Differences in clinical outcomes between octogenarian and nonagenarian patients with acute heart failure.

AIM: The number of hospitalized super-elderly patients with heart failure (HF) has increased with aging of the population. These patients are associated with poor clinical outcomes with the advance of age; however, few reports regarding acute HF have compared the clinical outcomes of nonagenarians with those of octogenarians. METHODS: This study enrolled 683 patients aged ≥80 years who were admitted to our institution for acute HF between 2016 and 2020. The outcomes of interest were the 1-year all-cause mortality, incidence of cardiac events (cardiac-related death or HF-related readmission), and physical function during hospitalization of patients with survival-to-discharge. Physical function was evaluated using the Barthel index. RESULTS: Post-discharge all-cause mortality, particularly non-cardiac mortality, was significantly higher in nonagenarians than octogenarians. Conversely, the incidence of cardiac death or rehospitalization for HF after discharge was comparable between the two groups. On admission, the Barthel index score was significantly lower in nonagenarians than octogenarians, and further decreased during hospitalization. Nonagenarians required social support at discharge more often than octogenarians (67.4% vs. 44.4%; P < 0.001). CONCLUSIONS: The current study demonstrated that nonagenarians have poorer non-cardiac outcomes and were more vulnerable regarding physical activities than octogenarians among patients with acute HF. Holistic medical care, including palliative care and social support, will be increasingly required with increasing age. Geriatr Gerontol Int 2023; 23: 227-233.

Slit3 regulates cell motility through Rac/Cdc42 activation in lipopolysaccharide-stimulated macrophages.

Three slit genes, slit1 to slit3, have been cloned to date. Slit1 and slit2 act as chemorepellent factors for axon guidance. Slit3 is involved in the formation of the diaphragm and kidney during embryogenesis. However, its molecular function remains unclear. We found that slit3 expression was induced by lipopolysaccharide (LPS)-stimulation in macrophages and that it was localized in the mitochondria and along the plasma membrane. Silencing of slit3 expression by RNA interference reduced cell motility and Rac/Cdc42 activation. These results suggest that slit3 functions as an intracellular signaling molecule for cell motility as part of the LPS-induced signaling cascade.

Bone augmentation using rhGDF-5-collagen composite.

The aim of this study was to evaluate the effectiveness of local application of growth differentiation factor-5 (GDF-5)-collagen composite on bone augmentation on the rat calvaria. GDF-5-collagen composite is made from recombinant human GDF-5 (rhGDF-5) and purified bovine type I atelocollagen. The GDF-5 solution was mixed with 0.3% atelocollagen acid solution, and the mixture was lyophilized. The spongy lyophilized material was pressed into the shape of a minidisk to make the GDF-5-collagen composite. The GDF-5-collagen composite contained 1, 10, or 100-microg rhGDF-5. The control collagen composite contained 0-microg rhGDF-5. The GDF-5-collagen composite or control collagen composite was inserted beneath the calvarial periosteum of 4-week-old rats. At 3 weeks after implantation, the implants containing 1-microg rhGDF-5 had mostly induced new bone formation on the cranial side. In the implants containing 10- microg rhGDF-5, bone formation had proceeded to the center of the GDF-5-collagen composite from the periosteal and the cranial sides, and bone marrow was seen focally. The augmented bone showed a connected trabecular structure with abundant vascularization. The implants containing 100-microg rhGDF-5 were nearly entirely replaced by new bone with bone marrow, and the augmented bone was firmly connected with the original bone. Neither cartilage nor bone formation was found in the control collagen composite. Thus, we conclude that the GDF-5-collagen composite may be a superior biomaterial for bone augmentation and this composite could be useful as a local osteoinductive device.

Solcoseryl, a tissue respiration stimulating agent, significantly enhances the effect of capacitively coupled electric field on the promotion of bone formation around dental implants.

In the present study we examined the combined effect of application of a capacitively coupled electric field (CCEF) and the tissue respiration stimulating agent, Solcoseryl, on the promotion of bone formation around dental implants histologically and mechanically. After a dental implant was inserted into each femur of Japanese white rabbits, Solcoseryl (2 ml/kg) was administered intravenously in the ear vein and a CCEF was applied for 4 h per day for 14 days. The degree of bone formation on microscopic observation, bone contact ratio, bone surface area ratio, and the level of removal torque of the implant in the Solcoseryl- and CCEF-treated group were significantly higher than the respective value in the control group, which had not been treated with Solcoseryl nor CCEF. Thus, the combination of CCEF stimulation and Solcoseryl effectively promoted the formation of new bone. It is suggested that the clinical use of a combination of CCEF stimulation and Solcoseryl for dental implants promotes osseointegration.