TiO2 Synthesis by the Pechini's Method and Application for Diclofenac Photodegradation†.

In this work, the effect of the calcination temperature on the TiO2 synthesis using Pechini's method was reported. The adopted calcination temperatures were 500, 600, and 700°C. XRD measurements indicated the composition of crystalline phases, and from there, the conversion of the anatase phase to rutile. TiO2 Evonik® was used as a reference standard and sodium diclofenac as a standard for photodegradation assessment. The average crystalline size increased. In both cases, this trend accompanied the increase in calcination temperature. The optical properties were performed using diffuse UV-Vis reflectance. Results obtained indicated maximum absorption wavelength values more intense and displaced to the visible region. Also, the estimated band gap energy values decreased. The photocatalytic performance of TiO2 samples was superior to the reference catalyst (TiO2 Evonik® ). Especially in the first 10 minutes, the comparative photodegradation was up to approximately 58% higher. The photodegradation kinetic constants were also higher, and by comparison, up to approximately 73% higher. Toxicity measurements, using Artemias salina, also indicated similar decay behavior in the first 10 minutes, with a performance of up to approximately 60%.

Initial analysis of relationship between plasma platinum concentration and hematological adverse reaction associated with weekly chemotherapy using nedaplatin in combination with radiotherapy for cervical carcinoma.

PURPOSE: Established therapeutic guidelines for cervical carcinoma recommend concurrent chemo- and radiotherapy as standard treatment for locally advanced cervical carcinoma. Nedaplatin (CDGP) is a platinum agent developed in Japan that is less nephrotoxic than cisplatin (CDDP), but with equivalent antitumor potency. In the standard dosage regimen for cervical carcinoma, CDGP is administered once every four weeks (monthly regimen). We investigated the efficacy and safety of a new dosage regimen, in which CDGP was administered once weekly for five weeks (weekly regimen). METHODS: We measured plasma platinum concentration of patients after administration of CDGP, and analyzed the relationship between plasma platinum concentration and hematological adverse reactions such as thrombocytopenia and leucopenia. RESULTS: The relative rates of change in platelet and white blood cell counts tended to increase as the plasma concentration of platinum increased. Furthermore, the rate of change in platelet counts in relation to the area under the curve was greater for the monthly regimen as compared to weekly. On the other hand, the relative rates of change in WBC were nearly the same between the regimens. CONCLUSIONS: These findings indicate that when using chemotherapy with CDGP for a patient with a cervical carcinoma, a weekly regimen might reduce the severity of thrombocytopenia, while still exhibiting the same therapeutic efficacy as the monthly regimen.

Sodium hyaluronate eye drops prevent late-onset bleb leakage after trabeculectomy with mitomycin C.

PURPOSE: To evaluate the efficacy of sodium hyaluronate eye drops for prevention of late-onset bleb leakage after trabeculectomy with mitomycin C (MMC). METHODS: Sixty-eight patients (68 eyes) who had trabeculectomy with MMC from March 1995 to February 2002 at the Marui Eye Clinic or the Department of Ophthalmology, Fukushima Medical University Hospital were examined in this study. Twenty-two were treated postoperatively with sodium hyaluronate eye drops (sodium hyaluronate group) and 46 eyes were not treated postoperatively (control group). The blebs were classified according to the avascular area, epithelial defect and degree of bleb wall leakage. Both groups were assigned classes (0, avascular or partial avascular bleb; 1, avascular or partial avascular bleb with an epithelial defect; 2, avascular or partial avascular bleb with oozing; 3, avascular or partial avascular bleb with a point of leakage). RESULTS: Follow-up duration ranged from 10 to 116 months (mean+/-SD, 57.6+/-30.5). The incidence of reclassification from class 1 to class 0 was significantly greater in the sodium hyaluronate group (four of six class 1 eyes improved to class 0 after application of sodium hyaluronate eye drops) than in the control group (zero of 10 eyes) (P=0.008). And, the incidence of reclassification from class 1 to class 2 or class 3 was significantly smaller in the sodium hyaluronate group (one of six eyes) than in the control group (nine of 10 eyes) (P=0.008). CONCLUSIONS: Sodium hyaluronate eye drops may prevent late-onset bleb leakage after trabeculectomy with MMC.

Immunoglobulin heavy chain gene analysis of ocular adnexal extranodal marginal zone B-cell lymphoma.

PURPOSE: To clarify the cellular origin of extranodal marginal-zone B-cell lymphoma (EZML) of the mucosa-associated lymphoid tissue (MALT) type in ocular adnexa, the somatic mutation was analyzed in the immunoglobulin heavy-chain variable region (VH) gene. METHODS: Eight cases of EZML in the orbit and four in the conjunctiva were studied. The VH genes were amplified by a seminested PCR and sequenced directly. These were compared with the closest published VH germline segments to determine the somatic mutation frequency. Intraclonal microheterogeneity, which was termed the ongoing mutation frequency in the current study, was estimated by counting the number of single nucleotide substitutions in individual clones and dividing by the total number of nucleotides analyzed. Nine cases of gastrointestinal EMZL were also examined for comparison. RESULTS: The somatic mutation frequency varied between 2.0% and 12.7%, with a mean value of 7.9%. Ten cases with intraclonal microheterogeneity showed between one and six further substitutions. The average of ongoing mutation frequency was 0.11%, with a range of 0% to 0.25%. In the gastrointestinal EMZLs, the average of somatic mutation frequency was 8.5% (1.5%-14.2%) and of ongoing mutation frequency was 0.51% (0.25%-0.75%). CONCLUSIONS: The average of ongoing mutation frequency in ocular adnexal EMZL was lower than that in gastrointestinal EMZL. Both ocular adnexal and gastrointestinal EMZLs are derived from postgerminal center memory B cells, but the low ongoing mutation frequencies of ocular adnexal EMZL may result from less antigen stimulation and follicular colonization in the orbit relative to gastrointestinal EMZL.

[Orbital development after enucleation without orbital implant in early childhood].

PURPOSE: To evaluate the development of orbital volume in five adults who underwent enucleation without orbital implant during early childhood, using reconstructed computed tomography(CT) images. MATERIALS AND METHODS: The orbital volume of 5 adults who underwent enucleation without orbital implants during early childhood was measured using CT images, and the results were compared between the anophthalmic orbit and the unaffected orbit in each case. The shape of maldevelopmental orbit and the relationship between orbital development and replacement of the prosthesis were also investigated. RESULTS: Orbital development in patients who underwent enucleation without orbital implant during early childhood was delayed in comparison with the unaffected orbit, and the delayed development was especially remarkable at the part of orbit corresponding to the equator of the eyeball. Maldevelopment of the orbit was severer in cases without replacement of the prosthesis than with it. CONCLUSION: For the development of orbital volume in anophthalmos after enucleation, orbital volume in place of the eyeball is required. Therefore, orbital implantation at the time of enucleation and replacement of the prosthesis with larger ones as the body grows are important.

Evaluation of the effective drugs for the prevention of nausea and vomiting induced by morphine used for postoperative pain: a quantitative systematic review.

Postoperative nausea and vomiting (PONV) with morphine therapy develops in more than 60% of patients after surgery, markedly reducing patient QOL. The prophylactic effect of several antiemetics has already been studied, but evaluations, and even those using the same drug, are not uniform. The present research involved a meta-analysis of randomized controlled trials on prophylactic drug therapy for PONV in patients receiving morphine for the treatment of postoperative pain. The efficacy of the prophylactic administration of the drugs was examined. As a result, meta-analysis of five drugs was possible and the evidence of efficacy was shown for three drugs ranked in order of an increasing odds ratio (OR) and confidence interval (CI): dexamethasone (OR: 0.23, 95% CI: 0.15-0.35, p < 0.00001), droperidol (OR: 0.27, 95% CI: 0.21-0.34, p < 0.00001), and metoclopramide (OR: 0.48, 95% CI: 0.30-0.75, p < 0.001). These results suggest that the three drugs are effective in prophylactic treatment for PONV. Of them, dexamethasone used as a prophylactic drug for PONV provided the best results. Dexamethasone was shown to reduce the incidence of PONV from 66-80% to 16-50% with a dose of 1.25 to 10 mg and to be suitable as a first drug of choice.

Acute abdominal pain preceding cutaneous manifestations of varicella zoster infection after allogeneic bone marrow transplantation.

The current communication describes clinical findings in two recipients of allogeneic bone marrow transplantation (BMT) with varicella zoster virus infection who complained of acute severe abdominal pain preceding cutaneous manifestations. Physical examination, laboratory data and gastroscopic findings were nonspecific. In these cases, acyclovir was very effective for the symptoms. Varicella zoster virus infection should be suspected in BMT recipients who have rebellant acute abdominal pain but no characteristic skin eruptions.

[Successful donor lymphocyte infusion for Epstein-Barr virus-associated lymphoproliferative disorder after allogeneic bone marrow transplantation from an HLA 1-locus-mismatched sibling donor in a patient with acute lymphocytic leukemia].

We report a case of Epstein-Barr virus-associated lymphoproliferative disorder (EBV-LPD) after allogeneic bone marrow transplantation (allo-BMT) from a partially mismatched related donor for acute lymphocytic leukemia, which was treated successfully by donor lymphocyte infusion (DLI). A 54-year-old woman in first complete remission from acute lymphocytic leukemia received an unmanipulated bone marrow transplant from an HLA-A 1-locus-mismatched sibling donor after preconditioning with cyclophosphamide and total body irradiation. Prophylaxis against graft-versus-host disease (GVHD) was done with tacrolimus and short-term methotrexate. Skin GVHD (grade I) occurred on day 36, but this subsided spontaneously without treatment. On day 61, rapidly progressive cervical lymphadenopathy with fever developed. Lymph node biopsy revealed lymphoid cell proliferation, which was positive for LCA, L26 and LMP-1. A diagnosis of EBV-LPD was made. After withdrawal of the tacrolimus, DLI (1 x 10(6) CD3 cells/kg) resulted in remission. This case suggests that even in the absence of risk factors such as severe GVHD, intensive immunosuppressive therapy and ATG administration, allo-BMT from an HLA 1-locus-mismatched related donor can be complicated by EBV-LPD, and that reduction of immunosuppressive therapy and DLI can be an effective treatment for it.

Orbital growth after unilateral enucleation in infancy without an orbital implant.

PURPOSE: To measure the volume of the anophthalmic orbit in adults who had undergone enucleation during infancy and to determine its growth. METHODS: The orbital volume in 5 adults who had undergone unilateral enucleation during infancy without an orbital implant was measured on x-ray computed tomography images. Comparisons were made between the anophthalmic and normal sides. In addition, we evaluated the morphology of the orbits showing growth retardation and the association between the prosthesis, if present, and orbital growth. RESULTS: In adults who underwent unilateral enucleation as infants, without an orbital implant, orbital growth was more retarded on the anophthalmic side than on the normal side. The difference was most marked in the area corresponding to the equator of the eyeball. This growth retardation was more severe in patients whose prosthesis was not replaced during childhood than in those who had regular replacement of their prosthesis. CONCLUSION: For orbital growth in anophthalmic orbits, an intraorbital volume that replaces the eyeball is necessary. An orbital implant at the time of enucleation and the replacement of the prosthesis with growth are important.

Studies on neurosteroids X. Determination of pregnenolone and dehydroepiandrosterone in rat brains using gas chromatography-mass spectrometry-mass spectrometry.

An assay method for pregnenolone and dehydroepiandrosterone in rat brains is developed using gas chromatography (GC)-electron ionization-mass spectrometry (MS)-MS. The extract of the rat brain homogenate containing deuterated internal standard with organic solvent is purified by silica gel minicolumn chromatography. The obtained fraction is derivatized into methyloxime, treated with dimethylisopropylsilylimidazole, and then subjected to GC-MS-MS. The method is applied to the determination of these steroids in the gray matter and olfactory bulbs of rat brains, which are divided into control and acute stressed specimens. Although pregnenolone in both regions of the rat brains increases more than three times after stress, dehydroepiandrosterone in both regions is not so clearly influenced by stress.

[Effects of an oxacephem antibiotic on liver function in orthopedic surgery].

The subjects were 531 patients who underwent orthopedic surgery. Flomoxef was administered, and liver function was examined before and after administration. Abnormal liver function after administration of flomoxef was found in 14.3% of patients. In male patients, a high rate of 18.8% was observed. A particularly high rate of 37.0% was obtained among patients who showed GOT values of more than 40 U/L before treatment with flomoxef. The prevalence of abnormal GOT and GPT values after administration of flomoxef was 3.6% and 13.2%, respectively. These values were significantly higher than those obtained with other cephem antibiotics. These rates of occurrence of abnormally high GOT and GPT are obviously higher than those submitted at the time of approval and reported in the drug use investigation. The prevalence of abnormal liver function values was high in patients receiving flomoxef, and particularly high in male patients and patients whose GOT was high before administration of flomoxef. Therefore, sufficient check of liver function appears important when administration of flomoxef to these types of patients is intended.

[T cell non-depleted bone marrow transplantation for primary refractory erythroleukemia using a partially HLA-mismatched related donor].

We performed an HLA-mismatched T cell non-depleted bone marrow transplant on a 53-year-old man with acute erythroleukemia that was highly resistant to conventional remission-induction chemotherapy. After conditioning that included total body irradiation, the patient received a two-HLA-antigen-mismatched bone marrow graft harvested from his sister using tacrolimus and methotrexate for graft-versus-host disease (GVHD) prophylaxis. He successfully established rapid engraftment accompanied by steroid-responsive GVHD localized to the skin. Although bone marrow samples on day 31 and day 66 disclosed a complete remission with full donor chimerism, the patient relapsed and died of pulmonary infection on day 154. There is evidence that tacrolimus is effective in alleviating GVHD. Selected patients who have partially mismatched related donors with less HLA disparity may benefit from tacrolimus-based T cell non-depleted bone marrow transplants because of the more potent graft-versus-leukemia effect that can be expected compared to transplants using T cell depleted inoculum.

The Cummins model: a framework for teaching nursing students for whom English is a second language.

The health care system requires nurses with the language ability and the cultural knowledge to meet the health care needs of ethnic minority immigrants. The recruitment, admission, retention, and graduation of English as a Second Language (ESL) students are essential to provide the workforce to meet the demands of the multicultural community. Yet, ESL students possess language difficulties that affect their academic achievement in nursing programs. The application of the Cummins Model of language proficiency is discussed. The Cummins Model provides a framework for nursing faculty to develop educational support that meets the learning needs of ESL students.

Studies on neurosteroids. IX. Characterization of estrogens in rat brains using gas chromatography-tandem mass spectrometry.

The characterization of the classical estrogens (estrone, estradiol, estriol) and guaiacol estrogens (2-hydroxyestrone 3-methyl ether, 4-hydroxyestrone 3-methyl ether) in rat brains was performed using gas chromatography-tandem mass spectrometry (GC-MS-MS). Estrogens were purified from Wistar strain rat brains by some chromatographic pre-treatments, such as solid-phase extraction, preparative thin-layer chromatography or preparative high-performance liquid chromatography. After the derivatization with O-methylhydroxylamine and/or N,O-bis(trimethylsilyl)trifluoroacetamide, estrogens were identified by comparison of their chromatographic behavior during GC-MS-MS operating in the product ion scan mode and comparison with the product ion MS spectra of an authentic sample. These evidences suggested that estrogens exist in rat brains as neurosteroids or neuroactive steroids.

[A consideration on the results of nationwide surveillance of antimicrobial susceptibilities--gram-negative bacilli].

The results of the semi-annual nationwide surveillance of antimicrobial susceptibilities, conducted by the Japanese Ministry of Health and Welfare during the period of January 1993 to July 1995, were analyzed for typical Gram-negative bacilli in the purpose of provision of an index for antimicrobial selection. During these 3 years, Escherichia coli, Citrobacter freundii, Enterobacter aerogenes and Proteus mirabilis showed slightly increasing tendency in susceptibility to fosfomycin (FOM) and Citrobacter freundii. Klebsiella pneumoniae and Enterobacter aerogenes showed slightly increasing tendency to minocycline (MINO). While Haemophilus influenzae and Haemophilus parainfluenzae showed slightly decreasing tendency to cefmetazole (CMZ). However, these annual changes were almost negligible. Generally, these microorganisms showed relatively good susceptibilities, every year, to the principal antimicrobial agents being approved for use against Gram-negative bacilli. However, Enterobacter cloacae, Enterobacter aerogenes, Serratia marcescens and Pseudomonas aeruginosa showed tendencies of decreased susceptibility to some of the antimicrobial agents. On the other hand, sulfamethoxazole-trimethoprim (ST), CMZ, latamoxef (LMOX), gentamicin (GM) and amikacin (AMK) showed good activities against some of the Gram-negative bacilli to which no indications are approved. In conclusion, bedside the identification of the causative microorganisms and the performance of antimicrobial susceptibility testing, such analyses (graphics of susceptibility tendency of clinical isolates to variety of antimicrobial agents) could be used as an index for selection of antimicrobial agents, when emergent and urgent selection of antimicrobial agents is necessary.

Multicenter clinical trial for evaluating methylprednisolone pulse treatment of idiopathic optic neuritis in Japan. Optic Neuritis Treatment Trial Multicenter Cooperative Research Group (ONMRG).

BACKGROUND: A randomized, controlled clinical trial was conducted in 1991 to compare an intravenous megadose of methylprednisolone with a control drug (mecobalamin) for treating acute idiopathic optic neuritis. CASES: Sixty-six cases from 22 clinical centers throughout Japan were examined to evaluate the treatment on visual function parameters, such as visual acuity, visual field, color vision, contrast sensitivity, and critical flicker frequency. OBSERVATIONS: The methylprednisolone pulse treatment group showed faster recovery of visual function, particularly the visual acuity at 1 week (P<.05), Humphrey field analyzer mean deviation at 3 weeks (P<.05), and color vision at 1 week (P<.05). Recovery of contrast sensitivity at several different spatial frequencies was significant in the pulse treatment group at 1 (P<.01), 2 (P<.05), and 4 weeks (P<.05) after the start of treatment. Visual function test results at 12 weeks and 1 year were essentially the same in the two treatment groups. Side effects appeared more frequently in the pulse treatment group than in the control (P<.05). CONCLUSIONS: Pulse treatment does not appear effective for idiopathic optic neuritis even though visual function in the pulse treatment group of this trial recovered more quickly during the initial phase compared to the controls. More effective and specific treatment should be established for optic neuritis.

Baseline features of idiopathic optic neuritis as determined by a multicenter treatment trial in Japan. Optic Neuritis Treatment Trial Multicenter Cooperative Research Group (ONMRG).

BACKGROUND: An optic neuritis treatment trial was conducted at 30 clinical centers in Japan using the same protocol. Patient participation was based on: age range of 14-55 years; acute symptoms indicative of unilateral optic neuritis of unknown or demyelinating origin; visual symptoms of 14-day duration or less; relative afferent pupillary defect in affected eye; and normal or swollen optic disc of affected eye. CASES: Initially, 102 patients qualified for participation; baseline data were obtained for analysis from 70 of these patients. Demographic characteristics of Japanese patients with optic neuritis were clarified and compared with those in a US study. OBSERVATIONS: The incidence of ocular or periocular pain and the presence of periventricular plaques were noted to be lower, and the incidence of disc swelling higher, in the Japanese patients, suggesting racial differences in the characteristics of the disease. Such differences may possibly be related to the lower incidence of multiple sclerosis in Japanese patients. The results of visual function tests were virtually the same in both studies. The nonaffected eyes of more than half the patients showed abnormal mean deviation in Humphrey field analysis, as also noted in the US study. CONCLUSIONS: The baseline clinical features of optic neuritis in the Japanese patients have been defined. Some racial differences in the characteristics of the disease may exist.

Plasma membrane disruption underlies injury of the corneal endothelium by ultrasound.

The nature and the extent of acute injury to corneal endothelial cells caused by exposure to ultrasound radiation were characterized, as well as the long-term reaction of these cells to this form of injury. It was found that the degree of lethal cell injury induced by ultrasound scaled with exposure intensity and duration. Immediate changes in plasma membrane permeability were induced by ultrasound exposure. This ultrasound-induced permeability change was, however, transient in many cells, allowing them to trap and retain a normally impermeant tracer, fluorescein dextran, in cytosol. Microvilli were present on ultrasound treated cells in far greater density than on control cells, characteristic of exocytosis-based resealing. Cultures containing a majority of transiently permeabilized endothelial cells were morphologically indistinguishable from untreated control cultures, and the fluorescein dextran-labeled cells in these populations locomoted and divided normally. We conclude that cell death due to ultrasound exposure can occur rapidly via a necrotic mechanism that can be attributed to mechanically induced damage to the plasma membrane. However, not all cells injured become necrotic: some survive and appear to behave normally after exposure. Conditions that favor plasma membrane disruption resealing, e.g. that result in sub-lethal rather than lethal cell injury, may mitigate the reduction in corneal endothelial cell density consequent on phacoemulsification and aspiration surgery.

Effect of growth factors on expression of integrin subtypes in microvascular endothelial cells isolated from bovine retinas.

We isolated microvascular endothelial cells from bovine retinas (BREC) by a colony isolation method, and investigated the effects of basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) on growth as well as integrin subtype expression of the cultured BREC. Either of the growth factors stimulated growth of the cultured BREC. In non-stimulated BREC, alpha v beta 3 integrin expression was predominant over the other integrin subtypes tested (alpha v beta 5, alpha 2 beta 1 and alpha 5 beta 1), but no enhancement of the alpha v beta 3 expression occurred by either growth factor stimulation. On the other hand, bFGF addition stimulated alpha v beta 5 and alpha 5 beta 1 expression while VEGF induced the alpha 2 beta 1 expression as well. These results suggest that external stimuli such as bFGF and VEGF alter integrin expression profiles of BREC and probably influence interactions of endothelial cells with extracellular matrix during angiogenesis which must be involved in pathogenesis of ischemic retinal disorders. In this respect, this BREC culture system could be useful to study the mechanism of neovascularization in these disorders.

[A consideration on the results of nationwide surveillance of antimicrobial susceptibilities--gram-positive cocci and gram-negative cocci].

The results of the semi-annual nationwide surveillance of antimicrobial susceptibilities, conducted by the Japanese Ministry of Health and Welfare during the period of January 1993 to July 1995, were analyzed for typical Gram-positive cocci and Gram-negative cocci in the purpose of provision of an index for antimicrobial selection. During these 3 years, Streptococcus pyogenes (group A) and Streptococcus agalactiae (group B) showed slightly increasing tendency in susceptibility to ofloxacin (OFLX) and sulfamethoxazole/trimethoprim (ST), while Streptococcus pneumoniae and Moraxella (Branhamella) catarrhalis showed slightly decreasing tendency to cefaclor (CCL). However, these annual changes were almost negligible. Generally, these microorganisms showed relatively good susceptibilities, every year, to the principal antimicrobial agents being approved for use against Gram-positive and -negative cocci. However, Staphylococcus aureus, Staphylococcus epidermidis and Enterococcus faecalis showed tendencies of decreased susceptibility to some of the antimicrobial agents. On the other hand, cefmetazole (CMZ), vancomycin (VCM), latamoxef (LMOX), ST and minocycline (MINO) showed good activities against some of the Gram-positive and -negative cocci to which no indication are approved. In conclusion, beside the identification of the causative microorganisms and the performance of antimicrobial susceptibility testing, such analyses (graphics of susceptibility tendency of clinical isolates to variety of antimicrobial agents) could be used as an index for selection of antimicrobial agents, when emergent and urgent selection of an antimicrobial agent is necessary.