Residents’ Experience of Scholarly Activities is Associated with Higher Satisfaction with Residency Training

BACKGROUND  The Ministry of Health, Labour and Welfare of Japan has been promoting participation in scholarly activities for physicians during residency training. However, there is debate regarding whether this is worthwhile for residents. OBJECTIVE  To evaluate residents’ opinions of engaging in scholarly activities and identify factors associated with overall satisfaction with their training program. DESIGN  Cross-sectional national survey. PARTICIPANTS  1,124 second-year residents in teaching hospitals in Japan in 2007 MEASUREMENTS  Collected data included demographics, teaching hospital characteristics and resources, residents’ research experiences, including type of activities, barriers to performing scholarly activities, residents’ opinions of scholarly requirements, and resident satisfaction with their residency program. RESULTS  1,124 residents/1,500 responded for a response rate of 74.9%. Our data showed that 60.2% of Japanese residents engaged in some type of scholarly activity. Barriers included: “No resident time”; “No mentor;” and “No resident interest.” Sixty-three percent of residents thought that research should be a residency requirement. In multivariate logistic analysis, residents’ overall satisfaction with their residency program was significantly associated with participation in research activity (odds ratio (OR), 1.5; 95% confidence interval (CI), 1.1–2.1); male gender (OR, 1.5; 95% CI: 1.1–2.2); satisfaction with residency compensation (OR, 3.8; 95% CI, 2.6–5.0), and satisfaction with the residency curriculum (OR, 19.5; 95% CI, 13.7–27.7). CONCLUSIONS  The majority of residents surveyed thought that research activity was worthwhile. Residents’ participation in research activity was associated with higher levels of satisfaction with residency training. Implementing measures to overcome existing barriers may have educational benefits for residents.     

Branched-chain amino acids suppress insulin-resistance-based hepatocarcinogenesis in obese diabetic rats

Background  Branched-chain amino acids (BCAAs) reportedly inhibit the incidence of hepatocellular carcinoma (HCC) in patients with liver cirrhosis and obesity that is frequently associated with insulin resistance (IR). However, the possible mechanism is still obscure. The aim of the present study was to examine the effect of BCAAs, especially in conjunction with angiogenesis, on hepatocarcinogenesis under the condition of IR. Methods  The effect of BCAAs on the development of liver enzyme-altered preneoplastic lesions and angiogenesis was examined in obese diabetic Otsuka Long-Evans Tokushima Fatty rats. We also performed an in vitro study to elucidate the possible mechanisms involved. Results  Treatment with BCAAs markedly inhibited glutathione-S-transferase placental form (GST-P)-positive preneoplastic lesions along with suppression of neovascularization in the liver. The hepatic expression of vascular endothelial growth factor (VEGF), a potent angiogenic factor, was also attenuated. BCAA treatment significantly suppressed glucose- and insulin-induced in vitro angiogenesis in the presence of VEGF. Conclusions  In obese diabetic rats BCAAs exerted a chemopreventive effect against HCC, associated with the suppression of VEGF expression and hepatic neovascularization. Since BCAA preparations are widely used in clinical practice for patients with chronic liver diseases, this agent may represent a new strategy for chemoprevention against HCC in the future.     

The fate of Nissl-stained dark neurons following traumatic brain injury in rats: difference between neocortex and hippocampus regarding survival rate

We studied the fate of Nissl-stained dark neurons (N-DNs) following traumatic brain injury (TBI). N-DNs were investigated in the cerebral neocortex and the hippocampus using a rat lateral fluid percussion injury model. Nissl stain, acid fuchsin stain and immunohistochemistry with phosphorylated extracellular signal-regulated protein kinase (pERK) antibody were used in order to assess posttraumatic neurons. In the neocortex, the number of dead neurons at 24 h postinjury was significantly less than that of the observed N-DNs in the earlier phase. Only a few N-DNs increased their pERK immunoreactivity. On the other hand, in the hippocampus the number of dead neurons was approximately the same number as that of the N-DNs, and most N-DNs showed an increased pERK immunoreactivity. These data suggest that not all N-DNs inevitably die especially in the neocortex after TBI. The fate of N-DNs is thus considered to differ depending on brain subfields.     

Effect of a thin HA coating on the stress/strain distribution in bone around dental implants using three-dimensional finite element analysis

Three-dimensional finite element analysis was performed for thin hydroxyapatite (HA) coated and titanium dental implants to study the effects on stress/strain distribution in the mandible with application of axial and oblique loads. The implants were of screw and cylinder types. With an axial load, the maximum equivalent bone stresses in the titanium implants were 21.5 and 29.0 MPa for the cylinder and screw types respectively, and the stress and strain distributions differed. For the cylinder type, the highest stress was located at the implant base, and for the screw type, it was located at the top edge of the first thread within the cortical bone. For the HA-coated cylinder and screw implants, the maximum equivalent bone stresses were 7.1 and 7.2 MPa respectively. The stress and strain distributions were similar, and the highest stress was located on the upper side of the cortical bone around the implant neck for both implants. Of the implants examined, the screw type HA-coated implant had the most uniform stress distribution in bone.     

Preparation of germanium apatite and its cytotoxicity

Germanium apatite was synthesized via the solid-state reaction between GeO(2) and (NH(4))(3)PO(4). The synthesized materials were characterized using XRD, and thermal analysis was carried out using TG-DTA. Ge(2)P(2)O(7) was preferentially produced at temperatures between 300-900 degrees C, and at temperatures above 1000 degrees C, germanium apatite (Ge(5)O(PO(4))(6), GeAp) was synthesized. In solubility tests, 0.36% and 0.65% of Ge ions were liberated from GeAp powder in distilled water at 37 and 80 degrees C after four weeks, respectively. A GeAp aqueous solution maintained at 37 degrees C was strongly acidic with a pH=1.67 after four weeks. The growth rate of human adult gingival fibroblast cells in a medium that included GeAp, HA, and GeO(2) was investigated. The growth rate of the cells in a 0.1 mg/ml GeAp medium was almost the same as that in the control. The cell growth was restricted in a 1.0 mg/ml GeAp medium, whereas the cell growth in a pH-adjusted 1.0 mg/ml GeAp medium at pH=7.60 was higher than that in non-adjusted medium at pH = 7.06.     

Super catalytic antibodies (antigenase) capable of destroying H. pylori urease

Antigenase has an ability to decompose the antigen peptide or protein. We have produced some monoclonal antibodies(HpU mAbs series) for H. pylori urease. Out of them, the light chain of HpU-9 mAb possesses a catalytic triad composed of Asp, Ser and His, which acts as a catalytic site against the antigen, based on the structural analysis of molecular modeling. HpU-9-L belongs to the germline cs1 which inherently encodes the catalytic triads in the sequence, indicating that HpU-9-L must be an antigenase. As expected, HpU-9-L showed the specific degradation against the beta-subunit of the urease. The heavy chain of HpU-2 also exhibited the specific degradation of the urease. These antigenases will be used for the medicinal application.     

A randomized comparison of pioglitazone to inhibit restenosis after coronary stenting in patients with type 2 diabetes

OBJECTIVE: Recent studies have demonstrated that the treatment with thiazolidinediones reduces in-stent restenosis. The aim of this study was to elucidate the mechanism of the efficacy of pioglitazone for preventing in-stent restenosis in type 2 diabetic patients. RESEARCH DESIGN AND METHODS: We conducted a prospective, randomized trial involving 54 type 2 diabetic patients referred for coronary stenting who were randomly assigned to either the control or the pioglitazone group. Quantitative coronary angiography was performed at study entry and at 6 months follow-up. Endothelial nitric oxide synthase (eNOS), tumor necrosis factor alpha, interleukin-6, leptin, and adiponectin were measured at study entry and at 6 months follow-up. RESULTS: A total of 28 patients were randomly assigned to the control group, and 26 patients were assigned to the pioglitazone group. There were no significant differences in glycemic control levels or in lipid levels in the two groups at baseline or at follow-up. Insulin, homeostasis model assessment of insulin resistance, eNOS, and leptin at follow-up were significantly reduced in the pioglitazone group compared with the control group. The late luminal loss and in-stent restenosis were significantly less in the pioglitazone group than in the control group. Leptin independently correlated with late luminal loss at multiple regression analysis. CONCLUSIONS: The treatment with pioglitazone in type 2 diabetic patients significantly reduced leptin. This decreased leptin improved insulin resistance and endothelial function with the reduction of insulin. The improved endothelial function affected the reduction of in-stent restenosis.