Apparent formation constants of Pu(IV) and Th(IV) with humic acids determined by solvent extraction method

Apparent formation constants of Pu(IV) and Th(IV) with two kinds of humic acids were determined in 0.1 M NaClO4 at 25 ºC using a solvent extraction method with thenoyltrifluoroacetone in xylene. The acid dissociation constants of humic acids were also measured by potentiometric titration and used as the degree of dissociation for calculating the formation constants. The effect of solution conditions, such as the pH, the initial metal and humic acid concentrations, and the ionic strength, on the formation constants was examined. The obtained data were compared with the ones in the literature.

Solubility measurement of zirconium(IV) hydrous oxide

The solubility of zirconium(IV) hydrous oxide was measured in the hydrogen ion concentration (pHc) range from 1 to 13 at 25 °C. The experiment was carried out with I=0.1, 0.5 and 1.0 mol/dm3 (M) of NaClO4 solution. The concentration of Zr was measured by ICP-MS after separating the aqueous phase from the solid phase by ultrafiltration methods. Some differences between the obtained values and literature data were observed due to the size distribution of chemical species. In the lower pHc region, the size distribution of filtrate species was investigated by different pore-size filtration in the range of 3 k to 100 kDa NMWL (nominal molecular weight limit) membranes. The solubility values of mononuclear species were obtained by the Flory model, and by using the specific ion interaction theory (SIT) for ionic strength corrections and the known literature value of the hydrolysis constant β1°, the tentative value of the solubility product (K sp°) was determined to be −56.94±0.32.

Complex formation and solubility of Pu(IV) with malonic and succinic acids

The complex formation constants of tetravalent plutonium ion with malonic and succinic acids in aqueous solution were determined by the solvent-extraction method. Also, by taking the known values of the solubility products, the hydrolysis constants and the formation constants, the experimental solubility data of plutonium in the presence of carboxylates were analyzed.

Hydrolysis constants and complexation of Th(IV) with carboxylates

The hydrolysis constants of Th(IV) were determined using the solvent extraction method in a NaClO4solution atI=0.1 and 25 °C. A trace amount of thorium below the solubility limit was used in order to avoid the formation of polynuclear species and colloids in the experiment. The values were compared with the literature data. Considering the effect of competitive hydrolysis reactions under weak acid conditions, the complexation constants of Th(IV) with a series of dicarboxylic acids containing different alkyl chain lengths were determined.

Influence of tongue pressure and width on tongue indentation formation

The purpose of this study was to clarify which physiological and anatomical factors were involved in the formation of tongue indentations, which are believed to be a clinical sign of clenching. Twenty-four dentulous subjects were investigated. They were divided into two groups, depending on the presence or absence of tongue indentations: (i) a tongue indentation group and (ii) a no tongue indentation group. Intraoral appliances containing a small pressure sensor were placed at the lingual surfaces of the upper and lower right first molars. Lingual pressure on the lingual surfaces of the upper and lower right first molars was then recorded under different conditions. The tasks selected as physiological factors to be recorded were: (i) silent reading at rest for 10 min, (ii) maximum voluntary clenching (MVC) for 5 s, (iii) 10% of MVC for 1 min and (iv) swallowing. The results for all tasks were compared between groups. Tongue width and dental arch width were also measured as anatomical factors. No significant differences were found between groups during silent reading at rest, clenching, swallowing, or in tongue pressure integration during silent reading at rest. However, a significant difference was found in terms of tongue width (P < 0.05). These results indicate that neither volume of lingual pressure exerted on the lingual surface of the teeth during rest, clenching, nor swallowing are related to the formation of tongue indentations. The results do suggest; however, that tongue width at rest plays an important role in the formation of tongue indentations.

Investigation of the factors related to the formation of the buccal mucosa ridging

The aim of this study was to clarify the factors related to the formation of the buccal mucosa ridging, which has been mentioned to be a clinical sign of clenching. Twenty-one individuals were investigated and divided into three groups: (i) those without buccal mucosa ridging, (ii) the buccal mucosa ridging located in all the posterior teeth region, and (iii) the buccal mucosa ridging corresponding only to the molar teeth region. A pressure sensor was used and placed at two points: first upper premolar and second upper molar. The recording tasks were: (i) silent reading at rest, (ii) light voluntary clenching, (iii) maximum voluntary clenching, (iv) holding the cheeks tightly against the teeth while light voluntary clenching, (v) holding the cheeks tightly against the teeth without tooth contact, (vi) pulling angle of mouth laterally while light voluntary clenching, (vii) pulling angle of mouth laterally without tooth contact and (viii) swallowing. No significant differences were found between groups in all the recording tasks except for the swallowing, at which significant difference (P < 0.05) was found between the groups of individuals having buccal mucosa ridging and without it. Based on these results it became clear that the buccal mucosa pressure exerted on the buccal aspect of teeth during swallowing plays an important role in the formation of buccal mucosa ridging.

Inhibition of neuronal nitric oxide synthase ameliorates renal hyperfiltration in streptozotocin-induced diabetic rat

Systemic inhibition of nitric oxide synthase (NOS) in streptozotocin-induced (STZ-induced) diabetic rats results in decreases in glomerular filtration rate (GFR) and renal plasma flow (RPF) and an increase in renal vascular resistance (RVR). However, the exact isoform of NOS involved in diabetic renal hyperfiltration has not been determined. This study was conducted to clarify whether NO derived from neuronal NOS is involved in diabetic renal hyperfiltration when using a selective inhibitor of neuronal NOS, 7-nitro indazole (7-NI). Continuous infusion of NG-nitro-L -arginine methyl ester (L-NAME) at 5 microg/kg/min ameliorated renal hyperfiltration, decreased RPF, and increased RVR in diabetic rats without affecting the mean arterial pressure (MAP). 7-NI administered intraperitoneally in diabetic rats significantly reduced GFR without affecting MAP, but the renal hyperfiltration was still observed after the administration of 7-NI. The combined administration of L-NAME after 7-NI caused a further decrease in GFR in diabetic rats and ultimately resulted in normalization of GFR. 7-NI did not change any parameters of renal hemodynamics in control rats. Urinary excretion of nitrite/nitrate and cyclic guanosine monophosphate was significantly increased in diabetic rats over values found in control rats. Our results suggested that a local inhibition of NO in the kidney was involved in the amelioration of diabetic renal hyperfiltration and that NO derived from neuronal NOS is involved, at least in part, in renal hyperfiltration in STZ-induced diabetic rats.

Evaluation of oxygen extraction ratio as a physiologic transfusion trigger in coronary artery bypass graft surgery patients

BACKGROUND

Approximately 20 percent of all allogeneic blood transfusions are administered in connection with coronary artery bypass graft (CABG) operations. Transfusion practices vary across the country. The whole-body oxygen extraction ratio (O2 ER) reflects the adequacy of the patient's response to acute normovolemic anemia with an O2 ER of approximately 50 percent being shown to be an appropriate transfusion trigger. The present study monitored the O2 ER in patients undergoing CABG and determined if transfusion practices would have been different if an O2 ER > or = 45 percent were used as a transfusion trigger.

STUDY DESIGN AND METHODS

Seventy patients with a postoperative Hct < = 25 percent were the test subjects. Arterial and mixed venous contents were determined before the operation, in the intensive care unit after the operation, and 12 hours after the operation.

RESULTS

There were no deaths. Forty-one patients received allogeneic transfusion. These patients were older, weighed less, and had a preoperative Hct lower than the nontransfused patients. There were no significant differences between transfused and nontransfused patients with respect to postoperative Hct (21.0 +/- 0.4 vs. 22.2 +/- 0.4), cardiac index (2.5 +/- 0.1 vs. 2.7 +/- 0.1), O2 delivery (6.4 +/- 0.3 vs. 6.7 +/- 0.3), O2 consumption (2.5 +/- 0.1 vs. 2.5 +/- 0.1), and O2 ER (38.3 +/- 1.7 vs. 37.5 +/- 1.5). In the transfusion group, 7 of 21 patients had a postoperative O2 ER > or = 45 percent, while 3 of 35 in the nontransfused group had that result.

CONCLUSION

The use of O2 ER as a transfusion trigger as part of a transfusion algorithm could lead to a reduction in allogeneic blood transfusion.

Long-term oral intake of low-dose cadmium exacerbates age-related impairment of renal functional reserve in rats

Our study was designed to clarify whether renal functional reserve (RFR) was impaired in rats chronically treated with oral low-dose cadmium (Cd). Rats (n = 15) were treated with 1 ppm of cadmium chloride added to drinking water. We measured RFR (representing the ability to increase glomerular filtration rate [GFR] and renal plasma flow [RPF] in response to infusion of glycine) at 2 and 10 months after initiation of exposure to Cd. Urinary excretion of Cd was significantly higher in 10-month Cd-treated rats than in age-matched control rats (provided with distilled water only). Weight gain was noted in Cd-treated rats, which was identical to that in age-matched control rats. Urinary volume and urinary excretions of sodium, protein, and glucose were similar in the two groups. There were no differences in the basal mean arterial pressure (MAP) and renal hemodynamics between 2-month Cd-treated and age-matched control rats. Infusion of glycine resulted in significant increases in GFR and RPF and a significant reduction in renal vascular resistance (RVR) in both 2-month Cd-treated and age-matched control rats (control, GFR: 133 +/- 10%, RPF: 148 +/- 8%; 2-month Cd-treated rats, GFR: 152 +/- 12% and RPF: 154 +/- 7%). The basal MAP and renal hemodynamics in 10-month Cd-treated rats were also identical to those in age-matched control rats. Infusion of glycine significantly increased GFR in 10-month control rats (132 +/- 15%), but not in 10-month Cd-treated rats (98 +/- 11%), but did not change MAP, RPF, and RVR in both groups. In addition to age-related pathological changes, mild renal interstitial edema and degenerative mitochondria with diminished matrix density and loss of the cristae in the proximal tubular cells were more frequent in 10-month Cd-treated rats. Our results suggest that long-term oral intake of low-dose Cd in rats exacerbate age-related impairment of renal functional reserve and degeneration of the proximal tubular epithelial cells.

Analysis of factors affecting the appearance of hepatocellular carcinoma in patients with chronic hepatitis C. A long term follow-up study after histologic diagnosis

BACKGROUND

Hepatocellular carcinoma (HCC) occurs more frequently in patients with hepatitis C virus (HCV)-related chronic liver disease than those with hepatitis B virus-related disease. It is important to assess the factors affecting the development of HCC.

METHODS

A long term follow-up study involving patients with chronic HCV was performed retrospectively. A total of 153 patients diagnosed between June 1981 and November 1990 with chronic HCV with or without cirrhosis by liver biopsy were enrolled in a long term follow-up study (average, 99.4 months) and the cumulative incidence rate of HCC and factors affecting the appearance of HCC were examined.

RESULTS

The 5-year cumulative incidence rate was 9%, the 10-year cumulative incidence rate was 23%, and the 15-year cumulative incidence rate was 42%. The annual rate of incidence increased as the follow-up period progressed. The authors selected ten variables and investigated their effect on the incidence rate of HCC, including age, gender, habitual heavy drinking, positivity of antibody against hepatitis B virus surface antigen, treatment with interferon (IFN) during the follow-up period, maximum and minimum serum alanine aminotransferase levels during the follow-up period, histologic staging, grading, and irregular regeneration of hepatocytes. Of the 10 variables, age (> 50 years), habitual heavy drinking, and histologic staging were determined to be independent risk factors according to multivariate Cox proportional hazards regression analysis. IFN therapy by itself was not found to be an independent factor affecting the appearance of HCC.

CONCLUSIONS

In patients with chronic HCV, the annual incidence rate of HCC appeared to increase as the follow-up period progressed. According to the results of the current study, the factors that independently affected the development of HCC were age, habitual heavy drinking, and histologic staging.

[Predictive evaluation and efficient management of medical examinations using Mahalanobis Taguchi System Method]

The Mahalanobis-Taguchi System (MTS), an evaluative technique used in quality engineering, was utilized in a system analysis of medical examinations to determine practicability, to differentiate cost reduction benefits of specific components for increasing efficiency, and to determine possibility of utility on forecasting of future health condition of individuals.

METHODS

1. Medical examination date over a two year period were utilized to differentiate subject into two groups: Group A--Healthy or normal; and Group C--Patient group requiring treatment or currently undergoing treatment. The Mahalanobis distance for Group C from the Mahalanobis space of Group A was calculated for each subject to determine differentiability. 2. Utilizing the MTS method specific components of the examination system were selected and analyzed for effectiveness in diagnosis and screening to enhance efficiency of the examination. 3. Group A subjects (determined from the two year data), were analyzed using the data at the end of 1 year to develop the Mahalanobis space and the Mahalanobis distance at the 2nd year point was calculated and analyzed.

RESULTS

1. Subjects who were classified as group A at both 1st and 2nd year points numbered 159. With a cutoff point of 2.0 for Mahalanobis distance 98.1% of the healthy subjects (Group A) were classified as belonging to the healthy group, and 91.9% of C group as belonging to the patient group. 2. Blood pressure, GOT, GPT, gamma-GTP, T Chol, TG, UA, Cr, BS, HbA1c, Hb, and MCH were found to be effective components in the examination. Based on this result the items included in the examination can be reduced by approximately 60%. 3. With cutoff value of 1.5, the results of 90% of subjects 1 year later could be predicted. The prediction that 15% of Group C subjects would improve to join Group A could be made. Overall, the results 1 year later could be predicted at a level of 90% accuracy.

CONCLUSION

These results suggest that the Mahalanobis-Taguchi System technique can accurately assess medical examination quality and can also be used, with reasonable accuracy, to predict the condition of individuals one year later. Therefore, the MTS can be used to help determine which patients should be receiving the examination 1 year later. In addition, components of the examination can be assessed using the MTS for benefits and costs to determine levels of essentiality of components. As a result, it can be used an effective tool for development and improvements in the examination system. With further development in the technique, it may become possible for use as a tool in disease diagnosis and treatment.

Application of alginate gel as a vehicle for liposomes. II. Erosion of alginate gel beads and the release of loaded liposomes

The possibility of producing calcium-induced alginate gel beads as a vehicle for liposomes was explored. The maximal loading of egg phosphatidylcholine liposomes (ca. 26 nm in diameter) in a fully-cured bead (1.2 mm in radius, initial alginate concn. of 4%) was 2.9 x 10(-6) mol/bead or ca. 18%, and the size of the bead slightly increased with an increase in liposome loading. The liposomes were well maintained within both fully-cured and washed beads. The liposome release from the fully-cured bead was much slower than that from the corresponding washed bead in a pH 7.4 releasing medium. The greater the liposome loading, the faster the release of the vesicles. The liposome release was investigated in terms of liposome loading, swelling of the gel body, calcium discharge and gel erosion, using washed beads. The liposome loading did not affect the bead erosion or calcium discharge but did the initial swelling ratio and liposome release. The results suggest that the loaded liposomes are not uniformly distributed in the bead but are rather gradually concentrated to the center. Such an inhomogeneous distribution of liposomes is possibly due to the fact that the gelation occurred instantly on the surface of the droplets, and the resulting gel network or layer acts as semipermeable membrane for liposomes and forces the vesicles to move into deeper concentric sections as gelation proceeds to the interior. As the liposomes loading increases, the forced migration might be very limited because of concentrically decreasing extra room to accommodate the vesicles in the bead.

Application of alginate gel as a vehicle for liposomes. I. Factors affecting the loading of drug-containing liposomes and drug release

To explore the feasibility of alginate gel as a vehicle for liposomes, we investigated the effects of various factors associated with the loading of drug-containing liposomes into the gel beads. The loading process includes (I) mixing of liposomes and alginate solution, (2) calcium induced gelation of alginates, (3) the time-dependent contraction of a gel body squeezing out interior water, and (4) possible leakage or release of a drug entrapped in liposomes in a series of each of theses processes. These effects were examined in terms of the leakage of a marker 5(6)-carboxyfluorescein (CF) from liposomes of egg phosphatidylcholine (EPC) and EPC/cholesterol (EPC/Cho) and liposome (phosphorus) release from curing and fully-cured gel beads whose initial polymer concentrations were 4 and 2%. Major findings were: (1) Alginate induced the leakage of a water-soluble drug incorporated in the liposomes as a function of the polymer concentration and the mixing time. (2) Calcium ions also stimulated the leakage of the drug. EPC/Cho liposomes were several times more resistant to the leakage of CF than were EPC liposomes. (3) The liposomes were well loaded without any loss in the gel bead despite the squeezing outflow of water and the bead contraction during gel curing. (4) Such curing caused leakage of the drug from the EPC liposomes in the very early stage while no effect was observed in the EPC/Cho liposomes. (5) In the gel-eroding medium (pH 7.4 Tris-HCl, 37 degrees C), the total drug release was controlled by the erosion rate of the bead body. Immediately after the bead erosion, EPC liposomes retained about 60% of the drug in the 2% bead and only about 20% in the 4% bead, whereas EPC/Cho liposomes retained more than 85% regardless of the initial alginate concentration. The results provide valuable information for the design and applicability of the gel-loaded liposome delivery system.

Purification, characterization and molecular cloning of Cha o 1, a major allergen of Chamaecyparis obtusa (Japanese cypress) pollen

Pollen of Chamaecyparis obtusa (Japanese cypress) is one of the causes of allergic pollinosis in Japan. A major allergen of the pollen designated Cha o 1, was purified by two-step ion exchange chromatography. Cha o 1 was separated into four components with molecular masses of 48.5 kDa and 52.0 kDa, each with pIs of 6.77 and 6.82. The 23-residue N-terminal sequence of Cha o 1 was determined and shown to have high identity with that of Cry j 1, a major allergen of Cryptomeria japonica pollen. cDNA coding for Cha o 1 was cloned by hybridization screening using Cry j 1 cDNA as a probe. One of the cDNA clones, pCHA-1 was sequenced and found to code for a putative 21-residue signal peptide and a 354-residue native protein with a derived molecular mass of 38.1 kDa. The deduced amino acid sequence of Cha o 1 showed 79-80% identity with those of Cry j 1. These findings were consistent with observations of a close crossreaction between the two allergens. Homology analyses revealed that Cha o 1 had 46-49% identity with Amb a 1 families and Amb a 2, the major allergens of short ragweed. Cry j 1 has pectate lyase enzyme activity, suggesting that Cha o 1 may have the same enzyme activity as Cry j 1.

Elevated levels of soluble Fc epsilon RII/CD23 and antibodies to Epstein-Barr virus in patients with Sjögren's syndrome

To clarify how Epstein-Barr virus (EBV) infection is responsible for Sjögren's syndrome (SjS) we measured both IgG and IgM antibodies to viral capsid antigen (VCA) of EBV in the sera of normal healthy subjects and patients with SjS. Anti-VCA IgG was detectable in all controls and patients however, anti-VCA IgG titers in the sera of SjS patients were significantly higher than those of the controls (p < 0.01). No anti-VCA IgM was detected in the sera of controls whereas anti-VCA IgM was detected in the sera from 10 out of the 13 patients with SjS. This suggests that SjS might be associated with EBV. The serum levels of sCD23 (IgE-binding factor) were also measured to assess the differential state in patients with SjS. The sCD23 level of normal individuals was 211.26 +/- 12.01 micrograms/L (value is mean +/- SE), and was 443.77 +/- 71.94 micrograms/L in the 13 patients with SjS. The mean sCD23 level in the 9 patients with SjS without any complication was 360.67 +/- 35.63 micrograms/L. In the patients with SjS, sCD23 levels were significantly higher than those in the normal individuals (p < 0.01).

Specific IgE to Japanese cypress (Chamaecyparis obtusa) in patients with nasal allergy

BACKGROUND

Japanese cedar (Cryptomeria japonica) is the most important pollen causing pollinois during spring. During recent years some patients' nasal symptoms have been getting worse after the Japanese cedar pollen season. Japanese cypress (Chamaecyparis obtusa) pollen is also observed in this period. The purpose of the study was to investigate the effect of Japanese cypress pollen and cross-allergenicity between Japanese cypress and Japanese cedar in patients with allergic rhinitis.

METHODS

A total of 267 patients were enrolled in the study. IgE antibodies to both tree pollens were measured by the CAP RAST method. The results of the CAP RAST test were compared with those of skin tests. In order to compare cross-allergenicity between these two pollens, CAP RAST inhibition assay was carried out.

RESULTS

The positive frequencies of Japanese cypress and Japanese cedar in 267 patients were 50.1% and 74.7%, respectively. A significant correlation (r = .765) was observed between the two tree pollens. There was good concordance (75%) between RAST and skin tests to Japanese cypress. The results of RAST inhibition assay indicated cross-allergenicity between these two pollens and species-specific allergens.

CONCLUSION

Measurement of IgE antibody to Japanese cypress is useful for the diagnosis of pollinois during the spring.

[A case of near total tracheal obstruction from recurrent esophageal carcinoma]

We have treated a 58-year-old man with almost complete tracheal occlusion arising as a result of recurrence of esophageal cancer. Although laser photoresection using partial cardiopulmonary bypass was desirable, neither laser nor cardiopulmonary bypass was available in our hospital. It was then decided to resect the tumor by forceps. In order to prevent bleeding from tumor during such emergency procedure, intratumoral injection of ethanol was preceded and tracheal lumen could be opened successfully. He was managed by insertion of a Dumon silicone stent seven days after the emergency. The result was satisfactory for maintaining the patency of the airway where the stent was placed. Unfortunately the patient died 113 days after the insertion of Dumon silicone stent from massive hemoptysis, which might resulted from the rupture of vessel feeding the tumor or the perforation of aorta involved by the tumor.

Causative allergens of allergic rhinitis in Japan with special reference to silkworm moth allergen

To determine the importance of silkworm moth allergens, we tested 267 patients with allergic rhinitis with CAP-RAST, a new assay system for detecting specific IgE in sera. We used the following allergen sources: house-dust mite, Candida, Alternaria, cat dander, orchard grass, ragweed, mugwort, Japanese hops, Japanese cedar, Japanese cypress, cotton, silk, larval chironomid midge, adult chironomid midge, and silkworm moth. As expected, the highest positive rate of reaction, as determined by CAP-RAST, was 73.8% for Japanese cedar, followed by 53.2% for mite and 50.6% for Japanese cypress. Although the positive rate for silkworm moth was not as high as for cedar pollen, one-third of patients had specific IgE against silkworm moth. The positive rate of reaction to silkworm moth was much higher than that to chironomid. It was interesting to note that the patients reported had not been documented as having frequent contact with silkworm moth allergen. Correlations between silkworm moth and silk, and silkworm moth and chironomid midge were found to be significant (P < 0.001). Silkworm moth allergen showed the third highest reaction rate in patients with severe symptoms. These results suggest that silkworm moth allergen should be considered to be important in patients with allergic rhinitis in Japan.

Alcohol consumption and risk of esophageal cancer in Japan: a case-control study in seven hospitals

In a multi-center case-control study, we evaluated the risk of esophageal cancer in the Japanese population. All patients and controls were inpatients in the surgical departments of seven hospitals nationwide. Patients eligible for the study were those newly diagnosed as having primary esophageal cancer. One control per case was selected from among patients admitted to the same hospital, and 141 male pairs were analyzed using logistic regression analysis. The results showed dose-response relation between the risk of esophageal cancer and both the quantity (g/week) and frequency (times/week) of alcohol drinking (P value for trend = 0.0001). Although a statistically significant risk increase was shown among moderate to heavy smokers (15 < or = cigarette/day < 25) (odds ratio, 4.35:95% confidence interval, 1.81-10.49), the dose-response for cigarette smoking was unclear (P value for trend = 0.07). No combined effect of alcohol drinking and cigarette smoking was found. A frequent intake of fruit was associated with a decreased risk (P value for trend = 0.02). After adjustment for alcohol consumption, cigarette smoking and fruit intake were found not to be associated with the risk, whereas a preference for high-temperature food and drink showed a statistically significant positive association (P value for trend = 0.02). Drinkers who consumed shochu most frequently showed a three-fold increased risk over that for beer consumers, although the association disappeared after adjusting for the amount of alcohol consumed. The present results confirm alcohol intake and a preference for high-temperature food to be associated with an increased risk of esophageal cancer and show the amount of alcohol consumed, rather than the type of alcoholic beverage, to be the main risk determinant.

[Defects of defence mechanisms against bacterial infections in patients with liver cirrhosis]

Patients with decompensated liver cirrhosis have a high risk of bacterial infection and a worse prognosis. They have defects of the humoral defence mechanism; impaired antibody production and depressed serum complement levels. The cellular defence mechanism is also defective. The function of neutrophil and reticuloendothelial system is depressed. The clearance of enteric organisms from the portal circulation is impaired by portosystemic shunt and impaired Kupffer cell function. Patients with massive ascites are prone to spontaneous bacterial peritonitis due to gram negative enteric organisms.

[Study of washout rate in patients with chronic renal failure by dipyridamole 201Tl myocardial scintigraphy--comparison with hypertrophic cardiomyopathy]

Fourteen patients with chronic renal failure (CRF) were studied by dipyridamole 201Tl myocardial scintigraphy. In this study, patients with coronary heart disease were excluded by clinical findings. 201Tl SPECT was performed at 8 min after injection of dipyridamole (0.56 mg/kg) and at a 3-hr delayed interval, and washout rates (WR) were calculated. Because UCG showed left ventricular hypertrophy (thickness; 13 +/ 2 mm) in CRF, the WR values were compared with those of hypertrophic cardiomyopathy (HCM) (n = 9). In CRF, an average WR was 54.2 +/- 6.8% and was significantly higher than that in normal (46.2 +/- 9.1%, p < 0.05, n = 9), though WR in HCM was significantly low (26.9 +/- 11.4%, p < 0.01). Hematocrit value was 24.5 +/- 3.2% in CRF and was significantly lower than that in normal (37.8 +/- 3.6%, p < 0.001). On the other hands, hemoconcentration was observed in HCM (hematocrit; 44.6 +/- 3.6%, p < 0.001). WR in CRF, HCM and normal had significant correlation with hematocrit values (r = -0.796, p < 0.001). These results suggest that anemia or hemoconcentration may affect coronary blood flow and WR, and this should be considered when diagnosing coronary heart disease in CRF or HCM.

[Definition, classification and clinical symptoms of cholelithiasis]

Generally, the cases with symptomatic biliary stone are diagnosed as cholelithiasis and asymptomatic cases are not defined as cholelithiasis in the strict sense. However, asymptomatic stones are often diagnosed and treated as cholelithiasis. In the diagnosis and treatment of cholelithiasis, it is important to study the localization and classification of biliary stones relation to clinical symptoms.

Relation between the hormonal and epidemiological aspects of esophageal cancer in Japan

Esophageal cancer with endemic distribution of high-risk areas in the world is also known to be more prevalent in the male--and in the aged-populations than in their counterparts. The hormonal characteristics of esophageal cancer patients and the geographical distribution of high and low-risk areas in Japan were comparatively investigated in search of the etiology of this neoplasia. A case-control study of 14 urinary steroids indicated that cancer patients of both sexes were associated with an acceleration of cortisone to hydrocortisone conversion within their bodies. Evidence was presented to suggest that the above state of glucocorticoid excess could be related to the production of hyperplasia as well as malignant transformation in the epithelial cells of the esophagus. The 10 highest risk areas and the 7 lowest risk areas were clearly separated by the 2 fault lines of the Japan Islands, a finding to suggest that some microelements of the soil play a role in conditioning the cancer risk. The possible linkage of the observed hormonal characteristics of Japanese patients to both the geochemistry of the soil and the genesis of this neoplasia is discussed in the light of the competitive relationship between the intake of vitamin C and endogenous nitrosation.

Poly (lactic/glycolic acid) microspheres containing antigen as a novel and potential agent of immunotherapy for allergic disorders

In order to establish a safer and simpler antigen administration method in immunotherapy, we prepared biodegradable microspheres containing antigen and evaluated its safety and efficacy using guinea pigs. Poly (lactic/glycolic acid); (LGA) microspheres containing ovalbumin (OA) were fabricated by solvent evaporation. Over 70% of the OA was released from the microspheres within 3 days, and release was completed within 14 days in vivo. The local tissue reactions to the OA-LGA microspheres were apparently weaker than those to OA-alum. Repeated injections of high dose OA-LGA microspheres to OA-sensitized guinea pigs (high-LGA group) for 8 weeks at intervals of 2 weeks elicited an excellent therapeutic effect, i.e. a significant increase in the threshold value of antigen inhalation test, with a significant increase in IgG2 blocking antibody. The therapeutic efficacy of the high-LGA group was comparable to the conventional immunotherapy model (conventional group) and was superior to the antigen-alum model (alum group). We concluded that administration of antigen-LGA microspheres could become a new immunotherapeutic method for allergic disorders, being safer and requiring a lower frequency of antigen injections than the conventional method.

Morphological study of parafollicular cells and the parathyroid gland in the house shrew (Suncus murinus)

A morphological study of parafollicular cells in the thyroid gland and parathyroid gland of the house shrew (Suncus murinus) was made. The results indicated that (1) there were two pairs of parathyroid glands which were located in the upper part of the house shrew thyroid gland, (2) the volumes of the house shrew parathyroid glands ranged from 0.014 to 0.079 mm3, (3) the number of parafollicular cells along the follicles was largest in the upper part of the thyroid lobe, while no parafollicular cells were present in the isthmus, and (4) there were about 20 parafollicular cells per 100 follicular cells and 1.519 parafollicular cells per follicle. The number of parafollicular cells per 100 follicular cells was thus about 5 times larger than that in rats and the number of parafollicular cells per follicle about 2.5 times larger than that in rats.

Phase II evaluation of cisplatin and 5-fluorouracil in advanced squamous cell carcinoma of the esophagus: a Japanese Esophageal Oncology Group Trial

Thirty-nine patients with advanced measurable squamous cell carcinomas were treated with two or more courses of 70 mg cisplatin/m2 on day 1 and 700 mg infused 5-fluorouracil/m2 on days 1-5 every 21 days. The overall response rate was 35.9 (95% confidence limits, 24.8-55.1%). Responses were seen in primary sites in the esophagus of five patients, in the lung of seven, the liver of one and the mediastinal lymph nodes of one. The average response duration was 3.5 (range 1-12) mo for patients who achieved partial response. The average survival time after the first administration was 9.5 mo for patients who responded to the treatment whereas, for those who did not, it was 5.6 mo. The major form of toxicity was myelosuppression and there were six patients with grade 3 toxicity and one with grade 4. The present study was designed to evaluate the effectiveness of combined cisplatin and 5-fluorouracil for advanced squamous cell carcinoma, and the results showed that it had a reasonable effect and might possibly be used as a postoperative chemotherapy because of its mild side effects.

Malignant lymphoma of mucosa-associated lymphoid tissue arising in the thymus of a patient with Sjögren's syndrome. A morphologic, phenotypic, and genotypic study

A 59-year-old woman with Sjögren's syndrome had an anterior mediastinal tumor. The tumor had epithelium-lined thymic cysts. Histologically, centrocyte-like (CCL) cells were present as clusters intermingling with small lymphocytes and plasma cells, invaded the epithelium, and formed characteristic lymphoepithelial lesions; the tumor was identified as malignant lymphoma arising in mucosa-associated lymphoid tissue (MALT). Within the tumor, trapped Hassall's corpuscles were recognized. Immunohistochemical staining demonstrated monotypic cytoplasmic kappa light chains in a small portion of the CCL cells. Furthermore, Southern blot hybridization studies showed rearrangements of immunoglobulin heavy chain, immunoglobulin kappa light chain, and T-cell receptor beta genes. The findings are consistent with thymic low-grade B-cell MALT lymphoma.

Anterior mediastinal tracheostomy with a latissimus dorsi musculocutaneous flap

We describe the reconstruction of an anterior mediastinal tracheostomy with a latissimus dorsi musculocutaneous flap. This procedure is safer, more easily carried out, a more reliable means of creating an anterior mediastinal tracheostomy and is better suited for chest wound healing than previous methods. In addition, the appearance of the patient's chest after operation is cosmetically excellent.

Application of cryo-sapphire knife in rapid frozen ultrathin sectioning for electron microscopy

Conventional sectioning of frozen and fixed tissues is usually performed using the glass knife. Although the glass knife is economical, it has several disadvantages. In this study, the Authors have examined the sectioning quality of the sapphire knife in frozen tissues as an alternative to the glass knife. It was concluded that the sapphire knife has better quality and durability than the conventional glass knife in cutting frozen tissues.

[Study on eosinophil cationic protein (ECP) and arylsulfatase B in nasal secretions and sera from patients with nasal allergy]

Recently four tissue toxic proteins namely major basic protein (MBP), eosinophil peroxidase (EPO), eosinophil-derived neurotoxin (EDN), and eosinophil cationic protein (ECP) were found in eosinophilic leucocytes. Although the characteristics of these proteins concerning tissue damage in the local site of type I allergic reaction have been investigated mainly in lower respiratory tract, the actual clinico-pathological roles of these proteins in nasal allergy are not clarified. Contrary, eosinophils also have histaminase, arylsulfatase, phospholipase D, which are considered to act on a negative feedback mechanism in allergic reaction through inactivation of chemical mediators. Therefore, estimation of ECP and simultaneously arylsulfatase B in nasal secretion and the sera from patients with nasal allergy may clarify the dynamics of clinico-pathological state, especially in the late phase of allergic reaction in each patients. ECP concentrations in the nasal secretions from 22 patients and in the sera from 12 patients with nasal allergy were measured by RIA method. The activities of arylsulfatase B in the nasal secretions and the sera were also estimated in the same specimens as ECP by measuring its hydrolytic activity using p-nitro cathecol sulfate as a substrate. The results obtained were as follows; 1) There was a significant correlation between ECP concentrations in the nasal secretions and the severities of clinical symptoms, especially the degree of nasal obstruction. ECP concentrations also significantly correlated to the score of eosinophilic leucocytes in the nasal smears. 2) The serum ECP concentrations significantly correlated to the number of eosinophilic leucocytes in the peripheral blood, and also showed slight tendency of correlation to the severity of clinical symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)

Phase II evaluation of combined cisplatin and vindesine in advanced squamous cell carcinoma of the esophagus: Japanese Esophageal Oncology Group Trial

In the present phase II study, 31 patients with advanced measurable esophageal carcinomas were treated with a combination of 30 mg vindesine/m2 and 70 mg cisplatin/m2. The overall response rate was 16.1% (95% confidence limits, 7.1-32.6%). Responses were seen in metastatic sites, including the liver in two patients, a lung in one, neck or mediastinal lymph nodes in two and primary sites in two. The response durations were between one and two months for patients achieving partial response. The average survival time after first administration was 5.5 months for patients who responded to treatment, whereas, for those who did not, it was 7.3 months. The major form of toxicity was myelosuppression, 14 patients developed grade 2-3 toxicity and one sepsis which led to death. No superiority of the combined chemotherapy over either cisplatin or vindesine therapy alone was suggested for cases of advanced squamous cell carcinoma of the esophagus by the present study.

[Study of surgical treatment of advanced small lung cancer]

We analyzed 15 patients with small but advanced primary lung cancer operated from 1965 to 1988. The size of tumors were less than 2.0 cm in largest dimension and their pathological stages III A, III B and IV. The histological types were adenocarcinoma in 13 cases and squamous cell carcinoma in 2 cases. Nine patients (69%) had elevated levels of preoperative serum CEA. The prognosis of patients with intrapulmonary metastases was better than that of those with pleural dissemination. In adenocarcinoma patients with mediastinal lymph node metastases, the survival rate of cases with small cancer less than 2.0 cm in diameter was higher than those with large cancer more than 5.0 cm in diameter.