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Histopathological features of liver damage induced by laser ablation in rabbits.

BACKGROUND AND OBJECTIVE: Possible mechanisms that promote or interfere with the effects of laser ablation of the liver have not been clarified. The aim of this study was to define the chronological alterations in the normal rabbit liver at early stages after laser ablation. STUDY DESIGN/MATERIALS AND METHODS: Rabbit livers were ablated with a laser via an optical fiber and then analyzed histopathologically by immunostaining for heat shock protein 70 (HSP70) and by the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) method. RESULTS: The lesions increased in size progressively over the 24 h that followed ablation and the area of the lesion coincided with the area that had been heated above 43 degrees C. TUNEL-positive hepatocytes were surrounded, at some distance, by HSP70-positive hepatocytes were surrounded, at some distance, by HSP70-positive hepatocytes at 6 h, and such cells were in contact with each other at 24 h. CONCLUSIONS: Injury to hepatocytes induced by laser ablation increases for 24 h and dying cells express nuclear HSP70, with subsequent fragmentation of DNA.

Animals↗

Polyurethane-coated Dacron-covered stent-grafts for TIPS: results in swine.

PURPOSE: To evaluate shunt patency after placing a new polyurethane-coated Dacron-covered spiral Z stent-graft to create a transjugular intrahepatic portosystemic shunt (TIPS). METHODS: TIPS stent-grafts were placed in six young swine, using polyurethane-coated, Dacron-covered spiral Z stent-grafts. Animals were followed weekly by transhepatic portal venography until shunt occlusion or up to 6 weeks, then were sacrificed for gross and histologic evaluation. RESULTS: Five of six TIPS stent-grafts were found to be occluded by 3 weeks and none were patent at 6 weeks. Histologic evaluation demonstrated a marked foreign body reaction with superimposed thrombosis occluding the graft lumen. CONCLUSION: Polyurethane-coated Dacron-covered stent-grafts do not improve TIPS patency.

Animals↗

[Usefulness of power Doppler ultrasonography for the diagnosis of autoinfarction of parathyroid gland in secondary hyperparathyroidism].

Spontaneous remission due to parathyroid infarction of secondary hyperparathyroidism is rare compared with that of primary hyperparathyroidism, probably because several glands are enlarged in secondary hyperparathyroidism. Lately, neck ultrasound examination has become a more beneficial and specific method for the diagnosis of enlarged parathyroid glands in contrast to classic diagnostic techniques such as computed tomography (CT), magnetic resonance imaging (MRI) and scintigraphy. However, the diagnosis of parathyroid infarction reported in previous studies was often based on CT, MRI and scintigraphy findings and there are few studies that reported such diagnosis by urgent power Doppler ultrasonography of the neck. Here we present a hemodialysis patient with autoinfarction of the left parathyroid gland diagnosed by urgent power Doppler ultrasonography of the neck.

Adult↗

Immunohistochemical and ultrastructural investigation on cutaneous neuroendocrine carcinoma: report of a case and review of the literature.

We report a tumor in an 80-year-old man that was difficult to distinguish from other tumors, i.e., small cell carcinoma of the lung, PNET/Ewing tumor, malignant lymphoma, or malignant melanoma (amelanotic), and which was finally identified as cutaneous neuroendocrine carcinoma using immunohistochemical and ultrastructural methods. Autopsy did not show any tumors in the lungs, excluding the possibility of small cell carcinoma of the lung. Immunohistochemistry tests gave negative results for LCA, UCHL-1, CD3, and CD20, thereby excluding malignant lymphoma, and the negative results for S-100 protein and HMB-45 ruled out malignant melanoma. The possibility of PNET/Ewing sarcoma was also excluded because of negativity for CD99. In addition, the ultramicrostructure showed intercellular junctional complexes and neuroendocrine granules, indicating that the tumor had characteristics of both epithelial and neuroendocrine tissues. We therefore diagnosed the primary carcinoma of the skin as cutaneous neuroendocrine carcinoma.

Aged, 80 and over↗

Simultaneous measurement of pulmonary diffusing capacity for CO and cardiac output by a rebreathing method in patients with pulmonary diseases.

Pulmonary diffusing capacity for CO (DLCO) and cardiac output (Q) were simultaneously measured by a noninvasive rebreathing method (RB) in 15 normal subjects and in 60 patients, including cardiac diseases (CD), bronchial asthma (BA), chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (PF). DLCO and Q were tested by the single breath method (SB) and the dye-dilution method (Dye), respectively. DLCO (RB) correlated well with DLCO (SB) (r = 0.890, p < 0.001). Q(RB) also correlated well with Q(Dye) (r = 0.909, p < 0.001). Factors affecting DLCO (RB) were age, height, body surface area, O2 consumption, Q, hematocrit (Het) and Q.Hct, among which Q.Hct was the prominent influential determinant. DLCO per lung volume was smaller in COPD and PF than in BA or healthy subjects, while, the ratio of DLCO/(Q.Hct) was significantly higher in COPD than in PF. Simultaneous measurements of DLCO and Q offer comprehensive characterization for functional changes in lung parenchyma.

Adult↗

[Accumulation mechanism of 111In in malignant tumor (author's transl)].

In order to clarify the accumulation mechanism of 111In in maligant tumor, subcellular distribution of 111In was quantitatively determined. Buffalo rats bearing Morris hepatoma 7316A were injected intraperitoneally 111In-chloride and tumor tissues were removed 24 hours later. Subcellular fractionation of tumor tissues were carried out according to the method of C. de Duve, et al. and radioactivity of each fraction was counted. Most of the total radioactivity was distributed among the soluble, nuclear and lysosomal fractions. On account of its low protein content, the relative specific radioactivity was the highest in the lysosomal fraction. The lysosomal fraction was solubilized gradually and the resultant stepwise release of 111In and acid phosphatase activity were measured. There was a close relationship between them. From these results it was concluded that 111In accumulated especially in the lysosomes. In the electron micrography the tumor lysosomes had already engulfed many foreign materials, so that the lysosomal function would be depressed.

Acid Phosphatase↗

Stereoscopic vascular architecture of the adult rat femoral head.

We studied the micro-architecture of the rat femoral head using a corroding casting method described by Murakami in comparison with haematoxylin-eosin preparation and transparent preparation. Stereoscopic architecture of the microvasculature in the femoral head was finely demonstrated. Vessels in the metaphysis and the epiphysis were aggregated to form a lobular-like structure. The lobules were interconnected with each other by a few capillaries. A bigger vessel probably corresponding to a drainage vein was seen crossing the growth plate. Loop formations, from simple hairpin-like loop to a more complex loop with a glomerular-like aspect, were demonstrated in the metaphysis underlying the growth plate as well as in the articular surface of the epiphysis.

Animals↗

[Spinal anesthesia with isobaric 0.5% bupivacaine for lower limb surgery: effects of different volumes].

BACKGROUND: The effects of different volumes (2.4, 2.6, 2.8 and 3.0 ml) of isobaric 0.5% bupivacaine used for spinal anesthesia were compared in 206 patients scheduled for lower limb surgery. METHODS: The spinal anesthesia was performed with the patients in the lateral position and the isobaric 0.5% bupivacaine was injected intrathecally at the L3-4 interspace. RESULTS: The time to maximum cephalad spread of anesthesia (loss of cold sensation) varied between 25 and 40 min. A significant difference was found in cephalad spread between 2.4 ml group and 3.0 ml group (T11 vs T7), and between 2.6 ml group and 3.0 ml group (T11 vs T7). Severe hypotension did not occur during the study. CONCLUSIONS: Spinal anesthesia with 2.8 ml of isobaric 0.5% bupivacaine proved satisfactory for lower limb surgery.

Adult↗

[Study of myocardial viability by thallium-201 SPECT. Conventional redistribution versus reinjection].

PURPOSE: To verify if a third series of images acquired by reinjection thallium-201, 24h after conventional myocardial perfusion with the radioisotope, improves the identification of myocardial viability segments. METHODS: We studied 30 patients, mean age 57.7 +/- 9.4 years, with old myocardial infarction using thallium (Tl)-201 SPECT (single-photon-emission computed tomography), and we obtained 3 series of images (stress, redistribution after 4h and reinjection after 24h. Cardiac images were divided in 5 segments (apical, lateral, anterior, septal and inferior) and each one received a value by a score system according to the Tl-201 myocardial uptake (0 = normal uptake; 1 = mild hypoperfusion; 2 = moderate hypoperfusion; 3 = severe hypoperfusion or no myocardial uptake). We considered viable myocardium when the uptake of Tl-201 in the segment related to the myocardial infarction increased at least 1 point in two different axis of Tl-201 SPECT. RESULTS: Seven (23.3%) patients demonstrated increase of Tl-201 uptake only at reinjection images, showing a higher efficacy of the method. Nine (30%) patients showed persistent hypoperfusion at all series of images suggesting only fibrosis in the area related to the infarction. Fourteen (46.7%) patients showed increase of Tl-201 concentration at redistribution images; among these patients, six showed improvement of myocardial uptake at reinjection. This condition were interpreted as regional chronic ischemic process: hibernating myocardium. CONCLUSION: Tl-201 hypoperfusion at redistribution images without significant changes in relation to the stress images do not represent fibrosis at all. The reinjection technic was better than conventional redistribution in the detection of viable myocardium. This data allows a better therapeutic orientation.

Adult↗

Double exposure: natural and artificial ultraviolet radiation exposure in beachgoers.

BACKGROUND: Although the beach is a high-risk environment for ultraviolet light exposure and subsequent skin damage, little is known about beachgoer tanning habits outside the beach setting. Our purpose was to evaluate indoor tanning and additional, nonbeach sunlight exposure in a beachgoing population. METHODS: We conducted an epidemiologic survey. RESULTS: There was more use of indoor tanning salons among sunbathing beachgoers who applied little or no skin protection from the sun (50.8% [31 of 61 respondents]) compared with nonsunbathing beachgoers (22.7% [5 of 22 respondents]). In addition to increased use of tanning salons, we observed that poorly protected sunbathers tanned at locations other than the beach on a regular basis (50.8% [31 of 61 respondents]) more than nonsunbathers did (9.1% [2 of 22 respondents]). CONCLUSION: Beachgoing sunbathers often used both natural sunlight and tanning beds, subjecting themselves to two forms of ultraviolet radiation exposure.

Adolescent↗

[Cerebral 11C-glucose metabolism during human sleep].

Some reports have suggested that there is no difference in cerebral metabolic rates between wakefulness and sleep. However recently Kennedy et al. and Heiss et al. reported a decrease in cerebral glucose utilization during NREM sleep measured by the using deoxyglucose method. We used a 11C-glucose method for positron emission tomography (PET) while estimating cerebral glucose metabolism during human sleep with polysomnography (PSG). This PET and PSG study was carried out on 11 healthy male volunteers ranging in age from 18 to 26 years. In order to facilitate the onset of sleep, the subjects were deprived of sleep, under observation in the lab, for a period of approximately 20 hours prior to the PSG and PET examination. All experiments were performed in the early morning, most often between 4 and 10 AM. The subjects' sleep was monitored by PSG, i.e. electroencephalogram, electrooculogram and a submental electroencephalogram, electrooculogram and a submental electromyogram. The 11C-glucose used in the experiment was prepared by the biosynthetic method developed by Lifton and Welch, using 11C produced by a baby cyclotron. The 11C-glucose solution, containing about 20 mCi of 11C activity was administered orally to the subjects. The time course of the 11C activity in the blood following the administration was determined by drawing 1 ml of blood from the antecubital vein once every 10 minutes. These samples were assayed for 11C activity in a NaI well counter. The PET images of a horizontal cross-section of the brain at 45 mm above the orbito-meatal line, were used for the analysis of the glucose metabolism.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

High prevalence of autoantibodies against carbonic anhydrase II and lactoferrin in type 1 diabetes: concept of autoimmune exocrinopathy and endocrinopathy of the pancreas.

INTRODUCTION: Dysfunction of the exocrine as well as the endocrine pancreas has been reported in type 1 diabetes. Lymphocytic infiltration of the exocrine pancreas is observed in approximately half of Japanese type 1 diabetic patients. AIMS: To investigate the involvement of autoimmunity against the exocrine pancreas in type 1 diabetes. METHODOLOGY: We examined autoantibodies against human carbonic anhydrase II (ACA) and lactoferrin (ALF), antigens in the pancreatic duct cells and the pancreatic acinus, respectively, in 43 type 1 diabetic patients and 20 type 2 diabetic patients using the enzyme-linked immunosorbent assay method. RESULTS: Of 43 type 1 diabetic patients, ACA was detected in 28 patients (65%) and ALF was detected in 29 patients (67%). One or both of the antibodies were detected in 33 type 1 diabetic patients (77%). In contrast, neither ACA nor ALF were detected in type 2 diabetic patients. CONCLUSIONS: The high prevalence of both ACA and ALF strongly suggests the involvement of autoimmunity against the exocrine pancreas as well as the endocrine pancreas in some type 1 diabetic patients. We propose that these conditions be referred to as autoimmune exocrinopathy and endocrinopathy of the pancreas.

Adolescent↗

Antilactoferrin antibodies in autoimmune liver diseases.

OBJECTIVE: Lactoferrin, an immunoregulatory protein in mucosal secretions, is one of the target antigens to perinuclear antineutrophil cytoplasmic antibodies (P-ANCAs). Circulating lactoferrin is cleared in the liver, but little is known about the implication of lactoferrin in hepatic inflammation. To evaluate the implication of immunological response to lactoferrin, we examined antilactoferrin antibodies in autoimmune liver diseases. METHODS: Fourteen patients with primary biliary cirrhosis (PBC), 14 with autoimmune hepatitis (AIH), five with autoimmune cholangitis (AIC), six with chronic hepatitis C, and five with chronic hepatitis B were studied. We evaluated autoantibodies to lactoferrin in the sera of the patients by the Western Immunoblotting method. RESULTS: Sera of five of the 14 patients (35.7%) with PBC, four of the 14 patients (28.6%) with AIH, and five of the five patients (100%) with AIC contained autoantibodies to human lactoferrin, but none with hepatitis B or C had them. The higher prevalence of serum antibodies to human lactoferrin was shown to be higher in patients with AIC than with hepatitis B (p < 0.01), hepatitis C (p < 0.01), PBC (p < 0.05), and AIH (p < 0.05). CONCLUSION: Lactoferrin located in bile ducts and liver cells is one of the candidates of target antigens in autoimmune liver diseases, especially in AIC.

Adolescent↗

Rotational three-dimensional cholangiography--initial clinical experience.

PURPOSE: The purpose of this study was to evaluate the feasibility and image quality of a novel biliary imaging technique that obtains 3D cholangiography image sets by infusing contrast material through a PTC-drainage tube, using 3D-digital subtraction angiography (DSA). METHODS: We applied this technique to seven patients suspected of having biliary disease. All patients underwent PTCD because of obstructive jaundice. Contrast material was introduced through the drainage tube, and the raw data were then transferred automatically to a workstation. Approximately 3 minutes of user time was required to generate the 3D images following image acquisition. RESULTS: Three-dimensional cholangiography was obtained in all patients who underwent 3D-DSA examination. Acceptable quality 3D-DSA cholangiograms were generated in six of the seven patients. CONCLUSION: We emphasize that our new technique may help during surgery as an aid to understanding anatomical structures in the biliary system.

Aged↗

Unconstrained cardiorespiratory and body movement monitoring system for home care.

An unconstrained respiratory rate (RR) and heart rate (HR) monitoring system to be used during sleeping is proposed. The system consisted of eight polyvinylidene fluoride cable sensors, charge amplifiers and measuring software, together with an analogue-to-digital converter unit. The cable sensors were horizontally embedded into a textile sheet on a bed surface covering the upper half of the body. The digital infinite impulse response filters were constructed to extract cardiorespiratory signals from displacement of the sensors. The system software automatically searched the optimum sensor(s) based on the power of the respective filter outputs. Then, the system obtained the 5 s average HR and 15 s average RR by measuring the intervals between the peaks of the respective autocorrelation functions of the filtered output. If the subject changed his posture, the system captured the image of the body position as a time stamp using a CCD camera. To show the validity of this method, the HR and RR obtained by this monitor were compared with those simultaneously measured using respiratory flow and an electrocardiogram. The results showed that the mean frame-by-frame difference ranged from -1.2 to 0.2 beats min(-1) for the HR and, for RR, ranged from -0.8 to 1.4 breath min(-1) during the short-term recordings. Similar differences were obtained during the first 2 h of overnight recordings. The proposed system is feasible for the combined long-term monitoring of a person's RR and HR with sleep posture changes and may be helpful for practical use in the home.

Adult↗

Prosthetic reconstruction for periacetabular malignant tumors.

This article reports the reconstruction method and functional results of a newly designed tumor hip prosthesis with a constrained joint mechanism which was used after treatment for 13 primary and 5 metastatic periacetabular malignant bone tumors. The overall 5-year survival rate for patients with primary tumors (n=13) was 50%. The local recurrence rate was 30%. More than 90% of the patients whose hips were reconstructed with the constrained tumor hip prosthesis experienced pain relief and were able to walk with a cane. No patients had greater than 3 cm shortening of the involved limb. Infection was the most serious complication. This prosthesis restored iliofemoral stability after surgical resection of periacetabular malignant tumors.

Acetabulum↗

No association between the sigma receptor type 1 gene and schizophrenia: results of analysis and meta-analysis of case-control studies.

BACKGROUND: Several lines of evidence have supported possible roles of the sigma receptors in the etiology of schizophrenia and mechanisms of antipsychotic efficacy. An association study provided genetic evidence that the sigma receptor type 1 gene (SIGMAR1) was a possible susceptibility factor for schizophrenia, however, it was not replicated by a subsequent study. It is necessary to evaluate further the possibility that the SIGMAR1 gene is associated with susceptibility to schizophrenia. METHODS: A case-control association study between two polymorphisms of the SIGMAR1 gene, G-241T/C-240T and Gln2Pro, and schizophrenia in Japanese population, and meta-analysis including present and previous studies. RESULTS: There was no significant association of any allele or genotype of the polymorphisms with schizophrenia. Neither significant association was observed with hebephrenic or paranoid subtype of schizophrenia. Furthermore, a meta-analysis including the present and previous studies comprising 779 controls and 636 schizophrenics also revealed no significant association between the SIGMAR1 gene and schizophrenia. CONCLUSION: In view of this evidence, it is likely that the SIGMAR1 gene does not confer susceptibility to schizophrenia.

Asian People↗

Regio- and stereoselective synthesis of carbocyclic 2',3'-dideoxy-3'-fluoro nucleosides as potential antiviral agents.

The synthesis and antiviral activity of racemic carbocyclic 2',3'-dideoxy-3'-fluoro nucleosides are reported. Carbocyclic 2',3'-dideoxy-3'-fluoro nucleosides were obtained from the 3-fluoro cyclopentane derivative 4, which was prepared by two methods. The SN2-displacement of the hydroxyl group of (+/-)-(1 beta, 2 alpha, 3 beta, 4 beta)-4-acetamido-2-fluoro-3-hydroxycyclopentylmethyl acetate (1) with Ph3P-I2 followed by tin hydride reduction afforded the 3-fluoroamino alcohol derivative 3. Alternatively, the protected fluoroamino alcohol 3 was prepared by regio- and stereoselective bromo-fluorination of cis-4 beta-acetamidocyclopent-2-enemethyl acetate (5) with hydrogen fluoride-pyridine/N-bromosuccinimide followed by tin hydride reduction to remove the bromine atom. Carbocyclic 2',3'-dideoxy-3'-fluoroguanosine (14) thus obtained was moderately active against herpes simplex virus in vitro.

Adenoviridae↗