A stereoselective and sensitive method for the determination of the enantiomers of felodipine, a dihydropyridine calcium antagonist, has been developed and the pharmacokinetic profiles of the enantiomers comparatively studied after oral administration to dogs and humans. D6-Felodipine, the internal standard, was added to the plasma, extracted with a solvent and then optically resolved into S(-) and R(+) enantiomers on a high performance liquid chromatographic Chiralcel OJ column. Each enantiomer in the effluent was analysed by capillary column gas chromatography/positive ion electron impact mass spectrometry. After oral administration of the felodipine racemate, the Tmax and t1/2 values hardly differed between the two enantiomers in dogs and humans. The Cmax and AUC0-24 h values of the S(-) enantiomer were slightly higher than those of the R(+) enantiomer in humans but the difference between the enantiomers was not significant. These results suggested that there is no large difference in the absorption, distribution and elimination of felodipine enantiomers after oral administration of the racemate in either dog or human.

Adult↗

PubMedDate not supplied

Function of the sphincter of Oddi in patients with juxtapapillary duodenal diverticula: evaluation by intraoperative biliary manometry under a duodenal pressure load.

The purpose of this study was to elucidate the function of the sphincter of Oddi (SO) in patients with juxtapapillary duodenal diverticula (JDDs). The SO function was evaluated by intraoperative biliary manometry in three groups of patients. Group 1 consisted of nine patients with JDDs and a dilated common bile duct (CBD) (diameter > 10 mm). Group 2 consisted of six patients with JDDs and a normal-sized CBD (diameter < 10 mm). Group 3 consisted of 26 patients without JDDs and with normal-sized CBDs. In the absence of a duodenal pressure load, the patients in group 1 demonstrated a lower baseline SO pressure and lower resistance of the biliary outflow than patients in group 3. They also demonstrated a lower baseline SO pressure and shorter decay time (which represented terminal biliary ductal resistance) than patients in group 2. In the presence of a duodenal pressure load of 300 mm H2O, the patients in group 1 demonstrated a lower incidence of phasic SO contractions, a higher baseline SO pressure, and a higher resistance of the biliary outflow than group 2 and group 3 patients. The decay time in group 1 and group 2 patients was higher than that of group 3 patients. Based on these findings, we conclude that the SO function in patients with JDDs is impaired owing in part to long-standing compression of the terminal biliary ductal system by a distended JDD associated with a rise in intraduodenal pressure in daily life.

Adult↗

PubMedDate not supplied

Three cases of solid and cystic tumor of the pancreas. Analysis comparing the histopathological findings and DNA histograms.

The pathological findings in three cases of solid and cystic tumor (SCT) of the pancreas were compared with the nuclear DNA histogram obtained by flow cytometry. One case involved malignant SCT with liver metastases. Two of the cases were benign SCT. In the malignant SCT, cellular atypia and mitotic figures were extensively observed. The proliferation index (PI) was 25, and the DNA index (DI) was 1.65. In the benign SCT, cellular atypia and mitotic figures were rarely observed. The PI was 8 and 13, respectively, and the DI was 1.0 in both cases. The proliferative activity and the biological malignant potential of the malignant SCT were thought to be higher than those of the benign SCT.

Adult↗

PubMedDate not supplied

Isolated dissection of the superior mesenteric artery: CT findings in six cases.

Dissection of the superior mesenteric artery (SMA) not associated with aortic dissection is rare. The purpose of this study is to describe the computed tomographic (CT) findings of this condition. We studied the CT findings of six patients with isolated dissection of the SMA. CT demonstrated thrombosis of the false lumen or intramural hematoma (n = 4) and/or intimal flap (n = 4) in all six patients. Other CT findings were enlarged diameter of the SMA (n = 5), increased attenuation of the fat around the SMA (n = 5), and hematoma in the mesentery with hemorrhagic ascites (n = 1). CT is useful for the diagnosis of isolated dissection of the SMA, and increased attenuation of the fat around the artery is considered the key to the diagnosis when no definite findings are evident.

Aged↗

PubMedDate not supplied

Gastrointestinal tract perforation: CT diagnosis of presence, site, and cause.

Gastrointestinal tract perforation is an emergent condition that requires prompt surgery. Diagnosis largely depends on imaging examinations, and correct diagnosis of the presence, level, and cause of perforation is essential for appropriate management and surgical planning. Plain radiography remains the first imaging study and may be followed by intraluminal contrast examination; however, the high clinical efficacy of computed tomographic examination in this field has been well recognized. The advent of spiral and multidetector-row computed tomographic scanners has enabled examination of the entire abdomen in a single breath-hold by using thin-slice sections that allow precise assessment of pathology in the alimentary tract. Extraluminal air that is too small to be detected by conventional radiography can be demonstrated by computed tomography. Indirect findings of bowel perforation such as phlegmon, abscess, peritoneal fluid, or an extraluminal foreign body can also be demonstrated. Gastrointestinal mural pathology and associated adjacent inflammation are precisely assessed with thin-section images and multiplanar reformations that aid in the assessment of the site and cause of perforation.

Barium Sulfate↗

PubMedDate not supplied

Thoracic esophageal carcinoma: evaluation in the sagittal section with magnetic resonance imaging.

Among 54 patients with thoracic esophageal carcinoma (53 squamous cell carcinoma, 1 adenosquamous carcinoma), the usefulness of MR sagittal imaging for evaluating local extent (T factor) was examined by measuring the anteroposterior (AP) diameter of the tumor. The MR examination was performed using ECG gated scans with a 3 mm slice at 1.5 Tesla. T1-weighted sagittal images were obtained. In 10 patients the appearance of the esophagus was normal, and in 44 patients a tumor was detected in the sagittal section. Thirty-seven lesions were histologically proved (Tis, 1; T1, 3; T2, 3; T3, 15; T4, 15). Lesions classified as 30 mm were resected. They were located in the lower esophagus. It is concluded that lesions detected in MR sagittal images might be T3 or T4 tumors, and masses of >30 mm might extend to adjacent organs, although two tumors with an AP diameter < 25 mm also invaded the trachea.

Adult↗

PubMedDate not supplied

Chemotherapy administered using two-route infusion of cisplatin and sodium thiosulfate and intravenous infusion of vinblastine and peplomycin in patients with oral cancer.

The therapeutic effects of neo-adjuvant chemotherapy administered by two-route infusion of cisplatin and its antidote, sodium thiosulfate, and intravenous infusion of vinblastine and peplomycin were studied in 22 patients with previously untreated squamous cell carcinoma of the oral cavity or maxillary sinus. The overall response rate to chemotherapy was 90.9%, with a complete response in 12 patients (54.5%), a partial response in 8 patients (36.4%), and no change in 2 patients (9.1%). Histologic assessment showed a grade V response in 7 patients (31.8%), grade IV in 3 patients (13.6%), grade III in 5 patients (22.7%), grade II in 4 patients (18.2%), and grade I in 3 patients (13.6%). The cumulative 5-year survival rate, including 3 patients who died of another disease, was 72.2%. Leukocytopenia, an important side effect apparently induced by vinblastine, was seen, but no life-threatening complications occurred. Renal toxicity by cisplatin was minimal because of the use of sodium thiosulfate and fosfomycin. These data indicate that this mode of chemotherapy may be more effective for treating head and neck cancer than ordinary chemotherapy, from clinical and histologic standpoints. The high complete-response rate is especially noteworthy. No serious side effects or reductions in treatment period occurred. The results are preliminary and additional studies using a larger patient population are needed.

Adult↗

PubMedDate not supplied

Predictors of 1-year outcome for patients with panic disorder.

The course of panic disorder (PD) is often prolonged, but factors that affect the social outcome have not yet been made clear. The aim of this study was to find predictors of outcome for patients with PD. The subjects were 65 outpatients (28 men and 37 women) with PD (DSM-III-R) who were treated at our hospital for more than 1 year. The factors affecting 1-year outcome were evaluated by multiple regression analysis. We found that the following were predictors of poor social outcome in PD: (1) severe agoraphobia at the first psychiatric examination and (2) long duration of illness before the first psychiatric consultation. Furthermore, the complication of hypochondriacal symptoms predicted a poor outcome for PD. Early attention to agoraphobia and hypochondriasis is essential for the treatment of PD, and early introduction to psychiatric treatment is recommended.

Adolescent↗

PubMedDate not supplied

The effect of sodium hyaluronate on the expression of gelatinases in rabbit corneal epithelial wound healing.

PURPOSE: We investigated the effect of sodium hyaluronate (Na-HA) on the expression of gelatinases in a rabbit model with corneal epithelial defects. METHODS: Topical administration of Na-HA or phosphate-buffered saline (PBS) was carried out in the experimental eyes after surgical removal of the corneal epithelium. At 0, 6, 24, 48, and 72 hours after wounding, mRNA expression of 72 kDa type gelatinase (MMP-2), 92 kDa type gelatinase (MMP-9), and tissue inhibitor of matrix metalloproteinases-1 (TIMP-1) were analyzed by reverse transcription polymerase chain reaction in those corneas. In addition, gelatinolytic activities were investigated using gelatin zymography. RESULTS: The levels of constitutive expression of MMP-2 and TIMP-1 mRNA persisted, whereas MMP-9 mRNA in the PBS-treated side was expressed temporarily after surgical removal. In the Na-HA-treated side, at 6 hours after wounding, a much higher expression of MMP-9 mRNA was reproducibly observed compared with that in the PBS-treated side. In zymography, the levels of gelatinolytic activity corresponding to proMMP-9 were significantly higher in the Na-HA-treated side than in the PBS-treated side at 6 hours after wounding. CONCLUSIONS: These results suggest a novel participation of Na-HA in the expression of MMP-9 in rabbit corneal epithelial wound healing.

Adjuvants, Immunologic↗

PubMedDate not supplied

The optimal molecular weight of dispersive type sodium hyaluronate for the reduction of corneal endothelial damage induced by sonication, irrigation, and aspiration.

PURPOSE: The purpose of this study was to investigate the optimal molecular weight of dispersive sodium hyaluronate (Na-HA) for the reduction of corneal endothelial damage induced by sonication, irrigation, and aspiration, using enucleated pig eyes. METHOD: The phaco-needle of phacoemulsification and aspiration (PEA) equipment was inserted into the anterior chamber after aqueous humor replacement with a 1% Na-HA solution of various molecular weights (2420 x 10(3), 1460 x 10(3), 1100 x 10(3), 520 x 10(3) or 290 x 10(3)). Then sonication, irrigation, and aspiration were conducted for 60 seconds. The residual rate of Na-HA in the anterior chamber and the damaged area of corneal endothelium were determined using an image analyzer. RESULTS: Na-HA with a molecular weight of 1100 x 10(3) gradually disappeared from the anterior chamber after mixing with the irrigating solution, and the damaged area in only the 1100 x 10(3) group was significantly smaller compared with that in the control group. CONCLUSION: These results suggest that an optimal molecular weight exists for dispersive hyaluronate applied for the protection of intraocular tissues during PEA. Under the conditions of this study, Na-HA with a molecular weight of 1100 x 10(3) displayed the highest protective efficacy.

Animals↗

PubMedDate not supplied

Increased expression of angiotensin-converting enzyme in retinas of diabetic rats.

PURPOSE: The aim of this study was to examine the localization and the changes in the amount of angiotensin-converting enzyme (ACE) and the relationship between the renin-angiotensin (RA) system and vascular endothelial growth factor (VEGF)/VEGF-receptor system in the retinas of diabetic rats. METHODS: Immunohistochemical localization of ACE, VEGF, and VEGF-receptor fetal liver kinase-1 (Flk-1) was examined in cryosections of the retinas of streptozotocin-injected diabetic rats. A semi-quantitative comparison of diabetic rats with age-matched controls was also performed by counting the ACE- or Flk-1-positive vessels per microscopic field. RESULTS: ACE immunoreactivity was localized in the retinal vessel walls, and the percentages of ACE-positive vessels were significantly increased in the retinas of diabetic rats maintained 3 to 5 months. Both VEGF and Flk-1 signals increased simultaneously with the increment of ACE immunoreactivity. CONCLUSIONS: ACE, expressed in the retinal vessel walls, increases simultaneously with the increment of both VEGF and Flk-1 in the retinas of diabetic rats, suggesting that upregulation of ACE might play some role in the progression of diabetic retinopathy through the VEGF/VEGF receptor system.

Animals↗

PubMedDate not supplied

Neonatal bone fragments for the induction of xenograft acceptance: transplantation of xenogeneic hematopoietic stem cells and species-specific microenvironment for hematopoiesis.

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Animals↗