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PubMed1984

The yield of active case-finding in persons with inactive pulmonary tuberculosis or fibrotic lesions. A 5-year study in tuberculosis clinics in Amsterdam, Rotterdam and Utrecht.

The aim of the study was to elucidate the yield of annual chest X-ray and bacteriological examination in subjects with inactive tuberculosis or fibrotic lesions. Nearly 15 000 such persons registered at the Tuberculosis Clinics (C.B.s.) in Amsterdam, Rotterdam and Utrecht were allocated at random to either the Check-up group or the Discharge group: every person had an initial chest X-ray and examination of sputum or tracheal lavage for tubercle bacilli. Those in the Check-up group were re-examined annually for 3 years, while those in the Discharge group were not, but were encouraged to come to the C.B. if they developed symptoms suggestive of tuberculosis. Every patient was invited, after 3 years, to attend for a final follow-up examination. Nearly 90% of patients in the Check-up group attended for annual examination. Twenty-eight reactivations were reported during the 3 years, 23 pulmonary and 5 non-respiratory. They occurred in 12 patients previously treated by chemotherapy (1.2 per 1000 per year), in 15 with inactive tuberculosis (1.5 per 1000 per year) and in one with a fibrotic lesion (0.3 per 1000). Tubercle bacilli were found by smear and culture in only 2 cases and by culture only in 24. In the majority of reactivations only a small number of colonies were isolated on culture and no deterioration on the X-ray was seen. In the discharge group, 917 persons reported to the C.B.s because of pulmonary symptoms; 12 reactivations were found during the 3 years: 10 of the patients had received previous chemotherapy. Only 2 patients were positive at microscopy and in the majority of culture-positive cases a small number of colonies were isolated; 5 of the 9 patients with pulmonary tuberculosis showed deterioration in the X-ray appearance. At the final re-examination in the fourth year, similar numbers of cases were found in the Check-up group (14) and Discharge group (15). However, there were less smear-positive cases in the Check-up group and less cases with X-ray deterioration. There were 69 confirmed reactivations in all. The annual rate of reactivation was 1.6 per 1000 in the Check-up group and 1.1 per 1000 in the Discharge group. It is suggested that routine annual check-ups of patients with inactive tuberculosis or fibrotic lesions should be discontinued.

Adolescent↗
PubMed2006

Rhenium-mediated coupling of acetonitrile and pyrazoles. New molecular clefts for anion binding.

The reaction of fac-[ReBr(CO)3(NCMe)2] (1) with either pyrazole (Hpz) or 3,5-dimethylpyrazole (Hdmpz) in a 1:2 Re/pyrazole ratio affords the known complexes fac-[ReBr(CO)3(Hpz)2] (2) and [ReBr(CO)3(Hdmpz)2] (3). Using a 1:1 ratio, MeCN as solvent, and longer reaction times led to a mixture in which the major components are the pyrazolylamidino complexes fac-[ReBr(CO)3(HN=C(CH3)pz-kappa2N,N)] (4) and fac-[ReBr(CO)3(HN=C(CH3)dmpz-kappa2N,N)] (5). The complexes fac-[ReBr(CO)3(Hpz)(NCMe)] (6) and fac-[ReBr(CO)3(Hdmpz)(NCMe)] (7) (along with 2 and 3) were found to be minor components of these reactions. Analogous reactions of fac-[Re(OClO3)(CO)3(NCMe)2] yielded fac-[Re(NCCH3)(CO)3(HN=C(CH3)pz-kappa2N,N)]ClO4 (8), fac-[Re(NCCH3)(CO)3(HN=C(CH3)dmpz-kappa2N,N)]ClO4 (9), fac-[Re(Hpz)(CO)3(HN=C(CH3)pz-kappa2N,N)]ClO4 (10), and fac-[Re(Hdmpz)(CO)3(HN=C(CH3)dmpz-kappa2N,N)]ClO4 (11). The X-ray structure of 11 showed the perchlorate anion to be hydrogen-bonded by the N-H groups of the pyrazole and pyrazolylamidino ligands. The behavior of the compound fac-[Re(Hdmpz)(CO)3(HN=C(CH3)dmpz-kappa2N,N)]BAr'4 (13) (synthesized by reaction of [ReBr(CO)3(Hdmpz)2] (3) with (i) AgOTf and (ii) NaBAr'(4)/MeCN) as an anion receptor has been studied in CD3CN solution. In addition, the structure of the supramolecular adduct fac-[Re(CO)3(Hdmpz)(HN=C(CH3)dmpz-kappa2N,N)].Cl (14), featuring chloride binding by the two N-H groups, was determined by X-ray diffraction.

Journal Article↗
PubMed1996

Syn-Anti Isomerism in a Mixed-Ligand Oxorhenium Complex, ReO[SN(R)S][S].

The simultaneous action of the tridentate ligand (C(2)H(5))(2)NCH(2)CH(2)N(CH(2)CH(2)SH)(2) and the monodentate coligand HSC(6)H(4)OCH(3) on a suitable ReO(3+) precursor results in a mixture of syn- and anti-oxorhenium complexes, ReO[(C(2)H(5))(2)NCH(2)CH(2)N(CH(2)CH(2)S)(2)] [SC(6)H(4)OCH(3)], in a ratio of 25/1. The complexes are prepared by a ligand exchange reaction using ReO(eg)(2) (eg = ethylene glycol), ReOCl(3)(PPh(3))(2), or Re(V)-citrate as precursor. Both complexes have been characterized by elemental analysis, FT-IR, UV-vis, X-ray crystallography, and NMR spectroscopy. The syn isomer C(17)H(29)N(2)O(2)S(3)Re crystallizes in the monoclinic space group P2(1)/n, a = 14.109(4) Å, b = 7.518(2) Å, c = 20.900(5) Å, beta = 103.07(1) degrees, V = 2159.4(9) Å(3), Z = 4. The anti isomer C(17)H(29)N(2)O(2)S(3)Re crystallizes in P2(1)/n, a = 9.3850(7) Å, b = 27.979(2) Å, c = 8.3648(6) Å, beta = 99.86(1) degrees, V = 2163.9(3) Å(3), Z = 4. Complete NMR studies show that the orientation of the N substituent chain with respect to the Re=O core greatly influences the observed chemical shifts. Complexes were also prepared at the tracer ((186)Re) level by using (186)Re-citrate as precursor. Corroboration of the structure at tracer level was achieved by comparative HPLC studies.

Journal Article↗
PubMedDate not supplied

Chemical and biological characterization of technetium(I) and Rhenium(I) tricarbonyl complexes with dithioether ligands serving as linkers for coupling the Tc(CO)(3) and Re(CO)(3) moieties to biologically active molecules.

The organometallic precursor (NEt(4))(2)[ReBr(3)(CO)(3)] was reacted with bidendate dithioethers (L) of the general formula H(3)C-S-CH(2)CH(2)-S-R (R = -CH(2)CH(2)COOH, CH(2)-C&tbd1;CH) and R'-S-CH(2)CH(2)-S-R' (R' = CH(3)CH(2)-, CH(3)CH(2)-OH, and CH(2)COOH) in methanol to form stable rhenium(I) tricarbonyl complexes of the general composition [ReBr(CO)(3)L]. Under these conditions, the functional groups do not participate in the coordination. As a prototypic representative of this type of Re compounds, the propargylic group bearing complex [ReBr(CO(3))(H(3)C-S-CH(2)CH(2)-S-CH(2)C&tbd1;CH)] Re2 was studied by X-ray diffraction analysis. Its molecular structure exhibits a slightly distorted octahedron with facial coordination of the carbonyl ligands. The potentially tetradentate ligand HO-CH(2)CH(2)-S-CH(2)CH(2)-S-CH(2)CH(2)-OH was reacted with the trinitrato precursor [Re(NO(3))(3)(CO)(3)](2-) to yield a cationic complex [Re(CO)(3)(HO-CH(2)CH(2)-S-CH(2)CH(2)-S-CH(2)CH(2)-OH)]NO(3) Re8 which shows the coordination of one hydroxy group. Re8 has been characterized by correct elemental analysis, infrared spectroscopy, capillary electrophoresis, and X-ray diffraction analysis. Ligand exchange reaction of the carboxylic group bearing ligands H(3)C-S-CH(2)CH(2)-S-CH(2)CH(2)-COOH and HOOC-CH(2)-S-CH(2)CH(2)-S-CH(2)-COOH with (NEt(4))(2)[ReBr(3)(CO)(3)] in water and with equimolar amounts of NaOH led to complexes in which the bromide is replaced by the carboxylic group. The X-ray structure analysis of the complex [Re(CO)(3)(OOC-CH(2)-S-CH(2)CH(2)-S-CH(2)-COOH)] Re6 shows the second carboxylic group noncoordinated offering an ideal site for functionalization or coupling a biomolecule. The no-carrier-added preparation of the analogous (99m)Tc(I) carbonyl thioether complexes could be performed using the precursor fac-[(99m)Tc(H(2)O)(3)(CO)(3)](+), with yields up to 90%. The behavior of the chlorine containing (99m)Tc complex [(99m)TcCl(CO)(3)(CH(3)CH(2)-S-CH(2)CH(2)-S-CH(2)CH(3))] Tc1 in aqueous solution at physiological pH value was investigated. In saline, the chromatographically separated compound was stable for at least 120 min. However, in chloride-free aqueous solution, a water-coordinated cationic species Tc1a of the proposed composition [(99m)Tc(H(2)O)(CO)(3)(CH(3)CH(2)-S-CH(2)CH(2)-S-CH(2)CH(3))](+) occurred. The cationic charge of the conversion product was confirmed by capillary electrophoresis. By the introduction of a carboxylic group into the thioether ligand as a third donor group, the conversion could be suppressed and thus the neutrality of the complex preserved. Biodistribution studies in the rat demonstrated for the neutral complexes [(99m)TcCl(CO)(3)(CH(3)CH(2)-S-CH(2)CH(2)-S-CH(2)CH(3))] Tc1 and [(99m)TcCl(CO)(3)(CH(2)-S-CH(2)CH(2)-S-CH(2)-C&tbd1;CH)] Tc2 a significant initial brain uptake (1.03 +/- 0.25% and 0.78 +/- 0.08% ID/organ at 5 min. p.i.). Challenge experiments with glutathione clearly indicated that no transchelation reaction occurs in vivo.

Animals↗
PubMed2000

[Management of pulmonary tuberculosis patients complicated with diabetes mellitus before diagnosis as pulmonary tuberculosis and feasibility of chemoprophylaxis].

We studied whether diabetics who are one of the high risk groups of developing pulmonary tuberculosis had undergone chest X-ray examination periodically. The feasibility of chemoprophylaxis in diabetics was also studied by investigating whether fibrotic lesions of tuberculosis can be found on previous chest X-ray films of these patients. Of the pulmonary tuberculosis patients admitted to our hospital for treatment, 78 patients complicated with diabetes mellitus were enrolled in this study. As to the mode of detection, the majority, 63 cases, are discovered, by undergoing medical examination because of respiratory symptoms, followed by 8 patients in whom pulmonary tuberculosis was found by health examination and only 1 patient was found by the periodic observation of diabetes mellitus. Of the 57 patients receiving the original treatment for pulmonary tuberculosis preceded by the discovery of diabetes mellitus, only 15 (26%) had undergone chest X-ray examination periodically. This fact shows that physicians treating diabetes mellitus have only a little concern on tuberculosis, thus the re-training of physicians dealing with diabetics on tuberculosis is considered to be necessary. According to chest X-ray films of 21 patients who had undergone chest X-ray examination and in whom the previous films were available, there were 6 patients without any lesion of pulmonary tuberculosis, 8 patients with fibrotic lesions and 7 patients with active lesions. The 8 patients showing fibrotic lesions have developed pulmonary tuberculosis on the average 15 years after they were diagnosed with diabetes mellitus, and the fact suggests that the prevention of the development of pulmonary tuberculosis among diabetics could be possible by chemoprophylaxis.

Chemoprevention↗
PubMed2000

Chiari type I malformation and postoperative respiratory failure.

PURPOSE: To present a case of respiratory failure following suboccipital craniectomy for Chiari type I malformation. CLINICAL FEATURES: A 22-yr-old man presented with a two year history of symptoms and signs suggestive of brainstem compression at the level of the foramen magnum. This was confirmed with magnetic resonance imaging. The procedure of suboccipital craniectomy, upper cervical laminectomy and fourth ventricle exploration was performed. Three hours postoperatively the patient experienced episodes of apnea and subsequently became drowsy. Blood gas analysis revealed hypercapnic respiratory failure. Chest X-ray revealed evidence of pulmonary aspiration. The trachea was re-intubated and the lungs ventilated in intensive care for 72 hr. He was discharged home two weeks postoperatively. CONCLUSION: Chiari type I malformation is associated with a number of associated anomalies. These patients are at considerable risk of respiratory depression and bulbar dysfunction in the perioperative period. The anesthetic issues are reviewed and discussed.

Adult↗
PubMed2005

The antenna system of photosystem II from Thermosynechococcus elongatus at 3.2 A resolution.

The content and type of cofactors harboured in the Photosystem II core complex (PS IIcc) of the cyanobacterium Thermosynechococcus elongatus has been determined by biochemical and spectroscopic methods. 17 +/- 1 chlorophyll a per pheophytin a and 0.25 beta-carotene per chlorophyll a have been found in re-dissolved crystals of dimeric PS IIcc. The X-ray crystal structure of PS IIcc from Thermosynechococcus elongatus at 3.2 A resolution clearly shows chlorophyll a molecules arranged in two layers close to the cytoplasmic and lumenal sides of the thylakoid membrane. Each of the cytoplasmic layers contains 9 chlorophyll a, whose positions and orientations are related by a local twofold rotation pseudo-C2 axis passing through the non-haem Fe2+. These chlorophyll a are arranged comparably to those in the antenna domains of PsaA and PsaB of cyanobacterial Photosystem I affirming an evolutionary relation. The chlorophyll a in the lumenal layer are less well conserved between Photosystems I and II and even between CP43 and CP47 with 4 chlorophyll a in the former and 7 in the latter.

Chromatography, High Pressure Liquid↗
PubMed1984

Putative polypeptide transfer from male to female Schistosoma mansoni.

Mature males and females, and unisexual females of Schistosoma mansoni were incubated in medium containing [14C]leucine. By use of polyacrylamide gel electrophoresis and fluorography no differences were detected in their ability to synthesize polypeptides. Male worms thus labelled were paired for various periods with unlabelled mature or unisexual females both in vitro and by surgical implantation into hamsters. Female worms paired in vitro had two controls: an accompanying female that did not pair and an additional female placed in the conditioned medium after removal of the other worms. After separation and washing, only small amounts of label were found in females by liquid scintillation counting despite the release by males of substantial amounts of label into the medium. No label was detected in fluorograms of polyacrylamide electrophoresis gels of re-paired females after 7 days' exposure to X-ray film, but a faint pattern of normal polypeptides above 50 kDa did develop after 6 weeks. In light microscope autoradiographs a low grain count was found over sections of unlabelled females paired with labelled males but this was no greater than that over females incubated in medium that had formerly held males. We have been unable to detect any polypeptide reported to be synthesized exclusively by male worms and transferred in large amounts to females. Although female worms did take up small amounts of male-derived metabolic products, the transfer of a specific polypeptide of 66 kDa in significant quantities did not take place under the conditions investigated.

Animals↗
PubMedDate not supplied

[Neoadjuvant chemotherapy MVAC in the treatment of infiltrating bladder carcinoma].

INTRODUCTION: Aiming to preserve the bladder in patients with infiltrative carcinoma of the bladder and to offer patients improved quality of life with no detriment for survival, a therapeutical protocol was set up. MATERIAL AND METHODS: Between August 1988 and January 1997 63 patients with stage T2 and T3a infiltrative carcinoma of the bladder, with no metastasis or node extension detectable with imaging techniques were treated in our unit. 45 of these patients met all protocol criteria and were given 3 neoadjuvant chemotherapy courses with MVAC (methotrexate, vincristine, adriamycin, cisplatin). INCLUSION CRITERIA: age under 75 years, Karnofsky greater than 50%, leucocytes greater than 2,500 cell/mL and platelet greater than 100,000/mL. Following chemotherapy, re-assessment was performed through lab tests, chest X-rays, abdomino-pelvic CT, bone scanning, cystoscopy, multiple randomized biopsies, tumoral bed scar resection and resection of relapsed urothelioma. Patients with complete remission were given radiotherapy. Those showing stabilisation of progression were proposed to undergo cystectomy. Fisher's test or chi 2 test were used for the comparison of qualitative variables. The survival analysis was performed using the Kaplan-Meier method. The curves comparison was done with Breslow's exact test. A Cox's proportional risk method allowed to calculate the relative risks together with their 95% confidence interval. RESULTS: 53.7% patients included in this protocol showed complete remission, 41.5% stable disease and 4.9% progression. 62.2% of patients were given radiotherapy versus 17.8% who underwent cystectomy. 20% received other therapies after rejecting both cystectomy or radiotherapy. Median follow-up was 43.38 months. Overall median survival was 96 months. The accumulate probability of survival at 4 years was 79%. 50% patients with complete clinical response relapsed during follow-up. Tumoral stage of those who relapsed was lower than the initial one in 63.7% cases, remained the same in 18.2%, and higher in 18.2%. With regards to grading, 66.7% patients had lower grading at relapse if tumour was initially grade 2. For those with initial tumour grade 3, only 20% had a lower grade. CONCLUSION: 64.4% patients retained their bladder. In 26.7% there was demonstrable metastatic disease. No differences were seen in the distribution or survival time based on the different treatment given after chemotherapy (p = 0.22). Patients with complete remission after chemotherapy have greater actuarial survival which is statistically significant (p = 0.04).

Aged↗
PubMed1997

Intermediate filament structure: hard alpha-keratin.

Structurally there are four classes of intermediate filaments (IF) with distinct but closely related axial organisations. One of these, hard alpha-keratin IF, has been studied to clarify several apparently exceptional features which include the number of molecules in the IF cross-section and the mode by which the axial organisation of its constituent molecules is stabilised. Using the dark-field mode of the STEM at the Brookhaven National Laboratory (USA) mass measurements were obtained from unstained IF isolated from hair keratin. The data thus obtained show that the number of chains in cross-section is about 30 (+/-3: standard deviation) and is very similar to the numbers determined in previous STEM experiments for the dominant filament type in other classes of IF (about 32). Furthermore, re-analysis of the low-angle equatorial X-ray diffraction pattern reveals, in contrast to earlier work, solutions that are compatible with the number of chains in cross-section indicated by the STEM data. The absence of the head-to-tail overlap between parallel molecules characteristic of most of IF may be compensated in hard alpha-keratin by a network of intermolecular disulfide bonds. It is concluded that native IF of hard alpha-keratin and desmin/vimentin--and probably many other kinds of IF as well--contain about 32 chains in cross-section, and that the axial structures of these various kinds of IF differ in small but significant ways, while generally observing the same basic modes of aggregation.

Animals↗
PubMed2006

A Re(CO)5 fragment bonded to a polyhedral oligomeric hydroxysilsesquioxane as a model which gives further evidence to the existence of an unexpected Re(CO)5 surface species.

Reaction of Re(CO)5O3SCF3 with (c-C6H11)7Si8O12O-Li+ at 273 K under a CO atmosphere affords the [Re(CO)5OR] (R = (c-C6H11)7Si8O12) derivative (1). 1 is the first example of a rhenium pentacarbonyl bearing an OR ligand (R = alkyl, aryl, or silyl) stable enough to be characterized, and it represents also the first molecular model of the surface [Re(CO)5OSi] species formed by reductive carbonylation of silica-supported [Re(CO)3OH]4. At room temperature, 1 loses one carbonyl ligand and dimerizes to afford {Re(CO)4[(mu-O)O12Si8(c-C6H11)7]}2 (2), which has been characterized by X-ray diffraction and is the first reported example of a rhenium tetracarbonyl mu-oxo-bridged dimer of the type [Re(CO)4(mu-OR)]2.

Journal Article↗
PubMed1999

Trichodinid ectoparasites (Ciliophora: Peritrichida) from the gills of cultured marine fishes in China, with the description of Trichodinella lomi n. sp.

Three species of cultured percoids, each heavily infested by trichodinid ectoparasites, were examined from over-wintering pools in Qingdao, China during the winter of 1995. A total of five species of trichodinids belonging to three genera, Trichodinella Sramek-Husek, 1953, Dipartiella Shtein, 1961 and Trichodina Ehrenberg, 1838 were recorded. One new species, Trichodinella lomi n. sp., is described, the denticle of which is characterised by its acutely triangular blade, comma-like central part and inconspicuous ray. The morphology of Trichodina murmanica Poljansky, 1955 was re-investigated. Three other little-known species are redescribed: Dipartiella simplex (Raabe, 1959) Shtein, 1961, Trichodina japonica Imai, Miyazaki & Nomura, 1991 and T. domerguei (Wallengren, 1897).

Animals↗
PubMed2000

Towards a unified description of the AMOB2O5 (A=K, Rb, Cs, Tl; M=Nb, Ta) family of compounds.

Single-crystal X-ray diffraction data (Mo Kalpha radiation) are used to re-refine the structure of RbNbOB2O5, rubidium niobium oxo pyroborate. The structure is refined as an incommensurate modulated structure with superspace group symmetry Pmn2(1)(0,0.4,0)s and lattice parameters a = 7.406 (2), b = 3.939 (2) and c = 9.475 (2) A. Refinement on 3242 unique reflections converged to R = 0.031, while a previous conventional superstructure refinement led to R = 0.090. This lowering of the R factor goes hand-in-hand with a substantial reduction in the number of refined parameters. The refinement strongly suggests that the structure is effectively incommensurately modulated, despite an apparently rational magnitude of the primary modulation wave-vector and overlap of satellite reflections.

Journal Article↗
PubMed1996

Stereospecificity for the hydrogen transfer and molecular evolution of pyridoxal enzymes.

We here describe the stereochemical aspects of the reactions of pyridoxal 5'-phosphate (PLP)-dependent enzymes, and the relationship between the stereochemistry of the enzyme reaction and molecular evolution of the enzyme. The reactions of PLP-dependent enzymes proceed through the formation of an anionic Schiff base intermediate between the substrate and the coenzyme. Three stereochemical possibilities exist for the formation and cleavage of bonds in the intermediate: the reaction occurs stereospecifically on either the si- or the re-face of the planar intermediate, or alternatively, non-stereospecifically on both faces. The stereospecificities for hydrogen transfer between C-4' of the cofactor and substrate in the transamination catalyzed by various PLP-dependent enzymes have been studied. The stereospecificities reflect the active-site structures of the enzymes, especially the topographical situation of a coenzyme-substrate Schiff base and a catalytic base for the hydrogen transfer. The aminotransferases and other PLP-enzymes catalyzing the transamination as a side-reaction so far studied catalyze only the si-face specific hydrogen transfer. This suggests that these PLP enzymes have similar active-site structures and are evolved divergently from a common ancestral protein. We recently established a new method for the identification of stereospecificity for the hydrogen transfer, and found that D-amino acid aminotransferase and branched chain L-amino acid aminotransferase, which have significant sequence similarity to each other, catalyze the re-face hydrogen transfer on the intermediate. The X-ray crystallographic studies of D-amino acid aminotransferase showed that the relative arrangement of the catalytic base of the enzyme active center to the C4' of the bound cofactor is opposite to that of other aminotransferases catalyzing the si-face hydrogen transfer. The folding of D-amino acid aminotransferase is also different from those of the other aminotransferase so far studied. Therefore, the classifications of the aminotransferases based on their primary structures, three dimensional structures, and stereochemistry of their hydrogen transfer coincide with one another. We also found that PLP-dependent amino acid racemases, the primary structures of which are similar to none of the other PLP-enzymes, catalyze the non-stereospecific hydrogen transfer on both faces of the planar intermediate. Stereospecificities for the hydrogen transfer suggest convergent evolution of the PLP-dependent enzymes. The stereochemical aspects of the enzyme reactions give a clue to the molecular evolution of the enzymes as well as the primary structures and three-dimensional structures of the enzymes.

Amino Acids↗
PubMed1991

The Needle Catheter Jejunostomy: a useful and cost-effective adjunct in bariatric surgery.

The safety and efficacy of the needle catheter jejunostomy (NCJJ) is evaluated in 200 consecutive, prospectively studied gastric bypass procedure patients with a follow-up of 6 months to 9.5 years. The NCJJ was used in place of intravenous fluid administration from the first postoperative day to supplement oral fluids for 6 weeks postoperatively and for complete temporary supplementation in 16 patients with viral illness or pouch outlet obstruction, thus avoiding re-hospitalization for rehydration. We did not use X-ray confirmation of the catheter placement. Analysis revealed no major complications with no catheter dislodgment, associated intra-abdominal sepsis or late bowel obstruction. There were 24 (12%) subcutaneous infections, only four (2%) of which required minor incisions and drainage under local anesthesia. Risk factors for the infections were insulin-dependent diabetes mellitus and the actual withdrawal of the NCJJ (50% of the infections occurred at this time). The NCJJ has been a safe, useful and cost-effective adjunct in the operative management of the morbidly obese patient.

Journal Article↗
PubMed2005

[Case of gastric perforation after TAI (trancatheter arterial infusion) of SMANCS with special reference to accessory left gastric artery].

In 1993, a 55-year-old-man was diagnosed with chronic active hepatitis (HCV). In January 1999, a solitary hepatocellular carcinoma (HCC) was discovered in his liver S8, and a sub-segmental hepatectomy was performed. In July 1999, multiple recurrences in the liver were noticed, and on August 6, 1999, the first SMANCS-TAE was performed. After that, PEIT was added, and then on July 18, 2000 and November 9, 2000, a second and third SMANCS-TAE were carried out, respectively. This time multiple HCCs in the bilateral lobes were discovered, and the 4 th SMANCS-TAE was undergone on April 12, 2001. On a celiac angiogram, the right hepatic artery was shown to have been obliterated by the last TAE. In addition, accessory left gastric artery (accessory LGA) originating in the left hepatic artery (LHA) proximal to the umbilical point (UP) could be seen. So we advanced a microcatheter to the LHA distal to the accessory LGA and injected SMANCS (0.8 mg) into the left hepatic artery. On April 24, he was admitted to hospital by ambulance due to severe upper abdominal pain. The muscular defense was noticed, and an air pocket under the diaphragm was indicated on an X-ray. An emergency total gastrectomy and R-Y re-construction were performed under the diagnosis of gastric perforation. A hole of approximately 10 cm in diameter was found in the anterior wall between the cardia and the upper body, and the accessory left gastric artery (LGA) was obliterated. The principal known side effects of SMANCS are fever, nausea and vomiting. However, as far as this writer has investigated, gastric perforation has never been reported. SMANCS presumably can flow into the stomach wall through the accessory LGA, triggering necrosis of the gastric wall due to circulatory damage. Although arterial infusion of SMANCS is an effective treatment, it causes considerable vascular damage, so intensive follow-up treatment is necessary.

Antineoplastic Agents↗
PubMed1991

[A case of intrathoracic multiple schwannoma].

A case of intrathoracic multiple schwannoma originating in the left sympathetic nerve was reported. A 38-year-old male was admitted to our department for re-evaluation of his nephrotic syndrome, the chest X-ray revealed an abnormal shadow. A chest tomogram and a chest computed tomogram revealed multiple masses along the left 10th thoracic vertebra. The operation was done on September 4, 1989 under the diagnosis of posterior mediastinal tumor. At thoracotomy, four tumors were seen along the 10th thoracic vertebra and the sympathetic nerve was ascertained to be connected. Histologically, the tumors were composed of spindle cells arranged in scattered palisading fashion, and diagnosed as schwannoma. Multiple schwannomas are very rare. There have been only 12 cases of intrathoracic multiple schwannoma in Japan. Available Japanese literature on the subject was reviewed and discussed.

Adult↗