Clinical significance of thyroglobulin antibodies and thyroid peroxidase antibodies in Graves' disease: a cross-sectional study.

PURPOSE: The significance of thyroglobulin antibodies (TgAbs) and thyroid peroxidase antibodies (TPOAbs) in Graves' disease (GD) remains unclear. Therefore, this study aimed to clarify the clinical significance of TgAbs and TPOAbs in GD. METHODS: A total of 442 patients with GD were recruited and divided into four groups based on TgAb and TPOAb positivity. Their clinical parameters and the characteristics of the groups were compared. Cox proportional hazard regression analysis was performed to assess risk factors for GD remission. RESULTS: The free triiodothyronine (FT3) level was significantly higher in groups positive for TgAbs and TPOAbs than in the other groups. The FT3 to free thyroxine (FT4) (FT3/FT4) ratio was significantly higher and thyrotropin-stimulating hormone (TSH) receptor antibodies (TRAbs) were significantly lower in the TgAb+/TPOAb- group. Time to FT4 recovery was significantly shorter for groups negative for TPOAbs, whereas time to TSH recovery was significantly longer for groups positive for TPOAbs. Cox proportional hazard regression analysis revealed that TgAb positivity, prolonged treatment duration with antithyroid drugs, and Graves' ophthalmopathy treated with methylprednisolone were significantly associated with GD remission and that a smoking history, elevated FT3/FT4 ratio, and treatment with propylthiouracil hindered GD remission. CONCLUSION: The contributions of TgAbs and TPOAbs to GD pathogenesis differ. Patients positive for TgAbs develop GD with lower TRAb titers and undergo earlier remission than those negative for TgAbs. Patients positive for TPOAbs develop GD with high TRAb titers and need a long time to achieve remission.

Critical Amino Acid Variants in HLA-DRB1 and -DQB1 Allotypes in the Development of Classical Type 1 Diabetes and Latent Autoimmune Diabetes in Adults in the Japanese Population.

The effects of amino acid variants encoded by the human leukocyte antigen (HLA) class II on the development of classical type 1 diabetes (T1D) and latent autoimmune diabetes in adults (LADA) have not been fully elucidated. We retrospectively investigated the HLA-DRB1 and -DQB1 genes of 72 patients with classical T1D and 102 patients with LADA in the Japanese population and compared the frequencies of HLA-DRB1 and -DQB1 alleles between these patients and the Japanese populations previously reported by another institution. We also performed a blind association analysis with all amino acid positions in classical T1D and LADA, and compared the associations of HLA-DRB1 and -DQB1 amino acid positions in classical T1D and LADA. The frequency of DRß-Phe-13 was significantly higher and those of DRß-Arg-13 and DQß-Gly-70 were significantly lower in patients with classical T1D and LADA than in controls. The frequencies of DRß-His-13 and DQß-Glu-70 were significantly higher in classical T1D patients than in controls. The frequency of DRß-Ser-13 was significantly lower and that of DQß-Arg-70 was significantly higher in LADA patients than in controls. HLA-DRß1 position 13 and HLA-DQß1 position 70 could be critical amino acid positions in the development of classical T1D and LADA.

Critical amino acid variants in HLA-DRB1 allotypes in the development of Graves' disease and Hashimoto's thyroiditis in the Japanese population.

The effects of amino acid variants encoded by human leukocyte antigen (HLA) class II on the development of Graves' disease (GD) and Hashimoto's thyroiditis (HT) have not been fully elucidated. We investigated the HLA-DRB1 genes of 243 GD patients and 82 HT patients in the Japanese population and compared the frequencies of HLA-DRB1 alleles and HLA-DRB1 amino acid variants between these patients and the Japanese populations previously reported by another institution. The frequencies of HLA-DRB1*04:05 and -DRB1*14:03 alleles were significantly higher and those of HLA-DRB1*01:01 and -DRB1*15:02 alleles were lower in GD patients than in controls. The frequencies of HLA-DRB1*08:03 and -DRB1*09:01 alleles were significantly higher and that of the HLA-DRB1*13:02 allele was lower in HT patients than in controls. A blind association analysis with all amino acid positions identified DRß9 and DRß31 for GD and DRß9, DRß13, and DRß21 for HT. The frequency of Glu-9 was significantly higher and that of Cys-9 was lower in GD patients than in controls. The frequencies of Lys-9 and Phe-13 were significantly higher in HT patients than in controls. DRß9 and DRß13 could be critical amino acid positions in the development of GD and HT.

[Progressive multifocal leukoencephalopathy developing subsequent to cord blood transplantation in a patient with severe aplastic anemia].

A 68-year-old female with severe aplastic anemia (SAA) refractory to initial immunosuppressive therapy, including anti-thymocyte globulin (ATG) and cyclosporine, received a reduced-intensity cord blood transplant (CBT) in June 2015. Tacrolimus (TAC) and mycophenolate mofetil were administered for graft-versus-host disease (GVHD) prophylaxis, and she received prolonged TAC and prednisolone to treat chronic GVHD. The patient presented with progressive ataxia 14 months after CBT. A brain magnetic resonance image (MRI, FLAIR) detected a high-intensity lesion in the left cerebellar hemisphere, which suggested infarction. Her consciousness level gradually continued to deteriorate and another brain MRI (T2) revealed that the size of the cerebellar lesion had increased and had involved the pons. A cerebrospinal fluid (CSF) examination showed normal cell count and protein levels; however, polymerase chain reaction (PCR) analysis of CSF was positive for JC virus (JCV). Therefore, she was eventually diagnosed with progressive multifocal leukoencephalopathy (PML) and treated with mefloquine. The symptoms were reduced after 3 months, and JCV in CSF disappeared without new lesions after 6 months. This is an unusual case of PML initially involving the cerebellum, and we report here PML after an immunosuppressive therapy and CBT in the patient with SAA.

Statistical description of the denatured structure of a single protein, staphylococcal nuclease, by FRET analysis.

Structural characterization of fully unfolded proteins is essential for understanding not only protein-folding mechanisms, but also the structures of intrinsically disordered proteins. Because an unfolded protein can assume all possible conformations, statistical descriptions of its structure are most appropriate. For this purpose, we applied Förster resonance energy transfer (FRET) analysis to fully unfolded staphylococcal nuclease. Artificial amino acids labeled with a FRET donor or acceptor were introduced by an amber codon and a four-base codon respectively. Eight double-labeled proteins were prepared, purified, and subjected to FRET analysis in 6 M urea. The observed behavior could be explained by a power law, R = αN0.44, where R, and N are the distance and the number of residues between donor and acceptor, and α is a coefficient. The index was smaller than the value expected for an excluded-volume random coil, 0.588, indicating that the fully unfolded proteins were more compact than polypeptides in good solvent. The FRET efficiency in the native state did not necessarily correlate to the distance obtained from crystal structure, suggesting that other factors such as the orientation factor made a substantial contribution to FRET.

Prednisone versus high-dose dexamethasone for untreated primary immune thrombocytopenia. A retrospective study of the Japan Hematology & Oncology Clinical Study Group.

High-dose dexamethasone (HDD) has been shown to be an effective initial treatment for immune thrombocytopenia (ITP), but it is not clear whether HDD offers any advantages over conventional-dose prednisone (PSL). We retrospectively compared the efficacy and toxicity of HDD and PSL for newly diagnosed ITP. The response was evaluated according to the International Working Group (IWG) criteria. We analyzed data from 31 and 69 patients in the HDD and PSL groups, respectively. There were no significant differences in patient characteristics between the two groups except for the incidence of the eradication of Helicobacter pylori. The response rate was better in the HDD group (42.7 vs. 28.4 %), and this difference was statistically significant when adjusted for other factors including the eradication of H. pylori. In the HDD group, a response was achieved earlier (28 vs. 152 days in median) and steroids were more frequently discontinued at 6 months (64.5 vs. 37.7 %). Among patients who achieved a response, there was no significant difference in the incidence of loss of response. There were no significant differences in the rate of adverse events, transition to chronic ITP, and splenectomy. In conclusion, HDD might enable the early cessation of steroids without a loss of response.

Systematic alanine insertion reveals the essential regions that encode structure formation and activity of dihydrofolate reductase.

Decoding sequence information is equivalent to elucidating the design principles of proteins. For this purpose, we conducted systematic alanine insertion analysis to reveal the regions in the primary structure where the sequence continuity cannot be disrupted. We applied this method to dihydrofolate reductase (DHFR), and examined the effects of alanine insertion on structure and the enzymatic activity by solubility assay and trimethoprim resistance, respectively. We revealed that DHFR is composed of "Structure Elements", "Function Elements" and linkers connecting these elements. The "Elements" are defined as regions where the alanine insertion caused DHFR to become unstructured or inactive. Some "Structure Elements" overlap with "Function Elements", indicating that loss of structure leads to loss of function. However, other "Structure Elements" are not "Function Elements", in that alanine insertion mutants of these regions exhibit substrate- or inhibitor-induced folding. There are also some "Function Elements" which are not "Structure Elements"; alanine insertion into these elements deforms the catalytic site topology without the loss of tertiary structure. We hypothesize that these elements are involved essential interactions for structure formation and functional expression. The "Elements" are closely related to the module structure of DHFR. An "Element" belongs to a single module, and a single module is composed of some number of "Elements." We propose that properties of a module are determined by the "Elements" it contains. Systematic alanine insertion analysis is an effective and unique method for deriving the regions of a sequence that are essential for structure formation and functional expression.

'Unwilling' versus 'unable': capuchin monkeys' (Cebus apella) understanding of human intentional action.

A sensitivity to the intentions behind human action is a crucial developmental achievement in infants. Is this intention reading ability a unique and relatively recent product of human evolution and culture, or does this capacity instead have roots in our non-human primate ancestors? Recent work by Call and colleagues (2004) lends credence to the latter hypothesis, providing evidence that chimpanzees are also sensitive to human intentions. Specifically, chimpanzees remained in a testing area longer and exhibited fewer frustration behaviors when an experimenter behaved as if he intended to give food but was unable to do so, than when the experimenter behaved as if he had no intention of giving food. The present research builds on and extends this paradigm, providing some of the first evidence of intention reading in a more distant primate relative, the capuchin monkey (Cebus apella). Like chimpanzees, capuchin monkeys distinguish between different goal-directed acts, vacating an enclosure sooner when an experimenter acts unwilling to give food than when she acts unable to give food. Additionally, we found that this pattern is specific to animate action, and does not obtain when the same actions are performed by inanimate rods instead of human hands (for a similar logic, see Woodward, 1998). Taken together with the previous evidence, the present research suggests that our own intention reading is not a wholly unique aspect of the human species, but rather is shared broadly across the primate order.

Continuity in social cognition from infancy to childhood.

Research examining the development of social cognition has largely been divided into two areas: infant perception of intentional agents, and preschoolers' understanding of others' mental states and beliefs (theory of mind). Many researchers have suggested that there is continuity in social cognitive development such that the abilities observed in infancy are related to later preschool ability, yet little empirical evidence exists for this claim. Here, we present preliminary evidence that capacities specific to the social domain contribute to performance in social cognition tasks both during infancy and in early childhood. Specifically, looking time patterns in an infant social cognition task correlated with preschool theory of mind; however, no such relationship was found for infants in a nonsocial cognition task.

Organic photodiodes for biosensor miniaturization.

Biosensors have successfully demonstrated the capability to detect multiple pathogens simultaneously at very low levels. Miniaturization of biosensors is essential for use in the field or at the point of care. While microfluidic systems reduce the footprint for biochemical processing devices and electronic components are continually becoming smaller, optical components suitable for integration--such as LEDs and CMOS chips--are generally still too expensive for disposable components. This paper describes the integration of polymer diodes onto a biosensor chip to create a disposable device that includes both the detector and the sensing surface coated with immobilized capture antibody. We performed a chemiluminescence immunoassay on the OPD substrate and measured the results using a hand-held reader attached to a laptop computer. The miniaturized biosensor with the disposable slide including the organic photodiode detected Staphylococcal enterotoxin B at concentrations as low as 0.5 ng/mL.

Electronic acceleration of atomic motions and disordering in bismuth.

The development of X-ray and electron diffraction methods with ultrahigh time resolution has made it possible to map directly, at the atomic level, structural changes in solids induced by laser excitation. This has resulted in unprecedented insights into the lattice dynamics of solids undergoing phase transitions. In aluminium, for example, femtosecond optical excitation hardly affects the potential energy surface of the lattice; instead, melting of the material is governed by the transfer of thermal energy between the excited electrons and the initially cold lattice. In semiconductors, in contrast, exciting approximately 10 per cent of the valence electrons results in non-thermal lattice collapse owing to the antibonding character of the conduction band. These different material responses raise the intriguing question of how Peierls-distorted systems such as bismuth will respond to strong excitations. The evolution of the atomic configuration of bismuth upon excitation of its A(1g) lattice mode, which involves damped oscillations of atoms along the direction of the Peierls distortion of the crystal, has been probed, but the actual melting of the material has not yet been investigated. Here we present a femtosecond electron diffraction study of the structural changes in crystalline bismuth as it undergoes laser-induced melting. We find that the dynamics of the phase transition depend strongly on the excitation intensity, with melting occurring within 190 fs (that is, within half a period of the unperturbed A(1g) lattice mode) at the highest excitation. We attribute the surprising speed of the melting process to laser-induced changes in the potential energy surface of the lattice, which result in strong acceleration of the atoms along the longitudinal direction of the lattice and efficient coupling of this motion to an unstable transverse vibrational mode. That is, the atomic motions in crystalline bismuth can be electronically accelerated so that the solid-to-liquid phase transition occurs on a sub-vibrational timescale.

Limits on Infants' Ability to Dynamically Update Object Representations.

Like adults, infants use working memory to represent occluded objects and can update these memory representations to reflect changes to a scene that unfold over time. Here we tested the limits of infants' ability to update object representations in working memory. Eleven-month-old infants participated in a modified foraging task in which they saw 2 quantities of crackers sequentially hidden in buckets and then were allowed to choose between them. We manipulated the working memory demands of the task by either hiding crackers in direct succession (i.e., infants saw all of the crackers hidden in the first location, then saw all of the crackers hidden in the second location), or hiding them in alternation (i.e., infants saw some crackers hidden in the first location, then saw some crackers hidden in the second location, then saw more crackers hidden in the first location). Across 6 experiments we found that infants successfully updated their representations of the hidden arrays when crackers were presented in succession. However, when crackers were hidden in alternation and infants had to reupdate an array that was no longer in the current focus of attention, infants showed a striking pattern of failure. These results suggest that, for infants as well as for adults, the flexibility of working memory is subject to processing constraints.

Application of partial least square on quantitative analysis of L-, D-, and DL-tartaric acid by terahertz absorption spectra.

Absorption spectra of polycrystalline L-, D-, and DL-tartaric acid have been measured by terahertz time domain spectroscopy (THz-TDS). Different absorption bands are observed for DL-tartaric acid and its enantiomers (L- and D-tartaric acid). This result shows that the THz-TDS can be used for distinguishing between DL-tartaric acid and enantiomers (L- and D-tartaric acid). Moreover, partial least square (PLS) can be found to improve the quantitation of L-tartaric acid in L- and DL-tartaric acid mixture by THz-TDS.

Analyses of ultraviolet-induced focus formation of hREV1 protein.

Translesional DNA synthesis (TLS) is one of the DNA damage tolerance mechanisms that allow cells with DNA damage to continue DNA replication. Each of the mammalian Y-family DNA polymerases (Pol eta, Pol iota, Pol kappa, and REV1) has been shown to carry out TLS by itself or in combination with another enzyme in vitro. Recently, the C-terminal region of mammalian REV1 (the total 1251 residues in human) was found to interact with Pol eta, Pol iota, and Pol kappa, as well as with the REV7 subunit of another TLS enzyme, Pol zeta. Thus, it is proposed that REV1 plays a pivotal role in TLS in vivo. We here describe our study on the localization of human REV1 protein (hREV1) in nondamaged and ultraviolet (UV)-irradiated cells. Ectopically expressed hREV1 in mammalian cells was localized to the nucleus and exhibited dozens of tiny foci in approximately 3% of nondamaged cells. The percentage of focus-forming cells markedly increased after UV irradiation in a time- and dose-dependent manner. The focus formation was associated with UV-induced DNA damage. Interestingly, although the hREV1 foci in S-phase cells colocalized with PCNA foci, suggesting the association of hREV1 with the replication machinery, hREV1 focus formation was observed not only in the S phase but also outside S phase. Furthermore, it was found that the hREV1 focus formation after UV irradiation required a region near the C-terminal (826-1178).