Influence of salivary macromolecules and fluoride on enamel lesion remineralization in vitro.

The aim of this study was to investigate the influence of salivary macromolecules on enamel lesion remineralization in the presence or absence of fluoride. Paraffin-stimulated whole saliva was centrifuged, and the supernatant was dialyzed in 1,000 molecular-weight cutoff dialysis tubes, first against a phosphate buffer and then against a mineral solution containing Ca and phosphate. Artificial subsurface lesions of human enamel, created in pH 4.5 acetate buffer, were remineralized for 28 days in 4 remineralizing solutions: group C--mineral solution as a control; group S--mineral solution + dialyzed saliva; group F--mineral solution + 1 ppm F; group SF--mineral solution + dialyzed saliva + 1 ppm F. Changes in relative mineral concentration in the lesions were assessed by transverse microradiography. The results showed statistically significant mineral gains in the lesion body in groups C (DeltaZ = 3,254 +/- 1,562% x microm) and SF (DeltaZ = 2,973 +/- 1,349% x microm), but not in groups S (DeltaZ = 5,192 +/- 1,863% x microm) and F (DeltaZ = 4,310 +/- 1,138% x microm) compared with the baseline group (DeltaZ = 5,414 +/- 461% x microm). It was also found that the mineral density at the surface layer in group F (75.0 +/- 15.7%) was greater than that in the baseline group (30.1 +/- 12.3%) with statistical significance, but not in group SF (39.9 +/- 16.5%). It was concluded that the macromolecules inhibited lesion remineralization fundamentally but that these molecules, in the presence of fluoride, seemed to play an important role in the continuation of remineralization by reducing mineral gains at the surface layer.

Production of emotional facial expressions in European American, Japanese, and Chinese infants.

European American, Japanese, and Chinese 11-month-olds participated in emotion-inducing laboratory procedures. Facial responses were scored with BabyFACS, an anatomically based coding system. Overall, Chinese infants were less expressive than European American and Japanese infants. On measures of smiling and crying, Chinese infants scored lower than European American infants, whereas Japanese infants were similar to the European American infants or fell between the two other groups. Results suggest that differences in expressivity between European American and Chinese infants are more robust than those between European American and Japanese infants and that Chinese and Japanese infants can differ significantly. Cross-cultural differences were also found for some specific brow, cheek, and midface facial actions (e.g., brows lowered). These are discussed in terms of current controversies about infant affective facial expressions.

Scavenging effects of Mallotus repandus on active oxygen species.

The active oxygen species scavenging potencies of Mallotus repandus (Willd.) Muell.-Arg. extracts were evaluated by the electron spin resonance (ESR) spin-trapping technique. Superoxide radical (O2.-) and hydroxyl radical (OH.) were supplied enzymatically from hypoxanthine-xanthine oxidase (HPX-XOD) reaction and hydrogen peroxide-ferrous sulfate (Fenton reaction), respectively, to the assay system. The ethyl acetate fraction of Mallotus repandus (stem) showed the greatest superoxide radical scavenger activity and the n-hexane fraction of Mallotus repandus (stem as well as root) the greatest hydroxyl radical scavenger activity.

Radical scavenger and antihepatotoxic activity of Ganoderma formosanum, Ganoderma lucidum and Ganoderma neo-japonicum.

The free radical scavenging and antihepatotoxic activity from Ganoderma lucidum, Ganoderma formosanum and Ganoderma neo-japonicum were studied. Treatment with the water extract of Ganoderma lucidum, Ganoderma formosanum and Ganoderma neo-japonicum caused a marked decrease in the CCl4-induced toxicity in rat liver, made evident by their effect on the levels of glutamic oxaloacetic transaminase (GOT) and lactic dehydrogenase (LDH) in the serum. The scavenging potency of the water extracts of the crude drugs was evaluated in terms of their ability to reduce the peaks of spin adducts using electron spin resonance (ESR) spin-trapping techniques. The results indicated that Ganoderma formosanum showed the greatest antihepatotoxic activity and the greatest free radical scavenging activity.

Long-term follow-up of the Indiana pouch: efficacy of the pouch construction using the absorbable gastrointestinal staples.

The Indiana pouch procedure was used on 34 bladder cancer patients. The Heinecke-Mikulicz reconfiguration was carried out, involving the conventional hand-sewn and the absorbable GIA stapled methods with the continence mechanism of a staple-tapered efferent limb. The tunnelled tenial anti-refluxing implantation of ureters was performed. The stapled pouch construction saved approximately 1 h of operating time and reduced by 18% the overall loss of blood. There were 3 complications (wound infection/dehiscence in two, leakage from the enteric anastomosis in one, and acute renal failure in one) within 30 days postoperatively. As a late complication, ureter implantation stricture was experienced in two and pouch stone formation in five. No significant difference in the incidence of stone formation was evident between the hand-sewn and the stapled pouches, nor was any difference of pouch volume and catheterization interval. All patients had acceptable continence. These data demonstrated that the Indiana pouch is a reliable procedure with an acceptable complication rate. The pouch construction using the stapled method, which simplified the procedure, is more convenient than the one using the hand-sewn technique.

Beat-to-beat QT interval variability before and after cardiac surgery.

Non-uniform recovery of excitability may be essential in triggering malignant ventricular tachycardia after cardiac surgery. Thirty-five channels ECG was recorded for 6 min in 27 patients before and after heart surgery and in 20 control subjects. Off-line analysis was performed. RR interval duration, RR SD, QT SD and power spectra of RR variability were computed from 256 s stable RR and QT interval series. When compared to controls, patients had decreased RR SD and increased QT SD before surgery (p<0.002 and p<0.0005, respectively); RR SD further decreased and QT SD increased after the surgery (p<0.0001 and p<0.0002, respectively). Increase of QT variability and decrease of RR variability after cardiac surgery may reflect disrupted electrophysiological stability of the myocardium and thus electrophysiological substrate for triggering malignant arrhythmia.

Evaluation of the antioxidant and hepatoprotective activity of Terminalia catappa.

The free radical scavenging and antihepatotoxic activity from Terminalia catappa was studied. Treatment with T. catappa water extracts showed antihepatotoxic activity against CCl4-induced toxicity in the rat liver that was tested. The crude drug also exhibited anti-oxidant effects in FeCl2-Ascorbic acid induced lipid peroxidation in the rat liver homogenate. Moreover, the superoxide radical scavenger effect of T. catappa was demonstrated using electron spin resonance (ESR) and spintrapping technique. The results indicate that T. catappa possesses good antihepatotoxic activity and superoxide radical scavenger activity.

Studies on Taiwan folk medicine, thang-kau-tin (II): Measurement of active oxygen scavenging activity using an ESR technique.

Using an electron spin resonance (ESR) technique, we measured the superoxide radical (O2) and hydroxyl radical (OH) scavenging activity from Mallotus repandus (Willd.) Muell.-Arg., Bauhinia championii Benth., Uncaria hirsuta Haviland and Uncaria rhynchophylla Miquel. O2- and OH were detected as spin adducts of spin traps 5,5-dimethylpyrroline-N-oxide (DMPO). The scavenging potencies of water extracts of crude drugs were evaluated in terms of their ability to reduce the peaks of spin adducts. The extract of B. championii showed the greatest superoxide radical and hydroxyl radical scavenger activity.

Anti-inflammatory and radical scavenge effects of Arctium lappa.

The effects of Arctium lappa L. (root) on anti-inflammatory and free radical scavenger activity were investigated. Subcutaneous administration of A. lappa crude extract significantly decreased carrageenan-induced rat paw edema. When simultaneously treated with CCl4, it produced pronounced activities against CCl4-induced acute liver damage. The free radical scavenging activity of its crude extract was also examined by means of an electron spin resonance (ESR) spectrometer. The IC50 of A. lappa extract on superoxide and hydroxyl radical scavenger activity was 2.06 mg/ml and 11.8 mg/ml, respectively. These findings suggest that Arctium lappa possess free radical scavenging activity. The inhibitory effects on carrageenan-induced paw edema and CCl4-induced hepatotoxicity could be due to the scavenging effect of A. lappa.

[Studies on serum and urinary alpha 1-microglobulin levels as parameter of the renal function--renal function observed after CDDP administration].

To evaluate the clinical usefulness of alpha 1-microglobulin (alpha 1-MG) as parameter of renal function, we determined the levels of alpha 1-MG in the serum and urine of patients who had no malignant tumors, and compared them with the levels of beta 2-microglobulin (beta 2-MG), serum creatinine, urinary N-acetyl-beta-glucosaminidase (NAG) and 24-hour creatinine clearance (24 Ccr). There were significant positive correlations between alpha 1-MG in the serum and urine, and those of beta 2-MG levels. Serum alpha 1-MG and 24 Ccr were inversely correlated. Combined measurements of alpha 1-MG in the serum and urine seemed to be useful to estimate glomerular and tubular renal functions. The renal function in 8 patients with advanced urogenital cancers treated with cis-diammine-dichloroplatinum (CDDP) was examined by measuring 24 Ccr, alpha 1-MG, and beta 2-MG in serum and urine and urinary NAG. Determination of urinary alpha 1-MG was useful for early detection of tubular damage after CDDP administration.

[Clinical statistics at the urological clinic of Sanjukai Hospital--statistics on new outpatients during the last five years].

We report the clinical statistics of new outpatients for five years since 1989 at our hospital. The average total number of new outpatients in a year was 8309.8 (8122-8691) and new outpatients tended to show little change. The male to female ratio was 1.57:1, and 24.3% of the outpatients were referred to us by others sources. The representative operations on outpatients were circumcision, vasectomy, resection of condyloma and resection of caruncle. A statistical study was made on new outpatients according to the international classification of disease. There were 140.6 (1.97%) malignant urogenital tumors per year. Sexually transmitted diseases showed a tendency to increase for the last five years. In males the major disease was upper urinary tract stone (21-24%), prostatistis (21-24%) and benign prostatic hypertrophy (17-20%) and in females they were cystitis (58-61%), upper urinary tract stone (15-17%) and pyelonephritis (3-4%). We conclude that our hospital plays a major role as a private urological hospital.

[Clinical application of Modulith SL20 on extracorporeal shock wave lithotripsy for upper urinary tract calculi].

Thirty-nine patients, 27 males and 12 females with renal and ureteral stones, were treated using the Modulith SL 20 between October 1990 and January 1991. Thirty-three of the 39 cases had a single session of extracorporeal shockwave lithotripsy (ESWL) and the other six cases had two sessions. The pulverization rate of ESWL by this device was 84.6%. According to the X-rays taken 21 days after ESWL, of the 37 cases, 14 (37.8%) were stone-free, 18 (48.7%) had residual sandy stones less than 4 mm in diameter, five (13.5%) had residual stone fragments larger than 4.1 mm in diameter, and two cases were not clear. Using the criterion of cases which can be expected to have spontaneous passage, in other words, residual stones less than 4 mm in diameter, lithotripsy with the Modulith SL 20 was regarded as "effective" in 32 of the 37 cases (86.5%). As side effects of this treatment, hematuria was observed for several days after ESWL in all patients, but not other serious complications were observed. Among the 37 cases in which the grade could be evaluated the evaluation for 24 (64.9%) was "useful" and that for 13 (35.1%) "useful to some extent". Therefore, ESWL was performed very successfully.

[Endoscopic correction of vesicoureteral reflux by Teflon].

From March 1988, 19 vesicoureteral reflux (VUR) patients were treated by endoscopic injection of Teflon paste. Of these patients 17 cases 27 ureters were followed for more than one year. After injection of Teflon paste, reflux was eliminated in 63%, decreased in 30%, and unchanged in 7%. Then 7 ureters were injected twice and 1 ureter three times. Finally, reflux was eliminated in 93% of all cases, and decreased in 7%. Early complications were fever up in 4 cases, flank pain 3, acute cystitis 1. In the follow up period, acute cystitis occurred in 1 patient, ureter stone in 1, and renal failure in 1. However, the ureter stone and renal failure were probably not caused by this procedure.

[Clinical statistics of the Urological Clinic of Sapporo Sanjukai Hospital. Clinical statistics on patients admitted from 1985 to 1989].

A clinical statistic survey was carried out on the patient admitted, diseases and operations experienced at our urological clinic during 1985-1989. The total number of inpatients was 8,750 (The male to female ratio was 2.8:1). The major diseases of the inpatients were urolithiasis (4,134 cases, 47.2%) and benign prostatic hypertrophy (1,529 cases, 17.5%). Among the operations extracorporeal shock-wave lithotripsy 2,589 cases (44.6%) and transurethral resection of prostate 1,295 cases (22.3%) were predominant.

[Sarcomatoid renal cell carcinoma: 3 case reports].

We report 3 cases of sarcomatoid renal cell carcinoma, which is an uncommon neoplasm consisting of a typical renal cell carcinoma associated intimately with a sarcomatoid component. All patients were symptomatic at hospitalization and underwent nephrectomy. Two patients died of metastatic renal cancer within a year, and another is alive without evidence of metastasis for 12 months after the surgery. Because sarcomatoid renal cell carcinoma has a highly malignant behavior and poor prognosis, an adjuvant treatment effective in controlling the disease is awaited.

[Clinical outcome of percutaneous nephrolithotripsy and recurrence of stones].

A total of 178 renal units in 173 patients with renal and upper ureteral calculi were treated by percutaneous nephrolithotripsy (PNL) between November 1984 and October 1995. PNL was performed as a monotherapy in 70 kidneys, while extracorporeal shock wave lithotripsy (ESWL) was combined in 108 kidneys. At the time discharged 110 (61.8%) kidneys were stone-free and the overall success rate, defined as no residual stone or fragments < 4 mm, was 96.1%. The stone-free rate was significantly lower (44.2%) for staghorn renal calculi. For 105 stone-free kidneys with > 6 months of follow-up, the cumulative stone recurrence rate was 4.2% at 1 year, 16.6% at 3 years, 29.2% at 5 years, 34.4% at 5 years and 55.4% at 10 years. None of the pretreatment parameters, such as stone size, number, location, composition, past history of urolithiasis and upper urinary tract obstruction, had a significant influence on stone recurrence.

[Recurrence of stones after extracorporeal shock wave lithotripsy].

During the 11-year period from September 1984 through August 1995, extracorporeal shock wave lithotripsy (ESWL) was performed on 5,558 patients using a Dornier HM3 apparatus. A recurrence questionnaire was sent out to 2,379 of those who had had complete elimination of the calculi and for whom at least 3 years had passed since the ESWL. The last day of follow-up was defined as follows: the day of completion of the questionnaire in the recurrence-free group (n = 787), the day when recurrence of calculi was diagnosed in the recurrence group (n = 415) and the day of the last visit to the outpatient clinic in the miscellaneous group (n = 1,133). The cumulative recurrence rates were calculated by the Kaplan-Meier equation. The resultant data were analyzed for statistically significant differences by the log rank test and the generalized Wilcoxon test. Ap value of < or = 0.05 was considered to indicate significance. The recurrence rate was examined for differences in relation to the following risk factors: the patients' age and sex, the stone location, size and number, the presence or absence of past history of lithiasis, the composition of the stone (s), and the presence or absence of urinary tract complications. The cumulative recurrence rates for the total cases were 2.0% at one year, 13.1% at 3 years, 23.9% at 5 years, 30.7% at 7 years and 40.7% at 10 years. Significantly higher recurrence rates were found for patients under 60 years of age, those with multiple stones and those with a past history of disease.

[Clinical statistics on outpatients at the urological clinic of Sanjukai Hospital in 1988].

A statistical study was performed on new outpatients. The total number of new outpatients in 1988 was 8,389 (male: 5,284, female: 3,105) and the male to female ratio was 1.70:1. They had urogenital diseases definitely diagnosed (7,486), urogenital diseases indefinitely diagnosed (576), no diseases (260), and diseases other than urogenital (67). Thirty-five percent of the outpatients were referred to us by other sources. The number of operations on new outpatients was 139, circumcision, vasectomy and resection of condyloma were representative. The peak of the age distribution was in the thirties for males and in the fifties for females. A statistical study was made on new outpatients according to the international classification of disease. There were 146 malignant (urogenital) tumors (1.8%). The major diseases of the new outpatients were cystitis (acute or chronic: 20.7%), upper urinary tract stone (18.5%), prostatitis (13.0%), and benign prostatic hypertrophy (11.2%). In males the major diseases were prostatitis, upper urinary tract stone, benign prostatic hypertrophy, balanoposthitis, phimosis and in females they were cystitis, upper urinary tract stone, pyelonephritis, renoptosis, and neurogenic bladder. We conclude that our hospital plays a major role as a private urological hospital.

[Metastatic renal tumor of esophageal carcinoma: report of a case].

In August 1987, a 66-year-old man was hospitalized because of macrohematuria and right flank pain. He had undergone resection of middle and lower part of the esophagus with esophagogastrostomy for esophageal carcinoma on April 16, 1984. Computed tomography revealed a solid, irregular, low density area in the upper pole of the right kidney and the right lobe of the liver. Arteriography showed a hypovascular mass in the upper pole of the right kidney, and several small tumor stains in the liver. At cystoscopic examination, the urinary bladder was normal and blood flowing from bilateral ureters was not seen. Cytological study of urine sediment disclosed squamous cell carcinoma. The patient was treated with systemic chemotherapy, but not improved. He died 6 months later, and the autopsy demonstrated widespread metastasis in various organs including the right kidney and liver. No recurrence was found in the residual esophagus. The kidney is the sixth organ of metastasis following the lung, liver, bone, adrenal, peritoneum and mesenterium. Although metastasis to the kidney is relatively common in autopsy, it is uncommon to be manifest clinically.

[Clinical experience with cefbuperazone in complicated urinary tract infection].

Cefbuperazone (CBPZ) was administered to inpatients with complicated urinary tract infections (UTI) at our department. Clinical efficacy and safety were evaluated in 22 chronic cases by the criteria for evaluation of clinical of antimicrobial agents on urinary tract infection. Overall clinical efficacy was excellent in 8 cases, moderate in 9 cases and poor in 5 cases with an effectiveness rate of 77%. Twenty-four of the 34 strains isolated from the patients were eradicated and eradication rate was 71%. Neither subjective nor objective adverse reactions were observed. Abnormal changes in laboratory tests were found in 9 patients, but were probably not related to CBPZ administration. Judging from these results, CBPZ is considered to be an effective and safe antibacterial for the treatment of complicated UTI.