To measure ambulatory physical activity and determine associations between physical inactivity and joint function, gait function, disease severity, and employment status in adult women with hip ...osteoarthritis (OA) living in the community.
Sixty-five adult women with hip OA were recruited from an outpatient clinic. Ambulatory physical activity was measured using an activity monitor based on an accelerometer over 7 days, which estimated step counts, net energy expenditure, and time spent in activity by acceleration intensity. The Harris hip score, walking speed, and radiographic stage were assessed for joint function, gait function, and disease severity, respectively. Employment status was classified into unemployed and employed (sitting occupations and standing/walking occupations).
More than 40% of patients were classified as inactive, with less time spent in moderate-intensity activity (median 5.6 vs 22.9 min/day) compared with their counterparts. Employment status and the presence or absence of stage 4 (endstage) arthritis were independently associated with activity classification, and there was an interaction between these 2 variables; i.e., although stage 4 arthritis was associated with inactivity in patients who were unemployed, it bore no relationship in patients who were employed.
A significant proportion of adult women with hip OA were physically inactive, with a lack of moderate-intensity activity. The possible interaction between endstage OA and employment status requires further study to determine whether being at work negates the adverse effects of endstage OA or whether higher functioning due to physical activity enables patients with endstage OA to be employed.
Holo-neocarzinostatin (holo-NCS) is a complex protein carrying the anti-tumor active enediyne ring chromophore by a scaffold consisting of an immunoglobulin-like seven-stranded anti-parallel ...β-barrel. Because of the labile chromophore reflecting its extremely strong DNA cleavage activity and complete stabilization in the complex, holo-NCS has attracted much attention in clinical use as well as for drug delivery systems. Despite many structural analyses for holo-NCS, the chromophore-releasing mechanism to trigger prompt attacks on the target DNA is still unclear. We determined the three-dimensional structure of the protein and the internal motion by multinuclear NMR to investigate the releasing mechanism. The internal motion studied by 13C NMR methine relaxation experiments showed that the complex has a rigid structure for its loops as well as the β-barrel in aqueous solution. This agrees with the refined NMR solution structure, which has good convergence in the loop regions. We also showed that the chromophore displayed a similar internal motion as the protein moiety. The structural comparison between the refined solution structure and x-ray crystal structure indicated characteristic differences. Based on the findings, we proposed the chromophore-releasing mechanism by a three-state equilibrium, which sufficiently describes both the strong binding and the prompt releasing of the chromophore. We demonstrated that we could bridge the dynamic properties and the static structure features with simple kinetic assumptions to solve the biochemical function.
A halo orthosis is often used to immobilize the cervical spine after severe injury in patients who cannot tolerate surgery. Although complications such as pin loosening or brain abscess have been ...reported, there are no reported cases of hemiparesis following pneumocephalus associated with halo use. The authors report the case of a 77-year-old man with multiple myeloma who, after undergoing halo vest therapy and chemotherapy, suddenly developed hemiparesis and speech disturbance. Diagnostic neuroimaging demonstrated penetration of the inner table at the right posterior pin site and intracerebral pneumocephalus at the parietal lobe. Intraoperative inspection revealed only air and no purulent materials or cerebrospinal fluid in the cystic lesion. When a halo device is used, attention to detail in pin application, maintenance, and proper pin-site care must be undertaken to minimize complications. The tightening of the pin in cases in which late-onset loosening has occurred should not be performed. Additionally, because late loosening of the pin and pin-site infection increase the risks of complications, a halo vest should be used only as a short-term treatment, and the clinician should be aware of the possible increased risk of serious complications such as pneumocephalus or subdural abscess formation.
Laparoscopy-assisted distal gastrectomy is a surgical procedure which is safe, useful, and technically feasible for patients with early gastric cancer. The aim of this study is to determine whether ...laparoscopy-assisted distal gastrectomy is also superior to conventional open distal gastrectomy.
The study comprised 27 consecutive patients with early gastric cancer who were admitted to our hospital from 1997 to 2000 and underwent distal gastrectomy. Ten patients underwent laparoscopy-assisted distal gastrectomy; and 17 conventional open distal gastrectomy.
Estimated blood loss was 17.7 +/- 12.1 g during laparoscopy-assisted distal gastrectomy, and 250.0 +/- 160.8 g during conventional open distal gastrectomy. The difference was statistically significant (p < 0.001). The day of ambulation (2.7 +/- 0.7 vs. 1.0 +/- 0.0), and start of liquid diet (6.9 +/- 1.2 vs. 4.3 +/- 0.5) were significantly delayed in conventional open distal gastrectomy compared with laparoscopy-assisted distal gastrectomy (p < 0.001, p < 0.05). At the 3rd postoperative day, the serum C-reactive protein level in laparoscopy-assisted distal gastrectomy decreased significantly more than that in conventional open distal gastrectomy (4.2 +/- 1.7 vs. 9.4 +/- 2.5: p < 0.05). No postoperative complication was found in laparaoscopy-assisted distal gastrectomy.
Laparoscopy-assisted distal gastrectomy is a safe and useful operation for most early gastric cancers. Laparoscopy-assisted distal gastrectomy has been superior to conventional open distal gastrectomy.
We previously reported that the cytotoxicity of carboquone (CQ) was potentiated in vitro and in vivo under acidic conditions. In this study, an acidic vehicle adjusted with lactate at various low pHs ...was used for CQ intra-arterial (i.a.) injection, in order to enhance the antitumor effects of i.a. CQ chemotherapy. Treatments were evaluated in Wistar/KA rats bearing a limb tumor 5 days after the inoculation of 3 x 10(6) syngeneic RBT-1 tumor cells into the hind limb. In chemotherapy experiments using an intrafemoral injection of CQ at 1.5 mg/kg in phosphate-buffered saline (PBS, pH 7.4) or in an acidic vehicle at pH 5.0 or 6.0, the antitumor effects seen in rats given CQ in acidic vehicles, evaluated by tumor weight 14 days after treatment, were significantly greater than that seen in rats given CQ in PBS. There were no significant differences either in changes of body weight or in the number of leukocytes after treatment between the groups given CQ in PBS and in an acidic vehicle at pH 6.0. Although in the group given CQ at 2.0 mg/kg in PBS, the antitumor effect was the same as that observed in rats given CQ at 1.5 mg/kg in an acidic vehicle at pH 6.0, the side effects observed in the former group were much severer than in the latter group. These data suggest that the antitumor effect of i.a. CQ chemotherapy can be potentiated by using an acidic vehicle.
OBJECTIVE: We compared the habitual food intake and plasma fatty acid composition in cirrhotic patients living in two different regions in Japan, Okayama and Toyama, and evaluated the effects of ...dietary polyunsaturated fatty acid and α-tocopherol intake on serum alanine aminotransferase (ALT) activity.
METHOD: A quantitative food-frequency questionnaire method was used.
RESULTS: The significantly higher intake of fish in the patients living in Toyama resulted in higher plasma levels of docosahexaenoic acid and lower levels of arachidonic acid. Serum ALT activity correlated negatively with plasma arachidonic acid (
r = −0.456,
P < 0.05) and α-tocopherol (
r = −0.505,
P < 0.05) levels. Dietary intakes of vitamin E and polyunsaturated fatty acids (mg/g) correlated negatively with serum ALT (
r = −0.377,
P < 0.05). Dietary intake of linoleic acid and the ratio of polyunsaturated to saturated fatty acid in dietary fat correlated significantly with serum ALT (
r = 0.604,
P < 0.01, and
r = 0.622,
P < 0.01, respectively). The amount of vegetable intake correlated with intake of vitamin E and polyunsaturated fatty acid (
r = 0.527,
P < 0.02).
CONCLUSIONS: These findings suggest that habitual food intake affects the plasma fatty acid profile and that elevated serum ALT may be related to arachidonic acid deficiency and vulnerability to lipid peroxidation in cirrhotic patients with hepatitis B and C viruses.
Staphylococcal protein A is a cell wall constituent of most strains of
Staphylococcus aureus, and it is characterized by its binding affinity to some immunological classes. A mutated low molecular ...weight type protein A (LPA; Mwt=27
kDa) which consists of the domains, E, D, A, B and 13 residues of the C-domain was prepared in this study. Since LPA does not possess a cell wall-bound region in contrast to wild-type protein A (WPA; Mwt=42
kDa), we have established a methodology of large scale purification of LPA without using any extracellular expression systems such as
Escherichia coli. Using this relatively abundant protein, the immobilization of the LPA with silk fibroin of
Bombyx mori was performed. Thermal stability of LPA immobilized with silk fibroin is higher than that of free LPA at high temperature judging from the immunoglobulin G (IgG)-binding affinity. However, the apparent value of its affinity decreased relative to that of immobilized WPA. These results indicate that structural information is essential to explore improvement of IgG-binding affinity of immobilized LPA. Therefore, secondary structure of free LPA was detected by its characteristic helical pattern in circular dichroism (CD) in aqueous solution. In addition to this, tertiary fold of four IgG-binding domains were investigated by two-dimensional
1H-NMR spectra. Four significantly high-field shifted cross-peaks attributed to methyl signals of alanine residues suggest that all four domains pack into a three helix bundle motif in solution. These structural data and properties of IgG-binding affinity suggest that spatial arrangement of four IgG-binding domains are packed into a compact globular molecular shape. This causes a certain active site of immobilized LPA to be buried in the silk fibroin fiber.
We present a case in which a synovial cyst arose from the proximal tibia and expanded in the calf of a patient after total knee arthroplasty. A cystogram showed a direct communication between the ...joint cavity and the cyst, apparently associated with a screw that penetrated the tibial cortex. Histologic examination of the cyst showed an inflammatory reaction, including macrophages, foreign body giant cells, and metal and polyethylene particles. To our knowledge, this is the first case report illustrating a paraosseous cyst that developed after total knee arthroplasty. Wear debris from the total knee prosthesis may have been responsible for this unusual cyst.
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