Serum immunoglobulin G antibody titer to Fusobacterium nucleatum is associated with unfavorable outcome after stroke.

Stroke can be a cause of death, while in non-fatal cases it is a common cause of various disabilities resulting from associated brain damage. However, whether a specific periodontal pathogen is associated with increased risk of unfavorable outcome after stroke remains unknown. We examined risk factors for unfavorable outcome following stroke occurrence, including serum antibody titers to periodontal pathogens. The enrolled cohort included 534 patients who had experienced an acute stroke, who were divided into favorable (n = 337) and unfavorable (n = 197) outcome groups according to modified ranking scale (mRS) score determined at 3 months after onset (favorable = score 0 or 1; unfavorable = score 2-6). The associations of risk factors with unfavorable outcome, including serum titers of IgG antibodies to 16 periodontal pathogens, were examined. Logistic regression analysis showed that the initial National Institutes of Health stroke scale score [odds ratio (OR) = 1·24, 95% confidence interval (CI) = 1·18-1·31, P < 0·001] and C-reactive protein (OR = 1·29, 95% CI = 1·10-1·51, P = 0·002) were independently associated with unfavorable outcome after stroke. Following adjustment with those, detection of the antibody for Fusobacterium nucleatum ATCC 10953 in serum remained an independent predictor of unfavorable outcome (OR = 3·12, 95% CI = 1·55-6·29, P = 0·002). Determination of the antibody titer to F. nucleatum ATCC 10953 in serum may be useful as a predictor of unfavorable outcome after stroke.

Wireless EEG patch sensor on forehead using on-demand stretchable electrode sheet and electrode-tissue impedance scanner.

A wireless electroencephalogram (EEG) sensor using a stretchable electrode sheet and electrode-tissue impedance measurement module is presented herein. The sensor can be attached to the forehead using biocompatible gel with the electrode sheet. The sensor is compactly designed for 3 cm × 9 cm × 6 mm with weight of 12 g. Impedance scanning circuit is also proposed to evaluate the skin surface condition before EEG measurements. We developed the impedance scanning board for 3 cm × 5 cm × 3 mm, with weight of 5.6 g. Results show that the proposed system demonstrates a promising performance in diagnosing the Alzheimer's disease using frequency domain analysis.

Pretreatment ASPECTS on DWI predicts 3-month outcome following rt-PA: SAMURAI rt-PA Registry.

OBJECTIVE: To evaluate whether the pretreatment Alberta Stroke Programme Early CT Score (ASPECTS) assessed using diffusion-weighted imaging (DWI) predicts stroke outcomes at 3 months following IV recombinant tissue-type plasminogen activator (rt-PA) therapy. METHODS: Stroke patients treated with rt-PA (0.6 mg/kg alteplase) in 10 stroke centers in Japan were retrospectively studied. ASPECTS was assessed on DWI just prior to rt-PA injection. The primary outcome was a modified Rankin Scale (mRS) score of 0-2 at 3 months. Secondary outcomes included death at 3 months and symptomatic intracerebral hemorrhage (sICH) within 36 hours. RESULTS: For the 477 patients (316 men, 71 +/- 11 years old) enrolled, the median NIH Stroke Scale score was 13 (interquartile range 7-18.5), the median ASPECTS on DWI was 8 (7-10), and sICH was identified in 15 patients (3.1%). At 3 months, 245 (51.4%) had an mRS score of 0-2, and 29 (6.1%) had died. Patients with an mRS score of 0-2 had higher median ASPECTS (9; interquartile range 8-10) than other patients (8; 6-9, p < 0.001). Using receiver operating characteristic curves, the optimal cutoff ASPECTS to predict an mRS score of 0-2 was > or =7. On multivariate regression analysis, ASPECTS > or =7 was related to an mRS score of 0-2 (odds ratio 1.85; 95% confidence interval 1.07-3.24), ASPECTS < or =4 was related to death (3.61; 1.23-9.91), and ASPECTS < or =5 was related to sICH (4.74; 1.54-13.64). CONCLUSION: ASPECTS on DWI was independently predictive of functional and vital outcomes at 3 months, as well as sICH within 36 hours, following rt-PA therapy for stroke patients.

Prognostic studies on gastric cancer with concomitant liver metastases.

BACKGROUND/AIMS: The aim of this study was to clarify prognostic factors after surgical treatments in gastric cancer patients having synchronous liver metastases. METHODOLOGY: Clinicopathological features and prognosis were retrospectively reviewed in 43 surgical patients with gastric cancer with concomitant liver metastases from 1984 to 1998. RESULTS: More than half of the patients (51.2%) had numerous liver metastases (H3). Rates of peritoneal metastases (P1, P2, P3: 34.9%), tumor serosal invasion (T3 or T4: 73.8%) and widespread lymph node metastases (N3, N4: 69.8%) were also high. Although the gastric resection was performed in 29 patients (67.5%), concomitant hepatectomy resection was performed in only 3 patients (7.0%). Univariate analysis revealed that the grade of liver metastases (H1, H2, H3) was only a statistically significant prognostic factor (P = 0.008). Concerning surgical treatments, the resection group had tendency to better survival than the nonresection group (P = 0.074). Eight cases survived more than 1 year. Seven of the 8 cases (87.5%) were patients with gastrectomy. All of the 5 two-year survivors were patients with gastrectomy. CONCLUSIONS: In patients with gastric cancer with concomitant liver metastases, the grade of liver metastases indicate prognosis. In addition, there is possibility of palliative gastrectomy increasing the survival rare to more than one year.

Thymidine diphosphate-6-deoxy-L-lyxo-4-hexulose reductase synthesizing dTDP-6-deoxy-L-talose from Actinobacillus actinomycetemcomitans.

The serotype c-specific polysaccharide antigen of Actinobacillus actinomycetemcomitans NCTC 9710 contains an unusual sugar, 6-deoxy-L-talose, which has been identified as a constituent of cell wall components in some bacteria. Two genes coding for thymidine diphosphate (dTDP)-6-deoxy-L-lyxo-4-hexulose reductases were identified in the gene cluster required for biosynthesis of serotype c-specific polysaccharide. Both dTDP-6-deoxy-L-lyxo-4-hexulose reductases were overproduced and purified from Escherichia coli transformed with the plasmids containing these genes. The sugar nucleotides converted by both reductases were purified by reversed-phase high performance liquid chromatography and identified by (1)H nuclear magnetic resonance and gas-liquid chromatography. The results indicated that one of two reductases produced dTDP-6-deoxy-L-talose and the other produced dTDP-L-rhamnose (dTDP-6-deoxy-L-mannose). The amino acid sequence of the dTDP-6-deoxy-L-lyxo-4-hexulose reductase forming dTDP-6-deoxy-L-talose shared only weak homology with that forming dTDP-L-rhamnose, despite the fact that these two enzymes catalyze the reduction of the same substrate and the products are determined by the stereospecificity of the reductase activity. Neither the gene for dTDP-6-deoxy-L-talose biosynthesis nor its corresponding protein product has been found in other bacteria; this biosynthetic pathway is identified here for the first time.

Interaction of water-soluble collagen with poly(acrylic acid).

Interactions between poly(acrylic acid) labeled with pyrene (PAA-Py) and succinylated calfskin collagen (type I) (SCSC) were studied by fluorescence spectroscopy. PAA-Py exhibits a strong emission from pyrene monomer (intensity, I(M)) when it exists in an extended conformation. It exhibits another broad emission from pyrene excimer (intensity, I(E)) when it adopts a collapsed globule conformation. At pH 3, a value that is lower than the isoelectric point of SCSC, the ratio I(E)/I(M) value decreased cooperatively with increasing concentration of SCSC at constant PAA-Py concentration, under salt-free condition. On the other hand, this effect was not observed in the presence of 0.1 M NaCl. At pH 7, a value higher than the isoelectric point of SCSC, the ratio I(E)/I(M) was not affected by the presence of SCSC in the absence and presence of salt. From electrophoretic light scattering experiments, it was found that at pH 3 PAA-Py was negatively charged, while SCSC had a positive charge. Thus it is strongly suggested that the two polymers interact by electrostatic attraction at low pH where they are oppositely charged, and that PAA-Py adopts an extended conformation in the complex formed with SCSC. Similar interactions are believed to occur between dentinal collagen and the polycarboxylate component of glass-ionomer cements.

The effects of alcoholic compounds on the stability of type I collagen studied by differential scanning calorimetry.

The interaction between bovine tendon collagen and a series of homologous alcohols were investigated using a differential scanning calorimetry. For all alcoholic substances, as well as 2-hydroxyethyl methacrylate (HEMA), the concentration dependence of the denaturation temperature of collagen was observed, which showed a minimum at 30%. Clearly there are two opposing actions on the stabilization of the collagen structure; destabilization dominates over stabilization at lower concentrations, and vice versa at higher concentrations. The concentration dependence became greater for longer chain alcohols, while it was suppressed by the increased number of OH groups. The chain length-dependent surface tension may be related, which controls the permeation of the additives through the collagen fibers. Overall hydrophobicity, indicated by the hydrophile-lipophile balance (HLB) numbers, suggests the importance of the hydrophobic effect in the interaction of collagen and alcoholic substances, including adhesive monomers such as HEMA.

Laparoscopic treatment for common bile duct stones by transcystic papilla balloon dilatation technique.

The laparoscopic transcystic common bile duct (CBD) approach is becoming increasingly more refined as an ideal technique to deal with gallbladder stones (GBS) and common bile duct stones (CBDS) during a single operation. Our method, transcystic CBD exploration and papilla balloon dilatation (PBD), is an easier, safer, and less invasive technique than the transcystic approaches that have previously been reported. With our method, a sheath is introduced through the cystic duct into the CBD in order to allow catheter exchange, and the CBDS is flushed out through the papilla into the duodenum after PBD. We applied our new technique, without complication, to a patient with GBS and CBDS. Our technique is one of the safest, easiest, and least invasive methods for the treatment of patients with GBS and CBDS.

A novel NDP-6-deoxyhexosyl-4-ulose reductase in the pathway for the synthesis of thymidine diphosphate-D-fucose.

The serotype-specific polysaccharide antigen of Actinobacillus actinomycetemcomitans Y4 (serotype b) consists of D-fucose and L-rhamnose. Thymidine diphosphate (dTDP)-D-fucose is the activated nucleotide sugar form of D-fucose, which has been identified as a constituent of structural polysaccharides in only a few bacteria. In this paper, we show that three dTDP-D-fucose synthetic enzymes are encoded by genes in the gene cluster responsible for the synthesis of serotype b-specific polysaccharide in A. actinomycetemcomitans. The first and second steps of the dTDP-D-fucose synthetic pathway are catalyzed by D-glucose-1-phosphate thymidylyltransferase and dTDP-D-glucose 4,6-dehydratase, which are encoded by rmlA and rmlB in the gene cluster, respectively. These two reactions are common to the well studied dTDP-L-rhamnose synthetic pathway. However, the enzyme catalyzing the last step of the dTDP-D-fucose synthetic pathway has never been reported. We identified the fcd gene encoding a dTDP-4-keto-6-deoxy-D-glucose reductase. After purifying the three enzymes, their enzymatic activities were analyzed by reversed-phase high performance liquid chromatography. In addition, nuclear magnetic resonance analysis and gas-liquid chromatography analysis proved that the fcd gene product converts dTDP-4-keto-6-deoxy-D-glucose to dTDP-D-fucose. Moreover, kinetic analysis of the enzyme indicated that the Km values for dTDP-4-keto-6-deoxy-D-glucose and NADPH are 97.3 and 28.7 microM, respectively, and that the enzyme follows the sequential mechanism. This paper is the first report on the dTDP-D-fucose synthetic pathway and dTDP-4-keto-6-deoxy-D-glucose reductase.

Dodecyldimethylamine Oxide Micelles in Solutions without Added Salt

Critical micelle concentrations (cmc) of dodecyldimethylamine oxide (DDAO) were determined at 25°C in solutions in the absence of salt at different pH values by four methods: surface tension, dye solubilization (Sudan III), pH-concentration break points, and counterion (Cl-) activity. With the aid of the cmc values, the degree of ionization of DDAO micelle alphaM was determined as a function of pH from the hydrogen ion titration. The cmc increased sharply in a narrow range of alphaM from 0.35 to 0.40. This destabilization of micelles was also noted on the anomalous change of pK on the hydrogen ion titration curve. The counterion activity was measured potentiometrically, and the degree of the counterion binding theta was determined as a function of alphaM. The value of theta showed a sharp increase with alphaM also around 0.4. The line width of NMR absorption peak of 35Cl ions was well correlated with alphaM. The surface electric potentials psi0 of DDAO micelles were evaluated from both the hydrogen ion titration and the acid-base indicators, and the former value was larger than the latter one. A procedure is proposed to compare the stabilities of the micelles having different alphaM values. The result indicates much larger dependences on alphaM than those uncorrected for different ionic strengths at the cmc. Copyright 1998 Academic Press. Copyright 1998Academic Press

Induction of circular dichroism of symmetrical porphyrins bound to random coil polypeptides in aqueous solutions.

Absorption spectra and c.d. spectra have been measured in the region of Soret transition for aqueous solutions of porphine-meso-tetra(4-N-methylpyridinium) (TMpyP) tosylate in the presence of poly-L-glutamic acid, and of sodium porphine-meso-tetra(4-benzenesulphonate) (TPPS) or sodium porphine-meso-tetra(4-benzoate) (TPPC) in the presence of poly-L-lysine, all at high [P]/[D] ratios at neutral pH. The TmpyP-poly-L-glutamic acid system shows essentially no hypochromism and negligibly weak induced c.d., while the TPPS-poly-L-lysine or TPPC-poly-L-lysine system exhibits strong hypochromism and strong induced c.d. The former absorption band slightly shifts to red, but the latter shows a large blue shift. The primary interaction of the porphyrin with the polypeptide is their electrostatic binding. The difference in their interaction must arise from different degrees of hydrophobic interaction, and stronger interaction of TPPS or TPPC with poly-L-lysine would cause most of TPPS ions or all of TPPC ions bound on poly-L-lysine to dimerize, fix rigidly and couple together electronically on fully charged poly-L-lysine.

[Sudden cardiac arrest during percutaneous nephrostolithotomy (PNL) under epidural anesthesia].

There have been few major complications of percutaneous nephrostolithotomy (PNL) reported. We recently experienced cardiac arrest during PNL under epidural anesthesia. The patient was a 52 year old man weighing 64 kg who had been suffering from right renal pelvic stone for years. He was scheduled for PLN under epidural anesthesia. Analgesia was obtained to the level of Th6. The operation proceeded uneventfully for about 60 min. By this time, he suddenly complained nausea, and hypotension with bradycardia occurred. Blood pressure and pulse rate returned immediately to the normal level by IV atropine and ephedrine. But after three minutes, blood pressure and pulse rate went down again. This hypotension with bradycardia was unresponsive to epinephrine, calcium chloride and sodium bicarbonate. This was followed by asystole. Resuscitation was successful with the addition of epinephrine, calcium chloride, and sodium bicarbonate about 15 min after cardiac massage had started. The patient was, on the fifth postoperative day, with no evidence of impairment of renal, cardiac and respiratory functions but a slight impairment of neurologic function. Several possible causes for this cardiac arrest and anesthetic management of percutaneous nephrostolithotomy are discussed.