FDG-PET/CT is increasingly being used for staging, restaging, and treatment monitoring for cancer patients. The introduction of a PET/CT system enables both morphological and metabolic imaging to be performed in a single session. Knowledge of the normal physiologic distribution of FDG and an understanding of the clinical indications and limitations of PET/CT enable accurate diagnosis and thus a better level of care for patients. J. Med. Invest. 54: 195-199, August, 2007

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Although the efficacy of extracorporeal circulation (ECC) is well established for open-heart surgery, application of ECC in other surgical areas has not been given much attention. Advances in the related surgical technique and anesthetic management combined with refinements in the ECC procedure itself have encouraged several institutions to use ECC for complex non-cardiac surgeries. ECC is beginning to be used for circulatory support or tissue oxygenation during surgery on the lung, brain, liver, and kidney as well as in emergency situations. With ECC, difficult and complex surgeries can be performed more safely, and the success rate of certain surgeries has been positively affected. It is important that the surgeon, anesthesiologist, and perfusionist are trained in non-cardiac surgery applications of ECC. Thus, we review here non-cardiac uses that have emerged and summarize the related procedures. J. Med. Invest. 54: 200-210, August, 2007

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Conformational conversion of the normal cellular isoform of prion protein, PrP^C, a glycoprotein anchored to the cell membrane by a glycosylphosphatidylinositol moiety, into the abnormally folded, amyloidogenic prion protein, PrP^Sc, plays a pivotal role in the pathogenesis of prion diseases. It has been suggested that PrP^C might be functionally disturbed by constitutive conversion to PrP^Sc due to either the resulting depletion of PrP^C or the dominant negative effects of PrP^Sc on PrP^C or both. Consistent with this, we and others showed that mice devoid of PrP^C (PrP-/-) spontaneously developed abnormal phenotypes very similar to the neurological abnormalities of prion diseases, supporting the concept that functional loss of PrP^C might at least be partly involved in the pathogenesis of the diseases. However, no neuronal cell death could be detected in PrP-/- mice, indicating that the functional loss of PrP^C alone might not be enough to induce neuronal cell death, one of major pathological hallmarks of prion diseases. Interestingly, it was recently shown that the first identified PrP-like protein, termed PrPLP/Doppel (Dpl), is neurotoxic in the absence of PrP^C, causing Purkinje cell degeneration in the cerebellum of mice. Although it is not understood if PrP^Sc could have a neurotoxic potential similar to PrPLP/Dpl, it is very interesting to speculate that accumulation of PrP^Sc and the functional disturbance of PrP^C, both of which are caused by constitutive conversion, might be required for the neurodegeneration in prion diseases. J. Med. Invest. 54: 211-223, August, 2007

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There are a number of research reports that address the various advantages that breastfeeding brings to mothers and children, as well as to families and society, and in addition to a number of physically positive effects, breastfeeding has an important role in terms of mental and psychological effects.
Ninety-five % of mothers desire to breastfeed, which reflects social acceptance, but the actual breastfeeding rate of the first month after childbirth is 42%, which accounts for about a half of all mothers. Breastfeeding is a natural behavior, but it cannot be performed only by instinct, so mothers discontinue breastfeeding for various reasons. While these reasons for the discontinuation of breastfeeding have been studied in many countries, research regarding the usability of care to support breastfeeding is being conducted in other countries at a level that can be considered evidential, but not yet in Japan. In addition, the current situation is that breastfeeding is strongly promoted but the support provided remains inadequate for mothers who cannot breastfeed, regardless of whatever efforts they make.
This article will review several factors associated with the continuation of breastfeeding and the current situation in Japan, with the intention of identifying desirable areas for further research. J. Med. Invest. 54: 224-234, August, 2007

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Immune cells and cells undergoing rapid turn-over can obtain exogenous nucleotides via salvage synthesis. We evaluated whether or not the balanced nucleoside and nucleotide mixture OG-VI, could rescue intestinal epithelial-like Caco-2 cells from the cytotoxic effects of several chemotherapeutic agents, in the presence and absence of glutamine (Gln). Cells were exposed to 5-fluorouracil (5FU), methotrexate (MTX) or 6-mercaptopurine (6MP), after which proliferation and cell cycle analyses were performed. Following exposure to the chemotherapeutic agents, we observed that cells treated with OG-VI proliferated well, whereas those without the supplement did not proliferate. Furthermore, following treatment with either 5FU or MTX, we observed that the number of cells in the G0/G1 phase decreased and those in the S phases increased. However, these cell cycle alterations were prevented by the addition of OG-VI. With the exception of 6MP-treated cells, we did not observe any effects on proliferation or cell cycle regulation that could be ascribed to the presence of Gln. Thus, we have demonstrated that OG-VI rescues cells from the cytotoxic effects of several chemotherapeutic agents. J. Med. Invest. 54: 235-242, August, 2007

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Background: Consumption of polyunsaturated fatty acids (PUFA) improves the lipid metabolism of diabetics, leading to prevents of arteriosclerosis. Exact relationship between saturated fatty acids (SFA) or PUFA and the insulin resistance of diabetics are unknown.
Subjects and Methods: We investigated the relationship between the serum concentrations of saturated and unsaturated fatty acids and the homeostasis model insulin resistance index (HOMA-R) in Japanese patients with type 2 diabetes mellitus.
Results: The SFA, i.e., lauric acid, myristic acid, palmitic acid, and stearic acid; the monounsaturated fatty acids (MUFA), i.e., palmitoleic acid, oleic acid, and erucic acid; and the PUFA, i.e., eicosadienoic acid, dihomo-γ-linolenic acid, docosatetraenoic acid, and docosapentaenoic acid were positively correlated with HOMA-R. However, no correlations were found between HOMA-R and SFA, i.e., arachidic acid, behenic acid, and lignoceric acid; the MUFA, i.e., eicosenoic acid and nervonic acid; and the PUFA, i.e., linoleic acid, γ-linolenic acid, linolenic acid, 5-8-11 eicosatrienoic acid, arachidonic acid, eicosapentaenoic acid, and docosahexaenoic acid.
Conclusions: Some PUFA as well as SFA were positively correlated with HOMA-R. These results indicate that the intake of diet fatty acid must be well balanced in diabetic patients and it is not always true to refrain from taking SFA and increase the unsaturated fatty acids in their diets. J. Med. Invest. 54: 243-247, August, 2007

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We have previously shown that osteoactivin, a type I membrane glycoprotein expressed in myofibers, upregulated expression of matrix metalloprotease (MMP)-3 and MMP-9 in fibroblasts infiltrated denervated skeletal muscle in mice. To address whether osteoactivin-mediated increase in MMPs in skeletal muscle is useful for regeneration of denervated skeletal muscle, we subjected osteoactivin-transgenic mice to long-term denervation for 70 or 90 days. Long-term denervation caused severe degeneration of myofibers and fibrosis in skeletal muscle of wild-type mice. However, overexpression of osteoactivin protected skeletal muscle from such changes. Infiltration of fibroblast-like cells and collagen deposition were sustained at low levels after long-term denervation in skeletal muscle of osteoactivin-transgenic mice. This cytoprotective effect of osteoactivin was supported by the expression of regeneration/degeneration-associated genes in the gastrocnemius muscle during denervation. Denervation significantly upregulated the expression of anti-fibrotic genes, such as glypican-1 and decorin-1, in the gastrocnemius muscle of osteoactivin-transgenic mice, compared with wild-type mice. In contrast, overexpression of osteoactivin caused a significant reduction in denervation-induced expression of elongation factor 1A-1, an indicator for the persistence of degenerated cells. Our results suggest that an osteoactivin-mediated increase in MMPs in skeletal muscle might be useful for protecting injured muscle from fibrosis, leading to full regeneration after denervation. J. Med. Invest. 54: 248-254, August, 2007

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Several specific locations in brain, including pyriform cortex and hypothalamus, are associated with regulation of food intake. Although lesions of these locations significantly alter food intake, their involvement in the selection of macronutrients is not well characterized. In this study, we examined distinct effects of anterior pyriform cortex (APC) and lateral hypothalamus (LH) lesions on protein intake in rats. The APC or LH of male adult rats were lesioned by treatment with kainic acid, and the rats were then given free access to two kinds of casein diets containing high (60%) and low (5%) protein. Total energy content of these diets was kept constant by changing the carbohydrate content. Following the APC lesions, body weight and food intake decreased, but returned to control levels on day 13 and day 4, respectively. APC lesions did not change the ratio of protein intake. In contrast, LH lesions disturbed body weight gain and the selection of a high protein diet for at least two weeks, although food intake returned to control levels by day 2. Our results suggest that LH, but not APC, may play an important role in the selection of protein intake in rats. J. Med. Invest. 54: 255-260, August, 2007

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Lung cancer is the leading cause of cancer deaths in developed countries. Recently, autofluorescence bronchoscopy has been reported to improve the early detection of lung cancer in high-risk individuals. In the present study, we evaluated the efficacy of autofluorescence bronchoscopy for the early detection of bronchial premalignant and malignant lesions. From November 2000 through March 2004, 123 high-risk individuals (114 men and 9 women with a mean age of 68 years) were enrolled. Among 282 biopsy specimens, 93 (33.0%) were premalignant or malignant lesions. The sensitivity and negative predictive value for the detection of bronchial premalignant and malignant lesions were significantly higher with the addition of autofluorescence bronchoscopy than white light bronchoscopy alone. Moreover, the sensitivity for the detection of bronchial premalignant lesions was extremely higher with the addition of autofluorescence bronchoscopy than white light bronchoscopy alone, whereas there was no significant difference between autofluorescence bronchoscopy and white light bronchoscopy alone for the detection of non-malignant and malignant lesions. Autofluorescence bronchoscopy is a novel modality for the early detection of bronchial abnormality, especially for bronchial premalignant lesions. J. Med. Invest. 54: 261-266, August, 2007

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Skin grafting has become a basic and established operation technique; however, it is not clear how skin grafts adapt to recipient beds and replace their functions. In this study, we analyzed the origin of cells in adapted transplants by using green fluorescent protein (GFP) transgenic mice, which emits green fluorescence in the whole body. The dorsal skins of GFP transgenic mice were transplanted to the back of wild-type mice. Similarly, wild-type skins were transplanted to the back of GFP transgenic mice. Since transplantation with full thickness back skin was not successful due to severe immunorejection, tail skins, which contain fewer epidermal Langerhans cells, were used for the experiments. Six months after transplantation, immunohistochemical analysis of the grafts revealed that tissues derived from ectodermal origin such as the epidermis, hair follicles, and sebaceous glands survived in transplanted grafts, but that other tissues such as the dermis, nerves and blood vessels are partly replaced by tissues from recipient beds. Our results further demonstrated that transplantation analyses with GFP transgenic mice could be a useful approach to study the origin of cells in transplants. J. Med. Invest. 54: 267-275, August, 2007

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Follistatin-related gene (FLRG) encodes a secretory glycoprotein that has characteristic cysteine-rich follistatin domains. FLRG protein binds to and neutralizes several transforming growth factor-β (TGF-β) superfamily members, including myostatin (MSTN), which is a potent negative regulator of skeletal muscle mass. We have previously reported that FLRG was abundantly expressed in fetal and adult mouse heart. In this study, we analyzed the expression of FLRG mRNA during mouse heart development. FLRG mRNA was continuously expressed in the embryonic heart, whereas it was very low in skeletal muscles. By contrast, MSTN mRNA was highly expressed in embryonic skeletal muscles, whereas the expression of MSTN mRNA was rather low in the heart. In situ hybridization and immunohistochemical analysis revealed that FLRG expressed in smooth muscle of the aorta and pulmonary artery, valve leaflets of mitral and tricuspid valves, and cardiac muscles in the ventricle of mouse embryonic heart. However, MSTN was expressed in very limited areas, such as valve leaflets of pulmonary and aortic valves, the top of the ventricular and atrial septa. Interestingly, the expression of MSTN was complementary to that of FLRG, especially in the valvular apparatus. Biochemical analyses with surface plasmon resonance biosensor and reporter assays demonstrated that FLRG hardly dissociates from MSTN and activin once it bound to them, and efficiently inhibits these activities. Our results suggest that FLRG could function as a negative regulator of activin family members including MSTN during heart development. J. Med. Invest. 54: 276-288, August, 2007

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Proteomic analysis was performed in an attempt to identify a gene responsible for the expression of type 2 diabetes using a congenic rat, F.O-Nidd2/of, which possesses a single hyperglycemic QTL locus derived from the diabetic OLETF (Otsuka Long-Evans Tokushima Fatty) rat. Since the genetic difference between the congenic and its host strain, the F344 rat, is limited to the introgressed segment of 38 cM or ca. 2% of the rat whole genome, any discordant protein spots on two dimensional polyacrylamid gel electrophoresis (2D PAGE) will be considered strong candidate genes of this locus. Here we analyzed ca. one thousand protein spots in three different tissue types, liver, muscle and pancreas at 10, 20 and 30 weeks of age, we found that an acidic protein of 55kD in muscle tissue shifts towards acidic end in an age dependent fashion in the congenic strain. However, the shift was not observed in the control rat, which is intriguing because the timing of the shift corresponds to the age at which hyperglycemia begins in the congenic. Future biochemical analysis should aid in elucidating the molecular mechanisms of glucose metabolism. J. Med. Invest. 54: 289-294, August, 2007

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Polymyositis (PM) and dermatomyositis (DM) are systemic inflammatory disorders affecting skeletal muscles and other organs, and are associated with high morbidity and mortality rates. In this study, we studied the prevalence, clinical features and its comparative outcome of PM/DM, comparing PM and DM. Twenty-three PM/DM patients (9 PM and 14 DM) were included in this study. The complication of interstitial pneumonia (IP) was found in 17 patients (74%). HRCT showed that non-specific interstitial pneumonia pattern was the most common in patterns of lung involvement. Twenty-one patients (91%) with PM/DM received high dose of prednisolone therapy. The percentage of patients who received methylprednisolone (mPSL) pulse and cyclosporin A was higher in DM patients than in PM patients. The percentage of patients who received mPSL pulse and cyclosporin A was higher in later (after Apr 2004) patients than in former (before Mar 2004) patients. Malignant diseases appeared in 3 patients with DM which consisted of breast cancer, epipharyngeal cancer and gastric cancer. We observed 2 deaths in DM patients during the course of therapy; one was due to IP, and the other due to miliary tuberculosis. This study showed that a poorer prognosis was observed in patients with DM when compared with those with PM, and immunosuppressive medications may be implicated at least partially in increased risk of infections and malignancies in PM/DM patients especially DM patients, indicating that patients with PM/DM may require careful monitoring during the clinical course. J. Med. Invest. 54: 295-302, August, 2007

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The differences in the waveform of Cerebral EP (Evoked Potential)s; SEP, VEP and AEP, among healthy subjects, schizophrenics, manic-depressives and epileptics were investigated. In 585 subjects of both sexes comprising these diagnostic groups, 6 channels of EPs, each 2 channels for each sensory modality, were recorded simultaneously/parallelly from each subject, without assigning a mental task. Then, waveforms of the g-m (group mean) EPs of each diagnostic group were superimposed for inspection. Peak latencies and inter-peak amplitudes of individual EPs were statistically tested among (ANCOVA) and between (Scheffe’s multiple comparison test) these diagnostic groups for each channel (modality), and for each sex. The waveforms of g-m EPs of each diagnostic group differed from each other. The differences of latencies and inter-peak amplitudes among these diagnostic groups attained to the significant level (P<0.05), with more significant differences between healthy subjects and each of these pathological diagnostic groups than between each of these pathological diagnostic groups, for each sex. Thus the differences in the waveform of EPs among these diagnostic groups were confirmed even taking the effect of medication on EPs into consideration. These results might suggest the existence of a waveform for individual EPs specific to each of these diagnostic groups, for each sex. J. Med. Invest. 54: 303-315, August, 2007

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We studied the effects of unilateral chronic anterior cruciate ligament (ACL) injury on bone size, bone mineral content (BMC), bone mineral density (BMD), soft tissue composition and muscle strength of the injured lower extremity in Japanese 21 men and 12 women aged 15 to 39 years. Bone area, BMD, BMC, lean mass and fat mass of lower extremity were measured using dual energy X-ray absorptiometry. The isometric and isokinetic muscle strength was assessed by an isokinetic machine.
BMC, lean mass, circumference of the thigh and circumference of the lower leg of the injured lower extremity were significantly smaller than those of the intact lower extremity (p=0.0002, p<0.0001, p<0.0001, p=0.0131). In cotrast, fat mass and %Fat of the injured lower extremity was significantly greater than that of the intact lower extremity (p=0.0301, p<0.0001). Bone area and BMD did not produce significant difference. These findings suggest that chronic insufficiency of ACL decreases BMC and lean mass of the injured lower extremity. J. Med. Invest. 54: 316-321, August, 2007

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The present study was designed to present evidence to clarify the relationships between learning ability, neuronal cell adhesion molecule L1 expression and hippocampal structural changes in the rat model received X-irradiation at an embryonic stage (E15). Water maze task indicated that all of the irradiated rats failed to learn the task in the whole training procedure. Their latency to the platform and swimming distance were significant differences from those sham-treated controls. Histological studies showed that the hippocampal ectopias induced by X-rays in the CA1 were involved in the spatial learning impairment, in which they hampered normal processes in learning development and transmission of information. Number, size and positions of the ectopias in the dorsal parts of the hippocampus were confirmed to be related to degrees of spatial learning impairment. On the other hand, L1 expression in the hippocampus was examined with Western blot analysis. The results indicated a lower content of L1 in the irradiated rats. A decrease in L1 might be one of reasons to cause disorganization of the septohippocampal pathways. These findings suggest some mechanisms of spatial learning impairment can be attributed to the formation of the hippocampal ectopias and redaction of L1 following prenatal exposure to X-irradiation. J. Med. Invest. 54: 322-330, August, 2007

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Syndecans are transmembranous heparan sulfate proteoglycans (HSPGs) with covalently attached glycosaminoglycan side-chains located on the cell surface. The mammalian syndecan family is composed of four types of syndecans (syndecan-1 to -4). Syndecans interact with the intracellular cytoskeleton through the cytoplasmic domains of their core proteins and membrane proteins, extracellular enzymes, growth factors, and matrix components, through their heparan-sulfate chains, to regulate developmental processes.
Here, as a first step to assess the possible roles of syndecan proteins in amelogenesis, we examined the expression patterns of all syndecan isoforms in continuously growing mouse incisors, in which we can overview major differentiation stages of amelogenesis at a glance. Understanding the expression domain of each syndecan isoform during specific developmental stages seems useful for investigating their physiological roles in amelogenesis.
Immunohistochemical analysis of syndecan core proteins in the lower incisors from postnatal day 1 mice revealed spatially and temporally specific expression patterns, with syndecan-1 expressed in undifferentiated epithelial and mesenchymal cells, and syndecan-2, -3, and -4 in more differentiated cells. These findings suggest that each syndecan isoform functions distinctly during the amelogenesis of the incisors of mice. J. Med. Invest. 54: 331-339, August, 2007

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We report the autopsy findings of a 40- year- old woman with lung complications of rheumatoid arthritis. She has been suffering from rheumatoid arthritis and interstitial pneumonia without satisfactory therapies because of her poor compliance. At autopsy, diffuse pleural adhesions and many protruding cysts were observed. The cut surfaces had rich fibrous changes and honey-comb like appearances dominantly in the left lower lobe. Microscopically, remarkable fibrous changes were observed with destruction of the alveolar structure. These fibroses were temporally homogeneous and lacked prominent fibroblastic foci. The histological pattern was consistent with fibrous non- specific interstitial pneumonia. In peripheral pulmonary arterioles, some thrombi were detected with much recanalization. Systemic amyloidosis was observed in the submandibular gland, thyroid, heart, and arterioles of the lung, kidney, and digestive tract. In the left pulmonary artery, a large embolus was detected. This embolism was the direct cause of death. Her pulmonary findings, except for the embolism, were considered sober states of lung complications of rheumatoid arthritis without the influence of therapy. J. Med. Invest. 54: 340-344, August, 2007

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We report three cases of vasculitis evaluated by FDG-PET/CT. Vasculitis is defined as inflammatory changes and necrosis in the aterial wall. The patients presented with non-specific symptoms such as fever up or elevated inflammatory markers. FDG-PET/CT clearly demonstrated intense FDG uptake in vessel walls. A 72-year-old female patient with a one month history of pyrexia had abnormal laboratory data suggesting an inflammatory process. FDG-PET/CT was very useful for the diagnosis of vasculitis. Steroid therapy was introduced. Normalization of laboratory data and symptomatic improvement correlated with normalization of FDG uptake in the vessels. J. Med. Invest. 54: 345-349, August, 2007

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HLA-B27 associated uveitis is characterized by recurrent alternating acute unilateral attacks of intraocular inflammation in the anterior chamber. The aim of this study was to report an unusual case of repeated exacerbations with vitreous hemorrhage in HLA-B27 associated uveitis. Thirty four-year-old man was diagnosed as HLA-B27 associated uveitis in his right eye. He showed repeated exacerbation of ocular inflammation with retinal vein dilation and small retinal hemorrhage following vitreous hemorrhage. Fluorescein fundus angiography a week before the appearance of vitreous hemorrhage showed no neovascularization. Oral prednisolone administration was started from 40mg/day with gradual tapering. About 3 weeks after the onset, most of the vitreous hemorrhage disappeared and visual acuity was improved to 20/20. Through the decreased vitreous hemorrhage, Weiss ring was detected later. The vitreous hemorrhage found in this patient is a severe exacerbation, and might be a consequence of the vitritis that leads to posterior vitreous detachment. J. Med. Invest. 54: 350-353, August, 2007

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We describe the case of a patient with neurofibromatosis type 1 (NF1) complicated by severe pulmonary aterial hypertension (PAH); only seven cases have been reported on this association so far, and PAH seems to be related to the vascular involvement of neurofibromatosis. The histology of our patient’s lung tissue showed thickening of arteries and veins by medial and/or intimal hypertrophy and fibrosis. In order to exclude a familiar PAH, the analysis of the bone morphogenetic protein receptor 2 gene was carried out, but no mutations were found.
On the basis of histological findings and of the results of genetic study we believe that PAH was a complication of NF1 in our patient and we suggest to screen patients with NF1 for the presence of PAH by means of trans-thoracic echocardiogram. J. Med. Invest. 54: 354-358, August, 2007

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Diabetic nephropathy is the leading cause of end-stage renal disease (ESRD) in Japan and other Westernized countries. Over 50% of the ESRD patients die from cardiovascular events. Cardiovascular disease (CVD) in ESRD patients with diabetes mellitus (DM) are implicated in the endothelial dysfunction caused by hyperglycemia, hyperlipidemia, and hypertension, and in the vascular calcification of intimal and medial arterial blood vessels caused by hyperphosphatemia. Therefore, dietary control of hyperglycemia and hyperphosphatemia should play an important role in the management of ESRD patients with DM. Furthermore, recent findings suggest that high concentrations of serum phosphate, even if within the normal range, may be a risk factor for CVD and mortality. An in vivo study using klotho knockout mice and fibroblast growth factor 23 (FGF-23) knockout mice has revealed that correction of hyperphosphatemia and hypervitaminosis D could ameliorate the premature aging-like phenotype. A low glycemic index and low phosphate diet may provide an advantage in the prevention of aging-related diseases in healthy individuals as well as in those with chronic kidney disease. J. Med. Invest. 54: 359-365, August, 2007

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In the present study, we investigated whether a diet deficient in inorganic phosphate (Pi) stimulates an ingestive behavior to seek sources of Pi. Male Wistar rats were placed in individual cages with unrestricted access to tap water and a low (LPD, 0.02% Pi) or normal (NPD, 0.6% Pi) Pi diet for 6 days. On day 7, LDP rats were given unlimited access to a solution of 25 mM potassium phosphate water (Pi-water) for 9 additional days. Rats fed LPD consumed 70-100% more Pi-water then those fed NPD. The increase in Pi-water intake resulted in a marked rise in the growth rate of rats fed LPD during day 9. A similar intake of Pi was induced after only 2 days of LPD and was associated with significant reductions in both plasma and cerebrospinal fluid (CSF) levels of Pi; these levels remained low throughout Pi restriction, despite a significant intake of Pi-water. Replenishment with a high-Pi diet rapidly quenched the appetite for Pi-water and was associated with restoration of both plasma and CSF Pi levels. These findings suggest that an appetite for Pi can be induced in rats, perhaps through lowered plasma and CSF Pi levels. J. Med. Invest. 54: 366-369, August, 2007

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Quercetin is a major dietary flavonoid found in onions and other vegetables. It is known that dietary quercetin is metabolized in the intestinal mucosa and the liver and is present as its glucuronide/sulfate conjugates with or without methylation. Although quercetin is known to possess strong antioxidant activity, there are only limited reports on the antioxidant activity of its metabolites. In this study, the antioxidant capacity of quercetin metabolites under physiological conditions was investigated. After consumption of cooked onion, more than 80% of quercetin metabolites were localized in the human plasma fraction containing concentrated serum albumin. Other lipoprotein fractions contained only small amounts of quercetin metabolites. Addition of quercetin 3-O-β-glucuronide to the lipoprotein-eliminated plasma fraction generated antioxidant activity against LDL oxidation in a dose-dependent manner. However, onion consumption failed to enhance the antioxidant activity of the lipoprotein-eliminated plasma fraction against LDL oxidation, probably because the amount of quercetin metabolites bound to albumin was less than the effective level in an ex vivo study. The physiological role of plasma albumin in retaining quercetin metabolites needs to be further clarified. J. Med. Invest. 54: 370-374, August, 2007

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A sixty-six year-old patient with liver cirrhosis and diabetes was nutritionally treated by administration of the low glycemic index liquid food (Inslow) as a late evening sack (LES) for 6 weeks. The mean energy intake increased from 825±48 kcal/d to 1567±66 kcal/d after the 6-week treatment period. The fasting glucose level did not change, remaining at about 100 mg/dl throughout this period. Interestingly, the amount of insulin administered was reduced from 38 units before treatment to 28 units in the fifth week of treatment without a change in the fasting glucose level. This indicates a marked improvement in insulin sensitivity due to Inslow administration in this patient. In conclusion, the long-term administration of Inslow as an LES may be an effective treatment for cirrhotic patients. J. Med. Invest. 54: 375-380, August, 2007

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In vascular smooth muscle cells, large-conductance Ca²⁺-activated K⁺ channels (K_Ca channels) play a pivotal role in determining membrane potential, and thereby the vascular tone. Ginsenoside Re, a phytochemical from ginseng, is reported to activate this channel, but its precise mechanism is unsolved. Patch clamp studies showed that ginsenoside Re activates K_Ca channels in the arterial smooth muscle cell line A10 in a dose-dependent manner. The channel-opening effect of ginsenoside Re was inhibited by 1 µM L-NIO, an inhibitor of eNOS, but not by 3 µM SMTC, an inhibitor of nNOS, indicating that ginsenoside Re activated K_Ca channels through activation of eNOS. SH-6 (10 µM), an Akt inhibitor, and wortmannin, a PI3-kinase inhibitor, completely blocked activation of K_Ca channels by ginsenoside Re, indicating that it activates eNOS via a c-Src/PI3-kinase/Akt-dependent mechanism. In addition, the ginsenoside Re-induced activation of eNOS and K_Ca channel was blocked by 10 µM ICI 182, 780, an inhibitor of membrane estrogen receptor-α, suggesting that eNOS activation occurs via a non-genomic pathway of this receptor. In conclusion, ginsenoside Re releases NO via a membrane sex steroid receptors, resulting in K_Ca channel activation in vascular smooth muscle cells, promoting vasodilation and preventing severe arterial contraction. J. Med. Invest. 54: 381-384, August, 2007

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Medium-chain fatty acids (MCFA) have attracted attention as part of a healthy diet, because they are absorbed and transported directly into the liver via the portal vein, metabolized rapidly by β-oxidation, and increase diet-induced thermogenesis. Because medium-chain triacylglycerols (MCT) containing only MCFA has a few weak points as frying oils, we have developed medium- and long-chain triacylglycerols (MLCT). MLCT is produced by lipase-catalyzed enzymatic transesterification. Recently, long-term clinical trials have demonstrated that MLCT and MCT result in less body fat-deposition. MLCT oil (Trade name: Healthy Resseta) is safe and can be substitute for common edible vegetable oils. Healthy Resseta has been approved as FOSHU (Food for Specified Health Use), by the Ministry of Health, Labour and Welfare of Japan in December 2002 for use as a cooking oil with a suppressing effect on body fat accumulation. Healthy Resseta is widely sold in Japan. J. Med. Invest. 54: 385-388, August, 2007

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As the living standard rises, people are more concerned with the health benefits of foods. Functional foods are, therefore, receiving increasing attention worldwide. The functional food market in Taiwan reached 1.78 billion US dollars in 2005. Only those which have been certified by the Department of Health can claim their health benefits. Until January 2007, only 88 functional foods have received the certificates. In addition to the product development in the food industry, research institutes and universities are also actively engaged in the technology development and basic research of functional foods. Many raw materials harvested in Taiwan, including edible plants, herbs, medicinal mushrooms, and sea foods, are investigated for their health benefits, bioactive components and suitable processing technologies. J. Med. Invest. 54: 389-391, August, 2007

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