Pathogenic role of NAMPT in the perivascular regions after ischemic stroke in mice with type 2 diabetes mellitus.

Ischemic stroke in patients with abnormal glucose tolerance results in poor outcomes. Nicotinamide phosphoribosyltransferase (NAMPT), an adipocytokine, exerts neuroprotective effects. However, the pathophysiological role of NAMPT after ischemic stroke with diabetes and the relationship of NAMPT with cerebrovascular lesions are unclear. The purpose of this study was to clarify the pathophysiological role of NAMPT in cerebral ischemia with diabetes, using db/db mice as a type 2 diabetes animal model. The number of degenerating neurons increased after middle cerebral artery occlusion and reperfusion (MCAO/R) in db/db mice compared with the degenerating neurons in db/+ mice. Extracellular NAMPT (eNAMPT) levels, especially monomeric eNAMPT, increased significantly in db/db MCAO/R mice but not db/+ mice in isolated brain microvessels. The increased eNAMPT levels were associated with increased expression of inflammatory cytokine mRNA. Immunohistochemical analysis demonstrated that NAMPT colocalized with GFAP-positive cells after MCAO/R. In addition, both dimeric and monomeric eNAMPT levels increased in the conditioned medium of primary cortical astrocytes under high glucose conditions subsequent oxygen/glucose deprivation. Our findings are the first to demonstrate the ability of increased monomeric eNAMPT to induce inflammatory responses in brain microvessels, which may be located near astrocyte foot processes.

Larvae of Clistobothrium grimaldii (Cestoda: Phyllobothriidea) from a Cape fur seal (Arctocephalus pusillus pusillus) kept in a zoo in Japan.

The larval form of the Phyllobothriidea cestode was found in the blubber of a Cape fur seal (Arctocephalus pusillus pusillus) from a zoo in Japan. Bladder-bearing larval cestodes with a scolex have been occasionally reported from blubbers of pinnipeds and morphologically identified as Clistobothrium delphini (formerly known as Phyllobothrium delphini) or rarely Clistobothrium grimaldii (Monorygma grimaldii). Although the larvae here morphologically resembled C. delphini, the 28S rDNA sequence was 100% (1,430/1,430 bp) homologous to the registered sequence of C. grimaldii (GenBank Accession No. KU724058). This discrepancy between morphological and molecular analyses confirms the difficulty of identifying C. delphini and C. grimaldii larvae based solely on morphology, and the need for molecular data to elucidate the morphological variations in Clistobothrium parasites.

Dietary protein supplementation results in molecular and cellular changes related to T helper type 2 immunity in the lung and small intestine in lactating rats re-infected with Nippostrongylus brasiliensis.

Acquired immunity to gastrointestinal nematodes reduces during late pregnancy and lactation which is known as periparturient relaxation of immunity (PPRI). Protein supplementation reduces the degree of PPRI in a rat model re-infected with Nippostrongylus brasiliensis, but the underlying molecular mechanisms have yet to be elucidated. Here, we hypothesized that protein supplementation will enhance T helper type 2 immunity (Th2) in the lung and small intestine. Nulliparous Sprague-Dawley rats were given a primary infection of N. brasiliensis prior to mating and restrictedly fed diets with either low protein (LP) or high protein (HP) during pregnancy and lactation. Dams were secondary infected with N. brasiliensis on day 2 post-parturition, and histology and gene expression were analysed for tissue samples collected at days 5, 8 and 11. Genes related to Th2 immunity in the lung, Retnla, Il13 and Mmp12, and in the intestine, Retnlb, were upregulated in HP dams compared to LP dams, which indicates the effect of dietary protein on Th2 immunity. HP dams also had increased splenic CD68+ macrophage populations compared to LP dams following secondary infection, suggesting enhanced immunity at a cellular level. Our data assist to define strategic utilization of nutrient supply in mammals undergoing reproductive and lactational efforts.

Subtype analysis and prevalence of mixed subtype infection of Blastocystis in farmed pigs from Chiba Prefecture, Japan.

Blastocystis is an intestinal eukaryote found globally in humans and a wide range of animals. Blastocystis has been reported in domestic pigs, with subtype (ST) 5 being the most dominant, followed by ST1 and ST3. PCR-sequencing is commonly used for ST identification in pigs, but it often results in an underestimation of the prevalence of mixed infections. Here, we aimed to investigate the ST distribution and prevalence of mixed ST infections of Blastocystis in pigs from Chiba Prefecture in eastern Japan. A total of 82 fecal samples positive for Blastocystis were collected from two different farms, A and B. PCR was performed using ST-specific primers for ST1, ST2, ST3, and ST5. The prevalence of single ST5 infections was 37.8% (31/82), whereas that of mixed infections with ST5 and other STs was 57.3% (47/82) . A high percentage of single ST5 infections was observed in sows, piglets, and weaners from farm A (13/15, 86.7%), whereas mixed infections of ST5 and other STs (ST1 and ST3) were observed in 3- to 5-month-old grower pigs (15/18, 83.3%). Similarly, in farm B, most sows and piglets under 1 month of age showed a single ST5 infections (12/17, 70.6%), whereas weaner, grower, and finisher pigs showed mixed infections with ST5 and other STs, including ST1, ST2, and ST3 (27/28, 96.4%). In domestic pigs, diet and rearing environments change dramatically over the course of the animal's lifetime, which may have caused this difference in the prevalence of mixed ST infections among different age groups.

Prevalence and Molecular Characterization of the Zoonotic Enteric Protozoans Cryptosporidium spp., Enterocytozoon bieneusi, and Blastocystis from Pallas's Squirrels (Callosciurus erythraeus) in Kanagawa Prefecture, Japan.

Pallas's squirrel (Callosciurus erythraeus) was introduced in Japan in the 1930s and has since established itself in several areas across the country. Although wild Sciuridae populations have been demonstrated to be potential reservoirs for zoonotic enteric protozoa, epidemiological studies of such pathogens in Japan are scarce. Here, we examined 423 fecal samples from Pallas's squirrels captured in Kanagawa Prefecture, Japan, using PCR and DNA sequencing to determine the occurrence of Cryptosporidium spp., Enterocytozoon bieneusi, and Blastocystis. The overall prevalence of Cryptosporidium spp., E. bieneusi, and Blastocystis was 4.3% (18/423 samples), 13.0% (55/423 samples), and 44.0% (186/423 samples), respectively. The prevalence of Blastocystis and E. bieneusi was significantly higher in spring (60.1% and 17.4%, respectively) than in winter (27.6% and 8.6%, respectively [P < 0.01]). Sequence analysis of Cryptosporidium spp., targeting the partial small subunit ribosomal RNA gene (SSU rDNA), showed 100% identity (541/541 bp) to Cryptosporidium ubiquitum, and analysis of the gp60 gene showed 99.76% (833/835 bp) identity to C. ubiquitum subtype XIIh. The sequences of the ribosomal internal transcribed spacer region of E. bieneusi and the partial SSU rDNA of Blastocystis were identified as E. bieneusi genotype SCC-2 and Blastocystis subtype 4, respectively. This study confirmed the presence of C. ubiquitum, E. bieneusi, and Blastocystis in Pallas's squirrels in Kanagawa Prefecture. Because Pallas's squirrels inhabit urban areas, living close to humans, the species may serve as a potential source of infection in human populations. IMPORTANCE Pallas's squirrel is designated a "regulated organism" under the Invasive Alien Species Act in Japan, and municipal authorities are introducing control measures to reduce its populations. It has been suggested that wild mammals may play a role in contaminating the environment with zoonotic pathogens. The present study detected the enteric pathogens Cryptosporidium ubiquitum, Enterocytozoon bieneusi, and Blastocystis in the feces of Pallas's squirrels inhabiting Kanagawa Prefecture, Japan. These pathogens persist in the environment and contaminate soils and water, which may potentially infect humans. Because Pallas's squirrels in Kanagawa Prefecture are found in urban areas, where they are in close contact with human populations, continued monitoring of zoonotic diseases among squirrel populations will be important for evaluating the significance of wildlife in pathogen transmission.

Eucoleus garfiai (Gállego et Mas-Coma, 1975) (Nematoda: Capillariidae) infection in wild boars (Sus scrofa leucomystax) from the Amakusa Islands, Japan.

We examined lingual tissues of Japanese wild boars (Sus scrofa leucomystax) captured in the Amakusa Islands off the coast of Kumamoto Prefecture. One hundred and forty wild boars were caught in 11 different locations in Kamishima (n = 36) and Shimoshima (n = 104) in the Amakusa Islands, Japan between January 2016 and April 2018. Lingual tissues were subjected to histological examinations, where helminths and their eggs were observed in the epithelium of 51 samples (36.4%). No significant differences in prevalence were observed according to maturity, sex or capture location. Lingual tissues positive for helminth infection were randomly selected and intact male and female worms were collected for morphological measurements. Based on the host species, site of infection, and morphological details, we identified the parasite as Eucoleus garfiai (Gállego et Mas-Coma, 1975) Moravec, 1982 (syn. Capillaria garfiai). This is the first report from outside Europe of E. garfiai infection in wild boars. Phylogenetic analysis of the parasite using the 18S ribosomal RNA gene sequence confirmed that the parasite grouped with other Eucoleus species, providing additional nucleotide sequence for this genus. Since wild boar populations are widely distributed in Japan, continuing surveys on the epidemiology of the parasite and identifying possible intermediate host candidates are crucial for elucidating the transmission route of the parasite.

Body Protein Reserves Sustain Maternal Performance in Early Lactation but Dietary Protein Is Necessary to Maintain Performance and Immune Responses to Nippostrongylus brasiliensis in Lactating Rats.

Background: It has been shown that dietary protein supplementation during lactation boosts immunity in Nippostrongylus brasiliensis-infected periparturient rats. It is not known whether body protein reserves accumulated during gestation have a similar effect during lactation. Objective: This study aimed to quantify the impact of body protein reserves and dietary protein supplementation on maternal performance and immune responses to N. brasiliensis during lactation. Methods: Multiparous female Sprague-Dawley rats were administered a primary infection of N. brasiliensis before mating and were restriction-fed either 60 g [low-protein diet gestation (Lge)] or 210 g [high-protein diet gestation (Hge)] crude protein (CP) per kilogram of dry matter (DM) until parturition. From parturition onward, dams were restriction-fed either 100 g [low-protein diet lactation (Lla)] or 300 g [high-protein diet lactation (Hla)] CP per kilogram of DM, generating 4 different dietary treatments. A subset of rats was sampled before parturition; postparturition, dams were secondarily infected with N. brasiliensis and samples were collected at days 5 and 11 postparturition. Results: Maternal performance until parturition, as measured by pup weight, was better in Hge rats than in Lge rats [Lge: 4.84 g; Hge: 6.15 g; standard error of the difference (SED): 0.19]. On day 11, pup weights of dams with reduced protein reserves fed protein during lactation (Lge-Hla; 20.28 g) were higher than their counterparts from Hge-Lla dams (17.88 g; SED: 0.92). Worm counts were significantly different between Lge-Lla-fed (253; 95% CI: 124, 382) and Hge-Hla-fed (87; 95% CI: 22, 104) dams on day 11 (P = 0.024). The expression of splenic interleukin 13 (Il13) and arachidonate 15-lipoxygenase (Alox15) was significantly higher (P < 0.05) in Hge-Hla dams compared with Lge-Lla dams on day 5. Conclusions: Although protein reserves were adequate to maintain maternal performance in the early stage of lactation in dams infected with N. brasiliensis, they were not adequate to maintain maternal performance and effective immune responses at later stages. Dietary protein supplementation was required to achieve this.

Prevalence and molecular subtyping of Blastocystis from dairy cattle in Kanagawa, Japan.

Blastocystis is an intestinal protist, commonly found in the human population and in a wide range of animals globally. Currently, isolates from mammalian and avian hosts are classified into 17 subtypes (STs) based on phylogeny of the small subunit rRNA gene (SSU rDNA), of which ten (ST1-9, 12) are reported in humans. ST10 is a major ST reported from livestock cattle. However, other STs including ST1, 3, 4, 5, and 6, which have the potential to be transmitted to humans, are also reported from cattle in several countries. Although a survey has been conducted previously in western Japan for livestock cattle, there is no information available regarding other parts of Japan. Therefore, this study surveyed the prevalence of Blastocystis and its STs in cattle from Kanagawa prefecture, eastern Japan. Fecal specimens, collected from 133 dairy cattle on four different farms, were subjected to a short-term xenic in vitro culture and Blastocystis were identified by microscopic examination. Seventy-two cattle were positive for Blastocystis (54.1%). Direct sequences for the partial SSU rDNA were obtained for 45 samples. Based on nucleotide sequence homology search and phylogenetic analysis, 44 isolates were identified as ST14 and one as ST10. Our study confirms the presence of these STs in dairy cattle in Japan for the first time. The STs identified here, ST10 and ST14, support previous findings that Bovidae may be the natural host for both STs.

Impact of baseline visceral fat accumulation on prognosis in patients with metastatic renal cell carcinoma treated with systemic therapy.

The aim of this study was to evaluate the clinical significance of visceral fat accumulation as a prognostic factor in patients with metastatic renal cell carcinoma (mRCC) treated with systemic therapies. A total of 114 patients were retrospectively reviewed. All patients received systemic therapy for mRCC at Keio University hospital in Japan. The intra-abdominal visceral fat area was determined by computed tomography at the umbilical level. The visceral fat accumulation was defined as ≥100 cm2. The mean visceral fat area was 107.4 ± 62.8 cm2. In the whole cohort, the median follow-up was 29 months. According to the Memorial Sloan Kettering Cancer Center (MSKCC) classification, 27.2% patients were favorable risk, 53.5% were intermediate risk, and 19.3% were poor risk. Visceral fat accumulation correlated with improved progression-free (P = 0.0070) and overall survival (P = 0.0001). On multivariate analysis, visceral fat accumulation (P = 0.0290) and MSKCC classification (P = 0.0085) were independent indices to predict progression-free survival in first-line treatment. In addition, visceral fat accumulation (P = 0.0007) and MSKCC classification (P = 0.0005) independently predicted overall survival. Prognostic grouping using visceral fat accumulation was identified as an independent prognostic marker in patients with mRCC. The addition of visceral fat accumulation improved the prognostic value of MSKCC classification alone in predicting overall survival in patients treated with systemic therapy for mRCC.

[Clinical characteristics and outcomes of congenital midureteral stricture detected by fetal ultrasonography].

OBJECTIVES: Congenital midureteral stricture (CMS), which develops from obstructive lesion between pyeloureteral junction and ureterovesical junction, is relatively rare and its clinical condition and therapeutic strategy have not yet been established. We analyzed the clinical characteristics and surgical outcomes of CMS. PATIENTS AND METHODS: From November 2006 to December 2012, out of 137 patients presented with congenital hydrohephrosis, we identified 4 pediatric patients diagnosed with CMS at our institutions. We retrospectively investigated clinical characteristics and surgical outcomes in these 4 patients. RESULTS: Three boys and one girl were identified in this study. All patients were detected hydronephrosis by fetal ultrasonography. The median age at the diagnosis of CMS was 1 year and 11 months. Three patients had obstructive lesion in left side and 1 patient in right. CMSs were located at the level of L4 in 2 patients, and at the level of L5 and S1 in each 1. Split renal function was decreased less than 45% in 3 of 4 patients. Ipsilateral pyeloureteral junction obstruction and ipsilateral hypoplastic kidney were identified in 2 and 1 patient, respectively. One patient developed urosepsis and underwent nephrostomy. Partial ureterectomy and ureteroureterostomy, pyeloplasty were performed in 3 and 1 patient, respectively. Extrinsic obstruction was detected in just 1 patient intraoperatively. In all patients, there were no protruded lesion and atrophied, fibrotic and ischemic muscles were not detected in pathological finding. Neither urinary tract infection nor recurrence of obstructive lesion was detected in all patients at the mean follow-up period of 3 years and 1 month. CONCLUSION: We analyzed the clinical characteristics of 4 pediatric patients with CMS. In order to prevent critical infection and maintain renal function, it could be considered that surgical intervention is undertaken just after making the diagnosis of CMS.

[Synchronous male bladder cancer and breast cancer - a case report].

A 74-year-old man complained of blood in his urine over a 1-week period beginning in early October 2013, and was examined in the urology department of our hospital. A thorough examination revealed bladder cancer, and surgery was planned after two cycles of preoperative gemcitabine plus cisplatin chemotherapy. A chest computed tomography (CT) performed to evaluate the response to chemotherapy revealed a mass in the right breast. The patient had previously complained about the same site, and mammography and ultrasonography had suggested the possibility of a malignant mammary gland tumor. The results of aspiration cytology were Class V, and based on that finding, a diagnosis of cancer of the right breast was made. In February 2014, we performed a mastectomy, while preserving the pectoral muscles, along with sentinel node biopsy, total cystectomy, urethrectomy, pelvic lymph node dissection, and ureteroileal anastomosis. The histopathological diagnosis of the right breast tumor was invasive ductal carcinoma[scirrhous carcinoma, ly (+), v (-), g (+), f (+), s (+), nuclear grade 1=atypia 2+mitosis 1, EIC (-), ICT (-), NCAT (-)]. A micrometastatic tumor measuring approximately 1mm was observed in the sentinel lymph node. The breast disease was classified as pT1N1mi(sn)M0, Stage IIA, and the tumor was ER (+), PgR (+), HER2/neu (2+), and FISH (-). The bladder cancer was diagnosed as urothelial carcinoma, non-papillary, invasive G2>G3, pT2a; no pelvic lymph node metastases were detected, and it was classified as pT2aN0M0, Stage II. Synchronous male breast cancer and bladder cancer is a very rare condition, and we report the case with a review of the literature.

A secreted decoy of InR antagonizes insulin/IGF signaling to restrict body growth in Drosophila.

Members of the insulin peptide family have conserved roles in the regulation of growth and metabolism in a wide variety of metazoans. Drosophila insulin-like peptides (Dilps) promote tissue growth through the single insulin-like receptor (InR). Despite the important role of Dilps in nutrient-dependent growth control, the molecular mechanism that regulates the activity of circulating Dilps is not well understood. Here, we report the function of a novel secreted decoy of InR (SDR) as a negative regulator of insulin signaling. SDR is predominantly expressed in glia and is secreted into the hemolymph. Larvae lacking SDR grow at a faster rate, thereby increasing adult body size. Conversely, overexpression of SDR reduces body growth non-cell-autonomously. SDR is structurally similar to the extracellular domain of InR and interacts with several Dilps in vitro independent of Imp-L2, the ortholog of the mammalian insulin-like growth factor-binding protein 7 (IGFBP7). We further demonstrate that SDR is constantly secreted into the hemolymph independent of nutritional status and is essential for adjusting insulin signaling under adverse food conditions. We propose that Drosophila uses a secreted decoy to fine-tune systemic growth against fluctuations of circulating insulin levels.

Renal cell carcinoma arising from a horseshoe kidney in a chronic hemodialysis patient.

A 60-year-old man undergoing hemodialysis for 13 years was referred to our department for evaluation of gross hematuria and a right renal mass. Voided urine cytology was negative. Computed tomography and magnetic resonance imaging demonstrated a right renal mass (32 × 22 × 20 mm in diameter). We clinically diagnosed the tumor as renal cell carcinoma staged T1aN0M0 arising from a horseshoe kidney, and performed right heminephrectomy. Pathological examination of the surgical specimen showed a grade 2, pT1a, clear cell carcinoma and negative surgical margin. To our knowledge, this is a rare case of a renal cell carcinoma arising from a horseshoe kidney in a chronic hemodialysis patient.