Heterogeneous structure and mechanical hardness of biomedical ß-type Ti-29Nb-13Ta-4.6Zr subjected to high-pressure torsion.

A novel ß-type titanium alloy, Ti-29Nb-13Ta-4.6Zr (TNTZ), has been developed as a candidate for biomedical applications. TNTZ exhibits non-toxicity and a low Young's modulus close to that of bone (10-30 GPa). Such a low Young's modulus of this alloy is achieved by comprising a single metastable ß phase. Greater mechanical biocompatibility, which implies higher mechanical strength and hardness while maintaining a low Young's modulus, has been aimed for TNTZ. Therefore, strengthening by grain refinement and increasing dislocation density is expected to provide TNTZ high mechanical strength while keeping a low Young's modulus because they keep the original ß phase. In this case, high-pressure torsion (HPT) processing is one of the effective ways to obtain these properties simultaneously in TNTZ. Thus, in this study, the effect of HPT processing on the microstructure and mechanical hardness of TNTZ was systematically investigated at rotation numbers (N) of 1 to 20 under a pressure of around 1.25 GPa at room temperature. On the cross sections of TNTZ subjected to HPT processing (TNTZ(HPT)) after cold rolling (TNTZ(CR)) at any rotation number, a heterogeneous microstructure consisting of a matrix and a non-etched band, which is not corroded by etching solution, can be observed. The thickness of non-etched band increases as rotation number and distance from specimen center increase. Both matrix and non-etched band comprise a single ß phase, but their grain geometries are different each other. Equiaxed grains and elongated grains are observed in the matrix and the non-etched band, respectively. The equiaxed grain diameter, which is ranged from 155 nm to 44 nm, in the matrix decreases with increasing rotation number. Contrastingly, the elongated grains with a length of around 300 nm and a width of 30 nm, which are nearly constant with rotation number, are observed in the non-etched band. The mechanical hardness of TNTZ(HPT) is consistently much higher than that of TNTZ(CR). The mechanical hardness distribution on the surface of TNTZ(HPT) is heterogeneous in the radial and depth directions, while that of TNTZ(CR) is homogeneous; the mechanical hardness is higher in the peripheral region than in the central region on the surfaces of TNTZ(HPT) at all N. Further, the mechanical hardness distribution on the cross sections of TNTZ(HPT) at all N is also heterogeneous in depth direction; the mechanical hardness is higher in the peripheral region than in the central region. The heterogeneous mechanical hardness distribution depending on the position on the surface and cross section of TNTZ(HPT) is considered to be related to grain refinement and imposed strain due to HPT processing.

Prognostic importance of tumour-infiltrating memory T cells in oesophageal squamous cell carcinoma.

Memory T cells survive for many months and years and are critically important for host defence in humans. In tumour immunity, they have been also suggested to play a significant role in tumour progression and metastasis. However, the role of memory T cells in actual human cancer remains largely unknown. In this study, the clinical importance of tumour-infiltrating CD45RO(+) memory T cells was investigated in human oesophageal squamous cell carcinoma (OSCC). CD45RO(+) T cells were evaluated by immunohistochemistry in primary OSCC tumours from 105 patients. Patients were classified into two groups as CD45RO(+hi) or CD45RO(+lo) based on the number of cells stained positively for CD45RO. No significant difference was observed between CD45RO status and several clinicopathological prognostic factors. However, the postoperative overall and disease-free survival for CD45RO(+hi) patients was significantly better than for CD45RO(+lo) patients. Furthermore, there were significant correlations of CD45RO status in the primary tumour with postoperative lymph node and pulmonary recurrence, suggesting that memory T cells may control postoperative metastatic recurrence. Most importantly, CD45RO(+) memory T cell status has a significant prognostic value for OSCC independently of conventional tumour-node-metastasis (TNM) classification. Our study may provide a rationale for developing a novel immunotherapy in intentional induction of memory T cells for the treatment of oesophageal cancer.

Clinical importance of B7-H3 expression in human pancreatic cancer.

BACKGROUND: B7-H3 is a new member of the B7 ligand family and regulates T-cell responses in various conditions. However, the role of B7-H3 in tumour immunity is largely unknown. The purpose of this study was to evaluate the clinical significance of B7-H3 expression in human pancreatic cancer and the therapeutic potential for cancer immunotherapy. METHODS: We investigated B7-H3 expression in 59 patients with pancreatic cancer by immunohistochemistry and real-time PCR. Furthermore, we examined the anti-tumour effect of B7-H3-blocking monoclonal antibody in vivo in a murine pancreatic cancer model. RESULTS: Tumour-related B7-H3 expression was abundant in most human pancreatic cancer tissues and was significantly higher compared with that in non-cancer tissue or normal pancreas. Moreover, its expression was significantly more intense in cases with lymph node metastasis and advanced pathological stage. B7-H3 blockade promoted CD8(+) T-cell infiltration into the tumour and induced a substantial anti-tumour effect on murine pancreatic cancer. In addition, the combination of gemcitabine with B7-H3 blockade showed a synergistic anti-tumour effect without overt toxicity. CONCLUSION: Our data show for the first time that B7-H3 may have a critical role in pancreatic cancer and provide the rationale for developing a novel cancer immunotherapy against this fatal disease.

Protective effect of prostaglandin E2 receptors EP2 and EP4 in alloimmune response in vivo.

Prostaglandin E2 (PGE2) is produced during inflammatory responses mediating a variety of both innate and adaptive immune responses through 4 distinct receptors: EP1 to EP4. The use of gene-targeted mice and selective agonists/antagonists responsible for each receptor has gradually revealed that each receptor plays a unique and important role in various disease conditions. In addition, PGE2 is known to have some immunosuppressive properties. In this study, we investigated the role of PGE2 receptors by examining the therapeutic efficacy of highly selective receptor agonists on the alloimmune response in vivo. We used a fully major histocompatibility complex (MHC)-mismatched murine cardiac transplantation model. C57BL/6 cardiac allografts were heterotopically transplanted into BALB/c recipients. We treated mice with a highly selective agonist for each EP receptor. EP2 and EP4 agonists significantly prolonged allograft survival compared with controls. In particular, the EP4 agonist was more effective than the EP2 agonist in the inhibition of acute allograft rejection. In conclusion, PGE2 receptors merit further study as novel therapeutics for clinical transplantation.

A novel CCR5/CXCR3 antagonist protects intestinal ischemia/reperfusion injury.

Chemokines and chemokine receptors have been demonstrated to be critical regulators in a variety of physiologic and pathologic immune responses. In particular, CCR5 and CXCR3 have been reported to play important roles in the alloimmune response. In this study, we investigated the therapeutic efficacy of a novel small-molecule compound, TAK779, an antagonist targeting both CCR5 and CXCR3 in intestinal ischemia/reperfusion (I/R) injury. We utilized an established murine intestinal I/R injury model. TAK779 treatment significantly improved mouse survival after 60 minutes of intestinal ischemia. We then examined the local intestinal expression of several cytokines and chemokines at 2 hours after reperfusion using real-time PCR. TAK779 treatment downregulated the expression of several cytokines, including TNF-alpha, IFN-gamma, and IL-4, suggesting that the beneficial effect of TAK779 was associated with inhibition of local immune activation. We further examined the systemic response after TAK779 treatment. Lung tissue damage was significantly prevented by the treatment, as determined by lung wet-to-dry weight ratios at 4 hours after intestinal I/R injury. In addition, we observed that CCR5 expression in the lung was significantly downregulated by the treatment, suggesting that TAK779 inhibited the infiltration of CCR5-positive cells into the remote organ. Our data suggest the critical role of CCR5 and CXCR3 in intestinal I/R injury and therapeutic efficacy of a novel small compound, TAK779, for protection against the intestinal I/R injury.

Fatigue characteristics of bioactive glass-ceramic-coated Ti-29Nb-13Ta-4.6Zr for biomedical application.

A new surface-coating method by which CaP invert glass is used to improve the bioactivity of titanium alloys has been developed recently. In this method, the powder of CaP invert glass (CaO-P2O5-TiO2-Na2O) is coated on the surface of titanium alloy samples and heated between 1073 and 1123 K. With this treatment, a calcium phosphate layer mainly containing beta-Ca3(PO4)2 phase can be coated easily on titanium alloy samples. In the present study, the effect of this coating process on the fatigue properties of Ti-29Nb-13Ta-4.6Zr, a new metastable beta alloy for biomedical applications, has been investigated. The fatigue endurance limit of the coated alloy was found to be about 15% higher than that of uncoated alloy, as a result of the formation of a hard (alpha + beta) layer and a small amount of the omega phase during the coating process. The coating exhibits excellent adhesion to the substrate during the tensile and fatigue tests. Subsequent ageing at 673 K for 259.2 ks greatly improves the fatigue resistance of the coated alloy due to isothermal omega phase precipitation, and does not have obvious detrimental effect on the coating properties.

Role of a sialyl Lewis(x)-like epitope selectively expressed on vascular endothelial cells in local skin inflammation of the rat.

The role of the inducible L-selectin ligand was studied in complement-dependent acute dermatitis in rats. Although mAbs against typical sialyl Lewis(x) (CSLEX-1 and SNH-3) did not react with skin venules, a sialyl Lewis(x)-like epitope defined by mAb 2H5 (2H5-Ag) was de novo expressed on the endothelial cells of skin venules in the area of inflammation. Expression of 2H5-Ag increased concomitantly with the progression of inflammation. 2H5-Ag was identified at the 75-, 150-, and 180-kDa bands when inflammatory skin tissue was analyzed by Western blotting. In contrast, P- and E-selectins were not detectable. The role of 2H5-Ag in this model was studied in in vitro and in vivo methods. First, 2H5 was i.v. injected 15 min before induction of dermatitis. 2H5 bound to skin venules and significantly reduced the neutrophil infiltration and plasma protein leakage. In contrast, CSLEX-1, mAb ARP2-4 (P-selectin blocker), or mAb ARE-5 (E-selectin blocker) had no effects. Second, adhesion of isolated rat neutrophils to the inflammatory skin section was inhibited significantly when the sections, but not neutrophils, were preincubated with 2H5. Third, fluorescein-labeled normal rat neutrophils were injected into a rat 10 h after induction of dermatitis. The number of labeled neutrophils infiltrated into the inflammatory site was reduced significantly when they were preincubated with HRL-3 (blocking mAb against rat L-selectin), but not with 2H5 or HRL-4 (nonblocking mAb against rat L-selectin). These data show that de novo expressed 2H5-Ag/L-selectin adhesion pathway contributes to the development of acute complement-dependent inflammation in the skin.

Effect of maternal lifestyle on cord blood IgE factor.

During recent decades much interest has been focused on the possibility of predicting and preventing atopic diseases during pregnancy. The idea of being able to detect a predisposition early and take suitable environmental measures in order to avoid overt allergy is an attractive position. Elevated cord IgE of around 1.0 IU/ml has been proposed as a predictor in western children. However, there remains no information about the effect of maternal lifestyle during pregnancy on these levels. Total IgE levels were therefore determined using Pharmacia CAP system and PRIST, with sensitivities of 0.01 kU/l and 0.25 kU/l, respectively, from serum samples taken from 1138 Japanese pairs of cord blood and pregnant women responding to a questionnaire regarding 17 health practices, intake of 32 food allergens and 5 environmental factors. Of these, 28 (2.5%) pairs of samples were excluded from further analysis because of high contamination of IgA (> 15.4 mg/ml) in cord blood. Median cord blood IgE was 0.286 kU/l and geometric mean IgE was 66.25 kU/l in maternal sera using CAP system; there was no significant correlation between maternal log (IgE) and cord blood IgE. Similar results were obtained from PRIST, whose correlation with CAP system was significant (r = 0.884, p < 0.001 for maternal and r = 0.765, p < 0.001 for cord blood). Multiple logistic analysis demonstrated that avoidance of simultaneous exposure to hens' eggs and cow's milk (relative risk = 1.3, p < 0.05) as well as soy beans (relative risk = 2.8, p < 0.01) should be advised to mothers with positive allergic histories and/or high total IgE (> 400 IU/ml), especially in women aged more than 35 years who are pregnant with a male child. However, maintenance of healthy lifestyles, especially taking proper exercise and sleeping, and avoidance of inhalant allergens during late pregnancy may be a more important strategy for the reduction of cord blood IgE levels.

Patterns of inspiratory muscle shortening during hypoxia and hypercapnia in dogs.

The shortening of parasternal intercostal muscles (Para) and crural (Cru) and costal diaphragms (Cos) are not precisely understood. We therefore examined shortening patterns of these inspiratory muscles by using chronically implanted sonomicrometers in dogs. To avoid acute effects of surgery, measurements were performed 3 weeks after implanting the sonomicrometers. Patterns of length changes of Para, Cru, and Cos were measured during hypoxia and hypercapnia under two levels of anaesthesia. Respiratory length change (delta L) was assessed as a percentage change relative to the resting length at functional residual capacity (LFRC). Peak tidal shortening was defined as the maximal change from LFRC (delta L/LFRC). Under light anesthesia, the delta L/LFRC was the same among the three muscle groups at all tidal volumes (VT). Under deep anaesthesia, the delta L/LFRC both of Cru and Cos exceeded that of Para. Under light anaesthesia, the maximal shortening velocity ((delta L/LFRC)/delta t) of Cru was greater than that of Para. Under deep anaesthesia, the (delta L/LFRC)/delta t of Para was exceeded by that both of Cru and Cos. Furthermore, the (delta L/LFRC)/delta t of each inspiratory muscle was greater during hypoxia than during hypercapnia at equal volume. We conclude that: 1) the contribution of the diaphragm to ventilation increases during deep anaesthesia; 2) the muscle shortening velocity during hypoxia or hypercapnia is lower in parasternal intercostal muscles than in the diaphragm; and 3) there is no difference in the shortening pattern between crural and costal diaphragms.

Large cell carcinoma of the lung metastatic to nuchal muscle.

Clinically apparent hematogenous skeletal muscle metastases from lung cancer are extremely rare. We present a 72-year-old man with a large cell lung carcinoma metastatic to nuchal muscle. Cervical computed tomography (CT) and magnetic resonance imaging (MRI) revealed the presence of a well-defined mass in the left splenius capitis muscle. A percutaneous needle biopsy was performed to establish a diagnosis. Localized skeletal muscle swelling may rarely prove to be metastases in patients with lung cancer, but should be investigated in the case of muscle swelling.

Alveolar surface area-to-lung volume ratio in oleic acid-induced pulmonary edema.

It is unknown how the in vivo alveolar surface area-to-volume ratio (S/V) changes in low-pressure pulmonary edema. Here, the S/V is the area of the air-tissue interface per unit total volume (air plus tissue). We hypothesized that in oleic acid (OA)-induced edema inactivation of the pulmonary surfactant may increase surface tension and decrease the S/V at any given lung volume. OA (0.04 mg/kg) was intravenously injected into dogs. We measured the in vivo S/V (equivalent to the inverse of optical mean free path by light-scattering stereology and the pressure-volume (PV) curve 60-90 min after OA administration. OA administration decreased the lung volume at each transpulmonary pressure and increased the wet-to-dry weight ratio. The S/V decreased after OA administration (optical mean free path increased). The air-filled PV curves shifted downward after OA, but the saline-filled PV curves after OA administration did not differ significantly from control saline-filled curves. The difference in transpulmonary pressure between air- and saline-filled PV curves (an index of the magnitude of surface tension) was increased in OA-induced pulmonary edema. This study suggests that in OA-induced pulmonary edema the alveolar surface tension increases and the S/V decreases, presumably due to inactivation of surfactant by serum leakage to alveoli.

Effects of surfactant on the in vivo alveolar surface-to-volume ratio.

To investigate how pulmonary surfactant influences alveolar structure in vivo, we examined the alveolar surface area-to-lung volume (S/V) ratio of the lung parenchyma of a live dog by light-scattering stereology before and after saline lavage. We measured the backscattered light pattern produced by applying a laser beam to the pleural surface of a ventilated animal and obtained the S/V [equivalent to the inverse of the optical mean free path (lambda)]. After saline lavage, V at transpulmonary pressure (P) of 30 cmH2O (defined as total lung capacity) decreased by 11.1 +/- 3.1% (SD) and the P-V curve shifted to a lower V. The lambda-V curve was shifted to a higher lambda and to a lower V after saline lavage. S/V decreased after saline lavage (lambda increased by 38 +/- 27% on the deflation limb at a V of 80% of control total lung capacity). The alveolar surface tension increased after saline lavage, and the increase in surface tension was greater on inflation than on deflation. We conclude that depletion of pulmonary surfactant increases the alveolar surface tension in vivo, resulting in a decrease in S/V.

Interchange trisomy 9 due to maternal t(6;9) translocation.

The occurrence of interchange trisomy due to a 3:1 malsegregation has been documented in only a few cases with trisomy 21. We describe the first case of interchange trisomy 9 due to a maternal t(6:9) translocation. The patient, a boy neonate who died immediately after birth, had intra-uterine growth retardation, specific craniofacial features including microcephaly with a high forehead, low-set ears, upslanting short palpebral fissures, microphthalmia, bulbous nose and micrognathia, cryptorchidism, cystic kidney and various skeletal anomalies. His phenotype was consistent with that of the trisomy 9 syndrome. Cytogenetic analysis showed his karyotype of 47,XY,-6, + der(6), + der(9)t(6;9)(q27;q21.1)mat. The present report indicates that a very rare interchange mode of a 3:1 segregation can give rise to a live birth with full trisomy 9 in female carriers with reciprocal translocations involving the proximal long arm of chromosome 9.

Dynamic behavior of alveolar surface-to-volume ratio in live dogs by light-scattering stereology.

To investigate the behavior of the surface-to-volume ratio (S/V) in lung lobes of live dogs, we measured the backscattered light pattern produced by applying a laser beam to the pleural surface. This pattern was used to estimate the optical mean free path, which is approximately proportional to the inverse square of the geometric S/V. Measurements were performed in mechanically ventilated animals with the chest widely opened. We found that during quasi-static large volume excursion, S/V changed approximately as the one-third power of lung volume but with hysteresis such that S/V during deflation was higher than during inflation. This finding is consistent with a relatively large stress hysteresis of surface tension compared with that of the tissue. During tidal breathing, however, the geometric hysteresis was inconsistent among animals at low frequency but was consistently changed at higher frequencies in a direction suggesting a lesser role of surface tension relative to tissue stress hysteresis.

Inspiratory muscle training and respiratory sensation during treadmill exercise.

We studied whether inspiratory muscle training (IMT) changed respiratory sensation during exercise in 12 healthy women; IMT was performed twice daily, for 15 minutes, using a pressure threshold device and continued for 4 weeks. The inspiratory threshold was set to 30 percent of each individual's maximal inspiratory pressure (Pimax). Breathing effort was evaluated during a progressive exercise test using Borg scale. After IMT, both Pimax and maximal transdiaphragmatic pressure increased by 30 percent in the training group (p < 0.05) but did not change in the control group. Prior to IMT, the Borg score increased in proportion to exercise grade. The difference in the sensory score-exercise stage curves before and after IMT in the training group was not significant. No significant difference was noted in the relationship of the Borg score to minute ventilation before and after 4 weeks in either group. We concluded that IMT may not affect respiratory sensation during exercise in normal subjects, although IMT increases diaphragmatic strength.

Effect of thyroid hormone on in vivo contractility of the canine diaphragm.

This study was designed to examine the effects of long-term (4 wk) administration of thyroid hormone on the in vivo contractility of the canine diaphragm. We implanted a pair of piezoelectric crystals chronically in the left crural and costal parts of the diaphragm by a midline laparotomy. Contractility was assessed by changes in the shortening of muscle fibers after twitch stimulation of both the crural and the costal parts of the diaphragm and in the transdiaphragmatic pressure (Pdi) after tetanic stimulation (10 to 100 Hz). As a reference, we also studied the response of the quadriceps femoris. Pretreatment measurements were taken 2 wk after surgery. Then, dogs assigned to the hyperthyroid group were given thyroid powder, 0.6 g/kg/day, orally for 4 wk. The control group was fed a diet without thyroid powder for 4 wk. Serum free-T4 level (RIA) in the hyperthyroid group (n = 9) increased from 0.68 +/- 0.07 to 5.72 +/- 0.95 ng/dl (mean +/- SE) (p less than 0.01). Pdi decreased 30 to 40% at all frequencies (p less than 0.05) except 10 Hz. Twitch shortening of the crural and costal parts, compared with pretreatment state, decreased significantly by 47.7 +/- 13.1 and 48.1 +/- 15.0%, respectively (p less than 0.05). The maximal rate of relaxation became significantly faster, by 63.5% (p less than 0.05), in the crural part, whereas that of the costal part tended to become faster but not to a significant extent. In the quadriceps femoris, although twitch force showed no change, both the maximal rate of contraction and maximal rate of relaxation became faster, and tetanic force decreased. Histologic examination of hyperthyroid dogs showed vacuolization and loss of fiber area of the diaphragm. These observations suggest that thyroid hormone impairs contractility of both the crural and costal parts of the diaphragm similarly, and that the decrease in contractility may be due to a loss of muscle mass and summation impairment of twitch contraction, which differs from that in other skeletal muscles.

[Usefulness of magnetic resonance imaging (MRI) in the detection of the lesions of gestational trophoblastic disease--comparison with computed tomography and digital subtraction angiography].

Twenty patients with gestational trophoblastic disease (GTN) were examined by Magnetic Resonance Imaging (MRI), Computed Tomography (CT) and Digital Subtraction Angiography (DSA), to evaluate their usefulness in the diagnosis of the disease. The lesions of hydatidiform mole were mainly composed of molar vesicles, dilated vessels and hemorrhage which were depicted as small round high intensity lesions on the T2-weighted images and as tree-like low intensity lesions and high or low intensity lesions of various shapes in the T1-, T2-weighted images. These MRI findings closely corresponded to the histopathological findings. On the other hand, CT findings obtained with hydatidiform mole were characterized by filling defects or a small round low density area on contrast enhanced images. The detection ratio for intramural lesions of invasive mole and choriocarcinoma by MRI was 83% (5/6), while that by CT was 50% (3/6). The obliteration of the junctional zone and interruption of the myometrium observed in MRI were significant signs suggesting intramural invasion of the disease. In fact, these signs in MRI were observed in all of the six cases with invasive mole or choriocarcinoma examined. In conclusion, MRI is a powerful means for the determining the intramural invasive mole and choriocarcinoma. Thus more accurate diagnosis of GTN will be obtained with the combined use of MRI and DSA.

Relationship of respiratory effort sensation to expiratory muscle fatigue during expiratory threshold loading.

We investigated whether fatigue of the expiratory muscle, that is, the abdominal muscle, may account for a change in the respiratory effort sensation in normal subjects during expiratory threshold loading. The respiratory effort sensation was scored using a modified Borg scale. Expiratory muscle fatigue was assessed both from changes in the maximal static expiratory pressure and in the centroid frequency (fc) of the abdominal muscle electromyogram (EMG). Expiratory threshold loading (magnitude of threshold; 40 to 60% of the maximal expiratory pressure at FRC, breathing frequency = 15/min, and duty cycle = 0.5) was continued until exhaustion or for 30 min. Loading was repeated following a 15-min recovery period after the end of the first expiratory loading. The maximal static expiratory pressure during loading (Pmmax) decreased initially and then remained decreased. Decreases were smaller with the 40% load (22 +/- 6%, SEM) than with the 60% load (37 +/- 3%) (p less than 0.05). The decrease during the second run of the 60% load was greater than during the first (p less than 0.01 by ANOVA). The maximal expiratory pressure at TLC before the second run of the 60% load was decreased by 9 +/- 3% compared with the control (p less than 0.02) but that with the 40% load was not. The fc with the 60% load decreased initially by 8 +/- 1% and then remained constant, although no change was observed with the 40% load.(ABSTRACT TRUNCATED AT 250 WORDS)

Pharmacokinetics of temocapril hydrochloride, a novel angiotensin converting enzyme inhibitor, in renal insufficiency.

The pharmacokinetics of temocapril hydrochloride, a novel prodrug-type angiotensin-I converting enzyme (ACE) inhibitor, has been studied in patients with mild (Group II) to severe (Group III) renal insufficiency in comparison with subjects with normal renal function (Group I). The pharmacokinetic parameters of the active diacid metabolite, including Cmax, AUC and half-life (t1/2), showed only slight changes between the three groups: AUC (0-inaffinity) was significantly larger in Group III than Group I, and t1/2 tended to be prolonged in Group III, but the change was not significant. The urinary recovery of the diacid was significantly decreased in Group III. (Group I, 28.1%, Group II, 21.6%, Group III, 12.8%). Compared with other ACE inhibitors, which are mainly excreted through the kidney, the plasma concentration of the active diacid metabolite was hardly influenced by renal function. It was speculated that lowering of the dose of temocapril might be recommended only in patients with severe renal insufficiency.