Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Uchida Method”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,459 records · Page 81Linked to original sources

Repeated adenoviral administration into the biliary tract can induce repeated expression of the original gene construct in rat livers without immunosuppressive strategies.

BACKGROUND: Systemic adenoviral readministration appears to be limited by immunogenicity. AIMS: We examined the feasibility of repeated adenovirus mediated gene transfer into the liver via the biliary tract. METHODS: Recombinant adenoviruses carrying a reporter lacZ gene were infused retrogradely into the common bile duct of rats. Transduction efficiency of the lacZ gene was estimated histochemically and quantitatively. RESULTS: Retrograde administration of recombinant adenoviruses into the common bile duct of rats resulted in efficient transgene expression in the liver, specifically in hepatocytes, but not in biliary epithelia. Transduction efficiency induced by intrabiliary adenoviral administration was not substantially different from that induced by intraportal adenoviral infusion. Transgene expression in the liver was however transient, and development of neutralising antibodies against adenovirus was observed in serum but not in bile. When adenoviruses were readministered into the common bile duct, successful re-expression of the transgene in the liver was achieved despite the existence of neutralising antibodies in serum. Interestingly, although proliferation of adenovirus specific T cells in response to adenoviral readministration was suppressed significantly by immunosuppressive FK506 treatment, levels of transgene expression in the liver achieved by intrabiliary adenoviral readministration were not significantly different between animals treated with and without FK506. Furthermore, third adenoviral administration into the common bile duct also induced successful transgene expression in the liver. CONCLUSIONS: These results suggest that adenovirus mediated gene transfer into the liver may be repeatable without immunosuppressive strategies in clinical settings by means of endoscopic retrograde cholangiography.

Adenoviridae↗

Mechanism of acceleration of functional reentry in the ventricle: effects of ATP-sensitive potassium channel opener.

BACKGROUND: The effect of effective refractory period (ERP) shortening on the vulnerability and characteristics of induced functional reentry in the ventricle remain poorly defined. We hypothesized that ERP shortening increases ventricular vulnerability to reentry and accelerates its rate, as is the case in the atrium. METHODS AND RESULTS: The epicardial surfaces of 19 isolated and superfused canine right ventricular slices (4x4 cm and <2 mm thick) were mapped with 480 bipolar electrodes 1.6 mm apart. Vulnerability was tested during pacing at a cycle length (CL) of 600 ms and with a single premature stimulus of 5-ms duration at increasing current strength of 1 to 100 mA. Cromakalim (10 micromol/L), an ATP-sensitive potassium channel opener, caused a significant (P<0. 001) shortening of the ERP but had no effect on conduction velocity. Cromakalim increased (P<0.01) the vulnerability (product of current and the stimulus coupling interval) for reentry induction. Reentry had a significantly shorter CL and lasted for a longer duration (P<0. 001). The central core around which the wave front rotated became smaller, which caused shortening of the CL of reentry. A significant (P<0.001) linear correlation was found between core size and reentry CL. These effects of cromakalim were reversible. Two-dimensional simulation studies using the modified Luo-Rudy I model of cardiac action potential, in which the refractory period was variably shortened by a progressive increase of the time-independent potassium conductance, reproduced the experimental findings. CONCLUSIONS: ERP shortening by an ATP-sensitive potassium channel opener increases ventricular vulnerability to reentry and accelerates its rate by decreasing the core size around which the wave front rotates.

Action Potentials↗

Accelerated plasminogen activator inhibitor may prevent late restenosis after coronary stenting in acute myocardial infarction.

BACKGROUND: Although acceleration of plasma plasminogen activator inhibitor-1 (PA-1) level after emergent coronary angioplasty in acute myocardial infarction (AMI) has been documented, its pathophysiologic role is still unknown. HYPOTHESIS: This study was designed to elucidate the role of PAI-1 in the development of restenosis after primary coronary stenting in AMI. METHODS: We selected for this study 66 patients with AMI, who underwent primary coronary stenting for infarct-related coronary artery lesions in an emergent situation. In all patients, plasma PAI-1 level was measured at admission, and at 3 h, 24 h, 48 h, and 1 month after coronary stenting. RESULTS: At admission, the PAI-1 level was equivalent in 24 patients who experienced restenosis and in 42 patients without restenosis (28 +/- 4 vs. 29 +/- 4 ng/ml). In patients with restenosis, the levels did not change during the course after coronary stenting. In patients without restenosis, however, the level significantly increased at 3 h (48 +/- 9 ng/ml, p < 0.001), 24 h (42 +/- 9, p < 0.01), and 48 h (38 +/- 7, p < 0.05) after coronary stenting, and was restored to the level equivalent to that at admission (27 +/- 2 ng/ml) I month aftercoronary stenting. The PA-1 level at 3 h after coronary stenting in patients without restenosis was significantly higher (p < 0.05) than the level (33 +/- 6 ng/ml) in patients with restenosis. Multiple logistic regression analysis indicated that the PAI-1 level 3 h after coronary stenting was an independent predictor of restenosis (Wald chi2 = 3.826, p = 0.019, odds ratio 0.921, 95% confidence interval 0.866-0.961). CONCLUSION: Accelerated PAI-1 after coronary stenting in patients with AMI may protect against the development of late restenosis.

Angioplasty, Balloon, Coronary↗

Open tension-free mesh repair for adult inguinal hernia: eight years of experience in a community hospital.

OBJECTIVE: The aim of this study was to determine the feasibility of using open tension-free mesh repair for adult inguinal hernias performed by resident surgeons under the supervision of a chief surgeon in a community hospital. METHODS: From May, 1992 through April, 2000, we performed 314 open tension-free mesh repairs on 289 patients (234 men, 55 women) with a mean age of 65.7 years. There were 173 right and 141 left hernias, and 25 were bilateral; while 220 were indirect, 77 were direct and 17 were of the femoral type. There were 281 primary and 33 recurrent lesions. Resident surgeons under the supervision of the first author (SY) performed all hernioplasties. Three types of open tension-free mesh repairs were performed; the Lichtenstein repair (n = 72), the mesh-plug repair (n = 134), and the Hernia System repair (n = 108). RESULTS: The duration of surgery averaged 73.0 minutes. There was no perioperative mortality. Five patients developed subcutaneous wound infections; no case required mesh removal. Hematoma occurred in eight patients, and seroma developed in 25. All haematomas and seromas subsided with repeated aspiration. The average duration of hospitalization was 6.5 days. The length of follow-up rose from 1 to 8 years, with a mean of 3.7 years. No patients in any group had a recurrence during the follow-up period. CONCLUSIONS: Under the close supervision of the staff surgeon, tension-free hernioplasties can be performed on adult inguinal hernias by surgeons-in-training in non-specialist centres with excellent outcomes, low postoperative complications and no recurrence.

Adult↗

The effects of glibenclamide, a K(ATP) channel blocker, on the warm-up phenomenon.

BACKGROUND: The warm-up phenomenon observed after the second of two sequential exercise tests is characterized by an increased time to ischemia and ischemic threshold, and the latter is related to ischemic preconditioning. Previous studies have demonstrated that a single dose of glibenclamide, a cardiac ATP-sensitive K (K(ATP)) channel blocker, prevents ischemic preconditioning. This study aimed to investigate the effects of chronic treatment with glibenclamide during two sequential exercise tests. METHODS: Forty patients with angina pectoris were divided into three groups: 20 nondiabetics (NDM), 10 patients with diabetes in treatment with glibenclamide (DMG) and 10 diabetic patients with other treatments (DMO). All patients underwent two consecutive exercise tests. RESULTS: Heart rate and rate-pressure product at 1.0 mm ST-segment depression significantly increased during the second exercise test in NDM group (121.3+/-16.5 vs 127.3+/-15.3 beats/min, P<0.001, and 216.7+43.1 vs 232.1+/-43.0 beats.min-1.mmHg.10(2), P<0.001), and in DMO group (114.1+/-19.6 vs 119.6+/-18.1 beats/min, P=0.001, and 199.8+/-36.6 vs 222.2+/-29.2 beats.min-1.mmHg.10(2), P=0.019), but it did not change in patients in DMG group (130.7+/-14.5 vs 132.1+/-4.7 beats/min, P=ns, and 251.7+/-47.2 vs 250.3+/-42.8 beats.min-1.mmHg.10(2), P=ns). In the three groups, NDM, DMO, and DMG, the time to 1.0 mm ST-segment depression during the second exercise test was greater than during the first (225.0+/-112.5 vs 267.0+/-122.3 seconds, P=0.006; 187.5+/-54.0 vs 226.5+/-74.6 seconds, P=0.029 and 150.0+/-78.7 vs 186.0+/-81.9 seconds, P<0.001). CONCLUSION: The chronic use of glibenclamide may have mediated the loss of preconditioning benefits in the warm-up phenomenon, probably through its KATP channel-blocker activity, but without acting upon the tolerance to exercise.

Analysis of Variance↗

Gastric mucosal hyperplasia via upregulation of gastrin induced by persistent activation of gastric innate immunity in major histocompatibility complex class II deficient mice.

BACKGROUND AND AIMS: Major histocompatibility complex class II deficient (Aalpha0/0) mice have decreased CD4+ T cells, making them immunologically similar to patients with acquired immunodeficiency syndrome (AIDS). Both patients with AIDS and Aalpha0/0 mice have hypertrophic gastric folds. To clarify the mechanism of gastric mucosal hyperplasia, we investigated the pathophysiology and the role of the innate immunity in the stomach of Aalpha0/0 mice. METHODS: Stomachs from 1-6 month old Aalpha0/0 mice, kept under specific pathogen free conditions, were examined at 1 month intervals histologically and immunohistochemically. Gene expression of proinflammatory cytokines, Toll-like receptors (TLRs), cyclooxygenase (COX)-2, and myeloperoxidase (MPO) activity in the gastric mucosa was investigated. Serum gastrin levels and gastric acidity were measured. Bacterial culture of the stomach was performed. To clarify the roles of hypergastrinaemia in the gastric mucosa, a gastrin receptor antagonist (AG041R) was administered. RESULTS: Aalpha0/0 mice had a diffusely thick corpus mucosa with infiltration of CD11b+ granulocytes and macrophages. Anti-Ki67 staining demonstrated expansion of the proliferating neck zone. Gene expression of interleukin 1beta, interferon gamma, TLR-2, TLR-4, and COX-2 were upregulated, and MPO activity was increased. Only a small amount of non-pathogenic bacteria was detected in the stomach. Serum gastrin levels and Reg-Ialpha positive cells in the gastric mucosa increased, despite normal gastric acidity. After treatment with AG041R, gastric mucosal thickness was significantly reduced. CONCLUSION: Persistent activation of innate immunity in the stomach induced gastric mucosal hyperplasia through upregulation of gastrin synthesis in Aalpha0/0 mice, suggesting a pathophysiology similar to the gastric changes in patients with AIDS.

Acquired Immunodeficiency Syndrome↗

Inhibitory effects of Helicobacter pylori infection on murine autoimmune gastritis.

BACKGROUND AND AIM: Long term Helicobacter pylori infection leads to atrophic gastritis but the relation between H pylori infection and autoimmune related atrophic gastritis (AIG) remains unclear. We studied the effects of H pylori infection on the pathophysiology of AIG in mice. MATERIALS AND METHODS: BALB/c nu/nu mice (n=40) with or without H pylori infection received splenocytes from neonatally thymectomised mice to induce AIG. Half of the mice were orally infected with H pylori prior to AIG induction. Histological findings, and local and systemic immune responses were serially evaluated. RESULTS: Two and six months after transfer, parietal cells in uninfected mice were depleted while those in infected mice were well preserved. The degree of gland atrophy (p<0.01), hyperplasia (p<0.01), gastric pH (p<0.05), and serum gastrin levels of infected mice were significantly lower than those of uninfected mice. Serum antiparietal cell antibody levels gradually decreased in infected mice, and were significantly lower than those of uninfected mice at six months (p<0.05). Real time polymerase chain reaction studies revealed significantly higher interleukin 4 (p<0.05) and transforming growth factor beta (p<0.05) gene expression in the gastric mucosa in infected mice than in uninfected mice at both two and six months after AIG induction. CONCLUSIONS: H pylori infection inhibited the development of AIG in mice. Th2-type immune responses and transforming growth factor beta in the gastric microenvironment might be involved in the inhibitory effects of H pylori infection on the development of AIG, in which Th1-type responses have an important role.

Animals↗

Method of cell transplantation promoting the organization of intraarterial thrombus.

BACKGROUND: Endovascular aortic repairs have been developed as less invasive treatments for aortic aneurysms. Some aneurismal cavities, however, remain without organization, causing a re-expansion of the aneurysms. We studied cell transplantation into the aneurismal sac to promote the organization of thrombus for the complete healing of aneurysms. METHODS AND RESULTS: Skin fibroblasts and skeletal myoblasts were isolated from rats for cell transplantation. An intraarterial thrombus model was made by ligation of the carotid artery. Culture medium (medium group, n=11), collagen gel (gel group, n=11), fibroblasts with collagen gel (F group, n=15), myoblasts with collagen gel (M group, n=12), or mixture of fibroblasts and myoblasts with collagen gel (F+M group, n=14) were injected into the thrombus. After 28 days, histologically, the arterial lumens of the F and M groups were partly filled with fibrous tissues, whereas in the F+M group organization was almost completed and luminal sizes diminished. Immunohistochemical staining demonstrated that alpha-smooth muscle actin-positive cells were more abundantly contained in the organized area of the F+M group than in the other groups. We also analyzed cellular function in vitro with immunofluorescence; coculture of fibroblasts and myoblasts showed that the fraction of alpha-smooth muscle actin-positive fibroblasts increased. This phenomenon accounts for the rapid organization of thrombus in the F+M group in vivo. CONCLUSIONS: Cell transplantation accelerated thrombus organization. Especially, myoblasts enhanced differentiation of fibroblasts into myofibroblasts, contributing to rapid thrombus organization. Cell transplantation into unorganized spaces seems applicable to endovascular treatment of aneurysms.

Aneurysm↗

DNA-binding characteristics of aclarubicin as compared with daunorubicin and doxorubicin.

The effect of ionic strength on aclarubicin - DNA complexes was studied in comparison with its effect on daunorubicin - or doxorubicin - DNA complexes, using the spectrophotometric method. The hypochromic shift of aclarubicin, induced by its binding to native DNA, decreased to a lesser extent by the addition of Na+ than those of daunorubicin and doxorubicin, which suggests that aclarubicin-native DNA complexes are the most stable at high ionic strength. Similar examinations were made with heat-denatured DNA and polyvinyl sulfate (PVS). Aclarubicin-denatured DNA complexes showed a greater decrease in the hypochromic shift by the addition of Na+ than the corresponding complexes with native DNA. However, for daunorubicin and doxorubicin, there were no significant differences between the complexes of anthracyclines with native and denatured DNAs. In addition, the hypochromic shift of aclarubicin-PVS complexes decreased more prominently by the addition of Na+ than those of daunorubicin - and doxorubicin - PVS complexes. These results suggest that the electrostatic interaction of aclarubicin with DNA is more labile than that of daunorubicin and doxorubicin, since anthracyclines bind to single-stranded DNA and polyelectrolytes primarily by electrostatic interaction. Therefore, the other types of interaction, which may be stronger than that of daunorubicin and doxorubicin, seem to be associated with the higher stability of aclarubicin-native DNA complexes at high ionic strength. The structural differences between aclarubicin and daunorubicin or doxorubicin are considered to contribute to the differences in DNA-binding characteristics observed in this study.

Aclarubicin↗

Mental effect of cholesterol in males: protective effect?

BACKGROUND: While the benefits of low cholesterol for physical health are not in doubt, a potential negative aspect of low cholesterol for mental health is suggested by several studies. To examine the association between cholesterol and mental health, the authors performed an observational study. METHOD: From April 1995 to March 2002, a series of questionnaires pertaining to physical activity, food consumption, alcohol, coffee, smoking, and mental health (12 item-version of General Health Questionnaire: GHQ-12) were administered to 1972 employees in Japan. Subjects with less than 150 mg/dL of total cholesterol (very low cholesterol cohort) and other subjects (control cohort) were followed up for one to six years, and their mental health compared using GHQ caseness (GHQ-12 scores more than 3). RESULTS: Kaplan-Meier survival curves revealed that the very low cholesterol cohort had significantly greater GHQ caseness than the control cohort. Notably, this finding applied to males but not to females. After adjustment for general health, Cox's proportional hazards regression model confirmed this association in males only. The survival curves of control cohort were significantly different between males and females whereas those of very low cholesterol cohort were not. LIMITATIONS: GHQ caseness was regarded as "death" in the survival analysis. As such, it is not possible to differentiate between transient and persistent mental dysfunction and therefore may lead to overestimation of GHQ caseness over observational years. CONCLUSION: The present findings suggest that very low cholesterol may be associated with worse mental health in males and conversely and interestingly indicate that moderate (but not very low) cholesterol levels may protect mental health in males.

Adult↗

Measurement of the maxilla and zygoma as an aid in installing zygomatic implants.

PURPOSE: This study used maxillary and zygomatic measurements to obtain information for installing zygomatic implants. PATIENTS AND METHODS: Angular and linear distances between the maxilla and the zygoma were measured in 12 cadavers (n = 22 sides) classified into short and tall groups by height (140 to 159 cm and 160 to 180 cm, respectively). RESULTS: Based on mean and standard deviation values, the installation angle of zygomatic implants was between 43.8 degrees and 50.6 degrees. The distance between the crest of the maxillary alveolar process near the palate and the jugale (Ju) point of the zygoma was between 44.3 and 54.3 mm. The minimum distance between the most lateral corner of the maxillary sinus and the Ju point was 6.41 mm, and the minimum anteroposterior length of the zygoma was 5.68 mm in the shorter group. CONCLUSIONS: When the installation angle of zygomatic implants is 43.8 degrees or less, perforation of the maxilla and the zygoma or the infratemporal fossa must be avoided. When the angle is 50.6 degrees or more, perforation of the orbital floor must be avoided. Special attention is needed to ensure osseointegration in shorter patients, because the distance between the most lateral corner of the antrum supporting the zygomatic implant and the Ju point is 10 mm or less. The apex of the implant is 3.75 mm in diameter, and the thickness of the zygoma must be 5.75 mm or more. The threads of the implant must not be exposed from the zygoma in shorter patients.

Body Height↗

Corneal stromal and endothelial cell precursors.

PURPOSE: To isolate precursors of human corneal stromal and endothelial cells in vitro and to compare the distribution of rabbit corneal endothelial cell precursors in the central and peripheral regions of the cornea. METHODS: Sphere-forming cells were isolated from human corneal stromal and endothelial cells by a reaggregation-free neurosphere assay. To promote differentiation of the cells, the isolated sphere colonies were plated in wells with a medium containing fetal bovine serum. Expression of various proteins was examined in the sphere colonies and their progeny by immunocytochemistry and reverse-transcriptase polymerase chain reaction (RT-PCR). Corneal endothelium and Descemet membrane of rabbits were demarcated into peripheral (6.0-10.0 mm in diameter) and central (6.0 mm in diameter) regions. Precursor cells were isolated from these 2 regions by sphere-forming assay, and the number of sphere colonies and size of spheres were compared in the central and peripheral regions. RESULTS: Human corneal stromal and endothelial cells formed sphere-shaped colonies that expressed mesenchymal and neural markers. The rate of sphere formation in the peripheral region of rabbit corneal endothelium was significantly higher than that in the central cornea. CONCLUSION: Adult human corneal stroma contains precursor cells that have a strong propensity to differentiate into mesenchymal fibroblasts, but these cells can also differentiate into neuronal lineage. Adult human corneal endothelium contains precursors with a propensity to differentiate into corneal endothelial cells, but these cells can also produce neuronal and mesenchymal cell proteins. The peripheral endothelium of rabbit cornea contains more precursors than the central region.

Animals↗

Antitumor activity of 1 M tegafur-0.4 M 5-chloro-2,4-dihydroxypyridine-1 M potassium oxonate (S-1) against human colon carcinoma orthotopically implanted into nude rats.

The purpose of this study was to establish a nude rat orthotopic (organ-specific) human colorectal cancer model as an in vivo secondary screen for general evaluation of new anticancer agents against colorectal cancer and to evaluate practically the antitumor activity of 1 M tegafur-0.4 M 5-chloro-2,4-dihydroxypyridine-1 M potassium oxonate (S-1), a new p.o. fluoropyrimidine, in comparison to 1 M tegafur-4 M uracil [(UFT) effective on colorectal tumor in clinical]. After implantation of KM12C, a human colorectal cancer cell line, into the subserosal layer of the colon as a single-cell suspension, extensive local tumor growth and invasion to both the mucosal and the serosal sides were observed in all rats. Metastatic foci were also formed in both lymph nodes and lungs following local tumor growth in all of them. Using this method, an equitoxic dose of S-1 (15 mg/kg/day) and UFT (30 mg/kg/day) was administered p.o. for 14 consecutive days from 7 days after tumor cell implantation. S-1 showed a higher tumor growth inhibition than UFT did [S-1, 57% (significantly different from the tumor weight of the untreated group at P < 0.05) and UFT, 18% (P > 0.05)]. When both drugs were administered to nude rats bearing KM12C injected into the cecal wall for 28 consecutive days at equitoxic doses, the mean survival in the S-1 group was 16 days longer than that in the untreated group (P < 0.01) but that in the UFT group was only 8 days longer (P > 0.05). After the administration of an equitoxic dose of both drugs, S-1 gave the higher levels than UFT in various pharmacokinetic parameters as follows: area under the curve 0-24 h of 5-fluorouracil in plasma (3.5-fold), area under the curve 0-24 h of 5-fluorouracil incorporated into RNA in the tumor (1.3-fold), and thymidylate synthase inhibition rate (percentage) in the tumor (about 20%). Collectively, these findings suggested that this orthotopic human colorectal tumor model in nude rats is useful to evaluate the clinical therapeutic efficacy of drugs or therapies for colorectal cancer, and that S-1 had a higher therapeutic effect on human colorectal tumor than UFT did.

Adenocarcinoma↗

Isolation and some properties of two deoxyribonucleases from a snail, Achatina fulica.

1. Two main DNases were found in the dried liver extract of a snail, Achatina fulica. They were purified by the phosphocellulose batch method and by phosphocellulose column chromatography. The enzyme eluted earlier from the phosphocellulose column was designated as Achatina DNase-1 and the other as Achatina DNase-2. DNase-1 was purified further by QAE-Sephadex A-25 column chromatography (twice) just before use because of the instability of the purified enzyme. By these procedures, DNase-1 and 2 were purified 200- and 130-fold, respectively. 2. Divalent or monovalent cations had no marked effect on either enzyme. The showed pH optima of 4.8 (DNase-1) and 5.2 (DNase-2). Ionic strength was found to be critical for the maximal activity. The isoelectric points of DNase-1 and 2 were both 6.9. On heating at 70--75 degrees C for 5 min, each enzymic activity fell to half of the initial value. 3. The enzyme preparations degraded native DNA 1.5--2.5 times faster than heat-denatured DNA. They both degraded heat-denatured DNA endonucleolytically, to give oligonucleotides with 3'-phosphates. 4. The 3'-phosphoryl and 5'-hydroxy termini of the resulting oligonucleotides were analyzed. DNase-1 possessed marked specificity for dThd at 3'-termini and dAdo at 5'-termini in the early stages of degradation, but only for dAdo at 5'-termini in the later stages. DNase-2 showed some preference for purine nucleotides at both 3'- and 5'-termini in the later stages of degradation.

Chromatography↗

Clinical analysis of autoimmune-related pancreatitis.

OBJECTIVE: Several investigators have reported on autoimmune-related pancreatitis, but the clinical findings and pathophysiology still remain unclear. To clarify it, we analyzed eight patients with autoimmune pancreatitis. METHODS: We evaluated clinical findings in eight patients (four men and four women) with autoimmune-related pancreatitis. Patients were aged 45-73 yr (mean, 57.5 yr). We examined blood chemistry and immunological studies, including autoantibodies against lactoferrin or carbonic anhydrase II, and compared ERCP images with clinical findings. In two patients, we studied the subset of lymphocytes infiltrating in the pancreas by immunohistochemistry and flow cytometry. RESULTS: Four of eight patients had jaundice, two had renal dysfunction, two had abdominal pain, and two had back pain. Three patients were complicated with other autoimmune diseases. Three patients showed abnormal pancreatic exocrine function by an N-benzoyl-L-tyrosyl-para-aminobenzoic acid excretion test. Antinuclear antibody was detected in four of eight patients, antilactoferrin antibody in three of six, anticarbonic anhydrase II antibody in two of six, antismooth muscle antibody in two of seven, and rheumatoid factor in one of eight. All eight patients showed segmental stenosis of the main pancreatic duct by ERCP. Four patients showed stenosis of the common bile duct as well as the pancreatic duct. Microscopic findings showed infiltration of CD4-positive lymphocytes around the pancreatic duct, and HLA-DR was expressed on both CD4-positive cells and pancreatic duct cells. In two patients, stenosis of the pancreatic duct improved by prednisolone. CONCLUSIONS: Autoimmune mechanism may be involved in some patients with idiopathic pancreatitis associated with hypergammaglobulinemia.

Aged↗

Normal myelination of anatomic nerve fiber bundles: MR analysis.

PURPOSE: In order to establish milestones of brain maturation by MR imaging, we examined the initiation of myelination of fiber bundles and of surrounding white matter. METHODS: The subjects included 54 healthy infants ranging in age from 35 to 145 weeks by corrected gestational age. Images were obtained on a 1.5-T MR unit. In 24 sites of 18 fiber bundles in eight cross sections obtained perpendicular to the long axis of the brain stem, we analyzed the initiation of myelination and the age at which fiber bundles become indistinguishable owing to myelination of the surrounding white matter (blurring). RESULTS: The fiber bundles were classified into two groups on the basis of the presence or absence of blurring. The first group (no blurring) was further divided into group 1A, in which myelination began at 35 weeks or less, and group 1B, in which myelination began at 44 weeks or later. The second group (blurring) was divided into group 2A, in which myelination began at 35 weeks or less and blurring occurred at 43 to 49 weeks; group 2B, in which myelination started at 35 weeks or less and blurring began at 67 to 145 weeks; and group 2C, in which myelination began at 36 weeks or later and blurring occurred at 67 to 145 weeks. CONCLUSION: The time of blurring, when myelinated fiber bundles become indistinguishable from surrounding white matter owing to the initiation of myelination, is considered to be a useful parameter of brain maturation in infancy.

Brain↗

Re-operation is frequently required when parathyroid glands remain after initial parathyroidectomy for advanced secondary hyperparathyroidism in uraemic patients.

BACKGROUND: Parathyroidectomy (PTx) is the most successful treatment for advanced secondary hyperparathyroidism (2HPT) not responsive to medical treatment. However, persistent HPT remains problematic after PTx if some glands remain. The clinical course in patients with persistent 2HPT was evaluated to clarify the risk for re-operation after PTx. METHODS: Between March 1981 and December 2001, initial total PTx with forearm autograft were performed in 1156 uraemic patients. Persistent HPT cases were defined as those in which the lowest post-operative intact parathyroid hormone (i-PTH) concentration was >60 pg/ml, and patients were classified into groups A, B and C, with i-PTH concentrations of >or=500, 300-500 and 60-300 pg/ml, respectively. These patients were followed for 7-234 months after PTx. RESULTS: Persistent HPT was identified in 49/1156 patients (4.2%), with nine cases in group A, 10 in group B and 30 in group C. Re-operation was required in 21/49 (42.8%) cases, and in seven of these the last i-PTH concentration was >or=500 pg/ml. All cases in group A required re-operation. In group C, 11/30 (36.7%) patients required re-operation. The missed glands removed at re-operation were supernumerary in 14 cases, and located in the mediastinum in 13 cases. The frequency of advanced HPT and re-operation was not negligible. CONCLUSIONS: To prevent persistent 2HPT, all parathyroid glands must be found and resected during the initial operation. Even if small parathyroid glands remain, there is a risk of progression. Complete PTx is the first treatment choice for advanced 2HPT.

Female↗

Effects of indocyanine green on retinal ganglion cells.

PURPOSE: Recently, indocyanine green (ICG) has been used to visualize the internal limiting membrane during vitrectomy. After intraocular administration, ICG accumulates at the optic disc. In this study, the effects of ICG on retinal ganglion cells (RGCs) were examined. METHODS: In vitro, rat RGCs were purified by a two-step immunopanning procedure, briefly exposed to ICG (2.5 x 10(3) mg/L), and irradiated with an endoilluminator for 15 minutes or incubated in the presence of ICG (concentration: 2-250 mg/L) without irradiation. The number of viable RGCs was counted after 3 days in culture. In vivo, after rats received an intravitreal injection of 3 micro L ICG (0.25 and 2.5 mg/L), the distribution of ICG was observed with a fundus camera, and the number of viable RGCs was examined by a DiI (1,1'-dioctadecyl-1-3,3,3',3'-tetramethylindocarbocyanine perchlorate)-retrolabeling technique. RESULTS: In vitro, a brief exposure to ICG and light did not affect RGC survival. However, ICG reduced the number of viable RGCs in a dose-dependent manner when the cells were exposed for 3 days. In vivo, the dye was initially distributed on the retinal surface and around the optic disc. At day 7, the fluorescence became invisible in the 0.25-mg/L group, whereas the staining of the optic disc contour was evident in the 2.5-mg/L group. The number of viable RGCs decreased significantly in the 2.5-mg/L group 14 days after the injection. CONCLUSIONS: ICG showed an inherent toxicity to RGCs in a dose-dependent manner. Lower concentration and shorter staining time of ICG should be used for dye-assisted vitrectomy.

Animals↗