescence and calcification of VSMCs via phosphate unloading. Our modified adenine-based uremic rat model is useful for evaluating uremia-related complications, including vascular calcification.


Subject(s)
Adenine/metabolism , Cellular Senescence/drug effects , Myocytes, Smooth Muscle/cytology , Phosphates/chemistry , Uremia/metabolism , Vascular Calcification/metabolism , Animal Feed , Animals , Calcinosis , Calcium Carbonate/chemistry , Disease Models, Animal , Disease Progression , Fibrosis/physiopathology , Immunohistochemistry , Inflammation/metabolism , Kidney/metabolism , Kidney/pathology , Kidney Failure, Chronic/metabolism , Kidney Failure, Chronic/prevention & control , Lanthanum/chemistry , Male , Muscle, Smooth, Vascular/cytology , Myocytes, Smooth Muscle/drug effects , Oxidative Stress , Rats , Rats, Sprague-Dawley , Renal Insufficiency, Chronic/prevention & control , Signal Transduction , Uremia/drug therapy
14.
Eur Psychiatry ; 29(7): 408-13, 2014 Sep.
Article in English | MEDLINE | ID: mdl-24969103

ABSTRACT

Several cross-sectional studies, but no prospective studies, have reported an association between an abnormal lipid profile and posttraumatic stress disorder (PTSD). We hypothesized that an abnormal lipid profile might predict risk for developing PTSD. In this prospective study, we analyzed data from 237 antidepressant-naïve severely injured patients who participated in the Tachikawa Cohort of Motor Vehicle Accident Study. High-density lipoprotein cholesterol (HDL-C) levels at baseline were significantly lower in patients with PTSD than those without PTSD at 6 months after motor vehicle accident (MVA) and were inversely associated with risk for PTSD. In contrast, triglycerides (TG) at baseline were significantly higher in patients with PTSD than in those without PTSD at 6 months post-MVA and were positively associated with risk for PTSD. There was no clear association between low-density lipoprotein cholesterol or total cholesterol and risk for PTSD. In conclusion, low HDL-C and high TG may be risk factors for PTSD. Determining lipid profiles might help identify those at risk for PTSD after experiencing trauma.


Subject(s)
Accidents, Traffic/psychology , Cholesterol, HDL/metabolism , Cholesterol, LDL/metabolism , Stress Disorders, Post-Traumatic/metabolism , Triglycerides/metabolism , Adult , Age Factors , Cholesterol/metabolism , Cohort Studies , Female , Humans , Longitudinal Studies , Male , Middle Aged , Prospective Studies , Risk Factors , Sex Factors , Stress Disorders, Post-Traumatic/psychology , Young Adult
15.
Transplant Proc ; 46(2): 395-9, 2014.
Article in English | MEDLINE | ID: mdl-24655972

ABSTRACT

BACKGROUND: Once-daily extended-release tacrolimus (Tac-QD) has been shown to have equivalent efficacy and safety to the twice-daily formulation (Tac-BID) in kidney transplant patients. However, detailed comparison of allograft pathology found on a protocol biopsy (PB) in Tac-QD- versus Tac-BID-based regimens has not been described. METHODS: We retrospectively investigated 119 de novo living donor kidney transplant patients treated with Tac-QD (n = 90) or Tac-BID (n = 29) and their 3- and 12-month PB results. Other immunosuppressive drugs administered included basiliximab, mycophenolate mofetil, and methylprednisolone. We evaluated daily doses and trough levels of Tac and serum creatinine levels, and compared pathologic findings. RESULTS: Daily doses were higher in the Tac-QD group, but trough levels and serum creatinine levels were comparable. On 3- and 12-month PB, the frequency of subclinical rejection was similar between the groups, whereas interstitial fibrosis and tubular atrophy (IF/TA) were less common in the Tac-QD group at 12 months (42.2% vs 20.6%, P = .04). Univariate and multivariate logistic regression analyses revealed that allograft rejection (borderline changes or higher) was associated with IF/TA (odds ratio 4.09, 95% confidence interval 1.76-10.10, P = .001). The Tac-QD-based regimen showed a trend toward the absence of IF/TA but it did not reach statistical significance. Tubular vacuolization and arteriolar hyaline changes were also comparable in the two groups. CONCLUSIONS: We found a trend toward milder IF/TA, but no significant differences in kidney allograft pathology in patients who were administered Tac-QD- versus Tac-BID-based regimens at 12 months. The effects of Tac-QD on chronic allograft injury must be studied by longer observation.


Subject(s)
Immunosuppressive Agents/therapeutic use , Kidney Transplantation , Living Donors , Tacrolimus/administration & dosage , Adult , Biopsy , Clinical Protocols , Drug Administration Schedule , Female , Humans , Male , Middle Aged , Young Adult
16.
Transplant Proc ; 46(2): 560-3, 2014.
Article in English | MEDLINE | ID: mdl-24656012

ABSTRACT

BACKGROUND: Polyomavirus BK nephropathy (BKVN) is an important infectious complication in kidney transplant patients. Regular screening using polymerase chain reaction for BK virus DNA in plasma and urinary cytology is effective for early diagnosis of BKVN. However, methods of follow-up and therapeutic targets are not well described. METHODS: Ten patients with BKVN who received biweekly urinary cytology and repeat biopsies after diagnosis were retrospectively studied. Histological remission of BKVN was determined when biopsy revealed negative SV40 large T-antigen (TAg) staining. Results of urinary cytology and repeat biopsy findings were compared. RESULTS: Urinary decoy cells disappeared in 8 of 10 patients 55 ± 25 (range 13-79) days after index biopsies. In those cases, allograft function was preserved and the final serum creatinine level was 2.14 ± 1.19 (0.80-4.55) mg/dL after 962 ± 393 (325-1563) days of follow-up. Two cases with persistent urinary decoy cells shedding lost their graft 195 and 362 days later. Amongst 29 repeat biopsies, there were 13 TAg-positive and 16 negative biopsies. In 12 of 13 TAg-positive biopsies (92%), urinary decoy cells were still positive, whereas at the same time in 15 TAg-negative biopsies, decoy cells had already disappeared (94%). CONCLUSIONS: Cytology testing is advantageous because of its cost effectiveness. Clearance of decoy cells from urine was closely related to histological remission of BKVN, and may possibly be a therapeutic target in BKVN.


Subject(s)
BK Virus/physiology , Kidney Diseases/virology , Urine/virology , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult
17.
Rev. mex. ing. bioméd ; 35(3): 253-262, abr. 2014. ilus, tab
Article in English | LILACS-Express | LILACS | ID: lil-740177

ABSTRACT

Pressure ulcers are injuries to the skin and/or underlying tissues caused by prolonged high pressures on supporting body areas, they affect mainly people with poor mobility that have stayed in seating position for a long time. Reducing the amount and duration of pressure has been widely accepted for minimizing the risk of formation of pressure ulcers. Recently, dynamic cushions have been developed to relieve pressure on supporting areas; nevertheless, there is no sufficient information about the adequate characteristics of alternating sequences for pressure ulcers prevention. Therefore, the aim of this work is to explore three sequences of alternating movements designed for an air cell cushion by comparing pressure redistribution on supporting areas when applied on healthy volunteers. The purpose of these sequences is to redistribute the pressure over a larger contact area. To evaluate the effect of the alternating sequences, eight healthy volunteers were asked to sit on the air cell cushion, and to try the three alternating sequences for 12 minutes, 2 minutes on static mode and 10 minutes on alternating mode. A parameter for quantitative assessment of alternating sequences was proposed in this work by determining the coefficient of variation of interface pressure. Furthermore, the percentage of relative change of coefficient of variation was computed for evaluating performance of the alternating sequences comparing to the static mode. It was found that the three proposed strategies maintained values of interface pressure lower than previous work. Additionally, the relative change allowed to differentiate the effects of alternation of each sequence showing the second strategy as the most effective. The results are encouraging for further studies in subjects who require a wheelchair for mobility.


Las úlceras por presión son lesiones en la piel y tejidos subyacentes, causadas por presiones excesivas y prolongadas en las superficies de apoyo del cuerpo. Estas lesiones afectan principalmente a personas con poca movilidad física, como aquellas que permanecen sentados por largos periodos. Para disminuir el riesgo del padecimiento de estas lesiones, se ha recomendado como punto de partida reducir la magnitud y el tiempo de acción de las presiones en las zonas de apoyo. Se han desarrollado cojines dinámicos para sillas de ruedas, los cuales generan movimientos alternantes en las diferentes zonas de apoyo, producido por la inyección de aire, con el fin de disminuir las presiones en esas zonas. Sin embargo, no se han encontrado referencias de las características adecuadas de las secuencias de movimientos alternantes para prevenir la aparición de esas lesiones. El propósito de este trabajo es evaluar tres secuencias de movimientos alternantes diseñadas para un cojín de aire. La evaluación se realizó comparando la distribución de presiones en zonas de apoyo antes y durante la aplicación de estas secuencias alternantes en personas sanas. Las secuencias propuestas se aplican para el inflado y desinflado de celdas que forman el cojín y fueron diseñadas con el objetivo de distribuir las presiones en un área mayor de apoyo. La prueba se realizó en 8 sujetos sanos, con un tiempo de estudio de 12 minutos para cada secuencia diseñada; 2 minutos en modo estático y 10 minutos en modo alternante. Se propuso determinar el coeficiente de variación para evaluar de forma cuantitativa el efecto de las secuencias alternantes sobre la presión de interfaz. Además se calculó el porcentaje de variación relativa del coeficiente de variabilidad entre los modos basal (estático) y alternante como una herramienta para evaluar el desempeño de las secuencias propuestas en relación a la presión de interfaz. Se encontró que las tres estrategias mantuvieron presiones de interfaz por debajo de los valores reportados en trabajos previos. El porcentaje de variación relativa permitió diferenciar el efecto de la alternancia de cada una de las secuencias propuestas, mostrando la segunda estrategia como la más efectiva. Los resultados obtenidos son alentadores para continuar el estudio en sujetos que requieren una silla de ruedas para su movilidad.

18.
Oncogenesis ; 2: e70, 2013 Sep 16.
Article in English | MEDLINE | ID: mdl-24042734

ABSTRACT

Protooncogene T-cell leukemia 1 (TCL1), which is implicated in human T-cell prolymphocytic leukemia (T-PLL), interacts with Akt and enhances its kinase activity, functioning as an Akt kinase co-activator. Two major isoforms of TCL1 Protooncogenes (TCL1 and TCL1b) are present adjacent to each other on human chromosome 14q.32. In human T-PLL, both TCL1 and TCL1b are activated by chromosomal translocation. Moreover, TCL1b-transgenic mice have never been created. Therefore, it remains unclear whether TCL1b itself, independent of TCL1, exhibits oncogenicity. In co-immunoprecipitation assays, both ectopic and endogenous TCL1b interacted with Akt. In in vitro Akt kinase assays, TCL1b enhanced Akt kinase activity in dose- and time-dependent manners. Bioinformatics approaches utilizing multiregression analysis, cluster analysis, KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway mapping, Venn diagrams and Gene Ontology (GO) demonstrated that TCL1b showed highly homologous gene-induction signatures similar to Myr-Akt or TCL1. TCL1b exhibited oncogenicity in in vitro colony-transformation assay. Further, two independent lines of ß-actin promoter-driven TCL1b-transgenic mice developed angiosarcoma on the intestinal tract. Angiosarcoma is a rare form of cancer in humans with poor prognosis. Using immunohistochemistry, 11 out of 13 human angiosarcoma samples were positively stained with both anti-TCL1b and anti-phospho-Akt antibodies. Consistently, in various cancer tissues, 69 out of 146 samples were positively stained with anti-TCL1b, out of which 46 were positively stained with anti-phospho-Akt antibodies. Moreover, TCL1b structure-based inhibitor 'TCL1b-Akt-in' inhibited Akt kinase activity in in vitro kinase assays and PDGF (platelet-derived growth factor)-induced Akt kinase activities-in turn, 'TCL1b-Akt-in' inhibited cellular proliferation of sarcoma. The current study disclosed TCL1b bears oncogenicity and hence serves as a novel therapeutic target for human neoplastic diseases.

19.
Br J Cancer ; 109(2): 472-81, 2013 Jul 23.
Article in English | MEDLINE | ID: mdl-23799843

ABSTRACT

BACKGROUND: The polypeptide N-acetylgalactosaminyltransferases (GalNAc-Ts) family of enzymes regulates the initial steps of mucin-type O-glycosylation. N-acetylgalactosaminyltransferases might show novel patterns of GalNAc-T glycosylation on tumour-derived proteins, which could influence cancer biology, but its mechanisms are unclear. We investigated the association of GalNAc-T3 and -T6 expressions with clinicopathological features and prognoses of patients with renal cell carcinomas (RCCs). METHODS: Expressions of GalNAc-T3/6 and cell-adhesion molecules were analysed immunohistochemically in 254 paraffin-embedded tumour samples of patients with RCC. RESULTS: Of 138 GalNAc-T3+ cases, 46 revealed significant co-expression with GalNAc-T6. N-acetylgalactosaminyltransferases-3+ expression showed a close relationship to poor clinical performance and large tumour size, or pathologically high Fuhrman's grading, and presence of vascular invasion and necrosis. The GalNAc-T3-positivity potentially suppressed adhesive effects with a significantly low ß-catenin expression. Univariate and multivariate analyses showed the GalNAc-T3+ group, but not the GalNAc-T6+ group, to have significantly worse survival rates. CONCLUSION: N-acetylgalactosaminyltransferases-3 expression independently predicts high-grade tumour and poor prognosis in patients with RCC, and may offer a therapeutic target against RCC.


Subject(s)
Biomarkers, Tumor/metabolism , Carcinoma, Renal Cell/pathology , Kidney Neoplasms/pathology , N-Acetylgalactosaminyltransferases/metabolism , Adult , Aged , Aged, 80 and over , Biomarkers, Tumor/genetics , Carcinoma, Renal Cell/enzymology , Cell Line, Tumor , Cohort Studies , Female , Humans , Kidney Neoplasms/enzymology , Male , Middle Aged , N-Acetylgalactosaminyltransferases/genetics , Neoplasm Grading , Prognosis , Retrospective Studies , Polypeptide N-acetylgalactosaminyltransferase
20.
Pharm Biol ; 51(1): 36-41, 2013 Jan.
Article in English | MEDLINE | ID: mdl-22979941

ABSTRACT

CONTEXT: Lawsone, lawsone methyl ether and 3,3'-methylelnebislawsone are the main active compounds of Impatiens balsamina L. (Balsaminaceae). These compounds possess various pharmacological activities that have been shown to assist with the treatment of skin diseases. OBJECTIVE: This work focused on increased naphthoquinone production in I. basamina root cultures using methionine feeding. MATERIALS AND METHODS: I. balsamina root cultures were maintained in liquid Gamborg's B5 medium supplemented with 0.1 mg/L α-naphthalene acetic acid, 0.1 mg/L kinetin, 1.0 mg/L 6-benzyladenine and 20 g/L sucrose. The effect of methionine concentration (50, 100, 300, 500 and 1000 mg/L) on naphthoquinone production of I. basamina root cultures was determined. Isolation of secondary metabolites from I. balsamina root cultures was also carried out. RESULTS AND DISCUSSION: Feeding of 300 mg/L methionine to the root cultures at the beginning of the growth cycle increased the production of 3,3'-methylelnebislawsone almost two-fold (0.63 mg/g dry weight, compared to the control group 0.32 mg/g dry weight). Optimization of the feeding conditions showed that adding 500 mg/L methionine to a 21-day old root cultures increased production of lawsone methyl ether and 3,3'-methylenebislawsone up to 2.6- and 3.1-fold higher, respectively, compared to the controls. In addition, various pharmacologically interesting secondary metabolites were isolated from I. balsamina root cultures, such as a flavonoid, luteolin, a naphthoquinone, 2,3-dihydroxy-1,4-naphthoquinone, and a triterpenoid, echinocystic acid. This is the first report of the occurrence of these compounds in this plant.


Subject(s)
Impatiens/metabolism , Methionine/pharmacology , Naphthoquinones/isolation & purification , Culture Techniques , Dose-Response Relationship, Drug , Flavonoids/isolation & purification , Impatiens/growth & development , Methionine/administration & dosage , Plant Roots , Triterpenes/isolation & purification
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