Patients with "reflux" gastritis after gastrectomy suffer from a variety of symptoms, and this type of gastritis may sometimes compromise the quality of life of these patients. Since Helicobacter pylori is considered to be one of the most important pathogenetic factors in gastritis, the association between H. pylori and reflux gastritis was investigated in this study. A total of 145 patients with gastrectomy were entered into the study. Five biopsy specimens from the gastric remnant were taken at upper gastrointestinal endoscopy. One specimen was examined pathohistologically, and the remaining four were examined for H. pylori infection. Fifty-two patients (36%) demonstrated H. pylori infection. The prevalence of H. pylori was significantly higher in patients who had a partial gastrectomy, and it was significantly lower in patients who had undergone gastrectomy more than 4 years previously. The histologic gastritis score in patients with H. pylori infection was significantly higher. Furthermore, H. pylori was eradicated in patients with some symptoms of gastritis and no bile reflux to the residual stomach at endoscopy; in these patients the symptoms were relieved and the histologic gastritis score decreased significantly. In conclusion, possible involvement of H. pylori is suspected in the pathogenesis of "nonreflux" gastritis after gastrectomy.

Aged↗

PubMedDate not supplied

Effect of hyperthermia combined with external radiation therapy in primary non-small cell lung cancer with direct bony invasion.

PURPOSE: Local control in lung cancer directly invading the bone is extremely poor. Effects of regional hyperthermia combined with conventional external beam radiation therapy were evaluated. MATERIALS AND METHODS: Thirteen patients with non-small lung cancer (NSCLC) with direct bony invasion were treated with hyperthermia plus irradiation (hyperthermia group). The treatment outcome was compared with the historical treatment results in 13 patients treated with external radiation therapy alone (radiation alone group). In patients with no distant metastasis, radiation therapy at a total dose of 60-70 Gy was administered to both groups. Hyperthermia was performed for 45-60 min immediately after irradiation for two-four sessions with radiofrequency capacitive heating devices. RESULTS: For primary response, 10 of the 13 tumours responded to the treatment (3 CR, 7 PR) in the hyperthermia group, whereas seven tumours responded (1 CR, 6 PR) in the radiation alone group. The 2-year local recurrence-free survival rate for clinical M(0) patients in the hyperthermia group and that in the radiation alone group were 76.1 and 16.9%, respectively. Three patients died of distant metastases within 2 years in the hyperthermia group, but two out of three tumours histologically disappeared, even in the autopsy examination. The 2-year overall survival rate for clinical M(0) patients in the hyperthermia group and that in the radiation alone group were 44.4 and 15.4%, respectively. No severe pulmonary complication was observed in either group. CONCLUSIONS: Regional hyperthermia combined with conventional irradiation could be a tool to improve local control in patients with NSCLC deeply invading the chest wall.

Adult↗

PubMedDate not supplied

In-storage hypothermic perfusion for heart and lung transplantation.

The authors developed a new waterproof-packed infusion device for easy and sterile in-storage hypothermic perfusion during organ transportation for heart and lung transplantation. They examined the accessibility and efficacy of this infusion device for portable heart and lung preservation in canine transplant models. Sixteen heart and bilateral lung blocks were preserved by an in-storage hypothermic perfusion technique using the infusion device with University of Wisconsin solution. Of 16 dog recipients, 5 underwent orthotopic heart transplantation with cardiopulmonary bypass, and 5 dogs received left lung transplantation; the remaining heart and lung blocks were intrathoracically transplanted into 6 dogs. Functional status and histology of 11 heart and 11 lung allografts were evaluated by post-transplant course, hemodynamic parameters, arterial blood gas measurements, microscopic examination, and so on. Eleven transplanted hearts showed good cardiac performance and maintained systemic circulation after weaning from cardiopulmonary bypass. Eleven transplanted lungs had excellent respiratory function, and all five dogs with left lung transplantation survived for 5-46 days (mean: 18.8 days). These results suggest that in-storage hypothermic perfusion with this waterproof-packed infusion device can be a useful technique for long-term organ preservation in heart and lung transplantation.

Animals↗

PubMedDate not supplied

A miniature intraventricular axial flow blood pump that is introduced through the left ventricular apex.

A new intraventricular axial flow blood pump has been designed and developed as an implantable left ventricular assist device (LVAD). The pump consists of a tube housing (10 cm in length and 14 mm in diameter), a three-vane impeller combined with a guide vane, and a DC motor. This pump is introduced into the LV cavity through the LV apex, and the outlet cannula is passed antegrade across the aortic valve. Blood is withdrawn from the LV through the inlet ports at the pump base, and discharged into the ascending aorta. A pump flow of > 8 L/min was obtained against 90 mmHg differential pressure in the mock circulatory system. In an acute dog model, this pump could produce a sufficient output of 200 ml/kg/min. In addition, the pump flow profile demonstrated a pulsatile pattern, although the rotation speed was fixed. This is mainly due to the changes in flow rate during a cardiac cycle--that is, during systole, the flow rate increases to the maximum, while the differential pressure between the LV and the aorta decreases to the minimum. Thus, this simple and compact axial flow blood pump can be a potential LVAD, with prompt accessibility and need for less invasive surgical procedures.

Animals↗

PubMedDate not supplied

Effect of plasmapheresis as initial monotherapy in a case of anti-neutrophil cytoplasmic autoantibody positive crescentic glomerulonephritis.

The effect of plasmapheresis (PP) monotherapy was evaluated in a 77 year old man with crescentic glomerulonephritis (CrGN). Because both anti-neutrophil cytoplasmic myeloperoxidase autoantibody (MPO-ANCA) and circulating immune complex (IC) were positive, removal of these substances was expected to be beneficial. Thus, the treatment was started with PP alone. During 2 month's time, three series of PP monotherapy were performed: three sessions of plasma exchange (PEX) with fresh frozen plasma (FFP); two sessions of double filtration plasmapheresis (DFPP); followed by another two sessions of PEX. The ANCA remained suppressed for 4 weeks after the first PEX, and increased thereafter. Subsequent DFPP caused a rebound in ANCA titer, whereas the second PEX suppressed ANCA for 1 week. Although creatinine clearance (Ccr) improved from 9.3 to 15 ml/min after the first PEX, and this level was maintained, ANCA increased again after the second PEX. Therefore, the patient was treated with methylprednisolone semi-pulse therapy (500 mg/day for 3 days), followed by mild "cocktail" therapy. In 2 weeks ANCA and IC became negative, and Ccr further improved to 20 ml/min. Thus, PP, when performed alone, was shown to be partially effective, arresting the progression of renal damage in the present case. These observations also argue for the advantage of PP, especially PEX, as an adjunct therapy to immunosuppressive therapy in CrGN.

Aged↗

PubMedDate not supplied

Relationship of blood pressure and pump flow in an implantable centrifugal blood pump during hypertension.

The purpose of this study was to evaluate the real time relationship between pump flow and pump differential pressure (D-P) during experimentally induced hypertension (HT). Two calves (80 and 68 kg) were implanted with the EVA-HEART centrifugal blood pump (SunMedical Technology Research Corp., Nagano, Japan) under general anesthesia. Blood pressure (BP) in diastole was increased to 100 mm Hg by norepinephrine to simulate HT. Pump flow, D-P, ECG, and BP were measured at pump speeds of 1,800, 2,100, and 2,300 rpm. All data were separated into systole and diastole, and pump flow during HT was compared with normotensive (NT) conditions at respective pump speeds. Diastolic BP was increased to 99.3+/-4.1 mm Hg from 66.5+/-4.4 mm Hg (p<0.01). D-P in systole was under 40 mm Hg (range of change was 10 to 40 mm Hg) even during HT. During NT, the average systolic pump flow volume was 60% of the total pump flow. However, during HT, the average systolic pump flow was 100% of total pump flow volume, although the pump flow volume in systole during HT decreased (33.1+/-5.7 vs. 25.9+/-4.0 ml/systole, p<0.01). In diastole, the average flow volume through the pump was 19.6+/-6.9 ml/diastole during NT and -2.2+/-11.1 ml/diastole during HT (p<0.01). The change in pump flow volume due to HT, in diastole, was greater than the change in pump flow in systole at each pump speed (p<0.001). This study suggests that the decrease of mean pump flow during HT is mainly due to the decrease of the diastolic pump flow and, to a much lesser degree, systolic pump flow.

Animals↗

PubMedDate not supplied

HeartMate III: pump design for a centrifugal LVAD with a magnetically levitated rotor.

A long-term, compact left ventricular assist device (LVAD), the HeartMate III, has been designed and fabricated, featuring a centrifugal pump with a magnetically levitated rotor. The pump has been optimized by in vitro testing to achieve a design point of 7 L/min against 135 mm Hg at high hydrodynamic efficiency (30%) and to be capable of up to 10 L/min under such a load. Furthermore, the pump has demonstrated no mechanical failures, low hemolysis (4-10 mg/dl plasma free Hb), and low thrombogenicity during six (40, 27, 59, 42, 27, and 49-day) in vivo bovine studies.

Animals↗

PubMedDate not supplied

Sodium ion specifically modifies plasma ionized calcium concentration.

BACKGROUND/AIM: Recently, we observed a progressive decline in the plasma ionized calcium (iCa) concentration after ingestion of Na-free beverage. Although both plasma pH and Na significantly correlated with iCa, the correlation of the latter was stronger than that of the former. Therefore, we explored the effect of Na on plasma iCa. METHODS: Pooled human plasma was diluted with normal saline, 5% glucose, 0.9% KCl, or distilled water to examine the effect of plasma dilution on iCa. Also, to evaluate the effects of an isovolemic increase in ion concentration and osmolarity on plasma iCa, NaCl, KCl, and D-glucose were added to plasma. Electrolytes (Na(+), K(+), Cl(-), iCa, HCO(-)(3)), pH, and osmolarity were measured by using ion-selective electrodes. RESULTS: In the plasma dilution study, although all solutions significantly decreased the iCa concentration, the decrease in iCa concentration in the normal saline treated solution was significantly lower than in others. When the plasma osmolarity was isovolemically increased, the iCa concentration significantly increased in parallel with the increase in osmolarity in the NaCl group (r = 0.604, p < 0.01, n = 50). In contrast, no significant change in the iCa concentration was seen in the other solutions. NaCl did not increase, but rather decreased the iCa concentration when added to a protein-free solution. CONCLUSION: The present study demonstrated that Na specifically affects plasma iCa independently of pH, presumably via modulating Ca binding to plasma proteins.

Analysis of Variance↗

PubMedDate not supplied

Brachytherapy for penile cancer using silicon mold.

We analyzed the treatment results of 15 patients with penile cancer treated by afterloading brachytherapy with a silicon-made mold we devised. The group included 8 patients with T1, 5 with T2 and 2 with T3 tumors, and inguinal lymph node metastases were noted in 4 patients. The total dose of brachytherapy ranged from 32 to 74 Gy with or without an electron beam boost. The median dose rate was 200 cGy/h ranging from 100 to 350 cGy/h. Local control was achieved in 12 of the 15 patients (80%), and was related to the T category, with 100% of T1 and 80% of T2, in contrast to 0% of T3 tumor. Three patients with partial response or residual tumor underwent amputation. Local recurrence was recognized in 1 patient with a T2 tumor, but salvaged by surgery. Penis conservation was achieved in 11 of 15 patients (73%). Of the 4 patients with inguinal lymph node metastases, 3 were controlled by surgery and radiation therapy. The other with a T3 tumor died from the disease. Brachytherapy with a mold for penile cancer was considered to be the first choice for penis-conserving therapy, and the patients with T1 and T2 tumors have good indications for this method of treatment.

Adult↗

PubMedDate not supplied

Hyperthermia-induced apoptosis in two rat yolk sac tumor cell lines with different radiothermosensitivity in vitro.

We investigated cell susceptibility to hyperthermia-induced apoptosis in two rat yolk sac tumor cell lines (RYSTs) and attempted to correlate this with the known potentially relevant molecular determinants of apoptosis, p53 protein status, Bcl-2 family of proteins and heat shock proteins (Hsp). Parent cell line, NMT-1 (carrying wild-type p53 gene) was radiosensitive but thermoresistant compared to the variant cell line, NMT-1R (mutated type p53), which was isolated from NMT-1 by repeated radiation exposure. Induction of apoptosis by hyperthermia at 43 degrees C was morphologically detected in both RYSTs using hematoxylin and eosin, and TUNEL staining and additionally confirmed by DNA ladder formation (the cleavage of DNA into oligonucleosomal fragments). Western blot analysis showed an increase in expression of p53, p21WAF1/CIP1, Hsp70 proteins in both cell lines after heat-shock at 43 degrees C for 30 min. Hsp90 expression increased in NMT-1 but was not affected by heating in NMT-1R cells, whereas hyperthermia exerted no effect on the endogenous expression of Bax. Bcl-2 protein could not be detected in either RYST. These results suggest that hyperthermia induced apoptosis in both NMT-1 and NMT-1R and apoptosis in RYSTs may be independent of p53-dependent signaling pathway.

Animals↗

PubMedDate not supplied

Clinical application of low dose-rate brachytherapy combined with simultaneous mild temperature hyperthermia.

BACKGROUND: Recent biological research has shown that mild temperature hyperthermia (MTH) around 41 degrees C simultaneously combined with low dose-rate irradiation (LDRI) is an effective treatment modality for cancer. The aim of the study was to assess the clinical usefulness of a combination of MTH and simultaneous low dose-rate brachytherapy. MATERIALS AND METHODS: Seven superficial and 8 deep-seated tumors were included in this protocol. Two tumors had no previous treatment and the remainder were recurrent tumors which had arisen from previously treated sites. The average major diameters of superficial and deep tumors were 8.6 and 7.0 cm, respectively. The average values for Tmin in superficial and deep tumors were 41.5 and 40.7 degrees C, respectively. Brachytherapy was delivered by 137Cs and/or 192Ir LDRI sources. RESULTS: For superficial tumors, six of the seven tumors responded to the treatment (4 achieved CR, 2 PR, 1 NC) and four tumors did not recur within the follow-up period of 5-15 months. All of the deep tumors responded and 5 achieved CR, 3 PR. Four tumors recurred 4-17 months after the treatment and the remainder showed no local recurrence within the follow-up period of 4-31 months. CONCLUSION: MTH simultaneously combined with LDRI was an effective method for treating progressive and bulky tumors with a previous treatment history.

Adult↗