Profiles of central nervous system surgical site infections in endoscopic transnasal surgery exposing the intradural space.

OBJECTIVE: Despite its efficacy and minimal invasiveness, the clean-contaminated nature of endoscopic transnasal surgery (ETS) may be susceptible to central nervous system surgical site infections (CNS-SSIs), especially when involving intradural exposure. However, the profiles of ETS-associated CNS-SSIs are not fully elucidated. METHODS: The institutional ETS cases performed between May 2017 and March 2023 were retrospectively analysed. The incidences of CNS-SSIs were calculated, and their risk factors examined. RESULTS: The incidence of CNS-SSIs was 2.3% (7/305) in the entire cohort and 5.0% (7/140) in ETSs with intradural exposure. All the CNS-SSIs were meningitis and developed following ETS with intradural exposure. The incidences were 0%, 5.6% and 5.8% in ETSs with Esposito grade 1, 2 and 3 intraoperative cerebrospinal fluid leakage, respectively. Among the pre- and intra-operative factors, body mass index (unit odds ratio (OR), 0.62; 95% confidence interval (CI), 0.44-0.89; P<0.01), serum albumin (unit OR, 0.03; 95% CI, 0.0007-0.92; P=0.02), and American Society of Anesthesiologists physical status score (unit OR, 20.7; 95% CI, 1.65-259; P<0.01) were significantly associated with CNS-SSIs. Moreover, postoperative cerebrospinal fluid leakage was also significantly associated with CNS-SSIs (OR, 18.4; 95% CI, 3.55-95.0; P<0.01). CONCLUSIONS: The incidence of ETS-associated CNS-SSIs is acceptably low. Intradural exposure was a prerequisite for CNS-SSIs. Malnutrition and poor comorbidity status should be recognized as important risks for CNS-SSIs in ETS.

Effect of Translucency and Curing Mode of Four CAD/CAM Materials on Polymerization Efficiency of Light and Dual Cure Resin Cements.

PURPOSE/AIM: To determine the effect of translucency of four CAD/CAM materials and different curing modes on the degree of conversion of resin cements. MATERIALS AND METHODS: Disks were fabricated from IPS e.max CAD, Vita Suprinity, Vita Enamic, and DD Cube X². Translucency was measured using a spectrophotometer. The degree of conversion of two resin cements Variolink Esthetic DC and LC were measured using a Fourier transform infrared spectrometer. For Esthetic DC, the degree of conversion was determined in self-cure and dual cure modes. ANOVA, Tukey HSD test, and /Linear Regression R2 were used to statistically analyze the data. RESULTS: There was a significant difference in the translucency of the four materials (P ⟨ 0.0001). The mean translucency of Vita Suprinity was significantly higher, followed by Vita Enamic, DD Cube X², and IPS E.max CAD. Degree of conversion of resin cements cured under DD Cube X² had the highest values (25.22%), whereas those cured under Vita Suprinity showed the lowest values (17.86%). The self-cure mode had the lowest degree of conversion values (16.22%) and dual cure mode showed the highest values (26.12%). A negative linear relationship was found between degree of conversion and translucency of the CAD/CAM materials.

Contrast ratio and masking ability of three ceramic veneering materials.

STATEMENT OF THE PROBLEM: Porcelain veneer materials are translucent and are therefore affected by their thickness as well as the color of the underlying substructure, which limits their masking ability and compromises the esthetic result in heavily stained teeth. PURPOSE: The purpose of this study was to compare the contrast ratio (CR) and masking ability of three different veneering ceramics with two thicknesses by measuring the color differences over white and black backgrounds. Correlations between CR and masking ability of these veneering ceramics were evaluated. METHODS AND MATERIALS: A total of 30 disc-shaped specimens (12 mm diameter × 1.0 mm or 1.5 mm) were fabricated in shade A2 from three types of all-ceramic systems: IPS e.max Press (IPSe; Ivoclar Vivadent, Schaan, Liechtensein), Vita VM7 (VM7; VITA Zahnfabrik, Bad Säckingen, Germany), and Nobel Rondo Press Alumina: Solo (NRPA; Nobel Biocare, Zürich-Flughafen, Switzerland). The CR, defined as the ratio of illuminance (Y) of the test material when placed on the black background (Yb) to the illuminance of the same material when placed over a white background (Yw), was determined (CR=Yb/Yw). The color (CIE L*a*b*) and Y of each specimen were measured over standard white and black tiles using a spectrophotometer (ColorEye 7000 A, Model C6, GretagMacbeth, New Windsor, NY, USA). Masking abilities of the specimens were determined by measuring the color difference (ΔE) over white and black backgrounds. Both CR and ΔE data were analyzed using two-way analysis of variance (ANOVA). One-way ANOVA was used to compare the mean values of CR across the three materials followed by the Duncan multiple comparison test. The correlations between CR and ΔE were determined by comparing R(2) values obtained from a linear regression analysis. A Student t-test for independent samples was used to compare the mean contrast ratio and ΔE values for the two thicknesses. RESULTS: CR values of NRPA were significantly less than those of IPSe and VM7, and the CR of IPSe was higher than that of VM7. Furthermore, CR increased as the thickness of the discs increased to 1.5 mm for all three materials. Mean ΔE values were significantly higher with 1.0-mm-thick discs than with 1.5-mm discs. Among the three materials it was observed that NRPA had the highest ΔE when compared with IPSe or VM7, whereas the ΔE of the latter two were not significantly different from one another. There was a strong linear correlation between CR and masking ability. CONCLUSION: CR and masking ability are affected by the type as well as the thickness of the ceramic used. IPSe and VM7 are similar in their masking abilities, whereas NRPA had the lowest masking ability. NRPA was the most translucent, followed by VM7; IPSe was the most opaque. None of the materials tested was able to completely mask the black background. It is therefore recommended that the type of ceramic should be chosen according to each clinical situation.

Regulation of muscle genes by moderate exercise.

Moderate-intensity exercise at the lactate threshold (LT) is considered to be a safe and effective training regimen for improving metabolic syndrome. The aim of the current study was to investigate the effects of moderate exercise performed at the LT on skeletal muscle gene expression. 6 healthy men participated in cycle ergometer training at LT, 60 min/d, 5 d/wk for 12 wks. Muscle samples were collected after 5 d of training, and then 2 d after training at wks 6 and 12. Quantitative real-time PCR analysis revealed that the expression of peroxisome proliferator activated receptor co-activated 1alpha was significantly increased at 1 h after the training session on day 5. Moreover, using serial analysis gene expression, we found that moderate training for 6 and 12 wks simultaneously induced the expression of a number of metabolic genes involved in the TCA cycle, beta-oxidation, and electron transport. Furthermore, several genes encoding antioxidant enzymes and contractile apparatus were induced. The expression levels of 233 novel transcripts were also altered in response to moderate exercise. Thus, moderate training at the LT is a sufficient stimulus to induce the expression of numerous genes implicated in the development of metabolic syndrome, transcripts involved in the contractile apparatus, and novel transcripts.

Gene expression profile of sprinter's muscle.

We have characterized the global gene expression profile in left vastus lateralis muscles of sprinters and sedentary men. The gene expression profile was analyzed by using serial analysis of gene expression (SAGE) method. The abundantly expressed transcripts in the sprinter's muscle were mainly involved in contraction and energy metabolism, whereas six transcripts were corresponding to potentially novel transcripts. Thirty-eight transcripts were differentially expressed between the sprinter and sedentary individuals. Moreover, sprinters showed higher expressions of both uncharacterized and potentially novel transcripts. Sprinters also highly expressed seven transcripts, such as glycine-rich protein, myosin heavy polypeptide (MYH) 2, expressed sequence tag similar to (EST) fructose-bisphosphate aldolase 1 isoform A (ALDOA), glyceraldehyde-3-phosphate dehydrogenase and ATP synthase F0 subunit 6. On the other hand, 20 transcripts such as MYH1, tropomyosin 2 and 3, troponin C slow, C2 fast, I slow, T1 slow and T3 fast, myoglobin, creatine kinase, ALDOA, glycogen phosphorylase, cytochrome c oxidase II and III, and NADH dehydrogenase 1 and 2 showed lower expression levels in the sprinters than the sedentary controls. The current study has characterized the global gene expressions in sprinters and identified a number of transcripts that can be subjected to further mechanistic analysis.

[Changes in sphingomyelinase activity, tumor necrosis factor alpha level, and lipid peroxidation rate in the course of development of cholestatic liver injury].

Changes in sphingomyelinase activity, tumor necrosis factor alpha expression, and lipid peroxidation rate in the course of development of cholestatic liver injury have been studied. The same type phase shifts in the parameters analyzed were observed, which included a marked decrease at the early stages of cholestasis (days 3-6) and a pronounced increase at the later stages (days 12-16), i.e., under the conditions of developed pathology. There is a significant positive linear correlation between tumor necrosis factor alpha expression, sphingomyelinase activity, and lipid peroxidation rate during cholestatic injury. The changes detected may reflect balance between the effects of the two major bile components--bilirubin, which is accumulated in the liver at the early stages of cholestasis, and bile acids, whose influence dominates at the later stages of pathologic process. Our results indicate that tumor necrosis factor alpha overexpression, the sphingomyelin cycle activation, and lipid peroxidation intensification may cause apoptosis of hepatocytes at the late stages of cholestasis.

Expression of prolactin receptors in human liver during cholestasis of different etiology and secondary liver cancer.

Indirect immunoperoxidase assay and computer analysis of photographic images revealed more intensive expression of prolactin receptors in hepatocytes of women compared to men. The intensity of expression was maximum in secondary liver cancer, high in obstructive jaundice of different etiology, and less pronounced in cholelithiasis. The expression of prolactin receptors in cholangiocytes was higher than in hepatocytes and was maximum during obstructive jaundice of different etiology. Cells of secondary tumors were characterized by low expression, while distant hepatocytes most intensively expressed prolactin receptors.

The I allele of the angiotensin-converting enzyme gene is associated with an increased percentage of slow-twitch type I fibers in human skeletal muscle.

The insertion (I) allele of the human angiotensin-converting enzyme (ACE) gene is associated with lower serum and tissue ACE activity, and with greater endurance performance and enhanced mechanical efficiency of trained muscle. We tested the hypothesis that the ACE-I allele may be associated with increased slow-twitch fiber, which is more efficient than fast-twitch fiber in low-velocity contraction, by examining the association between the ACE genotype and skeletal muscle fiber (SMF) types in 41 untrained healthy young volunteer subjects (31 males, 10 females, age 24 +/- 3 years). Skeletal muscle samples were taken from the left vastus lateralis using the needle-biopsy method. Slow-twitch type I fibers and fast-twitch type IIa and IIb fibers were classified histochemically based on staining for myosin adenosine triphosphatase (ATPase) activity at different pH values. Amylase-periodic acid-Schiff staining was used to visualize capillaries around fibers. ACE-II subjects had significantly (p < 0.01) higher percentages of type I fibers (50.1 +/- 13.9%vs 30.5 +/- 13.3%) and lower percentages of type IIb fibers (16.2 +/- 6.6%vs 32.9 +/- 7.4%) than ACE-DD subjects. The linear trends for decreases in type I fibers and increases in type IIb fibers from ACE-II --> ID --> DD genotypes were significant as assessed by an analysis of variance. The ratio of type I:II fibers also differed according to the ACE genotype. A multivariate logistic regression analysis showed that the ACE-I allele had significant additive and recessive (codominant) effects on the increased type I fibers and the ratio of type I:II fibers. No specific pattern of capillarization was observed among the three ACE genotypes. In conclusion, the ACE-I allele was associated with increased type I SMF, which may be a mechanism for the association between the ACE genotype and endurance performance.

Role of tumor necrosis factor alpha and sphingomyelin cycle activation in the induction of apoptosis by ischemia/reperfusion of the liver.

The signal transduction pathways triggering apoptotic mechanisms after ischemia/reperfusion may involve TNF-alpha secretion, ceramide generation, and initiation of lipid peroxidation. In the present study involvement of the TNF-alpha, sphingomyelin cycle, and lipid peroxidation in the initiation of apoptosis induced in liver cells by ischemia and reperfusion was investigated. Wistar rats were subjected to total liver ischemia (for 15, 30 min, and 1 h) followed by subsequent reperfusion. Ischemia caused sharp decrease of neutral sphingomyelinase activity. Activity of acidic sphingomyelinase initially decreased (during 15-30 min ischemia) but then increased (after 1 h of ischemic injury). Reperfusion of the ischemic lobe of the liver caused increase in neutral sphingomyelinase activity and decrease in acidic sphingomyelinase activity. A small amount of TNF-alpha detected by immunoblotting analysis was accumulated in the ischemic area of liver rapidly and the content of this cytokine dramatically increased after the reperfusion. TNF-alpha is known to induce free radical production. We found that the accumulation of TNF and increase of sphingomyelinase activity during the development of ischemic/reperfusion injury coincided with increase in content of lipid peroxidation products (conjugated dienes) and DNA degradation detected by gel electrophoresis. Recently it was shown that superoxide radicals are used as signaling molecules within the sphingomyelin pathway. This suggests the existence of cross-talk between the oxidation system and the sphingomyelin cycle in cells, which may have important implications for the initial phase and subsequent development of post-ischemic injury.

[Bone mineral density of the calcaneus and related factors in men].

In this cross-sectional study, the bone mineral density of the calcaneus was investigated in healthy young (n = 35, 22-33 years) and middle-aged (n = 49, 45-59 years) men. The relationships among the bone mineral density, body fatness, physical fitness, physical activity in recent and past days, smoking, alcohol, and sex hormones (free testosterone, estradiol, and dehydroepiandrosterone-sulfate; DHEA-S) and sex hormone binding globulin were evaluated. The speed of sound (SOS), broadband ultrasound attenuation (BUA) and stiffness were measured by ultrasonic measurement. There was no association between age and bone density in each group. In the young group, there was a positive correlation between the body mass index (BMI) and BUA and between the training time during junior high school and BUA, and an inverse correlation between alcohol consumption and SOS after adjustment for the confounding factors using partial correlation analysis. The level of DHEA-S was weakly but not significantly associated with BUA. In the middle-aged group, there was an inverse correlation between the waist to hip ratio and SOS, and between the height of jump and SOS after adjustment for the confounding factors using partial correlation analysis. These results suggest that different factors may affect bone density in the young and middle-aged men. In young men, the higher BMI and the longer training time during boyhood may have a positive effect, and heavy alcohol consumption may have a negative effect on bone density. In middle-aged men, abdominal fat accumulation has a negative effect and leg muscle power has a positive effect on bone density.

Th1-biased immune responses induced by DNA-based immunizations are mediated via action on professional antigen-presenting cells to up-regulate IL-12 production.

The efficacy of DNA-based immunization in conferring protective immunity against certain microbial pathogens including human immunodeficiency virus type 1 (HIV-1) has been described. The potential advantage of DNA-based immunization over the traditional vaccines largely results from its capacity to efficiently induce Th1-biased immune responses against an encoded antigen. We describe how Th1-biased immune responses are induced by DNA-based immunization, using a DNA vaccine construct encoding HIV-1 gp160 cDNA and an eukaryotic expression plasmid carrying murine IFN-gamma cDNA. Transfection of an eukaryotic expression plasmid carrying immunostimulatory sequences (ISS) as well as a gene of interest (DNA vaccine) into professional antigen presenting cells (APC) induced transactivation of IL-12 mRNA, which resulted in antigen-specific Th1-biased immune responses against the encoded antigen. Th1-biased immune responses induced by DNA-based immunization were substantially upregulated by a codelivery of an ectopic IFN-gamma expression system, and this augmentation was mediated via action on professional antigen presenting cells to upregulate IL-12 production. Taken together, it appears likely that Th1-biased immune responses induced by DNA-based immunization are mediated via action on professional antigen-presenting cells to produce IL-12. Interestingly, the model provided strikingly resembles that previously described in infection with Listeria monocytogenes, an intracellular Gram-positive bacterium that induces strong Th1-biased immune responses. The result suggests that DNA-based immunization mimics certain aspects of natural infection with microbial organisms like attenuated vaccines, which in turn provides a rationale to the question of why DNA-based immunization so efficiently induces protective immunity against these microbial pathogens.

Lifestyle-related risk factors for total and cancer mortality in men and women.

We conducted a 14-year follow-up study to analyze the hazard ratio (HR) of mortality regarding lifestyle-related factors in Saga Prefecture, Japan. The subjects included 2,170 people, who were randomly selected from men and women aged from 40 to 69 years old, and who also completed the standardized questionnaire on lifestyle in 1983. Information about death and corresponding data were obtained either by mail and/or through the city offices in 1997. We found that a lower body weight, a lower physical fitness level, not consuming a balanced diet, and cigarette smoking to be significantly elevated risks for all-causes of death in males after adjustment by age and health status. In addition, these results did not change even after excluding subjects for early death. The HR of the female subjects who quit smoking was significantly high, although it changed to insignificant after excluding subjects for early death. These results suggested that being underweight might be an index of a positive risk of death, while maintaining a higher physical fitness level, being careful to consume a more balanced diet, and non smoking all appear to be indexes of a negative risk of death. In addition, these results might also be considered good evidence for improving poor health habits in health promotion activities.

Decreased skeletal muscle capillary density is related to higher serum levels of low-density lipoprotein cholesterol and apolipoprotein B in men.

The relationships between skeletal muscle morphology, particularly muscle fiber capillary density, and serum lipid profiles were evaluated in 25 non-obese men aged 18 to 36 years (body mass index [BMI], 22.7 +/- 2.5 kg/m2; body fat, 13.6% +/- 4.0%, maximal oxygen uptake [VO2max], 46.2 < or = 6.3 mL/kg/min). Skeletal muscle samples were taken from the vastus lateralis using the needle-biopsy method. The fiber types (I, IIa, and IIx) and their percent distribution, the indices of capillary density, and the diffusion index expressed as the cross-sectional area occupied by one capillary were determined. Blood samples were drawn from the antecubital vein after a 12-hour fast. Based on Pearson's correlation analysis, the number of capillaries around type IIx fiber correlated inversely with the serum level of low-density lipoprotein cholesterol ([LDL-C] r = -.50, P < .05). The number of capillaries per fiber (cap/fiber ratio), number of capillaries per area (cap/mm2), and capillaries around each fiber type correlated inversely with the serum level of apolipoprotein B ([apo B] r = -.40 to -.54, P < .05 to .01). Further, the diffusion index for each fiber type correlated positively with LDL-C and apo B (r = .42 to .50, P < .05 to .01). Among 14 subjects in whom high-density lipoprotein cholesterol (HDL-C) subfractions were analyzed, a positive correlation was found between cap/mm2 and HDL2-C (r = .64, P < .05). Partial correlation analysis showed that these correlations either remain or improve after adjusting for age, VO2max, and body fatness. These results indicate that skeletal muscle capillary density and diffusion capacity are related to lipid and apolipoprotein concentrations for both type I and type II fibers.

Role of endogenous TNF-alpha and sphingosine in induced DNA synthesis in regenerating rat liver after partial hepatectomy.

Cytokine-stimulated metabolism of sphingomyelin results in the accumulation of ceramide and sphingosine which play a part in the regulation of cell proliferation, differentiation, and reception, as well as in oncogenesis. Formation of TNF-alpha (a member of the cytokine family), accumulation of sphingosine, and DNA synthesis (measured by immunoblotting, HPLC, and [3H]thymidine incorporation, respectively) were studied in rat liver after partial hepatectomy. The content of TNF-alpha was found to increase during 12 h following hepatectomy. The maximum of sphingomyelinase activity and accumulation of sphingosine precede the maximum of DNA synthesis. Sphingosine is known to inhibit protein kinase C. On the other hand, it stimulates the metabolism of phosphatidylinositol, thus causing accumulation of diacylglycerol and inositol-1,4,5-triphosphate, which in turn activate protein kinase C. Hence, the release of TNF-alpha in regenerating liver may modulate DNA synthesis through the accumulation of sphingosine which is involved in regulation of protein kinase C activity and of phosphatidylinositol turnover.

[Changes in the activity of neutral and acidic isoforms of sphingomyelinase in hepatoma-22, regenerating and ischemic liver]. / Izmenenie aktivnosti neitral'noi i kisloi izoform sfingomielinazy v gepatome-22, v regeneriruiushchei i ishemizirovannoi pecheni.

Activity of neutral and acidic sphingomyelinases (N- and A-SMases) were studied in regenerating liver after partial hepatectomy (during 48 hrs after operation), in ischemic liver during 15, 30 min and 1 and 2 hrs ischemia and during following reperfusion (from 5 min up to 2 hrs), in hepatoma- 22 after 15 days of transplantation and in liver of tumor bearing animals. It was shown that activity of N-SMase is increased in hepatoma-22 and in regenerating liver and it is decreased in ischemic liver. Following reperfusion of ischemic liver area activity of enzyme was found to have returned to baseline in dependence on time of ischemia and reperfusion. Activity of A-SMase is decreased in tumor, is not changed in regenerating liver and increased after long time of ischemia. It was supposed that N-SMase is involved in cell proliferation, but A-SMase is connected with cell damage.

Physiological levels of estradiol correlate with lipid / lipoprotein profiles in healthy men.

In this cross-sectional study, the relationships of the physiological levels of estradiol (E2) and dehydroepiandrosterone-sulfate (DHEA-S) to the lipid and lipoprotein profiles were investigated in 212 apparently healthy men aged from 18 to 59 years old. These subjects were divided into tertiles according to the levels of E2 and DHEA-S, respectively. We performed one-way analysis of variance and analysis of co-variance controlling for age, body mass index, percent body fat, waist to hip ratio, maximal oxygen uptake, alcohol and cigarette consumptions as confounding factors.A lower E2 level was associated with higher concentrations of total cholesterol (TC) and low density lipoprotein cholesterol. A lower DHEA-S level was associated with a lower concentration of high density lipoprotein cholesterol (HDLC) and a higher ratio of TC / HDLC. These correlations remained significant after adjusting for the above confounding factors. Neither free testosterone nor sex hormone-binding globulin was associated with the lipids and lipoproteins. These results suggest that higher levels of E2 and DHEA-S, at least in physiological concentrations, are related to the favorable lipid and lipoprotein levels in men.

[A survey of allergic diseases among elementary school children in Saga Prefecture. The first report. Prevalence and past history].

This study was carried out to determine the prevalence of several allergic diseases among elementary school children in Saga prefecture. A questionnaire was distributed to the parents of 2,795 children in 12 elementary schools located in urban, seaside and mountainous areas. The response rate was 92.8%. The prevalence rate of allergic diseases among school children was 24.6% (24.5% for boys and 21.5% for girls). The common types of allergic diseases among boys were allergic rhinitis (11.3%), atopic dermatitis (9.7%), and bronchial asthma (5.7%), and those among girls were atopic dermatitis (9.7%); allergic rhinitis (6.5%), and bronchial asthma (3.7%). Analysis by residential area of the children, showed that the prevalence rate of allergic diseases in total was increased in the order of mountainous (20.8%), seaside (24.1%) and urban area (28.7%). The most common type of allergic diseases was atopic dermatitis in urban and mountainous area, while allergic rhinitis was most common in seaside area.

High blood pressure and muscle morphology/metabolism--causal relationship or only associated factors?

As muscle tissue constitutes a main target organ for glucose metabolism and is responsible for the development of insulin resistance, it seems plausible to elucidate the relationship between blood pressure and muscle morphology and metabolism. The association between blood pressure and capillarization/morphology of the vastus lateralis muscle and metabolic variables was evaluated in 24 perimenopausal obese women [body mass index (BMI) 34.9 +/- 1.1; waist-hip ratio (WHR) 0.90 +/- 0.02]. The muscle enzyme activity of lipoprotein lipase (LPL), citrate synthase and glycogen synthase was determined. There was a significant negative correlation between the percentage of type I fibres and relative fibre area of type I on the one hand and systolic and diastolic blood pressure on the other. There was a negative correlation between the capillary density (i.e. number of capillaries/muscle fibre) and a positive correlation between the diffusion distance (fibre area supplied by one capillary) and diastolic blood pressure. The activities of LPL and citrate synthase were positively correlated with the percentage of type I and negatively correlated with the percentage of type II muscle fibres. The activity of LPL was also negatively correlated with plasma glucose and the insulin/C-peptide ratio. The insulin/C-peptide ratio was positively correlated with the percentage of type II muscle fibres. In stepwise multiple regression analyses, 20-30% of the variation in systolic and diastolic blood pressure could be explained by the variables of muscle fibre distribution. Excluding muscle morphological variables from the regression model, the insulin/C-peptide ratio accounted for 13% of the variation in systolic and diastolic blood pressure. The results of the study show the close association between muscle morphology and blood pressure. It remains to be elucidated whether this association indicates a causal relationship.