Fabrication and Characterization of Oleofoams Composed of Tribehenoyl-glycerol: Toward a Stable and Higher Air-content Colloidal System.

Oleofoams have garnered significant attention in many personal care applications because of their favorable physicochemical properties, including texture and detergency. To explore the potential use of mixtures of high-melting-point fat crystals (tribehenoyl-glycerol [BBB]) and edible oils as low-cost and stable aeration systems, we created oleofoams composed of olive oil and BBB. By whipping the BBB/olive oil oleogels after rapid cooling and subsequent heating, we successfully prepared oleofoams without emulsifier additives. Mixtures of the BBB/olive oil formed oleofoams at BBB concentrations of 4.0-20.0 wt.%. The resultant oleofoams maintained their overrun rates and did not coalesce, even with additional whipping after the overrun rate was maximized. More closely packed bubbles, concentrated bubble size distributions, and stronger interfacial elasticity were attributed to the increasing BBB concentrations, and the thermal results revealed that further heating was required to damage the foam structure. The characteristics of these new oleofoams are closely related to their BBB concentrations, and the observed effects are attributed to the network structure of the thickened crystal layer and enhanced gelling in the oil phase.

Heat stroke management during the COVID-19 pandemic: Recommendations from the experts in Japan (2nd edition).

Both coronavirus disease 2019 (COVID-19) and heat stroke have symptoms of fever or hyperthermia and the difficulty in distinguishing them could lead to a strain on emergency medical care. To mitigate the potential confusion that could arise from actions for preventing both COVID-19 spread and heat stroke, particularly in the context of record-breaking summer season temperatures, this work offers new knowledge and evidence that address concerns regarding indoor ventilation and indoor temperatures, mask wearing and heat stroke risk, and the isolation of older adults. Specifically, the current work is the second edition to the previously published guidance for handling heat stroke during the COVID-19 pandemic, prepared by the "Working group on heat stroke medical care during the COVID-19 epidemic," composed of members from four organizations in different medical and related fields. The group was established by the Japanese Association for Acute Medicine Heatstroke and Hypothermia Surveillance Committee. This second edition includes new knowledge, and conventional evidence gleaned from a primary selection of 60 articles from MEDLINE, one article from Cochrane, 13 articles from Ichushi, and a secondary/final selection of 56 articles. This work summarizes the contents that have been clarified in the prevention and treatment of infectious diseases and heat stroke to provide guidance for the prevention, diagnosis, and treatment of heat stroke during the COVID-19 pandemic.

Investigating age and regional effects on the relation between the incidence of heat-related ambulance transport and daily maximum temperature or WBGT.

BACKGROUND: Although age and regional climate are considered to have effects on the incidence ratio of heat-related illness, quantitative estimation of age or region on the effect of occurring temperature for heat stroke is limited. METHODS: By utilizing data on the number of daily heat-related ambulance transport (HAT) in each of three age groups (7-17, 18-64, 65 years old, or older) and 47 prefectures in Japan, and daily maximum temperature (DMT) or Wet Bulb Globe Temperature (DMW) of each prefecture for the summer season, the effects of age and region on heat-related illness were studied. Two-way ANOVA was used to analyze the significance of the effect of age and 10 regions in Japan on HAT. The population-weighted average of DMT or DMW measured at weather stations in each prefecture was used as DMT or DMW for each prefecture. DMT or DMW when HAT is one in 100,000 people (T1 and W1, respectively) was calculated for each age category and prefecture as an indicator of heat acclimatization. The relation between T1 or W1 and average DMT or DMW of each age category and prefecture were also analyzed. RESULTS: HAT of each age category and prefecture was plotted nearly on the exponential function of corresponding DMT or DMW. Average R2 of the regression function in 47 prefectures in terms of DMW was 0.86, 0.93, and 0.94 for juveniles, adults, and elderly, respectively. The largest regional difference of W1 in 47 prefectures was 4.5 and 4.8 °C for juveniles and adults, respectively between Hokkaido and Tokyo, 3.9 °C for elderly between Hokkaido and Okinawa. Estimated W1 and average DMT or DMW during the summer season for 47 prefectures was linearly related. Regarding age difference, the regression line showed that W1 of the prefecture for DMW at 30 °C of WBGT was 31.1 °C, 32.4 °C, and 29.8 °C for juveniles, adults, and elderly, respectively. CONCLUSIONS: Age and regional differences affected the incidence of HAT. Thus, it is recommended that public prevention measures for heat-related disorders take into consideration age and regional variability.

Formation and Physical Analysis of Oleogels Composed of Edible Oils and High-Melting Fat Crystals.

This paper reports the preparation of oleogels composed of edible oils (olive oil, squalene, and caprylic/capric triglyceride) and high-melting fat crystals (tribehenoyl-glycerol (BBB)) to explore the potential use of BBB/edible oil mixtures as low-cost and stable gelators. These mixtures exhibited gel-like behaviors upon rapid cooling and subsequent heating. The mixtures of BBB in the liquid oils formed oleogels at BBB concentrations > 4.0 wt%. The thermal behaviors, crystal structures, and crystal morphologies of mixtures of BBB produced from 6.0 wt% BBB crystals in 94.0 wt% liquid oils were examined following the treatment of these systems according to different temperature regimes. In addition, rheological analysis was conducted to evaluate the physical properties and storage stabilities of the prepared oleogels. It was found that rapid cooling to the crystallization temperature (Tc) from 70°C and subsequent heating to the final temperature (Tf) were necessary to reveal the gel-like behavior. In addition, the crystals treated with rapid cooling were smaller and more uniform in size than those treated with a simple cooling procedure. The differential scanning calorimetry melting peaks were broad or split, and exhibited the eutectic mixing behavior of multi-component triacylglycerols. The X-ray diffraction spectra showed that the melt-mediated α to ß transformation of the mixtures was a prerequisite for revealing the gel-like behavior. Moreover, the tempering procedure was found to influence the physical properties of the oleogels, wherein no visible changes were observed for any of the oleogels after rapid cooling and storage for 6 months at 25°C.

Elevated Hydrostatic Pressure Causes Retinal Degeneration Through Upregulating Lipocalin-2.

Elevation of intraocular pressure is a major risk factor for glaucoma development, which causes the loss of retinal ganglion cells (RGCs). Lipocalin 2 (Lcn2) is upregulated in glaucomatous retinae; however, whether Lcn2 is directly involved in glaucoma is debated. In this study, retinal explant cultures were subjected to increased water pressure using a two-chamber culture device, and Lcn2 protein levels were examined by immunoblotting. In situ TdT-mediated dUTP nick and labeling (TUNEL) and glial fibrillary acidic protein (GFAP) immunohistochemical assays were performed to assess apoptosis and gliosis, respectively. The neurotoxicity of Lcn2 in the retinal explant culture was determined with exogenous administration of recombinant Lcn2. The Lcn2 protein levels, percentage of TUNEL-positive cells, and GFAP-positive area were significantly higher in retinae cultured under 50 cm H2O pressure loads compared to those cultured under 20 cm H2O. We found that Lcn2 exhibited neurotoxicity in retinae at dose of 1 µg/ml. The negative effects of increased hydrostatic pressure were attenuated by the iron chelator deferoxamine. This is the first report demonstrating the direct upregulation of Lcn2 by elevating hydrostatic pressure. Modulating Lcn2 and iron levels may be a promising therapeutic approach for retinal degeneration.

Kinetic Study on Alpha-Form Crystallization of Mixed-Acid Triacylglycerols POP, PPO, and Their Mixture.

The crystallization behavior of the metastable α form of triacylglycerols (TAGs) plays a critical role as a precursor for the crystallization of more stable ß' and ß forms for various applications in food and pharmaceutical products. However, precise analysis of the crystallization kinetics of α has not been performed, likely due to its rapid and complex behavior. This paper presents the observation results of the initial stages of the isothermal crystallization kinetics of α forms of 1,3-dipalmitoyl-2-oleoyl-glycerol (POP), 1,2-dipalmitoyl-3-oleoyl-rac-glycerol (rac-PPO), and molecular compound (MC) crystals of a POP/rac-PPO (1/1) mixture (MCPOP/PPO) using synchrotron radiation time-resolved X-ray diffraction and polarized optical microscopy. In all the TAGs, α crystals with a worm-like morphology started to grow rapidly in the first stage. Then, the α crystals slowly transformed into more stable forms in different manners for different TAG samples. In POP, the conversion was simple, as the α-2 form transformed into γ-3, whereas in rac-PPO, the lamellar distance values of the α-2 form continuously decreased with time and changed into the α-3 form. In the MCPOP/PPO crystals, in contrast, separate crystallization of α-2 of a rac-PPO fraction initially occurred, followed by the crystallization of α-2 of POP, and the two α forms merged into α-2 of MCPOP/PPO. This separate crystallization was caused by large differences in the crystallization kinetics of the α forms of POP and rac-PPO.

Mixing Ratio and Cooling Rate Dependence of Molecular Compound Formation in OPO/POP Binary Mixture.

Owing to the increasing reports of the harmful effects of trans and saturated fatty acids, the demand for trans- and saturated-fatty-acid-free oil and fat products is increasing among consumers. However, it is difficult to maintain the product stability and shape retention of such oil and fat products. As a result, there is a high demand in the processed oil and fat industry to develop solutions to such problems. Herein, we used molecular compound (MC) crystals in an attempt to find alternatives to trans and saturated fatty acids. The MCs used were 1,3-dioleoyl-2-palmitoyl-sn-glycerol (OPO) and 1,3-dipalmitoyl-2-oleoyl-sn-glycerol (POP)-the main components of lard and palm oil, respectively. We believe that OPO and POP can be used to obtain no-trans, low-saturation, and high-oleic-acid oil and fat products. Optimal conditions for efficient MC crystallization were examined by changing the oil and fat composition under rapid cooling conditions assuming industrial cooling process by using differential scanning calorimetry and synchrotron radiation time-resolved X-ray diffraction methods. It was concluded that the increase in OPO concentration destabilized MC formation, while the increase in POP concentration stabilized it under rapid cooling conditions. As a result, it was shown that MC crystals can be efficiently obtained by reducing the degree of POP supercooling.

Multiple ß Forms of Saturated Monoacid Triacylglycerol Crystals.

We have investigated the polymorphism of triacylglycerol (TAG) crystals as they affect the qualities such as shelf life, mouth feel, and texture of chocolate and other products. Saturated monoacid TAGs, like trilaurin, are considered as models for TAG crystallization; however, there is still debate about the number of their polymorphs that exist. In this study, we characterized a set of novel polymorphs, ß forms of saturated monoacid TAGs, which were obtained via different pathways depending on the crystallization history, by polarized light microscopy, X-ray diffraction, and differential scanning calorimetry. Saturated monoacid TAGs were crystallized as the unstable polymorphs, the α or ß' forms first, and then they were transformed into ß forms by solid-solid transformations. The ß form that had transformed from ß' changed its morphology by a polymorphic transformation, while the ß form made from the α form kept its spherulite morphology. The ß forms obtained showed different melting points. Additional heat treatment promoted further polymorphic transformation. Four novel ß forms were found for each of the saturated monoacid TAGs, trilaurin, trimyristin, tripalmitin, and tristearin. They showed similar polymorphism with the same subcell packing.

Comparison of correction factor for both dynamic total thermal insulation and evaporative resistance between ISO 7933 and ISO 9920.

BACKGROUND: Thermal insulation and evaporative resistance of clothing are the physical parameters to quantify heat transfer and evaporative dissipation from the human body to the environment, respectively. Wind and body movement decrease thermal insulation and evaporative resistance of clothing, which is represented as correction factors for dynamic total thermal insulation (CFi) and evaporative resistance (CFe), respectively. Then, CFi and CFe are parts of the key parameters to predict heat strain of workers by computer simulation. The objective of this study was to elucidate the difference of CFi and CFe between ISO 7933 and ISO 9920 and compare the difference of predicted rectal temperature, water loss, and exposure time limit calculated by using each correction factor. METHODS: CFi of ISO 7933 (CFi7933) and ISO 9920 (CFi9920), and CFe of ISO 7933 (CFe7933) and two kinds of CFe of ISO 9920 (CFe9920a, CFe9920b) were compared in terms of relative air velocity, walking speed for three kinds of thermal insulation of clothing. Next, two modified predicted heat strain (PHS) models were developed: modified PHS integrated with CFi9920 and CFe9920a (PHSmA) and modified PHS integrated with CFi9920 and CFe9920b (PHSmB). We calculated the rectal temperature, water loss, and exposure time limit by PHS, PHSmA, and PHSmB and compared the results. RESULTS: CFi7933 and CFi9920 were almost similar in terms of Var and walking speed, while CFe9920a and CFe9920b were larger than CFe7933 when Var was more than 1.0 m·s-1. Intrinsic clothing insulation (Icl) diminished the effects of Var on CFi7933, CFi9920, CFe7933, and CFe9920b. However, CFe9920a was not influenced by Icl. The predicted rectal temperature and water loss difference were larger between PHS and PHSmA as CFe difference got larger. The duration time when limit of rectal temperature of 38 °C was reached (DlimTre38) calculated by PHS was significantly longer than PHSmA, PHSmB at higher Var. CONCLUSIONS: Precise correction factors for evaporative resistance are required to predict rectal temperature, water loss, and work-time limits.

Microsporidial keratitis retrospectively diagnosed by ultrastructural study of formalin-fixed paraffin-embedded corneal tissue: a case report.

BACKGROUND: The utility of formalin-fixed paraffin-embedded (FFPE) corneal tissue specimens for retrospective diagnosis of microsporidial keratitis was evaluated by transmission electron microscopy (TEM) analysis and the possible second case of microsporidial keratitis after Descemet stripping automated endothelial keratoplasty (DSAEK) was described. CASE PRESENTATION: A 68-year-old man presented with multiple crystalline opacities in the corneal stroma that progressed extremely slowly after DSAEK. Fungiflora Y staining of corneal scrapings from the affected regions revealed an oval microorganism. Topical voriconazole administration was ineffective and penetrating keratoplasty was performed. Histological and molecular analyses were carried out on the excised cornea. Ziehl-Neelsen staining revealed an acid-fast, oval organism that was visible by ultraviolet illumination after Fungiflora Y and Uvitex 2B staining, whereas periodic acid-Schiff and Grocott's staining did not yield any significant findings. Microsporidium was detected by TEM of FFPE tissue. Nosema or Vittaforma sp. was suspected as the causative microorganism by PCR of FFPE tissue and by the fact that those species are known to cause eye infection. The corneal graft has maintained transparency at 1 year and half postoperatively. CONCLUSIONS: This is the first known case of microsporidial keratitis diagnosed retrospectively by molecular and ultrastructural study of FFPE tissue, and the possible second case of microsporidial keratitis after DSAEK. Microsporidial keratitis should be considered when corneal opacity refractory to conventionally known therapy would occur after DSAEK. Our findings suggest that more microsporidial keratitis cases than have been reported to date can be identified by TEM or PCR examination of FFPE corneal specimens.

Effects of ventilation openings in industrial safety helmets on evaporative heat dissipation.

OBJECTIVES: This study aimed to investigate the effects of ventilation openings in commercial industrial safety helmets (ISHs) on evaporative heat dissipation. METHODS: Seven models of commercial ISH were examined quantitatively by a sweating thermal head manikin (SHM) with six separate zones. To simulate summer outdoor conditions, the measurements were done in a climate chamber, with the room temperature and relative humidity set at 34.0°C and 50%, respectively. The shell temperature of SHM was set at 34.0°C. Wind was blown from the front or left side at 1.0, 2.0, and 3.0 m/s. The necessary heat flux to keep the manikin skin temperature at 34.0°C was counted as evaporative heat dissipation in each zone. RESULTS: Openings at the front and back, and openings between the body and brim of the helmet played a significant role in increasing the heat flux in Forehead zone, but in all zones as a total, the effects were not significant. Heat flux for ISH with openings on both the right and left sides was not significantly different from that without openings. CONCLUSIONS: Our study utilizing SHM showed that ventilation openings on both the right and left sides or front and back sides of commercial ISHs were not significantly effective in increasing total evaporative heat dissipation under an equivalent temperature of ambience and manikin shell. Further improvements on ISH are needed to increase evaporative heat dissipation.

Binary Phase Behavior of Saturated-Unsaturated Mixed-Acid Triacylglycerols-A Review.

Most natural lipids contain a complex mixture of individual triacylglycerols (TAGs). An in-depth knowledge of the mixing behavior of TAGs is necessary for the rational design and engineering of food materials. The binary phase diagram of TAGs is a simplified model that can be explored to help foster an understanding of the phase behavior of complex fats and oils. This article reviews recent research on the binary phase behavior of saturated-unsaturated mixed-acid TAGs, with special emphasis on the stearicunsaturated and palmitic-unsaturated diacid TAGs. The occurrence of polymorphic forms and mutual solubility of TAG mixtures are strongly related to the glycerol conformation of the saturated-oleic diacid TAGs; it appears to be most influenced by the chain-length mismatch in saturated-elaidic diacid TAGs. In addition, the polymorphism of pure enantiomers and racemic mixture of chiral TAGs was also reviewed, while the effect of chirality on mixing behavior was discussed.

Background factors and short-term health-related quality of life in patients who initially underwent radical prostatectomy or androgen deprivation therapy for localized prostate cancer in a Japanese prospective observational study (J-CaP Innovative Study-1).

BACKGROUND: This prospective observational study elucidated the usefulness of hormonal therapy for localized prostate cancer. Background factors and the health-related quality of life in patients who initially underwent radical prostatectomy (RP) or primary androgen deprivation therapy (PADT) for localized prostate cancer are summarized. MATERIALS AND METHODS: Patients aged 67-76 years with clinical stage T1c or T2 localized prostate cancer treated with PADT or RP, a prostate-specific antigen concentration of <20 ng/mL, and Gleason score of ≤7 were included. Health-related quality of life results estimated by the Medical Outcomes Study 8-Item Short-Form Health Survey (SF-8) and the Expanded Prostate Cancer Index Composite (EPIC) were investigated. RESULTS: In total, 850 patients who underwent RP and 370 patients who underwent PADT were enrolled. The proportion of patients with comorbidities of hypertension, cardiovascular disease, and/or cerebrovascular disease was greater in the PADT group than in the RP group. The proportion of patients deciding on treatment was significantly higher in the PADT group than in the RP group. In the RP group, the scores of many SF-8 and EPIC domains decreased at 3 months following surgery and returned to baseline levels at 1 year. In the PADT group, several domains gradually decreased during the year after treatment initiation. The proportion of patients with decreased satisfaction scores at 1 year compared with baseline was lower in the PADT group than that in the RP group. CONCLUSION: Treatment risk influenced decisions on primary treatment for localized prostate cancer. Although there was a selection bias, short-term overall satisfaction in the PADT group was superior to that in the RP group in this clinical study.

Heat Strain and Hydration of Japanese Construction Workers during Work in Summer.

Objectives: The aim was to ascertain hydration and heat strain of construction workers in Japan during the summer who are at the highest risk of heat-related disorders. Methods: The subjects were 23 construction workers, whose average age was 41, average weight was 69 kg, and average height was 170 cm. We measured thermal working conditions with a wet bulb globe temperature (WBGT) measurement instrument affixed to the helmet of each worker, at fixed points outdoors in the sun and indoors. Heat strain was evaluated for water intake, urine specific gravity (Usg), urine temperature (UT), heart rate (HR), and body weight during work. Results: The average WBGT measured on the worker helmets over 3 consecutive days was 28.0 ± 0.7, 27.6 ± 0.8, and 27.6 ± 1.1°C. The average water intake was 2.6 l during a work shift. The average Usg, UT, and % HR reserve were the highest in the first half of afternoon work. Seventy-eight percent of the subjects exceeded at least one of the ACGIH TLV physiological guidelines for heat strain in terms of HR and weight loss or a clinically dehydrated level of Usg. Conclusions: Heat strain was the highest in the first half of afternoon work. The number of dehydrated workers increased during this shift because of insufficient water intake. Adequate hydration is required to decrease the risk of heat-related disorders among construction workers in the summer.

Early Gene Expression Profile in Retinal Ganglion Cell Layer After Optic Nerve Crush in Mice.

Purpose: Optic nerve crush (ONC) induces retinal ganglion cell (RGC) death, which causes vision loss in glaucoma. To investigate early events leading to apoptosis of RGCs, we performed gene expression analysis of injured retinas in the period before RGC loss. Methods: The temporal changes of gene profiles at 0, 1, and 4 days after ONC were determined by DNA microarray. To verify the gene expression changes in RGCs, we enriched RGCs by laser-captured microdissection and performed real-time RT-PCR of 14 selected genes. In situ localization study was performed by immunohistochemistry. Results: At 1 day and 4 days after ONC, 1423 and 2010 retinal genes were changed compared with 0 day, respectively; these genes were mainly related to apoptotic process, immune process, regulation of cell cycle, and ion transport. RT-PCR analysis revealed that expression levels of Activating transcription factor 3 (Atf3), Lipocalin 2 (Lcn2), and tumor necrosis factor receptor superfamily member 12a (Tnfrsf12a) were remarkably changed in RGC-enriched fraction within 4 days postcrush. Immunohistochemical analysis confirmed that all of these genes expressed highly in the ganglion cell layer of crushed retinas. Conclusions: In response to ONC, the expression of apoptotic genes was stimulated soon after crush. Atf3, Lcn2, and Tnfrsf12a might be key molecules responsible for RGC loss in glaucoma.

Deconvolution of partially compensated solar images from additional wavefront sensing.

A technique for restoring solar images partially compensated with adaptive optics is developed. An additional wavefront sensor is installed in an adaptive optics system to acquire residual wavefront information simultaneously to a solar image. A point spread function is derived from the wavefront information and used to deconvolve the solar image. Successful image restorations are demonstrated when the estimated point spread functions have relatively high Strehl ratios.

Validation of TNM classification for metastatic prostatic cancer treated using primary androgen deprivation therapy.

PURPOSE: The current tumor-node-metastasis (TNM) classification system has been used for many years. The prognosis of patients with metastatic prostate cancer (mPC) treated using primary androgen deprivation therapy (PADT) was analyzed according to the TNM classification. METHODS: A total of 5618 cases with lymph node metastases only (N1M0), non-regional lymph node metastasis (M1a), bone metastasis (M1b), and distant metastasis (M1c) were selected from the Japanese Study Group of Prostate Cancer database. Overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS) rates were calculated using Kaplan-Meier analysis. The influence of clinical variables on patient prognosis was evaluated using the Cox proportional hazard regression model. RESULTS: The 5-year OS, CSS, and PFS were 76.0, 83.2, and 38.8% in N1M0, 57.5, 69.0, and 23.0% in M1a, 54.0, 63.1, and 23.0% in M1b, and 40.0, 51.5, and 16.6% in M1c, respectively. OS, CSS, and PFS worsened as the stages progressed. OS, CSS, and PFS were all significantly worse in N1M1b compared with N0M1b. Multivariate analysis revealed that OS and CSS were worse in patients with a Gleason score ≥8 and that combined androgen blockade (CAB) treatment provided better OS than non-CAB treatments at any tumor stage. However, OS and CSS were worse in individuals with a prostate-specific antigen >100 ng/ml only in M1b. CONCLUSIONS: Patient prognosis worsened with stage progression; therefore, current TNM classification system of mPC for PADT was shown to be trustworthy. Each PC cell that develops bone or lymphoid metastasis may exhibit different characteristics.

Clinical outcomes and nadir prostate-specific antigen (PSA) according to initial PSA levels in primary androgen deprivation therapy for metastatic prostate cancer.

PURPOSE: To investigate the clinical outcomes of metastatic prostate cancer patients and the relationship between nadir prostate-specific antigen (PSA) levels and different types of primary androgen deprivation therapy (PADT). This study utilized data from the Japan Study Group of Prostate Cancer registry, which is a large, multicenter, population-based database. METHODS: A total of 2982 patients treated with PADT were enrolled. Kaplan-Meier analysis was used to compare progression-free survival (PFS) and overall survival (OS) in patients treated using combined androgen blockade (CAB) and non-CAB therapies. The relationships between nadir PSA levels and PADT type according to initial serum PSA levels were also investigated. RESULTS: Among the 2982 enrolled patients, 2101 (70.5 %) were treated with CAB. Although CAB-treated patients had worse clinical characteristics, their probability of PFS and OS was higher compared with those treated with a non-CAB therapy. These results were due to a survival benefit with CAB in patients with an initial PSA level of 500-1000 ng/mL. Nadir PSA levels were significantly lower in CAB patients than in non-CAB patients with comparable initial serum PSA levels. CONCLUSIONS: A small survival benefit for CAB in metastatic prostate cancer was demonstrated in a Japanese large-scale prospective cohort study. The clinical significance of nadir PSA levels following PADT was evident, but the predictive impact of PSA nadir on OS was different between CAB and non-CAB therapy.

Use of preoperative factors including urodynamic evaluations and nerve-sparing status for predicting urinary continence recovery after robot-assisted radical prostatectomy: Nerve-sparing technique contributes to the reduction of postprostatectomy incontinence.

AIMS: To examine which preoperative factors, including urodynamic evaluations, and operative procedures could predict continence status after robot-assisted radical prostatectomy (RARP) in this study. MATERIALS AND METHODS: Univariate and multivariate logistic regression analyses of preoperative factors such as age, body mass index, prostate-specific antigen level before biopsy, prostate size before surgery, membranous urethral length measured using magnetic resonance imaging (MRI), bladder compliance and maximum urethral closure pressure (MUCP) measured by urodynamic study (UDS), and nerve-sparing (NS) status predicting 24-hr pad test >2 g/day at 1 year after RARP were examined in 111 patients enrolled in this study. RESULTS: The number of patients with incontinence at 1 year after RARP was 39 (35.1%). The only predictive factor for urinary continence was NS grades. To investigate the contribution of NS to urinary continence, 84 patients underwent UDS three times; before, immediately after, and 1 year after RARP. Chronological UDS revealed that recovery patterns of storage and voiding functions were the same among non-NS, unilateral-NS, and bilateral-NS groups, and that higher degrees of NS contributed to lesser decreases in MUCP and longer functional urethral length (FUL) after RARP. CONCLUSION: Preoperative factors, including the results of UDS, could not predict continence 1 year after RARP. The NS procedure contributed to continence status. NS favorably affected MUCP and FUL; however, it did not affect bladder function after RARP. Neurourol. Urodynam. 35:1034-1039, 2016. © 2015 Wiley Periodicals, Inc.

Osteopontin Deficiency Accelerates Spontaneous Colitis in Mice with Disrupted Gut Microbiota and Macrophage Phagocytic Activity.

BACKGROUND: Osteopontin (OPN) is a multifunctional protein expressed in a variety of tissues and cells. Recent studies revealed increased OPN expression in the inflamed intestinal tissues of patients with inflammatory bowel disease (IBD). The role of OPN in the pathophysiology of IBD, however, remains unclear. AIMS: To investigate the role of OPN in the development of intestinal inflammation using a murine model of IBD, interleukin-10 knock out (IL-10 KO) mice. METHODS: We compared the development of colitis between IL-10 KO and OPN/IL-10 double KO (DKO) mice. OPN expression in the colonic tissues of IL-10 KO mice was examined by fluorescence in situ hybridization (FISH) analysis. Enteric microbiota were compared between IL-10 KO and OPN/IL-10 DKO mice by terminal restriction fragment length polymorphism analysis. The effect of OPN on macrophage phagocytic function was evaluated by phagocytosis assay. RESULTS: OPN/IL-10 DKO mice had an accelerated onset of colitis compared to IL-10 KO mice. FISH analysis revealed enhanced OPN synthesis in the colonic epithelial cells of IL-10 KO mice. OPN/IL-10 DKO mice had a distinctly different enteric bacterial profile with a significantly lower abundance of Clostridium subcluster XIVa and a greater abundance of Clostridium cluster XVIII compared to IL-10 KO mice. Intracellular OPN deletion in macrophages impaired phagocytosis of fluorescence particle-conjugated Escherichia coli in vitro. Exogenous OPN enhanced phagocytosis by OPN-deleted macrophages when administered at doses of 1 to 100 ng/ml, but not 1000 ng/ml. CONCLUSIONS: OPN deficiency accelerated the spontaneous development of colitis in mice with disrupted gut microbiota and macrophage phagocytic activity.