[Celiac and superior mesenteric arteriography].
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Celiac Artery↗
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Transfusion-associated graft-versus-host disease in immunocompetent patient: early diagnosis and therapy.
We report a case of transfusion-associated graft-versus-host disease in a previously healthy, 68-year-old Japanese man following an emergency surgery for an acute aortic dissection. We confirmed the chimerism of lymphocytes and the effect of drug therapy using DNA polymorphism analysis. This method is a sensitive, convenient, and rapid method that it is also useful for the evaluation of therapy. And the combination therapy with methylprednisolone, cyclosporine, and 15-deoxyspergualin may be effective in treating transfusion-associated GVHD.
Aged↗
Nizatidine accelerates gastric emptying of a solid meal in rats.
Nizatidine, a new histamine-2-receptor antagonist, stimulates gastrointestinal motility in dogs and gastric emptying of liquids in rats. Effect of nizatidine on gastric emptying of a solid meal was investigated using a novel gastric emptying model in rats. Male Wistar rats (weighing 200-300 g) were supplied with powdered food containing 30 w/w% barium 14 hr before the beginning of the experiment and x-ray photography of rat stomach was taken under light ether anesthesia. Gastric emptying was assessed by percentage of a decrease in area 30 min after drug was injected intraperitoneally. There was a positive correlation between the area of the gastric outline and the weight of the gastric contents (r = 0.94, P < 0.01). Ether anesthesia itself did not affect gastric emptying. Nizatidine increased gastric emptying dose-dependently (emptied percentage; vehicle: 4.9 +/- 1.5%, 1 mg/kg: 7.2 +/- 0.4%, 3 mg/kg: 10.4 +/- 2.0%, 10 mg/kg: 16.7 +/- 4.9%, 30 mg/kg: 25.7 +/- 7.4%). N-Desmethyl nizatidine (NDM) also stimulated gastric emptying, but nizatidine S-oxide, cimetidine, an famotidine had no significant effects on gastric emptying. Nizatidine and neostigmine, but not NDM, at a subthreshold dose accelerated gastric emptying treated with a low dose of acetylcholine (0.1 mg/kg). Atropine (2 mg/kg, -30 min) did not modulate the gastroprokinetic action of nizatidine, but blocked that of NDM. These findings suggest that this noninvasive method may allow measurement of gastric emptying of solids accurately and that nizatidine and NDM facilitate gastric emptying probably mediated by a direct and/or an indirect (acetylcholinesterase inhibition) cholinergic mechanism.
Acetylcholine↗
Estimation of regional lung function in interstitial pulmonary disease using 99mTc-technegas and 99mTc-macroaggregated albumin single-photon emission tomography.
For quantitative evaluation of the regional lung function in patients with interstitial pulmonary disease (IP) in the sitting position, 99mTc-Technegas and 99mTc-macroaggregated albumin (MAA) single-photon emission tomography (SPET) studies were performed in 12 healthy controls (HC) and 42 IP patients. Four transverse images were prepared from the data obtained and designated as slices no. 1-4 from the top downward. Regions of interest (ROIs) were determined in the anterior and posterior parts of the lung in each slice, and the ratio of the count per voxel in the ROIs to the count in the entire lung was calculated as the regional Technegas index (T). The regional perfusion index (Q) was calculated by a similar procedure using the data of 99mTc-MAA SPET. The ratios between T and Q (T/Q) in the anterior and posterior regions of the lung, and the ratios of T and Q between the anterior and posterior regions of the lung (Tp/Ta and Qp/Qa) were examined. In the HC group, T/Q decreased but Tp/Ta and Qp/Qa increased from the upper to the lower lung fields. When IP patients were classified into (I) those in whom T/Q decreased from the upper to the lower lung fields, (II) those in whom it was similar in all slices, (III) those in whom it increased from slice 3 to slice 4, and (IV) those in whom it increased from slice 2 to slices 3 and 4, this classification was more closely correlated with %VC than with %DLCO or PaO2. When the patients were classified according to Tp/Ta and Qp/Qa into (A) those in whom the values were greater in the lower than the upper lung field, (B) those in whom the values were similar in all slices, and (C) those in whom the values were smaller in lower than in upper lung fields, categories B and C were observed frequently even in patients whose %VC was in the normal range. This method is considered to be an effective means to evaluate the progression and pathology of IP and to detect early impairment of lung function.
Adult↗
A radioimmunoassay for pancreatic elastase 1: use of alpha 1-antitrypsin-elastase 1 conjugate as both standard and tracer to eliminate the influence of anti-elastase 1 autoantibodies.
We have recently reported the occurrence of anti-elastase 1 autoantibodies in human sera (Asada et al., Biochim Biophys Acta, 1991;1080:34-39). The usual radioimmunoassay of elastase 1 in autoantibody-positive sera gave abnormally high levels of elastase 1 and low recoveries of elastase 1 added to the sera. Now we have established a new radioimmunoassay system for determining pancreatic elastase 1 in serum, in which alpha 1-antitrypsin elastase 1 conjugate, the major conjugation form of elastase 1 in serum, is used as standard and alpha 1-antitrypsin-[125I]elastase 1 as tracer, because we found that the conjugate could bind to the elastase 1 specific antiserum but not to the autoantibodies. Thus the new assay system completely eliminate the unfavorable effects of the autoantibodies. The elastase 1 levels determined by the new assay method exhibited a good correlation with those obtained by a commercial assay kit in the autoantibody-negative sera, while no correlation was observed in the autoantibody-positive sera.
Acute Disease↗
Right upper lobe versus right middle lobe: differentiation with thin-section, high-resolution CT.
A new method was developed to differentiate the upper lobe from the middle lobe of the right lung with thin-section, high-resolution computed tomography. In the upper lobe, a medial subsegmental bronchus of an anterior segmental bronchus is always located lateral to the corresponding artery. In the middle lobe, a medial subsegmental bronchus of a lateral segmental bronchus and a superior and inferior subsegmental bronchus of a medial segmental bronchus are always located medial to the corresponding artery. In other words, the anatomic relationship between the subsegmental bronchi and the corresponding pulmonary arteries in the upper lobe is opposite to that in the middle lobe. One hundred seventeen cases, including 54 cases of lobar volume loss, were reviewed with this method, and in each case it was possible to differentiate the upper lobe from the middle lobe without the contiguous section analysis.
Adult↗
Assay of photoinhibition of photosystem II and protease activity.
Under light-stress conditions, the photosystem (PS)II reaction center D1 protein is photo-damaged. The damage to the D1 protein is induced by singlet oxygen molecules and endogenous free radicals generated by the photochemical reactions of PSII. To maintain PSII activity, the oxidatively damaged D1 protein is replaced by a newly synthesized protein. Thus, degradation and removal of the photodamaged D1 protein in PSII are essential steps for maintaining the viability of PSII. In the present chapter, we describe the method to induce photoinhibition of PSII both in vitro and in vivo, and also the method to assay the processes closely related to the photoinhibition, including degradation of the damaged D1 protein and its crosslinking with the neighboring polypeptides. The method to analyze the protease activity in the stroma that recognizes and digests the crosslinked products of the D1 protein generated by the light stress is also described.
Endopeptidases↗
[A case of huge renal angiomyolipoma calculated doubling time].
A 32-year-old man was admitted with a sudden onset of severe left flank pain. The abdominal and MRI showed bilateral renal tumors with left perirenal hematoma. Selective right renal biopsy under the guidance of ultrasonography revealed that right renal tumor was angiomyolipoma (AML). After performing left renal embolization of the left renal artery, left was performed. The histology of the excised specimen was also AML. This patient had visited to the other clinics in 1985 and in 1988, and was examined by CT. Accordingly, doubling time of this tumor was calculated by ellipsoid method. Doubling time in 1985-1988 was days, and that in 1988-1995 was 675 days. Growth change of left renal AML did not show curve.
Adult↗
Twinning rate in spontaneous abortions.
An unselected series of spontaneous abortions and their mothers were karyotyped with Q-bands to obtain a frequency of twin conceptions lost during the first trimester. Among 661 spontaneous abortions, 15 twin pairs were identified including two sets of conjoined twins. Analysis of Q-band variants permitted the exclusion of cases with two cell lines that could be attributed to maternal contamination or mosaicism. The twinning rate among spontaneous abortions was 1/44 compared with 1/103 live births and stillbirths in the Ontario population. If Weinberg's differential method is applied to these data, the frequency would be as high as 1/30 under the assumption that the incidence of monozygotic twins among abortions is the same as that for live births.
Abortion, Spontaneous↗
[Intra-arterial infusion through 2 routes in liver (primary and metastatic cancer].
Patients with unresectable liver cancer (primary and metastatic) were treated with a newly-devised arterial infusion chemotherapy using Cis-DDP and its antidote Sodium thiosulfate (STS). The patients consisted of 4 with primary hepatoma and 1 with metastatic liver cancer originated from intestinal cancer. For the purpose of reducing unfavourable side effects without changing anticancer effect, Cis-DDP was infused into hepatic artery through the catheter while STS being administered systemically. According to Koyama and Saito's criteria, 2 of 5 patients showed partial response (PR) and the others showed no change (NC). The median survival time after onset of therapy was 6.6 months ranging from 2 to 11 months in all the patients. The myelosuppression and renal toxicity, which were considered to be the most serious side effects of Cis-DDP, were not found and liver function was not affected in all the patients. However, all the patients complained of nausea and vomiting. Thus, our experience has indicated that this newly devised infusion chemotherapy is a promising method for treating unresectable liver cancer, although further efforts are necessary for reducing the gastrointestinal toxicity.
Adult↗
[Drug distribution of pelvic intraarterial infusion chemotherapy by bilateral internal iliac arterial catheter placement with coil occlusion of superior, inferior gluteal and obturator arteries].
The anticancer drug distribution in pelvic arterial infusion chemotherapy with bilateral internal iliac arterial catheter placement with coil occlusion of the superior, inferior and obturator arteries was indirectly evaluated by serially performed DSA, CTA and RI on 18 patients with pelvic malignancies. The distribution was judged to be Excellent (E), defined as uniform distribution in the entire lesion alone, in 9 of 18 patients (50%) evaluated prior to the start of the arterial infusion (AI), and as Good (G), defined as uniform distribution in the entire lesion and partly on an unaffected portion, in 9 (50%). Of the 11 patients evaluated after 7 times AI, E was found in 3 patients (27%), G in 7 (64%) and Fair (F), defined as distribution with a defect in the lesion, in one patient (9%). Of the 11 patients evaluated after 14 AI, E was found in 5 (45%), G in 4 (36%) and F in 2 (18%). Of the 7 patients evaluated after 21 AI, E was found in 2 (29%), G in 4 (57%) and F in one (14%). G was found in 2 of 2 patients (100%) evaluated after 28 AI. These results suggest that this method can maintain a favorable anticancer drug distribution even after multiple sessions of AI.
Adult↗
Intravascular ultrasound-guided direct intrahepatic portacaval shunt: description of technique and technical refinements.
PURPOSE: This is a prospective study designed to demonstrate the safety and feasibility of creating a direct inferior vena cava (IVC)-to-portal vein shunt with use of a new type of intravascular ultrasound (IVUS) to guide the puncture and completing the shunt with the use of a polytetrafluoroethylene (PTFE)-covered stent graft. MATERIALS AND METHODS: IVC-to-portal vein shunts were created in 31 sequential patients for ascites (n = 31) or bleeding (n = 8). Transfemorally placed IVUS transducers were positioned in the IVC to guide the puncture from the IVC to the portal vein, which was performed from a transjugular approach with a modified Rosch-Uchida liver access set. A 9-MHz axial imaging IVUS system was used for the first 11 patients, and a variable 5-10-MHz sagittal IVUS imaging system was used for the next 20 patients. The shunts were completed with the use of single (n = 11) or overlapping (n = 20) PTFE-covered Palmaz stent-grafts, deployed primarily at a diameter of 8 mm. Patients were followed clinically and with US, venography, and inspection at liver transplantation to establish 30-day patency rates. RESULTS: All direct intrahepatic portacaval shunts (DIPSs) were created successfully. Both IVUS systems were able to adequately guide the portal vein puncture. Resolution and operator confidence were subjectively superior with the sagittal IVUS imaging system compared to the axial IVUS system. Two extrahepatic portal vein punctures occurred during the procedures. Both were controlled by the placement of sheaths and subsequent placement of stent-grafts. Both patients remained asymptomatic, although one required transfusion of blood products. The mean portosystemic gradient was reduced from 24 mm Hg before DIPS creation to 10 mm after DIPS creation. Embolization of varices was also performed in eight patients with history of recent gastrointestinal bleeding. Two patients died in the first week of acute liver failure. Two patients with hepatocellular carcinoma refused further follow-up. Of the 27 remaining patients, patency was demonstrated in all DIPS at 30 days by US, venography, or direct inspection at liver transplantation. CONCLUSIONS: IVUS-guided direct IVC-to-portal vein shunts may be created successfully with minimal complications. The use of a stent-graft is recommended for this procedure. Modifications of current technique and IVUS systems are described.
Adult↗
Treatments of non-parasitic giant hepatic cysts.
This retrospective study presents the results of surgical treatments for large cyst of the liver over 10 cm in diameter in 9 patients diagnosed and treated at Kurume University Hospital. There were 8 women and 1 man, with an average age of 71.6 years. Although the chief complaints were abdominal pain or fullness, 1 had obstructive jaundice due to biliary compression by a large cyst. Cyst size ranged from 10 cm to 27 cm. There are several treatment modalities for giant hepatic cyst, such as cyst resection, unroofing, and sclerotherapy after cyst drainage. Operative procedures in the patients reported here were surgical resection of the liver cyst in 3 patients, unroofing with ethanol sclerotherapy in 1 patient and laparoscopic treatment in 2 patients. Sclerotherapy after percutaneous transhepatic cyst drainage was performed in 3 patients because their general condition was poor. There were no postoperative complications among these patients. Costs varied among the patients and depended mainly on the method of treatment and period of hospital stay. We discuss operative procedures and costs of treatment of each patient and review the literature.
Aged↗
A simple and reliable method for the detection and quantitation of the human T-cell leukemia virus type-I provirus in peripheral blood mononuclear cells of seropositive blood donors.
Human T-cell leukemia virus type I (HTLV-I) antibody detection has been widely used to screen HTLV-I carriers. Sometimes, however, it gives false positive or negative results. A demonstration of the HTLV-I provirus from patients' peripheral blood mononuclear cells (PBMC) should, therefore, give the crucial evidence for them being HTLV-I carriers. We established a simple and reliable method using the polymerase chain reaction (PCR) to detect one molecule of HTLV-I provirus in 100 x 10(3) PBMC, during which internal control primers for the human beta-globin gene were also employed in the same reaction tube to check the success of the amplification reaction. We can thus easily avoid any false negative judgement and quantitate the HTLV-I provirus in PBMC simply by diluting the sample before PCR. One ml blood was enough for ten or more determinations by PCR. Analysis of seropositive blood from donors demonstrated a wide range for the number of HTLV-I provirus in PBMC. The method could conveniently be used for quantitating HTLV-I proviruses and following up HTLV-I carriers to study the pathophysiology and mode of HTLV-I transmission.
Base Sequence↗
Middle ear fluid histamine and leukotriene B4 in acute otitis media: effect of antihistamine or corticosteroid treatment.
OBJECTIVE: Two potent mediators of acute inflammation, histamine and leukotriene B4 (LTB4), have been shown to play important roles in the pathogenesis and clinical course of acute otitis media (AOM) in children. The purpose of this study was to evaluate the ability of adjuvant drugs, antihistamine and corticosteroid, in reduction of the levels of histamine and LTB4 in the middle ear and their ability to improve outcomes of AOM. METHODS: Eighty children with AOM (aged 3 months to 6 years) were enrolled in a prospective, randomized, double-blind, placebo controlled study. All children received one dose of intramuscular ceftriaxone and were randomly assigned to receive either chlorpheniramine maleate (0.35 mg/kg per day) and/or prednisolone (2 mg/kg per day) or placebos three times a day for 5 days. Tympanocentesis was performed at enrollment and after 5 days of adjuvant drug treatment. MEFs were collected for bacterial and viral studies and histamine and LTB4 levels. The subjects were followed for the duration of middle ear effusion or up to 3 months. RESULTS: Histamine or LTB4 levels in the MEF after 5 days of treatment were not significantly reduced by adjuvant drug treatment. However, subjects receiving corticosteroid had a lower rate of treatment failure during the first 2 weeks and shorter duration of middle ear effusion. CONCLUSIONS: Five day of antihistamine or corticosteroid treatment does not reduce the levels of histamine or leukotriene B4 in the MEF of children with AOM. Positive clinical outcomes of AOM cases associated with corticosteroid treatment needs to be confirmed in a larger clinical trial of children with intact tympanic membranes, who do not receive tympanocentesis.
Acute Disease↗
Targeted retrograde gene delivery into the injured cervical spinal cord using recombinant adenovirus vector.
Direct routes of gene administration (intrathecal, intracerebroventricular or intraparenchymal infusion) have been used for effective and sustained gene delivery, but serious concerns exist about possible traumatic injury as well as neural damage that may lead to further tissue necrosis, apoptosis and cell death. We evaluated targeted retrograde gene delivery through the sternomastoid muscle (innervated by the spinal accessory nerves) into the injured cervical spinal cord using a recombinant adenovirus vector. LacZ gene expression in the cervical spinal cord was noted from 3 days to 4 weeks after the injection of vector into the sternomastoid muscles of the rats. Recombinant adenovirus vector was transferred via a retrograde mechanism into the injured cervical spinal cord with high transduction efficacy (80.6--98.9%) over certain adenoviral titer and dosage. Transduction was less efficient when the vector was injected 1 and 2 weeks after spinal cord injury (44.2--56.8%). Our results indicate retrograde delivery of recombinant adenovirus vector is possible immediately after spinal cord injury, and that this method is promising for gene delivery because it is effective, selective, less invasive to the injured spinal cord, has long-lasting gene expression, and is potentially feasible treatment choice for spinal cord injury.
Adenoviridae↗
Gas chromatographic--mass spectrometric determination of amitriptyline and its major metabolites in human serum.
A gas chromatographic--electron-impact ionization mass spectrometric method has been developed for the determination of amitriptyline (AMT) and its metabolites, nortriptyline (NT), 10-hydroxyamitriptyline (10-OH-AMT) and 10-hydroxynortriptyline (10-OH-NT) in human serum. The lower limit of detection was 2 ng/ml for all compounds except 5 ng/ml for 10-OH-NT. The calibration curves for AMT and 10-OH-AMT were linear up to 100 ng/ml, and up to 200 ng/ml for NT and 10-OH-NT. The accuracy of the assay in terms of coefficient of variation was less than 7%. The extraction efficiency was almost quantitative for all compounds except 60% for 10-OH-NT. Using this method, human serum samples which had been collected after oral administration of a single 50-mg dose of AMT were analyzed. Ratios of the conjugation of each metabolite were estimated, including AMT.
Amitriptyline↗
Rapid and effective detection of anthrax spores in soil by PCR.
AIMS: To detect Bacillus anthracis DNA from soil using rapid and simple procedures. METHODS AND RESULTS: Various amounts of B. anthracis Pasteur II spores were added artificially to 1 g of soil, which was then washed with ethanol and sterile water. Enrichment of the samples in trypticase soy broth was performed twice. A DNA template was prepared from the second enrichment culture using a FastPrep instrument. The template was then used for nested and real-time polymerase chain reaction (PCR) with B. anthracis-specific primers, to confirm the presence of B. anthracis chromosomal DNA and the pXO1/pXO2 plasmids. CONCLUSIONS: One cell of B. anthracis in 1 g of soil could be detected by nested and real-time PCR. The usefulness of the PCR method using field samples was also confirmed. SIGNIFICANCE AND IMPACT OF THE STUDY: The results indicate that this could be a useful method for detecting anthrax-spore contaminated soil with high sensitivity. Its application could have great impact on the progress of epidemiological surveillance.
Bacillus anthracis↗