Serum Wisteria floribunda agglutinin-positive Mac-2-binding protein for patients with chronic hepatitis B and C: a comparative study.

We compared Wisteria floribunda agglutinin-positive Mac-2-binding protein (WFA+ -M2BP) levels between patients with chronic hepatitis B (n=249) and chronic hepatitis C (n=386) based on the degree of liver fibrosis. We examined WFA+ -M2BP levels in patients with F4 (cirrhosis), F3 or more (advanced fibrosis) and F2 or more (significant fibrosis) in the two groups. We further examined the relationship between five fibrosis markers and the degree of fibrosis. The WFA+ -M2BP values ranged from 0.25 cut-off index (COI) to 12.9 COI in patients with hepatitis B and 0.34-20.0 COI in patients with hepatitis C (P<.0001). The median WFA+ -M2BP values in F4 in the two groups were 2.83 COI in patients with hepatitis B and 5.03 COI in patients with hepatitis C (P=.0046). The median WFA+ -M2BP values in F3 or more in the two groups were 1.79 COI in patients with hepatitis B and 3.79 COI in patients with hepatitis C (P<.0001). The median WFA+ -M2BP values in F2 or more in the two groups were 1.49 COI in the hepatitis B cohort and 3.19 COI in the hepatitis C group (P<.0001). Among five liver fibrosis markers, WFA+ -M2BP had the highest correlation coefficient (rs =.629) in terms of correlation with the degree of fibrosis in the patients with hepatitis C and had the second highest rs value (.415) in the hepatitis B group. Although WFA+ -M2BP could be a useful indicator of liver fibrosis, WFA+ -M2BP levels in the two groups significantly differed even in the same degree of fibrosis. Individual cut-off values in each aetiology for the degree of fibrosis should be determined.

Single mode emission and non-stochastic laser system based on disordered point-sized structures: toward a tuneable random laser.

As an advantage, random lasers may be elaborated from a large variety of materials and do not require any cavity oscillators that usually necessitate complicated and expensive fabrication techniques. Since the feedback process of those non-conventional laser systems is provided by light interference in a disordered medium, spectral and temporal uncertainties are usually considered as an intrinsic part of their optical proprieties. We investigated random laser action under two photon absorption experiments through an auto-organized InGaN/GaN quantum-disks ensemble. Thanks to our experimental approach, we evidence random lasing based on a gain medium constituted by point-sized structures. In such context, a stabilised and individual emission mode is observed as for conventional semiconductor lasers. By controlling the emission energy of these nanostructures, a tuneable and stable random laser may be built. Moreover, our findings suggest that disordered medium should play an important role in the conception of low cost quantum dot and up conversion laser systems.

Use of 123I-BMIPP single-photon emission tomography to estimate areas at risk following successful revascularization in patients with acute myocardial infarction.

Previous studies have indicated that iodine-123 labelled beta-methyliodophenyl pentadecanoic acid (BMIPP), an iodinated fatty acid analogue, can identify persistent alteration of fatty acid metabolism after restoration of blood flow. To assess whether fatty acid imaging can delineate areas at risk following successful revascularization in patients with acute myocardial infarction (AMI), BMIPP findings at 1 week post AMI were compared with perfusion imaging before and after revascularization therapy. Sixty-five patients with AMI underwent technetium-99m tetrofosmin single-photon emission tomography (SPET) before m (TF0) and 1 week (TF1) after successful revascularization therapy. BMIPP SPET was also performed under a fasting state at 1 week (BM1) post AMI. The extent scores were calculated from the defect scores in 20 segments. The BM1 score (7.7 +/- 3.9) was similar to the TF0 score (8.8 +/- 4.2) (r = 0.86, P < 0.0001), but significantly higher than the TF1 score (5.8 +/- 3.9) (P < 0.0001). A significant correlation was observed between the BM1 score and TF0 score (r = 0.86, P < 0.0001). Among a total of 1300 segments, the BM1 score was identical to the TF0 score in 1156 (88.9%). These data indicate that the ability of BMIPP imaging at 1 week post AMI to identify areas at risk is similar to that of tetrofosmin perfusion imaging in the acute phase. This may be due to the impairment of fatty acid uptake and metabolism reflecting prior severe ischaemic insult which persists at least 1 week after recovery of perfusion in the acute phase of AMI.

Flavor deterioration in yogurt.

Volatile components of flavored yogurt preserved at 5 degrees C in the dark for 0 day, 3 days and 10 days were recovered by simultaneous distillation extraction (SDE) and headspace (HS) procedures. Gas chromatography (GC) and GC-mass spectrometry (GC-MS) analyses of those samples showed remarkable changes in some compounds. Aldehydes which contribute to expressing citrusy notes were reduced to alcohols during fermentation process and storage. As a result, the strength of flavors which expressed well-balanced citrusy notes in yogurt were weakened, and fatty or oily notes mainly caused from alcohols were strengthened reversely. Hydrocarbons were also digested by bacteria during a fermentation process. A small amount of other compounds, such as esters and terpene alcohols changed. Fewer effects of sorption into a package material and chemical reactions, such as hydrolysis esters, hydration or oxidation of hydrocarbons, were observed.

[A clinical evaluation of the Hepcon/HMS: a new device of monitoring hemostasis management during cardiopulmonary bypass].

BACKGROUND: The "Hepcon/HMS", a small, protable console which can instantaneously measure residual whole blood heparin concentration and automatically compute the necessary dose of additional heparin during extracorporeal circulation and also compute the required dose of protamine to reverse the effect of residual heparin. METHOD: This study was performed in 32 consecutive patients undergoing primary elective cardiac operation between March and July 1996. Patients were divided randomly in two groups: control group and "Hepacon/HMS" group. Hematologic factors, total heparin dose, total protamine dose, postoperative bleeding and blood transfusion volume were compared between these two groups. RESULTS: Patients in the "Hepcon/HMS" group received significantly greater doses of heparin (p = 0.01) and lower doses of protamine (p = 0.01) compared with the control patients. CONCLUSION: By using "Hepcon/HMS", smaller amount of protamine to reverse residual heparin was achieved without no hemostatic derangement nor increase in the amount of postoperative bleeding, irrespective of the fact that the greater amount of heparin was administered during extracorporeal circulation as compared with the conventional anticoagulation protocol. It may help prevent the undesirable side effects of administering excessive amount of protamine, including depression of myocardial function, platelet dysfunction, anaphylactic reaction and catastrophic circulatory collapse.

[Evaluation of myocardial perfusion by 99mTc-tetrofosmin SPECT before and after emergent percutaneous transluminal coronary angioplasty for acute myocardial infarction].

To assess clinical performance of coronary perfusion in patients with acute myocardial infarction following successful PTCA, various 99mTc-tetrofosmin (TF) SPECT were obtained. Twenty-eight patients with acute myocardial infarction underwent TF SPECT before emergent PTCA (acute phase), after 7 days (subacute phase) and 4 weeks (chronic phase) later. Twenty-eight patients divided into 2 groups. Early group; time lug from onset of AMI till PTCA is 6 hours or shorter (n = 17), delayed group; time lug is more than 6 hrs (n = 11). The defect scores were graded by 4 points grading system (0 as normal to 3 as defect) in 14 myocardial segments. In early group, the mean defect score was 13 +/- 7 at acute phase, 6 +/- 5 at subacute phase, and 3 +/- 4 at chronic phase. In delayed group, the mean value of defect score at each phases were 18 +/- 7, 14 +/- 7, and 13 +/- 7. The improvement of defect score of early group was significantly larger than that of delayed group (p < 0.005). These data indicate that PTCA therapy for acute MI patients is useful particularly in the early stage following acute MI.

[Prevention of coronary spasm during and shortly after coronary revascularization in patients with variant angina].

From June 1990 to March 1993, 9 patients undergoing coronary artery bypass grafting (CABG), 4.4% of all CABG cases at our hospital during this period, had significant perioperative coronary spasm. For 4 patients who underwent CABG before May 1992 (Group 1), preventive and suppressive procedures for the coronary spasm were the addition of diltiazem in the cardioplegic solution and the continuous intravenous infusion of nitroglycerin. Perioperative myocardial infarction (PMI) occurred in all 4 patients in Group 1, with the mean peak MB-CPK of 356 +/- 197 IU/l. One patient had delayed sternal closure because of his unstable hemodynamic status. Thereafter, we changed our protocol as follows: 1) Ergometrine loading (intracoronary infusion) test was performed in all candidates for CABG, aiming at finding out patients with a high risk. And for the high-risk patients, in addition to the measures done in Group 1, 2) intraaortic balloon pumping was performed through the perioperative period, and 3) a pig-tail catheter was dwelled in the Valsalva sinus, through which bolus doses of isosorbide dinitrate were injected frequently in this period. 4) Additionally nifedipine was periodically administered through the nasogastric tube. With these intensive preventive/suppressive measures, the perioperative spasm in 5 patients (Group 2) with variant angina were successfully managed, with no resultant PMI nor operative death (The occurrence of PMI was significantly less frequent in Group 2 than in Group 1, with the p value < 0.05). For patients with variant angina undergoing CABG, combined intensive preventive/suppressive measures for perioperative coronary spasm as listed above proved effective.

[A new device: a fenestrated sheath for IABP, which reduces the incidence of ischemia in the lower limbs].

To decrease the incidence of ischemia in the lower limbs, we developed a new introducer sheath for IABP, which had 38 side holes (diameter; 1mm). Forty-five patients who received IABP counterpulsation support with this fenestrated sheath were compared with 108 patients in whom the ordinary nonfenestrated sheath was used. There was no significant statistical difference between these two study groups regarding age, height, weight and IABP insertion time. The frequency of ischemic episode of the lower limbs was 2.2% (one out of 45 patients) in the group with the fenestrated sheath, which was significantly lower than those with the ordinary sheath (18 out of 108: 16.7%) (p < 0.005). From these data, we deduced that this fenestrated sheath allowed more blood flow to the lower limb and was thus effective in preventing limb ischemia, particularly in patients with small caliber femoral arteries.

[A case of 21-hydroxylase deficiency and Bartter's syndrome associated with a balanced 6-9 translocation].

A 17-year-old female weighing 37 kg and 140 cm in height was referred to our hospital for evaluation of dwarfism and primary amenorrhea. She was delivered with 3350 g in weight and 50 cm in height after a ten month pregnancy without complications. No abnormal findings were revealed in physical appearance except critomegaly. Episodes of nausea, vomiting and dehydration were rare throughout her childhood, but she had a tendency to salt craving. At the age of 14, her height was 140 cm. On admission, her physical development was markedly retarded for her age, except external genitalia. Diffuse pigmentations on the trunk and extremities were observed. Her blood pressure was normal (112/62 mm Hg). Serum potassium concentration was 2.9 mEq/L. Arterial-blood gas analysis revealed metabolic alkalosis. Both of renin activity (PRA) and aldosterone concentration (PAC) in plasma at rest were markedly elevated to 15.5 ng/ml/h and 107.1 ng/dl, respectively. The plasma concentrations of pregnenolone (1449 ng/dl), progesterone (178 ng/dl), 17-OH-pregnenolone (1613 ng/dl), 17-OH-progesterone (180 ng/dl), dehydroepiandrosterone (3706 ng/dl), androstendione (824.6 ng/dl) and testosterone (900 ng/dl) were high, whereas deoxycorticosterone (15.7 ng/dl), corticosterone (0.65 microgram/dl) and cortisol (6.8 micrograms/dl) were within normal limits. Urinary 17-KS excretion showed high levels between 65.7 and 109.4 mg/day, while urinary 17-OHCS excretion was normal (5.7-7.0 mg/day). Vascular response to angiotensin II (A-II) was attenuated. Distal fractional chloride reabsorption was decreased (CH2O/CH2O+CCl = 0.62, normal: 0.92 +/- 0.04). Moderate hyperplasia of the juxtaglomerular cells was demonstrated in biopsy specimen of the kidney. Cytogenetic studies showed a 46, XX chromosome constitution with translocation of the long arm of chromosome 6 to the short arm of chromosome 9. Her mother as well as younger brother and sister, whose electrolytes and arterial-blood gas analysis showed normal values, had chromosomes with the same translocation. Treatment with dexamethasone (2 mg/day) reduced every adrenal steroids to normal range, but PRA and PAC remained high levels. Furthermore, neither hypokalemic alkalosis nor vasoreactivity to exogenous A-II was improved. Indomethacin (75 mg/day) decreased urinary excretion of prostaglandin E2 from a high level of 738.4 ng/day to 433.4 ng/day and normalized metabolic alkalosis. Vascular response to A-II was moderately improved. However, serum potassium remained low.(ABSTRACT TRUNCATED AT 400 WORDS)