Congenital venous anomalies associated with retrocaval ureter: evaluation using computed tomography.

BACKGROUND: Retrocaval ureter is a rare congenital anomaly resulting from anomalous development of inferior vena cava (IVC) and not from anomalous of the ureter. The anomaly always occurs on the right side due to regression of right supracardinal vein and persistence of right posterior cardinal vein. Retrocaval ureter tends to be associated with various vena cava anomalies because of the embryogenesis. We aimed to identify the prevalence of associated congenital venous anomalies (CVA) resulting from cardinal vein development in adults with retrocaval ureter using computed tomography (CT) images. MATERIALS AND METHODS: The study included 22 adults with retrocaval ureter. We evaluated CT findings and determined the incidence of associated CVA using thin slice data sets from CT scanner with 64 or more detectors. We compared the prevalence of CVA in the retrocaval ureter group (mean age: 57 ± 19 years) and in the control group of 6189 adults with normal ureter (mean age: 66 ± 14 years). RESULTS: In the retrocaval ureter group, 4 (18.2%) adults had CVA including double IVC, right double IVC, preisthmic IVC with horseshoe kidney, and preaortic iliac confluence. One of 2 adults with preaortic iliac confluence had right double right IVC. In the control group, 49 (0.79%) adults had CVA including 37 double IVC, 11 left IVC, and 1 IVC interruption azygos continuation. Fifteen horseshow kidneys were found. The prevalence of associated CVA in the retrocaval ureter group was higher than that in the control group (p < 0.001). CONCLUSIONS: Retrocaval ureter is frequently associated with CVA. Various CVA with retrocaval ureter could happen because of abnormal development of not only the right posterior or supra cardinal vein but also other cardinal veins.

Cibenzoline, an ATP-sensitive K(+) channel blocker, binds to the K(+)-binding site from the cytoplasmic side of gastric H(+),K(+)-ATPase.

1. Cibenzoline, (+/-)-2-(2,2-diphenylcyclopropyl-2-imidazoline succinate, has been clinically used as one of the Class I type antiarrhythmic agents and also reported to block ATP-sensitive K(+) channels in excised membranes from heart and pancreatic beta cells. In the present study, we investigated if this drug inhibited gastric H(+),K(+)-ATPase activity in vitro. 2. Cibenzoline inhibited H(+),K(+)-ATPase activity of permeabilized leaky hog gastric vesicles in a concentration-dependent manner (IC(50): 201 microM), whereas no effect was shown on Na(+),K(+)-ATPase activity of dog kidney (IC(50): >1000 microM). Similarly, cibenzoline inhibited H(+),K(+)-ATPase activity of HEK-293 cells (human embryonic kidney cell line) co-transfected with rabbit gastric H(+),K(+)-ATPase alpha- and beta-subunit cDNAs (IC(50): 183 microM). 3. In leaky gastric vesicles, inhibition of H(+),K(+)-ATPase activity by cibenzoline was attenuated by the addition of K(+) (0.5 - 5 mM) in a concentration-dependent manner. The Lineweaver-Burk plot of the H(+),K(+)-ATPase activity shows that cibenzoline increases K(m) value for K(+) without affecting V(max), indicating that this drug inhibits H(+),K(+)-ATPase activity competitively with respect to K(+). 4. The inhibitory effect of H(+),K(+)-ATPase activity by cibenzoline with normal tight gastric vesicles did not significantly differ from that with permeabilized leaky gastric vesicles, indicating that this drug reacted to the ATPase from the cytoplasmic side of the membrane. 5. These findings suggest that cibenzoline is an inhibitor of gastric H(+),K(+)-ATPase with a novel inhibition mechanism, which inhibits gastric H(+),K(+)-ATPase by binding its K(+)-recognition site from the cytoplasmic side.

Significance of lysine/glycine cluster structure in gastric H+,K+-ATPase.

Gastric H+,K+-ATPase consists of alpha- and beta-subunits. The catalytic alpha-subunit contains a very unique structure consisting of lysine and glycine clusters, KKK(or KKKK)AG(G/R)GGGK-(K/R)K, in the amino-terminal cytoplasmic region. This structure is well conserved in all gastric H+,K+-ATPases from different animal species, and was postulated to be the site controlling the access of cations (or proton) to its binding site. In this report, we studied the role of this unique structure by expressing several H+,K+-ATPase mutants of the alpha-subunit together with the wild-type beta-subunit in HEK-293 cells. Even after replacing all the positively-charged amino acid residues (six lysines and one arginine) in the cluster with alanine or removing all the glycine residues in the cluster, the mutants preserved the H+,K+-ATPase activity, and showed similar affinity for ATP and K+ as well as similar pH profiles as those of wild-type H+,K+-ATPase, indicating that the cluster is not indispensable for H+,K+-ATPase activity and not directly involved in determination of the affinity for cation (proton).

Detection of DNA restriction fragment polymorphisms in Streptococcus equi.

Large-restriction-fragment (LRF) polymorphisms in Streptococcus equi (S equi subspecies equi) were studied by pulsed-field gel electrophoresis. Five or six chromosomal fragments of between 194 and 915 kb were separated by digestion with the restriction endonuclease Notl. All 20 isolates of S equi, including 12 from independent Japanese outbreaks, four from independent American outbreaks, two from a single Irish outbreak, us vaccine strain F43, and type strain NCTC 9682 were successfully typed. Seven distinctive, reproducible and stable types were identified. The 12 Japanese isolates collected between 1992 and 1998 were of LRF type II suggesting that they were derived from the same source. The remaining eight isolates were of six types. The results indicate that LRF typing should be a useful technique for investigating the source and transmission of S equi.

[A survey on the current status and trends in bladder irrigation].

Questionnaires were sent to pharmacies and clinics in 592 Japanese hospitals from July to November, 1983 to investigate the use of bladder irrigation. The questionnaires were completed and returned by 418 hospitals, the rate of response being 70.8%. Fifty eight kinds of irrigants were prepared in hospital pharmacies and were reported to have been used in 1,171 patients. Of these irrigants, chlorhexidine gluconate accounted for 18.8%, Polymyxin B for 17.1%, normal saline for 13.3%, potassium permanganate for 6.9%, and boric acid for 5.7%. Chlorhexidine gluconate was usually used at a concentration of 0.02% (in 79% of the total use of the agent), Polymyxin B at 0.01%, 0.02% and 0.05%, potassium permanganate at 0.01% and 0.02% (in 73% of the total use), and acrinol at 0.01%, 0.05% and 0.1%. To questions about side effects, such as irritation, 65 hospitals answered that irritation had occurred. Irrigants were most frequently supplied to non-disposable 500 ml containers used exclusively for this purpose, 38% of all the hospitals using this method. Non-disposable 1 liter containers for exclusive use with bladder irrigants were used in 23% of the hospitals. Purified water was most frequently used to prepare the bladder irrigants (in 35% of hospitals) followed in descending order, by sterile purified water in 33%, and distilled water for injection in 26%. Water for irrigants was prepared at the hospital in 83% of the hospitals. The time of storage of the prepared bladder irrigants was mostly one week to one month, and was within one month in 78% of the hospitals. Seventeen percent of the hospitals answered that the preparation of bladder irrigants was a cause of overwork in their pharmacies. Irrigants against Pseudomonas infections were prepared separately in 40% of the hospitals, and there was no such regulation in 37%. Forty four agents were used to prepare such irrigants, and Polymyxin B accounted for 50%. The use of these agents significantly (P less than 0.001) differed between hospitals. Forty eight percent of the hospitals made special preparations for patients with clouded urine, and there was no such regulation in 46%. Thirty nine agents were used for this purpose. Polymyxin B was used in 30%, and chlorhexidine gluconate in 19%. The use of these agents differed significantly (P less than 0.001) between hospitals.(ABSTRACT TRUNCATED AT 400 WORDS)

[Validation of the hospital anxiety and depression scale in a gastro-intestinal clinic].

This study examined the validity of the Japanese version of the hospital anxiety and depression scale (HAD) in a gastro-intestinal outpatient clinic. One hundred and twenty-three men and 142 women consulting a gastro-intestinal outpatient clinic at a primary care hospital in Kyoto during 1995 were surveyed. Item-remainder correlation and internal consistency were examined for reliability. Concurrent validities were examined using the stait-trait anxiety inventory (STAI) and Zung's self-rating depression scale (SDS). The prevalence of psychiatric disorder in this population ranged from 27% to 39%. Cronbach's coefficients were greater than 0.8 for the anxiety subscale and more than 0.7 for the depression subscale. Spearman's correlation of the anxiety subscale scores and the STAI were r = 0.678 for men, and r = 0.717 for women. The correlation of depression subscale scores and SDS were r = 0.457 for men, and r = 0.565 for women. It is suggested that the use of the HAD to general hospital outpatients clinic would facilitate detecting emotional disorders in outpatients.

[A comparative study of psycho-social factors in peptic ulcer disease].

To evaluate the psycho-social factors of peptic ulcer, we carried out a comparative study. Seventy-six men and 19 women with peptic ulcers diagnosed at seven hospitals in Kyoto, Osaka and Hyogo Prefectures in Japan were surveyed during November 1990 about their daily hassles, depressive state, social support and life style using a self-administered questionnaire. The results were compared to those for two control groups. One control group was diagnosed with normal, atrophic gastritis, or superficial gastritis by the gastro-duodenal endoscopic examinations in the same hospitals. The other control group consisted of participants in a health-screening examination at one of the above hospitals. There were no significant differences between patients and controls in daily hassles, depressive state, and social support. However, being unmarried, smoking and eating irregular meals significantly increased the relative risk of peptic ulcer in men and family history of peptic ulcer significantly increased the risk in women.

Field-induced order-disorder transition in antiferromagnetic BaCo(2)V(2)O(8) driven by a softening of spinon excitation.

High field magnetization and ESR measurements on the quasi-one-dimensional (1D) antiferromagnet BaCo(2)V(2)O(8) have been performed in magnetic fields up to 50 T along the chain. The experimental results are explained well in terms of a 1D S=1/2 antiferromagnetic XXZ model in longitudinal fields. We show that the quantum phase transition from the Néel ordered phase to the spin liquid one in the model is responsible for a peculiar order to disorder transition in BaCo(2)V(2)O(8).

Observation of higher-harmonic helical spin-resonance modes in the chromium spinel CdCr2O4.

High frequency ESR measurements on the chromium spinel compound CdCr2O4 have been performed. The observed ESR modes below Hc' approximately 5.7 T can be explained well by the calculated resonance modes based on a molecular field theory assuming a helical spin structure. Other than the fundamental ones, we have succeeded in observing the higher-harmonic modes for the first time. A large change of the ESR modes above Hc' indicate that a variation of the spin structure from the helical to the four-sublattice canted one takes place around Hc'.

Degradation of insulin in perfused liver and skeletal muscle and insulin secretion in perfused pancreas of liver injury rat.

To study the mechanism of hyperinsulinism and glucose intolerance in liver disease, insulin removal rate by liver and muscle, glucose uptake by muscle and insulin secretion from pancreas were measured using the perfusion in rats with injured liver induced by carbon tetrachloride (liver injury rat). In the perfused liver, insulin removal rate of liver injury rat decreased to 62% of that of normal rat, but it did not alter in the perfused muscle. Insulin response to arginine by the perfused pancreas of liver injury rat was similar to that of normal rat. Before insulin infusion, glucose uptake by the perfused muscle was similar in liver injury rat and normal rat. In contrast, during insulin infusion, glucose uptake by the perfused muscle was 1.5 times higher in liver injury rat than in normal rat. These results suggested that the peripheral hyperinsulinism was solely due to decreased hepatic insulin degradation, but not hypersecretion of insulin from pancreas and furthermore, might suggest that the insulin resistance was related to appearance of biologically inactive endogenous insulin, because of exogenous insulin completely acting on peripheral target tissue.

Study of the ion-distribution dynamics of an aluminum laser-produced plasma with picosecond resolution.

The ion-distribution dynamics of an expanding aluminum plasma produced by a nanosecond laser pulse at moderate intensity (10(13) W cm(-2)) is studied by point-projection x-ray absorption spectroscopy with unprecedented, picosecond, time resolution. We show that the ionic populations measured as a function of distance to the target and at different probing times differ markedly from those predicted by widely accepted collisional radiative models coupled to hydrodynamic simulations. We discuss the effects of radiation, conduction, and expansion cooling on the spatiotemporal ionic distribution evolution.

Ab-interno erbium (Er):YAG laser sclerostomy with iridotomy in Dutch cross rabbits.

An ab-interno technique using a pigmented rabbit model has been developed that uses a pulsed erbium:YAG laser to create an iridotomy with a sclerostomy through the same corneal incision. Laser energy was delivered with an articulated arm terminating in side-firing (850 or 650 microns OD) or end-firing (850 or 400 microns OD) fiber optic endoprobes, which allowed iridotomies and sclerostomies, respectively, to be created. Initially, sclerostomies (8-10, 8 mJ/300 microseconds pulses) and basal iridotomies (1-3, 4 mJ/200 microseconds pulses) were created with the larger probes. Problems encountered with this technique included corneal decompensation and rapid formation of peripheral anterior synechiae with occlusion of sclerostomies. The smaller endoprobes were then used to create mid-peripheral iridotomies and sclerostomies utilizing the same energy parameters. Sclerostomies created in this manner remained patent in the first postoperative week until the animals were sacrificed to obtain material for histologic study.

Photodynamic laser cyclodestruction with chloroaluminum sulfonated phthalocyanine (CASPc) or Photofrin (PII) vs. Nd:YAG laser cyclodestruction in a pigmented rabbit model.

BACKGROUND AND OBJECTIVE: To investigate Photofrin (PII) and CASPc for photodynamic therapy (PDT) of the ciliary body in rabbits. STUDY DESIGN/MATERIALS AND METHODS: PII (10 mg/kg) or CASPc (1 mg/kg) was given by ear vein. Pharmacokinetics were studied in frozen sections by fluorescence microscopy (CCD camera based low light detection system with digital image processing) at 1 and 24 h (8 rabbits; 16 eyes). Laser light was delivered (argon pumped dye laser; 630 and 675 nm; 8 rabbits; 16 eyes) by contact fiberoptic. To compensate for iris attenuation, irradiance was 125 mW/cm2 (20, 40, 80, or 160 J/cm2). Controls (4 rabbits; 8 eyes) received laser light without photochemicals (OD) and for comparison, continuous wave Nd:YAG laser by fiberoptic (0.8-1.2J; OS). RESULTS: Localization studies showed intravascular distribution with some selective ciliary body distribution at 24 h (PII > CASPc). Rabbits treated with PII or CASPc exhibited variable amounts of gross ciliary body edema, infarction, and necrosis by 24-48 h. This response was not seen in PDT control tissues; damage was seen in the iris and ciliary body, with partial vacuolization of the pigment epithelium. CONCLUSION: PDT may offer a more selective approach to ciliary body destruction. A small but significant thermal effect was seen during PDT from melanin photon uptake with damage to iris and ciliary body. Thermal damage and potential interaction with ocular visual pigments may limit use of these photochemicals and wavelengths for PDT of the ciliary body.