Modelling the invasion of human small intestinal epithelial-like cells by Salmonella enterica Typhimurium and Listeria monocytogenes using Bayesian inference.

To develop a mechanistic bacterial dose-response model, based on the concept of Key Events Dose-Response Framework (KEDRF), this study aimed to investigate the invasion of intestinal model cells (Caco-2) by Salmonella Typhimurium and Listeria monocytogenes and described the behaviour of both pathogens as a mathematical model using Bayesian inference. Monolayer-cultured Caco-2 cells (approximately 105 cells) were co-cultured with various concentrations (103 -107 colony forming unit [CFU] ml-1 ) of Salm. Typhimurium and L. monocytogenes for up to 9 h to investigate the invasion of the pathogens into the Caco-2 cells. While an exposure of ≥103 CFU ml-1 of Salm. Typhimurium initiated the invasion of Caco-2 cells within 3 h, much less exposure (102 CFU ml-1 ) of L. monocytogenes was sufficient for invasion within the same period. Furthermore, while the maximum number of invading Salm. Typhimurium cells reached by approximately 103 CFU cm-2 for 6-h exposure, the invading maximum numbers of L. monocytogenes cells increased by approximately 106 CFU cm-2 for the same exposure period. The invasion kinetics of both the pathogens was successfully described as an asymptotic exponential mathematical model using Bayesian inference. The developed pathogen invasion model allowed the estimation of probability of Salm. Typhimurium and L. monocytogenes infection, based on the physiological natures of digestion process, which was comparable to the published dose-response relationship. The invasion models developed in the present study will play a key role in the development of an alternative pathogen dose-response model based on KEDRF concept.

Relationship between Histological Grade and Histopathological Appearance in Canine Mammary Carcinomas.

Canine mammary carcinomas are common tumours in female dogs and histopathological examination has an important role in identifying whether they are benign or malignant. The latest and most commonly used histological grading system was established by Peña et al. (2013) and is based on the extent of tubule formation, nuclear pleomorphism and number of mitoses. Before the establishment of this grading system, tumour size and classical histological indicators of malignancy such as lymphovascular invasion, infiltration into surrounding tissue, necrosis and presence of a micropapillary pattern were important predictors of biological behaviour. However, the system of Peña et al. does not consider tumour size or these histological features. Clarifying the association of these features and histological grade, especially in grade II and III carcinomas, is important. In this study, we confirmed that the system of Peña et al. is effective for predicting biological behaviour and that evaluation of histological features of malignancy reinforced histological grade, as determined by the system of Peña et al., especially in grade II carcinomas.

Influence of radiologic expertise in detecting lung tumors on chest radiographs.

PURPOSE: To analyze the influence of radiologic expertise in detecting lung tumors on chest radiographs. MATERIALS AND METHODS: We retrieved posteroanterior chest radiographs and CT examination obtained from 283 patients with solitary primary malignant lung tumors who underwent surgical resection. There were 176 men and 107 women with a mean age of 67.0±9.1 (SD) years (range: 33-88 years). Thirteen first-year post-graduate (PGY-1) trainees and nine pulmonary specialists (three radiologists, three thoracic surgeons, and three pulmonologists) interpreted the chest radiographs. Detection rates among trainees and specialists were compared using Student t test. RESULTS: The total numbers of detected tumors ranged from 103 (36.4%) to 136 (48.1%) with a mean of 127.9±9.1 (45.2±3.2%) in the trainee group, and 137 (48.4%) to 182 (64.3%) with a mean of 161.6±13.1 (57.1±4.6%) in the specialist group; the intergroup difference was statistically significant (P<0.001). Significant intergroup detectability differences of >10% were noted for tumors in the peripheral zone with (i) ground glass opacity (GGO) ratio ≥10% and <70% and any size, or (ii) GGO ratio <10% and size ≤2cm; and for tumors hidden by the mediastinum, heart, or diaphragm with (i) GGO ratio ≥10% and <30% and size >3cm, or (ii) GGO ratio <10% and size >2cm. CONCLUSION: Our study demonstrates significant differences in lung tumor detectability on chest radiographs between PGY-1 trainees and pulmonary specialists according to tumor size, extent of GGO, and tumor location.

Prediction of calving time in Holstein dairy cows by monitoring the ventral tail base surface temperature.

Dystocia adversely affects the health of calves and their dams. The aim of this study was to determine whether the ventral tail base surface temperature (ST) could be used to predict calving time in dairy cows. Pregnant Holstein cows were enrolled during the warm season (daily average air temperature 10-20°C; n=13) and cool season (daily average air temperature<10°C; n=22) in Hokkaido, Japan, and a wearable wireless ST sensor was attached to the surface of the ventral tail base of each cow 9-12days before the predicted calving date. The ventral tail base ST was measured every 2min until 24h after calving. Hourly maximum ventral tail base ST values were used in the analysis and changes in ventral tail base ST were expressed as residual temperatures (RTs) to exclude any circadian effects using the formula: RT=actual ST-mean ST for the same hour on the previous 3 days. In both seasons, there was a continual decrease in ventral tail base RT from approximately 24h before calving compared with the control ventral tail base RT from 120 to 97h before calving. The areas under the receiver operating characteristic curves (ROC-AUCs) for ventral tail base RT as a predictor of calving were 0.88-0.95. ROC-AUCs as a predictor of calving within 24h were higher in the warm season than in the cool season. These findings demonstrate that calving time in dairy cows can be predicted by monitoring ventral tail base ST with a wearable wireless sensor, but seasonal variability affects the accuracy of prediction of calving time.

Cytomegalic Inclusion Disease caused by Cytomegalovirus Infection in the Salivary Glands of an African Hedgehog (Atelerix arbiventris).

Cytomegalic inclusion disease (CID) in the salivary gland of African hedgehogs (Atelerix arbiventris) has been reported before, and is suspected to reflect a cytomegalovirus infection. However, a recent ultrastructural study reported that African hedgehog CID reflected oncocytic metaplasia, mimicking a cytomegalovirus infection. We examined the submandibular and sublingual salivary glands of a 1-year-old male African hedgehog. Histologically, there were multiple foci composed of cytomegalic cells with intranuclear inclusion bodies. Ultrastructurally, viral particles (109-118 nm in diameter) were observed in the nuclei of the cytomegalic cells. There were numerous vesicles containing various numbers of enveloped viruses in the cytoplasm. We also attempted to detect viral DNA fragments by degenerate polymerase chain reaction and obtained amplicons of a predicted size. Phylogenetic analysis indicated that the virus is a betaherpesvirus, comparatively related to human and rodent cytomegaloviruses. The present study suggested that African hedgehog CIDs also include those caused by the cytomegalovirus.

Olympic torch flap: one-stop option for simultaneous brow, upper and lower lid reconstruction in post burn patients.

Facial units reconstruction in a post burn patient poses tough challenges. Simultaneous brow and lid reconstruction is one of them. This article presents a 45-year-old epileptic male with burn of complete face. The task of reconstructing the brow, upper and lower lids was successfully accomplished using a modification of the Guyuron postauricular fasciocutaneous flap, after initial grafting and radial forearm flap reconstruction of forehead and other parts of the face. The article gives a single-stop solution for simultaneous reconstruction of brow and lids using a random pattern extension of the traditional postauricular flap, thus proving the excellent vascularity and hence durability of the flap in spite of a 180 degrees change in the orientation of the flap with respect to the axis.

La reconstruction des unités esthétiques de la face dans les séquelles de brûlures constitue un grand défi. La reconstruction simultanée du front et des paupières en fait partie. Il s'agit de l'observation d'une brûlure pan faciale chez un homme épileptique de 45 ans. L'objectif de reconstruction du front et des quatre paupières fut atteint avec succès, en utilisant une modification du lambeau fascio cutané rétro auriculaire de Guyuron, réalisé secondairement, à la suite de gestes itératifs : greffe initiale après détersion, réparation du front par un lambeau pédiculé ante brachial radial, et greffes d'autres parties du visage. L'article propose ainsi une solution idéale pour la reconstruction simultanée du front et des paupières en utilisant l'extension du lambeau au hasard qu'est le lambeau traditionnel rétro auriculaire, celui-ci garantissant une excellente vascularisation et ainsi sa pérennité, malgré un changement d'orientation de 180° en respectant son axe.

The Relation between Hamstring Strain Injury and Physical Characteristics of Japanese Collegiate Sepak Takraw Players.

The aim of this study was to investigate the injuries in Japanese collegiate sepak takraw players. We primarily focused on hamstring strain injury (HSI), and investigated the associated physical characteristics. The study included 77 Japanese collegiate sepak takraw players who were interviewed; data were collected regarding injuries sustained by them during the game within the past year. The hip range of motion (ROM) was measured. The total number of injuries was 48 in a year. The rate of HSI was the highest (31.3%) among all the injuries. All HSIs occurred in the dominant leg because of the sunback spike. Using the Mann-Whitney U test, significant differences in age and sport-related experience were observed between the injured group and uninjured group. Upon using logistic regression analysis, the presence of a HSI was found to be associated with the sport-related experience (adjusted odds ratio [OR], 0.30; 95% confidence interval [CI], 0.12-0.77) and the hip extension ROM (adjusted OR, 0.81; 95% CI, 0.66-0.99) after adjusting for sex, sport-related experience, and the hip ROM. HSI is the most common injury in Japanese collegiate sepak takraw players. Short sport-related experience and small hip extension ROM are related with the occurrence of HSI.

'Transfer out' tuberculosis patients: treatment outcomes after cross-checking registers, 2012-2013, Lusaka, Zambia.

SETTING: Lusaka, Zambia. OBJECTIVE: To assess the actual treatment outcomes of 'transfer out' (TO) cases at a diagnostic centre in Lusaka, in the third and fourth quarters of 2012, and to see the impact of this cross-check in treatment success rates (TSR) in 2013 and early 2014. DESIGN AND METHOD: In this retrospective cohort study, treatment outcomes for new bacteriologically positive tuberculosis (TB) cases referred from the diagnostic centre were reviewed and compared with those at the receiving treatment units. RESULTS: Of 49 (58%) cases referred to three treatment units, the treatment outcomes of nine had to be updated at the diagnostic centre, which reduced the proportion of TO cases from 17.6% to 11.8% and increased the TSR to 70.6% from 64.7%. CONCLUSION: The review and cross-checking of the TB registers at the diagnostic and treatment units led to a significant reduction in non-assessed cases, suggesting that the TB registers in the diagnostic and treatment units should be cross-checked regularly. There is also need for a complementary intervention to reduce the proportion of TOs associated with high loss to follow-up and non-evaluated TO rates.

Contexte : Lusaka, Zambie.Objectif : Evaluer les vrais résultats du traitement des cas « transférés hors zone ¼ (TO) dans un centre de diagnostic, à Lusaka, pendant les troisième et quatrième trimestres de 2012, et voir l'impact du croisement des informations dans le taux de succès du traitement (TSR) en 2013 et au début de 2014.Schéma et méthode : Dans cette étude rétrospective de cohorte, les résultats du traitement de nouveaux cas de tuberculose (TB) à bactériologie positive qui avaient été référés du centre de diagnostic ont été revus et comparés à ceux de l'unité de traitement.Résultats : Sur 49 cas (58%) qui ont été référés à trois unités de traitement, les résultats du traitement de neuf cas ont dû être mis à jour au centre de diagnostic, ce qui a abouti à la réduction de la proportion de cas « TO ¼ de 17,6% à 11,8% et à l'augmentation du TSR de 64,7% à 70,6%.Conclusion : La revue et le croisement des registres TB des unités des centres de diagnostic et de traitement a abouti à une réduction significative des cas non évalués, ce qui suggère que les registres TB des unités de diagnostic et de traitement devraient être fréquemment croisés. Il y a également un besoin d'interventions complémentaires afin de réduire la proportion de TO, qui est associée à un taux élevé de perdus de vue et de cas non évalués.

Marco de referencia: La ciudad de Lusaka en Zambia.Objetivo: Evaluar los desenlaces terapéuticos reales de los pacientes con tuberculosis (TB) 'transferidos a otro centro' (TO), en una unidad de diagnóstico de Lusaka durante el tercero y cuarto trimestres del 2012 y examinar el efecto de la verificación cruzada de las tasas de éxito terapéutico (TSR) en el 2013 y comienzos del 2014.Método: En el presente estudio retrospectivo de cohortes, se analizaron los desenlaces terapéuticos de los casos nuevos de TB con confirmación bacteriológica de una unidad diagnóstica que se remitieron a otros centros y se compararon con los resultados obtenidos en las unidades de tratamiento que los recibieron.Resultados: Se remitieron 49 pacientes (58%) del centro diagnóstico a tres unidades de tratamiento. Faltaba la actualización del desenlace terapéutico de nueve de estos pacientes en el centro de diagnóstico y tras la verificación cruzada, disminuyó la proporción de casos TO de 17,6% a 11,8% y la TSR aumentó de 64,7% a 70,6%.Conclusión: La revisión y la verificación cruzada de los registros de TB de las unidades de diagnóstico y las unidades de tratamiento dio lugar a una disminución considerable de los casos clasificados como no evaluados, lo cual destaca la necesidad de cotejar con frecuencia los registros de tuberculosis de las diferentes unidades. Se precisan intervenciones complementarias encaminadas a disminuir la proporción de TO, las cuales se asocian con una alta tasa de pérdida durante el seguimiento y de casos TO no evaluados.

Atomic step-and-terrace surface of polyimide sheet for advanced polymer substrate engineering.

Typical thermostable and flexible polyimide polymers exhibit many excellent properties such as strong mechanical and chemical resistance. However, in contrast to single-crystal substrates like silicon or sapphire, polymers mostly display disordered and rough surfaces, which may result in instability and degradation of the interfaces between thin films and polymer substrates. As a step toward the development of next-generation polymer substrates, we here report single-atom-layer imprinting onto the polyimide sheets, resulting in an ultrasmooth 0.3 nm high atomic step-and-terrace surface on the polyimides. The ultrasmooth polymer substrates are expected to be applied to the fabrication of nanostructures such as superlattices, nanowires, or quantum dots in nanoscale-controlled electronic devices. We fabricate smooth and atomically stepped indium tin oxide transparent conducting oxide thin films on the imprinted polyimide sheets for future use in organic-based optoelectronic devices processed with nanoscale precision. Furthermore, toward 2D polymer substrate nanoengineering, we demonstrate nanoscale letter writing on the atomic step-and-terrace polyimide surface via atomic force microscopy probe scratching.

Abundance and genetic damage of barn swallows from Fukushima.

A number of studies have assessed or modeled the distribution of the radionuclides released by the accident at the Fukushima-Daiichi Nuclear Power Plant (FDNPP). Few studies however have investigated its consequences for the local biota. We tested whether exposure of barn swallow (Hirundo rustica) nestlings to low dose ionizing radiation increased genetic damage to their peripheral erythrocytes. We estimated external radiation exposure by using thermoluminescent dosimeters, and by measuring radioactivity of the nest material. We then assessed DNA damage by means of the neutral comet assay. In addition, we conducted standard point-count censuses of barn swallows across environmental radiation levels, and estimated their abundance and local age ratio. Radioactivity of nest samples was in the range 479-143,349 Bq kg(-1), while external exposure varied between 0.15 and 4.9 mGy. Exposure to radioactive contamination did not correlate with higher genetic damage in nestlings. However, at higher levels of radioactive contamination the number of barn swallows declined and the fraction of juveniles decreased, indicating lower survival and lower reproduction and/or fledging rate. Thus, genetic damage to nestlings does not explain the decline of barn swallows in contaminated areas, and a proximate mechanism for the demographic effects documented here remains to be clarified.

Influence of Ankle Braces on the Maximum Strength of Plantar and Toe Flexor Muscles.

This study sought to investigate the influence of ankle braces on maximum strength of plantar and toe flexor muscles. 21 healthy participants volunteered, and their maximum isometric toe flexor muscle strength (TFS), plantar flexor muscle strength (PFS) and passive range of motion of the ankle joint (ROM) were measured. TFS, PFS and ROM were compared among barefoot as a control (BAR), ankle support (SUP) and ankle splint (SPL) conditions. TFS was significantly lower in SPL (90.7±32.5 N, p<0.0001) compared to BAR (117.3±39.5 N) and it was significantly lower in SPL than in SUP (110.5±36.7 N, p=0.0001), whereas it was not significantly different between SUP and BAR (p=0.2587). On the contrary, PFS and ROM were significantly lower in SUP (p=0.0087 for PFS; p=0.0095 for ROM) and SPL (p<0.0001 for PFS; p<0.0001 for ROM) compared to BAR, and they were significantly lower in SPL than in SUP (p=0.0073 for PFS; p<0.0001 for ROM). The ankle support could provide ankle joint stabilization without a large decrease in the muscle strength of the foot. The proper use of an ankle brace is required to prevent major impairment of the muscle functions of the ankle-foot complex.

Positive association between serum thymic stromal lymphopoietin and anti-citrullinated peptide antibodies in patients with rheumatoid arthritis.

Thymic stromal lymphopoietin (TSLP) has been suggested recently to play an important role in the pathophysiology of rheumatoid arthritis (RA). However, there is little information on serum TSLP concentrations in RA and its clinical significance. The present study investigated whether serum TSLP concentrations were affected in patients with RA. Using an enzyme-linked immunosorbent assay (ELISA), we measured TSLP concentrations in the serum obtained from 100 patients with RA, 60 patients with osteoarthritis (OA) and 34 healthy volunteers. We also investigated the correlation between serum TSLP concentrations and clinical parameters of disease activity in RA [disease activity score using 28 joint counts (DAS28)-C-reactive protein (CRP), DAS28-erythrocyte sedimentation rate (ESR), Clinical Disease Activity Index (CDAI]), patient's/-physician's Visual Analogue Scale (VAS), swollen joints count, tender joints count, CRP, ESR and matrix metalloproteinase-3 (MMP-3) concentrations]. In addition, we investigated the correlation between serum TSLP concentrations and anti-citrullinated peptide antibody (ACPA) and serum tumour necrosis factor (TNF)-α. Serum TSLP levels in patients with RA were significantly higher than those in patients with OA and in healthy volunteers. Interestingly, serum TSLP concentrations were correlated significantly with ACPA titres, but not with other clinical parameters. There was a significant increase in serum TSLP concentrations in patients with RA, which was correlated positively with serum ACPA titres. These findings suggest that in patients with RA, TSLP may play a role in ACPA production by B cells.

ROS evaluation for a series of CNTs and their derivatives using an ESR method with DMPO.

Carbon nanotubes (CNTs) are important materials in advanced industries. It is a concern that pulmonary exposure to CNTs may induce carcinogenic responses. It has been recently reported that CNTs scavenge ROS though non-carbon fibers generate ROS. A comprehensive evaluation of ROS scavenging using various kinds of CNTs has not been demonstrated well. The present work specifically investigates ROS scavenging capabilities with a series of CNTs and their derivatives that were physically treated, and with the number of commercially available CNTs. CNT concentrations were controlled at 0.2 through 0.6 wt%. The ROS scavenging rate was measured by ESR with DMPO. Interestingly, the ROS scavenging rate was not only influenced by physical treatments, but was also dependent on individual manufacturing methods. Ratio of CNTs to DMPO/ hydrogen peroxide is a key parameter to obtain appropriate ROS quenching results for comparison of CNTs. The present results suggest that dangling bonds are not a sole factor for scavenging, and electron transfer on the CNT surface is not clearly determined to be the sole mechanism to explain ROS scavenging.

Radiological abnormalities and low back pain in gymnasts.

Several studies have shown a higher prevalence of radiological abnormalities among gymnasts. However, the types of radiological abnormalities associated with low back pain (LBP) have not been clarified. The hypothesis was that significant relationships between radiological abnormalities and LBP may be revealed by discriminating between the types of MRI abnormalities while considering confounding factors. The subjects were 104 Japanese collegiate gymnasts (men, 70; women, 34). The presence of LBP was evaluated using the questionnaire developed by Osaka City University (OCU Test). Magnetic resonance imaging (MRI) abnormalities were evaluated using T1- and T2-weighted MRI. The prevalence of more than 1 MRI abnormality in gymnasts was 47.1% (49/104). The chi-square test showed that the incidence of lumbar disc degeneration (LDDG) and limbus vertebra was significantly greater in gymnasts with LBP than in gymnasts without LBP. By using logistic regression analysis to analyze the concomitant environmental variables, only LDDG (odds ratio, 2.70; 95% confidence interval, 1.10-6.66) was selected as a statistically significant variable accounting for LBP. In conclusion, LDDG is a predictor for LBP in Japanese collegiate gymnasts.

Analyses of laboratory data and establishment of reference values and intervals for healthy elderly people.

OBJECTIVE: Protein-energy malnutrition is a common disorder in the elderly. Although serum albumin is commonly used as a nutritional marker, data is lacking on serum albumin levels in the elderly. The purpose of this study was to determine whether serum albumin levels decrease with advancing age and to establish reference value and interval of laboratory data for elderly people (75 years and over). PARTICIPANTS: Blood samples from 13821 healthy people, 42064 outpatients, and 15959 inpatients were collected during 2008. Blood from 127 of our nutrition support team (NST) patients was also collected during August 2006 and May 2009, and analyzed. MEASUREMENTS: Serum albumin, hemoglobin, total cholesterol levels and lymphocyte count were determined. We analyzed the change in each parameter in accordance with age, compared the data for elderly people with younger people, and established new reference values. Clinical outcomes were examined depending on the improved reference values. RESULTS: Albumin was lower in older persons than in younger persons. The estimated reference value and interval were 42 (48-36) g/l in older persons and was much lower in NST patients. Hemoglobin was decreased while cholesterol and lymphocyte count were not changed in older persons: all were markedly decreased in NST patients. Terms of hospital stay were significantly longer and mortality rates were significantly higher in older persons, comparing from above to below using a new reference value of albumin (36 g/l). CONCLUSIONS: The serum albumin level decreases with advancing age, but it was maintained to some extent in healthy older people. Serum albumin levels related to the clinical outcome. Hemoglobin and cholesterol levels and lymphocyte count were all lower in NST patients. These measurements may be valuable markers of nutritional status and can help in guiding the need for nutritional support.

COL11A1 gene is associated with limbus vertebra in gymnasts.

Several studies have shown higher frequencies of radiological abnormalities among gymnasts. Recently, the gene encoding the α1 chain of type XI collagen, (COL11A1) (rs 1676486), was associated with lumbar disc herniation in the Japanese population. We hypothesized that there was a significant relationship between abnormal magnetic resonance imaging (MRI) findings of the lumbar spine and the COL11A1 4603C/T gene polymorphism in collegiate gymnasts. Our study participants included 103 Japanese collegiate gymnasts (70 men and 33 women). Radiological abnormalities were evaluated using T1- and T2-weighted MRI. Genotyping for COL11A1 was performed for all the participants. By using logistic regression analysis, we observed significant associations between limbus vertebra and age (adjusted odds ratio=0.51, 95% confidence interval: 0.27-0.96), sporting experience (adjusted odds ratio=1.49, 95% confidence interval: 1.14-1.94), and a TT genotype (adjusted odds ratio=7.83, 95% confidence interval: 1.33-46.03). We conclude that a TT genotype of COL11A1 polymorphism may be a significant risk factor for limbus vertebra in Japanese collegiate gymnasts.

Insulinoma may mask the existence of Type 1 diabetes.

BACKGROUND: Insulinoma is a tumour of insulin-producing cells of the pancreas and is known to be one of the causes of hypoglycaemia. Usually, appropriate removal of the insulinoma results in normalization of blood glucose levels. However, we found novel cases of insulinoma, in which hyperglycaemia developed soon after resection of the insulinoma. CASE REPORT: We encountered two patients with repeated hypoglycaemia caused by insulinoma. Following removal of the insulinoma, unanticipated hyperglycaemia was observed in both patients. Thereafter, their blood tests revealed low levels of serum C-peptide and high titres of anti-glutamic acid decarboxylase antibody, indicating concomitant Type 1 diabetes. Indeed, histological examination of the resected specimen revealed that one patient showed insulitis in non-tumorous pancreatic tissue in which ß-cells had already disappeared. Moreover, inflammatory cells infiltrated the insulinoma, as if it were insulitis of Type 1 diabetes, suggesting the existence of anti-islet autoimmunity. CONCLUSION: These are first cases of insulinoma associated with underlying Type 1 diabetes. Physicians should be aware of the possibility that insulinoma may mask Type 1 diabetes, and measurement of anti-islet autoantibodies may be helpful to find underlying Type 1 diabetes, such as in these cases. It is pathologically interesting that the immune cell infiltration into insulinoma may be suggestive of anti-islet autoimmunity.

Serum amyloid A low-density lipoprotein levels and smoking status in obese Japanese patients.

Serum amyloid A low-density lipoprotein (SAA-LDL) is formed by an oxidative interaction and is considered to be a new marker related to oxidative modification of LDL. As the effect of smoking on oxidized LDL is of concern, this study investigated the association between SAA-LDL and smoking status. A total of 578 Japanese obese outpatients (mean ± SD age 50.5 ± 14.3 years) were studied. Smoking status was examined via a self-reported questionnaire. Cardio metabolic variables, including high-sensitivity Creactive protein (hsCRP), were analysed in addition to SAA-LDL. There was an increasing trend in SAA-LDL levels from non- to ex- to current smokers, and significantly higher SAA-LDL levels were observed in current smokers versus non-smokers (median SAA-LDL level 36 µg/ml versus 28 µg/ml, respectively). This significant difference was reduced after adjusting for multiple confounders, including lipid levels. Smoking may be associated with increased levels of SAA-LDL in an obese Japanese population, but further studies are needed.

[Maxillary and mandibular fractures. Treatment concepts in maxillofacial surgery]. / Frakturen von Maxilla und Mandibula. Kieferchirurgische Behandlungskonzepte.

Maxillary and mandibular fractures are a relatively frequent occurrence due to the exposed location of the jaws and are caused mainly by acts of violence, traffic and recreational accidents. Mandibular fractures can be treated conservatively with dental splints and intermaxillary fixation. Since Michelet, miniplate osteosynthesis via intraoral access has become the method of choice. Champy showed that the monocortical fixation of miniplates at the level of the linea obliqua results in stable osteosynthesis, despite postoperative micro-movements in the fracture gap, and postulated the principle of dynamic compression. Dislocated fractures of the mandibular collum are treated with stable osteosynthesis via an intra- or extraoral approach, while fractures of the mandibular joint are usually treated conservatively and early functional rehabilitation is favored. For mandibular fractures, the principle of load-bearing and load-sharing should be considered, i.e. in the case of sufficient bone and uncomplicated fractures, the bone can bear most of the force, such that miniplates are sufficient (load-sharing). If bones are weakened by atrophy or in the case of infected, comminuted or defect fractures osteosynthesis plates must bear the load alone (load-bearing).

Increase in energy intake leads to a decrease in obestatin in restricting-type of anorexia nervosa.

Restricting-type of anorexia nervosa (AN-R) is a serious disorder affecting adolescents and young adults, and decreases quality of life over long period. Successful weight restoration is an important prognostic factor for disease outcome; however, the underlying mechanism of refeeding-resistance, a core psychopathology relevant to 'ambivalent' eating behaviors, remains unclear in this disorder. Obestatin plays an important role in the regulation of growth hormone release, appetite, and energy metabolism. However, the progress of these patients and changes in the levels of obestatin during treatment were not reported. The purpose of this study was to determine the changes in obestatin levels when energy intake increases in AN-R patients. As a result, obestatin was higher in AN-R patients than in control subjects as well as acyl ghrelin and des-acyl ghrelin. An increase in the intake calorie has decreased obestatin as well as des-acyl ghrelin. These findings indicate that the obestatin is an important factor in the diagnosis and treatment of AN-R, similarly to acyl ghrelin and des-acyl ghrelin. In the future, the research on the clinical application of the ghrelin peptide family and the receptor will be expected to progress.