Effects of micro-encapsulation on morphology and endocrine function of cryopreserved neonatal porcine islet-like cell clusters.

BACKGROUND: For the success of clinical islets transplantation, the development of a long-term storage method is necessary. However, the structure of digested islets is scanty for culture and cryopreservation. In this study, the effect of micro-encapsulation to cryopreserved porcine islet-like cell clusters (ICCs) was investigated. METHODS: The ICCs prepared from neonatal pigs by collagenase digestion and culture technique were cryopreserved and micro-encapsulated in 5% agarose membranes. After cryopreservation, ICC cultured without encapsulation (group A) and cultured with encapsulation (group B) were assessed by comparison with no cryopreserved ICC (control) both in vitro by static incubation test and in vivo in a xenotransplantation study. RESULTS: Micro-encapsulation was able to maintain the fine morphology and the number of ICCs of group B after 7 days of culture. There were not significant differences in insulin secretion of group B and control on day 1 and 7 of culture (1 day:11+/-0.99, 7 days: 5.30+/-1.08 microU/ICC/hr NS versus control). On day 7 of culture, the retrieval rate of group B (105.2+/-9.8%) is obviously higher compared with group A (63.0+/-6.3%). In the xenotransplatation model, the ICCs of group B showed long survival time (7.9+/-0.4 weeks) and good transplantation effect. CONCLUSION: Our study suggests that micro-encapsulation is one of the useful method for cryopreserved ICC to maintain the fine morphology and effectively recover the endocrine function.

A light microscopic study of glomerulosclerosis in Japanese patients with noninsulin-dependent diabetes mellitus: the relationship between clinical and histological features.

We studied the relationships of renal lesions with clinical features and renal prognosis in 128 Japanese patients with noninsulin-dependent diabetes mellitus (NIDDM). Diabetic glomerulosclerosis (DMGS) was found in 108 cases (84.4%), and DM-associated glomerulonephritis (GN), IgA nephropathy and membranous nephropathy, was in 20 cases (15.6%). There was no significant difference in age at renal biopsy, age at DM onset, DM duration, glomerular filtration rate (GFR), urine protein and serum IgA level between patients with DMGS and DM-associated GN. With respect to histological parameters, the increase in mesangial matrix was more closely related to DM duration, GFR and urine protein than to the degree of glomerular sclerosis. The index of glomerular lesion (IGL), which was calculated by combining these two lesions, had a more significant correlation with the clinical features than the tubulo-interstitial lesions. We suggested that the mesangial change was an initiating reaction, and the interstitial one was secondary in NIDDM patients. The prognosis of renal function after renal biopsy of the patients whose serum creatinine level was less than 1.2 mg/dl, was poorer in cases with nodular lesion than in those with diffuse lesion. The grade of tubulo-interstitial lesion was also more severe in these patients with nodular lesion. However, the controls of blood glucose, blood pressure, serum total cholesterol were not different among the two groups. On the other hand, serum creatinine level of most patients with associated GN did not change for a long period, up to 10 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Long-term follow-up of membranoproliferative glomerulonephritis type II and pregnancy: a case report.

A 24-year-old female was diagnosed as having membranoproliferative glomerulonephritis type II (or dense deposit disease), 11 years prior to becoming pregnant. The patient's first renal biopsy was performed 5 years after the onset of her renal symptoms. This biopsy was compared to a second renal biopsy taken just before the patient became pregnant. The second renal biopsy only showed a slight progression in the disease process. During the course of pregnancy, neither renal insufficiency nor hypertension were clinically evident. However, both an increase in proteinuria and a transient hypoalbuminemia were observed. The pregnancy, labor and delivery, and postpartum course for both the mother and child were without complications. Cases of membranoproliferative glomerulonephritis type I and pregnancy have been reported. However, to our knowledge, there are few reports documenting the outcome of pregnancy when a patient has membranoproliferative glomerulonephritis type II. We suggest that it is possible for a patient with membranoproliferative glomerulonephritis type II to have an uneventful pregnancy if she has neither hypertension nor renal insufficiency.

Immunotherapy for esophageal cancer. A randomized trial in combination with radiotherapy and radiochemotherapy. Cooperative Study Group for Esophageal Cancer in Japan.

We investigated the effect of multimodal therapy in 187 patients with esophageal cancer. All patients were followed up over a period of 5 years. Among the 187 patients, 174 (93.1%) eligible patients with biopsy-proved esophageal squamous cell carcinoma underwent esophagectomy and were randomly assigned to receive radiotherapy (RT) with or without protein-bound polysaccharide (PSK), or RT plus chemotherapy (CT) with or without PSK. The 5-year survival rates of patients with RT, RT+PSK, RT+CT and RT+CT+PSK were 40.0%, 42.3%, 29.1% and 37.2%, respectively. There was a tendency for longer survival on PSK, but statistical significance was not reached (RT+CT group versus RT+CT+PSK group: log-rank and generalized Wilcoxon tests, P = .1930, P = .1034). However, Cox multivariate regression analysis indicated that postoperative therapy with or without PSK was the most significant prognostic factor for patients receiving RT+CT and for the eligible patients. These results indicate that PSK may have a beneficial effect on esophageal carcinoma when given in combination with CT+RT.

Histological study of the hydroxyapatite-collagen complex implants in periodontal osseous defects in dogs.

This study was performed to determine whether the process of wound healing, following periodontal surgery, could be improved through the combined use of collagen and grafting of hydroxyapatite (HAP) particles. Twenty-four proximal defects were made in the mandibular fourth premolars and second molars of six adult mongrel dogs. Steel wires and resin were put into the defect to enhance plaque formation. At eight weeks, the wires and resin were removed. At ten weeks, HAP or HAP-collagen complex was implanted during reconstructive surgery, along the root surface treated with acid conditioning. Dogs that received no implant following a flap operation served as controls. In these three groups of animals, differences in the extent and features of healing were histopathologically examined two months later. Animals implanted with a HAP-collagen complex showed a larger amount of new cementum formation when compared with HAP-implanted or control animals. In addition, in animals from the HAP-complex group, the interdigitation between the root surface and the gingival connective tissue fibers tended to be reinforced resulting in suppressed epithelial downgrowth. However, neither bone formation nor the reformation of the periodontium was promoted in the HAP-collagen complex group. These results suggest that implantation of an HAP-collagen complex promotes cemento-genesis of the demineralized root surface and can establish a stronger interdigitation between the root surface and the gingival connective tissue fibers.

Lack of carcinogenicity of 8-nitroquinoline on long-term in vivo test in hamsters.

Syrian golden hamsters were administered 8-nitroquinoline, at a concentration of 0.05%, in a 10% ethanol solution as drinking water for 104 weeks. The animals were kept under observation until 112 weeks of age when the experiment was terminated. Both control and treated groups developed tumors in a pattern indistinguishable from that usually observed in Syrian golden hamsters. Thus the result of this experiment indicates that 8-nitroquinoline given orally at a concentration of 0.05% is not carcinogenic in Syrian golden hamsters.

Aortic valve replacement combined with endoventricular circulatory patch plasty (Dor operation) in a patient with aortic valve stenosis and severe ischemic cardiomyopathy.

A 58-year-old woman with ischemic cardiomyopathy and aortic valve stenosis, underwent aortic valve replacement and simultaneous endoventricular circulatory patch plasty (Dor operation). She underwent coronary artery bypass grafting for severe triple vessel disease 10 years ago. Recently she started to show severe congestive heart failure. Aortic valve stenosis with pressure gradient of 85-mmHg was also found. Coronary bypasses were all patent, but the left ventricle (LV) was severely dilated (LVDd/Ds=71/61 mm) and the ischemic cardiomyopathy was considered as the cause. She successfully underwent aortic valve replacement and endoventricular circulatory patch plasty. The initial postoperative course was complicated with intractable ventricular arrhythmia, but subsequent course was smooth and the patient was discharged with improved symptoms (NYHA Class II). Postoperative catheterization showed decreased left ventricular volume and improved contractility. This case implies the role of LV remodeling procedure in the ischemic cardiomyopathy combined with aortic valve lesion

Surgical removal of a stent entrapped in the left main coronary artery.

A stent entrapped in the coronary artery, which can not be removed by a trans-catheter approach, is extremely rare but is the biggest problem cardiologists face. Surgical retrieval appears to be the only possible treatment to avoid sudden death due to stent thrombosis. We experienced with a New Parmaz-Schatz stent entrapped in the left main coronary artery (LMT) of a 65-year-old man. He underwent surgical removal of the stent with ascending aorta incision and double coronary artery bypass grafting (CABG) using saphenous veins. We believe that a stent entrapped in the LMT must be removed as rapidly as possible to avoid sudden death. Furthermore, in order to avoid the risk of peripheral thrombosis, retrieval is also the case in patients whose distal coronary flow can be maintained with CABG.

Effects of cyclodextrins on the complexation between Methylene Blue and tetrakis(4-sulfonatophenyl)porphyrin in aqueous solutions.

In aqueous solutions buffered at pH 10.1, Methylene Blue (MB) forms a complex with tetrakis(4-sulfonatophenyl)porphyrin (TSPP). The equilibrium constant for the formation of the MB-TSPP complex has been evaluated to be 2.35 x 10(5) mol(-1) dm3 from the fluorescence quenching of MB by TSPP. Effects of alpha-, beta-, and gamma-cyclodextrin (CD), and heptakis(2,3,6-tri-O-methyl)-beta-cyclodextrin on the complexation between MB and TSPP have been examined by means of absorption and fluorescence spectroscopy. The binding of CDs to TSPP and/or MB in the MB-TSPP complex causes the dissociation of the MB-TSPP complex.

Intraosseous meningioma of the posterior fossa--Case report.

A 62-year-old male presented with a rare intraosseous meningioma with intradural extension manifesting as frequent vomiting and floating sensation that had persisted for 3 months. Neuroimaging detected a mass lesion that was mainly located extradurally in the right posterior fossa with a daughter lesion inside the dura. He underwent surgical excision of the mass lesion. Craniectomy exposed the main lesion of the tumor just beneath the thinned outer table of the skull, and in the extradural space, with the daughter lesion penetrating the dura. Both portions of the tumor were resected. There was no attachment to the adjacent dura mater. Histological examination showed meningotheliomatous meningioma containing scattered bony tissue. This intraosseous meningioma probably originated from the occipital bone with a small intradural extension caused by mechanical compression.

[A case of severe tsutsugamushi disease without eruption].

A 64-year-old male was admitted to our division because of fever. After admission, the patient was given beta-lactam antibiotics intravenously because he had no eruption and eschar. However, the fever continued, and he became unconsciousness and DIC appeared. We diagnosed the patient as Tsutsugamushi disease from indirect fluorescent antibody technique. Minocycline was excellently effective. Several reports of Tsutsugamushi disease without eruption have been given, so we must always be careful of Tsutsugamushi disease.

[Internal carotid artery stenosis and external carotid artery occlusion with unusual extracranial collateral pathway: case report].

A patient with stenosis of the internal carotid artery and occlusion of the external carotid artery associated with an unusual extracranial collateral pathway is presented. A 63-year-old man was hospitalized for sudden onset of black-out after urination. He was alert, and no neurological deficit was found. MRI showed multiple lacunae in the bilateral putamens. Cerebral angiogram demonstrated severe stenosis of the left internal carotid artery at its cervical segment and complete occlusion of the left external carotid artery at its origin. The ascending pharyngeal artery originated from the left internal carotid artery above its stenotic lesion and the superior thyroid artery originated from the left common carotid artery. The sternocleidomastoid branch from the left superior thyroid artery and the muscular branch from the left vertebral artery anastomosed with the muscular branch of the ascending pharyngeal artery. The ascending pharyngeal artery maintained patency of the internal carotid artery. It is important to perform vertebral angiography when there is proximal occlusion and severe stenosis of the internal carotid artery, and when the ascending pharyngeal artery has not been clearly identified as a branch from the ipsilateral external carotid artery on the common carotid angiogram.

[The estimation of effective renal plasma flow (ERPF) based on two compartment analysis using 99mTc-mercaptoacetyltriglycine (99mTc-MAG3)].

The effective renal plasma flow (ERPF) of patients with renal-urinary disorders were estimated employing 99mTc-mercaptoacetyltriglycine (99mTc-MAG3) and a newly-developed clearance method which needs no blood sampling and is based on two-compartment fitting of the cardiac time-activity curves. In comparison with 123I-ortho-iodohippurate (123I-OIH) (n = 9), the disappearance rate constants and ERPF values estimated by the clearance method and the ERPF values by Schlegel's method showed a good correlation between the two agents (r = 0.88, r = 0.83 and r = 0.85, respectively). The ERPF values evaluated using 99mTc-MAG3 and the clearance method correlated well with those by Schlegel's method (n = 11, r = 0.95). These results suggest that 99mTc-MAG3 shows pharmacokinetics which are similar to those of 123I-OIH and that it might be a useful diagnostic tool for estimating the ERPF in patients with renal disorders.

[Scintigraphic appearance in stress 201Tl myocardial SPECT of midportion lesion in left anterior descending artery].

Scintigraphic appearance of left anterior descending artery (LAD) lesion in stress 201Tl myocardial SPECT was studied in 43 patients (pts) with midportion lesion in LAD confirmed by coronary angiography. Right margin of ischemic region in the basal short axial image was -36 +/- 17 degrees and left margin was -128 +/- 75 degrees. In 28 pts of 43 pts left margin lied beyond -120 degrees. From the results it was concluded that in most cases basal inferior wall was perfused by septal branches from LAD. In 6 pts with midportion lesion situated proximal to the first diagonal branch and in 12 pts with midportion lesion situated proximal to the second diagonal branch ischemic region in the apical portion was noted at both septum and anterolateral wall. Critical short axial image, in which right margin of ischemic region shifted from plus to minus area, was the 3.2nd short axial image in the former group and the 5.2nd in the latter group (p < 0.01). In 10 pts with midportion lesion situated distal to the large first diagonal branch, ischemic region was noted in septal wall and not in anterolateral wall. It was concluded that right margin of ischemic region in the basal coronal image was the most useful sign for predicting midportion lesion and left margin for dominance between LAD and right coronary artery and that apical anterolateral ischemia was sign for LAD lesion involving diagonal branch. Critical short axial image was useful for determining whether the lesion was situated proximal or distal to the first diagonal branch and whether the lesion was situated proximal to the second diagonal branch.

[An interesting case of pituitary apoplexy showing abnormality in water-electrolyte before and after surgery].

Cases which present abnormality in water-electrolyte before and after operation of pituitary adenoma are occasionally reported. The authors have encountered a case in which neurological symptoms became aggravated abruptly with pituitary apoplexy after admission, hyponatremia was noted before operation and polyuria, not hypotonic urine was observed after operation. As a result of an endocrinological examination which may have an influence on water-electrolyte (ADH, aldosterone, ANP, etc.) the ADH level in hyponatremia before operation was high at 6.8 pg/ml; so, it was taken as SIADH. According to a study at the time of polyuria after operation, the ADH level was normal at 2.4 pg/ml, the ANP level was abnormally high at 140 pg/ml and the specific gravity of the urine was kept at 1.010 or more. So, polyuria was considered due to abnormally increased content of serum ANP. In polyuria due to abnormally increased content of serum ANP, the osmotic pressure of the urine is maintained relatively well, which is a clinical feature evidently different from diabetes insipidus. After operation for pituitary adenoma, water-electrolyte should be controlled with polyuria due to abnormally increased content of serum ANP in addition to diabetes insipidus taken into consideration.

[A case of hemolytic uremic syndrome associated with circulating anticoagulant].

A previously well 66-year-old woman was admitted to our hospital because of severe abdominal pain, oliguria, jaundice and hemoglobinuria. At admission, the following values were obtained: red blood cell count 261 x 10(4)/mm3, serum creatinine 2.8mg/100ml, total bilirubin 8.0mg/ml, indirect bilirubin 5.7mg/100ml, LDH 13886 WU, negative direct and indirect Coomb's test and peripheral blood smear showing schistocytosis. She was diagnosed as hemolytic uremic syndrome and was successfully treated with plasma infusion, plasma exchange and hemodialysis. The results of the tests for verotoxin titer of E. coli O157: H7 and circulating anticoagulant were positive. The test result for anticoagulant eventually became negative during her clinical course. In this case, circulating anticoagulant might have contributed to the pathogenesis of hemolytic uremic syndrome.

[A case of mitral stenosis with free floating ball thrombus].

A free floating thrombus in the left atrium is a rare complication of the mitral valvular disease. A 56-year-old woman with mitral stenosis was admitted for cerebral infarction and abdominal pain. A free floating ball thrombus was detected in the left atrium by echocardiography. We performed the emergent open heart surgery for removal of ball thrombus and mitral commissurotomy successfully. The size of thrombus was 4 x 3 x 2 cm. Postoperative course was uneventful.

[Comparative clinical study of MF(mitomycin and 5-fluorouracil) and MF.BH-AC therapy].

Sunrabim for injection (BH-AC), one of the antitumor agents available for acute leukemia, has considerable activity against a variety of transplanted solid tumors in rats and mice. A comparative clinical study was performed by randomized controlled trial on two different combined chemotherapies of MMC, 5-FU (MF group), and MMC, 5-FU, BH-AC (MF . BH-AC group) for 64 patients with a variety of solid cancers. Among 64 patients, 47 were evaluable for response (MF group: 23/32, MF . BH-AC group: 24/32). The partial response rate of the MF group was 4.3% (1/23), and that of the MF . BH-AC group was 33.3% (8/24). MF . BH-AC therapy was found to be more effective than MF therapy. The toxicity rates of the two therapies were similar (MF group: 46.7%, MF . BH-AC group: 50.0%). This study suggests that combined chemotherapy of MF plus BH-AC is more effective on a variety of solid cancers in comparison to MF therapy.

Outcomes of pediatric ABO-incompatible kidney transplantations are equivalent to ABO-compatible controls.

BACKGROUND: Due to the profound shortage of suitable deceased allografts, much effort has been made to investigate whether successful kidney transplantation (KT) is possible across the ABO blood group barrier even for pediatric recipients. METHODS: We reviewed 52 consecutive ABO incompatible (ABOic) transplantation performed between September 1989 and March 2011. The mean age at transplantation was 10.6 ± 3.9 years (range, 4.4-19.7), with 35 boys and 17 girls. The donor-to-recipient ABO blood antigen incompatibility was as follows: A1/O (n = 17); B/O (n = 13); A1/B (n = 6); B/A1 (n = 1); A1B/B (n = 9); and A1B/A (n = 6). As a control group, data were collected from 271 pediatric ABO compatible (ABOc) living donor KT in the same period. RESULTS: Overall acute rejection episodes (ARE) among the ABOic group were significantly higher than those of the ABOc group (44% vs 26%; P < .02). However, there was no difference in glomerular filtration rate (GFR) at 1 year after transplantation: 86 ± 31 mL/min for ABOic vs 99 ± 37 mL/min for ABOic, respectively. The 1-y, 5-y, and 10-year patient survival rates were 98%, 92%, and 92% in the ABOic group, respectively, and 99%, 98%, and 97% in the ABOc group, respectively (P = not significant [NS]). The overall 1-, 5-, 10-, and 15-year graft survival rates were 94%, 88%, 86%, and 86% in the ABOic group, respectively, and 95%, 92%, 88%, and 78% in the ABOc group, respectively. CONCLUSION: ABOic KT provided long-term allograft and patient survivals equivalent to ABOc live donor transplantations.