Predictive Factors for Subjective Improvement in Lumbar Spinal Stenosis Patients with Nonsurgical Treatment: A 3-Year Prospective Cohort Study

Objective

To assess the predictive factors for subjective improvement with nonsurgical treatment in consecutive patients with lumbar spinal stenosis (LSS).

Materials and Methods

Patients with LSS were enrolled from 17 medical centres in Japan. We followed up 274 patients (151 men; mean age, 71 ± 7.4 years) for 3 years. A multivariable logistic regression model was used to assess the predictive factors for subjective symptom improvement with nonsurgical treatment.

Results

In 30% of patients, conservative treatment led to a subjective improvement in the symptoms; in 70% of patients, the symptoms remained unchanged, worsened, or required surgical treatment. The multivariable analysis of predictive factors for subjective improvement with nonsurgical treatment showed that the absence of cauda equina symptoms (only radicular symptoms) had an odds ratio (OR) of 3.31 (95% confidence interval [CI]: 1.50–7.31); absence of degenerative spondylolisthesis/scoliosis had an OR of 2.53 (95% CI: 1.13–5.65); <1-year duration of illness had an OR of 3.81 (95% CI: 1.46–9.98); and hypertension had an OR of 2.09 (95% CI: 0.92–4.78).

Conclusions

The predictive factors for subjective symptom improvement with nonsurgical treatment in LSS patients were the presence of only radicular symptoms, absence of degenerative spondylolisthesis/scoliosis, and an illness duration of <1 year.     

Protein kinase C zeta plays an essential role for Mycobacterium tuberculosis-induced extracellular signal-regulated kinase 1/2 activation in monocytes/macrophages via Toll-like receptor 2

This study characterized the upstream signalling molecules involved in extracellular signal-regulated kinase (ERK) 1/2 activation and determined their effects on differential tumour necrosis factor (TNF)-alpha expression by monocytes/macrophages infected with virulent or avirulent mycobacteria. The avirulent Mycobacterium tuberculosis (MTB) strain H37Ra (MTBRa) induced higher levels of activation of ERK 1/2 and the upstream MAPK kinase (MEK)1 and, subsequently, higher levels of TNF-alpha expression in human primary monocytes and monocyte-derived macrophages, as compared with MTB strain H37Rv (MTBRv). The MTB-induced activation of ERK 1/2 was not dependent on Ras or Raf. However, inhibition of the activity of atypical protein kinase C (PKC) zeta decreased the in vitro phosphorylation of MEK, ERK 1/2 activation and subsequent TNF-alpha induction caused by MTBRv or MTBRa. Toll-like receptor (TLR) 2 was found to play a major role in MTB-induced TNF-alpha expression and PKCzeta phosphorylation. Co-immunoprecipitation experiments showed that PKCzeta interacts physically with TLR2 after MTB stimulation. Moreover, PKCzeta phosphorylation was increased more in macrophages following MTBRa, versus MTBRv, infection. This is the first demonstration that PKCzeta interacts with TLR2 to play an essential role in MTB-induced ERK 1/2 activation and subsequent TNF-alpha expression in monocytes/macrophages.     

Effect of annealing time of an ice crystal on the activity of type III antifreeze protein

Antifreeze proteins (AFPs) possess a unique ability to bind to a seed ice crystal to inhibit its growth. The strength of this binding has been evaluated by thermal hysteresis (TH). In this study, we examined the dependence of TH on experimental parameters, including cooling rate, annealing time, annealing temperature and the size of the seed ice crystal for an isoform of type III AFP from notched-fin eelpout (nfeAFP8). TH of nfeAFP8 dramatically decreased when using a fast cooling rate (0.20 degrees C x min(-1)). It also decreased with increasing seed crystal size under a slow cooling rate (0.01 degrees C x min(-1)), but such dependence was not detected under the fast cooling rate. TH was enhanced 1.4- and 2.5-fold when ice crystals were annealed for 3 h at 0.05 and 0.25 degrees C below T(m), respectively. After annealing for 2 h at 0.25 degrees C below T(m), TH activity showed marked dependence on the size of ice crystals. These results suggest that annealing of an ice crystal for 2-3 h significantly increased the TH value of type III AFP. Based on a proposed adsorption-inhibition model, we assume that type III AFP undergoes additional ice binding to the convex ice front over a 2-3 h time scale, which results in the TH dependence on the annealing time.     

Lymph Node Metastases and Prognosis in Left Upper Division Non-Small Cell Lung Cancers: The Impact of Interlobar Lymph Node Metastasis

Background

Left upper division segmentectomy is one of the major pulmonary procedures; however, it is sometimes difficult to completely dissect interlobar lymph nodes. We attempted to clarify the prognostic importance of hilar and mediastinal nodes, especially of interlobar lymph nodes, in patients with primary non-small cell lung cancer (NSCLC) located in the left upper division.

Methods

We retrospectively studied patients with primary left upper lobe NSCLC undergoing surgical pulmonary resection (at least lobectomy) with radical lymphadenectomy. The representative evaluation of therapeutic value from the lymph node dissection was determined using Sasako’s method. This analysis was calculated by multiplying the frequency of metastasis to the station and the 5-year survival rate of the patients with metastasis to the station.

Results

We enrolled 417 patients (237 men, 180 women). Tumors were located in the lingular lobe and at the upper division of left upper lobe in 69 and 348 patients, respectively. The pathological nodal statuses were pN0 in 263 patients, pN1 in 70 patients, and pN2 in 84 patients. Lymph nodes #11 and #7 were significantly correlated with differences in node involvement in patients with left upper lobe NSCLC. Among those with left upper division NSCLC, the 5-year overall survival in pN1 was 31.5% for #10, 39.3% for #11, and 50.4% for #12U. The involvement of node #11 was 1.89-fold higher in the anterior segment than that in the apicoposterior segment. The therapeutic index of estimated benefit from lymph node dissection for #11 was 3.38, #4L was 1.93, and the aortopulmonary window was 4.86 in primary left upper division NSCLC.

Conclusions

Interlobar node involvement is not rare in left upper division NSCLC, occurring in >20% cases. Furthermore, dissection of interlobar nodes was found to be beneficial in patients with left upper division NSCLC.     

Prolactin opens the sensitive period for androgen regulation of a larynx‐specific myosin heavy chain gene

The larynx of Xenopus laevis is a sexually differentiated vocal organ in which male muscle is entirely fast twitch and expresses high levels of a fast twitch myosin heavy chain gene, LM. Female muscle, however, is mostly slow twitch and expresses little LM. Androgen is unable to induce expression of LM until after metamorphosis is complete. The expression of LM during metamorphic and early postmetamorphic development parallels secretion and expression of the pituitary hormone prolactin. Here, we show that exposure to prolactin is neccessary to allow androgen‐induced LM expression in postmetamorphic froglets. In prolactin‐deprived animals, androgen‐induced changes in the contactile properties of laryngeal muscle are blocked, which prevents the rapid rates of muscle contraction required for males to produce courtship songs. Thus, prolactin opens the sensitive period for androgen‐induced LM expression in the larynx and controls the ability of male sex hormones to masculinize the vocal system both at the level of gene expression and vocal organ physiology. © 1999 John Wiley & Sons, Inc. J Neurobiol 41: 443–451, 1999     

FUNGAL CONTROL OF POPULATION CHANGES OF THE PLANKTONIC DIATOM ASTERIONELLA FORMOSA IN A SHALLOW EUTROPHIC LAKE1

Parasitic fungi infected an Asterionella formosa Hass. population for 10 months of the year, during which time the population density of the alga was over 100 cells-L^?1. High injection rates of more than 20% of the cells were observed between February and July except on a few occasions such as late April and late June. Mortality of infected diatom cells was temperature dependent in dialysis tube culture experiments; the loss rate of field populations due to fungal injection also was affected by temperature. Loss rates of diatom cells were negligibly small m February even though infection percentages were more than 20%, but increased toward summer with an increase m temperature. High infection percentages and correspondingly high loss rates (e.g. 0.3 d^?1) occurred periodically during the summer. The results suggest that this type of host-parasite interaction is an important control of algal population size in natural waters.     

Crystallographical analysis of tooth enamel using milligram samples

An X-ray diffraction microanalytical method, in which sample is loaded onto a silver membrane filter, was applied to assess the crystal content in tooth enamel. Each enamel powder was first examined at room temperature, and then examined again at intervals after heating to 200, 400, 600, 800, and 1000 degrees C. The hydroxyapatite composition weight and crystal weight of the samples were derived from the standard calibration curves. The "crystal content ratio" was defined as the ratio of crystal weight to sample weight. The following results were obtained: (1) beta-tricalcium phosphate (beta-TCP) replaced the hydroxyapatite after heating at the high temperatures; (2) the "crystal content ratio" in the tooth enamel increased with the rise in temperature; and (3) the lattice parameters of the enamel apatite and the beta-TCP were changed by the heating. The X-ray diffraction technique has the potential to analyze the crystal content using milligram samples.     

Chlorophyll b-Deficient Mutants of Rice: I. Absorption and Fluorescence Spectra and Chlorophyll a/b Ratios

Absorption spectra and their fourth derivatives of chloroplastsisolated from 16 different rice chlorina mutants were determinedat liquid nitrogen temperature. The results suggest that Chlb is absent from 10 mutants labelled chlorina-1 to -10, while6 mutants named chlorina-11 to -16 contain low levels of Chlb. Low temperature fluorescence emission spectra indicate thata light-harvesting Chl a/b protein of photosystem I is presentin chlorina-11 to -16 but not in chlorina-1 to -10. Reinvestigationof Chl a/b ratios by a sensitive fluorescence method shows thatthe 16 mutants are divided into three groups different in thedegree of Chl b-deficiency; chlorina-1 to -10 totally lack Chlb (Type I), chlorina-11 to -13 have Chl a/b ratio of about 10(Type II-A) and chlorina-14 to -16 have the ratio of about 15(Type II-B). (Received June 6, 1985; Accepted August 6, 1985)     

Reaction kinetics of P-700, cytochrome c-553 and cytochrome f in the cyanobacterium, Synechococcus sp

Absorption changes invoked by short flashes in the Soret band region were measured in the thermophilic cyanobacterium Synechococcus sp. and photoresponses of P-700, cytochrome c-553 and cytochrome f were resolved with the aid of a microcomputer. Cytochrome c-553 was oxidized very rapidly with a half-time of less than 20 μs, while the half oxidation time of cytochrome f was 35–45 μs. The two cytochromes were reduced monophasically with half-time of 2 ms after a lag lasting a few milliseconds. The reduction kinetics of P-700 showed three exponential phases with half-times of 40 μs, 200 μs and 2 ms, which are ascribed to electron donation from cytochrome f, the Rieske iron-sulfur protein and plastoquinone, respectively. The results support the following sequence and rates of linear electron transport at the physiological temperature of the cyanobacterium: P-700

cytochrome c-553

cytochrome f

Rieske protein

plastoquinone.     

Inactivation and Calcium-Dependent Reactivation of Oxygen Evolution in Photosystem II Preparations Treated at pH 3.0 or with High Concentrations of NaCl

A brief treatment at pH 3.0 of Photosystem II (PS II) membranescontaining two bound Ca²⁺ from rice resulted in strong suppressionof oxygen evolution concomitant with extraction of one Ca²⁺and the lost activity was restored on addition of 50 mM Ca²⁺.However, inactivation of oxygen evolution by low pH-treatmentof oxygen-evolving PS II complexes containing only one Ca²⁺from a rice chlorophyll b-deficient mutant was not associatedwith extraction of the bound Ca²⁺, although oxygen evolutionwas markedly enhanced by the addition of Ca²⁺ to the treatedcomplexes. Thus, the acid-inactivation of oxygen evolution cannotbe related to extraction of Ca²⁺. On the other hand, low pH-treatmentwas found to share the following common features with NaCl-treatmentwhich also causes a Ca²⁺-reversible inactivation of oxygen evolution.(1) Exposure of PS II membranes to pH 3.0 resulted in solubilizationof the 23 and 17 kDa extrinsic proteins, although the releasedproteins rebound to the membranes when pH was raised to 6.5.(2) There was an apparent heterogeneity in the binding affinityof Ca²⁺ effective in restoration of the oxygen-evolving activity.(3) Low pH-treated preparations required a higher concentrationof Ca²⁺ for the maximum reactivation of oxygen evolution thandid NaCl-washed preparations. This was also the case with Sr²⁺,which stimulated oxygen evolution of both low pH-treated andNaCl-washed PS II membranes to smaller extents. When the extrinsic23 and 17 kDa proteins had been removed, however, Ca²⁺ concentrationdependence of oxygen evolution in low pH-treated membranes becamesimilar to that in NaCl-washed PS II preparations and the changeswere largely reversed by rebinding of the two proteins. Theseresults strongly suggest that low pH-treatment and NaCl-washinvolve similar mechanisms of Ca²⁺-dependent reactivation. ¹ Present address: Solar Energy Research Group, The Instituteof Physical and Chemical Research (RIKEN), Wako, Saitama, 351-01Japan (Received August 27, 1990; Accepted February 12, 1991)