Pulmonary venous occlusion and death in pulmonary arterial hypertension: survival analyses using radiographic surrogates

BACKGROUND: Recent studies find that a considerable number of patients with pulmonary arterial hypertension (PAH) develop fibrous obstruction of the pulmonary veins. Such obstruction more commonly accompanies connective tissue disorder (CTD)-associated PAH than idiopathic PAH. However, few researchers have gauged the risk of death involving obstruction of the pulmonary veins. METHODS: Thirty-seven patients with PAH were enrolled (18 patients, idiopathic PAH; 19 patients, CTD-associated PAH). The patients were 49 ± 18 years and had a World Health Organization functional class of 3.2 ± 0.6. Thickening of the interlobular septa, centrilobular ground-glass attenuation, and mediastinal adenopathy were surrogates for obstruction of the pulmonary veins, and were detected by a 16-row multidetector computed tomography scanner. RESULTS: The follow-up period was 714 ± 552 days. Fifteen deaths occurred. Thickening of the interlobular septa, centrilobular ground-glass attenuation, and mediastinal adenopathy were found in 37.8%, 24.3%, and 16.2% of patients, respectively. Cox proportional hazard analysis revealed an increased risk of death with each radiographic surrogate (mediastinal adenopathy: p < 0.0001, hazard ratio = 13.9; thickening of interlobular septa: p < 0.001, hazard ratio = 12.0; ground-glass attenuation: p = 0.02, hazard ratio = 3.7). The statistical significance of these relationships was independent of the cause of PAH and plasma concentration of brain natriuretic peptide. CONCLUSIONS: The results of this study imply that obstruction of the pulmonary veins is associated with an increased risk of death in patients with PAH

SMAD3 mediates the specification of human induced pluripotent stem cell-derived epicardium into progenitors for the cardiac pericyte lineage

Understanding the molecular mechanisms of epicardial epithelial-to-mesenchymal transition (EMT), particularly in directing cell fate toward epicardial derivatives, is crucial for regenerative medicine using human induced pluripotent stem cell (iPSC)-derived epicardium. Although transforming growth factor β (TGF-β) plays a pivotal role in epicardial biology, orchestrating EMT during embryonic development via downstream signaling through SMAD proteins, the function of SMAD proteins in the epicardium in maintaining vascular homeostasis or mediating the differentiation of various epicardial-derived cells (EPDCs) is not yet well understood. Our study reveals that TGF-β-independent SMAD3 expression autonomously predicts epicardial cell specification and lineage maintenance, acting as a key mediator in promoting the angiogenic-oriented specification of the epicardium into cardiac pericyte progenitors. This finding uncovers a novel role for SMAD3 in the human epicardium, particularly in generating cardiac pericyte progenitors that enhance cardiac microvasculature angiogenesis. This insight opens new avenues for leveraging epicardial biology in developing more effective cardiac regeneration strategies

Reverse pharmacological effect of loop diuretics and altered rBSC1 expression in rats with lithium nephropathy

Reverse pharmacological effect of loop diuretics and altered rBSC1 expression in rats with lithium nephropathy.BackgroundRenal urinary concentration is associated with enhanced expression of rBSC1, a rat sodium cotransporter, in the thick ascending limb of Henle. Increased expression of rBSC1 was reported recently in nephrogenic diabetes insipidus induced by lithium chloride (Li nephropathy). However, the pathophysiological implication of altered rBSC1 expression has not yet been investigated.MethodsLi nephropathy was induced in rats by an oral administration of 40 mmol lithium/kg dry food. In rats with reduced urinary osmolality to less than 300 mOsm/kg H2O, we examined the expression of rBSC1 mRNA and protein, plasma arginine vasopressin (AVP) and RNA expression of kidney-specific water channel, aquaporin-2 (AQP2), of collecting ducts. Rats with Li nephropathy were treated with furosemide (3 mg/kg body weight), which blocks the activity of rBSC1, and changes in urine concentration, plasma AVP, medullary accumulation of Li ions, and apical AQP2 expression were determined.ResultsRats with Li nephropathy showed increased rBSC1 RNA and protein expression and reduced AQP2 RNA. In these rats, furosemide, which induces dilution of urine and polyuria in normal rats, resulted in a progressive and significant rise in urine osmolality from 167 ± 11 (mean ± SD) at baseline to 450 ± 45 mOsm/kg H2O at three hours after administration, and significant oliguria. In the same rats, plasma AVP decreased significantly from 5.7 to 3.0 pg/mL. In addition, recovery of apical AQP2 expression was noted in a proportion of epithelial cells of the collecting ducts. Although Li+ in the renal medulla was slightly lower in rats with Li nephropathy treated with furosemide, statistical significance was not achieved.ConclusionsOur results suggest that dehydration or high plasma AVP results in an enhanced rBSC1 expression in Li nephropathy, and that rBSC1 expression is closely associated with the adverse effects of Li ions on collecting duct function

Relation between walking fluctuation and physical fitness in the middle-aged and elderly

This study examined the relationship between walking fluctuation and physical fitness in 21 middle-aged and elderly healthy women (65.95 ± 6.6 years). Walking data was gained during a typical six-minute walk by using sensors in the participantsʼ shoes. Stride time (ST), the coefficient of variation of stride time (STCV), and the fractal-scaling index (α) were calculated. Also measured were the ten-meter usual walking time, functional reach, one-leg standing time with eyes open, vertical jump height, and grip strength, and a fitness age score (FAS) was then calculated by using these results. In addition, twenty-second stepping frequency, thirty-second chair standing frequency, and isometric knee extension strength were measured. There was a significant negative correlation between age and FAS (r=-0.590, p=0.005). When participants were divided into two groups by a median of ST, STCV and α, significantly superior physical fitness were observed in higher ST and higher STCV groups, whereas significantly longer step length were observed in higher α groups.This study therefore suggests that STCV is more affected by musculoskeletal function than α.論

Feasibility study of two schedules of sunitinib in combination with pemetrexed in patients with advanced solid tumors

Background Sunitinib is an oral multitargeted tyrosine kinase inhibitor of vascular endothelial growth factor and platelet-derived growth factor receptors, as well as of other receptor types. We have performed a feasibility study to investigate the safety of sunitinib in combination with pemetrexed for treatment of advanced refractory solid tumors. Methods Sunitinib was administered once daily on a continuous daily dosing (CDD) schedule (37.5 mg/day) or a 2-weeks-on, 1-week-off treatment schedule (50 mg/day, Schedule 2/1) in combination with pemetrexed at 500 mg/m2 on day 1 of repeated 21-day cycles. Results Twelve patients were enrolled in the study: six on the CDD schedule and six on Schedule 2/1. None of the treated patients experienced a dose-limiting toxicity. Toxicities were manageable and similar in type to those observed in monotherapy studies of sunitinib and pemetrexed. Pharmacokinetic analysis did not reveal any substantial drug–drug interaction. One patient with squamous cell lung cancer showed a partial response and five patients had stable disease. Conclusions Combination therapy with sunitinib administered on Schedule 2/1 (50 mg/day) or a CDD schedule (37.5 mg/day) together with standard-dose pemetrexed (500 mg/m2) was well tolerated in previously treated patients with advanced solid tumors

Investigation of cathodic reaction in SOFCs and PCFCs by using patterned thin film model electrodes

In recent years, fuel cells operating at relatively high temperatures, such as solid oxide fuel cells (SOFCs) using an oxide ion conducting electrolyte and proton ceramics fuel cells (PCFCs) using an proton conducting electrolyte, attract attentions as high-efficient energy-conversion devices. For further enhancements of the performance and the durability of SCFCs and PCFCs, it is essential to understand the electrode reactions. In particular, the knowledge on the dominant reaction path in the electrodes would help us to optimize the material and the microstructure of the electrode. Please click Additional Files below to see the full abstract

Exopolysaccharides From Streptococcus thermophilus ST538 Modulate the Antiviral Innate Immune Response in Porcine Intestinal Epitheliocytes

It was reported that exopolysaccharides (EPSs) from lactobacilli are able to differentially modulate mucosal antiviral immunity. Although research has described the ability of EPSs derived from Streptococcus thermophilus to modulate the mucosal immune system, their impact on antiviral immunity was less explored. In this work, we investigated the capacity of the EPS-producing S. thermophilus ST538 to modulate the innate antiviral immune response triggered by the activation of the Toll-like receptor 3 (TLR3) in porcine intestinal epitheliocytes (PIE cells). Moreover, in order to study the immunomodulatory potential of S. thermophilus ST538 EPS, we successfully developed two mutant strains through the knockout of the epsB or epsC genes. High-performance liquid chromatography and scanning electron microscopy studies demonstrated that the wild type (WT) strain produced as high as 595 μg/ml of EPS in the skim milk medium, while none of the mutant strains (S. thermophilus ΔepsB and ΔepsC) were able to produce EPS. Studies in PIE cells demonstrated that the EPS of S. thermophilus ST538 is able to significantly improve the expression of interferon β (IFN-β), interleukin 6 (IL-6), and C-X-C motif chemokine 10 (CXCL10) in response to TLR3 stimulation. The role of EPS in the modulation of antiviral immune response in PIE cells was confirmed by comparative studies of cell free culture supernatants and fermented skim milks obtained from S. thermophilus ΔepsB and ΔepsC. These results suggest that S. thermophilus ST538 could be used as an immunobiotic strain for the development of new immunologically functional foods, which might contribute to improve resistance against viral infections.Fil: Mizuno, Akira. Tohoku University; JapónFil: Tomotsune, Kae. Tohoku University; JapónFil: Islam, Md Aminul. Tohoku University; JapónFil: Funabashi, Ryutaro. Tohoku University; JapónFil: Albarracín, Leonardo Miguel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Centro de Referencia para Lactobacilos; Argentina. Tohoku University; Japón. Universidad Nacional de Tucumán. Facultad de Ciencias Exactas y Tecnología; ArgentinaFil: Ikeda Ohtsubo, Wakako. Tohoku University; JapónFil: Aso, Hisashi. Tohoku University; JapónFil: Takahashi, Hideki. Tohoku University; JapónFil: Kimura, Katsunori. Meiji Co.; JapónFil: Villena, Julio Cesar. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Centro de Referencia para Lactobacilos; Argentina. Tohoku University; JapónFil: Sasaki, Yasuko. Meiji University; JapónFil: Kitazawa, Haruki. Tohoku University; Japó

Observation of a nuclear-elastic-scattering effect caused by energetic protons on deuteron slowing-down behaviour on the Large Helical Device

A first attempt to observe a nuclear-elastic-scattering (NES) effect caused by energetic protons on deuteron slowing-down behaviour was made on the Large Helical Device located at the National Institute for Fusion Science. The NES effect on the slowing-down of fast ions can influence the confinement of fast ions, ion heating, fusion reaction rate coefficient, etc. An intense hydrogen beam was injected into a deuterium plasma to create a knock-on tail, i.e. a non-Maxwellian energetic component in the deuteron velocity distribution function. We conducted two types of experiment: (1) observation of the slowing-down of the knock-on tail and (2) observation of the NES effect on the slowing-down time of fast ions. The phenomena are discussed in terms of the difference in the decay process of the D(d,n)3He neutron generation rate after neutral beam heating is terminated between the cases when the knock-on effect is influential and not influential, and also from the difference in the neutron decay times. The results of a series of experiments indicate that the NES effect caused by energetic protons can have an impact on the slowing-down of fast deuterons

Fast deuteron diagnostics using visible light spectra of 3He produced by deuteron–deuteron reaction in deuterium plasmas

The fast deuteron (non-Maxwellian component) diagnostic method, which is based on the higher resolution optical spectroscopic measurement, has been developed as a powerful tool. Owing to a decrease in the D–H charge-exchange cross section, the diagnostic ability of conventional optical diagnostic methods should be improved for ∼MeV energy deuterons. Because the 3He–H charge-exchange cross section is much larger than that of D–H in the ∼MeV energy range, the visible light (VIS) spectrum of 3He produced by the dueteron–dueteron (DD) reaction may be a useful tool. Although the density of 3He is small because it is produced via the DD reaction, improvement of the emissivity of the VIS spectrum of 3He can be expected by using a high-energy beam. We evaluate the VIS spectrum of 3He for the cases when a fast deuteron tail is formed and not formed in the ITER-like beam injected deuterium plasma. Even when the beam energy is in the MeV energy range, a large change appears in the half width at half maximum of the VIS spectrum. The emissivity of the VIS spectrum of 3He and the emissivity of bremsstrahlung are compared, and the measurable VIS spectrum is obtained. It is shown that the VIS spectrum of 3He is a useful tool for the MeV beam deuteron tail diagnostics