Increased plasma endothelin-1 concentrations in E. coli septic peritonitis rats with diabetes mellitus

To study the diabetic mellitus (DM) patient's reaction to sepsis, we investigated the survival rate, the bacteremia, plasma endotoxin and plasma endothelin-1 levels in E. coli septic peritonitis rats with or without streptozotocin-induced DM. No significant difference could be detected between the DM and nondiabetic rats in the survival rate, the bacteremia level or the plasma endotoxin level. The DM rat manifested a significant increase compared to the nondiabetic rat in the plasma endothelin-1 level four hours after the outbreak of peritonitis. Endothelin-1 may thus play some role in the E. coli septic peritonitis rat with DM.

Acute gastroduodenal injury after ingestion of diluted herbicide pendimethalin

The herbicide, pendimethalin, is used worldwide, but its acute toxicity is not yet widely known. There have been some reported acute pendimethalin poisoning cases in humans and most of them intentionally ingested the concentrated formulation. We describe a 73-year-old man who developed corrosive gastroduodenal injury after accidental ingestion of the diluted (300 times with water) pendimethalin formulation. He had a history of reflux oesophagitis and had been taking omeprazol (10 mg/day) for a year. He consumed alcohol two hours after the accidental ingestion and then had nausea and epigastric pain. Endoscopy performed three days post-exposure revealed gastroduodenal injury. As he had consumed alcohol every day for years and had no history of gastroduodenal ulcer, the accidental ingestion may be associated with this injury. He was successfully treated by increasing his dosage of omeprazol (20 mg/day) for two weeks. This case indicates that ingestion of a small quantity of pendimethalin can provoke gastroduodenal injury.

Chemical studies on rutherfordium (Rf) at JAERI

Chemical studies on element 104, rutherfordium (Rf), at JAERI (Japan Atomic Energy Research Institute) are reviewed. The transactinide nuclide261Rf has been produced in the reaction248Cm(18O, 5n) at the JAERI tandem accelerator with the production cross section of about 13 nb. On-line anion-exchange experiments on Rf together with the lighter homologues, group-4 elements Zr and Hf, in acidic solutions have been conducted with a rapid ion-exchange separation apparatus. From the systematic study of the anion-exchange behavior of Rf, it has been found that the properties of Rf in HCl and HNO3solutions are quite similar to those of Zr and Hf, definitely confirming that Rf is a member of the group-4 elements. However, we have observed an unexpected chemical behavior of Rf in HF solutions; the fluoride complex formation of Rf is significantly different from those of the homologues. Prospects of extending chemical studies on transactinide elements in the near future at JAERI are briefly considered.

Successful treatment of disseminated Nocardia farcinica infection in a living-donor liver transplantation recipient

Nocardiosis is a serious infection with high mortality. We report a case of subcutaneous and neural lesions due to Nocardia farcinica infection after living-donor liver transplantation. The neural lesion was cured with antibiotics without drainage.

Effects of valsartan on the progression of chronic renal insufficiency in patients with nondiabetic renal diseases

The present study tested the effects of valsartan, an angiotensin II receptor blocker, on the progression of renal insufficiency in patients with nondiabetic renal diseases. The study subjects were 22 patients with nondiabetic renal diseases whose serum creatinine (Cr) ranged from 1.5 to 3.0 mg/dl. Valsartan (40-80 mg) or placebo was given once daily for 1 year each in a random crossover manner. In both periods, antihypertensive medications were titrated when the blood pressure was not lower than 140/90 mmHg. Blood sampling and urinalysis were performed bimonthly throughout the study periods. The average blood pressure was comparable between the valsartan and the placebo periods (130 +/- 9/86 +/- 6 vs. 131 +/- 8/86 +/- 6 mmHg). Serum Cr significantly increased from 1.9 +/- 0.5 to 2.3 +/- 0.8 mg/dl (p < 0.001) during the placebo period, but the change was insignificant in the valsartan period (2.1 +/- 0.6 to 2.2 +/- 0.9 mg/dl). The slope of decrease in the reciprocal of serum Cr was steeper in the placebo period than in the valsartan period (-0.064 +/- 0.070/year vs. -0.005 +/- 0.050/year, p < 0.01). During the valsartan period, urinary protein excretion was less than that during the placebo period (0.75 +/- 0.73 vs. 1.24 +/- 0.92 g/g Cr, p < 0.001). Serum K was significantly higher in the valsartan period than in the placebo period (4.6 +/- 0.5 vs. 4.4 +/- 0.5 mEq/l, p < 0.05); however, no patients discontinued taking valsartan as a result of hyperkalemia. It is possible that long-term treatment with an angiotensin II receptor blocker, valsartan, is effective at retarding the deterioration of renal function in patients with nondiabetic renal disease by a mechanism independent of blood pressure reduction.

Effect of perioperative steroid therapy on the postoperative course of patients with oesophageal cancer

BACKGROUND

Perioperative steroid therapy is often used in oesophageal cancer surgery and we evaluate the effect of this therapy on the secretory leukocyte protease inhibitor levels in the lungs (a major antiprotease in the conducting airways) and postoperative course in oesophageal cancer patients.

METHODS

Twenty-one patients operated on for oesophageal cancer in 2003-2004 were treated with perioperative steroid therapy (250 mg of methylprednisolone intravenously 1 h before the operation). Fifteen consecutive patients operated on in 2002 served as a control group. Secretory leukocyte protease inhibitor in bronchoalveolar lavage fluid and the postoperative course in the two groups were compared.

RESULTS

The mortality rate was 0% and there was no significant difference in the morbidity rate between the two groups. Days of intubation and systemic inflammatory response syndrome were significantly shorter for the steroid group. The bronchoalveolar lavage fluid secretory leukocyte protease inhibitor level was significantly higher in the steroid group than in the control group on postoperative days 2 and 3. The secretory leukocyte protease inhibitor level on postoperative day 3 was remarkably lower for the patients intubated for > or = 5 days and for those with pulmonary complications.

CONCLUSION

Perioperative steroid therapy increased the bronchoalveolar lavage fluid secretory leukocyte protease inhibitor level and reduced the days of intubation and systemic inflammatory response syndrome in patients with oesophagectomy.

Exclusive measurement of the nonmesonic weak decay of the lambda(5)He hypernucleus

We performed a coincidence measurement of two nucleons emitted from the nonmesonic weak decay of lambda(5)He formed via the 6Li(pi+, K+) reaction. The energies of the two nucleons and the pair number distributions in the opening angle between them were measured. In both np and nn pairs, we observed a clean back-to-back correlation coming from the two-body weak reactions of lambda p --> np and lambda n --> nn, respectively. The ratio of the nucleon pair numbers was N(nn)/N(np) = 0.45 +/- 0.11(stat) +/- 0.03(syst) in the kinematic region of cos theta(NN) < -0.8. Since each decay mode was exclusively detected, the measured ratio should be close to the ratio of gamma(lambda p --> np)/gamma(lambda n --> nn). The ratio is consistent with recent theoretical calculations based on the heavy meson and/or direct-quark exchange picture.

Experimental identification of spin-parities and single-particle configurations in 257No and its alpha-decay daughter 253Fm

alpha-gamma and alpha-electron coincidence spectroscopy for a short-lived heavy actinide nucleus (257)No (T(1/2) = 24.5 s) has been performed using a gas-jet transport system and an on-line isotope separator. Spin-parities of excited states in (253)Fm fed by the alpha decay of (257)No have been identified on the basis of the measured internal conversion coefficients. The nu3/2(+)[622] configuration has been assigned to the ground state of (257)No as well as to the 124.1 keV level in (253)Fm. It was found that the ground-state configuration of (257)No is different from that of lighter N = 155 isotones.

Bayesian classification of myocardial excitation abnormality using magnetocardiogram maps for mass screening

We propose a novel classification method based on the Bayes rule to utilize the magnetocardiogram (MCG) in noninvasive mass screening. The cardiac excitation is directly tracked by maps of the MCG field generated by myocardial excitation current through the excited wave front. To adopt the characteristics of the excited wave fronts as a parameter for the Bayes theorem, we developed a parameterization procedure that consists of a two-dimensional wavelet approximation and a cluster analysis of magnetic field maps. With the parameter determined by this procedure, the probability of a subject to belong to a disease group or to the normal group is estimated by the Bayes theorem. The subject is classified into the group of the highest probability. We applied the proposed method to ST-T period of MCG data of 6 old myocardial infarction (OMI) patients and 15 normal controls. The method showed sensitivity of 83%; specificity, 100%; positive predictive value, 100%; and negative predictive value, 94% in the classification of OMI patients and normal controls. The processing time is less than 5 seconds per one subject. It suggests a possible application of the proposed method in mass screening of abnormal MCG patterns.

An immunohistochemical study of TIMP-3 expression in oesophageal squamous cell carcinoma

Tissue inhibitor of metalloproteinase-3 (TIMP-3) inhibits the activity of matrix metalloproteinase, which may play an important role in carcinoma invasion and metastasis. We have investigated the relationship between TIMP-3 reduction and clinicopathological factors in oesophageal squamous cell carcinoma (ESCC). We examined tissue specimens that had been removed from 90 patients with thoracic oesophageal cancer who had undergone surgery between 1983 and 2001. Immunohistochemical staining was performed by the standard streptavidin–biotin method. Immunostaining of TIMP-3 was seen in the cytoplasm of cancer cells and normal oesophageal epithelial cells, particularly in cells located in shallow areas of the tumour. TIMP-3 preserved (+), moderate (±), and reduced (−) cases accounted for 30, 27, and 33 of the 90 patients, respectively (33, 30, 37%). Significant correlations were observed between TIMP-3 expression and depth of tumour invasion (P=0.001), number of lymph node metastases (P=0.003), infiltrative growth pattern (P=0.003), and disease stage (P=0.005). The survival rates of patients with TIMP-3 (−) cancer were significantly lower than those of patients with TIMP-3 (+) and TIMP-3 (±) cancer (P=0.0003). The mean 5-year survival rates of patients with TIMP-3 (+), (±), and (−) were 50, 58, and 21%, respectively. In conclusion, decreased expression of TIMP-3 protein correlates with invasive activity and metastasis. This makes the prognosis for patients with cancer that has lost TIMP-3 significantly less favourable than that for patients with cancer that has maintained TIMP-3.

Evidence of complete fusion in the sub-barrier 16O+238U reaction

Evaporation residue cross sections in the 16O+238U reaction were measured for the energy range from above- to extreme sub-barrier. The cross sections are reproduced by a statistical model calculation, for which partial cross sections are calculated by a coupled-channel model taking into account the prolate deformation of 238U. Complete fusion was observed in the collision of the projectile with the tips of the 238U target, in the same way as the side collision.

Increased cardiovascular risk in long-term hemodialysis patients carrying deletion allele of ACE gene polymorphism

BACKGROUND

Controversy continues about the relation of insertion (I)/deletion (D) polymorphism of the angiotensin-converting enzyme (ACE) gene to the genetic predisposition to develop such cardiovascular diseases as myocardial infarction, stroke, and other arteriosclerotic disorders.

METHODS

To examine the relation of ACE gene polymorphism to risk for developing cardiovascular diseases in long-term hemodialysis patients, we followed up 534 patients on long-term hemodialysis therapy for 3 years after determining ACE genotype.

RESULTS

Numbers of patients with the II, ID, and DD genotypes were 208, 245, and 81, and frequencies of the I and D alleles were 0.62 and 0.38, respectively. Background characteristics, such as age, sex, causative diseases of renal failure, and preexistence of cardiovascular diseases at the time of study entry, were similar among the 3 genotype groups. Serum ACE activity was significantly greater in the DD and ID groups than the II group; however, plasma angiotensin II concentrations were not significantly different among the 3 groups. During the 3 years of follow-up, 46 fatal and 167 nonfatal cardiovascular events occurred. The incidence of these cardiovascular events was significantly associated with older age (P < 0.001), diabetes (P < 0.001), preexistence of cardiovascular diseases (P < 0.001), systolic blood pressure (P = 0.009), high cardiothoracic ratio on chest roentgenogram (P < 0.001), electrocardiographic abnormalities (P < 0.001), and low serum sodium level (P < 0.001). In addition, the incidence of cardiovascular events was greater in patients carrying the D allele (II, 22.1%; ID, 31.8%; DD, 38.3%; P = 0.010).

CONCLUSION

It is suggested that the D allele of ACE gene polymorphism is a risk factor for cardiovascular complications in hemodialysis patients.

Interferon-gamma and granulocyte colony-stimulating factor in bronchoalveolar lavage fluid after oesophagectomy

BACKGROUND

Activated polymorphonuclear leucocytes play a pivotal role in pulmonary complications after oesophagectomy. A lot of inflammatory mediators including interferon-gamma and granulocyte colony-stimulating factor are reported to modify the life span of polymorphonuclear leucocytes.

AIMS

In this study we investigated whether interferon-gamma and granulocyte colony-stimulating factor are associated with pulmonary complications after oesophagectomy.

PATIENTS AND METHODS

We measured interferon-gamma and granulocyte colony-stimulating factor concentrations in bronchoalveolar lavage fluid of 37 patients who had undergone oesophagectomy and examined the relationship between these mediators and pulmonary complications.

RESULTS

Pulmonary complications occurred in nine patients (24%, Pneum(+)). There was no significant difference in age, gender, preoperative comorbid conditions, tumour stage, operation method, operating time or blood loss between the Pneum(+) group and another 28 patients(Pneum(-)). Days until extubation were significantly increased in the Pneum(+) group than in the Pneum(-) group. Interferon-gamma (on postoperative day 2) and granulocyte colony-stimulating factor (on postoperative days 1-3) in bronchoalveolar lavage fluid were significantly increased in the Pneum(+) group than in the Pneum(-) group and granulocyte colony-stimulating factor was significantly correlated with days until extubation.

CONCLUSIONS

Our results indicate that bronchoalveolar lavage fluid granulocyte colony-stimulating factor is associated with respiratory conditions after oesophagectomy and assaying it can be useful for predicting pulmonary complications.

Identifying patterns of spatial current dispersion that characterise and separate the Brugada syndrome and complete right-bundle branch block

The aim of the study was to detect patterns of spatial-current distribution in the late QRS and early ST-segments that distinguish Brugada-syndrome cases from complete right-bundle branch block (CRBBB). Magnetocardiograms (MCGs) were recorded from Brugada-syndrome patients (n = 6), CRBBB patients (n = 4) and the members of a control group (n = 33). The current distributions at six time points from Q-onset were estimated by producing current-arrow maps (CAMs). The angle of the current arrow of maximum amplitude at each time point was calculated. In the Brugada cases, the characteristic ST elevation was seen above the upper right chest, and abnormal currents appeared to be present in the right-ventricular outflow tract (RVOT). The angles of the abnormal arrows were -78 degrees +/- 51 degrees at 100 ms and -50 degrees +/- 61 degrees at 110 ms. In the cases of CRBBB, wide S- and R-waves were recorded above the upper right and lower right chest, respectively. The angles of the abnormal arrows for CRBBB were 152 degrees +/- 19 degrees at 100 ms, 159 degrees +/- 20 degrees at 110 ms, and 157 degrees +/- 19 degrees at 120 ms. The findings suggest that an abnormal current from the RVOT to the upper left chest may be a feature of the Brugada syndrome, and that the direction of this current is completely different from that seen in CRBBB.

CT is useful for identifying patients with complicated appendicitis

BACKGROUND AND AIMS

We often come across patients with complicated appendicitis (perforation, abscess formation, or peritonitis) and it is essential to get accurate and detailed information on these patients preoperatively. In this study, we investigated whether or not preoperative computed tomography is useful for identifying these patients.

PATIENTS AND METHODS

Plain and intravenously-contrasted helical computed tomography was obtained preoperatively in 94 (75%) of 125 patients who underwent appendectomy. Twenty-eight (30%) of the 94 patients had complicated appendicitis (Compli(+) group). We compared clinical factors and computed tomography findings of the Compli(+) group with those of 66 other patients (Compli(-) group).

RESULTS

There was no significant difference between the Compli(+) and Compli(-) groups in gender, white blood cell count, the present rate of an enlarged appendix, or appendicolith. Fat stranding and free fluid on computed tomography were significantly associated with complicated appendicitis by both univariate and multilogistic regression analysis. Fourteen (70%) of the 20 patients with fat stranding and free fluid on computed tomography had complicated appendicitis and only 1 (4%) of the 28 Compli(+) patients had neither fat stranding nor free fluid on computed tomography.

CONCLUSION

Our study has indicated that fat stranding and free fluid on computed tomography are significant for complicated appendicitis and helical computed tomography is a powerful tool for identifying patients with complicated appendicitis preoperatively.