Alkali-treated titanium dioxide promotes formation of proteoglycan layer and altered calcification and immunotolerance capacity in bone marrow stem cell.

Introduction: In this study, we report that a proteoglycans (PGs)-layer between the bone and titanium dioxide (TiO2) surface after osseointegration improved the calcification capacity and immunotolerance of human bone marrow mesenchymal stem cells (hBMSCs) on TiO2. Alkaline treatment of TiO2 is a method for promoting osteogenesis in hBMSCs. We hypothesized that promotion of osteogenesis due to alkaline treatment was caused by changing PGs-layer on TiO2. Objective: This study aimed to analyze whether alkaline treatment of TiO2 affects PGs-layer formation and immunotolerance in hBMSCs. Methods: The topology and wettability of the alkaline-treated titanium (Ti-Al) and unprocessed titanium (Ti-MS) surfaces were characterized. Initial cell attachment, cell proliferation, calcification capacity, alkaline phosphatase activity, PGs-layer formation, PGs function, and the expression of osteogenic and immunotolerance-related genes were analyzed. The conditioned medium (CM) from hBMSCs grown on Ti-Al and Ti-MS was added to macrophages (hMps) and Jurkat cells, and immunotolerance gene expression in these cells was analyzed. Results: hBMSCs cultured on Ti-Al showed increased initial cell attachment, cell proliferation, PG-layer formation, and osteogenic capacity compared with hBMSCs on Ti-MS. Gene expression of indoleamine 2,3-dioxygenase (IDO) in the hBMSCs cultured on Ti-Al was higher than that in the hBMSCs on Ti-MS. CM from hBMSCs did not affect markers of M1 and M2 macrophages in hMps. CM from hBMSCs cultured on Ti-Al altered the gene expression of Foxp3 in Jurkat cells compared to that of CM from hBMSCs on Ti-MS. Significance: These results suggest that alkaline treatment of TiO2 altered PGs-layer formation, and changed the osteogenesis and immunotolerance of hBMSCs.

Effects of perioperative oral care on prevention of postoperative pneumonia after lung resection: Multicenter retrospective study with propensity score matching analysis.

BACKGROUND: Postoperative pneumonia can be a fatal complication that may occur after lung resection in cancer patients. Some reports have shown that the incidence of postoperative pneumonia is decreased after esophageal surgery by perioperative oral care; however, there exist no data to suggest that a lack of perioperative oral care can be a risk factor for postoperative pneumonia after lung resection. To investigate the association between the preventive effect of oral care and postoperative pneumonia, we conducted a multicenter, retrospective study of lung cancer patients who underwent lung resection. METHODS: Between January 2014 and December 2016, a total of 721 patients underwent lung resections at 1 of the 6 hospitals included in our study. Among 721 patients, 280 (38.8%) received perioperative oral care, and the remaining 441 (61.2%) did not receive any such care. Propensity score matching was performed to minimize selection biases associated with the comparison of retrospective data between the oral care and control groups. RESULTS: Of the 721 patients, 54 (7.5%) experienced postoperative pneumonia involving 13 of the 280 patients (4.6%) in the oral care group and 41 of the 441 patients (9.3%) in the control group (P = .02). On propensity score analysis, a significant difference was also found between oral care intervention and incidence of postoperative pneumonia (P = .002). CONCLUSION: Our results suggest that perioperative oral care is an effective method to decrease the occurrence of postoperative pneumonia in patients who have undergone lung resection.

Serial changes of serum cytokines in Crohn's disease following treatment with adalimumab.

BACKGROUND/AIMS: We examined serum cytokine levels in Crohn's disease (CD) patients before and after Adalimumab (ADA) treatment. METHODOLOGY: A total of 24 patients with CD were enrolled (4 colonic type, 6 ileal type, 14 ileo-colonic type). Patients were divided into two groups according to disease duration. Patients were given ADA (160 mg at week 0 and 80 mg at week 2), followed by maintenance therapy (40 mg every other week). Serum levels of 17 cytokines were simultaneously determined using a Bio-Plex suspension array system before, 4 and 8 weeks after ADA treatment. Serum CRP levels were also measured before, 4 and 8 weeks after treatment. RESULTS: IL-6 and MCP-1 levels were significantly decreased in all CD patients and in the ileo-colonic type 8 weeks after ADA treatment compared to before treatment (P <0.05). MCP-1 levels were significantly decreased 8 weeks after treatment compared to pre-treatment samples if disease onset occurred longer than 8 years. A significant correlation was noted between CRP and IL-6 levels. CONCLUSIONS: The reduction of IL-6 and MCP-1 would be an important role for the improvement of inflammation after ADA treatment in CD which might be associated with disease types and disease duration,

The effect of granulocyte and monocyte adsorptive apheresis on serum cytokine levels in patients with ulcerative colitis.

BACKGROUND: Granulocyte and monocyte adsorptive apheresis (GMA) with an Adacolumn has been reported to be effective as induction therapy in ulcerative colitis (UC). However, the effects of GMA on serial changes in cytokine levels have not been well characterized. We therefore, investigated cytokine levels in UC patients before and after treatment with GMA. A total of 16 patients with active UC, 10 men, and six women, mean age, 42.6 years were included. Fourteen patients had total colitis and two patients had left-sided colitis. The study included nine patients with a chronic intermittent course, six with a chronic continuous course and one with a single episode. The duration of each GMA session was 60 min at a flow rate of 30 mL/min as per study protocol. Serum levels of 17 cytokines were determined simultaneously using a Bio-Plex suspension array system before and after treatment with GMA. Serum interleukin (IL)-10 and macrophage inflammatory protein-1ß levels were increased significantly in UC patients after GMA treatment compared to pre-treatment levels (P < 0.05). In particular, GMA treatment caused a significant increase in serum IL-10 levels compared to pre-treatment in patients with total colitis or with a chronic intermittent UC course. In conclusion, this investigation showed that GMA was associated with a marked increase in serum level of the anti-inflammatory cytokine, IL-10. The rise in circulating IL-10 is interesting, and potentially a significant factor in the efficacy of GMA in patients with inflammatory bowel diseases.

Colonic mucosa-associated lymphoid tissue lymphoma.

Colonic mucosa-associated lymphoid tissue (MALT) lymphomas are rare and a definitive treatment has not been established. Solitary or multiple, elevated or polypoid lesions are the usual appearances of MALT lymphoma in the colon and sometimes the surface may reveal abnormal vascularity. In this paper we report our experience with four cases of colonic MALT lymphoma and review the relevant literature. The first patient had a smooth elevated lesion in the rectum and histopathologic examination of the biopsy from the lesion showed centrocyte-like cells infiltrating the lamina propria. Endoscopic ultrasonography (EUS) revealed thickening of the submucosa and muscularis propria. The patient underwent radiation therapy, and 9 months later a repeat colonoscopy showed complete resolution of the lesion. In case 2, colonoscopy showed a polyp in the cecum; the biopsy was diagnostic of MALT lymphoma. EUS detected a hypoechoic lesion confined to the mucosal layer of the colonic wall. The patient underwent endoscopic mucosal resection of the lesion and after 6 years of follow-up there was no evidence of recurrence. The third patient had a sessile elevated lesion in the sigmoid colon for which she underwent sigmoidectomy. Pathological examination of the surgical specimen was suggestive of MALT lymphoma. The last patient had a smooth elevated lesion in the rectum and magnification endoscopy showed irregular vascular pattern. The patient underwent endoscopic submucosal dissection, and biopsy examination showed the tumor to be MALT lymphoma. Although rare, awareness of MALT lymphoma of the colon is important to evaluate the patient appropriately and to plan further management.

Unusual Manifestation of Gastric Helicobacter pylori Infection.

Infection with Helicobacter pylori (HP) is common in many parts of the world. While most patients are asymptomatic, it causes peptic ulcer disease and malignancy in some of them. Other rare conditions have occasionally been reported in association with this infection. We report a case of hypertrophic gastropathy caused by HP in a 52-year-old asymptomatic patient. He was found to have marked enlargement of the gastric mucosal folds on radiological imaging and endoscopy. A gastric mucosal biopsy showed HP colonization associated with neutrophilic inflammation. After exclusion of neoplasia, other infections and infiltrative disorders, HP was thought to be the cause of the gastric fold hypertrophy. The patient responded well to HP eradication therapy, with normalization of the gastric mucosal folds. HP infection should be considered in the differential diagnosis of hypertrophic gastropathy and treated accordingly.

Serial changes of cytokines in Crohn's disease treated with infliximab.

BACKGROUND/AIMS: Infliximab (IFX) has been reported to be useful as induction therapy and/or maintenance therapy for Crohn's disease (CD). However, the effects of IFX on serial changes in cytokine levels have not been well characterized. We examined cytokine levels in CD patients before and after administration of IFX. METHODOLOGY: A total of 37 patients with active CD were enrolled (24 men, 13 women; mean age, 31.9 years). Patients were given IFX 5mg/kg intravenously. Serum levels of 17 cytokines were simultaneously determined using a Bio-Plex suspension array system before treatment and, 4 and 8 weeks after IFX treatment. Patients were divided into two groups according to the disease duration: the 'early treatment' group and the 'in progress' treatment group. RESULTS: Serum IL-6, IL-7, IL-8 and MIP-1ß levels were significantly decreased in CD patients after IFX treatment compared to before treatment (p<0.05). In particular, serum levels of IL-8, IL-12 and MIP-1ß decreased significantly after IFX treatment in the 'in progress' treatment group. The changes in CD activity score (CDAI) after treatment were positively correlated with the changes of serum MIP-1ß. CONCLUSIONS: IFX treatment reduces serum levels of IL-6, IL-7, IL-8, IL-12 and MIP-1ß, which appears to be mediated by the inhibition of inflammation in CD.

Stable production of thermotolerant xylanase B of Clostridium stercorarium in transgenic tobacco and rice.

The xylanase B gene encoding a thermostable family 10 xylanase of Clostridium stercorarium was expressed in plants under the control of a constitutive promoter. Two forms of the xylanase B gene, the xynB gene encoding the full length of the xylanase B gene including the bacterial signal sequence and the xynBM gene without the signal sequence region, were introduced into tobacco BY-2 cells and tobacco plants respectively under the control of the cauliflower mosaic virus 35S promoter. Transgenic BY-2 cells and tobacco plants showed xylanase activity and normal growth. The recombinant enzyme produced in transgenic BY-2 cells harboring the xynB gene was secreted into the culture supernatant, and the recombinant enzyme produced in transgenic BY-2 cells harboring the xynBM gene was localized in the cells. In contrast to tobacco plants, expression of the xynB gene under the control of the rice actin promoter in rice plants was toxic to host cells. However, the recombinant XynBM accumulated in leaf cells, and no phenotypic effect of expression of the xynBM gene was observed. Enzyme activity was maintained in cell-free extracts of transgenic rice leaves at 60 degrees C for 72 h, and the recombinant XynBM degraded hemicellulosic polymers in cell-free extracts of transgenic rice leaves.

Characterization of follicular lymphoma in the small intestine using double-balloon endoscopy.

Follicular lymphomas occur rarely in the gastrointestinal tract, representing only 1-3% of all gastrointestinal tract B-cell non-Hodgkin lymphomas. We describe endoscopic analysis of 3 cases of follicular lymphoma in the small intestine using double-balloon endoscopy. Double-balloon endoscopy revealed multiple nodular lesions and elevated white patches, multiple polypoid lesions, and scattered white polypoid and nodular lesions in the duodenum and small intestine. Fuji Intelligent Chromo Endoscopy demonstrated small, whitish nodules, and narrow-band imaging showed a coiled, elongated vascular pattern within the elevated lesions. These cases are the first follicular lymphomas in the small intestine evaluated using narrow-band imaging or Fuji Intelligent Chromo Endoscopy to be reported.

Evaluation of Infliximab Effects on Gastrointestinal Bleeding in Crohn's Disease Using Double-Balloon Endoscopy.

Tumor necrosis factor α plays an important role in the pathogenesis of Crohn's disease (CD). The effects of infliximab on gastrointestinal bleeding in CD have not yet been fully evaluated. Herein we describe three CD cases who presented with gastrointestinal bleeding and received infliximab treatment. In case 1, double-balloon endoscopy showed a large ulcer with several irregularly shaped ulcers in the terminal ileum; 8 weeks after infliximab administration, complete healing of all lesions was observed. In case 2, double-balloon endoscopy showed linear ulcers and mucosal edema in the jejunum and ileum; 5 weeks after infliximab administration, all lesions were decreased in size and were healed. In case 3, double-balloon endoscopy revealed ulcerations and stenosis in the terminal ileum; 12 weeks after infliximab administration, ulcer healing and an increased diameter of the ileal stenosis were observed. These three cases have been receiving ongoing infliximab maintenance therapy and are currently symptom-free. Infliximab thus appears to be useful for treatment of gastrointestinal bleeding in CD patients.

Stable expression of a thermostable xylanase of Clostridium thermocellum in cultured tobacco cells.

Two distinct domains of the xynA gene from Clostridium thermocellum encoding a xylanase catalytic domain (XynAl) and a xylanase catalytic domain with a cellulose binding domain (XynA2) under the control of the cauliflower mosaic virus 35S promoter were electroporated into cultured tobacco BY-2 cells. Transgenic BY -2 calli expressing xylan-hydrolyzing activity were obtained at high frequency for both genes. Western blot analysis using an anti-XynA antibody indicated that XynAl and XynA2 were produced in these calli.