Nanofiber alignment and direction of mechanical strain affect the ECM production of human ACL fibroblast

The effects of fiber alignment and direction of mechanical stimuli on the ECM generation of human ligament fibroblast (HLF) were assessed. The nanofiber matrix was fabricated using electrospinning technique. To align the nanofibers, a rotating target was used. The HLFs on the aligned nanofibers were spindle-shaped and oriented in the direction of the nanofibers. The degree of ECM production was evaluated by comparing the amount of collagen on aligned and randomly oriented structures. Significantly more collagen was synthesized on aligned nanofiber sheets, although the proliferation did not differ significantly. This suggests that the spindle-shape observable in intact ligaments is preferable in producing ECM. To evaluate the effect of strain direction on the ECM production, HLFs were seeded on parallel aligned, vertically aligned to the strain direction, and randomly oriented nanofiber sheets attached to Flexcell plates. After a 48-h culture, 5% uniaxial strain was applied for 24h at a frequency of 12 cycles/min. The amounts of collagen produced were measured 2 days after halting the strain application. The HLFs were more sensitive to strain in the longitudinal direction. In conclusion, the aligned nanofiber scaffold used in this study constitutes a promising base material for tissue-engineered ligament in that it provides more preferable biomimetic structure, along with proper mechanical environment.     

The suppressed expression and functional activity of hepatic P-glycoprotein in rats with protein-calorie malnutrition

The effect of protein-calorie malnutrition (PCM) on the expression and functional activity of P-glycoprotein (P-gp) in the liver of rats was examined. Control protein diets and protein-restricted diets were fed to Sprague-Dawley rats for 4 weeks, and the expression of P-gp in the liver (Western blot), in vitro uptake of a representative substrate of P-gp, daunomycin, into canalicular liver plasma membrane (cLPM) vesicles, and in vivo canalicular excretion of daunomycin were compared between the control and PCM rats. The expression of P-gp in the cLPM vesicles was decreased (22%, p < 0.05) by PCM. Consistent with this result, the in vitro uptake rate (V(max)) was decreased (35%, p < 0.05) by PCM, with constant affinity (K(m)), for the carrier-mediated uptake of daunomycin into cLPM vesicles, resulting in a 33% (p < 0.05) decrease in the intrinsic uptake clearance (CL(int)). The in vivo canalicular excretion clearance (CL(exc)) of daunomycin was also decreased by 79% (p < 0.01) in PCM rats, but the degree was more severe than would be expected from the 22% decrease in the expression of P-gp and the 33% decrease in the uptake of daunomycin (CL(int)). The hepatic level of adenosine 5'-triphosphate, which was decreased by 60% (p < 0.01) in PCM rats, might have contributed to this severe decrease in CL(exc). In summary, the canalicular excretion of P-gp substrates, such as daunomycin, might be reduced in patients with PCM via a mechanism involving the suppression of the expression of P-gp.     

Impact of supervision and self-assessment on doctor-patient communication in rural Mexico.

OBJECTIVE: To determine whether supervision and self-assessment activities can improve doctor-patient communication. SETTING AND PARTICIPANTS: Six supervisors, 60 doctors in their last year of training, and 232 primary health care patients at rural health clinics in Michoacan, Mexico. DESIGN: The main evaluation compared post-intervention measures in control and intervention groups. A small panel study also examined changes from baseline to post-intervention rounds in both groups. INTERVENTION: Over a 4-month period, specially trained supervisors added 1 hour of supervision on interpersonal communication and counseling (IPC/C) to regular site visits. Doctors, who had received prior IPC/C training, periodically audiotaped and assessed their own consultations. MAIN OUTCOME MEASURES: These comprised frequency of doctors' facilitative communication, doctors' biomedical information-giving, and patients' active communication. RESULTS: The performance of all doctors improved markedly over the study period, but gains in facilitative communication and information-giving were significantly greater in the intervention than the control group. No single component of the intervention was responsible for the improvement; it resulted from the combination of activities. The doctors appreciated the more supportive relationship with supervisors that resulted from the intervention and found listening to themselves on audiotape a powerful, although initially stressful, experience. CONCLUSION: Supportive supervision and self-assessment activities can reinforce IPC/C training, prompt reflection and learning, and help novice doctors improve their interpersonal communication skills.     

Isolation of Citrobacter sp. mutants defective in decolorizing malachite green

To identify genes involved in the decolorization of malachite green, random mutants generated by transposon insertion in the malachite green-decolorizing bacterium, Citrobacter sp. were isolated. The resulting mutant bank yielded 24 mutants with complete defects in their abilities to decolorize malachite green. Southern hybridization with a Tn5 fragment as a probe showed a single hybridized band in 7 mutants, which appeared to have insertions at different sites of the chromosome. The Tn5-inserted genes were isolated and the DNA sequence flanking Tn5 was determined. Based on a sequence database, the putative protein products encoded by the mg genes were identified as follows. mg3, an ABC transporter homolog; mg6, a LysR-type regulatory protein; m11, an oxidoreductase; mg17, a MalG protein in the maltose transport system; and mg21, a sugar kinase. The deduced sequences from two mg genes (mg7 and mg18) showed no significant similarity to any protein with a known function, suggesting that these two mg genes encode unidentified proteins that are responsible for the decolorization of malachite green.     

Neonatal Iliopsoas Abscess: The First Korean Case

Iliopsoas abscess (IPA) is rare in neonates. We present a case of neonatal IPA that was initially believed to bean inguinal hernia. A 20-day-old male infant was referred to our hospital for herniorrhaphy after a 2-day history of swelling and bluish discoloration of the left inguinal area and leg without limitation of motion. Abdominal and pelvic ultrasonography suggested a femoral hernia, but the anatomy was unclear. Abdominal computed tomography revealed a multi-septated cystic mass extending into the psoas muscle from the lower pole of the left kidney to the femur neck. Broad spectrum antibiotics were initiated, and prompt surgical exploration was planned. After opening the retroperitoneal cavity via an inguinal incision, an IPA was diagnosed and surgically drained. Culture of the abscess fluid detected Staphylococcus aureus, sensitive to methicillin. The patient was discharged without complication on the 17th postoperative day.

Graphical Abstract

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EMG Activity of the Abductor Hallucis Muscle during Foot Arch Exercises Using Different Weight Bearing Postures

[Purpose] This study examined the effects of different weight-bearing postures on the activation of the abductor hallucis muscle during foot-arch exercises. [Subjects] The study recruited 11 healthy volunteers who were pain-free, had no history of foot or ankle surgery, and were able to maintain a standing posture. [Methods] The subjects performed short-foot and toe-spreading exercises while sitting and standing. [Results] The abductor hallucis muscle activation in the toe-spreading exercise was significantly greater when standing than in sitting, while that in the short-foot exercise did not differ significantly between the two postures. [Conclusion] The results of this study suggests that a weight bearing posture such as standing is the most effective method of increasing the EMG activity of abductor hallucis muscle in the toe-spreading exercise.Key words: Short foot exercise, Toe spreading exercise, Weight bearing     

Factors predicting the response to biofeedback-assisted pelvic floor muscle training for urinary incontinence

Objective

To evaluate the efficacy of biofeedback-assisted pelvic floor muscle training (PFMT) for urinary incontinence and to determine the patient characteristics predictive of success.

Methods

Clinical and physiologic data of 86 patients with urinary incontinence who had received biofeedback-assisted PFMT were analyzed retrospectively. The clinical response was determined to be a success (requiring no more therapy) or a failure (requiring surgery or other medical therapy) at 3 months after completion of treatment.

Results

The success group included 57% of the enrolled patients. In the univariate analysis, the following factors had P values of less than 0.20: alcohol consumption, detrusor overactivity, type of urinary incontinence, and the change in the average amplitude of tonic contraction before treatment and after the 8th session of biofeedback-assisted PFMT. In the multiple logistic regression analysis, the only independent predictive factor of a successful response was a significant change in the average tonic contraction before treatment and after the 8th session (odds ratio, 1.661; 95% confidence interval, 1.015- 2.721).

Conclusion

After biofeedback-assisted PFMT, 57% of patients with urinary incontinence required no further therapy. Increased pelvic floor muscle activity after the 8th session of PFMT predicted a successful response to treatment.     

Mitochondrial DNA in patients with essential tremor

Essential tremor (ET) is one of the most common of the movement disorders. However, there has been little agreement in the neurological literature regarding diagnostic criteria for ET. It is not clear to what extent ET is associated with defects of mitochondrial DNA. In this study, we analyzed mitochondrial DNA (mtDNA) from the blood cells of the normal and ET patients using the long and accurate polymerase chain reaction (LA-PCR) and PCR. The large deletions were detected within several regions of mtDNA, but were not detected in the D-loop or CO I regions in ET patients. From our study, it is suggested that ET is a disorder showing a deficiency of mtDNA multicomplexes, and it also appears that mitochondrial dysfunction could be one of the causative factors of ET.