Efficacy and safety of mesh non-fixation in patients undergoing laparo-endoscopic repair of groin hernia: a systematic review and meta-analysis.

PURPOSE: To examine updated evidence on the efficacy and safety of mesh non-fixation in patients undergoing laparo-endoscopic repair of groin hernias. METHODS: We searched MEDLINE, Cochrane Central Library, Embase, ClinicalTrials. gov, and ICTRP databases to identify randomized controlled trials. The primary outcomes were recurrence, chronic pain, and return to daily life. The certainty of evidence (CoE) was assessed by grading recommendations, assessments, developments, and evaluations. We performed a subgroup analysis based on the surgical type. This study was registered with PROSPERO (CRD 42022368929). RESULTS: We included 25 trials with 3,668 patients (4,038 hernias) were included. Mesh non-fixation resulted in little to no difference in hernia recurrence (relative risk [RR]:1.40, 95% confidence interval [CI]:0.59-3.31; I2 = 0%; moderate CoE) and chronic pain (RR:0.48, 95% CI:0.13-1.78; I2 = 77%; moderate CoE), but reduced return to daily life (mean difference [MD]: - 1.79 days, 95% CI: - 2.79 to -0.80; I2 = 96%; low CoE). In subgroup analyses, the transabdominal preperitoneal approach (TAPP) (MD: - 2.97 days, 95% CI: - 4.87 to - 1.08; I2 = 97%) reduced return to daily life than total extraperitoneal inguinal approach (MD: - 0.24 days, 95% CI - 0.71 to 0.24; I2 = 61%) (p = 0.006). CONCLUSIONS: Mesh nonfixation improves the return to daily life without increasing the risk of hernia recurrence or chronic pain. Surgeons and patients may discuss mesh nonfixation options to accommodate a patient's desired return to daily life. Further trials focusing on TAPP are required to confirm these findings.

DNA methylation of GJA1, BMP2 and BMP4 in a human cementoblast cell line induced by lipopolysaccharide.

AIM: To examine DNA methylation of GJA1, BMP2 and BMP4 in human cementoblasts (HCEM) induced by lipopolysaccharide (LPS). METHODOLOGY: HCEM were cultured in osteoinduction medium. After 24 h, Escherichia coli LPS (1 µg/mL) was added to the medium, which was changed every 2-3 days. Untreated samples were used as controls. Messenger RNA was extracted after 4 weeks, and quantitative real-time polymerase chain reaction (qRT-PCR) for GJA1, BMP2, BMP4 and DNMT1 was performed. Genomic DNA was extracted after 4 weeks, and quantitative methylation-specific polymerase chain reaction was carried out for GJA1, BMP2 and BMP4. To detect mineralization, alizarin red and alkaline phosphatase staining were performed. The cells were also treated with the DNA methyltransferase inhibitor 5-Aza-2'-deoxycytidine (5Aza) and examined. The significance of differences amongst groups was assessed using a two-way analysis of variance (ANOVA) followed by Bonferroni's multiple comparison test with P < 0.05 being significant. RESULTS: Decreased expression of mRNA was seen in GJA1, BMP2 and BMP4 after 4 weeks (P < 0.05). DNA hypermethylation was detected in GJA1, BMP2 and BMP4 (P < 0.05). Alizarin red staining and alkaline phosphatase staining revealed decreased mineralization levels in HCEM stimulated with LPS. 5Aza abolished the effects of DNA methylation in HCEM stimulated with LPS. CONCLUSIONS: These results suggest that long-term LPS stimulation induces DNA methylation of GJA1, BMP2 and BMP4 in HCEM.

Response of porcine epithelial rests of Malassez to stimulation by interleukin-6.

AIM: To investigate the proliferation and migration of epithelial cell rests of Malassez (ERM) after stimulation with IL-6. METHODOLOGY: Porcine-derived ERM were seeded on Dulbecco's modified Eagle's Medium, and IL-6 (100 pg mL-1 ) was incorporated into the culture medium. The WST-1 assay was performed to evaluate cell proliferation, and absorption was measured at 450 nm. A wound-healing assay and immunofluorescence assay for integrin α3 were conducted to investigate migration. The Kruskal-Wallis test and the Mann-Whitney U-test with Bonferroni correction were used to analyse data of WST-1 and wound-healing assays. RESULTS: Cell proliferation following the stimulation by IL-6 increased over time, with a significant increase being observed at 6 h (P < 0.05), but not in a concentration-dependent manner. Cell proliferation was significantly greater in IL-6-treated ERM than in nontreated ERM (P < 0.05). The results of the wound-healing assay revealed earlier closure in IL-6-treated ERM (P < 0.05). In the immunofluorescence assay, integrin α3 was detected at the edge of cell processes adjacent to the wound area. A neutralized antibody abrogated the effects of the IL-6 stimulation in cell proliferation and migration. CONCLUSION: IL-6 promoted the proliferation and migration of porcine ERM in vitro.

Coping strategies and risk of cardiovascular disease incidence and mortality: the Japan Public Health Center-based prospective Study.

AIMS: Coping strategies may be significantly associated with health outcomes. This is the first study to investigate the association between baseline coping strategies and cardiovascular disease (CVD) incidence and mortality in a general population cohort. METHODS AND RESULTS: The Japan Public Health Center-based prospective Study asked questions on coping in its third follow-up survey (2000-04). Analyses on CVD incidence and mortality included 57 017 subjects aged 50-79 without a history of CVD and who provided complete answers on approach- and avoidance-oriented coping behaviours and strategies. Cox regression models, adjusted for confounders, were used to determine hazard ratios (HRs) according to coping style. Mean follow-up time was 7.9 years for incidence and 8.0 years for mortality.The premorbid use of an approach-oriented coping strategy was inversely associated with incidence of stroke (HR = 0.85; 95% CI, 0.73-1.00) and CVD mortality (HR = 0.74; 95% CI, 0.55-0.99). Stroke subtype analyses revealed an inverse association between the approach-oriented coping strategy and incidence of ischaemic stroke (HR = 0.79; 95% CI, 0.64-0.98) and a positive association between the combined coping strategy and incidence of intra-parenchymal haemorrhage (HR = 2.03; 95% CI, 1.01-4.10). Utilizing an avoidance coping strategy was associated with increased mortality from ischaemic heart disease (IHD) only in hypertensive individuals (HR = 3.46; 95% CI, 1.07-11.18). The coping behaviours fantasizing and positive reappraisal were associated with increased risk of CVD incidence (HR = 1.24; 95% CI, 1.03-1.50) and reduced risk of IHD mortality (HR = 0.63; 95% CI, 0.40-0.99), respectively. CONCLUSION: An approach-oriented coping strategy, i.e. proactively dealing with sources of stress, may be associated with significantly reduced stroke incidence and CVD mortality in a Japanese population-based cohort.

Actin stabilization induces apoptosis in cultured porcine epithelial cell rests of Malassez.

AIM: To test whether actin stabilization by jasplakinolide induces inhibition of cell viability and apoptosis in epithelial cell rests of Malassez (ERM). METHODOLOGY: ERM derived from porcine were spread in a 96-well dish (5 × 10(4) /well) using Dulbecco's modified Eagle's medium. The actin-specific stabilization reagent, jasplakinolide, was incorporated into the culture medium and incubated for 24 h. To evaluate cell viability, the WST-1 assay was carried out and absorption (450 nm) was measured. To detect apoptotic cells, monoclonal antibody to single-strand DNA (ssDNA) was used and absorption (405 nm) was measured. Actin stabilization and apoptosis induced by jasplakinolide were morphologically investigated by staining with Alexa Fluor 568 phalloidin and observed under a fluorescent microscope. As a negative control, DMSO was used instead of jasplakinolide. Differences between the jasplakinolide-treated group and the control group were analysed statistically using the Student's t-test. RESULTS: Cell viability decreased in a concentration-dependent manner, and cell viability in the jasplakinolide-treated ERM was lower than that in nontreated ERM (n = 16, P < 0.01). Apoptotic cells in the jasplakinolide-treated ERM were more frequently detected compared to that in nontreated ERM (n = 16, P < 0.01). Morphologically, shrinkage, irregular forms and fragmentation of nuclei suggesting apoptotic bodies were observed in jasplakinolide-treated ERM, whilst actin filaments were extended in non-treated ERM. CONCLUSION: Actin stabilization by jasplakinolide inhibited cell viability and induced apoptosis in epithelial cell rests of Malassez.

Evaluation of oro-facial function in young subjects with temporomandibular disorders.

The aim of this study was to evaluate bite force (BF) and oro-facial functions at different dentition phases (initial-mixed, intermediate-mixed, final-mixed and permanent dentition) in children and adolescents diagnosed with temporomandibular disorders (TMDs). The sample was selected from four public schools in Piracicaba, São Paulo, Brazil. Of the 289 participants recruited, aged 8-14 years old, 46 were placed into the TMD group. TMD was diagnosed using Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (2011). Oro-facial functions were evaluated using the Nordic Orofacial Test-Screening (NOT-S), which involves both an interview and a clinical examination. BF was measured using a digital gnathodynamometer. Age and body mass index (BMI) were also considered. The data were analysed by the following tests: Kolmogorov-Smirnov test, Student's t-test, Spearman and Pearson coefficients, Qui-square test, Fisher's exact or binomial test, as indicated. Moreover, univariate and multivariable logistic regression were applied. For the TMD group, scores associated with NOT-S interview and NOT-S total were higher than for the control group (P = 0.033 and P = 0.0062, respectively). No differences in BF between genders or groups (P > 0.05) were detected. Variables included in the multivariate logistic regression were BMI and NOT-S total. Based on this analysis, NOT-S total was associated with TMDs. Reported sensory function was the specific domain within NOT-S interview that established the significant difference between the groups (P = 0.021). The TMD group also had a greater number of alterations in the face-at-rest domain of the NOT-S exam (P = 0.007). Concluding, it did not detect an association between TMDs and either dentition phase or BF. Instead, BF correlated with age and BMI. Oro-facial dysfunction was associated with TMD in the studied sample, but this association may be bidirectional, requiring further researches.

Changes in the oral-health-related quality of life of Brazilian children after an educational preventive programme: an 1-month longitudinal evaluation.

OBJECTIVE: This 1-month longitudinal study assessed whether the oral status and the oral-health-related quality of life (OHRQoL) of children changed after four sessions of an educational preventive programme. STUDY POPULATION AND METHODS: Fifty Brazilian students (11-12 year old) were examined for signs and symptoms of gingivitis using the Community Periodontal Index and two questions about gingival bleeding. The OHRQoL was measured using the Brazilian Portuguese version of the Child Oral Impacts on Daily Performances (Child-OIDP). Higher scores indicated worse OHRQoL. The results were analysed using the Shapiro-Wilk, Chi-square, Wilcoxon signed-rank and Mann-Whitney tests. The magnitude of the mean change was calculated using the effect size. RESULTS: Twenty-four percentage of children had more than six sites with bleeding at follow-up compared with 58% at baseline. There was a significant decline in the intensity and extension of impacts at follow-up. A significant improvement in the clinical status and oral hygiene was observed for both transitional categories. There was a significant decline in the Child-OIDP scores of those reporting 'much improved'. A significant improvement in the global ratings of oral health was observed at follow-up. CONCLUSIONS: In the studied sample, an improvement occurred with respect to the severity of disease, intensity and extension of impacts and global ratings of oral health after 1-month follow-up. These results suggest that improving the global transition in health by enhancing coping and management skills while inducing slight changes in the clinical status and the specific aspects of health compromised by the disease is possible.

Cell type-dependent effects of corticosteroid on periostin production by primary human tissue cells.

Overproduction of periostin, an IL-13-inducible matricellular protein, despite corticosteroid treatment is thought to be involved in the chronicity of allergic inflammation seen in corticosteroid-refractory tissue fibrosis. Therefore, we hypothesized that some tissue cells must produce periostin in a corticosteroid-insensitive manner. Here, we show that IL-4 and IL-13 each induced comparable levels of periostin production by primary normal human fibroblasts and microvascular endothelial cells derived from lung and skin. Dexamethasone, a corticosteroid, completely inhibited IL-4/13-induced, but did not affect TGF-ß-induced, periostin production by fibroblasts. In contrast, dexamethasone synergistically enhanced IL-4/13-induced periostin production by microvascular endothelial cells. TGF-ß did not induce periostin production by microvascular endothelial cells. Our novel findings suggest that IL-4/13-induced microvascular endothelium-derived and/or TGF-ß-induced fibroblast-derived periostin might play a pivotal role in corticosteroid-refractory tissue fibrosis, leading to chronic allergic inflammation in the lung and/or skin.

Effect of the angiotensin II receptor antagonist olmesartan on morning home blood pressure in hypertension: HONEST study at 16 weeks.

Morning home blood pressure (BP) levels are more closely associated with cardiovascular risk than clinic BP levels. However, control of morning home BP has been worse than that of clinic BP in clinical practice. We examined the effects of olmesartan-based treatment using data (n=21 341) from the first 16 weeks of the Home BP measurement with Olmesartan Naive patients to Establish Standard Target blood pressure (HONEST) study, a prospective observational study for olmesartan-naive patients with essential hypertension. After 16-week olmesartan-based treatment, the clinic and morning home systolic BP (SBP) lowered from 151.6±16.4 and 153.6±19.0 mm Hg to 135.0±13.7 and 135.5±13.7 mm Hg, respectively (P<0.0001). The achievement percentage of target morning home SBP (<135 mm Hg) in all patients, those with diabetes mellitus (DM), and those with chronic kidney disease (CKD) increased from 13.5, 16.4 and 17.2% to 50.8, 47.9 and 48.8%, respectively, and the proportion of patients with well-controlled hypertension (clinic SBP<140 mm Hg and morning home SBP<135 mm Hg) increased from 7.9, 9.2 and 10.2% to 38.9, 34.5 and 36.3%, respectively. After 16-week olmesartan-based treatment, the proportion of patients with masked and white coat hypertension changed from 11.8 to 24.2% and 5.6 to 11.9%. In conclusion, both clinic and morning home BP in all, DM and CKD patients improved with 16-week olmesartan-based treatment in the 'real world', and the results showed a sustained 24-hour BP-lowering effect of olmesartan. Decrease in clinic and home BP resulted in an increased rate of masked and white coat hypertension, and further management is needed in those patients.

Ozone microbubble treatment at various water temperatures for the removal of residual pesticides with negligible effects on the physical properties of lettuce and cherry tomatoes.

UNLABELLED: In this study, the effects of ozone microbubbles (OMCB) treatment at various water temperatures on the removal of residual fenitrothion (FT) pesticides and on the physical properties of lettuce and cherry tomatoes was examined. The residual FT percentage in lettuce and cherry tomatoes was shown decreased by using higher water temperatures, particularly at 30 °C, resulting in a decrease within the range of 32% to 52%, after the 20-min treatment. In addition, bubbling OMCB treatment did not alter the color and pulling strength of lettuce and cherry tomatoes. These results indicate that bubbling OMCB treatment at 30 °C is a highly effective method for the removal of FT residues in lettuce and cherry tomatoes, with relatively little effect on crop quality. PRACTICAL APPLICATION: The bubbling OMCB has a potential of reducing the FT reduces on vegetables with no adverse effect on the sensory quality of vegetables.

Estimation of sleepiness using pupillary response and its frequency components.

Pupillary response has been used as an index of sleepiness, but the validity of the index is not clear. In this paper, the influence of blinks on the Pupillary Unrest Index (PUI) and the Power Spectrum Density (PSD) as indices of pupil instability during a sleepiness test was examined. To create pupillary indices for sleepiness, four frequency components of the compensated pupillary change were extracted from PSD. These factor components were applied to two-class classifications of subjective sleepiness using discriminant analysis, and their performance was assessed. Differences in contribution ratios for the four factor components were observed between the two kinds of subjective sleepiness. Finally, a causal path diagram was created to show the relationship between blink, pupillary indices and subjective sleepiness.

Evaluation of masticatory performance and bite force in children with sleep bruxism.

The aim of this study was to evaluate the association between masticatory performance (MP) and bite force (BF) in children with sleep bruxism (SB) during the mixed dentition stage, considering also the occlusal characteristics. The sample was composed by 52 healthy children of both genders, aged 6-10 years. From those, 22 presented signs and symptoms of SB and 30 were the controls. SB diagnosis consisted of both parental report and presence of tooth wear. MP was evaluated by the individual's ability to communicate an artificial chewable test material for determining the median particle size (X50) and distribution of particles in the different sieves (b). BF was measured using a digital gnathodynamometer with fork strength of 8 mm. The results were submitted to descriptive statistics, Mann-Whitney and chi-square tests, Spearman's correlation and multiple logistic regression. Mean BF and X50 did not differ between groups with and without SB. A significant negative correlation was observed between BF and X50 only in the group of children with SB. Moreover, the logistic regression model showed an association between the presence of SB and higher b index. The other independent variables included in the model showed no association with SB. BF did not differ between children with and without SB. Besides, higher BFs in children with SB meant better MP; however, they were more likely to present chewed particles retained in the larger aperture sieves, consequently requiring more chewing cycles to break down the test material in smaller particles.

Effects of olmesartan on renal and cardiovascular outcomes in type 2 diabetes with overt nephropathy: a multicentre, randomised, placebo-controlled study.

AIMS/HYPOTHESIS: The renal and cardiovascular protective effects of angiotensin receptor blocker (ARB) remain controversial in type 2 diabetic patients treated with a contemporary regimen including an angiotensin converting enzyme inhibitor (ACEI). METHODS: We examined the effects of olmesartan, an ARB, on primary composite outcome of doubling of serum creatinine, endstage renal disease and death in type 2 diabetic patients with overt nephropathy. Secondary outcome included composite cardiovascular outcomes, changes in renal function and proteinuria. Randomisation and allocation to trial group were carried out by a central computer system. Participants, caregivers, the people carrying out examinations and people assessing the outcomes were blinded to group assignment. RESULTS: Five hundred and seventy-seven (377 Japanese, 200 Chinese) patients treated with antihypertensive therapy (73.5% [n = 424] received concomitant ACEI), were given either once-daily olmesartan (10-40 mg) (n = 288) or placebo (n = 289) over 3.2 ± 0.6 years (mean±SD). In the olmesartan group, 116 developed the primary outcome (41.1%) compared with 129 (45.4%) in the placebo group (HR 0.97, 95% CI 0.75, 1.24; p = 0.791). Olmesartan significantly decreased blood pressure, proteinuria and rate of change of reciprocal serum creatinine. Cardiovascular death was higher in the olmesartan group than the placebo group (ten vs three cases), whereas major adverse cardiovascular events (cardiovascular death plus non-fatal stroke and myocardial infarction) and all-cause death were similar between the two groups (major adverse cardiovascular events 18 vs 21 cases, all-cause deaths; 19 vs 20 cases). Hyperkalaemia was more frequent in the olmesartan group than the placebo group (9.2% vs 5.3%). CONCLUSIONS/INTERPRETATION: Olmesartan was well tolerated but did not improve renal outcome on top of ACEI. TRIAL REGISTRATION: ClinicalTrials.gov NCT00141453.

Removal of residual pesticides in vegetables using ozone microbubbles.

The removal of fenitrothion (FT) pesticide residues from vegetables by immersion in ozone-microbubbled solution was demonstrated. FT-treated lettuce, cherry tomatoes, and strawberries were immersed in ozone-microbubbled, ozone-millibubbled, and dechlorinated water. After that the percentage of residual FT in the vegetables was determined. Residual FT was efficiently removed from lettuce by immersing it in ozone-microbubbled solution containing more than 1.0 ppm dissolved ozone, or continuously generated ozone-microbubbled solution containing 2.0 ppm dissolved ozone. Similarly, for cherry tomatoes and strawberries, the continuously generated ozone-microbubbled solution containing 2.0 ppm dissolved ozone was highly effective. These results showed that ozone microbubbles effectively removed residual pesticides not only from leafy vegetables but also from fruity vegetables.

Prevention of excessive collagen accumulation by human intravenous immunoglobulin treatment in a murine model of bleomycin-induced scleroderma.

Systemic sclerosis (SSc) is an autoimmune disease characterized by fibrotic changes in skin and other organs involving excessive collagen deposition. Here we investigated the effect of intravenous immunoglobulin (IVIG) on fibrosis in a murine model of bleomycin (BLM)-induced scleroderma. Scleroderma was induced in C3H/He J mice by subcutaneous BLM injections daily for 35 days. The collagen content in skin samples from the BLM-injected group (6·30 ± 0·11 mg/g tissue) was significantly higher than the PBS group (5·80 ± 0·10 mg/g tissue), and corresponded with dermal thickening at the injection site. In contrast, mice treated with IVIG for 5 consecutive days after initiating BLM injection showed lesser collagen content significantly (IVIG group, 5·61 ± 0·09 mg/g tissue; BLM vs. IVIG). In order to investigate the cellular and protein characteristics in the early stage of the model, the skin samples were obtained 7 days after the onset of experiment. Macrophage infiltration to the dermis, monocyte chemoattractant protein (MCP-1)-positive cells, and increased TGF-ß1 mRNA expression were also observed in the BLM group. IVIG inhibited these early fibrogenic changes; MCP-1 expression was significantly lesser for the IVIG group (1·52 ± 0·19 pg/mg tissue) than for the BLM group (2·49 ± 0·26 pg/mg tissue). In contrast, TGF-ß1 mRNA expression was significantly inhibited by IVIG. These results suggest that IVIG treatment may inhibit macrophage recruitment to fibrotic sites by down regulating MCP-1 and TGF-ß production, and thus could be a potential drug for managing fibrotic disorders such as SSc.

Heart rate variability during high-intensity field exercise in female distance runners.

The purposes of this study were to demonstrate the transition of heart rate variability (HRV) during trials in the field and to examine the relationship between peak frequency of high-frequency band (HF) and stride frequency. Ten healthy long-distance college female runners (age 19-21 years) performed a 3000 m realistic time trial. The time-series power spectrum analysis by maximum entropy method was used to evaluate cardiac autonomic nervous activity during the race. Cross-correlation coefficients were calculated to estimate the degree of linear co-ordination between the central peak frequency of HF and stride frequency. Just after starting, the decrease in HF (0.15-1.00 Hz) and a transient increase of low-frequency band (LF)/HF were found. After that, the HF remained at a low level and LF/HF decreased sharply. These findings suggested that the parasympathetic activity was suppressed and sympathetic activity increased just after starting, and the sympathetic activity reached the saturated level according to continuation of high-intensity exercise. In spite of the significant decrease of HRV during trials, peak frequency of HF could be differentiated clearly. The cross-correlation coefficient of peak frequency of HF and stride frequency was from 0.703 to 0.868. This finding indicated that exercise rhythm reflected HRV during high-intensity running in the field.

Differences in the relationship between lipid CHD risk factors and body composition in Caucasians and Japanese.

OBJECTIVES: To examine differences in the relationship between fat distribution and lipid coronary risk factors in Caucasian and Japanese population and further to determine whether the cut-points for body mass index (BMI) and waist circumference (WC) proposed by WHO and NHLBI are applicable to Japanese population as a predictor of a lipid risk factor abnormality or not. RESEARCH METHODS AND PROCEDURES: Subjects were 895 participants of the Baltimore Longitudinal Study of Aging in the US (BLSA) and 1705 participants of the Longitudinal Study of Aging by the National Institutes for Longevity Science in Japan (NILS-LSA). Subjects were divided into four demographic groups as younger (age<65 y) men and women, and older (age> or =65 y) men and women. Blood total cholesterol, triglycerides, LDL- and HDL-cholesterol and anthropometry were measured. Regression coefficients of BMI and WC on risk factors, sensitivity and specificity of the BMI and WC cut-points for blood lipid abnormality, and mean values of blood lipids at BMI or WC cut-points were computed in both populations. RESULTS: Height, weight, WC and BMI were significantly greater in the BLSA than those in the NILS-LSA subjects. Total cholesterol, HDL- and LDL-cholesterol were significantly greater in the NILS-LSA than in the BLSA subjects. Sensitivities of BMI and WC cut-points were much lower in the NILS-LSA than in the BLSA subjects. Specificities of BMI and WC cut-points were higher in the NILS-LSA than in the BLSA subjects. Mean values of triglycerides, total cholesterol, HDL- and LDL-cholesterol at BMI=25 were significantly greater in the NILS-LSA than in the BLSA subjects. At the WC cut-point (94 cm for men, 80 cm for women), mean values of all lipids were significantly greater in the NILS-LSA than in the BLSA subjects with the exception of triglycerides in younger women. CONCLUSIONS: The Japanese subjects have smaller BMI and WC, worse total and LDL-cholesterol levels and better HDL-cholesterol levels compared to Caucasians. Sensitivities of BMI and WC for predicting lipid risk factor abnormality are much lower in Japanese. The cut-points for BMI and WC proposed by WHO and NHLBI may be too high for predicting an abnormality in triglycerides, total and LDL-cholesterol in Japanese. For detecting an abnormal HDL-cholesterol level, the BMI and WC cut-points may not be as beneficial for the Japanese population as for Caucasians.

Ozonolysis mechanism of lignin model compounds and microbial treatment of organic acids produced.

Treatment methods comprising ozonolysis and microbial treatment of lignin discharged from the pulp manufacture industries were investigated by using a sulfite pulp wastewater and a lignin model compound, i.e. sodium lignosulfonate. Dynamic behaviors for the formations of intermediate derivatives such as muconic acid, maleic acid, and oxalic acid produced from the ozonolysis of sulfite pulp wastewater were observed from data of UV absorption at 280 nm by a spectrophotometer and at 210 nm by high performance liquid chromatography. The microorganisms that were isolated by the enrichment culture method were used to degrade the organic acids such as oxalic acid and acetic acid. Time courses of biological degradation of these organic acids indicated diauxic growth, which was found in a culture with mixed substrates. In the treatment of sodium lignosulfonate, the ozonolysis and microbial treatment using activated sludge converted sodium lignosulfonate into carbon dioxide and water almost completely.

Cytokine and antibody production during the course of resolution in Plasmodium yoelii 17XL-infected BALB/c mice treated with febrifugine and isofebrifugine mixture from leaves of Hydrangea macrophylla var. Otaksa.

Cytokine and antibody production was investigated during the course of resolution of primary infection in Plasmodium yoelii 17XL-infected BALB/c mice treated with a mixture of febrifugine and isofebrifugine. The infected mice in an untreated control group showed a progressively increasing parasitemia, leading to mouse death. In contrast, infected mice given the mixture orally showed low parasitemia levels during administration. Following a transient increase in parasitemia in the bloodstream of the treated mice, no parasites could be detected by microscopic examination. Analysis of cytokines in plasma showed that the plasma IFN-gamma levels elevated significantly within the first week of infection in both groups. Furthermore, on day 20 the plasma IFN-gamma and IL-4 levels elevated significantly in the treated mice and the production of both cytokines was sustained until at least day 40. The production of both cytokines in the treated mice was coincident with a decrease in parasitemia. The production of parasite-specific antibodies in the course of P. yoelii 17XL infection was also monitored. In the drug-treated mice, the titers of parasite-specific IgG1, IgG2a, IgG2b and IgG3 elevated significantly from day 20; and the production of parasite-specific antibodies was coincident with a decrease in parasite numbers in the bloodstream.

Muscle performance after anterior cruciate ligament reconstruction.

We measured muscle strength in 36 patients after anterior cruciate ligament (ACL) reconstruction with autogenous bone-patellar tendon-bone graft. Quadriceps and hamstring isokinetic strength was assessed during concentric contraction at 60 and 180 degrees /s and was measured at 1, 6, 12 and 24 months postoperatively. At 24 months quadriceps muscle strength had recovered to approximately 90% of the level of the uninvolved side, both at 60 and 180 degrees /s. In contrast, hamstring muscle strength had already recovered to approximately 90% at 6 months. Age, gender, activity level, and anterior tibial laxity did not affect the muscle performance. However, the recovery of muscle strength was delayed in patients with anterior knee pain.