Mean Inner Potential of Nanostructured Noble Metal Catalysts - Pt/TiO2 Catalyst -

Catalytic properties of noble metal catalysts are often caused by their nanostructures. Gold catalysts are typical cases. It is especially interesting that the catalytic property of gold suddenly changes to resemble that of platinum when the mean size of gold dispersed on certain oxides is <2nm. This phenomenon should be owing to the change of the local electronic structure of the gold particle or the interface between the gold and the oxides, however its detail has not been cleared yet. We measured the mean inner potential of gold particles supported on TiO2 using electron holography and HREM, and found that the mean inner potential of gold depend largely on the size of the gold particles. When the size is >5nm, the mean inner potential is the same as the reported values of bulk gold (experimental: 21–23V, calculated: 25–30V). When the size is <5nm, it begins to increase >30V, and it begins to increase suddenly >40V at the size <2nm. It indicates that the electronic structure of the gold particle varies from that of the bulk state as the size of the gold reduces due to the nano-size effect or the interaction at the interface, since the mean inner potential is sensitive to the electronic state of the outer valence electron. On the other hand, the behavior of the platinum catalysts is different from that of gold catalysts. When the size of the platinum particle on the TiO2 support is >1.5nm, the mean inner potential of platinum is the same as that of the bulk (∼25V). In case of the particle with the size <1.5nm, it begins to increase and the increase rate is lower than that of the gold particles with the size <2nm. It is suggested to be due to the difference of the interaction with TiO2.

Relation between infusion rate of indomethacin and cerebral blood flow velocity

BACKGROUND

Indomethacin is a very effective drug for patent ductus arteriosus (PDA). Decrease of cerebral blood flow, however, is an adverse effect of this drug. Differences in cerebral blood flow velocity (CBFV) with the different administration periods and the relation between CBFV and plasma drug level were investigated with the aim of establishing an administration protocol.

METHODS

The subjects were 14 neonates with PDA in the Neonatal Intensive Care Unit of Ehime Prefectural Central Hospital who received indomethacin. They were divided into two groups: 10 min drug infusion (n = 8) and 120 min drug infusion (n = 6). CBFV and blood concentration of indomethacin were measured.

RESULTS

CBFV in the 10 min group was decreased significantly at 15 min and remained low until 120 min, but no significant change was seen in the 120 min group. The highest plasma levels in the 10 min group and 120 min group were 1257 ± 360 ng/mL and 819 ± 146 ng/mL, respectively. A comparison showed that the plasma level was significantly higher in the 10 min group, which had significantly lower CBFV. Changes in the plasma levels in the beta phase in the two groups were found to be almost the same. Ductus closure was confirmed in 13 of 14 neonates given indomethacin (10 min group, 7/8; 120 min group, 6/6).

CONCLUSION

Slow administration of indomethacin > 2 h is thought to be safer from the perspective of CBFV even though the clinical effect was unchanged.

Identification of QTLs that control clubroot resistance in Brassica oleracea and comparative analysis of clubroot resistance genes between B. rapa and B. oleracea

To perform comparative studies of CR (clubroot resistance) loci in Brassica oleracea and Brassica rapa and to develop marker-assisted selection in B. oleracea, we constructed a B. oleracea map, including specific markers linked to CR genes of B. rapa. We also analyzed CR-QTLs using the mean phenotypes of F(3) progenies from the cross of a resistant double-haploid line (Anju) with a susceptible double-haploid line (GC). In the nine linkage groups obtained (O1-O9), the major QTL, pb-Bo(Anju)1, was derived from Anju with a maximum LOD score (13.7) in O2. The QTL (LOD 5.1) located in O5, pb-Bo(GC)1, was derived from the susceptible GC. Other QTLs with smaller effects were found in O2, O3, and O7. Based on common markers, it was possible to compare our finding CR-QTLs with the B. oleracea CR loci reported by previous authors; pb-Bo(GC)1 may be identical to the CR-QTL reported previously or a different member contained in the same CR gene cluster. In total, the markers linked to seven B. rapa CR genes were mapped on the B. oleracea map. Based on the mapping position and markers of the CR genes, informative comparative studies of CR loci between B. oleracea and B. rapa were performed. Our map discloses specific primer sequences linked to CR genes and includes public SSR markers that will promote pyramiding CR genes in intra- and inter-specific crosses in Brassica crops. Five genes involved in glucosinolates biosynthesis were also mapped, and GSL-BoELONG and GSL-BoPro were found to be linked to the pb-Bo(Anju)1 and Bo(GC)1 loci, respectively. The linkage drag associated with the CR-QTLs is briefly discussed.

Standard steroid treatment for autoimmune pancreatitis

OBJECTIVE

To establish an appropriate steroid treatment regimen for autoimmune pancreatitis (AIP).

METHODS

A retrospective survey of AIP treatment was conducted in 17 centres in Japan. The main outcome measures were rate of remission and relapse.

RESULTS

Of 563 patients with AIP, 459 (82%) received steroid treatment. The remission rate of steroid-treated AIP was 98%, which was significantly higher than that of patients without steroid treatment (74%, 77/104; p<0.001). Steroid treatment was given for obstructive jaundice (60%), abdominal pain (11%), associated extrapancreatic lesions except the biliary duct (11%), and diffuse enlargement of the pancreas (10%). There was no relationship between the period necessary to achieve remission and the initial dose (30 mg/day vs 40 mg/day) of prednisolone. Maintenance steroid treatment was given in 377 (82%) of 459 steroid-treated patients, and steroid treatment was stopped in 104 patients. The relapse rate of patients with AIP on maintenance treatment was 23% (63/273), which was significantly lower than that of patients who stopped maintenance treatment (34%, 35/104; p = 0.048). From the start of steroid treatment, 56% (55/99) relapsed within 1 year and 92% (91/99) relapsed within 3 years. Of the 89 relapsed patients, 83 (93%) received steroid re-treatment, and steroid re-treatment was effective in 97% of them.

CONCLUSIONS

The major indication for steroid treatment in AIP is the presence of symptoms. An initial prednisolone dose of 0.6 mg/kg/day, is recommend, which is then reduced to a maintenance dose over a period of 3-6 months. Maintenance treatment with low-dose steroid reduces but dose not eliminate relapses.

[Continuous block of the sciatic nerve in the popliteal fossa for pain relief in three patients with intractable leg ulcer]

Pain of the leg ulcer significantly decreases patients' QOL, and pain control is an important treatment as the ulcer treatment. Continuous epidural block is often selected, but we can not provide enough continuous epidural block because of oral anticoagulant treatment and infection because of long-term indwelling catheter. We did continuous popliteal block and improved the patient's QOL significantly in the three case studied. We experienced fever and local redness because of catheter infection, but the removal of the catheter and the administration of antibiotics led to improved QOL without serious complications. We obtained approvals not only from patients but also from plastic surgeons and dermatologists. We suggest that continuous popliteal block can be a usual method of the general pain control procedure.

Physical fitness and indices of lifestyle-related diseases before and after interval walking training in middle-aged and older males and females

HYPOTHESIS

Whether increasing peak aerobic capacity for walking (VO(2peak)) by interval walking training (IWT) is closely linked with decreasing the indices of lifestyle-related diseases (LSDs) in middle-aged and older people were examined.

METHODS

For 4 months from April to September 2005 or 2006, 246 males and 580 females (∼65 years) performed IWT consisting of ≥5 sets of fast walking at ≥70% VO(2peak) for 3 min followed by slow walking at ≤40% VO(2peak) for 3 min ≥4 days/week. Before and after IWT, we measured VO(2peak), body mass index (BMI), %body fat, arterial blood pressure, thigh muscle strength and blood parameters. We analysed 198 males and 468 females who had undergone all the measurements both before and after IWT. To examine the hypothesis, we divided the subjects equally into three groups according to their pretraining VO(2peak): low, middle and high groups for each sex.

RESULTS

Before training, it was found that thigh muscle strength and blood high-density lipoprotein cholesterol concentration were lower, whereas body weight, BMI, %body fat, arterial blood pressure and blood glucose were higher in the low group than the high group (all, p<0.05). After training, although VO(2peak) and thigh muscle strength increased and body weight, BMI, %body fat, blood pressure and blood glucose concentration decreased in all groups (all, p<0.05), the changes were greatest in the low group for both sexes.

CONCLUSION

VO(2peak) at baseline and changes in response to training were closely linked with indices of LSDs.

Techniques to facilitate ERCP with a conventional endoscope in patients with previous pancreatoduodenectomy

There is little guidance on the performance of endoscopic retrograde cholangiopancreatography (ERCP) in patients with previous pancreatoduodenectomy. We reviewed techniques for ERCP with a conventional endoscope and assessed its value in 10 patients with previous pancreatoduodenectomy (15 ERCPs). After exploration of the surgical reconstruction, we used a front-viewing endoscope, and we used a small firm pillow under the abdomen and hand compression for preventing loop formation. Successful insertion to the ductal anastomoses and biliary cannulation were achieved in 13 / 15 procedures (87 %). In 6 procedures where we attempted pancreatic cannulation, we could not identify the pancreatojejunostomy, but after spraying contrast around the suspected location of the ductal anastomosis we obtained a pancreatogram in 4 / 6 procedures (67 %). Endoscopic biliary interventions were successful in 6 / 7 procedures (86 %). No complications were encountered. Use of appropriate techniques makes ERCP with a conventional endoscope feasible, effective, and safe in patients with previous pancreatoduodenectomy. Endoscopic therapy can be performed successfully in the bile duct, but has limited value regarding the pancreatic duct.

Effective "short" double-balloon enteroscope for diagnostic and therapeutic ERCP in patients with altered gastrointestinal anatomy: a large case series

BACKGROUND AND STUDY AIMS

Although endoscopic retrograde cholangiopancreatography (ERCP) is technically challenging in patients with altered gastrointestinal anatomy, a double-balloon enteroscope (DBE) permits examinations of a much longer segment of the small bowel than does a standard endoscope, and may be used to perform ERCP in such patients. Since only limited accessories are available for a conventional DBE, we performed ERCP with a "short" DBE, which has a 2.8-mm working channel and a 152-cm working length and for which conventional accessories are available, in patients with altered gastrointestinal anatomy, and evaluated this alternative technique.

PATIENTS AND METHODS

In 68 patients with a Roux-en-Y total gastrectomy (n = 36), Billroth II gastrectomy (n = 17), or pancreatoduodenectomy (n = 15), ERCP (103 procedures) was performed with a "short" DBE.

RESULTS

Deep insertion was successful in 100/103 procedures (97 %). Cholangiogram was successfully obtained in 98/100 procedures (98 %). Treatment was accomplished in all 98 procedures in which a cholangiogram was obtained (100 %). Therapeutic interventions including stone extraction (n = 47), nasobiliary drainage (n = 38), stent placement (n = 36), sphincterotomy (n = 31), choledochojejunostomy dilation (n = 29), tumor biopsy (n = 10), and naso-pancreatic duct drainage (n = 1) were performed successfully. Complications occurred in 5/103 procedures (5 %), all in patients with Roux-en-Y reconstruction.

CONCLUSIONS

Despite the relatively high rate of complications seen in patients with Roux-en-Y reconstruction, ERCP with a "short" DBE is effective in patients who have undergone bowel reconstruction.

Serological evidence of infection with hepatitis E virus among wild Yezo-deer, Cervus nippon yesoensis, in Hokkaido, Japan

In this study, 520 serum samples from Yezo-deer in the Hidaka district, Hokkaido, Japan were examined by enzyme-linked immunosorbent assay to investigate whether the animals were infected with hepatitis E virus (HEV). The distribution of optical density values showed a bimodal pattern and 181 samples (34.8%) were deemed to be antibody-positive against HEV. At least five (2.8%) of the positive sera gave specific bands by Western blot analysis. An age-dependent increase in prevalence of the antibodies was found among the animals. These findings indicate that Yezo-deer are a possible host for HEV infection. To avoid the risk of becoming HEV infected, the consumption of raw Yezo-deer meat must be prohibited.

[Relationship between postoperative neurological complications and regional cerebral oxygen saturation during retrograde cerebral perfusion]

BACKGROUND

Transient postoperative neurological disorders are common in patients undergoing aortic surgery with retrograde cerebral perfusion (RCP). We evaluated the relationship between transient postoperative neurological disorders and regional cerebral oxygen saturation (rSO2) during RCP.

METHODS

Thirty-seven patients with aortic aneurysm dissection were enrolled in the study. They underwent the ascending aorta or hemi-arch replacement. The postoperative neurological complications occurred in 17 patients, including 2 strokes, 1 hypoxic encephalopathy, 6 delay of awareness, and 8 disorientations. Strokes and a hypoxic encephalopathy were excluded because they could result from embolic episodes. Changes in rSO2 during RCP in 14 patients with transient neurological disorders were compared with changes in 20 patients without disorders.

RESULTS

The rSO2 values significantly decreased after the beginning of RCP in both groups. There was no difference in the lowest rSO2 value during RCP and in the rate of decrease from pre-RCP to the lowest rSO2 between two groups. However, the difference more than 10% between left and right was significantly associated with neurological disorders.

CONCLUSIONS

The rSO2 monitor could detect the decrease of cerebral perfusion during RCP. The wide asymmetry of rSO2 was associated with transient neurological disorders, although the lowest rSO2 value and the rate of decline did not relate.

Phase II trial report of the new neoadjuvant chemotherapy with S-1 and docetaxel for advanced breast cancer

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Background: Primary chemotherapy with anthracycline and taxanes is a gold standard regimen which realize pathologically complete response in 20% of patients with advanced breast cancer. However, sequential administration of anthracycline and taxanes induces serious side effects. This regimen is therefore difficult to use for higj-risk patients. S-1 is a new oral anti-tumor drug, which is composed of 5-fluoro-1-(tetrahydro -2- furanyl)-2, 4(1H, 3H)-pyrimidinedione (Tegafur, FT), 5-chloro-2, 4- dihydroxypyridine (Gimeracil, CDHP) and potassium 1, 2, 3, 4-tetrahydro-2, 4-dioxo-1, 3, 5-triazine-6-carboxylate (potassium Oteracil, Oxo). Combined treatment with docetaxel and S-1 yielded significant response in patients with gastric cancer with minimal side effects due to biochemical modulation of both CDHP and Oxo. The purpose of this study was to evaluate the efficacy and toxicity of docetaxel in combination with S-1 for advanced breast cancer. Methods: Patients with advanced breast cancer (Stage IIA to IV) were treated with i.v. docetaxel (40mg/m2) on day 1 and oral S-1(80mg as FT/m2/day) on days 1 to 14 every 3 weeks for 8 courses. The clinical response was evaluated every 3 months with MMG, MRI, ultrasonography and CT scan based on RECIST criteria. The patients underwent surgery after completion of chemotherapy. Pathologic examination was performed with thin-sliced specimens. The specimens were also reserved for genetic analysis. Written informed consent was obtained from all patients or family members after the Ethics Committee of Tokushima University Hospital approved the study protocol. Results: Twenty-two patients completed the therapy and underwent surgery. Four cases (18.2%) of pathologic complete response (pCR) were recognized on pathologic examination. The response rate was 90.9% and 95.5% of the patients could preserved their breast. Bone marrow suppression was substantial, and low-grade anorexia, nausea, and peripheral neuropathy were observed. Conclusions: The new regimen of S-1 combined with docetaxel is expected to exhibit satisfactory efficacy in treating advanced breast cancer as primary chemotherapy. Genetic analysis will be performed to examine and to find biomarkers for measurement of the efficacy of this therapy.

No significant financial relationships to disclose.

[Anesthetic case report of a patient with chronic inflammatory demyelinating polyneuropathy]

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an autoimmune disease characterized by progressive neurological distress and motor weakness in the legs and arms. We report a patient with CIDP who underwent thoracoscopic surgery under general anesthesia. A 43-year-old man was hospitalized for examination of unidentified fever, and PET detected accumulations in the inguinal and mediastinal lymph nodes. The inguinal lymph node biopsy could not reveal the cause, and he was scheduled for thoracoscopic mediastinal lymph node biopsy. He had been diagnosed CIDP by lower motor weakness and sensory disorder for five months, and underwent peritoneal dialysis for chronic renal failure over the past nine months. Anesthesia was induced with propofol, remifentanil, and high-dose sevoflurane. He could be intubated easily with a left-sided Broncho-Cath double-lumen tube with no muscle relaxants. Anesthesia was maintained by sevoflurane (1.5-1.7%) and remifentanil (0.10-0.15 microg x kg(-1) x min(-1)). After the operation, spontaneous respiration appeared immediately after discontinuing anesthetics. Endotracheal tube was removed because of the following data; Sp(O2), 99%; tidal volume, about 600 ml; respiratory rate, 12-15 min(-1); level of consciousness was good. Arterial blood gas determination at this time revealed pH, 7.418: Pa(CO2), 36.0 mmHg : Pa(O2), 329.3 mmHg under 8 l x min(-1) oxygen. The patient showed an uncomplicated postoperative course.

Surveys on the prevalence of pediatric bronchial asthma in Japan: a comparison between the 1982, 1992, and 2002 surveys conducted in the same region using the same methodology

BACKGROUND

We conducted and reported the first (1982; 55,388 subjects), and second (1992; 45,674 subjects), epidemiological surveys conducted on bronchial asthma in elementary students across 11 prefectures in western Japan. The 2 surveys were conducted in the same regions using the same methodology employing a modified Japanese version of the American Thoracic Society-Division of Lung Diseases (ATS-DLD) Epidemiology Questionnaire. We conducted the third survey in 2002, and compared the findings to those of previous studies.

METHODS

In the third survey, 37,036 students attending the same schools as in previous surveys (in 11 prefectures) were given the questionnaire. A total of 35,582 responses (96.1%) were collected. An ATS-DLD Epidemiology Questionnaire was also used in this study, and the findings were compared to those of previous studies.

RESULTS

1. The prevalence of bronchial asthma (BA) in boys, girls, and all students was 3.8%, 2.5%, and 3.2%, respectively, for the first survey; 5.6%, 3.5%, and 4.6% for the second survey; and 8.1%, 4.9%, and 6.5% for the third survey. 2. A decline in the BA prevalence in older subjects which could be seen in the first survey was absent in the second and third surveys. There were no regional differences in the third survey. 3. The boys-to-girls ratio in the first, second, and third surveys was 1.5, 1.6, and 1.6, respectively. 4. BA was more prevalent among subjects with a past history of respiratory disease in infancy and those with a family history of allergic disease. 5. The prevalence of asthma symptoms and wheezing in the first, second, and third surveys was 7.1%, 9.8%, and 11.8%, respectively. 6. A comparison of the prevalence of other allergic diseases between the second and third surveys revealed a decrease in atopic dermatitis and an increase in allergic rhinitis, allergic conjunctivitis, and cedar pollinosis.

CONCLUSIONS

BA prevalence in the third survey increased 2.1 and 1.4 times respectively compared to the first survey and second survey, indicating an upward trend in all regions and age groups surveyed.

[Case report : respiratory care for anesthesia in a patient with Menkes syndrome and micrognathia]

Menkes disease is a rare sex-linked disorder of copper metabolism, characterized with several multiple organ dysfunctions. It is frequently associated with seizure disorders, mental retardation, and urologic abnormalities. It may also have some serious respiratory complications, such as upper airway obstruction related to micrognathia, risks of gastroesophageal reflux and the aspiration with poor pharyngeal muscle control, and hazard to easy cerebral bleeding to noxious stimuli and easy fracture of the bones. We report a 1 year and 10 month-old boy of Menkes disease with a large bladder diverticulum associated with persistent urinary tract infections who required the surgical treatment. Cystostomy was scheduled and performed under general anesthesia. In the preoperative examination, three-dimentional computed tomography images were essential and very useful for preanesthetic anatomical evaluation of the upper airway, which revealed subglottic narrowing with micrognathia. Considering the anticipated difficulty of the tracheal intubation, and to avoid or minimize the noxious stimuli related to the intubation, we had chosen to use laryngeal mask airway, which provided an appropriate, safe anesthetic respiratory care in this case.

The evaluation of post-operative alignment in total knee replacement using a CT-based navigation system

We compared the alignment of 39 total knee replacements implanted using the conventional alignment guide system with 37 implanted using a CT-based navigation system, performed by a single surgeon. The knees were evaluated using full-length weight-bearing anteroposterior radiographs, lateral radiographs and CT scans. The mean hip-knee-ankle angle, coronal femoral component angle and coronal tibial component angle were 181.8 degrees (174.2 degrees to 188.3 degrees), 88.5 degrees (84.0 degrees to 91.8 degrees) and 89.7 degrees (86.3 degrees to 95.1 degrees), respectively for the conventional group and 180.8 degrees (178.2 degrees to 185.1 degrees), 89.3 degrees (85.8 degrees to 92.0 degrees) and 89.9 degrees (88.0 degrees to 93.0 degrees), respectively for the navigated group. The mean sagittal femoral component angle was 85.5 degrees (80.6 degrees to 92.8 degrees) for the conventional group and 89.6 degrees (85.5 degrees to 94.0 degrees) for the navigated group. The mean rotational femoral and tibial component angles were -0.7 degrees (-8.8 degrees to 9.8 degrees) and -3.3 degrees (-16.8 degrees to 5.8 degrees) for the conventional group and -0.6 degrees (-3.5 degrees to 3.0 degrees) and 0.3 degrees (-5.3 degrees to 7.7 degrees) for the navigated group. The ideal angles of all alignments in the navigated group were obtained at significantly higher rates than in the conventional group. Our results demonstrated significant improvements in component positioning with a CT-based navigation system, especially with respect to rotational alignment.