Nd3+-activated CaF2 ceramic lasers.

Nd,Y:CaF2 and Nd,La:CaF2 ceramics featuring good optical quality have been fabricated by reactive sintering and a hot isostatic pressing method. The transmission spectra, emission spectra, and fluorescence decay curves were measured. Lasing at 1064 and 1065 nm was observed in Nd,Y:CaF2 and Nd,La:CaF2, respectively, upon quasi-continuous-wave pumping by a diode laser emitting at 791 nm. To the best of our knowledge, this is the first demonstration of Nd3+-activated CaF2 ceramic laser.

Exposure to thoracic dust, airway symptoms and lung function in cement production workers.

Cement dust exposure has previously been associated with airway symptoms and ventilatory impairment. The aim of the present study was to examine lung function and airway symptoms among employees in different jobs and at different levels of exposure to thoracic dust in the cement production industry. At the start of a 4-yr prospective cohort study in 2007, exposure to cement dust, symptoms and lung function were recorded cross-sectionally in 4,265 employees in 24 European cement plants. Bronchial exposure was assessed by 2,670 full-shift dust samples with cyclones collecting the thoracic aerosol fraction. A job exposure matrix was constructed by grouping dust concentrations according to job type and plant. Elevated odds ratios for symptoms and airflow limitation (range 1.2-2.6 in the highest quartile), but not for chronic bronchitis, were found in the higher quartiles of exposure compared with the lowest quartile. Forced expiratory volume in 1 s (FEV(1)) showed an exposure-response relationship with a 270-mL deficit of FEV(1) (95% CI 190-300 mL) in the highest compared with the lowest exposure level. The results support the hypothesis that exposure to dust in cement production may lead to respiratory symptoms and airway obstruction.

Evaluation of prognostic-significance of p53 gene alterations in patients with surgically resected lung-cancer.

Clinical significance of p53 gene alterations, as a prognostic factor, was assessed in 69 patients with surgically resected lung cancer. The p53 gene alterations (exon 5-9) were examined by the polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) method of genomic DNA. The p53 gene alterations were detected in all histological types of lung cancer, with a positive rate of 45% (31/69). In the alteration-positive group, patients in the advanced stages of III and IV were seen more frequently than in the negative group (58% vs. 21%, p<0.05). Such a difference was not observed in other parameters such as age, gender, histological type and smoking habit. The prognosis was, on a whole, poorer in the alteration-positive group than for the -negative one (5-year survival rate: 19.3% vs. 40.6%, MST: 17 months vs. 36 months), but the difference did not reach statistical significance. However, in the case of females (p<0.05), adenocarcinoma (p<0.01), early stages of I and II (p<0.05) and non-smokers (p<0.005), a significantly poorer prognosis was observed in the gene alteration-positive group than for the -negative one. These results suggest that the p53 gene alteration may be a useful prognostic factor in certain subgroups with lung resected for cancer.

Survival and prognosis after pneumonectomy for lung cancer in the elderly.

BACKGROUND: The number of elderly patients with lung cancer is increasing. This study was undertaken to assess the validity of pneumonectomy for the treatment of lung cancer in this patient group. METHODS: Twenty-seven patients 70 years old or older (elderly group) and 95 patients younger than 70 years (younger group) who underwent pneumonectomy between January 1985 and March 1996 formed the study group. In the elderly group, 22 patients had squamous cell carcinoma, 2 had adenocarcinoma and 3, small cell carcinoma; 1 patient was in postoperative stage I, 4 patients were in stage II, 14 in stage IIIA, 5 in stage IIIB, and 3 in stage IV of the disease. The only significant differences in patient characteristics between the two groups were the percentage of patients undergoing right pneumonectomy and the percentage of patients receiving chemotherapy or radiotherapy within 3 months before or after operation or both times. RESULTS: The prognosis for the elderly group was comparable to that of the younger group for all stages of the disease; the overall 5-year survival rate was 30.5% for the younger group and 11.5% for the elderly group. However, operation-associated mortality was significantly higher in the elderly group (22.2% versus 3.2%; p < 0.005). The prognosis was better for patients with a centrally located tumor than a peripheral tumor in both groups [13.5% versus 2.0% in the elderly group and 46.7% versus 5.2% (p < 0.01) in the younger group] and significantly better for patients having a left pneumonectomy than a right pneumonectomy in the younger group (46.7% versus 5.2%; p < 0.01) but not in the elderly group (13.7% versus 22.2%). Adjuvant treatment did not have any beneficial effect on the prognosis in either group. CONCLUSIONS: Pneumonectomy for lung cancer in elderly patients appears to be justified because the outcome in our study was comparable with that for the younger patients. However, it should be performed only in carefully selected patients because of the increased operative risk.

Urodynamic studies on hemiplegic patients after cerebrovascular accident.

Thirty-nine hemiplegic patients were evaluated by complete urodynamic study after cerebrovascular accidents. Computerized tomography was performed to identify localization of the brain lesion. The common urinary symptoms were frequency and urgency incontinence (26/39), while 13 patients complained of dysuria or urinary retention. Ten of the 11 patients who had frontal and internal capsular lesions showed hyperactive bladder, and 6 showed uninhibited sphincter relaxation. Nine of the 10 patients who had putaminal lesions showed hyperactive bladder. Normal sphincter activity was demonstrated in 7 of these 10 patients. In the remaining patients with the other types of lesions, no correlation was found between urodynamic dysfunction and type of brain injury.

Microwave surgical treatment of diseases of prostate.

A new transurethral probe for microwave radiation of the prostate has been developed. As a preliminary experiment, sliced ham was radiated with microwaves using this probe in order to evaluate the extent of thermal effect. Using mongrel male dogs, microwave coagulation of the prostate was examined. These animal experiments showed marked destruction of the prostate gland. Furthermore, the safety of this method was confirmed on the basis of results from the experiments. Prostatic bladder neck obstruction also has been treated in 6 patients with benign prostatic hypertrophy or carcinoma of the prostate by this technique. There has been no mortality and also no complications. The results of this preliminary clinical trial have been excellent.

Properties of the descending limb of the spinobulbospinal micturition reflex pathway in the cat.

The micturition reflex is thought to be mediated by a spinobulbospinal reflex pathway passing through the rostral pons. This study examined the properties of the descending limb of the reflex pathway by monitoring the responses of the lower urinary tract to stimulation of the pons in the decerebrate cat. Electrical stimulation (300 microseconds pulses at 50 Hz intratrain frequencies, 300-500 ms trains, 0.5-15 V) in the region of the locus coeruleus (P 0.5-3.1/L 2-4/H to -2.75) was used to activate the descending excitatory pathway to the sacral parasympathetic nucleus. Low intensity stimulation induced small amplitude, short duration (14 +/- 11 cm H2O, 10 +/- 3 s) bladder contractions in a partially full bladder, whereas higher intensity stimulation induced large amplitude, long duration (69 +/- 29 cm H2O, 70 +/- 44 s) contractions which were similar to distension-induced reflex micturition contractions. The evoked bladder contractions coincided with a reduction in external urethral sphincter (EUS) EMG activity. Following bilateral L7-S3 dorsal root transection, electrical stimulation of the pons still elicited the small amplitude bladder contractions, but the larger amplitude, long duration micturition contractions were abolished. During these small evoked bladder contractions, a suppression of EUS activity still occurred following deafferentation, indicating a pontine mediated bladder/EUS synergy. It is concluded that the pons can initiate bladder contractions and coordinated bladder-sphincter activity, but that afferent feedback (via the dorsal roots) is needed to maintain the large amplitude micturition contractions.

Electrophysiological analysis of the ascending and descending components of the micturition reflex pathway in the rat.

Electrophysiological techniques were used to examine the organization of the spinobulbospinal micturition reflex pathway in the rat. Electrical stimulation of afferent axons in the pelvic nerve evoked a long latency (136 +/- 41 ms) response on bladder postganglionic nerves, whereas stimulation in the dorsal pontine tegmentum elicited shorter latency firing (72 +/- 25 ms) on these nerves. Transection of the pelvic nerve eliminated these responses. Firing on the bladder postganglionic nerves was evoked by stimulation in a relatively limited area of the pons within and close to the laterodorsal tegmental nucleus (LDT) and adjacent ventral periaqueductal gray. Stimulation at sites ventral to this excitatory area inhibited at latencies of 107 +/- 11 ms the asynchronous firing on the bladder postganglionic nerves elicited by bladder distension. Electrical stimulation of afferents in the pelvic nerve evoked short latency (13 +/- 3 ms) negative field potentials in the dorsal part of the periaqueductal gray as well as long latency (42 +/- 7 ms) field potentials in and adjacent to the LDT. The responses were not altered by neuromuscular blockade. Similar responses were elicited by stimulation of afferent axons in the bladder nerves. The sum of the latencies of the ascending and descending pathways between the LDT and the pelvic nerve (i.e. 72 ms plus 42 ms = 114 ms) is comparable although somewhat shorter (22 ms) than the latency of the entire micturition reflex. These results provide further evidence that the micturition reflex in the rat is mediated by a spinobulbospinal pathway which passes through the dorsal pontine tegmentum, and that neurons in the periaqueductal gray as well as the LDT may play as important role in the regulation of the micturition.

Pontine control of the urinary bladder and external urethral sphincter in the rat.

Neurons in the rostral pontine tegmentum are known to have an important role in controlling micturition. The present experiments used urethane anesthetized rats to examine the effects of electrical stimulation at various sites in the pons on bladder and external urethral sphincter activity and on the volume threshold for inducing micturition. Stimulation with short trains of pulses (50 Hz, 1-3 s trains, 1-15 V) in the laterodorsal tegmental nucleus (LDT), the periaqueductal grey (PAG) or the lateral parabrachial nucleus (L-PBN) elicited contractions of a partially filled, quiescent bladder. However stimulation during a bladder contraction aborted the contraction indicating that these areas have inhibitory as well as excitatory effects. Continuous stimulation (50 Hz) in the PAG or L-PBN during a cystometrogram decreased bladder capacity (mean decrease 36%). Conversely, continuous stimulation in the pontine reticular formation (in or near the dorsal subcoeruleus nucleus and medial parabrachial nucleus) increased bladder capacity (mean increase 50%). Stimulation at pontine sites (LDT, PAG and L-PBN) which elicited bladder contractions also elicited an increase in external urethral sphincter activity. A similar increase in urethral sphincter activity occurred during reflex micturition induced by bladder distension. These data suggest that bladder capacity and the coordination of bladder and external urethral functions are controlled by various neuronal populations in the rostral pons of the rat.

Excitatory and inhibitory influences on bladder activity elicited by electrical stimulation in the pontine micturition center in the rat.

Electrical stimulation at various sites in the dorsal pontine tegmentum in urethane anesthetized rats modulated activity of the urinary bladder as well as efferent firing on bladder postganglionic nerves. Electrical stimulation (0.2 ms 50 Hz, 5-20 V or 30-150 microA, 2-5 s train duration) using a microelectrode (tip diameter, 10-20 microns) in an excitatory area located rostral and medial to the locus coeruleus evoked short latency (less than 2 s) large amplitude (greater than 20 cm H2O) bladder contractions and increased firing on the bladder postganglionic nerves. Stimulation at sites adjacent to the excitatory area inhibited bladder postganglionic nerve firing and bladder activity. Inhibitory responses were evident as either a decrease in intravesical pressure, an increased interval between bladder contractions, or an interruption or elimination of bladder contractions. The threshold intensity for excitation using a large electrode (2-4 V) was slightly higher than that for inhibition (1.5-2 V). The optimum sites for evoking bladder contractions were located in and close to the laterodorsal tegmental nucleus (LDT) and in the periaqueductal gray just dorsal or dorsolateral to the LDT. The extent of the area that induced bladder contractions was 0.5-1.2 mm in diameter in each rat when a microelectrode was employed for electrical stimulation. Electrical stimulation in the optimum site for evoking bladder contractions induced relatively little striated muscle activity and produced no short-latency blood pressure changes. The longer latency blood pressure changes associated with a spontaneous bladder contraction were still present following a stimulation of the dorsolateral pons. These data are consistent with the view that neurons in the dorsal pontine tegmentum play an important role in the regulation of urine storage as well as urine release.

A comparison of angiotensinase and placental leucine aminopeptidase during normal pregnancy.

1. Serum leucine aminopeptidase activity measured by its action on hydrolysis of L-leucyl-beta-naphthylamide was increased progressively as pregnancy advanced. Angiotensinase activity determined by bioasaay showed parallel increase during normal pregnancy. 2. The effects of heat treatment and L-methionine on the activity of angiotensinase were compared with those on leucine aminopeptidase activity in pregnancy serum.

Results of pneumonectomy for non-small cell lung cancer: appropriateness of the new TNM staging system.

In the new TNM staging system for lung cancer in 1997, stage T3N0M0 was revised from stage IIIA to stage IIB. Therefore, we initiated a study to assess the appropriateness of this revision. One hundred and nineteen patients who had undergone pneumonectomy for non-small cell lung cancer (NSCLC) between January 1985 and March 1996 were analyzed. They included 87 squamous cell carcinoma (sq), 25 adenocarcinoma (ad), 4 large cell carcinoma (la), and 3 adenosquamous cell carcinoma (ad-sq), with 10 patients in postoperative stage I (3 IA + 7 IB), 29 stage II (1 IIA + 28 IIB), 74 stage III (39 IIIA + 35 IIIB) and 6 in stage IV of the disease. Stage IIB included 14 patients with T3N0M0 (12 sq, 1 ad, 1 la). The 5-year survival rate for patients with T3N0M0 was 69.6%, which was superior to that (55.7%) for patients with stage II (T1-2N1M0) of the previous system. According to the new TNM staging system, the 5-year survival rate was 40% in stage I, 66.2% in stage II, 24% in stage IIIA, 0% in stages IIIB and IV (stage I vs stage II, NS; stage II vs stage IIIA, p<0.01; stage IIIA vs stage IIIB, p<0.01; stage IIIB vs stage IV, p<0.01). A significant prognostic difference between stage II and stage IIIA was observed, which had not been observed in the previous system. Our results show that the revision of T3N0M0 from stage IIIA to stage II in the new TNM staging system seems appropriate with regard to the pneumonectomy group.

Prognosis for patients with pneumonectomy or lesser resections for non-small cell lung cancer based on histologic cell type.

Contrary results have been reported regarding prognosis by histologic cell type in surgical treatment for lung cancer. To evaluate whether histologic cell type has influence on prognosis, we separately analyzed the prognostic outcome of patients who had undergone pneumonectomy (n=119) and lesser resections (n=124) for non-small cell lung cancer (NSCLC) between January, 1985 and March, 1996. The pneumonectomy group included 87 (73%) squamous cell carcinoma (Sq), 25 (21%) adenocarcinoma (Ad) and 7 other types with 10 (8%) patients in postoperative stage I of the disease, 29 (24%) stage II, 74 (62%) stage III and 6 in stage IV. The lesser resection group included 45 (36%) Sq, 63 (51%) Ad and 16 other types with 71 (57%) patients in stage I, 9 (7%) stage II, 32 (26%) stage III and 12 stage IV. In patients with stages I-III, the 5-year survival rate was 42.8% for the Sq group and 41.1% for the Ad group in the case of lesser resections and 37.1% for the Sq group and 0% for the Ad group (p<0.05) in the case of pneumonectomy. The poorer prognosis for patients with Ad in the case of pneumonectomy was suspected to be due to the N factor; the percentage of patients with N0-1 was significantly lower in the Ad group than for the Sq group (28 vs 62%, p<0.005). Histologic cell type can be a prognostic factor for patients undergoing surgical treatments for NSCLC. One possible reason for the contrary results on prognosis by histologic cell type among investigators may be due to the mixed results of pneumonectomy and lesser resections.

The retrospective assessment of surgical resection in the management of small cell carcinoma of the lung.

Role of surgical resection for small cell lung carcinoma (SCLC) was retrospectively assessed in 16 patients with pTNM-stage I and 13 with pTNM-stages II and IIIA. The 3-year and 5-year survival rates in patients with stage I were 61% and 45%, respectively, and the median survival time (MST) was 23.5 months. On the other hand, the 3-year survival rate for the 13 surgical patients with stages II and IIIA was 28% (MST=19 m), which showed no statistical difference between that of 21% (MST=10 m) for the 16 non-surgical patients with clinical stages II acid IIIA. These results suggest that resection is desirable for patients with stage I, but is of no benefit for patients with stages II and IIIA.

The effect of alpha-2 agonists and antagonists on the upper urinary tract of the rat.

We examined the effect of the selective alpha-2 agonist dexmedetomidine and antagonist atipamizole on the upper urinary tract, renal pelvic pressure and ureteral peristalsis. Experiments were performed on twelve Sprague-Dawley female rats weighing 275-323 grams, with administration of urethane (1.2 micrograms/kg). Ventilatory support was provided through a tracheotomy. A continuous normal saline infusion was maintained through the left iliac vein at a rate of 2.5 ml/hr. Arterial pressure was measured at the left iliac artery, which was cannulated with a PE-100 tube connected to a pressure transducer. A mid-line incision was then made from the xyphoid to the symphysis to expose the left kidney, both ureters, and the bladder. The bladder was intubated and drained to avoid bladder pressure increase. Measurements of urine output rate were made from the right ureter and renal pelvic or ureteral pressure was measured using a nephrostomy placed into the pelvis. A ureterostomy was produced by introducing another catheter, into the upper segment of the left ureter for ureteral pressure measurements. The rats were divided into two groups as follows: 1) dexmedetomidine group (n = 6); injected intravenously with 2 micrograms/kg of dexmedetomidine dissolved in 0.5 ml saline. 2) atipamizole group (n = 6); injected intravenously with 2 micrograms/kg of atipamizole dissolved in 0.5 ml saline. Ureteral peristaltic frequency, baseline pressure, and contraction amplitude were compared before, after, and between the bolus injections of 2 micrograms/kg dexmedetomidine (n = 6) or 2 micrograms/kg atipamizole (n = 6) in 0.5 ml saline. The results showed that dexmedetomidine at 2 micrograms/kg produced a significant decrease in arterial pressure and an increase in urine output from 1.2 + 0.8 to 3.6 + 1.2 ml/min. There was no effect on the baseline pelvic pressure of 6.8 + 1.2 cmH2O or amplitude of the renal pelvic contractions: 3.5 + 0.6 cmH2O. The frequency of pelvic contractions was reduced from 0.37 + 0.03 to 0.27 + 0.02 Hz. Atipamizole at 2 micrograms/kg produced a significant reduction in urine flow rate of 1.1 + 0.8 to 0.6 + 0.2 ml/min. Atipamizole also showed no significant effects on baseline pelvic pressure or frequency, but increased the amplitude of pelvic contractions from control values of 3.0 + 0.9 to 3.4 + 0.9 cmH2O. Dexmedetomidine reduced both the baseline ureteral pressure of 8.5 + 2.4 and peristaltic contraction pressure of 11.5 + 2.3 cmH2O in 4/6 rats. Atipamizole reduced base-line ureteral pressure and increased peristaltic rate.(ABSTRACT TRUNCATED AT 400 WORDS)

[Effect of terazosin on lower urinary tract function in the male decerebrate dog].

The effect of terazosin on the lower urinary tract function was studied by combined recording of bladder and urethral pressures and external sphincter electromyogram in 8 male decerebrate dogs. Reflex micturitions were induced by bladder filling before and after terazosin. The statistical analysis was carried out on the urodynamic parameters. During the collecting phase, terazosin at doses of 10, 30 and 100 micrograms/kg produced a significant decrease in maximum urethral pressure in the dose dependent manner. Threshold pressure was significantly shown to decrease at doses of 30 and 100 micrograms/kg. In the urodynamic parameters of the emptying phase there was a significant decrease in maximum contraction pressure at 10 and 30 micrograms/kg, and in voided volume at 100 micrograms/kg. Terazosin seems to facilitate an initiation of the bladder contraction with a decrease in threshold pressure. In concludes that alpha 1 adrenergic activity seems to take an important role for the maintenance of the urethral pressure and to control the initiation of bladder contraction in modulation with threshold pressure.

Clinical study on thymoma: assessment of prognostic factors.

In order to define the clinical features of thymoma, we reviewed 51 thymoma patients in our departments from 1980 to 1995. Of 146 mediastinal tumors, 51 (35%) had thymoma, the most frequent tumor, and 21 (14%) had neurinoma. Twenty-one patients had non-invasive thymoma (Masaoka staging = stage I) and 30 had invasive thymoma (stages II-IV). In the non-invasive group, the male to female ratio was 0.8 (9/12) and the majority were of mixed histologic type (13/21 = 62%). Conversely in the invasive group, the male to female ratio was 1.7 (19/11), and the occurrence of the epithelial type (12 = 40%) was as frequent as the mixed type (13 = 43%). Patients with non-invasive thymoma were all treated with surgery only, and those with invasive thymoma were treated with multimodalities except for one. The 5-year survival rate was 100% for the non-invasive group, and 67% for the invasive group. Patients with accompanying myasthenia gravis (MG) showed a better prognosis than the non-MG patients (P < 0.05). The lymphocytic type also showed a better prognosis than the epithelial type, but this was not statistically significant. The prognosis for patients with thymoma was much better than for those with thymic cancer (n = 9). Thymoma showed a variety of clinical features depending on histologic type and association with myasthenia gravis.

Sex differences in clinicopathological features of peripheral T1 adenocarcinoma of the lung.

Clinicopathological features of surgically-treated peripheral T1 adenocarcinoma of the lung were compared between 30 females and 26 males, and the following sex differences were observed; 1) Females were younger than males, 2) There was a higher percentage of smokers among males, 3) The acinar histologic subtype was less frequently found in females, 4) Well differentiated tumors were more frequently found in females, 5) K-ras gene mutations were observed only in males, 6) Prognosis was slightly better in females. As to other factors such as N-factor, tumor ploidy or central fibrosis, there was no statistical difference between the two groups. Although we were not able to explain the causes for the above sex differences, it was speculated that smoking was mainly responsible for them.

Analysis of prognostic factors in patients with resected peripheral T1 adenocarcinoma of the lung.

Prognostic factors in patients with surgically-treated peripheral T1 (< or = 3 cm in greatest diameter) adenocarcinoma of the lung were analyzed in 45 cases. Statistical difference in survival was observed between stages I + II and III + IV (p < 0.05). However, neither sex, age, location of tumor, histological subtype, histological grade, tumor ploidy, nor presence of central fibrosis was of prognostic determinance. Our results suggest that only clinical stage is of prognostic importance in surgically-treated peripheral T1 adenocarcinoma of the lung.