Statins Induce the Regression of Left Ventricular Mass in Patients With Angina

Background There is evidence that statins induce the regression of cardiac hypertrophy in a transgenic rabbit model of hypertrophic cardiomyopathy. Methods and Results The association between treatment with statins and the regression of cardiac mass (left ventricular mass index, LVMI) was investigated in a case - control study using transthoracic echocardiography in 304 patients with angina who underwent coronary angiography. Those who received pravastatin or simvastatin were defined as cases (n=66), and age, sex and body mass index-matched controls (n=127) were selected. The cases showed a significant decrease in LVMI compared with the controls. Although the cases included a significantly higher percentage of patients with hypertension and calcium antagonist (CaA) treatment than the controls, there were no relationships between LVMI and either hypertension or CaA treatment. Because the cases had a significantly higher number of stenosed vessels than the controls, LVMI for each number of stenosed vessels was analyzed, and a significant interaction effect between the association of LVMI with statin and the number of stenosed vessels was found. Conclusions Treatment with statins was associated with a lower cardiac mass in patients with angina, suggesting that this is one of the drugs' pleiotropic effects.

Increased Expression of Monocyte CD11a and Intracellular Adhesion Molecule-1 in Patients With Initial Atherosclerotic Coronary Stenosis

BACKGROUND

Cell adhesion molecules have been implicated in the adhesion of leukocytes to endothelial cells and therefore play a role in atherosclerosis, which is a frequent cause of morbidity and mortality in patients with coronary artery disease (CAD) or undergoing hemodialysis (HD). The levels of expression of leukocyte adhesion molecules were evaluated in patients with CAD or HD.

METHODS AND RESULTS

The expression of leukocyte (ie, neutrophil, monocyte and lymphocyte) surface CD11a, CD18, intracellular adhesion molecule-1 (ICAM-1), very late antigen-4 alpha (VLA-4 alpha) and L-selectin was investigated by flow cytometry in 20 patients who were initially diagnosed with CAD (CAD group), 15 patients with coronary re-stenosed vessels (RESTE group), 20 undergoing HD (HD group) and 20 without CAD (CONT group). Monocyte surface expression of both CD11a and ICAM-1 in the CAD group was significantly higher than in the CONT group. Interestingly, when 15 patients with RESTE were analyzed, they showed monocyte CD11a and ICAM-1 expression levels comparable to those in the CONT group. On the other hand, there were no significant differences in the expression of CD11a, CD18, L-selectin or VLA-4 alpha between the HD group and CONT group, but monocyte L-selectin was increased in the CAD group compared with the CONT group.

CONCLUSIONS

Because CD11a and CD18 are expressed on the cell surface as a heterodimer and ICAM-1 is a ligand for CD11a/CD18, this increased expression of CD11a and ICAM-1 may affect the development of initial atherosclerotic coronary stenosis, but not re-stenosis.

Response to preoperative chemotherapy affects prognosis in esophageal cancer

The effect of preoperative chemotherapy on prognosis is still controversial. We have investigated the relationship between responses to preoperative chemotherapy and prognosis after curative operations in patients with esophageal squamous cell carcinoma. Thirty-nine patients received preoperative chemotherapy with continuous infusion of 500 mg/m2 of 5-fluorouracil (5-FU) and intravenous injection of 20 mg/m2 of leucovorin every 12 hours for 5 days. On the 5th day alone, 70 mg/m2 of cisplatin was also infused. The effect was evaluated approximately 14 days after the end of one course of chemotherapy. The rates of responders and non-responders were 64.1% and 35.9%, respectively. After an interval of 21-28 days, transthoracic esophagectomy was performed. Significant histological effect by chemotherapy was found in responders compared to non-responders (P < 0.05). Responders had a significantly better prognosis than non-responders by Log-rank test (P < 0.01). This suggests that preoperative chemotherapy may contribute to better prognosis when the tumor is sensitive to chemotherapy.

Finite element analysis of the stresses around fixtures in various reconstructed mandibular models--part II (effect of horizontal load)

AIM OF EXPERIMENT: Having already studied the effect of vertical load (Nagasao et al., 2002), the purpose of this study was to investigate the effect of horizontal load on implants embedded into a virtually reconstructed mandible.

MATERIAL AND METHODS

Three-dimensional virtual models of various reconstructed mandibles were designed on a PC and 50 N horizontal loads were applied on the cantilever portion of the upper structure. Then, using a finite element analysis, stresses occurring around the implants were calculated, and the directions of the forces that cause the maximum von Mises stresses were evaluated. Finally, the results were compared with those from vertical loading.

RESULTS

In all models, the maximum stresses occurred around the implants embedded on the premolar region of the loaded side. In addition, the locations at which the maximum von Mises stresses occurred were greatly influenced by the structural character of the loaded side.

CONCLUSION

When horizontal loads were applied to reconstructed mandibles, the location and direction of the maximum stresses around the dental implants appeared to be influenced much more by the structural characters of the reconstructed mandibles when compared with vertical loads.

Angiotensin-converting enzyme inhibitor promotes coronary collateral circulation in patients with coronary artery disease

Previous studies have suggested that angiotensin-converting enzyme inhibitors (ACEI) promote collateral circulation in ischemic limbs of rabbits. The present study was designed to determine the association between treatment with ACEI and the development of coronary collateral circulation, as assessed by the Rentrop Score, in patients with coronary artery disease (CAD) in a case - control study. Subjects included 456 patients with angina who underwent coronary angiography. Those who had one (1-V), two (2-V) or three (3-V) significantly stenosed vessels, and who received only ACEI without any other anti-hypertensive medication were defined as cases (n=33), and age, sex and body mass index-matched subjects (n=56) were selected as controls. Among 1-V patients, but not 2-V or 3-V patients, the cases included a higher percentage of patients with Rentrop Score of at least 1 than the controls, suggesting that ACEI was associated with coronary collateral circulation. Patients with 1-V disease who were treated with ACEI were most likely [odds ratio (confidence interval): 6.1 (1.4-30.1)] to develop collateral circulation, as assessed by a multiple logistic regression analysis. Therefore, treatment with ACEI was associated with the development of collateral circulation in patients with CAD, suggesting that such an action is associated with bradykinin production by ACEI.

Effectiveness of preoperative chemotherapy using carboplatin (CBDCA) and surgery against an esophageal small cell carcinoma

A 63-year-old man presented to our hospital with persistent dysphagia. Radiologic and endoscopic examination disclosed a 2.0-cm exophytic tumor in the middle third of the esophagus. An endscopically obtained biopsy specimen was found to represent undifferentiated small cell carcinoma. Computed tomography of the chest, abdomen, and cervical region was performed, as were gallium and bone scintigraphy. Metastasis to an adjacent lymph node was detected, without metastasis to distant organs. After neoadjuvant chemotherapy with carboplatin (CBDCA) (400 mg/m2) and etoposide (VP-16) (100 mg/m2), endoscopy and barium-swallow esophagography showed regression. Thoracic esophagectomy then was performed with mediastinal, abdominal and cervical lymph node dissection. The resected tumor was polypoid, measuring 0.5 x 0.5 cm. The lesion consisted mainly of small anaplastic cells, but included a small focus of squamous cell carcinoma. The patient has survived for more than 7 months with no further treatment and no evidence of recurrent disease.

Effects of preoperative chemotherapy on metastatic lymph nodes in esophageal squamous cell carcinoma

The aim of this study was to evaluate the effect of preoperative chemotherapy on metastatic lymph nodes and on the outcome of patients who underwent esophagectomy for advanced squamous cell carcinoma of the esophagus. Fifty-nine patients with potentially resectable squamous cell carcinoma of the esophagus were studied. Twenty patients (group A) were treated by preoperative chemotherapy with cisplatin, 5-fluorouracil, and leucovorin, followed by surgery. Thirty-nine patients underwent surgery alone (group B). A total of 2591 resected lymph nodes were histologically evaluated for metastasis and the effect of chemotherapy. The metastasis rate in the resected lymph nodes, the number of metastatic lymph nodes, and outcome of the patients were statistically analyzed between groups. In group A, the clinical and pathological response rates were 75% and 75% respectively. The metastasis rate in the resected lymph nodes was significantly higher in group B (P < 0.01). The mean number of metastatic lymph nodes was significantly lower in group A (P < 0.05). Furthermore, the mean number of metastatic lymph nodes was significantly lower in the chemotherapy responders than in non-responders. The survival rate in group A was better than in group B (P = 0.07). Preoperative chemotherapy reduced the number of metastatic lymph nodes and may contribute to improving the outcome of the patients who have undergone esophagectomy for squamous cell carcinoma of the esophagus.

Pravastatin promotes coronary collateral circulation in patients with coronary artery disease

BACKGROUND

Previous studies suggested that hydroxymethylglutaryl coenzyme A reductase inhibitor (statin) promotes collateral circulation in ischemic limbs of rabbits. The present study was designed to determine the association between treatment with pravastatin and the development of coronary collateral circulation as assessed by the Rentrop Score in patients with coronary artery disease (CAD) in a case-control study.

DESIGN

The study included patients who had one (1-V), two (2-V) or three (3-V) significantly stenosed vessels. Patients who did and did not receive pravastatin were defined as case participants (n = 42) and control participants (n = 100), respectively.

RESULTS

The case participants included a higher percentage of 3-V patients with a Rentrop Score 1 compared to the control participants but there was no difference among 1-V and 2-V patients, suggesting that pravastatin was associated with coronary collateral circulation independent of the number of stenosed vessels. Patients with 3-V disease who were treated with pravastatin were most likely [odds ratio (confidence interval), 17.4 (4.4-115)] to develop collateral circulation, as assessed by multiple logistic regression analysis.

CONCLUSIONS

Treatment with pravastatin was associated with the development of collateral circulation in patients with CAD, suggesting that such action constitutes part of the pleiotropic effects of statin.

Low vertebral cancellous bone density in peripubertal girls with Turner's syndrome and boys with hypogonadism

OBJECTIVE

To characterize the changes of vertebral cancellous bone density in children with hypogonadism.

STUDY DESIGN

Quantitative computed tomography (QCT) values of vertebral cancellous bone in 21 girls with Turner's syndrome, 12 boys with hypogonadism, and 46 age-matched controls (24 boys, 22 girls) were studied. The subjects were divided into the following subgroups by the age (year) at the time of the measurement: A. 4-6.9; B. 7-9.9; C. 10-12.9.

RESULTS

QCT values for Turner's syndrome vs control girls in the same age groups (A, B, and C) were (mean +/- SD) 226 +/- 36 vs 216 +/- 31 (NS), 193 +/- 29 vs 220 +/- 33 (NS), and 177 +/- 32 vs 217 +/- 17 (p < 0.01) mg/cm3, respectively. Those for boys with hypogonadism vs control boys (A, B, and C) were 236 +/- 15 vs 240 +/- 12 (NS), 187 +/- 21 vs 225 +/- 28 (p < 0.05), and 172 +/- 11 vs 216 +/- 26 (p < 0.0001) mg/cm, respectively. The cross-sectional data for Turner's syndrome and boys with hypogonadism had significant negative correlation with chronological age (r = 0.59; p < 0.001).

CONCLUSION

These results showed that vertebral cancellous bone density in children with hypogonadism began to decrease during the peripubertal period in contrast to the constant values in controls, suggesting that a small amount of gonadal steroid in healthy children has an important role in maintaining normal bone density.

Finite element analysis of the stresses around endosseous implants in various reconstructed mandibular models

PURPOSE

To calculate the location and intensity of the maximum stresses occurring around implants in the reconstructed mandible.

MATERIAL AND METHODS

Human preserved mandibles and fibulae were used to design 3-D mandibular models on a Desktop Computer. Various 3-D simulation models representing mandibles were made. Implants (fixtures) and superstructures were then embedded in each model and occlusal pressure was applied to the cantilever portion of the superstructure. Von Mises stress, the maximum and minimum principal stress on each model were calculated using finite element structural analysis software. Finally, evaluation of the stresses around each fixture hole was performed.

RESULTS

It appeared that for each fixture hole, the direction and the magnitude of the stresses were influenced by complex factors such as the thickness of the cortical bone where the fixtures were embedded, the degree of vertical displacement under load, and the relationship between adjacent fixtures.

CONCLUSION

Location and intensity of the stresses occurring around fixtures differs significantly between various types of mandibular reconstruction. Published by Elsevier Science Ltd.

Genetic polymorphisms of cytochrome P450 1A1 and risk of gallbladder cancer

The relation between cytochrome P4501A1 (CYP1A1) gene polymorphisms and the risk of gallbladder cancer was examined. To clarify individual differences in susceptibility to gallbladder carcinogenesis, we investigated the frequency of the Mspl and Ile-Val polymorphisms of the CYP1A1 gene, in 52 patients with gallbladder cancer (32 females, 20 males) and 104 healthy controls (64 females, 40 males). We then examined the relationship between the CYP1A1 polymorphisms and the development of gallbladder cancer in members of both sexes. A statistical difference in the frequencies of the MspI and Ile-Val polymorphisms or their alleles (ml, m2 and Ile, Val) was not observed in the male patients and controls. Among females, however, the frequencies of genotypes C and Ile/Val were significantly higher (p < 0.05) in the patients than in their controls. Moreover, the frequency of the hetero genotype Ile/Val was statistically higher (p < 0.05) in the female patients than in the male patients. This study demonstrated a significant over-representation of genotypes C and Ile/Val in female patients with gallbladder cancer. Females with genotypes C and/or Ile/Val may have a high genetic susceptibility to the development of gallbladder cancer.

Multiframe observation of an intense femtosecond optical pulse propagating in air

We have demonstrated femtosecond time-resolved and picosecond time-interval successive observations of a single femtosecond optical pulse propagating in air with ultrafast self-modulation such as filamentation. A quadruple femtosecond probe pulse crossing an intense propagating pulse at picosecond intervals was able to capture directly four successive images of the propagating pulse as in a movie but with femtosecond time resolution. From this observation, we can directly analyze and recognize the propagation process, which is significantly affected by pulse-energy fluctuation, and (or) atmospheric turbulence from shot to shot.

Three-dimensional imaging of a tissuelike phantom by diffusion optical tomography

Three-dimensional imaging of three small absorbers embedded in a tissuelike cylindrical solid phantom was conducted by diffusion optical tomography. Each absorber, which was 10 mm in diameter and 10 mm high, was located on the same plane in a phantom, which was 80 mm in diameter and 140 mm high. The optical properties of the phantom were similar to those of the human breast; that is, one absorber had lower absorption and the other two absorbers had higher absorption than that of the phantom. Reemission from the phantom was measured with a multichannel photon counting system. Image reconstruction was performed by our average value method. We were able to distinguish lower and higher absorbers quantitatively. This result shows that our method can diagnose not only the existence of but also a morbid state of breast cancer.

Intrahepatic cholangiojejunostomy for unresectable malignant biliary tumors with obstructive jaundice

We reviewed our experience with intrahepatic cholangiojejunostomy as a palliative therapy for patients with unresectable malignant diseases involving the ductal confluence or the common hepatic duct. Fifteen patients with malignant biliary obstruction were treated by cholangiojejunostomy at our hospital. Two patients had intrahepatic cholangiocarcinoma, 7 had gallbladder carcinoma, 5 had bile duct carcionoma, and 1 had pancreatic carcinoma. Segment III cholangiojejunostomies were performed in 14 patients and segment V cholangiojejunostomy in 1. Contraindications for surgical resection were locoregional invasion of tumors involving the proper and/or common hepatic artery and portal vein in 15 patients and the presence of hepatic metastases in 6 patients. Liver metastases were detected in 5 of the 7 patients with gallbladder carcinoma. Postoperative complications occurred in 2 patients (13%), but there was no leakage of the cholangioenteric anastomosis in our series. There was no operative mortality after cholangiojejunostomy. Of the 9 patients who survived for more than 6 months after surgery, 7 showed a significant improvement in performance status (PS) (82 +/- 10%) 3 months after the surgery compared with the preoperative PS (70 +/- 7%). Four of the 9 patients had recurrent cholangitis as a late complication, but 4 were completely free from jaundice. Median survival after cholangioenteric bypass was 9 months (range, 2-25 months). With respect to tumor location, the median survival time was 4 months (range, 2-25 months) in patients with gallbladder carcinoma and 15.5 months (range, 12-22 months) in those with bile duct carcinoma. While the median survival period after surgery was only 3 months (range, 2 to 8 months) in the 5 patients with hepatic metastases from gallbladder carcinoma, 2 patients without liver metastasis survived for 9 and 25 months after segment III cholangioenteric bypass. In conclusion, cholangiojejunostomy can provide useful palliation for malignant biliary obstruction when combined with careful patient selection.

Response of renal sympathetic nerve activity to parabolic flight-induced gravitational change in conscious rats

The renal sympathetic nerve activity (RNA) response to gravitational changes induced by parabolic flight was examined in chronically instrumented conscious rats. Two types of RNA responses were found. In six out of 12 rats, the RNA did not respond during the 2 G period, but immediately fell to background levels on entry into microgravity (microG), then recovered to the 1 G control level during continued microG (shutdown obvious group). In the other six rats, the RNA increased to 158+/-13% at the end of the 2 G period, increased further to 195+/-22% on entry into microG, then gradually recovered to that seen at 1 G (shutdown obscure group). The mean arterial pressure in the shutdown obvious group was significantly higher and the heart rate tended to be higher than in the shutdown obscure group, suggesting that the baseline sympathetic tone in the shutdown obvious group was higher than in the shutdown obscure group. These results suggest that the RNA response to parabolic flight might be affected by the baseline sympathetic tone.

Characterization of a membrane-bound arginine-specific serine protease from rat intestinal mucosa

Previously we isolated and characterized a membrane-bound, arginine-specific serine protease from pig intestinal mucosa [J. Biol. Chem. 269, 32985-32991 (1994)]. For further characterization of this type of enzyme, we cloned a cDNA from rat intestinal mucosa encoding the precursor of a similar protease. The partial amino acid sequences determined for the pig enzyme were found to be shared almost completely by the rat enzyme. The serine protease domain of the rat enzyme, heterologously expressed in Escherichia coli, specifically cleaved Arg (or Lys)-X bonds with a marked preference for Arg-Arg or Arg-Lys, similar to the pig enzyme. The mRNA for the rat enzyme was shown to be distributed mainly in intestine, and the enzyme was detected in the duodenal mucosa as a 70 kDa protein. Immunohistochemical analysis of the small intestinal tissue showed that the enzyme is localized mainly on brushborder membranes.

Vitamin D insufficiency in Japanese female college students: a preliminary report

Vitamin D insufficiency, a risk factor for osteoporosis, has been well investigated in elderly women worldwide, but little information has been available for younger women. This study aimed to determine serum 25-hydroxyvitamin D [25(OH)D] levels in Japanese female college students, and to test whether there is an association between 25(OH)D and bone strength. Subjects were 77 Japanese female junior college students aged 19-24 years. Serum 25(OH)D was measured with high performance liquid chromatography. Bone strength of the calcaneus was evaluated using the osteo sono-assessment index (OSI), a combined index reflecting the bone mass, bone architecture, and elasticity, as measured by quantitative ultrasound densitometry (AOS-100, Aloka). The mean 25(OH)D concentration was 34.2 nmol/L (SD +/- 12.1). The proportion of subjects with 25(OH)D less than 30 nmol/L, a cut-off value for vitamin D insufficiency, was 31/77 (40.3%). Simple linear regression analysis showed that there was a significant linear relationship between 25(OH)D and OSI (R2 = 0.098, p = 0.0069). The association held even after adjusting for weight (partial R2 = 0.098, p = 0.0023). Body weight was also a significant predictor of OSI (partial R2 = 0.105, p = 0.0034). These results suggest that vitamin D insufficiency may be prevalent in healthy young women. Moreover, low levels of 25(OH)D in young women may adversely affect bone strength. An additional, newly designed epidemiological study with a sufficient sample size is needed to confirm the present findings.

The effect of cAMP on electrogenic Na(+) absorption in the rat distal colon

Cyclic AMP is a ubiquitous second messenger produced in cells in response to extracellular stimulants. The aim of this study was to examine its role in the regulation of amiloride-sensitive electrogenic Na(+) absorption in the rat distal colon by measuring the short-circuit current (I(sc)) and (22)Na(+) fluxes in a chamber-mounted mucosal sheet. Forskolin stimulated the amiloride-inhibitable I(sc) and amiloride-inhibitable (22)Na(+) absorption. 8Br-cAMP also stimulated the amiloride-inhibitable I(sc). Furthermore, isoproterenol, acting via beta-adrenergic activation, stimulated the amiloride-inhibitable I(sc). The isoproterenol-induced increase in the amiloride-sensitive I(sc) was largely suppressed by H89, a protein kinase A inhibitor. In conclusion, cAMP can upregulate amiloride-sensitive electrogenic Na(+) absorption in the rat distal colon.

Photon path distribution and optical responses of turbid media: theoretical analysis based on the microscopic Beer-Lambert law

A concise theoretical treatment has been developed to describe the optical responses of a highly scattering inhomogeneous medium using functions of the photon path distribution (PPD). The treatment is based on the microscopic Beer-Lambert law and has been found to yield a complete set of optical responses by time- and frequency-domain measurements. The PPD is defined for possible photons having a total zigzag pathlength of l between the points of light input and detection. Such a distribution is independent of the absorption properties of the medium and can be uniquely determined for the medium under quantification. Therefore, the PPD can be calculated with an imaginary reference medium having the same optical properties as the medium under quantification except for the absence of absorption. One of the advantages of this method is that the optical responses, the total attenuation, the mean pathlength, etc are expressed by functions of the PPD and the absorption distribution.

Certain styrene oligomers have proliferative activity on MCF-7 human breast tumor cells and binding affinity for human estrogen receptor

To examine the estrogenic activities of styrene oligomers, we carried out cell proliferation assays with estrogen-sensitive MCF-7 cells and competitive binding assays to human estrogen receptor [alpha] (hER[alpha]). The styrene oligomers tested were 1,3-diphenyl propane (SD-1), 2,4-diphenyl-1-butene (SD-2), cis-1,2-diphenyl cyclobutane (SD-3), trans-1,2-diphenyl cyclobutane (SD-4), 2,4,6-triphenyl-1-hexene (ST-1), 1a-phenyl-4a-(1'-phenylethyl)tetralin (ST-2), 1a-phenyl-4e-(1'-phenylethyl)tetralin (ST-3), 1e-phenyl-4a-(1'-phenylethyl)tetralin (ST-4), 1e-phenyl-4e-(1'-phenylethyl)tetralin (ST-5), 1e,3e,5a-triphenylcyclohexane (ST-6), and 1e,3e,5e-triphenylcyclohexane (ST-7). In the MCF-7 cell proliferation assay, styrene trimers (ST-1, ST-3, ST-4, and ST-5) had the highest proliferative activities of the compounds tested. The relative potency of these chemicals was 0.0002-0.0015%, which was comparable with that of bisphenol A (0.0001-0.0025%), and their relative proliferative effect was 51-104%. Styrene dimers (SD-3 and SD-4) also significantly increased the cell yields. However, SD-1, SD-2, ST-2, ST-6, and ST-7 had insignificant proliferative activities. The competitive binding assay revealed the binding affinity of some styrene oligomers for hER[alpha]. The order of their binding potency for hER[alpha] was as follows: ST-4 > ST-2 > ST-3 > ST-5 > ST-1 > SD-3 > SD-4 > SD-2 > SD-1. ST-6 and ST-7 did not appear to bind to hER[alpha]. The present studies indicate that styrene dimers SD-3 and SD-4 and styrene trimers ST-1, ST-3, ST-4, and ST-5 have estrogenic activity on MCF-7 cells and binding affinity for hER[alpha]. These compounds might be endocrine disrupters.

A clinical evaluation of lymphangioma of the large intestine: a case presentation of lymphangioma of the descending colon and a review of 279 Japanese cases

With the development and widespread use of colonoscopy, lymphangioma of the large intestine has recently been reported frequently. This paper presents some findings from a review of 279 cases of this disease in Japan, including a typical case that we encountered. A 69-year-old female was diagnosed as having lymphangioma of the descending colon based on the findings of a barium enema and a colonoscopy, and the lesion was successfully removed by an endoscopic resection. In the published reports, the etiology of this disease is not clear yet but the age at onset range shows a tendency toward a higher incidence in comparatively older patients and the male-to-female ratio indicates a higher incidence in males. If there is no complication, endoscopic treatment seems to be the preferable procedure for this disease.

A giant left ventricular thrombus in a patient with acute myocardial infarction--a case report

The authors report a patient with acute anteroseptal myocardial infarction with a giant left ventricular thrombus at the apex. The patient also had nephrotic syndrome due to diabetic nephropathy. Coronary angiography showed 90% stenosis at segment 6 of the left anterior descending coronary artery. Percutaneous transluminal coronary angioplasty and intracoronary stenting were performed on the 30th day, and effective coronary blood flow was obtained. Heparin was injected intravenously for the first 7 days, and warfarin was administered thereafter. The left ventricular thrombus disappeared after 46 days. No evidence of arterial thromboembolism was found during the disappearance of the left ventricular thrombus as determined by echocardiography.

Acute response of aortic nerve activity to free drop-induced microgravity in anesthetized rats

To test the hypothesis that arterial baroreflex was stimulated during microgravity (microG), arterial pressure (AP), intrathoracic pressure (ITP), and aortic nerve activity (ANA) were measured in anesthetized rats during 4.5 s of microG produced by free drop. A smooth and immediate reduction in G occurred during free drop, microG being achieved 100 ms after the start of the drop. Acute microG elicited an immediate and striking, but transient, increase in ANA, with no significant change in the AP, but a significant decrease in the end-expiratory ITP. The calculated transmural pressure of the aorta increased by 6.9 mmHg 2 s after the start of the drop. The increase in ANA lasted 2 s, then ANA returned to the control level, despite the calculated end-expiratory transmural pressure still being high. These results suggest that microG conditions stimulate the aortic baroreceptor by increasing transmural pressure by reducing the ITP. However, this effect is only transient, probably due to the high-pass property of the baroreceptors.

Automatic color-temperature compensator with guest-host liquid-crystal filter for video image sensing

A color-temperature compensating system with an electrically controllable liquid-crystal filter and a color sensor mounted on a video camera has been developed for color image sensing. The filter contains two guest-host liquid-crystal devices with dichroic dyes that have strong light absorption for shorter-wavelength light; two devices are necessary because of the spectral difference between the sun and an incandescent lamp as light sources. The filter's absorption is continuously controlled by the voltage applied to the filter. Because the filter is driven according to spectral information about the illumination detected by the color sensor, the color balance of the video image to be sensed can be compensated automatically and rapidly. This is especially useful for video image shooting in which a video camera experiences changes in illumination color temperatures.

Impact of repeat hepatectomy on recurrent colorectal liver metastases

BACKGROUND

Hepatic recurrence is seen in approximately 40% of patients undergoing hepatectomy for colorectal metastases. This study was designed to assess the risks and clinical benefits of repeat hepatectomy for those patients.

METHODS

Twenty-six patients underwent repeat hepatectomy for hepatic recurrence, and their clinical data were retrospectively reviewed for operative morbidity and mortality, performance level, and survival.

RESULTS

There was no operative mortality after repeat hepatectomy. Operative bleeding was significantly increased in the second hepatectomy; but operating time, duration of hospital stay, and performance status after the second hepatectomy were comparable with those of the initial hepatectomy. The median survival time from the second hepatectomy was 31 months, and the 3- and 5-year survival rates were 62% and 32%, respectively. A short disease-free interval (6 months or less) between the initial hepatectomy and diagnosis of hepatic recurrence in the remnant liver was significantly associated with poor survival after the second hepatectomy.

CONCLUSIONS

Repeat resection contributed to clinical benefits for selected patients with hepatic recurrence after the initial hepatectomy for colorectal liver metastases. However, appearance of hepatic recurrence within 6 months or less after the initial hepatectomy is a poor prognostic factor for repeat hepatectomy.

Impact of repeat hepatectomy on recurrent colorectal liver metastases

BACKGROUND

Hepatic recurrence is seen in approximately 40% of patients undergoing hepatectomy for colorectal metastases. This study was designed to assess the risks and clinical benefits of repeat hepatectomy for those patients.

METHODS

Twenty-six patients underwent repeat hepatectomy for hepatic recurrence, and their clinical data were retrospectively reviewed for operative morbidity and mortality, performance level, and survival.

RESULTS

There was no operative mortality after repeat hepatectomy. Operative bleeding was significantly increased in the second hepatectomy; but operating time, duration of hospital stay, and performance status after the second hepatectomy were comparable with those of the initial hepatectomy. The median survival time from the second hepatectomy was 31 months, and the 3- and 5-year survival rates were 62% and 32%, respectively. A short disease-free interval (6 months or less) between the initial hepatectomy and diagnosis of hepatic recurrence in the remnant liver was significantly associated with poor survival after the second hepatectomy.

CONCLUSIONS

Repeat resection contributed to clinical benefits for selected patients with hepatic recurrence after the initial hepatectomy for colorectal liver metastases. However, appearance of hepatic recurrence within 6 months or less after the initial hepatectomy is a poor prognostic factor for repeat hepatectomy.

Fitness of biocompatible high-flux hemodiafiltration for dialysis-related amyloidosis

AIMS

In order to assess the long-term influence of high-flux hemodiafiltration (HDF) on hemodynamic stability in patients with dialysis-related amyloidosis.

METHODS

HDF with high-flux dialyzers was performed for a year in 11 patients who had undergone the surgery for carpal tunnel syndrome. Patients were divided into two groups, and for each group synthetic or cellulose membrane dialyzers were applied.

RESULTS

A year after the exchange from standard hemodialysis to HDF with cellulose high-flux dialyzers, beta(2)-microglobulin was decreased (45+/-3 to 28+/-2 mg/l, n = 5, p< 0.05), but plasma non-refilling ratio was not altered. However, the continuance of synthetic high-flux HDF for a year decreased plasma non-refilling ratio (17+/-5 to 7+/-4%, p<0.05), hypotensive episodes (4.3+/-0.6 to 2.5+/-0.4 sessions/month, p<0.05) and muscle cramps (3.8+/-0.5 to 1.8+/-0.5 sessions/month, p<0.01) in addition to the decrements in serum beta(2)-microglobulin (45+/-5 to 33+/-2 mg/l, n = 6, p<0.01).

CONCLUSIONS

Although the study on a large number of patients may be required to draw a final conclusion, our present data suggest that biocompatible high-flux HDF is uniquely suited for dialysis-related amyloidosis.

Lymphoepithelial cyst of the pancreas: report of a case

An extremely rare case of a lymphoepithelial cyst (LEC) of the pancreas is described herein. A pancreatic cystic tumor was initially detected in a 50-year-old man at a medical checkup. On admission, his serum carbohydrate antigen (CA) 19-9 level was 8100 U/ml and a computed tomography scan revealed a well-circumscribed multilocular cystic tumor in the pancreatic head and body. Magnetic resonance cholangiopancreatography showed no communication between the pancreatic ducts and the tumor. A distal pancreatectomy with lymph node dissection was performed because the lesion was suspected to be a mucinous cystadenoma or cystadenocarcinoma of the pancreas. However, histological examination revealed that the cyst was lined by stratified squamous epithelium and surrounded by lymphoid tissue. thereby confirming the diagnosis of LEC of the pancreas. The superficial layer of squamous epithelium and the cystic contents were found to be immunohistologically positive for CA19-9. Establishing a preoperative diagnosis of LEC is quite difficult because it resembles other cystic neoplasms of the pancreas in radiographic features and is frequently associated with an elevation of serum tumor markers such as CA19-9.

Portal vein thrombosis caused by microwave coagulation therapy for hepatocellular carcinoma: report of a case

Microwave coagulation therapy (MCT) is one of the treatment modalities for patients with hepatocellular carcinoma (HCC). A 67-year-old man with liver cirrhosis underwent MCT during a laparotomy for a deeply located HCC (2.5 cm in diameter) at the border of the anterior and posterior segments of the right hepatic lobe. Two weeks after MCT, he complained of abdominal fullness. Portal vein thrombosis (PVT) was diagnosed because he had massive ascites and an echogenic mass in the portal vein on abdominal ultrasonography. PVT was successfully treated by fibrinolytic therapy with a selective infusion of urokinase via the superior mesenteric artery (SMA). There have been few reports on PVT as a complication of MCT. Attention should be paid to the possible occurrence of PVT as a critical complication after MCT for liver tumors adjacent to the portal vein. Fibrinolytic therapy via the SMA is thus considered to be an effective approach for PVT after MCT.

Relationship between effects of phenolic compounds on the generation of free radicals from lactoperoxidase-catalyzed oxidation of NAD(P)H or GSH and their DPPH scavenging ability

The influence of various phenolic compounds on the lactoperoxidase (LPO)/hydrogen peroxide (H2O2)-catalyzed oxidation of biochemical reductants such as reduced beta-nicotinamide adenine dinucleotide (NADH), reduced beta-nicotinamide adenine dinucleotide phosphate (NADPH) or reduced glutathione (GSH) was investigated by electron spin resonance (ESR) spectroscopy. Micromolar quantities of phenolic compounds such as 17beta-estradiol, phenol, and p-chlorophenol enhanced the LPO/H2O2-catalyzed oxidation of NAD(P)H or GSH to generate a large amount of superoxide radical (O2*-) or glutathione thiyl radical (GS*), while, phenolic compounds such as quercetin and Trolox C greatly suppressed the generation of O2*- and GS*. In order to elucidate the effects of phenolic compounds on the generation of O2*- and GS*, their quenching activities for a stable radical, 1,1-diphenyl-2-picrylhydrazyl (DPPH), were investigated by ESR spectroscopy. 17beta-Estradiol, phenol, and p-chlorophenol showed very weak scavenging activities for DPPH, but quercetin and Trolox C showed strong activities. This suggests that the ability of phenolic compounds to enhance LPO/H2O2-catalyzed oxidation of NAD(P)H or GSH relates inversely to their ability to quench DPPH. That is, phenolic compounds having weak quenching activity against DPPH may enhance the LPO/H2O2-catalyzed oxidation of NAD(P)H or GSH to generate a large amount of O2*- or GS*.

Change of the host immune response during the early phase of interferon therapy correlates with its long-term efficacy for chronic hepatitis C

Host immunomodulation through T cell action may play a pivotal role in determining the response to interferon (IFN) therapy for chronic hepatitis C. We examined whether the early changes in the host immune response were helpful in predicting the final effect in 31 patients with chronic hepatitis C receiving IFN. IFN treatment significantly reduced the serum levels of intercellular adhesion molecule-1 (ICAM-1) and E-selectin, and significantly increased those of vascular cell adhesion molecule-1 (VCAM-1) and interleukin-2 receptor alpha (IL-2Ralpha) in the first 7-10 days. Serum levels of these immunological parameters did not correlate with serum alanine aminotransferase (ALT) when evaluated with either absolute values or relative values (over pre-treatment value), implying that our results are not just secondary to improvement in hepatic inflammation. The relative changes (Delta) in these parameters reflected the long-term response to IFN therapy, i.e. the lower the change, the more effective the therapy was. Among these serum parameters, DeltaIL-2Ralpha within the first 7-10 days of IFN treatment was the most useful parameter in predicting the response to therapy. In conclusion, a dynamic immunomodulation during the early phase of IFN therapy may determine the subsequent long-term response to IFN therapy.

Chaotic behavior in the locomotion of Amoeba proteus

The locomotion of Amoeba proteus has been investigated by algorithms evaluating correlation dimension and Lyapunov spectrum developed in the field of nonlinear science. It is presumed by these parameters whether the random behavior of the system is stochastic or deterministic. For the analysis of the nonlinear parameters, n-dimensional time-delayed vectors have been reconstructed from a time series of periphery and area of A. proteus images captured with a charge-coupled-device camera, which characterize its random motion. The correlation dimension analyzed has shown the random motion of A. proteus is subjected only to 3-4 macrovariables, though the system is a complex system composed of many degrees of freedom. Furthermore, the analysis of the Lyapunov spectrum has shown its largest exponent takes positive values. These results indicate the random behavior of A. proteus is chaotic and deterministic motion on an attractor with low dimension. It may be important for the elucidation of the cell locomotion to take account of nonlinear interactions among a small number of dynamics such as the sol-gel transformation, the cytoplasmic streaming, and the relating chemical reaction occurring in the cell.

Long-term evaluation of extracorporeal shock-wave lithotripsy for cholesterol gallstones

BACKGROUND

Extracorporeal shock-wave lithotripsy (ESWL) is a treatment that preserves the gallbladder. Problems after ESWL treatment include stone recurrence and the development of biliary symptoms.

METHODS

Two hundred and sixty-two patients with cholesterol-type gallstones, the best indication for ESWL treatment, and 42 control patients with cholesterol-type gallstones who received no treatment entered this study. We evaluated the factors associated with recurrence of gallstones after stone clearance and the development of biliary symptoms after ESWL treatment.

RESULTS

The 3-, 5- and 7-year cumulative probabilities of gallstone recurrence were 20.6, 27.1 and 33.1%, respectively, with the recurrence probability significantly lower in patients with good gallbladder contractility. In patients with recurrence, ursodeoxycholic acid (UDCA) treatment was effective. In 69 patients with residual gallstones, the 3-, 5- and 7-year cumulative risks of biliary symptoms were 17.3, 24.9 and 30.5%, respectively. With residual gallstones, the risk of biliary symptoms developing was significantly lower in patients with a < or = 3 mm fragment size at the end of ESWL treatment and in those treated consistently with UDCA for 6 months or more after treatment with ESWL. The risk of biliary symptoms was significantly lower in ESWL-treated patients with residual stones who had a < or = 3 mm fragment size after treatment compared to those of control patients.

CONCLUSIONS

Ursodeoxycholic acid was effective in clearing stones in patients with gallstone recurrence. In patients with residual stones, the fragmentation of stones to < or = 3 mm and UDCA administration effectively reduced the risk of subsequent biliary symptoms.

Na+-dependent recovery of intracellular pH from acid loading in mouse colonic crypt cells

The membrane transport mechanism for regulating the intracellular pH value (pHi) was investigated in mouse distal colon crypt cells. pHi was measured by microfluorometry in an isolated crypt fragment loaded with the pH-sensitive fluoroprobe, 2',7'-bis-(2-carboxyethyl)-5-(6) carboxyfluorescein. The pHi recovery process after acid loading induced by a 40 mM NH4Cl prepulse was almost totally dependent on Na+ in both the presence and absence of CO2/HCO3- in the perfusion solution. In the CO2/HCO3(-)-free, HEPES-buffered solution, amiloride partially inhibited the pHi recovery rate from acid loading with an ED50 value of 15 microM and maximum inhibition of 83%. In a CO2/HCO3- solution, amiloride inhibited the pHi recovery rate with an ED50 value of 18 microM, which was similar to that in the HEPES-buffered solution, while the rate of pHi recovery remaining in the presence of the maximum effective concentration of amiloride was significantly larger than that in the HEPES-buffered solution. The Na+-dependent pHi recovery from the acid loading was significantly less (by 18%) in the presence of forskolin. These results suggest that the pHi recovery from acid loading was mediated by 1) amiloride-sensitive Na+/H+ exchanger, 2) the amiloride-insensitive Na+/H+ exchanger, and 3) the Na+- and HCO3(-)-dependent acid extruder. The pHi recovery could be inhibited by cAMP.